From inside the room, Robert F. Kennedy Jr.’s confirmation hearings felt at times more like an awards show than a job interview. While the health-secretary nominee testified, his fans in the audience hooted and hollered in support. Even a five-minute bathroom break was punctuated by a standing ovation from spectators and cheers of “We love you, Bobby!” There were some detractors as well—one protester was ushered out after screaming “He lies!” and interrupting the proceedings—but they were dramatically outnumbered by people wearing Make America Healthy Again T-shirts and Confirm RFK Jr. hats.

The MAHA faithful have plenty of reason to be excited. If confirmed, RFK Jr. would oversee an agency that manages nearly $2 trillion, with the authority to remake public health in his image. “He just represents the exact opposite of all these establishment agencies,” Brandon Matlack, a 34-year-old who worked on Kennedy’s presidential campaign, told me on Wednesday. We chatted as he waited in a line of more than 150 people that snaked down a flight of stairs—all of whom were hoping to get a seat for the hearing. Many of them were relegated to an overflow room.

Of course, Matlack and other RFK Jr. fans could be in for a letdown. Whether Kennedy will actually be confirmed as health secretary is still up in the air. There was less raucous cheering during the hearing on Thursday, as Kennedy faced tough questions from Republican Senator Bill Cassidy of Louisiana, whose vote could be decisive in determining whether Kennedy gets confirmed. But the realization of RFK Jr.’s vision for health care in America may not hinge on his confirmation. The MAHA movement has turned the issue of chronic disease into such a potent political talking point that people like Matlack are willing to trek from Pennsylvania to Washington, D.C., just to support Kennedy. Politicians across the country are hearing from self-proclaimed “MAHA moms” (and likely some dads too) urging them to enact reforms. They’re starting to listen.

Kennedy is best known as an anti-vaccine activist who spreads conspiracy theories. His more outlandish ideas are shared by some MAHA supporters, but the movement itself is primarily oriented around improving America’s diet and the health problems it causes us. Some of the ways MAHA wants to go about that, such as pressuring food companies to not use seed oils, are not exactly scientific; others do have some research behind them. Consider artificial food dyes, a major MAHA rallying cry. Multiple food dyes have been shown in animal studies to be carcinogenic. And although a candy-corn aficionado likely isn’t going to die from the product’s red dye, the additive is effectively banned in the European Union. (Kennedy claims that food dyes are driving down America’s life expectancy. There’s no evidence directly linking food dyes to declining human life expectancy, though one study did show that they cut short the life of fruit flies.)

Until recently, concerns over food additives, such as artificial dyes, were the domain of Democrats. In 2023, California became the first state in the nation to ban certain food additives: red dye 3, potassium bromate, brominated vegetable oil, and propylparaben. But now food-additive bans are being proposed in Donald Trump country, including West Virginia, Arkansas, and Kentucky. Some of the efforts, such as the Make Arkansas Healthy Again Act, are an explicit attempt to enact Kennedy’s agenda.

In other states, something a bit more Schoolhouse Rock is happening: The purported dangers of food ingredients are riling up Americans, who are then going to their lawmakers seeking change. Eric Brooks, a Republican state legislator in West Virginia, told me that he decided to copy California’s food-additive bill after being prodded by a constituent. “I said, Well, I don’t normally look out West, especially out to California, for policy ideas, to be honest with you,” he told me. “But once I had done the research and I saw the validity of the issue, I said, Okay.” Although his bill, which was first introduced in January 2024, did not move forward in the previous legislative session because, in his words, “there were bigger fish to fry,” Brooks hopes the national interest coming from the MAHA movement will motivate West Virginia legislators to take another look at the proposal.

Other red-state efforts to follow California’s lead have similarly not yet been passed into law, but the fact that the bills have been introduced at all signifies how motivated Republicans are on the topic. The MAHA moms may be enough to propel Kennedy to the job of health secretary. One Republican, Senator Jim Banks of Indiana, told Kennedy on Thursday that he plans to vote to confirm him because doing anything else “would be thumbing my nose at that movement.” Republicans are not only introducing bills to ban food additives; they’re also taking up Kennedy’s other MAHA priorities. Arkansas Governor Sarah Huckabee Sanders recently asked the federal government for permission to forbid food-stamp recipients in her state from using their benefits to buy junk food—a policy Kennedy has repeatedly called for.

