\t\t\t<\/p>\n
\tJulie Rovner
\n\tKFF Health News<\/p>\n
\t\t\t \t\t\t \t\t\t \t\t\tJulie Rovner is chief Washington correspondent and host of KFF Health News\u2019 weekly health policy news podcast, \u201cWhat the Health?\u201d A noted expert on health policy issues, Julie is the author of the critically praised reference book \u201cHealth Care Politics and Policy A to Z,\u201d now in its third edition.\t\t<\/p>\n Oct. 1 is the start of the next fiscal year, and unless Congress reaches agreement on continued spending, big parts of the government could shut down that day. Democrats, whose votes will be needed in the Senate, would like Republicans to extend the Biden-era extra tax credits for Affordable Care Act insurance plans as part of a compromise, but so far Republicans don\u2019t seem willing.<\/p>\n Meanwhile, Health and Human Services Secretary Robert F. Kennedy Jr. released his much-anticipated \u201cMake America Healthy Again\u201d blueprint to improve children\u2019s health, but the report contained few specifics on how his goals would be reached.<\/p>\n This week\u2019s panelists are Julie Rovner of KFF Health News, Anna Edney of Bloomberg News, Sandhya Raman of CQ Roll Call, and Lauren Weber of The Washington Post.<\/p>\n \t\t\t \tAnna Edney \t\t\t \t\t\t \t\t\t \t\t\t \tSandhya Raman \t\t\t \t\t\t \t\t\t \t\t\t \tLauren Weber \t\t\t \t\t\t Among the takeaways from this week\u2019s episode:<\/p>\n Plus, for \u201cextra credit\u201d the panelists suggest health policy stories they read (or wrote) this week that they think you should read, too:\u00a0<\/p>\n Julie Rovner:<\/strong> NPR\u2019s \u201cWhat Kind of Dairy Does a Body Good? Science Is Updating the Answer<\/a>,\u201d by Will Stone.<\/p>\n Anna Edney:<\/strong> Bloomberg News\u2019 \u201cThe Implants Were Supposed to Dissolve. They Didn\u2019t<\/a>,\u201d by Anna Edney and Tanaz Meghjani.<\/p>\n Sandhya Raman:<\/strong> The Texas Tribune\u2019s \u201cTexas\u2019 New Parental Consent Law Leaves School Nurses Confused About Which Services They Can Provide to Students<\/a>,\u201d by Jaden Edison.<\/p>\n Lauren Weber:<\/strong> ProPublica\u2019s \u201c\u2018Just Let Me Die,\u2019<\/a>\u201d by Duaa Eldeib.<\/p>\n Also mentioned in this week\u2019s podcast:<\/p>\n \t\t\t\t\tclick to open the transcript\t\t\t\t<\/p>\n \t\t\t\t\t\tTranscript: Countdown to Government Shutdown\t\t\t\t<\/p>\n [Editor\u2019s note:<\/em><\/strong> This 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 Julie Rovner:<\/strong> Hello, and welcome back to \u201cWhat the Health?\u201d I\u2019m Julie Rovner, chief Washington correspondent for KFF Health News, and I\u2019m joined by some of the best and smartest health reporters in Washington. We\u2019re taping this week on Thursday, Sept. 11, at 10 a.m. As always, news happens fast and things might have changed by the time you hear this. So, here we go.\u00a0<\/p>\n Today we are joined via videoconference by Anna Edney of Bloomberg News.\u00a0<\/p>\n Anna Edney:<\/strong> Hey, everybody.\u00a0<\/p>\n Rovner:<\/strong> Lauren Weber of The Washington Post.\u00a0<\/p>\n Lauren Weber:<\/strong> Hello, hello.\u00a0<\/p>\n Rovner:<\/strong> And Sandhya Raman of CQ Roll Call.\u00a0<\/p>\n Sandhya Raman:<\/strong> Hello, everyone.\u00a0<\/p>\n Rovner:<\/strong> No interview this week, but plenty of news. So let us dive right in. As of today, we are less than three weeks away from a government shutdown if Congress can\u2019t pass all 12 spending bills \u2014 spoiler, that is not going to happen \u2014 or pass some sort of continuing resolution to keep the government funded while lawmakers continue working on the spending bills. Now, even though Republicans control the House, Senate, and the White House, it will take Democratic votes, at least in the Senate, to make any of this happen, because appropriations bills, unlike that budget reconciliation bill that passed earlier this summer, require 60 votes to pass rather than just 51. So how\u2019s it all going, appropriations watchers? Sandhya, you\u2019re there on the Hill.\u00a0<\/p>\n Raman:<\/strong> It\u2019s a work in progress. You know, I think there are a lot of different options kind of being floated around right now to try to avoid a government shutdown. So something our budget reporters reported yesterday is that House Republican leaders are trying to bring a clean CR to the floor next week, so the same spending levels that we have now through late November, early December. But that would include the ACA [Affordable Care Act] subsidy extension that the Democrats want.\u00a0<\/p>\n There\u2019s also, in the works right now, they\u2019re voting as we speak, kind of, in the House on advancing three of the spending bills, but not HHS [the Department of Health and Human Services] and maybe attaching a clean CR for the rest to that. And whether or not that could eventually include something else that the Democrats want is unclear. Or it\u2019s still in play where just now Democrats were speaking about how they want a very bipartisan \u2014 they won\u2019t come to the table unless they\u2019re getting their voice at the table. So it\u2019s unclear if any of these three options are going to happen, just because so much is in flux right now and we\u2019re still a couple weeks out from their deadline. And you know how Congress can be about this.\u00a0<\/p>\n Rovner:<\/strong> Yes, three whole weeks \u2014 why should they do anything? Let\u2019s talk about those ACA subsidies for a minute. We talked about them last week. Republicans are finally realizing that if they don\u2019t extend the Biden-era tax credits that it\u2019s going to be a lot of their voters who are going to see these sort of eye-popping premium increases. And the Democrats would like to sort of do a deal, but so far I\u2019ve seen Republicans saying, Nope, not going to happen.