‘I'm Not Quite Sure How to Respond to This Presentation'
The past three weeks have been auspicious for the anti-vaxxers. On June 9, Health Secretary Robert F. Kennedy Jr. purged the nation's most important panel of vaccine experts: All 17 voting members of the CDC's Advisory Committee on Immunization Practices (ACIP), which sets recommendations for the use of vaccines and determines which ones must be covered through insurance and provided free of charge to children on Medicaid, were abruptly fired. The small, ragtag crew of replacements that Kennedy appointed two days later met this week for the first time, amid lots of empty chairs in a conference room in Atlanta. They had come to talk about the safety of vaccines: to raise concerns about the data, to float hypotheses of harm, to issue findings.
The resulting spectacle was set against a backdrop of accelerating action from the secretary. On Wednesday, Kennedy terminated more than $1 billion in U.S. funding for Gavi, a global-health initiative that supports the vaccination of more than 65 million children every year. Lyn Redwood, a nurse practitioner and the former president of Children's Health Defense, the anti-vaccine organization that Kennedy used to chair, was just hired as a special government employee. (She presented at the ACIP meeting yesterday.) A recently posted scientific document on the ACIP website that underscored the safety of thimerosal, an ingredient in a small proportion of the nation's flu vaccines, had been taken down, a committee member said, because the document 'was not authorized by the office of the secretary.' (A spokesperson for the Department of Health and Human Services told me in an email that this document was provided to the ACIP members in their meeting briefing packets.)
What's clear enough is that, 61 years after ACIP's founding, America's vaccination policy is about to be recooked. Now we've had a glimpse inside the kitchen.
The meeting started with complaints. 'Some media outlets have been very harsh on the new members of this committee,' said Martin Kulldorff, a rangy Swedish biostatistician and noted COVID contrarian who is now ACIP's chair. (Kuldorff was one of the lead authors of the Great Barrington Declaration, a controversial proposal from the fall of 2020 to isolate seniors and other vulnerable people while reopening the rest of society.) In suggesting that he and Kennedy's other appointees are opposed to vaccination, Kulldorff said, journalists were misleading the public, weakening trust in public health, and fanning 'the flames of vaccine hesitancy.'
This was, in fact, the most pugnacious comment of the two-day meeting, which otherwise unfolded in a tone of fearmongering gentility. Robert Malone, a doctor and an infectious-diseases researcher who has embraced the 'anti-vaccine' label and published a conspiracy-theory-laden book that details government psyops against the American people, was unfailingly polite in his frequent intimations about the safety of vaccines, often thanking CDC staff for their hard work and lucid presentations. With his thick white beard, calm affect, and soldierly diction—Malone ended many of his comments by saying, 'Over' into the microphone—he presented less as a firebrand than as, say, the commanding officer of a submarine.
When Malone alluded to the worry, for example, that spike proteins from the mRNA-based COVID vaccines linger in the body following injection, he did so in respectful, even deferential, language, suggesting that the public would benefit from greater study of possible 'delayed effects' of immune-system activation. The CDC's traditional approach—its 'world-leading, rigorous' one, he clarified—might be improved by examining this question. A subject-matter expert responded that the CDC has been keeping tabs on real-world safety data on those vaccines for nearly five years, and has not detected any signs of long-term harm.
Later, Malone implied that COVID or its treatments might have, through some unspecified, bank-shot mechanism, left the U.S. population more susceptible to other illnesses. There was a 'paradoxical, sudden decrease' in flu cases in 2020 and 2021, he noted, followed by a trend of worsening harm. A CDC staffer pointed out that the decrease in flu during those years was not, in fact, a paradox; well-documented shifts in people's health behavior had temporarily reduced the load of many respiratory illnesses during that same period. But Malone pressed on: 'Some members of the scientific community have concern that they're coming out of the COVID pandemic—exposure to the virus, exposure to various countermeasures—there may be a pattern of broad-based, uh, energy,' he said, his eyes darting up for a moment as he said the word, 'that might contribute to increased severity of influenza disease.' He encouraged the agency to 'be sensitive to that hypothesis.'
