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This First Opinion originally appeared in STAT News on February 9, 2026.
During the first Trump administration, the Food and Drug Administration was widely viewed as a standout agency, enhancing and expediting drug regulation, regulating tobacco and vaping, and addressing food safety.
In the first year of Trump’s second term, the FDA, along with many other health agencies, has become politicized and demoralized. Conversely, the Center for Medicare and Medicaid Services — which oversees $1.7 trillion in outlays for health care services, 24% of the federal budget — has become the shining star.
In 2025, more than 10% of federal workers (300,000) left government service, including more than 10,000 people with STEM doctoral degrees. This administration has fired and driven out skilled, dedicated public servants, and demoralized those who remain. This exodus and other policies have damaged safety, health, finances, and education both in the U.S. and around the world. Health secretary Robert F. Kennedy Jr.’s scientifically unsupported paring down of the childhood vaccine schedule has put American lives at risk. Meanwhile, the departure of 50,000 employees from Veterans Affairs has increased waiting times for veterans seeking care and led to lower quality care by contractors.
In contrast, CMS stands out, making changes and innovating on the essential nonpartisan missions of the agency. Given the crisis status of the health care system, Trump’s CMS deserves recognition. One of us, Ezekiel, helped design the Affordable Care Act in the Obama administration, so that’s really saying something.
Read the full First Opinion here.
Authors
Ezekiel J. Emanuel, MD, PhD
Diane v.S. Levy and Robert M. Levy University Professor, Medical Ethics and Health Policy, Perelman School of Medicine; Diane v.S. Levy and Robert M. Levy University Professor, Health Care Management, Wharton School
Merjan Ozisik
Research Administrative Coordinator, Department of Medical Ethics and Health Policy, Perelman School of Medicine
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