Center for American Progress

The Trump Administration’s Assault on Environmental Protections Will Give Polluters a Free Pass While Causing Millions of Asthma Attacks
Report

The Trump Administration’s Assault on Environmental Protections Will Give Polluters a Free Pass While Causing Millions of Asthma Attacks

The Trump administration’s plan to weaken clean air protections could cause more than 10,000 asthma attacks per day while cutting lifesaving asthma prevention programs and as House Republicans seek to slash pollution reduction efforts, clean technology investments, and essential health care coverage—all to give tax breaks to billionaires.

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In this article
Cars sit in traffic as the sun sets behind a veil of smog.
Cars sit in traffic as the sun sets behind a veil of smog in Long Beach, California, on September 20, 2023. (Getty/Luis Sinco/The Los Angeles Times)

Introduction and summary

Asthma is a serious chronic lung disease that affects more than 26.8 million adults and 4.5 million children in the United States, harming people’s health and the U.S. economy.1 Asthma attacks can trigger coughing, wheezing, chest tightness, and gasping for breath, which interfere with everyday life, work, and school and may require emergency care.2 For Angela Garcia, a longtime resident of Globeville, a community in Denver, Colorado, that is surrounded by multiple sources of pollution, asthma is a constant worry. Garcia said: “Having to use an inhaler is a scary thing because you can’t breathe. I can walk outside and know I’m going to have to use it because of the smell that’s in the air.”3

Air pollution from fossil fuels, wildfire smoke, and hot days that cause smog to form is a leading trigger for asthma attacks, which is why eliminating fossil fuel combustion in cars and power plants alone could mean more than 2 million fewer asthma attacks by 2050, according to the American Lung Association.4 However, the Trump administration is pursuing policies that will worsen asthma in America, including an aggressive assault on environmental protections; the gutting of public health programs that support lifesaving asthma prevention, research, and care;5 and proposed pharmaceutical tariffs, which could increase the price of asthma medications by 13 percent or higher.6 The administration’s plan to roll back tailpipe and smokestack standards alone will likely cause more than 100 million asthma attacks over the next 25 years—or more than 10,000 asthma attacks daily—in the United States that could be avoided if the standards were left in place.7 Moreover, House Republican plans to drastically cut pollution reduction programs, clean energy incentives, and the Medicaid program—which covers critical health services for more than 71 million Americans—could compound these harms.8

This report analyzes how asthma affects Americans and how increasing pollution will cause people with asthma to experience more asthma attacks and more people to develop asthma. It also assesses the slew of actions by the Trump administration to weaken or eliminate environmental and climate protections that reduce pollution, to reverse the EPA’s scientific finding that planet-warming pollutants endanger Americans’ health and well-being and must be regulated, and to cancel funding to improve and monitor air quality and accelerate the adoption of clean energy and transportation. Lastly, it examines how the administration’s plans to eviscerate the U.S. public health system, including asthma prevention programs; the administration’s proposed pharmaceutical tariffs; and the House Republican plan to slash pollution reduction efforts, clean energy incentives, and essential health care coverage for low-income and working-class families will affect Americans with asthma and other pollution-related health conditions. Together, these actions would partially pay for tax cuts for billionaires and would increase pollution while boosting the profits of corporate polluters at the expense of American’s health.

Methodology

The data for the estimated number of asthma attacks were sourced from an Environmental Protection Network (EPN) analysis of the impacts of the Trump administration’s potential rollback of U.S. Environmental Protection Agency (EPA) standards.9 The EPN compiled EPA estimates of avoided asthma attacks from EPA Regulatory Impact Analyses for eight of the 12 EPA pollution standards for which asthma data were available that have been targeted by EPA Administrator Lee Zeldin for reconsideration or rollback. The EPN then tallied the sum of the EPA’s estimates for each of the eight standards and found that together, the standards would prevent 100,657,893 asthma attacks between 2025 and 2050 if left in place. If these standards are rolled back, it is expected that these asthma attacks would not be avoided. To estimate how many asthma attacks would not be avoided per day, the authors and the EPN divided 100,657,893 by 26 (2025 plus all the 25 total years through 2050) to arrive at an estimate of 3,871,457 attacks per year. They then divided this number by 365, the number of days in a year, to arrive at 10,606 attacks per day that could be avoided if the standards were left in place.

Air pollution is a leading cause of asthma

Asthma attacks can be life-threatening, interfere with everyday tasks, and may require emergency care, leading to millions of hospitalizations and averaging more than $50 billion in health care costs in the United States annually.10 Furthermore, children with asthma are more likely to miss school, disrupting their academic performance, and adults may be limited in their work productivity, even when taking medication.11 Asthma in the United States increased by about 10 million cases between 1990 and 2019.12 In 2018, 2.2 million children ages 5 to 17 missed 7.9 million school days due to asthma, and adults missed 10.9 million workdays13 These losses have economic ramifications: From 2008 to 2013, the average costs associated with asthma-related health care, deaths, and missed school and work days totaled $81.9 billion each year.14 While asthma affects millions of Americans, it hits children; older adults; and Black, Hispanic, Native American, and low-income communities the hardest.15
From 2008 to 2013, the average costs associated with asthma-related health care, deaths, and missed school and workdays totaled $81.9 billion each year.

Asthma causes inflamed airways that can flare into asthma attacks when exposed to environmental triggers, such as secondhand smoke, dust mites, and air pollution.16 According to the American Lung Association (ALA), despite decades of improvements in air quality, almost half of Americans—more than 156 million people—live with unhealthy levels of air pollution, an increase of nearly 25 million people in the past year and the highest number of people in roughly the last decade.17 The ALA found that more intense wildfires, extreme heat, and drought fueled by climate change are worsening air pollution throughout the country, putting the health of more Americans at risk. Americans’ exposure to ozone and soot pollution rose between 2021 and 2023, when Canada had its worst wildfire season on record.18 This increase in pollution is a departure from air quality trends that have steadily improved since the passage of the Clean Air Act of 1970—which authorized the federal government and states to limit pollution from industrial and mobile sources—and more recent lifesaving air pollution safeguards.19

Despite decades of improvements in air quality, almost half of Americans—more than 156 million people—live with unhealthy levels of air pollution.

