I've been producing a annotated news roundup on single-payer/public health, now called "Do Not Resuscitate," for nearly a decade. I recently migrated it to Substack [timfrasca]. Here's the latest edition. I'm taking out the hyperlinks due to space, but you can find them there. Sign up for free if you're interested. <https://substack.com/home/post/p-175715615>.
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Shutdown: The Federal Government’s
nap looks likely to continue as Democrats insist we preserve Obamacare’s
massive subsidies to for-profit conglomerates rather than accede to the GOP
plan to throw millions of Americans into uninsured purgatory. Heads, we destroy
everything; tails, we pay off the insurance companies. And that’s the good
news.
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Peter Sullivan, “ACA premiums to rise 114% without subsidy renewal,” Axios, Oct 1, 2025
Premiums will more than double for
millions of Obamacare policy purchasers if Congress ends the extra subsidies:
from an average of $888 to $1,904 per year. As those are averages, some people
will get slammed much more severely.
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Natalie Foster, “GOP to Gen Z: Pay double for health insurance or go without,” New York Times, Oct 5, 2025
Imagine a single 28-year-old making
a salary of $40K. This coming year, she’ll see her annual silver plan premium
close to double, from about $1,500 to nearly $3,000 a year.
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Mario Aguilar, “Home hospital programs in ‘terror’ as they grind to halt ahead of government shutdown,” STAT, Sep 30, 2025
“Hospital at home initiatives
across the country have already shut down” in anticipation of the Trump cuts.
These Covid-emergency era innovations were created to ease the pressure on
overburdened ERs; they’re grinding to a halt. Dr Oz at CMS ordered all
Medicare-funded hospital-at-home programs immediately to discharge their
patients and return them to hospitals.
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Melissa Goldin, “Democrats did not shut down the government to give health care to ‘illegal immigrants,’” Associated Press, Oct 3, 2025
The soundbite Republicans are
universally using over the shutdown is that Democrats are determined to shower
free stuff on those awful immigrants. False but probably
effective—immigrant-hatred is a winning strategy, at least for now. To repeat: Immigrants
in the U.S. illegally are not eligible for any federal health care programs,
including the commercial subsidies. Hospitals do have to treat everyone in
emergencies, and sometimes they get compensatory payments for that. Or we could
turn away people bleeding to death from gunshot wounds and let them die on the
street outside the ER.
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Emily Birnbaum, “Insurers spend big to save Obamacare subsidies at center of shutdown fight,” Bloomberg, Oct 1, 2025
This account of the lobbying blitz
around the subsidies highlights the eagerness of the for-profit insurance
agency to pull its lucrative Obamacare chestnuts out of the fire. “Health
insurers, long concerned a spike in insurance premiums triggered by the
subsidies’ expiration will drive away millions of customers, are seizing
the moment.” The ad campaign is co-sponsored by insurers and professional
associations like the AMA, American Lung Association, and other health care
advocates. This is where healthcare professionals have come to with the legacy
of Obamacare: shilling for the profiteers because the alternative is mass
exclusion from healthcare. Hard-line GOP ideologues, on the other hand, want
the punishment to continue and, ironically—or perversely—argue that the shutdown
is “Doing Insurers’ Bidding.” They’re not wrong.
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“The shutdown will make Trump’s theory of government—ICE but no healthcare—visible,” Empty Wheel, Oct 1, 2025
This unsigned column makes the
point that the Supreme Court has consistently given Trump the green light to
withhold legally authorized money, taking the Article One power away from
Congress and handing it to Trump’s anti-government enforcers. Therefore, while
the shutdown may give Trump a PR excuse to fire more workers, “The larger point
is that the government is already shut down and has been for several months.
Activities deemed ‘essential’ by the president—stalking immigrants, lobbing
missiles at Iran, etc.—have gone on, but activities purported to conflict with
the president’s policies have been stopped. The shutdown can certainly be used
rhetorically to justify more firings, but they’re just the same firings with a
different rationale.” Excellent clarification.
