“We had a great discussion about healthy options for all Americans and taking back control of our healthcare,” Barrett said in a June , after sampling the farm’s apple cider.

Like the focus on artificial dyes, however, many of the administration’s highest-profile health initiatives rely on voluntary agreements. The goals, such as lower drug prices and nutrition classes for doctors, have widespread appeal, cutting across party lines and economic divisions.

But the administration-industry deals lack the enforcement teeth of more traditional federal regulation. Their details are vague, and minimal oversight makes it hard to monitor progress. In some cases, the administration has claimed victories that have yet to materialize.

Republicans consider the dealmaking a winning strategy. It fits with the party’s anti-regulatory stance, they say, and enables the administration to quickly forge agreements President Donald Trump and his allies can tout as accomplishments. In the run-up to the midterm elections, some, like Barrett, hope to woo voters by trumpeting the Trump administration’s efforts to shape health policy.

The practice also raises questions. Though the deals are announced with great fanfare 鈥� often during televised events on stages, with live audiences 鈥� there’s little documentation or follow-through, creating doubts about whether the administration’s health agenda will lead to lasting change or unravel once the political attention fades.

The distinction could prove important to voters as Republicans defend their health records in November’s midterm elections.

“These deals are often not transparent, so there’s no way for the public to judge how meaningful they are,” said Larry Levitt, executive vice president for health policy at KFF, a health information nonprofit that includes 吃瓜不打烊.

Dealing With Dyes

The push to remove certain artificial dyes from food and drugs, for example, was a headline grabber. In April 2025, Kennedy to announce deals with food makers. He was flanked by young children and mothers holding placards reading “Make America Healthy Again.”

He and former FDA commissioner drew a standing ovation from an audience selected by Kennedy’s staff as they said companies had pledged to phase out all petroleum-based synthetic dyes from the nation’s food supply and medicines. They targeted nine synthetic dyes for removal.

Voters love the idea of stopping the use of such dyes. In a nationally representative March survey by Consumer Reports, said they were at least somewhat concerned about synthetic dyes, and two-thirds said companies should be required to phase them out.

A year after making the first announcement at HHS, during a discussion at the Conservative Political Action Conference, an annual political event.

“We’ve gotten rid of the nine synthetic-based food dyes,” he said.

Not quite. At the initial HHS event, federal officials said companies would voluntarily stop using six specific synthetic dyes . (The administration has also revoked or proposed revoking authorization for two other synthetic food dyes.)

Later, the FDA on its website quietly to the end of 2027. So, most are still in use.

In fact, the FDA posted a list of 27 companies it said had made voluntary pledges as of December 2025 to remove six synthetic dyes from products such as Doritos and Kellogg’s Froot Loops. More than a year and a half later, 鈥� fewer than 30% of those who bought in 鈥� had met their promised goals.

Many major food makers, such as the Coca-Cola Co. and Unilever, have made “” to remove the synthetic dyes, according to Consumer Reports. In addition, no pharmaceutical companies have publicly said they have plans to remove dyes from drugs.

“It’s just all talk,” said Leslie Dach, who chairs , a healthcare advocacy group that supports the Affordable Care Act. “They just govern for a day of publicity, and then it’s over. None of it happens. Yet the people don’t know because they have busy lives, so they think, 鈥楯ust look at all these initiatives.’”

In fact, the administration , allowing companies to say their products contain no artificial colors 鈥� as long as they don’t use petroleum-based dyes. Previously, food makers could not make that claim unless their products contained no added colors. Some food dyes made from natural ingredients can contain contaminants and may pose their own health risks, .

“The federal government hasn’t taken any regulatory action on food dyes, for the most part, since the beginning of this administration,” said , vice president for government affairs at the Environmental Working Group, an advocacy group.

HHS said the voluntary approach has yielded significant action, including commitments to remove synthetic dyes from products sold in schools for the 2026鈥�27 school year.

“HHS and the FDA are moving forward with clear timelines and concrete industry commitments, with major changes expected in foods served in schools during the coming school year and across full product portfolios by the end of 2027,” HHS spokesperson Emily Hilliard said in an email.

At the same CPAC convention event, Kennedy said “the MCAT testing companies are going to put nutrition on the MCAT for the first time, so the students will actually want to do it.” MCAT refers to the Medical College Admission Test, an exam required for admission to medical schools.

Again, not quite.

The Association of American Medical Colleges administers the MCAT. Spokesperson said Kennedy misspoke and may have meant to refer to a test taken by students to be licensed as doctors.

An Insurance Deal Falls Short of Promises

Kennedy again took to the HHS stage in June 2025, this time with Centers for Medicare & Medicaid Services Administrator Mehmet Oz, to make what was billed as a game-changing announcement. to reduce the volume of healthcare services subject to prior authorization, a practice widely used by the insurance industry that often requires patients or their medical teams to seek preapproval before undergoing treatment.

The administration said 80% of insurers pledged changes to preauthorization requirements for 80% of diseases and injuries . The administration also promised “” to track progress.

“It will happen very quickly,” Oz said at the event. “Necessary care will be delivered when it’s needed, in the right way.”

As of July, months past that January target date, health plans had reduced prior authorization for medical services by about 11%, according to AHIP, the insurer trade group. But no public dashboards have debuted to track the deal, and some insurers that signed the pledge last summer told 吃瓜不打烊 this year that they will not implement all the promised reforms as outlined by AHIP.

Hilliard did not respond to questions about the pace of progress.

The American Medical Association, in a 2025 web-based survey, asked 1,000 practicing doctors whether they believed the voluntary pledges would make a meaningful difference. said they believed they would.

Insurers made a , during the previous Trump administration. The next year, more than 80% of doctors said the number of prior authorization requests for drugs and medical services had been increasing, based on .

Meanwhile, the administration is testing an artificial intelligence-powered for Medicare, the federal health program for people 65 and older or with disabilities. In six states, Medicare beneficiaries must get preapproval for a few treatments that CMS considers to have little clinical benefit and to be susceptible to fraud or waste, including skin substitutes and knee arthroscopy for arthritis. The program began in January, the same deadline insurers had set for curtailing preauthorization delays.

Deals and Deregulation

The healthcare industry’s voluntary agreements appeal to voters who feel government regulation drives up costs and places unnecessary burdens on businesses, some supporters say.

“Secretary Kennedy is the antithesis of a public health industry that uses coercion over communication 鈥� and has demonstrated this by taking the time and effort to push voluntary initiatives over the typical approach of governmental mandates,” said , a political consultant who was a political appointee at HHS in Trump’s first term.

But voluntary agreements with the health industry can prove ineffective. Former President Jimmy Carter in 1977 proposed a legislative plan to curb rising hospital costs. Hospitals fought back, and Congress rejected the proposal, instead favoring a desired by the industry. It ultimately failed once public attention faded.

One upside: Deals are fast. can take two to three years. And some health analysts say the tempo of the agreements advanced by Kennedy and Trump may help take voters’ attention off the Trump administration’s inability so far to produce a long-promised health plan.

Instead, Republicans can point to the array of accords reached with industry, including the with drugmakers so they’re in line with lower amounts charged in peer countries. The White House calls it the “most-favored-nation” prescription drug pricing policy.

Seventeen companies, including Pfizer and AstraZeneca, with the administration to lower prices for Medicaid enrollees and cash-paying consumers using , a narrow, government-run consumer platform.

Many details remain unknown, but the lower prices apply only to new drugs and existing drugs available through Medicaid. And prices at TrumpRx aren’t as low as out-of-pocket prices for most consumers with insurance. But the voluntary deals appeal to an industry that has railed against mandatory approaches drugmakers deride as harmful price controls.

“Each company makes its own decisions about how it prices medicines, and our industry is committed to working with the Trump administration to ensure Americans have access to affordable medicines,” said Chanse Jones, a spokesperson for PhRMA, a pharmaceutical industry trade group.

Policies that lead to reductions in drug prices typically worry investors because profits also can drop. But rather than seeing their stock prices fall after the agreements were announced, the drugmakers saw largely .

Analysts say that’s partly because the deals are narrow in scope, largely exist only in principle, and don’t apply to existing drugs used by the more than 200 million Americans with commercial or private health insurance.

The Trump administration, however, is .

