Health Care https://washingtonsun.com/healthcare Health Care en-US Tue, 08 Sep 2026 22:30:10 GMT Challenge to Abortion Drug Heads Back to Court Ahead of Midterm Elections https://washingtonsun.com/courts/abortion-drug-court-elections Derek Hawkins, Paige Winfield Cunningham An appeals court hears oral arguments as the Trump administration considers its broader strategy for restricting access to mifepristone. Tue, 08 Sep 2026 22:30:10 GMT https://washingtonsun.com/courts/abortion-drug-court-elections Mifepristone tablets
Much of the case hangs on when the Trump administration will finalize its review of mifepristone. (AP Photo/Charlie Neibergall, File)
A federal appeals court in Louisiana is set to hear oral arguments Wednesday in a high-profile case that could limit access to a drug used in nearly two-thirds of abortions in the United States.

The court action over whether the abortion and miscarriage drug mifepristone can continue to be distributed through the mail and telemedicine appointments, coming weeks before the midterms, is legally and politically thorny for the Trump administration.

Health Secretary Robert F. Kennedy Jr. promised GOP state attorneys general a year ago that the Food and Drug Administration would review mifepristone’s safety. But the effort initially stalled amid sharp Trump administration divisions over how to handle the divisive issue in an election year.

The Justice Department is defending a Biden administration policy on mifepristone on procedural grounds at this stage, but Attorney General Todd Blanche told lawmakers during his confirmation hearing in July that the administration wants to reinstate restrictions on the drug.

Previously, patients could only get mifepristone at in-person doctor visits. The state of Louisiana, which sued the FDA last fall to reverse the Biden policy, has now asked the 5th U.S. Circuit Court of Appeals to side with it on a procedural issue as the case appears destined to return to the Supreme Court.

In its initial complaint, Louisiana argued Biden-era regulators expanded access without properly considering potential safety risks. The state also claimed the policy violated the Comstock Act, which generally bars mailing of abortion drugs.

More than 20 interest groups on both sides of the abortion debate have since intervened in the case, along with the drugmakers. After ping-ponging through the court system over the past year, oral arguments will be heard by a panel of three judges — appointees of former presidents George W. Bush, Barack Obama and Joe Biden.

The case has the potential to reshape access to medication abortions, which have become the most common method for terminating a pregnancy in the four years since the Supreme Court’s conservative majority ended the constitutional right to an abortion.

“This case isn’t just about Louisiana — it could make it much harder to get abortion pills in every state, from New York to California,” said Nancy Northup, head of the Center for Reproductive Rights. “This is not simply about convenience — for many people, telehealth could be the difference between getting an abortion and not.”

Much of the case hangs on when the Trump administration will finalize its review of mifepristone. A U.S. district judge in the underlying court case challenging the policy ruled in April that Louisiana was likely to succeed on the merits but that the litigation should be paused while the FDA conducted its review.

The FDA is required to update a district court by Oct. 7 on its progress. Anti-abortion activists say they’re still not sure whether much has been done. “Hopefully it started,” said Tom McClusky, director of government affairs for CatholicVote.

One GOP Senate staffer, granted anonymity because he wasn’t authorized to speak to the press, said: “We get the clear sense that the White House doesn’t want the report to be finalized until after Election Day.”

An FDA spokesperson told NOTUS the agency is undergoing the review. “The FDA is conducting a safety study of mifepristone and is performing a review of the mifepristone REMS [Risk Evaluation and Mitigation Strategy],” the spokesperson said. “The FDA cannot comment on potential future actions or decisions.”

Acting FDA Commissioner Kyle Diamantas called anti-abortion leaders after he took the agency’s helm last spring to assure them he’d make it happen. They said they’re hopeful that Heidi Overton, President Donald Trump’s nominee for permanent commissioner, will move the study along quickly.

Activists also hope the FDA review provides the agency with justification for reinstating the in-person dispensing requirements.

And some Republican lawmakers are looking for Blanche to follow through on the legal side. Sen. Josh Hawley (R-Missouri) pressured Blanche during a confirmation hearing in July to explain why the Trump administration had left the Biden administration’s policy in place.

Hawley asked how Blanche planned to help Republican-led states out of a tangle of litigation with the Trump administration over abortion pill access. In addition to Louisiana, several other states have challenged the approval of mifepristone or the loosening of access rules.

“We are not defending what Biden did, and will not,” Blanche said, adding that the Justice Department intended to let the FDA finish its mifepristone review.

“We’re trying to let FDA — we, meaning the Department of Justice — do their work, so that we can continue to protect the lives of the unborn children and frankly the states’ laws, like Missouri’s, which is really what’s being violated here,” Blanche testified.

Blanche’s remarks line up closely with what the Justice Department’s appellate attorneys wrote in their briefs in the 5th Circuit case. Taking a technical approach to the legal issues at play, they argued that the judges should preserve the status quo and put the litigation on hold while the FDA completes its review.

Louisiana’s lawyers, however, quoted Blanche’s own words to try to persuade the judges to rule the opposite. Blanche, they wrote, was “exactly right” when he told lawmakers the policy undercut the state’s laws.

Mifepristone, developed in the 1980s, is administered in the first 10 weeks of pregnancy and works by preventing the uterus from retaining a fertilized egg. It’s one of two pills typically taken for a medication abortion.

The pills and their broad availability through the mail have kept abortion accessible to women in states with abortion bans after the Supreme Court overturned Roe v. Wade in 2022. Under 2023 Biden administration rules, women can order the pills from a doctor in another state.

Anti-abortion activists are trying to put an immediate stop to that practice, asking Blanche to settle Louisiana’s lawsuit and block the mailing of the pills.

“Mail-order mifepristone has become a public health crisis in our country,” said Kelsey Pritchard, communications director for Susan B. Anthony Pro-Life America. “This is the opportunity to end the problem.”
]]> CDC Scrubs Two Pennsylvania Measles Deaths From Its Website https://washingtonsun.com/healthcare/rfk-cdc-scrubs-two-pennsylvania-measles-deaths-from-website Angie Orellana Hernandez The two deaths had been scrutinized by Health Secretary Robert F. Kennedy Jr., who suggested they had been wrongly classified or even fabricated. Tue, 01 Sep 2026 17:56:15 GMT https://washingtonsun.com/healthcare/rfk-cdc-scrubs-two-pennsylvania-measles-deaths-from-website CDC sign
The fatalities, flagged to the CDC by Pennsylvania on Aug. 25, are the state’s first reported measles-related deaths in 35 years. (Miguel Martinez/Atlanta Journal-Constitution via AP)
The Centers for Disease Control and Prevention removed two measles deaths in Pennsylvania from a national database just days after Health Secretary Robert F. Kennedy Jr. publicly disputed whether state officials had properly classified the cases.