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Morgan Lee, “New Mexico legislators rush to shore up safety net programs after federal cuts,” Associated Press, Oct 1, 2025
States have to figure out whether
to let their residents take the hit from Trump or do something. New Mexico has
a high Medicaid participation rate and a budget surplus, which it is using to
shore up that program and others. Because one quarter of the state’s residents
use food stamps, “New Mexico legislators are considering a quick infusion of
state spending on food assistance through SNAP and to food banks.” It will also
cover cuts to the public broadcasting system to keep tribal ratio stations
alive.
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Jess Mador, “Changes coming to Georgia’s work requirement Medicaid ‘Pathways’ program,” WABE [Atlanta], Sep 29, 2025
Medicaid will require beneficiaries
to prove they have the right to see doctors by documenting their noble
worthiness as gainfully employed persons, imitating the Georgia “Pathways to
Care” program, which has been a complete debacle and should be replicated in 49
other states. Georgia theoretically offers Medicaid to a married couple with
one kid if they earn no more than $2000 a month. But no sitting around at home
enjoying all that wealth. You have to be working, going to school, or now
caring for a toddler. The latter exception is new as the Georgia GOP tries to
expand its program beyond the 7,000 people who have entered it after a
year of huge administrative expense and bureaucratic chaos. The state will also
allow people to prove they work only once a year instead of every month in the
original plan. The average time sink to post all the documentation is at least
5 hours according to one beneficiary, which makes sense given that 2/3 of
Georgia’s Medicaid spending goes to admin costs. (Medicare spends 2%.) This
is the giant mess that Trump is forcing on everyone, and it’s not a failure:
it fulfills its true goal—throwing people off Medicaid.
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Shannon Firth, “Study on Medicaid work requirements finds no gains in insurance, employment,” MedPage Today, Oct 1, 2025
Just to confirm, this study from
Georgetown University demonstrates the utterly predictable: that Georgia's
Medicaid work requirements did nothing to increase employment while enrolling a
few thousand people. Meanwhile, North Carolina enrolled 650K (without
documenting your job) during a similar period. The study’s author called the
national rollout “shockingly bad health policy,” which is correct and a
“spectacular failure,” which is not because it clearly succeeded in letting
poor people get sick and die.
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Mark V. Pauly, “Instead of work requirements, Medicaid should turn to employer incentives,” STAT, Oct 1, 2025
This business professor proposes
that instead of harassing Medicaid beneficiaries over their work record, why
not help small businesses to provide medical coverage? “The only way for work
requirements to shrink the Medicaid rolls by inducing people to work is to get
them to take jobs that come with insurance benefits.” Therefore, he says, let’s
provide more subsidies to firms that offer health benefits. This is well
intentioned but more expensive tinkering around the edges of a failing
system. Universalizing Medicare and breaking up the healthcare conglomerates
would be cheaper and simpler.
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Jeni Hebert-Beirne, “My equity research is being censored. I knew this day was coming,” MedPage Today, Oct 1, 2025
Moving over to another of Trump’s
triumphs, the destruction of DEI, which we recall stands for Diversity, Equity,
and Inclusion. The Trump goal is Uniformity, Inequity, and Exclusion or,
“let’s make a UIE”), and it’s working as designed. This researcher’s grant was
accused of “immoral discrimination” against the privileged majority and
canceled. He was working with a community team in Chicago where average life
expectancy for black people is 11 fewer years than for whites, and food
insecurity is 40% versus 13%. And that, in Trumpland, is how things should be.
The author points out one little-known counterintuitive fact: that rich
societies with huge inequalities are unhealthier overall, meaning that the
wealthiest also do poorly.
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Lisa Schencker, “Black babies die suddenly, unexpectedly at 14 times the rate of white babies in Cook County,” Chicago Tribune, Oct 1, 2025
Another successful Trump
goal—killing off nonwhite infants at a comfortably high rate. Infant deaths are
mostly preventable with proper pre- and post-natal care, programs Trump is also
putting on the chopping block.
