RFK doesn't want you using antidepressants, armed forces no longer require flu vaccine, and Tracey teaches us all about mifepristone

Hoosier Health Matters
Season 2, Episode 14
Date: 5/8/2026
Title:  RFK doesn't want you using antidepressants, armed forces no longer require flu vaccine, and Tracey teaches us all about mifepristone

0:00- Intro

1:33- GTC is looking for an executive director!  More info here

2:11- Casey Means is out for Surgeon General, Nicole Saphier is in

3:20- 988 Hotline for LGBTQ+ youth in crisis, is being reinstated and a JAMA paper shows that it has saved a lot of lives

4:25- RFK, Jr wants people to stop using antidepressants

 5:58- Indiana Medicaid seeking return of $200 million of payments for attendant care providers

7:40- 400 new FSSA workers just to check eligibility with the new rules (holy crap)

9:23- 340B program changes will not apply to FQHC clinics (good news)

10:17- Audit of Marion County Office of Public Health and Safety not good

11:12- Indiana drops involvement in lawsuit regarding section 504 of Rehabilitation Act of 1973 (which is good) but for reasons that aren't great

12:04- Pentagon ends requirement for active duty military to be immunized against flu (which is bad policy)

13:37- COVID vaccine paper that HHS would not publish has been leaked and you can read it here

14:26- Tracey's primer on medication abortion and shenanigans by the 5th circuit court of appeals

 19:17- Ban on medicaid billing for Planned Parenthood up for grabs in Congress

20:09- Happy National Nurses Week!  And get to know the candidates in your district who won their primaries

21:02- Wrap up

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Transcript

Good Trouble Indiana (00:00)
you're kind of a wellness influencer, right? Like, I don't know, you have a podcast just like this lady. no.

Tracey (00:02)
⁓ right.

My

wellness influencing is not going to make anyone well.

Good Trouble Indiana (00:15)
Hello and welcome to Hoosier Health Matters for Friday, May 8th, 2026, brought to you by the Good Trouble Coalition. I'm Gabriel Bosselet, pulmonary and critical care physician and former and founding president of Good Trouble. I'm joined as always by Tracy Wilkinson, pediatrician, health services researcher and Good Trouble board member to talk about all things public health in Indiana. Hi Tracy.

Tracey (00:33)
Hey, Gabe, how are you? I had a moment of feeling really old this weekend and I wanted to tell people that if you want to be reminded of your age, try mulching

Good Trouble Indiana (00:34)
Fine, how are you?

Tracey (00:44)
because it very quickly, like very quickly, everybody in my muscle, every muscle in my body was telling me that ⁓ it was pissed.

Good Trouble Indiana (00:44)
because you like hurt yourself?

How much, how much malts did you have to get?

Tracey (00:59)
Okay, so my husband ordered 12 yards of

think we need more like five or six. Okay, I'll send you a picture of this pile of It's unchanged from when we started, even though we did two days worth of mulching.

Good Trouble Indiana (01:04)
⁓ my god!

Tracey (01:14)
not really sure what to do with that now.

Good Trouble Indiana (01:15)
Ordering

too much mulch is a problem because you gotta do something with that mulch.

Tracey (01:19)
I know, I know, and the rain has not been helpful. I know.

Good Trouble Indiana (01:24)
That makes the mulch heavier. Do you want

me to continue pointing out obvious facts about having mulch?

Tracy, should talk about Good Trouble Coalition is still looking for an executive director. The call is still open for applications we've gotten, which is great. But if you someone who'd be interested in a 25 % position to help Good Trouble execute on all the things that they do who would be good at it, organized, someone who is organized, a good decision maker, et cetera, we would love to hear from that person. So check your email.

Tracey (01:36)
Yes.

Yep, and our website also has information about applying in case you can't find your email.

so for this week's episode, Gabe, we're gonna take a break from interviews and just spend some time talking about the news for the last two weeks, there's been a

Good Trouble Indiana (02:10)
Okay, let's do it.

