A doctor holding T-shaped intrauterine birth control device. (Getty Photos) 

WASHINGTON — The National Family Planning and Reproductive Health Association and the American Civil Liberties Union filed a lawsuit in federal court Thursday challenging the Trump administration’s decision to withhold Title X family planning grants.

The 35-page filing alleges the Department of Health and Human Services, which administers the reproductive health program with funding approved by Congress, has withheld $65.8 million over disagreements about organizations’ “opposition to racism” and “providing care to undocumented immigrants.”

“The Affected Members and their subrecipients operate hundreds of Title X service sites across these states, which together provide family planning care to hundreds of thousands of low-income patients, many of whom would not otherwise be able to afford such care,” the complaint says. 

“Depriving these individuals of the high-quality, essential health care provided by Title X-funded health centers reduces access to (sexually transmitted infection) screening and treatment, cancer screening, and contraception, threatens the health and wellbeing of the individuals who rely on Title X for care, and undermines public health.”

The lawsuit contends California, Hawaiʻi, Maine, Mississippi, Missouri, Montana, and Utah have been completely cut off from Title X family planning grants, while Alaska, Connecticut, Idaho, Indiana, Kentucky, Minnesota, New Hampshire, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, Texas, Virginia, and West Virginia have had their access to the funding reduced.

The case was filed in the U.S. District Court for the District of Columbia but hadn’t been assigned to a judge as of Thursday afternoon.

HHS did not immediately reply to a request for comment.

Another suit

The lawsuit is the latest filed by organizations and Democratic state attorneys general challenging the Trump administration’s efforts to freeze funding for dozens of programs.

Some, but not all, of the cases are subject to injunctions from district courts that so far have prevented the spending cuts from taking effect while the cases proceed.

The Impoundment Control Act, a 1970s-era law that requires the president to spend the money Congress appropriates, is the subject of many of the disagreements between those filing lawsuits and the Trump administration.

The National Family Planning and Reproductive Health Association wrote in the lawsuit that it represents nearly 900 members, including state, county and local health departments.

Its members “operate or administer more than 3,000 health centers that provide family planning services to more than 2.2 million patients each year.”

HHS sent letters to some of the association’s members in late March, notifying them that their Title X family planning grant funding was “being temporarily withheld based on possible violations of the terms and conditions set forth in the notice of award,” according to the complaint.

The lawsuit alleges HHS’ decision to freeze the funding stems from its members having statements on their websites “indicating support for diversity, equity, and inclusion and opposition to racism, which, HHS claims, ‘suggests’ that the Affected Members are or may be engaged in conduct that violates federal civil rights laws.”

The federal government also chose to withhold the Title X funding over “a single public statement that HHS claims gives it ‘reason to believe’ that some of the Affected Members may be providing care to undocumented immigrants, in violation of Executive Order 14218 ‘Ending Taxpayer Subsidization of Open Borders.’”

The lawsuit says that HHS never actually told any of the National Family Planning and Reproductive Health Association’s members that they had violated federal regulations, executive orders, or the law. The letters from HHS referenced only “possible violations.” 

U.S. Senate Majority Leader John Thune and U.S. House Speaker Mike Johnson hold a press conference on the Republican budget resolution at the U.S. Capitol on April 10, 2025. The Republican leaders each face a challenge in uniting their divided conferences to pass a massive tax and spending plan supported by President Donald Trump. (Photo by Kayla Bartkowski/Getty Images)

WASHINGTON — Republicans in Congress have a difficult few months ahead of them as they look to broker agreement within their exceptionally narrow majority on policy issues that have already begun to divide centrists from far-right members of the party.

The negotiations will be the first test of the sort for Speaker Mike Johnson and Senate Majority Leader John Thune, who weren’t in the top posts eight years ago when the GOP passed its last reconciliation package.

Tax law and funding cuts to Medicaid are the issues most likely to prevent one “big, beautiful bill” from moving through both chambers and reaching President Donald Trump’s desk.

Republican leaders will also need to be cautious as the package takes shape about what types of proposals their more vulnerable members vote on, especially if they hope to hold onto at least one chamber of Congress following next year’s midterm elections.

“The swing-district Republicans are in a tougher spot because their voters do want to see some of those tax cuts extended, but they don’t want to see it at the expense of programs like Medicaid,” said Dr. Ben Sommers, Huntley Quelch professor of health care economics at Harvard.

“And so they’re walking a tightrope,” he said. “And at least until there’s a final bill on the floor, a lot of them are going to just keep pushing that final decision down the road and hope that something else happens and that they don’t have to make that tough call.”

The decision to bundle together a permanent extension of the 2017 tax law, hundreds of billions in new spending on border security and defense, a rewrite of the nation’s energy policy and spending cuts means that centrist Republicans will have to cast one take-it-or-leave-it vote.

Breaking up the sweeping package into two or more bills would have given at-risk Republicans the opportunity for more tailored votes, but GOP leaders ultimately rejected that idea — a choice that will put moderates under increasing pressure as the legislation takes shape in the coming weeks.

Democrats in both chambers are expected to unanimously oppose the package.

Normally that would present a challenge in the Senate, where 60 votes are usually needed to limit debate on a bill and move onto final passage. But GOP leaders are using the reconciliation process to pass their bill, meaning they only need the support of a simple majority in the Senate. 

Slim margins

House committee chairs are expected to release and mark up 11 bills after the chamber returns from a two-week break in late April, though that’s only the first step.

Once the pieces are all bundled into one package, it will need to get across the House floor without losing more than three Republican votes, a much narrower threshold than the dozen GOP lawmakers in that chamber who voted against the final version of the 2017 tax law.

Republican leaders will then need to keep the party from making significant changes to the package in the Senate, where lawmakers will be able to offer as many amendments as they want when the bill comes to the floor.

That vote-a-rama will test party unity, with Democrats likely to propose amendments re-writing or eliminating specific sections of the bill — especially those addressing tax provisions benefiting the wealthy or corporations, and Medicaid spending cuts.

If more than three Senate Republicans break from the party to alter various elements, it could endanger final approval. However, if GOP senators from swing states vote to keep unpopular provisions in the bill, it could lead to them losing their next reelection bid to a Democrat.

Difference of opinion on Medicaid

The disagreement between centrist Republicans and far-right lawmakers over potential spending cuts to Medicaid is already on full display.

During floor debate on the budget resolution that cleared the way for Republicans to write the massive reconciliation package, Texas Rep. Chip Roy excoriated the state-federal health program for lower income Americans and some people with disabilities.

“Medicaid is debilitating the vulnerable, not helping them,” Roy said. “We are shoveling money out to the able-bodied on the back of expansion of Obamacare.”

On the other ideological side of the conference, a group of 14 centrist House Republicans sent a letter to GOP leaders a few days after voting to adopt the budget resolution to announce they “cannot and will not support a final reconciliation bill that includes any reduction in Medicaid coverage for vulnerable populations.”

“Cuts to Medicaid also threaten the viability of hospitals, nursing homes, and safety-net providers nationwide,” they wrote. “Many hospitals — particularly in rural and underserved areas — rely heavily on Medicaid funding, with some receiving over half their revenue from the program alone.

“Providers in these areas are especially at risk of closure, with many unable to recover. When hospitals close, it affects all constituents, regardless of healthcare coverage.”

Failed Obamacare repeal

Republican leaders in Congress will want to avoid a repeat of the last time the party tried to overhaul health care in a reconciliation package.

During Trump’s first term, following years of GOP politicians pledging to repeal and replace the Affordable Care Act, also known as Obamacare, they sought to do just that through the same complex reconciliation process they’re using now.

Ultimately, twenty Republicans voted against the bill in the House and three GOP senators — Alaska’s Lisa Murkowski, Arizona’s John McCain and Maine’s Susan Collins — blocked that chamber’s repeal-and-replace bill.

Collins said in a floor speech at the time she voted against the House’s version of the bill for several reasons, including that it would have made “sweeping changes to the Medicaid program — an important safety net that for more than 50 years has helped poor and disabled individuals, including children and low-income seniors, receive health care.”

Murkowski wrote in a statement that she voted against the Senate’s so-called “skinny” repeal bill because “both sides must do better on process and substance.”

“I know that access to affordable care is a challenge for so many. I hear from fishermen who can’t afford the coverage that they have, small business owners who can’t afford insurance at all, and those who have gained coverage for the first time in their life,” Murkowski wrote. “These Alaskans have shared their anxiety that their personal situation may be made worse under the legislation considered this week.”

Medicaid cuts could hurt state budgets

GOP lawmakers in Congress won’t be the only members of the party that leaders need to keep in the fold. Republican governors may not have a vote in either chamber, but they do have considerable sway with their congressional delegations and many red states have a substantial percentage of their Medicaid programs covered by federal dollars.

Nevada Gov. Joe Lombardo released a letter last month seeking to assuage fears about potential federal cuts to Medicaid, writing that he was “actively engaged in conversations with the White House and others in the federal government to relay our state’s concerns.”

“An abrupt reduction in federal funding would not only disrupt care for those who rely on Medicaid, but would also destabilize public and private healthcare providers, leading to workforce reductions, service limitations, and financial strain on already overburdened health care facilities,” Lombardo wrote.

National Governors Association Chair Jared Polis, a Colorado Democrat, and Vice Chair Kevin Stitt, an Oklahoma Republican, wrote in a joint statement released in March that the organization is “committed to advocating for a robust and efficient health and human services system, including Medicaid.”

“Without consultation and proper planning, Congressionally proposed reductions to Medicaid would impact state budgets, rural hospitals and health care service providers,” they wrote. “It is necessary for Governors to have a seat at the table when discussing any reforms and cuts to Medicaid funding.”

Federal spending cuts to Medicaid could lead some of the 40 states that have expanded the program under Obamacare to roll it back, though Missouri, Oklahoma and South Dakota have the expansion in their constitutions, making the impact of congressional action more complicated for their budgets and residents.

Leighton Ku, professor of health policy and management at The George Washington University, said during an interview that even though GOP governors aren’t members of Congress, they still hold “powerful influence.”

“We’re talking about deep cuts in federal spending that will have profound effects on state economies and state employment,” Ku said. “Governors, particularly those who expanded Medicaid, should feel fairly nervous about: What are the implications for their states in terms of both their political futures as well as what it will do to their state economies?”

“Again, we’re talking about the possibility of maybe somewhere on the order of a million jobs being lost simply because of the Medicaid cuts,” he added. “And that should cause some trepidation among governors.”

Republicans in Congress, Ku said, are trying to reduce spending. But when it comes to Medicaid, where the cost of administering the program is split between states and the federal government, any change to the federal share will come at the expense of the states.

“So the states end up being losers,” he said. “And this will cause states’ governors some unease. Again, it depends on where they lie politically: They may still be willing to accept cuts if it fits in with their ideologies.”

State and local taxes

Republicans also find themselves in a sticky situation when it comes to a major tax provision set to expire at the end of 2025: a limit on the amount of state and local taxes a taxpayer can deduct on their federal tax return. The limit is often simply referred to as the SALT cap.

Like proposed Medicaid cuts, the SALT debate has potential to change the calculus of Republicans willing to vote for the one large reconciliation bill.

For many years prior to the 2017 Tax Cuts and Jobs Act, taxpayers were able to take full advantage of deducting state and local taxes from their federal taxable income. But in that law, GOP lawmakers changed course and enacted a $10,000 cap on the SALT deduction to raise revenue to cover some of the law’s massive tax breaks.

The ability to deduct all eligible state and local taxes on federal tax returns was a win for wealthy households located in states and municipalities with steeper taxes.

At the time, Democrats, who wholesale opposed Trump’s tax agenda, saw the SALT cap as an attack on high-earning, high-tax blue states. But the SALT cap drew ire from across the aisle as well, said Kyle Pomerleau, senior fellow and federal tax policy expert for the American Enterprise Institute, a conservative think tank.

“The original bill also had a few Republicans that didn’t vote for it because of the cap. So this has been controversial to some degree from the very beginning,” Pomerleau said.

With such a narrow majority in the House, Republicans from high-tax areas, including those representing New York’s Long Island and Staten Island and California’s wealthy suburbs, will have leverage in the coming debate.

“Republicans generally don’t come from those states. There’s only a handful of them. But that brings us back to the vote margin that Republicans have,” Pomerleau said. “They have a lot of power this time around to really get what they want. These lawmakers who represent people that are concerned about this cap are going to want that cap raised.”

