A clinical professor of pulmonary and critical care medicine at UCLA just published the most methodically damning indictment of this administration you will read this year. Robert B. Shpiner has spent more than 40 years watching children get hurt by disease, poverty, and bad luck. He says he has never, until now, watched a government do it on purpose.
Start at Birth, Because They Did
Writing in The Guardian, Shpiner walks through the Trump administration's assault on children's health the way a doctor actually thinks about it: in order, by age, by the specific biological consequences of each decision. The result is not a political rant. It is something considerably more disturbing.
It starts, literally, the moment a baby is born. Under RFK Jr.'s direction as health secretary, the routine childhood immunization schedule was narrowed from 17 diseases down to 11. The hepatitis B birth dose is gone. Shpiner translates that into medicine with the calm efficiency of someone who has explained bad news for four decades: a hepatitis B infection caught in infancy turns chronic in roughly nine out of ten cases. In adults, it's closer to one in twenty. That chronic infection is what produces cirrhosis and liver cancer thirty or forty years later. The whole point of vaccinating on day one is that the harm hides for a lifetime.
And that's before we get to vitamin K, which is not even a vaccine. It is the one intervention that stops a newborn from bleeding into its own brain. According to an analysis of more than five million births cited by Shpiner in The Guardian, refusals of the vitamin K shot nearly doubled between 2017 and 2024. We are, he writes, bringing back diseases that medicine spent a century learning to stop.
The Cuts Get Bigger as the Child Gets Older
Here is what the administration's budget does to a toddler. The WIC fruit-and-vegetable benefit for small children gets slashed by as much as three-quarters, from twenty-six dollars a month to ten. Head Start, which serves more than half a million of the poorest preschoolers in the country, was first marked for elimination, then frozen, with its federal staff cut by about a fifth.
By school age, that child is probably one of the nearly four in ten American kids who get their health insurance through Medicaid or the Children's Health Insurance Program. Georgetown University counted two million fewer children enrolled in those programs now than when Trump took office. The federal government's own slower data already concedes a drop of at least 1.5 million. The administration, for what it's worth, has not offered an explanation for where those kids went or how they're covered.
The Guardian piece points out that the deepest cuts haven't fully landed yet. The largest reduction to food stamps in sixty years is pushing four million people off the rolls, many of them parents feeding the same kids these other programs were protecting. A billion-dollar agriculture department program that bought locally grown produce for school cafeterias was cancelled outright. The official reason, direct quote: it "no longer effectuate[s] the goals of the agency." Which goals, exactly, cancelling fresh food for schoolchildren advances was not specified.
The Special Education Shuffle Nobody Can Explain
Then there are the 7.5 million children with disabilities who are guaranteed an education under the Individuals with Disabilities Education Act. The administration announced it would move oversight of that law to the Department of Health and Human Services and shift the Office for Civil Rights, which investigates discrimination against disabled kids, to the Department of Justice.
Shpiner notes in The Guardian that no one has explained how this reorganization helps a single child. He answers his own question with the only explanation that actually fits the evidence: it satisfies a campaign promise to abolish the Department of Education. That's it. That's the whole thing. Seven and a half million kids with disabilities get shuffled between agencies like a bureaucratic hot potato because someone needed a talking point.
Turning Off the Instruments That Would Measure the Damage
This is the part that should make you stop and reread it. Alongside every one of these cuts, the administration is dismantling the data collection systems that would tell us how bad the damage actually is. The Guardian reports that states no longer have to report whether children on Medicaid have been immunized. Vitamin K refusals were never counted at the federal level to begin with. No official has said how many children are expected to lose coverage.
Shpiner puts it the way any clinician would: silencing the monitor does not stabilize the patient. It only ensures no one hears the alarm. A government that wasn't expecting to find damage, he writes, would not work this hard to avoid looking for it. That sentence should be printed on a billboard outside the Department of Health and Human Services.
Meanwhile, RFK Jr. is not slowing down. According to The Guardian, Kennedy asked a federal appeals court last week to fast-track review of a March ruling that froze his vaccine changes, after a judge found thirteen of his fifteen new advisers unqualified to sit on the panel and the changes themselves arbitrary and capricious. He wants the reconstituted committee moving before autumn respiratory season. He is in a hurry. Make of that what you will.
The Doctor Has Seen This Movie Before
Shpiner ends the piece with a comparison that lands like a brick. He started his career in Los Angeles in the early 1980s, when a new disease was killing young men and much of the country had decided it would rather not look. The cost of looking away, he writes, is paid in lives. It is paid later. It is paid by the people least able to absorb it.
He is talking about AIDS. He is saying this administration's relationship to children's health rhymes with the Reagan administration's relationship to the HIV epidemic. Not in every detail. But in the essential structure: an ideologically motivated refusal to look at harm you are causing, combined with the systematic destruction of the tools that would quantify it.
The Dingo Take
Look, any one of these cuts, reported on its own, sounds like a budget dispute. A policy disagreement. The normal churn of a new administration setting different priorities. The genius of Shpiner's piece in The Guardian is that he refuses to let you see it that way. He lines up every single change in the order a child actually experiences growing up, and suddenly there is no innocent explanation that covers all of them. The pattern is too consistent. The direction is too clear.
Every single change points away from protecting children and toward the same destination: less coverage, less food, fewer vaccines, less data about what happens when you have less of all of it. That is not an accidental cluster of policy choices. That is a decision about whose kids matter and whose don't. The answer, consistently, is that poor kids don't. Kids with disabilities don't. Kids whose parents can't afford to pay out of pocket for what the federal government just stopped providing definitely don't.
RFK Jr. is trying to rush his vaccine changes through before anyone can measure the damage from the last round of vaccine changes. The administration cancelled the school food program and then stopped collecting data that would show us what happened to the kids who relied on it. Shpiner has been doing this work for forty years. He's watched a government look away before and he knows exactly what it costs. The only remaining question is whether anyone outside the medical profession is going to make enough noise about this before those costs come due.
