Since January 2025, the Trump administration and Congress have advanced a series of policies that are wreaking havoc on our health care systems, and will be especially damaging for maternal and child health. These include nearly $1 trillion in Medicaid cuts over the next decade, the program that covers 40 percent of U.S. births; drastic changes to the Supplemental Nutrition Assistance Program (SNAP); hamstringing the approval and roll-out of immunizations; and making maternal and reproductive care less comprehensive.
The narratives that accompany these policies are grossly misleading: SNAP reductions mean “freedom,” Medicaid cuts eliminate “fraud, waste, and abuse,” vaccine changes “restore gold-standard science.” In practice, these actions have throttled individuals’ health coverage, access to care, and nutrition support, and make our families less healthy.
It’s critical that we don’t take the messaging about these policy changes at face value. With maternal and infant mortality still high, the stakes remain as high as ever. In this commentary, we’ll take a closer look at five of these claims, evaluate their veracity, and describe the related policies’ true consequences.
Myth #1: The administration is making healthcare more affordable.
Example: The president’s “Great Healthcare Plan” promises to slash drug prices, give Americans money directly to buy their own healthcare, and hold insurance companies accountable for putting profits over patients.
Fact: The number of Americans who are losing or can’t afford coverage is skyrocketing because of HR 1.
Last year’s budget reconciliation bill (HR 1) made deep cuts to Medicaid and failed to extend the Affordable Care Act (ACA) subsidies that helped 22 million Americans afford health insurance last year. The law also imposes Medicaid work requirements that are making it harder for Americans to maintain coverage. Together, these policies are already rapidly reducing enrollment: 1 million fewer people have signed up for healthcare plans this cycle because they’re too expensive, and 3.4 million more people are expected to lose insurance in 2026 alone.
The administration has said that HR 1 reforms will protect Medicaid for every eligible American, and that eliminating waste, fraud, and abuse will improve effectiveness and program integrity. However, evidence consistently shows that work requirements create administrative barriers that lead to coverage loss among otherwise eligible people, and not to increased employment.
One in three households carry medical debt, and new mothers are twice as likely to be in medical debt compared to young women who have not given birth.
The discrepancy will not go unnoticed, because healthcare affordability is a top concern for Americans. Sixty-one percent report they think about healthcare “a great deal” and more than 82 million have made tradeoffs like stretching medications, skipping meals, or cutting back on utilities to afford care. Americans are also drowning in care-related debt: one in three households carry medical debt, and new mothers are twice as likely to be in medical debt compared to young women who have not given birth.
Myth #2: The healthcare system remains stable and accessible.
Example: When asked about large spending cuts prior to HR 1’s passing, the president said that he would “love and cherish Social Security, Medicaid, and Medicare… they won’t touch the programs unless they find waste and fraud… and people will not be affected.” Ross Vought, director of the Office of Management and Budget, reaffirmed that the bill would not make poorer Americans worse off.
Fact: As a result of HR 1, new administrative and financial burdens on state and local healthcare systems are reducing access to healthcare overall and to essential maternal healthcare in particular.
States are facing higher costs to implement federal Medicaid changes, straining their budgets, and limiting investments in maternal health. Montana was planning to reimburse doulas in its Medicaid program—an evidence-based intervention that has been shown to improve maternal health outcomes, particularly for Black women—but postponed it due to budget constraints linked to shrinking federal funding. While the state has now reversed this decision and their Medicaid program will pay for doula care after all, this service (along with other optional maternal health services) are still at risk of being cut later on.
Because Medicaid finances nearly half of U.S. births, coverage losses mean delayed prenatal care, increased risk during pregnancy, and worse outcomes for both parents and babies.
Rural health systems are especially affected, and hospitals are under financial pressure now that their Medicaid funding has been so significantly reduced. Medicaid spending in rural areas is projected to decrease by $137 billion over ten years, and 1.5 million rural Medicaid beneficiaries are expected to lose coverage. Because Medicaid finances nearly half of U.S. births, coverage losses mean delayed prenatal care, increased risk during pregnancy, and worse outcomes for both parents and babies. When hospitals absorb financial losses, labor and delivery (L&D) units are often cut first: more than 130 L&D units have closed nationwide, including twenty-nine closures in 2025 alone.
