Their family and friends thought the adventure-loving couple was on another jet-setting vacation, but they were keeping something else under wraps: They had turned off their phone locations to hide visits to a Greek clinic where they were trying to get pregnant.

The Solomons are among the growing numbers of Americans looking abroad, particularly to Greece and Spain, to escape the high cost of fertility treatments in the U.S., where such procedures are often not covered by insurance. The treatments include , which involves ovulation stimulation, retrieving the eggs, fertilizing them in a lab, and transferring the embryos into the uterus. Other less intensive medical therapies also address infertility.

President Donald Trump has made fertility, and IVF in particular, a focus of his administration’s agenda after he for women during his 2024 campaign. His administration intended to make it easier for employers to offer fertility coverage, although it has yet to be finalized. So far, the most concrete result has been lower costs for some IVF medications through TrumpRx, a site where cash-paying patients can find some discounted medicines through participating pharmacies. The White House projected that patients could save .

While significant, those savings are up against a since 2014, according to GoodRx, a prescription discount service. A released in July by Axene Health Partners and the Women’s Reproductive Health Foundation found that the overall cost for a cycle of IVF was over $29,000 — or 35% of the median annual household income in the U.S. Genetic testing, embryo storage, pregnancy care, and delivery costs can push the total over $54,000 per IVF-conceived birth, according to the study. An average patient needs two to three cycles to successfully have a child, so the costs for many patients would be even higher.

Infertility affects people in the U.S., but only an estimated 24% of treatment needs are met, because of those high costs and limited insurance coverage, according to the American Society for Reproductive Medicine. The condition is believed to be of people having children later, as well as such as pollution.

Still, were born via IVF in the U.S. in 2024 — a record, according to the Society for Assisted Reproductive Technology. An increasing share of people hoping to be parents are seeking help in Europe: The number of Americans choosing European clinics grew by more than 37% last year, according to , the chair of the European Fertility Society, a group that tracks data on fertility treatment in Europe.

The Solomons knew IVF was their only chance to have children together biologically, because Justin had testicular cancer in his late teens. What the college sweethearts had not expected was the cost — and they learned early in their IVF journey that their insurance would not cover their treatment. While some states have passed laws to require insurers to pay for some fertility care, the coverage .

When the couple first explored IVF in Florida, where they live, they were quoted $40,000 for one round of treatment. The price shocked them, and Emilie said the clinic’s offer of a spring discount for an embryo transfer felt “off-putting.”

“They just kind of prey upon your hopes and dreams to be parents,” Emilie said.

Treatment Plus Island-Hopping Tours

The price of IVF and uncertainty around in Florida, which the Solomons feared their control over their embryos, sent them to the Pelargos IVF Medical Group in Athens. There, in the first of two trips, Emilie underwent ovulation stimulation and egg retrieval.

Including medication, fertilization, storage, and the ultimate embryo insertion, the total treatment cost about $12,000, not including travel, according to the Solomons, a fraction of what they might have spent in America. That affordability drew the couple abroad, but so did the allure of sightseeing and experiencing a new country.

On that first trip, they spent a weekend between doctor appointments exploring the Greek island of Milos. Between Emilie’s hormonal injections, they rented a boat to explore the island. Their video from the trip shows them climbing the island’s striking white volcanic cliffs, and Emilie floating in the turquoise water of the Aegean Sea. Despite the emotional and physical toll of the IVF process, the couple remembers being in a little bubble, away from everyone, exploring a beautiful place.

“It was one of the best summers that we’ve had,” Emilie said.

When they traveled back to Greece for their embryo transfer in October 2025, they spent two days in Croatia.

IVF in Greece using a patient’s own eggs typically costs around $3,000 to $4,000, not including medication, so even with travel, it is often a fraction of what patients pay in the U.S.

“Americans choose Greece because they can access treatment that is more affordable, faster to begin, and well supported for international patients,” Dejewski said.

Patients in Greece do face some legal restrictions: Embryo storage is time-limited, donor anonymity is standard, sex selection and embryo-transfer numbers are restricted, surrogacy access is limited for nonresidents, and patients must carefully consider documentation requirements if they plan to move embryos between Greece and the U.S.

Penny Ampatzi said she is clear about these legal differences when Americans consult with her clinic in Athens. Serum IVF offers to schedule airport pickup for patients, as well as island-hopping tours. Ampatzi, the co-founder and clinic director at Serum IVF, said the main draw for the dozen or so American patients her clinic sees each month is the personalized fertility treatment plans. Affordability is close behind. A cycle at her clinic costs just under $6,000, not including embryo freezing. Almost all of Serum’s patients are foreigners, according to Ampatzi.

“You consider that you have a good possibility of success, plus you don’t pay that high amount of money, and you also have combined the treatment with holidays — so it’s a ‘Why not?’” she said.

Not Without Risks

IVF costs in the U.S. have been driven up by a mix of inflation, a shortage of embryologists, a surge in demand after pandemic backlogs, and private equity ownership, Dejewski said.

William Kiltz, vice president of marketing and business development at U.S.-based , said that the costs are becoming too far out of reach. “IVF is almost a treatment that only the top 1% can afford reasonably,” he said.

Kiltz said CNY’s model — offering IVF for around $8,000, not including embryo storage, at its 18 locations across the country — brings just enough profit to “keep the lights on” and open new locations while keeping its costs lower. “We’re trying to deliver this care at the absolute bare-minimum cost,” he said.

More than half of CNY’s patients travel from out of state in search of those lower-cost options, Kiltz said.

He said he hopes the IVF market will eventually settle out, as happens with many new technologies. But nearly five decades in, that normalization hasn’t come. Kiltz believes that’s because the market is so emotionally driven.

“People will do just about anything,” Kiltz said. “There’s certainly some risk in something like that, where the demand and the desire from a single individual is so strong that they could be taken advantage of.”

, the head fertility doctor at the CNY location in Norfolk, Virginia, pointed to the difficulties of trying to vet a clinic overseas when one doesn’t speak the language or understand the local IVF regulations. It also can be challenging to transport temperature-sensitive medication back home.

“It’s almost like a full-time job trying to play regulatory expert and inspector all at the same time, while you’re a patient,” Pakrashi said.

She said she also has had patients who sought treatment abroad return to her clinic struggling to transfer records or understand a diagnosis they received overseas. They often have to repeat tests.

And going abroad for IVF is still out of reach financially for many Americans.

The Solomons said seeking treatment overseas takes a certain type of adventurous spirit, too. But for them, all the logistics and travel were worth it. Their one cycle of IVF and two trips to Greece allowed them to welcome a healthy baby boy this summer.

This article first appeared on ³Ô¹Ï²»´òìÈ and is republished here under a .

“We had a great discussion about healthy options for all Americans and taking back control of our healthcare,” Barrett said in a June , after sampling the farm’s apple cider.

Like the focus on artificial dyes, however, many of the administration’s highest-profile health initiatives rely on voluntary agreements. The goals, such as lower drug prices and nutrition classes for doctors, have widespread appeal, cutting across party lines and economic divisions.

But the administration-industry deals lack the enforcement teeth of more traditional federal regulation. Their details are vague, and minimal oversight makes it hard to monitor progress. In some cases, the administration has claimed victories that have yet to materialize.

Republicans consider the dealmaking a winning strategy. It fits with the party’s anti-regulatory stance, they say, and enables the administration to quickly forge agreements President Donald Trump and his allies can tout as accomplishments. In the run-up to the midterm elections, some, like Barrett, hope to woo voters by trumpeting the Trump administration’s efforts to shape health policy.