Tracey (02:11)
So we learned this week that the Trump administration has withdrawn the nomination of Casey Means for US Surgeon General, and instead they have selected Nicole Safier.

who is a practice and physician. So that's an improvement, right? And a media contributor on Fox News since 2018. She also runs a podcast just like we do called Wellness Unmasked, where she engages in quote, unfiltered conversations about wellness and provides quote, evidence-based insight about healthy living practices.

Good Trouble Indiana (02:44)
the fact that we are talking about Casey Means is a prelude to the fact that we no longer have to talk about Casey Means, which I think is good. I don't know this person. This person is a radiologist at Memorial Sloan Kettering. I know that much. I've not had time to go like through the episodes of her podcast and see, she's in the wellness influencer phenotype.

Tracey (03:05)
it's interesting because like the Maha crowd is not very happy with this nomination and so we'll have to watch to see if it actually is successful.

Good Trouble Indiana (03:14)
Yeah, we'll see. No idea. We'll probably talk about her again in the future, but it's good that Casey Means is out.

Tracey (03:20)
Speaking of good news, I wanted to talk about the news that hotline is dedicated for LGBTQ youth that are in crisis is going to be

And this is really good of a recent study that showed this hotline has kind of almost a thousand deaths since its introduction.

Good Trouble Indiana (03:44)
Yeah, this is a paper in JAMA. I actually saw this study news. And it's an interesting study. it's clear that having a hotline for this group of individuals who are at higher risk just makes complete sense. So

Look, I'm glad they're putting it back in place. They're putting it back in place because Congress kind of made them. ⁓ And so, however, the proof will be in the pudding. It's not up yet. We've been told they're working on it, quote unquote, but once it's up, then I think that then we can give them some props.

Tracey (04:03)
Thanks.

And one more crazy story from RFK Jr. this week, because I'm not going to talk about him a lot. I've decided I need a little bit of a break.

So,

RFK Jr. has sent out a message as well as a letter to physicians really trying to emphasize that people should come off their SSRIs.

Good Trouble Indiana (04:33)
Yeah, this was an announcement after the Maha mental health and over medicalization summit, which talk about like telegraphing your findings. Yeah. this summit included no major health organizations. It included a woman who wrote a book about her journey with psychiatric illness, a bipolar disorder, which she

Tracey (04:42)
That is not a title.

Good Trouble Indiana (04:55)
found out she could gear on her own just

just through her own willpower. And so, RFK Jr. wants people to stop taking SSRIs. Now, the letter that was sent to physicians actually is a very reasonable letter. Like, yes, we should explore the things. to think that physicians who write prescriptions for SSRIs don't have the things in mind that he's talking about. Therapy, like,

healthy lifestyle, all this stuff. That's great. And that's fine. However, RFK Jr's words about this, when he talked about it, really made it sound like there's a lot of stigma around the taking of SSRIs, which is just,

this guy likes to be in front of everything and all over this stuff and keeps saying inflammatory bullshit. The mental health and over medicalization summit was really a bunch of fringe people getting together at a hotel talk fringe things.

Tracey (05:53)
I have no doubt he's going to pee all over the news moving forward. let's shift and talk a little bit about Indiana Medicaid. getting close to the start of new rules for Medicaid talking about

benefit, verifications, et cetera. But I did want to say FSSA announced that they are going to start seeking kind of return of payments, to $200 million for some payments of care that they've already paid head of Medicaid in Indiana, had a quote saying that the free lunch is over.

he's ready to kind of really crack down and come after people that are billing Medicaid incorrectly.

Good Trouble Indiana (06:36)
million is a lot of money. was for attendant care providers. I think that there this is a nuance, much more nuanced story than we want to think that it is Tracy, meaning that these dollars are used to help care for some of the most vulnerable individuals in Indiana. A lot. In fact, we've talked we talked to Debbie Holcomb on the show about ⁓ attendant care.

waivers and how they function for families with patients with severe disabilities. They're very important. I do think that there were some bad actors in this space. I don't think these were individual families who were taking advantage of the program, but I do think it was some of the attendant care servicers,

I suspect that's what this is going after. So it's important to cut back on fraud. I don't think most of these families were committing the fraud, but I, it's not out of the question that there weren't bad actors in this space.

