California’s Break from Federal Health Policy
Medical freedom is at the forefront of the political conversation today, but it isn’t just a national conversation. Here in California, decisions are being made that reshape who controls health policy, how scientific guidance is evaluated, and whether individuals retain the ability to weigh risk for themselves and their families. As the federal government steps away from global health institutions like the World Health Organization, California has chosen a different path.
Today, we have a lot to unpack – from our governor announcing on an international stage that California will reengage with the WHO, to the state building coalitions that place it at odds with the federal government, to legislation that fundamentally shifts medical decision-making away from individuals and families. I’m breaking it all down and underscoring why this moment, and these choices, matter directly for you.
Controversy Over the WHO
On the one-year anniversary of his inauguration, President Trump officially withdrew the United States from the WHO, or World Health Organization.
Just to back up, the WHO is a United Nations agency that sets global health guidance – such as pandemic handling, vaccines, disease surveillance, and emergency responses. When the U.S. withdraws it means that the federal government is no longer funding the WHO, participating in WHO decision-making, or obligated to align U.S. health policy with WHO guidance. In return, the WHO loses its largest funder – for reference, the U.S. contributed over $1.2 billion in 2022 and 2023[1] – as well as a major source of legitimacy and influence. It sends the message that we are entirely rejecting the model of global health governance.
President Trump cited the organization’s mishandling of the COVID-19 pandemic, inappropriate political influence, and disproportionate funding structures as the reasons for the withdrawal.[2] He had started the withdrawal process on Day 1 of his administration last year, and this was the completion of that process.[3] In terms of where we go from here, the HHS announcement stated:
“Going forward, the U.S. government will continue its global health leadership through existing and new engagements directly with other countries, the private sector, non-governmental organizations, and faith-based entities.”[4]
So, the President is looking to completely change course on this topic. At a structural level, Trump is trying to reassert national sovereignty over public health and break the idea that global institutions – especially ones he views as corrupt or politically captured by bad faith actors – get to set the terms during emergencies. Trump’s position is essentially that public health decisions for the United States should be made by the U.S. government and accountable to American voters, not to international agencies who don’t have American interests as their priority. It’s another arm of his administration’s America-First policies. If the WHO is wrong, as we saw happening during COVID, then Americans shouldn’t be bound to live under its guidance; instead, U.S. agencies should have to justify policy stances independently and have the freedom to determine a different course of action for their constituents.
Now – I know what you’re thinking. This is a federal move. Why does this matter for California? Well, the federal government seems to have intricately affected the actions of our state government, and as usual, our Governor specifically. Governor Newsom, in response to the President’s formal withdrawal, has decided that California won’t follow suit, and that this is his moment to place our state in direct opposition to Trump’s policy shift.
Just three days after Trump announced the United States would be formally leaving the WHO, Gavin Newsom showed up in Davos, Switzerland and told the WHO Director that California would be joining the World Health Organization’s Global Outbreak Alert and Response Network – making California the first state to do so.[5] This means he is directing state agencies to maintain alignment with WHO guidance, as well as continue cooperation on data, public health frameworks, and policy norms. It also signals our Governor’s and our state’s willingness to partner internationally and fund or support initiatives that the United States no longer backs from a federal level.
This clearly undermines what our federal government is trying to do. President Trump has cut federal alignment with the WHO, but Governor Newsom is restoring it at our state level. The federal government is denying the legitimacy of the WHO guidance, but California is keeping their policy guidance alive domestically and signals to other Democrat-run states to do the same.
Further California Isolationism
But reentering California into the WHO isn’t the only action our Governor has taken in recent months along these lines. This is just the cherry on top of a long line of policy moves in health care leadership that have sought to counteract federal direction on the topic.
In December, Governor Newsom announced the Public Health Network Innovation Exchange, which he described as “a new California-led initiative to modernize public health infrastructure and maintain trust in science-driven decision-making.”[6] This is directly in relation to the federal government and HHS’s recent moves regarding vaccines – specifically the decision to reduce the vaccine schedule and prioritize research into potential side effects or harm caused by vaccines.