The practice also raises questions. Though the deals are announced with great fanfare — often during televised events on stages, with live audiences — there’s little documentation or follow-through, creating doubts about whether the administration’s health agenda will lead to lasting change or unravel once the political attention fades.

The distinction could prove important to voters as Republicans defend their health records in November’s midterm elections.

“These deals are often not transparent, so there’s no way for the public to judge how meaningful they are,” said Larry Levitt, executive vice president for health policy at KFF, a health information nonprofit that includes ³Ô¹Ï²»´òìÈ.

Dealing With Dyes

The push to remove certain artificial dyes from food and drugs, for example, was a headline grabber. In April 2025, Kennedy to announce deals with food makers. He was flanked by young children and mothers holding placards reading “Make America Healthy Again.”

He and former FDA commissioner drew a standing ovation from an audience selected by Kennedy’s staff as they said companies had pledged to phase out all petroleum-based synthetic dyes from the nation’s food supply and medicines. They targeted nine synthetic dyes for removal.

Voters love the idea of stopping the use of such dyes. In a nationally representative March survey by Consumer Reports, said they were at least somewhat concerned about synthetic dyes, and two-thirds said companies should be required to phase them out.

A year after making the first announcement at HHS, during a discussion at the Conservative Political Action Conference, an annual political event.

“We’ve gotten rid of the nine synthetic-based food dyes,” he said.

Not quite. At the initial HHS event, federal officials said companies would voluntarily stop using six specific synthetic dyes . (The administration has also revoked or proposed revoking authorization for two other synthetic food dyes.)

Later, the FDA on its website quietly to the end of 2027. So, most are still in use.

In fact, the FDA posted a list of 27 companies it said had made voluntary pledges as of December 2025 to remove six synthetic dyes from products such as Doritos and Kellogg’s Froot Loops. More than a year and a half later, — fewer than 30% of those who bought in — had met their promised goals.

Many major food makers, such as the Coca-Cola Co. and Unilever, have made “” to remove the synthetic dyes, according to Consumer Reports. In addition, no pharmaceutical companies have publicly said they have plans to remove dyes from drugs.

“It’s just all talk,” said Leslie Dach, who chairs , a healthcare advocacy group that supports the Affordable Care Act. “They just govern for a day of publicity, and then it’s over. None of it happens. Yet the people don’t know because they have busy lives, so they think, ‘Just look at all these initiatives.’”

In fact, the administration , allowing companies to say their products contain no artificial colors — as long as they don’t use petroleum-based dyes. Previously, food makers could not make that claim unless their products contained no added colors. Some food dyes made from natural ingredients can contain contaminants and may pose their own health risks, .

“The federal government hasn’t taken any regulatory action on food dyes, for the most part, since the beginning of this administration,” said , vice president for government affairs at the Environmental Working Group, an advocacy group.

HHS said the voluntary approach has yielded significant action, including commitments to remove synthetic dyes from products sold in schools for the 2026–27 school year.

“HHS and the FDA are moving forward with clear timelines and concrete industry commitments, with major changes expected in foods served in schools during the coming school year and across full product portfolios by the end of 2027,” HHS spokesperson Emily Hilliard said in an email.

At the same CPAC convention event, Kennedy said “the MCAT testing companies are going to put nutrition on the MCAT for the first time, so the students will actually want to do it.” MCAT refers to the Medical College Admission Test, an exam required for admission to medical schools.

Again, not quite.

The Association of American Medical Colleges administers the MCAT. Spokesperson said Kennedy misspoke and may have meant to refer to a test taken by students to be licensed as doctors.

An Insurance Deal Falls Short of Promises

Kennedy again took to the HHS stage in June 2025, this time with Centers for Medicare & Medicaid Services Administrator Mehmet Oz, to make what was billed as a game-changing announcement. to reduce the volume of healthcare services subject to prior authorization, a practice widely used by the insurance industry that often requires patients or their medical teams to seek preapproval before undergoing treatment.

The administration said 80% of insurers pledged changes to preauthorization requirements for 80% of diseases and injuries . The administration also promised “” to track progress.

“It will happen very quickly,” Oz said at the event. “Necessary care will be delivered when it’s needed, in the right way.”

As of July, months past that January target date, health plans had reduced prior authorization for medical services by about 11%, according to AHIP, the insurer trade group. But no public dashboards have debuted to track the deal, and some insurers that signed the pledge last summer told ³Ô¹Ï²»´òìÈ this year that they will not implement all the promised reforms as outlined by AHIP.

Hilliard did not respond to questions about the pace of progress.

The American Medical Association, in a 2025 web-based survey, asked 1,000 practicing doctors whether they believed the voluntary pledges would make a meaningful difference. said they believed they would.

Insurers made a , during the previous Trump administration. The next year, more than 80% of doctors said the number of prior authorization requests for drugs and medical services had been increasing, based on .

Meanwhile, the administration is testing an artificial intelligence-powered for Medicare, the federal health program for people 65 and older or with disabilities. In six states, Medicare beneficiaries must get preapproval for a few treatments that CMS considers to have little clinical benefit and to be susceptible to fraud or waste, including skin substitutes and knee arthroscopy for arthritis. The program began in January, the same deadline insurers had set for curtailing preauthorization delays.

Deals and Deregulation

The healthcare industry’s voluntary agreements appeal to voters who feel government regulation drives up costs and places unnecessary burdens on businesses, some supporters say.

“Secretary Kennedy is the antithesis of a public health industry that uses coercion over communication — and has demonstrated this by taking the time and effort to push voluntary initiatives over the typical approach of governmental mandates,” said , a political consultant who was a political appointee at HHS in Trump’s first term.

But voluntary agreements with the health industry can prove ineffective. Former President Jimmy Carter in 1977 proposed a legislative plan to curb rising hospital costs. Hospitals fought back, and Congress rejected the proposal, instead favoring a desired by the industry. It ultimately failed once public attention faded.

One upside: Deals are fast. can take two to three years. And some health analysts say the tempo of the agreements advanced by Kennedy and Trump may help take voters’ attention off the Trump administration’s inability so far to produce a long-promised health plan.

Instead, Republicans can point to the array of accords reached with industry, including the with drugmakers so they’re in line with lower amounts charged in peer countries. The White House calls it the “most-favored-nation” prescription drug pricing policy.

Seventeen companies, including Pfizer and AstraZeneca, with the administration to lower prices for Medicaid enrollees and cash-paying consumers using , a narrow, government-run consumer platform.

Many details remain unknown, but the lower prices apply only to new drugs and existing drugs available through Medicaid. And prices at TrumpRx aren’t as low as out-of-pocket prices for most consumers with insurance. But the voluntary deals appeal to an industry that has railed against mandatory approaches drugmakers deride as harmful price controls.

“Each company makes its own decisions about how it prices medicines, and our industry is committed to working with the Trump administration to ensure Americans have access to affordable medicines,” said Chanse Jones, a spokesperson for PhRMA, a pharmaceutical industry trade group.

Policies that lead to reductions in drug prices typically worry investors because profits also can drop. But rather than seeing their stock prices fall after the agreements were announced, the drugmakers saw largely .

Analysts say that’s partly because the deals are narrow in scope, largely exist only in principle, and don’t apply to existing drugs used by the more than 200 million Americans with commercial or private health insurance.

