[Editor’s note: This transcript was generated using transcription software. It has been edited for style and clarity.] 

Julie Rovner: Hello, from Ñî¹óåú´«Ã½Ò•îl Health News and WAMU Public Radio in Washington, D.C. Welcome to What the Health? I’m Julie Rovner, chief Washington correspondent for Ñî¹óåú´«Ã½Ò•îl Health News. And, as always, I’m joined by some of the best and smartest health reporters covering Washington. We’re taping this week on Thursday, Aug. 6, 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 video conference by Alice Miranda Ollstein of Politico. 

Alice Miranda Ollstein: Hello. 

Rovner: Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico Magazine. 

Joanne Kenen: Hi, everybody. 

Rovner: And my Ñî¹óåú´«Ã½Ò•îl Health News colleague Amanda Seitz. 

Amanda Seitz: Hi, great to be here. 

Rovner: Later in this episode, we’ll have excerpts of my “How Would You Fix It?” interview with New Jersey Democratic Sen. Andy Kim, who’s proposing universal coverage starting with all American children. But first, the freight train of health news continues. 

We’re going to start this week in Michigan with that very closely watched Senate primary to fill the seat being vacated by the retiring Democrat Gary Peters. We’ve known for months the Republican candidate will be former congressman Mike Rogers, who narrowly lost to Sen. Elissa Slotkin two years ago. And now we know he will face Abdul El-Sayed, an MD epidemiologist and former public health director of Detroit. El-Sayed, who ran on a platform emphasizing “Medicare for All” and has even written a book about it, narrowly defeated four-term Democratic congresswoman Haley Stevens, who had a gigantic cash advantage, mostly provided by supporters of Israel. Now, the fight over Israel in Gaza is for some other podcast to get into, but I do think that this underscores the increasing popularity of Medicare for All in the base of the Democratic Party. What does El-Sayed’s primary win tell us? And can someone from the more progressive wing of the Democratic Party win in a very purple state like Michigan? 

Ollstein: Well, I also want to point out, like, this isn’t an outlier. It was really notable to me that during the Maine rushed, redo primary they just had for the Democratic Senate candidate to take on Susan Collins, everyone in that race was endorsing Medicare for All and calling for it. And Maine is also a very purple state with an older electorate, and, you know, not raging progressive. And so I think it is notable that this isn’t just in the big blue cities anymore. This is a growing drumbeat within the party, and, you know, of course it comes as we’re seeing a lot of people lose their health insurance, which we’re going to talk about. We’re seeing costs go way up, and so there’s just this wellspring of frustration that I think is fueling some of this. 

Seitz: Oh, I was just going to say I would caution, though, how big of a win this is for progressive Democrats. You know, they’ve won the battle, and I’ll say it has built quite a strong coalition. But this was a really narrow primary win, and that is not the situation you want to be in when you have two diametrically opposed candidates from the same party running in a primary in a very purple state headed into the midterm elections. 

Rovner: Yeah, well, let us talk a little bit more about Medicare for All because it’s a trendy moniker for something that’s not really all that specific. Some people think it’s just shorthand for “everyone gets government-provided health insurance.” Some think it’s actually socialized medicine. And some think it’s literally just an extension of today’s Medicare program, which is itself a very public-private hybrid. My friend Jonathan Cohn over at The Bulwark, who happens to live in Michigan, has a  that I will link to about how consideration of Medicare for All looks different in 2026 than it did in 2016 or even in 2009, when they were doing the Affordable Care Act. Where do you guys think we are on Medicare for All? I would remind that what was in the 2020 campaign, every candidate, every Democratic running except for Joe Biden said they were for Medicare for All, and yet Joe Biden is the one that came out of the primaries. 

Kenen: I think Kamala Harris was for “Medicare for All Who Wanted It.” She had some strange hybrid of it, but that is part of our past. I mean, Medicare for All is something you hear about from the Democratic Party, a segment of the Democratic Party, in pretty much every election with more or less intensity. And more so [with] Bernie Sanders running against Hillary [Clinton], it was a much more pronounced debate. In Michigan, I don’t think this is the defining issue. I mean, I think that global politics in the Middle East, and given the demographics of Michigan, and what the race is focused on, and points of contention are, it’s pretty easy to talk about wanting everybody to be covered, and it’s a lot harder to get there, as we all know, because we’ve been talking about it for decades. So I think you’ll hear about it from Democrats â€” I’m not sure in Michigan and elsewhere, but I’m not sure how specific a plan or a definition it is, sort of this holy grail that nobody knows quite what it looks like. 

Ollstein: But that also makes sense. I mean, it’s not really in their interest to put out detailed policy plans that people can pick apart at this phase of things. And so it makes sense that we’re in the grand, sweeping, dreams phase of things, and not in the â€¦ 

Rovner: We’re in the slogan phase. 

Ollstein: Exactly, exactly right. Because, you know, as soon as Democrats put out an actual bill, a draft bill, then the vultures will descend and point out all the downsides, and that doesn’t help them heading into, you know, a major midterm election. So we imagine that work is going on behind the scenes, because they want to have something ready to go if and when they have control in Congress. But what exactly that is, we don’t know. 

Kenen: But I also think there’s pressure for the Democrats to be â€” in the best-case scenario, if you had a united Democratic Party where they all wanted Medicare for All and they all agreed on what that meant, you don’t press a button and get there. It would be some kind of incremental phase, and it’s not going to be, like, OK, today we have this and tomorrow we have Medicare for All. So I think, in the short term, less controversial and maybe more urgent is affordability and access right this minute. We are going to talk about the coverage decline and affordability and just access on a day-to-day … even if you are able to afford your care and even if you have pretty good insurance, getting into a doctor when you need to has become really frustrating. Even if you’re sick and already know that doctor. So even if you’re a pretty health-savvy consumer, the way all of us are, we see this in our friends and family, and we understand the system â€” sort of, like “the system” in quotes. So I mean, I think there’s the Medicare for All, you know, Democratic dream, and it â€” I don’t mean it’s not sincere; I mean, that’s what many people want â€” but I also think you’re going to see a lot more nuts and bolts: What has happened in the last two years, and how do we fix it? 

Rovner: I’m interested in the fact that Republicans who are already sort of ginning up their talking points against the, you know, wave of progressive candidates like El-Sayed, although he’s not as progressive as, you know, the [Zohran] Mamdanis and, you know, some of the other avowed socialists. They’re talking about socialism and communism, and they’re talking about all kinds of things. They don’t seem to be talking about healthcare, which suggests to me that Republicans are kind of aware that things are not going well, and that, Joanne, as you point out, I mean, you know, it used to be let’s see if we can fix the health system without messing up the people who are happy. There are fewer and fewer people who are happy right now with how the health system is falling apart. 

Kenen: Including the doctors, right?  

Rovner: Right. Oh, absolutely. 

Kenen: Nobody’s happy. 

Rovner: Well, well, let us move on to all of the ways in which the healthcare system is falling apart. Item one is a new Gallup-West Health poll that found nearly a quarter of workers surveyed said they were staying in a current job that they otherwise wanted to leave only to retain their health insurance. That was up 8 percentage points since the last time they’d asked in 2021. Now “job lock,” as this is called, is something that HIPAA was supposed to address back in 1996. The “P” in HIPAA stands for Portability. It was the Health Insurance Portability [and Accountability] Act. How is this still a thing 30 years later, that people feel stuck because they can’t change health insurance? 

Ollstein: This was also a big driving force behind the argument for Obamacare. The argument was: We’re going to free up all these people by creating this individual market, we’re going to unleash American ingenuity, and we’re going to have entrepreneurs and people starting their own businesses and experimenting and trying things that they wouldn’t feel able to do because they’re so afraid of â€¦  

Rovner: Shark Tank for All! 

Ollstein: â€¦ losing their health insurance. And so I think the way the Trump administration has targeted some key pieces of Obamacare, you know, they obviously, as we know, failed to get rid of the whole thing, but they are chipping away at the subsidies, which has caused a lot of people to drop their coverage; they’re going after the Medicaid expansion piece of Obamacare, and so I think that’s driving some of this return to, you know, clinging to the job you have in order to maintain your health insurance. Although, going back to the point that nobody’s happy, employer health insurance, while it may be better than a lot of the other options, is, you know, people aren’t thrilled either. The costs are still quite high for both employers and employees. 

Rovner: And employers are looking for ways to cut back. Go ahead, Joanne. 

Kenen: I was also wondering, as I read those numbers about job lock â€” and we should also remember, even though it wasn’t in that particular story, there’s also something called “marriage lock,” where people stay in marriages they don’t really want to be in because they wouldn’t have, they fear they wouldn’t have coverage. But one thing I just sort of wondered about is I wonder how many people realize that they might, in fact, qualify for the Affordable Care Act. I think people are still confused about the ACA, as well as they’re confused about a whole laundry list of things that we could spend a year talking about. People aren’t always paying attention, so some of the people who are afraid that if they change jobs or think they have to stay in their job think that Obamacare is for somebody else. So I don’t know. 

Rovner: They wrongly think they’re in job lock. 

Kenen: Right, right. So, but it still affects the behavior. If you feel that way â€” you’re anxious and insecure and unhappy â€” then you’re anxious, insecure, and unhappy. Whether you are aware of there’s an alternative or not, it doesn’t affect how you feel now, which is, you know, grumpy. That’s not the right word, but you know what I mean. 

Rovner: I know what you mean. 

