Robert F. Kennedy Jr. on Sept. 4, 2025, in a Senate hearing

At a September Senate hearing, Health and Human Services Secretary Robert F. Kennedy Jr. boasted about a rural health initiative within听 President Donald Trump’s “.”

“It’s going to be the biggest infusion of federal dollars into rural health care in American history,” responding to criticism from Sen. Bernie Sanders (I-Vt.). Sanders said the law would harm patients and rural hospitals.

Kennedy was referring to the law’s five-year, $50 billion Rural Health Transformation Program, HHS spokesperson Emily Hilliard said. GOP lawmakers have made similar claims about the program.

The fund was added to the bill at the last minute to secure support from Republican lawmakers who represent rural states. Some were concerned about how the bill’s Medicaid cuts would harm rural America, where have stopped offering inpatient services or been shuttered completely since 2010, according to the Cecil G. Sheps Center for Health Services Research at the University of North Carolina.

“The transformation fund was really talked about in the context of saving rural hospitals that would be facing these significant Medicaid cuts,” said Carrie Cochran-McClain, chief policy officer at the National Rural Health Association. Medicaid is the joint state-federal health insurance program that primarily covers low-income people and those with disabilities.

So is Kennedy right in his description of the rural health fund as a historic cash infusion, or does it fail to acknowledge critical context?

The Rural Health Transformation Program

Trump’s tax and spending law is expected to reduce federal Medicaid spending in rural areas by at least $137 billion by 2034, according to an , a health information nonprofit that includes 麻豆女优 Health News. The the law will increase the overall number of uninsured patients by 10 million by 2034.

Rural health facilities disproportionately rely on Medicaid reimbursement to stay afloat. In 2023, 40.6% of children and 18.3% of adults under age 65 from rural areas and small towns , according to the Center for Children and Families at Georgetown University. In metro areas, the rates were 38.2% and 16.3%, respectively.

The Trump administration argues that rural hospitals cannot rely on “legacy” funding sources like Medicaid and Medicare due to the programs’ reimbursement structure, which ties payments to the number of services provided, a model that’s not financially sustainable for rural facilities with typically low patient volumes.

“Distinct from these other programs, the Rural Health Transformation Program is designed to provide a flexible source of investment” to promote innovation, efficiency, and sustainability, the White House .

Here’s how it works. States can propose projects spearheaded by state agencies, health care providers, consultants, and vendors aimed at various purposes, such as improving technology, access to care, and workforce recruitment.

States can use only 15% of their transformation program funding for provider payments and can direct money to non-rural areas, .

Half of the $50 billion will be evenly divided among states whose applications are approved 鈥� regardless of their rural and overall populations 鈥� according to the “” for the program.

The other half will be awarded based on “the transformative possibilities” of states’ grant proposals; how much they’ve committed to aligning their health policies with the Trump administration’s; and data on their rural population, rural health facilities, uncompensated care, and other measurements.

The application deadline is Nov. 5.

The Big Picture

Michael Meit, director of the Center for Rural Health and Research at East Tennessee State University, said the rural health community is excited about the innovations the new program might foster, but he’d “love for it to happen in the absence of these cuts that are going to devastate our rural health system.”

“It’s not going to fill the hole,” Meit said.

麻豆女优 estimates that the rural health fund’s five-year, $50 billion investment is a little over of federal funding in rural areas that will be spread over 10 years. According to that analysis, Medicaid cuts over that period would tally at least $137 billion in rural areas.

That number doesn’t听account for other reductions stemming from the same law, such as cuts to the ACA Marketplaces or the health system revenue loss expected听from an increase in the number of people without insurance.听

These factors are important to note because the rural health program is a temporary initiative, while reductions in federal spending are long-term.听听

Another issue is the difference in the program’s spirit. The rural health fund is focused on transforming the rural health care system 鈥� not providing continued funding to keep facilities open or making up for lost Medicaid funds. Even if the money triggers successful innovations, there are doubts that those will happen in time to prevent rural health facilities from closing.

“There’s a real misperception that somehow these funds are going to be able to save rural America or save rural hospitals,” Cochran-McClain said.

Joseph Antos, a health policy expert and senior fellow emeritus at the conservative-leaning American Enterprise Institute, said Kennedy’s comment is something “politicians say when they want to ignore the rest of the policies.”

“What they wanted was to say that they were creating a new program,” Antos said. “Well, this is a very inefficient way to distribute a relatively very small amount of money to hospitals that will incur much larger bad debt over the coming years, thanks to the cuts in Medicaid.”

One Caveat

Experts said that when viewed outside of mandatory programs like Medicare and Medicaid, the $50 billion rural health fund does appear to be unrivaled, especially for a limited, five-year program.

Several mentioned the Hill-Burton Act as another program that significantly boosted rural health care. The law provided loans and grants that , many of which were in rural areas, from 1946 to 1997, according to the Health Resources and Services Administration.

Incomplete funding data makes it difficult to account for inflation, said Kelsey Moran, an assistant professor and health economist at the University of Miami.

But that, during the life of the program, it spent $47 billion in 2024 dollars when using the Consumer Price Index, or $109 billion when using the CPI’s medical care index. The medical index has a higher inflation rate because health prices have risen more than overall prices.

Our Ruling听

Kennedy said the rural health fund is “going to be the biggest infusion of federal dollars into rural health care in American history.”

The statement contains an element of truth because the new program could be the most significant one-time investment in rural health funding.

But it ignores critical facts and context that create a different impression.

Federal contributions to rural areas from Medicaid and Medicare easily dwarf this program’s $50 billion mark. The new fund offers states flexibility in how they can allocate resources, meaning there’s no guarantee that all the new funding will go to rural Americans’ health care. The program comes at the same time rural areas are expected to lose far more from Medicaid cuts and an increase in uninsured patients than what the rural health fund infusion can backfill.

Experts say the rural health fund’s cash infusion is canceled out by other parts of Trump’s tax and spending law that call for cuts and policy changes.

We rate this statement Mostly False.

Our Sources

“,” CBS News, Sept. 4, 2025.

“$50B Rural Health 鈥楽lush Fund’ Faces Questions, Skepticism,” 麻豆女优 Health News, July 21, 2025.

“,” Cecil G. Sheps Center for Health Services Research at the University of North Carolina-Chapel Hill, accessed Sept. 15, 2025.

“,” Roll Call, June 20, 2025.

“,” 麻豆女优, Sept. 23, 2025.

“,” Congressional Budget Office, July 21, 2025.

“,” Georgetown University Center for Children and Families, Jan. 15, 2025.

“,” The White House, undated.

, government document published on Sept. 15, 2025.

“,” Congressional Budget Office, March 5, 2024.

“,” Congressional Budget Office, March 20, 2025.

“,” HRSA, accessed Sept. 16, 2025.

“,” working paper by Kelsey Moran updated on Sept. 15, 2025.

Phone interview with Matthew Fiedler, a senior fellow in economic studies at the Center on Health Policy at The Brookings Institution, Sept. 24, 2025.

Phone interview with Gbenga Ajilore, chief economist, and Allison Orris, director of Medicaid policy at the Center on Budget and Policy Priorities, Sept. 24, 2025.

Phone interview with Larry Levitt, executive vice president for health policy at 麻豆女优, Sept. 24, 2025.

Phone interview with Joseph Antos, a health policy expert and senior fellow emeritus at the American Enterprise Institute, Sept. 23, 2025.

Phone interview with Carrie Cochran-McClain, chief policy officer at the National Rural Health Association, Sept. 17, 2025.

Phone interview with Kelsey Moran, assistant professor in the Department of Health Management and Policy at the University of Miami, Sept. 15, 2025.

Phone interview with Alana Knudson, director of the NORC Walsh Center for Rural Health Analysis at the University of Chicago, Sept. 12, 2025.

Phone interview with Michael Meit, director of the Center for Rural Health and Research at East Tennessee State University, Sept. 11, 2025.

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Vice President JD Vance in a Sept. 28, 2025, Fox News interview

As the U.S. headed for a government shutdown, Republicans repeatedly accused Democrats of forcing the closure because they want to give health care access to immigrants in the U.S. illegally.

“Democrats are threatening to shut down the entire government because they want to give hundreds of billions of dollars of health care benefits to illegal aliens,” Vice President JD Vance听 on “Fox News Sunday.”

President听听House Speaker Mike Johnson, and Republican members of Congress have repeated this line.

It’s wrong.

Democrats have refused to vote for Republicans’ resolution to extend the federal spending deadline, and their position does, in part, hinge on health care spending. Democrats want to extend covid pandemic-era Affordable Care Act subsidies that are set to expire at the end of the year and roll back Medicaid cuts in the tax and spending bill that Trump signed into law this summer.听

The听听wouldn’t give health care to immigrants who lack legal status; that population is already largely ineligible for federally funded health care. Instead, the proposal would restore access to certain health care programs for legally present immigrants who will lose access under the Republican law.

The White House did not respond to PolitiFact’s request for comment for this fact check. Vance听听of his talking point in another interview by saying it was included in the Democrats’ spending proposal. It’s not.

A 听followed up with screenshots of the Democratic proposal repealing a section of the Republican law labeled “alien Medicaid eligibility.” It’s important to know that these changes would not give Medicaid access to immigrants who lack lawful status.

