Public Health Archives - Ñî¹óåú´«Ã½Ò•îl Health News /topics/public-health/ Ñî¹óåú´«Ã½Ò•îl Health News produces in-depth journalism on health issues and is a core operating program of KFF. Fri, 29 May 2026 21:55:20 +0000 en-US hourly 1 https://wordpress.org/?v=6.8.5 /wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=32 Public Health Archives - Ñî¹óåú´«Ã½Ò•îl Health News /topics/public-health/ 32 32 161476233 Gounder Gives Lowdown on Ebola, Peptides, and Colorectal Screenings /on-air/on-air-may-30-2026-celine-gounder-peptides-colorectal-cancer-ebola/ Sat, 30 May 2026 09:00:00 +0000 /?p=2244153&preview=true&preview_id=2244153

Céline Gounder, Ñî¹óåú´«Ã½Ò•îl Health News’ editor-at-large for public health, discussed recent warnings about research-grade peptides and new colorectal cancer screening guidelines on CBS News’ CBS Mornings on May 27. She also discussed the Ebola outbreak centered on the Democratic Republic of Congo and whether it’s expected to spread on May 26.

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<img id="republication-tracker-tool-source" src="/?republication-pixel=true&post=2244153&amp;ga4=G-J74WWTKFM0&quot; style="width:1px;height:1px;">]]> 2244153 More Kids Without Coverage /podcast/what-the-health-448-republicans-midterms-children-losing-insurance-may-28-2026/ Thu, 28 May 2026 18:50:15 +0000 /?p=2242581&post_type=podcast&preview_id=2242581 The Host
Julie Rovner photo
Julie Rovner Ñî¹óåú´«Ã½Ò•îl Health News Read Julie's stories. Julie Rovner is chief Washington correspondent and host of Ñî¹óåú´«Ã½Ò•îl Health News’ weekly health policy news podcast, "What the Health?" A noted expert on health policy issues, Julie is the author of the critically praised reference book "Health Care Politics and Policy A to Z," now in its third edition.

The One Big Beautiful Bill Act, passed by congressional Republicans in 2025, was supposed to backload cuts to health programs so they wouldn’t take effect until after the 2026 midterm elections. That’s not how things are working out, with numerous analyses showing insurance coverage is already starting to drop.

Meanwhile, the Trump administration claims that the coverage reductions prove its anti-fraud efforts are working. But those efforts are likely to affect far more people than just those who commit fraud against federal health programs.

This week’s panelists are Julie Rovner of Ñî¹óåú´«Ã½Ò•îl Health News, Maya Goldman of Axios, Shefali Luthra of The 19th, and Lauren Weber of The Washington Post.

Panelists

Maya Goldman photo
Maya Goldman Axios
Shefali Luthra photo
Shefali Luthra The 19th
Lauren Weber photo
Lauren Weber The Washington Post

Among the takeaways from this week’s episode:

  • Amid a recent decline in the number of Americans with health insurance, one affected group in particular stands out: children. Many kids are falling off the Medicaid rolls, largely because of the chilling effects of the Trump administration’s immigration crackdown and broader confusion about eligibility requirements.
  • Meanwhile, the high cost of health insurance is pressing people to seek alternatives, many of which offer few or no protections against large medical bills. On the campaign trail, high-profile Democrats are sounding the alarm about a problematic health ecosystem, even framing issues such as reproductive health in terms of affordability.
  • The Trump administration is raising eyebrows with its response to the emerging Ebola crisis as it works to keep American citizens exposed to the disease out of the country entirely. Countering previous government approaches, which prioritized not only public safety but also offering the best care available to Americans, this approach also stands in stark contrast with President Donald Trump’s dismissal of masks, isolation, and other measures during the covid pandemic.
  • And Trump declared himself healthy this week after undergoing his third physical exam in 13 months at Walter Reed National Military Medical Center. Trump’s resistance to answering specific questions, despite visible issues such as bruising and swelling, raises the point that a president’s health can be a public matter — especially for a president who is about to turn 80.

Also this week, Rovner interviews Ñî¹óåú´«Ã½Ò•îl Health News’ editor-at-large for public health, Céline Gounder, to discuss the Ebola outbreak in central Africa. 

Plus, for “extra credit” the panelists suggest health policy stories they read this week that they think you should read, too: 

Julie Rovner: ProPublica’s “,” by Kavitha Surana.  

Lauren Weber: The New York Times’ “,” by Sarah Kliff and Margot Sanger-Katz.  

Shefali Luthra: The New York Times’ “,” by Sejal Hathi.  

Maya Goldman: The Texas Tribune’s “,” by Terri Langford and Colleen DeGuzman. 

Also mentioned in this week’s podcast:

Click to open the transcript Transcript: More Kids Without Coverage

[Editor’s note: This transcript was generated using transcription software and a human’s light touch. It has been edited for style and clarity.] 

Julie Rovner: Hello, from Ñî¹óåú´«Ã½Ò•îl Health News and WAMU Public Radio in Washington, D.C. Welcome to What the Health? I’m Julie Rovner, chief Washington correspondent for Ñî¹óåú´«Ã½Ò•îl Health News. And, as always, I’m joined by some of the best and smartest health reporters covering Washington. We’re taping this week on Thursday, May 28, at 10 a.m. As always, news happens fast, and things might have changed by the time you hear this. So, here we go. Today, we are joined via video conference by Lauren Weber of The Washington Post. 

Lauren Weber: Hello, hello. 

Rovner: Maya Goldman of Axios News. 

Maya Goldman: Great to be here. 

Rovner: And Shefali Luthra of The 19th. 

Shefali Luthra: Hello. 

Rovner: Later in this episode, we’ll have my interview about the ongoing Ebola outbreak with Céline Gounder, Ñî¹óåú´«Ã½Ò•îl Health News’ public health editor-at-large and, conveniently for us, an infectious disease specialist. But first, this week’s news. I want to start this week with more of a trend than actual news, and that is the continued decline in health insurance coverage in the U.S.  on the number of children falling off the Medicaid rolls. It’s down about 1.75 million from the beginning of Trump 2.0 through this past January. Now, I thought we were told that none of the Medicaid cuts that Congress made last year would affect the core Medicaid constituencies: pregnant women, children, seniors, and people with disabilities. What’s happening here? 

Goldman: So, the law does exempt kids and parents of young kids from the eligibility and enrollment changes, work requirements, more frequent eligibility checks. That doesn’t mean that there aren’t going to be spillover effects, and we’re seeing that already, Absolutely, even though most of these provisions haven’t gone into effect. And there are a couple of reasons for that, including chilling effects from immigration enforcement and people who are in mixed-status households maybe not feeling comfortable enrolling their children in public benefits, even though their children would qualify, or also just confusion around who’s eligible for what. Often kids are eligible for Medicaid and Children’s Health Insurance Program â€” its sister program, CHIP â€” at a much higher income level than their parents, and that’s not communicated well to parents very often. And so one theory â€¦ is that this year, when a lot of parents maybe saw how much their ACA [Affordable Care Act] premiums were going up and decided that they couldn’t afford health coverage anymore, they were just pulling their whole family out of health insurance, even though their kids might still actually be eligible for Medicaid. And â€¦ there are a lot of other trends percolating in this, but I think it’s concerning to see this, these figures, even before this has really started. 

Rovner: Yeah, it’s funny, when you’re applying for health insurance, they’ve set it up so that you get funneled to the right place for which you’re eligible. But when you’re dropping your health insurance, there’s no funnel to say, hey, your kids might still be eligible for this, even though you’re no longer going to be getting Affordable Care Act insurance. 

Goldman: Exactly, and navigators for ACA coverage have also â€” funding for those programs have been cut, and so that’s harder, even harder for that process to actually work. 

Rovner: Yeah, I’ve also noticed in the states that are starting things like their work requirements early, there was kind of a shocking anecdote  â€” one of the states that’s starting early â€” who’s blind, has multiple health problems, and a chemotherapy port, who was told that she might be required to work under these rules and was seeing about getting her port taken out when finally another person told her, No, you’re exempt. So, I mean â€¦ in some of the states that are speeding this up, there’s a lack of knowledge among the state workers, which I think was one of the big concerns about people who are going to be dropped off the rolls, not because they’re no longer eligible, but because of mistakes. 

Weber: We also know that, in general, Medicaid enrollment is a tricky process. Typically, there’s paper forms that may get lost in the mail. Parents may not get the forms for their kids. This was very eloquently actually described on The Pitt â€” which, shoutout for getting this part of health policy correct. Although I’m still irritated about their Medicare-Medicaid mix-up in one of the other episodes, but we’ll get over it. 

Rovner: Yeah, me too. There were two of those. 

Weber: Yes, but very eloquently show[ed] how a mom who had moved and missed some Medicaid paperwork was now really in a hole financially. And so, as Maya has reported out, you know, more of these children falling off the rolls really could lead to some dire consequences for the families to which they belong. 

Goldman: Yeah, and I think one important thing to mention is that a lot of these kids that are uninsured are still eligible, and when they go to the hospital, the hospital can help them enroll in retroactive Medicaid coverage, but they’re not getting their yearly checkup, or maybe, like in The Pitt, they miss their asthma medication, and so now they’re in the hospital, and costs are just going up for the whole health system. 

Rovner: Well, along those same lines, we have another story in our Ñî¹óåú´«Ã½Ò•îl Health News series called “Priced Out” about how people who can no longer afford comprehensive coverage are patching together other forms of insurance, or in some cases not even actual insurance, that leaves them on the hook for thousands of dollars if they end up needing actual medical care, which kind of raises the perennial question with our health system: Is it better to have bad insurance and not know it, or to have no insurance, so at least you know that you’re not prepared if something happens. 

Weber: I thought what was so striking in that story was it led off with a retired teacher who said, I recognize I am gambling. I mean, that’s what she said, she’s very clear. But to her, I think her cost had risen something like $900-something a month, and the other plans that she cobbled together were $300 a month, and so to her the short-term risk was worth it. But as we all know, hospital stays can run you several thousand dollars and, you know, you can get hit by a car. You may be a very healthy person, but something bad can happen, and you are left with large, large medical debt. And I think it seemed like the folks interviewed in the story were at least clear that these plans were less favorable, but I do think there is also this submarket where a lot of folks think that the health ministry plan that they’re in is going to save them in case of an issue. And we have found over and over again, and KFF, in particular, has found over and over again in reporting, that’s just not the case. And so this whole question of Is a bad plan better than no plan? I don’t know, but it’s striking to see people say I’m willing to take the gamble, because this is just what these increases in premiums have meant for me. 

Luthra: I just think what’s so interesting about these, these health shares, in particular, is when I’ve talked to people who’ve used them or considered them, they know these are not insurance, but I don’t think they always fully understand just how restrictive they are, and how often medical needs will be dismissed as lifestyle choices. I mean, obviously, often contraception is not covered, but something related to drug or alcohol use might not be covered, because that’s immoral, right? Let’s say the ministry says, “Oh, well, this accident you got into, maybe that’s because of alcohol use.” That’s a huge expense that you just might not have realized wouldn’t be covered at all. And the other thing that I was just so struck by is very often childbirth isn’t covered. Or you have to be enrolled for a very long time before childbirth is covered, which health insurance is required to cover childbirth. It is very, very expensive. It’s fascinating, also, because a lot of these [sharing ministries] are so religiously aligned and ostensibly pro-family, etc. And yet this, in particular, is just something where people will opt for this instead because it looks more affordable than insurance. But very often you end up paying a not-zero amount of money, and ultimately getting basically nothing for very expensive, even bankrupting medical needs. 

Rovner: Or you’re gambling, you know, maybe, maybe you’ll get reimbursed, and maybe you won’t. Although these days people feel that way about their health insurance. Maya, you want to say something? 

Goldman: I think a lot of young people also take for granted that health insurance will cover preexisting conditions. If you’ve come up, you know, post-ACA, and certainly I do. I’m 28, and that’s, like, something that never even crossed my mind that I would need to consider, and that really struck me in this article. A lot of these alternative plans are not bound to those requirements. 

Rovner: Well, Shefali, I wanted to ask you in particular about  about how abortion rights supporters are trying to adapt reproductive health to fit under the bigger affordability umbrella that seems to be the theme of this year’s midterm campaigns â€” that things like whether or not to get pregnant or whether to get unpregnant, that those are all wrapped up in all sorts of financial issues, as you just mentioned. Is this a natural fit, or do you think they’re kind of forcing it here? 

Luthra: I think it really depends on how you talk about it, and the context of where you are. And after the mifepristone case was before the Supreme Court, I spent a lot of time looking at different Senate campaigns and examining how they’re talking about it. And one example is Jon Ossoff in Georgia actually has a really interesting example where he talks about access to abortion and healthcare as part of this larger argument around the state of reproductive healthcare, talking about hospital closures, talking about Medicaid cuts, and putting all of this together as this broader policy ecosystem that is making your healthcare harder to come by and ultimately threatening your life. I think that’s very interesting. It could work. It makes sense logically to me. The other one that does come to mind â€” and this is not abortion, but it’s related â€” is in Maine, Graham Platner talking about IVF [in vitro fertilization] in the lens of affordability, saying, Oh, I couldn’t afford it in America. I traveled to Norway to try and get fertility treatments. Those are fascinating approaches, and a lot of people who work in abortion rights advocacy will say this has long been an economic argument, and many of them will look at polling and put it out that says when you frame this as an economic story, voters really, really do appreciate it and resonate with it. I think sort of the question is whether we actually see these candidates â€” and it’s not lost on me the two who I mentioned are both men â€” actually talk about the word “abortion” specifically, rather than saying “reproductive healthcare” more broadly. And you know those are very different, and they just register with voters differently when you single out something as specific as abortion versus whether you don’t. 

Rovner: And Graham Platner, for those who don’t know, is going to be the Democratic candidate running against Susan Collins in Maine. Jon Ossoff is the incumbent Democrat in Georgia, which always feels weird to say. There haven’t been a lot of Democratic senators from Georgia, but right now there’s two. 

So, moving on, the Trump administration says the declines in health insurance coverage are fine because they’re more about fraud and kicking people off of public health insurance rolls who aren’t actually eligible or â€” in the case of Affordable Care Act broker fraud â€” who don’t even know they’re covered. But a lot of the tools in last year’s big budget bill are pretty blunt, and they’re going to impact both those who maybe shouldn’t be there and those the administration says it wants to keep serving. This week’s example is a newly proposed rule to implement that law’s cap on something called state-directed payments, which is, in fact, a key way many states help ensure adequate funding for hospitals, nursing homes, and other healthcare providers. Now, this isn’t fraud, but it is what analysts like to call creative funding, and Congress has every right to limit it. But that’s not to say that it won’t have an impact on healthcare at the delivery level, right? It’s not just going to impact people that the administration says don’t deserve to be covered. 

Goldman: Yeah, this came up when I was talking to children’s hospitals for the story on children’s coverage that I wrote this week. They’re saying, you know, this is going to affect all kids that we can care for. This is going to mean less money into our funds, and, you know, a lot of people argue that hospitals have enough money, but hospitals will say, “No, we don’t, not to take care of all the people that we need to take care of.” And this is going to be less money. And then it’s not just kids who are on Medicaid who are struggling, it’s all kids. And I think another interesting thing about this proposed rule is that it’s significantly more federal savings than was estimated originally. I think CBO, Congressional Budget Office, originally estimated that the state-directed payments provision would save about $150 billion, and this rule would save about $510 billion in federal funding. So hospitals are concerned. 

Rovner: Yes, this is always the issue. Are we overpaying hospitals? But when you take money out of it, what does that mean for the health system writ large? Which I imagine is going to continue to be a theme as we go forward. Well, the Trump administration is also going very high-profile in its health fraud-fighting effort. The president has put Vice President JD Vance in charge. Earlier this month, he announced that the administration will be withholding $1.3 billion in federal Medicaid funding from California, because, said the vice president, the state has not taken fraud very seriously. This is the second Democrat-led state the administration is taking the nearly unprecedented step of withholding funding from in advance, after Minnesota. California has responded that one reason the state’s home health bill has gone up is that it has raised wages for home healthcare workers, and it has expanded eligibility. It’s not because of fraud. Again, while there obviously is fraud â€” not just in Medicaid, but in all health programs, public and private, because there is so much money there â€” these blunt tools, I think, will probably punish more than just those who are defrauding the program. Right? 

Weber: I mean, absolutely. At the end of the day â€¦ look, it’s no coincidence that California is a blue state that seems to be getting targeted with that amount of cash. But let’s be very honest, there is a lot of fraud. I mean, all of us here have written stories about healthcare fraud. There is a lot of fraud to root out. So, to be very clear, I don’t think anyone should be upset about actual fraud being targeted. But there’s also a question of: What are the numbers? [Centers for Medicare & Medicaid Administrator Mehmet] Oz has gotten the numbers wrong before. The AP [Associated Press] had a great story on that a couple weeks ago. Show us the fraud, like, I want to see the actual fraud that we’re talking about. And, in addition, this reminds me of how the administration continuously says that they’re investing the most money in rural healthcare when they have this $50 billion rural healthcare fund. Well, the Medicaid cuts that [President Donald] Trump led is going to cut like triple that almost out of rural areas. So is this a talking point? Show us the money. I need to better understand what’s behind it. 

Rovner: Yeah, so far they’re doing well with a lot of very high-profile news events. We’ll see how much fraud they are actually able to ferret out. All right, we’re going to take a quick break, we will be right back. 

Let’s talk about Ebola. As you will hear later in this episode from our in-house expert, Dr. Céline Gounder, this is not likely to become the next covid or even a pandemic. But this administration, having hollowed out the Centers for Disease Control and Prevention and obliterated the U.S. Agency for International Development, is addressing this outbreak with many fewer arrows in its quiver. Lauren,  about someone close to this outbreak. Tell us about it. 

Weber: Yes, I was able to speak with an American missionary physician who was exposed to Ebola and actually evacuated to Prague and is sitting in basically like a bubble room waiting to see if he tests positive for Ebola. And what traumatizes him, as he was telling me, was that he’s sitting there, there’s all these people with endless gloves that are tending to him, he’s been evacuated, and stretchers with all this plastic and all these measures, and his colleagues that he worked alongside in the Congo are â€” you know, one died while we are in the middle of an interview, he learned of their death. And, in addition, they’re filling the hospitals themselves, that they say they don’t have enough gloves, they don’t have enough PPE [personal protective equipment]. There’s no vaccine to fight this current form of Ebola, and they’re in an environment in which people are very mistrustful. Ebola looks like malaria until it’s Ebola. And so you could send a family member into the hospital thinking it’s malaria, which is common in this part of the world, and then suddenly be told your relative has Ebola and died. A lot of people don’t believe it, and it’s leading to violence. And the usual public health measures and efforts by the international community to get in there are somewhat hampered. And Part Two, by the fact that this outbreak is happening in a really insecure region, where there’s roving militias and other violence. And there’s just a lot of concern that they caught this late, this could continue to explode, and case counts could really go up. But it was very humanizing to speak with this American missionary who obviously really put himself on the line to help these folks and is heartbroken to kind of be watching from afar as this continues to go poorly. 

Rovner: Well, meanwhile, the U.S. is banning foreign nationals who’ve been in any of these countries from entering the U.S. and also U.S. green-card holders who’ve been in countries where the virus is spreading. Not only that, but they’re not allowing exposed U.S. citizens to return, even though the U.S. has multiple facilities to care for exactly these types of patients. We have seen this before, just in the last 15 years. What happened to the medical freedom that this administration has been touting so much? 

