The Trump Administration’s Attack on Environmental Protections Will Increase Cancer-Causing Pollution

In 2022, more than 18 million Americans were living with cancer.¹ The National Cancer Institute estimates that roughly 39 percent of adults in the United States will be diagnosed with cancer at some stage in their lifetime.² More than 2 million new cancer cases, including almost 10,000 among children, will be diagnosed in the United States this year alone, with 618,120 people expected to die from the disease, according to estimates by the National Cancer Institute.³ Cancer is one of the top two leading causes of death in the country and is responsible for almost 1 in 5 deaths.⁴

Air pollution includes a mix of toxic substances that make it a leading environmental cause of cancer.⁵ Fossil fuel production and use—including from fossil fuel-fired power plants, fertilizer and petrochemical facilities, heavy-duty diesel engine trucks, gas-powered cars, the oil and gas industry, and ports—are significant sources of pollution tied to cancer.⁶ Air pollution also threatens public health by causing neurological and psychological conditions as well as asthma and lung and heart disease.⁷

Since 1970, the U.S. Environmental Protection Agency (EPA) has developed science-based pollution limits—which have had substantial public health and economic benefits—to cut pollution from fossil fuel production and use, protect Americans’ health, and avoid preventable cancer cases.⁸ Notably, for a variety of reasons, cancer deaths declined by 34 percent from 1991 to 2022.⁹ Yet in just the first six months of his second administration, President Donald Trump has pursued policies that will worsen cancer risks, threatening to reverse decades of progress.¹⁰ These actions include attacking pollution limits and environmental protections; gutting public health programs that support lifesaving cancer research, prevention, and care; and proposing pharmaceutical tariffs, which could limit access to and increase the price of cancer medications.¹¹ In addition, congressional Republicans’ One Big Beautiful Bill Act (OBBBA) will slash pollution reduction programs, end clean energy incentives, and gut the Medicaid program—which covers critical health services for more than 71 million Americans, including 1 in 10 adults and 1 in 3 children with a history of cancer. The consequences of these actions will compound the harm to Americans at risk of cancer or in need of cancer treatments, including kids, and undermine the administration’s goal to reduce chronic disease as part of its “Make America Healthy Again” agenda.¹²

Reducing access to cancer prevention and treatment while simultaneously increasing exposure to cancer-causing pollution is an assault on Americans. This report analyzes how cancer affects Americans and how increasing pollution will elevate cancer risks and cases. It also assesses the barrage of Trump administration actions to weaken or eliminate clean air and other environmental protections and to cancel funding to improve and monitor air quality and accelerate the adoption of clean energy and transportation, all of which help curb cancer-causing pollution. Communities across the country will likely see higher levels of pollution and preventable cancer. This is especially true for communities in the most polluted cities; those near the roughly 400 coal- and gas-fired power plants projected to run more as environmental protections and clean energy incentives are stripped away; and those close to the nearly 170 chemical plants, power plants, and other industrial facilities that have been given two extra years to comply with toxic air pollution limits. The top 10 states with these polluting facilities are Texas, Pennsylvania, California, Florida, Illinois, Louisiana, New Jersey, Virginia, Ohio, and Oklahoma. Five of these states are home to one or more metro areas with dangerous levels of year-round soot pollution, which can cause cancer. (see Figures 1a and 1b) Lastly, this report examines how the administration’s and congressional Republicans’ plans to eviscerate the U.S. public health system; to impose health care cuts and pharmaceutical tariffs; and to strip away clean energy incentives and essential health care coverage for working-class families through the OBBBA will kneecap the prevention of and treatment for cancer and other health conditions to help pay for tax cuts for the wealthy and benefit polluters.

