Monday, June 30, 2025
Opinion | How to Wreck the Nation’s Health, by the Numbers - The New York Times
How to Wreck the Nation’s Health, by the Numbers
Illustration by Javier Jaén
By Steven H. Woolf Graphics by Taylor Maggiacomo
"Dr. Woolf is a physician and a professor of family medicine and population health at Virginia Commonwealth University.
After decades as a physician studying the factors that determine our risks of getting sick and how long we live, I am convinced that the actions of the Trump administration will cost lives. Researchers like me know the data. For years we have warned that Americans have shorter life expectancies and higher disease rates than people in other high-income countries.
Now, the poor health of Americans is about to get worse.
While Robert F. Kennedy Jr., America’s health secretary, makes a spectacle of his plans to make America healthier (a laudable goal), in actuality, the administration is kneecapping the very infrastructure that would make that feasible and is instead enacting policies that will compromise health.
The Department of Health and Human Services has terminated thousands of grants, including funding for pandemic prevention, and research grants related to cancer, vaccines and chronic diseases. The loss of research funding will delay medical discoveries. Though the agency publishes a weekly list of terminated grants, the full scope of funding cancellations has been obscured, especially at the National Institutes of Health, the major funder of medical research. A database created by Harvard researchers, Grant Watch, has helped to fill in the gaps.
Grants terminated by the Department of Health and Human Services
Sources: HHS TAGGS; Grant Watch
Note: Data as of June 29.
The administration has upended the operation of almost every agency that deals with our health and medical care, leaving behind fewer staff members and programs to address critical needs, and changing policies in ways that could endanger us all. Regulations to protect health and safety are being lifted. Experts who monitor health threats have been fired. Medical schools are threatened. Congress is poised to make huge cuts to Medicaid, which would leave millions of Americans without health care coverage and force closures of health clinics, many in rural areas.
Don’t get me wrong, I am not defending the status quo. There is plenty of waste and inefficiency to fix in health care and research, and fresh approaches can help. But dismembering health agencies won’t improve efficiency. Real change comes from streamlining programs to better serve the public, not from closing programs and walking away.
The ripple effects of the havoc at health agencies will eventually reach you. The air you breathe could become more polluted because the administration is permitting factories to resume emitting toxins. Your drinking water could contain lead because the administration is closing lead abatement programs. Bacterial contamination of your food may increase since food safety workers have been fired. There may be fewer primary care doctors in your community because the administration is cutting funding for training programs. Cutting-edge treatments may be unavailable because the N.I.H. has terminated clinical trials.
Out of the 356 drugs that were approved from 2010 to 2019 ...
N.I.H. funding contributed to 354 of them, totaling $187 billion.
Only 2 were privately funded.
Source: Cleary et al., JAMA (2023)
The logic is baffling. Even though the United States faces a mental health crisis, especially among youth, the Trump administration is slashing funding for programs on mental illness, addiction, domestic violence and suicide prevention. It’s no longer offering specialized support to L.G.B.T.Q. callers to the national suicide prevention hotline, and it’s cutting nearly 600 contracts for the Department of Veterans Affairs. It canceled funding for a desperately needed program that expanded the number of mental health professionals in our children’s schools, which had won bipartisan support in Congress after the mass shooting in Uvalde, Texas. Unintentional injuries are the leading cause of death in children, but the administration has all but eliminated the injury prevention center working on efforts to prevent deaths from poisoning, car accidents and drownings.
Diseases that are preventable and rare in modern countries may now pose a threat in the United States. The measles outbreak is our first warning. Other vaccine-preventable diseases will increase if politicians like Mr. Kennedy continue to cast experts aside, roll back immunization guidelines and sow doubt about their safety.
All this under the banner of “Make America Healthy Again.” In a dangerous sleight of hand, Mr. Kennedy goes before cameras to make a big deal about food dyes and bizarre claims about autism while his department erases programs to address the nation’s leading chronic diseases. For example, smoking is the leading cause of preventable deaths in the United States. If this administration’s goal is truly to make America healthier, why has it effectively shuttered the nation’s top office on smoking? Mr. Kennedy rightly promotes the importance of healthy eating, but the administration is cutting funding for food assistance. He warns about the dangers of pesticides, but the administration is reportedly reconsidering a ban on asbestos and is moving quickly to relax other regulations meant to protect Americans from toxins.
