The Host
Julie Rovner
KFF Well being Information
Julie Rovner is chief Washington correspondent and host of KFF Well being Information’ weekly well being coverage information podcast, “What the Well being?” A famous knowledgeable on well being coverage points, Julie is the creator of the critically praised reference e-book “Well being Care Politics and Coverage A to Z,” now in its third version.
Open enrollment for 2026 Inexpensive Care Act insurance coverage begins in most states Nov. 1, with no decision in Congress about whether or not to proceed extra beneficiant premium tax credit expanded below President Joe Biden or allow them to expire on the finish of this yr. It’s unclear whether or not the backlash from hundreds of thousands of enrollees seeing skyrocketing premiums will transfer Democrats or Republicans to again away from entrenched positions which might be conserving many of the federal authorities shut down.
In the meantime, the Trump administration — having completed away earlier this yr with a Biden-era regulation that prevented medical debt from being included on customers’ credit score experiences — is now telling states they can’t go their very own legal guidelines to bar the observe.
This week’s panelists are Julie Rovner of KFF Well being Information, Paige Winfield Cunningham of The Washington Put up, Maya Goldman of Axios, and Alice Miranda Ollstein of Politico.
Panelists
Paige Winfield Cunningham
The Washington Put up
Maya Goldman
Axios
Alice Miranda Ollstein
Politico
Among the many takeaways from this week’s episode:
- Tens of hundreds of thousands of Individuals are bracing to lose authorities meals help on Nov. 1, after the Trump administration opted to not proceed funding the Supplemental Vitamin Help Program in the course of the shutdown. President Donald Trump and senior officers have made no secret of efforts to penalize authorities packages they see as Democratic priorities, to exert political strain because the stalemate continues on Capitol Hill.
- Folks starting to buy subsequent yr’s plans on the ACA marketplaces are experiencing sticker shock as a result of expiration of extra beneficiant premium tax credit that have been expanded in the course of the covid pandemic. The federal authorities will even take a selected hit because it covers rising prices for lower-income clients who will proceed to obtain help no matter a deal in Congress.
- In state information, after killing a Biden-era rule to dam medical debt from credit score experiences, the Trump administration is working to stop states from passing their very own protections. In Florida, medical doctors who help vaccine efforts are being muffled, and the state’s surgeon common says he didn’t mannequin the outcomes of ending childhood vaccination mandates earlier than pursuing the coverage — a dangerous proposition as public well being specialists warning that latest measles outbreaks are a canary within the coal mine for vaccine-preventable sicknesses.
- And in Texas, the state’s lawyer common, who can be operating for the U.S. Senate as a Republican, is suing the maker of Tylenol, claiming the corporate tried to dodge legal responsibility for the treatment’s unproven ties to autism. The lawsuit is the newest downside for Tylenol, with latest allegations undermining confidence within the widespread painkiller, the one one really useful for pregnant ladies to scale back doubtlessly harmful fevers and relieve ache.
Plus, for “additional credit score” the panelists recommend well being coverage tales they learn this week that they assume it is best to learn, too:
Julie Rovner: KFF Well being Information’ “Many Concern Federal Mortgage Caps Will Deter Aspiring Medical doctors and Worsen MD Scarcity,” by Bernard J. Wolfson.
Alice Miranda Ollstein: ProPublica’s “Citing Trump Order on ‘Organic Reality,’ VA Makes It Tougher for Male Veterans With Breast Most cancers To Get Protection,” by Eric Umansky.
Paige Winfield Cunningham: The Washington Put up’s “Research Finds mRNA Coronavirus Vaccines Extended Lifetime of Most cancers Sufferers,” by Mark Johnson.
Maya Goldman: KFF Well being Information’ “As Sports activities Betting Explodes, States Strive To Set Limits To Cease Playing Dependancy,” by Karen Brown, New England Public Media.
Additionally talked about on this week’s podcast:
Click on to open the transcript
Transcript: Completely happy Open Enrollment Eve!
[Editor’s note: This transcript was generated using both transcription software and a human’s light touch. It has been edited for style and clarity.]
Julie Rovner: Hiya, from KFF Well being Information and, beginning this week, from WAMU public radio in Washington, D.C., and welcome to “What the Well being?” I’m Julie Rovner, chief Washington correspondent for KFF Well being Information, and I’m joined by a few of the greatest and smartest well being reporters in Washington. We’re taping this week on Thursday, Oct. 30, at 10 a.m. As at all times, information occurs quick, and issues may’ve modified by the point you hear this. So right here we go. At this time, we’re joined through video convention by Alice Miranda Ollstein of Politico.