“The most-favored-nation agreements on drug prices that we just did are delivering the largest drug price cuts in history,” Trump said in June at a in Pennsylvania. “That alone should win us the midterms.”

This article first appeared on 吃瓜不打烊 and is republished here under a .

The decision by the Trump administration comes amid massive cuts in federal funding for Medicaid. Advocates worry this could be a one-two punch for disabled Americans who want to live independently.

吃瓜不打烊 senior correspondent Stephanie Armour joined WAMU’s Health Hub on Aug. 19 to explain what this change means for Americans with disabilities and their loved ones.

This article first appeared on 吃瓜不打烊 and is republished here under a .

While the released Aug. 10 does not directly mention autism, Trump’s demand to limit vaccine recommendations has puzzled leading medical groups, doctors, and political analysts alike. The directive landed less than 90 days before midterm elections, which Trump’s own could be jeopardized by anti-vaccine rhetoric.

“The political timing, particularly for members on the Republican side in swing districts, is not good,” said , a former Republican congressman and retired doctor.

Trump’s willingness to gamble on the issue underscores the president’s impatience for his health secretary to deliver on a promise that he’d pinpoint a culprit for the sharp rise in autism diagnoses.

After more than a year, Kennedy and his close, anti-vaccine allies have blown past a deadline to turn up definitive answers in a multimillion-dollar research mission shrouded in secrecy, leaving the president to recycle debunked notions as he publicly assaults vaccines.

“This is about the most closed project that I’ve ever heard of,” Helen Tager-Flusberg, a renowned psychologist who runs the Coalition of Autism Scientists, said of Kennedy’s autism research efforts. “They’re treating it like the Manhattan Project in the 1940s. This is as opaque as it could possibly be.”

The White House did not answer questions about what research is informing the president’s opinions or which vaccines he believes could be linked to autism.

The Department of Health and Human Services said the president’s action builds on the agency’s January announcement that it was reassessing the nation’s vaccine schedule and recommended reducing childhood immunizations based on peer countries’ guidance. However, no other peer country separates the measles, mumps, and rubella vaccine as the president has now ordered.

“As the secretary said, HHS will examine every biologically plausible hypothesis, follow the evidence wherever it leads, and make findings and actions available as they are ready,” HHS spokesperson Emily Hilliard said in an email.

Trump Dreams of a 鈥楤ig Day’

Trump especially has been enamored with finding autism’s cause, saying in August 2025 that it will be “such a big day” after Kennedy assured his boss that he had identified “clearly, almost certainly” factors causing autism that would soon be publicly revealed.

Decades of existing research and scientific studies show genetics is a leading factor. 鈥� including prenatal exposure to pollution, the age of the father, and maternal health 鈥� can also play a role.

But Kennedy has flatly rejected that science, often calling autism a “.” As health secretary, he has looking for root causes in a research effort that’s offered no public status updates and few details about who, or even which agency, is leading the effort.

Prominent autism advocacy groups, scientists, and researchers have not been consulted on the project. Nor have career scientists working at the federal health agencies, according to two officials 吃瓜不打烊 is not naming because they were not authorized to speak on the record about the matter.

Requests to meet with Kennedy on the issue have been ignored, said Delancy Allred, public policy manager at the Autism Society. Allred said that other federal agencies, such as the Department of Education, have engaged more directly with leading autism advocacy groups during meetings.

“No one has gotten to Kennedy. No one has gotten to the secretary level, that I’m aware of,” Allred said. “I think he likes to isolate himself with folks that are in his domain and group.”

Indeed, Kennedy has relied on allies, who’ve joined him over the years on a crusade against childhood vaccines, to lead the agency’s autism research and strategy efforts. It’s a top priority for his closest adviser, , a former environmental activist and , according to the unnamed sources. Spear did not respond to requests to talk about the autism study.

William “Reyn” Archer III 鈥� a former Texas health official, trained obstetrician-gynecologist, and whom Kennedy hired as a senior adviser 鈥� has spent months acquiring Americans’ medical records for political appointees to research a link between vaccines and autism. The National Institutes of Health under Trump has also issued about $50 million in grants to scientists at universities around the country for autism research, although most of the studies are not scheduled to be completed for a few years.

In January, Kennedy also restocked the Interagency Autism Coordinating Committee 鈥� an under-the-radar but influential group 鈥� with a full new slate of 21 members. His appointees include parents of autistic children, vaccine skeptics, and a doctor who was sued for “dangerous” autism treatment. It has met only once during Trump’s current term.

Late last month, the committee abruptly dropped a 336-page strategic plan that echoes some of Kennedy’s talking points: Federal researchers have focused too much on genetic links to autism, the plan suggests.

Diagnoses of autism, a that affects how people communicate and behave, the past couple of decades. The increase is attributed partly to and screening, a more expansive definition of the disorder, and parents having children at a later age, .

Trump and Kennedy have falsely claimed that the rise in diagnoses is isolated among American children 鈥� though diagnoses have dramatically and .

Despite his efforts to launch new research, Kennedy has provided Trump with no conclusive explanation for these increases. Trump began publicly pressing his health secretary on the issue last month when he asked Kennedy: “How are you doing on the autism research?”

Kennedy replied, “We will have an answer for you,” before Trump cut him off.

“That is so important,” the president pressed.

Kennedy’s vaccine agenda has been stymied, in part, by the White House’s infighting. Behind the scenes, White House officials have spent months waving Kennedy off his vaccine agenda amid a historic wave of measles infections.

With his Aug. 10 Oval Office signing, Trump made clear Kennedy’s vaccine agenda remains a top priority. The signing also came at a politically convenient moment: The Senate broke for a five-week recess, just after the White House secured the votes it needed for crucial confirmations of Centers for Disease Control and Prevention Director Erica Schwartz and Attorney General Todd Blanche.

Kennedy Misfires

Many of Kennedy’s claims so far on autism have not withstood scientific scrutiny. Last year, the health secretary said Tylenol use in pregnancy can lead to autism. A major new study in the peer-reviewed journal JAMA debunked the connection 鈥� a political stumble for Trump, who had publicly repeated the claim and urged women not to take the pain reliever.

Kennedy also offered that circumcision could be a cause during a Cabinet meeting in October. published in August in JAMA Pediatrics found no such evidence. He said in 2025 that a linked the in autism. However, his remarks misrepresented the findings; the he referred to later studied thimerosal exposure in vaccines and .

And Kennedy for research that was underway to search for autism’s causes, including potential environmental sources.

Pressed on details about the administration’s work studying autism, NIH Director Jay Bhattacharya admitted that no conclusion had been reached during an interview .

“If you ask me, as a scientist, do I know why we’ve seen this rise in autism? I’ll tell you I don’t know the answer to that question,” he said Aug. 9.

Seated at his desk in the Oval Office the next day, Trump repeatedly made the connection between autism and vaccines just before signing the executive order calling for fewer childhood shots.

Appearing alongside Trump, Kennedy seemed intent on quelling expectations that HHS would produce results expeditiously. He told the president he was racing to find answers before the end of his term.

“Mr. President, you have told us you want answers. So do I,” Kennedy said. “We have just over two years to finish the work, and I know you’re impatient, and we are moving with an urgency that that deadline demands.”

While Trump has repeatedly claimed there’s a link between autism and vaccines, he has not revealed which of the routine vaccinations he believes might be to blame, and he praised the polio vaccine as “amazing” during the White House event.

White House officials declined to answer questions about the status of Kennedy’s efforts to identify the cause of autism during a call a few hours later.

This article first appeared on 吃瓜不打烊 and is republished here under a .

That could change. In June, the Department of Justice issued saying federal disability rights laws don’t require states to provide services that allow people with disabilities to remain in their homes rather than institutions.

It’s a sharp reversal from 1999, when a held that unjustified institutionalization constituted discrimination under the Americans with Disabilities Act. Previous administrations have relied on that ruling to enforce civil rights for disabled people, but the Trump administration says that long-held interpretation is wrong.

Advocacy groups say legal protections for about and 5 million children who have disabilities could be undermined, and they worry that the new interpretation may herald a return to forced institutionalization.

The stage is also now set for a legal fight between advocates, states, and the federal government. Some states with ongoing lawsuits challenging disability rights requirements are already citing the DOJ opinion in hopes it will help them prevail.

