Many Americans say the health care system is sick. Experts worry it's not getting better.

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This article has been updated.

In a little more than 100 days, the Trump administration has brought unprecedented changes to federal support of the U.S. health care system, sparking turmoil and confusion, medical experts say.The Trump administration calls its sweeping changes a "critical course correction" to the way the nation delivers health care.

"This is not just policy ‒ it’s a revolution in public health," Department of Health and Human Services Secretary Robert F. Kennedy Jr. said in an April 29 statement touting the administration's accomplishments.

On the administration's list of accomplishments: a new commission to end childhood chronic diseases, a review of infant formula safety, an investigation into the causes of autism and an effort to reduce animal testing. HHS also plans to review whether fluoride is safe to add to drinking water, despite decades of evidence that it supports dental health and poses no substantial risks.

But some people on the front lines of the health care system – doctors and nurses, researchers, advocates and local officials – criticize the rapid-fire overhaul as "reckless" and say it will cost dollars and lives.

More than 70% of Americans said the health care system isn't meeting their needs in some way, according to a 2023 poll.

Yet some in the medical community fear an array of policy changes may make matters worse. Expected cuts to Medicaid and other programs could mean the loss of of health care benefits and prevention programs for the neediest. Tariffs are expected to push up drug prices, some experts worry. Critical research trials have been canceled midstream, and Trump's proposed fiscal year 2026 budget calls for a 37% cut to the National Institutes of Health.

Already announced cuts to the country's research infrastructure will trigger roughly $16 billion in economic losses and 68,000 jobs nationwide, according to the Science & Community Impacts Mapping Project (SCIMaP), which has mapped the economic impact of the cuts on every county in America.

"These are reckless, thoughtless cuts that will only make American communities less healthy and less safe," Dr. Richard Besser, president and CEO of the nonprofit Robert Wood Johnson Foundation, said in a statement. "They are systematically and cruelly dismantling our nation’s public health system and workforce, which threatens the health and wellbeing of everyone in America."

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Drug prices may come down ‒ or may not

Trump has criticized former President Joe Biden's plan for slowly lowering the price of select, popular medications. On April 15, he announced his own drug price reduction proposal in an executive order.

Some medical experts say it's not yet clear how Trump's plan will work in practice.

"Some of these proposed reforms could assist patients struggling with high drug prices; others would face significant legal and practical obstacles; and still others might even increase drug prices," Rachel Sachs, a former senior adviser at the HHS, wrote in a recent article in Health Affairs.

While Trump's initial round of tariffs left pharmaceuticals exempt, many of the raw materials that go into drugmaking are expected to increase in price, making it harder and more expensive to get these ingredients.

"There are clearly going to be tariffs that impact pharmaceutical supply chains," Tom Kraus, of the American Society of Health-System Pharmacists, which represents hospital pharmacists, previously told Paste BN. Generic drugs − which account for the vast majority of prescriptions − have small profit margins and are more likely to feel the financial squeeze from tariffs, he said.

But in a win for the administration, which aims to bring manufacturing back to the United States, drugmaker Roche announced on April 21 that it would invest $50 billion in building new manufacturing capacity, creating 12,000 jobs across five states.

Planned cuts to Medicaid

Across the country, local officials and low-income Americans are preparing for dramatic cuts to Medicaid, which serves 78 million low-income and disabled Americans and is funded with a combination of federal and state dollars.

Any cuts will have a ripple effect across the country, public health experts and health care advocates said, and even conservatives like Laura Loomer have advised against chopping Medicaid because of the expected political fallout from Trump supporters.

Trump has repeatedly promised he wouldn't touch Social Security or Medicare, but cutting Medicaid will harm the same people who receive those programs, Amber Christ, a managing director at the advocacy group Justice in Aging, said in a recent webinar. Roughly 30% of Medicaid spending supports Medicare enrollees, she said.

"Without Medicaid financial assistance, seniors could not afford Medicare," she said.

In Omaha, Nebraska, more than one-third of all children and nearly 1 in 5 of all residents receive Medicaid funding, according to the advocacy group FamiliesUSA. Medicaid also covers 5 in 9 nursing home residents in Nebraska.

