908: Measles Outbreak Simulator, HHS Secretary Testifies

JANSON SILVERS: 

This is the award-winning Public Health Review Morning Edition for Friday, May 16, 2025. I'm Janson Silvers. Now, today's news from the Association of State and Territorial Health Officials.

SAMEER VOHRA: 

With measles cases spreading across the country, our department wanted to ensure that our residents here in Illinois have access to meaningful information to guide our decision-making.

SILVERS: 

Dr. Sameer Vohra, the director of the Illinois Department of Public Health and an ASTHO member, tells us why his department wanted to create a dashboard focused on measles.

VOHRA: 

Our new dashboard provides school officials, local public health leaders, and also parents, and members of the general public the ability to review the measles vaccination rates in their local schools, and based on the risk of a large outbreak at that school, make the kind of educated choices about the vaccine needs for their children.

SILVERS: 

The dashboard provides predictions, projections, and estimates for the size and spread of a measles outbreak in schools throughout the state. Compiling this important data is one thing, making it usable is another.

VOHRA: 

When it comes to communicating with those outside the profession, whether they're school officials, parents, to general public, it's really important to make this data accessible so that it can be easily usable. That's a real goal for us at the Illinois Department of Public Health. We want to have information be presented in the best ways that the general public can use to make the decisions that they need to make.

SILVERS: 

You can check out Illinois' Measles Outbreak Simulator Dashboard. It's online now, and we have a link in the show notes.

Budget proposals, the HHS Secretary testifying on the Hill, and more. It's been a whirlwind on Capitol Hill lately. Luckily, we have ASTHO Senior Director of Government Affairs, Jeffrey Ekoma, joining us for this week's View from Washington, D.C. report to break it all down.

Jeffrey, how are you this morning?

JEFFREY EKOMA: 

I'm doing good. Good morning.

SILVERS: 

I know before we hopped on, you said it's been a busy week, and that's because there's been significant activity on Capitol Hill just in the last couple of weeks. Among the many things that occurred, the President also released his FY26 budget proposal to Congress. Can you explain what was in the budget and what will happen next?

EKOMA: 

Yes, before getting into the budget, you know, as a friendly reminder, the president's budget is a proposal to Congress, and Congress has the authority to approve, reject, or modify the recommendations made in the request. Now, the president released what we call a skinny budget, skinny in the sense that it provided a high level overview of the budget that included top line discretionary requests for federal agencies. Overall, the budget proposes a $163 billion or 23% reduction in non-defense discretionary funding. This includes decreasing CDC budget by $3.6 billion, HRSA budget by $1.7 billion, and SAMHSA budget by about a billion [dollars], ASPR's budget by $240 million, among other funding cuts. It also proposes eliminating the National Center for Chronic Diseases, the National Center for Environmental Health, the National Center for Injury Control, Global Health Center, Public Health Preparedness and Response, the Preventative Health and Health Services block grant, the Hospital Preparedness Program, Sexual Risk Avoidance Program, and Teen Pregnancy Prevention Program. It also proposes changes to FEMA, EPA's State Revolving Fund. It consolidates funding for infectious diseases, opioids, viral hepatitis, STIs, and tuberculosis into one grant program. We release a Leg [Legislative] Alert that goes into further detail about everything I mentioned today, and we're optimistic that the administration will release additional details on the budget in the coming weeks.

SILVERS: 

That's great information, and I know there's been a lot of activity on reconciliation this week. Can you describe what has happened since the last time the government affairs team provided an update?

EKOMA: 

Yes, this has been a really busy week. On the reconciliation front, the House Energy and Commerce Committee marked up out of committee. There's actually a 26- hour markup. It's a reconciliation bill that focuses on three priorities. So, first, being Medicaid. It proposes the implementation of work requirements. It reduces federal funding for states that provide coverage to undocumented immigrants. It limits how states fund their share of Medicaid by prohibiting any new provider taxes and freezing the current state-directed payment rates. It delays CMS eligibility and long-term staffing rules, among other things. The second thing it does is it seeks to reform the Affordable Care Act. So, it requires new income eligibility verification processes. It places limitations on special enrollment periods, among other provisions. And the last thing is, it seeks to improve Americans' access to care by imposing new requirements for pharmacy benefit managers, amongst other provisions. Now, separately, in the House Agricultural Committee, their reconciliation bill was marked up, and it includes a couple things as well. One is, it changes the Thrifty Food Plan. It makes amendments to SNAP, including eligibility, work requirements for able-bodied adults without dependents. It creates a state cost-sharing requirement for SNAP benefits, beginning FY28, which would require states to cover 5% of SNAP costs, and it would increase over time when the state's payment error exceeds by at least 6%, and it also would require the federal reimbursement rate for state SNAP administrative costs from 50% to 25%. Now, both bills are expected to be considered on the full House floor next week. It's something that we'd be able write an update soon.

SILVERS: 

It sounds like a lot of updates are coming from you and your team, and I know that also HHS Secretary Kennedy was on the Hill this week testifying before two congressional committees. Can you discuss those committees that he testified before and then tell me what was actually discussed?

EKOMA: 

Yes, the secretary had a busy week. First, he provided testimony to the House Appropriations Subcommittee on Labor, Health and Human Services, Education, and related agencies as well as the Senate Health, Education, Labor and Pensions Committee on HHS' FY26 budget. Now, the secretary discussed the priorities of the budget and how it reflects restructuring efforts of HHS and all the agencies under HHS. Members of Congress sought information on specific programs that were impacted by the reorg and the reduction of force efforts by the agency, potential cuts to Medicaid through the reconciliation package that I just talked about, funding cuts to biomedical research and public health departments, vaccines, the current response to the measles outbreak, and an anticipated timeline for committee members to receive additional information on current obligations of HHS and their alignment with current Fiscal Year appropriations as approved by Congress. So, lots of things were discussed, but yeah, the secretary had a busy week this week.

SILVERS: 

I'm not sure who's busier, you or the secretary, but we always appreciate you and your team, and the hard work you guys are doing. Jeffrey, thanks for stopping by on this Friday morning. I hope you have a great weekend.

EKOMA: 

Thank you so much, and you too.

SILVERS: 

Also, this weekend, an ASTHO member and an alum will both give commencement speeches to the students of the Meharry Medical College in Nashville, Tennessee. ASTHO member and Tennessee Commissioner of Health, Dr. Ralph Alvarado, and ASTHO alum, Dr. Georges Benjamin, executive director of the American Public Health Association, and the former secretary of health for the State of Maryland, will speak at the 8:30 a.m. and 2 p.m. ceremonies respectively.

Finally, if you're ever wondering about anything to do with the Public Health Infrastructure Grant, you're in luck. Stay current on PHIG deadlines, project updates, events, resources, opportunities, and successes through the PHIG national partners' Connections newsletter. Sign up using the link in the show notes.

That'll do it for today. We're back on Monday morning with more ASTHO news and information. I'm Janson Silvers, you're listening to the award-winning Public Health Review Morning Edition. Have a great weekend.