Implications of Year 1 Trump Administration Policies for Americansâ Lung Health, American Journal of Respiratory and Critical Care Medicine, March 3, 2026, by Adam W. Gaffney, et al
In 2025, the Trump Administration undertook multiple actions with major ramifications for the pulmonary health of Americans.
The âOne Big Beautiful Bill Actâ (OBBBA), signed into law by President Trump on July 4, 2025, will terminate healthcare coverage for many low-income Americans with lung disease. The administrationâs rollback of environmental protections and reduction in subsidies for clean energy production will worsen air quality and accelerate climate change. Cuts at the Centers for Disease Control and Prevention (CDC) could disrupt occupational health protections and tobacco and asthma control efforts; the Department of Health and Human Services (HHS) leadershipâs embrace of anti-vaccine theories will drive vaccine-preventable illness. The termination of federally-funded research grants, including some focused on respiratory diseases, could slow medical progress. And sweeping disruptions to global health aid may impede global tuberculosis control.
In this article, we assess the likely impacts on Americansâ pulmonary health, across the life course, of policies proposed or enacted in the first year of the second Trump Administration, drawing on peer reviewed studies, media reporting, Congressional Budget Office (CBO) reports, government agenciesâ impact analyses, and our analyses of national survey data.
Discussion
Lung disease is a leading cause of suffering and death. Policies pursued or enacted during the Trump Administrationâs first year will likely increase pulmonary morbidity and mortality, and widen already growing inequalities in lung health and care. These policies â a form of pulmonary structural violence â strip away essential measures that protect the respiratory health of all Americans, from infancy through old age: they appear set to degrade patient care, worsen air quality, accelerate climate change, increase vaccine-preventable and exposure-related respiratory illnesses, undermine tobacco control, upend global TB control, and hobble scientific progress on lung disease.
Such harms â particularly to the developing lungs of children â will long outlast the Trump Administration. In contrast, corporations facing relaxed pollution standards stand to benefit, as do wealthy individuals who are unlikely to work in dangerous jobs or live in polluted areas and who are the primary beneficiaries of tax cuts.
The pulmonary and critical care medicine community â including our already outspoken professional societies â should respond vigorously to this crisis. We must amplify the urgent message that these actions are inflicting imminent harms on our patients. Research should track these policiesâ impacts and the magnitude of their harms. Finally, we should advocate for alternative policies informed by decades of research to not only restore, but improve and expand care for every patient with respiratory disease, safeguard workersâ lungs, fight tobacco use, and ensure clean air for all.
Comment:
By Don McCanne, M.D.
Hey! Have you heard that the United States has by far the most expensive health care system in the world â a system that is one of the poorest performing in the industrialized world? Of course you have. What is almost unbelievable is that we have elected an administration that is further compounding the poor performance, as exemplified for lung disease in todayâs article.
This is astonishing considering that we have known for decades now how to convert to a high performance system which would be affordable to all by paying for it with progressive income and wealth taxes, which would make health care available to those with low incomes while budgets can be managed by eliminating the profound administrative waste and excess profits of the middlemen, such as the private insurance industry and private equity, that drains our health care dollars to create private wealth for the surplus, wasteful intermediaries. The increased tax assessment for the multimillionaires and billionaires would be enough to meet the deficiencies in tax revenues from lower income individuals, yet would have absolutely no negative impact on the lifestyles of the very wealthy. This would be especially fair considering the great increase in wealth disparities over recent decades.
What is different this time is that we have a window of opportunity to actually reform health care because the incompetence of the current administration has made it obvious to the majority of the public that we have to do something to make health care affordable for all, and that something requires removal of the gross mismanagement of the current administration.
If we want high quality health care that is accessible and affordable for everyone, now is the time to act. Why now? We have the midterm elections coming up shortly. We need to work together elect a Congress that will create the legislative proposal that will enact a single payer, improved Medicare for All. They will have two years at which time we can replace our dysfunctional administration with one that really cares about the people. Our current president has created a political atmosphere in which it is now obvious that a health care system for all of the people has become a mandate. This is the greatest political opportunity we have had to finally get reform right. Prior opportunities, even if well meaning, have fallen back into the false safety zone of incremental reform. Such incrementalism has left us with the most expensive system yet with miserably failing performance.
We no longer have to accept mediocrity. We can truly create a comprehensive healthcare system that is accessible to everyone, and it can be paid for (wait for this!) without creating financial hardship for anyone! NOW is the time to move forward. Donât just sit there thinking about what we should do. We know what we need to do. The most immediate task is to select midterm candidates who, regardless of political affiliation, support beneficial policies that will get us where we need to be. Again, when is that? Itâs NOW!
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