Republican state legislators across the country are filing a flurry of bills to advance the “Make America Healthy Again” agenda promoted by activist lawyer and former presidential candidate Robert F. Kennedy Jr., who’s in line to be the next U.S. health secretary.

Under the MAHA banner, state lawmakers are working to regulate candy and soda purchases under social welfare programs, remove fluoride from public water systems, roll back state vaccination requirements, and remove ultra-processed food from schools.

They’ve enlisted celebrities to help. They’re using #RFK and #MAHA hashtags on social media to share legislative wins. Lawmakers even walked the red carpet at a January gala celebrated as the official start of the MAHA movement in the Trump era.

“It’s pretty exciting for me,” said Wyoming Republican state Rep. Jacob Wasserburger, who has sponsored a MAHA bill in his state.

“I was a pretty overweight kid when I was growing up. … When I was about 16, I started trying to get healthy, and it seemed to me like there were some badly flawed issues with our health care in this country that weren’t being addressed,” he said.

Kennedy is a vocal vaccine skeptic with controversial and sometimes misleading views on a number of public health policies, from fluoride in public water to the underlying causes of HIV and autism. He’s decried ultra-processed foods, government overreach and greedy corporations for harming human health and the environment.

His often unorthodox — and in some cases, false — views have inspired some conservative lawmakers and given political cover to others, spurring them to reshape public health policy in myriad ways.

Candy, soda and SNAP

One popular MAHA measure is to prevent families who qualify for food stamps from using their benefits to purchase candy or soda.

Republican legislators in states including Arizona, Idaho, Kansas, Tennessee, Utah and Wyoming have introduced bills directing their respective state agencies to ask the federal government to allow them to remove candy and soda from the list of eligible products that can be purchased with food stamps, officially known as the Supplemental Nutrition Assistance Program. Arkansas Republican Gov. Sarah Huckabee Sanders sent a letter to the feds in December asking them to bar junk food items from SNAP, which is a federal program administered by the states.

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In Wyoming, Wasserburger sponsored a bill that would prevent people in SNAP from using their benefits to purchase candy and soda.

“I’m all in favor of people having food choice and freedoms, but if taxpayers are going to be funding the cost of that food with the Supplemental Nutrition Assistance Program, the funding should be going to what it says: nutrition,” Wasserburger told Stateline.

“Taxpayers shouldn’t have to pay for the soda and candy bars. Anybody can go buy that with their own money.”

The bill recently passed the Wyoming House and is headed to the Senate.

Proponents of the SNAP bills argue candy and sugary drinks harm the health of recipients, many of whom are children. And taxpayers, they say, shouldn’t have to pay for unhealthy foods that can lead to obesity and other issues.

Critics of the bills argue that the fundamental problem for SNAP recipients is that healthy food is more expensive and can be harder to find in low-income neighborhoods. Lobbyists contend that identifying foods as “good” or “bad” amounts to government overreach.

And even some Republicans say the definitions in the bills are too vague. Arizona’s bill, for example, could have prevented SNAP participants from buying granola bars and some cereals, while allowing them to buy potato chips. The Kansas bill defines prohibited candy in such a way that Kit Kat and Twix bars, which contain flour, wouldn’t be restricted.

Many of the state bills follow on the heels of a federal version, the Healthy SNAP Act, which Republicans reintroduced in Congress last month.

State and local governments, medical groups and other advocates have for years urged the federal government to restrict junk food purchases through the SNAP program. But the attention on junk food is an abrupt about-face for many conservatives, some of whom a decade ago fought then-first lady Michelle Obama’s efforts to make school lunches healthier.

And it’s a change under a Trump administration. During President Donald Trump’s first term, the U.S. Department of Agriculture denied Maine’s request in 2018 to prevent SNAP benefits from being used to buy candy and sugary drinks.

Wasserburger said he was asked to sponsor his bill by representatives from the Foundation for Government Accountability, a Florida-based conservative think tank that’s pushed state legislation to repeal Medicaid expansion, restrict SNAP in other ways, and thwart state ballot initiatives. Representatives from the foundation spoke in favor of the Kansas SNAP bill.

“It’s one of the bills they’ve encouraged a lot of people to run,” said Wasserburger, who added that he was surprised how little pushback he received when he presented the bill, which sailed through committee and earned House approval in less than two weeks. He attributed the warm reception to Kennedy making the issue a high priority.

But some critics warn that conservative groups like the foundation are glomming onto MAHA enthusiasm to further restrict public aid programs such as SNAP.

School lunches

At a news conference in Arizona last week, actor Rob Schneider — wearing a tall chef’s hat — and former race car driver Danica Patrick stood alongside Arizona state Rep. Leo Biasiucci to plug a bill that would ban public schools from serving foods with certain additives and dyes that Biasiucci argues are harmful to children’s health. Officials from national conservative groups, including the Foundation for Government Accountability and Turning Point Action, also spoke at the event.

