Extensive reporting for this story was provided by Diana Marszalek

WASHINGTON, DC—The election of Donald Trump to a second term as President of the United States—swiftly followed by the nomination of several individuals with radical views to senior positions in the new administration—has created an atmosphere of uncertainty among public relations and public affairs professionals representing several high-profile sectors.

During the election campaign, Trump had proposed a number of policies that would disrupt the manufacturing sector, media and technology companies, and perhaps most significantly the healthcare arena, and the individuals he has nominated to run the departments and agencies overseeing those sector suggest a determination to follow through on those promises.

But while public relations and public affairs executives are bracing themselves for major changes, they are also reacting to the extremes of Trump’s agenda with surprising calm and a faith in the power of the existing systems—from Congress to the courts—to rein in the worst impulses of the executive branch.

We talked to a number of experienced professionals about the changes they expect to see, and this is what we learned.

Big Pharma

Looking ahead at what the new Trump administration portends for the pharmaceutical sector, consulting giant PwC focuses on the positives, suggesting that Trump “is expected to maintain his strong stance on deregulation and prioritize policies that address healthcare access and costs.”

But the news that Trump will nominate vaccine skeptic and pharma critic Robert F Kennedy Jr. to head the Department of Health & Human Services clearly changes the calculus. “Legislators should cap drug prices so that companies can’t charge Americans substantially more than Europeans pay,” Kennedy wrote in a Wall Street Journal op-ed in September.

And of course, Kennedy has repeated numerous conspiracy theories about vaccine safety, from the long debunked claim that common vaccines cause autism to the belief that COVID was a “plandemic,” deliberately created by pharmaceutical companies to create demand for their products.

Not surprisingly, stocks of vaccine makers like Pfizer, Moderna, and Novavax all dropped after Trump said he was nominating Kennedy. Nevertheless, industry observers are cautiously optimistic.

“I don’t believe there will be vaccine bans,” says Brandon Edwards, founder and CEO of Unlock Health. “It’s easy to forget that the COVID vaccine was developed under the Trump administration, and from a purely realpolitik standpoint, that would alienate a large number of women and families.”

But others are not so sure. Said one Washington, DC-based healthcare public affairs expert, “If you look at the positions Trump adopts, he clearly prioritizes the pet topics of his base, of MAGA, over any political philosophy, even over the preference of voters. And the base has bought into the anti-vaccine narrative hook, line, and sinker.

“There may not be bans, but at the very least people will have more freedom to opt out of vaccines, and government funding will be withdrawn or severely curtailed. Or they could just change the rules protecting vaccine makers from product liability suits, which could have a chilling effect without a ban.”

Pam Jenkins, chief public affairs officer at Weber Shandwick, adds: “On vaccines, the new administration may take actions that could weaken vaccine mandates and further erode confidence in vaccine efficacy, such as withholding federal funding for vaccine education and outreach or restricting funding for schools with vaccine mandates,” depending, she says, on how much influence Kennedy ultimately has on policy.

But even beyond the vaccine question, the prospect of someone with Kennedy’s scorn for science at the helm of the FDA—and with Dr. Mehmet Oz, with similarly troubling views in charge of Medicare and Medicaid—there are more profound questions around healthcare policy and drug development.

“We don’t want FDA to become a political organization that doesn’t focus on good science and good policy. That would be devastating for the industry,” Daniel Kracov, chair of Arnold & Porter’s global life sciences industry practice, told the Washington Post.

On the plus side for the pharma industry, many expect the incoming administration to go after Biden’s Inflation Reduction Act, including a repeal of the laws that have seen big reductions in prescription drug prices.

Beyond that, “Trump’s picks to lead the HHS and FDA suggest a focus on deregulation, which could spur funding within the life sciences sector,” says Carrie Jones, CEO of JPA.

“The question, of course, is whether these policies will translate into improved outcomes for patients. That’s why our work as communicators and marketers really matters. We need to ensure that policy changes and innovations are clearly articulated, making them accessible to stakeholders at every level—from patients to providers to policymakers. It’s our job is to build bridges—connecting innovation, patient services, and policy to help the industry navigate and thrive over the next few years.”

