Podcast: KHN’s ‘What the Health?’ What’s next for the FDA?

Reviewed by Kate Anderton, B.Sc. (Editor)Mar 7 2019

The resignation of Scott Gottlieb as commissioner of the Food and Drug Administration caught many FDA watchers by surprise. Gottlieb has been an active regulator in a very anti-regulatory Trump administration. Unlike many Trump officials, Gottlieb's work on e-cigarettes, nutrition, opioids and generic drugs has won him praise from both Democrats and Republicans.

Meanwhile, efforts are underway on Capitol Hill and in the states to fix some problems with the Affordable Care Act.

And with several outbreaks of measles and other contagious diseases around the country, public health officials are refocusing on how to convince parents that it's safe to vaccinate their children.

This week's panelists are Julie Rovner of Kaiser Health News, Margot Sanger-Katz of The New York Times, Joanne Kenen of Politico and Kimberly Leonard of the Washington Examiner.

Among the takeaways from this week's podcast:

• With the departure from the FDA of Scott Gottlieb in the coming weeks, it is not clear that whoever succeeds him will want to — or be able to — pursue the same sort of activist agenda on everything from nutrition labeling to cracking down on flavored tobacco and nicotine products to promoting generic medications.
• Democrats in Congress are still hoping to fix some of the Affordable Care Act's outstanding issues, including reinstating funding for "navigators," who help consumers find and enroll in coverage, and boosting subsidies for those who earn just over the cutoff for federal help.
• Though within the Democratic caucus there is a lot of talk about sweeping reforms like "Medicare-for-all," the Democratic leadership is focusing first here. It's viewed as a good place for the party's moderates. Some also say it's an opportunity for bipartisan action. Republicans, however, tend to disagree. Any effort to amend the ACA will reopen a major fight over abortion.
• Medicaid expansion has been a big part of the ACA debate. But in some states where voters expressed their support for it, state legislators appear to be intervening and saying "not so fast." The later-adopting, more conservative states are interested in experimenting with expanding Medicaid, but they also want to put their stamp on the idea, by adding things like work requirements.
• A Senate committee held hearings this week on why parents are reluctant to vaccinate their children against preventable diseases. The consensus of many of the senators and witnesses was that public health officials need to do a better job explaining how dangerous diseases like measles really are. But others say persuasion will have less of an impact than laws that make it harder for unvaccinated children to attend public school.

Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read, too:

Julie Rovner: Kaiser Health News' "Hidden FDA Reports Detail Harm Caused By Scores Of Medical Devices," by Christina Jewett

Margot Sanger-Katz: The Washington Post's "Long Overlooked by Science, Pregnancy Is Finally Getting Attention It Deserves," by Carolyn Y. Johnson

Joanne Kenen: ProPublica's "I'm a Journalist. Apparently, I'm Also One of America's 'Top Doctors,'" by Marshall Allen

Kimberly Leonard: The Toronto Globe and Mail's "Pharmacare Panel Offers No Prescription for How the New Program Would Work," by Kelly Grant

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