The Host
Julie Rovner
KFF Well being Information
Julie Rovner is chief Washington correspondent and host of KFF Well being Information’ weekly well being coverage information podcast, “What the Well being?” A famous professional on well being coverage points, Julie is the creator of the critically praised reference ebook “Well being Care Politics and Coverage A to Z,” now in its third version.
Come January, Republicans will management the Home of Representatives, Senate, and White Home, regaining full energy for the primary time since 2018. That may give them vital clout to dramatically change well being coverage. However slim margins in Congress will go away little room for dissent.
In the meantime, President-elect Donald Trump has vowed to not contact Medicare, although there are Medicare-related points — together with drug worth negotiations and doctor pay — that can quickly demand consideration.
This week’s panelists are Julie Rovner of KFF Well being Information, Anna Edney of Bloomberg Information, Rachel Roubein of The Washington Submit, and Lauren Weber of The Washington Submit.
Panelists
Anna Edney
Bloomberg
Rachel Roubein
The Washington Submit
Lauren Weber
The Washington Submit
Among the many takeaways from this week’s episode:
- Republicans will management the Home and the Senate starting subsequent yr, probably providing Trump essential votes in assist of his nominees and agenda. Nonetheless, the get together will govern with solely a slim majority in each chambers, which may hamper its means to make sweeping or controversial adjustments. Regardless, the GOP will steer legislative efforts, corresponding to setting authorities spending ranges and limits, and management committees that determine what to prioritize and oversee.
- Trump this week named a number of folks he intends to appoint to his Cupboard. But a lot of his picks lack related expertise or have staked out controversial coverage positions — or each — elevating the query: Can they clear the Senate affirmation course of? Trump has steered utilizing recess appointments to get round that, a way that might largely bypass the Senate and restrict his Cupboard secretaries’ authority.
- In the meantime, among the many points on Robert F. Kennedy Jr.’s well being agenda are some that resonate with Democrats, corresponding to cracking down on ultra-processed meals and meals dyes. Notably, these types of initiatives — which may tighten guidelines for companies, as an illustration — haven’t been a part of the normal conservative playbook.
- And, trying forward, there’s rather a lot the Trump administration may do to additional erode abortion rights, and the GOP is prone to see this as a second for making an attempt issues.
Plus, for “additional credit score,” the panelists recommend well being coverage tales they learn this week that they suppose it is best to learn, too:
Julie Rovner: KFF Well being Information’ “In Vermont, The place Virtually Everybody Has Insurance coverage, Many Can’t Discover or Afford Care,” by Phil Galewitz.
Anna Edney: The Atlantic’s “Throw Out Your Black Plastic Spatula,” by Zoë Schlanger.
Rachel Roubein: Politico’s “‘Been a Lengthy Time Since I Felt That Approach’: Sexually Transmitted An infection Numbers Present New Hope,” by Alice Miranda Ollstein.
Lauren Weber: JAMA Community Open’s “Medical Board Self-discipline of Physicians for Spreading Medical Misinformation,” by Richard S. Saver.
Additionally talked about on this week’s podcast:
Click on to open the transcript
Transcript: Readying for Republican Rule
[Editor’s note: This transcript was generated using both transcription software and a human’s light touch. It has been edited for style and clarity.]
Julie Rovner: Hiya, and welcome again to “What The Well being?” I’m Julie Rovner, chief Washington correspondent for KFF Well being Information, and I’m joined by a few of the finest and smartest well being reporters in Washington. We’re taping this week on Thursday, November 14th, at 10 a.m. As all the time, and notably this week, information occurs quick and issues would possibly’ve modified by the point you hear this. So, right here we go.
Immediately we’re joined by way of videoconference by Rachel Roubein of The Washington Submit.
Rachel Roubein: Hello. Thanks for having me.
Rovner: Anna Edney of Bloomberg Information.
Anna Edney: Hiya.
Rovner: And Lauren Weber, additionally The Washington Submit.
Lauren Weber: Double hassle right now. Thanks for having me.
Rovner: No interview this week however greater than sufficient information to make up for it, so let’s dig proper in. In order of yesterday, it’s official. Come January twentieth, Republicans will management the presidency, the Senate, and the Home, though the ultimate break up continues to be but to be decided and may be even smaller than the handful it’s now. Plus President-elect [Donald] Trump retains naming Home Republicans to his administration, which can complicate issues and which we’ll speak about in a second. However assuming there’s a trifecta when Trump places his hand on the Bible at midday on January twentieth, what distinction is that going to make to the well being agenda than if the Home had flipped Democratic, even by a vote or two?
