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Speaker Johnson says mass layoffs would be 'regrettable'

admin - Latest News - October 5, 2025
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Speaker of the House Mike Johnson, R-La., joined “Meet the Press” as the White House threatens mass layoffs of federal workers amid the government shutdown.



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By Berkeley Lovelace Jr., Aria Bendix and Erika EdwardsPresident Donald Trump said Monday the Food and Drug Administration approved a chemotherapy drug called leucovorin as a treatment to alleviate symptoms of autism, despite little evidence that the medication works.Trump also said the administration is issuing a warning to doctors not to recommend acetaminophen — the active ingredient in Tylenol and other widely used medications — for pregnant women, claiming it may be linked to autism in children. Trump had been teasing the announcement for days, as Health Secretary Robert F. Kennedy Jr. and other health officials have pledged to determine the cause of the developmental disorder by September.The administration had planned to release its long-awaited report on causes of autism around Sept. 29 or Sept. 30, a person familiar with the matter told NBC News. But Trump pre-empted the rollout over the weekend, and details soon appeared in The Washington Post.“We understood a lot more than a lot of people who studied it,” Trump said from the White House, referring to autism. He spoke alongside Kennedy, Food and Drug Administration Commissioner Marty Makary, National Institutes of Health Director Jay Bhattacharya and Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services. ”Taking Tylenol is not good,” Trump said. “I’ll say it. It’s not good.”Leucovorin is a drug approved by the FDA to counteract the side effects of certain chemotherapy drugs and sometimes used off-label to treat vitamin B9 deficiency. Leucovorin is a form of folinic acid, a B vitamin. It has shown promise in clinical trials with helping some children with autism improve their speech. But the Autism Science Foundation, which funds evidence-based autism research, does not recommend it as a treatment yet and says more studies are needed.Trump said the FDA updated the drug’s label Monday for the treatment of autism symptoms. Oz said Medicaid — in partnership with states — will cover it with a prescription.“We believe insurance companies will rapidly follow our lead,” he said.Kennedy also said the FDA will issue a letter advising health care providers that the over-the-counter medication should be used during pregnancy only in cases of high fever, when the fever itself may pose a health risk to the fetus. The FDA’s notice, sometimes called a “Dear Doctor” letter, is meant to alert physicians and other prescribers about urgent or clinically significant safety issues it has identified with a drug. Kennedy also said the FDA will begin the process to initiate a safety label change for the drug.Bhattacharya said at Monday’s briefing that the NIH will dedicate $50 million to 13 research projects focused on identifying root causes and treatments for autism, an effort known as the “autism data science initiative.” The research will focus on environmental and medical factors, nutrition, events during pregnancy, biology and genetics, he said.“Given this wide range of symptoms across the spectrum, it seems certain that there will be a wide range of biological contributors to explaining the cause,” he said.Researchers who’ve spent decades researching potential causes of autism say the administration hasn’t uncovered any new evidence — and the existing data still doesn’t support its claims.“This is not new,” Dr. Allison Bryant, a high-risk obstetrician at Massachusetts General Hospital in Boston, said in an earlier interview. “It has bubbled up every now and again with studies that show maybe some kind of association but not clearly showing any cause and effect.”Experts say autism spectrum disorder, which is characterized by challenges with social and speech skills and by repetitive behaviors, most likely stems from multiple factors rather than a single cause. It affects 1 in 31 children in the United States, according to the Centers for Disease Control and Prevention.The bulk of scientific research hasn’t identified a link between acetaminophen and autism.