Tracey (07:31)
Yeah, I just think the quote, the free lunch is over really kind of puts the blame on patients, which is really disappointing coming from our Medicaid that that's what's happening.

Good Trouble Indiana (07:41)
especially after what they've done to snap.

Tracey (07:43)
Yeah, yeah, yeah, yeah. when we talk about administrative burdens and needing to have these repeated verifications of eligibility, they also announced that they're going to be hiring 400 people to start working at FSSA to handle all of the administrative stuff that's about to be required for Medicaid enrollment.

So that doesn't sound like you're cutting costs or administrative costs of Medicaid at all.

Good Trouble Indiana (08:12)
Yeah, so these people will just be checking Medicaid eligibility for people in Medicaid. Okay, let's do some quick math, Tracy. If these people are each making, if these are full-time positions, let's assume that they are, and these people are making $40,000 per year, probably a safe assumption. I don't know. I don't know. Maybe that's too high, but let's make that assumption. That's $16 million worth of salary for these people. That tells you, you you're not going to spend, I wouldn't, I would hope you're not going to spend $16 million of salary to make $5 million of

Tracey (08:19)
Yeah.

Yeah.

Okay, yeah.

Yeah.

Good Trouble Indiana (08:42)
back. they're going after a lot of money. They know that this is going to save the state a ton of money in people losing Medicaid benefits. And we've talked about this on the podcast before that it's mostly because of administrative burden, not because we're really cutting a lot of abuse and fraud out of the Medicaid so now we are rather than just providing benefits to people who

Studies have shown the vast majority of them need them. We're spending a crap load of money and making it harder for everyone in the program.

Tracey (09:12)
Mm-hmm. Yeah. So really disappointing,

So in good news, if you all recall, we have talked in depth about the 340B program, most recently season two, episode 10, when we had Alan Witchey as our guest. And we really talked about how the 340B program works and how the funds are used. And we learned some really good news that they have decided that the proposed changes to the 340B program will not apply.

to health clinics. So outpatient clinics like FQHCs that we were mainly focused on during that last episode will be exempt and we'll be able to use this funding to support care for individuals that cannot afford it.

Good Trouble Indiana (09:52)
Uh, yeah, that is good news. At the same time, a lot of what we talked about on that episode, um, was what this is going to do to rural hospitals who also benefit from these, um, this three feet or 40 B program. And if they're not exempt, this is still a big problem for them. So this helps some of the issues, but not all

Tracey (10:02)
Great.

Some other public health news that I wanted to flag is that there was recently an audit of the Office of Public Health and Safety. So this is for Marion County. It's run out of the mayor's office and there was an audit recently done that wasn't great. It really kind of showed some bad accounting practices and some,

contracts that were given to people that were friends or related to people. And so it really wasn't a great report to read and frustrating given the amount of examination around public health right now that we would like, you know, not be extra careful.

Good Trouble Indiana (10:56)
yeah, I mean, I think it's relatively safe to say, or I'm gonna give my opinion here, that I think the executive administration of the city of Indianapolis is woefully inept, period. I'm just gonna leave it there.

Tracey (11:11)
Okay, next story we had been part of a lawsuit with multiple states suing the federal government and challenging the Federal Disability Protections Act that they were challenging because one of the disabilities was gender dysphoria.

And so we learned that Todd Rakita has actually pulled out of that lawsuit because President Trump has fixed the issue by removing gender dysphoria from the list of disabilities so the lawsuit is no longer needed.

Another example of wasted time, wasted money.

Good Trouble Indiana (11:44)
Yeah,

yeah, I agree with that. I'm glad we're out of the lawsuit. This issue put at risk a disability protections. And so they were trying to throw the baby out with the bathwater here. And so I'm glad they got rid of this on one hand. On the other hand, like, I don't know, just leave

Tracey (11:46)
It's fine.

Mm-hmm.

Correct.

Yeah. Okay, let's talk briefly about vaccines. We learned that the Pentagon just recently ended its requirement for all active duty military personnel to be immunized for the flu.

