Future of health policy in the United States
Director of Health Care Reform and Senior Fellow, The Century Foundation
Drew Altman
President and CEO, KFF
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CEO, Oscar Health
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Miami Herald
5 hours ago
- Miami Herald
Why young Americans dread turning 26 as they face health insurance chaos
Amid the challenges of adulthood, one rite of passage is unique to the United States: the need to find your own health insurance by the time you turn 26. That is the age at which the Affordable Care Act declares that young adults generally must get off their family's plan and figure out their coverage themselves. When the ACA was voted into law in 2010, what's known as its dependent coverage expansion was immediately effective, guaranteeing health insurance to millions of young Americans up to age 26 who would otherwise not have had coverage. But for years, Republicans have whittled away at the infrastructure of the original ACA. Long gone is the requirement to buy insurance. Plans sold in the ACA's online insurance marketplaces have no stringent quality standards. Costs keep rising, and eligibility requirements and subsidies are moving targets. The erosion of the law has now created an 'insurance cliff' for Americans who are turning 26 and don't have a job that provides medical coverage. Some, scared off by the complexity of picking a policy and by the price tags, tumble over the edge and go without insurance in a health system where the rate for an emergency room visit can be thousands, if not tens of thousands, of dollars. Today, an estimated 15% of 26-year-olds go uninsured, which, according to a KFF analysis, is the highest rate among Americans of any age. If they qualify, young adults can sign up for Medicaid, the federal-state program for Americans with low incomes or disabilities, in most but not all states. Otherwise, many buy cheap subpar insurance that leaves them with insurmountable debt following a medical crisis. Others choose plans with extremely limited networks, losing access to longtime doctors and medicines. They often find those policies online, in what has become a dizzyingly complicated system of government-regulated insurance marketplaces created by the ACA. The marketplaces vary in quality from state to state; some are far better than others. But they generally offer few easily identifiable, affordable, and workable choices. 'The good news is that the ACA gave young people more options,' said Karen Pollitz, who directed consumer information and insurance oversight at the Department of Health and Human Services during the Obama administration. 'The bad news is the good stuff is hidden in a minefield of really bad options that'll leave you broke if you get sick.' Publicly funded counselors called 'navigators' or 'assisters' can help insurance seekers choose a plan. But those programs vary by state, and often customers don't realize that the help is available. The Trump administration has cut funding to publicize and operate those navigator programs. In addition, changes to Medicaid eligibility in the policy bill recently passed by Congress could mean that millions more ACA enrollees lose their insurance, according to the Congressional Budget Office. Those changes threaten the very viability of the ACA marketplaces, which currently provide insurance to 24 million Americans. In dozens of interviews, young adults described the unsettling and devastating consequences of having inadequate insurance, or no insurance at all. Damian Phillips, 26, a reporter at a West Virginia newspaper, considered joining the Navy to get insurance as his 26th birthday approached. Instead, he felt he 'didn't make enough to justify having health insurance' and has reluctantly gone without it. Ethan Evans, a 27-year-old aspiring actor in Chicago who works in retail, fell off his parents' plan and temporarily signed up for Medicaid. But the diminished mental health coverage meant cutting back on visits to his longtime therapist. Rep. Maxwell Frost, a Florida Democrat and the first Gen Z member of Congress, was able to quit his job and run for office at 25 only because he could stay on his mother's plan until he turned 26, he said. Now 28, he is insured through his federal job. 'The ACA was groundbreaking legislation, including the idea that every American needs health care,' he said. 'But there are pitfalls, and one of them is that when young adults turn 26, they fall into this abyss.' Back in 2010, the decision to make 26 the cutoff age for staying on a parent's insurance was 'kind of arbitrary,' recalled Nancy-Ann DeParle, deputy chief of staff for policy in the Obama White House. 'My kids were young , and I was trying to imagine when my child would be an adult.' Before that time, children were often kicked off family plans at much younger ages, typically 18. The Obama administration's idea was that young adults were most likely settling into careers and jobs with insurance by 26. If they still didn't have access to job-based insurance, Medicaid and the ACA marketplaces would offer alternatives, the thinking went. But over the years, the courts, Congress, and the first Trump administration eviscerated provisions of the ACA. By 2022, a shopper on a federal government-run marketplace had more than 100 choices, many of which included expensive trade-offs, presented in a way that made comparisons difficult without spreadsheets. Jack Galanty, 26, a freelance designer in Los Angeles, tried to plan for his 26th birthday by seeking coverage on the California insurance marketplace that would ensure treatment for his mild cerebral palsy and for HIV prevention. 'You're scrolling for what feels like years, looking at 450 little slides, at the little bars, and trying to remember, 'Was the one I liked No. 12 or 13?'' he recalled. 