KFF Health News' 'What the Health?': House GOP Plan Targets Medicaid
The House GOP’s budget proposal, which narrowly passed on Tuesday, likely would result in major cuts to Medicaid, the health program primarily for those with low incomes or who are disabled, to help pay for tax cuts. That sets up a battle with the Senate, which passed a separate, more modest budget proposal that includes neither tax cuts nor cuts to health programs — at least not initially.
Meanwhile, federal courts continue to weigh in on whether the Trump administration has the authority to cancel congressionally appropriated funding for federal programs and to summarily dismiss federal workers.
This week’s panelists are Julie Rovner of KFF Health News, Alice Miranda Ollstein of Politico, Shefali Luthra of The 19th, and Victoria Knight of Axios.
Panelists Victoria Knight Axios @victoriaregisk Read Victoria's stories. Shefali Luthra The 19th @shefalil Read Shefali's stories. Alice Miranda Ollstein Politico @AliceOllstein Read Alice's stories.Among the takeaways from this week’s episode:
- This week the House approved its budget blueprint calling, in part, for its Energy and Commerce Committee members to cut at least $880 billion from the government programs they oversee, which include Medicaid. But the plan also needs Senate approval. The Senate is advancing its own, competing blueprint, and some GOP senators have voiced concerns about the consequences of Medicaid cuts.
- In Supreme Court news, a new order from Chief Justice John Roberts allows the Trump administration to continue to freeze foreign aid, at least temporarily. And in an unexpected move, the Trump administration will take the same side as the Biden administration in a case before the court regarding the Affordable Care Act. The case addresses whether the U.S. Preventive Services Task Force may tell insurance companies what medical services must be covered. But the Trump administration is arguing that the head of the Department of Health and Human Services — Robert F. Kennedy Jr. — has authority over the panel and can influence determinations about coverage.
- President Donald Trump issued an executive order boosting his first-term efforts to press health providers and insurers to reveal actual prices to patients. Also, in the states, major research universities are bracing for federal funding cuts. And an outbreak in Texas and New Mexico has led to the nation’s first measles death in years — as Kennedy plays down the outbreak and, separately, says he will examine the childhood vaccination schedule.
Plus, for “extra credit,” the panelists suggest health policy stories they read this week that they think you should read, too:
Julie Rovner: WBUR’s “Canceled Meetings and Confusion: NIH Grant Funding in Limbo Despite Court Injunction,” by Anna Rubenstein.
Alice Miranda Ollstein: The Transmitter’s “Exclusive: NIH Appears To Archive Policy Requiring Female Animals in Studies,” by Claudia López Lloreda.
Victoria Knight: KFF Health News’ “With RFK Jr. in Charge, Supplement Makers See Chance To Cash In,” by Arthur Allen.
Shefali Luthra: NBC News’ “They Were Told To Get Extra Breast Cancer Screenings. Then They Got Stuck With the Bill,” by Gretchen Morgenson.
Also mentioned in this week’s podcast:
- One First’s “Chief Justice Roberts’ Administrative Stay in the Foreign Aid Funding Cases,” by Steve Vladeck.
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KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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Qué es el Proyecto 2025, una hoja de ruta para las medidas de salud de Trump
Probablemente pocos votantes esperaban que el presidente Donald Trump, en sus primeras semanas de mandato, recortara miles de millones de dólares de la principal agencia federal de investigación del cáncer del país.
Pero los recortes de financiación a los Institutos Nacionales de Salud (NIH) fueron presagiados en el “Mandato de liderazgo” del Proyecto 2025, un plan conservador para gobernar que, durante su campaña, Trump dijo ignorar, y que ahora su administración parece seguir al pie de la letra.
El manual de 922 páginas compilado por la Heritage Foundation, un grupo de investigación conservador en Washington, dice que “el monopolio de los NIH en la dirección de la investigación debe romperse” y pide limitar los pagos a universidades y sus hospitales para “ayudar a reducir la subvención de los contribuyentes federales a las agendas izquierdistas”.
