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TRUMP’S WAR ON GOVERNMENT WILL TAKE PUBLIC HEALTH BACK A CENTURY  
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Abdullah Shihipar
May 15, 2024
The New Republic
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_ Trump and his allies are planning to “deconstruct” the
administrative state by stripping its power and forcing out tens of
thousands of workers. That will put all of our lives at risk. _

Visiting nurse entering a row home surrounded by children and adults,
Visiting Nurse Society of Philladelphia, c, 1890 (Penn Nursing,
University of Pennsylvania),

 

It’s perhaps hard to imagine today, but we have two landmark books
to thank for some of the U.S. government’s most vital public health
regulations. Upton Sinclair’s _The Jungle,_ published in 1905,
shined a light on the unsanitary and unsafe practices of the
meatpacking industry and eventually led
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the creation of the Food and Drug Administration, which regulates the
safety of products for human consumption. In 1962, Rachel
Carson’s _Silent Spring _exposed the toxicity of the pesticide
DDT, which helped lay the groundwork
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creation of the Environmental Protection Agency. Today, these two
agencies are part of a multitude of government regulatory bodies that
ensure the health and safety of Americans.

Those bodies now find themselves under threat from right-wing
politicians and legal activists alike, who together are working to gut
the so-called administrative state on the grounds that it is
supposedly bloated, leftist, and too powerful. But these efforts,
which include two Supreme Court cases this term as well as Donald
Trump’s second-term plans, would have tangible and severe
consequences not just for those who keep our government functioning
every day but for the hundreds of millions of Americans who rely on
that government to keep them safe and healthy.

The federal government is a gargantuan institution tasked with
regulating all sorts of small but consequential minutiae of American
life—everything from regulations on airline safety to workplace
standards for dealing with hazardous chemicals. Congress grants
agencies the power to set these rules themselves—the FDA is governed
by the Federal Food, Drug, and Cosmetic Act of 1938, while the EPA’s
power is spread among laws like the Clean Air and Clean Water
Acts—because Congress itself has neither the time nor the expertise
to decide, or even simply review, the thousands of rules finalized
every year.

But conservatives want to eliminate these agencies’ long-standing
legal authority, and they just might succeed thanks to two
consequential cases before the Supreme Court. One is a challenge to
the FDA’s approval of mifepristone, the abortion medication, which
the plaintiffs—a coalition of anti-abortion medical
professionals—claim was insufficiently vetted. In oral arguments
last month, the Supreme Court signaled
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might find that the plaintiffs do not have standing, but if the
justices decide otherwise and side with the plaintiffs, experts warn
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the FDA’s regulatory processes would be completely undermined.
People would have the ability to challenge drugs for any reason,
political or otherwise.

Things are far grimmer with the second case, which calls upon the
Supreme Court to overturn _Chevron v. NRDC._ That 1984 ruling
established the so-called _Chevron_ doctrine, effectively allowing
the EPA and federal agencies to use their relevant expertise to
interpret ambiguous federal statutes when they make rules; courts then
defer to regulatory agencies’ expertise. To put it plainly, if
congressional bills had to outline every specific instance in which an
agency had to act, Congress would have to update bills constantly for
regulatory agencies to function.

The EPA is not the one facing scrutiny in this case, but rather the
National Marine Fisheries Service, a division of the National Oceanic
and Atmospheric Administration. In arguments in January
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the Supreme Court appeared willing to disregard or limit
the _Chevron_ ruling completely, which would make expert decisions
made by regulatory agencies subject to far more legal scrutiny. Just
like the aforementioned FDA case, a judge can override the expertise
of regulatory agencies and overturn rules, however specific and niche
they may be. Public health experts have warned
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this would dramatically limit the ability of agencies like the FDA and
Center for Medicare and Medicaid Services to operate by subjecting
them to routine legal interference.

Some examples of these rules implemented in the past year
include: rules
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methane
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oil and gas production, rules allowing
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dosages
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methadone and allowing take-home doses, rules allowing
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the health care coverage
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Deferred Action for Childhood Arrivals recipients, and much more.
Every year, there are between 3,000 and 4,500 rules
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Register, according to the Congressional Research Service.
Collectively, these rules help ensure that federal agencies can
implement their mandate—they all touch on small but significant
aspects of people’s lives. Disrupting this process may be
disastrous.

Beyond legal attacks, conservative activists want to dramatically
reduce the size of the federal workforce and remove civil service
protections, thereby turning long-standing federal employees into
essentially political appointees, serving at the pleasure of the
president. Late in his presidency, Trump signed an executive order to
strip away those protections for tens of thousands of government
workers, but Joe Biden’s victory put an end to that
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now. Trump, if he wins, is expected
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try to reenact the order, and he’s got some help from the Heritage
Foundation, whose Project 2025 [[link removed]] is
working “to assemble an army of aligned, vetted, trained, and
prepared conservatives to go to work on Day One to deconstruct the
Administrative State.”

One can imagine the dire future if the federal government is remade in
this way, especially during a pandemic. Once again, a highly
contagious virus is spreading through the United States and a
right-wing government is not interested in tackling the spread of the
disease. When the president says the seasonal flu is worse than a
pandemic [[link removed]] and is
contradicted by top disease experts at the National Institutes of
Health, he fires them. When a vaccine is finally developed and
approved by the FDA for emergency use, the decision is overturned by a
court when a coalition of states brings about a lawsuit questioning
the safety behind the vaccine. Left without proper information from
the government and no access to a vaccine, thousands more die.

At the heart of the conservative push to defang federal agencies is a
belief that the government should not impede the ability of companies
to make a profit, and that health and safety are an individual
responsibility. But public health regulations exist for a painfully
obvious reason: Environmental and societal factors are necessarily
beyond an individual’s control, and they can lead to bad health
outcomes. You can eat well and exercise but ultimately still develop
cancer from living a few miles from a plastics factory. In fact, as
Jessie Singer argues in _There Are No Accidents, _many of the major
causes of death in the U.S.—car accidents, overdoses, and other
things we consider tragedies or accidents—are the result of
negligent policy. Regulatory agencies like the FDA are the ones we
task to fix, improve, and maintain that policy.

Things are not perfect, of course. These agencies are just as subject
to corporate influence as any other arm of government. The
FDA controversially approved
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now abandoned
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drug, and the EPA recently approved
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fuel made from plastic that produces carcinogenic toxic emissions. But
that’s all the more reason these agencies need strengthening and
that weakening them would be catastrophic.

Americans are dying at a younger age: Life expectancy has declined
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people are getting cancers at a younger age
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overdoses are the top killer of people age 18 to 45
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and maternal mortality
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skyrocketed. We should be aggressively expanding regulations that
target the causes of death and disease. Instead, we are threatened by
the prospect of going back in time, when there were no protections for
your safety on the job, no recourse for being poisoned in your
backyard.

_[ABDULLAH SHIHIPAR is a writer and researcher based at the Brown
University School of Public Health. He directs Narrative Projects and
Policy Impact Initiatives at the People, Place and Health Collective
at Brown. @AShihipar [[link removed]]]_

* public health
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* Federal agencies
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* Donald Trump
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* MAGA
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* Make America Great Again
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* 2024 Elections
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* Right-wing agenda
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* pandemics
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* National Institute of Health
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* FDA
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* epa
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* Project 2025
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* administrative state
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