Air pollutants, including ozone (smog or haze) and particle pollution (commonly called soot), can cause asthma and worsen asthma attacks.20 These pollutants also shorten lives and increase the risk of cancer, other lung diseases such as chronic obstructive pulmonary disease (COPD), heart diseases such as heart attacks and strokes, premature birth, and other health conditions.21 When pollution surges, breathing unhealthy air can become a hazard, especially for children whose lungs are still developing.

Power plants, industrial facilities, diesel- and gas-powered vehicles and equipment, and other sources emit soot, nitrogen oxides, and sulfur oxides into the air.22 Soot can travel deep into the lungs and bloodstream, decreasing lung function and damaging heart health. It can harm vital organs such as the heart, brain, and cardiovascular system.23 Even short-term and low-level exposure to soot can worsen asthma attacks.24 Short-term exposure is linked to increased hospital admissions and emergency room visits for heart attacks and strokes, COPD, and increased likelihood of death in infants.25 Exposure to soot is estimated to cause more than 50,000 premature deaths in the United States every year.26

Ozone pollution also seriously affects lung function and can lead to premature death. It is linked to breathing problems, new cases of asthma in children, and increased hospitalizations and emergency department visits for people with asthma and COPD, among other health conditions.27

ALA’s 2025 “State of the Air” report found that more than 638,000 children and more than 3 million adults with asthma live in counties with failing grades on three air pollutants—ozone and two measures of fine particulate matter pollution.28

Air pollution is particularly harmful for working-class, Black, Hispanic, and low-income communities where pollution is often concentrated.29Black Americans are more likely than people of other races and ethnicities to live in areas with unhealthy air quality and be diagnosed with asthma.30 In 2021, the asthma death rate among Black Americans was more than twice as high as that for white Americans.

More than 26 million people of color live in counties that failed on all three measures of air pollution, including more than 15 million Hispanic Americans;31 Hispanic Americans are three times more likely than white Americans to live in a community with failing grades for all three air pollutants.32 According to Angela Garcia of Globeville, Colorado—a predominantly Hispanic and Latino neighborhood in Denver—people originally moved there to work for the railroad and the smelters to make money for their families. Garcia said: “We live here, we pay our taxes, we work hard. We give so much with our different cultures to the community to make it what it is—a good place to grow and exist.” At the same time, Garcia said, “We all have breathing problems. … It could be better if we didn’t have the pollutants that we have in our air.”33

Of those living in counties with a failing grade for at least one pollutant:

34M

are children under age 18

American Lung Association, “State of the Air 2025 Report.”

25M

are age 65 and older

19M

are people experiencing poverty

14.3M

people are living with asthma

Despite these troubling trends, the Trump administration is dismantling environmental protections at a staggering pace, with steep costs and consequences for Americans and their health.

See also

The Trump administration’s harmful actions

Eliminating environmental protections will increase asthma and other health risks for Americans

Starting on his first day in office in his second term, Trump and his administration have orchestrated an aggressive assault on environmental and public health protections, as outlined in Project 2025 and promised by President Trump on the campaign trail to oil executives to pad their profits in exchange for campaign contributions.34 EPA Administrator Lee Zeldin has committed to strip away air quality standards for ozone, soot, and air toxics—as well as emission requirements for power plants, vehicles, coal waste, and oil refineries, among other safeguards—even though studies show that roughly 75 percent of Americans are worried about air and water pollution.35

Trump and his administration have orchestrated an aggressive assault on environmental and public health protections, as outlined in Project 2025 and promised by President Trump on the campaign trail to oil executives.

In addition, the Trump administration has offered power plants the opportunity to emit more toxic pollution by simply submitting an email request for a temporary exemption from clean air rules, including limits on mercury, which can damage the brain and nervous system and lead to severe developmental problems for children.36 The administration has also offered nearly 70 coal-fired power plants, including some of the nation’s top emitters of toxic air pollutants, two-year exemptions from EPA’s latest mercury and air toxics standards.37 Industry groups representing hundreds of chemical and petrochemical manufacturers have also requested exemptions from these rules.38 The EPA had projected that these standards would reduce asthma attacks and other asthma symptoms; brain, nervous system, and kidney damage; cancer; premature deaths; and other health problems among Americans.39

In another series of radical moves, President Trump issued an avalanche of executive orders (EOs) to eviscerate environmental protections, including an EO that directed agencies to review existing regulations and take immediate steps to repeal any they deem “unlawful.”40 The order also directs agencies to end or slow-walk enforcement of rules that do not align with this administration’s priorities. This unprecedented effort to erase or ignore existing scientifically backed safeguards that were established after years of research and public input could have an alarming effect on the health and safety of people and communities across the country.41 For example, the administration could target clean air and water protections, as detailed in Project 2025.42 Targeted protections could include the tailpipe emissions limits for cars and light-duty trucks and pollution standards for power plants, among other safeguards that protect Americans from the effects of climate change and harmful pollution that causes asthma and other health problems.43

To further accelerate its assault on environmental protections, the Trump administration directed agencies to “sunset” environmental regulations that affect energy production, including safeguards for air quality,44 as soon as October 2026.45 The idea to simply “delete” regulations has been touted by Elon Musk, the former head of the Department of Government Efficiency, whose companies have historically sparred with federal regulators over alleged violations of environmental protections.46 Legal experts predict that efforts to sunset and abruptly repeal regulations will run afoul of the Administrative Procedures Act, which requires a thorough and transparent process and public input for agencies to create, change, or cancel rules.47

