The fallout from President Donald Trump’s “shock and awe” campaign to bend the federal government to his will is becoming painfully apparent. Doctors and advocates report that that the slew of new executive orders are already causing disruptions in treatment, all while Republicans in Congress consider spending cuts that analysts say could strip coverage for millions and spin the health system into further disarray.
Margaret Russell, a family physician and HIV specialist at a clinic in Chicago, was in the middle of seeing patients on Friday when she checked the Centers for Disease Control and Prevention (CDC) website for clinical guidelines doctors routinely reference, only to find that the specific page she was looking for had been taken down.
For the past week, agencies across the federal government have been racing to comply with Trump’s vague executive orders targeting “diversity, equity and inclusion (DEI)” and “gender ideology.” Russell and her colleagues quickly realized that the most up-to-date information on HIV prevention medication, sexually transmitted infection (STI) testing, contraception, childhood vaccination schedules, and more had been scrubbed from the CDC website. Like others across the country, the health workers scrambled to take screenshots of archived versions of the webpages before they could be censored as well.
“I cannot possibly overstate how bad this is,” Russell said in an interview.
Russell said a colleague reached out on Saturday with a question about a pregnant patient with an inconclusive syphilis screening. The U.S. is experiencing an alarming spike in cases of syphilis, an STI that is curable but requires treatment, but pregnancy is known to cause false positives in some tests.
Russell said she would usually consult the latest CDC guidelines to confirm next steps, but the section had been censored along with other information on serious STI infections in pregnant patients and newborns.
While the CDC reportedly restored some resources to its website after public outcry over Trump’s purge of content, a review by Truthout confirmed that pages providing information for the LGBTQ community and guidelines for the HIV prevention medication PrEP were down on January 31. A message on the CDC website now says modifications are being made to “comply” with Trump’s executive orders.
“It’s not that there are no other ways to access this information, but knowing that there is a reliable, trustworthy, central repository for these types of medical guidelines is really critical to our ability to provide good, safe, efficient care,” Russell said.
“I promise you: You want your doctor to be able to access the accurate, updated, complete medical information.”
Russell said the CDC website was also a reliable place to direct patients because the agency’s information must remain scientifically sound to maintain the public’s trust. That’s no longer the case. Doctors can now expect CDC guidelines to be edited based on the political preferences of whoever is in power, which means the nation’s top public health agency will no longer be a trustworthy source for the most up to date information on diseases and standards of care, Russell said.
Medical science and the latest threats to public health are always evolving, Russell said, so the archived versions of CDC webpages her colleagues “salvaged” the other day are not a long-term solution.
“I think a lot of people don’t believe this impacts them, but I promise you: You want your doctor to be able to access the accurate, updated, complete medical information,” Russell said. “And you don’t want to live in a community where people aren’t receiving appropriate treatment for infections that can be passed on to others.”
Trump and his allies have railed against perceived censorship of conservatives. But Robert Weissman, co-president of the watchdog Public Citizen, points out that censoring government websites that provide fact-based information on contraception and STI prevention shows what little value is placed on the First Amendment.
“Rather, they want to control people’s access to information as part of a dual agenda of advancing authoritarianism and an extremist, hateful cultural agenda,” Weissman said in a statement on Friday. “The Trumpian Thought Police are denying Americans fact-based information and endangering people’s health and well-being.”
The scrubbing of public health websites is just one way in which the new administration is upending public health. Trump’s nominee to run the Department of Health and Human Services, Robert F. Kennedy Jr., has spread dangerous misinformation about vaccines and flubbed questions about major federal health programs during confirmation hearings. Protests are erupting outside hospitals as providers curb gender-affirming care for teenagers to comply with Trump’s executive orders. And the chaos over Trump’s initial proposed funding freeze, which has been paused by a judge multiple times, still leaves health researchers and providers concerned about the potential loss in funding.
By further complicating an already dysfunctional health care system, Trump and his allies may be playing with fire. Polls show that besides the economy, health care remains the top concern for voters who are frustrated by spiraling costs and hostile insurance companies that are dysfunctional by design. The depth of the public’s anger was on display in December when the internet erupted in applause following the brazen assassination of a wealthy CEO at UnitedHealthcare, a top U.S. health insurer.
However, this has not prevented Republicans in Congress from considering deep cuts to programs that make health care affordable for millions of people.
As they search for ways to pay for an extension of Trump’s 2017 tax cuts which would pad the pockets of the wealthiest taxpayers without adding to the deficit, Republicans are considering massive cuts to federal health care spending. House Speaker Mike Johnson confirmed on Monday that the GOP is determined to extend the tax cuts without blowing a “hole in the deficit” during an interview on Fox News. Trump is “doing a lot by executive authority, which we applaud,” Johnson said, “but we’re going to follow that up and really reinforce what he’s doing, the agenda, through legislation.”
Kobie Christian, a spokesperson for the economic justice group Unrig Our Economy, said Johnson is determined to make working people foot the bill for millionaires and billionaires.
“Even as Americans continue to face higher prices nationwide, Republicans insist on further increasing costs for regular people by imposing tariffs on everyday items and cutting federal funding for essential programs such as health care and child care to pay for billionaires’ tax breaks,” Christian said in an email on Monday.
A GOP proposal under consideration would cut $2.3 trillion in funding over 10 years from Medicaid, which provides health insurance for lower-income people and people with disabilities. There are multiple ways to make the cuts, including by capping the amount of funding available to states or imposing work requirements that do not increase employment but force people out of the program with red tape.
Republicans may also reduce spending by allowing subsidies for the Affordable Care Act (ACA) marketplace health plans to expire, which would cause insurance costs for millions of people to skyrocket and leave an average 3.8 million more people without insurance each year, according to the Kaiser Family Foundation. In 2024, 56 percent of ACA marketplace enrollees lived in congressional districts represented by Republicans, and 76 percent of enrollees are in states won by Trump.
Trump has been silent about the proposed cuts to Medicaid and the ACA marketplace, but he has said that Medicare, Social Security and the defense budget should be spared cuts, which leaves Republicans in Congress with few other options besides slashing programs that provide health care to working-class people, including some of their own supporters. Despite Trump’s self-assured attacks on the system, health care will continue to raise vexing questions for the GOP moving forward.
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