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    Turmoil and tensions at FDA after dramatic exit of top drug regulator

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    After the dramatic ousting of the top drug regulator at the US Food and Drug Administration (FDA) two weeks ago, officials have scrambled to find a replacement in a process that has revealed the agency’s internal cracks and tensions.It’s troubling news for a regulatory agency that has previously enjoyed a reputation for stability and consistency.On Tuesday, the US Department of Health and Human Services (HHS) announced the top spot at the Center for Drug Evaluation and Research (CDER) would be filled by a surprising candidate.Richard Pazdur is a respected oncology expert and longtime FDA employee – that’s not the surprising part. But he reportedly turned down the position when he was approached last week, according to Pink Sheet. That’s when top leaders began searching for other candidates.“It boggles the mind,” said Peter Lurie, president of the Center for Science in the Public Interest and a former associate commissioner at the FDA. “Reversals upon reversals.”The news comes after several upheavals at the FDA.George Tidmarsh, who was only appointed as CDER director in late July, resigned in early November following accusations of retaliation against a former pharmaceutical business partner and reports of strife within the agency. Tidmarsh was accused, in an explosive lawsuit, of using his position to harm his former business partner.View image in fullscreenIn the days before his ouster, Tidmarsh had opposed a new form of rapid approval, he told Stat News. The new program, called “Commissioner’s National Priority Voucher”, promised the rapid reviews of drugs – but Tidmarsh said he questioned the legality of the plan.Tidmarsh also reportedly sparred with Vinay Prasad, simultaneously the agency’s chief medical and scientific officer and the director of the Center for Biologics Evaluation and Research (CBER), after Prasad repeatedly bypassed Tidmarsh to ask CDER employees to do work for him.The HHS did not respond to the Guardian’s questions about power struggles between Tidmarsh and Prasad, but the agency did confirm that Tidmarsh was no longer employed there.“Secretary Kennedy expects the highest ethical standards from all individuals serving under his leadership and remains committed to full transparency,” said Emily Hilliard, press secretary.Prasad himself was subject to reversals. He was forced to resign in July, but he returned unexpectedly less than a week later. FDA chief Marty Makary reportedly worked to bring him back.“Prasad has obviously been very aggressive, and he’s not been softened by the experience of getting fired – if anything he seems to feel that he has the wind at his back because he was restored,” Lurie said. “But none of it speaks well to the kind of relations between the center directors that are necessary to make the place work.”The degree of discord among top FDA officials is “very unusual”, Lurie said.Before the job was filled by Pazdur, one CDER employee told the Guardian that “I would never take it” because the position would be a “career killer” in the turnover and tumult at the agency.“Plus, I’d have Vinay Prasad bitching at me or about me non-stop,” said the employee, who asked for anonymity to protect their job.After Tidmarsh’s departure, several longtime employees said they were not interested in the position, and Sara Brenner, principal deputy commissioner at the FDA, sent an email on Friday to some CDER employees asking whether any of them wanted to apply.“The whole process of appointments at FDA in the current administration has been an enormous departure from accepted practices,” Lurie said. “The degree of upheaval at the agency is really difficult to overestimate and leaves people in the agency disconcerted.”Opening up the position to large numbers of employees “reeks of desperation” and gives the impression that FDA leaders struggled to fill the job, he said. But Pazdur has “the right qualifications”, and choosing an FDA insider might shore up confidence and morale, Lurie added.“There’s a sense among people who have worked at the agency for a while that they’re under siege by people who have come from the outside with only limited understanding of the way that FDA works and that they would be better served with somebody who actually understands the institution,” he said.Lurie notes that the pharmaceutical industry values stability at the FDA more than anything. There is a core belief in the industry – and among the public – that FDA review is valuable in order to maintain trust and safety. “Predictability from day to day is really what they want, and otherwise, everything is in upheaval,” Lurie said.The FDA has developed careful and relatively uncontroversial processes over the decades for evaluating drugs, biologics and medical devices.“But now, everything is up for grabs,” Lurie said. “Suddenly, we have people who can get their drug reviewed in a one-day meeting.”In addition to disrupting its regulatory work, the chaos at the FDA may also undermine the credibility of its experts in general, particularly as top officials within the administration continue to attack scientific expertise, Lurie said.“If the assault on government continues at the pace that it has,” he said, the idea that the government is not to be trusted “could actually become true”. More

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      Senate Republicans embrace Trump’s call – from his Florida golf course – to replace Obamacare

