For a long time, I wondered why more credible experts weren’t pushing back against health misinformation online.

Now I understand.

Because, of course, credible people have plenty to say. The hard part is saying it well, saying it often, withstanding the backlash, and somehow making the work financially sustainable without becoming part of the very ecosystem you are trying to critique.

Whether scientists, physicians, academics, and public health experts like it or not, social media is now one of the main places people go to learn about health. It shapes what people believe and who people trust. But the incentives of social media are often fundamentally misaligned with the values of good science and health communication.

Good science communication requires humility, nuance, and honesty. It requires being clear about what the evidence can and cannot say, and resisting the urge to make a claim sound more dramatic or more certain than it actually is.

Social media rewards the opposite.

The content that performs best online often makes people feel something quickly. It gives them a villain, a simple explanation, or a hidden truth. And unfortunately, the people most willing to make sweeping claims with total certainty are often the people least constrained by the evidence.

And when you are trying to communicate accurate information in that environment, growth makes the stakes feel bigger.

The larger my platform became, especially once my videos started reaching hundreds of thousands and then millions of people, the more responsibility I felt to ensure everything I said was accurate and carefully explained. I often fact-check myself several times before putting out a post. I’ve re-recorded entire videos because I felt one sentence could be interpreted in a slightly misleading way. Meanwhile, the internet rewards speed, constant output, and immediate reactions.

And then there is the issue of sustainability.

Creating high-quality science communication takes an enormous amount of time and effort. But many of the most common ways people monetize large online audiences do not fit neatly with trustworthy science communication. If your platform is built around maintaining scientific credibility and correcting harmful misinformation, the usual monetization playbook can quickly start to undermine the very trust you are trying to build.

And yet, if this work is going to exist at scale, it also has to be financially sustainable.

Because doing this work well asks a lot of people. It asks them to take on public scrutiny, professional risk, emotional stamina, and financial uncertainty, all while competing in an ecosystem where the people playing by fewer rules often grow bigger and scale faster.

But when evidence-based voices are missing from these spaces, as we’ve seen over the last decade, they get filled by people more willing to optimize for attention and use fear or pseudoscience to grow their businesses.

Over the last couple of years, I’ve had to figure out how to navigate all of this in real time while my own platform grew faster than I ever expected. How to communicate accurately in an ecosystem that rewards the opposite. How to become a public-facing science communicator without losing the trust and respect of the professional community I came from. And how to make this work financially sustainable without sacrificing the credibility the work depends on.

So in this post, I want to take you inside and show you what that has actually looked like: how a small side project about pregnancy nutrition became something much larger, what changed when my content moved into the center of the MAHA conversation, how the growth impacted me personally, and what it has taken to make this work financially sustainable without undermining the trust that makes it valuable.

I thought the hard part would be getting people to listen. I was wrong.

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This week, it was reported that HHS will lay off another round of employees as the Trump administration continues its dramatic downsizing of the federal health workforce.

The new notices come amid a historic downsizing of HHS that has eliminated roughly 20,000 positions and shrunk the department by about 25% since the start of Trump’s term. Roughly 10,000 employees were laid off in 2025, while another 10,000 accepted deferred resignation offers or early retirement packages as entire offices and programs across agencies like the CDC, NIH, FDA, and SAMHSA were eliminated or consolidated.

At the same time, we found out that the Trump administration is also moving to reclassify hundreds of senior federal positions in ways that would weaken longstanding civil service protections and make many career employees significantly easier to fire. This would ultimately give the administration far greater control over parts of the federal workforce that have historically operated with more insulation from direct political pressure.

Together, these actions reflect the broader vision outlined in Project 2025 and repeatedly discussed before the election to shrink the federal workforce, weaken the independence of federal agencies, and consolidate more power under the executive branch.

At the center of that vision is an ideology that increasingly views large parts of the federal bureaucracy, including public health and scientific agencies, as obstacles to presidential power rather than independent institutions designed to provide continuity, expertise, and insulation from political pressure across administrations.

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The Ideology Behind the Restructuring

One of the clearest architects of this vision is Russ Vought, now director of the Office of Management and Budget under Trump and one of the central figures behind Project 2025, the Heritage Foundation’s blueprint for a second Trump administration.

Vought has spent years arguing that large parts of the federal bureaucracy should be brought under far greater presidential control. Before the election, he openly discussed wanting federal employees to be “traumatically affected.”

“When they wake up in the morning, we want them to not want to go to work because they are increasingly viewed as the villains,” he said. “We want to put them in trauma.”

These are extraordinary statements to make about the career civil servants who keep the federal government functioning, including scientists, physicians, researchers, regulators, and public health officials working inside agencies like the CDC, FDA, and NIH. The comments also feel especially revealing given the often haphazard and damaging way the administration has approached downsizing the federal workforce as it works to implement many of the goals laid out in Project 2025.

Project 2025 became a major political issue during the campaign because it outlined a sweeping and highly ideological restructuring of the federal government, agency by agency, to expand presidential power and reshape the executive branch around a much more explicitly conservative agenda. As scrutiny of the plan grew, Trump repeatedly attempted to distance himself from it publicly, saying, “I know nothing about Project 2025.”

But since taking office, the administration has appeared to use it as a governing framework. Organizations tracking implementation of the agenda have found that the administration initiated or completed 53% of Project 2025’s domestic administrative policy agenda in just its first year.

At the center of this project is the belief that federal agencies should operate with far less independence from the executive branch and be made more directly responsive to the president. Within this framework, independent agencies staffed by longtime career experts are viewed as barriers to presidents fully controlling the executive branch and implementing their political agenda. In practice, that means weakening civil service protections, expanding political control over federal agencies, and making career government employees increasingly vulnerable to ideological pressure and removal.

And that matters because once scientific and public health agencies become more politically controlled, decisions that were historically shaped more heavily by scientific expertise and long-term institutional knowledge become increasingly vulnerable to political ideology and partisan priorities.

How MAHA Fits Into All of This

This is why the MAHA movement was so useful to this administration.

Project 2025 outlined a vision for dramatically downsizing the federal workforce, weakening independent federal agencies, and consolidating more power under the executive branch. But in order to do that politically, the administration needed to deepen the post-COVID distrust many Americans already felt toward public health institutions while also convincing even more people that those institutions were corrupt, untrustworthy, or working against them.

Enter MAHA.

The MAHA movement is a political movement that combines wellness culture, health-focused social media influencing, anti-establishment politics, and public distrust in major institutions into a unified political identity centered on health. One of the central figures who helped spearhead the movement was Calley Means, a former Heritage Foundation intern who helped align RFK Jr. with Trump in the summer of 2024 when they appeared together saying that they were going to “Make America Healthy Again.”

Relying heavily on the modern wellness influencer playbook, the MAHA movement grew rapidly online using fear-based rhetoric and framing public health agencies, regulators, scientists, physicians, and medical institutions as corrupt or captured by corporate interests.

The core message became simple and emotionally powerful: Americans are sick because public health institutions, government agencies, pharmaceutical companies, and the medical establishment have failed them, lied to them, or intentionally poisoned them.

And once people begin believing that institutions like the CDC, FDA, NIH, and broader public health establishment are fundamentally corrupt or working against the public, it becomes much easier politically to weaken those institutions, remove career experts, consolidate political control over agencies, or dismantle parts of the federal health infrastructure altogether.

That’s what made the alliance so powerful and so important for the Trump administration.

The MAHA movement did not just help bring additional voters and energy into Trump’s coalition. It also helped amplify anti-institutional distrust to audiences the traditional Republican political ecosystem could not have reached nearly as effectively on its own.

Instead of talking primarily about deregulation, executive power, or shrinking the federal bureaucracy, the message became something far more simple and emotionally resonant: your children are sick because corrupt public health institutions allowed it to happen. Your food is poisoned because federal agencies are captured. You cannot trust the CDC, FDA, NIH, or medical establishment because they are working for corporations rather than the public.

Then after the Trump administration took power, Russ Vought became director of the Office of Management and Budget and immediately began working to enact his ideological agenda and “traumatize” federal workers.

This is ultimately why, despite all of the rhetoric about “making America healthy again,” this administration continues enacting policy after policy that actively undermines the things actually required to improve health in this country. Because despite what many everyday people within the movement genuinely believed or hoped for, the MAHA movement was never about improving health. It was always a political tool for the Republican Party to carry out their agenda centered on advancing corporate and ideological interests, consolidating more political control over the executive branch, shrinking the federal workforce, weakening independent federal agencies, and dismantling parts of the country’s public health infrastructure.

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Happy Saturday everyone.

A few things before we get into the main stories of the week.

I joined Neil deGrasse Tyson on StarTalk to talk about nutrition myths, science, and how difficult it’s become to navigate health information online. Check it out here.

I was also on a podcast this week called Hack Your Happiness hosted by two teenage sisters, Mercedes and Anastasia Korngut. It was such a delightful conversations. They asked incredibly thoughtful, insightful questions, and I was genuinely so impressed by them. You can watch that episode here.

This week I posted videos about:
• SNAP and food prices
• The administration’s refusal to meaningfully address Black maternal mortality
• Why fructose is not a “poison,” despite what guys on TikTok say

And as always, thank you to everyone who supports this work here on Substack. Paid subscriptions help make all of this reporting, research, and content possible.

Alright, let’s get into it.

FDA Approves Fruit-Flavored Vapes

The FDA approved the sale and marketing of fruit-flavored e-cigarettes this month, marking the first time the agency has authorized vape products beyond tobacco and menthol for adults.

This is a major shift for the agency, which spent years restricting flavored vaping products over concerns they appeal to children. The FDA had previously rejected more than 1 million flavored vape applications, and the Supreme Court upheld the agency’s authority to do so after repeated legal challenges from nicotine companies.

Reports indicate there was internal disagreement over the decision, including from FDA Commissioner Marty Makary, who reportedly opposed authorizing the products. But Makary ultimately signed off on the approval before later resigning from the role.

This is part of a larger pattern with this administration. The largest corporate donation supporting Trump’s 2024 presidential bid was $10 million from a tobacco company to a Trump-aligned super PAC. And since returning to office, his administration has repeatedly moved in ways that benefit the tobacco industry. They eliminated the CDC’s Office on Smoking and Health, reversed the proposed ban on menthol cigarettes, shut down youth tobacco data collection, ended major public education campaigns like “Tips From Former Smokers,” and recently appointed a former tobacco industry executive to deputy director of legislative affairs at the CDC.

The fruit-flavored vape approval is unfortunately directly in line with that pattern, despite the well-established public health concerns around flavored nicotine products and youth uptake. And it is yet another example of an administration branding itself around “health” while repeatedly advancing policies that actively undermine it.

HHS Launches Maternal Health Website

HHS launched moms.gov this week to coincide with Women’s Health Week. The site is described as a centralized hub for information on IVF, perinatal care, nutrition, baby formula, and prescription drug discounts. But some of the biggest maternal health issues in this country are either barely mentioned or completely absent.

There is no meaningful discussion of Black maternal mortality, despite Black women being far more likely to die from pregnancy-related complications in the United States (see my video on this here). There is very little on maternal mental health. And the site doesn’t even mention WIC, the federal nutrition program that supports millions of pregnant women, infants, and children — all while this same administration is proposing major cuts to it.

Instead, the site includes links to anti-abortion crisis pregnancy centers, promotes pseudoscientific claims about Tylenol use during pregnancy, heavily emphasizes fertility-awareness based family planning methods, and includes branding for TrumpRx.

Despite the concerning information the website contains and omits, the broader issue is that improving maternal health requires far more than consolidating information onto a government website. It requires meaningful policy support for women and families, including protecting programs like WIC, expanding access to healthcare and mental healthcare, addressing the maternal mortality crisis, and being willing to openly discuss the large disparities that exist within it. Unfortunately, many of the administration’s current policies move in the opposite direction.

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Growing Leadership Vacancies at HHS

A growing number of senior leadership positions across HHS and the country’s top public health agencies remain unfilled, leaving major parts of the federal health system without permanent scientific leadership.

FDA Commissioner Marty Makary resigned this week, leaving the FDA without a permanent commissioner. HHS spokesperson Rich Danker also resigned, citing concerns about the administration’s decision to allow new fruit-flavored vaping products that could increase appeal to children.

The Surgeon General position also remains unfilled after Casey Means’ nomination was withdrawn. The NIH director is simultaneously serving as acting CDC director. The FDA still does not have a permanent vaccine chief after repeated leadership turnover in that role. And earlier this week, the head of the FDA’s Center for Drug Evaluation and Research, Tracy Beth Høeg, was fired after declining to resign.

At the CDC, nearly 80% of top leadership positions remain unfilled, leaving many of the agency’s major divisions without permanent leadership. FDA, NIH, and SAMHSA are all operating with substantial leadership gaps as well. This level of leadership absence across HHS is unusual and concerning, particularly at agencies responsible for overseeing drug approvals, vaccines, disease surveillance, outbreak response, scientific research, food safety, and public health guidance.

Leadership vacancies at this scale disrupt work and decision-making around drug approvals, disease surveillance, public health guidance, and emergency response. They also create significant gaps in institutional knowledge, continuity, and accountability, increasingly centralizing decisions around political leadership rather than longstanding scientific expertise and agency infrastructure.

Environmental Deregulation Continues

The Trump administration moved forward this week with several major deregulatory proposals affecting drinking water, air pollution, and public lands.

The EPA announced plans to weaken parts of the Biden administration’s first-ever federal PFAS drinking water standards by rescinding limits on three PFAS chemicals and extending compliance deadlines for others. Legal experts noted the move could face challenges under the Safe Drinking Water Act, which limits the EPA’s ability to weaken existing drinking water protections.

The agency also accelerated the permitting process for large power plants and data centers seeking clean air permits. These permits are designed to limit pollution and protect nearby communities, and the review process exists in part to ensure environmental oversight before projects move forward.

Later in the week, the EPA proposed eliminating a Biden-era rule that limited the release of toxic metals from coal-burning power plants into nearby waterways. The rule had only been finalized last year and gave facilities five years to comply. On the same day, the administration also announced a two-year delay of pollution standards for cars and trucks, which it says will save the auto industry more than $1 billion.

Separately, the administration reversed a rule that allowed public lands to be leased for conservation and restoration projects, making more land available for drilling, mining, and logging instead.

This is a significant amount of environmental rollback in a single week. And it reflects a broader pattern we have continued to see from this administration of weakening pollution protections, shrinking environmental oversight, speeding up industrial and energy development, and rolling back regulations that often took years of scientific review and legal process to put in place.

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CMS Withholds Medicaid Funds

Vice President Vance announced this week that the administration is pausing $1.3 billion in Medicaid payments to California as part of what it describes as an anti-fraud initiative, while also warning that additional freezes could follow in other states. At the same time, CMS Administrator Dr. Oz announced a six-month moratorium on approving new hospice and home health agency enrollments nationwide.

The administration says these actions are necessary to address fraud and abuse in federal health programs. And to be clear, real fraud in Medicaid is worth taking seriously. But most large-scale Medicaid fraud is committed by providers and organizations improperly billing the system, not by low-income patients seeking healthcare.

That distinction really matters because broad funding freezes and enrollment restrictions do not just affect bad actors. They can also disrupt access to care for elderly, disabled, and low-income Americans who rely on Medicaid-funded services every day. And since this fraud task force was established earlier this year, many of its highest-profile actions have disproportionately targeted Democratic-led states, making the effort look less like a neutral anti-fraud initiative and more like a mechanism for political punishment and leverage.

Freezing Medicaid payments to a single state and halting provider enrollments can have real downstream consequences for access to care, particularly for low-income, elderly, and disabled patients who rely on these services every day. In practice, abrupt funding disruptions and restrictions like this tend to affect patients and legitimate providers first.

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The MAHA movement and the Trump administration have spent the past couple of years convincing Americans that food additives and “chemicals” in the food supply are among the biggest drivers of chronic disease in this country.

That framing is wildly disproportionate to the actual role food additives likely play in population health. But that also does not mean food additives should be ignored or that they should not continue to be monitored and assessed for safety. Which is why the FDA’s newly released framework for post-market review of food chemicals is so notable. Despite the often fear-based and scientifically inconsistent rhetoric surrounding food additives over the past year, the framework FDA released this week is actually grounded in mainstream regulatory science.