Air pollution, which was responsible for almost 9 million early deaths globally in 2015, includes a mix of harmful substances, including some that cause cancer.¹³ Fossil fuel production and use is a significant source of pollution tied to cancer. It includes pollution from fossil fuel-fired power plants, heavy-duty diesel engine trucks, gas-powered cars, and the oil and gas industry, among others.¹⁴ (see Table 1)

A 2022 analysis by the Clean Air Task Force found that toxic air pollution emitted from the oil and gas sector alone puts 14 million people in the United States at increased risk of cancer.¹⁵ A recent American Lung Association review of scientific evidence, as well as other studies, shows a clear link between soot exposure from cars and trucks, power plants, and other sources and lung cancer cases and deaths.¹⁶ The American Lung Association report also found that 85 million people live in a U.S. county with unsafe levels of year-round particle pollution (particulate matter 2.5), also known as soot.¹⁷ According to the International Agency for Research on Cancer, soot, diesel exhaust, and outdoor air pollution are classified as group 1 carcinogens given the strong evidence that long-term exposure to air pollution can cause lung cancer.¹⁸

Despite recent declines in cancer cases and death rates, people with limited incomes and working-class, Black, Latino, American Indian/Alaska Native, rural Appalachian, and LGBTQI+ communities have higher rates of some types of cancer, are more likely to be diagnosed at a later stage of cancer, and are more likely to die of some types of cancers.¹⁹

For a variety of reasons, Black people are more likely to die of most leading types of cancer than other racial and ethnic groups.²⁰ Worse health care coverage, access, and affordability; social and economic inequalities that limit access to healthy food and opportunities to exercise; higher levels of exposure to dangerous pollution; and long-standing racism contribute to poorer cancer outcomes for Black and other affected communities.²¹ Redlining and the placement of facilities that emit toxic pollution in predominantly Black neighborhoods expose Black people to far greater levels of air pollution than white people experience, which adds to their risk of developing cancer.²² ProPublica analyzed data from 2014 to 2018 and identified more than 1,000 places where air pollution from industrial plants spreads cancer-causing chemicals, increasing the risk of cancer for communities.²³ Almost all of the 20 communities with the highest cancer risk are in states that have weaker environmental regulations.²⁴ In census tracts where more than 50 percent of residents are people of color, there is 40 percent more cancer-causing industrial air pollution on average compared with census tracts with mostly white residents.²⁵ The estimated risk of pollution-related cancer in majority Black census tracts is more than double that of majority white census tracts.²⁶

The national costs of cancer-related medical care were estimated to have been almost $209 billion in 2020—and are projected to increase to more than $245 billion by 2030.³¹ Patients’ cancer-related costs are estimated at more than $21 billion. In addition, a cancer diagnosis can limit an individual’s ability to work and go to school.³² In a 2012 survey, just more than half of working-age cancer survivors reported not working full time, which can reduce income, access to health insurance, and psychological well-being.³³

Communities across the United States could see higher levels of cancer-causing pollution if the Trump administration erases or weakens pollution limits—including for power plants, industrial facilities, and mobile sources such as cars and trucks that travel on highways and roads that often run alongside or through communities—as planned.³⁴ Among those areas that could see some of the highest increases in cancer-causing pollution and avoidable cancer risks and cases are those with the most soot pollution. The American Lung Association has identified 25 cities and metropolitan areas with the worst year-round soot pollution.³⁵ In addition, communities near roughly 400 coal- and gas-fired power plants—which the Rhodium Group has projected will run more as the Trump administration and the OBBBA strip away environmental protections and clean energy incentives—and communities close to the roughly 170 chemical plants, power plants, and other industrial facilities that have been granted two-year extensions to comply with toxic air pollution limits will also be at risk of exposure to more cancer-causing pollution.³⁶ All but four states have one or more polluting facilities expected to emit more cancer-causing pollution due to the actions of the Trump administration and the OBBBA. (see Figure 1a)

The top 10 states with the most polluting facilities that are exempted from toxic air pollution limits and/or are expected to run more as environmental protections are stripped away are Texas, Pennsylvania, California, Florida, Illinois, Louisiana, New Jersey, Virginia, Ohio, and Oklahoma. Each of these states has 15 or more polluting facilities that are likely to emit more cancer-causing pollution as environmental safeguards and clean energy incentives are canceled or weakened. (see Figure 1a) In addition, five of these states are home to one or more metro areas with dangerous levels of year-round soot pollution. (see Figure 1b)

