Julie Rovner, Author at KFF Health News

Listen: Amid Shutdown Stalemate, Families Brace for SNAP Cuts and Paycheck Limbo

Julie Rovner, KFF Health News — Fri, 24 Oct 2025 09:00:00 +0000

Listen: Health care has been at the heart of the federal government’s shutdown. KFF Health News chief Washington correspondent Julie Rovner appeared on WAMU’s Oct. 22 “Health Hub” to explain the health care compromises some lawmakers want before they will agree to reopen the government.

Affordable Care Act tax credits are at the heart of one of the longest government shutdowns in U.S. history. The impact is starting to be felt by families and federal employees. Food assistance programs could run out of money at the end of the month. And federal health agencies such as the Centers for Disease Control and Prevention have faced layoffs.

KFF Health News chief Washington correspondent Julie Rovner appeared on WAMU’s Oct. 22 “Health Hub” to discuss the possible compromises that could reopen the government.

KFF 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 KFF.

USE OUR CONTENT

This story can be republished for free (details).

Listen: Why ‘TrumpRx’ Might Not Save You Money

Julie Rovner, KFF Health News — Thu, 09 Oct 2025 09:00:00 +0000

KFF Health News chief Washington correspondent Julie Rovner appeared Oct. 6 on the podcast “Today, Explained” to discuss TrumpRx, President Donald Trump’s proposal for a direct-to-consumer website aimed at lowering prescription drug costs.

While few details were made public when the program was announced on Sept. 30, Rovner explains that consumers who are enrolled in health plans through their employers or government programs may save more money on drugs using their insurance or drugmakers’ patient discount programs.

USE OUR CONTENT

This story can be republished for free (details).

Shutdown Halts Some Health Services as Political Risks Test Parties’ Resolve

Wed, 01 Oct 2025 09:00:00 +0000

Threats of a federal government shutdown have gone from being an October surprise to a recurring theme. This time around, though, the stakes are higher.

Federal funding ran out at midnight on Oct. 1, after Congress failed to pass even a stopgap budget while negotiations continued.

Now the question is how long the deadlock will last, with Democrats pitted against Republicans and a presidential administration that has broken with constitutional norms and regularly used political intimidation and primary threats to achieve its ends. Because Republicans hold only a slim majority in the Senate, any deal will need to attract at least a few Democratic votes.

Ramifications from a shutdown on public health systems and health programs will be felt far beyond Washington, D.C., halting almost all of the federal government’s nonessential functions, including many operations related to public health.

Even on Sept. 30, as the clock ticked toward midnight, President Donald Trump renewed threats about mass firings of federal workers if Democrats didn’t acquiesce to GOP demands. Some people worry that such workforce reductions would further enable the administration to undermine federal government operations and reduce the budget impasse to what’s been described as three-dimensional chess or a game of chicken.

Such threats to fire, rather than temporarily suspend, federal workers are “unprecedented,” said G. William Hoagland of the Bipartisan Policy Center. The lack of negotiations between Capitol Hill Republicans and Democrats in advance of the shutdown is also unprecedented in his experience, said Hoagland, a longtime GOP Senate Budget Committee aide.

The stalemate centers largely on health coverage, with Democrats and Republicans clashing over the Affordable Care Act and Medicaid cuts. For Americans with ACA marketplace plans, government subsidies cap the percentage of household income they must pay toward premiums. Lawmakers expanded the subsidies in 2021 and extended that additional help through the end of 2025, and the looming expiration of those expanded subsidies would increase costs and reduce eligibility for assistance for millions of enrollees.

Democrats want a further extension of the subsidies, but many GOP lawmakers are resistant to extending them as is and say that debate must wait until after a budget deal to keep the federal government afloat. Antagonism has grown, with the parties in a pitched battle to convince voters the other party is to blame for the government’s closure.

Said Senate Minority Leader Chuck Schumer on the Senate floor Sept. 30: “Republicans have chosen the losing side of the health care debate, because they’re trying to take away people’s health care; they’re going to let people’s premiums rise.”

But Senate Majority Leader John Thune accused Democrats of attempting to “take government funding hostage.”

