{"id":895848,"date":"2026-03-31T08:15:11","date_gmt":"2026-03-31T13:15:11","guid":{"rendered":"https:\/\/newsycanuse.com\/index.php\/2026\/03\/31\/what-the-health-from-kff-health-news-turnarounds-and-shake-ups\/"},"modified":"2026-03-31T08:15:11","modified_gmt":"2026-03-31T13:15:11","slug":"what-the-health-from-kff-health-news-turnarounds-and-shake-ups","status":"publish","type":"post","link":"https:\/\/newsycanuse.com\/index.php\/2026\/03\/31\/what-the-health-from-kff-health-news-turnarounds-and-shake-ups\/","title":{"rendered":"What the Health? From KFF Health News: Turnarounds and Shake-Ups"},"content":{"rendered":"
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[<\/em>Editor\u2019s note:<\/em><\/strong>\u00a0This transcript was generated using both transcription software and a human\u2019s light touch. It has been edited for style and clarity.]<\/em>\u00a0<\/p>\n

Mary Agnes Carey:<\/strong>\u00a0Hello from\u00a0KFF\u00a0Health News and WAMU Public Radio\u00a0in Washington, D.C. Welcome to\u00a0What the\u00a0Health?<\/em>\u00a0I\u2019m\u00a0Mary Agnes Carey, managing editor of\u00a0KFF Health News, sitting in for your host, Julie Rovner.\u00a0I\u2019m\u00a0joined by some of the best and smartest health reporters covering Washington.\u00a0We\u2019re\u00a0taping this week on Thursday, Feb.\u00a019, at 10\u00a0a.m.\u00a0As always, news happens fast, and things might have changed by the time you hear this. So here we go. Today,\u00a0we\u2019re\u00a0joined via video conference by Lauren Weber of The Washington Post.\u00a0<\/p>\n

Lauren Weber:<\/strong>\u00a0Hello,\u00a0hello.\u00a0<\/p>\n

Carey:\u00a0<\/strong>Tami\u00a0Luhby of\u00a0CNN.\u00a0<\/p>\n

Tami Luhby:<\/strong>\u00a0Glad to be here.\u00a0<\/p>\n

Carey:<\/strong>\u00a0And Shefali\u00a0Luthra\u00a0of\u00a0The\u00a019th<\/sup>.\u00a0<\/p>\n

Shefali\u00a0Luthra:<\/strong>\u00a0Hello.\u00a0<\/p>\n

Carey:<\/strong>\u00a0Let\u2019s\u00a0start today with the Food and Drug Administration. The FDA has now agreed to\u00a0review\u00a0Moderna\u2019s application for a new flu vaccine, reversing the agency\u2019s decision from just a week ago to reject the application because it said the company\u2019s research design was flawed. What happened?\u00a0<\/p>\n

Weber:<\/strong>\u00a0I think we\u00a0got to take a step back, and we got to think about this in the lens of the midterms, because, of course, we got to talk about\u00a0the midterms on this\u00a0podcast.\u00a0<\/p>\n

Carey:<\/strong>\u00a0Of course.\u00a0<\/p>\n

Weber:<\/strong>\u00a0But what\u00a0we\u2019ve\u00a0seen, really, since the beginning of January, after\u00a0[Health and Human Services Secretary] Robert F.\u00a0Kennedy\u00a0[Jr.]\u00a0overhauled the vaccine schedule under Jim O\u2019Neill, is a lot of changes. And part of that, I think, is due to a big poll that came out by a Republican pollster, the Fabrizio poll, that\u00a0indicated\u00a0that some of the vaccine changes were making voters nervous.\u00a0Basically, it\u00a0told the president, and it told Republicans,\u00a0that\u00a0maybe you\u00a0shouldn\u2019t\u00a0mess with the vaccine schedule as much. And ever since that poll has\u00a0kind of reached\u00a0the ether,\u00a0you\u2019ve\u00a0seen a lot more tamping down of conversation about vaccines.\u00a0So\u00a0you\u2019ve\u00a0seen Kennedy stay a lot more on\u00a0message\u00a0about food. And then you saw what happened this past week with the\u00a0Moderna flu reversal. So what ended up happening is the FDA came out and said they were not going to review the\u00a0Moderna flu vaccine, which was an mRNA vaccine, which, as we all remember, was the vaccine technology that became quite famous during the covid pandemic that\u00a0[President Donald]\u00a0Trump really championed in his first term.\u00a0So\u00a0the FDA came out and was like,\u00a0You\u00a0know what,\u00a0we\u2019re\u00a0not going to review this\u00a0<\/em>\u2014\u00a0which was a huge issue. It caused massive shock waves through the vaccine industry. A lot of vaccine and pharma insiders\u00a0said this could really\u00a0dampen their ability to develop future vaccines, because they felt like this action was made without enough explanation.\u00a0And after a week of\u00a0pretty much\u00a0bad headlines and bad press, the decision was reversed.\u00a0And Lauren Gardner from Politico had a\u00a0great story<\/a>, along with a colleague\u00a0[Tim\u00a0R\u00f6hn], where she pointed out that this reversal happened after a meeting with the FDA head in the White House,\u00a0where Trump expressed some concern over the handling of vaccines. So I think this reversal that you\u2019re seeing fits into the broader picture of the unpopularity of Kennedy\u2019s push around vaccines, and I expect that, considering their hesitancy, along with a really contentious midterms race, we may see more pushback to whether or not Kennedy is able to continue on his push against vaccines.\u00a0<\/p>\n

Carey:<\/strong>\u00a0So,\u00a0what are the implications for drug and vaccine manufacturers in the months ahead?\u00a0How will this\u00a0impact\u00a0them? Does it provide stability and reassurance that if you spend billions of dollars on drug development,\u00a0you\u2019re\u00a0not going to be stopped by federal agencies?\u00a0<\/p>\n

