\t\t\t<\/p>\n
\tJulie Rovner
\n\tKFF Health News<\/p>\n
\t\t\t \t\t\t \t\t\t \t\t\tJulie Rovner is chief Washington correspondent and host of KFF Health News’ weekly health policy news podcast, “What the Health?” A noted expert on health policy issues, Julie is the author of the critically praised reference book “Health Care Politics and Policy A to Z,” now in its third edition.\t\t<\/p>\n Democrats and Republicans are both facing potential political consequences in their continuing standoff over federal government funding. Republicans are likely to face a voter backlash if they refuse to agree to Democrats’ demands that they renew additional tax credits for Affordable Care Act marketplace plans, since the majority of those facing premium hikes live in GOP-dominated states. For their part, Democrats are worried that Republicans will violate the terms of any potential spending deal.<\/p>\n At the same time, the Trump administration is using the shutdown to try to lay off thousands of federal workers, including those performing key public health roles at the Centers for Disease Control and Prevention.<\/p>\n This week’s panelists are Julie Rovner of KFF Health News, Anna Edney of Bloomberg News, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico Magazine, and Lauren Weber of The Washington Post.<\/p>\n \t\t\t \tAnna Edney \t\t\t \t\t\t \t\t\t \t\t\t \tJoanne Kenen \t\t\t \t\t\t \t\t\t \t\t\t \tLauren Weber \t\t\t \t\t\t Among the takeaways from this week’s episode:<\/p>\n Also this week, Rovner interviews health insurance analyst Louise Norris of Medicareresources.org<\/a> about the Medicare open enrollment period, which began Oct. 15.<\/p>\n\n Plus, for “extra credit” the panelists suggest health policy stories they read this week that they think you should read, too:\u00a0<\/p>\n Julie Rovner:<\/strong> Politico’s “RFK Jr.’s Got Advice for Pregnant Women. There’s Limited Data To Support It<\/a>,” by Alice Miranda Ollstein.<\/p>\n Anna Edney:<\/strong> The New York Times’ “The Drug That Took Away More Than Her Appetite<\/a>,” by Maia Szalavitz.<\/p>\n Joanne Kenen:<\/strong> Mother Jones’ “From Medicine to Mysticism: The Radicalization of Florida’s Top Doc<\/a>,” by Kiera Butler and Julianne McShane.<\/p>\n Lauren Weber:<\/strong> KFF Health News’ “Senators Press Deloitte, Other Contractors on Errors in Medicaid Eligibility Systems<\/a>,” by Rachana Pradhan and Samantha Liss.<\/p>\n Also mentioned in this week’s podcast:<\/p>\n \t\t\t\t\tclick to open the transcript\t\t\t\t<\/p>\n \t\t\t\t\t\tTranscript: Schrödinger’s Government Shutdown\t\t\t\t<\/p>\n [Editor’s note:<\/em><\/strong>\u00a0This transcript\u00a0was generated\u00a0using both transcription software and a human’s light touch. It has\u00a0been edited\u00a0for style and clarity.]<\/em>\u00a0<\/p>\n Julie\u00a0Rovner:<\/strong>\u00a0Hello, and welcome back to\u00a0“What\u00a0the Health?”\u00a0I’m\u00a0Julie Rovner, chief Washington\u00a0correspondent for KFF Health News, and\u00a0I’m\u00a0joined by\u00a0some of\u00a0the best and smartest health reporters in Washington.\u00a0We’re\u00a0taping this week on Thursday, Oct.\u00a016,\u00a0at 10\u00a0a.m. As always, news happens\u00a0fast\u00a0and things\u00a0might’ve\u00a0changed by the time you hear this. So,\u00a0here we go.\u00a0<\/p>\n Today we\u00a0are joined\u00a0via videoconference by Lauren Weber\u00a0of The Washington Post.\u00a0<\/p>\n Lauren Weber:<\/strong>\u00a0Hello, hello.\u00a0<\/p>\n Rovner:<\/strong>\u00a0Anna\u00a0Edney of\u00a0Bloomberg News.\u00a0<\/p>\n Anna\u00a0Edney:<\/strong>\u00a0Hi.\u00a0<\/p>\n Rovner:<\/strong>\u00a0And\u00a0Joanne\u00a0Kenen\u00a0of the Johns Hopkins Bloomberg School of Public Health and Politico Magazine.\u00a0<\/p>\n Joanne Kenen:<\/strong>\u00a0Hey,\u00a0everybody.\u00a0<\/p>\n Rovner:<\/strong>\u00a0Later in this episode\u00a0we’ll\u00a0play my interview with health insurance expert Louise Norris,\u00a0who will explain\u00a0some of\u00a0the changes coming with this year’s open enrollment for Medicare, which began Wednesday. But first,\u00a0this week’s news.\u00a0<\/p>\n So, today is\u00a0Day 16 of the government shutdown, and there is still no discernible end in\u00a0sight. This week Republicans shifted their main talking point against Democrats. They were arguing that Democrats are trying to restore eligibility for Medicaid to\u00a0illegal immigrants. Now\u00a0it’s\u00a0become a general takedown of the Affordable Care Act and arguing that in urging continuing the expanded tax credits for ACA premiums, Democrats want to throw good money after bad,\u00a0because the ACA has made health\u00a0care more expensive.\u00a0<\/p>\n First off, it has not.\u00a0There’s\u00a0lots of\u00a0evidence that the ACA has\u00a0actually held\u00a0down health spending increases, although other factors have pushed it up. But more to the point, do Republicans still not get that the\u00a0expiration\u00a0of these\u00a0additional\u00a0tax credits\u00a0are\u00a0going to hurt their voters more than\u00a0it’s\u00a0going to hurt\u00a0Democratic voters? I see arched eyebrows.\u00a0<\/p>\n Edney:<\/strong>\u00a0It\u00a0doesn’t\u00a0seem like they get that yet, but\u00a0I’m\u00a0not in those strategy rooms,\u00a0so\u00a0a little tough to say what their line will be with this game of chicken. They\u00a0basically are\u00a0allowing firings of federal workers to continue to go forward in a way that they hope\u00a0maybe will\u00a0turn the tide and attention. It\u00a0doesn’t\u00a0seem to be working. So I don’t know if they’re having these conversations quite yet, but I know that the notices are starting to go out to some people in some states about these increases, and so it really might depend on what that backlash is from people who are going to see much higher costs for their health\u00a0care.\u00a0<\/p>\n Rovner:<\/strong>\u00a0Yeah,\u00a0apparently open\u00a0enrollment began in Idaho on Wednesday.\u00a0I didn’t realize that they started early, and so there’s just that one little state where people are\u00a0actually able\u00a0to see what these premium increases look like,\u00a0assuming that\u00a0they do not continue these extra subsidies.\u00a0I’m\u00a0wondering\u00a0sort of\u00a0about\u00a0the Republican strategy of,\u00a0We\u00a0couldn’t\u00a0get any traction with the\u00a0illegal immigrants, so\u00a0we’re\u00a0just going to move to\u00a0“The ACA is terrible.”<\/em>\u00a0Joanne.