After suspending his presidential campaign in August, Robert F. Kennedy, Jr. met with President Donald Trump at Mar-a-Lago. An endorsement from Kennedy (who started his campaign as a Democrat) and a cabinet position from Trump were in play.

They discussed allying on certain critical issues. The first two involved the Ukraine War and censorship. The third issue was the most important to Kennedy, chronic disease. Identifying the root causes of chronic disease including corruption in regulatory agencies like the FDA, NIH, and HHS was paramount. Six months later, Secretary Kennedy now leads the HHS (Health and Human Services) which includes the NIH, FDA, and many other important sub-agencies. He now has the power to drastically change the big pharma, big agriculture, and big food industries he railed against. He is in charge of the very agencies he labeled corrupt. So what are the possible next moves for Robert F. Kennedy, Jr., Trump, and the Making America Healthy Again (MAHA) movement?

MAHA

On February 13, 2025, President Trump signed an executive order 14212 creating the President’s Commission to Make America Healthy Again. The goal is to make historic changes in America Health Care. There are many potential options for Robert F. Kennedy, Jr. to use his new power. Kennedy wants to dig into the root causes of the chronic disease epidemic ailing America, eliminate the corporate and bureaucratic conflicts of interests, ban chemicals, additives and toxins in our food, axe pharmaceutical DTC advertising, and of course, scrutinize vaccines.

RFK, Jr. laid out his message in an introduction video on his first day at HHS: "Americans suffer far higher levels of chronic disease, obesity, addiction, cancer, infertility, and depression than ever before in history and more than any other country in the world. I’m not going to tell you the reasons for this decline… because neither I nor anyone else can be certain. But what I will tell you is that we are going to find out, and we are going to do something about it."

Robert F. Kennedy, Jr. will be the chair of the MAHA Commission as the Secretary of Health and Human Services. But it's larger than just the HHS. This interagency commission also includes 13 other agencies and sub-agencies such as the Secretary of Veterans Affairs, the Administrator of the Environmental Protection Agency, the Director of the National Economic Council.

HHS: Health and Human Services

The HHS mission is to "enhance the health and well-being of all Americans."

The commission includes all sub-agencies of the HHS. HHS is a huge agency that includes the NIH, FDA, USDA, CDC, and 9 other sub-agencies. Its 1.8 trillion budget makes it the largest budget of any federal agency. If that was a budget of a country, it would rank as the fifth-largest. It counts 80,000 federal employees (for now) and oversees drug approvals, Medicare and Medicaid, vaccine recommendations, and public health crises. The agency sets health policies that are commonly used by state and local governments and even other countries. While many state and local bodies use federal guidance, often they have final say over the policies in their jurisdictions.

Chronic Disease

This rise of chronic disease in America, including in children, is the main focal point of Secretary Kennedy. The administration and others have highlighted several statistics to illustrate the situation:

• 60% of U.S. children currently have a chronic disease compared to only 6% in the 1960's.
• Nearly one in three U.S. children are diabetic or pre-diabetic.
• 74% of American adults are overweight or obese.
• Life expectancy is lower in US than most similar countries.
• 20% of adults in the U.S. are estimated to have a mental illness.
• Cancer rates in America have risen 88% since 1990.
• Autism affects 1 in 36 American children up from 1 to 4 out of 100,000 during the 1980s.

The treatment for many of these ailments is medication. 3.4 million children in the U.S. are now medicated for ADHD. These diseases are not only a health issue. Financially, they cost American $4.3 trillion each year, more than 3x the military budget.

The MAHA commission will study the underlying causes of the chronic disease trend. It will look at diet, policies, food ingredients, chemicals, corporate influence and more. Specific medications including "selective serotonin reuptake inhibitors, antipsychotics, mood stabilizers, stimulants, and weight-loss drugs" will be scrutinized.
Department officials are using the book Good Energy written by Dr. Casey Means as a roadmap of sorts for Kennedy and the administration to address chronic disease.

From Kennedy: "In our first 100 days, we’re going to examine every possible contributing factor to the epidemic of chronic disease. We will leave no stone unturned. We’re going to listen to the experts and to the dissidents. We’re going to listen to insiders and to the whistleblowers. We are going to listen to the doctors, and we are going to listen to the moms."

Food and Agriculture

In the goal of addressing the root causes of chronic disease over treating it later with more costly medications or procedures, food is key. Some low hanging fruit to support reduction in chronic disease is improving food and diets of Americans. One way to do this is change what is subsidized. Robert F. Kennedy, Jr. is perplexed that the most common ingredients in processed foods such as corn, soy, and wheat are heavily subsidized. Only 2% of subsidies go to fruits and vegetables. The secretary would like to subsidize organic produce instead of medications. Kennedy is against high-fructose corn syrup and some dyes like yellow dye tartrazine, which negatively impacts brain biochemistry.

