In early November, American voters chose to re-elect Republican party candidate Donald Trump for a second term. We know this election result is a gut punch, regardless of how likely it may or may not have seemed, and regardless of how we may feel about the Democratic party and its offer.
Trump ran on a platform centering racist, anti-immigrant rhetoric, alluding to the abolition of income tax and promising to revitalise the US economy while simultaneously planning to deport millions of workers and run up federal debt. It is very likely that hard-won equal rights are under threat in a country already hostile to minoritised communities.
We are very aware that the impacts of Trump’s appointment will be far-reaching and potentially catastrophic, impacting people and planet. The Republican party won the presidency, and a majority in Congress and the Supreme Court, which will make changing existing legislature and passing new laws far easier. We’ve taken a look at Trump’s policy positions and appointments, and what they may mean for areas relevant to Medact’s work.
PEACE & SECURITY
Speculating on Trump’s position on armed conflict is not simple. His first term was noted for its unpredictability: reneging on prior commitments; upending diplomatic conventions with Iran and Cuba; the pursuit of nuclear brinkmanship with the totalitarian nuclear state of North Korea. While Trump may be reluctant to put American troops on the ground, he is as comfortable as his predecessor, Obama, with distance drone warfare.
Towards the end of his 2024 campaign he promised to end the “war” in Gaza and war in Ukraine, which is sure to have compelled some voters but the mechanics of which seem unlikely to bring peace and justice to either region. That being said, Biden’s tenure as President will be historically marked by his unquestioning sponsorship of Netenyahu’s genocide of the Palestinian people, and dismissal of huge protest from Americans which possibly cost Democratic candidate Kamala Harris the presidency.
Many are suspicious of Trump’s so-called anti-interventionist foreign policy, especially given his recent appointments. Fox and Friends host Pete Hegseth will be his defence secretary (a man who advocated preemptively nuking North Korea in 2017). US ambassador to Israel will be the controversial evangelical Christian and self-described “unapologetic Zionist” Mike Huckabee, and real estate investor and landlord Steve Witkoff is Trump’s special envoy to the Middle East. Neither his track record nor the people he is positioning beside him inspire confidence that his second term will be one of restraint.
CLIMATE & ENVIRONMENT
Much is likely to be on the chopping block come January. President-elect Trump has pledged to roll back multiple environmental regulations and refocus US energy policy on the fossil fuels that are driving the climate crisis. There will be resistance to this from certain states, including California, but also support from other states for whom fossil fuel extraction is financially beneficial.
Trump appointed Lee Zeldin to lead the Environmental Protection Agency (EPA), a man whose 15-year voting record shows an unwavering allegiance to fossil fuel interests. His aim, as dictated by Trump, appears to be reducing the regulatory power of the EPA, which will likely increase air pollution and the risk of harmful waste and spills, increased domestic production of fossil fuels, loss of protection for national parks and indigenous land, and loss of funding for environmental programmes.
Zeldin is also a huge advocate for AI, which presents numerous and wide-ranging risks, including huge electricity consumption and heat production. Given the inaction of those nations producing the highest emissions and causing the most harm through extractivism to less powerful parts of the world, while facing front-on our final opportunities for making enough changes to secure a viable future for our planet, this is not good news for anyone in the world.
REFUGEES & MIGRANTS
Immigration might be Trump’s most well-known policy position. His use of racist and anti-immigrant rhetoric works in the same way as that of UK right and centre-right wing parties—he speaks to people’s genuine concerns about their material conditions, caused by neoliberalism and extreme wealth inequality, and points the finger of blame towards people who have been systematically othered and dehumanised for the entirety of American history, since Turtle Island was first colonised by white European immigrants.
In terms of achievements during his first term, Trump talked at length about his “wall” running the entire length of the border between Mexico and the USA, which unsurprisingly never materialised and is unlikely to be built at all (because it’s practically impossible). Immigration-related deportations under Trump were actually lower than the period of Bush’s second presidency and both Obama’s terms, and Obama oversaw more deportations than any other US president in history (under Biden, expulsions spiked due to Title 42 emergency legislation preventing people from crossing the border for public health reasons, but formal deportation figures were lower).
Trump’s commitment to declaring a “national emergency” on immigration, floating the use of the National Guard to carry out mass deportations, is extremely concerning but it’s unclear how genuinely enforceable this would be. Regardless, we know from his first term how anti-immigrant rhetoric became so ingrained in public consciousness that hostility towards documented and undocumented migrants, refugees and asylum seekers skyrocketed. His “Muslim ban” was briefly enforced and saw the USA return to a post-9/11 environment where anyone racialised as Muslim felt unsafe and targeted, even in so-called progressive parts of the USA.
With a pay-to-use healthcare system, economically marginalised people, like migrants and refugees, working jobs with no health insurance, will continue to struggle to access the healthcare they need, putting additional demand on NGO and non-profit providers—unless, of course, those providers are defunded for their political positions.