In a case in Texas, for example, that a rule instituting a 1973 civil rights law that led to community and home integration of people with disabilities is costly and infringes on states’ rights.

People like DeSimone-Shabrack are especially worried because, they say, the opinion follows a spate of White House and Republican-led initiatives that have already begun eroding hard-won protections for people with disabilities.

“I’m worried. Am I going to have to put him in an institution, and what’s that going to be like for him?” said DeSimone-Shabrack, whose personal home care help was recently reduced from 30 to 18 hours a week by the state. “As he gets older, am I going to be able to care for him without this support?”

The Department of Health and Human Services remains steadfast in enforcing federal civil rights laws, agency spokesperson Emily Hilliard said in an email.

“Our commitment to ensuring that individuals with disabilities are treated with dignity, afforded equal opportunity, and are able to meaningfully access community services remains unchanged,” she said.

But advocacy groups say the DOJ opinion could have sweeping repercussions. The opinion doesn’t change existing law, but advocates worry that HHS and the DOJ could begin that mandate integration for people with disabilities.

They’re concerned that agencies will stop enforcing disability laws that ensure people aren’t. HHS, for example, has historically investigated disability discrimination claims at hospitals and in states that get federal funding, enforcing compliance with home and community integration through . Disability rights experts say those agreements could now be imperiled.

And some states facing financial pressures may roll back Medicaid services that enable people with disabilities to stay in their homes and communities 鈥� a trend that’s already happening following last year’s passage of the One Big Beautiful Bill Act, which cuts a projected from the safety net program over a decade.

Democrats are seizing on the opinion, which was released in a DOJ memo, to portray President Donald Trump and Republicans as a threat to people with disabilities. Sen. Tammy Duckworth (D-Ill.) and other Senate Democrats led the calling on the DOJ to rescind the opinion.

“The Trump Administration’s memo is an outrageous attack on the rights and independence of the disability community,” Duckworth said in a statement.

The DOJ didn’t return emails seeking comment.

According to the DOJ’s interpretation, regulations that give disabled people the right to demand certain services for daily living 鈥� bathing, mental health counseling, and financial budgeting help, for instance 鈥� and that require states to extend to mentally disabled individuals are unlawful, a view the agency acknowledged “is out of step with the common understanding of that decision within the federal courts.”

States may have legitimate reason to treat mentally disabled people in institutions, “including resource constraints, capacity limitations in community-based facilities, and safety concerns for both the patient and the community,” the memo reads.

The Supreme Court case, Olmstead v. L.C., has long shaped federal policy. And while it remains to be seen how courts will respond to the DOJ, some states seeking to curtail disability protections see the opinion as significant.

Consider the in federal court in the Northern District of Texas by Republican-led states arguing that an HHS rule about the integration mandate is unlawful. The lawsuit began with broader claims and 17 state plaintiffs. Following significant advocacy from the disability community, only Texas, Alaska, and Florida remain.

Following the new DOJ interpretation, the states filed documentation to inform the court about the memo as a new and relevant development. Similar documentation citing the memo has been filed in disability rights cases in Florida and New Hampshire, according to The Arc of the United States, a disability advocacy group.

Advocates for people with disabilities say the speed at which plaintiffs are citing the opinion underscores how it may be used to justify the erosion of protections.

“The administration’s attempt to dismantle decades of progress in community integration is alarming and inconsistent with federal disability rights laws and Supreme Court precedent as well as the critical enforcement work of prior administrations,” said , senior executive officer of legal advocacy and general counsel at The Arc.

Forced institutionalization led to human rights violations, segregation, and a eugenics movement in the late 19th and early 20th centuries that included involuntary sterilization.

Exposure of the abuses, legal battles, and an caused a major shift toward integration. Fewer than 1% of people with intellectual or developmental disabilities lived in state-run facilities in 2021, down from almost 30% in 1967, from the University of Minnesota’s , which maintains metrics on such long-term services and supports.

The Trump administration has already taken steps to reverse that trend, advocates say.

Trump signed that addresses homelessness by expanding involuntary treatment and institutionalization, reversing a championed by the Biden administration.

Much of the special education program office is moving from the Department of Education to HHS, raising concerns among advocates that the administration is reverting to a view that disabilities are a medical issue to be fixed rather than differences that can be accommodated.

And cuts in federal funding for Medicaid, a federal-state insurance program for people with low incomes or disabilities, also portend fewer resources and services. States have responded by reducing some optional benefits such as home health aides and support. In addition, qualifying for an exemption from the program’s work requirements, which take effect Jan. 1 in most states, will pose significant hurdles for people with disabilities.

The June DOJ opinion, advocates say, could accelerate the shift and result in court rulings that chip away at disability rights.

“While it doesn’t overnight change the law, it’s very troubling and very dangerous,” said , director of the Disability Rights Program at the American Civil Liberties Union. “It reflects a really deeply held disrespect for disabled people from this administration and a total lack of awareness of the lived experiences of people with disabilities who are living in their homes.”

Data shows there can be benefits to involuntary institutionalization. Relative to those voluntarily admitted, people with psychiatric illness who were involuntarily admitted “experienced greater improvements in symptoms and function,” according to a in Psychiatry, Psychology and Law, a peer-reviewed academic journal.

Deinstitutionalization has created new challenges. More hospitals have been forced to board people with psychiatric illness in emergency rooms because of a dearth of available beds. And moving people into home- and community-based living was supposed to be accompanied by an increase in outpatient care and treatment that never materialized, creating gaps in support.

But advocates for the disabled community say involuntary institutionalization and poses a higher risk of neglect and abuse.

, 57, of Cleveland, spent two years in a nursing home. She has spinal muscular atrophy, a genetic disease that kills motor neurons, leaving her able to move only part of her left arm and her head.

At the institution, she said, she felt bored and trapped and developed intense itching from scabies, which is caused by microscopic mites.

For more than a decade, however, she has lived in an apartment with the help of caregivers who come in the morning to get her dressed and ready and return to put her to bed. She works at a disability rights group, and her care is covered by Medicaid.

“The two years I lived in the nursing home, it was the most horrible time in my life,” said Kucera, who worries about the DOJ opinion on Olmstead. “My future is a shaking floor beneath me. With the stroke of a pen, they could get rid of everything I’ve built for myself.”

This article first appeared on 吃瓜不打烊 and is republished here under a .

That’s the concern of food safety leaders across the U.S. who are raising alarms over federal cuts they say have made it harder to detect and stop the spread of foodborne illnesses, such as the recent outbreaks of cyclospora, which has in dozens of states. And they’re especially worried the next pathogen will be much more deadly.

Food safety in the U.S. is monitored by a piecemeal system of state and federal agencies. That network is in charge of detecting, investigating, and stopping outbreaks of foodborne illnesses. Key to the system is the Centers for Disease Control and Prevention’s FoodNet program, created after four children died from E. coli in hamburgers in the early 1990s. States participating in the program, officially called the Foodborne Diseases Active Surveillance Network, contact labs to get case data that can signal when a problem is emerging.

But in President Donald Trump’s second term, his administration has slashed billions of dollars in public health funding and fired thousands of workers at federal health agencies. It has also curtailed FoodNet, stopping the program’s mandatory tracking of cyclospora and five other pathogens that together kill hundreds of people in the U.S. each year.

“You’re basically allowing for outbreaks to continue without being figured out. Invariably more people will get sick,” said Bill Marler, a Seattle-area food safety lawyer and advocate who has filed lawsuits against Taco Bell on behalf of people who allege they were sickened by cyclospora after eating there.

Under the changes to the FoodNet surveillance system, the 10 participating states 鈥� meant to represent a cross section of the broader population 鈥� no longer have to report cases of listeria, for example. That bacteria of people who are diagnosed with it.

Complications from listeria infections can include convulsions, miscarriage, and sepsis that damages organs. It’s much more rare than the type of E. coli bacteria still required to be tracked by FoodNet, but of people infected with listeria wind up hospitalized. Listeria infections result in an estimated according to numbers from the CDC and the Food and Drug Administration.

“It’s very hard to identify listeria outbreaks,” said Neal Fortin, the director of the Institute of Food Laws and Regulations at Michigan State University. Seeing it cut from FoodNet’s mandatory surveillance “really does disturb me,” he said.

