{"id":2173869,"date":"2026-03-26T15:25:00","date_gmt":"2026-03-26T19:25:00","guid":{"rendered":"https:\/\/kffhealthnews.org\/?p=2173869&#038;post_type=podcast&#038;preview_id=2173869"},"modified":"2026-04-01T16:58:29","modified_gmt":"2026-04-01T20:58:29","slug":"what-the-health-439-cdc-lacks-leader-march-26-2026","status":"publish","type":"podcast","link":"https:\/\/kffhealthnews.org\/news\/podcast\/what-the-health-439-cdc-lacks-leader-march-26-2026\/","title":{"rendered":"What the Health? From KFF Health News: A Headless CDC"},"content":{"rendered":"\n<div class=\"wp-block-group is-layout-flow wp-block-group-is-layout-flow\"><div class=\"block--iframe\">\n\t<iframe\n\t\tallow=\"fullscreen\"\n\t\tframeborder=\"0\"\n\t\theight=\"188\"\n\t\tsrc=\"https:\/\/play.prx.org\/e?ge=prx_14448_98c75808-bd9e-4ab1-9522-cbcd98d6b5c9&#038;uf=https%3A%2F%2Fwhatthehealth.feeds.wamu.org\"\n\t\twidth=\"100%\"\n\t><\/iframe>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-people block--people\">\n\t\t<h3 class=\"people-title\">\n\t\tThe Host\t<\/h3>\n\t\t<div class=\"people-card-container single\">\n\t\n\n<div class=\"wp-block-people-card block--people-card\">\n\t\t\t\t<div class=\"author-image-container\">\n\t\t\t<img srcset=\"https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg 1100w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg?resize=150,150 150w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg?resize=500,500 500w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg?resize=768,768 768w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg?resize=480,480 480w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg?resize=100,100 100w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg?resize=120,120 120w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg?resize=170,170 170w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg?resize=300,300 300w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg?resize=315,315 315w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg?resize=630,630 630w\" sizes=\"(max-width: 767px) 100vw, 500px\" \/>\n\t\t<\/div>\n\t\t<div class=\"author-meta-container\">\n\t<div class=\"author-name\">Julie Rovner<\/div>\n\t<div class=\"author-affiliation\">KFF Health News<\/div>\n\t\t\t<div class=\"author-x\">\n\t\t\t<a class=\"icon-x author-link\" href=\"https:\/\/twitter.com\/jrovner\" title=\"@jrovner\">\n\t\t\t\t@jrovner\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<div class=\"author-bluesky\">\n\t\t\t<a class=\"icon-bluesky author-link\" href=\"https:\/\/bsky.app\/profile\/julierovner.bsky.social\" title=\"@julierovner.bsky.social\">\n\t\t\t\t@julierovner.bsky.social\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"author-stories-link\">\n\t\t\t<a class=\"author-link\" href=\"https:\/\/kffhealthnews.org\/news\/author\/julie-rovner\/\"> \n\t\t\t\tRead Julie&#039;s stories.\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t<div class=\"author-bio\">\n\t\t\tJulie Rovner is chief Washington correspondent and host of KFF Health News\u2019 weekly health policy news podcast, &quot;What the Health?&quot; A noted expert on health policy issues, Julie is the author of the critically praised reference book &quot;Health Care Politics and Policy A to Z,&quot; now in its third edition.\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\t<\/div>\n<\/div>\n\n\n\n<p>The Trump administration this week missed a deadline to nominate a new director for the Centers for Disease Control and Prevention. Without a nominee, current acting Director Jay Bhattacharya \u2014 who is also the director of the National Institutes of Health \u2014 has to give up that title, leaving no one at the helm of the nation\u2019s primary public health agency.&nbsp;<\/p>\n\n\n\n<p>Meanwhile, a week after one federal judge blocked changes to the childhood vaccine schedule made by the Department of Health and Human Services, another blocked a proposed ban on gender-affirming care for minors.&nbsp;<\/p>\n\n\n\n<p>This week\u2019s panelists are Julie Rovner of KFF Health News, Rachel Cohrs Zhang of Bloomberg News, Lizzy Lawrence of Stat, and Shefali Luthra of The 19th.<\/p>\n\n\n\n<div class=\"wp-block-people block--people\">\n\t\t<h3 class=\"people-title\">\n\t\tPanelists\t<\/h3>\n\t\t<div class=\"people-card-container threewide\">\n\t\n\n<div class=\"wp-block-people-card block--people-card\">\n\t\t\t\t<div class=\"author-image-container\">\n\t\t\t<img srcset=\"https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/rachel-cohrs-zhang_1024sq.jpg 1024w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/rachel-cohrs-zhang_1024sq.jpg?resize=150,150 150w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/rachel-cohrs-zhang_1024sq.jpg?resize=500,500 500w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/rachel-cohrs-zhang_1024sq.jpg?resize=768,768 768w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/rachel-cohrs-zhang_1024sq.jpg?resize=480,480 480w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/rachel-cohrs-zhang_1024sq.jpg?resize=100,100 100w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/rachel-cohrs-zhang_1024sq.jpg?resize=120,120 120w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/rachel-cohrs-zhang_1024sq.jpg?resize=170,170 170w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/rachel-cohrs-zhang_1024sq.jpg?resize=300,300 300w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/rachel-cohrs-zhang_1024sq.jpg?resize=315,315 315w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/rachel-cohrs-zhang_1024sq.jpg?resize=630,630 630w\" sizes=\"(max-width: 767px) 100vw, 500px\" \/>\n\t\t<\/div>\n\t\t<div class=\"author-meta-container\">\n\t<div class=\"author-name\">Rachel Cohrs Zhang<\/div>\n\t<div class=\"author-affiliation\">Bloomberg News<\/div>\n\t\t\t<div class=\"author-x\">\n\t\t\t<a class=\"icon-x author-link\" href=\"https:\/\/twitter.com\/rachelcohrs\" title=\"@rachelcohrs\">\n\t\t\t\t@rachelcohrs\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t\t\t<div class=\"author-bio\">\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-people-card block--people-card\">\n\t\t\t\t<div class=\"author-image-container\">\n\t\t\t<img srcset=\"https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Lawrence-Lizzy_1000sq.jpg 1000w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Lawrence-Lizzy_1000sq.jpg?resize=150,150 150w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Lawrence-Lizzy_1000sq.jpg?resize=500,500 500w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Lawrence-Lizzy_1000sq.jpg?resize=768,768 768w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Lawrence-Lizzy_1000sq.jpg?resize=480,480 480w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Lawrence-Lizzy_1000sq.jpg?resize=100,100 100w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Lawrence-Lizzy_1000sq.jpg?resize=120,120 120w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Lawrence-Lizzy_1000sq.jpg?resize=170,170 170w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Lawrence-Lizzy_1000sq.jpg?resize=300,300 300w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Lawrence-Lizzy_1000sq.jpg?resize=315,315 315w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Lawrence-Lizzy_1000sq.jpg?resize=630,630 630w\" sizes=\"(max-width: 767px) 100vw, 500px\" \/>\n\t\t<\/div>\n\t\t<div class=\"author-meta-container\">\n\t<div class=\"author-name\">Lizzy Lawrence<\/div>\n\t<div class=\"author-affiliation\">Stat<\/div>\n\t\t\t<div class=\"author-x\">\n\t\t\t<a class=\"icon-x author-link\" href=\"https:\/\/twitter.com\/LizzyLaw_\" title=\"@LizzyLaw_\">\n\t\t\t\t@LizzyLaw_\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<div class=\"author-bluesky\">\n\t\t\t<a class=\"icon-bluesky author-link\" href=\"https:\/\/bsky.app\/profile\/lizzylawrence.bsky.social\" title=\"@lizzylawrence.bsky.social\">\n\t\t\t\t@lizzylawrence.bsky.social\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"author-stories-link\">\n\t\t\t<a class=\"author-link\" href=\"https:\/\/www.statnews.com\/staff\/lizzy-lawrence\/\"> \n\t\t\t\tReady Lizzy&#039;s stories.\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t<div class=\"author-bio\">\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-people-card block--people-card\">\n\t\t\t\t<div class=\"author-image-container\">\n\t\t\t<img srcset=\"https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Luthra_757sq.jpg 757w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Luthra_757sq.jpg?resize=150,150 150w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Luthra_757sq.jpg?resize=500,500 500w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Luthra_757sq.jpg?resize=480,480 480w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Luthra_757sq.jpg?resize=100,100 100w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Luthra_757sq.jpg?resize=120,120 120w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Luthra_757sq.jpg?resize=170,170 170w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Luthra_757sq.jpg?resize=300,300 300w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Luthra_757sq.jpg?resize=315,315 315w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Luthra_757sq.jpg?resize=630,630 630w\" sizes=\"(max-width: 767px) 100vw, 500px\" \/>\n\t\t<\/div>\n\t\t<div class=\"author-meta-container\">\n\t<div class=\"author-name\">Shefali Luthra<\/div>\n\t<div class=\"author-affiliation\">The 19th<\/div>\n\t\t\t\t<div class=\"author-bluesky\">\n\t\t\t<a class=\"icon-bluesky author-link\" href=\"https:\/\/bsky.app\/profile\/shefali.bsky.social\" title=\"@shefali.bsky.social\">\n\t\t\t\t@shefali.bsky.social\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"author-stories-link\">\n\t\t\t<a class=\"author-link\" href=\"https:\/\/19thnews.org\/author\/shefali-luthra\/\"> \n\t\t\t\tRead Shefali&#039;s stories.