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      Medicaid recipients fear ‘buzzsaw cuts’ for Trump’s agenda: ‘We’re not going to be alive forever’

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      At the age of 62, Marya Parral knows that her, and her husband’s, years of being able to care for their two developmentally disabled sons are numbered, and so they have done everything they can to ensure their children can continue to live independently.For their oldest, Ian, that’s meant placing him in a program on an organic farm that caters to people diagnosed with autism. For Joey, their youngest, who has both autism and Down syndrome, Parral has found a caregiver who can help him deliver newspapers and run errands around their community of Ocean City, New Jersey.Parral said none of this would be affordable without help from Medicaid, the federal government’s insurance program for poor and disabled Americans. But this week, the Republican-controlled House of Representatives approved a budget framework that would make deep cuts to the program, and Parral worries her sons will lose what she has worked so hard to build.“We’re not going to be alive forever. We’re trying to set up a life for them, but that entire life that we’re working so hard to set up for them is dependent on Medicaid,” Parral said. “So it’s really devastating to think about cuts.”Producing a budget is the first step in the Republican-controlled Congress’s drive to enact legislation that will pay for Donald Trump’s priorities. House lawmakers will now spend weeks working to write and pass a bill that is expected to approve $4.5tn in extended tax cuts, as well as funding for Trump’s plan for mass deportations of undocumented immigrants.To pay for it, Republicans are considering a rollback of the federal social safety net, particularly Medicaid, which has nearly 80 million enrollees in all 50 states. The budget plan proposes an $880bn reduction in funding for the insurance over the next 10 years, an amount that experts warn would hollow out the program and have ripple effects across the entire American healthcare system.Megan Cole Brahim, a professor at Boston University School of Public Health and an expert on Medicaid, said the cut was the largest ever proposed, and if enacted would “have far-reaching impacts not just for those who rely on Medicaid, but for entire communities and economies”.“These changes mean millions of Americans – including the low-income, elderly, persons with disabilities, children – will lose health insurance coverage,” she said. “Others may see significant reductions in benefits or limited access to care. The impact on hospitals and health systems will be significant, particularly for safety-net and rural hospitals, which are already on the brink of closure. Patient revenues will fall, uncompensated care will rise. There will be staff layoffs and site closures.”John Driscoll, a healthcare executive and chair of the board of UConn Health in Connecticut, said: “The scale of the buzzsaw cuts to Medicaid would undermine every hospital’s ability to actually support its mission to care for the community, and would be a dangerous cut to the nursing-home infrastructure in the country.”Republican leaders backed the cuts to Medicaid, as well as to similar programs such as one that helps poor Americans afford food, as a way to mollify lawmakers in their party who want the US’s large budget deficit addressed. Still, not everyone is pleased. As the budget was being debated, eight Republican representatives, some of whom Democrats are keen to unseat in next year’s midterm elections, wrote to the House speaker, Mike Johnson, warning that their districts’ large Hispanic populations would be harmed.“Slashing Medicaid would have serious consequences, particularly in rural and predominantly Hispanic communities where hospitals and nursing homes are already struggling to keep their doors open,” they said.All eight ultimately voted for the resolution, but the dissent may be a warning sign for the budget’s prospects of enactment, particularly in the House, where the GOP has a mere three-seat majority. It also remains unclear whether Republicans will try to pass all of Trump’s priorities in one bill, or split them into two.The GOP has made clear they want to fully pay for the extension of Trump’s tax cuts, and Elyssa Schmier, vice-president of government relations for advocacy group MomsRising, said Medicaid and social safety programs are the party’s prime targets for cost savings.“If you’re not going to go after, say, the Pentagon budget, if they’re only going to go to some of these big mandatory spending programs, there’s only so many places that Republicans feel that they can go,” she said.In the days since the budget’s approval, Johnson and Trump have scrambled to downplay the possibility of slashing Medicaid, insisting they intend only to root out “fraud, waste and abuse.”“The president said over and over and over: ‘We’re not going to touch social security, Medicare or Medicaid.’ We’ve made the same commitment,” Johnson told CNN in an interview.Democrats have little leverage to stop the budget, which can be passed with simple majorities in both chambers. But the Democratic senator Ruben Gallego warned that gutting the social safety net to extend tax cuts that have mostly benefited the rich will alienate voters who sided with the GOP last November.“It will be on Donald Trump and Republicans, the fact that he’s going to side with the ultra-rich versus the working poor,” said Gallego, who won election to his seat in Arizona even as Trump captured the state’s electoral votes. “Families that are barely making a living, scratching a living, they’re now going to get kicked off healthcare to give tax cuts to the mega-rich.”The proposed cut to Medicaid would remove billions of dollars in funding from congressional districts nationwide that are represented by lawmakers from both parties, according to an analysis by the liberal Center for American Progress.In California’s San Joaquin valley, the Democratic representative Jim Costa’s district would lose the third-largest amount of funding, according to the data, and Medicaid coverage would be imperiled for more than 450,000 residents.“This reckless budget prioritizes the wealthy while devastating those who need help the most,” Costa said. “I voted no because this resolution is bad for our valley and a threat to the wellbeing of the people I represent.” More

