Food, fluoride and money: How Trump’s new policy could affect health in California

Donald Trump’s return to the White House stands to shape the health of Californians greatly – the food they eat, the medicine they take, the costs they face and more.

Trump said he would give a prominent health role to supporter Robert F. Kennedy Jr., who has made controversial claims about vaccines and criticized the advice of pediatricians and dentists for advocating an end to fluoridation. of water. Policy analysts expect Medicaid cuts.

And while Trump has publicly distanced himself from the conservative 2025 playbook, many of its proposals align with Trump’s agenda and the Republican Party platform. As such, critics say its detailed recommendations on opioid addiction, contraception, mental health treatment and surveillance bear more weight.

“I think everything is on the table,” said Gerald Kominski, a senior fellow at UCLA’s Center for Health Policy Research.

Now, California Atty. Gen. Rob Bonta has vowed to take the incoming president to court if his administration tries to disrupt the nation’s development agenda.

“Every action they take could lead to a lawsuit,” said Larry Levitt, vice president of health policy at the Kaiser Family Foundation. “California was a leader in legislative opposition to the first Trump administration, and I would expect that to be the case again this time.”

But some of those measures may not have legal remedies, Levitt warned. For example, if Kennedy makes changes to the Food and Drug Administration that weaken its ability to ensure that food and medicine are safe, “there’s not much California will be able to do to stop that.”

Choices are important. Here are six ways to touch the Golden State.

Reproductive rights

Although Trump has publicly claimed to be able to “kill” Roe vs. Wade with his Supreme Court nominations, it became more difficult to emphasize his plans for abortion in the second term. He has said on social media that he wants to leave that to governments, and favors exceptions for rape, having sex with a relative or life-threatening pregnancy.

With a state constitution that calls abortion a fundamental right, California has some of the strongest reproductive health care protections in America.

However the administration could try to prevent abortion in the country by limiting access to mifepristone, one of the most widely used drugs for medical abortion. Conservative groups are trying to get the courts to revoke FDA approval for this drug.

More than 60% of abortions in the US are induced by medication, according to Guttmacher Institutea research group that supports abortion rights.

Project 2025 proposes to limit access to mifepristone by restoring a 19th century law called the Comstock Act that prohibits sending abortion agents through the mail. Although Trump and the candidate’s Vice President, JD Vance, said during the campaign that they would not use it, Vance was one of 40 Republican lawmakers in attendance. sign the letter last year he asked the Department of Justice to do so. That could be important if Vance has another turn and tries to fool his boss.

“Obviously it would be challenged in court, but we could see a major setback to medical abortion if they decide to try to legalize that,” said Amy Friedrich-Karnik, director of federal policy at the Center. of Guttmacher.

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Public health experts are alarmed by Trump’s acceptance of Kennedy, who denies overwhelming evidence that vaccines are safe. A recent study estimated that the federal program to help pay for childhood vaccinations against diseases such as measles, polio and rotavirus has prevented more than 1 million deaths and 32 million hospitalizations since it began in 1994.

This week, Kennedy said he won’t take vaccines away from anyone who wants them. “People can do individual tests as to whether the product will work for them,” he said told NBC News.

Trump himself has said he will cut federal funding to schools that have a vaccination mandate. His campaign has said he is talking about COVID-19 vaccines in particular, but as a candidate, he has repeatedly made promises without specifying that. California requires elementary and middle school students to be vaccinated against many types of diseases unless they have a medical exemption; a COVID-19 shot is recommended but not mandatory.

In other areas of public health, Trump said “maybe it would” dismisses the White House Office of Pandemic Preparedness and Response, even as the country faces a growing bird flu threat.

Ms Kennedy sparked concern by calling fluoride “industrial waste” and said she would push for the mineral to be removed from drinking water. The CDC says fluoridation to prevent tooth decay is one of the 20th century the greatest achievements of public healthand more than half of Californians live in communities with protected water.

Gender mainstreaming

California law requires health plans and state-licensed insurers to provide transgender enrollees with necessary gender-affirming medical care. It also aims to protect doctors from laws that make such care illegal in other countries.

But access to equal care can still be limited by government action. Trump has said he will pressure Congress to block federal funding for gender pay, a position also reflected in the Republican Party’s platform.

The ban could be modeled after the decades-old Hyde Amendment, which prevents federal funds from being used to pay for abortions, or tied to debt securities, said Julianna S. Gonen, a federal policy director. for the National Center for Gay Rights.

If implemented, people who rely on public programs like Medicaid or Medicare could end up with “less access to equitable care,” said Lindsey Dawson, director of LGBTQ Health Policy for of KFF.

California officials may decide to let the state take over the matter. Gonen said it would be “very difficult” for the Trump administration to prevent states from doing so, although the last Trump administration threatened to withhold Medicaid funding from California for its abortion policies.

Trump has a specific goal of gender equality for transgender youth, and he has a stated goal of banning it in “all 50 states.” He said hospitals that provide such treatment will be deprived of Medicaid and Medicare funding. Gonen said losing that money would be an “existential threat” for health centers.

Medicaid

During his first term, Trump proposed changes that would reduce federal funding for Medicaid. Trump has promised to keep Medicare and Social Security, but that could make Medicaid a target if spending cuts are needed, some public health experts believe.

Edwin Park, a research professor at Georgetown University’s McCourt School of Public Policy said: “Medicaid will certainly be at the center of the cuts.

Cuts in Washington could force California to raise more money or reduce existing programs. California is counting on its dollars to expand its Medicaid program, known as Medi-Cal, to cover people regardless of their immigration status, said John Baackes, executive director of LA Care, a large initiative of public health in the country. But amid budget deficits, “there’s a limit to what California can do.”

Park added that Trump’s Republican allies have also created plans that would limit or limit the state tax on health care providers, further pressuring funding for Medicaid programs.

Nutrition and food security

After Kennedy dropped out of the race and endorsed Trump, the former president seemed eager to hand over food policy responsibilities to his new aide, to tell supporters last month, “I’ll let him eat.”

Kennedy told NBC that he would work to remove chemical additives from foods that are banned in Europe but are still allowed in the US Some of those things, including the red dye No. 3, shall be in California law in 2027 under the law signed by Gov. Gavin Newsom last year.

Kennedy said he would eliminate the FDA departments tasked with evaluating the safety of food products because they are not “doing their job.” It is unclear whether Trump will agree to that.

The 2025 plan calls for the repeal of national food guidelines because they deviate from considering the environmental impact of food production. Project 2025 also includes genetic engineering and other crop biotechnology. It’s unclear whether Trump supports those proposals, although during his first term he eased restrictions on genetically engineered foods.

The Affordable Care Act

Trump tried unsuccessfully to roll back the Affordable Care Act during his first term. This time, Trump said he would roll back the landmark legislation only if a better plan could be drawn up.

Vance introduced the idea of ​​dividing “risk pools,” which are used to share medical costs and calculate insurance premiums. Critics have warned that doing so could raise rates for older people with chronic conditions.

Mark A. Peterson, a professor at the UCLA Luskin School of Public Affairs, said that despite continuing to push for the law, “it is unlikely that Republicans will want to take up the Affordable Care Act.” They didn’t go so well last time… and now the Affordable Care Act is more popular than ever. “

An immediate target may be a set of improved subsidies for people who buy health insurance through the Affordable Care Act’s marketplaces, which are set to expire at the end of 2025. Another analysis found that if that happens, more than 1.5 million Californians will see it every year. costs rise by an average of $967.

The Trump campaign has criticized the subsidies, saying they helped insurance companies more than patients.