\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t<div class=\"author-bio\">\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\t<\/div>\n<\/div>\n\n\n\n<p>Among the takeaways from this week\u2019s episode:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>A federal judge ruled against the Trump administration\u2019s declaration intended to limit trans care for minors, though the ruling\u2019s practical effects will depend on whether hospitals resume such care. And a key member of the remade federal vaccine advisory panel resigned as the panel\u2019s activities \u2014 and even membership \u2014 remain in legal limbo.<\/li>\n\n\n\n<li>Two senior administration health posts remain unfilled, after President Donald Trump missed a deadline to fill the top job at the Centers for Disease Control and Prevention \u2014 and the Senate made little progress on confirming his nominee for surgeon general.<\/li>\n\n\n\n<li>The percentage of international graduates from foreign medical schools who match into U.S. residency positions has dropped to a five-year low. That\u2019s notable given immigrants represent a quarter of physicians, many of them in critical but lower-paid specialties such as primary care \u2014 particularly in rural areas. Meanwhile, new surveys show that more than a quarter of labs funded by the National Institutes of Health have laid off workers and that federal research funding cuts have had a disproportionate effect on women and early-career scientists.<\/li>\n\n\n\n<li>And new data shows the number of abortions in the United States stayed relatively stable last year, for the second straight year \u2014 largely due to telehealth access to abortion care. And a vocal opponent of abortion in the Senate, with his eyes on a presidential run, introduced legislation to effectively rescind federal approval for the abortion pill mifepristone.<\/li>\n<\/ul>\n\n\n\n<p>Also this week, Rovner interviews Georgetown Law Center\u2019s Katie Keith about the state of the Affordable Care Act on its 16th anniversary.<\/p>\n\n\n\n<p><\/p>\n\n\n<div\n\tclass=\"wp-block block--newsletter  \"\n\tdata-type=\"kaiser-health-news\/newsletter\"\n\tdata-align=\"center\"\n\tstyle=\"\"\n>\n\t<h4 class=\"newsletter__title\">\n\t\t<a href=\"\/email\/\">\n\t\t\tEmail Sign-Up\t\t<\/a>\n\t<\/h4>\n\t<p class=\"newsletter__description\">\n\t\tSubscribe to KFF Health News&#039; free Morning Briefing.\t<\/p>\n\t\n<form\n\taction=\"\/email-signup\/\"\n\tclass=\"kaiser-hubspot-mini-signup-form\"\n\tmethod=\"post\"\n>\n\t<input type=\"hidden\" id=\"kaiser_hubspot_nonce\" name=\"kaiser_hubspot_nonce\" value=\"87a489a56a\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/wp-json\/wp\/v2\/podcast\/2173869\" \/>\t\t\t\t<label\n\t\tclass=\"kaiser-hubspot-mini-signup-form__label--email\"\n\t\tfor=\"kaiser-hubspot-mini-signup-form-email\"\n\t>\n\t\t<span class=\"screen-reader-text\">\n\t\t\tYour Email Address\t\t<\/span>\n\t\t<input\n\t\t\tautocomplete=\"email\"\n\t\t\tclass=\"kaiser-hubspot-mini-signup-form__input--email\"\n\t\t\tid=\"kaiser-hubspot-mini-signup-form-email\"\n\t\t\tname=\"kaiser_hubspot_email\"\n\t\t\ttype=\"email\"\n\t\t\t\t\t\t\tplaceholder=\"Your email address\"\n\t\t\t\t\t\/>\n\t<\/label>\n\t<button class=\"kaiser-hubspot-mini-signup-form__submit\">\n\t\tSign Up\t<\/button>\n<\/form>\n<\/div>\n\n\n\n<p>Plus, for \u201cextra credit,\u201d the panelists suggest health policy stories they read this week that they think you should read, too:<\/p>\n\n\n\n<p><strong>Julie Rovner:<\/strong> Stat\u2019s \u201c<a href=\"https:\/\/www.statnews.com\/2026\/03\/24\/trump-mfn-drug-pricing-gop-strategy-raise-prices-overseas\/\">The Potential Loophole in Trump\u2019s Plan To Get Other Countries To Pay More for Drugs<\/a>,\u201d by John Wilkerson.&nbsp;<\/p>\n\n\n\n<p><strong>Shefali Luthra:<\/strong> NPR\u2019s \u201c<a href=\"https:\/\/www.npr.org\/2026\/03\/25\/nx-s1-5759732\/covid-vaccination-pregnancy-safety-efficacy\">Yep. A Mom\u2019s COVID Shot During Pregnancy Protects Her Baby, a Large Study Finds<\/a>,\u201d by Tara Haelle.&nbsp;<\/p>\n\n\n\n<p><strong>Lizzy Lawrence:<\/strong> The Atlantic\u2019s \u201c<a href=\"https:\/\/www.theatlantic.com\/health\/2026\/03\/robert-f-kennedy-jr-meme-laundering\/686515\/\">The Meme-Washing of RFK Jr.<\/a>,\u201d by Nicholas Florko.&nbsp;<\/p>\n\n\n\n<p><strong>Rachel Cohrs Zhang: <\/strong>The Boston Globe\u2019s \u201c<a href=\"https:\/\/www.bostonglobe.com\/2026\/03\/25\/nation\/tony-lyons-maha-rfk-jr\/?p1=StaffPage\">\u2018We\u2019re on the Inside Now\u2019: Meet the Man Building a Political Empire Behind RFK Jr.<\/a>,\u201d by Tal Kopan.&nbsp;<\/p>\n\n\n\n<p>Also mentioned in this week\u2019s podcast:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Stat\u2019s \u201c<a href=\"https:\/\/www.statnews.com\/2026\/03\/19\/nih-funding-national-researcher-survey-finds-cutbacks-disruptions\/\">National Survey of NIH-Funded Researchers Shows Precarious State of U.S. Science \u2014 \u2018This Is Like the Titanic<\/a>,\u2019\u201d by Jonathan Wosen.<\/li>\n\n\n\n<li>KFF Health News\u2019 \u201c<a href=\"https:\/\/kffhealthnews.org\/news\/article\/health-costs-middle-aged-adults-delay-affordable-care-act-obamacare-medicare\/\">Rising Health Costs Push Some Middle-Aged Adults To Skip the Doc Until Medicare<\/a>,\u201d by Sam Whitehead.<\/li>\n\n\n\n<li>Guttmacher\u2019s \u201c<a href=\"https:\/\/www.guttmacher.org\/report\/full-year-estimates-show-overall-stability-abortion-incidence-decreased-travel-increased-telehealth-provision\">Full-Year 2025 Estimates Show Overall Stability in Abortion Incidence, Decreased Travel and Increased Telehealth Provision<\/a>,\u201d by Isaac Maddow-Zimet and Kimya Forouzan.<\/li>\n\n\n\n<li>United for Medical Research\u2019s \u201c<a href=\"https:\/\/www.unitedformedicalresearch.org\/annual-economic-report\/\">2026 Update: NIH\u2019s Role in Sustaining the U.S. Economy<\/a>.\u201d<\/li>\n<\/ul>\n\n\n\n<section class=\"block--expandable has-label\"\n\t\t\tid=\"podcast-expandable\"\n\t>\n\t\t\t<input type=\"checkbox\" name=\"expandable-radio\" id=\"transcript-a-headless-cdc\">\n\t\t<label class=\"expandable__title-label\" for=\"transcript-a-headless-cdc\">\n\t\t\t\t\t\t\t<span\n\t\t\t\t\tclass=\"expandable__label  \"\n\t\t\t\t\tstyle=\"background-color: #cb1919;\"\n\t\t\t\t>\n\t\t\t\t\tclick to open the transcript\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span\n\t\t\t\t\tclass=\"expandable__title\"\n\t\t\t\t\tstyle=\"font-size: 36px;\"\n\t\t\t\t>\n\t\t\t\t\t\tTranscript: A Headless CDC\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\t\t<div class=\"expandable__content--container\">\n\t\t<div class=\"expandable__content\">\n\t\t\t\n\n<p><strong><em>[Editor\u2019s note:<\/em><\/strong><em>&nbsp;This transcript was generated using both transcription software and a human\u2019s light touch. It has been edited for style and clarity.]<\/em>&nbsp;<\/p>\n\n\n\n<p><strong>Julie Rovner:<\/strong>&nbsp;Hello,&nbsp;from KFF Health News and WAMU Public Radio in Washington, D.C. Welcome to&nbsp;<em>What the Health?<\/em>&nbsp;I\u2019m&nbsp;Julie Rovner, chief Washington correspondent for KFF Health News, and&nbsp;I\u2019m&nbsp;joined by some of the best and smartest reporters&nbsp;covering&nbsp;Washington.&nbsp;We\u2019re&nbsp;taping this week on Thursday,&nbsp;March 26,&nbsp;at 10&nbsp;a.m.&nbsp;As always, news happens fast, and things might have changed by the time you hear this. So,&nbsp;here we go.&nbsp;<\/p>\n\n\n\n<p>Today,&nbsp;we are joined via video conference by Rachel&nbsp;Cohrs Zhang&nbsp;of Bloomberg News.&nbsp;<\/p>\n\n\n\n<p><strong>Rachel Cohrs Zhang:<\/strong>&nbsp;Hi,&nbsp;everybody.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>Shefali Luthra&nbsp;of&nbsp;The&nbsp;19th.&nbsp;<\/p>\n\n\n\n<p><strong>Shefali Luthra:<\/strong>&nbsp;Hello.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong>&nbsp;And Lizzy Lawrence of Stat News.&nbsp;<\/p>\n\n\n\n<p><strong>Lizzy Lawrence:<\/strong>&nbsp;Hello.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>Later in this episode&nbsp;we\u2019ll&nbsp;have my interview with Katie Keith of Georgetown University about the state of the Affordable Care Act as it turns 16&nbsp;\u2014&nbsp;old enough to drive in most states. But first,&nbsp;this week\u2019s news.&nbsp;<\/p>\n\n\n\n<p>So,&nbsp;it has been another busy week at the Department of Health and Human Services. Last week, a federal judge in Massachusetts blocked the department\u2019s vaccine policy,&nbsp;ruling it had violated federal administrative procedures&nbsp;regarding&nbsp;advisory committees. This week, a federal judge in Portland, Oregon,&nbsp;ruled the department also&nbsp;didn\u2019t&nbsp;follow the required process to block federal reimbursement for transgender-related medical treatment. The case was brought by 21&nbsp;Democratic-led states. Where does this leave the hot-button issue of care for transgender teens? Shefali,&nbsp;you\u2019ve&nbsp;been following this.