Weber:<\/strong>\u00a0I think\u00a0the reversal\u00a0maybe does, but,\u00a0I mean, certainly\u00a0they\u2019re\u00a0still spooked. I mean, the reality is that\u00a0it\u2019s\u00a0a little unclear. Obviously, there was a pressure campaign to reverse this, and it has been reversed.\u00a0But the current makeup of the FDA, with\u00a0Vinay Prasad,\u00a0has led many to be unclear on what will and will not get approved.\u00a0Under this HHS administration,\u00a0there\u2019s\u00a0been a big push for placebo-controlled trials and so on, and\u00a0somewhat a\u00a0shifting of expectations. And I think that while the reversal will settle feelings a bit, you also\u00a0\u2026\u00a0this is on a backdrop of hundreds of millions of dollars being canceled in mRNA vaccine contracts.\u00a0So\u00a0I think\u00a0there\u2019s\u00a0a lot of unease, and\u00a0there\u2019s\u00a0a lot of fear that this could continue to\u00a0[dampen]\u00a0vaccine development.\u00a0<\/p>\n

Luthra:<\/strong>\u00a0I think,\u00a0to add to what Lauren\u2019s saying, it\u2019s just pretty hard to imagine that after the past year and change that anything could really feel predictable if you are in the business of developing biopharmaceuticals in any form.\u00a0It\u2019s\u00a0just so\u00a0much\u00a0has changed, and so much really seems to depend on the whims of where the politics are and where the different players are and\u00a0who\u2019s\u00a0carrying influence.\u00a0It\u2019s\u00a0just hard\u00a0to really think about how you would want to invest\u00a0\u2014\u00a0right?\u00a0\u2014\u00a0a lot of money in developing these products,\u00a0where you may or may not have success. But one other thing that I am just so struck by in this whole episode is there is a lot of tension in\u00a0different parts\u00a0of the health policy\u00a0community groups around how the FDA is approaching different policies.\u00a0And one area I\u2019ve been thinking about a lot is where the FDA has been on abortion is a source of real frustration for a lot of abortion opponents, and seeing this episode play out if the White House did get involved, I think it raises a really interesting question for people who oppose abortion and want the FDA to take a harder look at it.\u00a0Are they going to expect similar movement from the\u00a0president, similar intervention,\u00a0or conversations from the White House?\u00a0And if they don\u2019t get that, how does\u00a0that affect, again,\u00a0just another issue that feels really salient as we head into a midterm election that gets closer and closer.\u00a0<\/p>\n

Carey:<\/strong>\u00a0And\u00a0I think you\u00a0know, this is a sign of what health care might mean and play in the fall election, so\u00a0we\u2019ll\u00a0keep our eye on that. Lauren, you just\u00a0mentioned recently\u00a0some changes at the Department of Health and Human Services.\u00a0We\u2019re\u00a0going to shift from the FDA to HHS, where\u00a0there\u2019s\u00a0been a shake-up in top leadership.\u00a0Jim O\u2019Neill, who had served as the HHS deputy secretary and as acting director for the Centers for Disease Control and Prevention, is leaving those positions. Other agency changes include Chris Klomp, who oversees Medicare, being named\u00a0chief counselor at HHS, where he will oversee agency operations.\u00a0And National Institutes of Health. Director Dr.\u00a0Jay\u00a0Bhattacharya will also serve as acting director of the CDC.\u00a0Clearly, there\u00a0is a lot going on here. Why are these changes happening now?\u00a0<\/p>\n

Weber:<\/strong>\u00a0So\u00a0our understanding\u00a0from\u00a0reporting\u00a0is that the White House wanted to shake things up before the midterms. I mean, if you know\u00a0\u2014\u00a0kind of what I alluded to in my last comments is, you know, Jim O\u2019Neill was the person who signed off on the childhood vaccine schedule. I mean, his name was plastered all over that in January, and now\u00a0he\u2019s\u00a0been shipped off to be head of the National Science Foundation, but certainly not as high profile of an HHS deputy role or CDC acting director. From our understanding,\u00a0that\u2019s\u00a0because the White House wants a bit tighter control over messaging and overall\u00a0thrust\u00a0of HHS heading into the midterms.\u00a0And I think\u00a0it\u2019s\u00a0noticeable\u00a0\u2014 you mentioned Chris Klomp,\u00a0I mean,\u00a0let\u2019s\u00a0note where he came from. He came from\u00a0CMS. You know,\u00a0you\u2019re\u00a0seeing a fair amount of folks from CMS,\u00a0from\u00a0\u201cOz Land,\u201d\u00a0come into HHS and exert seemingly, it\u00a0looks like,\u00a0more power, based on the White House\u2019s judgment, along with Kennedy. Kennedy is said to have also signed off on these changes.\u00a0But it remains to be seen\u00a0how this will\u00a0impact\u00a0HHS focus going forward.\u00a0<\/p>\n

Carey:<\/strong>\u00a0So\u00a0while\u00a0we\u2019re\u00a0talking about HHS,\u00a0let\u2019s\u00a0look at\u00a0Secretary Robert F.\u00a0Kennedy Jr.\u2019s first year in office. There\u2019s so much we could talk about:\u00a0the firing of members of the Advisory Committee on Immunization Practices, also known as ACIP,\u00a0and the addition of several members who oppose some vaccines;\u00a0major changes in the childhood vaccine schedule, changes that the American Academy of Pediatrics has called\u00a0\u201cdangerous and unnecessary\u201d;\u00a0pullbacks of federal funding for vaccination programs at local departments that were later reversed by a federal judge;\u00a0the firing of Senate-confirmed CDC director Susan\u00a0Monarez, who had only served\u00a0in\u00a0that position for less than a month;\u00a0new dietary guidelines aimed at getting\u00a0ultra-processed foods out of our diets, but adding red meat and whole milk\u00a0\u2014\u00a0foods that many nutritionists have steered people away from. This is an open question for the panel:\u00a0What do you make of Kennedy\u2019s tenure so far?\u00a0<\/p>\n