Thirty-three people died and a pregnant woman had a miscarriage in 2011 after with listeria. The FDA identified the cause in .

States participating in FoodNet also no longer have to report illnesses caused by campylobacter, a bacteria often contracted from raw and undercooked poultry that afflicts an estimated 1.5 million people each year. The bacteria sickened about 60 people in Idaho this year in an outbreak linked to raw milk 鈥� a product Health and Human Services Secretary Robert F. Kennedy Jr. has championed, even though pasteurization kills harmful bacteria.

HHS denies that the changes to FoodNet or Trump administration staffing cuts have elevated the risk that future outbreaks will be harder to identify and stop.

“FDA investigators were not affected by staffing changes or force reductions, and the FY 2027 President’s Budget proposes a $33 million increase for food safety activities,” HHS spokesperson Emily Hilliard said in an email. And the CDC never stopped monitoring illnesses caused by cyclospora, she said.

The CDC has other, passive surveillance systems, but they rely on states to report problems.

“There’s no requirement of how long it takes them to do that,” said Barbara Kowalcyk, the director of the Institute for Food Safety and Nutrition Security at George Washington University.

And the FDA meets only a fraction of the number of inspections mandated by Congress. The FDA for domestic and foreign inspections since 2018, according to a report early last year by the Government Accountability Office.

Food safety by the FDA plummeted from 10,641 facilities in 2011 to about 4,500 a decade later. The agency had for domestic and foreign inspections in 2024, according to a GAO report.

That was before the Trump administration in a push to reduce federal spending.

Now, food safety leaders say the situation could get worse, because the Trump administration wants to push more routine food inspections to the states and further reduce the number of federal staffers that handle investigations and inspections.

State health departments are already overburdened from federal funding cuts and staffing shortages, forcing some to reduce or halt prevention programs so they can focus on more emergent concerns.

The cuts are being felt in Michigan, which has reported more than 7,000 cases of cyclosporiasis, the most of any state. The cyclospora parasite can cause frequent diarrhea that can last for days or even weeks, as well as abdominal pain, nausea, and fatigue.

The health department in Washtenaw County, Michigan, already pulled some staff off other work, such as immunizations and sexual health, to handle a recent measles outbreak that sickened seven people, including five kids. Now those same nurses are spending hours on the phone with hundreds of people with cyclosporiasis, trying to trace the source of their illness through weeks-old takeout receipts, bank statements, and recollections.

“We are starting to see the consequences of an underfunded public health system in 2026,” said Natasha Bagdasarian, Michigan’s chief medical executive. “Currently it’s cyclospora. Eventually, we are going to lose the ability to detect something else.”

This article first appeared on 吃瓜不打烊 and is republished here under a .

Researchers this spring discovered in water in several coastal locations across New York’s Long Island, and town officials in the Hamptons vacation destination about the findings. in Florida have been infected this year, and in June urged people to take precautions.

About 1 in 5 people infected by the bacteria die, sometimes within a day or two of becoming ill, according to a Centers for Disease Control and Prevention . The bacteria, Vibrio vulnificus, can enter open wounds and cause tissue death and systemic sepsis.

“Many people with Vibrio vulnificus infection can get seriously ill and need intensive care or limb amputation,” the CDC says.

The risk of such public threats is mounting because climate change is expanding the territory of certain pathogens, but researchers say there’s another concern. The Trump administration has cut investments in programs and agencies that prevent, track, and respond to health hazards the federal government is now confronting.

Consider the , which can infest and kill livestock, in the U.S. in June. The U.S. Department of Agriculture lost in the first six months of 2025, according to a report from the USDA’s Office of Inspector General, and the agency’s winnowed-down inspection service is helping lead the response to the parasite.

Or malaria. A freeze on foreign aid disrupted international malaria prevention efforts, and warned that the U.S. is vulnerable to the reintroduction of the infectious disease.

And when it comes to Vibrio, the Trump administration began removing hundreds of deep-sea instruments that and yield data that helps that can allow the bacteria to flourish. the data to study Vibrio, which can when water temperatures and .

“It is important to track coastal temperatures, and that will relate to the distributions of Vibrio,” said Christopher Gobler, a professor in the School of Marine and Atmospheric Sciences at New York’s Stony Brook University, though he added that there are also other sources of data for researchers.

The Trump administration to dismantle the ocean monitoring system following bipartisan opposition to the effort in Congress.

But it’s still curtailing Vibrio surveillance. The life-threatening species that’s found in water can also sicken or kill people who eat contaminated seafood, such as infected with the bacteria. And infections from Vibrio vulnificus linked to consuming raw or undercooked shellfish as the presence of other pathogens in food decrease.

Since 1995, 10 states have participated in a federal program called the Foodborne Disease Active Disease Surveillance Network, or FoodNet. The program, with the CDC, monitors and track cases of foodborne illness caused by eight specific pathogens, including Vibrio. But last year the Trump administration to report on all but two pathogens, which means states no longer must report cases to the CDC.

Federal officials deny the moves are putting Americans at risk, saying the CDC continues to monitor these pathogens through other national surveillance systems to ensure ongoing visibility into disease trends and outbreaks.

Meanwhile, some former health leaders say the ramifications of sweeping cuts to health agencies and global prevention programs are becoming more apparent, undermining U.S. response efforts and initiatives that aim to safeguard the country from diseases.

“We are letting down defenses that were necessary to protect against microbial threats,” said Tom Frieden, a former CDC director who is now president and chief executive of Resolve to Save Lives, which works to stop preventable disease. “Instead of protecting, we’re doing the opposite.”

Do Limited Resources Mean Higher Risks?

The administration defends its actions, including massive layoffs at government health agencies, as necessary to eliminate wasteful spending.

The Department of Health and Human Services “is advancing the most significant public health reforms in a generation focused on prevention, accountability, scientific transparency, and better health outcomes,” agency spokesperson Emily Hilliard said in an email. “The Department is putting American families at the center of public health decision-making.”

Evidence suggests health risks are rising even as the Trump administration pulls back on resources for research, detection, and response.

Early in his administration, President Donald Trump opted to freeze and review work on global health programs. Trump’s cost-reduction effort, led by billionaire Elon Musk, also dismantled the U.S. Agency for International Development.

As a result, work was disrupted on the President’s Malaria Initiative, a George W. Bush-era program aimed at combating malaria in hard-hit countries that is credited with saving more than . USAID had in the program since 2005.

In addition, for global malaria programs were targeted for termination, , an independent research group that includes 吃瓜不打烊. The report didn’t include data on the total value of those specific malaria grants.

And the spending freeze halted research for more effective . The administration dissolved the CDC’s , shuffling staffers to other divisions and on the disease. HHS didn’t respond to an email asking how many staff members had been moved.

The life-threatening infectious disease spread by mosquitos was in 1951. But the CDC’s updated guidance on investigating domestic cases that “the country remains susceptible to malaria reintroduction.”

resulted in 10 people in Arkansas, Florida, Maryland, and Texas becoming infected locally, and mosquitoes capable of transmitting malaria are found throughout most of the country.

“The majority of U.S. residents lack protective immunity against malaria, rendering persons susceptible to severe illness and death if infected,” the CDC said in the May report.

HHS declined to comment on any of the specific cuts but said the CDC works with domestic and international partners to reduce the burden of malaria and prevent its reestablishment in the U.S.

It’s not just cuts to funding that are raising health risks, say researchers and former health officials. Significant staffing cuts mean there are fewer people working on preventing or tracking diseases, they say.

“Yes, the programs have been cut in terms of reduction in staff, but I would say, equally important, you have reductions in expertise,” said Jeanne Marrazzo, CEO of the Infectious Diseases Society of America. “It’s irreplaceable.”

Screwworm is a species of parasitic blowfly producing larvae that can enter open wounds and devour tissue, infecting people and animals. Like malaria, it has long been eliminated in the U.S., and disease monitoring efforts have been key to keeping it out.

The cuts at USAID stripped from the United Nations’ , which focuses on global food security and the such as screwworm.

In the wake of the administration’s cost-cutting initiatives, more than 20,000 employees are gone from the USDA, which develops and implements agriculture policy and provides resources to producers of livestock vulnerable to the parasite.

On June 3, the first new case of screwworm in the U.S. was confirmed, and there have now been infected with parasite. An expanding outbreak could devastate the cattle industry.

