[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. 27, at 10 a.m. As always, news happens fast and things might have changed by the time you hear this. So, here we go. 

Today, we are joined via video conference by Alice Miranda Ollstein of Politico. 

Alice Miranda Ollstein: Hello. 

Rovner: Shefali Luthra of The 19th. 

Shefali Luthra: Hello. 

Rovner: And Victoria Knight of Axios News. 

Victoria Knight: Hey, everyone. 

Rovner: No interview this week but more than enough news, so we’re going to jump right in. We’re going to start this week on Capitol Hill for a change because, hey, the House passed a budget resolution! Now, mind you, they passed, by a single vote, a fiscal 2025 budget resolution, which was supposed to have gotten passed last April, but it’s something. It’s also the necessary first step towards what President {Donald] Trump calls his “one big, beautiful bill” that calls for trillions in tax cuts, and notably instructs the House Energy and Commerce Committee to come up with $880 billion in cuts from its jurisdiction, most likely from Medicaid. 

But it’s important to remember this is not yet a bill, and the next thing that happens is not that House committees get on with writing their reconciliation bills, but that the House and Senate reach a deal on a single budget resolution, which still looks quite a long ways off, since the resolution the Senate passed the week before last doesn’t include anything on taxes or health care. Victoria, you’re watching all this play out. The Senate didn’t exactly welcome this House resolution by saying, “OK, let’s do that instead.” Right? 

Knight: I mean, yeah. I think both chambers are very headstrong in the idea that they’re going to be the ones to pursue the path forward, and so I think that’s why we still have these two competing paths. Johnson yesterday was like, “We don’t want much …”  

Rovner: Speaker Johnson. 

Knight: Yeah, sorry, Speaker Johnson. Yes, he told reporters yesterday, “We don’t want many changes from the Senate side.” But then at the same time, you’re already hearing from senators, notably ones like Sen. Josh Hawley [R-Mo.], who’s pretty conservative on a lot of things, but he has some populist ideas sometimes. And he has said, “I don’t want to cut Medicaid,” but he is in support of Medicaid work requirements. But we’re already kind of hearing messages from the Senate side that they are not going to want as intensive cuts around Medicaid as the House has projecting that they may need to do. To be clear, they haven’t cut Medicaid yet. There’s a lot of Democratic messaging right now saying that’s already happened. Hasn’t happened yet, but there’s really no other way to get that savings of eight $880 billion from Energy and Commerce without touching Medicaid. So, I think it’s important to put that nuance in there. 

Rovner: Oh, and you have teed up my next question perfectly, which is Medicaid was a huge featured player in Wednesday’s House budget resolution debate. Here is House Budget Committee Ranking Democrat Brendan Boyle, sounding his party’s theme. 

Brendan Boyle: This is cutting health care and all sorts of programs for the American people in order to deliver tax cuts for billionaires who don’t need it. 

Rovner: And this was a clapback from Republican House Budget Committee Chair Jodey Arrington. 

Jodey Arrington: Mr. Chairman, what you won’t hear from my Democrat colleagues is any mention of the half a trillion dollars in waste, fraud, and abuse in the Medicaid program that jeopardizes that program for the most vulnerable Americans, and does a disservice to every taxpayer in this great country of ours. 

Rovner: Republicans also claimed correctly that the word Medicaid doesn’t actually appear in the budget resolution, but that doesn’t mean the Medicaid isn’t on the chopping block. Victoria, that’s what you were saying, right? 

Knight: Yes, yes. That was the line from House GOP leadership this week. Medicaid was not mentioned in the budget resolution. You heard it across the conference and from moderates when we asked them about the voting for this. And they were all like, “It’s OK. Medicaid’s not mentioned in the budget resolution.” That’s because that’s how budget resolutions are written. They’re written as an outline of what the committees then need to find savings for. So, of course, there’s no specific programs mentioned in it. So technically that’s accurate, but it’s kind of a misrepresentation of how that whole process works. 

Rovner: And also, the Energy and Commerce Committee doesn’t have any place else to get that much money from. 

Knight: Yeah. 

