\t\t\t<\/p>\n
\tJulie Rovner
\n\tKFF Health News<\/p>\n
\t\t\t \t\t\t \t\t\tJulie Rovner is chief Washington correspondent and host of KFF Health News\u2019 weekly health policy news podcast, \u201cWhat the Health?\u201d A noted expert on health policy issues, Julie is the author of the critically praised reference book \u201cHealth Care Politics and Policy A to Z,\u201d now in its third edition.\t\t<\/p>\n Two months into the new administration, federal workers and contractors remain off-balance as the Trump administration ramps up its efforts to cancel jobs and programs \u2014 even as federal judges declare many of those efforts illegal and\/or unconstitutional.<\/p>\n As it eliminates programs deemed duplicative or unnecessary, however, President Donald Trump\u2019s Department of Government Efficiency is also cutting programs and workers aligned with Health and Human Services Secretary Robert F. Kennedy Jr.\u2019s \u201cMake America Healthy Again\u201d agenda.<\/p>\n This week\u2019s panelists are Julie Rovner of KFF Health News, Jessie Hellmann of CQ Roll Call, Sarah Karlin-Smith of the Pink Sheet, and Rachel Roubein of The Washington Post.<\/p>\n \t\t\t \tJessie Hellmann \t\t\t \t\t\t \t\t\t \tSarah Karlin-Smith \t\t\t \t\t\t \t\t\t \tRachel Roubein \t\t\t \t\t\t Among the takeaways from this week\u2019s episode:<\/p>\n Plus, for \u201cextra credit,\u201d the panelists suggest health policy stories they read this week that they think you should read, too:<\/p>\n Julie Rovner:<\/strong> The Washington Post\u2019s \u201cThe Free-Living Bureaucrat<\/a>,\u201d by Michael Lewis.<\/p>\n Rachel Roubein:<\/strong> The Washington Post\u2019s \u201cHer Research Grant Mentioned \u2018Hesitancy.\u2019 Now Her Funding Is Gone.<\/a>\u201d by Carolyn Y. Johnson.<\/p>\n Sarah Karlin-Smith:<\/strong> KFF Health News\u2019 \u201cScientists Say NIH Officials Told Them To Scrub mRNA References on Grants<\/a>,\u201d by Arthur Allen.<\/p>\n Jessie Hellmann:<\/strong> Stat\u2019s \u201cNIH Cancels Funding for a Landmark Diabetes Study at a Time of Focus on Chronic Disease<\/a>,\u201d by Elaine Chen.<\/p>\n Also mentioned in this week\u2019s podcast:<\/p>\n \t\t\t\t\tclick to open the transcript\t\t\t\t<\/p>\n \t\t\t\t\t\tTranscript: Federal Health Work in Flux\t\t\t\t<\/p>\n [Editor\u2019s note:<\/em><\/strong> This transcript was generated using both transcription software and a human\u2019s light touch. It has been edited for style and clarity.]<\/em>\u00a0<\/p>\n Julie Rovner:<\/strong> Hello, and welcome back to \u201cWhat the Health?\u201d I\u2019m Julie Rovner, chief Washington correspondent for KFF Health News, and I\u2019m joined by some of the best and smartest health reporters in Washington. We\u2019re taping this week on Thursday, March 20, at 10 a.m. As always, news happens fast and things might have changed by the time you hear this. So, here we go.\u00a0<\/p>\n Today we are joined via videoconference by Rachel Roubein of The Washington Post.\u00a0<\/p>\n Rachel Roubein:<\/strong> Hi.\u00a0<\/p>\n Rovner:<\/strong> Sarah Karlin-Smith of the Pink Sheet.\u00a0<\/p>\n Sarah Karlin-Smith:<\/strong> Hi, everybody.\u00a0<\/p>\n Rovner:<\/strong> And Jessie Hellmann of CQ Roll Call.\u00a0<\/p>\n Jessie Hellmann:<\/strong> Hello.\u00a0<\/p>\n Rovner:<\/strong> No interview today, but, as usual, way more news than we can get to, so let us jump right in. In case you missed it, there\u2019s a bonus podcast episode in your feed. After last week\u2019s Senate Finance Committee confirmation hearing for Dr. Mehmet Oz to head the Centers for Medicare & Medicaid Services, my KFF Health News colleagues Stephanie Armour and Rachana Pradhan and I summarized the hearing and caught up on all the HHS [Department of Health and Human Services] nomination actions. It will be the episode in your feed right before this one.\u00a0<\/p>\n So even without Senate-confirmed heads at \u2014 checks notes \u2014 all of the major agencies at HHS, the department does continue to make news. First, Robert F. Kennedy Jr., the new HHS secretary, speaks. Last week it was measles. This week it was bird flu, which he says should be allowed to spread unchecked in chicken flocks to see which birds are resistant or immune. This feels kind of like what some people recommended during covid. Sarah, is there any science to suggest this might be a good idea?