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Trump’s War on Health Care: Public Health Watch

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April 28, 2025
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April 28, 2025

100 Days Of Trump, 100 Days of Public Health Catastrophe

Welcome to Public Health Watch, a weekly roundup from Protect Our Care tracking catastrophic activity as part of Donald Trump’s sweeping war on health care. From installing anti-vaccine zealot RFK Jr. as Secretary of HHS to empowering Elon Musk to make indiscriminate cuts to our public health infrastructure, including the National Institutes of Health and the Centers for Disease Control, Donald Trump is endangering the lives of millions of Americans. Protect Our Care’s Public Health Watch will shine a spotlight on the worst of the Trump/RFK/Musk war on vaccines, science and public health and serve as a resource for the press, public and advocacy groups to hold them accountable. 

What’s Happening In Public Health?

The First 100 Days: Catastrophic Cuts Are Creating Chaos And Endangering Americans’ Health And Scientific Innovation

Stat: NIH grants plummeted $2.3 billion in Trump’s first months, as federal-academia partnership crumbles The National Institutes of Health has scaled back its awards of new grants by at least $2.3 billion since the beginning of the year, with the biggest shortfalls hitting the study of infectious diseases, heart and lung ailments, and basic research into fundamental biological systems, a new STAT analysis has found. This roughly 28% contraction in funding comes on top of threats to freeze billions of dollars of NIH funding to specific universities as well as abrupt terminations to hundreds of research projects on Covid-19, HIV/AIDS, health disparities, vaccine hesitancy, and other areas targeted by President Trump’s political agenda.

  • Stat: Trump’s first 100 days, seen through 5 lives: Grants terminated. Dreams crushed. Futures in the balance At the National Institutes of Health, that pain has arrived sharply and swiftly. Not even 100 days into Trump’s second term, his administration’s onslaught of actions has slashed the agency’s workforce and choked off funding for biomedical research. By STAT’s own analysis, billions of dollars that would normally be flowing out to universities, academic medical centers, and nonprofit research organizations have either been staunched or clawed back. Harder to wrap one’s mind around is the human toll of all these cuts — the thousands of personal tragedies playing out across the country, far beyond the NIH’s Maryland campus — as labs go dark and careers evaporate and clinical trials for new medicines lag. That trauma looks like a young scientist suddenly worried about paying rent, a researcher halting her study of maternal mortality, a lung disease specialist forced out of his dream job by his own conscience, a cancer patient facing a treatment delay, a university administrator trying to hold it all together.

NOTUS: DOGE Is On a Tear at HHS. Even Insiders Are Struggling to Keep Up. DOGE has cut the Department of Health and Human Services so aggressively that even the department’s secretary has had trouble keeping up. “I’m not familiar with those cuts,” Health Secretary Robert F. Kennedy Jr. said last week in a CBS interview when pressed about the billions of dollars promised to state health agencies that were rescinded by his agency and touted by DOGE as “savings.” Kennedy also demurred on a question about how, exactly, DOGE decides which programs are worthy of being cut. “They have a very, very sophisticated group of people, and they have very sophisticated systems for detecting fraud, waste and abuse,” Kennedy said. DOGE’s sweeping actions and the health secretary’s professed lack of knowledge about cuts within his own agency showcase just how unilaterally the administration’s largely faceless cost-cutting initiative has been able to act — giving cover to leaders like Kennedy who are able to plead ignorance when pressed about specifics.

New York Times: Trump Budget to Take Ax to ‘Radical’ Safety Net Programs The Trump administration, which has made clear that it aims to slash government spending, is preparing to unveil a budget proposal as soon as next week that includes draconian cuts that would entirely eliminate some federal programs and fray the nation’s social safety net. The proposed budget for the 2026 fiscal year would cut billions of dollars from programs that support child care, health research, education, housing assistance, community development and the elderly, according to preliminary documents reviewed by The New York Times. The proposal, which is being finalized by the White House’s Office of Management and Budget, also targets longstanding initiatives that have been prized by Democrats and that Republicans view as “woke” or wasteful spending. The early blueprint reflects Mr. Trump’s long-held belief that some federal antipoverty programs are unnecessary or rife with waste, fraud and abuse. And it echoes many of the ideas espoused by his budget director, Russell T. Vought, a key architect of Project 2025 who subscribes to the view that the president has expansive powers to ignore Congress and cancel spending viewed as “woke and weaponized.” He previously endorsed some of the cuts to housing, education and other programs that Mr. Trump is expected to unveil in the coming days.