The longer a shutdown lasts, the more impacts could be felt. For example, some community health centers would be at risk of closure as their federal funding dries up.

Long-term projects by the Federal Emergency Management Agency to reduce damage from future natural disasters will stop, for example. Rescue services at national parks that stay open will be limited. And at the National Institutes of Health, many new patients awaiting access to experimental treatments may not be admitted to its clinical center.

Entitlement programs such as Medicaid and Medicare will continue, as will operations at the Indian Health Service. But disease surveillance, support from the Centers for Disease Control and Prevention to local and state health departments, and funding for health programs will all be hampered, based on federal health agencies’ contingency plans.

The Department of Health and Human Services is expected to furlough about 40% of its workforce, which has already been downsized by about 20,000 positions under the Trump administration. Across the federal government, roughly 750,000 employees will be furloughed, according to an estimate released Sept. 30 by the Congressional Budget Office, a nonpartisan agency that calculates the cost of legislation. While furloughed employees won’t be working, eventually they will get back pay, totaling about $400 million daily, the CBO estimated.

At HHS, research is expected to pause on the links between drug prices and the Inflation Reduction Act, the major law enacted under former President Joe Biden to boost the economy. Despite reports that Food and Drug Administration Commissioner Marty Makary said the FDA would basically be untouched, the agency won’t accept new drug applications and food safety efforts will be reduced. Federal oversight of a program that helps hospitals save lives and evacuate individuals in environmental crises is expected to stop.

Fewer federal staff will be available to provide help to Medicaid and Medicare enrollees. CDC responses to inquiries about public health matters will be suspended. And the work of a federal vaccine injury program is also anticipated to stop.

Congressional Democrats insist the ACA subsidies must be renewed now because enrollment for the Obama-era health program opens on Nov. 1. Without the extended subsidies, health insurers are warning of double-digit premium hikes for millions of enrollees.

House Democratic Leader Hakeem Jeffries has argued that a “Republican-caused health care crisis” is hanging over Americans as a result of Trump’s new tax-and-spending bill, which adds restrictions to Medicaid that are expected to kick millions off the program. Republicans have also advanced mass layoffs and funding cuts at the nation’s health department and caused widespread confusion over access to some vaccines.

“We’re not going to simply go along to get along with a Republican bill that continues to gut the health care of everyday Americans,” Jeffries told reporters Sept. 29. “These people have been trying to repeal and displace people off the Affordable Care Act since 2010.”

Republicans, meanwhile, have blasted Democrats for holding up funding over the subsidies and say any deal will require concessions.

“If there were some extension of the existing policy, I think it would have to come with some reforms,” Thune, the Senate Republican leader, said Sept. 26.

Such a deal may involve changes to a policy that caps what consumers have to pay for ACA marketplace plans at 8.5% of their income, no matter how much they earn. It could also alter their ability to obtain plans with no premiums, an option that became more widely available because of the beefed-up subsidies.

Adding restrictions to the ACA subsidies is likely to decrease enrollment in the program, which saw declines during the first Trump administration and did not reach 20 million for the first time until last year, a milestone reached in large part due to the subsidies.

Several Republicans have expressed interest in extending the subsidies, including a group of GOP representatives who proposed legislation to do so last month.

Democrats may be betting that the timing of the shutdown will put pressure on their Republican colleagues to come to the negotiation table on the ACA subsidies.

Within days of the government’s closure, ACA enrollees are expected to get notices from their health insurers advising them of steeper premiums. Insurers have said the expiring subsidies have forced those large premium hikes because the healthiest and youngest people are more likely to opt out of coverage when prices go up.

The White House, meanwhile, ramped up its pressure campaign on Democrats. White House press secretary Karoline Leavitt insisted Sept. 29 that Trump wants to keep the government open.

“Our most vulnerable in our society and our country will be impacted by a government shutdown,” she said.

USE OUR CONTENT

This story can be republished for free (details).