Throughout these and other questions from the committee members, the CDC's subject-matter experts did their best to explain their work and respond to scattershot technical and conceptual concerns. 'The CDC staff is still attempting to operate as an evidence-based organization,' Laura Morris, a professor at the University of Missouri School of Medicine, who has attended dozens of ACIP meetings in the past and attended this one as a nonvoting liaison to the committee from the American Academy of Family Physicians, told me. 'There was some tension in terms of the capacity of the committee to ask and understand the appropriate methodological questions. The CDC was trying to hold it down.'
That task became more difficult as the meeting progressed. 'The new ACIP is an independent body composed of experienced medical and public health experts who evaluate evidence, ask hard questions, and make decisions based on scientific integrity,' the HHS spokesperson told me. 'Bottom line: this process reflects open scientific inquiry and robust debate, not a pre-scripted narrative.' The most vocal questioner among the new recruits—and the one who seemed least beholden to a script—was the MIT business-school professor Retsef Levi, a lesser-known committee appointee who sat across the table from Malone. A scruffy former Israel Defense Forces intelligence officer with a ponytail that reached halfway down his back, Levi's academic background is in data modeling, risk management, and organizational logistics. He approached the proceedings with a swaggering incredulity, challenging the staffers' efforts and pointing out the risks of systematic errors in their thinking. (In a pinned post on his X profile, Levi writes that 'the evidence is mounting and indisputable that mRNA vaccines cause serious harm including death'—a position entirely at odds with copious data presented at the meeting.)
Shortly before the committee's vote to recommend a new, FDA-approved monoclonal antibody for preventing RSV in infants, Levi noted that he'd spent some time reviewing the relevant clinical-trial data for the drug and another like it, and found some worrying patterns in the statistics surrounding infant deaths. 'Should we not be concerned that maybe there are some potential safety signals?' he asked. But these very data had already been reviewed, at great length, in multiple settings: by the FDA, in the course of drug approval, and by the dozens of members of ACIP's relevant work group for RSV, which had, per the committee's standard practice, conducted its own staged analysis of the new treatment before the meeting and reached consensus that its benefits outweighed its risks. Levi was uncowed by any reference to this prior work. 'I'm a scientist, but I'm also a father of six kids,' he told the group; speaking as a father, he said, he personally would be concerned about the risk of harm from this new antibody for RSV.
In the end, Levi voted against recommending the antibody, as did Vicky Pebsworth, who is on the board of an anti-vaccine organization and holds a Ph.D. in public health and nursing. The five other members voted yes. That 5–2 vote aside, the most contentious issue on the meeting's schedule concerned the flu shots in America that contain thimerosal, which has been an obsession of the anti-vaccine movement for the past few decades. Despite extensive study, vaccines with thimerosal have not been found to be associated with any known harm in human patients, yet an unspecified vote regarding their use was slipped into the meeting's agenda in the absence of any work-group study or presentation from the CDC's staff scientists. What facts there were came almost exclusively from Redwood, the nurse who used to run Kennedy's anti-vaccine organization. Earlier this week, Reuters reported that at least one citation from her posted slides had been invented. That reference was removed before she spoke yesterday. (HHS did not address a request for comment on this issue in its response to me.)
The only one of Kennedy's appointees who had ever previously served on the committee—the pediatrician Cody Meissner—seemed perplexed, even pained, by the proceedings. 'I'm not quite sure how to respond to this presentation,' he said when Redwood finished. He went on to sum up his concerns: 'ACIP makes recommendations based on scientific evidence as much as possible. And there is no scientific evidence that thimerosal has caused a problem.' Alas, Meissner's warnings were for nought. Throughout the meeting, he came off as the committee's last remaining, classic 'expert'—a vaccine scientist clinging to ACIP's old ways—but his frequent protestations were often bulldozed over or ignored. In the end, his was the only vote against the resolutions on thimerosal.
Throughout the two-day meeting, Kuldorff kept returning to a favorite phrase: evidence-based medicine. 'Secretary Kennedy has given this committee a clear mandate to use evidence-based medicine,' he said on Wednesday morning; 'The purpose of this committee is to follow evidence-based medicine,' he said on Wednesday afternoon; 'What is important is using evidence-based medicine,' he said again when the meeting reached its end. All told, I heard him say evidence-based at least 10 times during the meeting. (To be fair, critics of Kuldorff and his colleagues also love this phrase.) But the committee was erratic in its posture toward the evidence from the very start; it cast doubt on CDC analyses and substituted lay advice and intuition for ACIP's normal methods of assessing and producing expert consensus. 'Decisons were made based on feelings and preferences rather than evidence,' Morris told me after the meeting. 'That's a dangerous way to make public-health policy.'