Luhby:<\/strong>\u00a0I mean,\u00a0he\u2019s\u00a0certainly been changing the agency in\u00a0ways that we somewhat\u00a0expected\u00a0and, you know, other ways that we\u00a0didn\u2019t. I will let the others speak to some of the\u00a0vaccine and others. But one thing\u00a0that\u2019s\u00a0also notable is the makeup of the agency.\u00a0They\u2019ve\u00a0laid off or prompted many people to quit or retire. You know, there\u2019s major staffing changes there as well, and\u00a0there\u2019s\u00a0a large brain drain, which has concerned a lot of people.\u00a0<\/p>\n

Weber:<\/strong>\u00a0Yeah,\u00a0I\u2019ll\u00a0chime in and say, I mean, I think public health officials have been horrified by his first year in office. There is a growing fear that,\u00a0obviously,\u00a0his many vaccine changes could have long-term consequences for vaccine\u00a0[uptake]\u00a0and an increase in vaccine hesitancy.\u00a0There\u2019s\u00a0been a lot of concern among public health officials and experts that Congress really has not stepped in to stop any of this.\u00a0That said,\u00a0there are currently\u00a0\u2026\u00a0there\u2019s a lawsuit the AAP has brought against these changes, which could have an outcome in the coming days that may or may not impact whether or not they\u2019re going forward.\u00a0You mentioned how he reconstituted ACIP, the\u00a0federal\u00a0advisory\u00a0committee on vaccination.\u00a0You know, what\u2019s really interesting is, right now, we\u2019re unclear if that ACIP meeting is still happening at the end of February.\u00a0And again, it\u00a0goes\u00a0back to my point of vaccines seem to be,\u00a0after this polling, not where Republicans want to be talking. And\u00a0so\u00a0a lot of Kennedy\u2019s primary concern, even though he talked a lot about food in his first year in office,\u00a0the\u00a0Post did an analysis<\/a>\u00a0of his social media, and he talked way more about food than he talked about vaccines. But his focus,\u00a0and ultimately, what\u00a0he was able to upend a lot of,\u00a0was vaccine infrastructure. And I think this year we will\u00a0see.\u00a0More of the impacts of that, and also whether or not he\u2019s allowed to make some of these changes, if there is enough backlash, or if there is enough pushback, or if there is enough political detriment that pushes back on what he has done.\u00a0\u00a0<\/p>\n

Luthra:<\/strong>\u00a0And I think\u00a0a really important\u00a0thing for us to think about, that Lauren just alluded to, is a lot of the consequences of this first year are things we will be seeing play out for many years to come. There has been this\u00a0dramatic upending of the vaccine infrastructure. We have seen medical groups try and step in and try and offer independent forms of authority and\u00a0expertise\u00a0to give people useful medical information. But\u00a0that\u2019s\u00a0a very big\u00a0role\u00a0to fill\u00a0in the context of this tremendous brain drain. And I think what we are waiting to see is, how does that translate to decision-making on the individual level and on the aggregate level?\u00a0Do people feel like they can trust the information\u00a0they\u2019re\u00a0given? Do they get the vaccines they would have gotten in the past for their families, for their children? Is it easier? Is it harder?\u00a0Does\u00a0those difficulties matter in the end?\u00a0And\u00a0that\u2019s\u00a0the kind of impact and consequence that we can talk about now, but that\u00a0we\u2019ll\u00a0only really understand in years to come when we look at whether and how population health outcomes shift.\u00a0<\/p>\n

Carey:<\/strong>\u00a0Sure.\u00a0And\u00a0so\u00a0we\u2019re\u00a0talking about, you know, Lauren and the full panel\u00a0has\u00a0made this clear, talking about some of the shifts in the messaging out of HHS as we head into the fall elections.\u00a0Lauren, if I heard you correctly, you were saying on Secretary Kennedy\u2019s social media feeds, he had talked a lot more about food than vaccines,\u00a0but yet, the vaccine message seems to have resonated more.\u00a0So,\u00a0as you look towards the fall elections, right?\u00a0We\u2019re\u00a0talking about\u00a0affordability,\u00a0in a moment\u00a0we\u2019re\u00a0going to be talking about the Affordable Care Act.\u00a0We\u2019ve\u00a0read a lot\u00a0\u2026\u00a0and folks have talked on this podcast about drug prices. Are the steps enough that are happening here on the messaging? Is it enough to\u00a0focus\u00a0the message, and is it going to land with voters, or will they be looking at it in\u00a0a different way?\u00a0<\/p>\n

