Countdown to Government Shutdown
The Host
Oct. 1 is the start of the next fiscal year, and unless Congress reaches agreement on continued spending, big parts of the government could shut down that day. Democrats, whose votes will be needed in the Senate, would like Republicans to extend the Biden-era extra tax credits for Affordable Care Act insurance plans as part of a compromise, but so far Republicans donât seem willing.
Meanwhile, Health and Human Services Secretary Robert F. Kennedy Jr. released his much-anticipated âMake America Healthy Againâ blueprint to improve childrenâs health, but the report contained few specifics on how his goals would be reached.
This weekâs panelists are Julie Rovner of șÚÁÏłÔčÏÍű News, Anna Edney of Bloomberg News, Sandhya Raman of CQ Roll Call, and Lauren Weber of The Washington Post.
Panelists
Among the takeaways from this weekâs episode:
- Congress has less than three weeks to approve federal government spending for the new fiscal year and avert a shutdown. Democrats are pushing for the legislation to include an extension of enhanced subsidies for those covered by ACA plans, which otherwise will expire at the end of the year and contribute to an increase in premium costs. But that proposal is already getting bogged down in longtime fights over abortion funding.
- The Department of Health and Human Services is expected to cite the use of Tylenol during pregnancy in a pending report on the causes of autism â despite a lack of definitive scientific evidence. And the remade Advisory Committee on Immunization Practices is scheduled to meet next week, while some Americans are struggling to access the covid vaccine.
- The lack of teeth in the MAHA report â along with the White Houseâs lengthy review before publication â suggests industry officials helped shape the final product. Plus, its calls for things like healthier meals in schools and hospitals amid federal funding cuts raise an important question: Who will pay for these policy changes?
- And the Trump administration is seeking changes to federal regulations on pharmaceutical advertising that could effectively kill drug ads on television, though free-speech rights could complicate that effort.
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Subscribe to șÚÁÏłÔčÏÍű News' free Morning Briefing.
Plus, for âextra creditâ the panelists suggest health policy stories they read (or wrote) this week that they think you should read, too:
Julie Rovner: NPRâs â,â by Will Stone.
Anna Edney: Bloomberg Newsâ â,â by Anna Edney and Tanaz Meghjani.
Sandhya Raman: The Texas Tribuneâs â,â by Jaden Edison.
Lauren Weber: ProPublicaâs ââ by Duaa Eldeib.
Also mentioned in this weekâs podcast:
- The New York Timesâ â,â by Caroline Kitchener.
click to open the transcript Transcript: Countdown to Government Shutdown
[Editorâs note: This transcript was generated using both transcription software and a humanâs light touch. It has been edited for style and clarity.]
Julie Rovner: Hello, and welcome back to âWhat the Health?â Iâm Julie Rovner, chief Washington correspondent for șÚÁÏłÔčÏÍű News, and Iâm joined by some of the best and smartest health reporters in Washington. Weâre taping this week on Thursday, Sept. 11, at 10 a.m. As always, news happens fast and things might have changed by the time you hear this. So, here we go.
Today we are joined via videoconference by Anna Edney of Bloomberg News.
Anna Edney: Hey, everybody.
Rovner: Lauren Weber of The Washington Post.
Lauren Weber: Hello, hello.
Rovner: And Sandhya Raman of CQ Roll Call.
Sandhya Raman: Hello, everyone.
Rovner: No interview this week, but plenty of news. So let us dive right in. As of today, we are less than three weeks away from a government shutdown if Congress canât pass all 12 spending bills â spoiler, that is not going to happen â or pass some sort of continuing resolution to keep the government funded while lawmakers continue working on the spending bills. Now, even though Republicans control the House, Senate, and the White House, it will take Democratic votes, at least in the Senate, to make any of this happen, because appropriations bills, unlike that budget reconciliation bill that passed earlier this summer, require 60 votes to pass rather than just 51. So howâs it all going, appropriations watchers? Sandhya, youâre there on the Hill.
Raman: Itâs a work in progress. You know, I think there are a lot of different options kind of being floated around right now to try to avoid a government shutdown. So something our budget reporters reported yesterday is that House Republican leaders are trying to bring a clean CR to the floor next week, so the same spending levels that we have now through late November, early December. But that would include the ACA [Affordable Care Act] subsidy extension that the Democrats want.