The top five states with the most polluting facilities—Texas, Pennsylvania, California, Florida, and Illinois—each have 32 or more facilities expected to emit more cancer-causing pollution. More than one-third of states (19) have 10 or more polluting facilities that are likely to emit more cancer-causing pollution as environmental protections are weakened. More than half of states (29) have seven or more polluting facilities expected to emit more cancer-causing pollution. (see Figure 1a)

Five fossil fuel-fired power plants are each projected to increase their electricity output by 11,800,000 megawatt-hours (MWh) or more by 2035 as environmental safeguards are weakened and clean energy incentives are canceled. These five plants—located in Ohio, Georgia, South Carolina, Texas, and West Virginia—will together increase their output by a total of 68,539,078 MWh, which is enough to power more than 6.5 million homes for a year.³⁷ Cancer-causing pollution from these five fossil fuel-fired power plants is expected to skyrocket as their output balloons to meet energy demand that would have been met by clean renewable energy if environmental protections and clean energy incentives were left in place.

In total, fossil fuel-fired power plants across the country are projected to generate an additional 513,728,614 MWh of electricity in 2035—enough electricity to power almost 49 million homes—as the Trump administration strips away environmental safeguards and slows the deployment of clean energy.³⁸ Demand for this electricity would have likely been met by renewable energy if the OBBBA had not canceled clean energy incentives and if the Trump administration keeps existing environmental protections in place.

Working to eliminate pollution limits

Studies show that roughly 75 percent of Americans are worried about air and water pollution, and a majority of voters see nearly all major environmental protections as essential.³⁹ Yet despite his promise to deliver the “cleanest air and water on the planet”, President Trump and his administration have moved rapidly to rip away critical environmental and public health protections, which will expose Americans to pollutants and toxins while undercutting the administration’s goal to reduce chronic disease as part of its “Make America Healthy Again” agenda.⁴⁰ On the campaign trail, President Trump promised oil executives that he would scrap dozens of pollution reduction policies in exchange for generous financing for his reelection bid.⁴¹ In March, the Trump administration announced its plans to repeal dozens of environmental protections, including limits on soot, air toxics such as mercury, and other cancer-causing pollution from cars, trucks, power plants, the oil and gas industry, iron and steel manufacturing, and other industrial sources.

Giving polluters a free pass

While the administration works to dismantle science-based pollution limits, it has found more immediate ways to benefit polluters while harming Americans’ health. In March, the administration granted 68 fossil-fuel fired power plants—most of which burn coal and many of which are located in working-class communities already overburdened by pollution across 23 states—two-year exemptions from the EPA’s latest mercury and air toxics standards, pushing compliance deadlines from 2027 to 2028⁴⁸ and allowing the power plants to emit more cancer-causing pollution. (see Figure 1a) According to the EPA’s own analysis, the standards provide $33 million in annual health benefits by limiting air toxics, which can cause cancer and other serious health problems, including brain and nervous system damage among children, asthma, and premature death.⁴⁹ Community and environmental groups are suing the administration, alleging that it is unlawfully exempting the power plants from the standards.⁵⁰

In July, President Trump issued several proclamations that gave more than 100 chemical plants; refineries; facilities that sterilize medical devices, equipment, and supplies; coal-fired power plants; and taconite iron ore processing facilities two-year extensions to meet air toxics standards.⁵¹ (see Figure 1a) The extensions will broadly push deadlines to meet key requirements from 2027 to 2029, granting corporations more time to continue releasing dangerous amounts of cancer-causing pollution, which will lower their costs while increasing cancer risks for Americans.⁵²

Abandoning limits on “forever chemicals”

In April, the EPA announced a commitment to addressing harmful “forever chemicals,” or PFAS, in drinking water. The next month, the EPA announced that it will abandon the first-ever nationwide limits on four types of PFAS for drinking water and allow water utilities to delay by two years the deadline for filtering out two other types of PFAS.⁵³ Exposure to these unsafe chemicals, which stay in the environment for decades and the human body for years, can increase cancer risks, reduce fertility, weaken the body’s immune system, and cause harm to children—including developmental delays, low birth weight, accelerated puberty, and behavioral changes—among other health problems.⁵⁴ The Environmental Working Group estimates that more than 158 million people across the country are exposed to PFAS in their drinking water, confirming that PFAS’ contamination of the nation’s water supply is a public health crisis.⁵⁵