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      Trump cuts reach FDA workers focused on food safety and medical devices

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      The Trump administration’s effort to slash the size of the federal workforce reached the Food and Drug Administration this weekend, as recently hired employees who review the safety of food ingredients, medical devices and other products were fired.Probationary employees across the FDA received notices on Saturday evening that their jobs were being eliminated, according to three FDA staffers who spoke to the Associated Press on condition of anonymity because they were not authorized to speak publicly.The total number of positions eliminated was not clear on Sunday, but the firings appeared to focus on employees in the agency’s centers for food, medical devices and tobacco products – which includes oversight of electronic cigarettes. It was not clear whether FDA employees who review drugs were exempted.On Friday, the US Department of Health and Human Services announced plans to fire 5,200 probationary employees across its agencies, which include the National Institutes of Health, the FDA and the Centers for Disease Control and Prevention.People who spoke with the AP on condition of anonymity on Friday said the number of probationary employees to be laid off at the CDC would total nearly 1,300. But as of early Sunday afternoon, about 700 people had received notices, according to three people who spoke on condition on anonymity because they were not authorized to speak publicly. They said none of the CDC layoffs affected the doctors and researchers who track diseases in what’s known as the Epidemic Intelligence Service.The FDA is headquartered in the Maryland suburbs outside Washington DC and employs nearly 20,000 people. It’s long been a target of newly sworn-in health secretary Robert Kennedy Jr, who last year accused the agency of waging a “war on public health” for not approving unproven treatments such as psychedelics, stem cells and chelation therapy.Kennedy also has called for eliminating thousands of chemicals and colorings from US foods. But the cuts at FDA include staffers responsible for reviewing the safety of new food additives and ingredients, according to an FDA staffer familiar with the firings.An HHS spokesperson did not immediately respond to a request for comment on Sunday afternoon.Nearly half of the FDA’s $6.9bn budget comes from fees paid by companies the agency regulates, including drug and medical device makers, which allows the agency to hire extra scientists to swiftly review products. Eliminating those positions will not reduce government spending.A former FDA official said cutting recent hires could backfire, eliminating staffers who tend to be younger and have more up-to-date technical skills. The FDA’s workforce skews toward older workers who have spent one or two decades at the agency, and the Government Accountability Office noted in 2022 that the FDA “has historically faced challenges in recruiting and retaining” staff due to better money in the private sector.“You want to bring in new blood,” said Peter Pitts, a former FDA associate commissioner under George W Bush. “You want people with new ideas, greater enthusiasm and the latest thinking in terms of technology.”Mitch Zeller, former FDA director for tobacco, said the firings are a way to “demoralize and undermine the spirit of the federal workforce”.“The combined effect of what they’re trying to do is going to destroy the ability to recruit and retain talent,” Zeller said.The FDA’s inspection force has been particularly strained in recent years after a wave of departures during the Covid-19 pandemic, and many of the agency’s current inspectors are recent hires. It was not immediately clear whether those employees were exempted.FDA inspectors are responsible for overseeing thousands of food, drug, tobacco and medical device facilities worldwide, though the AP reported last year that the agency faced a backlog of roughly 2,000 uninspected drug facilities that hadn’t been visited since before the pandemic.The agency’s inspection force have also been criticized for not moving faster to catch recent problems involving infant formula, baby food and eyedrops. More

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      Saying ‘women’ is not allowed, but ‘men’ and ‘white’ are OK? I’m (not) shocked | Arwa Mahdawi

