Archives for category: Health

Robert F. Kennedy Jr. visited in Samoa in 2019. While there, he proselytized on the dangers of vaccines. After he left, the number of people getting vaccines declined. 83 people died of measles, many of them children. They were not vaccinated. RFK is not merely a “vaccine skeptic,” he’s an opponent of vaccines.

The Washington Post reported:

Health officials around the world are alarmed over the likely impact of Robert F. Kennedy Jr. — a longtime vaccine skeptic who was tapped for the health secretary role this week — on global health. Experts from Samoa have been particularly vocal in sounding the alarm, citing the destructive impact of Kennedy’s rhetoric on the tiny Polynesian island nation.


Warning that Kennedy will empower the global anti-vaccine movement and may advocate for reduced funding for international agencies, Aiono Prof Alec Ekeroma, the director general of health for Samoa’s Health Ministry told The Washington Post that Kennedy “will be directly responsible for killing thousands of children around the world by allowing preventable infectious diseases to run rampant.”


“I don’t think it’s a legacy that should be associated with the Kennedy name,” Ekeroma said in an email Friday.


Ekeroma recalled a disastrous epidemic in 2019, when measles spread rapidly across the small Pacific Ocean country. Of Samoa’s population of 200,000, more than 5,700 were infected and 83 died, many of them young children. Hospitals were overrun, and the nation declared a state of emergency. To stop the outbreak, Samoa launched a massive vaccination campaign, and unvaccinated families were asked to hang red flags outside their homes.

The island nation already had a lagging measles vaccination rate of only about a third of infants, plummeting from 90 percent in 2013. Health experts attributed that drop in part to a public health scandal in which two nurses improperly mixed the measles vaccine with the wrong liquid, resulting in the deaths of two infants. Both nurses were sentenced to five years in prison, and the vaccination program was temporarily suspended — but the accident also opened the door to a wave of vaccine misinformation, including from Kennedy and his anti-vaccine nonprofit.


Kennedy had visited Samoa only four months before the outbreak and met with anti-vaccine advocates. He later characterized the outbreak in Samoa as “mild.”

Trump put Elon Musk and Vivek Ramaswamy in charge of a “Department of Government Efficiency” and told them to have fun cutting the federal budget. A billionaire and a millionaire who know nothing about government programs will start hacking away.

The Washington Post helpfully assembled a list of programs that are prime targets.

Jacob Bogage wrote:

Trump government efficiency advisers Elon Musk and Vivek Ramaswamy have pledged not to bring a chisel to government spending, but rather “a chainsaw.” The particular approach Ramaswamy has in mind could threaten dozens of programs that tens of millions of Americans rely on each day.


Ramaswamy floated on social media a proposal to eliminate programs that Congress funds but where specific spending authorization has lapsed. That may sound like an easy source of savings, but it would ax veterans’ health-care programs, drug research and development, opioid addiction treatment — even the State Department.


“We can & should save hundreds of billions each year by defunding government programs that Congress no longer authorizes,” Ramaswamy wrote.


The approach from President-elect Donald Trump, Musk and Ramaswamy’s out-of-government “Department of Government Efficiency,” or DOGE, demonstrates a fundamental misunderstanding of Congress and federal spending, experts say.


Though Ramaswamy suggested that programs Congress no longer authorizes are prime targets for cuts, in reality, many programs where Congress has let authorization lapse are covered by funding bills that policy wonks call “self-authorizing.”

In other words, instead of needing two laws — one to approve funding for an agency and another to actually allocate the money — Congress only passes one: the allocation, which intrinsically gives a department authority to spend its funding. It is Congress’s way of making legislative work more efficient, and its legality has been confirmed by numerous government studies.


There is plenty of room for policymakers to uncover and eliminate excess federal spending, experts say, an issue made even more serious by the country’s deteriorating financial health. The national debt is expected to eclipse $36 trillion in the coming days; Trump’s first-term policies accounted for $8.4 trillion of that amount, according to the nonpartisan Committee for a Responsible Federal Budget.


It just might be more difficult than DOGE’s backers suggest.


“It is obviously important for the government to be good stewards of taxpayer dollars. There’s real bipartisan areas where people agree there’s stuff to be done. But what Elon and Vivek and Trump are going for is not that,” said Bobby Kogan, an analyst at the center-left think tank Center for American Progress. “They don’t even get the basics right. They get the size of the budget wrong. They named it after a meme. In no way are they actually taking this seriously.”

Musk and Ramaswamy beg to differ, and have called the DOGE commission the United States’ next Manhattan Project.


