
Casey Means and MAHA Remove the 'Public' From Public Health
The Office of the Surgeon General is responsible for communicating scientific information to the public and addressing public health issues. Means' record would normally be considered antagonistic toward this fundamental goal, but Trump has praised the nominee as having "impeccable 'MAHA' credentials." Means describes herself as someone who left "traditional medicine," and has expressed health beliefs that flirt with pseudoscience and closely align with those of Robert F. Kennedy Jr.
Co-author of Good Energy: The Surprising Connection Between Metabolism and Limitless Health and co-founder of Levels (a company that sells continuous glucose monitors), Means has peddled health claims that are questionable at best and dangerous at worst. Like other wellness influencers, she has dabbled in some Goop-esque activities, like consulting with a spiritual medium and taking part in a full moon ceremony, which are a little woo-woo but don't harm anyone else. Of greater consequence to public health is Means' skepticism of vaccines. She has also called birth control use "disrespect of life" and endorsed the supposed health benefits of raw milk. The prospect of having a surgeon general who believes such things is terrifying.
Beyond the pseudoscience, Means' general orientation toward health is out of touch with the needs of average Americans. She has built her career and reputation on promoting lifestyle choices such as healthy eating and exercise. From afar, her takes may appear sensible, and at times, even compatible with sound medical advice. A healthy diet and exercise are important, but they alone do not translate to good, humane policies.
Means has suggested that health issues like "depression, anxiety, infertility, heart disease, erectile dysfunction, type 2 diabetes, Alzheimer's dementia, [and] cancer" are "under our control and simpler than we think." Simpler for whom? An emphasis on lifestyle ultimately assigns structural and institutional problems to individual Americans to solve for themselves. In a country where wealth buys health, how many Americans can afford to insulate themselves and their families from risks of disease and disability? The federal minimum wage has been stagnant at $7.25 since 2009. Meanwhile, the cost of necessities like housing, food, and child care have increased precipitously.
WASHINGTON, DC - MAY 12: U.S. Health and Human Services Secretary Robert F. Kennedy Jr. speaks alongside President Donald Trump during a press conference in the Roosevelt Room of the White House on May 12,...
WASHINGTON, DC - MAY 12: U.S. Health and Human Services Secretary Robert F. Kennedy Jr. speaks alongside President Donald Trump during a press conference in the Roosevelt Room of the White House on May 12, 2025, in Washington, DC. MoreIn her "health wishlist" for the Trump administration, Means says we need leaders who will "inspire people to care about their health, the food they eat, and their fitness." Americans do not need inspiration. Americans need access. It is cruel to push the idea that people are unhealthy simply because they do not care. Our most urgent public health problems cannot be solved with personal empowerment and lifestyle choices. For instance, 7.2 million children live in food-insecure households. Meanwhile, the House of Representatives is planning to cut $12 billion from federally funded school meal programs.
Health care is also inaccessible to many Americans because, unlike many of its peer countries, the U.S. does not offer universal health coverage. Even for those who do have health insurance, coverage is often insufficient, causing many to accrue medical debt. The Trump administration has added new public health problems: the Food and Drug Administration recently suspended quality control for milk, the Department of Agriculture withdrew a proposal to reduce Salmonella in raw poultry products, and the Environmental Protection Agency has loosened restrictions on mercury pollution. Meanwhile, Kennedy continues to fuel vaccine hesitancy amid a national measles outbreak.
MAHA priorities are misaligned with public health needs. Means' sunny website—where she promotes her book, recipes, and newsletters—frames good health as an individual project. Means' wish list to the Trump administration proposes actions that would address processed foods, "Big Pharma," vaccine safety, alternative medicine, and paternalistic restrictions on SNAP. It is apparent that her and Kennedy's health concerns reflect the airy worries of the rich. Their brand of health care is for people who can choose to be healthy, people with the time and money to pursue health optimization, and people comfortable enough to be fussy over food dyes.
Pandering to the desires of the upper class, MAHA pushes products and services that are out of reach for the average American. The surgeon general is supposed to be the nation's doctor. Means is just an entrepreneur who peddles an expensive lifestyle.
Catherine Tan is an Assistant Professor in Sociology at Vassar College. She is the author of Spaces on the Spectrum: How Autism Movements Resist Experts and Create Knowledge, published by Columbia University Press.