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Katia Riddle, “What Mississippi's infant mortality crisis says about the risks of Medicaid cuts,” NPR, Oct 2, 2025
Another example from Mississippi:
infant deaths are the highest in a decade and worsening, leading to the declaration
of a statewide public health emergency. Medicaid cuts will make it worse. “More
than half the counties in Mississippi are considered maternity care deserts
where prenatal care is difficult or impossible to find.” Destroying the rural
health safety net will make that worse.
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Paula Andalo, “Health centers face risks as government funding lapses,” KFF Health News/CBS News, Oct 3, 2025
More proud moments for the GOP
budget-slashers: 1,500 federally funded health centers, which run on sliding
scales to accommodate 34 million users, face “significant financial
challenges.” One network manager in California calls it the “worst time ever”
for his 28 clinics and their 40% Hispanic population. Several states are
trying to top up the clinics’ income with state funds, but California’s
governor Newsom promptly cut their budgets in anticipation of the coming
Medicaid disaster. No doubt that will make him an attractive “centrist” presidential
candidate in two more years.
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Brandy Zadrozny, “Mark Blaxill helped build the anti-vaccine movement. RFK Jr. just hired him at CDC,” MSNBC, Sep 26, 2025
On the quackocracy front, RFK Jr
isn’t slowing down a bit. He appointed another mountebank to a top role at the
CDC, one Mark Blaxill, who thinks all vaccines injure children and once edited
the anti-vaccine website, Age of Autism. Kennedy likes to cite one of
Blaxill’s papers but doesn’t mention that “Autism Tsunami” was later withdrawn
by the journal due to statistical misrepresentation, “unrepresentative data,
unjustified assumptions, and undisclosed conflicts of interest.”
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Céline Gounder, “Inside the high-stakes battle over vaccine injury compensation, autism and public trust,” CBS News, Sep 30, 2025
Here’s a Kennedy idea that could
lead to untold disaster: adding autism to the list of conditions covered by the
Vaccine Injury Compensation Program, which was created to accommodate people’s nervousness
about vaccines. Its entire reason to exist is to NOT demand clear proof of
direct causation but to give claimants the benefit of the doubt if there is
some plausible connection between a vaccine and an adverse event. It’s like no-fault
car insurance—everyone gets taken care of without lengthy court battles.
Kennedy wants to add autism as a probable outcome, which will bankrupt the
program and drive vaccines manufacturers to exit the business entirely. If he
gets away with this, we could end up with no vaccines at all.
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Aurora Horstkamp, Miriam Rabkin & Benedicte Callan, “Whopper of the Week: RFK Jr. is dead wrong babies won’t get hepatitis B,” Defend Public Health, Oct 8, 2025
WoW is a fun ongoing series that
everyone should sign up for produced by Defend Public Health. [Disclosure: I’m
a member.] Babies can and do get hepatitis B, or they used to before widespread
vaccination. The virus “easily passes from mother to child during childbirth”
but also can circulate in a household or a daycare center through casual
contact. Of the estimated 1 million Americans with chronic Hep B, and only half
of them know it. “Removing the recommendation for universal vaccination of
newborns and instead screening for hepatitis B infection in the mother will miss
12–16% of pregnant women who do not receive prenatal screening.” Of course,
we could improve prenatal care and drive that number down, but that would cost
money needed for tax cuts. How long will it take to work our way back up to the
20K annual infant Hep B infections per year that we used to enjoy?
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Lucy Hutner, Parvaneh Nouri & Yokarla Veras, “Self-blame and panic has set in among our pregnant patients,” MedPage Today, Oct 2, 2025
Donald Trump’s medical expertise
has led to a wave of “guilt, self-blame, and panic” among parents now freaking
out over the dangers of medications used during pregnancy. These psychiatrists
say the new message is landing “with searing clarity”: if anything goes wrong, it’s
Mom’s fault. You took Tylenol, and the baby’s a mess.
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Stephanie Soucheray, “Poll shows Americans view COVID-19 vaccines as unsafe for pregnant women,” CIDRAP, Oct 1, 2025
A new poll shows that fewer than
half think it’s safe for pregnant women to be vaccinated against Covid.