The issue is one of the few tax topics not polarized by party because it is defined by location, said Garrett Watson, director of policy analysis at the Tax Foundation, a think tank that generally supports lower taxes.

“It’s an interesting sort of debate, just because a lot of tax policy debates have political, partisan, ideological components, right? That’s somewhat predictable,” Watson said. “What’s interesting about SALT is actually it’s also a strong geographic story.”

Watson published the Tax Foundation’s 2023 county-by-county maps of state and local taxes paid as well as deducted from federal taxes in 2020. The data showed the top reporting counties were concentrated in California and New York.

Raising cap would cost federal government

But many Republicans would be happy if the cap on SALT deductions stayed in place to offset the cost of extending the 2017 tax cuts.

Raising the cap beyond the current $10,000 limit could reduce federal revenue between $200 billion to $1.2 trillion over the next decade, depending on what level Congress decides, according to a January analysis from the Urban-Brookings Tax Policy Center, a nonpartisan think tank that leans center-left.

In other words, households deducting more from their federal taxable income means the federal government reaping less revenue.

“Just to give you some order of magnitude, we looked at what would happen if you raised the cap from $10,000 to $20,000. That would cost (the federal government) $250 billion over 10 years. That’s a big number,” said Howard Gleckman, a senior fellow at the Tax Policy Center.

Deficit hawks, like Roy of Texas and Rep. Thomas Massie of Kentucky, have spoken out in recent months against raising the cap.

And while more federal revenue is lost with each dollar the cap increases, the benefit mainly goes to high-income earners, according to another Tax Policy Center analysis.

“We estimated when you raise the (SALT cap) from $10,000 to $20,000, 93% of the benefit goes to the top …20% , which are people making more than $200,000,” Gleckman said. “And half of it goes to people in the top 5% who are people who make more than $400,000.”

Most taxpayers take the standard deduction, which in 2025 sits at $15,000 for single taxpayers or $30,000 for married taxpayers filing jointly.

“That’s why the vast majority of people get no benefit from this. It’s only people who make a lot of money, who itemize, and who pay a lot of tax who get caught up in the cap,” Gleckman said.

But they may have an outsized voice as Congress hammers out its reconciliation bill in the coming months.

Johnson, a Louisiana Republican whose constituents would not benefit from raising the SALT cap, will have a “tough balancing act,” Gleckman said.

“Mike Johnson looks at the narrow majority he has in the House, and he sees if he loses half a dozen seats from places like New York and California because he doesn’t fix the cap then he could not be speaker anymore,” he said.

Republicans in the bipartisan SALT caucus include Reps. Mike Lawler, Nick LaLota, Andrew Garbarino and Nicole Malliotakis, all representing New York, as well as Tom Kean Jr. of New Jersey, and Young Kim of California.

Rachel Snyderman, managing director of economic policy at the Bipartisan Policy Center, said “complicated political tetris” is likely to emerge as lawmakers negotiate the reconciliation bill.

“The caucus that has called for (the cap’s) elimination over the past years has only gotten louder and more vocal and see this year as the opportunity to flex their muscle,” Snyderman said.

A doctor holding T-shaped intrauterine birth control device. (Getty Photos) 

WASHINGTON — The National Family Planning and Reproductive Health Association and the American Civil Liberties Union filed a lawsuit in federal court Thursday challenging the Trump administration’s decision to withhold Title X family planning grants.

The 35-page filing alleges the Department of Health and Human Services, which administers the reproductive health program with funding approved by Congress, has withheld $65.8 million over disagreements about organizations’ “opposition to racism” and “providing care to undocumented immigrants.”

“The Affected Members and their subrecipients operate hundreds of Title X service sites across these states, which together provide family planning care to hundreds of thousands of low-income patients, many of whom would not otherwise be able to afford such care,” the complaint says. 

“Depriving these individuals of the high-quality, essential health care provided by Title X-funded health centers reduces access to (sexually transmitted infection) screening and treatment, cancer screening, and contraception, threatens the health and wellbeing of the individuals who rely on Title X for care, and undermines public health.”

The lawsuit contends California, Hawaiʻi, Maine, Mississippi, Missouri, Montana, and Utah have been completely cut off from Title X family planning grants, while Alaska, Connecticut, Idaho, Indiana, Kentucky, Minnesota, New Hampshire, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, Texas, Virginia, and West Virginia have had their access to the funding reduced.

The case was filed in the U.S. District Court for the District of Columbia but hadn’t been assigned to a judge as of Thursday afternoon.

HHS did not immediately reply to a request for comment.

Another suit

The lawsuit is the latest filed by organizations and Democratic state attorneys general challenging the Trump administration’s efforts to freeze funding for dozens of programs.

Some, but not all, of the cases are subject to injunctions from district courts that so far have prevented the spending cuts from taking effect while the cases proceed.

The Impoundment Control Act, a 1970s-era law that requires the president to spend the money Congress appropriates, is the subject of many of the disagreements between those filing lawsuits and the Trump administration.

The National Family Planning and Reproductive Health Association wrote in the lawsuit that it represents nearly 900 members, including state, county and local health departments.

Its members “operate or administer more than 3,000 health centers that provide family planning services to more than 2.2 million patients each year.”

HHS sent letters to some of the association’s members in late March, notifying them that their Title X family planning grant funding was “being temporarily withheld based on possible violations of the terms and conditions set forth in the notice of award,” according to the complaint.

The lawsuit alleges HHS’ decision to freeze the funding stems from its members having statements on their websites “indicating support for diversity, equity, and inclusion and opposition to racism, which, HHS claims, ‘suggests’ that the Affected Members are or may be engaged in conduct that violates federal civil rights laws.”

The federal government also chose to withhold the Title X funding over “a single public statement that HHS claims gives it ‘reason to believe’ that some of the Affected Members may be providing care to undocumented immigrants, in violation of Executive Order 14218 ‘Ending Taxpayer Subsidization of Open Borders.’”

The lawsuit says that HHS never actually told any of the National Family Planning and Reproductive Health Association’s members that they had violated federal regulations, executive orders, or the law. The letters from HHS referenced only “possible violations.” 

U.S. Senate Majority Leader John Thune and U.S. House Speaker Mike Johnson hold a press conference on the Republican budget resolution at the U.S. Capitol on April 10, 2025. The Republican leaders each face a challenge in uniting their divided conferences to pass a massive tax and spending plan supported by President Donald Trump. (Photo by Kayla Bartkowski/Getty Images)

WASHINGTON — Republicans in Congress have a difficult few months ahead of them as they look to broker agreement within their exceptionally narrow majority on policy issues that have already begun to divide centrists from far-right members of the party.

The negotiations will be the first test of the sort for Speaker Mike Johnson and Senate Majority Leader John Thune, who weren’t in the top posts eight years ago when the GOP passed its last reconciliation package.

Tax law and funding cuts to Medicaid are the issues most likely to prevent one “big, beautiful bill” from moving through both chambers and reaching President Donald Trump’s desk.

Republican leaders will also need to be cautious as the package takes shape about what types of proposals their more vulnerable members vote on, especially if they hope to hold onto at least one chamber of Congress following next year’s midterm elections.

“The swing-district Republicans are in a tougher spot because their voters do want to see some of those tax cuts extended, but they don’t want to see it at the expense of programs like Medicaid,” said Dr. Ben Sommers, Huntley Quelch professor of health care economics at Harvard.

“And so they’re walking a tightrope,” he said. “And at least until there’s a final bill on the floor, a lot of them are going to just keep pushing that final decision down the road and hope that something else happens and that they don’t have to make that tough call.”

The decision to bundle together a permanent extension of the 2017 tax law, hundreds of billions in new spending on border security and defense, a rewrite of the nation’s energy policy and spending cuts means that centrist Republicans will have to cast one take-it-or-leave-it vote.

Breaking up the sweeping package into two or more bills would have given at-risk Republicans the opportunity for more tailored votes, but GOP leaders ultimately rejected that idea — a choice that will put moderates under increasing pressure as the legislation takes shape in the coming weeks.

Democrats in both chambers are expected to unanimously oppose the package.

Normally that would present a challenge in the Senate, where 60 votes are usually needed to limit debate on a bill and move onto final passage. But GOP leaders are using the reconciliation process to pass their bill, meaning they only need the support of a simple majority in the Senate. 

Slim margins

House committee chairs are expected to release and mark up 11 bills after the chamber returns from a two-week break in late April, though that’s only the first step.

Once the pieces are all bundled into one package, it will need to get across the House floor without losing more than three Republican votes, a much narrower threshold than the dozen GOP lawmakers in that chamber who voted against the final version of the 2017 tax law.

Republican leaders will then need to keep the party from making significant changes to the package in the Senate, where lawmakers will be able to offer as many amendments as they want when the bill comes to the floor.

That vote-a-rama will test party unity, with Democrats likely to propose amendments re-writing or eliminating specific sections of the bill — especially those addressing tax provisions benefiting the wealthy or corporations, and Medicaid spending cuts.

If more than three Senate Republicans break from the party to alter various elements, it could endanger final approval. However, if GOP senators from swing states vote to keep unpopular provisions in the bill, it could lead to them losing their next reelection bid to a Democrat.

Difference of opinion on Medicaid

The disagreement between centrist Republicans and far-right lawmakers over potential spending cuts to Medicaid is already on full display.

During floor debate on the budget resolution that cleared the way for Republicans to write the massive reconciliation package, Texas Rep. Chip Roy excoriated the state-federal health program for lower income Americans and some people with disabilities.

“Medicaid is debilitating the vulnerable, not helping them,” Roy said. “We are shoveling money out to the able-bodied on the back of expansion of Obamacare.”

On the other ideological side of the conference, a group of 14 centrist House Republicans sent a letter to GOP leaders a few days after voting to adopt the budget resolution to announce they “cannot and will not support a final reconciliation bill that includes any reduction in Medicaid coverage for vulnerable populations.”

“Cuts to Medicaid also threaten the viability of hospitals, nursing homes, and safety-net providers nationwide,” they wrote. “Many hospitals — particularly in rural and underserved areas — rely heavily on Medicaid funding, with some receiving over half their revenue from the program alone.

“Providers in these areas are especially at risk of closure, with many unable to recover. When hospitals close, it affects all constituents, regardless of healthcare coverage.”

Failed Obamacare repeal

Republican leaders in Congress will want to avoid a repeat of the last time the party tried to overhaul health care in a reconciliation package.

During Trump’s first term, following years of GOP politicians pledging to repeal and replace the Affordable Care Act, also known as Obamacare, they sought to do just that through the same complex reconciliation process they’re using now.

Ultimately, twenty Republicans voted against the bill in the House and three GOP senators — Alaska’s Lisa Murkowski, Arizona’s John McCain and Maine’s Susan Collins — blocked that chamber’s repeal-and-replace bill.

Collins said in a floor speech at the time she voted against the House’s version of the bill for several reasons, including that it would have made “sweeping changes to the Medicaid program — an important safety net that for more than 50 years has helped poor and disabled individuals, including children and low-income seniors, receive health care.”

Murkowski wrote in a statement that she voted against the Senate’s so-called “skinny” repeal bill because “both sides must do better on process and substance.”

“I know that access to affordable care is a challenge for so many. I hear from fishermen who can’t afford the coverage that they have, small business owners who can’t afford insurance at all, and those who have gained coverage for the first time in their life,” Murkowski wrote. “These Alaskans have shared their anxiety that their personal situation may be made worse under the legislation considered this week.”

Medicaid cuts could hurt state budgets

GOP lawmakers in Congress won’t be the only members of the party that leaders need to keep in the fold. Republican governors may not have a vote in either chamber, but they do have considerable sway with their congressional delegations and many red states have a substantial percentage of their Medicaid programs covered by federal dollars.

Nevada Gov. Joe Lombardo released a letter last month seeking to assuage fears about potential federal cuts to Medicaid, writing that he was “actively engaged in conversations with the White House and others in the federal government to relay our state’s concerns.”

“An abrupt reduction in federal funding would not only disrupt care for those who rely on Medicaid, but would also destabilize public and private healthcare providers, leading to workforce reductions, service limitations, and financial strain on already overburdened health care facilities,” Lombardo wrote.

National Governors Association Chair Jared Polis, a Colorado Democrat, and Vice Chair Kevin Stitt, an Oklahoma Republican, wrote in a joint statement released in March that the organization is “committed to advocating for a robust and efficient health and human services system, including Medicaid.”