Las universidades, que ahora se enfrentan a recortes radicales en las subvenciones de la agencia que cubren estos costos generales, dicen que estas políticas destruirán la ciencia biomédica actual y futura. El 10 de febrero, un juez federal detuvo temporalmente los recortes a la investigación médica después que 22 instituciones médicas y 22 estados desafiaran los recortes en los tribunales.
Un proyecto que es un prólogo
La rápida adopción de muchos de los objetivos del Proyecto 2025 indica que los seguidores de Trump (varios de su primer mandato y algunos nuevos) han planeado durante años los pasos para perturbar el sistema nacional de salud.
Esto contradice con la insistencia de Trump durante la campaña electoral. Cuando los demócratas convirtieron al Proyecto 2025 en una potente línea de ataque, dijo que ignoraba el documento.
“No tengo idea de qué es el Proyecto 2025”, dijo Trump el 31 de octubre en un mitín en Albuquerque, Nuevo México, una de las muchas veces que negó tener conocimiento del plan. “Nunca lo he leído y nunca lo haré”.
Pero como su administración se está ciñendo tan estrictamente al manual elaborado por la Heritage Foundation, grupos opositores y algunos líderes demócratas estatales dicen que pueden actuar con rapidez para contrarrestar las medidas de Trump en los tribunales.
Ahora se están preparando para que Trump tome acciones sobre las recomendaciones del Proyecto 2025 para algunos de los programas de salud más grandes e importantes del país, incluidos Medicaid y Medicare, y para las agencias federales de salud.
“Muchas organizaciones diferentes han estado planificando los litigios para desafiar las órdenes ejecutivas y otras acciones tempranas”, dijo Noah Bookbinder, presidente de Citizens for Responsibility and Ethics en Washington, un grupo de vigilancia. “El Proyecto 2025 permitió cierta preparación”.
El plan, por ejemplo, exige flexibilidad estatal para imponer primas para algunos beneficiarios de Medicaid. También requisitos laborales y topes de por vida o límites de tiempo en la cobertura para algunos inscritos en el programa creado para atender a estadounidenses de bajos ingresos o con discapacidades, lo que podría conducir a un aumento en el número de personas sin seguro después que la administración Biden expandiera dramáticamente la cobertura del programa.
“Estas propuestas no alteran directamente la elegibilidad para Medicaid o los beneficios que ofrece, pero el efecto final sería que menos personas tendrían cobertura de salud”, dijo Larry Levitt, vicepresidente ejecutivo de política de salud en KFF, una organización sin fines de lucro de información de salud que incluye a KFF Health News.
“Cuando se erigen barreras para que las personas se inscriban en Medicaid, como las primas o documentar la situación laboral, se termina racionando la cobertura por la complejidad del proceso, y la capacidad de pago”, agregó Levitt.
Los republicanos del Congreso están contemplando un plan presupuestario que podría resultar en un recorte de cientos de miles de millones de dólares a Medicaid en 10 años.
El Proyecto 2025 exigía ampliar el acceso a los planes de salud que no cumplieran con las protecciones al consumidor más sólidas de la Ley de Seguro de Salud a Bajo precio (ACA). Eso puede llevar a más opciones y primas mensuales más bajas para los compradores, pero los consumidores que no entienden bien el proceso pueden enfrentar gastos de bolsillo potencialmente masivos por la atención que los planes no cubrirán.
Y el Proyecto 2025 exigía que las filiales de Planned Parenthood dejaran de recibir financiación de Medicaid. Esta organización, importante proveedora de atención médica para mujeres en todo el país, recibe aproximadamente $700 millones anuales de Medicaid y otros programas gubernamentales, según su informe 2022-23. El aborto representó aproximadamente el 4% de los servicios que la organización brindó a los pacientes, dice el informe.
Las medidas de la administración para eliminar palabras como “equidad” de los documentos federales, borrar los identificadores transgénero y restringir la ayuda médica internacional — todo parte de la “lista de deseos” del Proyecto 2025— ya han tenido ramificaciones radicales, obstaculizando el acceso a la atención médica y desmembrando los programas internacionales que tienen como objetivo prevenir enfermedades y mejorar los resultados de la salud materna.
En virtud de un memorando de enero, por ejemplo, Trump restableció y amplió una prohibición de fondos federales a organizaciones globales que brindan información legal sobre abortos.
