Trump administration cuts disability research. Plus, other under-the-radar stories, and more.

A big catch-up for Monday March 10, 2025.

Hi everyone, I worked all weekend clinically but managed to put these updates together between shifts and family time. I’ve divided today’s newsletter into three sections. We start with three under-the-radar stories that you may not have read about. Then, a couple of updates in the fight to save US foreign aid. Lastly, some pro-vaccine science stuff, because that’s how we roll around here.

I hope you find it useful as we gear up for another week. Let’s get to it.

But first…

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Three under-the-radar stories…

1. Trump-controlled Social Security Administration cuts disability research.

The Trump administration apparently does not know the difference between “woke” and vital disparities research. This is troubling. In a story that flew under the radar, the Social Security Administration announced last month that it was immediately terminating an agreement with the Retirement and Disability Research Consortium (RDRC), which is a project of the National Bureau of Economic Research (NBER).

Why do we care? Because disparities research—which often overlaps with disability and disability claims research— has shown time and again that one of the best ways to improve the health of the US population is not through some fancy new innovation, but by simply making it so that all people have access to the best of what we already have. It’s less flashy, but it’s true. For example, as my friend and colleague Dr. Megan Ranney wrote with Dr. Atul Grover in STAT News recently, if we want to close most of America’s life expectancy gap with peer nations, all we need to do is enact known policies that will render our deaths from firearms, drugs, and alcohol as non-outliers. Further, as many have shown (including work by my colleagues and me in JAMA), if systemic racism were considered a cause of death, it would be among the leading causes of mortality in the US.

After a colleague alerted me to the abrupt termination of funding to the RDRC, I spent time looking through white papers that the group had published in recent years. The RDRC/NBER papers I read were notable for their importance and ingenuity, often asking fascinating questions whose answers might inform policy choices. One paper I read looked at the effect of paid family medical leave on that family’s ability to endure the financial shock of an unexpected medical emergency in the family. Turns out that paid family medical leave made it significantly less likely that “the (healthy) wives of individuals…who experience a hospitalization or surgery report leaving a job to care for home or family.”

In another interesting study, researchers examined the effects of cash transfers from tribal gaming casinos had on the life expectancies of Native Americans. I found it fascinating that these cash transfers were associated with mortality reductions, with the greatest decrease (five extra weeks of life—not bad for the amount of money being discussed) among women.

It seems like the Trump administration either has no idea what it cut, or worse, it does, and actually does not care about women, despite its claims. For its part, the RDRC/NBER sent a letter to members of Congress outlining some of the work it has done to help us understand where the opportunities to make America healthier really are. Meanwhile, in its announcement, the Social Security Administration bragged that it “will continue to root out waste and abuse to earn back America's trust and confidence in our agency.” Sure.

2. Deregulating regulations? An under-the-radar Trump power grab that you might need to know about.

Shortly after RFK Jr. was sworn in as HHS Secretary, the agency unveiled a new rule meant to eliminate transparency and public participation in its policies. The rule applies to “public property, loans, grants, benefits, or contracts.” A MedPage Today story explains why this rule with longstanding bipartisan support is so important. At the center of this rule—and many of the lawsuits against the Trump administration—is a law called the Administrative Procedure Act, which governs how the executive branch of the US federal government makes rules and regulations. The Administrative Procedure Act has already come up in a number of lawsuits against the Trump administration, including the USAID case above, another recent victory against Trump administration-directed censorship, and others. Suffice it to say, I expect this law to continue to be an important factor in our fight to save the many assets of the US federal government and our public health infrastructure. I’ll ask Professor Vladeck about this on Doctors Lounge on Substack Live tomorrow, Tuesday March 10 at 4 p.m. ET. (I’ll send a separate announcement about this later. You won’t want to miss it.)

