[Editor’s note: This transcript was generated using both transcription software and a human’s light touch. It has been edited for style and clarity.] 

Julie Rovner: Hello and welcome back to “What the Health?” I’m Julie Rovner, chief Washington correspondent for KFF Health News, and I’m joined by some of the best and smartest health reporters in Washington. We’re taping this week on Thursday, Feb. 6, at 10 a.m. As always, news happens fast and things might well have changed by the time you hear this. So, here we go. 

Today we are joined via videoconference by Alice Miranda Ollstein of Politico. 

Alice Miranda Ollstein: Hello. 

Rovner: And Lauren Weber of The Washington Post. 

Lauren Weber: Hello, hello. 

Rovner: Later in this episode, we’ll have my interview with my KFF Health News colleague Julie Appleby, who reported and wrote the latest “Bill of the Month” about a young woman, a grandfathered health plan, and a $14,000 IUD. It is a wild one. But first, this week’s health news. 

Now, I know a million things have happened since the Trump administration tried to freeze domestic spending and was ordered to stop by a federal judge. That happened, checks notes, last week. But I want to start there because it turns out that was far from the end of the story at the Department of Health and Human Services, and things are still far from normal. First of all, even though the funding freeze is, quote-unquote, “over,” there are still lots of reports of agencies that still can’t get paid, including Head Start programs, community health centers, and lots of nonprofits that provide domestic social services. 

We’ll get to the international stuff separately in a moment. This is potentially leaving not just people high and dry for services but staff unable to get paid, rent unable to get paid. Just to be clear, this is not supposed to be happening, right? 

Ollstein: There’s just so much confusion right now, and there is not across-the-board clarity that people can follow. And so some people are getting their funding, but they’re getting it late. Some people are not getting it at all. People are being told conflicting things. 

There are also a lot of health care providers around the country are also receiving confusing guidance about how to comply with various executive orders related to, quote-unquote, “DEI and gender.” And so they’re not clear if any program that serves lots of different people, including trans people, needs to be suspended or if anything related to serving particular, underserved minority groups needs to be suspended. There’s just so much confusion that we’re hearing, and a lot of folks are scrambling to draw down whatever funding they can now, because they don’t know what’s going to happen in the future. 

Rovner: And of course, adding to this is today is the deadline for federal workers to say whether they want to accept this strange offer allegedly from the Office of Personnel Management, which is not supposed to be sending out government-wide emails telling people that if they reply to the email with “resign,” they can have eight months of pay, even though the government is only funded at the moment through March 14. 

So, of course, all of these federal workers are getting all kinds of conflicting information about what they should do for their own situation, much less what they should do for the people they’re supposed to be serving in their jobs. 

Weber: Yeah. I think it’s important to look no further than what Elon Musk did to Twitter. He stripped it down to bare bones, and I think a lot of federal workers looking at that historical example potentially see the writing on the wall that their jobs may or may not exist. 

So they’re looking at this offer but with trepidation because, as you pointed out, how can they possibly pay the full eight months? How would that work? Is this legally possible? There’s just so much confusion swirling around, no one really has a sense of what’s up from down in terms of how this could go forward. 

Rovner: And we need to make it clear. When Elon Musk bought Twitter, he bought a company, he bought a private company. It was basically his to do with as he pleased. If he wanted to offer people buyouts — which, by the way, I think a lot of them didn’t get promised severance — he could. And if he wanted to fire people, he could. 

This is the federal government. Hundreds of thousands of civilian workers are supposed to have civil service protections. We’re not talking about political appointees. Most left on their own the day [Donald] Trump took over. These are people who were supposed to be there throughout changes in administration. 

People are just seeming to accept this at face value, that Elon Musk and his group of 19-to-25-year-olds can basically come in and fire the entire federal government at will. That’s not legal. 

Ollstein: And I’m also seeing a lot of federal worker unions telling people: Don’t fall for this. Don’t accept this “buyout.” Hold the line. They’re challenging this in court. And so again, what you both said, it’s not clear that they can fulfill this promise of funding through the fall, but it’s also not clear if any of this is legal. 

