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Front Burner Transcript for July 7, 2025

Host: Jayme Poisson

SOUNDCLIP

DONALD TRUMP: MAHA's become hot.

JAYME POISSON: On Friday, after weeks of pushback, the U.S. House of Representatives passed Donald Trump's big, beautiful bill. The multi-trillion-dollar legislation lays out big spending for the president's top priorities: defence and border control, millions of dollars of funding for ICE and tax cuts for the wealthiest citizens. It also slashes a trillion dollars from Medicaid, the government's health insurer for mostly low-income people. Those cuts will kick nearly 12 million people off of health insurance by 2034, according to an estimate from the Congressional Budget Office. Despite this, it's a bill that Trump's secretary of the Department of Health and Human Services, Robert F. Kennedy Jr., is wholeheartedly supporting.

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ROBERT F. KENNEDY JR.: It's going to help us do what we need to do with health care in this country, which was-- is to improve the quality of our health care and lower the cost, and give Americans more choice.

JP: Nicholas Florko is back on the show today. He's a staff writer with The Atlantic, and he's going to take us through the MAHA, or Make America Healthy Again movement, led by Kennedy. We're going to talk about what it's achieved so far and what the consequences could be for global health, including here in Canada.

[Music: Theme]

JP: Nick, hi. Thank you so much for coming back onto Front Brunner. It's a pleasure.

NICHOLAS FLORKO: Of course. Thanks for having me.

JP: So before we get into the MAHA movement more broadly, I just want to talk about this Medicaid cut. You might think that the head of HHS would not be a supporter of cuts to health coverage for poor Americans, but Kennedy is supporting this. And just, why?

NICHOLAS FLORKO: Yeah, I mean, it's confusing for sure. So, as a reminder, Medicaid serves our poorest population in the U.S. And Kennedy technically oversees that program as the health secretary of Health and Human Services. So it's definitely not every day you see someone cheering as a program they're responsible for goes through this type of cuts. Uh, his position's even more interesting because of his stated goal, like you said, of making America healthy again. Because folks on Medicaid are the same folks that Kennedy should be focusing on to make them healthy. It's a-- but it's a very sick population for a number of reasons. Kennedy has essentially said he supports the cuts because too many able-bodied adults are on the program and that's messing things up for folks who are truly in need. There's very little evidence to suggest that's correct, but it's striking nonetheless. And it's going to be interesting to see if Kennedy can in fact succeed in his overarching goal of making America healthy again, as millions of Americans lose their access to health-care coverage.

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ROBERT F. KENNEDY JR.: I want to promise you now that we're going to do more with less. No American is going to be left behind. Our key services delivered through Medicare and Medicaid, the FDA and CDC, and other agencies will enter a new era of responsiveness and a new area of effectiveness. We're going to consolidate all of these departments and make them accountable to you, the American taxpayer, and the American patient.

JP: I just wonder if you could give me maybe an example or a few examples of what cuts like that could look like practically on the ground.

NICHOLAS FLORKO: Yeah, absolutely. So the bill, essentially, the most controversial piece of it creates work requirements for Medicaid, meaning that folks will have to work 80 hours a month or be volunteering or going to school to qualify for benefits. And, you know, it sounds good on paper, but research suggests that work requirements don't actually increase workforce participation. Critics of this idea often point to the case of the U.S. state Arkansas, which tried to implement work requirements and found that it decreased enrollment in the program without increasing employment.

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FMR LEGAL AID OF ARKANSAS ATTORNEY: I was on the ground in Arkansas when the state tried requirements just like this in 2018. And we saw working people, disabled people, caregivers, all of them getting cut off the program left and right.

NICHOLAS FLORKO: We've seen concerns across the medical field to these cuts because folks essentially are worried that folks are no longer gonna have medical coverage. Therefore, they're not gonna be able to get their routine health care and they're going to overstress the system. So like the emergency physicians here in the U.S., for example, are concerned about this bill, because they're worried that folks who would normally go to their primary care doctor when they have a, you know, run-of-the-mill issue, now they're gonna have to go to the emergency room. And they are going to both stress the capacity of those emergency rooms. And the hospitals will likely have to write off those bills because folks won't have the money to pay.

JP: Has Kennedy responded to any of those critiques? Like, has he addressed them?

