Introduction

In his recent “Trumpapalooza” speech, HHS Secretary Robert F. Kennedy Jr. peevishly said that Democrats had “abolished my uncle’s physical fitness test because they said that competition was bad for children.”

He was referring to a program called the Presidential Fitness Test that existed before John F. Kennedy took office. In 1956, President Dwight D. Eisenhower issued an Executive Order creating the President’s Council on Youth Fitness with the goal of improving the physical fitness of America’s kids. This led to the establishment of the Youth Fitness Project by the American Alliance for Health, Physical Education, and Recreation and in 1958, they published the first official Youth Fitness Test.

The Youth Fitness Test, which had an assortment of elements involving running, jumping, sit-ups, and other activities, has undergone a number of changes over the years. However, when Democratic administrations made any changes, Republicans quickly and invariably demonized the efforts.

Let’s take a look at how the program evolved and the Republican hypocrisy about efforts led by Democrats.

John F. Kennedy through Ronald Reagan

In December 1960, shortly before he took office, Kennedy published an article in Sports Illustrated titled, “The Soft American” in which he decried the waning physical fitness of American kids. “The harsh fact of the matter is that there is … an increasingly large number of young Americans who are neglecting their bodies—whose physical fitness is not what it should be—who are getting soft,” Kennedy wrote. “And such softness on the part of individual citizens can help to strip and destroy the vitality of a nation.”

He changed the name of Eisenhower’s program to the President’s Council on Physical Fitness, expanding its focus beyond children. He began a nationwide public service advertising campaign, promoting physical fitness across all age groups.

When Lyndon B. Johnson took office, he created the Presidential Physical Fitness Award Program, the first presidential program acknowledging young people who met minimum requirements on a series of fitness tests. Throughout the 70s and 80s, the test was modified, removing some components and adding others.

During this time, one of the chief criticisms of the program was that it excluded kids who were physically challenged. While the program was continued and expanded during the Carter and Reagan administrations, the focus remained on top performers.

The Clinton and Obama Years

When he took office, Bill Clinton changed the aim of the program to include all children, not just high performers. With programs like “Get Off It!” and “Get Up, Get Out!”, Clinton’s programs de-emphasized the award aspect of the program and promoted physical activity, in general.

When Barack Obama became president, he retired the award program entirely and, in 2010, First Lady Michelle Obama established “Let’s Move!”, which remained focused on physical activity and nutrition. The website featured resources for healthy eating, an active lifestyle, and physical fitness. “In the end, as First Lady, this isn’t just a policy issue for me,” Obama wrote. “This is a passion. This is my mission. I am determined to work with folks across this country to change the way a generation of kids thinks about food and nutrition.”

In an NPR Morning Edition segment titled, “Checking Up On Michelle Obama’s Anti-Obesity Effort”, Myra Gutin of Rider University pointed out how unique Michelle Obama’s effort was:

Gutin says Michelle Obama goes further than her predecessors: “She has partners from Major League Baseball to Wal-Mart, and no other first lady initiative that I can think of had that kind of support from the corporate world.”

She also engaged celebrities in her effort. For example, Beyoncé rewrote her song “Get Me Bodied” for a workout video aimed at kids, and renamed it “Move Your Body”:

Conservatives Lose Their Minds

The Obamas’ decision to retire the fitness award program stemmed, in part, from research showing many kids felt excluded from participating. One study detailed the “fatphobia” experienced by many kids. Some recalled that during physical education classes, they often felt “humiliated, vulnerable, or incompetent.”

That didn’t stop Republicans from attacking both the President and the First Lady. Here’s more from NPR:

Glenn Beck, Rush Limbaugh and Sarah Palin have all attacked Michelle Obama’s program directly.

“Instead of a government thinking that they need to take over [and] make decisions for us according to some politician or politician’s wife’s priorities — just leave us alone. Get off our back,” Palin has said.

During the Super Bowl telecast, viewers in Washington, D.C., saw an ad against a proposed soda tax that struck a similar tone — without mentioning Obama’s program specifically.

“Give me a break. I can decide what to buy without government help,” the woman in the ad says. “The government is just getting too involved in our personal lives.”

As Tom Bartlett wrote for The Atlantic, “Fox News pundits such as Glenn Beck and Sean Hannity portrayed Let’s Move as a nanny-state plot to control the American diet, a slippery slope to the criminalization of french fries.”

The Los Angeles Times has more:

Radio talk show host Rush Limbaugh last week suggested Obama is a hypocrite for dining on ribs, and remarked on her waistline in the process. That was just the latest offering in what has been a steady diet of criticisms.

“Leaders are supposed to be leaders,” Limbaugh said. “If we are supposed to eat roots, berries and tree bark, show us how.”

Critics have carped about Obama’s spread at her Super Bowl party — and have suggested that the child-nutrition legislation she backed in Congress would bring about the end of school bake sales. Her work with the National Restaurant Assn. to develop healthier menu items has been decried in some circles as a government takeover of business.

Trump and RFK Jr. Take Us Back

All of which brings us to today. In his ongoing effort to take America back in time, Trump has joined the “🤬 Your [Kids’] Feelings” crowd. In 2025 he issued an Executive Order reinstating the Presidential Fitness Test, saying, “These next few years will be a golden age of athletics.”

Trans athletes need not apply.

During the signing ceremony for his Executive Order, Trump took the opportunity to slam the Obamas. “We had the Obama administration which phased out this wonderful tradition of physical fitness. Thank you, Barack, very much. Great job,” he said sarcastically. “But we’re bringing it back. We’re bringing it back.”

This is despite his stated belief that exercise drains the body’s “finite” energy resources and his claim that he exercises “like about one minute a day, max, if I’m lucky.”

The Hypocrisy Zone

Trump’s petulant effort to undo the accomplishments of Michelle and Barack Obama is just part of the hypocrisy of his administration and his sycophantic supporters. People who once decried the Obamas’ work to reduce sugary drinks and snacks in the diets of our nation’s kids as “the nanny state” telling us what to do are silent as RFK Jr. works to do the same thing. His “Eat Real Food” initiative is largely just a rebranding of previous efforts. At a MAHA event last year, he said, “I urge every governor to champion legislation that bans ultra-processed foods and dyes in public schools, and submit a waiver to the USDA to remove soda from SNAP.”

It all sounds vaguely familiar…

It’s very hard to see how Kennedy’s MAHA efforts are any different than the so-called nanny state directives Republicans derided not long ago. His rhetoric on this issue sounds so much like the things Michelle Obama said in promoting her “Let’s Move!” program that it verges on plagiarism.

In the end, encouraging healthy eating and an active lifestyle, especially for kids, is something we can all get behind. But let’s not pretend that this was an idea only Trump or Kennedy could conceive of. In fact, as a concept, a presidential focus on kids’ health and fitness predates even Kennedy’s famous uncle.

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From there, the conversation turns to the ongoing legal battle over mifepristone access. We break down last week’s developments in the Louisiana case against the FDA, which seeks to ban telehealth prescribing of the medication nationwide, and a separate case out of Texas and Florida aiming to revoke the drug’s FDA approval entirely.

We also spotlight HHS’s decision to cancel Office of Minority Health grants funding infant mortality prevention, cancer screening, and postpartum home visits — reportedly to redirect resources toward erectile dysfunction and sperm count research. Second, revelations about Senator Dr. Roger Marshall of Kansas, a former OBGYN who, while in private practice, sued roughly 700 of his own patients and had more than 80 arrested over unpaid medical bills as small as $101. On a brighter note, they highlight a $100 million philanthropic commitment from the Walton family aimed at cutting the U.S. maternal mortality rate in half by 2031.

Kristin and Erin sit down with Skye Perryman, President and CEO of Democracy Forward, an organization that has sued the Trump administration hundreds of times and WON the majority of those cases. Skye walks through two active lawsuits: one challenging changes to Title X family planning funding alongside Planned Parenthood, and another defending teen pregnancy prevention grants in Hennepin County, Minnesota, a program with a strong evidence base that the administration is attempting to redirect toward unproven, ideologically driven approaches. Skye explains what’s legally and practically at stake in both cases, and why she sees them as part of a broader pattern of using politics to override science-based healthcare policy.

Skye then discusses her new book, Ordinary People, Extraordinary Times, a practical guide for people who want to get involved but don’t know where to start. She offers concrete ways listeners can plug into advocacy work at whatever level fits their time and capacity.

