After a long hunt for the next CDC director, former Deputy Surgeon General Erica Schwartz officially got the nomination on April 16.
But in the $5.3 trillion healthcare industry that makes up 18% of the country’s GDP, what sort of impact can just one job really have? Especially considering how the Trump administration has made major shifts that have impacted how federal agencies are used and viewed over the last year and a half.
Experts told us the role can shape the healthcare industry and the future of patient care as it did during the Covid-19 pandemic and AIDS epidemic. And as the industry has already seen in policy changes like the One Big Beautiful Bill Act’s cuts to Medicaid, it also has the power to hinder how the industry is able to operate and can stymie potential progress.
According to David Dodd, president and CEO of drug company GeoVax, the CDC director has a few levers they can pull to yield power over healthcare: guidance to shape clinical practice, data on and surveillance of real-time disease intelligence, and instilling public trust.
“The CDC director doesn’t just guide public health—she/he shapes the conditions that determine whether scientific innovation actually reaches and protects people at scale,” he said.
The ‘unfillable seat.’ Before Schwartz was nominated, the CDC director role over the last year looked like an “unfillable seat” that recent nominees seemed to have found “untenable,” Eric Perakslis, chief science and data officer at data company Pluto Health, told Healthcare Brew.
That may be because scientists’ relationships with the federal government are shifting, experts told us. Perakslis believes scientists under the Trump administration have found that “non-science-based interference” has become “too much.”
While the structural authority of the role hasn’t changed, the “visibility and pressure surrounding it” has, Dodd added.
Clinician impact. According to Dodd, the levers the CDC influences don’t “mandate markets,” and instead they define “the conditions under which markets operate.”
The CDC director is also in charge of creating a medical and scientific agenda based on what they think the country needs, like addressing drug overdoses in the 2010s or the H1N1 flu in the early 2000s, Perakslis said.
“In the current political environment, it’s not going to be women’s health, although it was a few years ago,” he said. Now it could possibly be nutrition, he continued, due to the administration’s focus on “food as medicine” under its Make America Healthy Again initiative.
“In many ways, the CDC acts as the bridge between scientific approval and real-world utilization,” Dodd added.
Based on this agenda, Perakslis said the director can make funding priorities, including for studies or industry partnerships. These days, priorities include things like better understanding autism as well as weighing in on politicized topics such as vaccines, immigration, gender, and abortion.
This has had a direct impact on providers. For example, hospitals paused gender-affirming care in response to federal pushback, and independent abortion clinic closures have doubled as they grapple with financial limitations.
Public health complications. For vaccines in particular, the CDC has special power over who gets vaccinated and when, Dodd said, and can influence payers and providers to adhere to its guidance. For example, Stat and KFF both reported that changes to vaccination recommendations over the last few months could affect patients’ insurance coverage.
“That translates into real downstream economic impact across the entire healthcare system,” he said. “Vaccines are where the CDC director’s influence is most direct and measurable.”
And these moves at the CDC don’t just impact staff—the businesses operating within the industry feel it, too. For example, if the government changes the vaccine schedule or recommendations around yearly shots, it can create liability concerns for pharmaceutical companies.
Further, if people don’t get vaccines, it could also increase hospital stays in the often busy cold and flu season, per the CDC.
The American Public Health Association (APHA) wrote in a January statement that it has “grave concerns” about the new childhood vaccine schedule, adding that the “dramatic decrease in recommended vaccines coupled with fewer boosters leaves the American public, especially our children, more vulnerable to preventable illness and death.”
Leadership’s importance. Without strong CDC leadership, Dobb said states could end up with different policies, providers might receive mixed signals, and public trust could erode. That lack of steady federal guidance on vaccines could also cause lower vaccination rates, slower outbreak response, and more strain on health systems, he said.
Long term, the role should be based on trust through transparency and preparedness, he said.
On Schwartz’s nomination, the APHA said in an April 16 statement she has the “medical background and public health knowledge to lead” the CDC and it looks forward to working with her.
The CDC did not respond to Healthcare Brew’s request for comment.
“We rely on coordinated surveillance and response. If that weakens, the system becomes reactive rather than proactive,” Dodd said.
This report was originally published by Healthcare Brew.