As these closures accelerate, patients will be forced to travel farther or forgo care entirely. This will also worsen existing and create new maternity care deserts. For an increasing number of us, even if we have coverage, we might not have anywhere remotely nearby to go for care.
Myth #3: The administration’s reproductive health policies are solely about protecting life.
Example: The administration has framed its reproductive health agenda as protecting life, including an executive order, “Enforcing the Hyde Amendment,” which states that federal policy should end the use of taxpayer dollars to “fund or promote elective abortion.”
Fact: Restricting access to preventive and abortion care damages the quality and safety of pregnancy and birthing care as well.
The administration has renewed enforcement of the Hyde Amendment, which prohibits the use of federal funds for abortion care, framing it as a policy to protect life and strengthen families. However, wherever one places one’s values in the life–choice debate, it’s important to know that the consequences of these actions extend beyond banning abortion and erode the quality and safety of reproductive and preventive healthcare as a whole.
The Title X program, which served more than two million low-income Americans in 2023, is proposed for elimination in the president’s Fiscal Year 2027 Budget Request, and in the meantime has been redirected away from contraception and preventive care toward fertility. New guidance from the Department of Health and Human Services (HHS) encourages clinics to prioritize fertility education and restorative reproductive medicine. The administration also recently launched Moms.gov, a federal website framed as supporting mothers and “unexpected pregnancies” through fertility, parenting, and pregnancy-related resources. Expanding access to fertility care is critical, especially for Black women, who have less access to it. However, since federal funding determines which services clinics are able to offer, the reorientation of the program is likely to reduce access to abortion, contraception, and other preventive services because these do not align with the administration’s priorities.
All reproductive healthcare is foundational to maternal health. Contraception, abortion, mifepristone, preconception care, and other family planning services support healthy pregnancy spacing, prevent maternal mortality, and manage miscarriage (including if in vitro fertilization treatment fails and results in early pregnancy loss). It is no surprise that states with the most restrictions on abortion continue to have high rates of maternal death and worse maternal and child health outcomes. Limiting access to holistic reproductive health services weakens the entire continuum of care before, during, and after pregnancy.
Myth #4: The administration’s focus on “restoring gold-standard science” to vaccine policy will improve health outcomes.
Example: Last summer, HHS Secretary Robert F. Kennedy, Jr. fired all members of the Advisory Committee on Immunization Practice (ACIP), which is responsible for recommending immunizations to the Centers for Disease Control and Prevention. The administration claimed that this move aligned with the president’s “Restoring Gold Standard Science” executive order and ensured that new ACIP members would be guided by the most credible science.
Fact: Inconsistent and misleading public health guidance about vaccines is increasing confusion and undermining care.
Vaccination is central to maternal and child health. Vaccines during pregnancy protect infants, and evidence shows that maternal vaccination reduces infant hospitalizations for respiratory syncytial virus (RSV) by 80 percent. They also protect pregnant people from serious illness.
It’s therefore catastrophic that the federal government continues to use false claims and conspiracy theories instead of scientific evidence to guide federal immunization policy. When HHS Secretary Robert F. Kennedy Jr. fired all members of the ACIP last year and replaced them with vaccine skeptics, he did so under the guise of what the administration has called restoring “gold standard science.” The new committee removed recommendations for the Hepatitis B birth dose and the COVID-19 vaccine for pregnant people and children. A federal judge recently blocked parts of these changes and the appointment of new ACIP members, but the injunction may only be a temporary solution. In the meantime, these actions have raised concerns about medical misinformation, insurance coverage, and trust in vaccine guidance.
The unscientific nature of vaccine messaging has been widespread, including unfounded links the administration has made between vaccines and autism and warnings about Tylenol use in pregnancy. For example, the CDC’s Autism and Vaccines page now states that the claim “vaccines do not cause autism” is not “evidence-based.” Also, in 2025, President Trump told pregnant women to avoid using Tylenol during pregnancy because it would increase their children’s risk of autism. High-quality research continues to debunk this claim, but the damage has been done. In the months following the President’s claims, emergency room orders among pregnant patients for Tylenol went down by 10 percent.
