Gregg's Top Three Health Policy Articles

This was a very big week in health policy. While I was able to narrow it down to three articles, but if you are able, check out the “For a Deeper Dive” section for more context and perspective.

The Top Three...

Politico: RFK Jr.’s Massive Cuts Stun Staff, Leave Senior Employees Scrambling Robert F. Kennedy Jr.’s move to gut and reorganize the federal health department shocked many people tasked with making it happen, and left others fearful that everything from the safety of the nation’s drug supply to disease response could be at risk. The disaster preparedness agency in the Department of Health and Human Services has just two days to prepare a plan to fold itself into the Centers for Disease Control and Prevention, according to an HHS official, granted anonymity for fear of retribution. (Cancryn, Cirruzzo, Reader, Lim, Gardner and King, 3/27)

The New York Times: Senate Confirms Bhattacharya And Makary To H.H.S. Posts The Senate on Tuesday confirmed Dr. Martin A. Makary as commissioner of the Food and Drug Administration and Dr. Jay Bhattacharya as director of the National Institutes of Health, installing two critics of the medical establishment to influential posts amid a Trump administration campaign to cut spending at health agencies. (Mueller, 3/25)

Stat: Trump Picks Susan Monarez To Run The CDC After the chaotic withdrawal of President Trump’s previous nominee to lead the Centers for Disease Control and Prevention, the president selected the CDC’s acting director, Susan Monarez, to lead the agency. Monarez would be the first CDC director since 1953 not to have a medical degree. She has a B.S. and Ph.D. in microbiology from the University of Wisconsin-Madison. (Owermohle and Branswell, 3/24)

For a Deeper Dive...

MedPage Today: Patient Safety Research May Be Imperiled If AHRQ Is Downsized, Experts Warn The Trump administration's efforts to downsize the Agency for Healthcare Research and Quality (AHRQ) are causing alarm among public health workers as well as researchers who study patient safety and diagnostic errors. "Words like 'catastrophic' come to mind," David Newman-Toker, MD, PhD, director of the Armstrong Institute Center for Diagnostic Excellence at Johns Hopkins University in Baltimore, said in a phone interview Wednesday. "From the perspective of diagnostic safety and quality and diagnostic excellence, AHRQ is really the only substantive funder of this work. It is a tiny investment for the return." (Frieden, 3/27)

NPR: Mental Health And Addiction Funding On The Federal Chopping Block State and county public health departments and nonprofit groups are reeling after the Trump administration announced abrupt cancellation and revocation of roughly $11.4 billion in COVID-era funding for grants linked to addiction, mental health and other programs. "This is chopping things off in the middle while people are actually doing the work," said Keith Humphreys, an addiction policy researcher at Stanford University, who also volunteers doing harm reduction work with people in addiction. He warned the move could trigger layoffs and treatment disruptions. (Mann, 3/27)

MedPage Today: RFK Jr.'s Mass Layoffs: How Many Jobs Top Health Agencies Will Lose HHS will slash 10,000 full-time employees, which combined with its previous buyout and early retirement initiatives, will take the agency down from 82,000 to 62,000 workers. It will also create a new "Administration for a Healthy America," or AHA, that will combine five independent agencies into one. Shedding 10,000 employees will save the government $1.8 billion per year, the agency said. It announced the changes in a press release and a fact sheet on Thursday morning, and HHS Secretary Robert F. Kennedy Jr. simultaneously posted a video to X. (Fiore, 3/27)

Fierce Healthcare: Medicaid, SNAP Cuts To Lead To 1M Job Losses: Commonwealth Fund As the Trump administration and legislators weigh cuts to federal spending, Medicaid, the Supplemental Nutrition Assistance Program (SNAP) and other entitlements are set to be prime targets. But a new report from the Commonwealth Fund and the George Washington University Milken Institute School of Public Health warns that doing so could cause significant financial turmoil among the states. The paper estimates that budget cuts for Medicaid and SNAP could lead to the loss of 1 million jobs and a $113 billion decline in states' gross domestic product. (Minemyer, 3/27)

