KFF Health News’ ‘What the Health?’: Kennedy Cancels Vaccine Funding
The Host
Emmarie Huetteman
KFF Health News
Emmarie Huetteman, senior editor, oversees a team of Washington reporters, as well as “Bill of the Month” and KFF Health News’ “What the Health?” She previously spent more than a decade reporting on the federal government, most recently covering surprise medical bills, drug pricing reform, and other health policy debates in Washington and on the campaign trail.
Health and Human Services Secretary Robert F. Kennedy Jr.’s announcement that the federal government will cancel nearly $500 million in mRNA research funding is unnerving not only for those who develop vaccines, but also for public health experts who see the technology behind the first covid-19 shots as the nation’s best hope to combat a future pandemic.
And President Donald Trump is demanding that major pharmaceutical companies offer many American patients the same prices available to patients overseas. It isn’t the first time he’s made such threats, and drugmakers — who scored a couple of wins against Medicare negotiations in the president’s tax and spending law — are unlikely to volunteer to drop their prices.
This week’s panelists are Emmarie Huetteman of KFF Health News, Sarah Karlin-Smith of the Pink Sheet, Sandhya Raman of CQ Roll Call, and Lauren Weber of The Washington Post.
Panelists
Sarah Karlin-Smith
Pink Sheet
@sarahkarlin-smith.bsky.social
Sandhya Raman
CQ Roll Call
Lauren Weber
The Washington Post
Among the takeaways from this week’s episode:
- Explaining the decision to cancel some mRNA vaccine funding, a priority for vaccine critics, Kennedy falsely claimed that the technology is ineffective against respiratory illnesses. Researchers have been making headway into mRNA vaccines for maladies such as bird flu and even cancer, and the Trump administration’s opposition to backing vaccine development weakens the prospects for future breakthroughs.
- Trump’s insistence that big-name drugmakers voluntarily lower their prices underscores how few tools the presidency has to deliver results on this important pocketbook issue for many Americans. Medicare’s ability to negotiate drug prices took a hit under Trump’s big tax-and-spending law, which included two provisions advocated by the pharmaceutical industry that would delay or exclude some expensive drugs from the dealmaking process.
- A year after Trump promised on the campaign trail to secure coverage of in vitro fertilization, the White House reportedly is not planning to compel insurers to pay for those pricey reproductive services — a change that would require an act of Congress and could raise costs overall.
- And with Congress back home for its August recess and a late September deadline looming, the annual government funding process is in progress — but unlikely to resolve quickly or cleanly. Senate appropriators are further along in their work than usual, but the House of Representatives has yet to release its version, which is expected to cut deeper and hit social issues like abortion harder.
Plus, for “extra credit” the panelists suggest health policy stories they read (or wrote) this week that they think you should read, too:
Emmarie Huetteman: KFF Health News’ “New Medicaid Federal Work Requirements Mean Less Leeway for States,” by Katheryn Houghton and Bram Sable-Smith.
Sarah Karlin-Smith: Slate’s “Confessions of a Welfare Queen,” by Maria Kefalas.
Sandhya Raman: CQ Roll Call’s “Sweden’s Push for Smokeless Products Leads Some To Wonder About Risks,” by Sandhya Raman.
Lauren Weber: The New York Times’ “‘Hot Wasps’ Found at Nuclear Facility in South Carolina,” by Emily Anthes.
Also mentioned in this week’s podcast:
- The Washington Post’s “How RFK Jr.’s mRNA Crackdown Affects Vaccinemaking and Future Pandemics,” by Carolyn Y. Johnson and Lauren Weber.
- The AP’s “Fact Focus: Trump Says He’s Cut Drug Prices By Up to 1,500%. That’s Not Possible,” by Melissa Goldin.
- The Washington Post’s “Medicare, Medicaid Plan To Experiment with Covering Weight Loss Drugs,” by Paige Winfield Cunningham.
- The Washington Post’s “White House Has No Plan To Mandate IVF Care, Despite Campaign Pledge,” by Riley Beggin and Jeff Stein.
click to open the transcript
Transcript: Kennedy Cancels Vaccine Funding
[Editor’s note: This transcript was generated using both transcription software and a human’s light touch. It has been edited for style and clarity.]