\u00a0<\/p>\n Karlin-Smith:<\/strong> No, it seems like the science actually suggests the opposite, because doctors and veterinary specialists are saying basically every time you let the infection continue to infect birds, you\u2019re giving the virus more and more chances to mutate, which can lead to more problems down the road. The other thing is they were talking about the way we raise animals, and for food these days, there isn\u2019t going to be a lot of genetic variation for the chickens, so it\u2019s not like you\u2019re going to be able to find a huge subset of them that are going to survive bird flu.\u00a0<\/p>\n And then the other thing I thought is really interesting is just it doesn\u2019t seem economically to make the most sense either as well, both for the individual farmers but then for U.S. industry as a whole, because it seems like other countries will be particularly unhappy with us and even maybe put prohibitions on trading with us or those products due to the spread of bird flu.\u00a0<\/p>\n Rovner:<\/strong> Yeah, it was eyebrow-raising, let us say. Well, HHS this week also announced its first big policy effort, called Operation Stork Speed. It will press infant formula makers for more complete lists of ingredients, increase testing for heavy metals in formula, make it easier to import formula from other countries, and order more research into the health outcomes of feeding infant formula. This feels like maybe one of those things that\u2019s not totally controversial, except for the part that the FDA [Food and Drug Administration] workers who have been monitoring the infant formula shortage were part of the big DOGE [Department of Government Efficiency] layoffs.\u00a0<\/p>\n Roubein:<\/strong> I talked to some experts about this idea, and, like you said, they thought it kind of sounded good, but they basically needed more details. Like, what does it mean? Who\u2019s going to review these ingredients? To your point, some people did say that the agency would need to staff up, and there was a neonatologist who is heading up infant formula that was hired after the 2022 shortage who was part of the probationary worker terminations. However, when the FDA rescinded the terminations of some workers, so, that doctor has been hired back. So I think that\u2019s worth noting.\u00a0<\/p>\n Rovner:<\/strong> Yes. This is also, I guess, where we get to note that Calley Means, one of RFK Jr.\u2019s, I guess, brain trusts in the MAHA movement, has been hired as, I guess, in an Elon Musk-like position in the White House as an adviser. But this is certainly an area where he would expect to weigh in.\u00a0<\/p>\n Hellmann:<\/strong> Yeah, I saw he\u2019s really excited about this on Twitter, or X. There\u2019s just been concerns in the MAHA movement, \u201cMake America Healthy Again,\u201d about the ingredients that are in baby formula. And the only thing is I saw that he also retweeted somebody who said that \u201cbreast is best,\u201d and I\u2019m just hoping that we\u2019re not going back down that road again, because I feel like public health did a lot of work in pushing the message that formula and<\/em> breast milk is good for the child, and so that\u2019s just another angle that I\u2019ve been thinking about on this.\u00a0<\/p>\n Rovner:<\/strong> Yes, I think this is one of those things that everybody agrees we should look at and has the potential to get really controversial at some point. While we are on the subject of the federal workforce and layoffs, federal judges and DOGE continue to play cat-and-mouse, with lots of real people\u2019s lives and careers at stake. Various judges have ordered the reinstatement, as you mentioned, Rachel, of probationary and other workers. Although in many cases workers have been reinstated to an administrative leave status, meaning they get put back on the payroll and they get their benefits back, but they still can\u2019t do their jobs. At least one judge has said that does not satisfy his order, and this is all changing so fast it\u2019s basically impossible to keep up. But is it fair to say that it\u2019s not a very stable time to be a federal worker?\u00a0<\/p>\n Karlin-Smith:<\/strong> That\u2019s probably the nicest possible way to put it. When you talk to federal workers, everybody seems stressed and just unsure of their status. And if they do have a job, it\u2019s often from their perspective tougher to do their job lately, and then they\u2019re just not sure how stable it is. And many people are considering what options they have outside the federal government at this point.\u00a0<\/p>\n Rovner:<\/strong> So for those lucky federal workers who do still have jobs, the Trump administration has also ordered everyone back to offices, even if those offices aren\u2019t equipped to accommodate them. FDA headquarters here in Maryland\u2019s kind of been the poster child for this this week.