\u00a0<\/p>\n Kenen:<\/strong>\u00a0Well, I mean,\u00a0we talked about this a couple of weeks ago. And Julie linked to\u00a0the story<\/a>, and I wrote about the politics of this. And one of the issues is\u00a0[President Donald]\u00a0Trump is\u00a0a master of\u00a0deflection. Are these people going to think\u00a0it’s\u00a0really Republican\u00a0policy?\u00a0Or are they going to think\u00a0it’s\u00a0greedy insurers, leftovers of the flaws of Obamacare itself,\u00a0it’s\u00a0Biden’s fault?\u00a0And\u00a0also\u00a0concentration,\u00a0I mean where the voters are in these states.\u00a0Are there enough of them who\u00a0actually are\u00a0going to turn out to\u00a0make a difference?\u00a0They’re\u00a0not going to\u00a0flip\u00a0Texas, right?\u00a0<\/p>\n Are there enough of them in swing states or closer-margin states to make any difference?\u00a0Are\u00a0there enough in a single\u00a0congressional district to make any difference? I mean part of it, I think\u00a0they’re\u00a0just sort of banking on that they\u00a0won’t\u00a0get the blame,\u00a0that\u00a0it’s\u00a0really easy\u00a0for us to get mad at our insurers. And I think that’s part of what\u00a0they’re\u00a0hoping,\u00a0that they can just say:\u00a0Blame them. Blame the structure of Obamacare. Because\u00a0it’s\u00a0not our fault.<\/em>\u00a0So, whether that works\u00a0as a selling tactic remains to\u00a0be seen. If they thought it was a huge political risk, they\u00a0wouldn’t\u00a0do it.\u00a0<\/p>\n Rovner:<\/strong>\u00a0True. Lauren.\u00a0<\/p>\n Weber:<\/strong>\u00a0I’ve\u00a0been fascinated to see\u00a0[Rep.]\u00a0Marjorie Taylor-Green come out and say,\u00a0Wow, these are\u00a0some\u00a0expensive premiums.<\/em>\u00a0And her in general, her seeming split from\u00a0some\u00a0parts of the Republican Party,\u00a0is fascinating to watch for\u00a0many\u00a0reasons. But\u00a0it’s\u00a0just\u00a0a lot of\u00a0money that these people could be staring down. I mean, there was an analyst quoted in\u00a0some\u00a0coverage that was,\u00a0like, people will have to decide between groceries and rent. I mean, if you are paying over a thousand dollars more a month,\u00a0for\u00a0some of\u00a0these folks, I mean,\u00a0that is a significant amount of cash. So, I do feel like people vote with their pocketbooks more than they vote with anything else. But to Joanne’s point, I mean,\u00a0will they attribute the blame?\u00a0I’m\u00a0not sure.\u00a0<\/p>\n Rovner:<\/strong>\u00a0So,\u00a0Politico was reporting<\/a>\u00a0on some\u00a0possible options\u00a0for\u00a0a\u00a0deal on those subsidies, which lawmakers are\u00a0apparently talking\u00a0about quietly behind closed\u00a0doors,\u00a0since\u00a0actual negotiations are not yet happening. Two of those possibilities seem like real potential common ground. Minimum premiums\u00a0\u2014 so, people who are now not paying any premiums, and the argument from some Republicans is that that’s pushing fraud,\u00a0because some people, if they’re not paying premiums, don’t even know that they’re enrolled, and that the brokers are making money, which my colleague\u00a0Julie Appleby has written about<\/a>\u00a0ad nauseum.\u00a0So that seems like a\u00a0possible place\u00a0for compromise,\u00a0to have a minimum $5-a-month premium so people would know that they have insurance. And maximum\u00a0incomes\u00a0for the subsidies. I know that people are floating,\u00a0like,\u00a0$200,000 a year or something like that.\u00a0<\/p>\n Then there are two possibilities that at least strike me as less likely. One of them is grandfathering the subsidies, so only people who are getting them now could continue to get them, which would be problematic at a time when the economy seems to be shedding jobs, and changing the abortion language, which I don’t even want to start with. So,\u00a0I’m\u00a0seeing the first two\u00a0as a real possibility. The second two, not so much.\u00a0I’m\u00a0wondering what\u00a0you guys\u00a0think.\u00a0<\/p>\n Kenen:<\/strong>\u00a0I mean,\u00a0I’ve\u00a0talked to\u00a0some\u00a0Republicans who claim that the current structure of the subsidies would enable families who are making $600,000, which all of us would agree is a fair amount of money. When I\u00a0was told\u00a0that,\u00a0I went on a whole bunch of different calculators and pretended I was making $600,000. And could I\u00a0actually get\u00a0the subsidies?\u00a0And I kept\u00a0being laughed\u00a0at by these calculators.\u00a0I think there\u00a0are\u00a0probably\u00a0some\u00a0cases where this has happened.\u00a0It’s\u00a0a complicated formula where 8% of\u00a0\u2014\u00a0we\u00a0don’t\u00a0have to get into the technicality. There may be\u2014\u00a0<\/p>\n Rovner:<\/strong>\u00a0But it is a percent of your income. You only get a subsidy if\u00a0it’s\u00a0more than\u00a0\u2014\u00a0yeah.\u00a0<\/p>\n Kenen:<\/strong>\u00a0And\u00a0you’d\u00a0have to have a premium that’s,\u00a0like,\u00a0an extraordinarily rich premium.\u00a0I mean,\u00a0it\u00a0has to\u00a0be in a really, really, really,\u00a0really high\u00a0number.\u00a0Can this exist under current law?\u00a0Several\u00a0reputable Republicans have told me yes. Or conservatives\u00a0\u2014\u00a0they’re\u00a0not all necessarily Republicans. Conservative on this issue,\u00a0at least\u00a0\u2014\u00a0have said yes. I mean, if\u00a0that’s\u00a0the kind of thing that you want,\u00a0to\u00a0set\u00a0an income cap, that was\u00a0probably what\u00a0was intended. I would take that out of the nonstarter and into the starter pile. I\u00a0don’t\u00a0think\u00a0that’s\u00a0enough, but I think\u00a0that’s\u00a0a reasonable discussion for both sides to have. I\u00a0don’t\u00a0think the intention was to subsidize people who were\u00a0really not\u00a0lower-middle, middle class.\u00a0<\/p>\n Rovner:<\/strong>\u00a0The people who got the big tax cuts.\u00a0<\/p>\n Kenen:<\/strong>\u00a0Right.\u00a0They’re\u00a0getting other tax cuts. I thought that was an interesting piece with some interesting options, but I’m also hearing escalating rhetoric,\u00a0back to 2014 kind of rhetoric,\u00a0back to repeal kind of rhetoric, that\u00a0everything that you hate about the health\u00a0care system is the fault of Obamacare,\u00a0nothing in Obamacare works.\u00a0We’ve\u00a0got a\u00a0really\u00a0\u2014\u00a0they’re\u00a0not saying\u00a0“repeal,”\u00a0but\u00a0they’re\u00a0saying\u00a0reform it, and\u00a0I’m\u00a0hearing\u00a0more and more\u00a0of that.\u00a0It’s\u00a0just in the air now.\u00a0So, and\u00a0Jon Cohn had a really good piece\u00a0in\u00a0The\u00a0Bulwark<\/a>\u00a0about some of the background of this. I think it could mean that this becomes a more intense tug-of-war that does not bode well for a quick resolution of the shutdown.