Researchers say the children at about a mile away pay the price. They discovered the students there and at other elementary schools near major pollution sites in Pennsylvania had than other children in the state.

Residents and environmental advocates saw reason for hope and relief in the form of a designed to tamp down on coke oven plant pollution. But even before it took effect, President Donald Trump granted in the U.S. — including the one in Clairton — a from the standards.

Trump and Republicans have sought to align themselves with the Make America Healthy Again movement’s populist ideals, such as improving Americans’ food choices and reducing corporate harm to the environment. But the administration is ratcheting up its attacks on the very environmental protections that MAHA followers hold dear.

Taken together, these anti-environmental initiatives will lead to more pollution-related illnesses and higher health care spending, health researchers say. They could also have political ramifications, eroding MAHA’s support for GOP candidates in the November midterm elections if followers believe the party is more beholden to industry than to the movement’s agenda.

, including about a quarter of Republicans, support rolling back environmental regulations, according to a poll by the Energy Policy Institute at the University of Chicago and The Associated Press-NORC Center for Public Affairs Research.

Some MAHA supporters believe voters will support Republicans because the Trump administration is delivering on other goals important to the movement.

“MAHA has a pretty diverse set of policy goals, ranging from medical freedom to food and the environment,” said David Mansdoerfer, who served in Health and Human Services leadership during Trump’s first term. “In totality, the Trump administration has strongly delivered on much of the MAHA agenda.”

While MAHA voters have been upset at some of the administration’s actions that promote industry, it’s hard to know how that may play out in the midterms, said Christopher Bosso, a professor of public policy and politics at Northeastern University. Many were disillusioned by a Trump they viewed as promoting glyphosate, which HHS Secretary Robert F. Kennedy Jr. has .

“The glyphosate thing really ticks off a lot of them; they’re really upset,” Bosso said. “Kennedy said it was poison. If it is a poison, why aren’t we regulating it? That’s where the tension plays out.”

The situation with the Clairton coke plant and the others granted exemptions from regulations underscores the potential public health risks. Six of the 11 factories had “high priority” violations of the Clean Air Act as of last May, according to a Ñî¹óåú´«Ã½Ò•îl Health News analysis. Five coke oven plants logged major violations every quarter for at least three years straight.

“Poisoning continues to some of the most vulnerable residents of Allegheny County,” , who had lived in nearby Glassport, Pennsylvania, said at a about the coke plant.

Environmental Protection Agency spokesperson Brigit Hirsch said the president gave companies extra time because the technology needed to meet a new standard isn’t ready yet.

“Forcing plants to comply before the tools exist doesn’t make the air cleaner, it just shuts down facilities and kills jobs with nothing to show for it,” Hirsch said.

But environmental groups disagree that the plants were unable to comply at a reasonable cost, and they say the exemption from the EPA requirements shows the Trump administration is prioritizing the coal industry at the expense of public health.

“The Trump administration’s relentless actions to dismantle lifesaving environmental protections are a gut punch to the administration’s own promise to Make America Healthy Again,” said Cathleen Kelly, a senior fellow at the Center for American Progress, a liberal think tank.

Hard Times in Clairton

Sprawled across , the Clairton plant operates ovens in which coal is heated to as much as 2,000 degrees Fahrenheit to make up to 4.3 million tons annually of the carbon-rich fuel known as coke. The product is used in blast furnaces to produce iron.

It’s a dirty operation. The process leads to hazardous emissions of that the Centers for Disease Control and Prevention says can lead to anemia and leukemia, as well as , which can trigger severe asthma.

The Clairton operation has had repeated problems with its emissions and operations, including and of toxic chemicals. The plant has received more than from the Allegheny County Health Department since 2022, stemming largely from a fire in 2018 that led to high emissions, and violated the Clean Air Act in each of the last , with the last compliance monitoring in July 2025, according to the EPA.

Nippon Steel Corp. last year acquired U.S. Steel, which now operates as a subsidiary. The company didn’t respond to an email seeking comment. U.S. Steel said it spends $100 million annually on environmental compliance at Clairton.

“Environmental stewardship is a core value at U. S. Steel, and we remain committed to the safety of our communities,” spokesperson Andrew Fulton said in a written statement.

Clairton was once bustling with movie theaters, a mix of grocery stores, and riverside parks, with a dance pavilion and . But the decline of steel hit hard. The town’s population dwindled from more than in the mid-20th century to as of 2024. until they were razed and replaced with signs saying to keep out. The 1978 movie , which depicts a hardscrabble industrial town, is partly set there. Today, about 33% of residents live in poverty.

While the plant brings jobs and revenue, residents of the town and the surrounding areas have long complained about health problems they attribute to its emissions.

“My parents are gone. My mom had cancer, my dad,” , a Clairton resident, said at a 2025 County Council meeting. “I lost a lot of loved ones and seen other ones pass because of this mill.”

Pediatric allergist looked into asthma rates among 1,200 children who attended school near major pollution sites in the area — including students at Clairton Elementary School. They had nearly triple the national rate of asthma, with the highest rate among African American youth, according to she led.

“We were shocked,” she said. “It was double or triple what we expected. The people are proud of their industrial background. We need steel, but they’re not running a good enough operation.”

A found children with asthma living near the coke plant had an 80% higher chance of missing school when sulfur dioxide pollution was elevated.

Allegheny County, which includes Clairton and Pittsburgh, is home to a number of industrial plants, and to increased deaths, chronic heart disease, and adverse birth outcomes. It was ranked in the top 1% of counties in the nation for cancer risk from stationary industrial air pollutants in a 2018 .

Clairton has an age-adjusted cancer death rate of 170 per 100,000 people, higher than the broader county’s rate of 150 deaths per 100,000 people, based on a Ñî¹óåú´«Ã½Ò•îl Health News analysis of .

The American Lung Association in 2025 gave the county an F rating for its particle pollution levels. PennEnvironment, an environmental group that was party to a settlement with U.S. Steel involving the Clairton plant, says the coke operation caused of toxic releases in 2021, which amounted to 60% of all such releases in the county that year.

From 2020 through 2025, the Clairton plant racked up more in fines from Clean Air Act penalties than any other coke oven facility nationwide, costing U.S. Steel over $10 million, according to EPA facility reports.

“We are deeply concerned with exemptions, which allow air toxics to affect public health,” Allegheny County Health Department spokesperson Ronnie Das said in a statement.

The Clairton plant provides and hundreds of millions of dollars in tax revenue to the area. The jobs help generate nearly $3 billion in annual economic output, according to estimates from the Pennsylvania Manufacturers’ Association.

Some community members and advocacy groups hoped air quality would improve after the coke plant was sold. has pledged to upgrade facilities in the Monongahela River Valley.

Politics, Waivers, and Environmental Concerns

Under the Biden-era rule, coke plants were supposed to start meeting from the lids and doors of ovens that heat coal. They would also have had to monitor for benzene at their property lines and take steps to lower emissions of the carcinogen if they exceeded certain levels. Compliance deadlines were set for July 2025.

The Trump administration, which has sought to revive the coal industry, intervened. Last year, it , including coke plants such as Clairton’s, to seek from issued in 2024 by the EPA.

Then Trump in November went further, granting all coke plants a two-year compliance break.

The reprieve was necessary, the EPA spokesperson Hirsch said, because the requirements would have meant extra costs for the industry when standards already in effect work “extremely well” at reducing pollution.

Hirsch also said the agency under Trump is protecting the environment, pointing to action the administration has taken to called PFAS, prevent lead poisoning, strengthen chemical safety, and protect Americans’ food and water supply.

“We are building a future where the next generation of Americans is the healthiest in our nation’s history, and they inherit the cleanest air, land and water in the world,” Hirsch said.

However, the administration has taken several steps that environmental advocates say weaken health protections.

The president’s executive order on glyphosate, an herbicide the World Health Organization has linked to cancer, which touched off a who said they felt betrayed. The EPA has decided to stop considering the of reducing pollution when making policy decisions, instead focusing on the cost to industry of complying with rules. The agency also rescinded the legal and scientific basis that had long established as dangerous to public health.

The actions have rankled some MAHA enthusiasts who counted on the administration to tackle chronic disease, especially among children. A petition to Trump on with more than 15,000 signatures called for the removal of EPA Administrator Lee Zeldin, it said supported corporations over MAHA goals.

Some MAHA enthusiasts have sounded off on social media.

“No one should believe that MAHA is being upheld at the EPA at this point,” , a leader of American Regeneration, which focuses on a conservation approach to farming, said Feb. 8 on X.

, host of a , also aired her concerns on X, saying “there is something really freaking spooky going on at the EPA and I refuse to let the American people be gaslit into thinking they’re upholding the MAHA agenda.”

“A significant number of people who supported Trump are worried these rollbacks are going to hurt their health,” said , a Democratic strategist and the founder of the communications firm Third Degree Strategies. “The MAHA voters, especially women, are very sensitive to this. Republicans have put themselves in a bind.”

MAHA supporters shouldn’t be surprised by a Trump administration that doesn’t prioritize environmental protections over industry, because the president has always championed fossil fuels, said Kyle Kondik, managing editor of Sabato’s Crystal Ball, a nonpartisan election forecasting newsletter published by the University of Virginia Center for Politics.

The coke plant exemptions have disappointed some community members, environmental groups, and regulators concerned about public health and emissions.

Nearly 300,000 people live within 3 miles of the 11 active coke plants across the U.S., according to EPA data compiled by the Environmental Defense Fund.

Weakening environmental rules has helped boost Trump with the U.S. coal industry. In February, mining industry executives and lobbyists gathered at the White House, .

Coal miners, including some in white hard hats bedecked with American flags, with a bronze-colored trophy emblazoned “The Undisputed Champion of Beautiful Clean Coal.”

At the event, Trump praised their work. “We love clean, beautiful coal,” he said.

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The tensions risk fraying Kennedy’s dynamic MAHA coalition, potentially driving away critical supporters who helped fuel President Donald Trump’s 2024 election win.

The movement’s grassroots membership includes suburbanites, women, and independents who are generally newer entrants to the GOP and laser-focused on achieving certain results around the nation’s food supply and vaccines.

Promoting healthy foods tops their list and will be at the center of the White House’s pitch to voters during the midterm election cycle.

“President Trump’s mass appeal partly lies in his willingness to question our country’s broken status quo,” White House spokesperson Kush Desai said in a statement. “That includes food standards and nutrition guidelines that have helped fuel America’s chronic disease epidemic. Overhauling our food supply and nutrition standards to deliver on the MAHA agenda remains a key priority for both the President and his administration.”

At the same time, with most Americans , the White House has cooled on Kennedy’s aggressive policies to curb vaccines and MAHA’s interest in tamping down environmental chemicals that are linked to disease.

The result: Republicans are realizing just how demanding the MAHA vote can be. Moms Across America leader Zen Honeycutt warned that Republicans are facing their biggest setback yet with the MAHA movement, after Trump signed an executive order to support production of glyphosate, a herbicide the World Health Organization has .

“It has caused the biggest uproar in MAHA,” Honeycutt said during a CNN interview in late February.

A White House Warning

Trump’s top pollster, Tony Fabrizio, cautioned in December that an embrace of Kennedy’s anti-vaccine policies could cost politicians their jobs this year.

Eight in 10 MAHA voters and 86% of all voters believe vaccines save lives, his poll of 1,000 voters in 35 competitive districts found.

“In the districts that will decide the control of the House of Representatives next year, Republican and Democratic candidates who support eliminating long standing vaccine requirements will pay a price in the election,” on the poll stated.

The White House has since shaken up senior staffing at HHS, including removing from the deputy secretary role and his job as acting director of the Centers for Disease Control and Prevention, in which he curtailed the agency’s childhood vaccination recommendations. Ralph Abraham, a vaccine skeptic who as Louisiana’s surgeon general suspended its vaccination promotion program last year, stepped down as the CDC’s principal deputy director in late February.

, a doctor who said in congressional testimony that he doesn’t believe vaccines cause autism, is now running the CDC in addition to directing the National Institutes of Health.

Though Trump himself has frequently espoused doubts and mistruths about vaccines, polling around anti-vaccine policy has undoubtedly shaken the White House’s confidence during a tough midterm election year, said former , an Indiana Republican and retired doctor who left Congress last year.

Bucshon said Republicans can’t risk alienating voters, especially parents of young children who might be moved by Democratic attack ads on the topic at a time when hundreds of measles cases are popping up across the U.S.

“That’s the reason you’re seeing the White House get nervous about it,” Bucshon said. “This is just the political reality of it.”

Kennedy built some of his MAHA following with calls to end federal approval and recommendations for the covid vaccines during the pandemic. The Advisory Committee on Immunization Practices, a federal panel of outside experts who were handpicked by Kennedy to develop national vaccine recommendations, is expected to review and possibly withdraw its recommendation for covid shots. Its February meeting was postponed and is now scheduled for March 18-19, when the panel plans to discuss injuries from covid vaccines, HHS spokesperson Andrew Nixon confirmed on March 11.

“I’m not deaf to the calls that we need to get the covid vaccine mRNA products off the market. All I can say is stay tuned and wait for the upcoming ACIP meeting,” ACIP Vice Chair Robert Malone , a conservative account on the social platform X, before the meeting was postponed. “If the FDA won’t act, there are other entities that will.”

No Fury Like Scorned MAHA Moms

Bipartisan support is also extremely high — above 80% — for another core tenet of the MAHA agenda: eliminating the use of certain pesticides on crops.

