Axios Vitals

June 30, 2026
Let's Tuesday! Today's newsletter is 950 words, a 3.5-minute read.
1 big thing: Health nominee pileup awaits Senate
A slew of Trump health nominees are awaiting Senate confirmation hearings — and most have to go through a committee chaired by a senator who recently clashed with President Trump.
Why it matters: While the administration tries to staff up some health agencies after last year's DOGE cuts, top leadership roles remain unfilled.
- There are no full-time political leaders at the CDC and FDA. The surgeon general's post is vacant.
- And Trump only recently made his picks for deputy health secretary and assistant secretaries for planning and for preparedness.
The big picture: The gatekeeper who will preside over most of the nominations is Senate health committee Chair Bill Cassidy (R-La.), who had a shouting match with Trump in a closed-door meeting over the Iran war last week and has sparred with Health Secretary Robert F. Kennedy Jr. over vaccine policies.
- Cassidy — who lost his primary to a Trump-backed challenger in May — does not appear set to torpedo any of the nominees, in part because they're seen as more mainstream and less tied to Kennedy's "Make America Healthy Again" movement.
- "Lack of stability is a problem," Cassidy told CBS' "Face the Nation" on Sunday.
- He noted that his committee is moving forward with hearings and that he was "very favorably impressed" after meeting with CDC director designate Erica Schwartz and surgeon general nominee Nicole Saphier.
- "I can't speak for everybody, but I imagine they will be approved," he said.
Health committee spokesperson Stephen Lewerenz told Axios the panel plans to hold hearings in July on the nominations of Schwartz and Saphier, as well as Sean Kaufman for assistant secretary for preparedness and response.
- The Senate Finance Committee will vote on Chris Klomp's nomination for deputy health secretary.
Tensions could be eased by the way the administration has pivoted toward nominees who have been less overtly political or not staked out controversial positions.
2. Dem states sue over Medicaid work rules
Half of the states are suing the Trump administration over its directives for implementing Medicaid work requirements, arguing that exemptions for sick people are too narrow and violate administrative law.
Why it matters: Democrats contend the administration's rules will jeopardize care for some of the frailest Americans and cause more upheaval in states that already are rushing to implement the requirements by Jan. 1.
Driving the news: Twenty-five Democratic-led states and the District of Columbia asked a federal court in Massachusetts yesterday to toss out the administration's rule on the new eligibility restrictions.
- The states say the rule goes against congressional intent by making it overly difficult for people to qualify for an exemption from the work requirements due to illness.
- The rule will "cause immediate and irreparable harm" to states' Medicaid programs, the lawsuit says.
- "It will further strain safety net providers, lead to more uncompensated emergency care, and raise other costs associated with newly uninsured, medically frail residents. And it will cause rural hospitals to be even more likely to shutter."
Zoom in: The suit was filed by 23 Democratic attorneys general and the Democratic governors of Kentucky and Pennsylvania, which both have Republican attorneys general.
3. SCOTUS to weigh suit over runaway trans youth law
The Supreme Court yesterday agreed to review another case surrounding transition-related care that focuses on whether runaway minors can get treatments without parental notice or consent.
The big picture: The case addresses the constitutionality of a Washington state law that required licensed shelters to notify parents of runaways but carved out an exception in 2023 if the individual was seeking or receiving "protected health care services."
- The concern was that notification could expose youths to abuse or neglect.
- The decision to review the case arrives a year after justices, in a 6-3 ruling, upheld a Tennessee law banning gender-affirming care for transgender youth.
State of play: International Partners for Ethical Care and a group of parents challenged the Washington state law on the grounds it displaced their decision-making roles and chilled their free speech rights.
- The 9th U.S. Circuit Court of Appeals last July upheld a lower court ruling tossing the lawsuit, saying the harm the parents alleged was speculative and self-imposed.
- Justices in the fall term will review whether the parents have standing because they've established the law could cause current or future harm.
4. 1 big number: Young kids exposed to cannabis
Cannabis exposures increased by more than 6,000% in kids under 6 years old and in the 6–12 age group following federal policy changes that began in 2009, according to new research in Journal of Addiction Medicine.
Why it matters: Virtually all of the cases involved consuming cannabis-infused edibles. Some kids were admitted to hospital ICUs, and a small number had to be intubated and put on a ventilator, researchers said.
What they found: Reported exposures in those 12 and younger surged from 153 in 2009 to 11,324 in 2024, per the analysis of the National Poison Data System.
- They were especially high in children under 6 — a group previous research has suggested was especially prone to hospitalization.
The researchers called for better child-resistant packaging on flavored and sweetened edibles — and for further limiting the maximum amount of THC (the psychoactive compound in cannabis) per edibles package.
5. Catch up quick
🏥 A hospital funneled most of its bills through a surprise billing ban's arbitration process that's meant to be a last resort, quadrupling its revenue. (Stat)
🏭 The FDA selected Eli Lilly, Regeneron and five other companies for a pilot program to accelerate reviews of new domestic drug facilities. (Reuters)
⁉️ The New England Journal of Medicine retracted pivotal data behind Amgen's autoimmune drug Tavneos amid an FDA investigation of the results. (Endpoints)
Thanks for reading Axios Vitals, and to editors Adriel Bettelheim and David Nather and copy editor Matt Piper. Please ask your friends and colleagues to sign up.
Sign up for Axios Vitals








