Senate passes the tax-cut bill, House up next

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The Senate passed a $4.5 trillion tax-cut bill yesterday after making last-minute changes to its health care provisions as Republicans scrambled to get their party on board. The legislation would enact the largest cuts to federal health care spending in history, and the most sweeping changes for the industry since the 2010 passage of the Affordable Care Act.

Key changes in the latest version of the bill include the removal of provisions that would have banned federal Medicaid and Children’s Health Insurance Program funding from going to gender-affirming care. But another provision cutting off Planned Parenthood from Medicaid funds stayed, which the organization says could eliminate one in four abortion providers nationwide.

Next: The House must pass the Senate’s version of the bill, or embark on a potentially lengthy series of negotiations. As a reminder, President Trump wants to sign the bill by July 4 — two days from now. Read more from STAT’s D.C. team on the details of the bill and what challenges await it in the House. And if you find yourself wondering what exactly the Senate parliamentarian is, look no further than this week’s explainer video from Alex Hogan.

health

Teens got more bariatric surgery in the GLP-1 era

From 2021 to 2023, the number of teens in the U.S. getting metabolic and bariatric surgery increased nearly 15%, according to a study published in this month’s issue of the Journal of Pediatrics. Even after GLP-1 medications were FDA-approved as an obesity treatment for teens in December 2022, the number of surgeries increased among teens in 2023. That same year, surgeries decreased among adults.

The increase in surgeries was driven largely by Black and Hispanic adolescents, the study found. This signifies increased access and acceptance for a treatment that’s considered the “gold standard,” the study authors write. But it may also indicate unequal access to the newer, less invasive GLP-1 options. A recent MMWR report from the CDC found that while Black adolescents have a 27% higher rate of what’s called severe obesity than their white peers, in 2023, they were 39% less likely to receive a prescription for obesity medication.

health tech

Goodbye, Woebot

This week, therapeutic app developer Woebot Health shut down its core product: a smartphone app starring a cartoony bot that guides people through conversations meant to address anxiety and everyday problems using techniques from cognitive behavioral therapy. About 1.5 million people have used the bot, which issues pre-scripted responses that seemed more impressive before generative AI products like ChatGPT entered the scene, STAT’s Mario Aguilar writes.

Woebot founder and CEO Alison Darcy told Mario that shutting down the app is largely attributable to the cost and challenge of fulfilling the FDA’s requirements for marketing authorization. But the need to move on was also made more urgent by the advent of large language models that she wants to use, but the FDA hasn’t yet figured out how to regulate. The app’s fate underscores how the existing regulatory structures have struggled to keep up with new smartphone-based medical treatments and AI, Mario explains in his latest story. Read more.

first opinion

Tom Frieden breaks down RFK Jr’s anti-vax tactics

Samuel Corum/Getty Images

Last week, HHS Secretary Robert F. Kennedy Jr. announced that the U.S. will no longer contribute money to Gavi, a global alliance that helps provide vaccines to the world’s poorest children. In the message posted to X, Kennedy accused its members of “not taking vaccine safety seriously.” Former CDC director Tom Frieden takes issue with this claim, calling it “wrong and dangerous” in a new First Opinion essay.

In the same message, Kennedy also referenced a study that’s long been cited to claim that DPT vaccines are harmful to children. But Frieden says that study’s findings are “bullshit,” and breaks down the math on why. On top of that, “let’s apply common sense,” he writes. “This finding is clearly absurd, which is why no rigorous study has ever found anything like this.”

Read more from Frieden on how Kennedy’s tactics are straight from the anti-vaccine playbook.

health disparities

The link between segregation and lung cancer

While it’s long been understood by experts that socioeconomic factors significantly contribute to racial disparities in lung cancer rates, the impact of residential segregation in particular has been underexplored. But a study published yesterday in JAMA Network Open suggests a strong connection between where a Black person lives and their risk of lung cancer. In a cohort of more than 71,000 people living in Southern states between 2002 and 2019, lower residential segregation was significantly associated with decreased lung cancer risk for Black people — but not for their white peers.

There were some mediating factors — menthol smoking and exposure to fine particulate matter in the atmosphere influenced almost half of the association between segregation and cancer, according to the paper. But as the authors noted, that still leaves more than half of the variation in lung cancer risk for Black participants unexplained. While much more work needs to be done to reduce segregation, the authors note that there should also be public health efforts to address these mediating factors.

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What we're reading

Doctors don't get much menopause training. State lawmakers are trying to change that, NPR
People are using AI to 'sit' with them while they trip on psychedelics, MIT Technology Review
Psychedelic therapy shows promise in mid-stage study in treatment-resistant depression, STAT
What therapists treating immigrants hear, New Yorker
U.S. judge says HHS layoffs were likely unlawful and must be halted, AP

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