<\/em> At least not as part of this, keep-the-government-open continuing resolutions. That where they still are?\u00a0<\/p>\n Raman:<\/strong> I think it depends on who you talk to. When you talk to some of the more hard-line Republicans, they just don\u2019t want this continued. It\u2019s something that you have to offset with a lot of money, and so they\u2019re not on board at all. There are some of the more moderate Republicans in the House that have signed onto a bill last week that would extend it for a little bit, and so others have been a little bit more wishy-washy. But where they fall, I think that complicates things. We also have a new breakdown in the House right now where the Republicans only have a two-person majority, so it just makes it even more narrow for them to get something across if not everyone is aligned on this.\u00a0<\/p>\n Rovner:<\/strong> And of course, because this is the Affordable Care Act we\u2019re talking about, we\u2019re going to have an abortion fight with this too, right?\u00a0<\/p>\n Raman:<\/strong> You know I was just saying earlier that everything old is new again, that anytime that we get into this, we get into the debate of whether or not we include some sort of Hyde Amendment kind of language to say no federal funding for abortion except in rare circumstances. And so the anti-abortion groups have signed on and said, You should not support any sort of ACA subsidy extension that doesn\u2019t have that language.<\/em> Some of the Democrats have already come out saying that that\u2019s a no-go. In the past, generally when we\u2019ve had funding for health care, either if it\u2019s in the approps cycle or something separate, there has been that language, so I\u2019m not sure where that will land if they get to an extension. Just 15 minutes or so ago, House and Senate Democrats had said they really want to get to a bipartisan deal, but they didn\u2019t kind of draw a line in the sand that if the ACA subsidies weren\u2019t in whatever spending deal we get in the next few weeks that that would be a deal-breaker. So it\u2019s complicated in terms of where the cards may land in the next few weeks.\u00a0<\/p>\n Rovner:<\/strong> Long way to go.\u00a0<\/p>\n Raman:<\/strong> Yeah.\u00a0<\/p>\n Rovner:<\/strong> Well, meanwhile, the House Appropriation Committee this week approved its version of the bill that would fund the Department of Health and Human Services along with the Departments of Labor and Education. The House committee bill cuts HHS funding, but by far less than the Trump administration had asked, but still by a lot more than the more bipartisan bill approved by the Senate Appropriations Committee just before they left for the August recess. What is the outlook for HHS funding going forward?\u00a0<\/p>\n Raman:<\/strong> I don\u2019t think that we\u2019ll see, whenever we get to some sort of deal, something super close to what we had advanced by House appropriators today, but I also don\u2019t think that we\u2019re going to see something identical to what the Senate did before recess. My guess would be a little bit more aligned with what the Senate did. They\u2019re both run by Republicans, but that one did get, in the Senate, bipartisan support, and since they do need Democrats to pass it in the Senate, I could see it being a little bit more aligned there.\u00a0<\/p>\n The Senate one had slightly higher spending and didn\u2019t have as many of the new riders as in the House related to abortion and trans health and things like that. But we are in kind of a weird circumstance in that, earlier this year, instead of doing new funding, they renewed funding at the same level as last year for another year. So that\u2019s also a possibility, which is not something that happens super often, in the past, and I don\u2019t really see we\u2019re getting a lot happening in either chamber until we get kind of a deal, just because they don\u2019t have an agreement on any of the other funding really, either.\u00a0<\/p>\n Rovner:<\/strong> One of the things that we do see particularly appropriators complaining about with, and we\u2019ve talked about this, is this whole pocket rescission thing, the idea that they\u2019ve appropriated this money, they\u2019ve gotten a deal to pass this spending, Congress is supposed to be in charge of spending, and the administration isn\u2019t spending money that\u2019s been appropriated. Is there some possibility of putting in some kind of You must spend this money<\/em> guarantee, or at least an effort to make a guarantee, in one of these bills? Or are they just sort of tiptoeing around this?\u00a0<\/p>\n Raman:<\/strong> They\u2019ve kind of tiptoed around that. I mean, they\u2019re supposed to spend money. If they don\u2019t, they can have the impoundment issues that they\u2019ve had this year where they aren\u2019t spending the money and get told that you\u2019re violating the Impoundment Act, but that hasn\u2019t seemed to stop some of these cases. I think there\u2019s also a lot of things happening in this that haven\u2019t happened before. We\u2019ve had Russell Vought just kind of say that appropriations should be less of a bipartisan process than it has been. So I\u2019m not sure if even adding that kind of language would necessarily mean that that wouldn\u2019t happen or there wouldn\u2019t be different ways around that.