\t\t\t<\/p>\n
\tJulie Rovner
\n\tKFF Health News<\/p>\n
\t\t\t \t\t\t \t\t\t \t\t\tJulie Rovner is chief Washington correspondent and host of KFF Health News’ weekly health policy news podcast, “What the Health?” A noted expert on health policy issues, Julie is the author of the critically praised reference book “Health Care Politics and Policy A to Z,” now in its third edition.\t\t<\/p>\n The actions of federal Immigration and Customs Enforcement agents are having ramifications far beyond immigration. Medical groups say that ICE agents in health facilities in Minneapolis and other cities are imperiling patient care, while in Washington, the backlash from a second fatal shooting by agents in Minnesota has stalled action on an eleventh-hour suite of spending bills.<\/p>\n Meanwhile, anti-abortion groups remain unhappy with the Trump administration over what they see as its reluctance to scale back the availability of the abortion pill mifepristone.<\/p>\n This week’s panelists are Julie Rovner of KFF Health News, Maya Goldman of Axios, Alice Miranda Ollstein of Politico, and Rachel Roubein of The Washington Post.<\/p>\n \t\t\t \tMaya Goldman \t\t\t \t\t\t \t\t\t \t\t\t \tAlice Miranda Ollstein \t\t\t \t\t\t \t\t\t \t\t\t \tRachel Roubein \t\t\t \t\t\t Among the takeaways from this week’s episode:<\/p>\n And KFF Health News’ annual Health Policy Valentine contest is open. You can enter the contest here<\/a>.<\/p>\n Plus, for “extra credit” the panelists suggest health policy stories they read this week that they think you should read, too:<\/p>\n Julie Rovner:<\/strong> Science’s “U.S. Government Has Lost More Than 10,000 STEM Ph.D.s Since Trump Took Office<\/a>,” by Monica Hersher and Jeffrey Mervis.<\/p>\n Maya Goldman:<\/strong> NBC News’ “Many Obamacare Enrollees Have Switched to Cheaper Bronze Plans. Here’s Why That Could Be Risky<\/a>,” by Berkeley Lovelace Jr.<\/p>\n Alice Miranda Ollstein:<\/strong> The New York Times’ “After Donations, Trump Administration Revoked Rule Requiring More Nursing Home Staff<\/a>,” by Kenneth P. Vogel and Christina Jewett.<\/p>\n Rachel Roubein:<\/strong> Stat’s “HHS Appoints 21 New Members to Federal Autism Advisory Committee<\/a>,” by O. Rose Broderick.<\/p>\n Also mentioned in this week’s episode:<\/p>\n [Clarification:<\/strong> This article was revised at 12:30 p.m. ET on Jan. 30, 2026, to clarify that the agents involved in the Trump administration’s immigration crackdown represent not only the U.S. Immigration and Customs Enforcement agency but also the broader Department of Homeland Security.]<\/em><\/p>\n \t\t\t\t\tClick to open the transcript\t\t\t\t<\/p>\n \t\t\t\t\t\tTranscript: The Hazards of ICE for Public Health<\/strong>\t\t\t\t<\/p>\n [<\/em>Editor’s note:<\/em><\/strong>\u00a0This transcript\u00a0was generated\u00a0using transcription software. It has\u00a0been edited\u00a0for style and clarity.]<\/em>\u00a0<\/p>\n Julie Rovner:<\/strong>\u00a0Hello from\u00a0KFF\u00a0Health\u00a0News and WAMU\u00a0public radio\u00a0in Washington, D.C. Welcome to\u00a0What the\u00a0Health?<\/em>\u00a0I’m\u00a0Julie Rovner,\u00a0chief Washington correspondent for\u00a0KFF Health\u00a0News, and\u00a0I’m\u00a0joined by\u00a0some of\u00a0the best and smartest health reporters in Washington.\u00a0We’re\u00a0taping this week on Thursday, Jan.\u00a029,\u00a0at 10\u00a0a.m.\u00a0As always, news happens\u00a0fast\u00a0and things might have changed by the time you hear this. So,\u00a0here we go.\u00a0<\/p>\n Today\u00a0we\u00a0are joined\u00a0via\u00a0videoconference by Alice Miranda\u00a0Ollstein\u00a0of Politico.\u00a0<\/p>\n Alice Miranda\u00a0Ollstein:<\/strong>\u00a0Hello.\u00a0<\/p>\n Rovner:\u00a0<\/strong>Maya Goldman of Axios\u00a0News.\u00a0<\/p>\n Maya Goldman:<\/strong>\u00a0Hi.\u00a0<\/p>\n Rovner:\u00a0<\/strong>And Rachel\u00a0Roubein\u00a0of\u00a0The Washington Post.\u00a0<\/p>\n Rachel\u00a0Roubein:<\/strong>\u00a0Hi,\u00a0everyone.\u00a0<\/p>\n Rovner:\u00a0<\/strong>No interview\u00a0this iced-in\u00a0week here in Washington,\u00a0but\u00a0still\u00a0lots of\u00a0news. So last week at this time, Congress was busy patting itself on the back for\u00a0being poised\u00a0to pass all 12 annual appropriation bills before their Jan.\u00a030 deadline, including the two biggest ones, those funding the Departments of Defense and Health and Human Services.\u00a0Still, as\u00a0I believe I\u00a0said at the time, it’s not done until it’s done,\u00a0and,\u00a0well, it’s not done.\u00a0What happened, of course, is that after the House passed the remaining six spending bills and left for a week’s recess,\u00a0on Saturday,\u00a0federal\u00a0[Border Patrol]\u00a0officers shot and killed a VA\u00a0[Department of Veterans Affairs]\u00a0ICU nurse, Alex Pretti,\u00a0on the streets of Minneapolis, where he was participating in an\u00a0ICE\u00a0[Immigration and Customs Enforcement]\u00a0protest. That second killing of a civilian in three weeks\u00a0turned Senate Democrats,\u00a0who were supposed to approve the spending package this week,\u00a0unanimously against the spending bill for the Department of Homeland Security, which includes\u00a0ICE\u00a0and which\u00a0is included\u00a0within the appropriations package passed by the House last week. But\u00a0it’s\u00a0not as easy as splitting off the\u00a0Homeland\u00a0Security bill and passing the other five. If the Senate changes anything about the package, it\u00a0has to\u00a0go back to the\u00a0House, which, as I mentioned,\u00a0isn’t\u00a0even in town this week. So where are we?\u00a0And how likely is it that\u00a0we’re\u00a0going to look at a partial government shutdown\u00a0come\u00a0Saturday?