\u00a0<\/p>\n Karlin-Smith:<\/strong> Yeah, FDA is an interesting one because well before covid normalized working from home and transitioned a lot of people to working from home, FDA\u2019s headquarters couldn\u2019t accommodate a lot of the new growth in the agency over the years, like the tobacco part of the FDA. So it was typical that people at least worked part of their workweek at home, and FDA really found once covid gave them additional work-from-home flexibilities, they were able to recruit staff they really, really needed with specialized degrees and training who don\u2019t live near here, and it actually turned out to be quite a benefit from them.\u00a0<\/p>\n And now they\u2019re saying everybody needs to be in an office five days a week, and you have people basically cramped into conference rooms. There\u2019s not enough parking. People are trying to review technical scientific data, and you kind of can\u2019t hear yourself think. Or you\u2019re a lawyer \u2014 I heard of a situation where people are basically being told, Well, if you need to do a private phone call because of the confidentiality around what you\u2019re doing, go take the call in your car.<\/em> So I think in addition to all of the concerns people have around the stability of their jobs, there\u2019s now this element of, on a personal level, I think for many of them it\u2019s just made their lives more challenging. And then they just feel like they\u2019re not actually able to do, have the same level of efficiency at their work as they normally would.\u00a0<\/p>\n Rovner:<\/strong> And for those who don\u2019t know, the FDA campus is on a former military installation in the Maryland suburbs. It\u2019s not really near any public transportation. So you pretty much have to drive to get there. And I think that the parking lots are not that big, because, as you pointed out, Sarah, the workforce is now bigger than the headquarters was created to accommodate it. And we\u2019re seeing this across the government. This week it happened to be FDA. You have to ask the question: Is this really just an effort to make the government not work, to make federal workers, if they can\u2019t fire them, to make them quit?\u00a0<\/p>\n Hellmann:<\/strong> I definitely think that\u2019s part of the underlying goal. If you see some of the stuff that Elon Musk says about the federal workforce, it\u2019s very dismissive. He doesn\u2019t seem to have a lot of respect for the civil servants. And they\u2019ve been running into a lot of pushback from federal judges over many lawsuits targeting these terminations. And so I think just making conditions as frustrating as possible for some of these workers until they quit is definitely part of the strategy.\u00a0<\/p>\n Roubein:<\/strong> And I think this is overlaid with the additional buyout offers, the additional early retirement offers. There\u2019s also the reduction-in-force plans that federal workers have been unnerved about, bracing for future layoffs. So it\u2019s very clear that they want to shrink the size of the federal workforce.\u00a0<\/p>\n Rovner:<\/strong> Yeah, we\u2019ve seen a lot of these people, I\u2019ve seen interviews with them, who are being reinstated, but they\u2019re still worried that now they\u2019re going to be RIF-ed. They\u2019re back on the payroll, they\u2019re off the payroll. I mean there\u2019s nothing \u2014 this does not feel like a very efficient way to run the federal government.\u00a0<\/p>\n Karlin-Smith:<\/strong> Right. I think that\u2019s what a lot of people are talking about is, again, going back to offices, for many of these people, is not leading to productivity. I talked to one person who said: I\u2019m just leaving my laptop at the office now. I\u2019m not going to take it home and do the extra hours of work that they might\u2019ve normally gotten from me.<\/em> And that includes losing time to commute. FDA is paying for parking-garage spaces in downtown Silver Spring [Maryland] near the Metro so that they can then shuttle people to the FDA headquarters. I\u2019ve taken buses from that Metro to FDA headquarters. In traffic, that\u2019s a 30-minute drive. They\u2019re spending money on things that, again, I think are not going to in the long run create any government efficiency.