Vance defended his statement again in an Oct. 1 White House听, saying former President Joe Biden “waived away illegal immigration status” that helped migrants access federal assistance. It’s important to note that many people听听through humanitarian parole or Temporary Protected Status programs don’t automatically qualify for Medicaid; , and many people who entered the U.S. on humanitarian parole are required to wait five years before accessing it.

The Trump administration has ended humanitarian parole and Temporary Protected Status for many people, rendering them ineligible for Medicaid and health plans on the Affordable Care Act marketplace.

We did not find evidence that Democrats want to spend “hundreds of billions” in costs for insuring migrants with unlawful presence.

Immigrants Lacking Legal Status Are Already Ineligible

Most federal health care dollars cannot be spent on health care for people in the U.S. who lack legal status. They cannot enroll in Medicaid or Medicare, and they are听 through the Affordable Care Act marketplace. A small Medicaid program reimburses hospitals for uninsured emergency care, which can include immigrants in the country without authorization but is not exclusive to them.

States听such as California and Illinois for people regardless of their immigration status, and the states pay for that. Federal law already banned states from using federal money for these programs. An听听of the Republican spending law would have penalized such states by withholding funding, but that provision didn’t last.

People in the country without permission might receive some federally funded health care in emergency cases; in those situations, hospitals must provide care even if a person is uninsured or in the country illegally. Emergency Medicaid covers hospital care for immigrants who would be eligible for Medicaid if not for their immigration status. The Republican tax and spending law听 hospitals can receive for emergency immigrant care.

Most Emergency Medicaid spending is used on childbirth. In all, it represented of total Medicaid spending in fiscal year 2023, according to听麻豆女优, a health information nonprofit that includes 麻豆女优 Health News.

GOP Law Limited Care Access for Immigrants With Legal Status

The Republican tax and spending law made several changes to health care eligibility for immigrants living in the country with permission. An estimated 1.4 million legal immigrants are expected to lose their health insurance, according to a 听of听听projections.听

Starting October 2026, the law will restrict eligibility for Medicaid and the Children’s Health Insurance Program to lawfully permanent residents, people from the Marshall Islands, Micronesia, or Palau who lawfully reside in the U.S. under an听, and certain听.

Previously, a broad group, described as “,” was eligible for Medicaid and its related Children’s Health Insurance Program, known as CHIP, including refugees and people granted asylum.

Some immigrants eligible for Medicaid and CHIP, such as lawful permanent residents, are听听before accessing the benefits.听

The law also limited Affordable Care Act marketplace eligibility to the same group eligible for Medicaid and CHIP beginning Jan. 1, 2027. Previously, people who were described as “” were eligible. That group included the “qualified noncitizens” eligible for Medicaid and people with short-term statuses, such as Temporary Protected Status or international students.

Beneficiaries of the Deferred Action for Childhood Arrivals program, known as DACA, for immigrants who entered the U.S. without authorization as children were previously eligible for Affordable Care Act coverage and its subsidies. They are ineligible since a took effect in August.

Democrats’ Proposal Would Restore Legal Immigrants’ Access

The Democrats’ 听would, in part,听听the Affordable Care Act subsidies and roll back billions in Republican cuts to Medicaid and other health programs.听

The change would make Medicaid, CHIP, and Affordable Care Act coverage available to all legal immigrants who were previously eligible for it, such as refugees and people granted asylum.

The Democratic proposal would not broaden eligibility to federally funded health care programs to immigrants lacking legal status.

Vance said the Democratic policies would “give hundreds of billions of dollars of health care benefits to illegal aliens,” and the White House did not offer its source for that figure. When Johnson听, he referenced the Congressional Budget Office. The 麻豆女优听analysis听of 听found that the Republican law’s provisions related to legal immigrants would reduce federal spending by $131 billion; this projection did not include an estimate for people without legal status.

Our Ruling

Vance said, “Democrats are threatening to shut down the entire government because they want to give hundreds of billions of dollars of health care benefits to illegal aliens.”

Immigrants in the U.S. illegally are largely ineligible for the federally funded health care programs Medicare and Medicaid, and they cannot seek coverage in the Affordable Care Act marketplace or apply for subsidies.

The Democrats’ budget proposal would not change that.

The Democrats want to restore access to certain health care programs to legal immigrants who will lose access under the Republican tax and spending law 鈥� among other measures aimed at making Medicaid and Affordable Care Act insurance plans easier to keep.听

Their proposal would not grant federally supported health care benefits to people in the U.S. illegally, because they did not have access to them in the first place. The small amount of funding designated for Emergency Medicaid reimburses hospitals that provide emergency care to immigrants who would be eligible for Medicaid if not for their immigration status. Finally, we did not find evidence for Vance’s assertion that Democrats want “hundreds of billions” in health benefits for migrants in the country illegally.听

We rate the statement False.

Our Sources

Fox News,听“, Sept. 28, 2025.

The White House,听“,” Sept. 30, 2025.

President Donald Trump,听, Sept. 29, 2025.

U.S. House of Representatives听, accessed Oct. 1, 2025.

Congressional Budget Office,听“,” Aug. 11, 2025.

PolitiFact,听“,” May 16, 2025.

麻豆女优,听“,” July 8, 2025.

麻豆女优,听“,” June 17, 2025.

麻豆女优,听“,” Jan. 15, 2025.

麻豆女优,听“,” Sept. 25, 2025.

U.S. Citizenship and Immigration Services,听“,” accessed Oct. 1, 2025.

U.S. Citizenship and Immigration Services,听“t,” accessed Oct. 1, 2025.

Healthcare.gov,听“,” accessed Oct. 1, 2025.

Federal Register,听“,” June 25, 2025.

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President Donald Trump on Sept. 22, 2025, in a press conference

Obstetricians have long advised their pregnant patients that Tylenol is the safest option to reduce fever or pain. President Donald Trump stood before a national audience on Sept. 22 and contradicted that.

“Don’t take Tylenol,” Trump said during an hourlong White House press conference that included his leading health appointees. “There’s no downside. Don’t take it. You’ll be uncomfortable. It won’t be as easy, maybe, but don’t take it. If you’re pregnant, don’t take Tylenol.”

His advice has no clear basis in research and contradicts long-standing science and medical guidance. And there are downsides to avoiding acetaminophen, the active ingredient in Tylenol, when it is needed. Untreated fever during pregnancy can harm a mom and baby, medical experts warn. Untreated pain is a drawback, too.

Trump’s advice is based on听听that acetaminophen use during pregnancy increases a child’s risk of autism 鈥� a stance that he and Robert F. Kennedy Jr., the longtime anti-vaccine activist who is now Trump’s Health and Human Services secretary, touted throughout the announcement.

Although some studies have found that children exposed to acetaminophen during pregnancy were more likely to have autism symptoms or be diagnosed with autism, other studies found no such association. Association is听not the same as causation. That means that research showing an association between Tylenol and autism doesn’t mean the medication听caused听autism.

The Food and Drug Administration’s听听on the topic said as much.

“It is important to note that while an association between acetaminophen and neurological conditions has been described in many studies, a causal relationship has not been established and there are contrary studies in the scientific literature,” it said. “It is also noted that acetaminophen is the only over-the-counter drug approved for use to treat fevers during pregnancy, and high fevers in pregnant women can pose a risk to their children.”

The White House declined to provide data showing there are no downsides to avoiding Tylenol use. It provided a statement from White House press secretary Karoline Leavitt in which she cited “a connection” between acetaminophen use during pregnancy and autism as the reason for the guidance.

“The Trump Administration does not believe popping more pills is always the answer for better health,” Leavitt said.

Leavitt also shared on the social platform X听听from Andrea Baccarelli, dean of the Harvard T.H. Chan School of Public Health, who said his research “found evidence of an association” between prenatal acetaminophen exposure and neurodevelopmental disorders in children. Baccarelli warned of the risks of high fever and advocated for cautious acetaminophen use during pregnancy 鈥� not blanket avoidance.

The Risks of Untreated Fever During Pregnancy

Maternal and prenatal care groups, including the听听and the听, support the use of acetaminophen during pregnancy.

They Trump’s remarks.

There’s good reason for that: Acetaminophen is one of few safe options pregnant patients have to treat fever and manage pain.

Trump acknowledged this during the press conference.

“Sadly, first question: What can you take instead?” he said. “There’s not an alternative.” He said that other medicines such as aspirin and Advil “are absolutely proven bad.”

In 2020,听听advised that nonsteroidal anti-inflammatory drugs, or NSAIDs, which include common pain relievers such as Advil (also known as ibuprofen), Aleve (or naproxen), and aspirin shouldn’t be used during pregnancy after 20 weeks of gestation.

Those medications aren’t recommended during pregnancy because they could harm fetal development, Salena Zanotti, a Cleveland Clinic obstetrician and gynecologist,听.

Untreated fevers during pregnancy come with their own risks.

In听, Steven Fleischman, the association’s president, said the Trump administration’s anti-Tylenol advice sends a “harmful and confusing message” to pregnant patients.

“Maternal fever, headaches as an early sign of preeclampsia, and pain are all managed with the therapeutic use of acetaminophen, making acetaminophen essential to the people who need it,” Fleischman said.

Christopher Zahn, ACOG’s chief of clinical practice,听said听pregnant patients should talk with their doctors about the benefits and risks of available treatments. Avoiding treating medical conditions that call for acetaminophen is “far more dangerous than theoretical concerns based on inconclusive reviews of conflicting science,” Zahn said.

