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Senior leaders across the Department of Health and Human Services were put on leave and countless other employees lost their jobs Tuesday as the Trump administration began a sweeping purge of the agencies that oversee government health programs. Top officials at the National Institutes of Health, the Centers for Disease Control and Prevention, and the Food and Drug Administration were put on administrative leave or offered reassignment to the Indian Health Service. Other employees began receiving layoff notices or learned they had lost their jobs when their entry badges no longer worked Tuesday morning. (Johnson, Roubein, Achenbach, Sun and Weber, 4/1)

Newly confirmed National Institutes of Health director Jay Bhattacharya told staff that they face challenges amid large-scale cutbacks and that he will try his best to "implement new policies humanely," according to an all-staff email sent [Monday] and shared with Axios by the agency. (Goldman, 4/1)

Marty Makary’s first official day as commissioner of the Food and Drug Administration began with employees in tears, learning from security guards that they were losing their jobs. The news release announcing the start of his tenure points readers to a press office that, after large-scale layoffs, basically no longer exists. His first email to staff summarized his resume. (Lawrence and Todd, 4/1)

Directors of five National Institutes of Health institutes and at least two other members of senior leadership have been placed on administrative leave or offered new assignments since Monday, topping a list of hundreds of employees notified in the last 24 hours that they had lost their jobs as part of sweeping layoffs across federal health agencies. (Molteni, Wosen and Mast, 4/1)

The Food and Drug Administration’s chief tobacco regulator was removed from his post Tuesday, part of sweeping cuts to the federal health workforce that have cleared out many of the nation’s top experts overseeing food, drugs, vaccines and products containing nicotine. The agency’s tobacco director, Brian King, notified his staff in an email: “It is with a heavy heart and profound disappointment that I share I have been placed on administrative leave.” (Perrone, 4/1)

As part of the sweeping layoffs that rocked the Department of Health and Human Services on Tuesday, the entire staff that oversaw an annual survey to better understand infant and maternal health — and that was considered the gold standard in the field — was placed on administrative leave. (Oza, 4/1)

The layoffs at the Department of Health and Human Services slashed the staffs of major federal aging, disability and anti-poverty programs, leaving the future of those programs uncertain. At least 40% of staff got layoff notices and many were turned away at the front door Tuesday when they showed up for work at the Administration for Community Living, or ACL, which coordinates federal policy on aging and disability. (Shapiro, 4/1)

The Department of Health and Human Services made major cuts to teams across its agencies that handle communications, media relations, and Freedom of Information Act requests as part of mass layoffs Tuesday, a move that workers say will impair the department’s ability to relay critical health information to the public and run counter to secretary Robert F. Kennedy Jr.’s vow to promote “radical transparency.” (Chen, Lawrence and Cueto, 4/1)

Thousands of federal workers are newly reeligible for a Trump administration offer paying them to quit as agencies prepare to shed up to half of their staffs, documents reviewed by The Washington Post show. The deal, extended across at least five agencies in recent days, resurrects an option to resign now and be paid through September that President Donald Trump and his adviser, billionaire Elon Musk, extended early in their push to shrink the workforce. About 75,000 employees took the deal in its first round, officials said then, as unions mounted legal challenges panning the program as arbitrary and coercive. (Davies, Natanson and Rein, 4/2)

Amid the layoff notices sent to stunned employees of the Department of Health and Human Services Tuesday was yet another surprise: some of them, including top National Institutes of Health officials, were offered the chance to transfer to the Indian Health Service. (McFarling, 4/1)

Some government health employees who were laid off Tuesday were told to contact Anita Pinder with discrimination complaints. But Pinder, who was the director at the Office of Equal Opportunity and Civil Rights at the Centers for Medicare and Medicaid Services, died last year. The inclusion of Pinder’s name in reduction-in-force notices reflects the chaos of the Trump administration’s ongoing efforts to shed federal workers and was a gut punch to employees who knew her, said Karen Shields, who worked with Pinder. (Weber, 4/1)

Elon Musk and his Department of Government Efficiency (DOGE) team created the new org chart for HHS, said Robert F. Kennedy Jr. during an interview on News Nation. The HHS secretary said when he arrived at the department, the org chart was "incomprehensible," and Musk "came in for the first time with a real org chart for the agency." Kennedy's statements were confirmed during a Fox News interview with Musk and the DOGE team. DOGE member Anthony Armstrong -- a former Morgan Stanley banker who is now a senior advisor to the Office of Personnel Management -- outlined the team's approach to agency reorganizations. "We literally go in -- and this is mostly at night and over weekends -- with the secretaries of those agencies, and their senior staff, and we're going line by line in the employee org charts ... from the bottom up, talking about every function," Armstrong said. (Fiore, 4/1)

