Title: Health & Climate: Day One.

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Brian Lehrer: It's The Brian Lehrer Show on WNYC. Good morning again, everyone. One of the things we're doing on the show for the coming few months at least is a Health and Climate Tuesday section that focuses specifically on new policies and policy debates in those two related areas. There was a lot on climate and energy yesterday, including withdrawal from the Paris Climate Treaty and declaring an energy emergency in the United States. There was less on health, but there was at least one nod to the likely RFK Jr. Agenda in the inaugural address. We'll get to that.

At Trump's Capitol One Arena speech yesterday evening, kind of Trump unbound compared to even the pretty blunt inaugural address, Trump went directly after wind power as an alternative to fossil fuels. He painted wind power falsely as leaving people in their homes vulnerable to whether a particular day is windy or not, as he referred to a hypothetical couple wanting to watch TV.

Trump: They want to watch the debates on television, they want to watch your favorite president on television, but the wind isn't blowing, so we can't watch television that night, Gladys. Remember? Gladys, I'm sorry, the wind is just not blowing. We're not watching Trump tonight, but I'm immediately withdrawing from the unfair one-sided Paris Climate Accord ripoff.

Brian Lehrer: Trump last night. With us now, Jael Holzman, senior reporter at the climate-oriented news site, Heatmap. Previously, she was an energy and climate policy reporter for Axios and covered energy transition resources for E&E News. John Wilkerson, Washington correspondent for the health news site, STAT, who writes about the politics of health care. His bio page says for more than 20 years, he has reported on how health care is paid for and regulated. Previously, he worked at Inside Health Policy, the Associated Press, and the St. Louis Business Journal. John and Jael, thanks for joining us. Welcome to WNYC.

Jael Holzman: It's a pleasure.

John Wilkerson: Thanks for having me.

Brian Lehrer: Jael, would you fact-check the implications of the scenario in that clip first and say why wind power seems to be so firmly on President Trump's bad list as well?

Jael Holzman: Last night, in one of his first actions as president, Donald Trump ordered the federal government to halt all permits to wind energy projects as well as cut off leases for offshore wind energy projects. This is a priority for the state of New York as it seeks to meet its climate goals. Donald Trump has been an adversary of wind energy for quite some time. Some of this is personal due to an offshore wind project close to a hotel that he and his family have been involved in in Scotland.

However, overall, opposition to wind energy is part of a broader political and cultural move against the rise of zero-carbon technologies, stuff like solar battery storage, you name it. Donald Trump can be a wrench in the gears for the energy transition just by slowing down the pace of wind energy. It's going to be hard for New England, for New York State to decarbonize without wind because of dense urban areas being not suitable for large solar projects, and because it's just harder to cite in some of these areas, there's not a lot of ideal expanse for onshore wind. This is a priority and Donald Trump is poised to slow this down considerably.

On the fact-checking side of things, a lot of the concerns around wind energy point to impacts to the economy and to society that are certainly new, fresh, and/or real. For example, if you do build a large offshore wind project in the ocean, it is going to impact the ecosystem. People are rightfully concerned about building stuff in the ocean, hurting endangered whales, the livelihoods of fishing professionals. There's reams of evidence demonstrating that building anything big in the ocean will impact the ocean. The question is, does it make factual sense to say we should stop building this stuff in order to eliminate harms to oceanic ecosystems? That is not what scientists expert in climate change tell us. In fact, we know that these same species that Donald Trump says he's trying to protect by hindering wind development will be deeply impacted and harmed and made even more endangered by climate change.

Brian Lehrer: In terms of a day-by-day or even hour-by-hour reliance on whether the wind is blowing at that time to have enough electricity in your home to watch television, the scenario that he painted in that clip, not a thing, right?

Jael Holzman: Not a thing. There's a matter of intermittency, which is a technical term related to when the wind blows versus when it doesn't. The systems that energy grid designers are putting together take account for this. This is part of the reason why, for example, we are looking at also building these large batteries to store electrons to hold onto them, so that way, when the wind isn't blowing, for example, you have a lot of energy reserved. As we build out these resources, these wind energy facilities, we're going to generate more energy than we ultimately use over time. These projects can generate enough electricity without burning fossil fuels to generate millions of homes, the projects that are proposed off the East Coast.

Brian Lehrer: The ban that you said Trump announced last night, does the federal government have the power to do that? If New York State approves, at the state or local level, a wind farm off the coast or wherever, or the state of New Jersey or the state of Massachusetts or whoever, does the federal government have approval power over all those things such that what the President announced last night stops them all in their tracks?

Jael Holzman: Last night, what the president debuted does, in fact, stop in the tracks. Any wind project offshore off of the East Coast, that does not have all of its permits yet, which is more than half of the projects proposed off the East Coast. There are a handful of projects that are currently under construction that do have their permits, including projects off the coast of New York that have contracts with the state.

It is worth noting, however, just on offshore wind, that the executive order also lays out a process to kill or undo projects that already have all of their permits, as well as companies' leases. Companies would bid with the government to hold giant expanses of ocean for longer periods of time than even this one administration's term. There's a question as to whether or not any approval that the Biden administration issued could be vulnerable when it comes to offshore wind in this administration.