“Without consultation and proper planning, Congressionally proposed reductions to Medicaid would impact state budgets, rural hospitals and health care service providers,” they wrote. “It is necessary for Governors to have a seat at the table when discussing any reforms and cuts to Medicaid funding.”

Federal spending cuts to Medicaid could lead some of the 40 states that have expanded the program under Obamacare to roll it back, though Missouri, Oklahoma and South Dakota have the expansion in their constitutions, making the impact of congressional action more complicated for their budgets and residents.

Leighton Ku, professor of health policy and management at The George Washington University, said during an interview that even though GOP governors aren’t members of Congress, they still hold “powerful influence.”

“We’re talking about deep cuts in federal spending that will have profound effects on state economies and state employment,” Ku said. “Governors, particularly those who expanded Medicaid, should feel fairly nervous about: What are the implications for their states in terms of both their political futures as well as what it will do to their state economies?”

“Again, we’re talking about the possibility of maybe somewhere on the order of a million jobs being lost simply because of the Medicaid cuts,” he added. “And that should cause some trepidation among governors.”

Republicans in Congress, Ku said, are trying to reduce spending. But when it comes to Medicaid, where the cost of administering the program is split between states and the federal government, any change to the federal share will come at the expense of the states.

“So the states end up being losers,” he said. “And this will cause states’ governors some unease. Again, it depends on where they lie politically: They may still be willing to accept cuts if it fits in with their ideologies.”

State and local taxes

Republicans also find themselves in a sticky situation when it comes to a major tax provision set to expire at the end of 2025: a limit on the amount of state and local taxes a taxpayer can deduct on their federal tax return. The limit is often simply referred to as the SALT cap.

Like proposed Medicaid cuts, the SALT debate has potential to change the calculus of Republicans willing to vote for the one large reconciliation bill.

For many years prior to the 2017 Tax Cuts and Jobs Act, taxpayers were able to take full advantage of deducting state and local taxes from their federal taxable income. But in that law, GOP lawmakers changed course and enacted a $10,000 cap on the SALT deduction to raise revenue to cover some of the law’s massive tax breaks.

The ability to deduct all eligible state and local taxes on federal tax returns was a win for wealthy households located in states and municipalities with steeper taxes.

At the time, Democrats, who wholesale opposed Trump’s tax agenda, saw the SALT cap as an attack on high-earning, high-tax blue states. But the SALT cap drew ire from across the aisle as well, said Kyle Pomerleau, senior fellow and federal tax policy expert for the American Enterprise Institute, a conservative think tank.

“The original bill also had a few Republicans that didn’t vote for it because of the cap. So this has been controversial to some degree from the very beginning,” Pomerleau said.

With such a narrow majority in the House, Republicans from high-tax areas, including those representing New York’s Long Island and Staten Island and California’s wealthy suburbs, will have leverage in the coming debate.

“Republicans generally don’t come from those states. There’s only a handful of them. But that brings us back to the vote margin that Republicans have,” Pomerleau said. “They have a lot of power this time around to really get what they want. These lawmakers who represent people that are concerned about this cap are going to want that cap raised.”

The issue is one of the few tax topics not polarized by party because it is defined by location, said Garrett Watson, director of policy analysis at the Tax Foundation, a think tank that generally supports lower taxes.

“It’s an interesting sort of debate, just because a lot of tax policy debates have political, partisan, ideological components, right? That’s somewhat predictable,” Watson said. “What’s interesting about SALT is actually it’s also a strong geographic story.”

Watson published the Tax Foundation’s 2023 county-by-county maps of state and local taxes paid as well as deducted from federal taxes in 2020. The data showed the top reporting counties were concentrated in California and New York.

Raising cap would cost federal government

But many Republicans would be happy if the cap on SALT deductions stayed in place to offset the cost of extending the 2017 tax cuts.

Raising the cap beyond the current $10,000 limit could reduce federal revenue between $200 billion to $1.2 trillion over the next decade, depending on what level Congress decides, according to a January analysis from the Urban-Brookings Tax Policy Center, a nonpartisan think tank that leans center-left.

In other words, households deducting more from their federal taxable income means the federal government reaping less revenue.

“Just to give you some order of magnitude, we looked at what would happen if you raised the cap from $10,000 to $20,000. That would cost (the federal government) $250 billion over 10 years. That’s a big number,” said Howard Gleckman, a senior fellow at the Tax Policy Center.

Deficit hawks, like Roy of Texas and Rep. Thomas Massie of Kentucky, have spoken out in recent months against raising the cap.

And while more federal revenue is lost with each dollar the cap increases, the benefit mainly goes to high-income earners, according to another Tax Policy Center analysis.

“We estimated when you raise the (SALT cap) from $10,000 to $20,000, 93% of the benefit goes to the top …20% , which are people making more than $200,000,” Gleckman said. “And half of it goes to people in the top 5% who are people who make more than $400,000.”

Most taxpayers take the standard deduction, which in 2025 sits at $15,000 for single taxpayers or $30,000 for married taxpayers filing jointly.

“That’s why the vast majority of people get no benefit from this. It’s only people who make a lot of money, who itemize, and who pay a lot of tax who get caught up in the cap,” Gleckman said.

But they may have an outsized voice as Congress hammers out its reconciliation bill in the coming months.

Johnson, a Louisiana Republican whose constituents would not benefit from raising the SALT cap, will have a “tough balancing act,” Gleckman said.

“Mike Johnson looks at the narrow majority he has in the House, and he sees if he loses half a dozen seats from places like New York and California because he doesn’t fix the cap then he could not be speaker anymore,” he said.

Republicans in the bipartisan SALT caucus include Reps. Mike Lawler, Nick LaLota, Andrew Garbarino and Nicole Malliotakis, all representing New York, as well as Tom Kean Jr. of New Jersey, and Young Kim of California.

Rachel Snyderman, managing director of economic policy at the Bipartisan Policy Center, said “complicated political tetris” is likely to emerge as lawmakers negotiate the reconciliation bill.

“The caucus that has called for (the cap’s) elimination over the past years has only gotten louder and more vocal and see this year as the opportunity to flex their muscle,” Snyderman said.

A Social Security Administration field office in San Jose, California. The Trump administration plans to reduce the Social Security Administration’s workforce from 57,000 to 50,000 and close six of its ten regional offices. (Photo: Michael Vi/Getty Images)

WASHINGTON — A handful of leading U.S. Senate Democrats on Wednesday asked the Social Security Administration’s acting inspector general to examine how reductions in staff, closing some regional offices and other changes implemented by the Trump administration have impacted the safety net program.

“These actions have already created a chilling effect among the agency’s workforce, with several senior SSA officials with centuries’ worth of institutional knowledge and experience having already left the agency,” the five senators wrote in a letter. “We are concerned that this hostile environment will foster burnout, low morale, higher attrition, and worse productivity among employees.

“Collectively, this will undoubtedly lead to disruption in benefit payments and increasing barriers for Americans to access their Social Security benefits.”

Senate Minority Leader Chuck Schumer, D-N.Y., Finance Committee ranking member Ron Wyden, D-Ore., Elizabeth Warren, D-Mass., Special Committee on Aging ranking member Kirsten Gillibrand, D-N.Y., and Mark Kelly, D-Ariz., signed the letter.

They requested the office look into how the changes have impacted customer service throughout the agency, the speed of disability appeals hearings and how quickly employees can process clearances, among other requests.

The senators asked the acting inspector general to share quarterly updates on the effects “of the agency reorganization and any future workforce reductions” on customer service.

The Social Security Administration’s office of the inspector general didn’t immediately respond to a request from States Newsroom about whether the independent watchdog would respond to the letter.

Staff cuts

The Trump administration released a plan earlier this year to reduce the Social Security Administration’s workforce from 57,000 to 50,000 and close six of its ten regional offices.

The Social Security Administration’s acting commissioner also announced that the agency would reduce its budget by $800 million during the current fiscal year through freezing SSA and Disability Determination Services hiring and “drastically” reducing overtime within that division, canceling Information Technology Systems contracts and closing down office space.

U.S. DOGE Service, led by billionaire Elon Musk, has been spearheading efforts within the Trump administration to cut spending and restructure the executive branch.

Musk, however, plans to shift his attention back toward his businesses starting in May after watching Tesla’s stock drop more than 40% this year, according to news reports.

Nominee pledges to reduce wait times

President Donald Trump’s pick to lead the SSA, Frank Bisignano, hasn’t yet received Senate confirmation but did pledge during his hearing in March that if approved, he would ensure beneficiaries have the option to visit an office, use the website, or speak to a real person after calling the 1-800 number.

“On the phone, I’m committed to reducing wait times and providing beneficiaries with a better experience; waiting 20 minutes-plus to get an answer will be of yesteryear,” Bisignano said at the time. “I also believe we can significantly improve the length of the disability claim process.”

The Senate Finance Committee voted along party lines earlier this month to send Bisignano’s nomination to the floor, though GOP leaders haven’t scheduled a vote.

Democrats have criticized the Trump administration’s actions toward the Social Security Administration for months, arguing that staff cuts and proposed changes to how the agency operates could cause significant issues for recipients.

Former President Joe Biden made changes to the Social Security Administration the subject of his first public address after leaving office, urging the Trump administration to reverse course.

“Social Security is about more than retirement accounts. It’s about honoring a fundamental trust between government and people,” Biden said during the Chicago appearance. “It’s about peace of mind for those who work their whole lives, so they can rest assured they’ll have a chance to get back some of what they earned and what they deserve.”

A nurse gives an MMR vaccine at the Utah County Health Department on April 29, 2019, in Provo, Utah. The vaccine is 97% effective against measles when two doses are administered. (Photo by George Frey/Getty Images)

WASHINGTON — Americans are increasingly unsure what to believe about measles as an outbreak spreads throughout the country, according to a survey released Wednesday by the nonpartisan health research organization KFF.

The poll shows that nearly a quarter of those asked believe a commonly repeated false claim that getting a child vaccinated against measles could lead to autism. About the same percentage of those surveyed believe it’s either definitely or probably true that vitamin A can prevent someone from contracting measles, even though it cannot.

And 19% of those surveyed believed untrue statements that the vaccine for measles is more dangerous than contracting the virus.

Parents who believed at least one of the three incorrect claims were more likely to have delayed or skipped some vaccinations for their children. Nearly a quarter, 24%, of those surveyed said they haven’t protected their children via vaccination, more than double the 11% of parents who responded that all three of the false statements about measles were definitely or probably untrue.

Ongoing outbreak

The Centers for Disease Control and Prevention reports that as of late last week there are more than 800 measles diagnoses throughout at least 25 states.

The infections are spread throughout different age groups with 31% of cases in children under five years old, 38% of diagnoses in those between five and 19 years old, 29% in people above the age of 20 and 2% in those with an unknown age, according to the CDC.

Eighty-five patients have been hospitalized and three have died. Nearly all of the confirmed cases, 96%, are in people who have not received the MMR vaccine or who are unsure about their vaccination status, according to the CDC.

States with confirmed cases include Alaska, Arkansas, California, Colorado, Florida, Georgia, Hawaii, Indiana, Kansas, Kentucky, Maryland, Michigan, Minnesota, New Jersey, New Mexico, New York, Ohio, Oklahoma, Pennsylvania, Rhode Island, Tennessee, Texas, Vermont and Washington.

Virginia reported its first case this year over the weekend, though that’s not yet included on the CDC’s website about the ongoing outbreak.

Understanding linked with concern

KFF’s survey shows that even though there are many people who believe untrue claims about measles or the MMR vaccine — which protects against measles, mumps and rubella — there are higher percentages of people who understand basic facts about the virus and who are concerned about the ongoing outbreak.

Seventy-five percent of those polled said it was incorrect that the MMR vaccine leads to autism, 81% responded it was wrong to say the vaccine is more dangerous than contracting the virus and 75% said it was false that vitamin A can prevent someone from getting measles.

About half, or 51%, of those surveyed said they are at least somewhat concerned about the spread of measles. That worry was highest among Hispanic adults, 62%, and Black adults, 61%.

Most of the people surveyed, 56%, knew that the spread of measles was higher this year than during prior years, though that number varied among people of different political leanings.

Seventy-one percent of Democrats knew that diagnoses of measles have spiked in recent months, compared with 54% of independents and 49% of Republicans.

KFF conducted the survey of 1,380 adults between April 8 and April 15 via telephone and online questions. 

