\t\t\t<\/p>\n
\tJulie Rovner
\n\tKFF Health News<\/p>\n
\t\t\t \t\t\t \t\t\tJulie Rovner is chief Washington correspondent and host of KFF Health News\u2019 weekly health policy news podcast, \u201cWhat the Health?\u201d A noted expert on health policy issues, Julie is the author of the critically praised reference book \u201cHealth Care Politics and Policy A to Z,\u201d now in its third edition.\t\t<\/p>\n Come January, Republicans will control the House of Representatives, Senate, and White House, regaining full power for the first time since 2018. That will give them significant clout to dramatically change health policy. But slim margins in Congress will leave little room for dissent.<\/p>\n Meanwhile, President-elect Donald Trump has vowed not to touch Medicare, though there are Medicare-related issues \u2014 including drug price negotiations and physician pay \u2014 that will soon demand attention.<\/p>\n This week\u2019s panelists are Julie Rovner of KFF Health News, Anna Edney of Bloomberg News, Rachel Roubein of The Washington Post, and Lauren Weber of The Washington Post.<\/p>\n \t\t\t \tAnna Edney \t\t\t \t\t\t \t\t\t \tRachel Roubein \t\t\t \t\t\t \t\t\t \tLauren Weber \t\t\t \t\t\t Among the takeaways from this week\u2019s episode:<\/p>\n Plus, for \u201cextra credit,\u201d the panelists suggest health policy stories they read this week that they think you should read, too:<\/p>\n Julie Rovner:<\/strong> KFF Health News\u2019 \u201cIn Vermont, Where Almost Everyone Has Insurance, Many Can\u2019t Find or Afford Care<\/a>,\u201d by Phil Galewitz.<\/p>\n Anna Edney:<\/strong> The Atlantic\u2019s \u201cThrow Out Your Black Plastic Spatula<\/a>,\u201d by Zo\u00eb Schlanger.<\/p>\n Rachel Roubein:<\/strong> Politico\u2019s \u201c\u2018Been a Long Time Since I Felt That Way\u2019: Sexually Transmitted Infection Numbers Provide New Hope<\/a>,\u201d by Alice Miranda Ollstein.<\/p>\n Lauren Weber:<\/strong> JAMA Network Open\u2019s \u201cMedical Board Discipline of Physicians for Spreading Medical Misinformation<\/a>,\u201d by Richard S. Saver.<\/p>\n Also mentioned in this week\u2019s podcast:<\/p>\n \t\t\t\t\tClick to open the transcript\t\t\t\t<\/p>\n \t\t\t\t\t\tTranscript: Readying for Republican Rule\t\t\t\t<\/p>\n [<\/em>Editor\u2019s note:<\/em><\/strong> This transcript was generated using both transcription software and a human\u2019s light touch. It has been edited for style and clarity.]<\/em>\u00a0<\/p>\n Julie Rovner:<\/strong> Hello, and welcome back to \u201cWhat The Health?\u201d I\u2019m Julie Rovner, chief Washington correspondent for KFF Health News, and I\u2019m joined by some of the best and smartest health reporters in Washington. We\u2019re taping this week on Thursday, November 14th, at 10 a.m. As always, and particularly this week, news happens fast and things might\u2019ve changed by the time you hear this. So, here we go.\u00a0<\/p>\n Today we are joined via videoconference by Rachel Roubein of The Washington Post.\u00a0<\/p>\n Rachel Roubein:<\/strong> Hi. Thanks for having me.\u00a0<\/p>\n Rovner:<\/strong> Anna Edney of Bloomberg News.\u00a0<\/p>\n Anna Edney:<\/strong> Hello.\u00a0<\/p>\n Rovner:<\/strong> And Lauren Weber, also The Washington Post.\u00a0<\/p>\n Lauren Weber:<\/strong> Double trouble today. Thanks for having me.\u00a0<\/p>\n Rovner:<\/strong> No interview this week but more than enough news to make up for it, so let\u2019s dig right in. So as of yesterday, it\u2019s official. Come January 20th, Republicans will control the presidency, the Senate, and the House, although the final split is still yet to be determined and might be even smaller than the handful it is now. Plus President-elect [Donald] Trump keeps naming House Republicans to his administration, which will complicate things and which we\u2019ll talk about in a moment. But assuming there is a trifecta when Trump puts his hand on the Bible at noon on January 20th, what difference is that going to make to the health agenda than if the House had flipped Democratic, even by a vote or two?\u00a0<\/p>\n Edney:<\/strong> Well, I think that, as you just mentioned, this majority is likely to be so small. And just thinking to the past, we\u2019ve seen such divisions, even among the Republican Party, on what should be done.\u00a0<\/p>\n Rovner:<\/strong> It only takes one or two \u2014 when you can only afford to lose one or two votes, it only takes one or two people to gum up the works.\u00a0<\/p>\n Edney:<\/strong> Yeah, and there are a lot of members \u2014 and particularly, it seems like, in the GOP \u2014 that are very willing to do that. I mean, I think that also the potential is that health care is not top of mind for President Trump, at least. So I know we\u2019ve heard Speaker [Mike] Johnson say that he would like to overturn the ACA [Affordable Care Act] right away, but I don\u2019t know that, like we said, with the small majority, that that will be able to even happen.\u00a0<\/p>\n Rovner:<\/strong> I feel like that\u2019s a big difference from, I would say from 2017, when we came in and health care, repealing ACA, was right at the top. Not so much now. Lauren.