Weber: It’s a real plot twist. I mean, these are the folks that said that they were the contrarians that oppose quarantine and mask mandates, and they are strictly having the hantavirus folks in Nebraska. They’re signing off on travel bans that go further than other administrations, and not allowing Americans back in and sending them to Kenya if they’re exposed. My colleague Lena Sun and I had a report a week ago about how the White House didn’t want exposed Americans back in the U.S., but the Kenya step is another step in that direction. Is really could have huge ramifications for the response as a whole, because it will likely limit the number of people that want to go. If you know that you’re not going to be able to be sent back, we saw, I think, yesterday the State Department union was like, look, our foreign service officers were sent here under the impression that they would be able to come back. I mean, this is somewhat completely uncharted territories in the vein of how they’re handling this. So we’ll see. 

Goldman: I’m very curious to see what the MAGA [Make America Great Again] base and the MAHA [Make America Healthy Again] base that were so anti-mask mandates and things like that during covid, like, what are they going to say? Are they going to say anything? Is it partially our responsibility as the media to point out this contradiction? 

Rovner: Yeah, and obviously there’s also so much else happening right now. It’s interesting that the hantavirus, which turned out to not be such a big deal, got so much play, and yet this, which could be a much bigger deal, is getting so much less attention. 

Weber: Do we think there’s maybe a reason for that? Let’s all be honest. The hantavirus cruise was a lot of wealthy, some Americans on a cruise sailing around Argentina and Antarctica. And then this outbreak is happening in Africa, and I think there’s less interest from the general public, as they feel like hantavirus is novel, whereas Ebola, they’ve heard about it before, so a depressing reality of some of that. 

Rovner: Yes, and also, you know, Americans and Europeans versus Africans. 

Weber: Yes, yes, exactly. 

Rovner: All right, moving on. I want to catch up on some drug price news, because there’s been a lot over the past few weeks. The Supreme Court earlier this month declined to hear a case challenging the Medicare drug price negotiation system that was implemented under the Biden administration, which ironically will probably redound to the credit of the Trump administration, even though it nominally opposed the Biden program. Also, earlier this month, the president announced a big expansion of his TrumpRx website, adding links to websites selling lower-cost generic drugs, including the site run by Mark Cuban, Cost Plus Drugs. But the most provocative drug price story I have seen this month came from my colleague Darius Tahir, noting that Trump himself was buying stock in drug companies just as he was negotiating with those companies to help bring drugs, particularly those GLP-1 medications that he likes to call “the fat drugs,” to more people. Now this isn’t technically illegal, although there are lots of efforts on Capitol Hill to outlaw individual stock trading by members. But I can’t help think if any other government official in any other administration ever did this, they would be out of a job instantly, if only for the appearance of the conflict of interest. This is just â€” Lauren, as you were saying â€” one in this whole long list of things that keeps happening, but every time I look at it, I’m like, he was doing what?! 

Weber: Julie, when I saw Darius’ story, I was blown away. First off, I feel like this should have been front-page news on every outlet. But secondly, it was a lot of money, it was like over $600,000. And now I understand they say that Trump himself, they don’t know whether he directed this or not. And in fairness, Trump’s not the only one. I mean, we’ve seen plenty of members of Congress that have done also questionable stock trades. But it is a very conflict-of-interest-looking-like thing, considering that CMS recently expanded massive access to these drugs. And so I do think conflicts of interest like this, especially in HHS [Department of Health and Human Services], which has constantly decried conflicts of interest, despite having many of them, are very important to highlight. And so, thank you to Darius for surfacing this. 

Rovner: Yes, we will never not have enough to do here as health reporters. Well, finally, this week I want to . President Trump this week had his third, quote, “annual” physical in the past 13 months â€” math does not math there â€” after which he said he checked out perfectly. But he is about to turn 80. He’s been caught on camera dozing off at public events in the Oval Office and has gone on hours-long social media rants in the wee hours of the night/morning. Now, much of this hasn’t been treated as news, because well, it’s pretty much par for the course for Trump, just more so. And therein lies the question: When does his increasingly aberrant behavior and obvious health issues, like visibly bruised hands and swollen ankles, become a public right-to-know issue? And is there a double standard for Trump compared to former President [Joe] Biden, when he began to show obvious signs of aging, and it was all over the news all of the time? I see raised eyebrows. 

Luthra: No, it’s such a good question. On the one hand, there was obviously a lot more scrutiny on Joe Biden’s age than there appears to be on Donald Trump’s. But part of it, I think, is that a lot of what you just highlighted, Julie, is out in the open. Everyone has seen the president dozing off on camera, whereas under the last administration, there were things that were not public that then became public, and that was obviously very important. That said, there’s certainly a level of focus on this issue that perhaps is lacking. Maybe it would be useful or newsworthy to put some more attention, even something that we already know, highlighting why it is important, putting together the fact that having this many physicals at this point in the presidency is actually more than normal. What could that mean, contextualizing it with everything we have seen publicly about the president’s sleep patterns, risk factors as you age, bruising, etc. But I think this kind of thing is complicated in terms of how you cover it appropriately and fairly, also just because you don’t want to assume things that you don’t have the evidence for. 

Rovner: And, in fair, I mean, Trump has not been transparent about his health, going back to when he was a candidate in 2016. He’s the only major presidential candidate, you know, he put out that, this famous letter from his personal doctor saying, you know, he’s the healthiest man I’ve ever seen. That’s pretty much what we get, having covered presidential health for a lot of administrations. We have much, much less information about Trump than we have had about previous presidents, which has been a continuing policy concern among doctors. I mean, this is not to single out Trump, who just happens to be president right now and turning 80. But this is, you know, an issue that goes back obviously to, you know, Dwight Eisenhower, to Woodrow Wilson, when he had a stroke, and they kept it a secret. Presidential health is a policy issue. 

Goldman: Yeah, I think that’s an important caveat, or note, I guess. Presidential health is not always as transparent as it claims to be, even going back, as you said. And so it’s not totally out of the ordinary that Trump wouldn’t be transparent about his health, even though, maybe ethically â€¦ presidents in general should be. 

Rovner: Obviously something else we will continue to watch. All right, that is this week’s news. Now we’ll play my interview with Céline Gounder. Then we’ll come back and do our extra credits. 

I am pleased to welcome back to the podcast my colleague, Dr. Céline Gounder, Ñî¹óåú´«Ã½Ò•îl Health News’ editor-at-large for public health, a CBS News medical correspondent, and an internist, epidemiologist, and infectious disease doctor. I can’t think of anyone I trust more to explain what’s going on with Ebola than Céline. So, thank you very much for doing this. 

Céline Gounder: Oh, it’s my pleasure to be here, Julie. 

Rovner: So, when everybody was covering the hantavirus outbreak on that cruise ship a few weeks ago, experts like you were saying it was a cause for concern, but not likely to become a serious problem. All of those same experts seem much more concerned about this latest Ebola outbreak in Central Africa. How is this different from what we were just talking about with hantavirus, and how is it different from previous Ebola outbreaks? This is not the first one. 

Gounder: Yeah, so to give you a sense of perspective, when I first heard the reports of a viral respiratory illness out of Wuhan in very late 2019, early 2020, I was terrified by what I was hearing. When I heard the reports of the hantavirus outbreak on the cruise ship, I was concerned for the other people on the cruise ship. I was not worried about a larger outbreak, and I would be very surprised, especially at this point, if we see any further cases. With respect to this Ebola outbreak, I am very concerned about a very large, huge, regional epidemic, where we may have some sporadic spread to other countries outside of the region. I am not worried about a pandemic. So, this is one difference: An epidemic is usually within a certain region. Pandemic is when it goes worldwide. So, I think this is going to be an epidemic in Central, possibly also East, Africa, but not going beyond that. 

Rovner: So, how is this different from â€¦ you worked in one of the past Ebola outbreaks. This one people seem to think is more serious than the last couple that we’ve seen. 

Gounder: Yeah, so I worked in Guinea during the 2014-2016 Ebola epidemic. I was there for two months. You have some of the same risk factors for a large epidemic, so you have urban areas affected, you have cross-border spread. There you had the epidemic start in Guinea, then move to Liberia, then Sierra Leone, then back to Guinea, and then you also had migrant workers that would go back and forth. And so you have those same, exact risk factors with this current outbreak, and then, secondly, you have large refugee populations in South Sudan. And so both of those issues also further complicate movement, both in and out of the area. Healthcare workers trying to get in to address issues. Healthcare workers being safe doing this kind of work, and also getting supplies, in particular, PPE â€” personal protective equipment â€” as well as tests into the area to help respond. 

Rovner: What about the U.S. pullback in foreign aid? We’ve obviously, you know, seen sort of the demise of USAID and a hollowing out of the CDC here. I imagine that’s impacting how we’re responding to this. 

Gounder: Yeah, so starting with USAID. So, USAID funded the people on the ground that would do the contact tracing, who might help set up Ebola triage, as well as treatment units. And that funding is gone. In fact, over the last week, I’ve been talking to some of the Congolese doctors who used to have jobs funded by USAID. And, in addition, USAID really supported the supply chain infrastructure for the area. So now you’ve seen a collapse of their ability to get personal protective equipment. There are shortages of this, which is also contributing to healthcare workers getting infected right now. And then also pharmaceutical supply chain. So, you know, even the most basic of medications is a challenge to get into the area. With respect to CDC, there have been tremendous layoffs related to the DOGE [Department of Government Efficiency] cuts from last year. We had the CDC shooting last August, and morale at the agency is â€¦ it’s horrible, it’s horrible. And just in the last day or so, Dr. [Jay] Bhattacharya, who’s the NIH [National Institutes of Health] director, and also, I guess he’s calling himself something else, because he can’t technically be acting CDC director anymore. But … 

Rovner: He’s nominally in charge of CDC, without being the acting director. 

Gounder: Right, exactly, whatever that means. But he has asked for CDC staff to volunteer to go over to Kenya, and staff a quarantine and, sounds like, treatment unit for any American healthcare workers who might get sick or be exposed while responding to the Ebola outbreak. And based on what we’re hearing, it sounds like they do not want anyone with Ebola coming back into the U.S., including the very people they’re asking right now to volunteer to go to this unit in Kenya. So I think that is also going to further complicate the response. You know, like, if you volunteer for the Marines, you enlist, and you get sent overseas, and you have an injury, you expect to be repatriated as quickly as is possible for treatment here in the United States, right? That is not the case. These are people who are similarly putting their lives on the line, who are responding to that call for help, and we are not seeing similar respect for that sacrifice. 

Rovner: And yet, I mean, the U.S. is set up to take care of people with seriously contagious diseases, right? 

Gounder: Oh, yeah, we have over a dozen units that were specifically created for this very purpose. Several of them have hands-on expertise, experience with this. So, in particular, Emory [University School of Medicine] in Atlanta, [NYC Health + Hospitals/] Bellevue in New York City, where I am, as well as University of Nebraska Medical Center. All three of those have experience with Ebola, not just having done preparations. And it’s really confounding why you would not want to make use of that. When somebody gets Ebola, particularly if you’re talking about an American, you know, who has put themselves in harm’s way â€” there are some real questions about fairness and equity of access to certain levels of care â€” but American aid workers, the expectation is that they would get the full-court press. And that might include being on a ventilator, that might include needing dialysis, for example, and to do those things when somebody has Ebola, and you need to do that in biosafety Level 4 conditions, I have a hard time seeing how they’re going to be able to put that together in Kenya on such short notice. 

Rovner: So we learned a lot of lessons from covid, not all of them good, obviously. You have a , which I will post a link to, about the psychology of pushback. Can you talk about that briefly? Because I think that has a lot to do with how the U.S. is responding to this. 

Gounder: Yeah, and I think a lot of people may actually identify with their own experiences during covid. You had a lot of people who didn’t want to wear a mask. In fact, we saw masks being burned, right? People not wanting to get vaccinated. And what happens is, when you have somebody who, for whatever reason, people don’t trust telling them to do something, they feel like they’ve been backed into a corner and they lash out. And so you tell them to do something, very often they want to do the exact opposite. And I saw this exact same thing when I was in Guinea over 10 years ago now. It was related to the presidential elections at the time, and it was a way of expressing dissent towards the current, at that time current, president and ruling party. And so, you know, for Ebola, the measures are pretty basic, particularly at that time: It really came down to contact tracing, testing, safe burials. And people would refuse to do some of those really basic things, and it was their way, what we called in Guinea and French, La réticence c’est la résistance, so reticence and resistance. And you saw that whole spectrum manifest there, and I think we’re seeing the same thing all over again, predictably so, in the DRC [the Democratic Republic of Congo] right now. 

Rovner: So, what could this administration be doing better, or be doing that they’re not doing that could maybe help us tamp this down, I mean, before it gets out of hand? 

Gounder: Well, I am concerned it’s already out of hand. They’re only following up on one out of every five contacts, so that means four out of every five contacts could be seeding new chains of transmission. So I think this is going to get a lot worse before things start to turn around. In fact, I would predict this is going to be a year or two to control. I mean, based on prior experiences with the 2018-2019 outbreak in the same area, as well as the 2014-2016 outbreak in West Africa. This has the potential to be even worse. What could the U.S. be doing? Well, we are currently adopting a very isolationist stance with respect to our public health policy. The dismantling of USAID is a big part of that, but it’s not the only thing. And I think what is happening now, frankly, gives me flashbacks to the 2014 Ebola news and midterm elections, and the way in which Ebola was politicized at that time. At that time, President Trump was not president; he wasn’t even a candidate yet, but he spoke very loudly about having travel bans. He called for President [Barack] Obama to resign because he allowed, in fact, facilitated the transport of infected Americans back to the U.S. for treatment. And so he’s on the record as having said he never wanted anybody with Ebola in this country. And I think the current policy that you’re seeing is consistent with that. We’re headed into midterm elections again. We’re seeing travel bans being instituted for real this time, not just talked about. And one of the other concerns around travel bans at that time, and again now, was what would it mean for healthcare workers and other aid workers, their willingness to volunteer to respond? And I remember Craig Spencer, a very good friend of mine, he was hospitalized at Bellevue with Ebola, and it was right around that time as well, Kaci Hickox, a nurse who had responded, she came back to Newark Airport. Chris Christie, as I recall â€¦ 

Rovner: Then the governor of New Jersey. 

Gounder: Yeah, right, governor of New Jersey, Chris Christie, at that time mandated that she be quarantined. So she did not have symptoms, but that she be quarantined due to her work on, I think, it was the tarmac at Newark Airport with a Porta Potty and a tent, something along those lines. And I had a lot of friends at that time who pulled out of volunteering â€” between Craig getting sick and Kaci and the mandated quarantine really under inhuman[e] and humiliating conditions. And I think this time it’s going to be even worse because not only are you having to face potentially getting sick, but you may not get to come home. And it’s really unclear at what stage, if you get sick, would you be allowed home. Do you have to wait until you recover? And what if you die? What happens then? Does your body get repatriated? Does your family, right, get to receive the body? That’s a big deal for a lot of families to have that closure. So I know, even among my friends who, like me, are Ebola veterans, there’s a lot of hesitance about stepping up again. 

Rovner: Well, I hope we can call on you as this continues, alas. Thank you so much. 

Gounder: Oh, of course, Julie. 

Rovner: OK, we’re back. It’s time for our extra-credit segment. That’s where we each recognize a story we read this week we think you should read, too. Don’t worry if you miss it. We will post the links in our show notes on your phone or other mobile device. Maya, why don’t you start us off this week? 

Goldman: My extra credit this week is a story in The Texas Tribune by Terri Langford and Colleen DeGuzman titled “.” And you know, I think it’s obviously a very important political story in the fight over transgender rights, and specifically rights for transgender kids, and the medical practice around gender-affirming care. But one of the things that’s especially interesting to me about this settlement is that there’s not really demand for detransition services, at least at the level of having a dedicated clinic at a children’s hospital for them. And so this is basically a children’s hospital is going to put resources towards creating something that, or presumably put resources towards creating something that may not be used. And as hospitals are talking about how stressed they are for dollars, and just in general overextended, you know, I think this is a very interesting use of resources. 

Rovner: That’s one way to put it. Lauren. 

Weber: I have the New York Times investigation by Sarah Kliff and Margot Sanger-Katz â€” which, you know, as soon as you see those two names, you have to read it â€” titled “.” And it’s a great look and also builds upon, you know, some great reporting by The Wall Street Journal, I’ll have to shout them out as well in this area. But it details how, amid this focus on autism clinic fraud how â€¦ what that looks like on the ground. And it’s pretty terrible on the ground. A lot of these autism treatment clinics, the science is questionable on whether it really works. They’re encouraging people to send their kids there instead of to school. â€¦ There’s this horrific anecdote in the lede about how a child is woken up from a nap that can only last almost seven minutes, so they can bill more. I mean, it’s pretty gut-wrenching and gets at the clear issue in a lot of healthcare, which is that a lot of this is done to maximize profit and not necessarily for the patient. So it’s very well done. 

Rovner: Yeah, it is really scary. Shefali. 

Luthra: Mine is in the New York Times opinion section by Dr. Sejal Hathi. The headline is “.” She herself is a new mom, in addition to running the Oregon Health Authority, and she writes about how our postpartum care system is terrible. We do not care about new moms. We only care about infant checkups. We have very little medical care for people when they are postpartum, and that is not good, because pregnancy is really hard. You can have complications. Most pregnancy-related deaths happen after giving birth, not during. Most of them are preventable, and yet we don’t treat this as something that could be addressed, even though it very well could be, because in other countries they actually do make an effort to care about new moms. I love that she wrote about this from a personal and professional standpoint. I think it’s great, and I hope that it inspires some states to think about ways to improve postpartum health. 

Rovner: Yeah, that story made me so angry. Well, my extra credit this week is also about reproductive health. It’s from ProPublica by Pulitzer Prize-winning reporter Kavitha Surana. It’s called “.” And it’s about yet another case of a mom pregnant with her second child, a college-educated healthcare worker, whose membranes ruptured early, putting her at high risk of sepsis, but who couldn’t get the pregnancy terminated at the hospital where she worked, because the doomed fetus still had a heartbeat. This was a well-connected family. The patient’s father is a doctor. She was in the same sorority at the same college as Arkansas Gov. Sarah Huckabee Sanders, and she enlisted one of the top reproductive health lawyers in the country to plead her case with hospital officials. I won’t spoil the end for you, because you really should read the entire piece, but it underscores yet again that abortion bans can endanger people who don’t think they will ever want or need an abortion. 

All right, that is this week’s show. As always, thanks to our editor, Emmarie Huetteman, and our producer-engineer, Francis Ying. We also had production help this week from Taylor Cook. A reminder: What the Health? is now available on WAMU platforms, the NPR app, and wherever you get your podcasts — as well as, of course, kffhealthnews.org. Also, as always, you can email us your comments or questions. We’re at whatthehealth@kff.org. Or you can still find me on X , and on Bluesky . Where are you guys hanging these days? Maya. 

Goldman: I am on LinkedIn under my name and on X . 

Rovner: Shefali. 

Luthra: On Bluesky . 

Rovner: Lauren. 

Weber: Still on  and  under @LaurenWeberHP. As I like to say, the HP is for health policy. 

Rovner: We’ll be back in your feed next week. Until then, be healthy. 

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Ñî¹óåú´«Ã½Ò•îl Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .

This <a target="_blank" href="/podcast/what-the-health-448-republicans-midterms-children-losing-insurance-may-28-2026/">article</a&gt; first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

<img id="republication-tracker-tool-source" src="/?republication-pixel=true&post=2242581&amp;ga4=G-J74WWTKFM0&quot; style="width:1px;height:1px;">]]> 2242581 In a Vaccine-Skeptical California County, a Potential Playbook To Contain Measles /public-health/measles-outbreak-contained-vaccine-skeptical-california-shasta-county/ Thu, 28 May 2026 09:00:00 +0000 /?p=2240454 James Mu had braced for the call that came in late January.

A patient from his rural Northern California county , a disease so rare there that many physicians have never treated a case.

While California has some of the strictest vaccine laws in the country, conservative Shasta County’s approach during the covid pandemic stood in stark contrast with the state’s guidance. Its local leaders opposed masking and vaccine mandates, and the county public health officer, who had sought to enforce those state policies and other safety measures.