Agriculture Secretary Brooke Rollins during the Trump administration have led to screwworm’s return. Instead, she has , saying it didn’t do enough to prevent reintroduction into the U.S. Rollins said on X that “” under the previous Biden administration was partly to blame, providing no evidence.

The USDA did not respond to an email seeking comment.

Ashish Jha, a doctor who served as the White House covid response coordinator during the Biden administration, said there’s no truth to the claim that immigrants lacking legal status have brought screwworm into the U.S.

Investments in tracking and combating diseases have suffered, he said, because HHS Secretary Robert F. Kennedy Jr. is prioritizing the prevention of chronic disease at the expense of efforts to curtail infectious disease.

“Who doesn’t want a healthier country? It sounds great, but it’s kind of a bait and switch,” Jha said. “They’re doing the opposite. They’re letting down our defenses that are necessary to protect us against microbial threats.”

HHS’ Hilliard disagreed, saying Kennedy’s actions are making the agency more effective.

“Secretary Kennedy is delivering that reform by streamlining operations, reducing redundancies, and returning HHS to pre-pandemic staffing levels,” she said. “At the same time, he is dismantling policies and incentives that contributed to a nationwide chronic disease epidemic.”

Surveillance Gaps

Jha pointed to Trump’s decision to withdraw the U.S. from the World Health Organization, which coordinates global responses to public health issues and crises, and to the dismantling of USAID.

The pullback has had implications for the Ebola outbreak in the Democratic Republic of Congo, aid workers say.

Without the same amount of funding from USAID, the International Rescue Committee, which partners to deliver front-line health, surveillance, and outbreak preparedness activities in Congo, .

“Funding cuts have left the region dangerously exposed,” Heather Reoch Kerr, IRC’s country director for Congo, said .

The outbreak is roughly 7,000 miles away, but its spread has the , with stepped-up surveillance and entry restrictions on airline travelers. Federal officials have said that the dismantling of USAID hasn’t hampered detection or response.

“The U.S. government continues to move aggressively to contain the Ebola outbreak at its source in order to protect the American people and prevent further international spread,” the State Department said .

Trump’s decision to disengage with the WHO was criticized by following a hantavirus outbreak this spring on a cruise ship that had set sail from Argentina. the , and they questioned why the president suggested creating a costly new rather than sticking with the WHO 鈥� especially, they say, when the U.S. is cutting back on the surveillance programs it already has.

The federal government has tracked Vibrio cases as part of the FoodNet program, which aims in part to identify and curtail outbreaks. Reporting on cases of Vibrio is now optional.

Close to half of the cases of foodborne illness caused by Vibrio vulnificus have , and some within 24 hours after consumption of tainted shellfish such as raw oysters. The bacteria can multiply rapidly, leading to septic shock and blistering skin lesions. The pathogen is becoming to antibiotics.

The CDC estimates that of Vibrio infection occur annually, with infections from the most severe species, Vibrio vulnificus, steadily rising. , that species has led to 429 cases due to infections of open wounds and 135 cases from contaminated food.

“The more surveillance you get, you can connect the dots,” said Bill Marler, a Seattle-area food safety lawyer. “If a tree falls in the woods and you don’t hear it, did the tree fall? It’s easier not to report diseases. Then they can say, 鈥楲ook at how safe our food supply is.’”

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Protesters’ chants could be heard from inside the Cleveland City Club, where Kennedy was speaking to a bipartisan group of citizens as part of his recent tour of northern Ohio. His calls for parents to have more “choice” on vaccinating their children was met with applause from half of the room. The other half released exasperated sighs and gasps. 

His travel schedule is about to get busier: Kennedy is expected to stump for GOP lawmakers, traveling to states with competitive races in the upcoming midterm elections.

The goal of Kennedy’s campaign appearances is to shore up support for Republican candidates. But his targeted presence underscores the increasingly intense push and pull Kennedy faces as he works to maintain enduring political viability with GOP voters 鈥� especially MAHA supporters.

His challenge is complicated by a widening schism between the White House and Kennedy’s anti-vaccine crusade. Some MAHA adherents feel betrayed by the Trump administration, which they say is thwarting the movement’s agenda by not doing more to limit pesticides, halt access to covid shots, or investigate conspiracy theories about airplane contrails poisoning the skies.

Meanwhile, some in the MAHA camp hope Kennedy will announce his own run for the White House in 2028.

But Kennedy says he has no such aspirations. Asked by 吃瓜不打烊 on May 7 whether he sees a path to run for the presidency again as a Republican, he replied firmly: “No, I’m not going to run.”

Changing his position about running would put Kennedy on a collision course with President Donald Trump, who’s reportedly as possible successors. (Trump, too, has mused about running again in 2028, though the 22nd Amendment would prohibit it.) A Kennedy candidacy could also sap much of the Trump administration’s work on other MAHA causes, because the secretary would likely leave his role at the Department of Health and Human Services.

“If he isn’t secretary, then MAHA’s influence will severely diminish,” said David Mansdoerfer, who served as deputy assistant secretary for health at HHS in the first Trump administration.

“Running would be perfectly logical for Bobby,” said , a public policy and political science professor at Northeastern University. “Kennedy is being a good soldier, but to what extent? That is going to be a question.”

鈥楢 Grave Misstep’

Recent Trump administration actions have riled up MAHA supporters. The president in April nominated , a doctor and vaccine supporter, to lead the Centers for Disease Control and Prevention. Kennedy fired Susan Monarez, the agency’s previous director; she testified for not preapproving vaccine recommendations.

Schwartz’s nomination and White House efforts to shift Kennedy’s focus away from vaccines stand in stark contrast with 2024, when Trump pledged to let Kennedy “” on health.

In an interview, Kennedy said “I think I have” gone wild on health. He shot down claims that the White House has limited his work.

“President Trump has let me do more than any HHS secretary in history,” Kennedy said.

Kennedy has said he supports Schwartz, though he last month that he did not discuss her nomination with Trump. MAHA adherents have criticized her backing of covid vaccines, holding it up as evidence that the White House is restricting the health secretary.

“Trump’s pick to head the CDC, Erica Schwartz, would likely be a disaster,” a lawyer and Kennedy ally, said on X, citing her work supporting the covid vaccine rollout.

Trump also withdrew the nomination of wellness influencer Casey Means, another Kennedy ally, for U.S. surgeon general. In May, the president nominated Nicole Saphier, a radiologist and former Fox News contributor. MAHA adherents have panned the selection, which reflects a more mainstream and traditional medical approach to the position. Means had faced pushback from some Republican senators for questioning contraception methods and refusing to reject the debunked link between vaccines and autism.

“DOGE the Surgeon General!!! We want medical freedom!!!! If not Casey – we take no one!” Vani Hari, a MAHA influencer, said May 1 on X.

Taken together, these actions threaten to weaken MAHA support for GOP candidates. But many Republicans in competitive races are already distancing themselves from the grassroots, vaccine-skeptical “medical freedom” movement led by Kennedy.

Many MAHA supporters also feel let down by Trump administration directives that rolled back environmental regulations and promoted pesticides. Some now see a Kennedy presidency as critical to attaining their policy goals.

Stephanie Weidle “100%” wants to see Kennedy run again. The 34-year-old Washington, D.C., resident was outside the Supreme Court last month during a rally to oppose protections for the weed-killing chemical glyphosate.

A reliable Republican voter, Weidle described the administration’s actions as disappointing. She wants to see Kennedy go further on examining the childhood vaccine schedule and limiting chemical use on crops.

“His hands have been tied,” Weidle said of Kennedy. She believes the White House has ordered him to back down from those controversial issues. “Republicans have made a grave misstep in not leading with MAHA.” 

Vaccines Are a Flash Point

In the midst of these dynamics, Kennedy is attempting to thread the needle between the White House, which wants him to back away from attacking vaccines, and MAHA supporters who want him to do more. He has sought to appease both sides, praising Saphier as the surgeon general pick and describing her on X as a “ for the MAHA movement.”

He’s also tempered his public focus on vaccines. His podcast, which he said would “” that lead to illness, has veered away from the topic and centered instead on food and nutrition.

During his recent congressional hearings, he also focused on initiatives that poll well with voters. Appearing before the Kennedy offered an opening statement focused on healthcare affordability and drug prices, issues he had shied away from during his first few months on the job.