'It feels like it's nearly impossible to make a good choice in this scenario.' Out-of-pocket expenses have soared. Complex plans in the lightly regulated marketplaces featured rising premiums, high deductibles, and requirements that patients pay a significant portion of the cost of care, often 20% — a charge known as coinsurance. More than half of Americans ages 18 to 29 have incurred medical debt in the past five years, a KFF Health News data investigation found. Few have the reserves to pay it off. The networks of doctors to choose from in these plans are often so limited that an insured person struggles to get timely appointments. It can even be hard to find the official websites amid an explosion of look-alikes operated by commercial brokers. Sharing her contact information with one site that appeared legitimate left Lydia Herne, a social media producer in Brooklyn, 'drowning' in texts and phone calls offering plans of uncertain and unregulated quality. 'It never ends,' said Herne, 27. Young Invincibles, an advocacy group representing young adults, runs its own 'navigator' program to help young people choose health insurance plans. 'We hear the frustration,' said Martha Sanchez, the group's former director of health policy and advocacy. 'Twenty-six-year-olds have had negative experiences in a process that's become really complex. Many throw up their hands.' Elizabeth Mathis, 29, and Evan Pack, 30, a married couple in Salt Lake City, turned to the marketplaces two years ago, after Pack went uninsured for a 'really scary' year after he turned 26. 'Every time he got in the car, I thought, 'What if?'' Mathis said. The couple pays more than $200 a month for a high-deductible health plan backed by a federal subsidy (the kind set to expire next year). It's a significant expense, but they wanted to be sure they had access to contraception and an antidepressant. But last year, Pack suffered serious eye problems and underwent an emergency appendectomy. Their plan left them $9,000 in debt, for medical care billed at over $20,000. 'Technically, we gambled in the right direction,' Mathis said. 'But I don't feel like we've won.' The ACA was supposed to help consumers find affordable, high-quality plans online. The legislation also tried to expand Medicaid programs, which are administered by states, to provide health insurance to low-income Americans. But the Supreme Court ruled in 2012 that states could not be forced to expand Medicaid. Ten states, led mostly by Republicans, have not done so, leaving up to 1.5 million Americans, who could have qualified for coverage, without insurance. Even where Medicaid is available to 26-year-olds, the transition has often proved precarious. Madeline Nelkin of New Jersey, who was studying social work, applied for Medicaid coverage before her 26th birthday in April 2024 because her university's insurance premiums were more than $5,000 annually. But it was September before her Medicaid coverage kicked in, leaving her uninsured while she fought a chest infection over the summer. 'People tell you to think ahead, but I didn't think that meant six months,' she said. When Megan Hughes, 27, of Hartland, Maine, hit the cliff, she went without. An aide for children with developmental delays, she has a thyroid condition and polycystic ovary syndrome. She looked for a health care plan but found it hard to understand the marketplace. (She didn't know there were navigators who could help.) Now she can't afford her medicine or see her endocrinologist. 'I'm tired all the time,' Hughes said. 'My cycles are not regular anymore at all. When I do get one, it's debilitating.' She is hoping a new job will provide insurance later this year. Traditionally, most Americans with private health insurance got it through their jobs. But the job market has changed dramatically since the ACA became law, particularly in the wake of the pandemic, with the rise of a gig economy. Over 30% of people ages 18 to 29 said in recent surveys that they were working or have worked in short-term, part-time, or irregular jobs. The ACA requires organizations with 50 or more employees to offer insurance to people working 30 hours per week. This has led to a growing number of contract employees who work up to, but not past, the hourly limit. Many companies, which say they can't afford the rising costs of traditional insurance, offer their employees only a modicum of help, perhaps around $200 per month toward buying a marketplace plan, or a bare-bones company plan. Young people juggling part-time jobs and insurance options face bumpy, daunting transitions. In Oklahoma, Daisy Creager, 29, has had three employers over the past three years. Insurance was important to her, not least because her former husband had Type 1 diabetes. As she left the first of those jobs, her husband's endocrinologist helped the couple stockpile less expensive insulin from Canada, since they would be uninsured. After a few months, they bought a marketplace plan, but it was expensive and 'didn't cover a lot,' she said. When she found a new job, she dropped that plan, only to discover that her new insurance coverage didn't start until the end of her first month of employment. The couple would be uninsured for a few weeks. A few days later, she came home to find her husband unconscious on the floor, in a diabetic coma. After hovering near death in an intensive care unit for four days, he woke up and began to recover. 'I think I've done everything right,' Creager said. 