Front Burner - Medicaid cuts and RFK Jr’s MAHA mission

Episode Date: July 7, 2025

The passing of Donald Trump’s Big Beautiful Bill last week came with over a trillion dollars of cuts to Medicaid, kicking an estimated 12 million Americans off health insurance coverage by 2034. And it was passed with the blessing of the Secretary of Health and Human Services, Robert F. Kennedy Jr.Widespread upheaval of the American healthcare system, including cuts to public health departments and medical research, is all part of RFK Jr.’s plan to further his Make America Healthy Again agenda. But how will MAHA, a movement that’s touted vaccine disinformation among other things, actually impact the health of Americans and the world? Nicholas Florko from The Atlantic joins us. For transcripts of Front Burner, please visit: https://www.cbc.ca/radio/frontburner/transcripts

There are over 613,000 Canadian small businesses on TikTok. Businesses that added $1.4 billion to Canada's GDP in 2024. Like Edison Motors in Golden, BC, whose electric hybrid vehicles are driving innovation in Canada's trucking industry. Or XXL Scrunchie in Belleville, Ontario, who turned extra-large scrunchies into extra large economic impact. Visit TikTokCanada.ca to learn more about how TikTok is helping small businesses in Canada make a big impact. This is a CBC podcast. Maha's become hot. On Friday, after weeks of pushback, the U.S. House of Representatives passed Donald Trump's big beautiful bill. The multi-trillion dollar legislation lays out big spending for the president's top

priorities, defense and border control millions of dollars of funding for ICE, and tax cuts for the wealthiest citizens. It also slashes a trillion dollars from Medicaid, the government's health insurer for mostly low-income people. Those cuts will kick nearly 12 million people off of health insurance by 2034, according to an estimate from the Congressional Budget Office. Despite this, it's a bill that Trump's secretary of the Department of Health and Human Services,

Robert F. Kennedy Jr., is wholeheartedly supporting. It's gonna help us do what we need to do with healthcare in this country, which is to improve the quality of our healthcare and lower the cost and give Americans more choice. Nicholas Florco is back on the show today. He's a staff writer with The Atlantic, and he's going to take us through the Maha, or Make America Healthy Again movement led by Kennedy.

We're going to talk about what it's achieved so far and what the consequences could be for global health, including here in Canada. Nick, hi. Thank you so much for coming back onto FromBurner. It's a pleasure. Of course. Thanks for having me. So before we get into the MAHA movement more broadly, I just want to talk about this Medicaid cut. You might think that the head of HHS would not be a supporter of cuts to health coverage for poor Americans, but Kennedy is supporting this and just why?

Yeah, I mean, it's confusing for sure. So as a reminder, Medicaid serves our poorest population in the US and Kennedy technically oversees that program as the health set of care area of Health and Human Services. So it's definitely not every day you see someone cheering as a program they're responsible for goes through this type of cuts. His position is even more interesting because of his stated goal, like you said, of making America healthy again, because folks on Medicaid are the same folks that Kennedy should be focusing on to make them healthy. But it's a very sick population for a

number of reasons. Kennedy has essentially said he supports the cuts because too many able-bodied adults are on the program and that's messing things up for folks who are truly in need. There's very little evidence to suggest that's correct, but it's striking nonetheless. And it's going to be interesting to see if Kennedy can in fact succeed in his overarching goal of making America healthy again as millions of Americans lose their access to healthcare coverage. I want to promise you now

that we're going to do more with less. No American is going to be left behind. Our key services delivered through Medicare and Medicaid, the FDA and CDC, and other agencies will enter a new era of responsiveness and a new era of effectiveness. We're going to consolidate all of these departments and make them accountable to you, the American taxpayer and the American patient.