The two deaths had been reflected in the CDC’s national count before being scrubbed over the weekend. The CDC said in a note posted to its website that it was reviewing “additional information regarding the circumstances and causes of death.”

Currently available information “does not establish whether measles caused or contributed to the deaths or whether the individuals died from other causes while infected with measles,” the note says. The message mirrors the questions raised by Kennedy on Aug. 26 during a public spat with Pennsylvania Gov. Josh Shapiro.

Kennedy, a vaccine skeptic who has downplayed the severity of measles outbreaks during his tenure, questioned whether the contagious disease played an active role in the deaths. He also suggested the deaths may have been “fabricated” by one of Shapiro’s staffers.

A spokesperson for the Health and Human Services department said the two deaths have not been confirmed “based on the information currently available to CDC.”

“CDC has a responsibility to ensure its reporting accurately and transparently reflects what is known and what remains unconfirmed,” the spokesperson said in a statement. “The information currently posted reflects the best available information and our commitment to transparency and telling the American people the truth—a foundational principle of the Trump Administration.”

The fatalities, flagged to the CDC by Pennsylvania on Aug. 25, are the state’s first reported measles-related deaths in 35 years. Pennsylvania has recorded almost 500 measles cases this year, according to the state Department of Health, one of the highest numbers in the country.

One of the two people who died was a newborn who state health officials said had tested positive for measles and died from a ruptured spleen. Both deaths occurred in Pennsylvania’s Lancaster County.

The deaths aggravated Shapiro, who said in a news conference Aug. 26 that there were “real-life consequences to spreading misinformation.”

“Kennedy’s actions to dismantle public health agencies and his language that undermines confidence in vetted medical guidance are contributing to these kinds of outbreaks,” Shapiro wrote on X later in the day. “Just a few years ago, Secretary Kennedy was in Lancaster downplaying the severity of measles and saying that the cure was ‘chicken soup and vitamin A.’”]]> The Push Toward At-Home Care Is Caught in Trump’s Anti-Fraud Crusade https://washingtonsun.com/healthcare/at-home-care-is-caught-trump-anti-fraud-crusade Paige Winfield Cunningham, Natalie Alms The Trump administration is holding more money from California’s home-care program than anywhere else. Mon, 31 Aug 2026 09:04:00 GMT https://washingtonsun.com/healthcare/at-home-care-is-caught-trump-anti-fraud-crusade Administrator for the Centers for Medicare & Medicaid Services Dr. Mehmet Oz speaks beside Vice President JD Vance
Vice President JD Vance and Dr. Mehmet Oz (right), administrator for the Centers for Medicare & Medicaid Services, held a news conference in May on efforts to combat fraud in federal safety net programs. (Jacquelyn Martin/AP)
Thousands of Californians unable to feed, bathe and dress themselves have struggled to find caregivers, prompting the state to swell its in-home care program.

That effort is now being thrown back in its face.

The Trump administration is citing the rapid growth of California’s in-home services as evidence of fraud, withholding more money from it than any other single health program in the country.

The administration has paused $2.2 billion in Medicaid funds to the state, most of that — $1.7 billion — for California’s In-Home Supportive Services, putting the program at risk for cuts. The funds are being held as part of the administration’s high-profile crusade against fraud in federal safety net programs, led by Vice President JD Vance.

California officials say there’s no evidence the state’s personal-care program, among the nation’s most generous, has especially high levels of fraud. They fear the Trump administration is undermining the community-based approach Democrats and Republicans have supported for decades.

“If CMS is able to point out strong or major fraud concerns, we’d be happy to know about it,” said California Medicaid Director Tyler Sadwith. “Unfortunately, they haven't done that.”

California’s expansion effort began in 2021 when the state’s auditor identified a crucial flaw in the program that pays family members and caregivers to assist more than 900,000 disabled and elderly Californians with their daily personal care.

“You feel stuck,” Ligia Andrade Zúñiga, a 47-year-old disabled San Mateo resident, told NOTUS of life without a caregiver. “The four walls of your room become like a jail.”

A 2009 car accident paralyzed Zúñiga from the chest down. Since then, she has struggled for years at a time to find a consistent caregiver. She didn’t like asking her elderly mother to help her get out of bed, use the bathroom, brush her teeth and eat breakfast — but sometimes she had to. It strained their relationship, and she felt isolated, depressed and fought thoughts of self-harm.

“One of the biggest issues in this space over the past 10 years has been lack of caregivers and not sufficient services to meet demand,” Damon Terzaghi, vice president for Medicaid advocacy and programs at the National Alliance for Care at Home, a membership organization that represents providers.

But to Vance’s anti-fraud task force — which has deferred unprecedented sums of Medicaid payments to California and Minnesota this year — California’s expansion appears nefarious.

Dr. Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services, told reporters in July that spending on in-home programs went up by 24% in California over the last two fiscal years, compared with 12% on average for the rest of the country.

California says it’s complying with CMS’s requests for more information as the agency evaluates its funding in a process that could take months or more to work through. CMS did not respond to requests for comment.

The anti-fraud task force has dialed up the government’s focus on scams and deceit to previously unseen levels. Vance has regularly issued dire threats against scammers who officials say have been bilking the nation’s safety net programs unchecked for years.

Everyone agrees there’s some degree of fraud in entitlement programs. States have always worked on prosecuting it, some more earnestly than others. And personal-care providers have indeed been convicted of Medicaid fraud at higher rates nationally than other types of health care workers.

Yet the administration’s anti-fraud work has taken a sharp political tack. So far, it has held up large sums only from California and Minnesota — but not Florida, home to many massive fraud schemes. Nor has it provided specific evidence for withholding so much from California’s home-care program, merely citing faster growth in California’s program compared to other states, as well as “statistical anomalies” in the state’s data.

Vance and other Cabinet members in the task force trumpet their largely blue-state-focused efforts ahead of the midterm elections, insisting prosecution has been insufficient and promising to root out fraud once and for all.
JD Vance (5441x3671, AR: 1.48)“We’ve got a party that is fighting for fraud, and a party that is fighting against fraud,” Vance told an audience in Milwaukee in early July. “When you come to vote in November, are you going to vote for the pro-fraud party?”

While it’s normal for the Centers for Medicare and Medicaid Services to temporarily pause some Medicaid payments to states to double-check receipts, administrations have never deferred so much money for entire categories of services, experts say.

Public health administrators are also taken aback by the administration’s targeting of home health services, fearing the Trump administration is undermining policies federal and state lawmakers have prioritized for nearly 50 years.

Former President Ronald Reagan signed a law in 1981 that pushed people from institutional care to home services, as the public health community settled on home care as the more humane and less expensive approach. In 1999, the Supreme Court found that unnecessarily institutionalizing people with disabilities is illegal discrimination under the Americans with Disabilities Act. The federal government has long interpreted that decision as requiring states to offer home- and community-based services in most cases.