'So why am I in a position where the health insurance available to me doesn't cover what I need, or I can barely afford my premiums, or worse, at times I don't even have it?' Kathryn Russell, 27, developed excruciating back pain two months before her 26th birthday. After extensive testing, doctors determined she needed a complex surgery, which her surgeon couldn't schedule until after she would be off her family's insurance plan. Forget the pain and the fear of the operation, she said, it was insurance that kept her up at night. 'There's this impending terror of, 'What am I going to do?'' she recalled. (One day before she turned 26, her father's company agreed to keep her on his plan for six more months, if he paid higher premiums.) The idea that the ACA would offer a variety of good options for people turning 26 has not worked as well as the legislation's authors had hoped. The 'job lock' tying insurance to employment has long plagued the United States workforce. Young adults need guidance on their options beforehand, said Sanchez of Young Invincibles. None of those interviewed for this story, for example, knew there were navigators to help them find insurance on the online marketplaces. Experts agree that the marketplaces need stronger regulation. In 2023, the federal government defined clearer standards for what plans in each tier of insurance should offer, such as better prescription drug benefits, defined copays for X-rays, or coverage for emergency room visits. Certain types of basic care, such as primary care, should require just a small copay for at least a small number of initial visits. Each insurer must offer at least one plan that complies with these new standards for every level, known as an 'easy pricing' option or a 'standard plan.' Most plans on the marketplaces don't meet these criteria. Federal and state regulators had long planned to cull such 'noncompliant' plans, gradually — fearing that doing so too quickly would scare insurers away from participating. But with the priorities of the new Trump administration now in focus, and a Republican majority in Congress, it's far from clear what course President Donald Trump, who sought to repeal the ACA outright in his first term, will take. There are hints: Subsidies to help Americans buy insurance, adopted during the Biden administration, are set to expire at the end of 2025 unless the Republican-led Congress extends them. If the subsidies expire, premiums are likely to rise sharply for plans sold on the marketplaces, leaving insurance out of reach for many more young adults. KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism.
Miami Herald
a day ago
- Miami Herald
Even in states that fought Obamacare, Trump's new law poses health consequences
GOP lawmakers in the 10 states that refused the Affordable Care Act's Medicaid expansion for over a decade have argued their conservative approach to growing government programs would pay off in the long run. Instead, the Republican-passed budget law that includes many of President Donald Trump's priorities will pose at least as big a burden on patients and hospitals in the expansion holdout states as in the 40 states that have extended Medicaid coverage to more low-income adults, hospital executives and other officials warn. For instance, Georgia, with a population of just over 11 million, will see as many people lose insurance coverage sold through ACA marketplaces as will California, with more than triple the population, according to estimates by KFF, a health information nonprofit that includes KFF Health News. The new law imposes additional paperwork requirements on Obamacare enrollees, slashes the time they have each year to sign up, and cuts funding for navigators who help them shop for plans. Those changes, all of which will erode enrollment, are expected to have far more impact in states like Florida and Texas than in California because a higher proportion of residents in non-expansion states are enrolled in ACA plans. The budget law, which Republicans called the 'One Big Beautiful Bill,' will cause sweeping changes to health care across the country as it trims federal spending on Medicaid by more than $1 trillion over the next decade. The program covers more than 71 million people with low incomes and disabilities. Ten million people will lose coverage over the next decade due to the law, according to the nonpartisan Congressional Budget Office. Many of its provisions are focused on the 40 states that expanded Medicaid under the ACA, which added millions more low-income adults to the rolls. But the consequences are not confined to those states. A proposal from conservatives to cut more generous federal payments for people added to Medicaid by the ACA expansion didn't make it into the law. 'Politicians in non-expansion states should be furious about that,' said Michael Cannon, director of health policy studies at the Cato Institute, a libertarian think tank. The number of people losing coverage could accelerate in non-expansion states if enhanced federal subsidies for Obamacare plans expire at the end of the year, driving up premiums as early as January and adding to the rolls of uninsured. KFF estimates as many as 2.2 million people could become uninsured just in Florida, a state where lawmakers refused to expand Medicaid and, partly as a result, now leads the nation in ACA enrollment. For people like Francoise Cham of Miami, who has Obamacare coverage, the Republican policy changes could be life-altering. Before she had insurance, the 62-year-old single mom said she would donate blood just to get her cholesterol checked. Once a year, she'd splurge for a wellness exam at Planned Parenthood. She expects to make about $28,000 this year and currently pays about $100 a month for an ACA plan to cover herself and her daughter, and even that strains her budget. Cham choked up describing the 'safety net' that health insurance has afforded her — and at the prospect of being unable to afford coverage if premiums spike at the end of the year. 