The Trump administration, however, is .

“The most-favored-nation agreements on drug prices that we just did are delivering the largest drug price cuts in history,” Trump said in June at a in Pennsylvania. “That alone should win us the midterms.”

This article first appeared on ³Ô¹Ï²»´òìÈ and is republished here under a .

MILLVILLE, Pa. — In an open field, arrows whizzed through the humid June air and struck their targets. Campers and counselors cheered.

It was archery hour at . Operations director Drew Meyer watched, a few tears escaping from behind his dark sunglasses.

“They will surprise you, like, flat out,” he said of the campers, who have all survived brain injuries. “They’ll come out here, and they’ll shoot for three hours and start hitting the target.”

Campers, ranging in age from 10 to 21, have been coming to Camp Cranium in Pennsylvania’s rural Columbia County since 2008. Some of their brain injuries are so severe that they have to relearn basics, from talking to tying their shoelaces. Some use wheelchairs or crutches. But during a week at camp, they climb rock walls, swim, and whiz down a zip line through the lush forest.

The existence of Camp Cranium, and a handful of others like it, is a response to a decades-long national trend: More people, including children, now survive crises resulting in brain injury than did in the 1980s. The improvements in survival are largely due to seat belt laws and and trauma centers that can treat injuries quickly.

But recently, efforts to track and prevent one type of brain injury, traumatic ones, are in flux after Congress didn’t renew a and prevention of traumatic brain injuries, and the Trump administration fired hundreds of employees at the Centers for Disease Control and Prevention, including the team tracking traumatic brain injuries, or TBIs.

“Brain injury can happen to anybody,” said , executive director of the . “This community deserves more.”

Tracking Brain Injuries

Lucas Hardy, 14, smiled at the encouraging crowd below. In a shady clearing in the woods, he climbed the 30-foot rock wall, aided by a hoist that pulled him out of his wheelchair and helped support his moves. Hardy suffered a traumatic brain injury at age 3, when a tree branch fell on him at a birthday party.

Annually, an estimated 2.8 million Americans experience a TBI — including about 475,000 children, according to the .

Recent data suggests those are undercounts. In 2018, a CDC team piloted a household survey asking about TBIs in a sample of U.S. children and adults. The results concluding that such injuries, which are often considered “hidden” because the damage is internal and unseen, are more widespread than hospitalization numbers suggest.

The mass firings at the CDC in early 2025 studying TBI, right before they were expected to launch a . A spokesperson for the Department of Health and Human Services, Emily Hilliard, did not respond to questions about the number of employees terminated, or if they were reinstated or replaced.

In a statement, she said: “The Trump Administration remains committed to supporting efforts to prevent traumatic brain injuries, improve surveillance, and ensure Americans have access to practical, evidence-based information that can help protect their health and safety.”

She said the agency’s TBI work is now handled by other staff members at the National Center for Injury Prevention and Control.

Hilliard said the CDC is deciding how to establish a cost-effective national concussion surveillance system within the bounds of current funding, and said the agency in 2026 dedicated funds to support, among other things, an about concussions, an , and concussion surveillance.

But Wolfkiel still worries about how the CDC firings and the impasse over federal funding will affect brain injury research and prevention efforts in the long term.

“The lack of resources and programs and information that’s out there is really just sort of appalling,” Wolfkiel said.

Federal Funding Uncertainty

Tony Sadowski, the camp’s , remembers when his son, Bryan, suffered a brain bleed that caused a hemorrhagic stroke at age 6. “You’re in the emergency room,” he recalled, “not knowing what version of your son’s going to wake up.”

Now 18, Bryan Sadowski has attended the camp for years.

“We’re very lucky to be able to be here,” the elder Sadowski said.

In 1996, before Bryan was born, Congress passed the Traumatic Brain Injury Act, which has provided many states with grants for TBI research, advocacy, and services. Since then, Congress reauthorized the act four times, largely with bipartisan support, until 2024.

It has remained lapsed since then. Trump’s secretary of the Department of Homeland Security, , supported when he was a senator. Congress is whether to reauthorize funding through 2030.

Despite the lapse in funding, money is still flowing to TBI programs at the CDC and in states, according to , president and CEO of the Brain Injury Association of America.

Congress did appropriate $8.25 million for TBI program activities through the . That’s far less than the $23 million Congress provided for each fiscal year, from 2020 through 2024, the last time it .

“The TBI Act is the only piece of federal funding for traumatic brain injury at the federal level,” Willis said. “We’re aiming to preserve what we have.”

The funding uncertainty has not affected the handful of brain injury camps, including Camp Cranium and in Alabama, because they are nonprofits that mostly rely on private donations.

Back at Camp Cranium, bursts of laughter, whoops of delight, and distant chatter punctuated the humid summer air.

While her fellow campers did archery or art, Brianna Engleman moved between groups, collecting song requests for a dance that evening. When she was 5, doctors performed a to relieve her of debilitating seizures. But the surgery itself can injure other parts of the brain.

She lives in Northern Virginia and first attended Camp Cranium as a teen in 2018. It was her first time being around so many people like her, said Engleman, now 21.

“I’ve gotten more confident,” Engleman said. “It made me think, well, there’s actually good people out there.”

Next time she returns to camp, she said, she plans to do so as a counselor.

This article is from a partnership that includes , , and ³Ô¹Ï²»´òìÈ.

This article first appeared on ³Ô¹Ï²»´òìÈ and is republished here under a .

Transparency “is really important to help protect the integrity of the program, ensure funds are reaching the communities they’re meant to serve,” said Maya Sandalow, director of health policy for the Bipartisan Policy Center, a nonprofit think tank.

The federal government and states are compelled by public records laws to share documents when requested. But those requests can take months to fulfill, making their release too late for meaningful oversight as states rush to spend their allotments under tight federal deadlines.

In the meantime, the Centers for Medicare & Medicaid Services — which oversees the Rural Health Transformation Program — and some states aren’t proactively sharing information about where the funding is going and how it will be used.

CMS spokesperson Timothy Foster said the agency “will publish an annual report on state progress.”

States’ individual reports to CMS are “intended to be” shared upon request, but the agency won’t be proactively publishing the individual state reports, according to a CMS document.

Foster didn’t respond to questions about whether the agency will share examples of projects that are and aren’t working or create a tracker of funding recipients, award amounts, and what organizations plan to do with their funding — ideas that health and government transparency advocates have requested.

Instead, much of the program’s transparency thus far has been up to state governments, and “the level of details that states have publicized really varies,” said Sandalow, who co-wrote a on how the federal government can strengthen the rural health program, including through transparency.

Some states are sharing information with lawmakers, holding public meetings, and explaining where organizations plan to invest their money.

Others are more secretive, with multiple states declining to release public records in response to ³Ô¹Ï²»´òìÈ’ requests. Mississippi’s governor , West Virginia holds closed-door advisory meetings, and a South Dakota official wrote that he hoped CMS would keep its application from public view.

“I just don’t believe in all this secrecy,” said Mississippi state Sen. Hob Bryan, who chairs his chamber’s public health committee. “If they’re not up to something nefarious, why do they have to do it all in secret?”

Bryan, a Democrat, said there’s about the lack of transparency in his state.

Reaching Rural Patients

Congressional Republicans created the five-year Rural Health Transformation Program last summer as an eleventh-hour sweetener to President Donald Trump’s signature One Big Beautiful Bill Act. The money was intended to offset concerns about the anticipated in rural communities from the law, which is expected to by more than $900 billion over a decade.