\u00a0<\/p>\n I\u00a0don’t\u00a0think we necessarily get into a yearlong repeal fight, even if you call it reform. But I think that these demands and this rhetoric about,\u00a0Well, high-risk pools worked.<\/em>\u00a0Well, no, they\u00a0didn’t. That,\u00a0This\u00a0is why your insurance costs have gone up.<\/em>\u00a0No,\u00a0there’s\u00a0a whole bunch of incentives and structures and\u00a0bad stuff\u00a0in our health\u00a0care system. It is,\u00a0Obamacare fixed certain problems. Those of us, we all have employer insurance,\u00a0I believe, and all of us face cost increases and frustrations and hitting our head against brick walls and delays. And\u00a0things are not perfect by any means, but\u00a0it’s\u00a0not because of these subsidies in Obamacare.\u00a0<\/p>\n Rovner:<\/strong>\u00a0And\u00a0it’s\u00a0not because of Obamacare.\u00a0[Barack]\u00a0Obama himself this week was on a podcast and said it\u00a0was intended\u00a0as a start, not as the be-all,\u00a0end-all. I was surprised. I mean, I think one of the reasons that Republicans, I mean,\u00a0this is now in their talking points about,\u00a0We’re\u00a0going to go after Obamacare.<\/em>\u00a0And\u00a0[Rep.]\u00a0Mike Johnson, the speaker,\u00a0had\u00a0kind of a\u00a0rant on Monday, I\u00a0mean, which\u00a0sort of opened\u00a0this up. And I think\u00a0some of\u00a0the Republicans were also talking about it on the Sunday shows. But I\u00a0can’t\u00a0imagine that Republicans\u00a0don’t\u00a0remember that the last time they had this big fight against Obamacare,\u00a0Obamacare won. That was in 2017, and if anything,\u00a0it’s\u00a0even more popular now because\u00a0there’s\u00a0twice as\u00a0many\u00a0people on it, which was\u00a0kind of the\u00a0way I set up my first question.\u00a0<\/p>\n Kenen:<\/strong>\u00a0Right. But the dynamic of a year’s worth of repeal votes while other things are\u00a0actually functioning\u00a0in government versus a fight about this when Trump holds\u00a0a lot of\u00a0the cards in a shutdown\u00a0\u2014\u00a0it’s\u00a0comparable but not the same.\u00a0<\/p>\n Rovner:<\/strong>\u00a0Anna?\u00a0<\/p>\n Edney:<\/strong>\u00a0Well, and I also have to wonder if an actual extended replace, or reform, whatever we’re going to call it,\u00a0fight is what they want, or if this is a strategy to help blame the increases in premiums that are coming on Obamacare in general directed towards the Democrats, right?. I mean, you can see how that line could\u00a0be drawn. And\u00a0so\u00a0if they just keep bashing Obamacare,\u00a0it’s\u00a0Obamacare’s fault that Obamacare’s premiums got higher, not because they\u00a0didn’t\u00a0vote on extending the subsidies.\u00a0<\/p>\n Kenen:<\/strong>\u00a0And\u00a0we’re\u00a0also talking about Obamacare again. We\u00a0had\u00a0been talking about the Affordable Care Act. It had gone from Obamacare, which is politically toxic,\u00a0to\u00a0Affordable\u00a0Care Act, which was\u00a0sort of a\u00a0subtle acknowledgment that it had bipartisan popularity among people getting benefits. And now\u00a0we’re\u00a0back to Obamacare, which\u00a0sort of tells\u00a0me, yes,\u00a0we’re\u00a0back into\u00a0some of\u00a0this endless loop of political fights about Obamacare.\u00a0<\/p>\n Rovner:<\/strong>\u00a0Yeah.\u00a0<\/p>\n Kenen:<\/strong>\u00a0And trying\u00a0to get the Guinness Book of World\u00a0Records\u00a0for\u00a0repeal votes on a single piece of legislation.\u00a0<\/p>\n Rovner:<\/strong>\u00a0Well, meanwhile\u00a0\u2014\u00a0and I said this last week and I think the week before\u00a0\u2014\u00a0that\u00a0even if there is a deal on the tax credits, the bigger problem for Democrats right now is that if they make a deal on spending levels for fiscal 2026, which is what this fight is actually over, the administration can simply undo it, and Congress can ratify that undoing with a simple majority of just Republican votes.\u00a0This week,\u00a0even Republican\u00a0[Sen.]\u00a0Lisa Murkowski wondered aloud why Democrats would do a deal like that.\u00a0So, I’m still wondering how they get out of that box, even if they were to get\u00a0some kind of a\u00a0compromise on the ACA subsidies.\u00a0I certainly\u00a0don’t\u00a0know how Democrats get out of that box. I think the Republicans\u00a0don’t\u00a0know how they get out of that box.\u00a0<\/p>\n Kenen:<\/strong>\u00a0They\u00a0don’t\u00a0realize\u00a0they’re\u00a0both in the box.\u00a0That’s\u00a0one of the problems.\u00a0This is a large box.\u00a0<\/p>\n Rovner:<\/strong>\u00a0It’s\u00a0Schrödinger’s shutdown. We will have to see how that plays itself out. In the meantime,\u00a0I’m\u00a0not holding my breath. Well, moving on,\u00a0despite laws against it, as Anna already mentioned, the Trump administration began firing federal workers last week, and the cuts hit particularly hard at the Department of Health and Human Services and agencies like the Centers for Disease Control and Prevention and the Substance Abuse and Mental Health Services Administration. The cuts appeared both sweeping and devastating, at least at first, including the entire staff of the CDC’s\u00a0news\u00a0journal and lead public health\u00a0source\u00a0of information, the Morbidity\u00a0and Mortality\u00a0Weekly\u00a0Report. Though by the end of the weekend,\u00a0many\u00a0of the firings had\u00a0been rescinded. It’s not clear whether that really was a coding mistake,\u00a0as was the official explanation, or an effort to continue to put federal workers, quote, air quotes here,\u00a0“in trauma”\u00a0as OMB\u00a0[Office of Management and\u00a0Budget]\u00a0Director Russell Vought famously promised before he took office for the second time. Whichever,\u00a0it’s\u00a0not\u00a0really\u00a0the way to get the best work out of your workforce, right?\u00a0Telling you:\u00a0You’re\u00a0fired. No,\u00a0you’re\u00a0not.\u00a0Maybe you\u00a0are<\/em>?\u00a0Go ahead, Lauren.\u00a0<\/p>\n Weber:<\/strong>\u00a0I would like to go back to\u00a0the story I wrote in April<\/a>\u00a0when a bunch of fired health workers were told to contact an employee who had died.\u00a0I\u00a0don’t\u00a0think,\u00a0based on the coding error or\u00a0some of\u00a0these past things,\u00a0it does not seem like these layoffs are\u00a0being done\u00a0in any sort of organized way. It\u00a0doesn’t\u00a0seem like they have up-to-date records. It seems like,\u00a0also, are these layoffs even legal,\u00a0based on\u00a0some of\u00a0the litigation\u00a0that’s\u00a0been filed? I think\u00a0there’s\u00a0going to be\u00a0a lot\u00a0that\u00a0has to\u00a0shake out there. But,\u00a0I mean, to be quite honest, it is very striking to see a bunch of CDC employees continue to\u00a0get laid\u00a0off after, again, this is an agency that\u00a0got shot\u00a0at with hundreds of bullets. Police officer\u2014\u00a0<\/p>\n Rovner:<\/strong>\u00a0Yeah,\u00a0literally shot\u00a0at.