'Obamacare has been my lifesaver,' she said. If the enhanced ACA subsidies aren't extended, 'everyone will be hit hard,' said Cindy Mann, a health policy expert with Manatt Health, a consulting and legal firm, and a former deputy administrator for the Centers for Medicare & Medicaid Services. 'But a state that hasn't expanded Medicaid will have marketplace people enrolling at lower income levels,' she said. 'So, a greater share of residents are reliant on the marketplace.' Though GOP lawmakers may try to cut Medicaid even more this year, for now the states that expanded Medicaid largely appear to have made a smart decision, while states that haven't are facing similar financial pressures without any upside, said health policy experts and hospital industry observers. KFF Health News reached out to the governors of the 10 states that have not fully expanded Medicaid to see if the budget legislation made them regret that decision or made them more open to expansion. Spokespeople for Republican Gov. Henry McMaster of South Carolina and Republican Gov. Brian Kemp of Georgia did not indicate whether their states are considering Medicaid expansion. Brandon Charochak, a spokesperson for McMaster's office, said South Carolina's Medicaid program focuses on 'low-income children and families and disabled individuals,' adding, 'The state's Medicaid program does not anticipate a large impact on the agency's Medicaid population.' Enrollment in ACA marketplace plans nationwide has more than doubled since 2020 to 24.3 million. If enhanced subsidies expire, premiums for Obamacare coverage would rise by more than 75% on average, according to an analysis by KFF. Some insurers are already signaling they plan to charge more. The CBO estimates that allowing enhanced subsidies to expire will increase the number of people without health insurance by 4.2 million by 2034, compared with a permanent extension. That would come on top of the coverage losses caused by Trump's budget law. 'That is problematic and scary for us,' said Eric Boley, president of the Wyoming Hospital Association. He said his state, which did not expand Medicaid, has a relatively small population and hasn't been the most attractive for insurance providers — few companies currently offer plans on the ACA exchange — and he worried any increase in the uninsured rate would 'collapse the insurance market.' As the uninsured rate rises in non-expansion states and the budget law's Medicaid cuts loom, lawmakers say state funds will not backfill the loss of federal dollars, including in states that have refused to expand Medicaid. Those states got slightly favorable treatment under the law, but it's not enough, said Grace Hoge, press secretary for Kansas Gov. Laura Kelly, a Democrat who favors Medicaid expansion but who has been rebuffed by GOP state legislators. 'Kansans' ability to access affordable healthcare will be harmed,' Hoge said in an email. 'Kansas, nor our rural hospitals, will not be able to make up for these cuts.' For hospital leaders in other states that have refused full Medicaid expansion, the budget law poses another test by limiting financing arrangements states leveraged to make higher Medicaid payments to doctors and hospitals. Beginning in 2028, the law will reduce those payments by 10 percentage points each year until they are closer to what Medicare pays. Richard Roberson, president of the Mississippi Hospital Association, said the state's use of what's called directed payments in 2023 helped raise its Medicaid reimbursements to hospitals and other health institutions from $500 million a year to $1.5 billion a year. He said higher rates helped Mississippi's rural hospitals stay open. 'That payment program has just been a lifeline,' Roberson said. The budget law includes a $50 billion fund intended to insulate rural hospitals and clinics from its changes to Medicaid and the ACA. But a KFF analysis found it would offset only about one-third of the cuts to Medicaid in rural areas. Trump encouraged Florida, Tennessee, and Texas to continue refusing Medicaid expansion in his first term, when his administration gave them an unusual 10-year extension for financing programs known as uncompensated care pools, which generate billions of dollars to pay hospitals for treating the uninsured, said Allison Orris, director of Medicaid policy for the left-leaning think tank Center on Budget and Policy Priorities. 'Those were very clearly a decision from the first Trump administration to say, 'You get a lot of money for an uncompensated care pool instead of expanding Medicaid,'' she said. Those funds are not affected by Trump's new tax-and-spending law. But they do not help patients the way insurance coverage would, Orris said. 'This is paying hospitals, but it's not giving people health care,' she said. 'It's not giving people prevention.' States such as Florida, Georgia, and Mississippi have not only turned down the additional federal funding that Medicaid expansion brings, but most of the remaining non-expansion states spend less than the national average per Medicaid enrollee, provide fewer or less generous benefits, and cover fewer categories of low-income Americans. Mary Mayhew, president of the Florida Hospital Association, said the state's Medicaid program does not adequately cover children, older people, and people with disabilities because reimbursement rates are too low. 'Children don't have timely access to dentists,' she said. 'Expectant moms don't have access nearby to an OB-GYN. We've had labor and delivery units close in Florida.' She said the law will cost states more in the long run. 'The health care outcomes for the individuals we serve will deteriorate,' Mayhew said. 'That's going to lead to higher cost, more spending, more dependency on the emergency department.' KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism.