The episode wraps with reminders about voter registration deadlines ahead of the midterms and a call for listeners to stay engaged in the fight for evidence-based reproductive healthcare

LINKS

• Rolling Stone: Olivia Rodrigo’s Daisy Chain Fields Festival Raises $10 Million for Women and Girls Nonprofits

• Rolling Stone: Melinda French Gates Doubles Olivia Rodrigo’s Daisy Chain Fields Donation to $20 Million

• The Hill: States sue Trump administration over family planning grant changes

• Dept. of Justice: Challenges illegal Trump administration conditions on funding for reproductive health care, cancer screenings

• Roll Call: Cassidy says abortion pill makers turn blind eye to safety

• Mirror Indy: Indiana’s abortion ban has a ‘chilling effect’ on ER pregnancy care

• Stars and Stripes: Lawsuit over sexual assault aboard Navy transport ship dismissed as worker’s comp issue

• KCTV: New Missouri law allowing pregnant women to get divorced may cause custody dispute complications

• PBS News Hour: Custody fight over baby born via surrogate sparks fear of fertility treatment restrictions

• Virginia Mercury: If Va.’s reproductive rights amendment passes, challengers say they’ll fight to overturn it in court

• Check your voter registration status

FOLLOW THE DOCS ON SOCIAL MEDIA

• Dr Kristin Lyerly (@drkristinlyerly)

• Dr Erin Stevens (@erinstevensmdobgyn)

• Dr Chris Ford (@doc_4ord)

Join the fight at committeetoprotect.org.

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We pick apart his dubious claims about falling obesity rates (spoiler: it's GLP-1s, not MAHA), and his framing around NIH funding cuts that are actually being redirected away from cancer and drug research.

We also dig into RFK Jr.'s claims about censorship and "silenced doctors," farm policy fallout from USAID cuts, and what it all says about who he's really trying to impress as rumors swirl about his job security after the midterms.

LINKS

• FOX 4 Dallas-Fort Worth has the full video. Watch at your own risk

• CNN: Fact check: Trump, RFK Jr. and others make false claims on night 2 of GOP convention

Meanwhile, RFK Jr. finally admits that a second infant in Lancaster County, Pennsylvania, died of measles, after weeks of disputing the story, then argues the death “doesn’t count” because the child had a rare genetic condition. Rob explains why that logic is both medically dishonest and deeply cruel.

We also dig into new reporting revealing a secretive Pentagon agreement to divert billions of dollars from NIH’s infectious disease research budget without notifying Congress. Plus, new reporting exposes Kansas Senator Roger Marshall’s history of suing more than 700 of his own OB-GYN patients over unpaid medical bills, resulting in dozens of arrests. And forced Medicare Advantage disenrollments have surged nationwide as insurers like Humana, UnitedHealth, and Aetna abandon unprofitable markets, leaving seniors scrambling for new coverage.

Then, Will Sommer of The Bulwark joins us to take stock of the MAHA movement, mapping out the key figures orbiting RFK Jr.’s inner circle and explaining who actually holds influence in this chaotic era of U.S. health policy.

LINKS

• The Washington Sun: ‘It’s Trumpapalooza’

• The Washington Sun: Trump Offers $5,000 ‘Dividend’ to Every American Adult if Republicans Win Midterms

• Matt Rein’s tweet about the “L” falling off the podium at Trump-a-palooza

• The New York Times: Inside the D.O.J.’s Investigation of Fauci and Other Virus Scientists

• The Washington Post: Infant died of measles in Pennsylvania, coroner confirms

• RFK Jr. tweet shrugging off the deaths of the two Pennsylvania babies from measles

• MS NOW: Report: Kennedy intervened to prevent 2 deaths from being included in CDC measles tally

• House Democrats: Defense Officials Attempt to Raid NIH Funds to Cover Department of Defense Activities

• The Hill: Pentagon sought to divert NIH funds for defense use, top House Appropriations Democrat says

• MedPage Today: Docs Alarmed by NIH Plan to Redirect Medical Research $$ to Pentagon

• CIDRAP: Lawmakers criticize deal that would send NIH funds to Department of Defense

• FORBES: ‘Secretive’ Agreement Will Divert NIH Funds To Pentagon, Warns DeLauro

• The “agreement” between NIH and the DoD

• The New York Times: A Doctor Sued 700 Patients for Debts; 81 Were Arrested. Now He’s a Senator.

• JAMA: Forced Disenrollments Among Medicare Advantage Beneficiaries Following 2026 Plan Exits

• 24/7 Wall St: Being Forced Out of a Medicare Advantage Plan Was a 1% Event for Years. In 2026 It Hit 10%. The 2027 Letters Must Arrive by October 2.

• National Committee to Preserve Social Security & Medicare: Trouble Ahead for Medicare Advantage & Medicaid Patients

• Investopedia: Millions Must Switch Medicare Advantage Plans as Insurers Pull Back—What It Means for You

• Healthcare Dive: UnitedHealthcare expects to be ‘very competitive’ in Medicare Advantage next year, CFO says

• The Bulwark

• Will Sommer’s False Flag newsletter

• Will Sommer on X

• KFF Health News: The Covid Contrarian Clubhouse Makes Its Mark on Trump’s Washington

Join the fight at committeetoprotect.org.

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Have thoughts, questions, or your own health care story? Email us at feedback@pagingamerica.org.

grift

[grift] / grɪft /

Noun

1. (sometimes used with a plural verb) a group of methods for obtaining money falsely through the use of swindles, frauds, dishonest gambling, etc.

2. money obtained from such practices.

Introduction

The fact that the Trump administration is chock full of already-wealthy people enriching themselves with our tax dollars and other resources is a bit of a dog-bites-man story. Whether it’s Trump and his own kids making millions off cryptocurrency and merchandise schemes or administration officials receiving massive financial donations in exchange for favors or power, there’s a new scheme every week, it seems.

However, the most morally egregious of these grifts are the ones impacting health care and public health in general. Let’s take a look at some of the worst ones.

The Nursing Home Industry

Nursing home companies and industry executives gave nearly $4.8 million to MAGA Inc., a pro-Trump PAC, beginning in August 2025, including $750,000 each from PruittHealth Corporation and a subsidiary of the Ensign Group. The donations turned out to be an investment in getting the Trump administration to overturn a Biden administration rule requiring increased nursing home staffing levels. The rule was an effort to reduce neglect among residents which had resulted in injuries and other dangerous health outcomes. They had already gotten a 10-year moratorium when Trump signed his One Big Beautiful Bill Act into law. But that wasn’t enough for the multibillion dollar nursing home industry staring at numerous lawsuits over their dangerous facilities.

They wanted the rule killed forever.

The New York Times picks up the story from here:

Later that same month, a handful of nursing home executives who had given the biggest donations joined industry lobbyists at Mr. Trump’s golf club in suburban Washington to plead their case, according to campaign finance filings and people familiar with the meeting.

Over light lunch fare, the contingent “urged the president to formally repeal the harmful minimum staffing mandate, which would have surely forced providers throughout the country to close their doors to new residents — or possibly close their doors altogether,” Bill Weisberg, the founder and chief executive of Saber Healthcare Group, recounted in a text message to The New York Times.

Less than one month after the lunch meeting, Trump administration lawyers quietly stopped defending the pending staffing rule in court against challenges from the industry.

That wasn’t the end of it. Just before the end of the year, the nursing home industry saw their investment truly pay off. In a statement that echoed industry talking points, the Centers for Medicare & Medicaid Services announced they were rescinding the rule completely.

And so it was that an industry that pays its executives multimillion dollar salaries was able to buy influence and avoid staffing its facilities in a way that ensures patients are protected and safe. By one estimate, the rule they torpedoed would have saved 13,000 lives a year.

Extremity Care

Following $3 million in donations to pro-Trump Super PACs in 2024, Extremity Care, a medical products company that makes very pricey “skin substitute” bandages, gave $5 million to MAGA Inc. in February 2025. (By “very pricey”, we’re talking around $10,000 per square inch.) The company’s CEO, Oliver Burckhardt, also contributed $2.5 million to MAGA Inc. on the same day.

A week later, Burckhardt attended a small private event with Trump at Mar-a-Lago:

At the dinner, Mr. Burckhardt got a chance to speak briefly to the president and other guests about himself and the work of his company, Extremity Care, which makes pricey medical products including paper-thin bandages made of dried bits of placenta, according to three people who spoke on the condition of anonymity to describe the private event. He also brought copies of a flier urging the Trump administration to reverse a plan to restrict Medicare reimbursement for the bandages and criticizing former President Joseph R. Biden Jr. for having “rammed through a policy that would create more suffering and death for diabetic patients on Medicare.”

The next morning, Mr. Trump posted the flier on his social media site.

It was not just symbolic.

About one month later, the Trump administration announced it would delay until next year the Biden administration plan to limit Medicare’s coverage of the bandages, known as skin substitutes, saying that it was reviewing its policies.

