The Host
The Food and Drug Administration is back in the headlines, with a political appointee overruling agency scientists to reject an application from the drugmaker Moderna for a new flu vaccine, and FDA Commissioner Marty Makary continuing to take criticism from anti-abortion Republicans in the Senate for alleged delays reviewing the safety of the abortion pill mifepristone.
Meanwhile, in a very unlikely pairing, Sen. Elizabeth Warren, the Massachusetts Democrat, and Sen. Josh Hawley, the conservative Republican from Missouri, are co-sponsoring legislation aimed at breaking up the 鈥渧ertical integration鈥 of health care 鈥 when a single company owns health insurers, drug middlemen, and clinician practices.
This week鈥檚 panelists are Julie Rovner of 麻豆女优 Health News, Jackie Forti茅r of 麻豆女优 Health News, Lizzy Lawrence of Stat, and Alice Miranda Ollstein of Politico.
Panelists
Among the takeaways from this week鈥檚 episode:
- A top FDA official overruled agency staff in refusing to consider Moderna鈥檚 application for a new flu vaccine. The rejection, which Moderna is challenging, comes after the company consulted with the agency under President Joe Biden on how to develop the clinical trial for the vaccine and then spent considerable time and money. Clear, consistent federal guidance is important to maintaining the drug development ecosystem, and the decision stands as a warning to other companies developing new treatments.
- With measles cases rising and trust in federal vaccine recommendations falling, the Vaccine Integrity Project, based at the University of Minnesota鈥檚 Center for Infectious Disease Research & Policy, and the American Medical Association are launching their own vaccine review process 鈥 a parallel vaccine recommendation project offering an alternative to what are seen as ideologically driven federal recommendations.
- President Donald Trump unveiled the new TrumpRx website, billed as helping people save money on prescription drugs. But the site鈥檚 offerings are limited and offer limited benefits: It serves only those trying to buy drugs without insurance coverage, and some of the biggest savings are on popular obesity drugs rather than other commonly needed treatments. Nonetheless, it offers Trump a chance to stamp his name on an effort to lower drug prices.
- And more reporting is illuminating the health-related side effects of Trump鈥檚 immigration crackdown, including infectious disease outbreaks at detention centers. While at least some of the problems are not new to immigration enforcement, the large numbers of people being detained are intensifying the problems.
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Plus, for 鈥渆xtra credit鈥 the panelists suggest health policy stories they read this week that they think you should read, too:
Julie Rovner: ProPublica鈥檚 鈥,鈥 by Mica Rosenberg.
Alice Miranda Ollstein: Politico鈥檚 鈥,鈥 by Amanda Chu.
Lizzy Lawrence: 麻豆女优 Health News鈥 鈥US Cancer Institute Studying Ivermectin鈥檚 鈥楢bility To Kill Cancer Cells,鈥鈥 by Rachana Pradhan.
Jackie 贵辞谤迟颈茅谤: Stat鈥檚 鈥,鈥 by Ariana Hendrix.
Also mentioned in this week鈥檚 episode:
- Stat鈥檚 鈥,鈥 by Lizzy Lawrence.
- 麻豆女优 Health News鈥 鈥Public Health Workers Are Quitting Over Assignments to Guant谩namo,鈥 by Amy Maxmen.
- 麻豆女优 Health News鈥 鈥鈥業 Can鈥檛 Tell You鈥: Attorneys, Relatives Struggle To Find Hospitalized ICE Detainees,鈥 by Claudia Boyd-Barrett.
[Editor鈥檚 note: This transcript was generated using both transcription software and a human鈥檚 light touch. It has been edited for style and clarity.]
Julie Rovner: Hello from 麻豆女优 Health News and WAMU public radio in Washington, D.C. Welcome to What the Health? I鈥檓 Julie Rovner, chief Washington correspondent for 麻豆女优 Health News, and I鈥檓 joined by some of the best and smartest health reporters covering Washington. We鈥檙e taping this week on Thursday, Feb. 12, at 10 a.m. As always, news happens fast, and things might have changed by the time you hear this. So, here we go.
Today, we are joined via videoconference by Alice Miranda Ollstein of Politico.
Alice Miranda Ollstein: Hello.
Rovner: Lizzy Lawrence of Stat News.
Lizzy Lawrence: Hi.
Rovner: And up early to join us from California, my 麻豆女优 Health News colleague Jackie Forti茅r. Welcome, Jackie.
