How long will MAHA hold together? All spring, Robert F. Kennedy Jr., the secretary of health and human services, kept a relatively low profile — the outspoken tribune of an insurrectionary movement staying quiet at the reported urging of his boss. The agency rank and file rarely saw him. In recent weeks, he has made more public appearances, surrounded by rumors from longtime allies that he may leave the Trump administration — rumors his office denies. But however long Kennedy lasts in government, his Make America Healthy Again coalition already lies in shambles, its catalog of achievements short. What happened?
At present, there is no confirmed head of the Centers for Disease Control and Prevention or of the Food and Drug Administration. There is no surgeon general and no head of the National Institute for Allergy and Infectious Disease, effectively the government’s lead scientific position for Anthony Fauci’s nearly four decades in the role. There is also no confirmed boss at the F.D.A.’s Center for Biologics Evaluation and Research, which regulates vaccines, and none at its Center for Drugs Evaluation and Research, which oversees drug therapies. Last year, staffing at the Department of Health and Human Services was reduced by 25 percent, leaving huge deficits of personnel and expertise. The agency looks less like an army of acolytes than a barren bureaucracy. This is not an overhaul; it is an evacuation, a disemboweling.
If you knew one thing about Kennedy upon his confirmation, it was probably his vaccine skepticism. But even his experts haven’t significantly altered America’s vaccine policies, making changes only to federal recommendations that parents could easily skirt and states quickly overrode. MAHA has been steamrolled on food and pollution by business-aligned Trump appointees elsewhere in the government, forced to concede longtime crusades against glyphosate, mercury and other airborne toxins. It endured another setback from the Supreme Court, in a case described as MAHA v. Trump, in which the administration backed the company manufacturing Roundup, not the plaintiffs arguing that it gave them cancer. The administration just signed off on more forever chemicals in pesticides and drinking water. A much-hyped report trying to link autism with the use of Tylenol in pregnancy was quickly disproved by larger studies, and a memo linking 10 childhood deaths to Covid vaccination was contradicted by the agency’s own review of the evidence. The biggest effect of the new regime on research hasn’t been a major turn toward MAHA priorities but major cuts to science funding overall.
You could see this all coming. Kennedy’s team of contrarians arrived in Washington already divided on some big questions: Were drugs overregulated or underregulated? Were vaccines rushed to market or too slow to get there? Did “gold-standard science” require randomized controlled trials or just compelling anecdotal evidence — of, say, a diet that supposedly alleviated someone’s A.D.H.D. symptoms or a regimen of cod liver that supposedly protected against measles? Should we embrace medical miracles like GLP-1s or treat obesity as a morality tale in which fat people deserved to suffer more and die earlier? Do chronic disease, disability rates and skyrocketing mental illness reveal a medical system designed not to cure people but to treat them for profit? Or were they projections of safetyist hysteria, the way liberals made meaning out of anxiety while dreaming of a world without risk?
These contradictions didn’t stop MAHA from sweeping into power last year, looking like a rising tide of skepticism and distrust. In reality, the movement was even then a thin and contradictory coalition held together primarily by Covid resentments, which would inevitably fade with time.
Start with Kennedy himself. Today he is no more popular than President Trump and does not seem to represent an independent bloc; his support, like the president’s, comes from MAGA loyalists. Among independents, Kennedy is 37 points underwater. This is not even a real reversal of fortune: When Kennedy abandoned his presidential campaign and joined Trump’s in the summer of 2024, it was not from a position of culture-shaping strength. He was polling below 10 percent.
On questions of food and environmental contamination, Kennedy’s coalition can credibly claim to speak for an American public increasingly suspicious about what we’re all putting into our bodies. But this has not been his focus in power. Instead, his team has mostly deferred on food policy while waging a destructive campaign against the health and scientific establishment — most conspicuously over vaccines.
The problem is, 86 percent of self-identified MAHA parents say that routine vaccinations are important to their families and their communities, according to polling by the Kaiser Family Foundation. Among Americans as a whole, of course, the figure is even higher. Nationwide, vaccination rates for kindergartners are still running above 90 percent. This marks a small but epidemiologically meaningful drop since 2019, but it’s also the case that vaccination in South Carolina rebounded in response to the largest measles outbreak in decades there. However it may have felt at the time, the pandemic was not the vaccination Waterloo many feared. More than 95 percent of vulnerable seniors received the Covid shots in the same calendar year in which they became available.
From a certain vantage, the pandemic did seem catastrophic for institutional trust — as though missteps and miscalculations about policy and messaging in 2020 and 2021 had permanently alienated the public from scientific leadership. But today 77 percent of the country has either a “great deal” or a “fair amount” of trust in scientists to act in the best interests of the public, compared with only 22 percent who report “not too much” or “none at all.” Those numbers mark about a 10-point shift since the beginning of the pandemic, but they still compare favorably with American opinions about churches, the military and public schools. Surveys never capture the real texture of public opinion, but 77 percent is a pretty commanding supermajority, especially in a low-trust society. And MAHA has sapped trust more than the pandemic ever did. When Kennedy arrived at H.H.S., 77 percent of the country said it trusted the C.D.C. One year later, the figure was 50 percent.