Food and Drug Administration Commissioner Marty Makary holds up a container of carrot juice as he speaks during a news conference at the Health and Human Services Department headquarters in Washington, D.C., on April 22, 2025. Makary and Health and Human Services Secretary Robert F. Kennedy Jr. spoke about the FDA's intent to phase out synthetic food dye and offered carrot juice and other juices as possible alternatives. (Photo by Andrew Harnik/Getty Images)

WASHINGTON — Trump administration health officials announced Tuesday they hope to eliminate eight petroleum-based synthetic dyes from the nation’s food supply before the end of next year, though they haven’t received guarantees or written agreement from food companies.

Food and Drug Administration Commissioner Marty Makary detailed efforts to phase out the dyes during a press conference alongside Health and Human Services Secretary Robert F. Kennedy Jr. at the department’s Washington, D.C., headquarters.

“Let’s be honest, taking petroleum-based food dyes out of the food supply is not a silver bullet that will instantly make America’s children healthy, but it is one important step,” Makary said.

The FDA’s proposal would revoke authorization for Citrus Red No. 2 and Orange B while setting up the agency to work “with industry to eliminate” Green No. 3, Red No. 40, Yellow No. 5, Yellow No. 6, Blue No. 1 and Blue No. 2.

FDA will also authorize new, natural food dyes in the months ahead.

Kennedy said the Trump administration has an “understanding,” but not an “agreement” with food companies that use the dyes, before deferring to Makary, who said that “you win more bees with honey than fire.”

“There are a number of tools at our disposal. And so I believe in love, and let’s start in a friendly way and see if we can do this without any statutory or regulatory changes,” Makary said. “But we are exploring every tool in the toolbox to make sure this gets done very quickly. And they want to do it. They want to do it.

“So why go down a complicated road with Congress when they want to do this? They don’t want to deal with the patchwork of 30 different state plans.”

Christopher Gindlesperger, senior vice president of public affairs and communications at the National Confectioners Association, released a written statement that didn’t appear to agree entirely with the FDA’s proposed phase-out, however. 

“FDA and regulatory bodies around the world have deemed our products and ingredients safe, and we look forward to working with the Trump Administration and Congress on this issue,” Gindlesperger wrote. “We are in firm agreement that science-based evaluation of food additives will help eliminate consumer confusion and rebuild trust in our national food safety system.”

Removing additives

During the press conference, Makary held up watermelon, beet and carrot juices in clear containers, encouraging food companies to use those as dye, instead of the ones that may be removed from the market.

“We are simply asking American food companies to replace petroleum-based food dyes with natural ingredients for American children, just as they already do for children in other countries,” he said. “American children deserve good health.”

Makary said he believes there are several health conditions associated with petroleum-based synthetic dyes in food, including attention-deficit/hyperactivity disorder, obesity, diabetes, insulin resistance, cancer, genomic disruption, gastrointestinal issues, and allergic reactions.

Kennedy said his goal as HHS secretary is to remove all additives in food served in schools “that we can legally address.”

The department, Kenedy said, will also work with Congress and President Donald Trump to increase labeling for food ingredients that Kennedy called addictive, including sugar.

“There’s things that we’ll never be able to eliminate, like sugar. And sugar is poison and Americans need to know that,” Kennedy said. “It is poisoning us. Is giving us a diabetes crisis.”

Health effects unclear

Martin Bucknavage, senior food safety extension associate at Penn State University, said during an interview with States Newsroom that petroleum-based synthetic food dyes are derived just to get the color.

“It’s not like it’s just a nasty chemical that they’re putting in there,” he said. “It’s something that’s been taken, it’s been chemically made, modified and then purified, so that it is just that chemical that provides that color. And then those colors have been studied.”

Similar to the complicated nature of nutrition studies — which can have a challenging time separating out a person’s genetics, exercise and environmental factors from one specific part of their diet — research on food dyes hasn’t been conclusive, Bucknavage said.

“In some cases, it does have an impact on hypersensitivity, but not in all cases,” he said. “And not all studies are basically showing the same thing. So there’s a lot of variability that exists out there.

“And I’m not saying, ‘Listen, we shouldn’t go through and study these things more and get better information on them.’ We certainly should. But again, it’s not an easy thing to do. Some of these studies take time and take a lot of money and sometimes the results are kind … more variable in terms of the results.”

States regulating dyes

The FDA’s announcement wasn’t the first time the federal government or state lawmakers have sought to ban food additives or synthetic dyes.

The Biden administration announced in January that the federal government would ban Red No. 3 in food beginning in 2027 and from medicines in 2028. Makary said during the press conference Tuesday the current administration plans to ask companies to phase out that dye sooner.

California lawmakers approved a bill in 2023 that will ban Red No. 3, propylparaben, brominated vegetable oil and potassium bromate from food starting in 2027.

The following year, legislators in the Golden State approved another measure that, starting in 2028, will ban six food dyes — Blue 1, Blue 2, Green 3, Red 40, Yellow 5 and Yellow 6 — from being sold in schools.

Those two state laws followed the California Environmental Protection Agency’s Office of Environmental Health Hazard Assessment releasing a report in 2021 that concluded “scientific literature indicates that synthetic food dyes can impact neurobehavior in some children.”

Virginia lawmakers approved legislation earlier this year that Gov. Glenn Youngkin signed in March to ban some artificial food dyes in public schools, starting in July 2027.

In deeply red West Virginia, Republican Gov. Patrick Morrisey signed a bill a few days later that will prevent seven artificial dyes from being sold in grocery stores starting in 2028 or included in school lunches starting in August.

Arizona and Utah have implemented laws of their own addressing food dyes.

The Environmental Working Group, an advocacy organization focused on strengthening health standards, reports that legislators in several states, including Arkansas, Florida, Indiana, Iowa, Kentucky, Louisiana, Maryland, Minnesota, Missouri, New Jersey, New Mexico, North Carolina, Oklahoma, Oregon, Pennsylvania, Rhode Island and Washington have introduced bills that could ban certain food dyes or chemicals.

Melanie Benesh, EWG vice president for government affairs, wrote in a statement about the FDA announcement that the federal agency “has known for decades that synthetic food dyes are linked to health problems, particularly in children, but has failed to act.”

“We’re pleased the administration is following the lead of states like California and West Virginia by finally announcing their intent to ban dyes,” Benesh wrote. “We’re grateful that states like California and West Virginia have forced the FDA to make food safety a bigger priority.”

Peter Lurie, president and executive director of the self-described food and health watchdog group Center for Science in the Public Interest, wrote in a statement released Monday that Americans “don’t need synthetic dyes in the food supply, and no one will be harmed by their absence.”

“The most important thing to know about food dyes is that their only purpose is to make food companies money,” Lurie wrote. “They are purely cosmetic, serving no nutritional function. In other words, food dyes help make ultra-processed foods more attractive, especially to children, often by masking the absence of a colorful ingredient, like fruit.”

Ashley Murray contributed to this report. 

Secretary of Defense Pete Hegseth speaks during his Senate Armed Services Committee confirmation hearing on Jan. 14, 2025. (Photo by Andrew Harnik/Getty Images)

WASHINGTON — President Donald Trump said Monday he fully supports the secretary of Defense, despite The New York Times reporting over the weekend that Pete Hegseth shared details of a bombing campaign in Yemen in a second group chat, this time with his wife and brother.

“Ask the Houthis how much dysfunction there is?” Trump said, referring to the Iranian-backed terrorist organization that operates in Yemen. “There’s none. Pete’s doing a great job. Everybody’s happy with him.”

The New York Times published an article Sunday detailing a second group chat on the encrypted, commercial messaging app Signal, where Hegseth shared information about U.S. military plans.

Hegseth, asked during the White House Easter Egg roll on Monday about the latest New York Times report, didn’t deny that he sent messages in another group chat.

“What a big surprise that a few leakers get fired and suddenly a bunch of hit pieces come out from the same media that peddled the Russia hoax, won’t give back their Pulitzers, they got Pulitzers for a bunch of lies,” Hegseth said. “As they peddle those lies no one ever calls them on it. See, this is what the media does. They take anonymous sources from disgruntled former employees and then they try to slash and burn people and ruin their reputations.”

The New York Times report was the second time in less than a month that Hegseth’s discussion of military operations on the app came to light.

Someone on a chat meant to comprise only high-level administration officials accidentally included Jeffrey Goldberg, editor-in-chief of The Atlantic, who published an article in late March on the experience.

That group chat included Vice President J.D. Vance, Hegseth, Secretary of State Marco Rubio, Director of National Intelligence Tulsi Gabbard, CIA Director John Ratcliffe, National Security Advisor Michael Waltz and others. In that chat, Hegseth shared a precise timeline of U.S. bombing of Houthi targets in Yemen.

The Defense Department’s Office of the Inspector General opened an investigation earlier this month “to determine the extent to which the Secretary of Defense and other DoD personnel complied with DoD policies and procedures for the use of a commercial messaging application for official business. Additionally, we will review compliance with classification and records retention requirements.”

The OIG investigation came after U.S. Senate Armed Services Committee Chairman Roger Wicker, R-Miss., and ranking member Jack Reed, D-R.I., sent a letter to the acting inspector general asking the independent watchdog agency to look into the issue.

While Trump and most congressional Republicans continued to back Hegseth, Nebraska Republican Rep. Don Bacon raised concerns Monday about the operational security risk of communicating on “perceived secure applications” like Signal.

In a social media post that did not name Hegseth or specifically reference Signal, Bacon wrote that “admin officials must assume their phones are closely monitored by China & Russia.”

“They’re top priority targets. Our adversaries can put thousands of people in position just to monitor their phones & to penetrate perceived secure applications on non-secure phones,” Bacon wrote. “I’ve assumed my phones were monitored since I was a Colonel in Iraq & as Commander at Ramstein.”

The U.S. Supreme Court is pictured Oct. 9, 2024. (Photo by Jane Norman/States Newsroom)

WASHINGTON — The U.S. Supreme Court announced Thursday it will hear oral arguments next month over President Donald Trump’s efforts to restructure birthright citizenship, though the justices won’t decide on the merits of the case just yet. 

Instead, they will choose whether to leave in place nationwide injunctions from lower courts that so far have blocked the Trump administration from implementing the executive order.

The oral arguments, scheduled for May 15, will likely provide the first indication of whether any of the nine justices are interested in revisiting the Court’s interpretation of the 14th Amendment, which was ratified in 1868 following the Civil War.

The amendment states that “all persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the State wherein they reside.”

The Supreme Court ruled in 1898 in United States v. Wong Kim Ark that the 14th Amendment guarantees any child born in the United States is entitled to U.S. citizenship, even if their parents are not citizens.

Trump disagrees with that ruling and signed an executive order on his first day in office seeking to change which babies born in the United States become citizens. If that order were implemented, babies whose parents were “unlawfully present in the United States” or whose parents’ presence “was lawful but temporary” would not be eligible for citizenship.

Several organizations and Democratic attorneys general filed lawsuits seeking to block the executive order, leading to nationwide injunctions against its implementation.

Last month, the Trump administration asked the Supreme Court to intervene in the lower court’s nationwide injunctions, limiting them to the organizations and states that filed suit.

The three cases are Trump v. State of Washington, Trump v. CASA, Inc. and Trump v. State of New Jersey.

Legislation

Nationwide injunctions by lower court judges have become an issue for Republicans in Congress as well as the Trump administration.

Iowa Republican Sen. Chuck Grassley introduced a bill in Congress that would bar federal district court judges from being able to implement nationwide injunctions.

“We all have to agree to give up the universal injunction as a weapon against policies we disagree with,” Grassley said during a hearing earlier this month. “The damage it causes to the judicial system and to our democracy is too great.”

U.S. Health and Human Services Secretary Robert F. Kennedy Jr. speaks during a press conference at the department's headquarters in Washington, D.C., on Wednesday, April 16, 2025.  (Photo by Jennifer Shutt/States Newsroom)

WASHINGTON — U.S. Health and Human Services Secretary Robert F. Kennedy Jr. announced Wednesday the department will shift its research into autism toward potential environmental causes, though he declined to say exactly what the Trump administration would do if certain industries or pollutants were found responsible.

Kennedy, an environmental lawyer with no medical or research training, declared that autism is a preventable disease, argued research into genetic causes is a “dead end” and asserted that “we know it’s environmental exposure,” before saying HHS would fund “a series of new studies to identify precisely what the environmental toxins are that are causing it.”