A potential measles outbreak had “always been in my mind,” said Mu, an outspoken family physician who was to sign a opposing covid vaccine mandates. But Mu, the county’s current public health officer, said that when his department identified the first local measles case, it acted decisively: “We forgot about fear.”

They went to work, he and his team said, to painstakingly retrace the steps of sickened with measles, contacting more than 600 people who may have been exposed at Costco, a sushi restaurant, sporting events, a school, or a healthcare clinic. Just one of the nine contracted measles from one of those locations, while the others were characterized by the public health department as “close contacts.”

Two and a half months later, the Shasta County public health department had declared the measles outbreak over. Infectious disease experts say the rapid response executed in the mostly rural, vaccine-hesitant county offers a playbook for public health officers across the nation who are struggling to keep the highly contagious virus from spreading.

“To me, the story of Shasta is one of hope,” said Peter Chin-Hong, an infectious disease specialist at the University of California-San Francisco.

An aerial view of downtown Redding, California.
Downtown Redding, California, the seat of Shasta County. (iStock/Getty Images)

After more than a year of ongoing cases, measles has sickened more than in the U.S., according to the Centers for Disease Control and Prevention. For the first time in two decades, the U.S. is poised to lose its measles elimination status, a designation signaling that outbreaks are rare and rapidly contained.

673 measles cases as of late May while had seen at least 997, according to their state health departments. 74 cases.

Critical Rapid Response

In late January, when Shasta County identified the first case, Mu gathered with more than a dozen communicable-disease nurses, epidemiologists, and emergency and community relations staffers for an “initial threat assessment meeting.”

Measles is an that can linger in a room for two hours after an infected person leaves, so on-call nurses and responders faced a daunting task figuring out exactly when the patient was infectious and where they had been.

“Everything is about speed — speed in identifying the person and finding the sites where measles were occurring,” Chin-Hong said. “If you keep it down to a few cases, it’s much easier. If you wait just a little bit longer, those people would have been in contact with a lot more people.”

Roughly 9 in 10 unvaccinated people exposed to the virus become infected. All nine of Shasta County’s confirmed cases were people who were unvaccinated or had unknown vaccination status, according to the county’s public health department. Before the department called families who may have been exposed, county nurses sometimes enlisted school principals, church staff, clinic managers, or others to make first contact, said Daniel Walker, the county’s supervising epidemiologist.

Erika Piper, the head of Redding Christian School in Palo Cedro, talked to school families wary of requests by public health officials — and government in general — to provide immunization records or other personal information. She said she also had tough but respectful conversations with families to ensure exposed, unvaccinated kids stayed home from school, so their community could abide by public health guidance calling for .

“I would say to them: ‘That’s totally fine. You have a choice. You’ve made your choice. But there are still consequences to the choices we make,’” Piper said, referring to families who had opted not to vaccinate their children. “‘And so you can either be a willing helper and a partner with me in this, and we can make it work and get through it, or you can battle me on it. But either way, you can’t be in school.’”

She allowed work to be sent home to quarantined students and personally took daily attendance at the school to help ensure health guidelines were met.

The California Department of Public Health assisted with case investigation by making calls to exposed people at the county’s request and deployed a covid-era phone system, CalCONNECT, that automates symptom monitoring for exposed contacts.

Shasta officials warned people not to be wary of calls from contract tracers using a 279 area code, worrying they would dismiss them as scams.

Delicate Conversations

In Shasta County, the measles vaccination rate is just below the for community-level protection, but in pockets of the community the rates are lower and vary widely, according to . And in those vulnerable places, an outbreak can spread.

For example, more than a quarter of Shasta schools had rates below 95% in 2024-25, according to the latest state data available. Several were below 90%. Although Redding Christian School reported a kindergarten measles vaccination rate at or above 95% in 2024-25, it was 87.8% three years earlier.

When it came to talking to people who had been exposed to measles, Sharayne Loomis, a supervising public health nurse on Shasta’s communicable-disease team, described the department’s approach as “meeting people where they are.” That included nonjudgmental conversations that supported residents regardless of their stance on vaccination, Loomis said.

Mu said the same philosophy extended across the county’s health agencies, but he publicly “measles parties,” gatherings where unvaccinated children are intentionally exposed to build immunity. And he spoke against receiving high doses of vitamin A without medical supervision. Vitamin A has circulated as a measles treatment in vaccine-skeptical communities and was endorsed last year by Health and Human Services Secretary Robert F. Kennedy Jr., though the CDC website says that vitamin A “does not prevent measles and is not a substitute for vaccination.”

A headshot of James Mu indoors.
James Mu, Shasta County’s public health officer, led the rural, conservative California county’s effort to contain a measles outbreak that began in late January. (Shasta County)

Some community members said Mu’s department could have been more proactive before the outbreak, imploring him to emphasize the importance of vaccination in public messaging.

“Clearly, when the situation was known to be coming into our communities, that would have been a time to advise for vaccines,” Steve Kahn told county supervisors at their February board meeting. “I think he was negligent in that.”

For years, public health has been a political flash point for the region. The Board of Supervisors fired the previous public health officer, Karen Ramstrom, in May 2022 after upset with her enforcement of state covid rules.

In an effort to reach vaccine-hesitant Californians, state officials have been working in a coalition called Public Health for All Californians Together and through an effort nicknamed that uses social media monitoring and other research to tailor messaging to skeptical viewers.

Erica Pan, director of the California Department of Public Health, said the state is preparing for measles to possibly surge when it hosts World Cup soccer matches starting in June, as well as with increased summer travel.

But when it comes to mitigating an outbreak in a community, public health officials say, residents — especially those skeptical of vaccines — need to hear from the people they know.

“Trust is very important for us,” Mu said. “It is critical in getting people to follow our guidance, especially during an outbreak.”

Ñî¹óåú´«Ã½Ò•îl Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .

This <a target="_blank" href="/public-health/measles-outbreak-contained-vaccine-skeptical-california-shasta-county/">article</a&gt; first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

<img id="republication-tracker-tool-source" src="/?republication-pixel=true&post=2240454&amp;ga4=G-J74WWTKFM0&quot; style="width:1px;height:1px;">]]> 2240454 Journalists Distill News on Ebola, Licensing Midwives, and California’s Budget /on-air/on-air-may-23-2026-ebola-midwife-licensing-gavin-newsom-california-budget-medicaid/ Sat, 23 May 2026 09:00:00 +0000 /?p=2241530&preview=true&preview_id=2241530

Céline Gounder, Ñî¹óåú´«Ã½Ò•îl Health News’ editor-at-large for public health, discussed the diversion of a Detroit-bound plane to Canada over Ebola concerns on CBS News’ CBS Mornings on May 21. Gounder also discussed how the Democratic Republic of Congo’s Ebola outbreak has been declared a global health emergency on Fox’s LiveNOW on May 18.

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Ñî¹óåú´«Ã½Ò•îl Health News senior correspondent Renuka Rayasam discussed Georgia’s debate over licensing midwives on WUGA’s The Georgia Health Report on May 15.

Ñî¹óåú´«Ã½Ò•îl Health News senior correspondent Angela Hart discussed California Gov. Gavin Newsom’s budget rollbacks on KQED’s Political Breakdown on May 14.

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Ñî¹óåú´«Ã½Ò•îl Health News California correspondent Christine Mai-Duc discussed Medicaid funding in California on LAist’s AirTalk on May 14.

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Ñî¹óåú´«Ã½Ò•îl Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .

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<img id="republication-tracker-tool-source" src="/?republication-pixel=true&post=2241530&amp;ga4=G-J74WWTKFM0&quot; style="width:1px;height:1px;">]]> 2241530 Sen. Cassidy Unleashed /podcast/what-the-health-447-senator-bill-cassidy-primary-trump-ebola-may-21-2026/ Thu, 21 May 2026 18:48:26 +0000 /?p=2240466&post_type=podcast&preview_id=2240466 The Host
Julie Rovner photo
Julie Rovner Ñî¹óåú´«Ã½Ò•îl Health News Read Julie's stories. Julie Rovner is chief Washington correspondent and host of Ñî¹óåú´«Ã½Ò•îl Health News’ weekly health policy news podcast, "What the Health?" A noted expert on health policy issues, Julie is the author of the critically praised reference book "Health Care Politics and Policy A to Z," now in its third edition.

Just days after Sen. Bill Cassidy (R-La.), who is also a doctor, was ousted in a primary election, he has already begun to separate himself from the agenda of President Donald Trump, who endorsed one of his opponents. Cassidy has half a year left in office and could, in that time, reshape health policy in an administration from which he’s now effectively freed.

Meanwhile, a potentially serious Ebola outbreak in central Africa has experts worried that the U.S.’ dismantling of much of the nation’s public health infrastructure leaves it more vulnerable than in earlier outbreaks.

This week’s panelists are Julie Rovner of Ñî¹óåú´«Ã½Ò•îl Health News, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico Magazine, Sheryl Gay Stolberg of The New York Times, and Alice Miranda Ollstein of Politico.

Panelists

Joanne Kenen photo
Joanne Kenen Johns Hopkins University and Politico
Sheryl Gay Stolberg photo
Sheryl Gay Stolberg The New York Times
Alice Miranda Ollstein photo
Alice Miranda Ollstein Politico

Among the takeaways from this week’s episode:

  • Cassidy, the chairman of the Senate Health, Education, Labor and Pensions Committee, is still in charge of nominations for some major vacancies at the Department of Health and Human Services, including commissioner of the Food and Drug Administration, director of the Centers for Disease Control and Prevention, and surgeon general. Now that he’s no longer tied to pleasing Trump or HHS Secretary Robert F. Kennedy Jr., Cassidy will have more independence when it comes to who could get confirmed to fill some of these key health posts.
  • Kyle Diamantas, the acting head of the FDA, is trying to mend fences with anti-abortion activists concerned because he represented Planned Parenthood in his private law practice. Meanwhile, the promised safety study looking at the abortion pill mifepristone has apparently not yet begun — not because the FDA was delaying it but because officials have been unable to get access to a needed database.
  • Kennedy, having reshaped the Advisory Committee on Immunization Practices, is now taking aim at another key group of health advisers, the U.S. Preventive Services Task Force, which helps determine which preventive services are valuable enough to merit insurance coverage.
  • A new analysis from KFF shows that many more enrollees in Affordable Care Act plans now have much higher deductibles to pay before coverage kicks in, potentially leading to cases in which, even with insurance, patients will be unable to afford care. At the same time, the Trump administration is proposing new rules for 2027 that would encourage health plans with still higher deductibles.

Also this week, Rovner interviews health policy professor Miranda Yaver, the author of the new book .

Plus, for “extra credit” the panelists suggest health policy stories they read this week they think you should read, too:

Julie Rovner: The Wall Street Journal’s “,” by Liz Essley Whyte, Josh Dawsey and C. Ryan Barber.

Alice Miranda Ollstein: Stat’s “,” by Isabella Cueto.

Joanne Kenen: The Associated Press’ “,” by Tiffany Stanley.

Sheryl Gay Stolberg: Ñî¹óåú´«Ã½Ò•îl Health News’ “Religious Anti-Abortion Center Finds Opportunity in Town Without OB-GYNs,” by Jazmin Orozco Rodriguez.

Also mentioned in this week’s podcast:

  • The New York Times’ “,” by Sheryl Gay Stolberg.
  • Politico’s “,” by Alice Miranda Ollstein.
  • KFF’s “,” by Matt McGough, Jared Ortaliza, Justin Lo, and Cynthia Cox.
click to open the transcript Transcript: Sen. Cassidy Unleashed

[Editor’s note: This transcript was generated using both transcription software and a human’s light touch. It has been edited for style and clarity.] 

Julie Rovner: Hello, from Ñî¹óåú´«Ã½Ò•îl Health News and WAMU Public Radio in Washington, D.C. Welcome to What the Health? I’m Julie Rovner, chief Washington correspondent for Ñî¹óåú´«Ã½Ò•îl Health News. And, as always, I’m joined by some of the best and smartest health reporters covering Washington. We’re taping this week on Thursday, May 21, at 10 a.m. As always, news happens fast, and things might have changed by the time you hear this. So, here we go. Today, we are joined via video conference by Sheryl Gay Stolberg of The New York Times. 

Sheryl Gay Stolberg: Hi, Julie. 

Rovner: Alice Miranda Ollstein of Politico. 

Alice Miranda Ollstein: Hello. 

Rovner: And Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico Magazine. 

Joanne Kenen: Hi, everybody. 

Rovner: Later in this episode, we’ll have my interview with Miranda Yaver, a health policy professor at the University of Pittsburgh and author of a cool new book all about insurance denials. But first, this week’s news. 

So, the biggest health policy news in Washington this week is the primary defeat of Senate Health, Education, Labor, and Pensions Committee Chairman Bill Cassidy, who finished third in a three-way Republican primary in Louisiana Saturday â€” not just to congresswoman Julia Letlow, the candidate endorsed by President [Donald] Trump, but to state treasurer and former representative John Fleming, who, like Cassidy, is also a medical doctor. Fleming and Letlow will now advance to a runoff next month to see who will make the general election ballot in November and likely advance to the Senate from very red Louisiana. 

Meanwhile, though, Cassidy still has the rest of this year at the helm of the HELP Committee, where he is still in charge of filling Trump administration vacancies for surgeon general, Food and Drug Administration commissioner, and director of the Centers for Disease Control and Prevention. And, just judging from the last few days, Cassidy appears to feel liberated from his former fealty to President Trump. He switched sides and voted with Democrats to limit Trump’s war powers. He questioned the legality of a $1.8 billion fund to pay people who claimed they were victims of unfair federal prosecutions, and he defended his vote to convict Trump in the impeachment trial after Jan. 6, which is what got him in hot water with the president in the first place. What does this portend for what might happen at the HELP Committee going forward the rest of this year? 

Stolberg: Well, I think we see Cassidy, as you said, “liberated,” unfettered. You know, Cassidy agonized over whether or not to confirm Bobby Kennedy. I recently reread his testimony, and at the end, he delivered this soliloquy, and he said, Man, you know, I don’t know, can a 71-year-old man, you know, change his tune after all this time? He said, I’m 71; Kennedy’s 71, and he wondered if Kennedy could, you know, really do the things that he promised Cassidy he would do. And in the end, Kennedy did not, and Cassidy was kind of humiliated in Washington. He may have been defeated by forces in Louisiana other than what he did in Washington, but at least here in Washington, Cassidy, you know, still has his perch. He was never comfortable with Bobby Kennedy. There’s nothing holding him back now. When I asked him before his primary, I said, Will we see a vote on Casey Means? She was still the nominee then, and he said, We’ll talk about that later. And I have a feeling that Cassidy will talk about a few things later. 

Rovner: I feel like two things happen when senators are, you know, become lame ducks like this, is they can either go rogue and do everything they always wanted to do and say everything they always wanted to say â€” which we’re kind of seeing with Sen. Thom Tillis from North Carolina â€” or they can actually hunker down because they’re worried about what they might do when their term is over, and they want to get a job, and they want to be able to lobby their former colleagues. Do we have a feel for which way Cassidy is going? 

Stolberg: Cassidy already gave us a feel. In 2021, he voted to convict Trump on a charge of incitement of insurrection. He said at the time I voted to convict Trump because he’s guilty. Now it is true that Trump is still in office now; Cassidy probably never expected him to come back, but I don’t know. Cassidy tried containing or constraining himself, and it didn’t work out. He lost, so no, why not let it rip now? 

Kenen: I was always sort of struck that once he cast that impeachment vote, which was a really defining vote, even, as Sheryl just pointed out, not expecting Trump to â€” I mean, [Sen. Mitch] McConnell didn’t expect him to, a lot of people didn’t expect him to â€” come back after that. But he had done it, and he can’t erase it once Trump did come back. So once you have that, sort of, you know, what for Trump is a mark of Cain on your forehead, then why â€¦ like, we saw it was so visible, you could see Cassidy wrestling with the Kennedy nomination, you could see it. It was so visible, it was like [unintelligible] â€¦ 

Stolberg: It was like Hamlet. 

Kenen: And then vote against his conscience, probably, none of us are in his head or his heart, but you know it was not a vote he was completely comfortable with. And it wasn’t going to save him. Like, at that point, the politically smarter thing might have just gone, OK, I’m going to be an independent-minded guy, and if I lose, I’m going to lose if I do this, and take a gamble on doing that. I don’t think anyone expected him to come out ahead in this primary, although maybe he did. I never understood the Kennedy vote. I never â€¦ 

Rovner: I understood the Kennedy vote. What I never understood was what happened afterwards, when Kennedy did not keep all the promises that he made to Cassidy, that he would come and testify that he wasn’t going to change the vaccine schedule, all the things that he then did. And Cassidy sort of â€” you could see that he was disapproving of it, but he never really did anything about it. I think that was the part that surprised me much more than the actual vote. 

Ollstein: Cassidy also, throughout the course of his campaign, really tried to align himself with Trump and sort of tried to argue that, you know, forget about the impeachment vote a few years ago, you know, more recently we align on X policy and Y policy, and we both believe in border security, and we both believe in stopping fentanyl, and X, Y, and Z. And so, honestly, the entire primary was just about Trump. All three candidates tried to argue that they were the most aligned with Trump. Obviously, that was easiest for Letlow, who was endorsed by Trump, but all three tried to argue that they were carrying the MAGA [Make America Great Again] banner, including Cassidy, despite that impeachment vote, which was, I think, interesting. The RFK vote did not come up quite as much. It was really overshadowed by Trump. 

Stolberg: But you know what’s interesting? Cassidy did grow a little more vocal along the way. When I asked him in the early days how he thought Kennedy was responding to the measles outbreak, he said, Oh, it was, you know, OK. Like, he encouraged people to get vaccinated. And I said, No, he didn’t. He said â€¦ vaccination was a personal choice. And Cassidy said, Well, it’s the gestalt of the thing. And then he slowly, you know, did speak out more. But what I found very striking was the way Kennedy spoke out against Cassidy right after Trump withdrew the Casey Means nomination. And he accused Cassidy of doing the bidding of, you know, the pharmaceutical industry and of forces that would thwart MAHA [Make America Healthy Again], which really tells you that the relationship was and is broken. 

Rovner: Well, to push the segue a little bit, one of the things that Cassidy has, the freed Cassidy, has done this week, as I mentioned, is criticized that $1.8 billion potential fund out there for people to collect who say that they’ve been unfairly taken to court and possibly convicted by the federal government. Alice, it looks like that could include people who broke into and blocked patients from abortion clinics. That would be something that Cassidy would presumably like, because he’s so anti-abortion. But is that really true? 

Ollstein: Yes. So the text of this settlement that was released, it was extremely broad. Really, it’s saying that anyone who feels they’ve been victimized by any administration, past or present, can apply for money from this fund. There really aren’t a lot of guardrails on it, but it did give a few specific examples of people who could apply for this money. And one of those examples was people convicted under the FACE Act, the Freedom of Access to Clinic Entrances Act, which is a law, since the 1990s, that is aimed at protecting abortion clinics but also anti-abortion crisis pregnancy centers and houses of worship. And it has these additional federal penalties. And so these are folks who the Trump administration pardoned last year, people who are serving felony sentences in many cases for breaking into abortion clinics, blocking the entrances of it, of them. And so , who have been documenting a rise in threats to clinics over the last couple years, since the pardons that came in 2025, at the beginning of Trump’s second term. And now they’re worried that this potential payout to these folks could serve as an increased incentive for that kind of behavior. 

Rovner: Yeah. Well, we will see if Sen. Cassidy, and maybe Sen. Tillis, and maybe some others who’ve expressed some doubts about this fund, manage to block it. Whatever happens for the rest of this year, though, come 2027, there will be a new chairman at the Senate Health, Education, Labor, and Pensions Committee. If the Republicans maintain control of the Senate, it’s likely to be one of the two other doctors currently on the committee, Roger Marshall of Kansas or Rand Paul of Kentucky. What could we expect from either of them? They have very different outlooks. 