I just wonder if you could give me maybe an example or a few examples of what cuts like that could look like practically on the ground. Yeah, absolutely. So the bill essentially, the most controversial piece of it creates work requirements for Medicaid, meaning that folks will have to work 80 hours a month or be volunteering or going to school to qualify for benefits. And it sounds good on paper,

but research suggests that work requirements don't actually increase workforce participation. Critics of this idea often point to the case of the US state, Arkansas, which tried to implement work requirements and found that decreased enrollment in the program without increasing unemployment. I was on the ground in Arkansas when the state tried requirements just like this in 2018, and we saw working people, disabled people, caregivers, all of them getting cut off the program left and right. We've seen concerns across the medical field to these cuts because folks essentially are worried that folks are no longer going to have medical coverage, therefore they're not going to be able to get their routine health care and they're going to overstress the system.

So like the emergency physicians here in the US, for example, are concerned about this bill because they're worried that folks who would normally go to their primary care doctor when they have a run-of-the-mill issue, now they're going to have to go to the emergency room. And they're going to both stress the capacity of those emergency rooms, and the hospitals will likely have to write off those bills because folks won't have the money to pay.

Have Kennedy responded to any of those critiques? Like, has he addressed them? No. I mean, the closest that he has gotten has basically said, saying, you know, Medicaid is supposed to be for the poor. And there's too many people on the program that are able bodied and able to work and are not. This movement that he coined essentially, Maha, make America healthy again, how would you describe it? Yeah, I mean, the basic belief behind Maha is that something or perhaps many things are making Americans sicker and sicker. So it's really focused on tackling chronic diseases, and it's really focused on its leader, Robert F. Kennedy Jr.

I could read you a list of statistics proving that Americans suffer far higher levels of chronic disease, obesity, addiction, cancer, infertility, and depression than ever before in history and more than any other country in the world. You already know that. It's pretty obvious that something has gone terribly wrong with our health.

I find the movement fascinating because it has critiques of so many different things that it thinks it could be potentially tied to rates of chronic disease here in the U.S. So we see the Maha movement linked with everything from anti-vaccine rhetoric to concerns about seed oils in our foods, to efforts to remove fluoride from water. It spans a huge expanse of issues, but they're all focused on trying to get to the root cause of chronic diseases here in the US.

We will leave no stone unturned. We're going to listen to the experts and to the dissidents. We're going to listen to insiders and to the whistleblowers. We're going to listen to the doctors and we're going to listen to the moms. And how would you describe like the people who make up the movement? Like would you describe it as a coalition of sorts? Yeah, of sorts. So, I mean, the movement often talks about maha moms, essentially parents around the country who are concerned about what their kids eat and are often opting out of the current food system. So these are our moms and dads who might, you know, forbid their kids from eating Froot Loops. And instead, you know, they opt for organic, die-free alternatives,

or maybe they make their kids oatmeal every morning. Those moms definitely do exist and they've done a lot to make this movement popular and to be the voice of the movement. But I think it's really picked up steam because now it's being adopted by the Republican orthodoxy here in the US. I mean, we see Republican members of Congress creating a MAHA caucus to advocate for these types of views. And we especially see state governors

really trying to out MAHA each other by pushing specific policies. I mean, one that has really taken off is this idea that people should not be allowed to buy soda with their food stamps, their government assistance here in the US. And we're seeing state after state line up to be the latest to request doing that from the federal government. Well, tell me about some of the people that Kennedy has brought on board here to be part of this team or high profile members of his team.

Like, what roles are they playing? of his team, like what roles are they playing? Yeah, I mean, the number one person when I think of the Maha movement is Casey Means, who is the nominee for Surgeon General. So, Means has medical training, but she didn't finish her residency. I learned virtually nothing at Stanford Medical School about the tens of thousands of scientific papers that elucidate these root causes of why American health is plummeting and how environmental factors are causing it. She's most known for co-authoring a book with her brother, Callie Means, who was also actually an advisor in the White

House. And the book essentially argues that all of our chronic conditions are the result of poor nutrition, lack of exercise, issue with our sleep. I mean, she's been a very effective messenger for this Maha movement. Her book is a bestseller. Every Sunday after I go to the farmer's market, I lay out all the food and I literally pray with it. Like this is awe-inspiring to me. This is all the atoms and the molecules that over the next week or two are going to make up my cells.