Thereâs also, in the works right now, theyâre voting as we speak, kind of, in the House on advancing three of the spending bills, but not HHS [the Department of Health and Human Services] and maybe attaching a clean CR for the rest to that. And whether or not that could eventually include something else that the Democrats want is unclear. Or itâs still in play where just now Democrats were speaking about how they want a very bipartisan â they wonât come to the table unless theyâre getting their voice at the table. So itâs unclear if any of these three options are going to happen, just because so much is in flux right now and weâre still a couple weeks out from their deadline. And you know how Congress can be about this.
Rovner: Yes, three whole weeks â why should they do anything? Letâs talk about those ACA subsidies for a minute. We talked about them last week. Republicans are finally realizing that if they donât extend the Biden-era tax credits that itâs going to be a lot of their voters who are going to see these sort of eye-popping premium increases. And the Democrats would like to sort of do a deal, but so far Iâve seen Republicans saying, Nope, not going to happen. At least not as part of this, keep-the-government-open continuing resolutions. That where they still are?
Raman: I think it depends on who you talk to. When you talk to some of the more hard-line Republicans, they just donât want this continued. Itâs something that you have to offset with a lot of money, and so theyâre not on board at all. There are some of the more moderate Republicans in the House that have signed onto a bill last week that would extend it for a little bit, and so others have been a little bit more wishy-washy. But where they fall, I think that complicates things. We also have a new breakdown in the House right now where the Republicans only have a two-person majority, so it just makes it even more narrow for them to get something across if not everyone is aligned on this.
Rovner: And of course, because this is the Affordable Care Act weâre talking about, weâre going to have an abortion fight with this too, right?
Raman: You know I was just saying earlier that everything old is new again, that anytime that we get into this, we get into the debate of whether or not we include some sort of Hyde Amendment kind of language to say no federal funding for abortion except in rare circumstances. And so the anti-abortion groups have signed on and said, You should not support any sort of ACA subsidy extension that doesnât have that language. Some of the Democrats have already come out saying that thatâs a no-go. In the past, generally when weâve had funding for health care, either if itâs in the approps cycle or something separate, there has been that language, so Iâm not sure where that will land if they get to an extension. Just 15 minutes or so ago, House and Senate Democrats had said they really want to get to a bipartisan deal, but they didnât kind of draw a line in the sand that if the ACA subsidies werenât in whatever spending deal we get in the next few weeks that that would be a deal-breaker. So itâs complicated in terms of where the cards may land in the next few weeks.
Rovner: Long way to go.
Raman: Yeah.
Rovner: Well, meanwhile, the House Appropriation Committee this week approved its version of the bill that would fund the Department of Health and Human Services along with the Departments of Labor and Education. The House committee bill cuts HHS funding, but by far less than the Trump administration had asked, but still by a lot more than the more bipartisan bill approved by the Senate Appropriations Committee just before they left for the August recess. What is the outlook for HHS funding going forward?
Raman: I donât think that weâll see, whenever we get to some sort of deal, something super close to what we had advanced by House appropriators today, but I also donât think that weâre going to see something identical to what the Senate did before recess. My guess would be a little bit more aligned with what the Senate did. Theyâre both run by Republicans, but that one did get, in the Senate, bipartisan support, and since they do need Democrats to pass it in the Senate, I could see it being a little bit more aligned there.
The Senate one had slightly higher spending and didnât have as many of the new riders as in the House related to abortion and trans health and things like that. But we are in kind of a weird circumstance in that, earlier this year, instead of doing new funding, they renewed funding at the same level as last year for another year. So thatâs also a possibility, which is not something that happens super often, in the past, and I donât really see weâre getting a lot happening in either chamber until we get kind of a deal, just because they donât have an agreement on any of the other funding really, either.
Rovner: One of the things that we do see particularly appropriators complaining about with, and weâve talked about this, is this whole pocket rescission thing, the idea that theyâve appropriated this money, theyâve gotten a deal to pass this spending, Congress is supposed to be in charge of spending, and the administration isnât spending money thatâs been appropriated. Is there some possibility of putting in some kind of You must spend this money guarantee, or at least an effort to make a guarantee, in one of these bills? Or are they just sort of tiptoeing around this?