Planned cuts by the Trump administration would defund research on the leading causes of death
| cause of death | annual deaths | primarily researched by | proposed funding cut |
|---|---|---|---|
| Heart disease | 681,000 | National Institute on Body Systems* | -39% |
| Chronic lower respiratory diseases | 145,000 | ||
| Diabetes | 95,000 | ||
| Cancer | 613,000 | National Cancer Institute | -37% |
| Stroke | 163,000 | National Institute on Neuroscience and Brain Research* | -40% |
| Alzheimer's | 114,000 | National Institute on Aging | -40% |
| Drug overdoses | 97,000 | National Institute of Behavioral Health* | -38% |
| Suicide | 49,000 | ||
| Covid, flu and pneumonia | 95,000 | National Institute of Allergy and Infectious Diseases | -36% |
Sources: HHS.gov; CDC WONDER
Note: Annual deaths as of 2023. Proposed funding cut figures are based on the difference between 2025 and 2026 budget proposals. Institutes with asterisks are proposed consolidations of existing N.I.H. institutes.
Organizations like the American Medical Association are beginning to speak out, but their comments are largely restricted to specific issues such as Medicaid or immunization guidelines. The threat to the health of Americans is larger than one issue. It’s about more than Medicaid. It’s about more than vaccines. It’s about the totality of the administration’s agenda. It’s the cumulative effects of the entire basket of policies that put Americans at greatest risk.
Physicians like me know from the data that lives will be lost as a consequence. More than 6,000 health professionals (myself included) have warned the public about their concerns in an open letter. Yet institutions of all kinds seem to be cowering to Mr. Trump, afraid of being punished or prosecuted for questioning his wishes. The administration has defied the courts and gone after law firms and universities, and is unlikely to spare medicine. Just as it has pressured the media to alter the news, the government is now challenging medical journals to alter what they publish.
Times like these call on us to speak the truth. On matters of life and death, physicians like me have an added duty to warn patients and the public. People may feel that a shakeup in Washington is long overdue. But too many Americans, including our leaders, take their health for granted, assuming that the infrastructure to prevent disease and save their lives will always be there, that America will always lead the world in science and that systems to keep their children safe will always exist. None of this can be counted on, especially now.
About this data
For this analysis, The New York Times used data from the lists of terminated grants provided by the Department of Health and Human Services, as well as a crowdsourced list of grant terminations by Grant Watch. In cases where grants could be included under several categories, grants are listed under the category corresponding to the central focus of the research."
Political Costs of Trump Tax Cuts, Medicaid and ‘Debt Slavery’ - The New York Times
Weighing the Costs of Tax Cuts, Medicaid and ‘Debt Slavery’
"As the Senate prepares to vote on a key piece of the president’s domestic agenda, prominent critics, including Elon Musk, are speaking out.
Andrew here. We’re getting down to the wire for President Trump’s big beautiful bill. Elon Musk called the bill “insane” over the weekend — yet big business seems to be behind it after a number of last-minute changes were made.
Meanwhile, some trade deals may be getting closer to done. And we’re focused on comments that Zohran Mamdani, the presumptive front-runner for New York City mayor, made over the weekend about billionaires (and his refusal to condemn the phrase “globalize the intifada”).
A crucial vote nears
Republicans are slogging toward a vote later on Monday on the Senate’s version of a major domestic policy bill that’s the linchpin of President Trump’s agenda. But the proposal’s ultimate fate appears cloudier than ever.
Among the obstacles: the Senate’s rule keeper has struck several provisions, which could torpedo crucial support by wavering lawmakers; a potential price tag that far exceeds the fiscal impact of the House’s bill; and the latest fulminations online by Elon Musk, Trump’s erstwhile ally.
The latest: Senate leadership delayed a marathon series of votes on amendments to the legislation until Monday. Republicans are forging ahead with an accounting gimmick that’s meant to get around the chamber’s longstanding rules and unilaterally declare that extending the 2017 tax cuts — estimated to cost about $3.8 trillion over a decade — would add nothing to the federal deficit.