&nbsp;<\/p>\n\n\n\n<p><strong>Luthra:&nbsp;<\/strong>I mean, I think it\u2019s still really up in the air.&nbsp;A lot of this depends on how hospitals now respond&nbsp;\u2014&nbsp;whether they feel confident in the court\u2019s decision,&nbsp;having staying&nbsp;power enough to actually resume offering services.&nbsp;Because a lot of them stopped.&nbsp;And so that\u2019s something we\u2019re still waiting to actually see how this plays out in practice.&nbsp;Obviously,&nbsp;it\u2019s&nbsp;very symbolic, very legally meaningful, but whether this will translate into changes in practical health care access, I think, is&nbsp;an open question still.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>Yeah, we will&nbsp;definitely have&nbsp;to see how&nbsp;this one plays&nbsp;out&nbsp;\u2014 and,&nbsp;obviously,&nbsp;if and when&nbsp;the administration&nbsp;appeals&nbsp;it. Well, speaking of that vaccine ruling from last week&nbsp;\u2014&nbsp;which,&nbsp;apparently,&nbsp;the&nbsp;administration has not yet appealed, but is going to&nbsp;\u2014&nbsp;one of the most contentious members of that very contentious Advisory Committee on Immunization Practices has resigned. Dr.&nbsp;Robert Malone, a physician and&nbsp;biochemist, said he&nbsp;didn\u2019t&nbsp;want to be part of the&nbsp;\u201cdrama,\u201d&nbsp;air quotes.&nbsp;But he caused a lot of&nbsp;the drama, didn\u2019t he?&nbsp;<\/p>\n\n\n\n<p><strong>Cohrs Zhang:&nbsp;<\/strong>He has been&nbsp;pretty outspoken, and&nbsp;I think he&nbsp;isn\u2019t&nbsp;like a Washington person necessarily&nbsp;\u2014&nbsp;isn\u2019t&nbsp;somebody&nbsp;who\u2019s&nbsp;used to,&nbsp;like,&nbsp;being on a public stage and having your social media posts appear in large publications.&nbsp;So&nbsp;I think&nbsp;it\u2019s&nbsp;questionable, like, whether he had a position to resign from.&nbsp;I think his nomination&nbsp;was stayed,&nbsp;too.&nbsp;But I think it is&nbsp;\u2026&nbsp;the back-and-forth,&nbsp;I think,&nbsp;there is a good point that this limbo can be frustrating for people when meetings&nbsp;are canceled&nbsp;at&nbsp;the last minute, and people have travel plans,&nbsp;and it does&nbsp;\u2026&nbsp;just changes the calculus for kind of making it worth it to serve on one of these advisory committees.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>And I\u2019m not sure whether we mentioned it last week, but the judge\u2019s ruling not only said that the people were incorrectly appointed to ACIP, but it also stayed any meetings of the advisory committee until there is further court action, until basically, the case is done or it\u2019s overruled by a higher court. So&nbsp;\u2026&nbsp;vaccine policy&nbsp;definitely is&nbsp;in limbo.&nbsp;&nbsp;<\/p>\n\n\n\n<p>Well, meanwhile, yesterday was the deadline for the administration to nominate someone to head the Centers for Disease Control and Prevention since Susan&nbsp;Monarez&nbsp;was abruptly dismissed, let&nbsp;go, resigned, whatever, late last summer. Now that that deadline has passed, it means that acting&nbsp;Director Jay Bhattacharya, who had added that title to his day job as head of the National Institutes of Health,&nbsp;can no longer&nbsp;remain&nbsp;acting&nbsp;director of CDC.&nbsp;Apparently, though&nbsp;he&#8217;s&nbsp;going to&nbsp;sort of remain&nbsp;in charge, according to HHS spokespeople, with some authorities reverting to&nbsp;[Health and Human Services]&nbsp;Secretary&nbsp;[Robert F.]&nbsp;Kennedy&nbsp;[Jr.].&nbsp;What\u2019s&nbsp;taking so long to find a CDC director?&nbsp;&nbsp;<\/p>\n\n\n\n<p>To quote D.C.&nbsp;cardiologist and frequent cable TV health policy commentator&nbsp;<a href=\"https:\/\/x.com\/JReinerMD\/status\/2036915928609251636\" target=\"_blank\" rel=\"noreferrer noopener\">Jonathan Reiner<\/a>,&nbsp;\u201cThe problem here is that&nbsp;there\u2019s&nbsp;no candidate&nbsp;who\u2019s&nbsp;qualified, MAHA acceptable, and Senate confirmable. Those job requirements are mutually exclusive.\u201d&nbsp;That feels kind of accurate to me.&nbsp;Is that actually&nbsp;the&nbsp;problem?&nbsp;Rachel, I see you smiling.&nbsp;<\/p>\n\n\n\n<p><strong>Cohrs Zhang:&nbsp;<\/strong>Yeah.&nbsp;I think it is tough to find somebody who checks all of those boxes.&nbsp;And though it has been&nbsp;210 days&nbsp;since the clock&nbsp;has started, I would just point out that there has been a significant leadership shake-up at HHS, like among the people who are kind of running this search, and they came in, you know, not that long ago.&nbsp;It\u2019s&nbsp;only been, you know,&nbsp;a&nbsp;month and a half or so.&nbsp;So&nbsp;I think there certainly have been some&nbsp;new faces&nbsp;in the room who might have different opinions.&nbsp;But&nbsp;I think it&nbsp;isn\u2019t&nbsp;a good look for them to miss this deadline when they have this much notice. But I think&nbsp;there\u2019s&nbsp;also, like,&nbsp;legal experts that&nbsp;I\u2019ve&nbsp;spoken with&nbsp;don\u2019t&nbsp;think that&nbsp;there\u2019s&nbsp;going to be a huge&nbsp;day-to-day&nbsp;impact on the operations of the CDC. It&nbsp;kind of reminds&nbsp;me of that office where there\u2019s,&nbsp;like,&nbsp;an&nbsp;\u201cassistant&nbsp;to&nbsp;the&nbsp;regional&nbsp;manager vibe\u201d&nbsp;going on, where, like,&nbsp;Dr.&nbsp;Bhattacharya is now acting in the capacity of CDC director, even though he&nbsp;isn\u2019t&nbsp;acting&nbsp;CDC director&nbsp;anymore. So,&nbsp;I think I&nbsp;don\u2019t&nbsp;know that&nbsp;it\u2019ll&nbsp;have a huge&nbsp;day-to-day&nbsp;impact, but it is&nbsp;kind of hanging&nbsp;over HHS at this point, as they are already struggling with the&nbsp;surgeon&nbsp;general nomination,&nbsp;to get that through the Senate.&nbsp;So&nbsp;it just creates this backlog of nominations.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>I\u2019ve&nbsp;assumed&nbsp;they\u2019ve&nbsp;floated some names, let us say, one of which is Ernie Fletcher, the former governor of Kentucky, also a former member of the House Energy and Commerce health subcommittee, with&nbsp;some certainly medical chops, if not public health chops.&nbsp;I think&nbsp;the&nbsp;head of the health department in Mississippi. There was one other who&nbsp;I\u2019ve&nbsp;forgotten, who it is among the names that have been floated&nbsp;\u2026&nbsp;<\/p>\n\n\n\n<p><strong>Cohrs Zhang:&nbsp;<\/strong>Joseph Marine.&nbsp;He\u2019s&nbsp;a cardiologist at Johns Hopkins, who has&nbsp;\u2014&nbsp;is kind of like in the kind of Vinay Prasad world of critics of the FDA and,&nbsp;like,&nbsp;CDC\u2019s covid&nbsp;booster strategy.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>And yet, apparently, none of them could pass, I guess, all three tests. Do we think it might still be one of them? Or do we think there are other names that are yet&nbsp;to come?&nbsp;<\/p>\n\n\n\n<p><strong>Cohrs Zhang:&nbsp;<\/strong>Our understanding is that there are other candidates whose names have not become public, and I think there\u2019s also a possibility they don\u2019t choose any of these candidates and just drag it on for a while because,&nbsp;at this point, like, I don\u2019t know what the rush is,&nbsp;now that the deadline is passed.&nbsp;<\/p>\n\n\n\n<p><strong>Lawrence:<\/strong>&nbsp;Yeah, is there another deadline to miss?&nbsp;<\/p>\n\n\n\n<p><strong>Cohrs Zhang:&nbsp;<\/strong>I&nbsp;don\u2019t&nbsp;think so.&nbsp;<\/p>\n\n\n\n<p><strong>Lawrence:&nbsp;<\/strong>I think this&nbsp;was the only one.&nbsp;<\/p>\n\n\n\n<p><strong>Cohrs Zhang:&nbsp;<\/strong>This was the big one that they now have.&nbsp;It\u2019s&nbsp;vacant, but it was vacant before as well. Like, I think, earlier in the&nbsp;administration, when&nbsp;Susan&nbsp;Monarez&nbsp;was nominated.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>But she, well&nbsp;\u2026&nbsp;that\u2019s&nbsp;right, she was the&nbsp;\u201cacting,\u201d&nbsp;and then once she was nominated, she&nbsp;couldn\u2019t&nbsp;be the acting anymore.&nbsp;<\/p>\n\n\n\n<p><strong>Cohrs Zhang:&nbsp;<\/strong>Yeah.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>So&nbsp;I guess&nbsp;it&nbsp;was vacant while she was being considered.&nbsp;<\/p>\n\n\n\n<p><strong>Cohrs Zhang:&nbsp;<\/strong>It was.&nbsp;So&nbsp;it\u2019s&nbsp;not an unprecedented situation, even in this administration.&nbsp;It\u2019s&nbsp;just not a good&nbsp;look, I guess. And I think there is value in having a leader that can interface with the White House and with different leaders, and just having a direction for the agency, especially because it\u2019s in Atlanta, it\u2019s a little bit more removed from the everyday goings-on at HHS in general.&nbsp;So&nbsp;I think there\u2019s definitely a desire for some stability over there.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>And we have measles spreading in lots more states.&nbsp;I mean, every time I&nbsp;\u2026&nbsp;open up my news feeds, it\u2019s like, oh, now we have measles, you know, in Utah, I think,&nbsp;in Montana.&nbsp;Washtenaw County, Michigan,&nbsp;had its first measles case recently.&nbsp;So&nbsp;this is something that the CDC should be on top of, and yet there is no one on top of the CDC. Well, Rachel, you already alluded to this, but it is also apparently hard to find a surgeon general who\u2019s both acceptable to MAHA&nbsp;and Senate confirmable, which is my way of saying that the Casey&nbsp;Means nomination still appears to lack the votes to move out of the Senate, Health, Education, Labor&nbsp;&amp;&nbsp;Pensions Committee. Do we have any latest&nbsp;update&nbsp;on that?