\u00a0<\/p>\n Weber:<\/strong> I was just going to say: What version of the Trump administration on health care are we going to get? I mean, you have Robert F. Kennedy Jr. out there talking about \u201cMake America Healthy Again,\u201d which also flies in the face of a lot of Republican ideology. I mean, a lot of what he\u2019s talking about seems to be high regulation of ultra-processed foods. He seems to want to limit advertising for pharmaceutical ads. He wants to focus on chronic disease, which is something that a lot of people on the left would love to see more interest in, along with the ultra-processed food. But is that the new Republican Party focus for health? I don\u2019t know. I think we\u2019re going to see, I mean, considering RFK seems poised for a large position in the administration.\u00a0<\/p>\n Rovner:<\/strong> And we\u2019ll talk more about him in a few minutes. Rachel, you wanted to add something.\u00a0<\/p>\n Roubein:<\/strong> Yeah. I think of \u2014 when I think about Congress and the power structure, I\u2019m thinking a lot about just the government spending bills and how that is used to negotiate. Like, if you look from a few years ago, Democrats negotiated some Medicaid policies that they wanted on maternal health for exchange for what Republicans wanted on unwinding Medicaid. And so Democrats lose their negotiating leverage there. And really one of the big policies in Congress for next year, I think, is the expiration in 2025 of the enhanced Obamacare subsidies. So Democrats don\u2019t really have a chamber there.\u00a0<\/p>\n Rovner:<\/strong> Which we\u2019ll also get to. But, I mean, the big difference is that if the Democrats had gained a majority even by one or two votes, that would\u2019ve given them control of committees, which now they won\u2019t have. And that is, yes, a big deal. I was going to say, Anna, in a year when health is not necessarily at the top of the sort of big agenda, what happens in committee is often what happens.\u00a0<\/p>\n Edney:<\/strong> Right, yeah, what they decide to look into or not to look into. One of the places maybe where they could sort of cross paths or agree in a way with RFK Jr., if that\u2019s the way the Trump administration goes, is there\u2019s still a lot of anger on the right about the covid vaccine. So we could see investigations ongoing \u2014 I think they\u2019re still happening \u2014 but ongoing in that vein, and [Anthony] Fauci could keep getting called before Congress. And that leads to a sort of aversion to pandemic preparedness, which could be concerning because we\u2019re looking down at this bird flu potential problem that keeps getting slightly more concerning all the time.\u00a0<\/p>\n Rovner:<\/strong> There\u2019s a teenager in Canada in intensive care with bird flu, who was not exposed to anything on a farm. That has public health people concerned.\u00a0<\/p>\n Edney:<\/strong> Right, right, exactly. And when you think about raw milk and RFK Jr. in support of that \u2014 I know we\u2019ll get to him \u2014 but it all feels like a perfect storm, potentially. But I think that the way that the Republicans would prefer to go is not dealing with \u2014 they\u2019d rather gut pandemic preparedness. They don\u2019t see a place for it, so that those things could become important down the line.\u00a0<\/p>\n Rovner:<\/strong> So as I mentioned, President-elect Trump is already announcing lots and lots of people to staff the upper levels of his incoming administration. And even with the Senate, with the Republican majority, that seems pretty likely to give him whatever he wants, he\u2019s been curiously suggesting that he wants to use something called recess appointments for his major offices, which would mean his appointees would be temporary, but they would also avoid the normal Senate confirmation process, which involves vetting and hearings and votes and even on an expedited basis can take weeks. Are we starting to get an idea of why he wants that, given some of the folks that he\u2019s already named, like firebrand and ethics-challenged Republican congressman Matt Gaetz to be attorney general?\u00a0<\/p>\n Edney:<\/strong> Yeah, certainly. We haven\u2019t seen an HHS [Department of Health and Human Services] pick yet, and I can\u2019t even guess who it might be just given what\u2019s already come out was very unexpected. And so I think that you\u2019ve seen agencies like the Food and Drug Administration go through that before, where they\u2019ve just had these temporary people or they\u2019ve kept in place whoever was the deputy at the time, and they become the commissioner for a while and not confirmed. And it really hampers their ability to do a lot, though. There are decisions that a department or an agency can\u2019t make if someone\u2019s not Senate-confirmed.\u00a0<\/p>\n Rovner:<\/strong> But doesn\u2019t that throw more power back to the White House? Isn\u2019t that kind of the idea here?