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Some Republican senators, it seems, have begun to fret that Robert F. Kennedy Jr. was not being entirely honest when he sought their votes to confirm him as secretary of Health and Human Services. Back in January, Kennedy reassured lawmaker after lawmaker that he would not limit access to vaccines. But today, before the Senate Finance Committee, he aggressively defended anti-vaccine talking points, alarming Democrats and Republicans alike. “You promised to uphold the highest standards for vaccines,” Senator John Barrasso of Wyoming, a Republican, told Kennedy today. “Since then, I’ve grown deeply concerned.”

Today’s hearing was always going to be tumultuous. Although the panel was pitched as an opportunity to hear about President Donald Trump’s health-care agenda, it was a rare opportunity for senators to publicly question the secretary about his recent attacks on the U.S. vaccination system. In the past 200 days, Kennedy has terminated mRNA-research grants, stuffed a CDC advisory panel with anti-vaccine activists, and propped up unproven treatments during a deadly measles outbreak. Last week, he pushed out CDC Director Susan Monarez, whom senators had confirmed to her position less than a month prior. Lawmakers, understandably, were displeased. In today’s hearing, Kennedy claimed that Monarez had told him that she was untrustworthy after taking the job, to which Republican Senator Thom Tillis replied, “I would suggest in the interview you ask them if they’re truthful, rather than four weeks after we took the time of the U.S. Senate to confirm the person.”

All the while, Kennedy has insisted that these actions haven’t harmed the United States’ vaccination system. At today’s hearing, Senator Bill Cassidy said he had heard from a fellow doctor that the Trump administration’s recent decision to narrow eligibility for COVID vaccines was causing confusion. CVS, acting on the CDC’s recommendations, is now requiring prescriptions for COVID shots in certain areas of the country, and stopped offering them in a few states at least temporarily. Walgreens appears to have a similar policy. “I would say, effectively, we are denying people vaccine,” Cassidy said. Kennedy replied to him: “You’re wrong.”

That curt response was cordial compared with how Kennedy addressed several Democratic senators who had similar questions. Just a few minutes after shooting down Cassidy’s concerns, he was yelling at Democratic Senator Maggie Hassan of New Hampshire for alleging that people who want COVID vaccines are being denied them because of the Trump administration’s actions. “Everybody can get the vaccine. You’re just making things up. You’re making things up to scare people, and it’s a lie,” Kennedy told her. Kennedy also defended his previous concerns about the COVID shots, citing the risk that some people who get the shot may develop a potentially deadly inflammation of the heart known as myocarditis. (That risk is real, but very small.) He told Senator Michael Bennett that he agreed with Retsef Levi, whom he’d elevated to the CDC’s vaccine-advisory panel earlier this year, who has claimed that “evidence is mounting and indisputable that MRNA vaccines cause serious harm including death, especially among young people.” After Bennett said that he was lying, Kennedy shouted back: “Are you saying the mRNA vaccine has never been associated with myocarditis or pericarditis in teenagers? Is that what you’re trying to tell us?” (“Secretary Kennedy was debunking false claims and reminding everyone that the COVID-19 vaccine continues to be available to anyone who chooses it,” an HHS spokesperson told me in an email.)

[Read: RFK Jr.’s victory lap]

Kennedy is a longtime anti-vaccine activist who has made a career out of going after corporations and politicians. On his path to becoming health secretary, however, he showed only glimpses of this combative side. During his confirmation hearing, for example, he accused Bernie Sanders of corruption because of campaign donations that Sanders had allegedly received from pharmaceutical companies. (According to Sanders, the donations were small and came from pharma employees.) But on the issue of vaccines, Kennedy previously seemed eager to avoid a fight. When Cassidy outlined during Kennedy’s confirmation hearing the numerous studies disproving a link between vaccines and autism, Kennedy responded, “You show me those scientific studies, and you and I can meet about it.” Today, one of the few lawmakers Kennedy seemed content to sit back and listen to was Ron Johnson, arguably the most anti-vaccine member of the Senate. Kennedy nodded as Johnson laid out his case for why he believes that COVID vaccines are associated with thousands of deaths. (In fact, Johnson is basing his claim on a government database where anyone can report a potential side effect from a vaccine, which is not meant to demonstrate a causal link between the vaccine and death.)

This sort of aggression from a Cabinet secretary could seem like political suicide. The lawmakers Kennedy was chiding not only have the power to investigate his work at HHS; they also control the funds he needs to keep his agency running. But Congress has never removed a Cabinet secretary from office. And even if some Republican senators are starting to raise concerns, one very prominent Republican still seems to remain in Kennedy’s corner. Earlier this week, Trump questioned the value of COVID vaccines and the massive effort that his first administration orchestrated to bring them quickly to the public in 2020. “I hope OPERATION WARP SPEED was as ‘BRILLIANT’ as many say it was,” he wrote on Truth Social. “If not, we all want to know about it, and why???”

As Kennedy grows bolder in his attacks, Trump has been his greatest enabler. Trump achieved the rapid delivery of vaccines during the pandemic with Operation Warp Speed, yet he seems to be happily cheering Kennedy on in dismantling that legacy. He might share Kennedy’s views, or perhaps he sees the pitfalls of dismissing a secretary who has some of the highest favorability ratings in the Cabinet. Even recent speculation that Kennedy plans to run for president in 2028 failed to generate a public rebuke from Trump. (Kennedy has since denied that he’s running.) At least for the time being, Kennedy looks invincible. He knows it.

This spring, months before the recent dramatic departures from the CDC, Robert F. Kennedy Jr. battled with the agency’s scientists during the very first public-health crisis of his tenure as health secretary. As measles tore through a remote community in West Texas, Kennedy waffled on the vaccine and promoted alternative remedies, such as vitamin A. So the CDC pushed back. Demetre Daskalakis, who resigned last week as the CDC’s director of the National Center for Immunization and Respiratory Diseases, told me that the agency deliberately rebutted Kennedy by publishing a fact sheet, noting that vitamin A had been found to be effective against measles in countries that, unlike the United States, have high rates of vitamin-A deficiency. “We had to put up that PDF to subtly counter it, because providers were like, What the hell is actually happening?” Daskalakis said.

Since then, it’s become clear that Kennedy has prevailed. In June, he fired all the members of the CDC’s vaccine-advisory committee and replaced them with a cast that includes contrarians, anti-vaccine activists, and conspiracy theorists. Last week, Kennedy pushed out the CDC’s director after less than a month on the job, and three senior leaders, including the chief medical officer, resigned in protest. Today, reports emerged that Kennedy wishes to pull the Pfizer and Moderna COVID vaccines from the U.S. market, and that he plans to install more fringe figures on the vaccine committee ahead of its meeting on September 18. (HHS and the White House have maintained that Kennedy is basing policy on sound science. HHS did not respond to my request for comment.)

Kennedy appears to be taking a victory lap. In an op-ed published yesterday in The Wall Street Journal, the health secretary excoriated the CDC he took over as dysfunctional and politicized. Now, he argues, thanks to his leadership, the CDC is on the right track. As evidence, he cited its response to the measles outbreak, which claimed the lives of two unvaccinated girls who were members of the same Mennonite church. “When measles flared this year in Texas, we brought vaccines, therapeutics and resources to the epicenter. The outbreak ended quickly, proving the CDC can act swiftly with precision when guided by science and freed from ideology,” Kennedy wrote. “That response was neither ‘pro-vax’ nor ‘antivax.’ It wasn’t distracted by ‘equity outcomes’ or politically correct language like ‘pregnant people.’ It was effective.”

Much of that is misleading. Far from ending quickly, the outbreak in West Texas lasted from January to August and fed a measles surge that spread to 41 states—the country’s worst since 1992. The CDC documented 1,431 cases nationwide, though health officials say many of those who contracted measles were never tested and therefore weren’t counted. More than 100 children and teenagers were hospitalized. As for the “swift” response, although the CDC did send researchers to the area in early March after the first death, a recent story published by KFF Health News documents early confusion and silence from the federal government. On February 5, the public-health director in Lubbock, Texas, wrote in an email, “My staff feels like we are out here all alone.”

Yesterday’s op-ed isn’t the first time Kennedy has downplayed the outbreak’s severity. During a White House Cabinet meeting in February, Kennedy said that what was happening in West Texas was “not unusual,” even though a 6-year-old girl, Kayley Fehr, had already died, the first such death in the United States in a decade. He also claimed that those who were hospitalized were there “mainly for quarantine.” In fact, a hospital official later said, no one had been quarantined; children were being hospitalized because they were seriously ill.