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Buzz Feed
2 hours ago
- Buzz Feed
4 Words That Changed My Life After Diagnosis
One particularly stressful day a few years ago, while driving to an important work event, I was seized with a severe bout of tics. This was not unusual for me. I'd been ticcing nearly all my life, and stress always exacerbated my tics. On this day, my snorts and jerks were so out of control that I rear-ended a car. That's when I finally visited a neurologist. I needed to know, literally, what made me tic. What he told me — 'You have Tourette syndrome' — came as a shock. It was also a relief. For as long as I can remember, I've had the characteristic vocal and motor tics associated with the condition. Secreting them away in my mental lockbox, burying them well out of sight of others, was how I dealt with them. A diagnosis brought clarity, and it meant that I could deal with my tics in a healthier way — or so I thought. I grew up in a small western New York town in the 1980s, those heady days of ozone-depleting hairspray, goofy mullets, and syrupy synth pop. In my rural community, very few people knew what Tourette was. I certainly didn't. When I was a teenager, a television program, possibly 60 Minutes, aired an episode on the subject that I watched with my mom. It featured a young man who shouted obscenities in some large American city. By that time I'd been ticcing for years — in fact, I'd already been hiding my tics for years. But I didn't recognize myself in this program, because never, not once, did I swear or shout in public. When I was in elementary school, a teacher once stopped class to tell me to quit making noises and 'doing that thing you're doing with your head.' She actually demonstrated 'that thing' in front of my classmates because I was apparently annoying her and disrupting her lesson. Every head turned my way, and I put mine down, humiliated. I could not tell her that I couldn't help myself. In birding, there's something called a 'spark bird' — the bird that, when you first see it in the wild, truly gets you hooked on birding. But this was my spark moment, when I realized my tics were not 'normal' and that I needed to hide them if I wanted to be normal. If my mom made any connection between that kid we saw on TV and me, she didn't mention it, and my parents didn't take me to a neurologist to have me checked out. Because of that TV program, I assumed, wrongly, that having Tourette meant shouting obscenities in public. I learned that this version of Tourette is called coprolalia and, according to the Centers for Disease Control and Prevention, it 'only affects about 1 in 10 people with Tourette.' It is not as common as popular media likes to portray it. For me, ticcing has always meant a near-constant urge to do things with my body. 'Urge' may not be the right word for these head jerks, blinks, snorts, grunts, throat clearings, tongue clicks, etc., but it's the best I've got. From the moment I wake up to the moment I fall asleep, my body seems to have a will of its own. In any given hour, I probably tic at least 100 times. During periods of great stress, like when I rear-ended that car, my tics are like a parasitic fungus that assumes total control over my body. Nobody wants to twitch or make weird noises in public — to be the person people crane their necks to see. What's wrong with this guy? you imagine them thinking. After getting called out by my teacher, I only wanted to blend in — to become invisible — because when you're in elementary school, you don't want to be seen as a freak. You want to be like everyone else. I couldn't stop ticcing, but I discovered that I could make it less obvious. To shield myself from shame and embarrassment, I developed an arsenal of tic-hiding strategies. Instead of jerking my head, I would put my hand underneath the table and waggle my fingers or ball my fists repeatedly. Instead of snorting or chuffing — obvious and strange sounds — I'd click my tongue softly, like an irregular metronome. These tricks satisfied my near-constant urge to tic and kept me mostly hidden from view. I wasn't bullied or teased in school, as kids and adults with tics often are, but I probably would have been if I hadn't learned how to control my tics. I've been using these tricks ever since. When I'm out in public today, I'm keenly aware of my internal pressure to tic, but I've become adept at suppressing it, bottling it up and capping it tight. At home, where I'm free to be myself, it's a very different story. My tics come and go. Six months ago, I began squirting air from my mouth the way someone might blow hair off their face; a few weeks later, I started hocking as though to spit a loogie. Like uninvited guests overstaying their welcome, both tics remain with me as I write these words. Sometimes a particular tic will go away only to return a year later, like an exasperating big brother who'd gone off to college and come home with a sly grin and a shaggy beard. There is no cure for