\u00a0<\/p>\n Ollstein:<\/strong>\u00a0So\u00a0it’s\u00a0really a mess right now. You have\u00a0some\u00a0in both parties who are calling for passing the rest of the bills and pulling out the\u00a0Homeland\u00a0Security funding to keep negotiating.\u00a0Some\u00a0people are saying they should do a very short-term CR\u00a0[continuing resolution]\u00a0\u2014\u00a0a week, a couple\u00a0weeks\u00a0\u2014\u00a0in order to\u00a0give Congress more time to negotiate these reforms and restrictions that Democrats are demanding. But then you have House\u00a0Republicans who are saying,\u00a0Oh, if\u00a0we’re\u00a0opening this all back up again, we have\u00a0some\u00a0demands,\u00a0too, and we want more of this and more of that and XYZ<\/em>. And\u00a0so\u00a0they’re\u00a0saying,\u00a0We’re\u00a0gonna\u00a0defund all sanctuary cities<\/em>.\u00a0So, like you said, once you open this back up, it\u00a0opens up\u00a0a whole\u00a0can of worms. That said,\u00a0the Democrats’\u00a0base is really saying\u00a0don’t\u00a0give one penny more to this agency that they see as completely running amok and violating life and civil liberties. And\u00a0so\u00a0we’re\u00a0really at\u00a0kind of an\u00a0impasse right now.\u00a0<\/p>\n Rovner:<\/strong>\u00a0This is a classic\u00a0never-count-your-chickens in Congress. Maya, you want to add something.\u00a0<\/p>\n Goldman:<\/strong>\u00a0Yeah, I was going to\u00a0say,\u00a0it seems like the health\u00a0care package is collateral damage here, right?\u00a0There’s\u00a0a lot of\u00a0agreement, bipartisan agreement, that these changes that\u00a0they’re\u00a0trying to make, PBM\u00a0[pharmacy benefit manager]\u00a0changes, things like that,\u00a0should\u00a0be passed. But then, like you said, Julie,\u00a0it’s\u00a0never over till\u00a0it’s\u00a0over, and more time between getting a bill negotiated and\u00a0actually passing\u00a0it just gives interest groups more time to get things changed. So that will be interesting to see.\u00a0<\/p>\n Rovner:<\/strong>\u00a0And just a reminder for those who aren’t following this as closely as we are, there is this health package that’s riding along in this spending-bill package that includes the PBM reform and extensions for things like home health care and telehealth and other things that are not technically spending-bill issues but that need to be renewed periodically by Congress. So\u00a0that’s\u00a0also sitting out there waiting to see what the Senate decides to do and then what the House decides to do,\u00a0depending on what the Senate decides to do.\u00a0<\/p>\n Roubein:<\/strong>\u00a0And the last government shutdown,\u00a0in the fall,\u00a0was\u00a0based on health care. But as you mentioned, the fight was over Affordable Care Act subsidies, which is not part of this package that Julie mentioned.\u00a0<\/p>\n Rovner:<\/strong>\u00a0That’s\u00a0right. So that will continue. But I want to talk about\u00a0ICE. We have tiptoed into the immigration debate as it\u00a0impacts\u00a0health\u00a0care in recent months, but now\u00a0it’s\u00a0really front and center, and\u00a0I’m\u00a0talking about more than just the fight over ICE\u00a0tactics in Minnesota and blocking the spending bill for the entire Department of Health and Human Services. Maya,\u00a0you have a story<\/a>\u00a0about how\u00a0ICE\u00a0presence\u00a0in hospitals and other health\u00a0care facilities is having an impact on patient care. Tell us what you found.\u00a0<\/p>\n Goldman:<\/strong>\u00a0Yeah,\u00a0a lot of\u00a0physicians and nurses in Minneapolis, Twin Cities,\u00a0and also\u00a0across the country are saying that this is approaching, or has already\u00a0become,\u00a0a public health crisis. And the problem is twofold. It’s,\u00a0Part\u00a01, patients\u00a0aren’t\u00a0coming to get the care that they need, because\u00a0they’re\u00a0worried about leaving their homes. And one doctor during a press conference said she\u00a0even has patients who\u00a0don’t\u00a0want to take telehealth appointments,\u00a0because\u00a0they’re\u00a0afraid of getting on the phone or getting on the computer,\u00a0because\u00a0they’re\u00a0worried\u00a0they’re\u00a0being surveilled. So\u00a0that’s\u00a0a huge problem. And then\u00a0some\u00a0doctors are also saying that\u00a0ICE\u00a0presence in and around hospitals is making it harder for them to do their jobs of providing care, because there are reports of agents being aggressive and sort of being in places where they are not supposed to be, or are\u00a0physically impeding care.\u00a0So\u00a0two sides of the coin.\u00a0<\/p>\n Rovner:<\/strong>\u00a0Yeah,\u00a0a reminder that\u00a0ICE\u00a0was\u00a0largely forbidden\u00a0from\u00a0operating\u00a0in, quote,\u00a0“sensitive”\u00a0areas like schools and churches and health facilities,\u00a0in both Republican and Democratic administrations, until\u00a0[President Donald\u00a0Trump]\u00a0changed it last January.\u00a0We’ve\u00a0heard\u00a0a lot\u00a0since then about\u00a0ICE\u00a0being in\u00a0all of\u00a0these sensitive locations, right?\u00a0<\/p>\n Goldman:<\/strong>\u00a0Yeah,\u00a0yeah. And I think\u00a0it’s\u00a0important to\u00a0note\u00a0the Department of Homeland Security, when I reached out to them, said that they are not conducting enforcement operations in hospitals, even though they\u00a0are now allowed\u00a0to. If they take a patient\u00a0who’s\u00a0in custody\u00a0to\u00a0the hospital, they are in the hospital. They can get a warrant to come into the hospital. They can be in public spaces like parking lots and waiting rooms, waiting for people.\u00a0<\/p>\n Rovner:<\/strong>\u00a0And as\u00a0we’re\u00a0hearing,\u00a0that’s\u00a0exactly what\u00a0they’ve\u00a0been doing.