Which is really shocking.

Good Trouble Indiana (12:19)
Yeah, so this was a Pete Hegseth special, the secretary of the Department of Defense. So now we no longer require that people in the armed forces get the flu vaccine. If you're student of history, you know that in World War I, the United States lost as many soldiers to the flu

as they did to combat. around 45,000 soldiers died from influenza and related influenza pneumonia, and about 53,000 died of combat injuries.

the last thing you want, even though war has changed, the last thing you want is for influenza to rip through armed forces base ⁓ with a whole bunch of people on vaccinated because number one, they're going to a lot more people are going to get disease if they're on vaccinated. Number two, a lot more of them are going to be hospitalized. It's not a big percentage, but a lot more than before.

Tracey (13:00)
Mm-hmm.

Yeah.

Good Trouble Indiana (13:12)
So this is just, again, like leadership malpractice in the name of like personal liberty. This doesn't make Americans safer writ large. And again, we've talked about this before, having more unvaccinated people to diseases that are clearly preventable with have been proven to be safe vaccines is a poor national policy, period.

Tracey (13:34)
Yep, also expensive.

I also wanted to flag that, we talked last episode, Gabe, about a paper that the CDC was kind of refusing to release that was examining benefits to the COVID vaccine beyond just preventing COVID. And I did want to flag that that paper is now publicly available. We could put it in the show notes, but kudos to whoever got that publicly available so that the rest of us can see it, even though it's not being released by the CDC.

off of like the link.

Good Trouble Indiana (14:04)
Yeah, it's a PDF.

It's one of the original and actually Thomas Dushinsky is one of the authors who

Tracey (14:09)
Yeah.

Good Trouble Indiana (14:12)
professor at their Fairbanks School of Public Health here in Indiana. He's a terrific public health researcher. So there's an Indiana tie there.

Tracey (14:19)
How interesting. Okay.

or something. Okay.

Good Trouble Indiana (14:21)
Yeah, I can put a link to the PDF in the show notes for sure.

Tracey (14:24)
OK, cool. All right. I want to transition to a story that has been in the news a lot this last week in particular, and that is about medication abortion. Gabe, I'm going to give you a primer to just like get you on the same page. OK, so.

Good Trouble Indiana (14:34)
Go for it. Okay. Okay. Okay. Yes.

Tracey (14:40)
Mifepristone was approved in 2000 by the Food and Drug Administration. It is usually used in combination with mesoprostol. So Miphy and Meso are usually used together for medication abortion. We have over 20 years of research on Mifepristone.

Good Trouble Indiana (14:58)
Okay.

Tracey (15:03)
including its safety and how well it works, and it's used all over the world. And in 2021, mostly as like the result of the pandemic and additional research that happened very quickly, the FDA permanently removed the requirement that you have to receive Mifepristone in person. So that really opened the door for Mifepristone to be provided via telehealth.

anywhere. So that's an important piece. Okay, so that's all in 2021. Then we know DABS happened in 2022, which removed the federal protections for abortion access in many states, including our own. And so on the last episode, I flagged for you, there was a lawsuit brewing down in Louisiana. And it had been bumped up to the Fifth Circuit Court of Appeals. And I told you I was a little worried.

Good Trouble Indiana (15:59)
Yeah, you did. remember this. I was, I was there. We talked about it.

Tracey (16:01)
because the...

Yeah, yeah, yeah. So what happened on Friday, May 1st in the evening is that we learned that the Fifth Circuit Court of Appeals like nationally stopped

the ability to provide Mifepristone via telehealth immediately. so this was a really dramatic moment because it's obviously Friday evening and all of a sudden everybody's like, what can and we cannot do. The two manufacturers of this drug asked for an appeal at the Fifth Circuit Court of Appeals, did not get a response, so went to the Supreme Court and on Monday,

Justice Alito actually issued a stay reversing that order, permitting telehealth provision of Mifflipristone until May 11th. So we are in, yes, yes. The one and only, the one and only. It does, it does. It's only for a week, okay? So this is until May 11th. This episode's gonna...