Kennedy also undermined the CDC’s vaccination efforts by offering mixed messages about the measles vaccine and promoting unproven alternative treatments. After casting the decision to vaccinate as a “personal one” in March, he seemed to modify his stance, noting accurately that “the most effective way to prevent the spread of measles is the MMR vaccine.” But as I reported in April, when Kennedy went to Seminole for the funeral of a second girl, 8-year-old Daisy Hildebrand, he said at a gathering after her service “You don’t know what’s in the vaccine anymore,” according to her father. (HHS would not confirm this at the time.) Kennedy also referred to two doctors in West Texas who he said favored unproven measles treatments, such as cod-liver oil and an inhaled steroid, as “extraordinary healers.” In his Wall Street Journal op-ed, Kennedy wrote that the CDC sent “therapeutics”—evidently his term for treatments such as vitamin A, steroids, and antibiotics—to Seminole to combat the virus. But as my colleague Nicholas Florko wrote back in March, none of those treatments was requested by health-care providers in Texas—or delivered by the CDC. Yesterday, a spokesperson for the state’s health department confirmed to me that the CDC sent only vaccines. In late March, Covenant Children’s Hospital, in nearby Lubbock, reported treating a small number of unvaccinated children with measles who were also suffering from vitamin-A toxicity.

I visited Seminole during the outbreak and spoke with the families of the two children who’d died, along with others in their close-knit Mennonite community. I saw how public-health officials struggled to persuade a community suspicious of the vaccine to line up for shots. Many residents of Seminole echoed Kennedy’s anti-vaccine message, even as their children fell ill or awaited burial. Now fewer scientists in senior positions are left at the CDC to issue fact sheets, encourage visits to disease-stricken communities, and otherwise curb Kennedy’s worst anti-vaccine impulses.

Derrick Hiebert had planned to stick it out at FEMA. He was an assistant administrator working on hazard mitigation—he specialized in getting communities prepared for disasters—and like many emergency-management experts I’ve spoken with, he thinks that the American approach to administering disasters needed an overhaul, even a radical one. The systems had gotten “clunky over time,” he said. Something needed to change. So Hiebert was open to seeing how President Donald Trump might change it.

Then the Trump administration canceled a major grant-making program that helped states and towns build infrastructure to weather future storms and fires—a core mission of Hiebert’s department. (Last month, a judge temporarily blocked the administration from reallocating its funds.) Some FEMA leaders had been fired, and contract renewals for a substantial number of his on-the-ground employees were in jeopardy. Doing his job would only get harder, if not impossible, he thought. Hiebert also found out his wife was expecting twins. They already had two children, and suddenly the risk that his own role or perhaps his whole agency could be erased at any time looked more personally threatening. “If something happened and I were fired, with twins we would be destitute,” he told me. He left FEMA in June and took a job in disaster contracting, at AECOM, a main player in the sector.

The AECOM job paid better, Hiebert told me, but more attractive was its security. Whatever FEMA’s exact fate under Trump, disasters will still happen. Since many states lack their own cadre of emergency-management expertise or manpower, they will likely pay private contractors to step in where the federal government has stepped out. And many will be staffed by former federal employees.

Right now, the federal government’s expertise in disasters is essentially transferring to private companies. Hiebert estimates that between one-third and one-half of his colleagues in FEMA hazard-mitigation leadership have taken private-sector jobs, or will soon. Marion McFadden, who oversaw disaster grants at the Department of Housing and Urban Development during the Biden administration, told me that many of the HUD executives she worked with are moving to the private sector. She herself is now a vice president at the emergency-management contractor IEM, and knows of multiple contractors who have been preparing for an influx of business by hiring disaster-readiness corps. These would be “the exact same people who formerly worked directly for FEMA,” she said.

The path from government emergency management to disaster consulting is well trod: Former FEMA administrators and state emergency-management heads have gone on to lead consulting firms, and companies such as AECOM and IEM stock their ranks with former government employees. But the disaster managers and experts I spoke with said the current exodus from the public to the private sector is unique in its scope. “It’s a period like I’ve never seen before in the opportunity to hire experienced folks,” Bryan Koon, the CEO of IEM, told me.

The Trump administration says its aim in shrinking or possibly dissolving FEMA is to push more responsibility for disasters onto the states. This strategy is an inversion of what led President Jimmy Carter to create the agency in 1979: Governors, frustrated by the lack of a coordinating agency for disasters, requested it. Having 50 state agencies ready to respond to relatively rare catastrophes is inefficient; a federal disaster agency would have the advantages of standardized protocols, experience, and staff who can be deployed where needed. Now they may be largely on their own again. And most states, lacking their own cadre of expertise or manpower, will need support to fill in the gaps left by the federal government. States might lean on each other more than they already do, but they will surely also turn more to private contractors, many of which will now be staffed by former federal employees.

Private contractors already play a significant role in disaster recovery. A storm victim arriving at a disaster-recovery center might speak with a private consultant working alongside federal, state, or nonprofit personnel. Contractors are regularly hired to clear debris, do welfare checks, and complete damage assessments. Sometimes FEMA hires contractors directly, but states and cities hire them too—often to help make sense of the labyrinthine financial-assistance process for disasters.

This, many experts both in and outside of government agree, is part of the problem that needs fixing. Grants for recovery come from “30 different federal-government agencies that fund 91 different recovery programs,” Brock Long, a former head of FEMA under the first Trump administration, told me. Long works in private disaster contracting now too, as the executive chairman of Hagerty Consulting, and he said that, after getting billions of dollars promised by the federal government, “most local leaders look like deer in a headlights”—they “have no idea what they’re entitled to, how to seek the money, or use it within all of the rules and stipulations.” That’s where firms like his come in. The grant process also often involves lawyers, and years-long fights in which states try to recoup disaster funds from the feds. “Right now it takes a team of lawyers to get a claim through. That’s why I have a job. It’s insane,” Danielle Aymond, a lawyer at the firm Baker Donelson and former executive counsel for Louisiana’s emergency-management office, told me.

Fundamentally, the disaster consultants I spoke with felt that they were helping people at some of their worst moments. They tended to view their private-sector work as akin to the work they did in government: “A lot of us still see ourselves as public servants,” Hiebert said.

Still, for-profit companies can come with their own complications. Horne LLP, a consulting company awarded an $81 million contract this year to work on North Carolina’s Hurricane Helene recovery, was recently barred from receiving government contracts in West Virginia for “wanton indifference” to public interest after prosecutors alleged that the company falsified applicant information and filed fake invoices while working for the federal government. (The company denied wrongdoing and settled.) Federal-government auditors eventually found that, in Texas, after Hurricanes Dolly and Ike, disaster consultants were charging exorbitant rates for their services. In Louisiana after Hurricane Katrina, the government spent nearly $9 billion on contracts later understood to be plagued by “waste, fraud, mismanagement, or abuse.”

Already, finding out what governments do with the money they get for disaster response is difficult, Madison Sloan, a lawyer who directs a disaster-recovery project at Texas Appleseed, an advocacy organization, told me; she worries that adding in more contractors would make tracking spending impossible. Plus, unshackled from federal civil-rights obligations, states may not work as hard to distribute assistance equitably, DeeDee Bennett Gayle, the chair of the University at Albany’s emergency-management department, told me. “The challenges that existed before will likely increase.” The Trump administration has done away, for example, with civil rights and fair-housing obligations previously required for recipients of post-disaster housing grants from a major HUD program. In the absence of such restrictions, “some states are going to create rules that unfairly treat certain groups,” Andrew Rumbach, a senior fellow at the nonprofit Urban Institute, told me. And however good their intentions, contractors will be working for the state. “They don’t have a public-good mission. They’re doing the work that they’re contracted for,” he said.

Many emergency-management experts do agree that more of the burden of disaster risk needs to shift back onto states; FEMA, as it stands now, is trying to do too much. How exactly the Trump administration will reform the agency is still unclear: Trump has said he will end FEMA, but his administration also recently announced it is getting the agency “back on track.” Its employees and former administrators beg to differ: Last week, just before the 20th anniversary of Hurricane Katrina’s landfall, almost 200 FEMA employees signed a letter warning Congress that the agency was at risk of another failure on the same order. Jennifer Forester, a FEMA employee who signed her name to the letter and was, along with her fellow signatories, subsequently put on leave, told me that, although private companies are part of the mix of disaster response, they are no replacement for government, which “is not and should not be motivated by meeting a bottom line,” she said. The president’s FEMA-review council is supposed to make recommendations about the agency’s fate by November. “FEMA’s outsized role created a bloated bureaucracy that disincentivized state investment in their own resilience,” the White House spokesperson Abigail Jackson wrote in a statement; the review council’s recommendations would help ensure the agency’s work “remains supplemental and appropriate to the scale of disaster.” A FEMA spokesperson said in a statement that the council would “strengthen how assistance is delivered.”