Emmarie Huetteman: Hello, and welcome back to “What the Health?” I’m Emmarie Huetteman, a senior editor for KFF Health News, and I’m joined by some of the best and smartest health reporters in Washington. We’re taping this week on Thursday, Aug. 7, at 10 a.m. As always, news happens fast, and things might have changed by the time you hear this. Here we go.
Today, we’re joined via video conference by Lauren Weber of The Washington Post.
Lauren Weber: Hey, everybody.
Huetteman: Sandhya Raman of CQ Roll Call.
Sandhya Raman: Good morning.
Huetteman: And Sarah Karlin-Smith of the Pink Sheet.
Sarah Karlin-Smith: Hi, everybody.
Huetteman: It’s August, and here in the nation’s capital that means Congress has flown the coop, and a lot of the federal city has gone with them. No interview this week. And you may be wondering why you’re hearing my voice instead of the incomparable Julie Rovner. Julie’s out this week having surgery to repair her broken wrist. Good news: She’s on the mend and she’ll be back in your podcast feed very soon. Get well soon, Julie. Let’s get to the news.
On Tuesday, the Trump administration announced that the secretary of Health and Human Services, Robert F. Kennedy Jr., has canceled almost $500 million in federal grants and contracts to develop mRNA vaccines. That technology, of course, was responsible for the first covid vaccines, and researchers have been working on new ways to use mRNA, including against bird flu and even cancer. But in explaining his decision, Kennedy made false claims about mRNA vaccines, including that they do not protect against respiratory illnesses. Kennedy’s opposition to the covid vaccine, in particular, is well-documented. But before becoming health secretary, he advocated for federal officials to revoke approval for mRNA-based covid shots.
Sarah, you’re our pharmaceutical industry expert. What will this mean for vaccine development? Without this government funding, can that research continue?
Karlin-Smith: I think people are really concerned, particularly about the speed of vaccine development for pandemic situations. That’s a classic market failure in that companies aren’t that incentivized to work on developing products for hypothetical situations that may never come to pass, but we obviously want to be prepared for strains of the flu that can be particularly harmful and stuff. So I think that’s where people are really concerned.
I think, in general, this is just another mark in some of the vaccine actions that have taken place since this administration took over that makes people a little more nervous about just investing in the vaccine field, whether it’s mRNA or vaccines in general. FDA has made some unusual decisions around the indications for covid vaccines moving forward. The [Centers for Disease Control and Prevention’s] whole [Advisory Committee on Immunization Practices] has changed. So I do think there’s broader concern beyond the mRNA vaccines and our need to have this technology to really prepare for a pandemic about how confident industry will be in the places they normally would invest money on their own.
Huetteman: Lauren, you had a story yesterday about how Kennedy’s decision is intensifying concerns about our ability to fight future pandemics. Can you tell us what you’re hearing from public health experts?
Weber: Yeah. We spoke to a number of public health experts and vaccine experts, mRNA experts, who said, Look, this is the technology that you want to be spry, to be able to alter something, to fight potentially a bird flu. It’s also used in revolutionary ways to fight maybe even cancer here in the future. There’s a lot of fear about how this could have a chilling effect, as Sarah was pointing out, on the development pipeline and what that means in a pandemic situation.
I do think it’s important to note that just this morning, Trump was asked about this and said he was going to have a meeting on it at noon. Not sure exactly what that means, but potentially that could be something. Robert Malone, who’s an ACIP member, sent out an email trying to rally MAHA [“Make America Healthy Again”] supporters to make sure that they backed up Kennedy’s decision.
I think it’s also important to take a step back and look at Kennedy’s past remarks on mRNA, as you alluded to. This is a man who falsely called the covid vaccine “the deadliest ever made.” He’s described it as a poison in the past. Some anti-vaccine factions of MAHA have really been pushing to try and limit access to mRNA technology. You’ve seen this also in some Republican and far-right states, that are more right. You’ve seen some legislation suggested to remove access to mRNA technology. There’s a big question among some of the folks we talked to on if this is a bit of a signal to the base.
Karlin-Smith: I was going to say, ironically, the mRNA vaccines was probably the biggest success of the Trump administration’s first term in office. He was instrumental in spearheading the fast development of the vaccines for covid.
