As federal agencies once trusted to safeguard the nation’s health become increasingly politicized, states across the U.S. are forging their own paths, banding together to uphold science-driven policy and protect access to care.
Federal Retreat from Science-Based Health Policy
The Centers for Disease Control and Prevention (CDC) and Department of Health and Human Services (HHS) have faced sweeping upheaval in recent months:
- Leadership turmoil: The ouster of CDC Director Susan Monarez was followed by mass resignations, signaling a loss of confidence in the agency’s independence.
- Restructured vaccine policy bodies: HHS Secretary Robert F. Kennedy Jr. dissolved the CDC’s respected Advisory Committee on Immunization Practices (ACIP) and reconstituted it with members sympathetic to vaccine skepticism.
- Exclusion of major medical groups: Organizations such as the American Medical Association and the American Academy of Pediatrics have been removed from CDC vaccine workgroups, effectively sidelining long-standing medical expertise.
- Conflicting guidance: With divergent positions emerging between professional associations and the federal government, clinicians and patients are left navigating mixed messages.
This combination of leadership instability and ideological reshaping has eroded trust in federal institutions once considered the backbone of public health.
States Form Regional Health Alliances
In the absence of consistent national leadership, states are joining forces to ensure public health decisions remain rooted in evidence:
- West Coast Health Alliance: California, Oregon, and Washington launched a coalition to provide unified vaccine and public health guidance independent of federal.
- Northeast Collaboration: Eight states, including New York, New Jersey, and Pennsylvania, convened to align on vaccine recommendations and mitigate confusion for residents.
- Other regional efforts: Illinois and New Mexico are advancing their own measures to sustain access, from new guidance panels to lifting restrictions on pharmacy distribution.
- Nonprofit partnerships: Beyond government, nonprofits and professional societies are building alternative panels to issue science-based recommendations when federal agencies fall short.
These alliances reflect a fundamental reality: the health of Americans can no longer rest on federal consensus alone.
The Rise of Health Sects
Beyond state action, the U.S. is seeing a deeper fragmentation of medical belief systems — what analysts call the emergence of “health sects” as identified by BPD Healthcare’s Chris Bevolo in his book, Joe Public 2030.
Sparked by pandemic tribalism and amplified by political polarization, distrust of mainstream medicine has evolved into organized “schools of thought.” For example, in Idaho, a local health board went so far as to ban Covid-19 vaccines, a first in the nation — underscoring how political ideology is shaping healthcare delivery itself.
- Types of sects:
- Mainstreamers — aligned with established science and traditional health institutions.
- Progressives — favor minimal intervention combined with alternative and complementary care.
- Contrarians — reject mainstream medicine entirely, building alternative “facts” and delivery models for everything from vaccines to reproductive health.
These sects are not just theoretical. They are reshaping everything from reproductive rights and LGBTQ+ care to the Affordable Care Act (ACA) and HIPAA. The result is a patchwork system where access and standards depend not only on where one lives, but on which “sect” holds sway politically.
Why It Matters for Health Leaders
- Trust in science is fractured: With federal bodies weakened, individuals and communities may turn to whichever health sect affirms their worldview.
- A bumpy road ahead: Issues from reproductive rights to vaccination policy are now filtered through both political ideology and regional alliances.
- Hospitals and health systems must adapt: Leaders will increasingly face patients whose expectations and demands are shaped not by federal guidelines, but by the health sect or state framework they identify with.
- Opportunity to build trust and our community: Doctors and nurses remain some of the most trusted groups in America. Speaking at a local level to local communities, hospitals and health systems may be able to lower the temperature and improve health of the communities they serve.
Final Thought
As Washington drifts from its traditional role as steward of evidence-based public health, states and even competing medical sects, are filling the vacuum. The result is a fractured but adaptive landscape, one where alliances and ideologies, rather than federal leadership, define the future of healthcare in America.
