Gregg's Top Three Health Policy Articles

The premise of this newsletter is that you can keep up with major health policy developments by reading three curated articles a week. While generally true, there has been a dizzying pace of seismic changes in the past few weeks. I strongly encourage readers to take a deeper dive to more fully understand the profound implications of recent developments.

The Top Three...

The Washington Post: Widespread Layoffs, Purge Of Leadership Underway At U.S. Health Agencies Senior leaders across the Department of Health and Human Services were put on leave and countless other employees lost their jobs Tuesday as the Trump administration began a sweeping purge of the agencies that oversee government health programs. Top officials at the National Institutes of Health, the Centers for Disease Control and Prevention, and the Food and Drug Administration were put on administrative leave or offered reassignment to the Indian Health Service. Other employees began receiving layoff notices or learned they had lost their jobs when their entry badges no longer worked Tuesday morning. (Johnson, Roubein, Achenbach, Sun and Weber, 4/1)

Stat: Senate Confirms Oz To Run Medicare And Medicaid In a party-line vote of 53-45, the Senate on Thursday confirmed Mehmet Oz to lead the Centers for Medicare and Medicaid Services. Oz’s confirmation was expected; he is not as controversial as Health and Human Secretary Robert F. Kennedy Jr. or some other Trump picks to run health agencies within the HHS. (Wilkerson, 4/3)

CBS News: Federal Judge Temporarily Blocks $11 Billion In Trump Administration's Cuts To Public Health Funding A federal judge on Thursday temporarily blocked the Trump administration's move to cut over $11 billion in public health funding to states after 23 states and the District of Columbia sued to keep the funding intact. The coalition of states sued the Health and Human Services Department and Secretary Robert F. Kennedy Jr., arguing that the money is used for many "urgent public health needs," including tracking diseases, funding access to vaccines and mental health and addiction services, and improving health infrastructures. (Rosen and Tin, 4/3)

For a Deeper Dive...

Forbes: How The Layoff Of 10,000 Health Workers From HHS Could Affect Your Health This degree of downsizing may slow the approval process for many lifesaving drugs and delay inspection of food processing facilities. As an example, once the application for a new drug is submitted to the FDA, the agency has six to 10 months to approve the drug. Fewer employees mean less manpower to evaluate the safety and efficacy of new drugs that could dramatically impact diseases like cancer, diabetes and heart failure—issues that affect millions of Americans. (Awan, 3/30)

The Wall Street Journal: FDA’s Top Vaccine Official Forced Out The Food and Drug Administration’s top vaccine official has been pushed out, according to people familiar with the matter. Dr. Peter Marks, who played a key role in the first Trump administration’s Operation Warp Speed to develop Covid-19 vaccines, stepped down Friday. He submitted his resignation after a Health and Human Services official earlier in the day gave him the choice to resign or be fired, people familiar with the matter said. “It has become clear that truth and transparency are not desired by the Secretary, but rather he wishes subservient confirmation of his misinformation and lies,” Marks wrote in a resignation letter referring to HHS Secretary Robert F. Kennedy Jr. (Whyte, 3/28)

Stat: FDA Layoffs Roil Agency On Marty Makary’s First Day As Commissioner Marty Makary’s first official day as commissioner of the Food and Drug Administration began with employees in tears, learning from security guards that they were losing their jobs. The news release announcing the start of his tenure points readers to a press office that, after large-scale layoffs, basically no longer exists. His first email to staff summarized his resume. (Lawrence and Todd, 4/1)

Politico: Which Jobs Were Cut At CDC? Here’s A List The layoffs at CDC this week hit global and environmental health as well as HIV prevention programs especially hard, according to an overview document obtained by POLITICO. The document, shared during an agency meeting Tuesday, paints a picture of a Centers for Disease Control and Prevention that will be more narrowly focused on infectious disease, with a significantly less holistic view of public health. The job cuts include the elimination of about a fourth of the staff at the National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention and about a third of the workers at the CDC’s Injury Center. (Gardner, 4/3)

The New York Times: Trump Administration Demands Additional Cuts At C.D.C. Alongside extensive reductions to the staff of the Centers for Disease Control and Prevention, the Trump administration has asked the agency to cut $2.9 billion of its spending on contracts, according to three federal officials with knowledge of the matter. The administration’s cost-cutting program, called the Department of Government Efficiency, asked the public health agency to sever roughly 35 percent of its spending on contracts about two weeks ago. The C.D.C. was told to comply by April 18, according to the officials. (Mandavilli, 4/2)