Over the past two days, senators seemed shocked at just how loyal a following Kennedy has amassed. One pejoratively called him a prophet. MAHA believers I spoke with made clear that they want RFK Jr.—and only RFK Jr.—to lead this movement. Vani Hari, a MAHA influencer who goes by “Food Babe” on Instagram, told me that, if Kennedy fails to be confirmed, there “will be an uprising like you have never seen.”

But at this point, it seems that the movement could live on even without Kennedy. On Wednesday, the Heritage Foundation hosted a press gaggle with MAHA surrogates. Heritage, an intellectual home of the modern conservative movement, is now praising the banning of food dyes. This is the same pro-business think tank that a decade ago warned that should the FDA ban partially hydrogenated oils, trans fats that were contributing to heart attacks, the agency “would be taking away choices,” “disrespecting” Americans’ autonomy, and mounting “an attack on dietary decisions.”

Republicans have generally been a bulwark for the food industry against policies that could hurt its bottom line. Democrats and Republicans in Washington today seem more aligned on food issues than ever before. “When you have members on both sides of the aisle whose constituencies are now extremely interested in understanding fully what’s in their food products, it does shift the game a bit,” Brandon Lipps, a food lobbyist and a former USDA official under Trump, told me. After all, even Bernie Sanders, despite chastising Kennedy multiple times during this week’s confirmation hearings, professed his support for aspects of the MAHA movement. “I agree with you,” Sanders told Kennedy on Thursday, that America needs “a revolution in the nature of food.” During the same hearing, Cassidy said that he is struggling with Kennedy’s candidacy because, despite their deep disagreements on vaccine policy, on “ultra-processed foods, obesity, we are simpatico. We are completely aligned.”

Although MAHA has shown itself to be a unifying message, the real test will come down to the brass tacks of any political movement: passing actual legislation. How willing lawmakers—especially those with pro-business proclivities—will be to buck the status quo remains to be seen. Politicians have proved eager to speak out against ultra-processed foods; in that sense, MAHA is winning. But policy victories may still be a ways off.

The U.S. federal government manages a larger portfolio of risks than any other institution in the history of the world. In just the past few weeks, wildfires raged across Southern California, a commercial flight crashed over the Potomac, a powerful Chinese-developed AI model launched to great fanfare, the nuclear-weapons Doomsday Clock reached its closest point ever to midnight, a new strain of avian flu continued its spread across the globe, and interest rates on long-term government bonds surged—a sign that investors are worried about America’s fiscal future. The responsibility of managing such risks is suffused throughout the federal bureaucracy; agencies are dedicated to preparing for financial crises, natural disasters, cyberattacks, and all manner of other potential calamities.

When one of those far-off risks became a real-life pandemic in the final year of Donald Trump’s first term, this sprawling bureaucracy, staffed mostly by career civil servants with area-specific expertise, helped limit the damage, often despite Trump’s own negligence and attempts to interfere. This time, things may turn out differently. Trump is committed to dismantling the federal bureaucracy as we know it—and, with it, the government’s capacity to handle the next crisis. Like an individual who chooses to forgo health or fire insurance, most Americans won’t feel the negative impact of this effort as long as everything in the world runs smoothly. What happens when the next crisis strikes is another story altogether.  

No country was fully prepared for what became one of the deadliest pandemics in history, but it is hard to think of a leader who handled COVID more poorly than Trump. He spent the crucial weeks leading up to the outbreak downplaying the severity of the virus, at one point referring to it as the Democrats’ “new hoax.” His administration never developed a national plan for getting the virus under control and reopening the economy, leaving the states to fend for themselves. Meanwhile, the president undermined his own public-health agencies at every turn, telling states to “LIBERATE” their economies, refusing to wear a mask, and, at one point, suggesting bleach injections as a potential therapeutic. A February 2021 analysis by The Lancet, a British medical journal, found that the U.S. could have avoided 40 percent of the deaths that occurred under Trump’s watch if its death rate had matched the average among America’s peer countries.