Drugmakers made a calculated risk during HHS Secretary Robert F. Kennedy Jr.’s confirmation process in choosing not to publicly criticize a nominee who called their products dangerous. They’re starting to reconsider. After the firing of thousands of Department of Health and Human Services employees on Tuesday, industry trade groups that have mostly sought to curry favor with the new administration began to express alarm. “While we support improving FDA efficiency to deliver more affordable generic and biosimilar medicines to patients faster, many of the reported cuts appear to do the opposite,” said John Murphy, CEO of the Association for Accessible Medicines, which represents generic drugmakers. (Lim, 4/1)

A coalition of states sued the Trump administration on Tuesday over its decision to cut $11 billion in federal funds that go toward COVID-19 initiatives and various public health projects across the country. Attorneys general and other officials from 23 states sued in federal court in Rhode Island. They include New York Attorney General Letitia James and Colorado Attorney General Phil Weiser, as well as Kentucky Gov. Andy Beshear, Pennsylvania Gov. Josh Shapiro and the District of Columbia. The lawsuit argues the cuts are illegal, and that the federal government did not provide “rational basis” or facts to support the cuts. (Bose and Whitehurst, 4/1)

Chris Disher, the co-owner of a rural internet provider in Louisiana, is ready to start digging to get fast and reliable internet to some of the estimated 450,000 households and small businesses in the state that don’t have it. His company, Cajun Broadband, was awarded $33 million in January under a Biden administration plan to do just that. But the money isn’t flowing while the Trump administration revamps the program and opens it up more to satellite internet, including Elon Musk’s Starlink. Now Disher is worried that a long-promised push for rural access will be upended, leaving Louisianans desperate for internet waiting. (Mark, 4/1)

Illinois activists, community members and elected officials are calling on U.S. Immigration and Customs Enforcement (ICE) to release a detainee who was preparing to make an organ donation to save his brother’s life. A vigil was held Monday evening for José Gregorio, a 43-year-old from Venezuela, who has been held in an immigration detention center for nearly a month. Gregorio was preparing to donate a kidney to his brother, José Alfredo Pacheco, 37, who has end-stage renal disease. Pacheco said his brother is his lifeline to surviving and the only family member he has here to help him. (Spinelli and Ong, 4/1)

A coalition of advocacy groups including a leading addiction medicine society and a center-right think tank is pressing the Trump administration with an unlikely request: Use the U.S. DOGE Service to make methadone more widely available. (Facher, 4/2)

A House Democrat is introducing long-shot legislation that would force billionaire Trump lieutenant Elon Musk and his staffers at DOGE to undergo routine drug testing, Axios has learned. Rep. Mikie Sherrill (D-N.J.) cited a Wall Street Journal report from 2024 that alleged Musk has used illegal drugs including LSD, cocaine, ecstasy, mushrooms and ketamine as the impetus for her bill. (Solender, 4/1)

President Donald Trump’s trade tariffs on Canadian pharmaceuticals are expected to increase costs in the United States and strain drug supply chains, according to an analysis published yesterday in JAMA. [On April 2], pharmaceuticals will no longer be exempt from the Trump administration's 25% tariff on goods produced in Canada. (Soucheray, 4/1)

In what would be a rebuke to President Donald Trump, a Senate resolution to end the emergency declaration enabling tariffs against Canada is likely to have enough Republican votes to pass the chamber, according to Sen. Rand Paul, R-Kentucky. Paul is co-sponsoring the resolution with Sen. Tim Kaine, D-Virginia, who wants to force GOP lawmakers to go on the record on the policy. Trump implemented the emergency declaration in February to put tariffs on Canada for not going far enough to stop fentanyl from crossing into the United States. (Bacon, Beggin, Chambers, Jansen and Ortiz, 4/1)

On Wednesday at 4 p.m., Mr. Trump is expected to announce what he calls sweeping “reciprocal tariffs,” which could match the levies that other countries impose on U.S. products. The president has taken to calling this “liberation day,” arguing that it will end years of other countries “ripping us off.” (Swanson, Kaye, Gamio, Russell and Kim, 4/1)