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      US senators are working through the weekend for the first time since the government shutdown began more than a month ago, but hopes for a bipartisan agreement on how to end the standoff, and keep healthcare affordable for millions of Americans, appeared to recede as Republican senators floated a proposal toxic to Democrats: scrapping the Affordable Care Act (ACA), known as Obamacare.The impact on Americans from the longest shutdown of the federal government in history deepened on Saturday, as federal workers went unpaid, airlines were forced to cancel flights and Supplemental Nutrition Assistance Program (Snap) benefits have been delayed for 42 million Americans.As Saturday’s session got under way, Republican senators Lindsey Graham of South Carolina, Rick Scott of Florida and Bill Cassidy of Louisiana welcomed a proposal made on social media early Saturday by Donald Trump, from his golf course in West Palm Beach, for subsidies to be replaced by health savings accounts.In a Truth Social post, Trump suggested that instead of meeting the demand from Democrats to extend subsidies for health insurance plans purchased through the ACA marketplace, to pay for sharply increased premiums, Republicans should return to the project of replacing the Obama-era law, which failed during his first administration.“I am recommending to Senate Republicans that the Hundreds of Billions of Dollars currently being sent to money sucking Insurance Companies in order to save the bad Healthcare provided by ObamaCare, BE SENT DIRECTLY TO THE PEOPLE SO THAT THEY CAN PURCHASE THEIR OWN, MUCH BETTER, HEALTHCARE,” Trump wrote.Graham welcomed the proposal, which is similar to a replacement for Obamacare he put forward in 2017, writing on social media that Trump’s “recommendation that we stop sending tens of billions of dollars under Obamacare to money-sucking insurance companies and instead send that money directly to the people so they can buy better healthcare is simply brilliant”.“We’re going to replace this broken system with something that is actually better for the consumer,” Graham said later.Cassidy, who was a co-author of Graham’s similar plan in 2017, also praised Trump’s proposal on social media, and stood next to a giant blow-up of Trump’s post as he spoke on the Senate floor.“I’m writing the bill right now,” Scott posted in a response to Trump’s suggestion. “We must stop taxpayer money from going to insurance companies and instead give it directly to Americans in HSA-style accounts and let them buy the health care they want. This will increase competition & drive down costs.”None of the Republican senators seemed to grapple with the fact that consumers would still need to buy plans from the same insurance companies, or that Republican lawmakers need the support of eight Democrats to reopen the government, and the idea of repealing and replacing Obamacare with savings accounts is unlikely to earn a single Democratic vote.Elizabeth Warren, the Massachusetts Democrat, shared an alarmed response to Trump’s proposal from Larry Levitt, the executive vice-president for health policy at the Kaiser Family Foundation, who wrote on social media: “You have to read between the lines here to imagine what President Trump is proposing. But, it sounds like it could be a plan for health accounts that could be used for insurance that doesn’t cover pre-existing conditions, which could create a death spiral in ACA plans that do.”“In other words, Donald Trump’s ‘concept of a plan’ for health care is another cynical attempt to repeal Obamacare,” Warren commented. “It’s the same failed Republican plan that’s been rejected by voters and Congress. We can lower costs and open the government TODAY by extending ACA tax credits.”Senate Republican leaders have signaled an openness to an emerging proposal from a small group of moderate Democrats to end the shutdown in exchange for a later vote on the “Obamacare” subsidies.Senator Jeanne Shaheen, a Democrat from New Hampshire, who is leading the talks among moderates, said Friday evening that Democrats “need another path forward” after Republicans rejected an offer from Democratic leader Chuck Schumer of New York to reopen the government and extend the subsidies for a year.Shaheen and others, negotiating among themselves and with some Republicans, have been discussing bills that would pay for parts of government – food aid, veterans’ programs and the legislative branch, among other things – and extend funding for everything else until December or January. The agreement would only come with the promise of a future healthcare vote, rather than a guarantee of extended subsidies.It was unclear whether enough Democrats would support such a plan. Even with a deal, Trump appears unlikely to support an extension of the health benefits. The Republican House speaker, Mike Johnson, also said this week that he would not commit to a health vote.Schumer on Saturday persisted in arguing that Republicans should accept a one-year extension of the subsidies before negotiating the future of the tax credits.“Doing nothing is derelict because people will go bankrupt, people will lose insurance, people will get sicker,” Schumer said in a floor speech. “That’s what will happen if this Congress fails to act.”Earlier, Bernie Sanders, an independent from Vermont who caucuses with the Democrats, said they need to stand strong after overwhelming Democratic victories on election day.One bizarre element of the Republican effort to signal that their party is working overtime to end the shutdown, even as Trump golfs in Florida, was a social media post on Saturday from Markwayne Mullin, an Oklahoma senator. Mullin posted four photographs of himself and two other Republican senators meeting with Trump in the Oval Office, with the caption: “Working through the weekend with President Donald J Trump. It’s always an honor to be in the Oval Office– I never take this opportunity to serve Oklahoma for granted.”What Mullin failed to make clear is that the photographs were taken on Friday, before Trump left for a weekend golf trip at his Florida resort. Mullin himself had previously posted one of the photographs in a social media video Friday night.The Associated Press contributed reporting More