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      From banning books to policing wordsThanks to the intolerant left, nobody can say the word “women” anymore! Do you remember when that was a major talking point in certain quarters? Prominent columnists wrote endless pieces declaring that the word “women” had “become verboten”. The thought police, these people claimed, were forcing everyone to say “bodies with vaginas” and “menstruators” instead. Even the likes of Margaret Atwood tweeted articles with headlines like: “Why can’t we say ‘woman’ anymore?”That, of course, was complete nonsense. While there was certainly a push for more inclusive language, nobody with any influence was trying to ban the word “women”.Now, however? Now, it’s a very different story. Thanks to Donald Trump’s sweeping executive orders attacking “gender ideology” and DEI programs, the word “women” – along with a number of other terms – is quite literally being erased. The likes of Nasa have been busy scrubbing mentions of terms related to women in leadership from public websites in an attempt to comply with Trump’s executive orders, for example. Agencies like the Centers for Disease Control and Prevention (CDC) have taken down numerous webpages related to gender in the wake of Trump’s orders – although a federal judged ordered on Tuesday that they should be reinstated.Meanwhile, the National Science Foundation (NSF) has an internal list of hot-button words (which include “women”, “gender”, “minority”, “biases”) that they are cross-referencing against active research projects and grant applications. The Washington Post reports that once one of these very dangerous words is identified, staff then have to go through a flowchart to see whether a research project should be flagged for further review.The National Institutes of Health and multiple university research departments are going through a similar dystopian exercise. Researchers at the University of California at San Diego, for example, have said their work is now at risk if it contains language deemed potentially problematic, including the word “women”.Rebecca Fielding-Miller, a UCSD public health scientist, told KPBS that the list of banned words circling in scientific communities was Orwellian and would hamper important research. “If I can’t say the word ‘women,’ I can’t tell you that an abortion ban is going to hurt women,” Fielding-Miller said.Fielding-Miller also noted that it was illuminating to see which words hadn’t been flagged as problematic. “I guess a word that’s not on here is ‘men’, and I guess a word that I don’t see on here is ‘white’, so I guess we’ll see what’s going on with white men and what they need,” Fielding-Miller added.Amid all the anxiety about what you are allowed to say in this brave new world, a lot of researchers are erring on the side of caution. Some scientists have said that they are considering self-censoring to improve their chances of getting grants. Others are gravitating towards “safe” topics – like, you know, issues that concern white men. This is a dance we’ve seen many times before: Republicans will advance ambiguous, and possibly unconstitutional, legislation. Because no one knows what the hell is going on or how they might get punished for violating these vague new laws, people self-censor and aggressively police themselves.So, I guess this is where we are now: Republicans aren’t just banning books, they’re policing words. An administration effectively fronted by Elon Musk – a self-proclaimed “free speech absolutist” – is so touchy about the language that we use that scientists are now self-censoring. It’s so prescriptive about what things are called that it’s blocking journalists from events for continuing to refer to the Gulf of Mexico instead of the Gulf of America. It’s so obsessed with controlling how we think that it’s erasing references to trans people from the website for the Stonewall national monument. Under the disingenuous guise of “restoring freedom of speech”, the Trump administration has made clear it is intent on controlling the very words we use.Errol Musk, who impregnated his former stepdaughter, says Elon is a bad dadElon Musk seems to get some of his extreme views about pro-natalism from his father, Errol, who also has multiple children. Errol has even fathered two kids with his former stepdaughter, who was only four years old when he married her mother. I bring this up because Errol is currently in the news calling Elon a terrible father. He’s certainly not wrong about that – the Tesla billionaire seems to treat his kids like props rather than people – but his statements bring to mind certain adages about pots and kettles as well as glass houses.Investigation launched into human egg trafficking ringThailand and Georgia have said they are investigating a human-trafficking ring accused of harvesting human eggs from Thai women who came to Georgia thinking they’d be surrogates. Instead, they were reportedly held captive and had their eggs harvested. This story is just the latest example of the way in which the global egg trade has given rise to black markets and abuse. Last year, for example, a Bloomberg Businessweek investigation reported that Greek police had identified up to 75 cases of alleged theft of eggs taken from the ovaries of IVF patients at a clinic on Crete.Infant mortality rates rise in US states with abortion bans, study findsJust your latest reminder that anti-abortion activists are in no way “pro-life”.Domestic violence study that strangled rats should not have been approved, animal advocates argueThe rats were non-fatally strangled as part of research that aimed to improve the detection of brain injury resulting from intimate partner violence.The Syrian feminists who forged a new world in a land of warThe Guardian has a fascinating piece on the autonomous region of Rojava, in north-eastern Syria, which has a government with arguably the most complete gender equality in the world.A pregnant woman in the West Bank was shot by Israeli soldiersSondos Shalabi, 23, was eight months pregnant. Her killing comes as Israeli settlers are unofficially annexing large areas of the occupied West Bank and escalating violence has displaced around 40,000 Palestinians. The West Bank is becoming another Gaza.How Sasha DiGiulian broke climbing’s glass ceilingThe big-wall climber talks to the Guardian about sexism in climbing – including a tendency for routes that women have climbed getting “immediately downgraded by male climbers”.The ‘puppygirl hacker polycule’ leaks numerous police filesThe group told the Daily Dot there are not “enough hacks against the police”, adding: “So we took matters into our own paws.”The week in pawtriarchyPalmerston is a black-and-white cat who was – until recently – retired after a long and distinguished career as chief mouser for the UK’s Foreign and Commonwealth Office in London. The “DiploMog” has emerged from retirement to start work work as feline relations consultant to the new governor of Bermuda. If only the US would learn from this: government needs more cats and fewer Doges. More