Canadian Prime Minister Mark Carney told President Donald Trump Friday that his nation will retaliate against the United States with tariffs of its own if Trump presses forward with his promised levies – potentially escalating what is already developing into an ugly and damaging trade war. Trump responded that he’s open to deals – but potentially after his tariffs go into effect. The leaders of the bordering nations spoke Friday before the White House’s expected tariffs go into place April 2 – a day Trump has been calling America’s “Liberation Day.” (Saltman, Klein and Goldman, 3/29)

During an interview on the Somebody’s Gotta Win With Tara Palmeri podcast, billionaire entrepreneur Mark Cuban warned that the drug company he cofounded, Cost Plus Drugs, would be forced to raise its prices in response to a tariff on goods imported from India. “We won’t have a choice,” Cuban said. (Freedman, 4/1)

Tuesday's house hearing on medical device cybersecurity included discussions on how hospitals and other providers can keep up with cyber threats as well as what the effect of Tuesday's massive layoffs at FDA and other HHS divisions will mean for cybersecurity safeguards. There are a broad range of medical devices that may be vulnerable to cybersecurity breaches, said Rep. Gary Palmer (R-Ala.), chairman of the House Energy & Commerce Oversight and Investigations Subcommittee, at a subcommittee hearing on "Aging Technology, Emerging Threats: Examining Cybersecurity Vulnerabilities in Legacy Medical Devices." (Frieden, 4/1)

The U.S. House on Tuesday rebuked House Republican leadership, voting down a measure that would have blocked a bipartisan effort to make serving in Congress easier for new parents. (Panetta, 4/1)

Education Secretary Linda McMahon is having a meeting with House Democrats Wednesday over their concerns surrounding the layoffs at the Department of Education, which she and President Trump have been vocal about trying to eliminate entirely.  Rep. Mark Takano (Calif.) and at least ten other Democratic members will meet with McMahon at 9:30 a.m. local time, according to information obtained by NewsNation, after the number of Education Department employees was cut in half from over 4,000 to a little more than 2,000.  (Cochran, 4/2)

Senator Cory Booker, his voice still booming after more than a day spent on the Senate floor railing against the Trump administration, on Tuesday night surpassed Strom Thurmond for the longest Senate speech on record, in an act of astonishing stamina that he framed as a call to action. “My voice is inadequate,” Mr. Booker said more than 19 hours into the speech. “My efforts today are inadequate to stop what they’re trying to do. But we the people are powerful.” (Balk, Ives and Bigg, 4/1)

A liberal candidate for a pivotal seat on the Wisconsin Supreme Court overcame $25 million in spending from Elon Musk and defeated her conservative opponent on Tuesday, The Associated Press reported, in a contest that became a kind of referendum on Mr. Musk and his slashing of the federal government. The victory for Judge Susan Crawford, 60, who won a 10-year term, maintains a 4-to-3 majority for liberals on the court, which in coming months is poised to deliver key decisions on abortion and labor rights. (Epstein, 4/2)

Wyoming no longer has a clinic offering procedural abortions. Now, patients are traveling hundreds more miles to neighboring states for care. The women’s health clinic in Casper, Wellspring Health Access, has served patients from across Wyoming, South Dakota, Idaho and 16 other states. A new state law, pushed by abortion opponents, placed strict requirements on the clinic, including getting its physicians admitting privileges at nearby hospitals and making extensive renovations. (Merzbach, 4/1)

The Supreme Court is set to hear arguments Wednesday over South Carolina’s effort to keep Planned Parenthood facilities from receiving Medicaid funding if they perform abortions, part of a dispute that could impact Congress’ ability to mandate coverage in the program. (Macagnone, 4/1)

The federal government has paused $27.5 million for organizations that provide family planning, contraception, cancer screenings and sexually transmitted infection services as it investigates whether they’re complying with the law. The National Family Planning and Reproductive Health Association says 16 organizations received notice Monday that funding is on hold. At least 11 Planned Parenthood Federation of America regional affiliates and all recipients of federal family planning, or Title X, grants in seven states, had funding withheld. (Mulvihill, 4/1)

The United States is ending its financial support for family planning programs in developing countries, cutting nearly 50 million women off from access to contraception. This policy change has attracted little attention amid the wholesale dismantling of American foreign aid, but it stands to have enormous implications, including more maternal deaths and an overall increase in poverty. It derails an effort that had brought long-acting contraceptives to women in some of the poorest and most isolated parts of the world in recent years. (Nolen, 4/1)