\u00a0<\/p>\n Goldman:<\/strong>\u00a0Exactly.\u00a0<\/p>\n Rovner:<\/strong>\u00a0Even though\u00a0they’re\u00a0not, quote-unquote,\u00a0“conducting enforcement operations”\u00a0there.\u00a0Doesn’t\u00a0mean\u00a0they’re\u00a0not there. So even the American Medical Association, not exactly a left-wing group, issued a statement expressing concern about\u00a0ICE\u00a0activity in and around hospital emergency rooms, which it called a,\u00a0quote,\u00a0“tactic\u00a0fueling fear among patients and hospital staff alike.”\u00a0Are we starting to turn a corner here? I feel like this is,\u00a0maybe it\u00a0was a combination of what happened last week,\u00a0coincided with the big snowstorm in half the country and people were stuck inside watching TV. I do feel like there’s way more awareness than there was even two or three weeks ago of this stuff.\u00a0<\/p>\n Ollstein:<\/strong>\u00a0I think it\u00a0remains to\u00a0be seen\u00a0whether there is\u00a0a meaningful policy and\u00a0practice\u00a0change or just a sort of symbolic or rhetorical change.\u00a0There’s\u00a0a different tone\u00a0being struck.\u00a0There’s\u00a0sort of backpedaling\u00a0on\u00a0the immediate reaction from government officials we heard,\u00a0which was to blame the people who\u00a0were killed\u00a0for their own killings. There are calls for investigations coming from both sides of the aisle. There are calls for\u00a0some\u00a0top officials’\u00a0resignations. But again,\u00a0we’re\u00a0hearing from people on the ground that things have not actually shifted in the enforcement behavior of these agents. And\u00a0so\u00a0I think it\u00a0really remains to\u00a0be seen\u00a0what happens in Congress in terms of passing policies. There’s discussion of putting limitations in the spending bill on what\u00a0ICE\u00a0can do. But again, there is a lot of concern that I’ve heard from the advocacy community that they’re going to set up some government official\u00a0\u2014\u00a0whether it’s\u00a0[Homeland Security Secretary]\u00a0Kristi Noem\u00a0or\u00a0[Trump deputy chief of staff]\u00a0Stephen Miller or,\u00a0already we’ve seen\u00a0[Border Patrol official\u00a0Gregory]\u00a0Bovino\u00a0\u2014\u00a0to be a fall guy\u00a0and then nothing will actually change substantially beyond that. And\u00a0so\u00a0there’s continued anxiety around that.\u00a0<\/p>\n Rovner:<\/strong>\u00a0Yeah, and\u00a0just a reminder that even if the spending bill\u00a0doesn’t,\u00a0for the Department of Homeland Security,\u00a0didn’t\u00a0pass and they\u00a0didn’t\u00a0even\u00a0do\u00a0a continuing resolution,\u00a0ICE\u00a0has\u00a0I believe\u00a0it’s\u00a0$75 billion\u00a0from the budget bill that passed last year.\u00a0So\u00a0they have\u00a0a big chunk\u00a0of money to keep\u00a0operating\u00a0regardless.\u00a0Talk about collateral damage\u00a0\u2014\u00a0it would be\u00a0all of\u00a0these other agencies that would have to sort of stop operating if there is\u00a0some kind of a\u00a0shutdown.\u00a0<\/p>\n Well, meanwhile,\u00a0it’s\u00a0not just\u00a0ICE\u00a0that’s\u00a0going after the state of Minnesota. The Centers for Medicare\u00a0&\u00a0Medicaid Services earlier this month cut off a chunk of the state’s Medicaid funding\u00a0going forward.\u00a0They’re\u00a0charging that the state is, quote,\u00a0“operating its program in substantial noncompliance”\u00a0with rules to detect waste, fraud,\u00a0and abuse. This is not how this is supposed to work. CMS can sanction states for their anti-fraud efforts being lacking, but\u00a0there’s\u00a0supposed to be\u00a0a lot of\u00a0due process first, with\u00a0lots of\u00a0hearings and\u00a0appeals and fact-finding and all kinds of\u00a0mumbo jumbo that we do go through before people\u00a0actually get\u00a0sanctioned.\u00a0That’s\u00a0apparently not\u00a0what’s\u00a0happening here. Although the\u00a0ICE\u00a0headlines are overshadowing the other punitive measures the\u00a0federal government is taking toward Minnesota,\u00a0I’m\u00a0kind of surprised\u00a0this aspect of the story\u00a0isn’t\u00a0getting more attention. Might it when other governors realize that this could happen to them,\u00a0too, even if they\u00a0didn’t\u00a0happen to be on the ballot against Trump in the last election, like Minnesota Gov. [Tim]\u00a0Walz\u00a0was?\u00a0<\/p>\n Goldman:<\/strong>\u00a0Yeah, I was talking to somebody in the Medicaid space from a different blue state who was\u00a0saying this feels like a turning point, something that they\u00a0are scared\u00a0of\u00a0happening\u00a0in their state as well.\u00a0And,\u00a0yeah,\u00a0I think there\u00a0are\u00a0a lot of\u00a0things that we need to see how they’ll play out, but this is\u00a0definitely raising\u00a0eyebrows.\u00a0<\/p>\n Rovner:<\/strong>\u00a0Yeah, and I will post in the show notes\u00a0a link to a piece<\/a>\u00a0by Andy Schneider\u00a0\u2014\u00a0who’s at Georgetown University and\u00a0who\u00a0wrote, when he worked on the Hill, wrote a lot of the Medicaid statute\u00a0\u2014\u00a0explaining how this is all supposed to work and quite how different this is. But I would expect to be hearing more about this in the coming days and weeks, particularly if the administration\u00a0doesn’t\u00a0back off, because\u00a0it’s\u00a0a lot of\u00a0money and,\u00a0as we know, Medicaid is a huge, huge piece of every single\u00a0state’s\u00a0budget.\u00a0<\/p>\n Well, meanwhile, on the abortion front, last week was the annual March for Life, marking the anniversary of the now overturned Supreme Court decision\u00a0Roe v.