RFK Jr. adviser Calley Means and Kennedy’s son Finn attended the Enhanced Games, the pro-doping athletic competition and biohacking extravaganza that took place over the weekend in Las Vegas, according to The Washington Post. Send news tips and personal bests to John.Wilkerson@statnews.com or John_Wilkerson.07 on Signal.

Ripple effects

For weeks, Republicans have been preoccupied with an immigration funding bill that they’re pushing through Congress, without support from Democrats. I’ve not been writing about that bill because it doesn’t include health care policies. But it’s now becoming relevant to health care, albeit indirectly.

Early last week, Republicans were expected to pass that budget reconciliation bill without much friction. By the end of the week, Senate Republicans adjourned for a week-long recess without voting on it due to an impasse over a new $1.8 billion settlement fund for Trump’s allies. They’d also butted heads with the president over his demands for $1 billion for a White House complex and ballroom.

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Hospitals and other providers are bracing for an end to the extra money they’ve gotten for treating Medicaid patients, one of the many cuts contained in Republicans’ sweeping 2025 tax law.

But the Trump administration disclosed this week that it plans to take the cuts to state directed payments even further, setting up what’s likely to be a showdown with provider groups. 

Since 2024, some hospitals, doctors, nursing homes, and other types of providers have been reimbursed for Medicaid services at much higher commercial rates, thanks to a Biden-era change. The One Big Beautiful Bill Act, passed in July, directs the Centers for Medicare and Medicaid Services to gradually trim those payments beginning in 2028 until they’re close to or on par with Medicare rates. 

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With thousands of illegal e-cigarettes for sale in the U.S., both the Trump and Biden administrations have vowed to crack down on the illicit fruit- and candy-flavored vapes that hold particular appeal to minors. But a new government report suggests law enforcement efforts by the Department of Justice lag far behind the scope of the problem. 

Most DOJ enforcement actions between fiscal year 2022 and fiscal year 2025 — 50 out of a total of 88 — were to add the names of remote e-cigarette sellers to a list of unauthorized businesses, according to the report from the Government Accountability Office. The second-most common type of enforcement actions (20 out of 88) noted in the report were injunctions to stop legal violations. 

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In which RFK Jr. says the “government lies to us” while sitting in front of an HHS seal. Send news tips and podcast recommendations to John.Wilkerson@statnews.com or John_Wilkerson.07 on Signal.

First, control health care costs

Last month, a group of 12 Senate Democrats proposed a framework for rebuilding the health care system. The idea was to spur input from others ahead of when Democrats might get a chance to act on those plans.

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You’re reading the web edition of D.C. Diagnosis, STAT’s twice-weekly newsletter about the politics and policy of health and medicine. Sign up here to receive it in your inbox on Tuesdays and Thursdays.

The 2026 STAT Madness competition was stacked with research on topics like smart dental floss that monitors stress, Baby KJ’s personalized gene therapy, and an artificial intelligence model designed to predict cell behavior. Check out the winner, unveiled this morning. And as always, send news tips to John.Wilkerson@statnews.com or John_Wilkerson.07 on Signal.

Budget reruns

The 2027 budget that the Trump administration released on Friday is in many ways a repeat of last year’s proposal: It includes deep cuts to the National Institutes of Health, the elimination of a health research agency, and the creation of a new agency devoted to chronic diseases called the Administration for a Healthy America.

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