Seitz: Yeah, well, and I think that that’s what I found fascinating, too, is like when we look back at 2022, there was a lot of head-scratching as to how Democrats performed so well in the midterm elections. But you look back at that time, and people â€”it was the peak of the Great Resignation â€” people were leaving their jobs. They were able to get big raises for the first time in a while. Unemployment was extremely low, so you had, like, an electorate that was pretty happy and didn’t have that anxiety. And now you’re staring down a situation where people are afraid to leave their jobs. They’re afraid to lose their health insurance, and the social safety net is deteriorating at the behest of the Trump administration. And I think that’s not a very good situation to have a lot of Americans in, as you head to a midterm election. 

Rovner: Well, item two: Several outlets, , reported last week that hospital systems are seeing what the Times’ Reed Abelson described as, quote, an “unexpectedly sharp rise in uninsured patients and the costs associated with treating them.” We are starting to hear this in earnings reports from for-profit chains and anecdotally from nonprofits. Now, this was something that we saw coming. People can no longer afford their ACA plans and drop them, or as they can no longer afford the premiums without the expanded subsidies and had to buy down to less-generous plans with larger deductibles, which they then can’t cover when they end up in the hospital. This would suggest the Trump administration’s claim that the drop in ACA coverage is all due to fraudulently enrolled people with zero claims might not actually be the case. 

Seitz: I question how much, like, the Trump administration realizes they’re playing with fire here. And I think in part because during the first Trump administration, you saw a few hundred thousand people disenroll from the ACA. They kind of let it to languish, but there was also a lot of question about the ACA marketplaces’ ability to survive. This time around is so much different. You’re talking about millions of people losing coverage within the first year. The Trump administration came in; they had record enrollment in the program. So these are real losses. These are real hospitals, and these are going to be real headlines of real people experiencing these real misfortunes. And you’re going to have either taxpayers eating the cost of the care through emergency Medicaid, or you’re going to have people winding up with really big medical bills that they can’t pay. And again, those are going to be real stories. And the Trump administration is going to find that they can’t just continue to yell fraud to cover all that up. 

Ollstein: Yeah, to Amanda’s point, I think this message could definitely backfire politically. Nobody likes to be told that they are a fraudster or don’t exist when they are losing their health insurance. And this is hitting red-state hospitals just as much as blue states, if not more. And so, I think going into the midterm election, sticking by this line and not admitting who is being harmed is definitely risky. 

Rovner: Yeah, it’s worth pointing out that, I mean, it does hit red states harder because the red states that didn’t expand Medicaid ended up with bigger enrollment in the ACA when they expanded the subsidies â€¦ 

Seitz: Florida’s the biggest. 

Rovner: â€¦ and so those people are now losing coverage. Yeah, Florida, Georgia, Texas. Those are the places where the hospitals are going to see it first when people are showing up who can’t pay their bills. 

Kenen: And those are the states that already have a lot of rural hospital closures. There are rural hospital closures and hospital closures across the country, but the rate of closures is much more acute in the states that did not expand Medicaid. So now you’re going to have more hospitals in jeopardy. It is not a healthy situation. 

Rovner: Well, related to this, we have the impending cuts to Medicaid. A federal judge appointed by Bill Clinton declined to block the Medicaid work rules from taking effect as scheduled Jan. 1. This was in a lawsuit filed by Democrat-led states. But there could still be some delay, right? I know doctor groups are completely freaked out by having to potentially write notes for tens of thousands of patients who may or may not be too medically frail to work. There’s still a lot of sort of panic, if you will, in the states about what’s going to happen to people if they can’t meet these work requirements. 

Ollstein: Yeah, and I want to make sure people know that the judge [who] ruled in this case, he said you shouldn’t take this ruling to mean that I think the states are wrong in challenging this policy. They could very well prevail eventually and strike it down. He just said, basically, this isn’t ripe. You don’t have enough evidence right now of harm to the states because the policy hasn’t officially started yet. Although it has in a couple states that weren’t part of the lawsuit, which we can get into. But this particular piece of the story is not over. Also, people should know that what was being challenged in court was not the entirety of the work requirements; it was just the piece requiring sick people on Medicaid to prove that they are too sick to work, prove beyond just having a diagnosis of cancer or an autoimmune disease or something. Just the diagnosis is not enough; they have to have some kind of proof. It’s not totally clear what kind of proof will count. And, to your point, they’re worried that it’s going to end up being individual doctors’ notes, which will completely overwhelm the system. Doctors don’t have the capacity to see all these people to document this and provide care. 

Rovner: And doctors don’t have the training to determine, you know, who’s disabled and who isn’t. That’s why we have these, you know, special masters for disability programs. Your average doctor is not really in a position to say, “Well, so-and-so can work this month but not next month.” Really, I mean, doctor groups really are legitimately worried about that this is going to fall to them. 

Kenen: And also, like, an awful lot of the people on Medicaid who would be affected â€¦ this is the Medicaid expansion population. It’s not all of Medicaid. But a lot of this population has chronic disease. And chronic disease is often sort of on and off, right? You’re doing OK for a while. You can work, and then kaboom, you have an exacerbation. You have a setback. You have an episode. Whatever your disease is, there are different things that happen, and then you can’t work. And doctors don’t know â€” I mean, mental illness is clearly one of the things where people could be stable for a long time and then crash and then recover and stabilize again. Cancer, you can be doing fine, on chemo for a certain amount of time, and then your body just says, you know, I’ve had enough chemicals pumped into it. Or you have â€¦ every chronic disease is pretty much â€¦ every one I can think of is an up-and-down, on-and-off â€¦ like how bad do you feel or how good you feel at any given time. And they certainly don’t have â€” then you’re out of compliance. You know, well, you’re healthy enough to work. Why aren’t you working? You know, bye-bye healthcare. So it’s really a complicated mess. The only little thing that may buy the states some time, in addition to whatever happens in the court, is for the first year and only the first year, people will be allowed to self-attest, meaning I’m just going up and saying I’m, you know, here’s my diagnosis, and I’m too sick to work. That is not likely to be extended. It’s unclear how that will play. I’ve written about it in somewhat detail about one state. I’m not exactly sure how it’ll run out in all 50, but it is part of the current rule that, this controversial rule that was dropped on June 1, that made this all sort of more complicated and more difficult. That self-attestation would be available on Jan. 1 for a limited period of time. 

Ollstein: But not in every state. So CMS [the Centers for Medicare & Medicaid Services], the federal government, said states can accept self-attestation. Several states are saying no thanks. We’re going to start requiring proof right away. No self-attestation allowed. So this is yet another sort of natural experiment where we’re going to see, you know, the differences between these states with these different policies, and how many people lose coverage as a result. 

Kenen: But it’s going to be way more than we thought at the beginning. I mean, the difference in this medical frailty rule versus what CMS was telling states until a few weeks ago versus, kaboom, on June 1, it is a much more cumbersome process. I mean, nobody thinks the old estimates of coverage loss are accurate anymore. I mean, there’s always a lot of guesswork in that, right? None of us know exactly how many people will lose coverage, but it looks like a lot more than we thought. 

Rovner: So we already have one of these natural experiments going on in Nebraska, which volunteered to implement its work rules first. The state is now getting ready to disenroll the first Medicaid patients who have failed to meet the requirements. Clearly, some of those people are still eligible, including a pregnant woman reported on by Nebraska Public Media who showed up for an appointment and was denied coverage because apparently the state missed the fact that she was pregnant and therefore eligible. I imagine we’re expecting more of this, right, Alice? We’ve seen this movie before? 

Ollstein: Yes, so we’re getting a sneak preview in Nebraska of what could happen in the rest of the states that expanded Medicaid come Jan. 1. A couple other states are also starting early, although they have different rules about when the penalties kick in and when the enforcement kicks in. But yes, you know we’re seeing a lot of confusion, people losing coverage who are technically eligible for coverage, and basically everything that providers and community groups and patient advocates predicted would happen. 

Kenen: And we know from Georgia, which does have work requirements already, they’re not a full-expansion state. They have their own version of a partial expansion, but it’s still, the law still applies to them. And they’ve had a lot of people losing coverage who probably are still eligible. We know from Arkansas’ experiment in, I believe was 2018, tons of people â€” I think it was 17,000 or 18,000 â€” who lost coverage, and most of them actually qualify. In fairness, the technology since 2018 and 2027 â€¦ and learning from Arkansas’ mistakes. â€¦ I think it’s important to be aware of how flawed and problematic Arkansas was. I don’t think it necessarily means that everything will be exactly that bad because, you know, there’s more broadband access in rural America, etc. We don’t have to go into all that. But it’s not a great precedent in terms of smooth rollouts. 

Seitz: And we also know it from the Medicaid unwind during the pandemic, too. We saw these errors and the initial estimates of how many people would be removed from coverage after the federal government said, OK, you can’t allow continuous enrollment anymore. They blew past those initial estimates. So, to your point, Joanne, earlier about how we are going to see much greater disenrollment than was initially predicted.  

Rovner: All right, we’re going to take a quick break. We will be right back. 

We are back, turning to abortion. Alice, you were part of a  about U.S. Attorney General nominee Todd Blanche and something he promised to anti-abortion groups. Tell us what he said. 

Ollstein: Yes, so this was on a private call that the White House Faith Office did with what they said were thousands of faith leaders around the country. And they, you know, said over and over on this call, this is private, this is off the record, this is not for the news, and then they posted it on YouTube for some reason and on some other places online. Explain that. Anyways, it’s been taken down since our story published, but we have the audio saved. So Blanche was basically promising that not only would he take action to restrict mail delivery of abortion pills and curbing abortion access in other ways, if confirmed, he sort of went beyond that and said that policies are already in the works. There’s already discussions going on between the White House, DOJ [Department of Justice], FDA, all of these different agencies sort of pledged to stop the ability of patients in red states to order abortion pills online and get them delivered by mail, which is, you know, a key line of access that patients have turned to in this post-Roe era of bans. It was not clear from the audio that we obtained how he plans to go about doing that. I also imagine if, you know, the FDA does come out and change its policy, that his remarks could be used to challenge that and say, you know, this was not based on science. This was based on ideology and religious opposition to abortion, which is not what the FDA is supposed to base its drug access policies on. So this was really fascinating, particularly because it did not really jive with what he said publicly in his confirmation hearing, where he sort of hemmed and hawed and said, “Oh, I can’t speak to that because there’s ongoing litigation,” and sort of made â€” yes, this was more specific promise of action than we’ve heard from him publicly. 