And so you have these unions and organizations pleading with federal workers not to fall for it and not to take the resignation offer. But you also have a lot of people saying, Well, if the choice is accept this or wait and just be laid off with nothing, then I’m going to accept this. And then so a lot of people are worried about their own livelihoods and thinking this is sort of a lifeboat. 

Rovner: Well, meanwhile, it’s not just funding. At the same time, webpages around the Department of Health and Human Services, mostly from the Centers for Disease Control and Prevention, the FDA [Food and Drug Administration] and the NIH [National Institutes of Health] have been disappeared. Some have been reappeared. A banner atop the main page for the CDC website says it’s, quote, “being modified to comply with President Trump’s Executive Orders.” 

And while the freeze on outside meetings and travel and grant review at NIH has been loosened, it is still ongoing. Oh, and we haven’t had a Morbidity and Mortality Weekly Report from the CDC in two weeks now. News flash: There’s an Ebola outbreak in Uganda and a herd of cattle in Nevada with a different strain of bird flu than the one that’s been going around. 

What are you guys hearing about what’s happening in these departments with their outside communications? They’re not really allowed to talk to the public yet, right? 

Weber: I think it’s just widespread confusion. It depends on the agency. It depends on your interpretation of the guidance, what you’re able to say, what you need to modify, what’s being taken down. I think, overall, a lot of folks that are on the inside are doing their best to comply and maintain their jobs, and also deal with the restrictions that seem to come and go. 

Ollstein: And I will say, like we were talking about the funding issue, the communications issue has completely been spotty, and enforcement is all over the place. For instance, yesterday we did get a report out from CDC on maternal mortality data, which we can talk about if we want. But people were not sure whether that would be released or not amid all of this, because other reports have been held up. And so it’s just all seeming from the outside to be very ad hoc right now, and there’s not, like, blanket policies that people can depend on. 

Rovner: So, Alice, you referred to this earlier, but one of those executive orders that agencies are supposed to be bringing their programs and funding in line with is aimed at eliminating any vestiges of what’s known as diversity, equity, inclusion, and accessibility in the federal government and in grant programs. 

Over at the National Science Foundation, apparently projects are suspect if they include keywords including “disability,” “female,” “historically,” “socioeconomic,” or “women,” also “minority,” “institutional,” or “excluded.” Basically, if your grant has any of those words in it, it is marked for potential cancellation. And it’s not just in government. Stat this week is reporting that the American Society for Microbiology, which is not a government agency, although it does receive some federal funding, has removed all the DEI content from its website. 

And the impact may be having unintended effects also. Eliminating all DEI jobs in federal agencies also includes people like sign language interpreters for the deaf and others who provide accommodations for workers with disabilities, which is required under — remember those? — federal laws like the Americans With Disabilities Act. Has anybody asked the White House about this or even HHS? We’re seeing reports of things happening that one assumes were not intended by these executive orders. 

Weber: There’s just so much, there’s such a flooding the zone of this, I think a lot of the federal agencies are also waiting till their new heads get into place. I think there’s a little bit of a waiting game going on here. Obviously, we saw that Robert F. Kennedy Jr.’s confirmation hearing’s advanced. 

Assumedly, sometime next week, he will likely be confirmed. I think you will see more clarification potentially. I think that’s, well, potentially, after you have some of these heads of agencies, whether that’s HHS, CDC, FDA, come into place. I think some of this was a stop, hold the line, kind of get situated. 

But the reality is, as I pointed out, Kennedy is not currently HHS head, and so there’s still a lot of waiting time. And in the meantime, there’s a lot of confusion over what the communications are. What’s allowed? What’s not allowed? What’s complying? What’s not complying? 

You saw some of that clarified when Pete Hegseth took over at DOD [the Department of Defense]. I think that some of the health agencies have just a little bit more of a waiting game, because their folks aren’t going to be confirmed for a period of time here. 

Rovner: Right. There are no Senate-confirmed agency heads at HHS yet. 

Ollstein: And I will just point out that it is a bit ironic that a big part of Kennedy’s message, as he’s sought confirmation, is being pro-data, pro-science, wanting more transparency on both. And he is saying that at a time when things are being stripped offline, decades-old databases are going down, communication is halted. And so that’s an interesting tension, and I haven’t seen members of Congress really press him on that. 

Rovner: Oh, you were anticipating my next question, which is: Where are the Democrats? 

