Every new presidential administration comes with policy changes, but the incoming second administration of President-elect Donald Trump and his proposed secretary of Health and Human Services, Robert F. Kennedy, Jr., could dramatically reshape the public health landscape.
Kennedy, a former political rival of Trump, became a close ally of Trump over the final months of the 2024 campaign and was named to the HHS post shortly after the election. The department houses the National Institutes of Health, Food and Drug Administration, Centers for Disease Control and Prevention, and Centers for Medicare and Medicaid Services.
Kennedy鈥檚 views on health and his stated policy initiatives could have far reaching effects on public health, including on policies in Illinois. Kennedy healthier food consumption for Americans 鈥� a goal Illinois Democrats could support.
But Kennedy holds other views at odds with science. In a 3 FOX News interview he said he believes a debunked that vaccines cause autism. He has also proposed discouraging fluoridating public water 鈥� a public health measure that supports dental health, .
Kennedy is not receiving a warm reception from Democratic U.S. Sen. Dick Durbin, of Illinois, who will vote on Kennedy鈥檚 nomination if it advances to the U.S. Senate floor.
鈥淭his is one of the most important and sensitive appointments that a president can make,鈥� Durbin said at an unrelated news conference in Chicago in November. 鈥淩obert F. Kennedy, Jr. may be qualified in some areas; he is totally unqualified for this job. He has engaged in quack science and crazy theories right and left and drawn a lot of attention because of it. I fear this man is going to bring the same ideas to the administration of this life and death agency and that would be a disaster.鈥�
If Kennedy becomes the HHS secretary, his administration鈥檚 work could put Illinois health policy at odds with federal directives in some areas. But the state might also find a partner in Kennedy as the General Assembly considers food regulation.
Fluoride in water
If Kennedy gets his way, the Trump administration鈥檚 Centers for Disease Control and Prevention would recommend public water systems stop putting fluoride in public drinking water on the very day Trump is sworn in on Jan. 20, according to a Kennedy made days before the election.
鈥淔luoride is an industrial waste,鈥� Kennedy said, claiming it causes bone and neurological issues as well as other problems.
Fluoride keeps teeth strong and is a naturally occurring mineral that is often used in toothpaste because of its benefits for dental health, . Putting it in water supplies was named by the agency one of the .
As for Kennedy鈥檚 claim that it causes health problems, found a possible link between fluoride levels of 1.5 milligrams per liter or higher and lower IQs in children. However, researchers noted more studies are needed to draw specific conclusions. Illinois water systems keep fluoride levels at 0.7 parts per million and are required to notify customers when levels exceed 2 milligrams per liter, according to the Illinois Environmental Protection Agency.
Nearly every Illinois resident consumes fluoride in their drinking water, according to a . The annual report found 90% of state water systems had fluoride. Together, they serve 98% of the state鈥檚 population.
Fluoride is required in Illinois drinking water under a 1967 state law, which was amended in 2016 to lower the amount of fluoride water systems are required to use. However, the 2016 law says the levels 鈥渟hall be in compliance with the recommendations on optimal fluoridation for community water levels as proposed and adopted by the U.S. Department of Health and Human Services and the Centers for Disease Control and Prevention.鈥�
Additional rules established by the state鈥檚 Pollution Control Board also govern the level of fluoride in water. It鈥檚 not clear how Illinois鈥� fluoride use would change if federal recommendations change.
鈥淚llinois EPA cannot speculate on what actions may be taken if such decisions are made at the federal level. State regulations can be more stringent than federal regulation but cannot be less stringent,鈥� agency spokesperson Kim Biggs said in an email.
Vaccines
Kennedy is known for being skeptical of vaccines and spreading false information about them. What he would do about vaccines as HHS secretary is unclear. He has he wouldn鈥檛 take any vaccines away. However, he has pushed for significant deregulation and changes at HHS and its agencies that could affect approval of future vaccines.