\u00a0<\/p>\n Weber:<\/strong>\u00a0Literally shot at with hundreds of bullets, and a police officer died responding to that,\u00a0due to a shooter who had\u00a0been radicalized\u00a0in part,\u00a0it seems,\u00a0from his father’s account,\u00a0by information that was wrong about the\u00a0covid\u00a0vaccine. So, to see more of those employees\u00a0get laid\u00a0off, I mean, you just\u00a0have to\u00a0wonder\u00a0who’s\u00a0going to want to work at these places.\u00a0Morale is just completely,\u00a0as we understand it, terrible. But yeah, I also question if that was a coding error or what exactly was happening there,\u00a0because there were a lot of priorities of folks that were seemingly let go that are\u00a0allegedly\u00a0Make America\u00a0Healthy\u00a0Again priorities, but that’s also been true for many months of policymaking, so\u2014\u00a0<\/p>\n Rovner:<\/strong>\u00a0Yeah,\u00a0there’s\u00a0a lot of\u00a0right\u00a0hand not\u00a0seemingly knowing\u00a0what left hand is doing in all of this, which may be the goal.\u00a0I mean,\u00a0I\u00a0think you\u00a0put your finger on it.\u00a0It’s\u00a0like,\u00a0who would want to work at these places after\u00a0what’s\u00a0being done? And I think\u00a0that’s\u00a0the whole idea of the Russell Vought strategy of,\u00a0Let’s\u00a0shrink the federal government to a point where\u00a0it’s\u00a0so small that you can just\u00a0sort of put\u00a0it in a box and put it under the bed.<\/em>\u00a0That’s\u00a0essentially where we are.\u00a0Well, Lauren, as you mentioned, Wednesday afternoon, a federal district court judge ordered the administration to pause the firings.\u00a0But will they\u00a0actually obey\u00a0that?\u00a0And do we even know what offices have been most affected at this point?\u00a0<\/p>\n I mean, we heard\u00a0a lot of\u00a0things like the entire Office of Population\u00a0Affairs at HHS, which runs Title\u00a0X,\u00a0has\u00a0apparently been\u00a0reduced to one person. The people who do\u00a0a lot of\u00a0the statistics\u00a0and\u00a0survey\u00a0work at CDC. All these people\u00a0sort of appear\u00a0to have\u00a0been laid\u00a0off, but\u00a0we’re\u00a0not quite sure, and\u00a0we’re\u00a0not quite sure\u00a0what’s\u00a0going to happen from here.\u00a0<\/p>\n Kenen:<\/strong>\u00a0I’m\u00a0not sure if\u00a0they<\/em>\u00a0know\u00a0they’ve\u00a0been laid off and rehired,\u00a0because if you were laid off, you lost your access to your work email, and then if you get an email in your work email saying,\u00a0Oops,\u00a0you’re\u00a0hired.<\/em>\u00a0I mean,\u00a0I guess people\u00a0sort of may just see if they have access again, but I’m not\u00a0really sure\u00a0how the actual notification of this\u00a0somewhat chaotic\u00a0layoff, no-layoff thing is.\u00a0<\/p>\n Rovner:<\/strong>\u00a0It has been chaotic. I think\u00a0that’s\u00a0a good word to describe all of this. Well, one reason it was\u00a0relatively easy\u00a0for the administration to go after the CDC is that it\u00a0doesn’t\u00a0have a leader\u00a0\u2014\u00a0or even a nominated leader\u00a0\u2014\u00a0at the moment,\u00a0after the firing of Susan\u00a0Monarez\u00a0in August, less than a month after her Senate confirmation vote. Another high HHS position that\u00a0remains\u00a0vacant is that of\u00a0surgeon\u00a0general, although that office at least has a nominee, Casey Means.\u00a0She’s\u00a0the sister of RFK\u00a0[Robert F. Kennedy]\u00a0Jr.\u00a0top\u00a0aide\u00a0and MAHA\u00a0associate Calley Means and more\u00a0than\u00a0a little bit controversial. Lauren, you did a deep dive this week into the prospective\u00a0surgeon\u00a0general.\u00a0What’d\u00a0you find?\u00a0<\/p>\n Weber:<\/strong>\u00a0Yeah, my colleague Rachel\u00a0Roubein\u00a0and I did\u00a0a deep dive<\/a>\u00a0into her background.\u00a0And she’s, look,\u00a0she’s\u00a0a fascinating example,\u00a0really,\u00a0of MAHA today.\u00a0And you could argue she really wrote the manifesto to MAHA with her book\u00a0“Good Energy”\u00a0that she authored with her brother,\u00a0Calley Means. But\u00a0basically\u00a0she’s\u00a0a very accomplished person in the sense that she went to Stanford\u00a0undergrad;\u00a0she graduated from Stanford\u00a0med\u00a0school;\u00a0she had a very prestigious residency in ear, nose, and throat surgery;\u00a0and then she resigned. She left and decided she wanted to take a different path and has become a bestselling author, a health products entrepreneur, and has also worked,\u00a0as her financial disclosures have revealed,\u00a0to promote a variety of products in\u00a0some of\u00a0her work. Financial disclosures revealed that she had received over half a million dollars over basically\u00a0the last\u00a0year and a half promoting a variety of different supplements, teas, elixirs, diagnostic products,\u00a0and so on.\u00a0<\/p>\n And several of the medical and scientific experts I spoke to said that they worried that she spoke in too absolute\u00a0of\u00a0terms about health, and they were really concerned that as someone who would be the surgeon general that she would use that bully\u00a0pulpit\u00a0and speak in terms not necessarily grounded in evidence. They pointed to\u00a0some of\u00a0her remarks about how cancer and Alzheimer’s and fertility\u00a0was\u00a0within one’s power to prevent and reverse, and they felt like that language went a step too far. And looking at her history, they are concerned about what that could mean for the health of the nation if she is directing it.\u00a0<\/p>\n Rovner:<\/strong>\u00a0She\u00a0doesn’t\u00a0even have a confirmation hearing scheduled yet, does she? Well, the Senate’s in so they could.\u00a0<\/p>\n Weber:<\/strong>\u00a0She\u00a0is pregnant, so\u00a0I think\u00a0that\u00a0is playing into the timing of\u00a0some of\u00a0her stuff. But yes, she does not have it scheduled.\u00a0Her forms\u00a0seemingly were\u00a0pretty delayed.\u00a0And then obviously there’s other things going on. I mean, I think the CDC firing also sucked\u00a0a lot of\u00a0health\u00a0air out of the room of what people want to deal with and spend their political capital on, I suspect. But yes, we shall see.\u00a0<\/p>\n Kenen:<\/strong>\u00a0Yeah, she\u00a0has to\u00a0go before the\u00a0[Senate]\u00a0HELP\u00a0[Health, Education, Labor, and Pensions] Committee, which is,\u00a0Sen.