Sandalow said some states may be struggling to share information since they’re busy rushing to hire staff and meet the program’s tight deadlines, including an annual report due Aug. 31.

In the meantime, a slew of media outlets, nonprofits, and businesses are stepping in to make it easier for the public to track the rural health program.

³Ô¹Ï²»´òìÈ is collecting states’ applications and approved plans and budgets, not all of which have been posted on state websites.

Rural Health Payout

Tracking Applications for Rural Health Transformation Funds

³Ô¹Ï²»´òìÈ is working to collect and post complete application materials, by state, here and will update this repository as new materials, released in response to public records requests, arrive.

Dec. 4, 2025

Rural Health Payout

Tracking State Rural Health Transformation Plans

³Ô¹Ï²»´òìÈ is working to collect and post approved plans as more states respond to emails and public records requests for their documents.

July 27, 2026

And several and have created trackers that , post funding opportunities, or list award recipients. But some resources are available only through paid services, aimed at helping businesses interested in applying for money.

Sandalow said previous federal programs “tend to draw attention for gaps in transparency and oversight rather than for doing it well.”

As an example, she pointed to the lack of oversight and transparency with the CARES Act and other covid relief programs, which saw .

In March, CMS published proposed quarterly and annual state reporting requirements for the rural health program, and a . At least three groups replied with letters expressing concerns about transparency.

CMS should share states’ progress reports, funding recipients, and what organizations plan to do with their awards, , the Bipartisan Policy Center’s vice president for health policy.

Sharing this information would make it easier to track progress, identify successful programs that other states may want to replicate, and “ensure funds reach the rural communities they are intended to serve,” he wrote.

Molly Smith, group vice president for public policy at the American Hospital Association, “to be as detailed as possible” about the “final destinations of these funds, given the complexity of the grant funding process.”

In , Charlene MacDonald, who leads the Federation of American Hospitals, noted that some funding recipients, such as large health systems and academic medical centers, will be distributing their awards to other entities.

CMS should collect those “downstream subrecipients,” wrote MacDonald, whose group represents for-profit hospitals and healthcare systems.

Without this information, she said, it will be difficult to know if “funding is reaching the rural hospitals, providers, and communities primarily intended to benefit from the program.”

It can also be difficult to know which for-profit companies are being paid with rural health money.

For example, and have listed hospitals and other health facilities that received funding to purchase telehealth, scanning devices, and other health technology. But the states list only some of the companies from which recipients will buy those products.

States won’t have to report “downstream” funding in their August reports to CMS but will have to do so for all future reports, according to the agency’s recently finalized .

The CMS documents say states must list subrecipients that receive subawards as well as vendors or contractors paid by an organization using rural health funding. Although states must report how much money these downstream recipients receive, they don’t have to describe which specific services or products the recipient is providing.

DIY Dashboards

As groups ask CMS to share more information, some states have created their own rural health spending dashboards or recipient lists, with varying levels of detail.

Alaska, , and other states list which organizations receive funding, their award amounts, and detailed descriptions of how recipients will spend the money.

and , however, are among the states that don’t share what awardees plan to do with their funding.

New Hampshire is that detail projects and their budgets on its Rural Health Transformation Program website. Some other states have uploaded contracts and grants on general procurement or award databases, which can be difficult to navigate.

, , and have used press releases to announce awards. But the announcements aren’t posted on their Rural Health Transformation Program websites, which could make it difficult to find this information.

Many states created advisory groups to provide transparency and accountability for their programs. Most committees host public meetings and upload minutes, recordings, or other materials from the discussions.

But the West Virginia Department of Health won’t share what’s discussed in its rural health advisory panel’s closed-door meetings, according to spokesperson Gailyn Markham.

“The panel is intended to serve as an informal forum for discussion and feedback among invited participants and program staff,” Markham said.

South Dakota, North Dakota, and Mississippi are among the states without advisory committees.

In response to public records requests, South Dakota released a nearly completely redacted version of its budget for the rural health program while Mississippi declined to release its budget.

Mississippi’s he vetoed a because it would “create an unnecessary layer of bureaucracy” that would have slowed the award process, which could cause the state to lose out on future funds. Mississippi is “ in all this secrecy,” Bryan, the state lawmaker, told ³Ô¹Ï²»´òìÈ.

Sandalow said it’s important for states to publish the impact of their rural health projects, adding that CMS should share which rural health projects are and aren’t working.

She said national and state health organizations are creating networks and holding conferences to help spread this information. States should “be able to learn from each other, get a sense of lessons learned and best practices, and then be able to pivot their initiatives accordingly,” Sandalow said.

Michael Cannon, who oversees health policy studies at the libertarian Cato Institute, said people should know how their $50 billion in taxes is being spent on the rural health program, and whether state projects are making rural patients healthier.

If investors put that much money into a project, there is “no way” they “would let the recipients of those funds get away with the shoddy approach to transparency and accountability that the states are taking,” he said.

This article first appeared on ³Ô¹Ï²»´òìÈ and is republished here under a .

Ethan has autism and attention-deficit/hyperactivity disorder. He was diagnosed with autism in kindergarten after displaying behavior that concerned his relatives: He paced, flapped his arms, and became consumed with highly specific interests, such as Martin Luther King Jr. and dachshunds.

In a meeting with school administrators and the district to develop his individualized education program, a legal agreement that outlines the support Ethan requires, the team agreed he required a trained paraprofessional to help him regulate his emotions and remain in class, according to complaints Smith filed against the school. However, the complaints alleged, administrators were unwilling to provide the dedicated aide. Instead of implementing the supports her son needed, his school repeatedly removed him from instruction, suspended him, and even called police on him when he was in third grade, Smith wrote.

Smith, a seventh grade science teacher, said she first filed complaints with the school district and the state with these allegations. But when problems persisted, she turned to the U.S. Department of Education’s Office for Civil Rights, the federal agency tasked with resolving complaints like hers. Smith’s federal complaint included the same account and alleged that the school discriminated against her son because of his disability and race, including deploying pressure tactics to push her Black son out of the public school. In May, the office said it would investigate several of her allegations.

For families who believe their child’s rights were violated based on race, disability, or gender in school, the federal agency often has been one of the main places to turn. But the White House cut its offices and weakened its ability to follow up with cases, as well as slashed funding to that people of color face in for disabilities.

About 1 in 31 U.S. kids by age 8 had been as of 2022. Although previous research on disparities in childhood autism diagnoses has had mixed results, a recent study from the State University of New York at Albany’s Institute for Social and Health Equity found that race, gender, and socioeconomic . Among fourth graders from 2003 to 2022, students of color, girls, low-income students, and multilingual learners were less likely than peers to be identified with autism in school, even as diagnoses rose among children from historically marginalized groups, the study found. A large forthcoming study by the same researchers found the biggest gaps among overlapping identities. Black and Hispanic girls were especially unlikely to be identified.

All this has happened as President Donald Trump’s second administration has put autism in the spotlight. In early August, Trump to whittle down routine immunizations for kids while falsely tying vaccines to autism. He has presented it as a and one of “the most alarming public health developments in history.” Health and Human Services Secretary Robert F. Kennedy Jr. in April 2025 called autism a and he’s lent credence to , including unfounded links to childhood vaccines and .