Rovner: And just to be clear, I think I have this right: Even if the FDA doesn’t change its policy, the DOJ could decide We’re going to enforce the Comstock Act â€” that 1873 law that bans the mailing of abortion drugs. And that would sort of leave FDA out of the entire equation, right? I mean, in theory, he could do that. 

Ollstein: Yes, and a lot of anti-abortion activists are very frustrated that the administration has not done that yet. They could have done that a year ago, theoretically put out a new OLC memo. Of course … 

Rovner: OLC, the Office of Legal Counsel. 

Ollstein: Yeah, which the Biden administration used to say that the Comstock Act cannot be used for cracking down on mail delivery of abortion pills. Of course, even if that happened â€” and there’s no sign that that’s necessarily imminent or something the administration would want to do ahead of the midterms potentially â€” but, you know, I think it’s notable to ask: How would they enforce that? This is private mail going to people’s private homes â€” short of mass surveillance and looking at everyone’s mail. I mean, logistically and constitutionally, it raises a lot of questions. 

Rovner: It does. Well, and now Sen. Susan Collins has cited it as one of the reasons that she’s going to vote against Blanche’s confirmation. Although I will quickly add that once Susan Collins announces she’s voting against something controversial, that usually means Republicans already have the votes they need and can let her go. â€¦ I see nodding. Do we think that’s the case here? 

Kenen: She’s always in tight races. For the past 30 years, she’s won. But you know, Maine is really obviously in play this year. None of us have a good enough crystal ball to know how this plays out. But the issue for her, in many ways, is just her [Supreme Court Justice Brett] Kavanaugh confirmation vote. So anything she does seen as further eroding abortion could really tip the election for her. So I’m not positive that this goes through. I think it’s likely, but [Sen. Bill] Cassidy, I don’t believe, has said what he’s going to do. [Sen. Lisa] Murkowski hasn’t said â€¦ if someone has more recent information, please update me. But my understanding …  

Rovner: As of this morning, Cassidy and Murkowski are still holdouts. 

Kenen: Right. And I’m not 100%, even though [Sen. John] Cornyn and [Sen. Thom] Tillis got him out of committee, they’re watching. They’re seeing, you know, what’s going on. Abortion is not the issue for them, but the weaponization, you know, what did he really mean by, you know, does his memo really stop it? What else are they going to do? I don’t think this is a done deal, as opposed to getting closer to being a done deal. But there’s no question that Collins had to vote against this. 

Rovner: We will see. All right. Well, over at the Department of Health and Human Services, things continue to be messy, which is also the description of an interview that Secretary Robert F. Kennedy Jr. gave to CNN’s Dana Bash on Sunday. Here’s how my colleague . I don’t think I can improve on this. “This morning, HHS Secretary Robert F. Kennedy Jr. sat down with Dana Bash on CNN’s State of the Union, and for 20 minutes it went about the way you’d expect. Both of them raised their voices, each accused the other of attacking them. He told her she’d committed press malpractice and that scaring people was the job of CNN. She told him he was causing inaccurate information to circulate. By 9:20 a.m. they were calling each other parrots.” By the way, this week saw publication of yet another large-scale study, 2.5 million children large, that found no association between autism and the measles, mumps, and rubella vaccine. But it raises the broader question: Does giving the secretary a mainstream platform like this actually make the media complicit in spreading the misinformation that he likes to spew? 

Ollstein: Things like this are such a Rorschach test because you had everyone on the left describing it as a crash out and, you know, a meltdown and something that made the secretary look really terrible, and you had people on the right who support him sharing it widely and saying, “Oh, he really gave it to the evil mainstream media.” And so, in terms of, you know, value to the public, I’m not sure. 

Seitz: I think you’re totally right, Alice. But what was really revealing is we have a health secretary who could not articulate what his plan is for any sort of outbreak, as there are multiple infectious disease outbreaks exploding throughout the country. And the one thing that he said he would do repeatedly was he would listen to doctors. Well, doctors on the front line of emergency rooms are saying, We are overwhelmed with measles. We are overwhelmed with infectious disease. Please, promote vaccines more. Please get your children vaccinated. So I think that was really just revealing. And again, it’s really troubling to see because everyone’s going to walk away from that conversation viewing it one way or the other, and not agreeing on anything, it seems. 

Rovner: Yeah, I will say, I mean, I watched it live. It was hard to watch. I don’t think it covered anybody with any kind of glory. Well, earlier this morning, speaking of breaking news, Kentucky Sen. Rand Paul’s Homeland Security and Governmental Affairs Committee voted to hold former NIH [National Institutes of Health] institute director and White House science adviser Anthony Fauci in contempt of Congress for pleading the Fifth, rather than answering their questions at a hearing last week. As former Trump surgeon general Jerome Adams quipped on X: “Your healthcare costs are exploding and the entire U.S. financing system is collapsing in real time… Meanwhile Congress is spending more energy debating whether to lock up an 85-year-old over his private journal entries about Barbra Streisand. Priorities.” At the same time, Politico is reporting that a top candidate for Fauci’s old job, running the National Institute of Allergy and Infectious Diseases, is a pharma executive who co-authored a book arguing that covid came from a lab leak and that fact was covered up by U.S. scientists. Steven Quay, who’s the nominee, has no training in infectious disease and was not selected for an interview by NIH staff for the NIAID job, but was instead handpicked by RFK Jr. Institute directors, I would hasten to add, are not usually political positions, unlike the director of NIH as a whole. So, what does this all suggest? 

Kenen: More of the same and worse. The Fauci situation is mind-boggling, even to people whose minds are now frequently boggles. Right? It’s â€¦ I think it’s safe to guess that he regrets writing certain things down on a government computer. And now they’ve got his phone. Sen. Johnson has his phone â€¦ or a copy of what his phone is. So I don’t know what’s going to come out about that, and how it will be interpreted. Remember that the measures that people are so angry about, several years later, were actually done during the Trump administration. They were not implemented by Biden. The national rules set at the, you know, the “six weeks to stop the spread” — that was Trump. Later regulations about opening restaurants and so forth, and other businesses and schools, and schools being the most contentious â€” churches are also contentious â€” that was done at the state level. Anthony Fauci did not go around the country locking churches. So public health made mistakes. But what people are forgetting about is that public health made mistakes dealing with a completely unprecedented and extremely complicated disease, which we still don’t understand all the sequel, all the stuff that people are still dealing with post-covid, right? And under emergency circumstances, in a politically volatile environment. And what we’re also forgetting is mistakes were made on the other side too. People were spreading quote-unquote “facts” that harmed people, that killed people. … I don’t mean they went out and murdered people, but things that led to unnecessary and avoidable deaths. So the whole debate, I mean, you can tell I’m â€” I’ll stop. Tony Fauci was not single-handedly making every decision, and the people trying to make public health decisions in a difficult environment were doing their best to save lives. And â€¦ it doesn’t matter what he said about Barbra Streisand. 

Rovner: And I would just add that it is Congress’ job to do things like examine the mistakes that were made and how things could have been done better, how communication could have been better. And I feel like, you know, Congress is just is so busy finding a scapegoat that it is not doing what could be a really useful exercise in an after-action report. Because there will be another pandemic, and, you know as we’ve said, we are having smaller-scale public health emergencies even as we speak, and nobody is dealing with it well. 

All right, moving on. Finally, this week, the House has decamped for its August recess, but the Senate is still here on Capitol Hill, trying to get a pretty ambitious list of things passed before it leaves at the end of the week, starting with a continuing resolution to keep the government open when the new fiscal year begins Oct. 1. The House passed a CR to run until after the midterms before it left in July. The Senate’s CR is similar with one big change that we have actually discussed lately. It would block, at least temporarily, a controversial rule from the Office of Management and Budget that would further politicize the grant-making process by allowing political appointees to decide whether individual grants conform to the president’s agenda. Can this get back through the House, assuming the Senate passes it when the House comes back in September? Or is this going to come down to the wire and we’re going to have a fight over it as we approach Oct. 1? 

Kenen: Well, the other question that some researchers, you know, when I when I talk to some people about, well, they â€” and remember they’re not killing this rule; they’re halting its implementation. 

Rovner: They’re delaying it, right? 

Kenen: Right. You know, one of the scientists’ first response was, “Yeah, well, just because Congress passes a law doesn’t mean the administration will respect it.” There are other ways to politicize, and I mean, they’ve been cutting funding and stopping grants and virtually shutting down agencies. Science has already been hurt. So whatever happens in the House, which, and I think Julie is right, I don’t think they just come back and say, “OK, we’re going to just agree.” I think there’ll be some kind of fight â€” how it fits into other trade-offs between the House and the Senate. And there are things other than health that we don’t pay as much attention to that are also out there, including a couple of wars. So yes, there’ll be some fighting about it. No, we don’t know how it turns out. But at the end of the day, if the administration really wants to further politicize an already politicized grant-making process, they will probably find a way of doing so. 