\u00a0[Bill]\u00a0Cassidy is the chair. He is not a happy camper\u00a0at the moment,\u00a0from his public statements, and we do not know what\u00a0the private\u00a0conversations he is having\u00a0at this point in time.\u00a0<\/p>\n Rovner:<\/strong>\u00a0And of course, that committee will also have to pass on the new CDC nominee when there is one.\u00a0<\/p>\n Kenen:<\/strong>\u00a0Yes. And the last CDC hearing, which all of us watched, I think\u00a0he’s\u00a0clearly concerned and displeased by\u00a0lots of\u00a0things going on at the federal health agencies. So, none of us are in those rooms, but\u00a0they’re\u00a0probably interesting\u00a0conversations.\u00a0<\/p>\n Rovner:<\/strong>\u00a0As I like to say, we will watch that space. Well, turning to reproductive health,\u00a0The New York Times has\u00a0a story<\/a>\u00a0this week about something that\u00a0we’ve\u00a0talked about before on the podcast, arguments by anti-abortion activists that abortion pill residue in wastewater might be contaminating the nation’s waterways. Notwithstanding that there is no evidence of that, the Environmental Protection\u00a0[Agency],\u00a0acting on a request from anti-abortion lawmakers in Congress,\u00a0ordered scientists to see if they could develop methods to detect the drug in wastewater. Now, the groups that originally pushed this say they were concerned about pollution. But if such a detection method\u00a0is successfully developed, abortion rights supporters worry that it could\u00a0be used\u00a0to trace users in particular buildings\u00a0in order to\u00a0enforce abortion bans. This is\u00a0basically another\u00a0step in this sort\u00a0of,\u00a0Let’s\u00a0try and shut down abortion nationwide.<\/em>\u00a0Is it not? And\u00a0Anna\u00a0I see you nodding.\u00a0<\/p>\n Edney:<\/strong>\u00a0Well, I mean that was my feeling when I read this\u00a0really good\u00a0piece that\u00a0you’re\u00a0talking about. And\u00a0it’s\u00a0a little bit lower down in the piece when they do start talking about using this to target\u00a0maybe buildings\u00a0or places where someone might have used an abortion drug. And I kind of was like,\u00a0Yes, this is what I assumed they\u00a0were trying to do<\/em>, as I read this. And the reason for that is not just because I feel like there’s always a vindictive motive or something, but it’s because there are lots of drugs that are in our wastewater, and people are taking far larger amounts daily of many more things that is all going into our wastewater. So, particularly,\u00a0why you would want to track that one, which\u00a0is not used\u00a0by millions of people for a chronic condition\u00a0on a daily basis, it seems like there would be an ulterior motive.\u00a0<\/p>\n Rovner:<\/strong>\u00a0And has not\u00a0been shown\u00a0to do any harm, even if it is showing up in trace amounts in the wastewater. Although\u00a0presumably that’s\u00a0what the EPA scientists\u00a0were also tasked\u00a0with trying to figure out.\u00a0<\/p>\n Kenen:<\/strong>\u00a0I mean, it’s\u00a0really hard\u00a0to get rid of a drug you no longer take.\u00a0I mean, pharmacies\u00a0don’t\u00a0want to take it back. In my neighborhood, there is a pharmacy at a supermarket that does have a take-back, which is great, but\u00a0it’s\u00a0always broken. If you have any drug that you want to get rid of responsibly and not have it end up\u00a0\u2014\u00a0Anna’s\u00a0right, I mean,\u00a0there’s\u00a0just\u00a0a lot of\u00a0stuff in our water.\u00a0It’s\u00a0really hard\u00a0to do.\u00a0And this is not the only drug that is an issue with.\u00a0<\/p>\n Rovner:<\/strong>\u00a0Although if you Google it, there are\u00a0a lot of\u00a0places where you can\u00a0actually take\u00a0back drugs.\u00a0<\/p>\n Kenen:<\/strong>\u00a0It’s\u00a0hard.\u00a0It’s\u00a0limited hours, limited access, and the machines are often\u2014\u00a0<\/p>\n Rovner:<\/strong>\u00a0Yeah.\u00a0Yeah.\u00a0<\/p>\n Kenen:<\/strong>\u00a0I’ve been\u00a0trying for\u00a0a couple of them for\u00a0a few\u00a0months,\u00a0actually.\u00a0<\/p>\n Rovner:<\/strong>\u00a0You do have to\u00a0actually take\u00a0some\u00a0steps actively to do it.\u00a0Well, turning to drugs, and drug prices, there\u00a0was so much other news, you\u00a0might’ve\u00a0missed this, but President Trump last Friday afternoon announced a deal with a second drug company to bring back manufacturing,\u00a0in order to\u00a0avoid tariffs. This deals with AstraZeneca, which promised to build a plant in Virginia. But Anna, is there any promise to\u00a0actually bring\u00a0down prices for consumers in any of\u00a0this?\u00a0<\/p>\n Edney:<\/strong>\u00a0Minimally, possibly.\u00a0It’s\u00a0a lot\u00a0like the Pfizer deal, and we saw\u00a0that\u00a0focus\u00a0largely on\u00a0Medicaid,\u00a0that already has extremely steep discounts that\u00a0are required\u00a0by law. And so how much\u00a0they’d\u00a0actually be\u00a0slashing to offer the\u00a0“most favored nations”\u00a0pricing that Trump wants to the Medicaid program, it seems like that\u00a0probably\u00a0isn’t\u00a0a huge leap, and certainly we saw that Wall Street\u00a0didn’t\u00a0react with any hair on fire.\u00a0They’re\u00a0not worried about the bottom lines of these companies when these deals come out, and\u00a0they’re\u00a0avoiding tariffs for three years. So,\u00a0kind of net\u00a0positive,\u00a0seemingly.\u00a0We\u00a0don’t\u00a0have all the details of the deal\u2014\u00a0<\/p>\n Rovner:<\/strong>\u00a0Like with the Pfizer deal where we never got all the details.\u00a0<\/p>\n Edney:<\/strong>\u00a0Yeah, exactly. So,\u00a0there’s\u00a0some\u00a0stuff that we still\u00a0don’t\u00a0know, but Medicaid is the\u00a0main focus. Then\u00a0they’ll\u00a0offer, again,\u00a0some of\u00a0their drugs on\u00a0TrumpRx. So, maybe if your insurance\u00a0doesn’t\u00a0cover something, or if you\u00a0don’t\u00a0have insurance, and you want to get a drug, that might be helpful. But most people I think are going to opt to pay their lower copay than the cost of a drug that\u00a0is discounted\u00a0but still full price.\u00a0<\/p>\n Rovner:<\/strong>\u00a0Well, in case\u00a0you’re\u00a0looking for\u00a0a reason why\u00a0it might be a good thing to reshore some drug manufacturing, the World Health Organization this week warned of\u00a0potentially poisonous cough syrup<\/a>\u00a0made in India. According to one of your Bloomberg colleagues, Anna,\u00a022 children have died in the central Indian state of Madhya Pradesh\u00a0\u2014\u00a0I hope\u00a0I’m\u00a0pronouncing that close to right. And this is far from the\u00a0first time\u00a0poisonous substances have\u00a0been found\u00a0in medications made in India, right?