Rovner: I mean, they traditionally do things like sell Spectrum and there are energy programs. There’s other things that they can do to cut the budget, but the two really big chunks of money they have are Medicare, half of Medicare, and Medicaid. 

Knight: Yes, and President Trump has made it clear that he doesn’t want to touch Medicare. He has also started saying that about Medicaid as well. He’s kind of been repeating that over the past weeks, as recently as Wednesday he said that. But it’s still not clear — he’s saying, but just waste fraud and abuse as you mentioned — it’s not clear what exactly that means. But it does sound like they’re getting closer to maybe not doing some of the more extreme proposals such as per capita caps, which means just giving states an allotted amount of money for each person that the Medicaid program covers. 

Speaker Johnson said on Wednesday on CNN, “It kind of looks like we’re moving away from that.” We’ve been kind of hearing that, and that is the policy change that would actually give the most savings amount of money. It would get them closest to that $880 billion. So if that’s off the table, then what are they going to use to pay for these tax cuts? It’s not really clear. I guess maybe we’ll find out more? I think they’re also trying to fudge the budget math a little where they maybe don’t have to offset these tax cuts as much as they’ve been saying they need to. So, much is still up in the air. 

Rovner: So, cut taxes without cutting programs. This is where I get to do my little screed about Medicaid waste, fraud, and abuse and what are called “improper payments,” because I’ve been covering them for 35 years. Improper payments don’t necessarily mean fraud or abuse. Most often, improper payments are things for which there is not — somebody skipped an administrative step. They didn’t check a box, they didn’t put in the right code. Very often improper payments are for legitimate expenses that were given to legitimate beneficiaries, but somebody didn’t do something that they should have. That’s what happens when you audit a program like this. 

So, even if you could get all of the improper payments out, you wouldn’t come anywhere near any of the types of savings that they’re talking about. And of course, the next thing they’re all talking about is work requirements, which, Alice, it’s always nice to have you here when we talk about work requirements because you covered the last time we actually had a work requirement and it didn’t really work very well, did it? 

Ollstein: Well, like I always say, it depends what the actual goal of it is. If the actual goal is to help people who are not working, encourage them to start working, and then maybe move them off of Medicaid and onto private insurance, it does not accomplish that. What it does accomplish is it saves a bunch of money by kicking people who should qualify but aren’t able to navigate the bureaucracy, navigate the reporting requirements, and so they lose their Medicaid. And so, if your goal is just to save money and reduce Medicaid enrollment, it does accomplish that, but it doesn’t accomplish that by helping people find work or transition into private coverage. 

Rovner: Or get people working who weren’t working before. 

Ollstein: Exactly. Because as we’ve discussed many times over the years, almost everybody on Medicaid is either working or they’re a full-time caregiver, they’re a student. There’s a legitimate reason, they have a disability. There’s a legitimate reason why they cannot have employment. 

Rovner: Nobody lives off their Medicaid benefits. Medicaid doesn’t give money to people. It gives money to health providers who provide health services for people. 

Ollstein: Right. And I mean, the terms “waste, fraud, and abuse” are being thrown around a lot recently, and I think it’s really important for journalists to pin down lawmakers on what exactly they mean by that because different people mean very different things when they say those words. And to Julie’s point, of course there is waste, fraud, and abuse. And to some level in every single program — private, government, what have you — but there is not $880 billion of that. There is no way to achieve those savings without cutting much deeper. 

Rovner: And just, I think, to circle back to what Victoria was saying at the beginning, not only has none of this happened yet, but in 2017, when the Republicans were unable to repeal the Affordable Care Act, Medicaid turned out to be a big reason why. That was when we discovered that, hey, Medicaid’s popular because lots of people get it. Well, it is now eight years later, and not only are more people getting Medicaid, but more Trump voters are getting Medicaid, which kind of explains why really red senators like Josh Hawley are saying, “Whoa, maybe we don’t want to do this.” I mean, this is going to be really, really politically hard, right? I see you nodding. 

