Maha’s big reversal and a Scotus decision on tariffs

0:00James Politi: The hustle doesn't have to hurt. If performance pressure is making it hard to breathe, Grow Therapy helps you navigate stress, set boundaries, and actually feel like yourself again. Whether it's your first time in therapy or your 50th, Grow makes it easier to find a therapist who fits you, not the other way around. You can search by what matters, like insurance, specialty, identity, or availability, and get started in as little as two days. There are no subscriptions, no long-term commitments. You just pay per session. Grow helps you find therapy on your time. Whatever challenges you're facing, Grow Therapy is here to help.

0:36James Politi: Grow accepts over 100 insurance plans, including Medicaid in some states. Sessions average about$21 with insurance, and some pay as little as$0, depending on their plan. Visit growtherapy.com slash start now to get started. That's growtherapy.com slash start now. GrowTherapy.com slash start now. Availability and coverage vary by state and insurance plan. Hey, Swamp Noters. We had another show prepared for you today, but we're going to spend some time at the start of this episode breaking down some big news. The U.S. Supreme Court ruled that President Donald Trump's sweeping tariffs are illegal.

1:16James Politi: The 6-3 decision is a real rebuke of the president's economic agenda and the first major defeat for Trump at the high court. I called up James Politi, the FT's Washington bureau chief, to help make sense of the decision. Hi, James. Hi, good to be with you. So, James, why did the justices rule against Trump's tariffs? So they ruled against Trump's tariffs saying that President Trump did not have the authority to impose the tariffs under IEPA, which is the Emergency Economic Powers Law from 1977 that he had claimed as this kind of statutory basis for his tariffs. So it was a pretty blanket ruling, a very clear-cut ruling by the justices, saying that this statute contained no reference to tariffs or duties, and that no previous president had used IEPA to impose tariffs, and that the president had to essentially claim a clear congressional authorization for them, which he failed to do.

2:27James Politi: And what does this mean for the tariffs currently in place? Are they going to get repealed? That's where it all gets quite hazy because the justices only ruled on the legality or constitutionality of the use of emergency powers to impose tariffs. but they didn't offer any kind of indication of what the remedy would be, if there should be refunds or if there shouldn't be refunds to consumers who had to pay the tariffs. These would be the importers. And so it leaves everything in limbo. They essentially sent it all back to the lower courts to decide. And so it's all a bit up in the air on that front.

3:10James Politi: That's the FT's James Politi. Thanks so much, James. Thanks so much, Mark. After James and I spoke on Friday, President Trump held a press conference strongly condemning the court's decision. I'm going to just start. Although I firmly disagree with the court's holding today, the decision might not substantially constrain a president's ability to order tariffs going forward. Trump said he would impose a 10 percent, quote, global tariff on top of existing U.S. levies using the Trade Act of 1974. We'll have more on the Supreme Court's ruling in Monday's FT News briefing for now. Here's the rest of the show.

3:50James Politi: The Trump administration dumped a big pharmaceutical company recently. The U.S. Food and Drug Administration announced recently it will not review Moderna's mRNA flu vaccine. But then they patched things up.

4:03Brooke Masters: The FDA is reversing course and it says it will now review Moderna's mRNA flu vaccine.

4:09James Politi: It's the latest sign of a complicated relationship between healthcare companies and a president that says he wants to make America healthy again.

4:22James Politi: This is Swamp Notes, the weekly podcast from the Financial Times, where we talk about everything happening in U.S. politics, finance, and the economy. I'm Mark Filippino, and this week we're asking, what's going on with Trump's healthcare agenda? Here with me to discuss is Patrick Temple-West. He's the FT's U.S. Pharmaceuticals correspondent. Hi, Patrick. Hello, Mark. And we've also got Brooke Masters, the FT's U.S. managing editor. Hi, Brooke. Hello. So, Patrick, this little spat I was just talking about was between the Federal Drug Administration and the drug maker Moderna. What happened there exactly?

4:53Patrick Temple-West: Yeah, so it has to do with flu shots. Did you get your flu shot? I did get my flu shot. Yes. I'm all vaxxed up. Well, in 2026, for next year's flu shot season, you might be able to get a Moderna flu shot. This would be their first flu shot offering. And that's what this spat was about. Moderna is famous for its COVID-19 vaccines, but it is trying to launch a flu vaccine as well. And what's controversial about that? For all new drug products, you have to go through a trial process. As part of this process, because these biotech companies are spending millions of dollars on the trials, You go to the FDA and say, hey, if we ran our tests this way, would you be OK with that once we give you the results?