Los estudios han encontrado que la prohibición, conocida como la “regla de mordaza global” o “Política de la Ciudad de México”, ha quitado millones de dólares a los grupos de ayuda extranjera que no la cumplieron. También ha tenido un efecto paralizante: en Zambia, un grupo retiró folletos con información sobre anticonceptivos, y en Turquía, algunos proveedores dejaron de hablar con las pacientes sobre la regulación menstrual como una forma de planificación familiar.
Trump también firmó una orden ejecutiva que revierte los derechos de las personas transgénero al prohibir el uso de fondos federales para la atención relacionada con la transición para personas menores de 19 años. Otra orden que firmó también ordenó al gobierno federal reconocer solo dos sexos, masculino y femenino, y usar el término “sexo” en lugar de “género”.
El documento del Proyecto 2025 pide eliminar el término “identidad de género” de las normas, regulaciones y subvenciones federales, y desmantelar las políticas y procedimientos que, según sus autores, se utilizan para promover una “redefinición radical del sexo”. Además, establece que los programas del Departamento de Salud y Servicios Humanos (HHS) deben “proteger las mentes y los cuerpos de los niños”.
Datos que desaparecen
Investigadores de salud dicen que, como resultado de la orden de Trump sobre identidad de género, los Centros para el Control y Prevención de Enfermedades (CDC) eliminaron información en línea sobre la salud de las personas transgénero y datos sobre la salud de las personas LGBTQ+.
El 11 de febrero, un juez federal ordenó que se restableciera gran parte de la información; la administración cumplió, pero agregó avisos a algunas páginas web etiquetándolas de “extremadamente inexactas” y afirmando que no “reflejan la realidad biológica”.
Los CDC también retrasaron la publicación de información y hallazgos sobre la gripe aviar en el Informe Semanal de Morbilidad y Mortalidad de la agencia.
Los trabajadores federales han dicho que se les dijo que se retractaran de los artículos que contienen palabras como “no binario” o “transgénero”. Y algunos hospitales suspendieron la atención de afirmación de género, como la terapia hormonal y los bloqueadores de la pubertad para los jóvenes.
Grupos de defensa dicen que estas órdenes discriminan y plantean barreras a la atención médicamente necesaria, y los niños transgénero y sus familias han presentado una serie de recursos judiciales.
Abogados, defensores e investigadores dicen que la implementación de muchos de los objetivos de política de salud del Proyecto 2025 plantean amenazas.
“El manual presenta una agenda anticiencia, antidatos y antimedicina”, según un artículo del año pasado de investigadores de la Universidad de Boston en JAMA.
El plan del Proyecto 2025 establece objetivos para limitar el acceso al aborto con medicamentos, reestructurar las agencias de salud pública y debilitar las protecciones contra la discriminación basada en el sexo.
Haría que las personas mayores se inscribieran directamente en planes Medicare Advantage administrados por aseguradoras comerciales, en esencia privatizando el programa de salud para los estadounidenses mayores. Y pide eliminar los requisitos de cobertura para los planes de ACA que las personas compran sin subsidios federales, lo que, según los expertos en seguros, corre el riesgo de dejar a muchos con un seguro insuficiente.
“Es la agenda de la administración Trump”, dijo Robert Weissman, copresidente de Public Citizen, un grupo progresista de defensa de los derechos del consumidor. “Es para minimizar el acceso a la atención médica bajo el disfraz de estrictos requisitos laborales en Medicaid, privatizar Medicare y reducir las protecciones y subsidios al consumidor en la Ley de Cuidado de Salud a Bajo Precio”.
La Casa Blanca no respondió a un pedido de comentarios. Los conservadores han dicho que la implementación de las propuestas del proyecto frenaría el despilfarro y el fraude en los programas de salud federales y liberaría a los sistemas de salud de las garras de una agenda radical “woke”.
“Los estadounidenses están cansados de que su gobierno sea utilizado en su contra”, dijo el año pasado Paul Dans, abogado y ex director del Proyecto 2025. “El estado administrativo está, en el mejor de los casos, completamente fuera de contacto con el pueblo estadounidense y, en el peor, se utiliza como arma contra ellos”.