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      ‘A scary time to be a scientist’: how medical research cuts will hurt the maternal mortality crisis

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      On Tuesday, a few days after the Trump administration announced its plan to slash billions of dollars in funding for biomedical and behavioral research, an investigator at a maternal health research center in Pennsylvania told Dr Meghan Lane-Fall that the cuts may lead her to leave academia altogether.Lane-Fall urged her not to make any sudden moves. “It’s not like nothing has happened. No one’s threatened her job,” said Lane-Fall, a professor at the University of Pennsylvania. “But if she looks six months down the line, it looks uncertain.”She did advise her colleague to update her resume.Among the many fields of research threatened by the funding cuts is the growing effort to curb the US maternal mortality rate, which is far worse than in other rich nations. Not only could the cuts delay vital breakthroughs but women’s health experts warn they could also push promising young scientists out of the field.“Above and beyond the stalling of progress, we’re going to see this hollowing out of the workforce that’s been working on this research,” Lane-Fall said. “That will reverberate for years, if not decades.”Late last week, the Trump administration declared that the National Institutes of Health (NIH) would only reimburse 15% of researchers’ “indirect costs”, which can pay for expenses such as staff and laboratory maintenance. Normally, such costs hover at around 50% for elite universities. If indirect costs are capped at such a low percentage, scientists and the institutions where they work say they will not be able to carry out research.A court ordered that the Trump administration suspend the policy earlier this week, but this change – which was reportedly the work of the Elon Musk-run “department of government efficiency” (Doge) – casts into doubt the future of the NIH, the planet’s premier public funder of biomedical research. In 2023, the NIH spent more than $35bn on grants. If implemented, the new policy would endanger at least $4bn worth of funding, but its impact could go much further, imperiling the ability of research institutions – especially smaller ones – to do their work at all. The US maternal mortality rate almost doubled between 2018 and 2022, with rates of deaths among Black and Indigenous expecting or new mothers increasing at a disproportionally fast clip. States that Donald Trump won may be hit especially hard by NIH cuts: they are home to some of the country’s worst maternal mortality rates.To address this crisis, the NIH in 2023 launched a seven-year, $168m initiative to set up more than a dozen research centers to investigate and improve maternal health outcomes, as well as help train new maternal health researchers. The future of these centers – one of which is co-led by Lane-Fall – are now in question.“We’re working with agencies across 20 Michigan counties – that have more than 7 million people in them – to be able to improve services so that moms don’t get sick and die,” said Dr Jennifer E Johnson, a Michigan State University public health professor who helps run one of the research centers in Flint, Michigan. “To do that, we need offices. We need electricity. We need lights, heat, IT, infrastructure, people to create and sell the contracts. All of the support for that would be cut dramatically.”Normally, Johnson said, NIH reimburses about 57% of the indirect costs for Michigan State University’s grants, including hers. It’s not feasible, she said, for the university to cover those costs on its own or for her center to lower its indirect costs so substantially.“If we can’t turn on the lights and we can’t pay the rent and we can’t get people hired – I don’t know what we would do,” Johnson said. “The research is the car. All the infrastructure costs are the road. You can go a little while, but if there’s no maintenance on that, it’s a problem.”Several of the institutions that host the maternal health centers – which tend to focus on improving maternal mortality among people of color and rural communities – are set to lose millions over the NIH cuts. Stanford University officials have said the school, whose center aims to reduce the risk of dangerous postpartum hemorrhages, would take a $160m loss. The University of Utah, which studies how drug addiction impacts pregnancy, would lose $45m.The Guardian reached out to dozens of researchers who have NIH grants to study the health of women, children and parents. Many declined to speak, often citing the ongoing uncertainty of the situation. “I’m honestly not sure what to say as like