Similarly, the Society for Maternal-Fetal Medicine said that untreated fever and pain during pregnancy carry “significant maternal and infant health risks.”

“Untreated fever, particularly in the first trimester, increases the risk of miscarriage, birth defects, and premature birth, and untreated pain can lead to maternal depression, anxiety, and high blood pressure,” it听said.

Research on these risks goes back more than a decade: A听听of available evidence on fevers during pregnancy found “substantial evidence” that maternal fever might negatively affect fetal health in the short and long term, including increasing the risks of neural tube defects, congenital heart defects, and oral clefts.

The Centers for Disease Control and Prevention 听that听fever听during pregnancy to including birth defects.

, a听nonprofit that provides information about the benefits and risks of medications and other exposures during pregnancy and while breastfeeding,听warns听that a fever-caused increase in body temperature during early pregnancy , including a small chance for birth defects. Some studies 听that fevers are associated with increased chances of a child having attention-deficit/hyperactivity disorder or autism.

Kenvue, Tylenol’s parent company, said acetaminophen is “the safest pain reliever” option available throughout pregnancy.

“Without it, women face dangerous choices: suffer through conditions like fever that are potentially harmful to both mom and baby or use riskier alternatives,” the company’s statement said. “High fevers and pain are widely recognized as potential risks to a pregnancy if left untreated.”

Tylenol, responding to the news attention听, cited the ACOG position on acetaminophen use during pregnancy and highlighted a section of the Tylenol label that encourages people who are pregnant or breastfeeding to talk to a health professional.

“Your doctor is the best person to advise whether taking medication is right for you based on your specific health needs,” the video said.

Our Ruling

Trump said “there’s no downside” to avoiding Tylenol use during pregnancy.

Researchers have long documented health risks associated with untreated fevers during pregnancy. They can lead to increased risk of birth defects and other pregnancy complications, particularly in the first trimester. Untreated pain can lead to maternal depression and anxiety. These risks outweigh conflicting research into possible links between the drug and autism, according to maternal and fetal health organizations.

Doctors and researchers have found acetaminophen to be a safe pain and fever reducer during pregnancy. By comparison, other over-the-counter pain relievers come with documented risks, making Tylenol one of the only options available to pregnant mothers.

We rate Trump’s statement Pants on Fire!

Sources

Emailed statement from Kenvue, Sept. 22, 2025

Emailed statement from the American College of Obstetricians and Gynecologists, Sept. 22, 2025

Emailed statement from the Society for Maternal-Fetal Medicine, Sept. 22, 2025

Emailed statement from White House press secretary Karoline Leavitt, Sept. 22, 2025

White House press secretary Karoline Leavitt’s听, Sept. 22, 2025

PolitiFact,听“,” Sept. 15, 2025

Tylenol听, Sept. 22, 2025

Cleveland Clinic, “” March 17, 2025

Email interview with Christopher Zahn, American College of Obstetricians and Gynecologists’ chief of clinical practice, Sept. 10, 2025

Centers for Disease Control and Prevention, “,” Sept. 17, 2024

Centers for Disease Control and Prevention, “,” June 25, 2024

Centers for Disease Control and Prevention, “,” June 17, 2024

MotherToBaby, “,” Feb. 1, 2025

Food and Drug Administration, “,” Jan. 19, 2016

Food and Drug Administration, “,” Sept. 22, 2025

American Journal of Obstetrics & Gynecology, “,” March 2017

American College of Obstetricians and Gynecologists,听“,” accessed Sept. 22, 2025

Vogue, “,” Sept. 22, 2025

The HIPAA Journal, “,” Jan. 22, 2025

Pediatrics, “,” March 1, 2014

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Robert F. Kennedy Jr. on Sept. 4 in a Senate Finance Committee hearing

When health secretary Robert F. Kennedy Jr. testified before the Senate Finance Committee on Sept. 4, several senators criticized him for restricting the covid-19 shots after promising in November he wouldn’t “take away anybody’s vaccines.”

“Did you hold up a big sign saying that you were lying when you said that?” Sen. Elizabeth Warren (D-Mass.) asked Kennedy.

On Aug. 27, the its covid , limiting the groups of people approved to get the updated shot to anyone 65 or older and any person at least 6 months old who has at least one underlying health condition that increases their risk of a severe covid infection.

Kennedy pushed back. “Anybody can get the booster,” he said, later adding that “it’s not recommended for healthy people.”

Warren said, “If you don’t recommend, then the consequence of that in many states is that you can’t walk into a pharmacy and get one. It means insurance companies don’t have to cover the $200 or so cost.”

Warren and Kennedy continued to speak over each other, debating the vaccines’ availability.

“It depends on the states,” Kennedy said. “But they can still get it. Everybody can get it. Everybody can get it, senator.”

Asked for evidence, the Health and Human Services Department pointed to an on the social platform X from Kennedy that said, “These vaccines are available for all patients who choose them after consulting with their doctors.”

Kennedy’s blanket statement to senators is misleading and premature.

Under current guidance, healthy people under 65 might need a doctor’s prescription to get the shot. If they successfully get a prescription, they may need to pay out-of-pocket.

Further, whether the vaccine is available at pharmacies and covered by insurance is largely dependent on a vaccine panel that has so far issued no recommendations.

What was the status quo for years 鈥� that most Americans, regardless of age, could easily make an appointment at their local pharmacy for the vaccine at little to no out-of-pocket cost 鈥� is no longer guaranteed in the 2025-26 season.

Limited Approval, No Guidance

The FDA’s approval is not the only step in the process of making vaccines available to the public.

The Advisory Committee on Immunization Practices, a panel of independent experts that guides vaccine policy, has not voted on or issued current guidance. Typically, the Centers for Disease Control and Prevention recommends vaccines based on the .

And that guidance affects insurance coverage and vaccine access. Federal law requires that most health insurance plans vaccines recommended by the CDC. also require these recommendations before they allow vaccines to be offered over-the-counter at pharmacies.

On June 9, Kennedy fired all 17 members of the CDC’s immunization advisory committee and with new members, many of whom have expressed anti-vaccine views. CDC Director Susan Monarez Aug. 27 over what Monarez described as a .

According to the CDC’s website, the advisory panel is Sept. 18 to 19.

Access Varies by State

People in the FDA-approved groups should be able to schedule vaccinations as soon as authorized health care providers receive supplies, likely in the next few weeks.

Even if you are in these approved groups, where you can get a covid shot varies by state. By law, pharmacies in certain states won’t be able to offer the vaccine or will administer it only with a doctor’s prescription until the CDC’s vaccine advisory panel .

That means despite the FDA having issued its approval for some groups, in 18 states and Washington, D.C., “pharmacists cannot administer it because it isn’t on the CDC immunization schedule yet,” Brigid Groves, the American Pharmacists Association’s vice president of professional affairs, .

As of Sept. 4, the scheduling apps for Walgreens and CVS notified patients in some locations that they could not schedule a covid vaccine appointment because of state restrictions, inventory, or the need for a prescription.

鈥極ff-Label’ Prescriptions

People not in the FDA’s approved group are not banned from getting a covid vaccine, per se. But accessing the vaccine will likely require navigating barriers.

Doctors can legally prescribe a covid vaccine for people who fall outside the FDA categories.

That’s true for adults and children 鈥� and the practice of prescribing medications and vaccines for “off-label” use is fairly common in pediatrics, William Schaffner, a Vanderbilt University Medical Center professor of infectious diseases, PolitiFact.

That requires making and paying for a doctor’s appointment, and finding a doctor willing to prescribe it off-label.

Depending on ACIP’s guidance, pharmacists might be able to vaccinate people not in an FDA-approved group through a process called “.”

That means, for example, “if you were 52 years old and otherwise healthy, but you nonetheless wanted to get the vaccine, you could discuss that with your doctor 鈥� shared clinical decision-making 鈥� and you could receive the vaccine,” Schaffner said.

Pharmacists are considered clinicians who can conduct shared decision-making, Groves said.

But again, without CDC recommendations, “we don’t know if that provision is still there,” Schaffner said.

Waiting on the CDC

Insurance coverage for the vaccine is still up in the air, too, and will largely depend on what the CDC recommends.

Insurance coverage is more probable for people in an FDA-approved category. But, if the CDC recommendations include giving vaccines to healthy people through the shared clinical decision-making process, insurance companies will generally honor that, Schaffner said.

Covid vaccines cost about $142, according to the . It’s unclear whether that would be the out-of-pocket cost for patients receiving a covid vaccine not covered by insurance.

Our Ruling

Kennedy said “everybody can get” a covid vaccine.

The FDA limited the groups of people eligible for the covid vaccines, which has already diminished the shots’ drugstore availability in some states. People who are not in those groups aren’t banned from getting a shot, but are likely to face additional barriers. For example, people may need a doctor to prescribe the vaccine “off-label,” making the process more challenging and potentially more costly.

Kennedy’s blanket statement also is premature.

A CDC vaccine panel has not issued recommendations for the vaccines. The group’s guidance might affect insurance coverage and over-the-counter access.

The statement contains an element of truth 鈥� the vaccine has not been banned and some people are approved to get it. But it ignores critical facts about the barriers others could face in accessing and paying for it. We rate it Mostly False.