Raman: Theyâve kind of tiptoed around that. I mean, theyâre supposed to spend money. If they donât, they can have the impoundment issues that theyâve had this year where they arenât spending the money and get told that youâre violating the Impoundment Act, but that hasnât seemed to stop some of these cases. I think thereâs also a lot of things happening in this that havenât happened before. Weâve had Russell Vought just kind of say that appropriations should be less of a bipartisan process than it has been. So Iâm not sure if even adding that kind of language would necessarily mean that that wouldnât happen or there wouldnât be different ways around that.
Rovner: And of course, Russell Vought, the head of OMB [the Office of Management and Budget], is just itching to take this to the Supreme Court so that they can say that the Impoundment Act is illegal and that the administration can decide whether or not it wants to spend money that Congress has appropriated, which is obviously something that we will get to at some point with the Supreme Court, but I think weâre not quite there yet.
Well, moving on, the fallout continues from efforts at the Department of Health and Human Services to translate Secretary Robert F. Kennedy Jr.âs anti-vaccine views into policy. We now know that the ousted director of the Centers for Disease Control and Prevention, Susan Monarez, is scheduled to testify before the Senate HELP [Health, Education, Labor, and Pensions] Committee next week. Thatâs the committee chaired by Sen. Bill Cassidy, the Republican doctor who cast the deciding vote to confirm Kennedy back in the winter. The meeting of the CDCâs advisory committee on vaccines is also scheduled for next week. Do we know if thatâs going to happen? I know several officials, including Cassidy, have called on it to be postponed. Anna, are you planning for it to take place?
Edney: I think, so far, planning for it to take place, but maybe not so sure what theyâre going to discuss and whether the covid vaccines will be something that theyâll vote on, at least, because thatâs what a lot of people are waiting on. Thatâs what has caused a lot of confusion is that the FDA [Food and Drug Administration] gave its limited approval to some of these, and then we havenât heard ACIPâs [the Advisory Committee on Immunization Practicesâ] vote on that, or it hasnât been held. And so insurers are finding ways not to cover those vaccines for some people, and people are confused whether they can get them. Pharmacies in some states need prescriptions to be able to give them out. So thereâs just a lot of confusion around and people â the middle of September is already late, and so people were hoping, at least people who are interested and, once the confusion cleared up, were hoping that this will come up. But no indication for sure yet.
Rovner: One of Kennedyâs most stubborn pushbacks at last weekâs hearing at the Senate Finance Committee was that he has not prevented people from getting the covid vaccine. Except in the ensuing days weâve seen story after story about people who should be eligible for covid boosters but still havenât been able to get them or, and as you said, havenât been able to get them covered by insurance, even in some states where governors have tried to intervene to make them more available. I had a note from a friend in Oregon whose 80-plus-year-old husband couldnât get the vaccine. I mean, obviously over 65 and couldnât get a prescription from his doctor to get the vaccine because â and, of course, one of those states that doesnât have MinuteClinics where you can go and get a nurse practitioner to give you the vaccine. I mean, what are you guys hearing about peopleâs ability to actually get this vaccine? Weâve now been sort of conditioned to: OK. itâs September. Kids are back to school. We should go and get our flu shots and our covid boosters.
Edney: Yeah, I think that Secretary Kennedy had said everyone can get it, and maybe thereâs a tiny kernel of truth in there in the sense that if you knew all the work-arounds you could do it. Maybe you could find a way to get someone to put the shot in your arm. Who would pay for it, though? I mean, weâve heard of people postponing because theyâre hoping that insurance will cover it. Theyâd rather not pay $200. So essentially this is causing a lot of people to gamble with their health because theyâre hoping in the next few weeks they donât get covid while theyâre waiting on insurance to possibly cover it and on direction.
So itâs not true that just anyone can get it if they want to, I donât think, or those arenât the stories that Iâm reading, that Iâm seeing, or even hearing. There was a colleague, actually, she had an interesting story. Her husband had, instead of signing up on the website for a pharmacy, because you have to answer the questions if you have any preexisting conditions, a lot of people donât if theyâre under 65. He just walked in and he said: Well, the pharmacist didnât ask me anything there. They just gave it to me. So, I mean, people are finding ways, but it doesnât mean that everyone can do it or pay for it.
