The scale and breadth of the damage President Donald Trump has inflicted on the United States and the wider world are so vast that they can be difficult to fully comprehend. The impact stretches across public and private institutions, core democratic traditions, the legal system, universities, and even into public health, where misinformation has left lasting consequences.
One way to understand the depth of Trump’s approach is to examine a single case. In May 2025, Anjee Davis, chief executive of Fight Colorectal Cancer, a patient advocacy organization, told CBS News:
“We have a member who is being treated for Stage IV colorectal cancer. She had just qualified to enter a clinical trial that was going to be her last-chance effort to slow the spread of her cancer. Her trial was about to start when N.I.H. funding was pulled overnight, and the trial was canceled.”
Davis later confirmed in an email that the patient died without ever receiving the treatment. “This patient has since passed away without receiving the clinical trial she was counting on,” she wrote.
“What we will never know,” Davis added, “is whether that trial could have given her more time with her children.”
That case is just one example in a growing list of consequences tied to Trump’s policies. Analysts warn that millions of deaths could result from sweeping budget cuts implemented without direct congressional approval. A study published in The Lancet estimated that reductions in U.S.A.I.D. funding “would result in approximately 1,776,539 all-age deaths and 689,900 deaths in children younger than 5 years” in 2025 alone.
“Over the remainder of the period,” the study continued, “the complete defunding of U.S.A.I.D. would cause an estimated 2,450,000 all-age deaths annually, leading to a total of 14,051,750 excess all-age deaths and 4,537,157 excess under-5 deaths by 2030.”
Financial harm has also followed policy decisions. A June 2025 report from Democrats on the House Judiciary Committee found that “Trump’s pardons cheat victims out of an astounding $1.3 billion in restitution and fines, allowing fraudsters, tax evaders, drug traffickers to keep ill-gotten gains.”
Environmental rollbacks have added further concern. An Associated Press investigation reported that the administration sought to eliminate or weaken “at least 30 major rules that seek to protect air and water and reduce emissions that cause climate change.” Those protections, if maintained, were estimated to save “more than 30,000 lives annually.”
At the same time, federal support for scientific and medical research has been cut. A study in JAMA Internal Medicine found that “in the first half of 2025, the N.I.H. terminated grants supporting 383 unique clinical trials, affecting 74,311 individuals.”
Researchers warned of the ethical implications. In an accompanying commentary, Dr. Teva D. Brender and Dr. Cary P. Gross wrote:
“There is a more direct and sobering impact of premature and scientifically unjustifiable trial terminations: the violation of foundational ethical principles of human participant research. First and foremost, it is betrayal of the fundamental principles of informed consent for research” and “participants who have been exposed to an intervention in the context of a trial may be harmed by its premature withdrawal or inadequate follow-up and monitoring for adverse effects.”
Further reporting in Nature Medicine noted that “at least 148 clinical trials have been impacted, with over 138,000 patients due to be enrolled or already enrolled,” underscoring the scale of disruption.
Beyond healthcare, Trump’s policies have weakened the United States’ position in global energy competition. A September analysis by CarbonCredits.com highlighted the gap:
“China is on track for 1,400 GW, while the U.S. will reach only about 350 GW.”
“China plans to add 212 gigawatts of solar and 51 GW of wind, compared to less than 100 GW combined” in the United States.
“Offshore wind: China already has 42.7 gigawatts installed, compared with the U.S.’s Empire Wind project (816 megawatts in Phase 1, with a potential expansion to 2.1 gigawatts).”
Trump has openly dismissed climate concerns. Speaking at the United Nations General Assembly, he said climate change is “the greatest con job ever perpetrated on the world.” He added:
“All of these predictions made by the United Nations and many others, often for bad reasons, were wrong. They were made by stupid people that have cost their country’s fortunes and given those same countries no chance for success.”
Foreign policy decisions have also strained alliances. A Politico survey published April 8 found:
“Only 12 percent of those polled in March in Poland, Spain, Belgium, France, Germany and Italy saw America as a close ally while 36 percent saw it as a threat. By contrast, China was seen as a threat by 29 percent of those polled across the six countries.”
Experts say the long-term consequences could be profound. Donald Kettl, a professor emeritus at the University of Maryland, placed Trump among the most consequential presidents in U.S. history, but noted that “Trump’s consequences have been aggressive efforts to unravel the ideas of the other four presidents.”
Michael Bailey of Georgetown University was more blunt, saying Trump ranks “as easily the worst president in U.S. history. The corruption and damage to long-term U.S. institutions and reputation are far beyond anything we’ve seen before.”
He added that Trump has been “highly consequential in an overwhelmingly negative way. He will leave a lasting negative legacy.”
Legal scholars have also raised alarms. Kate Shaw of the University of Pennsylvania pointed to “Trump’s violation of numerous statutes passed by Congress,” warning that repeated disregard for the law risks normalizing such behavior.
Gary Jacobson of the University of California-San Diego said Trump “has done serious damage to many aspects of American government and politics that will be difficult and costly and, in some cases, impossible to undo.”
He added: “The mass firing of dedicated and experienced civil servants has made government dumber and weaker and will make it harder to attract talented replacements even if the next administration wants to make it smarter and more effective.”
Concerns about democratic norms are equally stark. Barbara Walter of UC San Diego warned:
“American democracy remained strong for so long because both its political parties and its presidents respected a set of unwritten rules.”
She added that Trump “has shown that you can violate them and survive politically. He’s torn down the invisible wall that kept the worst impulses of political life in check, and once that’s torn down, a new, ugly world emerges.”
Yphtach Lelkes of the University of Pennsylvania echoed that concern:
“I’m less confident about which specific policies or institutions belong on which list than I am about the broader effect on norms. My guess is that this is where Trump’s longest shadow will fall.”
“Norms take a long time to develop because they rest on habits of restraint and on the expectation that violations will be punished. But they can disappear quickly once it becomes clear that punishment is not coming.”
As a result, Lelkes concluded, “Trump’s most consequential legacy may be less any single policy than the lesson he taught politicians: Norms can be broken, repeatedly and openly, without necessarily paying much of a price.”
Even so, some analysts believe future political shifts could attempt to reverse course. But the broader damage—particularly the erosion of trust—may take far longer to repair.
Donald Moynihan of the University of Michigan warned that weakening institutional credibility has lasting effects:
“Trump might be an empowered executive, but the effect is to weaken American government in any situation where people are asked to place trust in the long-term credibility of U.S. government commitments.”
He added: “As Trump has created an environment where private businesses, universities or civil society can be threatened by the president, such organizations can assume that traditional norms of equal-handed application of the law, due process and fair treatment that they once took for granted no longer hold.”
Ultimately, the legacy extends beyond policy into perception. The cumulative impact, experts argue, is a lasting stain on American governance—one shaped not only by decisions, but by the precedent they set.