PolitiFact staff writer Madison Czopek contributed to this report.

Our Sources

Email statement from the Department of Health and Human Services, Sept. 4, 2025.

PolitiFact, “” Aug. 29, 2025.

, Aug. 27, 2025.

Centers for Disease Control and Prevention, “,” Aug. 8, 2025.

NBC News, “,” Aug. 21, 2025.

PBS NewsHour, “,” Sept. 3, 2025.

USA Today, “,” Sept. 3, 2025.

PolitiFact, “,” June 18, 2025.

The Washington Post, “” Aug. 28, 2025.

Center for Infectious Disease Research & Policy, “,” Aug. 28, 2025.

Centers for Disease Control and Prevention, “,” June 18, 2025.

Centers for Disease Control and Prevention, “,” Jan. 7, 2025.

Centers for Disease Control and Prevention, , Sept. 1, 2025.

PBS News, “,” Sept. 3, 2025.

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Scott Jennings on “CNN NewsNight with Abby Phillip” on July 1

Republicans defended the GOP megabill’s Medicaid changes as targeting a group of people they believe shouldn’t qualify: people who can work but instead choose to stay home and chill.

Several 听and pundits, including CNN senior political commentator Scott Jennings, pegged that group’s size at about 5 million people.

“There are like almost 5 million able-bodied people on Medicaid who simply choose not to work,” Jennings 听on “CNN NewsNight with Abby Phillip.” “They spend six hours a day socializing and watching television. And if you can’t get off grandma’s couch and work, I don’t want to pay for your welfare.”

Centers for Medicare & Medicaid Services Administrator Mehmet Oz picked up on some of these points during a听听on Fox News. “When the program was created 60 years ago, it never dawned on anyone that you would take able-bodied individuals who could work and put them on Medicaid. Today the average able-bodied person on Medicaid who doesn’t work, they watch 6.1 hours of television or just hang out,” Oz said.

Medicaid is a federal-state health insurance program that covers medical care for lower-income people.

Jennings cited two pieces of data: an estimate of how many fewer people would have coverage because of the work requirement and an analysis of how nonworking Medicaid recipients spend their time. But he made assumptions that the data doesn’t support.

Jennings Misrepresents CBO Estimate

The 4.8 million figure stems from a June 24 听of a preliminary House version of the massive tax and spending package. The office, Congress’ nonpartisan research arm, projected that provisions of the bill would cause 7.8 million fewer people to have health coverage by 2034. They would include 4.8 million people previously eligible for Medicaid described as “able-bodied” adults 19 to 64 years old who have no dependents and who “do not meet the community engagement requirement” of doing “work-related activities”听at least 80 hours a month.

Apart from working, doing community service and attending school also fulfill the community engagement requirement.

Jennings paired that statistic with a separate analysis of how nondisabled adult Medicaid recipients without dependent children spend their time.

But the CBO estimate was a projection 鈥� it doesn’t represent the current number of nondisabled Medicaid recipients, nor does it say 4.8 million people in this group “choose not to work.” The figure represented how many fewer people would have coverage because of the bill’s community engagement requirement.

“The challenge with Jennings’ comments 鈥� and they’ve been echoed elsewhere by elected Republicans 鈥� is that CBO never said that 4.8 million people were out of compliance with the proposed work requirements; they said that 4.8 million people would lose coverage because of the work requirements,” said Adrianna McIntyre, an assistant professor of health policy and politics at the Harvard T.H. Chan School of Public Health.

Among the Medicaid expansion population, the law requires most adults without dependent children and parents of children older than 13 to work or participate in other qualifying activities 80 hours every month. States will need to verify that applicants met the work requirement for one to three months before they applied. States will also be required to verify that existing enrollees met the work requirement for at least a month between eligibility determinations, which will be required at least twice a year.

Research into Medicaid work requirements imposed at the state level has shown that people found it difficult to fulfill them and submit documentation, contributing to .

In Arkansas, which added a work requirement to Medicaid in 2018, a听study听based on nearly 6,000 respondents found that about 95% of the target population were already working or qualified for an exemption, but a third of them did not hear about the work requirements. As a result, nearly 17,000 Medicaid recipients subject to work requirements lost coverage.

听that adults ages 50 to 64 are more at risk of losing Medicaid coverage because of the new work requirements. More than 1 in 10 in that age group said they had retired, and among them, 28% reported being disabled, said 麻豆女优, a health information nonprofit that includes 麻豆女优 Health News.

Benjamin Sommers, a health care economics professor at the Harvard Chan school, said many of the 4.8 million “able-bodied” people in the CBO estimate “will actually be engaged in the activities they are supposed to be doing, and lose coverage because they are not able to navigate the reporting requirements with the state and lose coverage from red tape.”

When Recipients Don’t Work, It’s Rarely From Lack of Interest

There is no universal definition for “able-bodied”; disability can be assessed in different ways. But other studies offer much smaller estimates than 4.8 million Medicaid recipients without dependents who can work but choose not to.

Millions of working-age, nondisabled adults joined the Medicaid ranks in states that expanded eligibility under the Affordable Care Act. There were about 34 million working-age nondisabled Medicaid enrollees in 2024, , 15 million of whom enrolled through the ACA.

A听听found a smaller figure of 26 million Medicaid-covered adults, ages 19 to 64, who don’t receive Supplemental Security Income, Social Security Disability Insurance, or Medicare benefits.

Among this group, 麻豆女优 estimated, 64% were working either full time or part time. The reasons the rest were not working included caregiving (12%); illness or disability (10%); retirement, inability to find work, or other reason (8%); and school attendance (7%).

Few people cited lack of interest in working as the reason for their unemployment. An听听found 2% of Medicaid expansion enrollees without dependents who neither worked nor attended school 鈥� or听听out of a projected 15 million subject to work requirements 鈥� cited a lack of interest in working as the reason they were unemployed.

This was consistent with the听’s June 5 analysis that found that, of 4.3 million adult enrollees who worked fewer than 80 hours a month and did not have any activity limitations or illnesses, about 300,000 reported that they “did not work because they did not want to.”

Mostly Women, Mostly With a High School Degree or Less

听 nondisabled adult Medicaid recipients, they have often portrayed them as men in their 30s “playing video games” in their parents’ basement or who “smoke weed all day.” Research paints a different picture.

Jane Tavares and Marc Cohen, of the University of Massachusetts-Boston Gerontology Department,听 who are not disabled or working, have no dependent children under 18, and are not in school. They cited 2023 census data from the American Community Survey.

They found:

• The average age of this population is 41, and 26% are older than 50.
• Almost 80% are female.
• Most, 80%, have a high school education or less.
• Their median individual income is $0, and their median household income is $44,800.
• About 56% worked in the past five years, and 23% worked in the prior year. About 30% are looking or available for work.

“They are not healthy young adults just hanging out,” the authors, along with health law experts Sara Rosenbaum and Alison Barkoff,听.

“It’s clear based on their prior work history and family size/income that they are exceptionally poor and have likely left the workforce to care for adult children or older adults,” Tavares told PolitiFact. “Even if these individuals could work, they would have very few job opportunities and it would come at the cost of the people they are providing care for.”

AEI Study Not Definitively Linked to CBO Estimate

, Jennings posted the CBO letter and a 听by the American Enterprise Institute, a conservative think tank, about “how nondisabled Medicaid recipients without children spend their time.” PolitiFact contacted CNN to reach Jennings but did not receive a reply.

The author of that study, American Enterprise Institute senior fellow Kevin Corinth, analyzed survey data and found that Medicaid recipients who do not report working spend on average 6.1 hours a day “on all socializing, relaxing and leisure activities (including television and video games).”

But it’s uncertain whether the people in the survey population he analyzed overlap with the people included in the CBO analysis, said Jennifer Tolbert, deputy director of 麻豆女优’s Program on Medicaid and the Uninsured.

Corinth told PolitiFact “it is difficult to say” how the population he analyzed differs from the CBO’s. Tavares, Cohen, Rosenbaum, and Barkoff听said听Corinth’s dataset , leading to a “serious underestimation of disability” among the population of Medicaid recipients he looked into. It focused on Medicaid recipients who receive Supplemental Security Income or have a health condition that prevents them from working. The researchers said this approach is too narrow because the SSI program accounts for only those “most deeply impoverished adults with severe disabilities.”

The group gave a hypothetical example of a 54-year-old woman with a serious heart condition who can work only a few hours a week. She may not be considered disabled under the SSI program, but she may be limited in the work she can do and may need time to rest.

“Using her 鈥榣eisure time’ to justify a work requirement grossly misrepresents her reality,” the听group听wrote.

Corinth’s analysis also shows that nonworking Medicaid recipients spend less time socializing, relaxing, or engaged in leisure activities than nonworking people who aren’t covered by Medicaid. Nonworking Medicaid recipients also spend more time looking for work and doing housework and errands, it found.

Our Ruling

Jennings said almost 5 million nondisabled Medicaid recipients “simply choose not to work” and “spend six hours a day socializing and watching television.”

The 5 million figure stems from a CBO projection that 4.8 million people would go without coverage by 2034 as a result of not fulfilling the community engagement requirements. It is not descriptive of current enrollees and does not specify that these people choose not to work.

