| |  | The Lead Brief | Two top Trump administration officials are out amid a shake-up at the Department of Health and Human Services ahead of November’s crucial midterm elections, when Republicans will be defending their control of both chambers on Capitol Hill. My Washington Post colleagues Lauren Weber, Rachel Roubein and Dan Diamond have all the details in their latest story. They talked to more than a half-dozen people with knowledge of the changes, which include the high-level departures and a number of other deputies gaining more responsibility. Who’s out - Jim O’Neill, who had served as the deputy secretary of HHS and acting director of the Centers for Disease Control and Prevention, will leave both positions.
He’s been interim leader of the CDC since August, when Health Secretary Robert F. Kennedy Jr. fired Susan Monarez from the role after the two clashed over vaccines. Last month, O’Neill announced the controversial overhaul of the childhood vaccine schedule. O’Neill will be offered an ambassador position, my colleagues reported. - HHS General Counsel Mike Stuart will also be departing after just a few months. As the agency’s top lawyer, Stuart had been part of the administration’s efforts to go after fraud in states, mostly run by Democrats, and freeze billions in federal funds.
Why it matters: Although it’s too early to say what the overall shake-up means for the agency, the Trump administration is making the changes as Kennedy has been on a nationwide tour to emphasize the federal government’s approach to encouraging healthy food instead of the more divisive issue of vaccine policy. Politico first reported the moves. → This comes a day after HHS announced that it made “enhancements” to the health department’s leadership to push President Donald Trump’s so-called Great Healthcare Plan and the administration’s Make America Healthy Again agenda. Who’s up Some of those changes include putting Chris Klomp, who oversees the Medicare program, in charge of day-to-day operations at HHS as its new chief counselor. (He’ll maintain his role at the Centers for Medicare and Medicaid Services, an agency within HHS.) John Brooks, chief policy and regulatory officer at CMS, will now also be senior counselor at HHS for CMS-related issues. Two Food and Drug Administration officials — Kyle Diamantas, who leads the agency’s nutrition and food oversight, and Grace Graham, the top official in FDA’s policy shop — will also serve as senior counselors at HHS for FDA-related issues. Behind the curtain: Some of the health officials tapped to play a larger role at the department have helped lead the Trump administration’s “Most Favored Nation” drug-price initiative, a top priority for Trump. That work helped boost their standing at the White House, my colleagues report. The White House began considering reorganizing HHS’s leadership team last year amid controversial vaccine policy changes and struggles to stay on message. Those efforts began to accelerate in recent weeks, with The Post reporting that Brad Smith, a top health official during Trump’s first term, privately assessed and recommended staffing changes. Looking ahead The White House told The Post that Kennedy was aligned on the staffing moves. The administration touted its record on moving to make medicines cheaper, improve the nation’s food supply and other initiatives that officials said would be part of Republicans’ midterm messaging. “They’ve had plenty of victories,” a White House official, who spoke on the condition of anonymity to discuss personnel changes, told my colleagues. “We want to make sure they’re muscled up to keep delivering wins in the midterm year.” | 
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