Ollstein: Just a quick point about Hawley. So, Missouri is one of seven states that has voted since 2017 to expand Medicaid by popular vote. And so, that’s an even stronger, I think, dynamic here. It’s not like the legislature just did it, like in all of the other states. This is something his voters voted directly for, saying, “We want this,” and now they’re upset that it could be cut and rolled back. And so, I think as difficult it was for Congress to go after Medicaid in 2017, it’s far more difficult now, and these ballot measures are a piece of that. 

Knight: Yeah. To what you asked before, Julie, how politically difficult will this be? It’s going to be very difficult. I think, as you said, moderates and House GOP leadership has been like, “Well, Medicaid is not mentioned.” That’s how they got them to vote just for this budget resolution, which is just an outline of what may happen. It’s not even actual policy written down that they’re voting on yet. And so, I think once they start doing that, it could be very difficult to actually do. The other thing I just wanted to mention real quick was, there does seem to be more support for work requirements than in any other Medicaid reform change, but that only saves about $100 to $120 billion. So, it’s really just a small fraction of that $880 billion, even if they were somehow able to get everyone to vote for that. At least it just seems they got “mods” on board this week by saying that, but what about when Medicaid is actually named in the bill? 

Rovner: And before we leave Capitol Hill, we are two weeks from another potential shutdown. I don’t hear anything happening on, people are saying. … They talk about this, my frustration, the budget resolution like it’s the budget, and then they talk about the continuing resolution [CR] like it’s the budget. Neither one of them is actually the budget, but when that continuing resolution, which is all the appropriations, expires on March 14, unless Congress does something, the rest of the government shuts down. 

Knight: Yeah, it’s been a little undercovered because I think there’s been so much other news. Lawmakers on the Hill are definitely aware of it. 

Rovner: Good to know. 

Knight: It doesn’t mean they’ve done anything about it, but they know what’s happening. Yeah, no, I’ve been talking to appropriators this week, and Republican leadership is talking about, they want to do a yearlong CR, so that means they want to just pass it and it’ll end at the end of this fiscal year, so the end of September. 

Rovner: So, it’s not really a — they talk about it as yearlong CR, but it’s a seven-month CR. 

Knight: Yeah, exactly. But it’s not clear there’s Democratic support for that. I don’t think there is. They’re at an impasse because Democrats want language that says Congress has full appropriations control, not the president, not the executive branch. They want language to ensure that Republicans are saying, “We don’t want to give them that. We’re a trifecta. We’re not giving anything to Democrats right now.” That’s what Tom Cole [R-Okla.] literally said yesterday, the House Appropriations chair, because there are hard-line conservatives in the House that don’t want to vote for any, really, funding bill. It’s not clear they would have the votes to pass a yearlong CR without Democrats. So, I don’t know what they’re going to do, but they’re … 

Rovner: Well, they have two whole weeks to figure it out. All right. Let us move to the administration where things are happening much faster than they’re happening on Capitol Hill. The one thing that is slowing it down just slightly are federal court judges. In one case, a judge ordered the government to pay all outstanding invoices for foreign aid through Feb. 13 by 11: 59 last night, which did not happen. That was temporarily put on hold by Chief Justice Roberts. Shefali, you are following this. What the heck is going on with this case? 

Luthra: This is a really big deal. This is in regards to a ruling from the judge around Valentine’s Day. So, it’s been a couple of weeks in which he said, “This has to be blocked. This emergency freeze on all of the already allocated, already contracted USAID grants.” The government hasn’t been paying, those companies aren’t getting them, they aren’t able to actually distribute funds they were already promised. And so, they have sued, arguing that this has been arbitrary and capricious. The judge agreed with them and said the government has to pay. It has been a couple of weeks and the money has not come. And USAID, headed through the Department of State, has said, “Oh, well that’s because we’ve found these other reasons that we aren’t able to. We’ve been canceling these contracts. Everything we have not paid is in fact appropriate and legal.” And the judge has said, “This is insane. Give me a break.” And was really, seemed quite angry at how the government has not complied and gave them a deadline of midnight last night/this morning to comply. 

The government said, “That is not enough time. We will not be able to get these payments out. It will take weeks” — even though, of course, they had weeks — and appealed and finally went up to the Supreme Court. The Supreme Court has suspended that deadline and is asking for information from both the defendants and the plaintiffs and will get a ruling at some point, potentially as soon as Friday. 