3. Follow-up: DOGE lawyers were behind the purge of NIH-funded LBGTQ+ research.

Last Monday, I shared the story of two scientists whose NIH grants were terminated because the Trump administration fears many research projects that offend its delicate sensibilities (and the administration apparently lacks the care and the curiosity to try to understand why such efforts matter.) At the time, I pointed out that while the grant termination letters the researchers received were signed by two different NIH staffers, a closer look at the document properties indicated that they had a common source, one “JoshuaAHanley.” I found a D.C. lawyer on LinkedIn by that name and began to wonder if, perhaps, this guy was a new DOGE operative. I sent him a message asking to discuss the termination. The next day, his LinkedIn profile was gone. I had my suspicions. Those were confirmed on Wednesday when The Intercept published a story about DOGE operatives, including our friend Mr. Hanley. So, now we know that the federal government is spending taxpayer dollars on lawyers to find (flimsy) reasons to terminate NIH grants. Sounds really efficient, doesn’t it?

Two updates on the attack on US foreign aid…

1. The Supreme Court rules that USAID commitments must be paid. Some payments are starting to come through.

Last week, the Supreme Court ruled that the government must pay $2 billion that it owes various USAID projects. It was the second time the court has ruled against the Trump administration, making the score 0-2. Had the court ruled in favor of the Trump administration, the destruction of not just USAID but many other important federal government assets that Elon Musk and President Trump would like to axe, no matter how many people die in the pursuit of paltry savings in taxpayer dollars. Instead, the fight will rage on.

In this case, the details of the $2 billion payouts must be worked out by the district court (which already ruled in favor of the USAID-related plaintiffs and which the Supreme Court backed). According to one expert, some payments have already begun to occur, though no specifics were provided.

For more—including a deeper understanding of what the decision means—I’d highly recommend this explainer by our friend Professor Steve Vladeck of Georgetown Law. (A more formal version also appeared in The Atlantic.) Meanwhile, the bigger question remains: what happens if the Trump administration disobeys the courts? Here’s yet another New York Times essay (the third of its kind in recent memory) that explains.

2. The State Department’s bizarre questionnaire to help decide which foreign projects to save.

Last week, organizations that receive funding from the State Department received messages requiring them to fill out a 36-item self assessment. The questionnaire is meant to determine whether these endeavors align with the “President’s America First foreign policy.” At stake: the future of said funding. Based on the answers, bureaucrats are supposed to determine whether the funding should continue, be modified, phased out (within 30 days), or just terminated (because, hey, why not)?

Politico reported on this, including some of the downright wacky and often contradicting questions. But the whole exercise is so Kafka-esque that it’s worth highlighting a bunch of them. The line between “America First” and offending the administration’s delicate sensibilities is virtually impossible to suss out, as you’ll see. Here are some doozies (bold added for emphasis), followed by some insights and analysis:

• “Can you confirm that your organization does not work with entities associated with communist, socialist, or totalitarian parties, or any party that espouses anti-American beliefs? [yes/no]”

  • Where would Russia fall in this?

• “Does this project reinforce U.S. sovereignty by limiting reliance on international organizations or global governance structures (e.g., UN, WHO)? [yes/no]”

  • Seems like a trick question. Why? Because later in the questionnaire, it asks whether the project can be transitioned away from foreign (read: US) assistance. Yet another question asks whether the project has “burden sharing, cost sharing, or private investments?” It seems a little backward to say that involving international partners would threaten US sovereignty whilst advocating that the project engage in “burden sharing” and “cost sharing” and have an exit strategy (which indeed would often include increased involvement from foreign actors like the UN and WHO). As the kids say, it’s giving “heads I win, tails you lose” energy.

• “Can you confirm that this is no [sic] DEI project or DEI elements of the project? [yes /no]”

  • First, why can’t they hire a copyeditor? Second, how would this be defined? The questionnaire linked to the Trump Executive Order, but that manifesto is more of an unhinged rant than a useful guidance document.