  • Politico: DOGE slashes disability and aging services The Trump administration has drawn a bright line around Medicare and Social Security, promising Americans that the two programs will remain untouched. But a budget proposal obtained by POLITICO shows a different kind of rollback underway — one that could impact the lives of millions of older Americans and people with disabilities. The Trump administration is poised to eliminate dozens of federal programs, including protective services for vulnerable seniors, chronic disease self-management education, resource centers for people who have been paralyzed or lost a limb and one that tries to help older people prevent falls. Even a more modest federal initiative aimed at making polling places more accessible would be eliminated under the proposal. All of these programs facing the knife fall under the Administration for Community Living, a component of the Department of Health and Human Services that aims to help older adults and people with disabilities remain in their homes and communities. The whole department is being zeroed out, according to the budget proposal.

NBC: Medical journals complain of ‘harassment’ from Justice Department At least three medical journals have received letters from the U.S. Department of Justice that questioned their editorial practices and standards, prompting several journals to push back and assert their independence.   British medical journal The Lancet, which did not receive one of the letters, published an editorial describing the inquiries as “harassment” and intimidation, adding that U.S. science was being “violently dismembered” by the Trump administration. Last week, the interim U.S. attorney for the District of Columbia, Ed Martin, sent a letter to the CHEST Journal, a scientific journal for chest doctors, implying it was partisan and asking a series of questions about the steps it took to include competing viewpoints and protect the public from misinformation.  The letter drew ire from a First Amendment group and some scientists, who raised concerns that inquiries from law enforcement could chill academic freedom and speech. The letter prompted the journal to post a statement saying its publisher, the American College of Chest Physicians, “supports the journal’s editorial independence.”  This week, the New England Journal of Medicine told NBC News it had received a similar letter from the interim U.S. attorney.

Health Impacts:

Local Impacts: 

Chaotic Firings and Re-Hirings:

Cruel and Destructive Policy Changes:

The FDA Is Being Dismantled – Stalling Drug Development And Leaving Us Vulnerable To Food-Borne Illness

CBS: FDA head falsely claims no scientists laid off, as agency shutters food safety labs  The head of the Food and Drug Administration has repeatedly claimed in recent interviews that no scientists have been laid off at his agency, but one of the scientists in a food safety lab shuttered by the FDA’s cuts says he is either “blatantly lying” or “out of touch.” “There were no layoffs to scientists or food inspectors,” FDA Commissioner Dr. Marty Makary told CNN on Wednesday. Makary previously said in an April 17 interview with Megyn Kelly that there “were not cuts to scientists, or reviewers, or inspectors. Absolutely none.” “That just made me so mad, that he said no scientists were cut,” said one laid-off FDA scientist, a chemist who had worked for the agency for years. Nearly all of the scientists at food safety laboratories run by the FDA in the San Francisco and Chicago areas received layoff notices this month, four laid-off chemists and microbiologists said. The scientists, who were not authorized to speak publicly, spoke on the condition of anonymity.  The San Francisco lab, opened during the first Trump administration, had been ramping up testing of infant formula. Its closure has now reduced the agency’s baby formula testing capacity by a quarter, at a time when Health and Human Services Secretary Robert F. Kennedy Jr. has called for stepped up testing, laid-off scientists said.

Reuters: US FDA suspends milk quality tests amid workforce cuts The Food and Drug Administration is suspending a quality control program for testing of fluid milk and other dairy products due to reduced capacity in its food safety and nutrition division, according to an internal email seen by Reuters. The suspension is another disruption to the nation’s food safety programs after the termination and departure of 20,000 employees of the Department of Health and Human Services, which includes the FDA, as part of President Donald Trump’s effort to shrink the federal workforce.

Axios: Key FDA drug data goes missing amid DOGE cuts Food and Drug Administration databases that physicians and public health experts rely on for key drug safety and manufacturing information have been neglected due to DOGE-directed layoffs, leaving health professionals flying blind on basic questions about certain drugs they’re prescribing, current and former FDA officials tell Axios. Why it matters: Information gaps that have become a hallmark of the workforce reductions and the sweeping reorganization of federal health agencies under Health Secretary Robert F. Kennedy Jr. are putting patient safety at risk, according to agency employees. “It’s really a nightmare,” said a current FDA official who requested anonymity because they were not authorized to speak to the press. “Things that used to function are no longer functioning.”