But warning signs keep cropping up:
Even as pressure from Trump on Senator Thom Tillis over his misgivings about potential cuts to Medicaid prompted the lawmaker’s retirement, the North Carolina Republican warned his colleagues that they were about to “make a mistake on health care and betray a promise.” Tillis’s comment underscores some lawmakers’ fears that the potential Medicaid cuts could cost Republicans at the polls.
One of the latest rulings by the Senate parliamentarian struck a provision meant to benefit Alaska, to help win support from Senator Lisa Murkowski. While she voted to advance the bill out of committee, some Republicans worry that the loss of that sweetener could cost her support. The parliamentarian also rejected an effort to expand a Medicare drug price negotiation exemption for “orphan” drugs.
The nonpartisan Congressional Budget Office calculated that the Senate bill would add $3.3 trillion to the federal deficit, compared with a $2.4 trillion hit from the House’s version. That could erode support in the lower chamber — especially from the House Freedom Caucus — which must approve the Senate’s changes.
And Musk has weighed in again. Over the weekend, the billionaire — whose public denunciations of the legislation opened a rift between him and Trump — called the Senate proposal “political suicide” for Republicans and said it would “destroy millions of jobs in America.” He added that it would put the country “in the fast lane to debt slavery.”
The Tesla chief also took aim at the legislation’s proposed cuts to clean energy initiatives, calling it “a massive strategic error” that “will leave America extremely vulnerable in the future.”
That said, Musk’s earlier criticism appeared to fail in persuading House Republicans to vote against the legislation.
Will all this reignite Musk’s feud with Trump? A war of words between the two earlier this month raised the prospect of the president using his administration to attack his former ally’s businesses, many of which could be vulnerable to tougher regulation.
The men had appeared to settle their differences, with Trump telling Fox News in an interview recorded on Friday, before Musk’s latest criticisms, “I think Elon is a wonderful guy.” Trump added of their previous interaction, “he got a little bit upset, and that wasn’t appropriate.”
HERE’S WHAT’S HAPPENING
Iran could enrich uranium in “a matter of months,” a U.N. inspector says. The statement by Rafael Mariano Grossi, the head of the International Atomic Energy Agency, is at odds with President Trump’s claim that U.S. strikes had “obliterated” the country’s nuclear facilities, and more closely matches reports from European intelligence and a preliminary report by the Defense Intelligence Agency. It raises the prospect of further fighting that could unsettle energy markets.
Trump says a buyer for TikTok has emerged. He told Fox News in an interview that aired on Sunday that a “group of very wealthy people” are in the running to acquire the popular Chinese-owned video app, without identifying them. Speculation on bidders — from Amazon to a group led by Larry Ellison’s Oracle — has percolated in recent months, but a deal still hinges on approval from Beijing, which may see TikTok as leverage in trade talks.
Baidu makes a big A.I. bet. The Chinese tech behemoth plans to open-source Ernie, its large language model, CNBC reports. The move, which would make Ernie freely available to developers, could further undercut interest in closed-source proprietary models from OpenAI and Anthropic — but some that have embraced the open-source approach, such as Meta, are reconsidering.
Apple finally takes a box-office victory lap. “F1: The Movie,” starring Brad Pitt and produced by the tech giant, pulled in $144 million globally this weekend, giving the iPhone maker a sorely needed win for its Hollywood efforts after a series of theatrical duds. Still, “F1” cost Apple an estimated $350 million to make and market, meaning it still has a long way to go to be profitable.
A bullish pivot on trade
The drama in Washington over President Trump’s policy bill doesn’t seem to be fazing investors.
Global markets were edging higher on Monday amid hopes that progress is being made on trade deals ahead of next week’s deadline for some of Trump’s biggest tariffs.
The latest: Canada said it would scrap a digital services tax that had drawn the ire of Trump and tech giants and had become a flashpoint in trade talks between the countries. Last week, Trump had threatened to pull out of negotiations over the tax, which was to go into effect on Monday.
Trump suggested he can be more flexible in negotiations, telling Fox News’s Maria Bartiromo in an interview that aired on Sunday that it would be “no big deal” if he were to extend a July 9 deadline before reciprocal tariffs to kick in. (Treasury Secretary Scott Bessent suggested the same last week). But Trump added, “I don’t think I’ll need to.”