“There’s a new sheriff in town. Donald Trump’s the president. He has mandated us for radical, drastic reform of this federal bureaucracy with the learnings of that first term,” Ramaswamy said on Fox News. “And look, Elon and I — Elon is solving major problems of physics. I came from the world of biology. What we’re solving here now is not a natural problem. This is a man-made problem, and when you have a man-made problem, you better darn well have a man-made solution. That’s what we’re bringing to the table.”
Trump transition officials did not immediately return a request for comment.


The programs without separate spending authorization that Ramaswamy would do away with represent more than $516 billion, according to the Congressional Budget Office. The 10 largest make up $380 billion. Here’s a look at what some of those programs do.

Veterans’ health care


A 1996 law set eligibility requirements for military veterans to receive hospital, medical and nursing home care and authorized spending for those services and patient enrollment. That law has not been renewed, but Congress regularly allocates additional Department of Veterans Affairs funding and allows benefits to increase automatically based on inflation. VA provides medical care to more than 9.1 million enrolled veterans, according to the agency.
Drug development and opioid addiction treatment.


Most of this spending relates to the bipartisan 21st Century Cures Act of 2016. That law provided money to the National Institutes of Health and Food and Drug Administration to modernize pharmaceutical research and medical trials. It funded research for cancer cures and state-level grants for opioid addiction and other substance abuse treatment.


State Department


In 2003, Congress passed the Foreign Relations Authorization Act, which set policy priorities and created spending authority for the State Department. That law has not been renewed, but Congress every year since has passed annual funding bills for the department, which Trump has announced he’ll nominate Sen. Marco Rubio (R-Florida) to run.


Housing assistance


President Bill Clinton in 1998 signed the Quality Housing and Work Responsibility Act, which overhauled federal housing assistance policies, including voucher programs and other antipoverty assistance. The Department of Housing and Urban Development and other agencies continue using this law to implement federal housing programs.


Justice Department


In 1994, Congress passed the landmark Violence Against Women Act and has renewed it multiple times since. In 2006, lawmakers packaged a VAWA renewal with authorizing legislation for the Justice Department. As with the State Department, Congress has not approved new authorizing legislation for the Justice Department since, but it has funded the agency — and even authorized hundreds of millions of dollars more for a new FBI headquarters — every year.


Education spending


The 2015 Every Student Succeeds Act delegated power to state and local education officials to set primary and secondary education achievement standards. It gives billions of dollars in federal grant money to state and local education officials to fund schools and school districts. Those standards are still used by the Education Department, even though the legislation has not been reauthorized. Trump has suggested he’d like to eliminate the entire department.


NASA


Stripping funding for NASA, which was last reauthorized in 2017, could spell doom for Musk’s commercial spaceflight firm, SpaceX. The company has contracts worth more than $4 billion — including for return trips to the moon and retiring the International Space Station — linked to programs approved in the 2017 law.
Health-care and student loan programs
What’s known as the Affordable Care Act, or Obamacare, was actually passed in two separate bills in 2010. The Health Care and Education Reconciliation Act represents the second bill, which included some tax revisions and technical changes to the ACA. The law has not been reauthorized since, but the Department of Health and Human Services reported in March that more than 45 million people have health insurance coverage backed by the Affordable Care Act.

The law that made those final tweaks to the ACA also overhauled the Education Department’s student loan program. Where some schools relied on private lenders to issue federally backed loans, with this law, the government itself became the lender. That change has since enabled President Joe Biden to offer student loan debt relief, though many of his most ambitious policies have been blocked by the courts. Student loans are generally funded through mandatory spending — similar to social safety net programs such as Medicare and Social Security — and not subject to annual spending laws.


International security programs


The 1985 International Security and Development Cooperation Act bundled together authorizations for a number of international security programs, including funding and regulations for arms sales to allies, economic aid for developing countries, airport security, anti-narcotics-trafficking policies, the Peace Corps and more. This Reagan-era law continues to be foundational to congressional funding and federal policy.


Head Start


Head Start provides preschool education for children from low-income families. In the 2023 fiscal year, more than 800,000 children enrolled in Head Start programs, according to the National Head Start Association. The program also helped place more than 530,000 parents in jobs, school or job-training programs. It was last authorized in 2007.

The article contains a graphic of programs that are on the chopping block, along with their appropriations. I can’t copy it. If you subscribe to the Washington Post, please open the link and post the graphic in your comment.

https://www.denverpost.com/2024/11/14/jared-polis-rfk-jr-trump-hhs-endorsement-tweet/

Colorado Gov. Jared Polis holds up a copy of Project 2025 as he speaks during the Democratic National Convention Wednesday, Aug. 21, 2024, in Chicago. (AP Photo/J. Scott Applewhite)
Colorado Gov. Jared Polis holds up a copy of Project 2025 as he speaks during the Democratic National Convention Wednesday, Aug. 21, 2024, in Chicago. (AP Photo/J. Scott Applewhite)

Colorado Gov. Jared Polis on Thursday cheered anti-vaccine advocate Robert F. Kennedy Jr.’s nomination to lead the nation’s top public health agency, highlighting the controversial nominee’s stances on “big pharma” and “corporate ag.”

