Trump cuts could clash with Kennedy's long to-do list

By Patrick Wingrove, Michael Erman and Stephanie Kelly

(Reuters) -Robert F. Kennedy Jr, the new U.S. health secretary, has promised to address an epidemic of chronic illness with President Donald Trump's backing, but his broad agenda from making food healthier to studying vaccines may clash with government spending cuts.

Trump on Thursday ordered the creation of a 'Make America Healthy Again' Commission made up of Kennedy and other secretaries to look at everything from the high rates of autism and asthma in children to how much medicine is being prescribed to them for ADHD or other conditions.

Kennedy, a 71-year-old environmental lawyer, has said the government should open up its data, conduct new scientific studies on vaccines and tackle gaps in rural healthcare with artificial intelligence and telemedicine. He has plans to go after food additives, an area regulated by the U.S. Food and Drug Administration, one of about a dozen agencies within the $3 trillion U.S. Department of Health and Human Services.

At the same time, Republicans are looking to offset extensive tax cuts by slashing the federal workforce. One HHS agency - the U.S. Centers for Disease Control and Prevention - plans to cut its probationary staff, about one-tenth of its employees, according to the Associated Press.

To make a lasting change, as Kennedy has said he wants to do, it takes years and requires technical experts who can change regulations, said Dan Troy, managing director at consulting firm BRG and former FDA Chief Counsel under President George W. Bush.

"If you walk in and you fire the people who are best able to help you get regulations done, then not a lot's going to get done," Troy said. "They're going to have to decide, do they want to actually attack the issue of food additives... or do they want to get rid of the people in the food additive division? You can't really do both."

The administration is also targeting Medicaid spending through specific cuts by the agency, two sources with direct knowledge of the government's plans told Reuters. Medicaid health programs are jointly paid by states and the federal government and cover low-income individuals and families.

Reform of Medicaid, Medicare and the Affordable Care Act could free up resources for Kennedy to spend on promoting nutrition, physical activity and social engagement, said Brian Blasé, president of think tank Paragon Health Institute, which is closely aligned with the Trump administration.

"It's time to stop wasting so much money on low value government health programs," Blasé said.

Ameet Sarpatwari, a professor at Harvard Medical School, said there could be tensions between Kennedy and the president's staff on some of these issues, but that he and Trump would be aligned on most policy matters.

Joseph Antos, senior fellow emeritus at conservative think tank the American Enterprise Institute, agreed. "If there's going to be a problem, it's going to be more about (Kennedy's) personal interests butting up against the heads of somebody in the White House."

DATA, FOOD, INDEPENDENCE

Some of Kennedy's allies who supported him throughout his presidential campaign, abandoned last August, said they want him to prioritize transparency of government data, removing ultra-processed food from school lunches and ensuring government health decisions are independent from corporate agendas.

“His top priority should be total transparency of all studies that have been used to approve all medical products and all food additives, preservatives, colorings, so that we as a country can use gold standard science to unravel why we continue to have the sickest children of any of the 30 industrialized nations," said Tony Lyons, co-chairman of American Values PAC, a super PAC that supported Kennedy's independent presidential campaign.

Scott Faber, senior vice president of government affairs at the Environmental Working Group said that the FDA can “with the stroke of a pen,” close a loophole that allows companies to self-regulate ingredients added to food. Nonprofits like EWG argue that the loophole allows potentially unsafe chemicals into food without regulatory review.

“If the new administration is truly determined to make America healthier, closing the loophole that lets chemical companies decide which chemicals are safe to eat is the lowest of low hanging fruit,” Faber said.

Trump's health order for his new secretary's first day does not mention one of the items Kennedy raised during Congressional testimony - that he would ask for a review of the safety of abortion drug mifepristone.

Project 2025, a series of detailed policy proposals put together by hundreds of high-profile conservatives, some of whom Trump has named to his administration, calls for a series of detailed anti-abortion measures like banning abortion pills and withdrawing Medicaid funds from pro-abortion states.

(Reporting by Patrick Wingrove, Michael Erman, Stephanie Kelly and Jessica DiNapoli in New York, Ahmed Aboulenein in Washington, and Deena Beasley in Los Angeles; Editing by Caroline Humer, Diane Craft and Bill Berkrot)