“This has not been done before,” Kennedy said. “We’re going to do it in a thorough and comprehensive way and we’re going to get back with an answer to the American people very, very quickly.”

Kennedy said during his first press conference since receiving Senate confirmation that he wanted researchers to look into numerous potential factors, including mold, food additives, pesticides, air, water, medicines, ultrasound, age of parents, obesity in parents and diabetes in parents.

He pledged to have “some of the answers by September,” though he added the research will “be an evolving process.”

Kennedy appeared confident in his personal assessment that environmental factors lead to autism, without attributing that belief to any one industry or contaminant.

“This is coming from an environmental toxin and somebody made a profit by putting that environmental toxin into our air, our water, our medicines, our food,” Kennedy said. “And it’s to their benefit to normalize it, to say, ‘This is all normal. It has always been here.’ But that’s not good for our country.”

Autism experts, however, cast doubt on Kennedy’s assertion that environmental factors lead to autism and questioned his proposed timeline to prove such a link.

When asked by a reporter what exactly the Trump administration would do if research found conclusive evidence that one specific industry or pollutant was causing autism, Kennedy didn’t say whether HHS would push to ban it or close down any businesses. 

“I think we’re going to figure out a way to make pressure on them to remove it,” he said. “I think also there will be market forces that also exert pressure on them to remove it.”

Research difficult

Catherine Lord, professor of psychiatry with the school of medicine at the University of California, Los Angeles, said during an interview with States Newsroom following Kennedy’s remarks that trying to reach a definitive cause of autism before September was an “utterly ridiculous” timeline.

Lord said “the most likely hypothesis is that there may be interactions between genetics and, for example, environmental exposures, or even experiences like extreme prematurity.”

But she noted that studying the impact of environmental contaminants on people’s health, or a complex diagnosis like autism, is challenging because scientists obviously cannot expose people to toxins.

“It’s so difficult to do that work well, and people do it, but they can’t do it quickly,” Lord said. “And so I think that we do need work in that area, and I think it has been funded in the last few years. It just hasn’t come out with anything that is earth-shattering. It’s more the same thing, which is that if you’re exposed to something bad, your chances of having a child with any kind of neurodevelopmental disorder is going to go up.”

Lord expressed concern about moving funding and research away from genetic factors, saying “we do know that autism is genetic, so I think that is not under question.”

“I think the genetic work was moving forward,” she said. “It’s a slow pace, again, because they’re addressing so many different genetic patterns. But I think that at least there’s clear progress within this science.”

Limits funding for genetic research

Eric Fombonne, professor emeritus of psychiatry at Oregon Health and Science University, said during an interview that it was unwise for Kennedy to say there would be some answers about autism within a few months.

“It’s ridiculous to say that he’s going to unravel the etiology of autism in six months,” Fombonne said. “I mean, he could give, like, all the money of the world to any lab or any person. They could never report any results before several years from now, at the minimum.”

The pace of medical research, he said, is slow and Kennedy’s comments show “a complete ignorance and disregard for science and what we do and how complicated it is and the time it takes.”

Directing research dollars toward possible environmental contributors to autism will also limit the amount of funding available for genetic research, which Fombonne said “has been incredibly productive.”

“The pie is limited,” Fombonne said. “So if you move funds from genetic research to environmental research, you’re going to slow down the pace of genetic research.”

Fombonne explained that research into genetics and autism is “quite complicated” and has shown that not all genetic mechanisms are “the same across different families.”

“So it’s a very complex puzzle. And as you know, the brain is a very hard organ to study. So understanding the pathophysiology, which is associated with these gene variants, is a very hard process,” he said. “But we are doing that and we are progressing. And this has been paying off enormously over the last 20 or 30 years.”

Fombonne wouldn’t make the same assessment of potential environmental factors, saying there are no signs of higher rates of autism in certain areas or certain time periods, like scientists have found for some other conditions.

“There is no evidence that there is a cluster of cases of kids who have been living in a polluted area, or exposed to particular environmental circumstances,” Fombonne said. “There is no starting point, which is strong, to start environmental research somewhere we can say is going to pay off.

“So it’s going to be very exploratory initially, which may be a good thing to do. But at least, let’s do it well, and most of the studies so far are short.”

Former President Biden speaks about Social Security at a disability conference in Chicago on April 15, 2025. The remarks were his first in public since leaving office in January. (Image via C-SPAN livestream)

Former President Joe Biden on Tuesday used his first public address since leaving office to criticize the current administration for cutting thousands of employees at the Social Security Administration and to rebut those who have questioned the program’s relevance.

“In fewer than 100 days, this new administration has done so much damage and so much destruction. It’s kind of breathtaking it could happen that soon,” Biden said. “They’ve taken a hatchet to the Social Security Administration, pushing 7,000 employees — 7,000 — out the door in that time, including the most seasoned career officials.”

The Social Security Administration announced earlier this year it would cut staffing from 57,000 to 50,000 employees and reduce the number of regional offices from 10 to four.

Biden urged Republicans to preserve Social Security for future generations, arguing during his 30-minute speech to the national conference of Advocates, Counselors, and Representatives for the Disabled in Chicago that people have been able to rely on it throughout wars, recessions and the pandemic.

“Social Security is about more than retirement accounts. It’s about honoring a fundamental trust between government and people,” Biden said. “It’s about peace of mind for those who work their whole lives, so they can rest assured they’ll have a chance to get back some of what they earned and what they deserve.”

Biden, who accepted the organization’s Beacon of Hope award, said protecting Social Security and the federal workers who administer the program is about defending core principles.

“Who are we? What makes us distinct from the rest of the world?” Biden asked. “It comes down to basic, in my view, fundamental American values — nobody’s king, nobody’s the boss. Everybody has a shot.” 

Biden criticized members of President Donald Trump’s Cabinet for making harsh comments about the program. He noted Commerce Secretary Howard Lutnick said his mother-in-law wouldn’t complain if she missed a Social Security payment and that “the easiest way to find the fraudster is to stop payments and listen because whoever screams is the one stealing.”

Biden also called out billionaire and head of U.S. DOGE Service Elon Musk for calling Social Security a “Ponzi scheme.”

“​​What the hell are they talking about?” Biden said. “People earn these benefits. They paid into that benefit. They rely on that benefit.”

White House pledges to maintain program

White House press secretary Karoline Leavitt said during a briefing several hours before Biden’s speech the Trump administration doesn’t plan to cut off Americans’ Social Security benefits.

“Let me make it very clear ahead of former President Biden’s remarks: The president, this president, President Trump is absolutely certain about protecting Social Security benefits for law-abiding, tax-paying American citizens and seniors who have paid into this program,” she said. “He will always protect that program. He campaigned on it. He protected it in his first term.”

Leavitt also took a swipe at Biden’s age, saying she didn’t expect him to give a speech during the evening.

“My first reaction when seeing former President Biden was speaking tonight was, I’m shocked that he was speaking at nighttime. I had thought his bedtime was much earlier than his speech tonight,” she said. 

Biden, 82, last year dropped his reelection bid in a rematch against Trump, 78, amid concerns about his age and mental acuity.

Administrator nominee to target errors

Democrats have raised concerns for months that staffing cuts at the Social Security Administration will impact Americans’ ability to get their questions about the program answered or their issues resolved quickly.

Social Security Commissioner nominee Frank Bisignano testified during his hearing in March that, if confirmed, he would try to “ensure that every beneficiary receives their payments on time, that disability claims are processed in the manner they should be.”

Bisignano said he hoped to ensure Social Security recipients could visit an office, use the website, or speak to a real person after calling the 1-800 number.

“On the phone, I’m committed to reducing wait times and providing beneficiaries with a better experience; waiting 20 minutes-plus to get an answer will be of yesteryear,” Bisignano said. “I also believe we can significantly improve the length of the disability claim process.”

Bisignano promised lawmakers he would reduce the 1% error rate in payments, which he said was “five decimal places too high.” And he said repeatedly that personally identifiable information will be “protected.”

The Senate Finance Committee voted along party lines in early April to send Bisignano’s nomination to the floor, but he hasn’t yet been confirmed. 

OMB Director Russ Vought testifies before the Senate Homeland Security and Governmental Affairs Committee on Jan. 15, 2025. (Screenshot from committee webcast)

WASHINGTON — A nonprofit organization filed suit against the Trump administration on Monday, alleging its decision to stop posting budget documents in late March violates federal law.

Protect Democracy Project’s case is the second lawsuit challenging the Office of Management and Budget’s choice to pull down a webpage with apportionment information that detailed when and how the administration was spending money appropriated by Congress.

The case, as well as the one brought by Citizens for Responsibility and Ethics in Washington last week, asks a federal judge to require OMB to restore the website that publicly shared the data for years.

OMB Director Russ Vought told Congress late last month that the budget office would no longer publicly post apportionment information, writing in a letter that to do so would disclose “sensitive, predecisional, and deliberative information.”

“Such disclosures have a chilling effect on the deliberations within the Executive Branch,” Vought wrote. “Indeed, these disclosure provisions have already adversely impacted the candor contained in OMB’s communications with agencies and have undermined OMB’s effectiveness in supervising agency spending.

“Moreover, apportionments may contain sensitive information, the automatic public disclosure of which may pose a danger to national security and foreign policy.”

A ‘brazen move’

Democrats in Congress sharply criticized the decision, with a few calling on the Government Accountability Office, a watchdog agency, to investigate. 

House Appropriations Committee ranking member Rosa DeLauro, D-Conn., and Senate Appropriations Committee ranking member Patty Murray, D-Wash., issued a joint statement in late March urging Vought to reverse course.

“Congress enacted these requirements over a Democratic President’s objections on a bipartisan basis because our constituents, and all American taxpayers, deserve transparency and accountability for how their money is being spent,” DeLauro and Murray wrote. “Taking down this website is not just illegal it is a brazen move to hide this administration’s spending from the American people and from Congress.”

Oregon Sen. Jeff Merkley and Pennsylvania Rep. Brendan Boyle, the top Democrats on the Budget committees, urged the Government Accountability Office to look into the matter.

GAO General Counsel Edda Emmanuelli Perez did and wrote in a letter released earlier this month that OMB’s decision to withhold publicly sharing the apportionment information was “very concerning.”

“We understand that OMB took down the website taking the position that it requires the disclosure of predecisional, and deliberative information,” he wrote. “We disagree.”

Perez rejected OMB’s argument that all of the information had to be removed since “apportionments may contain sensitive information which, if disclosed publicly automatically, may pose a danger to national security and foreign policy.”

“While there may be some information that is sensitive if disclosed publicly, it is certainly not the case that all apportionment data meets that standard,” he wrote. “Where there is such sensitive data that should be protected from public disclosure, those would be the exception and should not serve to take down the entire database.”

Lawsuits want public info restored

The two lawsuits — Citizens for Responsibility and Ethics in Washington v. Office of Management and Budget and Protect Democracy Project v. U.S. Office of Management and Budget — ask federal judges to require OMB to post the information online once again.

CREW wrote in its filing that OMB posted a public version of the database in July 2022, after Congress required it to do so in a government funding bill.

The Trump administration removed that webpage on March 24, though OMB “provided no notice or explanation prior to its removal,” according to the lawsuit.

The CREW lawsuit was filed in the U.S. District Court for the District of Columbia and assigned to Judge Emmet G. Sullivan, who was nominated by former President Bill Clinton.

Protect Democracy Project wrote in its lawsuit that the “laws requiring transparency for apportionments make it more difficult for the executive branch to impound funds unlawfully outside the view of Congress and the public.”

The Trump administration faces numerous lawsuits stemming from its efforts to block several departments and agencies from spending money appropriated by Congress, also known as impoundment.

The Impoundment Control Act of 1974 bars the executive branch from holding onto money instead of spending it as directed by Congress. But Vought has said several times he believes the law is unconstitutional.

Protect Democracy Project’s lawsuit was also filed in the U.S. District Court for the District of Columbia, though it hadn’t been assigned to a judge as of Monday afternoon.  

U.S. Senate Majority Leader John Thune, R-S.D., right, and Speaker of the House Mike Johnson, R-La., hold a press conference on the Republican budget resolution at the U.S. Capitol on April 10, 2025 in Washington, D.C. (Photo by Kayla Bartkowski/Getty Images)

This story was updated at 11:54 a.m. EDT.