Polis, a Democrat, faced quick pushback on social media after he said he was “excited” by President-elect Donald Trump’s selection, and he posted againan hour later to clarify his thoughts. A spokesman for the governor then further walked back Polis’ support for Kennedy in a statement to The Denver Post.

Trump, a Republican, nominated Kennedy to lead the U.S. Department of Health and Human Services. In the presidential race, Kennedy initially had sought the Democratic nomination, then ran as an independent. A member of the dynastic Kennedy family, he later abandoned his presidential campaign and backed Trump.

Kennedy has pushed a number of public health conspiracies, most prominently around vaccines, and has advocated for other positions that are generally out of the mainstream, such as more availability of unpasteurized milk. He has said he wants to remove fluoride from the American water supply, and when he ran for president, he said he wanted to pause research into pharmaceuticals and infectious diseases for at least eight years.

He has falsely suggested that COVID-19 was “ethnically targeted” to “attack” certain groups and that mass shootings have been caused by prescription drugs, among other debunked conspiracy theories.

Kennedy has adopted some mainstream health positions, such as limiting ultra-processed foods and the use of pesticides in growing crops. Polis, citing specific quotes by Kennedy, focused on those latter views in his first post Thursday afternoon on the social platform X.

“‘In some categories, there are entire departments, like the nutrition department at the (Food and Drug Administration) that are — that have to go, that are not doing their job, they’re not protecting our kids,” Polis quoted Kennedy as saying, then added himself: “YES! The entire nutrition regime is dominated by big corporate ag rather than human health and they do more harm than good.”

Polis — who’d previously criticized Kennedy’s anti-vaccine stances this summer — acknowledged those positions in his posts Thursday but urged his 136,000 X followers to hold off on mocking or disagreeing with Kennedy.

He said Kennedy had “helped us defeat vaccine mandates in Colorado in 2019.” He was referring to a defeated legislative measure that would have made it harder for parents to opt out of vaccine mandates for public schools.

Polis wrote that he hoped Kennedy would make vaccines a matter of choice, not about bans or requirements.

Polis’ comments drew swift backlash. Outgoing state Rep. David Ortiz, a Littleton Democrat, called the governor’s endorsement “pathetic pandering.” Rep. Javier Mabrey, a Denver Democrat, quipped on X: “Yikes.” Shad Murib, the chair of the Colorado Democratic Party, tweeted “Welp” shortly after Polis’ comments, and he subsequently criticized Kennedy’s conspiratorial history in a Thursday evening statement from the party.

Sen. Kyle Mullica, a Thornton Democrat and emergency room nurse, was blunter.

“This is just complete bullshit,” he said in an interview, and then repeated that point for emphasis. 

Mullica rejected Polis’ suggestion that state officials had sought vaccine mandates in the past. He said legislators worked to improve immunization rates through medical exemption reform and through education. Polis previously supported parents’ ability to opt out of vaccinations — drawing support from anti-vaccine advocates — despite the state’s poor rankings for pediatric immunization.

“The biggest thing is — look, science matters, man,” Mullica continued. “And with all the disinformation and misinformation that’s being put out by people like RFK Jr. and the internet, we need leaders who can stand up, follow the science, understand it and (make) sure we are making decisions based on evidence and science.”

Asked why Polis endorsed Kennedy in light of his often-conspiratorial stances, a spokesman for the governor responded by referring to a subsequent Polis social media post. The spokesman, Eric Maruyama, then issued a statement distancing the governor from the controversial figure he had just backed.

Maruyama wrote that Polis “does not endorse actions that would lead to measles outbreaks and opposes unscientific propaganda.”

“Governor Polis has not changed his view as a whole on RFK Jr. or on the Governor’s previously stated concerns regarding some of  RFK Jr’s positions,” Maruyama wrote. “While opposed to RFK’s positions on a host of issues, including vaccines and banning fluoridation, (Polis) would appreciate seeing action on pesticides and efforts to lower prescription drug costs and if Trump is going to nominate someone like him then let them also take on soda, processed food, pesticides and heavy metals contamination.”

Trump knows that there is a strong possibility that some of his nominees for his Cabinet are so unqualified that they may not be approved by the Republican majority of the Senate. The Senate typically advises and gives its consent to high-level appointments. But Trump is trying to exercise a relatively obscure provision of the Constitution to bypass the Senate.

Since we know that Trump never read the Constitution, it’s certain that one of his creative lawyers planted the idea.

