The Trump administration along with its rubber stamp republican controlled congress is conducting an unprecedented assault on US health infrastructure and on medical research. In this post I will write about the details of that assault and the current and likely future effects on people in the US and around the world.
HIV Funding Cuts
Funding has been cut for current studies on HIV vaccines being carried out by Duke University, The Scripps Research Institute and Moderna’s clinical trials. These vaccines showed great promise for preventing HIV infection.
The administration has eliminated the CDC HIV prevention division
Funding for the Presidents Emergency Plan for AIDS Relief has been eliminated. This program, begun in 2003 during the George Bush administration, has delivered lifesaving treatment to 25 million people in 54 countries and had previously bipartisan support. Without this funding, thousands of people around the world, especially in African countries will die. Children born with HIV are especially vulnerable.
Center for Disease Control cuts
The CDC has historically held a strong reputation as a global leader in public health. It has been considered the “gold standard” for national health agencies. In April of this year 2400 CDC employees’ jobs were terminated, shuttering whole programs at the agency. About 460 of those employees have been rehired. The Trump administration 2026 proposed budget cuts CDC funding by 50%. Much of CDC funding goes to state health departments, so state health departments will struggle and public health programs like TB treatment, and STD treatment will be understaffed if not eliminated entirely.
Vaccines
Robert F Kennedy Jr was appointed by Trump as head of HHS. He has a long history of conspiracy theories about vaccines. He recently fired all 17 members of the CDC immunization advisory panel and appointed 8 new members, many of whom have been critical of mRNA vaccines as well as other vaccines. Vaccines recommended by the panel have to be covered by insurance. It seems likely that rare side effects of vaccines will be emphasized and that vaccination rates will continue to fall in the US. Prepare yourself for the return of measles, pertussis (whooping cough), and maybe even polio.
Cuts to Medicaid
It is clear that Federal Medicaid funding will decrease substantially, but we won’t know how much until a final budget is worked out between the House and Senate. The Senate version cuts Medicaid even more than the House version. Medicaid cuts will not only affect the health of Medicaid recipients but will have downstream severe effects on the entire US healthcare system. This will include hospitals, physicians, federally qualified health centers, certified nursing facilities, and even insured persons (because premiums will increase). There is an excellent viewpoint piece in JAMA detailing all the damage to US medical care caused by substantial cuts in Medicaid spending. Here is a link to that article. It is worth reading.
Effects of Medicaid Cuts on the Medical Care Ecosystem.
Medicaid Work Requirements
The vast majority of Medicaid recipients who are able to work are working. in 2023, nearly two-thirds of adults ages 19-64 covered by Medicaid were working and nearly three in ten were not working because of caregiving responsibilities, illness or disability, or due to school attendance, reasons that counted as qualifying exemptions from the work requirements under previous policies (Understanding the Intersection of Medicaid and Work: An Update). Arkansas is the only state that has previously tried work requirements for Medicaid recipients. The documentation requirements were such that over 18,000 people lost their Medicaid insurance, despite the fact that the vast majority of them were already working. If Congress passes Medicaid work requirements, millions of people will lose Medicaid. That means more emergency room care, more untreated chronic illness and more deaths.
Reduced Subsidies for Affordable Health Care Insurance Marketplace
The premium tax credits for the ACA insurance marketplace are set to expire in 2025. The House budget bill does not extend those tax credits. Without those tax credits millions of people will lose their insurance because they will not be able to afford the increased cost.
Cuts to Research Funding
National Institutes of Health (NIH)
The Current Trump administration budget includes a 40% cut in funding for NIH! This is completely unprecedented. If that level of budget cut happens, the NIH will be unable to award any new research grants for at least 3 years!
Importance of NIH Funded Research on Health
NIH funded research has resulted in numerous health benefits in the US and the world. These include improvements in chronic disease treatment and prevention, cancer diagnosis and treatment, infant and maternal health, identification and treatment of immune diseases, and a host of other benefits. Here is a link to an NIH website documenting the health benefits of NIH funded research: Improving Health.
Long Term Effects on US Research
The quality of research in the US has long been among the very best in the world. The US has attracted talented researchers from all over the world. The NIH budget cuts along with the cancellation of existing research grants makes the US a much less attractive place for researchers. The Trump administration focus on limiting immigration also makes the US much less attractive to talented researchers from outside the US.
A recent survey of US scientists was carried out by the prestigious science journal Nature. The survey found that 75% of US scientists were considering leaving the US (The Hill).
Recruitment of US scientists by other countries
A number of countries are actively recruiting top US scientists. They are offering not only funding, but also emphasizing academic freedom (Economic Times).
Bottom Line
The cuts to HIV treatment and HIV vaccine research will result in thousands of preventable deaths from HIV. The One Big Beautiful Bill Act (that is the actual name of the budget bill) will result in millions of people losing both Medicaid and ACA insurance. It will decimate medical research as well as severely compromise the US Public Health Service (because of the CDC cuts). The lack of emphasis on vaccines by HHS will likely result in continued lower vaccination rates with return of measles, pertussis, diptheria and polio. All of this will be a health care disaster.
Feel free to share this post. Also write your congressional representative and your senators. It may not help, but it can’t hurt to do what you can to mitigate this disaster in progress.