Background on FDA’s Oversight of Food Chemicals

One of the longstanding problems with FDA oversight of food chemicals is that the agency has historically lacked both the resources and, in some cases, the clear authority to continuously, comprehensively, and systematically reassess chemicals already on the market. The FDA oversees a range of substances that can end up in the food supply, including food additives, color additives, food contact substances, contaminants, and ingredients classified as “Generally Recognized as Safe” (GRAS). Some are intentionally added to foods, while others enter food through packaging, food processing (such as acrylamide formed during high-heat cooking), environmental contamination, or naturally occur within foods themselves.

In FDA’s latest plan, the agency appropriately states that the “goal of this process is to ensure that all substances in food are safe for people to consume. Everything in food is made up of chemicals – whether natural or synthetic.” Given the enormous number of substances under FDA oversight, one of the agency’s biggest challenges has been determining which chemicals should be prioritized for reassessment using consistent scientific criteria and how to do so with limited agency resources.

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So What Actually Went Into the Development of This Newly Released Framework?

Concerns about FDA’s ability to systematically reassess food chemicals already on the market have existed for years among scientists, regulators, public health experts, and consumer advocates. Those concerns ultimately helped drive the development of this newly released framework. FDA scientists had already been attempting to monitor food chemicals on an ongoing basis, but without a truly systematic post-market review process. At the same time, the agency was also working to develop a modernized, science-based prioritization tool (referred to as the Expanded Decision Tree) designed to help determine which chemicals should be reviewed first.

That prioritization tool was designed to draw upon available information related to potential toxicity, vulnerable populations, exposure patterns, and emerging scientific evidence in order to help FDA identify which chemicals may warrant reassessment and where limited agency resources should be directed.

In August 2024, during the Biden administration, FDA released a public discussion paper outlining what it described as an “enhanced systematic process” for post-market review of food chemicals. The agency also opened a public docket to collect feedback on multiple aspects of the proposal and later hosted a public meeting in September 2024. In July 2025, FDA released the modernized prioritization tool itself for additional public comment and external peer review. After receiving more than 70,000 comments throughout the process, the agency released the final framework this week.

What is Actually in the Final Framework?

At its core, the framework creates a more formalized and transparent process for how FDA identifies, prioritizes, evaluates, and potentially takes action on food chemicals already on the market. The process includes ongoing “signal detection” to identify chemicals that may warrant reassessment, prioritization tools designed to rank chemicals based on factors like toxicity and exposure, scientific review processes, opportunities for public comment, and potential peer review of assessments before regulatory action is taken.

Having read the final framework, what stood out most to us was how strongly it emphasized standard scientific and regulatory principles that have often been missing from the broader public conversation around food chemicals.

Some of the language in the framework was especially notable and worthy of comment:

1. It explicitly acknowledges that both natural and synthetic chemicals are to be considered similarly.

2. It acknowledges that there is public misinformation around some chemicals and states that FDA may publish communications clarifying the safety of food chemicals where appropriate.

3. It recognizes that route of exposure matters, meaning risks associated with inhalation or dermal exposure are not automatically interchangeable with risks associated with oral consumption.

4. It follows standard regulatory and scientific practices, including references to the Information Quality Act, external peer review, public comment periods, and evidence-based assessment frameworks.

This is what we SHOULD expect from food regulators, and while this SHOULD be regulatory business as usual, it stands in stark contrast to the rhetoric and many of the actions taken around food chemicals under the leadership of Secretary Kennedy and former Commissioner Makary.

The Framework vs. The Rhetoric

In announcing the framework, Secretary Kennedy stated that “the American people have a right to see the data, understand the decisions, and hold us accountable. At HHS we follow the evidence, we make our work visible, and we act to protect the American people.”

That sounds great. The problem is that much of the administration’s actual handling of food chemicals over the past year has often contradicted the very scientific and regulatory principles outlined in this framework.

For example, the Trump administration publicly announced that it was seeking a voluntary removal of synthetic food dyes from the food supply by the end of 2026 before publicly releasing any kind of updated scientific risk assessment. There was no transparent public evidence review, no release of a comprehensive risk analysis, no meaningful public comment process, and little clarity around how decisions were being made. Accountability largely consisted of missed timelines and a website of voluntary industry pledges. In other words, the risk management discussion came before the transparent scientific reassessment process this framework now describes.

That is backwards.

As we have written previously here and here, replacing synthetic food dyes, which are batch-tested by FDA and have been used for decades, with alternative “natural” color additives could also create unintended consequences depending on the substitutes ultimately used. Natural color additives are not inherently safer simply because they are natural, and many come with their own limitations related to stability (potentially increasing food waste), allergenicity, consistency, and both financial and opportunity costs with the food industry focusing on food reformulation for color additives rather than things like excess sodium, added sugar, and saturated fat that are known drivers of chronic disease.

Another example of the framework differing substantially from the rhetoric involves talc. FDA previously hosted an “expert panel” meeting focused on concerns surrounding talc in foods and drugs, much of which centered on associations between inhaled talc and lung cancer risk, as well as dermally applied talc and ovarian cancer risk. However, as of this writing, talc itself does not appear on FDA’s list of prioritized food chemicals of concern.

That makes another section of the framework particularly notable because it explicitly acknowledges that route of exposure matters and that risks associated with inhalation or dermal exposure are not automatically interchangeable with risks associated with oral consumption.

Ultimately, this recently released plan of oversight for food chemical safety reflects science rather than rhetoric, so kudos to the FDA. Additionally, as we are writing this, Commissioner Makary has now resigned from FDA, and Deputy Commissioner Kyle Diamantas, who was at the helm of the Human Foods Program for this release, is now being elevated to Acting Commissioner.

Does this signal a pivot away from the unscientific policies of Makary and Kennedy around issues like talc and synthetic dyes and toward a return to evidence-based policymaking, transparent science, and normal regulatory procedures?

We certainly hope so.

A lot of reporting has come out recently suggesting the Republican Party might be losing parts of the MAHA movement after a series of decisions that directly contradict what many of those supporters say they care about.

And because MAHA has always been a political movement to win votes for the Republican Party, the Trump administration appears to be trying to re-engage its biggest voices to lock in that support ahead of the midterms.

As such, several of those MAHA influencers were invited to the White House, where they met with President Trump and MAHA leadership, including RFK Jr., Calley Means, Casey Means, and Kyle Diamantas to discuss MAHA concerns and highlight what they described as “wins.”

In the days following that meeting, many of those same influencers began posting content that closely echoed administration messaging, clearly aimed at re-engaging their audiences and reinforcing support. One influencer, in particular, claimed she had watched every administration over the last 15 years ignore America’s health crisis, and that this administration is finally the one doing something about it.

It was a remarkable example of revisionist history that requires either abandoning reality entirely or simply not paying attention to health policy over the last 15 years, which makes it worth taking an honest look at what’s actually happened over that time period.

So let’s take a look at what nutrition and food policy has actually looked like across the Obama, Trump 1.0, Biden, and Trump 2.0 presidencies over the last 17 years, because food quality and chronic disease have become such a central focus of MAHA messaging.

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Obama (2009-2016)

The Obama administration was one of the most nutrition-policy-active administration in modern U.S. history, pursuing stricter nutrition standards, clearer food labeling, reduced trans fats, healthier school meals, expanded access to nutritious foods, and stronger food safety authority.

The administration passed the Healthy, Hunger-Free Kids Act, which overhauled school meal standards for the first time in decades by increasing fruits, vegetables, and whole grains, limiting trans fats, lowering sodium targets, and improving the nutritional quality of school lunches served to more than 30 million children per day. Research later showed measurable improvements in diet quality among children eating school lunches.

It passed the FDA Food Safety Modernization Act, which was the largest expansion of federal food safety authority in decades, shifting the FDA from reacting to foodborne illness outbreaks to actively trying to prevent them through stronger inspections, preventive controls, and mandatory recall authority.

The administration also finalized the largest update to the Nutrition Facts label in roughly 20 years, including the addition of “added sugars” labeling and more realistic serving sizes. During this period, the USDA also replaced the decades-old Food Pyramid with MyPlate, a simpler visual framework intended to help Americans build more balanced meals around fruits, vegetables, grains, protein, and dairy.

Under Obama, the FDA also moved to eliminate artificial trans fats from the U.S. food supply after determining partially hydrogenated oils were no longer considered safe, a major public health intervention tied to reducing cardiovascular disease risk that is estimated to save thousands of lives and billions of dollars in healthcare costs over time.

The administration implemented national calorie menu labeling requirements for chain restaurants, launched major initiatives, like the Healthy Food Financing Initiative, to expand healthy food access in underserved communities, and elevated childhood nutrition and obesity prevention into a national public health priority through Michelle Obama’s Let’s Move! campaign.

People can debate whether these policies went far enough or whether they were the right approach. But the idea that nobody in government spent the last 15 years trying to address nutrition, food safety, or chronic disease is simply not true.

Trump 1 (2017-2020)

The Trump administration took a notably more deregulatory approach to nutrition and food policy, often framing Obama-era nutrition standards as overly burdensome to industry, schools, and consumers.

Early in the administration, Trump signed the “two regulations out for every one in” executive order, a sweeping deregulatory initiative that slowed or stalled the development of new federal regulations across agencies, including food and public health regulation. During this period, enforcement and implementation of parts of the FDA Food Safety Modernization Act were repeatedly delayed, slowing the rollout of stronger food safety oversight established under Obama.

The administration also rolled back several Obama-era school nutrition standards by giving schools more flexibility on whole grain requirements, sodium reduction targets, and flavored milk rules. Advocates argued the changes weakened the nutritional quality improvements established under the Healthy, Hunger-Free Kids Act.

Trump repeatedly proposed substantial cuts to SNAP and supported stricter work requirements and eligibility rules for the program, moves that would reduce food access for vulnerable populations, though many of the administration’s proposed SNAP cuts were ultimately blocked by Congress.

At the same time, the administration continued implementing some previously established policies, including the final phaseout of artificial trans fats. They also signed the 2018 Farm Bill, which maintained funding for major federal nutrition assistance programs and expanded produce prescription and nutrition incentive pilot programs through GusNIP.

During COVID, Congress passed major emergency food assistance measures, including Pandemic EBT for children who relied on school meals and expanded SNAP emergency allotments, which the Trump administration implemented. But even then, he fought some of those benefits in court.

Overall, compared to the Obama administration, Trump 1.0 did not make nutrition, food safety, or chronic disease prevention a central policy focus and generally moved toward deregulation, weaker nutrition standards, and rolling back or slowing several Obama-era public health and nutrition initiatives.

Biden (2021-2024)

The Biden administration moved back toward a more regulation-oriented and public health-focused approach to nutrition and food policy, with greater emphasis on food access, chronic disease prevention, school nutrition, and federal oversight. However, unlike the Obama era, these issues were not elevated into a defining public-facing identity of the administration in the same highly visible way, with much of the work happening more quietly through federal agencies and policy initiatives.

One of the administration’s biggest nutrition-related actions was increasing SNAP benefits through an update to the Thrifty Food Plan, the largest permanent increase in SNAP benefits in the program’s history. The administration also expanded free school meal access during the pandemic, supported summer EBT programs aimed at reducing childhood food insecurity, modernized WIC food packages to include more fruits, vegetables, and whole grains, and expanded online purchasing options for both WIC and SNAP.

Biden also launched the first National Strategy on Hunger, Nutrition, and Health since 1969 and hosted the first White House Conference on Hunger, Nutrition, and Health in more than 50 years, framing nutrition, food access, and chronic disease prevention as major national priorities. The administration’s strategy included goals around reducing diet-related disease, improving food labeling, integrating nutrition into healthcare, and expanding “Food is Medicine” initiatives.

At the FDA, the administration restructured the agency’s food division following repeated criticism over infant formula contamination, foodborne illness outbreaks, and weak oversight of the food supply. The FDA created a new unified Human Foods Program intended to take a more prevention-focused approach to food safety, nutrition, and oversight of chemicals and contaminants in the food supply.

During this period, the FDA also increased attention on heavy metals and contaminants in foods commonly consumed by babies and young children, proposed stricter limits on lead exposure from food, advanced new sodium reduction targets, and finalized bans on brominated vegetable oil and Red Dye 3.

The administration additionally moved to restore stronger school nutrition standards that had been weakened under Trump, including updated sodium reduction targets, stronger whole grain requirements, and the first federal limits on added sugars in school meals. It also invested in local food systems, including grants to small and regional farmers to help schools source more fresh, local foods.

Trump 2.0 (2025-Present)

The second Trump administration has made chronic disease, food quality, and skepticism of the modern food system far more central to its public messaging than Trump 1.0, largely through the influence of RFK Jr. and the MAHA movement.

Early in the administration, Trump established the MAHA Commission, which was tasked with examining chronic disease, childhood illness, environmental exposures, food additives, and broader drivers of declining health in the United States. The administration has also publicly emphasized issues like ultra-processed foods, food dyes, pesticides, environmental toxins, and conflicts of interest within federal health agencies and the food industry.

However, many of the administration’s actual nutrition and food policy actions have remained broadly aligned with the deregulatory and reduced-government approach that characterized Trump 1.0. The administration has pursued major reductions to federal nutrition assistance programs, including roughly $186 billion in SNAP cuts, stricter work requirements, and the complete elimination of SNAP-Ed, the program’s nutrition education initiative. The administration has also scaled back or eliminated several programs that connected schools, food banks, and local farmers.

The 2026–2030 Dietary Guidelines have become one of the administration’s central talking points around their “wins” for nutrition reform. The guidelines, which come out every five years, are not actually a dramatic departure from previous evidence-based recommendations. However, the “upside down food pyramid” or food tornado that has circulated alongside them does not accurately reflect either the guidelines themselves or the broader global nutrition science consensus and instead looks like it was created by some carnivore-adjacent wellness influencers. I wrote more about the new dietary guidelines here.

On the food safety side, the administration has overseen major staffing reductions across agencies responsible for food oversight and public health, including FDA food safety scientists, inspectors, and toxicologists responsible for evaluating chemical risks in the food supply. The administration has also withdrawn or weakened several proposed food safety rules and surveillance programs, including a proposed USDA salmonella rule for poultry that had been years in development. All are listed here.

While the administration has made food dyes, additives, ultra-processed foods, and chronic disease a major part of its public messaging, its actual governing approach has remained heavily deregulatory. In practice, the administration has paired rhetoric about improving food quality and reducing chronic disease with cuts to nutrition assistance programs, reductions in food safety and public health infrastructure, and broader efforts to weaken federal regulatory authority.

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What Else?

Because this is already getting long, I’m keeping this to just nutrition and food policy.

But health outcomes are, of course, shaped by far more than food alone. They are also shaped by healthcare access and affordability, housing, income, wages, education, labor protections, transportation, environmental regulation, pollution exposure, public health infrastructure, behavioral health services, scientific research, neighborhood safety, social connection, and other social determinants of health. And all of those things are shaped, directly or indirectly, by policy decisions.

For example, administrations that support expanding healthcare access generally increase access to preventive care, chronic disease management, maternal and infant healthcare, and financial stability, while administrations that cut healthcare access or public insurance programs generally increase the number of uninsured people and create more barriers to receiving care. Administrations that prioritize environmental regulation generally strengthen oversight of environmental toxins and reduce pollution exposure, while more deregulatory approaches often weaken those protections in the name of reducing burdens on industry. Investments in public health infrastructure strengthen disease prevention, outbreak response, food safety oversight, and scientific research capacity, while cuts to those systems weaken them.

Ultimately, health policy is not just whichever administration talks the most about chronic disease online. It is the cumulative effect of thousands of policy decisions that shape the conditions people live in and the systems surrounding them, including whether people can access healthcare, whether food assistance programs exist, whether environmental toxins are regulated, whether public health agencies are funded, whether scientific research is supported, whether school meals are nutritious, whether workplaces are safe, and whether the institutions responsible for protecting population health are actually functional.