With respect to wind farms, wind projects that aren't in the ocean, which is the vast majority of wind projects in the United States, a lot of those don't get built on federal lands. The federal government doesn't hold as much land as it does ocean. With that, they own essentially everything off the coast for miles and miles and miles. That's not the case when it comes to inshore. However, there are a number of places where because of wind energy's sheer size, these giant poles stretch so high into the air and the blades are so long in their scope that they do have a risk of impacting endangered birds and impacting aviation.

There are places, like with the Transportation Department and the Fish and Wildlife Service, where the federal government regularly has to weigh in on whether a project needs permits or can be legally built without hurting endangered birds or impeding on commercial or recreational flight. Those are places that industry is looking at and is concerned. I've been on the phone with people in the last 24 hours and I get the sense there's a lump in some of my friends' throats in the wind energy business right now.

Brian Lehrer: I guess so. All right, Jael, stay there. We're going to come back to you for more climate policy developments in the last day. John Wilkerson from STAT, thank you for your patience, and let's go on to health. I heard just two brief references in the inaugural address. Here's one.

Trump: We have a public health system that does not deliver in times of disaster, yet more money is spent on it than any country anywhere in the world.

Brian Lehrer: Here's the other, which, to my ear, nods to an RFK agenda item.

Trump: Together, we will end the chronic disease epidemic and keep our children safe, healthy, and disease-free.

Brian Lehrer: John, let's start there. How do you hear Trump referring to chronic disease? I believe RFK says, switch the focus of government health policy from infectious to chronic disease prevention, yes?

John Wilkerson: Yes, that's true. RFK Jr. is really interesting. Trump really did not talk about health care at all during his most recent campaign. That's probably in large part because everything he had done on healthcare during his first term went fairly badly. When Republicans tried to repeal the Affordable Care Act, that was very unpopular. Operation Warp Speed developed COVID vaccines really quickly. That was a huge success by pretty much all measures. When Trump tried to tout that a year out of office, he was booed.

He also hasn't really taken much credit for appointing the Supreme Court justices who overturned Roe v. Wade. A lot of his biggest accomplishments on health care, he's walked away from. The ACA, they're pretty much leaving that alone. Then along comes Robert F. Kennedy Jr. He's a Democrat and he was running for president. When he dropped out, I'm assuming that Trump picked up some of his supporters when RFK Jr. endorsed him.

On top of that, Trump finally picked up a populist message on health care that he hadn't had until that point. It was very late in the campaign. It's both populist and very vague. It has an anti-establishment and anti-corporate sentiment to it. There aren't a lot of details about what they want to do, but you're right that generally they want to focus on chronic care, improving people's diets. The only concrete things that they've really talked about so far are, for instance, water fluoridation, like red dye in food. It's not very specific. I'm not sure how they're going to accomplish what they want to.

Brian Lehrer: Of course, chronic diseases, notably heart disease and cancer, are the top two killers in the United States. I think there would be a consensus in the US that there should be more research, more policy, more limiting corporate promotions of things that wind up increasing the prevalence of heart disease and cancer. More focus on chronic disease is good. It just doesn't have to be in opposition to things like vaccines.

John Wilkerson: Oh, absolutely. Everybody's for ending chronic disease. It's very popular. It's not as though that's not been worked on. None of this is really new, at least at a 30,000-foot level. RFK Jr.'s anti-vaccine sentiment is definitely new. Most would argue that that runs counter to keeping Americans healthy.

Brian Lehrer: I'm glad you reminded us that it was Trump in his last year in office who was very proud of implementing or presiding over, what did he call it? Operation Warp Speed-

John Wilkerson: That's right.

Brian Lehrer: -to develop a COVID vaccine in record time when the pandemic was at its height. The New York Times had an article last week in that context revealing that at the height of COVID in 2021, when thousands of people were still dying per week, RFK petitioned to revoke the COVID vaccine authorization that Trump and then Biden had gotten through. Did you see that?

John Wilkerson: I did. RFK Jr. and Republicans generally have definitely been trying to back off a lot of what RFK has written and said in the past. He's written quite a few books. He's spoken endlessly. He's been on all sorts of podcasts. His positions in the past were clearly against vaccines, but he's now adopting a position that he says he's just questioning vaccines, and he's saying things like, "I'm not going to take your vaccines away from you. It'll be your choice to take those vaccines or not."

Brian Lehrer: Pulling back on mandatory vaccines, especially for kids going into school with other kids raises public health concerns. It's not just for the individuals who choose to get vaccines or not, but we're going to save that for another segment. You also wrote an article on STAT called Trump Faces an ACA Subsidy Conundrum. ACA, the Affordable Care Act, or Obamacare. What's the subsidy conundrum that you say Trump faces?

John Wilkerson: During the Biden administration, Affordable Care Act insurance enrollment nearly doubled to about 24 million people. That was in large part due to the extra government subsidies that were given to people to make their premiums more affordable. They usually refer to those as enhanced subsidies because there were already subsidies before this.

