Trump cuts could clash with Kennedy’s goals

Robert F. Kennedy Jr, the new US health secretary, has promised to address an epidemic of chronic illness with President Donald Trump’s backing, but his broad agenda from making food healthier to studying vaccines may clash with government spending cuts.

Trump on Thursday ordered the creation of a ‘Make America Healthy Again’ Commission made up of Kennedy and other secretaries to look at everything from the high rates of autism and asthma in children to how much medicine is being prescribed to them for ADHD or other conditions. Kennedy, a 71-year-old environmental lawyer, has said the government should open up its data, conduct new scientific studies on vaccines and tackle gaps in rural healthcare with artificial intelligence and telemedicine. He has plans to go after food additives, an area regulated by the US Food and Drug Administration, one of about a dozen agencies within the $3 trillion US Department of Health and Human Services, according to a Reuters report.

At the same time, Republicans are looking to offset extensive tax cuts by slashing the federal workforce. One HHS agency – the US Centers for Disease Control and Prevention – plans to cut its probationary staff, about one-tenth of its employees, according to the Associated Press, says the report.

To make a lasting change, as Kennedy has said he wants to do, it takes years and requires technical experts who can change regulations, said Dan Troy, managing director at consulting firm BRG and former FDA Chief Counsel under President George W. Bush. “If you walk in and you fire the people who are best able to help you get regulations done, then not a lot’s going to get done,” Troy said. “They’re going to have to decide, do they want to actually attack the issue of food additives... or do they want to get rid of the people in the food additive division? You can’t really do both.”

The administration is also targeting Medicaid spending through specific cuts by the agency, two sources with direct knowledge of the government’s plans told Reuters. Medicaid health programmes are jointly paid by states and the federal government and cover low-income individuals and families. Reform of Medicaid, Medicare and the Affordable Care Act could free up resources for Kennedy to spend on promoting nutrition, physical activity and social engagement, said Brian Blasé, president of think tank Paragon Health Institute, which is closely aligned with the Trump administration.  “It’s time to stop wasting so much money on low value government health programmes,” Blasé said.

Ameet Sarpatwari, a professor at Harvard Medical School, said there could be tensions between Kennedy and the president’s staff on some of these issues, but that he and Trump would be aligned on most policy matters.

Joseph Antos, senior fellow emeritus at conservative think tank the American Enterprise Institute, agreed. “If there’s going to be a problem, it’s going to be more about (Kennedy’s) personal interests butting up against the heads of somebody in the White House.”

Some of Kennedy’s allies who supported him throughout his presidential campaign, abandoned last August, said they want him to prioritise transparency of government data, removing ultra-processed food from school lunches and ensuring government health decisions are independent from corporate agendas, the Reuters report adds. Trump’s health order for his new secretary’s first day does not mention one of the items Kennedy raised during Congressional testimony – that he would ask for a review of the safety of abortion drug mifepristone.

Project 2025, a series of detailed policy proposals put together by hundreds of high-profile conservatives, some of whom Trump has named to his administration, calls for a series of detailed anti-abortion measures like banning abortion pills and withdrawing Medicaid funds from pro-abortion states.