&nbsp;<\/p>\n\n\n\n<p><strong>Cohrs Zhang:&nbsp;<\/strong>I think the latest update, I mean, my colleagues at Bloomberg Government just&nbsp;kind of had&nbsp;an update this week that&nbsp;they\u2019re&nbsp;still not to&nbsp;\u201cyes\u201d \u2014&nbsp;like,&nbsp;there are some key senators that still&nbsp;haven\u2019t&nbsp;announced their positions publicly.&nbsp;So&nbsp;I think a lot of the same things that&nbsp;we\u2019ve&nbsp;been hearing&nbsp;\u2026&nbsp;like&nbsp;Sens.&nbsp;Susan Collins and&nbsp;Lisa Murkowski and Bill Cassidy obviously have not&nbsp;stated&nbsp;their positions publicly on the nomination.&nbsp;Sen.&nbsp;Thom Tillis, who you&nbsp;know&nbsp;is kind of in a lame-duck scenario and doesn\u2019t really have anything to lose, has, you know, said he\u2019s not really made a decision.&nbsp;So&nbsp;I think they\u2019re kind of in this weird limbo where they, like, don\u2019t have the votes to advance her, but they also have not made a decision to pull the nomination at this time. So either, I think,&nbsp;they have to push harder on some of these senators, and I think senators see this as a leverage point that I don\u2019t know that a lot of&nbsp;\u2014&nbsp;that all of the complaints are about Dr.&nbsp;Means specifically, but anytime that there is frustration with the wider department, then this is an opportunity for senators to have their voice heard, to&nbsp;\u2026&nbsp;potentially extract some concessions. And&nbsp;so&nbsp;there\u2019s&nbsp;a question right now, are they going to change course again for this position, or are they going to, you know, sit down at the bargaining&nbsp;table&nbsp;and really cut some deals to advance her nomination? I just&nbsp;don\u2019t&nbsp;think we know the answer to that yet.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>Yeah,&nbsp;it\u2019s&nbsp;worth reminding that,&nbsp;frequently,&nbsp;nominations get held up for reasons that are totally disconnected from the person involved. We went&nbsp;\u2014&nbsp;I should go back and look this up&nbsp;\u2014 we went, like, four years in two different administrations without a confirmed head of the Centers for Medicare&nbsp;&amp;&nbsp;Medicaid&nbsp;Services because members of Congress were angry about other things, not because of any of the people who had actually been nominated to fill that position. But in this case, it does seem to be, I think,&nbsp;both Casey&nbsp;Means and,&nbsp;you know, her connection to&nbsp;MAHA,&nbsp;and the fact that among those who haven\u2019t declared their positions yet,&nbsp;it\u2019s the chairman of the committee, Bill Cassidy, who\u2019s in this very tight primary to keep his seat.&nbsp;So&nbsp;we will keep&nbsp;on that one.&nbsp;&nbsp;<\/p>\n\n\n\n<p>Also, meanwhile, HHS continues to push its&nbsp;Make America&nbsp;Healthy&nbsp;Again priority. Secretary Kennedy hinted on the Joe Rogan podcast last month that the FDA will soon take unspecified action to make customized peptides easier to obtain from compounding pharmacies. These&nbsp;mini-proteins&nbsp;are part of a biohacking trend that many MAHA&nbsp;adherents say can&nbsp;benefit&nbsp;health,&nbsp;despite their not having been shown to be safe and effective in the normal FDA approval process. The FDA&nbsp;has&nbsp;also&nbsp;formally&nbsp;pulled&nbsp;a proposed rule that would have banned teens from using tanning beds. We know that the&nbsp;secretary is a fan of tanning salons, even though that&nbsp;<em>has<\/em>&nbsp;been shown to cause potential health problems,&nbsp;like skin cancer. Lizzy,&nbsp;is Kennedy just going to push as much MAHA&nbsp;as he can until the courts or the White House stops him?&nbsp;<\/p>\n\n\n\n<p><strong>Lawrence:&nbsp;<\/strong>I guess so. I mean, we do have this new structure at HHS&nbsp;now that\u2019s trying to&nbsp;\u2014&nbsp;clearly&nbsp;\u2026&nbsp;there are warring factions with the MAHA agenda and the White House really trying to focus more on affordability and less on&nbsp;\u2026&nbsp;vaccine scrutiny and the medical freedom movement that is really popular among Kennedy\u2019s supporters.&nbsp;\u2026&nbsp;I\u2019m&nbsp;very curious about&nbsp;what\u2019s&nbsp;going to happen with peptides, because&nbsp;it\u2019s&nbsp;a sign of Kennedy\u2019s regulatory philosophy, where&nbsp;there\u2019s&nbsp;some products that are good and some that are bad.&nbsp;It\u2019s&nbsp;very atypical, of course, for&nbsp;\u2026&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>And that he gets&nbsp;to decide&nbsp;rather than the scientists, because he&nbsp;doesn\u2019t&nbsp;trust the scientists.&nbsp;<\/p>\n\n\n\n<p><strong>Lawrence:&nbsp;<\/strong>Right. Right.&nbsp;But there has been, I mean, the FDA has kind of been pretty severe on GLP-1&nbsp;compounders&nbsp;Hims&nbsp;&amp;&nbsp;Hers, so it\u2019ll be interesting to see, you know, how much Kennedy is able to exert his will here, and how much FDA regulators will be able to push back and make their voices heard.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong>&nbsp;My favorite piece of FDA&nbsp;trivia&nbsp;this week is that FDA is posting the jobs that are about to be vacant at the vaccine center, and one of the things that it actually says in the job description is that you don\u2019t have to be immunized. I&nbsp;don\u2019t&nbsp;know if&nbsp;that\u2019s&nbsp;a signal or what.&nbsp;<\/p>\n\n\n\n<p><strong>Lawrence:&nbsp;<\/strong>Yeah,&nbsp;I think it&nbsp;said no telework, which Vinay Prasad famously was teleworking from San Francisco. So,&nbsp;yeah, I&nbsp;don\u2019t&nbsp;know.&nbsp;But&nbsp;this&nbsp;was,&nbsp;I think it&nbsp;was for his deputy, although&nbsp;I\u2019m&nbsp;sure, I mean, they do need a CBER&nbsp;[Center for Biologics Evaluation and Research]&nbsp;director as well.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong>&nbsp;Yeah,&nbsp;there\u2019s&nbsp;a lot of openings right now at HHS.&nbsp;All right,&nbsp;we\u2019re&nbsp;gonna&nbsp;take a quick break. We will be right back.&nbsp;<\/p>\n\n\n\n<p>So&nbsp;Monday was the 16th anniversary of the signing of the Affordable Care Act, which we will hear more about in my interview with Katie Keith.&nbsp;But I wanted to highlight a&nbsp;<a href=\"https:\/\/kffhealthnews.org\/news\/article\/health-costs-middle-aged-adults-delay-affordable-care-act-obamacare-medicare\/\" target=\"_blank\" rel=\"noreferrer noopener\">story by my&nbsp;KFF&nbsp;Health&nbsp;News colleague Sam Whitehead<\/a>&nbsp;about older Americans nearing Medicare eligibility putting off preventive and other care until they qualify for federal coverage that will let them afford it. For those who listened to my interview last week with Drew Altman, this hearkens back to one of the big problems with our health system. There are so many quote-unquote&nbsp;\u201csavings\u201d&nbsp;that are&nbsp;actually just&nbsp;cost-shifting, and often that cost-shifting raises costs overall. In this case, because those older people can no longer afford their insurance or their deductibles,&nbsp;they put off care until it becomes more expensive to treat. At that point,&nbsp;because&nbsp;they\u2019re&nbsp;on Medicare, the&nbsp;federal taxpayer will foot a bill&nbsp;that\u2019s&nbsp;even bigger than the bill that would have been paid by the insurance company.&nbsp;So&nbsp;the savings taxpayers gained by Congress cutting back the Affordable Care Act subsidies are lost on the Medicare end. Is this cost-shifting the inevitable outcome of addressing everything in our health care system except the actual prices of medical care?&nbsp;<\/p>\n\n\n\n<p><strong>Cohrs Zhang:&nbsp;<\/strong>I think&nbsp;it\u2019s&nbsp;just another example of how people\u2019s behavior responds to these weird incentives. And I think&nbsp;we\u2019re&nbsp;seeing this problem, certainly among early retirees,&nbsp;exacerbated&nbsp;by the&nbsp;expiration&nbsp;of the Affordable Care Act subsidies that&nbsp;we\u2019ve&nbsp;talked about very often on this podcast, because it affects these higher earners, and it can dramatically increase costs for coverage. And&nbsp;I think people&nbsp;just hope that they can hold on. But again, these&nbsp;statutory deadlines that lawmakers make up sometimes,&nbsp;not with a lot of forethought or rational&nbsp;reasoning,&nbsp;they have consequences.&nbsp;And obviously, the Medicare program continues to pay beyond age 65 as well.&nbsp;And I think&nbsp;it\u2019s&nbsp;just another symptom of what the administration talks about when they talk about emphasizing, you know, preventative care and addressing chronic conditions&nbsp;\u2014&nbsp;like,&nbsp;that is a real problem. And,&nbsp;yeah, I think&nbsp;we\u2019re&nbsp;going to see these problems in this population continue to get worse as more people forgo care, as it becomes more expensive on the individual markets.