Episode #53 Deep Dive – MAHA Got Played and Big Tobacco Got a Promotion
A deep dive into this week's episode of Paging America
››› RFK Jr. vs. Sen. Bill Cassidy
Louisiana Senator and physician Bill Cassidy faced off with RFK Jr. at two different Senate committee hearings last week. And, while he has been hard on Kennedy about his actions on vaccines in the past, this time, he seemed to go easy on him. “I am a doctor who has seen people die from vaccine-preventable diseases,” he said to Kennedy. “And when I see outbreaks numbering in the thousands and people dying once more from vaccine-preventable diseases, particularly children, it seems more than tragic.” He also challenged Kennedy on two papers he cited in his testimony and, as is typical with him, had mischaracterized the results. But, rather than challenging him for the damage he has done, he asked about other things like preparations for the upcoming World Cup and America 250 events.
Cassidy did, however, go after Kennedy on abortion pills, a new tack for him. “Why has the department not acted with greater urgency on reinstating the in-person dispensing requirement?” Cassidy asked him. He followed up by asking why he has failed to “stop the illegal importation of counterfeit and unapproved abortion drugs.”
Cassidy may have pulled his punches on vaccines because he is in a difficult primary this year and may not want to seem at odds with Trump, who has endorsed his primary challenger, Rep. Julia Letlow. MAHA PAC has vowed to support Letlow with $1 million in donations. Going after abortion pills in the conservative south may be less politically risky for Cassidy than fighting for vaccines.
››› A former Big Tobacco exec is now a CDC deputy director
In another typically Trumpian move, a vacant deputy director position at the CDC is being filled with an industry insider:
Stephen Sayle, named in March as the CDC’s deputy director for legislative affairs, previously worked at Fontem Ventures, a subsidiary of the British multinational tobacco corporation Imperial Brands. Between 2017 and 2018, he was U.S. vice president of corporate affairs at Fontem, which is focused on non-combustible tobacco products like the e-cigarette brand blu and the oral nicotine pouch brand Zone.
From a public health perspective, appointing a former tobacco executive to a high-level role at the CDC is “unprecedented,” Timothy McAfee, who headed the Office of Smoking and Health at the CDC from 2010 to 2017, wrote in an editorial published this week in the journal Tobacco Control. McAfee told STAT that Sayle’s appointment is also “completely inconsistent” with health secretary Robert F. Kennedy Jr.’s previous pledges to “shut the revolving door” between industry and government.
McAfee went on to say that Sayle’s appointment at CDC is “opening a door that has been closed for decades, and letting the fox into the henhouse with open arms.”
››› Big corporations swoop in to profit from $50B Rural Health Fund
KFF Health News reports that small community health care providers may find they are sharing the $50 billion from the Rural Health Transformation Program, part of last summer’s Big Beautiful Bill and billionaire tax giveaway, with an army of corporate giants:
Science Applications International Corp., a Fortune 500 government contractor, pulled together the Alliance for Advancing Rural Healthcare. SAIC does a variety of technology work such as cybersecurity and engineering support. The alliance also includes Walgreens and Mission Mobile Medical, which turns RVs into primary care clinics. [...]
Gainwell Technologies, which operates the systems for dozens of state Medicaid programs, is spearheading another coalition…Maine’s Medicaid plan contracts with Gainwell, and the state’s initial application listed four contracts worth more than $16 million over five years for the company. [...]
James Lomastro, a senior-care advocate in rural Massachusetts with the nonprofit Dignity Alliance, said he worries that large vendors and health systems will get the state’s transformation dollars.
››› Trump is coming after your birth control
In an op-ed in The New York TImes titled, “The Trump Administration Is Coming After Birth Control Access in a Terrifying New Way” Jill Filipovic writes about Trump’s plans to completely change the focus of Title X, the first federal program entirely dedicated to family planning and reproductive health care. The program was originally designed to help poor families stay out of poverty by giving them choices when it comes to family planning. The Trump administration’s approach is perverting that mission:
[Title X] would go on to become one of the most successful federal programs of the last century, with one study finding it prevented some 20 million unintended pregnancies in just 20 of its 50 years by providing women with free and low-cost birth control. It has significantly reduced child poverty. In 1957, nearly one in 10 teenage girls gave birth. Today, the rate is closer to one in 100. For every dollar spent on family planning funds, the government saves $7 in Medicaid costs.