Becker's Hospital Review: Hospital Finance, Supply Leaders Predict 15% Increase In Tariff-Related Costs In a survey of 200 healthcare industry experts, 82% said they expect tariff-related import expenses to increase hospital and health system costs by 15% in the next six months. Black Book Market Research, a healthcare research and analysis firm, conducted the survey in late January — about a month before the U.S. enacted 25% tariffs on products from Canada and Mexico and a 10% tariff on items from China. (Twenter, 3/27)

Stat: On NIH Director’s First Day, The Agency Tackles One Of His Priorities — Ending ‘Censorship’ In Science In October, Jay Bhattacharya, then a health economist at Stanford University, posted on X: “If you favor government control of misinformation, you are an enemy of free speech.” On Wednesday, on his first morning serving as director of the National Institutes of Health, the agency directed staff to compile a list of grants and contracts related to “fighting misinformation or disinformation” — a step that in recent weeks has preceded the termination of research funding in areas that run counter to the Trump administration’s priorities. (Oza, 3/26)

AP: 5 High-Level CDC Officials Are Leaving In The Latest Turmoil For The Public Health Agency The Centers for Disease Control and Prevention was rocked by five high-level departures on Tuesday in the latest turmoil for the nation’s top public health agency. The departures were announced at a meeting of agency senior leaders. The Atlanta-based CDC has two dozen centers and offices. The heads of five of them are stepping down, and that follows three other departures in recent weeks. This means close to a third of the agency’s top management is leaving or left recently. (Stobbe, 3/25)

ProPublica: NIH Ends Funding To Study The Health Effects Of Climate Change The National Institutes of Health will no longer be funding work on the health effects of climate change, according to internal records reviewed by ProPublica. The guidance, which was distributed to several staffers last week, comes on the back of multiple new directives to cut off NIH funding to grants that are focused on subjects that are viewed as conflicting with the Trump administration’s priorities, such as gender identity, LGBTQ+ issues, vaccine hesitancy, and diversity, equity and inclusion. (Waldman and Lerner, 3/24)

Modern Healthcare: ACOs In Shared Savings Program Wary As CMS Halts Pay Models Accountable care organizations and healthcare providers are closely watching for changes to Medicare’s permanent value-based payment program as the Trump administration begins putting its stamp on Medicare policy. Weeks into President Donald Trump's second term, stakeholders are assessing whether the Centers for Medicare and Medicaid Services is committed to the Medicare Shared Savings Program or if the agency will heed calls from conservatives to scrap or diminish the ACO initiative, which the Heritage Foundation's Project 2025 playbook for the administration says should be terminated. (Early, 3/25)

The Washington Post: Vaccine Skeptic Hired To Head Federal Study Of Immunizations And Autism A vaccine skeptic who has long promoted false claims about the connection between immunizations and autism has been tapped by the federal government to conduct a critical study of possible links between the two, according to current and former federal health officials. The Department of Health and Human Services has hired David Geier to conduct the analysis, according to the officials, who spoke on the condition of anonymity for fear of retaliation. (Sun and Nirappil, 3/25)

The New York Times: ‘Chaos And Confusion’ At The N.I.H., The Crown Jewel Of American Science Seven senior investigators working in different parts of the National Institutes of Health described rules put in place on orders from the Department of Government Efficiency that risk hampering and undermining American medical science. All spoke on the condition of anonymity because they feared for their jobs for speaking publicly. One said that DOGE had begun a reign of “chaos and confusion.” The scientists warned that it had the potential to seriously weaken the N.I.H. (Kolata, 3/24)

Politico: Trump Admin Considers Shutting Down Some CDC Expert Panels The Trump administration is considering killing some panels of outside experts that advise the CDC on key health threats like HIV and avian flu, according to an email seen by POLITICO. The email, sent to CDC leaders Friday, said the Department of Health and Human Services is “recommending termination” of the panels that are not mandated by law. The email said CDC leaders would need to justify keeping the committees by 10 tonight, but a second, follow-up email said that “no response is required at this time.” (Gardner, 3/21)

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For the Visual Among Us...

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