On August 27, the White House released a statement that Dr. Susan Monarez was terminated from her role as director of the Centers for Disease Control and Prevention (CDC) after reportedly being asked to resign by Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr., and refusing. The CDC was under her leadership for 28 days. Several other top CDC career officials resigned the same day, which has raised significant concern from members of Congress and stakeholders regarding the decisions and recommendations being made on scientific issues, particularly vaccine recommendations.
- The departures also leave the agency chiefly responsible for public health without permanent leadership after being significantly affected by Reductions in Force (RIFs) and the recent attack on the CDC in which one person was killed. Jim O’Neill, who is currently the HHS Deputy Secretary, has been named the acting director of CDC. The CDC Director is a Senate confirmed position, so a new permanent director cannot be installed without action by Congress.
- Key Senators have called for oversight of HHS following the announcements, and the top Democrat on the Senate Appropriations Committee called for Secretary Kennedy to be dismissed from his role. Secretary Kennedy is scheduled to testify before the Senate Finance Committee on Thursday, September 4. The hearing is titled, “The President’s 2026 Health Care Agenda,” and, although it is not specifically related to the recent events at CDC, Senators on both sides of the aisle will likely raise questions about the recent departures and the future of the agency.
On August 19, the Centers for Medicare and Medicaid Services (CMS) announced an oversight initiative to remove individual enrollees who do not meet citizenship requirements from the Medicaid and CHIP programs. As part of the initiative, CMS will begin sending states monthly enrollment reports that flag individuals whose citizenship or immigration status cannot be confirmed through federal databases, including DHS’ Systematic Alien Verification for Entitlements (SAVE) system. States are expected to review flagged cases, request additional documentation where needed, and take actions, including coverage adjustments when eligibility cannot be verified. Funders should be aware and ready to assist partners helping eligible immigrants retain Medicaid and CHIP coverage. The nonpartisan Congressional Research Service notes the following types of noncitizens may be eligible for Medicaid: “lawful permanent residents (LPRs), refugees, aliens granted parole for at least one year, aliens granted asylum or related relief, certain abused spouses and children, Cuban-Haitian entrants, and Citizens of the Freely Associated States (FAS) residing in the U.S. states and territories.”
HHS also moved to revoke the remaining emergency use authorizations (EUAs) for the COVID-19 vaccine, issuing market authorization for updated boosters only for adults 65 and older and individuals under the age of 65 who are at increased risk for severe COVID-19. Several public health officials, including Dr. Paul Offit, a member of the Food and Drug Administration’s (FDA) Vaccines and Related Biological Products Advisory Committee, and Dr. Jerome Adams, the Surgeon General under the first Trump Administration, expressed concern that this action from FDA will restrict access to the COVID-19 vaccine. The revocation of the EUAs as well as other recent actions related to vaccines could mean that COVID-19 vaccine access at pharmacies will be limited and/or payment will be required, where previously they were available with no cost-sharing.
HHS recently announced an initiative urging medical education organizations to implement “comprehensive nutrition education and training” into their curriculums, in collaboration with the Department of Education. HHS stated the vast majority of physicians graduate with “little to no training in nutrition,” citing research that 75 percent of U.S. medical schools have no required clinical nutrition classes, and only 14 percent of medical residency programs have a required nutrition curriculum. As such, HHS has directed medical education organizations to submit to HHS written plans detailing the “scope, timeline, standards alignment, measurable milestones, and accountability measures” of their nutrition education commitments by September 10. Reforming nutrition education for medical schools has been a priority for Secretary Kennedy under his Make America Healthy Again agenda, with an unofficial draft of the “Make Our Children Healthy Again Strategy” recommending that CMS use its regulatory authorities in this regard.
The unofficial draft of the “Make Our Children Health Again Strategy,” action plan was reported by The New York Times on August 14. The reported draft includes several policy recommendations for HHS, many of which have already been circulated by HHS leadership. Initial responses to the reported draft strategy have been mixed, with some indicating that MAHA supporters hoped to see more aggressive policies regarding ultra-processed foods and the agriculture industry.
The draft strategy outlines policies addressing four key drivers of poor health outcomes identified by the MAHA Report: Poor Diet, Chemical Exposure, Lack of Physical Activity and Chronic Stress, and Overmedicalization. Specific action items include:
- Launch a National Institutes of Health (NIH) MAHA Chronic Disease Task Force;
- Launch a mental health diagnosis and prescription working group to evaluate prescription patterns for selective serotonin reuptake inhibitors (SSRIs), antipsychotics, stimulants, and other relevant drugs for children;
- Produce a study on electromagnetic radiation and its health impacts;
- Revise the proposed Front-of-Pack Nutrition labeling rule;
- Increase Federal Trade Commission (FTC) and Department of Justice (DOJ) oversight of Direct-to-Consumer Pharmaceutical advertising; and
- Explore enhanced prior authorization requirements to “address the overuse of medications in school-age children.”
The timing for the unveiling of the final strategy has not been announced but could be in the coming weeks.
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