Friday, November 15, 2024

HHS pick Kennedy looks to shake up the agency

Presented by The Campaign for Sustainable Rx Pricing: Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy.
Nov 15, 2024 View in browser
 
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By Chelsea Cirruzzo and Ben Leonard

Presented by The Campaign for Sustainable Rx Pricing

With help from Lauren Gardner and Carmen Paun

Driving the Day

 Robert F. Kennedy Jr. greets Donald Trump during a campaign rally.

The nomination of Robert F. Kennedy Jr. by President-elect Donald Trump signals a health-policy shift. | Rebecca Noble/Getty Images

KENNEDY’S HHS PRIORITIES — President-elect Donald Trump has nominated anti-vaccine activist and environmental lawyer Robert F. Kennedy Jr. as the next HHS secretary in the Trump administration, perhaps heralding a massive rethinking of the U.S. public health system, Chelsea and POLITICO’s Daniel Payne, Marcia Brown, Brittany Gibson and Annie Snider report.

On social media Thursday afternoon, Trump wrote that “Americans have been crushed by the industrial food complex and drug companies who have engaged in deception, misinformation, and disinformation when it comes to Public Health.”

Kennedy, 70, thanked Trump for choosing him Thursday night.

“I look forward to working with the more than 80,000 employees at HHS to free the agencies from the smothering cloud of corporate capture so they can pursue their mission to make Americans once again the healthiest people on Earth,” he posted on X.

Why it matters: Kennedy and his Make America Healthy Again movement blame Americans’ poor health partly on what he calls a corrupt alliance among the food and drug industries and the regulators supposed to watch over them. They want to replace the bureaucrats and overhaul the systems for overseeing pesticides, food additives and vaccines.

Many Republicans in Congress said they’re open to Kennedy’s ideas.

Here’s what Kennedy and MAHA want to do:

Cut corporate influences out of regulation: Kennedy told MSNBC he’d like to see “entire departments ” at the FDA, particularly nutrition regulators, dismissed. The agency’s work includes setting nutrition guidance, overseeing food labeling and safety and combating food-related ailments, such as obesity and heart disease.

The full force of industry pushback has yet to emerge, several lobbyists said; instead, it’s waiting to see the extent to which Trump will incorporate MAHA ideas into his policy agenda.

But Republicans in Congress have also voiced interest in overhauling the agencies and made clear their distrust in the health system overall.

Reexamine vaccine approvals: Kennedy is well known for touting the debunked claim that vaccines can cause autism. During the pandemic, he argued that Covid-19 shots were unsafe and has pointed to the government’s system for approving vaccines as “agency capture on steroids.”

He’s said he wants to examine government vaccine safety data and communicate it to the public.

The vast majority of health experts and doctors support vaccine use, pointing to the long history of safe and effective shots that have nearly wiped out many diseases in the U.S. And they say the safety data is already a matter of public record.

Kennedy’s false claims about vaccines have concerned some lawmakers.

“He could be in an advisory role, but he should not be in an official role,” said Rep. Larry Bucshon (R-Ind.), a cardiothoracic surgeon. “His views on, particularly, vaccinations are not mainstream and have not been.”

Ban toxic chemicals: Kennedy has spent much of his career pushing for stricter regulation of hazardous chemicals.

Just days before the November election, he put an obscure topic — fluoride in drinking water — front and center when he said on X that the Trump administration would, on Inauguration Day, advise all U.S. drinking water systems to stop fluoridation.

While the American Dental Association and the CDC recommend adding small amounts of fluoride to drinking water to prevent cavities, recent research has raised concerns about possible impacts on babies’ and children’s brains.

WELCOME TO FRIDAY PULSE. NPR took a look inside a town where vending machines have Narcan and clean needles to fight overdoses and infectious diseases. Some studies have shown the harm-reduction method to be effective. Send your tips, scoops and feedback to ccirruzzo@politico.com and bleonard@politico.com and follow along @ChelseaCirruzzo and @_BenLeonard_.

 

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Big Pharma games the system to keep prescription drug prices high. Brand name drug companies build blockades of patents to extend monopolies and block competition from more affordable alternatives – costing patients, taxpayers and the U.S. health care system billions of dollars each year. Market-based solutions to hold Big Pharma accountable for their egregious anti-competitive tactics, especially patent thickets, have broad bipartisan support. Congress must pass these solutions into law. Learn more.

 
AROUND THE AGENCIES

Chip Roy speaking with reporters while walking in the U.S. Capitol.

Rep. Chip Roy is one of Kennedy's supporters in Congress and looks forward to the HHS secretary nominee playing the role of "disruptor" in the Trump administration. | Francis Chung/POLITICO

MIXED REACTIONS TO KENNEDY — The prospect of Robert F. Kennedy Jr. overseeing U.S. public health policy was immediately met with celebration in some quarters, mostly from Republican lawmakers. Health agency veterans were aghast, POLITICO’s Brittany Gibson, David Lim, Sophie Gardner and Lauren Gardner report.

Kennedy has many supporters on Capitol Hill where, in September, he hosted a health policy roundtable with Sen. Ron Johnson (R-Wis.) and met about 10 GOP lawmakers for lunch from both the House and Senate. Those lawmakers were quick to celebrate Trump’s latest Cabinet pick.

“I think Robert is another disruptor. We need a disruptor. I will be glad, and I’m looking forward to working with him,” Rep. Chip Roy (R-Texas), who was at the lunch with Kennedy, said on Fox News. “I’ve got great bills and a great agenda to work side by side.”

