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How to square a tobacco boost with MAHA values

March 20, 2026
March 20, 2026
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Morning Rounds Writer and Reporter

Good morning and happy Friday. I'm off today, but I'll talk to you next week. 

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Highlights from yesterday's summit

Chris Klomp speaks at the Summit. He's wearing a suit, tie, and an American flag pin.

Greg Riccardi for STAT

For me, the top moment from yesterday's event may have been the seconds-long silence after STAT's Lizzy Lawrence asked Medicare Director Chris Klomp how he and other HHS leaders are trying to combat the intense levels of turnover and discontent at the FDA.

"Great talent takes time to cultivate, and great teams take time to work together," Klomp said eventually. Read more from STAT's Tara Bannow on what else Klomp had to say about drug pricing and Medicare Advantage in his conversation with Mario Aguilar. And here are some other great quotes from the day:

  • "If the FDA were a company, you know what would happen? People would be shorting the stock," Exelixis board chairman and biotech godfather Stelios Papadopoulos said. (This was a lively conversation, in which Papadopoulos also gushed over Klomp. "This guy is amazing," he said. "He's my hero.")
  • "Whether we like it or not, social media is a primary news source for a lot of people, and that's the format in which people want to receive information," said Jessica Malaty Rivera, an epidemiologist and science communicator.
  • Robert Califf, too, is a Klomp fan. "I would go to work for that guy," he told Lizzy. Read more from Daniel about that conversation.
  • And of course, there was talk of China. "I do think we should adapt our system and restore some of our competitiveness with China," said Michel Sadelain, who directs the Columbia Initiative in Cell Engineering and Therapy. "And I hope that we'll see an evolution here very soon to allow that." Read more from Megan on that panel.

policy

Judge will rule against Kennedy's gender-affirming care declaration

A U.S. district judge in Oregon said he'll vacate a declaration made late last year by health secretary Robert F. Kennedy Jr. that asserted gender-affirming care for young trans people does not meet medical standards of care.

"The declaration itself is no mere opinion," Judge Mustafa T. Kasubhai said at the end of oral arguments Thursday. An official written decision is forthcoming.

When it was issued in December, a coalition of states immediately sued Kennedy over the declaration, calling it an overreach of Kennedy's authority. The regulation of medicine is largely left up to states, and any federal rules need to go through public notice and comment periods. Read more from me on what arguments were made and what the judge had to say about them.

first opinion

Doctors want to make IUD insertion less painful

OB-GYN Maryl Sackeim can see the anxiety on women's faces as soon as they enter her office. More and more attention has been paid to the pain that can come with IUD insertion or other gynecological procedures over the past few years. But in a new First Opinion essay, Sackeim emphasizes that many doctors increasingly can — and want to — address that pain.

"I'm not only a women's health physician; I've also been a patient," she writes. Sackeim has gone through IUD placement and removal. She's had two c-section deliveries, she's had eggs retrieved for IVF, she's had a hysterectomy. "I know firsthand," she writes, "that pain is real." Read more about how she approaches pain management with her patients.

commercial determinants

Squaring a tobacco boost with MAHA values

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Ed Reinke/AP 

An inconspicuous amendment to the 2026 farm bill working its way through Congress would make tobacco farmers eligible for funding from a certain federal aid program that they've been excluded from since the federal tobacco program ended more than 20 years ago. It's not exactly in line with the MAHA goal to lower chronic disease rates in the U.S.

The overall impact of the amendment would be relatively small, "but it amounts to subsidizing a product that kills half a million Americans every year," according to Kelsey Romeo-Stuppy, a nonprofit attorney. Despite the conflict with MAHA goals, if the amendment is included in the final bill, it would be another win for an industry that's having a good run under the Trump administration. Read more from STAT's Sarah Todd on the details.

surveys say

Majority of Americans connect alcohol to cancer

Quick: What's the first thing that comes to mind when you think of the latest Dietary Guidelines for Americans? It's probably not alcohol.

You may recall the 2025-2030 guidelines' inverted food pyramid, with a steak, a stick of butter, and a turkey crowding broccoli, frozen peas, and carrots at the top. What's missing from that image is alcohol. The final version released in January had only two bullet points on that subject: consume "less alcohol for better overall health" and no alcohol if you're pregnant, have alcohol use disorder, or take certain medications.

Still, more than half of Americans said in both February 2025 and February 2026 that drinking alcohol raises your risk of cancer, the Annenberg Public Policy Center reported yesterday. That's a jump from September 2024, when only 40% said they knew of the connection.

Why? Well, the 2025 survey was done a month after U.S. Surgeon General Vivek Murthy called for updated warning labels to alert consumers to the higher risk for at least seven types of cancer. The Annenberg Center connected the dots. — Elizabeth Cooney

science

Meat eating and dementia risk?

As Liz mentioned, the new dietary guidelines, topped with a steak, garnered mixed reactions from experts. Many were particularly troubled by the meat recommendations due to the importance of limiting saturated fat. A study on meat consumption and Alzheimer's risk, published yesterday in JAMA Network Open, adds interesting early data to the discussion, but should be considered with nuance.

Researchers analyzing data from more than 2,100 Swedish residents ages 60 and older found that for those with key gene variations (APOE 3/4 and 4/4) that increase Alzheimer's risk, eating more meat was associated with better cognitive outcomes. However, that positive association was not observed for everyone else.

"Our findings suggest that conventional dietary advice may be unfavourable to a genetically defined subgroup of the population," lead author Jakob Norgren said in a press release. It's only an observational study, and Norgren also acknowledged that there isn't much research into the connections between diet and brain health. So before you bulk order some steak, more studies are necessary.

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