Attorney General Pam Bondi on Tuesday said she had ordered federal prosecutors to seek the death penalty against Luigi Mangione, who is charged with murdering UnitedHealthcare CEO Brian Thompson in New York City in December. (Mangan, 4/1)

Health care remains stubbornly unaffordable for millions of people, according to a new survey released Wednesday that underscores the struggle many people have in paying for a doctor’s visit or a prescription drug — even before any talk of cutting government coverage. In the survey, 11 percent of people said they could not afford medication and care within the past three months, the highest level in the four years the survey has been conducted. More than a third of those surveyed, representing some 91 million adults, said if they were to need medical care, they would not be able to pay for it. (Abelson, 4/2)

Palo Alto, Calif.-based Stanford Health Care incorporates an intentional process for evaluating, implementing and monitoring new technologies, particularly artificial intelligence. To this end, a new AI tool has led to meaningful results in billing practices, Aditya Bhasin, vice president of software, technology and digital solutions at SHC, told Becker’s. SHC, which has long leveraged AI to solve clinical issues, developed the new tool to streamline billing practices while improving staff wellness and the patient experience. (Gooch, 4/1)

�鶹Ů�� Health News: How Much Will That Surgery Cost? 🤷 Hospital Prices Remain Largely Unhelpful. 

It’s a holy grail of health care: forcing the industry to reveal prices negotiated between health plans and hospitals — information that had long been treated as a trade secret. And among the flurry of executive orders President Donald Trump signed during his first five weeks back in office was a promise to “Make America Healthy Again” by giving patients accurate health care prices. The goal is to force hospitals and health insurance companies to make it easier for consumers to compare the actual prices of medical procedures and prescription drugs. Trump gave his administration until the end of May to come up with a standard and a mechanism to make sure the health care industry complies. (Chang, 4/2)

The American Telemedicine Association’s lobbying arm, ATA Action, acquired the Digital Therapeutics Alliance in a bid to beef up its digital health presence and advocate for health technology further upstream in the regulatory process. While ATA Action mainly focuses on extending already-enacted Medicare telehealth flexibilities in Congress and at the agencies, the Digital Therapeutics Alliance has been waging policy battles for payment of novel medical devices that Medicare says it doesn’t have the authority to cover. (Beavins, 4/1)

The Los Angeles County Board of Supervisors approved a plan to move hundreds of millions of dollars out of the region’s homeless services agency on Tuesday, despite warnings from L.A. Mayor Karen Bass about creating a “massive disruption” in the region’s fight against homelessness. On a 4-0 vote, the supervisors signed off on the strategy to form a new county homelessness department with a budget that would almost immediately exceed $1 billion. By July 2026, the supervisors will move more than $300 million from Measure A, a half-percent sales tax, out of the Los Angeles Homeless Services Authority, or LAHSA, and into the new county agency. (Zahniser and Ellis, 4/1)

A nonprofit medical center with 15 health clinics in Alameda County has agreed to a financial settlement with three female employees after a federal investigation found that it paid them less than a male colleague. Tiburcio Vasquez Health Center will pay the three employees $195,000 in damages following the investigation by the U.S. Equal Employment Opportunity Commission, the federal agency announced Tuesday. The women will split the settlement money. (Mishanec, 4/1)

Hundreds of current and aspiring physician assistants rallied inside the Massachusetts State House on Tuesday to support a bill that they say would help them ease the state’s primary care workforce shortage. The legislation would remove supervision requirements for physician assistants who have completed 2,000 clinical hours. Under current law, all physician assistants must have a supervising physician on file with the state in order to practice, including prescribing medication and ordering tests. (Halpin, 4/1)

The Georgia Composite Medical Board has renewed the license of Atlanta cosmetic surgeon Harvey “Chip” Cole while he battles 10 lawsuits from patients alleging he ruined their faces. Cole’s medical license was renewed in March for another two years, according to his profile on the board’s website. The profile shows Cole, who denies any wrongdoing in the lawsuits, has lost his hospital privileges. (Manins, 4/2)

The Colorado Senate commemorated Transgender Day of Visibility on Monday with a resolution on the chamber floor, but Democrats want to do more than just talk. They’re also proposing new protections for trans people. (Woods, 4/1)

An Illinois individual at the Brookside campus of Waukegan High School was diagnosed with an active case of tuberculosis (TB) last week while the Waukegan Community Unit School District 60 community was on spring break. The subject is currently isolated from others and undergoing treatment, according to an email from the Lake County Health Department, which notified the district and is working together with it to protect the community. (Sadin, 4/1)