\u00a0<\/p>\n Edney:<\/strong> Yeah, true. That\u2019s a good point. If RFK Jr. gets this sort of health czar spot \u2014 I\u2019ve been telling people I couldn\u2019t really see him as HHS secretary, because a lot of what he wants to do is under the USDA [Agriculture Department], so that would make no sense. And so if he just kind of has the power he wants in the White House to do what he needs, you make a good point there as well.\u00a0<\/p>\n Rovner:<\/strong> Yeah, what else are \u2014 I would\u2019ve said before yesterday that they would never name RFK Jr. to be HHS secretary. Although after some of the names we got yesterday, maybe that will happen. This could happen while we\u2019re taping this. But what other names are we hearing, if any? I know I have three people here who have been covering the FDA. I mean, obviously during the first Trump administration, the FDA was headed by Scott Gottlieb, who we would consider a traditional Republican, a doctor. He\u2019d worked in the agency before. He\u2019d been in government. That doesn\u2019t seem likely what we\u2019re going to see this time around.\u00a0<\/p>\n Edney:<\/strong> I think that\u2019s true. I think the one thing is what Trump\u2019s focus will be. If he does let someone else kind of take the reins on this, maybe we would see someone a little more measured. I would say right now, most of the names that I\u2019m hearing for HHS or FDA are very much recycling from last time around. And so I\u2019m really unsure whether people are just batting that around because those are names that have come forward before or whether that\u2019s who we\u2019ll actually see named. I think we will know in short order, because I do think that these are coming out quickly. And I appreciated, Julie, that you corrected everyone that they\u2019re not nominated. There is an intent to nominate by a president-elect, so, but still will\u2014\u00a0<\/p>\n Rovner:<\/strong> Although, I will say, his statements say that he\u2019s nominating, which is confusing people.\u00a0<\/p>\n Edney:<\/strong> Yeah. I think they\u2019re less concerned with the specifics.\u00a0<\/p>\n Rovner:<\/strong> Yes. Well, surprise, surprise. All right, now let\u2019s talk about RFK Jr. Obviously, we don\u2019t know what position he\u2019s going to fill, but we\u2019ve talked a lot about his more Republican-friendly positions, anti-vax stuff and raw milk and sort of anti-public-health. But Rachel and Lauren, you\u2019ve got a story up today<\/a> about some other positions that Democrats might be a little more sympathetic to. What are some of those?\u00a0<\/p>\n Roubein:<\/strong> There\u2019s at least two ideas that we had sort of looked at in this story that have found some public support on both the right and the left, such as stripping ultra-processed food from school cafeterias and kind of cracking down on food dyes. And, I mean, one of the things we noted up top is that this is, some of this would be a contradiction from Trump\u2019s first term, where Sonny Perdue, who was Trump\u2019s agriculture secretary, within the first week or two of him being in his position, he vowed to quote-unquote \u201cmake school meals great again\u201d and then kind of waged this assault on Michelle Obama\u2019s efforts to make school meals healthier. That\u2019s not to say that Kennedy being a position of power doesn\u2019t alarm federal health officials or public health experts or people in the food industry, because it does. But there are some policies that he could have a [Sen.] Bernie Sanders agree with him on.\u00a0<\/p>\n Rovner:<\/strong> And while we\u2019re on the subject of ultra-processed food, Lauren, you\u2019re our Lunchables correspondent, and there\u2019s Lunchables news<\/a> this week. Tell us about it.\u00a0<\/p>\n Weber:<\/strong> There is Lunchables news this week, and loyal listeners of the pod will remember that I did a story<\/a> at The Washington Post last year with some of my colleagues that looked at how Lunchables had ended up on school lunch trays for the first time ever. Kraft Heinz had kind of tinkered with the formula, reformulated it, and actually ended up adding more sodium while adding more protein and other things to qualify for the National School Lunch Program. And, obviously, a lot of nutrition experts were appalled because they felt like this is an example of ultra-processed foods that\u2019s being served as free and reduced lunch to kids who don\u2019t necessarily have as much of a choice there on what\u2019s being served to them. And we got news this week that Kraft Heinz didn\u2019t make enough money, that school districts did not purchase their reformulated product, and they had, due to quote \u201clack of demand,\u201d they\u2019re taking them off the options.