[Editor’s note: This transcript was generated using both transcription software and a human’s light touch. It has been edited for style and clarity.] 

Julie Rovner: Hello from KFF Health News and WAMU radio in Washington, D.C. Welcome to What the Health? I’m Julie Rovner, chief Washington correspondent for KFF Health News, and I’m joined by some of the best and smartest health reporters in Washington. We’re taping this week on Thursday, Feb. 5, at 10 a.m. As always, news happens fast, and things might have changed by the time you hear this. So here we go. 

Today, we are joined via video conference by Sandhya Raman of CQ Roll Call. 

Sandhya Raman: Good morning. 

Rovner: Anna Edney at Bloomberg News. 

Anna Edney: Hi, everybody. 

Rovner: And Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico Magazine. 

Kenen: Hi, everybody. 

Rovner: Later in this episode, we’ll have my interview with Renuka Rayasam about our new KFF Health News project “Priced Out.” If you have a story you’d like to share with us about your inability to afford your health insurance or your health care, I will post a link in our show notes. But first, this week’s news. 

So after a two-week detour, during which funding for the Department of Homeland Security was separated out for a separate resolution, which is still TBD, President [Donald] Trump on Tuesday signed into law the rest of an omnibus spending bill that includes funding for the remainder of the fiscal year for the Department of Health and Human Services, as well as a separate health package that includes, among other things, new rules for pharmacy benefit managers and an extension of temporary Medicare programs, expanding payment for telehealth and so-called hospital at-home care. Sandhya, you succinctly summarized all of this the last time you were on, when we thought this was about to become law. But I think it bears repeating that the spending part of this bill includes very few of the cuts to health programs President Trump asked for in his budget proposal last year. How confident are we that this money is actually going to get spent the way Congress is ordering? 

Raman: I think that’s kind of difficult to say. I think one clue we can look at is in the lead-up to this. We did have some of the different grants rescinded and then reinstated in a short amount of time — related to mental health and in public health and a few other areas like that — in order to get this across the finish line. I don’t know what guarantees we have that if it’s not this, it’s something else. But I think they do seem a little bit more confident that they got a little bit more language in there this time to prevent that. But I think we’ll also see, as we get into fiscal 2027 spending and what the White House ends up proposing there. 

Rovner: Yeah, I heard an interview with Sen. Tammy Baldwin, who’s the ranking Democrat on the subcommittee that handles HHS, saying that, you know, unlike last year, when it was just a continuing resolution, this year they actually put in language that says, You will spend this this way. But of course, they’ve had language that’s supposed to spend certain things a certain way, which they have thus far ignored, right? 

Raman: Yeah, and I think it’s something that comes up in all of the hearings they have on this that, you know, appropriators love to say Congress has the power of the purse. You know, this is what they are there to do, is to dole out who gets what. And so it’s an affront to them to say, you know, you’ve spent all this time deciding how much should go to various things, and then it doesn’t actually end up that way. So we’ll see how that plays out. 

Rovner: As you mentioned, it’s worth noting that the president’s budget for fiscal 2027, which starts in just eight months, is already technically late. It was due this past Monday. Any idea when we’ll see a budget from the administration? What might be in it? I know it usually comes after the president’s State of the Union, but that speech is usually at the end of January, and this year the State of the Union isn’t until the end of February. 

Raman: So, I will say that almost always the White House budget comes after the date that it’s supposed to, in statute. But we are, I think, expecting at this point either very late this month or pushing into next month, in terms of when we get it. I think in terms of what would be in there, a lot of what we can look to is similar to what we saw in last year’s request; since the White House budget request is a wish list — it’s the things the White House wants, not necessarily the things they will get. So I think we can look for a lot of the same proposed cuts as before, because some of those were even proposed in the first Trump administration. I think we can also probably look for a lot of, you know, MAHA-oriented things proposed in there that didn’t get across the finish line — the new agency, Administration for a Healthy America, and just kind of flushing that out. And I think those are the big things I’d look for as we get closer to that. 