闯补肠办颈别&苍产蝉辫;贵辞谤迟颈茅谤: Hey, everyone.
Rovner: No interview this week, but plenty of news. So let鈥檚 jump right in. We will start this week at the Food and Drug Administration, where things are 鈥 why don鈥檛 we call it 鈥 newsmaking. The biggest FDA story that broke this week was controversial vaccine chief Vinay Prasad outright rejecting an application for a new flu vaccine from Moderna, maker of the mRNA covid vaccine that so many anti-vaxxers have criticized. Lizzy, you . Congratulations. What happened exactly? And why is this such a big deal beyond the flu vaccine?
Lawrence: This is a big deal because to refuse to file is a pretty rare occurrence in general, because in general the FDA and industry like to have agreed-upon standards for clinical trials before companies embark on them and pour millions of dollars into them. So that was surprising. And then鈥
Rovner: And refuse to file means that they said that they鈥檝e got the application and said: Yeah, we鈥檙e not accepting that. We鈥檙e not going to review this. Right?
Lawrence: Yes, yes. And Prasad wrote that the grounds for this was that it wasn鈥檛 an adequate, controlled trial. Well, Moderna is saying that actually the FDA greenlit this trial back under the Biden administration in 2024. They acknowledged that there was basically a control vaccine that the FDA say they would prefer that Moderna use for the older population. But they said, however, it鈥檚 acceptable if you don鈥檛 do that.
Rovner: And I want to make sure I understand this. The complication here is that this is supposed to be a better vaccine for older people, but right now there鈥檚 vaccines for older people that start at age 65 and this is a vaccine that鈥檚 supposed to start at age 50, right? So it was unclear who they were going to test it against, whether it was going to be the 50-to-64s or the 65s and older. Because there isn鈥檛 a vaccine right now that鈥檚 approved for 50 and up, right?
Lawrence: Exactly, exactly. So it was there鈥檚 the high-dose vaccine, which is recommended for the above-65s, but that is not recommended for the 50-to-64, which is part of why Moderna didn鈥檛 use that high-dose vaccine, because the population that they were studying was broader than this over-65s. So anyway, so yeah, so refusing to file is already rare, and then for there to be an overriding refuse to file, where the, I was told, basically, while there may have been individuals who agreed with Dr. Prasad鈥檚 assessment, the review team, every discipline, thought that it was reviewable. And the head of vaccines wrote a memo explaining why he thought it was viable, so that the career staff kind of documented their thoughts here. It鈥檚 not clear whether this will be made public ever, but one would hope, with radical transparency, but we鈥檒l see. Despite that, Dr. Prasad still refused to review Moderna鈥檚 application.
Rovner: So obviously it鈥檚 a big deal for the flu vaccine, but it鈥檚 a big deal beyond this. Moderna鈥檚 CEO was on cable news this morning, said that, as you said, after consulting with the FDA officials about the trial, they spent a billion dollars on this trial. How do we expect companies to invest in new medicines like this if the FDA is basically acting on vibes?
Lawrence: I don鈥檛 know. Yeah. And it鈥檚 interesting. It doesn鈥檛 seem like there鈥檚 a ton of sympathy from this administration. Even back last year, [FDA] Commissioner [Marty] Makary tweeted something 鈥 this was when they were limiting, wanted to require more data for covid vaccines for the under-65 crowd. And I think he said something like: Our goal is not to save companies money. That鈥檚 not something we 鈥 which of course that isn鈥檛. The FDA鈥檚 goal is to promote public health. But it鈥檚 definitely a change in tune. I think that in the past, the FDA has understood that you鈥檙e really only going to get innovation if you have clear, consistent guidance and that it鈥檚 a really worst-case scenario for a company to spend a billion dollars on a clinical trial and then there鈥檚 nothing to show for it and nothing for it to benefit patients, either. So.
Rovner: Is this over? What happens now?
Lawrence: So now Moderna has requested a meeting to challenge this decision, and now there begins a kind of negotiation. It might be possible that the FDA would, in fact, would review at least the 50-to-64 cohort, because they don鈥檛 have any objections there, seemingly. But we鈥檒l have to see. On a call yesterday, a senior FDA official talked about Moderna kind of coming to the agency with humility and acknowledging that the FDA had recommended this high-dose vaccine. And so I don鈥檛 know. I think companies are definitely 鈥 it鈥檚 a lesson that they鈥檙e, especially if you鈥檙e in the vaccine space, you have to tread very carefully.