\u00a0<\/p>\n So it\u2019s kind of interesting. RFK\u2019s push against ultra-processed food is coming at a moment not just in school lunches but in the United States, where there has been growing awareness about ultra-processed foods making up 60% of the American\u2019s diet. And for a very, very long time, food industry has been really successful in Congress at watering down some of the regulations against stuff like ultra-processed food, especially in school lunches, to kind of weaken these regulations, as Rachel talked about, that Michelle Obama had pushed for and other ways, so that they could continue selling their products. And so some of the food industry folks that Rachel and I talked to are quite concerned about a possible RFK role because he\u2019s really pushing against the powers that be there. And it\u2019s really interesting to see that dynamic, because, as Rachel pointed out, the only other person that\u2019s really been doing that recently is Bernie Sanders. So you kind of have this horseshoe of right and left that\u2019s coming to the forefront here.\u00a0<\/p>\n Edney:<\/strong> I was just going to add, I actually wrote my newsletter on this today. The FDA is doing some things in this vein that are sort of interesting. I said it was kind of an RFK-FDA, very tiny, very small Venn diagram in that the agency is also looking at ultra-processed food. They said \u2014 Jim Jones is their deputy commissioner for human foods, and he said recently that they were doing some work trying to figure out how to study whether there\u2019s really causality, but he did say they\u2019ve been working and they have done a lot on certain trans fats, getting them out of food. They\u2019ve done a lot to try to, they\u2019re trying to reduce sodium levels. That\u2019s going to be a stepwise process in food. And they have made consumers a lot more aware, including on the label, of added sugars. And he was like, This is all what we see in processed foods that is a problem.<\/em>\u00a0<\/p>\n And so there\u2019s sort of this quiet\u2014 they\u2019re quietly going after it, just not calling it that. And then on the dyes, they\u2019re certainly not going as far as RFK Jr. and saying, We want to ban all dyes.<\/em> But they have had a petition in front of them for a couple years, and Jim Jones said he expected a response from the FDA. I forget exactly the quote, but it was very soon on what they\u2019re going to do on Red Dye Number 3, which is sort of the one that has been studied the most and has links to cancer and potentially hyperactivity in kids.\u00a0<\/p>\n Roubein:<\/strong> I think it\u2019s also worth noting, in talking about the FDA\u2019s nutrition department, is the day after the election, RFK Jr. was on MSNBC saying that there are entire departments at FDA that have to go, and he specifically said the nutrition department. Again, whether you could just have kind of a mass firing of civil servants is kind of pretty TBD, but that\u2019s how he\u2019s viewing the nutritionists there, and that is alarming to staff. FDA Commissioner Robert Califf the other day said that, called them hardworking people. He was asked about it and had a bit of a defense there.\u00a0<\/p>\n Weber:<\/strong> Just to add in on that, too, there are some nutrition advocates that wouldn\u2019t be that sad about that. I mean, I know that they feel like the FDA has been too slow, is too influenced by industry. I mean, look at the food label story <\/a>that we talked about also on this podcast, that Rachel and I did. The Biden administration was supposed to propose potential front-of-pack labels for front of food, and a lot of nutrition advocates thought, even though this proposal has not come out yet, that what they were thinking about was too weak and too deferential to industry. So RFK has certainly tapped into this growing anger, it seems, at the lack of protections for kids or in general about the food supply. I think part of it is is that he and Trump are very good marketers. They have these catchy slogans, \u201cMake America Healthy Again.\u201d I think that\u2019s somewhat at play as well.\u00a0<\/p>\n Rovner:<\/strong> I think before we leave this sort of next administration segment, though, I do want to broaden it out a little bit, because we\u2019ve been talking about this contradiction that is Donald Trump, which is, on the one hand, he\u2019s got a group of people that wants to strip the federal government of all of its ability to regulate and get rid of regulations and let industry run wild because, as Vivek Ramaswamy says, regulation is a yoke around the neck of innovation. On the other hand, he\u2019s got people like RFK Jr. who want to come in and say: No, let\u2019s get industry out of government. Let government do its job regulating.<\/em> I mean, the health industry must be \u2014 their heads must be spinning, because this obviously is going to affect different portions of the industry different ways, right?\u00a0<\/p>\n Edney:<\/strong> Yeah, it\u2019s a confusing thing, too, when you think about the pharma industry, for instance. I can say, they are highly regulated in the sense that they pay lots of money to the FDA, millions and millions of dollars to have their new drug applications reviewed. There\u2019s a very strict process of what they get for that, what the FDA will do for that. They don\u2019t want that thrown away, because that gives them a lot of security on, Here\u2019s how things are going to work and we need to know that<\/em>, versus if you just had somebody up there being like, Yes to that one, no to that one.