Rovner: Well, turning to the Affordable Care Act — remember the Affordable Care Act and those expired subsidies that are driving up costs for millions of Americans? Remember the frantic negotiations in the Senate to come up with a compromise after the House passed a Democratic-led effort to extend those enhanced subsidies for three more years? Well, apparently, negotiations on a deal have collapsed, and it’s, apparently — as we’ve said many times — over the often insurmountable issue of abortion. Is this really it for the ACA negotiations, or could this issue come back later this winter, even spring, as more and more people end up dropping their coverage because they can’t afford the new premiums? 

Edney: I think that’s the key point, is we don’t have those numbers. We don’t have a great sense of what that’s going to look like. So I think that when lawmakers start getting those phone calls, that could revive things. I think certainly with the ACA, as it relates to the Hyde Amendment — which it is kind of a “never say never,” like, it often kills these deals, but then suddenly something can kind of appear so … so, yeah, I think you’re right. 

Rovner: Yeah, the Hyde Amendment, just for those who don’t remember, is what basically bans federal funding for abortion through the Labor-HHS spending bill. But anti-abortion forces want to put it in permanent law, rather than having it renewed every year through the spending bill process. And that’s a hang-up that almost blocked the ACA from becoming law in the first place, because even Democrats disagreed over it. 

Edney: Exactly, yeah, and it comes up every single time. You know, there’s … just no solution, no good solution. 

Raman: I feel like this is maybe the last straw at this point, based on the conversations from the Hill this week. I mean, there was a little hope earlier in the week when we talked to Sen. Tim Kaine [D-Va.], and he said, you know, we’ll see in the next couple days or so, we’re still talking. They met this week. They’re planning to meet more this week and talk about it, and then I think in the last day or so, it just … I think both sides were kind of admitting that it was done … because of this issue, [and] there are a couple of other things that are sticking points, and even things that they hadn’t gotten to really ironing out. But they’d said it was kind of moot at this point, if they couldn’t get over Hyde and some of the stuff related to health savings accounts, so. … There are some people that are still hopeful that said that maybe, but I really don’t see how they continue without the people that are most focused on this in the Senate, like really dialing into it. 

Rovner: Yeah, they seem to be sort of consumed right now with figuring out what to do about the Department of Homeland Security in general, and ICE [Immigration and Customs Enforcement] in particular. And I’m glad you mentioned health savings accounts, because obviously that’s been a big Republican push, to give more money directly to people, rather than to insurance companies. Well, it turns out there’s a study in the Journal of the American Medical Association [Network] this week that found that cancer patients who have those high-deductible health plans, which get combined with the health savings accounts, those patients had lower rates of survival compared to those with more comprehensive insurance coverage. Quoting from the study, “These data suggest that insurance coverage that financially discourages medical care may financially discourage necessary care and ultimately worsen cancer outcomes.” That’s not going to help Republicans in their efforts to make patients more financially responsible for their care, I wouldn’t think. 

Edney: Yeah, I think a lot of these things that a cancer patient can’t afford — I mean, this isn’t a $40 copay; often it’s hundreds of thousands of dollars, they’re considering selling property, selling a house, whatever. So it’s not … something that people are shopping around for, becoming more fiscally responsible, trying to find, like, a cheaper option to do this. This is something that, clearly, if they could do it, they would. And you know, instead, as this study showed, they’re more at risk of dying because they can’t get these treatments. 

Kenen: I think that just in general, you know, that these high-deductible plans people treat them as for an emergency, for a catastrophic expense, which means people are delaying — uninsured people and poorly insured people — often delay preventive care and screening. And therefore, if you catch a cancer, and I don’t know the stage of diagnosis — I read part of the study; I didn’t read the entire thing. I don’t know the stage of diagnosis. But if your cancer is caught later because you didn’t do preventive screening, some of which are free now, and some of which are not, or some of which are just caught by, you know, when you’re going in for something else, whatever. Later-stage cancer diagnosis is a worse cancer diagnosis. So the disincentives for preventive care, the disincentives for going in earlier, because you don’t want a big bill for something that you are hoping is nothing, is part of the overall picture. 

Rovner: Yeah, and I mean, it also bears saying that, you know, when we were first arguing about health savings accounts and high-deductible health plans, high-deductible health plans had deductibles of, like, $500 or $1,000. Now, high deductibles are five figures. They’re $10,000 and up. And that’s way more than just inflation over the last 20 years. We know that generally people don’t even have $400 set aside for an emergency. So the idea that they can meet a $10,000 deductible so their insurance can kick in is kind of fanciful, I think, for most people. 