Huetteman: Right, Operation Warp Speed. Interesting how far we’ve come. To be clear, this isn’t all of the government’s mRNA contracts, right? This is just a piece of the research funding?
Karlin-Smith: This is a piece of it coming through BARDA [the Biomedical Advanced Research and Development Authority], which is particularly designed to help fill those market gaps in pandemic preparedness, but they’ve also cut other mRNA vaccine contracts previously in this administration, including a big one around bird flu, which people are concerned about right now. I’ve even seen some media reports where people, researchers in the cancer but mRNA space, were concerned about grants just being flagged just because they had the terminology. It’s not everything, but I think there’s certainly fears that this is just a step in a bigger process that is problematic.
Huetteman: Absolutely. We’ll be keeping an eye on that. And vaccine contracts aren’t the only thing that President Trump’s team is undoing this week. Under a new federal rule, VA hospitals would no longer be able to perform abortions in cases of rape, incest, or health endangerment. You may remember that the Biden administration introduced that policy at the Department of Veterans Affairs in 2022, after the Supreme Court ended the constitutional right to an abortion. The policy has allowed veterans and their relatives to obtain abortion services even while they are stationed in states with restrictions.
Meanwhile, lots of news to get to this week. In prescription drug news, late last week, President Donald Trump sent letters to more than a dozen drugmakers insisting that they drop their prices within 60 days. Specifically, the president demanded that pharmaceutical companies offer many American patients the same prices that drugmakers charge abroad. Over the weekend, Trump told reporters that his administration is dramatically lowering drug prices, “up to 1,500%,” he said — which, well, I think that technically means the drugmaker would pay you.
Anyway, Trump told drugmakers that if they don’t lower drug prices, “We will deploy every tool in our arsenal.” What can the president do to force drugmakers to comply?
Karlin-Smith: I think, in some ways, he doesn’t have as many tools in the toolbox as he probably would like to think. At least, not ones that are making the industry particularly fearful right now. He doesn’t have the power to just issue a regulation saying, “The Medicare-Medicaid reimbursement rates are tied to the rates countries are paying abroad.” That would have to be through legislation. And I think there are reasons that both Republicans and Democrats don’t really like this most-favored-nation approach to drug pricing. There is some sort of limited authority for them to do a demonstration project through CMS’ [Centers for Medicare & Medicaid Services’] Medicare-Medicaid Innovation Center. They could come up with a test of this in some kind of limited area. They tried to start implementing that [in] his last term and they got scuttled by lawsuits, so we’ll see if they have a way to avoid that problem this time.
But the ironic thing is that when the administration issued this executive order in May calling for this most-favored-nation pricing, he set this 30-day-ish deadline of saying, OK, we’ll tell you what prices we want, you guys lower them. If not, we’re going to do rulemaking. One thing that came up when he issued this letter, these letters on Friday, giving industry another 60 days is, Well, why are they not just going through with some kind of rulemaking or next steps? It almost seemed to some people like almost a more muted threat because they haven’t done the follow-through yet or come up with what the follow-through is here.
Huetteman: Now, where is the Medicare’s drug negotiation ability in this equation? Why isn’t the president doing more to leverage Medicare’s power to negotiate at this point?
Weber: Well, that’s really interesting because in the “Big, Beautiful Bill,” there were two provisions that a lot of people missed that limited the ability to negotiate on some key drugs, which has been estimated to likely cost the American taxpayer and the government billions of dollars over the next couple years.
Huetteman: Yeah, the CBO says that those changes will cost Medicare at least $5 billion in missed savings over 10 years.
Weber: Yes, that’s what’s called effective lobbying. Essentially, what happened is some pharma companies were able to tuck in provisions that key drugs, I think it was Keytruda, I’m not sure if I’m pronouncing that right, or Keytruda, which is used to treat cancer, it’s a drug by Merck. It had $17.9 billion in U.S. sales in 2024. That’s the kind of drug that they won’t be able to negotiate prices on for a bit.
Huetteman: Yeah, that’s right. Of course, that also means that Medicare patients will be subject to paying their percentage of those higher prices as well. On top of talking about this CBO score there, we’re talking about drug prices that real people are paying for their expensive cancer drugs right now. I guess I’m curious why Trump isn’t using the negotiation process in order to lower those drug prices?