“The science hasn’t changed regardless of what comes out from the report,” said Brian K. Lee, a professor of epidemiology at Drexel University in Philadelphia, referring to the Trump administration’s finding. “I’m not sure what the administration is doing, but it looks like they’re just going back and reviewing the evidence and they’re coming to a different conclusion than many scientists would.”Acetaminophen was introduced in the United States in the 1950s as a prescription alternative to aspirin. By the 1970s, it had been made available over the counter and became one of the most commonly used pain and fever medications in the country. The American College of Obstetricians and Gynecologists and other major medical groups say acetaminophen is one of the only safe pain relievers for women during pregnancy, and studies have shown no clear evidence that use during pregnancy leads to developmental issues in kids. The drug is also found in name brands like Theraflu and Excedrin.Forty percent to 65% of women use acetaminophen at some point during pregnancy, according to a 2014 study published in the American Family Physician.Earlier Monday, White House press secretary Karoline Leavitt touted a “major announcement” from Trump, telling reporters at a briefing to go into the autism announcement with “some critical thinking skills and with some open ears.”“They are paying attention to studies, and the gold standard of science and research, that many in this city for far too long have turned a blind eye to,” she said.Trump administration officials are citing previous research, including a literature review Mount Sinai and Harvard researchers published last month in the journal BMC Environmental Health. The review concluded there was most likely an association between autism and acetaminophen exposure during pregnancy. Outside autism researchers, however, said that the review wasn’t rigorously conducted and that it cherry-picked studies that supported its conclusion. The review’s senior author, Andrea Baccarelli, served in 2023 as a paid expert in a class action lawsuit against acetaminophen manufacturers, in which he testified that there was a link between the medication and autism. A judge ultimately excluded his testimony for being scientifically unsound and last year dismissed the case, which is being appealed.Baccarelli said in a statement that he and his colleagues conducted a rigorous review and that the association with neurodevelopmental disorders was strongest when acetaminophen was taken for four weeks or longer. He said he discussed his findings with Kennedy and Bhattacharya in recent weeks.“Further research is needed to confirm the association and determine causality, but based on existing evidence, I believe that caution about acetaminophen use during pregnancy — especially heavy or prolonged use — is warranted,” Baccarelli said.However, other autism researchers have pointed to a large study last year published in the Journal of the American Medical Association, which found no link between acetaminophen use in pregnancy and autism, ADHD or intellectual disability. The study, from Lee and his colleagues in Sweden, analyzed data from more than 2.4 million children. When the researchers looked solely at children with autism, there was a small increased risk possibly associated with acetaminophen. But when the researchers compared siblings within the same families — one exposed during pregnancy, the other not — the link disappeared. The comparison allowed them to control for variables that past studies couldn’t. Siblings share a large part of their genetic background and often have similar environmental exposures in utero and at home.“The biggest elephant in the room here is genetics,” Lee said. “We know that autism, ADHD and other neurodevelopmental disorders are highly heritable.”In an emailed statement, a spokesperson for Kenvue, the maker of Tylenol, said the drug is the safest pain reliever option for pregnant women.“Without it, women face dangerous choices: suffer through conditions like fever that are potentially harmful to both mom and baby or use riskier alternatives,” the spokesperson said. “We believe independent, sound science clearly shows that taking acetaminophen does not cause autism.”Bryant, of Massachusetts General Hospital, said, “The best science that we have available would still suggest that acetaminophen is a safe pain reliever and fever reducer in pregnancy.”Berkeley Lovelace Jr.Berkeley Lovelace Jr. is a health and medical reporter for NBC News. He covers the Food and Drug Administration, with a special focus on Covid vaccines, prescription drug pricing and health care. He previously covered the biotech and pharmaceutical industry with CNBC.Aria BendixAria Bendix is the breaking health reporter for NBC News Digital.Erika EdwardsErika Edwards is a health and medical news writer and reporter for NBC News and “TODAY.”