• “Can you confirm this is not a climate or “environmental justice” project or include such elements?[yes/no]” and “Does this project support U.S. energy independence or reduce global reliance on hostile countries for

  energy resources? [yes/no]”

  • Again, in normal times, these ideas might go together. Here, the administration seems to be implying that it’s one or the other.

• “Does this project support lifesaving assistance? [yes/no].”

  • I just want to know: if someone puts “yes,” would that increase the Trump administration’s likelihood of keeping it or not?

• “Does this project take appropriate measures to protect women and to defend against gender ideology as defined in the below Executive Order? [yes/no]”

  • Why such a question falls within the scope of a foreign aid project, I can’t begin to imagine. What would “yes” even look like? And for people filling this out who realize what a non sequitur this is, will they be punished for saying “no,” simply because the Trump administration’s narrow ideology has nothing to do with any of this?

• What impact does this project have on protecting religious minorities, promoting religious freedom, and combatting Christian prosecution? (1 – No Impact, 2 – Minor Impact, 3 – Neutral, 4 – Moderate Impact, 5 – Major Impact, 0 – Not applicable).

  • I included this one because it is, as my six-year-old says, cuckoo bananas. The government is literally deciding what to fund based on a composite score. The above question is given as much weight as another question: “To what degree does this project directly impact U.S. health security, such as biological threats, pandemics, and foreign dependence on medical supplies? (1 – No Impact, 2 – Minor Impact, 3 – Neutral, 4 – Moderate Impact, 5 – Major Impact, 0 – Not applicable).”

    It seems to me that this last question was among the only relevant questions on the entire form. And yet, it’s given equal weight as the perplexing inquiry on combating Christian “prosecution.” Also: I think they mean persecution, but these guys are so darned efficient, they can't be bothered to have a copyeditor check their work—upon which millions of lives literally depend.

Two reminders that vaccines are good and politicizing them is bad.

1. We must protect vaccines and transparency. A transcript and video of my interview with Dr. Paul Offit.

Last week, Dr. Paul Offit and I spoke on Instagram in a session we called “Vaccination in the Crosshairs.” Many of you asked for the transcript of that conversation, which was filled with Dr. Offit’s expertise, and many of your questions. You really can’t find a more impressive expert on these issues than Paul. It was an important and informative conversation, and I was glad to host it. Here it is.

As some of you may recall, it was thanks to Paul that we broke the news right here in Inside Medicine that the FDA recently canceled a meeting of its vaccine advisory committee (upon which Paul serves) to discuss the flu shot for the upcoming season. In our interview, we discussed how those meetings are both useful for developing upcoming flu shots and serve as a valuable mechanism for transparency during which the experts discuss last year’s shots. In short, the meetings help improve accountability to the public.

2. CDC posts Advisory Committee on Immunization Practices (ACIP) “conflicts of interest.”

Speaking of defending vaccines, the CDC is now posting “conflicts of interest” disclosures by experts who serve on its Advisory Committee on Immunization Practices (ACIP). There’s nothing wrong with this per se, except that it’s clear that RFK Jr. apparently believes that too many members of ACIP (and the FDA’s corresponding committee) have shady conflict, and he wanted this done, likely as part of a broader effort to undermine vaccines which have saved millions of lives.

However, if you look at the list of disclosures (as I did), two things are clear. Most of the supposed disclosures are not conflicts but rather simply indicators of expertise. Second, if anything, the committee members are overzealous in recusing themselves from votes where a perceived conflict of interest may exist. So, to my read, this little attempt to undermine the dedicated experts who serve on the CDC’s ACIP was a failure on the merits. Of course, that won’t stop bad-faith actors from making loud and misleading statements claiming that some number of ACIP members “admit” that they have conflicts of interest. Sounds salacious. It isn’t. It’s expertise and transparency from your federal government. That’s supposed to be a good thing.

That’s all for now! If you have information about any of the unfolding stories we are following, please email me or find me on Signal at InsideMedicine.88.

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