WASHINGTON — U.S. House Republicans adopted a budget resolution Thursday, clearing the way for both chambers of Congress to write a bill extending 2017 tax cuts and bolstering funding for border security and defense, though the blueprint set vastly different targets for spending cuts.

The cliff-hanger 216-214 vote followed a tumultuous week on Capitol Hill. Far-right members of the GOP Conference said repeatedly they wouldn’t accept the outline, since it requires the House to write a bill that cuts spending by at least $1.5 trillion, while senators set themselves a floor of $4 billion in cuts.

Speaker Mike Johnson, R-La., was forced to postpone a floor vote on the budget resolution on Wednesday evening. But Johnson was able to secure the votes needed after he and Senate Majority Leader John Thune, R-S.D., announced Thursday morning that they were in agreement about meeting the higher threshold for spending cuts.

Johnson said both chambers of Congress “are committed to finding at least $1.5 trillion in savings for the American people, while also preserving our essential programs.”

“Many of us are going to aim much higher and find those savings because we believe they are there,” Johnson said. “We want to make the government more efficient, effective and leaner for the American people. And I think that will serve every American of every party. And we’re happy to do that.”

Despite the difference in reconciliation instructions, Thune said the Senate is “aligned with the House” when it comes to cutting spending over the next decade.

“The speaker has talked about $1.5 trillion,” Thune said. “We have a lot of United States senators who believe that is a minimum.”

Thune added he believes it’s time for Congress “to get the country on a more sustainable fiscal path and that entails us taking a hard scrub of our government and figuring out where we can find those savings.”

Democrats, and some centrist Republicans, have expressed deep concerns the House’s instructions require the Energy and Commerce Committee, which oversees Medicaid, to cut at least $880 billion.

The panel, which also oversees Medicare and other programs, could not recoup that level of spending without pulling hundreds of billions from Medicaid, the state-federal program for lower-income Americans and some people with disabilities.

The budget resolution has been endorsed by President Donald Trump, who’s repeatedly urged the House to adopt the measure. “Great News! “The Big, Beautiful Bill” is coming along really well. Republicans are working together nicely. Biggest Tax Cuts in USA History!!! Getting close. DJT,” Trump posted on social media Thursday morning prior to the vote.

Kentucky Rep. Thomas Massie and Indiana Rep. Victoria Spartz were the only members of the Republican Party to vote against approval.

“If you were trying to hasten financial collapse of our country and bribe voters to go along with it, the strategy wouldn’t look much different than what Congress is doing today,” Massie wrote on social media. “The big beautiful bill cuts taxes while keeping spending on an increasingly unsustainable trajectory.”

Spartz wrote in a social media post of her own that the reconciliation instructions “we voted on today are still setting us up for the largest deficit increase in the history of our Republic, & opening up a ‘pandora’s box’ by changing accounting rules to hide it.

“In good conscience, I couldn’t vote YES.”

Only a beginning

The House adopting the 68-page budget resolution only marks the start of the months-long journey of writing and voting on the reconciliation package.

Republicans hope to use that bill to permanently extend the 2017 tax law, increase spending on border security and defense by hundreds of billions of dollars and rework energy policy.

The budget resolution includes different budget targets for many of those goals, and for raising the debt limit. It calls on the House to increase the country’s borrowing authority by $4 trillion, while the Senate’s instructions say that chamber would lift the debt ceiling by up to $5 trillion.

Writing the various elements of the reconciliation package will fall to 11 committee chairs in the House and 10 committee leaders in the Senate, as well as Johnson, Thune and a lot of staffers.

In the House, the Agriculture Committee needs to slice at least $230 billion; Education and Workforce must reduce spending by a minimum of $330 billion; Energy and Commerce needs to cut no less than $880 billion; Financial Services must find at least $1 billion in savings; Natural Resources has a minimum of $1 billion; Oversight and Government Reform has a floor of $50 billion; and the Transportation Committee needs to reduce deficits by $10 billion or more.

Four Senate committees — Agriculture, Nutrition, and Forestry; Banking, Housing and Urban Affairs; Energy and Natural Resources; and Health, Education, Labor and Pensions, or HELP — must each find at least $1 billion in spending cuts over the 10-year budget window.

House committees that can increase the federal deficit include the Armed Services Committee with a cap of $100 billion in new spending, Homeland Security with a $90 billion ceiling for new funding for programs it oversees, Judiciary with a maximum of $110 billion and Ways and Means, which can increase deficits up to $4.5 trillion for tax cuts.

Senate committees also got instructions for increasing the deficit, which will allow them to spend up to the dollar amount outlined in the budget resolution. Those committees include Armed Services at $150 billion; Commerce, Science and Transportation with $20 billion; Environment and Public Works at $1 billion; Finance with $1.5 trillion in new deficits, likely for tax cuts; Homeland Security at $175 billion and Judiciary with $175 billion.

The back story

If the process to reach agreement on a final reconciliation package is anything like the path to adopting the budget resolution, it will be long, winding and filled with drama.

The Senate voted for a completely different budget resolution in February that would have set up Congress to enact Republicans’ agenda in two reconciliation bills instead of one.

Budget Chairman Lindsey Graham, R-S.C., referred to the reconciliation instructions in that budget proposal as “Plan B.”

That tax-and-spending blueprint would have had lawmakers first write a bill increasing funding for border security and defense, and rewriting energy policy, before debating another bill later in the year to extend the 2017 tax law and cut federal spending.

The House voted about a week later to approve its original budget resolution, but not without a bit of theatrics.

Johnson didn’t originally have the votes and opted to recess the chamber before calling lawmakers back about 15 minutes later to approve that version of the budget resolution.

The Senate made changes to its reconciliation instructions in the House-approved budget resolution, before voting to send it back across the Capitol for their colleagues to vote on final approval, which they did Thursday.

Politically difficult votes ahead

Each time the Senate voted on a budget resolution it undertook a marathon amendment voting session, known as a vote-a-rama, where lawmakers stay on the floor overnight to debate various aspects of the outline.

Senators will need to undertake one more of those when they debate the actual reconciliation package later this year, though the stakes will be much higher.

The budget resolution is a blueprint for how Congress wants to shape tax and spending policy during the 10-year budget window. It’s not a bill so it never becomes law. And it contains no actual money, it’s simply a plan for how lawmakers want to structure policy.

The reconciliation package, once written, will have the chance of becoming law, so any amendments offered during the Senate’s vote-a-rama will carry greater weight than the proposals voted on when the chamber took up the two budget resolutions.

Democrats will have an opportunity to challenge centrist GOP senators on whether they support or want to remove every single policy that Republicans put in their reconciliation package.

That could create real issues for GOP leadership if they include tax policy or spending cuts that cannot garner the backing of senators like Alaska’s Lisa Murkowski, Kentucky’s Mitch McConnell, Maine’s Susan Collins and others.

The final reconciliation package will need support from nearly every Republican in Congress. GOP leaders will not be able to lose more than three House lawmakers or three Republican senators, under their very slender majorities. 

Four or more Republicans opposing the reconciliation package in one chamber, either because it cuts too much spending or doesn’t cut enough, would likely prevent it from becoming law. 

The U.S. Capitol, as seen on Oct. 9, 2024. (Photo by Jane Norman/States Newsroom)

WASHINGTON — U.S. House Speaker Mike Johnson postponed a vote on the budget resolution that was supposed to take place Wednesday, as he tried to get the support of far-right members of the party who object because it won’t go far enough to achieve their goals of slashing government spending.

Johnson, R-La., said he hoped the House would be able to vote on the tax and spending blueprint Thursday, before leaving town for a two-week recess, though he didn’t rule out setting up a conference process with the Senate, or changing the budget resolution and sending it back across the Capitol.

“We are working through some good ideas and solutions to get everybody there,” Johnson said. “It may not happen tonight, but probably by tomorrow morning.”

Johnson’s comments came after he huddled behind closed doors for about an hour with more than a dozen far-right House Republicans who believe the budget resolution doesn’t require the Senate to cut enough spending.

“We want everybody to have a high degree of comfort about what is happening here,” Johnson said. “And we have a small subset of members who weren’t totally satisfied with the product as it stands. So we’re going to talk about maybe going to conference with the Senate, or adding an amendment. But we’re going to make that decision. We are going to continue to move forward. This is all positive.”

The House and Senate are far from agreement on how much to reduce federal spending later this year when they write the reconciliation bill.

The House instructions call on numerous committees to cut spending by at least $1.5 trillion, with more than half of that deficit savings coming from the committee that oversees Medicaid. Those instructions would likely lead to hundreds of billions in federal funding being pulled from the program, though Republicans insisted during floor debate they were only looking to address waste, fraud and abuse.

The Senate has given itself a floor of $4 billion in spending cuts, which could lead to substantial deficit increases. The nonpartisan Committee for a Responsible Federal Budget released analysis last week, showing the reconciliation package could bolster deficits by up to $5.8 trillion during the next decade.

Trump lobbying, last-minute drama

House debate, which took place before the vote was delayed, followed days of lobbying by House GOP leaders and President Donald Trump, who urged holdouts to adopt the budget resolution during a campaign fundraising dinner Tuesday evening.

“I think we are there,” Trump said. “But just in case there are a couple of Republicans out there, you just got to get there, close your eyes and get there. It’s a phenomenal bill. Stop grandstanding, just stop grandstanding.”

That didn’t sway everyone, however, leading Speaker Johnson to pull about a dozen of the far-right members off the floor Wednesday evening just as the House was supposed to move on to the budget vote.

The rest of the chamber’s lawmakers waited on the floor for more than an hour as the group huddled nearby.

Freedom Caucus Chairman Andy Harris, R-Md., Pennsylvania Rep. Scott Perry, South Carolina Rep. Ralph Norman, Tennessee Rep. Tim Burchett and Texas Rep. Chip Roy were among the members to get summoned off the floor by Johnson.

Scalise pleads to ‘get America back on track’

House Majority Leader Steve Scalise, R-La., called on Republicans to adopt the budget resolution earlier in the day during floor debate, saying it “just opens the door to” using the complex budget reconciliation process to enact their agenda.

“The process where 11 of our committees here in the House will go to work to start making improvements in so many areas to get America back on track,” Scalise said. “And ultimately, that’s why we all come here. We come here to solve big problems. We deal with small issues too. But every now and then — and it’s not often — you deal with a big issue that can actually improve the lives of families all across this country.”

Budget Committee ranking member Rep. Brendan Boyle, D-Pa., said members of his party wouldn’t allow the parts of the 2017 tax law that benefit the middle class to expire at the end of the year, rejecting claims from GOP lawmakers.

“If you’re a middle-class American, if you are in the 99%, you will not see your taxes go up next year,” Boyle said. “There is no question about that. What is at issue is the tax cuts for multimillionaires, billionaires and big corporations.”

Pennsylvania Republican Rep. Lloyd Smucker said he couldn’t vote to approve the budget resolution since the Senate’s instructions for spending cuts were “not acceptable.”

“To me, it’s important we have the guardrails in the initial resolution,” Smucker said, before encouraging House leaders to amend the budget resolution to increase the amount of spending cuts the Senate must implement.

“I can’t vote on this bill as it is, but there’s a path forward here and that is very, very important,” Smucker said.

Roy of Texas also spoke out against the budget resolution, saying the Senate’s instructions didn’t go far enough to reduce deficits.

“The Senate sent over a joke. And we’re going to capitulate to the Senate, knowing full well that the Senate instructions carry the day,” Roy said. “And we’re going to be sitting there in a reconciliation debate, where we’re going to end up on the short end of the stick. But worse, the American people are going to end up on the short end of the stick because it absolutely increases deficits. No one can deny it.”

Roy added that members of Congress should “pass a math test” because the numbers in the budget resolution didn’t add up.

Lengthy struggle

Republican leaders have struggled for months to get the vast majority of their members on board with the outline.

Even if the House finally approves the resolution, Johnson and Senate Majority Leader John Thune, R-S.D., have months of work ahead of them as committees begin writing and debating their sections of the reconciliation package.

The budget resolution tasks 11 House committees and 10 Senate panels with meeting vague budget targets. Committees either have a minimum amount of spending to cut or a maximum amount of deficits they can create.

The House and Senate are relatively aligned on some of those targets, though they are far apart on spending cuts and potentially tax policy.