But I think what really matters about this case is a) the very real implications for the entire foreign aid sector and its vast health work around the world. But also, this feels like a very important moment in understanding if the courts will in fact have the power to intervene when the executive does not do something or tries to not spend money allocated by Congress. If this judicial ruling from the D.C. court is able to be enforced, that’s a very powerful check. But if it is not, that could very well be a signal to the Trump administration that they can keep going and not worry about being blocked by the courts. 

Rovner: Yeah, law professor Stephen Vladeck has a wonderful explanation of exactly what happened and exactly what it could mean, and obviously we won’t know what it’s going to mean until probably Friday, late Friday at the earliest. But I will post that in the show notes.  

Well, in other courtroom news, the administration is going to defend a challenge to the preventive care provision to the Affordable Care Act in a case coming before the Supreme Court in April. Alice, we’ve talked a lot about this Braidwood case before, which targets HIV-preventive medications. And this is a bit of a surprise that the Trump administration is going to argue on the side of the ACA, but there’s more to it than it first might appear, right? 

Ollstein: Yes, indeed. Yeah. I thought some of the coverage of this is a little too simplistic saying, “Oh, the Trump administration’s defending Obamacare. Who knew?” So, this is about whether these panels of experts that are supposed to be independent that advise HHS on what services should be covered by insurance with no cost sharing. So, things like mental health screenings, I mean all kinds of things. 

Rovner: Contraception. 

Ollstein: Yes, yes. And while this doesn’t specifically touch vaccines, whatever the outcome of this case is could impact how vaccines are approved because that is also from one of these quasi-independent panels that make recommendations to HHS. So, what was really fascinating is, the lawsuit that’s been percolating for years basically says that these panels, the structure is fundamentally unconstitutional because these panels were not approved by Congress. So, they’re sort of not accountable. 

Rovner: The panels are, but the membership, each individual member is not, they’re not Senate-confirmed. 

Ollstein: Right. Exactly. 

Rovner: I guess in Braidwood, it’s the U.S. Preventive Services Task Force, right? 

Ollstein: Right. And so, they’re saying that they’re not accountable enough to the people, essentially. And so, the Trump administration’s argument — this is our sort of first window into how they’re looking at the case since they took it over from the Biden administration — they’re saying, “So, these panels are perfectly lawful because our new secretary, RFK Jr., can order them to study certain things. He can ignore the recommendations, he can delay them, he can overrule them, he can remove members who make recommendations he doesn’t like.” And so, they’re trying to say, “Look, he really is the boss of these panels. They are accountable to him for these reasons.” 

So, I talked to some legal experts who are very troubled by this and see it as a sign of how the Trump administration wants to wield power over these panels that were supposed to be guaranteed independence from political meddling in the statute itself when they were created. But I’d also talk to some other experts who says, “Look, the main thing is that we just save these panels from being eliminated completely. They’re arguing what they need to argue, and if they try to meddle with them in the future, we’ll fight that battle then.” And so, sort of heard a mixed response. 

Rovner: Well, along those same lines, the measles outbreak that’s going on now in Texas and New Mexico has reached beyond 100 cases and resulted in at least one death of an unvaccinated child. And despite the fact that HHS Secretary Robert F. Kennedy Jr. said at a Cabinet meeting yesterday that, “It’s not that unusual,” and, “There are measles outbreaks all the time” — this is, in fact, the first measles death in the U.S. in a decade. Yet, in one of his first acts as secretary, RFK Jr. said he would review the childhood vaccine schedule, and the CDC canceled its scheduled meeting of the Advisory Committee on Immunization Practices, one of those quasi-independent advisory committees that was supposed to happen this week. This feels like exactly what Kennedy assured Senate Health Committee Chairman Bill Cassidy he was not going to do, doesn’t it? 

Luthra: It really does, and I think what that goes to show us is that this is something that a lot of people could have pretty accurately seen coming. There has been no effort to really hide how RFK Jr. feels about vaccines. And there is a lot of power HHS has, and this is going to have potentially very significant consequences. I’m hearing a lot from, especially, parents who are very concerned they won’t be able to get their children vaccines in the coming years. And people looking up, did I get my measles vaccination when I was a child? Finding 30-year-old medical records, because the implications are going to be very significant. 