most of my colleagues I was taken off guard and it’s really unclear how this will play out now that courts are involved,” one scientist, from Missouri, wrote in an email.While Republicans have generally been supportive of Musk’s slash-and-burn approach to the government in the last few weeks, some members of Congress have expressed alarm about the NIH cuts. “It’s pretty drastic. So I’m thinking we need to look at this,” Shelley Moore Capito, the West Virginia senator, told the Washington Post. Alabama senator Katie Britt said she planned to work with Robert F Kennedy Jr, the new leader of the Department of Health and Human Services, to address the impact. “A smart, targeted approach is needed in order to not hinder life-saving, groundbreaking research at high-achieving institutions like those in Alabama,” she told AL.com.One of the agencies behind the maternal health centers is the NIH’s Office of Research on Women’s Health – whose website has been hollowed out by the Trump administration’s recent, widespread purges of government websites. Links to pages on the Office of Research on Women’s Health website about “funding opportunities and notices”, “research programs and initiatives” and “supporting women in biomedical careers” have all vanished.“It is a scary time to be a scientist in the United States,” said Johnson, who is also concerned about recent reports of efforts at the National Science Foundation – an NIH sibling agency that focuses on scientific and engineering research – to scrutinize projects that include words like “women”, “disability” and “underrepresented”. Johnson continued: “All of a sudden, we’re working in a world where we’re not sure we’re going to be allowed to say what the data clearly shows.”On Monday, the day the new policy was supposed to take effect, the Association of American Medical Colleges sued to halt it.“Even at larger, well-resourced institutions, this unlawful action will impose enormous harms, including on these institutions’ ability to contribute to medical and scientific breakthroughs,” the association, which represents several of the US medical schools that host maternal health centers, said in its lawsuit. The association continued: “Smaller institutions will fare even worse – faced with more unrecoverable costs on every dollar of grants funds received, many will not be able to sustain any research at all and could close entirely.”A federal judge then ordered Trump to suspend the cuts, writing in a court order that implementing the cuts would cause “immediate and irreparable injury”. A hearing in the case is set for 21 February.However, it is unclear whether Trump will obey. Although the administration is legally required to heed court orders, a federal judge ruled in another case this week that Trump had defied an order to halt a separate freeze in federal funding. Disregarding court orders may tee up a showdown between the executive and judicial branches of the government – and a constitutional crisis.Regardless of when, how or if NIH grants function in the future, Lane-Fall believes the chaos unleashed by the Trump administration has already led science to suffer. Lane-Fall had to pause plans to hold a conference and told some postdoctoral students that they cannot yet move forward with research projects. She’s now worried that maternal health centers – who have built partnerships with local groups that champion doulas, breastfeeding among Black women and more – will not be able to compensate those groups.“One really important trend in maternal and child health research is that we are working now more with communities than we ever have before, because we understand that there’s a lot of lived experience and expertise in communities. Part of what makes that partnership possible is that we’re able to compensate them for their time,” Lane-Fall said. “When we go to those communities and we say: ‘We promised you money, but it might not be there’ – that is devastating.”Dr Nancy E Lane is haunted by the idea that the confusion will lead women’s health scientists to leave academia. A University of California, Davis, doctor who specializes in osteoporosis and osteoarthritis, Lane was part of a 2024 report calling for more NIH funding for women’s health. Between 2013 and 2023, just 8.8% of NIH grant dollars focused on investigating it.“My career has tremendously benefited from the resources from the National Institutes of Health. It’s what made me who I am,” Lane said. “How much will the current generation put up with this before they’ll just throw their hands up?” More

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      The Guardian view on supporting vaccines: humans can work miracles – so why wouldn’t we? | Editorial