Ultimately, the president may be accepting reality, as administration officials acknowledge the difficulty in striking quick deals, Politico reports.
Market bulls are heartened. S&P 500 futures point to a solid open after Friday’s record close, with investors betting the Fed may lower borrowing costs soon to bolster a slowing economy, as consumers pull back on spending.
That puts added focus on Thursday’s jobs report. Any sign of significant cooling in the labor market could put additional pressure on the Fed.
Andrew Hollenhorst, an economist at Citi, wrote in a research note on Friday that the first cut of the year could come at the July meeting if the unemployment rate rises to around 4.5 percent, from the current 4.2 percent. The futures market on Monday morning was pricing in roughly two cuts by year-end, with the first coming in September.
Watch what Jay Powell, the Fed chair, has to say on Tuesday at the European Central Bank’s annual confab in Sintra, Portugal. The event has taken on more significance after a warning on Sunday by the Bank for International Settlements that the trade wars could reignite inflation.
There’s one more thing markets are watching: Powell and Trump. The president has been pushing Powell to cut rates or resign — an unrelenting attack on the independence of the central bank that, when combined with the deficit-expanding G.O.P. policy bill, could destabilize investor demand for U.S. financial assets, economists warn.
“I even ask them, ‘Is there anything you want me to say to prove that I’m a real human?’ ”
— Jessica Lindsey, a customer service agent for the outsourcing services provider Concentrix, on callers who question if she is actually an artificial intelligence bot. (She can’t always convince them.)
Mamdani vs. the billionaire class
As many of New York City’s business elites study ways to stop Zohran Mamdani, the democratic socialist who won the Democratic mayoral primary, he doubled down on Sunday on some of the policies that are making them nervous.
“I don’t think that we should have billionaires,” Mamdani told “Meet the Press” on NBC News. “Because frankly, it is so much money in a moment of such inequality.” He added, “I look forward to work with everyone, including billionaires, to make a city that is fairer for all of them.”
Mamdani intends to fund many of his ambitious plans — including a rent freeze and free city buses — in part by raising the corporate tax rate and income taxes for the city’s millionaires by two percentage points, and by having the city issue tens of billions in new debt. On Sunday, he said the tax increase on millionaires had “broad support.”
Further worrying some executives was Mamdani’s refusal to condemn the phrase “globalize the intifada,” though he added that he would be a mayor who “protects Jewish New Yorkers” if elected.
Some business leaders haven’t let up on their criticism. Among them is Bill Ackman, the billionaire financier who backed Andrew Cuomo in the primary and on Sunday reposted an X message “from the perspective of someone who helped @AOCwin, and now sees the light.”
Still, Mamdani on Sunday reaffirmed his commitment to his tax plans, citing benefits for the wealthiest New Yorkers, too. “The reason I want to increase these taxes on the top 1 percent, the most profitable corporations, is to increase quality of life for everyone, including those who are going to be taxed,” he told “Meet the Press.”
One problem: Gov. Kathy Hochul, who would have to sign off on the increase, says she’s deeply opposed.
President Trump is starting to target Mamdani, too. In an interview with Fox News that aired on Sunday, Trump, a billionaire himself, threatened to withhold federal funding from New York City. “He’s going to have to do the right thing or they’re not getting any money,” Trump said. (The president also claimed that Mamdani is a communist, which Mamdani denied.)
But how corporate leaders will actually move to stop Mamdani remains unclear.Some — including Dan Loeb of the hedge fund Third Point, Shayne Coplan of the prediction market Polymarket and Rob Wiesenthal of the aviation company Blade — have met with Mayor Eric Adams, The Times previously reported.
And Bloomberg has reported that some Republican donors are examining if there is a way to remove Curtis Sliwa, a longtime social activist who is the GOP nominee, from the ballot to give that line to Adams. But state election law makes that exceedingly tricky, and Sliwa has said he doesn’t plan to step aside.
That said, bets on Polymarket and a rival prediction market, Kalshi, suggest that Adams, whom polls have shown is deeply unpopular, faces long-shot odds.
Bonus: CNN’s inside account of how Cuomo lost to Mamdani in the primary, despite having raised tens of millions from business leaders and others.