But MAHA leaders were incensed when Trump issued a Feb. 18 promoting the production of glyphosate, a chemical used in weed killers sprayed on U.S. crops and which Kennedy has railed against and sued over because of its reported links to cancer.

“There’s gonna be ups and downs, and there is zero question that this week was a down,” Calley Means, a senior adviser to the health secretary and a former White House employee, told a MAHA rally in Austin, Texas, on Feb. 26. “I am not going to gaslight or sugarcoat it: This glyphosate thing was extremely disappointing. Bobby’s disappointed.”

Despite deep unhappiness from MAHA followers, Kennedy endorsed Trump’s executive order defending access to such pesticides.

“I support President Trump’s Executive Order to bring agricultural chemical production back to the United States and end our near-total reliance on adversarial nations,” Kennedy .

Without offering policy changes, Kennedy promised a future agricultural system that “is less dependent on harmful chemicals.”

White House officials are now trying to downplay the executive order.

“The President’s executive order was not an endorsement of any product or practice,” Desai said in a statement.

But that’s done little to dampen criticism from leading MAHA influencers who had hoped, with Kennedy’s influence in the administration, that the chemical would be banned.

Some Democrats see an opening.

of Maine earned cheers from MAHA loyalists for co-sponsoring legislation with Rep. Thomas Massie (R-Ky.) to undo the executive order.

“The Trump Admin. cannot keep paying lip service to while propping up Big Chemical like this and choosing corporate profits over Americans’ health,” .

, a prominent MAHA influencer who promotes healthy eating, responded on X with a “HELL YES.”

‘Eat Real Food’

The White House and Kennedy are refocusing their messaging to emphasize one of the most popular elements of the MAHA platform: food.

At the start of the year, Kennedy unveiled new dietary guidelines that emphasize vegetables, fruits, and meats while urging Americans to avoid ultraprocessed foods.

Kennedy has leaned into his new “Eat Real Food” campaign, launching a nationwide tour in January. Ahead of the late-February MAHA rally, he stopped at a barbecue joint in Austin where he took photos with stacks of smoked ribs and grilled sausages. Large “Eat Real Food” signs have been provided for crowds of supporters to hold up during major announcements at HHS’ headquarters this year.

Focusing on nutrition will please MAHA moms, suburban swing voters, and conservatives alike, said , a physician and former Republican representative from Texas.

“They keep them happy by talking about the food pyramid,” Burgess said. “That’s an area where there is broad, bipartisan support.”

Indeed, Fabrizio’s poll shows equal support — 95% — among respondents who voted for former Vice President Kamala Harris and those who voted for Trump for requiring labeling of harmful ingredients in ultraprocessed foods.

Trump is keenly aware that Kennedy’s MAHA movement is key to his political survival. At a Cabinet meeting in January, Kennedy rattled off a list of his agency’s efforts researching autism and tackling high drug prices.

Trump leaned in at the table.

“I read an article today where they think Bobby is going to be really great for the Republican Party in the midterms,” , “so I have to be very careful that Bobby likes us.”

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There, he waited. Reyes, now 51, made repeated requests for the procedure, according to a against the federal government, but months went by even though there was blood in his urine — a potential sign of cancer that’s spread.

“It may have gone from very treatable to metastasized,” said , who, as a lawyer with the American Civil Liberties Union’s National Prison Project, is involved with the lawsuit.

“There are vulnerable populations; it’s crowded. The medical care isn’t there to handle the increased number of people who are sick,” Virgien said.

President Donald Trump’s mass deportation effort has led to a record number of immigrants being held in federal detention centers, local jails, and private prisons. The situation is putting detainees’ health at risk. Immigration and Customs Enforcement is violating standards that ensure immigrants receive initial medical screenings, routine health care, and timely responses to physical complaints, according to a review of more than 200 pages of , and reports, and recent by Democrats.

Complaints about inadequate medical care at detention facilities risk adding to the political backlash Trump faces over his aggressive deportation campaign, including the killing of in Minneapolis. Democratic members of Congress have insisted on reining in federal immigration agents as part of a 2026 spending bill for the Department of Homeland Security, an impasse that threatens to largely shut down the agency.

Spokespeople for ICE and ICE Health Services Corps, the Department of Homeland Security, and the White House didn’t respond to repeated requests for comment on this article. IHSC assesses health for deportation, oversees medical standards in contracted facilities, and reimburses for off-site medical care.

However, on the , assistant director Stewart Smith said the corps “upholds health care standards across ICE-owned and contracted facilities, and ensures the provision of required health care delivery for detained aliens.” For ICE’s part, its that “many aliens may not have received recent or reliable medical treatment for existing conditions prior to entering ICE custody. For some individuals, this may represent their first access to comprehensive medical care.”

Some Democratic lawmakers have demanded autopsy reports on detainees who died in custody and have publicly accused ICE of denying immigrants access to care. Rep. Kelly Morrison (D-Minn.) said that a she visited at the state’s historic Fort Snelling had no medical policy and “no real” on-site medical care.

“It raises alarm bells from a medical and public health perspective,” Morrison, who is a doctor, told Ñî¹óåú´«Ã½Ò•îl Health News. “There are no beds, no blankets, minimal food. It’s freezing in there. Everyone is in leg shackles. It’s chaotic, disorganized, and, frankly, dangerous.”

(D-Texas) recently denounced the health care given to detainees at a she held after visiting , a 5-year-old boy in Minneapolis who was sent to the Dilley Immigration Processing Center in South Texas. She went to the center following media reports that he’d developed a fever and was .

“The treatment these people are suffering under right now is worse than those who are accused and sometimes even convicted of crimes. That’s how bad it is,” she said.

DHS locked down Dilley this month after two detainees . The facility also houses children who are vulnerable to severe complications of the illness, such as brain swelling.

(D-Conn.) on Feb. 1 accused the administration of denying him entry to Dilley in late January in order to hide the .

And were recently in .

Public concern is mounting, with nearly 60% of voters of how Trump has handled immigration, according to a recent poll conducted by and The New York Times.

The type and scope of health care services that adult immigrants are supposed to receive depend in part on where they’re held. ICE detention standards apply to specific centers such as private prisons that house both inmates and detainees, while are required at facilities that generally house .

Despite the differences, are expected. Immigrants are supposed to receive a medical, dental, and mental health screening when they arrive, and they’re supposed to receive daily sick calls, round-the-clock emergency care, and other services, including preventive care, screening, diagnosis, and treatment.

The standards exist to “ensure that detainees are treated humanely; protected from harm; provided appropriate medical and mental health care; and receive the rights and protections to which they are entitled,” according to ICE’s , revised last year.

But the agency’s failure to adhere to its own standards is leaving immigrant detainees at risk of medical emergencies and death, complications from untreated chronic illnesses, and infection with communicable diseases, according to , , and .

DHS has criticized some of the investigations as false, including a report by Sen. Jon Ossoff (D-Ga.) on pregnant women and children in detention.

“ICE detention facilities have higher standards than most U.S. prisons that detain American citizens. All detainees are provided with comprehensive medical care, proper meals,” DHS spokesperson Tricia McLaughlin said in an . On Feb. 17, McLaughlin announced she would be from her DHS post.

Weakened Oversight, Less Infrastructure

Access to adequate health services has been imperiled because of the surge in detainees, a lack of oversight by the Trump administration, and a delay in processing medical claims that’s jeopardized care, say advocates, lawyers, and some doctors.

“The challenges have been exacerbated because the pace of removals hasn’t kept up with the pace of detentions. It adds to the problem,” said , an associate director at KFF, a health information nonprofit that includes Ñî¹óåú´«Ã½Ò•îl Health News. “There are more public health issues when facilities are crowded.”

The number of immigrants in detention swelled from about 40,000 in November 2023 under former President Joe Biden to a in mid-January, according to the American Immigration Council, an advocacy group that focuses on litigation and research.

At the same time, the Trump administration has weakened oversight of the conditions and health services at detention centers. It cut staff at the DHS Immigration Detention Ombudsman office, effectively , according to a KFF analysis and the Economic Policy Institute, a nonprofit that focuses on economic research.

The has been to “independently examine immigration detention to promote safe, humane conditions,” according to the agency. DHS is currently the target of a partial government shutdown because of Democrats’ opposition to a for the agency. As advanced by Republicans, that measure would zero out the ombudsman’s funding.

There are also lengthy delays to process detainee health payment claims from third-party doctors and hospitals — a holdup that advocates and the federal government have said jeopardizes care.

The Department of Veterans Affairs’ Financial Services Center long had a contract with ICE to process claims for care outside detention centers, such as oncology treatments or dialysis.

Congressional Republicans and claimed it diverted resources from veterans.

Veterans Affairs in October detainees’ claims. Documents ICE posted on a federal contracting website said the termination “created an emergency” by compromising the ability to reimburse providers and left the agency with no mechanism to provide services such as tuberculosis screening, nonemergency medical transportation, and medical equipment purchases.

“It is an absolute emergency for ICE to immediately procure claims processing support because lack of this support will delay critical medical care … such as dialysis, prenatal care, oncology, chemotherapy, etc.,” according to posted in late 2025 at , a federal system for contract data.

A new claims processor, , has been retained, but ICE has said on its website that no claims will be processed until April 30. Advocates say it’s unclear whether detainees are getting access to off-site care as needed and say the claims delays are also discouraging medical providers from providing services to the immigrants.

“DHS has signed a new contract to process these claims and is currently onboarding the vendor,” said Veterans Affairs spokesperson Pete Kasperowicz. “Meanwhile, VA is supporting this transition until May to ensure claims are processed appropriately.”

Deaths in Custody

that at least eight detainees have died in custody so far in 2026, with 33 detainee deaths in 2025 and 11 in 2024. Those figures are contested, however, by some advocates and lawmakers who say the totals exclude detainees who died while being apprehended or in the care of U.S. Customs and Border Protection.

House Democrats on the Homeland Security Committee say 53 people have died in ICE or CBP custody since Trump took office. They are from DHS, including autopsy reports for each death, staffing requirements for medical professionals, and video footage of one detainee who died in Texas.

“We are outraged” at the deaths, according to a Jan. 22 letter from the 13 lawmakers. “It is obvious yet tragic that ICE is unwilling or unable to provide basic care for detainees.”

The Democrats pointed to the death of , 55, who was born in Cuba. He died Jan. 3 at a detention center in Fort Bliss, Texas, after ICE said he experienced medical distress. He had been taken into custody almost six months earlier.

“At no time during detention is a detained alien denied emergency care,” ICE said in a Jan. 9 statement on the death.

The El Paso County Medical Examiner’s Office that occurred after Campos was restrained by law enforcement.

Meanwhile, other immigrants are still waiting for care. Reyes, who needed a biopsy for possible prostate cancer, eventually had the screening test, but as of early February had not received results. “He is in constant agonizing pain,” according to the lawsuit filed in the Northern District of California.

On Feb. 10, a federal judge ordered ICE and DHS to provide to detainees and to conduct external monitoring, including on-site inspections of the detention center.

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Covid, for instance, is now linked in studies to in children of mothers who were infected during pregnancy, as well as a decline in mental cognition and greater risk of heart problems. It’s even been shown to trigger the awakening of dormant cancer cells in people who are in remission.  

Policies around covid and vaccination have economic ramifications. The annual average burden of the disease’s long-term health effects is estimated at $9,000 per patient in the U.S., according to a in November in the journal NPJ Primary Care Respiratory Medicine. In this country, the annual lost earnings are estimated to be about $170 billion. 

The virus that causes covid, SARS-CoV-2, leaves damage that can linger for months and sometimes years. In the brain, the virus leads to an immune response that triggers inflammation, can damage brain cells, and can even shrink brain volume, according to published in March 2022 in the journal Nature.  

, a clinical epidemiologist who has studied longer-term health effects from covid, estimated the virus may have increased the number of adults in the U.S. with an IQ less than 70 from 4.7 million to 7.5 million — dealing with “a level of cognitive impairment that requires significant societal support,” he wrote. 

Meanwhile, data from more than a suggests covid vaccines can help reduce risk of severe infection as well as longer-lasting health effects, although researchers say more study is needed. But last May, Health and Human Services Secretary Robert F. Kennedy Jr. said on X that the Centers for Disease Control and Prevention would for , citing a . The FDA has since issued new guidelines limiting the vaccines to people 65 and older and individuals 6 months or older with at least one risk factor, though many states continue to make them more widely available. 

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Federal officials in May 2023 declared an end to the . But more than two years later, a growing body of research continues to reveal information about the virus and its ability to cause harm long after initial infections resolve, even in some cases when symptoms were mild.

The discoveries raise fresh concerns about the Trump administration’s covid policies, researchers say. While some studies show covid vaccines offer protective benefits against longer-term health effects, the Department of Health and Human Services has drastically limited recommendations about who should get the shot. The administration also aimed at developing more protective covid vaccines.

The federal government is curtailing such efforts just as researchers call for more funding and, in some cases, long-term monitoring of people previously infected.

“People forget, but the legacy of covid is going to be long, and we are going to be learning about the chronic effects of the virus for some time to come,” said , an epidemiologist who directs the University of Minnesota’s Center for Infectious Disease Research and Policy.

The Trump administration said that the covid vaccine remains available and that individuals are encouraged to talk with their health providers about what is best for them. The covid vaccine and others on the schedule of the Centers for Disease Control and Prevention remain covered by insurance so that individuals don’t need to pay out-of-pocket, officials said.