All right. Well, meanwhile, there is lots more news on the vaccine front. In an interview with Politico this week, the new chair of the CDC’s [Centers for Disease Control and Prevention] Advisory Committee on Immunization Practices, Kirk Milhoan, said that the panel should be viewed, quote, “more as a safety committee.” “Efficacy,” he said, “will be secondary.” Basically, he’s saying the panel, whose actual charge is to weigh benefits versus risks of various immunizations, is going to put its finger on the scale to emphasize the risks. Am I reading that right, Anna? 

Edney: Yeah, that’s what, that’s how I read his conversation with Politico. … They’re really charged now to look at the risks of these, which is interesting, because, to put it mildly, because I think it’s kind of a warped way of thinking about vaccines, generally. … There are some risks … but we are potentially stopping how many hundreds, thousands of deaths from polio or something like that. So seems like it could get worked into focusing on those risks versus the lives that are saved by it. It seems to be the direction that this administration certainly wants to go. 

Rovner: And that’s, I mean, the point of having … an expert outside committee is for them to actually do that weighing of benefit versus risk, at least that was my assumption. It’s what I’ve always been told in the almost 40 years I’ve been doing this. 

Edney: Right, and whether it should be a required vaccine versus something you … deciding to get or something like that. Conversation can help with those kinds of decisions. But this is something — a vaccine doesn’t come to market if the FDA is looking at these risks when they consider it in the clinical trials, and that side of it is vetted by the people who are able to have access to a lot of that information. I don’t know that the panel is going to see [it] in the same way, because if you’re looking at the adverse-event database that is kept on vaccines, anyone can send in a side effect to that, or, you know, say that something happened after they had a vaccine. And it can be tough to read that and actually get helpful information from that if we’re looking at the post-market vaccine side effects coming in. 

Rovner: We will continue to watch this space. And it turns out that the changes to vaccine policy extend beyond the United States, too. Reuters broke the story this week that the U.S. is threatening to stop giving money to the global vaccine group Gavi, unless it promises to phase out the use of vaccines that still contain the preservative thimerosal, which has long since been cleared of accusations about causing autism. Gavi provides vaccines to children in the poorest parts of the world, and to stretch its funding, it often relies on less expensive, multidose vaccine vials, which use preservatives to prevent contamination. Apparently, this threat applies to the $300 million the U.S. is already withholding from Gavi that was approved by Congress and to any future funding. So now the U.S. is exporting its effort to scale back childhood immunizations around the world, too? 

Edney: Yeah. It was surprising to see something like that, kind of a demand like that put on Gavi. I guess, in a way, it’s surprising that the administration is still funding Gavi, maybe at all. So you know, I guess, maybe not as shocking that they asked for certain stipulations to be met. But as you mentioned, it is a way to stretch the vaccines to get them to people and countries who otherwise might not have any access to them. So there’s been concern, as you said, that has been debunked about thimerosal, and so we’re not using them that much in vaccines in the U.S., but it’s kind of pushing a first-world problem on other countries. 

Kenen: One really helpful way of thinking about the risk of this preservative is it’s been, as Anna just said, it’s been phased out, not entirely, but mostly in the United States. But in the years … like, most children are not getting it in their shots. And it has to do with storage of large quantities versus individual vials. We don’t have to go into details there. It’s just not, there’s not much of it anymore, and the autism rate has continued to go up while the thimerosal use went down. So that’s … even if you’re not a biostatistician, a statistician, it should tell you something, you know. … If that was the cause, we wouldn’t be seeing more cases. The rise of autism is a complicated thing. We don’t have time to discuss all the theories and measurements and how we do it right here, but it’s easy to understand: One went up, and one went down. It didn’t cause it. 

