The Opposite of the MAHA Agenda

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For Robert F. Kennedy Jr., “Make America healthy again” is far more than a nice slogan. His cosmic purpose in life, he has said, is to fix the country’s health woes. “The first thing I’ve done every morning for the past 20 years is to get on my knees and pray to God that he would put me in a position to end the chronic-disease epidemic,” Kennedy told senators during his confirmation hearing in January. As health secretary, he has continued to emphasize his commitment to that goal. But yesterday, Kennedy cheered a move that is all but guaranteed to make America less healthy.Trump’s “Big Beautiful Bill,” which the Senate passed yesterday, includes provisions that would dramatically change Medicaid, the government program that provides health insurance primarily to low-income people. The bill requires a significant portion of Medicaid enrollees to work in order to access benefits, and creates other barriers for people enrolling in the program. All told, it would kick nearly 12 million people off health insurance by 2034, according to an estimate from the nonpartisan Congressional Budget Office. If the bill passes the House, it will then head to President Donald Trump, who will sign it into law.Medicaid is an expensive program, and the White House has said that more stringently policing who can access it will root out fraud and save funds for the neediest Americans. (Fraud is indeed a problem with the program.) Kennedy, who oversees Medicaid as the head of Health and Human Services, has echoed that message. Yesterday, he posted on X that the bill will allow the Trump administration “to deliver better care to America’s most vulnerable citizens.” But nearly the entire medical establishment warns that slashing Medicaid and limiting access to medical care would have grave consequences for Americans’ health. The American Hospital Association has said the bill “will result in irreparable harm to our health care system.” The American College of Emergency Physicians has said that it “will have dangerous ripple effects that impact anyone in need of lifesaving emergency care.”Kennedy has argued several times that the number of people on Medicaid needs to shrink. In a recent congressional hearing, Kennedy argued that Medicaid should be for only “poor children,” “mothers,” and “the disabled,” rather than “able-bodied people who are not looking for jobs.” During his Senate confirmation hearing, Kennedy made clear that his problem with Medicaid is unsatisfactory outcomes. “We are spending $900 billion, and our people are getting sicker every single year,” he said. (An HHS spokesperson didn’t respond to a request for comment.)But cutting Medicaid would directly undermine Kennedy’s MAHA agenda. Many of the sickest Americans are on Medicaid, and they might not otherwise be able to afford health insurance. The program allows them to access care for the kinds of diseases that RFK Jr. is set on remedying. Nine in 10 adults who are on Medicaid and have chronic conditions report seeing a doctor in the past year, versus just 63 percent of uninsured adults, according to KFF, a nonpartisan organization.There’s a lot for Kennedy to like in the services Medicaid provides. The health secretary is perhaps the most outspoken advocate for the concept that food is medicine, but Medicaid has long embraced the idea. Every state runs its own Medicaid program, and Massachusetts, for example, provides healthy meals to people with certain diet-related conditions. This pilot program has reduced hospitalizations by nearly a quarter, according to one study. Kennedy has also cited his longtime advocacy for people with disabilities. Several states, including California, pay for aides who can help disabled enrollees with personal-care tasks. Some will even pay for renovations to make homes more accessible, ensuring that people with disabilities can live more independently.With his framing on Medicaid, Kennedy has reversed the causes and effects of America’s health woes. He is right to point out that Medicaid serves an incredibly sick population. Adults below the poverty line are roughly twice as likely to report only fair or poor health compared with the entire U.S. population, according to the CDC. But Medicaid is part of the solution, not the problem itself.