And even looking narrowly at nutrition and food policy alone, the idea that nobody cared about chronic disease or Americans’ health until the MAHA movement came along falls apart under even a basic review of the last 17 years of policy and government action.

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We’ve been in a phase over here where my kids are constantly asking “why” about everything.

Why do kids have to go to school? Why are there bubbles in sparkling water? Why can’t our dog talk like us? Why can’t I be a lizard when I grow up? Why do humans exist?

Honestly, it’s like living with tiny philosophers.

And I’ve caught myself thinking about how little of that energy exists in the way most of what’s happening right now is actually explained.

There’s certainly a lot going on. A lot of big decisions with real consequences. But very little of it gets broken down in a way that answers: why is this happening, and why does it actually matter?

Before I get into this week’s updates, I want to say thank you to those of you who support this work as paid subscribers. If you’ve found this work helpful, please consider becoming a paid subscriber. It’s the most direct way to support this work and keep it going at this level. Thank you.

Now let’s get into it.

FDA Study Shows Infant Formula is Safe

The FDA tested more than 300 infant formula products for contaminants and found that they are safe for consumption.

In total, the agency analyzed 312 formulas across 16 brands. All samples tested well below EPA and EU limits for heavy metals, and all but three were free of the 318 pesticides tested.

The testing also looked at PFAS, phthalates, and other contaminants, with levels characterized as very low. FDA Commissioner Marty Makary called the findings “encouraging.”

This was part of “Operation Stork Speed,” a Trump administration initiative aimed at increasing oversight of the formula industry, expanding contaminant testing, and updating regulations that haven’t meaningfully changed since 1998. A worthwhile effort.

The results should be reassuring to parents. At the same time, the U.S. still does not have enforceable federal limits for heavy metals in infant formula. Manufacturers do conduct their own testing and operate under safety requirements, but having clear, enforceable standards at the federal level would add an additional layer of accountability and reassurance.

Ultimately, after the past year or so of fear-based messaging around infant formula, it’s good to see the evidence continue to show that infant formula in the U.S. is safe.

Farm Bill Passes House After Liability Shield Is Stripped

This week, the House passed an amendment to remove a pesticide preemption provision from the farm bill that would have made it much harder for individuals and states to sue manufacturers for harm.

In practice, this would have protected companies like Bayer from thousands of ongoing and future lawsuits tied to glyphosate.

If you’re not familiar with preemption, or how it’s being used in a number of policy fights right now, Helena Bottemiller Evich wrote a great explainer on it in her recent newsletter, which is worth reading here.

The amendment was introduced by Rep. Luna (R-FL) and passed 280–142, with strong support from Democrats (207–6) and opposition from Republicans (73–135). It was also backed by MAHA, which has been very vocal about chemical exposures and the need for stronger protections.

The full farm bill ultimately passed the House 224–200, mostly along party lines, with limited Democratic support. A big reason for that is the bill does not even partially restore the nearly $200 billion in SNAP cuts included in last year’s Big Beautiful Bill, which remains a dealbreaker for many Democrats.

Now the bill moves to the Senate, where it’ll face further debate and likely changes before anything is finalized.

Casey Means Withdrawn as Surgeon General Nominee

Nearly one year after announcing Casey Means as his pick for U.S. Surgeon General, Trump has officially withdrawn her nomination.

He announced the decision in a Truth Social post, placing the blame on Senator Bill Cassidy, a physician and Chair of the Senate HELP Committee. Cassidy was the deciding vote to confirm RFK Jr. as HHS Secretary, and only did so in exchange for a series of commitments that were not ultimately kept.

Despite trying to place blame on a single Senator, her confirmation hearing left several senators uneasy about her views on vaccines, her clinical background, and her broader alignment with the MAHA movement. She declined to give answers on routine vaccination, which drew scrutiny from senators who might otherwise have supported her.

Her nomination also faced opposition from within the medical and public health community. Jerome Adams, who served as Surgeon General during Trump’s first administration, publicly questioned her qualifications and said she was not qualified for the role.

In her place, Trump nominated Dr. Nicole Saphier, a radiologist, former Fox News correspondent, wellness podcast host, and MAHA advocate.

She is reportedly likely to be confirmed.

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Former Tobacco Executive Joins CDC Senior Leadership

A former tobacco industry executive was appointed deputy director of legislative affairs at the CDC, which is unprecedented and directly conflicts with RFK Jr.’s rhetoric about “ending corruption” and “closing the revolving door” in our public health agencies.

This appointment follows a series of pro–tobacco industry actions over the last year, including reversing the proposed ban on menthol cigarettes, eliminating the CDC’s Office on Smoking and Health (OSH), which has been called “the greatest gift to the tobacco industry in the last half century,” shutting down surveillance systems, youth tobacco data collection, and major public education campaigns like “Tips From Former Smokers,” and allowing Biden-era proposed rules to reduce nicotine levels in cigarettes to stall.

Notably, the largest corporate donation to Trump’s 2024 presidential race, which was $10 million, came from a tobacco company. And in response, the Trump administration has continued to be very good to the tobacco industry. I made a video on that here.

Smoking is still one of the leading causes of preventable disease. CDC data shows that more than 16 million people in the U.S. are living with at least one smoking-related disease, and another 58 million nonsmoking Americans are exposed to secondhand smoke.

And importantly, the CDC plays a central role in shaping public health policy and recommendations. So putting someone with tobacco industry ties in a senior policy role raises real questions about how those decisions are going to be made and who they’re being made for.

National Science Board Dismissed

Last weekend, the Trump administration abruptly fired all 24 members of the National Science Board. The Board oversees the National Science Foundation (NSF) and advises Congress and the president on science policy.

No explanation was provided.

This is happening just as the administration released its proposal to cut NSF funding by more than 50% next year. And the board, which includes professors and industry executives who have served for over a decade across both parties, has been actively advising Congress on the importance of that funding.

The NSF funds early-stage research that has enabled technologies such as MRIs, LASIK eye surgery, kidney matching, CRISPR, 3D printing, smartphones, and the internet. It also supports research for systems that track weather forecasts and natural disasters.

Removing the entire board at once raises some real questions about how scientific priorities and funding decisions are going to be made moving forward. It also makes it easier to push through proposed cuts to NSF funding without as many independent voices in place to weigh in, which could ultimately reshape the role the U.S. plays in supporting scientific research and innovation.

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1. LIE: “I’m not anti-vax, I’m pro-science” (April 17, before the House Education and Workforce Committee)

TRUTH: For years, RFK Jr. has spread anti-vaccine messaging. In 2023 on the Lex Friedman podcast he said “there is no vaccine that is safe and effective.” When questioned about polio, he said he couldn’t answer if the vaccine caused more deaths than it averted. But the polio vaccine is highly effective and safe. It has been eliminated in the US, and the vaccine has prevented an estimated 20 million cases of paralysis in children since 1988.

A 2019 study found that the majority of the Facebook ads spreading vaccine misinformation were coming from just two anti-vaccine groups. One of them was Children’s Health Defense, which at the time was founded and led by RFK Jr.

And in just the past year, as HHS secretary, RFK Jr. has made many anti-vax, anti-science moves, including:

1. Ended $500 million for mRNA vaccines

2. Removed 8,000+ public-facing federal health and science webpages, including datasets on youth risk behavior, reproductive health, and environmental hazards

3. Changed the pediatric vaccine schedule

4. Fired all ACIP members and replaced them with anti-vaxxers

5. Cut HIV vaccine research

6. Canceled a contract with Moderna to study bird flu vaccine

Saying “I’m not anti-vax, I’m pro-science” is a well-documented rhetorical strategy that’s been used in anti-vaccine movements for years to broaden appeal and avoid immediate dismissal. It’s used to make anti-vaccine positions sound credible and aligned with scientific values, while continuing to erode trust in the actual scientific consensus. And it provides cover. When called out, they can default to “I’m just asking questions” or “I never said don’t vaccinate,” despite a clear pattern of messaging that does exactly that.

2. LIE: “COVID is gone” (April 22, before the HELP Committee)

TRUTH: COVID is not gone. The pandemic is over, but SARS-CoV-2, the virus that causes COVID, is here to stay. It is now an endemic virus, which means it will continue to circulate in our population, at times seasonally, but there’s no chance of eradication. Not only is the claim false, it’s also cruel, especially when you look at the data. COVID continues to sicken, disable, and kill people all over the world. In 2025, COVID resulted in 450,000 hospitalizations and up to 53,000 deaths in the US alone.

3. LIE: “The hepatitis B vaccine was tested for 4 days…there was no placebo in that, so we don’t know the risk factor of that” (April 21, before the Senate Committee on Appropriations)

TRUTH: This is a common anti-vaccine claim based on the misinterpretation of the vaccine insert information. Both Engerix-B and Recombivax HB were studied as 3-dose vaccines given over a 6-month period, with participants followed for 9–18 months. The 4–5 day window referenced in inserts is specifically for tracking acute adverse events, not the full duration of safety monitoring.

We also have decades of research showing the hepatitis B vaccine is safe and effective, including studies with placebo groups.

And we know the impacts of the hepatitis vaccine:

1. A dramatic reduction in infant hepatitis B following the universal birth dose, one of public health’s major successes

2. Prevention of serious illness and childhood deaths

4. LIE: “It [measles outbreak] has nothing to do with me” (April 22, before the Finance Committee)

TRUTH: As much as RFK Jr. wants to claim this outbreak began before his tenure as HHS Secretary, that ignores a much bigger reality. He has spent nearly two decades as one of the most visible figures in the anti-vaccine movement, repeatedly spreading misinformation about the Measles, Mumps, and Rubella (MMR) vaccine.

The data show that over 4,000 measles cases have been confirmed since his confirmation. Most of those cases are unvaccinated individuals who believed his many lies about the MMR vaccine, such as:

1. The MMR vaccine leads to deaths every year–it doesn’t

2. The MMR vaccine causes “all the illnesses” of the disease–it doesn’t

3. The MMR vaccine “wanes about 4.5%” per year–it doesn’t

4. The MMR vaccine “does not appear to provide maternal immunity”-- if given before pregnancy–it does

5. LIE: “mRNA vaccines have limited efficacy against respiratory viruses” “I terminated the COVID vaccine because it didn’t make any sense” (April 22, before the HELP and Finance Committees)

TRUTH: Kennedy has repeatedly made the false claim that mRNA vaccines are not effective against respiratory viruses, but 6 years of vaccine effectiveness data prove him wrong. The mRNA COVID-19 vaccines prevented millions of deaths.

In general, vaccines are designed to prevent severe illness, hospitalization, and death–the mRNA vaccines for COVID-19 continue to do this very well. Vaccines that do not completely prevent infection are not “ineffective”--it’s important to remember we have these tools for harm reduction, not harm elimination. When we have high enough vaccination rates in populations, we can also see a reduction in infections and transmission.

Cutting funding for mRNA vaccines for respiratory viruses will set the US back, especially when it comes to the seasonal burden of viruses like flu and COVID-19 that mutate rapidly.

6. LIE: “Russ Vought doesn’t want to cut NIH programs” (April 21, before the House Energy & Commerce Health Subcommittee)

TRUTH: Russel Vought was one of the key authors of Project 2025 where he created a blueprint to cut government programs and consolidate control under the President. He is an outspoken proponent of massive firings of career civil servants. At a conservative event talking about our federal employees, he said “We want the bureaucrats to be traumatically affected. When they wake up in the morning, we want them to not want to go to work, because they are increasingly viewed as the villains. We want their funding to be shut down … We want to put them in trauma.”

Now he is in charge of the federal budget and between Vought and DOGE, the Trump administration has cut billions of dollars in NIH funding. Vought also withheld NIH spending for months into the fiscal year, leading to significantly less grants awarded this year at this point compared to previous years.

7. LIE: “We have done more for maternal health than any administration in our history” (April 17, before the House Committee on Education & Workforce)

TRUTH: The FY 2027 proposed budget does the opposite. It eliminates programs like Healthy Start and cuts the CDC’s safe motherhood and infant health portfolio, which supports Maternal Mortality Review Committees, Perinatal Quality Collaboratives, and the Pregnancy Risk Assessment Monitoring System. It also eliminates the Infant and Early Childhood Mental Health program at Substance Abuse and Mental Health Services Administration.

At the same time, NIH grants focused on maternal health are being canceled, including research specifically on Black maternal health, despite the fact that Black women are three times more likely to die from pregnancy-related causes than white or Hispanic women, according to the CDC.

You cannot claim to prioritize maternal health while dismantling the very programs and research infrastructure designed to improve it.

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8. LIE: “I never said that”…“I have no memory of saying anything like that” [on his comments about Re-parenting Black children] (April 16, before the Ways and Means Committee, and April 22, before the HELP committee)

TRUTH: In 2024, RFK Jr. appeared on the High Level Conversations podcast and said: “Psychiatric drugs, which every Black kid is now just standard put on—Adderall, SSRIs, benzos—which are known to induce violence… those kids are going to have a chance to go somewhere and get re-parented; to live in a community where there’ll be no cell phones, no screens, you’ll actually have to talk to people.”

And this is part of a pattern with this man. RFK Jr. has a documented history of making race-based claims about health. During the COVID-19 pandemic, he repeatedly promoted the false idea that the virus was “ethnically targeted” to spare Ashkenazi Jewish and Chinese populations while specifically targeting Black and white individuals. He has also claimed that Black people have “better” immune systems than white people and, for that reason, should follow different vaccine schedules, along with other race-based pseudoscientific claims.

9. LIE: The rate of autism is increasing “Autism rates have gone from 1 in 10,000 in 1970 to 1 in every 31 today” (April 22, before the HELP Committee)

TRUTH: The rate of autism is not increasing, the diagnoses are–and that’s because we now have better tools and diagnostics to identify cases that went undetected for years, sometimes decades. RFK Jr. has repeatedly claimed that autism rates are increasing, and mischaracterized the prevalence as an “epidemic.” First, autism is not a disease, therefore it cannot be an epidemic. Second, we are better at identifying autism spectrum disorder. Many people who would today be diagnosed as autistic would have probably received insufficient and incorrect diagnoses such as “intellectual disability.” In fact, a correlated decline in diagnoses of “intellectual disability” or “learning disability” suggests that there is a bit of accurate substitution happening, rather than a true increase.

10. LIE: “The US had the highest death of any country on earth” (April 22, before the HELP Committee)

TRUTH: This lie is especially telling. In September 2025, during another congressional hearing, RFK Jr. claimed that no one actually knows how many Americans died from COVID-19 because of “data chaos” and “perverse incentives.”

So which is it? Do we have the highest death toll, or do we not know the number at all?

We know that at least 1.2 million people in the US died from COVID-19, and even that is considered a significant undercount.

We also know the US did not have the highest mortality rate in the world, despite him repeating that claim all week. When you look at deaths per million, multiple countries had higher rates, including Peru, Bulgaria, Croatia, and Hungary.

11. LIE: “There are no cuts to Medicaid” (April 22, before the Finance Committee)

TRUTH: Just like defending the idea that President Trump can invent his own way to calculate percentages, this claim only works if you ignore how basic math and budgeting actually function.

The Big Beautiful Bill cut nearly $1 trillion from Medicaid over the next decade compared to what the program would have received under current law, according to the Congressional Budget Office. That is, by definition, a cut.

Saying “there are no cuts” relies on pointing to the fact that total spending may still increase over time. But health policy experts say that the increase is driven by inflation, rising healthcare costs, and population changes, not expanded coverage or benefits.

In reality, spending will be reduced by close to $1 trillion over the next decade because of the cut compared with prior projections, even as absolute spending continues to rise. And as a result, nearly 7 to 8 million people are projected to lose Medicaid coverage, largely due to work requirements and new administrative barriers, not because of immigration status.

