HHS considers cutting HIV prevention funding

HHS is considering drastically cutting the federal government's funding for domestic HIV prevention and shutting down the HIV prevention division of CDC, potentially shifting some of these responsibilities to another agency, according to sources who spoke to the Wall Street Journal and the New York Times.

CDC's HIV prevention department funds state and local surveillance programs for HIV, syringe services, and community-outreach initiatives. During the 2023 fiscal year, CDC spent around $1.3 billion on the prevention of HIV, viral hepatitis, sexually transmitted infections, and tuberculosis, according to the agency's website.

One of the programs that could be eliminated or scaled back is CDC's PrEP initiative, which was launched as a pilot program last fall and provides free pre-exposure prophylaxis — medication that helps prevent HIV, according to Mitchell Warren, executive director of the HIV prevention organization AVAC.

"One of the greatest lessons in public health is you can't end epidemics with treatment alone. Without prevention, we are going to be fighting the virus with one hand behind our back," Warren said, noting that cuts to domestic HIV prevention would conflict with President Donald Trump's pledge in 2019 to end the HIV epidemic in the United States.

The plan has yet to be finalized and the potential timing of it is unclear. "It's not 100% going to happen, but 100% being discussed," said a federal official who spoke to the Times. (Whyte et al., Wall Street Journal, 3/18; Mandavilli, New York Times, 3/19)

Dr. Oz's confirmation hearing

Members of the Senate Finance Committee on Friday questioned Mehmet Oz, President Donald Trump's pick to lead CMS, on several topics, including his support for proposals that would cut Medicaid funding.

Sen. Ron Wyden (D-Ore.), the top Democrat on the committee, asked Oz, "Since you cherish Medicaid, will you agree to oppose cuts in the Medicaid program?" Sen. Maria Cantwell (D-Wash.) and Sen. Ben Ray Lujan (D-N.M.) also asked Oz if he would support cuts to Medicaid.

Oz said he wants to ensure there are providers who will accept Medicaid patients and that these providers are paid fairly under the program, adding that he wants to make sure Medicaid is "viable at every level."

Oz suggested that Medicaid expansion under the Affordable Care Act (ACA) has grown the program beyond its original purpose. "For some states it made sense, for some it didn't," Oz said.

"The rapid expansion of the required expenses of monies for Medicaid is far beyond what was ever envisioned when ACA was originally passed," Oz added. "It is one of the ways we can do better."

Oz also said he supports Medicaid work requirements but noted that they could be implemented without the amount of burdensome paperwork that is common in some states that have implemented the requirements.

"I don't think you need to use paperwork to prove a work requirement, and I don't think that should be used as an obstacle, a disingenuous effort to block people from getting on Medicaid," Oz said.

Sen. Elizabeth Warren (D-Mass.) brought up the issue of some Medicare Advantage plans padding patient records with extra diagnoses in order to receive higher per-patient payments from Medicare. Oz said CMS is "aware of this" and said that if he's confirmed, "this will be one of the topics that is relatively enjoyable to go after, because I think we have bipartisan support." (Frieden, MedPage Today, 3/14; Weixel, The Hill, 3/14; Abelson/Craig, New York Times, 3/14)

RFK Jr. presses infant formula makers on product ingredients

HHS Secretary Robert F. Kennedy Jr. on Tuesday met with executives from Abbott, Reckitt Benckiser, Bobbie, and Perrigo and pressed the companies on certain ingredients included in their infant formulas, especially seed oils, according to a person familiar with the meeting who spoke to STAT. Kennedy and other members of the Make America Health Again movement have singled out seed oils as a cause of chronic disease.

"Each ingredient in our formulas is purposefully chosen for the type of baby we're feeding and their unique dietary needs, and we're continuously working to get our formulas closer to breast milk," said Abbott spokesperson Scott Stoffel.

Brad Joseph, a spokesperson for Perrigo, said the company and Kennedy spoke about the importance of maintaining a secure supply of infant formula.

Following the meeting, HHS and FDA released a joint statement announcing "Operation Stork Speed," a program aimed at improving the quality and availability of infant formula. FDA said that in the coming months, it will request nutrient lists from infant formula companies, increase testing for heavy metals, encourage clearer labeling, expand importation of foreign formula, and work with NIH to conduct more research into health outcomes associated with formula feeding.

"The FDA will use all resources and authorities at its disposal to make sure infant formula products are safe and wholesome for the families and children who rely on them," Kennedy said in the statement. (Lawrence/Todd, STAT+ [subscription required], 3/18)

HHS removes Surgeon General warning declaring gun violence a public health crisis

To comply with President Trump's executive order to protect Second Amendment rights, HHS has removed from its site a warning from former Surgeon General Vivek Murthy that declared gun violence a public health crisis, according to a White House official who spoke to POLITICO.

"Illegal violence of any sort is a crime issue, and as he again made clear during his recent speech at the Department of Justice, President Trump is committed to Making America Safe Again by empowering law enforcement to uphold law and order," a White House official said in a statement to POLITICO.

Trump's executive order, which he signed last month, directed the federal government to halt any existing policies the administration deemed to be in violation of the Second Amendment.

"By removing this important public health advisory with lifesaving resources, President Trump has chosen to prioritize gun industry profits over protecting kids and families," said Emma Brown, executive director of Giffords, a gun violence prevention group founded by former Rep. Gabby Giffords. "Guns have been the number one killer of American children and adolescents since 2020, and non-partisan health care experts have understood gun violence as a public health crisis for years." (Friedman, POLITICO, 3/17)

VA phases out gender-affirming treatments for veterans

The Department of Veterans Affairs on Monday announced that it is phasing out all gender-affirming medical treatments for veterans, including hormone treatment for patients diagnosed with gender dysphoria. However, VA said it will continue providing hormone treatment for veterans who currently receive it or were receiving it when they separated from the military, arguing that abrupt cessation could be harmful to their health.

In a release, VA said the decision was made to comply with President Trump's executive order stating that the United States only recognizes two sexes, male and female, which "are not changeable."

"I mean no disrespect to anyone, but V.A. should not be focused on helping veterans attempt to change their sex," said VA Secretary Doug Collins.

According to an estimate from the Veterans Health Administration, less than one-tenth of 1% of the 9.1 million veterans in VA care are transgender.

In a statement, Lindsay Church, executive director of Minority Veterans of America, said the VA's decision is "a direct attack on the dignity and well-being of transgender, nonbinary, and intersex veterans — one that will have deadly outcomes."

"Transgender individuals serve at a higher rate than the general public; this decision will force our community to defer or delay care and opt out of VA services altogether," Church said. "This decision will exacerbate our already devastatingly high suicide rates and push more veterans into crisis for no reason other than hate." (Rabin, New York Times, 3/17; Amos, Axios, 3/18)