\u00a0You’ve\u00a0done\u00a0a lot of\u00a0reporting on this.\u00a0<\/p>\n Edney:<\/strong>\u00a0Yeah, for sure, and these are\u00a0really tragic\u00a0stories that now seem to keep, particularly with\u00a0these kind of cough medicines,\u00a0keep popping up. And thankfully the FDA did put out a message saying these cough medicines in this round\u00a0were not sold\u00a0in the U.S.,\u00a0but there have been times where India has imported\u00a0some of\u00a0these. There were children in\u00a0the Gambia that died last time\u00a0\u2014\u00a0this was\u00a0a few\u00a0years ago. Because\u00a0what’s\u00a0happening is\u00a0some of\u00a0the drugmakers in India are supposed to be\u00a0purchasing\u00a0a solvent.\u00a0It’s\u00a0propylene glycol. Well, that\u00a0solvent,\u00a0that\u00a0helps the medicine\u00a0kind of all\u00a0mix together. It can be\u00a0a lot\u00a0cheaper if you buy something that looks like it but is\u00a0actually deadly,\u00a0diethylene glycol. And so\u00a0that’s\u00a0what\u00a0some of\u00a0these companies are doing,\u00a0is\u00a0saving money and substituting\u00a0a deadly ingredient. And\u00a0so\u00a0we see that this is a problem\u00a0a lot of\u00a0times with\u00a0some of\u00a0the drugmakers, and\u00a0it’s\u00a0happened,\u00a0unfortunately, particularly in India,\u00a0where the cost-cutting, the corner-cutting has\u00a0actually affected\u00a0people’s lives, and in this case, tragically,\u00a0children.\u00a0<\/p>\n Rovner:<\/strong>\u00a0Yeah.\u00a0There is reason to\u00a0kind of\u00a0want\u00a0to keep drug manufacturing where the FDA can keep an eye on it, which I know you will continue to report on.\u00a0<\/p>\n Edney:<\/strong>\u00a0For sure.\u00a0<\/p>\n Rovner:<\/strong>\u00a0Because that has been your specialty,\u00a0I know,\u00a0of late.\u00a0<\/p>\n Edney:<\/strong>\u00a0Yes.\u00a0<\/p>\n Rovner:<\/strong>\u00a0All right, that is this\u00a0week’s\u00a0news. Now we will play my Medicare open enrollment interview with Louise Norris, and then\u00a0we’ll\u00a0come back with our extra credits.\u00a0<\/p>\n I am so pleased to\u00a0welcome to\u00a0the podcast Louise Norris.\u00a0She’s\u00a0a health policy analyst at Medicareresources.org and at Healthinsurance.org and the author of\u00a0some of\u00a0the most helpful guides to health insurance out there\u00a0\u2014\u00a0and the person who keeps track of all the changes for health reporters like me. Louise, so happy to welcome you to\u00a0“What the Health?”\u00a0<\/p>\n Louise Norris:<\/strong>\u00a0Thank you so much, Julie.\u00a0It’s\u00a0a pleasure to be here.\u00a0<\/p>\n Rovner:<\/strong>\u00a0So,\u00a0we’ve\u00a0talked a lot these past few months about how the Affordable Care Act\u00a0and its potentially skyrocketing premiums for 2026 is about to happen, but we\u00a0haven’t\u00a0talked as much about some of the changes to Medicare,\u00a0for which open enrollment began this week. Now, most years\u00a0it’s\u00a0probably\u00a0OK\u00a0for Medicare recipients just to let whatever coverage they have kind of roll over. But\u00a0that’s\u00a0not the case this year, right?\u00a0<\/p>\n Norris:<\/strong>\u00a0Well, I feel like\u00a0it’s\u00a0never the best idea to just let your coverage roll over,\u00a0because there’s always plan-specific changes that people just really need to pay attention to. And even though averages might be\u00a0fairly steady\u00a0in terms of premiums and benefits, that\u00a0doesn’t\u00a0mean your plan will have a steady premium or benefits.\u00a0And for 2026,\u00a0we’re\u00a0seeing in the Medicare Advantage and Part D\u00a0\u2014stand-alone\u00a0Part D\u00a0\u2014\u00a0drug plans, there\u00a0are fewer plans available on average and\u00a0actually a\u00a0slight average decrease in premiums. But I feel like if people see that as the headline, they might be\u00a0sort of lulled\u00a0into complacency,\u00a0of like,\u00a0Oh, I just\u00a0don’t\u00a0need to look<\/em>,\u00a0when\u00a0in reality\u00a0there’s\u00a0quite a bit of variation from one plan to another. So, although the average stand-alone\u00a0Part D plan premium is\u00a0actually decreasing\u00a0slightly,\u00a0some\u00a0plans are increasing their premiums by as much as $50 a month. So, you need to really pay attention to the notice you got from your plan about\u00a0what’s\u00a0happening for 2026 and then\u00a0comparison-shop.\u00a0Comparison-shop\u00a0is always in your best interest every year.\u00a0<\/p>\n Rovner:<\/strong>\u00a0Right, because,\u00a0I mean,\u00a0people\u00a0don’t\u00a0realize that\u00a0maybe your\u00a0doctor’s\u00a0been dropped\u00a0from your Medicare Advantage\u00a0plan\u00a0or your drug has\u00a0been dropped\u00a0from your Part D plan. So, I mean,\u00a0even if your premium\u00a0doesn’t\u00a0change that much, your coverage might be changing\u00a0a lot, right?\u00a0<\/p>\n Norris:<\/strong>\u00a0Exactly. And you\u00a0don’t\u00a0want to find that out when you go to the pharmacy in January to fill your prescription and then\u00a0you’re\u00a0locked into your Part D plan for all of 2026. It’s\u00a0definitely better\u00a0to know all those\u00a0details at this\u00a0right now during open enrollment.\u00a0<\/p>\n Rovner:<\/strong>\u00a0Now there are\u00a0some\u00a0coverage changes that people are starting to feel from really a couple of years ago, yes?\u00a0<\/p>\n Norris:<\/strong>\u00a0There are. So,\u00a0there’s\u00a0some\u00a0basic changes like,\u00a0for example, the maximum out-of-pocket cost on Part D plans, which just went into effect in 2025 under the Inflation Reduction Act, it\u00a0was a $2,000 cap on out-of-pocket costs for Part D.\u00a0That\u00a0is indexed\u00a0for inflation.\u00a0So\u00a0for 2026 it goes up to $2,100.\u00a0So not a huge change but\u00a0definitely a\u00a0change people should know about.\u00a0And you do still have the\u00a0option\u00a0to work with your plan to spread that out in equal payments across all 12 months of the year instead of having to meet it right at the beginning of the\u00a0year, if\u00a0you take an expensive medication.\u00a0There’s\u00a0this change in the maximum Part D deductible, just like there is every year. This year\u00a0it’s,\u00a0for 2025, it’s\u00a0$590 is the\u00a0maximum\u00a0deductible.\u00a0It’ll\u00a0be\u00a0$615 next year. That\u00a0doesn’t\u00a0mean your plan will have a $615 deductible, but it might.\u00a0<\/p>\n But there are also plan-specific changes that vary from one plan to another.\u00a0So, for example, your Medicare Advantage plan might be adding or subtracting supplemental benefits. They might be changing the amount of your deductible or changing the amount of your inpatient hospital copay.