Subsequently, Extremity Care or one of its affiliates dropped $2.5 million on Trump’s ballroom project. Given that Medicare payments for skin substitutes rose from $256 million in 2021 to $10 billion last in 2025 and Extremity Care received a sizable chunk of that spending, their investments in Trump’s pay-to-play scheme have paid massive dividends.

Big Tobacco

In May of this year, the FDA approved fruit-flavored vapes under the Orwellian excuse that it would tamp down on underage use of e-cigarettes. This didn’t happen by accident, of course. If you’re thinking there must have been some sort of quid pro quo involved, you’re absolutely correct. The New York Times is reporting that a Big Tobacco company made a $5 million donation to Trump’s MAGA Inc. super PAC just before the FDA announced its decision:

The tobacco company Reynolds American donated $5 million to a super PAC backed by President Trump last month, about one week before his administration rolled out a new policy that could prove lucrative to the tobacco industry.

The donation, which came through a Reynolds subsidiary and brings to $8 million the total donated by the subsidiary to MAGA Inc., the Trump-backed super PAC, was revealed in a campaign finance report filed Wednesday night.

The Times says two days after the donation, Trump had lunch with several tobacco company executives where they complained about how the FDA was regulating them. “Mr. Trump interrupted the conversation to call Dr. Marty Makary, the FDA commissioner,” the Times reports. When Makary didn’t pick up, he called RFK Jr. and Dr. Oz to share the Big Tobacco executives’ complaints with them. The decision on the fruit-flavored vapes came days later.

Not to leave nicotine pouches out of all the fun, the FDA also changed its rules to allow Philip Morris to market its Zyn products as “lower risk” compared to other forms of tobacco. You could almost hear the cheers from the corporate boardroom. It’s no wonder that, as MedPath points out, “Philip Morris expects Zyn pouches to make eight times the gross profits of its cigarettes.”

But the grift doesn’t end there. KFF Health News reported that the president bought stock in multiple tobacco companies this year:

Since late 2023, MAGA Inc. has received over $20 million in funding from the [tobacco] industry, federal campaign records show. Trump’s inauguration garnered nearly $4 million more. His ballroom project has disclosed donations of an unknown amount from Altria and Reynolds American.

Recent Trump administration actions show he’s followed through with his [pro-tobacco] campaign rhetoric. In May, the FDA released consequential guidance that allows manufacturers to market their vapes and nicotine pouches while awaiting agency approval. It also approved several vaping products. The month before, the Vapor Technology Association, which donated $1.25 million to Trump’s inauguration, told its vape-manufacturer members it had met with the White House to discuss its concerns.

By that point, Trump had gone on a stock-purchasing spree. In March he made eight separate purchases of Philip Morris or Altria stock.

KFF reports that Trump grew his stock holdings this year to as much as $1.64 million in Philip Morris, alone.

Kratom

Kratom is an herbal extract from the leaves of an evergreen tree. It is sold in gas stations, vitamin stores, vape shops, and other retail stores as an energy booster, mood lifter, and pain reliever. In high enough doses, it can produce opioid- and stimulant-like effects.

It is not approved or legally regulated by the FDA but it is still legal in over 40 states so long as it’s not sold as a dietary supplement, food additive, or approved drug.

Kratom is also addictive, can cause liver damage, seizures, and life-threatening respiratory depression, and is linked to thousands of deaths.

Oregon Senator Ron Wyden sent a letter to HHS Secretary RFK Jr. where he said a “quid-pro-quo seems to be unfolding between the Trump Administration and the kratom industry.” In his letter, Wyden focused on recent actions of Jerry Ross, founder of the kratom company Botanic Tonics, as well as at least one Trump administration official.

STAT shares why:

Ross donated to Kennedy’s already-defunct presidential campaign after Kennedy had been nominated as health secretary, and later his company made a $1 million donation to the MAHA Political Action Committee, according to Wyden. As health secretary, Kennedy tried to discourage Ohio’s governor from moving forward with a crackdown on kratom products, as reported by the Times. The letter also notes the Times’ reporting that Homeland Security Secretary Markwayne Mullin has advocated for policies favorable to Botanic Tonics while holding a large financial stake in the company, worth as much as $1 million.

Wyden points out in his letter that the DEA’s recently announced plans to temporarily ban concentrated and synthetic 7-OH products (a psychoactive compound also found in trace amounts in kratom) will benefit Botanic Tonics. “This regulatory action is exactly what Secretary Mullin wants: it will remove Botanic Tonics’s synthetic competitors from shelves so that your products gain market share and his investment soars,” he wrote.

In other words, RFK Jr. and Mullin have essentially become lobbyists for the kratom industry, enriching themselves in the process.

Peptides

Peptides are short chains of amino acids that act as biological signaling molecules in the body, instructing cells and organs to perform specific tasks like regulating hormones, managing appetite, and healing tissue. Insulin is a peptide, for example. But, the most popular peptides at the moment are GLP-1 weight loss drugs. It is estimated that the market for GLP-1 drugs will rise from over $70 billion a year now to over $170 billion annually by 2030.

However, GLP-1s are not the only peptides and the FDA recently approved six for compounding. The move was controversial at best.

Via the American Journal of Managed Care:

When a reconstituted FDA advisory panel voted in late July to recommend 6 peptides for legal compounding, it was overriding the recommendation of the agency’s own career scientists, who recommended against it due to a lack of human safety data. The clash comes as HHS Secretary Robert F. Kennedy Jr is moving to reclassify 14 of the 19 restricted peptides back to legal status. However, almost none of these compounds have FDA-approved indications, and with little regulation in place, gray-market vials remain the default source for millions of Americans.

It’s not just RFK Jr. who pushes peptides. There are other Trump administration members who have a deep interest and, more importantly, a financial stake. For example, former FDA chief Marty Makary was a top executive of the telehealth company Sesame, which connects consumers to physicians who can prescribe compounded weight-loss drugs.

But there’s a more blatant example with the FDA’s Pharmacy Compounding Advisory Committee (PCAC), the group that approved the six new molecules for compounding. The self-dealing with PCAC is so blatant that a consumer watchdog group is urging the HHS to investigate conflicts of interest among the group’s 12 members. Why? Because over half of PCAC members have financial ties to the peptide industry.

Via MedPage Today:

A consumer watchdog group is demanding that the HHS Office of Inspector General look into potential conflicts of interest among members of an FDA advisory committee that recommended that six peptides be added to the list of substances that can be compounded, despite a lack of evidence of their efficacy.

“Several members of the 2026 Pharmacy Compounding Advisory Committee appear to have had disqualifying financial interests in the pharmaceutical and peptide industries at the time of the July meeting…” [they] wrote last week in a letter to HHS Inspector General T. March Bell. [...]

At least seven committee members had financial interests in the peptide and pharmaceutical industries.

All but two of the 12 PCAC members were appointed while Trump was in office.

Conclusion

Pay-to-play politics and self-dealing by government officials is hardly a new phenomenon. What is new is the brazenness and the scope. In the realm of health care and public health, the grift can be dangerous and lead to actual harm to patients seeking care or consumers who are unaware of the dangers of products like kratom.

Trump has ushered in a new Gilded Age and it is a dangerous place.

Except for the super-wealthy and well-connected few, of course.

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The conversation covers how telehealth and mifepristone access have become an unexpected bright spot since Dobbs, the escalating legal attacks on medication abortion (including the case out of Louisiana), how shield laws protect providers across state lines, the criminalization of patients and providers in states like Texas and Louisiana, and why emergency room clinicians are being trained to navigate murky post-Dobbs laws without delaying care.

Julie also speaks candidly about upcoming political appointments, the power of voting in every election and the lessons she carries from Ireland’s reproductive rights movement into the fight ahead in the U.S.

A candid, clear-eyed, and ultimately hopeful conversation about strategy, resilience, and what it will take to protect reproductive freedom going forward.

Learn more about Reproductive Futures: https://www.reproductivefutures.org/

FOLLOW THE DOCS ON SOCIAL MEDIA

• Dr Kristin Lyerly (@drkristinlyerly)

• Dr Erin Stevens (@erinstevensmdobgyn)

• Dr Chris Ford (@doc_4ord)

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Rob and Miles dissect the brutal economics behind insurance claim rejections, the lack of transparency around prior authorization data, and the devastating impact on working families.

Then, looking at recent federal moves taking equity stakes and “golden shares” in private companies like Intel and US Steel, Miles raises a provocative question: If the government can intervene in defense and semiconductor markets for national security, why shouldn’t the public take an equity stake in massive corporate health insurers to stop predatory care denials?