Rovner: I feel like Kennedy has sort of conflated the I didnât ban it with the Everybody can get it. Those are two very different things. Lauren, yes.
Weber: I mean, Kennedy also has previously said that the covid vaccine is the deadliest vaccine ever made and then claimed that [President Donald] Trump should get the Nobel Peace Prize for Operation Warp Speed. So there is a lot of dissonance between the secretaryâs statements and sometimes with the reality.
Rovner: And I will note, actually going back to our budget discussion, that there was a bipartisan amendment at the House Appropriations Committee to restore the money for mRNA vaccine research that Kennedy cut. Who knows whether weâll ever see that into law, but I was interested to see that Republicans joined with Democrats to sort of push back at that.
Edney: Yeah, I think mRNA has a lot of applications beyond vaccines that even hard-line anti-vaxxers could see. Is curing cancer a good idea, or treating it? I mean, it has a lot of other things that mRNA really is meant for.
Rovner: Yeah, and also the speed with which, I mean, that was what made Operation Warp Speed work was the speed with which you can actually make vaccines using the mRNA technology. Well, now, apparently, at least according to , HHS is planning to link Tylenol taken in pregnancy to the rise of autism. Just the story appearing on the website tanked the stock of the drugmaker that makes Tylenol last week and has prompted quite the pushback from doctors and researchers as well as drugmakers. What do we know about the links between Tylenol, acetaminophen, and autism?
Edney: I think what we know is that there are mixed results in studies out there, that no one has definitively linked it. No one has definitively, either way. I think thereâs sort of confusion. But the big study that theyâre using out of Harvard to kind of say that Tylenol use during pregnancy causes autism, even the studyâs authors say: Thatâs not what we were saying. We were saying that there is an association, but that doesnât mean causation. I think thatâs something we always come back to when weâre talking about studies. And in this sense, I think itâs unfortunate that the discussion is happening without more definitive answers.
Because when youâre talking about pregnancy, and if acetaminophen is the only thing a pregnant woman can take when she has a very high fever, then high fever can cause a lot of problems as well, and youâre scaring women off from, even, it can cause birth defects if the fever is high enough. The March of Dimes actually says there is concern that a high fever during pregnancy in the first trimester is linked to autism. So you just have this circle that nobody actually has any answers, and unfortunately I donât anticipate that the autism report is going to provide them. It might provide more fear for pregnant women.
Rovner: Lauren, you want to add something
Weber: Yeah, I mean, Robert F. Kennedy Jr. has promised to have the cause of autism by September, which, many medical experts and autism researchers have cautioned, seems like that may not be a complete report, as this is something that has been examined for many years and it seems to be multifaceted. But I think itâs worth noting that in the lead-up to this report being due, we at The Washington Post, in looking at MAHA influencers, noticed that Tylenol has been 15 times more likely to be mentioned by these influencers in August as opposed to April. So there seems to be a lot of MAHA contingent around the Tylenol hypothesis that also potentially could be driving some of this, but weâll see what happens when we see more of the report.
Rovner: So where exactly is President Trump on this whole vaccine issue? On the one hand, heâs been pro-vaccine in some of the comments that heâs made since Kennedyâs confrontational appearance last week at the Finance Committee. But he also posted on, he the president, also posted on his social media a video pushing the long-since discredited accusation that autism is linked to the vaccine preserved with thimerosal, which hasnât even been in most childhood vaccines for the last two decades. I feel like the presidentâs kind of walking this fine line waiting to see which way public opinion falls.
Weber: I think thatâs right, Julie. I think also we have to go back. The president has a history of making vaccine-skeptical comments. I mean, in presidential debates heâs asked questions about vaccines being too big for a horse for children. I mean, heâs said, certainly, things that are of vaccine-skeptical rhetoric. That said, I think he and others have seen polling recently that shows that vaccines are overwhelmingly popular. The vast majority of Americans do vaccinate their children, and while he is conscious that Kennedy and the MAHA movement brought him voters, I think heâs maybe being counseled by others that he could lose voters if he goes too far. So if anything, the man has a shrewd assessment of whatâs going to win him political points. So it seems to me that itâs a messaging to both sides of the fence and itâs kind of a You pick the message you want to hear so you can stay in the tent kind of vibe is how I am interpreting it.