Rovner: And in late breaking news, the Centers for Disease Control and Prevention has canceled its March advisory committee meeting to decide which flu strains to include in next fall’s vaccine, timing of which is obviously delicate. They need to decide which strains to include because they need a five- or six-month lead time to actually make the vaccines, so it will be available in the fall when people should get vaccinated. Now, RFK Jr. has said he wouldn’t do anything to deter people from getting vaccines, but not having a flu vaccine available would seem to be a pretty big deterrent. 

Ollstein: So, I think all of these developments just sort of go right to the heart of exposing the tensions around this whole RFK Jr. “MAHA Movement,” basically promoting this idea of choice and freedom, and we’ll just give people the information and they can decide for themselves whether or not to get vaccinated. But we’re taking steps down a path where we won’t have a choice. We won’t have a choice to get a vaccine that is effective and has been approved and developed to meet where the virus is, at the moment. I think the whole thing about choice and freedom also gets complicated when these are infectious diseases, and what I personally do impacts more than just me. Measles is so contagious that somebody can walk into a room, cough, walk out, two hours later, I walk into that room, and I could get measles. It’s so contagious, and the actions of one individual person can impact an entire community. 

Rovner: Yes. Well, meanwhile over at the National Institutes of Health, apparently some funding is starting to flow again, but the repercussions from the virtual freeze are continuing to spread. A number of major universities have stopped admitting and even rescinded acceptances of graduate students in the sciences, given that so many of the stipends that those grad students get are funded by federal grants. Among the headlines I’ve seen of universities doing this are the University of Pennsylvania, Vanderbilt, USC, the University of Washington, and the University of Pittsburgh. I would’ve thought that Congress would literally be up in arms about this by now. What am I missing here? 

Knight: I mean, I think it’s partially there’s just such a flood of everything happening. You did see initially from some Republican senators concern, especially ones that have big academic centers in their state, like Sen. [and] HELP Chair Bill Cassidy, Sen. Katie Britt, who is from Alabama. There’s University of Alabama-Huntsville and -Birmingham. They did initially be like, “Hey, what is going on with these changes in NIH?” Their structure for reimbursing indirect cost, which is a whole other thing. But I’ve honestly been asking about that a bit and they’re kind of like, “Oh, well, there’s not really any updates right now. The court case is kind of handling that.” And so, I don’t know. I think it’s partially just because there’s so many other things happening that they’re not focusing on this. 

Rovner: I got to say, I’m still kind of shocked by this one. I really would’ve thought that if, I mean, it’s one thing when foreign aid doesn’t happen, that’s sort of over there, but it’s another thing that the major employers in your state or district are coming to you screaming that they’re going to have to shut things down. 

Ollstein: Well, even the foreign aid. I mean, the food aid is produced by farmers here. The medication that we send overseas through USAID is also produced here. It isn’t just over there. It’s impacting us too. Not to mention we’re losing influence and soft power around the world. We’re losing access to data that the WHO [World Health Organization] has, etc. And so, it’s all interconnected, but you’re so right that you would think that even more direct hits through the universities, which are major employers, major job providers in these districts, you would think there would be more of a response. 

Luthra: Another point there though, Julie, is I wonder if it will still come. One thing I have been hearing from a lot of folks in academia is they are very nervous right now to talk about the impact that they are experiencing because they are worried that that could lead to further cuts or targeting of some sort. And I wonder if, with time, if more people are able to speak publicly about how this is affecting them and the very concrete implications if that might help gain more traction, if that could help voters and eventually exert pressure on constituents to truly underscore the very vast economic consequences. But I think we’re still in the early stages of just seeing how significant a response could be. 

Rovner: Yeah. Clearly lots more to come. Well, of course, President Trump continues to push out executive orders, because he clearly likes those photo ops where he signs things and then holds them up for everyone to see. This week’s health entry is on price transparency, which is one of those issues that he did push hard in his first term, and which hasn’t worked out as well as either his administration or the Biden administration, which also supported this, had hoped. How could this new executive order help? 