So how did the story of mass Covid backlash become such conventional wisdom that MAHA looked like a necessary correction? Pandemics suck, and no policy response is ever likely to be perfect. Ours wasn’t, and mitigation policies felt more abrasive here than in other countries, where feelings of mutual obligation and solidarity come more naturally. Here, as elsewhere, the burden of containment was shouldered almost uniformly, even though old people were by far the most vulnerable and plenty of Americans felt entitled to special accommodation. Some resented what they saw as public-health overreach, others inconsistency from prominent officials, and still others incompetence or perhaps indifference in the face of mass illness and death.
But the grievances Americans carried with them out of the Covid emergency were not actually a political mandate pointing in any particular direction. It’s easy to say that Americans lost faith in their leadership in those years, but every single incumbent governor who ran won re-election in 2020, and all but one of 28 incumbents did in 2022. By 2024, pandemic politics had almost entirely disappeared from the campaign; when voters talked about the failures of the political establishment, they were talking not about vaccine mandates but about inflation. And today large majorities of Americans tell pollsters that, even with the benefit of hindsight, they support the broad outlines of the Covid response in 2020 — work-from-home, social distancing, mask-wearing, school closures. If presented with the chance for a do-over, Americans would want guidance to be a bit clearer and restrictions lifted sooner. But when asked by researchers at Harvard’s school of public health whether they would support any of the measures employed to fight Covid in 2020 if faced with a similar pathogen in the future, the result was a landslide: 81-19.
We haven’t seen such a pathogen yet in the MAHA era, but it already seems clear that the resentful health libertarianism that bound the movement together in podcast studios, social media groups and conferences stages has no novel answer for new disease threats, even lesser ones.
The last time Ebola suddenly exploded in West Africa, in 2014, President Barack Obama uncorked an “all of government” response: 10,000 doctors, nurses and other frontline responders dispatched; $5.4 billion in emergency funding; an Ebola czar with enough political capital that he would later become White House chief of staff commanding the first-ever deployment of American troops to combat infectious disease abroad. Almost 30,000 people fell ill, and almost 12,000 died, but initial modeling suggested as many as 1.4 million cases. That might have meant more than half a million deaths. The difference between those two outcomes owes something to U.S. intervention.
This time, when hundreds of people contracted Ebola in the Democratic Republic of Congo, the response was more muted, with the United States dispatching no doctors, providing much less equipment and committing a tiny fraction of the funding. Last year, Elon Musk said in the Oval Office that he had accidentally cut funding for Ebola; this year, Secretary of State Marco Rubio went so far as to mock the competence of the W.H.O., which was presiding over the outbreak — the organization crippled when the United States withdrew and cut almost a billion dollars in annual funding. The official case count has since climbed past a thousand; hundreds of people have died.
But at home, indifference isn’t an especially appealing approach to governance, particularly in times of fear. That’s why it was always likely that — whatever it had to say about the way we eat — MAHA’s approach to disease control would be neutered by its first contact with new threats.
Consider Jay Bhattacharya, head of the National Institutes of Health and acting director of the C.D.C. Over the course of the pandemic, Bhattacharya, then a health economist at Stanford University, made his name first by playing down the risk of Covid — suggesting in the spring of 2020 that Covid might kill only 20,000 to 40,000 Americans, far from the 1.2 million who ultimately died — and then by railing against government overreach in response to its spread. As recently as last fall, Bhattacharya was arguing that the country should discard its pandemic playbook because the best way to prepare for infectious disease was to make America healthy again.
But when measles flared up on his watch, Bhattacharya promoted vaccination. When Ebola re-emerged in Central Africa, he implemented a travel ban like the one for Covid that he criticized in 2020. After the hantavirus outbreak on a cruise ship in May, he imposed a far stricter isolation policy on those exposed to the disease than anything entertained during Covid: He forced some citizens to remain against their will at a quarantine unit in Omaha, despite negative tests for the disease. When officials eventually allowed them to leave, it was under conditions of health surveillance that the country’s paranoid fringe fretted over in 2020. When an internal review concluded that less intrusive surveillance would be sufficient, Kennedy himself intervened to overrule it. All this may well be defensible, even advisable as policy. But it is not the health libertarianism that MAHA pledged to deliver.
Fifty years ago, during debates over the war on poverty, Irving Kristol famously quipped that a neoconservative was what you call a liberal who had been mugged by reality. What do we call a MAHA advocate who has gotten sick — or been tasked with containing the spread of a new disease?
Source images for illustration above: Jay Janner/The Austin American-Statesman, via Getty Images; Aaron Schwartz/CNP/Bloomberg, via Getty Images