But President Trump seems intent on killing Title X. This month, the Department of Health and Human Services quietly issued new funding guidelines that have effectively subverted the program’s entire purpose. Instead of getting highly effective contraception methods to the country’s poorest women so that they may decide if and when to have children, Title X under Mr. Trump seems aimed at getting more women pregnant, whether they want to be or not. [...]
More than half of patients at Title X clinics use modern contraceptive methods to prevent pregnancy. But the word “contraception” comes up just once in the Title X funding document, and only in a section on “reducing overmedicalization in health care.” Instead, in a change pulled directly from Project 2025, H.H.S. tells Title X clinics to emphasize “fertility-awareness-based methods.
Filipovic goes on to say that the move appears to be part of Trump’s coalition management strategy by appealing to three very different groups: the anti-abortion movement; the MAHA movement, and pronatalists who want to see birthrates rise at nearly any cost.
One pronatalist appears to be Katie Miller, podcasting wife of White House goon Stephen Miller who lamented falling teen birthrates in a tweet. “Our biological destiny is to have babies — not slave behind desks chasing careers while our civilization dies,” she wrote.
››› MAHA is cooling on Trump and the GOP, also running out of money
The New York Times has yet another article saying the MAHA movement not particularly enamored with Trump and Republicans:
Six of the [MAHA] movement’s most prominent leaders, who together have millions of social media followers, said in separate interviews that the mostly white, mostly female voters who followed Mr. Kennedy into Mr. Trump’s camp are so disappointed with the president that Republicans risk losing them. [...]
“They have nowhere to go,” said [conservative young wellness podcaster Alex] Clark, who works for Turning Point U.S.A., the right-wing organization founded by Charlie Kirk. “They feel like their vote is useless. They have lost the energy. They have lost the enthusiasm. They feel like the Democrats don’t care about them. They feel like the Republicans lied to them, and they’re not planning on voting.”
This reporting comes as the US Supreme Court heard a case this week surrounding the pesticide glyphosate (aka “Roundup”) that could limit Americans’ ability to sue pesticide companies, something that would send MAHA adherents over the edge.
The news gets worse: The Trump and RFK Jr.-aligned PACs pushing the so-called “MAHA” agenda are in financial trouble. POLITICO reports that they aren’t raising much money and much of what they did raise is actually from Big Pharma, the industry they are most at odds with:
The MAHA PAC reported only three donations so far in 2026 — two $50,000 contributions from Venni Capital, a little-known New York investment firm whose address links to the headquarters of Chartwell Pharmaceuticals, a generic drug manufacturer and compounding pharmacy that has secured hundreds of millions in contracts with the federal government. [...]
Six of MAHA PAC’s largest donors last year came from entities with interests in biopharma, including OPS International, which sells weight-loss drugs and other wellness products that haven’t received government approval under the name Olympia Pharmaceuticals; biotech firms owned by Lou Reese, a Kennedy ally; and LucyRx, a small pharmacy benefit manager that negotiates drug prices for insurers.
Links for a deeper dive on Episode #53
MedPage Today: How ‘The Pitt’ Gets Emergency Medicine Right
NBC News: Cassidy clashes with RFK Jr. on vaccines and abortion medicine
POLITICO: Bill Cassidy’s still attacking RFK Jr. Now it’s about abortion.
AP: RFK Jr. faced the Senate. One lawmaker’s competing loyalties were on display
The New York Times: MAHA Group Pledges $1 Million to Help Defeat Senator Cassidy in Louisiana Primary
STAT: Former tobacco executive joins CDC senior leadership, raising concerns over industry influence
KFF Health News: Big Companies Position Themselves for Payday From $50B Federal Rural Health Fund
The New York Times: The Trump Administration Is Coming After Birth Control Access in a Terrifying New Way
Newsweek: Stephen Miller’s Wife Condemns Teen Birth Rate Falling-‘Biological Destiny’
Katie Miller’s tweet lamenting falling teen birthrates
The New York Times: The ‘Make America Healthy Again’ Movement Is Cooling on Trump and Republicans
The Hill: Supreme Court hears Roundup case that could limit Americans’ ability to sue pesticide companies
POLITICO: The groups backing RFK Jr. are running low on cash