Trump’s selection of Matt Gaetz, who faces allegations of sex-trafficking minors and drug abuse, as Attorney General, produced shock and disbelief among some Republicans. So has Tulsi Gabbard, whom Trump would elevate to the highest position in the American intelligence community. So has Robert Kennedy Jr., the anti-vaccine advocate, to head the Department of Health and Human Services. Medical and scientific experts are appalled. So has Trump’s choice of Pete Hegseth, FOX talk show host, to lead the department of Defense.

But Trump could give them “recess appointments” and have no scrutiny or review by Senators. And avoid the risk that some or all might be rejected.

We know that Trump doesn’t care about norms, traditions or laws that constrain his power. If the Senate abandoned its role to please Trump, he would be empowered to trample the rule of law at every turn. That is most definitely a threat to our democracy.

Senate Majority Leader John Thune says “all options are on the table,” and has neither accepted or refuted the scheme.

Edward Whelan, a prominent conservative lawyer, criticized Trump’s devious route in this op-ed in The Washington Post.

He wrote:

President-elect Donald Trump is threatening to turn the Constitution’s appointment process for Cabinet officers on its head. If what I’m hearing through the conservative legal grapevine is correct, he might resort to a cockamamie scheme that would require House Speaker Mike Johnson (R-Louisiana) to play a critical role. Johnson can and should immediately put an end to this scheme.

The Senate’s power to approve or reject a president’s nominees for Cabinet positions is a fundamental feature of the Constitution’s system of checks and balances. As Alexander Hamilton explained in the Federalist Papers, that power “would tend greatly to prevent the appointment of unfit characters,” including those “who had no other merit than that … of possessing the necessary insignificance and pliancy to render them the obsequious instruments of [the president’s] pleasure.” Almost as if Hamilton were describing Matt Gaetz, Trump’s pick for attorney general.

To be sure, the Constitution also provides a backup provision that allows the president to make recess appointments — “to fill up all Vacancies that may happen during the Recess of the Senate.” But as Hamilton put it, this “auxiliary method of appointment” is “nothing more than a supplement” to the “general mode of appointing officers of the United States” and is to used “in cases to which the general method was inadequate.”

It appears that the Trump team is working on a scheme to allow Trump to recess-appoint his Cabinet officers. This scheme would exploit an obscure and never-before-used provision of the Constitution (part of Article II, Section 3) stating that “in Case of Disagreement” between the houses of Congress, “with Respect to the Time of Adjournment,” the president “may adjourn them to such Time as he shall think proper.”

Under this scheme, it appears that the House would adopt a concurrent resolution that provided for the adjournment of both the House and the Senate. If the Senate didn’t adopt the resolution, Trump would purport to adjourn both houses for at least 10 days (and perhaps much longer). He would then use the resulting intrasession recess to appoint Gaetz and other Cabinet nominees.

Ten years ago, Supreme Court Justice Antonin Scalia labeled the president’s recess-appointment power an “anachronism” because “modern forms of communication and transportation” make the Senate always available to consider nominations. Along with three of his colleagues, Scalia also argued that the president’s power to make recess appointments is limited to intersession recesses and does not apply to the intrasession recess that the Trump scheme would concoct. The justice, who died in 2016, would be aghast at the notion that a president could create an intrasession recess for the purpose of bypassing the Senate approval process for nominations.

Mike Johnson should not be complicit in eviscerating the Senate’s advice-and-consent role. He should promptly make clear that the House will abide by its usual schedule of recesses and will not attempt to engineer a recess of the Senate.

Edward Whelan is a distinguished senior fellow of the Ethics and Public Policy Center, where he holds the Antonin Scalia chair in constitutional studies.

Miranda Yaver, a professor of public health policy at the university of Pittsburgh, writes about Trump’s disastrous choice to run the National Institutes of Health.

She writes:

I first got interested in health policy because of Ronald Reagan, but not in the way you might think. 

Growing up in the San Francisco Bay Area with a mom who worked at the United Way, I was well aware of the HIV/AIDS epidemic. I knew people who were HIV positive. So when HBO released the film adaptation of And the Band Played On, I was riveted. Enraged. Filled with righteous indignation. 

To be honest, it hasn’t really worn off. 

Randy Shilts wrote in his prologue to And the Band Played On (which I reread amid the COVID-19 pandemic) the following:

“The bitter truth was that AIDS did not just happen to America – it was allowed to happen by an array of institutions, all of which failed to perform their appropriate tasks to safeguard the public health. This failure of the system leaves a legacy of unnecessary suffering that will haunt the Western world for decades to come…. The story of these first five years of AIDS in America is a drama of national failure, played out against a backdrop of needless death. People died while Reagan administration officials ignored pleas from government scientists and did not allocate adequate funding for AIDS research until the epidemic had already spread throughout the country… People died while public health authorities and the political leaders who guided them refused to take the tough measures necessary to curb the epidemic’s spread, opting for political expediency over the public health.”