“This administration is taking us backwards,” said , founder and executive director of The Color of Autism Foundation.

HHS spokesperson Emily Hilliard said in an email that Kennedy’s statements last spring “emphasized the need for increased research into environmental factors contributing to the rise in autism diagnoses, not to stigmatize individuals with autism or their families.” She added that the agency changes are “about making federal support systems work better for children and families.” White House spokesperson Kush Desai did not respond to a request for comment. Neither did the press office for the Department of Education.

The cuts to agencies and research have affected parts of the federal government focused on students with disabilities. In March 2025, Trump signed an to dismantle the Department of Education and of its Office for Civil Rights’ 12 regional offices. This June, his administration special-education oversight to HHS and the Office for Civil Rights to the Department of Justice.

“On paper, it’s a reorganization,” said , a former supervising attorney at the Office for Civil Rights who now runs her own education law firm. In practice, she said, it could leave families whose complaints involve overlapping harms — such as race and disability discrimination — caught between agencies built for different jobs. “The hardest thing to prove in these cases is now the thing with no obvious home.”

In April, a year after the order, a Senate committee report from Sen. Bernie Sanders (I-Vt.) concluded that the Office for Civil Rights had in resolutions to discrimination complaints and had a backlog of nearly 12,000 civil rights cases. A recent Washington Post investigation found that the Trump administration “indefinitely froze” many of these cases.

On top of those cuts, the White House vowed to in areas such as school discipline despite research showing that nonwhite and low-income kids disproportionately face barriers to being identified with autism and and other neurodevelopmental diagnoses.

It the Institute of Education Sciences, the Department of Education’s research arm, canceling roughly $900 million in funding for research, including . The administration further data collection on racial disparities in school discipline. The National Institutes of Health and National Science Foundation have referencing terms including “race” and “gender,” focused on diversity, equity, or inclusion.

“If we’re cutting any data collection that helps us understand the problem, we’re not going to fix it,” said , director of the Institute for Social and Health Equity at SUNY-Albany, who led the studies on disparities in autism diagnoses. “All we’re doing right now is making the situation worse.”

The nation’s also appears to lack prominent scientists and Black members and has fewer autistic self-advocates than before, said Proctor of The Color of Autism Foundation, who served on the panel before the Trump administration took over. The panel has also been criticized for including .

HHS’ Hilliard said the members “bring decades of experience in autism research and clinical care” and are committed to aligning “federal policy with gold-standard science.”

Disability advocates say federal officials are focused on the wrong priorities.

“All of it creates chaos where chaos is not necessary,” said Cameron Lynch, a former policy analyst for the .

Disability rights advocates fear the changes to special education oversight weaken the federal safety net for autistic students and others with disabilities, making these systems more confusing when families need help enforcing students’ rights.

David Sitcovsky, Autism Speaks’ vice president of advocacy, said families, especially those from marginalized communities, already often lack support for their children to receive a timely diagnosis or services in their school systems.

“The common thread across these issues is access,” Sitcovsky said. “If their child’s rights are not being upheld, do they have a clear path to get help?”

Smith awaits a decision about her federal civil rights case, which she was told could take more than a year amid the backlog, as Ethan has started fourth grade. She wants Ethan transferred to a school better equipped to support him. She has also requested an expedited hearing for a due process complaint she filed with the state.

The family is also navigating battery charges against Ethan, the first of which was filed in March after the school called police on him for allegedly hitting staff. A police report and an email provided by Smith showed that police arrived at her door hours after Smith informed the school district in writing that she had filed a federal discrimination complaint. Smith also pointed out the timing in several of her complaints.

A Polk County Public Schools spokesperson declined to comment, citing student confidentiality. The Florida Department of Education did not respond to a request for comment.

“As a Black mom, you dare not complain about anything,” Smith said. “Once you start advocating for your kids, it’s a problem. But it’s not these kids’ fault that they have a disability.”

Without timely assessments and interventions, , children of color with disabilities such as Ethan are disproportionately at risk of being and into the juvenile and criminal justice systems.

led the Education Department’s Office for Civil Rights in the Obama and Biden administrations and is now executive director of the Edley Center on Law & Democracy at the University of California-Berkeley School of Law. She said it’s a scary time for families who want to protect their children’s rights.

“People speed if they don’t see a police car,” Lhamon said. “If they think that there’s no one at the federal government watching them in school, we will see an increase in discrimination.”

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If the state Office of Health Care Affordability adopts the fines next week, hospitals, medical groups, insurers, and others could face penalties that amount to as much as 125% of the total they spend above the state’s annual growth targets.

The penalty proposal comes after healthcare entities in California were asked to limit growth by 3.5% last year and ramp down to 3% by 2029. Seven hospitals that state officials consider particularly expensive face even smaller growth targets: 1.8% in 2026, dropping to 1.6% by 2029.

Consumer advocates argue that state financial deterrents are critical to bring relief to millions of Californians struggling with high insurance premiums and out-of-pocket expenses. Hospitals accounted for in U.S. health spending from 2022 to 2024, compared with 11% from retail prescription drugs. But adding teeth to those targets sets up a fight with the powerful hospital industry, which has a challenging the spending limits as unreasonable. Hospitals warned that they will cut back on vital services, including in emergency rooms, obstetrics, and behavioral health.

Healthcare industry representatives said the state affordability office hasn’t accounted for year-to-year volatility or other factors beyond the industry’s control, such as rising minimum wages, state earthquake retrofit requirements, and expensive new drugs.

“They’re building the plane while flying it,” said Ben Johnson, group vice president for financial policy at the California Hospital Association. “We know improvements in affordability are needed, but we have serious questions about how and about what the unintended consequences could be under OHCA’s rather stringent approaches.”

When calculating penalties, California regulators would consider various factors, including a healthcare entity’s financial situation, its market impact, and the gravity and number of offenses, according to a in June. And entities would first be given opportunities to implement performance improvement plans to bring their spending into line before penalties are imposed. For those that don’t comply, the board is considering penalties of $10,000 a day or a flat $500,000.

The penalties, which the affordability office’s eight-member board is required by to adopt, are slated for discussion, and a potential vote, at the board’s . The soonest healthcare providers would be subject to penalties is 2028, because it’s expected it will take two years to collect and publicly report spending data to measure against the 2026 targets. The state is still collecting data on how entities performed against the 2025 targets, which aren’t enforceable, according to Andrew DiLuccia, a spokesperson for the California Department of Health Care Access and Information.

States Set Targets

California is one of at least eight states that have set spending targets as part of an expanding effort to curb soaring healthcare spending across the nation. Connecticut, Massachusetts, Oregon, and Rhode Island have also authorized the use of some type of financial penalty. The specifics of each vary widely, although so far no state has applied them.

A by the California Health Care Foundation found that 4 out of 10 state residents said they had medical debt, and 6 in 10 reported that they or a family member had skipped or delayed medical care in the previous 12 months because of cost. Nationwide, about say it is difficult to afford healthcare costs.

After Rosalyn Book got stiches on her chin, the elementary school teacher received a $15,000 ER bill from a local hospital, despite having insurance. Many teachers in her district leave because they can’t afford the cost of healthcare and insurance premiums, she said.

“The healthcare charges are just insanity, and what we get as patients for the care, it’s not the best either,” said Book, president of the Monterey Bay Teachers Association. “If you’re a working, regular individual in terms of how much you make, the cost of living and especially the healthcare is just not doable.”