To Cut Medicaid, the GOP’s Following a Path Often Used To Expand Health Care

Julie Rovner, KFF Health News — Wed, 02 Jul 2025 09:00:00 +0000

President Donald Trump’s “One Big Beautiful” budget reconciliation bill would make some of the most sweeping changes in health policy in years, largely affecting Medicaid and Affordable Care Act plans — with reverberations felt throughout the health care system.

With only a few exceptions, the budget reconciliation process — which allows the political party in control to pass a bill with only 51 votes in the Senate, rather than the usual 60 — is how nearly every major piece of health legislation has passed Congress since the 1980s.

But using reconciliation to constrict rather than expand health coverage, as the GOP is attempting now? That is unusual.

One of the best-known programs born via reconciliation is the “COBRA” health insurance continuation, which allows people who leave jobs with employer-provided insurance to keep it for a time, as long as they pay the full premium.

That is one of dozens of health provisions tucked into COBRA, or the Consolidated Omnibus Budget Reconciliation Act of 1985. Also included was the Emergency Medical Treatment and Active Labor Act , which requires hospitals that take Medicare to treat or transfer patients with medical emergencies, regardless of their insurance status — a law that’s become a focus of abortion opponents as they seek to limit access to the procedure.

A key reason so much health policy has passed this way has to do with how Congress manages the federal budget. Federal government spending falls into two categories: mandatory, or spending required by existing law, and discretionary, which traditionally is allocated and renewed each year as part of the appropriations process.

Lawmakers use the reconciliation process to make changes to mandatory spending programs — Medicare and Medicaid are among the largest — as well as tax policy. (For complicated political reasons, reconciliation bills cannot touch Social Security, the last prong in the entitlement program trifecta.)

Reconciliation comes into play only if it is needed to reconcile taxes or mandatory spending to comply with the terms Congress sets for itself each year, through the annual budget resolution. This year the GOP’s focus is finding the cash to renew Trump’s expiring tax cuts, which largely benefit wealthier Americans, and boost military and border security spending.

In years when Congress orders a reconciliation bill, health policy almost always plays a major part. Usually, reconciliation instructions call for reductions in payments to health providers under Medicare — which costs the most of the federal health programs.

For much of the 1980s and 1990s, Democrats in Congress quietly used reconciliation to expand eligibility for the Medicaid program, often by cutting more than the budget called for from Medicare. For every $5 cut from Medicare, about $1 would be redirected to provide Medicaid to more low-income people.

But budget reconciliation has also become a convenient way to make policy changes to the nation’s major health programs, as it is usually considered a “must-pass” bill likely to be signed by the president and not subject to filibuster in the Senate.

As a result, all manner of now-familiar health programs were created by budget reconciliation bills, many of which provided health coverage to more Americans.

The 1989 reconciliation bill created a new system for paying doctors who treat Medicare patients, as well as a new federal agency to study the cost, quality, and effectiveness of health care, today known as the Agency for Healthcare Research and Quality.

Children’s health has been a popular add-on over the years, including the gradual expansion of Medicaid coverage to more children based on family income. The 1993 reconciliation bill created the Vaccines for Children program, which ensures the availability and affordability of vaccines nationwide for uninsured and underinsured kids. The 1997 reconciliation bill created the Children’s Health Insurance Program, which today provides insurance to more than 7 million children.

In fact, the list of major health bills of the past 50 years not passed using budget reconciliation is short. For instance, the 2003 Medicare Modernization Act, which added a prescription drug benefit to the program for the first time, attracted just enough bipartisan support to pass on its own.

The biggest health care law of recent decades — the Affordable Care Act — didn’t start out as a reconciliation bill, but it ended up using the process to clear its final hurdles.

After initial passage of the bill in December 2009, a special election cost Democrats their 60th seat in the Senate — and with it, the supermajority they needed to pass the bill without Republican votes. In the end, the two chambers used a separate reconciliation measure, the Health Care and Education Reconciliation Act of 2010, to negotiate a compromise that included the ACA.

HealthBent, a regular feature of KFF Health News, offers insight into and analysis of policies and politics from KFF Health News chief Washington correspondent Julie Rovner, who has covered health care for more than 30 years.

USE OUR CONTENT

This story can be republished for free (details).

Q&A: What Does the Budget Bill Mean for Your Health?