Stat: With the FDA in turmoil, the ‘revolving door’ with industry is spinning faster Health and Human Services Secretary Robert F. Kennedy Jr. has railed against what he sees as a “revolving door” between workers at drug companies and the Food and Drug Administration. But his department’s actions now seem to be causing that door to spin ever faster.  Scores of FDA employees are searching for an exit from an agency in turmoil, particularly staff members tasked with reviewing drug applications, according to interviews with former employees and industry recruiters. Many of those joining the exodus were protected from the layoffs that hit the agency earlier this month, but their work environment has become morose, and cuts to other departments are making it more difficult to do their jobs. As many as 600 drug reviewers have recused themselves from approval processes because they’re interviewing with pharma companies, former FDA commissioner Scott Gottlieb estimated during an appearance on CNBC’s “Squawk Box” earlier this week. These staff members oversee applications for new medicines and are partially funded through user fees that the FDA collects from drug companies.  “There’s an expectation that there’s going to be a lot of voluntary departures from the agency over the summer,” Gottlieb said.

Additional FDA News: 

RFK Jr. Is An Extreme MAGA Anti-Vaxxer Who’s Breaking His “Assurances” To Key Republicans To Get Confirmed And Mis-Managing HHS

Politico: RFK Jr. isn’t staying in his lane. Trump is thrilled. Robert F. Kennedy Jr. is fast becoming the most prominent face of the Trump administration’s domestic agenda, taking on a portfolio well beyond the role of a traditional Health secretary. And the White House is thrilled. Senior aides believe Kennedy’s “Make America Healthy Again” loyalists helped deliver the popular vote for President Donald Trump last November — and that keeping them in the GOP tent will be crucial to ensuring the party holds onto power come the midterms, according to four Trump aides and advisers granted anonymity to discuss internal thinking. That’s why they’re more than happy to let the presidential candidate-turned-top health official exert influence over an expanding array of key policy priorities across the government, even if it ruffles a few feathers among officials in other agencies who feel Kennedy is encroaching on their turf.

Washington Post: Americans unsure what to believe about the measles vaccine, poll shows Most Americans have encountered false claims about the measles vaccine, and many aren’t sure what the truth is, according to a KFF poll released Wednesday. Misconceptions about measles, a highly contagious virus, and its vaccine abound as cases continue rising across the United States, according to the poll. Prominent false claims suggest that there is a link between autism and the measles, mumps and rubella (MMR) vaccine; that the vaccine is more dangerous than measles itself; and that vitamin A can prevent measles infections. More than half of surveyed adults expressed uncertainty about whether to believe the false statements, which Health Secretary Robert F. Kennedy Jr. has amplified. The proliferation of measles misinformation may have far-reaching implications, said Liz Hamel, director of public opinion and survey research at KFF, a health policy research organization. “When we look at parents, those who believe or lean toward believing one of those false claims, they’re more likely to delay or skip vaccines for their children, compared to other parents,” she said. “There’s a relationship between belief or openness to believing misinformation about measles, and decisions to vaccinate your own children.”

New York Times: Kennedy Declares ‘Sugar Is Poison’ While Announcing Ban on Food Dyes Health Secretary Robert F. Kennedy Jr. escalated his war against the food industry on Tuesday, declaring that “sugar is poison.” Mr. Kennedy’s comment came during a highly publicized news conference where he also asserted that he has “an understanding” with major food manufacturers to remove petroleum-based food colorings from their products by 2026. No one from the food industry attended the event, and none have publicly agreed to Mr. Kennedy’s demands, although the International Dairy Foods Association has pledged to eliminate artificial colors in milk, cheese and yogurt sold to schools as part of the federal lunch and breakfast programs by the start of the 2026 school year. However, Mr. Kennedy and his advisers said that every major food manufacturer and some fast-food companies have contacted the agency looking for guidance. “Four years from now, we are going to have most of these products off the market, or you will know about them when you go to the grocery store,” Mr. Kennedy said.

  • Bloomberg: Food Industry Says There’s No Agreement With US Health Agency to Cut Dyes The US Department of Health and Human Services said Tuesday it plans to work with food companies to phase out use of many artificial food colorings by 2026, but industry lobbyists say there’s no agreement in place to remove the dyes, according to people familiar with the matter. In its announcement, HHS said it planned to eliminate artificial food dyes by working with companies that rely heavily on them. HHS Secretary Robert F. Kennedy Jr. said his agency and the Food and Drug Administration had an “understanding” with the industry about their removal on a voluntary basis. Yet multiple people familiar with the matter, who were not authorized to speak publicly, said there was no agreement.