During the news conference, Biasiucci thanked Kennedy for bringing attention to the issue of food additives.

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“It took Bobby to get into the position that he is in now for something to happen,” said Biasiucci, who also sponsored Arizona’s SNAP bill, which failed in committee late last month. “I can’t thank him enough for being the microphone … at the high level, to finally put a spotlight on this.”

In Utah, a Republican state representative last week introduced a similar bill to ban some food additives.

Vaccines

Republican lawmakers in more than a dozen states have introduced bills to change their vaccine rules, including Arizona, Arkansas, Connecticut, Indiana, Minnesota, Mississippi, New Jersey, New York, Oklahoma, Oregon, Texas and Virginia. And in West Virginia, which historically has had one of the strongest school immunization rates in the country and only allows medical exemptions from state-required vaccines, Republican Gov. Patrick Morrisey last month signed an executive order directing the state to come up with a policy to allow parents to claim a religious exemption.

Kennedy has denied that he is anti-vaccine. But over the years he has made numerous baseless or false claims about vaccines, including linking them to autism and cancer, saying there is “poison” in the coronavirus vaccine, and suggesting Black people shouldn’t have the same vaccine schedule as white people because they have different immune systems.

His skepticism has given some legislators the political cover they need to roll back vaccination policies in their states.

If confirmed as the secretary of the Department of Health and Human Services, he’ll oversee most U.S. vaccination efforts, from funding new vaccines to distribution through public programs.

Fluoride and drinking water

Kennedy has called fluoride “an industrial waste associated with arthritis, bone fractures, bone cancer, IQ loss, neurodevelopmental disorders, and thyroid disease.”

And now Republican state legislators are taking aim at fluoride.

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Legislators in several states have introduced bills that would prohibit adding fluoride to public water systems, including Arkansas, Hawaii, New Hampshire, North Dakota, Tennessee and Utah. Other states, such as Kentucky and Nebraska, are considering bills to make fluoridation programs optional.

Most major medical organizations including the American Medical Association and American Dental Association, as well as the federal Centers for Disease Control and Prevention, support public water fluoride programs, and say fluoride at recommended levels is safe and an effective way to prevent cavities. However, some studies of pregnant women and their children suggest that fluoride might harm developing brains at levels of 1.5 milligrams or more per liter. Nearly 3 million Americans live in areas where the fluoride level in tap water is at or above that level, according to one 2023 study.

And the National Toxicology Program, which is part of the U.S. Department of Health and Human Services, earlier this year concluded with “moderate confidence” that higher levels of fluoride in drinking water — above 1.5 milligrams per liter — are associated with lower IQ in kids.

Stateline is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Stateline maintains editorial independence. Contact Editor Scott S. Greenberger for questions: info@stateline.org.

Widespread support for abortion rights continued to defy partisan labels in Tuesday’s election, but several of the ballot measures that voters approved may face legal and legislative challenges in the coming months. And supporters worry that federal efforts could eventually override the state measures.

Voters in seven states — including deep-red Missouri and Montana — chose to protect or expand access to abortion through ballot initiatives.

“This won’t be the last time Missourians vote on so-called ‘reproductive rights,’” Missouri Republican state Sen. Mary Elizabeth Coleman, who opposed the ballot measure, wrote in a press release. “I will do everything in my power to ensure that vote happens.”

Voters approve most abortion-rights measures in flurry of ballot initiatives

In Missouri and Arizona, the ballot measures will expand abortion access beyond what state laws currently allow. Though those constitutional amendments are set to go into effect in the coming weeks, abortion is unlikely to become immediately accessible in those states because abortion-rights advocates will have to go to court to overturn existing laws.

In addition, anti-abortion groups and their legislative allies in recent years have worked to undermine abortion protections through laws and court challenges based on concepts such as fetal personhood, parental rights and fetal viability. Those efforts could limit the impact of the new ballot measures.

Supporters of the Missouri measure anticipate continued opposition. Mallory Schwartz, the executive director of Abortion Action Missouri, told a crowd celebrating on Tuesday night that “anti-abortion, anti-democracy politicians are going to try to stomp us out,” according to the Missouri Independent.

“They’re going to try to fight us in court, and they’re going to file new attacks in Jefferson City,” Schwartz said.

Some abortion-rights supporters worry that without a federal constitutional right to abortion, which the U.S. Supreme Court struck down in its 2022 Dobbs ruling, the new state-level protections are vulnerable to federal moves that could override them.

After the Dobbs decision, the Biden administration took several steps to protect access to birth control, abortion medication and emergency abortion care at hospitals.

But Nourbese Flint, president of the abortion-rights group All* In Action Fund, said the incoming Trump administration could restrict access even in states that have abortion-rights measures on the books.