Now, the Trump administration is reconsidering that legal mandate.

Earlier this summer, the Justice Department said it won’t enforce its own guidance implementing that Supreme Court decision as it writes new guidelines. It also released a memo calling into question how that decision about not institutionalizing people with disabilities has been interpreted for decades.

Oz has also repeatedly questioned whether the government should pay family members to care for loved ones at home.

“Personal care services: these help Medicaid patients do something that our families would normally do for us, like carrying groceries,” Oz said in a social media video in March about a CMS probe focused on New York, adding that the program is being abused.

He acknowledged at a July press conference that “done correctly, these programs could make sense.”

Hagar Dickman, an advocate for long-term services in California at the nonprofit Justice in Aging, said Oz’s comments show a misunderstanding of how personal care works. In most cases, to be eligible for In-Home Supportive Services, a patient must require care beyond what a typical family member with a full-time job could offer.

“The most generous interpretation of that statement is that it’s out of touch with what Americans and what Californians need financially in order to be secure in their homes,” Dickman said. “Most Californians require a two-income household.”

For the first 15 years of Amanda Andresen’s life, her mother, Rosa, didn’t know she could get paid for caring for her. Amanda’s brain lacks a critical bridge of fibers separating its left and right halves. She is 28 years old but cognitively around 15 months old.

Rosa is constantly by Amanda’s side. She keeps Amanda safe during daily seizures. She changes her diapers. She shreds Amanda’s chicken into tiny pieces that she’s able to swallow. She keeps Amanda from wandering away in the grocery store.
IMG_0459 copy.jpg (6145x4032, AR: 1.52)“From the moment she gets up, I have to help her,” Rosa told NOTUS.

After Rosa’s husband died in 2013, leaving her without income, she learned she could qualify to be paid $19.65 an hour under IHSS.

She applied, submitted to a background check and attended training. A social worker visited her home to determine how many hours of paid care Amanda qualified for. At first, Amanda was granted just two hours a day, but after Rosa appealed the decision, it was upped to roughly nine hours a day — the maximum a patient can get.

Now Rosa brings in around $5,560 a month plus smaller supplemental security income checks — enough to pay their $2,700 rent and cover living expenses with help from food stamps. To get paid, she enters her hours in an online portal. She can’t work more than 283 hours a month.

That’s unquestionably cheaper than keeping a patient in a 24-hour facility. IHSS costs Medi-Cal roughly $17,000 a year per recipient, compared to well over $100,000 for a skilled nursing facility, according to 2021 estimates by the state auditor.

“This model has been universally accepted across parties for such a long time as the most cost-effective way of providing care,” said Arnulfo De La Cruz, president of SEIU Local 2015, which represents home health workers.

Some personal-care assistants do commit fraud. States convicted far more personal-care providers last year — 326 in total — than any other type of caregiver, the Department of Health and Human Services Inspector General found. (That figure may also be influenced by the type of cases prosecutors typically pursue.)

Home health care claims were a significant part of a massive batch of prosecutions the anti-fraud task force announced in June. Nearly half of the state cases involved personal-care assistants. Missouri had the most.

In one case, St. Louis resident Patricia Busby billed Medicaid $18,278 for services she claimed to have provided to her adult daughter Christine Busby — even as both women worked as armed security guards for three- to 12-hour shifts.

Four of the cases were in California, and they all involved individuals submitting false time sheets.
Vance Fraud Task Force (4323x2882, AR: 1.50)Yet at times the administration has tripped up in its eagerness to claim fraud. A month after Oz accused New York of turning its home-care program into a “massive jobs program,” the administration admitted it had inaccurately claimed that nearly three-fourths of the state’s Medicaid enrollees use personal-care services. CMS had misidentified the state’s billing codes in its analyses.

Some IHSS advocates and patients worry the intense scrutiny on personal care — on top of legislation passed last year by congressional Republicans projected to reduce Medicaid spending by hundreds of billions — could make the program eligible for future cuts in California and beyond.

The impact could be immense: Medicaid funds well over half of all home care in the United States, according to KFF.

States must offer certain services in Medicaid, but personal care is optional, making it an easy target for reductions. Cuts have recently been on the table in California. Gov. Gavin Newsom’s budget proposal released earlier this year included millions of dollars worth of cuts to IHSS, drawing sharp pushback from the disability community before the reductions were ultimately rejected.

The state, like others, has already installed checks meant to prevent fraudsters from siphoning off taxpayer dollars, including unannounced home visits and data checks meant to catch bad actors. Providers have to log their work in a GPS-enabled electronic time sheet, as required by Congress in 2016.

Keeping fraudsters out of the program and eligible people who need assistance in it is a delicate balance, said Alice Burns, associate director of KFF’s Program on Medicaid and the Uninsured. Take guardrails away, and both eligible patients and bad actors may benefit. Add too many hurdles meant to trip up fraudsters, and enrollees may have a difficult time accessing care — a problem California and many other states have already faced.

Access to caregivers can be life altering. Zúñiga said she has a good rapport with her current caregiver, who arrives early in the morning to help her get ready for work; she runs a disability rights nonprofit, serves on a local governance board for in-home services and is on her local school board.

“I cannot serve my community,” she said, “without being able to get up out of my bed in the morning.”

Update: This story has been updated to reflect Damon Terzaghi's title change on the National Alliance for Care at Home's website.]]> Judge Blocks Trump’s Abstinence-Only Overhaul of Teen Pregnancy Prevention Program https://washingtonsun.com/courts/abstinence-only-teen-pregnancy-blocked Torrie Herrington The court, however, declined to reinstate any of the funding that had already been cut. Wed, 19 Aug 2026 19:58:43 GMT https://washingtonsun.com/courts/abstinence-only-teen-pregnancy-blocked Sex Education State Laws
The federally funded Teen Pregnancy Prevention Program was established by Congress in 2010 to fund evidence-based sexual health curricula. Rogelio V. Solis/AP
A federal judge halted the Trump administration’s recent abstinence-only overhaul of the federally funded Teen Pregnancy Prevention Program on Wednesday, throwing a wrench into the White House’s plan to accomplish a long-held goal of American conservatives.

Chistopher Cooper, a federal judge in Washington, ruled against the administration’s sweeping grant cuts to sex education programs in order to favor abstinence-only education.

“Millions of American teenagers have sex,” Cooper wrote, matter-of-fact, in the opening line of his decision.

“Alarmed by the country’s rising teenage birth rate, Congress funded grants through the Teen Pregnancy Prevention (‘TPP’) Program to support local initiatives proven to reduce teen pregnancy, as well as promising approaches that might also prove effective after further observation and study,” Cooper wrote, also saying that Congress intended for these programs to “employ a range of strategies, from encouragement of abstinence and delayed sexual activity to education about contraceptives.”