\u00a0<\/p>\n And in fact, I\u2019ve been talking to people who are worried it\u2019s going to do the opposite, that drug review, device review, medical product review times and things like that are going to slow. We talked about food safety. I think The New York Times had a really good story this week about concerns about losing the people. We need to make sure that baby formula is actually safe. So there\u2019s a lot of contradictions in the messaging of what they\u2019re trying to accomplish and how the actions actually are playing out.\u00a0<\/p>\n Rovner:<\/strong> Well, and finally, I\u2019m going to lay one more layer on this. There\u2019s the question of whether you can even put the toothpaste back in the tube if you wanted to. After weeks of back-and-forth, the federal judge ruled on Tuesday that the dissolution of USAID [the U.S. Agency for International Development] was illegal and probably unconstitutional, and ordered email and computer access restored for the remaining workers while blocking further cuts. But with nearly everybody fired, called back from overseas, and contracts canceled, USAID couldn\u2019t possibly come close to doing what it did before DOGE basically took it apart, right?.\u00a0<\/p>\n Karlin-Smith:<\/strong> You hear stories of if someone already takes a new job, they\u2019re lucky enough to find a new job, why are they going to come back? Again, even if you\u2019re brought back, my expectation is a lot of people who have been brought back are probably looking for new jobs regardless because you don\u2019t have that stability. And I think the USAID thing is interesting, too, because again, you have people that were working in all corners of the world and you have partnerships with other countries and contractors that have to be able to trust you moving forward. And the question is, do those countries and those organizations want to continue working with the U.S. if they can\u2019t have that sort of trust? And as people said, the U.S. government was known as, they could pay contractors less because they always paid you. And when you take that away, that creates a lot of problems for negotiating deals to work with them moving forward.\u00a0<\/p>\n Rovner:<\/strong> And I think that\u2019s true for federal workers, too. There\u2019s always been the idea that you probably could earn more in the private sector than you can working for the federal government, but it\u2019s always been a pretty stable job. And I think right now it\u2019s anything but, so comes the question of: Are we deterring people from wanting to work for the federal government? Eventually one would assume there\u2019s still going to be a federal government to work for, and there may not be anybody who wants to do it.\u00a0<\/p>\n Roubein:<\/strong> Yeah, you saw various hiring authorities given to try and recruit scientists and other researchers who make a lot, lot more in the public health sector, and some of those were a part of the probationary workforce because they had been hired recently under those authorities.\u00a0<\/p>\n Rovner:<\/strong> Yeah, and now this is all sort of coming apart. Well, meanwhile, the cuts are continuing even faster than federal judges can rule against them. Last week, the administration said it would reduce the number of HHS regional offices from 10 to four. Considering these are where the department\u2019s major fraud-fighting efforts take place, that doesn\u2019t seem a very effective way of going after fraud and abuse in programs like Medicare and Medicaid. Those regional offices are also where lots of beneficiary protections come from, like inspections of nursing homes and Head Start facilities. How does this serve RFK Jr.\u2019s Make America Healthy Again agenda?\u00a0<\/p>\n Karlin-Smith:<\/strong> I think it\u2019s not clear that it does, right? You\u2019re talking about, again, the Department of Government Efficiency has focused on efficiency, cost savings, and Medicare and Medicaid does a pretty good job of fighting fraud and making HHS OIG [Office of Inspector General], all those organizations, they collect a lot of money back. So when you lose people\u2014\u00a0<\/p>\n Rovner:<\/strong> And of course the inspector general has also been laid off in all of this.\u00a0<\/p>\n Karlin-Smith:<\/strong> Right. It\u2019s not clear to me, I think one of the things with that whole reorganization of their chief counsel is people are suggesting, again, this is sort of a power move of HHS wanting to get a little bit more control of the legal operations at the lower agencies, whether it\u2019s NIH [the National Institutes of Health] or FDA and so forth. But, right, it\u2019s reducing head count without really thinking about what people\u2019s roles actually were and what you lose when you let them go.