<\/em> And there could be other areas. Certainly Big Pharma would not love it if everything was tried to be cured with ivermectin and the hydroxychloroquine. So that would be a problem for all of us. So I think that there\u2019s just a lot of confusion and uncertainty in pharma, at least.\u00a0<\/p>\n Rovner:<\/strong> And I mean, the one thing we know is that industry hates uncertainty. They would like to be able to plan.\u00a0<\/p>\n Edney:<\/strong> Yes. Right, yes. They very much need that for themselves, for their researchers, for their shareholders. That\u2019s super important.\u00a0<\/p>\n Rovner:<\/strong> Yeah, so obviously, everybody in health care is sort of watching eagerly. All right, well, while we\u2019ve all been busy talking about the election, open enrollment began for the Affordable Care Act for 2025, possibly the last year that millions of Americans will remain eligible for expanded subsidies, since a fully Republican Congress and president seem unlikely to extend them beyond December 31st, 2025. What is going to become of the ACA expanded subsidies? Is there any chance they get extended? It would displace millions of people who have gotten health insurance through the ACA.\u00a0<\/p>\n Edney:<\/strong> Well, I think if we\u2019re talking in ways that Trump may be interested in, the insurance companies wouldn\u2019t like it, because they don\u2019t want to lose all of those patients. So I guess maybe that is the potential glimmer of hope for people who want those expanded subsidies to stay intact.\u00a0<\/p>\n Rovner:<\/strong> And we still don\u2019t know what the Republicans have in mind for the Affordable Care Act. As I like to point out, they\u2019ve been talking about a replacement since 2010 and we\u2019ve never actually seen one.\u00a0<\/p>\n Roubein:<\/strong> Trump has concepts of a plan, he says.\u00a0<\/p>\n Rovner:<\/strong> So we have heard.\u00a0<\/p>\n Roubein:<\/strong> Remember that in the debate? I mean, we heard that for how many years, right? Years and years.\u00a0<\/p>\n Rovner:<\/strong> Two weeks. He\u2019s going to have something in two weeks.\u00a0<\/p>\n Edney:<\/strong> I was going to say, if anyone writes an In two weeks it\u2019s coming<\/em> story, they have to buy drinks for everyone.\u00a0<\/p>\n Rovner:<\/strong> Absolutely. Lauren, you wanted to say something.\u00a0<\/p>\n Weber:<\/strong> I mean, I was just going to say that the first Trump administration was not known for expanding any sort of subsidies for the ACA. So I\u2019m curious. But as Anna pointed out, frankly it\u2019s always hard to take away something that\u2019s popular. You don\u2019t necessarily want those people mad at you. So to be quite honest, let\u2019s wait and see.\u00a0<\/p>\n Rovner:<\/strong> Yeah, TBD.\u00a0<\/p>\n Weber:<\/strong> TBD.\u00a0<\/p>\n Rovner:<\/strong> Well, this is also the first year that DACA [Deferred Action for Childhood Arrivals] recipients, the so-called \u201cDreamers\u201d who were brought to the U.S. without documentation as children, are eligible themselves for subsidized ACA coverage. That\u2019s estimated to be about 100,000 people. I wouldn\u2019t expect that to last either, though. And I\u2019m wondering, it might not even make it through the year, as it\u2019s the subject of a lawsuit brought by Republican attorneys general that I expect a new Justice Department would just drop?\u00a0<\/p>\n Roubein:<\/strong> Yeah, I feel like with everything, there\u2019s kind of a road map to look at what Trump did in the first term, just kind of speaking broadly, not just on DACA. But then there are things that they might not do again. So I feel like it\u2019s hard to predict, but yeah, feasibly I feel like that could sort of be the thinking.\u00a0<\/p>\n Rovner:<\/strong> Trump has been nothing more than unpredictable all the way through. So I\u2019m going to do my extra-credit story early this week because I want us all to talk about it a little bit. It\u2019s from my KFF Health News colleague Phil Galewitz, and it\u2019s called \u201cIn Vermont, Where Almost Everyone Has Insurance, Many Can\u2019t Find or Afford Care<\/a>.\u201d And it\u2019s about a problem that\u2019s kind of been sneaking up on us and is now here for all to see: Having insurance is necessary but not sufficient to get health care.\u00a0<\/p>\n As Phil points out, Vermont has basically the lowest uninsured rate in the United States, but care there is expensive. Both providers and insurers are having financial difficulties, and growing numbers of patients either can\u2019t find care or can\u2019t pay for it or both. Some of this appears to be demographics. Vermont is, on average, older and more rural than most other states, and some of it is possibly due to health provider consolidation. But I feel like this is kind of the early warning of the same sorts of things happening around the country. At what point do we have to actually take stock of the fact that our health system is not functioning very well? I mean, we\u2019re so busy talking about what industry wants and what government wants and what will help this group and what will help that group. And it\u2019s like, even with an all-time-low uninsured rate, the stories about people being unable to get care are becoming more than anecdotal, right?