Rovner: Yeah. And I would think others in the drug space, too. It鈥檚 not just 鈥 that鈥檚 the point of this 鈥 it鈥檚 not just vaccines. Alice, you wanted to say something.
Ollstein: Oh, yeah. Not only the monetary investment, which we鈥檝e touched on a bunch, but companies spend years. So it鈥檚 the time investment as well. And why would you dedicate years of effort to something that you鈥檙e not sure if a political appointee is going to swoop in and override career scientific officials鈥 assessment, if you can鈥檛 trust the regulatory system to work as it鈥檚 always worked. There really is just a lot of risk there, and you might see people not making these submissions on all kinds of fronts. Of course, this is coming as we鈥檝e had a really bad flu season. I鈥檝e had people in my life get really sick and say it鈥檚 been really, really bad. So the prospect of having something that works better to prevent, or even just make it milder, not coming to fruition is rough.
Rovner: Yeah. And this year, as we know, this year鈥檚 flu vaccine was not very well matched to the strains that ended up circulating. And that鈥檚 kind of the point of this Moderna vaccine, this mRNA vaccine, is that they say it would be much faster for them to match strains to what鈥檚 going around. If it works as the clinical trials suggest it would actually be a better flu vaccine than we have now.
Well, meanwhile, cases of measles are also continuing to multiply, as they do when people aren鈥檛 vaccinated, and not just in the places we鈥檝e talked about, like Texas and South Carolina, but also all around us here in the nation鈥檚 capital, apparently, as a result of people traveling here for the anti-abortion March for Life in January. There have been more than 730 confirmed cases of measles in the U.S. already this year. That鈥檚 four times more than have been typical for a full year, and it鈥檚 not yet the middle of February. Yet that doesn鈥檛 seem to be deterring the administration from its anti-vaccine activities. So now, the American Medical Association and the University of Minnesota Vaccine Integrity Project have announced they鈥檒l convene a parallel group of experts to make vaccine recommendations, basically saying they are done following the Centers for Disease Control and Prevention. This has been brewing for a while. Right, Lizzy?
Lawrence: Yes. As soon as the secretary fired all of the experts who served on the advisory panel to the CDC on vaccines, I think there鈥檚 been unease. And now, as you said, there鈥檚 an active parallel public health establishment that鈥檚 trying to spread credible information and provide an alternative resource, because it鈥檚 clear that HHS [the Department of Health and Human Services] has become compromised when it comes to vaccine recommendations. And yet, you鈥檙e seeing the spread of infectious diseases right now.
贵辞谤迟颈茅谤: Having kind of this rival court is not surprising, because they鈥檝e refused to participate in any of the Advisory Committee on Immunization Practices meetings for months and months. I do wonder if this will maybe change some of the tone. We do have an upcoming ACIP meeting in February. Normally we would have a agenda out by now. Before Secretary [Robert F.] Kennedy [Jr.] we would have them weeks in advance, and we haven鈥檛 seen one yet, so we鈥檙e really not totally sure what they鈥檙e going to be talking about. But Dr. [Mehmet] Oz did say this week that he finally advised people 鈥 he鈥檚 the CMS [Centers for Medicare & Medicaid Services] director鈥 to take the vaccine. And there鈥檚 been over 933 cases in just South Carolina during this outbreak that started last October. And so when I talk to people on the ground who are treating folks in South Carolina and have been treating them for months, and they鈥檝e been doing vaccine clinics and things like that, they were just so fed up with Dr. Oz and the administration, because they partially blame them for these various outbreaks. And I had one of them tell me, like, well, it鈥檚 like a band-aid on a bullet hole. Like, now they鈥檙e finally encouraging people to get vaccinated when we could have had this months ago.
Rovner: And, of course, the CDC doesn鈥檛 have a director at the moment, because the Senate-approved director was summarily fired and/or quit, not clear which, after refusing to basically rubber-stamp the immunization panel鈥檚 recommendations that had not been made at the time. So the American Academy of Pediatrics is suing to stop this February ACIP meeting. I did not hear what the last decision was on that, but I know that there鈥檚 still a lot of movement around here. I guess the big worry is: Who should the public trust now? Is it going to be this sort of grouping of medical societies led by the AMA, or the CDC, which people and doctors are used to following the advice of?