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      It is easy to become so used to scientific and social advances that we take them for granted. But sometimes we should pause to celebrate – to feel genuine awe – at the wonders that we have seen. Amid all the wars, the disasters and the crimes of the last half century, we have witnessed nothing short of a miracle.Vaccination, in addition to clean water, sanitation and improved nutrition, has been one of the greatest contributors to global health. It is responsible for much of the astounding fall in child mortality, which plummeted by 59% between 1990 and 2022. It has saved more than 150 million lives, mostly of infants, since the Expanded Programme on Immunisation was launched by the World Health Organization in 1974. Initially designed to protect children against diseases including smallpox, tuberculosis, polio and measles, the scheme has since been extended to cover more pathogens. Then, in 2000, came the Global Alliance for Vaccines and Immunisation (Gavi), a public-private organisation that provides financial and technical support for vaccination in poorer countries and negotiates with manufacturers to lower costs.The results have been remarkable. Prevention is better – and cheaper and easier – than cure. Smallpox was declared eradicated in 1980. Almost all the world is now polio-free. Cases of many other diseases have been slashed. Much more can be done: an estimated 5 million children have been protected against malaria since routine vaccinations were launched a year ago. And from a scientific perspective, we are entering a golden age of vaccines.Yet this is a dangerous moment in other ways. The climate crisis is spurring disease outbreaks. Conflict has dramatically increased the number of unprotected children. Vaccine scepticism has grown. Now cuts to funding threaten to turn the clock back. The trashing of USAid will hinder delivery and has halted a groundbreaking programme to create new malaria vaccines. Robert F Kennedy Jr – who once claimed that “no vaccine is safe and effective” and who tried to persuade the US government to rescind authorisation for the coronavirus vaccine at the height of the pandemic – was confirmed this week as health secretary.Now the UK, one of Gavi’s founding donors and the country which has given most to its core programme, is considering a significant cut to its support. This would be a grave error. While some aspects of Gavi’s approach have faced sensible scrutiny in the past, it has vaccinated over 1 billion children and done so cost-effectively: 97 pence in every pound it is given goes on vaccine programmes. Its success is also evident in the number of countries which have graduated from being beneficiaries to paying their own way; some, including Indonesia, are becoming donors in turn. And Gavi’s stockpiles help to keep people safe in wealthier countries too, as well as ensuring that poorer nations are healthier and more stable.For all these reasons, Gavi has long enjoyed bipartisan support in the UK, which has given it more than £2bn over the last four years. Now, more than ever, its funding must be sustained. The world is full of apparently intractable conflicts and complex moral dilemmas. Few decisions are truly simple for governments. But this one is a no-brainer. It should astonish us that we can so easily save lives. It should be self-evident that we must continue to seize that opportunity. More

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      Judge pauses Trump’s order restricting healthcare for transgender youth

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      A federal judge on Thursday temporarily blocked Donald Trump’s recent executive order aimed at restricting gender-affirming healthcare for transgender people under age 19.The judge’s ruling came after a lawsuit was filed earlier this month on behalf of families with transgender or non-binary children who allege their healthcare has already been compromised by the president’s order. A national group for family of LGBTQ+ people and a doctors organization are also plaintiffs in the court challenge, one of many lawsuits opposing a slew of executive orders Trump has issued as he seeks to reverse the policies of former president Joe Biden.Judge Brendan Hurson, who was nominated by Biden, granted the plaintiffs’ request for a temporary restraining order following a hearing in federal court in Baltimore. The ruling, in effect for 14 days, essentially puts Trump’s directive on hold while the case proceeds. The restraining order could also be extended.Trump’s executive order “seems to deny that this population even exists, or deserves to exist”, Hurson said.Shortly after taking office, Trump signed an executive order directing federally run insurance programs to exclude coverage for gender-affirming care. That includes Medicaid, which covers such services in some states, and Tricare for military families. Trump’s order also called on the Department of Justice to vigorously pursue litigation and legislation to oppose the practice.The lawsuit includes several accounts from families of appointments being canceled as medical institutions react to the new directive.Attorneys for the plaintiffs argue Trump’s executive order is “unlawful and unconstitutional” because it seeks to withhold federal funds previously authorized by Congress and because it violates anti-discrimination laws while infringing on the rights of parents.Like legal challenges to state bans on gender-affirming care, the lawsuit also alleges the policy is discriminatory because it allows federal funds to cover the same treatments when they are not used for gender transition.Some hospitals immediately paused gender-affirming care, including prescriptions for puberty blockers and hormone therapy, while they assess how the order affects them.Trump’s approach on the issue represents an abrupt change from the Biden administration, which sought to explicitly extend civil rights protections to transgender people. Trump has used strong language in opposing gender-affirming care, asserting falsely that “medical professionals are maiming and sterilizing a growing number of impressionable children under the radical and false claim that adults can change a child’s sex”.Major medical groups such as the American Medical Association and the American Academy of Pediatrics support access to gender-affirming care.Young people who persistently identify as a gender that differs from their sex assigned at birth are first evaluated by a team of professionals. Some may try a social transition, involving changing a hairstyle or pronouns. Some may later also receive puberty blockers or hormones. Surgery is extremely rare for minors. More

