RFK Jr.'s MAHA tour

STAT's Lev Facher provides an insightful dispatch from Robert F. Kennedy Jr.'s swing through the Southwest, far from the HHS agencies that are wracked by layoffs and with scant mention of the measles outbreak that could end up defining his tenure as the nation's health secretary.

Kennedy's trip was scheduled with little notice and tacked on to his trip to Texas to attend the funeral of an unvaccinated 8-year-old girl who died of measles.

He did not visit HHS facilities, instead opting for stops that included a charter school, the Arizona Capitol where the crowd included many MAHA supporters, and an hourlong hike in Navajo Nation. Kennedy mostly talked about state legislation considered victories for the movement, such as Utah's first-in-nation ban of fluoride in tap water.

But Kennedy's public appearances were just as notable for the topics he avoided as those he discussed.

medicare advantage

Republicans are becoming more skeptical of MA

Usually, you can count on Republicans in Congress to push back against changes that would cut funding to Medicare Advantage, the private form of Medicare that was originally their brainchild.

That's no longer the case, as a STAT team of four reporters explain. Several Republicans, most of them doctors, are loudly calling on regulators to root out fraud in the program.

There are two primary dynamics driving the change of heart: budget negotiations in Congress that call for a major reduction in government savings, and the growing evidence pile of MA funny business that is becoming increasingly difficult to ignore. The story has tons of great details. Read more from Casey Ross, Tara Bannow, Bob Herman and Lizzy Lawrence.

fda

The impact of FDA layoffs on generics

It's been hard to assess the potential impact of the cutbacks at the FDA. Ed Silverman provides some granularity on a little-known but important office that was eliminated.

The Division of Policy Development in the Office of Generic Drug Policy was responsible for a host of activities that were central to ensuring generic drugs were approved properly for the American market.

The implications of its elimination will likely be felt by drugmakers and consumers. Read more from Ed.

trump administration

Requesting Kennedy's resignation

The executive director of a national public health organization is calling for Kennedy to resign weeks after Kennedy assumed the post as the nation's health secretary, Elizabeth Cooney reports.

The statement by Georges Benjamin, of the American Public Health Association, focuses on HHS layoffs. Those job cuts are "the latest example of poor and thoughtless management that will only undermine the work of our nation's top public health agencies to keep us all healthy," he wrote.

medicaid

Disagreeing to agreeing to disagree

The House last night delayed a vote on a budget blueprint that, depending on how you look at it, could set the stage for hundreds of billions of dollars in potential cuts to Medicaid, nearly no cuts, or something in between.

House Speaker Mike Johnson (R-La.) said he hopes to hold a vote on the bill today.

Even if they manage to pass the bill, Republicans are still very far apart on the amount of government spending they're willing to cut and the level of deficits they're willing to countenance.

The budget bill that Republicans are debating among themselves includes two tracks, one each for the Senate and the House. The House seeks $1.5 trillion to $2 trillion in reductions, while the Senate set a paltry $4 billion in spending reductions for itself. The House is willing to spend $4 trillion to $4.5 trillion on tax cuts, and the Senate is willing to spend up to $5 trillion.

Fiscal hawks in the House see this as their last chance to have much leverage over the final outcome, and that's why they're hesitant to go with the two-track approach.

The Senate's savings targets are low in large part because it takes 60 votes to overrule a Senate budget resolution and avoid a filibuster. In other words, Senate Republicans can't change their budget resolution now that they've passed it, without the help of Democrats. The House requires only a simple majority to alter its resolution, and House conservatives say that would allow the Senate to force its bill on the House, as, essentially, the path of least resistance.

That yawning gap offers some hope to those worried about Medicaid cuts because it means the level of cuts will likely be lower for Medicaid than was feared when the House directed its Energy and Commerce Committee to come up with $880 billion in savings, much of which would need to come from Medicaid.

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What we're reading

U.S. maternal mortality rate increased 27% over five years, NIH study finds, STAT
RFK Jr. vowed to upend American health care. It's happening faster than expected, Politico
HHS firings could face legal challenges over inaccuracies, process used to make cuts, STAT