Plus: Hospitals lose at Supreme Court | Wednesday, April 30, 2025
 
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PRESENTED BY THE COALITION TO STRENGTHEN AMERICA’S HEALTHCARE
 
Axios Vitals
By Maya Goldman and Tina Reed · Apr 30, 2025

Halfway through the week! Today's newsletter is 974 words or a 3.5-minute read.

 
 
1 big thing: RFK Jr.'s not-so-secret weapon: moms
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Photo illustration of Robert F. Kennedy Jr. surrounded by disjointed photos of Vani Hari, Courtney Swan, seed oils, and cell phones.

Photo illustration: Maura Losch/Axios. Photos: Will Oliver/EPA/Bloomberg, Vivien Killilea/Getty Images for Los Angeles Magazine, and courtesy of Lydia Emrich

 

A cadre of moms on social media is using TikTok activism around wellness causes to amplify HHS Secretary Robert F. Kennedy Jr.'s calls to clean up America's food supply.

Why it matters: At a time when "bro-casters" like Joe Rogan are helping drive the political narrative, Kennedy has tapped into the following of these "mom-fluencers" to further his agenda, which has included narratives that aren't scientifically sound.

Driving the news: The alliance was on display last week when Kennedy announced an "understanding" with food makers to cut certain dyes from their products.

  • At a press conference filled with a who's who of popular online influencers, Kennedy pointed to states like West Virginia that have recently passed laws banning certain food dyes from products sold.
  • "The only reason that those states have banned these products is because of these ladies and millions more across the country, the warrior moms, who have powered the MAHA movement," Kennedy said.

Between the lines: Influencers such as Vani Hari, better known as the "Food Babe," can be found on platforms including Instagram, TikTok, Substack and on the podcast circuits.

  • Their pet causes range from food additives and seed oils to the use of glyphosate in farming, fluoride in water and the vaccine schedule. But they've coalesced around Kennedy's suspicion of the pharmaceutical and food industries, and his contention that regulators have grown cozy with the businesses they're supposed to be policing.

Reality check: While the moms discuss the value of eating whole foods, getting exercise and quality sleep, they've often veered into misinformation as they advocate for natural health and parental choice, experts said.

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2. Scoop: GOP poll shows Medicaid messaging risk
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Illustration of a small blue megaphone against a red background.

Illustration: Brendan Lynch/Axios

 

New internal GOP polling shows Republicans will have to be careful with how they message on any changes to Medicaid, with U.S. voters opposed to spending cuts to the program — even when framed as an effort to lower national debt.

Why it matters: It's a warning sign for Republican lawmakers eyeing spending cuts, even as many of the top priorities in President Trump's sweeping budget package are popular.

  • A plurality of independent voters — and voters overall — were opposed to Medicaid cuts to lower the national debt, according to the poll by Gray House shared with Senate Republicans, and first obtained by Axios.
  • The findings follow similar results from polling done by Trumpworld insiders earlier this month.

Zoom in: 57% also supported adding work requirements to Medicaid and 60% backed the broader idea of rooting out "waste, fraud and abuse" from the program.

  • 47% of voters polled said they are opposed to reducing Medicaid spending to lower the national debt, while 41% said they are in favor.

What we're hearing: Sen. Tom Cotton (R-Ark.) shared top lines with senators during a closed-door lunch on Tuesday.

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3. SCOTUS sides with HHS on Medicare payments
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Illustration of a gavel coming down on a hospital.

Illustration: Maura Losch/Axios

 

The Supreme Court sided with HHS on Tuesday in a case over whether safety net hospitals that care for low-income seniors should get higher Medicare reimbursements.

Why it matters: Billions of dollars were on the line for the more than 200 hospitals pressing the case, who claimed they'd been underpaid from 2006 to 2009.

Driving the news: Justices ruled 7-2 that Medicare used the appropriate method for calculating the safety-net payments, with Justice Elena Kagan joining the court's conservatives.

  • The dispute centered on so-called disproportionate share payments that hospitals get based in part on how many days they care for patients who are on both Medicare and Supplemental Security Income.
  • HHS only reimburses hospitals for those patients who received cash benefits in the month of their hospitalization.
  • Hospitals argued they should get credit for taking care of people who don't obtain benefits in a particular month or who aren't eligible for cash benefits but can get other SSI-related services.

State of play: The majority of justices ruled that the law considers SSI to refer to cash benefits, with eligibility determined on a monthly basis.

The other side: Justice Ketanji Brown Jackson, joined by Justice Sonia Sotomayor, wrote in a dissent that the opinion endorses a formula that "arbitrarily undercounts" the low-income patients served by a hospital.

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A MESSAGE FROM THE COALITION TO STRENGTHEN AMERICA’S HEALTHCARE

We need Medicaid for a healthy America
 
 

Tell Congress: Don’t cut Medicaid for America’s children and families.

The reason: Medicaid helps keep more than 30 million children across America healthy, covering life-saving surgeries and so much more.

Learn more and take action.

 
 
4. Unpacking the maternal death rate increase
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Illustration of a pregnant Black woman with a concentric hand drawn pattern focusing on her belly.

Illustration: Aïda Amer/Axios

 

The addition of a "pregnancy checkbox" on death certificates has driven much of the increase in reported maternal mortality over the past 20 years, according to a new study in JAMA Pediatrics.

Why it matters: The study authors say their results highlight the need for rigorous data collection and analysis on maternal health to inform policy. But earlier this month, Robert F. Kennedy Jr.'s agency reorganization plan placed on leave the entire staff overseeing the main federal survey on maternal and infant health.

The big picture: About 66% of the United States' increase in reported maternal mortality between 2000 and 2019 is associated with the introduction of the pregnancy checkbox, the NIH-funded study found. The checkbox started becoming commonplace in 2003.

  • But a separate paper published last year in the American Journal of Obstetrics and Gynecology found the checkbox may have led to an increase in deaths being misclassified as related to pregnancy.

Yes, but: Maternal deaths did significantly spike to 18.9 per 100,000 live births in 2021 during the COVID-19 pandemic.

  • They hovered between 6.8 and 10.2 deaths per 100,000 in the two decades prior, per the research, and returned to pre-pandemic rates in 2022.
  • Black women had the highest maternal mortality rates across the years of the study period.
  • Future pandemic preparedness plans should also include specific actions to limit preventable maternal deaths, the study says.
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