\u00a0<\/p>\n Weber:<\/strong> I mean, I think, Julie, go back to the name of this podcast. The podcast is called \u201cWhat the Health?\u201d I mean, I think you\u2019ve, obviously, and all of us here have been covering this for many years. But Phil\u2019s story was just beautifully done, because it showed how multifaceted the problem is. But that also means there\u2019s not a quick fix. But the bottom-line kicker was these people are paying a ton of money for their health care and are having to wait months and months and months for stuff they feel like is not that great, or they\u2019re forced to go across state lines and pay more somewhere else to get it quicker. And obviously that\u2019s, as you said, not quite a solution. So a fascinating look at, what it seems like, a large number of factors that are causing serious issues with people\u2019s health care delivery.\u00a0<\/p>\n Rovner:<\/strong> I just feel like it\u2019s a warning to not \u2014 I mean, obviously we are health reporters. We look at things in the micro. But sometimes I feel like we\u2019re kind of losing the forest for the trees, and this was a really good reminder. It\u2019s like there\u2019s a forest out there and things are not going great in the forest.\u00a0<\/p>\n All right, well, let\u2019s turn to abortion. Even though seven out of 10 states with ballot measures voted for the abortion rights position \u2014 eight states, if you count Florida, where the measure to overturn the state six-week ban got 57%, but that was short of the 60% it needed to pass \u2014 the anti-abortion movement is nonetheless gearing up to undo as much of this as it can.\u00a0<\/p>\n According to our podcast panelist Alice Ollstein<\/a>, some of the strategies anti-abortion groups plan to pursue are ones that we have talked about here before, including requiring that abortion pills be labeled as a controlled substance, like they\u2019re doing in Louisiana, or that the remains of medication abortion be handled as medical waste. Other ideas are new or at least new-ish, like trying to cut off funding to colleges and universities that provide abortion pills at campus facilities. The anti-abortion movement is also trying to push state legislation aimed at circumventing the protective amendments that those states\u2019 voters just passed. This fight is a long way from being over, right?\u00a0<\/p>\n Edney:<\/strong> Oh, yeah. And you just mentioned states. That\u2019s where I\u2019m sure that a lot of the focus is, because if Trump holds to his word, and I don\u2019t know if that\u2019s the case, he said it should be up to the states on how they handle all of this stuff. So I imagine now is their moment if they\u2019re going to try some of these more out-of-the-box ways of dealing with it.\u00a0<\/p>\n Roubein:<\/strong> And I think one thing that emerged, particularly after Republicans took back the House in 2022 and Roe v. Wade<\/em> was overturned, was that the battleground being states, but also the executive branch. The battleground in terms of Congress, the House didn\u2019t bring up a bill to ban abortion at 15 weeks or anything politically\u2014\u00a0<\/p>\n Rovner:<\/strong> They couldn\u2019t have gotten the votes with their tiny majority.\u00a0<\/p>\n Roubein:<\/strong> Yeah, it\u2019s very politically tricky. We\u2019ve seen Republicans back away from those stances. And then you look at the Biden administration, which has said, There are things we can do to sort of do some guidelines, et cetera,<\/em> like letting the VA [Department of Veterans Affairs] do abortions in certain instances, or they rolled back Trump\u2019s changes on the Title X federal family program that basically forced Planned Parenthood out. So you could sort of see some of those things being rolled back again.\u00a0<\/p>\n Rovner:<\/strong> Well, one of the things that I haven\u2019t seen noted by anybody, and I absolutely agree with you about: The first thing that the Trump and whoever in the Trump administration to do is reverse the things that [President Joe] Biden did, which in some ways were reversals of things that Trump did the first time around. But we do have a bunch of abortion-related lawsuits still in play that involve the Justice Department. Remember that Supreme Court case where the justices ruled that the anti-abortion doctors who brought the case didn\u2019t have standing to sue? Well, that case is still alive. It\u2019s still in court, because states have stepped in as plaintiffs. Then there are cases challenging the Biden administration\u2019s interpretation of EMTALA, which is the federal law that requires emergency abortions be provided to protect a pregnant woman\u2019s health and says that those override state laws that only allow abortions if the woman\u2019s life is imminently endangered. I would think those cases would go away under Attorney General Matt Gaetz or whoever is going to be in charge of the Justice Department, right?