12. LIE: “The flu shot is an intervention that is often ineffective. It has a 20% efficacy rate. There are studies that show that getting a flu shot actually increases the chance of a non-flu infection” (aka non-specific effects) (April 22, before the HELP Committee)

TRUTH: RFK Jr. loves this made-up statistic. The problem is he’s turned his skepticism into policy, with the removal of CDC flu vaccine campaigns and the most recent move to no longer mandate it for US military personnel. Flu vaccines are designed to do two main things: reduce severe infections requiring hospitalization and deaths. Flu vaccines do not increase your chance of non-flu infections. RFK Jr’s claim is based on a pre-print study (not peer-reviewed) with significant limitations, including selection bias. The study did not show a causal link between vaccination and non-flu illnesses nor did it measure the risk of serious illness or new infections.

13. LIE: “[The study says] 80% in mortalities from chronic disease that took place in the 20th century – almost none of it was attributable to vaccines. (April 22, before the HELP Committee)

TRUTH: RFK Jr. referred to a “Johns Hopkins study” which he has referred to before to incorrectly claim that vaccines do not account for “impressive declines in mortality” in the first half of the century. Senator Cassidy, a board-certified physician, fact-checked him on the conveniently missing context from said study, which concludes the exact opposite. The paper notes “the reductions in vaccine-preventable diseases, however, are impressive.”

In the mid 1900s, vaccines, particularly for measles and diphtheria, were instrumental in reducing overall mortality in the US. Over a century of data has shown that the two largest contributing factors to our increased life expectancy (and reduced mortality) are vaccines and clean water. A landmark study led by the WHO shows that global immunization efforts have saved at least 154 million lives over the past 50 years.

RFK Jr., who for years has denied germ theory, continues to promote that deeply problematic and eugenic principles of terrain theory.

14. LIE: The Trump administration is delivering the “largest investment in rural health in our nation’s history” (April 16, before the Ways and Means committee)

TRUTH: This is the same logic as calling a cut an increase. You take something away, give a small portion back, and present it as a historic investment.

The Big Beautiful Bill cut more than $900 billion from Medicaid, a program that rural hospitals, clinics, and nursing homes rely on to stay open. As a result, nearly 880 hospitals, clinics, and nursing homes are at risk of closure or have already cut essential services.

Because of this, the bill also included roughly $50 billion in funding for rural healthcare to help offset some of the damage those Medicaid cuts are expected to cause. So, importantly, that funding is not a new investment on its own. It is there to respond to the consequences of the cuts themselves.

Framing that as a historic investment is highly misleading. You do not get to slash the foundation rural healthcare depends on and then call partial stabilization funding a major health victory.

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15. LIE: TrumpRx is making a difference “Americans no longer pay more than people in other wealthy countries for the exact same medications” (April 22, before the Finance Committee)

TRUTH: Last month, the New York Times reported that Americans could pay nearly twice as much for prescription drugs through TrumpRx compared to other countries, including GLP-1s.

TrumpRx is essentially a discount card, similar to GoodRx. It doesn’t actually solve the problem of pricing since most insured individuals already get negotiated rates on drugs. For the uninsured, a discount card to pay out-of-pocket has not proven to be cheaper than the discount programs already available in the US.

And in some cases, it’s not even cheaper. During the hearing, Senator Elizabeth Warren pointed out that a 30-day supply of Protonix costs about $200 on TrumpRx, while the exact same medication in generic form costs about $16 at Costco. That means patients using TrumpRx could end up paying significantly more for the same drug.

In fact, analysis presented in the hearing found people have more than a one-in-four chance of paying more through TrumpRx than they would through existing options. So no, Americans are not suddenly paying less than people in other countries. In some cases, they’re paying more than they need to.

16. LIE: “For the first time they [Dietary Guidelines] are not dogma based guidelines, but science based guidelines” (April 16, before the Ways and Means Committee)

TRUTH: The Dietary Guidelines have always been grounded in science and informed by an independent advisory committee that reviews the totality of nutrition evidence.

This past year, RFK Jr. rejected that committee’s evidence-based recommendations and instead relied on a newly selected group with ties to the meat and dairy industry, overriding the established scientific review process.

The resulting guidelines diverge from global nutrition consensus and contain inconsistencies and factual errors, including contradictions between the written recommendations and the consumer-facing visual guidance.

17. LIE: “All decisions that have been made at that agency [FDA] are made with the approvals of panels of career scientists” (April 21, before the House Energy & Commerce Health Subcommittee)

TRUTH: Career scientists have faced layoffs and pressure under the Trump administration, leading to a wave of resignations across federal health agencies. At the same time, key decisions, like changes in drug approvals, have increasingly bypassed or overridden standard scientific review processes, with political appointees stepping in where career experts traditionally lead. This has included instances where career scientists’ recommendations on COVID-19 vaccines were overruled.

And former CDC Director Susan Monarez, who RFK Jr. fired, testified before Congress that she was instructed to not speak to or work with any career scientists at CDC, directly contradicting the claim that these decisions are driven by independent scientific panels.

18. LIE: “The food pyramid was written by food industry lobbyists for 50 years. And it reflected the mercantile impulses of those companies that put Fruit Loops at the top of the food pyramid” (April 22, before the HELP committee)

TRUTH: Fruit Loops have never been on the food pyramid. Federal ethics rules prohibit USDA officials from endorsing private brands in official guidance.

The 1992 Food Guide Pyramid, which was discontinued and replaced in 2005, recommended grains, fruits, vegetables, dairy, and a mix of plant and animal proteins, while emphasizing variety and moderation. It explicitly placed fats and added sugars at the top with a clear “use sparingly” label.

There is no evidence that the pyramid promoted or instructed people to eat products like sugary cereals. Quite the opposite.

19. LIE: “I authorized $500 million for cancer vaccines” (April 17, before the House Committee on Education & Workforce)

TRUTH: There is no evidence of a $500 million investment in cancer vaccines. If anything, this appears to be a reversal of what actually happened.

Last year, RFK Jr. canceled $500 million in mRNA vaccine research, a platform also being studied for cancer treatments like personalized cancer vaccines.

Cutting funding to this technology not only slows progress in areas like cancer, but also puts the US at a disadvantage as other countries continue investing in it.

20. LIE: “The Mennonites have not vaccinated since 1796” [while blaming the current measles outbreaks on Mennonites, Canadians, and Mexicans] (April 21, before the House Energy & Commerce Health Subcommittee)

TRUTH: This is historically and factually incorrect. There is no evidence that Mennonites have universally avoided vaccination for centuries. While some Mennonite and Amish communities have lower vaccination rates, this is not uniform and is largely a more recent trend, not something that dates back to the origins of vaccination. Framing an entire religious group this way is both inaccurate and misleading.

21. LIE “This [COVID] was not a disease that was killing healthy people. It was killing sick people” (April 22, before the HELP Committee)

TRUTH: COVID killed the young, the old, the healthy, and the sick. This has been documented for years. What RFK Jr. wants you to believe is the lie that comorbidities from chronic illnesses were WHY people died–this is based on a 6-year-old misinterpretation of a CDC death certificate chart data.

Many people, including children, without comorbidities have died from COVID-19. By far, the biggest risk factor for COVID mortality was age, and no chronic diseases came close to age as far as impact on COVID mortality outcomes go. RFK Jr. cannot accept the fact that at least 200,000 Americans needlessly died because they refused the life-saving COVID-19 vaccines.

Final Thoughts

RFK Jr. asked for “one piece of misinformation” he’s ever said. These are 21 examples from just the last week of hearings. At this point, the volume and consistency of these claims make it difficult to believe this is about confusion or misunderstanding. The line between fact and fiction in his messaging has become so blurred that it’s effectively meaningless.

And that would be concerning on its own, but it is especially dangerous given that he is leading HHS, where these views can directly shape policy, influence public behavior, and impact health outcomes.

RFK Jr. is in the middle of an unusually packed week on Capitol Hill with seven congressional hearings in seven days. He completed three last week and will testify four more times this week, on Tuesday and Wednesday, ending in front of the Senate HELP Committee, which is the same committee that confirmed him last year.

This is happening as part of the annual budget process. Each year, cabinet secretaries go before multiple committees in both the House and the Senate to defend their proposed budgets and answer questions about how they are running their agencies. But these hearings are also giving lawmakers an opportunity to question RFK Jr. on the direction of his policies and the real-world impact they are having on public health.

The Budget

The White House’s 2027 budget proposal would cut HHS discretionary spending by roughly 12.5%, or nearly $16 billion. Within that, the NIH would lose $5 billion. Several institutes would be eliminated entirely, including those studying minority health, global health, and alternative medicine. The Low Income Home Energy Assistance Program, which helps low-income families cover utility bills, would be cut by $4 billion. The Agency for Healthcare Research and Quality, which has already lost more than half its staff since the start of the Trump administration, would be reduced further.

Congress ultimately controls federal appropriations, and last year, Congress largely rejected the administration’s proposed cuts to scientific research. The administration is now trying again, but some Republicans have already expressed concerns about the new proposal, particularly the cuts to the NIH.

The budget, however, is only part of what these hearings have been about.

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The First Three Hearings

There were several memorable moments across last week’s three hearings, and I did response videos to a couple of them already. But overall, what was most obvious was a clear and coordinated effort by RFK Jr. to redirect the conversation toward a specific set of issues and away from others.

When pressed on vaccines, his responses were often brief, qualified, and quickly moved past. He described the measles vaccine as “safe and effective for most people,” which is a big shift from his confirmation hearings, when he would not say unequivocally that the MMR vaccine does not cause autism. He also agreed the measles vaccine was safer than getting measles, and acknowledged that it may have saved the lives of the two unvaccinated children who died of measles in Texas earlier this year.

When he had the chance, he seemed to focus on safer topics like chronic disease, nutrition, food policy, and fraud in healthcare programs. This is not surprising. Several reports have indicated that RFK Jr. has been told to move away from vaccine messaging and focus on safer issues that tend to resonate more broadly with voters heading into the midterms.

In his opening remarks, he called nutrition “the bedrock of health.” He pointed to the administration’s work on food dyes, dietary guidelines, and faster drug approvals, and when pressed on the NIH cuts, he tried to redirect the conversation to disease prevention.

The shift in tone, however, has not changed the substance of what RFK Jr. is actually doing at HHS. And across the three hearings, he repeatedly misled lawmakers about the administration's policies and denied things that are happening in plain sight.

In the hearings, he told Congress that the current measles crisis, which has grown to over 1,700 cases this year, has “nothing to do with me,” despite years of anti-vax rhetoric and public statements questioning the MMR vaccine. He absurdly claimed that Medicaid “wasn’t touched” by the Big Beautiful Bill, which contains close to a trillion dollars in Medicaid cuts. In reality, the CBO projects 10 million Americans will lose Medicaid coverage as a result of the law. When pressed on those coverage losses, RFK Jr. claimed the people affected were only undocumented immigrants, which is not possible under current federal law, as undocumented immigrants are already explicitly excluded from Medicaid, Medicare, and ACA coverage. He further claimed that “they found 1.5 million illegal immigrants were collecting Medicaid illegally,” a number that appears to be entirely fabricated.

Additionally, he said gun violence is not a public health issue, contradicting the position of every major medical and public health association. And he continued to defend the administration’s claim of a link between Tylenol use during pregnancy and autism, a claim that is not supported by the scientific evidence, even after a Republican lawmaker who is the father of a neurodivergent child told him directly that the claim had been hurtful to his wife.

And in one of the most egregious moments, Rep. Terri Sewell confronted him with his own 2024 comments proposing that Black children on medications like Adderall be sent to “wellness farms” to be “reparented.” RFK Jr. claimed he didn’t “even know what that phrase means” and accused her of making it up. There is video of him saying exactly that.

Taken together, the three hearings last week were revealing. The strategy was clearly to keep the conversation on nutrition, food policy, and chronic disease, and to move past vaccines whenever possible. But the limits of this approach became apparent every time members pressed. Throughout the hearings, RFK Jr.’s answers often shifted from controlled messaging to deflection, contradiction, and claims that simply did not align with either the law or the scientific evidence.

What to Watch This Week

Four more hearings remain, with the most significant being Wednesday’s appearance before the Senate HELP Committee.

A few things are worth watching.

First, whether more Republican lawmakers join the few already expressing concern about the proposed NIH cuts. Last year, the administration proposed cuts of approximately 40% to federal science funding, and Congress rejected most of them. The hope is that the same resistance holds this year.

Second, whether RFK Jr. can stay on the messaging plan the White House has laid out for him. So far, he has repeatedly been pulled off script whenever members press. The Senate HELP Committee, which includes members with significant public health expertise, will have both the time and the knowledge to press harder.

Third, and the one I’ll be watching most closely, whether the committee that confirmed RFK Jr. last year has any reconsideration to offer about what they confirmed.

Given the deeply concerning leadership we’ve seen so far, and the far-reaching consequences already unfolding for science and public health, they certainly should.

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Like many of you, I’ve spent the last couple of weeks, and especially the last couple of days following Friday’s reentry and splashdown, unexpectedly emotional watching the Artemis II mission and the crew.

It’s hard to fully explain why, but there’s something deeply moving about watching a group of incredibly capable, prepared, thoughtful, emotionally grounded people do something this complex and this high stakes, supported by thousands of equally brilliant people behind the scenes.

Especially right now.

Every time NASA posts a video or I watch a clip from the splashdown, I find myself getting emotional in a way that feels a little disproportionate, until I start to understand what it actually represents.

It’s about watching something go right.

Watching people who are deeply competent, who take their roles seriously, who communicate clearly, and who understand the weight of what they’re doing, execute something extraordinarily complex and do it well.

And I think for a lot of us, that hits differently right now.

There’s something about seeing that level of competence, clarity, and humanity all at once that reminds you what things are supposed to look like when they’re working. And for a moment, it felt like people collectively paused and appreciated science, not as an abstract idea, but as something real, human, and worth investing in.

Maybe even a reminder that expertise and excellence still matter, and that when we prioritize them, things can actually go right.

Anyway, I just wanted to acknowledge that, because it’s been a real bright spot.

There has also been a lot happening this week across public health, food policy, and science that is worth paying attention to, and I want to walk through some of that here with a bit more context.

SNAP Cuts and Restrictions Show Early Impacts

Under the Trump administration, the Supplemental Nutrition Assistance Program (SNAP) has undergone significant changes, both through direct funding cuts and through new state-level policies that restrict how benefits can be used.

The Big Beautiful Bill cut nearly $186 billion from SNAP and eliminated SNAP-Ed, the program that provided nutrition education to low-income families. A major way those savings are expected to be achieved is through expanded work requirements, which are projected to reduce the number of people receiving benefits.

At the same time, states have been encouraged to pursue SNAP waiver programs that limit what people can purchase with their benefits. This is where the MAHA movement has focused its attention, promoting these restrictions as a way to improve Americans’ diets and a major public health win.

But the evidence behind these policies tells a different story.

We have decades of data showing that SNAP work requirements do not meaningfully increase employment. What they do is make the program harder to navigate, increasing administrative burden and confusion, which leads to eligible people losing benefits.

And when it comes to food restriction waivers, we don’t have strong evidence that they meaningfully improve diet quality. What we do know is that they make the program more complex, less efficient, and harder for both families and retailers to navigate.

Now, we’re starting to see the effects of these policies in real time.

• In Arizona, SNAP participation has dropped by 47% since the cuts took effect, meaning 424,000 people, including 181,000 children, no longer receive food assistance benefits.

• New research published this week found that the SNAP work requirements included in the One Big Beautiful Bill do not increase employment, but instead reduce participation by adding administrative barriers and confusion.

• In Texas, where SNAP food restriction waivers went into effect on April 1, families report confusion, stigma, and concerns about losing access to affordable foods, including items used to manage health conditions like hypoglycemia.

• In Montana, the governor has promoted SNAP restrictions as a way to reduce “junk food” consumption, but there is little evidence that these policies meaningfully change dietary patterns, and retailers are already facing new administrative burdens as a result.

We know from decades of data, as well as emerging evidence now, that a drop in participation does not mean a drop in need. It usually means people are getting pushed out of the program. When you take a program that is highly effective at reducing food insecurity and make it harder to access and more complicated to use, a rise in food insecurity is expected to follow.

CDC Delays COVID-19 Vaccine Effectiveness Report

A CDC report showing that COVID-19 vaccine significantly reduced emergency department visits and hospitalizations among healthy adults last year has not been published despite being scheduled for release in the CDC Morbidity and Mortality Weekly Report on March 19.

