The Trump administration just dropped a long-awaited follow-up to the “Make America Healthy Again” report from May. The latest dispatch is packed with 128 recommendations — but still leaves plenty of questions on the table.
The Make America Healthy Again (MAHA) Commission’s plan, unveiled Tuesday, promises reforms on vaccines, chronic disease, nutrition, and kids’ mental health — yet overlooks two of the biggest threats: food insecurity and gun violence. Just last year, U.S. Surgeon General Dr. Vivek Murthy warned that America’s epidemic of shootings is the leading threat to children and teens.
Yet despite those omissions, Health Secretary Robert F. Kennedy Jr. hailed the report as “historic and unprecedented,” insisting, “There’s never been an effort like this across all the government agencies.”
The new installment also highlights RFK Jr.’s growing imprint on the administration’s health agenda — from restricting access to Covid vaccines to questioning psychiatric prescriptions for children. And it even offers a glimpse of where policy could be headed next: reviving the Presidential Fitness Test in schools, redefining what counts as “ultra-processed” food, and reshaping pesticide regulation. So we took a closer look at what’s inside the report.
Vaccines
The strategy directs the White House Domestic Policy Council and the Department of Health and Human Services to develop a new vaccine framework that emphasizes “medical freedom” — a phrase that, in this context, appears to signal support for giving parents more leeway in deciding whether to vaccinate their children.
It also pledges to modernize American immunizations and address so-called “vaccine injuries” — a term generally used to describe rare but recognized side effects from vaccines — by making sure claims of harm are taken seriously and handled through proper systems.
Kennedy’s recent actions have fueled worries that he may further chip away at an evidence-based, uniform approach to vaccination. His skepticism has long stirred alarm and controversy — most recently when he forced out Centers for Disease Control and Prevention director Susan Monarez and restricted Covid shots to adults 65 and older, along with younger people who have certain health conditions, like asthma.
In a Senate hearing with Kennedy last week, Democratic Sen. Patty Murray called for Kennedy to be fired immediately, saying, “This man is burning down our public health system from the inside.”
Chronic disease and nutrition
The MAHA strategy report lays out plans for new research on preventing chronic illness, which Kennedy called “an existential crisis for our country.” He’s pointed to the National Institutes of Health as central to that work, with an Autism Data Science Initiative set to mine large real-world datasets and fund up to 25 studies by the end of September. At the same time, a forthcoming HHS report is poised to suggest that prenatal Tylenol (acetaminophen) use may be linked to autism — a claim scientists say is not backed by credible evidence.
The MAHA strategy report lays out plans for new research on preventing chronic illness, which Kennedy called “an existential crisis for our country.” Kennedy has said the National Institutes of Health will be central to that effort, creating a new real-world data platform to study autism, with the first studies expected to roll out this month. In one, he’s expected to announce that pregnant women’s use of an over-the-counter pain medication is potentially linked to autism.
The commission’s first report in May argued that kids are being overmedicated — pointing in particular to vaccines and psychiatric drugs. Building on that, the second installment says HHS will launch a “mental health diagnosis and prescription working group” to review how often children are prescribed medications like antidepressants, mood stabilizers, and stimulants. It also directs the National Institutes of Health and the Food and Drug Administration to explore whether existing drugs could be repurposed to treat chronic disease.
The strategy doesn’t stop there. It also zeroes in on nutrition, noting that about 60 percent of the calories U.S. kids consume come from highly processed foods loaded with salt, sugar, and refined starch. To counter that, the government plans an educational campaign tied to the upcoming updates of the dietary guidelines. The effort would promote more whole foods in schools, curb the use of SNAP benefits (formerly food stamps) for unhealthy items, and establish a clear definition of what qualifies as “ultra-processed.”
Former FDA official Susan Mayne told NPR that defining ultra-processed foods is a good first step — but it’s not enough. “There are steps they should be taking immediately to reduce things like excess sodium, sugar, and saturated fat in those foods,” she said.
The report also points to “unprecedented levels of inactivity” among children. To address this, it proposes collaborating with the President’s Council on Sports, Fitness, and Nutrition to revive the old Presidential Fitness Test and expand after-school programs that encourage physical activity among children. The plan also includes a surgeon general–led education campaign on screen time, one of the main culprits behind inactivity. (Trump has yet to appoint a surgeon general, though Casey Means has been nominated.)
Toxic chemicals
The commission warns that “children are exposed to an increasing number of synthetic chemicals, some of which have been linked to developmental issues and chronic disease.” Pesticides fall into that category, yet instead of recommending tougher oversight, the report emphasizes “reforming the approval process” and speeding up “innovative growing solutions for farmers.”
That shift has alarmed environmental advocates, who say the commission is retreating from its own earlier warnings. “The May MAHA assessment described a hellscape of environmental toxins that were threatening the very existence of humanity. The September MAHA recommendations not only fail to address the harms posed by toxic chemicals in our food and water and air, but instead defend the current pesticide review system and suggest the real problem is we’re not approving new pesticides fast enough,” said Scott Faber, head of government affairs for the Environmental Working Group, in an interview with Politico.
On water quality, the MAHA report says the CDC will update its recommendations on fluoride after RFK Jr. ordered a review of the long-standing guidance. While groups like the American Dental Association maintain that fluoride is safe and effective at preventing cavities, Kennedy has opposed adding it to drinking water and has pushed widely debunked claims tying it to issues ranging from arthritis to lower IQ.
The CDC is also expected to update its guidelines on per- and polyfluoroalkyl substances, or PFAS — the so-called “forever chemicals.” Here, there’s more scientific agreement: Many PFAS compounds have been shown to be toxic and are linked to diseases, including kidney and testicular cancer. The Biden administration set the first federal drinking water standards for six types of PFAS, while the Trump administration has said it will keep but delay enforcement for two and reevaluate standards for the other four.
Ultimately, what’s missing from the report may matter just as much as what’s in it. As the administration puts Kennedy’s agenda into motion, the real question is whether these recommendations will genuinely make kids healthier — or leave the biggest risks untouched.
