National

The Food and Drug Administration and Juul agreed Wednesday to suspend their court case while the governmental agency conducts a review of Juul's e-cigarettes.

Why it matters: The agreement between the two sides comes after the FDA on Tuesday temporarily paused its order banning Juul from marketing and selling its popular electronic cigarettes.

Driving the news: The joint legal motion between the two sides will allow Juul to continue selling its product, according to court documents obtained by Axios.

"FDA does not intend to take enforcement action against the products subject to (Juul's) marketing denial order while the administrative stay is in place," the document reads.

What they're saying: “With this administrative stay from the FDA now in place, we continue to offer our products to adult smokers while we pursue the Agency’s internal review process," said Joe Murillo, Juul's chief regulatory officer, in a statement to Axios.

Catch up quick: The FDA said Tuesday it "has determined that there are scientific issues unique to the JUUL application that warrant additional review."

"This administrative stay temporarily suspends the marketing denial order during the additional review but does not rescind it," the agency added.

A federal appeals court had already blocked the FDA's marketing denial order in June, allowing Juul to continue selling its products while challenging the ban in court.

The big picture: The FDA's decision to ban the sale of Juul products came amid a push to cap nicotine in cigarettes. The move signals the Biden administration is trying to limit tobacco use in the U.S., Axios' Arielle Dreher reports.

The agency said last month that it denied Juul authorization to market its products because the company's application "lacked sufficient evidence ... to demonstrate that marketing of the products would be appropriate for the protection of the public health."

FDA commissioner Robert Califf added that Juul products played a "disproportionate role in the rise in youth vaping."

What we're watching: If the FDA decides to bring back the ban after its new review, Juul will have 30 days to seek another stay, the Associated Press reports.

FDA temporarily pauses ban on Juul e-cigarette sales

The FDA "determined that there are scientific issues unique to the JUUL application that warrant additional review."

Electronic cigarettes and pods by Juul, the nation's largest maker of vaping products, are offered for sale at the Smoke Depot on September 13, 2018, in Chicago.

Food and Drug Administration (FDA)

Vaping

The U.S. faces a range of health care flashpoints — unaffordable drugs, opioids, vaping — as we debate whether to adopt universal care. For now, the Affordable Care Act is the law of the land, but Republicans want to issue it a final death blow.

Health

Juul is seeking a temporary ban on the Food and Drug Administration's order to remove its e-cigarettes from the U.S. market, writing in a court filing Friday that it was "extraordinary and unlawful."

Driving the news: Juul asked a federal appeals court for a temporary administrative stay until the court grants an emergency review of the order, according to the court filing with the U.S. Court of Appeals for the D.C. Circuit.

"FDA cannot credibly argue that there is a critical and urgent public interest in removing [Juul's] products from the market right now, rather than after this Court reviews FDA’s action," per the court filing.

"FDA's extraordinary and unlawful action ... warrants the emergency interim relief requested," Juul wrote.

State of play: The FDA's decision comes amid a broader push to limit nicotine in cigarettes and signals the Biden administration is escalating its attempt to curb tobacco usage in the U.S., Axios' Arielle Dreher reports.

Juul said hours after the FDA issued a marketing denial order that it would seek a stay and was exploring a possible appeal.

Go deeper... Americans can't stop searching "How to stop vaping"

Juul asks court for temporary ban on FDA's e-cigarette order

"FDA’s extraordinary and unlawful action ... warrants the emergency interim relief requested."

JUUL Labs Inc. Virginia tobacco and menthol flavored vaping e-cigarette products are displayed in a convenience store on June 23, 2022 in El Segundo, California.

JUUL Labs Inc. Virginia tobacco and menthol flavored vaping e-cigarette products in a convenience store on June 23 in El Segundo, California. Photo: Patrick T. Fallon/AFP via Getty Images

Juul

The FDA's decision to order Juul e-cigarette products off the U.S. market opens a new and grinding battle in the push to revamp the government’s rules for smoking and vaping. 

The big picture: With parallel efforts to cap nicotine in cigarettes and ban menthol cigarettes and flavored cigars, the Biden administration is pursuing a broad tobacco agenda not seen since the Clinton administration.

Yes, but: It could be a drawn-out and costly fight. Hours after the FDA issued its marketing denial order on Thursday, Juul said it would seek a stay and was exploring a possible appeal.