The report found that COVID-19 vaccination reduced the risk of emergency department and urgent care visits by 50% and COVID-realted hospitalizations by 55% among healthy adults. CDC career scientists and other experts have raised concerns that the report is being delayed because its findings contradict RFK Jr. ‘s public anti-vaccine stance.

The acting CDC director, Jay Bhattacharya, has said there are “methodological concerns.” But this study already cleared the CDC’s internal scientific review process and used the same approach that’s been used in vaccine effectiveness research for years, including studies published in major journals like The Lancet and The New England Journal of Medicine.

This delay raises real concerns about scientific independence and whether these agencies can still do what they’re meant to do, which is to transparently inform public health decisions.

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The U.S. Forest Service is Being Restructured

The Forest Service is undergoing a major restructuring that will close all nine of its regional offices and relocate its headquarters from Washington, D.C. to Salt Lake City, Utah.

The Forest Service manages about 193 million acres of public land across 174 national forests and grasslands. That’s one of the largest public land systems in the country, significantly larger than the entire national park system.

The reorganization would halt much of the agency’s experimental forest research and close research stations, which are critical for understanding wildfire behavior, forest health, drought, and climate impacts. All of this is happening within an agency that is already understaffed and stretched thin.

And it’s happening at a time when those functions, according to experts, are becoming even more important. This past winter was the warmest on record, with below-average snowpack in many regions, conditions that are strongly associated with increased wildfire risk heading into summer and fall.

So we are reducing the infrastructure, staffing, and research capacity of the agency responsible for managing wildfire risk, while entering a period where that risk is expected to increase.

On top of that, there are legal questions being raised, as some advocates argue that parts of this restructuring may violate provisions in the FY 2026 budget that explicitly prohibited certain changes.

The White House’s newly released proposed FY 2027 budget, meanwhile, emphasizes the need to “combat the wildfire crisis.” But if wildfire mitigation is actually a priority, dismantling core parts of the agency responsible for it is a very strange way to approach that problem.

CDC’s Vaccine Panel Gets New Rules

RFK Jr. signed a new charter this week for the Advisory Committee on Immunization Practices (ACIP), the group that makes recommendations to the CDC on vaccine use in the United States, including the childhood vaccine schedule and which vaccines are covered by insurance.

Last year, RFK Jr. attempted to replace all 17 members of ACIP with a new group that included several vaccine-skeptical figures. A federal judge blocked that effort, ruling that the panel had been created unlawfully and raising concerns about whether the appointees met the qualifications required for the role.

ACIP charters are typically renewed every two years, but this version includes some notable changes.

It expands the scope of the committee beyond its traditional role in disease prevention to include advising on vaccine safety, “serious vaccine injury,” evaluation of the childhood vaccine schedule, and vaccine ingredients.

It also broadens who can participate. The updated charter expands the types of expertise considered eligible for membership and allows outside organizations, including those with a history of vaccine skepticism, to serve as nonvoting liaisons.

It’s hard to view this as anything other than an attempt by RFK Jr. to work around the earlier ruling and rebuild the committee under a different set of rules. The earlier version was blocked in part because of concerns about qualifications and vetting. By broadening the types of expertise allowed and expanding the committee’s scope, it becomes much easier to appoint people who wouldn’t have qualified under the previous charter.

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RFK Jr. Launches a Podcast

Ahead of the midterms, our HHS Secretary is launching a podcast called The Secretary Kennedy Podcast, which the department says will promote “radical transparency” and expand the reach of the MAHA agenda. According to RFK Jr., it will focus on exposing failures in public health, government corruption, and chronic disease.

I did a video response to the announcement that you can see here.

His conspiratorial, government corruption framing is, of course, not new. It’s the same set of ideas that built the MAHA movement in the first place. What is different now is that this is coming from someone currently running the Department of Health and Human Services.

And that context matters, because the administration is now well into its second year, which means there is an actual policy record to evaluate alongside the messaging. And that record does not match its stated goal of improving American health. Even if you ignore the dozens of actions negatively impacting public health, science, and health policy over the last 15 months, as I outlined here, they haven’t actually done much on MAHA’s own pet priorities either.

Not one synthetic food dye has been banned (because banning them requires evidence). Seed oils are still in infant formula (because they are safe and provide essential fatty acids to infants). Glyphosate regulations have expanded, not tightened (and RFK Jr. publicly supported that move). There is still no federal definition of ultra-processed food (which is necessary if you want to actually regulate it). And environmental rollbacks are on track to increase heavy metals and pollutants in our air and water.

As midterms approach, and reporting shows they’re starting to lose support within the MAHA movement, this reads as a shift back to what has always worked for them: focusing on corruption, conspiracies, toxins, and distrust in institutions, and tapping into fear and anxiety instead of being evaluated on their actual record.

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Last week, the Trump administration released its budget proposal for Fiscal Year 2027, the annual document every White House sends to Congress to lay out its spending priorities for the year ahead.

While Congress ultimately decides what gets funded, the President’s budget is one of the clearest windows into what a government values and what kind of country it is trying to build.

And unsurprisingly, this latest budget reflects many of the same governing instincts that have shaped both Trumpism and the broader conservative policy agenda around it, with less investment in the systems that support collective well-being and more investment in militarization, enforcement, and centralized power.

Those priorities are especially important to view in the context of an administration that has tried to frame itself as a champion of “Making America Healthy Again.” Because when you move past the rhetoric and examine what this budget actually does, it becomes clear that it undermines that stated goal by targeting many of the systems we know directly shape health.

To be clear, this is not the final budget. Congress blocked many of these same cuts last year, and it may block many of them again. But the proposal still matters because it shows where this administration actually wants to take the country.

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What’s In the Budget?

If an administration were truly focused on making its country healthier, there are a few things we would expect to see. We would expect investment in the systems that help people access food, prevent disease, generate scientific knowledge, and live in conditions that support health rather than undermine it. But this budget moves in a very different direction.

Food and Nutrition

This administration and its allies have spent months talking about the need for Americans to eat better. But this budget would reduce SNAP funding from $107.5 billion to $101.2 billion and cut SNAP administrative funding from $82 million to $56 million, building on last year’s Republican megabill, which already cut roughly $186 billion from SNAP over the next decade and made the program more restrictive and harder for states to administer.

It would also significantly reduce the WIC fruit and vegetable benefit, cutting it from $26 to just $9 per month for children and from $48-$52 down to just $11 per month for pregnant and postpartum participants. That amounts to a 62-75% reduction and an estimated $1.4 billion cut to the program.

It would also cut $591 million from Summer EBT benefit dollars, eliminating benefits for an estimated 4.9 million children, while cutting another $94 million in administrative funding for states. And it would eliminate the Commodity Supplemental Food Program, which currently provides monthly food boxes to more than 700,000 low-income seniors.

These programs shape whether children have consistent access to meals, whether pregnant and postpartum people can afford nutritious groceries, whether seniors can fill gaps in their diets, and whether families are forced to make tradeoffs between food and other basic needs. They influence birth outcomes, child development, household stress, and long-term chronic disease risk.

You cannot claim to prioritize chronic disease, children’s health, and nutrition while making it harder for millions of people, particularly those most at risk of poor health outcomes, to consistently access enough nutritious food.

Science and Public Health

Science and public health funding matter because this is how a country figures out what is making people sick and how to better protect people’s health. This is the funding that helps researchers study cancer, Alzheimer’s, diabetes, maternal health, infectious disease, environmental exposures, and the drivers of chronic illness. It also supports the less visible work that most people rarely think about unless something goes wrong, like tracking outbreaks, monitoring health trends, evaluating what interventions actually work, and helping communities prepare for and respond to public health threats before they become far more costly and harder to contain. A budget focused on improving the health of Americans would invest in these systems.

This budget would cut $5 billion from the NIH, a 12% reduction from the enacted FY 2026 level, including the elimination of the National Institute on Minority Health and Health Disparities, the Fogarty International Center, and the National Center for Complementary and Integrative Health. It would also cut $1.8 billion from NIAID, the institute that funds research on infectious disease, immunology, and vaccine-related science.

At the same time, it would cut $3.6 billion from the CDC, a 41% reduction, while also slashing $755.6 million from the Ending the HIV Epidemic Initiative and $70 million from programs focused on viral hepatitis, sexually transmitted diseases, and tuberculosis. It also proposes major cuts to the public health workforce, including $1.02 billion in health workforce support, as well as cuts to AHRQ and ASPR, two agencies involved in health systems research and emergency preparedness.

And beyond HHS, the proposal also goes after the broader scientific ecosystem, with a $5.2 billion cut to the National Science Foundation, a 23% cut to NASA, including a $3.4 billion cut to NASA science, a $1.6 billion cut to NOAA, and a $1.1 billion cut to the Department of Energy’s Office of Science.

The New Administration for a Healthy America

The administration does point to a set of smaller investments under its “Make America Healthy Again” agenda, which it has placed under a new entity at HHS called the Administration for a Healthy America. These include funding for nutrition services at health centers, food safety initiatives at the FDA, infection prevention efforts at the CDC, telehealth programs, and a new prevention program for Tribal communities.

In total, these MAHA-related investments amount to roughly $178 million.

But these need to be understood in context. They are being proposed inside a much larger HHS reorganization and cuts package, not as a broad new investment in population health. And even taken at face value, they are extremely small relative to the scale of the proposed cuts. The $5 billion cut to NIH alone is roughly 28 times larger than the administration’s entire MAHA investment. The $3.6 billion cut to CDC is about 20 times larger. Combined, those two cuts alone are roughly 48 times larger than the total amount being framed as an investment in “Making America Healthy Again.”

So while the administration is highlighting these smaller “health” investments, they do not come close to offsetting the broader reductions. They function more as targeted carveouts and political talking points than as a meaningful investment in the systems that actually shape population health.

Ultimately, if an administration were truly serious about making the country healthier, it would not be gutting the institutions responsible for generating scientific knowledge, tracking threats, funding prevention, and building the evidence base modern public health and medicine depend on.

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Health Policies

We know from decades of public health research that health is shaped by the broader conditions people live, including whether they have clean water, stable housing, safe air, access to heating and cooling, and environments that support health rather than undermine it.

And this budget proposes cuts to many of those things too.

It would cut the EPA by $4.6 billion, a 52% reduction, including a 90% cut to Clean Water and Drinking Water State funds, which help communities finance basic water infrastructure. It would also eliminate environmental justice programs and cut funding tied to climate and environmental health research, even as these exposures are increasingly recognized as major drivers of population health.

It would eliminate the $4 billion Low-Income Home Energy Assistance Program, which helps families keep the heat or air conditioning on, and eliminate the Weatherization Assistance Program, which lowers energy costs and makes homes safer and more livable for low-income households.

It would also cut FEMA Federal Assistance by $1.3 billion, reduce HUD by 12.7%, eliminate the $3.3 billion Community Development Block Grant, and cut housing-related supports including housing counseling and the Housing Opportunities for Persons with AIDS program, which currently receives $529 million.

A country does not become healthier by cutting clean water infrastructure, reducing protections against environmental risk, destabilizing housing, making utilities harder to afford, and weakening the systems that help communities absorb and recover from harm.

What are their priorities?

One of the most revealing things about this budget is that it is not simply cutting spending across the board. It is cutting very specific kinds of spending while increasing others.

While proposing cuts to nutrition assistance, scientific research, public health infrastructure, clean water, housing-related supports, and other systems that shape whether people can live healthy lives, this budget would increase defense spending to $1.5 trillion, including a 28% increase from FY 2026 and a 44% increase for shipbuilding, munitions, and missiles. It would also significantly increase funding for the National Nuclear Security Administration, bring new money to AI initiatives, and continue directing major resources toward immigration enforcement and other forms of state power.

Final Thoughts

The most important takeaway from this budget proposal, for me, is how clearly it shows what this administration actually prioritizes.

It proposes large cuts to nutrition assistance, biomedical research, infectious disease prevention, environmental protections, housing-related supports, and the public health infrastructure that helps keep communities safe. At the same time, it increases spending on defense, nuclear programs, AI, immigration enforcement, and other priorities tied to militarization and enforcement.

That tells us something important.

This is not an administration investing in the systems we know, from decades of evidence, actually drive health outcomes. Instead, it keeps using the language of health while repeatedly trying to defund many of the very things that evidence tells us matter most. And that matters, because if you are paying attention only to the rhetoric, you can miss what is actually happening underneath it.

What this budget makes clear is that “Make America Healthy Again” is not really functioning as a governing framework. It is functioning as branding, and more importantly, as a Trojan horse for a very different political agenda.

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With the United States government now funding functional medicine interventions through Medicare pilot programs, explicitly embedding functional medicine into nutrition competencies for medical education, and increasingly legitimizing these approaches through federal health policy, I think it’s time I talk about my experience with the loosely regulated functional medicine industry.

I was exactly the kind of person functional medicine should have appealed to.

I had spent years studying chronic disease prevention and risk reduction. My master’s degree is in exercise science, and my Ph.D. is in nutrition science in a program literally called Physical Activity, Nutrition, and Wellness. The researchers in that department studied many of the core drivers of health, including nutrition, exercise, sleep, stress, and behavior change.

So when I first learned about functional medicine a couple of years after graduate school, it sounded compelling.

My first real introduction came when I attended an Institute for Functional Medicine (IFM) conference with a company I was working with at the time.

I was genuinely excited to go. I had heard functional medicine framed as this more thoughtful, prevention-oriented model of care, one that focused on identifying and addressing the “root cause” of health problems rather than just managing symptoms. Which, on paper, was exactly the kind of thing I cared about. The idea that there might be a model of care that actually took the upstream drivers of health seriously, and built them into how we treat and prevent disease, sounded encouraging to me.

And at first, the conference seemed to reflect that. Many of the foundational ideas discussed seemed to be grounded in concepts I had studied extensively and was passionate about. But the more time I spent there, and especially once I started walking around the vendor floor, the more something started to feel off.

There were supplements everywhere. High-end testing panels for everything from hormones to gut health to “toxins,” many of which were being used in ways that lacked clear clinical diagnostic criteria and meaningful evidence to support their use. Table after table offering solutions to problems that were often vaguely defined, difficult to measure, and framed in ways that seemed to prey on people’s vulnerabilities.

Much of what I was seeing borrowed heavily from evidence-based health, but then stretched far beyond what the evidence could actually support. Practitioners in the space frequently described themselves as “early adopters,” which I came to understand often meant taking a plausible biological mechanism, sometimes one observed in a rodent study or a petri dish, and extrapolating it into confident claims about what patients should test, treat, avoid, or buy.

That conference was the first time I really started to question the functional medicine model. But what I saw at the next conference is what made the whole thing click.

I’m going to start sharing one more personal, behind-the-scenes piece per month for paid subscribers, as a way to give something a little more intimate and substantial to the people who financially support this work. This felt like the right place to start.

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Because Dr. Adams held this role during such a contentious time, I especially wanted to hear his perspective on how trust in public health has changed, why so many people feel skeptical of health institutions, and what it actually looks like to communicate science in a way that reaches people. We talked about everything from vaccines and the opioid epidemic to social media, surveillance, and the challenge of rebuilding trust in public health.

We also talked about his approach to communication, including his belief that “people need to know that you care before they care what you know,” and why empathy and meeting people where they are matter so much in this work.

And because he has actually done this job, I also asked for his perspective on the current U.S. Surgeon General nominee, Casey Means, and what he believes this role should require.

I really enjoyed this conversation, and I hope you do as well.

You can find a copy of Dr. Jerome Adams’s book, Crisis and Chaos: Lessons from the Front Lines of the War Against COVID-19, here.

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I hope everyone is having a good weekend.

We’ve been trying to take advantage of the spring weather here in Colorado and encourage our 6- and 3-year-old to become little Colorado hikers who love the outdoors. So far, it seems to be working pretty well with my son. My 3-year-old daughter, on the other hand, seems to prefer indoor activities for now, particularly anything involving crayons, dolls, or snacks. We will have to see how that goes.