\u00a0<\/p>\n Rovner:<\/strong> Well, the Trump administration is also continuing to cut grants and contracts that seem like they\u2019d be the kind of things that directly relate to Make America Healthy Again. Jessie, you\u2019ve chosen one of those as your extra credit this week. Tell us about it.\u00a0<\/p>\n Hellmann:<\/strong> Yeah. So my story is from Stat [\u201cNIH Cancels Funding for a Landmark Diabetes Study at a Time of Focus on Chronic Disease<\/a>\u201d], and it\u2019s about a nationwide study that tracks patients with prediabetes and diabetes. And it was housed at Columbia University, which as we know has been the subject of some criticism from the Trump administration. They had lost about $400 million in grants because the administration didn\u2019t like Columbia\u2019s response to some of the protests that were on campus last year. But that has an effect on some research that really doesn\u2019t have much to do with that, including a study that looked at diabetes over a really long period of time.\u00a0<\/p>\n So it was able to over decades result in 200 publications about prediabetes and diabetes, and led to some of the knowledge that we have now about the interventions for that. And the latest stage was going to focus on dementia and cognitive impairment, since some of the people that they\u2019ve been following for years are now in their older ages. And now they have to put a stop to that. They don\u2019t even have funding to analyze blood samples that they\u2019ve done and the brain scans that they\u2019ve collected. So it\u2019s just another example of how what\u2019s being done at the administration level is contradicting some of the goals that they say that they have.\u00a0<\/p>\n Rovner:<\/strong> Yeah, and it\u2019s important to remember that Columbia\u2019s funding is being cut not because they deemed this particular project to be not helpful but because they are, as you said, angry at Columbia for not cracking down more on pro-Palestinian protesters after Oct. 7.\u00a0<\/p>\n Well, meanwhile, people are bracing for still more cuts. The Wall Street Journal is reporting<\/a> the administration plans to cut domestic AIDS-HIV programming on top of the cuts to the international PEPFAR [President\u2019s Emergency Plan for AIDS Relief] program that was hammered as part of the USAID cancellation. Is fighting AIDS and HIV just way too George W. Bush for this administration?\u00a0<\/p>\n Hellmann:<\/strong> It\u2019s interesting because President [Donald] Trump unveiled the Ending the HIV Epidemic initiative in his first term, and the goal was to end the epidemic in the United States. And so if they were talking about reducing some of that funding, or I know there were reports that maybe they would move the funding from CDC [the Centers for Disease Control and Prevention] to HRSA [the Health Resources and Services Administration], it\u2019s very unclear at this point. Then it raises questions about whether it would undermine that effort. And there\u2019s already actions that the Trump administration has done to undermine the initiative, like the attacks on trans people. They\u2019ve canceled grants to researchers studying HIV. They have done a whole host of things. They canceled funding to HIV services organizations because they have \u201ctrans\u201d in their programming or on their websites. So it\u2019s already caused a lot of anxiety in this community. And yeah, it\u2019s just a total turnaround from the first administration.\u00a0<\/p>\n Rovner:<\/strong> I know the Whitman-Walker clinic here in Washington, which has long been one of the premier AIDS-HIV clinics, had just huge layoffs. This is already happening, and as you point out, this was something that President Trump in his first term vowed to end AIDS-HIV in the U.S. So this is not one would think how one would go about that.\u00a0<\/p>\n Well, it\u2019s not just the administration that\u2019s working to constrict rights and services. A group of 17 states, led by Texas, of course, are suing to have Biden-era regulations concerning discrimination against trans people struck down, except as part of that suit, the states are asking that the entirety of Section 504 of the Rehabilitation Act<\/a> be declared unconstitutional. Now, you may never have heard of Section 504, but it is a very big deal. It was the forerunner of the Americans With Disabilities Act, and it prevents discrimination on the basis of disability in all federally funded activities. It is literally a lifeline for millions of disabled people that enables them to live in the community rather than in institutions. Are we looking at an actual attempt to roll back basically all civil rights as part of this war on \u201cwoke\u201d and DEI [diversity, equity, and inclusion] and trans people?