“Updating CDC guidance and expanding shared clinical decision-making restores informed consent, centers parents and clinicians, and discourages ‘one size fits all’ policies,” said HHS spokesperson Emily Hilliard.

Although covid has become less deadly, because of population immunization and mutations making the virus less severe, researchers say the politicization around the infection is obscuring what science is increasingly confirming: covid’s potential to cause unexpected, possibly chronic health issues. That in turn, these scientists say, drives the need for more, rather than less, research, because over the long term, covid could have significant economic and societal implications, such as higher health care costs and more demands on social programs and caregivers.

The annual average burden of the disease’s long-term health effects is estimated at $1 trillion globally and $9,000 per patient in the U.S., according to a in November in the journal NPJ Primary Care Respiratory Medicine. In this country, the annual lost earnings are estimated to be about $170 billion.

One study estimates that the flu resulted in $16 billion in direct health costs and $13 billion in productivity losses in the 2023-2024 season, according to , an online platform that publishes work not yet certified by peer review.

Covid’s Growing Reach

Much has been learned about covid since the virus emerged in 2019, unleashing a pandemic that the World Health Organization reports has killed more than . By the spring of 2020, the term “long covid” had been coined to describe chronic health problems that can persist post-infection.

More recent studies show that infection by the virus that causes covid, SARS-CoV-2, can result in heightened health risks months to more than a year later.

For example, researchers following children born to mothers who contracted the virus while pregnant have discovered they may have an , delayed speech and motor development, or other neurodevelopmental challenges.

found babies exposed to covid in utero experienced accelerated weight gain in their first year, a possible harbinger of metabolic issues that could later carry an increased risk for cardiovascular disease.

These studies suggest avoiding severe covid in pregnancy may reduce risk not just during pregnancy but for future generations. That may be another good reason to get vaccinated when pregnant.

“There are other body symptoms apart from the developing fetal brain that also may be impacted,” said Andrea Edlow, an associate professor of obstetrics, gynecology, and reproductive biology at Harvard Medical School who was involved in both studies. “We definitely need more research.”

Epidemiologists point to some specific, emerging challenges.

A in the New England Journal of Medicine found people who from mild covid infections experienced a cognitive deficit equal to a three-point drop in IQ. Among the more than 100,000 participants, deficits were greater in people who had persistent symptoms and reached the equivalent of a nine-point IQ drop for individuals admitted to intensive care.

, a clinical epidemiologist who has studied longer-term health effects from covid, did the math. He estimated covid may have increased the number of adults in the U.S. with an IQ of less than 70 from 4.7 million to 7.5 million — dealing with “a level of cognitive impairment that requires significant societal support,” he wrote.

“People get covid-19, some people do fine and bounce back, but there are people who start experiencing problems with memory, cognition, and fuzzy brain,” he said. “Even people with mild symptoms. They might not even be aware.”

Diane Yormark, 67, of Boca Raton, Florida, can relate. She got covid in 2022 and 2023. The second infection left her with brain fog and fatigue.

“I felt like if you had a little bit too much wine the night before and you’re out of it,” said Yormark, a retired copywriter, who said the worst of her symptoms lasted for about three months after the infection. “Some of the fog has lifted. But do I feel like myself? Not like I was.”

Data from more than a suggests covid vaccines can help reduce risk of severe infection as well as longer-lasting health effects, although researchers say more study is needed.

But vaccination rates remain low in the U.S., with only about 17% of the adult population reporting that they got the updated 2025-2026 shot as of Jan. 16, based on .

Trump administration officials led by Health and Human Services Secretary Robert F. Kennedy Jr. have reduced access to covid vaccines despite the lack of any new, substantiated evidence of harm. Though the shots were a hallmark achievement of the first Trump administration, which led the effort for their development, Kennedy has said without evidence that they are “.”

In May he said on X that the CDC would for , citing a . The Food and Drug Administration has since issued new guidelines limiting the vaccine to people 65 or older and individuals 6 months or older with at least one risk factor, though many states continue to make them more widely available.

The Trump administration also halted for mRNA-based vaccines. Administration officials and a number of Republicans question the safety of the Nobel Prize-winning technology — heralded for the potential to treat many diseases beyond covid — even though clinical trials with tens of thousands of volunteers were performed before the covid mRNA vaccines were made available to the public.

And numerous studies, including new research in 2025, show covid vaccine benefits include a , although the protective effects wane over time.

Following the Findings

Researchers say more and broader support is important because much remains unknown about covid and its impact on the body.

The growing awareness that, even in mild covid cases, the possibility exists for longer-term, often undetected also warrants more examination, researchers say. A in eBioMedicine found people with neurocognitive issues such as changes in smell or headaches after infection had significant levels of a protein linked to Alzheimer’s in their blood plasma. EBioMedicine is a peer-reviewed, open-access journal published by .

In the brain, the virus leads to an immune response that triggers inflammation, can damage brain cells, and can even shrink brain volume, according to that was published in March 2022 in the journal Nature.

An of advanced brain images found significant alterations even among people who had already recovered from mild infections — a possible explanation for that may persist for years. Lead study author Kiran Thapaliya said the research suggests the virus “may leave a silent, lasting effect on brain health.”

Al-Alay agreed.

“We don’t know what will happen to people 10 years down the road,” he said. “Inflammation of the brain is not a good thing. It’s absolutely not a good thing.”

That inflammatory response has also been linked to blood clots, arrhythmias, and higher risk of cardiovascular issues, even following a mild infection.

A University of Southern California study published in October 2024 in the journal Arteriosclerosis, Thrombosis, and Vascular Biology found the risk for a remains elevated nearly three years after covid infection. The findings held even for people who were not hospitalized.

“We were surprised to see the effects that far out” regardless of individual heart disease history, said James R. Hilser, the study’s lead author and a postdoctoral fellow at the UCLA David Geffen School of Medicine.

Covid can also and trigger a relapse, according to research published in July in the journal Nature. Researchers found that the chance of dying from cancer among cancer survivors was higher among people who’d had covid, especially in the year after being infected. There was nearly a twofold increase in cancer mortality in those who tested positive compared with those who tested negative.

The potential of the covid virus to affect future generations is yielding new findings as well. Australian researchers looked at male mice and found that those who had been from covid experienced changes to their sperm that altered their offspring’s behavior, causing them to exhibit more anxiety.

Meanwhile, many people are now living — and struggling — with the virus’ after-effects.

Dee Farrand, 57, of Marana, Arizona, could once run five miles and was excelling at her job in sales. She recovered from a covid infection in May 2021.

Two months later, her heart began to beat irregularly. Farrand underwent a battery of tests at a hospital. Ultimately, the condition became so severe she had to go on supplemental oxygen for two years.

Her cognitive abilities declined so severely she couldn’t read, because she’d forget the first sentence after reading the second. She also had to leave herself reminders that she is allergic to shrimp or that she likes avocados. She said she lost her job and returned to her previous occupation as a social worker.

“I was the person who is like the Energizer bunny and all of a sudden I’d get so tired getting dressed that I had to go back to bed,” Farrand said.

While she is better, covid has left a mark. She said she’s not yet able to run the five miles she used to do without any problems.

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At the same time, congressional Republicans are eyeing health issues from the “Make America Healthy Again” perspective, hoping it will provide a boost in the midterm elections. 

Here’s why. 

Republicans see the MAHA constituency as critical in the midterms and beyond because its supporters include desirable voting demographics: independents and some Democrats, many of whom are women, younger voters, or suburbanites. 

The strategy risks backfiring, though, because polls show  about reducing health care costs than about MAHA’s war on junk food or efforts to roll back access to vaccines. The affordability issue was thrust center stage last year when enhanced subsidies for Affordable Care Act marketplace plans expired. 

As a result, many of the roughly 23 million people who buy coverage on the health law’s marketplaces are now facing premium payments more than double what they faced last year.  with what has emerged as a key kitchen table issue. 

Democrats are strategizing about how to use public support for MAHA priorities to their own advantage. They’re hoping to expose GOP policies that run counter to MAHA priorities; trumpet Democrats’ efforts to tackle health care costs; and highlight their own party’s work on such MAHA goals as , according to some Democratic strategists. 

Democrats are talking about their continuing fight to address health care costs while largely avoiding direct attacks on Health and Human Services Secretary Robert F. Kennedy Jr. or MAHA, because the movement resonates with the public. Meanwhile, cracks are  the Make America Great Again coalition and the lockstep support Trump has enjoyed from Capitol Hill Republicans. 

For Republicans, the next batch of MAHA events and summits is already scheduled. After taking a political back seat in recent years, health care may dominate the 2026 election races.

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The daylong, invitation-only event in November featured a who’s who of MAHA luminaries. Vice President JD Vance attended, as did Health and Human Services Secretary Robert F. Kennedy Jr., the leader of the ad hoc movement whose members rail against vaccines, Big Pharma, and ultraprocessed food.

During a that organizers broadcasted online, Vance extolled MAHA’s impact on the Trump administration, calling it “a critical part of our success in Washington.”

The summit underscored just how closely Republicans have hitched themselves to the MAHA campaign, banking on its popularity to give them an electoral bounce in the midterms. But the strategy carries risks, because is cratering and polls show about reducing health care costs than MAHA priorities such as ending vaccine mandates and promoting raw milk.

“Polls show clearly MAHA issues are not the top issues for people,” said , a professor emeritus of health policy and political analysis at Harvard University. “The top health care voting issue is cost, and costs are actually rising.”

The disconnect was on display Nov. 12, the day of the , where attendees picked up swag bags and mingled amid the hotel’s blue-velvet couches and crystal chandeliers.

A few blocks away at the White House, President Donald Trump that day to reopen the federal government. The centered on disagreement over expiring Affordable Care Act subsidies, which Democrats wanted to extend and GOP congressional leadership declined to take up. The government went back to business and, in the midst of a political and legislative , those subsidies expired at the end of 2025. That has fueled the national affordability debate, as many of the roughly 24 million people who buy coverage on the health law’s marketplaces are now facing premium payments more than double what they faced last year. In January, with what has emerged as a key kitchen table issue.

Said Blendon: “MAHA is not lowering the cost.”

MAHA was mainstreamed as part of the political platform embraced by Kennedy, an environmental lawyer and anti-vaccine activist who ran for president in 2023 and 2024. When he suspended his campaign and endorsed Trump, Kennedy united MAHA with conservatives, marrying the “health freedom” movement with MAGA.

But the movement took root before then, during the covid pandemic, grounded in the idea that the U.S. is in the throes of a chronic disease epidemic caused by corruption in the food, medical, and pharmaceutical industries, as well as federal agencies. Some adherents also are skeptical of or opposed to vaccines.

“Covid was really eye-opening for people,” said Andrea Nazarenko, a psychologist and MAHA supporter who co-authored a . “They realized, ‘Wait a minute — the systems I trusted may not be as trustworthy as I thought.’ At its core, people are noticing the systems they relied on are failing them.”

MAHA has since emerged as an influential force for the GOP, gaining significant clout in a short time. Case in point: Early this month, Kennedy announced and updated , which were both part of the movement’s wish list and departures from existing frameworks.

In addition, members of Congress have founded a MAHA caucus. Lawmakers in Republican-led states are introducing or passing legislation to advance the MAHA agenda, including laws to restrict mRNA vaccines or in food. And food manufacturers including Nestle, General Mills, and Kraft Heinz have pledged to remove artificial dyes or additives.

Republicans see the MAHA constituency as critical in the 2026 midterm elections and beyond. Its supporters include desirable voting demographics — independents and some Democrats, many of whom are women, younger voters, or suburbanites. About 21% of independent voters and 8% of Democratic voters held a favorable or somewhat favorable view of MAHA as of early fall, according to by Change Research.

“I think one reason I won reelection was that I advocated for the covid-vaccine-injured and was an ally of Bobby Kennedy back then when he was being vilified,” Sen. Ron Johnson (R-Wis.) said. “People appreciated that. It’s about basic health.”

Republicans are counting on a MAHA bounce, and political analysts say they may need it. The party took a drubbing in November’s statewide races, and from 47% in early 2025 to 36% by December, according to Gallup polls. Those are ominous trends for the GOP, since the party with the presidency has lost ground in midterm House elections.

Meanwhile, cracks are starting to threaten the Make America Great Again coalition and the lockstep support Trump has enjoyed from Capitol Hill Republicans. While MAGA shows signs of weakening, MAHA is flourishing.

“Kennedy has ratified the Republican agenda around health and food,” said David Mansdoerfer, who served in HHS leadership during the first Trump administration. “We sound very much like the issues Democrats were into in the 1990s and 2000s. We’ve almost done a 180 and co-opted a topic under a Republican agenda.”

Kennedy is expected to soon check another item off MAHA’s list by pressing states to remove fluoride from the water supply, according to a source who asked to remain anonymous because he isn’t authorized to speak to the media.

But Republicans’ embrace of MAHA in the run-up to the November midterm elections could also cost them, political strategists say.

Polling shows popular support for MAHA initiatives such as ridding food of synthetic dyes, but voters are far less enthusiastic about Kennedy and his denouncements of vaccines and efforts to limit access to them. Almost 60% of adults disapprove of his work as head of HHS, according to by KFF, a health information nonprofit that includes Ñî¹óåú´«Ã½Ò•îl Health News.

And only 26% of registered voters support defunding mRNA vaccine research, according to a by left-leaning pollster Navigator Research. In the same poll, 3 in 4 reported feeling positively toward the measles vaccine.