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      Zohran Mamdani represents the future of the Democratic party | Robert Reich

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      The only upside to living through this dark time is it pushes us to rethink and perhaps totally remake things we once thought immutable.Like the Democratic party.In case you hadn’t noticed, the current Democratic party is dysfunctional, if not dead.Better dysfunctional than a fascist cult like Donald Trump’s Republican party. But if there were ever a time when America needed a strong, vibrant Democratic party, it’s now. And we don’t have one.The brightest light in the Democratic party is Zohran Mamdani, the 34-year-old member of the New York state assembly who has a good chance of being elected the next mayor of New York City when New Yorkers go to the polls a week from Tuesday.Mamdani is talking about what matters to most voters: the cost of living. He says New York should be affordable for everyone.He’s addressing the problems New Yorkers discuss at their kitchen tables. He’s not debating “Trumpism” or “capitalism” or “Democratic socialism”. He’s not offering a typical Democratic “10-point plan” with refundable tax credits that no one understands.He’s proposing a few easy-to-understand things: free buses, free childcare, a four-year rent freeze for about 2 million residents, and a $30 minimum wage. He’s aiming to do what Franklin D Roosevelt did in the 1930s: fix it.You may not agree with all his proposals (I don’t), but they are understandable. And if they don’t work, I expect that, like FDR, he will try something else.The clincher for me is that he’s inspiring a new generation of young people. He’s got them excited about politics. (My 17-year-old granddaughter is spending her weekends knocking on doors for him, as are her friends.)You don’t have to reach too far back in history to find Democratic politicians who have inspired young people. Bernie Sanders (technically an independent) and AOC. Barack Obama. (I was inspired in my youth by Bobby Kennedy – the real Bobby Kennedy – and Senator Eugene McCarthy.)And Mamdani.What do all of them have in common? They’re authentic. They’re passionate. They care about real people. They want to make America fairer. They advocate practical solutions that people can understand.View image in fullscreenNonetheless, Mamdani is horrifying the leaders of the Democratic party. Chuck Schumer still hasn’t endorsed him. Bill Clinton has endorsed Andrew Cuomo, who is spending what are probably the last days of his political career indulging in the kind of racist, Islamophobic attacks we’d expect from Trump.Meanwhile, the editorial board of the New York Times counsels “moderation”, urging Democratic candidates to move to the “center”. Tell me: where is the center between democracy and fascism, and why would anyone want to go there?In truth, the Times’s so-called “moderate center” is code for corporate Democrats using gobs of money to pursue culturally conservative “swing” voters – which is what the Democratic party has been doing for decades.This is part of the reason America got Trump. Corporate Democrats took the party away from its real mission: to lift up the working class and lower-middle class and help the poor. Instead, they pushed for globalization, privatization and the deregulation of Wall Street. They became Republican-lite.skip past newsletter promotionafter newsletter promotionIn 2016 and again in 2024, working and lower-middle class voters saw this and opted for a squalid real estate developer who at least sounded like he was on their side. He wasn’t and still isn’t – he is on the side of the billionaires to whom he gave two whopping tax cuts. But if the choice is between someone who sounds like he’s on your side and someone who sounds like a traditional politician, guess who wins?Trump also fed voters red-meat cultural populism – blaming their problems on immigrants, Hispanic people, Black people, transgender people, bureaucrats and “coastal elites”. Democrats, meanwhile, gave voters incomprehensible 10-point plans.The Times tries to buttress its argument that Democrats should move to the “center” by citing Democrats who won election last year in places Trump also won.But that argument is bunk. Democrats won in these places by imitating Trump. One mocked the term “Latinx” and was hawkish on immigration. Two wanted to crack down harder on illegal immigration. Two others emphasized crime and public safety. Another bragged about taking on federal bureaucrats.This isn’t the way forward for Democrats. Red-meat cultural populism does not fill hungry bellies or pay medical bills or help with utility bills or pay the rent.Mamdani poses a particular threat to New York’s corporate Democrats because he wants to tax the wealthy to pay for his plan to make New York more affordable to people who aren’t wealthy.He aims to generate $9bn in new tax revenue by raising taxes on the city’s wealthiest residents and businesses. He’s calling for a 2% tax on incomes more than $1m, which would produce $4bn in tax revenue. He wants to increase the state’s corporate tax rate to 11.5% to match New Jersey’s, generating about $5bn annually.He’s right. The wealthy have never been as wealthy as they are now, while the tax rate they pay hasn’t been as low in living memory.Inequalities of income and wealth are at record levels. A handful of billionaires now control almost every facet of the United States government and economy.Even as the stock market continues to hit new highs, working-class and lower-middle-class families across America are getting shafted. Wages are nearly stagnant, prices are rising. Monopolies control food processing, housing, high-tech, oil and gas.The time is made for the Democrats. If the party stands for anything, it should be the growing needs of the bottom 90% – for affordable groceries, housing and childcare. For higher wages and better working conditions. For paid family leave. For busting up monopolies that keep prices high. For making it easier to form and join labor unions.Pay for this by raising taxes on the wealthy. Get big money out of politics.This dark time should wake us up to the bankruptcy of the corporate Democratic party.It should mark the birth of the people’s Democratic party. Zohran Mamdani and others like him are its future.

