Healthcare Leaders Warn of Trump's Threat to Public Health
Released May 9, 2024
To the American People:
We write today as people who have dedicated our lives to helping people. As former leaders of national health care and delivery organizations, we have come to understand how policy can impact public health and, just as importantly, the ability of American families to afford the healthcare they need. The possibility of Americans not receiving essential healthcare, either due to cost or lack of access, is among our greatest worries.
If he is elected president, Donald Trump will make our fears a reality. The price of healthcare for American families under Trump would skyrocket, while millions would lose access to healthcare altogether. While his specific policies are at best ambiguous, his track record and his words make clear the damage he would do.
We therefore encourage anyone concerned about the price, availability, and safety of healthcare to keep Mr. Trump out of the White House.
Mr. Trump’s ambiguity on healthcare policy is our first reason for concern. As Larry Levitt, the Executive Vice President for Health Policy at the Kaiser Family Foundation put it, “the Trump campaign does not issue the typical policy papers that are provided by presidential candidates.” We therefore must “surmise” what Trump will do based on his prior record and his recent remarks. What we can surmise is troubling. Our concerns involve many of the most important issues impacting the cost of healthcare and people’s access to it.
The Affordable Care Act:
People without health insurance live sicker and die younger. By making health insurance available to millions of previously uninsured Americans, the Affordable Care Act (ACA) made countless Americans healthier and saved many lives. It also expanded Medicaid eligibility, bringing health care access to millions of others. Mr. Trump tried unsuccessfully to repeal the ACA and supported an unsuccessful lawsuit to overturn it. He did, however, repeal the individual mandate penalty, which drove up the cost of insurance for all participants, and reduced funding for consumer assistance navigators by 84% and outreach by 90%. This made it harder to coordinate care for those insured, and resulted in decreased enrollment among eligible individuals and their families. He also shortened the enrollment period by half, from 12 weeks to 6 weeks, leading to decreasing enrollment.
The Trump administration also supported the expansion of short-term insurance products which discriminate against sicker people, or those with pre-existing conditions, making it harder and more expensive for those groups to obtain coverage. These short-term policies frequently have reduced benefits and limited coverage.
In the current campaign, Trump has vowed to repeal and replace the ACA, but has provided no details as to how he plans to accomplish that. As the ACA’s premium subsidies are set to expire in 2025, the next president will have the chance to implement major changes. Given his opposition to these subsidies in the past, we can only assume that these subsidies would be limited under a Trump administration.
In 2017, the American Medical Association called Mr. Trump’s proposed replacement for the ACA “critically flawed.” We have every reason to think that the plan for a second Trump Administration would be worse.
Children’s Healthcare:
During his first administration, Mr. Trump attempted to cut seven billion dollars out of the Children’s Health Insurance Program (CHIP), which provides essential healthcare for millions of children. We believe that children should not be punished simply because their parents cannot afford health insurance, and that providing health insurance for children is the very least we as a society owe them. Cutting funds from CHIP does not even make fiscal sense, as most healthcare for children is preventative care that keeps us from having to fix bigger, more expensive medical issues down the road.
Public Health:
While Trump did sign the bipartisan COVID relief bill which enabled Operation Warp Speed to bring vaccines to availability in a year, the administration’s overall response to the COVID epidemic was wanting. Mr. Trump fought publicly with his advisors, promulgated ineffective treatments, and politicized the governmental response. The resulting chaos was reflected in a growing disrespect for government public health agencies and mistrust of vaccines that protect us, particularly the most vulnerable among us.
In the current campaign, he has called for restructuring or eliminating the FDA and the CDC, organizations that have historically protected us from disasters due to ineffective or dangerous pharmaceuticals and deadly infections. Such changes would sicken countless Americans and make American medical care far less safe and effective.
Veterans’ health:
The Trump administration made it possible for Veterans to seek care outside the VA system, but then undercut efforts to fund the program. Veterans have earned the right to access healthcare. We cannot trust an administration that would quietly try to take it from them.