Edney: Effectively, I believe that, as you simply talked about, this majority is prone to be so small. And simply considering to the previous, we’ve seen such divisions, even among the many Republican Celebration, on what ought to be achieved.
Rovner: It solely takes one or two — when you’ll be able to solely afford to lose one or two votes, it solely takes one or two folks to gum up the works.
Edney: Yeah, and there are quite a lot of members — and notably, it looks as if, within the GOP — which can be very keen to do this. I imply, I believe that additionally the potential is that well being care is just not prime of thoughts for President Trump, at the very least. So I do know we’ve heard Speaker [Mike] Johnson say that he wish to overturn the ACA [Affordable Care Act] immediately, however I don’t know that, like we mentioned, with the small majority, that that can have the ability to even occur.
Rovner: I really feel like that’s a giant distinction from, I’d say from 2017, after we got here in and well being care, repealing ACA, was proper on the prime. Not a lot now. Lauren.
Weber: I used to be simply going to say: What model of the Trump administration on well being care are we going to get? I imply, you’ve got Robert F. Kennedy Jr. on the market speaking about “Make America Wholesome Once more,” which additionally flies within the face of quite a lot of Republican ideology. I imply, quite a lot of what he’s speaking about appears to be excessive regulation of ultra-processed meals. He appears to need to restrict promoting for pharmaceutical advertisements. He desires to give attention to continual illness, which is one thing that lots of people on the left would like to see extra curiosity in, together with the ultra-processed meals. However is that the brand new Republican Celebration focus for well being? I don’t know. I believe we’re going to see, I imply, contemplating RFK appears poised for a big place within the administration.
Rovner: And we’ll discuss extra about him in a couple of minutes. Rachel, you needed so as to add one thing.
Roubein: Yeah. I consider — once I take into consideration Congress and the facility construction, I’m considering rather a lot about simply the federal government spending payments and the way that’s used to barter. Like, in the event you look from just a few years in the past, Democrats negotiated some Medicaid insurance policies that they needed on maternal well being for change for what Republicans needed on unwinding Medicaid. And so Democrats lose their negotiating leverage there. And actually one of many huge insurance policies in Congress for subsequent yr, I believe, is the expiration in 2025 of the improved Obamacare subsidies. So Democrats don’t actually have a chamber there.
Rovner: Which we’ll additionally get to. However, I imply, the massive distinction is that if the Democrats had gained a majority even by one or two votes, that might’ve given them management of committees, which now they gained’t have. And that’s, sure, a giant deal. I used to be going to say, Anna, in a yr when well being is just not essentially on the prime of the type of huge agenda, what occurs in committee is usually what occurs.
Edney: Proper, yeah, what they determine to look into or to not look into. One of many locations perhaps the place they might type of cross paths or agree in a means with RFK Jr., if that’s the best way the Trump administration goes, is there’s nonetheless quite a lot of anger on the best concerning the covid vaccine. So we may see investigations ongoing — I believe they’re nonetheless occurring — however ongoing in that vein, and [Anthony] Fauci may maintain getting referred to as earlier than Congress. And that results in a type of aversion to pandemic preparedness, which could possibly be regarding as a result of we’re trying down at this fowl flu potential downside that retains getting barely extra regarding on a regular basis.
Rovner: There’s a young person in Canada in intensive care with fowl flu, who was not uncovered to something on a farm. That has public well being folks involved.
Edney: Proper, proper, precisely. And when you consider uncooked milk and RFK Jr. in assist of that — I do know we’ll get to him — however it all seems like an ideal storm, probably. However I believe that the best way that the Republicans would like to go is just not coping with — they’d fairly intestine pandemic preparedness. They don’t see a spot for it, in order that these issues may develop into necessary down the road.
Rovner: In order I discussed, President-elect Trump is already saying heaps and plenty of folks to employees the higher ranges of his incoming administration. And even with the Senate, with the Republican majority, that appears fairly seemingly to provide him no matter he desires, he’s been curiously suggesting that he desires to make use of one thing referred to as recess appointments for his main places of work, which might imply his appointees could be non permanent, however they’d additionally keep away from the traditional Senate affirmation course of, which includes vetting and hearings and votes and even on an expedited foundation can take weeks. Are we beginning to get an concept of why he desires that, given a few of the people that he’s already named, like firebrand and ethics-challenged Republican congressman Matt Gaetz to be legal professional basic?