In June, the Trump administration also announced it would delay and review the EPA’s ban on all uses of asbestos, a cancer-causing mineral that kills 40,000 Americans each year. However, it reversed course in July, a move celebrated by advocates concerned that stalling the ban would cause chaos and endanger public health.⁵⁶

Moving to end federal actions to fight the climate crisis

The Trump administration has also formally proposed overturning the EPA’s endangerment finding—a scientific finding that planet-warming pollutants endanger Americans’ health and well-being—despite the consensus among scientists and the overwhelming evidence that validate it.⁵⁷ The endangerment finding provides the legal foundation for nearly every existing federal safeguard to tackle the climate crisis by cutting heat-trapping pollution—which also reduces other harmful emissions that cause cancer and other health problems—from power plants, cars, diesel trucks, and oil and gas operations.⁵⁸ Overturning the endangerment finding would also increase the risk of more frequent and dangerous extreme weather, such as the devastating and costly wildfires in California, the recent catastrophic floods in Texas, heat waves,⁵⁹ and hurricanes, among other climate disasters that elevate cancer-causing pollution and inflict high costs and harms on the American people.⁶⁰ In July, the Trump administration released its proposal to rescind the endangerment finding, claiming that “many have stated that the American people and auto manufacturing have suffered from significant uncertainties and massive costs related to general regulations of greenhouse gases from vehicles and trucks,” despite the fact that the EPA’s own data show that the clean car rule and clean trucks rule together provide at least $136.7 billion in annual public health and other benefits.⁶¹ According to the EPN, this conservative estimate of benefits is more than four times greater than the annual $30 billion in auto- and truck-maker compliance costs.⁶² Furthermore, to arrive at these conclusions, the Trump administration appears to have relied heavily on a report that was allegedly commissioned “secretly” from five scientists known for contradicting the overwhelming scientific evidence and consensus that planet-warming greenhouse gas emissions from burning fossil fuels cause climate change. In a lawsuit, environmental advocates allege that this violated the Federal Advisory Committee Act, which requires government advisory committees to make their meetings, emails, and other information available to the public.⁶³

Canceling funding to reduce and monitor pollution

Delivering yet another blow to Americans’ health, the administration has halted funding for many efforts across the country to monitor and reduce pollution that causes cancer and other health harms.⁶⁴ In an April court filing, the EPA acknowledged that it canceled roughly 377 grants and planned to terminate an additional 404 grants, all of which aimed to advance environmental justice by improving air and water quality in America’s most polluted communities.⁶⁵ For example, one of the canceled grants assisted air pollution regulators in Louisville, Kentucky, in monitoring toxic air pollution, including near a cluster of chemical plants where a previous study found that cancer-causing pollution levels were unacceptably high.⁶⁶

In June, a federal judge ruled that the EPA’s cancellation of $600 million in environmental justice grants was unlawful.⁶⁷ That same month, a coalition of community groups, Tribes, and local governments sued the Trump administration, alleging that it was illegally terminating grant funding designed to bolster their protection from environmental harms.⁶⁸

Gutting the EPA’s ability to protect Americans’ health

Further paralyzing progress on cutting cancer-causing pollution, EPA Administrator Lee Zeldin has shuttered or proposed to eliminate the agency’s programs on science, research and development, environmental justice, climate protection, and air quality, as well as a leading lab that studies how air pollution harms human health, while installing fossil fuel and chemical industry insiders in leadership positions.⁶⁹ In response to the EPA’s July announcement that it will eliminate its science office, Jennifer Orme-Zavaleta, former EPA principal deputy assistant administrator for science, said in a statement: “This does not save taxpayers money; it simply shifts costs to hospitals, families and communities left to bear the health and economic consequences of increased pollution and weakened oversight.”⁷⁰