They are going to become me. I am going to take on the characteristics of this food. And I know... And so if she's confirmed to Surgeon General, she's definitely going to continue to be that mouthpiece for the movement. But beyond her, I mean, we have folks like Dr. Mehmet Oz, the physician who came to prominence

thanks to his frequent appearances on the Oprah Winfrey Show. Oz runs CMS, which oversees Medicare, which is our program for the elderly, and then Medicaid, the program that we've already talked about that provides insurance for the poor. You know, when the president signed that executive order, he put a bunch of sheriffs, new sheriffs in town,

and that's what you're looking at on stage today and many others like us who are not going to tolerate this anymore. We're stopping stolen taxpayer money from leaving the door, stopping it in its tracks. And then we have folks like Jay Bhattacharya, who is the head of the National Institutes of Health here. So he's in charge of biomedical research essentially.

And he rose to prominence for his controversial views around COVID. I mean, he was one of the authors of a document called the Great Barrington Declaration, which essentially argued that COVID lockdowns need to end and the world should embrace people that are at low risk of dying, embrace them and actually getting infected with COVID

to build up natural immunity to the virus. It's not a question of let. Open schools is a good example. Are we letting the virus spread when we open schools? No, we're letting school happen. The virus may or may not spread. And then to round out that crew is Marty McCarrey, who is the head of the Food and Drug Administration.

He's a surgeon at Johns Hopkins University. Quite honestly, he's less controversial, I think, than the rest of the folks in sort of Kennedy's crew, but he's been critical of the FDA all the same, and he clearly wants to be seen as a reformer. We're all looking for great places to visit in Canada. One of my favorites is the Stratford Festival. The theater is truly of the highest caliber and there's so much selection. They have 11 large-scale shows on stage and trust me, whatever is on when you're there will be exceptional. People always think Shakespeare when they think of Stratford, but it's so much more.

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that matter. It's exactly what we do over at This Is Toronto. Each week we dive deep into the issues that move and shape the people and places that make up the greater Toronto area from politics to culture and everything in between. This Is Toronto talks about the issues you're thinking about. But we also have a lot of fun as we explore what makes this region feel like home. If this sounds interesting to you, please give us a listen. This Is Toronto. I wish we were sold in stores near you, but you can only get us where you get your podcasts. So I want to dig into what RFK Jr. and this movement and the people that he's brought on have actually accomplished since he was installed in this position six months ago. This administration, I don't have to tell you, has been moving at such a clip, right? A lot of these headlines

are getting buried in a way. I think there are massive changes happening to public health in the US right now. Could we start with vaccines? R.F.K. Jr. ousted his entire vaccine advisory committee last month. And just what happened there? Yeah. So, I mean, as you mentioned, Secretary Kennedy announced that he was firing all members of a group called the ACIP, which is the Vaccine Advisory Committee at our Centers for Disease

and Prevention here in the U.S. It's a group of independent experts who essentially debate the safety and efficacy of vaccines, and they're most known for making suggestions for what shots should be added to the childhood vaccination schedule. So Kennedy and firing all those members claimed that the current members had conflicts of interest and that he needed to clean house to rebuild trust. Now, I mean, the truth is there's a vigorous vetting process for conflicts of interest on the panel and any relevant conflicts are disclosed, but still Kennedy fired everyone. And in that place, he put together a smaller panel, including some known vaccine skeptics. This group has already met once. They spent a lot of time debating a preservative

called thimerosal. This was removed from most vaccines more than two decades ago, and science shows that thimerosal doesn't cause autism, but that's the primary concern of vaccine skeptics. And so we had a situation where this newly formed panel was debating thimerosal as if it was still common in vaccines. And they ultimately voted for it to be removed from vaccines.

I mean, the reality is that doesn't really change that much because, again, it's not used in most vaccines, but it's a really symbolic victory for the anti-vaccine crowd. And it validates these unfounded concerns. SHARA KAUB-MURTHY might also be worth mentioning here that Kennedy has also pulled funding from Gavi, this vaccine alliance, and how does that fit into the conversation that we're having? Yeah, I mean, that is right. He's pulled funding from GAVI. And I mean, it's a further, I think it's just a further escalation of sort of this combative stance towards vaccines here in the US and also efforts to sort of insulate us from the rest of the world. I

mean, we've also seen, of course, critiques waged at the WHO. It's the same sort of concern here. And so it remains to be seen sort of what impact that will have on Gavi, what impact it will have on the world. But it's certainly striking. How would you describe RFK Jr.'s position on vaccines. You know, he's, as you said, such a central figure to this whole movement. Yeah. I've been very upfront in saying that he's an anti-vaccine conspiracy theorist.