The majority of American voters are concerned about climate change and say that it is already affecting weather in the United States, with two-thirds of voters expecting their community to be affected.48 In addition, a majority of American voters want federal agencies to do more than they are already doing to protect people from climate change health risks.49 Despite these concerns, the Trump administration has taken steps to overturn the EPA’s scientific finding that planet-warming pollutants endanger Americans’ health and well-being and must be regulated under the Clean Air Act.50 In April 2025, EPA Administrator Zeldin announced that the agency will reconsider the EPA’s endangerment finding—the backbone and legal foundation for nearly every climate and environmental safeguard enacted to curtail asthma-inducing pollution from power plants, cars, diesel trucks, and oil and gas operations.51 In May, The New York Times reported that internal EPA documents revealed the agency’s plans to eliminate all limits on greenhouse gas emissions from U.S. power plants that burn coal and natural gas.52 Reversing the science-based endangerment finding and emissions limits would boost the bottom line for big polluters while increasing pollution and causing more asthma and other health conditions, particularly in communities where pollution is concentrated.53 Overturning the endangerment finding would also increase the risk of more frequent and dangerous heat waves, more devastating and costly wildfires, and other extreme weather events that increase the pollution that causes asthma.54

The Trump administration has also canceled funding authorized by Congress through the Inflation Reduction Act (IRA) and the Infrastructure Investment and Jobs Act (IIJA) to reduce and monitor air pollution—despite multiple court orders to reinstate the funds.55 For example, the administration is canceling nearly 800 grants aimed at helping communities across the country improve air and water quality and protect against more extreme weather events.56 The administration has also canceled grants to improve access to trees and green spaces in urban areas, which can help to reduce air pollution and make neighborhoods cooler, healthier, and more resilient to heat waves made worse by climate change.57 As Angela Garcia said: “A community-based organization [in Globeville] had received funds under the Biden administration to put trees and natural grasses on both sides of the highway, to help alleviate the pollution. We found out a month ago that that funding is going to be cut.”58

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The House Republicans’ budget plan would take these actions a step further by eliminating funding for key IRA programs designed to monitor and reduce harmful pollution in communities—sacrificing Americans’ health to partially pay for tax cuts that primarily benefit the wealthy.59

The Trump administration has also eliminated the EPA’s environmental justice and science and research offices while instating fossil fuel and chemical industry insiders and lobbyists in leadership positions.60 It additionally committed to ending enforcement action against major polluters in communities of color that are unfairly bombarded with dangerous pollution if the aim of the action is to protect against climate change or if the enforcement could “shut down” energy production.61 To further undermine the EPA, President Trump and Administrator Zeldin plan to slash the agency’s budget by 65 percent, which would make itimpossible for the agency to fulfill its mission to protect public health and the environment.62

All of these actions would increase pollution while boosting the profits of corporate polluters at the expense of Americans’ health. According to the EPN, if implemented, these rapid rollbacks would cause more than 10,000 asthma attacks daily—or more than 100 million asthma attacks over the next 25 years—in communities across the country that could be avoided if the standards were left in place. (see Table 1)63

Canceling clean energy investments will worsen asthma among Americans and increase energy costs

Alongside its efforts to gut pollution standards and cut funding to monitor and improve air quality, the Trump administration is also working to end federal investments in clean energy, which would otherwise reduce pollution and, thus, asthma.64 Issued on the first day of Trump’s second term as president, Executive Order 14154 directs federal agencies to freeze funding for IRA and IIJA clean energy programs. These include the Greenhouse Gas Reduction Fund, which would help more than 900,000 working-class and lower-income households access the benefits of solar energy, and the Home Energy Rebates program, which assists families in making home energy efficiency improvements to save money on their electricity bills, improve indoor air quality, and reduce asthma risks in their homes.65 The Trump administration has assembled a list of 300 clean energy projects funded by the U.S. Department of Energy to potentially eliminate.66 Examples include household solar installations and energy efficiency projects that would reduce demand on power plants, decreasing particulate pollution and ground-level ozone concentrations.67

Increasing household electricity costs

Eliminating clean energy and energy efficiency programs would have significant economic ramifications for families. The U.S. Department of Energy estimates that home appliance updates made possible by the Home Energy Rebates program would save families up to $1 billion annually.68 Despite these benefits, the Trump administration’s funding freeze denies families needed support to cut their energy costs and improve their homes’ energy efficiency and indoor air quality, as well as their health and safety.69 In addition, the House Republican budget bill would essentially repeal the IRA’s clean energy incentives and could cause annual home electric bills to jump $110 by 2026.70These moves come on top of a host of other actions taken by the Trump administration that will raise electricity costs for consumers, such as imposing tariffs on key electrical components and encouraging ratepayer subsidization of new data centers.71

Cutting clean energy and energy efficiency programs will compound the financial and health struggles that too many American families face—many of which are deeply interconnected. Across the country, 33 million families experience energy insecurity, 4.9 million lack basic heating, and 6.3 million lack air conditioning.72 As climate change makes extreme weather more common, American families will face higher asthma risks from stifling heat and cold as well as from dry air, which can trigger asthma attacks. They will also face higher energy bills as their heating and cooling needs soar.73In fact, extreme heat causes more death and injury than any other weather phenomena in the United States, creating $1 billion in health care costs every summer.74

Over the past two years, even before the Trump administration attempted to withhold IRA funds that Congress obligated, Republicans in Congress made repeated attempts to overturn the IRA, voting 54 times to do so.75 Recently, House Republicans passed a budget bill that would functionally do the same.76 Repealing the IRA would not only prevent the funding described above from reaching Americans but would also discontinue incentives for clean energy that are essential to lowering energy costs and decreasing asthma-inducing air pollution by reducing reliance on fossil fuels.