Tourette — all you can do is try to manage your tics. There are treatments available, ranging from antihypertensives like guanfacine and clonidine to alternative options like the antipsychotic drugs risperidone and Abilify. But I'd honestly rather have tics than the potential side effects these drugs can cause. When I was first diagnosed, I tried guanfacine and I'd wake up in the middle of the night so parched that it was like I'd swallowed sand; my sleeplessness felt more like a punishment, especially since the drug didn't even control my tics, so I quit taking the pill. Since then, I've chosen no other treatments, though I recently learned of a promising option I will try called 'comprehensive behavioral intervention for tics,' or CBIT. This doesn't involve any drugs. Instead, it trains you to change your behaviors and tic less. Researchers estimate that between 350,000 and 450,000 Americans have Tourette syndrome, while roughly 1 million have other persistent tic disorders. There's said to be insufficient evidence to determine the number of adults with Tourette because many people simply outgrow their tics by late adolescence. According to the Tourette Association of America, the condition 'occurs in 1 in 160 (0.6%) school-aged children, although it is estimated that 50% are going undiagnosed ' (italics mine). A 2022 survey by the group suggested that 1 in 10 children with a tic disorder 'attempted suicide at least once during the past 12 months.' That's a scary number, and it speaks to how difficult it is for many people with tics to feel comfortable in their own bodies. I'm glad that kids (and their parents) who are diagnosed with Tourette today now have resources available to them — including a supportive community — to feel less stigmatized or ostracized by this awkward thing in their lives. I did not outgrow my tics. Because it's hard to admit publicly something I've always internalized and associated with shame, few people know this part of me. Even if you're not bullied or harassed, hurt and humiliation run deep; they form scars that are easily scraped off. How many other adults fly under the radar, as I do? Who, like me, never outgrew their tics but developed strategies for concealing them? Who didn't benefit from services that the Tourette Association of America offers, or the wealth of research being done today? Who struggled to form truly lasting friendships for fear of being exposed as someone with tics? Apart from the nuisance of having tics, I live what society would likely deem a 'good' and 'regular' life. I have a wife, a child, a great job, a house, and a creative life as a writer and translator. I have Tourette, but Tourette doesn't have me — though my wife would certainly disagree with this. When we got together 25 years ago, I suppressed my tics in front of her, but you can't hide something like this from someone you live with. I no longer try. Even on those nights when my ticcing body keeps her up, she's supportive. Since I've spent a lifetime hiding my tics, I've become successful at blending in, even when I'm meeting people for work or on stage in front of an audience, giving a reading or interviewing authors. But I've also experienced moments of deep loneliness. Retreating into yourself is a good way to not be publicly embarrassed, but you pay a price. Eventually, you end up feeling like a ghost in your own life — known to no one but yourself and a few carefully curated individuals whom you trust. I don't make friends easily. Later this year, I will publish my debut novel, The Book of Losman, after translating more than a dozen novels from Danish and writing countless unsold manuscripts over the past 30 years. It's about a literary translator, like me, with Tourette, but that's where the similarities end. It's a speculative fiction about a man named Losman who lives in Copenhagen, Denmark, and gets involved in an experimental drug study to relive childhood memories in the hope of finding a cure for his Tourette. Why not? The beauty of fiction is that you can imagine anything you want, provided the world you create is believable. In real life, I can't go back in time to reassure the little kid who got called out in elementary school, but I'm old enough to understand something he couldn't: 'Normal' is a highly subjective word, one laced with many assumptions. At nearly 50 years old, my tics (and the need to control them) are ingrained in the very fabric of my being. Even after publishing this essay, I will continue to hide my tics in public. Why? The stigma is a great burden. The line between dignity and humiliation is, in the end, a thin one — at least for me. I truly admire those in the younger generation, who can go on TikTok or YouTube and put themselves out there for the world to see. That's not for me. But by sharing my story here, what I can do is help normalize Tourette and other tic disorders. People like me, we're all around you. All that we ask for is what every human being deserves: to live a judgment-free life.
