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“This is not just a policy shift—it’s a wholesale abandonment of government commitments to the American public," said one advocate.
The so-called "Make America Healthy Again" movement encapsulated a key campaign promise ahead of President Donald Trump's second term in office, with Trump telling one Pennsylvania crowd in 2024, "We’re going to get toxic chemicals out of our environment, and we’re going to get them out of our food supply."
But the Trump administration has gradually announced a slew of public health-related policies and proposals since the president took office—pushing to loosen emissions rules for the cancer-causing gas ethylene oxide; suggesting the polio vaccine should be optional; and mandating the production of carcinogenic glyphosate—and a peer-reviewed study has now cataloged the "grave threat to America's health" that Trump's policies present.
"During the first administration of President Donald Trump, nearly 100 environmental and occupational protections, including air-quality safeguards, were rescinded," reads the study, published in The New England Journal of Medicine (NEJM) on March 25. "Although many of those rescissions were delayed by litigation or reversed by President Joe Biden, they inflicted considerable harm on Americans’ health. The second Trump administration’s actions have been even more aggressive, portending greater harm."
Weeks after the US Senate confirmed Health and Human Services Secretary Robert F. Kennedy in February 2025—a confirmation that he secured after making the baseless claim that Americans would prefer the for-profit insurance system over universal healthcare and refusing to reject debunked claims about vaccines—the administration appeared to make clear its true views on public health when it announced 31 climate regulation rollbacks.
"Those initiatives and other administration actions are set to reverse progress on pollution, make workplaces more dangerous, and (in Environmental Protection Agency Administrator Lee Zeldin’s words) drive 'a dagger straight into the heart of the climate change religion,'" reads the study.
The proposals swiftly introduced by the administration included:
Ken Cook, co-founder of the Environmental Working Group (EWG), said the study described "a deliberate dismantling of safeguards that protect the air, water, and health of nearly every person in this country—all in the service of polluters."
“This is not just a policy shift—it’s a wholesale abandonment of government commitments to the American public and the MAHA movement that helped propel Trump into office,” said Cook, who did not contribute to the study.
Philip Landrigan, a pediatrician and public health physician who directs the Global Observatory on Planetary Health at Boston College and is the lead author of the paper, told EWG that the “impacts of these rollbacks will fall most heavily on the most vulnerable among us—including infants—resulting in brain injury, neurodevelopmental disorders, increased preterm births, and elevated lifelong risk of chronic disease.”
Children and other vulnerable populations, including those in low-income communities situated close to petrochemical industrial areas, are likely to have increased mercury, benzene, and arsenic exposures—raising their risk of developing cancers and other diseases—due to the Trump administration's rollbacks, according to the study.
"Several proposed policies would weaken water-quality standards, reducing drinking-water safety for millions of people," reads the paper. "For example, the EPA seeks to weaken regulations governing effluent discharges from coal-fired power plants. The resulting increase in waterborne lead, mercury, and arsenic will increase the incidence of bladder cancers and adversely affect children’s cognitive function."
The study's authors emphasized that "statistics and documentation are not enough" to protect the public from the White House's harmfiul policies.
"Unless health professionals speak up, and unless we put a human face on the tragic consequences of these environmental rollbacks, the connection between these seemingly abstract policy changes and the real health harms they cause may remain invisible," reads the study. "We health professionals must call urgent attention to this silent but deadly assault on Americans’ health, work with broad coalitions to halt it, and ultimately rebuild the agencies, protections, and shared sense of trust and responsibility that have given us clean air and water and enabled us and our children to live longer, healthier lives."
Cook noted that the NEJM itself has been a target of the administration, with Kennedy calling highly respected, science-based journals "corrupt" and the Department of Justice questioning the publication's editorial integrity.
“No amount of political pressure or intimidation should silence independent science or the experts working to protect public health,” Cook said. “The NEJM and the study’s authors rightly ignore those threats and lay bare the real-world consequences of the Trump administration’s actions—and the American people deserve to hear it.”
"Republicans in Congress want to cut Americans' healthcare to pay for more war in Iran. Let that sink in."