Edney: Yeah, actually. We haven’t seen an HHS [Department of Health and Human Services] choose but, and I can’t even guess who it may be simply given what’s already come out was very surprising. And so I believe that you just’ve seen businesses just like the Meals and Drug Administration undergo that earlier than, the place they’ve simply had these non permanent folks or they’ve stored in place whoever was the deputy on the time, and so they develop into the commissioner for some time and never confirmed. And it actually hampers their means to do rather a lot, although. There are selections {that a} division or an company can’t make if somebody’s not Senate-confirmed.
Rovner: However doesn’t that throw extra energy again to the White Home? Isn’t that form of the thought right here?
Edney: Yeah, true. That’s a very good level. If RFK Jr. will get this type of well being czar spot — I’ve been telling folks I couldn’t actually see him as HHS secretary, as a result of quite a lot of what he desires to do is underneath the USDA [Agriculture Department], so that might make no sense. And so if he simply form of has the facility he desires within the White Home to do what he wants, you make a very good level there as nicely.
Rovner: Yeah, what else are — I’d’ve mentioned earlier than yesterday that they’d by no means identify RFK Jr. to be HHS secretary. Though after a few of the names we bought yesterday, perhaps that can occur. This might occur whereas we’re taping this. However what different names are we listening to, if any? I do know I’ve three folks right here who’ve been overlaying the FDA. I imply, clearly through the first Trump administration, the FDA was headed by Scott Gottlieb, who we might contemplate a conventional Republican, a physician. He’d labored within the company earlier than. He’d been in authorities. That doesn’t appear seemingly what we’re going to see this time round.
Edney: I believe that’s true. I believe the one factor is what Trump’s focus will probably be. If he does let another person form of take the reins on this, perhaps we might see somebody a little bit extra measured. I’d say proper now, many of the names that I’m listening to for HHS or FDA are very a lot recycling from final time round. And so I’m actually not sure whether or not persons are simply batting that round as a result of these are names which have come ahead earlier than or whether or not that’s who we’ll truly see named. I believe we are going to know in brief order, as a result of I do suppose that these are popping out shortly. And I appreciated, Julie, that you just corrected everybody that they’re not nominated. There’s an intent to appoint by a president-elect, so, however nonetheless will—
Rovner: Though, I’ll say, his statements say that he’s nominating, which is complicated folks.
Edney: Yeah. I believe they’re much less involved with the specifics.
Rovner: Sure. Effectively, shock, shock. All proper, now let’s speak about RFK Jr. Clearly, we don’t know what place he’s going to fill, however we’ve talked rather a lot about his extra Republican-friendly positions, anti-vax stuff and uncooked milk and type of anti-public-health. However Rachel and Lauren, you’ve bought a narrative up right now about another positions that Democrats may be a little bit extra sympathetic to. What are a few of these?
Roubein: There’s at the very least two concepts that we had type of checked out on this story which have discovered some public assist on each the best and the left, corresponding to stripping ultra-processed meals from faculty cafeterias and form of cracking down on meals dyes. And, I imply, one of many issues we famous up prime is that that is, a few of this could be a contradiction from Trump’s first time period, the place Sonny Perdue, who was Trump’s agriculture secretary, inside the first week or two of him being in his place, he vowed to quote-unquote “make faculty meals nice once more” after which form of waged this assault on Michelle Obama’s efforts to make faculty meals more healthy. That’s to not say that Kennedy being a place of energy doesn’t alarm federal well being officers or public well being consultants or folks within the meals trade, as a result of it does. However there are some insurance policies that he may have a [Sen.] Bernie Sanders agree with him on.
Rovner: And whereas we’re as regards to ultra-processed meals, Lauren, you’re our Lunchables correspondent, and there’s Lunchables information this week. Inform us about it.
