By Nina B. Elkadi for Sentient.
Broadcast version by Nadia Ramlagan for Kentucky News Connection reporting for the Sentient-Public News Service Collaboration
The day that Robert F. Kennedy Jr. was confirmed secretary of Health and Human Services (HHS), President Donald Trump established a commission in service of the Make America Healthy Again tagline. The purpose of the commission, according to the executive order, is to "address the growing health crisis in America," by redirecting our national focus to "drastically lowering chronic disease rates and ending childhood chronic disease." The MAHA Commission also appears poised to extend RFK's reach beyond HHS to the department tasked with "nourishing Americans," but some food system reformers are skeptical that change is ahead.
After endorsing Trump in 2024, former presidential candidate Robert F. Kennedy Jr. claimed that Trump promised him "control" of several agencies, including the United States Department of Agriculture and Health and Human Services. In a video of Kennedy outside the USDA building in Washington D.C., he criticized large-scale industrialized agriculture and its negative effect on soil and water health. The description of the video reads: "When @DonaldJTrumpforPresident gets me inside the USDA, we're going to give farmers an off-ramp from the current system that destroys soil, makes people sick, and harms family farms."
Some advocates are calling into question his ability to follow through on the promises he made.
"He's going to do nothing to farming because he has no authority," says Ken Cook, president of the non-profit Environmental Working Group. "I don't think it's going to be the revolutionary era at USDA in the way Kennedy suggests."
The future of food and agriculture policy is largely left in the hands of the Department of Agriculture and the Environmental Protection Agency, the heads of which are also on the MAHA commission. Secretary of Agriculture Brooke Rollins is not expected to tighten regulations on corporate interests, and thus far has been taking the advice of the Department of Government Efficiency to cut - not add - programs.
EPA Administrator Lee Zeldin, dubbed the "great deregulator" is unlikely to increase pollution enforcement and other environmental protections. As of late, the USDA secretary has not been a position of great reform; former USDA secretary Secretary Tom Vilsack spent his career revolving from industry to government and back again. As head of the Department of Health and Human Services, it is unclear what sort of oversight Kennedy will have over the agricultural changes he was prioritizing months ago.
DOGE Takes on USDA
On February 16, the Department of Government Efficiency, spearheaded by Elon Musk, put out a call on X asking for "insights on finding and fixing waste, fraud and abuse relating to the US Department of Agriculture."
"It's essentially a wildfire that's burning through the federal government right now," says Sarah Sorscher, director of regulatory affairs at Center for Science in the Public Interest. "[They're] intent on dismantling the federal government, which will undermine the agenda of RFK Jr. and his MAHA cohort, because without a functioning federal government, you can't have smarter regulation. You can't have a smarter approach to food safety and chemical safety and healthcare product safety."
On January 31, the Trump White House announced a de-regulatory blitz, requiring that "whenever an agency promulgates a new rule, regulation, or guidance, it must identify at least 10 existing rules, regulations, or guidance documents to be repealed."
"It's been made very clear that those departments, USDA, EPA, interior, energy, they're going about their own deregulatory agenda, and most of that's not consistent with what I thought was Kennedy's worldview for years, which was that we needed to protect the environment from greedy, corporate interests," Cook says.
Left or Right, Big Ag Is Around
Farm Action Fund, the legislative arm of the non-profit advocacy group Farm Action, came out in support of Kennedy in late January.
"His food and agriculture policy has been very much in line with Farm Action's mission around addressing corporate abuse in the food system [and] corporate influence over government policy," says president and co-founder of Farm Action Angela Huffman.
Farm Action is largely focused on reducing corporate influence within the food system, and in a blog post they outlined how Kennedy could change the food system while at HHS. They write that Kennedy could "shape the Trump administration's agriculture and food policy." For Farm Action, the issues Kennedy has brought to the forefront have not been at the forefront of agricultural policy in decades.
"Folks have been fighting for so long on these issues, and [Kennedy] has brought them to the level that the President of the United States tweeted about taking on the industrial food complex," Huffman says.
While Kennedy has made agricultural reform a key talking point, as HHS Secretary it is unclear how much he could actually get done. Brooke Rollins, Secretary of Agriculture, is so far less vocal about flipping the system on its head than Kennedy was on the campaign trail.
Both Huffman and Cook say that "Big Ag" has dominated agricultural policy on both sides of the aisle.
"We don't defend Democrats if they don't do things well and drop the ball," Cook says. "We don't work for the DNC. I've had pretty harsh things to say about [Secretary Tom] Vilsack when he was nominated by Biden."
After his first stint as Secretary of Agriculture, Tom Vilsack immediately took a position at a dairy lobbying trade group, confirming criticisms of his "friendliness" to industry.
Misaligned 'Alignment'
For many advocates in the food and agriculture space, some of Kennedy's claims have been far from controversial, such as promoting healthy food and reducing consolidation in the industry. Some of his other takes, like vaccine skepticism (as HHS Secretary he is already breaking promises to not alter childhood vaccine schedules), are more than enough for some, like Cook, to pump the brakes.