\u00a0<\/p>\n Hellmann:<\/strong> The story is interesting, because it seems like some of the attorneys general are saying, That\u2019s not our intent.<\/em> But if you look at the court filings, it definitely seems like it is. And yeah, like you said, this is something that would just have a tremendous impact. And Medicaid coverage of home- and community-based services is one of those things that states are constantly struggling to pay for. You\u2019re just continuing to see more and more people need these services. Some states have waiting lists, so\u2014\u00a0<\/p>\n Rovner:<\/strong> I think most states have waiting lists.\u00a0<\/p>\n Hellmann:<\/strong> Yeah. It\u2019s something, you have to really question what the intent is here. Even if people are saying, This isn\u2019t our intent,<\/em> it\u2019s pretty black-and-white on paper in the court records, so\u2014\u00a0<\/p>\n Rovner:<\/strong> Yeah, just to be clear, this was a Biden administration regulation, updating the rules for Section 504, that included reference to trans people. But in the process of trying to get that struck down, the court filings do, as you say, call for the entirety of Section 504 to be declared unconstitutional. This is obviously one of those court cases that\u2019s still before the district court, so it\u2019s a long way to go. But the entire disability community, certainly it has their attention.\u00a0<\/p>\n Well, we haven\u2019t had any big abortion news the past couple of weeks, but that is changing. In Texas, a midwife and her associate have become the first people arrested under the state\u2019s 2022 abortion ban. The details of the case are still pretty fuzzy, but if convicted, the midwife who reportedly worked as an OB-GYN doctor in her native Peru and served a mostly Spanish-speaking clientele, could be sentenced to up to 20 years in prison. So, obviously, be watching that one. Meanwhile, here in Washington, Hilary Perkins, a career lawyer chosen by FDA commissioner nominee Marty Makary to serve as the agency\u2019s general counsel, resigned less than two days into her new position after complaints from Missouri Sen. Josh Hawley that she defended the Biden administration\u2019s position on the abortion pill mifepristone.\u00a0<\/p>\n Now, Hilary Perkins is no liberal trying to hide out in the bureaucracy. She\u2019s a self-described pro-life Christian conservative hired in the first Trump administration, but she was apparently forced out for the high crime of doing her job as a career lawyer. Is this administration really going to try to evict anyone who ever supported a Biden position? Will that leave anybody left?\u00a0<\/p>\n Roubein:<\/strong> I think what\u2019s notable is Sen. Josh Hawley here, who expressed concerns and I had heard expressed concerns to the White House, and the post on X from the FDA came an hour before the hearing. There were concerns that he was not going to make it out of committee and\u2014\u00a0<\/p>\n Rovner:<\/strong> Before the Marty Makary hearing.\u00a0<\/p>\n Roubein:<\/strong> Yes, sorry, before the vote in the HELP [Health, Education, Labor and Pensions] Committee on Marty Makary. And Hawley said because of that, he would vote to support him. What was interesting is two Democrats actually ended up supporting him, so he could have passed without Hawley\u2019s vote. But I think in general it poses a test for Marty Makary when he\u2019s an FDA commissioner, and how and whether he\u2019s going to get his people in and how he\u2019ll respond to different pressure points in Congress and with HHS and with the White House.\u00a0<\/p>\n Rovner:<\/strong> And of course, Hawley\u2019s not a disinterested bystander here, right?\u00a0<\/p>\n Karlin-Smith:<\/strong> So his wife was one of the key attorneys in the recent big Supreme Court case that was pushed down to the lower courts for a lack of standing, but she was trying to essentially get tighter controls on the abortion pill mifepristone. But it seems like almost maybe Hawley jumped too soon before doing all of his research or fully understanding the role of people at Justice. Because even before this whole controversy erupted, I had talked to people the day before about this and asked them, \u201cShould we read into this, her being involved in this?\u201d And everybody I talked to, including, I think, a lot of people that have different views than Perkins does on the case, that they were saying she was in a role as a career attorney. You do what your boss, what the administration, wants.