Still, the Trump administration has its attack on vaccines. The Food and Drug Administration’s top vaccine official in November that the agency would overhaul vaccine regulation, asserting without evidence that at least 10 children had died from covid shots.

In December, a federal vaccine advisory panel handpicked by Kennedy voted to stop recommending routine vaccination of newborns against hepatitis B. Medical groups denounced the panel’s actions, saying the vaccine is safe and that the recommendation would lead to more infections with the virus, which causes serious liver damage.

Democrats see an opening. The Democratic Doctors Caucus, a group of medical doctors in Congress, condemning the federal advisory panel’s changed recommendation on the hepatitis B vaccine, calling it an attack on basic science. And Democratic Reps. Frank Pallone of New Jersey, Diana DeGette of Colorado, and Yvette Clarke of New York demanding data from the agency on the covid death claims.

Highlighting the risks of the Trump administration’s anti-vaccine initiatives is only part of Democrats’ game plan to counter Republicans’ alliance with MAHA.

Strategists describe three aims: Expose GOP policies that run counter to MAHA priorities; trumpet Democrats’ efforts to tackle health care costs; and highlight their own party’s work on such MAHA goals as cracking down on pesticide-makers.

“If people want to be healthier, they need affordable health care, and Democrats are the only ones pushing for affordable health care,” said , communications director for the House Majority PAC, a fundraising group that works to elect more Democrats.

Most notably, the strategy so far hasn’t really involved attacks on Kennedy or MAHA itself.

“If Democrats focus on attacking Kennedy, saying he’s crazy and he has a brain worm, some voters hear that as reinforcing the notion that Democrats are wedded to Big Pharma and Big Ag,” said , a senior adviser at the Center for Economic and Policy Research, a progressive nonprofit focused on economic policy.

So Democrats will talk about their continuing fight to address health care costs, such as with a possible retroactive fix to the now-expired ACA subsidies, or by Sen. Cory Booker (D-N.J.) to prevent pesticide manufacturers from getting legal immunity against health claims. And they plan to discuss Trump administration actions that seemingly run counter to the MAHA agenda, such as a decision by the Environmental Protection Agency to relax the of the carcinogen formaldehyde.

“Everything they’re doing actually makes people sicker with higher bills, dirtier air, and fewer people covered with insurance,” said , a Democratic strategist. “Democrats do need to take MAHA seriously and can’t brush it off. The core is to show Democrats are focused on health and health care and exposing what the Republican agenda means.”

For Republicans, the next batch of MAHA events and summits is already scheduled. After taking a political back seat in recent years, health care may dominate the 2026 election races.

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“Our country wants us to be birthing machines, but they’re cutting what resources there already are,” said Olcott, 20. “And a $1,000 baby bonus? It’s low-key like, what, bro? That wouldn’t even cover my month’s rent.”

The Trump administration wants Americans to have more babies, and the federal government is debuting policy initiatives to reverse the falling U.S. fertility rate. In mid-October, the White House unveiled a plan to to in vitro fertilization treatment. President Donald Trump has , calling himself “the .”

But reproductive rights groups and other advocacy organizations say these efforts to buttress the birth rate don’t make up for broader administration priorities aimed at cutting federal programs such as Medicaid, its related Children’s Health Insurance Program, and other initiatives that support women and children. The pro-family focus, they say, isn’t just about boosting procreation. Instead, they say, it’s being weaponized to push a conservative agenda that threatens women’s health, reproductive rights, and labor force participation.

Some predict these efforts could deter parenthood and lead to increases in maternal mortality.

“The religious right wants more white Christian babies and is trying to curtail women’s reproductive freedom in order to achieve that aim,” said , a spokesperson for Population Connection, a nonprofit that promotes population stabilization through increased access to birth control and abortion. “The real danger is the constant whittling down of reproductive rights.”

The White House did not respond to repeated interview requests.

A slate of federal programs that have long helped women and children are also being targeted by Trump and Cabinet members who say they champion pronatalist policies.

Medicaid work requirements, for instance, put in place by the Republicans’ One Big Beautiful Bill Act, a budget law enacted in July, will lead to extra paperwork and other requirements that, according to the , will cause to lose coverage. Medicaid covers more than in the U.S.

The measure also cuts federal funding for a national program that provides monthly food benefits. Almost in fiscal 2023 were children.

GOP spending cuts and staffing freezes have , a federal education program that provides day care and preschool for young, low-income children, even as U.S. adults implore the government to .

And the GOP halted Medicaid funding to Planned Parenthood of America for one year because it provides abortion services, forcing around the country to close since the beginning of 2025. Planned Parenthood provides a wide range of women’s health services, from wellness exams to breast cancer screenings and .

Groups that advocate for women’s health and reproductive rights say the actions by the administration and congressional Republicans to attack these programs are making it harder for families to get the support and medical care they need.

“There is a lot of rhetoric about who is worthy of public assistance, and to many policymakers, it’s not the single mother,” said , a public health law and policy analyst at the Milken Institute School of Public Health at George Washington University.

The pronatalist perspective generally supports government intervention to encourage procreation and is rooted in a belief that modern culture has failed to celebrate the nuclear family. The movement’s supporters also say policies to encourage childbearing are an economic necessity.

A Declining Birth Rate

The has largely been on a downward trajectory since 2007, with the number of births declining by an average 2% per year from 2015 through 2020, according to the , although the rate has fluctuated since.

The concepts that shape the movement can be found in Project 2025, a political initiative led by the conservative Heritage Foundation that has seen many of its proposals adopted by Trump. The document asserts that in a “heterosexual, intact marriage.”

“Married men and women are the ideal, natural family structure because all children have a right to be raised by the men and women who conceived them,” it says.

Project 2025 also includes many proposals that critics say aren’t friendly toward women’s health. For instance, it calls for eliminating access to mifepristone, a drug commonly used in abortions as well as in the management of miscarriages, and encourages states to block Planned Parenthood facilities from receiving Medicaid funding.

The “more babies” mantra is being embraced at the highest levels of the federal government.

“I can’t remember any other administration being so tied to the pronatalist movement,” said Brian Dixon, Population Connection’s senior vice president for government and political affairs.

Just days after he was sworn in, Vice President JD Vance declared, “I want in the United States of America.” He has also criticized of women and men who opt not to start families.

The White House in October did announce a discount on certain drugs used in through , a yet-to-debut government website that aims to connect consumers with lower-priced drugs. Mehmet Oz, who heads Medicare and Medicaid, heralded a possible future of “,” resulting from the lower-priced infertility drugs.

The administration also announced it would encourage employers to move to a new model for as a stand-alone option in which employees can enroll. But that is far from Trump’s earlier pledge to make infertility treatments free and may not be enough to overcome other long-term financial worries that often guide decisions about whether to have children.

Angel Albring, a mother of six, says her dream of having a big family always hinged on her ability to work and avoid child care costs. Her career as a freelance writer enabled her to do so while still contributing to the family’s income, working during nap times and at night, while the rest of her household slept.

“The whole thing of ‘sleep when the baby sleeps’ never applied to me,” Albring said.

Some of her friends, though, aren’t so fortunate. They fear they cannot afford children because of climbing costs for day care, groceries, and housing, she said.

Delivering on ‘Baby Bonuses’?

The Trump administration, meanwhile, has advanced another policy aimed at giving children a future financial boost.

The One Big Beautiful Bill Act establishes a tax-advantaged “” seeded with $1,000 in federal funds — often called a “baby bonus” — on behalf of every eligible American child. The initial deposits are scheduled to start in 2026 with the federal government automatically opening an account for children born after Dec. 31, 2024, and before Jan. 1, 2029.

Parents could contribute up to $5,000 a year initially to the account, with employers able to annually of that amount. The accounts reportedly would be vehicles for long-term savings. Details are still being ironed out, but funds could not be withdrawn before the child turns 18. After that, the accounts would likely become traditional IRAs.

On Tuesday, billionaires Michael and Susan Dell of Dell computer fame said they would give $250 to 25 million children age 10 and under in the U.S. The donations will be aimed at encouraging participation in the Trump accounts.

Pronatalism extends to other parts of the federal government, too.

Transportation Secretary Sean Duffy, who has , instructed his department to prioritize federal funds for communities with , though it has not yet announced any projects directly related to the initiative. For a time, the administration considered bestowing on mothers with six or more children.

Except there’s one hitch: Data suggests the policies and programs the Trump administration has proposed won’t necessarily work.

Other countries have offered more robust programs to encourage childbearing and ease parenting but haven’t seen their birth rates go up, noted Michael Geruso, an economist for the University of Texas-Austin who hopes to see the global population increase. Israel, for example, has offered free IVF treatment for roughly three decades, yet its birth rates have stayed statistically stagnant, at just under three children for every woman, he said.

France and Sweden have extensive social safety-net programs to support families, including paid time off and paid paternity and maternity leave, and subsidized child care and health care, but their fertility rates are also falling, said Peggy O’Donnell Heffington, a University of Chicago assistant senior instructional professor in the history department who wrote a book on non-motherhood.

“Nobody yet knows how to avoid depopulation,” Geruso said.

Some point to a different solution to reverse the United States’ declining population: to ensure a younger labor force and stronger tax base. The Trump administration, however, is doing the opposite — revoking visas and creating an environment in which immigrants who are in the U.S. legally feel increasingly uncomfortable because of heavy-handed policies, analysts say.

The country’s this year fell for the since the 1960s, according to a Pew Research Center analysis.

Meanwhile, to critics of the administration, the focus on encouraging childbirth allows the Trump administration and Republicans to sound as if they support families.

“You’re not seeing policies that support families with children,” said , vice president of income security and child care at the National Women’s Law Center, a nonprofit focused on gender rights. “It’s a white, heterosexual, fundamentalist Christian, two-parent marriage that’s being held up.”

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Fast-forward to the congressional stalemate that has closed the federal government for more than a month. Democrats, entrenched on one side of the legislative battle, staked their political future on merely preserving parts of the Affordable Care Act — a far cry from the systemic health policy changes that party members once described as crucial for tackling the high price of care.

Democrats succeeded in focusing national attention on rising health insurance costs, vowing to hold up funding for the federal government until a deal could be made to extend the more generous tax subsidies that have cut premiums for Obamacare plans. Their doggedness could help them win votes in midterm elections next year.

But health care prices are rocketing, costly high-deductible plans are proliferating, and 4 in 10 adults have some form of health care debt. As health costs reach a crisis point, a yawning gulf exists between voters’ desire for more aggressive action and the political urgency in Washington for sweeping change.

“There isn’t a lot of eagerness among politicians,” said , an economist who played a key role in drafting the ACA. “Why aren’t they being more bold? Probably scars from the ACA fights. But health care is a winning issue. The truth is we need universal coverage and price regulation.”

Voters rank lowering health care costs as a top priority, above housing, jobs, immigration, and crime, according to a by Hart Research Associates for Families USA, a consumer health advocacy group.

And costs are climbing. Premiums for job-based health insurance rose 6% in 2025 to an average of $26,993 a year for family coverage, according to an annual survey of employers released Oct. 22 by KFF, a health information nonprofit that includes Ñî¹óåú´«Ã½Ò•îl Health News. For all the attention given to grocery, gas, and energy prices, health premiums and deductibles in recent years have risen and wages.

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Kennedy is expected to create a task force to recommend possible federal action, according to a former agency official, an internal agency memo obtained by Ñî¹óåú´«Ã½Ò•îl Health News, and a consultant who says he helped with the memo. 

“HHS does not comment on future or potential policy decisions and task forces,” agency spokesperson Emily Hilliard said by email. 

The plans show how rumors and conspiracy theories can gain an air of legitimacy under the Trump administration, where researchers say that unscientific ideas have unusual power to take hold and shape public health policy. 

The concept posits that airplane vapor trails are that harm public health. Another version alleges planes or devices are , private companies, or researchers to trigger big weather changes, such as hurricanes, or to alter the Earth’s climate, emitting hazardous chemicals in the process. 

HHS is expected to appoint a special government employee to investigate climate and weather control, according to of the department’s Make America Healthy Again agenda. He said he drafted the internal agency memo. HHS has interviewed applicants to lead a “chemtrails” task force, said Jim Lee, a blogger focused on weather and climate who Delany said helped edit the memo, which Lee confirmed. 

Delany, who was from HHS, said Kennedy has expressed strong interest in chemtrails. The memo alleges that “aerosolized heavy metals such as Aluminum, Barium, and Strontium, as well as other materials such as sulfuric acid precursors, are sprayed into the atmosphere under the auspices of combatting global warming,” through a process of stratospheric aerosol injection. 

“That is a pretty shocking memo,” said Daniel Swain, a climate scientist at the University of California. “It doesn’t get more tinfoil hat. They really believe toxins are being sprayed.” 

Deploying chemtrails to poison people is just one of many baseless conspiracy theories that have found traction among Trump administration health policy officials led by Kennedy, a longtime anti-vaccine activist before entering politics who embraces a range of such ideas. 

In April, Kennedy was asked on “Dr. Phil Primetime” about chemicals being sprayed into the stratosphere to change the Earth’s climate. “It’s done, we think, by DARPA,” referring to a Department of Defense agency that develops emerging technology for the military’s use. “And a lot of it now is coming out of the jet fuel. Those materials are put in jet fuel. I’m going to do everything in my power to stop it. We’re bringing on somebody who’s going to think only about that.” 

DARPA officials didn’t return a message seeking comment.

