Pantsuits and Lawsuits with Attorneys General Kris Mayes and Dana Nessel

Tomorrow's Cures, Today's Cuts: The Hidden Cost of Health Agency Rollbacks

• Attorneys General Kris Mayes & Dana Nessel • Season 1 • Episode 15

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The dismantling of America's public health infrastructure is happening at breakneck speed, with potentially catastrophic consequences for generations to come. When top CDC scientists walk out in protest, we should all pay attention. That's exactly what we explore in this urgent conversation with Will Humble, Executive Director for the Arizona Public Health Association, who brings decades of public health leadership experience to help us understand what's at stake.

What happens when anti-vaccine ideology drives national health policy? The answer is chilling. Humble breaks down how the gutting of the Advisory Committee for Immunization Practices could lead to essential childhood vaccines being dropped from recommended schedules. Since these recommendations determine what's covered by both the Vaccines for Children program (serving over 50% of American children) and private insurance, the result would be widespread vaccine inaccessibility. At $200 per COVID vaccine and similar costs for other immunizations, many families simply couldn't afford to protect their children.

Beyond vaccines, the administration's proposed 40% cut to the National Institutes of Health threatens to collapse the research pipeline that delivers medical breakthroughs. As Humble explains, NIH-funded research on mRNA technology enabled rapid COVID vaccine development and now holds tremendous promise for cancer treatment. Cutting this funding doesn't just delay progress—it drives researchers overseas and creates a scientific brain drain that could take decades to rebuild.

The assault extends to medical education itself, with new loan limits making it financially impossible for many students to become doctors, especially in critically needed primary care fields. Combined with inadequate support for residency programs, these policies will worsen physician shortages, particularly in rural areas where healthcare access is already precarious.

The stakes couldn't be higher. Listen now to understand the full scope of this public health crisis and what we can do to fight back before it's too late. Share this episode with anyone who cares about protecting our nation's health and scientific leadership.

Attorney General Kris Mayes:

Hello everybody, Arizona Attorney General Chris Mays here.

Attorney General Dana Nessel:

And, hi, I'm Dana Nessel, Michigan Attorney General.

Attorney General Kris Mayes:

And we are so excited to welcome you back to another awesome episode of "Pantsuits and Lawsuits," your favorite place to catch up on all the"machinations of litigation and in the federal government and in state government and the tangled web that American jurisprudence is today. So welcome back.

Attorney General Dana Nessel:

Yeah, this week we are going to be tackling a pretty serious and disturbing subject area. We're going to be talking to Will Humble, who's the executive director for the Arizona Public Health Association, and discussing the Trump Administration's reckless, chaotic and dangerous dismantlement of the nation's medical research and public health infrastructure.

Attorney General Kris Mayes:

Yeah, and it's going to be awesome to have Will Humble. I think everybody's going to enjoy him and we've been so fortunate to have him out here in Arizona for a long time working on public health. But, man, has this issue ever come to the fore? It's never been so timely, Dana. We've seen, obviously, mass firings, lab closures, et cetera, at the CDC, at the FDA, and other agencies within HHS, but just in the last 48 hours we saw, I think, the three or four top scientists and top people at the CDC walk out in protest against the anti-science agenda of RFK Jr. So a very alarming situation going on. You have to wonder, and I think we'll probably learn more from them in the days to come, what exactly is going on inside the CDC.

Attorney General Dana Nessel:

Yeah, it's really, it's hard to say in terms of why all of this is happening. I guess I would say. I mean, clearly, I don't think any of us are surprised that RFK Jr. is behaving the way he is. I mean, he's been notorious for decades as somebody who's anti-vaccine and who does not subscribe to, you know, the decades and decades of research on the science of many different types of treatments, of all the way from just regular ailments to, you know, more nuanced types of diseases and infections, and the list goes on and on.

