Months before the 2026 midterm elections, major actions in the federal government’s “Make America Healthy Again” campaign are on pause.
President Donald Trump and his administration rolled out the “MAHA” initiative in early 2025, which has included a MAHA commission to mitigate chronic disease, a push to expand lifestyle medicine offerings, enhance nutrition training in medical schools, create healthier hospital food, and an inverted food pyramid emphasizing protein and high-fat dairy.
At the same time, the federal government has approved legislation to reduce federal Medicaid spending by hundreds of billions of dollars, reduced the workforces of several federal health agencies and frozen thousands of U.S.-funded scientific grants.
As of late March, the CDC is operating without an acting director, the White House’s surgeon general nominee is awaiting a confirmation decision, and federal courts have blocked several efforts from HHS Secretary Robert Kennedy Jr.
CDC leadership shakeups
The CDC has lacked a Senate-confirmed acting director since August.
The Trump administration withdrew a nominee in March 2025 and dismissed its most recent permanent director, Susan Monarez, PhD, in August after less than a month in the role.
At the time, Dr. Monarez’s lawyers said she refused to “rubber-stamp unscientific, reckless directives and fire dedicated health experts,” while the White House said Dr. Monarez was fired due to misalignment with President Trump’s MAHA agenda.
The agency’s current interim leader, National Institutes of Health Director Jay Bhattacharya, MD, PhD, is running both agencies simultaneously from separate locations. He has led the agency on an interim basis since February, and although his acting title expired March 25, he will continue overseeing the agency until a permanent director is confirmed. At a staff meeting that day, Dr. Bhattacharya acknowledged a difficult year marked by workforce reductions and low morale, and he said the president could name a nominee imminently.
Surgeon General nomination in limbo
Wellness entrepreneur and author Casey Means, MD, appeared before the Senate Health, Education, Labor and Pensions Committee in late February, nearly a year after her initial nomination. Her first scheduled hearing was canceled when she went into labor the day it was set to begin.
Senators from both parties questioned her on vaccines, her inactive medical license and potential financial conflicts of interest. She said she believes vaccines save lives but declined to directly encourage parents to vaccinate their children, framing her position around informed consent and physician-patient dialogue.
Her confirmation remains uncertain. She does not hold an active medical license and did not complete her medical residency — which would make her an unprecedented pick for a role traditionally held by clinicians with extensive practice experience.
Court blocks vaccine recommendation changes
A federal court in March temporarily blocked HHS’ January decision to scale back the number of routinely recommended childhood vaccines. The ruling also froze the appointments of Mr. Kennedy’s selections for the CDC’s vaccine advisory committee, finding that the overhaul likely violated federal administrative law.
Administration officials have moved to install a seasoned political operator as Mr. Kennedy’s deputy, with a mandate to steer HHS toward less contentious priorities ahead of the midterms, according to The Washington Post.
With court losses mounting, key nominations stalled and the CDC still without permanent leadership, the MAHA movement’s near-term direction appears unclear.
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