September 24, 2025
Sept. 24, 2025, 5:00 AM EDTBy Lauren Sausser and Darius Tahir | KFF Health NewsTaking a page from the private insurance industry’s playbook, the Trump administration will launch a program next year to find out how much money an artificial intelligence algorithm could save the federal government by denying care to Medicare patients.The pilot program, designed to weed out wasteful, “low-value” services, amounts to a federal expansion of an unpopular process called prior authorization, which requires patients or someone on their medical team to seek insurance approval before proceeding with certain procedures, tests, and prescriptions. It will affect Medicare patients, and the doctors and hospitals who care for them, in Arizona, Ohio, Oklahoma, New Jersey, Texas, and Washington, starting Jan. 1 and running through 2031.The move has raised eyebrows among politicians and policy experts. The traditional version of Medicare, which covers adults 65 and older and some people with disabilities, has mostly eschewed prior authorization. Still, it is widely used by private insurers, especially in the Medicare Advantage market.And the timing was surprising: The pilot was announced in late June, just days after the Trump administration unveiled a voluntary effort by private health insurers to revamp and reduce their own use of prior authorization, which causes care to be “significantly delayed,” said Dr. Mehmet Oz, administrator of the Centers for Medicare & Medicaid Services.“It erodes public trust in the health care system,” Oz told the media. “It’s something that we can’t tolerate in this administration.”But some critics, like Dr. Vinay Rathi, an Ohio State University doctor and policy researcher, have accused the Trump administration of sending mixed messages.On one hand, the federal government wants to borrow cost-cutting measures used by private insurance, he said. “On the other, it slaps them on the wrist.”Administration officials are “talking out of both sides of their mouth,” said Rep. Suzan DelBene, a Washington Democrat. “It’s hugely concerning.”Patients, doctors and other lawmakers have also been critical of what they see as delay-or-deny tactics, which can slow down or block access to care, causing irreparable harm and even death.“Insurance companies have put it in their mantra that they will take patients’ money and then do their damnedest to deny giving it to the people who deliver care,” said Rep. Greg Murphy, a North Carolina Republican and a urologist. “That goes on in every insurance company boardroom.”Insurers have long argued that prior authorization reduces fraud and wasteful spending, as well as prevents potential harm. Public displeasure with insurance denials dominated the news in December, when the shooting death of UnitedHealthcare’s CEO led many to anoint his alleged killer as a folk hero.And the public broadly dislikes the practice: Nearly three-quarters of respondents thought prior authorization was a “major” problem in a July poll published by KFF, a health information nonprofit that includes KFF Health News.Indeed, Oz said during his June press conference that “violence in the streets” prompted the Trump administration to take on the issue of prior authorization reform in the private insurance industry.Still, the administration is expanding the use of prior authorization in Medicare. CMS spokesperson Alexx Pons said both initiatives “serve the same goal of protecting patients and Medicare dollars.”Unanswered questionsThe pilot program, WISeR — short for “Wasteful and Inappropriate Service Reduction” — will test the use of an AI algorithm in making prior authorization decisions for some Medicare services, including skin and tissue substitutes, electrical nerve stimulator implants, and knee arthroscopy.The federal government says such procedures are particularly vulnerable to “fraud, waste, and abuse” and could be held in check by prior authorization.Other procedures may be added to the list. But services that are inpatient-only, emergency or “would pose a substantial risk to patients if significantly delayed” would not be subject to the AI model’s assessment, according to the federal announcement.While the use of AI in health insurance isn’t new, Medicare has been slow to adopt the private-sector tools. Medicare has historically used prior authorization in a limited way, with contractors who aren’t incentivized to deny services. But experts who have studied the plan believe the federal pilot could change that.Pons told KFF Health News that no Medicare request will be denied before being reviewed by a “qualified human clinician,” and that vendors “are prohibited from compensation arrangements tied to denial rates.” While the government says vendors will be rewarded for savings, Pons said multiple safeguards will “remove any incentive to deny medically appropriate care.”“Shared savings arrangements mean that vendors financially benefit when less care is delivered,” a structure that can create a powerful incentive for companies to deny medically necessary care, said Jennifer Brackeen, senior director of government affairs for the Washington State Hospital Association.And doctors and policy experts say that’s only one concern.Rathi said the plan “is not fully fleshed out” and relies on “messy and subjective” measures. The model, he said, ultimately depends on contractors to assess their own results, a choice that makes the results potentially suspect.