THE SPEED READ
Deals
The Justice Department settled its lawsuit seeking to block Hewlett Packard Enterprise’s $14 billion deal for Juniper Networks. (Reuters)
In I.P.O. news: Lens Technology, a major supplier to Apple, is seeking to raise roughly $600 million in a Hong Kong listing; and Klarna is accelerating its push into digital banking as it prepares a second attempt to go public. (Bloomberg, FT)
Tech and artificial intelligence
Hundreds of children have reportedly lost access to schooling after Mark Zuckerberg and his wife, Priscilla Chan, pulled back on their philanthropic efforts (WaPo)
Can you spot the difference between A.I.-generated videos and the real thing? (NYT)
Best of the rest
An investigation into the ties between Sheikh Mansour bin Zayed al-Nahyan, the Emirati owner of the Manchester City soccer club, and some of Africa’s most notorious warlords and autocrats. (NYT)
“The Mysterious Billionaire Behind the OnlyFans Porn Empire” (WSJ)
We’d like your feedback! Please email thoughts and suggestions to dealbook@nytimes.com.
Andrew Ross Sorkin is a columnist and the founder of DealBook, the flagship business and policy newsletter at The Times and an annual conference.
Bernhard Warner is a senior editor for DealBook, a newsletter from The Times, covering business trends, the economy and the markets.
Sarah Kessler is the weekend edition editor of the DealBook newsletter and writes features on business.
Michael J. de la Merced has covered global business and finance news for The Times since 2006.
Danielle Kaye is a Times business reporter and a 2024 David Carr Fellow, a program for journalists early in their careers."
Sunday, June 29, 2025
What Zohran Mamdani’s Defeat of Andrew Cuomo Means for the Democrats
What Zohran Mamdani’s Defeat of Andrew Cuomo Means for the Democrats
“The article describes Zohran Mamdani's victory in the Democratic primary for mayor of New York City. Mamdani's campaign focused on affordability, a key issue for many New Yorkers. The article also suggests that Mamdani's victory signals a generational shift in the Democratic Party, with younger candidates embracing a more progressive agenda.
On Tuesday, the thirty-three-year-old left-wing mayoral candidate sent an unmissable message to his party: be new.
In 2002, The New Yorker’s John Lahr visited Morningside Heights to write a Profile of the filmmaker Mira Nair, and took notice of her nine-year-old child: “Nair’s talkative doe-eyed son, Zohran, who exudes the charm of the well-loved, is known by dozens of coinages, including Z, Zoru, Fadoose, and Nonstop Mamdani.”
Sometimes early observations are trenchant ones. (The charm of the well-loved!) The already sweat-drenched summer of 2025 has been defined by Nonstop Mamdani, a thirty-three-year-old left-wing state assemblyman from Queens, who, on Tuesday night, seemingly won a striking victory in the Democratic primary for mayor, defeating a former governor and lapping a field of candidates, most of whom were more established and initially better known. Mamdani’s campaign said it had knocked on a million and a half doors across the city—not unprecedented in the annals of municipal politics but probably essential for an unknown. The candidate himself appeared in every conceivable media venue, from the TikTok series “Subway Takes” to “The Late Show with Stephen Colbert.” In the mid-June heat, Mamdani walked the length of Manhattan, from Inwood to the Battery. He beat Andrew Cuomo, the former governor, in the first round of ranked-choice voting by about seven percentage points, but, in campaign buttons and other merch visible across the five boroughs, it was a landslide. Mamdani got his central issue—affordability—exactly right, and, with his easy smile, his ubiquity, and his steady rise in the polls, he embodied his campaign’s essential theme, that life in New York doesn’t have to be so oppressively hard.
Even if Mamdani’s victory was built on the ultimate virtue of local politics—hustle—it also carries an unmissable message for his beleaguered national party: be new. During the long and often difficult years since Obama’s election, the Democrats have mostly worked from the top down and the inside out: the Party’s past three Presidential nominees have been Obama’s Secretary of State, Obama’s Vice-President, and Obama’s Vice-President’s Vice-President. Joe Biden’s age and fragility defined last year’s election, and may also threaten to define the Party for a generation. Even this past spring, Democrats in the House lost a vote they might have won—for passage of the “Big Beautiful” budget-reconciliation bill—because too many congressmen had died too recently to be replaced.
