The meat of the matter is summed up nicely in the following paragraph:
Mr. Trump is at heart a billionaire doing favors for other billionaires by cutting their taxes and eliminating or not enforcing rules that protect the rest of us from asthma and cancer. During his four years in office, he managed to dismantle or degrade over 100 environmental rules, which brought real-world death and suffering. The medical journal The Lancet estimated that in the year 2019 alone these policies led to 22,000 excess deaths from heart disease, asthma and lung cancer, among other causes.
It's an opinion article. Those are meant to break down groupthink/publish pieces that typically the editorial board wouldn't publish to make people think/consider other perspectives.
The article itself is pretty harshly anti-Trump; I think the picture is intended as more of a caricature than an endorsement in any case.