The views expressed in this article are the writer's own.
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Los Angeles Times
27 minutes ago
- Los Angeles Times
Criminalization or support? President Trump's executive order on homelessness gets mixed reaction
An executive order signed by President Trump purporting to protect Americans from 'endemic vagrancy, disorderly behavior, sudden confrontations, and violent attacks' attributed to homelessness has left local officials and homeless advocates outraged over its harsh tone while also grasping for a hopeful message in its fine print. The order Trump signed Thursday would require federal agencies to reverse precedents or consent decrees that impede U.S. policy 'encouraging civil commitment of individuals with mental illness who pose risks to themselves or the public or are living on the streets and cannot care for themselves.' It ordered those agencies to 'ensure the availability of funds to support encampment removal efforts.' Depending on how that edict is carried out, it could extend a lifeline for Mayor Karen Bass' Inside Safe program, which has eliminated dozens of the city's most notable encampments but faces budget challenges to maintain the hotel and motel beds that allow people to move indoors. Responding to the order Friday, Bass said she was troubled that it called for ending street homelessness and moving people into rehabilitation facilities at the same time as the administration's cuts to Medicaid have affected funding 'streams for facilities for people to stay in, especially people who are disabled.' 'Of course I'm concerned about any punitive measures,' Bass said. 'But first and foremost, if you want to end street homelessness, then you have got to have housing and services for people who are on the street.' Kevin Murray, president and chief executive of the Weingart Center homeless services and housing agency, saw ambiguity in the language. 'I couldn't tell whether he is offering money for people who want to do it his way or taking money away from people who don't do it his way,' Murray said. Others took their cue from the order's provocative tone set in a preamble declaring that the overwhelming majority of the 274,224 people reported living on the street in 2024 'are addicted to drugs, have a mental health condition, or both.' The order contradicted a growing body of research finding that substance use and mental illness, while significant, are not overriding factors in homelessness. 'Nearly two-thirds of homeless individuals report having regularly used hard drugs like methamphetamines, cocaine, or opioids in their lifetimes. An equally large share of homeless individuals reported suffering from mental health conditions.' A February study by the Benioff Homeless and Housing Initiative at UC San Francisco found that only about 37% of more than 3,000 homeless people surveyed in California were using illicit drugs regularly, but just over 65% reported having regularly used at some point in their lives. More than a third said their drug use had decreased after they became homeless and one in five interviewed in depth said they were seeking treatment but couldn't get it. 'As with most executive orders, it doesn't have much effect on its own,' said Steve Berg, chief policy officer for the National Alliance to End Homelessness. 'It tells the federal agencies to do different things. Depending on how the federal agencies do those things, that's what will have the impact.' In concrete terms, the order seeks to divert funding from two pillars of mainstream homelessness practice, 'housing first,' the prioritization of permanent housing over temporary shelter, and 'harm reduction,' the rejection of abstinence as a condition of receiving services and housing. According to the order, grants issued under the Substance Abuse and Mental Health Services Administration should 'not fund programs that fail to achieve adequate outcomes, including so-called 'harm reduction' or 'safe consumption' efforts that only facilitate illegal drug use and its attendant harm.' And the Secretary of Health and Human Services and the Secretary of Housing and Urban Development should, to the extent permitted by law, end support for 'housing first' policies that 'deprioritize accountability and fail to promote treatment, recovery, and self-sufficiency.' To some extent, those themes reflect shifts that have been underway in the state and local response to homelessness. Under pressure from Gov. Gavin Newsom, the California legislature established rules allowing relatives and service providers to refer people to court for treatment and expanded the definition of gravely disabled to include substance use. Locally, Bass' Inside Safe program and the county's counterpart, Pathway Home, have prioritized expanding interim housing to get people off the streets immediately. Trump's order goes farther, though, wading into the controversial issue of how much coercion is justified in eliminating encampments. The Attorney General and the other federal agencies, it said, should take steps to ensure that grants go to states and cities that enforce prohibitions on open illicit drug use, urban camping and loitering and squatting. Homeless advocacy organizations saw those edicts as a push for criminalization of homelessness and mental illness. 'We'll be back to the days of 'One Flew Over the Cuckcoo's Nest,' 'Berg said, referring to the 1962 novel and subsequent movie dramatizing oppressive conditions in mental health institutions. Defending Housing First as a proven strategy that is the most cost-effective way to get people off the street, Berg said the order encourages agencies to use the money in less cost-effective ways. 'What we want to do is reduce homelessness,' he said. 'I'm not sure that is the goal of the Trump administration.' The National Homelessness Law Center said in a statement saying, 'This Executive Order is rooted in outdated, racist myths about homelessness and will undoubtedly make homelessness worse.... Trump's actions will force more people into homelessness, divert taxpayer money away from people in need, and make it harder for local communities to solve homelessness.' Murray, who describes himself as not a fan of Housing First, noted that key policies pressed in the order—civil commitment, encampment removal and substance use treatment—are already gaining prominence in the state and local response to homelessness. 'We all think if it came from Trump it is horrible,' Murray said. 'It is certainly overbearing. It certainly misses some nuances of what real people with mental illness and substance use are like. But we've started down the path of most of this stuff.' His main concern was that the order might be interpreted to apply to Section 8, the primary federal financial tool for getting homeless people into housing. What would happen, he asked, if someone with a voucher refused treatment? 'It might encourage more people to stay on the streets,' he said. 'Getting people into treatment isn't easy.'