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      Judge blocks Trump from cutting billions in medical research funding

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      A federal judge in Massachusetts blocked Donald Trump’s administration from cutting scientific research grants from the National Institutes of Health (NIH) after 22 mostly Democratic-leaning states sued.The Trump administration sought to impose a 15% cap on “indirect costs” for grants – money that goes toward overhead, such as keeping the lights on in labs or maintaining advanced equipment. On Tuesday, major universities filed a second lawsuit, calling the administration’s actions “flagrantly unlawful” in a complaint.“A cut to [indirect costs] for NIH grants is a cut to the medical research that helps countless American families whose loved ones face incurable diseases or untreatable debilitating conditions,” a group of university associations said in a statement.Indirect costs, “are the real and necessary costs of conducting the groundbreaking research that has led to so many medical breakthroughs over the past decades”, they said.Speedy court action to block the proposed cuts comes at a time when the Trump administration is teasing the idea of ignoring courts, prompting fears of a constitutional crisis.“To hand his billionaire backers another tax cut, Trump tried to slash funding for critical disease prevention research, including for pediatric cancer,” Ken Martin, Democratic National Committee chair, said in a statement.“We aren’t going to sit back as Trump goes after America’s kids.”The NIH is an arm of the Department of Health and Human Services. With a budget of $48bn, it is the world’s largest public funder of biomedical and behavioral research, with impacts that ripple across the scientific world.NIH grants fund a vast array of science, especially including early stage research that leads to blockbuster drugs. The agency’s grants have contributed to many of the drugs Americans are now familiar with, including statins such as Lipitor and curative hepatitis C drugs such as Harvoni.NIH-funded basic or applied research has also contributed to 386 of the 387 drugs the Food and Drug Administration approved between 2000 and 2019, and more than 100 Nobel prizes have been awarded to scientists based on NIH-funded work.In one of the first social media posts since Trump’s inauguration, the NIH said that the 15% cap on indirect costs would save $4bn per year, and singled out Harvard, Yale and Johns Hopkins as spending too much on overhead.skip past newsletter promotionafter newsletter promotionAlthough the NIH’s budget is less than 1% of all federal spending, the scientific agency has become a target of the Trump administration, and cutting the NIH serves multiple aims.The move comes ahead of an expected debate to extend Trump’s 2017 tax cuts. The cuts helped billionaires pay less in taxes than the working class for the first time. An extension is expected to add to a huge budget deficit.Many of Trump’s supporters also criticized the NIH following the Covid-19 pandemic, and laid out plans to dramatically reorganize it in Project 2025. Additionally, cutting NIH grants hits American universities, including many elite research institutions, in their pocketbooks. The administration has repeatedly attacked such universities as bastions of liberalism.This is not the first time Trump proposed cutting scientific research. In 2017, his budget attempted to slash scientific research funding.Within scientific circles, many agree the NIH could benefit from reform. However, many also argue the process needs to be transparent and involve stakeholders. More

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      Robert F Kennedy Jr has mass appeal despite his extreme ideas. This theory explains why | Darren Loucaides