Jennings cited an American Enterprise Institute analysis on how nondisabled Medicaid recipients with no dependents spend their time, but it is uncertain if the population in that analysis overlaps with that in the CBO estimate.

Current snapshots of the population Jennings described produce a smaller number. A survey by the Urban Institute found that 2% of Medicaid expansion enrollees without dependents who were neither working nor attending school 鈥� about 300,000 people 鈥� cited a lack of interest in working. Other research has found reasons this group doesn’t work include caregiving, illness or disability, retirement, and inability to find work.

Studies of nonworking Medicaid recipients have found the majority are women and have a high school education or less. Their average age is 41, and more than half have a work history in the past five years.

We rate Jennings’ statement False.

Our Sources

Email interview, Jane Tavares, University of Massachusetts-Boston adjunct instructor in gerontology, July 2, 2025

Email interview, Marc Cohen, University of Massachusetts-Boston professor of gerontology, July 2, 2025

Email interview, Sara Rosenbaum, George Washington University Milken Institute School of Public Health professor emerita of health law and policy, July 2, 2025

Email interview, Alison Barkoff, George Washington University Milken Institute School of Public Health associate professor of health law and policy, July 2, 2025

Email interview, Edwin Park, Georgetown University McCourt School of Public Policy Center for Children and Families research professor, July 2, 2025

Email interview, Benjamin Sommers, Harvard T.H. Chan School of Public Health professor of health care economics, July 2, 2025

Phone interview, Jennifer Tolbert, deputy director of 麻豆女优’s Program on Medicaid and the Uninsured, July 2, 2025

Email interview, Adrianna McIntyre, Harvard T.H. Chan School of Public Health assistant professor of health policy and politics, July 2, 2025

Phone interview, Michael Karpman, Urban Institute Health Policy Division principal research associate, July 3, 2025

Email exchange, Congressional Budget Office spokesperson, July 2, 2025

Email interview, Kevin Corinth, American Enterprise Institute senior fellow, July 3, 2025

, June 30, 2025

July 1, 2025

Congressional Budget Office,听“,” June 24, 2025

Benjamin D. Sommers, M.D., Ph.D., Anna L. Goldman, M.D., M.P.A., M.P.H., Robert J. Blendon, Sc.D., E. John Orav, Ph.D., and Arnold M. Epstein, M.D.,听“,” June 19, 2019

Congressional Budget Office,听, June 2024

麻豆女优,听“,” May 30, 2025

Urban Institute,听“,” June 11, 2025

Wisconsin Watch,听“” July 2, 2025

CBS News,听“,” June 26, 2025

Brookings Institution,听“,” June 5, 2025

, July 2, 2025

American Enterprise Institute,听“,” May 29, 2025

Congressional Budget Office,听“,” June 29, 2025

Geiger Gibson Program in Community Health, George Washington University Milken Institute School of Public Health,听“,” June 4, 2025

, July 1, 2025

, July 2, 2025

LeadingAge LTSS Center @UMass Boston,听“,” May 2025

The Milbank Quarterly,听“,” April 30, 2025

麻豆女优,听“,” June 25, 2025

麻豆女优 Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at 麻豆女优鈥攁n independent source of health policy research, polling, and journalism. Learn more about .

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Sen. John Thune (R-S.D.), in an interview with KOTA on May 30, 2025

Millions of people are expected to lose access to Medicaid and Affordable Care Act marketplace health insurance plans if federal lawmakers approve the One Big Beautiful Bill Act, President Donald Trump’s domestic policy package, which is now moving through the Senate.

Senate Majority Leader John Thune discussed health care and the pending legislation in an , a South Dakota TV station. But he focused on a different kind of health insurance 鈥� employer-sponsored insurance.

“A lot of times, health care comes with a job,” Thune said.

Thune’s comments in the interview were made in the context of highlighting part of the GOP’s economic policy objective. “Creating those better-paying jobs that come with benefits is ultimately the goal here,” he said.

麻豆女优 Health News reached out to Thune’s office to find out the basis for this comment. His communications director, Ryan Wrasse, responded by reiterating Thune’s message: “Getting a job has the potential to lead a worker to acquiring health care.”

Paul Fronstin, director of health benefits research at the Employee Benefit Research Institute, said Thune’s comment may also be alluding to discussions surrounding Medicaid work requirements. The One Big Beautiful Bill Act enroll in Medicaid only if they prove they’re volunteering, working, or searching or training for work.

Medicaid, funded by the federal government and states, is the country’s main health insurance program for people with low incomes. Some people with disabilities also qualify.

Some Republicans have built on the jobs talking point in defending the Medicaid cuts and work requirements. Sen. James Lankford (R-Okla.), for instance, the bill isn’t about “kicking people off Medicaid. It’s transitioning from Medicaid to employer-provided health care.”

But the health policy experts we checked with made clear that getting a job isn’t a guarantee for getting work-sponsored insurance.

Employer-Sponsored Health Insurance: The Basics

These experts said most jobs do offer health insurance. But they also said the link between employment and work-based coverage is not always straightforward.

“When I see this statement, I’m like, 鈥業’ve got so much more to say about this.’ But I’m not arguing with the statement,” Fronstin said.

Matthew Rae, an associate director focused on researching private insurance at 麻豆女优, a health information nonprofit that includes 麻豆女优 Health News, also weighed in.

“Employer-sponsored coverage remains the bedrock of how people get health insurance in the United States,” Rae said. “I would say that getting a job is not a guarantee you’re going to have health insurance. It just increases your chances of getting it.”

About 60% of Americans younger than 65 receive health insurance through their job or as the spouse, child, or other dependent of someone insured through their work,

Among workers ages 18 to 64 who were eligible but didn’t sign up for their workplace insurance, 28% said the reason they decided not to enroll was that the plans were too expensive, showed.

Most of these workers found health insurance elsewhere, such as through a relative’s workplace plan. But a small percentage of eligible employees, 3.7%, .

Health insurance has been “the most valued benefit in the workplace” since businesses to recruit employees in a tight labor market during World War II, Fronstin said.

Federal law also encourages companies to offer plans. Under the Affordable Care Act, employers with 50 or more full-time workers if they don’t offer most employees insurance that the federal government considers affordable.

As of last year, 54% of companies offered health insurance to at least some employees, .

But that’s not the main way the of people without health insurance, said Melissa Thomasson, a professor at Miami University in Ohio who specializes in the economic history of health insurance. “Nearly all of that” change, she said, came from the ACA creating private marketplace plans and allowing states to expand Medicaid eligibility.

Health policy analysts say the One Big Beautiful Bill would make it more difficult for people to qualify or afford marketplace plans, with proposals that would increase paperwork, shorten enrollment periods, and allow enhanced tax credits to fizzle out. Thomasson also noted that political rhetoric surrounding jobs and health insurance doesn’t always align.

“We often talk about small businesses being the engine of job creation,” but those are the businesses that often can’t afford to offer workplace insurance, she said.

So Who Isn’t Insured Through Workplace Insurance?

The most obvious category of people who don’t have workplace insurance are those who don’t have a job. This group includes children and retirees, people searching for work, people who choose not to work, and those who can’t work, because of a disability or illness.

Another group without employer-provided insurance is the 25% of people ages 18 to 64 who have a job but are unable to obtain such insurance, according to .

Some of these people work for companies that don’t offer health insurance. These employers tend to be small businesses or part of certain industries, such as farming and construction.

Others are part-time, temporary, or seasonal workers at companies that offer health insurance only to full-time employees. Workers with low incomes are significantly less likely than those with higher incomes to be eligible for workplace insurance,

People who aren’t employed or don’t get insurance through their job can get coverage in other ways. Some are insured through a relative’s workplace plan, while others purchase plans and may qualify for subsidies on the ACA marketplace.

Others get insurance through Medicaid or Medicare, the federal health insurance program for people 65 or older and some people with disabilities.

Cost and Quality 鈥� And Therefore Access to Care 鈥� Vary

Just because someone has health insurance doesn’t mean they’ll get the health care they need. People may skip or delay care if their plans are unaffordable or if they limit in-network providers.

“Health benefits come in all shapes and sizes,” Fronstin said. “Some employers offer very generous benefits, and others less so.”

麻豆女优 data shows that premiums and enrollees’ cost-sharing expenses grew faster than wages but have .

Whether workplace insurance is affordable significantly varies by income. , lower-income families insured through a full-time worker spent, on average, 10.4% of their income on premiums and out-of-pocket costs. That’s more than twice the rate when looking at families across all incomes.

Our Ruling

Thune said, “A lot of times, health care comes with a job.”

This statement is partially accurate. Most workers in the U.S. get health coverage through work. But it glosses over aspects of our nation’s job-based health insurance system 鈥� such as how costs and coverage, especially for those with lower incomes, can make an employer plan out of reach even if it is available.

Bottom line: Not all jobs provide health insurance or offer plans to all their workers. When they do, cost and quality vary widely 鈥� making Thune’s statement an oversimplification.

We rate this statement Half True.

Sources

with Sen. John Thune, May 30, 2025.

with Sen. James Lankford, June 5, 2025.

麻豆女优, “,” Oct. 9, 2024.

麻豆女优, “,” Feb. 29, 2024.

麻豆女优, “,” May 28, 2024.

Peterson-麻豆女优 Health System Tracker, “” Dec. 22, 2023.

Peterson-麻豆女优 Health System Tracker, “,”March 10, 2022.

