America’s public health care system is not well, and the prognosis doesn’t look good. Brutal federal budget cuts, layoffs, the restructuring of agencies and the vilification of health experts are making us sick. This roundup takes our proverbial temperature:

 

All the vaccine experts on the Advisory Committee on Immunization Practices (ACIP) were removed by Robert F. Kennedy Jr., who leads the nation’s Department of Health and Human Services and is known as an anti-vaccine activist. ACIP sets U.S. vaccine policies, such as recommending vaccination against human papillomavirus (HPV), which causes cervical cancer. RFK Jr. replaced the experts with members who, many fear, could steer policy away from evidence-based science and toward ideology and misinformation.

 

Cost-free preventive care is under attack, including certain cancer and diabetes screenings, statins and PrEP (pre-exposure prophylaxis) to prevent HIV. The Affordable Care Act (ACA, or Obamacare) legally requires health insurers to cover, at no cost to enrollees, preventive services that receive an A or B grade from the U.S. Preventive Services Task Force. In June, the Supreme Court upheld this requirement, stressing that the task force is overseen by the nation’s health secretary. That person is RFK Jr. As we go to press, the Wall Street Journal reports he is about to fire the entire panel of experts.

 

12 million people will lose health insurance because of a $1 trillion cut from Medicaid in the reconciliation bill—aka the One Big Beautiful Bill—that Republicans passed in July, according to the nonpartisan Congressional Budget Office. An additional 4.2 million individuals are projected to lose ACA coverage because Congress failed to extend credits to help pay for the plans.

 

Trump’s proposed 2026 budget aims to cut $33.3 billion (26%) from the health department, including $3.6 billion (almost 50%) from the Centers for Disease Control and Prevention and $18 billion (40%) from the National Institutes of Health. This would mean far less research for cures and treatments, fewer clinical trials and a lack of health data. Some Congress members are fighting to save and even boost funding. Stay tuned.