Meanwhile, hospitals are warning there’s a risk of more closures. According to Yale University’s , 17 hospitals have closed in the state since 2016, compared with only six openings.

Hospitals and other healthcare providers have said the proposed multimillion-dollar penalties are too steep and could destabilize their operations at a time when they’re facing funding challenges, including massive federal cuts to Medicaid, the end of enhanced federal subsidies for Affordable Care Act plans, and a sharp rise in uninsured patients. The One Big Beautiful Bill Act, passed by congressional Republicans and signed by President Donald Trump last summer, is expected to reduce federal Medicaid spending by more than — including by in California — and increase the rolls of the uninsured in the U.S. by over a decade.

Johnson said hospitals raise prices on commercial payers to offset the expense of treating uninsured patients, as well as patients on Medicaid and Medicare, which can reimburse care providers at rates that fall short of treatment costs.

In addition, said Anete Millers, vice president of legal and regulatory affairs at the California Association of Health Plans, tax increases on managed-care plans recently to offset federal Medicaid cuts will force plans to increase their prices for consumers.

“Some spending pressures originate outside of the control of health plans and are the result of public policy decisions rather than underlying changes in healthcare utilization or efficiency,” she told the affordability office’s .

Kristof Stremikis, the director of market analysis and insight at the nonprofit California Health Care Foundation, acknowledged that external forces can drive costs but said that plenty of unnecessary spending is within the healthcare system’s control, such as administrative waste and duplicative tests and procedures. of U.S. healthcare spending is considered wasteful, according to .

Elizabeth Mitchell, a former Office of Health Care Affordability board member whose term ended in May, agreed.

“Every business has external challenges,” said Mitchell, who is now president and CEO of Purchaser Business Group on Health, a nonprofit coalition representing large employers. “The hospital industry has not taken accountability to actually manage costs. I have heard those excuses for decades, and at some point, they have to make changes.”

First Step To Bring Down Costs

of five states with cost growth benchmarks, published in June, found that some have succeeded in modestly slowing healthcare spending, particularly those with enforcement mechanisms. However, spending growth in most states has still set. 

Jeremy Vandehey, a consultant with the Peterson-Milbank Program for Sustainable Health Care Costs, said setting benchmarks and collecting data to analyze which entities meet them is only a first step. Armed with information about what and who is driving up costs, states are more empowered to take additional action, such as imposing penalties or regulating prices, to bring down costs, he said.

“I don’t think anybody in any state is declaring victory on healthcare costs, but I wouldn’t say that that means the programs are a failure,” Vandehey said. “In all of these states, there’s much more robust conversations happening about, OK, we haven’t solved our cost crisis, so we need additional action.”

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The state health department wanted to add covid vaccines to the school immunization schedule, a move no state has ever implemented. Robert F. Kennedy Jr., then known as a leading vaccine skeptic, had already claimed the covid shot was “the deadliest vaccine ever made” during a poster board presentation at the legislative hearing.

Griffin, a longtime OB-GYN, relied on nearly identical images during her own blistering testimony against the proposal. After the hearing, she expected splashy headlines about Kennedy’s assertions, shifting the public debate over covid policies and vaccines. But that did not happen; one news outlet dismissed him as a . Griffin was shocked.

That is “when I saw how the world worked,” she recalled in a podcast interview. Griffin said she and her husband, a vascular surgeon, decided to take action and “shine light on things.”

Now, Kennedy is the nation’s health secretary, and Griffin holds prominent roles that position her to help carry out his vision.

Last September, Kennedy appointed her to ACIP, the advisory panel for federal immunization policy, where she voted to recommend limiting access to covid vaccines and ending universal newborn immunizations for hepatitis B, steps that a . In December, Gov. Jeff Landry of Louisiana, a conservative Republican and an ally of President Donald Trump’s, named Griffin as the state’s surgeon general.

That makes her the top public health physician in Louisiana, which has the among states.

She is an unconventional choice. Griffin has no background or specialty training in infectious diseases or public health. She is aligned with alternative health movements — including Make America Healthy Again, or MAHA — and has hosted some speakers promoting fringe medical views.

Griffin declined interview requests for this article. “My vision as Louisiana’s surgeon general is to help shift our healthcare system toward preventing disease, not just managing or treating it,” she said in a statement.

Eight months into her tenure, she has yet to make major changes at the health department. She has faced hurdles in her efforts to tighten access to vaccines and limit public health powers, testifying on several bills that legislators rejected.

Still, Griffin’s political rise of Kennedy’s vaccine agenda at the , a vital testing ground for laws aimed at eroding government mandates. State officials have enormous power to set health policy and beat back infectious disease outbreaks. While Griffin’s post is largely a bully pulpit, she could spur real change by advising the governor, state health secretary, and lawmakers.

Some public health and infectious disease experts warned that if Griffin eventually succeeded in curtailing the state’s authority, illnesses and deaths could escalate and Louisiana could be hamstrung in a future pandemic. At one vaccine panel meeting last year, she said it was “unclear” whether vaccines were linked to autism, as Kennedy has suggested. When asked by The New York Times, she declined to say whether she believed any vaccines should be mandated for schoolchildren.

“Someone who has expressed the views she has, who’s now in a public policy position, is very dangerous,” said , the chief executive of the American Public Health Association.

But , a pastor and pediatric cardiologist who serves as chair of the federal vaccine panel, defended Griffin as an “excellent choice” for surgeon general. “No one should be afraid of Dr. Evelyn Griffin having the heart’s desire to take care of the population of Louisiana,” he said in an interview.

While Griffin is on a learning curve as a political novice, she has signaled big ambitions.

She called for “dramatic transformational change” during a public meeting in January, promising to focus on women’s health, rural health, and the root causes of disease. An accompanying said Louisiana would lead through “family, faith, and fearlessness.”

Griffin, 49, often cites her family background in explaining her trajectory.

She was born Ewelina Bulczynski under Communist rule in Poland in 1976. When she was 5, her family defected to a refugee camp in Austria before immigrating to Canada. She and her two brothers later came to the United States to practice as physicians. She has credited this history with giving her a “different perspective” as a doctor and influencing her skepticism of government mandates.

“My parents escaped Communist Poland so that we could come here for the freedoms, such as medical freedom, that this country has,” she told Louisiana lawmakers in 2022.

She met her husband, Joseph Griffin, while they attended Ross University School of Medicine, then located in Dominica. After residency programs in New Orleans, they settled in Baton Rouge and raised two children.

People who have known Griffin during her 20-year career delivering babies and treating women described her as a kind, caring, and smart physician. “Patients loved her,” said Francis Dauterive, who worked with her.

In the years before the pandemic, Griffin had noticed a rise in chronic health problems among her patients. She began studying how nutrition and lifestyle choices could treat and prevent illness, and pursued online training in functional medicine. She started an filled with images of jackfruit sloppy Joes and vegan jambalaya, her dog lounging on a yoga mat, and her backyard strawberry plants.

She also learned of Barbara O’Neill, a Christian wellness figure popular on social media. O’Neill was from giving medical advice in Australia after claiming that cancer was caused by a fungus and could be treated with baking soda, and that vaccines caused “an epidemic of ADHD, autism, epilepsy and cot death.” In a , Griffin called O’Neill a “sage” teacher who was ostracized for focusing on lifestyle solutions to medical issues. She said she kept O’Neill’s advice for a healthy life — including exercise, sunshine, and trust in God — posted on her fridge.