Ollstein: There are a variety of tactics and approaches, from trying to hold press conferences and trying to enter certain federal agencies and being turned away. There are folks who are pressuring individual nominees. You’ve had Democrats pressure Kennedy to change his ethics agreement, so that he isn’t directly profiting from these anti-vax lawsuits that he was going to maintain a financial stake in. Although now it has been transferred to his son, which Sen. Elizabeth Warren and others argue is still a huge conflict of interest and doesn’t really fix the problem. There is not a unified response and message. Individual members of Congress seem to all be doing what they think is best in this moment. 

Weber: Yeah. 

Rovner: Let me ask— 

Weber: Oh, go ahead. 

Rovner: No, let me ask the question in a slightly different way. A lot of what’s happening right now was all written out in Project 2025 for those of us who read it. They are literally following the guidebook. Why weren’t the Democrats ready for any of this? They just seem frozen in place. Lauren? 

Weber: I was just going to say, Steve Bannon has publicly said, many members of the Trump administration going in have said the plan is to flood the zone. So it is a good question, Julie. If you are the opposing party, why would you not have a better plan for that? But I would just say that the Dems have seemed to be in disarray since Kamala Harris lost. They’ve been pointing a lot of fingers. I think now, one would think they would get together with some sort of unity, but they’ve yet to kind of coalesce. They’ve all been doing their own individualistic fighting back. 

We’ll continue to see how this plays out. I think flooding the zone is an effective tactic in the sense of there’s so much to respond to that they seem to not be able to get together to work on that. But we’ll have to see how this unfolds. 

Rovner: They have sent lots of sternly worded letters, as far as I can tell, that’s been — and press conferences that are scheduled like a day and a half when something happens. And then 14 other things happen between the time they schedule the press conference and the time they have it. Because that’s the strategy right now, as you say, is to flood the zone. 

Before we leave this, separately from the DEI stuff are executive orders aimed at transgender people. A judge has already blocked an effort to transfer three transgender women federal inmates to men’s facilities and to cut off their access to hormone therapy. But meanwhile, demonstrating that these orders go further than many might’ve anticipated, and I think one of you actually already mentioned this: Hospitals around the country are already cutting off treatment, including reversible treatments to transgender minors, for fear of losing all of their federal funding. 

Now, I know a lot of families moved from states with restrictive policies to states with less restrictive ones over the past couple of years. This is like what they want to do on abortion — right? — is just cut off access nationwide. 

Ollstein: I think that there are a lot of parallels with abortion in this space. I think, one, you see impacts on blue-state residents who thought they would be, quote-unquote, “safe” from these policies being effected. You’re seeing hospitals in California, you’re seeing hospitals in New York, you’re seeing hospitals in other states with their own state protections suspending services out of confusion and fear of losing federal funding, etc. I think, in both contexts, we’ve really seen over the last few years especially just how fundamentally risk-averse and cautious the health care world is. 

And when there is a gray area, they tend to lean more towards overcompliance than undercompliance. I think you’re seeing that both in the abortion space and in the trans care space right now. 

Weber: I just wanted to add, at the end of the day, hospitals are businesses. If the threat is half of your revenue from Medicaid and Medicare is cut off, they’re going to comply. That’s just a massive amount of money for a lot of these hospitals that they’d potentially be putting at risk. Not to mention the research grants that may or may not also be affected. So I think the stories that we’ve already seen trickle out, obviously, of the hospitals you mentioned in California and New York, some in D.C. and Virginia and in our backyard, is going to become very much the norm until this is sorted out more. 

Rovner: Yeah. I think what a lot of people were not expecting, Congress is basically nowhere to be seen. All of this is happening because of these executive orders, which on the one hand, yes, can reach the federal government itself. But I think people didn’t anticipate how far beyond they are reaching, basically anybody who gets federal money, which is almost everybody. The reach of this kind of executive power is, I think it’s fair to say, unprecedented. 

As someone already mentioned, Robert F. Kennedy Jr. is likely to soon become the secretary of health and human services, although he is not there yet. The Senate Finance Committee approved his nomination on a party-line vote on Tuesday. The yes votes included one from doctor and Health, Education, Labor, and Pensions Committee chairman Bill Cassidy, who serves on the Finance Committee also. Cassidy was considered the key swing vote, having sharply criticized Kennedy’s anti-vaccine advocacy. 