So was also the case for the COVID-19 pandemic, which was unleashed upon the world at a time in which the United States’ public health bureaucracy was hotly politicized, chronically underfunded, and constrained by anti-science forces at the head of the Trump Administration. 

And rather than learning from the mistakes of this pandemic, the most dangerous among them are being rewarded with high-level posts from which to spew anti-scientific drivel, which can come with real life-or-death consequences. 

I’m not talking about R.F.K. Jr… this time. Right now, I’m talking about Jay Bhattacharya, who according to Dan Diamond of The Washington Post is likely poised to be the new head of the National Institute of Health (NIH), having been listed by RFK Jr. as a top contender for the position, which falls under the broader umbrella of HHS. 

It has admittedly been an interesting experience to watch the nominations unfold, having written a doctoral dissertation on the problems that arise when agencies are headed by people who oppose the agencies’ core missions, and when Congress and others are ill-equipped or disinclined to hold those agencies accountable. You know, hypothetically. 

So, who is Jay Bhattacharya? Needless to say, he has been a critic of the NIH while being celebrated by noted public health opponent, Florida Governor Ron DeSantis. His other cheerleaders include Peter Thiel, Elon Musk, and Joe Rogan – you know the voices of reason in public health. 

His opposition within the public health community is not about partisanship, but rather the anti-science stances that he embraced over the course of the deadly pandemic, and which have been widely perceived among experts as having prioritized the business community over health outcomes. While I joined with experts in public health and medicine through the organization Brief-19 to disseminate evidence-based analyses of the public health and policy implications of what we were learning from day to day about the pandemic, Bhattacharya downplayed the threat of the virus, instead emphasizing less government control and more reliance on individual choices to self-protect. 

Rugged individualism and self-reliance. Now where have we heard that before? 

To be sure, I have had many quibbles with Ayn Rand and her followers over the years. Some of it is political. Some of it isn’t. 

The reality is that rugged self-reliance just simply doesn’t work in the public health setting. Public health can and indeed must be rather paternalistic, because by definition it’s focused not on individual health, but collective health outcomes and system performance. Choosing not to get vaccinated is bad for you, but it’s really bad for your community. Choosing not to mask or socially distance during a pandemic undercuts not only your and your family’s safety, but it compromises scientifically-grounded public interventions aimed at flattening the curve. This requires that we care not just about “me me me,” but to think more broadly. That isn‘t always easy for Americans. But given that we know that the next pandemic isn’t a matter of “if” but rather “when,” it’s vital that our institutions of public health be staffed with grown-ups who believe in science and understand that effective public health interventions should be prioritized over individual convenience. And they absolutely need to be staffed with people who know better than to elevate pseudoscience and grifters – whether in hedge funds, on podcasts, or widely discredited academics relying on a degree to lend credence to anti-scientific and/or anti-democratic theories. 

Indeed, a prominent supporter of Bhattacharya was his Stanford colleague Scott Atlas, who went against the scientific community in encouraging lower-risk people to become infected with COVID-19 as a means to promote herd immunity, and who urged the reopening of schools even as we knew that there would be risks of increased transmission in those settings. And Bhattacharya contributed to The Great Barrington Declaration, which urged that younger Americans return to work and build immunity against the COVID virus. 

All of this was in the interest of creating a false dichotomy between helping the economy and promoting public health. But the reality is that while people of both parties want a robust business sector, containing a deadly virus is an important precursor. What is the value of having a business open if would-be patrons are sick or dying? What is the value of forcing a business open if staff immediately become exposed and sick? 

Investments in public health pay off. We see this in the insurance setting, which is where most of my own research and teaching are situated. Of course, covering people costs money. But what is the result? People are able to access needed care. They are able to manage chronic and acute medical conditions. They are able to not only survive but thrive. And in light of that, they can be productive in the American economy, while health care providers are relieved of the economic burdens of uncompensated care. 

These are not burdens. They are investments. 

America just emerged – far from unscathed – from a major, deadly pandemic the likes of which we had not seen since the 1918 Spanish flu. And we deserve public health leaders who learned the right lessons from it. Instead, Bhattacharya’s impulse amid the COVID pandemic was to see the core problem as the stifling of dissent (which is to say, prioritizing public health expertise over the legitimization of quackery).