LINKS:

• WFFF: United Healthcare, PSA Airlines deem traumatic brain injury treatment ‘not medically necessary’ for Upstate patient

• The Mirror US: UnitedHealthcare sparks fury after denying rehab treatment to young man severely injured in crash

• POLITICO: Why Trump’s ‘golden shares’ are enticing progressives

We open with a bombshell leaked grand jury report out of Florida revealing how the administration of Governor Ron DeSantis redirected $10 million from a major Medicaid settlement into Hope Florida, an initiative spearheaded by First Lady Casey DeSantis. The funds were rapidly laundered through a web of nonprofits and a dark-money political action committee before landing in the Florida Republican Party’s coffers to defeat the 2024 citizen initiative to legalize recreational marijuana. Those public healthcare funds were meant to expand insurance coverage for poor children and were repurposed into a political slush fund. How low can you get?

Groundbreaking data from Epic Research showing that self-pay encounters in emergency rooms have surged by 38%, while Medicaid-backed emergency visits saw a steep decline. Dr. Davidson provides a stark front-line perspective on what this means for bedside care: patients avoiding primary care until preventable conditions turn into critical medical crises, only to face exorbitant uninsured hospital rates far higher than what private insurers negotiate. Compounding this disaster, federal protections keeping medical debt off credit scores have been systematically dismantled, leaving millions of vulnerable families exposed to catastrophic long-term financial fallout.

From there, the discussion shifts to the toothless corporate health “deals” championed by the Trump administration. As major insurers increasingly deploy automated AI algorithms to arbitrarily deny lifesaving surgeries, stress tests, and essential medications, doctors are left buried under administrative red tape while corporate balance sheets flourish. We also highlight the latest questionable public health personnel move: appointing an Ohio megachurch pastor with zero medical experience as an official CDC tobacco health advisor.

Finally, we’re joined by former FDA Chief Scientist and Georgetown professor Dr. Jesse Goodman to sound the alarm on the administration’s executive order overhauling the childhood immunization schedule and mandating the breakup of the measles, mumps, and rubella (MMR) shot. Dr. Goodman explains the rigorous multi-phase clinical trial processes that establish vaccine safety, dismantles RFK Jr.’s misleading claims regarding placebo-controlled studies, and details the logistical nightmare of separating established combination vaccines. It’s a reckless shift that would require billions of dollars, take years of manufacturing overhauls, and result in children receiving more injections.

LINKS

• RFK Jr. talking about eating a cheeseburger omelette for breakfast

• CBS News: Outrage, call for change continue to mount following Hope Florida grand jury report

• CBS News: Grand jury finds DeSantis administration “misappropriated” $10 million in taxpayer money to Hope Florida

• PBS: Florida grand jury finds DeSantis administration misused $10 million, but no charges have been filed

• Tampa Bay Times: Hope Florida charity took in $867,000, gave away little in first year

• Becker’s Payer Issues: $10M from Florida’s Centene Medicaid settlement misappropriated by DeSantis administration: Report

• Epic Research: Self-Pay Encounters Rose and Medicaid Fell Across All Care Settings from 2022 to 2026

• Health Care Dive: Medicaid losses leave more patients paying cash, Epic finds

• Modern Healthcare: Trump, RFK Jr. health deals lack enforcement, show little progress

• Trump’s announcement of Pastor Scott’s appointment

• The New Republic: Trump Appoints Pastor With No Experience as CDC Tobacco Adviser

• Pastor Darrell Scott’s Wikipedia page

• Expert Vaccine Analysis Team’s website

• Expert Vaccine Analysis Team on Instagram

• Expert Vaccine Analysis Team on YouTube

Join the fight at committeetoprotect.org.

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INTRODUCTION

With election season pretty much in full swing, ads from members of Congress trying to keep their seats next year are ramping up, not just in quantity, but in bogusness. While this is hardly the first year campaign ads have strayed from the truth, there’s been a noticeable and concerning new pattern among multiple Republicans running for reelection. From Iowa to Florida, and Colorado to New Jersey, Republicans are claiming to be…taking on “Big Insurance”?

You read that right. The very same Republicans who have sided with health insurance companies again and again, blocking any sort of meaningful health care reform since the Affordable Care Act, are now claiming to be enemies of the industry.

But their campaign bank accounts tell a different story.

Let’s take a look at some examples.

REP. MARIANNETTE JANE MILLER-MEEKS (IA-01)

Miller-Meeks is an ophthalmologist who has been in Congress since 2021. She has a new campaign ad out where she says, “In Congress, I fight the Big Insurance Lobby. I’m their number one enemy. Well, you know what I say to Big Insurance? Bring it on.”

Here’s the truth: Iowa Starting Line found that “Big Insurance” has been very generous to Miller-Meeks. In this election cycle alone, she brought in an astonishing $501,000 in health industry PAC donations, second biggest category in her campaign. $11,500 of that was from Big Insurance. She even rented an apartment from Big Pharma lobbyists and paid for it with tax dollars. At the time, she sat on the subcommittee that oversees drug pricing.

So, to summarize, she’s a physician, she took in a half million dollars from health industry PACs, and she voted for the OBBBA. All while running an ad telling Big Insurance to “bring it on.”

REP. KAT CAMMACK (FL-03)

Cammack has also been in Congress since 2021. She is currently running an ad where she says she is “taking on Big Insurance” and “fighting to increase care, lower costs and hold insurance companies accountable.”

Turns out that, this cycle alone, she’s already taken in $37,000 from Big Insurance companies. Since 2020, she’s received at least $113,500 from them.

REP. JEFF HURD (CO-03)

Hurd has been in office since 2025. He has a new ad out where he says he took on insurance and drug companies to lower costs. In the short time he has been in office, Hurd has already taken $6,500 from insurance companies alone, according to the Health Insurance Influence Tracker.

Given the type of pushback Hurd is getting from constituents, it’s not surprising that he’s pretending that he “took on insurance and drug companies.” This is from a report about a recent coffee he had for constituents:

As part of his official duties, he’s setting up coffees throughout the vast district to meet with constituents and hear their concerns. For more than an hour, Hurd went table to table at the Glenwood Springs library. He faced tough questions from voters like McCullough. She is a full-time caregiver for her adult son Chris, who lives with significant disabilities.

She told Hurd she was very disappointed he voted for the Republicans’ massive tax cut package in the One Big Beautiful Bill Act, and said it directly affected her family.

“I was not happy with that and still am not happy with that. And my question to you would be, why would you have voted for that if you know that it’s going to take money and services and everything away from your constituents?” [...]

He contended his vote didn’t cut services.

“Well, you haven’t convinced me. Sorry,” McCullough replied.

There is no mention of health care anywhere on Hurd’s campaign website.

REP. THOMAS KEAN, JR. (NJ-07)

Kean has been in office since 2023. In his new ad, he appears very, very serious saying, “I meet too many families who pay too much, who get denied care, who suffer because of Big Insurance companies. I had enough. I took on the insurance companies to get costs down…” He also took their money. This cycle, he took $8,000 from them. Since he took office, he’s taken over $21,000 from the ten largest insurers.

BUT WAIT, THERE’S MORE…

In July of 2025, Donald Trump signed the so-called “One Big Beautiful Bill Act” (OBBBA) into law. It is estimated to cut taxes, mostly for the super-wealthy, by $4.5 billion over the next ten years. To pay for that tax giveaway, it cuts health care spending by over $1 trillion and will throw a projected 10 million people off their health insurance coverage by 2034.

The bill passed both the House and Senate exclusively with Republican votes. In fact, only three GOP Senators and two GOP House members voted against it.

With health care costs now surging – along with groceries, gas, and just about everything else – Democrats are hammering Republicans with an affordability message that is resonating with voters. It’s no wonder Republicans are now pretending that they are the ones who care about affordability, telling voters that they are taking on insurance companies and blaming these corporations for the problem. It’s a diversion to avoid being accountable for their own personal roles in the massive spike in health care costs being experienced by nearly every American.

CONCLUSION

Thanks to moves by Republicans last year, there are few Americans who haven’t seen their health care costs skyrocket. After passing the OBBBA, they made matters worse by refusing to extend the enhanced premium subsidies for Affordable Care Act policies, ensuring that those who can least afford it get hit a second time.

But affordability is in the front of everyone’s minds as we head into the November midterms and Republicans know it. Their efforts to claim they have “taken on Big Insurance companies” fall flat when Americans see no improvement and especially when they find out these very same lawmakers happily take campaign donations from the corporations they claim to be taking on.

Their hypocrisy rivals the days of Republicans taking credit for the infrastructure investments put in place by Democrats and holding giant checks for photo ops.

The question is if voters will hold them accountable. A big part of that is making sure they know about the hypocrisy and know that it is Republicans who are responsible for their much higher health care costs, no matter what they say in their campaign ads.

That, in part, is on us.