Finally, one observer in the UK had an additional warning: “Right now, the US Food & Drug Administration has global influence. Its verdict carries weight because it is seen as an independent body with rigorous scientific standards. But if there is an attempt to undermine or delegitimize the FDA, that has implications for the approval process in the UK and Europe.”

The Healthcare System

It’s not only vaccine makers and big pharma companies bracing themselves for the Trump administration’s disruption of the healthcare system.

“The Trump reelection will mean some changes for healthcare, but I think anyone who believes they can accurately predict policy changes from this administration isn’t being totally honest,” says Edwards. “The underlying healthcare philosophy of the Trump administration has never been clear, yet the stock market’s reaction on November 6 tells us a lot:  health plan stocks like United and Elevance were up across the board, and every single hospital company stock fell.

“The market clearly believes that Trump will lean-in to Medicare Advantage and favor health plans over the provider sector.”

Edwards says he does not expect a repeal of Obamacare, pointing out that it did not happen during his first term, but not everyone is so sanguine. At the very least, they expect the administration to follow through on Vice President-elect JD Vance’s plan to place people with chronic conditions into separate risk pools, which would raise premiums for those with pre-existing conditions.

Says Doug Thornell, CEO of Stagwell’s SKDK public affairs shop, “I expect the Trump administration and Congressional Republicans to pursue big changes to health policy in America, starting with Obama–Biden era health care policies. Based on rhetoric on the campaign trail and recent history, you have to expect the ACA will come under attack— even if Trump only has ‘concepts of a plan,’ that won’t stop the effort to pursue full or partial repeal.”

Beyond that, if Elon Musk’s desire to find two trillion dollars in government savings is not just hyperbole, “the math just doesn’t work unless you have radical cuts to either Medicare or Social Security.”

Indeed, the incoming administration will almost certainly allow states to condition Medicaid eligibility on meeting work and reporting requirements—especially as it will need to pay for tax cuts benefiting corporations and the very rich.

Health education

Some o the most memorable, groundbreaking, and meaningful communications campaigns of the past 30 years have taken place in the health education arena, from the focus on sexual health that arose in response to the AIDS epidemic to the many vaccine safety initiatives that helped combat the COVID pandemic.

More recently, there has been a focus on health inequities, particularly those related to chronic diseases that impact minority populations disproportionately.

“Much is at stake—approaches to infectious disease prevention, gender rights, women’s health, food policy, and tackling health disparities,” says Gil Bashe, who leads healthcare at Finn Partners. “But political rhetoric often gives way to keeping voters happy. Sickness is heartbreaking and expensive, draining emotions and the economy.

“The government tends to look at issues through the lens of voters’ interests, party lines, and cost. Medicine is less expensive than sick care, and the industry will work hard to reinforce the human value of innovation for the public—and government—good. PR pros will be busy reinforcing access to care policies and protecting proven public health mandates.”

The most encouraging point here is that most of the actual work around health education is done at the state level, and at least in blue states it is unlikely that the administration can do much to prevent good information from reaching the public.

Says Bashe, “Health communication is rooted in science and addresses pressing medical needs and the harsh reality that without intervention, despair, disease and death win.”

One thing that is unclear is what will happen if the newly politicized agencies seek public relations help to spread misinformation about topics such as vaccine safety or the link between HIV and AIDS (which Kennedy has called false). Many legitimate PR firms would presumably decline to participate in such campaigns, but it would presumably be easy to find other firms more aligned with the administration’s goals.

Food

Announcing Kennedy as his pick to lead HHS, Trump posted on X that “Americans have been crushed by the industrial food complex,” suggesting that pharmaceutical companies might not be the only ones who have to pay attention to Kennedy’s unconventional views on health.

Kennedy has claimed that the food industry is “mass poisoning” the American public, and some of his ideas to change the nation’s food policy have garnered support from the left as well as the far right. He has said he wants to remove ultra-processed foods from school meals, for example, and talked of his desire to “get the chemicals out” out of food in the United States.