Attorney General Dana Nessel:

But I want to ask you this, Kris, if you have any theories. I know we try not to fall down the rabbit hole too much in terms of these conspiracies, but I mean, climate change. I got it right, like I understood exactly what the these members of the government were doing, working in coordination with big oil, fossil fuel companies for denial of climate change, because it benefited them financially to do so and it kept them selling their product. But what is this about, do you think? I understand things have changed substantially since COVID and, for some reason, it seemed to benefit Donald Trump to say that COVID wasn't that serious, it wasn't that big a deal, to downplay the number of people who became ill or died from it. But, I mean, all of this. What do you think is going on?

Attorney General Kris Mayes:

Well, I know and the COVID thing is fascinating to me as well and from this standpoint, when you really think about it, one of Donald Trump's most important and signature achievements was Operation Warp Speed and the development of the vaccine that's probably saved hundreds of thousands, if not millions, of lives, which now, of course, he doesn't take credit for at all. Never talks about it, right? And then he hires the RFK Jr. to head the nation's most important health agency, who is an anti-vaxxer, you know? And they are putting out guidance that will lead to fewer COVID vaccines being available, because if the CDC doesn't recommend it, then insurance companies don't pay for it. So I think that's why a lot of these guys just walked out of the CDC, because they didn't want to be and couldn't be a part of all of that. You know, I was just going back to your original question -- why do we think this is happening?

Attorney General Kris Mayes:

I mean, I will say that I think there is a part of the MAHA movement that resonates across the political spectrum and that is people feel as though our kids are less healthy than they used to be, are eating more poorly, and are getting too much junk food. As a mom of a 12-year-old, I can say that's something I worry about too, and I struggle with in terms of trying to make sure that my kiddo is not eating too much junk food either at school or at home, and so that is a good sentiment, right? Like that's something we all agree with. But, unfortunately, that then bleeds over into this vaccine realm, and that is a whole, whole different story.

Attorney General Dana Nessel:

Yeah. I mean, I think it's one thing to say that you don't want your child to eat too many Twinkies or Cheetos. It's another thing to say, "And so I'm also not going to get my child vaccinated against rubella.

Attorney General Kris Mayes:

Right. Our vaccine, yeah, on schedule, you know, or at all or at all. So it's going to be interesting to see how all this plays out. I hope it's -- the ending of all of this is not tragic.

Attorney General Kris Mayes:

That's one of the incredible ironies -- and frankly, there's a sadness associated with it -- of our litigation, is that states now that are being hit the hardest by these funding denials and claw backs and rescissions, et cetera, are the Republican states. And, obviously, that's incredibly sad for them that they're being harmed the most because they don't have an AG fighting for them. I think it's particularly troublesome when it comes to public health grants, because we are a nation when it comes to public health, right? If there is a measles outbreak in Texas because Texas didn't fight for its own public health grants, and then that spreads to New Mexico and that spreads to Arizona and that spreads to California, we are a nation -- a nation of states -- and in this particular area, I think these, these cuts and the failure of the Republican states to fight against Donald Trump's cuts is particularly impactful. Potentially, and to your point, we won't find out until there's a nationwide outbreak of some sort. Hi Will, Humble.

Attorney General Dana Nessel:

Hi Will. I'm Dana.

Will Humble:

Hi. Nice to meet you.

Attorney General Dana Nessel:

Nice to meet you. Thanks for appearing on our podcast.

Will Humble:

Yeah, my pleasure.

Attorney General Kris Mayes:

So it is so good to see you, Will Humble. Thank you for joining Dana and I. I want to introduce you to our listeners. You are the executive director for the Arizona Public Health Association, but you've worn many hats in your past, including heading up Arizona's top public health agency and a few other things. So, welcome to "Pantsuits and Lawsuits and we'll just jump right into it. We are so glad to have you, given everything that's going on in the last 48 hours at the CDC, where we had, you know, I think, three or four of their top officials walk out in protest, and also, you know, NIH cuts, which Dana and I and the other Democratic AGs have been fighting against. Let me just ask you about the latest news. What do you make of what is going on at the CDC?