Atlantic
4 hours ago
- Atlantic
‘I'm Not Quite Sure How to Respond to This Presentation'
The past three weeks have been auspicious for the anti-vaxxers. On June 9, Health Secretary Robert F. Kennedy Jr. purged the nation's most important panel of vaccine experts: All 17 voting members of the CDC's Advisory Committee on Immunization Practices (ACIP), which sets recommendations for the use of vaccines and determines which ones must be covered through insurance and provided free of charge to children on Medicaid, were abruptly fired. The small, ragtag crew of replacements that Kennedy appointed two days later met this week for the first time, amid lots of empty chairs in a conference room in Atlanta. They had come to talk about the safety of vaccines: to raise concerns about the data, to float hypotheses of harm, to issue findings. The resulting spectacle was set against a backdrop of accelerating action from the secretary. On Wednesday, Kennedy terminated more than $1 billion in U.S. funding for Gavi, a global-health initiative that supports the vaccination of more than 65 million children every year. Lyn Redwood, a nurse practitioner and the former president of Children's Health Defense, the anti-vaccine organization that Kennedy used to chair, was just hired as a special government employee. (She presented at the ACIP meeting yesterday.) A recently posted scientific document on the ACIP website that underscored the safety of thimerosal, an ingredient in a small proportion of the nation's flu vaccines, had been taken down, a committee member said, because the document 'was not authorized by the office of the secretary.' (A spokesperson for the Department of Health and Human Services told me in an email that this document was provided to the ACIP members in their meeting briefing packets.) What's clear enough is that, 61 years after ACIP's founding, America's vaccination policy is about to be recooked. Now we've had a glimpse inside the kitchen. The meeting started with complaints. 'Some media outlets have been very harsh on the new members of this committee,' said Martin Kulldorff, a rangy Swedish biostatistician and noted COVID contrarian who is now ACIP's chair. (Kuldorff was one of the lead authors of the Great Barrington Declaration, a controversial proposal from the fall of 2020 to isolate seniors and other vulnerable people while reopening the rest of society.) In suggesting that he and Kennedy's other appointees are opposed to vaccination, Kulldorff said, journalists were misleading the public, weakening trust in public health, and fanning 'the flames of vaccine hesitancy.' This was, in fact, the most pugnacious comment of the two-day meeting, which otherwise unfolded in a tone of fearmongering gentility. Robert Malone, a doctor and an infectious-diseases researcher who has embraced the 'anti-vaccine' label and published a conspiracy-theory-laden book that details government psyops against the American people, was unfailingly polite in his frequent intimations about the safety of vaccines, often thanking CDC staff for their hard work and lucid presentations. With his thick white beard, calm affect, and soldierly diction—Malone ended many of his comments by saying, 'Over' into the microphone—he presented less as a firebrand than as, say, the commanding officer of a submarine. When Malone alluded to the worry, for example, that spike proteins from the mRNA-based COVID vaccines linger in the body following injection, he did so in respectful, even deferential, language, suggesting that the public would benefit from greater study of possible 'delayed effects' of immune-system activation. The CDC's traditional approach—its 'world-leading, rigorous' one, he clarified—might be improved by examining this question. A subject-matter expert responded that the CDC has been keeping tabs on real-world safety data on those vaccines for nearly five years, and has not detected any signs of long-term harm. Later, Malone implied that COVID or its treatments might have, through some unspecified, bank-shot mechanism, left the U.S. population more susceptible to other illnesses. There was a 'paradoxical, sudden decrease' in flu cases in 2020 and 2021, he noted, followed by a trend of worsening harm. A CDC staffer pointed out that the decrease in flu during those years was not, in fact, a paradox; well-documented shifts in people's health behavior had temporarily reduced the load of many respiratory illnesses during that same period. But Malone pressed on: 'Some members of the scientific community have concern that they're coming out of the COVID pandemic—exposure to the virus, exposure to various countermeasures—there may be a pattern of broad-based, uh, energy,' he said, his eyes darting up for a moment as he said the word, 'that might contribute to increased severity of influenza disease.' He encouraged the agency to 'be sensitive to that hypothesis.' Throughout these and other questions from the committee members, the CDC's subject-matter experts did their best to explain their work and respond to scattershot technical and conceptual concerns. 'The CDC staff is still attempting to operate as an evidence-based organization,' Laura Morris, a professor at the University of Missouri School of Medicine, who has attended dozens of ACIP meetings in the past and attended this one as a nonvoting liaison to the committee from the American Academy of Family Physicians, told me. 