The tobacco lobby, e-cigarette makers and libertarian-leaning groups are digging in, portraying e-cigarettes as an effective cessation tool to wean adult smokers off cigarettes.

"The agency is hellbent on rigging the process to fulfill its prohibitionist agenda," said Amanda Wheeler, president of the American Vapor Manufacturers Association.

Go deeper: The FDA on Thursday said Juul's marketing application didn't have enough evidence to show the sale of the company's products would be appropriate for the protection of public health.

FDA commissioner Robert Califf also said Juul products may have played a "disproportionate role in the rise in youth vaping."

Public health groups like the American Heart Association said the decision marks a dramatic step to discourage youth smoking.

The popularity of the company's products led a new generation of teens to get hooked on smoking, driven by fruit and mint-flavored cartridges that fit in small vaping devices, research in the journal Pediatrics showed.

The burst in youth vaping led the FDA to ban most flavored cartridges products in a bid to cut off an alternative nicotine source.

The road ahead: The FDA has authorized 23 e-cigarette products and continues to work through a slew of pending applications.

These include numerous bottled vaping liquids sold to adults in different flavors and nicotine strengths, per the Washington Post.

The agency has rejected applications for close to 1 million products, but last October granted tobacco giant R.J. Reynolds permission to sell three of its Vuse vaping products.

The bottom line: Anti-tobacco advocates say Thursday's decision didn't address the continued role of flavored e-cigarettes, including menthol-flavored products, in sustaining youth e-cigarette use. 

"These remain critical issues requiring FDA to deny marketing applications for all flavored e-cigarettes, including all menthol-flavored products and the flavored disposable products like Puff Bar that have become so popular with kids," said Matthew Myers, president Campaign for Tobacco-Free Kids.

But the decision still could ease some pressure on the agency from Democrats in Congress, who had accused the FDA of moving too slowly and giving big tobacco companies a free pass.

Juul decision triggers broader tobacco fight

FDA's Juul ban could trigger grinding fight over smoking rules

Photo: Patrick T. Fallon/AFP via Getty Images

Public health

The Food and Drug Administration is poised to sweep Juul e-cigarette products off store shelves, the Wall Street Journal reported on Wednesday, in what could be a major turning point for an agency that's taken a sluggish, at times disjointed approach to regulating the vaping industry.

Why it matters: The move, coming amid a push to cap nicotine in cigarettes, may signal the Biden administration is ready to try to put tobacco use behind us.

Where it stands: The FDA is ready to deny Juul a marketing order for its menthol and tobacco-flavored products after a two-year review that weighed the products' benefits for adult smokers against risks to teens, the WSJ reported, citing people familiar with the matter.

Juul has been in regulatory limbo for several years, even while its market share swelled, driven in part by flavored products popular among teens.

Now, all e-cigarette products must go through pre-marketing reviews at the FDA, which missed a court-ordered deadline last fall to decide which products could be sold. 

The agency reviewed many smaller manufacturers' products, denying close to 1 million, but hasn't yet ruled on Juul. 

What they're saying: The FDA wouldn't confirm or deny the WSJ report or provide a status on its Juul deliberations. 

Juul did not respond to emailed request for comment.

Groups that oppose youth smoking say taking the company off the market would mark a dramatic step to discourage youth smoking.

"This is a most-welcomed and a long-overdue decision," Erika Sward, assistant vice president of advocacy for the American Lung Association, told Axios.

"FDA should have acted years ago, but if it acts now and we do more to educate young people, this is a reversible epidemic," Matt Myers, president of the Campaign for Tobacco-Free Kids, told Axios.

Background: A 2016 FDA rule required makers of tobacco products to submit applications for products made after 2007.

A court ordered the FDA to make decisions by September 2021. After the agency missed the deadline, the American Lung Association and other advocacy groups and pediatricians successfully sued to speed up the process. 

Now, all e-cigarette manufacturers have to show products are "appropriate for the protection of public health," per the FDA.

Congress also recently gave the FDA the authority to regulate synthetic nicotine products, which are subject to the same application requirements.

Flashback: The FDA banned Juul flavored products as part of a bigger crackdown on flavored vapes, prompting many teens to use disposable e-cigarettes and menthol-flavored products that are still sold.

From February 2020 to February 2022, disposable e-cigarette sales increased by 215.4%, data from the CDC Foundation show, and more than half of youth who reported smoking in 2021 used disposable e-cigs.