Wall Street Journal: FDA Asks Vaccine Maker to Complete New Clinical Trial for Delayed Covid-19 Shot Federal regulators are asking Novavax NVAX 2.47%increase; green up pointing triangle to complete an additional randomized clinical trial on its Covid-19 vaccine after previously delaying approval, people familiar with the matter said, a request that could be so prohibitively expensive the company might not be able to fulfill it.  The Maryland-based company was asked by the Food and Drug Administration to show its vaccine is effective with another randomized study after appointees under Health Secretary Robert F. Kennedy Jr. intervened in the approval process, the people said. The additional step goes beyond what other Covid-19 vaccine makers had to do to win approval, and could be an early sign of new challenges for drugmakers hoping to get approvals. The company’s shot already showed 90% efficacy in a 30,000-person, placebo-controlled trial, and it is already available in the U.S. under an emergency use authorization and has won full approval in Australia, Europe and Japan. A new randomized trial with enough participants to judge the vaccine’s ability to prevent disease could cost tens of millions of dollars, vaccine experts said.

  • Stat: U.S. health officials inject new uncertainty into approval process for Covid boosters Confusion over the Food and Drug Administration’s delay in granting full approval to Novavax’s Covid-19 vaccine deepened over the weekend when the agency’s commissioner, Marty Makary, took to social media to defend the FDA’s controversial handling of the company’s submission. In the process, Makary and a spokesman for the Department of Health and Human Services appeared to raise the specter that, going forward, manufacturers of Covid vaccines might have to generate new effectiveness data before the release of annual updates of their vaccines — a hurdle they would be unlikely to clear to vaccinate people in time to protect them when Covid transmission is occurring.

Other MAHA Activities:

RFK’s Autism Plans Draw Widespread Condemnation And Calls For His Resignation

CBS: RFK Jr.’s autism study to amass medical records of many Americans  The National Institutes of Health is amassing private medical records from a number of federal and commercial databases to give to Health and Human Services Secretary Robert F. Kennedy Jr.’s new effort to study autism, the NIH’s top official said Monday. The new data will allow external researchers picked for Kennedy’s autism studies to study “comprehensive” patient data with “broad coverage” of the U.S. population for the first time, NIH Director Dr. Jay Bhattacharya said. “The idea of the platform is that the existing data resources are often fragmented and difficult to obtain. The NIH itself will often pay multiple times for the same data resource. Even data resources that are within the federal government are difficult to obtain,” he said in a presentation to the agency’s advisers.  Medication records from pharmacy chains, lab testing and genomics data from patients treated by the Department of Veterans Affairs and Indian Health Service, claims from private insurers and data from smartwatches and fitness trackers will all be linked together, he said.  The NIH is also now in talks with the Centers for Medicare and Medicaid Services to broaden agreements governing access to their data, Bhattacharya said.

  • Stat: No new autism registry, HHS says, walking back NIH director’s claim The federal health department is not creating a new registry of Americans with autism, a Department of Health and Human Services official said in a written statement Thursday. Instead, the official said, HHS will launch a $50 million research effort to understand the causes of autism spectrum disorder and improve treatments. The announcement arrives two days after National Institutes of Health Director Jay Bhattacharya announced the intent to create such a registry at an all staff meeting, kicking off a firestorm of panic and confusion among autism self-advocates and the broader research community. Much of the fear centered around Bhattacharya’s remarks that the government would pull health data from private sources, such as electronic health records maintained by health care providers, pharmacy data, insurance claims and even wearables like smart watches and fitness trackers. While the NIH has dozens of existing registries for diseases and routinely awards grants to study conditions such as autism, the NIH director’s words chilled the community, leaving many people worried, including some who expressed their fears on social media.

NOTUS: Health Leaders Throw Cold Water on Robert F. Kennedy Jr.’s Sweeping Goals and Fast Timelines The Trump administration’s health leaders came before reporters this week in an attempt to show how united they are in advancing Health Secretary Robert F. Kennedy Jr.’s “Make America Healthy Again” agenda. Instead, they revealed divisions over whether or not that agenda is realistic. The most stark example came over an issue Kennedy has publicly prioritized: autism. National Institutes of Health director Jayanta Bhattacharya contradicted Kennedy’s timeline for determining the causes of autism when speaking to reporters after Tuesday’s event at HHS headquarters. Bhattacharya, who was previously a professor of medicine and health policy at Stanford, said that he would like researchers to “start to put out the preliminary results” within a year. He said such a timeline would constitute a “very rapid study by NIH normal standards.” Kennedy said at a cabinet meeting this month that HHS would uncover the cause of autism much earlier. “By September, we will know what has caused the autism epidemic, and we’ll be able to eliminate those exposures,” he said during the televised meeting. But Bhattacharya said on Tuesday that “it’s hard to guarantee when science will make an advance.” “Nature has its say,” he added.

