“Make America Healthy Again,” a take on the 2020 and 2024 campaign slogan of President Donald Trump, has recently released a strategy titled “Make Our Children Healthy Again.” The initial MAHA commission was created through Executive Order 14212 in February of this year with the purpose of addressing America’s childhood chronic disease crisis. President Trump appointed Robert F. Kennedy Jr. as Secretary of Health and Human Services to oversee this committee. The MOCHA (Make Our Children Healthy Again) strategy contained 128 points in order to restructure federal government research programs, specifically the National Institute of Health.
AI-generated Image of a protester advocating against Robert F. Kennedy Jr. in favor of public health, OpenAI
The official MOCHA document ambiguously explains the legality of this reallocation of power and how new research programs will affect previously existing projects. Overall goals include the implementation of artificial intelligence as a research tool, encouraging public-private cooperation, and improving public outreach. These approaches, while not inherently controversial, have stirred debate within the scientific and political communities due to Robert F. Kennedy Jr. ‘s status. Credited, scientifically supported organizations such as the Academy of Managed Care Pharmacy and PBS News fear that the commission is endorsing discredited claims that vaccines cause autism or the implementation of other discredited MAHA principles, beliefs long held by Secretary Robert F. Kennedy Jr. This new strategy also calls for the recusal of government officials if they exhibit any conflicts of interest.
In another executive order just six months later, Executive Order 14332, President Trump redistributed executive power from federally employed scientists to politically appointed officials. Political appointees have since had the ability to allocate federal grant money based solely on whether the project is “consistent with agency priorities” or not. This unprecedented act disrupted the hierarchy of approval that had existed previously. In the past, the budgeting of grant funds for the National Institutes of Health was based on a scoring system provided by expert opinion collected from review panels. The panel is composed of a Scientific Review Group, also known as a study section. This group contains scientists who are not federally employed, further separating the institute from the government. These scientists would take scientific merit and public significance into account when considering proposals. However, as a result of this new legislation, such carefully compiled groups of scientists can be bypassed and superseded by political officials with little to no experience in the subject matter. The funding of these important projects rests on the backs of organizations such as the National Institutes of Health, and the power of these decisions is now with uneducated individuals.
One intention of this new legislation is to prevent funding for “diversity, equity, and inclusion and other far-left initiatives,” as supplied from the Executive Order. Additionally, President Trump aims to prevent these projects from recurring and “streamline, agency grantmaking” through the executive branch’s appointed leaders. These changes will speed up the decision making process as it eliminates official channels that facilitated fact-checking and consulted expert opinions.
The restructuring of the National Institutes of Health through both the “Make Our Children Healthy Again” strategy and irrational power allocation to political officials on scientific grant funding exemplify America’s trend of democratic backsliding. Executive aggrandizement, which is defined as “attempts by democratically elected incumbents to concentrate power,” has been on a rise throughout this process. Democratic norms, such as respecting the authority of senior scientists who earned their positions through the National Institutes of Health rather than concentrating power in the hands of federally appointed officials, are eroding.
The firing of officials throughout the National Institutes of Health has also occurred since the restructuring of the NIH, such as four scientific division chiefs. The directors of the National Institute of Allergy and Infectious Diseases (NIAID), the National Institute of Child Health and Human Development (NICHD), the National Institute on Minority Health and Health Disparities (NIMHD), and the National Institute of Nursing Research (NINR) were all removed. Deposing scientists or removing officials entirely is a blatant example of a leader removing opposition from positions of power, a form of executive aggrandisement.
Other causes of democratic erosion include the weakening of domestic institutions and an influx of agent-based actions. The excessive use of executive orders under the Trump Administration, such as the two discussed in this article, undermines the existing branches’ checks on power. By allowing legislation to originate in the executive branch rather than through debate in Congress, diverse perspectives are excluded. Although Congress and the Supreme Court can block these orders, the process for doing so is deliberately difficult.
Through these actions, citizens’ voices are diminished, and the government faces less accountability as scientists are systematically removed from positions of influence. This contributes to the erosion of vertical accountability, as both this transition and the “Make America Healthy Again” commission’s efforts to block funding for DEI research weaken public oversight and limit diverse representation in policymaking.
