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Government shutdown looms; MFN plans due Monday

September 25, 2025
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Washington Correspondent, D.C. Diagnosis Writer

This week has been crazy, and next week promises more of the same. The deadline for funding the government is midnight on Tuesday, a day after drugmakers are supposed to tell the government how they plan to bring U.S. prices in line with those abroad. But there's always room for more news tips, which you may send to John.Wilkerson@statnews.com or John_Wilkerson.07 on Signal

congress

Bracing for a government shutdown

A government shutdown might feel a lot different to Department of Health and Human Services employees under Trump than under previous administrations. 

HHS has yet to release a shutdown plan with less than a week to fund the government and the two political parties at loggerheads.

President Trump this week declined to meet with congressional Democrats to negotiate a stopgap government funding deal. Last week, Republicans and Democrats blocked each other's continuing resolutions. The Senate is scheduled to return from recess next week, two days before the funding deadline, and neither side has shown signs of budging.  

Without an HHS plan, it's difficult to know precisely how a shutdown would impact the agency. Essential services, especially those related to public safety, continue to operate during a shutdown, and programs with mandatory spending, such as Medicare, are mostly unaffected. But the White House has discretion over who is furloughed, and this administration has shown a disdain for federal employees. 

During the Clinton administration, the government shut down for a total of 26 days due to back-to-back funding lapses. Donna Shalala, who was the health secretary at the time, said she planned extensively. She lessened the blow of missed paychecks by delaying FICA tax deductions from employee paychecks. She even directed managers to regularly call all of their employees during the shutdown. 

When managers asked what they should say to employees, Shalala responded, "Just tell them you love them. Say the secretary wants you to keep in touch," she told STAT.


drug prices

Drug pricing deadline approaches

In July, President Trump asked 17 major drugmakers to submit plans for lowering prices in U.S. public health programs to levels in other rich countries, a policy called most-favored nation. The deadline for those plans is Monday, and we'll be watching to see what the companies do.

Separately, or perhaps relatedly, Bloomberg News reported that the Trump administration is creating a website to help patients buy discounted drugs directly from their makers. Drugmakers like the idea of cutting out middlemen, at least for some drugs that consumers are more likely to buy without insurance. And we should find out soon how many companies plan to tout direct-to-consumer sales as part of their plans to meet the president's demands.



nih

NCI head front-runner

Anthony Letai, a cancer researcher and doctor at the Dana-Farber Cancer Institute and Harvard University, is a leading candidate to run the National Cancer Institute, Matthew Herper and Angus Chen scoop

The choice of Letai would come as a relief to scientists, who praised him for his ability and demeanor. Matt and Angus spoke to multiple sources with direct knowledge of the situation for their story.

The NCI is the largest NIH institute and the only institute with a director appointed by the president. Read more.


vaccines

RFK Jr. is getting his way

Trump has at turns embraced health secretary Robert F. Kennedy Jr.'s vaccine skepticism or seemed at odds with it. Regardless, Kennedy is plowing ahead with big changes to vaccine policy, and Trump isn't standing in his way. Chelsea Cirruzzo and Daniel Payne have the analysis.

Days after Kennedy ousted the CDC director, Trump said the agency was "being ripped apart" over Covid vaccine policies. A week later, when Florida officials announced plans to phase out all childhood vaccine mandates, Trump struck a note of caution.  

But Trump's widely covered anti-vaccine comments on Monday signal that, all things considered, Kennedy is mostly getting his way. How much will the pair upend vaccine policy?


Medical advice

Doctor in chief

"Ask your doctor." It's one of the most-uttered phrases in medicine. It's a way of emphasizing that the practice of medicine is complicated and that medical advice should not be given without examining patients, whose conditions and situations vary considerably. 

But Trump ignored this conventional wisdom when he repeatedly and forcefully provided medical advice to the public that is at odds with the scientific consensus, telling pregnant women to avoid taking Tylenol, Jonathan Wosen and Angus Chen write.

"Presidents have a long history of giving the public advice on public health issues," said John Evans, a sociologist at the University of California San Diego who studies the relationship between science and society. "​The difference here is that there has never been a president who has taken stances that are in opposition to the vast majority of scientists and doctors."

Read more.


research

'Unreliable' source

Trump based his assertion that taking Tylenol during pregnancy can cause autism on research by a Harvard dean, who is a preeminent epidemiologist.

Andrea Baccarelli, dean of the Harvard T.H. Chan School of Public Health, was paid $150,000 to provide a review of research tying Tylenol use during pregnancy to autism as part of expert testimony in a lawsuit against Tylenol's maker. 

But when a federal judge reviewed the testimony, she concluded it was "unreliable," O. Rose Broderick reports.


drugs

Drugs vs. dietary supplements

The Trump administration announcement that it's bringing back leucovorin as a potential treatment for some people with autism resurfaced a common conundrum for consumers: go through the trouble of getting a prescription for the drug, or buy the active ingredient over the counter as a dietary supplement.

Leucovorin's approval could be a boon for supplement makers, Tara Bannow reports. Leucovorin is the trade name for folinic acid, a supplement that's sold over the counter. But there's a big difference between the medication and the supplement.

For starters, a kid would need to swallow more than 60 folinic acid tablets to get the same dose available in drug form. Read more to understand the differences between drugs and supplements and to get an explanation of why some people thought Mehmet Oz, director of the agency that runs Medicare, would profit from folinic acid sales (he won't.).


More around STAT
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What we're reading

  • Trump's 'tough it out' to pregnant women meets wave of opposition by medical experts, STAT
  • Trump administration rehires hundreds of federal employees laid off by DOGE, AP
  • Global health groups push to make cheap generic versions of an HIV prevention drug sold by Gilead, STAT
  • Why Obamacare Bills May Double Next Year, The New York Times

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