Rovner: Well, finally, on the vaccine front, this week, here’s what happens when fewer people get immunized. Two detainees at one of the Department of Homeland Security’s family detention centers in Texas have now tested positive for measles, which, as we have discussed at some length, is among the most contagious diseases in the known world. Measles has also been found at another detention facility in Arizona. Now, in the first Trump administration, I remember complaints about children who were being held in detention, having been separated from their parents, being vaccinated without their parents’ permission. But which is worse? Getting vaccinated without parents’ permission, or getting a potentially deadly vaccine-preventable disease? 

Edney: Yeah, that’s certainly, certainly, I think, an easy answer. But you know … these detention centers, it’s so scary because everyone is just packed in there. Everything we’ve heard is how crowded they are, and the people not even being able to lay down. So you do have to wonder whether they’re starting to think differently about just letting it rage through there, or what’s going to happen. I mean, we don’t know yet if quarantine has worked, or anything along those lines. 

Raman: And I think that goes hand in hand a little bit with what we’ve talked about in the past, about, you know, it already being harder to get care for the folks in these facilities, and providers not being able to do that. And if you’re not able to stop something that is so contagious and spreading, it’s just going to exacerbate the whole situation. 

Rovner: Yeah, we have talked at some length about health care for people who are in these detention camps, and how it appears to be significantly lacking. All right, we’re going to take a quick break. We will be right back. 

Back on Capitol Hill, National Institutes of Health Director Jay Bhattacharya appeared before the Senate HELP [Health, Education, Labor & Pensions] Committee on Tuesday and tried to make the case that the agency’s work hasn’t been disrupted by the on-again, off-again funding and grant cuts made during the course of 2025. He pointed out that eventually NIH did spend all of the money that was appropriated to it, but boy, a lot of it came in the last couple of weeks of the fiscal year. Also, as we’ve discussed at some length, there are plenty of stories out there that show that, in fact, funding disruptions have hurt science, including two new ones this week. Stat News has a story about first-year PhD students who are having trouble finding positions in labs — even those students who have their own funding via scholarships or fellowships — because the labs don’t know how to plan for what they’re going to have in terms of money. And here at KFF Health News, we have a story about a Harvard breast cancer lab that’s lost seven of its 18 lab employees after getting its grant frozen and eventually unfrozen, but too late to apply for it to be renewed. Bhattacharya made a big deal of, you know, the NIH, it’s like, OK, we spent all your money. But turning this spigot off and then on again, and then off and then on again, doesn’t feel like a particularly efficient way to spend it. 

Kenen: No, it hurt. It’s really well documented. There are labs all across the country that were hurt, and that meant science that didn’t happen, or didn’t happen as fast and as well as it could have and should have happened. So … to say on-again, off-again biomedical science funding is fine and dandy. It’s not fine or dandy. 

Rovner: And there were patients whose care was disrupted. 

Kenen: And people in clinical trials who were taking a risk, and inconvenience as well as risk, to be part of a clinical trial. I mean, this was more true of some of the stuff in Africa, when the USAID [United States Agency for International Development] money went away, but some really extreme examples there. But people whose care was interrupted, and people who had volunteered in clinical trials whose care has been interrupted. 

Rovner: Yeah, and people, I mean, for whom these clinical trials were their last chance for, you know, for life or death. I mean, we did see stories from all across the country about clinical trials that got, just stopped in their tracks, and you can’t really restart those, because now you’ve interrupted the care. So the science from them is not going to be as valuable. I mean, you basically have to start over. 

Kenen: You could restart but not where you left off. You have to start again. 

Rovner: Right, exactly. You have to start again, which is also not a great use of money. 

Well, meanwhile, over at the FDA, there are still apparently some pretty loud complaints over the agency’s new, quote, “priority voucher” program, which promises expedited approvals for drugs that, quote, “align with national priorities,” which can apparently be political as well as medical. Our podcast panelist Lizzy Lawrence, over at Stat, got a readout from an employee town hall at FDA, as well as members of Congress who are continuing to express concerns about the potential, if not actual, politicization of the drug review process with this program. Anna, what are you hearing? 