      Robert Reich, a former US secretary of labor, is a professor of public policy emeritus at the University of California, Berkeley. He is a Guardian US columnist and his newsletter is at robertreich.substack.com. His new book, Coming Up Short: A Memoir of My America, is out now More

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      Troops on the streets, Ice thuggery – and prices still climbing: welcome to Trump’s ‘golden age’ | Steven Greenhouse

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      In his inauguration speech last January, Donald Trump bombastically declared: “The golden age of America begins right now.” Our braggadocious president has stuck to that theme ever since, telling the United National general assembly in late September: “This is indeed the golden age of America.”With the federal government shut down for more than two weeks, the nation more polarized than at any time since the civil war, political violence growing and the job market slowing, it doesn’t feel remotely like a golden age, unless one focuses on Trump’s Louis XIV-like effort to gild as many things as possible in the Oval Office.Decoration spree aside, it in no way feels like a golden age when Trump sends the national guard into Los Angeles and Chicago to fight “the enemy within” or when he says the governor of Illinois and mayor of Chicago should be in jail for opposing his plans to deploy troops to Chicago. I doubt that the 27 Chicago police officers who were accidentally teargassed by Ice agents think it’s a golden age and ditto for the growing number of US citizens Ice has arrested.Nor does the US seem like the shining city upon a hill when Ice agents slam a 79-year-old US citizen to the ground in Los Angeles. Nor when Trump’s Department of Homeland Security posts thuggish videos of stormtrooper-like Ice agents – videos that seem more like Germany in the 1930s than any golden vision of the US as it approaches its 250th birthday.Only a huckster would boast of a golden age when his public approval ratings are deep underwater. According to a CBS/YouGov poll in early October, 58% of the US public disapproves of Trump’s performance, while 42% approve. Another poll found that 62% of Americans believe the country is heading in the wrong direction.As part of his golden vision, Trump promised good times for working-class Americans, but 74% of the US public says the economy is in poor or fair condition and nearly two-thirds oppose his signature policy of tariffs and more tariffs. In a big thumbs down for Trump, 53% of the public says his policies are making the economy worse.Candidate Trump promised that prices would begin falling on his first day back as president, but prices have continued to climb since he returned to office, partly because of the tariffs he’s imposed. What’s more, Trump’s tariff mania has created so much economic uncertainty that job growth has slowed hugely under Trump compared with under Joe Biden. According to Mark Zandi, the chief economist at Moody’s Analytics, there was “essentially no job growth” in September.Trump promised blue-collar Americans he would increase manufacturing and the number of factory jobs, but factory activity has declined for seven straight months, and factory employment has fallen since April, too. There’s nothing golden about any of that.Showing Americans’ increased pessimism under Trump, a Wall Street Journal-Norc poll found in September that the share of Americans who say they have a good chance of improving their standard of living has fallen to just 25%, a record low in surveys taken since 1987.The 10 million Americans who will lose health coverage because of Trump’s One Big (Not So) Beautiful Bill Act probably don’t consider this a golden age. Likewise with the 22 million Americans whose health insurance premiums will double on average, often soaring by thousands of dollars, unless Trump and congressional Republicans extend subsidies for the Affordable Care Act.Scientists complain that Trump is singlehandedly ending America’s golden age of scientific research with his deep, myopic cuts – cuts that could end US leadership in medicine and other vital fields of research. At the same time, Robert F Kennedy Jr is undermining trust in vaccines, with the US seeing the highest number of measles cases since Bill Clinton was in office and signed a law establishing free universal vaccinations for children.It seems like anything but a golden age for justice when the Department of Justice indicts the former FBI director James Comey and the New York state attorney general Letitia James after Trump in effect ordered prosecutors to get them (or get fired). Nor does one feel golden about the attorney general Pam Bondi not only stonewalling a Senate hearing (especially when asked about Trump’s relationship with Jeffrey Epstein), but insulting several senators – she called Adam Schiff of California a “failed lawyer”. In the same crude vein, a White House spokesperson slimed the Illinois governor, JB Pritzker, calling him “an incompetent slob”. It doesn’t look like transparency or civility are part of Trump’s golden age.Trump can’t possibly feel golden about an August poll that found that nearly two-thirds of Americans believe he is corrupt, with 45% viewing him as “very corrupt”.When Trump spoke at the UN in September, the assembled diplomats must have thought it was a dark age for US diplomacy, not a golden one, when Trump berated them by saying: “Your countries are going to hell.” The next day, Britain’s Daily Mirror ran a front-page photo of Trump with the headline: “DERANGED – World’s Most Powerful Man-Baby.”In his inauguration speech, Trump said: “From this day forward, our country will flourish and be respected again all over the world.” But people from many countries are giving low marks to second-term Trump. When Pew asked residents of various countries whether they have confidence that Trump will do the right thing in world affairs, in Canada 77% of respondents said they had no confidence, while 22% had confidence. In Mexico, 91% had no confidence. In Germany 81% had no confidence, while 18% had confidence. In the UK, 62% had no confidence to 37% who had confidence.skip past newsletter promotionafter newsletter promotionSince Trump returned to office, many countries’ views of the US have soured substantially and not just because they’re livid about Trump’s tariff war. It’s harder than ever to view the US as a bulwark of democracy and freedom, considering that Trump has embraced Vladimir Putin, deployed troops to major cities, declared war on leading universities, dispatched masked agents to make mass arrests, and pushed to indict his political enemies. In Mexico, the favorability rating of the US has plummeted 32 percentage points since 2024, to just 29%, while in Canada, it has fallen 20 points to just 34% favorable. In Sweden, the US’s favorability rating is down 28 points to 19%, and in Germany it’s down 16 points, to 33%.I’m sure that many rightwing, “don’t tread on me” Americans don’t see this as a golden age. I can’t imagine they like seeing masked agents snatching people off the streets or Black Hawk helicopters descending on apartment buildings or Ice agents bashing in doors and windows. That’s not what freedom looks like.Even the country music star Zach Bryan – a navy veteran who calls himself “confused” politically – is complaining, with a new song saying Ice “is going to come bust down your door” and “the middle finger’s rising, and it won’t stop showing/ Got some bad news / The fading of the red, white and blue.”Trump, the salesman and showman, always feels the need to boast – to brag that things are the best ever under him. But his high disapproval ratings at home and abroad suggest many people think he is ushering in a dark age – an age of disinformation and division, of suppressing critics and indicting enemies, of taking one authoritarian, anti-democratic action after another.For a lucky few, it is a golden age. For the craftsmen hired to gild Trump’s Oval Office and his humongous new ballroom, it’s certainly a golden payday. As they grow ever richer, the country’s billionaires are no doubt basking in this new gilded age as Trump slashes their taxes, strips away regulations and steers deals to his buddies (like Larry Ellison, the world’s second-richest person). And Trump no doubt thinks it is a golden age for himself as he grabs ever more power, dominates the headlines, enriches himself further and decorates the White House with ever more gold.But to millions of us it feels like the opposite of a golden age as Trump takes a wrecking ball to truth, democracy and the rule of law. In declaring that it is a golden age, Trump is like the fraudster who says: “I have some wonderful, shiny gold I’ll sell you for $4,000 an ounce.” But in truth it’s just worthless fool’s gold.No one should be fooled by Trump’s delusional boasts.