Peterson-麻豆女优 Health System Tracker, “,” Aug. 14, 2019.

Manhattan Institute, “” May 22, 2025.

Brookings, “,” July 22, 2024.

Harvard Business Review, “?” March 15, 2019.

on the One Big Beautiful Bill Act increasing the number of uninsured people, June 4, 2025.

Phone interview with Paul Fronstin, director of health benefits research at the Employee Benefit Research Institute and a member of the Commonwealth Fund’s National Task Force on the Future Role of Employers in the U.S. Health System, June 6, 2025.听

Phone interview with Melissa Thomasson, professor and health economist at Miami University, June 6, 2025.

Phone interview with Maanasa Kona, associate research professor at the Center on Health Insurance Reforms at Georgetown University, June 6, 2025.听

Phone interview with Matthew Rae, associate director for the Health Care Marketplace Program at 麻豆女优, June 10, 2025.听

Phone interview with Sally Pipes, president and CEO of the Pacific Research Institute, June 11, 2025.

Email correspondence with Ryan Wrasse, communications director for Sen. John Thune, June 10, 2025.

麻豆女优 Health News, “Some Employers Test Arrangement To Give Workers Allowance for Coverage,” Oct. 2, 2024.

麻豆女优 Health News, “Trump’s 鈥極ne Big Beautiful Bill’ Continues Assault on Obamacare,” June 3, 2025.

麻豆女优 Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at 麻豆女优鈥攁n independent source of health policy research, polling, and journalism. Learn more about .

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This story can be republished for free (details).

stated on June 1, 2025, in an interview on CNN’s “State of the Union.”

Responding to charges that President Donald Trump’s tax and spending bill would cut Medicaid coverage for millions of Americans, that it targets only waste, fraud, and abuse.

During an interview on CNN’s “State of the Union,” Russell Vought, the administration’s director of the Office of Management and Budget, framed Medicaid as sagging under the weight of improper payments.

An “improper” payment refers to payments made erroneously to beneficiaries and their providers or without sufficient documentation.

Pressed by CNN host Dana Bash about concerns that low-income Americans would suffer if the bill becomes law, Vought called such arguments “totally ridiculous.”

“This bill will preserve and protect the programs, the social safety net, but it will make it much more commonsense,” Vought said. “Look, one out of every $5 or $6 in Medicaid [payments] is improper.”

That would mean Medicaid’s improper payment rate is 16% to 20%.

In a 2024 report covering the years 2022, 2023, and 2024, Medicaid’s parent agency 鈥� the Centers for Medicare & Medicaid Services 鈥� said the rate was about 5.1%.

One conservative group, the Paragon Health Institute, said the agency has been using an incomplete calculation method and that the percentage could be as high as 25%. Other experts told PolitiFact that the actual numbers could be higher than what the federal government reports, although not as high as Paragon’s estimate.

The White House did not respond to an inquiry for this article.

How High Is the Medicaid Improper Payment Rate?

Medicaid and its closely related Children’s Health Insurance program to roughly , accounting for about one-fifth of health care spending overall. It is funded through a mix of federal and state money and is administered by states under federal government rules.

Every year, the Centers for Medicare & Medicaid Services publishes for the share of improper Medicaid payments, and in other federal health insurance programs the agency oversees.

In a 2024 review of in 2022, 2023, and 2024, the agency found that 5.09% of Medicaid payments totaling $31.10 billion were improper.

The 5.09% rate represented a decrease from the 8.58% rate cited in its 2023 report, which was also based on a three-year time span. The 2024 figure annual decline.

Are These Numbers Complete?

In March 2025, Brian Blase, a conservative health policy analyst and president of Paragon Health, a health policy think tank, that said the official CMS improper payment rate figures were unrealistically low for eight of the past 10 years, because in some years the agency failed to undergo widespread auditing of its beneficiaries’ Medicaid eligibility.

From 2017 to 2019, during Trump’s first term, Blase served as Trump’s special assistant for economic policy. Before that, he served as a health policy analyst for the Senate Republican Policy Committee and has worked for the Heritage Foundation, a conservative think tank.

The report said if the agency’s analysis had looked at eligibility checks every year, more ineligible beneficiaries and payments on their behalf would have been discovered. The report said this might have increased the improper payment rate as high as 25%, based on the rates found in 2020 and 2021, when a high number of eligibility checks were included in the agency’s methodology.

However, it’s hard to confirm whether lack of eligibility auditing caused higher improper payment rates in 2020 and 2021, said Jennifer Wagner, director of Medicaid eligibility and enrollment at the Center on Budget and Policy Priorities, a liberal think tank.

Wagner said Medicaid enrollment procedures have fluctuated, which could help explain the higher rates in some years rather than others. Using two years of data to generalize about trends across a decade, she said, is not necessarily valid.

Robert Westbrooks, the federal Pandemic Response Accountability Committee executive director who worked in government oversight roles during Democratic and Republican administrations, told PolitiFact it’s plausible that the officially reported improper payment rates for Medicaid could be too low.

However, Westbrooks said pinpointing how much higher the rate is in reality is a speculative process. “I don’t believe anyone can credibly quantify the [difference],” he said.

What Is an Improper Payment?

Health care experts emphasized that improper payments are not the same thing as waste, fraud, or abuse.

CMS maintains for these terms:

• Fraud: “When someone knowingly deceives, conceals, or misrepresents to obtain money or property from any health care benefit program.”
• Waste: “Overusing services or other practices that directly or indirectly result in unnecessary costs to any health care benefit program. Examples of waste are conducting excessive office visits, prescribing more medications than necessary, and ordering excessive laboratory tests.”
• Abuse: “When health care providers or suppliers perform actions that directly or indirectly result in unnecessary costs to any health care benefit program,” which can include overbilling or misusing billing codes.

By contrast, an improper payment “includes any payment to an ineligible recipient, any payment for an ineligible good or service, any duplicate payment, any payment for a good or service not received, and any payment that does not account for credit for applicable discounts,” 麻豆女优, a health information nonprofit that includes 麻豆女优 Health News, .

“Although all fraudulent payments are improper, not all improper payments are fraudulent,” said Jessica Tillipman, associate dean for government procurement law at George Washington University’s law school. “Most providers identify the improper payments and return them knowing how aggressively enforced” the legal provisions are. “When they don’t, they open the door to significant liability.”

CMS said about 79% of improper payments happened when there was .

This typically involved cases in which a state or provider missed an administrative step, and it did not necessarily indicate fraud or abuse, the agency said. Instead, it could be an accidental oversight or mistake.

In other words, it was rare for ordinary beneficiaries to be scamming the government. “The vast majority of fraud in Medicaid is committed by providers or other actors, not enrollees,” Wagner said.

Our Ruling

Vought said that “one out of every $5 or $6 in Medicaid [payments] is improper.”

The official improper payment rate calculated by the Centers for Medicare & Medicaid Services in 2024 was about 5%, smaller than the 16% to 20% rate Vought described.

A health policy analyst and former Trump adviser said methodological shortcomings in the agency’s analysis could mean the rate is as high as 25%. Although it’s possible the rate is higher than the 5% the government reported, how much higher is speculative.

The statement contains an element of truth but ignores critical facts, namely the federal government’s own data. We rate the statement Mostly False.

Our Sources

Russell Vought, ,” June 1, 2025.

Centers for Medicare & Medicaid Services, “,” Nov. 15, 2024.

Centers for Medicare & Medicaid Services, “,” accessed June 4, 2025.

Centers for Medicare & Medicaid Services, “,” accessed June 4, 2025.

Paymentaccuracy.gov, “,” accessed June 3, 2025.

麻豆女优, “,” March 18, 2025.

麻豆女优, “,” April 24, 2025.

Paragon Health Institute, “,” March 3, 2025.

Government Accountability Office, “,” March 11, 2025.

Email interviews with Tammie Smith and Craig Palosky, spokespersons for 麻豆女优, June 2, 2025.

Email interview with Jennifer Wagner, director of Medicaid eligibility and enrollment at the Center on Budget and Policy Priorities.

Email interview with Jessica Tillipman, associate dean for government procurement law at George Washington University’s law school, June 3, 2025.

Email interview with Robert Westbrooks, Pandemic Response Accountability Committee executive director who worked in government oversight roles during Democratic and Republican administrations, June 3, 2025.

麻豆女优 Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at 麻豆女优鈥攁n independent source of health policy research, polling, and journalism. Learn more about .

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President Donald Trump, in a May 11 post on Truth Social

President Donald Trump expressed high hopes for an executive order to reduce drug prices.

On May 11, the day before he held a White House event to sign the executive order, Trump posted on Truth Social, “Prescription Drug and Pharmaceutical prices will be REDUCED, almost immediately, by 30% to 80%.”

However, the听,听unveiled May 12, undercut the president’s description of how soon consumers could experience this potential boon.

The idea of the executive order, he said, was to lower high prescription drug costs in the U.S. to levels more typical in other countries.

“We’re going to equalize,” Trump said at the order signing. “We’re all going to pay the same. We’re going to pay what Europe’s going to pay.”

Experts said Trump’s action could lower the cost of prescription drugs, perhaps by the 30% to 80% Trump said, but they cautioned that the order’s required procedural steps would make it far from an immediate fix.