Will Humble:

Well, I've got some colleagues that I know inside CDC and so I try to get some like inside the building scoop on what's going on. And when Susan Morrows was first nominated, the employees over at CDC were like we really don't know her that well. She has great academic credentials. She's really well respected professionally. Because you can have different kinds of directors. Some will be super compliant and really just try to keep their job and others will be in it so that they actually do their job.

Will Humble:

And they discovered very quickly that she was exactly who they wanted, somebody who would stick with the evidence, stick with science, make evidence-based recommendations and decisions for what the agency does. So they were really pleased to see her in action, respecting the staff and lifting up the expertise within CDC so that the secretary would hear from them if he was interested. It appears he is not. And so the staff is really now just like, "oh my gosh, now what?" But it's clear to me that Secretary Kennedy is interested in you know, in a lapdog, basically, somebody who will do whatever they are told. And when he releases his report next week that we all expect he will say vaccines are causing autism. He will then start directing the CDC director to eliminate some of these childhood vaccines, which will be catastrophic.

Attorney General Kris Mayes:

I think you make an incredible observation and I kind of heard the same thing that they may be on the precipice of releasing this study that tries to tie autism to vaccines. I hadn't really understood that that would then lead possibly automatically to them saying don't get the childhood vaccinations.

Will Humble:

Right. Well, it wouldn't directly, but because Secretary Kennedy got rid of everybody on the Advisory Committee for Immunization Practices, what I expect to happen is this report comes out, h e's going to say autism is caused by vaccines. He's going to call an ACIP meeting with his new members, who will then make recommendations that would become part of the Vaccines for Children program, VFC, which provides vaccinations for more than 50% of the US kids, and private health insurance, who would then adopt the new ACIP standards. And then you would have, I don't know which vaccines, but some vaccines being dropped off the list. Now it hasn't happened yet, but I'm just looking at the road that he's grading and that's where it's leading, in my opinion.

Attorney General Dana Nessel:

Can you talk, Will, a little bit about what your projections are? I mean, if this happens, the way that you believe and many others seem to believe this is going to occur, can you tell us how quickly you're -- we're likely to see an impact, and what kind of impact do you anticipate?

Will Humble:

Yeah.

Will Humble:

So to the first part of your question, I think what remains to be seen is whether Article 1 of the Constitution still means anything. You know, because up until now we haven't seen any real oversight from Congress of the decisions being made within the executive branch. The only thing that's been holding the public health system together in the last six months is Article 3, your work as attorney generals, pushing back on both illegal and unconstitutional decisions that this Administration is making. So, what's going to happen hinges on whether Congress wakes up, whether those committees in the Senate, especially in the Senate -- I think there's four Republican physicians in the Senate, if I'm right -- whether they say up or not is ultimately the answer to your first part of your question. Do we start to see checks and balances from Congress or are we going to, for the next at least year and a half, have to rely on the judicial branch and plaintiffs like yourselves to keep the wheels on, and I can't give you an answer to the question because I don't know whether they're going to stand up to them or not.

Attorney General Kris Mayes:

Can you explain to our listeners why the NIH is important and why the CDC, why we should care about what is happening to these critical public health agencies and how that trickles down to the, to the states, because I think sometimes people look at it and they're like, "oh, it's just a bureaucracy," but why does this matter to everyday Arizonans and Michiganders?

Will Humble:

Yeah, it should matter to everybody. I mean, the reason we have had and made so many really dramatic strides in treatment of things like cancer and all kinds of medical conditions is because we've invested over the last decades in funding to the National Institutes of Health, which pays for at the universities really that foundational science research that establishes the evidence base that then private sector entities can use to develop new therapies. So it starts with the foundational research that NIH supplies the funding for and then private sector, which plays a really important role in developing these new therapies and medical devices, they do the translational research and then they pay for the clinical trials. But if we don't invest in the foundational research then there isn't the ability for them to do that translational research and then later the clinical trials that result in the new therapies and medical devices that are saving so many lives. Let me just use a quick example with messenger RNA. Like mRNA studies through NIH were funded for many, many years building that basic evidence base for messenger RNA technology and then that led Moderna, Pfizer, BioNTech and others to use that foundational research to come up with the COVID-19 vaccine in record speed. So now that messenger RNA research that the NIH provided is really super promising for cancer therapy and it really has the potential to displace chemotherapy, which is a super blunt instrument when you have cancer be cured, with a targeted technology based on the mRNA research that the NIH did.