But Cassidy explained on the Senate floor after the Finance Committee vote that Kennedy has promised to work closely with him and not to do anything to deter Americans from getting vaccines. We have a cut of tape. 

Sen. Bill Cassidy: We need a leader at HHS who will guide President Trump’s agenda to make America healthy again. Based on Mr. Kennedy’s assurances on vaccines and his platform to positively influence Americans’ health, it is my consideration that he will get this done. 

Rovner: So what are we to make of Cassidy’s confidence that all will go well here for supporters of childhood and other vaccines? 

Weber: Is that confidence, or is that him saying he struck a deal, and these are the terms of the deal, and we’ll see how that deal turns out? Georges C. Benjamin’s told me, from the American Public Health Association, he said, Do you think that Kennedy’s going to call Cassidy every time he makes a controversial decision? And I think it’s a good question asked by the doctor over, that runs the American Public Health Association. I think at the end of the day it seems— 

Rovner: That’s what Cassidy said, though. He said that Kennedy would consult with him on all of these decisions. 

Weber: That is, I understand that’s what he said. I’m curious to see if that’s actually how that happens. Cassidy sang quite a different tune than he did in his questioning the second day of the hearings, where he said, I just really — I have a hard time believing that a 71-year-old man’s going to change his stripes. But it seemed by the time the vote came around this week that he felt that way, despite RFK Jr. really [not] giving him any sort of assurances that his position had changed on his numerous instances of falsely claiming that vaccines are linked to autism. 

Ollstein: I completely agree. And there were almost points in the hearing where Cassidy seemed to be begging Kennedy to give him something to work with, to give him some shred of a sign that he had really changed his views, and he did not get that. But clearly he was convinced by whatever assurances he got. We know because Cassidy said so, that he’s been bombarded, his office has been bombarded by phone calls. 

We know that [Vice President] JD Vance and other administration officials had been putting the screws on him in the lead-up to the vote. We’ve seen in the wake of his decision to vote for Kennedy, the public health world being really outraged and feeling that he chose his role as a politician over his role as a medical doctor. It’s also worth noting that he is up for reelection soon, would likely face a primary from the right, and so that is seen as playing into this, too. Yeah, I’ve just seen a lot of the health world really upset. I’ve seen people referring to this as “the Louisiana Purchase.” 

Rovner: I had not seen that. 

Ollstein: Feeling that he was bought off, not necessarily with money but with these pledges and promises. 

Rovner: And also, I believe he also already has a primary opponent. He’s up in the next round of elections. 

Ollstein: But we don’t know if he’s running. We don’t know if Cassidy is running for reelection, but if he does run, he will have a primary challenger. Yes. 

Rovner: Yes, that’s fair. All right. Well, leaving HHS for a moment, I want to remind our listeners that foreign policy is also health policy, which brings us to the U.S. Agency for International Development. Despite the fact that this is a congressionally created agency with an appropriated budget, Elon Musk’s “DOGE” [Department of Government Efficiency] is basically disassembling it. 

And as of the end of this week, nearly all employees will have been placed on administrative leave and those overseas being ordered home. Among the programs run by USAID is PEPFAR [the President’s Emergency Plan for AIDS Relief], the HIV/AIDS program created by President George W. Bush that’s credited with saving tens of millions of lives in Africa and other developing nations. 

Secretary of State Marco Rubio has said he’d grant exceptions for some ongoing humanitarian assistance, but the status of PEPFAR remains unclear. What, if anything, are you all hearing about all of the global health activities that had been going on? 

Ollstein: It’s hard to operate as reporters, and we are hearing from sources that it is hard for them to operate these programs, because what they’re hearing announced from the administration is not the reality they’re experiencing on the ground. And so they’re losing trust in the official announcements and guidance that they’re getting, because the frozen funds were supposed to be unfrozen, but the funds are not flowing. So there is a real fear that there is going to be a lot of tangible human suffering associated with this, millions of people losing access to the programs that keep them alive and prevent transmission. And as we know, when it comes to a transmissible disease like this, even a small pause could mean more spread and more problems down the line, even if things are restored. 