Dans no respondió a los mensajes para opinar en este artículo.
La Heritage Foundation ha buscado separarse a sí misma y al Proyecto 2025 de las órdenes ejecutivas de Trump y otras iniciativas en materia de salud.
“No se trata de nuestras recomendaciones en el Proyecto 2025, algo que hemos estado haciendo durante más de 40 años. “Se trata de que el presidente Trump cumpla sus promesas de hacer que Estados Unidos sea más seguro, más fuerte y mejor que nunca, y él y su equipo merecen el crédito”, dijo Ellen Keenan, vocera de Heritage, en un comunicado.
Se han producido versiones del documento aproximadamente cada cuatro años desde la década de 1980 y han influido en otros presidentes republicanos. El ex presidente Ronald Reagan adoptó alrededor de dos tercios de las recomendaciones de una guía anterior de Heritage, dice el grupo.
En algunos casos, la administración Trump no solo ha seguido las propuestas del Proyecto 2025, sino que las ha superado.
El documento instaba al próximo presidente a reducir y “desradicalizar” la Agencia de Estados Unidos para el Desarrollo Internacional (USAID), una agencia federal independiente que brinda ayuda y asistencia extranjera, incluidos muchos programas de salud internacionales. La administración no solo ha reducido la USAID.
El asesor de Trump, Elon Musk, se jactó en su plataforma de redes sociales X que su “Departamento de Eficiencia Gubernamental” metió a la agencia “en la trituradora de madera”, cerrando físicamente sus oficinas y poniendo a casi todo su personal bajo licencia administrativa mientras terminaba con la financiación de sus programas y difundía información errónea.
Pero la administración corre el riesgo de perder el apoyo público si adopta los objetivos del proyecto para cambiar radicalmente la atención médica y la política de salud de Estados Unidos. Casi el 60% de los votantes dijeron que tenían una opinión negativa sobre el Proyecto 2025 en una encuesta de septiembre de NBC News.
“El Proyecto 2025 nunca fue un ejercicio de pensamiento; siempre fue un plan”, dijo Ally Boguhn, vocera de Reproductive Freedom for All, un grupo a favor del derecho al aborto. “Solo llevamos unas pocas semanas bajo su presidencia, y está sentando las bases para aún más”.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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Trump Froze Out Project 2025 in His Campaign. Now Its Blueprint Is His Health Care Playbook.
Few voters likely expected President Donald Trump in the first weeks of his administration to slash billions of dollars from the nation’s premier federal cancer research agency.
But funding cuts to the National Institutes of Health were presaged in Project 2025’s “Mandate for Leadership,” a conservative plan for governing that Trump said he knew nothing about during his campaign. Now, his administration has embraced it.
The 922-page playbook compiled by the Heritage Foundation, a conservative research group in Washington, says “the NIH monopoly on directing research should be broken” and calls for capping payments to universities and their hospitals to “help reduce federal taxpayer subsidization of leftist agendas.”
Universities, now slated to face sweeping cuts in agency grants that cover these overhead costs, say the policy will destroy ongoing and future biomedical science. A federal judge temporarily halted the cuts to medical research on Feb. 10 after they drew legal challenges from medical institutions and 22 states.
Project 2025 as Prologue
The rapid-fire adoption of many of Project 2025’s objectives indicates that Trump acolytes — many of its contributors were veterans of his first term, and some have joined his second administration — have for years quietly laid the groundwork to disrupt the national health system. That runs counter to Trump’s insistence on the campaign trail, after Democrats made Project 2025 a potent attack line, that he was ignorant of the document.
“I have no idea what Project 2025 is,” Trump said Oct. 31 at a rally in Albuquerque, New Mexico, one of many times he disclaimed any knowledge of the plan. “I’ve never read it, and I never will.”
But because his administration is hewing to the Heritage Foundation-compiled playbook so closely, opposition groups and some state Democratic leaders say they’re able to act swiftly to counter Trump’s moves in court.
They’re now preparing for Trump to act on Project 2025 recommendations for some of the nation’s largest and most important health programs, including Medicaid and Medicare, and for federal health agencies.
