The Trump administration's crackdown on gender-affirming care is expanding rapidly as officials investigate hospitals, cut off benefits for federal workers and their dependents, and pick new fights with blue states.

Why it matters: The latest moves could put hospitals and other providers in the middle of a showdown between federal power and patient privacy protections — or even force health providers to break their own state laws.

• The actions have also created an atmosphere of fear for transgender individuals, their families, and health providers who say they're providing medically necessary care and haven't violated any laws.

"As of this month, we have really seen escalation," said Kellan Baker, senior adviser for health policy at the Movement Advancement Project, a policy think tank.

• "I think there's this gallop to cause as much damage as possible in as short a time as possible, before the political repercussions ... manifest."

Driving the news: Federal court filings made public last week revealed the Justice Department has subpoenaed hospitals for extensive data surrounding transition-related care for individuals under 19 provided since the beginning of 2020.

• The demands included the Social Security numbers of patients who were prescribed puberty blockers or hormone therapy.
• The Justice Department's subpoenas to children's hospitals potentially set up a collision with HIPAA, said Lisa Pierce Reisz, a lawyer at the firm Epstein Becker Green.
• "These kinds of subpoenas, I think, are an effort to test the legal limits of what they can get," said Don Bell, policy counsel at the Project on Government Oversight.

Also last week, the Office of Personnel Management stripped coverage of gender-affirming care for minors and adults for federal workers beginning next year, other than mental health treatment and certain ongoing hormonal treatment.

• HHS said on Thursday that it's pulling a $5.8 million annual grant from a California program aimed at preventing teen pregnancy and sexually transmitted infections in adolescents because the state refused to scrub mentions of what officials called "gender ideology."

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Health Secretary Robert F. Kennedy Jr. is already working to rally his MAHA movement as a critical constituency for keeping GOP control of Congress in next year's midterms.

Why it matters: The coalition draws several slices of voters who otherwise might shun MAGA, including some traditionally Democratic- and independent-leaning suburbanites, women and younger voters.

Mustering President Trump's MAHA support for House, Senate and governor races in a midterm year could be tough.

• A further impediment to a "MAHA bounce": Some activists who bought into Trump's campaign because of Kennedy's eat-healthy, question-vaccines mantra aren't totally happy with how things are going.
• Many of MAHA's most vocal activists are disappointed the Trump administration isn't following through on its campaign promise to crack down on pesticides — and are warning that could dampen the movement's support for Republicans next year.

Anticipating those obstacles, Kennedy's allies are preparing an aggressive, strategy to try to turn out MAHA voters. The blueprint:

Put RFK Jr. on the road

Kennedy's aides say he's the best symbol for the cause, and are planning on deploying him across the country to sell his agenda.

• HHS is aggressively promoting his tour, this week launching a "MAHA in Action" website highlighting his schedule.

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Officials from eight Northeast states met last week to consider ways of collaborating on future public health recommendations amid shifting Trump administration priorities, per the Boston Globe.

Why it matters: The gathering may indicate a move toward independence from federal guidance on vaccines, as well as more interstate coordination on disease tracking and emergency response in the face of budget cuts to federal health agencies, the Globe wrote.

Leaders from the public health departments of Maine, Vermont, Massachusetts, Rhode Island, Connecticut, New York, New Jersey and Pennsylvania were in attendance.

• "When we have such dramatic changes at the CDC ... it's important for us to really double down on our commitment to science and evidence based recommendations," Robbie Goldstein, Massachusetts' public health commissioner, told the Globe.

Catch up quick: It comes at a time when medical societies have begun breaking with federal health agencies on guidance to doctors when it comes to COVID-19 and flu vaccinations.

• An ad hoc group of infectious disease doctors and health researchers recently held a public vetting of studies on the safety and effectiveness of COVID, RSV and flu vaccines, in the belief the data isn't being adequately considered by federal health officials.

California restaurants may be required to disclose some of the most common food allergens on their menus if a bill passes the state legislature next month.

Why it matters: It would make California the first state to mandate disclosure of the most common food allergens, including milk, eggs, fish, shellfish, tree nuts, peanuts, wheat, sesame and soybeans, AP reported.

The details: Under the bill, restaurants could either post the allergens on their physical menu or make them available some other way, including via QR codes.

• Food trucks would be exempt.
• Advocates for those with food allergies say it would make dining out a less stressful and safer experience. But restaurant owners are fighting the proposal, saying it would increase burdens on restaurants already struggling with rising food prices, tariffs and labor shortages, AP writes.

👉 The White House budget office has only allocated $2.9 billion of $6 billion appropriated by Congress for the President's Emergency Plan for AIDS Relief in the 2025 fiscal year spending bill. (NYT)

💊 Eli Lilly's obesity pill remains a viable rival to Novo Nordisk's oral Wegovy despite data that underwhelmed investors. (CNBC)

💰 Maryland patients hope for a last-minute insurance agreement between Johns Hopkins and UnitedHealthcare, with coverage for 60,000 on the line. (CBS News)