Alice Miranda Ollstein: Hiya.
Rovner: Maya Goldman of Axios Information.
Maya Goldman: Good to be right here.
Rovner: And we welcome again to the podcast one among our unique panelists, Paige Winfield Cunningham of The Washington Put up. So nice to see you once more.
Winfield Cunningham: Hello, Julie. It’s nice to be again.
Rovner: Earlier than we dive in, now we have slightly of our personal information to announce. Beginning this week, we’re partnering with WAMU, Washington D.C.’s public radio station, to distribute the podcast. Which means you too can now discover us on the NPR app. And welcome to all you new listeners. OK, onto the information. We are actually 30 days into the federal authorities shutdown, and there may be nonetheless no discernible finish in sight. And this Saturday will not be solely the beginning of open enrollment in most states for the Inexpensive Care Act well being plans, which we’ll discuss extra about in a minute. It’s additionally the day an estimated 42 million Individuals will lose entry to meals stamps after the Trump administration determined to cease funding the SNAP [Supplemental Nutrition Assistance] program. That’s one thing the administration did hold funding over the past Trump shutdown in 2019, and, in response to funds specialists, may proceed to do now. So what’s behind this? As I feel I identified final week, not such an awesome look to deprive individuals of meals help proper earlier than Thanksgiving.
Ollstein: So I feel this follows the sample we’ve seen all through the shutdown, which is simply loads of selecting and selecting of what will get funded and what doesn’t. The angle of this I’ve lined is that out of the entire uniformed forces of the federal government, the Trump administration dug round and located cash to maintain paying the armed members, however not the general public well being officers, who’re additionally a part of the uniformed branches of the nation. And yeah, you’re seeing this within the SNAP house as properly. President Trump and his officers have overtly threatened to go after what they see as Democrat packages. So it’s simply attention-grabbing what they take into account in that class. However you’re seeing loads of decisions being made to exert most political strain and drive varied sides of this combat to cave, however we’re not seeing that but both.
Rovner: Yeah, they’re. I imply, it appears that is additionally backwards as a result of it’s often the Republicans who’re shutting down the federal government, the Democrats who’re attempting to strain them to reopen it. And now, in fact, we’re seeing the other as a result of the Democrats need the Republicans to do one thing concerning the Inexpensive Care Act subsidies, and the Republicans are going after beforehand what had been type of sacrosanct bipartisan packages like meals stamps and the WIC [the Special Supplemental Nutrition Program for Women, Infants, and Children] program, for pregnant and breastfeeding mothers and infants. And now, apparently, they’re going to cease funding for Head Begin, the preschool program for low-income households with children. On the one hand, you’re proper, they’re packages which might be very cherished by Democrats, however I really feel like this complete shutdown is now type of going after essentially the most susceptible individuals in America.
Goldman: It’s additionally been attention-grabbing as a result of [Health and Human Services] Secretary [Robert F.] Kennedy [Jr.] has tried to make use of SNAP as a automobile for his Make America Wholesome Once more agenda, proper? Attempting to get states to restrict the sugary drinks that their SNAP packages supply. And he’s, like, actually touted that as a part of the agenda. And now there doesn’t appear to be any curiosity from HHS in talking out about that.
Rovner: Nicely, in fact, and SNAP isn’t an HHS program.
Goldman: Precisely. Precisely.
Rovner: It’s a program within the Division of Agriculture, which is much more complicated, however you’re completely proper. I imply, it’s odd that a few of the issues that he’s been pointing to are issues that this administration is type of attempting to put on the Democrats’ ft, as in, You need this program, reopen the federal government. In order I discussed, Saturday is the beginning of Obamacare open enrollment in many of the states. And, Paige, you bought a sneak peek on the premiums for plans within the 30 states that use the federal market, which is now open for what we name window-shopping earlier than open enrollment formally begins. What did you discover?
Winfield Cunningham: Yeah. So I received some paperwork on the finish of final week exhibiting that the typical premium for the second-lowest-cost silver plan — which, in fact, is what, we all know … that’s what the subsidies are pegged to — goes up 30%, which is the second-highest premium improve. The very best we noticed was 2017 to 2018. However this can be a actually, actually vital improve. And naturally, CMS [the Centers for Medicare & Medicaid Services] didn’t embrace that quantity within the doc that it lastly launched this week. So the paperwork I noticed had some type of numbers like that, which have been all stripped out of the official paperwork. However all of that is simply so attention-grabbing as a result of I used to be eager about, again to 2017-2018, and the politics of this are so flipped proper now as a result of principally it was the Democrats then who didn’t wish to speak about premium will increase and the Republicans who have been yelling about it.
