Gregg's Top Three Health Policy Articles

A new section, “What Is Changing?” has been added to the newsletter and will include articles that describe changes to major federal health programs as objectively as possible—I will leave it to the reader to determine if these changes are worth the ‘trade-offs.’

If you can only read three things about health policy this week, I suggest...

The Top Three...

AP: Trump 100 Days: Public Health At the Department of Health and Human Services, 10,000 jobs are gone. Billions of dollars in research sent to scientists and universities was shut off. Public meetings to discuss flu shots and other vaccines have been canceled. Fluoride in drinking water may be the next to go, according to Health Secretary Robert F. Kennedy Jr. Kennedy has done a blitz of his “Make America Healthy Again” campaign at day cares, schools and health centers around the country where he has promised to work with Trump’s other agency leaders to prohibit soda from the federal Supplemental Nutrition Assistance Program, limit dyes in the food supply and call for fluoride to be removed from drinking water. (Seitz, 4/27)

Politico: The White House Wants To Avoid Medicaid Cuts. To GOP Hard-Liners, They’re Essential. The fate of Republicans’ sweeping domestic policy bill is snagged on a crucial question: Are deep cuts to Medicaid, the federal health care program covering nearly 80 million Americans, something to be avoided? Or are they the whole point of pursuing the legislation? That clash — with the White House on one side and GOP hard-liners in Congress on the other — is now playing out in closed-door meetings and in the hallways of Capitol Hill as the party rushes to write the megabill and potentially cut more than a half-trillion dollars from the safety-net health program over the coming decade. (Cancryn, Leonard and Lee Hill, 5/1)

The Wall Street Journal: U.S. Delays Hospital Payments As Medicaid Scrutiny Intensifies Unexpected delays in billions of dollars of supplemental Medicaid payments have forced some hospitals across the country to cut costs including laying off staff and pausing payments to medical suppliers. Hospital associations in at least 10 states said the Centers for Medicare and Medicaid Services, the federal agency responsible for approving funds known as state-directed payments, has been unusually slow at processing applications for them. Some of the delays date to the fall of 2024. (Mosbergen, 5/2)

For a deeper Dive…

The New York Times: Kennedy Advises New Parents To ‘Do Your Own Research’ On Vaccines Health Secretary Robert F. Kennedy Jr. advised parents of newborns to “do your own research” before vaccinating their infants during a televised interview in which he also suggested the measles shot was unsafe and repeatedly made false statements that cast doubt on the benefits of vaccination and the independence of the Food and Drug Administration. Mr. Kennedy made the remarks to the talk show host Dr. Phil in an interview that aired Monday on MeritTV to mark the 100th day of the Trump administration. (Gay Stolberg and Jewett, 4/29)

The Washington Post: RFK Jr. Will Order 'Placebo' Testing For New Vaccines, Alarming Health Experts Health and Human Services Secretary Robert F. Kennedy Jr. intends to shift the way vaccines are tested, a move that the agency said will increase transparency but that medical experts fear could limit access to vaccines and undermine the public’s trust in immunization depending on its implementation. The potential change outlined in a statement says all new vaccines will be required to undergo placebo testing, a procedure in which some people receive the vaccine and others receive an inert substance — such as a saline shot — before the results are compared. (Weber, Roubein, Sun and Johnson, 4/30)

Roll Call: Supreme Court Decides Medicare Reimbursement Calculation The Supreme Court sided on Tuesday with the Department of Health and Human Services in a dispute over the rate under Medicare the government pays to hospitals that serve low-income patients. The 7-2 decision rejected an attempt from a group of more than 200 hospitals across 30 states to change the formula the government uses to calculate reimbursement for hospitals that serve a disproportionate share of low-income patients. (Macagnone, 4/29)

NBC News: Kennedy Planning $20 Million HHS 'Take Back Your Health' Ad Campaign Health and Human Services Secretary Robert F. Kennedy Jr. plans to launch a sweeping, four-year public relations campaign called “Take Back Your Health” that could cost tens of millions of dollars, according to a document obtained by NBC News. ... The document, a request for proposals, calls for public relations firms to bid to run the campaign. The winning firm would employ up to 30 people to manage the campaign and oversee the purchase of up to three ads a day on five major television networks. (Strickler, 4/29)

The New York Times: Trump’s Cuts To Science Funding Could Hurt U.S. Economy, Study Shows Cutting federal funding for scientific research could cause long-run economic damage equivalent to a major recession, according to a new study from researchers at American University. In recent months, the Trump administration has sought to cancel or freeze billions of dollars in grants to scientists at Columbia, Harvard and other universities, and has moved to sharply curtail funding for academic medical centers and other institutions. Deeper cuts could be on the way. As soon as this week, the White House is expected to propose sharp reductions in discretionary spending, including on research and development, as part of the annual budget process. (Casselman, 4/30)

What Is Changing?