Ollstein: Yeah, Roger Marshall is a big cheerleader of RFK Jr. and the MAHA movement. He is the head of a MAHA caucus in Congress, and so it would be a complete reversal of the criticisms we have been getting from Cassidy of the administration’s actions on that front â€” so, really, replacing one of the HHS secretary’s biggest critics with one of its biggest cheerleaders. 

Stolberg: I think Rand Paul wants to keep [his chairmanship of the ] Homeland Security [and Governmental Affairs Committee], I really do. Because I’m pretty sure he could have been â€” could he have been chairman this time around? 

Rovner: I think he, I think â€” no, Joanne is shaking her head no. 

Kenen: I might be wrong, but I think not. 

Rovner: But he definitely â€¦ could be chairman, I think, if he wanted it. I think he’s senior to Marshall. 

Stolberg: But I do think he wants to keep Homeland Security. But I think if we saw a Rand Paul chairmanship, we would see a lot of going after the NIH [National Institutes of Health] and investigating [Anthony] Fauci. Rand Paul has repeatedly said he thinks Fauci should be in prison. And â€¦ I think he’s kind of like a dog with a bone there. I don’t think he’s going to let that go. 

Rovner: No, he’s sort of the biggest iconoclast, I think, on that committee. 

Kenen: But there’s also two quite moderate, among the most moderate, Republicans on that committee, which [is] Susan Collins, who obviously has a tough race, and we’re not sure if she’ll be there next year, and Lisa Murkowski. Both of them have other committee assignments on Approps [Appropriations], they’re not being talked about so much in the in the mix for succeeding Cassidy. But it’s an odd committee. It’s always been an interesting committee for years to watch because of the mix of who wants to be on it and what they can do. But the speculation right now is Marshall. 

Stolberg: And if they lose, Bernie Sanders will be the chair, and we’re going to hear a lot about drug prices. 

Rovner: Yes, I think that’s fair. Well, meanwhile, this year, there are still more vacancies happening at a Department of Health and Human Services that never seems to get settled, in the wake of the departure of FDA Commissioner Marty Makary last week. Was it really just last week? Also out is Tracy Beth Høeg, who was running FDA’s drug center and was a vaccine critic and a favorite of the MAHA movement. But, meanwhile, the acting FDA chief, Kyle Diamantes, did some “kiss and make up” with anti-abortion activists who helped lead to Makary’s ouster. Alice, did this work? 

Ollstein: Depends what you mean by “work.” So we reported this a couple weeks ago, and it was really notable that he spent his first couple days in power making personal phone calls to several anti-abortion groups, trying to reassure them that he is on their side, that he has been personally anti-abortion for a while. He was trying to calm a storm that had been brewing when court records came to light showing that he had, as a private attorney a decade ago, represented Planned Parenthood in a legal case in Florida. 

Rovner: It was a real estate case. It had nothing to do with abortion. 

Ollstein: Sort of. It sort of had to do with abortion. It was about what is a surgery, and can a building at this site, you know, be approved for surgery, and is abortion a surgery or just a procedure? So it sort of had to do with abortion. But obviously defending Planned Parenthood in any capacity is verboten in the anti-abortion community, and so that was seen as sort of a black mark on his record that he was rushing to reassure these groups that he did that against his will, that he tried to leave the case, etc. I will say that blitz of outreach did not completely alleviate concerns. We heard from both anti-abortion folks on Capitol Hill and in the advocacy community that they remain concerned. But since he is rumored to not be in the running to be the leader of the agency on a more long-term basis, I think that those concerns are sort of just simmering for now. 

Kenen: Didn’t he represent Planned Parenthood for three full years? 

Ollstein: His name â€¦  

Kenen: I mean, the case might not have been active, but his name was on there for three â€¦  

Ollstein: Right. His name was on the documents. 

Kenen: It’s hard to talk about three years and say, Well, I withdrew because I’m morally opposed to abortion. You know, if his name was on there for a week, it would be a more easier case to make, but three years is a lot of days. 

Ollstein: Yeah, and that’s what some folks told us. They said they still have questions, basically, that it’s not clear when he asked to be removed from the case, what his involvement was, etc. And so, yes, people do remain concerned. But because he seems to not be in consideration to be the FDA leader more permanently, then it’s sort of a moot point. 

Rovner: But the immediate concern is this purported study of the safety of mifepristone, which was one of the things that the anti-abortion movement said Makary was sitting on and not doing. Sheryl, I see you nodding â€” you guys had some reporting [on] this. What the heck is the status of this study? 

Stolberg: So this is what we reported this week, my colleague Christina Jewett and I. First of all, this study hasn’t even started. 

Rovner: Surprise! 

Stolberg: The basic issue here: There’s a court case going on. The FDA left intact a Biden policy that broadened access to mifepristone, an abortion pill. The state of Louisiana is suing, saying that that policy undermines its ability to enforce its abortion restrictions, which are some of the strictest in the nation, no exceptions for rape or incest. So the FDA has been saying, We will study this issue, we’re studying it, and when we have a determination about the safety of mifepristone, we will reconsider this policy. And they’ve been saying this for months, since last fall. But the fact of the matter is, as we reported, this study has not even begun. And the reason it hasn’t begun, at least according to our sources, is not that Marty Makary was sitting on it. Makary is actually anti-abortion. It is because the FDA wanted to use this database, called the Sentinel Initiative, which is [a] vast database of medical records and insurance billing claims, but they needed an updated version, and it’s been caught up in the bureaucracy by the higher-ups at the somewhat dysfunctional headquarters of the Department of Health and Human Services. So, absent having this database, our sources said the FDA couldn’t begin the study. 

Now, it is true that the delay conveniently coincides with pushing this study past the midterm elections. And Trump and his White House, and Republicans more generally, really want this issue of abortion to go away by the time of the midterms, because they saw what happened in 2022 right after Dobbs. In those midterms, nobody thought abortion was going to be an issue in 2022. Then Dobbs came along, and it really benefited Democrats, and they regained control of the Senate, and they only lost a few seats in the House, where they were supposed to, you know, get slaughtered. So Trump does not want a repeat of that, and they just want this whole thing to go away. 

Rovner: We will keep watching that space. So it’s not just the FDA where the Department of Health and Human Services is seeing changes. Secretary Kennedy has now fired the two leaders of the U.S. Preventive Services Task Force, which is in charge of determining what preventive services are covered by health insurance. The deadline to nominate new members is this Saturday. It’s unclear as of this morning what will happen. But this is an important group that’s now headless and looks likely to remain that way for some time. And this is not Kennedy’s first strike at the USPSTF. He canceled the panel’s last several meetings and appears to be looking to sideline it completely? I mean, this could create havoc in a lot of other places â€¦ there’s 150 million Americans who are in plans that are covered basically by USPSTF recommendations. 

Kenen: Right, I mean, we should make clear that, in addition to saying, certifying this is a good thing to do for preventive care, it’s also â€¦ creates what certain health plans have to cover legally. 

Rovner: Right, under the Affordable Care Act. 

Stolberg: Such as mammograms, right? 

Kenen: Right, so it’s not just like a recommendation, it’s whether people really do have coverage to follow through on these recommendations. So it’s incredibly important. It hasn’t been, like, compared to a lot of things that are always controversial, and they flip back and forth in different administrations, and they come and go. There’s been controversy sometimes about a specific recommendation changing or causing confusion, but sort of â€¦ there hasn’t been an existential crisis before about it, at least that I remember. 

Rovner: Right. What age should mammograms start, I think, has been the biggest controversy. 

Kenen: That one, yeah, there’s like, and prostate cancer. There are things that like that, which there’s scientific debate, and things change, and â€¦ but that’s different. Like, the fact that this agency that most Americans don’t know exists, but benefit from, it has never been a hot potato, the way you know various other alphabet soup things that people may not be familiar with, but have constantly been, you know, in Congress, you know, AARP, for instance, or â€¦ but this one has just sort of been, Oh yeah, you know, it’s how I get my shots free. 

Rovner: Do we know why Kennedy has had knives out for this? Is it because of the vaccine recommendations? 

Kenen: Probably a factor, but also he does have a lot of control over this agency, and it does shape what he regards as preventive care. I mean, some things are not controversial, some things we would all agree are preventive care, and there’s some things that, you know, we’ve said before that there are things that he’s, he believes â€¦ certain things that there’s broad consensus about. But I think that the whole shift in how he thinks about health and the health industry, or the health industrial complex, as he might call it, and maybe has called it. This is one of the sort of obscure to normal people, but it’s one of the battlegrounds for what is preventive care? Who pays for it, and who gets access? So, I think it’s potentially â€¦ recommending coverage of some unproven supplements, or something like that. 

Stolberg: Right. That’s exactly what I was gonna say. I … 

Kenen: Peptides. 

Stolberg: Kennedy is fixated on prevention, right? He’s always saying that America has a sick care system, not a healthcare system. We need to focus on prevention. It’s kind of curious to me, then, why he is decimating the CDC, which has the word “prevention” in its name. But I do wonder if he wants to reshape this committee in a way that will cover other things that he sees as prevention â€” like supplements, like wearables, like peptides, or all of these other things that are unproven, but that are part of what public health people would call the wellness industrial complex. You know, he rails against the medical industrial complex, but public health people complain about the wellness industry. That’s the only thing that I can think about as to why he might have done this, but I confess I don’t have direct insight into his thinking about this, and just talking about it kind of makes me want to know more. 

Rovner: Well, we will keep watching this space. 

Stolberg: So stay tuned. Maybe Alice knows. 

Rovner: Alice, you have â€¦ you would like to add something? 

Ollstein: Yeah, so we got some foreshadowing that this was coming more than a year ago, because this issue was before the Supreme Court, and the administration surprised some people by technically defending the Affordable Care Act. But, in its argument in defense of this panel, said that it is legal and its folks were legally appointed because they really stressed that the HHS secretary has the power to fire and replace these people or ignore their recommendations or override them. And so the fact that they wanted to make it clear to the court that they had the power to do this â€” and, lo and behold, now they’re doing it â€” should surprise no one. But, like Sheryl said, exactly why they want to do it and what they plan to do next, we still don’t know. 

Rovner: Well, there could still be even more big personnel changes to come. Department of Health and Human Services last Friday announced that it is moving hundreds of senior career staff to a new civil service classification that strips them of many protections and makes it easier to fire them. This is a new version of the so-called Schedule F that the president floated at the end of his first term, and then was included in Project 2025. Now, if this really happens, and apparently it still requires a separate executive order from the president, it would give Kennedy power to oust even more career HHS workers than have already either been pushed out or forced to retire, or, you know, whatever. I mean, really remake the department in his image, right? 

Stolberg: I’m hearing from a lot of HHS employees who are really worried about this. They’re worried that it’s a de facto system of expanding political appointees â€” that, basically, once you serve at will, you’re not really a career servant anymore, you’re serving the whims of your boss, maybe the NIH director or the CDC director, or whomever. And there’s a lot of fear that this will diminish independence at these agencies, especially in the scientific agencies: the NIH, the FDA, and the CDC. 

Rovner: And also just, I mean, discourage people from speaking out, many of them, as scientists, to talk about what the evidence shows, not what a political appointee might desire. 

All right, we’re going to take a quick break. We will be right back. 

OK, we are back. Moving on to public health, the hantavirus outbreak from that cruise ship was apparently just our warm-up. Now we have an outbreak of Ebola in Africa that seems to have all those public health experts who said not to worry about hantavirus, now they’re really worried about Ebola. What’s different about this Ebola outbreak? We’ve had them before, and it’s never really affected us here. 

Stolberg: It’s a novel strain, and, Joanne, you should talk in a minute, but what I think is different, frankly, is that the Trump administration has really injured the public health infrastructure around the world to prevent and track and respond to infectious disease outbreaks. So we’ve withdrawn from the World Health Organization, we’ve dismantled USAID [the United States Agency for International Development], which I noticed was founded in 1961 under President John F. Kennedy, in part to combat the spread of disease. And funding is withering, and people in [the Democratic Republic of] Congo, public health people in Congo, are saying, like, this outbreak got out of hand before they even knew it was happening. And the question is, did all of these cuts hinder our response? 

Rovner: Yeah, which, I mean, if we’d had people on the ground, we probably would have known about it sooner. 

Kenen: Yeah, I agree with everything Sheryl said. The other thing is, I mean, this is one of the poorest countries in the world, and yet they’ve had a bunch of Ebola outbreaks, and they’re actually pretty good at handling them, for a low-resource country. This is much worse for where it broke out. There’s conflict in parts of the country. There’s refugee camps, where sanitation and people are very close. And it’s just a worst-case scenario. And because it is the rare strain, the standard, most commonly used tests don’t pick it up. So it’s not like they didn’t notice something bad was going on, but when they tested, the locally available tests came out negative, because it was not the most common Zaire strain they were most used to seeing, and that were best at fighting. So this is already spread undetected. It wasn’t like they thought, Oh, this couldn’t be Ebola, and then it had already spread before they knew it, not just in that country, but in, at least, to Uganda. And the real bad thing is the vaccine doesn’t work, as far as they know. And most of the treatments that have been developed for Ebola, which is not an easily treatable or curable disease, even with the advances that have been made, they don’t work for this one, or at least they’re not believed to work very well. Every time I look it up, the number’s gone up by like another 100. I think there’s 600 confirmed cases now, something in that range. And by tomorrow, as the disease spreads and as they detect more, we’re looking at a really terrible scenario of late detection and a hard-to-treat, really lethal version of this disease that’s already in a geopolitical bad place for a bad disease. 

Rovner: And possible spread. 

Kenen: Yes, and plus, as Sheryl said, you know, the global public health infrastructure â€” combination of the cutting of â€¦ the wood chipping of AID, plus the U.S.’s intent of leaving WHO, and we’re a big source of funding â€” and it’s just really a diminished capacity. 

Rovner: We will clearly have more on this next week. Moving on to news about the Affordable Care Act, my colleagues here at KFF have a  out projecting that marketplace enrollment could fall by 5 million by the end of the year. And that even those who have managed to hang on to coverage have much higher deductibles, with the average of nearly $4,000 before their insurance kicks in for most things. That’s up $1,000 from the year before, and the biggest increase in the history of the program. And in its final rule for 2027, the Trump administration is proposing even more big changes to the ACA, including making it easier for people to sign up for those so-called catastrophic plans with even bigger deductibles, and to sign up for something called non-network plans, which, as far as I can tell, basically say we, the insurance company, will pay a set fee for services, and if you can’t find a healthcare provider to accept that fee, that’s too bad for you. Am I misreading this? Is that how these plans seem to work? 

Kenen: Your guess is as good as mine, Julie. We haven’t seen this before, and we don’t know â€¦ like many things this administration proposes, and we don’t always know exactly what they mean at the beginning, and then when it becomes â€¦ presumably it will become somewhat clearer. But I’d never heard of this before. 

Stolberg: I would just say this is â€¦ not what Congress intended when it passed the ACA, and Obama signed it into law in 2010. 

Rovner: I think that is definitely fair. I will say, when the ACA passed, I spent a lot of time reading it, and all the places that it gave, quote-unquote, “secretarial discretion,” I thought to myself, The secretary isn’t always going to be somebody who supports this. I think this is a good example of it, that the secretary of HHS has a lot of discretion to do stuff like this, and they seem to be doing it. And you know, unlike some of the other things that they’re doing, this does not seem to be against the rules. â€¦ It seems fairly clear that they can. Alice, did you want to add something? 

Ollstein: Yeah, I mean, I think it just helps us to keep in mind that, you know, while there’s always a lot of attention on the numbers of uninsured and the recent numbers of people dropping their insurance because they can’t afford it anymore, there’s a whole other category of people who are newly becoming underinsured, who are moving from comprehensive plans that’ll be there for them when they need them, when they get sick, when they have facing a major health crisis, and plans that are very skimpy and won’t really cover what they need, or they’ll be facing such a huge deductible that they can’t afford to pay that either, and so I think it helps us keep a broader scope in terms of assessing, you know, the health of the marketplace. The uninsured numbers aren’t the only thing to pay attention to. 

Rovner: Yeah, and I think it’s important that â€¦ the KFF analysis said that the numbers of people losing insurance were smaller than had originally been predicted, because so many people moved from affordable deductible plans to basically unaffordable deductible plans. So they still have insurance, sort of in name, even if most people don’t have $10,000 hanging around that they can use to pay their deductible if something happens. 

Kenen: The first Trump administration, obviously, you know, he got elected on “repeal and replace,” which was a failure. Spent a lot of political capital and didn’t repeal â€¦ or certainly didn’t replace it. But from the very beginning, from like the very, very beginning, they were always trying to undermine the ACA, and in a variety of ways. And uninsurance â€” those numbers did rise after the first few years of the ACA. There was a steady increase in coverage and in comprehensive coverage. It deteriorated in the Trump administration the first time around, but what we’re seeing this time is much, much larger projections of lost coverage. And that’s not even counting â€” that’s just in the ACA. That doesn’t count what’s going to happen with Medicaid and the private insurance market in general, and whatever they’re going to do with discussions about changes in Medicare. People aren’t going to lose Medicare completely, but there could be â€” no one’s talking about repealing Medicare, but there are a lot of levers to change how people get care. So this is a pretty aggressive approach without using the politically difficult traumatic memories of repeal and replace. 

Rovner: Yeah, we’re just gonna go in and change it a lot. 

Stolberg: I was gonna say it suggests that we need to start tracking people who have catastrophic plans, because to call them insured is really not the case. And you know, this really plays out in people’s lives. I actually know someone who fell and injured both legs, and the doctors wanted to do MRIs on each, and this person said, “No, I can only afford one.” And you know, you think about the choices that people are forced to make. 

Rovner: And that they’re not forced to make in any other industrialized country. I think that’s sort of the thing that people miss. It’s like we are the only country where you can fall down the stairs and go broke. You will get care, we â€¦ have EMTALA [the Emergency Medical Treatment and Active Labor Act], we have other laws. You will be taken to a medical facility, and care will be delivered, and then you will be broke. I mean, that’s kind of where we are in the United States right now. 

Kenen: But we should also point out a version of catastrophic plans, or bronze plans, has existed. It’s always been options for people who truly want that option, right? For some individuals, that might be the best choice, and the original version of ACA had it. But it’s being changed because the end of the enhanced subsidies and other factors, the other options are less affordable for many people. There’s a lot of nudges in capital letters pushing people into these flimsier plans. So it’s been around for a while in various forms. Some people want them. But they’re looming now as like a big part of coverage, as opposed to an option that some people might want to choose. 

Rovner: And originally catastrophic plans were supposed to be accompanied by medical savings accounts â€” they were originally called, now they’re called health savings accounts. The idea is that you would, you, the consumer, would be given some money, so that you would be able to pay for these things before you got to your deductible, and that’s kind of going away. I mean, rich people now have health savings accounts because they’re a good tax shelter. But most people with high-deductible plans don’t. They’re just expected to be able to come up with this money on their own. That was not even the original conservative idea: Give people more control over their money. This is simply, We’re going to give you cheaper insurance by saying that we’re not going to pay for the first however many thousands dollars’ worth of care that you need. 

Kenen: We’re going to give you great cheap insurance as long as you don’t get sick or injured. 

Rovner: Exactly. All right. Well, that is this week’s news. Now we will play my interview with Miranda Yaver. Then we will come back and do our extra credits.  

I am pleased to welcome to the podcast Miranda Yaver, who I have followed for some years now. She’s an assistant professor of health policy and management at the University of Pittsburgh, and the author of a timely new book called Coverage Denied: How Health Insurers Drive Inequality in the United States. Miranda Yaver, welcome to What the Health? 

Miranda Yaver: Thanks so much for having me. I appreciate it. 