Rovner: Well, speaking of which, the administration has figured out other ways to effectively gut programs. Case in point: Head Start, which is a bipartisanly popular preschool education, nutrition, and healthcare program for low-income kids, just this morning, HHS is dropping new rules that would basically eliminate many of the required standards for Head Start programs, including things like teacher-to-student ratios. This administration is nothing if not creative, because this is not â€” you know, last year they were delaying the money going out for Head Start. Now they’re just going to say, Well, we’re just going to take away the rules, and you can sort of take this money and do whatever you want. Amanda, you’re nodding. 

Seitz: Yeah. Well, I found this really striking because I was with Secretary Kennedy a few months ago at a Head Start in Toledo, [Ohio], where he talked about the importance of the program, that it was inspired by his uncle, and he he said he really stood up against the White House to make sure â€¦ it was still funded last year, and he demanded that. And the other thing that really struck me about that visit is the Head Start’s owner had flown in from New York in this tailored suit to take photos with Kennedy and greet him personally. And I was a little confused why this person from New York is owning this Head Start. And it turns out a lot of private equity firms have been buying up daycares across the country, and this was the case for this Head Start. So, you know, pulling back the regulations of Head Start around class sizes â€” that seems like it would benefit more the private equity firms than the teachers and the children in the classrooms. 

Rovner: Fancy that! All right. Well, finally, finally, one of the things the Senate has managed to do this week is confirm Erica Schwartz as the director of the Centers for Disease Control and Prevention. That agency has been operating without a Senate-confirmed head since the departure of Susan Monarez last August, just weeks after she had been confirmed over differences with Secretary RFK Jr. over vaccine policy. How confident are we that Dr. Schwartz, who is a retired rear admiral in the U.S. Public Health Service Commissioned Corps and a self-proclaimed vaccine supporter, will last longer than her predecessor? 

Seitz: I think that is a huge question. I mean, we’re now on our third CDC nominee of this administration, second confirmed candidate, and we know that Secretary Kennedy and Susan Monarez never really got along. It was not, she was not his first choice. That has been made very clear with Schwartz as well, when he said that he was not even consulted really about the pick. So I think the big question is: Can these two work together, and how quickly will that potentially deteriorate? 

Rovner: Yeah, well, the clock is about to start. I guess as soon as she is sworn in. â€¦ She was just confirmed on Wednesday, so I don’t think she’s been sworn in yet. Alice, you want to add something? 

Ollstein: Yeah, I did think it was interesting, though. On Capitol Hill, you heard from some senators that, you know, they did have concerns about her ability to stand up to RFK and advocate for evidence-based medicine science, you know, particularly on the vaccine front. But because there hasn’t been a leader at this crucial agency for a year now, they wanted to vote to confirm her just for some stability and some leadership. I mean, look, we’ve got diarrhea lettuce, we’ve got salmonella eggs, we’ve got measles. We’ve got a lot of problems, and it’s never a great time to not have a leader of the CDC, but right now is really not a good time to not have a leader of the CDC. 

Rovner: Yeah, I think that’s what Tim Kaine of Virginia, a Democrat, said. I think he was the only Democrat that voted for her. More important to have somebody at the CDC leading it. 

All right, that is this week’s news, or as much of this week’s news as we could get to. Now we’ll play my “How Would You Fix It?” interview with New Jersey Democratic Sen. Andy Kim. Then we’ll come back with our extra credits. 

I am pleased to welcome New Jersey Democratic Sen. Andy Kim to “How Would You Fix It?” Sen. Kim’s a member of the Senate Health, Education, Labor, and Pensions Committee, and just introduced legislation to guarantee health coverage to every child up to age 26. Sen. Kim, welcome. 

Andy Kim: Yeah, thanks for having me. It’s a pleasure. 

Rovner: As I hope this series is highlighting, it appears the country is moving, albeit kind of slowly, towards another major debate over healthcare coverage and cost. What made you decide to step into these very choppy political waters? 

Kim: Well, first of all, I’ll say it is because of healthcare that I ran for Congress to start with. So, you know, eight years ago or so, when I first started running, it was because I had a little baby boy who had some real health issues right there as he was born, and I was one of those very scared, anxious parents trying to figure out what kind of care could my kid get. Meanwhile, we saw a debate in Congress where the Republican-led Congress in 2017 was trying to gut the Affordable Care Act. So that was why I actually got engaged in politics, [because] my congressman was leading that charge on trying to cut preexisting condition protections.  

The other aspect of this is right now things are just moving in the wrong direction. We have upwards of, you know, 1.75 million to 2 million more kids losing Medicaid over the last year and a half. We see the numbers already atrocious. You know, 4.4 million children in this country without health insurance, 23 million kids that are underinsured, which means they have coverage that doesn’t cover their full needs. I’m appalled by that. I’ll be honest with you. Like, you know, we’re the richest, most powerful country in the world. I’m here at the Capitol, where we’re right now having these debates about, you know, a $1.5 trillion defense budget and other things that, you know, just are pushing forward. Yet we are just for some reason just OK with, or at least just allowing this type of void when it comes to our healthcare. I just find it to be â€” I mean, just appalling and a real dereliction of our duty that we have not found a way to be able to ensure that every child is able to go see a doctor when they need to without breaking the bank. So I think, for me, this has just been years in the making, and right now I wanted to introduce this because I can’t just be talking about what I’m against. I have to be talking about what I’m for. What is the vision for this country? Not just to reverse things that I think are wrong from what this administration has done, but I owe it to my constituents and to the American people to lay out a vision forward for us to try to think through where we go from here. 

Rovner: So, how would this bill work? 

Kim: First of all, the bill is called MediKids. So, as you said, it would be a guarantee of healthcare from birth to 26. I think one of the more novel parts of this that is different from what we see right now is that there’s an automatic enrollment upon birth into MediKids, which is a foundation built upon Medicaid. So the idea right now is we’re seeing so many kids and families losing Medicaid or potentially losing Medicaid in part because of just the onerous paperwork, the bureaucracy, the different types of things that are meant right now, just the twice-annual requirements to be able to recertify. That’s what’s standing in the way here and preventing so much of the progress that we need. So I wanted to really tackle that and be able to make sure that people can be able to get the care that they need.  

And another part of it is that I chose to put the platform upon Medicaid because Medicaid, in many ways, was designed for kids. You know, when it comes to the early and periodic screenings and diagnostics and treatment, that whole system is, as I’ve looked at it, really the most comprehensive system for kids. What healthcare experts have really shared with me over the years, as I taught talk them, is we can’t just think of kids as little adults. But instead, like, having a system that is designed for kids, that is designed to be able to have the screenings at the appropriate times and age intervals, to be able to have that requirement, to be able to treat any and all problems that are determined, and to think about this as comprehensively â€” not just like healthcare here, dental and vision, but to think about it across all of it. All of that is necessary for kids because their bodies are developing, their brains are developing well into their 20s, which is why, again, I pushed meta kids out into the 20s. It’s like you want to make sure that all of these kids are able to get the care that they need, and that you don’t see the kind of withdrawal of or restriction of care that could have real consequences down the road. So that’s really what we were trying to do. 

Rovner: So, as you well know, Democrats have been fighting for decades now over whether to try for a really comprehensive overhaul of the nation’s healthcare system or something more incremental. Obviously, the Affordable Care Act was something more incremental, but also fairly comprehensive. Is that how you envision this? Where do you fall on the “Let’s pull it up and start over from scratch,” and the “Let’s try to fix it one step at a time” debate? 

Kim: Well, yeah. Well, look, I want to be bold, and I want something that can really push forward. Because look, I’ll be honest: The American people want something bold. Like, the problems that we are facing are enormous. No one is happy with the status quo, so we need to have that change. But I was also thinking through how to design something that I think will have enormous impact upon healthcare, but doing it in a way that is implementable. You know, so with MediKids, I’m not creating some new bureaucracy. I’m not creating some new agency or new department. I am taking something that is already, frankly, covering a large percentage of children in this country already, and I’m trying to make it available for everybody through that automatic enrollment, and taking something that is proven to be able to have that comprehensive approach and use that as a foundation. I really tried to design this in a way that is implementable. As I’ve been in Congress now for eight years, I see the types of bills that can get through parliamentarians and get through into passage, and I’ve really tried to design something that hits that sweet spot while still fundamentally reshaping how healthcare in this country will be attained by people. And I really do think that it will have a sizable impact tremendously. Not just in terms of providing that care for kids, but everyone knows healthier kids means healthier adults, which means a healthier workforce, which means a stronger economy, which means lower healthcare costs. The knock-on effects are so strong. So many of the challenges that we see amongst adults when it comes to chronic illnesses and other challenges are often things that have been exacerbated because of the lateness of diagnosis or the lack of treatment early on. So those are the things that we’re really trying to think through when it comes to this approach. 

Rovner: Back in 1994, when the Bill Clinton plan went down, the first big health reform that I covered, there was an effort, mostly spearheaded by Sen. Tom Harkin of Iowa, that they called “Kids First.” They said, well, let’s just cover kids. It still took three years, a lot of fighting, and sort of they luckily found a tobacco tax to help pay for it. But it was bipartisan. Do you have any thoughts that Republicans are going to maybe have some renewed interest in increasing healthcare coverage? 