Ollstein: And there鈥檚 all these state alliances forming to do the same thing. And so I think, yeah, the more competing recommendations the average person hears, the more they just sort of throw their hands up and say: I don鈥檛 even know who to trust anymore. I鈥檓 not listening to any of these people. And the trust that鈥檚 eroded in the federal government, that鈥檚 going to be really hard to recuperate in the future. You can鈥檛 just flip a switch and say: OK, it鈥檚 a different government. We trust them again. Once those seeds of doubt are planted in people鈥檚 minds, it鈥檚 really hard to unearth. And so, if not permanent damage, all of this is doing at least very long-term damage to the idea of expertise and authoritative information.
Rovner: And science, which this administration insists it wants to follow. Well, turning to FDA-related 鈥淢AHA鈥 [鈥淢ake America Healthy Again鈥漖 news, the agency said last week it would relax enforcement of its food additive regulations to make it easier for manufacturers to say they鈥檙e not using artificial dyes. Now this was a huge deal when the agency announced the phaseout of artificial coloring. Looking at you, fancy-colored Froot Loops. Now the administration says it鈥檚 going to allow foodmakers to say they鈥檙e not using artificial colors as long as they鈥檙e not using petroleum-based dyes. Apparently, natural dyes are OK. But even that is controversial, and it appears that this whole effort really relies on manufacturers鈥 willingness to comply rather than, you know, actual regulation, which is kind of what the FDA does for a living. It鈥檚 a regulatory agency.
Ollstein: Well, every time the word 鈥渘atural鈥 comes up, I always laugh because there is no definition of that. And there are plenty of things that are natural that could kill you or hurt you very badly. And there are plenty of things that are synthetically manufactured that are helpful and fine for you. And so it has this veneer of safety, veneer of health with no actual substance. So my red flags go up whenever I hear that word, and I think everyone should be skeptical.
Rovner: But it goes with RFK Jr.鈥檚 quest now that you should, quote, 鈥渆at real food.鈥
Lawrence: Right. Yeah. I was going to say same with 鈥渃hemical.鈥 I feel like, 鈥渃hemical鈥 abortion drug, 鈥渃hemical.鈥 And it鈥檚 like, a lot of things are chemicals. That鈥檚 not鈥
Ollstein: Yeah, like in your own body, naturally.
Lawrence: Yeah.
Ollstein: You have chemicals.
Lawrence: We are chemicals.
Ollstein: We are chemicals.
Rovner: You guys are all too young to remember the Dow Chemical advertising line 鈥淏etter Living Through Chemistry,鈥 which at the time, in the 鈥60s and 鈥70s, was true. There was, there 鈥 we鈥檝e had a lot of better living through chemistry. And some of it has turned out to be maybe not so good for us, but a lot of it has turned out to be pretty darn good for us.
Well, finally, in FDA land, Commissioner Marty Makary this week met with anti-abortion senators about that ongoing review of the abortion pill mifepristone, which senators want the FDA to remove from the market. Alice, how鈥檇 that meeting go?
Ollstein: Not great for the FDA, from what I was told. I got on the phone with Sen. Josh Hawley after it, and he was extremely frustrated. He said he didn鈥檛 get answers to any of the questions he鈥檚 been sending in public letters to the FDA for months and now asking in this briefing behind closed doors that they held on Capitol Hill this week. He said he didn鈥檛 get answers about what the timeline is for this review of the abortion pill mifepristone, what the review consists of, whether it鈥檚 even begun, really, whether it鈥檚 even underway. And so he is sort of concluding that this is not going anywhere, and he wants Congress to step in and take action. Now, Congress has tried to step in and take action before. They鈥檝e tried to put restrictions on mifepristone in the FDA funding bill. That didn鈥檛 pass. So I don鈥檛 know if this is even plausible in this environment where Congress can鈥檛 really pass much of anything anymore.
But Hawley is not just another Republican senator. He is very intertwined with the anti-abortion movement. His wife is an extremely prominent anti-abortion lawyer who鈥檚 led a lot of the major cases trying to restrict or ban mifepristone. They founded their own anti-abortion advocacy group. And so it really shows that the tensions, clashes, whatever we want to call them, between the anti-abortion movement and the Trump administration, so after backing the Trump administration for years and years, they鈥檙e really getting fed up. And they鈥檙e fed up that even after they achieved their grand goal of overturning Roe v. Wade, there are actually more abortions happening now than before, and that鈥檚 largely through these pills and people鈥檚 ability to get them. And so they鈥檙e getting increasingly impatient with the Trump administration, who has been sort of stringing them along and saying: Yeah, we鈥檙e working on it. We鈥檙e working on it. But they want to see results. Now, of course, if there were some sort of restrictions imposed, that could have a big political effect. And so a lot of Republicans are very torn about that. But not Sen. Hawley. Sen. Hawley wants to see it.