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A new study out of Indiana showing that the state’s near-total abortion ban is making ER doctors more hesitant to independently treat pregnant patients. Dr Ford, an ER physician, walks through a new study out of Indianapolis examining how the ban in Indiana is reshaping behavior inside emergency departments. Not because the law explicitly tells doctors what they can't do, but because the resulting legal uncertainty is enough on its own to change clinical decision-making. The study found that ER physicians are now more hesitant to independently manage pregnant patients who present with vaginal bleeding, and are instead more likely to defer that care to OB-GYN specialists. These are physicians who are often already overextended and, in many parts of the state, simply not available in time.

The conversation then shifts to a disturbing case involving a Navy civilian engineer, Elsie Dominguez, whose lawsuit over being raped by a ship’s captain was dismissed as a workers’ comp/labor dispute issue. Sorry, but being raped isn’t “part of the job” for service members.

On a more hopeful note, the hosts cover Missouri’s new law finally allowing pregnant women to get divorced without delay and name the four remaining states (Texas, Arizona, Arkansas, and Mississippi) where that right still doesn’t exist. They also unpack a complicated Texas surrogacy custody case involving a fetal diagnosis of hypoplastic left heart syndrome, intended parents who considered termination, a surrogate who fled to Texas with help from an anti-abortion group, and how the case is being used to fuel calls to restrict or ban surrogacy and IVF. Kristin shares a personal story about pregnancy loss to underscore why these deeply individual medical decisions can’t be legislated in black and white.

Finally, the hosts discuss efforts by anti-abortion groups to challenge and potentially invalidate a Virginia constitutional amendment protecting reproductive freedom before voters even get the chance to weigh in this November.

LINKS

• Rolling Stone: Olivia Rodrigo’s Daisy Chain Fields Festival Raises $10 Million for Women and Girls Nonprofits

• Rolling Stone: Melinda French Gates Doubles Olivia Rodrigo’s Daisy Chain Fields Donation to $20 Million

• The Hill: States sue Trump administration over family planning grant changes

• Dept. of Justice: Challenges illegal Trump administration conditions on funding for reproductive health care, cancer screenings

• Roll Call: Cassidy says abortion pill makers turn blind eye to safety

• Mirror Indy: Indiana’s abortion ban has a ‘chilling effect’ on ER pregnancy care

• Stars and Stripes: Lawsuit over sexual assault aboard Navy transport ship dismissed as worker’s comp issue

• KCTV: New Missouri law allowing pregnant women to get divorced may cause custody dispute complications

• PBS News Hour: Custody fight over baby born via surrogate sparks fear of fertility treatment restrictions

• Virginia Mercury: If Va.’s reproductive rights amendment passes, challengers say they’ll fight to overturn it in court

FOLLOW THE DOCS ON SOCIAL MEDIA

• Dr Kristin Lyerly (@drkristinlyerly)

• Dr Erin Stevens (@erinstevensmdobgyn)

• Dr Chris Ford (@doc_4ord)

Join the fight at committeetoprotect.org.

Subscribe, share, and leave a rating to help more people find Paging America.

Have thoughts, questions, or your own health care story? Email us at feedback@pagingamerica.org.

The letter RFK Jr. sent to Samoa in 2019: https://www.documentcloud.org/documents/28581231-letter-from-rfk-jr/

We also look into a new report on Medicare Advantage overpayments nearing $1 trillion. We explain how that number came to be and what can be done moving forward.

Plus, the newly appointed South Carolina Senator Darline Graham’s unusual campaign-trail argument against universal healthcare. You won’t believe what she has to say about how to address healthcare in this country.

Finally, we turn to RFK Jr.’s new cooking show, “The Real Food Show,” where the Health Secretary tours the country cooking “budget-friendly” meals with celebrity chefs. We’re joined by registered dietitian Abby Langer, who watched all of RFK’s cooking shows and she has plenty to say about the misinformation shared in them. From wildly inflated diabetes statistics and vague fearmongering about ultra-processed foods, to a supposedly “under $5 per serving” recipe built around six-dollar-a-dozen pasture-raised eggs and imported French butter, Abby breaks down how the show’s nostalgic, “grandma knew best” messaging around seed oils and beef tallow doesn’t hold up to actual nutrition science. It conveniently ignores the fact that most Americans struggling with health outcomes are struggling with access and affordability, not a lack of willpower.

LINKS

• The Washington Post: Doctors say Trump’s weight poses a significant health risk

• Video of RFK Jr. talking about measles in Pennsylvania in 2021

• ABC News: 2 people die from measles in Pennsylvania, marking state’s first deaths in 35 years

• CIDRAP: CDC adds 211 new cases to accelerating US measles outbreak

• CDC: Measles Cases and Outbreaks

• PA Gov. Josh Shapiro’s tweet about RFK Jr.’s meltdown

• RFK Jr.’s tweet accusing Shapiro of making up the deaths

• The New Republic: RFK Jr. Resignation Calls Grow as Two People Die From Measles

• Lancaster Online: Lancaster County coroner’s records don’t add clarity to 2 Pa. deaths tied to measles

• Dr. Oz’s tweet minimizing children’s deaths related to measles

• American Journal of Managed Care: FDA Panel Backs 6 Peptides for Compounding

• Pharmacy Compounding Advisory Committees Roster

• MedPage Today: Watchdog Urges HHS to Investigate Conflicts Among FDA’s Peptide Panelists

• Committee for a Responsible Federal Budget: CBO Analysis Suggests $1 Trillion in Medicare Advantage Overpayments

• Congressional Budget Office: Federal Subsidies for Health Insurance, 2026 to 2036

• Video of Sen. Darline Graham talking about her parents’ deaths

• Dr. Annie Andrews’ website

• Men’s Health: I’m a Dietitian. I Watched RFK’s New Cooking Show for 38 Minutes—And Caught 32 Mistakes. (But It’s Not All Bad.)

• Abby Langer’s website: Abbylangernutrition.com

• Abby Langer on Substack: Bite Me

Join the fight at committeetoprotect.org.

Subscribe to our YouTube channel: https://www.youtube.com/@pagingamerica

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Have thoughts, questions, or your own health care story? Email us at feedback@pagingamerica.org.

INTRODUCTION

Following the resignation of Marty Makary last spring, Trump has nominated Dr. Heidi Overton, the Deputy Assistant to the President for Domestic Policy, to be the next commissioner of the Food and Drug Administration (FDA). The FDA has a staff of around 18,000 people and is responsible for regulating food, drugs and medical devices, as well as tobacco, cosmetics, supplements and other products.

Overton received a medical degree from the University of New Mexico and a Ph.D. in clinical investigation at Johns Hopkins. She also trained as a general surgery resident at Hopkins, working with pancreatic surgeon and former FDA commissioner Makary before he led the FDA.

Overton is most notable for being pro-MAHA, vehemently anti-abortion, and a supporter of Trump’s wild ideas about vaccines. During his first term, she served as a White House fellow focused on health policy. After Trump’s defeat in 2020, she served four years as the director of the Center for a Healthy America at a Trump-aligned conservative think tank, America First Policy Institute (a group The Atlantic describes as “a Cabinet-in-waiting for a second Trump term”.) The Atlantic calls Overton “one of the most powerful public-health officials in Trump’s orbit.”

The Wall Street Journal reported that she was offered the job of director of the Centers for Disease Control and Prevention after HHS Administrator Robert F. Kennedy Jr. (RFK Jr.) fired Susan Monarez in August 2025, but she turned it down.

Overton enjoys enormous support from Kennedy, whose MAHA initiatives she has long supported. After Trump announced her as his pick, Kennedy praised her on social media. “Heidi brings exceptional judgment, professionalism, discipline, and an unwavering commitment to the American people,” he wrote. “I have seen her challenge assumptions, demand excellence, and turn bold ideas into meaningful results.”

While she may be beloved by Trump and Kennedy, her path to leading the FDA is not certain...

PROBLEM #1: SHE MAY BE PRO-MAHA, BUT MAHA IS NOT PRO-OVERTON

In Trump’s announcement of her as his choice on social media, he offered a glimpse of why he chose Overton: he believes she helps him with Make America Healthy Again (MAHA) voters. “Dr. Heidi will work with Secretary Kennedy and Dr. Oz to RAPIDLY deliver on my priorities of FASTER Cures, INCREASED American Innovation, MAJOR Clinical Trial Reforms, LOWER Drug Prices, and even more MAHA WINS!,” he wrote.

However, that plan may not go as Trump hopes it will. STAT reports that many influential MAHA leaders are very unhappy with her being chosen:

[M]any MAHA activists are convinced Overton has been to blame for stalled policy initiatives and slow progress in the first half of the Trump administration.

Kelly Ryerson, a MAHA advocate who previously met with administration officials about its health agenda, said in a post on X that Overton’s nomination was “witnessing the steep fall into depths of the swamp.” Toby Rogers, a fellow at the MAHA-aligned Brownstone Institute, wrote on social media that Overton had “purged all of the MAHA reformers from FDA and CDC.”