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Researchers say the children at about a mile away pay the price. They discovered the students there and at other elementary schools near major pollution sites in Pennsylvania had than other children in the state.

Residents and environmental advocates saw reason for hope and relief in the form of a designed to tamp down on coke oven plant pollution. But even before it took effect, President Donald Trump granted in the U.S. — including the one in Clairton — a from the standards.

Trump and Republicans have sought to align themselves with the Make America Healthy Again movement’s populist ideals, such as improving Americans’ food choices and reducing corporate harm to the environment. But the administration is ratcheting up its attacks on the very environmental protections that MAHA followers hold dear.

Taken together, these anti-environmental initiatives will lead to more pollution-related illnesses and higher health care spending, health researchers say. They could also have political ramifications, eroding MAHA’s support for GOP candidates in the November midterm elections if followers believe the party is more beholden to industry than to the movement’s agenda.

, including about a quarter of Republicans, support rolling back environmental regulations, according to a poll by the Energy Policy Institute at the University of Chicago and The Associated Press-NORC Center for Public Affairs Research.

Some MAHA supporters believe voters will support Republicans because the Trump administration is delivering on other goals important to the movement.

“MAHA has a pretty diverse set of policy goals, ranging from medical freedom to food and the environment,” said David Mansdoerfer, who served in Health and Human Services leadership during Trump’s first term. “In totality, the Trump administration has strongly delivered on much of the MAHA agenda.”

While MAHA voters have been upset at some of the administration’s actions that promote industry, it’s hard to know how that may play out in the midterms, said Christopher Bosso, a professor of public policy and politics at Northeastern University. Many were disillusioned by a Trump they viewed as promoting glyphosate, which HHS Secretary Robert F. Kennedy Jr. has .

“The glyphosate thing really ticks off a lot of them; they’re really upset,” Bosso said. “Kennedy said it was poison. If it is a poison, why aren’t we regulating it? That’s where the tension plays out.”

The situation with the Clairton coke plant and the others granted exemptions from regulations underscores the potential public health risks. Six of the 11 factories had “high priority” violations of the Clean Air Act as of last May, according to a Ñî¹óåú´«Ã½Ò•îl Health News analysis. Five coke oven plants logged major violations every quarter for at least three years straight.

“Poisoning continues to some of the most vulnerable residents of Allegheny County,” , who had lived in nearby Glassport, Pennsylvania, said at a about the coke plant.

Environmental Protection Agency spokesperson Brigit Hirsch said the president gave companies extra time because the technology needed to meet a new standard isn’t ready yet.

“Forcing plants to comply before the tools exist doesn’t make the air cleaner, it just shuts down facilities and kills jobs with nothing to show for it,” Hirsch said.

But environmental groups disagree that the plants were unable to comply at a reasonable cost, and they say the exemption from the EPA requirements shows the Trump administration is prioritizing the coal industry at the expense of public health.

“The Trump administration’s relentless actions to dismantle lifesaving environmental protections are a gut punch to the administration’s own promise to Make America Healthy Again,” said Cathleen Kelly, a senior fellow at the Center for American Progress, a liberal think tank.

Hard Times in Clairton

Sprawled across , the Clairton plant operates ovens in which coal is heated to as much as 2,000 degrees Fahrenheit to make up to 4.3 million tons annually of the carbon-rich fuel known as coke. The product is used in blast furnaces to produce iron.

It’s a dirty operation. The process leads to hazardous emissions of that the Centers for Disease Control and Prevention says can lead to anemia and leukemia, as well as , which can trigger severe asthma.

The Clairton operation has had repeated problems with its emissions and operations, including and of toxic chemicals. The plant has received more than from the Allegheny County Health Department since 2022, stemming largely from a fire in 2018 that led to high emissions, and violated the Clean Air Act in each of the last , with the last compliance monitoring in July 2025, according to the EPA.

Nippon Steel Corp. last year acquired U.S. Steel, which now operates as a subsidiary. The company didn’t respond to an email seeking comment. U.S. Steel said it spends $100 million annually on environmental compliance at Clairton.

“Environmental stewardship is a core value at U. S. Steel, and we remain committed to the safety of our communities,” spokesperson Andrew Fulton said in a written statement.

Clairton was once bustling with movie theaters, a mix of grocery stores, and riverside parks, with a dance pavilion and . But the decline of steel hit hard. The town’s population dwindled from more than in the mid-20th century to as of 2024. until they were razed and replaced with signs saying to keep out. The 1978 movie , which depicts a hardscrabble industrial town, is partly set there. Today, about 33% of residents live in poverty.

While the plant brings jobs and revenue, residents of the town and the surrounding areas have long complained about health problems they attribute to its emissions.

“My parents are gone. My mom had cancer, my dad,” , a Clairton resident, said at a 2025 County Council meeting. “I lost a lot of loved ones and seen other ones pass because of this mill.”

Pediatric allergist looked into asthma rates among 1,200 children who attended school near major pollution sites in the area — including students at Clairton Elementary School. They had nearly triple the national rate of asthma, with the highest rate among African American youth, according to she led.

“We were shocked,” she said. “It was double or triple what we expected. The people are proud of their industrial background. We need steel, but they’re not running a good enough operation.”

A found children with asthma living near the coke plant had an 80% higher chance of missing school when sulfur dioxide pollution was elevated.

Allegheny County, which includes Clairton and Pittsburgh, is home to a number of industrial plants, and to increased deaths, chronic heart disease, and adverse birth outcomes. It was ranked in the top 1% of counties in the nation for cancer risk from stationary industrial air pollutants in a 2018 .

Clairton has an age-adjusted cancer death rate of 170 per 100,000 people, higher than the broader county’s rate of 150 deaths per 100,000 people, based on a Ñî¹óåú´«Ã½Ò•îl Health News analysis of .

The American Lung Association in 2025 gave the county an F rating for its particle pollution levels. PennEnvironment, an environmental group that was party to a settlement with U.S. Steel involving the Clairton plant, says the coke operation caused of toxic releases in 2021, which amounted to 60% of all such releases in the county that year.

From 2020 through 2025, the Clairton plant racked up more in fines from Clean Air Act penalties than any other coke oven facility nationwide, costing U.S. Steel over $10 million, according to EPA facility reports.

“We are deeply concerned with exemptions, which allow air toxics to affect public health,” Allegheny County Health Department spokesperson Ronnie Das said in a statement.

The Clairton plant provides and hundreds of millions of dollars in tax revenue to the area. The jobs help generate nearly $3 billion in annual economic output, according to estimates from the Pennsylvania Manufacturers’ Association.

Some community members and advocacy groups hoped air quality would improve after the coke plant was sold. has pledged to upgrade facilities in the Monongahela River Valley.

Politics, Waivers, and Environmental Concerns

Under the Biden-era rule, coke plants were supposed to start meeting from the lids and doors of ovens that heat coal. They would also have had to monitor for benzene at their property lines and take steps to lower emissions of the carcinogen if they exceeded certain levels. Compliance deadlines were set for July 2025.

The Trump administration, which has sought to revive the coal industry, intervened. Last year, it , including coke plants such as Clairton’s, to seek from issued in 2024 by the EPA.

Then Trump in November went further, granting all coke plants a two-year compliance break.

The reprieve was necessary, the EPA spokesperson Hirsch said, because the requirements would have meant extra costs for the industry when standards already in effect work “extremely well” at reducing pollution.

Hirsch also said the agency under Trump is protecting the environment, pointing to action the administration has taken to called PFAS, prevent lead poisoning, strengthen chemical safety, and protect Americans’ food and water supply.

“We are building a future where the next generation of Americans is the healthiest in our nation’s history, and they inherit the cleanest air, land and water in the world,” Hirsch said.

However, the administration has taken several steps that environmental advocates say weaken health protections.

The president’s executive order on glyphosate, an herbicide the World Health Organization has linked to cancer, which touched off a who said they felt betrayed. The EPA has decided to stop considering the of reducing pollution when making policy decisions, instead focusing on the cost to industry of complying with rules. The agency also rescinded the legal and scientific basis that had long established as dangerous to public health.

The actions have rankled some MAHA enthusiasts who counted on the administration to tackle chronic disease, especially among children. A petition to Trump on with more than 15,000 signatures called for the removal of EPA Administrator Lee Zeldin, it said supported corporations over MAHA goals.

Some MAHA enthusiasts have sounded off on social media.

“No one should believe that MAHA is being upheld at the EPA at this point,” , a leader of American Regeneration, which focuses on a conservation approach to farming, said Feb. 8 on X.

, host of a , also aired her concerns on X, saying “there is something really freaking spooky going on at the EPA and I refuse to let the American people be gaslit into thinking they’re upholding the MAHA agenda.”

“A significant number of people who supported Trump are worried these rollbacks are going to hurt their health,” said , a Democratic strategist and the founder of the communications firm Third Degree Strategies. “The MAHA voters, especially women, are very sensitive to this. Republicans have put themselves in a bind.”

MAHA supporters shouldn’t be surprised by a Trump administration that doesn’t prioritize environmental protections over industry, because the president has always championed fossil fuels, said Kyle Kondik, managing editor of Sabato’s Crystal Ball, a nonpartisan election forecasting newsletter published by the University of Virginia Center for Politics.

The coke plant exemptions have disappointed some community members, environmental groups, and regulators concerned about public health and emissions.

Nearly 300,000 people live within 3 miles of the 11 active coke plants across the U.S., according to EPA data compiled by the Environmental Defense Fund.

Weakening environmental rules has helped boost Trump with the U.S. coal industry. In February, mining industry executives and lobbyists gathered at the White House, .

Coal miners, including some in white hard hats bedecked with American flags, with a bronze-colored trophy emblazoned “The Undisputed Champion of Beautiful Clean Coal.”

At the event, Trump praised their work. “We love clean, beautiful coal,” he said.

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The tensions risk fraying Kennedy’s dynamic MAHA coalition, potentially driving away critical supporters who helped fuel President Donald Trump’s 2024 election win.

The movement’s grassroots membership includes suburbanites, women, and independents who are generally newer entrants to the GOP and laser-focused on achieving certain results around the nation’s food supply and vaccines.

Promoting healthy foods tops their list and will be at the center of the White House’s pitch to voters during the midterm election cycle.

“President Trump’s mass appeal partly lies in his willingness to question our country’s broken status quo,” White House spokesperson Kush Desai said in a statement. “That includes food standards and nutrition guidelines that have helped fuel America’s chronic disease epidemic. Overhauling our food supply and nutrition standards to deliver on the MAHA agenda remains a key priority for both the President and his administration.”

At the same time, with most Americans , the White House has cooled on Kennedy’s aggressive policies to curb vaccines and MAHA’s interest in tamping down environmental chemicals that are linked to disease.

The result: Republicans are realizing just how demanding the MAHA vote can be. Moms Across America leader Zen Honeycutt warned that Republicans are facing their biggest setback yet with the MAHA movement, after Trump signed an executive order to support production of glyphosate, a herbicide the World Health Organization has .

“It has caused the biggest uproar in MAHA,” Honeycutt said during a CNN interview in late February.

A White House Warning

Trump’s top pollster, Tony Fabrizio, cautioned in December that an embrace of Kennedy’s anti-vaccine policies could cost politicians their jobs this year.

Eight in 10 MAHA voters and 86% of all voters believe vaccines save lives, his poll of 1,000 voters in 35 competitive districts found.

“In the districts that will decide the control of the House of Representatives next year, Republican and Democratic candidates who support eliminating long standing vaccine requirements will pay a price in the election,” on the poll stated.

The White House has since shaken up senior staffing at HHS, including removing from the deputy secretary role and his job as acting director of the Centers for Disease Control and Prevention, in which he curtailed the agency’s childhood vaccination recommendations. Ralph Abraham, a vaccine skeptic who as Louisiana’s surgeon general suspended its vaccination promotion program last year, stepped down as the CDC’s principal deputy director in late February.

, a doctor who said in congressional testimony that he doesn’t believe vaccines cause autism, is now running the CDC in addition to directing the National Institutes of Health.

Though Trump himself has frequently espoused doubts and mistruths about vaccines, polling around anti-vaccine policy has undoubtedly shaken the White House’s confidence during a tough midterm election year, said former , an Indiana Republican and retired doctor who left Congress last year.

Bucshon said Republicans can’t risk alienating voters, especially parents of young children who might be moved by Democratic attack ads on the topic at a time when hundreds of measles cases are popping up across the U.S.

“That’s the reason you’re seeing the White House get nervous about it,” Bucshon said. “This is just the political reality of it.”

Kennedy built some of his MAHA following with calls to end federal approval and recommendations for the covid vaccines during the pandemic. The Advisory Committee on Immunization Practices, a federal panel of outside experts who were handpicked by Kennedy to develop national vaccine recommendations, is expected to review and possibly withdraw its recommendation for covid shots. Its February meeting was postponed and is now scheduled for March 18-19, when the panel plans to discuss injuries from covid vaccines, HHS spokesperson Andrew Nixon confirmed on March 11.

“I’m not deaf to the calls that we need to get the covid vaccine mRNA products off the market. All I can say is stay tuned and wait for the upcoming ACIP meeting,” ACIP Vice Chair Robert Malone , a conservative account on the social platform X, before the meeting was postponed. “If the FDA won’t act, there are other entities that will.”

No Fury Like Scorned MAHA Moms

Bipartisan support is also extremely high — above 80% — for another core tenet of the MAHA agenda: eliminating the use of certain pesticides on crops.