He has been very clear in his opposition to vaccines throughout his career. I mean, as a reminder, he said that the COVID vaccines clear in his opposition to vaccines throughout his career. I mean, as a reminder, he said that the COVID vaccines were the deadliest vaccines ever made. The only measure that CDC has, that it uses, it is the most dangerous vaccine and has killed more people than anybody, than any other vaccine in history.

And he urged the government, the US government, to revoke their authorization. He will argue that... News reports have claimed that I am anti-vaccine or anti-industry. I am neither. I am pro-safing. The line that I've heard him say quite a few times

is essentially... I worked for years to raise awareness about the mercury and toxic chemicals and fish and nobody called me any fish. Different folks give him more benefit of the doubt than others. And I think he's really demonstrated pretty clearly that he is he is anti vaccine and that he spread conspiracy theories around them. Of course, one of his first tests, right, has been these measles outbreaks that the US is dealing with,

but also we're dealing with it in Canada and Ontario and Alberta in particular. It has been spreading amongst unvaccinated people. And just how has Kennedy been responding to this outbreak specifically? How has that been received? Yeah, he's been walking a fine line. So he has emphasized that it is, you know, personal choice. There are adverse events from the vaccine. It does cause deaths every year. It causes,

it causes all the illnesses that measles itself cause cause encephalitis and blindness, etc. And so people ought to be able to make that choice for themselves. He's even claimed on, I believe it was Fox News at one point, that the community where measles outbreaks were happening in the state of Texas. Mennonites have told me and their leaders, there's a number of vaccine-injured kids, about a dozen in that community. They had had a bunch of kids who were harmed by vaccines already. So he's given credence to this view that it is acceptable and maybe the right decision

to not get vaccinated. At the same time, he has said pretty publicly that vaccination is the best way to prevent the spread of measles. The federal government's position, my position is people should get the measles vaccine, but if the government should not be mandating those. So he is very clearly not going full anti-vaccine when talking about an outbreak that he now has to deal with, but at the same time, he is making sure to say, you know, I get it if you don't want to get vaccinated. And he's also, I mean, promoted some potential treatments that, you know, the the

evidence really don't stack up. Cod liver oil, which has high, high concentrations of vitamin A. And so there's a worry that he's spreading medical misinformation even as this is occurring. I do think it's worth us also digging into just the level of upheaval and the cuts that have already taken place between RKJ and Doge, it's 20,000 staff positions that have been eliminated across HHS, including roles in the Food and Drug Administration, the National Institutes of Health, the Centers for Disease Control and Prevention. And just what kind of impacts do people worry this kind of slashing could have? Yeah, I mean, there's a fear that, you know, all the progress that we've made on various

public health issues will be wiped out. I mean, one piece of this that I've found really fascinating is the case of HIV AIDS. There's been substantial cuts at CDC on that work in particular. And the reason that stood out to me is because Donald Trump in his first term in office made it a priority to try to end the HIV epidemic. And significant progress had been made. And then there was essentially a flip of a switch.

And now we're back to the point where we're thinking of, we're re- the point where we're thinking of, we're re-G funding these programs. And so it's been really difficult to ascertain exactly why certain programs have been targeted versus not. And it's still, I think, too early to say what the long-term effect of all this is going to be. But the fear is that all progress is going to be lost or significantly slowed. I know Kennedy is called the HHS's structure incomprehensible and an alphabet soup of departments. In your view, is there any truth to how he's described that kind of like bureaucracy? So HHS is without a doubt a giant bureaucracy, but I think it's an open question of whether

there's a better way to structure the organization than what currently existed. I mean, one of the pieces of this that I find fascinating, at least as a reporter, right, is Kennedy has often made the point of saying, HHS has more than 100 communications offices. And we don't need that many, we only need one. And at least for me, when I experienced this, I know that I cover the FDA quite closely, they had a group of experts who could explain FDA policy to a reporter and that's their job.