“MAHA has turned into a nightmare,” Rogers wrote.

AP has more:

Kelly Ryerson, an activist critical of pesticides who is known to her supporters as “Glyphosate Girl,” told The Associated Press that Overton parroted pesticide manufacturer Bayer’s talking points in a MAHA roundtable at the White House in April.

“I was stunned by the blatant, undisguised corruption,” Ryerson said.

Other MAHA leaders see Overton as an impediment to getting their way. In an article in The Atlantic titled, “The White House’s MAHA Gatekeeper”, Michael Scherer and Tom Bartlett write that she threw sand in the gears when Joe Rogan was encouraging Trump to sign an executive order on psychedelic therapies as well as with a number of other of Trump’s efforts:

Members of the “Make America Healthy Again” movement were furious, convinced that Overton, not for the first time, had undermined Trump’s own desires. The friction, which has not been previously reported, became so intense that Rogan and W. Bryan Hubbard, the CEO of Americans for Ibogaine, a nonprofit that champions the drug’s therapeutic benefits, threatened to pull out of the signing ceremony if they did not have a say in Overton’s final edits, according to three people familiar with the events. [...]

Overton’s detractors describe her as one of the biggest obstacles to MAHA actually realizing its priorities…They accuse her of slow-walking marijuana rescheduling, trying to limit MAHA changes to federal nutrition guidelines, and delaying or weakening several other initiatives. “As an unelected bureaucrat, Heidi Overton sought to use her pen to override the intended exercise of presidential power,” one person outside of government who was familiar with the psychedelic-executive-order process told us.

Turning Point USA’s Alex Clark, a leading online voice in the MAHA movement, tweeted a call to MAHA adherents to “rise up” against Overton’s nomination:

She was called a “DEI hire” by Trump whisperer Laura Loomer:

PROBLEM #2: OVERTON SUPPORTS TRUMP’S BIZARRE VACCINE IDEAS

Earlier this month, Heidi Overton was present in the Oval Office during Trump’s childhood vaccine Executive Order signing ceremony [VIDEO]. She spoke at the event, urging states to follow the Trump guidelines, which include vaccinating for fewer diseases and breaking up the MMR shot into three separate shots. During the event, she urged states to put Trump’s vaccine ideas into their state law “so that when parents go to enroll their kids in school, they do not have to meet some of the requirements for the vaccines that are no longer recommended.”

Historically, Overton (in her own words) “continually opposed the draconian, Fauci-era COVID mandates, including school closures, mask mandates, and vaccine mandates.”

STAT reports that, while RFK Jr. has been the leader of the MAHA movement, Overton has been instrumental behind the scenes in crafting MAHA-based policy:

The Trump administration did not overhaul the childhood vaccine schedule or flip the food pyramid until Heidi Overton, deputy director of domestic policy for the White House, had her say.

While health secretary Robert F. Kennedy Jr. has been the public face of the Make America Healthy Again movement, Overton has been the top health policymaker behind the scenes, according to two people, including a senior administration official, familiar with her White House influence.

Louisiana Senator Bill Cassidy, Chair of the powerful Senate Committee on Health, Education, Labor and Pensions, called Overton’s participation in Trump’s “nonsensical vaccine executive order” “almost disqualifying” in a social media post where he expressed his “strong concerns” about her nomination.

Her lack of management experience worries Big Pharma, as well:

The choice of Overton, an ally of Makary, may deepen concerns among drugmakers and some FDA staff seeking stability after months of upheaval. Chris Meekins, a former Trump health official who ​is now an analyst at Raymond James, said industry groups are likely to view Overton’s lack of management experience negatively and warned her appointment could accelerate staff ​departures and reverse progress made since Makary’s exit.

Meekins told Reuters, “Industry will view this ​pick as extremely troublesome and FDA ⁠career staff will continue to flee the agency in my view. Any progress made since Makary’s departure is likely to be quickly reversed if she is confirmed.”

PROBLEM #3: SHE’S WILDLY ANTI-ABORTION

Reproductive rights advocates are validly concerned with Overton being nominated to run FDA. Via Ms. Magazine:

Trump has officially nominated Dr. Heidi Overton as the FDA commissioner. Overton previously called the abortion pill “telebortion,” and called on Congress to strictly regulate it. With the FDA currently reevaluating its approval of mifepristone and its regulations permitting providers to mail the medication, Overton’s nomination represents yet another challenge to mifepristone’s widespread usage—which accounts for over two-thirds of all abortions, including in states with bans.

Mini Timmaraju, president and CEO of national repro rights group Reproductive Freedom for All, called Overton, “one of the most extreme, one of the most unhinged folks we’ve seen.”

Here are some things she’s said about abortion:

• On the overturning of Roe: “Today the Supreme Court delivered a huge victory for life and recognized the tremendous advances in medicine over the past 50 years…While doctors can now save the lives of babies with minimally invasive surgeries to treat conditions as early as 16 weeks gestation, six states plus Washington, D.C., allow abortion all the way up until the time of birth. The Supreme Court’s decision today will allow Americans to reevaluate the value of the potential of every baby in the womb and choose life through a democratic process. [SOURCE]

• “Today, in six states plus the District of Columbia, there are absolutely no state-level restrictions on when an abortion can take place—meaning that fully formed babies can be killed in the womb until the point of birth.” [SOURCE]

• “Though Americans clearly align with the beliefs of the pro-life movement, Leftists relentlessly attack these views as extreme. In reality, the Left’s positions are furthest removed from sentiments of the American people and are drastically more extreme than most of the world.” [SOURCE]

• “The pro-choice movement, fueled by radical liberals, only offers women facing difficult circumstances one solution: termination of the life of her unborn child.” [SOURCE]

• “Abortion pills, also called chemical abortions... are far more dangerous to women, enabling rapid access to abortion.” [SOURCE]

With the right to an abortion enjoying the support of over 60% of Americans, she can’t afford to lose any Republican votes on her nomination.

PROBLEM #4: NO MANAGERIAL EXPERIENCE

When he tweeted about his “strong concerns” with Overton, Bill Cassidy cited her “lack of managerial experience” to run an enormous and complex organization like the FDA. “Her lack of managerial experience does not prepare her well for leading a large organization that is already dealing with staffing and morale issues,” he wrote, seemingly poised to vote against her. POLITICO writes that his lack of support may doom her chances:

Without the support of Cassidy, who’s frequently pushed back on vaccine policies championed by Trump and Health Secretary Robert F. Kennedy, Jr., it would be nearly impossible for her to become commissioner. Cassidy could deny her the committee vote she needs, or simply join Democrats in voting her down there. The Senate would then never get the chance to consider her.

Her lack of management experience worries Big Pharma, as well:

The choice of Overton, an ally of Makary, may deepen concerns among drugmakers and some FDA staff seeking stability after months of upheaval. Chris Meekins, a former Trump health official who ​is now an analyst at Raymond James, said industry groups are likely to view Overton’s lack of management experience negatively and warned her appointment could accelerate staff ​departures and reverse progress made since Makary’s exit.

Meekins told Reuters, “Industry will view this ​pick as extremely troublesome and FDA ⁠career staff will continue to flee the agency in my view. Any progress made since Makary’s departure is likely to be quickly reversed if she is confirmed.”

NOT SLAM DUNK RFK Jr. and TRUMP HOPED FOR

Dr. Heidi Overton has insinuated herself into nearly every aspect of the Trump administration’s public health policymaking. She has ingratiated herself with both Trump and RFK Jr. and her fingerprints are on nearly every health-related thing the administration has done.

However, with the right to abortion enjoying 60% support among voters and vaccines being even more popular, she represents very unpopular views. In addition to that, Trump’s hopes that she will shore up the MAHA vote seem misplaced: she has drawn the ire of a wide array of MAHA leaders and influencers.

Because of this, she is not likely to get any votes from Democrats, which means she can’t lose more than three Republican votes if her nomination advances to the full Senate. HELP Committee Bill Cassidy may be one vote she loses and, as a lame duck, he no longer has to worry about earning the favor of Trump and his supporters. Susan Collins of Maine is up for reelection this fall and she is at the very least a tepid supporter of reproductive rights, and Lisa Murkowski of Alaska is also a pro-Choice Republican. Overton’s vehement anti-abortion stances and actions may lose their votes, as well.

Whether she can keep the rest of the Senate Republicans on her side remains to be seen.

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From there,we tackles a packed week of reproductive health news: Trump’s pick to lead the FDA, Dr. Heidi Overton, and what her anti-abortion record means for patients nationwide. Can she be confirmed? Will outgoing Sen. Bill Cassidy (R-LA) grow a spine and put a stop to the medical nonsense from Trump’s WH?