\u00a0<\/p>\n Rovner:<\/strong> And of course, Russell Vought, the head of OMB [the Office of Management and Budget], is just itching to take this to the Supreme Court so that they can say that the Impoundment Act is illegal and that the administration can decide whether or not it wants to spend money that Congress has appropriated, which is obviously something that we will get to at some point with the Supreme Court, but I think we\u2019re not quite there yet.\u00a0<\/p>\n Well, moving on, the fallout continues from efforts at the Department of Health and Human Services to translate Secretary Robert F. Kennedy Jr.\u2019s anti-vaccine views into policy. We now know that the ousted director of the Centers for Disease Control and Prevention, Susan Monarez, is scheduled to testify before the Senate HELP [Health, Education, Labor, and Pensions] Committee next week. That\u2019s the committee chaired by Sen. Bill Cassidy, the Republican doctor who cast the deciding vote to confirm Kennedy back in the winter. The meeting of the CDC\u2019s advisory committee on vaccines is also scheduled for next week. Do we know if that\u2019s going to happen? I know several officials, including Cassidy, have called on it to be postponed. Anna, are you planning for it to take place?\u00a0<\/p>\n Edney:<\/strong> I think, so far, planning for it to take place, but maybe not so sure what they\u2019re going to discuss and whether the covid vaccines will be something that they\u2019ll vote on, at least, because that\u2019s what a lot of people are waiting on. That\u2019s what has caused a lot of confusion is that the FDA [Food and Drug Administration] gave its limited approval to some of these, and then we haven\u2019t heard ACIP\u2019s [the Advisory Committee on Immunization Practices\u2019] vote on that, or it hasn\u2019t been held. And so insurers are finding ways not to cover those vaccines for some people, and people are confused whether they can get them. Pharmacies in some states need prescriptions to be able to give them out. So there\u2019s just a lot of confusion around and people \u2014 the middle of September is already late, and so people were hoping, at least people who are interested and, once the confusion cleared up, were hoping that this will come up. But no indication for sure yet.\u00a0<\/p>\n Rovner:<\/strong> One of Kennedy\u2019s most stubborn pushbacks at last week\u2019s hearing at the Senate Finance Committee was that he has not prevented people from getting the covid vaccine. Except in the ensuing days we\u2019ve seen story after story about people who should be eligible for covid boosters but still haven\u2019t been able to get them or, and as you said, haven\u2019t been able to get them covered by insurance, even in some states where governors have tried to intervene to make them more available. I had a note from a friend in Oregon whose 80-plus-year-old husband couldn\u2019t get the vaccine. I mean, obviously over 65 and couldn\u2019t get a prescription from his doctor to get the vaccine because \u2014 and, of course, one of those states that doesn\u2019t have MinuteClinics where you can go and get a nurse practitioner to give you the vaccine. I mean, what are you guys hearing about people\u2019s ability to actually get this vaccine? We\u2019ve now been sort of conditioned to: OK. it\u2019s September. Kids are back to school. We should go and get our flu shots and our covid boosters.<\/em>\u00a0<\/p>\n Edney:<\/strong> Yeah, I think that Secretary Kennedy had said everyone can get it, and maybe there\u2019s a tiny kernel of truth in there in the sense that if you knew all the work-arounds you could do it. Maybe you could find a way to get someone to put the shot in your arm. Who would pay for it, though? I mean, we\u2019ve heard of people postponing because they\u2019re hoping that insurance will cover it. They\u2019d rather not pay $200. So essentially this is causing a lot of people to gamble with their health because they\u2019re hoping in the next few weeks they don\u2019t get covid while they\u2019re waiting on insurance to possibly cover it and on direction.\u00a0<\/p>\n So it\u2019s not true that just anyone can get it if they want to, I don\u2019t think, or those aren\u2019t the stories that I\u2019m reading, that I\u2019m seeing, or even hearing. There was a colleague, actually, she had an interesting story. Her husband had, instead of signing up on the website for a pharmacy, because you have to answer the questions if you have any preexisting conditions, a lot of people don\u2019t if they\u2019re under 65. He just walked in and he said: Well, the pharmacist didn\u2019t ask me anything there. They just gave it to me.<\/em> So, I mean, people are finding ways, but it doesn\u2019t mean that everyone can do it or pay for it.\u00a0<\/p>\n Rovner:<\/strong> I feel like Kennedy has sort of conflated the I didn\u2019t ban it<\/em> with the Everybody can get it.<\/em> Those are two very different things. Lauren, yes.\u00a0<\/p>\n Weber:<\/strong> I mean, Kennedy also has previously said that the covid vaccine is the deadliest vaccine ever made and then claimed that [President Donald] Trump should get the Nobel Peace Prize for Operation Warp Speed. So there is a lot of dissonance between the secretary\u2019s statements and sometimes with the reality.\u00a0<\/p>\n Rovner:<\/strong> And I will note, actually going back to our budget discussion, that there was a bipartisan amendment at the House Appropriations Committee to restore the money for mRNA vaccine research that Kennedy cut. Who knows whether we\u2019ll ever see that into law, but I was interested to see that Republicans joined with Democrats to sort of push back at that.