Weber:<\/strong>\u00a0And will he stay on message?\u00a0<\/p>\n

Carey:<\/strong>\u00a0Exactly.\u00a0<\/p>\n

Weber:<\/strong>\u00a0I\u2019ve\u00a0watched,\u00a0I\u2019ve\u00a0watched hundreds of hours of Kennedy speaking, and the man,\u00a0when let rip\u00a0\u2014\u00a0I mean, recently he said in a podcast, he talked about snorting\u00a0cocaine\u00a0off a toilet seat. I mean, that was something that came up in a long-form conversation. Obviously,\u00a0there\u2019s\u00a0more context around it.\u00a0But he is known for\u00a0speaking off the cuff. And so, I think it remains to be seen if, if they are able to see how that messaging\u00a0\u2014\u00a0in order to talk about drug prices, talk about affordability\u00a0\u2014\u00a0if that continues to play for the midterms, and if it doesn\u2019t, what the consequences of that may be. I think\u00a0it\u2019s\u00a0important\u00a0too\u00a0\u2026\u00a0I mean, last night, Trump issued an executive order that is aimed at encouraging the domestic production of glyphosate, which is a really widely used weed killer that has been key in a bunch of health lawsuits around\u00a0Roundup and other pesticides, is a real shot against,\u00a0across the bow for the MAHA\u00a0[\u201cMake America Healthy Again\u201d]\u00a0crowd, and it puts Kennedy in a tough position. I mean, he\u2019s issued a statement saying he supports the president, but I mean, this is a man who\u2019s advocated against glyphosate and pesticides for years and years and years, and it\u2019s really divided the MAHA movement that,\u00a0you know\u00a0\u2026\u00a0many folks who said they joined MAHA,\u00a0many\u00a0MAHA\u00a0moms, pesticides are a huge issue, and this could fracture this movement,\u00a0you know,\u00a0that\u00a0Republicans so want to keep in line for the midterms<\/a>, just as they\u2019re starting to try to get on message.\u00a0<\/p>\n

Luhby:<\/strong>\u00a0One thing also that my colleague, I wanted to talk about, my colleague Meg Tirrell did a\u00a0fantastic piece last week\u00a0about Kennedy\u2019s first year, and\u00a0it\u2019s\u00a0headlined\u00a0\u201cTrump\u00a0Promised RFK Jr.\u00a0Would\u00a0\u2018Restore\u00a0Faith in American\u00a0Health\u00a0Care\u2019:\u00a0A\u00a0Year\u00a0In,\u00a0Trust\u00a0Has\u00a0Plummeted<\/a>.\u201d\u00a0So I think that that\u2019s one thing that also we have to look at is that Trump had said that there would be historic reforms to health and public health, and that, you know, it would bring back people\u2019s trust and confidence in the American health\u00a0care systems after covid\u00a0\u2014 and you know, after what he criticized the Biden administration for.\u00a0But\u00a0also\u00a0it shows that actually,\u00a0if you look at\u00a0recent polling from\u00a0KFF, it shows that trust in government health agencies has plummeted over the last year. So\u00a0that\u2019s\u00a0going to be something that they also\u00a0will\u00a0have to contend with, both in the midterms and going forward.\u00a0<\/p>\n

Carey:<\/strong>\u00a0We\u2019ll\u00a0keep our eye on those issues now and in the months ahead. And right now,\u00a0we\u2019re\u00a0taking a quick break.\u00a0We\u2019ll\u00a0be right back.\u00a0<\/p>\n

All right,\u00a0we\u2019re\u00a0back and returning to the upcoming confirmation hearing for Dr.\u00a0Casey Means.\u00a0She\u2019s\u00a0President Trump\u2019s nominee to be\u00a0surgeon\u00a0general.\u00a0The Senate Health, Education, Labor\u00a0&\u00a0Pensions, or HELP,\u00a0Committee, as it is known, will consider that nomination next Wednesday, Feb.\u00a025.\u00a0You might remember that\u00a0Means\u2019\u00a0confirmation hearing was scheduled for late October, but it was delayed when she went into labor.\u00a0She was expected then to face tough questions about her medical credentials and her stance on vaccines, among other areas. Means is known as a wellness influencer, an entrepreneur, an author,\u00a0and a critic of the current medical system, which she says is more focused on managing disease than addressing its\u00a0root causes. If confirmed as\u00a0surgeon\u00a0general, she would oversee the more than 6,000 members of the U.S.\u00a0Public Health Service, which includes physicians, nurses,\u00a0and scientists working at various federal agencies. What do you expect from the hearing,\u00a0and what should people look for?\u00a0<\/p>\n

Weber:<\/strong>\u00a0So\u00a0I did a\u00a0longer profile with my colleague Rachel\u00a0Roubein\u00a0on Casey\u00a0Means<\/a>\u00a0last fall. And what we learned,\u00a0in\u00a0really digging into reading her book, going through her newsletters, going through her public comments, is that this is someone who left the medical establishment. She left her residency near the end of\u00a0it, and\u00a0has really promoted and become central in\u00a0MAHA\u00a0world due to her book,\u00a0Good\u00a0Energy<\/em>, which, you know, some folks in politics referred to as the\u00a0bible of\u00a0MAHA.\u00a0So\u00a0if\u00a0confirmed, I think she could play a rather\u00a0large role\u00a0in shepherding the MAHA movement. But I think\u00a0she\u2019ll\u00a0face a lot of questions from folks about her medical license and practicing medicine.\u00a0So\u00a0Casey\u00a0Means currently has a medical license in Oregon that she voluntarily placed in\u00a0inactive status, which, according to the Oregon State Medical Board, means she cannot practice medicine in the state as of the beginning of 2024.\u00a0Additionally, she has received over half a million dollars in partnerships from various wellness products and diagnostic companies, you know, some of which in her disclosure forms talked about elixirs and supplements and so on. And I expect\u00a0that\u00a0will get a lot of scrutiny from senators as well. And I will just note,\u00a0too, I think it\u2019s important to look at a passage from her book that a lot of public health experts that we spoke to were a bit concerned about, because she wrote in her book that\u00a0\u201cthe ability to prevent and reverse\u201d\u00a0a variety of ailments, including infertility and Alzheimer\u2019s,\u00a0\u201cis under your control and simpler than you think.\u201d\u00a0And statements like that really\u00a0worried\u00a0a fair amount of the public health experts I spoke to. [They]\u00a0said she would have this\u00a0bully\u00a0pulpit to speak about health, but\u00a0they\u2019re\u00a0concerned that she\u00a0doesn\u2019t\u00a0underpin it with enough scientific reasoning. And\u00a0so\u00a0we\u2019ll\u00a0see if those issues and,\u00a0also obviously having to answer for Kennedy and the HHS shake-ups and Kennedy and vaccines\u00a0\u2014\u00a0I\u2019m\u00a0sure a lot of that will come up as well. It should\u00a0\u2026\u00a0I expect it to be a hearing with a fair\u00a0amount\u00a0of fireworks.\u00a0<\/p>\n