More fallout from RFK Jr.’s autism plans:

Disastrous, Dangerous Appointments

CBS: Trump’s surgeon general nominee, Dr. Janette Nesheiwat, faces scrutiny over credentials President Trump’s nominee to be the U.S. surgeon general, the Fox News contributor and family medicine physician Dr. Janette Nesheiwat, has described herself as a double board-certified physician with a degree from the University of Arkansas School of Medicine — credentials the president touted in his announcement. But those claims about her certification and schooling appear to be misleading.  Nesheiwat actually earned her medical degree from the American University of the Caribbean (AUC) School of Medicine, located in St. Maarten, in the Caribbean, according to records reviewed by CBS News. A spokesperson for the University of Arkansas confirmed to CBS News she completed her residency through its family medicine program in Fayetteville, Arkansas, but did not obtain her medical degree there.  Nesheiwat has not yet come before the U.S. Senate’s health committee for a confirmation hearing, where she is expected to face questions about her credentials.

Public Health Threats

Washington Post: Millions of U.S. measles cases forecast over 25 years if shots decline The United States faces millions of measles cases over the next 25 years if vaccination rates for the disease drop 10 percent, according to new research published Thursday. No change in the current vaccination rate would result in hundreds of thousands of measles cases over the same period, according to a mathematical model produced by a team of Stanford University researchers. “Our country is on a tipping point for measles to once again become a common household disease,” said Nathan Lo, a Stanford physician and author of the study published in the medical journal JAMA.

New York Times: Measles Surge in Southwest Is Now the Largest Single Outbreak Since 2000 The spread of measles in the Southwest now constitutes the largest single outbreak since the United States declared the disease eliminated in 2000, federal scientists told state officials in a meeting on Monday. The New York Times obtained a recording of the meeting. Until now, the Centers for Disease Control and Prevention had not publicly described the outbreak in such stark terms. More measles cases were reported mostly in Orthodox Jewish communities in New York City and New York State in 2019. But health officials regard those as separate outbreaks, because they were fueled by multiple introductions of the virus by international travelers. C.D.C. officials now view the spread of measles in Texas, Oklahoma and New Mexico as a single outbreak, Dr. Dan Filardo, who leads the agency’s task force for the measles response, told state health officials at the meeting. “This is the largest outbreak in the U.S. since measles elimination was declared in 2000,” he said. The agency was sending seven additional officials to Texas, epicenter of the escalating crisis, he added.

Bloomberg: Whooping Cough on Track for Worst US Outbreak in 70 Years Whooping cough cases have surged in the US since the beginning of the year, infecting Americans at a faster pace than any time since the mid-1950s as national vaccination rates decline and protection wanes. The bacterial infection also known as pertussis has sickened 8,077 people in the US through April 16, according to data from the US Centers for Disease Control and Prevention. That’s more than double the same period a year ago, when the agency confirmed 3,847 cases, and rivals the 2012 outbreak that was the biggest in half a century. At least four people have died from whooping cough this year, including two infants in Louisiana, an adult in Idaho and a child in South Dakota who was infected with both influenza and pertussis. The rise in cases comes as the US battles a measles outbreak, with 800 confirmed cases in 24 states as of April 18. Doctors point to a decline in vaccination rates nationally for the pickup in infections. Fewer than 93% of kindergartners received routine vaccinations for the 2023-2024 school year, including the diphtheria, tetanus, and acellular pertussis shot that protects against whooping cough.

New York Times: They Caught the Flu, and Never Came Home Lauren Caggiano had felt sick for days by the time she tested positive for the flu in an emergency room on a February afternoon. Hours later, she was in the intensive care unit. By 4 in the morning, she was on a ventilator. Ms. Caggiano, a paralegal who lived in Oceanside, Calif., doted on her two dogs and had recently become a grandmother, died two days later. She was 49. “You don’t really think, if you’re in decent health, that’s going to be what gets you,” her son, Brandon Salgado, said. Many people recover from a bout of flu within a few days or a week. But every year, the virus still kills more than 36,000 people across the United States and sends hundreds of thousands to the hospital. The Centers for Disease Control and Prevention has said that this flu season has been especially severe. Some of those who died were at greater risk for getting seriously ill because of underlying conditions or their age. Others, like Ms. Caggiano, were otherwise healthy before their infections. Some had not received the flu shot, which reduces but does not eliminate the risk of death. Some were hospitalized for weeks; others felt ill for only days before they died. All of their deaths came as a shock to the people who knew them.

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