Rovner: So, you came to health policy less because of initial academic interest than because of need, right? How did you end up here [rolling] in the muck with us other health policy nerds? 

Yaver: Yeah, we’d been really interested in health policy, and I’d been writing on the ACA repeal efforts, but my work had been pretty separate. And then I ran into some health issues, and the great American experience is running into health issues often means running into insurance issues. And I just kept sort of stepping back and realizing I have so much privilege in terms of health literacy, job flexibility. If I’m struggling, what do other people who don’t have the education and the stamina to be able to do it, how did they navigate healthcare access? And so I just really wanted to take this opportunity to bring my social science skills to this health policy space that felt rather understudied. 

Rovner: So, there are a lot of things that are wrong with our healthcare system. How did you come to focus on insurance company denials, and what does that tell us about the greater dysfunction of the U.S. healthcare system? 

Yaver: Yeah, so one of the things that I was really struck by as I was experiencing denials of my own, was that KFF had done such great work to catalog the number of claim denials and the infrequency of appeals. But no one had really gotten under the hood to get a feel for who these people are, and how does this reshape lives? And so people can get denied in a couple of different ways, it can be prior to treatment â€” or, which is to say prior authorization, or required health insurer preapproval â€” or it can happen on the other end. And those are going to have very different experiences for the patient, where prior authorization may mean that healthcare is going to be out of reach for a while in a country where healthcare is exceedingly expensive. Whereas with claim denials, where we will have received the care, but then we’re dealing with the financial repercussions of the insurer not picking up at least part of the tab. And so thinking about this through the lens of burden and equity felt like a really important story here. So I really look at this insurance complexity through this lens of administrative burden, because these are these really big bureaucracies that we often have to navigate when we’re not having our best day. 

Rovner: I mean, it’s not just education, often it’s just time. I mean, one of the things that insurers love to do is make you sit on hold forever. If you have not a desk job, basically you can’t do that. 

Yaver: Yeah, absolutely. I’m fortunate â€” in academia, I work a lot, but it is sufficiently flexible that I can be on hold between 2 and 4 on a Tuesday and make up my work later, and that isn’t something that everyone can do. And so Annie Lowrey has this great piece in The Atlantic called “The Time Tax,” which I cite in this book. And it really is laborious, and it becomes easy once you’ve started to navigate this oneself to realize why so many appeals are ultimately abandoned by patients. 

Rovner: So, in many cases, insurers deny coverage because healthcare providers have incentives to provide too much care, often care that’s not necessary, or maybe more expensive than necessary, in order to pad their own pocketbooks, or serve their own private equity owners, or whatever. Doesn’t some of the blame for this problem fall on providers? 

Yaver: Yeah, these tools didn’t originate without any underlying purpose. So we see prior authorization come up amid concerns about greater healthcare spending, health inflation, but also overutilization â€” overtesting and overtreatment. And so my book doesn’t so much aim to dispel that argument so much as raise the question of: Do we address this with a hammer or a scalpel? And essentially thinking about, yes, there is overutilization, and there’s a really great book called Unhealthy Politics that also really dives into what accounts for this. Some of it is financial incentive, some of it is just practices get really entrenched, and we don’t update our beliefs very quickly, based on, you know, a latest study, potentially, and a lot of other factors. And so there is this overutilization. There’s some question about exactly how much there is. And then, you know, medical malpractice raises defensive medicine concerns on top of all of that. And so there are a lot of reasons why we have overutilization, but then there’s this question that I raise, which is essentially: Is the answer to this utilization to impose broad-based barriers to care and administrative burdens that are borne by both patients as well as their physicians, as opposed to going after the overprescribers? 

Rovner: So what surprised you most in researching and writing this book? 

Yaver: So I was really initially coming at this book from the patient perspective. So I did a survey, I did interviews, and I wasn’t actually thinking about the physician side quite as much when I was writing this. And I realized I was wrong, that even though we do have these challenges of overprescribing prior auth works to mitigate, I also really got a better appreciation of the immense staffing support and broader burdens that this causes for physicians, which I’ve also argued elsewhere can contribute to inequities among physicians’ experience of this. Because Black and Hispanic physicians are more likely to work in smaller solo practices, where we can’t have all that staffing support. And mental health providers are more likely to operate in small and solo practices, where it’s just harder to shift that burden to administrative support. And so I really enjoyed getting to dive into that side of things. And then, you know, I was just really felt grateful that so many patients just trusted me with their stories. And some of them were infuriating, some were heartbreaking, and some really just highlighted that there’s also administrative error that can be costly to both patients and their physicians. 

Rovner: So is there a way to address this without tearing the entire system down and rebuilding it all at once, which I know we’re probably moving towards at some point. 

Yaver: So one of the ways that I argue that this can be addressed â€¦ is through a shift to an audit-based model. So if overprescribing is an issue, and it is an issue to some extent, why not target those who are prescribing outliers? And then maybe do random audits of everyone else with the idea that prior authorization could potentially be a penalty for overprescribing â€” a watchful eye when someone seems to be ordering a tremendous number of lower lumbar spine MRIs, which is a sign of overprescribing. And then for people who seem to be doing appropriate prescribing, allow them to have the greater professional autonomy in doing so. And so I think that this would bring prior authorization closer to its original purpose of an appropriate guardrail, whereas right now I think a lot of the pain and frustration that my book works to illuminate is that it has just seeped into every corner of healthcare delivery, even areas where there isn’t evidence of abuse. I mean, PrEP can have prior authorization â€” we’re not taking that for fun. Insulin is a huge source of frustration to get covered. 

Rovner: One would think that doctors are not prescribing insulin for profit. 

Yaver: No, exactly. And especially in a country where insulin is so expensive, this is not something that people are taking for a rainy day. So I think that that is a real illustration of how prior auth has evolved. And I think that then, when I was really diving into insulin in the book, I kept wondering, like, if you don’t give someone a continuous glucose monitor, aren’t they going to get sicker and costlier to treat? And I think that the surprising factor that I hadn’t really appreciated until writing this was the fact that people changing insurance companies can often reshape the incentives to cover these things. 

Rovner: Well, dare I say it, this sounds like something that Congress would actually have to address. 

Yaver: Yeah, I mean that’s one of the challenging things is that this big gnarly law called ERISA [the Employee Retirement Income Security Act of 1974] — which I’m now writing a book about, because I have some masochistic tendencies, it turns out â€” really limits what states can do with respect to the majority of employer-sponsored health insurance. And so in so many areas of health policy, we’re pretty accustomed to saying, OK, well, D.C. is really gridlocked, but at least California and Massachusetts â€” and take your pick of other states â€” can move the needle. And ERISA, preempting state policymaking that relates to so much of health insurance, really limits that. And so this really is an area where national reform is needed, but, of course, politics is pretty fraught right now, to say the least. 

Rovner: We will come back when maybe politics is a little bit less fraught. But Miranda Yaver, thank you. Thank you for contributing to the knowledge base here, and thanks for coming on. 

Yaver: Thanks so much. It’s been a real pleasure. 

Rovner: OK, we are back. It’s time for our extra-credit segment. That’s where we each recognize a story we read this week we think you should read, too. Don’t worry if you miss it. We will post the links in our show notes on your phone or other mobile device. Alice, why don’t you start us off this week? 

Ollstein: Yes, so I have a very grim story that is part of Stat’s ongoing series on alcohol and its many healthcare consequences. And this latest installment is by Isabella Cueto [“”], and it is about drinking during pregnancy, which is unfortunately, despite decades of public health efforts to stop it, is still fairly prevalent and really damaging. It has lots of physical and neurological impacts on developing fetuses. It got worse during the pandemic, and there is a lot of misinformation. And so, to be clear, this article stresses that the medical evidence is that no amount of drinking in pregnancy is considered safe. And that comes as people are getting mixed messages, even from doctors, about whether that’s the case. So, definitely something I recommend reading. 

Rovner: Yeah, the whole series is really good. Joanne. 

Kenen: This is a story from The Associated Press by Tiffany Stanley: “.” It was interesting because this is â€” he’s a reproductive endocrinologist working on IVF [in vitro fertilization], and he’s anti-abortion, deeply religious, and has been wrestling, you know, with the destruction of the excess embryos, or the perpetual storage of them. But he also believed, you know, he found value in helping couples have babies, and his â€” I don’t want to use the word “compromised” in any kind of negative way, I mean â€” his solution for him was to start a sort of a Christian-guided IVF practice, where they’re basically using fewer embryos. Now that makes some of the religious couples more comfortable. It can raise the cost, because IVF is not 100% certain by any means, so if you have fewer embryos, you might have to go through even more cycles. It also made me think, and I’m not an expert on this, and one of you might know, I mean, there is such things as egg freezing now. The technology is not fabulous yet. It is better than it was a few years ago. I mean, I’m sort of wondering, do we get â€” IVF technology is much better. Success rates are better. There are fewer multiple births. There’s â€¦ they were able to bring the embryos out to six or seven days after fertilization. It’s very different than it was 20 or 30 years ago. But if you got to the point where egg freezing was really viable and that they really worked well, it would eliminate this whole issue of the stored embryos. But I just thought it was interesting in that this was a man with two competing sets of values, right? He was against the destruction of embryos, and he was for the creation of embryos, and as a doctor, he had the power to address both in a way that probably some Christians would still find ethically problematic, but it does give religious couples some new choices too. 

Rovner: Yeah, it was a really interesting story. Sheryl, you also have a reproductive health story. Oh, go ahead. 

Stolberg: I do, but I just want to say about Joanne’s story, that is so interesting to me because 25 years ago, when George W. Bush was considering stem cells, I wrote about an adoption agency, a Nightlight Christian Adoptions that â€¦ 

Rovner: Snowflake babies! 

Stolberg: â€¦ had these quote-unquote “snowflake babies,” right. And they were adopting out frozen embryos with the argument was that, see, we don’t have to destroy these embryos for stem cells, we can adopt them out to religious couples. 

Kenen: That’s mentioned in this story too, that is â€¦ but it’s never â€¦ I wrote about them too, and Julie did, but it’s never really caught on on a super â€” and we all know people have gone through IVF, and even people who aren’t deeply religious, or the whole thing of those leftover frozen embryos does bother people. And the science is changing, and â€¦ you don’t need as many embryos as you might have, or they freeze better, you could have one IVF cycle, and two kids. But I just thought it was a thoughtful article about an interesting phenomenon. 

Rovner: It was. OK, Sheryl, your extra credit. 

Stolberg: My extra credit is Ñî¹óåú´«Ã½Ò•îl Health News by Jazmin Orozco Rodriguez. It’s called “Religious Anti-Abortion Center Finds Opportunity in Town Without OB-GYNs.” And the story is set in Idaho, where crisis pregnancy centers are flourishing, as they are across the country in the wake of Dobbs. And one reason I really like this was because, in 2023, I traveled to Idaho and I , and maternity care was suffering as a result. And this story really shows what’s happening three years on, which is that local hospitals are shuttering their maternity wards and their labor and delivery units. And in towns with very limited maternity care, these crisis pregnancy centers, often run by religious organizations, are basically the replacement. But in this particular case, this center that they focused on was not medically licensed, not required to meet regulatory standards for medical facilities, and has an agenda that discourages pregnant women from terminating their pregnancies. And there have been a lot of investigations of these kind of centers saying that they mislead patients by drawing them in with offers that, you know, you’ll get free pregnancy care, etc., etc. And so this is really kind of the upshot of Dobbs and how it’s playing out and in small towns and rural places across America. 

Rovner: Yeah, it is. All right, my extra credit this week is from The Wall Street Journal. It’s called “” It’s by Josh Dawsey, C. Ryan Barber, and Liz Essley Whyte, who, by the way, will be joining our podcast panel soon. It’s quite the eye-opener to follow on our tobacco discussion of the past few weeks about how yet another source of nicotine, in addition to cigarettes and vapes, nicotine pouches have become hugely popular in Trump administration circles as a way to get that nicotine buzz without inhaling stuff into your lungs. Now, these are not harmless products. Nicotine is addictive, and scientific evidence on the pouch’s safety is relatively thin, although they’ve been growing rapidly in popularity, particularly among young men, pushed by some of the biggest tobacco companies. It’s yet another piece of the puzzle of why this administration, which purports to be so health-conscious, seems to have kind of a blind spot when it comes to tobacco-related substances. 

All right, that is this week’s show. As always, thanks to our editor this week, Stephanie Stapleton, and our producer-engineer, Francis Ying. A reminder: What the Health? is now available on WAMU platforms, the NPR app, and wherever you get your podcasts — as well as, of course, kffhealthnews.org. Also, as always, you can email us your comments or questions. We’re at whatthehealth@kff.org. Or you can still find me on X , or on Bluesky . Where are you folks hanging these days? Alice? 

Ollstein:  on Bluesky and  on X. 

Rovner: Joanne. 

Kenen: I’m Joanne Kenen on  and I’m on . 

Rovner: Sheryl. 

Stolberg: And I’m at @SherylNYT on  and also on . That’s Sheryl with an S. 

Rovner: We will be back in your feed next week. Until then, be healthy. 

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<img id="republication-tracker-tool-source" src="/?republication-pixel=true&post=2240466&amp;ga4=G-J74WWTKFM0&quot; style="width:1px;height:1px;">]]> 2240466 Colorado Charts Its Own Course on Vaccines Amid Federal Pullback /public-health/colorado-vaccine-law-coalition-cdc-acip-infectious-disease-prevention-polio/ Thu, 21 May 2026 09:00:00 +0000 /?p=2238762 In response to abrupt and politicized , concerned Coloradans have taken several steps to shore up support for vaccine science.

A bill in March then by Democratic Gov. Jared Polis allows Colorado to further uncouple itself from federal guidance.

The law allows health officials to follow the recommendations of national medical groups when making decisions such as purchasing bulk vaccines for the Medicaid program.

“We are insulating our state from the dysfunction coming out of Washington,” said Democratic state , a co-sponsor of the bill and a registered nurse. “We’re going to rely on science.”

“From fighting during the pandemic for Coloradans to get vaccines as quickly as possible to combating the Trump Administration’s barriers to getting vaccinated, we have expanded access to vaccines for Coloradans who want them,” Polis said in a statement when he signed the law.

Colorado is one of that, along with Washington, D.C., have taken steps to bypass the new federal recommendations amid worries that the changes could chip away at public trust in vaccines and erode .

Previously, Colorado, like most states, had followed federal guidance set by the Centers for Disease Control and Prevention. In January, CDC advisory panelists, selected by Health and Human Services Secretary Robert F. Kennedy Jr., from the agency’s universal recommendation list.

Last year, doctors, scientists, local leaders, and other supporters came together to form an outreach and advocacy coalition called .

The group aims to offer a clear, unified voice on the proven benefits of vaccines and reassure residents confused by the many federal changes.

, a former Denver City Council member, joined the group because she wants more people to hear her own chilling story about vaccine-preventable illness.

“Every summer everybody got sick,” Boigon said, recounting her childhood in 1950s Detroit.

The illness was polio, a highly contagious viral disease that , sometimes causing partial or full paralysis.

During the summer of 1953, “the whole block was sick and some of us got crippled, and that was just the way it was,” she said.

New Group Steps Up

Boigon’s personal history will be part of the new generations about the dangers of infectious diseases that were once common in the U.S. but are now relatively rare.

The group, which formed last September, will also compile vaccine information from medical groups and the state health department and advocate for policy proposals with the state government.

Several pieces of paper are arranged on a table. One is a professional biography of Carol Boigon from the Denver City Council. Next is a clipping from The Detroit Times. Last is a 1985 Colorado Press Award.
Boigon shows memorabilia from her life and career. (Kevin J. Beaty/Colorado Public Radio/Denverite)

“It was in direct response to the federal threats,” said another coalition member, former state lawmaker . She leads the nonprofit .

Another member, public relations specialist Elizabet Garcia, wants more outreach to Hispanics, whose vaccination rates .

“A lot of time it’s this fear that they’re going to have to pay out-of-pocket, that their insurance doesn’t cover it, that they might not even have insurance in general,” Garcia said.

Boigon was 5 when she got sick and was hospitalized for six weeks with a fever. The virus attacked her spine.

“None of my limbs worked immediately afterwards,” Boigon said.

Although she regained function in her other limbs, her right arm never fully recovered. She had to adapt, relearning everyday tasks such as reaching out to shake hands with people with her left hand.

In 1955, not long after she got sick, the new polio vaccine became more widely available to the public. As vaccinations took off, U.S. cases of polio, once one of the nation’s most feared diseases, .

Increasing Public Trust

State leaders have taken other steps to promote public health. After the Trump administration pulled the U.S. out of the World Health Organization, several states, including Colorado, the WHO’s Global Outbreak Alert and Response Network on their own.

Colorado also challenging the Trump administration’s changes to the childhood vaccine schedule.

And the new state law has provisions besides allowing the state to diverge from federal recommendations. It codifies pharmacists’ ability to prescribe and give vaccines themselves. It also increases legal protections for healthcare workers who give vaccines.

“This law will provide more clarity to guide all Coloradans, including providers who administer vaccines,” Lontine said.

But the legislation has opponents who say it would interfere with parental choice and claim vaccines might be unsafe or ineffective.

“I just want to make sure we’re not just getting into a big political dispute between the federal recommendations — the CDC and so forth — and different political views in Colorado here,” said Republican state , who voted against the vaccine bill.

NPR contacted the U.S. Department of Health and Human Services about Colorado’s new law. Spokesperson Emily Hilliard answered in an email: “The updated CDC childhood schedule continues to protect children against serious diseases.”

Preventable Illnesses Surge

The flurry of statewide activity comes as Colorado and the nation have seen surges in illnesses .

As of mid-May, Colorado had recorded 22 measles cases this year. In 2025, it registered , according to the state health department, far surpassing totals from previous years.

Across Colorado, for measles were 88% last school year — with only a few counties achieving rates of 95%, the level needed for herd immunity, according to data in December.

This has also been Colorado’s worst flu season in recent years.

Vaccination rates for both flu and covid-19 have dropped slightly in Colorado, according to the state health department.

Eight children in Colorado have died this season ; one from covid; and one from RSV, or respiratory syncytial virus. are available for children and recommended by the state’s health department.

Kennedy, a longtime anti-vaccine activist, has defended his decisions to overhaul the recommended schedule for childhood vaccinations.

In March, a federal judge many of the changes.

“We’re not taking vaccines away from anybody. If you want to get the vaccine, you could get it. It’s going to be fully covered by insurance just like it was before,” Kennedy in January.

When a reporter suggested the new changes could result in fewer people getting a flu vaccine, Kennedy said: “Well, that may be, and maybe that’s a better thing.”

Boigon is sometimes incredulous at everything that has happened.

“It’s like we’re going backwards,” she said. “It’s like we have decided we don’t want a modern life; we want to be back in the 1950s, where children are sick and dying.”

Carol Boigon sits on her sofa at home.
Boigon at home in Denver. (Kevin J. Beaty/Colorado Public Radio/Denverite)

This article is from a partnership that includes ,Ìý, and Ñî¹óåú´«Ã½Ò•îl Health News.

Ñî¹óåú´«Ã½Ò•îl Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .

This <a target="_blank" href="/public-health/colorado-vaccine-law-coalition-cdc-acip-infectious-disease-prevention-polio/">article</a&gt; first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

<img id="republication-tracker-tool-source" src="/?republication-pixel=true&post=2238762&amp;ga4=G-J74WWTKFM0&quot; style="width:1px;height:1px;">]]> 2238762 Efforts To Understand the Nation’s Drugged Driving Problem Stall Under Trump /public-health/drugged-driving-impairment-research-stalled-trump-policies/ Tue, 19 May 2026 09:00:00 +0000 /?p=2235912 GRAND JUNCTION, Colo. — Two state transportation workers were replacing a sign on the shoulder of U.S. Highway 6 in western Colorado one morning when a Jeep Grand Cherokee swerved off the road and struck them.