Cooper also wrote that Health and Human Services had imposed conditions on grant recipients that were unreasonable, unexplained or that Congress did not intend.

HHS did not immediately respond to a request for comment.

The program was established by Congress in 2010 to fund evidence-based sexual health curricula. The first Trump administration attempted to shorten grant periods and redirect funding toward abstinence-only-until-marriage approaches, but that triggered legal pushback from public health advocates.

In June, HHS abruptly canceled 53 out of 67 existing TPP grants — totaling roughly $68 million — citing “misalignment with agency priority” and defunding university, health department and Planned Parenthood programs across many states.

In July, the administration introduced a replacement framework shifting resources toward “reproductive goals counseling,” anatomy, fertility tracking, and abstinence rather than contraceptives.

Also in July, a coalition of organizations and local governments filed a lawsuit in the U.S. District Court for the District of Columbia, alleging HHS violated federal law by ignoring Congress' statutory mandate that the program’s funds be guided by medical and scientific evidence, not political ideology.

The court ruled in favor of the plaintiffs on the curriculum of these sex education programs and grant requirements, but did not reinstate any of the previously cut funding “because of lingering uncertainty over the Court’s power to order such relief.”]]> ‘Graveyard for Grants’: NIH Is Holding Up Medical Research Funding https://washingtonsun.com/health-science/nih-holding-up-medical-research-funding-status-19 Paige Winfield Cunningham Hundreds of grants, including for maternal health, contraceptives and drug abuse, are in limbo, subject to political reviews. Mon, 17 Aug 2026 10:00:00 GMT https://washingtonsun.com/health-science/nih-holding-up-medical-research-funding-status-19 Trump Jay Battacharya
The Trump administration is implementing more political oversight of grants. Alex Brandon/AP
It used to be that once a National Institutes of Health grant award hit “status 19,” the money was about to go out the door.

That’s not the case anymore. The Trump administration has enacted an unprecedented political review process, pushing hundreds of awards into limbo. Status 19 — an administrative code describing awards with senior leadership sign-off — is being used as the holding cell.

Current and former career staff say this extra review by senior leaders is occurring after grants have undergone peer review, been approved by multiple offices in NIH, and screened for red-flag words around race, gender or other behavioral and social sciences. The extra political reviews are required not only for newly funded grants but also for annual payment installments for previously awarded projects.

As a result, some grants are lingering in status 19 for weeks or even months, gumming up the works as grant officers try to get awards out the door ahead of the new fiscal year starting in October. Flagged grants reviewed by NOTUS had to do with maternal health, contraceptive use, aging, dementia and opioid abuse.

“The notion that Francis Collins or Mike Lauer would ever have reviewed individual grants like this is so beyond the realm of comprehension,” a senior career staffer said, referring to the former directors of NIH and its Office of Extramural Research. “It’s laughable to me.”

A second senior NIH official called status 19 a “graveyard for grants.” The NIH staffers were granted anonymity because they weren’t authorized to speak to the media.

As one of the largest grant funders in the federal government, NIH’s process is a prime example of how the Trump administration is implementing more political oversight of grants across a wide swath of agencies, even as its efforts to formalize those reviews face pushback.

Senate Republicans voted to temporarily block a White House regulation to formalize political review, which has already led to delays in posting and awarding grants at the Centers for Disease Control and Prevention, the Substance Abuse and Mental Health Services Administration, the Department of Interior and other agencies.

Researchers, patient advocates and biotech companies are outraged by the proposed regulation, which the White House is seeking to implement by Oct. 1 but could be blocked until December if the House also approves a delay.

Senior NIH leaders sent around a new agency review flowchart in May outlining additional steps once an award hits status 19. The flowchart, viewed by NOTUS, mandates a review by the NIH Office of Extramural Research (OER) and an HHS counselor before grantees are given a notice of award. There are no political appointees at OER, but its director reports to NIH Director and Trump appointee Jay Bhattacharya.

As a result of the extra reviews, the number of grants sitting for weeks in status 19 have surged. Around 8% of new grant awards are sitting in status 19 for anywhere from two to seven weeks, according to internal data shared with NOTUS.

In past years, around 11% of first-time awards had been released to the recipients within a week. This year, it’s 2%.

The delays are even more pronounced for annual payment installments for ongoing grants. The vast majority previously left status 19 within three days; now it takes 53 days to get 90% of payments out the door.

Lauer, who served as NIH’s extramural research director from 2015 to February 2025, said he couldn’t recall a time when a political appointee — including the NIH director — halted awarding of a research grant after it had gone through the review and approval process.

“Status 19 was not something I thought about,” Lauer told NOTUS.

NIH career staff stress that by the time grant awards reach status 19, they have been through dozens of editing and review steps. They’ve undergone peer review and a second look by an advisory council. Grant officers have gone through a checklist, including confirming that women and racial minorities have been appropriately included, something required by statute.

In grants reviewed by NOTUS, HHS or EOR staff flagged words including “diverse,” “equity,” “structural” and “underrepresented” and asked for clarification about what the researchers meant by them. In one project, a staffer wrote that the word “structural” could include concepts that are inconsistent with NIH priorities.

They asked for more clarification in projects that focused on health disparities or racial groups. Officials wrote that focusing on specific racial groups required more justification. In one project that expressed support for scholars and researchers from a variety of backgrounds, an official responded that the language could raise legal concerns if interpreted as targeting people based on demographics.

In multiple flagged grants, officials expressed concerns that they weren’t worth funding because their only practical use might be to support the writing of new laws.

HHS spokeswoman Emily Hilliard disputed the notion that status 19 is being used to hold up grants under extra political reviews. She said grants can remain in status 19 for five to 10 days while they are given final review by the Office of Extramural Research.

“There is no political appointee review stage in the NIH grant review process,” Hilliard said in a statement. “OER's review is a longstanding part of NIH’s grant review process.”

Lauer said releasing grant money might face occasional delays, but it was almost always because Congress had failed to pass a budget for NIH, leading to uncertainty about how much total grant funding would be available.

Trump appointees are also conducting extra layers of review to the notices posted by the government to let researchers know money is available for specific projects or programs. Researchers say they’ve seen more delays in posting those notices — another obstacle in getting grant funding out the door.

“It’s this black box of HHS review,” said Colleen Kelley, an associate dean for research at Emory University.]]> Trump Administration to End Federal Funding for Gender-Affirming Care for Children https://washingtonsun.com/healthcare/transgender-gender-affirming-care-children-federal-funding Marissa Martinez “Please remember this when you are casting your vote,” President Trump said, tying the move to the upcoming midterm elections. Tue, 11 Aug 2026 23:14:19 GMT https://washingtonsun.com/healthcare/transgender-gender-affirming-care-children-federal-funding Outside the Supreme Court
The rule blocks federal funding from going toward puberty blockers, gender-affirming hormone therapy and gender-affirming surgery. It provides an exemption for treatments related to intersex conditions or complications from prior procedures. Jacquelyn Martin/AP
The Trump administration announced a new rule that would prevent federal Medicaid and Children’s Health Insurance Program dollars from funding gender-affirming care for children after Oct. 13.