But MAHA leaders were incensed when Trump issued a Feb. 18 promoting the production of glyphosate, a chemical used in weed killers sprayed on U.S. crops and which Kennedy has railed against and sued over because of its reported links to cancer.

“There’s gonna be ups and downs, and there is zero question that this week was a down,” Calley Means, a senior adviser to the health secretary and a former White House employee, told a MAHA rally in Austin, Texas, on Feb. 26. “I am not going to gaslight or sugarcoat it: This glyphosate thing was extremely disappointing. Bobby’s disappointed.”

Despite deep unhappiness from MAHA followers, Kennedy endorsed Trump’s executive order defending access to such pesticides.

“I support President Trump’s Executive Order to bring agricultural chemical production back to the United States and end our near-total reliance on adversarial nations,” Kennedy .

Without offering policy changes, Kennedy promised a future agricultural system that “is less dependent on harmful chemicals.”

White House officials are now trying to downplay the executive order.

“The President’s executive order was not an endorsement of any product or practice,” Desai said in a statement.

But that’s done little to dampen criticism from leading MAHA influencers who had hoped, with Kennedy’s influence in the administration, that the chemical would be banned.

Some Democrats see an opening.

of Maine earned cheers from MAHA loyalists for co-sponsoring legislation with Rep. Thomas Massie (R-Ky.) to undo the executive order.

“The Trump Admin. cannot keep paying lip service to while propping up Big Chemical like this and choosing corporate profits over Americans’ health,” .

, a prominent MAHA influencer who promotes healthy eating, responded on X with a “HELL YES.”

‘Eat Real Food’

The White House and Kennedy are refocusing their messaging to emphasize one of the most popular elements of the MAHA platform: food.

At the start of the year, Kennedy unveiled new dietary guidelines that emphasize vegetables, fruits, and meats while urging Americans to avoid ultraprocessed foods.

Kennedy has leaned into his new “Eat Real Food” campaign, launching a nationwide tour in January. Ahead of the late-February MAHA rally, he stopped at a barbecue joint in Austin where he took photos with stacks of smoked ribs and grilled sausages. Large “Eat Real Food” signs have been provided for crowds of supporters to hold up during major announcements at HHS’ headquarters this year.

Focusing on nutrition will please MAHA moms, suburban swing voters, and conservatives alike, said , a physician and former Republican representative from Texas.

“They keep them happy by talking about the food pyramid,” Burgess said. “That’s an area where there is broad, bipartisan support.”

Indeed, Fabrizio’s poll shows equal support — 95% — among respondents who voted for former Vice President Kamala Harris and those who voted for Trump for requiring labeling of harmful ingredients in ultraprocessed foods.

Trump is keenly aware that Kennedy’s MAHA movement is key to his political survival. At a Cabinet meeting in January, Kennedy rattled off a list of his agency’s efforts researching autism and tackling high drug prices.

Trump leaned in at the table.

“I read an article today where they think Bobby is going to be really great for the Republican Party in the midterms,” , “so I have to be very careful that Bobby likes us.”

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There, he waited. Reyes, now 51, made repeated requests for the procedure, according to a against the federal government, but months went by even though there was blood in his urine — a potential sign of cancer that’s spread.

“It may have gone from very treatable to metastasized,” said , who, as a lawyer with the American Civil Liberties Union’s National Prison Project, is involved with the lawsuit.

“There are vulnerable populations; it’s crowded. The medical care isn’t there to handle the increased number of people who are sick,” Virgien said.

President Donald Trump’s mass deportation effort has led to a record number of immigrants being held in federal detention centers, local jails, and private prisons. The situation is putting detainees’ health at risk. Immigration and Customs Enforcement is violating standards that ensure immigrants receive initial medical screenings, routine health care, and timely responses to physical complaints, according to a review of more than 200 pages of , and reports, and recent by Democrats.

Complaints about inadequate medical care at detention facilities risk adding to the political backlash Trump faces over his aggressive deportation campaign, including the killing of in Minneapolis. Democratic members of Congress have insisted on reining in federal immigration agents as part of a 2026 spending bill for the Department of Homeland Security, an impasse that threatens to largely shut down the agency.

Spokespeople for ICE and ICE Health Services Corps, the Department of Homeland Security, and the White House didn’t respond to repeated requests for comment on this article. IHSC assesses health for deportation, oversees medical standards in contracted facilities, and reimburses for off-site medical care.

However, on the , assistant director Stewart Smith said the corps “upholds health care standards across ICE-owned and contracted facilities, and ensures the provision of required health care delivery for detained aliens.” For ICE’s part, its that “many aliens may not have received recent or reliable medical treatment for existing conditions prior to entering ICE custody. For some individuals, this may represent their first access to comprehensive medical care.”

Some Democratic lawmakers have demanded autopsy reports on detainees who died in custody and have publicly accused ICE of denying immigrants access to care. Rep. Kelly Morrison (D-Minn.) said that a she visited at the state’s historic Fort Snelling had no medical policy and “no real” on-site medical care.

“It raises alarm bells from a medical and public health perspective,” Morrison, who is a doctor, told Ñî¹óåú´«Ã½Ò•îl Health News. “There are no beds, no blankets, minimal food. It’s freezing in there. Everyone is in leg shackles. It’s chaotic, disorganized, and, frankly, dangerous.”

(D-Texas) recently denounced the health care given to detainees at a she held after visiting , a 5-year-old boy in Minneapolis who was sent to the Dilley Immigration Processing Center in South Texas. She went to the center following media reports that he’d developed a fever and was .

“The treatment these people are suffering under right now is worse than those who are accused and sometimes even convicted of crimes. That’s how bad it is,” she said.

DHS locked down Dilley this month after two detainees . The facility also houses children who are vulnerable to severe complications of the illness, such as brain swelling.

(D-Conn.) on Feb. 1 accused the administration of denying him entry to Dilley in late January in order to hide the .

And were recently in .

Public concern is mounting, with nearly 60% of voters of how Trump has handled immigration, according to a recent poll conducted by and The New York Times.

The type and scope of health care services that adult immigrants are supposed to receive depend in part on where they’re held. ICE detention standards apply to specific centers such as private prisons that house both inmates and detainees, while are required at facilities that generally house .

Despite the differences, are expected. Immigrants are supposed to receive a medical, dental, and mental health screening when they arrive, and they’re supposed to receive daily sick calls, round-the-clock emergency care, and other services, including preventive care, screening, diagnosis, and treatment.

The standards exist to “ensure that detainees are treated humanely; protected from harm; provided appropriate medical and mental health care; and receive the rights and protections to which they are entitled,” according to ICE’s , revised last year.

But the agency’s failure to adhere to its own standards is leaving immigrant detainees at risk of medical emergencies and death, complications from untreated chronic illnesses, and infection with communicable diseases, according to , , and .

DHS has criticized some of the investigations as false, including a report by Sen. Jon Ossoff (D-Ga.) on pregnant women and children in detention.

“ICE detention facilities have higher standards than most U.S. prisons that detain American citizens. All detainees are provided with comprehensive medical care, proper meals,” DHS spokesperson Tricia McLaughlin said in an . On Feb. 17, McLaughlin announced she would be from her DHS post.

Weakened Oversight, Less Infrastructure

Access to adequate health services has been imperiled because of the surge in detainees, a lack of oversight by the Trump administration, and a delay in processing medical claims that’s jeopardized care, say advocates, lawyers, and some doctors.

“The challenges have been exacerbated because the pace of removals hasn’t kept up with the pace of detentions. It adds to the problem,” said , an associate director at KFF, a health information nonprofit that includes Ñî¹óåú´«Ã½Ò•îl Health News. “There are more public health issues when facilities are crowded.”

The number of immigrants in detention swelled from about 40,000 in November 2023 under former President Joe Biden to a in mid-January, according to the American Immigration Council, an advocacy group that focuses on litigation and research.

At the same time, the Trump administration has weakened oversight of the conditions and health services at detention centers. It cut staff at the DHS Immigration Detention Ombudsman office, effectively , according to a KFF analysis and the Economic Policy Institute, a nonprofit that focuses on economic research.

The has been to “independently examine immigration detention to promote safe, humane conditions,” according to the agency. DHS is currently the target of a partial government shutdown because of Democrats’ opposition to a for the agency. As advanced by Republicans, that measure would zero out the ombudsman’s funding.

There are also lengthy delays to process detainee health payment claims from third-party doctors and hospitals — a holdup that advocates and the federal government have said jeopardizes care.

The Department of Veterans Affairs’ Financial Services Center long had a contract with ICE to process claims for care outside detention centers, such as oncology treatments or dialysis.

Congressional Republicans and claimed it diverted resources from veterans.

Veterans Affairs in October detainees’ claims. Documents ICE posted on a federal contracting website said the termination “created an emergency” by compromising the ability to reimburse providers and left the agency with no mechanism to provide services such as tuberculosis screening, nonemergency medical transportation, and medical equipment purchases.

“It is an absolute emergency for ICE to immediately procure claims processing support because lack of this support will delay critical medical care … such as dialysis, prenatal care, oncology, chemotherapy, etc.,” according to posted in late 2025 at , a federal system for contract data.

A new claims processor, , has been retained, but ICE has said on its website that no claims will be processed until April 30. Advocates say it’s unclear whether detainees are getting access to off-site care as needed and say the claims delays are also discouraging medical providers from providing services to the immigrants.

“DHS has signed a new contract to process these claims and is currently onboarding the vendor,” said Veterans Affairs spokesperson Pete Kasperowicz. “Meanwhile, VA is supporting this transition until May to ensure claims are processed appropriately.”

Deaths in Custody

that at least eight detainees have died in custody so far in 2026, with 33 detainee deaths in 2025 and 11 in 2024. Those figures are contested, however, by some advocates and lawmakers who say the totals exclude detainees who died while being apprehended or in the care of U.S. Customs and Border Protection.

House Democrats on the Homeland Security Committee say 53 people have died in ICE or CBP custody since Trump took office. They are from DHS, including autopsy reports for each death, staffing requirements for medical professionals, and video footage of one detainee who died in Texas.

“We are outraged” at the deaths, according to a Jan. 22 letter from the 13 lawmakers. “It is obvious yet tragic that ICE is unwilling or unable to provide basic care for detainees.”

The Democrats pointed to the death of , 55, who was born in Cuba. He died Jan. 3 at a detention center in Fort Bliss, Texas, after ICE said he experienced medical distress. He had been taken into custody almost six months earlier.

“At no time during detention is a detained alien denied emergency care,” ICE said in a Jan. 9 statement on the death.

The El Paso County Medical Examiner’s Office that occurred after Campos was restrained by law enforcement.

Meanwhile, other immigrants are still waiting for care. Reyes, who needed a biopsy for possible prostate cancer, eventually had the screening test, but as of early February had not received results. “He is in constant agonizing pain,” according to the lawsuit filed in the Northern District of California.

On Feb. 10, a federal judge ordered ICE and DHS to provide to detainees and to conduct external monitoring, including on-site inspections of the detention center.

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Covid, for instance, is now linked in studies to in children of mothers who were infected during pregnancy, as well as a decline in mental cognition and greater risk of heart problems. It’s even been shown to trigger the awakening of dormant cancer cells in people who are in remission.  

Policies around covid and vaccination have economic ramifications. The annual average burden of the disease’s long-term health effects is estimated at $9,000 per patient in the U.S., according to a in November in the journal NPJ Primary Care Respiratory Medicine. In this country, the annual lost earnings are estimated to be about $170 billion. 

The virus that causes covid, SARS-CoV-2, leaves damage that can linger for months and sometimes years. In the brain, the virus leads to an immune response that triggers inflammation, can damage brain cells, and can even shrink brain volume, according to published in March 2022 in the journal Nature.  

, a clinical epidemiologist who has studied longer-term health effects from covid, estimated the virus may have increased the number of adults in the U.S. with an IQ less than 70 from 4.7 million to 7.5 million — dealing with “a level of cognitive impairment that requires significant societal support,” he wrote. 

Meanwhile, data from more than a suggests covid vaccines can help reduce risk of severe infection as well as longer-lasting health effects, although researchers say more study is needed. But last May, Health and Human Services Secretary Robert F. Kennedy Jr. said on X that the Centers for Disease Control and Prevention would for , citing a . The FDA has since issued new guidelines limiting the vaccines to people 65 and older and individuals 6 months or older with at least one risk factor, though many states continue to make them more widely available. 

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Federal officials in May 2023 declared an end to the . But more than two years later, a growing body of research continues to reveal information about the virus and its ability to cause harm long after initial infections resolve, even in some cases when symptoms were mild.

The discoveries raise fresh concerns about the Trump administration’s covid policies, researchers say. While some studies show covid vaccines offer protective benefits against longer-term health effects, the Department of Health and Human Services has drastically limited recommendations about who should get the shot. The administration also aimed at developing more protective covid vaccines.

The federal government is curtailing such efforts just as researchers call for more funding and, in some cases, long-term monitoring of people previously infected.

“People forget, but the legacy of covid is going to be long, and we are going to be learning about the chronic effects of the virus for some time to come,” said , an epidemiologist who directs the University of Minnesota’s Center for Infectious Disease Research and Policy.

The Trump administration said that the covid vaccine remains available and that individuals are encouraged to talk with their health providers about what is best for them. The covid vaccine and others on the schedule of the Centers for Disease Control and Prevention remain covered by insurance so that individuals don’t need to pay out-of-pocket, officials said.