Better food starts with better agriculture. Soil health and regenerative agriculture are literal root causes. Potential environment toxins like pesticides and other chemicals will receive more scrutiny for possible links to disease. Microplastics and forever chemicals have also been mentioned by Robert F. Kennedy, Jr. Secretary Kennedy's background is in environmental law where he won several cases against Big Ag companies such as Monsanto for using glyphosate in Roundup.

Another issue is cozy relationships between USDA and corporations that many say are conflicts of interest. 94% of a USDA panel in charge of updating nutritional guidelines had potential conflicting ties with the industry players they were regulating.

Like many, Kennedy is concerned about the alarming spike in childhood obesity over that the last few decades. Commonly known as food stamps, the SNAP program could be reformed to not allow sugary beverages, such as soda, and other processed foods from being eligible for these funds. SNAP is a federally funded program that provides funds to low-income families for groceries. 9% of SNAP funds go to sweetened beverages, like soda, so the U.S. is essentially subsidizing unhealthy sugar bombs. SNAP reform has been attempted before without success including a failed bill by Marco Rubio, current Secretary of State. Change will not come easy due to lobbying efforts and deep pockets of soda manufacturers like Coca-Cola and PepsiCo.

Kennedy said, “It’s nonsensical for U.S. taxpayers to spend tens of billions of dollars subsidizing junk that harms the health of low-income Americans.”

Pharmaceutical Companies

Similar to the USDA, Secretary Kennedy is concerned about conflicts of interest within the NIH (National Institute of Health). It's all about following the money.

Mr. Kennedy wants to overhaul the panels that review drug approvals. More than 60% of FDA reviewers go on to work for the drug companies they were reviewing products for. Project 2025, which has been used as a blueprint for other administration policies, recommends a "cooling off period" as long as 15 years before FDA regulators can work at the pharmaceutical companies they regulated. A similar regulation may be enacted for pharma industry veterans moving to government as regulators. Many past FDA leaders are on the boards of big pharma companies.

There are legal but suspect financial arrangements between pharma companies and the government. One way is that drug companies contribute to the nonprofit CDC foundation. Pfizer, Merck and Biogen have all sent millions to the government in this setup.

Another concerning funding source is the Prescription Drug User Fee Act. Drug companies pay to have their drugs approved and this funding makes up 75% of the FDA's drug division's budget. This could also crowd out smaller companies from having their drugs reviewed in a timely manner.

Yet another financial connection between pharma and the NIH is a result of the Bayh-Dole Act. This law allows NIH and its scientists to profit from royalties of the drugs they help develop. For example, the NIH owns a significant share of Moderna Covid-19 vaccines and NIH scientists receive royalties from it. This could incent the NIH to focus more on researching drugs than the underlying causes of the diseases, the latter which has little to no financial upside for the scientists.

Drug Prices

Trump recently posted “America first drug prices.” Back in 2020, Trump signed the Most Favored Nation (MFN) executive order which caps drug prices at levels of comparable countries, which is usually a much lower price than America pays. For example, Germany pays less than one-tenth the $20,000 U.S. Ozempic price tag because, unlike America, it can negotiate drug prices. These MFN drug pricing policies are likely to increase so that Americans are not charged significantly more than other countries.

Another potential policy, outlined in Project 2025, is increasing generic drugs, which are usually less than $20 per subscription. By removing some practices extending patents and delaying generics by brand name manufacturers, more generic drugs can enter the market more quickly.

Pharma DTC Advertising

Another blow to the pharmaceutical industry could be major limits put on DTC (direct-to-consumer) advertising. Pharmaceutical companies are the largest advertisers of major media organizations, accounting for up to 70% of advertising dollars for evening news programs. That means they may not just be influencing consumers but also the news coverage. While pharma advertising has been legal in its current form since 1997, it's one of only two countries in the world to allow it.

It was no surprise then when pharmaceutical stock prices fell after the announcement of Robert F. Kennedy, Jr.'s nomination and subsequent approval.

So far, pharmaceutical executives are trying to stay optimistic about the less-than-ideal situation and find commonalities with the new administration. “My stance is that you need to engage with him,” Pfizer CEO Albert Bourla referring to Kennedy. “I told him many times that there are a lot of things that we can do together,” said Bourla. "Let’s try to cure cancer."

President and CEO of the drug industry lobbying group PhRMA, Stephen Ubl, remains optimistic about working with Kennedy. “During his confirmation hearings, Secretary Kennedy discussed the need to reduce the burden of chronic disease, improve health outcomes and make healthcare more affordable for the American people,” Ubl said. “Our industry is eager to work with the Trump administration to help address these urgent priorities.”

