| | | | |  | | By Ben Leonard and Chelsea Cirruzzo | Presented by the Coalition to Strengthen America’s Healthcare | | | | 
President-elect Donald Trump's choice to lead HHS, Robert F. Kennedy Jr., is making the rounds in Capitol Hill this week in an attempt to win over lawmakers. | Angelina Katsanis/POLITICO | KENNEDY DILEMMA — Public health leaders face a dilemma when it comes to Robert F. Kennedy Jr., POLITICO’s Daniel Payne reports. President-elect Donald Trump’s nominee to lead HHS is pitching a reframing of health policy to focus on the causes of the rise in chronic diseases, including those rooted in diet or pollutants — one that experts have long pushed. But they fear Kennedy could also cause an explosion in infectious disease — the kind vaccines protect against — and wipe out decades of progress. Worse, they worry Kennedy could undermine the public’s trust in the medical establishment, which could prevent future progress across the board. “This is a really, really sticky situation,” said Katelyn Jetelina, an epidemiologist who has focused on improving public trust in quality health information since the pandemic. “How do we push one part of public health forward without letting the other areas slip backwards? That’s going to be the question over the next four years.” The concerns mirror those of senators weighing the potential pros and cons of confirming Kennedy — several of them meeting the nominee this week. Kennedy has said he only wants to increase transparency around vaccines and government regulatory practices, not take vaccines from the public, despite Trump saying he was open to pulling vaccines depending on his nominee’s review. Some public health leaders, including clinicians, say the answer to Kennedy is easy: Try to stop him from being confirmed. “We have to deal with the person in front of us and what he represents,” said Dr. Rob Davidson, executive director of the Committee to Protect Health Care. “There’s a clear and present danger in front of us.” But others see a nomination that puts two major public health goals at odds: the need to rebuild trust in reliable health information, which Kennedy threatens, and the need to address the rise of chronic diseases, which make up many leading causes of death in the U.S. WELCOME TO TUESDAY PULSE. Is your boss meeting with RFK Jr. today or tomorrow? Let us know when. Send your tips, scoops and feedback to bleonard@politico.com and ccirruzzo@politico.com and follow along @_BenLeonard_ and @ChelseaCirruzzo.
| | | | A message from the Coalition to Strengthen America’s Healthcare: Hospitals are there for you and your family every hour of every day, ensuring you receive the appropriate level of care. Nearly half of all hospitals offer a trauma center that includes a multi-disciplinary team of surgeons, physicians and caregivers ready to help patients facing life-threatening injuries such as falls, motor vehicle collisions or gunshot wounds. GET THE FACTS. | | | | | | | 
Sen. Rick Scott was one of the lawmakers that Robert F. Kennedy Jr. met with on the Hill yesterday. | Lynne Sladky/AP | ‘ALL FOR THE POLIO VACCINE’ — Robert F. Kennedy Jr., president-elect Donald Trump’s choice to lead HHS, said he was “all for the polio vaccine” in response to reporters’ questions as he visited Capitol Hill on Monday, Chelsea reports. He did not, however, respond to questions on issues like school vaccine mandates. Kennedy met with Republican Sens. Rick Scott (R-Fla.),Ron Johnson (R-Wis.), Markwayne Mullin (R-Okla.) and Tim Scott (R-S.C.) on Monday. He will meet with more Republican senators during the week, as POLITICO first reported last week. His comment on polio comes after a published report that one of his attorneys had previously called on the FDA to revoke its approval, and several days after Senate Majority Leader Mitch McConnell, a polio survivor, said “efforts to undermine public confidence in proven cures are not just uninformed — they’re dangerous.” Kennedy has repeated debunked claims linking vaccines to autism in children and was chair of the anti-vaccine advocacy group the Children’s Health Defense. But on the Hill Monday, Kennedy appeared to pull back on the polio vaccine. Mullin told reporters that Kennedy promised him “100 percent” support for the polio vaccine. HEALTH CARE DEAL LATEST — Lawmakers are still poised for a significant health care package that would rein in the business practices of pharmacy benefit managers and extend telehealth rules in Medicare and the commercial markets. That’s despite the text of the legislation to fund the government that the deal would be attached to not being released Monday as expected. Conservatives like Rep. Chip Roy (R-Texas) — who would probably vote against the stopgap measure regardless — have raised concerns about the PBM provisions. Roy posted on X on Monday that “Pharma is dancing in the streets over” the PBM legislation. “We should reduce the deficit and not pass stupid policies,” Roy said. The PBM provisions in the package, reported by POLITICO, are expected to save the federal government money, according to the Congressional Budget Office. President-elect Donald Trump endorsed PBM regulation at a news conference Monday, which could help PBM regulation proponents’ cause. PBMs — companies that negotiate drug prices for insurers and employers — are fighting back. “The proposed spending package begs the question: What problem is Congress trying to solve? If the goal is to lower health care costs, then a giant windfall for drug companies that results in fewer choices for health plan sponsors and increased health care and taxpayer spending is not the answer,” the Pharmaceutical Care Management Association, a PBM lobby, said in a statement Monday. It’s not yet clear when the bill text will be released. “We’re hopeful,” Senate Finance Committee Chair Ron Wyden (D-Ore.) told Pulse. “I’ll leave it at that.”