Will Humble:

So to get to your question, Secretary Kennedy wants to cut the NIH budget by 40%.

Will Humble:

Well, what that does is eliminate that foundational research that ends up later going into translational research and the clinical trials that help improve therapies for cancer and a whole host of other things.

Will Humble:

And when you cut that pipeline, a) you're eliminating that foundational research, so you're stalling the future of medical advances, but you're also eliminating the workforce that can do that. And so in three- and- a- half years, if we all realize finally, "oh my God, this country made a huge mistake. We've got to start putting some money back in NIH." You will have researchers who left for Europe, left for China, and did their career work somewhere else, and we will not have the research workforce to be able to recover from this, and that -- that's how it becomes not just a blip in the reduction in medical research, but a long-term atrophy of our ability to do this. And, by the way, it puts the Europeans in the driver's seat when it comes to that next level research that ends up in clinical trials, they're the ones that can end up getting the patents and developing the therapies. They won't be developed here because that foundational research didn't happen because of the decisions made by Kennedy and Congress. We may have to go along with it. And so we'll see what happens.

Attorney General Dana Nessel:

So, Will, let me ask you this. You know, what I've been hearing and reading about is that, you know, many -- I don't know if it's the AMA or that are not official boards that are being formulated because obviously so many physicians and infectious disease experts and all the rest know that they can't have faith in the government experts anymore. Can you tell us what you know about that?

Will Humble:

Yeah, I mean I'm really proud of the American Academy of Pediatrics. Their board and their members fully recognize that they are going to really need to step up over the next three and a half years to provide real-life evidence based recommendations to, especially, pediatricians, and that's what they've been doing.

Will Humble:

So they've committed to maintaining their own recommended childhood vaccine schedule. The problem is that U. S. law and the regulations that have been established as Code of Federal Regulations all refer back to the Advisory Committee for Immunization Practices and the CDC recommendations. So, as a matter of practice, in terms of reimbursement for vaccines -- both the Administration and the vaccines themselves -- everything hinges on, "can we get paid for these things" and reduce the schedule? Then the Vaccines for Children program would automatically drop those vaccines and 50 percent of kids would automatically not have access to those lifesaving, important vaccines. And kids with private health insurance, their plans would likely stop covering it, covering it, and so, even with those member organizations which is what they are having alternative schedules as a matter of law, in terms of reimbursement from CMS, center for Medicare and Medicaid Services and Vaccines for Children program, which is run out of CDC, they would become inaccessible.

Attorney General Kris Mayes:

Just to drill down a little bit further on that, if we had to private- pay for a vaccine, for, like, the MMR vaccines, what would that cost? Do you have any idea?

Will Humble:

I don't know about MMR. For the COVID vaccine, for example, is about $200. I don't know about the MMR, I didn't research that. But I could tell you a Medicaid member who walks into their pediatric office and is told we really recommend this MMR vaccine to your kiddo, but you're going to have to pay cash for it. You know,, some will not eat that week so that they can pay for the vaccine, but others will take a pass. Kennedy will continue to talk vaccines down over the next three and a half years, if he's in there that long. But this is an administrative mechanism to change the funding to make that a reality. So it's not just what he says into a microphone, but decisions that he and his agency directors make that make the vaccines inaccessible.