So it’s humorous how that has modified. However I suppose on the politics of this, it appeared for some time like Democrats have been pondering perhaps the Nov. 1 begin of open enrollment would offer this out for them to go the spending invoice as a result of they may say, like, OK, we tried. Now open enrollment has began, or the premiums are type of baked, so we will’t actually do something to alter it now. However I don’t assume we’re going to have something this week. It looks as if either side are fairly dug in nonetheless. I imply, I suppose the opposite factor I might say on these prices, it’s actually highlighting a weak point that we’ve recognized for a very long time within the Inexpensive Care Act, which is that, like, sure, it made medical health insurance inexpensive for lots of people, however there’s at all times been this smaller variety of individuals which might be above 400% federal poverty which have had no protect from insurance coverage prices. They’ve the final 4 years, and now they’re not going to have one anymore. And it’s humorous as a result of Democrats are speaking about this, however that’s type of an issue they hadn’t needed to acknowledge for a very long time within the early years of the Inexpensive Care Act. And as you guys all know, there’s not going to be any political will for bipartisan work to create inexpensive choices for these of us until the subsidies get prolonged, which, in fact, that doesn’t appear very probably in the mean time from how issues stand.
Rovner: Yeah. Going again to what the Republicans type of introduced, their speaking factors, is that, properly, first the premium will increase aren’t that huge and that the expiring additional subsidies aren’t that huge a bit of it, each of which are literally type of true. However, in fact, that’s not the place the sticker shock is coming from. The sticker shock is coming from the expiration of these tax credit that’s going to …
So individuals who had been shielded from these very excessive premiums are now not going to be shielded from them. And that’s why, when you take a look at social media, you see all these screenshots now of insurance coverage that prices $3,000 a month for individuals who have been paying $150 a month, which is clearly not inexpensive. Why is it so tough to clarify the distinction? I’ve been engaged on other ways to clarify it for the final three weeks.
Goldman: I used to be attempting to determine this out final evening, once I was writing one thing for my publication right this moment. And I feel one of many actually complicated components about that is that, like Paige stated, like Paige scooped, premiums are going up a specific amount, and that’s not really what persons are seeing. That’s not what nearly anybody goes to really face. Both you’re getting that massive sticker shock since you’re dropping your subsidies that you simply had this yr otherwise you’re persevering with to have subsidies, they’re not fairly the identical, however you’re nonetheless not going to pay a 30% improve. And so I feel that that’s actually complicated for me even, and laborious to clarify.
Winfield Cunningham: I feel a technique to consider that is just like the social gathering that’s going to bear the brunt of the premium prices to a big diploma is the federal government as a result of for those that are earlier than 400% federal poverty, they’re principally assured below the Inexpensive Care Act that they’re not going to need to pay extra for premiums over a sure proportion of their earnings. And so this simply means, like, the subsidies are getting actually costly for the federal authorities, which fits again to the difficulty of type of like why Democrats didn’t lengthen these enhanced premiums indefinitely — as a result of it’s simply costly to do it. That is the federal government subsidizing personal medical health insurance. After which it’s additionally vital once more for these individuals over 400% poverty who had had a cap on what they’d pay. I feel it was 9.5% of their earnings below the improved … and now they haven’t any cap.
Rovner: I feel 8.5% of their earnings, really, below the improved premiums.
Winfield Cunningham: Underneath the improved. OK.
Rovner: It’s going to return to 10%.
Winfield Cunningham: Yeah. Yeah. However there’s no cap when you’re like over, over 400%.
Rovner: 400%.
Winfield Cunningham: Proper. Yeah. Yeah.
Rovner: That’s proper.
Winfield Cunningham: Yeah. However that’s why persons are confused. And the opposite factor is, like, the administration is appropriate, that the overwhelming majority of individuals within the marketplaces will proceed to get subsidies. And we’re principally going again to what the scenario was earlier than covid, but it surely’s that smaller variety of individuals which might be on the increased earnings ranges. However the different thought I had was, in fact, the well being care trade and Democrats are speaking rather a lot about this and spreading these large premium will increase far and huge and ensuring everyone hears about them, but it surely’s like a comparatively small variety of individuals, if you consider it.
And I feel it’s solely like a pair million individuals within the marketplaces who’re at that increased earnings ranges. And I ponder if that elements into Republicans’ calculations right here, the place they’re what number of voters are literally seeing these huge premium will increase, having to pay for all of them. And in the entire scheme of the U.S. inhabitants, it’s not like a ton of individuals. So I simply surprise if that’s one motive they’re type of, like, appear to be more and more dug in on this and really reticent to increase these subsidies.
