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