Weber: There’s Lunchables information this week, and constant listeners of the pod will keep in mind that I did a narrative at The Washington Submit final yr with a few of my colleagues that checked out how Lunchables had ended up on faculty lunch trays for the primary time ever. Kraft Heinz had form of tinkered with the system, reformulated it, and really ended up including extra sodium whereas including extra protein and different issues to qualify for the Nationwide Faculty Lunch Program. And, clearly, quite a lot of diet consultants had been appalled as a result of they felt like that is an instance of ultra-processed meals that’s being served as free and decreased lunch to children who don’t essentially have as a lot of a alternative there on what’s being served to them. And we bought information this week that Kraft Heinz didn’t make sufficient cash, that faculty districts didn’t buy their reformulated product, and so they had, because of quote “lack of demand,” they’re taking them off the choices.
So it’s form of attention-grabbing. RFK’s push in opposition to ultra-processed meals is coming at a second not simply in class lunches however in the USA, the place there was rising consciousness about ultra-processed meals making up 60% of the American’s food plan. And for a really, very very long time, meals trade has been actually profitable in Congress at watering down a few of the laws in opposition to stuff like ultra-processed meals, particularly in class lunches, to form of weaken these laws, as Rachel talked about, that Michelle Obama had pushed for and different methods, in order that they might proceed promoting their merchandise. And so a few of the meals trade people that Rachel and I talked to are fairly involved a few attainable RFK function as a result of he’s actually pushing in opposition to the powers that be there. And it’s actually attention-grabbing to see that dynamic, as a result of, as Rachel identified, the one different individual that’s actually been doing that lately is Bernie Sanders. So that you form of have this horseshoe of proper and left that’s coming to the forefront right here.
Edney: I used to be simply going so as to add, I truly wrote my e-newsletter on this right now. The FDA is doing a little issues on this vein which can be type of attention-grabbing. I mentioned it was form of an RFK-FDA, very tiny, very small Venn diagram in that the company can be ultra-processed meals. They mentioned — Jim Jones is their deputy commissioner for human meals, and he mentioned lately that they had been doing a little work making an attempt to determine the way to research whether or not there’s actually causality, however he did say they’ve been working and so they have achieved rather a lot on sure trans fat, getting them out of meals. They’ve achieved rather a lot to attempt to, they’re making an attempt to scale back sodium ranges. That’s going to be a stepwise course of in meals. They usually have made customers much more conscious, together with on the label, of added sugars. And he was like, That is all what we see in processed meals that may be a downside.
And so there’s type of this quiet— they’re quietly going after it, simply not calling it that. After which on the dyes, they’re actually not going so far as RFK Jr. and saying, We need to ban all dyes. However they’ve had a petition in entrance of them for a pair years, and Jim Jones mentioned he anticipated a response from the FDA. I neglect precisely the quote, however it was very quickly on what they’re going to do on Crimson Dye Quantity 3, which is type of the one which has been studied essentially the most and has hyperlinks to most cancers and probably hyperactivity in children.
Roubein: I believe it’s additionally price noting, in speaking concerning the FDA’s diet division, is the day after the election, RFK Jr. was on MSNBC saying that there are whole departments at FDA that must go, and he particularly mentioned the diet division. Once more, whether or not you might simply have form of a mass firing of civil servants is form of fairly TBD, however that’s how he’s viewing the nutritionists there, and that’s alarming to employees. FDA Commissioner Robert Califf the opposite day mentioned that, referred to as them hardworking folks. He was requested about it and had a little bit of a protection there.
Weber: Simply so as to add in on that, too, there are some diet advocates that wouldn’t be that unhappy about that. I imply, I do know that they really feel just like the FDA has been too sluggish, is just too influenced by trade. I imply, have a look at the meals label story that we talked about additionally on this podcast, that Rachel and I did. The Biden administration was speculated to suggest potential front-of-pack labels for entrance of meals, and quite a lot of diet advocates thought, though this proposal has not come out but, that what they had been eager about was too weak and too deferential to trade. So RFK has actually tapped into this rising anger, it appears, on the lack of protections for youths or normally concerning the meals provide. I believe a part of it’s is that he and Trump are excellent entrepreneurs. They’ve these catchy slogans, “Make America Wholesome Once more.” I believe that’s considerably at play as nicely.