NICHOLAS FLORKO: No. I mean, the closest that he has gotten has basically said-- he's saying, you know, Medicaid is supposed to be for the poor. And there's too many people on the program that are able-bodied and able to work and are not.

[music]

JP: This movement that he coined, essentially -- MAHA, Make America Healthy Again -- how would you describe it?

NICHOLAS FLORKO: Yeah. I mean, the basic belief behind MAHA is that something or perhaps many things are making Americans sicker and sicker. So it's really focused on tackling chronic diseases, and it's really focused on its leader, Robert F. Kennedy Jr.

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ROBERT F. KENNEDY JR.: I could read you a list of statistics proving that Americans suffer far higher levels of chronic disease, obesity, addiction, cancer, infertility and depression than ever before in history and more than any other country in the world. You already know that. It's pretty obvious that something has gone terribly wrong with our health.

NICHOLAS FLORKO: I find the movement fascinating because it has critiques of so many different things that it thinks could be potentially tied to rates of chronic disease here in the U.S. So we see the MAHA movement linked with everything from anti-vaccine rhetoric to concerns about seed oils in our foods, to efforts to remove fluoride from water. It spans a huge expanse of issues. But they're all focused on trying to get to the root cause of chronic diseases here in the U.S.

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ROBERT F. KENNEDY JR.: We will leave no stone unturned. We're gonna listen to the experts and to the dissidents. We're going to listen to insiders and to the whistleblowers. We're gonna listen to the doctors and we're gonna listen to the moms.

JP: And how would you describe, like, the people who make up the movement? Like would you describe it as a coalition of sorts?

NICHOLAS FLORKO: Yeah, of sorts. So I mean, the movement often talks about MAHA moms -- essentially parents around the country who are concerned about what their kids eat and are often opting out of the current food system. So these are moms and dads who might, you know, forbid their kids from eating Fruit Loops, and instead, you know, they opt for organic, dye-free alternatives. Or maybe they make their kids oatmeal every morning. And those moms definitely do exist, and they've done a lot to make this movement popular and to be the voice of the movement. But I think it's really picked up steam because now it's being adopted by the Republican orthodoxy here in the U.S. I mean, we see Republican members of Congress creating a MAHA caucus to advocate for these types of views. And we especially see state governors really trying to out-MAHA each other by pushing specific policies. I mean, one that has really taken off is this idea that people should not be allowed to buy soda with their food stamps, their government assistance here in the U.S. And we're seeing state after state line up to be the latest to request doing that from the federal government.

JP: Well, tell me about some of the people that Kennedy has brought on board here to be part of this team or high-profile members of his team. Like what roles are they playing?

NICHOLAS FLORKO: Yeah. I mean, the number one person when I think of the MAHA movement is Casey Means, who is the nominee for surgeon general. So Means has medical training, but she didn't finish her residency.

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CASEY MEANS: I learned virtually nothing at Stanford Medical School about the tens of thousands of scientific papers that elucidate these root causes of why American health is plummeting and how environmental factors are causing it.

NICHOLAS FLORKO: She's most known for co-authoring a book with her brother, Calley Means, who is also actually an advisor in the White House. And the book essentially argues that all of our chronic conditions are the result of, you know, poor nutrition, lack of exercise, issue with our sleep. I mean, she's been a very effective messenger for this MAHA movement. Her book is a bestseller.

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CASEY MEANS: Every Sunday after I go to the farmer's market, I lay out all the food and I literally pray with it. Like this is, this is awe-inspiring to me. This is all the atoms and the molecules that over the next week or two are going to make up my cells. They are going become me. I am going to take on the characteristics of this food.

NICHOLAS FLORKO: And so if she's confirmed to surgeon general, she's definitely gonna continue to be that mouthpiece for the movement. But beyond her, I mean, we have folks like Dr. Mehmet Oz, the physician who came to prominence thanks to his frequent appearances on the Oprah Winfrey Show. Oz runs CMS, which oversees Medicare, which is our program for the elderly, and then Medicaid, the program that we've already talked about that provides insurance for the poor.

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DR. MEHMET OZ: You know, when the president signed that executive order he put a bunch of sheriffs, new sheriffs in town. And that's what you're looking at on stage today and many others like us who are not going to tolerate this anymore. We're stopping stolen taxpayer money from leaving the door, stopping it in its tracks.