“There has been a lot of planning on the litigation side to challenge the executive orders and other early actions from a lot of different organizations,” said Noah Bookbinder, president of Citizens for Responsibility and Ethics in Washington, a watchdog group. “Project 2025 allowed for some preparation.”
The plan, for example, calls for state flexibility to impose premiums for some beneficiaries, work requirements, and lifetime caps or time limits on Medicaid coverage for some enrollees in the program for low-income and disabled Americans, which could lead to a surge in the number of uninsured after the Biden administration vastly expanded the program’s coverage.
“These proposals don’t directly alter eligibility for Medicaid or the benefits provided, but the ultimate effect would be fewer people with health coverage,” said Larry Levitt, executive vice president for health policy at KFF, a health information nonprofit that includes KFF Health News. “When you erect barriers to people enrolling in Medicaid, like premiums or documenting work status, you end up rationing coverage by complexity and ability to pay.”
Congressional Republicans are contemplating a budget plan that could result in hundreds of billions of dollars being trimmed from Medicaid over 10 years.
Project 2025 called for expanding access to health plans that don’t comply with the Affordable Care Act’s strongest consumer protections. That may lead to more choice and lower monthly premiums for buyers, but unwitting consumers may face potentially massive out-of-pocket costs for care the plans won’t cover.
And Project 2025 called for halting Medicaid funding to Planned Parenthood affiliates. The organization, an important health care provider for women across the country, gets roughly $700 million annually from Medicaid and other government programs, based on its 2022-23 report. Abortion made up about 4% of services the organization provided to patients, the report says.
The administration’s steps to scrub words such as “equity” from federal documents, erase transgender identifiers, and curtail international medical aid — all part of the Project 2025 wish list — have already had sweeping ramifications, hobbling access to health care and eviscerating international programs that aim to prevent disease and improve maternal health outcomes.
Under a memorandum issued in January, for example, Trump reinstated and expanded a ban on federal funds to global organizations that provide legal information on abortions.
Studies have found that the ban, known as the “global gag rule” or “Mexico City Policy,” has stripped millions of dollars away from foreign aid groups that didn’t abide by it. It’s also had a chilling effect: In Zambia, one group removed information in brochures on contraception, and in Turkey, some providers stopped talking with patients about menstrual regulation as a form of family planning.
Project 2025 called on the next president to reinstate the gag rule, saying it “should be drafted broadly to apply to all foreign assistance.”
Trump also signed an executive order rolling back transgender rights by banning federal funds for transition-related care for people under age 19. An order he signed also directed the federal government to recognize only two sexes, male and female, and use the term “sex” instead of “gender.”
The Project 2025 document calls for deleting the term “gender identity” from federal rules, regulations, and grants and for unwinding policies and procedures that its authors say are used to advance a “radical redefinition of sex.” In addition, it states that Department of Health and Human Services programs should “protect children’s minds and bodies.”
“Radical actors inside and outside government are promoting harmful identity politics that replaces biological sex with subjective notions of ‘gender identity,’” the Project 2025 road map reads.
Data Disappears
As a result of Trump’s order on gender identity, health researchers say, the Centers for Disease Control and Prevention took down online information about transgender health and removed data on LGBTQ+ health. A federal judge on Feb. 11 ordered that much of the information be restored; the administration complied but added notices to some webpages labeling them “extremely inaccurate” and claiming they don’t “reflect biological reality.”
The CDC also delayed the release of information and findings on bird flu in the agency’s Morbidity and Mortality Weekly Report. Federal workers have said they were told to retract papers that contain words such as “nonbinary” or “transgender.” And some hospitals suspended gender-affirming care such as hormone therapy and puberty blockers for youths.
Advocacy groups say the orders discriminate and pose barriers to medically necessary care, and transgender children and their families have filed a number of court challenges.
Lawyers, advocates, and researchers say implementation of many of Project 2025’s health policy goals poses a threat.
“The playbook presents an antiscience, antidata, and antimedicine agenda,” according to a piece last year by Boston University researchers in JAMA.
