Trump admin removes 760K ACA enrollees from exchanges

Vice President JD Vance on Tuesday announced the Trump administration has removed 760,000 Affordable Care Act (ACA) enrollees from public healthcare exchanges, alleging the people were either fraudulently enrolled in the program or don't exist.

"We're actually making sure that the people receiving [ACA] subsidies are actually entitled to receive them," Vance said at a news conference, adding that he estimated removing the targeted enrollees will save the government $2.2 billion.

The dropped enrollees account for around 4% of the 19 million people who receive health coverage through the ACA marketplaces.

Vance said the cancellation of around 315,000 enrollments covering 760,000 people was partly done because the government wasn't checking whether the people enrolled were eligible, noting that some enrollments lacked social security numbers or immigration documentation. Vance added that another 419,000 enrollments will get additional verification to ensure they're eligible for the benefit.

Cynthia Cox, a VP and director of the ACA program at KFF, said she thinks "there's no question that somebody who was fraudulently enrolled should have their coverage canceled," however, "I think the question is whether this was the appropriate process by which to identify fraudulent enrollees, and also whether all of them were indeed fraudulently enrolled."

(Sanger-Katz, et al., New York Times, 9/22; Hussein/Price, Associated Press, 9/22)

White House aims to take control of NIH grants

IIn an Oval Office meeting on Friday, President Donald Trump directed Russ Vought, director of the Office of Management and Budget (OMB), to draft an executive order establishing a board that would decide which grants NIH should fund, according to people with knowledge of the meeting who spoke to the New York Times and POLITICO. The board would also be able to veto grants that don't align with the Trump administration's political agenda.

The proposed board would include both Vought and NIH Director Jay Bhattacharya, officials familiar with the matter told POLITICO.

Trump, Vought, and Bhattacharya were present at the meeting, the officials said, as were Department of Education Secretary Linda McMahon, Department of Treasury Secretary Scott Bessent, White House Deputy Chief of Staff Stephen Miller, White House Counsel Will Scharf, and OMB General Counsel Mark Paoletta.

During the meeting, Trump complained about his administration's failings against Harvard University, as the administration has lost two lawsuits against the university in its push against "woke" ideology in higher education.

Last year, the administration aimed to block $2.6 billion in grant funding to Harvard after accusing the university of failing to address antisemitism on campus. Harvard then sued, arguing the administration was violating its free speech rights, and a federal judge restored the funding.

The meeting was partly called to discuss why NIH hadn't done enough to push the Trump administration's agenda through academia — especially in Ivy League schools, according to two administration officials familiar with the planning who spoke to the Times.

Joshua Pradko, a spokesperson for NIH, said the agency "remains committed to its mission of funding biomedical research to benefit the health of the American People," adding that "[t]here will be no recissions to NIH grant monies. All NIH grant monies will be spent."

(Johnson, et al., New York Times, 9/20; Cai/Röhn, POLITICO, 9/19)

RFK Jr. revives USPSTF, appoints 8 new members

HHS Secretary Robert F. Kennedy Jr. last week appointed eight new members to the U.S. Preventive Services Task Force (USPSTF), a panel of experts who assess the evidence behind a variety of preventive medical services and hasn't met in over a year.

The panel is made up of 16 volunteer members who are appointed by the HHS secretary and serve staggered four-year terms.

Seth Corey, a pediatric hematologist-oncologist who works in the departments of pediatrics and heart, blood, and kidney research at Cleveland Clinic, will serve as new chair of USPSTF. Other appointees include:

Kennedy has long been critical of USPSTF, saying during a House hearing in April that he was reforming the task force, calling it "lackadaisical and negligent." In May, Kennedy fired two vice chairs of the task force, saying in letters to the two vice chairs that the firings were "administrative in nature and … unrelated to your performance of many years or dedicated service to the Task Force."

The USPSTF was also the subject of a lawsuit last year, which reached the U.S. Supreme Court. The Supreme Court upheld the structure of the task force but also ruled that Kennedy could unilaterally remove members from the panel and override its decisions.

In an opinion piece published Thursday by Fox News, Kennedy defended his appointment of specialists over primary care physicians to the panel, noting eight members picked during President Joe Biden's administration remained as well.

"[P]reventive medicine does not stop at the boundaries of any one discipline. It encompasses cancer detection, cardiovascular disease, medical imaging, pediatric care, diagnostic technologies, chronic disease, and other areas where specialized clinical knowledge can sharpen the evaluation of evidence," he wrote.

(Gleeson, Fierce Healthcare, 9/17; Cirruzzo, et al., STAT, 9/17)

Trump demands drugmakers split vaccines into more doses

President Donald Trump on Friday said he will be "demanding" that drugmakers split up vaccines into five doses given in six-month intervals and claimed doing so would reduce autism rates.

"The vaccine size will be much, much less," Trump said. "I think you're going to see a massive reduction in autism. And that's a big deal, a very big deal. We're going to be recommending that and actually demanding it."

So far, it's unclear which vaccines Trump is seeking to break up.

Trump has repeatedly questioned whether childhood vaccines can cause autism, despite decades of research finding no link between the two. In August, Trump signed an executive order reducing the number of universally recommended vaccines for children and calling for splitting up the measles, mumps, and rubella (MMR) vaccine into three shots administered at separate medical visits. He also suggested during a signing ceremony that the MMR vaccine could be "quite lethal" and that reducing the number of vaccines children receive would reduce autism rates.

Trump's rhetoric around vaccines has alarmed vaccine experts and medical groups who have noted there's no new evidence to justify further breaking up shots and that doing so could leave children vulnerable to infectious diseases for longer.

"That is an incorrect way of giving the vaccine because vaccines are formulated so that the total dosage that they're getting is the one that delivers the best immune response," said José Romero, who was a top health official in Arkansas during the COVID-19 pandemic and then at CDC.

The American Academy of Pediatrics has also said claims that the number of childhood vaccines on the immunization schedule can overwhelm a child's immune system are "inaccurate and dangerous."

(Roubein, Washington Post, 9/18)