By January 2026, staff overseeing the Pregnancy Risk Assessment Monitoring System (PRAMS), the gold standard for maternal-infant health data, were placed on leave and the system's future is uncertain. The administration has also cut hundreds of millions in NIH grants for health disparities research, leaving the U.S. blind to preventable health inequities.
The record
Healthcare
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HHS has cut 2,400 CDC and 3,500 FDA jobs, weakening federal outbreak detection just before the 2026 FIFA World Cup. A proposed budget would slash NWSS funding by roughly $100 million, though the Consolidated Appropriations Act, 2026, signed in February, appears to have averted immediate elimination. Expert-led wastewater monitoring continues during the tournament, but it is a separate, nongovernmental effort that does not replace the hollowed-out federal capacity.
The Trump administration has cited over 500 hospitals for failing to comply with the CMS Hospital Price Transparency rule, which requires hospitals to post a machine-readable file (MRF) of all items and services and a separate consumer-friendly display of 300 shoppable services. While recent data shows compliance has improved—with some industry commentators citing 95% or better compliance among payrolled hospitals (Pharmacy Times, Dec 2025)—persistent noncompliance can still undermine consumer access to pricing information and enable hidden costs.
CMS's Medicare GLP-1 Bridge provides access to select GLP-1 drugs for beneficiaries with obesity beginning July 1, 2026, but only through December 31, 2027, and with specific BMI thresholds (per American Journal of Managed Care). Meanwhile, the BALANCE Model's Part D component is delayed for CY 2027, leaving permanent coverage uncertain.
The MAHA coalition's break with Trump reflects broken promises on children's health: the February 18, 2026 executive order invoked the Defense Production Act to boost glyphosate production, and the House-passed farm bill (H.R. 7567) contains no new pesticide restrictions—undermining the health-conscious base that helped elect Trump.
The new Medicaid work requirements, enacted under the 2025 reconciliation law, are projected by CBO to increase the number of uninsured by 7.5 million in 2034 (Georgetown CCF, August 2025) and by 4.8 million from Medicaid changes alone (KFF, August 2025). Decades of evidence show these requirements do not boost employment but instead cause coverage loss through administrative burdens, particularly harming people with chronic conditions.
On June 4, 2026, Acting Attorney General Todd Blanche and FBI Director Kash Patel announced in Columbus the indictment of 14 defendants, including two employees of the Ohio Department of Job and Family Services, for schemes totaling over $50 million—including Medicaid fraud, COVID-19 PPP fraud, and a romance scam—with luxury vehicles seized including a Bentley, Maserati, McLaren, Mercedes-Benz sedans, and others, but no Porsche.
An Ebola outbreak caused by Bundibugyo virus in DRC and Uganda has been declared a PHEIC; as of June 3, 363 confirmed cases and 62 confirmed deaths highlight the need for robust international health response.
Project 2025's HHS agenda to expand conscience refusals, reverse FDA approval of mifepristone, restrict Medicaid funding for abortion providers, and weaken EMTALA emergency-care protections is now being executed through executive orders, budget-reconciliation laws, and Supreme Court rulings. These actions are already reducing access to reproductive healthcare, particularly for low-income women in Medicaid, and reversing them will require legislative repeal, new guidance, and judicial intervention.
Project 2025 envisions transforming HHS into a 'Department of Life' that rejects abortion as healthcare, replaces the reproductive health access task force with a pro-life task force, and erases protections for LGBTQ+ people—while consolidating the Assistant Secretary for Health and Surgeon General roles. As of late 2025, the restructuring is partially implemented, but the explicit pro-life task force and 'Department of Life' rebranding have not yet been enacted.
Project 2025's reproductive health agenda is already partially in motion: HHS has announced comprehensive enforcement of conscience rights (Jan 2026), while new requirements for state compliance with the Coats-Snowe Amendment, ACGME accreditation, and opt-in abortion training for medical students remain proposed but signal a coordinated effort to restrict abortion access through medical education regulation.
The rapid growth of telehealth and urgent care since COVID-19 has created a 'drive-thru' healthcare model that prioritizes convenience and profit over comprehensive, continuous care, risking fragmented treatment and overuse of profitable services like weight loss and hair loss drugs—even as these services expand access for millions. The American Hospital Association projects a shortage of up to 86,000 physicians by 2036, deepening the crisis of lost primary care infrastructure.
Executive Order 14407 directs CDC and ACIP to realign childhood vaccine recommendations with a scientific assessment finding the U.S. recommends 17 routine vaccines vs. 11 in peer countries. The order reduces pressure for mandates and increases parental flexibility but risks lowering population-level herd immunity and enabling outbreaks, especially in states with weaker mandates. Cost-free access to all currently recommended vaccines is preserved.
Project 2025 targets medication abortion as the 'single greatest threat' to anti-abortion goals and seeks to restrict mifepristone through FDA action, enforce the 19th-century Comstock Act, and eliminate federal collection of gender identity data—moves that undermine evidence-based public health, reproductive rights, and scientific integrity.
Project 2025 proposes six structural changes to the CDC that would cripple its public health authority, independence, and data integrity. The agenda would ban CDC from issuing prescriptive guidance on masks and vaccines, cut pharma funding, transfer vaccine safety oversight to the FDA, condition state health funding on abortion surveillance, mandate real-time data systems, and prohibit research using aborted fetal cell lines. As of June 2026, the fetal tissue research ban has already been enacted via an HHS announcement in January 2026, halting NIH-funded studies that used critical cell lines. The other five proposals remain unimplemented but represent a coordinated blueprint to undermine the agency's ability to lead during public health emergencies, censor scientific recommendations, and politicize reproductive health data.
Project 2025 proposes to split the CDC into separate data-gathering and policy-recommendation agencies, restrict HHS officials from private-sector ties, and impose transparency mandates. The Trump administration has already acted to eliminate equity-related federal data, delay releases, and fire key statistical agency heads, eroding capacity to measure health disparities; vaccine uptake among kindergarteners has dropped sharply since the pandemic.
Project 2025 targets abortion access through multiple federal levers: reinstating stricter separate payment requirements under ACA Section 1303, auditing Hyde Amendment compliance across HHS programs, rescinding the 2022 EMTALA guidance that protects emergency abortion care, and codifying permanent Hyde and Weldon restrictions. These actions would strip coverage, criminalize providers, and endanger patients in states with abortion bans.
Project 2025's blueprint for a Day One executive order to reorganize and downsize the EPA — with 'pause and review' teams that can indefinitely freeze major rules, stop grants, and terminate newest hires — would deliberately dismantle the agency's capacity to enforce clean air, safe water, and health-protective regulations, with direct consequences for life expectancy in frontline and low-income communities, as partially signaled by second-term administration actions.
EO 14401 directs FDA and DEA to create Right to Try pathways for Schedule I psychedelic drugs including ibogaine, leverages existing FDA Breakthrough Therapy designation mechanisms for qualifying psychedelics, allocates funds from existing HHS and ARPA-H budgets to federal-state psychedelic research partnerships, and orders the Attorney General to initiate expedited rescheduling review for any Schedule I substance that successfully completes clinical trials. Specific dollar figures and any named voucher instruments cited beyond what the source excerpt confirms should be treated as unverified pending full EO text review.