&nbsp;<\/p>\n\n\n\n<p><strong>Luthra:&nbsp;<\/strong>I think you&nbsp;also make a good point, though, Julie, because the increase in costs and cost sharing is not limited to people with marketplace plans, right? Also, people with employer-sponsored health care are seeing their out-of-pocket costs&nbsp;go up. Employers are seeing what they pay for insurance&nbsp;go&nbsp;up as well. And there absolutely is something to be said about&nbsp;it\u2019s&nbsp;been 16 years since the Affordable Care Act&nbsp;passed,&nbsp;we&nbsp;haven\u2019t&nbsp;really had meaningful intervention on the key source of health care prices, right? Hospitals, providers, physicians. And it does seem, just thinking about where the public is and the politics are, that there is possibly&nbsp;appetite&nbsp;around this. You see a lot of talk about affordability, but a lot of&nbsp;this feels, at least as an observer,&nbsp;very focused&nbsp;on insurance, which makes sense. Insurance is&nbsp;a very easy&nbsp;villain to cast.&nbsp;But I think you\u2019ve raised a&nbsp;really good point:&nbsp;that addressing these really potent burdens on individuals and eventually on the public just requires something&nbsp;more systemic and more serious if we actually want to yield better outcomes.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>Yeah, there\u2019s just, there\u2019s so much passing the hat that, you know,&nbsp;<em>I don\u2019t want to do this,&nbsp;so&nbsp;<\/em><em>you<\/em><em>&nbsp;have to do this<\/em>.&nbsp;You know, inevitably, people need health care.&nbsp;Somebody has to pay for it.&nbsp;And I think that\u2019s&nbsp;sort of the&nbsp;bottom line that nobody really seems to want to address.&nbsp;<\/p>\n\n\n\n<p>Well, the other theme of 2026 that I feel like I keep repeating is what funding cutbacks and other changes are doing to the future of the nation\u2019s biomedical and medical workforces. Last week was Match Day.&nbsp;That\u2019s&nbsp;when graduating medical school seniors find out if and where they will do their residency training. One big headline from this year\u2019s match is that the percentage of non-U.S.&nbsp;citizen graduates of foreign medical schools matching to a U.S.&nbsp;residency position fell to a five-year low of 56.4%.&nbsp;That compares to a 93.5% matching rate for U.S.&nbsp;citizen graduates of U.S.&nbsp;medical schools. Why does that matter? Well, a quarter of the U.S.&nbsp;physician workforce are immigrants, and they are disproportionately represented, both in lower-paid primary care specialties, particularly in rural areas, both of which&nbsp;U.S.&nbsp;doctors tend to find less desirable. This would seem to be the result of a combination of new fees for visas for foreign professionals that&nbsp;we\u2019ve&nbsp;talked about, a general reduction in visa approvals,&nbsp;and some people&nbsp;likely not&nbsp;wanting to even come to the U.S.&nbsp;to practice. But that rural health fund that Republicans say will revitalize rural health care&nbsp;doesn\u2019t&nbsp;seem like&nbsp;it\u2019s&nbsp;really going to work without an adequate number of doctors and nurses, I would humbly suggest.&nbsp;<\/p>\n\n\n\n<p><strong>Lawrence:<\/strong>&nbsp;Yeah, absolutely. I mean,&nbsp;it\u2019s&nbsp;patients that suffer, right? I mean, you need the people doing the work. And&nbsp;so&nbsp;I think that the impacts will start being felt sooner rather than later. That is something that hopefully people will start to feel the pain from.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong>&nbsp;I feel like when people think about the immigrant workforce, they think about lower-skilled, lower-paid jobs that immigrants do, and they don\u2019t think about the fact that some of the most highly skilled, highly paid jobs that we have, like being doctors, are actually filled by immigrants, and that if we cut that back, we\u2019re just going to exacerbate shortages that we already know we have.&nbsp;<\/p>\n\n\n\n<p><strong>Luthra:&nbsp;<\/strong>And training doctors takes, famously,&nbsp;a very long&nbsp;time. And&nbsp;so&nbsp;if you are disincentivizing people from coming here to practice, cutting off this key source of supply,&nbsp;it\u2019s&nbsp;not as if you can&nbsp;immediately&nbsp;go out and say,&nbsp;<em>Here,&nbsp;let\u2019s&nbsp;find some new people and make them doctors<\/em>. It will take years to make that tenable, make that attractive,&nbsp;and make that a reality. And it just seems,&nbsp;to Lizzy\u2019s point,&nbsp;that even in the scenario where that was possible&nbsp;\u2014&nbsp;which I would be somewhat doubtful;&nbsp;medicine is a hard and difficult career;&nbsp;it\u2019s not like you can make someone want to do that overnight&nbsp;\u2014&nbsp;patients will absolutely see the consequences. I&nbsp;don\u2019t&nbsp;know if&nbsp;it\u2019s&nbsp;enough to change how people think about immigration policy and ways in which we recruit and engage with immigrant workers, but&nbsp;it\u2019s&nbsp;absolutely something that should be part of our discussion.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>Yeah, and I think&nbsp;it\u2019s&nbsp;been left out.&nbsp;Well,&nbsp;meanwhile,&nbsp;over at the National Institutes of Health, a&nbsp;<a href=\"https:\/\/www.statnews.com\/2026\/03\/19\/nih-funding-national-researcher-survey-finds-cutbacks-disruptions\/\" target=\"_blank\" rel=\"noreferrer noopener\">survey of 1,000 researchers by your colleagues at&nbsp;Stat<\/a>,&nbsp;Lizzy,&nbsp;found that more than a quarter have laid off laboratory workers. More than&nbsp;2&nbsp;in&nbsp;5&nbsp;have canceled research,&nbsp;and two-thirds have counseled students to consider careers outside of academic research. A separate study published this week found that women and early-career scientists have been disproportionately affected by the NIH cuts, even though most of the money goes to men and to later-career scientists. As I keep saying,&nbsp;this&nbsp;isn\u2019t&nbsp;just about the&nbsp;future of science. Biomedical research is a&nbsp;huge piece of the U.S.&nbsp;economy. Earlier this month, the group&nbsp;United for&nbsp;Medical&nbsp;Research&nbsp;<a href=\"https:\/\/www.unitedformedicalresearch.org\/annual-economic-report\/\" target=\"_blank\" rel=\"noreferrer noopener\">updated its annual estimates about NIH<\/a>,&nbsp;finding&nbsp;that every dollar invested produced $2.57 for the economy. Concerned members of Congress from both parties last week at an appropriations hearing got NIH Director Jay Bhattacharya to again promise to push all the money that they appropriated out the door.&nbsp;But&nbsp;it\u2019s&nbsp;not clear whether&nbsp;it\u2019s&nbsp;going to continue to compromise the future workforce. I feel like, you know, we talk about all these missing people and nomination stuff, but&nbsp;we\u2019re&nbsp;not really talking a lot about&nbsp;what\u2019s&nbsp;going on at the National Institutes of Health, which is a, you know, almost&nbsp;$50 billion-a-year enterprise.&nbsp;<\/p>\n\n\n\n<p><strong>Lawrence:<\/strong>&nbsp;Right.&nbsp;In some labs, the damage has already been done. You&nbsp;know, even if Dr.&nbsp;Bhattacharya&nbsp;[follows through],&nbsp;try spending all the money that has been appropriated. There are young&nbsp;researchers that have been shut out and people that have had to choose alternative career paths. And&nbsp;I think this&nbsp;is one of those things&nbsp;that\u2019s&nbsp;difficult politically or, you know, in&nbsp;the public&nbsp;consciousness, because it is hard to see the immediate impacts&nbsp;it\u2019s&nbsp;measured. And I think my colleague Jonathan wrote&nbsp;[that]&nbsp;breakthroughs&nbsp;are&nbsp;not&nbsp;discovered&nbsp;things, you know.&nbsp;So&nbsp;it\u2019s&nbsp;hard to know what&nbsp;is being missed.&nbsp;But the immediate impact of the workforce and&nbsp;not missing this whole generation of scientists that has decided to go to another country or go to do something else, those impacts will be felt for years to come.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong>&nbsp;Yeah, this is another one where you&nbsp;can\u2019t&nbsp;just turn the spigot back on and have it&nbsp;immediately&nbsp;refill.&nbsp;&nbsp;<\/p>\n\n\n\n<p>Finally, this week, there is always&nbsp;reproductive&nbsp;health&nbsp;news. This week,&nbsp;we got the Alan Guttmacher Institute\u2019s&nbsp;<a href=\"https:\/\/www.guttmacher.org\/report\/full-year-estimates-show-overall-stability-abortion-incidence-decreased-travel-increased-telehealth-provision\" target=\"_blank\" rel=\"noreferrer noopener\">annual abortion estimates<\/a>&nbsp;for the year 2025,&nbsp;which both sides of the debate consider the most accurate, and it found that for the second year in a row, the number of abortions in the U.S.&nbsp;remained relatively stable, despite the fact that it\u2019s outlawed or seriously restricted in nearly half the states.&nbsp;Of course, that\u2019s because of the use of telehealth, which abortion opponents are furiously trying to get stopped, either by the FDA itself or by Congress.&nbsp;Last week, anti-abortion Sen.&nbsp;Josh Hawley of Missouri introduced legislation that would&nbsp;basically rescind&nbsp;approval for the abortion pill mifepristone. But that legislation is&nbsp;apparently giving&nbsp;some Republicans in the Senate heartburn, as they really&nbsp;don\u2019t&nbsp;want to engage this issue before the midterms.&nbsp;And,&nbsp;apparently,&nbsp;the&nbsp;Trump administration&nbsp;doesn\u2019t&nbsp;either, given what we know about the FDA saying that&nbsp;they\u2019re&nbsp;still studying this.&nbsp;On the other hand, Republicans&nbsp;can\u2019t&nbsp;afford to lose the backing of the anti-abortion activists either.&nbsp;They put lots of time, effort,&nbsp;and money into turning out votes, particularly in times like midterms. How big a controversy is this becoming, Shefali?