'There was some tension in terms of the capacity of the committee to ask and understand the appropriate methodological questions. The CDC was trying to hold it down.' That task became more difficult as the meeting progressed. 'The new ACIP is an independent body composed of experienced medical and public health experts who evaluate evidence, ask hard questions, and make decisions based on scientific integrity,' the HHS spokesperson told me. 'Bottom line: this process reflects open scientific inquiry and robust debate, not a pre-scripted narrative.' The most vocal questioner among the new recruits—and the one who seemed least beholden to a script—was the MIT business-school professor Retsef Levi, a lesser-known committee appointee who sat across the table from Malone. A scruffy former Israel Defense Forces intelligence officer with a ponytail that reached halfway down his back, Levi's academic background is in data modeling, risk management, and organizational logistics. He approached the proceedings with a swaggering incredulity, challenging the staffers' efforts and pointing out the risks of systematic errors in their thinking. (In a pinned post on his X profile, Levi writes that 'the evidence is mounting and indisputable that mRNA vaccines cause serious harm including death'—a position entirely at odds with copious data presented at the meeting.) Shortly before the committee's vote to recommend a new, FDA-approved monoclonal antibody for preventing RSV in infants, Levi noted that he'd spent some time reviewing the relevant clinical-trial data for the drug and another like it, and found some worrying patterns in the statistics surrounding infant deaths. 'Should we not be concerned that maybe there are some potential safety signals?' he asked. But these very data had already been reviewed, at great length, in multiple settings: by the FDA, in the course of drug approval, and by the dozens of members of ACIP's relevant work group for RSV, which had, per the committee's standard practice, conducted its own staged analysis of the new treatment before the meeting and reached consensus that its benefits outweighed its risks. Levi was uncowed by any reference to this prior work. 'I'm a scientist, but I'm also a father of six kids,' he told the group; speaking as a father, he said, he personally would be concerned about the risk of harm from this new antibody for RSV. In the end, Levi voted against recommending the antibody, as did Vicky Pebsworth, who is on the board of an anti-vaccine organization and holds a Ph.D. in public health and nursing. The five other members voted yes. That 5–2 vote aside, the most contentious issue on the meeting's schedule concerned the flu shots in America that contain thimerosal, which has been an obsession of the anti-vaccine movement for the past few decades. Despite extensive study, vaccines with thimerosal have not been found to be associated with any known harm in human patients, yet an unspecified vote regarding their use was slipped into the meeting's agenda in the absence of any work-group study or presentation from the CDC's staff scientists. What facts there were came almost exclusively from Redwood, the nurse who used to run Kennedy's anti-vaccine organization. Earlier this week, Reuters reported that at least one citation from her posted slides had been invented. That reference was removed before she spoke yesterday. (HHS did not address a request for comment on this issue in its response to me.) The only one of Kennedy's appointees who had ever previously served on the committee—the pediatrician Cody Meissner—seemed perplexed, even pained, by the proceedings. 'I'm not quite sure how to respond to this presentation,' he said when Redwood finished. He went on to sum up his concerns: 'ACIP makes recommendations based on scientific evidence as much as possible. And there is no scientific evidence that thimerosal has caused a problem.' Alas, Meissner's warnings were for nought. Throughout the meeting, he came off as the committee's last remaining, classic 'expert'—a vaccine scientist clinging to ACIP's old ways—but his frequent protestations were often bulldozed over or ignored. In the end, his was the only vote against the resolutions on thimerosal. Throughout the two-day meeting, Kuldorff kept returning to a favorite phrase: evidence-based medicine. 'Secretary Kennedy has given this committee a clear mandate to use evidence-based medicine,' he said on Wednesday morning; 'The purpose of this committee is to follow evidence-based medicine,' he said on Wednesday afternoon; 'What is important is using evidence-based medicine,' he said again when the meeting reached its end. All told, I heard him say evidence-based at least 10 times during the meeting. (To be fair, critics of Kuldorff and his colleagues also love this phrase.) But the committee was erratic in its posture toward the evidence from the very start; it cast doubt on CDC analyses and substituted lay advice and intuition for ACIP's normal methods of assessing and producing expert consensus. 'Decisons were made based on feelings and preferences rather than evidence,' Morris told me after the meeting. 'That's a dangerous way to make public-health policy.'
