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California Governor Gavin Newsom is positioning the state as a stronghold against the Trump administration’s revised health care directives, led by Health and Human Services Secretary Robert F. Kennedy Jr. Experts note that this strategic stance could foreshadow a fragmented national public health approach, as states increasingly distance themselves from federal oversight.
Throughout 2025, California has spearheaded state initiatives challenging the latest health guidelines from the Department of Health and Human Services, particularly concerning infectious diseases and vaccination policies.
Steven Maviglio, a Democratic strategist from California, believes that health policy offers Newsom a distinctive stage to counter President Trump’s agenda.
“Governor Newsom seems to start each day by observing Trump’s actions and then seeks to chart a different course,” Maviglio commented. “He aims to lead the Democratic opposition to Trump with assertiveness.”
Following the Trump administration’s reduction of staff at the Centers for Disease Control and Prevention (CDC) and the subsequent departure of several top officials who cited political meddling, California, along with three other states, formed the West Coast Health Alliance in September.
The West Coast governors blasted the administration for turning the agency into a political tool that “peddles ideology” and said their coalition would provide “evidence-based unified recommendations.”
In October, California joined another collective of more than a dozen other states in launching the Governors Public Health Alliance, which Newsom described as a “public health system that puts science before politics.”
Weeks later, Newsom hired Susan Monarez, former CDC director, and Debra Houry, former CDC chief medical officer, to join the California Department of Public Health following their high-profile departures from the agency. They are tasked with helping to launch the Public Health Network Innovation Exchange, a California-led initiative that will “modernize public health infrastructure and maintain trust in science-driven decision-making.”
The state’s rebuke of the Trump administration’s health care policies moved to the global stage last month when Newsom traveled to Davos, Switzerland, for the World Economic Forum, where he met with World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus.
There, he committed California to becoming the first state to join the WHO’s Global Outbreak Alert and Response Network, right as the U.S. officially exited the organization.
John Swartzberg, an infectious disease physician and emeritus professor at the University of California, Berkeley School of Public Health, commended Newsom’s efforts to insulate the state from “political interference by HHS [Health and Human Services].”
“I’ve been teaching and practicing infectious diseases for 50 years, and for 49 of those years, I instilled the virtues, the wonderful virtues, of the Centers for Disease Control. In the last six months or so, I unfortunately had to say for the first time in my life that I cannot trust what comes out of the CDC when it comes to vaccination,” Swartzberg said.
California, with a population of some 40 million, is known for having an especially robust public health infrastructure. But Swartzberg cautioned that decades of inadequate funding have diminished the state’s capabilities somewhat.
While California can do “very well” on its own, Swartzberg said “it could do a lot better if it was working in concert with the rest of the United States, as opposed to the Balkanized structure we’re in the process of creating now.”
Swartzberg advised that Newsom should ensure that the state’s health department has the funding and workforce to meet his ambitions, if he plans to go all in on making California the premier public health authority outside of Washington, D.C.
California, as the state with the highest GDP, is uniquely positioned to lead the public health resistance. While other states are supportive of California’s efforts to build public health policies apart from the Trump administration, they may not be able to follow its lead.
When asked if there were plans to similarly join the WHO’s global network, the Hawaii Department of Health said in a statement to The Hill it could not commit staff and resources to foreign countries.
Nearly three years out from the 2028 election, Newsom is widely considered a front-runner to be the Democratic presidential candidate, with his time in the governor’s office coming to an end next year, and his efforts to lead the Trump resistance are a constant signal of his national ambitions.
Maviglio suggested his efforts on the public health front would not be as aggressive if not for his future aspirations.
“Politics for a governor are limited to the state’s borders or to Washington. He’s moved it up a notch by going overseas,” Maviglio said. “It’s largely a political move for his national ambition, rather than an effort to really do something for the people of the state. Really, he wouldn’t be doing this if he wasn’t running for president.”
314 Action, a progressive PAC that aims to get STEM-educated Democrats elected to office, has lauded Democratic governors for focusing on public health issues in the current environment.
“The number one responsibility of our elected leaders is to keep us safe. As the Trump administration abdicates their responsibility by using the White House and Department of Health and Human Services to spread misinformation, power is returning back to the states. In the absence of federal leadership, it’s more important than ever for Democratic governors to step up and protect public health,” 314 Action President Shaughnessy Naughton said in a statement to The Hill.
“It’s up to pro-science leaders to stop RFK Jr. in his tracks and keep Americans safe and healthy.”