&nbsp;<\/p>\n\n\n\n<p><strong>Luthra:<\/strong>&nbsp;This is a huge controversy, and&nbsp;it\u2019s&nbsp;so interesting to watch this play out. When I saw Sen.&nbsp;Hawley\u2019s bill, I mean, that stood out to me as positioning for 2028.&nbsp;He clearly wants to be a favorite among the anti-abortion&nbsp;movement&nbsp;heading into a future presidential primary. But at the same time, this is teasing out&nbsp;really potent&nbsp;and powerful dynamics among the anti-abortion movement and Republican lawmakers,&nbsp;exactly what you said. Republican lawmakers know this is not popular. They do not want to talk about abortion, an issue at which they are at a huge disadvantage&nbsp;with&nbsp;the public. Susan B Anthony&nbsp;List and other such organizations are trying to make the argument that if they are taken for granted,&nbsp;as they feel as if they are, that will result in an enthusiasm gap.&nbsp;Right? People will not turn out. They will not go door-knocking,&nbsp;they&nbsp;won\u2019t&nbsp;deploy their tremendous resources to get victories in a lot of these contested,&nbsp;particularly Senate and House,&nbsp;races. And obviously, the&nbsp;president cares a lot about the midterms.&nbsp;He\u2019s&nbsp;very concerned&nbsp;about what happens&nbsp;when&nbsp;Democrats take control of Congress. But I think what Republicans are wagering, and&nbsp;it\u2019s&nbsp;a fair thought, is that where would anti-abortion activists go? Are they going to go to Democrats,&nbsp;who&nbsp;largely support&nbsp;abortion rights? And a lot of them seem confident that they would rather risk some people staying home and,&nbsp;overall, not alienating a very large sector of the American public that does not support restrictions on abortion nationwide, especially those that many are concerned are not in keeping with the actual science.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>Yeah, I think the White House, as you said, would like to make this not front and center, let\u2019s&nbsp;put it that way,&nbsp;for the midterms. But&nbsp;yeah, and just to be clear, I mean, Sen.&nbsp;Hawley introduced this bill. It&nbsp;can\u2019t&nbsp;pass.&nbsp;There\u2019s&nbsp;no way it gets 60 votes in the Senate.&nbsp;I\u2019d&nbsp;be surprised if it could get 50 votes in the Senate.&nbsp;So&nbsp;he\u2019s&nbsp;obviously doing this just to turn up the heat on his colleagues, many of whom are not&nbsp;very happy&nbsp;about that.&nbsp;<\/p>\n\n\n\n<p><strong>Luthra:&nbsp;<\/strong>And anti-abortion activists are already thinking about 2028.&nbsp;They are, in fact, talking to people like Sen.&nbsp;Hawley, like the&nbsp;vice&nbsp;president, like Marco Rubio, trying to figure out who will&nbsp;actually be&nbsp;their champion in a post-Trump landscape. And so far, what&nbsp;I\u2019m&nbsp;hearing,&nbsp;is that they are&nbsp;very optimistic&nbsp;that anyone else could be better for them than the&nbsp;president&nbsp;is because they are just so dissatisfied with how little&nbsp;they\u2019ve&nbsp;gotten.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>Although they did get the overturn of&nbsp;<em>Roe v.&nbsp;Wade<\/em>.&nbsp;<\/p>\n\n\n\n<p><strong>Luthra:<\/strong>&nbsp;That&#8217;s&nbsp;true.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>But you know, it goes back to&nbsp;sort of my&nbsp;original thought for this week, which is that the number of abortions&nbsp;isn\u2019t&nbsp;going down because of the&nbsp;relatively easy&nbsp;availability of abortion pills by mail. Well, speaking of which, in a&nbsp;somewhat related&nbsp;story, a woman in Georgia has been charged with murder for taking abortion pills later in pregnancy than&nbsp;it\u2019s&nbsp;been approved for, and delivering a live fetus who&nbsp;subsequently&nbsp;died. But the judge in the case has already suggested the prosecutors have a giant hill to climb to convict her and set her bail at $1.&nbsp;Are we going to see our first murder trial of a woman for inducing her own abortion?&nbsp;We\u2019ve&nbsp;been&nbsp;sort of flirting&nbsp;with this possibility for a while.&nbsp;<\/p>\n\n\n\n<p><strong>Luthra:<\/strong>&nbsp;It seems possible.&nbsp;I think it\u2019s a really good question, and this moment certainly feels like a possible Rubicon, because going after people who get abortions is just so toxic for the anti-abortion movement.&nbsp;They have promised they would not go after people who are pregnant, who get abortions.&nbsp;And this is exactly what they are doing. And&nbsp;I think what&nbsp;really stands out to me about this case is so much of it depends on individual prosecutors and individual judges. You have&nbsp;the law enforcement officials who decided to make this a case, and&nbsp;they\u2019re&nbsp;actually using, not the abortion law, even though the language in the case,&nbsp;right,&nbsp;really resonates, reflects with the law in Georgia\u2019s&nbsp;six-week ban. Excuse me, with the&nbsp;<em>language<\/em>&nbsp;in Georgia\u2019s&nbsp;six-week ban. But then you have a judge who says this is very suspect. And what feels so significant is that your rights and your protection under abortion laws depend not only on what state you live in, but who happens to be the local prosecutor, the local cop, the local judge, and that\u2019s just a level of micro-precision that I think a lot of Americans would be very surprised to realize they live under.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>Yeah, absolutely. We should point out that the woman has been charged but not yet indicted, because many, many people are watching this case very, very carefully.&nbsp;And we&nbsp;will&nbsp;too.&nbsp;<\/p>\n\n\n\n<p>All right, that is this week\u2019s news. Now&nbsp;I\u2019ll&nbsp;play my interview with Katie Keith of Georgetown University Law Center, and then&nbsp;we\u2019ll&nbsp;come back with our extra credits.&nbsp;<\/p>\n\n\n\n<p>I am pleased to welcome back to the podcast Katie Keith. Katie is the founding director of the Center for Health Policy and the&nbsp;Law at the Georgetown University Law Center and a contributing editor at Health Affairs, where she keeps all of us up to date on the latest health policy, legal happenings. Katie, thanks for joining us again.&nbsp;It\u2019s&nbsp;been a minute.&nbsp;<\/p>\n\n\n\n<p><strong>Katie Keith:<\/strong>&nbsp;Yeah.&nbsp;Thanks for having me,&nbsp;Julie,&nbsp;and happy ACA anniversary.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>So&nbsp;you are my&nbsp;go-to for all things Affordable Care Act, which is why I wanted you this week in particular,&nbsp;when the health law turned 16. How would you describe the state of the ACA today?&nbsp;<\/p>\n\n\n\n<p><strong>Keith:&nbsp;<\/strong>Yeah,&nbsp;it\u2019s&nbsp;a great question. So,&nbsp;the ACA&nbsp;remains&nbsp;a hugely important source of coverage for millions of people who do not have access to job-based coverage. I am thinking of&nbsp;farmers,&nbsp;and&nbsp;self-employed people,&nbsp;and small-business owners.&nbsp;And you know, in 2025,&nbsp;more than&nbsp;24 million people&nbsp;relied on the marketplaces all across the country for this coverage.&nbsp;So&nbsp;it&nbsp;remains&nbsp;a hugely&nbsp;important place&nbsp;where people get their health insurance. And we are already starting to see real erosion&nbsp;in&nbsp;the gains made under the Biden administration&nbsp;as a result of, I think, three primary changes that were made in 2025.&nbsp;So&nbsp;the first would be Congress\u2019&nbsp;failure to extend the enhanced premium tax credits, which you have covered a ton,&nbsp;Julie&nbsp;and the team,&nbsp;as having&nbsp;a huge impact&nbsp;there. The second is the changes from the&nbsp;One&nbsp;Big&nbsp;Beautiful Bill&nbsp;Act. And then the third is some of the administrative changes made by the Trump administration that&nbsp;we\u2019re&nbsp;already seeing.&nbsp;So&nbsp;we&nbsp;don\u2019t&nbsp;yet have full data to understand the impact of all three of those&nbsp;things yet.&nbsp;We\u2019re&nbsp;still waiting.&nbsp;But the preliminary data shows that already enrollments&nbsp;down&nbsp;by more than a million people.&nbsp;I\u2019m&nbsp;expecting that to drop further. There was some&nbsp;KFF&nbsp;survey data out last week that about&nbsp;1&nbsp;in 10 people are going uninsured from the marketplace already, and that\u2019s not even, doesn\u2019t even account for all the people who are paying more but getting less, which their survey data shows is about, you know,&nbsp;3&nbsp;in 10 folks.&nbsp;So&nbsp;you know what makes all of this really,&nbsp;really tough, as you and I have discussed before, is, I think,&nbsp;2025, was really a peak year. We saw peak enrollment at the ACA. We saw peak popularity of the law, which has been more popular than not ever since 2017,&nbsp;when Republicans in Congress tried to repeal it the first time.&nbsp;And&nbsp;\u2026&nbsp;but now it feels like we\u2019re sort of on this precipice for 2026,&nbsp;watching what\u2019s going to happen with the data into this really important source of coverage for so many people.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>And&nbsp;\u2026&nbsp;there\u2019s&nbsp;been so much news that I think&nbsp;it\u2019s&nbsp;been hard for people to absorb. You know, in 2017,&nbsp;when Republicans tried to repeal the Affordable Care Act, they said&nbsp;that,&nbsp;<em>We\u2019re&nbsp;trying to repeal the Affordable Care Act<\/em>. Well,&nbsp;the&nbsp;2025 you know,&nbsp;\u201cBig,&nbsp;Beautiful&nbsp;Bill,\u201d&nbsp;they&nbsp;didn\u2019t&nbsp;call it a repeal, but it had&nbsp;pretty much the&nbsp;same impact, right?