Experts believe he might rewrite FDA regulations on additives, prevent companies from being able to self-certify the safety of their food ingredient. Kennedy also wants to bar food stamps from being used to buy soda or processed foods. And he may use his position to advocate for the consumption of raw milk, which he says “advances human health.”

“What we know from the first Trump administration is that some in the food industry were pleased, and some were disappointed,” says Erin DeSimone, executive vice president at Padilla and group lead of its FoodMinds specialist group. “In some instances, nutrition-focused regulations, like school meal standards, were walked back—but in other instances, like labeling and sodium reduction, work advanced. We’re anticipating another mix of loosening and tightening of health-focused food policies in President Trump’s second term.”

The Washington Post, however, points out that next year, the Trump administration will be charged with rewriting the Dietary Guidelines for Americans, a publication that provides recommendations every five years for what Americans should eat and is “a cornerstone of federal nutrition policy.” Those guidelines could provide Kennedy with a mechanism to influence food consumption in America.

Says DeSimone, “For now, we’re helping clients keep close tabs on how important positions that guide sustainability, food and nutrition policy—such as Secretary of Agriculture and FDA Commissioner— will be filled. In the meantime, we’re counseling food and beverage industry members to continue to advocate for science-based nutrition and health policies over the next four years.”

Technology

The technology sector was facing intense political scrutiny even before this election— the DOJ’s demand that Google be forced to sell off its Chrome web browser is just one example—but Trump’s nominee to chair the Federal Communications Commission has the potential to make life exceedingly difficult for big tech companies (with one notable exception).

Brendan Carr, a Republican telecommunications lawyer who Trump made an FCC commissioner, has attacked technology Facebook, Google, Apple, and Microsoft for exercising their First Amendment rights (as this article in Reason explains). And many of those companies have already a demonstrated a willingness to surrender the fight against disinformation in order to appease Republican lawmakers.

The threat to technology and media companies is exacerbated by the fact that Carr will be serving a president who has hinted at punishing newspapers and broadcast companies for exercising their First Amendment rights, and the fact that Elon Musk—whose companies compete directly with Facebook, Google, Apple, and Microsoft—is likely to be a prominent member of the administration.

Says Lou Hoffman, founder of technology PR specialist The Hoffman Agency, “We can assume Team Trump will be doing everything humanly possible—and perhaps a few inhumane things—to undermine the credibility of the media.”

Nilay Patel, editor-in-chief of The Verge, has been even more blint: “To be as clear as I can be, the second Trump administration with Elon Musk embedded within it represents the most direct and sustained threat to the First Amendment and the freedom of the press any of us will ever experience. If you’re a media executive or editorial leader and you haven’t met with your legal team to understand the current landscape of First Amendment threats, let alone the ones to come, you’re already behind.”

At the same time, some Silicon Valley venture capitalists are betting that deregulation in a second Trump term could boost innovation

And Hoffman captures the ambivalence of many in the tech PR world when he says, “It’s crystal clear to me that a Trump White House will serve as an accelerant for the tech industry and be a positive for firms like us that specialize in tech. A policy mindset to get rid of regulations will increase the flow of capital into the tech sector touching everything ranging from startups to R&D.”

Of course, Trump’s putative tariffs on China and other international trade also have implications for the tech sector, which are perhaps more difficult to predict.

Climate Change

Donald Trump has made it crystal clear that he considers climate science to be a “hoax” and he campaigned on a pledge to end the Biden administration’s climate initiatives and rules aimed at lowering emissions. And he has repeatedly stated  he plans to expand oil and gas drilling in the United States—already at record levels.

One promise most observers expect Trump to deliver on is his pledge to withdraw from the Paris Climate Agreement.

Says Jenkins, “He will likely use executive orders to roll back or weaken key environmental regulations, potentially including EPA rules limiting greenhouse gas emissions and vehicle emission standards. He may remove restrictions on liquefied natural gas exports and lessen methane emission regulations, which would incentivize oil and gas drilling.