Inconsistent public health messaging undoubtedly has contributed to the worst U.S. measles outbreak in decades and declining public confidence in federal health leadership. Less than half of Americans report confidence in RFK Jr. and Dr. Mehmet Oz, the administrator of the Centers for Medicare and Medicaid Services, to provide trustworthy public health information. And they should be. When it comes to maternal and child health, inconsistent health messaging is not merely an inconvenience. It shapes real-world decisions about vaccination and preventive care that are critical for our families’ well-being.
Myth #5: Fewer Americans on SNAP means families are reclaiming freedom from government assistance.
Example: On X/Twitter, the U.S. Department of Agriculture Secretary, Brooke Rollins, said that declining SNAP participation means Americans are reclaiming their “freedom.”
Fact: SNAP participation has declined not because of reduced need, but because of reduced access to the program and restrictions on what food can be purchased.
Over the past year, 3.3 million fewer people have participated in SNAP. Most alarmingly, Arizona recently reported a 47-percent drop in program participation. This decline includes over 180,000 children losing food assistance.
The U.S. Department of Agriculture Secretary, Brooke Rollins, says that declining participation means Americans are reclaiming their “freedom” and no longer need support purchasing food. In reality, part of this decline coincides with HR 1 administrative changes to the program that restrict eligibility and increase administrative costs for states to run the program, which forces them to turn assistance away from those who need it. Between HR 1’s enactment in July 2025 and December 2025, 2.5 million fewer people participated in SNAP. Declining participation may also be fueled by a decline in trust in the program after families lost benefits during the November 2025 government shutdown.
Restrictions on SNAP benefits have also limited what families can purchase. Increasing families’ financial resources to buy food would actually help them experience “freedom.” Instead, these restrictions only fuel stigma at grocery store check-out lines and keep people hungry as food prices soar.
In practice, framing reduced participation in food programs as “freedom” obscures the reality that many families are simply losing access to critical nutrition support.
Families Need Care Based on Fact, Not Fiction
Recent federal actions are making it harder for families to keep their health insurance, afford care, and put food on the table. While framed as efficiency, freedom, and scientific integrity, these health policies are creating more barriers at a time when families already feel stretched thin by everyday costs. For maternal and child health, the consequences of these policies are clear: delayed care, higher-risk pregnancies, and worse health outcomes for parents and babies.
Tags: Reproductive Health Care, maternal heatlh, health care affordability, family planning
Myths, Facts, and What’s at Stake When It Comes to Federal Maternal and Child Health Policy
Since January 2025, the Trump administration and Congress have advanced a series of policies that are wreaking havoc on our health care systems, and will be especially damaging for maternal and child health. These include nearly $1 trillion in Medicaid cuts over the next decade, the program that covers 40 percent of U.S. births; drastic changes to the Supplemental Nutrition Assistance Program (SNAP); hamstringing the approval and roll-out of immunizations; and making maternal and reproductive care less comprehensive.
The narratives that accompany these policies are grossly misleading: SNAP reductions mean “freedom,” Medicaid cuts eliminate “fraud, waste, and abuse,” vaccine changes “restore gold-standard science.” In practice, these actions have throttled individuals’ health coverage, access to care, and nutrition support, and make our families less healthy.
It’s critical that we don’t take the messaging about these policy changes at face value. With maternal and infant mortality still high, the stakes remain as high as ever. In this commentary, we’ll take a closer look at five of these claims, evaluate their veracity, and describe the related policies’ true consequences.
Myth #1: The administration is making healthcare more affordable.
Example: The president’s “Great Healthcare Plan” promises to slash drug prices, give Americans money directly to buy their own healthcare, and hold insurance companies accountable for putting profits over patients.
Fact: The number of Americans who are losing or can’t afford coverage is skyrocketing because of HR 1.
Last year’s budget reconciliation bill (HR 1) made deep cuts to Medicaid and failed to extend the Affordable Care Act (ACA) subsidies that helped 22 million Americans afford health insurance last year. The law also imposes Medicaid work requirements that are making it harder for Americans to maintain coverage. Together, these policies are already rapidly reducing enrollment: 1 million fewer people have signed up for healthcare plans this cycle because they’re too expensive, and 3.4 million more people are expected to lose insurance in 2026 alone.
The administration has said that HR 1 reforms will protect Medicaid for every eligible American, and that eliminating waste, fraud, and abuse will improve effectiveness and program integrity. However, evidence consistently shows that work requirements create administrative barriers that lead to coverage loss among otherwise eligible people, and not to increased employment.