Kim: Well, what I will say is, first of all, if ever there was an issue that should be bipartisan or, frankly, nonpartisan, it should be about our kids, right? And that’s why I wanted to focus on this too. I think it’s the strongest argument that we have in our country when it comes to guaranteed healthcare. I get it, eyes wide open, I was on the Senate floor last year when I saw my colleagues vote to cut Medicaid at such a dangerous level, so I have my eyes wide open. But what I will say is, I’ve gone around the Senate over the last period of time, like the last two weeks since I’ve introduced, is that it is sparking that conversation. And whether or not my colleagues on the other side of the aisle or both sides of the aisle agree with all the different principles and proposals that I have in MediKids, it is creating this dialogue and this debate about healthcare for our kids. And that’s what I want. Yeah, that’s what I want us to be able to do. And you’re right. Like, we’ve seen bipartisan support in the past for CHIP [the Children’s Health Insurance Program], for healthcare for kids in different ways, and I just saw that going in the wrong direction last year, which is why I wanted to release this now to try to move it back into the fold. I saw a real deprioritization of concerns raised by parents of kids with disabilities that were worried about how these Medicaid cuts would affect them. It’s not good enough for them to just get, like, a wink and a “trust us” type of message. We really need to make sure that we just never have parents with that type of anxiety about whether or not they’re going to lose care for their child. So, well, we’ll see going forward. But at least my early conversations with my colleagues from both sides of the aisle, certainly around the overarching principles of care for kids, is promising. And I’m hopeful to be able to make some gains as we move forward in both the Senate, as well as in the House, as we start to push forward on that debate there too. 

Rovner: Well, we’re all about keeping the conversation going forward. Sen. Andy Kim, thank you so much. 

Kim: Yeah, thanks so much for having me. 

Rovner: OK, we’re back. It’s time for our extra-credit segment. That’s where we each recognize a story we read this week we think you should read, too. Don’t worry if you miss it. We will post the links in our show notes on your phone or other mobile device. Joanne, why don’t you go first this week? 

Kenen: OK. This is a story that’s up online in The New York Times, and I believe it’ll be in the Sunday Magazine this weekend. It’s by Dr. Helen Ouyang, whose name I don’t know how to pronounce, so I’m just going to apologize for not knowing how to pronounce it. The story is “.” For me, it’s not great because I was working on the same story, talking to some of the same people, and you know that’s not going to happen now. But something like she used the number 4 million, and it’s probably closer to 6 million, kids, between roughly the ages of like 10 and 18 or 19, are in fact the major caregiver for a sick parent or grandparent, and they are trying to juggle some kind of attendance at school and then doing medically complicated things, plus the psychological burden and not being able to be a normal teen. And these are largely poor kids. They are disproportionately Black and Hispanic kids. We do not have a system for helping them. The answer is not let them be caregivers because no one would be a caregiver. The person would have no care. The question is, really, how do we support them? Make it easier. Make sure they’re connected to whatever community resources or state resources or health resources that are available. Make sure they’re maxing out on that. But it’s a really disturbing and very moving story what these kids go through, because even those of us who are adults who’ve taken care of grandparents or parents, it’s really hard. And if you’re 15 or 10, it’s even harder. 

Rovner: Yeah, and taking care of siblings too in a lot of cases. Amanda. 

Seitz: My pick this week is “,” by Katherine Long of The Wall Street Journal. This is a story about a surrogate who agreed to carry what ended up being triplets for a father overseas in China. What I just found really remarkable about the reporting is that it takes this really horrible case â€” these children have essentially been left in the U.S. with the surrogate mother because the father from China hadn’t been able to come over due to visa issues. And, but it takes this really complicated story and looks at just the overall perils of the surrogacy industry that has exploded while being completely unregulated, and how all of these cases are largely playing out in courts and being complicated by the immigration policies of the Trump administration. So it was just a really fascinating read. 

Rovner: Other things that policymakers could be doing with their time. Alice. 

Ollstein: My pick is from NOTUS. It is called “.” So we talked about the vote to hold Fauci in contempt, but this is a look at what inadvertently, I guess, happened as a result of Rand Paul, who, let’s remember, is a doctor himself as well as a senator, releasing a huge tranche of private documents from Fauci and not redacting people’s personal medical information about their diagnoses. And this article talks about how that happened and how little recourse the people involved have about their information being exposed, and how this is a pattern with the administration of failing to redact people’s sensitive information when they do these big document dumps. 

Rovner: Oops. Yeah. Well, my extra credit this week is also about the Fauci affair. It’s from our podcast pal Sheryl Gay Stolberg at The New York Times, and it’s called “.” And wouldn’t you just know it, but it turns out that HHS Secretary RFK Jr. and one of his sons, and Kentucky Republican Sen. Rand Paul, have all published books accusing Tony Fauci of various crimes and misdeeds, and that after last week’s hearing, sales of those books jumped. Wrote Sheryl, “Ethics experts say that Mr. Kennedy, his son and Mr. Paul did not cross any legal or ethical lines, but several said the secretary and the senator did cross a threshold for hypocrisy by using their platforms to sell books about Dr. Fauci while accusing the scientist of profiting from his own public service.” I will let you all draw your own conclusions. 

All right, that is this week’s show. Thanks to our editor, Emmarie Huetteman, and our producer-engineer, Francis Ying. We also had production help this week from Taylor Cook. A reminder: What the Health? is now available on WAMU platforms, the NPR app, and wherever you get your podcasts — as well as, of course, kffhealthnews.org. Also, as always, you can email us your comments or questions. We’re at whatthehealth@kff.org. Or you can still find me on X , or on Bluesky . Where are you folks hanging these days. Alice? 

Ollstein: On Bluesky , and on X . 

Rovner: Joanne. 

Kenen: I’m mostly on  and on  . 

Rovner: Amanda. 

Seitz: And I am still tweeting from X on . 

Rovner: We’ll be back in your feed next week. Until then, be healthy. 

[Editor’s note: This transcript was generated using transcription software. It has been edited for style and clarity.] 

Julie Rovner: Hello, from Ñî¹óåú´«Ã½Ò•îl Health News and WAMU Public Radio in Washington, D.C. Welcome to What the Health? I’m Julie Rovner, chief Washington correspondent for Ñî¹óåú´«Ã½Ò•îl Health News. And, as always, I’m joined by some of the best and smartest health reporters covering Washington. We’re taping this week on Thursday, July 30, 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 video conference by Rachel Cohrs Zhang of Bloomberg News. 

Rachel Cohrs Zhang: Hi, everyone. 

Rovner: Liz Essley Whyte of The Wall Street Journal. 

Liz Essley Whyte: Hello. 

Rovner: And Shefali Luthra of The 19^th. 

Shefali Luthra: Hello. 

Rovner: No interview this week, but more than enough news, so we’ll get right to it. I want to start with a story that I feel like is getting a little bit buried because it broke last Friday.  on a federal court filing in which the Trump administration admitted that it canceled $7.5 billion in clean-energy grants solely because they were located in states represented by Democrats that voted for Kamala Harris in 2024. In other words, the actions were purely political. Now, this is before the administration finalizes proposed rules that would give political appointees still more power over how grant funding is distributed. I heard one pundit say on cable news that in any other administration, this sort of information would lead to an immediate impeachment inquiry. But these days, it’s just another day that ends in “y.” Is the lack of public outcry about this because everyone already assumes that everything this administration does is political? Or is this considered just too inside baseball for most voters?  

Whyte: Well, I was gonna say I think this has long been people’s suspicions about why certain grants are cut in the way that they are, or some of these Medicare/Medicaid investigations are the way that they are. And so I think maybe the lack of outcry was just people shrugging their shoulders and saying, I mean, yeah, we guessed that, you know. I don’t know. 

Cohrs Zhang: It was really chaotic too, and hard to keep track of all these different things for people whose job it is to do so. So I feel like the fact that this is protracted for so long, we’re like, which DOGE [Department of Government Efficiency] cuts were those? And I think it is important, certainly, and I’m glad there’s been coverage of it, just for the record, and just kind of for history purposes and just understanding the limits of that kind of change to government at that speed. But yeah, I think it is just hard to break through in this news cycle, and it was very chaotic and confusing for everyone.  

Luthra: One thing I have been thinking about, though, is when you think about these states where grants were canceled, there are a lot of people who live there who did, in fact, vote for Donald Trump. And depending on the size of the state, you probably have members of Congress who are actually in Republican districts. And that, I think, is really interesting. And I just wonder if eventually there is some sort of conversation. Those are probably in some cases members who might be a little bit more on the defensive in other ways, just given the political environment we are in. And is this an issue that Democrats can talk about and highlight and sort of bring to voters and say, you know, your representative is not here defending your interests because of these broader sort of punitive measures being taken by the White House. I think that’s an interesting thing that we don’t know the answer to yet. 

Rovner: I know I keep saying this, but I can’t believe that Republicans on the [Senate] Appropriations Committee aren’t being louder about this. This is the one power that they have. It’s why you get on the Appropriations Committee, is you get to steer money to your state or your district. That is the great perquisite of being in Congress, and the administration is basically taking it away. And they’re just letting them. I mean, Susan Collins told Politico, quote, “I obviously think that’s wrong.” But she doesn’t seem willing to do anything about this. I mean, she’s the chairman of the Senate Appropriations Committee! 

Cohrs Zhang: I think we’re, like, testing the checks-and-balances system to its fullest extent. This administration. They can only pick so many fights, you know. 

Whyte: Yeah, Susan Collins, especially, this whole administration has had to choose about when to say something and when to push behind closed doors, push publicly. I mean, there’s been lots of stuff that she hasn’t liked. 

Rovner: Yeah, for sure. Well, this is not the only case where the government has admitted to canceling grants for political reasons. In a case brought by researchers from the University of California, the administration confirmed it canceled some grants because  like “diversity,” “gender,” and “vaccine hesitancy” to cut off funding. The plaintiffs in that case argue that it’s a First Amendment violation. Again, we’ve known for some time that this has been happening. Are the courts just too slow to be able to deal with it, Rachel? That’s kind of what you were intimating. This has been dragging out, sort of bit by bit by bit. 