The听executive order听says that within 30 days, administration officials must determine and communicate to drugmakers “most-favored-nation price targets,” to push the companies to “bring prices for American patients in line with comparably developed nations.”

After an unspecified period of time, the administration will gauge whether “significant progress” toward lower pricing has been achieved. If not, the order requires the secretary of Health and Human Services to “propose a rulemaking plan to impose most-favored-nation pricing,” which could take months or years to take effect.

“Executive orders are wish lists,” said Joseph Antos, a senior fellow emeritus in health care policy at the conservative American Enterprise Institute. The order “hopes that manufacturers will unilaterally lower U.S. prices. The legal authority to intervene in the market is unclear if this implausible scenario doesn’t happen.”

When contacted for comment, the White House did not provide evidence that the executive order would provide immediate results.

Why Do Americans Pay More for Prescriptions?

There is 听that drug prices are unusually high in the U.S. The prices Americans pay for pharmaceuticals are nearly three times the average among a group of other industrialized countries in the Organization for Economic Cooperation and Development.

A听, a nonpartisan research organization, found that, across all drugs, U.S. prices were 2.78 times as high as the average prices across 33 OECD countries. The gap was even wider for brand-name drugs, with U.S. prices averaging 4.22 times as much.

The U.S. has lower prices than comparable nations for unbranded, generic drugs, which account for about 90% of filled prescriptions in the U.S. But generics account for only a fifth of U.S. prescription drug spending.

Experts cite several reasons for this pricing discrepancy.

One is that the U.S. has more limited price negotiation with drug manufacturers than听听do. Often, if another country fails to find the extra cost of a new drug is justified by improved results, it’ll reject the drug application. Some countries also set听.

Another factor is patent exclusivity. Over the years, U.S. pharmaceutical companies have used strong legal protections to amass patents that can keep generic competitors from the marketplace.Drug companies have also argued that high prices help pay for research and development of new and improved pharmaceuticals. When Trump released the executive order, Stephen J. Ubl, president and CEO of the drug industry group Pharmaceutical Research and Manufacturers of America, , “It would mean less treatments and cures and would jeopardize the hundreds of billions our member companies are planning to invest in America.” (In Trump’s May 13 interview with Fox News’ Sean Hannity, Trump offered a different picture of what drug company officials have told him; he said they agreed “it’s time” to lower U.S. prices.)

Recent studies have cast doubt on the idea that high prices pay for research and development. A听听found that from 1999 to 2018, the world’s 15 largest biopharmaceutical companies spent more on selling and general administrative activities, which include marketing, than on research and development. The study also said most new medicines developed during this period offered little to no clinical benefit over existing treatments.

The long-standing reality of high U.S. drug prices has driven Democratic and Republican efforts to bring them down. Then-President Joe Biden signed legislation to require Medicare, the federal health care program that covers Americans over 65, to听听with the makers of some popular, high-cost medicines. And Sen. Bernie Sanders (I-Vt.) has made lowering drug prices a听听during his political career.

During his first term, Trump sought to lower prices for certain drugs under Medicare, but the courts听 on procedural grounds.

Trump’s drug-price push could attract bipartisan support, experts said.

Jonathan Cohn, who has worked for several left-of-center media outlets 听听on health care policy,听 for Trump’s executive order in The Bulwark, a publication generally critical of Trump, calling it “a serious policy initiative, one that credible people think could bring some relief on drug prices.”

Andrew Mulcahy, a Rand Corp. senior health economist, said one part of Trump’s statement 鈥� the possibility of a 30% to 80% price reduction 鈥� is plausible.

“Of course, the devil’s in the policy design and implementation details,” Mulcahy said. “But at first blush, a savings of roughly two-thirds on what we spend now for drugs seems in line” with what Rand’s research has shown.

What Would Trump’s Executive Order Do?

Referring to high U.S. drug prices, Trump told Hannity that “I ended it” by issuing the executive order. But that’s not how the order is structured.

The executive order makes plain that any actions will not happen quickly.

“That 鈥榓lmost’ in 鈥榓lmost immediately’ is doing a lot of work,” Mulcahy said, referring to Trump’s statement.

The executive order also could face court challenges, just as Trump’s first-term executive order did.

“It seems unlikely that the federal government can set prices for drugs outside of the Medicare program,” Antos said. If Trump wants reduced prices to benefit all U.S. consumers, experts said, Congress will likely have to pass new legislation. While executive orders direct federal agencies what to do, requiring action from privately owned companies likely would require legislation passed by Congress, experts said.

If Congress gets involved, that will not only tack on extra time, but it also could draw opposition from the Republican majority in one or both chambers. Historically, Antos said, “federal price controls are anathema for many Republicans in Congress.”

Our Ruling

Trump said that, because of his new executive order, prescription drug prices would be reduced “almost immediately.”

Experts said that if the goals of the executive order are achieved, price reductions would not happen “almost immediately.”

The order sets out a 30-day period to develop pricing targets for drugmakers, followed by an unspecified amount of time to see if companies achieve the targets. If they don’t, a formal rulemaking process would begin, requiring months or even years. And if Trump intends to lower prices for all consumers, not only those who have federal coverage such as Medicare, Congress will likely have to pass a law to do it.

Trump gives the impression that Americans will shortly see steep decreases in what they pay for prescription drugs. But even if the executive order acts as intended 鈥� which would require a lot to go right 鈥� it could take months or years.

The statement contains an element of truth but ignores evidence that would give a different impression. We rate it Mostly False.

Sources

Donald Trump, , May 11, 2025

White House, “,”听May 12, 2025

Rand Corp., “,” February 2024

Government Accountability Office, “,” March 2021

The BMJ, “,” Feb. 15, 2023

Pharmaceutical Research and Manufacturers of America, “,” May 12, 2025

USA Today, “,” May 12, 2025

The Associated Press, “,” Dec. 23, 2020

The Associated Press, “,” Aug. 15, 2024

PolitiFact, “,” March 4, 2024

Email interview with Joseph Antos, senior fellow emeritus in health care policy at the American Enterprise Institute, May 12, 2025

Email interview with Andrew Mulcahy, senior health economist with Rand Corp., May 12, 2025

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Kennedy held an April 16听听pegged to a new 听that found the听 rising to 1 in 31 among 8-year-olds, the latest in a series of increases in recent decades.

Kennedy said “autism destroys families” and is an “individual tragedy as well.”听

Kennedy said many autistic children were “fully functional” and had “regressed” into autism “when they were 2 years old. And these are kids who will never pay taxes, they’ll never hold a job, they’ll never play baseball, they’ll never write a poem, they’ll never go out on a date. Many of them will never use a toilet unassisted.”

He also said: “Most cases now are severe. Twenty-five percent of the kids who are diagnosed with autism are nonverbal, non-toilet-trained, and have other stereotypical features.”

Medical experts, along with people on the autism spectrum, told PolitiFact that Kennedy’s portrayal was skewed. A 2023 study written by CDC officials and university researchers found that one-quarter of people on the autism spectrum have severe limitations. But this is on the high end of studies, and many people in that one-quarter of the autism population do not have the limitations Kennedy mentioned.听

The vast majority of people on the spectrum do not have those severe challenges.

“I wish he would spend some time with parents of other autistic children, and well-regarded scientists who have studied this condition for decades,” said David Mandell, a University of Pennsylvania psychiatry professor and director of the Penn Center for Mental Health. “He has a fixed, myopic view.”

The Department of Health and Human Services did not provide data on what share of people with autism diagnoses are unable to do the things Kennedy described.听

“Secretary Kennedy remains committed to working toward a society where people with autism have access to meaningful opportunities, appropriate supports, and the full respect and recognition they deserve,” department press secretary Vianca N. Rodriguez Feliciano told PolitiFact. “His statements emphasized the need for increased research into environmental factors contributing to the rise in autism diagnoses, not to stigmatize individuals with autism or their families.”

听that an HHS spokesperson said Kennedy “was referring to those that are severely affected by this chronic condition” and that “this was in no way a general characterization.”

We took a closer look at the available data and research.

What Is Autism Spectrum Disorder?

At root, “autism is a difference in how your child’s brain works that shapes how they interact with the world around them,” according to the听. People with autism diagnoses, the clinic says, “may excel more in certain areas and need more support in other areas compared to their neurotypical peers.”

Over the years, autism’s definition and diagnosis has changed.

In the 1950s and 1960s, “it is very likely that many people with profound autism were misdiagnosed with 鈥榤ental retardation,’ a term in use at the time, or schizophrenia, while other autistic people probably got no diagnosis at all,” said John J. Pitney Jr., a Claremont McKenna College politics professor, author of the book “The Politics of Autism: Navigating the Contested Spectrum,” and a father of an autistic son who’s about to graduate from college.

In more recent decades, the diagnostic criteria for autism have broadened, producing a spectrum ranging from severe impacts to more modest ones. Today’s definition encompasses “individuals with milder symptoms, stronger language skills, and higher IQs,” said Christopher Banks, president and CEO of the Autism Society of America.

How Common are the More Limiting Forms of Autism?

Autism’s expanded definition means a minority of people on the spectrum have the kinds of severe limitations Kennedy cited, though it’s hard to say how many.

The highest total we found comes from a , written by CDC officials and university researchers. It found that 26.7% of 8-year-olds with autism had “profound” autism, a newly framed (and not universally accepted) definition that included children who were nonverbal, were minimally verbal, or had an IQ below 50. (“Average” IQ is considered 90 to 109.)

