| Sen. Bill Cassidy (R-Louisiana) sharply criticized Health Secretary Robert F. Kennedy Jr., accusing him of undermining public health with claims about vaccines that Cassidy said are not grounded in science. Cassidy, a physician who leads the Senate Health, Education, Labor and Pensions Committee, said in an interview with CBS News’s “Face the Nation” over the weekend that he had lost trust in Kennedy. → The Post’s Mariana Alfaro reported on the details of the interview: “If you build public health upon a foundation of lies, then you’re going to have the absence of adequate public health. You need to build everything in life on truth,” Cassidy said. “Once you lose trust in somebody, you’re not quite sure what to trust going forward. In fact, you don’t trust anything.” The Department of Health and Human Services didn’t respond to Cassidy’s comments. Last year, Cassidy cast the key vote to advance Kennedy’s nomination out of committee. But, in the CBS interview that aired Sunday, he said Kennedy had broken an agreement to clearly state that there is no scientific evidence linking vaccines to autism in federal materials. The Louisiana Republican, who lost his reelection bid to a Trump-backed challenger and will leave the Senate in January, suggested his support for Kennedy was based on assurances that his actions would be constrained by established public health processes. The comments about Kennedy’s health leadership came days after Cassidy blew up at President Donald Trump over his handling of the military action against Iran. → But the blow-up matters because, although Cassidy is on his way out, there are still several high-profile health care nominees who need to go through the committee he runs. That includes Trump’s pick to lead the Centers for Disease Control and Prevention, Erica Schwartz; the third attempt to fill the U.S. surgeon general role, Nicole Saphier; Sean Kaufman, who has been nominated to be the assistant secretary for preparedness and response at HHS; and Jim O’Neill, nominated to lead the National Science Foundation. — Meanwhile, the front-runner to fill Cassidy’s seat, Rep. Julia Letlow (R-Louisiana), clinched the Senate GOP nomination in a runoff over the weekend. She beat John Fleming, Louisiana’s state treasurer, who had poured more than $11 million of his own money into his campaign. In the weeks leading up to the runoff, Letlow secured nearly $90,000 in support from dozens of health care lobbyists and industry associations, according to my tally of federal campaign records dating from the beginning of June. That includes checks from Rai Downs at Tarplin, Downs & Young, Mark Rayder at Alston & Bird, Martin Delgado at S-3 Group and Kelly Lange of East End Group, among others. Letlow also received contributions from health-related political action committees, including ones tied to the American Academy of Neurology, the American Hospital Association, insurer Elevance Health and the Nevada State Medical Association. → She isn’t an unknown to the health world: Letlow sits on multiple health-related committees, including the House Committee on Education and the Workforce and the House Appropriations subcommittees that oversee HHS and the Food and Drug Administration. Lobbyists tell me that she’s been willing to engage, and note that she’s played a role in advancing policies to support women’s and maternal health initiatives. Two dozen states and the District of Columbia are suing the Centers for Medicare and Medicaid Services over its new work requirement rules for the Medicaid program, specifically calling out the Trump administration’s interpretation of what makes a person too “medically frail” to work. The rule “creates new requirements that constrain who is exempt due to their medically frail status and force medically frail individuals in need of health care to jump through unnecessary administrative hoops to get and retain life-saving healthcare coverage,” the states write in the lawsuit. → The lawsuit, which asked a federal court in Massachusetts to pause and ultimately strike the new rules, has been brought by mostly Democratic-run states, including Massachusetts, California and New Jersey. However, Nevada — led by Gov. Joe Lombardo (R) — also signed onto the suit. HHS and CMS did not immediately comment on the lawsuit. The law outlining Medicaid’s work requirements, the One Big Beautiful Bill passed by Republicans in Congress last year, had allowed for people who are “medically frail” to be carved out from the new requirements but did not define the term. “The mantra we kept coming back to was that we’re forgiving, but we’re not foolish,” CMS Administrator Mehmet Oz said about the new rules when they were released earlier this month. “If we make it so easy to defraud [Medicaid] — that everyone feels that they’re fooled for not defrauding it — that’s not so good,” he said. In the rule, CMS ultimately tied medical frailty to an individual’s ability to work or otherwise satisfy the requirements, rather than broadly exempting people whose health conditions could deteriorate if they lose coverage. The Trump administration said it had taken an approach it thought would protect the most vulnerable, but some advocates and health policy experts expressed concerns about how CMS had narrowed the definition. 