Julie Rovner, KFF Health News — Fri, 20 Jun 2025 09:00:00 +0000

LISTEN: Congress is considering roughly $800 billion in Medicaid cuts. You could feel the effects even if you’re not on the government program for people with low incomes and disabilities. KFF Health News chief Washington correspondent Julie Rovner explained how on WAMU’s “Health Hub,” June 18.

Health programs including Medicaid, Affordable Care Act subsidies, and food assistance are facing cuts in the budget reconciliation bill making its way through Congress. If passed as written, the “One Big Beautiful Bill” could dramatically reduce health care access for millions of Americans. And even those who don’t rely on these programs could see local hospitals close.

KFF Health News chief Washington correspondent Julie Rovner appeared on WAMU’s “Health Hub” on June 18 to answer listeners’ questions and break down how the bill could reshape U.S. health care.

USE OUR CONTENT

This story can be republished for free (details).

Watch: The Dr. Oz Show Comes to Congress

Julie Rovner, KFF Health News and Rachana Pradhan and Stephanie Armour — Mon, 17 Mar 2025 09:00:00 +0000

The Senate Finance Committee got its chance March 14 to question Mehmet Oz, President Donald Trump’s nominee to lead the vast Centers for Medicare & Medicaid Services, the largest agency within the Department of Health and Human Services. Oz, with his long history in television, was as polished as one would expect, brushing off even some more controversial parts of his past with apparent ease. In this special bonus episode of the “What the Health?” podcast, KFF Health News’ Rachana Pradhan and Stephanie Armour join host Julie Rovner to recap the Oz hearing. They also provide an update on the progress of nominees to lead the National Institutes of Health, the Food and Drug Administration, and the Centers for Disease Control and Prevention.

USE OUR CONTENT

This story can be republished for free (details).

Leaving Abortion to the States: A Broken Trump Campaign Promise

Julie Rovner, KFF Health News — Fri, 07 Feb 2025 19:35:00 +0000

On the campaign trail, Donald Trump repeatedly said that restricting abortion access at the national level would not be a priority in a second term. “My view is, now that we have abortion where everybody wanted it from a legal standpoint, the states will determine by vote or legislation, or perhaps both, and whatever they decide must be the law of the land,” he said in a video posted last April.

And indeed, abortion opponents held their breath when, during Trump’s first few days in office, his piles of executive orders did not include any on abortion.

But he has more than made up for it since, having gone further in his first two weeks in office to restrict abortion than any president since Roe v. Wade was decided in 1973.

As was widely expected, Trump has reinstated the “Mexico City Policy,” an order issued by every GOP president since it was adopted by former President Ronald Reagan in 1984. It bars funding to international aid organizations that “perform or actively promote” abortion.

He also issued a similar-sounding order seeking to end “the forced use of Federal taxpayer dollars to fund or promote elective abortion” in domestic programs. It in fact goes further to restrict abortion than previous presidents in the modern era.

Trump’s order, and a memo from the Department of Health and Human Services following up on it, says that the basis for this policy is the Hyde Amendment, which was named for the late GOP congressman and anti-abortion crusader Henry Hyde. That measure has barred federal funding of most abortions since Congress first passed it in the late 1970s.

In its current iteration (it has changed several times over the years), the Hyde Amendment says that no HHS funding “shall be expended for health benefits coverage that includes coverage of abortion.”

But Hyde bars only payment. Unlike the Mexico City Policy, it says nothing about “promoting” abortion.

In fact, for decades, the Hyde Amendment existed side by side with a requirement in the federal family planning program, Title X, that grantee providers give patients with unintended pregnancies “nondirective” counseling about all their options, including abortion, and be referred for abortions if they request it. Former President Joe Biden reinstated that requirement in 2021 after Trump eliminated it during his first term.

With Roe now in the rearview mirror, the Trump administration could take even more dramatic action to restrict abortion at the federal level, including by canceling FDA approval of the abortion pill mifepristone. His anti-abortion backers are expecting he will. So are those who support abortion rights.

“We said they were coming for us,” said Clare Coleman, president and CEO of the National Family Planning & Reproductive Health Association. “And they are.”

