Senators vie to set agenda, shake up agency appointments

Who will replace Mitch McConnell as the top GOP senator? He's moving the caucus quickly to find out. Republicans senators are slated for a closed-door vote this Wednesday, just one day after they return from recess, to pick their next majority leader.

There are three leading names in the race and high stakes for who gets appointed to lead federal health agencies. Sens. John Cornyn of Texas and John Thune of South Dakota have both served as the No. 2 Republican (Thune's currently in the role) and were previously seen as frontrunners.

But Sen. Rick Scott of Florida mounted a campaign for the top spot with promises that he'd get Trump's picks for top jobs confirmed "as quickly as possible," even if that means deploying recess appointments. That process allows the president to appoint top officials if the Senate is out of session for 10 days or more, letting them sidestep the confirmation process, sometimes through a whole congressional session. But the move is ultimately temporary, and wouldn't let an appointee serve through a four-year Trump term. Both Cornyn and Thune have said they're open to that pathway as well.

Scott, with his straightforward endorsement of the plan, attracted a deluge of Trumpworld endorsements, including from Robert F. Kennedy Jr. "Without Rick Scott, the entire Trump reform agenda wobbly," the transition adviser, who says he's set to pick health agency heads, wrote on X.

the trump transition

RFK is crowdsourcing the Cabinet

RFK Jr. is wasting no time getting ready for that potential shortcut on Senate confirmations. He's already begun soliciting nominees — albeit in an unconventional way, Isabella Cueto reports.

The Trump adviser last week launched a webpage to crowdsource potential appointees for roles across the government. So far, the people's picks include a few familiar "Make America Healthy Again" faces, along with influencers, wellness entrepreneurs, and some unorthodox physicians.

Unsurprisingly, many users also want to see Kennedy in a leadership position, even if that seems unlikely. But by Monday, it seems non-MAHA internet users had found their way to the page: former official and RFK Jr.-nemesis Anthony Fauci popped up on the page, as did billionaire Harris campaign supporter Mark Cuban. More from Isa on the names you should know.

health policy

The health care industry's second spin with Trump

There's some good news and some bad coming for hospitals, insurers, and pharmaceutical companies in a second Trump presidency. Part of their fate depends on which factions of the Trump coalition win out: Will drugmakers see relief from Medicare negotiation plans, or instability from RFK Jr.'s rhetoric around the FDA and drug approvals?

Insurers and hospitals could also see vast changes to payment policies and the federal programs that oversee them. STAT's intrepid Rachel Cohrs Zhang, Bob Herman, and Tara Bannow break down some of the biggest potential priorities for the incoming Trump presidency, and how they might work.

Plus: The STAT team came together to lay out what Trump and congressional Republicans could do on a range of health care issues, from vaccine policy to health agency reforms, reproductive rights and yes, even fluoride. More from us.

lgtbq+ care

Clinicians who provide trans health care brace for Trump

Trump made restricting gender-affirming care a cornerstone of his presidential campaign. He's promised to revoke Biden policies ensuring access to this care "on day one" of his presidency, bar federal funding for procedures and ban gender-affirming care entirely for minors.

Gender-affirming care experts and transgender people, already bracing for Trump's campaign promises, are scrambling, STAT's Theresa Gaffney reports. By Wednesday morning, hours after the official election call, clinicians were already receiving messages from patients worried about access to care.

The Trevor Project, a suicide prevention organization for LGBTQ+ young people, told STAT that the number of calls, chats, and texts to its crisis line rose nearly 700% on the day after the election, as compared to the weeks beforehand. Many people in crisis directly referenced the election results. More from Theresa.

War on Recovery

The recovery community's blind spot

Thousands of institutions that claim to offer refuge from opioid addiction are among those most hostile to life-saving addiction medications, Lev Facher reports in part five of his War on Recovery series.

In recovery housing programs, residents are evicted if "caught" taking methadone or buprenorphine. In rehab and detox facilities, residents are only admitted if they aren't taking either medication or pledge to quickly wean off. In Narcotics Anonymous chapter meetings, people who take methadone or buprenorphine are told to sit in the back row or are barred from speaking.

The policy landscape hasn't helped. The federal government has never enforced a requirement that addiction treatment facilities receiving taxpayer funds offer medication. Accreditation groups that work with the government to certify rehab programs continue to green-light abstinence-only approaches. More from Lev.

industry intel

ICYMI: Another BIO departure

Pharmaceutical industry giant GSK plans to depart the biotechnology industry's largest trade group, BIO, STAT learned exclusively Friday.

The British company, known for its vaccine division, reported a decline in vaccine sales and some "short-term" pressures to investors late last month. BIO has also faced its pressures this year, including layoffs, restructuring, and a drop in lobbying spending. More from us.

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What we're reading

Coercive Care series: 'What's your pain right now?' Sickle cell, loss, and survival in America, STAT
More than 2 million voters backed both Trump and abortion access, Bloomberg
What the 2024 election looks like from the therapist's room, STAT
Inside House Dems' 11th-hour plot to sabotage Trump's agenda, Axios