Meanwhile, the administration has also taken unprecedented steps that have propped up corporate polluters and promoted fossil fuels.77 For example, President Trump issued an EO mandating agencies to bail out the coal industry, which has been in decline for decades, by opening federal lands to coal leasing and attempting to extend the operating life of coal plants to keep them running as long as possible.78The EO also directs agencies to review and consider weakening or canceling regulations, programs, and incentives that support the transition away from coal use—the dirtiest and most carbon-intensive fossil fuel—to clean renewable energy.79 An Energy Innovation study found that renewable energy, such as wind and solar, would provide cheaper energy than 99 percent of coal plants.80 Coal plants are not only cost inefficient, they are dangerous. Researchers at Harvard University, George Mason University, and the University of Texas, Austin, found that soot pollution from coal plants has killed a ‘’staggering’’ number of Americans—460,000 between 1999 and 2020.81

These actions come at a time when power demand is expected to rapidly increase due to demand from artificial intelligence-focused data centers.82 If cleaner technologies are not available to supply power to these data center projects, it is estimated that existing facilities and new build-outs in the United States could cause an additional 600,000 asthma cases and 1,300 premature deaths in 2030.83

Freezing funds for clean transportation will increase pollution

Eliminating environmental protections and freezing funding for energy efficiency, community solar, and wind projects are not the only Trump administration actions that will increase pollution and, as a result, asthma. The transportation sector is one of the most significant sources of air pollution because combustion engine vehicles emit pollution directly into densely populated environments and therefore have an outsize impact on public health. This is especially true of medium and heavy-duty trucks and buses, which are far more likely to use diesel engines.84 Diesel-powered heavy-duty vehicles make up less than 10 percent of vehicles on U.S. roads but are responsible for 20 percent of vehicle nitrogen oxide and 25 percent of vehicle soot emissions, two major contributors to asthma.85Diesel exhaust is also known to contain at least 40 cancer-causing substances.86 In 2010, roughly 18 percent of all new childhood asthma cases wereestimated to be attributable to nitrogen dioxide pollution, most of which comes from transportation.87 Electrifying transportation is an efficient way to reduce pollution from the sector and therefore decrease the risk of asthma.

Despite these dangers, the Trump administration has wasted no time trying to freeze federal programs to electrify heavy-duty trucks. Executive Order 14154 directed the EPA to freeze funding through the IRA and IIJA’s Clean Ports, Clean School Bus, and Clean Heavy-Duty Vehicles programs.88 These programs supported the electrification of heavy-duty vehicles that have a significant impact, such as school buses that carry kids through communities every school day and port drayage trucks that move thousands of containers around and through port-side communities.89 The ALA estimates that electrifying all new heavy-duty vehicles by 2040, alongside 100 percent clean electricity generation, would prevent 1.75 million asthma attacks by 2050.90

The Trump administration has also attacked efforts to electrify passenger cars and trucks by attempting to pause funding under the National Electric Vehicle Infrastructure program.91 While emitting less per vehicle than heavy-duty trucks, passenger vehicles still contribute significantly to asthma. The ALA estimates that moving to 100 percent electrified passenger vehicle sales and 100 percent clean electricity generation by 2035 would prevent 2.2 million asthma attacks by 2050.92

To take these actions even further, House Republicans’ budget plan would rapidly phase out IRA tax credits for clean vehicles; functionally eliminate a critical clean energy manufacturing tax credit; and rescind unspent funding for grants supporting the electrification of heavy-duty trucking, port operations, and school buses.93 In addition, it would add a $250 registration fee for electric vehicles and a $100 registration fee for hybrid vehicles—punishing Americans who switch to vehicles that are less reliant on gasoline.94 The House Republican budget bill would also raise gasoline prices by 25 cents to 37 cents per gallon by 2035 as demand for oil increases due to the bill’s termination of federal electric vehicle affordability programs, fuel economy standards, and tailpipe emission standards. 95

Furthermore, on May 22, Senate Republicans improperly voted through 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. As noted by more than 100 public health and environmental organizations, overturning California’s standards will lead to “more children suffering asthma attacks and missing school, more grandparents dying prematurely, and more death and destruction from extreme weather.”96

Cutting funds for asthma prevention, education, and treatment will increase asthma complications

Among the programs and staff gutted by Health and Human Services Secretary Robert F. Kennedy Jr. are programs to address asthma, smoking, and tuberculosis, even though he claims that reducing chronic disease is a priority.97

Housed within the U.S. Centers for Disease Control and Prevention, the National Center for Environmental Health (NCEH) includes a variety of education, research, and prevention programs designed to reduce the harms of asthma.98 Gutting the NCEH—including its support for state and local health departments—will diminish public health protections from environmental hazards such as air pollution, climate change, and chemical exposures. These cuts affect the following programs that reduce asthma risks for Americans:

  • The National Asthma Control Program and its work to reduce asthma-related deaths, hospitalizations, and emergency department visits by promoting policies to reduce air pollution. This includes supporting communities, schools, and families in identifying asthma triggers, managing asthma, and improving asthma health care by providing health care providers and schools with evidence-based treatment guidelines.99 From 1999 through 2018, this program helped reduce asthma-related death rates by more than 45 percent, saving $71 in health care costs and lost income for every dollar spent.100 Experts predict that cuts will leave schools less prepared to support students with asthma, which could lead to more hospitalizations and emergency department visits, poorer health, preventable deaths, and higher health care costs.101
  • The Climate and Health Program, which supports state and local health departments in identifying and preparing for climate-related health threats, including wildfires and other extreme weather events that lower air quality and trigger asthma.102 Efforts to help states identify the most at-risk populations and communities have also been cut.
  • The Office on Smoking and Health, which works to identify trends in tobacco product use, which exacerbates asthma.103 Public education campaigns and support to those who want to quit smoking have also been cut.104 These cuts threaten to unwind progress in reducing smoking rates among adults and teens.
  • The National Institute for Occupational Safety and Health, which identifies, prevents, and reduces occupational asthma and respiratory hazards in the workplace.105 Even with some recent staff reinstatements, sweeping layoffs have significantly hampered federal efforts to protect the respiratory health of firefighters, medical providers, and construction workers, among others.106
  • The Trump administration has also cut and undermined regulation and enforcement of tobacco products, which are known asthma triggers reducing protections against chronic diseases.107