Carey:<\/strong>\u00a0Do you think the fact that\u00a0\u2026\u00a0they\u2019ve\u00a0scheduled this hearing means that they have the votes for confirmation? Or is it simply a sign that the administration just wants to get moving on this, or shift a bit from some of the hotter issues that have happened recently?\u00a0<\/p>\n

Weber:<\/strong>\u00a0I mean, this is a long time for the American public to not have a surgeon general.\u00a0So\u00a0I mean,\u00a0I think they\u00a0were hoping to get this\u00a0moving, to get her in the position.\u00a0As I said, she could be\u00a0a very strong\u00a0voice for\u00a0MAHA,\u00a0considering her book underpins a lot of the MAHA movement. I think,\u00a0in general, Republicans do have the votes to confirm her, but it just depends on how much they are agitated by her medical credentials and some of her past comments. I think we could see some fireworks, but, you know, we saw fireworks\u00a0in\u00a0the Kennedy hearing, and he got approved. So, you know,\u00a0I think it\u00a0remains to be seen what happens next week.\u00a0<\/p>\n

Carey:<\/strong>\u00a0Sure. Well, thanks for that.\u00a0Let\u2019s\u00a0move on to the Affordable Care Act,\u00a0or the ACA.\u00a0More Americans than expected enrolled in ACA health plans for this year, even though the enhanced premium subsidies expired Jan.\u00a01. But\u00a0it\u2019s\u00a0unclear if these folks are going to keep their coverage as their health care costs increase. Federal data released late last month showed a\u00a0year-over-year\u00a0drop of about 1.2 million enrollments across the federal and state\u00a0marketplaces. But these aren\u2019t the final numbers, right?\u00a0<\/p>\n

Luhby:<\/strong>\u00a0No.\u00a0What\u2019s\u00a0going to happen is people have time\u00a0now,\u00a0they still\u00a0have to\u00a0pay their premiums. The numbers that were being released were the number of people who signed up for plans.\u00a0So\u00a0what experts expect is that,\u00a0over time, people who receive their bills may not pay them.\u00a0A\u00a0lot of people,\u00a0remember, get automatically enrolled, so they may not be even aware of how much their premiums are going to increase until they actually get their bill.\u00a0So\u00a0they may not pay the bills, or they may try to pay the bills for\u00a0a short time\u00a0and find that\u00a0they\u2019re\u00a0just too high. Remember that the premiums,\u00a0on average, premium payments were expected to increase by 114% according to\u00a0KFF. So that just may be unmanageable. The experts\u00a0I\u2019ve\u00a0spoken to expect that we should get better numbers around April or so to see what the numbers of actual enrollees are.\u00a0Because people,\u00a0actually, if they don\u2019t pay their premiums, can stay in the plants for three months, and then they get washed out.\u00a0So\u00a0we\u2019re\u00a0expecting to see if, hopefully,\u00a0CMS will release it, but\u00a0we\u2019re\u00a0hoping to see better numbers in April.\u00a0<\/p>\n

Carey:<\/strong>\u00a0Shefali, I know you closely follow abortion. How much has the abortion and the Hyde Amendment played in all these discussions about Congress trying to find,\u00a0if they really want to find,\u00a0a resolution to this subsidy issue?\u00a0<\/p>\n

Luthra:<\/strong>\u00a0It\u2019s\u00a0so interesting. A lot of anti-abortion activists have been quite firm. They say that there cannot be any permission that ACA-subsidized plans cover abortion if the subsidies are renewed.\u00a0That, of course, would go\u00a0against laws in some states that require those claims to cover abortion using state funds, not using federal funds, because of the Hyde Amendment.\u00a0The president\u00a0relatively recently, even though it feels like a lifetime, said,\u00a0Oh, we should be flexible on this abortion restriction that anti-abortion activists want<\/em>. They were, of course, furious with him and said,\u00a0We\u00a0can\u2019t\u00a0compromise on this.\u00a0This is\u00a0very important\u00a0to our base<\/em>.\u00a0And they view it as the federal government making\u00a0abortion\u00a0more available. And\u00a0so\u00a0I think\u00a0it\u2019s\u00a0still an open question as to whether this will\u00a0ultimately be\u00a0a factor.\u00a0It\u2019s,\u00a0to your point, not really clear that lawmakers are anywhere close to coming to a deal on the subsidies.\u00a0They very well may not,\u00a0right?\u00a0They still\u00a0have to\u00a0figure out funding for\u00a0DHS\u00a0[Department of Homeland\u00a0Security].\u00a0They have many other things that\u00a0are keeping\u00a0them quite occupied.\u00a0But this is absolutely something that abortion opponents will remain very firm on. And I mean, they\u00a0haven\u2019t\u00a0had the victories they really would have hoped for in this administration so far, and I think\u00a0it\u2019d\u00a0be\u00a0very difficult\u00a0for them to take another loss.\u00a0<\/p>\n

Carey:<\/strong>\u00a0So,\u00a0Lauren,\u00a0what\u2019s\u00a0going on with the discussions on Capitol Hill about potentially extending the enhanced ACA subsidies?\u00a0We\u2019re\u00a0hearing reports from negotiators that the deal might be dead. How would that impact voters in November?\u00a0<\/p>\n

