Bob Sheak, June 30, 2025

Introduction

Trump’s actions show that he wants to reduce federally supported health care programs. This post documents what he is doing in this respect and what he hopes to do. If successful, it will not be good for citizens or people around the world, many of whom will lack access to health care or only to inadequate health care.

Trump uses Executive Order to end US support for the World Health Organization (WHO)

The Blumberg School of Public Health delves into this issue (https://publichealth.jhu,edu/2025/the-consequences-of-the-us-withdrawal-from-the-who). Trump used executive action to withdraw from WHO in January, 2025. It was one of his first actions as president. As a consequence, the U.S. will lose a host of benefits, such as, detecting, monitoring, and responding to emerging health threats, pandemics, and diseases of importance; gathering and evaluating data and information from all over the world in order to understand the status of health globally and detect emerging problems; setting standards and developing guidelines that help people around the world, including here in the U.S., deal with various health threats and crises—not only infectious diseases, but all sorts of health issues. At the same time, as WHO is already struggling financially, it will lose somewhere between 12% and 15% of U.S. contributions. Additionally, according to Blumberg,

“Health provides an entryway for us to engage with countries, many of whom we may not agree with, and to have diplomatic conversations and other conversations. If that is lost, it will have tremendous consequences for the U.S.’s security and long-term economic and political outlook.”

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Trump reduced the number of workers in health agencies

Rachel Roubein, Lena H. Sun and Carolyn Y Johnson assess Trump’s firing of workers in the nation’s health agencies

(https://washingtonpost.com/health/2025.02.18.trump-health-firings-fda-cdc).

They write: “Many of those terminated worked on issues critical to consumers, from improving health care to regulating food packaging to responding to infectious-disease outbreaks.”

“Several thousand probationary employees across the Department of Health and Human Services were notified they would be terminated after four weeks of leave — fired in what some are calling a ‘Valentine’s Day massacre.’ The termination notices, which arrived over the weekend, capped a chaotic week of speculation about when the cuts would come and who would be affected.

“The terminations had a swift impact. The Food and Drug Administration’s top food official resigned Monday, citing the “indiscriminate firing” of 89 staff members from the agency’s food program and Robert F. Kennedy Jr.’s rhetoric toward staff.”

“I was looking forward to working to pursue the Department’s agenda of improving the health of Americans by reducing diet-related chronic disease and risks from chemicals in food,” Jim Jones, the FDA’s deputy commissioner for human foods, wrote in a letter — reviewed by The Washington Post — to the agency’s acting commissioner. “It has been increasingly clear that with the Trump Administration’s disdain for the very people necessary to implement your agenda, however, it would have been fruitless for me to continue in this role.”

“Overall, several thousand people from the more than 80,000 workers employed at HHS agencies were told they were terminated. All were probationary, meaning they had just a year or two on the job or had recently been promoted. Many worked on issues critical to consumers, such as improving health care, regulating food packaging or responding to infectious-disease outbreaks.”

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The GOP health care bill threatens bad outcomes

Margot Sanger-Katz, reporting for the New York Times, informs readers that “[a]nalysis from the nonpartisan Congressional Budget Office found that Republicans’ new version of the legislation would make far deeper cuts and lead to more people becoming uninsured than previous proposals” (https://nytimes.com/2025/06/29/us/politics/trump-policy-bill-health-insurance-cuts.html).  Specifically, The G.O.P. Bill has “$1.1 Trillion in Health Cuts and 11.8 Million Losing Care, C.B.O. Says”

Sanger-Katz: “According to a report published late Saturday night, the legislation would mean 11.8 million more Americans would become uninsured by 2034. Federal spending on Medicaid, Medicare and Obamacare would be reduced by more than $1.1 trillion over that period — with more than $1 trillion of those cuts coming from Medicaid alone.” These are unprecedented cuts. The bulk of the cuts come from two features of the legislation.

“One would establish a new, strict national work requirement for some people on the program, who would need to demonstrate they had worked at least 80 hours the month before they sign up, or qualified for an exemption. The Senate version applies this provision to the poor parents of children older than 14 in addition to childless adults without disabilities, the group targeted by the House version. The budget office estimated that that provision alone would reduce federal spending by more than $325 billion over the decade.

“The second big source of savings comes from new restrictions on a strategy many states use to finance Medicaid, by imposing taxes on medical providers to leverage a larger federal contribution. The bill’s restrictions on provider taxes and a related mechanism known as state directed payments would cut spending by a combined $375 billion, according to the report. The House bill would freeze the tax rate for most states, but the Senate version would require many states to lower their existing taxes, beginning in 2027.”

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Doctors Warn Medicaid Cuts in Senate Budget Bill Will Kill Their Patients

Mike Ludwig reports on doctors who warn that cuts to Medicaid and Snap will lead to some patients unnecessarily dying (https://truthout.org/articles/my-patients-will-die-doctors-slam-gop-budget-bill-as-senate-rushes-to-vote). Here is some of what he reports.