But it was the pandemic that transformed her career. In speeches and interviews, she said she began to question public health guidance and that of her former employer, Ochsner Health, Louisiana’s largest health system, on masking, vaccines, and mandates.

Griffin wanted to share research with colleagues that wasn’t “mainstream” science, studies she said were from contacts in Europe on early covid treatments. Griffin was repeatedly rebuffed, she said.

Eventually, she resigned. “I’m going to stick to my principles,” she later recalled thinking. She now works at the Baton Rouge General health system. Ochsner officials declined to comment.

Louisiana had been hit hard by the pandemic. By December 2021, more than 14,000 people had died from covid. That summer, the Delta surge had killed six pregnant women there over two months, and maternal health organizations were urging vaccination.

But in her testimony to lawmakers that December, Griffin had questioned the vaccine’s safety after health officials had reported . She invoked a public health catastrophe: The , prescribed during pregnancy in Europe (and tested in the United States) in the 1950s, had left thousands of babies with missing or malformed limbs. She also reminded lawmakers of the Nuremberg trials, where Nazi collaborators had been for medical experimentation.

“So everyone has to be on notice when making these types of decisions,” Griffin said, looking at the politicians. The state later dropped plans to require covid vaccines for students.

Griffin and her husband have since embedded themselves in Louisiana’s right-leaning alternative health communities. They have espoused views that, amid the swirl of social-media-fueled wellness trends, pandemic backlash, and widespread dismay over Americans’ poor health, have become ascendant in the second Trump presidency.

Griffin returned to the state Capitol over the next three years to testify for favored causes, including bills supported by Health Freedom Louisiana, a group aligned with Kennedy. to , an antiparasitic drug popular among vaccine skeptics, though numerous studies have shown it is ineffective in treating covid, and future government health mandates, which Griffin has Neither got out of committee. She also testified in support of a ban on gender-transition treatments for minors, which .

After the U.S. Supreme Court overturned Roe v. Wade in 2022 and Louisiana’s near-total took effect, Griffin became an ally of Louisiana Right to Life, the state’s leading anti-abortion group. She recorded videos arguing that the law did not impede pregnancy care. The ban was later and lead to unnecessary cesarean sections, according to doctors and reproductive rights groups.

Griffin and her husband struck up a friendship with Tony Spell, the in Baton Rouge, sometimes joining him for Bible study. Pastor Spell refused to shut his evangelical church during the pandemic, leading to that were overturned by the Louisiana Supreme Court. Griffin called him “an absolute hero.”

She has spoken at annual health freedom gatherings on the church’s sprawling grounds and launched her own wellness events there two years ago. Guests have talked about backyard gardening, naturopathic medicine, the benefits of doulas and raw milk — a — which recently sickened nearly a dozen Louisiana residents.

One speaker, an OB-GYN, said contraception encouraged abortion. Another, an ophthalmologist, questioned the safety of wireless technology, as has Griffin. Quoting O’Neill, the Australian wellness figure, Griffin warned the crowd to “stay away from sunscreen,” adding there were “lots and lots of chemicals” in it.

Spirituality is “the foundation for health,” she said during the event in 2025, and some of her speakers have presented faith in Jesus as essential to being healthy. At the 2024 gathering, Sean Troxclair, an internist who is now her deputy, said that when he was “injured” by a vaccine, “I got with Jesus.” He added, “If you’re not with him, no matter what you do, you’re not going to get better.”

In written comments to the Times, Griffin said that faith was not a prerequisite for good health, and that she “may not share every perspective presented” by her speakers.

Griffin’s appointment is among Gov. Landry’s wider efforts to move Louisiana, already a deeply red state, further to the right. He has supported a who mail abortion pills to Louisiana patients and a to stop the practice nationwide. The U.S. Supreme Court said the pills could still be sent by mail while the FDA case continues in the lower courts.

The governor’s first appointee as surgeon general, , another supporter of Kennedy’s, blocked his staff from promoting any vaccines amid an that killed two babies.

Griffin has begun her tenure more quietly, seeking ties with the state’s medical community while trying to find her place in a health department hierarchy where the secretary still wields much of the power.

For her staff, she’s recruited figures from wellness and vaccine-skeptical circles, including Troxclair and Kathleen Willis, an internist who has of the childhood vaccine schedule, .

A surprising presence in the department is Griffin’s husband, whom she’s called “like-minded.” Though he is not employed by the agency, he has joined her appointments with state and federal officials and participated in department meetings, sometimes providing feedback or asking questions, according to two people present at the sessions. Griffin has also placed him on a . Griffin said in a statement that he was “not involved in formal decision-making.”

Bruce Greenstein, the state health secretary, introduced the couple during a public meeting in January, saying, “We basically get two doctors for the price of one.” In May, Griffin’s husband joined the governor on a to Greenland, which Trump has periodically .

Griffin’s beliefs represent a shift away from public health policies that prioritize the protection of the wider community in favor of ones that prioritize individual choice. Like Kennedy, she has said this is necessary to restore faith in public health systems battered by the anger over pandemic restrictions.

Such a reframing of the government’s role would upend long-standing public health principles and risk harming society’s most vulnerable, said Paul Offit, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia.

“Are we in no way responsible for people who we are going to sit next to on a bus or get into a crowded elevator?” he asked. “Do we have no sense of responsibility to other members of society?”

Florida’s former health secretary and surgeon general, whose vaccine mandates, said rising vaccine skepticism was already contributing to and . “This is something that our country will regret as we start seeing our sons, daughters, neighbors, friends, cousins, pay the price,” he said in an interview.

Even though Griffin has allied herself with some lawmakers in the Republican-controlled legislature, she testified on three bills this year that failed to proceed. One would have created new for vaccines — including banning mothers from agreeing to vaccines for 12 hours after giving birth, when Griffin said hormones and other factors could impede their thinking.

Another would have the government’s ability to require vaccines, testing, or masks in a future outbreak, mandates that Griffin testified infringed on individual rights and were discriminatory. A , her own proposal, would have given her office sweeping access to all medical records in the state, which are now protected by medical privacy laws.

Gov. Landry did not publicly push for the measures, a sign that they may not be priorities for his administration. A majority of Louisiana voters support school vaccine mandates, according to polls by and the . Most proposals to weaken vaccine laws also this year.

Since her appointment, Griffin has traveled the state to meet with residents. In June, she and her husband wandered through a wellness event, sponsored by the Northshore Alternative Health Alliance, in Mandeville. She had been invited to give the keynote address by Abigail Licatino, a member of Health Freedom Louisiana who has said that .

Booths featured local farmers, reiki practitioners, functional medicine doctors, chiropractors, spiritual healers, and purveyors of peptides, supplements, and IV treatments. The event represented some of the “holistic approaches” Griffin said she planned to highlight as surgeon general.

In speeches before her appointment, Griffin had offered a far-reaching vision. While conventional medicine would still play an indispensable role, she said, the current health system was failing Americans and would “collapse.” The health freedom and wellness movements would help show “the path forward.”

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The New York Times’ Kitty Bennett, Sheelagh McNeill, and Kirsten Noyes contributed research for this article.

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The decision by the Trump administration comes amid massive cuts in federal funding for Medicaid. Advocates worry this could be a one-two punch for disabled Americans who want to live independently.

³Ô¹Ï²»´òìÈ senior correspondent Stephanie Armour joined WAMU’s Health Hub on Aug. 19 to explain what this change means for Americans with disabilities and their loved ones.