Weber:<\/strong>\u00a0I think people should be interested in getting a solution, because I think\u00a0\u2014\u00a0talk about hitting voters\u2019\u00a0pocketbooks and actual consequences. I mean, this seems like this is a thing\u00a0that\u2019s\u00a0only going to continue to pick up speed. I was fascinated\u00a0\u2026\u00a0I know you want to talk more about that great\u00a0Politico piece that dives into the\u00a0ticktock of how this all happened. But\u00a0\u2026\u00a0\u00a0<\/p>\n

Carey:<\/strong>\u00a0Yes,\u00a0great story.\u00a0<\/p>\n

Weber:<\/strong>\u00a0I think, in general, the ACA\u00a0subsidies fall into a trap of most of the contentious two-party system that we\u2019re in right now, where different issues that are issues that we can\u2019t touch end up blowing up problems that affect\u00a0everyday\u00a0Americans in their day-to-day, and then no action gets made, and then we end up closer to the midterms,\u00a0where people actually may or may not want to do something.\u00a0So\u00a0I\u2019m\u00a0not sure that people\u00a0don\u2019t\u00a0want to do something.\u00a0I\u2019m\u00a0just not sure that\u00a0there\u2019s\u00a0enough consensus around what that would be, and in the meantime, actual people are feeling the pain.\u00a0So\u00a0we\u2019ll\u00a0see how that continues to play out.\u00a0\u00a0<\/p>\n

Carey:<\/strong>\u00a0Sure.\u00a0<\/p>\n

Luthra:<\/strong>\u00a0I\u00a0just\u00a0wanna\u00a0say, just to add one more point to what Lauren mentioned about political pressure and backlash.\u00a0The\u00a0latest polling from\u00a0KFF<\/a>\u00a0shows that health\u00a0care costs are voters\u2019\u00a0No. 1\u00a0affordability concern. And we know there was that\u00a0brief moment\u00a0when the\u00a0president said,\u00a0We\u00a0should be the affordability party<\/em>,\u00a0not\u00a0Zohran Mamdani\u00a0and the Democrats<\/em>. And\u00a0so\u00a0I think that\u2019s really interesting, right? Are they able to stick to that? Are they able to address this policy that voters are saying is such a high priority for them, because it is so visceral, right? You know what\u00a0you\u2019re\u00a0paying, and you know that your bills are higher than last\u00a0year.\u00a0And if they can\u2019t, is that the kind of thing that actually does shape how voters react in November, especially given so many other\u00a0cost-of-living\u00a0concerns many of them have.\u00a0<\/p>\n

Luhby:<\/strong>\u00a0Right, well, one of\u00a0my White House colleagues today wrote a great story<\/a>\u00a0about how the Trump administration\u2019s messaging,\u00a0or what\u00a0they\u2019re\u00a0suggesting that the GOP message for the midterms is lower drug prices, which is something that they have been\u00a0very active\u00a0on.\u00a0So\u00a0they\u00a0don\u2019t\u00a0want to discuss the exchanges, and\u00a0we\u2019ll\u00a0talk a little bit about the new rule that\u00a0they\u2019ve\u00a0just proposed.\u00a0But yeah, I think the administration is going to focus on health care.\u00a0They\u2019re aware of the concerns of health care, and their message is going to be\u00a0\u201cmost favored nation,\u201d\u00a0TrumpRx,\u00a0and the other efforts that they\u2019ve made to lower drug prices, which is something,\u00a0of course, Trump was also very focused on in his first term as well, but to less effect.\u00a0<\/p>\n

Carey:<\/strong>\u00a0Speaking of that rule, Tami, can you tell us more about that?\u00a0<\/p>\n

Luhby:<\/strong>\u00a0Sure.\u00a0Well, CMS wants to make sweeping changes for ACA plans for 2027.\u00a0It issued a proposed rule last week that would give more consumers access to catastrophic policies. Now these are policies that have\u00a0very high\u00a0deductibles and\u00a0out-of-pocket costs,\u00a0generally offer\u00a0skimpier benefits, but,\u00a0importantly\u00a0for the administration, have lower premiums. The proposed rule would also repeal a requirement that exchanges offer standardized plans, which are designed to make it easier for people to compare options. It would ease network adequacy rules and require, as we were just talking about, require more income verifications to get subsidies and crack down on brokers and agents who,\u00a0we\u2019ve just discussed about, you know, have been\u00a0\u2026\u00a0some of whom have been complicit in fraud. The goal is to lower the ACA premiums and give people more choice,\u00a0according to CMS. Premiums, of course, have been a big issue, as we discussed\u00a0\u2026\u00a0because of the increase in monthly\u00a0payments due to the\u00a0expiration\u00a0of the subsidies. But notably, the agency itself says that up to\u00a02 million people\u00a0could lose ACA coverage because of this proposed rule.\u00a0It\u2019s\u00a0a sweeping,\u00a0577-page rule, I think?\u00a0And if you want to get more information, I highly recommend you read Georgetown\u2019s Katie Keith\u2019s\u00a0extensive three-part breakdown<\/a>, which was published in Health Affairs.\u00a0<\/p>\n

Carey:<\/strong>\u00a0All right, well,\u00a0we\u2019ll\u00a0have to keep our eye on that rule and all the comments that I\u00a0am\u00a0sure will come in.\u00a0<\/p>\n

Luhby:<\/strong>\u00a0Many comments.\u00a0<\/p>\n

Carey:<\/strong>\u00a0Many.\u00a0I\u2019m\u00a0also intrigued about some of the GOP talking points on potential fraud in the program. For example, the House Judiciary Committee has subpoenaed eight health insurers,\u00a0asking for information on their subsidized ACA enrollees and potential\u00a0subsidy-related\u00a0fraud. It has been a Republican talking point that\u00a0it\u2019s\u00a0their\u00a0perception, for many Republicans, that there is a lot of fraud in the program that needs to be investigated. Is there any merit to the claim, and will this discussion of fraud shift away from this\u00a0really critical\u00a0affordability issue that\u00a0we\u2019re\u00a0all talking about?\u00a0<\/p>\n