The rule, announced Tuesday, is part of a wider White House push to restrict transgender or nonbinary children from receiving gender-affirming procedures — particularly surgery, which is already a rare option for youth — and to more strictly define gender.

The rule blocks federal funding from going toward puberty blockers, gender-affirming hormone therapy and gender-affirming surgery. It provides an exemption for treatments related to intersex conditions or complications from prior procedures.

The rule also carves out up to six months of funding for those already receiving gender-affirming hormone therapy after criticism rose during the public comment period. That funding is meant to allow beneficiaries “to phase off these medications in a manner that allows for clinical discretion.”

“Children deserve our protection, not experimental interventions that can have dangerous, lifelong consequences,” Centers for Medicare and Medicaid Services Administrator Mehmet Oz said in a video announcing the rule.

“The government cannot keep signing these checks,” he continued, calling evidence for the procedures “weak.”

The rule bars funding for federal-state healthcare programs from going toward such gender-affirming care, but states can still help separately cover treatment costs. Over half of states have enacted laws limiting youth access to gender-affirming care, according to health policy organization KFF.

The agency projected a reduction in Medicaid and CHIP spending by $235 million over the next decade. More than $28 million of the roughly $31 million of Medicaid dollars spent on gender dysphoria treatment in 2023 went to hormone therapy or puberty blockers, the rule says, citing an analysis from that year. A little over $2.3 million went to inpatient or outpatient hospital services with surgery in the same time period.

Republicans at the state and federal level have moved to limit legal protections and health care access for transgender people while leaning heavily on the issue as a campaign message over the last two years. Trump on Tuesday applauded the agency’s announcement, reiterating his longstanding position against gender-affirming surgeries for children.

“Please remember this when you are casting your vote in the Midterm Elections in November,” he wrote on Truth Social.

A number of medical organizations, including the American Psychological Association, support wide access to psychological care and evidence-based treatment for transgender and nonbinary people.

Past White House efforts to curb gender-affirming care include Trump’s January 2025 order meant to cut off funding for similar treatments for people under 19, which prompted a lawsuit from Oregon, Washington state and New York.

Another coalition of states sued Health Secretary Robert F. Kennedy Jr. in December 2025 over an order that called gender-affirming treatments unsafe and ineffective and warned that doctors could be excluded from federal health programs for providing this care.]]> Medical Groups Quickly Denounce Trump’s ‘Dangerous’ Vaccine Order https://washingtonsun.com/healthcare/trump-vaccine-order-dangerous-medical-groups-warn Angie Orellana Hernandez The influential organizations roundly criticized the order for the effects it could have on children’s health. Tue, 11 Aug 2026 19:02:05 GMT https://washingtonsun.com/healthcare/trump-vaccine-order-dangerous-medical-groups-warn President Donald Trump
The White House and conservative groups have clashed with the medical establishment over vaccine guidance since Trump returned to office. Alex Brandon/AP
Numerous professional medical associations are openly opposing President Donald Trump’s executive order to reshape the nation’s childhood vaccine schedule, calling it a “dangerous” and abrupt departure from science-based recommendations.

The American Medical Association, American Academy of Pediatrics and American College of Physicians, among others, wrote in separate statements that the executive order is part of the second Trump administration’s amplification of vaccine skepticism. Health Secretary Robert F. Kennedy Jr.’s earlier attempts to change the vaccine schedule were blocked in court due to a legal challenge by the AAP.

The AAP said the order Trump signed Monday was “not only disheartening but dangerous.”

“There is no new evidence to justify significant changes to childhood immunization guidance,” the group added in a statement Monday. “Dozens of studies involving millions of people show there is no link between vaccines and autism, and yet federal leaders continue to promote this outdated, disproven idea to scare families.”

Trump’s order calls for dividing childhood vaccines into three categories, with different recommendations for who should get them, and directs federal agencies to implement the changes. It also suggested splitting up combined vaccine doses, which are currently used to limit the number of hospital visits children must undergo, into separate shots.

The White House and conservative groups have clashed with the medical establishment over vaccine guidance since Trump returned to office.

In August 2025, eight medical groups announced in a joint statement that they were removed as liaison organizations to the Advisory Committee on Immunization Practices — a move that barred them from reviewing scientific evidence and providing vaccine recommendations. The federal government deemed the eight groups “biased” at the time of their removal, the joint statement said.

Trump has recently pressured Kennedy to move more aggressively on changing the childhood vaccine schedule and probing a repeatedly debunked link between vaccines and autism, according to news reports.

At Trump’s press conference Monday, the president made a slew of misleading and unsubstantiated claims — including that babies get “72 jabs,” a number that some fact-checkers have said might refer to the number of recommended vaccine doses that a child is eligible to receive before the age of 18.

“Nothing bad can happen from what we’re doing,” Trump said Monday. “Nothing bad can happen.”

Medical groups firmly disagreed.

Willie Underwood III, the president of the American Medical Association, one of the most influential medical groups in the country, said upending a “proven vaccination schedule without credible evidence risks” would weaken public confidence and put children’s health at risk.

The changes, if enacted, could also increase costs and place a “greater burden on families needing to schedule multiple appointments for a multiple-dose MMR vaccine,” said Jan Carney, president of the American College of Physicians.

The Society for Maternal-Fetal Medicine wrote in a statement that “unnecessarily changing standard vaccinations” would negatively affect the health of mothers and children, and would “harm the health of families and communities.”

The World Health Organization, which Trump withdrew the United States from, shared a social media post Tuesday explaining why “timing matters for vaccines.” The National Foundation for Infectious Diseases and the Infectious Diseases Society of America also raised alarms that the changes were being proposed amid a resurgence of the measles.

“When vaccines become more difficult to obtain, fewer children are protected, increasing the risk that diseases long held in check can re-emerge,” NFID Medical Director Robert Hopkins said Monday. “At a time when communities across the country are confronting the return of preventable diseases, the nation should be strengthening its ability to protect children, not putting that progress at risk.”]]> Trump Executive Order Reshapes Childhood Vaccine Schedule https://washingtonsun.com/trump-white-house/trump-executive-order-reshapes-childhood-vaccine-schedule Paige Winfield Cunningham, Ben T.N. Mause RFK Jr.’s previous attempts to alter how and when children are vaccinated have been blocked in court. Mon, 10 Aug 2026 20:00:26 GMT https://washingtonsun.com/trump-white-house/trump-executive-order-reshapes-childhood-vaccine-schedule President Donald Trump
“Nothing bad can happen from what we’re doing,” President Donald Trump said while announcing the changes. Jacquelyn Martin/AP Photo
President Donald Trump signed an executive order Monday to reshape the nation’s childhood vaccine schedule after earlier changes attempted by Health Secretary Robert F. Kennedy Jr. were blocked in court.