Knight: So, the idea of this one is Biden left this regulation in place while he was president, but there was kind of complaints that compliance wasn’t great with hospitals, insurers having to post some of their prices for procedures or items or whatever. 

Rovner: I think it’s fair to say that they were posted grudgingly, if at all. 

Knight: Yeah, and also in really huge data files that were also very difficult to extract information from. So, it wasn’t super easy for the consumer always. So, yeah, I think there’s some stat that only a handful of hospitals really got slapped on the hand by the Biden administration over not complying. And so, President Trump, basically, his order said that it orders HHS to rapidly implement and enforce the requirements. So, he’s trying to kind of say, “Speed up compliance and check if these hospitals are actually posting their prices.” So, we’ll see if that’s effective or not, but that’s kind of the difference between the previous order and this one. 

Rovner: Well, this will probably, will likely have to be done by the Centers for Medicare & Medicaid Services, which will be headed, possibly, by Dr. Mehmet Oz, who’s going to be up for his Senate confirmation hearing in the next couple of weeks. Dr. Oz is, shall we say, we’ve now seen from his financial disclosures that he’s rather wrapped up in the entire health care industry, isn’t he? 

Luthra: He is, and also what will it matter? I mean, lawmakers will talk about this. This will be an object of discussion at his confirmation hearings. RFK Jr. also had some conflicts that lawmakers really focused on, and in the end he was confirmed almost entirely on party lines. And I think what we’ve seen over the past few weeks and even months is this real outrage early on at some of the picks who were floated to run various departments and agencies, and, with the exception of Matt Gaetz withdrawing, that’s kind of dissipated. And we have seen people be confirmed with conflicts or with various issues that in the past would have been career-ending and just simply aren’t anymore. It’s a different era. 

Rovner: Definitely different era. Well, finally this week, there is always news in the world of abortion and reproductive rights. First, the Supreme Court actually declined to take an abortion-related case, this one over the right to protest outside health facilities. Big deal, yes, big deal no? My two abortion experts. 

Ollstein: Yes and no. I mean, I think that the bigger question of where and how protesters can demonstrate outside of abortion clinics is going to continue. There are already other lawsuits lower down in the courts that could bubble up, no pun intended, since these are called “bubble zones.” But I think it is really interesting that even as we get more and more data, including just this week that the vast majority of abortions are taking place using medication and not necessarily in a physical clinic, physical clinics are still going to be an ongoing site of clashes and tensions and legal battles and even physical battles. And I think that’s just really fascinating. 

I think that could take on heightened importance as many states and potentially the federal government try to cut off access to the medications and make going to a clinic the only option again. And so, what the Supreme Court did is sort of put it off for another day, the sort of big showdown on this front. But I think, given that the Trump administration is signaling that it’s not going to enforce federal laws as much regarding protests outside of clinics, these state and local laws that were the subject of what the Supreme Court was weighing are going to be really the big game. 

Rovner: And speaking of Supreme Court cases about abortion, remember that case trying to revoke approval of the abortion pill that the Supreme Court sent back to Texas because the plaintiffs didn’t have standing, and those plaintiffs have been replaced by a number of states. Well, abortion pill maker GenBioPro has asked to join the list of defendants, which would be a big deal, assuming the Trump FDA opts not to fight the suit, right? 

Luthra: Definitely. And this is something that many of us had been keeping an eye out for because it is hard to imagine the current administration maintaining its stance on this case, that this case is one that longtime listeners will think of very familiarly with a lot of fondness and memories for the efforts to take mifepristone either off the market entirely or to eliminate telehealth, which is one of the key ways in which mifepristone and misoprostol are together used for abortions. And so, GenBioPro entering essentially keeps this case alive, which is really important because a handful of conservative states — Idaho, Kansas, and Missouri — have jumped into say, “Even if these doctors in Texas couldn’t sue to get mifepristone banned, we can.” And they’re arguing that it is harming their states and their residents to have it available through telehealth. 