Rovner: Yeah, thatâs my impression, too. And as we know, heâs very good at being on all sides of an issue until he actually has to come down one way or the other. Well, there was a lot more from the Department of Health and Human Services this week than just vaccine news. Secretary Kennedy issued the second part of his long-awaited Make America Healthy Again strategy to improve childrenâs health. It didnât mention some of the biggest threats that we know about for childrenâs health, like gun violence, climate change, or tobacco. It did mention things Kennedy has talked about a lot, like exposure to chemicals and ultraprocessed food, but it didnât really lay out concrete plans for how the administration plans to address those concerns. So what does this report say? And do we think it got watered down by the White House? Do we think it mightâve been stronger at some point?
Edney: I think with what I saw with the report when I read the report is sort of a list of a lot of the things that Kennedy would like to focus on that he sees as the biggest threats to children. Although it got watered down, I think, for sure throughout this process and certainly potentially as the White House held it for about a month or so from coming out. But a lot of people have made the point that Kennedy had to work with the heads of the EPA [Environmental Protection Agency] and the Agriculture Department on this, who are in many ways more aligned with the chemical companies and the big farmers than Kennedy himself might be or had wanted to be in this.
So you kind of lost any ability to maybe go after chemicals in the food supply or things like that. And so there werenât a lot of concrete things that it would do or ways forward, which I would expect in a large administration report like this is kind of more of the next steps, not just the list of whatâs going on. And I imagine weâll talk about it, but there was one piece in that with drug ads that it kind of simultaneously came out with the report.
Rovner: Yes, weâll get to that next.
Edney: Yeah, so I assume weâll talk about that. So maybe they have some plans on some things that we just donât know about yet. But I think that that has, for me, been a struggle in covering and watching this administration is thereâs been a lot of talk and itâs hard to know what the rhetoric is versus what is actually being done. And I kind of see that continuing, and even with drug ads, when we talk about that and get there.
Rovner: Yeah. Lauren, youâve obviously been following the MAHA movement pretty closely. What was your take from this report?
Weber: Well, my takeaway from this report is I was fascinated there were no footnotes, so there could be no AI conversation like the last time we talked about this on the podcast. But no, my other takeaway was, clearly, as Anna pointed out, it seems like industry influence had watered down some of the big pushes of the MAHA movement around pesticides. And I also, my biggest takeaway is: Whoâs paying for all of this? I mean, they promised healthy, nutritious foods in schools, VAs [Department of Veterans Affairs facilities], hospitals. These are things that nutritionists have wanted for a very long time. There was talk of MAHA boxes. Whereâs the funding? I mean, as far as I understand, all the fundingâs getting cut everywhere I turn around. So Iâm curious where the funding for this transformation of Americaâs health care is coming from. And I also think itâs worth noting that in there there was a conversation around some pet projects among folks that are involved in the Trump administration. Iâm very curious. Right now it was basically a bullet points with no action plan. So as Anna smartly pointed out: When will the rhetoric become reality? We shall see.
Raman: I was just going to agree with Lauren. That was kind of exactly my takeaway is that if youâre calling for more research and this and this and then the White House at the same time, when they put out their budget proposal, they called for a 40% decrease in NIH [National Institutes of Health] funding. It just seems counterintuitive. And even thus far in the appropriations process, the Senate didnât even have money for MAHA in theirs. The House did. But we donât know if that happens. And so I am very curious how they would get to do some of these things that theyâre exploring, because it really did seem more like an executive order in the formatting, is like: This is early on. Explore this issue. Rather than Here are concrete things we need you to do.
Rovner: And I would just, to underscore something that Lauren said, a lot of talk about how to improve nutrition for kids and things about the SNAP [Supplemental Nutrition Assistance Program] food stamp program, then at the same time that the âBig Beautiful Billâ cut food stamps. So there is sort of right hand not recognizing what the left hand is doing. Well, Anna, as you mentioned, on the same day, the administration issued its not-so-earth-shaking MAHA report, the president signed an order that could end those annoying direct-to-consumer TV ads for pharmaceuticals, at least as we know them.