Meanwhile, there has also been a lot happening this week that you may have missed, which is part of why I keep writing these roundups to help make sense of what is going on with more clarity and context.

If you find value in this work, please consider financially supporting it by becoming a paid subscriber. The support of paid subscribers in this community has helped me hire a former HHS employee, strengthen the research and reporting behind this newsletter, and create more of the kind of evidence-based analysis I think is urgently needed right now. Either way, thank you for being here.

Now let’s get into it.

Changes to Childhood Vaccine Schedule Are Paused

Last week, a federal judge blocked major recent changes to the childhood vaccine schedule and put RFK Jr.’s hand-picked vaccine advisory committee, the Advisory Committee on Immunization Practices (ACIP), on hold.

The court found that the administration likely acted unlawfully both in how it reshaped ACIP and in how it changed vaccine policy, effectively suspending the committee’s recent actions for now. That means the recent overhaul of the childhood immunization schedule is paused while the case moves forward.

Those changes had significantly narrowed the list of vaccines routinely recommended for children, including changes to recommendations for vaccines protecting against hepatitis A, hepatitis B, influenza, rotavirus, RSV, COVID-19, and meningococcal disease. The ruling also blocks the downgraded recommendation for the universal hepatitis B birth dose from taking effect for now.

The decision is a significant rebuke of the administration’s attempt to bypass the normal scientific process for vaccine policy, which has historically relied on independent expert review, public meetings, and evidence-based recommendations.

Following the ruling, ACIP vice chair Robert Malone said he would not return even if the committee is reinstated, citing internal conflict, public scrutiny, and the unpaid nature of the role.

The Trump administration is expected to appeal. But for now, the ruling preserves the prior vaccine framework and represents an important win for evidence-based vaccination policy.

For more on this, please check out the article Dr. Paul Offit wrote on his Substack this week.

USDA Cancels Land Access Program for Farmers

The USDA is canceling a $300 million program designed to help underserved farmers and ranchers access land, capital, and markets. The Increasing Land, Capital, and Market Access Program was intended to support groups that have historically faced major barriers to land ownership and federal farm support, including Black, Indigenous, immigrant, and veteran farmers.

The program funded 50 projects announced in 2023 and was meant to help address land access and financing, which are some of the biggest structural barriers in agriculture.

USDA has framed the cancellation as part of its effort to eliminate what it calls wasteful spending and DEI-driven programming. But in practice, this was a program aimed at helping underserved farmers overcome longstanding structural barriers to entering and staying in agriculture.

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CDC Director Nomination Delays

The CDC still does not have a permanent director.

Since former CDC Director Susan Monarez was fired in late August after reportedly clashing with RFK Jr. over vaccine policy, the agency has cycled through interim leadership and remained without a Senate-confirmed head. NIH Director Dr. Jay Bhattacharya has been overseeing the CDC since February, but federal law generally limits how long a vacant Senate-confirmed role can be filled on an acting basis without a formal nomination.

That deadline tied to the vacancy was reached this week, yet the Trump administration still has not announced a nominee and says that Dr. Bhattacharya will continue overseeing both the NIH and CDC for now.

The delay suggests the administration is still trying to find someone who both aligns with its political agenda and can survive Senate confirmation. That tension was on display this week when Bhattacharya, in remarks to CDC staff, called the measles vaccine “absolutely vital” for children, a straightforward public health message that nonetheless stands out in an administration that has repeatedly undermined evidence-based vaccine policy.

In the meantime, the CDC continues to operate without stable leadership while navigating staffing shortages, vaccine litigation, and a growing measles outbreak.

NIH Funding Delays Disrupt Research

Despite receiving congressional approval for funding on February 3, NIH grant awards have slowed dramatically. So far this fiscal year, which began on October 1, the NIH has awarded 66% fewer grants compared to the same period in fiscal years 2021 through 2024.

New grants and competitive renewals have seen the greatest delays, while noncompetitive renewals for ongoing projects have continued at a steadier pace. As a result, the NIH is relying on leftover funds from the previous fiscal year to keep existing research going, while universities and research institutions are left waiting to start new projects.

These delays come as the President’s Fiscal Year 2027 budget request is expected soon and is anticipated to propose a roughly 20% cut to NIH funding. If you remember, last year a proposed 40% cut was rejected by Congress.

At the same time, new research published this week found that last year’s funding cuts disproportionately affected women and early-career researchers, highlighting the broader workforce implications of funding instability.

The NIH is the largest public funder of biomedical research in the world. Funding cuts or delays can lead to delayed hiring in labs, stalled projects, and early-career scientists facing increasing uncertainty. Overall, these delays are extremely concerning and are likely to destabilize the scientific workforce.

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New Healthcare Advisory Committee Announced

HHS and CMS announced a new 18-member Healthcare Advisory Committee that will advise RFK Jr. and Dr. Oz on healthcare financing and delivery across major federal health programs.

According to the administration, the committee will focus on chronic disease, care quality, and healthcare financing, including ways to strengthen Medicare Advantage, the private insurance alternative to traditional Medicare.

The group includes healthcare executives, physicians, lawyers, policy officials, and, notably, motivational speaker Tony Robbins. Yes, the fire-walking self-help guy.

Advisory committees like this do not set policy directly, but they can influence priorities and the direction of future reforms. Given the focus on Medicare Advantage and care delivery, the recommendations from this group could shape how care is structured and funded for millions of Americans, particularly those covered by Medicare and Medicaid.

Surgeon General Nomination Remains Stalled

More than 10 months after being nominated, Casey Means still has not been confirmed as U.S. Surgeon General.

Her nomination appears to be stalled because several Republican senators remain uneasy about her views on vaccines, her clinical background, and her broader alignment with the MAHA movement. During her confirmation hearing, she repeatedly declined to clearly answer basic questions about routine vaccination, which rightfully raised concerns even among senators who might otherwise be open to supporting her. Senators Susan Collins and Lisa Murkowski have both publicly expressed reservations, and Senator Bill Cassidy has not indicated whether he will support her.

When I was in Washington, D.C. last week, this is exactly what I was hearing in meetings as well. There does not appear to be much momentum behind her nomination right now, and it remains unclear whether she will ultimately have the votes to make it through committee.

If that changes and she advances out of committee, the nomination would then move to the full Senate for a vote. But for now, it appears to be stalled.

In the meantime, people can still call their senators, especially Collins, Murkowski, and Cassidy, and make clear that they oppose this nomination and want the Surgeon General to be someone who will clearly uphold evidence-based public health guidance. You can contact your senators by calling the U.S. Capitol switchboard at (202) 224-3121 and asking to be connected to their office.

Over the last year, I’ve been keeping a running list of the actions this administration has taken that negatively impact public health, scientific integrity, and basic health protections in this country. Policies, regulatory decisions, funding cuts, institutional changes, and more. I published that list a few weeks ago.

It is overwhelming.

And in my view, it is overwhelmingly convincing. If you actually care about improving the health of Americans, it is very difficult to look at that list and conclude that this administration is doing anything other than weakening the foundations of public health, science, and health protection in the United States.

As someone who closely tracks these policies, I find it increasingly hard to believe that continued support from many MAHA advocates is still rooted in a genuine commitment to improving the nation’s health. At this point, for some, the support appears to be driven less by a grounded evaluation of what would actually improve public health and more by identity, belonging, or political and cultural alignment.

At the same time, I imagine there are likely many people who are simply seeing curated messaging about MAHA “wins” without visibility into the full range of actions this administration has taken that affect public health.

Because of this, I often look directly at MAHA-aligned platforms to understand what they consider meaningful health victories. What, in their view, justifies overlooking the steady dismantling of public health and scientific infrastructure while continuing to claim the goal is to “Make America Healthy Again”?

What do they believe are their biggest wins?

Last month provided an answer, when a list of the top accomplishments under Secretary Kennedy’s leadership was published. It was not long. Eleven items, presented as the administration’s most significant achievements in making America healthy again.

So let’s go through them, one by one.

And to ground us, a real public health win should meaningfully improve health, strengthen health protections, expand access to care or nutrition, improve patient safety at scale, or support the systems and institutions that shape population health. A press release, a voluntary pledge, a report, or a symbolic gesture is not the same thing.

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Updated Dietary Guidelines for Americans

HHS and USDA released the most significant reset of federal nutrition policy in decades with the 2025-2030 Dietary Guidelines for Americans.

This is not a meaningful public health win.

First, the administration bypassed the normal transparent process used to develop the Dietary Guidelines. The independent Dietary Guidelines Advisory Committee spent two years reviewing the scientific evidence and producing a comprehensive report. Instead of following that process, the administration rejected that report and produced its own shortened review with several contributors who have documented ties to the meat and dairy industries. This from the “rooting out conflicts of interest” crew.

Second, the inverted pyramid visual released alongside the guidelines does not clearly align with the written recommendations and heavily emphasizes animal foods in ways that do not reflect the broader scientific consensus on healthy dietary patterns.

Lastly, aside from the meat-heavy visual representation, the underlying recommendations themselves are largely unchanged. The guidelines still recommend prioritizing fruits and vegetables, whole grains, a variety of plant and animal protein sources, limiting added sugars and sodium, and keeping saturated fat below 10% of total calories.

The biggest problem with the dietary guidelines has never been the guidance itself. It’s that almost no Americans actually follow them.

I wrote a much more detailed breakdown of the new guidelines, the historical revisionism around the food pyramid, and the contradictions between the written guidance and the visual here.

Food Dyes

Approximately 40% of the food industry has pledged to voluntarily phase out synthetic dyes.

This is also not a meaningful public health win.

First, these are voluntary pledges from food companies, not regulatory actions. Companies can announce plans to phase out synthetic dyes without any enforceable requirement to follow through, and without any meaningful oversight from regulators.

Second, replacing synthetic dyes with natural colorings does not meaningfully change the nutritional quality of the products where these dyes are typically used. Food dyes are most commonly found in candy, soda, desserts, and sugary cereals. Swapping one coloring agent for another does not reduce added sugar, improve nutrient density, or meaningfully change the role these foods play in the diet.

Third, despite framing this as a major crackdown on food dyes, the administration has not actually banned any synthetic dyes. Instead, it has relied on voluntary industry pledges while approving additional “natural” color additives for use in foods, meaning the total number of approved food dyes has actually increased.

Actual regulatory bans would require scientific evidence demonstrating that these dyes pose a safety risk under their approved uses. That evidence has not been established. This is why food safety authorities around the world, including those in Canada, the European Union, Australia, and New Zealand, have evaluated the same synthetic dyes used in the United States and determined that they are safe at current exposure levels.

In other words, this “win” largely amounts to changing the color of ultra-processed products without meaningfully changing their nutritional quality or likely health impact.

Updated Childhood Immunization Schedule

The updated childhood vaccination schedule now emphasizes informed consent and gold-standard science.

This is a major departure from evidence-based vaccination policy and a move that undermines decades of scientific and medical consensus on childhood immunization.

In RFK Jr.’s confirmation hearing he said “I support the childhood vaccine schedule.” This statement makes sense because the childhood vaccine schedule was backed by evidence-based research and by leading medical organizations. Yet, earlier this year, RFK Jr. reduced the number of routinely recommended vaccines on the childhood schedule. This change bypassed the established process for changing federal vaccine recommendations, which usually includes internal reviews with CDC experts, and a public hearing through the Advisory Committee of Immunization Practices.

The vaccines removed from routine universal recommendation on the childhood schedule were hepatitis A, hepatitis B, meningococcal disease, rotavirus, influenza, and COVID-19. These vaccines were changed to the “shared clinical decision-making” designation, which means individuals could benefit from vaccination, but broad vaccination is “unlikely to have population-level impacts.”

Hepatitis B was not only removed from the recommended vaccine list, the universal birth dose vaccination recommendation ended. Now it is only recommended for high-risk babies. The newborn dose reduces infant hepatitis B by 99%, and when given within 24 hours of birth, it is about 90% effective in preventing mother-to-child transmission.

Due to the lack of evidence that the new childhood vaccine schedule is beneficial, major medical organizations such as the American Academy of Pediatrics still recommends the old vaccine schedule for all children.

This was not a public health win. It was a politically driven departure from established vaccine policy with the potential to reduce population-level protection against preventable disease.

As such, on March 16, 2026, a federal judge blocked these changes while the legal challenge moves forward.

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The MAHA Report and Strategy

The MAHA Commission Report & Strategy presented a historic assessment of public health in the United States and actions to address the childhood chronic disease crisis.

This is not a public health win. It is simply the release of a report.

Publishing a report does not improve health, strengthen public health systems, expand access to care, or implement any meaningful policy. It is not an achievement. It is messaging.

And the report itself immediately raised credibility concerns. Several citations appear to have been AI-generated hallucinations, referencing papers that did not exist. That alone should raise serious questions about the rigor of the process behind it.

More broadly, the report reads less like a careful scientific assessment and more like an effort to validate a set of preexisting MAHA beliefs. It leans on familiar talking points, elevates pseudoscientific or conspiratorial explanations, and largely ignores the well-established structural drivers of health, including healthcare access, economic conditions, environmental exposures, and the broader systems that shape the food environment.

The accompanying strategy document is similarly thin on substance. It offers a long list of ideas but little detail about implementation, evidence, or how any of it would meaningfully improve population health. Some of what it describes reflects work federal agencies were already doing. Other parts directly contradict the administration’s own actions to weaken public health and scientific infrastructure.

In other words, this is not a policy achievement. It is an ideological messaging document.

Rooting Out Waste, Fraud, and Abuse in Healthcare

HHS froze access to federal funds for five states and in three programs after serious concerns about fraud and misuse of taxpayer dollars.

I honestly cannot believe they included this as a “win.”

If there is any indication that this list is short on real accomplishments, it’s that freezing funding for social assistance programs — without presenting evidence of fraud and in a move that was quickly blocked by a federal judge — is somehow being presented as a public health victory.

What the administration is referring to here is a decision by HHS to freeze access to federal funds for five states — California, Colorado, Illinois, Minnesota, and New York — across three programs: the Child Care and Development Fund (which helps low-income families afford childcare), Temporary Assistance for Needy Families (cash assistance for families in poverty), and the Social Services Block Grant (which funds services for children, elderly people, and other vulnerable populations). These programs exist specifically to support some of the most economically vulnerable people in the country.

The administration justified the freeze by claiming there were “serious concerns” about fraud and misuse of funds. But when the action was announced, no detailed evidence of widespread fraud in these states or in these programs was presented publicly.

Not surprisingly, the states sued. And within three days, a federal judge issued a temporary restraining order blocking the funding freeze. So the “win” they are claiming lasted about three days before being stopped by the courts.

In Minnesota, there was a large pandemic-era fraud case involving a nonprofit called Feeding Our Future, which submitted fraudulent reimbursement claims for meals that were never actually served to children through a federal COVID child nutrition program. But that scheme was uncovered years ago and has already been extensively investigated and prosecuted by federal authorities. Dozens of people were charged beginning in 2022, and many have since pleaded guilty or been convicted. In other words, the fraud was detected and dealt with through the normal legal process. More importantly, that case involved a temporary pandemic child nutrition reimbursement program, not the childcare, cash assistance, or social services programs that the administration attempted to freeze funding for across these five states. And no comparable evidence of fraud was presented in any of the other states, suggesting this past, already-prosecuted case in a single state is now being used as political justification for withholding funding from several Democratic-led states.

In other words, this was not a health policy reform, a fraud prevention system, or a meaningful protection of taxpayer dollars. It was an attempt to withhold funding from programs that support low-income families in Democratic-led states — an action that courts immediately blocked because the justification was unsupported.

Calling that a MAHA “win” is absurd.

$50 Billion to Strengthen Rural Health

All 50 states will receive awards under the Rural Health Transformation Program, marking the largest investment in rural health in the country’s history.

This is not a meaningful investment in rural healthcare. It is an attempt to soften the impact of the administration’s own Medicaid cuts.

The Rural Health Transformation Program was included in the Big Beautiful Bill after more than $900 billion was cut from Medicaid, the primary program that keeps many rural hospitals financially viable. Those cuts are expected to lead to millions of people losing coverage, higher costs for others, and hospital and nursing home closures, particularly in rural communities that depend heavily on Medicaid funding. In other words, the administration cut the core financing structure that sustains rural healthcare systems, then allocated a much smaller pool of funding to help stabilize the damage.