Cohrs Zhang: Yeah, I think it’s hard. And I â€” just like with these grants dragging out too, it has impact for the people who are supposed to be receiving this funding and how their cycles work and hiring and just all the â€¦ that grant process. But I think it’s hard to make that connection, back to the individual voter. And I think that’s just a tough hill to climb in terms of public communications. So I think, yeah, we’re seeing these similar themes play out. 

Luthra: And one thing that I think is really relevant that I keep coming back to is we did see a test run of this with the USAID [United States Agency for International Development] cuts at the beginning of the administration. Those happened very quickly. The courts took a very, very long time, and by the time there was any kind of real momentum in any direction, it was too late. People did not have money, firms had downsized, people had left their jobs, left the industry altogether. And, at the time, that seemed to me like a really striking test. If this is able to happen here, and it shows that things just continue, why not happen in other areas as well, where you have these grants being put out there that have maybe ideological tension with where the administration wants to be going? 

Rovner: So I wanted to talk about some specific impacts on health policy, notably AHRQ, the Agency for Healthcare Quality and Research, which, like USAID, the administration has all but eliminated, despite the fact that it was appropriated nearly $350 million for this year in a bill signed by President Trump. AHRQ, which is down to a fraction of its original staff and hasn’t funded any grants in more than a year, is actually a completely bipartisan creation from the 1990s. It was established to study healthcare quality and access issues, many of which go neatly hand in hand with the “Make America Healthy Again” agenda. Earlier this month, the administration stopped funding more than 100 grants, and an HHS [Department of Health and Human Services] spokeswoman told my Ñî¹óåú´«Ã½Ò•îl Health News colleague Arthur Allen only that the agency plans to establish a new, quote, “framework,” which I thought was the job of Congress. Again, too small to attract much notice? 

Luthra: Probably. I mean, voters don’t know what AHRQ is. Like, we know about it because of our jobs, but this is not something people wake up and think about or talk to their neighbors about. It just feels very divorced from a lot of people’s realities. Even though, to your point, the consequences are far-reaching. They are long-term, and, also, the significance in terms of, as Rachel pointed out, separation of powers, checks and balances are also very striking.  

Rovner: I mean, AHRQ studies things like patient safety. I’m old enough to remember when the, you know, the big Institute of Medicine [now National Academy of Science] report came out that said how many people were injured by medical errors. It was a huge, huge issue. I mean, for years. And that’s basically what AHRQ does, and that’s what this administration says that they care about. They care about gold-standard science. They care about fraud. They care about making the health system safer. And yet, you know, AHRQ is just, well, we don’t know what it is, so we’re going to make it go away, basically. 

Whyte: Obviously, the HHS has not been as clear on this as you might hope and expect for the “most transparent administration in history.” But it is clear that, like, Kennedy is looking for pots of money to do the things that he wants to do. And it seems like this is one of the pots they’ve landed on as something that can be shifted around. 

Rovner: Yeah, so it does. Well, one cut that is likely to be noticed is the administration’s decision to end the temporary subsidy for Medicare Part D that prevented the addition of an out-of-pocket cap on how much enrollees have to spend each year on prescription drugs from spiking those monthly premiums. This will almost certainly raise premiums for many, if not most, of the 25 million seniors who have stand-alone Part D drug plans. And they will see those increases right before Election Day, because Medicare open enrollment starts Oct. 15. And, by the way, seniors vote in disproportionate numbers in midterm elections. If I was a political adviser for this administration, I don’t think I would have advised doing this. Am I missing something here? 

Cohrs Zhang: I think you are seeing there’s an interesting shift happening in terms of the power of the fiscal conservative wing of the administration. And I think we’ll continue to see that play out. I will say it’s unclear, like, how much premiums would have increased anyway without this subsidy program ending, given that the premium increases are capped by statute, in the Inflation Reduction Act through 2029. So, I mean, there is a chance that they might have gone up 6% anyway. We’re maxing out that increase. But the messaging certainly was not stellar for them. And I think we saw some cleanup efforts on that, for them trying to say that, you know, most seniors will see, you know, no increase or an increase of less than $10 a month. 

Rovner: Or they’ll have, I think Dr. [Mehmet] Oz said, they’ll still have an option for a cheaper plan. Of course, that cheaper plan might not cover all their drugs, but â€¦ 

Cohrs Zhang: Yes. So I think that’s just like a â€¦ this is one, I think, data point in this larger theme I’m thinking about. And how do we see â€” as we move past the midterm elections and affordability may not be top of mind if there’s no electoral accountability for it â€” how does that change what we’re seeing out of these agencies? 

Rovner: I’m just old enough to remember when, you know, you don’t raise costs for Medicare beneficiaries right before a midterm election, which is what this will do. Well, it isn’t all cuts. The administration this week finally released the $600 million that Congress had appropriated for the global Vaccine Initiative, Gavi. That was money for last year and this year. The funding had been blocked by HHS Secretary Robert F. Kennedy Jr. even though it goes through the State Department, not the Department of Health and Human Services. Kennedy had been concerned that Gavi was paying for vaccines containing the preservative thimerosal, which has been accused, and cleared, of causing autism. Do we know what finally sprung this money loose? 

Cohrs Zhang: I think there was a deadline of Sept. 30, and the funding would have expired. And we did see kind of an exchange with Secretary of State Marco Rubio and Susan Collins, where he said, “You know, I’m going to take ownership of this, and we’re going to get it done.” And so I think there was a push by administration officials to get this funding pried loose. And I think there are questions about whether Gavi was kind of heading this way already with some of these vaccines. I think they were starting the transition, but I think there â€¦ we’ll see how the implementation works on it. But I think there might be an argument that maybe this transition might have happened maybe faster â€¦ or to a broader degree. 

Rovner: The transition away from using thimerosal. 

Cohrs Zhang: Yes, the states â€¦ there’s one hexavalent vaccine where countries could already apply to transition to a different formulation without thimerosal starting in 2023. So, but maybe an option would be broader. Just there’s kind of a lot up in the air as to actually how this gets operationalized in the timeline. 

Rovner: Yeah, I was thinking, though, this might have been one of the cases where Congress complaining, both publicly and privately, did actually have some impact. But also, I know a lot of it was Marco Rubio stepping in and saying, “Hey, this is a State Department thing.” And finally, you know, I say a year and eight months later, the money gets distributed. All right, we’re going to take a quick break. We will be right back.  

Well, speaking of things that may or may not be good politics, Republican Sen. Rand Paul of Kentucky called former NIH [National Institutes of Health] and White House science official Tony Fauci before his Homeland Security Committee Wednesday to rake him over the coals again over his handling of the covid pandemic. Fauci, who received a preemptive pardon from President Joe Biden as Biden was walking out of the Oval Office door in 2025, did not take the bait. He pleaded the Fifth, lest anything he said be used for a new prosecution for lying to Congress. Meanwhile, Paul says he’ll try to find Fauci in contempt of Congress, which, by the way, would take 60 votes, which feels a little unlikely. Separately, several red-state attorneys general say they now want to investigate Fauci since his pardon doesn’t cover state prosecutions. First, prosecute him for what? And is relitigating covid origins and lockdowns really good politics for Republicans? I’m sure it riles up the base, but it’s hard to see them running on this as their health agenda. 

Whyte: So Rand Paul actually said on TV last night that he just thinks his committee needs to do the contempt of Congress vote, and then they can refer it to the DOJ [Department of Justice]. So they may not need 60 votes. So that will be interesting. Meanwhile, [Sen.] Ron Johnson [R-Wis.] has also threatened to subpoena Fauci. And the Florida attorney general is opening an investigation. And Alabama Sen. Tommy Tuberville says if he becomes governor, he’s going to try to figure out a way to prosecute Fauci in Alabama. So there’s definitely a lot of focus on Dr. Fauci. 

Rovner: I repeat, though, prosecute him for what? 

Whyte: Well, you know, before the hearing, Rand Paul was saying, Yeah, his preemptive pardon covers stuff in the past, but if he lies again at this hearing, then we will, you know, go after him or whatever. 

Rovner: Right, and that’s why he didn’t, that’s why he pleaded the Fifth.  

Whyte: Right, which is why it was viewed as an â€¦ entrapment situation that he should probably steer clear of, and why he would not even answer, like, what is the color of the carpet. 

Rovner: And what color his tie was, or was it Sen. [Josh] Hawley’s tie? 

Whyte: Yeah, and what day of the week it was, yeah. Whether it’s good politics for Republicans, I think we’ll have to see. There’s an Ohio candidate that they’ve tried to get for being, you know, covid czar or whatever, and that really hasn’t gone anywhere in Ohio. She’s polling OK. So I think that’s a good question on whether voters still care about this or not. I think obviously a lot of them do, but, like, the suburban women who are, you know, the famous swing voters, what do they think about Dr. Fauci? Will be interesting to see. 

Rovner: Yeah, I mean, I guess just for watching the questioning, it seemed that they’re trying to, you know, that we know that Democrats have more enthusiasm going into this midterm than Republicans. And it looked like the Republicans were trying to, you know, reactivate the angry covid base, if you will, to get them to come out and vote. It’s just hard to know how many people are angry enough to come out, you know, six years later.  

All right. Well, speaking of buzzy stories, Liz, you  about how Trump might be pushing RFK Jr. on childhood vaccine policy rather than what we all assumed was the other way around. So tell us about it. 