"Republicans won't think twice about *literally* sacrificing you to get their way."
That's how Democrats on the US House Ways and Means Committee responded to Axios' Monday reporting on congressional Republicans considering more healthcare cuts to help fulfill President Donald Trump's request for $200 billion to continue partnering with Israel for an unconstitutional war on Iran—including a potential ground invasion.
Other critics said:
Michael Hardaway, a geopolitical strategist who has worked for top Democrats, argued that they "must convert this into a House AND Senate majority in November," noting that Republicans "took healthcare away from millions of Americans to pay for tax cuts for the 1%."
That was last year, when congressional Republicans and Trump used the budget reconciliation process to pass their so-called One Big Beautiful Bill Act. Between $1 trillion cuts to Medicaid over the next decade and failing to extend expiring Affordable Care Act (ACA) tax credits, the OBBBA is expected to strip healthcare coverage from up to 15 million Americans.
While the impacts of the OBBBA will play out over years, already, "in red states and blue states alike, Republican healthcare cuts are hitting communities like a wrecking ball," Senate Finance Committee Ranking Member Ron Wyden (D-Ore.) said last week, while releasing a related report with House Energy and Commerce Committee Ranking Member Frank Pallone Jr. (D-NJ).
Wyden and Pallone found that over half of the people who reenrolled in an ACA plan this year have had to or plan to reduce spending on other essentials; at least 19 health facilities have closed across 11 states; and nearly 500 employees were laid off in four states because of the GOP's healthcare cuts last year.
"Despite attempts by Trump and his allies to cast blame elsewhere, the stories and facts are rolling in from across the country," Wyden said. "Democrats will not stop elevating the voices of Americans whose health is in harm's way as a result of Republicans' healthcare cuts."

One proposal that the GOP considered but ultimately did not include in the OBBBA related to ACA cost-sharing reductions. The Congressional Budget Office estimated that the specific policy considered last year would save $31 billion but leave 300,000 more Americans uninsured through 2034.
Reporting emerged last week that House Budget Committee Chair Jodey Arrington (R-Texas) wants to bring back the push for that policy. It quickly spurred criticism, with Sen. Elizabeth Warren (D-Mass.) saying: "Republicans in Congress want to cut Americans' healthcare to pay for more war in Iran. Let that sink in."
"Republicans ransacked $1 trillion from Medicaid, and then they more than doubled premiums for over 20 million Americans in order to fund tax breaks for billionaires and big corporations," Leslie Dach, chair of the advocacy group Protect Our Care, said in a statement last week. "Now, care for 15 million working Americans will be ripped away, nursing homes and hospitals are on the chopping block nationwide, and Americans are buried under skyrocketing healthcare hikes."
"But that's not enough for Republicans who have been at war with working families' healthcare for decades—now they want to slash healthcare even more to bankroll the war in the Middle East and to fund ICE, Trump's unaccountable, lawless paramilitary force," Dach continued, referring to US Immigration and Customs Enforcement. "The American people reject these Republican priorities and will make their voice known in November."
Axios reported Monday on Arrington's preferred timeline for a new budget package: "60 to 90 days," he said.
Arrington is also eyeing some potential changes to Medicare, which provides health insurance coverage to Americans age 65 and older, according to Axios:
As for Medicaid, one of the programs attacked by the OBBBA, Arrington told the outlet that there is hesitancy "to open that back up," but some policies considered in 2025 could be revived.
In a Monday statement, Democratic National Committee rapid response director Kendall Witmer called out Trump and Vice President JD Vance for past and possible future GOP healthcare cuts, accusing them of breaking their campaign promises.
"Donald Trump and Republicans already made the largest cuts to healthcare in history, causing healthcare costs to skyrocket for millions of Americans while billionaires and big corporations get massive tax cuts," Witmer said. "Now, Republicans want to slash even more healthcare funding for working families to pay for their war with Iran."
"After promising on the campaign trail to stop the endless wars, reduce the national debt, and lower costs," Witmer added, "Trump and JD Vance have done the opposite: putting everyday Americans on the chopping block to wage their deadly and costly war of choice."