Rovner: Yeah. Lauren, are you following this at all? 

Weber: The level of confusion, I think, is amplified when you have folks in far-flung corners of the world who are dealing with life-and-death situations and have no one to reach out to. We’re talking about people that work at refugee camps. We’re talking about people that deliver nutritional aid in various countries on the brink of famine. We’re talking about folks that are now emailing people back at USAID who don’t have emails anymore. 

The scale of this is somewhat mind-boggling to those who are covering it, and as Alice said, the lack of clarity around it is pretty clear. And at the end of the day, Elon Musk has gone as far as to call the program, I believe it was, “evil”? I’ll have to check the language, but the vilification of a program that has been credited with quite a lot of impact in such a short period of time has been very complete. 

Rovner: Well, we talked about this a little bit on the domestic side. It’s not just these government workers. It’s the people who are on the ground, the contractors doing the job. And interestingly, the largest contractor for USAID is Catholic Charities, which is now faced with having to stop work and lay people off. So, again, did President Trump really think that he should be going after Catholic Charities? We’re going to find out, because that’s in fact what’s happening. 

It’s not just foreign policy. Trade policy is also health policy. Last week, President Trump announced new tariffs on goods from Mexico, Canada, and China. The big story for most of the media was the 30-day pause on the Mexican and Canadian tariffs. But the tariffs on China took effect as scheduled, and those could drive up the cost of drugs, particularly generic drugs, and many drug ingredients, which are increasingly made overseas, as well as other medical devices. I thought we were trying to reduce our reliance on China during covid, particularly for medical supplies. What happened with that? 

Weber: Well, what happened with that is it’s very expensive to build manufacturing facilities for products that don’t make people a lot of money. So no, there was not much done to really alleviate that. That was a boom-bust cycle of pandemic funding that we’re far beyond the bust. We’ve busted the bust here. So if these tariffs stay in place, many drug experts say, you could expect generic drugs to go up in the coming months. Contracts are in place that minimize probably the pocketbook hit right now, but in the coming months, that very well could change. 

Rovner: Well, meanwhile, it’s not on the front burner, but the future of abortion is still way up in the air. The big news last week came from Louisiana, where a grand jury in Baton Rouge indicted a doctor from New York for legally prescribing an abortion pill online to a Louisiana teenager. The teen’s mother is also charged with a felony. Now, the New York doctor is specifically protected by her state’s shield law, or she is supposed to be. Alice, this is the beginning of the big fight we’ve been expecting for a while, right? 

Ollstein: Well, it’s really a continuation of the big fight. We’ve seen cross-border fights. It’s an escalation, for sure. We already saw Texas bring civil charges against this very same New York doctor. And so this is a criminal charge, which is again an escalation but not a completely new attempt. And I think we’ve all been pointing out all along that, quote-unquote, “sending abortion back to the states” is not possible, because we live in an interconnected country. People travel, medications travel, and these laws are in direct conflict with one another. It’s interesting, because conservatives argue that New York providers are being allowed to meddle in and undermine the anti-abortion laws of red states, while progressives say that it’s the red states that are attempting to reach across their borders and criminalize behavior that’s legal in the place that it’s being practiced. 

It’s legal for the New York doctor sitting at her desk in New York to prescribe these medications, and they are attempting to criminalize that behavior. So this was sort of inevitable, and it will be fascinating to see how courts treat it. Of course, we have still ongoing, the same mifepristone lawsuit that now three states are leading in Texas. And so you have three other— 

Rovner: Three states that don’t include Texas. 

Ollstein: Correct. Three other GOP-led states claiming standing in a Texas court in Amarillo against mifepristone availability all over the United States. So we shall see what happens to that, but some of these cases will certainly be back on their way to the Supreme Court sooner or later. 

Rovner: Well, it’s not just in the state. I have my own column out about this week, which I will shamelessly link to in the show notes. But abortion restrictions are tightening here in Washington on the federal level as well, despite President Trump’s claim on the campaign trail that he would leave the issue to the states. This week, newly approved defense secretary Pete Hegseth, as expected, rolled back the policy instituted by President [Joe] Biden allowing members of the military time off and travel allowances to obtain abortions for themselves or a family member if they’re stationed in a banned state. 