Reproductive Health Care:
Trump has boasted that he is personally responsible for the overturn of Roe v Wade by the judges who he appointed to the Supreme Court. While the implications of the Dobbs decision are still unfolding, there has been a chilling effect on other aspects of reproductive care, including in vitro fertilization. IVF is not only a last hope for couples facing infertility issues, but is also important for people facing fertility-endangering consequences of chemotherapy and other conditions.
The Trump administration also supported a Title X gag rule on providers discussing abortion with patients. They excluded Planned Parenthood and other similar organizations from the Federal Family Planning Program in an attempt to restrict abortion and family planning access. Regulatory changes also allowed employers and providers to more easily decline to participate in activities which they claimed would violate their religions or moral beliefs.
The Heritage Foundation Project 2025 states that “The CDC should ensure that it is not promoting abortion as health care.” Were a second Trump administration to follow through on such a recommendation, and we have every reason to assume it would, it would be putting countless women in danger based on guidance that is simply incorrect.
We, the undersigned, as former leaders of national health care and delivery organizations, understand the critical role that health policy plays in helping Americans live longer, healthier lives. Accordingly, we believe that a vote for Donald Trump is a vote for more expensive, more dangerous, and less accessible healthcare. We believe a second Trump administration would be harmful to the health of American families. We urge Americans of all stripes to reject him and his policies.
Sincerely,
Andrew W. Gurman MD
Former president, American Medical Association
Clara Adams-Ender RN, BSN, MSN, MMAS, PhD, FAAN, LLAN
Brigadier General (Ret), USA
Former Commanding General, Ft. Belvoir & Chief, Army Nurse Corps, USA
Omar T. Atiq MD, MACP
President Emeritus, American College of Physicians
Edward Baker MD, MPH
Rear Admiral & Assistant Surgeon General (Ret), USPHS
Former Director, PHPP/CDC & Deputy Director, NIOSH/CDC
Donna Barbisch DHA, RN
Major General (Ret), USA
Former Director, Chemical, Biological, Radiological and Nuclear Integration, USA
Jacqueline A. Bello MD
Former chair, American Medical Association Council on Medical Education
Ronald Blanck DO, MACP
Lieutenant General (Ret), USA
Former Surgeon General, USA
Lonnie R. Bristow MD
Former president, American Medical Association
Kristine Campbell PhD, RN
Brigadier General (Ret), USAR
Former Assistant Surgeon General, USAR
Peter W. Carmel MD, PhD
Former president, American Medical Association
Mitchell Cohen MD
Rear Admiral & Assistant Surgeon General (Ret), USPHS
Former Director, CCID/CDC
Molly Cooke MD
President Emerita, American College of Physicians
José F. Cordero MD, MPH, FAAP
Rear Admiral & Assistant Surgeon General (Ret), USPHS
Former Director, NCBDDD/CDC & Deputy Director, NIP/CDC
Mary Pat Couig PhD, MPH, RN, FAAN
Rear Admiral & Assistant Surgeon General (Ret), USPHS
Former Chief Nurse Officer, USPHS & Associate Director, CDER/FDA
Charles Cutler MD
Former chair, board of regents, American College of Physicians
Jack Ende MD, MACP
President Emeritus, American College of Physicians
Marlene Haffner MD, MPH
Rear Admiral & Assistant Surgeon General (Ret), USPHS
Former Director, Office of Orphan Products Development/FDA
Bryan Hardin PhD, ATS
Rear Admiral & Assistant Surgeon General (Ret), USPHS