Rovner: I believe earlier than we go away this type of subsequent administration section, although, I do need to broaden it out a little bit bit, as a result of we’ve been speaking about this contradiction that’s Donald Trump, which is, on the one hand, he’s bought a bunch of individuals that desires to strip the federal authorities of all of its means to manage and do away with laws and let trade run wild as a result of, as Vivek Ramaswamy says, regulation is a yoke across the neck of innovation. Alternatively, he’s bought folks like RFK Jr. who need to are available in and say: No, let’s get trade out of presidency. Let authorities do its job regulating. I imply, the well being trade have to be — their heads have to be spinning, as a result of this clearly goes to have an effect on completely different parts of the trade other ways, proper?
Edney: Yeah, it’s a complicated factor, too, when you consider the pharma trade, as an illustration. I can say, they’re extremely regulated within the sense that they pay plenty of cash to the FDA, thousands and thousands and thousands and thousands of {dollars} to have their new drug purposes reviewed. There’s a really strict strategy of what they get for that, what the FDA will do for that. They don’t need that thrown away, as a result of that offers them quite a lot of safety on, Right here’s how issues are going to work and we have to know that, versus in the event you simply had someone up there being like, Sure to that one, no to that one. And there could possibly be different areas. Actually Large Pharma wouldn’t adore it if all the pieces was tried to be cured with ivermectin and the hydroxychloroquine. So that might be an issue for all of us. So I believe that there’s simply quite a lot of confusion and uncertainty in pharma, at the very least.
Rovner: And I imply, the one factor we all know is that trade hates uncertainty. They want to have the ability to plan.
Edney: Sure. Proper, sure. They very a lot want that for themselves, for his or her researchers, for his or her shareholders. That’s tremendous necessary.
Rovner: Yeah, so clearly, everyone in well being care is type of watching eagerly. All proper, nicely, whereas we’ve all been busy speaking concerning the election, open enrollment started for the Inexpensive Care Act for 2025, probably the final yr that thousands and thousands of Individuals will stay eligible for expanded subsidies, since a completely Republican Congress and president appear unlikely to increase them past December thirty first, 2025. What will develop into of the ACA expanded subsidies? Is there any likelihood they get prolonged? It might displace thousands and thousands of people that have gotten medical insurance via the ACA.
Edney: Effectively, I believe if we’re speaking in ways in which Trump could also be occupied with, the insurance coverage corporations wouldn’t prefer it, as a result of they don’t need to lose all of these sufferers. So I assume perhaps that’s the potential glimmer of hope for individuals who need these expanded subsidies to remain intact.
Rovner: And we nonetheless don’t know what the Republicans bear in mind for the Inexpensive Care Act. As I prefer to level out, they’ve been speaking a few alternative since 2010 and we’ve by no means truly seen one.
Roubein: Trump has ideas of a plan, he says.
Rovner: So we now have heard.
Roubein: Keep in mind that within the debate? I imply, we heard that for what number of years, proper? Years and years.
Rovner: Two weeks. He’s going to have one thing in two weeks.
Edney: I used to be going to say, if anybody writes an In two weeks it’s coming story, they’ve to purchase drinks for everybody.
Rovner: Completely. Lauren, you needed to say one thing.
Weber: I imply, I used to be simply going to say that the primary Trump administration was not identified for increasing any type of subsidies for the ACA. So I’m curious. However as Anna identified, frankly it’s all the time exhausting to remove one thing that’s fashionable. You don’t essentially need these folks mad at you. So to be fairly sincere, let’s wait and see.
Rovner: Yeah, TBD.
Weber: TBD.
Rovner: Effectively, that is additionally the primary yr that DACA [Deferred Action for Childhood Arrivals] recipients, the so-called “Dreamers” who had been delivered to the U.S. with out documentation as kids, are eligible themselves for sponsored ACA protection. That’s estimated to be about 100,000 folks. I wouldn’t count on that to final both, although. And I’m questioning, it won’t even make it via the yr, because it’s the topic of a lawsuit introduced by Republican attorneys basic that I count on a brand new Justice Division would simply drop?
Roubein: Yeah, I really feel like with all the pieces, there’s form of a highway map to take a look at what Trump did within the first time period, simply form of talking broadly, not simply on DACA. However then there are issues that they won’t do once more. So I really feel prefer it’s exhausting to foretell, however yeah, feasibly I really feel like that might type of be the considering.
Rovner: Trump has been nothing greater than unpredictable throughout. So I’m going to do my extra-credit story early this week as a result of I would like us all to speak about it a little bit bit. It’s from my KFF Well being Information colleague Phil Galewitz, and it’s referred to as “In Vermont, The place Virtually Everybody Has Insurance coverage, Many Can’t Discover or Afford Care.” And it’s about an issue that’s form of been sneaking up on us and is now right here for all to see: Having insurance coverage is important however not adequate to get well being care.