\u00a0Wade<\/em>, and it’s fair to say that the anti-abortion movement is not happy with the Trump administration’s actions so far on the issue. Let’s start with what the administration did do to prove its devotion to the anti-abortion cause, To mark the movement’s big day in D.C., the Department of Health and Human Services reinstated its first-Trump-term ban on the use of fetal tissue in biomedical research, which President\u00a0[Joe]\u00a0Biden had reversed, and it expanded pretty dramatically the so-called Mexico\u00a0City\u00a0Policy that bans\u00a0U.S.\u00a0funding for international groups that, quote,\u00a0“perform”\u00a0or\u00a0“promote”\u00a0abortion. Now things like\u00a0DEI [diversity, equality, and inclusion]\u00a0and gender-affirming care\u00a0are included,\u00a0too. Alice and Rachel,\u00a0you guys\u00a0cover this. What should we know about these two new policies? It\u00a0doesn’t\u00a0seem like\u00a0much,\u00a0because they had both been in effect before, but\u00a0it’s\u00a0pretty big.\u00a0<\/p>\n Ollstein:<\/strong>\u00a0So\u00a0the fetal tissue ban is also,\u00a0research, is also an expansion of the first-term version, just like the Mexico City Policy. It goes further than before. And\u00a0so\u00a0the\u00a0new version\u00a0bans not only in-house government research but also government funding of research at outside institutions that use fetal tissue that\u00a0was donated\u00a0from abortions,\u00a0and that has\u00a0been used\u00a0in\u00a0all kinds of\u00a0really important\u00a0medical research,\u00a0development\u00a0of\u00a0vaccines,\u00a0etc.\u00a0And\u00a0so\u00a0there is\u00a0a lot of\u00a0concern about that. They also imposed new restrictions on accepting new stem cell lines.\u00a0There are\u00a0lots of\u00a0existing stem cell lines that they just keep propagating\u00a0over and over\u00a0from a long time ago, but\u00a0they’re\u00a0pausing\u00a0accepting new ones while,\u00a0they say,\u00a0they’re\u00a0exploring\u00a0alternatives that they find more ethical. All of this has really rattled the research community.\u00a0<\/p>\n And as for the Mexico City Policy, the expansion there is far beyond the issue of abortion.\u00a0It’s\u00a0banning funding going to groups that promote what they consider\u00a0DEI\u00a0and what they consider\u00a0gender ideology. And\u00a0so\u00a0this is groups that serve\u00a0the trans community in other countries and have programs for specific marginalized groups. So again,\u00a0a lot of\u00a0concern in\u00a0the\u00a0public health world\u00a0because\u00a0in order to\u00a0tackle big public health problems, you often need to direct resources to the communities most at risk, and often that is the trans community, that is racial minorities. And\u00a0so\u00a0there’s\u00a0a fear of this really impeding the delivery of services in a way that will\u00a0impact\u00a0the broader population.\u00a0<\/p>\n Rovner:<\/strong>\u00a0All right, so now to what the administration\u00a0didn’t\u00a0do that makes the anti-abortion movement so unhappy\u00a0\u2014\u00a0anything further to restrict the abortion pill mifepristone. In fact, as expected, the Justice Department filed its brief in a closely watched lawsuit out of Louisiana this week, urging the court to pause the suit while the FDA\u00a0[Food and Drug Administration]\u00a0finishes its study of mifepristone, a study that abortion opponents say is the FDA purposely using to drag its feet on any action.\u00a0So\u00a0what the heck\u00a0is going on here? Rachel, you start.\u00a0<\/p>\n Roubein:<\/strong>\u00a0Yeah,\u00a0basically the\u00a0Department of Justice\u00a0asked for a stay<\/a>\u00a0in this lawsuit in Louisiana, and\u00a0basically their\u00a0justification was that:\u00a0The Food and Drug Administration is reviewing mifepristone. We need time to do that.<\/em>\u00a0So that was\u00a0basically\u00a0what\u00a0their\u00a0ask\u00a0was, was,\u00a0like:\u00a0Put this on pause. We will do this review<\/em>\u00a0that, as you said, anti-abortion advocates have been upset and said that it has been moving too slowly.\u00a0<\/p>\n Ollstein:<\/strong>\u00a0So I really saw the\u00a0legal\u00a0brief was kind of a Rorschach test that people could see different things and signs in it, because you had the pro-abortion-rights community looking at them saying:\u00a0Look, they’re saying that the FDA didn’t properly review this in the past, and that’s why they’re doing this rigorous review now.\u00a0That’s\u00a0a sign that\u00a0they’re\u00a0going to impose restrictions.<\/em>\u00a0Also, the anti-abortion side looked at\u00a0it\u00a0and they were upset, one,\u00a0that the Justice Department is arguing that the FDA allowing telemedicine\u00a0doesn’t\u00a0harm the states, and the\u00a0states believe that it does, and so\u00a0they’re\u00a0saying:\u00a0You\u00a0can’t\u00a0prove harm. You\u00a0don’t\u00a0have\u00a0standing\u00a0to bring this case.<\/em>\u00a0I think really the common theme in this filing and in\u00a0some\u00a0other\u00a0ones\u00a0last year\u00a0related to these state abortion lawsuits is that the Trump administration is defending federal power and federal decision-making, and that can cut both ways. And\u00a0so\u00a0they’re\u00a0saying,\u00a0Leave it to us<\/em>. And the anti-abortion groups are saying:\u00a0We\u00a0don’t\u00a0trust you. We\u00a0don’t\u00a0want to leave it\u00a0to\u00a0you. We want to let these state lawsuits move forward.<\/em>\u00a0<\/p>\n Just to very quickly go back,\u00a0the Trump administration did one other thing around the\u00a0March for\u00a0Life as a bone to the anti-abortion community,\u00a0throwing them a bone, and that is they are attempting to claw back\u00a0tens\u00a0of millions of dollars in covid loans that went to Planned Parenthood affiliates.