Edney: Yeah, I think that that is still the concern. That town hall did not fix anything in the sense that there’s — it’s a completely new paradigm for how they are choosing drugs and pushing them to the front of the line. The FDA has never before really been supposed to or has considered price or anything beyond Is this drug going to be beneficial? They would give things priority review, if it was something that was for lifesaving treatments, or something that just, you know, had, was a huge advance, never existed before. But now they’re saying, If you align with the national views, and nobody really knows exactly what that means. It seems to be that, you know, maybe if you made a deal with Trump to bring down drug prices, you might get some of these. Or if it’s, you know, if you’ve promised to build more manufacturing in the U.S., you might get this. Or if it’s a drug that they just like, then you might get it. I think there’s still just a lot of concern about the legality of this. So even among some drugmakers, there are ones obviously who want this. There are about, I think, 15 right now who have this voucher to get to the front of the line to be, have a superfast review. But there is concern from some that, if another administration comes in, is this even valid? You know, if we get approval, do we even, does it even count if they want to, like, take it, if somebody wants to take it off the market, just given the process? So there’s … you know, people have quit at the FDA over it, very high-profile people, and it’s interesting that it’s still going, that Marty Makary, the commissioner, is still trying to sell it. And [he] even told staff, you know, according to the reporting from Lizzy, that he was doing it because it was really their idea. So. 

Rovner: Meaning the staff’s idea. 

Edney: Yeah, that’s one way to sell it. 

Rovner: I saw that part. I feel like this is a theme throughout the department, which is that, you know, we’ve had for decades in Republican administrations, and Democratic administrations, science sort of shielded from the political leadership of these agencies, of the FDA and the NIH and the CDC, that the science … that you can lay over the politics. It’s like, here are our priorities, but the science is the science. And I feel like we’ve had now politics entering every single one of these what are supposed to be scientific agencies, right? 

Edney: Yeah, that’s absolutely true. There’s more political appointees. I think this was brought up when Bhattacharya was before Congress, as well. At NIH, there’s more political appointees, just people with an idea in mind of what might be more important than something else, rather than following where the science is going at the moment. And in the case of FDA, before it was not about trying to go as fast as possible. And it’s not just that there’s politics injected, but it’s that we’re cutting out the regular reviewers with the scientific knowledge because they would like to go faster. That’s part of the appeal, I guess, of the voucher. 

Rovner: Yeah, well, we’ll see how that plays out. All right, that’s the news for this week. Now we will play my interview with KFF Health News’ Renuka Rayasam, and then we will come back and do our extra credits. 

I am pleased to welcome back to the podcast my KFF Health News colleague Renuka Rayasam, who is spearheading our newest series, called “Priced Out.” I will, of course, post links to the first stories in our show notes. Renuka, welcome back to What the Health? 

Renuka Rayasam: Thanks for having me, Julie. 

Rovner: Tell us about this project and what the goal is in pursuing it. 

Rayasam: So actually, we started thinking about this a year ago, my colleague Sam Whitehead and I. And we looked at what was happening both with health care costs generally, but also with what Congress was likely to do or not do. And we realized we’re going to start to see uninsurance rates climb back up after years and years of falling. And so that’s what was the impetus for this project. And then, of course, by the end of the year, Congress didn’t extend enhanced subsidies for ACA premiums. People started to feel and see their ACA premiums jump because of that and because of other things that have led to an increase in health care costs. And overall, obviously, people are feeling the pinch in their budgets, and health care is no exception. And this was born out of watching all those trends come together. And then people started writing to us and saying things like: I have insurance, but my deductible is a quarter of my take-home income. You know: I’m a lawyer. I have my own business, but I can’t afford for my family to be on insurance this year. I can’t afford my medication. I can’t afford going to the doctor. And so I think that was really how this series came together, was hearing those stories about people who, whether they’re insured or not, and often not, were just really facing these high costs of health care. 

Rovner: Yeah, as you say, this is not just the binary: Do you have insurance or do you not have insurance? A lot of this is about people who have health insurance and still can’t afford to access care. That’s a big part of this, isn’t it? 