The workers, Nathan Jones and Trent Umberger, died in the September 2024 crash, as did a passenger in the Jeep. Tests found that the driver, Patrick Sneddon, then 59, had oxycodone and six times Colorado’s presumed impairment threshold for THC — the psychoactive compound in cannabis — in his blood. He pleaded guilty and is serving on three counts of vehicular homicide and other charges.

“Our four children are completely crushed without their Dad,” wrote Kristine Umberger, the wife of Trent, in a victim impact statement for the local district attorney. “We have lost our ability to live life like we used to.”

Federal highway safety officials have long tracked the role of alcohol in fatal crashes, but they don’t track deaths that involve a driver under the influence of drugs or a combination of drugs and alcohol.

That discrepancy is partly due to the challenges of proving impairment, since some drugs remain detectable for weeks after use. Sneddon’s attorney, Jennifer Gregory, said a driver can be presumed impaired under Colorado law if their blood contains 5 nanograms of THC or higher per liter. But that “permissible inference” threshold is different from a legal limit — such as the 0.08% blood alcohol content limit — and the level set by Colorado is not supported by published scientific studies, Gregory said.

Such information could prove useful as the nation struggles with , the on marijuana, and more than 40 states have legalized or decriminalized some forms of cannabis and .

“Impaired driving is a top public safety issue that extends beyond alcohol,” said Sean Rushton, a spokesperson for the federal highway safety agency, which is tackling the issue collaboratively, with resources to ensure a “comprehensive and coordinated approach.”

But President Donald Trump’s cuts to the federal workforce since he returned to office in 2025, along with dwindling federal investments, mean that efforts to expand and improve the tracking of impaired-driving deaths nationwide have slowed.

The gap in data can be significant. In Mesa County, Colorado, where Jones and Umberger were killed, the coroner’s office tracks various forms of impaired-driving fatalities. From 2017 through 2024, a third of traffic deaths involved alcohol alone, according to data from the county coroner’s office.

When drugs are factored in, nearly half of Mesa County’s traffic deaths over the same period involved a driver intoxicated with alcohol, drugs, or a combination, according to the coroner’s reports.

“If you want to solve a problem, you need to understand the problem,” National Transportation Safety Board researcher Jana Price said. “If you only know that alcohol is present, then it limits your ability to fully understand what might have been impairing a person or a population of people. It trickles into the countermeasures that we use as a society to address the problem.”

Identifying a Hidden Issue

NTSB researchers that, across four geographical samples of roughly 26,000 drivers, about half of those arrested for impaired driving and more than a quarter of drivers killed in crashes tested positive for more than one substance, such as cocaine, sedatives, and antidepressants. The analysis also found that only four states and the District of Columbia drug-tested more than 60% of fatally injured drivers in 2020.

Those findings led the NTSB, an independent federal agency that investigates major incidents, to make a series of recommendations to the and states to establish a comprehensive, nationwide dataset on impaired driving.

But hurdles remain to creating such a system. Fatality and injury reports submitted to the NHTSA database often feature missing or erroneous data, according to a .

Varying state laws around testing arrestees and decedents for drugs make getting uniform data difficult, according to , a former employee of NHTSA’s impaired-driving division, as does a lack of proven metrics like blood alcohol content to measure drug impairment, not just the presence of a drug.

“It’s a slow process, which is incredibly difficult when you know that each day that passes is risking a lack of safety for however many people facing the potential of a drug-impaired-driving crash,” Cash said. “But some progress is better than no progress.”

Acknowledging how long those efforts will take, the NTSB also recommended that NHTSA build an interim surveillance system that would use data from trauma centers to create a national sample of crash-involved impaired drivers.

The agency made some headway, reporting in 2023 that it was conducting its own study with the help of 11 trauma centers and medical examiner offices. It also helped California establish a 19-month statewide surveillance system, which NHTSA will use to evaluate the feasibility of a nationally representative system.

Such programs are useful for public awareness and for improving the ability of police to understand drugged driving patterns that can help them tailor enforcement, said , a University of California-Davis associate professor who researches toxicology and was involved in the California program. But some trauma centers, especially in rural areas, often lack the research infrastructure necessary for round-the-clock drug testing and participation.

Still, it’s possible, and he said the benefit is apparent in the findings from California’s surveillance system.

“If you go out there and tell people that 44% of drivers who ended up in the ER from a car accident had at least one potentially impairing substance in their blood at the time of the accident, that gets people’s attention,” Chenoweth said.

Shrinking Research Teams

Since NHTSA’s update to the NTSB three years ago, however, the agency has yet to follow up on the recommendation. Staff cuts and departures at NHTSA last year paint a poor outlook for change.

From 2021 to 2024, the agency . At the end of Trump’s first year in office, NHTSA had dropped to about 550 people due to government-wide cuts and people leaving on their own.

Cash, who now works for the nonprofit Governors Highway Safety Association, was one of five employees who left NHTSA’s last year. That leaves just two staff members in the division, she said.

Ian O’Dowd, a former employee in NHTSA’s , said he was part of a team of 16 people who studied, in part, impaired driving. Only three or four team members are still with the agency, he said.

“At some point, it becomes unwieldy for a handful of people to be managing all of the research work going on,” O’Dowd said.

NHTSA communications director Sean Rushton said the agency has “both the financial and personnel resources necessary to support its programs with multiple offices carrying out this work collaboratively, ensuring a comprehensive and coordinated approach.”

The 2021 infrastructure law, passed under the Biden administration, increased funding for NHTSA’s state highway safety program from about $667 million in 2021 to nearly $953 million this year.

The law included $750 million to modernize crash-data programs, but as of January over $475 million was unused. The funds expired in September unless they were obligated through a signed agreement.

A report by the U.S. Government Accountability Office found that nearly a quarter of entities awarded grants in 2022 had not received a signed agreement when surveyed between December 2024 and March 2025. It also found that over 1 in 5 grantees reported that obtaining timely replies from Department of Transportation staff was moderately or very challenging.

With the Biden-era infrastructure law expiring later this year, Congress could extend the unused crash-data fund or implement a new approach to impaired driving.

In mid-April, House Transportation and Infrastructure Committee Chairman Sam Graves (R-Mo.) said proposed legislation — less than half of the current bill’s $1.2 trillion — with a more “traditional” focus on roads and bridges.

The bill has amid negotiations for more funding, leaving future support uncertain.

“Certainly, we are always hoping that there will be an increase in the amount of money available to do this work,” Cash said. “Whether or not that will happen this year, I don’t know.”

Ñî¹óåú´«Ã½Ò•îl Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .

This <a target="_blank" href="/public-health/drugged-driving-impairment-research-stalled-trump-policies/">article</a&gt; first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

<img id="republication-tracker-tool-source" src="/?republication-pixel=true&post=2235912&amp;ga4=G-J74WWTKFM0&quot; style="width:1px;height:1px;">]]> 2235912 A Danish Couple’s Maverick African Research Finds Its Moment in RFK Jr.’s Vaccine Policy /public-health/rfk-kennedy-vaccines-denmark-danish-scientists-africa-aaby-benn-dtap-dtp/ Mon, 18 May 2026 09:00:00 +0000 /?p=2228870 In 1996, Guinea-Bissau seemed like an ideal research post for budding pediatrician Lone Graff Stensballe. Her supervisor, a fellow Dane named Peter Aaby, had spent on 100,000 people living in the mud brick homes of the West African country’s capital.

Aaby and his partner, Christine Stabell Benn, believed that the years of research in the impoverished country had yielded a major discovery about vaccines — and what they described as “non-specific effects”: The measles and tuberculosis vaccines, which were derived from live, weakened viruses and bacteria, they said, boosted child survival beyond protecting against those particular pathogens.

But, the scientists said, shots made from deactivated whole germs, or pieces of them, such as the diphtheria-tetanus-pertussis shot, caused more deaths — especially in little girls — than getting no vaccine at all.

The World Health Organization repeatedly and inconclusively examined these astonishing findings, which tended to elicit shrugs from the researchers’ colleagues in global health.

Then came Donald Trump, covid, and the administrative reign of anti-vaccine advocate Robert F. Kennedy Jr.

Suddenly, Aaby and Benn weren’t just sending up distant smoke signals from a far corner of the planet. They were and policy prescriptions online and in medical journals. The “framework” for “testing, approving, and regulating vaccines needs to be updated to accommodate non-specific effects,” their team wrote in .

And the Trump administration has taken notice.

“They became more strident in saying that their findings were real and that the world needed to do something about it,” said Kathryn Edwards, a Vanderbilt University vaccinologist who has been aware of Aaby’s work since the 1990s. “And they became more aligned with RFK.”

Kennedy, as secretary of the Department of Health and Human Services, to justify slashing $2.6 billion in U.S. support for Gavi, a global alliance of vaccination initiatives. The cut could result in 1.2 million preventable deaths over five years in the world’s poorest countries, the nonprofit agency has estimated. Kennedy has in current Gavi funding over largely debunked vaccine safety claims.

Kennedy described as a “landmark study” by “five highly regarded mainstream vaccine experts” that found that girls who received a diphtheria-tetanus-pertussis, or DTP, shot were 10 times as likely as unvaccinated children to die from all causes.

In fact, the study was far too small to confidently make such assertions, as Benn later acknowledged. In a study of historical data that included about 500 girls, four of those vaccinated against DTP in a three-month period of infancy died of unrelated causes, while one unvaccinated girl died during that period. A in 2022 found that the DTP shot by itself had no effect on mortality. Critics say the 2017 study, rather than being a landmark, exemplified the troubling shortfalls they perceive in the Danish team’s research.

As Aaby and Benn’s U.S. profile has risen, scientists in Denmark have set upon the work of their compatriots. In news and journal published over the past 18 months, Danish statisticians and infectious disease experts have said the duo’s methods were , even , and structured to support . A national scientific board is investigating their work.

A Danish woman walks down a dirt road.
Christine Stabell Benn has led a vaccine research project in Guinea-Bissau for nearly three decades with her husband, Peter Aaby. (Thomas Lekfeldt/Ritzau Scanpix/Sipa USA)

Stensballe, who worked with Aaby and Benn for 20 years, has been among those voicing doubts.

“It took years to see what I see clearly today, that there is a strange concerning pattern in their work,” Stensballe said in a phone interview from Copenhagen, where she treats children at Rigshospitalet, the city’s largest teaching hospital. She said their work is full of confirmation bias — favoring interpretations that fit their hypotheses.

Those hypotheses overlap, in important areas, with the notions of Kennedy and other vaccine-skeptical officials at HHS.

In December, HHS announced the agency would award the scientists’ Bandim Health Project in Guinea-Bissau $1.6 million to study whether the birth dose of hepatitis B vaccine weakens babies’ immune systems or causes neurological issues.

The researchers plan to withhold the vaccine from half of the 14,000 newborns in the study, although the long-established vaccine is 90% effective in preventing infection. The Bandim group justifies this decision by noting that impoverished Guinea-Bissau does not yet routinely vaccinate infants against hepatitis B. Given that 1 in 5 Guinea-Bissauan adults carry the hepatitis B virus, however, and many say it is unethical to withhold the birth dose.

Aaby and Benn did not respond to repeated requests for comment. They have elsewhere.

A Mixed Reputation

Many Danes admire the two for their decades of work in Guinea-Bissau, a nation of over 2 million people where, as in much of Africa, infant mortality has plunged over the past five decades. There’s even a novel, the 2013 Danish thriller The Arc of the Swallow, featuring a corporate plot to murder a scientist character clearly based on Aaby. The company’s goal: to keep him from publishing data showing deadly effects from the DTP shot. Benn the idea for the book.

Aaby and Benn have trained around 30 scientists through their Bandim Health Project, named for a district of Bissau, Guinea-Bissau’s capital. The research group has published over 1,000 academic papers and won scientific prizes. The Danish king knighted Benn last year. Their notion of non-specific vaccine effects gained enough traction to merit a short chapter in the 2023 edition of Plotkin’s Vaccines, the authoritative text of vaccinology.

Yet Danish health authorities have never followed Aaby and Benn’s vaccine advice. They still offer vaccines based on inactivated viruses and bacteria, that Kennedy largely shifted the U.S. to in January. (A federal judge on March 16 temporarily blocked those changes.) Danish vaccine authorities are considering the addition of two of the shots Kennedy sought to drop from the U.S. schedule — against rotavirus and respiratory syncytial virus, or RSV.

“What’s important is that Christine doesn’t have influence on our vaccine policy,” said Anders Hviid, chief epidemiologist at Statens Serum Institut, the Danish equivalent of the Centers for Disease Control and Prevention.

Hviid — who knows Benn, as do most members of the tiny Danish vaccine fraternity — has contributed to many vaccine safety studies, including a that found no link between measles-mumps-rubella, or MMR, vaccination and autism. Kennedy to get a journal to retract showing no link between aluminum-adsorbed vaccines and allergies or neurodevelopmental disorders.

In a with Tracy Beth Høeg, the Danish American sports medicine doctor and covid vaccine skeptic who led the FDA’s drug regulation from December until she was , Benn said she had vaccinated her son and daughter, now in their late 20s, under the complete Danish schedule of vaccines. Like the U.S. schedule, Denmark’s includes a less reactive form of the DTP shot known as DTaP.

Tracy Beth Høeg sits at a table, a microphone and nameplate in front of her. A laptop is on the table to her left.
Tracy Beth Høeg, a sports medicine doctor and covid vaccine skeptic who emerged as the chief FDA drug regulator under Health and Human Services Secretary Robert F. Kennedy Jr., takes part in an Advisory Committee on Immunization Practices hearing in Atlanta in December. She was fired on May 15. (Megan Varner/Bloomberg via Getty Images)

These vaccines aren’t dangerous to kids in well-off countries like the U.S. and Denmark, she said. But she said she would “never vaccinate my child according to the U.S. program.” She singled out the hepatitis B vaccine birth dose, which her group plans to test in Guinea-Bissau, saying she was “appalled” that the CDC recommended a universal birth dose.

Kennedy’s handpicked vaccine advisory committee — which a federal judge in , questioning its members’ qualifications — withdrew the birth dose recommendation last year.

Compatriots Grow Skeptical

Kennedy’s championing of Aaby and Benn prompted criticism from Danish scientists that has extended to the . “It is disturbing that Danish researchers could carry out such actions involving African children,” Stensballe said.

As of early March, the study was paused while officials from Guinea-Bissau and the African Centers for Disease Control examined it. Public Health Minister Quinhin Nantote, who took office after a November coup in Guinea-Bissau, said in January he had no evidence that the six-member ethics committee that signed off on the study earlier had ever met to discuss it.

HHS spokesperson Andrew Nixon told Ñî¹óåú´«Ã½Ò•îl Health News the proposed study was “based on the highest scientific and ethical standards” and “represents the world’s first and perhaps only opportunity to test the overall health effects” of the hepatitis B vaccine.

It’s only one area of the couple’s research that is under scrutiny.

In 2024, Danish physician and journalist Charlotte Strøm noting that the Bandim group scientists had failed to publish data they’d collected that contradicted their frequent claims that the vaccine caused high mortality in infants.

Strøm called it “an ethical and scientific scandal,” and it led to an by the news outlet Weekendavisen. In February, the University of Southern Denmark forwarded its probe into the duo’s possible withholding of DTP data to the Danish Agency for Higher Education and Science’s Board on Research Misconduct.

In response to the Weekendavisen articles, Aaby and Benn pushed out a . They said they hadn’t sought to publish it earlier because one co-author died in a boating accident and another left the project after getting pregnant.

“This is a bit fishy,” said Henrik Støvring, a statistician at the University of Southern Denmark and Aarhus University who co-authored with Strøm and others an of clinical trials conducted by Benn and Aaby.

In January, a and three other Danish infectious disease researchers questioned whether Aaby and Benn had actually proved that vaccines had bad or good “non-specific effects” beyond preventing the diseases they were designed to counter.

Scholars also have questions about Aaby and Benn’s studies of the tuberculosis vaccine, BCG. The pair recently began a study in which babies received a second vaccination with the live bacterial vaccine, although a they conducted some 15 years earlier was stopped after , compared with four in the control group, during a four-month span.

The study was aimed at testing Aaby and Benn’s hypothesis that the alleged dangers of DTP vaccination could be ameliorated by a shot soon after with live BCG.

Although there is some evidence that BCG provides a systemic boost to infant immune systems, the WHO does not recommend a second BCG dose, Vanderbilt’s Edwards noted. “Given the suspicion engendered with this group, there should be heightened attention to this protocol, with meticulous review of their work in Africa by the African authorities,” she said.

The Big Controversy

Aaby and Benn’s most controversial position is their stance on DTP, perhaps the most widely provided vaccine in the world. True evidence of its harm would be vitally important. And experts argue that research by others has not supported Benn and Aaby’s thesis.

A syringe is inserted into a young Indonesian child's arm.
An elementary school student in Indonesia receives a diphtheria-tetanus-pertussis, or DTP, shot in 2018. (Aditya Irawan/NurPhoto via Getty Images)

One involving nearly 55,000 newborns in Ghana and Tanzania, found that both BCG and DTP vaccines enhanced the survival of babies. The authors of the paper submitted it to a journal and fought long and hard with Benn, who happened to be a peer reviewer. They eventually resubmitted the paper to another journal to get it published in 2022, said co-author Emily Smith, an assistant professor of global health at the Milken Institute School of Public Health at George Washington University.

Benn’s approach “involves splitting up trial data a bunch of different ways using a bunch of different methods,” she said.

“If you split up the data” enough ways, she said, “you’re going to end up with maybe thinking you found something.”

Hviid said that Benn and Aaby continuously modify their hypotheses to fit new data even when the patterns they detect may have popped up by chance. Most of the footnotes in their studies and opinion pieces refer to their own work, he noted.

“They’ve been talking about their paradigm for years,” Hviid said. “But when you look at the numbers, it’s just a house of cards. There’s nothing there.”

To examine their many hypotheses about the interactions of vitamins and vaccines, “hundreds of thousands of African babies have been tested,” Stensballe said. “Is that ethical?”

Aaby and Benn asked the editors of the journal Vaccine to retract Strøm and Støvring’s paper. The request was denied.

The Danish Influence in America

The Bandim group’s influence on U.S. policy has roots in the covid pandemic, when Benn befriended Høeg, who had earned a PhD in epidemiology and public health from the University of Copenhagen in 2014 for a study of eye disease. In a series of YouTube videos, they bonded over skepticism about covid vaccines and lockdowns. Benn argued that mRNA vaccines were insufficiently studied and that covid should be allowed to run its course among kids. Høeg landed an adjunct professorship at the University of Southern Denmark, where Benn holds a senior position, in April 2023.

Høeg did not respond to a question about whether she was involved in the CDC decision to fund Benn’s hepatitis B study. Benn and Aaby also received $1.8 million from the Pershing Square Foundation, co-founded by Bill Ackman, an ally of President Trump who .

Ackman did not respond to requests for comment.

from the University of Southern Denmark showed that Benn secured the grant after communicating with anti-vaccine CDC officials Lyn Redwood and Stuart Burns around the time the agency’s Advisory Committee on Immunization Practices was preparing to stop recommending hepatitis B vaccination for U.S. newborns.

Yet during a public debate with Støvring on Dec. 4, Benn said news reports had dried up all funding for her research. “You have literally closed our field station,” she said.

Aaby’s History

An anthropologist by training, Aaby, 81, has cultivated the image of a persecuted Galileo, Hviid said, “with us in the role of the dogmatic clergy.”

Aaby wrote in 1998 that he was “exploring and making sense of the unknown” while most of his colleagues’ work was “trivial.” At the December debate, he said Støvring’s work was “incredibly stupid.”

The Bandim Health Project’s study area covers six poor districts, now with about 200,000 inhabitants, around a third of the capital. The researchers say they have collected health and socioeconomic data from residents for more than 30 years.

