22-05-2025
MAHA report has food and farm industries on edge
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Driving The Day
SWEATING THE MAHA REPORT — A report expected today from Robert F. Kennedy Jr. on childhood chronic diseases could spark tension between congressional Republicans and a health secretary whose plans to tighten food industry oversight could adversely impact farm and food companies, POLITICO's Carmen Paun reports.
Republican lawmakers representing farm and food districts have warned Kennedy to lay off, but they and the industries they represent are still fretting over the report. They worry it will point to pesticides and food dyes as potential causes for kids' diseases and propose regulations that could cut profits and cost jobs. Even if Kennedy steers clear of regulatory proposals, they fear his report could dampen demand for the products their constituents make.
Why it matters: What's inside the report could spell danger for how Kennedy will interact with certain Republicans who once endorsed President Donald Trump's decision to let Kennedy 'go wild' on health care.
Lately, they've asked him pointed questions about what's coming in his Make America Healthy Again Commission's report. Kennedy has repeatedly argued that food companies make people sick for profit.
At a Senate hearing this week, Kennedy told Mississippi Republican Cindy Hyde-Smith that farmers have nothing to worry about from his report. He offered similar assurances to Republicans at a House hearing last week, including Rep. Andy Harris (R-Md.), whose Eastern Shore constituents use pesticides to protect their corn, soybeans, and wheat.
'We cannot make America healthy again without the partnership of the American farmers. We cannot be putting them out of business,' Kennedy told Harris.
Other Republicans are all-in on Kennedy's plans. During a confirmation hearing earlier this year, Alabama Sen. Tommy Tuberville told Kennedy he thought one common dye, Red No. 3, which is used in candy, drinks and chips, causes cancer. 'What in the heck's going on?' Tuberville asked.
Whether Kennedy is successful in pursuing his goal of rooting out chemicals in our food will depend on whether he can win more such allies.
What's in the report? Kennedy's report is expected to target pesticides as one of the many reasons for Americans' soaring rates of chronic disease, said one person familiar with the matter and granted anonymity because they weren't authorized to speak publicly.
Farm and food lobbyists are blowing up lawmakers' phones and ratcheting up spending as they seek to counter accusations from Kennedy and push back on the charges they fear his report will level.
Farm groups are especially peeved that the administration has essentially brushed off their concerns about how the report will treat pesticides.
'Grower groups are becoming furious that we've asked for meetings and have heard nothing,' said one person close to the pressure campaign.
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Medicaid
WHAT'S IN STORE FOR MEDICAID — In a bid to please hard-liners pushing for deeper cuts to Medicaid, House Republicans have made changes to President Donald Trump's 'big beautiful bill' that would significantly affect the program, POLITICO's Ben Leonard, Meredith Lee Hill and Robert King report.
Amendments to the megabill released Wednesday night call for moving up the start date of Medicaid work requirements from Jan. 1, 2029, to Dec. 31, 2026. The work requirements included in the previous bill would yield nearly $280 billion in savings, according to congressional scorekeepers. The new accelerated timeline could lead to additional savings of tens of billions of dollars but also result in even more people losing coverage.
The revisions would expand the criteria for states that could lose a portion of their federal payments if they offer coverage to undocumented people. It also moves to bar coverage of gender-affirming care for adults under the program, not just minors as previously proposed.
The Congressional Budget Office estimated that a previous iteration of the bill could lead to 7.6 million people who had Medicaid going uninsured, and millions more from the Affordable Care Act marketplace also losing coverage. Those coverage losses are expected to be higher with this new version.
The new amendments would make another notable change to Medicaid -— one that hard-liners hope would incentivize states to not expand their programs under the ACA after the legislation goes into effect. The wonky measures would give states a financial incentive not to expand coverage to people with higher incomes than traditional enrollees, though still near the poverty line. The policy would make higher payments to providers like hospitals for uncompensated care.
One senior GOP aide described the provision as 'a small Medicaid tweak' that would give the hard-liners a reason to support the bill, along with several other minor changes.
And in a major departure, the bill would fund cost-sharing reduction payments to insurers on Obamacare's insurance exchanges.
The new bill doesn't include controversial changes hard-liners had pushed for that would alter the federal share of spending in the joint federal-state Medicaid program.
The House Rules Committee voted to tee up the more than 1,000-page bill for overnight floor action late Wednesday, as GOP leaders race to call a passage vote before lawmakers are scheduled to leave town for a week-long Memorial Day.
AROUND THE AGENCIES
WILL VAX EUA BE REVOKED? Public health experts worry that if HHS Secretary Robert F. Kennedy Jr. revokes the emergency use authorizations of Covid-19 vaccines, it would leave children — especially those who have weak immune systems — without a tool that can protect them from the virus while the vaccine applications undergo agency review, POLITICO's David Lim reports.