New York Times
a day ago
- New York Times
Kennedy's Next Target: the Federal Vaccine Court
For nearly 40 years, a special federal court system has compensated Americans who prove they were harmed by vaccines while also protecting the manufacturers from litigation. Even the staunchest defenders of the Vaccine Injury Compensation Program agree it needs reform. It is slow, understaffed and can feel adversarial to families legitimately in need. Now Health Secretary Robert F. Kennedy Jr. plans to overhaul the program, saying he will make it more efficient and speedier for Americans seeking payment. He said in a social media post last month that the vaccine court had 'devolved into a morass of inefficiency, favoritism and outright corruption.' Parents who believe their children were injured by vaccines are 'facing the monumental power and bottomless pockets of the U.S. government,' he said. Mr. Kennedy has also claimed, falsely, that the compensation program prevents families from suing vaccine makers in traditional courts. And he has claimed that the vaccine court punishes and intimidates expert witnesses and petitioners' attorneys. Experts fear that some of the changes Mr. Kennedy has hinted at could lead to an onslaught of lawsuits, jeopardizing the manufacture of vaccines and undermining their use. 'Kennedy can fix this system without burning it down,' said Tony Yang, a health policy expert at George Washington University. But Mr. Kennedy sounds 'more like a frustrated lawyer who lost cases than an eager secretary trying to fix things.' Indeed, allies of the secretary have fared poorly in the vaccine court. Their litigation in traditional courts — including a 2022 lawsuit in which Mr. Kennedy delivered closing arguments — also has fallen short. The Department of Health and Human Services did not respond to repeated requests for comment. Public health officials in the United States have been tracking vaccine safety for decades and have long said that shots routinely given to children are safe. But all vaccines have at least occasional side effects, and there are rare instances of serious injury. Congress set up the vaccine court in 1986 after a spate of lawsuits began to drive vaccine makers out of the market. So-called special masters judge claims of injuries from vaccines, weighing the available evidence. The program covers most routine immunizations given to children and pregnant women, and is funded by a small tax on each shot. The vaccine court has paid $5.4 billion in claims since its inception, awarding compensation in about 42 percent of the roughly 28,000 claims filed. But in accordance with a great body of scientific evidence, the court's special masters have denied thousands of claims that childhood vaccines are linked to autism. Mr. Kennedy, a prominent vaccine skeptic, believes that there is such a link and has long accused government officials of hiding the risks. Some reforms widely seen as necessary would require Congress to intervene. Among them: more of the special masters who preside as judges over cases. The legislation establishing the program allowed for three; five more were added later. But at least double that number are needed to adjudicate the roughly 1,200 applications each year, according to some experts. The program also needs more staff to review medical records, and an online system for families to track the status of their claims. The compensation fund has a $4 billion surplus, some of which could be applied to remedy these problems. Mr. Kennedy said in an interview last month that he wanted to ensure families seeking compensation 'get it very quickly, and they get it without the kind of adversarial impediments that have now been erected over the past 40 years.' A new fast-track system for rare injuries that studies have definitively linked to certain vaccines could speed up the process. In the current system, government lawyers sometimes fight families over settled links, said Altom Maglio, an attorney who has represented people in the vaccine court for 25 years. 'Fighting tooth and nail is just not appropriate, and doesn't meet the goals,' he said. At the same time, special masters sometimes make awards even when the connection between a side effect and vaccine is tenuous, said Dr. Daniel Salmon, director of the Institute for Vaccine Safety at Johns Hopkins Bloomberg School of Public Health. 'There are a lot of things that are being compensated where there's inadequate evidence,' Dr. Salmon said. 