\u00a0A lot of\u00a0these loans\u00a0were already forgiven\u00a0by the Biden administration, but they are trying anyways to claim there was fraud going on and to get their money back. This boils down to\u00a0sort of wonky\u00a0arguments of whether the specific state Planned Parenthood chapters\u00a0are considered\u00a0enough part of\u00a0national Planned Parenthood that they\u00a0can’t\u00a0claim to be a small business. This is going to\u00a0be a legal fight. Planned Parenthood\u00a0maintains\u00a0they did absolutely nothing wrong. The state affiliates are separate from the national group, but\u2014\u00a0<\/p>\n Rovner:<\/strong>\u00a0Which they\u00a0are, by the way.\u00a0<\/p>\n Ollstein:<\/strong>\u00a0They are. They are. And courts have found that they\u00a0are\u00a0in the past. However, the anti-abortion movement was\u00a0very\u00a0excited\u00a0about this. They see it as the first step towards declaring all\u00a0Planned\u00a0Parenthoods ineligible for any government funding,\u00a0something\u00a0they’re\u00a0calling debarment, which\u00a0they’ve\u00a0been pushing for\u00a0for\u00a0a while. So\u00a0that’s\u00a0one other thing to keep an eye on.\u00a0<\/p>\n Rovner:<\/strong>\u00a0And a reminder,\u00a0many,\u00a0many\u00a0Planned\u00a0Parenthoods\u00a0don’t\u00a0and never have offered abortion.\u00a0Well\u00a0we\u00a0won’t\u00a0get as far into the weeds as we could here, but if you press me, I will.\u00a0All right,\u00a0we’re\u00a0going to take a quick break. We will be right back.\u00a0<\/p>\n So over at the Department of Health and Human Services, we have yet another mysterious case of stopping funding and then almost\u00a0immediately\u00a0restarting it. Earlier this month, the Substance Abuse and Mental Health Services Administration cut off\u00a0nearly\u00a0$2 billion\u00a0worth of grants to drug abuse and mental health providers, only to reverse that decision a day later. Now,\u00a0nearly\u00a0the\u00a0same thing has\u00a0basically happened\u00a0with about\u00a0$5 billion\u00a0worth of grants from the Centers for Disease Control and Prevention to all 50 state health departments for things like community outreach, emergency preparedness,\u00a0and disease outbreaks. According to The Washington Post, which broke\u00a0the story<\/a>, notices to states were sent out Friday and barely 12 hours later, an HHS official told the\u00a0Post the funding pause,\u00a0quote,\u00a0“had been lifted.”\u00a0Still, it\u00a0apparently took\u00a0several\u00a0more days for states to be able to access their funding portals. You\u00a0can’t\u00a0help but think that at least\u00a0some of\u00a0this is an actual effort to destabilize the nation’s public health infrastructure, right?\u00a0They\u00a0can’t\u00a0be that sort of disorganized that\u00a0they’re\u00a0going to cut off funding and put it back.\u00a0There\u00a0has to\u00a0be a reason here.\u00a0Rachel,\u00a0you’re\u00a0smiling.\u00a0<\/p>\n Roubein:<\/strong>\u00a0My colleague Lena\u00a0Sun\u00a0and I were hearing about this on Saturday, ahead of the\u00a0big storm. State officials were trying to kind of figure out\u00a0what’s\u00a0going on.\u00a0With the mental health grants, you saw\u00a0a very kind\u00a0of concerted push from the advocacy community, from Republicans and Democrats on the Hill,\u00a0to push for,\u00a0that was a termination of those grants,\u00a0to\u00a0be rescinded, and they were within about a day. This happened\u00a0sort of over\u00a0the weekend, and it happened very quickly. So, I\u00a0can’t\u00a0say what the result of\u00a0sort of the\u00a0change was,\u00a0because the notices\u00a0were dated\u00a0Friday, but state officials\u00a0didn’t\u00a0really start getting them\u00a0till\u00a0on\u00a0Saturday. And then\u00a0we’d\u00a0heard sort of midday Saturday that the temporary pause\u00a0was lifted. But\u00a0it\u00a0definitely threw,\u00a0sort of,\u00a0state and local health departments that we were talking about into sort of a state of confusion trying to figure out sort of what they needed to do\u00a0and\u00a0by when.\u00a0<\/p>\n Rovner:<\/strong>\u00a0Yeah, and we have seen this repeatedly from this administration.\u00a0These are sort of two dramatic cases just this month, but the stopping and starting of grant funding is making it impossible to do any planning and figure out what you can do when.\u00a0It’s\u00a0just, it feels like just a matter of,\u00a0Let’s\u00a0make it as hard as possible for these people to do their jobs.<\/em>\u00a0<\/p>\n Goldman:<\/strong>\u00a0Yeah, and\u2014\u00a0<\/p>\n Rovner:<\/strong>\u00a0By\u00a0“these,”\u00a0yeah,\u00a0I’d\u00a0say by\u00a0“these people”\u00a0I mean the grant recipients, not the people who are overseeing the money.\u00a0<\/p>\n Goldman:<\/strong>\u00a0I\u00a0can’t\u00a0claim to know exactly\u00a0what’s\u00a0going on behind the scenes, but I think,\u00a0what do you expect to happen when you gut\u00a0all of\u00a0the administrative functions of these agencies, which is what HHS did earlier this year?\u00a0And of course,\u00a0some of\u00a0those people have come back, but\u00a0there’s\u00a0a lot of\u00a0instability in HHS’\u00a0rank-and-file workforce itself, and so that naturally will trickle down to their grantees.\u00a0<\/p>\n Rovner:<\/strong>\u00a0Right, and particularly at the CDC. Well, adding to that,\u00a0elsewhere at the CDC,\u00a0some\u00a0key databases, mostly concerning vaccines, are not\u00a0being updated.\u00a0That’s\u00a0according to\u00a0a study<\/a>\u00a0in this week’s Annals of Internal Medicine\u00a0medical\u00a0journal. The study found what the authors called\u00a0“unexplained pauses”\u00a0in\u00a0nearly half\u00a0of the 82 databases they studied that\u00a0are normally updated\u00a0monthly.