Donald Trump’s return to the White House stands to significantly shape the health of Californians — the foods they eat, the medicines they take, the costs they face and more.
Reproductive Rights
While Trump has publicly claimed credit for being able to “kill” Roe vs. Wade through his Supreme Court appointments, he’s been harder to pin down on his plans for abortion in a second term. He has said on social media that he wants to leave the matter up to the states, and favors exceptions for rape, incest or life-threatening pregnancies.
With a state constitution that names abortion as a fundamental right, California has some of the strongest reproductive healthcare protections in the U.S.
Yet the administration could attempt to restrict abortion in the state by limiting access to mifepristone, one of the most common drugs used in medication-induced abortions. Conservative groups have been trying to get courts to withdraw the FDA’s approval for the drug.
More than 60% of abortions in the U.S. are induced with medication, according to the Guttmacher Institute, a research group that supports abortion rights.
Project 2025 suggests limiting access to mifepristone by reviving a 19th century law called the Comstock Act that prohibits sending abortion-causing agents by mail. Though both Trump and Vice President-elect JD Vance said during the campaign that they would not enforce it, Vance was among 40 Republican lawmakers who signed a letter last year asking the Department of Justice to do just that.
Vaccines
Public health experts have been alarmed by Trump’s embrace of Kennedy, who dismisses overwhelming evidence that vaccines are safe. A recent study estimated that a federal program to help pay for childhood immunizations against diseases such as measles, polio and rotavirus has prevented more than 1 million deaths and 32 million hospitalizations since its inception in 1994.
This week, Kennedy said he wouldn’t take vaccines away from anyone who wanted them. “People can make individual assessments about whether that product is going to be good for them,” he told NBC News.
Trump himself said he would cut federal funding to schools with vaccine mandates. His campaign said he was talking about COVID-19 vaccines in particular, but as a candidate, he repeatedly made the pledge without clarifying that. California requires elementary and secondary school students to be immunized against a range of diseases unless they have a medical exemption; the COVID-19 shot is recommended but not mandatory.
Gender-Affirming Care
California law requires health plans and insurers licensed by the state to provide transgender enrollees with medically necessary gender-affirming care. It also aims to protect doctors from laws that criminalize such care in other states.
But access to gender-affirming care could still be undermined by federal action. Trump said he would press Congress to block the use of federal funds for gender-affirming care, a position also reflected in the Republican Party platform.
A prohibition could be modeled on the decades-old Hyde Amendment, which prevents federal funds from being used to pay for abortions, or tied to appropriations bills, said Julianna S. Gonen, director of federal policy for the National Center for Lesbian Rights.
Medicaid
In his first term, Trump proposed changes that would reduce federal spending on Medicaid. Trump has promised to spare Medicare and Social Security, but that could make Medicaid a target if spending cuts are needed, some public health experts believe.
“Medicaid would definitely be on the chopping block,” said Edwin Park, a research professor at Georgetown University’s McCourt School of Public Policy.
Cuts in Washington could force California to either pony up more money or shrink existing programs. California has relied on its own dollars to expand its Medicaid program, known as Medi-Cal, to cover people regardless of their immigration status, said John Baackes, chief executive of L.A. Care, the largest publicly operated health plan in the country.
Nutrition and Food Safety
After Kennedy dropped out of the race and endorsed Trump, the former president seemed eager to delegate responsibility for food policy to his new ally, telling supporters last month that “I’m gonna let him go wild on the food.”
Kennedy told NBC that he would work to remove chemical additives from foods that are banned in Europe but still allowed in the U.S. Some of those substances, including red dye No. 3, will become illegal in California in 2027 under a law signed by Gov. Gavin Newsom last year.
Kennedy said he would eliminate the FDA departments tasked with assessing the safety of food ingredients because they are not “doing their job.” It’s not clear if Trump would go along with that.
The Affordable Care Act
Trump tried unsuccessfully to roll back the Affordable Care Act during his first term. This time around, Trump has said he would only replace the landmark law if a better plan were devised.
Vance raised the idea of dividing up “risk pools,” which are used to share medical costs and calculate insurance premiums. Critics cautioned that doing so could drive up rates for elderly people with chronic conditions.
Conclusion
The Trump administration’s return to power poses significant threats to the health and well-being of Californians. From reproductive rights to vaccine policy, Medicaid, nutrition and food safety, and the Affordable Care Act, there are numerous areas where the administration could make changes that would have far-reaching impacts on the state’s residents.
California officials and advocates are likely to push back against these changes, but the state’s ability to do so will depend on its own resources and the willingness of the federal government to compromise.
FAQs
Q: What are the potential impacts of Trump’s return to power on reproductive rights in California?
A: Trump has publicly claimed credit for being able to “kill” Roe vs. Wade through his Supreme Court appointments, and has said he wants to leave the matter up to the states. This could lead to restrictions on abortion access in California, including limiting access to mifepristone.
Q: How might Trump’s administration affect vaccine policy in California?
A: Trump has publicly questioned the safety of vaccines, and has said he would cut federal funding to schools with vaccine mandates. This could lead to a decrease in vaccination rates in California, particularly among low-income communities and communities of color.
Q: What are the potential impacts of Trump’s administration on Medicaid in California?
A: Trump has proposed changes that would reduce federal spending on Medicaid, which could lead to cuts in California’s Medicaid program, Medi-Cal. This could have significant impacts on low-income families and individuals who rely on the program for healthcare coverage.
Q: How might Trump’s administration affect nutrition and food safety in California?
A: Trump has publicly questioned the safety of food additives, and has said he would work to remove chemical additives from foods that are banned in Europe but still allowed in the U.S. This could lead to changes in food labeling and safety regulations in California.
Q: What are the potential impacts of Trump’s administration on the Affordable Care Act in California?
A: Trump has said he would only replace the Affordable Care Act if a better plan were devised. This could lead to changes in the law that would impact Californians who rely on the program for healthcare coverage, including those who purchase insurance through the state’s exchange, Covered California.