However, CDC Director Mandy Cohen, speaking with POLITICO before the nomination announcement, said she was concerned about what putting Kennedy in a place of authority could mean for trust in vaccines given his views.

“Any misinformation coming from places of influence, of power, are concerning,” she told POLITICO.

Cohen, who has spent her tenure at the CDC working to regain public trust in the agency after the pandemic, noted that the U.S. has already seen vaccination rates fall among kindergartners and more people seeking exemptions from routine immunizations.

“I don’t want to go backwards and see children or adults suffer or lose their lives to remind us that vaccines work.”

Can he get confirmed? That’s the question since Kennedy’s past advocacy against vaccine mandates and skepticism about the safety of all vaccines looms over his nomination.

“Vaccines are the most powerful public health innovation in history, saving more lives than any other tool. Few people my age are able to remember a neighbor with polio or a child who lost hearing to measles,” Kyle McGowan, former chief of staff at CDC during Trump’s first term, told POLITICO. “In public health, defending childhood vaccines is the hill to die on — no other single tool has saved more lives, prevented more disabilities, or delivered greater economic impact.”

 

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COLLINS TAPPED FOR VA — A Trump attorney and former GOP House member has been nominated by the president-elect to lead the Department of Veterans Affairs, Ben reports.

President-elect Donald Trump announced Thursday he had picked Doug Collins, an Air Force Reserve chaplain who served in Iraq.

Under Trump, the VA is expected to roll back a Biden administration policy that allows the agency to provide abortion counseling and, in some cases, the procedure, in the wake of the Supreme Court’s Dobbs decision.

If confirmed, Collins — a staunch Trump ally — will have to grapple with financial issues at the agency stemming from a bipartisan 2022 law that expanded benefits for veterans exposed to Agent Orange and other toxins. He’ll also inherit the VA’s beleaguered electronic health records overhaul.

HHS’ DEI IN CROSSHAIRS — A key Trump ally selected to co-lead an effort to slash government efficiency is targeting diversity, equity and inclusion efforts at HHS.

Vivek Ramaswamy, a biotech investor who briefly ran against Trump for the Republican presidential nomination, posted on X, formerly known as Twitter, that HHS has “gone wild” on DEI.

He criticized the department for staffing seven Offices of Minority Health at agencies like CMS, the CDC and the Substance Abuse and Mental Health Services Administration.

“An efficient government has no place for DEI bloat. Time to DOGE it,” he wrote, referring to the Department of Government Efficiency, which Trump tapped him to lead alongside Elon Musk.

However, the offices were created as part of the Affordable Care Act — which means Congress would likely have to act. House Speaker Mike Johnson has promised “massive changes” to the ACA with Trump in the White House.

HHS did not respond to a request for comment.

 

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In Congress

BIG MEDICAID PLANS — Medicaid could see major changes next Congress when Republicans take control, Ben and POLITICO’s Robert King report.

Sen. John Cornyn (R-Texas) said that while Social Security and Medicare cuts are likely off the table, Medicaid could be ripe for reform. Specifically, Cornyn teased the idea of providing states with a lump sum to cover medical expenses — known as a block grant — instead of running the program as an open-ended entitlement.

Rep. Greg Murphy (R-N.C.), a member of the GOP Doctors Caucus who sits on the House Ways and Means Committee, also said Congress needs to consider block grants.

“I think that is a reasonable thing to do,” he said.

Republicans would almost certainly need to rely on a budget reconciliation package next year — which would allow them to pass a sweeping package with simple majorities in both chambers — to make substantial cuts to Medicaid. And many Republicans might be looking for ways to help pay for an extension of the Trump tax cuts due to expire in 2025.

Still, not all Republicans were jumping on board. Rep. Brett Guthrie (R-Ky.), who’s running to helm Energy and Commerce, said he has not heard of Medicaid cuts.

Rep. Buddy Carter (R-Ga.), who’s seeking to run the E&C’s Health Subcommittee, said, “Everything is on the table.”

Democrats would be loathe to get on board with such a move and insist Republicans will regret trying to reform Medicaid.

 

Policy change is coming—be the pro who saw it first. Access POLITICO Pro’s Issue Analysis series on what the transition means for agriculture, defense, health care, tech, and more. Strengthen your strategy.

 
 
Names in the News

The GOP Doctors Caucus has elected Rep. John Joyce (R-Pa.) to join Rep. Greg Murphy (R-N.C.) as co-chair.

WHAT WE'RE READING

POLITICO’s Lauren Gardner reports on falling vaccine company stocks after the Kennedy nomination.

ABC News reports on a surge of measles cases worldwide, according to the WHO.

The Guardian reports on signs of resistance to a crucial malaria drug, worrying researchers.

 

A message from The Campaign for Sustainable Rx Pricing:

Big Pharma's abuse of the patent system is designed to maintain monopolies over their biggest money-makers, boosting brand name drug makers’ profits at the expense of American patients and taxpayers. One of their anti-competitive tactics involves filing dozens, sometimes hundreds, of patents on blockbuster products to build extensive “patent thickets,” completely disconnected from any true innovation. An economic analysis found Big Pharma’s patent thickets on just five drugs cost American patients and the U.S. health care system more than $16 billion in a single year.

The Congressional Budget Office has confirmed bipartisan, market-based solutions to hold Big Pharma accountable for patent abuse will lower drug prices and the U.S. Senate unanimously passed one solution, Cornyn-Blumenthal (S.150), earlier this year. Now is the time for Congress to finish the job – and pass solutions to lower drug prices by cracking down on patent abuse and promoting competition. Learn more.

 
 

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