\u00a0Eighty-seven percent\u00a0of those databases were on vaccination-related topics. Now,\u00a0this could be political. It could also be due, as Maya was just saying,\u00a0to the\u00a0budget and personnel cuts at CDC that\u00a0we’ve\u00a0talked about so much over the past year. But it does seem that\u00a0we’re\u00a0continuing to fly ever more blind on things like disease surveillance, right?\u00a0<\/p>\n Goldman:<\/strong>\u00a0Yeah, and then when you couple that with the state and local public health divisions are the ones who would be the backstop there, but if their funding is in question\u00a0now, that is even more concerning for public health surveillance.\u00a0<\/p>\n Rovner:<\/strong>\u00a0Yeah, and of course, we are in the middle of big measles outbreaks in South Carolina and Texas and trying to watch that closely, but\u00a0it’s\u00a0hard to do if you only have\u00a0sort of state-by-state\u00a0backups to look at.\u00a0<\/p>\n All right.\u00a0Well, before we go, we need to talk about the Affordable Care Act. Remember the Affordable Care Act?\u00a0Before it\u00a0was subsumed\u00a0by all the other headlines?\u00a0Apparently, the\u00a0Senate is still working on a bipartisan compromise that could restart lapsed subsidies that have spiked health insurance premiums for millions of Americans. And\u00a0apparently things\u00a0aren’t\u00a0going all that well. And to add to it,\u00a0here’s\u00a0the headline on the press release for\u00a0the latest\u00a0KFF\u00a0poll<\/a>,\u00a0hot off the presses just this morning\u00a0\u2014\u00a0quote,\u00a0“Health\u00a0Care\u00a0Costs\u00a0Tops\u00a0the\u00a0Public’s\u00a0Economic\u00a0Worries\u00a0as the\u00a0Runup to the\u00a0Midterms\u00a0Begin;\u00a0Independent\u00a0Voters\u00a0Are\u00a0More\u00a0Likely to\u00a0Trust Democrats than Republicans on the\u00a0Issue<\/a>.”\u00a0On the other hand, the poll did find that Republicans still trust Republicans more. And while the ACA\u00a0remains\u00a0pretty popular\u00a0overall, it is less popular with Republicans than it was before last fall’s campaign by Republicans to blame\u00a0all of\u00a0the health care system’s ills on the 2010 health law. So where does that leave us?\u00a0We’re\u00a0with\u00a0\u2014\u00a0this is the end of January. People who have been\u00a0sort of reenrolled\u00a0in the ACA are starting to get these huge premium notices that they may or may not be able to pay. Has Congress just\u00a0kind of moved\u00a0onto the next crisis?\u00a0<\/p>\n Ollstein:<\/strong>\u00a0So\u00a0some\u00a0people in Congress are still trying to resolve this crisis, even as new crises pile up. The bipartisan talks are still going on, but there is just not\u00a0a lot of\u00a0optimism here. There is not really\u00a0agreement\u00a0on\u00a0lots of\u00a0aspects of extending the subsidies, and all of this is really discussing, at most,\u00a0sort of a\u00a0one-year extension. And\u00a0so\u00a0they would just have to have this whole fight all over again. But yes, I would say things are looking\u00a0more bleak\u00a0on that front than even\u00a0a few\u00a0weeks ago.\u00a0I\u00a0don’t\u00a0know what my fellow panelists think.\u00a0<\/p>\n Rovner:<\/strong>\u00a0And\u00a0any anybody\u00a0have\u00a0optimism for getting these subsidies extended?\u00a0I’m\u00a0not seeing anybody raising their\u00a0hand. Well,\u00a0we will continue, obviously, to watch this space.\u00a0<\/p>\n All right. Lastly, health insurers are starting to get the same heartburn as the pharmaceutical industry.\u00a0Last week,\u00a0in back-to-back hearings at the House Energy and Commerce and Ways and Means committees, the heads of five of the biggest health insurers got\u00a0pretty much\u00a0filleted\u00a0by\u00a0members of both parties. Then this week, the Trump administration\u00a0kind of shocked\u00a0the markets by offering a much-smaller-than-expected increase for private Medicare Advantage plans. Those have been the darlings of Republicans for a couple of decades\u00a0now. Maybe Republicans do really mean it when they say they want to stop giving so much taxpayer money to health insurers?\u00a0<\/p>\n Goldman:<\/strong>\u00a0I was a little bit struck by how surprised everybody was at\u00a0this, because\u00a0I think\u00a0[CMS Administrator]\u00a0Dr.\u00a0Mehmet\u00a0Oz has been hinting that he’s much more amenable to cracking down on reported improper behavior among Medicare Advantage plans than people anticipated the next Trump administration would be.\u00a0And\u00a0there’s\u00a0really this groundswell in the House of Representatives as well among Republicans to sort of rein in improper spending\u00a0in\u00a0Medicare Advantage.\u00a0<\/p>\n Rovner:<\/strong>\u00a0Sen.\u00a0Bill Cassidy has been pretty\u2014\u00a0<\/p>\n Goldman:<\/strong>\u00a0Yes.\u00a0<\/p>\n Rovner:<\/strong>\u00a0\u2014outspoken on it, which surprised\u00a0a lot of\u00a0people. Now\u00a0his,\u00a0the committee that\u00a0he’s\u00a0the\u00a0chairman\u00a0of\u00a0doesn’t\u00a0have\u00a0jurisdiction\u00a0over this, but he is also a member of the\u00a0Finance\u00a0Committee,\u00a0which does have\u00a0jurisdiction\u00a0over this.\u00a0<\/p>\n Goldman:<\/strong>\u00a0Exactly. Exactly. And\u00a0so\u00a0to me it\u00a0wasn’t\u00a0that surprising,\u00a0I have to say.\u00a0But\u00a0it sent\u00a0shock\u00a0waves through the markets?\u00a0Obviously, insurers are saying that if this\u00a0is\u00a0finalized\u00a0as proposed,\u00a0they’re\u00a0going to have to cut benefits for seniors even\u00a0more,\u00a0they’re\u00a0going to have to raise premiums and things like that. And of course this could be a bad political move,\u00a0potentially,\u00a0for Republicans. But\u00a0I think\u2014\u00a0<\/p>\n Rovner:<\/strong>\u00a0Because there are\u00a0lots of\u00a0Republican voters who are in Medicare Advantage plans\u2014\u00a0<\/p>\n Goldman:<\/strong>\u00a0Absolutely.