As Phil factors out, Vermont has principally the bottom uninsured fee in the USA, however care there may be costly. Each suppliers and insurers are having monetary difficulties, and rising numbers of sufferers both can’t discover care or can’t pay for it or each. A few of this seems to be demographics. Vermont is, on common, older and extra rural than most different states, and a few of it’s probably because of well being supplier consolidation. However I really feel like that is form of the early warning of the identical types of issues occurring across the nation. At what level do we now have to really take inventory of the truth that our well being system is just not functioning very nicely? I imply, we’re so busy speaking about what trade desires and what authorities desires and what is going to assist this group and what is going to assist that group. And it’s like, even with an all-time-low uninsured fee, the tales about folks being unable to get care have gotten greater than anecdotal, proper?
Weber: I imply, I believe, Julie, return to the identify of this podcast. The podcast known as “What the Well being?” I imply, I believe you’ve, clearly, and all of us right here have been overlaying this for a few years. However Phil’s story was simply fantastically achieved, as a result of it confirmed how multifaceted the issue is. However that additionally means there’s not a fast repair. However the bottom-line kicker was these persons are paying a ton of cash for his or her well being care and are having to attend months and months and months for stuff they really feel like is just not that nice, or they’re pressured to go throughout state strains and pay extra elsewhere to get it faster. And clearly that’s, as you mentioned, not fairly an answer. So a captivating have a look at, what it looks as if, numerous elements which can be inflicting severe points with folks’s well being care supply.
Rovner: I simply really feel prefer it’s a warning to not — I imply, clearly we’re well being reporters. We have a look at issues within the micro. However generally I really feel like we’re form of dropping the forest for the bushes, and this was a very good reminder. It’s like there’s a forest on the market and issues aren’t going nice within the forest.
All proper, nicely, let’s flip to abortion. Though seven out of 10 states with poll measures voted for the abortion rights place — eight states, in the event you depend Florida, the place the measure to overturn the state six-week ban bought 57%, however that was wanting the 60% it wanted to cross — the anti-abortion motion is nonetheless gearing as much as undo as a lot of this as it will possibly.
In response to our podcast panelist Alice Ollstein, a few of the methods anti-abortion teams plan to pursue are ones that we now have talked about right here earlier than, together with requiring that abortion tablets be labeled as a managed substance, like they’re doing in Louisiana, or that the stays of remedy abortion be dealt with as medical waste. Different concepts are new or at the very least new-ish, like making an attempt to chop off funding to high schools and universities that present abortion tablets at campus services. The anti-abortion motion can be making an attempt to push state laws geared toward circumventing the protecting amendments that these states’ voters simply handed. This battle is a good distance from being over, proper?
Edney: Oh, yeah. And also you simply talked about states. That’s the place I’m certain that quite a lot of the main focus is, as a result of if Trump holds to his phrase, and I don’t know if that’s the case, he mentioned it ought to be as much as the states on how they deal with all of these items. So I think about now could be their second in the event that they’re going to attempt a few of these extra out-of-the-box methods of coping with it.
Roubein: And I believe one factor that emerged, notably after Republicans took again the Home in 2022 and Roe v. Wade was overturned, was that the battleground being states, but additionally the manager department. The battleground when it comes to Congress, the Home didn’t carry up a invoice to ban abortion at 15 weeks or something politically—
Rovner: They couldn’t have gotten the votes with their tiny majority.
Roubein: Yeah, it’s very politically difficult. We’ve seen Republicans again away from these stances. And you then have a look at the Biden administration, which has mentioned, There are issues we will do to type of do some pointers, et cetera, like letting the VA [Department of Veterans Affairs] do abortions in sure cases, or they rolled again Trump’s adjustments on the Title X federal household program that principally pressured Deliberate Parenthood out. So you might type of see a few of these issues being rolled again once more.