President Trump and Administrator Zeldin also aim to slash the EPA’s budget by a staggering 65 percent, which former agency leaders say would gut its ability to fulfill its mission to protect public health and the environment.⁷¹ President Trump’s fiscal year 2026 budget proposed a disabling 54 percent cut to the EPA’s budget.⁷² While the House Appropriations Committee approved legislation that would inflict a steep 23 percent cut to the EPA’s budget—a cut that would affect funding for clean and safe drinking water and the enforcement of pollution limits—Senate appropriators approved only a 5 percent cut, challenging both the House and White House EPA budget proposals.⁷³ Senate appropriators also pushed back against the EPA’s plans to close its scientific research office, stating in their EPA and U.S. Department of the Interior spending bill report that closure would lead to “immeasurable risk to our health and environment.” It ordered the EPA to “immediately halt” the closure and other changes that would affect the EPA’s scientific workforce.⁷⁴

Gutting the EPA and eliminating environmental protections is not what voters—including Trump voters—want. An EPN post-election poll found overwhelming public support for the EPA and pollution limits, with 76 percent of Trump voters and 86 percent of all voters opposing efforts to weaken the agency.⁷⁵ Before knowing who Trump had picked to lead the EPA, nearly two-thirds of Trump voters and 88 percent of all voters conveyed concern that his EPA administrator would “put the interests of polluting corporations ahead of protecting clean water, clean air, and public health.”⁷⁶

Together, these actions would expand profits for big polluters by cutting their costs while also increasing cancer cases and risks. (see Table 2) According to former EPA leaders, the actions would endanger the lives of millions of Americans, particularly in working-class, low-income, Black, Latino, and other communities where pollution is concentrated.⁷⁷

The OBBBA sharpens the Trump administration’s attack on environmental protections and clean energy in ways that will further increase pollution, driving up cancer, health care, and energy costs while giving the fossil fuel industry roughly $15 billion in new tax breaks.⁷⁸

Abandoning clean energy necessary to meet the rising U.S. energy demand

Overall, the OBBBA is expected to reduce clean energy additions to the electrical grid by up to 62 percent by 2035.⁷⁹ Doing this, especially as power demand is set to increase substantially, will drive toxic emissions from fossil fuel power plants through the roof—with a high cost for Americans’ health.⁸⁰ Estimates predict that the OBBBA could lead to 430 preventable deaths per year by 2030 due to air pollution and resulting health conditions; this number could rise to 930 deaths per year by 2035.⁸¹

Furthermore, the OBBBA’s cuts to federal clean energy investments make it much more likely that data centers, forecasted to make up a significant portion of increasing energy demand, will be powered by coal and natural gas, driving up cancer-causing pollution. For example, Elon Musk’s xAI built a data center in a Memphis community already bombarded by pollution from 17 industrial facilities and powered it with more than two dozen unpermitted natural gas turbines, which emit soot and other hazardous air pollutants.⁸² These turbines also lack pollution controls.⁸³ On July 2, 2025, despite vocal local opposition, Memphis-area regulators granted xAI permits for its turbines.⁸⁴ In addition to producing emissions from generating electricity, the manufacturing of semiconductors used at data centers creates significant amounts of PFAS pollution, which can contaminate water and is linked to cancer.⁸⁵ The OBBBA also jettisons decades of progress to improve the fuel economy of cars by zeroing out fines under the Corporate Average Fuel Economy standards, which lead to less cancer-causing air pollution from vehicles.

Even before the OBBBA passed, Congress had taken extreme action to slash health protections. On May 22, the Senate voted 51-44 to pass three Congressional Review Act (CRA) resolutions targeting California’s vehicle emission standards, functionally breaking the chamber’s own rules by evading the Senate parliamentarian’s ruling that California’s standards are not subject to the CRA.⁸⁶ All Republicans voted “yes,” with every Democrat opposing—except for one. These protections were set to save thousands of lives by reducing soot pollution from vehicles, especially heavy-duty trucks.⁸⁷