What makes this seem like more of a politically biased move than a principally driven one is Newsom’s immediate appointment of political actors opposed to President Trump, as well as the initiative’s potential to create a parallel, rather than unified, national public health system. The initiative is led by former CDC officials who were publicly critical of the second Trump administration, which one could argue politicizes the, aimed-at-being, “science-based” entity.[7]
And really, Democrats aren’t hiding the strategy here. California Democratic strategist Steven Maviglio has made it clear that health policy has given Newsom a platform to position himself directly in opposition to President Trump, saying, “The governor wakes up every morning and sees what Trump does and tries to do the opposite, and I think that’s the case here. He’s positioning himself as the leader of the Democratic resistance to Trump.”[8] Now, I would prefer my Governor wake up in the morning thinking, how can I lower housing costs, crime, homelessness, and a whole host of other issues plaguing California – but at least someone is being honest about Gavin’s priorities.
Newsom also launched a “Governors Public Health Alliance” back in October of last year, which has similar goals as the Public Health Network Innovation Exchange, but more from a policy level as he directly works with the governors of 14 other states to make state-level decisions on emergency preparedness and emerging health threats. This came after California already joined several states in forming a “West Coast health Alliance.” This group consists of California, Oregon, Washington, and Hawaii, with the specific goal of aligning their vaccine recommendations together in spite of the federal government’s recommendations.[9] So, clearly our Governor has been hard at work building alliances and coalitions to shore up California’s public health policy away from the Trump Administration’s perspective, and toward the traditional recommendations of the CDC under the Biden and other Democrat Administrations.
California’s Policy Shift - AB 144
But, this hasn’t been confined to just building random coalitions and alliances, or virtue signaling by reentering us into international agreements. This has – as it always does – directly flown through into our legislation, which brings us to Assembly Bill 144, signed by our Governor in September of 2025.
This bill creates a California-specific standard for required immunizations by cutting federal vaccine oversight. How does it do this? First, it locks in federal vaccine recommendations from January 1, 2025 – meaning that new federal recommendations after that date, such as the recent vaccine recommendations announced by HHS, will not be considered or incorporated into California law. Second, it shifts authority from federal agencies solely to the California Department of Public Health to decide which vaccines are required and covered in our state. And third, it requires that licensed healthcare providers in California must follow California Department of Public Health guidance rather than federal guidance when it comes to vaccines.[10]
Basically, California is cutting out any recommendations made by HHS or ACIP or even the CDC under the Trump Administration. For families and healthcare professionals here in California who advocate for medical freedom and informed consent, this bill is a nightmare. It also stands directly in opposition to the Make America Healthy Again (MAHA) movement that has swept the nation – California included. It’s very clear that California lawmakers only believe in “following the science” insofar as the science aligns with what they’ve always believed about vaccines and the like.
And this is where the bigger picture comes into focus. AB 144 is a clear declaration – saying that when the federal government changes course, when it investigates topics that have, in the past, been “off limits,” California will not only refuse to follow, but will insulate itself from those changes entirely. This is the domestic counterpart to Newsom’s international posturing. Just as California moved to align itself with the WHO after the United States withdrew, AB 144 ensures that even if the federal government reforms its public health approach, those reforms will not make their way to California. The will of the American people, expressed through a federal election and a change in leadership, is rendered irrelevant here.
In effect, California is no longer participating in a shared national public health framework, yet it will participate in an international framework, where United States interests are not a priority. That should concern every American, and every Californian, regardless of where you stand on vaccines or public health policy, because it represents a breakdown in how our system is supposed to function.
States’ Rights or Constitutional Considerations?
Which brings us to the big question in all of this: how should states and the federal government interact on these issues? Is this simply a states’ rights issue, or are there deeper constitutional and practical concerns at play?
Here’s the thing: I am generally in favor of the federal government getting out of the way. States are closer to the people, more responsive, and often better suited to handle localized needs. But there is a critical distinction between decentralization within a nation and fragmentation of a nation. States’ rights were never meant to include conducting foreign policy or aligning independently with international governing bodies.