Rovner: Effectively, one of many issues that I haven’t seen famous by anyone, and I completely agree with you about: The very first thing that the Trump and whoever within the Trump administration to do is reverse the issues that [President Joe] Biden did, which in some methods had been reversals of issues that Trump did the primary time round. However we do have a bunch of abortion-related lawsuits nonetheless in play that contain the Justice Division. Keep in mind that Supreme Courtroom case the place the justices dominated that the anti-abortion medical doctors who introduced the case didn’t have standing to sue? Effectively, that case continues to be alive. It’s nonetheless in court docket, as a result of states have stepped in as plaintiffs. Then there are instances difficult the Biden administration’s interpretation of EMTALA, which is the federal regulation that requires emergency abortions be supplied to guard a pregnant lady’s well being and says that these override state legal guidelines that solely enable abortions if the lady’s life is imminently endangered. I’d suppose these instances would go away underneath Lawyer Common Matt Gaetz or whoever goes to be in control of the Justice Division, proper?
Edney: I imply, that makes good sense to me that they’d not proceed arguing these by any means except Trump is extra centered on making an attempt to overturn his personal convictions. I don’t know what that might appear like.
Rovner: Sure, it doesn’t matter what, the Justice Division will probably be very busy, however I think not very busy arguing the abortion rights aspect of abortion instances.
Edney: Proper.
Rovner: Effectively, I need to flip to Medicare. Trump insisted through the marketing campaign that he wouldn’t contact Medicare, however that’s not truly attainable for a Congress and an administration. The one actual query is how Medicare will probably be touched. Medical doctors are, as soon as once more, going through a Medicare pay reduce for subsequent yr. This one is slightly below 3%. And that’s one thing that the lame-duck Congress, which is simply getting again into session this week, might or might not cancel, given how loopy issues are proper now on Capitol Hill. And The Wall Avenue Journal has a chunk this week about how sicker persons are leaving their Medicare Benefit plans to return to conventional Medicare, which is sensible as a result of non-public Medicare Benefit plans make care more durable to entry whenever you’re sick. In order that finally ends up making — after they go away, it finally ends up making the plans richer as a result of they don’t must pay for the care, and the taxpayers poorer as a result of now Medicare, conventional Medicare, is paying for the care. So Medicare’s going to must be on the desk in some kind. We will’t simply ignore Medicare for 4 years, proper?
Edney: Yeah, I believe notably that is the type of greater image. However when you consider if Trump does need to do a bunch of tax cuts and the place does the cash come from, I’m certain there are methods to do it. There are all types of finances methods that may be achieved to appear like you’re not touching Medicare however you’re touching Medicare, so you’ll be able to maintain that marketing campaign promise. And I don’t know if that’s actually on the desk for them, however I don’t suppose we will count on nobody to be this, notably additionally due to the type of Republican need to prop up the Medicare Benefit a little bit bit extra to get … So I don’t know if there’s a option to encourage some folks again on these plans or how they’re going to take a look at that.
Rovner: Yeah, it’s necessary to keep in mind that the normal Republican concept on Medicare is to get extra folks to enter Medicare Benefit, which is occurring naturally anyway as a result of people who find themselves growing older into Medicare are principally popping out of managed care plans, so that they’re used to being in managed care plans. So it’s simple for them to enter these Medicare Benefit plans that say, Hey, we’re going to give you additional advantages that Medicare doesn’t. And it’s not till they really want care and may’t get it that they notice that perhaps that wasn’t one of the best concept. However I actually count on this complete debate to hold over to the subsequent administration.
Edney: Effectively, and also you additionally … I don’t know why, however you jogged my memory that there are nonetheless medicine to barter underneath Medicare.
Rovner: That’s proper.
Edney: And also you someway must cope with that, and taking it away could be fairly tough, seemingly.
Rovner: And price some huge cash.
Edney: And price some huge cash. However you might negotiate issues otherwise or — I’m unsure.
Rovner: Sure, we’ll have loads of Medicare to speak about. All proper, nicely, that’s the information, at the very least up till this second. Now it’s time for our extra-credit section. That’s the place we every acknowledge a narrative we learn this week we expect it is best to learn, too. Don’t fear in the event you miss it. We are going to put the hyperlinks in our present notes in your cellphone or different cell system. I’ve already achieved mine. Anna, why don’t you go subsequent? Yours is so very on model for you.
Edney: Thanks. So mine is from The Atlantic. It’s referred to as “Throw Out Your Black Plastic Spatula.” Actually, I grew up in my household and my dad and mom nonetheless have all their black cooking utensils. And what that is speaking about is how most of our black cooking utensils are constituted of recycled electronics. And there’s a complete motive for that. It’s actually attention-grabbing to examine. However the final result is that there are additionally quite a lot of hearth retardants in these, so we’re getting hearth retardants leaching out into our meals.