Brian Lehrer: Depending on your income.

John Wilkerson: Depending on your income, absolutely. These additional subsidies, which are in the form of tax credits, they end at the end of this year. If those go away, it's expected that a lot of people will no longer renew their Affordable Care Act insurance coverage and will then be uninsured. I'm sure that some will find coverage elsewhere, but enrollment will definitely drop.

Brian Lehrer: All right. The other clip we played, and this is going to bring us back to Jael on the climate beat in a minute, the clip referred to the public health disaster response, like after Hurricane Helene last year, that Trump brought up in his inaugural. Are there implied policy changes in that?

John Wilkerson: I'm not really sure. I think that has more to do with pandemics. He also said that he's going to start the process for withdrawing from the World Health Organization. I think that might fit into what he was talking about there potentially. That, not being part of the WHO, will probably have indirect impacts on the United States eventually, but it's not something that you're going to feel immediately like losing health insurance.

Brian Lehrer: What would an example of that be? Jael, I'll get to you in a minute. In addition to pulling out of the Paris Climate Accord, he's pulling the US out of the World Health Organization. It sounded like it was because he thinks that the rest of the world is getting over on the United States for doing so much to fund the WHO as opposed to any health policies coming out of WHO or recommendations that he thinks hurt Americans' health. How do you understand it?

John Wilkerson: Yes, that's right. He thinks that we're paying too much compared to other countries. He also thinks that the WHO mishandled the pandemic and was not independent enough from China. Those are his stated reasons for wanting to pull out of the World Health Organization.

Brian Lehrer: All right. Jael, on disaster response, it brings us back to you on your climate beat, because one of the critiques, fair or not, of California, is that they focus too much on reducing emissions in state policy and not enough on preparing for the effects of climate change like the wildfires. I'm curious if this is on your beat at all to say whether that's a real tension in California or any other state or local policy, or that's just something being ginned up by the climate deniers.

Jael Holzman: The Trump administration last night, it's important to emphasize, also declared an energy emergency in the United States, in part related to the myriad health and wellness effects that they describe as a result of our economic situation. Depending on how much that's tied to fact or politics, is for the economists and health experts to decide. However, with particular respect to California, there was an effort last night to focus in on the state and to try to address what the Trump administration historically has seen as the big issue in California, which is water access and the amount of timber removal in the state.

Overall, Republicans do see issues of wildfires. Republicans in Congress and in federal government, to be precise, do see issues of wildfire as primarily one related to how much excess wood is lying around and how much water is made available specifically for the purposes of extinguishing fires. There's been a point of issue around an endangered fish called the delta smelt in California that Trump, in his past presidency, did try to relax protections on in order to make water more plentiful for a variety of purposes, not just including extinguishing fires, but also for agriculture in the state's Central Valley. We did see a revisiting of those themes last night and an order that did nod toward the fish and toward the circumstances in California. It's unclear if there's going to be any benefit.

Brian Lehrer: Is it possible that everybody's right? In this case, climate change is real and makes the wildfires worse, but so does forestry policy and water delivery policy.

Jael Holzman: It is possible that water delivery policy, forestry policy, urbanization policy, it's possible that these other things play some role in the fires we're seeing in Los Angeles area right now. It is worth, however, noting that all of these circumstances become far worse due to climate change. You can't tackle the broader problem without tackling the broader problem. If we just focus on one of these issues as opposed to the broader piece, we're going to keep having fires, we're going to keep having new problems develop. That's what the science says.

Brian Lehrer: Last question, Jael, for today. In addition to everything else that we've talked about, we know Trump promises to drill, baby, drill. He talked about that again yesterday. Specifically, to make the US a top exporter of energy, he referred to oil as black gold. Is there any way yet that any of your sources are estimating what Trump policies, if fully enacted the way he talks about them, what the effect would be on carbon emissions in the next four years compared to if we continued along the Biden policy lines, as they were?

Jael Holzman: It's pretty safe to say that without a president and a federal government putting its thumb on the scale in favor of decarbonization, you're just going to see less of that. That's what the bully pulpit and our broader culture and how it mixed with our politics, that's how it impacts corporate decision-making. It is worth saying people are going to still keep developing renewable energy projects. People are still going to keep some of their pledges. Even as banks and other corporate entities pull out of global coalitions geared at net zero carbon emissions, it is still too early to say if the US is going to be any better off on its emissions four years from now.

It is, however, worth noting that we can say this new federal government will look to ease regulations to make it easier to drill for oil and gas while potentially taking away permits from renewable energy. The trajectory on climate is yet to be determined. If you are an advocate for using renewable energy to reduce our emissions footprint, you cannot be happy today.

Brian Lehrer: Jael Holzman is a senior reporter at the climate-oriented news site, Heatmap. John Wilkerson is Washington correspondent for the health news site, STAT. Thank you both so much for joining us today.

Jael Holzman: Thank you.

John Wilkerson: Thank you.

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