The order calls for splitting up childhood vaccines into three categories, with different recommendations for who should get them, and directs federal agencies to implement the changes. It also proposed splitting up multiple vaccine doses, which are now used to limit the number of shots children must get, into separate shots.

“This updated recommendation finally aligns the United States with other advanced and developed nations around the world,” Trump said during the signing. “More importantly, it aligns us with common sense and knowledge.”

Trump was joined at the signing by Kennedy, deputy chief of staff Stephen Miller and Jay Bhattacharya, director of the National Institutes of Health.

Earlier this year, Kennedy bypassed a panel of vaccine advisers to pare the number of recommended childhood vaccines from 17 to 11, although courts have blocked that move thus far.

Kennedy pledged that the Department of Health and Human Services would deliver on the executive order within 90 days.

“We will keep working with urgency until American parents can have confidence that the medical advice that their government gives them is worthy of their trust,” Kennedy said.

The NIH has been overseeing a research initiative to seek possible causes of autism, which Trump and health officials announced last September. The effort — which includes 13 grants to outside researchers — won’t conclude for another two years, but Bhattacharya said over the weekend NIH will release some early results “in a couple weeks.”

“It’s not going to be a simple answer,” he said Sunday on CBS’s “Face the Nation.”

Trump, who harbors his own vaccine skepticism, has lately been pressuring Kennedy to move faster and more aggressively on enacting more changes to the childhood vaccine schedule and probing a repeatedly debunked link between vaccines and autism, according to news reports.

Yet White House officials have also sought to throttle Kennedy’s antivaccine proclivities. Both he and Bhattacharya have said in the past week that children should generally get vaccinated when questioned in television interviews about the worst measles outbreak in decades.

Bhattacharya said the order restores “autonomy of families and parents to make good decisions for their kids.”

In January, Kennedy appointed members to a federal autism advisory board who have been involved with antivaccine organizations or questioned the safety of the shots. The advisory board, created in 2000 to develop strategic plans for autism research and services, is scheduled to meet later this month.

“Nothing bad can happen from what we’re doing,” Trump said Monday. “Nothing bad can happen.”]]> An Antidote to the Anti-Vaccine Movement Lives in Rural West Virginia https://washingtonsun.com/healthcare/west-virginia-vaccinations-community-doctor-hospital Margaret Manto Growing distrust in the medical establishment is spelling trouble for public health. An answer may be in the very kind of care that’s growing more obsolete. Mon, 10 Aug 2026 09:49:00 GMT https://washingtonsun.com/healthcare/west-virginia-vaccinations-community-doctor-hospital COVID-19 vaccine
Local health officials in Summersville, West Virginia, credit Dr. Mark Tomsho for the area's high vaccination rates. Chris Jackson for NOTUS
This story was published with the assistance of the Journalism & Women Symposium (JAWS) Health Journalism Fellowship, supported by The Commonwealth Fund.

For a pediatrician, Mark Tomsho is surprisingly calm when talking about the decline of childhood vaccination rates.

“Pendulums swing, pendulums swing,” he mused, Zen-like, in his office between seeing patients one April evening. “Nothing stays the same. And I find that truth and reality usually win out.”

Tomsho has spent the last 40 years practicing medicine in the small town of Summersville, West Virginia, population less than 5,000. Nestled in the rolling hills of Nicholas County, Summersville has voted for President Donald Trump three times. It has an annual potato festival. It’s best known for coal mining and the large, man-made lake ringed with white cliffs that poaches tourists from New River Gorge National Park, a 30 minutes’ drive south.

It’s also known for its high vaccination rates. Local health officials credit Tomsho for that.

“I have seen the difference in cervical cancer rates based on who the health care provider was, because I know they were vaccinated if they saw Mark,” said Anita Stewart, health officer of the Nicholas County Health Department and a practicing OB-GYN.

West Virginia has some of the highest childhood vaccine rates of any state in the U.S., and Nicholas County routinely rivals the more populous counties that surround it in the number of vaccines distributed.

That all feels under threat now. A national movement pushing distrust in the medical establishment has ascended to the highest echelons of public health. Historic measles outbreaks have cropped up in unvaccinated communities. And the local figures like Tomsho who have long served as the backstop to that kind of pervasive politics are dwindling in numbers.

The pendulum is swinging.

Small private practices are closing at a rapid rate, making way for big hospital groups that can afford to be in rural areas like Summersville. That shift has had to happen to maintain health coverage in the often forgotten parts of the country. But it's also created a facelessness to medicine that many fear could undercut the herd immunity doctors have worked for decades to establish in their hometowns.

Without established relationships with doctors, patients are more likely to believe misinformation.

In a KFF poll, nearly 40% of people who didn’t have a trusted health care provider said they believed it is “definitely” or “probably” true that the measles-mumps-rubella vaccine causes autism in children, a claim that isn’t backed up by scientific evidence. When people did have a trusted provider, that percentage dropped to about 25%.

“People know you, and they know that you’ve extended yourself into the community, and you’ve been there and your practice has been there, both for their well-child visits and when their children are ill. They tend to trust you,” Tomsho said.
Tomsho-21 copy.jpg (2149x1432, AR: 1.50)Tomsho is soft-spoken and bespectacled, with close-cropped white hair and a more-than-passing resemblance to Anthony Fauci. His desk and office are as full and busy as his schedule; on the ground, piles of papers and medical files sit beside two framed diplomas that are unlikely, from the looks of it, to ever find a home on the wall.

“A name everyone in the county knows,” one father said of Tomsho while sitting next to his son in the waiting room. Rainbow letters above read, “The Future of the World is in This Room.”

Tomsho has practiced medicine in Summersville since July 1986. He’s treated families for generations, watching them grow and shrink. Some families said they drove more than 45 minutes to see him that day.

“Trust helps them to agree with what we recommend,” Tomsho continued. “As corporate medicine takes over, I think we’ll see less of that.”

***

Across the street from Tomsho’s office is a regional hospital where he, until recently, had admitting privileges so he could follow his young patients there if necessary. He had to stop due to health issues of his own.

The state’s largest health system, WVU Medicine, purchased the hospital in 2018.
Tomsho-27 copy.jpg (2500x1667, AR: 1.50)The hospital is a physical reminder that Tomsho, who is 70 and reluctantly considering retirement — it “crosses my wife’s mind a lot” — is a vestige of a waning kind of health care.