NICHOLAS FLORKO: And then we have folks like Jay Bhattacharya, who is the head of the National Institutes of Health here. So he's in charge of biomedical research essentially. And he rose to prominence for his controversial views around COVID. I mean, he was one of the authors of a document called the Great Barrington Declaration, which essentially argued that COVID lockdowns need to end, and the world should embrace people that are at low risk of dying. Embrace them and actually getting infected with COVID to build up natural immunity to the virus.

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JAY BHATTACHARYA: It's not a question of let. Open schools is a good example. Are we letting the virus spread when we open schools? No, we're letting school happen. And the virus may or may not spread. Um.

[Applause]

NICHOLAS FLORKO: And then to round out that crew is Marty Makary, who is the head of the Food and Drug Administration. He's a surgeon at Johns Hopkins University. Quite honestly, he's less controversial, I think, than the rest of the folks in sort of Kennedy's crew. But he's been critical of the FDA all the same, and he clearly wants to be seen as a reformer.

[music]

JP: So I wanna dig into what RFK Jr. and this movement and the people that he's brought on have actually accomplished since he was installed in this position six months ago. This administration, I don't have to tell you, has been moving at such a clip, right? A lot of these headlines are getting buried in a way. I think there are massive changes happening to public health in the U.S. right now. Um, could we start with vaccines? RFK Jr. ousted his entire vaccine advisory committee last month and just, what happened there?

NICHOLAS FLORKO: Yeah. So, I mean, as you mentioned, Secretary Kennedy announced that he was firing all members of a group called the ACIP, which is the vaccine advisory committee at our Centers for Disease and Prevention here in the U.S. It's a group of independent experts who essentially debate the safety and efficacy of vaccines, and they're most known for making suggestions for what shots should be added to the childhood vaccination schedule. So Kennedy in firing all those members claimed that the current members had conflicts of interest and that he needed to clean house to rebuild trust. Now, I mean, the truth is there's a vigorous vetting process for conflicts of interest on the panel, and any relevant conflicts are disclosed. But still, Kennedy fired everyone, and in their place, he put together a smaller panel, including some known vaccine skeptics. This group has already met once. They spent a lot of time debating a preservative called thimerosal. This was removed from most vaccines more than two decades ago. And science shows that thimerosal doesn't cause autism, but that's the primary concern of vaccine skeptics. And so we had a situation where this newly formed panel was debating thimerosal as if it was still common in vaccines. And they ultimately voted for it to be removed from vaccines. I mean, that-- the reality is that doesn't really change that much because again, it's not used in most vaccines. But it's a really symbolic victory for the anti-vaccine crowd and it validates these unfounded concerns.

JP: Might also be worth mentioning here that Kennedy has also pulled funding from Gavi, this vaccines alliance. And how does that fit into the conversation that we're having?

NICHOLAS FLORKO: Yeah. I mean, that is right, he's pulled funding from, from Gavi. And I mean, it's a further... I think it's just a further escalation of sort of this combative stance towards vaccines here in the U.S. And also, efforts to sort of insulate us from the rest of the world. I mean, we've also seen, of course, critiques waged at the WHO. It's the same sort of concern here. And so, it remains to be seen sort of what impact that will have on Gavi, what impact it'll have on the world. But it's certainly striking.

JP: How would you describe RFK Jr.'s position on vaccines? You know, he's, as you said, such a central figure to this whole movement.

NICHOLAS FLORKO: Yeah, um, I've been very upfront in saying that he's an anti-vaccine conspiracy theorist. He has been very clear in his opposition to vaccines throughout his career. I mean, as a reminder, he said that the COVID vaccines were the deadliest vaccines ever made.

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ROBERT F. KENNEDY JR.: The only measure that CDC has, that it uses, it is the most dangerous vaccine and has killed more people than, uh, than anybody, than any other vaccine in history.

NICHOLAS FLORKO: And he urged the government, the U.S. government, to revoke their authorization. He will argue that:

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ROBERT F. KENNEDY JR.: News reports have claimed that I am anti-vaccine or anti-industry. I am neither.

[Unidentified person yells out]

ROBERT F. KENNEDY JR.: I am pro-safety.