New bills seek to reinforce a false binary between abortion care and care for pregnancy loss, but this will only harm pregnant patients and further restrict access to comprehensive sexual and reproductive healthcare.
People experiencing pregnancy complications in states that restrict abortion have died preventable deaths; others have been forced to bleed out while waiting for providers to deem their conditions were life-threatening enough to receive care under narrow legal exceptions or had to travel out of state for emergency abortion care. Meanwhile survivors of rape and incest have been denied care, despite exceptions that supposedly permitted abortion in those circumstances.
This is the new reality of seeking pregnancy-loss care and abortion care post-Dobbs. But instead of addressing the root issue—abortion bans and restrictions—policymakers are advancing a new strategy: redefining abortion itself. These new bills seek to reinforce a false binary between abortion care and care for pregnancy loss, but this will only harm pregnant patients and further restrict access to comprehensive sexual and reproductive healthcare.
For example, a bill in Utah would allow people who have obtained abortion care for certain reasons (such as treating an ectopic pregnancy; removing a dead fetus; or in the cases of fetal anomaly, rape, or incest) to request that their medical record state that the abortion was “involuntary.” The proposed legislation attempts to legally codify the distinction between “elective” abortions and those obtained for medical reasons to further stigmatize abortion care. The bill’s sponsor has been at the forefront of restricting abortion in Utah, and claims this bill is for medical records and to prevent patient “distress.” However, there is no need for legislators to define medical care for the sake of providers or patients. People’s reproductive experiences are highly personal, and the language they use to describe them should be up to them—not politicians.
In other states, attempts to omit care for pregnancy loss from the legal definition of abortion opens the door for abortion to be further restricted. In Missouri, Wisconsin, and South Dakota, bills are being pushed that change the definition of abortion to exclude a range of pregnancy-loss care. Wisconsin’s bill, for example, aims to “exempt [this care] from abortion restrictions,” implying that there is some reproductive healthcare that should be protected, while some should not.
The only way to ensure that people in medical emergencies or who have experienced violence can get the care they need is expanding and protecting abortion care for all.
These bills all also rely on language that personifies the fetus or embryo, advancing the long-held anti-abortion goal of granting full legal rights to embryos and fetuses. Fetal personhood directly undercuts pregnant people’s rights and can be used to target other reproductive healthcare such as forms of contraception and IVF. While this language was eventually removed from the South Dakota bill, its inclusion when it was first introduced exposes the policymakers' intention: to carve out some forms of pregnancy care and use that as a foundation to attack abortion care.
The push to “clarify” exceptions, or what care can be provided under abortion bans, stems from understandable public outrage—outrage we share. The horrific outcomes for pregnant people who have died preventable deaths are the direct result of abortion bans--but adding legal carve outs designed by the same policymakers who champion draconian abortion laws is not the way to ensure that everyone has access to essential pregnancy-loss care.
The truth is, it’s impossible to silo abortion care from the rest of reproductive healthcare through medical or legal frameworks. Abortion, pregnancy-loss care, and pregnancy care are interconnected by their practices, medications, and the people that provide and obtain them. The only way to ensure that people in medical emergencies or who have experienced violence can get the care they need is expanding and protecting abortion care for all.
Separating abortion care from pregnancy-loss care also does not align with many people's lived experiences. Guttmacher research shows that people’s understanding of the boundaries between reproductive experiences are deeply nuanced. The author and model Chrissy Tiegen, for example, has been public about redefining her own pregnancy loss as an abortion, which she proceeded with after learning she would not survive the pregnancy without medical intervention. Ultimately, how someone defines their pregnancy outcome and the care they receive is subjective, and policymakers’ efforts to establish clear legal distinctions ignore the frequently blurred boundaries between these experiences.
Categorizing abortions as elective or "involuntary” is not only stigmatizing and medically unnecessary but ignores the complexities of people’s reproductive lives. Likewise, “clarifying” exceptions is simply another tool of the anti-abortion movement to further restrict and stigmatize abortion. What pregnant people need is compassionate and personalized care, not further state involvement in their bodies and decisions.