Rovner: Though I might level out that when the Inexpensive Care Act began, it was solely a small quantity of people that misplaced their insurance coverage, and that turned a huge political difficulty.
Winfield Cunningham: That is very true.
Rovner: So it’s the individuals who get damage who generally yell the loudest, though you’re proper. I imply, at that time, the Democrats stayed the course and ultimately, as Nancy Pelosi stated, individuals got here to love it. So it may work out the identical approach. It does assist clarify why everyone’s nonetheless dug in. Maya, you needed to say one thing.
Goldman: I used to be simply going to say, I feel it’ll be attention-grabbing to see, if subsidies aren’t prolonged, how this impacts premiums subsequent yr for individuals and for the federal authorities, as a result of if a pair million individuals drop out of the ACA market as a result of it’s too costly, and people individuals are usually more healthy, then the remaining pool of individuals is sicker, after which that’s the loss of life spiral, proper? So …
Rovner: Yeah. Though it’s …
Goldman: Clearly, that’s loads of what ifs, however …
Rovner: … solely the loss of life spiral that goes again to previous to covid, which — it was type of steady at 12 million. I’m type of amused by seeing Republicans complaining about subsidizing insurance coverage corporations. It’s like, however this was the Republicans’ concept within the first place, going again to the very origin of the ACA.
Ollstein: And we must always not neglect that there’s a group of people who find themselves going to be dropping all of their subsidies, not simply the improved subsidies. And that’s authorized immigrants, and that’s tons of of 1000’s of individuals. So, like Maya stated, that can most likely imply loads of youthful, more healthy individuals dropping protection altogether, which can make the remaining pool of individuals dearer to insure. So these items have ripple results, issues that affect one a part of the inhabitants inevitably affect different components of the inhabitants. And once more, these are authorized tax-paying immigrants with papers — shall be topic to the complete drive of the premium will increase as a result of they received’t have any subsidies.
Rovner: Sure, our well being system at work. All proper, we’re going to take a fast break. We shall be proper again with extra well being information.
Transferring on, the federal authorities is technically shut down, however the Trump administration continues to be making coverage. You may keep in mind final summer time, a federal choose blocked a Biden administration rule that prevented medical debt from showing on individuals’s credit score experiences. The Trump administration selected to not enchantment that ruling, thus killing the rule. Now the administration goes a step additional — this week, placing out steering that tries to cease states from passing their very own legal guidelines to stop medical debt from ruining individuals’s credit score, and sometimes their capability to lease, or purchase a home, or buy a automobile, and even generally get a job. In accordance with the performing head of the federal Shopper Monetary Safety [Bureau], Russell Vought — sure, that very same Russell Vought who’s additionally reducing federal packages as head of the Workplace of Administration and Price range — states don’t have the authority to limit medical debt from showing on credit score experiences, solely the federal authorities does, which in fact he has already proven he doesn’t wish to do. Who does this assist? I’m unsure I see what the purpose is of claiming we’re not going to do it and states, you may’t do it both. A part of this, I do know, is Russell Vought has made no secret of the truth that he wish to undo as a lot of the federal authorities as he can. On this case, is he doing the bidding of, I suppose it’s the individuals who lengthen credit score, who, I suppose, need this data, wish to know whether or not individuals have medical debt, assume that that’s going to affect whether or not or not they’ll pay again their loans, or is that this simply Russell Vought being Russell Vought?
Goldman: I suppose, in idea, perhaps it goes again to the concept you probably have penalties for medical debt, then individuals can pay their payments, and perhaps that will assist the well being techniques in the long term. However I additionally assume that — I don’t know what well being techniques have stated about this explicit transfer, to be sincere — however I feel there’s an curiosity in making medical debt more easy for individuals to bear in the entire well being system. So I’m unsure how well-liked that’s.
Rovner: Yeah. Sure. One other a type of issues that’s type of like, we’re going to harm the general public to thwart the Democrats, which type of appears to be an ongoing theme right here. Nicely, as we tape this morning, the Senate well being committee was presupposed to be holding a listening to on the nomination of RFK Jr. MAHA ally Casey Means to be U.S. surgeon common. Casey Means was going to testify through video convention as a result of she is pregnant, however, apparently, she has gone into labor, in order that listening to will not be occurring. We’ll choose up on it when that will get rescheduled. Maybe she’s going to seem together with her toddler.