One very real possibility is that the country will simply spend less on disaster preparation and recovery in the years to come. Koon, the IEM executive, is hiring some departing FEMA folks, but told me uncertainty over how or whether the Trump administration will fund states’ disaster recoveries has kept him from hiring more. Disasters will keep getting worse and more frequent, “so there’s plenty of work that will need to be done,” he said. But without FEMA and other federal agencies to step in when their budgets fall short, state and local leaders will ask themselves whether they can afford to or whether they wish to offer the full suite of disaster work that the federal government once did. Financial assistance, housing assistance, and disaster-care management may shrink, Koon said. So his contracts may too.

At present, most states maintain a rainy-day fund, but few have enough saved to manage a disaster. Small states can be overwhelmed by a disaster that leaves a few million dollars’s worth of damage; Eric Forand, the director of Vermont’s division of emergency management, told me that damage from flooding in 2023 ran to $600 million statewide. Floods have pummeled the state every summer since: This year, flooding in Sutton, home to fewer than 1,000 people, ran to 25 times the town’s annual road budget, he said. The state has pre-disaster agreements with some private contractors but, depending on what happens to FEMA, could need to lean on the private sector more. “We can’t increase and decrease the size of our permanent staff” as disasters come and go, Forand said.

As summer floods increase with climate change, Vermont has been working toward altering its budget so it can manage more of its smaller disasters on its own. But private contracting is expensive, and no matter how the state contorts itself, “there will always be a place for FEMA and the federal government for large disasters,” Forand told me. The cost and personnel demands of a major disaster will always far outstrip Vermont’s capacity to pay for and staff one, as they would outstrip the capacity of many states. Disaster recovery in every state is already a long, hard, imperfect road. If FEMA stops stepping in after catastrophic events, Hiebert told me, “I think you’d see a lot of places that would just never recover.” Disaster contractors will undoubtedly step in more, but only as much as a state can pay.

In February 2010, Michelle Obama launched “Let’s Move!” with a wide-ranging plan to curb childhood obesity. The campaign took aim at processed foods, flagged concerns about sugary drinks, and called for children to spend more time playing outside and less time staring at screens. The campaign was roundly skewered by conservatives. Fox News pundits such as Glenn Beck and Sean Hannity portrayed Let’s Move as a nanny-state plot to control the American diet, a slippery slope to the criminalization of french fries.

Those ideas might sound familiar. Today, conservatives have embraced the same goals as Let’s Move as part of the Trump administration’s “Make America Healthy Again” agenda. Health Secretary Robert F. Kennedy Jr. is essentially rerunning Obama’s playbook—and, in one key way, has taken it a step further. “They did something we were hesitant to do, which is to identify the food industry as the root cause of the problem,” Jerold Mande, a health official at the U.S. Department of Agriculture during the Obama administration, told me. But the strategy that Kennedy’s HHS is using to address the problem so far—pressuring food companies to alter their products instead of introducing new regulations—is the same one that Obama relied on, and will likely fall short for the same reason hers did a decade ago.

The problem that Let’s Move meant to solve—approximately one in three children was overweight or obese—was serious, but the vibe was cool-mom fun. In a video that launched the campaign, the first lady admitted that, along with lots of other busy parents, she sometimes defaulted to less-healthy options such as pizza when feeding her two daughters. Her mission was twofold: encourage Americans to think a little more about their diets while pushing the food industry to make the task somewhat less onerous. To that end, Obama leaned on the power of celebrity. She slow danced with Big Bird in a grocery store, ate an apple with LeBron James at the White House, and enlisted Beyoncé to lead a cafeteria full of kids in the Dougie.

Her approach to food companies was friendly, and they promised to do their part. In 2011, Walmart, the nation’s largest grocer, committed to removing 10 percent of sugar and 25 percent of sodium from its store brands—and to working with other brands they carried to reach those levels—by 2015. Darden Restaurants, which owns Olive Garden and LongHorn Steakhouse, among other chains, pledged to reduce calories and sodium in its restaurants by 20 percent over the following decade. The first lady showed up at an Olive Garden to praise Darden, and the company put out a press release touting its “comprehensive health and wellness commitment.” The announcements seemed to signal that, thanks to Let’s Move, major companies were taking seriously the role they play in public health rather than merely engineering their offerings to be ever more irresistible. Maybe a gentle nudge was all America needed to shift its food environment for the better.

But as the architects of Let’s Move learned, handshake deals don’t carry the same weight as regulatory oversight. Today, for example, Olive Garden’s signature “Tour of Italy” dish has 3,200 milligrams of sodium—more than double what the American Heart Association considers an optimal daily amount for adults. When I got in touch with Darden Restaurants recently and asked about the 20 percent pledge, a spokesperson couldn’t locate any details about whether progress had been made and said in an email that the officials who were involved with the pledge are no longer with the company. (Michelle Obama didn’t respond to interview requests made via the Obama Foundation.)

[Read: A ‘MAHA box’ might be coming to your doorstep]

Other commitments were at least partially met. A spokesperson for Walmart told me in an email that, according to its most recent analysis, done in 2017, the company had reduced sugar by more than 10 percent and sodium by 18 percent—though only in its store brands. A consortium of 16 food companies including ConAgra, Coca-Cola, and Unilever fulfilled a pledge to remove 1.5 trillion calories from the food they sell, according to a 2014 post from the Let’s Move executive director.

Even these relative successes did not make much difference. For one, total-calorie sales can be a misleading metric; when ConAgra and its peers made their pledge, the industry’s total-calorie sales were trending down anyway, likely due in part to the Great Recession and shrinkflation. The companies also treated all calories as if they were equal, whether they came from Pringles or peas. The consortium’s pledge “provided the appearance of progress when there wasn’t any,” Kelly Brownell, a director emeritus of the World Food Policy Center at Duke University, told me. As for Let’s Move, he said it “didn’t address the heart of what is driving the poor diet in America, which is food-industry actions.” Today, Americans consume roughly the same amount of sodium as they did in 2013. Debra Eschmeyer, the former executive director of Let’s Move, maintains that the campaign made progress, such as successfully prompting McDonald’s to include apple slices in every Happy Meal. But she also acknowledges that the marketplace tends to determine what’s on shelves and menus. “What’s going to change corporations the most is what consumers are buying,” she told me.

Eschmeyer said that she’s been heartened by MAHA’s momentum. In fact, Kennedy has arguably already had more success than Obama in shifting consumer demand. As my colleague Yasmin Tayag has written, corporations have been MAHA-washing their products to highlight those free of artificial dyes, high-fructose corn syrup, and seed oils. General Mills and Kraft Heinz have said they will remove synthetic dyes from all of their products, and Mars Wrigley announced it will offer some dye-free alternatives. The companies’ press releases point to “evolving consumer needs” and continuing an “innovation journey” as motivation for the changes, but these moves were clearly a win for Kennedy, who considers the dyes “poisonous.”

[Read: The MAHA trend in groceries will backfire]

If Let’s Move was defined by the gentle nudges of a cool mom, the MAHA approach, on its surface, takes the stance of a stern dad. Kennedy has portrayed the food industry as callous and predatory, saying that companies “mass poison American children” and “could care less about the health of the American people.” He’s condemned the “attack on whole milk and cheese and yogurt” and insisted that ultra-processed food is a “genocide on the American Indian.” Compared with Let’s Move’s easygoing recommendations—children should get at least one hour of physical activity each day, and everyone should drink one more glass of water—MAHA is also considerably more macho. The Obama administration replaced the Presidential Fitness Test with the less competitive Presidential Youth Fitness Program; today, the White House is bringing the fitness test back, and Kennedy and Defense Secretary Pete Hegseth recently rolled out the “Pete and Bobby Challenge,” in which you try to do 100 push-ups and 50 pull-ups in less than 10 minutes. The 71-year-old Kennedy—who takes testosterone as part of what he calls an “anti-aging protocol” and has been known to peel off his shirt while working out in public—noted in an interview that he was able to reach that mark in fewer than six minutes.

This display exposes the campaign’s braggadocio. Finishing the Pete and Bobby Challenge would be next to impossible for all but the most dedicated gym rats, whereas the health department’s own physical-activity guidelines suggest that everyday tasks, such as carrying groceries upstairs and shoveling snow, can qualify as vigorous exercise, and they don’t require a timer or a gym membership. Asking ordinary Americans to perform grueling feats of strength is unlikely to make a dent in the obesity rate, no matter how tough the talk.

Similarly, most of MAHA’s flashiest food initiatives aren’t supported by good science, and would do little to improve health. Kennedy and his allies have demonized seed oils and fluoride (despite a dearth of evidence of their harms), insisted that cane sugar is healthier than high-fructose corn syrup (a claim that nutrition experts generally reject), and promoted raw milk (which the FDA has long warned can contain disease-causing bacteria). The evidence connecting excess salt and sugar to poor health is much stronger than that regarding food dyes. Kennedy, Eschmeyer told me, would do well to “stay evidence-based and not to get distracted by an overly simplistic focus on individual ingredients.”