Eliminating funds to reduce pollution

The One Big Beautiful Bill Act abandons critical federal investments in reducing pollution across numerous sectors of the economy. In the transportation sector, the bill cancels investments that reduce diesel exhaust pollution, which contains 40 known carcinogens including benzene, formaldehyde, and polycyclic aromatic hydrocarbons.⁸⁸ These dangerous pollutants are emitted from the tailpipes of school buses, port vehicles, and long-haul trucks, as well as other diesel-fueled vehicles. In the electric sector, the bill cancels federal incentives to build new clean electricity generation sources that would otherwise reduce the need for coal and natural gas power plants.⁸⁹ Coal and natural gas plants are a large source of soot, arsenic, cadmium, and cobalt—carcinogenic pollutants that have been known to harm human health for decades.⁹⁰ And in the industrial sector, the bill cuts incentives and funding for industrial facilities such as iron smelters—which are significant emitters of arsenic as well as hexavalent chromium—to switch to cleaner fuels. In addition, the OBBBA repealed unobligated funds for several major pollution reduction programs including environmental and climate justice block grants, the Greenhouse Gas Reduction Fund and funding for diesel emission reductions, clean heavy-duty vehicles, and efforts to address air pollution, among others. These repeals jeopardize communities’ ability to invest in projects that reduce cancer-causing pollution.⁹¹

In a reversal of President Biden’s efforts to reestablish the “Cancer Moonshot” program to identify medical breakthroughs, and despite a claimed interest in reducing chronic disease, the Trump administration is slashing cancer prevention programs.⁹²

As part of its agenda to cut the U.S. Department of Health and Human Services, the Department of Government Efficiency (DOGE) dissolved the National Institutes of Health’s (NIH) National Cancer Institute Office of Communications and Public Liaison, which provided information about cancer to the public, patients, and physicians.⁹³ President Trump’s proposed budget for FY 2026 calls for an additional cut of $2.7 billion from the National Cancer Institute—a 37 percent reduction in funding for the agency, including eliminating research and public health programs that support cancer prevention, early detection, and treatment.⁹⁴ Secretary Robert F. Kennedy Jr.’s decision to halt and cancel mRNA vaccine research poses yet another threat to cancer patients: mRNA vaccine research has shown promise for developing a vaccine that can fight treatment-resistant tumors, potentially providing an alternative to surgery, radiation, and chemotherapy for cancer patients.⁹⁵ Currently the National Cancer Institute is the largest funder of cancer research in the world.⁹⁶ Experts fear that drastic cuts to research and training programs will not only stall scientific innovation, including cancer treatments, but also threaten the pipeline of young scientists who may leave the field or take their talents to other countries.⁹⁷

According to the administration’s May “Make America Healthy Again” assessment, reducing the threat of exposure to environmental toxins is one of its four priorities to reduce childhood chronic disease, yet according to experts, the administration’s policies are moving in the opposite direction.⁹⁸ The administration’s September follow-up report fails to address these threats. Instead of holding corporate polluters accountable for exposing kids and families to environmental toxins, the report only calls for more research on the health impact of environmental chemicals even though federal research grants on this subject are being canceled.⁹⁹ The administration’s proposed FY 2026 budget would cut $320 million from the NIH National Institute of Environmental Health Sciences, shrinking it by 35 percent.¹⁰⁰

The FY 2026 budget also proposes to eliminate the Centers for Disease Control and Prevention’s (CDC) Division of Cancer Prevention and Control.¹⁰¹ DOGE has cut staff that regulated and enforced tobacco products, in addition to terminating staff at CDC’s Office on Smoking and Health, which has long provided education, collected data, operated quit hotlines, and supported smoking prevention policies.¹⁰² This is essential work, as smoking is responsible for about 20 percent of all cancers and about 30 percent of all cancer deaths in the United States.¹⁰³

In addition, the OBBBA cuts programs that provide treatment for cancer patients and survivors. According to the Congressional Budget Office, the OBBBA’s cuts to the Medicaid program—the largest ever made—in conjunction with changes that will make Affordable Care Act Marketplace insurance plans less affordable, will cause more than 14 million people to lose their health insurance.¹⁰⁴ The increase in health costs will strain families’ budgets, which could cause people to delay cancer screenings that catch the disease early when it is most treatable.¹⁰⁵ In fact, having health insurance is one of the strongest predictors of cancer survival in the United States, with uninsured people more likely to be diagnosed with cancer at a later stage and less likely to receive evidence-based preventive care, screening, treatment, and end-of-life care than people with health insurance coverage.¹⁰⁶ According to a 2020 research review, coverage disruptions are linked to delays in cancer screening and treatment, late-stage cancer, and worse chances of survival.¹⁰⁷ Although Medicaid expansion has been associated with an increase in cancer survival and a reduction in health disparities, policies that disrupt care, such as the OBBBA’s newly imposed Medicaid work reporting requirements, will worsen health disparities and create additional burdens for cancer patients who may have to prove that they qualify for exemptions.¹⁰⁸ The OBBBA also delays or ends Medicare price negotiations to lower prescription drug costs for certain cancer drugs including Keytruda, Opdivo, and Yervoy.¹⁰⁹ To make matters worse, cuts to cancer research will harm cancer data tracking, making it harder to determine how these federal policies affect cancer care going forward.