Public health groups say it's important for the FDA to finally have a clear, consistent policy on vaping, without loopholes.

The other side: The e-cigarette industry is worried regulators will take a carte blanche approach to policing its products.

Juul's application process involved nearly two years of submitting data and evidence to the FDA, WSJ reported, and industry leaders say its data was sound.

"If that level of science isn't sufficient, it begs the question of what is," Tony Abboud, executive director of the Vapor Technology Association, told Axios.

E-cigarette industry groups are calling on the FDA to go after bad actors that are skirting the review process.

The industry also claims its products are used successfully to wean adult smokers off cigarettes, and that removing e-cigarettes from the market will force people to return to cigarettes again.

"FDA's staggering indifference to ordinary Americans and their right to switch to the vastly safer alternative of vaping will surely rank as one of the greatest episodes of regulatory malpractice in American history," American Vapor Manufacturers Association President Amanda Wheeler said in a statement.

Context: Juul's rise in popularity from 2017 to 2019 coincided with more than a million teens getting hooked on nicotine, while flavored vape cartridges and pods were still available.

A study in Pediatrics assessed found most new tobacco use during that time was among teens using e-cigs.

"There was no evidence that [older] smokers were using them," John Pierce, one of the study authors, told Axios.

What's next: The FDA still has many products to review and a bipartisan group of lawmakers in Congress is calling on the agency to expedite the process and take aim at addictive products marketed towards teens.

The bottom line: If Juul is pulled from the market, health risks to youths will have trumped arguments for using e-cigarettes as cessation products.

FDA may toss Juul e-cigs from store shelves

With pressure from Congress and health groups mounting, FDA may order Juul to take its products off the market this week.

Illustration of a juul device forming a "no" symbol with a cloud of vapor around it

Under a new law that took effect this week, the Food and Drug Administration can crack down on vaping companies that use synthetic nicotine, the AP reports. 

Driving the news: The new law closed a loophole that certain companies had exploited to avoid oversight of their products, including flavored e-cigarette company Puff Bar.

Background: Originally, FDA oversight of cigarettes and related products pertained solely to tobacco-based nicotine. Some companies pivoted to using synthetic nicotine in e-cigarette liquid cartridges and nicotine pouches.

The change, which Congress passed in March, gives the FDA the authority to regulate all forms of nicotine. 

While the measure doesn’t outlaw synthetic nicotine products automatically, companies are now required to register with the FDA and submit their products for review within 30 days.

The new law also subjects synthetic nicotine products to the same age limit and sales restrictions as natural tobacco products.

The FDA banned all flavors in cartridge-based e-cigarettes except menthol and tobacco in 2020. However, the ban didn’t apply to disposable e-cigarettes and other vaping devices.

What they’re saying: FDA Commissioner Robert Califf tweeted that the new law gave the agency the authority to "hold e-cigarette companies using synthetic nicotine to the same public health standards we’ve implemented for other tobacco products.”

FDA increasing oversight of synthetic nicotine products

The new law closed a loophole that certain companies had exploited to avoid oversight of their products.

A photo illustration of Puff Bar e-cigarettes

Puff Bar E-Cigarette products sit on a counter. Photo: Joe Raedle/Getty Images

E-cigarette

E-cigarette giant Juul Labs will pay Arizona $14.5 million as part of a settlement for a lawsuit alleging it illegally targeted young people in its marketing.

Why it matters: The company faces over 2,000 lawsuits related to its marketing practices, which included fruit-flavored liquid pods and ad buys on youth websites like Cartoon Network, per Reuters. State and local governments have said it fueled a vaping epidemic among teens.

Details: $12.5 million of the settlement will be allocated to anti-addiction programs, while the remaining $2 million will help cover litigation expenses and go to a general consumer protection fund.

Though Juul has admitted no wrongdoing, it called the settlement "another step in our ongoing effort to reset our company."

"We will continue working with federal and state stakeholders to advance a fully regulated, science-based marketplace for vapor products."

"As part of that process, we will continue to support Tobacco 21 and enforcement against illicit and illegally marketed products, such as certain disposables, that jeopardize the harm reduction potential of alternative vapor products," the company added.

Worth noting: In 2018, over 3.6 million youth in America, including 1 in 5 high school students and 1 in 20 middle school students, used e-cigarettes, according to the Centers for Disease Control and Prevention.