[Read: The giant asterisk to MAHA’s food-dye crackdown]

Ezekiel Emanuel, who was a health-care adviser to Barack Obama, has been critical of Kennedy’s anti-vaccine views and worries that the movement’s fondness for supplements of dubious merit could be a distraction. Still, Emanuel believes MAHA’s focus on chronic illness that’s caused by obesity is “100 percent right” and that, so far, “we haven’t approached the problem as if it were a major national threat.” Both Emanuel and Mande, the former USDA official, told me that they’re withholding judgment until MAHA manages to secure more significant concessions from the food industry. Rhetoric, as they’ve learned from experience, doesn’t necessarily translate into meaningful reform.

Despite that rhetoric, Kennedy, like Michelle Obama was, can be friendly with food companies that please him. He has treated handshake promises as genuine advances and firms that make gestures toward his preferences as real allies. After Steak ’n Shake switched to cooking with beef tallow, announcing on X that the company’s fries would now be “RFK’d,” the secretary nibbled on fries with Hannity at one of its Florida locations. Perhaps Kennedy’s fondness for fries will allay worries that they’ll be banned this time around.

The White House’s AI Action Plan, released in July, mentions “health care” only three times. But it is one of the most consequential health policies of the second Trump administration. Its sweeping ambitions for AI—rolling back safeguards, fast-tracking “private-sector-led innovation,” and banning “ideological dogmas such as DEI”—will have long-term consequences for how medicine is practiced, how public health is governed, and who gets left behind.

Already, the Trump administration has purged data from government websites, slashed funding for research on marginalized communities, and pressured government researchers to restrict or retract work that contradicts political ideology. These actions aren’t just symbolic—they shape what gets measured, who gets studied, and which findings get published. Now, those same constraints are moving into the development of AI itself. Under the administration’s policies, developers have a clear incentive to make design choices or pick data sets that won’t provoke political scrutiny.

These signals are shaping the AI systems that will guide medical decision making for decades to come. The accumulation of technical choices that follows—encoded in algorithms, embedded in protocols, and scaled across millions of patients—will cement the particular biases of this moment in time into medicine’s future. And history has shown that once bias is encoded into clinical tools, even obvious harms can take decades to undo—if they’re undone at all.

AI tools were permeating every corner of medicine before the action plan was released: assisting radiologists, processing insurance claims, even communicating on behalf of overworked providers. They’re also being used to fast-track the discovery of new cancer therapies and antibiotics, while advancing precision medicine that helps providers tailor treatments to individual patients. Two-thirds of physicians used AI in 2024—a 78 percent jump from the year prior. Soon, not using AI to help determine diagnoses or treatments could be seen as malpractice.

At the same time, AI’s promise for medicine is limited by the technology’s shortcomings. One health-care AI model confidently hallucinated a nonexistent body part. Another may make doctors’ procedural skills worse. Providers are demanding stronger regulatory oversight of AI tools, and some patients are hesitant to have AI analyze their data.

The stated goal of the Trump administration’s AI Action Plan is to preserve American supremacy in the global AI arms race. But the plan also prompts developers of leading-edge AI models to make products free from “ideological bias” and “designed to pursue objective truth rather than social engineering agendas.” This guidance is murky enough that developers must interpret vague ideological cues, then quietly calibrate what their models can say, show, or even learn to avoid crossing a line that’s never clearly drawn.

Some medical tools incorporate large language models such as ChatGPT. But many AI tools are bespoke and proprietary and rely on narrower sets of medical data. Given how this administration has aimed to restrict data collection at the Department of Health and Human Services and ensure that those data conform to its ideas about gender and race, any health tools developed under Donald Trump’s AI action plan may face pressure to rely on training data that reflects similar principles. (In response to a request for comment, a White House official said in an email that the AI plan and the president’s executive order on scientific integrity together ensure that “scientists in the government use only objective, verifiable data and criteria in scientific decision making and when building and contracting for AI,” and that future clinical tools are “not limited by the political or ideological bias of the day.”)

Models don’t invent the world they govern; they depend on and reflect the data we feed them. That’s what every research scientist learns early on: garbage in, garbage out. And if governments narrow what counts as legitimate health data and research as AI models are built into medical practice, the blind spots won’t just persist; they’ll compound and calcify into the standards of care.

In the United States, gaps in data have already limited the perspective of AI tools. During the first years of COVID, data on race and ethnicity were frequently missing from death and vaccination reports. A review of data sets fed to AI models used during the pandemic found similarly poor representation. Cleaning up these gaps is difficult and expensive—but it’s the best way to ensure the algorithms don’t indelibly incorporate existing inequities into clinical code. After years of advocacy and investment, the U.S. had finally begun to close long-standing gaps in how we track health and who gets counted.

But over the past several months, that type of fragile progress has been deliberately rolled back. At times, CDC web pages have been rewritten to reflect ideology, not epidemiology. The National Institutes of Health halted funding for projects it labeled as “DEI”—despite never defining what that actually includes. Robert F. Kennedy Jr. has made noise about letting NIH scientists publish only in government-run journals, and demanded the retraction of a rigorous study, published in the Annals of Internal Medicine, that found no link between aluminum and autism. (Kennedy has promoted the opposite idea: that such vaccine ingredients are a cause of autism.) And a recent executive order gives political appointees control over research grants, including the power to cancel those that don’t “advance the President’s policy priorities.” Selective erasure of data is becoming the foundation for future health decisions.

American medicine has seen the consequences of building on such a shaky foundation before. Day-to-day practice has long relied on clinical tools that confuse race with biology. Lung-function testing used race corrections derived from slavery-era plantation medicine, leading to widespread underdiagnosis of serious lung disease in Black patients. In 2023, the American Thoracic Society urged the use of a race-neutral approach, yet adoption is uneven, with many labs and devices still defaulting to race-based settings. A kidney-function test used race coefficients that delayed specialty referrals and transplant eligibility. An obstetric calculator factored in race and ethnicity in ways that increased unnecessary Cesarean sections among Black and Hispanic women.

Once race-based adjustments are baked into software defaults, clinical guidelines, and training, they persist—quietly and predictably—for years. Even now, dozens of flawed decision-making tools that rely on outdated assumptions remain in daily use. Medical devices tell a similar story. Pulse oximeters can miss dangerously low oxygen levels in darker-skinned patients. During the COVID pandemic, those readings fed into hospital-triage algorithms—leading to disparities in treatment and trust. Once flawed metrics get embedded into “objective” tools, bias becomes practice, then policy.

When people in power define which data matter and the outputs are unchallenged, the outcomes can be disastrous. In the early 20th century, the founders of modern statistics—Francis Galton, Ronald Fisher, and Karl Pearson—were also architects of the eugenics movement. Galton, who coined the term eugenics, pioneered correlation and regression and used these tools to argue that traits like intelligence and morality were heritable and should be managed through selective breeding. Fisher, often hailed as the “father of modern statistics,” was an active leader in the U.K.’s Eugenics Society and backed its policy of “voluntary” sterilization of those deemed “feeble-minded.” Pearson, creator of the p-value and chi-squared tests, founded the Annals of Eugenics journal and deployed statistical analysis to argue that Jewish immigrants would become a “parasitic race.”

For each of these men—and the broader medical and public-health community that supported the eugenics movement—the veneer of data objectivity helped transform prejudice into policy. In the 1927 case Buck v. Bell, the Supreme Court codified their ideas when it upheld compulsory sterilization in the name of public health. That decision has never been formally overturned.

Many AI proponents argue concerns of bias are overblown. They’ll note that bias has been fretted over for years, and to some extent, they’re right: Bias was always present in AI models, but its effects were more limited—in part because the systems themselves were narrowly deployed. Until recently, the number of AI tools used in medicine was small, and most operated at the margins of health care, not at its core. What’s different now is the speed and the scale of AI’s expansion into this field, at the same time the Trump administration is dismantling guardrails for regulating AI and shaping these models’ future.

Human providers are biased, too, of course. Researchers have found that women’s medical concerns are dismissed more often than men’s, and some white medical students falsely believe Black patients have thicker skin or feel less pain. Human bias and AI bias alike can be addressed through training, transparency, and accountability, but the path for the latter requires accounting for both human fallibility and that of the technology itself. Technical fixes exist—reweighing data, retraining models, and bias audits—but they’re often narrow and opaque. Many advanced AI models—especially large language models—are functionally black boxes: Using them means feeding information in and waiting for outputs. When biases are produced in the computational process, the people who depend on that process are left unaware of when or how they were introduced. That opacity fuels a bias feedback loop: AI amplifies what we put in, then shapes what we take away, leaving humans more biased for having trusted it.

A “move fast and break things” rollout of AI in health care, especially when based on already biased data sets, will encode similar assumptions into models that are enigmatic and self-reinforcing. By the time anyone recognizes the flaws, they won’t just be baked into a formula; they’ll be indelibly built into the infrastructure of care.