Again at HHS, a U.S. district choose this week indefinitely barred the Trump administration from shedding federal staff in the course of the shutdown, however on the Facilities for Illness Management and Prevention, it seems the injury is already completed. The New York Instances’ world well being reporter, Apoorva Mandavilli, experiences that the company seems to have had its workforce decreased by a 3rd and that the complete management now consists of political appointees loyal to HHS secretary Kennedy, who has not hidden his disdain for the company and the truth that he needs to see it dissolved and its actions assigned elsewhere across the division. What would that imply in observe if there, in impact, was no extra CDC?
Winfield Cunningham: Hopefully we don’t have one other pandemic. There’s simply loads of stuff the CDC does. And it’s been actually complicated to comply with these layoffs as a result of on this final spherical, I keep in mind attempting to determine with my colleague Lena Solar how many individuals have been despatched notices after which tons of have been type of, these have been rescinded they usually have been introduced again. However yeah, I imply, I feel we’re going to see the results of this over the subsequent couple of years. Once I’ve requested the administration broadly concerning the reductions to HHS, what they are saying is that the company total has grown quite a bit in its headcount by the pandemic, which is true. I feel they received as much as like 90,000 or so. After which, in response to our greatest estimates, perhaps they’re again round 80,000, though I’m not fully positive if that’s correct. Once more, it’s actually been laborious to trace this.
Rovner: Yeah. I’ve seen numbers as little as 60,000.
Winfield Cunningham: It might be decrease. Yeah. Yeah. So I feel really the 80,000, which will have been the headcount earlier than the pandemic. Anyway, all that to say, it did develop in the course of the pandemic, and that’s type of the argument that they’re making, is that they’re simply bringing it again to pre-pandemic ranges.
Rovner: However CDC, I imply, it actually does seem like they wish to simply type of devolve every part that CDC does to the states, proper? I imply, that we’re simply not going to have as a lot of a federal public well being presence as we’ve had over these previous 50, 60 years.
Winfield Cunningham: For positive. They’ve positively focused CDC. I imply, they largely left CMS alone and FDA as a result of, statutorily, I feel it’s simpler for them to shrink CDC, but it surely positively goes to have huge results over the subsequent couple of years, particularly as we see future pandemics.
Ollstein: And the entire argument about returning to pre-covid, that doesn’t match with what they’re really reducing. I imply, they’re gutting places of work which were round for many years — targeted on smoking, targeted on maternal well being, all these various things. And so this isn’t simply rolling again will increase from the previous few years. That is going deeper than that.
Winfield Cunningham: Nicely, yeah, it’s not like they’re simply reducing the roles that have been added because the pandemic.
Ollstein: Precisely.
Rovner: It’s not a last-in, first-out type of factor. Nicely, as I stated, because it appears to be like like public well being is now largely going to be devolved to the states, let’s test in on some state doings. In Florida, the place state Surgeon Common Joseph Ladapo final month introduced a plan to finish faculty vaccination mandates. My KFF Well being Information colleague Arthur Allen has a narrative about how well being officers, together with college professors and county well being officers, who really do consider in vaccinating kids, are successfully being muzzled, instructed they can’t communicate to reporters with out the approval of their supervisors, who’re more likely to say no. Seeing the rising variety of unvaccinated kids in a state like Florida, the place so many vacationers come and go, elevating the probability of spreading vaccine preventable illnesses, this all appears type of dangerous, sure?
Goldman: Sure. That was a implausible article out of your colleague, and there was a very illuminating line, which I feel had been reported earlier than, however a reporter requested the surgeon common if he had completed any illness modeling earlier than making the choice. And he stated, Completely not, as a result of this to him was a private alternative difficulty and never a public well being difficulty. And I feel that simply goes to point out that we don’t know what will occur because of this public well being choice and it may have huge ripple results.
Rovner: However what we’re already seeing are the rise of vaccine-preventable illnesses across the nation. I imply, measles, first in Texas, now in South Carolina; whooping cough in Louisiana; I’m positive I’m lacking some, however we’re already seeing the results of this dwindling herd immunity, if you’ll. Alice, you’re nodding your head.
Ollstein: Yeah. And I’ve heard from specialists that measles is admittedly type of the canary within the coal mine right here as a result of it’s so infectious. It spreads so simply. You may have an contaminated individual cough in a room and go away the room, after which some time later, another person comes within the room they usually can catch it. Not all of those vaccine-preventable sicknesses are like that. So the truth that we’re seeing these measles outbreaks is a sign that different issues are most likely spreading as properly. We’re simply not seeing it but, which is fairly scary.