Huffman, of Farm Action, tells Sentient that her organization is very strictly focused on agriculture issues.
"We understand that he has broader interests than that, and we really don't weigh in on issues outside of our lane," Huffman says.
In his role, Kennedy wants to target certain food additives that are given special exemptions and can be added to food without approval from the Food and Drug Administration. The administration he is working for, though, recently cut numerous FDA staff members, and the deputy commissioner for human foods (who led the ban on Red Dye No. 3) resigned on February 17.
"If your goal is to get a better functioning federal government, it's not the right approach to go in there with a hatchet and start tearing things down," Sorscher says. "What you want to be doing is going in in a surgical way, and operating with a scalpel and not a hacksaw. I think this administration still has not learned how to do that, and it's actually moving us in the wrong direction."
Nina B. Elkadi wrote this article for Sentient.
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As federal Medicaid cuts loom, consumer advocates are celebrating Washington's new bill limiting hospital prices for state and public school employees.
Senate Bill 5083 caps reimbursement rates for nearly 700,000 people covered by the Public Employees Benefits Board and School Employees Benefits Board.
Sam Hatzenbeler, legislative director for the Economic Opportunity Institute, said public and school employees pay more than twice what the federal government said is a fair price for Medicare, with some hospitals charging up to four times more.
"At a time when everyone is going to be asked to tighten their belts due to federal cuts, it's more important than ever to be prudent with our health care resources," Hatzenbeler contended.
Washington hospitals pushed hard against the bill, warning it will add pressure to their already stretched budgets. Hatzenbeler pointed to a similar law passed in Oregon in 2019, which saved the state more than $100 million and cut out-of-pocket costs for patients by nearly 10%.
Adam Zarrin, director of state government affairs for the Leukemia and Lymphoma Society, said large hospitals consolidating through buying up their competitors is one of the reasons health care costs have grown out of control.
"States can and should take action to try to increase competition in this health care space," Zarrin argued. "Because we know that those market factors can help drive and keep costs down."
Public and school employee health insurance rates have risen more than 6% annually since 2021, compared to roughly 10% annually for other plans. Hatzenbeler added while the cap is a step forward for public workers, lawmakers must expand the relief statewide.
"The data tell us that there are plenty of ways to trim excessive spending," Hatzenbeler emphasized. "For example, we can look at healthcare CEO salary data. But we simply can't shift more costs onto the backs of people who are already struggling to get health care."
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Nearly 1,000 New Mexicans have already accessed a new online portal which provides transparency about how much the cost of prescriptions and medical procedures vary from one location to another.
Introduced in 2024, the state service now has been updated to include costs in Spanish for the first time.
Ervin Garcia, health systems epidemiology program manager for the New Mexico Department of Health, said in addition to prescriptions, the portal shows the average costs for doctor visits and medical procedures.
"They can compare how much it would cost in one city versus the other because when you search you can put in your ZIP code and it tells you the closest around you," Garcia explained.
Research suggests health care quality is enhanced when people know what they will pay ahead of time. It also shows most people take at least one prescription drug, and lower prices help people better maintain overall health and wellness.
Garcia noted the online service could be a lifesaver for folks prescribed medicines or procedures who do not feel comfortable revealing their financial or insurance status to medical professionals.
"This kind of helps ease the health care procedures that way, so that they can kind of get a familiarity on how much it would cost," Garcia added.
Americans do not necessarily take more medications than people in other wealthy countries but federal government data from 2022 show U.S. prices across all drugs including generics were three times as high as prices in comparable countries.
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By Marilyn Odendahl for The Indiana Citizen.
Broadcast version by Joe Ulery for Indiana News Service reporting for the Indiana Citizen-Free Press Indiana-Public News Service Collaboration.
In a move applauded by advocates and lawmakers alike, the Indiana General Assembly will be taking a closer look at the estimated $2.2 billion in medical debt that is saddling many Hoosiers and often causing a devastating impact beyond the household budget.
“We all want to be able to care for ourselves and our loved ones, but medical debt poses undue financial hardship that prevents this from being a reality for countless Hoosiers,” Zia Saylor, researcher at the Indiana Community Action Poverty Institute, said in a press release. “It is important that lawmakers recognize the medical debt crisis we have and the urgent need for policies to address it.”
The Legislative Council included medical debt among the 22 topics that it assigned for further examination by the interim study committee process this summer and fall. On Wednesday, the council members unanimously passed a resolution that divided the topics between more than a dozen interim committees.
Initially, the Legislative Council began with 100 proposals for study topics this summer, plus 300 agency reports that presented more topics for possible review, according to George Angelone, executive director of the Legislative Services Agency. Through a “bipartisan process,” the list was whittled down to less than two dozen.
Other subjects scheduled for study include the economic value of Indiana’s public land for recreation, barriers to entering licensed professions, teaching water safety as part of the K-12 curriculum, salaries for K-12 administrators, the usage and cost of long-term-care insurance, and pollution caused by improperly discarded cables. Also, the Government Reform Task Force has been charged with reviewing the “efficiency and effectiveness” of various state boards, commissions and councils, and the Artificial Intelligence Task Force, established by state statute in 2024, will continue to examine the use of AI technology and the potential effects on Indiana residents’ constitutional rights, employment and economic welfare.