“The Senate GOP is looking to make $1 trillion in cuts to federal health care programs over the next decade, including Medicaid, which provides health insurance to lower-income families and people with disabilities. Deep cuts to food assistance for millions of people are also on the table as lawmakers look for ways to cut spending on the Supplemental Nutrition Assistance Program by pushing costs onto states.”

“Senate Republicans are under mounting pressure from doctors and medical associations to reject massive cuts to health care and food assistance as they rush to complete a draft of the budget reconciliation bill designed to implement President Donald Trump’s agenda. Despite an ongoing debate over deep cuts to Medicaid — cuts experts say would devastate already underfunded health systems especially in rural areas.” But the Republican-controlled Congress is going ahead with the cuts anyway.

Ludwig quotes an expert on the damage the bill will do.

“‘If Medicaid is cut, my patients will die. I realize I am being dramatic. It is a dramatic situation,’ said Helen Pope, a physician in Louisiana and assistant professor of medicine at Tulane University, in a statement to Senate staffers. ‘[T]hey are humans who are doing their best. Please don’t allow them to suffer more.’”

Republicans hit a snag on Thursday after the Senate parliamentarian ruled that a proposal to change how states can tax Medicaid providers — a bid to pass on more costs to states — does not adhere to the rules for fast-tracking and passing legislation with a simple majority. Democrats hailed the decision as a win, but Republicans are still determined to make the desired cuts.

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Trump Medicaid cuts would devastate rural health services and hospitals

Andy Sullivan and Richard Cowan focus their attention on how the Medicaid cuts “would devastate rural health services” (https://reuters.com/business/healthcare-pharmaceuticals/trump-medicaid-cuts-could-devastate-rural-health-services-hospitals-2025-06-13). Here are excerpts from the article.

“Rural hospitals are sounding the alarm over proposed healthcare cuts in President Donald Trump‘s sweeping tax-cut and spending package, warning the changes could force them to scale back services or close their doors.

“The bill would reduce federal spending on Medicaid, the health program for low-income Americans, by tightening enrollment standards and limiting federal aid to states.

“That worries rural providers, who rely heavily on the program to serve a population that tends to be poorer and sicker than the nation as a whole.

“‘We can’t sustain serving our community the way we are with additional cuts,’ said Carrie Lutz, CEO of Holton Community Hospital in Holton, Kansas. The independent nonprofit hospital, which serves a farming community of 13,000, is asking voters for a quarter-cent sales-tax increase to help cover its costs, which outpace annual revenues in many years.”

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Cuts in Veterans Administration

Abby Vesoulis reports on the harmful effects of Trump’s VA cuts  

(https://motherjones.com/politics/2025/06/these-veterans-fought-for-the-us-now-theyre-fighting-trumps-va-cuts).

“The Trump administration has proposed eliminating 15 percent of the Department of Veterans Affairs workforce.”

“Since his inauguration in January, President Donald Trump has moved to slash and burn the federal workforce—and the Department of Veterans Affairs (VA) is no exception. Already, the sprawling agency serving America’s 16 million military veterans has fired 2,400 probationary workers and proposed eliminating an additional 15 percentof its workforce—about 80,000 people.

“Veterans rely on the VA for help with critical needs like counseling for addiction and PTSD, prostheses, senior services, and treatments for cancer stemming from exposure to toxic chemicals. Medical research by VA doctors and scientists not only saves veterans’ lives, but benefits civilians; over the years, the breakthroughs have included pacemakers and CT scans.”

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RFK Jr. falsely disparages vaccines

Lauren Weber and Caitlin Gilbert consider RFK’s harmful impact on the US healthcare system (https://washingtonpost.com/health/2025/01/28/rfk-jr-disparaged-vaccines-dozens-times-recent-years-misled-race).

Specifically, they report on Kennedy’s false statements linking vaccines to autism and on alleged racial differences in vaccine impacts. Here’s some of what they have uncovered.

“Robert F. Kennedy Jr., President Donald Trump’s nominee [now appointed] for the nation’s top health post, has repeatedly disparaged vaccines, falsely linked them to autism and argued that White and Black people should have separate vaccination schedules, according to a Washington Post review of his public statements from recent years.

“In at least 36 appearances, Kennedy linked autism to vaccines, despite overwhelming scientific evidence supporting the use of vaccination to protect people from deadly infectious diseases and refuting any ties to autism, The Post found in a review of more than 400 of Kennedy’s podcast appearances, interviews and public speeches since 2020.

“He criticized vaccines more broadly in at least 114 appearances, calling them dangerous, saying the risks outweigh the benefits and making misleading claims about vaccine safety testing or discrediting vaccine efficacy.”