Alternative, Preventative, and Holistic treatments

Secretary Kennedy has proposed shifting "half of research budgets from the NIH toward preventive, alternative and holistic approaches to health." This budget could be taken from the aforementioned NIH drug research and applied towards studying root causes.

Seen as pro-cannabis as well as for certain psychedelics, Kennedy's nomination caused stocks for Cannabis companies to rise. Restrictive bank regulations may ease for cannabis companies as a result. Also, cannabis could be reclassification as a lower level Schedule III drug for the Controlled Substances Act. RFK Jr. exercises, meditates and attends 12-step meetings daily.

Hospitals and HSAs

What about changes to actual healthcare, such as hospital visits?

This does not seem to be as big a focus of MAHA. Project 2025 does mention reforming that the Affordable Care Act (ACA or Obamacare) restriction prohibiting reimbursements to physician-owned and specialty hospitals. It claims this is a boon to large hospital systems and limits consumer choice and competition. It's yet to be seen if MAHA takes this issue on.

One area Robert F. Kennedy, Jr. has endorsed on the campaign trail is expanding health savings accounts (HSAs). He believes every American should have an HSA, which can be used for healthcare outside of insurance. HSAs could potentially fund preventative behavior such as fitness investments and healthier food purchases.

Vaccines

Maybe the most-known stance of Robert F. Kennedy, Jr. is vaccine safety (which critics call anti-vaccine). Robert F. Kennedy, Jr. will certainly scrutinize childhood vaccines as HHS head.

That said, Robert F. Kennedy, Jr. presented a moderate front on vaccine issues during confirmation, perhaps to facilitate approval, which was the result. For example, he stated that he would not remove statements from the CDC website about vaccines not causing autism and would provide sufficient notice for any major vaccine changes. Yet Robert F. Kennedy, Jr. has claimed many times in the past that vaccines cause autism, which he has refused to rebut recently.

Robert F. Kennedy, Jr.'s is against the broad legal protections that vaccine manufacturer's have long held due to the National Childhood Vaccine Injury Act of 1986, which limits the liability of vaccine producers. Aligned with his background a lawyer, Robert F. Kennedy, Jr. believes vaccines makers should be liable if there vaccines cause harm.

Secretary Kennedy has specifically expressed concerns with links between MMR (measles, mumps, and rubella) vaccine and autism. Scientists and others have disagreed with these claims. Jill Escher, a mother of two autistic children, said in The Free Press, “Every epidemiological study on the topic has confirmed zero association between vaccination status and the development of autism.”

One thing for certain is that the rising rates of autism are devastating. Robert F. Kennedy, Jr. will be looking at the problem with fresh eyes unafraid to try new approaches.

“Nothing is going to be off limits.” Mr. Kennedy said.

Medicaid and Medicare

Medicaid and Medicare make up 85% of the HHS budget. Medicaid costs have been increasing since the Affordable Care Act expanded Medicaid eligibility to people at or below 138% of the poverty level.

However, observers indicate that reforms here won't be a priority since Robert F. Kennedy, Jr. didn't go deep into Medicaid or Medicare during confirmation hearings.

Trump seems aligned with this: “We are going to love and cherish Social Security, Medicare and Medicaid. We are not going to do anything with that other than if we can find some abuse or waste, we’d do something. But the people won’t be affected. It will only be more effective and better.”

All this said, Project 2025 does have recommendations for Medicaid and Medicare reform that may eventually make their way to the administration, including value-based reimbursement over service-based, reforming drug price negotiation (from the Inflation Reduction Act), and reducing government share of catastrophe payments. It's yet to see if the Project 2025 playbook for healthcare will be as influential as other parts of the playbook.

Medicare Advantage Expansion

Medicare Advantage (MA) plans are likely to increase under the Trump Administration. Medicare Advantage plans are private market alternatives to traditional Medicare plans for senior healthcare. While they provide additional benefits such as gym memberships, dental, or vision, they usually have a limited network of care providers and require more prior authorizations. Although Medicare Advantage plans are generally popular with members, it's unclear what cost savings will be realized from these plans over regular Medicare for members or the government.

Project 2025 is for expanded Medicare Advantage, even proposing it to be the default option instead of traditional Medicare.

Dr. Oz, who has been nominated to lead the Centers for Medicare & Medicaid Services (CMS), has been a long time promoter of MA plans. Secretary Kennedy recently said he is on a Medicare Advantage plan.

Tracking What's Next

Healthcare is an extremely important area and MAHA is a completely new approach to address it. Most in the U.S. would agree it is a broken system. As the Trump administration and MAHA movement unfolds, we at Trendpublic will track major actions of it and the effects on the healthcare industry, U.S. companies, and American people.