Will Trump Make America Healthy Again?

Reporter Helena Bottemiller Evich looks into her crystal ball

I first heard the phrase “Make America Healthy Again” (MAHA) in early September. Robert F. Kennedy Jr., environmental lawyer and infamous vaccine skeptic, had dropped his third-party bid for president and endorsed Donald Trump. Suddenly, he was at rallies and writing an op-ed, declaring that, with Trump’s blessing, he was going to get dangerous chemicals out of our food and processed ingredients out of school lunches. Never mind that most action Trump took in his first term suggested an antithetical agenda.

In the final weeks of the campaign, Trump said he was ready to let RFK Jr. “go wild on health.”  In the week since Trump’s victory, Kennedy has suggested his role will be as a kind of White House health czar (not, as many thought, as a cabinet secretary or head of an agency). And the question everyone is asking is: Is MAHA for real?

Helena, Washington’s star food policy journalist

For the inside scoop, I reached out to Helena Bottemiller Evich, the founder and editor-in-chief of Food Fix and without doubt the most esteemed reporter on this beat. (Subscribe! You won’t regret it.) The truth, Helena told me, is that for most things, it’s still too early to know. This includes whether Trump’s embrace of MAHA is anything more than electioneering.

“That's the big question for sure,” she told me. “But one thing that has stuck out to me is the fact that talking about getting toxins out of the food supply or letting RFK ‘go wild on health’ — those have been getting pretty strong reactions from the crowd at rallies. And if there's one thing that Trump is really gifted at, it's picking up on where there's energy.”

No doubt. But promising revolutionary change is much easier than delivering it — even if Republicans go on to win the House, as they have the Senate. There will be a tsunami of lobbying from industry and advocates in the anti-hunger and environmental lobbies. (Case in point: Here’s Kenneth Cook, president of the Environmental Working Group, calling MAHA a “scam.”) The extent to which the administration can withstand this pressure, Helena said, will reveal how serious it is about these issues.

I spoke to Helena on Friday, Nov. 8. Our conversation has been edited for length and clarity.

Jane: Make America Healthy Again — and Trump’s emphasis on food issues — came seemingly out of nowhere. There’s still a lot we don’t know. But as of today what is your gut feeling about whether we’re about to see a food policy revolution?

Helena: I keep using the word disorienting. It’s disorienting because for all the time I’ve been covering these issues, there's been a pretty traditional Republican-Democrat divide. Republicans tend to be more deregulatory and friendlier to industry. And Democrats are the flip side of that. Now, everyone's trying to figure out whether the ground has really shifted. Is this a real political realignment where RFK Jr. is essentially setting policy in the Trump administration?

There are real questions because the Make America Healthy Again agenda is in many ways at odds or completely opposite of the first Trump administration’s position on many issues: pesticides, nutrition, food chemicals. 

There's no question that RFK Jr. is at this moment wielding a lot of influence over the transition effort. But time will tell who the ultimate decision makers are here. Who is agriculture secretary? Who is FDA commissioner? Who is leading Health and Human Services? These matter a lot.

Jane: One of the strangest things about MAHA is how much it seems to overlap with what liberals have been saying for years. Is that your take? Or is MAHA only superficially the same?

Helena:  A lot of it is what liberals have been saying for years.

Food additives is one of the most interesting examples. California, this big liberal state, has banned controversial food additives across the entire California food supply, and some artificial food colorings in school food. On the face of it, those appear to be liberal, “California” policies. But those policies were broadly supported by Republicans and Democrats in the state legislature. And so it's hard to say how much of this is a Republican realignment and how much of it is that some of these things are just really popular.

Another example is the idea that you need to crack down on ultra-processed foods. That's generally considered a liberal policy, but it’s also core to MAHA. RFK Jr. has said he wants to get rid of all processed food in school meals immediately. That goes way further than Michelle Obama’s school-nutrition reform. The policies are scrambled.

Will Trump keep his deal with RFK, Jr.?

FOOD PRICES

Jane: I think we can all agree that high prices, especially at the grocery store, were one of the top factors in the election. Trump’s promised solution is tariffs, which is scary to think about when some 15 percent of our food is imported, including 50 to 60 percent of our fruits and vegetables — the things that people already think are expensive!

Helena: In general, the tools the government has to bring down food prices are pretty limited. And I think you saw that with the Biden administration. This was the big political issue, and if you could wave a magic wand and reduce food prices, I think most presidents would do that. So I don’t know what Trump will or can do to fix that.