Raman: I would add that something that makes this more difficult is that Trump has been very back-and-forth about a lot of his opinions on different things that he’s going to do throughout the last several months in this process. Even if you look at something like how we would deal with tariffs on the pharmaceutical industry, we’ve been a little bit all over the place. I think even if he’s not demonstrating the clear idea of which way he’d want to go, it makes it a little bit harder for the regulators, whether it would be in Congress or through the FDA, to do anything, given that he’s been changing a lot what he’s hinting at wanting to do.
Huetteman: Yeah, that’s right. Actually, Sarah, you brought up the CMS innovation option. There’s a story out about this this week. The Washington Post reports that the Trump administration is considering using that center to do a pilot project to expand access to GLP-1 drugs for weight loss purposes by allowing state Medicaid and Medicare Part D plans to cover them.
Now, insurance premiums are slated to go way up next year. If I’m not mistaken, the cost of covering GLP-1 drugs is one reason that insurers have cited for those premium hikes. If this happens, can we expect that the cost of those drugs would strain state and federal budgets?
Karlin-Smith: Actually, one I guess positive thing is that some GLP-1 drugs are slated to be subject to negotiation through the IRA [Inflation Reduction Act] program next year, so that there’s maybe positive news around the prices of those going down. Again, that’s obviously only for Medicare. But the problem on the back end is that, based on law, Medicare is not allowed in Part D to cover drugs for weight loss.
The Biden administration had tried through rulemaking to make an argument that weight loss drugs and drugs that treat obesity are two different things, hearkening back to — when that law was written we really didn’t understand obesity as a disease process and all the health problems it has on your body. We thought of weight loss as more of a cosmetic thing. The Trump administration actually pulled that rule, so this would be a much more small step in the direction of trying to get coverage. The report says it would be a “voluntary demo.”
The biggest question in my mind, which is again, knowing that these drugs, even with cheaper prices, would likely raise costs, is what is the incentive for health plans to voluntarily want to participate in this? What would the government have to do to incentivize this? Without some sort of push there for states and for Medicare Part D plans, I’m not sure the private plans are just going to pick up these products given the amount of people that would qualify for them. I think we need a lot more details from the Trump administration to know if they can actually make this feasible.
Weber: I just find this to be such a fascinating move considering [CMS Administrator Mehmet] Oz and Kennedy have such different opinions about weight loss drugs, as does MAHA as a whole. We at The Washington Post had reported previously that Oz does have financial ties to Ozempic through his show — they had to run a sponsored ad to some extent — and also through other means. It’s fascinating to see that clearly this is going forward, despite Kennedy having said repeatedly, often, constantly that he does not want to pay for these drugs, that he thinks other interventions, healthy diet and lifestyle, should be implemented. Which Oz has also really promoted as well. So fascinating to see how this experiment plays out. I agree with Sarah; I’m not sure where the incentives are, considering the cost that this will be to see it play out.
Huetteman: And one year after Trump promised coverage for in vitro fertilization services on the campaign trail, The Washington Post reports that the White House does not plan to require health insurers to cover IVF. The president had said that “if he were elected, the government would either pay for IVF services itself or require insurance companies to do it.”
What’s standing in the way here? What’s involved in making something an essential health benefit?
Raman: I think this whole process has been interesting. In February, Trump had put out an executive order directing his administration to come up ways to reduce the out-of-pocket costs for IVF. At the time, it’s pretty vague in terms of what that would entail. After the deadline passed, in part, I think a lot of people weren’t surprised because a) IVF is very expensive. And b) I think there are a lot of complicated nuances to some of his base and whether or not they fully support IVF. We had a lot of this last year, with people saying that they support it, but then also some of the folks that are more pro-life have some stipulations about not wanting embryos destroyed. It just complicated that some of the people that were talking to him about some of the other abortion-related issues were not on board with all of the IVF things. I think that has played definitely a factor in what they’re going to do with this.