Public health administration can and should primarily happen at the state level; foreign policy cannot. The Constitution is clear on this. Article I, Section 10, prohibits states from entering treaties, alliances, or confederations with foreign powers, giving the federal government primary authority over international relations.[11] And it is clear on this for a reason: the United States must speak with one voice on the world stage. When California signals alignment with the WHO after the federal government has withdrawn, it isn’t exercising states’ rights, it is undermining national sovereignty. That is unconstitutional, and quite frankly, foolish.
It also has implications for our right to representation as citizens and voters. When a state circumvents federal authority by anchoring its policies to international institutions, it creates a backdoor for global governance that voters cannot meaningfully check. Even those who support global cooperation should be alarmed by the precedent: if states can independently affiliate with international bodies, then federal decisions become optional, and elections lose their force.
This really isn’t about whether the WHO is good or bad. Regardless of what you believe about the WHO we should all be able to clearly see that the federal government is accountable to the American people, while international institutions, like the UN or WHO are not. When California chooses to privilege the latter over the former, it is directly placing its liberal ideology above democratic legitimacy – Newsom’s interests to oppose President Trump over the interests of the American people. States and the federal government are supposed to work in sync, meaning that states should work to administer policy within a national framework, and when it disagrees with that framework, it should then work to change public opinion and prove why the framework is wrong. What is should NOT do is carve out parallel systems in open defiance of the federal government. That is lazy, it is wrong, and just leads to further division, confusion, and the slow erosion of the very constitutional order designed to hold the country together.
But, outside of the foreign policy side of things, what about California’s efforts to remove federal guidance from its public health considerations? Let me be clear: states absolutely have the right to conduct their own health policy. I have strongly disagreed with federal administrations on public health issues and I have strongly agreed with them – my personal feelings toward the federal government’s policies do not change the fact that government should get out of the way of its citizens and of its states. States are able to tailor emergency health responses to their specific populations, weigh regional risks, and even diverge from federal recommendations when there is a clear, evidence-based reason to do so.
But what California has done here is something very different. AB 144 doesn’t say the state will evaluate future federal guidance and decide whether to adopt it. It enshrines into law that California will disregard it altogether, in advance, regardless of its merits. That is pre-committing Californians to always opposing guidance released by the federal government, without even knowing what that guidance will be or what it will be rooted in.
This is where the “follow the science” mantra clearly collapses. Science is continually evolving. It corrects itself. It requires constant reassessment of new data, new outcomes, and new evidence. Declaring ahead of time that guidance from HHS, the CDC, or ACIP will no longer even be considered is ridiculous on its face – it is not scientific rigor, but is ideological influence. If California truly believed in following the science, it would examine all credible guidance – federal, state, and international – and make its case transparently. Instead, AB 144 removes federal input – not because it has been proven wrong, but because it might change from the accepted norms. And that reveals the real concern top of mind for our lawmakers, which is not scientific accuracy, but control.
A state that is confident in its science does not need to shield itself from scrutiny. It does not need to freeze recommendations or wall itself off from dissenting evidence. It can defend its policies in the open. But California’s approach isn’t doing that – it’s just discounting guidance from people it disagrees with politically. Which is asinine. In other words, this isn’t about empowering doctors or protecting patients, it’s about ensuring that no matter what the data says, no matter how federal health policy evolves, California’s course is already locked in.
The bottom line in all of this is that California is acting like a nation-state. Governor Newsom is overstepping his authority, our legislature is passing bad policies that do not allow for individual consideration of risk or protect medical freedom, and we are letting them.
I care deeply about medical freedom because healthcare is not one-size-fits-all. Real medicine requires informed consent, individualized risk assessment, and the humility to admit that data evolves. What California is doing right now moves us in the exact opposite direction, and California has been on this path for decades. Parents are not allowed to make the best decisions they believe in for their children. If you do not agree with the narrative, you are outcast from schools, extracurriculars, and larger society.