A photo of two kids playing foosball as two others watch. A fifth walks by on the left.
Children play foosball in the Mindará neighborhood of Bissau, the capital of Guinea-Bissau, in 2018. Peter Aaby and Christine Stabell Benn have conducted childhood vaccine research in the West African city for decades. (Xaume Olleros/AFP via Getty Images)

Stensballe’s conflict with Benn and Aaby came to a head in 2015 as the team of 4,262 Danish babies comparing those who got a BCG vaccine at birth with those who didn’t. that his African research on vaccines would be duplicated in the developed world.

The Danish BCG study showed no difference in hospitalization rates between the two groups. But Benn and Aaby combed the data for other answers, known as secondary findings, and leaped upon a comparison that showed lower hospitalization rates in babies whose mothers had been vaccinated against BCG decades earlier, Stensballe recalled.

She found that troubling. “If the primary outcome is negative, the trial is negative,” she said.

The manner in which Aaby and Benn pose questions sows unnecessary doubt, said Arthur Reingold, a professor emeritus of epidemiology at the University of California-Berkeley.

“Some of the questions they propose to answer are important but can never be answered in my lifetime,” he said, “and not by an ethical study done in the real world.”

“And in the meantime,” he added, “babies will miss vaccines and get sick and die of preventable illness.”

Ñî¹óåú´«Ã½Ò•îl Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .

This <a target="_blank" href="/public-health/rfk-kennedy-vaccines-denmark-danish-scientists-africa-aaby-benn-dtap-dtp/">article</a&gt; first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

<img id="republication-tracker-tool-source" src="/?republication-pixel=true&post=2228870&amp;ga4=G-J74WWTKFM0&quot; style="width:1px;height:1px;">]]> 2228870 Kennedy Swaps Vaccine Rhetoric for Story Time but Can’t Quite Change the Subject /public-health/the-week-in-brief-rfk-jr-ohio-visit-maha-rhetoric/ Fri, 15 May 2026 18:30:00 +0000 /?p=2238096&preview=true&preview_id=2238096 Here in Washington, we’ve been hearing about tensions between the White House and one of its most controversial â€” but, at least in some circles, most popular â€” figures: Robert F. Kennedy Jr.

Polling of likely voters indicates that the Health and Human Services secretary can be an asset to Republicans when he’s talking about improving the nation’s food supply or labeling ultraprocessed foods. But when he’s talking about removing recommendations for routine childhood vaccinations, he can be a detriment.

So, when I learned Kennedy would be taking his show on the road to my home state of Ohio, where populist figures tend to perform well, I knew I had to be there.

How would a politician who built his reputation seeding widespread doubts about routine childhood immunizations stay away from one of the core messages he’s preached for years?

Well, it turns out, he starts by reading a book about a trash truck to preschoolers.

The trip took us across northern Ohio, from a regenerative farm in Huron owned by two brothers who grow colorful vegetables to the Cleveland Clinic, where Kennedy masked up entering an operating room of a heart surgery patient.

In the end, though, Kennedy couldn’t escape the vaccine talk.

Speaking at the City Club of Cleveland, Kennedy raised doubts about the safety of vaccines that had been â€” up until last year â€” universally recommended to prevent hepatitis B, an incurable disease.

He called for parents to “be given that choice” on administering the vaccine to newborns,Ìýa remark that gave way to cheers and applause from half the room.

The other half groaned and booed.

When I sat down with the health secretary for a few minutes in an Ohio farmhouse, Kennedy ticked off his accomplishments during his first year in office; redesigning federal nutrition guidelines and defining ultraprocessed foods for the American public were among them.

As his list grew longer, I thought about the mothers I’d talked to over the last year who had become increasingly nervous about taking their infants out in crowded places amid a raging measles outbreak and the growing threat from other infectious diseases.

What was his message for those parents, I asked?

“I would say everybody should be vaccinated â€” against measles,” Kennedy told me. “But we need to pay more and more attention to chronic disease. All of the vaccine-preventable, infectious diseases put together kill probably 10,000 Americans a year.” 

The number of deaths is , according to scientific researchers.

Ñî¹óåú´«Ã½Ò•îl Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .

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<img id="republication-tracker-tool-source" src="/?republication-pixel=true&post=2238096&amp;ga4=G-J74WWTKFM0&quot; style="width:1px;height:1px;">]]> 2238096 In Search of a New FDA Commissioner /podcast/what-the-health-446-fda-marty-makary-abortion-pill-may-14-2026/ Thu, 14 May 2026 18:00:00 +0000 /?p=2237552&post_type=podcast&preview_id=2237552 The Host
Julie Rovner photo
Julie Rovner Ñî¹óåú´«Ã½Ò•îl Health News Read Julie's stories. Julie Rovner is chief Washington correspondent and host of Ñî¹óåú´«Ã½Ò•îl Health News’ weekly health policy news podcast, "What the Health?" A noted expert on health policy issues, Julie is the author of the critically praised reference book "Health Care Politics and Policy A to Z," now in its third edition.

As had been rumored for weeks, Marty Makary is out as commissioner of the FDA after a chaotic 13 months presiding over drama in every corner of the agency. That leaves Robert F. Kennedy Jr.’s Department of Health and Human Services with three senior vacancies: FDA commissioner, surgeon general, and director of the Centers for Disease Control and Prevention. All must pass through the Senate committee chaired by Sen. Bill Cassidy (R-La.), who has had a troubled relationship with Kennedy and President Donald Trump.

Meanwhile, opponents of abortion remain unhappy with the Trump administration, demanding a more robust federal crackdown on abortion in general and the abortion pill in particular. The administration, meanwhile, has been pushing policies to encourage families to have more children.

This week’s panelists are Julie Rovner of Ñî¹óåú´«Ã½Ò•îl Health News, Rachel Cohrs Zhang of Bloomberg News, Alice Miranda Ollstein of Politico, and Lauren Weber of The Washington Post.

Panelists

Rachel Cohrs Zhang photo
Rachel Cohrs Zhang Bloomberg News
Alice Miranda Ollstein photo
Alice Miranda Ollstein Politico
Lauren Weber photo
Lauren Weber The Washington Post

Among the takeaways from this week’s episode:

  • Makary is leaving his role as FDA commissioner after a troubled tenure. While tensions over granting approval for fruit-flavored vapes appear to have been the last straw, Makary led an agency in near-constant turmoil that cast a shadow over its employees and the industries it oversees. Kyle Diamantas, who will serve as acting director, is not a doctor but rather a lawyer with ties to the Trump family.
  • The fate of telehealth access to the abortion pill mifepristone hung in the balance this week after the Supreme Court extended its stay on a lower-court order halting that access. Should the court affirm that lower-court ruling, it would be the biggest change to abortion access nationwide since it overturned the constitutional right to an abortion in 2022.
  • And the hantavirus outbreak on a cruise ship continues to transfix the globe, with many American passengers in quarantine. The situation highlights the lack of U.S. engagement in global public health, as well as the slashing of federal resources at the CDC under the Trump administration.

Also this week, Rovner interviews Sen. Tammy Baldwin (D-Wis.), a senior member of the Senate Health, Education, Labor, and Pensions Committee and the Senate Appropriations Committee.

Plus, for “extra credit” the panelists suggest health policy stories they read this week that they think you should read, too: 

Julie Rovner: ProPublica’s “,” by Rob Davis. 

Rachel Cohrs Zhang: The Wall Street Journal’s “,” by Liz Essley Whyte and Josh Dawsey.  

Alice Miranda Ollstein: Politico’s “,” by Katherine Tully-McManus.  

Lauren Weber: Stat’s “,” by Lev Facher and Isabella Cueto. 

Also mentioned in this week’s podcast:

  • Bloomberg News’ “,” by Rachel Cohrs Zhang.
  • The Washington Post’s “,” by Lena H. Sun.
Click to open the transcript Transcript: In Search of a New FDA Commissioner

[Editor’s note: This transcript was generated using both transcription software and a human’s light touch. It has been edited for style and clarity.] 

Julie Rovner: Hello from KFF Health News and WAMU public radio in Washington, D.C. Welcome to What the Health? I’m Julie Rovner, chief Washington correspondent for Ñî¹óåú´«Ã½Ò•îl Health News, and, as always, I’m joined by some of the best and smartest health reporters covering Washington. We’re taping this week on Thursday, May 14, at 10 a.m. As always, news happens fast and things might have changed by the time you hear this. So, here we go. 

Today, we are joined via videoconference by Lauren Weber of The Washington Post. 

Lauren Weber: Hello, hello. 

Rovner: Rachel Cohrs Zhang of Bloomberg News. 

Rachel Cohrs Zhang: Hi, everybody. 

Rovner: And Alice Miranda Ollstein of Politico. 

Alice Miranda Ollstein: Hi. 

Rovner: Later in this episode, we’ll have my interview with Wisconsin Democratic Sen. Tammy Baldwin. But first, this week’s news. 

Well, as we foreshadowed last week, Marty Makary’s tenure as commissioner of the Food and Drug Administration has come to an end. It’s not entirely clear whether he was fired or whether he resigned or whether he was forced to resign, but what is clear is that his 13-month tenure at the helm of the agency that regulates $1 of every $5 worth of consumer products in the U.S. was chaotic, to say the least. Quoting from the excellent  on his exit, “He had upset advocates for vaping and rare-disease patients, antiabortion groups, and some drug-industry leaders â€” as well as other officials in the administration.” Rachel, you’ve been following this story very closely and breaking a lot of news on it. Who didn’t Marty Makary piss off? And tell us more about that Wall Street Journal ticktock of his last few days, since it’s your “extra credit” this week. 

Cohrs Zhang: It is my extra credit. Truly nothing scares me more than seeing Josh Dawsey’s byline on a story on my beat. So I think the tension with Dr. Makary had been going on for months. I think there was kind of an effort that bubbled up, kind of last fall, in November, about â€” that raised some questions about his future and just his ability to cooperate. But he was able to keep his job at that point in time. But I think there have been a lot of changes at HHS [the Department of Health and Human Services] this calendar year, and I think there’s been an effort to kind of stabilize things, start to get people in place for some of these other positions, at surgeon general and at CDC [the Centers for Disease Control and Prevention]. And once those personnel searches started wrapping up, I think it shifted the focus back, I think, to FDA a little bit more, and there’s a lot of drama coming out of there. 

And I think there is certainly a desire from the White House to get wins out of their agencies to tout, and especially ahead of the midterms, they just want people to be on message and to not have distractions. And I think the FDA, under Dr. Makary’s tenure, just continued to produce distractions. And there was personnel issues. There were certain policy issues that he was not necessarily aligned with the White House on. But there’s also just internal dynamics. When you’re leading an organization, you’re coming in after DOGE [the Department of Government Efficiency], it takes a lot of work to build trust back with career staff who saw their bosses fired, their colleagues retiring. It’s â€” there was so much turnover. 

Rovner: And I was going to say, FDA took a big hit from DOGE, didn’t it? 

Cohrs Zhang: It did take a big hit. 

Rovner: This was before Makary came in. 

Cohrs Zhang: Yes, technically before he came in. But I think we’ve seen other agencies â€” certainly not the level of turnover we saw at FDA â€” but try to build bridges and speak positively about career staff and really make an effort to value their expertise and bring them in the room. And I think we just didn’t really see that at the FDA. I think there was just mistrust and genuinely a view that we hear in public sometimes that career staff, or the “deep state,” weren’t supportive of the administration’s goals. And I think ultimately just the culture becomes toxic enough, and it’s just a difficult work environment for people doing really important work. 

Rovner: And people, the stakeholders at FDA, are really important people, many of them. 

Rachel Cohrs Zhang: They are. It cuts across so many different industries, like tobacco, food, medical devices, drugs, Big Pharma, small biotech. Truly, it’s a tough job to balance all the stakeholder interest. But I think if there had been a sense that he was really taking on industry and pursuing needed reforms, I think that would have been OK. But I think it was just communication issues, unpredictability. It’s just investors, companies don’t like unpredictability. They don’t like surprises, especially kind of a regulator that usually is pretty â€” has a lot of continuity from one administration to another. 

Julie Rovner: Well, it seems like the last straw, as we discussed last week, was this fight over vaping â€” in particular, fruit-flavored vapes, which might help adults quit more-dangerous tobacco products but also might attract children to start vaping. Makary was against the fruit-flavored vapes. [President Donald] Trump had promised the vaping industry during the 2024 campaign that he would protect them. Is there going to be more fallout from this whole vaping fight? I did see that a top HHS spokesman quit this week, also citing approval of the fruit-flavored vapes. But there’s more to that story, too. Right, Rachel? 

Cohrs Zhang: Yeah, I think personnel issues are really hard to cover, and the context that I would want to provide is that these resignations, both of Dr. Makary and the , Rich Danker, were not resignations where these individuals had the possibility of a long and robust career at these agencies. I think they both kind of reached the end of the line. And certainly, are there policy disagreements that occurred about fruity-flavored vapes? Absolutely, yes. But those dynamics have been ongoing for a long time. I think it’s also important to point out that the agency did approve these before the exit of both of these officials. And I think there’s just, the timeline, it’s a little complicated. Personnel issues are complicated, but I think, again, the Wall Street Journal story by Liz [Essley Whyte] and Josh did a really good job of trying to get that 360 view and kind of explain it in a fair and balanced way as to how that all went down. 

Rovner: So the question that this keeps leaving in my mind is: How is tobacco not a bigger piece of MAHA? If we’re going to “Make America Healthy Again,” isn’t the first thing we want to do is get people to stop using tobacco products? Why is this out in this sort of little island by itself, when [Health and Human Services Secretary] RFK [Robert F. Kennedy] Jr. is beating up on pretty much everything else? 

Cohrs Zhang: That is an interesting point. Calley Means at the White House also did a conversation with Harvard this morning and just kind of mentioned that they’re not trying to ban anything in the administration. That was kind of the talking point they were using: We’re not banning cigarettes. We’re not banning ultraprocessed food. We’re just trying to educate people on what’s good or bad for you. So that’s kind of the line they’re taking. 

Rovner: So it’s like vaccines? It’s like everything should be up to your choice about what you put in your body? 

Weber: I just wanted to add that, Julie, I feel like you’re asking a question of the MAHA movement the MAHA movement is unable to answer, which is: What is the MAHA movement? If we care so much about chronic disease, why aren’t we looking at one of the things that kills people a lot, which is tobacco? So, which leads also, and we’ll get to it later, to my extra credit, which is on Stat’s excellent series on alcohol, which the administration is also not really looking at. So I think when MAHA talks about these underlying pillars of combating the chronic disease epidemic, that’s all great. But what are they defining as the chronic disease epidemic? Because a lot of their attention has been focused on vaccines, which scientists have very clearly stated are not causing the chronic disease epidemic. So, we’ll see how this continues to unfold. 

Rovner: And reversing the food pyramid, to emphasize things that science has shown do contribute to chronic disease, like lots of animal products. So it’s a little bit curious, let us say. Well, the person who is now installed to replace Dr. Makary, at least on an interim basis, isn’t even a doctor. He’s a former corporate lawyer at the firm Jones Day and a hunting partner of Donald Trump Jr.’s. What else do we know about Kyle Diamantas, who’s been heading up FDA’s food division? 

Ollstein: So the anti-abortion groups that were demanding Makary’s ouster, some of them, over accusations that Makary was not doing enough to restrict access to abortion pills, are already worried about the acting replacement because records surfaced showing that he represented Planned Parenthood as a private attorney a decade ago, and so â€” 

Rovner: In a real estate case, right? 

Ollstein: In a real estate case, in a dispute between a clinic and its landlord. So clearly this was a concern, because within hours of his appointment as acting FDA leader, he was on the phone with anti-abortion groups, and he’s been talking to them on Tuesday, on Wednesday, on Thursday, different groups, trying to reassure them that he personally opposes abortion and will work with them going forward. But I think if he is nominated to lead the agency on a more permanent basis, that could potentially become a flash point. 

Rovner: And of course, we do know, Rachel, I think you were breaking this morning that the idea of him replacing Makary on a more permanent basis is already not going over very well in the Senate. 

Cohrs Zhang: Yeah, I think Sen. Bill Cassidy made some comments about Kyle. And I think there is absolutely a permanent search. I am not under the impression that they are planning to nominate Kyle Diamantas to be the permanent leader. I think they are searching for somebody with more robust expertise. But I think he’s just made a lot of allies. He’s been a pretty predictable and rational actor in the FDA. He got promoted earlier this year to be an adviser. He’s been doing public appearances, conferences, and on podcasts and television. So I think they just see him as a kind of a steady hand to guide the agency and not cause a lot of drama going into the midterms, because there’s a big backup of nominations in the Senate. So this could drag on for a while. 

Rovner: Right. That is my next question. Who is likely to get this job permanently? And, wow, the nominations are stacking up at the Senate HELP [Health, Education, Labor, and Pensions] Committee, where chairman and troubled Trump ally Bill Cassidy now has to oversee the confirmations of a new FDA commissioner, a new CDC director, and a surgeon general. And Cassidy himself is facing a primary election this weekend in which the president has endorsed one of his opponents. Awkward much? 

Cohrs Zhang: Yeah, it’s an interesting test of some of this proof of concept. Secretary Kennedy’s political operation has backed congresswoman Julia Letlow and so has the president. So there are these bigger macro issues of loyalty to the president and kind of where the Republican Party is headed. But there is a distinct healthcare flavor to this, given Sen. Cassidy’s influence over health policy in the Senate, and also just the involvement of a sitting Cabinet secretary’s political operation, which is pretty unusual, especially countering a sitting senator from his own party. So, yeah. It’ll be interesting to watch on Saturday. 

Rovner: Lauren, you want to add something. 

Weber: I want to call out again that Trump and RFK and Calley Means went pretty scorched-earth on Cassidy when they pulled Casey Means out, too. It’s not just that Trump has opposed him. It’s that this is like blow-everything-up-on-the-field oppose Bill Cassidy. So it is very curious to hear how this goes over, considering that Cassidy was the vote that got RFK his secretary post. So the weekend will be one to watch. 

Rovner: Yeah, it will. Well, the other big story from last week that continues this week is also FDA-related. It’s the fate of the abortion pill mifepristone and whether it will continue to be available via telehealth prescribing. The Supreme Court last week put a temporary hold on a 5th Circuit Court of Appeals ruling that would have rolled back the tele-prescribing option. We were supposed to get a decision on whether or not that appeals court ruling would take effect by the end of the day Monday. But, as we so often say in Washington, that did not happen. Alice, where are we with this case? 

Ollstein: We’re in a real hurry-up-and-wait situation. I had all my pre-writes ready to go on Monday, and I still have them ready to go for today. Look, the Supreme Court could punt again. They could say we need even more time. That’s happened before. They could say that the nationwide restrictions that the 5th Circuit put into effect that would cut off telehealth access to abortion pills and mail delivery of abortion pills and reinstate a prior rule saying patients can only get the drugs in person from a doctor, they could let that go into effect. Or they could say, Look, we’re going to maintain the status quo for now while this case makes its way through the courts. Those are sort of the three options. There could be a secret fourth thing. This is the Supreme Court. They kind of do what they want. One possibility is some parties in the case have asked the Supreme Court to leapfrog the 5th Circuit and just deal with this themselves once and for all. So that could happen, or they could send it back down to the 5th Circuit. 

We can sort of take some clues from what they did when a different case challenging abortion pills came before them in 2023, which is: They maintained the status quo. They maintained nationwide telehealth access while sending the case back to the 5th Circuit. And then it eventually came back to the Supreme Court, and they eventually sort of dodged the heart of the issue and decided it based on standing. That could happen again here, too. We have no idea. But this is really a major case because if these nationwide restrictions on telehealth go into effect, it’ll be really the biggest rollback of access since Roe v. Wade was overturned in 2022. And it will really go after access in blue states with protections on the books for abortion access in a way that people in those states really haven’t experienced before now, which could have very big political as well as healthcare implications. 