But it’s also a hard thing to do, to just make this something that — even with prescription drugs, reducing the costs of those is not simple. In order for them to make it an essential health benefit, I think, is also more complicated given the issues that we’ve been having with preventative care, and just the concerns about the [U.S. Preventive Services Task Force] getting removed and what that’ll do to different things that are covered. It’s complicated and I wouldn’t really see this changing on IVF in the near future, at least from the executive level.
Karlin-Smith: It needs to go through Congress to be an essential health benefit. I think there’s a theme in some of the topics we’re coming up to today where Trump is clearly coming up to the limits of his bully power and his threats of negotiation. I think Martin Makary, the head of the FDA, said, “You get more bees with honey.” Well, unfortunately, sometimes it’s just not enough to attract these industries to make major changes.
Yes, they’ve gotten some sort of minor concessions, I think. I know they would like to think they’re transformative, but I think a lot of what they’ve gotten voluntarily is pretty minor, in terms of both health impact, and also how much it harms industry in terms of, like, food dyes. Or even the insurance companies saying, Oh, sure, we’ll do better on not going crazy on prior authorization.
I think Trump now has to actually double-down and work with policymakers on rule writing, or work with Congress. It’s more complicated, especially again, as Sandhya said, IVF is something that’s complicated for his base to support.
Huetteman: That’s right. This all came out of the blowback about how far towards banning abortion the country was going to go under Trump. This was a way to say, We’re preserving some parts of the reproductive health that are really important to people in our base, right?
Raman: Yet even when Congress has tried to look at any of the IVF legislation in the past, it’s fallen on party lines. There have been ones that have been more messaging on either side. I think the closest we’ve gotten is that, on the defense side, trying to consider measures there for folks with Tricare, but it’s difficult to get folks on board with things like this through Congress.
Huetteman: Well, speaking of Congress, Congress has left the building. August recess has begun and lawmakers are back home. Say, how is that government funding coming along. Sandhya?
Raman: I think we’re in a similar place to many years in that it’s August, they’re out. We need government funding by the end of September, and we’re nowhere close to getting that. I would say on the plus side, the Senate is further along than they usually are. Before they left, they did mark up the Labor, HHS, Education funding bill, and that was overwhelmingly bipartisan. It included some money that would be a boost for NIH [the National Institutes of Health], which I know was a big concern for a lot of folks given what was in the White House proposal. It maintains funding for some of the programs that would be cut under the White House, things like Title X, Ryan White HIV. It also has a little bit of a pushback on making sure that the agencies continue the staffing to keep up some of their statutory duties.
But again, it’s just the Senate. The House has not put out their bill. I would expect theirs to be a bit more conservative, given that the head of the Appropriations Committee in the Senate is Susan Collins, who’s been a little bit more moderate. The House is expected to release theirs and mark up theirs right after they get back. They meant to do it before recess but got pushed back because of reconciliation and that changing their schedule.
It depends what they say in theirs and how much difference there is. I would expect there to be a lot of differences. It seems like we’re headed toward the usual of at least some sort of temporary spending to kick it down the line. Whether or not that ends up being a year again, like we did this year, or a short-term thing, we’re not sure yet. It depends on where we are in September.
Huetteman: Right. And possibly preceded by a lot of fighting over social issues that get thrown into the health bill, and fights over the actual funding levels, if I had to guess, based on how House lawmakers have been talking about it so far.
Raman: Oh, no. I think just the fact that we had such a big rescissions debate this year and the fact that we might do that again, it has definitely left a sour taste for a lot of Democrats who are worried that if whatever they vote for here might just get clawed back later on down the line. That’ll be another thorn in it.
Huetteman: Awesome. Well, thanks for that take. That’s this week’s news. Now it’s time for our extra-credits segment. That’s where we each recognize a story we read this week that we think you should read, too. Don’t worry if you miss it; we’ll put the links in our show notes on your phone or other mobile device.
Lauren, why don’t you go first this week?
Weber: I have a doozy of a story from The New York Times titled “‘Hot Wasps’ Found at Nuclear Facility in South Carolina,” by Emily Anthes. Yeah, it’s the stuff of nightmares. It’s all about how wasps became radioactive — four wasps’ nests near a South Carolina nuclear facility.
Huetteman: Yikes.