Every year, there is a single day when summer turns to fall. In 2025, on the Gregorian calendar, this day is September 22. On the pumpkin-spice calendar, it was Tuesday, when Starbucks reintroduced its legendary latte. (For Dunkin’ loyalists, fall began on August 20.)

Pumpkin spice, as fans and haters alike will tell you, is not simply a flavor. It is a state of mind. You might imagine that, by now, our national appetite would be sated. You would be incorrect. This year, among other innovations, we will be graced with pumpkin-spice-dipped waffle cones, pumpkin-spice protein shakes, and pumpkin-spice spreadable cheese. That there are still products left to pumpkin spice-ify is a testament to human ingenuity. You can already find pumpkin-spice yogurt, pumpkin-spice almonds, pumpkin-spice graham-cracker Goldfish, and pumpkin-spice fig bars. There is pumpkin-spice bacon and pumpkin-spice cottage cheese. For the seed oil–conscious, there is pumpkin-spice avocado oil.

But just as the Pumpkin-Spice Industrial Complex whirs into action, as it does every August, there is a new threat. On Wednesday, the Trump administration imposed 50 percent tariffs on imports from India. This might be just another episode in Donald Trump’s ongoing trade war, except that India is a major exporter of spices: among them, cinnamon, nutmeg, and cloves. Together, along with allspice and ginger, these form the backbone of the pumpkin-spice mix. Like so many other goods, pumpkin spice—the taste, smell, and spirit of fall—might get more expensive. Just how much do Americans love it? We’re about to find out.

The timing is spectacularly inopportune. Long after Starbucks unleashed the pumpkin-spice latte upon America in 2003, it was easy to dismiss pumpkin spice as a trend. The nature of the world is that people get tired of things and move on. There was a period when everyone lost their mind over the concept of roasted brussels sprouts, but then they discovered cauliflower.

Instead, pumpkin spice only continued to rise. It became a personality. Pumpkin spice was a 20-something white girl in Ugg boots who kept a Pinterest board to catalog ideas about her future wedding, distilled into a single flavor. It became so popular that its very popularity inspired a backlash. Disliking pumpkin spice, if you did it very loudly, became a shorthand to indicate you had discerning taste. Anthony Bourdain hated it. John Oliver railed against it. Facebook communities sprang up to spread the gospel of revulsion. It was offensive precisely because it was so aggressively benign.

[Read: How Starbucks perfected autumn]

But pumpkin spice just keeps winning. Many people who might have once looked down on pumpkin spice, or slurped in secret, now “just embrace it,” Diana Kelter, the director of consumer trends at Mintel, North America, told me. Pumpkin spice has become so omnipresent that it no longer says all that much about you. Oh, you’re the kind of person who likes air? You’re one of those water drinkers? “It’s, like, beyond big,” Leigh O’Donnell, a consumer-insights analyst at Kantar, a market-research firm, told me. Over Zoom, she showed me a graph of consumer transactions involving pumpkin-flavored and pumpkin-spice-flavored things. The figures aren’t skyrocketing, but each year shows results higher than the one before. “Freight train,” she said, gesturing at the chart. “Ain’t no slowing down.”

The scope and scale of pumpkin spice—pumpkin-spice air freshener! pumpkin-spice dog treats!—only mean the tariffs could hurt more. Don’t expect major changes immediately. At Starbucks, a PSL costs the same as last year, a spokesperson told me: $5.75 to $7.25 for a grande, depending on the location. (Dunkin’ did not respond to my request for comment.) For now, there will still be plenty of pumpkin spice: pumpkin-spice crackers, pumpkin-spice bone broth, pumpkin-spice oat milk. (While Trader Joe’s will not be offering any pumpkin-spice hummus, that is only because it was discontinued in 2023.) This autumn’s pumpkin-spice products were almost certainly made with cinnamon, nutmeg, and cloves that were imported before this week’s tariffs. (There are also the seemingly unlimited possibilities of artificial flavoring.)

Eventually, though, America’s pumpkin-spice fix will become more expensive. It might happen sooner rather than later. Sana Javeri Kadri, the founder and CEO of Diaspora Co., a spice company that imports exclusively from India and Sri Lanka, anticipates that she’ll have no choice but to raise prices: A tin of Diaspora Co. pumpkin spice that now goes for $13 might soon be $14.50. “Everybody’s in the same boat right now, in that we’re fucked,” she told me. Even companies that likely have back stock and source spices from lots of countries—Indonesia, China, Vietnam, Mexico—are bracing: On an earnings call this summer, the spice goliath McCormick, which sources globally, predicted that tariffs could cost the company $90 million a year.

Imported spices, of course, won’t be the only reason the cost of a cozy autumn could go up. Your PSL might be served in a paper cup that is now more expensive because of tariffs, and the coffee is certainly imported; the foil top of your pumpkin-spice-yogurt container might have been made from aluminum that was imported and taxed. Americans are already beginning to feel the weight of the tariffs, and prices are poised to rise on all kinds of products. It’s another way that pumpkin spice is not special. Economically, as culturally, it is like everything else.

If a trade war doesn’t blunt America’s appetite for pumpkin spice, it’s hard to see what will. You could read its sheer dominance as a symptom of cultural collapse—evidence that everyone is simple now; that criticism, like punk, is dead. But unlike the current churn of trends that seemingly arise whole-cloth from nowhere—Dubai chocolate? Labubus? Lafufus?—pumpkin spice is staunchly rooted in reality. The pumpkin-spice latte was a corporate invention, but the first recipe for spiced “pompkin pie” was published in 1796. The appeal is obvious: It’s cozy; it’s nostalgic; it helps blunt the taste of coffee. Most things in the world are volatile, but not pumpkin spice. It appears each year like clockwork, reassuring us that, despite the actual weather, fall has arrived.

The Centers for Disease Control and Prevention is coming undone. The White House announced last night that it had ousted the agency’s newly sworn-in director, Susan Monarez, whose lawyers insist that she still has her job because only President Donald Trump himself can fire her. (Yes, it’s a mess.) Four top officials resigned yesterday. Two of them—Demetre Daskalakis, who was the director of the National Center for Immunization and Respiratory Diseases, and Debra Houry, who was the chief medical officer—told me that the group quit together to signal that they believe science is being ignored and that public health is in danger.

The departures leave a leadership void that, according to current and former CDC officials, has demoralized the agency’s staff and will further undermine its ability to provide reliable guidance to Americans. As Lakshmi Panagiotakopoulos, who resigned from the agency in June as co-leader of a group that advises outside experts on COVID vaccines, told me, “It feels like the CDC is over.”

I spoke with Daskalakis this morning just before he and Houry were escorted from the CDC’s Atlanta headquarters. He told me that his decision to resign was prompted by a number of factors, including “the replacement of science with ideology” and “the sidelining of scientists so that their data cannot be seen.” He also fears that important information isn’t finding its way to Health Secretary Robert F. Kennedy Jr. According to Daskalakis, no one from his center had been allowed to brief Kennedy directly on any of the issues that it covers, including polio, measles, COVID-19, and various vaccines. “I’m not sure where he’s getting his information other than Substacks that are erroneous,” he said.

A spokesperson for Health and Human Services did not respond to requests for comment. In an interview with Fox & Friends this morning, Kennedy declined to comment on personnel matters. “CDC has problems,” he said, accusing the agency of spreading “misinformation” during the coronavirus pandemic. “We need to look at the priorities of the agency, if there’s really a deeply, deeply embedded—I would say—malaise at the agency, and we need strong leadership that will go in there and that will be able to execute on President Trump’s broad ambitions.”

The CDC had already been in turmoil for months before this week’s departures. Health workers at the agency were caught up in the Trump administration’s mass government layoffs earlier this year. In June, Kennedy removed all 17 members of a respected vaccine-advisory committee and appointed eight new members, including Robert Malone, a prominent COVID-vaccine critic who believes that the United States government has “reality-bending information-control capabilities,” and Vicky Pebsworth, who, like Kennedy, has a long history of insinuating that vaccines can cause autism despite decades of high-quality studies refuting that connection. In response, CDC workers and alumni protested outside the agency’s headquarters, calling for Kennedy to resign. Then, early this month, a 30-year-old man who blamed COVID vaccines for his depression fired nearly 200 shots into the campus, killing a police officer. A letter signed by hundreds of CDC employees after the shooting objected to the “politicized rhetoric that has turned public health professionals from trusted experts into targets of villainization” and accused Kennedy of being “complicit in dismantling America’s public health infrastructure and endangering the nation’s health by repeatedly spreading inaccurate health information.” (After the shooting, Kennedy posted a statement on X in which he lamented the shooting and the officer’s death. “Public health workers show up every day with purpose—even in moments of grief and uncertainty,” he said. “We honor their service.”)