NICHOLAS FLORKO: The line that I've heard him say quite a few times is essentially:

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ROBERT F. KENNEDY JR.: I worked for years to raise awareness about the mercury and toxic chemicals in fish, and nobody called me anti-fish.

NICHOLAS FLORKO: Different folks give him more benefit of the doubt than others, and I, I think he's really demonstrated pretty clearly that he is anti-vaccine and that he's spread conspiracy theories around them.

JP: Of course, one of his first tests, right, has been these measles outbreaks that the U.S. is dealing with. But also we're dealing with it in Canada, in Ontario and Alberta in particular. It has been spreading amongst unvaccinated people. And just how has Kennedy been responding to this outbreak specifically? How has that been received?

NICHOLAS FLORKO: Yeah, he's been walking a fine line. So he has emphasized that it is, you know, personal choice.

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ROBERT F. KENNEDY JR.: There are adverse events from the vaccine. It does cause deaths every year. It causes... It causes all the illnesses that... Measles itself causes encephalitis and blindness, et cetera. And so people ought to be able to make that choice for themselves.

NICHOLAS FLORKO: He's even claimed on, I believe it was Fox News, at one point, that, you know, the community where measles outbreaks were happening in the state of Texas:

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ROBERT F. KENNEDY JR.: The Mennonites have told me and their leaders, there's a number of vaccine injured kids, about a dozen of them in that community.

NICHOLAS FLORKO: That they had had a bunch of kids who were um, who were harmed by vaccines already. So he's, you know, he's given credence to this view that it is acceptable and maybe the right decision to not get vaccinated. At the same time, he has said pretty publicly that vaccination is the best way to prevent the spread of measles.

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ROBERT F. KENNEDY JR.: The federal government's position, my position, is people should get the measles vaccine. But if the -- the government should not be mandating this.

HOST: I understand. But...

NICHOLAS FLORKO: So, you know, he is very clearly not going, you know, full anti-vaccine when talking about an outbreak that he now has to deal with. But at the same time he is making sure to say, you know, I get it if you don't want to get vaccinated. And he's also-- and he promoted some potential treatments that, you know, the evidence really don't stack up.

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ROBERT F. KENNEDY JR.: Cod liver oil, which has high concentrations of vitamin A.

NICHOLAS FLORKO: And so, there's a worry that he's spreading medical misinformation even as this is occurring.

[music]

JP: I do think it's worth us also digging into just the level of upheaval and the cuts that have already taken place between RFK Jr. and DOGE. It's 20,000 staff positions that have been eliminated across HHS, including roles in the Food and Drug Administration, the National Institutes of Health, the Centers for Disease Control and Prevention. And just what kind of impacts do people worry this kind of slashing could have?

NICHOLAS FLORKO: Yeah, I mean, there's a fear that, you know, our... all the progress that we've made on various public health issues will be wiped out. I mean, one piece of this that I've found really fascinating is the case of HIV AIDS. There's been substantial cuts at CDC on that work in particular. And the reason that stood out to me is because Donald Trump in his first term in office made it a priority to try to end the HIV epidemic. And significant progress had been made. And then there was essentially a, you know, a flip of a switch, and now we're back to the point of where we're thinking of, you know, where we defunding these programs. And so, uh, it's been really, it's been really difficult to ascertain exactly why certain programs have been targeted versus not. And it's still, I think, too early to say what the long-term effect of all this is gonna be. But the fear is that all progress is going to be lost or significantly slowed.

JP: I know Kennedy is called the HHS's structure incomprehensible and an alphabet soup of departments. I just, in your view, is there any truth to how he's described that kind of like bureaucracy?

NICHOLAS FLORKO: So HHS is without a doubt a giant bureaucracy. But I think it's an open question of whether there's a better way to structure the organization than what currently existed. I mean, one of the pieces of this that I find fascinating, at least as a reporter, right, is Kennedy has often made the point of saying:

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ROBERT F. KENNEDY JR.: HHS has more than a hundred communications offices.

NICHOLAS FLORKO: And we don't need that many. We only need one. And at least for me, when I, you know, experienced this, I know that -- I cover the FDA quite closely -- they had a group of experts who could explain FDA policy to a reporter, and that's their job. And now they're relying essentially on one central office, which is much smaller. So you lose all of that subject matter expertise, where if I'm reporter that's going deep on some FDA point and I really want to understand what's going on here, there's no one I can call anymore in the same way through the communications departments that used to exist. And I mean, you can imagine already how that would backfire. But those are the sorts of things that Kennedy has said, you know, are wasteful and need to be rooted out.