USE OUR CONTENT

This story can be republished for free (details).

Trump’s Already Gone Back on His Promise To Leave Abortion to States

Julie Rovner, KFF Health News — Wed, 05 Feb 2025 10:00:00 +0000

Abortion foes worried before his election that President Donald Trump had moved on, now that Roe v. Wade is overturned and abortion policy, as he said on the campaign trail, “has been returned to the states.”

Their concerns mounted after Trump named Robert F. Kennedy Jr., a longtime supporter of abortion rights, to lead the Department of Health and Human Services — and then as he signed a slew of Day 1 executive orders that said nothing about abortion.

As it turns out, they had nothing to worry about. In its first two weeks, the Trump administration went further to restrict abortion than any president since the original Roe decision in 1973.

Hours after Trump and Vice President JD Vance spoke to abortion opponents gathered in Washington for the annual March for Life, the president issued a memorandum reinstating what’s known as the Mexico City Policy, which bars funding to international aid organizations that “perform or actively promote” abortion — an action taken by every modern Republican president.

But Trump also did something new, signing an executive order ending “the forced use of Federal taxpayer dollars to fund or promote elective abortion” in domestic programs — effectively ordering government agencies to halt funding to programs that can be construed to “promote” abortion, such as family planning counseling.

Dorothy Fink, the acting secretary of Health and Human Services, followed up with a memo early last week ordering the department to “reevaluate all programs, regulations, and guidance to ensure Federal taxpayer dollars are not being used to pay for or promote elective abortion, consistent with the Hyde Amendment.”

The emphasis on the word “promote” is mine, because that’s not what the Hyde Amendment says. It is true that the amendment — which has been included in every HHS spending bill since the 1970s — prohibits the use of federal dollars to pay for abortions except in cases of rape or incest or to save the mother’s life.

But it bars only payment. As the current HHS appropriation says, none of the funding “shall be expended for health benefits coverage that includes coverage of abortion.”

In fact, for decades, the Hyde Amendment existed side by side with a requirement in the federal family planning program, Title X, that patients with unintended pregnancies be given “nondirective” counseling about all their options, including abortion. Former President Joe Biden reinstated that requirement in 2021 after Trump eliminated it during his first term.

So, what is the upshot of Trump’s order?

For one thing, it directly overturned two of Biden’s executive orders. One was intended to strengthen medical privacy protections for people seeking abortion care and enforce a 1994 law criminalizing harassment of people attempting to enter clinics that provide abortions. The other sought to ensure women with pregnancy complications have access to emergency abortions in hospitals that accept Medicare even in states with abortion bans. The latter policy is making its way through federal court.

Trump’s order is also leading government agencies to reverse other key Biden administration policies implemented after the fall of Roe v. Wade. They include a 2022 Department of Defense policy explicitly allowing service members and their dependents to travel out of states with abortion bans to access the procedure and providing travel allowances for those trips. (The Pentagon officially followed through on that change on Jan. 30, just a few days after Defense Secretary Pete Hegseth took over the job: Service members are no longer allowed leave or travel allowances for such trips.) The order is also likely to reverse a policy allowing the Department of Veterans Affairs to provide abortions in some cases, as well as to provide abortion counseling.

But it could also have more wide-ranging effects.

“This executive order could affect other major policies related to access to reproductive health care,” former Biden administration official Katie Keith wrote in the policy journal Health Affairs. These include protections for medication abortion, emergency medical care for women experiencing pregnancy complications, and even in vitro fertilization.

“These and similar changes would, if and when adopted, make it even more challenging for women and their families to access reproductive health care, especially in the more than 20 states with abortion bans,” she wrote.

Anti-abortion groups praised the new administration — not just for the executive orders, but also for pardoning activists convicted of violating a law that protects physical access to abortion clinics.

“One after another, President Trump’s great pro-life victories are being restored and this is just the beginning,” Marjorie Dannenfelser, president of Susan B. Anthony Pro-Life America, said in a statement.