Rovner: And naturally, one of many issues that the CDC does is acquire all of that information, so we’re most likely not seeing it for that motive, too. Nicely, in the meantime, in Texas, Lawyer Common and Republican Senate candidate Ken Paxton is suing the makers of Tylenol. He’s claiming that Johnson & Johnson spun off its shopper merchandise division — that features not simply Tylenol, but additionally issues like Band-Aids and Child Shampoo — to protect it from legal responsibility from Tylenol’s inflicting of autism, one thing that has not been scientifically demonstrated by the way in which — even Secretary Kennedy admits that has not been scientifically demonstrated. My recollection, although, is that Johnson & Johnson was attempting to protect itself from legal responsibility when it spun off its shopper merchandise division, however not due to Tylenol, fairly from most cancers claims associated to talc in its eponymous Child Powder. So what’s Paxton attempting to do right here past display his fealty to President Trump and Robert F. Kennedy Jr.?
Ollstein: I used to be to see some GOP senators distancing themselves from the Texas lawsuit and saying like, Look, there is no such thing as a proof of this connection and this hurt. Let’s not go loopy. However as I’ve reported, it’s simply very laborious to get good data out to individuals as a result of there simply isn’t sufficient information on the protection of varied medicine, as a result of testing medicine on pregnant ladies was at all times laborious and it’s gotten even more durable lately. And so, based mostly on the info now we have, this can be a correlation, not causation. However it will be simpler to allay individuals’s fears if we had extra sturdy and higher information.
Rovner: Yeah. Does a lawsuit like this, although, type of unfold the … give credence to this concept that — I see you nodding, Maya — that there’s something to be frightened about utilizing Tylenol when pregnant? Which is freaking out the medical neighborhood as a result of Tylenol is just about the one drug that at present is really useful for pregnant ladies to take care of fever and ache.
Goldman: Yeah. I feel a few of my colleagues have reported on the priority of one other loss of life spiral right here, proper? The place individuals get involved, maybe with out foundation, of taking Tylenol or every other medicine, vaccines even, as a result of there are lawsuits after which the makers of those medicine say it’s not value it for us to make these anymore. After which they don’t make them. After which it’s like a foul cascade of occasions. And so it’s clearly too quickly to see if that’s what’s occurring right here, but it surely’s definitely one thing to look at.
Rovner: However as we’ve identified earlier, not treating, significantly, fever also can trigger issues. So …
Ollstein: Proper. Mainly the entire alternate options are extra harmful. Not taking something to deal with ache and fever in being pregnant will be harmful and may result in start results. And taking different painkillers and fever reducers are recognized to have harmful negative effects. Tylenol was the most secure possibility recognized to science. And now that that’s being questioned within the courtroom of public opinion, persons are frightened about these ramifications.
Winfield Cunningham: I take into consideration the impact on mothers who’ve children with autism who are actually pondering again to their pregnancies and pondering, Oh my gosh, how a lot Tylenol did I take? I do know I took, I had pregnancies that I took loads of Tylenol throughout. My nephew has autism, and I used to be speaking to my sister about this, and he or she was like, “I took Tylenol.” And what they’re doing is, I suppose, different reflection I’ve on it’s, on the whole, there’s simply much less analysis on most issues than we want. And there are some research exhibiting a correlation, which as everyone knows will not be causation. And what it appears to be like just like the administration did was they took these tiny little nuggets of options and have blown them up into this overly assured declaration of Tylenol and being pregnant and possibly unnecessarily inflicting many ladies responsible themselves or assume, Ought to I’ve completed one thing in a different way throughout my being pregnant? after they have been actually simply doing what their physician really useful they do.
Ollstein: I’m shocked that we haven’t seen authorized motion from Tylenol but. I think about we’d sooner or later, particularly if there may be some type of authorities motion round this, like a label change. I feel we’ll see some type of authorized motion from the corporate as a result of that is completely going to affect their backside line.
Rovner: Yeah. All proper. Nicely, lastly this week, extra information on the reproductive well being entrance. California introduced it will assist fund Deliberate Parenthood clinics to allow them to proceed offering fundamental well being companies, in addition to reproductive well being companies, after Congress made the group ineligible for Medicaid funds for a yr and the massive funds invoice handed final summer time. California’s the fourth state to pitch in becoming a member of fellow blue states Washington, Colorado, and New Mexico. In the meantime, household planning clinics in Maine are closing right this moment because of that lack of Medicaid funding. And on the similar time, the Well being and Human Companies Workplace of Inhabitants Affairs, which oversees the federal household planning program, Title X, is down apparently from a workers of 40 to 50 to a single worker, in response to my colleague Céline Gounder. Is contraception going to turn into the subsequent well being care service that’s solely obtainable in blue states, Alice?