In addition, the administration is expected to slash funding for the Department of Housing and Urban Development—including millions of dollars in funding for projects that improve housing energy efficiency, indoor air quality, and climate resilience—despite evidence that poor housing quality affects asthma.108 The administration’s cuts at the National Institutes of Health threaten research on asthma, translation of research into strategies to reduce disease, support for effective asthma treatments, and education and outreach to help people with asthma stay healthy.109

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These cuts come at a time of rising asthma rates and costs. As noted above, asthma in the United States increased by about 10 million cases between 1990 and 2019, with an average annual cost of approximately $82 billion from 2008 to 2013.110 The Trump administration cuts to asthma and tobacco prevention programs and other federal programs focusing on air pollution and worker health and safety are expected to lead to more avoidable hospitalizations and emergency department visits, poorer quality air, higher health care costs, and poorer health outcomes.111

Medicaid cuts could dramatically reduce the ability of working-class families to pay for health care appointments, medicine such as inhalers, and emergency care if needed.

Although asthma can be controlled with proper medical care and other precautions, it cannot be cured,112 and thus access to quality health care is critical. Yet at the same time that the Trump administration is increasing pollution and is cutting asthma-related prevention, outreach, and education programs, House Republicans’ budget bill includes historic cuts to the Medicaid program—threatening access to asthma care for millions of children and adults.113 Medicaid and the Children’s Health Insurance Program cover health care costs for almost half of all children with asthma in the United States, and Medicaid also covers costs for many adults with asthma.114 Adults under age 65 with Medicaid or other public insurance coverage are about twice as likely to have asthma compared with those covered by private insurance.115 Approximately 1 in 10 children and adults covered by the Medicaid program have asthma.116 Therefore, Medicaid cuts could dramatically reduce the ability of working-class families to pay for health care appointments, medicine such as inhalers, and emergency care if needed.

See also

These moves are compounded by the Trump administration’s proposed pharmaceutical tariffs, which, if enacted, could drive up the cost of asthma medications, cause medication shortages, and slow research and development of new asthma treatments.117 The Budget Lab at Yale found that a 25 percent tariff would raise prescription medication prices by an average of 15 percent, with increases likely to be passed on to individuals and families.118 Another study commissioned by a U.S. pharmaceutical lobby group predicted an average price increase of roughly 13 percent, not including the impact of potential retaliatory tariffs.119 This could mean that the average retail price of an albuterol inhaler, a commonly used asthma medication, at slightly more than $98 in 2024, would climb by roughly $13 to about $111 or higher.120

Conclusion

The Trump administration is aggressively rolling back environmental protections and cutting funds for asthma research and prevention, even as half of Americans are breathing unhealthy air and climate disasters are worsening air quality.Health experts warn that stripping away environmental safeguards will have dangerous consequences, including increasing harmful air pollution, threatening Americans’ health, and increasing cases of asthma and asthma attacks.121 As President Trump breaks his promise to deliver “the cleanest air and water on the planet” and his administration’s tariffs threaten to increase medication prices and limit availability—alongside House Republicans’ plan to eliminate clean energy incentives and funding for pollution reduction programs and rip away health care coverage for millions—more children and adults will gasp for breath.122 These moves will worsen all Americans’ health and quality of life, but they will have the greatest impact on people with asthma and in places where pollution levels are the highest.123

“Our most vulnerable and our most valuable, our children and our elders, deserve so much better,” said Garcia. “We need and deserve a government that works for everyone, not just large corporate developers, not just polluters, not just the rich.”124 

We need and deserve a government that works for everyone, not just large corporate developers, not just polluters, not just the rich. Angela Garcia

Americans need a government that will strengthen and accelerate actions to protect their health, not strip away clean air and public health safeguards. In addition, Americans deserve a government that works for all people—not just billionaires and fossil fuel executives. To reduce asthma risks, protect public health, lower health care costs, and reduce productivity losses tied to poor health, Americans need a government that will improve environmental protections. An administration that truly wants to make America healthy could implement strong pollution standards, expand access to clean renewable energy, incentivize clean energy storage to replace fossil-fueled peaker plants, and prevent the permitting or expansion of fossil fuel projects and polluting industrial facilities in communities already struggling to cope with the health risks tied to pollution.125 An administration committed to protecting Americans’ health and safety could also ensure cool and healthy homes for all by investing in efficient and cost-effective heat pump air conditioning and programs to lower household electricity costs, reduce pollution, and protect low-income and working-class families from dangerous heat.126

These actions—along with adequately and sustainably supporting asthma prevention, education, and treatment—are essential to protect public health; control preventable disease; and safeguard the right of all Americans to breathe clean air, drink clean water, and live in healthy communities. The Trump administration’s agenda to abandon environmental and public health protections would rob everyday Americans of this right and threaten their health, lives, and economic security—all to let big polluters off the hook and boost their own bottom lines.127

Acknowledgements

The authors would like to thank Beatrice Aronson, Mona Alsaidi, Shannon Baker-Branstetter, Carl Chancellor, Margaret Cooney, Andrea Ducas, Trevor Higgins, Brian Keyser, Jessica Ordóñez-Lancet, Devon Lespier, Drew McConville, Olivia Mowry, Ryan Mullholand, Cindy Murphy-Tofig, Anh Nguyen, Kate Petosa, and Mariam Rashid from the Center for American Progress. The authors would also like to thank Angela Garcia, Jeremy Symons of the Environmental Protection Network, Laura Kate Bender of the American Lung Association, and Madeline Page of the Climate Action Campaign.