| | | | Billions in spending. Critical foreign aid. Immigration reform. The final weeks of 2024 could bring major policy changes. Inside Congress provides daily insights into how Congressional leaders are navigating these high-stakes issues. Subscribe today. | | | | | | | | | KENNEDY’S MESSAGING — The early signs are that Robert F. Kennedy Jr. is trying to soften his image heading into the confirmation process. Trump said Monday that Kennedy won’t be “radical” in his health policies — a concern for Senate Republicans weighing his confirmation. “He’s going to have an open mind, or I wouldn’t have put him there,” Trump said. But in the same news conference, Trump suggested he was open to Kennedy’s more radical ideas and dodged a question about whether he believes vaccines cause autism, a claim research has repeatedly debunked. A nonprofit aligned with Kennedy, MAHA Action, is pointing to a letter signed by 800 medical professionals, including Dr. Mehmet Oz, Trump’s pick to lead CMS; Dr. Casey Means, a former surgeon turned wellness influencer; and Dr. Mark Hyman, founder of the Cleveland Clinic Center for Functional Medicine, to signal he has “broad support” from the medical community. Trump also said he’s a “big believer” in the polio vaccine and promised that “you’re not going to lose” it. That comes after criticism from outgoing Senate Minority Leader and polio survivor Mitch McConnell. The New York Times last week reported that an attorney for Kennedy, Aaron Siri, sought to yank the polio vaccine approval.
| | | | A message from the Coalition to Strengthen America’s Healthcare:   | | | | | INSIDE HHS’ AI — HHS disclosed on Monday how it has used artificial intelligence as required under executive orders from then-President Donald Trump and President Joe Biden. The agency is leaning into AI more than before. In 2024, it disclosed use cases for AI in 271 applications, up from 163 last year. Of the 271 use cases, 59 have been initiated, 57 are under development or targeted for development, 35 are being implemented and assessed, 104 are integrated into operations and 16 have been retired. Here are some of the ways HHS is using AI that stood out to us: The unsexy tasks: The agency uses AI for various basic but essential tasks, such as automating data entry, using ChatGPT to summarize reports and auto-correcting documents. Many of these tasks might not match the perception of AI — such as the algorithms behind Google Maps and travel website preferences. Additionally, NIH uses AI to streamline the grant application referral process. Advanced tools: The CDC is toying with several advanced AI tools. It’s acquiring or developing machine-learning models to detect stimulant and opioid misuse, as well as identify failed wastewater systems that can contaminate water and soil through image classification models. The public health agency is also implementing disease modeling to help guide federal, state and local response to disease outbreaks, leaning on data from wastewater, hospitals and public health laboratories. Regulatory analysis: The CDC says it’s implementing and assessing in-house AI to help gauge sentiment in public comments on regulations. Agencies often receive a flood of lengthy comments they have to sift through during the rulemaking process. “Reviewing the public comments currently involves a manual review process that necessitates a high level of time and effort on the part of regulatory analysts,” the CDC said.
| | | | Write your own chapter in the new Washington. From the Lame Duck Congress Series to New Administration insights, POLITICO Pro delivers intelligence across 22+ policy areas to help you anticipate and navigate change. Discover how a Pro subscription empowers you. Learn more today. | | | | | | | | | Dr. Joneigh S. Khaldun has been named the new CEO of the Public Health Accreditation Board. She was previously at CVS Health. Daniel Henke is now senior donor manager for U.S. strategy at Gavi, the Vaccine Alliance. He previously was director of U.S. government relations at the One Campaign. Richard C. Rose is joining Polsinelli's health care litigation practice group. He comes from Miller & Martin.
| | Modern Healthcare reports on PBM shares sinking after President-elect Donald Trump said Monday he wants to "knock out" the intermediaries. STAT reports on what CDC Director Mandy Cohen is doing as her tenure winds down.
| | | | A message from the Coalition to Strengthen America’s Healthcare: When tragedy strikes, you want to receive the best care possible for yourself and your loved ones. Nearly 85% of all trauma patients require the highest levels of complex, life-saving care that only hospitals are equipped to provide. It’s essential to protect these critical access points and the unique care they provide to patients in their communities 24 hours a day, 7 days a week, 365 days a year.
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