THE 2025 HEALTH AGENDA — The new year will likely bring major changes to health policy with Republican majorities in both chambers of Congress and President-elect Donald Trump in the White House. Trump’s picks to lead key health care agencies have vowed to shake up the sector, with Robert F. Kennedy Jr. — Trump’s pick to lead HHS — promising to reduce chronic disease. Trump’s choice of Kennedy has also led to broad questions about how the administration will approach vaccines. Many of Trump’s other picks to head agencies — like TV personality and former heart surgeon Dr. Mehmet Oz to lead CMS — are political outsiders with little or no experience in government. As things heat up in the new year, here’s what POLITICO’s health team will be monitoring: In Congress, we’ll closely watch Kennedy’s confirmation hearing. How he interacts with Republican senators — whose votes he needs for confirmation — will likely signal his approach as head of U.S. public health agencies. Kennedy might downplay previous positions not aligned with core Republican orthodoxy like support for reproductive rights, which Kennedy has flip-flopped on, and concerns about climate change’s effect on public health. In HHS and its agencies, we’ll follow how Kennedy, if confirmed, implements his Make America Healthy Again agenda, particularly plans to redirect public health agencies’ focus on chronic disease. That could stifle action on infectious disease as avian flu outbreaks continue in cattle herds across several states. In the CDC, we’ll observe how CDC director nominee Dave Weldon handles the ongoing bird flu threat. This year, at least 875 dairy cattle herds have been sickened by avian flu, and the CDC has confirmed 61 cases in humans — though none through human-to-human spread. But the response is especially high stakes, as experts warn that changes to the virus could create a pandemic threat. In the NIH, we’ll keep tabs on how GOP-proposed reforms play out. In 2023, House and Senate Republicans proposed overhauling the agency, including increasing transparency, cracking down on NIH scientists’ conflicts of interest, rethinking the grant and peer-review processes, instituting term limits for agency leadership and shrinking the number of institutes and centers from 27 to 15. Their reform push could be made easier if the Senate confirms Trump’s pick for NIH director, Dr. Jay Bhattacharya. A Stanford University physician and economist, Bhattacharya has advocated for shaking up the agency and cracking down on gain-of-function research, which some Republican members believe triggered the Covid-19 pandemic. At the FDA, we’ll look to see how Trump’s impact might first materialize at the agency’s tobacco center. Under FDA Commissioner Robert Califf, the Biden administration recently moved to limit the levels of nicotine in cigarettes — an idea initially put forward by Trump’s first FDA commissioner, Dr. Scott Gottlieb, in 2018 — and pressed the White House to implement a ban on menthol cigarettes and flavored cigars. But the tobacco industry contributed heavily to Trump’s campaign, and he pledged to “save vaping” after meeting with a prominent vaping lobbyist before the election. At CMS, we’ll watch how Oz — who’s been supportive of Novo Nordisk’s Ozempic — will decide whether to finalize a rule proposed by the Biden administration to extend Medicare coverage for semaglutide anti-obesity drugs. Read more of what we’re watching. WELCOME TO MONDAY PULSE. A shutdown was averted this weekend when Congress passed a short-term spending bill with scaled-back health provisions. A last-minute effort to include more funding for juvenile cancer research failed. Send your tips, scoops and feedback to ccirruzzo@politico.com and bleonard@politico.com and follow along @ChelseaCirruzzo and @_BenLeonard_.
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