\u00a0<\/p>\n Rovner:<\/strong>\u00a0\u2014and\u00a0don’t\u00a0want to\u00a0see their benefits cut.\u00a0<\/p>\n Goldman:<\/strong>\u00a0Absolutely,\u00a0and Medicare Advantage insurers have been saying this\u00a0over and over again.\u00a0The Biden administration was also\u00a0pretty conservative\u00a0on Medicare Advantage.\u00a0I guess maybe\u00a0“conservative”\u00a0is a funny word choice, but\u2014\u00a0<\/p>\n Rovner:<\/strong>\u00a0Light-handed.\u00a0<\/p>\n Goldman:<\/strong>\u00a0Yes.\u00a0<\/p>\n Rovner:<\/strong>\u00a0Were light-handed.\u00a0<\/p>\n Goldman:<\/strong>\u00a0Yes,\u00a0I think, and\u00a0insurers were\u00a0largely able\u00a0to weather that. Of course, there are\u00a0some\u00a0changes that\u00a0they’re\u00a0making this year.\u00a0We’re\u00a0seeing\u00a0some\u00a0market realignment.\u00a0So\u00a0it, another year of that, who knows what would happen.\u00a0But\u00a0I think it\u00a0still remains\u00a0to\u00a0be seen\u00a0how impactful this will\u00a0actually be\u00a0for beneficiaries.\u00a0<\/p>\n Rovner:<\/strong>\u00a0Yeah, well, another constituency to\u00a0get riled\u00a0up in the run-up to the midterms. All right, that is this week’s news. Now\u00a0it’s\u00a0time for our\u00a0extra-credit\u00a0segment.\u00a0That’s\u00a0where we each recognize the story we read this\u00a0week\u00a0we think that you should read,\u00a0too.\u00a0Don’t\u00a0worry if you miss it.\u00a0We’ll\u00a0post the links in our show notes on your phone or other mobile device. Alice, why don’t you start us off this week?\u00a0<\/p>\n Ollstein:<\/strong>\u00a0Yeah.\u00a0So\u00a0I have this fascinating investigation from\u00a0The New York Times. The headline is\u00a0“After\u00a0Donations, Trump\u00a0Administration Revoked Rule Requiring More Nursing Home Staff<\/a>.”\u00a0So\u00a0this is a story about these nursing home industry groups making massive donations to Trump’s super PAC and,\u00a0after that, gaining\u00a0a lot of\u00a0access to him and using that access to lobby for the scrapping of a rule that required minimum staffing in\u00a0nursing homes. And that rule was already not really\u00a0being enforced, but now they are getting rid of it formally. And so I think the story does a good job of saying,\u00a0Look, we can’t prove exactly that they got rid of this rule because of the donations, but it is part of a pattern where people who have given a lot of money to the\u00a0president’s various groups have gotten just an incredible amount of access to him and other top officials.<\/em>\u00a0And the story also stresses\u00a0why we should care about all of this.\u00a0There’s just been a lot of horrific data coming out of nursing homes of problems caused by understaffing,\u00a0patients\u00a0experiencing preventable injuries, infections and other health problems that go unnoticed until it’s too late or it gets way more serious, and even facilities using, basically drugging patients to keep them\u00a0easy to control and complacent,\u00a0because there just isn’t enough staff to attend to them.\u00a0People who have dementia and other things\u00a0need\u00a0a lot of\u00a0care and can get\u00a0upset and disoriented.\u00a0And instead of taking care of them,\u00a0they’re\u00a0putting\u00a0them\u00a0on heavy\u00a0psychotropic drugs. And\u00a0so\u00a0it’s a\u00a0really sad\u00a0and serious situation, and this article shows\u00a0some\u00a0potential pay to play.\u00a0<\/p>\n Rovner:<\/strong>\u00a0Yeah, I tend to be, in general, skeptical of administrations doing things that we thought they were going to do\u00a0anyway\u00a0and someone else happened to give them money.\u00a0But this draws a pretty clear line.\u00a0They did do what they were going to do anyway, which was going to\u00a0sort of not\u00a0really enforce these regulations.\u00a0Anyway\u00a0it’s\u00a0really\u00a0good story.\u00a0Should\u00a0read it. Maya.\u00a0<\/p>\n Goldman:<\/strong>\u00a0My\u00a0extra credit this week is\u00a0“Many Obamacare\u00a0Enrollees\u00a0Have\u00a0Switched to\u00a0Cheaper Bronze\u00a0Plans. Here’s\u00a0Why\u00a0That\u00a0Could\u00a0Be\u00a0Risky<\/a>,”on NBC News by Berkeley Lovelace Jr. And\u00a0it’s\u00a0one of those stories that, wow, I wish I had written this. It’s a really great explanation of one of the sort of lesser-talked-about side effects of losing enhanced ACA subsidies, which is that people are going into plans that are\u00a0\u2014\u00a0they’re still opting to be in insurance, but they’re taking plans that are lower premiums but much higher deductibles, which means that their coverage is less valuable. And they might still have to pay\u00a0a lot of\u00a0money out-of-pocket for most services, and then they might not seek those services, which\u00a0sort of negates\u00a0the purpose of having health insurance and its effect on public health. And this story shows that Kentucky, Idaho, Massachusetts, New York, Virginia, Rhode Island, California are all seeing decreases in\u00a0“silver”\u00a0plan enrollment, which is\u00a0sort of that\u00a0lower-deductible, higher-premium tier, and increases in\u00a0“bronze”\u00a0enrollment, which is super-high-deductible.\u00a0So\u00a0huge thing to watch.\u00a0<\/p>\n Rovner:<\/strong>\u00a0Really,\u00a0really good\u00a0explanation.\u00a0Rachel.\u00a0<\/p>\n Roubein:<\/strong>\u00a0My extra credit is by\u00a0Stat\u00a0News. The headline is\u00a0“HHS\u00a0Appoints 21\u00a0New Members to a Federal Autism Advisory Committee<\/a>,”\u00a0by O.