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While the released Aug. 10 does not directly mention autism, Trump’s demand to limit vaccine recommendations has puzzled leading medical groups, doctors, and political analysts alike. The directive landed less than 90 days before midterm elections, which Trump’s own could be jeopardized by anti-vaccine rhetoric.

“The political timing, particularly for members on the Republican side in swing districts, is not good,” said , a former Republican congressman and retired doctor.

Trump’s willingness to gamble on the issue underscores the president’s impatience for his health secretary to deliver on a promise that he’d pinpoint a culprit for the sharp rise in autism diagnoses.

After more than a year, Kennedy and his close, anti-vaccine allies have blown past a deadline to turn up definitive answers in a multimillion-dollar research mission shrouded in secrecy, leaving the president to recycle debunked notions as he publicly assaults vaccines.

“This is about the most closed project that I’ve ever heard of,” Helen Tager-Flusberg, a renowned psychologist who runs the Coalition of Autism Scientists, said of Kennedy’s autism research efforts. “They’re treating it like the Manhattan Project in the 1940s. This is as opaque as it could possibly be.”

The White House did not answer questions about what research is informing the president’s opinions or which vaccines he believes could be linked to autism.

The Department of Health and Human Services said the president’s action builds on the agency’s January announcement that it was reassessing the nation’s vaccine schedule and recommended reducing childhood immunizations based on peer countries’ guidance. However, no other peer country separates the measles, mumps, and rubella vaccine as the president has now ordered.

“As the secretary said, HHS will examine every biologically plausible hypothesis, follow the evidence wherever it leads, and make findings and actions available as they are ready,” HHS spokesperson Emily Hilliard said in an email.

Trump Dreams of a ‘Big Day’

Trump especially has been enamored with finding autism’s cause, saying in August 2025 that it will be “such a big day” after Kennedy assured his boss that he had identified “clearly, almost certainly” factors causing autism that would soon be publicly revealed.

Decades of existing research and scientific studies show genetics is a leading factor. — including prenatal exposure to pollution, the age of the father, and maternal health — can also play a role.

But Kennedy has flatly rejected that science, often calling autism a “.” As health secretary, he has looking for root causes in a research effort that’s offered no public status updates and few details about who, or even which agency, is leading the effort.

Prominent autism advocacy groups, scientists, and researchers have not been consulted on the project. Nor have career scientists working at the federal health agencies, according to two officials ³Ô¹Ï²»´òìÈ is not naming because they were not authorized to speak on the record about the matter.

Requests to meet with Kennedy on the issue have been ignored, said Delancy Allred, public policy manager at the Autism Society. Allred said that other federal agencies, such as the Department of Education, have engaged more directly with leading autism advocacy groups during meetings.

“No one has gotten to Kennedy. No one has gotten to the secretary level, that I’m aware of,” Allred said. “I think he likes to isolate himself with folks that are in his domain and group.”

Indeed, Kennedy has relied on allies, who’ve joined him over the years on a crusade against childhood vaccines, to lead the agency’s autism research and strategy efforts. It’s a top priority for his closest adviser, , a former environmental activist and , according to the unnamed sources. Spear did not respond to requests to talk about the autism study.

William “Reyn” Archer III — a former Texas health official, trained obstetrician-gynecologist, and whom Kennedy hired as a senior adviser — has spent months acquiring Americans’ medical records for political appointees to research a link between vaccines and autism. The National Institutes of Health under Trump has also issued about $50 million in grants to scientists at universities around the country for autism research, although most of the studies are not scheduled to be completed for a few years.

In January, Kennedy also restocked the Interagency Autism Coordinating Committee — an under-the-radar but influential group — with a full new slate of 21 members. His appointees include parents of autistic children, vaccine skeptics, and a doctor who was sued for “dangerous” autism treatment. It has met only once during Trump’s current term.

Late last month, the committee abruptly dropped a 336-page strategic plan that echoes some of Kennedy’s talking points: Federal researchers have focused too much on genetic links to autism, the plan suggests.

Diagnoses of autism, a that affects how people communicate and behave, the past couple of decades. The increase is attributed partly to and screening, a more expansive definition of the disorder, and parents having children at a later age, .

Trump and Kennedy have falsely claimed that the rise in diagnoses is isolated among American children — though diagnoses have dramatically and .

Despite his efforts to launch new research, Kennedy has provided Trump with no conclusive explanation for these increases. Trump began publicly pressing his health secretary on the issue last month when he asked Kennedy: “How are you doing on the autism research?”

Kennedy replied, “We will have an answer for you,” before Trump cut him off.

“That is so important,” the president pressed.

Kennedy’s vaccine agenda has been stymied, in part, by the White House’s infighting. Behind the scenes, White House officials have spent months waving Kennedy off his vaccine agenda amid a historic wave of measles infections.

With his Aug. 10 Oval Office signing, Trump made clear Kennedy’s vaccine agenda remains a top priority. The signing also came at a politically convenient moment: The Senate broke for a five-week recess, just after the White House secured the votes it needed for crucial confirmations of Centers for Disease Control and Prevention Director Erica Schwartz and Attorney General Todd Blanche.

Kennedy Misfires

Many of Kennedy’s claims so far on autism have not withstood scientific scrutiny. Last year, the health secretary said Tylenol use in pregnancy can lead to autism. A major new study in the peer-reviewed journal JAMA debunked the connection — a political stumble for Trump, who had publicly repeated the claim and urged women not to take the pain reliever.

Kennedy also offered that circumcision could be a cause during a Cabinet meeting in October. published in August in JAMA Pediatrics found no such evidence. He said in 2025 that a linked the in autism. However, his remarks misrepresented the findings; the he referred to later studied thimerosal exposure in vaccines and .

And Kennedy for research that was underway to search for autism’s causes, including potential environmental sources.

Pressed on details about the administration’s work studying autism, NIH Director Jay Bhattacharya admitted that no conclusion had been reached during an interview .

“If you ask me, as a scientist, do I know why we’ve seen this rise in autism? I’ll tell you I don’t know the answer to that question,” he said Aug. 9.

Seated at his desk in the Oval Office the next day, Trump repeatedly made the connection between autism and vaccines just before signing the executive order calling for fewer childhood shots.

Appearing alongside Trump, Kennedy seemed intent on quelling expectations that HHS would produce results expeditiously. He told the president he was racing to find answers before the end of his term.

“Mr. President, you have told us you want answers. So do I,” Kennedy said. “We have just over two years to finish the work, and I know you’re impatient, and we are moving with an urgency that that deadline demands.”

While Trump has repeatedly claimed there’s a link between autism and vaccines, he has not revealed which of the routine vaccinations he believes might be to blame, and he praised the polio vaccine as “amazing” during the White House event.

White House officials declined to answer questions about the status of Kennedy’s efforts to identify the cause of autism during a call a few hours later.

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Céline Gounder, ³Ô¹Ï²»´òìÈ’ editor-at-large for public health, discussed Americans’ skepticism toward public health experts and President Donald Trump’s executive order on childhood vaccines on CBS News 24/7 and CBS News’ CBS Mornings, respectively, on Aug. 11.

On Aug. 10, Gounder discussed the risks and benefits of egg freezing on CBS Mornings.

Gounder also discussed organ donation and scientists’ creation of new viruses with AI on CBS Mornings and CBS News 24/7, respectively, on Aug 7.

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