“A dozen vaccine experts, physicians and public health leaders said they were alarmed that someone who could shape vaccine policy as health and human services secretary failed to recognize reams of scientific data showing vaccines are safe and effective. Kennedy, who has been critical of vaccines for years, founded Children’s Health Defense, an anti-vaccine group.

“False statements about the safety of vaccines pepper Kennedy’s appearances on podcasts, TV, radio and the website of Children’s Health Defense (Kennedy’s ethics disclosures note he resigned his position as chairman of the board and chief legal counsel in December after Trump picked him for the HHS job). He asserts vaccines ‘poisoned an entire generation of American children’ and that doctors have ‘butchered all these children’ by administering shots recommended by federal authorities.

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The harms are multiplied

“The Department of Health and Human Services,” under RFK Jr., “has terminated thousands of grants, including funding for pandemic prevention, and research grants related to cancer, vaccines and chronic diseases. The loss of research funding will delay medical discoveries. Though the agency publishes a weekly list of terminated grants, the full scope of funding cancellations has been obscured, especially at the National Institutes of Health, the major funder of medical research. A database created by Harvard researchers, Grant Watch, has helped to fill in the gaps (https://nytimes.com/interactive/2025/06/30/opinion/hhs-cuts-harming-american-health.html).

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Democrats challenge RFK Jr. on vaccines.

Carmen Paun considers the controversy for Politico, June 24, 2025

(https://politico.com/news/2025/06/24/rfk-jr-isnt-hiding-his-plans-for-vaccines-democrats-say-it-will-cost-lives-00421525).

“The health secretary resurfaced anti-vaccine claims at a House hearing, alleging collusion by pharma companies, public health experts and politicians to mask the truth.”

“The health secretary and longtime vaccine skeptic pledged during his Senate confirmation earlier this year to leave that alone. But at a House health panel hearing Tuesday, Kennedy said there was ample reason to worry some vaccines aren’t safe and gave no ground to Democrats who pointed out that most scientists and public health experts vehemently disagree.”

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RFK Jr. says U.S. will stop funding global vaccine alliance Gavi

Niha Masih reports on this (https://washingtonpost.com/health/2025/06/26/rfk-jr-vaccine-gavi-funding-cut).

“The United States will halt its contributions to Gavi, the global alliance that works to expand access to vaccines for children in some of the world’s poorest countries, Health and Human Services Secretary Robert F. Kennedy Jr. said Wednesday — a move that public health experts said would have deadly consequences.

“Kennedy — who has a history of spreading vaccine misinformation — announced the decision in video remarks made to a Gavi summit in Brussels, during which he accused the group of neglecting ‘the key issue of vaccine safety.’

“In his remarks, Kennedy cited a study linking the DTP vaccine — for diphtheria, tetanus and pertussis — to increased child mortality. He also said Gavi should “consider the best science available.”

“‘Until that happens, the United States won’t contribute more to Gavi,’ he said.

“In a statement, Gavi pushed back against Kennedy’s allegations, saying decisions over its vaccine portfolio are guided by recommendations from World Health Organization experts who review all available data through a “rigorous, transparent, and independent process.”

“Gavi says it has helped vaccinate more than 1.1 billion children in 78 low-income countries since its founding that year, preventing 18.8 million future deaths.

“The Washington Post reported in March that the U.S. planned to terminate more than $1 billion in funding for Gavi. The U.S. was the third-largest contributor to the group, accounting for 12 percent of its overall funding as of last year, behind Britain and the Gates Foundation, according to KFF.”

Experts decry the RFK decision, maintaining that it will cause children to die, as  Prabhat Jha, a professor in global health and epidemiology at the University of Toronto Dalla Lana School of Public Health, said in an email.

“‘The suggestion that Gavi ignores science is pure nonsense,’ he said, pointing out that the alliance has a ‘robust science committee, draws experts from around the world’ and maintains a high level of scrutiny on manufacturing.

“Atul Gawande, the former head of global health at the U.S. Agency for International Development, said in a social media post that the withdrawal of funding was a ‘travesty and a nightmare.’

“‘This pull out will cost 100s of thousands of children’s lives a year — and RFK Jr will be personally responsible,’ he wrote.”

“Billionaire Bill Gates, whose foundation helped create Gavi, urged Congress to rethink the decision. He said on social media that the funding cuts would have ‘devastating consequences: more sick kids who fall behind in school, more overcrowded hospital wards, and eventually more grieving parents.’”

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Concluding thoughts

Trump wants to reduce government personnel and services in healthcare and everywhere in the federal government budget, in order (1) to increase the chances of getting his tax for the rich included in the Republican budget and (2) to undermine health care services in the public sector so that he can be better able to justify reducing the size of the federal government, “the administrative state.”