Alice, this administration got off to a kind of slow start on abortion. We actually talked about it amongst ourselves. How are the president’s anti-abortion backers feeling about it now? 

Ollstein: They’re feeling quite good, and they’re feeling good about Kennedy, as well. He said a lot of things in his confirmation hearing that they wanted to hear, which we can walk through if we want. But I would say what’s been interesting is a lot of the stuff they’re doing, they’re doing a bit under the radar. 

So that defense policy, that didn’t get a big, splashy announcement. That was sort of quietly put out there. And like you said before, they did not do the big, splashy Day 1 executive orders that past conservative administrations have done. But Trump ran on trying to please both sides, and a lot of people who support abortion rights did vote for Trump. 

But it’s been clear, even if he’s not doing everything anti-abortion people want, he is only doing things that they want. He is not doing things that the other side wants. So he sort of ran on pleasing both sides, but it’s pretty clear which side he’s chosen. 

Rovner: Yeah, and we will. Obviously, once Kennedy gets set up at HHS, then we will talk about what’s going to go on there, because, obviously, there are many, many more shoes to fall on this particular subject. All right. Well, that’s as much news as we have time for this week. Now we will play my “Bill of the Month” interview with Julie Appleby, and then we’ll come back and do our extra credits. 

I am pleased to welcome back to the podcast my KFF Health News colleague Julie Appleby, who reported and wrote the latest KFF Health News “Bill of the Month.” Julie, thanks for joining us. 

Julie Appleby: Thanks for having me. 

Rovner: So tell us about this month’s patient, who she is, and what kind of medical care she got. 

Appleby: This month’s patient is Callie Anderson. She’s 25, she lives in Scranton, Pennsylvania, and she went to the doctor and wanted to get off the birth control pill. So they discussed it and decided that an IUD [intrauterine device] would be right for her. So she got an appointment a couple months later and got an IUD. 

Rovner: This feels like a slam dunk, right? She has health insurance. FDA-approved contraception, including long-acting contraception like IUDs, are supposed to be covered with no patient copay under the Affordable Care Act. But that’s not what happened here. How much was the bill she got? 

Appleby: Her bill was $14,658. 

Rovner: That sounds like a lot for an IUD, even if you didn’t have insurance. Is that a lot? 

Appleby: Yes, it is a lot. The Geisinger Health System charges in this case were multiple times what the average looks like it is. For example, I spoke with Planned Parenthood, and they say it can vary depending on the type of IUD and where you live and things like that. But in general, $500 to $1,500 for an insertion is what they’re seeing. And I also looked at FAIR Health, which tracks claims, and they say, for an uninsured person, it can range from about $1,100 to $4,300, depending on where you get it. 

Rovner: So this was really an astronomically high amount. 

Appleby: That’s what one of the folks I spoke with described it, yes. 

Rovner: And why wasn’t it covered with no copay like the ACA required? 

Appleby: Very good question. There’s a type of coverage that doesn’t require plans to follow the Affordable Care Act, and these are called “grandfathered” plans. And they’re called “grandfathered” because they were in existence before March 23, 2010, which was when President Barack Obama signed the Affordable Care Act, and they’ve remained sort of substantially the same since then. So they don’t have to follow all the rules of the Affordable Care Act. And Callie Anderson’s plan — which she got through her dad because she’s 25 and she’s still on his plan, and he’s a retired police officer in Pennsylvania — that plan is grandfathered. 

Rovner: So retired police officers in Pennsylvania didn’t have coverage for FDA-approved contraception before the Affordable Care Act? 

Appleby: Yes, because it’s a grandfathered plan. And interestingly, KFF, which does an employer survey, found that about 14% of all covered workers in 2020 were on grandfathered plans. So they’re a little unusual but not that unusual. 

Rovner: Yeah. That feels like a lot to have a plan that really hasn’t substantially changed in 15 years. 

Appleby: That does seem like a lot. 

Rovner: So what’s the takeaway here for patients in this situation? 

Appleby: Experts always say it’s always best to read your benefit booklet or call your insurer before you undergo some kind of nonemergency medical procedure, just to check: Is it covered? And ask to speak with a representative. Call your insurance plan, find out how much you might owe out-of-pocket for the procedure. 