\u00a0<\/p>\n Edney:<\/strong> I mean, that makes perfect sense to me that they would not continue arguing those by any means unless Trump is more focused on trying to overturn his own convictions. I don\u2019t know what that could look like.\u00a0<\/p>\n Rovner:<\/strong> Yes, no matter what, the Justice Department will be very busy, but I suspect not very busy arguing the abortion rights side of abortion cases.\u00a0<\/p>\n Edney:<\/strong> Right.\u00a0<\/p>\n Rovner:<\/strong> Well, I want to turn to Medicare. Trump insisted during the campaign that he wouldn\u2019t touch Medicare, but that\u2019s not actually possible for a Congress and an administration. The only real question is how Medicare will be touched. Doctors are, once again, facing a Medicare pay cut for next year. This one is just under 3%. And that\u2019s something that the lame-duck Congress, which is just getting back into session this week, may or may not cancel, given how crazy things are right now on Capitol Hill. And The Wall Street Journal has a piece this week<\/a> about how sicker people are leaving their Medicare Advantage plans to return to traditional Medicare, which makes sense because private Medicare Advantage plans make care harder to access when you\u2019re sick. So that ends up making \u2014 when they leave, it ends up making the plans richer because they don\u2019t have to pay for the care, and the taxpayers poorer because now Medicare, traditional Medicare, is paying for the care. So Medicare\u2019s going to have to be on the table in some form. We can\u2019t just ignore Medicare for four years, right?\u00a0<\/p>\n Edney:<\/strong> Yeah, I think particularly this is the sort of bigger picture. But when you think about if Trump does want to do a bunch of tax cuts and where does the money come from, I\u2019m sure there are ways to do it. There are all kinds of budget tricks that can be done to look like you\u2019re not touching Medicare but you\u2019re touching Medicare, so you can keep that campaign promise. And I don\u2019t know if that\u2019s really on the table for them, but I don\u2019t think we can expect no one to be looking at this, particularly also because of the sort of Republican desire to prop up the Medicare Advantage a little bit more to get \u2026 So I don\u2019t know if there\u2019s a way to encourage some people back on those plans or how they\u2019re going to look at that.\u00a0<\/p>\n Rovner:<\/strong> Yeah, it\u2019s important to remember that the traditional Republican idea on Medicare is to get more people to go into Medicare Advantage, which is happening naturally anyway because people who are aging into Medicare are mostly coming out of managed care plans, so they\u2019re used to being in managed care plans. So it\u2019s easy for them to go into these Medicare Advantage plans that say, Hey, we\u2019re going to offer you extra benefits that Medicare doesn\u2019t.<\/em> And it\u2019s not until they actually need care and can\u2019t get it that they realize that maybe that wasn\u2019t the best idea. But I certainly expect this entire debate to carry over to the next administration.\u00a0<\/p>\n Edney:<\/strong> Well, and you also \u2026 I don\u2019t know why, but you reminded me that there are still drugs to negotiate under Medicare.\u00a0<\/p>\n Rovner:<\/strong> That\u2019s right.\u00a0<\/p>\n Edney:<\/strong> And you somehow have to deal with that, and taking it away would be pretty difficult, seemingly.\u00a0<\/p>\n Rovner:<\/strong> And cost a lot of money.\u00a0<\/p>\n Edney:<\/strong> And cost a lot of money. But you could negotiate things differently or \u2014 I\u2019m not sure.\u00a0<\/p>\n Rovner:<\/strong> Yes, we\u2019ll have plenty of Medicare to talk about. All right, well, that is the news, at least up until this moment. Now it\u2019s time for our extra-credit segment. That\u2019s where we each recognize a story we read this week we think you should read, too. Don\u2019t worry if you miss it. We will put the links in our show notes on your phone or other mobile device. I\u2019ve already done mine. Anna, why don\u2019t you go next? Yours is so very on brand for you.\u00a0<\/p>\n Edney:<\/strong> Thank you. So mine is from The Atlantic. It\u2019s called \u201cThrow Out Your Black Plastic Spatula<\/a>.\u201d Certainly, I grew up in my family and my parents still have all their black cooking utensils. And what this is talking about is how most of our black cooking utensils are made from recycled electronics. And there\u2019s a whole reason for that. It\u2019s really interesting to read about. But the outcome is that there are also a lot of fire retardants in those, so we are getting fire retardants leaching out into our food.