More than 100 million Americans are obese, 38 million are diabetic, 116 million are hypertensive, and 26 million suffer from asthma. Whether or not you’re among the 60 percent of Americans whose medical chart lists a chronic illness, everyone suffers from them: They keep people out of work and in pain and contribute to skyrocketing healthcare bills that come out of the country’s coffers and yours. Most importantly, they shatter families whose loved ones die prematurely from the conditions. At a White House event in May, President Donald Trump affirmed he was intent on addressing this public health crisis. Flanked by Health and Human Services Secretary Robert F. Kennedy Jr.—whose remit includes the National Institutes of Health, Centers for Disease Control and Prevention, and the Food and Drug Administration—Trump said the rate at which Americans develop chronic illnesses is nothing short of “alarming, unbelievable, terrible.”
In principle, this issue might be a rare point of agreement between most public health experts and the president and his HHS secretary. But while Trump and his administration have championed the Make America Healthy Again (MAHA) initiative, it’s more like an optical illusion with roundtables and flashy baseball hats. Though promoting what may appear to be a worthy endeavor, health experts argue the MAHA slogan is undermined by policies that do the opposite—especially for low-income Americans whose relative health status and long-term outcomes are disproportionately worse than for affluent ones.
“Health is wealth” is a popular saying among crunchy MAHA influencers. But the reality in the US, especially when the Trump policies and budget cuts begin to hit, is the inverse: wealth is health. In just six months, this “pro-health” administration, whose initiatives are led by an anti-vax advocate, has terminated 2,100 NIH research grants and withheld $140 million worth of funding already earmarked for fentanyl addiction response. Those cuts are small in comparison with the dual blows wrapped into the Republican-led One Big Beautiful Bill Act, which Trump signed into law on the Fourth of July. The legislation gifted roughly 16 million people the loss of health insurance (to begin in 2027) and removed $186 billion in funding for food assistance programs for low-income people.
“Health is wealth” is a popular saying among crunchy MAHA influencers. But the reality in the US, especially after these cuts, is the inverse: wealth is health.
The duplicity of an administration that trumpets its commitment to transforming the state of health in the US versus the dire consequences of its policies confounds public health experts, hospital administrators, and physicians alike.
“It is incongruous to say ‘I’m making America healthy,’ and then, on the other hand, say, ‘But I’m taking away the resources that are necessary to make people healthy,’” Dr. Richard Carmona, who served as the US Surgeon General under President George W. Bush, tells me. “It doesn’t make a lot of sense.”
Consider the federal free and reduced-cost school lunch program, which has been shown to reduce rates of poor health by at least 29 percent and lower rates of obesity by at least 17 percent. The program is connected to the Supplemental Nutrition Assistance Program (SNAP), which supports 12 percent of US households, nearly half of which include children. Put simply, cuts to SNAP eligibility mean fewer recipients of free breakfast and lunch at school.
As my former colleague Tom Philpott explained in a recent article, the new budget bill Trump signed into law is “literally taking food off the tables of poor people and handing much of the savings to large-scale commodity farmers.”
Then there is projected $1 trillion in Medicaid cuts over the next decade, which will have even more obvious and drastic effects on public health than the SNAP cuts. Some Medicaid expansion enrollees will see their co-pays increase, and others may see reduced benefits as state governments cut optional services when they become responsible for a larger share of the costs.
Additionally, new Medicaid work requirements require beneficiaries to more frequently prove their eligibility, which is anticipated to result in the loss of benefits for many people who do have jobs. As the Atlantic put it, the increase in arduous paperwork is akin to “annoying people to death.”
There is one population that Jill Rosenthal, the director of public health policy at the Center for American Progress, anticipates will be especially hard hit by new bureaucratic hurdles and tightened eligibility: cancer patients and people who will develop cancer, cases of which are increasing.
“People who are uninsured are more likely to be diagnosed with cancer later in the progression of their cancer, they’re less likely to get evidence-based preventive care, screening, treatment, and end-of-life care,” she says. Not a problem, according to Republican Sen. Joni Ernst of Iowa. She reassured her constituents who were expressing concerns about Medicaid cuts by saying, “Well, we all are going to die.”
Privately insured Americans will feel the pinch, too. The Medicaid changes are anticipated to burden hospitals, especially those in rural areas that treat more Medicaid patients. Even without insurance,low-income people will still have medical emergencies requiring hospital care, and hospitals are legally obliged to stabilize them. This increase in what healthcare administrators call “uncompensated care” will lead to staff layoffs, reduced services, or even hospital closures, as has already taken place in Curtis, Nebraska.
Kevin Stansbury, the CEO of a 25-bed hospital about 107 miles Southeast of Denver, recently told me that about a quarter of its patients are on Medicaid. If program cuts pushed the county-owned hospital out of business, the next closest emergency room would be 85 miles away. And what would happen in the community if they closed? “More fatalities,” he said.
A little credit where credit is due: The MAHA movement has raised important questions about the health of the food items that dominate grocery store aisles and our pantry shelves.
Roughly 60 percent of what Americans eat (and 67 percent of what kids consume) is ultra-processed, such as sugary cereals, frozen meals, sodas, and fast food—all of which Kennedy refers to as “poison.”
While this isan exaggeration—for all their liabilities, these foods do go through safety testing—he’s correct that the overconsumption of processed foods has been linked to poorer health outcomes. A 2024 review of 10 million study participants found “convincing” evidence that ultra-processed foods increase the risk of cardiovascular disease by 50 percent. The same review found “highly suggestive” evidence that people whose diets are dominated by these foods are at much greater risk for obesity, sleep disorders**,** and depression. A separate study, published in 2022, concluded that men who ate large amounts of ultra-processed foods were 29 percent more likely to develop colon cancer.
“That is something that could improve Americans’ health, and so it’s a valid issue,” Rosenthal says about reducing the consumption of ultra-processed foods.
But potato chips and frozen pizzas can be extremely difficult to resist—not only thanks to marketing and synthetic ingredients, which certainly help, but because this is what appears in stores that serve low-income communities, areas often referred to as food deserts.
“Communities that don’t have access to grocery stores and need to buy their food from other sources often can’t find good, nutritious food, and they often find that it’s more expensive,” Rosenthal explains.
In other words, slashing a benefit that helps poor Americans afford more nutritious alternatives is effectively to say, “Kale for me, but not for thee.” (Just look at the ultra-processed chicken bacon ranch pasta dishes Kennedy is eagerly sending to Medicare and Medicaid patients.)
Former Surgeon General Carmona adds that Kennedy’s interest in increasing the consumption of more natural foods is “a great opportunity” for bipartisanship. But that would require breaking through the “hyper-partisan, divisive, acronym politics that we are dealing with today.”
Outside of hyping healthy foods, some of MAHA’s other priorities are more suspect. The 73-page MAHA report the White House published in May, stridently argues for more research to explore a long-discredited theory linking childhood vaccinations and autism.
Most experts reason that diagnoses of neurodivergence have increased due to increased societal awareness and improved diagnostic criteria. But for those still unsure, a newly released study tracking more than 1.2 million children across 21 years found no connection between early childhood vaccines containing aluminum and any of the 50 conditions that were reviewed, including autism and ADHD.
Meanwhile, measles outbreaks continue to rise alongside the decline of vaccination rates for a disease whose incidence was nearly eradicated over the last sixty years. That kind of data should matter to anyone who says they are serious about making America “healthy again.”
“They’re moving us back almost into the Dark Ages,” says Carmona. “The ramifications are extraordinary, and the policies that are being promulgated are ignorant.”
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