In 2020, these numbers declined to about 20% of high schoolers and 5%, according to the FDA, which notes: "3.58 million youth currently using e-cigarettes is still far too many."

The big picture: Juul stopped selling popular flavors in its stores and shut down social media channels after facing pressure from regulators in 2018. 

It agreed to a $40 million settlement with North Carolina in June to resolve a similar suit.

The Food and Drug Administration is still weighing whether to ban Juul products in the U.S., though it has barred sales of nearly 950,000 lesser-known e-cigarette products, ABC News reports.

Editor's note: This article has been updated with further statistics on youth e-cigarette use. 

Juul reaches $14.5 million settlement in Arizona vaping suit

State and local governments have said the company helped fuel a vaping epidemic among teens.

A sign advertising Juul products displayed in a store in New York City. Photo: Stephanie Keith via Getty Images

President Biden has made the COVID-19 crisis and a post-Trump return to national unity and traditional democratic ideals his top priorities. From vaccinations to stimulus to schools, Biden is seeking bipartisan compromise while showing a willingness to use executive authority and bare Democratic majorities in the U.S. House and Senate to implement his policies. Republican leaders are navigating deep party divisions over if and how to move beyond former President Trump.

Politics & Policy

Axios Pro Rata

Philip Morris International (NYSE: PM) won a shareholder vote to take control of British asthma inhaler maker Vectura Group (LSE: VEC) for £1.1 billion ($1.5 billion), having previously outbid The Carlyle Group.

Why it matters: The world's largest maker of cigarettes, a major contributor to respiratory disease, will now make products that treat respiratory disease. Some health advocates have asked Britain's competition authority to intervene, asking it to consider what they refer to as "monopolies of harm."

Details: Carlyle, whose European health deals are led by a former GlaxoSmithKline exec, had kept its lower-priced offer on the table, hoping that shareholders wouldn't approve the sale.

Bottom line: "Philip Morris, whose name has long been associated with Marlboro, the world's best-selling cigarette brand, says the deal is part of its plan to diversify its portfolio beyond tobacco and nicotine, with an emphasis on 'inhaled therapeutics.'" — Bill Chappell, NPR

Philip Morris wins control of inhaler maker Vectura

The world's largest maker of cigarettes will now make products that treat respiratory disease.

Illustration of an arm in a business suit making a gun sign with smoke coming out of the fingertips.

Big Tobacco

Stock market

After a record economic expansion, the coronavirus pandemic sent the U.S. economy into a recession as unemployment soared to staggering heights. The country now faces urgent questions about how much stimulus is needed for reeling consumers and businesses, and what a recovery might look like.

Economy & Business

The Food and Drug Administration said Thursday it will delay its decision on top-seller Juul, but thousands of other electronic cigarettes will be ordered off the U.S. market.

Why it matters: The stalled decision prolongs the agency's determination on whether there is enough data to show if adult cigarette smokers switching to a less harmful option outweighs the detrimental costs of young people getting hooked on nicotine by vaping. 

The companies with the most to lose are Vuse, owned by Reynolds American and Juul, with Altria having a 35% stake. 

The big picture: The FDA rejected applications for about 950,000 flavored e-cigarettes and related products. The reasoning was their flavor profiles and appeal to underage teens could be problematic. 

Vaping in the last few years has been a huge concern by parents, politicians and anti-tobacco advocates who have pushed the agency to ban high-nicotine devices, products Juul has mainly been blamed for.  Still, the agency said it would need more time to rule on  company’s products.

Zoom out: In September 2020, the agency required all U.S. e-cigarette manufacturers to take their vaping products off the market or submit them for FDA review. The FDA was facing a Thursday deadline to decide whether vaping has a net positive or negative effect on American public health. 

The companies were required to show through scientific evidence that each product was less harmful than traditional cigarettes and that cigarette smokers would be more likely to stop smoking if they used it.

Since then, more than 500 companies have filed applications for about 6.5 million products. Another government agency in June had asked the FDA for more time considering the application size. 

The FDA in August already blocked the sale of 55,000 flavored vape products from three companies. More individual bans could be under consideration. 

Noteworthy: In April, the FDA announced plans to propose banning menthol cigarettes and flavored cigars. It is also reportedly considering whether to seek limits on nicotine levels in cigarettes to reduce their addictive potential.

The agency did enact temporary restrictions on some sweet and fruity-flavored products in an effort to curb youth vaping.