Rayasam: Yeah, absolutely. I mean, so interesting talking to this guy, Noah Hulsman. He’s in Louisville, Kentucky. He owns a skateboard shop there. Youngish guy, 37 and he was saying, you know, he had a “gold” plan last year that he bought through the exchange, and now he has a “bronze” plan, and he’s paying the same amount per month for his premium, but he’s, like, you know, if something were to actually go wrong, I can’t afford my deductible, like, I can’t pay the bills I need for my shop and meet my deductible. And his shoulders hurt, and he’s, like, I can’t afford to get it looked at because of the copays and all the out-of-pocket costs that come along with that. And I think, you know, in this administration and in this Congress, this GOP-led Congress, a lot of talk of things like short-term health plans and lowering premium costs, but these are a lot of plans that come with high costs if you actually try to go and use the health care. And that’s the sticker shock that people are going to face when they start to actually try to go and get health care when they have an issue that they need to get taken care of. 

Rovner: So one of the first stories in this series includes some actionable information, as we call it, for folks who are looking for alternate ways to afford the care that they need if they’ve had to drop or scale back their insurance. What are some of those ways? 

Rayasam: Sure. So I’ll put this caveat out there: Every single person I spoke with in putting these tips together said, even if you have a high deductible, even if the out-of-pocket costs are really high, you should have health insurance because that is the best protection against big bills. If something really catastrophic were to happen, it’s better than nothing. It’ll keep you from going bankrupt. So that’s a caveat out there. But if, after all of that, you still cannot find a plan, you can still, can’t find a plan that you can afford — which is a lot of people, that’s, you know, it’s not a negligible number of people in this country. A few things you can do: Talk to your doctor. I think a lot of people are really nervous about talking to their doctor about money and costs, but, you know, I think if a doctor knows this patient is paying out-of-pocket, they might have a cheaper cash-pay option. They might be able to adjust care to try things that are maybe less expensive, you know, maybe get the same quality of care, but try different things that might be a little cheaper. If your doctor is not budging, then go to a place that does specialize in treating patients without insurance. So federally qualified health clinics, community health clinics, a lot of doctors will advertise cash pay. I’m seeing that more and more, actually, a lot of doctors saying, Hey, we do cash-pay options. When you get a prescription from your doctor, don’t just head to the local pharmacy. Comparison-shop. It’s a lot easier to shop for drugs than doctors. A lot of drugmakers have coupons and drug discounts and other ways you can get those products for cheaper. And a lot of big-box retailers — like Walmart, Costco — will offer generic options for your prescription for really affordable prices, and so … be sure that you’re shopping around and that you’re being a smart consumer and looking at different avenues and ways to get care. You know, one last thing I’ll mention is something people don’t think about a lot, which is their local county health center. They have a lot of services, disease testing and screenings, and, in a lot of cases, even mental health or substance abuse care. So contact your local county, see what’s out there, and look around. There are ways to get care if you don’t have insurance. It’s harder. It’s going to take more time, but there are options out there. 

Rovner: Can you give us a preview of some of the upcoming stories in the series? 

Rayasam: That’s a good question. So we’re starting to get people who are writing to us and talking about their concerns and, like I said, these are people who could no longer afford their insurance premiums, people who’ve had to scale back on the coverage they’ve gotten and are dealing with that. And so we’re going to sift through those responses and start to write more stories about the things that people are facing and the consequences of that. You know, one of the women I talked to for this first story was talking about how she started rationing her rheumatoid arthritis medication when she found out that she wasn’t going to be able to afford her ACA plan. So we’re, you know, going to dive deeper into issues like that. And, you know, what are the health risks if you have to ration your medication? What are the problems there? What are ways that people can get into troubles? Things like medical credit cards. I think people might be tempted to turn to a medical credit card, but I think there’s a lot of ways that can make the problem of cost of care worse, you know, if that interest starts compounding. And so I think we’re going to look into all the ways that the cost of care [is] affecting people — their physical health, their financial health, and just their overall well-being. It’s incredibly stressful, and it can really affect so many parts of your life to not have access to affordable care. 

Rovner: Well, it’s a really important series. Renuka Rayasam, I’m looking forward to reading the rest of it. 

OK, we’re back. It’s time for our extra-credit segment. That’s where we each recognize a story we read this week we think you should read, too. Don’t worry if you miss it. We will post the links in our show notes on your phone or other mobile device. Sandhya, why don’t you go first this week? 