This is the moment where I get to repeat the fact that the U.S. and New Zealand are the only developed countries that allow drugmakers to advertise their products on TV. The executive order purports to return to the status quo before 1997, when drug companies basically couldnât advertise on TV, because they were required to talk at so much length about possible side effects and contraindications. Now, I think both Republicans and Democrats in the past 28 years wouldâve loved to have taken this same action. Drug ads arenât exactly popular with the public. But thereâs a First Amendment issue here, right? Something about commercial speech?
Edney: Yes. Yeah, certainly. It seems like long ago the train left the station on banning these pharmaceutical ads completely, because the free-speech protection seems to have encompassed this and it feels like no getting rid of them. Thereâs been no successful effort. So what the Trump administration has said that theyâre going to do is change that regulation that allowed them, the drugmakers, to water down their statement in those ads on all of the awful side effects that can happen to you by taking drugs. And so right now in a drug ad, they can just say, Talk to your doctor and visit this website to see what the side effects are.
And so they want to roll that back and so be able to take it back to having to list all of them, which if youâve looked at a drug pamphlet, a prescription drug pamphlet, I mean, that could take several minutes to get through, and so effectively possibly killing a lot of these advertisements. I think this is still a situation that where the devilâs in the details. We havenât seen the regulation. And I feel like this happens pretty often where they say theyâre going to roll back a huge thing and then it becomes a little bit different than that when the actual regulation is out. But you never know. I mean, I would love â Iâm not a fan of drug ads, either, so itâs not like I need to listen to them on theâ
Rovner: Yeah, could they at least get rid of the jingles?
Edney: Right. So you donât say them all day in your head.
Rovner: Yes.
Edney: But yeah. And then they said that, the FDA commissioner said, they were going to be sending out warning letters to potentially thousands of companies, and Just to let you know, weâre going to be cracking down on this, because thatâs not something the FDA has done a lot in recent years, making sure that theyâre complying with regulations in their advertisements. But they made it into more of a â a warning letterâs a very strong thing that the FDA can do. What this is is more of a form letter saying, Just to let you know weâre going to, not that you specifically violated it, but weâre going to start cracking down on this. So Iâll be curious to see where this lands. They also want to go after more of the social media influencers because they donât fall under these regulations, so bring them more in line with the idea that they need to talk about the side effects and not just how much weight they quickly lost or something along those lines.
Rovner: But certainly we would expect the drug companies, if not TV networks, to sue to protect the right to run these ads, in cases of the networks to get paid to run these ads.
Edney: Definitely. I think that thereâll be some litigation over this, and that first requires the regulation to be made, and so that also takes some time. So this could be a kind of a long haul.
Rovner: Yeah, it was actual big news. Well, last week we caught up with some but not all of the reproductive health news that happened over our break. One thing I didnât want to leave out is that lawsuit that the Supreme Court threw out earlier this summer, challenging the FDAâs approval 25 years ago of the abortion pill, mifepristone. It is not dead yet. While the justices said the anti-abortion doctor group that sued originally did not have standing to sue, since then three states â Missouri, Kansas, and Idaho â have replaced the group as plaintiffs, and now Texas and Florida are asking to join the suit as well. Sandhya, the original suit sought to wipe away the FDAâs original approval. Thatâs now off the table. But the states do want the courts to effectively end the mailing of the pills and return to the FDAâs tighter rules that were enforced before the pandemic, right? Just that could have a major impact.
Raman: It really could, just, if you look at in the last few years, how much of it, abortion, is medication abortion, how much of that has been telehealth after covid, and if you look at whatâs happening in some of the states right now. Texas has cracked down on it. But then thereâs [Texas] Attorney General [Ken] Paxton last year had sued a doctor in New York for allegedly mailing medication abortion to Texas. And then just this week, the attorney general of New York, Letitia James, has intervened in that lawsuit. So itâs going to be a battle between two of probably the most front-and-center attorney generals, especially in these kinds of issues. So I think with those odds, itâs something that I would definitely watch to see does this go back to the Supreme Court at some point. Even if itâs not this case, this issue is rising up again.