Rovner: That鈥檚 right. Well, moving to what I call FDA-adjacent news, one of the many thorny issues that FDA has been dealing with is the compounding of those very popular and very pricey obesity drugs. When the drugs were in shortage, it was legal for compounders to make their own copies. But now the shortage for both of the leading medications 鈥 semaglutide, made by Novo Nordisk, and tirzepatide, made by Eli Lilly 鈥 is over, and those cheaper copycats were supposed to be pulled from the market. So it was a bit of a surprise when the company Hims, one of those direct-to-consumer drug sites, announced the unveiling of a semaglutide tablet just weeks after the first such drug was approved by the FDA, by Novo Nordisk. The FDA promptly referred the company to the Justice Department for possible violation of federal drug laws, after which Hims said, Oh, maybe we won鈥檛 start selling the drug after all. Oh, and Novo is suing for patent infringement. But I would think that the war over the 鈥渇at鈥 drugs, as President [Donald] Trump likes to call them, is likely to lower prices just as effectively as government regulation might. Or am I misreading that? Lizzy, this has been quite the sideshow, if you will.
Lawrence: Yeah. It might. I think that the compounding, the FDA鈥檚 crackdown on Hims was very interesting to me because I think before the commissioner had come into his role, there was some speculation. He had worked for a telehealth company that prescribed compounded drugs. And there鈥檚 also, I think compounders have tried to tap into a little bit of the MAHA medical freedom aspect. But clearly that鈥檚 not been the case, at least at the FDA. They are clearly very upset about this and mean business, and I think it鈥檚 tying into their crackdown on direct-to-consumer drug advertising as well. But as far as price, yeah. I think the deals that Trump has managed to strike with the companies could actually be reducing price for patients. I think we鈥檒l have to see. I know there鈥檚 obviously drug pricing programs as well that they could pursue. So, yeah, we鈥檒l have to see.
Rovner: All right. Well, we鈥檙e going to take a quick break. We will be right back.
OK. We鈥檙e back. And speaking of President Trump, there鈥檚 also drug news this week that鈥檚 not directly related to the FDA. That鈥檚 the official unveiling of TrumpRx, the website the president says will lower drug prices like no one鈥檚 鈥渆ver seen before.鈥 That鈥檚 a direct quote, by the way. Except it turns out that鈥檚 not quite the case. First, these discounts are only for people who are paying out-of-pocket, not those with insurance, which makes them valuable mostly for people who have no coverage or people who take drugs that insurance often doesn鈥檛 cover, like those for obesity or infertility. Yet of the 43 drugs so far that are promoted on the TrumpRx website, about half already have cheaper generic copies available through sites like GoodRx and Mark Cuban鈥檚 Cost Plus Drugs. And really, the website just points people to already existing manufacturer websites that were already offering those lower prices. So what is the point of TrumpRx?
Lawrence: Great question. Yeah. This administration has been very focused on, obviously, media and wins and attaching President Trump鈥檚 name to things. So it accomplishes that goal. Maybe it does raise awareness for these other sites that already exist. But that鈥檚 a theme of a lot of the movement on health care so far, has been 鈥 there鈥檚 been a lot of chaos, and then there鈥檚 also sometimes things that they announce as like a grand, brand-new, no-one鈥檚-ever-thought-of-it-before policy, but then there are already, of course, existing programs or avenues for that.
Rovner: And to be fair, Trump has jawboned down some prices, including some prices for the obesity drugs, by basically dragging in the CEOs of these companies and saying, You will lower prices.
Lawrence: Yeah, yeah. The dealmaking has been effective. And I think the question is: Will this last beyond his administration? Will there be a legacy there?
Ollstein: I think there鈥檚 also some danger in overpromising, because he鈥檚 out there saying things that don鈥檛 comport with how math works. He鈥檚 basically suggesting prices will come down so many percents that we鈥檒l be getting paid to take drugs, because that鈥檚 what more than 100% is. And people who are hearing that, voters who are hearing that, if they aren鈥檛 seeing that show up in their bills, if they鈥檙e not actually seeing those drastic, drastic drops that they鈥檙e being promised by the president, are they going to get upset? And is that going to impact how they vote? So yes, there has been some, on the margins, improvements, but when you鈥檙e out there promising 600% reductions and not delivering, there鈥檚 a risk to that.