Whyte: Yeah, this is a bit of a counterintuitive news development for two reasons. One, because everybody thinks RFK Jr. is the big vaccine skeptic in the administration. And two, because the White House had, you know, is widely reported that they were telling HHS to “ix-nay on the accines-vay” ahead of the midterms â€” like, just dial it down a little bit because of polling they had from the winter that showed while food and ag [agricultural] stuff was really popular, the other MAHA stuff, vaccine skepticism, was not, and they kind of wanted to tone it down. But the president does what he wants. He does not always listen to the polling. And he has been telling Kennedy since at least May, why aren’t you doing more to probe the connection, in his mind, between vaccines and autism? And this took Kennedy aback, actually, at a golf course lunch in May. He was surprised because he was still under the impression they were supposed to be dialing back. And President Trump told him, “You have the yips,” which I just think is such a funny word. 

Rovner: It’s a golf term. 

Whyte: Yes, it’s a golf term. And that has continued to be, actually, a point of tension between the two men, with the president venting his frustration to Kennedy at a mid-June Oval Office meeting. And part of the reason we’re seeing some of this increased action, even if it’s not, you know, really talked about much, but appeals to the federal appeals court to speed up the decision for the key vaccine advisory panel of the CDC [Centers for Disease Control and Prevention], and then also there was that EO [executive order] in May that Trump put out on the childhood vaccine schedule, and just kind of general scrambling behind the scenes to figure out, like, what they can deliver for the president, who is, I’m told, a results guy and wants to see results and thinks, you know, it’s been a year and a half, and why aren’t there results? So, we’ll see where that leads. 

Rovner: Well, meanwhile, if this puts Kennedy in hot water with the president,  what the newest, who the newest likely candidate is should RFK Jr. leave his post, either voluntarily or not so voluntarily. Tell us about your story. 

Cohrs Zhang: So I have been working on this story for a very long time. But I think we’ve seen kind of this surprise in Washington that Dr. Oz, who’s leading Medicare and Medicaid, has actually like navigated the Trump administration with great skill, and I think we were finally able to capture the scope of that, him translating that skill into personal relationships with the president, with the secretary, and getting himself a seat at the table on far more policy issues than a CMS [Centers for Medicare & Medicaid Services] administrator would normally get. And I think we saw, those of us who remember the first Trump administration, how ugly things got between HHS and CMS â€” was like very adversarial, like a really bad time in there, very toxic. But I think we’ve seen him take a more, like, cooperative approach. He wields his influence, is more explaining things. He is a medical doctor, his training, unlike the secretary. And I think there is just, like, a general trust and, like, personal friendship between the two of them that has translated into this interesting dynamic, where Dr. Oz kind of serves as a go-between on some of these issues between the White House and the secretary and gets everybody kind of to the place where they need to go. And he’s just a good communicator and has built a lot of trust and parlayed that into getting himself a seat at the table. 

Rovner: Yeah, and Liz â€¦ your story about Kennedy and Trump also suggested that Oz’s favor is rising, shall we say? 

Whyte: Yeah, the White House staff love Oz because they know they can send him to the Hill. They can put him on TV. Like, he’s going to do a great job. Rachel had this too. You know, the president calling and texting Oz and saying, you know, what about this issue? and it has nothing to do with CMS. He’s, you know, being called upon to do other stuff that is not in his portfolio. So yeah, every lobbyist is just, like, watching their clock and seeing when Oz takes over. I don’t know that it’s that straightforward. I think the president and secretary have a very warm friendship, and it took a lot for Kristi Noem to get let go, and I don’t think we’re anywhere near that. So we’ll have to see if the mood changes after the midterms. But it doesn’t seem to me that anything would be imminent. 

Rovner: I would add that I know Oz is the one person practically in the entire administration, not just at HHS, who actually does well when he goes to the Hill. Who, you know, is respectful and sort of understands how administration officials are supposed to conduct themselves when they are in front of the people who theoretically are responsible for them having their jobs.  

Whyte: Yeah, you’ll find the Democrat staffers are like, Oh, we actually like Oz, which is funny, I think.  

Rovner: He’s a good politician! What can I say? Rachel, do you want to add something? 

Cohrs Zhang: I will say, though, he did play a role in selling all these Medicaid cuts that are going to be coming down the pike. 

Rovner: He did. 

Cohrs Zhang: And so I think he is going to be the face of this when they actually go to implement it.  

Rovner: He will. 

Cohrs Zhang: So yeah, we’ll see how that goes.  

Rovner: We’ll see how that goes.  

Cohrs Zhang: What time frame they’ll be doing that in. But yeah, certainly. Yeah, it’s interesting. 

Whyte: They’ve kind of given up selling that, too. You know, it’s not something they’re being like, Oh, look at all the great stuff we did with Medicaid in the One Big Beautiful Bill. It’s very much pivoted to fraud.  

Rovner: Yeah, but when it starts, when it takes effect next year, I think there’s going to be, there will be lots of questions to answer. Shefali, do you want to add something before we move on? 

Luthra: The only thing that really just I keep thinking about is the long history of this relationship between Dr. Oz and the president, and, in particular, when during the 2016 campaign he was the one to talk about the president’s testosterone levels on TV and how they were excellent. And I just think it’s really special that we’ve come full circle in this way. 

Rovner: Yes, yes, it is, and we have. All right, moving on. One thing that Secretary RFK Jr. said this week that’s pretty clearly not true is that the department has the cyclospora parasite outbreak, quote, “under control.” A former deputy commissioner of food at the FDA under both the first Trump administration and President Biden told Politico this week that, quote, “it is starting to approach a catastrophic level in terms of how mismanaged it’s been on multiple fronts.” Rachel, you’re keeping an eye on this. What is the latest? What do we know about cyclospora and where it’s coming from? And are the recalls that are in existence enough to stop it? 

Cohrs Zhang: I don’t think they’re stopping it, by any means, especially with an incubation period of two weeks. I think we are continuing to see more cases reported, and I think, like you mentioned, there’s, I think, fingers pointing in all directions. Our team and others have done reporting on just how Taylor Farms has handled themselves behind the scenes. The public spat between Taylor Farms and the FDA was not something you usually see in an outbreak of this kind. It’s just worth probably pointing out that the FDA did DOGE much of its communications staff that has experience with this sort of outbreak. We have, you know, officials shifting around, and there’s some key vacancies at the FDA as well in a lot of these leadership positions. So I think there’s been complaints, certainly, at, like, the report you mentioned about the federal response, but also about the company and their speed and their clarity and communication, and whether that’s truly serving the public interest or not. And I think there are, if I’m not mistaken, some ongoing investigations into other potential causes. But we are seeing a lot of these cases tied back to lettuce from a specific part of Mexico. So I think they have gotten the word out now, but just the confusion and the back-and-forth. And I think former FDA commissioner Scott Gottlieb got on CNBC and said he would have expected more communication from the FDA on this issue. But it’s kind of a tough one when it’s a voluntary recall, and there’s a company, and they’ve used some restrictions, you know, and what they’re supposed to be talking about publicly. But I think there has just been so much consumer confusion, and that’s not in anyone’s interest. 

Rovner: And as we said, this is not a simple thing to track. It’s not like E. coli; you can’t really find it. Liz, you and your colleagues reported, though, on, you know, Taylor Farms going straight to the White House to try and sort of go over the heads of the FDA on this. 

Whyte: Yeah, Bloomberg and The Wall Street Journal had stories with different pieces of this, and it was, you know, in our story, you could see that they were trying to distance themselves from the outbreak before they got named publicly, which is kind of this new wild West of lobbying that we’re in, where it makes a lot of sense for companies to go straight to the White House and skip over dealing with career officials. And what was interesting was that the way all that played out with the communications is Taylor was able to say, FDA apologized to us, made this like really confusing statement. And the FDA, maybe because it didn’t have the comms folks with experience, like Rachel was talking about, at the FDA with, you know, various layers of people who have done this before, you know, it took them till the next day to say: By the way, our epidemiology on this is really good. It’s definitely still Taylor Farms. We just, like, had that one false positive. It was crazy to me how, like, twisted and turned that got. 

Rovner: It was not well handled from a public communications standpoint, shall we say? All right. Well, one thing that we know that RFK Jr. thinks highly of are peptides; those are the amino acids that wellness influencers say can build muscle, heal injuries, and burn fat, among other things. Last week, an FDA advisory committee voted, over the objections of FDA’s own scientists â€” who say evidence on the benefits of peptides is either skimpy or nonexistent — to nonetheless make it easier for compounding pharmacies to make and sell products containing several different specific peptides. Now, this is not just a scientific disagreement. Several members of this advisory panel are actual sellers of this product, right? 

Whyte: Yeah, the panel was a bunch of members who either worked for companies that sell peptides or had a clinic that offers them. And the HHS said these people went through a conflict process. It doesn’t seem like it could have been as rigorous as the previous conflict processes that were in place. I haven’t seen a ton of reporting on that. But, you know, predictably they greenlighted most of the peptides that they looked at over and against the strong recommendations from FDA staff scientists who said we don’t have evidence that these are safe. Like, this is kind of unprecedented. The argument in favor was, well, you know, we do something similar with supplements. You know, Secretary Kennedy has said people should be free to try these out, and you know he wants to end the war on peptides. And meanwhile, scientists with a traditional background in looking at risk and benefits are saying the risks are there, the benefits are not proven, and this almost creates a different paradigm for how we’re looking at medical interventions now. 

Rovner: Yeah, and I think we’ve seen this across the FDA and across HHS. I mean, this is basically what they’re, you know, calling gold-standard science. That there’s a lot of people â€¦ go ahead, Rachel. 

Cohrs Zhang: I was just gonna say, and I’m â€¦ I think, looking forward, this creates a split decision, right, between the FDA scientists and the ag comm, and that’s gonna put the FDA in a tough position as to who what they’re going to choose because former commissioner Marty Makary loved to say he was siding with the career scientists, and now we have this forum to hear what they actually think, like, presented to the public. So I think that’s going to be a tough decision ahead, and that’ll tell us how things are working inside. 