Tomsho’s practice doesn’t have a website; he is elusive via email. His waiting room feels almost quaint in an age where doctors are Amazon employees and AI agents. An intermittent beeping noise, like one from an AOL dial-up modem, constantly emits from behind the check-in desk.

That’s our fax machine, the receptionist tells a young parent confused by the noise. It’s “either trying to receive or send a fax.”

For a long time, West Virginia’s approach to rural health looked more like Tomsho’s office than not. In the 1800s, the state opened three local hospitals to treat miners and other industrial workers — “not something that you're going to see in other states” at that time, said Katie Thompson, a historian at the William A. Neal Museum of the Health Sciences at West Virginia University.
Tomsho-2 copy.jpg (2434x1622, AR: 1.50)“Things in West Virginia are very community based,” Thompson said. “A lot of the health care is set up in West Virginia with access in mind.”

West Virginia was one of the first states to offer community polio vaccination events in the 1950s, and doctors in the state were still doing house calls even into the 1960s, long after that practice was discontinued elsewhere.

The state passed a no-exceptions school vaccine requirement in 1937. It took until 1980 for all 50 states to pass vaccination mandates for school children. West Virginia is the only state that has, since the inception of vaccine mandates, always required all of its public school students to receive all of their shots.

The strengths of such a system were on display during the rollout of the COVID-19 vaccine, when West Virginia outpaced other states in how quickly it distributed its allocated shots.

Unlike other states, West Virginia declined to distribute the vaccine through pharmacy chains like Walgreens and CVS. Instead, it created its own network of local, independently-owned pharmacies and long-term care facilities to distribute the vaccine. The National Guard helped.

“There’s nothing like being able to help your neighbor,” one local pharmacy owner told NBC News at the time.

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Like elsewhere in the country, West Virginia has faced attempts to change its pro-vaccination policies. Gov. Patrick Morrisey is a staunch Robert F. Kennedy Jr. ally who’s pushed to align his state with the vaccine-skeptical Make America Healthy Again movement. He’s tried to weaken the state’s childhood vaccine mandates.

Public health officials say they’re fielding more questions from West Virginians about vaccines and diseases, like measles, hepatitis B and RSV.

“I think it’s certainly highlighted the importance of listening to patients and community members and others about the questions that they have related to immunization, and being able to answer them,” said Elaine Darling, who co-runs The Center for Rural Health Development.

As of spring 2026, the majority of West Virginians supported vaccines and vaccination requirements for school-aged children.

“West Virginians have a tendency to try to protect each other,” Darling said. “I think that probably does factor in quite a bit to why we're able to maintain high vaccination rates.”

Still, the state isn’t immune to the financial challenges of maintaining a localized rural health system. A report last year found that of West Virginia’s 33 rural hospitals, 13 are in danger of closing; five could close in the next two to three years.

WVU Medicine and Vandalia Health System now own 70% of the hospitals across the state, according to the West Virginia Center on Budget and Policy.
Tomsho-28 copy.jpg (1982x1322, AR: 1.50)The change has happened rapidly. Three health systems merged to form Vandalia in 2022 and 2023. WVU Medicine has doubled the number of hospitals it owns over the last four years.

In some respects, these health giants have saved struggling rural hospitals from the brink of closure. When WVU Medicine announced that it would take over the operations of the medical center in Fairmont, a town close to Morgantown, where West Virginia University is located, and reopen it while it built a new, 100-bed hospital next door, the community was happy.

“That’s a pretty big deal for people who need care in that area,” Thompson said. “I haven’t heard a lot of negative.”

But that change comes with a cost. New health providers can mean new faces, new systems and new challenges with insurance.

“That erodes the long-term trust,” Tomsho said.

***
Study after study have reached the same conclusion: The more time people spend with their doctors, the more they know them, and feel known, the more they trust the system.

Big health systems don’t always work that way. More advanced scheduling systems limit providers’ down time and result in shorter visits with patients. There’s less time to learn about their lives and build a relationship with them.

At smaller practices in more rural areas, doctors are “known as community members,” said Richard Frankel, who studies clinician-patient relationships at the Indiana University School of Medicine. “They know their patients’ families.”

“In larger communities, it’s much more anonymous, and there may well be a feeling on the patient’s part of being just a cog in a wheel,” he said.

“It’s like showing up at church and suddenly there’s a different preacher,” said Mark Hall, a professor emeritus at Wake Forest University who’s studied patient-provider relationships and health care consolidation. “It doesn’t matter that they’re a perfectly good preacher. ‘Wait, where’s my preacher?’”

A 2020 study in Pittsburgh, Pennsylvania, found that patients saw big hospital groups as “less navigable, accountable, and transparent to outsiders” — even if they also recognized that they needed these big health systems to come in and save their health institutions. They were “mostly beneficial for the long-term viability.”

***

When Tomsho first arrived in Summersville, his new neighbors weren’t so sure he’d last.

“‘Are you just going to be here a year or two and then leave like everybody else?’” he recounted being asked.

Tomsho grew up in California, started his pediatrics residency in Colorado, then transferred to Pittsburgh when his mother got sick. He came to Summersville as part of the National Health Service Corps, a program that sends doctors to rural, underserved areas. He joined because it “aligned with his ethics” and helped pay for medical school.

“I came here, visited. There was no pediatrician. So I said, ‘This is just what I want to do,’” Tomsho said. “I was starting out just fresh, and I was still young and enthusiastic.”

Tomsho-3 copy.jpg (2296x1531, AR: 1.50)Tomsho-32 copy.jpg (2500x1667, AR: 1.50)It’s easy to see why Summersville would entice a young doctor: It’s in a beautiful area, and the people are friendly. Every fall, the Army Corps of Engineers releases millions of gallons of water from Summersville Lake into the Gauley River; the ensuing “Gauley Season” of temporary whitewater rapids draws rafters from across the country. The town is quiet the rest of the year.

It was just him, a nurse and a receptionist at first. They set up in a “little tin building” that now serves as the town’s pharmacy. The original “Top Gun” was in theaters.

Tomsho had to prove himself. He wrote a column in the newspaper for a while, which helped. Word of mouth did, too. He’s given talks at the local schools and participated in local health fairs, sports physical clinics. At some point it became clear that he wasn’t going anywhere. In 2022, he was even chosen to serve as the 52nd grand marshal of the Nicholas County Potato Festival.

***

Forty years after Tomsho first started practicing medicine, West Virginia is still a place that draws a certain kind of person. A certain kind of doctor.

Kara Piechowski, a clinical pharmacist and recently-graduated physician from West Virginia, took a personal interest in the state’s vaccine policy when Morrisey pushed legislation to weaken it in 2025.

“I created a website, just a personal Google website, and coded it to where I could put all of our West Virginia legislators’ emails in one link, and then did a draft email that you could tailor,” Piechowski said. “And that link was used, like, 7,500 times to contact our state legislators.”