The Illinois Department of Public Health requires a schedule of 12 vaccines children must receive and stipulates parents present their child鈥檚 school with proof of immunization for certain vaccines by certain grade levels. There are also various vaccine requirements for college students and health care workplaces.
Illinois鈥� school vaccine policy is set at the state level based on recommendations of a CDC advisory committee on vaccines, according to IDPH.
The state鈥檚 history of requiring vaccines in schools goes back more than a century. The Illinois State Board of Health first required children to get vaccines against smallpox to attend school in 1894. The World Health Organization eventually declared smallpox eradicated in 1977 after decades of vaccination against the virus.
Broader vaccine requirements that apply today were mandated by the General Assembly beginning in 1967.
The State Board of Health, a division of IDPH, is primarily responsible for any changes to Illinois鈥� vaccine requirements, even if recommendations change at the federal level. Any changes to the requirements would be recommended by the Board of Health following a public hearing, according to IDPH, and are based on recommendations issued by a CDC review panel. States bear the responsibility of setting specific requirements for vaccines, .
Some common vaccines such as Hepatitis A, flu and COVID-19 are not required for children to attend school in Illinois despite appearing on the . Illinois law requires school districts to provide parents with information about flu shots, however.
State law also allows parents and guardians to skip vaccines for their children for religious or medical reasons.
Food ingredients
Another of Kennedy鈥檚 priorities is establishing healthy diets to combat obesity and chronic diseases. He has called for more regulation of food ingredients in a pledge to crack down on ultra-processed foods and ingredients linked to health problems.
鈥淕iven the current nominee鈥檚 interest, it鈥檚 likely something like this could be on the docket on the federal level,鈥� University of Illinois Chicago School of Public Health Senior Associate Dean and Professor Jamie Chriqui told Capitol News Illinois. 鈥淯sually what we see is it gets tested first at the state and local level before it becomes a federal push, unless there is a champion at the federal level who is interested in making changes.鈥�
Despite controversy around Kennedy, the Trump administration could have a partner with Illinois on ingredient restrictions. The state Senate took a bipartisan vote this spring to advance a bill that would ban brominated vegetable oil, red dye No. 3, propylparaben and potassium bromate 鈥� which are all used in food manufacturing 鈥� in food sold in Illinois beginning in 2028. The bill is currently stalled in the House.
鈥淚 agree with the science and in this case, it appears RFK does as well,鈥� bill sponsor Sen. Willie Preston, D-Chicago, told Capitol News Illinois. 鈥淲e鈥檙e in alignment. I鈥檓 happy to work with him if that鈥檚 possible to move this issue forward, certainly here in Illinois, which I have a responsibility to do, but across this country.鈥�
Kennedy is 鈥減roblematic鈥� on other issues, Preston said, but he said he believes on the issue of food additives, Kennedy鈥檚 appointment shows the country is moving toward further regulation to make food healthier.
The U.S. Food and Drug Administration, which in size and scope, has authorization for brominated vegetable oil. These ingredients are all linked to health issues from cancer to nervous system issues, Chriqui said.
California has already cracked down on several artificial ingredients Illinois lawmakers are targeting, though food and business organizations have opposed such regulations, including in Illinois. Chriqui pointed to the as evidence food manufacturers can make changes when prompted by the government.
鈥淭here was a similar push back, and ultimately when the FDA came out with federal regulations related to trans fats, manufacturers were able to comply,鈥� Chriqui said.
While the FDA plays a key role in shaping federal food regulations, states maintain similar power, Chriqui said. She stressed that doesn鈥檛 mean it would be a good idea for Kennedy to abolish parts of the FDA, but that states have historically been the initial drivers of nutrition policy changes, such as regulating trans fats and food in schools.
鈥淪tates like California and Illinois, who have a history of leading important food safety regulations, can continue to demonstrate how science-backed policies can make a positive impact,鈥� Chriqui said.
While Kennedy has also suggested reforms he would make to school lunch programs, those are managed by the U.S. Department of Agriculture. An Illinois State Board of Education spokesperson said ISBE receives four grants from HHS, but they are not related to the lunch program.
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