MedPage Today: Musk, DOGE Created New HHS Org Chart Elon Musk and his Department of Government Efficiency (DOGE) team created the new org chart for HHS, said Robert F. Kennedy Jr. during an interview on News Nation. The HHS secretary said when he arrived at the department, the org chart was "incomprehensible," and Musk "came in for the first time with a real org chart for the agency." Kennedy's statements were confirmed during a Fox News interview with Musk and the DOGE team. DOGE member Anthony Armstrong -- a former Morgan Stanley banker who is now a senior advisor to the Office of Personnel Management -- outlined the team's approach to agency reorganizations. "We literally go in -- and this is mostly at night and over weekends -- with the secretaries of those agencies, and their senior staff, and we're going line by line in the employee org charts ... from the bottom up, talking about every function," Armstrong said. (Fiore, 4/1)

KFF Health News: What’s Lost: Trump Whacks Tiny Agency That Works To Make The Nation's Health Care Safer Sue Sheridan’s baby boy, Cal, suffered brain damage from undetected jaundice in 1995. Helen Haskell’s 15-year-old son, Lewis, died after surgery in 2000 because weekend hospital staffers didn’t realize he was in shock. The episodes turned both women into advocates for patients and spurred research that made American health care safer. On April 1, the Trump administration slashed the organization that supported that research ... and fired roughly half of its remaining employees as part of a perplexing reorganization of the federal Health and Human Services Department. (Allen, 4/3)

The Hill: HHS Staff To Brief House Committee Following Massive Agency Layoffs House Democrats on the Energy and Commerce committee are demanding a hearing with Health and Human Services Secretary (HHS) Robert F Kennedy Jr. about the massive layoffs happening at his agency. But so far, GOP leadership has committed to a staff-level briefing only, according to a spokesperson for Energy and Commerce Chair Brett Guthrie (R-Ky.). Health subcommittee ranking member Diana DeGette (D-Colo.) in a statement Thursday said a staff briefing isn’t enough. (Weixel, 4/3)

Axios: RFK Jr.'s Emerging Vision For HHS: More Centralized Power Health and Human Services Secretary Robert F. Kennedy Jr. says sweeping layoffs and restructuring in the department will bring order to a bureaucracy he claims is in "pandemonium." But experts say the overhaul also likely gives him far greater control over dozens of federal health agencies. (Reed, 3/31)

The Hill: Kennedy Suggests 20 Percent Of HHS Cuts May Be Reversed Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. said that he expects about 20 percent of fired employees to be reinstated as the agency backtracks after making cuts directed by the Department of Government Efficiency (DOGE). “Some programs that were cut, they’re being reinstated,” Kennedy told reporters Thursday. “Personnel that should not have been cut were cut. We’re reinstating them.” (Irwin, 4/3)

The New York Times: Alabama Can’t Prosecute Those Who Help With Out-Of-State Abortions, Judge Rules Alabama cannot prosecute doctors and reproductive health organizations for helping patients travel out of the state to obtain abortions, a federal judge ruled on Monday. Alabama has one of the strictest abortion bans in the country, and in 2022 its attorney general, Steve Marshall, a Republican, raised the possibility of charging doctors with criminal conspiracy for recommending abortion care out of state. On Monday, the judge, Myron H. Thompson of the Middle District of Alabama, in Montgomery, ruled that Mr. Marshall would be violating both the First Amendment and the right to travel if he sought prosecution. (Cochrane, 3/31)

Politico: One Takeaway From POLITICO’s Health Care Summit: Trump Has Broken Open America’s Partisan Divide On Health President Donald Trump’s allies and adversaries battled over the best ways to improve the U.S. health care system at POLITICO’s Health Care Summit on Wednesday, highlighting deep divides over the upheaval the administration has unleashed. The partisans sparred after Trump dismissed thousands of health agency employees, launched a massive restructuring of the nation’s health agencies, and proposed stripping billions from university research budgets. (Hooper and Paun, 4/2)

Politico: Republicans Say Efficiencies Will Save Medicaid. Dems Say 'Not Possible' The Trump administration and Republicans broadly have said they can cut Medicaid’s budget without hurting patient care by finding efficiencies. Colorado Rep. Diana DeGette, the top Democrat on a key health care panel, says that’s not so. “We just simply don’t have that much money,” DeGette said at POLITICO’s Health Care Summit Wednesday. (Reader, 4/2)

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A few years ago I started a weekly e-mail for friends and colleagues who want to keep up on major federal health policy developments but did not have time to plod through all the minutiae--they were busy doing important things like running organizations and taking care of patients! Much to my surprise, it became pretty popular. I have now converted to a weekly newsletter format so you can manage your own subscription preferences and forward to others that might be interested.

These summaries represent my judgement on health policy issues that may not on the front pages, but are relevant to clinicians, administrators, and educators. I monitor many news sources and clipping services to identify content for this newsletter and I try hard to be as factual, balanced, and non-partisan as possible. While the articles are written by others (with credit attributed), the choice of what to include is entirely mine. If you are interested in receiving a daily summary of health policy news, you might consider signing up for the KHN Morning Briefing. If you enjoy podcasts, I suggest What the Health? and Tradeoffs.

-Gregg S. Margolis, PhD