While he mentioned his redesign of nutritional guidelines and pressing industry to cease its use of certain food dyes, he avoided more controversial topics that underscored his first few months in office, including his attempt to upend the childhood vaccine schedule and efforts to explore causes of autism.

Despite his pivot to more popular subjects, Kennedy’s draw weakens beyond MAHA circles. A March straw poll of more than 1,600 attendees at the annual found nearly zero support for him as a presidential candidate when participants were asked who they would vote for if the election were held today.

“He has a constituency that is very much attached to MAHA that may not vote in the Republican primaries or in a general election,” said Robert Blendon, professor emeritus of health policy and political analysis at Harvard University.

Kennedy ran for president in the 2024 race as a Democrat, then as an independent, before halting his campaign in August 2024 and throwing his support behind Trump.

Some of the president’s advisers credit Kennedy’s MAHA voters with tipping the scales just enough to help Trump secure his 2024 election win. About a third of U.S. adults now identify as MAHA supporters, according to a , and support is highest among Republicans who also back Trump’s Make America Great Again political movement.

Vaccine policy is galvanizing voters on both sides. Eighty-one percent of voters said vaccine policy, including decisions about what vaccines are recommended for children, will have an impact on their decision to vote in the 2026 midterm elections, according to a conducted in April. Voters said they trust Democrats more than Republicans on vaccine policy and other health issues, according to the poll.

But healthcare 鈥� especially its costs 鈥� looms larger as an issue. Sixty-four percent of voters said that they are very or somewhat worried about healthcare, including the cost of health insurance and out-of-pocket costs for things like office visits and prescription drugs, and 88% said such costs will have an impact on their vote. 

Many of the MAHA faithful question whether their political muscle really matters.

Republicans seem less convinced the constituency will make or break the midterm election results.

Republicans in Congress and the administration “have decided not to run on MAHA for the midterms,” Robert Malone, a scientist and Kennedy ally who stepped away in March from his position on the federal Advisory Committee on Immunization Practices, said April 16 on X.

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It is urging the public to report hospitals and nursing homes that serve sugary drinks, nutrition shakes, or meals that it says don’t meet dietary guidelines established last year by the U.S. Department of Agriculture, with officials vowing to withhold millions of dollars in federal funding if violations occur.

The initiative from Health and Human Services Secretary Robert F. Kennedy Jr. is spurring backlash from some doctors and medical providers who say it fails to account for patients’ unique dietary needs and is anathema to Republicans who have long embraced an anti-regulatory stance.

It’s also not clear that HHS has the regulatory authority to enforce its threat without going through a formal rulemaking process, lawyers and dietitians say.

“Most of this is political theater. HHS doesn’t have the power to do much,” said , a dietitian and research scientist who is an assistant professor at the University of Toronto. “Also, if it’s to the point that you’re trying to control people’s choices, well, you look a little fascist.”

The agency to hospitals asking them to align their food purchases with the administration’s 2025-30 dietary guidelines to ensure continued eligibility for Medicaid and Medicare payments, Kennedy said at a March 30 press event.

“We are going to bring all the hospitals in the country in line with good food,” he said, describing the instructions as “essentially a .”

“If a hospital is serving patients sugary drinks, they are out of compliance with government standards and are putting their reimbursements in jeopardy,” top Kennedy adviser Calley Means “If you see patients being served sugary drinks, please post information below or let CMS know.”

The comment included a link to an HHS webpage with a toll-free number for reporting complaints typically used for medical bills. Withholding federal funding from hospitals is one of the most extreme enforcement tools available to regulators, one the Centers for Medicare & Medicaid Services has seldom deployed.

Even serving liquid nutrition products like Ensure to patients could put hospitals in jeopardy, Means warned. “They need to change or lose reimbursement. Please report them if you see it,” he told an X user.

Medicare and Medicaid, combined, are the of hospital expenditures.

The notice came in the form of a “Conditions of Participation” update released by CMS to ensure hospital patients’ food adheres to the dietary guidelines, HHS spokesperson Andrew Nixon said. “We commend the many hospitals who have made commitments to improve their food offerings, and expect every hospital system to do so,” he said.

Means did not respond directly to requests for comment from 吃瓜不打烊, instead posting on X shortly after he was contacted: “鈥楾rump Derangement Syndrome’ has led Democrats to defend the medical importance of mass-serving soda and junk food to American patients.” In a text with 吃瓜不打烊, he said, “That’s to cite if you want. I don’t have a comment.”

Still, some administration officials have made it clear they will not shy away from halting federal funding, a rarely taken step that can imperil the ability of a hospital to remain open.

A Carrot and a Stick

HHS can withhold or threaten federal funding if hospitals violate mandatory minimum health and safety standards set by the agency. The standards stipulate that hospitals must protect patient privacy, for example, and uphold infection control.

The standards do address hospital food, but they don’t explicitly refer to the 2025-30 established by the USDA.

Rather, the standards require that “individual patient nutritional needs must be met in accordance with recognized dietary practices,” and list other requirements for hospitals, such as having access to a qualified dietitian.

“CMS has never before interpreted this requirement as mandating adherence to any set of dietary guidelines,” according to an from law firm .

The CMS memo shows the agency is taking the “notable step” to incorporate the dietary guidelines “into the hospital regulatory framework without new rulemaking,” according to the brief.

Hospitals are likely to comply because they are loath to cross the federal government and want to avoid a legal tussle or enforcement action by Kennedy, some lawyers say.

“He doesn’t have a legal basis to do this, but hospitals and nursing homes can’t afford to ignore it altogether because of what it signals about potential enforcement action,” said , a University of Michigan law professor.

If federal funding were withheld, hospitals could always sue to try and challenge HHS’ authority.

“When the agency goes to the hospital and says, We’re going to take away your money for this, the hospital can sue and say, Look, nothing requires us to fry our fries in beef tallow or whatever,” Bagley said.

For hospitals looking to comply, the agency’s memo provides examples of what should and shouldn’t be served to patients.

Food as Medicine

What the guidance calls “don’ts”: sugar-sweetened beverages or juice. And “do’s”: water, unsweetened tea, milk, or coffee. Meals suggested in the memo include grilled salmon with quinoa or bean-based entrees with leafy greens.

Some nutritionists welcomed the focus on hospital food for patients. Marion Nestle, a public health advocate and molecular biologist, lauded the initiative, saying, “These sound terrific!” in an on her blog, .

Other health leaders and doctors pushed back, noting hospitalized patients often have more individualized nutrition needs that may not conform to federal dietary recommendations.

For “a patient struggling to swallow from just having a stroke, salmon and quinoa is the worst thing for them. They’re going to risk aspirating on it,” said Klatt, the University of Toronto dietitian.

Hospitals that neglect to provide certain standards of care, such as protein shakes to treat malnutrition or an unhealthy weight loss, could open themselves up to possible legal liability. Eighty percent of malnourished elderly patients gained weight and improved muscle mass on nutritional supplements such as Ensure, according to the published in Nutrición Hospitalaria, a peer-reviewed scientific journal.

Abbott, which , makes a range of products including shakes for people who “could be malnourished due to medical treatments, such as chemotherapy, and not be getting the calories they need because they don’t have much of an appetite,” company spokesperson John Koval said in a statement.

“It’s always a struggle to get people to eat. Losing weight in the hospital raises the risk of mortality,” said Mary Talley Bowden, a , who has with Make America Healthy Again causes but on X, posting: “Give me a break Calley. A hospital snitch line for soda?”

“It’s a little tyrannical,” she said in an interview.

The focus on hospital food came in late March as part of Kennedy’s MAHA initiative, in which he has touted changes to federal dietary guidelines that emphasize protein and healthy fats while eschewing processed foods.

Kennedy has leaned heavily into his work on changing eating habits, which fits into the MAHA gestalt and polls well with both Democratic and Republican voters. Eighty-six percent of registered voters surveyed said it should be easier for every American family to access fresh fruits and vegetables, released in September by Navigator Research.

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Researchers say the children at about a mile away pay the price. They discovered the students there and at other elementary schools near major pollution sites in Pennsylvania had than other children in the state.

Residents and environmental advocates saw reason for hope and relief in the form of a designed to tamp down on coke oven plant pollution. But even before it took effect, President Donald Trump granted in the U.S. — including the one in Clairton — a from the standards.