Rovner: Jackie, you wanted to add something.
贵辞谤迟颈茅谤: Well, I was going to say, I think it鈥檚 also confusing for a lot of people, from a consumer perspective, because you log on and I think people, they hear these huge promises, like Alice is talking about, and then they think that they can, necessarily, buy the drugs through there and immediately get them shipped, what these third parties like Hims and Weight Watchers are doing a lot of with the GLP-1s. And that鈥檚 not how this works. You still have another step of getting a prescription and then going to the pharmacy and using these to potentially get discounts and lower prices, in the same way that these have been available from pharmaceutical manufacturers and other things like GoodRx for years. But it鈥檚 that disconnect between, even if you can get a discount, actually getting the discount and crediting the Trump administration for that that I think is going to be really difficult for a lot of voters to make that connection in the way that the administration wants them to.
Rovner: And this was ever the case with rebates 鈥 for other consumer products, not just talking about drugs. We鈥檒l give you a $15 rebate, but you have to fill out 87 forms and send it to this place and get it exactly right, do it before the end date, and we鈥檒l send you back $15. Because they count on most people not being able or willing to follow all of the various steps. So instead of giving everybody the discounted price, they make you really basically work for your discount, which is a consumer thing, but it鈥檚 pretty popular in the drug space as well. Rather than just lowering prices, they鈥檙e going to say, We will give you a discount, but you鈥檙e going to have to do this, that, and the other thing in order to get it.
贵辞谤迟颈茅谤: Right. But when you鈥檙e president and you want credit for it, it鈥檚 going to be a little more 鈥 it鈥檚 harder in order to make that connection. Sorry.
Rovner: Yes, that鈥檚 true. That is a good point. All right, moving on. We have talked a lot about consolidation in the health care industry, particularly companies like UnitedHealthcare, which used to be just an insurer, now owns its own PBM [pharmacy benefit manager], its own claims processing company, and thousands of medical practices around the country. Well, now an extremely unlikely pair in the Senate, Massachusetts Democrat Elizabeth Warren and Missouri Republican Josh Hawley, have joined to introduce something called the Break Up Big Medicine Act, which would basically outlaw so-called vertical integration, like that of United and, to a somewhat lesser extent, Cigna and CVS Health, which owns Aetna, the insurer. Some are referring to this as the health version of the 1932 Glass-Steagall Act, which separated commercial from investment banking 鈥 and, side note, whose repeal in 1999 is considered a major factor setting off the financial crisis of 2008. But that was a risk thing. It was done to prevent another stock market crash like the one in 1929. This is a cost thing. This is to go after high health care costs. Could it work? Could it pass? And is this the beginning of the next big thing in health reform?
Lawrence: Perhaps. Yeah. Last year, I worked with my colleagues on kind of examining UnitedHealth Group and the effects of consolidation on doctors and patients. And at the time, I think, there were some vocal lawmakers on either side of the aisle who were criticizing this, especially in the wake of the murder of the UnitedHealth CEO, and which had a surprising 鈥 the public sort of had this reaction and to鈥
Rovner: Not in United鈥檚 favor.
Lawrence: Not in United鈥檚 favor. And so I think that there is, this is a political issue that affects everyone, Republican and Democrat, the, well, cost in general, but I think there鈥檚 a lot of resentment and anger, and it seems like that is bringing together these unlikely and pretty powerful senators. I鈥檓 not an expert on the Hill. I don鈥檛 know if this has a chance. Especially, it鈥檚 targeting massive, powerful companies with hands in every part of the health care system. So it鈥檚 something that you would imagine the entire health care industry would fight against. But, yeah, I don鈥檛 know.
Rovner: And I will point out that Sen. Josh Hawley, in addition to all his anti-abortion activities, last year, when Congress was debating the Medicaid cuts, kept vowing not to vote for those Medicaid cuts. So he鈥檚 鈥 which, of course, in the end, he did 鈥 but he鈥檚 been sort of on the consumer side of health care for a while now. It鈥檚 just this is not brand new to him.
Lawrence: Right. And I鈥檓 not sure how many other Republican senators would follow him down this path. But it鈥檚 definitely a noteworthy development, and curious to see where it goes.