The bottom line: Both tobacco companies and special interest groups planned on moving forward with court battles depending on the outcome of the FDA review. 

FDA needs more time on Juul e-cigarette ban decision

The products with the most to lose are Vuse and Juul.

The Food and Drug Administration announced Thursday it will move forward with a nationwide ban on menthol cigarettes and other tobacco products, a blow to the tobacco industry that has lobbied for years to keep sales legal. 

Why it matters: The decision, which could take years to implement, kicks off the official rule-making process and comment period by the agency. Tobacco companies are expected to challenge any final regulation in court. 

The decision left out banning menthol-flavored e-cigarettes.

"With these actions, the FDA will help significantly reduce youth initiation, increase the chances of smoking cessation among current smokers, and address health disparities experienced by communities of color, low-income populations, and LGBTQ+ individuals, all of whom are far more likely to use these tobacco products," acting FDA commissioner Dr. Janet Woodcock said in a statement.

The big picture: The debate on whether to ban menthol cigarettes has been touch and go through multiple administrations. 

After years without a response to the 2013 citizen petition that sought out a menthol cigarette ban, a lawsuit was filed by public health groups last year, including the African American Tobacco Control Leadership Council and Action on Smoking and Health, to compel the FDA to issue a decision.

What's happening: Anti-tobacco activists and some members in Congress saw a real chance for a federal ban in recent months with President Biden's promises to reduce health disparities exacerbated by the pandemic and the Black Lives Matter movement's spotlight on institutional racism in the U.S.

Tobacco opponents and public health groups have said a ban is critical to curb tobacco use, which remains a contributor to the leading causes of illness and death, especially among people of color.

Civil rights groups have also found that menthol tobacco products disproportionately targets and hurts Black communities. 

Menthol and mint tobacco products like vapes and mass-produced cigars have been shown to significantly increase youth tobacco use and fuel addiction. 

By the numbers: Menthol tobacco products have become an important portion of tobacco industry sales.

More than a third of cigarette purchases in the U.S. are for menthols, the largest proportion of sales, according to the Centers for Disease Control and Prevention. 

The share of smokers who use menthols has risen continuously, from 30.5% in 2005 to 40.2% in 2019, according to data from the National Survey on Drug Use and Health, analyzed by the Wall Street Journal. 44% of children ages 12 to 17 who smoke say they use menthols, according to the data. 

Joelle Lester, director of commercial tobacco control programs at the Public Health Law Center at Mitchell Hamline School of Law in Minnesota: "It’s a really exciting day to have the FDA arrive at a moment where it’s had a lot of evidence and authority for a long time but I think there’s a lot of momentum to consider carefully health disparities and how to address those now in the current climate."

Philip Morris International: "As FDA examines how best to address combusted cigarette use, we believe it is critical that the agency continue recognizing the important role that innovative products play in addressing the burden of tobacco use and the need for policies that can accelerate switching to FDA-authorized alternatives, thus promoting public health."

ACLU senior legislative counsel Aamra Ahmad said the organization is concerned a ban "will eventually foster an underground market that is sure to trigger criminal penalties," and disproportionately affect communities of color.

FDA moves to ban menthol cigarettes

Tobacco companies are expected to challenge any final regulation in court.

The White House is exploring whether to make tobacco companies reduce nicotine levels in cigarettes, the Wall Street Journal reports. 

Why it matters: The policy would make nicotine levels so low that cigarettes wouldn't be addictive, and wouldn't satisfy nicotine addiction — theoretically pushing smokers to buy less harmful tobacco products instead.

The big picture: Nicotine reduction has been on the Food and Drug Administration's radar for years, and could prevent nearly 8 million premature deaths, according to agency estimates.

What they're saying: "We advanced this major public health endeavor ... and the White House should secure this effort," former FDA commissioner Scott Gottlieb tweeted on Monday. 

What's next: The FDA is also supposed to announce a decision by late April on whether to ban menthol tobacco products.

How Could Lowering Nicotine Levels in Cigarettes Change the Future of Public Health?

White House considers policy push to strip nicotine from cigarettes

Nicotine does not cause the health problems and disease that is linked to the nearly 500,000 deaths in the U.S.

Photo: Roberto Machado Noa/LightRocket via Getty Images

There are 2,807 confirmed hospital cases of lung injury associated with vaping in all 50 states, Washington, D.C. and two U.S. territories, the Centers for Disease Control and Prevention reports as of Feb 18.