When Hurricane Helene ripped through western North Carolina, it downed power lines, leaving tens of thousands of residents without electricity for days, even weeks. At Duke Energy’s Marshall Substation in the town of Hot Springs, heavy rains and flooding forced the shutdown of the facility. But Hot Springs was more fortunate than most. In 2023, Duke Energy had installed a microgrid of solar panels and lithium-ion batteries to restore power quickly in case of emergency. (Atwater, 4/2)

�鶹Ů�� Health News: Hit Hard By Opioid Crisis, Black Patients Further Hurt By Barriers To Care 

Purple flags, representing the nearly 300 Mecklenburg County residents who died of opioid overdose in 2023, fluttered in the humid breeze last August in recognition of International Overdose Awareness Day on the city’s predominantly Black west side. As recently as five years ago, the event might have attracted an overwhelmingly white crowd. But the gathering on the last day of the month at the Valerie C. Woodard Community Resource Center drew large attendance from Black people eager to learn more about a crisis that now has them at the center. (Newsome, 4/2)

Phthalates — the synthetic chemicals used in everyday products for food packaging, personal care, toys and more — have been linked to abnormal neurological development in infants. Now, scientists may have discovered a biological pathway for how this phenomenon could occur. (Rogers, 4/2)

A new drug is showing promise in tackling treatment-resistant ovarian cancer. Relacorilant, the drug tested in a phase 3 ROSELLA trial with Corcept Therapeutics in California, was found to improve overall survival and progression of the disease when matched with a chemotherapy drug called nab-paclitaxel. (Stabile, 4/1)

Yesterday the US Food and Drug Administration (FDA) approved a freeze-dried formulation of Bavarian Nordic's mpox vaccine, Jynneos, which can also be used to prevent smallpox. As with the frozen liquid version that is already FDA-approved, the freeze-dried version can be used in adults. (Wappes, 4/1)

Taking a trendy ice bath—or, as they are formally known, "cold-water immersion"—actually changes the way your cells operate. This is the conclusion of researchers from the University of Ottawa, Canada, who found that a week of hour-long ice baths was linked to an improvement in cellular tolerance to the cold. "We were amazed to see how quickly the body adapted," said paper author and physiologist Kelli King in a statement. (Randall, 4/1)

�鶹Ů�� Health News: Listen To The Latest '�鶹Ů�� Health News Minute'

Zach Dyer delivers this week’s news: Federal regulators want to collect more data to figure out why some CT scans deliver much more radiation than others, and opposition to mRNA vaccines could end promising efforts to cure diseases including pancreatic cancer. (4/1)

We used to think of measles outbreaks in the United States as isolated events: short-lived and confined to close-knit communities with low vaccination rates. A flare here, a bubble there. But as those bubbles grow and converge, the United States could be at risk for tens of thousands of cases. (Michael Mina, 4/2)

After the Supreme Court’s 2022 decision discarding the constitutional right to abortion, Louisiana was among the first states to ban nearly all abortions. Some residents get around the law by traveling to other states where the procedure remains legal. Some turn to out-of-state providers for pills to end their pregnancies. (Nationally, medication abortions now account for 63% of terminations.) (Steve Chapman, 4/2)

Over the last two months, the pharmaceutical industry has remained on the sidelines as Health and Human Services Secretary Robert F. Kennedy Jr. and Elon Musk's Department of Government Efficiency have taken a hatchet to our nation’s public health agencies. Executives likely believed that nothing good would come from speaking up — and that their most immediate concern, the parts of the Food and Drug Administration that biotech and pharma companies rely on to review new drugs, would survive unscathed. (Lisa Jarvis, 4/1)

The CDC cuts announced Tuesday threaten America’s health, safety, and economy. Despite claims of efficiency, these cuts target proven programs that prevent disease and save lives — and as a result, Americans will be sicker and face increased health care costs. The government’s goal should not be to hit an arbitrary number of jobs eliminated, but to focus on the number of illnesses and premature deaths prevented. (Tom Frieden, 4/1)

Every doctor is a writer, or that’s what I used to believe. From the first days of medical school, my classmates and I learned how to write, albeit for a particular purpose and according to strict rules — a type of writing that wasn’t necessarily beautiful, or even particularly interesting. But it was writing. (Christine Henneberg, 4/2)