\u00a0<\/p>\n If you really, really had a big moral problem with that, you can quit your job. But it\u2019s perfectly normal for an attorney in that kind of position to defend a client\u2019s interest and then have another client and maybe have to defend them wrongly. So it seems like if they had just maybe even picked up the phone and had a conversation with her, the whole crisis could have been averted. And she was on CNN yesterday trying to plead her case and, again, emphasize her positions because perhaps she\u2019s worried about her future career prospects, I guess, over this debacle.\u00a0<\/p>\n Rovner:<\/strong> Yeah, now she\u2019s going to be blackballed by both sides for having done her job, basically. Anyway, all right, well, one big Biden initiative that looks like it will continue is the Medicare Drug Price Negotiation program. And we think we know this because CMS announced last week that the makers of all of the 15 drugs selected for the second round of negotiations have agreed to, well, negotiate. Sarah, this is news, right? Because we were wondering whether this was really going to go forward.\u00a0<\/p>\n Karlin-Smith:<\/strong> Yeah, they\u2019ve made some other signals since taking over that they were going to keep going with this, including last week at his confirmation hearing, Dr. Oz, for CMS, also indicated he seemed like he would uphold that law and they were looking for ways to lower drug costs. So I think what people are going to be watching for is whether they yield around the edges in terms of tweaks the industry wants to the law, or is there something about the prices they actually negotiate that signal they\u2019re not really trying to get them as low as they can go? But this seems to be one populist issue for Trump that he wants to keep leaning into and keep the same consistency, I think, from his first administration, where he always took a pretty hard line on the drug industry and drug pricing.\u00a0<\/p>\n Rovner:<\/strong> And I know Ozempic is on that list of 15 drugs, but the administration hasn\u2019t said yet. I assume that\u2019s Ozempic for its original purpose in treating diabetes. This administration hasn\u2019t said yet whether they\u2019ll continue the Biden declaration that these drugs could be available for people for weight loss, right?\u00a0<\/p>\n Karlin-Smith:<\/strong> Correct. And I think that\u2019s going to be more complicated because that\u2019s so costly. So negotiating the price of drugs saves money. So yes, basically because Ozempic and Wegovy are the same drug, that price should be available regardless of the indication. But I\u2019m more skeptical that they continue that policy, because of the cost and also just because, again, HHS Secretary Robert F. Kennedy seems to be particularly skeptical of the drugs, or at least using that as a first line of defense, widespread use, reliance on that. He tends to, in general, I think, support other ways of medical, I guess, treatment or health treatments before turning to pharmaceuticals.\u00a0<\/p>\n Rovner:<\/strong> Eating better and exercising.\u00a0<\/p>\n Karlin-Smith:<\/strong> Correct, right. So I think that\u2019s going to be a hard sell for them because it\u2019s just so costly.\u00a0<\/p>\n Rovner:<\/strong> We will see. All right, that is as much news as we have time for this week. Now, it is time for our extra-credit segment, that\u2019s where we each recognize the story we read this week we think you should read, too. Don\u2019t worry if you miss it. We will put the links in our show notes on your phone or other mobile device. Jessie, you\u2019ve done yours already this week. Rachel, why don\u2019t you go next?\u00a0<\/p>\n Roubein:<\/strong> My extra credit, the headline is \u201cHer Research Grant Mentioned \u2018Hesitancy.\u2019 Now Her Funding Is Gone.<\/a>\u201d In The Washington Post by my colleague Carolyn Y. Johnson. And I thought the story was particularly interesting because it really dove into the personal level. You hear about all these cuts from a high level, but you don\u2019t always really know what it means and how it came about. So the backstory is the National Institutes of Health terminated dozens of research grants that focused on why some people are hesitant to accept vaccines.