Luhby:<\/strong>\u00a0Well, we know that there has been fraud in the program, particularly after the enhanced subsidies went into effect. I mean, even the Biden\u00a0administration released reports and information about brokers and agents that were\u00a0basically switching\u00a0people into different plans, switching them into low-cost plans,\u00a0enrolling them\u00a0in order to\u00a0get the commissions.\u00a0And\u00a0it\u2019s\u00a0one\u00a0that\u00a0actually played\u00a0also into the argument on Capitol Hill about extending the subsidies,\u00a0whereas\u00a0the Republicans were very forceful about not having zero-premium subsidies, because they felt that this helped contribute to the fraud.\u00a0So\u00a0you know,\u00a0that\u2019s\u00a0not an issue anymore, because the subsidies were not renewed, but both CMS and Congress are still focused on this idea of fraud with the subsidies.\u00a0<\/p>\n

Carey:<\/strong>\u00a0All right, well,\u00a0we\u2019ll\u00a0keep watching that now\u00a0and in the months\u00a0ahead.\u00a0\u00a0<\/p>\n

So\u00a0that\u2019s\u00a0the news for this week. And before we\u00a0get to\u00a0our extra credits, we need to correct the name of the winner of our\u00a0Health\u00a0Policy Valentines contest. The winner is Andrew Carleen of Massachusetts, and thanks again to everyone who entered.\u00a0\u00a0<\/p>\n

All right, now\u00a0it\u2019s\u00a0time for our\u00a0extra-credit\u00a0segment.\u00a0That\u2019s\u00a0where we each recognize a story that we read this week and think you should read,\u00a0too.\u00a0Don\u2019t\u00a0worry if you miss it.\u00a0We\u2019ll\u00a0post the links in our show notes. Lauren, why don\u2019t you start us off this week?\u00a0<\/p>\n

Weber:<\/strong>\u00a0Yeah, I have two pieces, a piece from\u00a0NiemanLab:\u00a0\u201cThe Atlantic\u2019s Elizabeth Bruenig on Her \u2018Hypothetical,\u2019 Heavily Reported Measles Essay<\/a>.\u201d\u00a0And then I also have one from my\u00a0publication\u00a0at\u00a0The Washington Post.\u00a0It\u2019s\u00a0from Scott Nover.\u00a0The Atlantic\u2019s\u00a0essay about measles was\u00a0gut-wrenching.\u00a0And some readers feel deceived. And for a little bit of background for anyone who\u00a0didn\u2019t\u00a0read it, Elizabeth wrote a very striking, beautifully written piece in The Atlantic from the perspective of a mom who lost her child to measles after a fatal complication that can happen for measles. But the way it was written, a lot of people did not realize it was fiction, or creative nonfiction,\u00a0or creative\u00a0fiction to some degree.\u00a0And\u00a0so\u00a0it was written from the perspective like it was\u00a0Bruenig\u2019s\u00a0story, but at the very end of the piece, and it turns out this was attached later,\u00a0after\u00a0publication, was an editor\u2019s note saying this piece is based on interviews.\u00a0I\u00a0gotta\u00a0say, as,\u00a0when I initially\u00a0read it, as a savvy consumer, I initially was like,\u00a0Is\u00a0this her story?<\/em>\u00a0until I got to the\u00a0editor\u2019s\u00a0note at the end.\u00a0The\u00a0NiemanLab\u00a0reporting says that that\u00a0editor\u2019s\u00a0note wasn\u2019t actually even on the piece when it started.\u00a0I think this\u00a0is a fascinating question,\u00a0in general. I think that in an era where vaccine misinformation is rampant and the truth is important, it seems like having a pretty clear\u00a0editor\u2019s\u00a0note at the top of this piece is essential.\u00a0But\u00a0that\u2019s\u00a0just my two cents on that, and I thought both the discussion and the online discussion about it was really fascinating this week.\u00a0<\/p>\n

Carey:<\/strong>\u00a0That\u2019s\u00a0fascinating. Indeed. Tami,\u00a0what\u2019s\u00a0your extra credit?\u00a0<\/p>\n

Luhby:<\/strong>\u00a0My extra credit is titled\u00a0\u201cNewYork-Presbyterian Nurses Reject Contract by Overwhelming Margin<\/a>,\u201d\u00a0by\u00a0Claudia Irizarry Aponte and Ben\u00a0Fractenberg\u00a0in\u00a0The\u00a0City, an online publication covering New York.\u00a0We\u2019ve\u00a0been having a major nurses\u2019\u00a0strike in New York City. It\u2019s, you know, notable\u00a0in\u00a0the size and number of hospitals and length of the strike, which has been going on already for over a month.\u00a0It\u2019s\u00a0affected several large hospitals\u00a0\u2014\u00a0Mount Sinai,\u00a0Montefiore,\u00a0and\u00a0NewYork-Presbyterian\u00a0\u2014\u00a0with nurses demanding stronger\u00a0nurse-to-patient\u00a0staffing ratios, which, you know, has been a long-standing issue at many hospitals. Now, the interesting development is that the city uncovered a rift between\u00a0NewYork-Presbyterian\u2019s\u00a0nurses\u00a0union and their leadership.\u00a0So\u00a0what happened is the nurses at Montefiore and Mount Sinai have recently approved their contracts\u00a0and are back to work, but the\u00a0NewYork-Presbyterian nurses did not approve their contract because the language differed on the staffing-ratio enforcement and did not guarantee job security for existing nurses. And what actually apparently happened is that the\u00a0union\u2019s\u00a0executive committee rejected the contract, but the union leaders still forced the vote on it, which was,\u00a0actually,\u00a0ended\u00a0up voting down. So now the nurses have demanded a formal disciplinary investigation into the union\u00a0leaders for\u00a0forcing this vote. So more than 1,500 nurses\u00a0at\u00a0NewYork-Presbyterian signed the petition,\u00a0and more than 50 nurses delivered it to the New York State Nurses Association headquarters. One nurse told\u00a0The\u00a0City they are overriding our voices. The union president urged members not to rush to judgment. Now, the\u00a0NewYork-Presbyterian nurses remain on strike, which has lasted already for more than a month, and it\u2019s going to be interesting to watch how this develops, especially because you have, obviously, the contentious negotiations between the hospital and the\u00a0nurses\u00a0union, but now you also have this revolt, and, you know, issues within the\u00a0nurses\u00a0union itself.\u00a0<\/p>\n