Endnotes

  1. American Lung Association, “Asthma Trend Brief,” available at https://www.lung.org/research/trends-in-lung-disease/asthma-trends-brief (last accessed May 2025).
  2. U.S. Centers for Disease Control and Prevention, “Living with Asthma,” available at https://www.cdc.gov/asthma/living-with/index.html (last accessed May 2025).
  3. Angela Garcia, advocate for the Globeville and Elyria-Swansea community and former employee of the Colorado Department of Public Health and Environment, interview via Zoom with Margaret Cooney, senior campaign manager at CAP, and Olivia Mowry, video producer at CAP, April 18, 2025, on file with authors.
  4. Harvard University T.H. Chan School of Public Health, “Asthma and Air Pollution: Protecting Children’s Health,” available at https://hsph.harvard.edu/research/climate-health-c-change/climate-kids-and-health/asthma/ (last accessed May 2025); University of Pennsylvania, “Managing Asthma Amid the Summer Heat and Dips in Air Quality,”, June 27, 2019, available at https://penntoday.upenn.edu/news/managing-asthma-amid-summer-heat-and-dips-air-quality; American Lung Association, “Driving to Clean Air: Health Benefits of Zero-Emission Cars and Electricity” (Chicago, IL: 2023), available at https://www.lung.org/getmedia/9e9947ea-d4a6-476c-9c78-cccf7d49ffe2/ala-driving-to-clean-air-report.pdf.
  5. Coral Davenport, “Inside Trump’s Plan to Halt Hundreds of Regulations,” The New York Times, April 15, 2025, available at https://www.nytimes.com/2025/04/15/us/politics/trump-doge-regulations.html; Cathleen Kelly and Jasia Smith, “How the Trump Administration’s Agenda To Eliminate Environmental Protections and Promote the Fossil Fuel Industry Harms Public Health,” Center for American Progress, April 2, 2025, available at https://www.americanprogress.org/article/how-the-trump-administrations-agenda-to-eliminate-environmental-protections-and-promote-the-fossil-fuel-industry-harms-public-health/; Lisa Friedman and Hiroko Tabuchi, “E.P.A. Targets Dozens of Environmental Rules as It Reframes Its Purpose,” The New York Times, March 12, 2025, available at https://www.nytimes.com/2025/03/12/climate/epa-zeldin-rollbacks-pollution.html; Jill Rosenthal, Marquisha Johns, and Jasia Smith, “Project 2025 Would Make It Easier for Big Corporations To Dump Dangerous Toxins That Poison Americans,” Center for American Progress, August 7, 2024, available at https://www.americanprogress.org/article/project-2025-would-make-it-easier-for-big-corporations-to-dump-dangerous-toxins-that-poison-americans/; Earthjustice, “What Project 2025 Would Do to the Environment – and How We Will Respond,” November 12, 2024, available at https://earthjustice.org/article/what-project-2025-would-do-to-the-environment-and-how-we-will-respond; Josh Dawsey and Maxine Joselow, “What Trump promised oil CEOs as he asked them to steer $1 billion to his campaign,” The Washington Post, May 9, 2024, available at https://www.washingtonpost.com/politics/2024/05/09/trump-oil-industry-campaign-money/; Ariel Wittenberg and E&E News, “Childhood Asthma Will Worsen with Pollution Rollbacks and CDC Cuts,” Scientific American, April 22, 2025, available at https://www.scientificamerican.com/article/child-asthma-will-worsen-with-trumps-pollution-rollbacks-and-rfk-jr-s-cdc/; Nick Valencia and others, “‘It’s a bloodbath’: Massive wave of job cuts underway at US health agencies,” CNN, April 2, 2025, available at https://www.cnn.com/2025/04/01/health/staff-cuts-at-federal-health-agencies-have-begun/index.html.
  6. Mary Kekatos, “Trump’s proposed pharmaceutical tariffs could drive up costs, lead to drug shortages: Experts,” ABC News, April 9, 2025, available at https://abcnews.go.com/Health/trumps-proposed-pharmaceutical-tariffs-drive-costs-lead-drug/story?id=120630296; The Budget Lab at Yale, “The Fiscal and Economic Effects of the Revised April 9 Tariffs,” April 10, 2025, available at https://budgetlab.yale.edu/research/fiscal-and-economic-effects-revised-april-9-tariffs.
  7. Environmental Protection Network, “Facts: The Trump Administration’s Attacks on EPA Will Harm Public Health and Safety,” available at https://www.environmentalprotectionnetwork.org/epafacts/the-trump-administrations-attacks-on-epa-will-harm-public-health-safety/ (last accessed May 2025); Oliver Milman, Dharna Noor, and Aliya Uteuova, “Trump’s EPA aims to cut pollution rules projected to save nearly 200,000 lives: ‘People will be hurt,’” The Guardian, March 19, 2025, available at https://www.theguardian.com/us-news/2025/mar/19/trump-epa-pollution-regulation-cuts; Hayley Smith, “Trump is cutting the nation’s environmental programs. Here are the health risks to Americans,” Los Angeles Times, April 5, 2025, available at https://www.latimes.com/environment/story/2025-04-05/trump-is-gutting-the-nations-environmental-programs-heres-how-much-it-will-cost-americans; Environmental Protection Network, “Facts: Rollbacks of Pollution Rules Will Cost 200k Lives,” available at https://www.environmentalprotectionnetwork.org/epafacts/facts-rollbacks-of-pollution-rules-will-cost-over-200k-lives/ (last accessed May 2025).