Ollstein: So Title X has been in conservatives’ crosshairs for a very long time. There have been makes an attempt on Capitol Hill to defund it. There have been varied insurance policies of varied administrations to make numerous modifications to it. A few of these modifications have actually restricted who will get care. And so it’s been a political soccer for some time. In fact, Title X doesn’t simply do contraception. It’s one of many main issues they do, offering backed and generally even free contraception to hundreds of thousands of low-income individuals across the nation. However additionally they present STI testing, even some infertility counseling and different issues, most cancers screenings. And so that is actually hitting individuals concurrently the anticipated Medicaid cuts, and on the similar time Deliberate Parenthood clinics are closing as a result of they received defunded. And so it’s only one on prime of one other within the reproductive well being house. Every one alone can be actually impactful, however taken all collectively, yeah, there’s loads of concern about individuals dropping entry to those companies.
Winfield Cunningham: I feel the politics of this are extra attention-grabbing to me than the sensible impact. I imply, below the ACA, contraception needs to be lined, proper? by market plans. Usually talking, if individuals have insurance coverage, they do have protection for a variety of contraception. However the Title X program is attention-grabbing as a result of it appears to love overlap between the MAHA priorities and the social conservatives. In fact, as Alice stated, this has lengthy been a goal of social conservatives. I feel in Mission 2025 referred to as for any Title X, I consider. After which there’s this present within the MAHA motion that’s type of like anti-hormonal contraception and there’s additionally these sorts of streams of pronatalist individuals, of have extra infants, don’t take contraception. In order that’s type of attention-grabbing to me as a result of there’s this bigger narrative I feel in HHS proper now of the RFK MAHA individuals versus the standard conservative, anti-abortion individuals. In order that’s identical to one program the place I see overlap between the 2.
Rovner: Certainly one of my favourite items of congressional trivia is that Title X has not been reauthorized since 1984, which, by the way in which, is earlier than I began protecting this. However I’ve been doing this 39 years and I’ve by no means lined a profitable reauthorization of the Title X program. So it’s clearly been in crosshairs for a really, very very long time. Maya, did you wish to add one thing?
Goldman: I used to be simply going to say to Paige’s level, telling ladies that they’ll’t take any painkillers throughout being pregnant will not be a great way to lift the start fee.
Rovner: Sure. That’s additionally a good level. Nicely, in the meantime, purple states try to broaden the position of disaster being pregnant facilities, which give largely nonmedical companies and attempt to persuade these with unplanned pregnancies to not have abortions. In Wyoming, state lawmakers are pushing a invoice that will prohibit the state or any of the localities from regulating these facilities “based mostly on the middle’s stance in opposition to abortion.” This comes after the same proposal turned regulation in Montana, the efforts being pushed by the anti-abortion group Alliance Defending Freedom. Is the concept right here to have disaster being pregnant facilities change these Title X clinics and Deliberate Parenthoods?
Ollstein: I feel there are lots of people that wish to see that, however, as you stated, they don’t present the identical companies, so it will not be a one-to-one alternative. Already, there are far more disaster being pregnant facilities across the nation than there are Deliberate Parenthood clinics, for instance, however that doesn’t imply that everybody has entry to all of the companies they need.
Rovner: And lots of of those disaster being pregnant facilities don’t have any medical personnel, proper? I imply, a few of them do, however …
Ollstein: It’s actually a variety. I imply, some have a medical director on workers, or perhaps there’s one medical one that oversees a number of clinics, some don’t. Some supply ultrasounds, some don’t, some simply give pamphlets and diapers and donated objects. It’s simply actually a variety across the nation. And states have additionally been grappling with how a lot to, on the conservative aspect, help and fund such facilities. And on the opposite aspect, states like California have actually gone to battle over regulating what they inform sufferers, what they’re required to inform sufferers, what they’ll’t inform sufferers. And that’s gotten into the courts they usually’ve fought over whether or not that violates their speech rights. And so it’s an actual ongoing combat.
Rovner: Sure, I’m positive this may proceed. All proper, that’s the information for this week. Now it’s time for our extra-credit section. That’s the place we every acknowledge a narrative we learn this week we predict it is best to learn too. Don’t fear when you miss it; we’ll put the hyperlinks in our present notes in your telephone or different cell machine. Maya, why don’t you go first this week?
Goldman: Positive. So this story is from KFF Well being Information and New England Public Media. It’s referred to as “As Sports activities Betting Explodes, States Strive To Set Limits To Cease Playing Dependancy,” by Karen Brown. And I feel this stood out to me as a result of I used to be simply in Vegas final week for well being, however this, I feel, is a very attention-grabbing difficulty to discover by a public well being lens, the difficulty of sports activities betting and betting habit. And there are states which might be attempting to do loads of work round this and simply organizations. After which in fact the gaming corporations themselves have their very own pushback on that, and I feel this story simply lays it out very well and it’s an necessary difficulty that will get very neglected.