But zoom out for a moment, because this isn’t just about vaccines or public health. This is about the country we are becoming, because yes, California IS part of this country. When a state openly defies the federal government, aligns itself with international institutions, and insulates itself from democratic change, it deepens the fractures already tearing this nation apart. We cannot survive as a country if our largest state no longer sees itself as part of a shared system, accountable to a shared people.
Call To Action!
But here is the most important part that I want to emphasize: this is not inevitable. These laws were passed by people, and they can be challenged and replaced by people. But that requires us to open our eyes to what is happening around us, to think critically about if it is right, and to push back against laws and policies that do not allow for each person to ask questions and come to their own conclusions. If we disengage because it feels too big – like our Governor speaking for us on the world stage, or too late – like laws that have shut people out from making their own medical choices for years, if we let ourselves accept that with apathy, then we hand more power to those who are counting on that very apathy.
If you care about medical freedom, about honest science, about democratic accountability – it is not too late. Now is the time to pay attention! Call your representatives. Support organizations pushing back. Ask harder questions. Refuse to accept that this is just how things have to be.
We can still change course – but only if we are willing to wake up, speak up, and act before this divide becomes permanent.
References:
[1] Emanuel, Gabrielle. “Trump Declares U.S. Will Withdraw From the World Health Organization.” NPR, January 21, 2025. https://www.npr.org/sections/goats-and-soda/2025/01/20/g-s1-42918/trump-world-health-organization-withdrawal#:~:text=President%20Trump%20is%20making%20good,as%20he%20signed%20executive%20actions.
[2] The White House, “Withdrawing the United States From the World Health Organization,” January 21, 2025, https://www.whitehouse.gov/presidential-actions/2025/01/withdrawing-the-united-states-from-the-worldhealth-organization/.
[3] Emanuel, “Trump Declares U.S. Will Withdraw From the World Health Organization.”
[4] HHS Press Office. “United States Completes WHO Withdrawal.” U.S. Department of Health And Human Services, January 22, 2026. https://www.hhs.gov/press-room/united-states-completes-who-withdrawal.html.
[5] Hrehor, Brock. “California to Join WHO Health Network in Rebuke of Trump.” POLITICO, January 23, 2026. https://www.politico.com/news/2026/01/23/california-to-join-who-health-network-in-rebuke-of-trump-00745350.
[6] Governor Gavin Newsom Press Office. “Governor Newsom Meets With World Health Organization Director-General, Announces California Becomes First State to Join WHO-coordinated International Network | Governor of California.” Governor of California, January 23, 2026. https://www.gov.ca.gov/2026/01/23/governor-newsom-meets-with-world-health-organization-director-general-announces-california-becomes-first-state-to-join-who-coordinated-international-network/.
[7] Braun, Sara. “Newsom Appoints ex-CDC Officials to Lead California’s New Public Health Network.” The Guardian, December 15, 2025. https://www.theguardian.com/us-news/2025/dec/15/california-public-health-cdc-officials#:~:text=%E2%80%9CBy%20bringing%20on%20expert%20scientific,again%20due%20to%20term%20limits.
[8] Choi, Joseph. “Newsom Leads Resistance to RFK Jr.’s Public Health Upheaval.” The Hill, February 2, 2026. https://www.wane.com/hill-politics/newsom-leads-resistance-to-rfk-jr-s-public-health-upheaval/.
[9] Governor Gavin Newsom Press Office, “Governor Newsom Meets With World Health Organization Director-General, Announces California Becomes First State to Join WHO-Coordinated International Network | Governor of California.”
[10] Dukes, Kris. “California Moves to Cut Federal Vaccine Oversight — Informed Policy Advocates.” Informed Policy Advocates, September 17, 2025. https://www.informedpolicyadvocates.org/news/california-moves-to-cut-federal-vaccine-oversight.
[11] Library of Congress. “Constitutional Limits on States’ Power Over Foreign Affairs.” Congress.gov, August 15, 2022. https://www.congress.gov/crs-product/LSB10808.