\u00a0<\/p>\n Edney:<\/strong> Yeah, I think mRNA has a lot of applications beyond vaccines that even hard-line anti-vaxxers could see. Is curing cancer a good idea, or treating it? I mean, it has a lot of other things that mRNA really is meant for.\u00a0<\/p>\n Rovner:<\/strong> Yeah, and also the speed with which, I mean, that was what made Operation Warp Speed work was the speed with which you can actually make vaccines using the mRNA technology. Well, now, apparently, at least according to The Wall Street Journal<\/a>, HHS is planning to link Tylenol taken in pregnancy to the rise of autism. Just the story appearing on the website tanked the stock of the drugmaker that makes Tylenol last week and has prompted quite the pushback from doctors and researchers as well as drugmakers. What do we know about the links between Tylenol, acetaminophen, and autism?\u00a0<\/p>\n Edney:<\/strong> I think what we know is that there are mixed results in studies out there, that no one has definitively linked it. No one has definitively, either way. I think there\u2019s sort of confusion. But the big study that they\u2019re using out of Harvard to kind of say that Tylenol use during pregnancy causes autism, even the study\u2019s authors say: That\u2019s not what we were saying. We were saying that there is an association, but that doesn\u2019t mean causation.<\/em> I think that\u2019s something we always come back to when we\u2019re talking about studies. And in this sense, I think it\u2019s unfortunate that the discussion is happening without more definitive answers.\u00a0<\/p>\n Because when you\u2019re talking about pregnancy, and if acetaminophen is the only thing a pregnant woman can take when she has a very high fever, then high fever can cause a lot of problems as well, and you\u2019re scaring women off from, even, it can cause birth defects if the fever is high enough. The March of Dimes actually says there is concern that a high fever during pregnancy in the first trimester is linked to autism. So you just have this circle that nobody actually has any answers, and unfortunately I don\u2019t anticipate that the autism report is going to provide them. It might provide more fear for pregnant women.\u00a0<\/p>\n Rovner:<\/strong> Lauren, you want to add something\u00a0<\/p>\n Weber:<\/strong> Yeah, I mean, Robert F. Kennedy Jr. has promised to have the cause of autism by September, which, many medical experts and autism researchers have cautioned, seems like that may not be a complete report, as this is something that has been examined for many years and it seems to be multifaceted. But I think it\u2019s worth noting that in the lead-up to this report being due, we at The Washington Post, in looking at MAHA influencers, noticed that Tylenol has been 15 times more likely to be mentioned by these influencers in August as opposed to April. So there seems to be a lot of MAHA contingent around the Tylenol hypothesis that also potentially could be driving some of this, but we\u2019ll see what happens when we see more of the report.\u00a0<\/p>\n Rovner:<\/strong> So where exactly is President Trump on this whole vaccine issue? On the one hand, he\u2019s been pro-vaccine in some of the comments that he\u2019s made since Kennedy\u2019s confrontational appearance last week at the Finance Committee. But he also posted on, he the president, also posted on his social media a video pushing the long-since discredited accusation that autism is linked to the vaccine preserved with thimerosal, which hasn\u2019t even been in most childhood vaccines for the last two decades. I feel like the president\u2019s kind of walking this fine line waiting to see which way public opinion falls.\u00a0<\/p>\n Weber:<\/strong> I think that\u2019s right, Julie. I think also we have to go back. The president has a history of making vaccine-skeptical comments. I mean, in presidential debates he\u2019s asked questions about vaccines being too big for a horse for children. I mean, he\u2019s said, certainly, things that are of vaccine-skeptical rhetoric. That said, I think he and others have seen polling recently that shows that vaccines are overwhelmingly popular. The vast majority of Americans do vaccinate their children, and while he is conscious that Kennedy and the MAHA movement brought him voters, I think he\u2019s maybe being counseled by others that he could lose voters if he goes too far. So if anything, the man has a shrewd assessment of what\u2019s going to win him political points. So it seems to me that it\u2019s a messaging to both sides of the fence and it\u2019s kind of a You pick the message you want to hear so you can stay in the tent<\/em> kind of vibe is how I am interpreting it.\u00a0<\/p>\n Rovner:<\/strong> Yeah, that\u2019s my impression, too. And as we know, he\u2019s very good at being on all sides of an issue until he actually has to come down one way or the other. Well, there was a lot more from the Department of Health and Human Services this week than just vaccine news. Secretary Kennedy issued the second part of his long-awaited Make America Healthy Again strategy to improve children\u2019s health. It didn\u2019t mention some of the biggest threats that we know about for children\u2019s health, like gun violence, climate change, or tobacco. It did mention things Kennedy has talked about a lot, like exposure to chemicals and ultraprocessed food, but it didn\u2019t really lay out concrete plans for how the administration plans to address those concerns. So what does this report say? And do we think it got watered down by the White House? Do we think it might\u2019ve been stronger at some point?