      Steven Greenhouse is a journalist and author, focusing on labor and the workplace, as well as economic and legal issues More

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      Six former US surgeons general warn RFK Jr is ‘endangering nation’s health’

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      Six former US surgeons general – the top medical posting in Washington – warned in an opinion column published on Tuesday that policy changes enacted by the health and human services (HHS) secretary, Robert F Kennedy Jr, are “endangering the health of the nation”.The surgeons general – Jerome Adams, Richard Carmona, Joycelyn Elders, Vivek Murthy, Antonia Novello and David Satcher – who served under both Republican and Democrat administrations, identified changes in vaccine policy, medical research funding, a shift in priorities from rationality to ideology, plunging morale, and changes to staffing as areas of concern.Referring to their oaths of office, both Hippocratic as physicians and as public servants, the former officials wrote in the Washington Post that they felt “compelled to speak with one voice to say that the actions of Health and Human Services Secretary Robert F. Kennedy Jr. are endangering the health of the nation”.“Never before have we issued a joint public warning like this. But the profound, immediate and unprecedented threat that Kennedy’s policies and positions pose to the nation’s health cannot be ignored,” they said, adding that they could not ignore the “profound, immediate and unprecedented threat” of his policies.Under a “Make America Healthy Again” (Maha) agenda, Kennedy has accelerated vaccine policy changes despite opposition from scientists, including narrowing eligibility for Covid-19 vaccine shots and dismissing members of a vaccine advisory panel.He has cut federal funding for mRNA vaccine research for respiratory illnesses and instituted a review of vaccine recommendations. Kennedy also sought the dismissal of Dr Susan Monarez, former head of the US Centers for Disease Control and Prevention (CDC).Monarez testified before Congress last month that her firing by Donald Trump came after refusing a request from Kennedy to dismiss CDC vaccine experts “without cause”.Kennedy said in June that waning public trust in US healthcare and conflicts of interest between the medical establishment and the pharmaceutical industry are behind a mission to put “the restoration of public trust above any pro- or anti-vaccine agenda”.“The public must know that unbiased science guides the recommendations from our health agencies. This will ensure the American people receive the safest vaccines possible,” he said.The surgeons general pushed back on that characterization in their letter, noting that they had uniformly “watched with increasing alarm as the foundations of our nation’s public health system have been undermined.“Science and expertise have taken a back seat to ideology and misinformation. Morale has plummeted in our health agencies, and talent is fleeing at a time when we face rising threats – from resurgent infectious diseases to worsening chronic illnesses,” they said.They accused Kennedy of failing to ground public healthcare policy in science, pointing out that Kennedy “has spent decades advancing dangerous and discredited claims about vaccines” and referred to the recent measles outbreak in parts of the US.“Secretary Kennedy is entitled to his views,” the authors concluded. “But he is not entitled to put people’s health at risk. He has rejected science, misled the public and compromised the health of Americans.”Last week, two psychiatric organizations – the Southern California Psychiatric Society and a grassroots startup, the Committee to Protect Public Mental Health – called for Kennedy’s removal as health secretary in a statement, arguing that the HHS had “been damaged in ways that directly endanger lives, degrade scientific integrity, and obstruct effective treatment for mental health and substance use disorders”.The groups pointed to Kennedy’s restructuring of the agency including changes to the substance abuse and mental health services administration (Samhsa), which the secretary plans to place under the control of a new entity, titled the Administration for a Healthy America (AHA).Emily Hilliard, a spokesperson for the federal health department, said in a statement to NPR that “Secretary Kennedy remains firmly committed to delivering on President Trump’s promise to Make America Healthy Again by dismantling the failed status quo, restoring public trust in health institutions, and ensuring the transparency, accountability, and decision-making power the American people voted for.” More

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      Democrats are embracing the risky politics of a government shutdown to rein in president, activists say