These are not the only reasons why Bhattacharya would be a problematic selection to head NIH. While he boasts impressive academic credentials, he has never before overseen a large bureaucratic organization, while the National Institute of Health has nearly 20,000 staff. To be sure, RFK Jr. and others within Trump’s orbit see it as an advantage to lack government experience, largely because of a deeper distrust of the government apparatus and hostility to government interventions (even those which could honestly be termed “pro-life”). But governmental and managerial competence is vital, and when this is put on the back burner in the domain of public health, there are life-or-death consequences. 

Bhattacharya has ideas for how the NIH should operate, and it doesn’t look good, essentially coming down to its decentralization as well as deprioritizing the expertise of long-serving bureaucrats. This disregard for agency expertise fits well within the Trump Administration’s broader opinions on the administrative state (or what’s left of it after Loper Bright), seeking to clamp down on civil servants who are perceived as being politically disloyal. Prof. Don Moynihan has written extensively on these issues in Schedule F positions, and you should read it.

If we are lucky, as with the first Administration, the degree of incompetence will exceed the high degrees of malevolence, thus stymying the most dangerous policy proposals that have been floated. But we should not have to root for public health incompetence when our lives – not to mention our research funding on a broad array of public health and health policy subjects – depend on the strength of this agency. 

Jay Bhattacharya would deeply damage our efforts to study public health problems facing the country and the world and would signal even further entrenchment of conspiratorial perspectives and political expediency where we most need to follow the science. Tom Nichols wrote a book called The Death of Expertise: The Campaign Against Established Knowledge and Why it Matters. As with my own work on bureaucratic noncompliance amid misaligned agency objectives, I fear that this will be all too relevant in the coming months and years.

Jamelle Bouie writes regularly for The New York Times. I subscribed to get extra writing from him. In this one, he asks the question that has undoubtedly occurred to many people.

Bouie writes:

On Tuesday, Donald Trump became the first Republican in 20 years to win the national popular vote and the Electoral College.

The people — or at least, a bare majority of the voting people — spoke, and they said to “make America great again.”

What they bought, however, isn’t necessarily what they’ll get.

The voters who put Trump in the White House a second time expect lower prices — cheaper gas, cheaper groceries and cheaper homes.

But nothing in the former president’s policy portfolio would deliver any of the above. His tariffs would probably raise prices of consumer goods, and his deportation plans would almost certainly raise the costs of food and housing construction. Taken together, the two policies could cause a recession, putting millions of Americans — millions of his voters — out of work.

And then there is the rest of the agenda. Do Trump voters know that they voted for a Food and Drug Administration that might try to restrict birth control and effectively ban abortion? Do they know that they voted for a Justice Department that would effectively stop enforcement of civil and voting rights laws? Do they know they voted for a National Labor Relations Board that would side with employers or an Environmental Protection Agency that would turn a blind eye to pollution and environmental degradation? Do they know they voted to gut or repeal the Affordable Care Act? Do they know that they voted for cuts to Medicaid, and possible cuts Medicare and Social Security if Trump cuts taxes down to the bone?

Do they know that they voted for a Supreme Court that would side with the powerful at every opportunity against their needs and interests?

I’m going to guess that they don’t know. But they’ll find out soon enough.

When Robert F. Kennedy Jr. abandoned his independent campaign and endorsed Trump, Trump offered him any job he wanted. He wanted a role in public health.

The New York Times reported:

Robert F. Kennedy Jr., who President-elect Donald J. Trump has suggested would have a “big role” in his second administration, wasted no time laying out potential public health measures he would oversee if given the chance.

Mr. Kennedy, an environmental lawyer who has no medical or public health degrees and has promoted anti-vaccine conspiracies for years, told NBC News on Wednesday that he would not “take away anybody’s vaccines,” but that he wanted Americans to be informed with the “best information” available so they “can make individual assessments about whether that product is going to be good for them.”

“People ought to have choice,” he said, adding that he has “never been anti-vaccine.”

Mr. Kennedy has been a prominent critic of the childhood vaccination schedule and has frequently linked some vaccines to autism and other health issues. Studies have long shown no such connection.

On the topic of adding fluoride to drinking water, which helps to protect teeth, Mr. Kennedy said the mineral was “lowering I.Q. in our children,” despite decades’ worth of studies that show its efficacy and safety.

“I think fluoride is on its way out,” he said. “I think the faster that it goes out, the better. I’m not going to compel anybody to take it out, but I’m going to advise the water districts about their legal liability.”

The treatment of public water with small amounts of fluoride has been widely hailed as one of the most important public health interventions of the past century; the American Dental Association has said that it reduces dental decay by at least 25 percent.

Mr. Kennedy also said that if he were given a position in Mr. Trump’s administration, he would focus on eliminating corruption at public health agencies like the Food and Drug Administration and the Centers for Disease Control and Prevention.