“Updating CDC guidance and expanding shared clinical decision-making restores informed consent, centers parents and clinicians, and discourages ‘one size fits all’ policies,” said HHS spokesperson Emily Hilliard.

Although covid has become less deadly, because of population immunization and mutations making the virus less severe, researchers say the politicization around the infection is obscuring what science is increasingly confirming: covid’s potential to cause unexpected, possibly chronic health issues. That in turn, these scientists say, drives the need for more, rather than less, research, because over the long term, covid could have significant economic and societal implications, such as higher health care costs and more demands on social programs and caregivers.

The annual average burden of the disease’s long-term health effects is estimated at $1 trillion globally and $9,000 per patient in the U.S., according to a in November in the journal NPJ Primary Care Respiratory Medicine. In this country, the annual lost earnings are estimated to be about $170 billion.

One study estimates that the flu resulted in $16 billion in direct health costs and $13 billion in productivity losses in the 2023-2024 season, according to , an online platform that publishes work not yet certified by peer review.

Covid’s Growing Reach

Much has been learned about covid since the virus emerged in 2019, unleashing a pandemic that the World Health Organization reports has killed more than . By the spring of 2020, the term “long covid” had been coined to describe chronic health problems that can persist post-infection.

More recent studies show that infection by the virus that causes covid, SARS-CoV-2, can result in heightened health risks months to more than a year later.

For example, researchers following children born to mothers who contracted the virus while pregnant have discovered they may have an , delayed speech and motor development, or other neurodevelopmental challenges.

found babies exposed to covid in utero experienced accelerated weight gain in their first year, a possible harbinger of metabolic issues that could later carry an increased risk for cardiovascular disease.

These studies suggest avoiding severe covid in pregnancy may reduce risk not just during pregnancy but for future generations. That may be another good reason to get vaccinated when pregnant.

“There are other body symptoms apart from the developing fetal brain that also may be impacted,” said Andrea Edlow, an associate professor of obstetrics, gynecology, and reproductive biology at Harvard Medical School who was involved in both studies. “We definitely need more research.”

Epidemiologists point to some specific, emerging challenges.

A in the New England Journal of Medicine found people who from mild covid infections experienced a cognitive deficit equal to a three-point drop in IQ. Among the more than 100,000 participants, deficits were greater in people who had persistent symptoms and reached the equivalent of a nine-point IQ drop for individuals admitted to intensive care.

, a clinical epidemiologist who has studied longer-term health effects from covid, did the math. He estimated covid may have increased the number of adults in the U.S. with an IQ of less than 70 from 4.7 million to 7.5 million — dealing with “a level of cognitive impairment that requires significant societal support,” he wrote.

“People get covid-19, some people do fine and bounce back, but there are people who start experiencing problems with memory, cognition, and fuzzy brain,” he said. “Even people with mild symptoms. They might not even be aware.”

Diane Yormark, 67, of Boca Raton, Florida, can relate. She got covid in 2022 and 2023. The second infection left her with brain fog and fatigue.

“I felt like if you had a little bit too much wine the night before and you’re out of it,” said Yormark, a retired copywriter, who said the worst of her symptoms lasted for about three months after the infection. “Some of the fog has lifted. But do I feel like myself? Not like I was.”

Data from more than a suggests covid vaccines can help reduce risk of severe infection as well as longer-lasting health effects, although researchers say more study is needed.

But vaccination rates remain low in the U.S., with only about 17% of the adult population reporting that they got the updated 2025-2026 shot as of Jan. 16, based on .

Trump administration officials led by Health and Human Services Secretary Robert F. Kennedy Jr. have reduced access to covid vaccines despite the lack of any new, substantiated evidence of harm. Though the shots were a hallmark achievement of the first Trump administration, which led the effort for their development, Kennedy has said without evidence that they are “.”

In May he said on X that the CDC would for , citing a . The Food and Drug Administration has since issued new guidelines limiting the vaccine to people 65 or older and individuals 6 months or older with at least one risk factor, though many states continue to make them more widely available.

The Trump administration also halted for mRNA-based vaccines. Administration officials and a number of Republicans question the safety of the Nobel Prize-winning technology — heralded for the potential to treat many diseases beyond covid — even though clinical trials with tens of thousands of volunteers were performed before the covid mRNA vaccines were made available to the public.

And numerous studies, including new research in 2025, show covid vaccine benefits include a , although the protective effects wane over time.

Following the Findings

Researchers say more and broader support is important because much remains unknown about covid and its impact on the body.

The growing awareness that, even in mild covid cases, the possibility exists for longer-term, often undetected also warrants more examination, researchers say. A in eBioMedicine found people with neurocognitive issues such as changes in smell or headaches after infection had significant levels of a protein linked to Alzheimer’s in their blood plasma. EBioMedicine is a peer-reviewed, open-access journal published by .

In the brain, the virus leads to an immune response that triggers inflammation, can damage brain cells, and can even shrink brain volume, according to that was published in March 2022 in the journal Nature.

An of advanced brain images found significant alterations even among people who had already recovered from mild infections — a possible explanation for that may persist for years. Lead study author Kiran Thapaliya said the research suggests the virus “may leave a silent, lasting effect on brain health.”

Al-Alay agreed.

“We don’t know what will happen to people 10 years down the road,” he said. “Inflammation of the brain is not a good thing. It’s absolutely not a good thing.”

That inflammatory response has also been linked to blood clots, arrhythmias, and higher risk of cardiovascular issues, even following a mild infection.

A University of Southern California study published in October 2024 in the journal Arteriosclerosis, Thrombosis, and Vascular Biology found the risk for a remains elevated nearly three years after covid infection. The findings held even for people who were not hospitalized.

“We were surprised to see the effects that far out” regardless of individual heart disease history, said James R. Hilser, the study’s lead author and a postdoctoral fellow at the UCLA David Geffen School of Medicine.

Covid can also and trigger a relapse, according to research published in July in the journal Nature. Researchers found that the chance of dying from cancer among cancer survivors was higher among people who’d had covid, especially in the year after being infected. There was nearly a twofold increase in cancer mortality in those who tested positive compared with those who tested negative.

The potential of the covid virus to affect future generations is yielding new findings as well. Australian researchers looked at male mice and found that those who had been from covid experienced changes to their sperm that altered their offspring’s behavior, causing them to exhibit more anxiety.

Meanwhile, many people are now living — and struggling — with the virus’ after-effects.

Dee Farrand, 57, of Marana, Arizona, could once run five miles and was excelling at her job in sales. She recovered from a covid infection in May 2021.

Two months later, her heart began to beat irregularly. Farrand underwent a battery of tests at a hospital. Ultimately, the condition became so severe she had to go on supplemental oxygen for two years.

Her cognitive abilities declined so severely she couldn’t read, because she’d forget the first sentence after reading the second. She also had to leave herself reminders that she is allergic to shrimp or that she likes avocados. She said she lost her job and returned to her previous occupation as a social worker.

“I was the person who is like the Energizer bunny and all of a sudden I’d get so tired getting dressed that I had to go back to bed,” Farrand said.

While she is better, covid has left a mark. She said she’s not yet able to run the five miles she used to do without any problems.

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At the same time, congressional Republicans are eyeing health issues from the “Make America Healthy Again” perspective, hoping it will provide a boost in the midterm elections. 

Here’s why. 

Republicans see the MAHA constituency as critical in the midterms and beyond because its supporters include desirable voting demographics: independents and some Democrats, many of whom are women, younger voters, or suburbanites. 

The strategy risks backfiring, though, because polls show  about reducing health care costs than about MAHA’s war on junk food or efforts to roll back access to vaccines. The affordability issue was thrust center stage last year when enhanced subsidies for Affordable Care Act marketplace plans expired. 

As a result, many of the roughly 23 million people who buy coverage on the health law’s marketplaces are now facing premium payments more than double what they faced last year.  with what has emerged as a key kitchen table issue. 

Democrats are strategizing about how to use public support for MAHA priorities to their own advantage. They’re hoping to expose GOP policies that run counter to MAHA priorities; trumpet Democrats’ efforts to tackle health care costs; and highlight their own party’s work on such MAHA goals as , according to some Democratic strategists. 

Democrats are talking about their continuing fight to address health care costs while largely avoiding direct attacks on Health and Human Services Secretary Robert F. Kennedy Jr. or MAHA, because the movement resonates with the public. Meanwhile, cracks are  the Make America Great Again coalition and the lockstep support Trump has enjoyed from Capitol Hill Republicans. 

For Republicans, the next batch of MAHA events and summits is already scheduled. After taking a political back seat in recent years, health care may dominate the 2026 election races.

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The daylong, invitation-only event in November featured a who’s who of MAHA luminaries. Vice President JD Vance attended, as did Health and Human Services Secretary Robert F. Kennedy Jr., the leader of the ad hoc movement whose members rail against vaccines, Big Pharma, and ultraprocessed food.

During a that organizers broadcasted online, Vance extolled MAHA’s impact on the Trump administration, calling it “a critical part of our success in Washington.”

The summit underscored just how closely Republicans have hitched themselves to the MAHA campaign, banking on its popularity to give them an electoral bounce in the midterms. But the strategy carries risks, because is cratering and polls show about reducing health care costs than MAHA priorities such as ending vaccine mandates and promoting raw milk.

“Polls show clearly MAHA issues are not the top issues for people,” said , a professor emeritus of health policy and political analysis at Harvard University. “The top health care voting issue is cost, and costs are actually rising.”

The disconnect was on display Nov. 12, the day of the , where attendees picked up swag bags and mingled amid the hotel’s blue-velvet couches and crystal chandeliers.

A few blocks away at the White House, President Donald Trump that day to reopen the federal government. The centered on disagreement over expiring Affordable Care Act subsidies, which Democrats wanted to extend and GOP congressional leadership declined to take up. The government went back to business and, in the midst of a political and legislative , those subsidies expired at the end of 2025. That has fueled the national affordability debate, as many of the roughly 24 million people who buy coverage on the health law’s marketplaces are now facing premium payments more than double what they faced last year. In January, with what has emerged as a key kitchen table issue.

Said Blendon: “MAHA is not lowering the cost.”

MAHA was mainstreamed as part of the political platform embraced by Kennedy, an environmental lawyer and anti-vaccine activist who ran for president in 2023 and 2024. When he suspended his campaign and endorsed Trump, Kennedy united MAHA with conservatives, marrying the “health freedom” movement with MAGA.

But the movement took root before then, during the covid pandemic, grounded in the idea that the U.S. is in the throes of a chronic disease epidemic caused by corruption in the food, medical, and pharmaceutical industries, as well as federal agencies. Some adherents also are skeptical of or opposed to vaccines.

“Covid was really eye-opening for people,” said Andrea Nazarenko, a psychologist and MAHA supporter who co-authored a . “They realized, ‘Wait a minute — the systems I trusted may not be as trustworthy as I thought.’ At its core, people are noticing the systems they relied on are failing them.”

MAHA has since emerged as an influential force for the GOP, gaining significant clout in a short time. Case in point: Early this month, Kennedy announced and updated , which were both part of the movement’s wish list and departures from existing frameworks.

In addition, members of Congress have founded a MAHA caucus. Lawmakers in Republican-led states are introducing or passing legislation to advance the MAHA agenda, including laws to restrict mRNA vaccines or in food. And food manufacturers including Nestle, General Mills, and Kraft Heinz have pledged to remove artificial dyes or additives.

Republicans see the MAHA constituency as critical in the 2026 midterm elections and beyond. Its supporters include desirable voting demographics — independents and some Democrats, many of whom are women, younger voters, or suburbanites. About 21% of independent voters and 8% of Democratic voters held a favorable or somewhat favorable view of MAHA as of early fall, according to by Change Research.

“I think one reason I won reelection was that I advocated for the covid-vaccine-injured and was an ally of Bobby Kennedy back then when he was being vilified,” Sen. Ron Johnson (R-Wis.) said. “People appreciated that. It’s about basic health.”

Republicans are counting on a MAHA bounce, and political analysts say they may need it. The party took a drubbing in November’s statewide races, and from 47% in early 2025 to 36% by December, according to Gallup polls. Those are ominous trends for the GOP, since the party with the presidency has lost ground in midterm House elections.

Meanwhile, cracks are starting to threaten the Make America Great Again coalition and the lockstep support Trump has enjoyed from Capitol Hill Republicans. While MAGA shows signs of weakening, MAHA is flourishing.

“Kennedy has ratified the Republican agenda around health and food,” said David Mansdoerfer, who served in HHS leadership during the first Trump administration. “We sound very much like the issues Democrats were into in the 1990s and 2000s. We’ve almost done a 180 and co-opted a topic under a Republican agenda.”

Kennedy is expected to soon check another item off MAHA’s list by pressing states to remove fluoride from the water supply, according to a source who asked to remain anonymous because he isn’t authorized to speak to the media.

But Republicans’ embrace of MAHA in the run-up to the November midterm elections could also cost them, political strategists say.

Polling shows popular support for MAHA initiatives such as ridding food of synthetic dyes, but voters are far less enthusiastic about Kennedy and his denouncements of vaccines and efforts to limit access to them. Almost 60% of adults disapprove of his work as head of HHS, according to by KFF, a health information nonprofit that includes Ñî¹óåú´«Ã½Ò•îl Health News.

And only 26% of registered voters support defunding mRNA vaccine research, according to a by left-leaning pollster Navigator Research. In the same poll, 3 in 4 reported feeling positively toward the measles vaccine.