\u00a0<\/p>\n Rovner:<\/strong> Of course, fire retardants are why they had them in the first place, right? Because you\u2019re putting them in very hot things.\u00a0<\/p>\n Edney:<\/strong> Well, this is more because of the electronics. Like, yeah, when you\u2019re using an electronic, I guess there\u2019s fire retardants in there because you don\u2019t want the battery blowing up or whatever. But if you\u2019re recycling those and making utensils out of them, then you\u2019re going to get some of that in your food.\u00a0<\/p>\n Rovner:<\/strong> The dark side of recycling.\u00a0<\/p>\n Edney:<\/strong> Yes.\u00a0<\/p>\n Rovner:<\/strong> Lauren, why don\u2019t you go next?\u00a0<\/p>\n Weber:<\/strong> Mine\u2019s actually a study in JAMA that\u2019s titled \u201cMedical Board Discipline of Physicians for Spreading Medical Misinformation<\/a>.\u201d And the study found that actually the least common reason for medical board discipline was spreading misinformation, which was not actually news to me or some of my colleagues at The Washington Post, as they cite our work in this study. But Lena Sun, Hayden Godfrey, and I last year did a large investigation<\/a> in which we actually surveyed all 50 medical boards and went through and asked them about whether or not they had disciplined anyone for misinformation.\u00a0<\/p>\n And then on the boards that did not respond, which was many, we then went through and read every single disciplinary action to see what we could find. And the bottom line is is doctors didn\u2019t get punished. There\u2019s a lot of free-speech protections, and, frankly, it had to be very, very, very egregious for medical boards to step in. In general, medical boards are weak. They are known to be poor at self-regulating their own. It takes a lot to really get punished by a medical board, so it\u2019s not that surprising. But after a lot of clamor during covid and a lot of physicians that really became megaphones for unscientific evidence, it\u2019s still quite striking that not very many of them faced any sort of repercussions for that.\u00a0<\/p>\n Rovner:<\/strong> Yeah, another issue going forward. Rachel.\u00a0<\/p>\n Roubein:<\/strong> My extra credit, it\u2019s titled \u201c\u2018Been a Long Time Since I Felt That Way\u2019: Sexually Transmitted Infection Numbers Provide New Hope<\/a>,\u201d in Politico by Alice Miranda Ollstein. The story talks about basically how there\u2019s been this drop in sexually transmitted infections, and that has followed years of just skyrocketing cases. So this is from new data from the Centers for Disease Control and Prevention that came out this week. So, for instance, total cases of syphilis increased 1% and congenital syphilis ticked up 3%, but that\u2019s a far slower rate of growth than the spikes of the last few years. So that\u2019s an encouraging note for STD health directors in states. But in the piece, she talks about how there\u2019s some concern from public health experts and other advocates about potentially backsliding under Trump, depending what happens, and also noting that Congress last year clawed back hundreds of millions of dollars in public health funding.\u00a0<\/p>\n Rovner:<\/strong> That\u2019s right. And obviously the federal Family Planning Program plays a big role in the prevention of sexually transmitted infections, and we have no idea what\u2019s going to become of the federal Family Planning Program under a Republican trifecta. So again, a story that I\u2019m sure we will spend more time talking about.\u00a0<\/p>\n All right, that is this week\u2019s show. As always, if you enjoy the podcast, you can subscribe wherever you get your podcasts. We\u2019d appreciate it if you left us a review. That helps other people find us, too. Special thanks this week to our temporary production team, Taylor Cook and Lonnie Ro, as well as our editor, Emmarie Huetteman. As always, you can email us your comments or questions. We\u2019re at whatthehealth, all one word, @kff.org. Or you can still find me at X @jrovner<\/a> and increasingly at Bluesky @julierovner.bsky.social<\/a>. Where are you guys these days? Lauren?\u00a0<\/p>\n Weber:<\/strong> Still just on X, LaurenWeberHP<\/a>. The \u201cHP\u201d is for \u201chealth policy.\u201d\u00a0<\/p>\n Rovner:<\/strong> Anna.\u00a0<\/p>\n Edney:<\/strong> On X. It\u2019s @annaedney<\/a>. And I am trying out Bluesky<\/a> as well, but I\u2019m so new that I don\u2019t even remember my name.\u00a0<\/p>\n Rovner:<\/strong> It\u2019s OK.\u00a0<\/p>\n Edney:<\/strong> I\u2019ll get that next time.\u00a0<\/p>\n Rovner:<\/strong> Rachel.\u00a0<\/p>\n Roubein:<\/strong> Similarly to Lauren, on X, @rachel_roubein<\/a>.\u00a0<\/p>\n Rovner:<\/strong> We will be back in your feed next week. Until then, be healthy.\u00a0<\/p>\n \tTaylor Cook \tLonnie Ro \tEmmarie Huetteman To hear all our podcasts,\u00a0click here<\/a>.<\/em><\/p>\n And subscribe to KFF Health News\u2019 \u201cWhat the Health?\u201d on\u00a0Spotify<\/a>,\u00a0Apple Podcasts<\/a>,\u00a0Pocket Casts<\/a>, or wherever you listen to podcasts.<\/em><\/p>\n
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