Abortion rights groups, meanwhile, were not surprised by the actions or even their timing, said Clare Coleman, president and CEO of the National Family Planning & Reproductive Health Association. The association represents grantees of Title X, which has been a longtime target of abortion opponents.

“We said we didn’t think it would be a Day 1 thing,” Coleman said in an interview. “But we said they were coming for us, and they are.”

USE OUR CONTENT

This story can be republished for free (details).

Trump’s Picks for Top Health Jobs Not Just Team of Rivals but ‘Team of Opponents’

Stephanie Armour and Julie Rovner, KFF Health News — Tue, 17 Dec 2024 10:00:00 +0000

Many of President-elect Donald Trump’s candidates for federal health agencies have promoted policies and goals that put them at odds with one another or with Trump’s choice to run the Department of Health and Human Services, Robert F. Kennedy Jr., setting the stage for internal friction over public health initiatives.

The picks hold different views on matters such as limits on abortion, the safety of childhood vaccines, the covid-19 response, and the use of weight-loss medications. The divide pits Trump picks who adhere to more traditional and orthodox science, such as the long-held, scientifically supported findings that vaccines are safe, against often unsubstantiated views advanced by Kennedy and other selections who have claimed vaccines are linked with autism.

The Trump transition team and the designated nominees mentioned in this article did not respond to requests for comment.

It’s a potential “team of opponents” at the government’s health agencies, said Michael Cannon, director of health policy studies at the Cato Institute, a libertarian policy organization.

Kennedy, he said, is known for rejecting opposing views when confronted with science.

“The heads of the FDA and NIH will be spending all their time explaining to their boss what a confidence interval is,” Cannon said, referring to a statistical term used in medical studies.

Those whose views prevail will have significant power in shaping policy, from who is appointed to sit on federal vaccine advisory committees to federal authorization for covid vaccines to restrictions on abortion medications. If confirmed as HHS secretary, Kennedy is expected to set much of the agenda.

“If President Trump’s nomination of RFK Jr. to be secretary is confirmed, if you don’t subscribe to his views, it will be very hard to rise in that department,” said Amesh Adalja, an infectious disease specialist and senior scholar at the Johns Hopkins Center for Health Security. “They will need to suppress their views to fit with RFK Jr’s. In this administration, and any administration, independent public disagreement isn’t welcome.”

Kennedy is chair of Children’s Health Defense, an anti-vaccine nonprofit. He has vowed to curb the country’s appetite for ultra-processed food and its incidence of chronic disease. He helped select Trump’s choices to lead the Centers for Disease Control and Prevention, the Food and Drug Administration, and the National Institutes of Health. If confirmed, he would lead them from the helm of HHS, with its more than $1.7 trillion budget.

Clashes are likely. Kennedy has supported access to abortion until a fetus is viable. That puts him at odds with Dave Weldon, the former Florida congressman whom Trump has chosen to run the CDC. Weldon, a physician, is an abortion opponent who wrote one of the major laws allowing health professionals to opt out of participating in the procedure.

Weldon would head an agency that’s been in the crosshairs of conservatives since the covid pandemic began. He has touted his “100% pro-life voting record” on his campaign website. (He unsuccessfully ran earlier this year for a seat in Florida’s House of Representatives.)

Trump has said he would leave decisions about abortion to the states, but the CDC under Weldon could, for example, fund studies on abortion risks. The agency could require states to provide information about abortions performed within their borders to the federal government or risk the loss of federal funds.

Weldon, like Kennedy, has questioned the safety of vaccines and has said he believes they can cause autism. That’s at odds with the views of Marty Makary, a Johns Hopkins surgeon whom Trump plans to nominate for FDA commissioner. The British American said on the “Brian Kilmeade Show” on Fox News Radio that vaccines “save lives,” although he added that it’s good to question the U.S. vaccine schedule for children.

The American Academy of Pediatricians encourages parents and their children’s doctors to stick to the recommended schedule of childhood vaccines. “Nonstandard schedules that spread out vaccines or start when a child is older put entire communities at risk of serious illnesses, including infants and young children,” the group says in guidance for its members.

Jay Bhattacharya, a doctor and economist who is Trump’s selection to lead NIH, has also supported vaccines.