People with profound autism “will require lifetime, round-the-clock care,” said Judith Ursitti, co-founder and president of the Profound Autism Alliance, a nonprofit. Ursitti said her 21-year-old son “is not headed towards employment or a career in poetry or baseball. Acknowledging this fact is important, as this population is often excluded from media portrayals and research.”

Other estimates are lower.听

A ,听by researchers at the University of Utah and Children’s Hospital of Philadelphia, looked at 1,368 U.S. children with autism. When parents were asked whether they would characterize their child’s autism as “severe,” 10.1% said yes. Among this group of children with “severe” autism, a minority 鈥� 38% 鈥� were classified as having a “severe” intellectual disability.听

“Even among those with an intellectual disability, there’s huge variability,” Mandell said. “People with Down syndrome have an intellectual disability but often are quite capable and can do all the things RFK points to.”

The CDC published听 showing that 42% of people with autism had an IQ in the average or higher range, and 听has found that this figure could be as high as 60%.听

Zoe Gross, the director of advocacy at the Autistic Self Advocacy Network, said limited available data suggests that Kennedy’s characterization is exaggerated.

Gross, who is on the spectrum herself, said 听found that 61% of people on the spectrum who were studied were employed. As for baseball, the Special Olympics, which was founded by Kennedy’s family and includes competitors who are on the spectrum, . At least two people who played major league baseball,听听and听, were public about their autism diagnoses.听

Gross said there is no official data on autistic poets, but she was aware of the poet听, a nonspeaking but highly literate advocate. Gross was also unable to find data on dating, but she said she’s married, and she pointed to the Netflix reality show “,” which follows autistic people’s dating lives. It is now in its third season.听

As for not using a toilet unassisted, the 2024 study that analyzed 1,368 U.S. children with autism and found that 10.1% were considered “severe” found that 67% of those in the “severe” category had trouble bathing or dressing, which, if generalizable to the entire autistic population, would be less than 7%. 听found urinary incontinence reported by 12.5% of the autistic people studied and fecal incontinence by 7.9%.

Eric M. Garcia, who is on the spectrum and who has written the book “We’re Not Broken: Changing the Autism Conversation,” was covering Kennedy’s remarks as Washington bureau chief of The Independent. Hearing his words “felt so demoralizing,” Garcia told PolitiFact. “A lot of people will respond by saying, 鈥楬e didn’t mean autistic people like you.’ But that doesn’t make it any better.”

PolitiFact staff writer Madison Czopek contributed to this article.

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Rep. Nick LaLota (R-N.Y.), in a YouTube video posted March 4, 2025

On Feb. 25, Rep. Nick LaLota (R-N.Y.) voted in favor of a that calls for sharp cuts in spending across a vast array of government areas. Medicaid is among the programs that could be at risk 鈥� catapulting it to the center of the political debate.

he won’t harm Medicaid, Medicare, and Social Security benefits, saying his administration is looking to root out fraud. , saying the sheer size of the proposed cuts will result in harm to the Medicaid program, its enrollees, and medical providers.

has found widespread public support for Medicaid, which suggests efforts to cut the program could face political headwinds. 麻豆女优 is a health information nonprofit that includes 麻豆女优 Health News.

LaLota, who represents part of Long Island, for his constituents explaining his position: “I voted yes on a budget resolution that protects Social Security, Medicare, and Medicaid while cutting some spending elsewhere.” Because much of his video focused on Medicaid, we did too. We found that his statement in this regard was layered with mischaracterizations and inaccuracies. Yet, in his video, LaLota advises his constituents to get their information straight from him, saying, “I’ll always be honest with you.”

We asked LaLota’s office for the information he used to back up his statement. The budget resolution makes no cuts to those programs, he wrote in a statement emailed by his communications aide Mary O’Hara. “Rather, it opens the door to protect Medicaid with common-sense solutions which ensure its availability for those Americans who qualify, including the removal of illegals from the rolls, work requirements for able-bodied adults, and the elimination of waste, fraud, and abuse.”

Let’s parse what the resolution does say and do, and the changes it could trigger for Medicaid.

Explaining the Basics

Budget resolutions are not law, but rather blueprints that guide lawmakers on budget-related legislation. The House-passed resolution 鈥� approved with voting for it and 214 Democrats and one Republican against 鈥� is just one part of the budget process. The Senate also has a say, so changes are possible.

As written, the resolution seeks broad spending reductions across a range of areas overseen by various committees. It specifically asks the House Committee on Energy and Commerce to submit proposals “to reduce the deficit by not less than $880,000,000,000 [$880 billion] for the period of fiscal years 2025 through 2034.”

It does not say it would protect Medicaid. The word Medicaid is nowhere in the document. It does not prescribe any specific action on the program, such as instituting work requirements for recipients. Lawmakers separately draft legislation to make program adjustments to achieve the spending cut targets.

A little background: Medicaid is a state-federal program that provides medical coverage to lower-income residents, as well as payments to nursing homes for caring for seniors and disabled residents. Medicaid and the closely related Children’s Health Insurance Program cover .

that provides health insurance for some disabled people and most people over age 65. More than 68 million people are enrolled.

The resolution directs the committee to draft legislative language that would cut spending from areas under its jurisdiction, which include Medicaid and about half of Medicare.

Social Security is mainly overseen in the House by the Committee on Ways and Means. The panel also shares jurisdiction over Medicare with Energy and Commerce.

Policy experts have said that, after removing Medicare from consideration, there’s not enough under the committee’s jurisdiction to cut $880 billion without substantially reducing Medicaid spending. (Medicare is generally considered a third rail because its beneficiaries are a powerful voting bloc.)

Indeed, of the $8.8 trillion in projected spending under the committee’s purview for the 10-year period, Medicaid accounts for $8.2 trillion, or 93%.

“Even if the committee eliminated all of non-Medicare and non-Medicaid spending, they would still have to cut Medicaid by well over $700 billion,” said Alice Burns, an associate director of 麻豆女优’s Program on Medicaid and the Uninsured.

Adding work requirements 鈥� most Medicaid recipients already have jobs 鈥� would not yield that level of savings and . Other cuts suggested by Republicans, including capping federal spending per enrollee, reducing federal matching dollars, and eliminating the use of provider taxes, which states use to pay for their share of Medicaid spending, could force states to cut spending or find new revenue sources.

“Cuts to Medicaid could mean eliminating coverage for children, parents, working adults or those who might need long term care; limiting benefits; or cutting payment rates for health plans or providers. These choices could come at a time when state revenue growth is slowing, and most states face requirements to pass balanced budgets,” according to an analysis by Robin Rudowitz, vice president of the 麻豆女优 Program on Medicaid and the Uninsured.

The downstream effects if the House-passed budget resolution were enacted would be wide-ranging and significantly alter the safety net program, said Edwin Park, a research professor at the Center for Children and Families at Georgetown University.

He noted growing opposition to such large-scale Medicaid cuts from “beneficiaries and parents of children with disabilities, families with parents in nursing homes, and from health care providers.”

“Medicaid cuts are highly unpopular even among Trump voters,” he said.

Opposition to Medicaid cuts helped kill the 2017 attempt to repeal the Affordable Care Act during the first Trump administration, noted Joseph Antos, a senior fellow emeritus at the American Enterprise Institute.

Antos thinks the current spending cut target is unrealistic and will likely not survive the effort to merge the House budget blueprint with what the Senate wishes to do.

“Ultimately, the problem is you can’t take that much out of Medicaid,” Antos said.

LaLota’s focus on immigrants lacking legal status as a way to reduce federal spending on Medicaid is also misleading.

, including New York, offer coverage to children or adults regardless of immigration status, but they can use only state money to pay for such programs.

“States cannot use federal funding to cover undocumented immigrants,” Burns said. So removing them “won’t do anything for the deficit reduction targets.”

Our Ruling

LaLota said, “On Feb. 25, I voted yes on a budget resolution that protects Social Security, Medicare, and Medicaid while cutting some spending elsewhere.”

His statement is inaccurate and mischaracterizes laws and the language included in the budget resolution, creating a false impression of what his vote supported.

The 32-word sentence that directs the Energy and Commerce Committee to trim $880 billion over 10 years from programs it authorizes does not include any protections, guardrails, or specific directions for the panel to follow.

We rate this claim False.

Sources:

Rep. Nick LaLota, , March 4, 2025.

Clerk, United States House of Representatives, “,” Feb. 25, 2025.

Newsweek, “,” March 10, 2025.

Rep. Hakeem Jeffries, , March 16, 2025.

麻豆女优, , March 7, 2025.

Medicaid.gov, “,” accessed March 17, 2025.

Congressional Budget Office, March 5, 2025.

麻豆女优 Quick Takes, “,” Feb. 20, 2025.

麻豆女优, “, Jan. 15, 2025.

Telephone interview with , senior fellow emeritus, American Enterprise Institute, March 17, 2025.

Telephone interview with , research professor at the Center for Children and Families, Georgetown University, March 17, 2025.

Telephone interview with associate director, Program on Medicaid and the Uninsured, 麻豆女优, March 17, 2025.

麻豆女优 Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at 麻豆女优鈥攁n independent source of health policy research, polling, and journalism. Learn more about .

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This story can be republished for free (details).