&nbsp;<\/p>\n\n\n\n<p><strong>Keith:&nbsp;<\/strong>It had&nbsp;a quite&nbsp;significant impact. And I think a lot,&nbsp;like,&nbsp;you know, there was so much coverage about how Democrats in Congress and the White House learned,&nbsp;in doing the Affordable Care Act, learned from the failed effort of the Clinton health reform in the&nbsp;\u201990s. I think similarly here you saw Republicans in Congress, in the White House, learn from the failed effort in 2017 to be successful here. And&nbsp;so&nbsp;you\u2019re exactly right. You did not hear any talk of&nbsp;\u201crepeal and replace,\u201d&nbsp;by any stretch of the imagination. I think in 2017 Republicans were judged harshly&nbsp;\u2014&nbsp;and appropriately so, in my opinion&nbsp;\u2014&nbsp;by the&nbsp;\u201creplace\u201d&nbsp;portion&nbsp;of what,&nbsp;you know, what they were going to do, and it just&nbsp;wasn\u2019t&nbsp;there. And&nbsp;so&nbsp;you did not see that kind of framing this time around. Instead, it really is an attempt to do death by&nbsp;a thousand&nbsp;paper cuts and impose administrative burdens and a real focus on&nbsp;kind of who&nbsp;\u2014&nbsp;you can\u2019t see me, but air quotes,&nbsp;you know&nbsp;\u2014&nbsp;who&nbsp;\u201cdeserves\u201d&nbsp;coverage and a focus on immigrant populations. So&nbsp;\u2026&nbsp;those changes,&nbsp;when you layer all of them on&nbsp;\u2014&nbsp;changes to Medicaid coverage, Medicaid financing, paperwork burdens, all across all these different programs&nbsp;\u2014&nbsp;you know, the&nbsp;One&nbsp;Big&nbsp;Beautiful Bill&nbsp;Act,&nbsp;it really does erect new barriers that fundamentally change how Medicaid and the Affordable Care Act will work for people. And&nbsp;so&nbsp;it\u2019s&nbsp;not repealed. I think those programs will still be there, but they will look very different than how they have and,&nbsp;you know, the CBO&nbsp;[Congressional Budget Office]&nbsp;at the time, the coverage losses almost&nbsp;\u2026&nbsp;they look quite close to, you know, the skinny repeal that we all remember in the middle of the morning&nbsp;\u2014&nbsp;early,&nbsp;like,&nbsp;late night,&nbsp;Sen.&nbsp;John McCain with his thumbs down.&nbsp;The coverage losses were almost the same,&nbsp;and you\u2019ve got&nbsp;the&nbsp;CBO now saying,&nbsp;estimating about 35 million uninsured people by 2028,&nbsp;which,&nbsp;you know,&nbsp;is not&nbsp;\u2026&nbsp;it\u2019s just&nbsp;erasing, I think, not all, but a lot of the gains we\u2019ve made over the past 15, now 16,&nbsp;years under the Affordable Care Act.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>And now the Trump&nbsp;administration is proposing still more changes to the law, right?&nbsp;<\/p>\n\n\n\n<p><strong>Keith:&nbsp;<\/strong>Yep,&nbsp;that\u2019s&nbsp;right.&nbsp;They\u2019re&nbsp;continuing, I think, a lot of the same.&nbsp;There\u2019s&nbsp;several changes that, you know, go back to the first Trump administration that&nbsp;they\u2019re&nbsp;trying to reimpose. Others are sort of&nbsp;new ideas.&nbsp;I\u2019m&nbsp;thinking some of the same ideas are some of the paperwork burdens. So really, in some cases, building&nbsp;off of&nbsp;what has been pushed in Congress.&nbsp;What\u2019s&nbsp;maybe new&nbsp;this time around for 2027 that&nbsp;they\u2019re&nbsp;pushing is a significant expansion of catastrophic plans. So huge, huge, high-deductible plans that,&nbsp;you know,&nbsp;really&nbsp;don\u2019t&nbsp;cover much until you hit&nbsp;tens&nbsp;of&nbsp;thousands&nbsp;of dollars in out-of-pocket costs. You get your preventive services and three primary care visits, but&nbsp;that\u2019s&nbsp;it.&nbsp;You\u2019re&nbsp;on the hook for anything else you might need until you hit these&nbsp;really catastrophic&nbsp;costs.&nbsp;They\u2019re&nbsp;punting to&nbsp;the states on core things like network adequacy. You know, again, some of&nbsp;it\u2019s&nbsp;sort of new. Some of&nbsp;it\u2019s&nbsp;a throwback to the first Trump administration, so not as surprising. And then on the legislative front, I&nbsp;don\u2019t&nbsp;know what the prospects are, but you do continue to see President&nbsp;[Donald]&nbsp;Trump call for, you know,&nbsp;health&nbsp;savings&nbsp;account expansions. We think, I think, you know, the idea is to send people money to buy coverage, rather than send the money to the insurers, which I think folks have interpreted as health savings accounts.&nbsp;There\u2019s&nbsp;a continued focus on funding cost-sharing reductions, but that issue continues to be snarled by abortion restrictions across the country. So&nbsp;that\u2019s&nbsp;something that continues to be discussed, but I&nbsp;don\u2019t&nbsp;know if it will ever happen. And you know anything else that\u2019s&nbsp;kind of under&nbsp;the so-called&nbsp;Great&nbsp;Healthcare&nbsp;Plan that the White House has put out.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>You mentioned that 2025 was the peak not just of enrollment but of popularity.&nbsp;And we have seen in poll after poll that the changes that the Trump administration&nbsp;and&nbsp;Congress&nbsp;is&nbsp;making are not popular with the public, including&nbsp;the vast majority of&nbsp;independents and many, many Republicans as well. Is there any chance that Congress and President Trump might relent on some of these changes between now and the midterms?&nbsp;We did see a bunch of Republicans, you know, break with the rest of the party to try to extend the, you know, the enhanced premiums. Do you see any signs that&nbsp;they\u2019re&nbsp;weakening&nbsp;or&nbsp;are&nbsp;we off onto other things entirely&nbsp;right now?&nbsp;<\/p>\n\n\n\n<p><strong>Keith:&nbsp;<\/strong>It\u2019s&nbsp;a great question.&nbsp;I think you&nbsp;probably need&nbsp;a different analyst to ask that&nbsp;question to. I&nbsp;don\u2019t&nbsp;think my crystal ball covers those types of predictions. But to your point, Julie, I thought that if there would have been time for a compromise and&nbsp;sort of a&nbsp;path forward, it would have been around the enhanced premium tax credits. And it was remarkable, you know, given what the history of this law has been&nbsp;and&nbsp;the politics&nbsp;surrounding it, to see 17 Republicans join all Democrats in the House to vote for a clean three-year extension of the premium tax credits. But no, I think especially thinking about where those enhanced tax credits have had the most benefit, it is states like Georgia, Florida, Texas, and I thought that&nbsp;maybe would,&nbsp;could have moved the needle if there was a needle to be moved.&nbsp;So&nbsp;I,&nbsp;it seems like&nbsp;there\u2019s&nbsp;much more focus on prescription drugs and other issues, but anything can happen.&nbsp;So&nbsp;I guess&nbsp;we\u2019ll&nbsp;all&nbsp;stay tuned.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>Well,&nbsp;we\u2019ll&nbsp;do this again for the 17th anniversary. Katie Keith, thank you so much.&nbsp;<\/p>\n\n\n\n<p><strong>Keith:&nbsp;<\/strong>Thanks,&nbsp;Julie.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>OK,&nbsp;we\u2019re&nbsp;back.&nbsp;It\u2019s&nbsp;time for our&nbsp;extra-credit&nbsp;segment.&nbsp;That\u2019s&nbsp;where we each recognize&nbsp;a&nbsp;story we read this&nbsp;week&nbsp;we think you should read too.&nbsp;Don\u2019t&nbsp;worry if you miss it. We will post the links in our show notes on your phone or other mobile device. Lizzy, why don\u2019t you start us off this week?&nbsp;<\/p>\n\n\n\n<p><strong>Lawrence:&nbsp;<\/strong>Sure.&nbsp;So&nbsp;my extra credit is by&nbsp;Nick&nbsp;[Nicholas]&nbsp;Florko, former&nbsp;Stat-ian,&nbsp;in&nbsp;The Atlantic,&nbsp;\u201c<a href=\"https:\/\/www.theatlantic.com\/health\/2026\/03\/robert-f-kennedy-jr-meme-laundering\/686515\/\" target=\"_blank\" rel=\"noreferrer noopener\">The Meme-Washing of RFK Jr.<\/a>\u201d&nbsp;I&nbsp;immediately&nbsp;read this&nbsp;piece, because&nbsp;this is something&nbsp;that\u2019s&nbsp;been driving me&nbsp;kind of crazy. Just seeing&nbsp;\u2014&nbsp;if&nbsp;you\u2019ve&nbsp;missed it&nbsp;\u2014&nbsp;there have been&nbsp;\u2026&nbsp;HHS has been posting AI-generated videos of Secretary Kennedy wrestling a Twinkie,&nbsp;wearing waterproof jeans,&nbsp;all of&nbsp;these things. And this has been, this is not unique to HHS&nbsp;\u2014&nbsp;[the]&nbsp;White House in general has really embraced AI slop as a genre, and I&nbsp;can\u2019t&nbsp;look away. And&nbsp;so&nbsp;I thought&nbsp;Nick did&nbsp;a good job&nbsp;just acknowledging how crazy this is, and then also what goes&nbsp;unsaid in these videos.&nbsp;I think I&nbsp;personally am just very curious if this resonates with people, or if&nbsp;it\u2019s&nbsp;kind of disconcerting&nbsp;for the average American&nbsp;seeing these videos like,&nbsp;<em>Oh, my government is&nbsp;making&nbsp;AI slop<\/em>.&nbsp;Like I,&nbsp;you know, social media strategy is so important, so&nbsp;maybe for&nbsp;some&nbsp;people are&nbsp;really&nbsp;liking&nbsp;this. But&nbsp;yeah,&nbsp;I\u2019m&nbsp;just&nbsp;kind of curious&nbsp;about public sentiment.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong>&nbsp;I know I would say, you know, the National Park Service and the Consumer Product Safety Commission have been&nbsp;sort of famous&nbsp;for their very cutesy social media posts, but&nbsp;not quite to&nbsp;this extent. I mean,&nbsp;it\u2019s&nbsp;one thing to be cheeky and funny. This is&nbsp;sort of beyond&nbsp;cheeky and funny.