Los Angeles Times
4 hours ago
- Los Angeles Times
California will see ‘devastating' healthcare cuts under GOP bill, Newsom says
As many as 3.4 million Californians could lose their state Medi-Cal health insurance under the budget bill making its way through the U.S. Senate, Gov. Gavin Newsom said Friday. Newsom said the proposed cuts to healthcare in the 'one big, beautiful bill,' a cornerstone of President Trump's second-term agenda, could force the closure of struggling rural hospitals, reduce government food assistance for those in need and drive up premiums for people who rely on Covered California, the state's Affordable Care Act health insurance marketplace. 'This is devastating,' Newsom said. 'I know that word is often overused in this line of work, but this is, in many ways, an understatement of how reckless and cruel and damaging this is.' Medicaid provides health insurance for about 1 in 5 Americans and generally uses income, rather than employment, as a condition for enrollment. Roughly 15 million Californians, more than a third of the state, are on Medi-Cal, the state's version of Medicaid, with some of the highest percentages in rural counties that supported Trump in the November election. More than half of California children receive healthcare coverage through Medi-Cal. The Senate is still debating its version of the bill. But the current version would require many Medicaid recipients to prove every six months that they work, volunteer or attend school at least 80 hours per month. States would be required to set up their work eligibility verification systems by the end of 2026, just after the midterm elections. States that do not set up those systems could lose federal Medicaid funding. Republican House Speaker Mike Johnson told reporters last month that the aim of the policy was to encourage poor Americans to contribute and 'return the dignity of work to young men who need to be out working instead of playing video games all day.' The nonpartisan Congressional Budget Office estimated this month that the requirements would cut about $344 billion in Medicaid spending over a decade and leave 4.8 million more people uninsured. Health policy experts warn that work requirements can lead to people who are eligible, but can't prove it, losing their benefits. Newsom said 5.1 million people in California would need to go through the work verification progress and about one-third would 'likely' meet the requirements. The other two-thirds would 'go through the labyrinth of manual verification,' Newsom said. He said 3 million people in California could lose coverage through the new Medicaid work requirements, and 400,000 more could lose their insurance if they were required to re-verify their eligibility every six months. Newsom said that the state's estimate was based on the number of people who dropped off Medicaid in New Hampshire and Arkansas after those states briefly implemented their own work requirements. Last year, California became the first state in the nation to offer healthcare to low-income undocumented immigrants. The expansion, approved by Newsom and the Democratic-led Legislature, has cost the state billions and drawn sharp criticism from Republicans. Assembly Minority Leader James Gallagher (R-Yuba City), who has previously called on Newsom to walk back that coverage, said on social media Friday that Newsom and Democratic legislative leaders had 'obliterated' the healthcare system. Newsom's budget proposal in May proposed substantial cuts to the healthcare program for undocumented immigrants, including freezing new enrollment in 2026, requiring adults to pay $100 monthly premiums and cutting full dental coverage. Lawmakers ultimately agreed to require undocumented immigrant adults ages 19 to 59 to pay $30 monthly premiums beginning July 2027. Their plan adopts Newsom's enrollment cap but gives people three months to reapply if their coverage lapses instead of immediately cutting off their eligibility. Democrats agreed to cut full dental coverage for adult immigrants who are undocumented, but delayed the change until July 1, 2026. In Congress, the GOP bill could also pose a serious threat to 16 struggling hospitals in 14 rural counties, which received a $300-million lifeline in interest-free loans in 2023, Newsom said. He said the Republican members of Congress in California who supported the bill and represent rural parts of California, including Central Valley Rep. David Valadao (R-Hanford) and Rep. Kevin Kiley (R-Rocklin), are 'gutting an already vulnerable system.' Some senators are pushing to change a requirement that would require states to freeze and cut by half the tax they impose on Medicaid providers, slashing a key source of funding for rural hospitals. Michelle Baass, the director of the California Department of Health Care Services, said that change could be 'fatal for the many rural and critical-access hospitals that are already financially strained.' Newsom said in aggregate, the cuts could threaten California's progress in reducing the share of residents without health insurance, which stands at about 6.4%.
