As President-elect Donald Trump prepares to assume office for a second term, health policy observers are closely watching for changes across key federal health agencies. Trump, who oversaw the COVID-19 response in his first term, has voiced intentions to reshape the American healthcare landscape. He has pledged to “make America healthy again” and granted leeway to prominent vaccine skeptic Robert F. Kennedy Jr. to address issues surrounding food and medicine, signaling a shift that could impact the U.S. Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), and the National Institutes of Health (NIH).
Trump’s rhetoric has targeted major health institutions, including the CDC, FDA, and NIH, which he has criticized for perceived inefficiencies and alleged corruption. His second term will likely see leadership changes across these agencies, affecting federal policies in health research, drug approvals, food safety, and disease prevention.
Key Positions in Focus
- Secretary of Health and Human Services (HHS): Overseeing the FDA, CDC, and numerous social programs, HHS is a pivotal agency for health policy. The Secretary of HHS, appointed by the president and confirmed by the Senate, manages critical services including child wellness, vaccinations, maternal health, and mental health. With a Republican-majority Senate, Trump’s appointee is expected to face a smoother confirmation process. This role also holds influence over Medicare and Medicaid drug pricing, a responsibility that expanded under President Biden’s Inflation Reduction Act, which allows the Secretary to negotiate drug prices with pharmaceutical companies starting in 2026.
- Director of the National Institutes of Health (NIH): The NIH, a major player in public biomedical research, boasts a $47 billion budget funding research across 27 specialized institutes. Known for foundational discoveries, including advancements contributing to COVID-19 vaccines, NIH’s leadership plays a central role in shaping the future of public health research. While the position does not automatically change with new administrations, a second Trump term may bring new leadership aligned with his views on health funding and policy.
- Commissioner of the FDA: The FDA, responsible for regulating new drugs, vaccines, and food safety, operates under a commissioner appointed by the president and confirmed by the Senate. During the COVID-19 pandemic, the FDA was instrumental in evaluating mRNA vaccines and ensuring their safety. Given Trump’s past critiques of the agency’s handling of approvals, his new appointee may bring changes in drug and vaccine regulatory approaches.
- Director of the CDC: For the first time, the CDC director will require Senate confirmation following a 2022 law. Trump’s supporters have expressed dissatisfaction with the CDC’s pandemic response, especially on mask and vaccination mandates. Trump’s appointee could face pressure to narrow the agency’s focus on public health initiatives, potentially scaling back responsibilities in areas like workplace safety and environmental health.
- Administrator of the Centers for Medicare and Medicaid Services (CMS): The CMS administrator influences healthcare access for 140 million Americans by determining reimbursements for drugs and treatments under Medicare and Medicaid. With the Inflation Reduction Act tasking CMS with implementing negotiated drug price reductions, Trump’s appointee may impact the cost and accessibility of medications for Medicare beneficiaries. This administrator, appointed by the president and confirmed by the Senate, often shapes industry standards, as private insurers frequently adopt CMS guidelines.
With these influential roles soon to be appointed, Trump’s incoming administration has the potential to reshape policies impacting healthcare access, research, and drug pricing. His new term could bring considerable shifts in the federal approach to healthcare, from public health mandates to Medicaid and Medicare management, aligning with his promise of a health-focused agenda under conservative leadership.