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      “Back at home in the United States, the newspapers are saying that I came here today to speak to about 5,000 Nazis,” Robert F Kennedy Jr told a large crowd in Berlin. Estimated at 38,000 people, the crowd was a mix of hippies, anti-war types, Green party voters and anti-vaxxers, rubbing shoulders with a smattering of skinheads. It was late August 2020 and a group called Querdenken had rallied this motley crew together in defiance of Covid-19 restrictions.“Governments love pandemics,” Kennedy said. “They love pandemics for the same reason they love war – it gives them the ability to impose controls that the population would otherwise never accept.”Last month, in Senate confirmation hearings for his appointment as the US secretary of health and human services, Kennedy was questioned on having previously compared the Center for Disease Control’s work to that of “Nazi death camps”, calling Covid-19 a bioweapon genetically engineered to target black and white people while sparing Ashkenazi Jews and Chinese people, and blaming school shootings on antidepressants. “He has made it his life’s work to sow doubt and discourage parents from getting their kids life-saving vaccines,” said the Democratic senator Ron Wyden. “It has been lucrative for him and put him on the verge of immense power.”Kennedy has gone from courting the conspiratorial fringes of the internet to the halls of the White House. He could be confirmed within days. With hindsight, the Berlin speech he gave five years ago was the moment a dangerous new political phenomenon went global. It’s called diagonalism.Coined by the political theorist William Callison and the historian Quinn Slobodian, diagonalism describes the union of disparate groups across the political spectrum around a suspicion of all power being involved in conspiracy. Diagonal movements see big tech, big pharma, banks, climate science and traditional media as accomplices in totalitarianism, evidenced by Covid mandates through to innocuous intergovernmental proposals such as the “great reset” and 15-minute cities.For diagonalists, the control of electoral processes by powerful interests means that governments are de facto illegitimate. And so they advocate for distributed power – not to empower any community, but the individual. By definition they are susceptible to far-right radicalisation. Callison and Slobodian trace their use of the term back to Querdenken – which roughly translates as “lateral thinkers” – the group that organised the Berlin rally addressed by Kennedy.Kennedy recalled his uncle’s visit to the same city decades earlier, even repeating the historic line “Ich bin ein Berliner”. “And today again, Berlin is the frontline against global totalitarianism,” he said, before working through a bingo card of conspiracy theories. An extended “quote” Kennedy read from Hermann Göring’s testimony at the Nuremberg trials, including that “the only thing a government needs to make people into slaves is fear”, was copy and pasted across social media for months afterwards – even though there is no record of Göring saying those words.But Kennedy’s Berlin speech and the Querdenken rally itself were not merely notable for the controversy they caused. In drawing together veterans of anti-war and anti-globalist groups alongside health influencers, environmentalists and the far right, Querdenken became the blueprint for diagonal movements. Through its anti-power conspiratorial framing and the mirroring of methods used by decentralised grassroots movements, Querdenken was able to draw diagonal lines across pre-existing political allegiances, cultural divides and single issues, such as the climate or vaccines, to forge a mass coalition of support. Kennedy himself epitomises this new coalition – one that was nascent at the time, but is now at the heart of Trumpism.As a former environmental lawyer, Kennedy spoke with eloquence and passion in the past about corporations contaminating rivers and polluting the skies, the plight of asthma especially afflicting black people, and the existential threat of the climate crisis. In the Berlin speech, Kennedy mingled conspiracy theories with genuine concerns and anxieties held by the public. He said he saw “people who want leaders who are not going to lie to them, people who want leaders who will not make up arbitrary rules and regulations to orchestrate the obedience of the population. We want health officials who don’t have financial entanglements with the pharmaceutical industry, who are working for us and not big pharma.”In her book Doppelganger, Naomi Klein writes powerfully on how diagonal movements and influencers often identify real issues that progressives had grown timid about – the sway of oligarchical wealth over politics, the rise of digital surveillance, the impact of rampant capitalism on our mental and physical health. But instead of articulating the actual causes or plausible solutions, they have constructed bogus metanarratives. Rather than increasingly antidemocratic billionaires, it was an organised cabal of global elites, unaccountable deep-state bureaucrats who secretly ran the world – or, at the furthest end, blood-sucking satanists, as QAnon followers believed. A mirrorworld had emerged. And it is demagogues such as Trump who have benefited.“Despite claims of post-partisanship, it is right-wing, often far-right, political parties around the world that have managed to absorb the unruly passions and energy of diagonalism,” says Klein, “folding its Covid-era grievances into preexisting projects opposing ‘wokeness’ and drumming up fears of migrant ‘invasions’. Still, it is important for these movements to present themselves (and to believe themselves to be) ruptures with politics-as-usual; to claim to be something new, beyond traditional left-right poles.”While the crowd that listened to Kennedy’s speech that day in 2020 was a heterogeneous mix, a few miles away, a mob of far-right activists and QAnon supporters tried to storm the Reichstag, home to Germany’s parliament, after one of their number falsely announced Trump was in Berlin to liberate the country. The violent scenes would be replicated in the more deadly assault on the Capitol on 6 January 2021. This was the extreme end of diagonalism exploding into life. (An investigation I led into Covid-sceptic groups found that by then, Querdenken and others had become obsessed with Trump – and gravely radicalised.)If Robert F Kennedy Jr is confirmed to Trump’s cabinet, a once-staunch environmentalist and defender of women’s reproductive rights turned conspiracy theorist and super-spreader of health misinformation will dictate health policy in the US. Diagonalism has ascended to the pinnacle of global power. The mirrorworld is becoming our reality.

      Darren Loucaides is a writer based in Barcelona and London

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