GenBioPro could be a really important source for arguing that this medication, which is very safe, is very effective, is very common, and the science is largely on its side to keep it available as such, could make sure that it remains available. Although, again, it’s going to be a fairly long process to see how this plays out in practice. But it’s a case that folks in the anti-abortion movement care a lot about, because, as Alice mentioned, their top priority is finding ways to block access to medication abortion, one of the most effective ways for people, including in states with abortion bans, to keep getting care. 

Rovner: Yeah, I think this is the big kahuna that’s out there, at least for the moment. I’m sure there will be more. Well, meanwhile, last week we talked about President Trump’s executive order urging greater availability of in vitro fertilization, which we all agreed the executive order didn’t do a whole lot. Well, one thing it did do is make the U.S. Conference of Catholic Bishops very angry. In their press release, they said IVF “ends countless human lives and treats persons like property.” 

But those who oppose IVF aren’t even the fringe of the anti-abortion movement right now. In Oklahoma and North Dakota, state lawmakers debated measures that would declare abortion murder, with penalties including the death penalty. And in Montana, lawmakers held a hearing on the first-in-the-nation bill to make it an explicit crime to travel to another state for an abortion, even if abortion is legal there. Is it just me or is the Overton window moving a lot all of a sudden? Sort of what the outside of the anti-abortion movement is. 

Luthra: When you flagged these bills, Julie, it took me back to when Donald Trump ran for president the first time, and he was asked about abortion and he said, “Well, there should be some punishment for the woman.” And then, very quickly backtracked because of the very loud outcry, the sort of sense that that’s a line you don’t cross. And then, after the Dobbs decision, we saw a bill in Louisiana that was debated that would have also made abortion a crime with penalties for the pregnant patient. And again, that was seen as a line that you don’t cross. 

And as we get further and further along in the post-Dobbs reality and people become more used to living in a world with abortion bans, that is creating more of an opening, because, again, the end goal of the anti-abortion movement is to end abortions. And that a core belief of the anti-abortion movement is that an abortion is taking a life. And so, this is a natural endpoint for it to go. I think we will still continue to see a lot of back-and-forth. We have seen the Oklahoma bill, for instance, isn’t moving forward. We will continue to see efforts to block these kinds of bills, but they’ll become more and more frequent as lawmakers who oppose abortion try and think of new ways to stop it from happening. 

Rovner: But we’re getting from the … one lawmaker introduces a bill to the, we’re going to have a hearing on this bill to the, we’re going to vote on this bill. I mean, it does seem to be very sort of quietly moving more into the, I won’t say mainstream, but I mean, like I said, the Overton window is shifting a little bit on these. 

Ollstein: I think you’re also seeing a lot of frustration in the anti-abortion movement and people are channeling that frustration in different ways. But the frustration is that   and all of these states passing abortion bans has not reduced the overall number of abortions in the country. Yes, many people are not getting abortions who want them, but a lot of people are, whether it’s through traveling or through telemedicine or through some other means. And so, I think the movement is really trying to think of what to do now. And so, you have a significant faction that is pushing for these bills that would’ve been considered completely untouchable in the past. And I think you’re seeing a lot of internal tensions and clashes within the anti-abortion movement over that, both from sort of a PR perspective, but also from an efficacy perspective. What even is effective and is going to work in this space? 

Rovner: Yeah. This debate is a long way from being over. All right, that’s as much news as we have time for this week. Now it’s time for our extra-credit segment. That’s where we each recognize a story we read this week we think you should read too. Don’t worry if you miss it. We will put the links in our show notes, on your phone or other mobile device. Victoria, why don’t you go first this week? 

Knight: Sure thing. So, my story this week is by your KFF Health News colleague Arthur Allen. The title is “With RFK Jr. in Charge, Supplement Makers See Chance To Cash In.” So, it kind of outlines the current state of the supplement industry and how it’s not really regulated. The FDA at some point tried to, and Congress kind of tried to, and there’s a lot of pushback from the supplement industry who doesn’t really want to be regulated. 

Rovner: I covered that. It was quite the pushback. 

Knight: Really? 

Rovner: This was in the early Nineties. 

Knight: OK. 