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Leana S. Wen, “The real problem with Tylenol (it’s not autism),” Washington Post, Sep 30, 2025
Nuance does not make for good
soundbites, so cautioning people about acetaminophen use will be harder than
ever after the Trump-RFK Jr medical PR spectacle. Tylenol probably shouldn’t be
an over-the-counter medication and should certainly have more consistent
warnings about how easy it is to overdose on it. Acetaminophen present in 600
medicines, meaning one can easily mix them and poison oneself either
accidentally or intentionally. We should check labels for abbreviations such as
“APAP,” “Acetam,” or the alternate name paracetamol.
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Mikhail Zinshteyn, “Trump administration restores research grants to UCLA following federal judge’s order,” CalMatters/Associated Press, Sep 30, 2025
On the destruction of biomedical
research, the Trump Administration lost a round in federal court after a judge
restored almost all of UCLA’s NIH grants. So far, Trump’s officials have obeyed
the order, but the fight over phony anti-Semitism in the UC system continues.
Let’s see if the judge who issued the ruling still gets called out by the White
House or if her house blows up. “Rita Lin has restored hundreds of other
research grants from multiple agencies across the UC system.”
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Meg Tirrell, “RFK Jr.’s HHS killed a research grant to investigate vaccine safety, then asked the researcher to publicly present results,” CNN, Oct 4, 2025
Tragicomedy at HHS: “About 90
seconds into his presentation on Covid-19 vaccine safety at a closely watched
meeting of advisers to the CDC last month, Dr. Bruce Carleton made a startling
revelation: The government grant supporting his research had been abruptly
terminated.” That’s right, he was researching Covid vaccine safety, but the
algorithm or some junior DOGEbag saw the word Covid, said, That’s
all over, and canceled his grant. After the researcher’s announcement, the HHS
immediately said it wasn’t true, which it was.
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Amudalat Ajasa & Rachel Roubein, “How the agriculture lobby rushed to defend pesticides from MAHA,” Washington Post, Oct 6, 2025
What about Kennedy’s public stance
at a crusader against environmental toxins? It doesn’t hold up. “Alarmed by the
first MAHA commission report, the agriculture industry mobilized to shape the
next installment.” And didn’t that pay off! Pesticides and herbicides got the
kid gloves treatment in the next MAHA report. Specifically, there were no more
questions about glyphosate and atrazine, despise their known
carcinogenic attributes. Moms Across America denounced the “glaring example of
chemical company influence,” but in the battle between corporate America and
the Moms, I’m betting on Kyle Kunkler, former director of government affairs
for the American Soybean Association, now deputy assistant
administrator for pesticides in the Office of Chemical Safety and Pollution
Prevention. That’s right, the guy who used to lobby Washington to protect
pesticides is now in charge of regulating them.
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Walt Bogdanich, Carson Kessler & Jeremy Singer-Vine, “How private equity oversees the ethics of drug research,” New York Times, Oct 4, 2025
After shocking abuses in medical
research came to light, such as the notorious Tuskegee syphilis study in which
black men were left untreated so that they could be studied as they got sick
and died, researchers now have to monitored by ethics committees, which are
called IRBs, Independent Review Boards. How independent are they? Not so much,
according to this account about how private equity has absorbed the for-profit
IRB business. Novo Nordisk, for example, makers of one of the fat shots,
“didn’t have to venture far to hire an ethics panel for its liver-disease trial.
It chose WCG Clinical, a review board partly owned by its own corporate
parent.” How convenient! The same outfit is eager to prove a drug works gets
ethics approval from an affiliated IRB. “Private-equity investors are
transforming this obscure but vital corner of American health care. Today,
more than half of all U.S. drug trials are reviewed by for-profit panels, blurring
the line between the reviewer and the reviewed.” And we wonder why crackpots
have convinced millions of people to distrust everything. This cozy
relationship raises the question of what may have been shoved under the rug in
the testing of the wildly popular fat shots. No doubt we’ll find out in a few years.
Worth reading in full.
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See the full archive at www.nypan.org/single-payer-news
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