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      For months, as Donald Trump has used the levers of the US federal government to consolidate power, silence dissent and punish his political enemies, Democrats have been bombarded with a single demand: do something. Last week, they did.In a rare display of unity, out-of-power Democrats embraced the risky politics of a government shutdown – their boldest effort yet to rein in a president whom many Americans and constitutional scholars now view as a threat to US democracy.“It’s not a fight for fighting’s sake,” said Adam Green, co-founder of the Progressive Change Campaign Committee, one of the outside groups closely coordinating with Democratic leaders on Capitol Hill. “This is a battle about Donald Trump’s attacks on the constitution and him seizing the power over all spending from Congress – and whether Congress is going to let him get away with that.”Washington is bracing for what could be an extended government shutdown, which officially began at 12.01am on Wednesday. Last week, Senate Democrats repeatedly blocked a Republican funding measure to reopen the government, as the parties traded blame and each side insisted they would not bend to the other’s demands.Democrats are pressing for an array of healthcare-centered priorities, including the extension of tax credits for Affordable Care Act plans set to expire at the end of the year. The White House and Republicans, who control both chambers of Congress, have refused to include any healthcare concessions as part of a deal to reopen the government, though some GOP lawmakers are open to extending the ACA subsidies.Democrats, with little leverage and deep skepticism that Republicans will honor any future deal, view the shutdown as their only option to force the issue.But the Trump administration is working to make the closures as painful as possible for Democrats, who Republicans accuse of trying to “sabotage” the president’s agenda.Trump has called the shutdown an “unprecedented opportunity” to dismantle federal programs and what he called “Democrat agencies”. In a sharp break from precedent, the Trump administration is readying plans to permanently layoffs of federal workers while it takes punitive action against Democratic-led states. Several government departments have posted partisan and potentially illegal messages saying their operations are curtailed due to “the Radical Left Democrat shutdown”. In the Senate, the majority leader John Thune has said he plans to hold more votes on a plan to reopen the government this week.But Democrats say the stakes are too high – and the greater risk is capitulating to the president.“Remember, right now, our healthcare system is broken. Right now, we’re the only major country on Earth not to guarantee healthcare to all people,” the senator Bernie Sanders said in a video with progressive New York congresswoman Alexandria Ocasio-Cortez, explaining the Democrats’ opposition to the Republican funding bill. “And these guys want to make it even worse. We’re not going to let that happen.”Progressive activists who have been sharply critical of the party’s congressional leaders, Senate Democratic leader Chuck Schumer and House Democratic leader Hakeem Jeffries, are now praising them for continuing to “hold the line on healthcare”.“What our members see is Democrats willing to stand up and fight,” said Joel Payne, a spokesperson for MoveOn, which is part of a coalition of progressive groups flooding Democrats with calls to hold fast in shutdown negotiations.Payne said healthcare was Democrats’ “north star” – the party’s strongest issue with voters and one that has helped propel them to victory in the past. If Democrats are successful, he added, the showdown over healthcare could serve as a blueprint for safeguarding other rights under attack by the administration.House Republicans did not need Democrats to pass their short-term spending bill last month, which would fund the government mostly at current levels through 21 November. But in the Senate, where Republicans hold a 53-47 majority, they need Democratic support to clear the 60-vote threshold required to advance most legislation.So far, only three members of the Senate Democratic caucus have broken ranks: John Fetterman of Pennsylvania, Catherine Cortez Masto of Nevada and Angus King, an independent of Maine.In the House, Maine congressman Jared Golden, was only House Democrat to back the Republican funding bill when it passed the House last month. In a statement last week, Golden said the shutdown was the “result of hardball politics” driven by the demands of “far-left groups” eager to show their opposition to Trump.Early polling suggests voters are more inclined to blame Trump and Republicans than Democrats for the federal shutdown. A Washington Post poll released