In the House, the Agriculture Committee needs to slice at least $230 billion; Education and Workforce must reduce spending by a minimum of $330 billion; Energy and Commerce needs to cut no less than $880 billion; Financial Services must find at least $1 billion in savings; Natural Resources has a minimum of $1 billion; Oversight and Government Reform has a floor of $50 billion; and the Transportation Committee needs to reduce deficits by $10 billion or more.

The Energy and Commerce Committee’s instructions have been a central issue for Democrats, and many centrist Republicans, who are concerned that Medicaid, the state-federal health program for lower-income people, will be a target for hundreds of billions in cuts.

Four Senate committees — Agriculture, Nutrition, and Forestry; Banking, Housing and Urban Affairs; Energy and Natural Resources; and Health, Education, Labor and Pensions, or HELP — must each find at least $1 billion in spending cuts over the 10-year budget window.

House committees that can increase the federal deficit include the Armed Services Committee with a cap of $100 billion in new spending, Homeland Security with a $90 billion ceiling for new funding for programs it oversees, Judiciary with a maximum of $110 billion and Ways and Means, which can increase deficits up to $4.5 trillion for tax cuts.

Senate committees also got instructions for increasing the deficit, which will allow them to spend up to the dollar amount outlined in the budget resolution. Those committees include Armed Services at $150 billion; Commerce, Science and Transportation with $20 billion; Environment and Public Works at $1 billion; Finance with $1.5 trillion in new deficits, likely for tax cuts; Homeland Security at $175 billion and Judiciary with $175 billion.

House instructions call for the reconciliation package to raise the debt limit by $4 trillion while the Senate’s plans say lawmakers can raise it by up to $5 trillion.

Slim majority

Assuming the House adopts the budget resolution, GOP leaders will need to keep nearly all of their members supportive during the next couple months as those numbers turn into tangible policy proposals.

House Republican leaders can only lose three members on party-line votes, given their paper-thin 220-lawmaker majority.

The same number of GOP senators can vote against the final reconciliation package as long as Vice President J.D. Vance casts the tie-breaking vote.

Any more Republicans opposing the package would prevent it from becoming law. 

A Social Security Administration field office in San Jose, California. The Trump administration plans to reduce the Social Security Administration’s workforce from 57,000 to 50,000 and close six of its ten regional offices. (Photo: Michael Vi/Getty Images)

WASHINGTON — A handful of leading U.S. Senate Democrats on Wednesday asked the Social Security Administration’s acting inspector general to examine how reductions in staff, closing some regional offices and other changes implemented by the Trump administration have impacted the safety net program.

“These actions have already created a chilling effect among the agency’s workforce, with several senior SSA officials with centuries’ worth of institutional knowledge and experience having already left the agency,” the five senators wrote in a letter. “We are concerned that this hostile environment will foster burnout, low morale, higher attrition, and worse productivity among employees.

“Collectively, this will undoubtedly lead to disruption in benefit payments and increasing barriers for Americans to access their Social Security benefits.”

Senate Minority Leader Chuck Schumer, D-N.Y., Finance Committee ranking member Ron Wyden, D-Ore., Elizabeth Warren, D-Mass., Special Committee on Aging ranking member Kirsten Gillibrand, D-N.Y., and Mark Kelly, D-Ariz., signed the letter.

They requested the office look into how the changes have impacted customer service throughout the agency, the speed of disability appeals hearings and how quickly employees can process clearances, among other requests.

The senators asked the acting inspector general to share quarterly updates on the effects “of the agency reorganization and any future workforce reductions” on customer service.

The Social Security Administration’s office of the inspector general didn’t immediately respond to a request from States Newsroom about whether the independent watchdog would respond to the letter.

Staff cuts

The Trump administration released a plan earlier this year to reduce the Social Security Administration’s workforce from 57,000 to 50,000 and close six of its ten regional offices.

The Social Security Administration’s acting commissioner also announced that the agency would reduce its budget by $800 million during the current fiscal year through freezing SSA and Disability Determination Services hiring and “drastically” reducing overtime within that division, canceling Information Technology Systems contracts and closing down office space.

U.S. DOGE Service, led by billionaire Elon Musk, has been spearheading efforts within the Trump administration to cut spending and restructure the executive branch.

Musk, however, plans to shift his attention back toward his businesses starting in May after watching Tesla’s stock drop more than 40% this year, according to news reports.

Nominee pledges to reduce wait times

President Donald Trump’s pick to lead the SSA, Frank Bisignano, hasn’t yet received Senate confirmation but did pledge during his hearing in March that if approved, he would ensure beneficiaries have the option to visit an office, use the website, or speak to a real person after calling the 1-800 number.

“On the phone, I’m committed to reducing wait times and providing beneficiaries with a better experience; waiting 20 minutes-plus to get an answer will be of yesteryear,” Bisignano said at the time. “I also believe we can significantly improve the length of the disability claim process.”

The Senate Finance Committee voted along party lines earlier this month to send Bisignano’s nomination to the floor, though GOP leaders haven’t scheduled a vote.

Democrats have criticized the Trump administration’s actions toward the Social Security Administration for months, arguing that staff cuts and proposed changes to how the agency operates could cause significant issues for recipients.

Former President Joe Biden made changes to the Social Security Administration the subject of his first public address after leaving office, urging the Trump administration to reverse course.

“Social Security is about more than retirement accounts. It’s about honoring a fundamental trust between government and people,” Biden said during the Chicago appearance. “It’s about peace of mind for those who work their whole lives, so they can rest assured they’ll have a chance to get back some of what they earned and what they deserve.”

A nurse gives an MMR vaccine at the Utah County Health Department on April 29, 2019, in Provo, Utah. The vaccine is 97% effective against measles when two doses are administered. (Photo by George Frey/Getty Images)

WASHINGTON — Americans are increasingly unsure what to believe about measles as an outbreak spreads throughout the country, according to a survey released Wednesday by the nonpartisan health research organization KFF.

The poll shows that nearly a quarter of those asked believe a commonly repeated false claim that getting a child vaccinated against measles could lead to autism. About the same percentage of those surveyed believe it’s either definitely or probably true that vitamin A can prevent someone from contracting measles, even though it cannot.

And 19% of those surveyed believed untrue statements that the vaccine for measles is more dangerous than contracting the virus.

Parents who believed at least one of the three incorrect claims were more likely to have delayed or skipped some vaccinations for their children. Nearly a quarter, 24%, of those surveyed said they haven’t protected their children via vaccination, more than double the 11% of parents who responded that all three of the false statements about measles were definitely or probably untrue.

Ongoing outbreak

The Centers for Disease Control and Prevention reports that as of late last week there are more than 800 measles diagnoses throughout at least 25 states.

The infections are spread throughout different age groups with 31% of cases in children under five years old, 38% of diagnoses in those between five and 19 years old, 29% in people above the age of 20 and 2% in those with an unknown age, according to the CDC.

Eighty-five patients have been hospitalized and three have died. Nearly all of the confirmed cases, 96%, are in people who have not received the MMR vaccine or who are unsure about their vaccination status, according to the CDC.

States with confirmed cases include Alaska, Arkansas, California, Colorado, Florida, Georgia, Hawaii, Indiana, Kansas, Kentucky, Maryland, Michigan, Minnesota, New Jersey, New Mexico, New York, Ohio, Oklahoma, Pennsylvania, Rhode Island, Tennessee, Texas, Vermont and Washington.

Virginia reported its first case this year over the weekend, though that’s not yet included on the CDC’s website about the ongoing outbreak.

Understanding linked with concern

KFF’s survey shows that even though there are many people who believe untrue claims about measles or the MMR vaccine — which protects against measles, mumps and rubella — there are higher percentages of people who understand basic facts about the virus and who are concerned about the ongoing outbreak.

Seventy-five percent of those polled said it was incorrect that the MMR vaccine leads to autism, 81% responded it was wrong to say the vaccine is more dangerous than contracting the virus and 75% said it was false that vitamin A can prevent someone from getting measles.

About half, or 51%, of those surveyed said they are at least somewhat concerned about the spread of measles. That worry was highest among Hispanic adults, 62%, and Black adults, 61%.

Most of the people surveyed, 56%, knew that the spread of measles was higher this year than during prior years, though that number varied among people of different political leanings.

Seventy-one percent of Democrats knew that diagnoses of measles have spiked in recent months, compared with 54% of independents and 49% of Republicans.

KFF conducted the survey of 1,380 adults between April 8 and April 15 via telephone and online questions. 

Food and Drug Administration Commissioner Marty Makary holds up a container of carrot juice as he speaks during a news conference at the Health and Human Services Department headquarters in Washington, D.C., on April 22, 2025. Makary and Health and Human Services Secretary Robert F. Kennedy Jr. spoke about the FDA's intent to phase out synthetic food dye and offered carrot juice and other juices as possible alternatives. (Photo by Andrew Harnik/Getty Images)

WASHINGTON — Trump administration health officials announced Tuesday they hope to eliminate eight petroleum-based synthetic dyes from the nation’s food supply before the end of next year, though they haven’t received guarantees or written agreement from food companies.

Food and Drug Administration Commissioner Marty Makary detailed efforts to phase out the dyes during a press conference alongside Health and Human Services Secretary Robert F. Kennedy Jr. at the department’s Washington, D.C., headquarters.

“Let’s be honest, taking petroleum-based food dyes out of the food supply is not a silver bullet that will instantly make America’s children healthy, but it is one important step,” Makary said.

The FDA’s proposal would revoke authorization for Citrus Red No. 2 and Orange B while setting up the agency to work “with industry to eliminate” Green No. 3, Red No. 40, Yellow No. 5, Yellow No. 6, Blue No. 1 and Blue No. 2.

FDA will also authorize new, natural food dyes in the months ahead.

Kennedy said the Trump administration has an “understanding,” but not an “agreement” with food companies that use the dyes, before deferring to Makary, who said that “you win more bees with honey than fire.”

“There are a number of tools at our disposal. And so I believe in love, and let’s start in a friendly way and see if we can do this without any statutory or regulatory changes,” Makary said. “But we are exploring every tool in the toolbox to make sure this gets done very quickly. And they want to do it. They want to do it.

“So why go down a complicated road with Congress when they want to do this? They don’t want to deal with the patchwork of 30 different state plans.”

Christopher Gindlesperger, senior vice president of public affairs and communications at the National Confectioners Association, released a written statement that didn’t appear to agree entirely with the FDA’s proposed phase-out, however. 

“FDA and regulatory bodies around the world have deemed our products and ingredients safe, and we look forward to working with the Trump Administration and Congress on this issue,” Gindlesperger wrote. “We are in firm agreement that science-based evaluation of food additives will help eliminate consumer confusion and rebuild trust in our national food safety system.”

Removing additives

During the press conference, Makary held up watermelon, beet and carrot juices in clear containers, encouraging food companies to use those as dye, instead of the ones that may be removed from the market.

“We are simply asking American food companies to replace petroleum-based food dyes with natural ingredients for American children, just as they already do for children in other countries,” he said. “American children deserve good health.”

Makary said he believes there are several health conditions associated with petroleum-based synthetic dyes in food, including attention-deficit/hyperactivity disorder, obesity, diabetes, insulin resistance, cancer, genomic disruption, gastrointestinal issues, and allergic reactions.

Kennedy said his goal as HHS secretary is to remove all additives in food served in schools “that we can legally address.”

The department, Kenedy said, will also work with Congress and President Donald Trump to increase labeling for food ingredients that Kennedy called addictive, including sugar.

“There’s things that we’ll never be able to eliminate, like sugar. And sugar is poison and Americans need to know that,” Kennedy said. “It is poisoning us. Is giving us a diabetes crisis.”

Health effects unclear

Martin Bucknavage, senior food safety extension associate at Penn State University, said during an interview with States Newsroom that petroleum-based synthetic food dyes are derived just to get the color.

“It’s not like it’s just a nasty chemical that they’re putting in there,” he said. “It’s something that’s been taken, it’s been chemically made, modified and then purified, so that it is just that chemical that provides that color. And then those colors have been studied.”

Similar to the complicated nature of nutrition studies — which can have a challenging time separating out a person’s genetics, exercise and environmental factors from one specific part of their diet — research on food dyes hasn’t been conclusive, Bucknavage said.

“In some cases, it does have an impact on hypersensitivity, but not in all cases,” he said. “And not all studies are basically showing the same thing. So there’s a lot of variability that exists out there.

“And I’m not saying, ‘Listen, we shouldn’t go through and study these things more and get better information on them.’ We certainly should. But again, it’s not an easy thing to do. Some of these studies take time and take a lot of money and sometimes the results are kind … more variable in terms of the results.”