[Read: ‘I’m actually surprised it didn’t happen sooner’]

Yesterday’s attempt to remove Monarez as director was the last straw in the four officials’ decision to resign, Houry said. (Along with Houry and Daskalakis, the resignees include Daniel Jernigan, the director of the National Center for Emerging and Zoonotic Infectious Diseases, and Jennifer Layden, who oversaw the agency’s Office of Public Health Data, Surveillance, and Technology.) Houry told me that officials across the CDC were excited for Monarez to take the helm when she was confirmed last month. At the time, Kennedy praised her as a “public health expert with unimpeachable scientific credentials” and a “longtime champion of MAHA values.” (She was apparently not the administration’s first choice for the position: Before nominating Monarez, the White House withdrew the nomination of David Weldon, a physician and former congressman, over concerns that his anti-vaccine views would undermine his Senate confirmation.) Then, just weeks later, Monarez was shown the door. “When we knew that her job was in jeopardy, that we weren’t going to have scientific leadership anymore, that was the final tipping point for us,” Houry told me. “We could not stay if there was not a scientific leader at CDC.”

A statement from Monarez’s lawyers said that she had been targeted by Kennedy because she “refused to rubber-stamp unscientific, reckless directives and fire dedicated health experts.” Yesterday afternoon, a post on the Health and Human Services X account said that Monarez was “no longer director” of the agency. But Monarez’s lawyers said that, even though she had been notified by a White House staffer that she’d been fired, she believes that her termination has to come from President Trump himself. A statement from the White House spokesperson Kush Desai said that the director had been fired after “refusing to resign despite informing HHS leadership of her intent to do so.” The statement also said that Monarez is “not aligned with the President’s agenda of Making America Healthy Again.” (Monarez didn’t reply to an interview request.)

Last night and this morning, current and former CDC employees told me that many scientists who remain wonder how they will continue, and whether the agency is still dedicated to providing science-based guidance to the nation. “People are at their wit’s end, and there has been trauma after trauma after trauma,” one longtime CDC official, who asked not to be named for fear of repercussions from HHS, told me today. “I just don’t know how much more our staff can take.”

Daskalakis and Houry told me that they had stayed at the agency despite their misgivings about Kennedy’s views and concern about those he appointed to key positions. They stayed after he cast doubt on the safety of the measles vaccine amid the nation’s largest outbreak since the disease was declared eliminated in 2000. They stayed after he canceled $500 million in funding for mRNA-vaccine development. They felt that as long as they were able to put out accurate data, remaining at the CDC was worthwhile. But after Monarez’s ouster, they no longer believe that’s possible.

[Read: Why RFK Jr.’s anti-vaccine campaign is working]

They leave behind an agency that is now even more vulnerable to political interference, with fewer people standing between Kennedy and the career scientists whose work he has repeatedly maligned. Current and former officials I spoke with expect more resignations to come.

The mosquitoes and the National Guard were out, but it was otherwise a perfect day in the capital. Clear and sunny, not too hot: baseball weather. The first pitch was at about 9:30 in the morning. A player waiting in the dugout yammered “Whaddaya say, whaddaya say” before nearly every pitch. Another, after working a long at-bat and winning a walk, celebrated by turning to her teammates and tossing her bat gently toward them with both hands, palms up, like she was presenting them with a gift.

It was a regular workday, a Monday, for the rest of Washington, D.C., but inside Nationals Park, it was the final day of tryouts for the new Women’s Professional Baseball League. This will be the first of its kind since the dissolution of the All-American Girls Professional Baseball League—a wartime entertainment that gave hundreds of women the opportunity to play baseball in front of paying fans, but which fell apart in the early 1950s due to mismanagement and dwindling attendance.

More than 600 players from 10 countries, including Japan, Australia, Canada, and Venezuela—places that have fielded successful teams in the Women’s Baseball World Cup—had reported on the first day of drills and evaluation. The tryouts were led by Alex Hugo, a former player who won a silver medal with the U.S. team during the most recent World Cup and who said in a Monday press conference that the open-tryout format was designed to find “anybody that we would have missed just trying to search ourselves.” Over the weekend, women were evaluated in the batting cages, in fielding drills, and as pitchers, with cuts at the end of each day. The count had been narrowed to just more than 100 for Monday’s doubleheader of scrimmages, which was open to the public. Those who made the final cut in the tryouts will be eligible for a draft in October.

The ceremonial first pitch was thrown out by Maybelle Blair, the 98-year-old elder stateswoman of women’s baseball, who played for the AAGPBL’s Peoria Redwings and now uses a cane made out of a baseball bat. Instantly identifiable by her white bouffant and chunky sunglasses, Blair has been a celebrity for many years, and is often associated with the 1992 movie A League of Their Own, which resurfaced women’s-baseball history in popular memory. “You have no idea the fun I went through when I was playing ball and how I wish that these girls could have the same opportunity,” she said in a press conference afterward. “I never in holy, holy life figured that we would have another league of their own, and here it is.”

A few hundred were people in the stadium, many of them families with young children. Preteen girls who’d come with their parents ate stadium nachos for breakfast and cheered for players who are household names, at least in certain households—Mo’ne Davis, who, 11 years ago, was the first girl to pitch a shutout in the Little League World Series; Alli Schroder, a Canadian pitching phenom who is also a firefighter (a baseball commentator’s dream). One roaming pack of three girls and two boys ran around the stands looking for Kelsie Whitmore, the face of the new league and arguably the most famous woman baseball player in the United States. She was one of the first women to play professional baseball, in a men’s independent league in 2016, and is currently pitching for the Savannah Bananas, the Harlem Globetrotters of baseball. The (mostly male) Bananas play regular baseball, except they also dance and do tricks and comedy bits during the game (and it counts as an out when a fan catches a foul ball).

When Whitmore came up to bat, a mom and daughter seated near me cheered enthusiastically. “Do you know her?” I asked, because many in the stands were there to support family members. “Yeah, who doesn’t know her?” the mom, a New Yorker named Jennifer Montero, replied. “It’s Kelsie Whitmore.” She and her daughter, Edally, had responded to the open call for players, but Edally was only 16 and had been told to come back when she was older. They stayed for the rest of the week anyway to watch. “It’s definitely surreal,” said Edally, who works on her curveball on the weekends in Central Park and plays on her high school’s otherwise all-boys baseball team. “It gives me hope, knowing I’m not working towards nothing.”

The league will start small, with four to six teams. They will play in small ballparks predominantly in the Northeast—places with about 3,000 seats, one of the league’s co-founders, Justine Siegal, told me. These are roughly half the size of those used by lower-level Minor League teams affiliated with Major League Baseball. Still, however modest its beginning, this league is historic: Though I wrote a feature on the history of women’s baseball in the U.S. earlier this year, I was still a little surprised when Whitmore and Davis used the word integration in the press conference, pointing out that the AAGPBL had been whites-only. They’re right. The WPBL, when it starts play in the spring of 2026, will be the first-ever integrated baseball league for women in the U.S.

[From the April 2025 issue: Why aren’t women allowed to play baseball?]

When I spoke with Whitmore after the conference, she rattled off a list of things she hopes to see in the next five years. That would be a full six-month season, a full spring training, maybe a winter league to help accelerate player development. There should be high-school and college baseball for girls in order to create a pipeline of talent, and the women should have salaries that allow them to make baseball their full-time job (a common issue with women’s sports). While playing for the Savannah Bananas, she is also getting a glimpse of the further-off future. “I feel like I’m living two different dreams right now,” she said. “I’m in an environment of playing women’s professional baseball, and then, on top of it, I’m playing in front of sold-out crowds in Major League parks. So, I mean the ultimate goal is we have sold-out crowds for women’s professional baseball.”

In the meantime, she was thrilled by the few days she’d gotten to spend with women who might be her teammates next year. She told me that she feels more like herself and plays more freely “with the girls.” “They’re just a breath of fresh air,” she said. Usually, when this happens—at an international tournament or after an exhibition game—the women have no idea when their next opportunity to play together will be. With a new league on the horizon, that’s over.

What that new league will look like in practice, and how would-be fans will engage with it, is still somewhat of a mystery, but the Savannah Bananas are an interesting parallel. Their goofy theatrics are not to my personal taste, but it’s obvious people like them in part because they feel approachable in a way that Major Leaguers really can’t. During the morning game at the tryouts, players who were scheduled for the second game lounged in the stands among everyone else. At one point, I watched a girl in an Aaron Judge jersey walk up and get an autograph from a WPBL player who was just finishing a hot dog.

The casualness reminded me of a conversation I had with Kevin Baker, the author of The New York Game: Baseball and the Rise of a New City, earlier this year. We were talking about how a new women’s league might be able to differentiate itself by recapturing some of the old neighborhood spirit of baseball. The Dodgers were just guys who lived in Brooklyn; Mickey Mantle walked to work through Central Park. “Players are so much more aloof now and kind of have to be aloof; I don’t blame them for it,” he said. “But you know, when they could live among us, that was in a way more thrilling.”