“There is also potential that he could weaken climate-focused government offices and programs, such as the EPA and NOAA’s climate research capabilities. His early appointments to posts in NOAA, the EPA and the Department of the Interior will be important to watch, as the appointment of climate skeptics to these positions may lead to faster, stronger executive action.”

The American Energy Alliance congratulated Trump, saying the group looks forward to working with him to unwind the Biden-Harris administration’s environmental and onsumer protections. And clean energy stocks took a hit after the election, although industry voices remain optimistic about their long-term prospects.

“There is no denying that another Trump presidency will stall national efforts to tackle the climate crisis and protect the environment, but most U.S. state, local, and private sector leaders are committed to charging ahead,” Dan Lashof, US director of the World Resources Institute, said in a statement.

Not surprisingly, a somewhat more apocalyptic tone is adopted by climate advocates, such as Duncan Meisel, executive director of the activist group, Clean Creatives. “Donald Trump's presidency is an obvious and immediate threat to the health of people around the planet,” Meisel says.

“He was backed to the hilt by fossil fuel polluters, and they plan to push forward with policies that will harm tens of millions of people in his term, and beyond. It's up to the communications industry to honor its responsibility to act in accordance with science, and reject working to expand the footprint of polluting industries that are sickening and displacing people at higher rates than ever."

The decision to nominate Chris Wright, an oil industry executive and staunch proponent of fossil fuels, to lead the Department of Energy has done nothing to assuage these fears.

Finance

Bank stocks soared the day after Trump’s victory, recording double-digit gains based primarily on the widespread view that financial regulation under the new administration will be more industry friendly and will loosen constraints on banking industry mergers and acquisitions. Bank capitalization and liquidity requirements—many of them a response to the last global financial crisis—are also likely to be rolled back.

So for now, the potential for greater freedom of action seems to outweigh any concerns over uncertainty and instability.

“Across the board, the markets are not reacting with a lot of volatility which might seem counterintuitive because the person just elected is not famous for being stable, for projecting stability and predictability,” says Dan Simon, founder and CEO of financial consultancy Vested. “But I think a lot of that has to do with the fact that the financial services industry across the board feels that the Trump administration in the simplest terms will stand for and has signaled a desire to loosen regulation and oversight and that will be good for business.”

There are particularly strong positive vibes in the crypto community, which poured millions of dollars into supporting right-wing candidates in this election cycle.

“Regarding cryptocurrency, Trump has stated an intention to fire the head of the SEC Gary Gensler who is a crypto skeptic and has for a long time argued that crypto should be regulated as a financial security as opposed to a currency or a commodity,” Simon says. “Trump is pro-crypto and will dispense with oversight and will let the crypto industry run rampant. There’s no downside for you if you’re a pro-Trump crypto bro.”

The nomination of hedge fund manager Scott Bessent, a cryptocurrency enthusiast, as Treasury Secretary is likely to fuel even greater exuberance in the sector.

Tariffs

So far, the excitement in the financial sector has not been tempered by widespread concern over the impact of Trump’s plans for tariffs. Despite the fact that they were a central plank of his election platform, many observers apparently remain skeptical that they will be implemented.

During the campaign, Trump said he would impose  60% tariffs on goods from China and a 20% tariff on everything else the United States imports. He also insisted that the cost of taxing imported goods would be absorbed by the countries that produce those goods—a suggestion that has been dismissed by most economists, who point out that tariffs mean higher prices of US importers, who typically pass along that cost to consumers.

Last month, the Peterson Institute for International Economics predicted that Trump’s policies—including tariffs and his plans for mass deportations—would drive consumer prices sharply higher. They could cost the average US household about $2,600 per year, the Institute says.

Most experts agree. “This will directly impact people’s pocketbooks,” said Rob Handfield, a professor of operations and supply-chain management at North Carolina State University. And Kent Smetters of the University of Pennsylvania’s Penn Wharton Budget Model added: “There’s no question that tariffs are inflationary. Exactly how much—that’s where economists can debate it.”

As a result, companies such as Walmart and Lowe’s—retailers who deal directly with consumers and sell products that are particularly vulnerable in the event of a trade war—have already warned investors about likely price increases.