In a case of missing maternal data, Texas’s maternal mortality review board conveniently skipped the two years right after the state’s abortion ban was put into place. Given the obvious public interest in those numbers, we have to wonder why Texas is hiding behind incomplete data.

New Jersey’s bold new law shielding abortion and trans care providers from out-of-state prosecution. Gov. Mikie Sherrill signed the law that clarifies both abortion and gender-affirming care for transgender people are "legally protected" reproductive care.

Plus, we have sobering new data from The March of Dimes showing that over a third of U.S. counties are now maternity care deserts. This means there are no birthing facilities and no obstetric clinicians for those counties. That is a population of more than 2.4 million women of reproductive age, who gave birth to nearly 149,000 infants in those counties. And those numbers will only get worse.

LINKS

• The New York Times: Trump Nominates Heidi Overton, a Top Domestic Policy Aide, for F.D.A. Commissioner

• Senate Democrats: TRANSCRIPT: President Trump Signs an Executive Order on Vaccination Schedules, 8.10.26

• VIDEO: Trump childhood vaccine Executive Order signing

• America First Policy Institute: SCOTUS Statements on Roe v. Wade

• America First Policy Institute: Who Are the Real Abortion Radicals? A Comparative Perspective

• America First Policy Institute: Risking Two lives—The Dangerous Rise of Chemical abortion

• POLITICO: Judge halts Trump’s abstinence-only overhaul of teen sex ed program

• Indy Star: Federal court: Indiana cannot punish doctors who tell minors about out-of-state abortions

• New Jersey Monitor: Gov. Sherrill signs shield law aimed at protecting reproductive, transgender healthcare

• TIME: More Than One Third of U.S. Counties Are Maternity Care Deserts

FOLLOW THE DOCS ON SOCIAL MEDIA

• Dr Kristin Lyerly (@drkristinlyerly)

• Dr Erin Stevens (@erinstevensmdobgyn)

• Dr Chris Ford (@doc_4ord)

Join the fight at committeetoprotect.org.

Subscribe, share, and leave a rating to help more people find Paging America.

Have thoughts, questions, or your own health care story? Email us at feedback@pagingamerica.org.

From there, we turn to RFK Jr.’s latest vaccine falsehood. He cites new research that supports splitting up the MMR shot. The problem is…. He just made the research up. It doesn’t exist.

Plus, we take a look at the Trump administration’s slow and possibly influence-tainted response to a massive cyclospora outbreak, nwhich now tops 27,000 cases. The outbreak has been linked to a Taylor Farms lettuce facility in Mexico that hadn’t been FDA-inspected in seven years. Not to mention the political contributions flowing from Taylor Farms to Donald Trump and his bank accounts.

Finally, Miles and Dr. Rob sit down with William Lawrence, the Democratic nominee in Michigan’s 7th Congressional District, fresh off a primary win that outside observers called unprecedented for the region. They talk about his grassroots, organizer-driven campaign; the fight against data center development bulldozing small Michigan towns; the impact of a shuttered Planned Parenthood clinic on over 60,000 district residents; and what Democrats should prioritize in the next two years to set the stage for real healthcare reform in 2029.

LINKS

• The Hill: Rubio calls RFK Jr’s meat and sauerkraut menu ‘a crazy diet’

• USA Today: RFK Jr. says ‘boxes and boxes’ of McDonald’s travel with Trump

• The Washington Post: Trump selects Heidi Overton, White House aide, to lead FDA

• Senate Democrats: TRANSCRIPT: President Trump Signs an Executive Order on Vaccination Schedules, 8.10.26

• VIDEO: Trump childhood vaccine Executive Order signing

• America First Policy Institute: SCOTUS Statements on Roe v. Wade

• America First Policy Institute: Who Are the Real Abortion Radicals? A Comparative Perspective

• America First Policy Institute: Risking Two lives—The Dangerous Rise of Chemical abortion

• Bill Cassidy clutches his pearls about Heidi Overton on X

• The Washington Post: Cassidy on Trump’s vaccine overhaul: ‘Crazy, stupid thing’

• RFK Jr. cites non-existent study

• FactCheck.org: RFK Jr. Falsely Claims New Evidence Supports Splitting MMR Vaccine

• The Commonwealth Fund: What Americans Want Fixed in Health Care — and Who They Think Should Do It

• CDC: Surveillance of Cyclosporiasis

• CBS News: Farm linked to cyclosporiasis outbreak hadn’t been inspected in 7 years as FDA lags on foreign inspection targets

• The Hill: Warren presses RFK Jr. on Trump ties to lettuce distributor

• Sen. Warren: Warren Investigates Trump Admin’s Failed Response to Cyclospora Outbreak, Raises Questions About Corruption and Influence-Peddling

• Sen. Warren’s letter to RFK Jr. about the cyclosporiasis response

• The New York Times: Trump Officials Falsely Connect Covid Vaccines to Miscarriage

• FactCheck.org: Republicans Revive False Miscarriage Statistic, Twist Fauci’s Texts About COVID-19 Shots

• Will Lawrence’s campaign website: WeWill2026.com

• Will Lawrence on Instagram

• Will Lawrence on Facebook

• Will Lawrence on X

• Will Lawrence on BlueSky

• Will Lawrence on TikTok

Join the fight at committeetoprotect.org.

Subscribe to our YouTube channel: https://www.youtube.com/@pagingamerica

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Have thoughts, questions, or your own health care story? Email us at feedback@pagingamerica.org.

The headlines tell the story:

“National report lists almost 20% of rural Arkansas hospitals at ‘immediate risk of closing‘”

“Report: Roughly 1 in 5 rural Virginia hospitals at risk of closure”

“Report: 12 Tennessee rural hospitals at ‘immediate risk’ for closure”

“Rural Nebraska Dialysis Unit Closes Despite the State’s $219M in Rural Health Funding”

“700 rural hospitals at risk of closing, by state”

Rural hospitals already on the brink

The 2020 census showed one in five Americans live in rural areas. In general, the residents there are older, in poorer health, and have less insurance coverage than the rest of the country, or no coverage at all. In the seven years before the last census, 4% of rural hospitals closed, leaving their communities without local emergency services, maternity wards, and other essential health care services.

One analysis shows that, between 2010 and 2025, 182 rural hospitals closed and 46% of rural hospitals had a negative operating margin.

In other words, rural hospitals were already struggling when Trump and congressional Republicans passed the so-called “One Big Beautiful Bill Act” (OBBBA). When Trump signed it into law in the summer of 2025, it cut $137 billion in Medicaid dollars from rural areas over ten years and replaced it with a one-time infusion of $50 billion through the Rural Health Transformation Fund (RHTF.)

Trump calls the RHTF “largest ever investment in rural healthcare,” HHS Secretary Robert F. Kennedy Jr. has called it “the biggest infusion of federal dollars into rural health care in American history,” and Centers for Medicare and Medicaid Services Administrator Mehmet Oz called it the “biggest investment, the most ambitious investment, in rural health care ever.” With a straight face, they say this while asking us to ignore the fact that the OBBBA represents an $87 billion cut to rural health care. They also fail to mention that it will throw over 10 million Americans off their health insurance while cutting taxes by $5 trillion, mostly benefiting the country’s wealthiest people.

Rural residents face monumental health care disparities

In a piece titled, “The Crisis in Rural Health Care”, the University of Kansas Medical Center has a depressing list of ways in which rural residents are impacted by health care disparities. For example:

• Rural death rates are higher for both men and women.

• The suicide rate is significantly higher in rural areas particularly among adult men and children.

• Hypertension is more common in rural areas.

• Only one-third of all motor vehicle accidents occur in rural areas but two-thirds of the deaths attributed to these accidents occur on rural roads.

• While 25% of the U.S. population lives in rural areas, only 10% of U.S. physicians work in those areas.

• There are only 40.1 specialists per 100,000 people in rural areas versus 134.1 in urban areas.

• 20% of rural communities lack mental health services compared to 5% of metropolitan counties.

Because the care they need is not locally available, rural patients often turn to telehealth. However, that is often not an option, either. The USDA estimates that over 22% of Americans in rural areas lacked access to the broadband internet services that are needed for telehealth services.

The “beating heart” of their communities

Not only do rural hospitals provide essential services to their surrounding communities, they’re also a bedrock institution that touches people in other ways:

Hospitals are often one of the largest employers in rural communities. They provide stable, high-paying jobs and support local economies through purchasing, construction, and partnerships with small businesses. When a rural hospital closes, it triggers a ripple effect—leading to job losses, business closures, and population decline. [...]