Still, the Trump administration has its attack on vaccines. The Food and Drug Administration’s top vaccine official in November that the agency would overhaul vaccine regulation, asserting without evidence that at least 10 children had died from covid shots.

In December, a federal vaccine advisory panel handpicked by Kennedy voted to stop recommending routine vaccination of newborns against hepatitis B. Medical groups denounced the panel’s actions, saying the vaccine is safe and that the recommendation would lead to more infections with the virus, which causes serious liver damage.

Democrats see an opening. The Democratic Doctors Caucus, a group of medical doctors in Congress, condemning the federal advisory panel’s changed recommendation on the hepatitis B vaccine, calling it an attack on basic science. And Democratic Reps. Frank Pallone of New Jersey, Diana DeGette of Colorado, and Yvette Clarke of New York demanding data from the agency on the covid death claims.

Highlighting the risks of the Trump administration’s anti-vaccine initiatives is only part of Democrats’ game plan to counter Republicans’ alliance with MAHA.

Strategists describe three aims: Expose GOP policies that run counter to MAHA priorities; trumpet Democrats’ efforts to tackle health care costs; and highlight their own party’s work on such MAHA goals as cracking down on pesticide-makers.

“If people want to be healthier, they need affordable health care, and Democrats are the only ones pushing for affordable health care,” said , communications director for the House Majority PAC, a fundraising group that works to elect more Democrats.

Most notably, the strategy so far hasn’t really involved attacks on Kennedy or MAHA itself.

“If Democrats focus on attacking Kennedy, saying he’s crazy and he has a brain worm, some voters hear that as reinforcing the notion that Democrats are wedded to Big Pharma and Big Ag,” said , a senior adviser at the Center for Economic and Policy Research, a progressive nonprofit focused on economic policy.

So Democrats will talk about their continuing fight to address health care costs, such as with a possible retroactive fix to the now-expired ACA subsidies, or by Sen. Cory Booker (D-N.J.) to prevent pesticide manufacturers from getting legal immunity against health claims. And they plan to discuss Trump administration actions that seemingly run counter to the MAHA agenda, such as a decision by the Environmental Protection Agency to relax the of the carcinogen formaldehyde.

“Everything they’re doing actually makes people sicker with higher bills, dirtier air, and fewer people covered with insurance,” said , a Democratic strategist. “Democrats do need to take MAHA seriously and can’t brush it off. The core is to show Democrats are focused on health and health care and exposing what the Republican agenda means.”

For Republicans, the next batch of MAHA events and summits is already scheduled. After taking a political back seat in recent years, health care may dominate the 2026 election races.

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“Our country wants us to be birthing machines, but they’re cutting what resources there already are,” said Olcott, 20. “And a $1,000 baby bonus? It’s low-key like, what, bro? That wouldn’t even cover my month’s rent.”

The Trump administration wants Americans to have more babies, and the federal government is debuting policy initiatives to reverse the falling U.S. fertility rate. In mid-October, the White House unveiled a plan to to in vitro fertilization treatment. President Donald Trump has , calling himself “the .”

But reproductive rights groups and other advocacy organizations say these efforts to buttress the birth rate don’t make up for broader administration priorities aimed at cutting federal programs such as Medicaid, its related Children’s Health Insurance Program, and other initiatives that support women and children. The pro-family focus, they say, isn’t just about boosting procreation. Instead, they say, it’s being weaponized to push a conservative agenda that threatens women’s health, reproductive rights, and labor force participation.

Some predict these efforts could deter parenthood and lead to increases in maternal mortality.

“The religious right wants more white Christian babies and is trying to curtail women’s reproductive freedom in order to achieve that aim,” said , a spokesperson for Population Connection, a nonprofit that promotes population stabilization through increased access to birth control and abortion. “The real danger is the constant whittling down of reproductive rights.”

The White House did not respond to repeated interview requests.

A slate of federal programs that have long helped women and children are also being targeted by Trump and Cabinet members who say they champion pronatalist policies.

Medicaid work requirements, for instance, put in place by the Republicans’ One Big Beautiful Bill Act, a budget law enacted in July, will lead to extra paperwork and other requirements that, according to the , will cause to lose coverage. Medicaid covers more than in the U.S.

The measure also cuts federal funding for a national program that provides monthly food benefits. Almost in fiscal 2023 were children.

GOP spending cuts and staffing freezes have , a federal education program that provides day care and preschool for young, low-income children, even as U.S. adults implore the government to .

And the GOP halted Medicaid funding to Planned Parenthood of America for one year because it provides abortion services, forcing around the country to close since the beginning of 2025. Planned Parenthood provides a wide range of women’s health services, from wellness exams to breast cancer screenings and .

Groups that advocate for women’s health and reproductive rights say the actions by the administration and congressional Republicans to attack these programs are making it harder for families to get the support and medical care they need.

“There is a lot of rhetoric about who is worthy of public assistance, and to many policymakers, it’s not the single mother,” said , a public health law and policy analyst at the Milken Institute School of Public Health at George Washington University.

The pronatalist perspective generally supports government intervention to encourage procreation and is rooted in a belief that modern culture has failed to celebrate the nuclear family. The movement’s supporters also say policies to encourage childbearing are an economic necessity.

A Declining Birth Rate

The has largely been on a downward trajectory since 2007, with the number of births declining by an average 2% per year from 2015 through 2020, according to the , although the rate has fluctuated since.

The concepts that shape the movement can be found in Project 2025, a political initiative led by the conservative Heritage Foundation that has seen many of its proposals adopted by Trump. The document asserts that in a “heterosexual, intact marriage.”

“Married men and women are the ideal, natural family structure because all children have a right to be raised by the men and women who conceived them,” it says.

Project 2025 also includes many proposals that critics say aren’t friendly toward women’s health. For instance, it calls for eliminating access to mifepristone, a drug commonly used in abortions as well as in the management of miscarriages, and encourages states to block Planned Parenthood facilities from receiving Medicaid funding.

The “more babies” mantra is being embraced at the highest levels of the federal government.

“I can’t remember any other administration being so tied to the pronatalist movement,” said Brian Dixon, Population Connection’s senior vice president for government and political affairs.

Just days after he was sworn in, Vice President JD Vance declared, “I want in the United States of America.” He has also criticized of women and men who opt not to start families.

The White House in October did announce a discount on certain drugs used in through , a yet-to-debut government website that aims to connect consumers with lower-priced drugs. Mehmet Oz, who heads Medicare and Medicaid, heralded a possible future of “,” resulting from the lower-priced infertility drugs.

The administration also announced it would encourage employers to move to a new model for as a stand-alone option in which employees can enroll. But that is far from Trump’s earlier pledge to make infertility treatments free and may not be enough to overcome other long-term financial worries that often guide decisions about whether to have children.

Angel Albring, a mother of six, says her dream of having a big family always hinged on her ability to work and avoid child care costs. Her career as a freelance writer enabled her to do so while still contributing to the family’s income, working during nap times and at night, while the rest of her household slept.

“The whole thing of ‘sleep when the baby sleeps’ never applied to me,” Albring said.

Some of her friends, though, aren’t so fortunate. They fear they cannot afford children because of climbing costs for day care, groceries, and housing, she said.

Delivering on ‘Baby Bonuses’?

The Trump administration, meanwhile, has advanced another policy aimed at giving children a future financial boost.

The One Big Beautiful Bill Act establishes a tax-advantaged “” seeded with $1,000 in federal funds — often called a “baby bonus” — on behalf of every eligible American child. The initial deposits are scheduled to start in 2026 with the federal government automatically opening an account for children born after Dec. 31, 2024, and before Jan. 1, 2029.

Parents could contribute up to $5,000 a year initially to the account, with employers able to annually of that amount. The accounts reportedly would be vehicles for long-term savings. Details are still being ironed out, but funds could not be withdrawn before the child turns 18. After that, the accounts would likely become traditional IRAs.

On Tuesday, billionaires Michael and Susan Dell of Dell computer fame said they would give $250 to 25 million children age 10 and under in the U.S. The donations will be aimed at encouraging participation in the Trump accounts.

Pronatalism extends to other parts of the federal government, too.

Transportation Secretary Sean Duffy, who has , instructed his department to prioritize federal funds for communities with , though it has not yet announced any projects directly related to the initiative. For a time, the administration considered bestowing on mothers with six or more children.

Except there’s one hitch: Data suggests the policies and programs the Trump administration has proposed won’t necessarily work.

Other countries have offered more robust programs to encourage childbearing and ease parenting but haven’t seen their birth rates go up, noted Michael Geruso, an economist for the University of Texas-Austin who hopes to see the global population increase. Israel, for example, has offered free IVF treatment for roughly three decades, yet its birth rates have stayed statistically stagnant, at just under three children for every woman, he said.

France and Sweden have extensive social safety-net programs to support families, including paid time off and paid paternity and maternity leave, and subsidized child care and health care, but their fertility rates are also falling, said Peggy O’Donnell Heffington, a University of Chicago assistant senior instructional professor in the history department who wrote a book on non-motherhood.

“Nobody yet knows how to avoid depopulation,” Geruso said.

Some point to a different solution to reverse the United States’ declining population: to ensure a younger labor force and stronger tax base. The Trump administration, however, is doing the opposite — revoking visas and creating an environment in which immigrants who are in the U.S. legally feel increasingly uncomfortable because of heavy-handed policies, analysts say.

The country’s this year fell for the since the 1960s, according to a Pew Research Center analysis.

Meanwhile, to critics of the administration, the focus on encouraging childbirth allows the Trump administration and Republicans to sound as if they support families.

“You’re not seeing policies that support families with children,” said , vice president of income security and child care at the National Women’s Law Center, a nonprofit focused on gender rights. “It’s a white, heterosexual, fundamentalist Christian, two-parent marriage that’s being held up.”

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Fast-forward to the congressional stalemate that has closed the federal government for more than a month. Democrats, entrenched on one side of the legislative battle, staked their political future on merely preserving parts of the Affordable Care Act — a far cry from the systemic health policy changes that party members once described as crucial for tackling the high price of care.

Democrats succeeded in focusing national attention on rising health insurance costs, vowing to hold up funding for the federal government until a deal could be made to extend the more generous tax subsidies that have cut premiums for Obamacare plans. Their doggedness could help them win votes in midterm elections next year.

But health care prices are rocketing, costly high-deductible plans are proliferating, and 4 in 10 adults have some form of health care debt. As health costs reach a crisis point, a yawning gulf exists between voters’ desire for more aggressive action and the political urgency in Washington for sweeping change.

“There isn’t a lot of eagerness among politicians,” said , an economist who played a key role in drafting the ACA. “Why aren’t they being more bold? Probably scars from the ACA fights. But health care is a winning issue. The truth is we need universal coverage and price regulation.”

Voters rank lowering health care costs as a top priority, above housing, jobs, immigration, and crime, according to a by Hart Research Associates for Families USA, a consumer health advocacy group.

And costs are climbing. Premiums for job-based health insurance rose 6% in 2025 to an average of $26,993 a year for family coverage, according to an annual survey of employers released Oct. 22 by KFF, a health information nonprofit that includes Ñî¹óåú´«Ã½Ò•îl Health News. For all the attention given to grocery, gas, and energy prices, health premiums and deductibles in recent years have risen and wages.

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Kennedy is expected to create a task force to recommend possible federal action, according to a former agency official, an internal agency memo obtained by Ñî¹óåú´«Ã½Ò•îl Health News, and a consultant who says he helped with the memo. 

“HHS does not comment on future or potential policy decisions and task forces,” agency spokesperson Emily Hilliard said by email. 

The plans show how rumors and conspiracy theories can gain an air of legitimacy under the Trump administration, where researchers say that unscientific ideas have unusual power to take hold and shape public health policy. 

The concept posits that airplane vapor trails are that harm public health. Another version alleges planes or devices are , private companies, or researchers to trigger big weather changes, such as hurricanes, or to alter the Earth’s climate, emitting hazardous chemicals in the process. 

HHS is expected to appoint a special government employee to investigate climate and weather control, according to of the department’s Make America Healthy Again agenda. He said he drafted the internal agency memo. HHS has interviewed applicants to lead a “chemtrails” task force, said Jim Lee, a blogger focused on weather and climate who Delany said helped edit the memo, which Lee confirmed. 

Delany, who was from HHS, said Kennedy has expressed strong interest in chemtrails. The memo alleges that “aerosolized heavy metals such as Aluminum, Barium, and Strontium, as well as other materials such as sulfuric acid precursors, are sprayed into the atmosphere under the auspices of combatting global warming,” through a process of stratospheric aerosol injection. 

“That is a pretty shocking memo,” said Daniel Swain, a climate scientist at the University of California. “It doesn’t get more tinfoil hat. They really believe toxins are being sprayed.” 

Deploying chemtrails to poison people is just one of many baseless conspiracy theories that have found traction among Trump administration health policy officials led by Kennedy, a longtime anti-vaccine activist before entering politics who embraces a range of such ideas. 

In April, Kennedy was asked on “Dr. Phil Primetime” about chemicals being sprayed into the stratosphere to change the Earth’s climate. “It’s done, we think, by DARPA,” referring to a Department of Defense agency that develops emerging technology for the military’s use. “And a lot of it now is coming out of the jet fuel. Those materials are put in jet fuel. I’m going to do everything in my power to stop it. We’re bringing on somebody who’s going to think only about that.” 

DARPA officials didn’t return a message seeking comment.

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