Former Deputy Director, NIOSH/CDC
Clare Helminiak MD, MPH
Rear Admiral & Assistant Surgeon General (Ret), USPHS
Former Chief Medical Officer, USPHS
Alan Hinman MD, MPH
Rear Admiral & Assistant Surgeon General (Ret), USPHS
Former Director, NCPS/CDC
Ardis D. Hoven MD
Former president, American Medical Association
James Hughes MD, FIDSA
Rear Admiral & Assistant Surgeon General (Ret), USPHS
Former Director, NCID/CDC
Douglas Kamerow MD, MPH
Rear Admiral & Assistant Surgeon General (Ret), USPHS
Former Director, Center for Practice & Technology Assessment, AHRQ
W. Robert Kiser MD, MBA, MS (Bioethics)
Rear Admiral (Ret), USN
Former Inaugural Commandant, Medical Education & Training Campus, Ft. Sam Houston
William Lassek MD
Rear Admiral & Assistant Surgeon General (Ret), USPHS
Former Regional Health Administrator, USDHHS
Richard Lemen PhD, MSPH
Rear Admiral & Assistant Surgeon General (Ret), USPHS
Former Acting Director & Deputy Director, NIOSH/CDC
David Lichtman MD
Rear Admiral (Ret), USN
Former Commanding Officer, National Naval Medical Center, Bethesda, USN
Former President, American Society for Surgery of the Hand
Samuel Lin MD, PhD, MBA, MPA, MS
Rear Admiral & Assistant Surgeon General (Ret), USPHS
Former Deputy Assistant Secretary for Health, USDHHS
Boris Lushniak MD, MPH, FAAD, FACPM
Rear Admiral & Deputy Surgeon General of the U.S. (Ret), USPHS
Former Acting Surgeon General of the U.S., USPHS
Barbara L. McAneny MD
Former president, American Medical Association
William McDaniel MD
Rear Admiral (Ret), USN
Former Commander, Naval Medical Center, Portsmouth, USN
Michael Mittelman OD, MPH, MBA, FACHE, FAAO
Rear Admiral (Ret), USN
Former Deputy Surgeon General, USN
Kenneth Moritsugu MD, MPH, FACPM
Rear Admiral & Deputy Surgeon General of the U.S. (Ret), USPHS
Former Acting Surgeon General of the U.S., USPHS
Audrey Nora MD, MPH
Rear Admiral & Assistant Surgeon General (Ret), USPHS
Former Director, Bureau of Maternal & Child Health, HRSA
Patrick W. O’Carroll MD, PPH, FACPM, FACMI
Rear Admiral & Assistant Surgeon General (Ret), USPHS
Former Regional Health Administrator, USDHHS
Gale Pollock CRNA, FACHE, FAAN
Major General & Deputy Surgeon General (Ret), USA
Former Acting Surgeon General & Chief, Army Nurse Corps, USA
Charles Roadman MD
Lieutenant General (Ret), USAF
Former Surgeon General, USAF
Mark Rosenberg MD, MPH
Rear Admiral & Assistant Surgeon General (Ret), USPHS
Former Director, NCIPC/CDC
William S. Stokes DVM, DACAW, DACLAW
Rear Admiral & Assistant Surgeon General (Ret), USPHS
Former Chief Veterinary Officer, USPHS & Director, NICEATM/NIEHS
Loree Sutton MD, MS
Brigadier General (Ret), USA
Former Commander, DeWitt Army Community Hospital, USA
Robin Umberg MBA, RN
Brigadier General (Ret), USA
Former Chief of Professional Services, 3rd Medical Command, USA
Craig Vanderwagen MD
Rear Admiral & Deputy Surgeon General (Ret), USPHS
Former Assistant Secretary for Preparedness & Response, USDHHS
Deborah Wheeling MS, MSN, BSN
Major General (Ret), ARNG/USA
Former Deputy Surgeon General, ARNG/USA
Robert Whitney, Jr. DVM, MS, DACLAM
Rear Admiral & Deputy Surgeon General of the U.S. (Ret), USPHS
Former Acting Surgeon General of the U.S., USPHS
Margaret Wilmoth PhD, MSS, RN, FAAN
Major General (Ret), USA
Former Deputy Surgeon General, USAR
Cecil B Wilson MD
Former president, American Medical Association
Former chair, board of regents, American College of Physicians
Michael Wyrick MHA
Major General (Ret), USAF
Former Deputy Surgeon General, USAF
Stephen Xenakis MD
Brigadier General (Ret), USA
Former Commanding General, Southeast Regional Medical Command, USA