NBC News
28 minutes ago
- NBC News
The next big health care fight that's splitting Republicans: From the Politics Desk
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GOP leaders are facing growing calls from their members to extend a bucket of funding for the Affordable Care Act that is set to expire at the end of this year as some look to avert insurance premium hikes and millions of Americans losing their health coverage. But the cause faces opposition from conservatives who detest Obamacare and don't want to lift a finger to protect it. Some argue it'd be too expensive to continue the premium tax credits, which cost over $30 billion per year and were initially adopted as part of a Covid-19 response. The nonpartisan Congressional Budget Office projects that about 5 million Americans will lose their insurance by 2034 if the money expires. The divide: Rep. Brian Fitzpatrick, R-Pa., who represents a swing district that Trump lost in 2024, said that Congress should continue those ACA tax credits in order to avoid price increases. 'I think we gotta be doing everything to keep costs low across the board — health care, groceries, energy, all of the above. So I am currently working on addressing that as we speak,' he said. But Rep. Andy Harris, R-Md., the chair of the hard-right House Freedom Caucus, said he 'absolutely' wants that funding to end. 'It'll cost hundreds of billions of dollars. Can't afford it,' he said. 'That was a Covid-era policy. Newsflash to America: Covid is over.' For now, top Republican leaders are keeping their powder dry about whether — or how — they will take up the issue. 'I think that goes to the end of the calendar year, so we'll have discussion about the issue later. But it hasn't come up yet,' House Speaker Mike Johnson, R-La., said when asked about an ACA subsidy extension. 'But it's on the radar.' 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Will it force the party onto the defense at a time where it needs to be cementing public sentiment about its landmark tax cuts and spending bill, which Democrats are already weaponizing as a key midterm issue? Could Democrats overplay their hand if it overshadows their message on the most important issue to many voters, the economy? We'll discuss this and more on this Sunday's 'Meet the Press.' In addition to Khanna and Massie, House Speaker Mike Johnson, R-La., and Sen. Lindsey Graham, R-S.C., will also be joining us. Thanks to everyone who emailed us! This week's reader question is on Republicans' attempts to draw new congressional maps in Texas. 'Is it legal what Gov. Greg Abbott and Texas Republicans want to do for Trump?' To answer that, we turned to senior politics editor Scott Bland. Here's his response: Redistricting happens every decade after the decennial census, so that each state has representation in the House of Representatives reflecting its official population and each district in a state has the same number of people in it. But this isn't the first time someone has moved to change the maps mid-decade. In fact, this isn't even the first time it's happened in Texas. In 2002, Texas Republicans gained full control of the state Legislature, and they decided the following year to draw a new map to replace a court-drawn one that had been imposed for that decade — and to increase the GOP advantage in the state. 'I'm the majority leader and we want more seats,' Rep. Tom DeLay, R-Texas, told reporters at the time. What flies in Texas doesn't necessarily fly everywhere, though. Colorado Republicans also tried to redraw maps in their state in 2003, but the state Supreme Court ruled that the state Constitution forbade revisiting the maps more than once per decade. 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San Francisco Chronicle
an hour ago
- San Francisco Chronicle
Following Venus Williams' comment on health insurance, here's what to know about athlete coverage
Venus Williams' recent singles win at the D.C. Open showcased her longevity and brought attention to health coverage for aging athletes following a joking comment she made in an on-court interview. 'I had to come back for the insurance,' the five-time Wimbledon champion said after Tuesday's match, her first in 16 months. 