&nbsp;I agree with you. I have no idea how this is going over the public, but they keep doing it.&nbsp;It\u2019s a really good story.&nbsp;Rachel.&nbsp;<\/p>\n\n\n\n<p><strong>Cohrs Zhang:&nbsp;<\/strong>Mine is a story in The Boston Globe, and the headline is&nbsp;\u201c<a href=\"https:\/\/www.bostonglobe.com\/2026\/03\/25\/nation\/tony-lyons-maha-rfk-jr\/?p1=StaffPage\" target=\"_blank\" rel=\"noreferrer noopener\">\u2018We\u2019re on the Inside Now\u2019: Meet the Man Building a Political Empire Behind RFK Jr.,<\/a>\u201d&nbsp;by&nbsp;Tal Kopan.&nbsp;And this was a really good profile of Tony Lyons, who is Robert F.&nbsp;Kennedy Jr.\u2019s book publisher, and he\u2019s kind of had the role of institutionalizing all the political energy behind RFK Jr.&nbsp;and trying to make this into a more enduring political force.&nbsp;So&nbsp;I think he&nbsp;is, like, mostly a behind-the-scenes guy, not really like a D.C.&nbsp;fixture, more of like a New York book publishing figure.&nbsp;But I think his efforts and what they\u2019re using, all the money they\u2019re raising for, I think,&nbsp;is a really important thing to watch in the midterms, and like, whether they can actually leverage this beyond a Trump administration, or beyond however long Secretary Kennedy will be in his position.&nbsp;So&nbsp;I think it&nbsp;was just a good overview of&nbsp;all the tentacles of institutional MAHA&nbsp;that are trying to, you know, find their footing here, potentially for the long term.&nbsp;&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>I had&nbsp;never heard of him, so I was glad to read this story.&nbsp;Shefali.&nbsp;<\/p>\n\n\n\n<p><strong>Luthra:&nbsp;<\/strong>My story is from NPR. It is by&nbsp;Tara&nbsp;Haelle. The headline is&nbsp;\u201c<a href=\"https:\/\/www.npr.org\/2026\/03\/25\/nx-s1-5759732\/covid-vaccination-pregnancy-safety-efficacy\" target=\"_blank\" rel=\"noreferrer noopener\">Yep. A Mom\u2019s COVID Shot During Pregnancy Protects Her Baby, a Large Study Finds<\/a>.\u201d&nbsp;Story says exactly what it promises, that if you have an infant, babies&nbsp;under&nbsp;6&nbsp;months, then getting a covid vaccine while you are pregnant will&nbsp;actually protect&nbsp;your baby, which is great because there is no vaccine for infants that young. I love this because it\u2019s a good reminder of something that we were starting to see, and now it just really underscores that this is true, and in the midst of so much conversation around vaccines and safety and effectiveness, it\u2019s a reminder that really, really good research can show us that it is a very good idea to take this vaccine, especially if you&nbsp;are pregnant.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong>&nbsp;More fodder for the argument, I guess. All&nbsp;right,&nbsp;my extra credit this week is a clever story from&nbsp;Stat\u2019s John Wilkerson called&nbsp;\u201c<a href=\"https:\/\/www.statnews.com\/2026\/03\/24\/trump-mfn-drug-pricing-gop-strategy-raise-prices-overseas\/\" target=\"_blank\" rel=\"noreferrer noopener\">The Potential Loophole in Trump\u2019s Plan To Get Other Countries To Pay More for Drugs<\/a>.\u201d&nbsp;And,&nbsp;spoiler,&nbsp;that loophole is that&nbsp;one way&nbsp;companies can avoid running afoul of their promise not to charge other countries less for their products than they charge&nbsp;U.S.&nbsp;patients is for them to simply delay launching those drugs in those other countries that have price controls.&nbsp;Already, most drugs are launched in the U.S.&nbsp;first, and&nbsp;apparently some&nbsp;of the companies that have done deals with the administration limited their promises to three years,&nbsp;anyway. That way they can charge&nbsp;U.S.&nbsp;consumers however much they think the market will bear before they take their smaller profits overseas. Like I said,&nbsp;clever.&nbsp;Maybe that\u2019s&nbsp;why so many companies were ready to do those deals.&nbsp;<\/p>\n\n\n\n<p>All right, that is this week\u2019s show.&nbsp;As always, thanks to our editor,&nbsp;Emmarie&nbsp;Huetteman;&nbsp;our producer-engineer, Francis Ying;&nbsp;and our interview producer,&nbsp;Taylor Cook.&nbsp;A&nbsp;reminder:&nbsp;<em>What the&nbsp;Health?<\/em>&nbsp;is now available on WAMU platforms, the NPR app,&nbsp;and wherever you get your podcasts, as well as,&nbsp;of course,&nbsp;<a href=\"https:\/\/kffhealthnews.org\/\" target=\"_blank\" rel=\"noreferrer noopener\">kffhealthnews.org<\/a>. Also, as always, you can email&nbsp;us&nbsp;your comments or questions.&nbsp;We\u2019re&nbsp;at&nbsp;<a href=\"mailto:whatthehealth@kff.org\" target=\"_blank\" rel=\"noreferrer noopener\">whatthehealth@kff.org<\/a>.&nbsp;Or you can still find me on&nbsp;X&nbsp;<a href=\"https:\/\/twitter.com\/jrovner\" target=\"_blank\" rel=\"noreferrer noopener\">@jrovner<\/a>&nbsp;or&nbsp;on Bluesky&nbsp;<a href=\"https:\/\/bsky.app\/profile\/julierovner.bsky.social\" target=\"_blank\" rel=\"noreferrer noopener\">@julierovner<\/a>. Where are you folks hanging these days?&nbsp;Shefali?&nbsp;<\/p>\n\n\n\n<p><strong>Luthra:&nbsp;<\/strong>I am on&nbsp;Bluesky&nbsp;<a href=\"https:\/\/bsky.app\/profile\/shefali.bsky.social\" target=\"_blank\" rel=\"noreferrer noopener\">@shefali<\/a>.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong>&nbsp;Rachel.&nbsp;<\/p>\n\n\n\n<p><strong>Cohrs Zhang:&nbsp;<\/strong>On&nbsp;X&nbsp;<a href=\"https:\/\/twitter.com\/rachelcohrs\" target=\"_blank\" rel=\"noreferrer noopener\">@rachelcohrs<\/a>, or&nbsp;<a href=\"https:\/\/www.linkedin.com\/in\/rachelcohrs\/\" target=\"_blank\" rel=\"noreferrer noopener\">LinkedIn<\/a>.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong>&nbsp;Lizzy.&nbsp;<\/p>\n\n\n\n<p><strong>Lawrence:&nbsp;<\/strong>I\u2019m&nbsp;on&nbsp;X&nbsp;<a href=\"https:\/\/x.com\/LizzyLaw_\" target=\"_blank\" rel=\"noreferrer noopener\">@LizzyLaw_<\/a>&nbsp;and&nbsp;<a href=\"https:\/\/bsky.app\/profile\/lizzylawrence.bsky.social\" target=\"_blank\" rel=\"noreferrer noopener\">Bluesky<\/a>&nbsp;and&nbsp;<a href=\"https:\/\/www.linkedin.com\/in\/lizzy-lawrence1\/\" target=\"_blank\" rel=\"noreferrer noopener\">LinkedIn<\/a>.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>We will be back in your feed&nbsp;next week.&nbsp;Until then, be healthy.&nbsp;<\/p>\n\n\t\t<\/div>\n\t<\/div>\n<\/section>\n\n\n\n<div class=\"wp-block-credits block--credits\">\n\t\t<h3 class=\"credits-title\">\n\t\tCredits\t<\/h3>\n\t\t<div class=\"credits-card-container threewide\">\n\t\n\n<div class=\"wp-block-people-card block--people-card\">\n\t\t\t<div class=\"author-meta-container\">\n\t<div class=\"author-name\">Francis Ying<\/div>\n\t<div class=\"author-affiliation\">Audio producer<\/div>\n\t\t\t\t\t\t<div class=\"author-bio\">\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-people-card block--people-card\">\n\t\t\t<div class=\"author-meta-container\">\n\t<div class=\"author-name\">Taylor Cook<\/div>\n\t<div class=\"author-affiliation\">Audio producer<\/div>\n\t\t\t\t\t\t<div class=\"author-bio\">\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-people-card block--people-card\">\n\t\t\t<div class=\"author-meta-container\">\n\t<div class=\"author-name\">Emmarie Huetteman <\/div>\n\t<div class=\"author-affiliation\">Editor <\/div>\n\t\t\t\t\t\t<div class=\"author-bio\">\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\t<\/div>\n<\/div>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\" \/>\n\n\n\n<p><em><a href=\"https:\/\/kffhealthnews.org\/our-podcasts\/\"><u>Click here to find all our podcasts.<\/u><\/a><\/em><\/p>\n\n\n\n<p><em>And subscribe to &#8220;What the Health? From KFF Health News&#8221; on <a href=\"https:\/\/podcasts.apple.com\/us\/podcast\/what-the-health\/id1253607372?mt=2\"><u>Apple Podcasts<\/u><\/a>, <a href=\"https:\/\/open.spotify.com\/show\/32EdsB662C3oyIrqLMmBXI?si=TQhRjzzLTgWtK3crfbOFtA\"><u>Spotify<\/u><\/a>, <a href=\"https:\/\/app.npr.org\/aggregation\/fis-1269164038\"><u>the NPR app<\/u><\/a>, <a href=\"https:\/\/www.youtube.com\/playlist?list=PL5Qew-7pSXbAucCUQnyRx6qpLglzrxzFb\" target=\"_blank\" rel=\"noopener\">YouTube<\/a>, <a href=\"https:\/\/play.pocketcasts.com\/web\/podcasts\/a379e280-3f57-0135-9028-63f4b61a9224\"><u>Pocket Casts<\/u><\/a>, or wherever you listen to podcasts.<\/em><\/p>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The Trump administration faces the challenge of naming a new director of the Centers for Disease Control and Prevention who can both satisfy the Make America Healthy Again movement and get confirmed by the Senate. 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Also this week, Rovner interviews Georgetown University Law Center\u2019s Katie Keith about the state of the Affordable Care Act on its 16th anniversary.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/kffhealthnews.org\/news\/podcast\/what-the-health-439-cdc-lacks-leader-march-26-2026\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"A Headless CDC - KFF Health News\" \/>\n<meta property=\"og:description\" content=\"The Trump administration faces the challenge of naming a new director of the Centers for Disease Control and Prevention who can both satisfy the Make America Healthy Again movement and get confirmed by the Senate. 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