\u00a0<\/p>\n Edney:<\/strong> I think with what I saw with the report when I read the report is sort of a list of a lot of the things that Kennedy would like to focus on that he sees as the biggest threats to children. Although it got watered down, I think, for sure throughout this process and certainly potentially as the White House held it for about a month or so from coming out. But a lot of people have made the point that Kennedy had to work with the heads of the EPA [Environmental Protection Agency] and the Agriculture Department on this, who are in many ways more aligned with the chemical companies and the big farmers than Kennedy himself might be or had wanted to be in this.\u00a0<\/p>\n So you kind of lost any ability to maybe go after chemicals in the food supply or things like that. And so there weren\u2019t a lot of concrete things that it would do or ways forward, which I would expect in a large administration report like this is kind of more of the next steps, not just the list of what\u2019s going on. And I imagine we\u2019ll talk about it, but there was one piece in that with drug ads that it kind of simultaneously came out with the report.\u00a0<\/p>\n Rovner:<\/strong> Yes, we\u2019ll get to that next.\u00a0<\/p>\n Edney:<\/strong> Yeah, so I assume we\u2019ll talk about that. So maybe they have some plans on some things that we just don\u2019t know about yet. But I think that that has, for me, been a struggle in covering and watching this administration is there\u2019s been a lot of talk and it\u2019s hard to know what the rhetoric is versus what is actually being done. And I kind of see that continuing, and even with drug ads, when we talk about that and get there.\u00a0<\/p>\n Rovner:<\/strong> Yeah. Lauren, you\u2019ve obviously been following the MAHA movement pretty closely. What was your take from this report?\u00a0<\/p>\n Weber:<\/strong> Well, my takeaway from this report is I was fascinated there were no footnotes, so there could be no AI conversation like the last time we talked about this on the podcast. But no, my other takeaway was, clearly, as Anna pointed out, it seems like industry influence had watered down some of the big pushes of the MAHA movement around pesticides. And I also, my biggest takeaway is: Who\u2019s paying for all of this? I mean, they promised healthy, nutritious foods in schools, VAs [Department of Veterans Affairs facilities], hospitals. These are things that nutritionists have wanted for a very long time. There was talk of MAHA boxes. Where\u2019s the funding? I mean, as far as I understand, all the funding\u2019s getting cut everywhere I turn around. So I\u2019m curious where the funding for this transformation of America\u2019s health care is coming from. And I also think it\u2019s worth noting that in there there was a conversation around some pet projects among folks that are involved in the Trump administration. I\u2019m very curious. Right now it was basically a bullet points with no action plan. So as Anna smartly pointed out: When will the rhetoric become reality? We shall see.\u00a0<\/p>\n Raman:<\/strong> I was just going to agree with Lauren. That was kind of exactly my takeaway is that if you\u2019re calling for more research and this and this and then the White House at the same time, when they put out their budget proposal, they called for a 40% decrease in NIH [National Institutes of Health] funding. It just seems counterintuitive. And even thus far in the appropriations process, the Senate didn\u2019t even have money for MAHA in theirs. The House did. But we don\u2019t know if that happens. And so I am very curious how they would get to do some of these things that they\u2019re exploring, because it really did seem more like an executive order in the formatting, is like: This is early on. Explore this issue.<\/em> Rather than Here are concrete things we need you to do.<\/em>\u00a0<\/p>\n Rovner:<\/strong> And I would just, to underscore something that Lauren said, a lot of talk about how to improve nutrition for kids and things about the SNAP [Supplemental Nutrition Assistance Program] food stamp program, then at the same time that the \u201cBig Beautiful Bill\u201d cut food stamps. So there is sort of right hand not recognizing what the left hand is doing. Well, Anna, as you mentioned, on the same day, the administration issued its not-so-earth-shaking MAHA report, the president signed an order that could end those annoying direct-to-consumer TV ads for pharmaceuticals, at least as we know them.\u00a0<\/p>\n This is the moment where I get to repeat the fact that the U.S. and New Zealand are the only developed countries that allow drugmakers to advertise their products on TV. The executive order purports to return to the status quo before 1997, when drug companies basically couldn\u2019t advertise on TV, because they were required to talk at so much length about possible side effects and contraindications. Now, I think both Republicans and Democrats in the past 28 years would\u2019ve loved to have taken this same action. Drug ads aren\u2019t exactly popular with the public. But there\u2019s a First Amendment issue here, right? Something about commercial speech?