Some departments, including those focused on nutrition, “have to go,” he told NBC. “They’re not protecting our kids.”

“Once Americans are getting good science and allowed to make their own choices, they’re going to get a lot healthier,” he added.

As president, Mr. Trump would have only limited authority to make some of these changes, and some would need congressional approval. But on the campaign trail, Mr. Trump said he would let Mr. Kennedy “go wild on health.”

“I want to be in the White House, and he has assured me that I’m going to have that,” Mr. Kennedy said this week.

Remy Tumin is a reporter for The Times covering breaking news and other topics. More about Remy Tumin

Wtiting on the MSNBC website, experienced journalist Molly Jong-Fast says that women can’t risk another Trump term. The issue that will be decisive, she believes, is reproductive rights. Women had them for 50 years, then Trump’s Supreme Court abolished them. Never before has the Supreme Court taken rights away.

She writes:

In 2016, in her presidential campaign against Donald TrumpHillary Clinton prophesied, “In a single term, the Supreme Court could demolish pillars of the progressive movement, and as someone who has worked on every single one of these issues for decades, I see this as a make-or-break moment.” Trump, of course, was elected and proceeded to appoint three justices to the Supreme Court, thus positioning a conservative-majority Supreme Court to rubber-stamp the most arrant conservative nonsense. And top of that Republican wish list was overturning the 1973 Supreme Court decision Roe v. Wade.

Now, in 2024, we’re seeing what happens when women’s bodily autonomy is threatened and stripped away. We’re seeing a striking gender gap when it comes to support for Vice President Kamala Harris and Trump, with early voting polls showing a 10-percentage-point gender gap. And when we look at the policies Trump has helped enact versus the promises Harris has pledged, it’s no mystery why.

Before Roe was struck down, and seemingly as a trial run, in 2021 Texas passed Senate Bill 8, which made abortion after six weeks illegal in Texas. The Supreme Court had a chance to stop the law on the shadow docket. The justices declined, a harbinger of things to come. A year later, the Supreme Court overturned the law that codified abortion.

A sea of trigger laws written for this eventuality followed; some red states banned abortion as quickly as they could. Republicans wrote bills that banned abortion broadly, with little or no cutout for the life of the woman. The idea was simple: make doctors afraid to treat. Texas courts have several times rejected requests to provide specificity about the health exception. 

In Louisiana not only can you not get an abortion; you may struggle just to get first-trimester pregnancy care. “We were stunned by just how much regular medical practice for pregnant people has been disrupted,” Michele Heisler, the medical director of Physicians for Human Rights, told NPR. Elsewhere in the country, things are looking similarly bleak. According to a 2023 report from The New York Times, “All told, more than a dozen labor and delivery doctors — including five of Idaho’s nine longtime maternal-fetal experts — will have either left or retired by the end of this year.” Medical care for women is under threat, and it extends far beyond what’s traditionally discussed as abortion, especially by Republicans who demonize an entire category of lifesaving health care. 

After Roe was overturned, a lot of us were sure this would mean women would die. We were told we were being hysterical. But “the SB 8 effect” was real.According to Nancy L. Cohen, president of the Gender Equity Policy Institute, “There’s only one explanation for this staggering difference in maternal mortality. All the research points to Texas’ abortion ban as the primary driver of this alarming increase.” And it wasn’t just pregnant women who died. Infant mortality also increased by about 13%, according to a study from Johns Hopkins, which also stated, “This suggests that SB 8 was driving this increase in infant mortality.” It’s now three years later. Women have died. 

In the one election since the fall of Roe, the 2022 midterm election, there was warning of a red wave, projecting that Republicans planned to compensate for Joe Biden’s 2020 victory. 

But Republicans underperformed, and Democrats kept the Senate and almost kept the House. Two years later, conservative pundits wishcasted that women have gotten over losing that constitutional right. But evidence supports the theory that if anything, women are more enraged than ever.

ProPublica tells the story of 18-year-old Nevaeh Crain. She was pregnant. She was holding a baby shower to celebrate the imminent birth of the baby. At her party, she collapsed in pain. Her mother took her to three different hospitals. The first two sent her away without treating her. The doctors and nurses in Texas hospitals are aware of the draconian abortion ban in Texas; it threatens to harshly punish any medical personnel who are involved in an abortion with loss of their license and as much as 99 years in prison.

Would anyone risk their own life to save the pregnant girl who was screaming in pain?

Nevaeh Crain died because of Texas’ extreme abortion ban. She was killed by politicians and religious zealots. She was killed by the U.S. Supreme Court’s Dobbs decision. She should be alive.

ProPublica reported:

Candace Fails screamed for someone in the Texas hospital to help her pregnant daughter. “Do something,” she pleaded, on the morning of Oct. 29, 2023.