\u00a0There’s\u00a0all sorts of changes that\u00a0aren’t\u00a0necessarily\u00a0broadly\u00a0applicable\u00a0but that apply to your plan. And then,\u00a0like you were saying,\u00a0whether or not\u00a0your doctor and hospital are still in the network, whether your prescription drug\u00a0is still covered\u00a0and covered at the same level, plans can move prescription drugs from one tier to another. So, those are all the sorts of things you really need to pay attention to now so that you can\u00a0comparison-shop\u00a0and see if something else might be a better\u00a0option.\u00a0<\/p>\n Rovner:<\/strong>\u00a0And we are seeing plans starting to\u00a0sort of drop\u00a0out.\u00a0I mean, I know at one point there was concern that there were too many plans for people to choose from, that it was, just, it was\u00a0too confusing. But now are we running the risk of having too few plans in\u00a0some\u00a0places?\u00a0<\/p>\n Norris:<\/strong>\u00a0Well, I think the concern about too many plans is\u00a0definitely valid.\u00a0For a while,\u00a0there were \u2014\u00a0it could\u00a0definitely be\u00a0overwhelming for people shopping for coverage.\u00a0For both Medicare Advantage and Part D, we do have,\u00a0overall,\u00a0an average of a reduction in how\u00a0many\u00a0plans are available for next year. There are\u00a0a few\u00a0states where the average beneficiary will\u00a0actually see\u00a0more options for Medicare Advantage, but\u00a0that’s\u00a0rare. But the average beneficiary will have access to more Medicare Advantage plans than they did before 2022, for example.\u00a0It’s\u00a0just been in the last few years that it has decreased, but it still\u00a0hasn’t\u00a0decreased below the level that it\u00a0was\u00a0in 2022.\u00a0So\u00a0it’s\u00a0still\u00a0a lot. I believe\u00a0it’s\u00a0an average of 32 plans. And then in\u00a0the Part\u00a0D, for people who buy stand-alone\u00a0Part D coverage, everybody has between eight\u00a0and 12 plans to pick from.\u00a0<\/p>\n So, if your plan is ending, you obviously need to shop for new coverage. If\u00a0you’re\u00a0on a Medicare Advantage plan and you\u00a0don’t\u00a0shop for new coverage,\u00a0you’ll\u00a0just\u00a0be automatically moved\u00a0to original Medicare on Jan.\u00a01. If\u00a0you’re\u00a0on a Medicare Advantage plan\u00a0that’s\u00a0ending,\u00a0because\u00a0your carrier is exiting the market or pulling out of your area and your plan\u00a0can’t\u00a0be renewed, you can pick any other Medicare Advantage plan\u00a0that’s\u00a0available in your area. But you also\u00a0can\u00a0do, you\u00a0can switch to\u00a0original Medicare, and\u00a0you’ll\u00a0have guaranteed issue access to Medigap, which is not normally the case. During this open enrollment period, people have guaranteed\u00a0issue\u00a0access to Medicare Advantage and Part D but not Medigap. So, for other folks whose Medicare Advantage plan is continuing, obviously\u00a0they have the\u00a0option\u00a0to switch to original Medicare. But depending on how long\u00a0they’ve\u00a0been on their\u00a0Advantage plan and what state\u00a0they’re\u00a0in, they do not have guaranteed\u00a0issue\u00a0access to Medigap.\u00a0So, that is an important thing for folks to know if their plan is\u00a0actually ending,\u00a0is that they can make that choice if they want to.\u00a0<\/p>\n Rovner:<\/strong>\u00a0We’ve\u00a0seen\u00a0a lot of\u00a0increases in health\u00a0care costs overall, and I guess\u00a0that’s\u00a0true for Medicare, too. I mean, why should people who aren’t on Medicare care about what happens to Medicare and what happens to the Medicare market?\u00a0<\/p>\n Norris:<\/strong>\u00a0First of all, hopefully all of us will eventually be on Medicare.\u00a0Almost everyone\u00a0by the time\u00a0they’re\u00a065 is on Medicare. But even if\u00a0you’re\u00a0a\u00a0long ways\u00a0away from that, it is important to know how\u00a0much\u00a0the whole Medicare sphere,\u00a0in terms of the insurance companies and the regulations, how that sort of trickles down to the rest of the commercial insurance sector. Drug price negotiation,\u00a0for example, that will have a trickle-down effect into what the insurance companies in the rest of the commercial market pay for drugs. When regulations come out for Medicare, they oftentimes,\u00a0the insurance companies follow suit in the private market, or states will follow suit in terms of how they regulate the private market. So, it certainly does matter\u00a0for\u00a0everyone, even if\u00a0it’s\u00a0not a direct effect.\u00a0<\/p>\n Rovner:<\/strong>\u00a0So even if\u00a0you’re\u00a0not 65 or helping somebody\u00a0who’s\u00a0over 65.\u00a0<\/p>\n Norris:<\/strong>\u00a0Exactly, yes, and\u00a0that’s\u00a0the other thing is\u00a0a lot of\u00a0folks who are younger are helping a parent or a grandparent navigate this, and so it really does affect most people.\u00a0<\/p>\n Rovner:<\/strong>\u00a0Yeah, it is one of the autumn tasks for\u00a0many\u00a0people.\u00a0<\/p>\n Norris:<\/strong>\u00a0Absolutely.\u00a0<\/p>\n Rovner:<\/strong>\u00a0Helping\u00a0Mom and\u00a0Dad or\u00a0Grandma and\u00a0Grandpa navigate their Medicare coverage for the following year.\u00a0<\/p>\n Norris:<\/strong>\u00a0And I do think, like you were saying earlier, as far as just letting it ride, obviously if you comparison-shop and you’re happy with your coverage and you’ve determined that it is still the best option, then,\u00a0yes, you do not need to do anything.\u00a0You just,\u00a0assuming it’s still available for renewal, you just let it renew.\u00a0But oftentimes I think people\u00a0don’t\u00a0comparison-shop,\u00a0simply because the process seems overwhelming and they just figure,\u00a0I’ll\u00a0just keep what I have.<\/em>\u00a0And of course, if you’re in that situation, you might be one of the people who’s on a Part D plan that’s increasing by $50 a month next year, or you might find out in January that your doctor’s no longer in-network with your\u00a0Advantage plan.\u00a0<\/p>\n So\u00a0if you get those notices from your plan and something\u00a0doesn’t\u00a0make sense or\u00a0you’re\u00a0confused,\u00a0it’s\u00a0much better to reach out to someone who can help you, whether\u00a0it’s\u00a0a family member\u00a0or friend,\u00a0asking them for help, or call 1-800-MEDICARE.\u00a0Call\u00a0the Medicare\u00a0SHIP\u00a0in your state. Every state has a\u00a0State\u00a0Health\u00a0Insurance\u00a0Assistance\u00a0Program\u00a0that’s\u00a0staffed with people who can answer your questions. Contact a Medicare broker in\u00a0your area. Just asking questions\u00a0and finding out the answers is a much better approach than just assuming things will work out\u00a0if you just let your plan renew.