  8. Natasha Murphy and Andrea Ducas, “Congressional Republicans’ Proposals To Slash Medicaid Could Cost Tens of Thousands of Lives,” Center for American Progress, April 23, 2025, available at https://www.americanprogress.org/article/congressional-republicans-proposals-to-slash-medicaid-could-cost-tens-of-thousands-of-lives/; U.S. Centers for Medicare and Medicaid Services, “December 2024 Medicaid & CHIP Enrollment Data Highlights,” available at https://www.medicaid.gov/medicaid/program-information/medicaid-and-chip-enrollment-data/report-highlights#:~:text=78%2C532%2C341%20people%20were%20enrolled%20in,Medicaid%20and%20CHIP%20program%20enrollment (last accessed May 2025); Colin Seeberger and others, “The Devastating Harms of House Republicans’ Big ‘Beautiful’ Bill by State and Congressional District,” Center for American Progress, May 21, 2025, available at https://www.americanprogress.org/article/the-devastating-harms-of-house-republicans-big-beautiful-bill-by-state-and-congressional-district/.
  9. Environmental Protection Network, “Facts: Rollbacks of Pollution Rules Will Cost 200k Lives.”
  10. Ibid; Mayo Clinic, “Asthma,” available at https://www.mayoclinic.org/diseases-conditions/asthma/symptoms-causes/syc-20369653 (last accessed May 2025); American Lung Association, “Asthma Trends Brief”; American Lung Association, “Asthma Trends and Burden,” available at https://www.lung.org/research/trends-in-lung-disease/asthma-trends-brief/trends-and-burden (last accessed May 2025).
  11. Daphne Koinis-Mitchell and others, “Asthma and Academic Performance in Urban Children,” Annuals of Allergy, Asthma & Immunology 122 (5) (2019): 471–477, available at https://pmc.ncbi.nlm.nih.gov/articles/PMC6538301/; Kevin Gruffydd-Jones and others, “Asthma impacts on workplace productivity in employed patients who are symptomatic despite background therapy: a multinational survey,” Journal of Asthma and Allergy 12 (2019): 183–194, available at https://pmc.ncbi.nlm.nih.gov/articles/PMC6636188/#:~:text=This%20survey%20showed%20that%20workers,by%20more%20than%20a%20third.
  12. Tamara Thomas, “Asthma Cases in the US Surge By 10 Million Over 3 Decades,” Urban Health Today, May 23, 2024, available at https://urbanhealthtoday.com/post/asthma-cases-in-the-us-surge-by-10-million-over-3-decades.
  13. American Lung Association, “Asthma Trends and Burden.”
  14. Ibid.
  15. Asthma and Allergy Foundation of America, “Asthma Facts,” available at https://aafa.org/asthma/asthma-facts/ (last accessed May 2025); Shyamali C. Dharmage, Jennifer L. Perret, and Adnan Custovic, “Epidemiology of Asthma in Children and Adults,” Frontiers in Pediatrics 7 (246)  (2019), available at https://pmc.ncbi.nlm.nih.gov/articles/PMC6591438/#:~:text=It%20is%20well%2Dknown%20that,mortality%20are%20higher%20in%20adults.
  16. Adrian Gillissen and Maria Paparoupa, “Inflammation and infections in asthma,” The Clinical Respiratory Journal 9 (3) (2014): 257–269, available at https://pmc.ncbi.nlm.nih.gov/articles/PMC7162380/; U.S. Centers for Disease Control and Prevention, “Controlling Asthma,” available at https://www.cdc.gov/asthma/control/index.html (last accessed May 2025).
  17. American Lung Association, “State of the Air 2025 Report” (Chicago, IL: 2025), available at https://www.lung.org/getmedia/5d8035e5-4e86-4205-b408-865550860783/State-of-the-Air-2025.pdf; U.S. Environmental Protection Agency, “Air Quality – National Summary,” available at https://www.epa.gov/air-trends/air-quality-national-summary (last accessed May 2025).
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  19. U.S. Environmental Protection Agency, “Air Quality – National Summary”; U.S. Environmental Protection Agency, “Evolution of the Clean Air Act,” available at https://www.epa.gov/clean-air-act-overview/evolution-clean-air-act#:~:text=The%20Clean%20Air%20Act%20of,monitoring%20and%20controlling%20air%20pollution (last accessed May 2025); American Lung Association, “Recommendations for Action,” available at https://www.lung.org/research/sota/protect-yourself-community (last accessed May 2025).
  20. Asthma and Allergy Foundation of America, “Air Pollution and Asthma,” available at https://aafa.org/asthma/asthma-triggers-causes/air-pollution-smog-asthma/ (last accessed May 2025).
  21. American Lung Association, “Health Impact of Air Pollution,” available at https://www.lung.org/research/sota/health-risks#:~:text=Long%2Dterm%20exposure%20to%20particle,%2C%20with%20life%2Dlong%20consequences (last accessed May 2025).
  22. Ibid.
  23. Dr. Vijay Limaye, John Walke, and Emily Davis, “Local Air Quality Monitoring Lagging Across U.S., NRDC Finds,” Natural Resources Defense Council, January 6, 2023, available at https://www.nrdc.org/bio/vijay-limaye/local-air-quality-monitoring-lagging-across-us-nrdc-finds.
  24. American Lung Association, “Health Impact of Air Pollution.”
  25. American Lung Association, “State of the Air 2025 Report.”
  26. American Lung Association, “Health Impact of Air Pollution.”
  27. American Lung Association, “State of the Air 2025 Report”; Alden Woods, “Children exposed to higher ozone levels early in life are more likely to develop asthma,” University of Washington News, April 2, 2025, available at https://www.washington.edu/news/2025/04/02/children-exposed-to-higher-ozone-levels-early-in-life-are-more-likely-to-develop-asthma/#:~:text=They%20found%20that%20a%20relatively,at%20age%204%2D6%20years.
  28. American Lung Association, “Populations at Risk,” available at https://www.lung.org/research/sota/key-findings/people-at-risk (last accessed May 2025).
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  30. American Lung Association, “Asthma Trends and Burden.”
  31. American Lung Association, “State of the Air 2025 Report.”
  32. American Lung Association, “Key Findings,” available at https://www.lung.org/research/sota/key-findings (last accessed May 2025).
  33. Angela Garcia, interview via Zoom with Margaret Cooney and Olivia Mowry, on file with authors.