States regulating dyes

The FDA’s announcement wasn’t the first time the federal government or state lawmakers have sought to ban food additives or synthetic dyes.

The Biden administration announced in January that the federal government would ban Red No. 3 in food beginning in 2027 and from medicines in 2028. Makary said during the press conference Tuesday the current administration plans to ask companies to phase out that dye sooner.

California lawmakers approved a bill in 2023 that will ban Red No. 3, propylparaben, brominated vegetable oil and potassium bromate from food starting in 2027.

The following year, legislators in the Golden State approved another measure that, starting in 2028, will ban six food dyes — Blue 1, Blue 2, Green 3, Red 40, Yellow 5 and Yellow 6 — from being sold in schools.

Those two state laws followed the California Environmental Protection Agency’s Office of Environmental Health Hazard Assessment releasing a report in 2021 that concluded “scientific literature indicates that synthetic food dyes can impact neurobehavior in some children.”

Virginia lawmakers approved legislation earlier this year that Gov. Glenn Youngkin signed in March to ban some artificial food dyes in public schools, starting in July 2027.

In deeply red West Virginia, Republican Gov. Patrick Morrisey signed a bill a few days later that will prevent seven artificial dyes from being sold in grocery stores starting in 2028 or included in school lunches starting in August.

Arizona and Utah have implemented laws of their own addressing food dyes.

The Environmental Working Group, an advocacy organization focused on strengthening health standards, reports that legislators in several states, including Arkansas, Florida, Indiana, Iowa, Kentucky, Louisiana, Maryland, Minnesota, Missouri, New Jersey, New Mexico, North Carolina, Oklahoma, Oregon, Pennsylvania, Rhode Island and Washington have introduced bills that could ban certain food dyes or chemicals.

Melanie Benesh, EWG vice president for government affairs, wrote in a statement about the FDA announcement that the federal agency “has known for decades that synthetic food dyes are linked to health problems, particularly in children, but has failed to act.”

“We’re pleased the administration is following the lead of states like California and West Virginia by finally announcing their intent to ban dyes,” Benesh wrote. “We’re grateful that states like California and West Virginia have forced the FDA to make food safety a bigger priority.”

Peter Lurie, president and executive director of the self-described food and health watchdog group Center for Science in the Public Interest, wrote in a statement released Monday that Americans “don’t need synthetic dyes in the food supply, and no one will be harmed by their absence.”

“The most important thing to know about food dyes is that their only purpose is to make food companies money,” Lurie wrote. “They are purely cosmetic, serving no nutritional function. In other words, food dyes help make ultra-processed foods more attractive, especially to children, often by masking the absence of a colorful ingredient, like fruit.”

Ashley Murray contributed to this report. 

Secretary of Defense Pete Hegseth speaks during his Senate Armed Services Committee confirmation hearing on Jan. 14, 2025. (Photo by Andrew Harnik/Getty Images)

WASHINGTON — President Donald Trump said Monday he fully supports the secretary of Defense, despite The New York Times reporting over the weekend that Pete Hegseth shared details of a bombing campaign in Yemen in a second group chat, this time with his wife and brother.

“Ask the Houthis how much dysfunction there is?” Trump said, referring to the Iranian-backed terrorist organization that operates in Yemen. “There’s none. Pete’s doing a great job. Everybody’s happy with him.”

The New York Times published an article Sunday detailing a second group chat on the encrypted, commercial messaging app Signal, where Hegseth shared information about U.S. military plans.

Hegseth, asked during the White House Easter Egg roll on Monday about the latest New York Times report, didn’t deny that he sent messages in another group chat.

“What a big surprise that a few leakers get fired and suddenly a bunch of hit pieces come out from the same media that peddled the Russia hoax, won’t give back their Pulitzers, they got Pulitzers for a bunch of lies,” Hegseth said. “As they peddle those lies no one ever calls them on it. See, this is what the media does. They take anonymous sources from disgruntled former employees and then they try to slash and burn people and ruin their reputations.”

The New York Times report was the second time in less than a month that Hegseth’s discussion of military operations on the app came to light.

Someone on a chat meant to comprise only high-level administration officials accidentally included Jeffrey Goldberg, editor-in-chief of The Atlantic, who published an article in late March on the experience.

That group chat included Vice President J.D. Vance, Hegseth, Secretary of State Marco Rubio, Director of National Intelligence Tulsi Gabbard, CIA Director John Ratcliffe, National Security Advisor Michael Waltz and others. In that chat, Hegseth shared a precise timeline of U.S. bombing of Houthi targets in Yemen.

The Defense Department’s Office of the Inspector General opened an investigation earlier this month “to determine the extent to which the Secretary of Defense and other DoD personnel complied with DoD policies and procedures for the use of a commercial messaging application for official business. Additionally, we will review compliance with classification and records retention requirements.”

The OIG investigation came after U.S. Senate Armed Services Committee Chairman Roger Wicker, R-Miss., and ranking member Jack Reed, D-R.I., sent a letter to the acting inspector general asking the independent watchdog agency to look into the issue.

While Trump and most congressional Republicans continued to back Hegseth, Nebraska Republican Rep. Don Bacon raised concerns Monday about the operational security risk of communicating on “perceived secure applications” like Signal.

In a social media post that did not name Hegseth or specifically reference Signal, Bacon wrote that “admin officials must assume their phones are closely monitored by China & Russia.”

“They’re top priority targets. Our adversaries can put thousands of people in position just to monitor their phones & to penetrate perceived secure applications on non-secure phones,” Bacon wrote. “I’ve assumed my phones were monitored since I was a Colonel in Iraq & as Commander at Ramstein.”

The U.S. Supreme Court is pictured Oct. 9, 2024. (Photo by Jane Norman/States Newsroom)

WASHINGTON — The U.S. Supreme Court announced Thursday it will hear oral arguments next month over President Donald Trump’s efforts to restructure birthright citizenship, though the justices won’t decide on the merits of the case just yet. 

Instead, they will choose whether to leave in place nationwide injunctions from lower courts that so far have blocked the Trump administration from implementing the executive order.

The oral arguments, scheduled for May 15, will likely provide the first indication of whether any of the nine justices are interested in revisiting the Court’s interpretation of the 14th Amendment, which was ratified in 1868 following the Civil War.

The amendment states that “all persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the State wherein they reside.”

The Supreme Court ruled in 1898 in United States v. Wong Kim Ark that the 14th Amendment guarantees any child born in the United States is entitled to U.S. citizenship, even if their parents are not citizens.

Trump disagrees with that ruling and signed an executive order on his first day in office seeking to change which babies born in the United States become citizens. If that order were implemented, babies whose parents were “unlawfully present in the United States” or whose parents’ presence “was lawful but temporary” would not be eligible for citizenship.

Several organizations and Democratic attorneys general filed lawsuits seeking to block the executive order, leading to nationwide injunctions against its implementation.

Last month, the Trump administration asked the Supreme Court to intervene in the lower court’s nationwide injunctions, limiting them to the organizations and states that filed suit.

The three cases are Trump v. State of Washington, Trump v. CASA, Inc. and Trump v. State of New Jersey.

Legislation

Nationwide injunctions by lower court judges have become an issue for Republicans in Congress as well as the Trump administration.

Iowa Republican Sen. Chuck Grassley introduced a bill in Congress that would bar federal district court judges from being able to implement nationwide injunctions.

“We all have to agree to give up the universal injunction as a weapon against policies we disagree with,” Grassley said during a hearing earlier this month. “The damage it causes to the judicial system and to our democracy is too great.”

U.S. Health and Human Services Secretary Robert F. Kennedy Jr. speaks during a press conference at the department's headquarters in Washington, D.C., on Wednesday, April 16, 2025.  (Photo by Jennifer Shutt/States Newsroom)

WASHINGTON — U.S. Health and Human Services Secretary Robert F. Kennedy Jr. announced Wednesday the department will shift its research into autism toward potential environmental causes, though he declined to say exactly what the Trump administration would do if certain industries or pollutants were found responsible.

Kennedy, an environmental lawyer with no medical or research training, declared that autism is a preventable disease, argued research into genetic causes is a “dead end” and asserted that “we know it’s environmental exposure,” before saying HHS would fund “a series of new studies to identify precisely what the environmental toxins are that are causing it.”

“This has not been done before,” Kennedy said. “We’re going to do it in a thorough and comprehensive way and we’re going to get back with an answer to the American people very, very quickly.”

Kennedy said during his first press conference since receiving Senate confirmation that he wanted researchers to look into numerous potential factors, including mold, food additives, pesticides, air, water, medicines, ultrasound, age of parents, obesity in parents and diabetes in parents.

He pledged to have “some of the answers by September,” though he added the research will “be an evolving process.”

Kennedy appeared confident in his personal assessment that environmental factors lead to autism, without attributing that belief to any one industry or contaminant.

“This is coming from an environmental toxin and somebody made a profit by putting that environmental toxin into our air, our water, our medicines, our food,” Kennedy said. “And it’s to their benefit to normalize it, to say, ‘This is all normal. It has always been here.’ But that’s not good for our country.”

Autism experts, however, cast doubt on Kennedy’s assertion that environmental factors lead to autism and questioned his proposed timeline to prove such a link.

When asked by a reporter what exactly the Trump administration would do if research found conclusive evidence that one specific industry or pollutant was causing autism, Kennedy didn’t say whether HHS would push to ban it or close down any businesses. 

“I think we’re going to figure out a way to make pressure on them to remove it,” he said. “I think also there will be market forces that also exert pressure on them to remove it.”

Research difficult

Catherine Lord, professor of psychiatry with the school of medicine at the University of California, Los Angeles, said during an interview with States Newsroom following Kennedy’s remarks that trying to reach a definitive cause of autism before September was an “utterly ridiculous” timeline.

Lord said “the most likely hypothesis is that there may be interactions between genetics and, for example, environmental exposures, or even experiences like extreme prematurity.”

But she noted that studying the impact of environmental contaminants on people’s health, or a complex diagnosis like autism, is challenging because scientists obviously cannot expose people to toxins.

“It’s so difficult to do that work well, and people do it, but they can’t do it quickly,” Lord said. “And so I think that we do need work in that area, and I think it has been funded in the last few years. It just hasn’t come out with anything that is earth-shattering. It’s more the same thing, which is that if you’re exposed to something bad, your chances of having a child with any kind of neurodevelopmental disorder is going to go up.”

Lord expressed concern about moving funding and research away from genetic factors, saying “we do know that autism is genetic, so I think that is not under question.”

“I think the genetic work was moving forward,” she said. “It’s a slow pace, again, because they’re addressing so many different genetic patterns. But I think that at least there’s clear progress within this science.”

Limits funding for genetic research

Eric Fombonne, professor emeritus of psychiatry at Oregon Health and Science University, said during an interview that it was unwise for Kennedy to say there would be some answers about autism within a few months.

“It’s ridiculous to say that he’s going to unravel the etiology of autism in six months,” Fombonne said. “I mean, he could give, like, all the money of the world to any lab or any person. They could never report any results before several years from now, at the minimum.”

The pace of medical research, he said, is slow and Kennedy’s comments show “a complete ignorance and disregard for science and what we do and how complicated it is and the time it takes.”

Directing research dollars toward possible environmental contributors to autism will also limit the amount of funding available for genetic research, which Fombonne said “has been incredibly productive.”

“The pie is limited,” Fombonne said. “So if you move funds from genetic research to environmental research, you’re going to slow down the pace of genetic research.”

Fombonne explained that research into genetics and autism is “quite complicated” and has shown that not all genetic mechanisms are “the same across different families.”

“So it’s a very complex puzzle. And as you know, the brain is a very hard organ to study. So understanding the pathophysiology, which is associated with these gene variants, is a very hard process,” he said. “But we are doing that and we are progressing. And this has been paying off enormously over the last 20 or 30 years.”

Fombonne wouldn’t make the same assessment of potential environmental factors, saying there are no signs of higher rates of autism in certain areas or certain time periods, like scientists have found for some other conditions.

“There is no evidence that there is a cluster of cases of kids who have been living in a polluted area, or exposed to particular environmental circumstances,” Fombonne said. “There is no starting point, which is strong, to start environmental research somewhere we can say is going to pay off.

“So it’s going to be very exploratory initially, which may be a good thing to do. But at least, let’s do it well, and most of the studies so far are short.”