Trump and Republicans have sought to align themselves with the Make America Healthy Again movement’s populist ideals, such as improving Americans’ food choices and reducing corporate harm to the environment. But the administration is ratcheting up its attacks on the very environmental protections that MAHA followers hold dear.

Taken together, these anti-environmental initiatives will lead to more pollution-related illnesses and higher health care spending, health researchers say. They could also have political ramifications, eroding MAHA’s support for GOP candidates in the November midterm elections if followers believe the party is more beholden to industry than to the movement’s agenda.

All 11 Active Coke Plants in the US Are Exempt From EPA Rules

Coke ovens heat coal at temperatures as high as 2,000 degrees Fahrenheit to make the carbon-rich fuel known as coke, which is used in the production of iron.

, including about a quarter of Republicans, support rolling back environmental regulations, according to a poll by the Energy Policy Institute at the University of Chicago and The Associated Press-NORC Center for Public Affairs Research.

Some MAHA supporters believe voters will support Republicans because the Trump administration is delivering on other goals important to the movement.

“MAHA has a pretty diverse set of policy goals, ranging from medical freedom to food and the environment,” said David Mansdoerfer, who served in Health and Human Services leadership during Trump’s first term. “In totality, the Trump administration has strongly delivered on much of the MAHA agenda.”

While MAHA voters have been upset at some of the administration’s actions that promote industry, it’s hard to know how that may play out in the midterms, said Christopher Bosso, a professor of public policy and politics at Northeastern University. Many were disillusioned by a Trump they viewed as promoting glyphosate, which HHS Secretary Robert F. Kennedy Jr. has .

“The glyphosate thing really ticks off a lot of them; they’re really upset,” Bosso said. “Kennedy said it was poison. If it is a poison, why aren’t we regulating it? That’s where the tension plays out.”

The situation with the Clairton coke plant and the others granted exemptions from regulations underscores the potential public health risks. Six of the 11 factories had “high priority” violations of the Clean Air Act as of last May, according to a 吃瓜不打烊 analysis. Five coke oven plants logged major violations every quarter for at least three years straight.

“Poisoning continues to some of the most vulnerable residents of Allegheny County,” , who had lived in nearby Glassport, Pennsylvania, said at a about the coke plant.

Environmental Protection Agency spokesperson Brigit Hirsch said the president gave companies extra time because the technology needed to meet a new standard isn’t ready yet.

“Forcing plants to comply before the tools exist doesn’t make the air cleaner, it just shuts down facilities and kills jobs with nothing to show for it,” Hirsch said.

But environmental groups disagree that the plants were unable to comply at a reasonable cost, and they say the exemption from the EPA requirements shows the Trump administration is prioritizing the coal industry at the expense of public health.

“The Trump administration’s relentless actions to dismantle lifesaving environmental protections are a gut punch to the administration’s own promise to Make America Healthy Again,” said Cathleen Kelly, a senior fellow at the Center for American Progress, a liberal think tank.

Hard Times in Clairton

Sprawled across , the Clairton plant operates ovens in which coal is heated to as much as 2,000 degrees Fahrenheit to make up to 4.3 million tons annually of the carbon-rich fuel known as coke. The product is used in blast furnaces to produce iron.

It’s a dirty operation. The process leads to hazardous emissions of that the Centers for Disease Control and Prevention says can lead to anemia and leukemia, as well as , which can trigger severe asthma.

The Clairton operation has had repeated problems with its emissions and operations, including and of toxic chemicals. The plant has received more than from the Allegheny County Health Department since 2022, stemming largely from a fire in 2018 that led to high emissions, and violated the Clean Air Act in each of the last , with the last compliance monitoring in July 2025, according to the EPA.

Nippon Steel Corp. last year acquired U.S. Steel, which now operates as a subsidiary. The company didn’t respond to an email seeking comment. U.S. Steel said it spends $100 million annually on environmental compliance at Clairton.

“Environmental stewardship is a core value at U. S. Steel, and we remain committed to the safety of our communities,” spokesperson Andrew Fulton said in a written statement.

Clairton was once bustling with movie theaters, a mix of grocery stores, and riverside parks, with a dance pavilion and . But the decline of steel hit hard. The town’s population dwindled from more than in the mid-20th century to as of 2024. until they were razed and replaced with signs saying to keep out. The 1978 movie , which depicts a hardscrabble industrial town, is partly set there. Today, about 33% of residents live in poverty.

While the plant brings jobs and revenue, residents of the town and the surrounding areas have long complained about health problems they attribute to its emissions.

“My parents are gone. My mom had cancer, my dad,” , a Clairton resident, said at a 2025 County Council meeting. “I lost a lot of loved ones and seen other ones pass because of this mill.”

Pediatric allergist looked into asthma rates among 1,200 children who attended school near major pollution sites in the area — including students at Clairton Elementary School. They had nearly triple the national rate of asthma, with the highest rate among African American youth, according to she led.

“We were shocked,” she said. “It was double or triple what we expected. The people are proud of their industrial background. We need steel, but they’re not running a good enough operation.”

A found children with asthma living near the coke plant had an 80% higher chance of missing school when sulfur dioxide pollution was elevated.

Allegheny County, which includes Clairton and Pittsburgh, is home to a number of industrial plants, and to increased deaths, chronic heart disease, and adverse birth outcomes. It was ranked in the top 1% of counties in the nation for cancer risk from stationary industrial air pollutants in a 2018 .

Clairton has an age-adjusted cancer death rate of 170 per 100,000 people, higher than the broader county’s rate of 150 deaths per 100,000 people, based on a 吃瓜不打烊 analysis of .

The American Lung Association in 2025 gave the county an F rating for its particle pollution levels. PennEnvironment, an environmental group that was party to a settlement with U.S. Steel involving the Clairton plant, says the coke operation caused of toxic releases in 2021, which amounted to 60% of all such releases in the county that year.

From 2020 through 2025, the Clairton plant racked up more in fines from Clean Air Act penalties than any other coke oven facility nationwide, costing U.S. Steel over $10 million, according to EPA facility reports.

“We are deeply concerned with exemptions, which allow air toxics to affect public health,” Allegheny County Health Department spokesperson Ronnie Das said in a statement.

The Clairton plant provides and hundreds of millions of dollars in tax revenue to the area. The jobs help generate nearly $3 billion in annual economic output, according to estimates from the Pennsylvania Manufacturers’ Association.

Some community members and advocacy groups hoped air quality would improve after the coke plant was sold. has pledged to upgrade facilities in the Monongahela River Valley.

Politics, Waivers, and Environmental Concerns

Under the Biden-era rule, coke plants were supposed to start meeting from the lids and doors of ovens that heat coal. They would also have had to monitor for benzene at their property lines and take steps to lower emissions of the carcinogen if they exceeded certain levels. Compliance deadlines were set for July 2025.

The Trump administration, which has sought to revive the coal industry, intervened. Last year, it , including coke plants such as Clairton’s, to seek from issued in 2024 by the EPA.

Then Trump in November went further, granting all coke plants a two-year compliance break.

The reprieve was necessary, the EPA spokesperson Hirsch said, because the requirements would have meant extra costs for the industry when standards already in effect work “extremely well” at reducing pollution.

Hirsch also said the agency under Trump is protecting the environment, pointing to action the administration has taken to called PFAS, prevent lead poisoning, strengthen chemical safety, and protect Americans’ food and water supply.

“We are building a future where the next generation of Americans is the healthiest in our nation’s history, and they inherit the cleanest air, land and water in the world,” Hirsch said.

However, the administration has taken several steps that environmental advocates say weaken health protections.

The president’s executive order on glyphosate, an herbicide the World Health Organization has linked to cancer, which touched off a who said they felt betrayed. The EPA has decided to stop considering the of reducing pollution when making policy decisions, instead focusing on the cost to industry of complying with rules. The agency also rescinded the legal and scientific basis that had long established as dangerous to public health.

The actions have rankled some MAHA enthusiasts who counted on the administration to tackle chronic disease, especially among children. A petition to Trump on with more than 15,000 signatures called for the removal of EPA Administrator Lee Zeldin, it said supported corporations over MAHA goals.

Some MAHA enthusiasts have sounded off on social media.