Framing that as a historic investment is highly misleading. You do not get to slash the foundation rural healthcare depends on and then call partial stabilization funding a major health victory.

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HHS Bars Hospitals From Performing Sex-Rejecting Procedures on Children

HHS took action to protect children from medical centers that provide minors with treatments that deny biological reality.

This is not a clear public health win. It is a proposed restriction on medical care that runs counter to the positions of major medical organizations and is not even finalized policy.

HHS announced a set of proposed rules that would prohibit hospitals receiving Medicare and Medicaid funding from providing gender-affirming care to minors, including puberty blockers, hormone therapy, and surgical interventions. It would also prohibit Medicaid and the Children’s Health Insurance Program from covering this care. Because most hospitals rely on federal funding, the practical effect would likely be widespread loss of access to this care if the rule were finalized.

But it is important to be clear about what this is and what it is not. This is a proposed rule, not an implemented policy. It still must go through the federal rulemaking process, including public comment, and will almost certainly face significant legal challenges. A judge has already ruled that HHS overstepped in declaring these treatments unsafe. More importantly, this move runs counter to the positions of major medical organizations, which support access to gender-affirming care for minors when determined appropriate by patients, families, and their healthcare providers.

Even setting aside the broader political and cultural debate, a proposed rule that restricts access to evidence-based medical care for a specific group is not, on its own, a meaningful public health achievement. And it is certainly not a finalized one.

SNAP Waivers

22 SNAP waivers have been signed, empowering states to strengthen nutrition standards.

At first glance, this feels like a public health win. The idea of limiting soda and candy purchases with SNAP benefits is intuitively appealing, because most of us would agree that less soda and candy consumption is a good thing.

But while this has been debated in public health for years, we still do not have strong evidence that restricting specific foods within SNAP meaningfully improves diet quality or health outcomes.

That matters even more because these waivers are being paired with roughly $186 billion in SNAP cuts, which makes it much harder to view this as a serious nutrition policy and much easier to view it as part of a broader effort to make the program smaller, more restrictive, and easier to cut.

If the real goal were to improve diet quality, policymakers would be increasing benefit adequacy, expanding fruit and vegetable incentives, and strengthening programs like SNAP-Ed, which is specifically designed to support healthier eating, not completely cutting it while layering new restrictions onto the program.

When you pair the lack of evidence behind these restrictions with major cuts to SNAP, including its nutrition education arm, and the absence of investment in strategies we know can improve diet quality, this is not a meaningful public health win. It is a politically popular restriction layered onto a broader effort to weaken one of the country’s most important anti-hunger programs.

Full Safety Disclosures in Drug Ads

HHS and FDA announced a major reform requiring drug companies to include full safety warnings in all of their direct-to-consumer ads.

This is a policy initiative and rule making intention, not a meaningful public health victory.

The Full Safety Disclosures in Drug Ads memorandum aims to close a 1997 regulatory loophole known as “adequate provision,” which allows drug advertisements to highlight only a brief set of major drug risks in direct-to-consumer ads while directing viewers to websites or toll-free numbers for full safety information. HHS and FDA argue that the adequate provision “conceals critical safety risks” in ads, which contributes to over-prescription and erodes public trust.

If implemented as described, the final rule could improve transparency by requiring more complete and clearly presented safety information within drug ads, rather than directing consumers elsewhere for full details. This could modestly address the long-standing imbalance in advertising, where benefits are often emphasized more clearly than risks.

But this is ultimately a reform to the content of prescription drug ads, not the broader system that allows prescription drugs to be marketed directly to consumers in the first place. The United States remains one of the only countries in the world that permits this kind of advertising, so this does not solve the larger structural issue. Still, if implemented as described, requiring more complete safety disclosures in ads could be a meaningful improvement in transparency and a step in a better direction.

Funding for AI-Backed Childhood Cancer Research

HHS is doubling funding for its Childhood Cancer Data Initiative at the National Cancer Institute from $50 million to $100 million.

This is a positive step, but it is being framed in a way that dramatically overstates its significance.

The Childhood Cancer Data Initiative was launched in 2019 to improve how pediatric cancer data are collected, shared, and analyzed so researchers can better study rare childhood cancers. HHS’s announcement last year expands that effort by increasing funding and supporting researchers and private sector partners using AI and data tools to accelerate discovery. That is not a bad thing. Better data infrastructure can help researchers work more effectively. But this is not a transformative public health achievement, and it should not be framed that way.

First, the funding increase is relatively small in the context of the broader federal biomedical research system. NIH’s annual research budget is tens of billions of dollars, meaning a $50 million increase, while worthwhile, is modest. Second, this funding is primarily directed toward data infrastructure, analytics, and research coordination, not directly toward clinical trials, treatment development, or improving access to care for children with cancer. And third, it cannot be viewed in isolation from the administration’s broader weakening of the federal research enterprise. Throughout 2025, thousands of federal research grants were delayed, frozen, or cut, and thousands of research staff were fired or left their positions. A relatively small funding increase for one initiative does not offset broader damage to the scientific system that supports medical progress.

In other words, this is a worthwhile but limited research investment, not a major “make America healthy” victory.

Organ Donation Reform

HHS took action to reform the organ transplant system to protect patient dignity and honor the sanctity of life.

This is a net positive ethical and patient safety improvement.

Building on efforts from the Biden administration to modernize the Organ Procurement and Transplantation Network, a federal investigation found that some Organ Procurement Organizations (OPOs) violated established organ donation protocols. The violations raised serious ethical and legal concerns, including questions about consent and cases where organ procurement preparations began before death determination was established.

In response, HHS announced reforms that strengthen organ procurement safety and oversight. The reforms include new safety rules allowing any staff involved in a potential donation to halt the process if they have safety concerns, tighter protocols for determining death status and confirming consent, and stronger accountability for OPOs, including decertification for unsafe OPOs.

This is a real patient safety and ethical improvement. That matters. But this is not a major “make America healthier” victory, nor is it any kind of meaningful public health win.

Final Thoughts

As someone who genuinely wants to make America healthier, I find this list of year one “achievements” both frustrating and revealing.

Many of these so-called “wins” are not meaningful public health achievements at all. They are symbolic gestures, ideological moves, voluntary corporate pledges, reports, proposed rules, or small initiatives framed as transformational while the administration simultaneously weakens the very systems that actually shape health, including food access, healthcare access, environmental protections, scientific institutions, public health infrastructure, and social supports.

If this is the strongest list of accomplishments available, that is not evidence of a serious health agenda. It is evidence of a branding and messaging strategy designed to distract from the far more consequential policies being enacted.

And that is the central problem with MAHA. It packages cultural grievance, anti-establishment rhetoric, and symbolic gestures as health policy while doing very little to materially improve the conditions that actually make people healthy.

If you found this helpful and want to support this kind of work, consider becoming a paid subscriber. Your support helps me keep spending the time it takes to research, write, and share pieces like this, and I’m genuinely grateful for it. Thank you for being here.

What We Covered

• Why birth has become such a common target for misinformation online

• Some of the biggest myths people are hearing right now, and how social media can make it harder to know what is actually evidence-based information

• Common questions about labor and delivery, including inductions, epidurals, vaginal births after cesarean (VBAC), Pitocin, continuous fetal monitoring, eating during labor, and the idea that interventions are always something to fear

• Whether lower-intervention models of care, including midwifery, should be more integrated into mainstream maternity care

• Whether there is any benefit to consuming your placenta

• How people can better evaluate the pregnancy and birth information they come across online, and what to look for when trying to figure out whether something on social media is actually credible

Why it Matters

Pregnancy and birth are deeply personal experiences, but they are also shaped by the quality of information, support, and care people receive. Dr. Lincoln explained what respectful maternity care actually looks like in practice, how patients can recognize when they’re not receiving it, and what red flags to pay attention to in prenatal care.

This conversation was a reminder that understanding your options and knowing what questions to ask can make pregnancy and birth feel far less overwhelming. I really enjoyed this conversation and I hope you do as well.

Get a copy of Dr. Jennifer Lincoln’s new book, The Birth Book: An OB-GYN’s Guide to Demystifying Labor and Delivery here.

If you found this helpful and would like to support the work I do here, please consider upgrading to become a paid subscriber. Every new subscriber helps me reach more people and do more of this work. Thank you.

I can’t believe it’s mid-March already. While last year felt like it dragged on forever, almost like several years compressed into one, for whatever reason this year seems to be flying. Anyone else feel that way?

I’m headed to New York and Washington, D.C. this week to record a podcast with one of the great science communicators of our time, attend a science conference and speak on a panel about combating misinformation in the online space, and then head to Capitol Hill to meet with members of Congress about evidence-based public health policy.

Weeks like this are a reminder of why I started writing this newsletter in the first place. There is a lot happening right now across public health, food policy, and science that rarely gets explained clearly or in context, even though these decisions affect millions of people.

Before we dive in, I want to say thank you to the paid subscribers who support this work. Your support makes it possible for me to spend the time researching and writing these analyses, and it’s also what allows me to bring evidence-based perspectives into spaces like the meetings I’ll be having this week.

This work is entirely reader-supported. If you find value in the analysis and context I share here, becoming a paid subscriber is the best way to support it.

Now let’s take a look at some major recent events.

The Farm Bill Advances Out of House Agriculture Committee

The House Agriculture Committee just advanced the 2026 Farm Bill, which means it’s now heading to the full House for a vote. Like most Farm Bills, it will probably face a lot of debate and revisions as it moves forward.

If you’re not familiar, the Farm Bill is one of the biggest pieces of legislation shaping the U.S. food system. It determines funding for programs like SNAP, supports farmers, and heavily influences what crops are grown across the country. It’s typically renewed every five years, but the last one actually expired in 2023. Since then, Congress has just been passing temporary extensions of the 2018 Farm Bill while they try to negotiate a new one.

There are a couple things worth noting about this proposal. It does not restore any of the SNAP cuts made in the One Big Beautiful Bill, and it keeps existing liability protections for pesticide companies that some MAHA advocates have been pushing to remove. While the One Big Beautiful Bill included some additional funding for farm programs, the Farm Bill is still the legislation that sets the structure for most U.S. agriculture and nutrition policy.

As in previous bills, the proposal focuses subsidies on six primary crops: corn, wheat, cotton, rice, soybeans, and peanuts. These subsidies strongly influence what farmers grow. Corn alone is expected to receive just under 35% of total commodity support.

So while the Farm Bill might sound like something that only affects farmers, it actually shapes the entire U.S. food system. Decisions about SNAP funding and agricultural subsidies ripple outward to affect food security, public health, farming practices, and even the environment.

We will be watching closely to see how this bill changes as it moves through the House.

FDA Advisory Committee Recommends Fall Flu Vaccine Strains

For the first time in over a year, the FDA’s Vaccine and Related Biological Products Advisory Committee (VRBPAC) met this week to recommend influenza strains for the upcoming fall flu vaccine. The VRBPAC is composed of infectious disease and immunology experts who review vaccine data and provide independent recommendations to the FDA.

Last year, the FDA cancelled the committee’s meeting and chose vaccine strains in a closed meeting without input from independent experts. This decision raised concerns among public health experts about transparency and scientific oversight.

At this week’s meeting, the committee endorsed the World Health Organization’s recommended strains, including the new strain known as “subclade K” that emerged this past flu season. These recommendations are important because flu vaccines take months to produce, and getting the strain selection right can have impacts on health outcomes. Even during this past season when the vaccine wasn’t well matched, flu vaccination reduced the risk of hospitalization by over 30% overall.

Ultimately, FDA commissioner Marty Makary will make the final decision on which strains manufacturers will include in the fall 2026 flu vaccine.

HHS Announces Nutrition Education for Medical Schools

This week, HHS announced that 53 medical schools made “voluntary commitments” to include 40 hours of nutrition education in their curricula. They also released 71 nutrition competencies intended to guide that training. While many of these are core nutrition competencies you would expect in a basic curriculum, the administration added several that suggest an effort to turn medical doctors into dietitians, and slipped in a number of concerning competencies that promote non-evidence-based and pseudoscientific nutrition ideas. For an in-depth analysis of the competencies informing the curriculum, see Dr. Kevin Klatt’s article here.

I generally think that evidence-based nutrition education is a good thing for some medical specialties, but the most meaningful improvements would come from better integrating nutrition expertise into the healthcare system itself. Physicians should be able to recognize nutrition-related health issues, understand the basics of nutrition science, and, most importantly, know when and how to refer patients to Registered Dietitians, who remain underutilized members of the healthcare team.

But to be clear, simply adding truncated nutrition education to an already overburdened healthcare workforce won’t fix the systemic issues in U.S. healthcare. Physicians already face intense workloads, and our for-profit healthcare system often fails to adequately reimburse nutrition services through insurance, limiting how often doctors can realistically integrate nutrition into patient care. Without structural changes in how care is delivered and reimbursed, the impact of these educational initiatives will likely remain limited.

Certainly, expanding coverage for Registered Dietitian services and strengthening preventative care systems would better utilize existing experts and could lead to stronger health outcomes.

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SNAP Waiver Lawsuit

The USDA has approved SNAP waivers in 22 states that restrict the purchase of certain foods and drinks, including candy, packaged desserts, soda, sugar-sweetened beverages, and energy drinks, depending on the state.

On Wednesday, SNAP recipients in five states filed a lawsuit challenging the waivers, arguing that the restrictions exceeded the government’s legal authority and harms households that rely on the program. The lawsuit also argues that restrictions weaken SNAP by creating confusion about what foods are eligible and by imposing additional administrative burdens on retailers and participants.

“I am finding Iowa’s food restriction waiver extremely complicated to navigate,” Marc Craig, a plaintiff from Iowa said in a press release. “When I shop for food, I have to read the ingredient list on everything I buy to try to figure out if I can use SNAP to buy it. I still get to the register only to be told I cannot use SNAP to buy everything I have selected.”

It will be interesting to see what happens with these lawsuits, but these reports are exactly what many predicted. Restrictions can make the program harder to navigate, and when programs become more complicated, some eligible people simply opt out, even if they need the support. At a time when one-third of Americans report cutting back on healthcare because of the rising cost of food, groceries, and gas, adding complexity to the country’s largest and most effective anti-hunger program is unlikely to improve health outcomes.

The U.S. Votes “No” to Women’s Rights Document

This week, the United States cast the only “no” vote on a global women’s rights document at the UN Commission on the Status of Women. The resolution still passed, but the vote marked a significant break from decades of consensus.

The Commission on the Status of Women is the UN’s primary body dedicated to advancing gender equality. Since its creation in 1946, it has played a central role in shaping global standards on women’s rights and empowerment.

Each year, the commission meets to assess progress and negotiate a document known as the “Agreed Conclusions,” which outlines shared global priorities for advancing gender equality. While not legally binding, the conclusions help guide international policy and funding for gender equality initiatives.

For nearly three decades, these conclusions have been adopted by consensus, meaning all member states agreed to the final language without a formal vote. This year was different.

After negotiations, the United States sought to remove references to gender and reproductive health, arguing the language promoted “gender ideology” and implied abortion rights. When those amendments were rejected by other member states, the document went to a vote.

It passed 37–1, with the United States casting the only “no” vote and six countries abstaining, including Côte d’Ivoire, the Democratic Republic of Congo, Egypt, Mali, Mauritania, and Saudi Arabia.

While the outcome may not be entirely surprising given the U.S. withdrawal from UN Women earlier this year, the vote is still diplomatically significant. It breaks with decades of consensus and highlights a growing divide in global gender policy.

Certainly not an encouraging signal for the future of global cooperation on women’s rights.

Dr. Sekhon shared her own fertility journey and what inspired her to become a fertility specialist. We also talked about how surprisingly little many of us learn about reproduction and fertility growing up. She explained when someone should consider seeing a fertility specialist and how age factors into that decision.

Because fertility and women’s health have become popular topics on social media, we also spent time talking about the growing amount of misinformation circulating online. We discussed common myths about birth control and infertility, as well as whether lifestyle factors such as diet, supplements, and the environment actually influence fertility.