Photo by ChatGBT, OpenAI. (2025).
An overarching idea throughout your piece that I will discuss further is Trump’s inappropriate use of executive orders. The reality is that the executive branch the framers carefully crafted was not built for an abusive leader such as Trump: the original understanding of executive orders are directives from the president that can have the force of law.
Article II of the Constitution requires the President to ensure that “laws be faithfully executed,” so, generally, executive orders serve as instructions to the distinct government components, guaranteeing that they effectively perform their duties. Executive orders, however, lack the ability to countermand laws, rather they give the President enforcing power.
Though Executive Order 14212 and Executive Order 14332 are not overtly in violation of any particular statute, there are more obvious examples that play a similar role in endeavoring to undermine the existing branches’ checks on power, which you describe.
Fitting to his anti-immigration agenda, Trump signed Executive Order 14160, which puts conditions on who is a natural born citizen. Despite the passing of the 14th Amendment, which effectively established birthright citizenship through the simple fact of someone being born on U.S. soil and the ruling of US v. Wong Kim Ark (which ruled that children of any immigrant who are born in the U.S. are U.S. citizens), Trump attacked this longstanding legal conception.
Lower-court judges have blocked such an obvious attack on the country’s most significant democratic ideal. Nonetheless, Trump has asked the Supreme Court, which has been making questionable rulings favoring Trump through the shadow docket, to review this case. Regardless of whether the Supreme Court hears the case or not, Trump’s signing of the executive order in the first place is undemocratic as it seeks to create an unequal society through the stripping of rights for certain groups.
The gutting of the NIH under the Trump administration exemplifies executive aggrandizement, where politicians concentrate power by weakening expert institutions that safeguard vertical accountability. However, it also poses a significant risk to public health, showing how authoritarian rule puts people at risk in ways beyond losing their civil liberties. By reallocating decision-making power from independent scientists to loyalists to the Trump regime, the administration creates a precedent where research or decisions that impact our health could be deprioritized if deemed inconsistent with “agency priorities.” If public health is not truly important to the administration, this could hold dire consequences for people’s health and safety, which we have continued to see with the loosening of health regulations such as on food products and makeup.
Going back to the weakening of vertical accountability, removing nonpartisan scientific review limits the public’s ability to access knowledge and education both for decisions regarding their own life and health and evaluating government decisions. This is strategic, as an uneducated electorate is more likely to allow the government to retain popular support.
Finally, the emphasis on “streamlining” grantmaking is another effort to weaken institutions. While efficiency is touted to maintain popular support, bypassing deliberative processes erodes the checks and balances necessary to prevent the abuse of power. In public health, information is power. The MOCHA strategy highlights how the Trump administration is using executive orders to take power away from the people and into the hands of the executive.
An angle I think is worth adding on is how these changes also reshape who gets to define what counts as valid knowledge inside the government. Democracies don’t only rely on the legislative branch and the judicial branch to keep leaders in check. They also depend on the scientific institutions to provide neutral information that everyone, regardless of politics, can work from. When political appointees replace expert panels and peer-review committees, the administration isn’t just sidelining scientists; it’s rewriting the rules of whose expertise matters.
This kind of shift has severe long-term consequences because once scientific decision-making becomes intertwined with political loyalty, the public stops seeing institutions like the NIH as independent or trustworthy. So once the reputational damage to these scientific organizations and institutions occurs, it is much harder for citizens to evaluate what is true. Especially when it comes to areas like healthcare, public health, and research. There is so much misinformation that exists for the public to fall into, and not having a fully credible institution is weakening democratic accountability from a different angle. If the people cannot rely on neutral expertise like trustworthy science, it is much easier for leaders to justify extreme policy moves or to delegitimize critics.
It also creates a cycle. As trust in scientific institutions drops, it becomes easier for political actors to argue that scientists are “biased” and replace even more experts with loyalists. So the issue isn’t only the concentration of power now. These changes make it easier to keep undermining institutions in the future.