That’s one of many ways in which the women’s game might be different. In the stands, I spoke with a group of four players from Vancouver who’d come to the tryouts together and offered various other practical considerations. The women’s league will use metal bats instead of wooden ones. “Realistically, we don’t hit the ball as hard or as fast as men,” Claire Eccles, a pitcher and an outfielder, told me. Metal bats will mean more hits and a faster game, which is what people generally want to see. (Though it’s a new challenge for some of the pitchers who are used to playing with men and throwing to wooden bats.)

Juliette Kladko, a pitcher and first baseman sitting next to Eccles, guessed that the average fastball at the tryouts was probably in the range of 70 to 75 miles an hour. Professional men usually throw in the mid-90s or harder, so women who have played with men their whole life have often focused more on the timing and location of their pitches, the shape of their breaking balls, and what old-timers call the “lost art” of pitching. All four of the Vancouver women had a curveball in their repertoire, and one of them, Eccles, had a knuckleball. The classic curveball is an endangered pitch in velocity-obsessed Major League Baseball, and there are currently no knuckleballers.

The WPBL could offer a looser, more familiar, backyard kind of play, even if it intends to roster elite talent. Not only may the pitching be more painterly; the pitchers will also be the batters, base runners, and defenders. Shohei Ohtani, the Dodgers’ $700 million superstar, is an anomaly and a thrilling novelty because he has continued to pitch and hit at the highest level, even after the practice went completely out of style in the age of the designated hitter. In the WPBL, that would be the norm. Most of the women have been compelled by circumstances and limited opportunities to be super–utility players, and the WPBL teams will probably not even have full-size rosters, so it will remain necessary for women to do it all.

The scrimmages I watched were a bit sloppy at times—lots of hit-by-pitches, lots of defensive errors—but they had exhilarating moments too. On a sharp, bang-bang double play, someone behind me let out a “Hoo, hoo, that was sweet.” After I watched a great play in the outfield, I chatted with two older men in the stands. One of them, Jeff Stewart, told me he’d also gone to watch the Colorado Silver Bullets, a women’s barnstorming team that played for a short time in the 1990s. He was impressed by the WPBL games, he said, and excited for the new league. Obviously, there was room for improvement, but there was a lot of potential. “You saw it!” he said. “That girl in center field just made an outstanding catch.”

The day was generally jubilant, but there was a hum of anxiety in the air. Siegal more than once made a point of saying that the league was going to be built to last and would be around, as she put it, forever. “My grandchild is going to play in this league,” she said in the press conference. Although everyone present certainly wanted that to be true, it doesn’t feel like a given. The first season of the new league will be only four weeks long, followed by a week of All-Star events and two weeks of playoffs, barely a blip on the calendar in comparison with Major League Baseball. During the four weeks of the regular season, each team will play two games a week.

Nobody expected the league to start with 162 games a year, but this seems awfully short—like the season would have hardly begun before it was over already. Montero, the mom who came with her 16-year-old, was dismayed. “Definitely it should be longer, way longer,” she said. “We’ve waited how many years?”

One of the more surreal knock-on effects of the gutting of USAID is that the U.S. government is now holding a massive fire sale for mosquito nets, water towers, printers, iPads, chairs, generators, defibrillators, textbooks, agricultural equipment, motorbikes, mobile health clinics, and more. Until recently, these items supported the 5,000-plus foreign-aid projects that the Trump administration has now canceled.

Normally, when a USAID project ends, its leftover, usable goods get methodically inventoried, then distributed to other projects or local partners who can put them to good use. This year is, quite obviously, different.

Federal and humanitarian workers have scrambled​​ to run a mass closeout before their own termination or their project’s bankruptcy, with little guidance from leadership at USAID or the State Department. The result is that millions of dollars’ worth of equipment that the United States has already purchased is being auctioned off, likely at an extreme loss, or simply abandoned. (The State Department declined to comment after repeated requests.)

Some USAID workers and local partners have managed to follow Plan A—that is, donating goods where they can be most useful—despite the fact that there are no longer any USAID-funded projects to hand equipment off to. (The State Department has assumed responsibility for the roughly 20 percent of USAID’s original projects that will continue.) A worker at one NGO that operates in Myanmar told me that her colleagues donated bed nets and medical equipment to the country’s collapsed health system after the U.S. government terminated a malaria project. (She, like many other current and former USAID workers I spoke with for this article, requested anonymity out of fear of professional reprisal.) Shumet Amdemichael, the director of the nonprofit Mercy Corps’ Nigeria programs, told me that his organization may off-load generators to local hospitals. “But if they don’t have the money for the fuel for those generators,” he said, “it won’t be very useful.” An employee at an NGO operating in Kenya told me that her organization ended up donating USAID vehicles to local technical colleges so that engineering students could pick them apart. In Nigeria, a small team orchestrated the handoff of at least 140 vehicles and 1,350 pieces of furniture and IT or office equipment, according to an internal document I reviewed earlier this summer. Former USAID officials in Nigeria told me that they believe the items went mostly to local health ministries. There is seemingly no public record of where these items, or any of USAID’s other assets, have gone.

The Trump administration, for its part, has given few straight answers on where U.S. government property overseas should go. A recent report to Congress on operations in Iraq and Syria found that “USAID staff said that much of the direction they received regarding the transition was informal in nature, often with no follow-up to document decisions taken.” In Afghanistan, the Trump administration canceled a project that ran schools in community settings—crucial for girls who, under the Taliban’s rules, can’t continue their formal education past sixth grade. (That program had continued even after the Biden administration’s withdrawal from Afghanistan.) Then it waited months to tell the nonprofit International Rescue Committee what to do with hundreds of thousands of textbooks and school-supply kits, James Sussman, an IRC spokesperson, told me. When the project was canceled in February, the books and stationery had been in a warehouse awaiting distribution, where they have since remained. The IRC also operated a network of health clinics in Afghanistan, and when that funding was terminated, several were forced to close. The organization gathered the leftover supplies—medical-examination tables, stethoscopes, gloves, measuring tapes to diagnose severely malnourished kids, fortified pastes for treating them—to restock its surviving clinics, Sherine Ibrahim, IRC’s country director in Afghanistan, told me. Legally, those items are the property of the U.S. government, which has not green-lit this redistribution, Ibrahim said. But, she added, “it is very hard for us to see nutritional support for children and say, Okay, we’re not going to use this because we are waiting for the U.S. government to tell us what to do with it.”

[Read: The actual math behind DOGE’s cuts]

When donation fails, Plan B is generally to hold an auction. In Guatemala, the U.S. embassy has auctioned off iPads, ring lights, megaphones, and defibrillators that were once the property of USAID. At least 13 lots sold for a total of about $13,600. In Nigeria, the U.S. embassy advertised the auction of the contents of a USAID warehouse, including computer supplies and used generators. Earlier this year, in a letter to two congresspeople, USAID’s acting deputy inspector general expressed concern that auctions like the ones that have now happened in multiple countries would “return only cents on the dollar.” They also come with national-security concerns. The Trump administration is not publicly tracking the bidders of any auctioned USAID goods, which could plausibly end up being a cheap source of supplies for terrorist organizations, as the acting deputy inspector general noted in her letter. USAID is also not requiring employees to bring in their electronics to be erased in person, which leaves open the possibility that sensitive information remains on devices now being sold to the highest bidder.

Some items have been stranded or even abandoned. For much of this summer, the U.S. government has reportedly paid a parking garage in Nepal 80 cents a day per vehicle to store more than 500 cars and motorbikes used in the administration’s canceled USAID projects. Lisa Schechtman, a former senior USAID adviser, told me that the Trump administration left more than 20 water and sanitation projects half-finished across the globe. Another $4 million worth of tools and equipment meant for clean-water work in Ethiopia is likely lying unused somewhere in a warehouse, Schechtman said. But as of July 4, when she left her job, senior USAID leadership didn’t seem to know where the tools were, she told me. According to a recent federal report, the status of four USAID projects in Ukraine—more than $115 million worth of work that provided food, “building materials to repair war-damaged homes,” and more—was “unknown” as of June 30.

Other aid purchased by U.S. taxpayers is simply being destroyed. The Trump administration, as I previously reported, ordered the incineration of nearly 500 tons of food meant for children in Afghanistan and Pakistan.​​ It also intends to incinerate nearly $10 million worth of contraceptives, despite offers from the United Nations to buy the items, and has wasted hundreds of thousands of mpox-vaccine doses that are now so near expiration that they can’t be shipped to the African countries experiencing an outbreak. A former senior official at a major nonprofit told me that tubes of an antibiotic ointment—used in infants to prevent an infection that can cause blindness—sat unused in Mozambique while her colleagues waited for guidance from USAID that never came. Some portion of the antibiotics expired, she said, and were ultimately destroyed. Burning the emergency food alone cost American taxpayers more than $100,000; burning the contraceptives, the State Department says, will cost $100,000 more. In June, a Bloomberg reporter obtained a memo by USAID’s deputy administrator estimating that shutting down the agency would cost the federal government $6 billion a year for an undetermined amount of time. That figure doesn’t appear to include the sunk costs of half-finished projects and now-worthless goods.