Finally, Dr. Lucky emphasized the importance of education, protecting your mental health, and building a strong support system when navigating the fertility journey. For many people, having accurate information and emotional support can make all the difference when going through the process.

I learned a lot in this conversation, and I hope you do as well. And if you know someone who might be navigating fertility challenges or could use a little support right now, consider sharing this with them.

You can find a copy of Dr. Lucky Sekhon’s new book, The Lucky Egg, here.

If you found this helpful and would like to support the work I do here, please consider upgrading to become a paid subscriber. Every new subscriber helps me reach more people and do more of this work. Thank you.

On Saturday, The Lancet, one of the world’s oldest and most respected medical journals, published an editorial titled “Robert F. Kennedy Jr: 1 year of failure,” an unusually direct rebuke of a sitting U.S. Secretary of Health and Human Services by a leading global scientific journal.

Importantly, The Lancet does not typically publish year-in-review condemnations of individual U.S. cabinet officials. Its editorials are unsigned and represent the voice of the journal itself, meaning they are institutional statements, not guest opinions. And while the journal has long taken positions on global health policy, war, climate change, and public health funding, directly assessing a sitting HHS Secretary’s first year in office in this way is highly unusual.

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Weakened Guardrails

The editorial begins by revisiting Kennedy’s first speech as Secretary, in which he promised to restore public trust in federal health institutions through transparency, gold-standard science, and ethical leadership. It then walks through a series of actions taken during Kennedy’s first year as Secretary of Health and Human Services, most of which directly contradict his promises and message.

For example:

• Ten days after promising transparency, HHS rescinded a 54-year-old policy of soliciting public comment on new rules and regulations.

• Advisers and experts were dismissed.

• A whistleblower was fired.

• Policy changes were communicated through paywalled outlets rather than standard public channels.

• Thousands of public health datasets on drug overdoses, maternal mortality, and food security are no longer publicly available.

Taken together, these reflect a shift away from institutional process and toward centralized, personality-driven governance. But public health agencies are not supposed to be personality-driven institutions. They are supposed to be structured, procedural, and governed by norms.

For example, public comment periods exist so stakeholders can weigh in and there can be full transparency. Advisory committees exist to bring independent experts into the decision-making process, so policy is informed by subject-matter expertise rather than political preference. Public health data are made public so independent researchers can analyze trends, states can allocate resources, and agencies can be held accountable for their decisions. And scientific reports exist so agencies can assess evidence and communicate health risks transparently, even when those risks implicate powerful industries or complicate political narratives.

This last year, we have seen each of these safeguards eroded in different ways.

Changing Scientific Priorities

The editorial then turns to substantive scientific and regulatory shifts, noting that under Kennedy’s leadership:

• NIH programs studying the health effects of air pollution were canceled, despite decades of evidence linking air pollution exposure to cardiovascular disease, asthma, adverse pregnancy outcomes, and cognitive decline.

• A federal report linking alcohol consumption to cancer was withheld, even though alcohol is internationally classified as a known human carcinogen.

• The FDA withdrew warnings about products such as raw milk and chlorine dioxide being falsely marketed as treatments for autism, despite established safety concerns.

• Changes at CDC have led 26 states to reject official vaccine guidance, fracturing what has historically been a relatively unified national immunization framework.

And then there is the Guinea-Bissau study.

In December, the CDC awarded a $1.6 million grant to conduct a vaccine study in Guinea-Bissau that critics argued could have risked exposing unvaccinated children to hepatitis B. The ethical concerns were significant enough that some observers compared the proposal to the Tuskegee Syphilis Study, which is one of the most infamous violations of research ethics in U.S. history. Officials in Guinea-Bissau have since stopped the study from moving forward based on those ethical concerns.

The editorial argues that this pattern represents a broader reordering of federal science priorities, writing that Kennedy has “made a habit of throwing good money after bad science” and describing a shift in which:

• Cutting-edge areas of inquiry, including mRNA vaccine development, diabetes research, and dementia, face funding constraints or stalled progress.

• Projects and narratives aligned with Kennedy’s long-standing ideological positions, which they call “junk science” and “fringe beliefs” receive disproportionate attention.

• Standards for what qualifies as rigorous, evidence-based science appear inconsistently applied across agencies.

And, as they point out, this is happening in the middle of real, ongoing public health challenges.

In November 2025, the first recorded human infection and death from the H5N5 strain of avian influenza was reported in Washington state. Pertussis continues to spread. And a measles outbreak that began last year now threatens elimination status in both the United States and Mexico.

Why This Matters

For the past year, many scientists, public health officials, and career staff inside and around our public health agencies have been raising concerns about sidelined advisory committees, altered guidance, research priorities shifting in ways that feel ideological rather than evidence-driven, data becoming harder to access, and ethical boundaries being tested.

Now, one of the world’s most respected scientific journals is echoing those concerns in an unusually direct way.

When The Lancet publishes an editorial like this, it suggests that concerns raised within the United States are being recognized more broadly as structural questions about the stability of institutions that shape global health.

Importantly, the editorial is not simply disagreeing with partisan policy choices. It is arguing that the guardrails designed to keep public health institutions stable and evidence-driven are being weakened, and that the consequences of that weakening may “take generations to repair.”

The piece concludes by calling on Congress to exercise its duty of oversight and hold Kennedy accountable for his record.

Congress should take that responsibility seriously.

If you found this helpful and would like to support the work I do here, please consider upgrading to become a paid subscriber. Every new subscriber helps me reach more people and do more of this work. Thank you.

On Monday, The Heritage Foundation hosted an event celebrating one year of the Make America Healthy Again (MAHA) movement, featuring RFK Jr. and Heritage President Kevin Roberts. While on stage, RFK Jr. did what he often does and reframed a discussion about scientific evidence into a discussion about distrusting “experts.”

“Trusting the experts,” he said, “is not a feature of democracy and it's not a feature of science. It's a feature of religion and totalitarianism. Not of democracy.”

Huh?

This statement is, of course, ridiculous. But more than that, it is a deliberate attempt to confuse the public, because it only works if the audience accepts the false premise that individual experts and scientific consensus are the same thing. They are not, and RFK Jr.’s movement relies on people either not understanding that distinction or deciding it does not matter.

An individual expert is a person. A human being. Sometimes biased. Sometimes wrong.

Scientific consensus is something else entirely. It is the accumulated weight of evidence across many independent researchers, institutions, countries, and methods, tested and retested over time. It is not authority. It is process.

RFK Jr. blurs this distinction on purpose. Because once you convince people that “experts” and “scientific consensus” are interchangeable, you can attack consensus science by attacking experts. And once trust in consensus is weakened, you can elevate a small number of dissenting voices and present them as equally valid, regardless of the quality or quantity of evidence behind them.

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What Makes an Expert Trustworthy

The question is not whether a scientific or medical expert has credentials. It is whether their claims are anchored in the scientific process and the accumulated weight of evidence.

A trustworthy expert:

• Grounds claims in the broader body of evidence, not isolated findings

• Acknowledges uncertainty, complexity, and limits in the data

• Aligns with the convergence of evidence across independent research groups

• Situates claims within the broader scientific consensus rather than relying solely on personal interpretation

• Updates views when new evidence emerges

For example:

An infectious disease physician that references converging data across countries, consistent findings across studies, and agreement among major scientific organizations.

A nutrition scientist who bases conclusions on the full weight of global evidence and clearly communicates both what the research shows and where it is still uncertain.

Trustworthiness comes from adherence to process, not from title, platform size, or confidence.

What Makes an Expert Untrustworthy

Credentials alone do not guarantee reliability. An expert becomes untrustworthy when they step outside the scientific process and replace evidence with ideology or narrative.

An untrustworthy expert:

• Dismisses scientific consensus without strong evidence

• Cherry-picks data while ignoring the full body of research

• Frames disagreement as proof of corruption rather than part of scientific inquiry

• Claims hidden or suppressed knowledge

• Relies on anecdotes, isolated studies, or sensational claims

• Promotes expensive solutions unsupported by robust evidence

For example:

A scientist who rejects the broader scientific consensus and suggests a vaccine is unsafe based on selective data, isolated studies, or anecdotal reports rather than the full body of evidence.

A medical doctor who repeatedly promotes new “miracle” supplements on a podcast or television show, making sweeping claims unsupported by rigorous, consistent scientific evidence.

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Why This Distinction Matters

In fields like medicine and science, expertise is essential for interpreting evidence, understanding uncertainty, and translating research into real-world decisions. A functioning society depends on people who have spent years developing this kind of expertise, and credentials often signal that training. But, of course, credentials do not guarantee accuracy or reliability. And when people with those credentials step outside the scientific process and use their titles to project authority rather than ground claims in evidence, they can do some of the greatest harm, because they are no longer grounding claims in evidence but instead using perceived authority to lend credibility to ideas that are weak or unsupported.

When RFK Jr. tells the public not to trust experts, what he is actually doing is encouraging distrust of evidence-based consensus so that when he elevates his own chosen “experts” expressing contrarian, unsupported, or anti-scientific views, those claims can be treated as equally credible.

This is why the distinction between individual experts and scientific consensus matters.

Scientific consensus is not the opinion of a single expert, nor is it an expression of authority. It reflects the accumulated weight of evidence across independent researchers, methods, populations, and institutions, tested and retested over time. It is built through replication, convergence, and the self-correcting nature of science. Individual experts can and do disagree, especially as evidence is still evolving, but isolated dissent is not equivalent to the broader body of accumulated evidence.

When that distinction is blurred, the hierarchy of evidence collapses, and consensus science begins to appear interchangeable with isolated claims, regardless of how much evidence supports each. This then opens the door for opinion and ideology to be presented as equal to scientific evidence, and for conclusions to be shaped by ideology, belief, and persuasion.

A pseudoscientific grifter’s dream.

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Let me start with some good news. Early last week, after several healthcare providers in Minnesota reached out to me, I made a video to help raise funds for the Hennepin Healthcare pediatric mobile unit. The unit was experiencing a sharp increase in demand from the community, as many families were avoiding traditional healthcare settings due to ICE activity and ongoing reports of detentions and violence.

Yesterday, I received an email from their philanthropy director. Together, we raised $590,524 from 7,465 donors across the United States and around the world to help expand medical services in the Minneapolis community. These contributions have made it possible for the mobile unit to operate seven days a week through the end of 2026, extending care to young families and prenatal mothers who need it most. Beyond medical services, the team is now delivering prescriptions, food, diapers, and essential supplies to help families stay safe and supported in their homes.

I am honestly overwhelmed by the generosity behind this. Thousands of people chose to show up for families they will never meet, and because of that, children will receive care, mothers will have support, and families will be able to stay safe during a moment of real fear and uncertainty. It’s rare to see something move this quickly from concern to meaningful, tangible impact, and I am deeply grateful to everyone who made it possible.

Before we turn to recent news stories, I also want to acknowledge something important. Work like this, and the ability to respond quickly when moments like this arise, is only possible because of reader support. To the paid subscribers here, thank you. Your support allows me to remain fully independent and continue producing thoughtful, evidence-based analysis with honesty and clarity. If you are able, I hope you will consider becoming a paid subscriber. This work is reader-supported, so if you find it valuable, your support truly makes it possible.

Now let’s dive in.

1. Government Shutdown and ICE Funding

Last week, Congress was expected to pass a funding package to keep the federal government operating through September ahead of the late-January deadline. The proposal included full-year funding for most agencies but became politically contentious after the killing of Alex Pretti, when Democrats said they would not support continued funding for the Department of Homeland Security without reforms to immigration enforcement.

On January 31, the Senate passed a compromise package funding most of the government through September while extending DHS funding for two weeks, through February 13, to allow negotiations to continue. Because the House had not yet acted on the measure, a partial government shutdown began over the weekend. However, the House passed the bill earlier this week, ending the shutdown.

Congress now has about one week to reach an agreement on DHS funding and potential reforms to immigration enforcement before funding expires again.

2. Vaccine Information and Policy

Over the past year, the Trump administration removed thousands of federal websites and health databases. A new study published in the Annals of Internal Medicine showed that of 82 CDC databases previously updated monthly, 38 have been paused, and 34 of those haven’t been updated in over 6 months.

Notably, all 33 of the CDC databases that reported vaccine rates are among those that are paused. That matters because public health officials rely on these databases to track outbreaks early, identify at-risk communities, and target vaccination campaigns. And without real-time data, outbreaks become harder to control and preventable illnesses are more likely.

This year, we have also seen significant changes to vaccine policy, including the removal of six vaccines from the routine childhood schedule. In response, the American Academy of Pediatrics (AAP), for the first time, released a vaccine schedule that differs from the CDC’s, and the majority of states have declined to adopt the HHS changes.

On a global scale, Gavi, the Vaccine Alliance, which supports vaccine access in low-income countries, continues to face funding threats from the United States. Last year, the U.S. withdrew funding from Gavi, and last week the Trump administration indicated it would cut additional support unless Gavi stops using thimerosal, a mercury-containing preservative used in small amounts in some vaccines to prevent microbial contamination. The World Health Organization has repeatedly concluded that thimerosal is safe and does not cause harm. Robert F. Kennedy Jr., however, has continued to claim, without credible scientific evidence, that thimerosal is linked to autism.

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3. HHS Appoints New Autism Advisory Committee Members

HHS recently appointed 21 new members to the Interagency Autism Coordinating Committee (IACC), which advises the Secretary of Health and Human Services on federal autism policy and research. Several of the new appointees have publicly rejected well-established scientific evidence showing that vaccines do not cause autism. The committee also lacks representation from major autism advocacy organizations and experienced autism researchers.

Historically, the IACC has guided federal autism research through a balance of scientific expertise, advocacy input, and family perspectives. This year’s committee includes fewer members with relevant experience and little continuity from prior leadership.

Shifting autism policy away from evidence-based research risks misdirecting funding, slowing scientific progress, and ultimately harming people with autism and their families by prioritizing ideology over care, services, and support.

4. Research Shows Discrimination Reduces Lifespan in Black Communities

A new study published in JAMA Network Open examines how long-term exposure to systemic racism affects health and longevity in Black communities. The researchers found that repeated experiences of race-based discrimination are associated with higher chronic stress, which in turn drives persistent inflammation, a biological pathway linked to accelerated aging and increased risk of premature death. Over time, the cumulative burden of adversity, trauma, discrimination, and economic hardship contributes to shorter life expectancy compared with white populations.

The authors note that the study measured only “major experiences of discrimination,” meaning the findings likely underestimate the full health impact of racism, since everyday and more subtle forms of racial stress were not captured.

This research reinforces that racism is not only a social issue, but a public health issue. Reducing health disparities requires policies that address structural drivers of health, including housing conditions, economic stability, environmental exposures, and access to resources that support long-term health.

5. Loss of Scientific Expertise

A new analysis published in Science found that in the year since Trump took office, the U.S. government has lost more than 10,000 PhD-trained scientists, representing about 14% of the scientists in STEM and health fields employed by the federal government at the end of 2024.

These are the scientists who review drug safety, track foodborne illness, set air and water safety standards, conduct cancer and Alzheimer’s research, and help ensure that federal science remains grounded in evidence rather than politics.

At the same time, more than half of NIH advisory review panel seats are projected to go vacant this year, raising the risk of major delays in research funding. The administration has not replaced many outgoing members, and a significant share of the scientists who would typically fill those roles were among those who left federal service last year.

6. Public Lands Opened to Oil and Gas Development

On January 27, the USDA finalized revisions to rules governing federal oil and gas leasing on National Forest System lands, streamlining the process for energy development across millions of acres of public land.

The rule accelerates lease approvals by reducing what the administration describes as “duplicative analysis” and creating a single decision point for permitting. In practice, faster permitting timelines can limit the depth and duration of environmental review, raising concerns about potential impacts on air and water quality, wildlife habitat, public lands, and long-term ecosystem stability.

While the administration frames these changes as improving efficiency and energy security, environmental experts warn that reducing layers of review may weaken safeguards designed to protect forests, communities, and environmental health.