And now they're relying essentially on one central office, which is much smaller. So you lose all of that subject matter expertise where if I'm a reporter that's going deep on some FDA point, and I really want to understand what's going on here, there's no one I can call anymore in the same way through the communications departments that used to exist. And I mean, you can imagine already how that would backfire, but those are the sorts of things that Kennedy has said are wasteful and need to be rooted out. Right, sort of related to that, I was reading that like officials in charge of regulating tobacco were put on leave in the CDC office that monitors tobacco use was dismantled, which is like a curious decision considering how much Kennedy and also this movement bangs on about chronic diseases, right?

Yeah, I mean, it's been one of the more fascinating, I think a lot of people would say most troubling developments here. I mean, the CDC's office, as you mentioned, has been largely dismantled. And then there's also been a dismantling at the FDA. And the FDA at this point had been working for years to try to get a handle on issues related to vaping here in the US. And now we're seeing that the leader of that center, for example, has left.

And the position is still vacant. So we really we sort of wonder what will happen to what we know is one of the driving causes of chronic disease in this country and why aren't we focusing on that as much as we're focusing on things like food additives or vaccines, for example. With this massive defunding, Kennedy has also said, he's like also saying at the same time that Americans should do their own research. And I just, I'd be interested to hear your thoughts on what we know about his take on

who basically bears responsibility for public health and public health research. Yeah, I mean, I think there's this belief, perhaps shared by Kennedy, but definitely shared by some in the in the maja world that, you know, the establishment, the medical establishment is to blame for our current situation. There's essentially a belief that, you know, it's understandable folks don't trust their doctor because those doctors have, you know, continued to sit on their hands while, you know, rates of type two diabetes and heart disease continue to grow. That's, I mean, really a point that is made by Casey and Callie Means in their book is this idea of you shouldn't trust,

it's okay not to trust your doctor on these issues of chronic disease. Again, it's gonna be interesting to see sort of like what the long-term impact of that is and how we see trust in medical establishments if that is deeply impacted. But it's certainly a point that's been made of like, if you have doubts about your doctor on chronic disease,

you should do your own research and it's okay to have those doubts because they can't be trusted because they don't know what's going on. And speaking of chronic diseases, they released this landmark report recently that exposes the root cause, they say, of childhood disease. And just could you tell me a bit about what's in that

report and what it says to you? Yeah, I mean, it's a sweeping report. And I think if folks are thinking if they're reading it to find out the secret as to why we're so unhealthy, they're probably going to be disappointed. Because to me, the report really underscores what I was saying at the start, which is that maha is focused on a bunch of different issues, all that sort of revolve around chronic disease, but we haven't figured out what is actually the focus. What are the causes? Which I mean, it goes from everything from talking about diet to vaccines to sleep. I mean, there's just it's a very sweeping report.

And I it's going to be interesting to see sort of how they narrow its focus in the future, because at this point, you know, we've really just seen sometimes it feels like we're throwing darts at a dartboard and sort of like what issue where we're worried because at this point, you know, we've really just seen, sometimes it feels like we're throwing darts at a dartboard and sort of like what issue we're worried about at this moment on chronic diseases. And it's gonna be interesting to see if we can sort of whittle that down to some actual core concerns because I don't think we're there yet.