\u00a0<\/p>\n Edney:<\/strong> Yes. Yeah, certainly. It seems like long ago the train left the station on banning these pharmaceutical ads completely, because the free-speech protection seems to have encompassed this and it feels like no getting rid of them. There\u2019s been no successful effort. So what the Trump administration has said that they\u2019re going to do is change that regulation that allowed them, the drugmakers, to water down their statement in those ads on all of the awful side effects that can happen to you by taking drugs. And so right now in a drug ad, they can just say, Talk to your doctor and visit this website to see what the side effects are.<\/em>\u00a0<\/p>\n And so they want to roll that back and so be able to take it back to having to list all of them, which if you\u2019ve looked at a drug pamphlet, a prescription drug pamphlet, I mean, that could take several minutes to get through, and so effectively possibly killing a lot of these advertisements. I think this is still a situation that where the devil\u2019s in the details. We haven\u2019t seen the regulation. And I feel like this happens pretty often where they say they\u2019re going to roll back a huge thing and then it becomes a little bit different than that when the actual regulation is out. But you never know. I mean, I would love \u2014 I\u2019m not a fan of drug ads, either, so it\u2019s not like I need to listen to them on the\u2014\u00a0<\/p>\n Rovner:<\/strong> Yeah, could they at least get rid of the jingles?\u00a0<\/p>\n Edney:<\/strong> Right. So you don\u2019t say them all day in your head.\u00a0<\/p>\n Rovner:<\/strong> Yes.\u00a0<\/p>\n Edney:<\/strong> But yeah. And then they said that, the FDA commissioner said, they were going to be sending out warning letters to potentially thousands of companies, and Just to let you know, we\u2019re going to be cracking down on this,<\/em> because that\u2019s not something the FDA has done a lot in recent years, making sure that they\u2019re complying with regulations in their advertisements. But they made it into more of a \u2014 a warning letter\u2019s a very strong thing that the FDA can do. What this is is more of a form letter saying, Just to let you know we\u2019re going to, not that you specifically violated it, but we\u2019re going to start cracking down on this.<\/em> So I\u2019ll be curious to see where this lands. They also want to go after more of the social media influencers because they don\u2019t fall under these regulations, so bring them more in line with the idea that they need to talk about the side effects and not just how much weight they quickly lost or something along those lines.\u00a0<\/p>\n Rovner:<\/strong> But certainly we would expect the drug companies, if not TV networks, to sue to protect the right to run these ads, in cases of the networks to get paid to run these ads.\u00a0<\/p>\n Edney:<\/strong> Definitely. I think that there\u2019ll be some litigation over this, and that first requires the regulation to be made, and so that also takes some time. So this could be a kind of a long haul.\u00a0<\/p>\n Rovner:<\/strong> Yeah, it was actual big news. Well, last week we caught up with some but not all of the reproductive health news that happened over our break. One thing I didn\u2019t want to leave out is that lawsuit that the Supreme Court threw out earlier this summer, challenging the FDA\u2019s approval 25 years ago of the abortion pill, mifepristone. It is not dead yet. While the justices said the anti-abortion doctor group that sued originally did not have standing to sue, since then three states \u2014 Missouri, Kansas, and Idaho \u2014 have replaced the group as plaintiffs, and now Texas and Florida are asking to join the suit as well. Sandhya, the original suit sought to wipe away the FDA\u2019s original approval. That\u2019s now off the table. But the states do want the courts to effectively end the mailing of the pills and return to the FDA\u2019s tighter rules that were enforced before the pandemic, right? Just that could have a major impact.\u00a0<\/p>\n Raman:<\/strong> It really could, just, if you look at in the last few years, how much of it, abortion, is medication abortion, how much of that has been telehealth after covid, and if you look at what\u2019s happening in some of the states right now. Texas has cracked down on it. But then there\u2019s [Texas] Attorney General [Ken] Paxton last year had sued a doctor in New York for allegedly mailing medication abortion to Texas. And then just this week, the attorney general of New York, Letitia James, has intervened in that lawsuit. So it\u2019s going to be a battle between two of probably the most front-and-center attorney generals, especially in these kinds of issues. So I think with those odds, it\u2019s something that I would definitely watch to see does this go back to the Supreme Court at some point. Even if it\u2019s not this case, this issue is rising up again.\u00a0<\/p>\n Rovner:<\/strong> Yeah, that\u2019s right. That\u2019s what I was going to say. I mean, at some point the Supreme Court is going to have to adjudicate this question about these blue-state shield laws. Not only has Texas gone after this doctor in New York, Louisiana, I believe, has indicted this doctor in New York, has tried to charge her criminally, which Attorney General James in New York is also trying to prevent. So I mean, we\u2019re going to see this come to the Supreme Court at some point, right?\u00a0<\/p>\n Raman:<\/strong> I do think so. Just because of how front and center this within the whole movement has kind of become, and especially I think even if we look past, in the past few weeks, how much more mifepristone has come up is something that Republicans want HHS to look into. RFK Jr. has brought it up. There could even be changes on that level that spur a lawsuit, or I think that there\u2019s a lot going on, and so even if it\u2019s not this specifically, something else will nudge it that we see that elevate.