MedPage Today: CDC Advisory Committee's Days Are Numbered With several members receiving termination letters and its webpage archived, public health experts believe the days are numbered for CDC's Healthcare Infection Control Practices Advisory Committee (HICPAC). HICPAC develops guidance for preventing and controlling healthcare-associated infections. While the committee operates with less attention than CDC's well-known Advisory Committee on Immunization Practices (ACIP), it made headlines in recent years after some groups pushed back on revisions to one of its infection control guidances. (Fiore, 4/29)

AP: Email Discloses HHS Plans To Cut Research Of Child Welfare Programs The Trump administration could gut research on the effectiveness of child welfare programs, with plans to terminate dozens of university grants studying improvements to Head Start and child care policy, according to a spreadsheet mistakenly made public this week. The document listed more than 150 research projects under consideration for termination by the U.S. Department of Health and Human Services. It covered grants funded by the Office of Planning, Research and Evaluation, which says it “builds evidence to improve lives” by helping policymakers evaluate programs that help low-income children and families. (Foley, 5/2)

The New York Times: Citing N.I.H. Cuts, A Top Science Journal Stops Accepting Submissions Environmental Health Perspectives, widely considered the premier environmental health journal, has announced that it would pause acceptance of new studies for publication, as federal cuts have left its future uncertain. For more than 50 years, the journal has received funding from the National Institutes of Health to review studies on the health effects of environmental toxins — from “forever chemicals” to air pollution — and publish the research free of charge. (Rosenbluth and Mandavilli, 4/29)

CIDRAP: PEPFAR Funding Cuts Will Lead To Up To 74,000 Excess HIV Deaths In Africa By 2030, Experts Warn The Trump administration's executive order to suspend funds intended to prevent and treat HIV in sub-Saharan Africa (SSA) will result in 60,000 to 74,000 excess deaths over the next 5 years—and possibly many more—a mathematical modeling study published late last week in eClinicalMedicine forecasts. On January 24, 2025, the US government froze all foreign aid programs, including the President's Emergency Plan for AIDS Relief (PEPFAR), for 90 days. (Van Beusekom, 4/28)

KFF Health News: Federal Cuts Gut Food Banks As They Face Record Demand Food bank shortages caused by high demand and cuts to federal aid programs have some residents of a small community that straddles Idaho and Nevada growing their own food to get by. For those living in Duck Valley, a reservation of about 1,000 people that is home to the Shoshone-Paiute Tribes, there’s just one grocery store where prices are too high for many to afford, said Brandy Bull Chief, local director of a federal food distribution program for tribes. The next-closest grocery stores are more than 100 miles away in Mountain Home, Idaho, and Elko, Nevada. And the local food bank’s troubles are mirrored by many nationwide, squeezed between growing need and shrinking aid. (Orozco Rodriguez, 5/1)

The New York Times: Trump Budget Draft Ends Narcan Program And Other Addiction Measures. The opioid overdose reversal medication commercially known as Narcan saves hundreds of thousands of lives a year and is routinely praised by public health experts for contributing to the continuing drop in opioid-related deaths. But the Trump administration plans to terminate a $56 million annual grant program that distributes doses and trains emergency responders in communities across the country to administer them, according to a draft budget proposal. In the document, which outlines details of the drastic reorganization and shrinking planned for the Department of Health and Human Services, the grant is among many addiction prevention and treatment programs to be zeroed out. (Hoffman, 4/25)

NBC News: Health Program For 9/11 Illnesses Faces Uncertain Future After Federal Staffing Cuts More than 23 years after the Twin Towers collapsed, blanketing lower Manhattan in toxic dust and debris, the number of people diagnosed with 9/11-related illnesses is still growing. Since 2011, the main resource for people exposed to the fumes has been the World Trade Center Health Program, which covers treatment for cancer, asthma and post-traumatic stress disorder, among other health conditions. (Bendix, 4/26)

Bloomberg: Global Race To Lure US Researchers Intensifies After Trump Funding Cuts A global race to recruit US scientists is heating up as President Donald Trump’s sweeping cuts to research funding and federal agencies trigger an exodus from the country’s research institutions. Canada, France, Germany, Denmark, Norway, and Australia are among nations offering incentives — including funding, streamlined immigration pathways and competitive relocation packages — to entice scientists facing mounting uncertainty at home. (Gale, 4/27)

The Boston Globe: Amid Trump Cuts, How Will Labs Make Up For Lost Research Funding? The funding geyser that propelled US medical advances for much of the past century may be drying up as the Trump administration pulls back federal research money from Harvard University and other New England institutions that have been reliable engines of discovery and innovation. Yet as labs scramble for alternative funding sources — from foundations, industry, even their university hosts — there’s little hope, in the short term, that those players can fill the gaps resulting from White House rollbacks. (Gokee, Saltzman and Weisman, 4/28)

Politico: Trump Administration To Close A Civil Rights Office In RFK Jr.'s HHS The Centers for Medicare and Medicaid Services will close its civil rights office in June, according to an email sent to staff Monday and viewed by POLITICO. The office closure is part of HHS Secretary Robert F. Kennedy Jr.’s mass reorganization of his department that has seen the agency downsized by roughly 20 percent. Kennedy and President Donald Trump have also focused on programs and agencies they say promote diversity, equity and inclusion. (Cirruzzo, 4/28)

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