HOUSING
Trump’s economic campaigning platform focused on deregulation, tax cuts and reducing mortgage rates, reiterating his promise to reduce regulatory barriers and make federal land available for housing projects. Rather than the federal government itself building housing, land will instead be sold to the highest bidder from the private development sector—provided that they commit to maintaining a percentage of units at affordable rates for local communities. We know from the UK’s private development sector how easily that “commitment” is dropped, and with enforcement under Trump as unlikely as it has been under every other president, the housing crisis seems likely to continue.
Over half a million people currently experience homelessness in the USA, many of whom are “chronically homeless”, having been unhoused for a year or more, and over 200,000 being unsheltered or street homeless. The physical and mental health impacts of homelessness or living in poor-quality, insecure housing are substantial. In the USA, estimates indicate that over half of chronically homeless people live with mental illness, 25% of which is classed as “severe”. With a for-profit healthcare system totally incompatible with poor or destitute individual’s needs, lack of housing or unsuitable housing lead to totally preventable illness and deaths.
Furthermore, if the president elect is successful in carrying out mass deportations, a huge quantity of construction work currently performed by undocumented people will be lost, with American citizens unlikely to step into those poorly paid and dangerous roles, impacting any ability to deliver on new housing commitments.
HEALTHCARE
Access to healthcare
The US healthcare system is private and for-profit, and anyone wishing to use it must either pay for health insurance (which is often linked to employment status) or qualify for free/lower-cost care through programmes like Medicare and Medicaid. The 2021 American Rescue Plan, instituted in response to the COVID-19 pandemic, expanded assistance to millions of Americans but expires in 2025. The odds of a Trump administration extending this access are extremely low. At least 15 million people are likely to lose access to affordable healthcare as a result, and will either forgo essential, life-changing or life-saving care, or rack up millions of dollars of medical debt that will financially ruin them and any dependents they have. Trump also plans to cut funding for Affordable Care Act outreach, leading to millions of eligible people being unaware of their ability to access healthcare, and cut funding for Medicaid resulting in less available treatment for over 65’s who have increased need for age-related care, and many people living with disabilities.
Regulation
Despite a lack of medical qualifications, Robert F. Kennedy Jr is poised to take over the Department of Health and Human Services, which oversees the regulatory Food and Drug Administration (FDA). This could be catastrophic for American health due to Kennedy’s vaccine scepticism and support of non-traditional, untested and unregulated alternatives to medicine. Kennedy has already campaigned against fluoride in drinking water, spelling disaster for American dental health, where 90% of adults already experience tooth decay and over half of children and adolescents are experiencing cavities.
Reproductive rights
The rollback of Roe v Wade in June 2022 set a precedent for reducing access to reproductive healthcare that has already caused multiple preventable deaths. While access is currently on a state-by-state basis, once in office, Trump can wield his control of Congress and the Supreme Court to limit access federally. The health impacts of restricting access to safe, legal abortions are extremely well documented, and if Trump does exercise this power, it will lead to more suffering and more deaths.
Trans healthcare
For trans people in America, access to gender affirming care will continue to be a huge challenge and very dependent on state of residence. Progressive states are signposting attempts to become “sanctuaries” for trans people, in addition to migrants and refugees. Similarly to the UK, sections of US society and government demonstrate extreme transphobia, which is guaranteed to increase under Trump’s administration, given his promise to sign an executive order instructing federal agencies to end programmes that “promote the concept of sex and gender transition at any age”.
WHAT’S NEXT?
While it’s hard not to feel defeated by all this before it’s even begun, it’s important to remember that though Trump has in the past seemed unpredictable, rash and ego-driven, he’s not as much of an anomaly policy-wise as those before him. From our perspective, the American administration has hardly gone from strength to strength in the last 40-some years as far as civil rights, economic equality, peacebuilding and environmental protections are concerned. Reaganomics set the groundwork for the polycrises across health, housing and social care, and expanding the war on drugs; George W. Bush followed in Bush Sr.’s footsteps when it came to foreign policy, causing over a million deaths in Iraq and Afghanistan; Barack Obama ruthlessly deported millions of undocumented migrants and cemented the USA’s reliance on drone warfare; and Joe Biden will go down in history for his enabling of the Israeli government’s current efforts to finally complete ethnic cleansing in Palestine. All have seen civil rights and human rights rolled back under their rule. The mechanics of American power are imperialist, capitalist and white supremacist, regardless of figurehead.
Furthermore, Trump’s first term demonstrated an inefficiency in winning conservative policy goals. For one, he does not have universal support within the Republican party, and some proposals are likely to see resistance within the right. Many will recall an administration marked by scandal, corruption, changes in staffing and internal disagreements. It’s difficult to speculate what might be different this time, and he has surrounded himself with “loyal” yes-men, so we should neither underestimate this destructive potential, nor exaggerate his competence.
Activists and advocates for justice and liberation the world over have our work cut out for us. But since when has that not been the case? We know that power must be built from below, and change can only be won with a strong movement of people working together towards a world in which all of our rights are protected and all people are free. Trump doesn’t change the work that needs to be done, but he may spur more to join us, so it’s important that we’re ready to grow our numbers and work through our differences in order to present a unified front against nihilist fascism.
