President-elect Trump's second term may look to expand on his first in terms of the impacts on our health care. Much of what we've heard has been from Trump ally Robert F. Kennedy Jr.'s "Make America Healthy Again" plan.
Trump's first term may also offer clues to what's to come. And there's Agenda 47, Trump's policy plans for his time in office.
Some changes to federal health bureaus and purviews could include the Affordable Care Act, public health regulations, CDC guidance, research, vaccines, and drinking water.
Public health experts shared their worry about what Trump's second term may bring.
"We remain concerned that a lot of the rhetoric that occurred during the campaign. Now, I understand its campaign rhetoric, [but it] wasn't necessarily evidence based. And we know that many of the people that have been speaking are people that have been known to give bad information, misinformation, and in some cases disinformation around health," said Dr. Georges Benjamin, the Executive Director of the American Public Health Association.
RFK Jr. has said sweeping changes will come for federal health agencies, both during and after he suspended his own campaign.
In a November 5 video on his website, he said "Our big priority will be to clean up the public health agencies like CDC, NIH, FDA and U.S. Department of Agriculture. Those agencies have become sock puppets in the industries that they're supposed to regulate."
Experts say RFK Jr. has a history of spreading anti-vaccine false information, including the long-debunked claim of vaccines and autism that stemmed from flawed studies in the late 90s and early 2000s which have since been retracted.
"For decades, RFK Jr. has been a source of misinformation and outright lies regarding vaccinations and other treatments for disease. When you see someone like him get the ear of the president elect and sort of brag about the influence they're going to have, that is something that could be very chilling," said Dr. Amesh Adalja, Senior Scholar at the Johns Hopkins Center for Health Security. "To me, to be against a technology that has added decades to everyone's life span, that saves hundreds of millions of children from early deaths, that makes the world so much more hospitable to humans — to be against something like that is to be downright evil. It's requires high levels of evasion of all the evidence that supports how vaccines have changed humanity for the better."
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In an exclusive MSNBC interview Wednesday, RFK was asked about pulling vaccines from the market.
"If vaccines are working for somebody, I'm not going to take them away. People ought to have a choice. And that choice ought to be informed by the best information. So I'm going to make sure scientific studies and efficacies are out there and people can make individual assessments about whether that product is going to be good for them," he said.
"To put that qualifier there, especially from someone like RFK Jr. tells you that good science to him means science that agrees with his preconceived notion. Not science that's adhering to the facts of reality, not science that's derived from the evidence of the senses, but science that fits some explanation that he wants to use for political gain or for political power," Adalja told Scripps News.
The Affordable Care Act could come up next year with Congress debating whether to extend some of those plan subsidies expanded during the Biden administration. In its first term, the Trump administration made efforts to offer more short-term health plans, and we could see that again. A 2018 KFF analysis found that 71% of those plans did not cover prescription drugs and none of the plans covered maternity care.
We may also see guidelines change from Biden to Trump administrations for forever chemicals in drinking water. RFK Jr. has also said to expect a pullback on fluoride added to public drinking water.
The CDC calls fluoridation, along with vaccines, among the "10 great public health interventions of the 20th century."
When it comes to the many potential changes, public health advocates are preparing for what's to come.
"When they're doing things that we think are in the public's health, we'll be with them. But when they're doing things that are not in the public's health, you can be darn sure we're going to advocate against them," Benjamin said.
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