Rovner: Yeah, thatâs right. Thatâs what I was going to say. I mean, at some point the Supreme Court is going to have to adjudicate this question about these blue-state shield laws. Not only has Texas gone after this doctor in New York, Louisiana, I believe, has indicted this doctor in New York, has tried to charge her criminally, which Attorney General James in New York is also trying to prevent. So I mean, weâre going to see this come to the Supreme Court at some point, right?
Raman: I do think so. Just because of how front and center this within the whole movement has kind of become, and especially I think even if we look past, in the past few weeks, how much more mifepristone has come up is something that Republicans want HHS to look into. RFK Jr. has brought it up. There could even be changes on that level that spur a lawsuit, or I think that thereâs a lot going on, and so even if itâs not this specifically, something else will nudge it that we see that elevate.
Rovner: Well, meanwhile, anti-abortion groups, or should I say anti-in-vitro-fertilization groups, are now promoting something called ârestorative reproductive medicineâ as an alternative to IVF. According to Caroline Kitchener , quote, âthe concept addresses what proponents describe as the âroot causesâ of infertility, while leaving I.V.F. as a last resort,â close quote. Groups that support IVF are not amused. The American Society of Reproductive Medicine, which represents doctors that treat infertility, calls ârestorative reproductive medicineâ and âethical IVF,â quote, âmisleading terms that threaten access.â Sandhya, is this yet another effort to ban reproductive technologies that have pretty broad political support by basically rebranding bans?
Raman: You know this one is interesting because it also, to me, has a tinge of kind of what we see in MAHA in that itâs kind of pointing to Weâre doing this whole-person thing to elevate health care in the same way that theyâve said: Itâs not that youâre having these issues because of something you need medicine for. Itâs the food. Itâs the chemicals and that kind of stuff. So Iâm curious, A, if this gets kind of elevated more just because thereâs similar thinking in both of those, but also just kind of how the messaging plays out. When weâve had some of these IVF battles, weâve had people walking kind of a fine line because maybe theyâve used it themselves or someone in their lives had but that they know that some of the people in their base do have some issues related to if all the embryos get used and things like that. So elevating this does seem like something that would be politically easier for certain people to message on, but Iâm not sure.
Rovner: Lauren, you want to add something.
Weber: Yeah, I mean, I think we talked about Trump toeing a political line earlier in this podcast, and I see this as a similar version of that. I mean, this is the president who vowed to expand access to IVF, but some of his hard-right conservative base has issues with it. They see it as potentially interfering with life itself. And so I think offering up this alternative health care strategy, which, to be clear, there could be good things in there â treating women with endometriosis, investing in the root causes of infertility. Thereâs nothing inherently wrong with that. In fact, thereâs a fair amount of lack of information where it becomes questionable and where Iâ
Rovner: Thereâs also, I said, thereâs nothing inherently controversial about any of that.
Weber: No, I think thereâs a lot of people that would be very excited about that. I think where it hits a line thatâs confusing and that Carolineâs story kind of gets into is, is it at the expense of â thatâs usually the entry point, which a lot of these health organizations have made clear. Those are all great things to do, but at some point there is potentially a need to hit the next step, and there is concern that this movement could replace the push for IVF. And so I think that tension point and how Trump and the administration is kind of toeing that line with both the MAHA group and the far right is really interesting.
Rovner: Yeah, I mean, I would add that IVF is expensive, involved, unpleasant. Itâs not something that people turn to as a first choice anyway, so I was a little bit sort of taken. Itâs like, yes, I would think that people with infertility do explore most of their other options first. But yes, whatâs wrong with having more research to try and solve the problem before you actually have to resort to IVF? We will watch this one as well.
All right, that is this weekâs news. Now itâs time for our extra-credit segment. Thatâs where we each recognize the story we read this week we think you should read, too. Donât worry if you miss it. We will put the links in our show notes on your phone or other mobile device. Anna, why donât you go first? You have your story, which Iâm really glad youâre doing.