\u00a0<\/p>\n Rovner:<\/strong>\u00a0I’ll\u00a0put a link to your site also.\u00a0<\/p>\n Norris:<\/strong>\u00a0Yeah,\u00a0Medicareresources.org<\/a>.\u00a0We do have an open enrollment guide where we list\u00a0all of\u00a0the changes that are happening for 2026, the broad changes, and\u00a0we’ll\u00a0continue to update that. For example, we\u00a0don’t\u00a0yet have the Medicare Part B premiums for 2026, so as those numbers come out,\u00a0we’ll\u00a0update that guide with everything people need to know.\u00a0<\/p>\n Rovner:<\/strong>\u00a0Louise Norris, thank you so much.\u00a0<\/p>\n Norris:<\/strong>\u00a0Absolutely. Thank you so much for having me, Julie.\u00a0<\/p>\n Rovner:<\/strong>\u00a0OK,\u00a0we’re\u00a0back.\u00a0It’s\u00a0time for our\u00a0extra-credit\u00a0segment.\u00a0That’s\u00a0where we each recognize the story we read this\u00a0week\u00a0we think you should read,\u00a0too.\u00a0Don’t\u00a0worry if you miss it. We\u00a0will put the links in our show notes on your phone or other mobile device. Joanne, why don’t you go first this week?\u00a0<\/p>\n Kenen:<\/strong>\u00a0The piece I have this week is from Mother Jones, and it’s about Florida Surgeon General Dr. Joseph Ladapo. And the headline is\u00a0“From Medicine to Mysticism:\u00a0The Radicalization of Florida’s Top Doc<\/a>,”\u00a0by Kiera Butler and Julianne McShane. It’s a phenomenal read. He has stellar credentials\u00a0\u2014\u00a0Harvard, Stanford.\u00a0He was an\u00a0academic medicine MPH\u00a0[master\u00a0of public health]. He’s public health and medicine. He had this stellar traditional career. He was widely respected.\u00a0And now he is this leading voice. He’s trying to get rid of the vaccine mandates, childhood vaccine mandates,\u00a0to the whole state of Florida. He has questioned\u00a0all sorts of established public health practices. He is out there. And we’ve sort of all wondered:\u00a0How do people get to this point?\u00a0<\/p>\n And this story talks about his wife and her mysticism, and their guru healer,\u00a0who walks on their thighs to the point that\u00a0it’s\u00a0painful. And they\u00a0emerge\u00a0from this foot-walking thigh-walking thing, and his mystical experiences with this whole different take on the human experience and the role of health. I cannot begin to capture it. And here it is. It is\u00a0a long,\u00a0detailed, and fascinating read\u00a0on\u00a0his wife, who he met on an airplane, and her beliefs\u00a0in,\u00a0we bring certain things on ourselves because of who we are\u00a0and who are the ancestors that we carry. She sees auras and visions, and this is their current belief system. And it is not compatible with what\u00a0most of\u00a0us think of as science-based public health. Really\u00a0good\u00a0read. Really,\u00a0really\u00a0good read.\u00a0<\/p>\n Rovner:<\/strong>\u00a0Definitely MAHA\u00a0to the max. Anna.\u00a0<\/p>\n Edney:<\/strong>\u00a0Mine was a guest essay in\u00a0The New York Times,\u00a0“The Drug That Took Away More Than Her Appetite<\/a>,”\u00a0[by Maia\u00a0Szalavitz].\u00a0And I thought it was a\u00a0really great\u00a0look at how\u00a0some of\u00a0these obesity medications, the GLP-1s like Ozempic and others, can\u00a0be used\u00a0to treat addiction. And\u00a0so\u00a0it follows this woman who was addicted to\u00a0different kinds\u00a0of drugs at\u00a0different times. And she lost her children and all sorts of horrible things and had tried over and over again to stop using, and then has been in this program that uses a version of these GLP-1s at a lower level\u00a0\u2014 they don’t necessarily want you also losing weight\u00a0\u2014\u00a0but to treat addiction,\u00a0and just how it’s kind of been the only thing that’s worked for her. It stops the cravings,\u00a0kind of as you think it might do for people with obesity as well.\u00a0<\/p>\n I thought we\u00a0don’t\u00a0see this as much, and the companies that make these drugs\u00a0aren’t\u00a0extremely focused\u00a0on this. So I thought the article did a good job of saying why this could be really important, and looking at the fact that right now it requires federal funding of research to keep the promise alive, and hope that at some point some pharmaceutical company will be more willing to pick it up.\u00a0<\/p>\n Rovner:<\/strong>\u00a0Right now,\u00a0there’s\u00a0a lot\u00a0more money to\u00a0be made\u00a0in\u00a0the\u00a0obesity\u00a0side of this.\u00a0But\u00a0yeah, it’s\u00a0a really interesting\u00a0story.\u00a0Lauren.\u00a0<\/p>\n Weber:<\/strong>\u00a0I\u00a0actually highlighted\u00a0work from Rachana Pradhan and Samantha Liss from KFF Health News.\u00a0The article’s titled\u00a0“Senators Press Deloitte, Other Contractors on Errors in Medicaid Eligibility Systems<\/a>.”\u00a0It’s\u00a0impact from\u00a0their\u00a0great reporting<\/a>, which\u00a0I think we\u00a0talked about on this podcast earlier in the year,\u00a0about how\u00a0\u2014\u00a0talk about waste, fraud, and abuse\u00a0\u2014\u00a0that\u00a0there’s\u00a0some questionable issues with how Deloitte manages Medicaid systems and how\u00a0money’s\u00a0being wasted through them. And the senators, it looks like,\u00a0read KFF Health News’\u00a0reporting and have sent\u00a0some\u00a0letters about it. So,\u00a0great work\u00a0by the team over there, and eye-opening for sure to see,\u00a0on\u00a0some of\u00a0the dollars,\u00a0Medicaid,\u00a0that are not going to patients.\u00a0<\/p>\n Rovner:<\/strong>\u00a0Journalism impact.\u00a0My extra credit this week is a\u00a0really thoughtful\u00a0story from our fellow podcast panelist Alice Miranda Olstein at Politico.\u00a0It’s\u00a0called\u00a0“
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\n\t\t\t\t@julierovner.bsky.social\t\t\t<\/a><\/p>\n
\n\t\t\t\tRead Julie’s stories.\t\t\t<\/a><\/p>\n\n\t\tPanelists\t<\/h3>\n
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\n\tBloomberg News<\/p>\n
\n\t\t\t\t@annaedney\t\t\t<\/a><\/p>\n
\n\t\t\t\t@annaedney.bsky.social\t\t\t<\/a><\/p>\n
\n\t\t\t\tRead Anna’s stories.\t\t\t<\/a><\/p>\n<\/p>\n
\n\tJohns Hopkins University and Politico<\/p>\n
\n\t\t\t\t@JoanneKenen\t\t\t<\/a><\/p>\n
\n\t\t\t\t@joannekenen.bsky.social\t\t\t<\/a><\/p>\n
\n\t\t\t\tRead Joanne’s bio.\t\t\t<\/a><\/p>\n<\/p>\n
\n\tThe Washington Post<\/p>\n
\n\t\t\t\t@LaurenWeberHP\t\t\t<\/a><\/p>\n
\n\t\t\t\tRead Lauren’s stories.\t\t\t<\/a><\/p>\n\n
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