Piechowski said she plans to return to the state after she completes her residency. (She recently matched into a combined internal medicine and pediatrics residency program at the Ohio State University.)

The trust providers form with patients in West Virginia is “unmatched” compared to the other states where she’s worked, Piechowski said.

“You just don’t get to know patients on a level that you do here in West Virginia in a lot of, if not most, other places,” she said. “I think people say, or think at least, ‘This is someone who’s like me and has my best interests at heart, so maybe I’ll trust them.’ But that’s just a guess.”
Tomsho-24 copy.jpg (2403x1602, AR: 1.50)When asked what he’d do if West Virginia stopped requiring vaccines for public school attendance, Tomsho remained characteristically calm.

“We’ll just have to do as much of an in-office campaign, maybe a little bit in local media, about the importance of vaccines and our experience with prevention of these vaccine-preventable diseases,” he said.

Tomsho shrugs off suggestions that he personally has some kind of especially effective approach to getting people vaccinated. It’s just how it is in West Virginia. The American Academy of Pediatrics is very strong in the state, he said, and they encourage it. There’s a nonprofit rural health network that focuses on vaccinations. The insurance companies still encourage it, and Medicaid still encourages it.

Pendulums swing, pendulums swing.

But he allowed that it might also have something to do with the fact that he is simply there.

“It’s their ability to decide that empowers them, and I think that’s important to them,” Tomsho said of his vaccine-hesitant families. “We do not exclude them from the practice in any way. I just tell them, ‘I will ask you about it every visit to make sure you haven’t changed your mind.’”
]]> RFK Jr.’s Big Promise to Ban Pharmaceutical Ads Is in the Slow Lane https://washingtonsun.com/health-science/rfk-jr-big-promise-ban-pharmaceutical-ads-slow Paige Winfield Cunningham Meanwhile, drugmakers are spending more on TV ads this year than last year. Mon, 27 Jul 2026 09:34:00 GMT https://washingtonsun.com/health-science/rfk-jr-big-promise-ban-pharmaceutical-ads-slow Medication Health Ozempic
Top spenders of pharmaceutical advertising over the past year were makers of GLP-1 weight-loss drugs and drugs to treat psoriasis and Crohn’s disease. David J. Phillip/AP
Health Secretary Robert F. Kennedy Jr. has the power to stop pharmaceutical companies from advertising directly to consumers. He could do it almost instantaneously by revising the ’90s-era guidance giving drugmakers the opening to run 30-second TV ads on their products.

However, the Department of Health and Human Services is taking a different approach — one that indicates the matter is not as high on the Trump administration’s priority list as Kennedy told his supporters.

The Food and Drug Administration has posted its intent to require drugmakers to disclose all risk and safety information within ads instead of directing consumers to an external source — a way to effectively end television and radio drug ads by rendering them untenably long, experts say.

The push is through the traditional regulatory process. A senior administration official told NOTUS that the rule is “on the priority list” but there is no firm timeline to get it enacted.

“I don’t take it seriously at all,” Lars Noah, a law professor at the University of Florida who focuses on pharmaceutical regulation, said of Kennedy’s pledge to ban drug commercials.

Two days before the 2024 general election, Kennedy promised to halt the prescription drug ads millions of Americans see on their screens every day.

“Let’s get President Trump back in the White House and me to DC so we can ban pharmaceutical advertising,” he wrote on X.

Last September, President Donald Trump signed a memorandum ordering HHS to go after pharmaceutical advertising. Forcing drug companies to report all the side effects in their advertisements “might create an advertisement that’s four minutes long,” Kennedy said at the time. The FDA also sent letters to dozens of pharmaceutical companies ordering them to either halt or revise ads the agency considers misleading.

But even as Kennedy’s “Make America Healthy Again” report last year decried drug advertising, it stopped short of calling for a ban. And Kennedy himself has spent far more time talking about his efforts to prevent chronic disease with healthy eating and exercise in speeches around the country.

Nearly a year later, the drug industry’s ad spending continues to climb.

When Americans tune into cable and network news and sports games, they are increasingly likely to see ads for medications. Since Trump’s September memorandum, drugmakers have spent $5.2 billion on TV ads, according to an analysis provided to NOTUS by iSpot, a TV measurement company. That’s 8% more than the same period the year prior.

Top spenders over the past year were makers of GLP-1 weight-loss drugs and drugs to treat psoriasis and Crohn’s disease. In February alone — the month of the Super Bowl — Novo Nordisk spent $33 million on an ad for the weight-loss drug Wegovy.

The industry fiercely opposes stricter rules on drug ads. Pharmaceutical commercials can bring in revenue five times the cost of making the ad, industry analysts say. Drugmakers, who court doctors to prescribe their medications, use commercials as a way to drive demand directly among patients.

“Clearly there is value to the companies that are buying these expensive ads, otherwise they wouldn’t do it,” Noah said.

The American Medical Association and other critics of pharmaceutical advertising say ads can mislead consumers by emphasizing the benefits of treatments while downplaying negative side effects. The consumer advocacy group Public Citizen wrote Thursday to acting FDA Commissioner Kyle Diamantas, urging the agency to ban direct-to-consumer advertising.

“The advertisements appeal to patients’ emotions, distract them, and distort their perceptions of a drug’s benefits and risks,” the letter said.

Kennedy, who believes too many Americans take medications instead of fixing their underlying health, says ads convince people they need medicines they don’t.

Such ads are confusing patients and “distorting the doctor-patient relationship” by causing people to think they need medications they don’t, the FDA notice says.

Drugmakers contend that existing regulations are sufficient.

“Direct-to-consumer advertising helps patients make informed prescription medicine decisions with their health care providers,” said Andrew Powaleny, deputy vice president of public affairs at PhRMA, the pharmaceutical industry association.

PhRMA has been lobbying against Trump’s memorandum and on a bipartisan bill from Sens. Dick Durbin (D-Illinois) and Roger Marshall (R-Kansas) that would create civil penalties for online influencers saying false or misleading things about prescription drugs, according to lobbying disclosure filings.

“If this administration is serious about wanting to address DTC advertisements, I welcome ways to work together to get it done,” Durbin said in a statement provided to NOTUS.

The United States is one of just two countries that allows direct-to-consumer drug advertising. Ad spending spiked after 1997, when the FDA issued guidance allowing companies to summarize a medication’s risks briefly enough to fit into a 30-second TV spot.

Kennedy could easily rescind that guidance, experts said, although it would almost certainly be challenged in court by drugmakers. A federal judge blocked an effort during the first Trump administration to require ads to mention the drug’s price.

“I think it is unlikely that we will see drug advertising be totally banned under the current legal framework,” said Aaron Kesselheim, a professor of medicine at Harvard Medical School.

Before entering office, however, that appeared to be a legal fight Kennedy was eager to get into.]]>