Rovner: In fact, hearth retardants are why that they had them within the first place, proper? Since you’re placing them in very popular issues.
Edney: Effectively, that is extra due to the electronics. Like, yeah, whenever you’re utilizing an digital, I assume there’s hearth retardants in there since you don’t need the battery blowing up or no matter. However in the event you’re recycling these and making utensils out of them, you then’re going to get a few of that in your meals.
Rovner: The darkish aspect of recycling.
Edney: Sure.
Rovner: Lauren, why don’t you go subsequent?
Weber: Mine’s truly a research in JAMA that’s titled “Medical Board Self-discipline of Physicians for Spreading Medical Misinformation.” And the research discovered that really the least frequent motive for medical board self-discipline was spreading misinformation, which was not truly information to me or a few of my colleagues at The Washington Submit, as they cite our work on this research. However Lena Solar, Hayden Godfrey, and I final yr did a big investigation through which we truly surveyed all 50 medical boards and went via and requested them about whether or not or not that they had disciplined anybody for misinformation.
After which on the boards that didn’t reply, which was many, we then went via and skim each single disciplinary motion to see what we may discover. And the underside line is is medical doctors didn’t get punished. There’s quite a lot of free-speech protections, and, frankly, it needed to be very, very, very egregious for medical boards to step in. Typically, medical boards are weak. They’re identified to be poor at self-regulating their very own. It takes rather a lot to essentially get punished by a medical board, so it’s not that shocking. However after quite a lot of clamor throughout covid and quite a lot of physicians that basically turned megaphones for unscientific proof, it’s nonetheless fairly hanging that not very a lot of them confronted any type of repercussions for that.
Rovner: Yeah, one other difficulty going ahead. Rachel.
Roubein: My additional credit score, it’s titled “‘Been a Lengthy Time Since I Felt That Approach’: Sexually Transmitted An infection Numbers Present New Hope,” in Politico by Alice Miranda Ollstein. The story talks about principally how there’s been this drop in sexually transmitted infections, and that has adopted years of simply skyrocketing instances. So that is from new information from the Facilities for Illness Management and Prevention that got here out this week. So, as an illustration, complete instances of syphilis elevated 1% and congenital syphilis ticked up 3%, however that’s a far slower fee of development than the spikes of the previous couple of years. In order that’s an encouraging be aware for STD well being administrators in states. However within the piece, she talks about how there’s some concern from public well being consultants and different advocates about probably backsliding underneath Trump, relying what occurs, and likewise noting that Congress final yr clawed again tons of of thousands and thousands of {dollars} in public well being funding.
Rovner: That’s proper. And clearly the federal Household Planning Program performs a giant function within the prevention of sexually transmitted infections, and we don’t know what’s going to develop into of the federal Household Planning Program underneath a Republican trifecta. So once more, a narrative that I’m certain we are going to spend extra time speaking about.
All proper, that’s this week’s present. As all the time, in the event you benefit from the podcast, you’ll be able to subscribe wherever you get your podcasts. We’d admire it in the event you left us a evaluation. That helps different folks discover us, too. Particular thanks this week to our non permanent manufacturing staff, Taylor Cook dinner and Lonnie Ro, in addition to our editor, Emmarie Huetteman. As all the time, you’ll be able to electronic mail us your feedback or questions. We’re at whatthehealth, all one phrase, @kff.org. Or you’ll be able to nonetheless discover me at X @jrovner and more and more at Bluesky @julierovner.bsky.social. The place are you guys as of late? Lauren?
Weber: Nonetheless simply on X, LaurenWeberHP. The “HP” is for “well being coverage.”
Rovner: Anna.
Edney: On X. It’s @annaedney. And I’m making an attempt out Bluesky as nicely, however I’m so new that I don’t even keep in mind my identify.
Rovner: It’s OK.
Edney: I’ll get that subsequent time.
Rovner: Rachel.
Roubein: Equally to Lauren, on X, @rachel_roubein.
Rovner: We will probably be again in your feed subsequent week. Till then, be wholesome.
Credit
Taylor Cook dinner
Audio producer
Lonnie Ro
Audio producer
Emmarie Huetteman
Editor
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