Rovner: Yeah, it’s a public well being difficulty, an attention-grabbing one. Alice?
Ollstein: I selected a narrative from ProPublica by reporter, Eric Umansky, and it’s referred to as “Citing Trump Order on ‘Organic Reality,’ VA Makes It Tougher for Male Veterans With Breast Most cancers To Get Protection.” So that is one among many examples that you can give of insurance policies supposed to focus on transgender of us having spillover results and impacting cisgender of us, too. On this occasion, it’s now more durable for male veterans to qualify to get therapy for breast most cancers. Males can get breast most cancers. Let’s simply say that. Males can and do get breast most cancers, and it may be more durable to detect and really deadly, and clearly very costly to deal with when you don’t have protection. And so this story has loads of unhappy quotes from of us who’re dropping their protection, particularly as a result of they probably acquired most cancers by being uncovered throughout their service to numerous poisonous substances. And so I feel, yeah.
Rovner: Yeah. A mixture of loads of various factors in that story.
Ollstein: Positively.
Rovner: Paige?
Winfield Cunningham: Yeah. So my story is by, really, my colleague Mark Johnson. I sit subsequent to him at The [Washington] Put up, and the headline is “Research Finds mRNA Coronavirus Vaccines Extended Lifetime of Most cancers Sufferers.” I used to be actually struck by this story as a result of it talks about how sufferers with superior lung most cancers, they got the covid vaccines and it one way or the other had the impact of supercharging their immune techniques. And, really, their median survival charges went up by 17 months in contrast with people who weren’t given the vaccines. And, in fact, this administration has actually gone after the covid vaccines and the mRNA analysis, specifically, and canceled $500 million in funding for mRNA analysis. And the entire ACIP’s [Advisory Committee on Immunization Practices’] strikes on vaccines have gotten a lot consideration. However I feel the factor that is also going to be maybe much more impactful is pulling again on this actually promising analysis, as a result of it has type of turn into politicized as a result of the covid vaccines have turn into politicized. And it appears a disgrace that we’re pulling again on this actually promising analysis. So I believed that was a very attention-grabbing story by my colleague.
Rovner: Sure. One more theme from 2025. My additional credit score this week is from my KFF Well being Information colleague Bernard J. Wolfson, and it’s referred to as “Many Concern Federal Mortgage Caps Will Deter Aspiring Medical doctors and Worsen MD Scarcity.” And it’s a superb reminder about one thing we did speak about earlier this yr when the Republican funds invoice handed. It limits federal grad faculty loans to $50,000 per yr at a time when the median tuition for a yr in medical faculty is greater than $80,000. The thought right here is to push medical colleges to decrease their tuition, however within the brief run, it’s extra more likely to push lower-income college students both out of medication altogether or to require them to take out personal loans with extra stringent compensation phrases, which may in flip push them into pursuing extra profitable medical specialties fairly than the first care slots which might be already so tough to fill. It’s one more instance of how everyone agrees on an issue: Medical schooling is approach too costly on this nation. However no one is aware of fairly the right way to repair it.
OK. That’s this week’s present. Thanks this week to our editor, Emmarie Huetteman, and our producer-engineer, Francis Ying. A reminder, “What the Well being?” is now obtainable on WAMU platforms, the NPR app, and wherever else you get your podcasts, in addition to, in fact, kffhealthnews.org. For those who already comply with the present, nothing will change. The podcast will present up in your feed as typical. Additionally, as at all times, you may electronic mail us your feedback or questions. We’re at whatthehealth@kff.org, or you will discover me at X, @jrovner, or on Bluesky, @julierovner. The place are you of us hanging as of late? Maya?
Goldman: I’m on X as @mayagoldman_ and I’m additionally on LinkedIn, just below my identify.
Rovner: Alice?
Ollstein: @alicemiranda on Bluesky and @AliceOllstein on X.
Rovner: Paige?
Winfield Cunningham: I’m nonetheless @pw_cunningham on X.
Rovner: Nice. We shall be again in your feed subsequent week. Till then, be wholesome.
Credit
Francis Ying
Audio producer
Emmarie Huetteman
Editor
Click on right here to seek out all our podcasts.
And subscribe to “What the Well being? From KFF Well being Information” on Apple Podcasts, Spotify, YouTube, Pocket Casts, or wherever you take heed to podcasts.