“No one should believe that MAHA is being upheld at the EPA at this point,” , a leader of American Regeneration, which focuses on a conservation approach to farming, said Feb. 8 on X.

, host of a , also aired her concerns on X, saying “there is something really freaking spooky going on at the EPA and I refuse to let the American people be gaslit into thinking they’re upholding the MAHA agenda.”

“A significant number of people who supported Trump are worried these rollbacks are going to hurt their health,” said , a Democratic strategist and the founder of the communications firm Third Degree Strategies. “The MAHA voters, especially women, are very sensitive to this. Republicans have put themselves in a bind.”

MAHA supporters shouldn’t be surprised by a Trump administration that doesn’t prioritize environmental protections over industry, because the president has always championed fossil fuels, said Kyle Kondik, managing editor of Sabato’s Crystal Ball, a nonpartisan election forecasting newsletter published by the University of Virginia Center for Politics.

The coke plant exemptions have disappointed some community members, environmental groups, and regulators concerned about public health and emissions.

Nearly 300,000 people live within 3 miles of the 11 active coke plants across the U.S., according to EPA data compiled by the Environmental Defense Fund.

Weakening environmental rules has helped boost Trump with the U.S. coal industry. In February, mining industry executives and lobbyists gathered at the White House, .

Coal miners, including some in white hard hats bedecked with American flags, with a bronze-colored trophy emblazoned “The Undisputed Champion of Beautiful Clean Coal.”

At the event, Trump praised their work. “We love clean, beautiful coal,” he said.

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The tensions risk fraying Kennedy’s dynamic MAHA coalition, potentially driving away critical supporters who helped fuel President Donald Trump’s 2024 election win.

The movement’s grassroots membership includes suburbanites, women, and independents who are generally newer entrants to the GOP and laser-focused on achieving certain results around the nation’s food supply and vaccines.

Promoting healthy foods tops their list and will be at the center of the White House’s pitch to voters during the midterm election cycle.

“President Trump’s mass appeal partly lies in his willingness to question our country’s broken status quo,” White House spokesperson Kush Desai said in a statement. “That includes food standards and nutrition guidelines that have helped fuel America’s chronic disease epidemic. Overhauling our food supply and nutrition standards to deliver on the MAHA agenda remains a key priority for both the President and his administration.”

At the same time, with most Americans , the White House has cooled on Kennedy’s aggressive policies to curb vaccines and MAHA’s interest in tamping down environmental chemicals that are linked to disease.

The result: Republicans are realizing just how demanding the MAHA vote can be. Moms Across America leader Zen Honeycutt warned that Republicans are facing their biggest setback yet with the MAHA movement, after Trump signed an executive order to support production of glyphosate, a herbicide the World Health Organization has .

“It has caused the biggest uproar in MAHA,” Honeycutt said during a CNN interview in late February.

A White House Warning

Trump’s top pollster, Tony Fabrizio, cautioned in December that an embrace of Kennedy’s anti-vaccine policies could cost politicians their jobs this year.

Eight in 10 MAHA voters and 86% of all voters believe vaccines save lives, his poll of 1,000 voters in 35 competitive districts found.

“In the districts that will decide the control of the House of Representatives next year, Republican and Democratic candidates who support eliminating long standing vaccine requirements will pay a price in the election,” on the poll stated.

The White House has since shaken up senior staffing at HHS, including removing from the deputy secretary role and his job as acting director of the Centers for Disease Control and Prevention, in which he curtailed the agency’s childhood vaccination recommendations. Ralph Abraham, a vaccine skeptic who as Louisiana’s surgeon general suspended its vaccination promotion program last year, stepped down as the CDC’s principal deputy director in late February.

, a doctor who said in congressional testimony that he doesn’t believe vaccines cause autism, is now running the CDC in addition to directing the National Institutes of Health.

Though Trump himself has frequently espoused doubts and mistruths about vaccines, polling around anti-vaccine policy has undoubtedly shaken the White House’s confidence during a tough midterm election year, said former , an Indiana Republican and retired doctor who left Congress last year.

Bucshon said Republicans can’t risk alienating voters, especially parents of young children who might be moved by Democratic attack ads on the topic at a time when hundreds of measles cases are popping up across the U.S.

“That’s the reason you’re seeing the White House get nervous about it,” Bucshon said. “This is just the political reality of it.”

Kennedy built some of his MAHA following with calls to end federal approval and recommendations for the covid vaccines during the pandemic. The Advisory Committee on Immunization Practices, a federal panel of outside experts who were handpicked by Kennedy to develop national vaccine recommendations, is expected to review and possibly withdraw its recommendation for covid shots. Its February meeting was postponed and is now scheduled for March 18-19, when the panel plans to discuss injuries from covid vaccines, HHS spokesperson Andrew Nixon confirmed on March 11.

“I’m not deaf to the calls that we need to get the covid vaccine mRNA products off the market. All I can say is stay tuned and wait for the upcoming ACIP meeting,” ACIP Vice Chair Robert Malone , a conservative account on the social platform X, before the meeting was postponed. “If the FDA won’t act, there are other entities that will.”

No Fury Like Scorned MAHA Moms

Bipartisan support is also extremely high — above 80% — for another core tenet of the MAHA agenda: eliminating the use of certain pesticides on crops.

But MAHA leaders were incensed when Trump issued a Feb. 18 promoting the production of glyphosate, a chemical used in weed killers sprayed on U.S. crops and which Kennedy has railed against and sued over because of its reported links to cancer.

“There’s gonna be ups and downs, and there is zero question that this week was a down,” Calley Means, a senior adviser to the health secretary and a former White House employee, told a MAHA rally in Austin, Texas, on Feb. 26. “I am not going to gaslight or sugarcoat it: This glyphosate thing was extremely disappointing. Bobby’s disappointed.”

Despite deep unhappiness from MAHA followers, Kennedy endorsed Trump’s executive order defending access to such pesticides.

“I support President Trump’s Executive Order to bring agricultural chemical production back to the United States and end our near-total reliance on adversarial nations,” Kennedy .

Without offering policy changes, Kennedy promised a future agricultural system that “is less dependent on harmful chemicals.”

White House officials are now trying to downplay the executive order.

“The President’s executive order was not an endorsement of any product or practice,” Desai said in a statement.

But that’s done little to dampen criticism from leading MAHA influencers who had hoped, with Kennedy’s influence in the administration, that the chemical would be banned.

Some Democrats see an opening.

of Maine earned cheers from MAHA loyalists for co-sponsoring legislation with Rep. Thomas Massie (R-Ky.) to undo the executive order.

“The Trump Admin. cannot keep paying lip service to while propping up Big Chemical like this and choosing corporate profits over Americans’ health,” .

, a prominent MAHA influencer who promotes healthy eating, responded on X with a “HELL YES.”

‘Eat Real Food’

The White House and Kennedy are refocusing their messaging to emphasize one of the most popular elements of the MAHA platform: food.

At the start of the year, Kennedy unveiled new dietary guidelines that emphasize vegetables, fruits, and meats while urging Americans to avoid ultraprocessed foods.

Kennedy has leaned into his new “Eat Real Food” campaign, launching a nationwide tour in January. Ahead of the late-February MAHA rally, he stopped at a barbecue joint in Austin where he took photos with stacks of smoked ribs and grilled sausages. Large “Eat Real Food” signs have been provided for crowds of supporters to hold up during major announcements at HHS’ headquarters this year.

Focusing on nutrition will please MAHA moms, suburban swing voters, and conservatives alike, said , a physician and former Republican representative from Texas.

“They keep them happy by talking about the food pyramid,” Burgess said. “That’s an area where there is broad, bipartisan support.”

Indeed, Fabrizio’s poll shows equal support — 95% — among respondents who voted for former Vice President Kamala Harris and those who voted for Trump for requiring labeling of harmful ingredients in ultraprocessed foods.

Trump is keenly aware that Kennedy’s MAHA movement is key to his political survival. At a Cabinet meeting in January, Kennedy rattled off a list of his agency’s efforts researching autism and tackling high drug prices.

Trump leaned in at the table.

“I read an article today where they think Bobby is going to be really great for the Republican Party in the midterms,” , “so I have to be very careful that Bobby likes us.”

This article first appeared on 吃瓜不打烊 and is republished here under a .