After the council hearing, Senate President Pro Tempore Rod Bray, R-Martinsville, said the work of the interim study committees are an important part of the legislative process. It allows state representatives and senators to dive into the topics and enables the public to provide input as well, which is helpful, he said. Bray and House Speaker Todd Huston, R-Fishers, serve as chair and vice chair, respectively, of the Legislative Council, which is comprised of eight members of the Indiana Senate and eight members of the House.
“Maybe it doesn’t end up in a proposed bill for the next legislative session, but people are always going to walk away with more facts and more information about that particular subject,” Bray said.
Democratic lawmakers were upbeat about the assignments to the committees. Senate Minority Leader Shelli Yoder, D-Bloomington, said the Democrats pushed topics that focused on improving Hoosiers’ lives. Many families, she said, are struggling to raise their children, care for their aging parents and stretch their wages to cover rising costs.
“That why our caucus fought very hard to make sure that this year’s study committee didn’t just check a box (but) that they had something meaningful to offer to Hoosiers,” Yoder said after the hearing. “We pushed hard for real topics, real impact and we have many successes to point to.”
‘Medical debt is no-fault debt’
For Democrats, the legislature’s decision to study medical debt is a win.
The interim study committee on the courts and the judiciary has been tasked with examining medical debt, the only topic on its agenda. As part of its study, the committee will look at financial protections for individuals through caps on monthly payments for such debt and limitations on collections or liens on property, along with restrictions on garnishment of wages. Also, the committee will focus on nonprofit and county hospitals by reviewing the definition for charitable care and the requirement to offer payment plans in addition to notices about medical bills to patients.
Speaker Huston and Sen. Fady Qaddoura, D-Indianapolis, both suggested the medical debt topic.
Huston said the topic was spurred by the many different constituents who reached out, telling their stories of the immense financial burden that overdue medical bills can be.
“We will at least take a look at it and understand it, particularly for low-income folks or people that have had some kind of… large, expensive medical procedures,” Huston said of medical debt. “How do you help them get out from behind the eight ball? We’ll take a look at that and see what the options are.”
During the 2025 legislative session, Qaddoura introduced Senate Bill 317 which sought to address medical debt by offering protections similar to those that will be studied by the committee. The measure died after it was narrowly defeated in a 26-to-23 vote in the Senate.
“We should stop penalizing people for getting sick,” Qaddoura said in a statement. “Medical debt is often unavoidable and disproportionately affects those already struggling. Our goal should be to create a path forward that lifts people up, not holds them back.”
Indiana residents are some of the most burdened with medical debt in the country. A 2022 study by the Indiana Community Action Poverty Institute, Grassroots Maternal and Child Health Initiative, and Prosperity Indiana, found that residents of the Hoosier state had the 11th highest share of medical debt in collections nationwide, which equals $2.2 billion outstanding and was the highest among the state’s Midwestern neighbors.
Delinquent or high medical debt contributes to a number of harmful consequences, according to the report. More than negatively impacting the financial health of a household, medical debt can degrade an individual’s physical and mental health. Also, unpaid medical bills can create barriers to credit and housing and can lead to garnishment of wages, property liens and reduced access to health care services.
“Medical debt is no-fault debt,” Dave Almeida, director of state government affairs for the Leukemia & Lymphoma Society, said in a press release. “It’s different from other debt because no one chooses to become sick, which means that no one should have to choose between putting food on the table, paying the rent, putting the kids through college, or engaging in life-saving treatment.”
Council bypasses some committees
Six study committee created by statute were not assigned any topics, including the elections body.
The interim study committee on elections has not met since 2017. However, bills that mostly restrict voting and elections have been introduced each legislative session, culminating in a flood of legislation this year that one voting-rights advocate described as “an assault on democracy.”
Bray did not express any concern about not giving any topics to elections and other committees, including education, public policy and public safety, and military affairs.
“We had a lot of legislation in those areas this last session and sometimes you’ve got to let some of those issues bake a little while … before you have a new issue that you really have to grapple with,” Bray said.
Yoder said she was disappointed that the Child Welfare Task Force was not assigned any topics. Passed this session with strong bipartisan support, House Enrolled Act 1273, authored by Rep. Dale DeVon, R-Granger, created the 22-member task force to study child welfare topics. The law requires the task force to submit two reports in October 2026 and October 2027, but does not specify any areas or subjects that should be studied.
Sen. Andrea Hunley, D-Indianapolis, was hopeful the study committees’ examination of the issues most concerning to families, such as clean water, maternal health and medical debt, would yield some legislation addressing key concerns in the 2026 General Assembly session.
“We also know that a single study in the interim isn’t going to fix everything,” Hunley said. “But we also know that it can spark the change that is necessary. It can be the momentum builder that we need to make sure that we’ve got the momentum going into session, so that we can have the bipartisan support necessary to pass important legislation that this is the time where that happens.”
Marilyn Odendahl wrote this article for The Indiana Citizen.
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