Kennedy has said on NPR that federal authorities under his leadership wouldn’t “take vaccines away from anybody.” But the FDA oversees approval of vaccines, and, under his leadership, the agency could put vaccine skeptics on advisory panels or could make changes to a program that largely protects vaccine makers from consumer injury lawsuits.

“I do believe that autism does come from vaccines,” Kennedy said in 2023 on Fox News. Many scientific studies have discredited the claim that vaccines cause autism.

Ashish Jha, a doctor who served as the White House covid response coordinator from 2022 to 2023, noted that Bhattacharya and Makary have had long and distinguished careers in medicine and research and would bring decades of experience to these top jobs. But, he said, it “is going to be a lot more difficult than they think” to stand up for their views in the new administration.

It’s hard “to do things that displease your boss, and if [Kennedy] gets confirmed, he will be their boss,” Jha said. “They have their work cut out for them if they’re going to stand up for their opinions on science. If they don’t, it will just demoralize the staff.”

Most of Trump’s picks share the view that federal health agencies bungled the pandemic response, a stance that resonated with many of the president-elect’s voters and supporters — even though Trump led that response until Joe Biden took office in 2021.

Kennedy said in a 2021 Louisiana House oversight meeting that the covid vaccine was the “deadliest” ever made. He has cited no evidence to back the claim.

Federal health officials say the vaccines have saved millions of lives around the globe and offer important protection against covid. Protection lasts even though their effectiveness wanes over time.

The vaccines’ effectiveness against infection stood at 52% after four weeks, according to a May study in The New England Journal of Medicine, and their effectiveness against hospitalization was about 67% after four weeks. The vaccines were produced through Operation Warp Speed, a public-private partnership Trump launched in his first term to fast-track the shots as well as other treatments.

Makary criticized covid vaccine guidance that called for giving young children the shots. He argued that, for many people, natural immunity from infections could substitute for the vaccine. Bhattacharya opposed measures used to curb the spread of covid in 2020 and advised that everyone except the most vulnerable go about their lives as usual. The World Health Organization warned that such an approach would overwhelm hospitals.

Mehmet Oz, Trump’s choice to head the Centers for Medicare & Medicaid Services, an agency within HHS, has said the vaccines were oversold. He promoted the use of the anti-malaria drug hydroxychloroquine as a treatment. The FDA in 2020 revoked emergency authorization of hydroxychloroquine for covid, saying that it was unlikely to be effective against the virus and that the risk of dangerous side effects was too high.

Janette Nesheiwat, meanwhile, a former Fox News contributor and Trump’s pick for surgeon general, has taken a different stance. The doctor described covid vaccines as a gift from God in a Fox News opinion piece.

Kennedy’s qualms about vaccines are likely to be a central issue early in the administration. He has said he wants federal health agencies to shift their focus from preparing for and combating infectious disease to addressing chronic disease.

The shifting focus and questioning of vaccines concern some public health leaders amid the spread of the H5N1 bird flu virus among dairy cattle. There have been 60 human infections reported in the U.S. this year, all but two of them linked to exposure to cattle or poultry.

“Early on, they’re going to have to have a discussion about vaccinating people and animals” against bird flu, said Georges C. Benjamin, executive director of the American Public Health Association. “We all bring opinions to the table. A department’s cohesive policy is driven by the secretary.”

USE OUR CONTENT

This story can be republished for free (details).

Trump Doesn’t Need Congress To Make Abortion Effectively Unavailable

Julie Rovner, KFF Health News — Wed, 27 Nov 2024 10:00:00 +0000

On the campaign trail, Donald Trump tried mightily to reassure abortion rights supporters, vowing he would not sign into law a nationwide abortion ban even if Congress sent him one.

But once he returns to the White House in January, Trump can make abortions difficult — or illegal —across the United States without Congress taking action at all.

The president-elect will have a variety of tools to restrict reproductive rights in general and abortion rights in particular, both directly from 1600 Pennsylvania Ave. and from the executive agencies he’ll oversee. They include strategies he used during his first term, but also new ones that emerged in the wake of the Supreme Court’s overturn of Roe v. Wade in 2022.

