Late last November, President Donald Trump announced Jim O'Neill as his nominee for deputy secretary of Health and Human Services (HHS), where he would work under Robert F. Kennedy Jr., Trump's pick for HHS secretary upon confirmation. As deputy secretary, O'Neill would essentially function as the Chief Operating Officer of the department, overseeing "the day-to-day operations of all sub-agencies" as well as leading "public health emergency preparedness," i.e. the government's policy responses to bio-terror events, pandemics, etc. In addition, O'Neill would "oversee the development and clearance of HHS regulations" and ostensibly be the main implementer of the "Make America Healthy Again" (MAHA) policy agenda.

Built on a promise to eliminate industry capture of public health regulatory agencies and curb the influence of Big Pharma and Big Food, Robert F. Kennedy Jr.'s MAHA movement played a crucial role in funneling would-be Kennedy voters into the Trump camp. MAHA, in essence, granted the Trump campaign a tinge of populist legitimacy among Covid era dissidents, which grew out of the shuttering of RFK Jr.'s independent presidential run.

However, O'Neill's business connections, both past and present, as well as his previous statements on public health policy, strongly suggest that he is not only unlikely to implement the policies that MAHA-centric voters are expecting, but that he may in fact pursue an agenda that stands in direct conflict with the main tenets of the MAHA movement. Specifically, he advocates reforming the FDA to deregulate and accelerate the pathway from drug development to legalization. This would notably aid the biotech industry, which has long struggled to get its products approved outside of an "emergency"-based deregulatory paradigm.

When considering the investments and board positions that O'Neill himself has made and held in biotechnology companies, this would likely include mRNA products that Kennedy and other MAHA influencers have spent years criticizing since the Covid-19 pandemic — a clear contradiction between O'Neill's views on public health, and those which the MAGA base were sold on the campaign trail.