Attorney General Dana Nessel:

Yeah, one of the things I found really interesting was that the new budget bill -- I will call it -- sets a lifetime loan limit of $200,000 for medical and dental school, even though the average cost of tuition through graduation normally exceeds $300,000. So you're basically saying that unless you're, you know, a multimillionaire, people can't become doctors anymore. Doctors are the most esteemed individuals. You know, like my mom, to this day, is like, Why are you an attorney general instead of you know, an internist? Because she would have preferred that because that would be more bragging rights for her and her friend group. But, for real, I mean growing up, one of the things that was always interesting to me is when I was trying to find cases, we would refer to anybody else as Mr. or Ms., but not medical doctors. They were Dr. so-and-so, Doctor Whomever, because we revere doctors. And so it's so bizarre to me that this Administration is really handicapping our institutions and making it almost impossible for people to become physicians in the first place.

Will Humble:

Right and it's a double -- and they're doing it in two different ways. Number one is what you already mentioned in terms of, you know, the medical school part of this. A nd, by the way, what that does is it puts even more pressure for new physicians to specialize in procedural, high-end practice, and that's great. Surgeons we do need surgeons, but where the lives are really saved is in primary care. I mean, they're the ones who identify the blood pressure 20 years ago that would have ended up in a stroke or a heart attack 20 years later and a surgeon going in and trying to fix that stuff. So the way you keep a population healthy is with primary care visits. Because of the cost of tuition and the lack of federal support for those primary care specialties, there's already a disincentive to doing primary care and this just makes that even worse by not supporting there.

Will Humble:

And the other prong of this that needs, I think, a lot more attention and people recognizing this, is that residencies are as important or more important than the number of -- I would say more important -- than the number of medical students, and we've got to start investing more federal funds and distributing those funds more fairly among the states for graduate medical education because that is what builds the pipeline for physicians. You could graduate from medical school, but if you don't find a residency program, you're not going to be practicing in the field. So residencies are, I think, the most underappreciated part of building the inventory of clinicians that we're going to be needing in the future. And a lot of doctors are in, like, my age and they're increasingly looking to retire, in part because of the hassles they have with insurance program plans and stuff. And so, if we don't fix this kind of thing now, the pipeline is a long pipe.

Will Humble:

It's a several year pipeline to build the inventory of clinicians. A nd if we don't change things fast, both on residencies and what you described on the medical school side, there's going to be a much worse shortage than there already is. And it's really bad in rural parts -- in the Arizona rural areas. I'm sure it's the same in Michigan. Some specialties, like, you just can't get an appointment. You got to drive to Tucson or Phoenix. It's probably the same in Michigan, I'm sure.

Attorney General Dana Nessel:

Yeah, it is actually. A state rep that I know just needed to have some pretty advanced surgery. She lives in Traverse City, which is, you know, in Northwest Michigan, and yet she had to come down to Ann Arbor in order to get the procedure. And that is becoming more and more the norm as more and more rural hospitals shut down and as there are fewer specialists.

Will Humble:

I don't know where this is all going to end. I mean I -- you know, the American people are going to speak in, you know, 18 months, and again in, you know, three- an- a- half years. And the future of the republic and public health is in their hands.

Attorney General Kris Mayes:

Will, I think you did an amazing job of encapsulating this whole conversation and why it's so important. You know, we are on the cusp, especially with mRNA, of possibly curing forms of cancer, including glioblastoma, what Senator McCain had, including glioblastoma what Senator McCain had and to yank the rug out from underneath that is so, so wrong and so misguided. Yeah, let's hope Article 1 wakes up and does something about it in the next few months, because we need them to show up. And Dana and I promise you and everyone else that we'll keep fighting for Americans and for our democracy and for our public health system.

Will Humble:

Thank goodness for Article 3 and for attorney generals like you that are standing up for the people.

Attorney General Dana Nessel:

Thanks so much for being on the podcast, Will. Much appreciated. And thank you so much for all your incredible work. Well, that's all we have time for on this week's episode of Pantsuits and Lawsuits.

Attorney General Kris Mayes:

Thanks for listening, everybody. Please be sure to follow us on all of your social media and stay in the loop about our department's various legal updates. We'd love to have you continue to follow us and we will get through this together. Let's hope we