Good Trouble Indiana (16:54)
Sam Alito did that? Our Sam Alito? That seems out of character, okay.

Tracey (17:08)
air on May 8th. And so for anybody listening after May 11th, make sure that you touch base to figure out what the update is. And we'll continue talking about it on the episode. I did want to flag that obviously there's been a lot of like legal work happening. We have Democratic attorney generals from 22 different states filing amicus briefs saying that, you know, number one, Miffl-Pristone is safe. Number removing

requiring the in-person requirement is not ⁓ appropriate. And they said that the Fifth Circuit Court of Appeals harms the authority of pro-choice states. And this is really interesting because it's setting up a battle between states that permit abortion and states that do not permit abortion. And that's why this is going to become a Supreme Court question. And it is very, very

nerve-racking because the Supreme Court is now going to be stuck as to which states' rights count the most. And we know where a majority of the Supreme Court justices sit when it comes to abortion access. Yes, I'll try to answer it.

Good Trouble Indiana (18:13)
I have a question. This is just

applying to mythopristone. Can we do, can, is there, yeah. So can you do just mesoprostol?

Tracey (18:18)
It is. Very good question.

You can, and that actually is the original protocol for medication abortion, and it is the most widely used regimen around the world, mainly because mesoprostol is very cheap. when you look at analysis of efficacy, it's really good. 90 % of patients were able to have a complete abortion with mesoprostol alone compared to your MIFI meso regimen, which is 95%.

Good Trouble Indiana (18:49)
Okay, so this would mean that you could still get access to a less effective, okay, that makes sense.

Tracey (18:49)
So.

Yeah, yeah,

comes down to principal

because of the sovereignty of the FDA, which is a national agency that applies, you know, access and policy around drugs to our whole nation. And we do not have state level FDAs for a reason.

Good Trouble Indiana (19:13)
interesting. You did call this Tracy. You said this in the last episode.

Tracey (19:14)
Okay. I

did. I also want to flag that if you guys remember the big, beautiful bill prohibited any Medicaid billing from Planned Parenthood for a year, that is set to expire on July 4th. And it is causing massive fighting within the Republican Party.

Because obviously there are people in the Republican Party that want that to continue and then there are people in the Republican Party that are like there's no way we can get this bill passed if we continue it longer so we should be watching what's happening at the federal level in terms of This battle continuing because it's really going to signal who has the power

on this issue.

Good Trouble Indiana (19:54)
The Congressional Budget Office said defunding Planned Parenthood would raise the deficit by $300 million. So it doesn't make financial sense either.

Tracy, now's the time on the podcast where we talk about things you can do this week to affect change or a good vibe. What are you gonna do?

Tracey (20:09)
right now is National Nurses Week. And so I encourage everybody who's listening to tell a nurse in your life or in your clinical space if you happen to work in one, thank you and tell them how much you appreciate them.

Good Trouble Indiana (20:22)
That's very nice, Tracy. I will do that. Mine is the primaries happened earlier this week. so everyone's ballot is set now for November, both their congressional ballots, so their House of Representatives election and their state house. And if you have a state Senate election this year, state Senate election.

So now's the time to get to know the candidates. The Good Trouble Coalition will do a candidate survey and database later this summer so that people where candidates stand in regards to the issues

cares about. But now's the time to start just looking at who won in your districts and start to get to know those people.

Tracey (21:02)
So if you enjoyed this episode, please subscribe, rate, and review us wherever you get your podcasts. Also email us with your thoughts and issues you think we should be covering at GoodTrouble at GoodTroubleIndiana.org. If you aren't already a GTC member, please become one by visiting our website. It's free and easy, and we promise not to overwhelm you with emails. Also consider becoming a donor. Even $20 a month will help and support and grow this work. You can find the links to join and or donate in the show notes.

You can also follow us on social media, Blue Sky, Facebook, and Instagram. Please look for our next episode two weeks from now on May 22nd, where we will continue to discuss health policy happenings at the State House and all other things public health. Thanks again for joining us. Until next time, be safe.

Good Trouble Indiana (21:44)
and be kind