Families in the Omaha metro area are already struggling to pay for their health care bills, FamiliesUSA found, with 18% saying they have trouble paying medical bills.

In a little-noticed move, the federal workers who determine eligibility limits for Medicaid have all been laid off, said Manat Singh, executive director of the Colorado Consumer Health Initiative, an advocacy group.

"Everything that makes all of the work we do function is getting cut, dismantled, gutted, defunded, moved around, and it's hard enough for those of us who work on this every day to figure out what's going on," she said in a recent webinar.

Cutting back on lead testing

All of the Centers for Disease Control and Prevention's staff involved in testing for lead poisoning in children have been eliminated, as have many grants for that purpose.

The city of Milwaukee, for example, was relying on expertise from the federal CDC to help it address a growing problem of older elementary school students with lead poisoning, said Dr. Michael Totoraitis, the city's health commissioner.

Milwaukee has lost $5 million in federal health care funding so far, including a grant to reduce health care disparities, wastewater testing for infectious diseases and support in addressing childhood lead poisoning.

Totoraitis' staff was working with CDC officials to develop a long-term plan for helping older children with lead poisoning. But the entire childhood lead team at the CDC was cut on April 3, and his city's request for help addressing lead poisoning was denied, he said in a Big Cities Health Coalition webinar.

"Children are getting hurt, life expectancy is declining," he said. "We are handcuffed in our ability to help our own residents because the federal government had been helping us for decades with all these fights and currently is unresponsive to our needs."

Emphasizing chronic diseases

Kennedy has said he wants to put more public emphasis on addressing chronic diseases, particularly those in childhood.

Marlene Schwartz, who directs the Rudd Center for Food Policy & Health at the University of Connecticut, said she's thrilled the administration is interested in trying to prevent diet-related chronic diseases.

Kennedy has promised a complete overhaul of the school lunch program, but so far, she's worried the only concrete change has been to cut a $1 billion Biden plan to buy local fresh foods for schools, child care centers and food banks.

Kids typically eat healthier at school than at home, Schwartz said. Research has shown school meals are helping to reduce childhood obesity, and the plan also would have benefited local farmers, she said.

"I hope that the administration reconsiders and puts that program back into place," Schwartz said, "because I do think that it's very consistent with the goals of the administration to really improve children's diets."

Cutting back on vaccinations and infectious disease spending

Government support for vaccines and disease prevention has seen a major reversal under Kennedy. The Trump administration has ended financial support for wastewater screening, which allowed communities like Milwaukee to track the spread of COVID-19, along with flu and RSV. It also has delayed approval for updated and improved COVID-19 vaccines, cut research funding for other dangerous coronaviruses that might appear in the future and ended spending on long COVID.

As the largest and deadliest measles outbreak in years rages in western Texas, Dallas County had to cancel more than 50 free measles vaccine clinics. Dr. Philip Huang, the health director in the county that includes the city of Dallas, said his department has had to lay off 21 staff members who conduct those clinics.

No one in Dallas County has so far come down with measles in the outbreak, though two adjacent counties have had cases. "If we get more people opting out and not vaccinated, this is what we start seeing," Huang said.

The federal cutbacks have cost his department four out of its 30 epidemiologists, making it harder to investigate possible cases of measles, which are happening more often because of the state's outbreak, he said.

Eliminating prevention programs "is very short-sighted and crazy," Huang said. "If you're trying to be efficient, it makes absolutely no sense."

Cuts to basic research and future treatments

Between the end of February and the end of April, 700 federal research grants were cut, totaling $1.8 billion, according to a new study in the Journal of the American Medical Association.

Those cuts affected 210 institutions, both public and private, all across the country ‒ not just the elite schools that have been the focus of political and media attention, said co-author Kushal Kadakia.

One in five of those grants had been awarded to early career researchers, said Kadakai, who graduates from Harvard Medical School in a few weeks and is heading into a medical residency program.

"We're hopeful that any health research priority or policy for the United States is always seeking to advance the next generation of researchers," he said. "It'll remain to be seen whether these cuts are a temporary blip or it becomes the new policy, or what it looks like for long-term sustainability for career researchers in the United States."

Contributed: Ken Alltucker, Adrianna Rodriguez

(This story was updated to add new information.)