\u00a0<\/p>\n And Carolyn profiled one researcher, Nisha Acharya, but there was a twist, and the twist was she doesn\u2019t actually study how to combat vaccine hesitancy or ways to increase vaccine uptake. Instead, she studies how well the shingles vaccine works to prevent the infection, with a focus on whether the shot also prevents the virus from affecting people\u2019s eyes. But in the summary of her project, she had used the word \u201chesitancy\u201d once and used the word \u201cuptake\u201d once. And so this highlights the sweeping approach to halting some of these vaccine hesitancy research grants.\u00a0<\/p>\n Rovner:<\/strong> Yeah that was like the DOD [Department of Defense] getting rid of the picture of the Enola Gay, the plane that dropped the atomic bomb, because it had the word \u201cGay\u201d in it. This is the downside, I guess, of using AI for these sorts of things. Sarah.\u00a0<\/p>\n Karlin-Smith:<\/strong> I took a look at a KFF story by Arthur Allen, \u201cScientists Say NIH Officials Told Them to Scrub mRNA References on Grants<\/a>,\u201d and it\u2019s about NIH officials urging people to remove any reference to mRNA vaccine technology from their grants. And the story indicates it\u2019s not yet clear if that is going to translate to defunding of such research, but the implications are quite vast. I think most people probably remember the mRNA vaccine technology is really what helped many of us survive the covid pandemic and is credited with saving millions of lives, but the technology promise seems vast even beyond infectious diseases, and there\u2019s a lot of hope for it in cancer.\u00a0<\/p>\n And so this has a lot of people worried. It\u2019s not particularly surprising, I guess, because again, the anti-vaccine movement, which Kennedy has been a leader of, has been particularly skeptical of the mRNA technology. But it is problematic, I think, for research. And we spent a lot of time on this call talking about the decimation of the federal workforce that may happen here, and I think this story and some of the other things we talked about today also show how we may just decimate our entire scientific research infrastructure and workforce in the U.S. outside of just the federal government, because so much of it is funded by NIH, and the decisions they\u2019re making are going to make it impossible for a lot of scientists to do their job.\u00a0<\/p>\n Rovner:<\/strong> Yeah, we\u2019re also seeing scientists going to other countries, but that\u2019s for another time. Well, my extra credit this week, probably along the same lines, also from The Washington Post. It\u2019s part of a series called \u201cWho Is Government?<\/a>\u201d This particular piece [\u201cThe Free-Living Bureaucrat<\/a>\u201d] is by bestselling author Michael Lewis, and it\u2019s a sprawling \u2014 and I mean sprawling \u2014 story of how a mid-level FDA employee who wanted to help find new treatments for rare diseases ended up not only figuring out a cure for a child who was dying of a rare brain amoeba but managed to obtain the drug for the family in time to save her. It\u2019s a really good piece, and it\u2019s a really excellent series that tells the stories of mostly faceless bureaucrats who actually are working to try to make the country a better place.\u00a0<\/p>\n OK, that\u2019s this week\u2019s show. As always, if you enjoy the podcast, you can subscribe wherever you get your podcasts. We\u2019d appreciate it if you left us a review. That helps other people find us, too. Thanks as always to our producer, Francis Ying, and our editor, Emmarie Huetteman. As always, you can email us your comments or questions. We\u2019re at whatthehealth@kff.org, or you can still find me at X, @jrovner<\/a>, and at Bluesky, @julierovner<\/a>. Where are you guys these days? Sarah?\u00a0<\/p>\n Karlin-Smith:<\/strong> A little bit everywhere. X<\/a>, Bluesky<\/a>, LinkedIn<\/a> \u2014 @SarahKarlin or @sarahkarlin-smith.\u00a0<\/p>\n Rovner:<\/strong> Jessie.\u00a0<\/p>\n Hellmann:<\/strong> I\u2019m @jessiehellmann on X<\/a> and Bluesky<\/a>, and I\u2019m also on LinkedIn<\/a> more these days.\u00a0<\/p>\n Rovner:<\/strong> Great. Rachel.\u00a0<\/p>\n Roubein:<\/strong> @rachelroubein<\/a> at Bluesky, @rachel_roubein<\/a> on X, and also on LinkedIn<\/a>.\u00a0<\/p>\n Rovner:<\/strong> We will be back in your feed next week. Until then, be healthy.\u00a0<\/p>\n \tFrancis Ying \tEmmarie Huetteman To hear all our podcasts,\u00a0click here<\/a>.<\/em><\/p>\n And subscribe to KFF Health News\u2019 \u201cWhat the Health?\u201d on\u00a0Spotify<\/a>,\u00a0Apple Podcasts<\/a>,\u00a0Pocket Casts<\/a>, or wherever you listen to podcasts.<\/em><\/p>\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/p>\n
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