Rovner: We still had fax machines and they would crash all the members of Congress’ fax machines, like, “Don’t regulate our supplements!” 

Knight: Yeah. 

Rovner: Sorry, go ahead. 

Knight: I’m sure it was a lucrative industry. So, there’s already really not a ton of regulation. And this kind of discussed how there could be even more loosening of requirements for supplement makers. Right now, there’s some restrictions on how they can advertise products and what they can claim these products can do. And so, there’s talk of with RFK Jr. now the head of HHS and how he could loosen some of those things. Over his time in the public eye and running for president, he talked about how he wanted to loosen requirements and get rid of how the FDA regulates things. And so, I think this is just one area that the supplement makers see an opportunity, and it was very clear in that article that they’re excited about that and they’re ready. 

Rovner: It was a real good story. 

Knight: Yeah. 

Rovner: Alice. 

Ollstein: So, I have a piece from the outlet The Transmitter, which is about a seeming change in NIH policy that’s been really troubling to a lot of scientists [“Exclusive: NIH Appears To Archive Policy Requiring Female Animals in Studies,” by Claudia López Lloreda]. Basically, the requirement that studies in mice use both male and female mice, now it’s being labeled a historic document. And so, it’s not clear what that means, but people should understand that, for a long time, studies in humans only used male test subjects and that meant that medications were developed and they didn’t know if they worked on women or worked on women the same, or if the dose needed to be different or if it absorbed differently or whatnot. 

And that trickles all the way down to the testing-on-animals level because bodies are different. People have different hormones. So, there’s a lot of fear now that we are going back to before these improvements and reforms were implemented, back to an era where things are only tested on male animals and humans. I’ll also say, I’ve seen some speculation within the scientific community that this all happened because of a misinterpretation of the phrase “sex as a biological variable.” And maybe people misinterpreting that to be something related to transgender people and people’s sex varying over time? But that’s not what that means. And so, I think we’ve seen this on other fronts where studies that had the word “diverse” in them when it was referring to a diverse microbiome, not racial diversity. So, we’re seeing a lot of this, sort of, using a blunt instrument to go into these very nuanced scientific areas. 

Rovner: Yeah. There’s a lot of this going around. Shefali. 

Luthra: My piece is from NBC News, by Gretchen Morgensen. The headline is “They Were Told To Get Extra Breast Cancer Screenings. Then They Got Stuck With the Bill.” It’s a great piece, one of our favorite kinds of journalism, looking at uncovered, unanticipated medical costs for consumers and these systems that allow them to happen. In this particular case, it looks at people who are at high risk for breast cancer and are recommended to get follow-up screenings, and then find out that those screenings are often not covered by insurance, including Medicare and private insurance. 

And this piece does a really good job looking at the people who are affected by this and also how it might affect their behavior, including data showing that when people find out their extra tests might not be covered by insurance, a meaningful share say, “Well, I won’t get them at all.” And I think this is really important because as we talk more about various changes to our health care system, one area that gets less and less attention now than it did even a few years ago is costs for consumers. But it is a really important factor that affects how people continue to access or not access health care. In cases like this, it really could have long-term implications for their health. 

Rovner: And it could be fixed by Congress or by one of these Preventive Health Task Force kind of agencies. But we digress. My extra credit this week is from WBUR. It’s called “Canceled Meetings and Confusion: NIH Grant Funding in Limbo Despite Court Injunction,” by Anna Rubenstein. And it’s something we’ve been talking about for the past several weeks, including today. But this story is somewhat different in that it’s mostly individual stories of real people who are being affected by what’s described in Washington as, you know, just a bureaucratic thing. 

I still contend that this might be the thing that really gets Congress to push back, is these individual stories from people who are being impacted by these funding freezes. 

All right, that is this week’s show. As always, if you enjoy 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, as always, to our producer and editor, 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 at Bluesky @julierovner. Where are you guys hanging these days? Alice? 

Ollstein: I am on X @AliceOllstein, and on Bluesky @alicemiranda. 

Rovner: Victoria. 

Knight: I’m still on X @victoriaregisk. 

Rovner: Shefali. 

Luthra: I am at Bluesky @shefali. 

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