Edney: Thank you. Yeah, I appreciate that. So mine was from last week: ââ So I did an investigation into this device called BioZorb thatâs made by a company called Hologic. And they have a huge womenâs health division and a breast division that â so a lot of mammogram machines that they sell and things like that. But they were selling BioZorb. It was supposed to revolutionize breast cancer treatment because, at least the idea, this isnât what they had FDA approval for, but what it was talked about as is something that could help women when they were healing, that their breasts would grow back after a tumor was taken out. Their breasts would grow back more, heal more full-looking, not have dips and maybe other deformities that can happen with a lumpectomy. And instead, these women have experienced all kinds of awful infections, and some people actually had the device poking through their breasts because it was supposed to dissolve, but it was years where some people still had it.
A woman I talked to, it shattered inside of her. So there were 24 pieces of plastic, sharp shards in her breast that were causing immense pain. A lot of people complained about pain, but the key to this is that Hologic and a company that invented the device and sold it early on, called Focal, were hiding these complaints. They were not handing them over to the FDA as they should have, and some for as long as 10 years. So nobody knew what was going on, but women were still being implanted with the devices. I think itâs just a bigger story about oversight of devices and also how devices come to market, because this device was never studied in humans, in women, despite it being implanted inside of them. And thatâs actually really typical to how devices make their way through the FDA.
Rovner: Really important investigation. Thank you. Sandhya.
Raman: So my extra credit is called â,â and itâs at The Texas Tribune, by Jaden Edison. And I picked this because I thought it was something really interesting that Iâd never really thought about before, but thereâs a new law in Texas that you have to get parental consent before the nurse or whoever at the school can do health services for students. And theyâre getting more confused about if they would also be penalized for handing out Band-Aids or ice packs or just first aid. And school districts are required by the law to discipline violations of the law, but how itâs kind of being done across the state is a little varied, and some places have been saying theyâll only even intervene if itâs life-threatening. So I think itâs interesting as part of the parental consent movement of when is this something that is debilitating and if someone doesnât have a form signed, how thatâs going to affect kids at school.
Rovner: Yeah, a lot of good discussion about thinking things all the way through. Lauren.
Weber: Mine is titled ââ by ProPublica, written by Duaa Eldeib. And it is just a heartbreaking tale, one that ProPublica has been doing really well, where they examine the fact of prior authorization and what it means for patients. And itâs about a gentleman who was trying to get approved for mental health stays after several suicide attempts. Itâs a gutting story. And the reviewer at the end of the appeal process, he was so appalled by what had happened that he called the wife of the man who had been trying to get these appeals. And itâs an important read, especially as Congress is weighing things on prior authorization and as [Centers for Medicare & Medicaid Services Administrator Mehmet] Oz has vowed to expand prior authorization for some things. So a lot here to be unpacked. And ProPublica, again, big props for how theyâve covered the prior auth issue in the last couple of years.
Rovner: Yeah, itâs been fodder for a lot of â really a lot of â good stories. All right. My extra credit this week is from NPR by Will Stone. Itâs called â,â and itâs a really clear story about how it turns out that full-fat dairy, at least in some cases, isnât nearly as bad for you as other high-fat animal products appear to be. It looks at this one case where science is working as itâs supposed to, with researchers continually updating and refining what they know and recommend. Bottom line seems to be that full-fat cheese and yogurt â probably not bad for you, maybe even good for you. But butter? Still not great. Itâs too bad for me. I like butter. Also, what matters is what else is in your dairy products. Itâs one of those really well-done pieces that itâs like: OK, this is what we know. This is what weâre trying to find out. This is whatâs new. This is the kind of consumer-helpful information we should have more of.
OK. That is this weekâs show. Thanks as always to our editor, Emmarie Huetteman, and our producer-engineer, Francis Ying. If you enjoy the podcast, you can subscribe wherever you get your podcasts. Weâd appreciate it if you left us a review. That helps other people find us, too. Also, as always, you can email us your comments or questions. Weâre at whatthehealth@kff.org, or you can still find me on X, , or on Bluesky, . Where are you folks hanging these days? Sandhya.
Raman: and , @SandhyaWrites.
Rovner: Anna.
Edney: , @annaedney.
Rovner: Lauren.
Weber: , @LaurenWeberHP. The HP is for âhealth policy.â
Rovner: We will be back in your feed next week. Until then, be healthy.
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