On Feb. 13, moments after Robert F. Kennedy Jr. was confirmed as secretary of health and human services, President Donald Trump issued his first health care Executive Order (EO) under new leadership, laying the groundwork to prioritize aggressively combatting the rising rates of mental health disorders, obesity, diabetes and other chronic diseases. The EO establishes the president’s “Make America Healthy Again Commission,” which Secretary Kennedy will chair. The assistant to the president for domestic policy will also serve as executive director.
The commission is tasked with investigating and addressing the root causes of America’s health crisis, with an initial focus on childhood chronic diseases. It has four main policy directives to reverse the rise of chronic diseases. First, it directs all federally funded health research to empower Americans through transparency and open-source data and avoid or eliminate conflicts of interest that “skew outcomes and perpetuate distrust.” It also directs the National Institutes of Health (NIH) and other health-related research funded by the federal government to prioritize “gold-standard” research on the root causes of why Americans get sick. It encourages agencies to ensure the availability of expanded treatment options and flexibility for health insurance coverage. Lastly, it directs agencies to work with farmers to ensure food is healthy, abundant and affordable. The commission will broadly aim to restore trust in medical and scientific institutions.
The EO states that the mission of the commission will be to advise and assist on how to exercise authority to address the childhood chronic disease crisis. Specifically, the commission will study the scope of childhood chronic diseases and any potential contributing causes, including the American diet, toxic materials, medical treatments, environmental factors, electromagnetic radiation and government policies. It will also advise President Trump on informing the American people regarding the crisis and provide governmentwide recommendations on policy and strategy. The commission will be joined by many officials across the federal government, including the secretaries of the departments of Housing and Urban Development, Agriculture, Veterans’ Affairs and Education, as well as officials from the NIH, Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDC), National Economic Council (NEC), Office of Management and Budget (OMB) and Environmental Protection Agency (EPA), among many others. Notably absent from the list of members is the Centers for Medicare and Medicaid Services (CMS). The EO provides specific time directives with a tight deadline:
- 100 Days – Produce an Assessment Summarizing Known and Unknown: Within 100 days of the date of the EO, the commission must submit to the president the “Make Our Children Healthy Again Assessment” to assess what is known and any questions that remain. This will include issues such as:
- The chronic disease epidemic compared to other countries;
- Overutilization of medication, food ingredients and other chemicals that may lead to chronic inflammation;
- Prevalence of and threat posed by serotonin reuptake inhibitors, mood stabilizers and weight-loss drugs;
- Best practices for preventing childhood health issues;
- Effectiveness of existing educational programs related to nutrition, physical activity and mental health;
- Transparency of current data and unpublished analyses related to chronic childhood diseases;
- Effectiveness of the current federal government’s approach to childhood health data and metrics;
- Integrity of science, including industry influence; and
- Frameworks for transparency and ethics review in industry-funded projects.
- 180 Days – Produce a Strategy Based on Findings of Assessment: Within 180 days of the date of the EO, the commission will submit to the president a “Make Our Children Healthy Again Strategy” to tackle the issue. The strategy would address appropriately restructuring the federal government’s response to the childhood chronic disease epidemic and potentially propose ending certain practices that exacerbate the health crisis or unsuccessfully attempt to address it. The report would build on the commission’s initial findings and is expected to include key policy recommendations and steps the administration could take to address the increasing rates of chronic diseases.
The EO highlights that after the commission submits its strategy to the president, leadership can propose updates to its mission and include recommendations for further action and reports. It emphasized that the commission will not reconvene until a revised mission is formally submitted.
Notably, the EO indicates that the chair will hold public hearings, roundtables and similar events as appropriate and receive expert input from leaders in public health and government accountability. This provides an avenue for stakeholders to express their opinions and provide expertise as the commission begins its work on both the assessment and strategy.
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