Carey:<\/strong>\u00a0Wow, that is also an amazing story. Shefali?\u00a0<\/p>\n

Luthra:<\/strong>\u00a0Sure. My piece is from NPR. It is\u00a0by\u00a0Jasmine Garsd. The headline is\u00a0\u201cMinneapolis Doctors Warn of Lasting Medical Effects, Even After ICE Agents Leave<\/a>.\u201d\u00a0And the story looks at something that we know from research happens, but on the ground in Minneapolis, of people concerned about\u00a0ICE\u00a0[Immigration and Customs Enforcement]\u00a0and immigration presence at medical centers, delaying important health\u00a0care that can be treatment for chronic ailments, it can also be treatment for acute conditions. And what I like about this story is that it highlights that this is something that is going to have consequences, even now with this surge of DHS law enforcement in Minnesota winding down.\u00a0The consequences of\u00a0missed\u00a0health\u00a0care can last for\u00a0a very long\u00a0time. And something I have heard often when just talking to immigrants and medical providers in the Minneapolis metropolitan area is exactly this fear that they\u00a0actually don\u2019t\u00a0know what the coming weeks and months are going to bring.\u00a0They don\u2019t know when they will feel safe getting health care again, when it will feel as if the consequences of this really concentrated federal blitz will be ameliorated in any way.\u00a0And I love that this story\u00a0takes that longer view and highlights that we are going to be navigating the medical effects of something so seismic and frankly\u00a0pretty unprecedented\u00a0for quite some time. And I encourage people\u00a0to read it.\u00a0<\/p>\n

Carey:<\/strong>\u00a0Thank you for that. My extra credit is from Politico by Robert King and Simon\u00a0J. Levien, called\u00a0\u201cWhy Congress Failed To Reach an Obamacare Deal<\/a>.\u201d\u00a0The piece is an inside look at why and how Congress\u00a0failed to\u00a0take action\u00a0on extending the enhanced Affordable Care Act subsidies, which led to the longest government shutdown\u00a0in U.S.\u00a0history and higher ACA premiums for millions of Americans.\u00a0<\/p>\n

OK, that\u2019s this week\u2019s show.\u00a0As always,\u00a0thanks to our editor, Emmarie\u00a0Huetteman, and our producer and engineer,\u00a0Francis Ying.\u00a0A\u00a0reminder:\u00a0What the\u00a0Health?<\/em>\u00a0is now available on WAMU platforms, the NPR app,\u00a0and wherever you get your podcasts\u00a0\u2014\u00a0as well as, of course,\u00a0kffhealthnews.org<\/a>.\u00a0Also, as always, you can email us with your comments or questions.\u00a0We\u2019re\u00a0at\u00a0wh***********<\/span>@*<\/span>ff.org<\/span><\/a>,\u00a0or you can find me on\u00a0X\u00a0@maryagnescarey<\/a>.\u00a0Lauren, where can people find you these days?\u00a0<\/p>\n

Weber:<\/strong>\u00a0On\u00a0X<\/a>\u00a0and on\u00a0Bluesky<\/a>:\u00a0@LaurenWeberHP.\u00a0The\u00a0HP stands for\u00a0health\u00a0policy.\u00a0<\/p>\n

Carey:<\/strong>\u00a0All right.\u00a0Shefali.\u00a0<\/p>\n

Luthra:<\/strong>\u00a0On\u00a0Bluesky:\u00a0@shefali<\/a>\u00a0<\/p>\n

Carey:<\/strong>\u00a0And Tami.\u00a0<\/p>\n

Luhby:\u00a0<\/strong>You can find me\u00a0at\u00a0cnn.com<\/a>.\u00a0<\/p>\n

Carey:<\/strong>\u00a0We\u2019ll\u00a0be back in your feed next week. Until then, be healthy.\u00a0<\/p>\n<\/p><\/div>\n

Read More<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

[ Editor\u2019s note: \u00a0This transcript was generated using both transcription software and a human\u2019s light touch. It has been edited for style and clarity.]\u00a0 Mary Agnes Carey:\u00a0Hello from\u00a0KFF\u00a0Health News and WAMU Public Radio\u00a0in Washington, D.C. Welcome to\u00a0What the\u00a0Health?\u00a0I\u2019m\u00a0Mary Agnes Carey, managing editor of\u00a0KFF Health News, sitting in for your host, Julie Rovner.\u00a0I\u2019m\u00a0joined by some of<\/p>\n","protected":false},"author":1,"featured_media":895849,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[267,27781],"tags":[7419,102603],"class_list":{"0":"post-895848","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health","8":"category-turnarounds","9":"tag-health","10":"tag-turnarounds"},"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/posts\/895848","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/comments?post=895848"}],"version-history":[{"count":0,"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/posts\/895848\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/media\/895849"}],"wp:attachment":[{"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/media?parent=895848"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/categories?post=895848"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/tags?post=895848"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}