2.9 million That’s how many fewer people were enrolled in Affordable Care Act plans in 2026 compared to the year before, according to federal figures released by HHS on Friday. The department said that there are 19.2 million Americans enrolled in these plans vs. 22.1 million in 2025, a 13 percent decrease. → The Trump administration credits the drop in enrollment to efforts to tamp down on fraudulent enrollment in marketplace health plans, including “phantom” enrollees who are signed up for coverage without their knowledge. In a brief published on Friday, HHS analysts say that there are still about 2.6 million “improper and phantom enrollments,” including about 1 million tied to coverage without a Social Security number. However, policy experts who study the data say that real people have opted to drop their insurance coverage due to increasing costs. Congress also didn’t extend enhanced subsidies that helped millions of Americans purchase insurance. “This coverage loss happened at the same time millions of people faced steep increases in their premium payments — often in the double or even triple digits — with the expiration of enhanced tax credits,” Cynthia Cox, the director of the program on the ACA at KFF, wrote in a recent post. Initially passed as part of pandemic relief legislation, Democrats temporarily extended the enhanced premium tax credits through 2025, but gridlock prevented another extension. The number of people enrolled in Affordable Care Act plans had been steadily increasing over the years, from 10.6 million in 2020 to 20.1 million in 2024. HHS notes that the figures for 2026 are higher than in every year before 2024. The Trump administration is moving forward with its plans to lower drug costs for Americans by requiring manufacturers to offer medicines at the same prices paid in peer countries, known as most-favored-nation (MFN) pricing. On Friday evening, the Centers for Medicare and Medicaid submitted its final version of a mandatory pilot program implementing the pricing policies in the Medicare Part B program, called the Global Benchmark for Efficient Drug Pricing (GLOBE) model, to the White House for review. This comes about two weeks after the White House received the final version of the Guarding U.S. Medicare Against Rising Drug Costs (GUARD) model, which requires drugmakers to offer MFN pricing in the Medicare Part D program. There aren’t yet any specifics about whether the agency made any changes to its proposed models, which garnered significant pushback from drugmakers, but it’s the next step before these pilot programs roll out. My colleague Rebecca Adams, the lead health care analyst at WP Intelligence, went all-in on the Trump administration’s newly launched effort to try and curb China’s growing dominance in the biotech sector in her latest report. The initiative involves multiple health agencies, including the National Institutes of Health and the FDA. One quote from Rebecca’s report stuck out to me as a reality check about the use of artificial intelligence in drug development: “In terms of whether AI is actually expediting any of these [new drugs] and really pushing through any of the bottlenecks, my sense is that we are getting faster in places,” said Morgan Hanger, the executive director of the Clinical Trials Transformation Initiative, a public-private partnership by Duke University and the FDA aimed at improving trials. “But [advances] are all kind of piecemeal, and you don’t necessarily have that hoped-for return on investment because of how piecemeal it is — and because of all the human processes that are still baked in around what the AI can potentially do a little bit faster,” Hanger told Rebecca. Read the full report: “Trump administration tackles drug development bottlenecks.” “Patients can save thousands with drug coupons, but only if insurers honor them,” Daniel Chang writes for The Washington Post. BioPharma Dive is out with its “10 clinical trials to watch in the second half of 2026.” “The Baby Formula Probe Produced a Pile of Evidence. Then the DOJ Dropped the Case.”, report Dave Michaels, Sadie Gurman and Liz Essley Whyte at the Wall Street Journal. “After her insurer denied coverage of medication, she ended up in the ER,” Samantha Liss writes at KFF Health News. “The ERs that can turn patients away — and are reaping millions,” Tara Bannow reports at STAT. This newsletter is published by WP Intelligence, The Washington Post’s subscription service for professionals that provides business, policy and thought leaders with actionable insights. WP Intelligence operates independently from The Washington Post newsroom. Learn more about WP Intelligence. | 
