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Today: December 27, 2024
Today: December 27, 2024

A look at how some of Trump's picks to lead health agencies could help carry out Kennedy's overhaul

Trump Transition Health
November 23, 2024

The team that President-elect Donald Trump has selected to lead federal health agencies in his second administration includes a retired congressman, a surgeon and a former talk-show host.

All could play pivotal roles in fulfilling a political agenda that could change how the government goes about safeguarding Americans' health — from health care and medicines to food safety and science research. In line to lead the Department of Health and Human Services secretary is environmental lawyer and anti-vaccine organizer Robert F. Kennedy Jr.

Trump's choices don't have experience running large bureaucratic agencies, but they know how to talk about health on TV.

Centers for Medicare and Medicaid pick Dr. Mehmet Oz hosted a talk show for 13 years and is a well-known wellness and lifestyle influencer. The pick for the Food and Drug Administration, Dr. Marty Makary, and for surgeon general, Dr. Janette Nesheiwat, are frequent Fox News contributors.

Many on the list were critical of COVID-19 measures like masking and booster vaccinations for young people. Some of them have ties to Florida like many of Trump's other Cabinet nominees: Dave Weldon, the pick for the Centers for Disease Control and Prevention, represented the state in Congress for 14 years and is affiliated with a medical group on the state's Atlantic coast. Nesheiwat's brother-in-law is Rep. Mike Waltz, R-Fla., tapped by Trump as national security adviser.

Here's a look at the nominees' potential role in carrying out what Kennedy says is the task to “reorganize” agencies, which have an overall $1.7 trillion budget, employ 80,000 scientists, researchers, doctors and other officials, and effect Americans' daily lives:

Centers for Disease Control and Prevention

The Atlanta-based CDC, with a $9.2 billion core budget, is charged with protecting Americans from disease outbreaks and other public health threats.

Kennedy has long attacked vaccines and criticized the CDC, repeatedly alleging corruption at the agency. He said on a 2023 podcast that there is "no vaccine that is safe and effective,” and urged people to resist the CDC's guidelines about if and when kids should get vaccinated. The World Health Organization estimates that vaccines have saved more than 150 million lives over the past 50 years, and that 100 million of them were infants.

Decades ago, Kennedy found common ground with Weldon, 71, who served in the Army and worked as an internal medicine doctor before he represented a central Florida congressional district from 1995 to 2009.

Starting in the early 2000s, Weldon had a prominent part in a debate about whether there was a relationship between a vaccine preservative called thimerosal and autism. He was a founding member of the Congressional Autism Caucus and tried to ban thimerosal from all vaccines. Kennedy, then a senior attorney for the Natural Resources Defense Council, believed there was a tie between thimerosal and autism and also charged that the government hid documents showing the danger.

Since 2001, all vaccines manufactured for the U.S. market and routinely recommended for children 6 years or younger have contained no thimerosal or only trace amounts, with the exception of inactivated influenza vaccine. Meanwhile, study after study after study found no evidence that thimerosal caused autism.

Weldon's congressional voting record suggests he may go along with Republican efforts to downsize the CDC, including to eliminate the National Center for Injury Prevention and Control, which works on topics like drownings, drug overdoses and shooting deaths. Weldon also voted to ban federal funding for needle-exchange programs as an approach to reduce overdoses, and the National Rifle Association gave him an “A” rating for his pro-gun rights voting record.

Food and Drug Administration

Kennedy is extremely critical of the FDA, which has 18,000 employees and is responsible for the safety and effectiveness of prescription drugs, vaccines and other medical products, as well as overseeing cosmetics, electronic cigarettes and most foods.

Makary, Trump’s pick to run the FDA, is closely aligned with Kennedy on several topics. The professor at Johns Hopkins University who is a trained surgeon and cancer specialist has decried the overprescribing of drugs, the use of pesticides on foods and the undue influence of pharmaceutical and insurance companies over doctors and government regulators.

Kennedy has suggested he'll clear out “entire” FDA departments and also recently threatened to fire FDA employees for “aggressive suppression” of a host of unsubstantiated products and therapies, including stem cells, raw milk, psychedelics and discredited COVID-era treatments like ivermectin and hydroxychloroquine.

Makary's contrarian views during the COVID-19 pandemic included questioning the need for masking and giving young kids COVID-19 vaccine boosters.

But anything Makary and Kennedy might want to do when it comes to unwinding FDA regulations or revoking long-standing vaccine and drug approvals would be challenging. The agency has lengthy requirements for removing medicines from the market, which are based on federal laws passed by Congress.

Centers for Medicaid and Medicare Services

The agency provides health care coverage for more than 160 million people through Medicaid, Medicare and the Affordable Care Act, and also sets Medicare payment rates for hospitals, doctors and other providers. With a $1.1 trillion budget and more than 6,000 employees, Oz has a massive agency to run if confirmed — and an agency that Kennedy hasn't talked about much when it comes to his plans.

While Trump tried to scrap the Affordable Care Act in his first term, Kennedy has not taken aim at it yet. But he has been critical of Medicaid and Medicare for covering expensive weight-loss drugs — though they're not widely covered by either.

Trump said during his campaign that he would protect Medicare, which provides insurance for older Americans. Oz has endorsed expanding Medicare Advantage — a privately run version of Medicare that is popular but also a source of widespread fraud — in an AARP questionnaire during his failed 2022 bid for a U.S. Senate seat in Pennsylvania and in a 2020 Forbes op-ed with a former Kaiser Permanente CEO.

Oz also said in a Washington Examiner op-ed with three co-writers that aging healthier and living longer could help fix the U.S. budget deficit because people would work longer and add more to the gross domestic product.

Neither Trump nor Kennedy have said much about Medicaid, the insurance program for low-income Americans. Trump's first administration reshaped the program by allowing states to introduce work requirements for recipients.

Surgeon general

Kennedy doesn't appear to have said much publicly about what he'd like to see from surgeon general position, which is the nation's top doctor and oversees 6,000 U.S. Public Health Service Corps members.

The surgeon general has little administrative power, but can be an influential government spokesperson on what counts as a public health danger and what to do about it — suggesting things like warning labels for products and issuing advisories. The current surgeon general, Vivek Murthy, declared gun violence as a public health crisis in June.

Trump's pick, Nesheiwat, is employed as a New York City medical director with CityMD, a group of urgent care facilities in the New York and New Jersey area, and has been at City MD for 12 years. She also has appeared on Fox News and other TV shows, authored a book on the “transformative power of prayer” in her medical career and endorses a brand of vitamin supplements.

She encouraged COVID-19 vaccines during the pandemic, calling them “a gift from God” in a February 2021 Fox News op-ed, as well as anti-viral pills like Paxlovid. In a 2019 Q&A with the Women in Medicine Legacy Foundation, Nesheiwat said she is a “firm believer in preventive medicine” and “can give a dissertation on hand-washing alone.”

National Institutes of Health

As of Saturday, Trump had not yet named his choice to lead the National Institutes of Health, which funds medical research through grants to researchers across the nation and conducts its own research. It has a $48 billion budget.

Kennedy has said he'd pause drug development and infectious disease research to shift the focus to chronic diseases. He'd like to keep NIH funding from researchers with conflicts of interest, and criticized the agency in 2017 for what he said was not doing enough research into the role of vaccines in autism — an idea that has long been debunked.

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Associated Press writers Amanda Seitz and Matt Perrone and AP editor Erica Hunzinger contributed to this report.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

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This story has been corrected to reflect that the health agencies have an overall budget of about $1.7 trillion, not $1.7 billion.

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