Rovner: And which those states have also sued. 

Ollstein: Yes. Yes, yes, yes. 

Rovner: The blue states. So there’s more to come. What role if any did the anti-abortion movement have in Dr. Makary’s losing his job? As we discussed last week, they blamed him for the FDA’s slow-walking of a review of mifepristone safety, even though it’s pretty clear that that delay came from the White House, not from Makary himself. And I know there was a White House meeting just last Friday with anti-abortion groups, just as the Makary-is-on-his-way-out rumors began to fly in earnest. Connected? 

Ollstein: So the administration is definitely trying to reassure the anti-abortion movement and keep them in their good graces leading up to the midterms. But that’s not entirely been successful. The anti-abortion groups are still upset. They still want to see these policy actions. They want the FDA or the DOJ [Department of Justice] or the EPA [Environmental Protection Agency] or some agency to do something to cut off access to abortion pills. They have not gotten that yet. They’re also really upset that the current ban on Planned Parenthood receiving Medicaid funding is set to expire in July, and it’s not totally clear Congress is going to manage to extend that defunding provision at all or in time for its expiration. And so these are two big priorities of theirs that they are very upset about. And so it’s not clear that all of this access that the administration is extending to them in these meetings and these phone calls, if that’s not followed up by concrete policy action, they’re not going to be satisfied. They’re going to keep complaining, loudly, as we’ve already seen this week. 

Rovner: Well, meanwhile the Trump administration used Mother’s Day this week to unveil a new regulation aimed at making it easier for employers to offer IVF [in vitro fertilization] coverage to their workers, though not making it free, as Trump had promised on the campaign trail in 2024. And at a maternal health event on Monday in the White House, administration officials continued to press their pro-natal push for more people to procreate. Here’s how [Centers for] Medicare & Medicaid [Services] chief Dr. Mehmet Oz put it at the event. 

Mehmet Oz: One in 3 Americans are under-babied. What does under-babied mean? That means that you either don’t have any children or you have less children than you would normally want to have. 

Rovner: Um, OK then. This event also featured the unveiling of a new federal website, moms.gov, which HHS says is a, quote, “user-friendly, one-stop digital hub providing new and expectant mothers with essential resources.” But it also links users to an anti-abortion group site that collects lots of sensitive personal information that can apparently be used any way the group, Heartbeat International, sees fit. Alice, this has prompted some concern in the reproductive health community. Has it not? 

Ollstein: It has, and it’s also a good example of how the administration is both working to appeal to anti-abortion activists while also continuing to piss them off, disappoint them. And so there was just a lot of mixed reaction to the unveiling of this website, because the anti-abortion folks were thrilled that it was steering people, using government resources to steer people to these often faith-based, anti-abortion crisis pregnancy centers. But at the same time, it was promoting IVF, which many of them oppose. They see it as akin to abortion. They — some see it as even worse than abortion, because it’s creating all these embryos and discarding them. And so it’s this real sort of push and pull where they’re not happy and, as you mentioned, the pro-abortion-rights camp is really not happy, either. 

Rovner: So we will have more of this as we go forward. All right, we’re going to take a quick break. We will be right back. 

So back in February â€”I looked this up â€” we talked about the Trump administration threatening to withhold millions of dollars appropriated to the global childhood vaccine group called Gavi, because it wouldn’t promise to phase out the use of the preservative thimerosal, which, by the way, has long since been cleared of accusations that it causes autism. The U.S., which helped create Gavi, now owes it $600 million â€” $300 million each for the last fiscal year and the current fiscal year. And last week, a bipartisan group of senators, led by Senate Appropriations Chairwoman Susan Collins of Maine, sent a letter to Secretary of State Marco Rubio asking him to, you know, spend the money that Congress appropriated. Now, Gavi says it has specific reasons for using vaccines with preservatives, because it mostly operates in poor countries, where refrigeration can be spotty, and it has to make the best use of limited funds. My bigger question is: How does the secretary of Health and Human Services get to stop the State Department from spending money appropriated by Congress? 

Weber: I think that’s a great question, Julie. At the end of the day, Kennedy, for years â€” this is not something he came up with overnight. This is something he’s been harping on for years. He wrote a book about thimerosal. He has linked it to autism, which is a claim that has been disproven by scientists and even folks at his own agency, before his handpicked advisory committee voted to get rid of it, in a decision that now is on ice with the federal court. But he also has railed against the sending of these vaccines abroad for years. I’ve listened to him talk about it. He really dislikes Bill Gates for his involvement in some of this. And so on. So it was a personal issue for him that he’s held tightly. I’m not sure how you get ahold of State Department funds, but I’m not sure of a lot of things these days. So, here we are. 

Rovner: Neither is Congress, apparently. We will watch the Gavi space, too. Well, meanwhile, we are also still watching this hantavirus outbreak that apparently came from Dutch tourists in Argentina, who caught it and spread it on a cruise ship in the Atlantic. So far, there are nine confirmed cases and two more people showing symptoms. Public health experts, including what’s left of the Centers for Disease Control and Prevention here in the U.S., seem fairly united in the view that while this is an odd outbreak, since hantavirus rarely spreads from person to person, they’re still not super worried about it morphing into another pandemic. But it does underscore just how unprepared the U.S. is should another outbreak of this or something else prove more dangerous, now that the nation has basically cut public health capacity to the bone, cut ties with international public health organizations like the World Health Organization, and defunded much of the federal public health infrastructure. Although, I have to add, there is at least a little bit of karma in watching all these officials who rose to prominence criticizing the nation’s covid response trying to respond to a public health emergency of their own. What are you guys watching for? Lauren, you must be on this one. 

Weber: Yeah, no, I had  earlier in the week about: What’s it like to be in the Nebraska national quarantine unit? Which it was kind of fascinating to me. So basically there’s this whole setup in the middle of the country â€” and as a Midwesterner, I obviously love a Midwest shout-out â€” where they repatriated all these people off the cruise ship and sent them to Nebraska. And you end up, basically, if you’re in the quarantine unit, in what’s essentially a souped-up hotel room. There’s an exercise bike. Apparently, the staff is very nice. But you can’t leave, really, unless â€” there is some talk about letting some of the people that seem to really have no symptoms potentially leave to stay at home, but it’s a little unclear what’s happening there. Staff comes in in protected masks. And you don’t get to see people for a while, so that’s kind of a tough go after you were on a cruise ship sailing the world. That really went awry. So â€” 

Rovner: And it’s a long incubation period for this particular strain of hantavirus. 

Weber: It’s a long â€” 42 days! That’s a long time to be stuck in a room. But again, officials â€” as you said, Julie, I think which was smart to point out â€” have said this is not covid. This does have very low risk of spreading to the general public. I do think there is some question about this question of prolonged contact and what that means â€” it seems like it’s being debated a little bit about how exactly this spreads and how exactly many people may end up coming down with it â€” that we’ll have to continue to watch as well. 

Rovner: And of course, we’re already seeing people online, like, selling more ivermectin. And, this sort of thing does bring out the less-than-scrupulous actors in public health, shall we say? 

Weber: Nothing like a crisis. But, in general, I think it’s a good reminder. As you pointed out, we’re watching the contrarians run the ship. I was fascinated. In the Oval Office, basically, RFK Jr. said there’s nothing to worry about, Nothing to see here kind of thing. And that is, it’s interesting, the public health messaging, which has varied from person to person in the administration, because they have litigated how covid was messaged for such a long time. Now, again, this is not covid. But it’s very fascinating to see players that had such strong opinions deal with some of the same terms, like “quarantine,” “6-feet isolation,” the uncertainty of what’s happening, and, again, deal with it in a backdrop of: We’ve withdrawn from the WHO. There have been CDC cuts. And what happens now? 

Rovner: Yeah, and also the fact, and we talked about this a little bit last week, that the U.S. didn’t even know that some of the people who were exposed had already gotten off the ship and gone home. And those people are not in quarantine in Nebraska. Those people are apparently being watched by their individual state health departments. So the coordination effort here was not great, either. 

Weber: Well, it does sound like the CDC was on the horn with state health officials. But yeah, I mean, some of these people kind of flew into the wind, so to speak, and they haven’t found everyone. But that said, you know, I talked to the Virginia state health official who was like, Look, we’re in talks with the patient in Virginia who â€¦ they check in for daily monitoring of temperature checks and so on. The California state health official that I listened to said, Look, these people that we’re watching were either a row behind or a row in front of, or two seats next to, for at least 15 minutes a suspected ill passenger on a plane. That’s why we’re watching them. And that’s interesting to me, too, because that speaks to the level: Is that prolonged contact? What does prolonged contact mean? is my underlying question I continue to ask. So we’ll have to continue to see what we learn more on this front. 

Rovner: Well, at very least, they’re getting an idea that covid was not so easy to deal with â€” these people who’ve been criticizing the covid response. OK, that is this week’s news. Now we’ll play my interview with Sen. Tammy Baldwin of Wisconsin, and then we’ll come back and do our extra credits. 

I am so pleased to welcome to the podcast U.S. Sen. Tammy Baldwin, Democrat of Wisconsin. Sen. Baldwin is a senior member of both the Health, Education, Labor, and Pensions Committee and the Senate Appropriations Committee, where she’s the top Democrat on the subcommittee that funds the Department of Health and Human Services. Sen. Baldwin, thank you so much for joining us. 

Sen. Tammy Baldwin: Thank you for having me. 

Rovner: So we spend a lot of time on the podcast talking about health issues that are divisive, and often divisive by party, but one feel-good story of the past few months comes from a study showing that the new 988 suicide prevention hotline has, in fact, reduced youth suicides. That was a very bipartisan effort in Congress that you were, I know, a big part of. How satisfying has it been to see that succeed, and is there a chance that you could repeat that work on other health issues, or was this kind of a one-off? 

Baldwin: Look, I knew when we wrote the bill to establish the 988 hotline that it was going to save lives. But to have this study showing that there was 10% to 11% reduction in youth suicide and attributable to this 988 hotline â€” it’s heartwarming to know that this work matters. And it was very bipartisan legislation to establish the 988 hotline. You know, we’ve long had a mental health crisis suicide prevention hotline. It was a 10-digit number that no one would remember at a time of crisis and need. And so now people remember it and can use it, and it’s also modern in that you can also chat or text as well as call. And with the young generation, sometimes that’s their preferred way of reaching out and communicating. But again, heartwarming to hear what I always believed would be true about 988 â€” that it is saving lives and people are using it. 

Rovner: I know that as much of a success as this has been, you’ve been critical of HHS Secretary RFK Jr. for eliminating the part of the hotline that provided a separate option for LGBTQ+ youth. What’s the status of your effort to get that restored? 

Baldwin: Yeah, and I’ll focus on that. And there’s some other concerns that I have about the way in which we support 988. But let me start with that. There are certain populations in the United States that have higher rates of suicide. I think we all immediately think of our military veterans. And so when you call the 988 hotline, one of the first screening questions is: “Are you a military veteran? Press 1.” And if you are, you have the option then of getting your call or inquiry responded to by somebody in the VA [Department of Veterans Affairs] system who, I might say, has walked in your boots before and understands the experiences that you might have had while serving in the military. Another population with a very high rate of suicide is LGBTQ youth, and so the “Press 3” option made sure that youth who were in the LGBTQ community and reaching out for help in crisis were getting their calls and texts responded to by somebody who was specially trained and understood their situation. And you know, again, it promotes use of the line because you don’t think when you call that you’re likely to be judged. And by the way, the study that showed this was having a very positive impact on reducing suicide said that 1 in 10 calls to the 988 hotline, people utilize the “Press 3” option. But what happened there is the Trump administration last year abruptly ended the service and defended that by saying, Well, we want to treat everyone the same. We don’t want to discriminate. Well, they kept the “Press 1” option for veterans, and understanding that specialized response for veterans would be important to keep, but they eliminated the service “Press 3” for LGBTQ youth. Very unfortunate. But fortunately, there was a bipartisan pushback to that â€”on two fronts for that, one successful and the other still in progress. We wanted to make sure that the administration restored the “Press 3” option and restored the contracts with nonprofits that are able to provide the response to those calls. And that was written into our appropriations law for the fiscal year 2026. Now we’re chasing down the administration and Secretary Kennedy, saying, It’s in the law. Let’s get it done. It hasn’t happened yet, but we have his public commitment to make sure it does. And so we’re pressing him for expeditious restoration of the “Press 3” option. That said, we also want to make this permanent law. And so I have a bill that is bipartisan with Sen. Lisa Murkowski that would write into statute that a “Press 3” option has to exist and so that it doesn’t become political football in the future. 

Rovner: Well, I’m so glad you mentioned things that have been written into the appropriations law, because one of the continuing issues that we’ve chronicled over this last year has been this administration just refusing to spend money as appropriated by Congress. Now, I’ve been covering Congress in general â€” and the Labor-HHS appropriation, in particular â€” for four decades now, and a 25-year-old or 35-year-old me could not imagine appropriators standing for any administration, ignoring their power of the purse, which this one seems to be doing. Why has there been so little pushback, and is that going to change? 

Baldwin: Yeah, in answer to your question, I want to say that in this most recently passed bill that Donald Trump signed into law, we had to put guardrails that we’ve never had to put into our appropriations laws before to enforce our spending bills. And those laws have made it clear that we expect that they must spend what we have appropriated, and not just, you know, all of it at the end of the fiscal year, but in a timely manner throughout the year. And we also are more specific about staffing requirements, because we saw last year these incredible numbers of people fired, RIF’d, as well as really heavy pressure to get people to sign up to early retirements, etc., but just a big push to get people out of the agencies. And so we had to write into the appropriations law that they have to maintain staffing sufficient for their mission. And I can give you any number of examples where people needed to reach out to divisions within the CDC, for example, and no one was there. 

Rovner: Is there going to be more pushback, do you think, if the administration tries this year to avoid spending money in the way that they tried to avoid spending money last year â€” and, as you kind of mentioned, dumped a lot of money out the door at the very end of the fiscal year? 

Baldwin: Yeah, so one of the areas in which they did that in a significant way was NIH [the National Institutes of Health]. We saw thousands fewer grants awarded last fiscal year, and we’re very worried that they would continue to act in that vein. And part of that battle is still ongoing. There’s something â€” we’re going to get in the weeds here for a second â€” but there’s something they call forward funding, where instead of just annually funding one year of grant research activity, you actually fund multiyear grants all at once up-front. And the administration has wanted to move into doing that more and more and more, but if you have a finite number of dollars, that simply means fewer grants will be awarded each year. And the way I liken it, if you’re thinking about NIH and curing cancer or finding a better treatment for Alzheimer’s, these are more shots on goal. We need to not just invest in a few research endeavors to try to cure cancer, to try to treat Alzheimer’s, to deal with all of the things that NIH is trying to advance, you have to have as many shots on goal as you can. And so this forward funding is really tying up a lot of resources in fewer and fewer research endeavors. 

Rovner: And that â€” which leads me to my last question, which is â€¦ concerns the other thing we’ve talked about a lot, is that future health care and research worker pipeline having fewer grants means fewer jobs for students and PhDs. And this administration has also made it more difficult for medical students and other health profession students to take out loans by capping the loan amount. How big a concern is this? And what can you do from your posts, either on the HELP Committee or on the Appropriations Committee, to make sure that there is a future workforce for healthcare and research? 

Baldwin: Yes. Well, especially in research, I was proud to â€¦ lead bipartisan legislation called the Next Generation Researchers Act that passed many years ago but is definitely in threat under this administration. I represent the state of Wisconsin. We have a couple of academic research centers that are exceptional. And I remember visiting on so many occasions and seeing these bright postdocs looking forward to their opportunity to advance treatments and cures for devastating illnesses and learn about the basic mechanisms of biology. And knowing each year that the average age of the first-time grant awardee is getting older and older and older, and the opportunities for a career in research â€” which is such an investment by the individual to their education and postdoc work â€” their opportunities are shrinking and shrinking. And some are leaving research and going into private industry. Some are leaving the country and are actually being lured by other nations who want to take advantage of this neglect here in the United States. This is something we’ve got to turn around. And forward funding is one of the things that is making it harder, but also the lack of commitment to just increasing the overall research enterprise in the United States, which is something we are known for globally. You have to keep up with it. Costs increase, and so you can’t just flat-fund, that means less. You can’t forward-fund, that means less. So we’re going to have some bipartisan pushback, but we also are going to have a very limited amount of resources to deal with, especially â€” just to drop a big topic at the very end here â€” especially with a Defense Department that is seeking $1.5 trillion in funding â€” that, just the math doesn’t work out. 

Rovner: Well, we will be watching the appropriations process closely as it moves forward. 

Baldwin: Yes, indeed. 

Rovner: Sen. Baldwin, thank you so much for joining us. 

Baldwin: Thank you for having me. 

Rovner: OK, we are back. It’s time for our extra-credit segment. That’s where we each recognize a story we read this week we think you should read too. Don’t worry if you miss it. We will post the links in our show notes on your phone or other mobile device. Rachel, you have already done yours. Lauren, why don’t you go next? 

Weber: Yeah, I wanted to highlight Stat’s series, the first of which is titled “,” by Lev Facher and Isabella Cueto. And it’s just a fabulous step-back look at how this administration, in particular, which would seem to be primed to look into alcohol as an addiction, considering that Trump himself is a teetotaler and RFK Jr. has publicly spoken about his recovery from addiction to alcohol, is not seizing the moment. And this is happening at a time that ER visits for alcohol are going up, and that alcohol does, speaking of chronic diseases, contribute to quite a large amount of American healthcare costs. And it’s a real bracing look at an issue that, you know, oftentimes people don’t want to look at in this way, as alcohol is such an inherent part of America’s social fabric. So kudos to them for the look. 

Rovner: Yeah, I would point out that both alcohol and tobacco are, you know, two of those vices that have been bipartisan over the years. Republicans and Democrats in Congress have worked on, but this administration seems to be sort of downplaying both of them. Alice. 

Ollstein: Yes, I have a piece by my colleague Katherine Tully-McManus titled “.” Now we’ve been hearing a lot about the threats to medical privacy with everything being in these electronic records, and, you know, being shared from company to company. And turns out, even being a member of Congress does not protect you from this brave new world that we live in. And there was a data breach this week that lawmakers were informed of, and potentially their prescription history was unveiled. And so that is information I am sure they do not want out there. So it just really shows that if even they can be at risk, then, you know, what’s going to happen to the rest of us? 

Rovner: Yeah, that was some story. And I would add that TMZ is looking for members of Congress who smoke weed. That’s a separate story. Not my extra credit. My extra credit this week is from ProPublica. It’s called “,” by Rob Davis. It’s about a state law that gave Oregon officials the power to stop mergers and acquisitions that were deemed not in the best interest of patients. The idea was to, if not stop them, then at least slow the consolidation push that was cutting access and driving up healthcare costs â€” except it hasn’t worked, at least not yet. Quoting from the story: “Of the nine healthcare deals for which regulators have done follow-up reviews, at least three had outcomes the law was meant to forestall.” As always, complicated healthcare problems defy simple solutions, but I assume they’ll keep trying. 

OK, that’s this week’s show. As always, thanks to our editor, Emmarie Huetteman, and our producer-engineer, Francis Ying. A reminder: What the Health? is now available on WAMU platforms, the NPR app, and wherever you get your podcasts — as well as, of course, kffhealthnews.org. Also, as always, you can email us your comments or questions. We’re at whatthehealth@kff.org. Or you can still find me on X , or on Bluesky . Where are you guys hanging these days? Lauren. 

Weber: I am still on X  and the same thing on . 

Rovner: Rachel. 

Cohrs Zhang: I’m on X  and on . 

Rovner: Alice. 

Ollstein: I am  on Bluesky and  on X. 

Rovner: We’ll be back in your feed next week. Until then, be healthy. 

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