On a related note, there’s been recent press attention on how Trump’s hardline immigration policies could affect food prices. People do not realize the extent to which the food system — and by that I mean meat processing plants, farms, restaurants — is largely propped up by undocumented labor. Not exclusively, but there is a significant portion of the workforce that is undocumented, and so there's a lot of economic consequences.

Note from Jane: To better understand how immigration policies could affect food price of meat, read this excellent NYT opinion piece and this Bloomberg analysis.

FOOD LABELING 

Jane: One of the few changes we were expecting from the Biden administration on food was a new regulation that would require labeling on the front of food packages that make it easier to decipher how nutritious a packaged food product is. This has been done in countries all over the world with some, but not sweeping, success. Is that still coming our way?

Helena: I think front-of-pack labeling is toast for now. The Biden administration hasn't even sent the proposed regulation to the Office of Management and Budget yet. Even if they got it out, it's likely dead on arrival.

Jane: The FDA also regulates chemicals in our food. That’s one of RFK Jr.’s big focuses.

Helena: True, but one thing we do know is that no one is betting that the FDA gets more resources. If you want to regulate food chemicals, all of a sudden you need a lot more staff to do it. I do not see a world in which Congress gives FDA substantially more money anytime soon. 

Another challenge on that front, and this is a bit wonky, is that the FDA is different than other agencies in that it doesn’t have a lot of political appointees. That could make it a little more difficult to radically change the direction of the agency. The big thing to watch is who the new FDA commissioner is and what he or she thinks about these issues.

FOOD ASSISTANCE

Jane: Fifteen years ago I wrote a story for the front page of The Washington Post about how liberals were trying to restrict people on food stamps from buying junk food and soda. The idea was to channel government dollars into fresh, nutrient-dense foods, to architect health through food-assistance dollars. Now, with RFK Jr. potentially leading the charge, this has become a big Republican and MAHA issue. I see this a bit like Nixon going to China — only a Republican could do it. Do you think this is going to happen?

Helena: I think this will be a fight because the farm bill, which includes SNAP policy, is potentially around the corner, and you now have the conservative populists who are part of the Trump base fired up about. The way they see it, restricting processed foods and soda is sticking it to the food industry. Because government dollars spent on that are a form of corporate welfare and a poor diet also fuels more government spending on health care.

This is another one where what was once a liberal policy idea is now a MAHA one. But the anti-hunger groups and the food industry are strongly against it. They argue that it's patronizing to ban these foods because SNAP household shopping habits are not really that different from the average American family’s. And so, yeah, I think that's one we're going to hear about.

SCHOOL LUNCH

Jane: What is likely to happen to the idea of universal school lunch, where all kids are fed for free regardless of their family income level? That was gaining quite a lot of momentum during the campaign, in part because it was something Tim Walz did in Minnesota.

Helena: I think that issue is dead for now. And so is all the momentum you saw for the USDA to tweak policies that helped to move schools toward universal. To go full universal nationwide, you need Congress. We're now going to be facing a Republican Senate, likely a Republican House, and a Republican administration. So all that momentum around universal school meals is going to be halted at the federal level. State legislatures can still move forward on those plans if they want — and they have the money to do it.

Jane: And what about RFK Jr.’s promise to get all processed food out of schools immediately? It’s fascinating because the Republicans attacked Michelle Obama just for trying to reduce sodium and add some whole grains to school lunches.

Helena: I think this is one to watch because if this is indeed a priority, as RFK Jr. has said it is, they're going to run into the issue very quickly of how much money it would cost to do that. Lots of schools don't have kitchens, don't have enough staff to scratch cook. The food costs would probably go up. It's also possible that they're going to be pushing on so many other things that this isn’t one of the top priorities.

AGRICULTURE

Jane: Many farmers supported Trump — not least because he gave them billions of dollars in payouts in his first term. Now RFK Jr. is talking about radically upending “big” agriculture, including slashing subsidies for commodity crops and restricting the use of chemical fertilizers.

Helena: I talked to Calley Means who is an influential adviser and the Kennedy-Trump alliance point. The overall tone on agriculture seems to have shifted a little bit. They're now saying farmers need to come to the table. All stakeholders are going to come to the table to talk about how to change ag policy. So it doesn't sound the same as what they're saying about the pharmaceutical industry, which is essentially: We're at war with Big Pharma.

I think they're trying to figure out how to thread the needle of wanting to reform ag policy without being in a big ol’ fight with so-called Big Ag and farmers. That is a much more complicated political equation. I foresee a struggle behind the scenes between these industry groups and the reformers.