JP: Right. Sort of related to that, I was reading that like, uh, officials in charge of regulating tobacco were put on lead-- uh, leave. Um. And the CDC office that monitors tobacco use was dismantled, which is like a curious decision considering how much Kennedy and also this movement bangs on about chronic diseases, right?

NICHOLAS FLORKO: Yeah, I mean, it's been one of the more fascinating, I think a lot of people would say, most troubling developments here. I mean, the CDC's office, as you mentioned, has been largely dismantled. And then there's also been a dismantling at the FDA. And the FDA at this point had been working for years to try to get a handle on issues related to vaping here in the U.S. And now we're seeing that, you know, the leader of that centre, for example, has left and the position is still vacant. So we really, we sort of wonder what will happen to what we know is one of the, um, the driving causes of chronic disease in this country. And why aren't we focusing on that as much as we're focusing on, you know, things like food additives or vaccines, for example.

[music]

JP: With this massive defunding, Kennedy has also said-- he's like also saying at the same time that Americans should do their own research. And I just, I'd be interested to hear your thoughts, um, on what we know about his take on who basically bears responsibility for public health and public health research.

NICHOLAS FLORKO: Yeah. I mean, I think there's this belief, perhaps shared by Kennedy, but definitely shared by some in the MAHA world, that, you know, the establishment, the medical establishment is to blame for our current situation. There's essentially a belief that, you know, it's understandable folks don't trust their doctor because those doctors have, you know, continued to sit on their hands while rates of type 2 diabetes and heart disease continue to grow. That's, I mean, really a point that is made by Casey and Calley Means in their book, is this idea of you shouldn't trust-- you know, it's okay not to trust your doctor on these issues of chronic disease. Um. Again, it's going to be interesting to see sort of like what the long-term impact of that is, and what we-- how we see, you know, trust in medical establishments if that is deeply impacted. But it's certainly a point that's been made of like, if you have doubts about your doctor on chronic disease you should do your own research, and it's okay to have those doubts because, you know, they can't be trusted because they don't know what's going on.

JP: And speaking of chronic diseases, they released this landmark report, right, recently, that exposes the root cause, they say, of childhood disease. And just, could you tell me a bit about what's in that report and what it says to you?

NICHOLAS FLORKO: Yeah, I mean, it's a sweeping report. And I think if folks are-- if they're reading it to find out the secret as to why we're so unhealthy, they're probably gonna be disappointed. Because to me, the report really underscores what I was saying at the start, which is that MAHA is focused on a bunch of different issues, all that sort of revolve around chronic disease. But we haven't figured out what is actually the focus, what are the causes. It's-- I mean, it goes from everything from talking about diet to vaccines to sleep. I mean, there's just-- it's a very sweeping report, and I-- it's going to be interesting to see sort of how they narrow its focus in the future. Because at this point, you know, we've really just seen-- Sometimes it feels like we're throwing darts at a dartboard, and sort of like what issue we're, we're worried about at this moment on our, on the, on chronic diseases. And it's going to be interesting to see if we can sort of whittle that down to some actual core concerns, because I don't think we're there yet.

JP: Yeah, I mean, it's interesting the report mentions things like fluoridated water, but not stuff like cigarettes, alcohol use [NICHOLAS: Exactly.] in adolescents. The last big example that I want to dig into with you now is how RFK Jr. is working to change, well, the food system, nutritional recommendations, right? I know you mentioned at the beginning of this conversation, some of the big concerns in this movement are around seed oils and food dyes. Um. And so, what's been happening on that front?

NICHOLAS FLORKO: Yeah. I mean, this is one of the few places I think where RFK has had some notable success from the start. And I don't mean that he's successfully revolutionized our food system, but he's, he's pushed change on issues that he sees as tied to chronic disease problems. So the one that I think most comes to mind is his concern about synthetic dyes in foods.

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ROBERT F. KENNEDY JR.: I was talking with my staff about these petroleum-based dyes, and I said if they want to add petroleum, they want to eat petroleum, they ought to add it themselves at home. They shouldn't be feeding it to the rest of us.