'We need more science.' Mr. Kennedy has also suggested that injury claims regarding Covid-19 shots should be moved to the vaccine court. At present, those claims are piling up in a parallel federal system called the Countermeasures Injury Compensation Program. Of more than 14,000 injury claims filed regarding Covid vaccines, only 69 have been paid out. More than 9,400 are pending, and about 4,800 have been dismissed. Congress would need to act to move those claims to the Vaccine Injury Compensation Program. But adding the large Covid backlog to the vaccine court's own poses huge challenges, Dr. Yang said: 'You're complaining about your kitchen sink, it's clogged, and then you try to wash your bike in it.' There are some aspects of the program that Mr. Kennedy can change without Congress. That includes altering the official table detailing the injuries presumed to be linked to certain vaccines. Changing the table to say that certain vaccines cause autism or asthma, months or years after shots, for example, could hobble the system, opening the doors to tens of thousands of new claims that would previously have been dismissed. 'He's talking about opening a can of worms that could result in Americans losing access to some vaccines and huge expenditures in court fees,' said Dr. Thomas R. Frieden, a former director of the Centers for Disease Control and Prevention. Mr. Kennedy has said, falsely, that the vaccine court is the 'exclusive remedy' for families seeking compensation. In fact, claimants can sue vaccine makers in traditional courts if the government does not respond to them within 240 days, or if they are dissatisfied with its offer of compensation. But the traditional courts have not been any more generous to Americans who believe they were injured, said Renee Gentry, director of the Vaccine Injury Litigation Clinic at George Washington University. 'The idea that going to straight to civil litigation means you're going to win is absurd,' Ms. Gentry said. 'These are incredibly difficult cases.' She believes her clients are better off in the vaccine court. Mr. Kennedy has been deeply involved in litigation over vaccines for years. For example, he worked on lawsuits against Merck over claims related to the Gardasil vaccine, which protects against the human papilloma virus. As health secretary, Mr. Kennedy initially planned to keep his financial stake in the litigation. But he relinquished those earnings to an adult son following controversy at his confirmation hearing. Senator Elizabeth Warren, Democrat of Massachusetts, also pressed him to pledge to refrain from suing pharmaceutical companies after he leaves government. 'I'm not going to agree to that,' Mr. Kennedy said. His harsh criticism of the program — and claims that it is corrupt — appear tied to his steadfast support to people who have lost in the court with unproven claims that vaccines cause autism, said Dorit Reiss, a law professor at the University of California, San Francisco, who has followed the cases. Rolf Hazlehurst, who was until recently a lawyer with Children's Health Defense, the anti-vaccine group Mr. Kennedy founded, has litigated his son's case for 22 years, claiming that the measles vaccine and thimerosal, a preservative, caused his son's autism. The case has failed in forum after forum. Mr. Kennedy became involved in 2022, when claims were brought in a Tennessee court against the pediatrician who in 2001 inoculated Mr. Hazlehurst's child. Mr. Kennedy delivered the closing argument. The jury sided with the doctor. Mr. Kennedy has also recently hired at H.H.S. — and has defended — David Geier, who has for years pushed the discredited theory that thimerosal caused autism. Mr. Geier's attempts to bill the vaccine court for his expertise regarding vaccine injuries were often challenged. One judge determined in 2016 that Mr. Geier's report was 'neither useful nor relevant, because he is not qualified as an expert concerning the matters he discusses.' Mr. Kennedy also has hired another Children's Health Defense alumna, Lyn Redwood, who presented inaccurate data that thimerosal caused autism at recent meeting of scientific advisers to the C.D.C. The panelists, newly appointed by Mr. Kennedy, voted to withdraw endorsements of the few flu vaccines in which thimerosal is an ingredient. Some experts are concerned that Mr. Kennedy may open the door to at least one proposal already pending in Congress — to abolish the Vaccine Injury Compensation Program altogether. 'I think he's been really clear,' said Richard Hughes IV, a lawyer who represents vaccine makers. 'He would be fine with the total collapse of the program.'