The Project 2025 blueprint sets out goals to curb access to medication abortion, restructure public health agencies, and weaken protections against sex-based discrimination. It would have seniors enroll by default in Medicare Advantage plans run by commercial insurers, in essence privatizing the health program for older Americans. And it calls for eliminating coverage requirements for Affordable Care Act plans that people buy without federal subsidies, which, insurance experts say, risks leaving people underinsured.
“It’s the agenda of the Trump administration,” said Robert Weissman, a co-president of Public Citizen, a progressive consumer rights advocacy group. “It’s to minimize access to care under the guise of strict work requirements in Medicaid, privatizing Medicare, and rolling back consumer protections and subsidies in the Affordable Care Act.”
The White House didn’t respond to a message seeking comment. Conservatives have said implementation of the project’s proposals would curb waste and fraud in federal health programs and free health systems from the clutches of a radical “woke” agenda.
“Americans are tired of their government being used against them,” Paul Dans, a lawyer and former director of Project 2025, said last year in a statement. “The administrative state is, at best, completely out of touch with the American people and, at worst, is weaponized against them.”
Dans did not return messages seeking comment for this article.
The Heritage Foundation has sought to separate itself and Project 2025 from Trump’s executive orders and other initiatives on health.
“This isn’t about our recommendations in Project 2025 – something we’ve been doing for more than 40 years. This is about President Trump delivering on his promises to make America safer, stronger, and better than ever before, and he and his team deserve the credit,” Ellen Keenan, a spokesperson for Heritage, said in a statement.
Versions of the document have been produced roughly every four years since the 1980s and have influenced other GOP presidents. Former President Ronald Reagan adopted about two-thirds of the recommendations from an earlier Heritage guide, the group says.
In some instances, the Trump administration hasn’t just followed Project 2025’s proposals but has gone beyond them.
The document called on the next president to scale back and “deradicalize” the U.S. Agency for International Development, an independent federal agency that provides foreign aid and assistance, including for many international health programs. The administration hasn’t just scaled back USAID. Trump adviser Elon Musk bragged on his social media platform, X, that his “Department of Government Efficiency” fed the agency “into the wood chipper,” physically closing its offices and putting nearly all its staff on administrative leave while ending funding for its programs and disseminating misinformation about them.
But the administration risks waning public support if it adopts the project’s goals to upend U.S. health care and health policy. Almost 60% of voters said they felt negatively about Project 2025 in a September poll by NBC News.
“Project 2025 was never a thought exercise; it was always a blueprint,” said Ally Boguhn, a spokesperson for Reproductive Freedom for All, an abortion rights group. “We’re only a few weeks into his presidency, and it’s setting the groundwork for even more.”
We’d like to speak with current and former personnel from the Department of Health and Human Services or its component agencies who believe the public should understand the impact of what’s happening within the federal health bureaucracy. Please message KFF Health News on Signal at (415) 519-8778 or get in touch here.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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Journalists Talk Southern Health Care: HIV Drug Access, Medicaid Expansion, Vaccination Rates
KFF Health News contributor Sarah Boden discussed cats and bird flu on KVPR’s “Central Valley Daily” on Feb. 12.
- Click here to hear Boden on “Central Valley Daily”
- Read Boden’s “House Cats With Bird Flu Could Pose a Risk to Public Health”
KFF Health News South Carolina correspondent Lauren Sausser juxtaposed the increasing trendiness of rural health care and the lack of Medicaid expansion in the South on America’s Heroes Group on Feb. 12.
- Click here to watch Sausser on America’s Heroes Group
- Read Sausser’s “Across the South, Rural Health Care Has Become ‘Trendy.’ Medicaid Expansion Has Not.”
KFF Health News contributor Rebecca Grapevine, of Healthbeat, discussed the barriers to lifesaving HIV drugs in Georgia on America’s Heroes Group on Feb. 12.
- Click here to watch Grapevine on America’s Heroes Group
- Read “Biden Rule Cleared Hurdles to Lifesaving HIV Drug, but in Georgia Barriers Remain”
KFF Health News Southern correspondent Sam Whitehead discussed childhood vaccination rates on WUGA’s “The Georgia Health Report” on Feb. 7.