Rovner: Yeah, I鈥檓 curious to see sort of if the populist part of health care costs sort of rises to the fore. We鈥檒l have to, we will have to watch that space. Well, finally this week, more on the impact of the Trump administration鈥檚 immigration crackdowns and health. My 麻豆女优 Health News colleague Amy Maxmen has a story about health professionals in the U.S. Public Health Service Commissioned Corps actually resigning rather than accepting postings to Guant谩namo Bay, Cuba, where some immigrants are being detained in prisons that used to hold al-Qaida suspects. Another 麻豆女优 Health News story by Claudia Boyd-Barrett describes how when people detained by ICE [Immigration and Customs Enforcement] end up in the hospital, often their immediate families and their lawyers aren鈥檛 even allowed to know where. And remember, last week we talked about cases of measles in some immigration detention facilities. Well, now there are two confirmed cases of tuberculosis at the ICE facility at Fort Bliss in El Paso, Texas. I鈥檓 thinking maybe the health part of this is starting to kind of get to people as much as the whole depriving-civil-liberties part.
贵辞谤迟颈茅谤: Yeah, and there鈥檚 also been cases of covid-19, which makes sense. You鈥檙e going to have respiratory viruses as you get hundreds of people grouped together. That makes sense. A judge in California a couple days ago ordered that there had to be adequate health provided to detainees in one specific California 鈥 it was a prison and now it鈥檚 an ICE detainee facility. That鈥檚 specific to there, but it鈥檚 鈥 more and more senators, I think, are also looking at this and pointing out that they鈥檙e just not providing the health facilities that people need. And especially ongoing care 鈥 a lot of folks need diabetes treatment, and that treatment just isn鈥檛 really happening in many cases.
Rovner: Yeah, we鈥檝e talked about this at some length, over many weeks, that people in detention are not getting health care, even though it is required, that we keep hearing stories about people not getting needed health care. I didn鈥檛 know until I read this story that people who actually end up being hospitalized, that their family members are not allowed to know. That鈥檚 allegedly, well, it is because of security, because the idea is that if somebody who鈥檚 in detention is in a hospital, you don鈥檛 necessarily want bad people knowing that and being able to come to the hospital. But these are people often who are, as we have documented at length, do not have criminal records, and it鈥檚 hard to find out where they are. Alice, you wanted to add something.
Ollstein: Yeah. So there was a recent GAO [Government Accountability Office] report about this, and it found that people were not getting evaluated when they entered a facility to see if they were medically vulnerable and at risk of having a really bad episode or emergency, and that even children, pregnant women, vulnerable populations weren鈥檛 getting that initial evaluation, which then led to problems down the road. And it also said that people upon their release 鈥 either deportation or release within the United States if that鈥檚 what a court ordered 鈥 they weren鈥檛 being given their medical records, their prescriptions. And so the continuity of care was disrupted. And it鈥檚 important to note that that GAO report was about a few years ago under the Biden administration. So this isn鈥檛 new. These problems aren鈥檛 new, but they鈥檙e getting much worse, because the number of people detained is at record levels and so everything鈥檚 just getting multiplied.
Rovner: Yeah, it is. Well, we will keep watching that space. OK, that鈥檚 this week鈥檚 news. Before we get to our extra credits, I am pleased to present the winner of our annual 麻豆女优 Health News Health Policy Valentine contest. It鈥檚 from [Andrew Carleen] of Massachusetts, based on a story about Medicare Advantage overpayments. And it goes like this: 鈥淚 thought it was love. My heart felt spring-loaded. Turns out our relationship was significantly upcoded.鈥 Congratulations, and happy Valentine鈥檚 Day to all.
OK, now it鈥檚 time for our extra-credit segment. That鈥檚 where we each recognize a story we read this week we think you should read, too. Don鈥檛 worry if you miss it. We will post the links in our show notes on your phone or other mobile device. Alice, why don鈥檛 you start us off this week?
Ollstein: Sure. So I have a kind of fun story [鈥溾漖 from my co-worker Amanda Chu about how the Oura ring has taken over D.C. They have been heavily lobbying the Trump administration and Congress to prevent tough regulations. Basically, there鈥檚 a debate about whether it should be regulated as a medical device or not.
Rovner: Tell us again what it does.
Ollstein: It鈥檚 a ring you wear on your finger that monitors different health metrics. And so the Trump administration MAHA movement has gone all in on this. They love it. The Pentagon has a huge contract with them. Other government agencies are looking at it, too. I think it鈥檚 interesting because it is this very sort of conservative mindset of individual responsibility in health care and, oh, if you could just track your own metrics and do the right things. That鈥檚 an approach that is sort of counter to the idea of public health and government protecting your health through policy.