President Trump’s tariffs will also threaten access to cancer treatment and could cause delays in care. The Trump administration has imposed a 15 percent tariff on imported medicines from Europe but has not yet finalized pharmaceutical tariffs levied on other countries, including India and China, that are major producers of generic drugs.¹¹⁴ According to one economic analysis, a 25 percent pharmaceutical tariff, which President Trump has floated multiple times, could increase the price of a 24-week generic prescription used to treat cancer by up to $10,000.¹¹⁵ In addition to higher prices, markets are showing, through their reactions to tariff news, that tariffs could trigger drug shortages.¹¹⁶ Under a 25 percent tariff, cancer drugs in particular could become unprofitable for manufacturers because they often sell these drugs at discounted prices under the 340B safety-net drug-pricing program.¹¹⁷ If they have to absorb the tariff, they may decide to leave the market.

The Society of Nuclear Medicine and Molecular Imaging has also warned that the 20 million nuclear medicine procedures that use specialized drugs with ingredients from other countries could be at risk, which could have a significant impact on access to cancer imaging and treatment and cause patients to experience delays in care—particularly in rural and underserved areas.¹¹⁸

Cutting health care and cancer prevention and treatment while simultaneously increasing exposure to cancer-causing pollution threatens the health and well-being of Americans. The Trump administration’s plan to unleash cancer-causing pollution by erasing pollution limits; canceling clean energy projects and incentives; cutting funds for cancer research and prevention initiatives; ripping away health care coverage from millions of Americans; and driving up health care, medication, and utilities costs will increase preventable cancer cases and deaths. The administration’s actions have broken the president’s promise to deliver “the cleanest air and water on the planet”¹¹⁹ while delivering a crushing blow to Americans’ health and bank accounts and the “Make America Healthy Again” goal to reduce chronic disease—all to boost polluters’ profits and cut taxes for the ultrawealthy.

Americans want a government that will protect their health and strengthen rather than strip away environmental safeguards,¹²⁰ and they deserve a government that works for everyone, not just the superrich and fossil fuel executives. Leaders who genuinely want to make America healthy, protect kids from toxic pollution, reduce cancer risks and cases, and lower health care and energy costs should follow recommendations from community leaders, states, and experts doing the work. These recommendations include strengthening pollution limits, expanding access to clean renewable energy and electric vehicles, creating incentives for home energy efficiency improvements and clean energy storage to replace fossil-fueled power plants, and preventing the permitting or expansion of dirty peaker power plants, or plants that run only during periods of peak electricity demand, and industrial polluters in communities already bombarded by dangerous pollution.¹²¹ These actions—along with strong and stable support for health care and cancer research, prevention, and treatment—are essential to control preventable disease as well as to protect public health and the right of all Americans to breathe clean air, drink clean water, and live in healthy communities.

The authors would like to thank Mona Alsaidi, Beatrice Aronson, Shannon Baker-Branstetter, Margaret Cooney, Andrea Ducas, Jamie Friedman, Mark Haggerty, Trevor Higgins, Jessica Ordóñez-Lancet, Devon Lespier, Meghan Miller, Kate Petosa, Bill Rapp, Mariam Rashid, Bianca Serbin, and Kat So from the Center for American Progress. The authors would also like to thank Jeremy Symons of the Environmental Protection Network; Jennifer Orme-Zavaleta, former principal deputy assistant administrator for the EPA’s Office of Research and Development; and Ben King and Hannah Kolus of Rhodium Group.