\u00a0<\/p>\n Rovner:<\/strong> Well, meanwhile, anti-abortion groups, or should I say anti-in-vitro-fertilization groups, are now promoting something called \u201crestorative reproductive medicine\u201d as an alternative to IVF. According to Caroline Kitchener writing in The New York Times<\/a>, quote, \u201cthe concept addresses what proponents describe as the \u2018root causes\u2019 of infertility, while leaving I.V.F. as a last resort,\u201d close quote. Groups that support IVF are not amused. The American Society of Reproductive Medicine, which represents doctors that treat infertility, calls \u201crestorative reproductive medicine\u201d and \u201cethical IVF,\u201d quote, \u201cmisleading terms that threaten access.\u201d Sandhya, is this yet another effort to ban reproductive technologies that have pretty broad political support by basically rebranding bans?\u00a0<\/p>\n Raman:<\/strong> You know this one is interesting because it also, to me, has a tinge of kind of what we see in MAHA in that it\u2019s kind of pointing to We\u2019re doing this whole-person thing<\/em> to elevate health care<\/em> in the same way that they\u2019ve said: It\u2019s not that you\u2019re having these issues because of something you need medicine for. It\u2019s the food. It\u2019s the chemicals and that kind of stuff.<\/em> So I\u2019m curious, A, if this gets kind of elevated more just because there\u2019s similar thinking in both of those, but also just kind of how the messaging plays out. When we\u2019ve had some of these IVF battles, we\u2019ve had people walking kind of a fine line because maybe they\u2019ve used it themselves or someone in their lives had but that they know that some of the people in their base do have some issues related to if all the embryos get used and things like that. So elevating this does seem like something that would be politically easier for certain people to message on, but I\u2019m not sure.\u00a0<\/p>\n Rovner:<\/strong> Lauren, you want to add something.\u00a0<\/p>\n Weber:<\/strong> Yeah, I mean, I think we talked about Trump toeing a political line earlier in this podcast, and I see this as a similar version of that. I mean, this is the president who vowed to expand access to IVF, but some of his hard-right conservative base has issues with it. They see it as potentially interfering with life itself. And so I think offering up this alternative health care strategy, which, to be clear, there could be good things in there \u2014 treating women with endometriosis, investing in the root causes of infertility. There\u2019s nothing inherently wrong with that. In fact, there\u2019s a fair amount of lack of information where it becomes questionable and where I\u2014\u00a0<\/p>\n Rovner:<\/strong> There\u2019s also, I said, there\u2019s nothing inherently controversial about any of that.\u00a0<\/p>\n Weber:<\/strong> No, I think there\u2019s a lot of people that would be very excited about that. I think where it hits a line that\u2019s confusing and that Caroline\u2019s story kind of gets into is, is it at the expense of \u2014 that\u2019s usually the entry point, which a lot of these health organizations have made clear. Those are all great things to do, but at some point there is potentially a need to hit the next step, and there is concern that this movement could replace the push for IVF. And so I think that tension point and how Trump and the administration is kind of toeing that line with both the MAHA group and the far right is really interesting.\u00a0<\/p>\n Rovner:<\/strong> Yeah, I mean, I would add that IVF is expensive, involved, unpleasant. It\u2019s not something that people turn to as a first choice anyway, so I was a little bit sort of taken. It\u2019s like, yes, I would think that people with infertility do explore most of their other options first. But yes, what\u2019s wrong with having more research to try and solve the problem before you actually have to resort to IVF? We will watch this one as well.\u00a0<\/p>\n All right, that is this week\u2019s news. Now it\u2019s time for our extra-credit segment. That\u2019s where we each recognize the story we read this week we think you should read, too. Don\u2019t worry if you miss it. We will put the links in our show notes on your phone or other mobile device. Anna, why don\u2019t you go first? You have your story, which I\u2019m really glad you\u2019re doing.\u00a0<\/p>\n Edney:<\/strong> Thank you. Yeah, I appreciate that. So mine was from last week: \u201cThe Implants Were Supposed to Dissolve. They didn\u2019t.<\/a>\u201d So I did an investigation into this device called BioZorb that\u2019s made by a company called Hologic. And they have a huge women\u2019s health division and a breast division that \u2014 so a lot of mammogram machines that they sell and things like that. But they were selling BioZorb. It was supposed to revolutionize breast cancer treatment because, at least the idea, this isn\u2019t what they had FDA approval for, but what it was talked about as is something that could help women when they were healing, that their breasts would grow back after a tumor was taken out. Their breasts would grow back more, heal more full-looking, not have dips and maybe other deformities that can happen with a lumpectomy. And instead, these women have experienced all kinds of awful infections, and some people actually had the device poking through their breasts because it was supposed to dissolve, but it was years where some people still had it.