'They informed me this year that I'm on COBRA, so it's like, I got to get my benefits on.' The 45-year-old Williams, who has won seven major singles titles in her career, became the second-oldest woman to win a tour-level singles match in professional tennis with Tuesday's victory. After losing on Thursday, she acknowledged that her comment on health insurance was a 'fun and funny moment.' The Consolidated Omnibus Budget Reconciliation Act, more commonly referred to as COBRA, allows Americans to stay on their employer's insurance plan for a limited amount of time after leaving their job. It comes with high costs. Williams' comment led to questions about health insurance in the sports world. For most active professional athletes, partially or fully subsidized health insurance is provided by their league or governing body and guaranteed in their collective bargaining agreement. A CBA is an agreement reached between a league and its players that guarantees certain levels of player compensation and benefits, and can be renegotiated every few years. So when athletes are playing, they're usually covered. But Williams, coming back to the sport after a 16-month hiatus, brought to light how long that insurance lasts — or doesn't last — for athletes when they're not playing. Women's Tennis In the WTA, the governing body of the women's tour, players are eligible to enroll in the health insurance plan if they are ranked in the top 500 in singles or top 175 in doubles and have played a minimum of three WTA 250 level or above tournaments that year. If players are in the top 150 in singles or top 50 in doubles, the WTA will pay a portion of the premiums. If a player is no longer eligible under those requirements, they can enroll in COBRA for up to 18 months, which is likely the situation that Williams was referencing. That is also the WTA's only option for retiring players. 'Nobody wants to be on COBRA, right?' Williams said after her second-round loss on Thursday night. 'That remains an issue in my life … Obviously (the interview was) a fun and funny moment, but it's an issue that people are dealing with, so it is serious.' Men's Tennis The ATP provides health insurance to men's tennis players who rank in the top 250 in singles or top 50 in doubles. All other players with a ranking point are given the opportunity to purchase health insurance through the ATP's provider. For retired players, the only option is COBRA for up to three years. Golf As an individual sport without a CBA, golf tours vary. They do have a group insurance plan that is available to active members of the PGA Tour, the PGA Tour Champions (the tour for golfers over 50) and the Korn Ferry Tour (the feeder circuit for the PGA). For players who meet certain 'performance criteria,' including how many tournaments they played and how often they won, the PGA will partially subsidize the plan. In retirement, players are responsible for their own insurance. Some players join the PGA Tour Champions after the PGA Tour and play into their mid-60s, during which they maintain coverage. Top players can receive a subsidy from the PGA in retirement. The LPGA Tour, the women's professional golf tour, started offering its players fully funded health insurance for the first time this year. Before this year, players were given a $4,000 stipend. NBA NBA players have access to one of the most inclusive insurance plans in retirement. If they played at least three years in the league, retired NBA players are eligible for fully-funded health insurance in retirement, and if they played at least 10 years, they will have healthcare covered for their entire family. WNBA WNBA players are fighting for retirement healthcare as part of their new CBA, which they are currently negotiating with the league. Those negotiations have been heated, and the most recent meeting between the two sides last weekend did not result in an agreement. One unique facet of the W's healthcare is that athletes who have spent more than eight years in the league can be reimbursed up to $20,000 a year for costs related to adoption, surrogacy, egg freezing or additional fertility treatments. NFL The NFL has less long-term coverage for retirees than most other team sport leagues — athletes who played in the league for at least three years can remain on the NFL health insurance plan, but only for five years into retirement. NHL NHL players who have played more than 160 games with the league, which is about two seasons, are eligible to buy NHL health insurance for their retirement. The retirement insurance plan is eligible for partial subsidization from the league. MLB Baseball players who spent at least four years in the league have the option to pay premiums to stay on the MLB's healthcare plan indefinitely. Minor League Baseball has its own separate CBA, which also guarantees health insurance for active players. In the minors, however, players who get cut or leave the league lose coverage at the end of that month. ___