President-elect Donald Trump has flip-flopped on abortion and other reproductive rights, bragging for years that his U.S. Supreme Court nominations led to the Dobbs decision — then telling Fox News viewers last month that some state abortion laws were “too tough” and would be “redone.”

“Unfortunately, we are in a position where even if your state has passed great legislation, the actual, tangible access to medication abortion might be harder” in the future, Flint said.

Some anti-abortion groups want the Trump administration to enforce the Comstock Act, a long-dormant 1873 law they believe could be used to make it a federal crime to send or receive abortion pills in the mail.

The Trump administration also could reverse a current policy under the federal Food and Drug Administration that allows the mailing of abortion medication. And when the U.S. Supreme Court dismissed a case earlier this year involving FDA regulation of the abortion medication mifepristone, it left the door open for future challenges. Meanwhile, some states have laws limiting access, such as requiring in-person physician visits for abortion medication, effectively barring patients from accessing it via telemedicine.

“I don’t want people to think just because they voted ‘yes’ to protect reproductive rights there is going to be a magic wand to restore those rights,” said Chris Melody Fields Figueredo, executive director of the Ballot Initiative Strategy Center, which supports progressive ballot initiatives nationwide.

“They’re going to have to double down and fight to make sure people are going to receive the reproductive care they need and deserve.”

In addition to reliably red Missouri and Montana, voters on Tuesday also approved abortion-rights measures in presidential battlegrounds Arizona and Nevada and solidly blue Colorado, Maryland and New York. In Nevada, voters will have to approve the amendment again in 2026 for it to go into effect.

Before last week, voters in six states — including conservative Kansas and Kentucky — had endorsed abortion rights when presented with abortion-related ballot questions.

But Tuesday’s election marked the first time since the fall of Roe v. Wade that abortion-rights ballot measures failed: Voters defeated proposed amendments in Nebraska and South Dakota. And in Florida, 57% of voters supported an abortion-rights amendment, but it fell short of the 60% supermajority required for passage.

Questioning viability

The ballot measures in Arizona, Missouri and Montana establish the right to abortion up to “fetal viability.” It’s a term that lacks an exact medical or legal definition, and thanks to medical advances over the years, viability has moved earlier in pregnancy. Today, it’s generally considered to be around 23 or 24 weeks of pregnancy.

“‘Fetal viability’ is not a legal term,” said Dale Margolin Cecka, director of the Family Violence Litigation Clinic at Albany Law School and a former Georgia assistant attorney general. “Even in states that now have amended their constitutions [to permit abortion], I can foresee challenges to the ‘fetal viability’ aspect of those amendments.”

For example, she said, state legislators could attempt to restrict abortions by defining “fetal viability” in state law in such a way that might create doubt in the minds of providers about whether a patient’s pregnancy meets state requirements for a legal abortion.

Abortion rights opponents try to derail ballot initiatives

In the days leading up to the election, Florida Attorney General Ashley Moody, a Republican, used the vagueness of the “viability” standard in Florida’s proposed abortion amendment to ask the state’s highest court to keep the measure off the ballot, though the court declined to do so.

In Montana, where abortion was already legal until fetal viability under a 1999 state Supreme Court ruling, the new constitutional amendment shores up that protection by defining fetal viability. The amendment says viability should be based on “the good faith judgment of a treating health care professional and based on the particular facts of the case.”

‘Personhood’ and parental rights

The concept of “fetal personhood” also could be used to circumvent state constitutional amendments on abortion. Long a cornerstone of the anti-abortion movement, fetal personhood is the idea that a fetus, embryo or fertilized egg has the same legal rights as a person who has been born. If state law considers fetuses to be people, the thinking goes, the abortion would be considered murder.

Missouri state Rep. Brian Seitz, a Republican, told Stateline in July that he plans to introduce a fetal personhood bill in the upcoming legislative session that would grant “unborn children” the same rights as newborns. His hope was that the bill could protect embryos and fetuses regardless of whether Missourians passed a constitutional amendment guaranteeing the right to abortion.

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Cecka also expects to see state legislators continue testing abortion protections with so-called parental rights laws. Since Dobbs, conservative legislators in several states have filed parental consent bills to restrict access to abortion, birth control and other reproductive health care for people under age 18. Proponents argue such laws are needed to protect the rights of parents and to prevent other adults from persuading adolescents to get abortions.

The lawsuit filed last week by Missouri reproductive care providers to strike down several of Missouri’s abortion restriction laws after passage of the constitutional amendment does not challenge the state’s parental consent law.

In Cecka’s view, abortion access remains at risk, even in states that have passed protective laws, unless federal protections are put in place.

“In red states where there’s a strong enough push, the anti-reproductive freedom movement is a big machine with a deep bench, and they’re ready to fight,” she said.

Stateline is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Stateline maintains editorial independence. Contact Editor Scott S. Greenberger for questions: info@stateline.org. Follow Stateline on Facebook and X.