  34. Executive Office of the President, “Executive Order 14154: Unleashing American Energy,” Federal Register 90 (18) (2025): 8353–8359, available at https://www.federalregister.gov/documents/2025/01/29/2025-01956/unleashing-american-energy#page-; Davenport, “Inside Trump’s Plan to Halt Hundreds of Regulations”; Oliver Milman, “Trump has launched more attacks on the environment in 100 days than his entire first term,” The Guardian, May 1, 2025, available at https://www.theguardian.com/environment/2025/may/01/trump-air-climate-pollution-regulation-100-days; Friedman and Tabuchi, “E.P.A. Targets Dozens of Environmental Rules as It Reframes Its Purpose”; Rosenthal, Johns, and Smith, “Project 2025 Would Make It Easier for Big Corporations To Dump Dangerous Toxins That Poison Americans”; Earthjustice, “What Project 2025 Would Do to the Environment – and How We Will Respond”; Dawsey and Joselow, “What Trump promised oil CEOs as he asked them to steer $1 billion to his campaign.”
  35. U.S. Environmental Protection Agency, “EPA Launches Biggest Deregulatory Action in U.S. History,” Press release, March 12, 2025, available at https://www.epa.gov/newsreleases/epa-launches-biggest-deregulatory-action-us-history; Anthony Leiserowitz and others, “Climate Change in the American Mind: Beliefs & Attitudes, Fall 2024” (New Haven, CT: Yale University Program on Climate Change Communication: 2025), available at https://climatecommunication.yale.edu/publications/climate-change-in-the-american-mind-beliefs-attitudes-fall-2024/toc/2/
  36. Leo Banks and Lucero Marquez, “The Trump Administration Has Invited Power Plants to Emit More Toxic Pollution in a Giveaway to Corporate Polluters,” Center for American Progress, April 4, 2025, available at https://www.americanprogress.org/article/the-trump-administration-has-invited-power-plants-to-emit-more-toxic-pollution-in-a-giveaway-to-corporate-polluters/; Hiroko Tabuchi, “E.P.A. Offers a Way to Avoid Clean-Air Rules: Send an Email,” The New York Times, March 27, 2025, available at https://www.nytimes.com/2025/03/27/climate/epa-air-pollution-exemption-mercury-coal-ash.html?smid=nytcore-ios-share&referringSource=articleShare; Lisa Friedman, “E.P.A. to Tighten Limits on Mercury and Other Pollutants From Power Plants,” The New York Times, April 5, 2023, available at https://www.nytimes.com/2023/04/05/climate/epa-mercury-coal-plants.html; U.S. Environmental Protection Agency, “Biden-Harris Administration Proposes to Strengthen the Mercury and Air Toxics Standards for Power Plants,” Press release, April 5, 2023, available at https://www.epa.gov/newsreleases/biden-harris-administration-proposes-strengthen-mercury-and-air-toxics-standards-power.
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  38. Matthew Daly, “Chemical industry seeks exemptions from US pollution rules as part of Trump administration offer,” The Associated Press, April 4, 2025, available at https://apnews.com/article/trump-epa-toxic-chemicals-exemption-mercury-97feb73daa61df0cfbe537bf580ef99a.
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  42.  Rosenthal, Johns, and Smith, “Project 2025 Would Make It Easier for Big Corporations To Dump Dangerous Toxins That Poison Americans.”
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  45.  Ibid. 
  46. Matt O’Brien, Tom Krisher, and The Associated Press, “Elon Musk’s own businesses sit front and center as he says he and Trump have a ‘mandate to delete’ regulations with DOGE,” Fortune, November 14, 2024, available athttps://fortune.com/2024/11/14/elon-musk-tesla-spacex-x-trump-mandate-to-delete-regulations-doge/; Stephen Fowler and Shannon Bond, “What has DOGE done in Trump’s first 100 days?”, NPR, April 28, 2025, available at https://www.npr.org/2025/04/28/nx-s1-5377445/doge-musk-trump-100-days; House Committee on the Judiciary Democrats, “Fact Sheet: Trump Administration, DOGE Punish Agencies Investigating Elon Musk’s Companies,” available at https://democrats-judiciary.house.gov/uploadedfiles/2025.02.13_fact_sheet_re_musk_investigations.pdf (last accessed May 2025). 
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The positions of American Progress, and our policy experts, are independent, and the findings and conclusions presented are those of American Progress alone. American Progress would like to acknowledge the many generous supporters who make our work possible.

Authors

Cathleen Kelly

Senior Fellow

Jill Rosenthal

Director, Public Health

Leo Banks

Research Associate

Team

Domestic Climate

It’s time to build a 100 percent clean future, deliver on environmental justice, and empower workers to compete in the global clean energy economy.

Explore The Series

A person is seen amid hazy conditions in New York City caused by wildfires in Canada.

All Americans have a fundamental right to breathe clean air, drink safe water, and live in healthy communities. Yet the Trump administration and House Republicans are abandoning environmental protections and ending efforts to cut deadly pollution, all to enrich big polluters and billionaires at the expense of people’s health.

This series highlights how the Trump administration’s attack on environmental and public health protections will harm Americans’ health, including by increasing asthma attacks, cancer risks, and early deaths. These actions put everyone at risk, but they will hit working class, low-income, front-line, Black and Latino communities, children, older adults, and other vulnerable populations the hardest. Americans need a government that works for all people—not just billionaires and fossil fuel executives.

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Variable Opt Ins

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