on Thursday found that, by a 17-percentage-point margin, Americans blame Republicans for the shutdown. Independents overwhelmingly sided with Democrats, the survey found.Yet there were signs public opinion could shift as more Americans face the ripple effects of government-wide closures. In several polls, a significant share of voters said they held both parties equally responsible or were unsure of whom to blame.The call for Democrats to take a harder line against Trump has been building for months. Across the country, progressive activists, disaffected Republicans and voters outraged by the administration’s actions have packed town halls, marched in protests and launched campaigns of their own – sending a clear message to Democrats: step up, or step aside.“Everybody wants a fighter,” said Lanae Erickson, senior vice-president at the centrist thinktank Third Way that is often at odds with the party’s left flank.Erickson said the focus on healthcare – an issue that unifies the party’s diverse coalition and falls squarely in the “Venn diagram of things voters care about” – was both good politics and good policy.“The ACA subsidies are a real ask,” she said. “If Democrats got that, it would be a way to declare victory in this moment.”Democrats feel confident going to battle over healthcare. A Kaiser Family Foundation (KFF) poll showed that 78% of Americans support extending the credits, which disproportionately benefit Republican-held congressional districts.Without action, insurance premiums for millions of Americans could double next year, according to an analysis by KFF. Democrats have also sought to reverse Medicaid cuts included in Trump’s marquee tax-and-immigration package, which the nonpartisan congressional budget office projects will leave 10 million more Americans uninsured over the next decade.Republicans have countered by falsely claiming Democrats forced a shutdown to provide free health benefits to undocumented immigrants. The White House has taunted Democrats with a deepfake video of Schumer and Jeffries, wearing a sombrero and fake mustache that has been widely denounced as racist. Vance laughed off the criticism, calling the video “funny”.Democrats like Gavin Newsom, the governor of California, fired back with memes and taunts of their own. In one tweet, Newsom’s press team posted an AI generated image of Trump in a towering wig and an 18th-century gown: TRUMP “MARIE ANTOINETTE” SAYS, “NO HEALTH CARE FOR YOU PEASANTS, BUT A BALLROOM FOR THE QUEEN!”Democrats are betting that the shutdown strategy can help shift momentum heading into next year’s midterm elections. By wielding their most powerful legislative tool, party leaders aim to rebuild trust with their disillusioned base – a group whose frustration has dragged Democratic approval ratings to decade lows and hurt fundraising.Many Democrats argue that their best hope of restraining Trump is to regain the House in 2026, and that the most straightforward path to doing so is to focus on kitchen-table issues like healthcare.Some Democratic strategists warn that by focusing primarily on healthcare, the party risks downplaying what many view as Trump’s authoritarian lurch – reducing it to just another policy showdown in Washington’s partisan budget battles.Anat Shenker-Osorio, a Democratic strategist and communications researcher, believes a sharper message – such as “we will not fund fascism” or “no dollars for dictatorship” – would help cut through the noise and clarify the stakes.“In order for people to fight this regime, they have to understand it as a regime hellbent on taking our freedoms,” she said.As part of their demands, Democrats are also pushing for ways to curtail Trump’s ability to rescind funding already approved by Congress, as he has done with foreign aid programs and public broadcasting. An alternative short-term funding bill offered by Democrats included provisions that would make it harder for the president to undermine Congress’s funding power.Ezra Levin, co-founder of Indivisible and a leading voice on the left pushing Democrats to fight harder against what he calls the Trump “regime”, said he was encouraged to see the party’s leadership sharpen its tactics. Though Levin shares the view that the stakes are far bigger than a healthcare policy dispute, he believes Democrats’ demands, if met, could “constrain the regime in some meaningful ways”.Indivisible is helping to coordinate a second wave of No Kings rallies across the country to protest what organizers described as Trump’s “authoritarian power grab”. The day of action, planned for 18 October, will be another opportunity to mobilize Americans and, Levin hopes, to celebrate Democrats for their resolve.“I hope what we will not be doing is criticizing them for having surrendered again,” he said. “So the play is to win.” More