\u00a0Rose Broderick. And the story lays out how the Department of Health and Human Services yesterday, on Wednesday, announced the appointment of new members to a federal committee that will advise Secretary\u00a0[Robert\u00a0F.]\u00a0Kennedy\u00a0[Jr.]\u00a0on autism.\u00a0Broderick\u00a0reports that\u00a0many\u00a0of the new members of the committee, which\u00a0is called\u00a0the\u00a0Interagency Autism Coordinating Committee, have publicly expressed or belonged to groups that have publicly expressed a belief in the debunked claim that vaccines can cause autism. Stat had\u00a0also reported<\/a>\u00a0earlier this week that the members of the committee had met in secret and that some members of the kind of broader autism community were worried about the panel.\u00a0And just kind of for sort of the big-picture point of view, Kennedy, last year, pledged to find the causes of autism. And during his tenure as HHS\u00a0secretary,\u00a0he’s\u00a0challenged years of public health messaging on vaccines, such as instructing the CDC to contradict the long-settled scientific conclusion that vaccines do not cause autism. Kennedy, in a press release\u00a0yesterday, called the researchers\u00a0“the most qualified experts\u00a0\u2014\u00a0leaders with decades of experience studying, researching,\u00a0and treating autism.”\u00a0<\/p>\n Rovner:<\/strong>\u00a0Yet another piece of this.\u00a0There’s\u00a0a lot\u00a0of\u00a0advisory committees at HHS, and there are\u00a0many\u00a0of them worth keeping a close eye on. All right, my extra credit this week is from\u00a0Science\u00a0magazine,\u00a0by Monica\u00a0Hersher\u00a0and Jeffrey Mervis.\u00a0It’s\u00a0called\u00a0“U.S.\u00a0Government\u00a0Has Lost More Than 10,000 Stem Ph.D.s Since\u00a0Trump\u00a0Took Office<\/a>,”\u00a0and it puts\u00a0some actual numbers to the science brain drain that\u00a0we’ve\u00a0been talking about. The authors looked at 14 agencies across the federal government, including the NIH\u00a0[National Institutes of Health],\u00a0FDA,\u00a0and CDC at HHS. They noted that those 10,000-plus experts represented only 3% of the more than 300,000 federal workers\u00a0who’ve\u00a0left employment since Trump took office, but they\u00a0represent\u00a014% of the total number of\u00a0Ph.D.s\u00a0in science, technology, engineering, math,\u00a0and health fields. Most\u00a0quit\u00a0or retired after taking buyouts rather than\u00a0being fired, according to the data. But as the authors noted, quote,\u00a0“these departing\u00a0Ph.D.s\u00a0took with them a wealth of subject matter expertise and knowledge about how these agencies operate.”\u00a0Certainly\u00a0a win for the Trump administration, which wants to remake the federal government’s approach to science. For the rest of us, we will have to wait and see.\u00a0<\/p>\n OK, that’s this week’s show.\u00a0Before we go, a reminder that our annual\u00a0KFF\u00a0Health\u00a0Policy Valentine contest is open. We want to see your clever, heartfelt,\u00a0or hilarious tributes to the policies that shape health care.\u00a0Submit your poem, whether conventional, free-form, or\u00a0haiku, by noon Eastern on Wednesday, Feb.\u00a04. The winning poem will receive a custom comic illustration in the\u00a0Morning\u00a0Briefing<\/a>\u00a0on Feb.\u00a013.\u00a0I will post a link to\u00a0the formal announcement<\/a>\u00a0in our show notes.\u00a0<\/p>\n As always, thanks to our editor,\u00a0Emmarie Huetteman,\u00a0and our producer-engineer,\u00a0Francis Ying.\u00a0A\u00a0reminder:\u00a0What the\u00a0Health?<\/em>\u00a0is now available on WAMU platforms, the NPR app,\u00a0and wherever you get your podcasts, as well as, of course,\u00a0kffhealthnews.org<\/a>.\u00a0Also, as always, you can email\u00a0us\u00a0your comments\u00a0or questions.\u00a0We’re\u00a0at\u00a0whatthehealth@kff.org<\/a>,\u00a0or you can still find me on\u00a0X,\u00a0@jrovner<\/a>,\u00a0or on\u00a0Bluesky,\u00a0@julierovner<\/a>. Where are you folks these days?\u00a0Maya?\u00a0<\/p>\n Goldman:<\/strong>\u00a0You can find me on\u00a0LinkedIn<\/a>\u00a0under my name or on\u00a0X,\u00a0@mayagoldman_<\/a>.\u00a0<\/p>\n Rovner:<\/strong>\u00a0Alice.\u00a0<\/p>\n Ollstein:<\/strong>\u00a0Still on\u00a0X,\u00a0@AliceOllstein<\/a>,\u00a0and on\u00a0Bluesky,\u00a0@alicemiranda<\/a>.\u00a0<\/p>\n Rovner:<\/strong>\u00a0Rachel.\u00a0<\/p>\n Roubein:<\/strong>\u00a0LinkedIn<\/a>\u00a0under my name.\u00a0Bluesky,\u00a0@rachelroubein<\/a>.\u00a0X,\u00a0@rachel_roubein<\/a>.\u00a0<\/p>\n Rovner:<\/strong>\u00a0We will\u00a0be back in your feed next week. Until then, be healthy.\u00a0<\/p>\n \tFrancis Ying \tEmmarie Huetteman Click here to find all our podcasts.<\/a><\/em><\/p>\n And subscribe to “What the Health? From KFF Health News” on Apple Podcasts<\/a>, Spotify<\/a>, the NPR app<\/a>, YouTube<\/a>, Pocket Casts<\/a>, or wherever you listen to podcasts.<\/em><\/p>\n\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/p>\n
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\n\t\t\t\tRead Julie’s stories.\t\t\t<\/a><\/p>\n\n\t\tPanelists\t<\/h3>\n
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\n\tAxios<\/p>\n
\n\t\t\t\t@mayagoldman_\t\t\t<\/a><\/p>\n
\n\t\t\t\t@maya-goldman.bsky.social\t\t\t<\/a><\/p>\n
\n\t\t\t\tRead Maya’s stories.\t\t\t<\/a><\/p>\n<\/p>\n
\n\tPolitico<\/p>\n
\n\t\t\t\t@AliceOllstein\t\t\t<\/a><\/p>\n
\n\t\t\t\t@alicemiranda.bsky.social\t\t\t<\/a><\/p>\n
\n\t\t\t\tRead Alice’s stories.\t\t\t<\/a><\/p>\n<\/p>\n
\n\tThe Washington Post<\/p>\n
\n\t\t\t\t@rachel_roubein\t\t\t<\/a><\/p>\n
\n\t\t\t\tRead Rachel’s stories.\t\t\t<\/a><\/p>\n\n
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\n\t\tCredits\t<\/h3>\n
\n\tAudio producer<\/p>\n
\n\tEditor <\/p>\nUSE OUR CONTENT<\/h3>\n