Yeah, I mean, it's interesting. The report mentions things like fluoridated water, but not stuff like cigarettes, alcohol use, and adolescents. The last big example that I want to dig into with you now is how RFK Jr. is working to change, some of the big concerns in this movement are around seed oils and food dyes. And so what's been happening on that front? Yeah. I mean, this is one of the few places, I think, where RFK has had some notable success from the start. And I don't mean that he's successfully revolutionized our food system, but he's pushed

change on issues that he sees as tied to chronic disease problems. So the one that I think most comes to mind is his concern about synthetic dyes in foods. I was talking with my staff about these petroleum-based dyes and I said if they want to add petroleum they want to eat petroleum they ought to add it themselves at home. They shouldn't be feeding it to the rest of us. He apparently feels pretty strongly that these dyes are tied to a bunch of different chronic conditions. I mean one dye in particular he had said that it was tied to tumor growth and neurological damage and anxiety and depression. The reality is the research is much shakier on that front, but what he has done is he's made

synthetic food dyes into a liability for food makers. And with that, he has had some success in actually pressuring food companies to remove these dyes from their foods. So companies like Hershey, for example, have pledged to remove them. But these dies by 2027 smuckers has pledged the same Nestle and Conagra are making pledges as well. And so he's clearly having an impact there. He is also promised to rewrite our dietary guidelines here in the US, which sounds wonky, but actually has a really big impact. So the dietary guidelines are the basis for programs like our national

school lunch program here in the US. And he has said that 453 page documents out look like it was written by the food processing industry. And we're, we are going to come up with a document that is simple, that lets people know with great clarity what kind of foods their children need to eat, what kind of foods they can eat, and what's good for them, what's good nutrition. So it's going to be really interesting to see how that sort of change actually does trickle down to all these programs in our country, which are impacted by the dietary guidelines. I wonder if some of this stuff that you're talking about right now has quite broad appeal.

It does, and I think that's why it's been so successful, especially on the food dye issue, for example. You know, Kennedy's big talking point here is that food companies in Europe in particular don't use these same dyes in their products. And why are they giving us in the U.S. artificial versions of these products when they've clearly shown that they can do it another way. And I think, you know, he he raises a good point here. I mean, if you're critical of the maha movement, you could sort of see this push against food dyes as being unscientific because we don't have this sort of ironclad evidence that these are actually making people sick. But at the same time, it's one of those issues that perhaps we should be investigating further.

And I think that that discrepancy that he's, you know, continually harped on between Europe and the US, for example, that really resonates with folks. And I think that's one of the reasons why we're seeing food companies so quickly realizing, oh, this is a liability for us and we are going to change what we're doing. So just to broaden this conversation out a bit, because all these radical changes happening in the U.S. have far-reaching global implications. The Canadian Medical Association Journal recently wrote this op-ed saying that Canada should do more to strengthen our health surveillance system as cuts to U.S. health institutions threaten access to crucial monitoring data. We're talking about being alerted to outbreaks here.

And just what else could all this spill over borders that we haven't talked about yet? I know we talked about Gavi, we've talked about HIV, but what else are people really concerned about here, globally? Yeah, I mean, just to sort of further build out the concerns about vaccines here, I think there's also just a question of whether

what is going on in the US gives a further air of legitimacy to vaccine hesitancy in Canada as well. If we see the ACIP panel here in the US continually debating things like thimerosal, what does that mean for the movement in Canada? And the other concern that I have heard related to vaccines specifically is if we start to see much more stringent change, so if we start to see companies getting their vaccines kicked off of the childhood schedule, for example, how does that impact their business portfolios and how does that impact availability in other countries? Because you could you could imagine a scenario where if a company gets their vaccine kicked off the US schedule,

they start to question whether they should still make that vaccine or how much of it they should make. And if they decide to scale back production, how does that impact other markets like Canada? And do we start to see shortages? I think we could see the same in the food space as well. I mean, food is obviously a global market. If the companies in the US can't sell the products with the artificial food dyes, how does that impact what products they're making and what products they're selling around the world and will that also lead to spillover in Canada?

There it could be a potential good thing. Perhaps more natural dyes get used and we see that in Canada as well. I think all of this just emphasizes that, you know, none of these, the US is not in a vacuum, right? Everything that occurs in our healthcare system reverberates to our neighbors. And so I think we are gonna see some of that in the next few years.

Nick, this was great, really interesting and helpful. Thank you so much. Of course, thanks are happening. MUSIC Alright, that's all for today. I'm JB Poisson. Thanks so much for listening. Talk to you tomorrow. MUSIC For more CBC podcasts, go to cbc.ca slash podcasts.