What's new: Because of the consistent declines in new EVALI cases since Sept. 2019, as well as the identification of vitamin E acetate as a primary cause of EVALI, Tuesday's report will be the final CDC update on the number of hospitalized EVALI cases and deaths nationally.

By the numbers: The CDC confirmed the death toll has reached 68 people in 29 states and D.C., as of Feb. 18.

The influx of cases has slowed considerably since August. But the agency said the decline was due in part to a reporting lag in early December.

The impact: CDC explains the steady drop in cases as likely multifactorial and possibly related to...

Public awareness of the risk associated with THC-containing e-cigarettes, vaping and product use.

The elimination of vitamin E acetate from some products.

Law enforcement response related to illicit products.

Details: CDC, FDA and individual state health officials "have made progress in identifying the cause of EVALI," CDC reports.

Nationally, most vaping-related patients with data on how they sourced products reported obtaining THC-containing products from "informal sources," per the CDC. The agency recommends users should consider no longer vaping THC products, rather than its original claim to refrain from e-cigarettes.

Vitamin E acetate has been found in product samples tested by FDA and state labs and patient lung fluid samples tested by CDC across the country. 

Vitamin E acetate is not present in the lung fluid of those who do not have EVALI.

Based on several studies, federal health officials found in late 2019 vitamin E acetate in a sample of illicit products in select states and the additive also caused lung fluid in 48 patients out of 51 diagnosed with the vaping illness.

Additional lab tests for 1,782 hospitalized patients took place relating to a variety of vape products used, per CDC figures as of Dec. 17. Based on data released Dec. 3, the majority of people with the pulmonary illness (EVALI) are young males:

78% are under the age of 35, and 67% are males.

About 80% reported using products containing THC, 35% reported exclusive use of THC-containing products and 54% reported use of products with nicotine.

"Significant increase" in teens vaping menthol or mint flavored e-cigarettes

Scoop: Trump ready to ban vape flavors except tobacco, menthol

Editor's note: This story has been updated to reflect the latest details. Check back for more.

CDC confirms 2,807 hospital cases of lung injury linked to vaping

The CDC confirmed the death toll has reached 68 people in 29 states and D.C., as of Feb. 18.

Health Care

President Trump told his health secretary yesterday that he regrets getting involved in the administration's policy on vaping, according to two sources familiar with the conversation. "I should never have done that f***ing vaping thing," Trump said during an impromptu call on speakerphone in an Oval Office meeting.

Why it matters: The administration's ban on flavored vapes is one of its most prominent health policy decisions, but trying to find a compromise between public health groups and the pro-vaping community caused massive political headaches.

Behind the scenes: Trump decided to call Health and Human Services Secretary Alex Azar during a campaign meeting, while discussing health care with his political team. He sometimes does that with cabinet secretaries, in an impromptu fashion, during meetings when their issues come up.

Azar got defensive after Trump expressed regret for the vaping policy, per a source familiar. 

Both sources familiar with the conversation said Trump wasn't expressing regret for the specific vaping policy outcome, which the team believes is the right one, but rather for personally wading into vaping and e-cigarette policy in the first place rather than leaving it up to the Food and Drug Administration.

Trump campaign pollster Tony Fabrizio was talking during the meeting about health care as a 2020 issue, including the importance of protecting people with pre-existing conditions.

Trump also ribbed Azar over drug prices, per two sources familiar, asking him, "When are you gonna get these drug prices lower?" and pressing him to "hurry up" on rules that would let people import cheaper drugs from Canada.

One source described Trump's tone as "play bantering." The New York Times' Maggie Haberman was the first to report the call between Azar and the president.

What they're saying: "President Trump has said this Administration will protect people with pre-existing conditions, lower drug prices even further, end surprise medical bills, and make sure Americans get the highest quality of care they deserve," White House spokesman Judd Deere said.

"There’s no daylight between the White House and HHS as we work to implement the President’s policies and improve the American healthcare system for everyone, not just those in the individual market," he added.

Reality check: The administration hasn't accomplished much on health care. Congress did not repeal the Affordable Care Act — Trump's top priority — and it did not address surprise medical bills, either. The administration has done very little on drug prices, and is urging the courts to throw out protections for pre-existing conditions.

Scoop: Trump told Azar he regrets involvement in vaping policy

It's one of Trump's few health care accomplishments heading into 2020.

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