- Click here to hear Whitehead on “The Georgia Health Report”
- Read Whitehead’s “Childhood Vaccination Rates, a Rare Health Bright Spot in Struggling States, Are Slipping,” co-reported with Daniel Chang
KFF Health News public health local editor and correspondent Amy Maxmen discussed the U.S.’ pulling out of the World Health Organization on America’s Heroes Group on Feb. 5.
- Click here to watch Maxmen on America’s Heroes Group
- Read Maxmen’s “What a US Exit From the WHO Means for Global Health”
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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KFF Health News' 'What the Health?': Courts Try To Curb Health Cuts
Congress has mostly stood by as the Trump administration — spurred by Elon Musk and his Department of Government Efficiency, named and created by President Donald Trump — takes a chainsaw to a broad array of government programs. But now the courts are stepping in to slow or stop some efforts that critics claim are illegal, unconstitutional, or both.
Funding freezes and contract cancellations are already having a chilling effect on health programs, such as biomedical research grants for the National Institutes of Health, humanitarian and health aid provided overseas by the U.S. Agency for International Development, and federal funding owed to community health centers and other domestic agencies.
This week’s panelists are Julie Rovner of KFF Health News, Jessie Hellmann of CQ Roll Call, Shefali Luthra of The 19th, and Maya Goldman of Axios.
Panelists Jessie Hellmann CQ Roll Call @jessiehellmann Read Jessie's stories. Shefali Luthra The 19th @shefalil Read Shefali's stories. Maya Goldman Axios @mayagoldman_ Read Maya's storiesAmong the takeaways from this week’s episode:
- Universities are reconsidering hiring and other forward-looking actions after the Trump administration imposed an abrupt, immediate cap on indirect costs, which help cover overhead and related expenses that aren’t included in federal research grants. A slowdown at research institutions could undermine the prospects for innovation generally — and the nation’s economy specifically, as the United States relies quite a bit on those jobs and the developments they produce.
- The Trump administration’s decision to apply the cap on indirect costs to not only future but also current federal grants specifically violates the terms of spending legislation passed by Congress. Meanwhile, the health impacts of the sudden shuttering of USAID are becoming clear, including concerns about how unprepared the nation could be for a health threat that emerges abroad.
- Congress still hasn’t approved a full funding package for this year, and Republicans don’t seem to be in a hurry to do more than extend the current extension — and pass a budget resolution to fund Trump’s priorities and defund his chosen targets.
- The House GOP budget resolution package released this week includes a call for $880 billion in spending cuts that is expected to hit Medicaid hard. House Republican leaders say they’re weighing imposing work requirements, but only a small percentage of Medicaid beneficiaries would be subject to that change, as most would be exempt due to disability or other reasons — or are already working. Cuts to Medicaid could have cascading consequences, including for the national problem of maternal mortality.
Also this week, Rovner interviews Mark McClellan — director of the Duke-Margolis Institute for Health Policy who led the FDA and the Centers for Medicare & Medicaid Services during the George W. Bush administration — about the impact of cutting funding to research universities. And Rovner reads the winner of the annual KFF Health News’ “health policy valentines” contest.
Plus, for “extra credit,” the panelists suggest health policy stories they read this week that they think you should read, too:
Julie Rovner: Axios’ “Nonprofit Hospital Draws Backlash for Super Bowl Ad,” by Maya Goldman.
Shefali Luthra: Politico’s “‘Americans Can and Will Die From This’: USAID Worker Details Dangers, Chaos,” by Jonathan Martin.
Maya Goldman: KFF Health News’ “Doctor Wanted: Small Town in Florida Offers Big Perks To Attract a Physician,” by Daniel Chang.
Jessie Hellmann: NPR’s “Trump’s Ban on Gender-Affirming Care for Young People Puts Hospitals in a Bind,” by Selena Simmons-Duffin.
Also mentioned in this week’s podcast:
- Reuters’ “USAID Families Have Their Lives Upended by Trump Move To Shut Agency,” by Jonathan Landay and Humeyra Pamuk.
- Newsweek’s “First USAID Death as Freeze Sees Oxygen Supplies Cut Off for Refugee,” by Theo Burman.
To hear all our podcasts, click here.
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KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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