The National Rural Health Association calls them “the beating heart of a local economy”:

A hospital is often the centerpiece of economic viability in rural America, providing jobs for a community’s residents and resources for its development. The positive impact of a thriving hospital starts at the heart of nearby towns and stretches across many miles, providing a vital boost to families and local businesses in the surrounding region. Nationwide, hospitals support more than 16 million total jobs, including 5.7 million direct jobs in health care and 10.3 million ripple-effect jobs, according to the American Hospital Association’s January 2017 report on the economic contributions of hospitals. The report estimates that every dollar spent by a hospital supports $2.30 of additional business activity. For rural communities, the link between hospitals and the local economy is even more pronounced, often due to the absence of other large employers.

The impacts of the massive cut to rural health care are quickly being felt

Thanks to the OBBBA, hospitals are already closing. For example, in Wisconsin, Hospital Sisters Health System and Prevea announced a “complete exit” from Western Wisconsin in January, which included closing two hospitals and 19 clinics. CNN reports about a hospital in Georgia:

St. Mary’s Sacred Heart Hospital in rural Lavonia, Georgia, closed its labor and delivery unit, as well as its obstetrics and gynecology center, last fall. Expectant mothers now must drive about 30 minutes to the nearest hospital with labor and delivery services or about an hour to St. Mary’s hospital in Athens, which still operates a maternity ward.

In rural Nebraska, a hospital closed its dialysis unit in March despite the state receiving $219 million from the RHTF. Seven of Virginia’s 36 rural hospitals either face an immediate closure risk or are at high risk of experiencing financial distress, according to one report.

These are examples of the 700 rural hospitals – one-third of all rural hospitals in the country – that one study found to be currently at risk of closing because of the serious financial problems they are experiencing. When they close, rural residents lose access to vital services like emergency care, prenatal and maternity care, oncology care, and inpatient care – medical or psychiatric care that requires an overnight stay in a hospital or specialized treatment facility.

In addition, patients are forced to travel much farther for the care they need, even to emergency departments. The General Accounting Office found that when a rural hospital closes, patients have to travel nearly 24 miles for inpatient care. In urban areas, they travel just over three miles.

Republicans take no blame, have no real answers

Having satisfied their wealthy donors with this massive tax cut bill, Republicans are attempting to shift the blame for and to paint a rosy picture of the rural hospital crisis they created. For example, Dr. Oz blamed it on big cities and undocumented residents.

Speaking to reporters in February, Vice President JD Vance responded to a question about the rural hospital crisis by saying, “Unfortunately, this, like so much of what’s going on in the country right now, is a problem we inherited from the previous administration.”

Dr. Oz even seems to think it’s cool that there are not enough physicians to serve rural communities. At a White House roundtable discussion about health care in rural America with Trump, RFK Jr., and other healthcare advisers, he said it’s “pretty cool” that they’re having to use robots to perform ultrasounds on pregnant people because of the shortage of OB/GYNs there:

“Alabama has no OBGYNs in many of their counties, so they’re doing something pretty cool. They’re actually having robots do ultrasounds on these pregnant moms so we can actually get those images back to the big center so we know if this child has a problem and we know if that mother is at risk. We have one of the highest maternal mortality rates in the world in the country with the best medicine in the world…”

Oz and RFK Jr. both tout artificial intelligence as the solution for dying hospitals:

Health Secretary Robert F. Kennedy Jr. and his team want to Make Rural America Healthy again.

He has suggested that AI nurses could save dying rural hospitals. Centers for Medicare and Medicaid Services Administrator Mehmet Oz said robots could give ultrasounds to women and touted how AI avatars could help. [...]

Their ultimate “solution” to the crisis is invariably the RHTF. Not only does it not even half fill the $137 billion hole in rural health care funding they created with the OBBBA, it’s being used as both a cudgel and a political weapon. For example, the federal government can claw back RHTF funds or reduce future funding to force states to do things the way the Trump administration wants them done. Via KFF Health News:

During the past six months, as states raced to meet the program’s looming federal deadlines, CMS staffers worked with state health departments to make a flurry of changes, including scrapping some initiatives. The federal agency has the power to rescind existing funding — or reduce future awards — if states don’t follow rules or meet their goals. “We will take the money back” if states “don’t abide by what they wrote, if they don’t do a good job,” Oz said at an event this month in Washington, D.C. [...]

Talking Points Memo highlighted how the requirements for receiving funds from the RHTF are politically charged:

Before the program was rolled out, healthcare stakeholders told TPM that its parameters could disadvantage certain states and benefit others. The CMS scoring system distributed the funds based on a complex weighted formula which included a range of partisan policy-based factors, including whether states restrict SNAP users from buying “non-nutritious foods” and whether states plan to require Trump’s “Presidential Fitness Test” in schools. State scores could also be impacted if the state restricts certain health insurance plans, sometimes called junk plans, which don’t comply with Affordable Care Act coverage standards.

“We have an administration which just says right out, ‘We’re gonna cut money to blue states and blue communities,’ and it is doing it,” Adam Searing, an attorney and research professor at the Georgetown University McCourt School of Public Policy, told TPM in November. “If you happen to live in a community that we disagree with politically, too bad.”

Crisis not averted

Dr. Oz was right about one thing, rural hospitals have been in big trouble for some time. However, taking $137 billion from them and replacing it with less than half that amount of a “hunger games” style program that is used to force states to comply with the Trump administration’s goals is rapidly making matters worse. The problems confronting rural communities will not be addressed solely through the use of robots and artificial intelligence. They need a comprehensive plan of investment into health care that can strengthen these important components of rural communities.

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In this episode, Dr. Erin Stevens and Dr. Rob Davidson break down what's driving the decline in vaccination rates around the country. We have state-level exemption policies and rhetoric from RFK Jr. and the Trump administration around splitting up the MMR vaccine leading to mass confusion over health policy. It’s led to measles, a disease the U.S. declared eliminated in 2000, is now seeing its highest case numbers in 35 years. They discuss the real health risks of measles (including encephalitis and long-term organ damage), why public trust and misinformation are central to the problem, and what it will take to reverse the trend.

We then turn to Idaho, where a federal judge ruled the state can’t enforce its near-total abortion ban against physicians acting to protect a patient’s health, not just their life. Dr Chris Ford explains that legal distinction matters clinically, drawing on his experience in emergency medicine to explain how pregnancy complications can turn deadly within minutes.

From there, it’s a tour of wins and losses across the map: Colorado becomes the fifth state requiring abortion medication access on college campuses, a move the hosts say normalizes reproductive healthcare as part of everyday student life. In Michigan, Oakland County votes to keep a Planned Parenthood clinic open with $1.5 million in local funding, a reminder that Planned Parenthood provides far more than abortion care. But Oklahoma delivers a gut punch, criminalizing possession of abortion-inducing drugs with penalties of up to ten years in prison.

The conversation widens to a global scale as the hosts examine the fallout from the dissolution of USAID, which has cut off maternal health resources, contraception, and postpartum care to countries around the world. They discuss rising maternal deaths in places like Nigeria and Myanmar, and soaring rates of unsafe abortion in countries like Liberia, where access to contraception has collapsed alongside U.S. funding.

Finally, Chris and Kristin take aim at Senators Ron Johnson and Rand Paul for resurfacing old, since-debunked texts from Dr. Fauci to falsely suggest a link between COVID vaccines and miscarriage. The hosts unpack the difference between a theoretical risk raised in real time during a global pandemic and the years of evidence that followed and why weaponizing outdated science to scare pregnant patients does lasting damage to public trust in medicine. As always, the doctors close with a reminder: trust your providers, not your politicians.

LINKS

• The Hill: Massachusetts Gov. Maura Healey signs late-term abortion bill into law

• Idaho Capital Sun: Idaho judge ruling allows abortion if it protects mother’s health, prevents self-harm

• REWIRE: More College Students Will Have Access to Abortion Medication

• CBS News: Oakland County approves $1.5 million Planned Parenthood contract

• The Journal Record: Oklahoma law making abortion pill trafficking a felony takes effect

• AP: USAID fallout: In Nepal, when the aid workers stopped coming, the women and babies started dying

• SciDev.net: Funding cuts leave Liberian girls without contraception

• JEZEBEL: The GOP Wants To Take Down Fauci—and Is Putting Pregnant Women in the Crossfire

• Meghan McCain’s tweet

• FOX News: Fauci refuses Senate appearance after invoking Fifth Amendment more than 100 times in COVID probe

• AP: Dr. Anthony Fauci declines request to appear before a second Senate panel after GOP contempt vote

FOLLOW THE DOCS ON SOCIAL MEDIA

• Dr Kristin Lyerly (@drkristinlyerly)

• Dr Erin Stevens (@erinstevensmdobgyn)

• Dr Chris Ford (@doc_4ord)

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