Rovner: And of course, we only have an acting commissioner of FDA right now, so â€¦  

Cohrs Zhang: Yes, with instructions to not make news. 

Rovner: Finally, this week, news on reproductive health â€” because there is always news on reproductive health. Shefali, we had a decision in one of the court cases challenging how the FDA regulates the abortion pill mifepristone, but it’s not the case that we’ve all been watching, right? 

Luthra: No, this was the Virginia case. And what it reminds us is that there’s actually a million different mifepristone cases because you have people looking for more restrictions on mifepristone, and you also have people looking for fewer restrictions on mifepristone. And a lot of the folks who provide the drug, the doctors and manufacturers, have argued that, in fact, there are more restrictions than are actually appropriate. That this is actually much safer, and it does not need to be so hard to get because, for all of the concerns from conservatives and abortion opponents, it actually is very difficult to prescribe and make mifepristone available without going through a lot of hoops of certification. And so we see, right, in some cases, like here, an effort to try and loosen those restrictions a bit and say this could be more available, especially, I mean, people when they have miscarriages, it is actually very hard to get mifepristone, even though it actually would be very beneficial for management. But I think what this does, practically, is again not much changes for now because we have so much going through so many courts in different ways. Realistically, I mean, access to the drug stays as what it is: available in some places, not available in others. And the big case that we’re all waiting for, the Louisiana one, that could possibly bring restrictions in, that very briefly did bring restrictions in mifepristone earlier this year â€” we’ll probably see more on that closer to the election. And that could be very interesting because, as we’ve talked about so many times, this is not really an issue the White House or a lot of Republicans, frankly, would like to be in the news, because they know that restrictions on abortion just remain so unpopular and continue to be for a long time. 

Rovner: And this is almost certainly heading for the Supreme Court, right? We now have a court, you know, a lower court saying that the Biden administration’s restrictions were too tight, and one assumes that coming out of Louisiana, we will have a decision that says that they’re not tight enough. 

Luthra: I would be stunned if the Supreme Court did not hear a mifepristone case in the coming few years. It just seems like we’ve been building in this direction for a very long time. You’re totally right. The split circuit looming makes that more likely. And I mean, realistically, if I supported abortion rights, if I wanted to make this pill more available, as the folks arguing against the Biden restrictions are, I don’t know that I would be thrilled about this being something before the Supreme Court because this is known to be a more conservative court. A lot of members who think abortion should be far less available than it is â€” this is the same court that overturned Roe v. Wade. And so I think there’s a real possibility that as we see more and more abortion decisions make their way to the Supreme Court, the restrictions we have become even more so, and where we are now becomes a baseline for making this even more difficult for people to obtain. 

Rovner: We will have to see. Meanwhile, our podcast pal Alice [Miranda] Ollstein has a co-bylined story at Politico this week about how anti-abortion groups are pulling out all the stops to try to show that the increased use of . Now they have a study, commissioned by the group Students for Life, claiming that mifepristone is showing up in, quote, “significant levels” in waterways in Austin, Texas; Blacksburg, Virginia; and Carbondale, Illinois â€” all major college towns, not coincidentally. And while the science behind this remains questionable, the politics don’t, right? 

Luthra: Right. And this is a strategy they’ve been working on for quite some time, putting bills in state legislatures, talking to anyone who will listen about this, and saying, If we care about the environment, the left cares about the environment,why don’t we care about what they say is this mifepristone pollution in the water that they say is caused by medication abortions? And they want to use this argument as a different prong on the way to stop people from having mifepristone made available, of making medication abortions harder to obtain. We haven’t really seen this really yield fruit yet. However, this is part of, again, a longer-term strategy to lay groundwork. And studies like this, they create an intellectual groundwork as well. We saw that with the telehealth studies, the mifepristone safety and efficacy studies â€” and I perhaps should do “studies” in air quotes because a lot of mainstream researchers call these not very good science. But if you create a large-enough body to point to, then ultimately you can have people in positions of power say, “Well, we’ve looked at the evidence from all sides, and we see these real concerns, and we’re going to use them to inform policy.” I don’t know that that will happen anytime soon, but it’s certainly a goal that they’re building toward. 

Rovner: They’re talking points, basically. 

Luthra: Absolutely. 

Rovner: All right. Well, that is this week’s news. Now it’s time for our extra-credit segment. That’s where we each recognize a story we read this week we think you should read, too. Don’t worry if you miss it. We will post the links in our show notes on your phone or other mobile device. Rachel, why don’t you go first this week? 

Cohrs Zhang: Mine is from Ñî¹óåú´«Ã½Ò•îl Health News. The headline is “Trump Administration Demands Hospitals Share Emergency Room Records,” by Amanda Seitz, Maia Rosenfeld, and Darius Tahir. I think this is one installment, and that this broader arc of coverage that they have really owned â€” it’s so diffuse. There’s like states, and there’s providers, and there’s government officials involved, but I think it really illuminates kind of like where is the Trump administration looking for data? I think this is something that started during the DOGE era, where you had DOGE employees trying to get data from different government agencies. But you’re seeing it as, I think, we’ve talked about previously, like, there’s a desire for studies and, you know, things to move faster. Like, where are we looking for data? I think this whole arc of coverage has been really valuable in illuminating: Where are they looking. Is this precedented? Kind of how could these datasets be used? What are the patient potential issues? Are there privacy issues? Can this data be protected? That I think are going to be really important as we kind of look into the rest of this administration, because we’re only a year and a half in. Like, we got a ways to go. 

Rovner: And, oh I mean we say over many, many, many years it’s always been Republicans who have been, you know, very much into the federal government shouldn’t have its hands in people’s personal data, and yet here we have an administration that’s trying to get personal data from every single possible place. 

Cohrs Zhang: Right, it’s fascinating. And this just makes it so concrete. And I think it’s great accountability work, and they’ve clearly developed great sourcing on this. 

Rovner: Yeah. Liz. 

Whyte: Mine is a  by two doctors who are concerned about the burgeoning pediatric public health emergency, as they call it, about e-bikes and e-scooters. And I’ve been wondering about this for a long time because I see kids doing two, three kids on these scooters going so fast with no helmets. It’s always boggling my mind, but it’s apparently gotten really bad. They looked at data from 2020 to 2021 and saw an increase in injuries, up 71% in just one year â€” kid injuries with e-scooters and e-bikes. So that was 8,545 of those injuries in 2021. And the doctors discuss how, you know, these injury patterns that these kids get â€” I mean, they’re going up to like 28 mph â€” look very similar to when a child gets hit by a car. And that’s, it’s just real sad. So TBD on whether anybody does any kind of age-appropriate access standards or something like that that can help dial back these injuries. And then I guess I’m cheating Julie, but a shoutout to  recently, about how peptide med spa clinics have less regulation at the state level than your local restaurant or hair salon. She contacted all 50 states, and I thought it was just a really good supplement to the peptide news that we saw recently. 

Rovner: It was, and â€¦ forgive me for not mentioning it, and we will link to that one too. But I’m so glad you did the e-bike thing because if you hadn’t done that, I was going to, because the number of kids just in my neighborhood, little kids on motorized vehicles, it’s like: Shouldn’t they have to have driver’s licenses to do this? Anyway. Shefali. 

Luthra: My piece is by Aaron Carroll. It is an op-ed in The Washington Post. The headline is: “.” And what he talks about, I think, is just so smart. It’s about how it actually would be great if we had better and more research on SSRIs. However, the point he makes is that the government is actually not really approaching this from that kind of vantage. And instead the idea is to try and just cut back access to SSRIs, rather than learn more about them, learn how to make them work better, if they are as effective as they want them to be. And the point that he gets at the end as well is that while it is really good and worthwhile to investigate and study how well SSRIs work, one thing that we are actually getting into, which is really problematic, is stigmatizing use of them. And he talks about why that’s actually not good, and that is not actually helpful when it comes to thinking about how to make treatment for depression better and better and better. And I love this framing because we should try and make medications better for people. We should always be looking at treatments we have and saying, yes, they work. But what if we made them work better and better? What if we had fewer side effects? What if we made them more effective? That would be awesome. And I really love that he is putting those questions out there in a way that is smart and productive and forward-looking. 

Rovner: And not partisan. This has never been partisan. This is just so â€¦  it’s all so unprecedented. All right. My extra credit this week is from The Arkansas Times. It’s called “,” by Byron Tate. And it’s about exactly what the headline says. Since Congress gave states the option to extend Medicaid coverage to postpartum women for a full year after they give birth, 49 states have exercised that option â€” all but Arkansas, where that coverage still ends after 60 days. And Arkansas has one of the nation’s highest maternal mortality rates. So who’s against it? Apparently, the governor, Republican Sarah Huckabee Sanders, herself a mom. She says these women should be transitioning to other coverage, except apparently most of them are not. According to one study, 94% of those losing postpartum Medicaid are becoming uninsured instead. 

OK, that is this week’s show. Thanks to our editor, Emmarie Huetteman, and our producer-engineer, Francis Ying. A reminder: What the Health? is now available on WAMU platforms, the NPR app, and wherever you get your podcasts — as well as, of course, kffhealthnews.org. Also, as always, you can email us your comments or questions. We’re at whatthehealth@kff.org. Or you can still find me on X , and on Bluesky . Where are you folks hanging on socials these days? Rachel? 

Cohrs Zhang: I’m on X  and also on . 

Rovner: Shefali. 

Luthra: On Bluesky . 

Rovner: Liz. 

Whyte: I am on X  â€” with a “Y,” W-H-Y-T-E â€” and . You can Google me. 

Rovner: I’m sure people can find you. All right, we’ll be back in your feed next week. Until then, be healthy.