\u00a0<\/p>\n A woman I talked to, it shattered inside of her. So there were 24 pieces of plastic, sharp shards in her breast that were causing immense pain. A lot of people complained about pain, but the key to this is that Hologic and a company that invented the device and sold it early on, called Focal, were hiding these complaints. They were not handing them over to the FDA as they should have, and some for as long as 10 years. So nobody knew what was going on, but women were still being implanted with the devices. I think it\u2019s just a bigger story about oversight of devices and also how devices come to market, because this device was never studied in humans, in women, despite it being implanted inside of them. And that\u2019s actually really typical to how devices make their way through the FDA.\u00a0<\/p>\n Rovner:<\/strong> Really important investigation. Thank you. Sandhya.\u00a0<\/p>\n Raman:<\/strong> So my extra credit is called \u201cTexas\u2019 New Parental Consent Law Leaves School Nurses Confused About Which Services They Can Provide to Students<\/a>,\u201d and it\u2019s at The Texas Tribune, by Jaden Edison. And I picked this because I thought it was something really interesting that I\u2019d never really thought about before, but there\u2019s a new law in Texas that you have to get parental consent before the nurse or whoever at the school can do health services for students. And they\u2019re getting more confused about if they would also be penalized for handing out Band-Aids or ice packs or just first aid. And school districts are required by the law to discipline violations of the law, but how it\u2019s kind of being done across the state is a little varied, and some places have been saying they\u2019ll only even intervene if it\u2019s life-threatening. So I think it\u2019s interesting as part of the parental consent movement of when is this something that is debilitating and if someone doesn\u2019t have a form signed, how that\u2019s going to affect kids at school.\u00a0<\/p>\n Rovner:<\/strong> Yeah, a lot of good discussion about thinking things all the way through. Lauren.\u00a0<\/p>\n Weber:<\/strong> Mine is titled \u201c\u2018Just Let Me Die,\u2019<\/a>\u201d by ProPublica, written by Duaa Eldeib. And it is just a heartbreaking tale, one that ProPublica has been doing really well, where they examine the fact of prior authorization and what it means for patients. And it\u2019s about a gentleman who was trying to get approved for mental health stays after several suicide attempts. It\u2019s a gutting story. And the reviewer at the end of the appeal process, he was so appalled by what had happened that he called the wife of the man who had been trying to get these appeals. And it\u2019s an important read, especially as Congress is weighing things on prior authorization and as [Centers for Medicare & Medicaid Services Administrator Mehmet] Oz has vowed to expand prior authorization for some things. So a lot here to be unpacked. And ProPublica, again, big props for how they\u2019ve covered the prior auth issue in the last couple of years.\u00a0<\/p>\n Rovner:<\/strong> Yeah, it\u2019s been fodder for a lot of \u2014 really a lot of \u2014 good stories. All right. My extra credit this week is from NPR by Will Stone. It\u2019s called \u201cWhat Kind of Dairy Does a Body Good? Science Is Updating the Answer<\/a>,\u201d and it\u2019s a really clear story about how it turns out that full-fat dairy, at least in some cases, isn\u2019t nearly as bad for you as other high-fat animal products appear to be. It looks at this one case where science is working as it\u2019s supposed to, with researchers continually updating and refining what they know and recommend. Bottom line seems to be that full-fat cheese and yogurt \u2014 probably not bad for you, maybe even good for you. But butter? Still not great. It\u2019s too bad for me. I like butter. Also, what matters is what else is in your dairy products. It\u2019s one of those really well-done pieces that it\u2019s like: OK, this is what we know. This is what we\u2019re trying to find out. This is what\u2019s new.<\/em> This is the kind of consumer-helpful information we should have more of.\u00a0<\/p>\n OK. That is this week\u2019s show. Thanks as always to our editor, Emmarie Huetteman, and our producer-engineer, Francis Ying. If you enjoy the podcast, you can subscribe wherever you get your podcasts. We\u2019d appreciate it if you left us a review. That helps other people find us, too. Also, as always, you can email us your comments or questions. We\u2019re at whatthehealth@kff.org, or you can still find me on X, @jrovner<\/a>, or on Bluesky, @julierovner<\/a>. Where are you folks hanging these days? Sandhya.\u00a0<\/p>\n Raman:<\/strong> On X<\/a> and on Bluesky<\/a>, @SandhyaWrites.\u00a0<\/p>\n Rovner:<\/strong> Anna.\u00a0<\/p>\n Edney:<\/strong> Same<\/a> places<\/a>, @annaedney.\u00a0<\/p>\n Rovner:<\/strong> Lauren.\u00a0<\/p>\n Weber:<\/strong> Same<\/a> spots<\/a>, @LaurenWeberHP. The HP is for \u201chealth policy.\u201d\u00a0<\/p>\n Rovner:<\/strong> We will be back in your feed next week. Until then, be healthy.\u00a0<\/p>\n \tFrancis Ying \tEmmarie Huetteman To hear all our podcasts,\u00a0click here<\/a>.<\/em><\/p>\n And subscribe to KFF Health News\u2019 \u201cWhat the Health?\u201d on\u00a0Spotify<\/a>,\u00a0Apple Podcasts<\/a>,\u00a0Pocket Casts<\/a>, or wherever you listen to podcasts.<\/em><\/p>\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/p>\n
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