The discrepancy will not go unnoticed, because healthcare affordability is a top concern for Americans. Sixty-one percent report they think about healthcare “a great deal” and more than 82 million have made tradeoffs like stretching medications, skipping meals, or cutting back on utilities to afford care. Americans are also drowning in care-related debt: one in three households carry medical debt, and new mothers are twice as likely to be in medical debt compared to young women who have not given birth.
Myth #2: The healthcare system remains stable and accessible.
Example: When asked about large spending cuts prior to HR 1’s passing, the president said that he would “love and cherish Social Security, Medicaid, and Medicare… they won’t touch the programs unless they find waste and fraud… and people will not be affected.” Ross Vought, director of the Office of Management and Budget, reaffirmed that the bill would not make poorer Americans worse off.
Fact: As a result of HR 1, new administrative and financial burdens on state and local healthcare systems are reducing access to healthcare overall and to essential maternal healthcare in particular.
States are facing higher costs to implement federal Medicaid changes, straining their budgets, and limiting investments in maternal health. Montana was planning to reimburse doulas in its Medicaid program—an evidence-based intervention that has been shown to improve maternal health outcomes, particularly for Black women—but postponed it due to budget constraints linked to shrinking federal funding. While the state has now reversed this decision and their Medicaid program will pay for doula care after all, this service (along with other optional maternal health services) are still at risk of being cut later on.
Rural health systems are especially affected, and hospitals are under financial pressure now that their Medicaid funding has been so significantly reduced. Medicaid spending in rural areas is projected to decrease by $137 billion over ten years, and 1.5 million rural Medicaid beneficiaries are expected to lose coverage. Because Medicaid finances nearly half of U.S. births, coverage losses mean delayed prenatal care, increased risk during pregnancy, and worse outcomes for both parents and babies. When hospitals absorb financial losses, labor and delivery (L&D) units are often cut first: more than 130 L&D units have closed nationwide, including twenty-nine closures in 2025 alone.
As these closures accelerate, patients will be forced to travel farther or forgo care entirely. This will also worsen existing and create new maternity care deserts. For an increasing number of us, even if we have coverage, we might not have anywhere remotely nearby to go for care.
Myth #3: The administration’s reproductive health policies are solely about protecting life.
Example: The administration has framed its reproductive health agenda as protecting life, including an executive order, “Enforcing the Hyde Amendment,” which states that federal policy should end the use of taxpayer dollars to “fund or promote elective abortion.”
Fact: Restricting access to preventive and abortion care damages the quality and safety of pregnancy and birthing care as well.
The administration has renewed enforcement of the Hyde Amendment, which prohibits the use of federal funds for abortion care, framing it as a policy to protect life and strengthen families. However, wherever one places one’s values in the life–choice debate, it’s important to know that the consequences of these actions extend beyond banning abortion and erode the quality and safety of reproductive and preventive healthcare as a whole.
The Title X program, which served more than two million low-income Americans in 2023, is proposed for elimination in the president’s Fiscal Year 2027 Budget Request, and in the meantime has been redirected away from contraception and preventive care toward fertility. New guidance from the Department of Health and Human Services (HHS) encourages clinics to prioritize fertility education and restorative reproductive medicine. The administration also recently launched Moms.gov, a federal website framed as supporting mothers and “unexpected pregnancies” through fertility, parenting, and pregnancy-related resources. Expanding access to fertility care is critical, especially for Black women, who have less access to it. However, since federal funding determines which services clinics are able to offer, the reorientation of the program is likely to reduce access to abortion, contraception, and other preventive services because these do not align with the administration’s priorities.
All reproductive healthcare is foundational to maternal health. Contraception, abortion, mifepristone, preconception care, and other family planning services support healthy pregnancy spacing, prevent maternal mortality, and manage miscarriage (including if in vitro fertilization treatment fails and results in early pregnancy loss). It is no surprise that states with the most restrictions on abortion continue to have high rates of maternal death and worse maternal and child health outcomes. Limiting access to holistic reproductive health services weakens the entire continuum of care before, during, and after pregnancy.
Myth #4: The administration’s focus on “restoring gold-standard science” to vaccine policy will improve health outcomes.