The Trump transition team did not respond to a request for comment on this topic.

By far the most sweeping thing Trump could do without Congress would be to order the Justice Department to enforce the Comstock Act, an 1873 anti-vice law that bars the mailing of “obscene matter and articles used to produce abortion.”

While Roe was in effect, the law was presumed unconstitutional, but many legal scholars say it could be resurrected. “And it is so broad that it would ban abortion nationwide from the beginning of a pregnancy without exception. Procedural abortion, pills, everything,” Greer Donley, an associate professor and abortion policy researcher at the University of Pittsburgh Law School, said on KFF Health News’ “What the Health?” podcast early this year.

Even if he does not turn to Comstock, Trump is expected to quickly reimpose restrictions embraced by every GOP president for the past four decades. When Trump took office in 2017, he reinstituted the “Mexico City Policy” (also known as the “global gag rule”), a Ronald Reagan-era rule that banned U.S. aid to international organizations that support abortion rights. He also pulled U.S. funding for the United Nations Population Fund. Both actions were undone when President Joe Biden took office in 2021.

Those aren’t the only policies Trump could resurrect. Others that Trump imposed and Biden overturned include:

Barring providers who perform abortions and entities that provide referrals for abortion (such as Planned Parenthood) from the federal family planning program, Title X. The Trump administration imposed the rules in 2019; Biden formally overturned them in 2021.
Banning the use of human fetal tissue in research funded by the National Institutes of Health. The Trump administration issued guidance barring the practice in 2019; the Biden administration overturned it in 2021.
Requiring health plans under the Affordable Care Act to collect separate premiums if they offer coverage for abortion. The 2019 Trump administration regulation was overturned by Biden officials in 2021.
Allowing health providers to refuse to offer any service that violates their conscience. The 2019 Trump administration regulation — a revision of one originally implemented by President George W. Bush — had already been blocked by several appeals courts before being rescinded and rewritten by the Biden administration. The new, narrower rule was issued in January.

Anti-abortion groups say those changes are the minimum they expect. “The commonsense policies of President Trump’s first term become the baseline for the second, along with reversing Biden-Harris administration’s unprecedented violation of longstanding federal laws,” Marjorie Dannenfelser, president of Susan B. Anthony Pro-Life America, said in a statement to KFF Health News.

Dannenfelser was referring to the expectation that Trump will overturn actions that Biden took toward protecting abortion rights after the Supreme Court’s decision. Some included:

Providing that members of the military and their dependents who live in states with abortion bans be permitted to take leave and travel to other states for reproductive health care.
Allowing VA medical facilities to provide abortion counseling and, in limited circumstances, abortions to veterans and VA beneficiaries, regardless of the laws in the state where the facility is located.
Expanding the availability of the abortion pill mifepristone.
Clarifying that the Emergency Medical Treatment and Active Labor Act of 1986 requires hospitals to provide abortions to women with pregnancy complications that threaten their health, not just their life regardless of state law.

Even easier than formal changes of policy, though, Trump could simply order the Justice Department to drop several cases being heard in federal court in which the federal government is effectively arguing to preserve abortion rights. Those cases include:

FDA v. The Alliance for Hippocratic Medicine. This case out of Texas challenges the FDA’s approval of the abortion pill mifepristone. The Supreme Court in June ruled that the original plaintiffs lacked standing to sue, but attorneys general in three states (Missouri, Idaho, and Kansas) have stepped in as plaintiffs. The case has been revived at the U.S. District Court for the Northern District of Texas.
Texas v. Becerra. In this case, the state of Texas is suing the Department of Health and Human Services, charging that the Biden administration’s interpretation of a law requiring emergency abortions to protect the health of the pregnant woman oversteps its authority. The Supreme Court denied a petition to hear the case in October, but that left the possibility that the court would have to step in later — depending on the outcome of a similar case from Idaho that the justices sent back to the Court of Appeals.

Whether Trump will take any or all of these actions is anyone’s guess. Whether he can take these actions, however, is unquestioned.

USE OUR CONTENT

This story can be republished for free (details).