Ron Bonjean, co-founder and partner at ROKK Solutions, says, “Trump has pledged to use tariffs as a way to encourage increased American manufacturing production and create new jobs. While there are no specific proposals being offered at this time, the president-elect could go after China right away with tariffs as much as 60% on imports.

“While many companies are waiting for Trump’s new policies, his election is already causing some to immediately adjust or reexamine their supply chains and to stock up on imports before he creates these changes.”

And Jenkins adds: “It’s highly likely that President-Elect Trump will enact some sort of tariff policy. He has proposed a 10-20% tariff on global imports and a 60% or higher tariff on Chinese imports. Tariffs could have wide-ranging impact on American corporations, small businesses, and the broader economy.

“While it’s widely believed tariffs will be smaller, economists speculate they could result in retaliatory actions and an erosion of global trade rules, a hallmark of trade policy throughout modern time.”

As a result, she says, “We are already seeing companies hedge against the possibility of significant Chinese tariffs by assessing their vulnerability and diversifying suppliers to likely low-tariff countries, such as India. Some companies are accelerating imports before tariffs take effect and exploring options like Foreign Trade Zones for export-oriented production.”

The bottom line: “Communications with customers, investors, suppliers, and employees will remain critical throughout these actions.”

 

The Big Picture

Taken as a whole, the predictions about the likely changes in policy suggest that the public relations and public affairs community expects incremental changes—within the existing system—rather than the radical agenda that Trump and the majority of his cabinet nominees have promised.

It may be that the worst of that agenda—the mass deportations, the use of American troops on domestic soil, the purging of government agencies—don't directly impact corporate America. Or it maybe that the value of drastic cuts to consumer, employee, and environmental protections and tax cuts for corporations and the super-rich far outweighs the economic risks posed by tariffs and the societal upheaval that might result from attacks on healthcare, clean energy, and an independent media.

But even so, on questions about Obamacare, for example, there appears to be a high level of confidence that the second Trump administration will resemble the first, or that the relative popularity of some of his targets will give him pause.

The former belief requires one to ignore the fact that Trump has said his administration will be about “promises made, promises kept”; the identity of the individuals—from Elon Musk to JD Vance to Robert Kennedy to Steven Miller—Trump has nominated for key positions; and the agenda laid out in Project 2025, which was shaped by many of those nominees.

As CNN has noted, “Figures who once hoped to act as stabilizing forces — including a string of chiefs of staff, defense secretaries, a national security adviser, a national intelligence adviser and an attorney general—have abandoned Trump, leaving behind recriminations about his character and abilities.

“They’ve been replaced by a cohort of advisers and officials uninterested in keeping Trump in check. Instead of acting as bulwarks against him, those working for Trump this time around share his views and are intent on upholding the extreme pledges he made as a candidate without concern for norms, traditions or law that past aides sought to maintain.”

The latter belief, meanwhile, requires one to dismiss the warnings of individuals such as Trump’s former chairman of the joint chiefs Mark Milley (Trump is a “fascist to the core” and “the most dangerous person to this country”) and former chief of staff John Kelly (Trump “certainly prefers the dictator approach to government”).

At Slate, legal experts Dahlia Lithwick and Mark Joseph Stern have pointed out that Trump “believes the president is an elected authoritarian who can and indeed should concentrate all state power within himself and wield it to achieve his own personal ambitions and retributions. There is no daylight between his own selfish interests and the state’s needs, because to his mind, he is the state.”

And, as a result of the Supreme Court’s ruing earlier this year, “he is forever immune from punishment when he chooses to corruptly manipulate the tools of his office to punish his enemies and reward his friends. He is the state, but he is also the law.”

Given his appointments to lead the Department of Defense and the Department of Justice, and his pledge to purge both departments of individuals not loyal to him personally, it is far from clear how Congressional refusal to cooperate or even a Supreme Court judgment could be effectively implemented.

As CBS News chief political analyst John Dickerson has said, Trump “no longer has the constraints we associate with the presidency. Presidents always want to do stuff, but they are constrained by traditions of the office. Those have all been taken away. So you have a person of impulse with all of those things gone.”