Trump's NIH Plan B
With Erin Schumaker
FUNDING THROWDOWN — A federal court has temporarily blocked the Trump administration's proposed across-the-board cut to the National Institutes of Health funding for universities' 'indirect costs,' such as facilities and administration.
But even if the courts reject the plan, Trump could turn to Plan B — renegotiating the payments one university at a time, Erin reports. At stake is $4 billion, a shortfall the universities say would devastate the nation's scientific enterprise.
'Every action the administration has taken to date on this issue and in response to litigation in federal courts regarding other executive orders indicates that the administration will seek to achieve the results through other means,' said Daniel Graham, a partner at law firm McDermott Will & Emery who advises NIH grant recipients.
How so? Universities that sued to block the cuts will likely prevail, partly because Congress passed a law last year to fund the NIH, which stipulated that the agency couldn't deviate from the rates it had negotiated with them.
But the agreements universities have already reached with the government don't require the NIH to reimburse for costs that aren't 'allowable.' The Trump administration could find an example of poor documentation or a cost that shouldn't have been included in a university's proposal and argue it needs to review all NIH rate agreements to determine the scope of the problem.
What's next: While Graham doesn't think the position is legally defensible, he said he fears a 'cat-and-mouse game where the government tries to justify the result it has achieved, which is we're not going to pay more than 15 percent, by saying that it is taking some individualized grant-by-grant approach.'
WELCOME TO MONDAY PULSE. Harrison Ford dropped out of presenting at the Oscars last night after being diagnosed with shingles — a disease that 1 in 3 Americans will experience in their lifetime, according to the CDC. Send your tips, scoops and feedback to khooper@politico.com and ccirruzzo@politico.com, and follow along @Kelhoops and @ChelseaCirruzzo.
In Congress
MORE ETHICS COMMITMENTS — Senate Democrats are closely scrutinizing President Donald Trump's picks to lead the FDA and the NIH, with Sen. Elizabeth Warren (D-Mass.) requesting further ethics commitments from the nominees, POLITICO's Daniel Payne reports.
Both picks will face senators in their confirmation hearings this week.
Warren sent a letter Sunday asking Trump's choice for FDA, Johns Hopkins surgeon Marty Makary, and NIH, Stanford Medical School professor Jay Bhattacharya, to abstain from lobbying for or joining the industries they will regulate for four years after they leave office, should they be confirmed.
Key context: Democrats had also pressed HHS Secretary Robert F. Kennedy Jr. for similar commitments ahead of his confirmation hearing last month. Kennedy declined to steer clear of involvement in lawsuits against pharmaceutical companies after he leaves HHS, but he did agree to turn over to his son fees for referring clients to a law firm suing drugmaker Merck over alleged side effects from its HPV vaccine Gardasil.
Kennedy has said rooting out conflicts of interest at HHS — the parent agency of the FDA and the NIH — is a foremost priority. Warren's request from Makary and Bhattacharya suggests she shares Kennedy's concerns about industry involvement in HHS.
Warren's requests,shared first with POLITICO, also ask them to recuse themselves from any matter related to their former clients or employers if they're confirmed.
What's next: The Senate Health, Education, Labor and Pensions Committee will question Bhattacharya on Wednesday and Makary on Thursday.
AROUND THE AGENCIES
A MEASLES CALL TO ACTION — HHS Secretary Robert F. Kennedy Jr. called on health care leaders and policymakers Sunday to protect public health and make vaccines readily available amid the measles outbreak in Texas, where an unvaccinated child has died.
In a Fox News op-ed, Kennedy, who has a decades-long history of questioning vaccines and promoting anti-vaccine views, said he is 'deeply concerned' about the outbreak and touted HHS' response. He said the agency is offering technical assistance, laboratory support, vaccines and therapeutic medicine to Texas health authorities. The state has reported 146 confirmed cases since late January.
'As healthcare providers, community leaders, and policymakers, we have a shared responsibility to protect public health,' Kennedy wrote. 'This includes ensuring that accurate information about vaccine safety and efficacy is disseminated. We must engage with communities to understand their concerns, provide culturally competent education, and make vaccines readily accessible for all those who want them.'