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      Why healthcare spending was at the center of the US government shutdown battle

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      The federal government shut down on Wednesday in part, due to a battle between Democrats and Republicans over healthcare spending.Democrats had said that they would not vote for legislation to keep the government open unless Donald Trump and Republicans, who hold the majority in Congress, agreed to reverse cuts to Medicaid and extend subsidies for Affordable Care Act plans. That did not respire in either of the votes in the Senate on Tuesday.In June, the US president approved legislation he calls his “big, beautiful bill”, which the Congressional Budget Office estimated would reduce federal Medicaid spending by $793bn and increase the number of uninsured people by 7.8 million.The savings in federal Medicaid spending will largely come from the implementation of the new requirements, which include completing 80 hours of work or community service activities per month, or meeting exemption criteria.The law also means that the premium tax credits implemented during the Covid-19 pandemic for insurance purchased through the Health Insurance Marketplace will expire at the end of 2025. That would make coverage more expensive and lead to 3.1 million more people without health insurance, according to the CBO.skip past newsletter promotionafter newsletter promotion“We are not going to support a partisan Republican spending bill that continues to gut the healthcare of everyday Americans,” Jeffries said following a negotiation with Trump and Republican leaders on Monday.Meanwhile, Trump doubled down during an Oval Office press conference on Tuesday that if the parties can’t reach an agreement, “we can do things during the shutdown that are irreversible, that are bad for them,” Trump said while speaking to reporters in the Oval Office on Tuesday afternoon. “Like cutting vast numbers of people out, cutting things that they like, cutting programs that they like.”He did not mention Medicaid or the Affordable Care Act but said: “We can do things medically and other ways, including benefits.”Still, there could be an opening for negotiation in coming weeks. The Senate majority leader, John Thune, said on the Senate floor on Tuesday that the Democrats should vote to keep the government open until 21 November and that he would be happy to fix the “ACA credit issue” before the credits expire at the end of the year. More

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      Tensions expected as Trump meets with top Democrats and Republicans in effort to avoid shutdown

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      Democrats and Republicans are gearing up for a crunch White House meeting with Donald Trump in an 11th-hour bid to avert a potentially damaging federal government shutdown.Monday’s gathering is aimed at reaching an agreement over funding the government and largely hinges on Democrat demands for an extension of funding subsidies for health insurance under the Affordable Care Act, also known as Obamacare, beyond the end of the year, when they are due to expire.Hakeem Jeffries, the Democrat leader in the House of Representatives, and Chuck Schumer, the party’s leader in the Senate, will meet Trump along with their Republican counterparts, Mike Johnson, the House speaker, and John Thune, the Senate majority leader, for talks that are expected to be tense if not confrontational.It will be Trump’s first meeting with the two Democrats since his return to the White House in January. Jeffries and Trump have never previously met in person.Expectations for the encounter are low, with failure likely to result in large swathes of the federal government shutting down from 1 October.Trump and the Republicans have signaled that they are unfazed at that prospect, calculating that the public will blame Democrat intransigence.The White House office of management and budget (OMB) has also indicated that it will exploit a shutdown to carry out more mass firings as part of its crusade to slash government bureaucracy.An OMB memorandum said government agencies have been instructed “use this opportunity to consider reduction in force (RIF) notices for all employees in programs, projects, or activities”, The Hill reported.Republicans have also warned that Trump could make a shutdown politically costly by targeting spending programmes that are disproportionately used by Democrat-run states and cities.CBS, citing a source close to Trump, reported that he privately welcomes the prospect of a shutdown because it would “enable him to wield executive power to slash some government programs and salaries”.“I just don’t know how we are going to solve this issue,” Trump told the network in a telephone interview. “They [the Democrats] are not interested in waste, fraud and abuse.”skip past newsletter promotionafter newsletter promotionSome Democrats have acknowledged that they have “no good options” in trying to end the standoff.“It’s doubly made no good because it’s very clear that Republicans want [a shutdown]. Trump wants it. He’s fine with that, happy to have it,” The Hill quoted a Democratic Senate aide as saying.. “I don’t really know what your good option here is when they want one.”However, Schumer is under pressure to be seen taking a more actively confrontational stance after being fiercely criticized by fellow Democrats for backing a Republican funding packing in March to avert an earlier government shutdown.With Rand Paul, the Kentucky Republican senator, likely to vote against the funding package, it would need the support of eight Democrats to overcome a Senate filibuster. More