Weber: If this gave you bad dreams, it definitely did for me. Essentially, what some of the researchers have posited is that wasps could have burrowed in some sort of bad wood or wood that was contaminated or other parts of the area that are contaminated. But this idea that it sounds like something out of Chernobyl, or something like that. But this idea that in the U.S., you could have a nuclear facility that is potentially transforming some of the near-wildlife is concerning in terms of cleanup efforts, and also concerning in terms of contamination control. Clearly, there’s more that needs to be dug into there. Hopefully everyone sleeps after hearing about this.
Huetteman: Woof, yeah. I might need to take an Ambien tonight. Sandhya, how about you go next?
Raman: My extra credit is from me in Roll Call. It’s my last dispatch from my reporting trip in Sweden earlier this year. And it’s called “Sweden’s Push for Smokeless Products Leads Some To Wonder About Risks.” It looks a little bit at some of the public health impacts as Sweden has really tried to reduce their smoking rate to become smoke-free. The U.S. is also at a low from smoking. Some of the things that public health experts are thinking about as people shift to other products and how they’re able to message to the remaining smokers that are not willing to give that up still.
Huetteman: Awesome. Thanks for telling us about your work there. And Sarah?
Karlin-Smith: I looked at a story from Slate, “Confessions of a Welfare Queen: I Study Poverty for a Living, and I Never Thought I’d Need Medicaid. Then My Child Was Diagnosed With a Terminal Illness,” by Maria Kefalas. It’s a personal story from a mother whose family needed Medicaid when their young child was diagnosed with an illness that was going to severely require intense medical care and limit her lifespan. They were able to take advantage of what are known as “Katie Beckett waivers” that were instituted by Ronald Reagan to allow states to voluntarily allow higher income requirements so that people could get Medicaid and care for their children at home. The original girl it was named for was otherwise basically going to be stuck living her life, and she lived until 34, in a hospital.
The purpose of the story is really to point out that now that the “Big, Beautiful Bill” has passed and there are $1 trillion in spending cuts to Medicaid, that these are some of the sorts of people and programs, because it is not a mandatory program, that may unfortunately be on the first for the chopping block. I think the piece does a good job of pointing out, while there’s been a lot of rhetoric around the people who are going to get hurt by this are people that are not working or somehow abusing the system, and the mother does a pretty good job of talking about how both she and her husband continue to work. Most of the families that need this program, to the extent they can, want to keep working. You just get a really human picture of the type of people that are at risk of losing services.
Huetteman: Yeah, for sure. It’s a really illuminating story. Thanks for talking about it. My extra credit this week is from my colleagues here at KFF Health News. The headline is “New Medicaid Federal Work Requirements Mean Less Leeway for States.” It’s by Katheryn Houghton and Bram Sable-Smith.
They report that at least 14 states are in progress designing their own work requirement programs. But now, with the passage of Trump’s law last month, which institutes federal work requirements, those states must make sure that their programs meet federal standards. In some cases, the states are actually going even further than federal requirements, my colleagues report. For instance, Arizona state law would institute a five-year lifetime limit on Medicaid coverage for “able-bodied adults.”
OK, that’s this week’s show. Thanks as always to our producer-engineer, Francis Ying, and to Stephanie Stapleton, our editor this week. If you enjoyed the podcast, you can subscribe wherever you get your podcasts. We’d appreciate it if you left a review; that helps other people find us, too. Also, as always, you can email us your comments or questions. We’re at whatthehealth@kff.org. Or you can find me on LinkedIn. Where are you guys these days? Sandhya?
Raman: I’m on X and Bluesky @SandhyaWrites.
Huetteman: Sarah?
Karlin-Smith: A little bit of everywhere, but X, Bluesky, LinkedIn @SarahKarlin or @sarahkarlin-smith.
Huetteman: And Lauren?
Weber: I’m at X and Bluesky @laurenweberhp. Yes, the HP is for “health policy.”
Huetteman: We’ll be back in your feed next week. Until then, be healthy.
Credits
Francis Ying
Audio producer
Stephanie Stapleton
Editor
To hear all our podcasts, click here.
And subscribe to KFF Health News’ “What the Health?” on Spotify, Apple Podcasts, Pocket Casts, or wherever you listen to podcasts.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
USE OUR CONTENT
This story can be republished for free (details).