Now there is a glimmer of possibility. Donald Trump has, during the past six months, quite efficiently abandoned his brand as a populist for a more comfortable position as a straightforward right-winger. Trump let loose the richest man in the world in a hastily conceived blitzkrieg against the civil service; despite having spent years promising peace and “America First,” he ordered an impulsive bombing of Iran under pressure from hawks at home and allies in Israel; the current iteration of his “Big Beautiful Bill,” which is now on the verge of Senate passage, would strip millions of Americans of their health insurance in order to give deficit-increasing tax breaks to the very rich; and, though he campaigned and won the election by running against Biden’s inflation, he is fixated on tariffs that would bring more of it. Trump is seventy-nine years old and has been President twice. He and his party can’t run as the outsiders forever.
Does a generational change for the Democrats necessarily mean a sharp move toward the left, as Mamdani’s supporters might hope? T.B.D. So far, the experiments in explicitly left-wing governance—as opposed to the principled backbenching of Bernie Sanders and Alexandria Ocasio-Cortez—have gone badly for the Party. In Chicago, Brandon Johnson’s year and a half as mayor has been pretty disastrous, measured both by the city’s mounting budget crisis and his own plummeting popularity. Chesa Boudin’s brief tenure as the avowedly progressive district attorney in San Francisco ended with his removal by voter referendum and contributed to the tech backlash that helped power Trump’s victory in the 2024 election. (Michelle Wu, the young Boston mayor and Elizabeth Warren’s former protégé, offers a more pragmatic and successful model.) In New York this past spring, where Michael Bloomberg led an ill-advised stampede of the wealthy to back the lethargic and disgraced Cuomo, there was a fear of Mamdani that, at times, veered toward the hysterical: “Terror is the feeling,” Kathryn Wylde, the C.E.O. of Partnership for New York City, a nonprofit that advocates on behalf of business leaders, told CNBC on primary day. Even Mamdani’s natural ally Ocasio-Cortez, who endorsed him in early June, noted that, if elected, Mamdani would need to surround himself with a more experienced staff to succeed. City Hall, Albany—these have been fortresses of political entrenchment for a century. Is this really the guy—and the place—for the contemporary left to succeed where it has so far failed?
If Mamdani wins the general election in November, in which he will begin as the likeliest victor but not a sure thing, then his political fortunes and his significance to his party will hinge on his ability to actually improve what he has correctly identified as a crisis of affordability in New York. (His electoral coalition was less notably poor than it was young—Cuomo performed well among both the richest and the poorest New Yorkers, but Mamdani ran up the score among those under forty-five.) Surely Trump will see him as a target. Mamdani’s proposal of a rent freeze proved popular in the campaign, but Bill de Blasio froze the rent three times, and it has hardly made New York housing cheaper in a lasting way. Other ideas seem either a little fanciful (the establishment of five city-run grocery stores) or politically difficult (tax hikes). During the campaign, Mamdani sometimes appeared a little more flexible than his socialist image—he has been interested, for instance, in ideas about how to build more housing that have germinated in the abundance movement, and in cutting red tape for small businesses—but his affordability program still has some of the haziness of the well-loved.
But political change often depends less on the tectonic movement of demographics than on the arrival of new personalities. That Mamdani would become the presumptive Democratic nominee (the final result of the ranked-choice abacus is still pending) wasn’t fated at all. Other, more prominent young politicians could have sensed Eric Adams’s and Cuomo’s weaknesses and run: the thirty-five-year-old Ocasio-Cortez; the thirty-seven-year-old centrist congressman from the Bronx, Ritchie Torres (a friend of development and a loud defender of the Israeli cause); or the practically ancient forty-four-year-old pragmatist Jessica Tisch, who, as the former sanitation commissioner and now as police commissioner, has had a major hand in arguably the two most successful city initiatives since universal pre-K: trash containerization and the continuing abatement of violent crime. Had any of them decided to run, their candidacies might have suggested a quite different kind of Democratic future. But part of political talent is recognizing an opportunity, and Mamdani saw three things clearly: that the cost of living had surpassed public safety as the city’s cardinal issue, that fortune favors the relentless, and that generational change, however belated, was eventually bound to come. “