“I’m not sure they know, even, how they’re going to figure out whether this is helping or hurting patients,” he said.Pons said the use of AI in the Medicare pilot will be “subject to strict oversight to ensure transparency, accountability, and alignment with Medicare rules and patient protection.”“CMS remains committed to ensuring that automated tools support, not replace, clinically sound decision-making,” he said.Experts agree that AI is theoretically capable of expediting what has been a cumbersome process marked by delays and denials that can harm patients’ health. Health insurers have argued that AI eliminates human error and bias and will save the health care system money. These companies have also insisted that humans, not computers, are ultimately reviewing coverage decisions.But some scholars are doubtful that’s routinely happening. “I think that there’s also probably a little bit of ambiguity over what constitutes ‘meaningful human review,’” said Amy Killelea, an assistant research professor at the Center on Health Insurance Reforms at Georgetown University.A 2023 report published by ProPublica found that, over a two-month period, doctors at Cigna who reviewed requests for payment spent an average of only 1.2 seconds on each case.Cigna spokesperson Justine Sessions told KFF Health News that the company does not use AI to deny care or claims. The ProPublica investigation referenced a “simple software-driven process that helped accelerate payments to clinicians for common, relatively low-cost tests and treatments, and it is not powered by AI,” Sessions said. “It was not used for prior authorizations.”And yet class-action lawsuits filed against major health insurers have alleged that flawed AI models undermine doctor recommendations and fail to take patients’ unique needs into account, forcing some people to shoulder the financial burden of their care.Meanwhile, a survey of physicians published by the American Medical Association in February found that 61% think AI is “increasing prior authorization denials, exacerbating avoidable patient harms and escalating unnecessary waste now and into the future.”Chris Bond, a spokesperson for the insurers’ trade group AHIP, told KFF Health News that the organization is “zeroed in” on implementing the commitments made to the government. Those include reducing the scope of prior authorization and making sure that communications with patients about denials and appeals are easy to understand.‘This is a pilot’The Medicare pilot program underscores ongoing concerns about prior authorization and raises new ones.While private health insurers have been opaque about how they use AI and the extent to which they use prior authorization, policy researchers believe these algorithms are often programmed to automatically deny high-cost care.“The more expensive it is, the more likely it is to be denied,” said Jennifer Oliva, a professor at the Maurer School of Law at Indiana University-Bloomington, whose work focuses on AI regulation and health coverage.Oliva explained in a recent paper for the Indiana Law Journal that when a patient is expected to die within a few years, health insurers are “motivated to rely on the algorithm.” As time passes and the patient or their provider is forced to appeal a denial, the chance of the patient dying during that process increases. The longer an appeal, the less likely the health insurer is to pay the claim, Oliva said.“The No. 1 thing to do is make it very, very difficult for people to get high-cost services,” she said.As the use of AI by health insurers is poised to grow, insurance company algorithms amount to a “regulatory blind spot” and demand more scrutiny, said Carmel Shachar, a faculty director at Harvard Law School’s Center for Health Law and Policy Innovation.The WISeR pilot is “an interesting step” toward using AI to ensure that Medicare dollars are purchasing high-quality health care, she said. But the lack of details makes it difficult to determine whether it will work.Politicians are grappling with some of the same questions.“How is this being tested in the first place? How are you going to make sure that it is working and not denying care or producing higher rates of care denial?” asked DelBene, who signed an August letter to Oz with other Democrats demanding answers about the AI program. But Democrats aren’t the only ones worried.Murphy, who co-chairs the House GOP Doctors Caucus, acknowledged that many physicians are concerned the WISeR pilot could overreach into their practice of medicine if the AI algorithm denies doctor-recommended care.Meanwhile, House members of both parties recently supported a measure proposed by Rep. Lois Frankel, a Florida Democrat, to block funding for the pilot in the fiscal 2026 budget of the Department of Health and Human Services.AI in health care is here to stay, Murphy said, but it remains to be seen whether the WISeR pilot will save Medicare money or contribute to the problems already posed by prior authorization.“This is a pilot, and I’m open to see what’s going to happen with this,” Murphy said, “but I will always, always err on the side that doctors know what’s best for their patients.”Lauren Sausser and Darius Tahir | KFF Health NewsLauren Sausser and Darius Tahir | KFF Health News
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