[Read: The Trump administration is about to incinerate 500 tons of emergency food]

By the federal government’s own standards, USAID’s fire sale is unacceptable. Paul Martin, USAID’s former inspector general, told me that agency staffers could normally get fired for failing to properly oversee the disposition of equipment bought with taxpayer dollars. (Martin was fired in February after his office released a report warning that USAID’s shutdown risked aid going to waste or being stolen.) A former USAID contracting officer told me that under normal closeout circumstances, if goods are hoarded or fall into the wrong hands, federal employees can “literally go to jail.” One former USAID worker I spoke with helped evacuate agency staff from Afghanistan as the Taliban took over in 2021. He told me that this year’s retreat also felt chaotic and disjointed. “There was no intellectual curiosity as to how to do it right,” he said.

The motorcycles, malaria nets, and nutritional biscuits that the U.S. is currently off-loading are the last vestiges of a pre-2025 American commitment to humanitarian aid abroad. The American pullback could result in more than 14 million additional deaths by 2030, according to a study published in The Lancet last month. Governments that previously relied on the U.S. for basic health services are urgently trying to fill the vacuum, even though many of them lack the funds to do so, especially on such short notice. Nonprofits and philanthropists are also working to blunt the impact. Whether they succeed—and how many of those 14 million people survive—depends in part on whether they have the equipment they need and, therefore, on how efficiently the Trump administration can distribute what’s left.

If you are like me, you brush your teeth—too vigorously, I’m told—with a plastic rack of plastic bristles. You use your plastic brush to lather a paste pushed from a plastic tube. When you have a cavity, you go to a dentist who might fill the hole with a plastic composite then sand it flush right there in your mouth. Say you grind your teeth at night. Your dentist might prescribe you a fitted piece of cured acrylic to grind into instead, the surface of which eventually gets visibly rough and worn. Perhaps your teeth are not very straight, so you contemplate getting aligners—thin sheets of thermoplastic that would be heated and then molded to the contours of your mouth and that you would need to wear almost constantly. The retainers you’d wear afterward to keep your newly straight teeth in place might also be plastic.

Nearly every part of modern dentistry and orthodontics involves—and is enhanced by—this remarkably useful material. In some cases, it’s part of necessary medical treatments: A cavity must be filled to prevent worse damage, and at least the plastic-glass composite filling your cavity won’t leach mercury, like the silver fillings that were more common for prior generations. But in cases that are purely aesthetic—tooth straightening can fall into this category—the trade-offs may look different.

Although many hands are wrung over the microplastics that pass from our tea bags and carpets and water bottles into our bodies, when it comes to oral health, we welcome plastic intentionally, and sometimes permanently, directly in our mouths. This troubles Adith Venugopal, an orthodontist and a senior lecturer in the Faculty of Dentistry at the University of Otago, New Zealand; he published a letter in a dental journal last year raising concerns about the micro- and nanoplastics that slough off aligners and retainers. A robust body of research links chemical compounds that leak out of plastic to hormone disruption, developmental abnormalities, and cancer, but the effect of the actual fragments of plastic accumulating in our tissues and organs is less clear. Venugopal started researching microplastics in orthodontics after seeing a paper that found patients with micro- and nanoplastics embedded in their artery plaques were more likely to have a heart attack or stroke. Plastic exposure from dentistry or orthodontics, Venugopal thinks, is ethically different than the worries over plastic exposure resulting from consumer choices. “Prescribing it from a medical standpoint, knowing that it would leach out and cause so many millions of particles to be ingested on a yearly basis, is troublesome, isn’t it?” he told me. “I mean, that’s the first thing, to do no harm.”

But what the harm of dental and orthodontic plastics might be is, as of yet, poorly understood. Venugopal’s letter is one in a growing body of statements and studies coming out of those professions that ask if plastic may be harming patients. (“Microplastics: An Orthodontic Concern!” yelped an editorial in the Journal of the World Federation of Orthodontists last year.) So far, few if any papers have looked at the issue in humans, though preliminary studies attempt to replicate aspects of mouths in a lab, by simulating wear and tear from liquid and friction. The Nordic Institute of Dental Materials has been looking into the release of microplastics from night guards. The chief scientific officer of the American Dental Association’s research arm, Ben Wu, said in a statement that the association is “closely monitoring the scientific literature on microplastics” but that “no clinical evidence currently exists showing a meaningful oral or overall health impact from the particles.” The ADA’s best current advice to patients is to monitor their plastic dental devices for cracks, roughness, or breaks, and look into a replacement. Or, Wu suggested, instead of opting for clear plastic aligners, a person could get metal braces or retainers.

The American Association of Orthodontists is taking a more proactive approach. “This is certainly something that is high in our consciousness,” Steven Siegel, the organization’s president, told me. The association recently convened a panel of researchers to look at all of the available studies to date, and has asked its awards committee to put out a call for proposals for new research in this area. It hasn’t taken an official position on microplastics, because the group, like Venugopal and the ADA, considers the available research to be “preliminary,” he said. But it believes microplastics are “an issue that we need to pay close attention to.”

Clear orthodontic aligners have become a particular focus of early research attention, given the nature of their use. “They’re supposed to be worn about 22 hours a day for optimal tooth movement,” Venugopal told me. People typically change theirs out after one or two weeks and continue that cycle for months to years. A group of Italian researchers published a paper in 2023 that found that aligners did indeed leach microplastics after seven days when exposed to artificial saliva in a lab. But Venugopal points out that the lab study couldn’t capture the onslaught of enzymes, teeth gritting, and temperature variation that a real human mouth inflicts. So he and a doctoral student are now conducting what he believes is the first real-world study of how much microplastic leaches into saliva while an actual person is wearing aligners.

There is always the alternative that the ADA pointed to: metal braces. Although these may still use a small amount of plastic adhesive to bond the equipment to the front of a wearer’s teeth, at least the plastic isn’t on the chewing surface. (This doesn’t elide concerns entirely; one paper has tried to characterize the microplastics sloughed off by orthodontic rubber bands. It may be a lot.)

In his own practice, instead of prescribing plastic retainers, which can be removed, Venugopal says he’s intentionally prescribing more fixed-wire retainers for people who would get a similar benefit from either. (Some patients would still benefit more from having thermoplastic molded ones, he said. But for those who could go either way, they’re getting metal.) “So, yes, it is affecting me as a clinician as well,” he said. If a patient were to ask him about microplastics, he would tell them what research has shown (that microplastics leak from objects such as aligners) and what it hasn’t (whether the leakage from an aligner or retainer alone poses a significant danger). “Without being informed about that, I don’t want to scare patients,” he said. Each of his patients—like everyone—is already inhaling, drinking, and eating microplastics just by living in the world.

The only way to get us out of the dental-plastic loop will be to develop different materials. A plastic-bristled toothbrush may add approximately 30 to 120 microparticles of plastic to your diet with each brushing, according to one study. Another put the estimate at an average of 39 particles a day. Either calculation suggests that a plastic toothbrush adds tens of thousands of particles to one’s yearly load of microplastics, which is significant when considering that estimates of microplastic exposure from food, air, and water put a person’s yearly particle load at more than 100,000. Nonplastic toothbrush options exist, but they’re hardly mainstream. Most dental floss is plastic, too—alternatives, such as silk floss, are mostly a health-food-store find.

Conversely, not brushing your teeth would be a dental disaster, and no one should choose not to fill a cavity. The downside of an untreated cavity almost certainly far exceeds any hypothetical harm from additional microplastic exposure. “I was at a dental meeting a couple of months back, and I bit down and I fractured two molars, old fillings,” Siegel said. “And I went to my friend who’s an excellent dentist. I didn’t hesitate to have composite restorations with the materials that we use. I put it in that context: I think that the release, if any, of some of the compounds and microplastics is probably relatively minimal.”

The same goes for mouth guards: Siegel said he wasn’t aware of any material that could take the place of my acrylic set prescribed for tooth grinding. “Whether it’s crossing the street or having a medical procedure, one always looks at the risks and benefits,” Siegel told me. “I try and limit microplastic exposure in my own life. I try not to reheat things in plastic containers. I limit processed-food intake, things like that.” But, he said, when it comes to the health of your mouth, you want to ask yourself: Do the benefits of protecting your teeth and jaw outweigh the potential risks of adding to your microplastic dose? “For me personally, if I ground my teeth, I would wear a night guard,” he said. That was a sensible assessment, I thought, even if—for now—we don’t really have the information to base that decision on. Still, I got his point. I’ll pull mine out of storage tonight.