Raman: All right. So I picked a story from The Washington Post by David Ovalle, and it’s called “[Free HIV Drugs Save Lives. Why One State Is Restricting Access for Thousands].” And his story looks at some of the impacts after the Florida AIDS Drug Assistance Program, which is funded through federal money; it’s helped a lot of people with HIV who weren’t able to afford antiretroviral drugs, be able to afford that. And what’s happened in Florida is that the state officials have lowered the income thresholds to get those benefits, saying that there are financial difficulties. And just kind of looking at, you know, some of the cases, and how that’s affecting people over there. 

Rovner: Yeah, good story. Joanne. 

Kenen: This is from Inside Climate News by Johnny Sturgeon, and it’s called “‘Toxic Colonialism’ on the Bay of Bengal.” And I had never heard of this before. There’s something called shipbreaking. And shipbreaking is exactly what it sounds like. You take a great big ship, like a big transport, you know, freighter transport ship — we’re not talking about, like, little rubber things in a bathtub. And they are full of heavy metals, radioactive materials, and all sorts of toxic waste. And the way you get them out when you’re done with them is you ram them into the beach as hard and fast as you can. It’s shipbreaking! So this is in poor areas, in areas that already have, you know, pollution: India, Pakistan, and Bangladesh are not known for having the cleanest air and water in the world, and poor people live near there. And it’s huge, it’s a really interesting story about something that you would have thought, like, somebody was making up on a comedy show. But it’s happening, and it’s harming people, and it’s harming the planet. 

Rovner: Yeah, I never thought about what happens to a ship when you’re done with it. 

Kenen: I thought there would be some way of, like, I think in our country, we have some way of taking them apart safely. But no. I mean, and this is a global thing. I mean … it’s not just ships from the region. … This is happening to hundreds of ships a year. 

Rovner: Anna. 

Edney: Following in the theme of Joanne’s article, mine is “Forever Stained: Inside America’s Carpet Capital: An Empire and its Toxic Legacy.” This was a really interesting collaboration with al.com, The Atlanta Journal-Constitution, The Associated Press, and a few others. I won’t name all of them, but it’s a look at … there’s a town in Georgia that is the carpet capital of the U.S., and is how they use Scotchgard on all the carpets, and how that has forever chemicals in it, and has, over the years, just polluted the water there, and people are getting sick. You know, someone’s goats all died. It’s a really inside look at how the local government, the industries, have all collaborated to get to this point. And you know, just as something was potentially being done about PFAS under the Biden administration, the Trump administration has rolled a lot of that back, so I think it makes that particularly relevant now. 

Rovner: Yeah, it does. All right, well, I also have a story from Florida. My extra credit’s from Politico. It’s called “DeSantis’ Canadian Drug Import Plan in Florida Goes From Campaign Trail to Tough Realities.” It’s by Arek Sarkissian, and it’s from the “Who could possibly have seen this coming, except everyone?” file. It turns out that although FDA specifically gave Florida permission to begin importing cheaper drugs from Canada — more than two years ago, Florida was the first state to actually get permission to do this. And although the state has spent an estimated $82 million in state taxpayer funds to contract with a logistics company and open a warehouse for the drugs, it seems that none have been imported yet. Why? Well, because Canada apparently wasn’t kidding when it said its government had no interest in selling drugs to Balkan states so that they could basically import Canada’s price controls. But fear not. The DeSantis administration says it’s still trying to get the program up and running, and it has until May of this year to do that, under the permission that was granted by the FDA. I will be watching that space but not holding my breath. 

OK, that is this week’s show. As always, thanks to our editor, Emmarie Huetteman, and our producer-engineer, Francis Ying. A reminder: What the Health? is now available on WAMU platforms, the NPR app, and wherever you get your podcasts — as well as, of course, kffhealthnews.org. Also, as always, you can email us your comments or questions. We’re at whatthehealth@kff.org, or you can find me on X @jrovner, or on Bluesky @julierovner. Where are you guys hanging these days? Sandhya? 

Raman: I’m on X and on Bluesky @SandhyaWrites. 

Rovner: Joanne. 

Kenen: I’m on Bluesky and LinkedIn @JoanneKenen. 

Rovner: Anna. 

Edney: Bluesky and X @annaedney. 

Rovner: We’ll be back in your feed next week. Until then, be healthy.