Example: Last summer, HHS Secretary Robert F. Kennedy, Jr. fired all members of the Advisory Committee on Immunization Practice (ACIP), which is responsible for recommending immunizations to the Centers for Disease Control and Prevention. The administration claimed that this move aligned with the president’s “Restoring Gold Standard Science” executive order and ensured that new ACIP members would be guided by the most credible science.
Fact: Inconsistent and misleading public health guidance about vaccines is increasing confusion and undermining care.
Vaccination is central to maternal and child health. Vaccines during pregnancy protect infants, and evidence shows that maternal vaccination reduces infant hospitalizations for respiratory syncytial virus (RSV) by 80 percent. They also protect pregnant people from serious illness.
It’s therefore catastrophic that the federal government continues to use false claims and conspiracy theories instead of scientific evidence to guide federal immunization policy. When HHS Secretary Robert F. Kennedy Jr. fired all members of the ACIP last year and replaced them with vaccine skeptics, he did so under the guise of what the administration has called restoring “gold standard science.” The new committee removed recommendations for the Hepatitis B birth dose and the COVID-19 vaccine for pregnant people and children. A federal judge recently blocked parts of these changes and the appointment of new ACIP members, but the injunction may only be a temporary solution. In the meantime, these actions have raised concerns about medical misinformation, insurance coverage, and trust in vaccine guidance.
The unscientific nature of vaccine messaging has been widespread, including unfounded links the administration has made between vaccines and autism and warnings about Tylenol use in pregnancy. For example, the CDC’s Autism and Vaccines page now states that the claim “vaccines do not cause autism” is not “evidence-based.” Also, in 2025, President Trump told pregnant women to avoid using Tylenol during pregnancy because it would increase their children’s risk of autism. High-quality research continues to debunk this claim, but the damage has been done. In the months following the President’s claims, emergency room orders among pregnant patients for Tylenol went down by 10 percent.
Inconsistent public health messaging undoubtedly has contributed to the worst U.S. measles outbreak in decades and declining public confidence in federal health leadership. Less than half of Americans report confidence in RFK Jr. and Dr. Mehmet Oz, the administrator of the Centers for Medicare and Medicaid Services, to provide trustworthy public health information. And they should be. When it comes to maternal and child health, inconsistent health messaging is not merely an inconvenience. It shapes real-world decisions about vaccination and preventive care that are critical for our families’ well-being.
Myth #5: Fewer Americans on SNAP means families are reclaiming freedom from government assistance.
Example: On X/Twitter, the U.S. Department of Agriculture Secretary, Brooke Rollins, said that declining SNAP participation means Americans are reclaiming their “freedom.”
Fact: SNAP participation has declined not because of reduced need, but because of reduced access to the program and restrictions on what food can be purchased.
Over the past year, 3.3 million fewer people have participated in SNAP. Most alarmingly, Arizona recently reported a 47-percent drop in program participation. This decline includes over 180,000 children losing food assistance.
The U.S. Department of Agriculture Secretary, Brooke Rollins, says that declining participation means Americans are reclaiming their “freedom” and no longer need support purchasing food. In reality, part of this decline coincides with HR 1 administrative changes to the program that restrict eligibility and increase administrative costs for states to run the program, which forces them to turn assistance away from those who need it. Between HR 1’s enactment in July 2025 and December 2025, 2.5 million fewer people participated in SNAP. Declining participation may also be fueled by a decline in trust in the program after families lost benefits during the November 2025 government shutdown.
Restrictions on SNAP benefits have also limited what families can purchase. Increasing families’ financial resources to buy food would actually help them experience “freedom.” Instead, these restrictions only fuel stigma at grocery store check-out lines and keep people hungry as food prices soar.
In practice, framing reduced participation in food programs as “freedom” obscures the reality that many families are simply losing access to critical nutrition support.
Families Need Care Based on Fact, Not Fiction
Recent federal actions are making it harder for families to keep their health insurance, afford care, and put food on the table. While framed as efficiency, freedom, and scientific integrity, these health policies are creating more barriers at a time when families already feel stretched thin by everyday costs. For maternal and child health, the consequences of these policies are clear: delayed care, higher-risk pregnancies, and worse health outcomes for parents and babies.
Tags: Reproductive Health Care, maternal heatlh, health care affordability, family planning