Pfizer and Moderna have asked the FDA to fully approve their Covid shots for kids ages 6 months to 11 years.
But FDA Commissioner Marty Makary, one of Kennedy's top deputies and the regulator in charge of vaccines, has expressed concern that data is insufficient to understand whether the benefits of giving the shot to young, healthy children outweigh the risks.
Asked about Kennedy's plans for the emergency authorizations, HHS spokesperson Andrew Nixon said in an email: 'HHS will ensure the Gold Standard of Science is met.'
Background: On Tuesday, Makary unveiled a new framework for Covid vaccines that could make it difficult for vaccine makers to quickly obtain approval for young, healthy children.
But Kennedy allies have signaled that they want him to go further. Mary Holland, CEO at the anti-vaccine group where Kennedy worked for years, Children's Health Defense, told POLITICO last week the group continues to believe 'that there is no justification for children getting Covid vaccines' and would support Kennedy if he pulled the emergency use authorizations for the shots.
Arthur Caplan, a New York University professor of medical ethics, said that if Kennedy used his authority as HHS secretary to pull the EUAs for Covid vaccines, it would prompt an immediate fight over children's access to the shots.
'I expect Kennedy to use this in an attempt to impose what I consider an unscientific and probably unethical bar to jump over for Covid vaccines,' Caplan said, noting that kids with weak immune systems are at risk from the virus.
Covid vaccine manufacturers are pressing forward with applications seeking full approval, or licensure.
FDA ASKS PFIZER, MODERNA TO UPDATE WARNING LABELS — The FDA has asked the makers of the mRNA Covid-19 vaccines to expand the warning labels on their products to include the risk of a rare heart injury side effect, according to two letters posted by the FDA on Wednesday.
The letters, first reported by CBS News, came on the same day a Senate panel invited vaccine skeptics to the Hill to weigh in on how 'health officials downplayed' the adverse effect of myocarditis, or inflammation of the heart muscle.
Context: The FDA added a warning to Covid vaccine fact sheets in 2021 about myocarditis after a CDC safety panel determined a 'likely association' between the mRNA shots and the condition. The CDC says cases are rare but occur most often in young males.
In the letters sent to Pfizer and Moderna in April, the FDA asked the vaccine makers to expand the age group with the highest risk.
Moderna's current label warns of a high risk in males ages 18 through 24 years. Pfizer's label says the highest risk is in males 12 through 17.
The FDA is asking companies to expand the warning to males ages 16 through 25.
'Americans deserve radical transparency around the safety and efficacy of COVID vaccines and the FDA is delivering on their promise to do just that. Pfizer and Moderna should take steps to ensure that individuals are aware of COVID vaccine related adverse events resulting in myocarditis and pericarditis in their Spikevax and Comirnaty vaccines,' HHS spokesperson Andrew Nixon said in a statement.
Neither company responded to requests for comment.
In Congress
FORMER OFFICIAL: PROVIDER TAX NOT A SCAM — A former health official for two red states has warned conservative lawmakers against freezing taxes on health providers amid lawmakers' efforts to finalize President Donald Trump's domestic policy megabill, Robert reports.
Key context: Conservative GOP lawmakers and think tanks accuse states of using a loophole to levy taxes on hospitals as a loophole to get more federal money from the federal government — a practice they say is akin to legal 'money laundering.' The legislation would freeze current provider tax rates and place a moratorium on new provider taxes.
But hospital groups and states disagree, arguing that provider taxes keep rural hospitals afloat. Red states — and Trump voters — in particular might suffer.
'It is a real problem if you change these programs without thinking through how they affect rural communities,' said Alan Levine, who previously led health agencies in Florida and Louisiana under Republican governors and now serves as president and CEO of the hospital system Ballad Health, which has rural hospitals across parts of Appalachia.
In an interview with POLITICO Magazine, Levine argued the taxes aren't a scam, but a tool for states to help rural and underserved hospitals with high Medicare and Medicaid populations that already run on thin margins.
How he combated waste, fraud and abuse in Florida and Louisiana health programs: 'In both states, I worked collaboratively with the attorneys general and cracked down on Medicaid fraud.… A lot of our efforts were using computer mechanisms and technology that is ancient compared to what they have today.
'To the naked eye, when you are processing 160 million claims a year, it is not easy to catch that.
'With the use of technology, which I think [CMS Administrator Mehmet] Oz is committed to, I think you can catch a lot of those schemes and get those bad players out of the program.'
WHAT WE'RE READING
Bloomberg reports on how CVS is trying to boost vaccine sales.
The New York Times reports on a blood test for Alzheimer's.