As the outbreak has predominantly affected children, Kennedy said, 'All parents should consult with their healthcare providers to understand their options to get the MMR vaccine.' But he added that 'the decision to vaccinate is a personal one' and 'good nutrition remains a best defense against most chronic and infectious illnesses.'
Key context: The Texas Department of State Health Services recently told POLITICO that only one CDC employee — a field officer who's usually based in Austin — is in Texas helping with the measles outbreak response because the state hasn't asked for additional assistance from the federal agency, and the CDC can't send personnel unless the state requests help.
FORMER CMS OFFICIAL STRIKES BACK — An outgoing career official at the Centers for Medicare and Medicaid Services on Friday lambasted the HHS leader carrying out mass firings across the agency.
Jeff Grant, a 41-year veteran of the federal workforce who retired from CMS on Friday, sent a scathing open letter to acting HHS Chief Human Capital Officer Jeffery Anoka, who's been tasked with carrying out the Trump administration's chaotic purge of the federal workforce across the nation's health agencies. Grant, who was the deputy director for operations of the CMS division that oversees Obamacare and other programs, said in the letter that 82 of his former employees were wrongly terminated and asked that they be rehired.
'As a career federal official and senior human capital officer, you had to know that what you were doing was wrong,' Grant wrote. 'If you were ordered to write those letters, you should have refused to follow that unlawful directive.'
HHS did not respond to a request for comment.
Background: While Trump officials have cast the layoffs imposed by billionaire Elon Musk's unofficial Department of Government Efficiency as methodical decisions meant to spare HHS' core functions, people inside its agency have disputed that characterization and said the deep cuts have at times seemed indiscriminate.
In the letter, Grant disputed the termination notice that 82 of his former employees — about 15 percent of his workforce — received a few weeks ago, where Anoka claimed they were 'not fit for continued employment because your ability, knowledge, and skills do not fit the Agency's current needs, and your performance has not been adequate to justify further employment at the agency.' Grant said the fired staff members were in positions that align with Trump administration priorities, including a new proposed program integrity rule that targets fraud in the Obamacare marketplace.
Grant also emphasized that the dozens of employees fired from his division, the Center for Consumer Information and Insurance Oversight, were highly qualified, and many 'received the highest possible performance ratings.'
Abortion
PARDONED ACTIVISTS BACK TO WORK — Several anti-abortion activists recently released from federal prison vow to resume efforts to shut down the nation's abortion clinics, POLITICO's Alice Miranda Ollstein reports.
President Donald Trump pardoned nearly two dozen people in January who had broken into and blocked access to abortion clinics. At a recent online event by the anti-abortion group LiveAction, the pardoned activists urged fellow abortion opponents to join them as they plan new protests.
'Get out there, whether it's outside the clinic or inside, or wherever you need to be to actually prevent unborn children's lives from being taken,' said Herb Geraghty, a Pittsburgh-based anti-abortion activist who entered a Washington abortion clinic in 2020 to disrupt its operations and implore patients to not terminate their pregnancies.
Background: Trump's FBI and DOJ have dropped several ongoing investigations into threats against abortion clinics and issued a new memo signaling reduced enforcement going forward against such acts. Those moves indicate clinics will reemerge as a front in the battle over abortion access and a focus of a president who called himself 'the most pro-life' in history.
Geraghty, who served 17 months of a 27-month sentence before receiving a pardon he attempted to reject, told POLITICO that despite being 'traumatized' by prison, his incarceration was worth it, and he remains 'committed to nonviolent direct action in service of the pro-life cause.'
Several others pardoned by Trump said they plan to go into abortion clinics either by force or stealth to 'rescue' fetuses.
Names in the News
Alfonso Guida Jr. is joining consulting firm Healthsperien as a partner in its mental health and addiction policy practice. Guida was most recently president and CEO of Guide Consulting Services.
WHAT WE'RE READING
POLITICO's David Lim and Erin Schumaker report on HHS rescinding a policy requiring the agency to notify the public and take public comment about a broad swath of its work.
The Associated Press' Lauran Neergaard reports on Dr. Francis Collins' retirement from leading the NIH.
Reuters' Idrees Ali and Phil Stewart report on the Trump administration forcing the head of the military's health agency to retire.
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