[Theodore Roosevelt: An object lesson in civil-service reform]

The administration’s pandemic response did include one shining success: Operation Warp Speed, a public-private partnership that produced and distributed high-quality vaccines in record time, saving countless lives. But that triumph is the exception that proves the rule. The idea for the program came from Robert Kadlec, an assistant secretary for preparedness and response at the Department of Health and Human Services, and Peter Marks, an FDA official—two seasoned public-health experts who had served in top government roles for years beforeTrump took office. The project was then championed by HHS Secretary Alex Azar, who had been appointed by Trump after working off and on for the department since 2001; managed by Gustave Perna, a four-star general who had served in the military for more than 40 years; and staffed by bureaucrats with decades of public-health experience. (This success story has, of course, become distasteful to mention on the right, because it involves vaccines.)

These are exactly the sorts of experienced public servants whom Trump is trying to push out of government. On his first day in office, Trump issued an executive order known as Schedule F; if upheld in court, it will give him expansive new power to unilaterally fire federal employees. In the meantime, his administration is finding creative ways to begin its purge of the federal government. Last week, the administration “reassigned” at least 20 career lawyers at the Department of Justice, allowing them to be sidelined without being officially fired; sent home 160 members of the National Security Council; and offered the remaining 2 million federal employees an ultimatum: Resign voluntarily and receive a severance package, or stay and risk being fired at some point in the future. As Axios reports, the White House expects 5 to 10 percent of the federal work force to take the buyout. Those bureaucrats who remain will, by and large, be reporting to Trump loyalists.

If Trump’s plan succeeds, the inevitable result will be a government that finds itself hamstrung in the face of the kinds of risks that it is designed to manage. (Almost unbelievably, Trump has also floated the idea of abolishing FEMA.) Imagine how much worse the pandemic would have been if Kadlec and Marks, the architects of Operation Warp Speed, had been pushed out of government before March 2020. Imagine if Robert F. Kennedy Jr., an anti-vaccine conspiracy theorist, had been in charge of the nation’s public-health apparatus, and surrounded not by scientific experts but by hard-core Trumpists. How many more Americans would have died?

For now, that question is a thought experiment. Soon, it might not be. In recent weeks, public-health officials have begun warning about the rapid spread of a new variant of the H5N1 virus, also known as bird flu, which infected 67 Americans last year and appears to be becoming more transmissible. Rather, officials were warning about it; last week, the Trump administration instructed federal health officials to temporarily halt all public communications, including reports about the escalating H5N1 crisis, “as the new Administration considers its plan for managing federal policy and public communications.” Kennedy has already cast doubt on the safety of H5N1 vaccines and implied that the virus itself was partly a creation of the U.S. government.

[Kristen V. Brown: Trump has created health-care chaos]

Pandemics are only one example of a broad swath of risks facing America today. Tensions between the U.S. and China are high, the AI arms race is well under way, wars have broken out across the globe, and climate-change-fueled natural disasters have become ever more common. None of this means that a major crisis will inevitably strike next week, or even over the next four years. But Trump’s actions make that possibility far more likely, including by exposing the country to risks that might have previously seemed arcane. On Thursday, the U.S. experienced its first fatal crash of an American airliner in 16 years. This was barely a week after the Trump administration dissolved the federal Aviation Security Advisory Committee, a body that advises the Transportation Security Administration on airline safety, and fired the head of the TSA, whom Trump himself had appointed during his first term. As the aviator and Atlantic contributor James Fallows points out, dismantling the board was likely not directly responsible for the crash, but it represents “the thoughtless destruction of the taken-for-granted institutions that have made modern aviation as safe as it is.” Trump, meanwhile, in a moment that revealed how he might respond to future crises, immediately began blaming the incident on a push for DEI initiatives within the Federal Aviation Administration.

In a crowded field, this might be the most alarming aspect of Trump’s second term. At first, most people won’t notice an agency gutted here or a program slashed there. But those cuts will make disaster more likely, and when that disaster strikes—whether during Trump’s presidency or his successor’s—the government will be far less capable of handling it. What we don’t know is how bad that crisis will be, and whether Trump will still be in office to face the consequences.