And sometimes you have to get really specific with birth control, because while birth control is covered, you might have to specify exactly what type you want. Because some insurers only cover certain brands or certain types, so it’s always best to double-check that. But that puts a lot of onus on the patient. And in this case, Callie did ask that she get prior authorization through her health system, and she thought that had been done, but it had not. 

Rovner: And what is happening with her bill? 

Appleby: What’s happening with her bill is she was offered a discount. And then she got a discount off the discount if she agreed to pay the entire amount in full, in one payment. So she ended up paying $5,236 for her IUD. 

Rovner: Still a lot. 

Appleby: Yes, still a lot of money. 

Rovner: Alas, we have plenty more Bills of the Month that we can still do. Julie Appleby, thank you so much. 

Appleby: Thank you. 

Rovner: OK, we are back. It’s time for our extra-credit segment. That’s where we each recognize a story we read this week we think you should read, too. Don’t worry, if you miss it, we will put the links in our show notes on your phone or other mobile device. Lauren, why don’t you go first this week? 

Weber: I pitched an article in CNN [“Human brain samples contain an entire spoon’s worth of nanoplastics, study says”] that talked about how we have a lot more plastic that is apparently residing in the cracks and crevices of our brains. Now, it’s microplastics. They’re very, very small, much smaller even than a strand of your hair. But their health impact is not known. 

And there was also some findings, not correlated, but potentially that there was more plastic, or there appeared to be more plastic, in some of the brains that were examined of folks that had dementia or Alzheimer’s. It’s unclear whether or not that’s because those brains change in size, shape, and leave reservoirs more for plastic to hide in. But as we all talk about microplastics and their health impacts, it is alarming to see that they appear to be showing up more in people’s brains. 

Rovner: I hope this is something that RFK is worried about, too. Alice. 

Ollstein: So I chose Lauren’s story [“Did RFK Jr. or Michelle Obama say it about food? Take our quiz”] at The Washington Post that is a quiz to show how much the things that RFK Jr. has been saying about the nation’s food system — you know, they sound pretty familiar. And they sound pretty familiar because they sound a hell of a lot like things Michelle Obama said when she was promoting her healthy food campaigns. 

And so it’s a quiz of: Who said it, RFK Jr. or Michelle Obama? And I will say, I got most of them right. But my strategy was that I focused on the style of speaking rather than the content, because the content is very similar but the style of speaking is not. So that’s my tip for all you out there, but it does show that— 

Rovner: Oh, cheater. 

Ollstein: —that conservatives who were outraged when Michelle Obama said these things — they thought it was a nanny state and big government telling you what to do and it’s our American right to eat french fries and all that — are now embracing this MAHA [“Make America Healthy Again”] movement that’s making very similar points. 

Rovner: Well, I took the quiz and I got most of them wrong. 

Weber: Well, Julie, that was the point. That was the point, though. 

Rovner: Yeah, exactly. All right. My extra credit this week is another podcast, the Jan. 30 episode of The New York Times’ “The Daily.” It’s called “How R.F.K. Jr. and ‘Medical Freedom’ Rose to Power.” And it’s an interview with longtime health policy and politics reporter Sheryl Gay Stolberg, who has coincidentally been working on a book on the political history of public health. In the podcast, she shares just enough of what she’s learned to make me really look forward to reading the book. But in the meantime, it’s a great half hour of how we got to where we are now in our distrust of public health. 

OK, that is this week’s show. As always, if you enjoyed the podcast, you can subscribe wherever you get your podcasts. We’d appreciate it if you left us a review. That helps other people find us, too. Thanks again to our producer, Francis Ying, and our editor, Emmarie Huetteman. As always, you can email us your comments or questions. We’re at whatthehealth@kff.org. Or you can still find me at X, @jrovner, and also at Bluesky, @julierovner. Where are you guys these days? Lauren? 

Weber: You know what? I did finally get a Bluesky account, so I am now on both X and Bluesky, @laurenweberhp, because I just can’t let the “hp” for “health policy” go. 

Rovner: There you go. Alice. 

Ollstein: I’m mainly on Bluesky, @alicemiranda, and still on X, @AliceOllstein. 

Rovner: We will be back in your feed next week. Until then, be healthy.