Nevaeh Crain was crying in pain, too weak to walk, blood staining her thighs. Feverish and vomiting the day of her baby shower, the 18-year-old had gone to two different emergency rooms within 12 hours, returning home each time worse than before.

The first hospital diagnosed her with strep throat without investigating her sharp abdominal cramps. At the second, she screened positive for sepsis, a life-threatening and fast-moving reaction to an infection, medical records show. But doctors said her six-month fetus had a heartbeat and that Crain was fine to leave.

Now on Crain’s third hospital visit, an obstetrician insisted on two ultrasounds to “confirm fetal demise,” a nurse wrote, before moving her to intensive care. 

By then, more than two hours after her arrival, Crain’s blood pressure had plummeted and a nurse had noted that her lips were “blue and dusky.” Her organs began failing. 

Hours later, she was dead.

Fails, who would have seen her daughter turn 20 this Friday, still cannot understand why Crain’s emergency was not treated like an emergency. 

But that is what many pregnant women are now facing in states with strict abortion bans, doctors and lawyers have told ProPublica.

“Pregnant women have become essentially untouchables,” said Sara Rosenbaum, a health law and policy professor emerita at George Washington University.

Texas’s abortion ban threatens prison time for interventions that end a fetal heartbeat, whether the pregnancy is wanted or not. It includes exceptions for life-threatening conditions, but still, doctors told ProPublica that confusion and fear about the potential legal repercussions are changing the way their colleagues treat pregnant patients with complications.

Open the link to continue reading.

Jess Piper is a former teacher who lives in a farm in Missouri. She is an energetic Democrat who spends time getting out the vote in rural areas. As she explains in her latest blog post, she has spent lots of time in Iowa.

She explains the startling results of the latest poll from Iowa. It’s a ruby-red state, but the highly respected Selzer poll reported that Harris has taken the lead in a state that Trump won twice.

The biggest issue, she says, is abortion. The fight against the abortion ban is led by mothers and grandmothers, who are defending their daughters and granddaughters from entering a world where they might die for lack of health care.

By the way, dynamic Jess Piper will speak at the Network for Public Education Annual Conference in Columbus, Ohio, April 5-6, 2025.

She writes:

Here’s the thing that a lot of pollsters have been getting wrong: they don’t think abortion will be the reason that older women choose to vote for a Democrat. And I know that isn’t true. I have talked to hundreds of folks on the ground in places like Iowa. I’ve spoken to so many women.

Abortion may be seen as a political strategy to some, but it is life or death for women and girls.

I spoke in Mt Ayr, Iowa last year. The population is 1600. I was again summoned by the Ringgold County Democrats led by a woman. We met in a woman-owned bookstore. There was wine and food and desserts and they gave me one of my favorite t-shirts. It says “Hard Working Rural Democrat” and I wear it often. 

Over half of the folks who showed up to this Mt Ayr event were teachers. That’s very often the case in the spaces I travel to speak…they are quiet, but they always show up. You’d think with all of those teachers that the topic would be public schools and that is indeed where we started, but the Q and A session turned into a forum on abortion bans. Most of the women at the event were grandmothers — they worried that their daughters would need reproductive care and could die waiting for it under an abortion ban. 

That is a fair worry. A worry that women have been dealing with since the creation of the United States.

“I desire you would remember the ladies and be more generous and favorable to them than your ancestors. Do not put such unlimited power into the hands of the husbands. Remember, all men would be tyrants if they could. If particular care and attention is not paid to the ladies, we are determined to foment a rebellion, and will not hold ourselves bound by any laws in which we have no voice or representation.”

~Abigail Adams to her husband John Adams, 1776.

We have been fighting for equal rights under the law for hundreds of years. 

I have been in Council Bluffs. I have spoken in Iowa City. I traveled to Sioux City. I have been to Mount Pleasant. I have traveled the state for the past two years and I can tell you that while I am excited to see the data on Iowa, I have been telling you the stories for a while now. The rural stories — the organizing stories. 

The poll reinforces what we are seeing on the ground.

The Selzer Poll shows that Trump still leads in rural spaces in Iowa, but here is what I know: he’s losing his grip on those folks. And the reason? Women voters. Rural women voters.

The Republican ban on abortion was a step too far for most women…even for Independent and Republican voters. Especially with those rural voters who believe in limited government. Who believe that lawmakers don’t belong in doctor’s offices. Who believe in freedom.

I also have to take every poll with a grain of salt. 

We know that polls don’t win elections — voters will decide who takes the Presidency on Tuesday. But, here is what I am telling you; the vibes have changed. I am in the rooms and you have a reason to be hopeful. You have reason to think Iowa may just go for Harris and wonder if it can happen there, where else may it happen?