Kennedy's plan to ‘fix' vaccine injury compensation

Politico

2 days ago

With help from Carmen Paun
Driving the Day
WHAT IS VICP? Health Secretary Robert F. Kennedy Jr. took to the social media platform X on Monday — as well as conservative activist Charlie Kirk's show — to promote his plan to 'fix' the system that HHS uses to compensate people injured by vaccines.
The National Vaccine Injury Compensation Program has long been a target of Kennedy's ire, and now, he plans major changes to it.
I spoke with POLITICO's Lauren Gardner, who covers the program closely, about how it operates and what we know so far about Kennedy's plans.
Here's our conversation, edited for length and clarity.
Why was the VICP created and how does it work?
Congress created the VICP in 1986 after a series of lawsuits against vaccine makers prompted many of them to pull out of the market. Lawmakers worked with companies, public health advocates and parents who said their children were vaccine-injured to establish a no-fault alternative to the traditional tort system.
Under the program, drugmakers' liability is limited, and compensation from an industry-funded tax is available with a lower burden of proof. The intention was to reduce the uncertainty for everyone involved and ensure the stability of the domestic supply of childhood vaccines.
To be considered for compensation, a petitioner must file a claim generally within three years of the injury's onset. If the person's injury is listed on a table of injuries presumed to be caused by a given vaccine during a certain timeframe, it's typically easier for them to win compensation; otherwise, they must show their injury was 'more likely than not' caused by the immunization.
Kennedy has repeatedly critiqued the program. What does he say is the issue?
Some of the secretary's problems with the program are shared by public health experts and, unsurprisingly, vaccine injury lawyers who say the process has become more adversarial in recent years and can take many years to resolve. On the latter point, legal experts point to the law's limit on the number of 'special masters' — essentially judges who consider these cases — at the vaccine court as something Kennedy can't address without Congress.
However, Kennedy also made several false or misleading claims Monday, including stating that 'the act has changed' so that the vaccine court is the 'exclusive remedy' for families who might prefer to sue drugmakers in state court. They can do that — as he should know, given his work as an injury lawyer outside of the program — but they have to exhaust their claim at the VICP first.
What details do we have about how Kennedy wants to 'fix' VICP?
Kennedy didn't say anything new about his plans in Monday's interview. So far, we know he wants to increase the statute of limitations and to somehow compensate people injured by Covid-19 vaccines via the VICP; they currently fall under a separate program that's been widely panned as ineffective.
Kennedy specifically referenced a 1995 change to the vaccine injury table's definition of encephalopathy, a broad term for brain dysfunction, that he said 'made it so there's no way you can prove' it was caused by a vaccine. He called the program a 'heartless system that is designed to deny vaccine injury and to deny compensation to people who badly need it, and we are about to fix all that.'
He also namechecked Attorney General Pam Bondi as someone who's working with him on this, so since the Justice Department works with HHS to administer the VICP, we could see changes come from that side of Washington, too.
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AROUND THE AGENCIES
PREMIUM RISES — Medicare drug plan premiums are expected to rise next year, according to the 2026 preliminary rate information for Medicare's prescription drug program released by CMS.
The agency is projecting the average base premium will be $38.99, a slight increase from 2025's average base premium of $36.78, POLITICO's Robert King reports.
CMS said it worked with insurers to blunt larger premium hikes from plans. The Wall Street Journal was the first to report the rate release.
'Following these negotiations, CMS approved some revised bids and, for the first time, rejected standalone [prescription drug plan] bids that failed to address concerns regarding significant year-over-year premium increases,' the agency said in a release.
The 2022 Inflation Reduction Act included several major changes to Part D, chief among them a $2,000 annual cap on out-of-pocket drug costs. CMS was concerned that Medicare Part D plans would raise premiums to compensate for the changes.
Key context: Last year, the agency sought to blunt the premium impact through a $5 billion program that's expected to end after 2027. It provided insurers who signed with an additional $15 per member per month. Insurers will still receive extra money, but only $10. It will also increase the limit on a plan's total Part D monthly premium from $35 to $50.
CMS said the changes will result in approximately $3.6 billion in additional Medicare payments for 2026, a 42 percent reduction compared to 2025 costs.
GOOD NEWS, BAD NEWS IN DRUG-USE SURVEY — The percentage of teenagers who seriously considered suicide declined between 2021 and 2024, Carmen reports.
That's according to the Annual National Survey on Drug Use and Health, which reflects 2024 data, that HHS's Substance Abuse and Mental Health Services Administration, or SAMHSA, published Monday.
The good news: The percentage of teens who made a suicide plan over the past year dropped from 6.2 percent in 2021 to 4.6 percent in 2024, according to the survey, which relies on self-reported data. And the percentage of teens who attempted suicide decreased from 3.6 percent in 2021 to 2.7 percent in 2024.
The use of certain drugs also declined in teenagers and adults, with reported prescription opioid misuse lowering from 3 percent in 2021 to 2.6 percent in 2024.
The bad news: The percentage of people ages 12 and older who reported having a drug use disorder in the past year increased from 8.7 percent in 2021 to 9.8 percent in 2024.
The use of marijuana increased from 19 percent in 2021 to just over 22 percent last year.
So did the use of hallucinogens, also known as psychedelics, with 3.6 percent reporting using them last year compared with 2.7 percent in 2021.
Why it matters: In response to the country's mental health and drug use crises that worsened during the pandemic, federal officials and lawmakers have made efforts to regulate social media use and expand access to substance use disorder treatment.
Health Secretary Robert F. Kennedy Jr., who's in long-term recovery from past opioid use, has promoted the ban of cellphone use in schools and healthier food to improve children and teens' wellbeing.
HHS LAUNCHES HEP C PILOT — SAMHSA has put $100 million into a pilot program focusing on hepatitis C in people with a substance use disorder, a serious mental illness or both, Carmen reports.
State and community-based organizations are among the entities that can apply for funding from the program, which 'is designed to support communities severely affected by homelessness and to gain insights on effective ways to identify patients, complete treatment, cure infections, and reduce' hepatitis C reinfection, HHS said in a statement Monday.
HHS hailed the pilot program as 'a significant accomplishment in President Trump's agenda to Make America Healthy Again … This upfront investment is a common-sense and scientifically driven initiative projected to both save lives and save community health care costs in the long run.'
The CDC estimates that between 2.4 million and 4 million people in the U.S. had hepatitis C between 2017 and 2020.
The disease is an inflammation of the liver, caused mainly by a viral infection that can progress to severe liver disease or liver cancer if left untreated, according to the World Health Organization.
Oral medication can treat and cure the disease if taken for eight to 12 weeks, but greater access to treatment is needed to achieve disease elimination, according to former National Institutes of Health Director Francis Collins, who has advocated for the cause as former President Joe Biden's science adviser.
WHAT WE'RE READING
POLITICO's Maya Kaufman reports that the Justice Department has launched an antitrust probe into New York-Presbyterian, one of the nation's largest hospitals.
STAT's Anil Oza reports on a new analysis that outlines what the Trump administration's proposed cuts to the NIH could mean long-term.