Rovner: And we know HHS Secretary Kennedy is a big fan of wearables.
Ollstein: Exactly, and this is one of the most popular ones right now. And so this story does a good job digging into all the lobbying and also into concerns about data privacy and pointing out that these technologies are moving much faster than government can regulate them. And that is leaving some lawmakers really concerned about who could have access to this data.
Rovner: Jackie.
贵辞谤迟颈茅谤: Mine is by Ariana Hendrix. She鈥檚 a writer based in Norway. It鈥檚 entitled 鈥.鈥 It was published in Stat. And she writes eloquently about being a parent in Norway and knowing that her children wouldn鈥檛 go to day care until they were about 16 months old, because Norway has paid parental leave. And she points out, beyond the vaccine debate there鈥檚 a bigger issue, that the U.S. lacks universal health care and federal paid parental leave. So changes in infant vaccines in the U.S. have a large effect, because babies in the U.S. often go to day care, when they鈥檙e around a lot of other kids when they鈥檙e just a few weeks old. So she points to the, in January, the infant RSV [respiratory syncytial virus] vaccine was moved to the high-risk category of shots, so now it isn鈥檛 routinely recommended for all babies in the U.S. And RSV, of course, is the most common cause of hospitalizations for infants, and that鈥檚 due to the fact that they鈥檙e exposed to the virus in day care a lot earlier than other children in other countries like Norway and Denmark whose vaccine schedules U.S. officials are now kind of trying to emulate. So she does a really great job of laying out how families face greater health and financial risks in the U.S. without the same safety net that other countries have.
Rovner: Or just the same social policies that other countries have.
贵辞谤迟颈茅谤: Yeah, it reminded me鈥
Rovner: It鈥檚 hard to, right, it鈥檚 hard to import another country鈥檚 鈥 part of another country鈥檚 鈥 policies without importing all of them. It is really good story. Lizzy.
Lawrence: Yeah. So my piece is by Rachana Pradhan and 麻豆女优 Health News, and it鈥檚 about the 鈥US Cancer Institute Studying Ivermectin鈥檚 鈥楢bility To Kill Cancer Cells.鈥鈥 And I thought this piece was very interesting, just because in general I鈥檝e been fascinated by 鈥 politicization of medicine isn鈥檛 new 鈥 but just like right-wing-coded products and left-wing-coded products. And in this piece, Rachana talks about NIH [National Institutes of Health] Director Jay Bhattacharya kind of talking about how, It鈥檚 the people鈥檚 NIH and if a lot of people are using it, well, we want to investigate it. So she just, she does a really good job of kind of unpacking why this is problematic, that they鈥檙e kind of just choosing a random medication and there鈥檚 not really any scientific reason to be investing in it as much as they are. And she got a response from NIH after the fact as well, kind of where they were trying to defend this decision to pour this much investment. And so, yeah, I think it鈥檚 just a really interesting development in NIH land.
Rovner: It is. My extra credit this week is from ProPublica, by Mica Rosenberg, and it鈥檚 called 鈥.鈥 It鈥檚 about what immigration detention looks like from the point of view of children being held at a family facility in Dilley, Texas. That鈥檚 the one where the two cases of measles were diagnosed earlier this winter. The story includes some pretty wrenching letters and video calls from kids who were living elsewhere in the U.S., while their parents were mostly working within the immigration system. And these kids had been ripped from their daily lives, their other parents and siblings in some cases, their schools and their classmates, and in many cases, from hope itself. Wrote one 14-year-old from Hicksville, New York, quote: 鈥淪ince I got to this Center all you will feel is sadness and mostly depression.鈥 It really is a must-read story.
OK. That is this week鈥檚 show. As always, thanks to our editor, Emmarie Huetteman, and our producer-engineer, Francis Ying. A reminder: What the Health? is now available on WAMU platforms, the NPR app, and wherever you get your podcasts, as well as, of course, kffhealthnews.org. Also, as always, you can email us your comments or questions. We鈥檙e at whatthehealth@kff.org. Or you can find me on X, , or on Bluesky, . Where are you folks hanging these days? Jackie.
贵辞谤迟颈茅谤: Bluesky mainly, .
Rovner: Alice.
Ollstein: Mainly on Bluesky, , and still on X, .
Rovner: Lizzy.
Lawrence: On X, . On Bluesky, .
Rovner: We鈥檒l be back in your feed next week. Until then, be healthy.
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