NICHOLAS FLORKO: He apparently feels pretty strongly that these dyes are tied to a bunch of different chronic conditions. I mean, one dye in particular, he had said that it was tied to tumor growth and neurological damage and anxiety and depression. The reality is the research is much shakier on that front. But what he has done is he's made synthetic food dyes into a liability for food makers. And with that, he has had some success in actually pressuring food companies to remove these dyes from their foods. So companies like Hershey, for example, have pledged to remove them, these dyes, by 2027. Smuckers has pledged the same. Nestlé and Conagra are making pledges as well. And so he's clearly having an impact there. He has also promised to rewrite our dietary guidelines here in the U.S., which sounds wonky, but actually has a really big impact. So, the dietary guidelines are the basis for programs like our national school lunch program here in the U.S. And he has said that:

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ROBERT F. KENNEDY JR.: There is a 453-page document that looked like it was written by the food processing industry. And we are going to come up with a document that is simple and lets people know with great clarity what kind of foods their children need to eat, what kind of foods they can eat, and what's good for them. What's good nutrition.

NICHOLAS FLORKO: So it's gonna be really interesting to see how that sort of change actually does trickle down to all these programs in our country, which are impacted by the dietary guidelines.

JP: I wonder if some of this stuff that you're talking about right now has quite broad appeal.

NICHOLAS FLORKO: It does. And I think that's why it's been so successful. Especially on the food dye issue, for example. You know, they-- Kennedy's big talking point here is that food companies in Europe in particular don't use these same dyes in their products. And why are they giving us in the U.S. artificial versions of these products when they've clearly shown that they can do it another way? And I think, you know, he raises a good point here. I mean, if you're critical of the MAHA movement, you could sort of see this push against food dyes as being unscientific because we don't have this sort of ironclad evidence that these are actually making people sick. But at the same time, it's one of those issues that perhaps we should be investigating further. And I think that that discrepancy that he's, you know, continually harped on between Europe and the U.S., for example, that really resonates with folks. And I think that's one of the reasons why we're seeing food companies so quickly realizing, oh, this is a liability for us and we are going to change what we're doing.

[music]

JP: So just to broaden this conversation out a bit, because all these radical changes happening in the U.S. have far-reaching global implications. The Canadian Medical Association Journal recently wrote this op-ed saying that Canada should do more to strengthen our health surveillance system as cuts to U.S. health institutions threaten access to crucial monitoring data. We're talking about being alerted to like outbreaks here. And just, what else could all this spill over borders that we haven't talked about yet? I know we talked about Gavi, we've talked about HIV, but what else are people really concerned about here globally?

NICHOLAS FLORKO: Yeah. I mean, just to sort of further build out the concerns about vaccines here, I think there's also just a question of whether what is going on in the U.S. gives a further air of legitimacy to vaccine hesitancy in Canada as well. If we see, you know, the ACIP panel here in the U.S. continually debating things like thimerosal, what does that mean for the movement in Canada? And the other concern that I have heard related to vaccines specifically is if we start to see much more stringent change, so if we start to see companies getting their vaccines kicked off of the childhood schedule, for example, how does that impact their business portfolios and how does that impact availability in other countries? Because you can imagine a scenario where if a company gets their vaccine kicked off the U.S. schedule, they start to question whether they should still make that vaccine or how much of it they should make. And if they decide to scale back production, how does that impact other markets like Canada, and do we start to see shortages? I think we could see the same in the food space as well. I mean, food is obviously a global market. If uh, if the companies in the U.S. can't sell the products with the artificial food dyes, how does that impact what products they're making and what products they're selling around the world, and will that also lead to spillover in Canada? There, it could be a potential good thing. Perhaps more natural dyes get used and we see that in Canada as well. But I think all of this just emphasizes that, you know, none of these... The U.S. is not in a vacuum, right? Everything that occurs in our health-care system reverberates to our neighbours. And so I think we are gonna see some of that in the next few years.

JP: Nick, this was great, really interesting and helpful. Thank you so much.

NICHOLAS FLORKO: Of course. Thanks for having me.

[Music: Theme]

JP: All right, that's all for today. I'm Jayme Poisson. Thanks so much for listening. Talk to you tomorrow.

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Medicaid cuts and RFK Jr's MAHA mission - Transcript

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