5:39Patrick Temple-West: Back in 2024, the FDA said, yes, Moderna, your flu shot trial looks good to us. Moderna has gone through with that now and requested that the FDA consider it. The FDA said no last week.

5:57Brooke Masters: Crucial difference. First time FDA was run by Biden appointees. This time the FDA is run by Trump appointees.

6:04James Politi: Right, right, right, right. I said that they patched things up. How did they get things resolved?

6:10Patrick Temple-West: Moderna put out a regulatory filing this week and said now the FDA will accept its proposed trial. The share price jumped again and basically Moderna got what it was asking for. What we learned later after the FDA said, okay, Moderna, you can proceed with this trial, there was a meeting between the FDA commissioner, Marty McHarrie, and President Trump. Now, the Trump administration is saying there's nothing to see here. The president didn't have any influence over this. The president meets with lots of people. He calls people up at all hours. This was a healthy back and forth between a drug regulator and biotech that's doing something new.

6:56Patrick Temple-West: But you can somewhat read between the lines that the FDA last week said no to Moderna and then very quickly within a few days said, yes, you can proceed with what we had agreed to.

7:10James Politi: Brooke, what do you think about the FDA's about-face and what does it say about this backlash that they got for turning down Moderna's application? Because they did get quite a bit of backlash for it.

7:21Brooke Masters: Absolutely. Moderna's share price tanked and much of the drugs industry was very upset because you can't run a business based on innovation if the government changes the rules on how you test them and get them approved midway through the process. And there is also growing concern outside of the president's really tight base about the influence of Robert F. Kennedy Jr., the Secretary of Health and Human Services, who is very anti-vax and has been openly anti-mRNA vaccines in particular. There's a lot of concern that he's got too much influence. And the rejection of an mRNA flu vaccine, even though it appeared in early testing to do better than regular vaccines, really, really upset lots and lots of people.

8:09Brooke Masters: And, you know, we don't know what Trump said, but it didn't play well with both the business community and the health community and probably also with ordinary people who'd like a flu shot that works. Right.

8:20James Politi: And Robert F. Kennedy, the Secretary of Health and Human Services, which oversees the agencies that make these kinds of decisions. And RFK Jr. has led this controversial movement, Make America Healthy Again, which is, of course, a play on Make America Great Again. What can you guys tell me about Maha, as it's called?

8:41Brooke Masters: It kind of has multi-prongs. Some of it is skepticism of big drug companies. So they're cracking down on drug advertising. Some of it is skepticism about big food and so cracking down on ingredients that RFK and his followers believe are bad for you, including things like seed oils. And some of it is, you know, they're reformulating the dietary pyramid. We all grew up getting told you had to eat a lot of bread, and now they're telling you don't. It's a funny mix of, like, weird anti-corporate stuff that threaded through with, you know, paranoia about the COVID vaccine and genuine smart efforts to sort of make Americans less obese and healthier.

9:25James Politi: Is it popular? Do we have any reaction from Trump's base about whether or not people like this Maha initiative?

9:32Patrick Temple-West: Yes, it pulls well. And specifically on the food elements that you were just talking about. The vaccine skepticism is way more challenging for the Trump administration. Remember, the vaccines came online in the waning days of the Trump administration. And President Trump has always wanted to take credit for that, for getting the COVID-19 vaccines up and running so quickly. So there is a tension on the vaccine element of the Maha community.

10:05James Politi: There's also a tension between Trump and some of these drug makers that we mentioned. Just generally, the Trump administration has kind of made it a mission to lower drug costs, which are astronomically high in the U.S. And the Trump administration took months to negotiate with drug companies to lower these prices. It resulted in a website called TrumpRx, which was announced recently. What do we know about that and whether or not it's been received well?

10:34Patrick Temple-West: So TrumpRx officially launched in January. It was proposed back in September, October, in conjunction with these deals that Trump negotiated with pharmaceutical companies, Pfizer, Novo Nordisk, Eli Lilly, more than 15 have reached deals with the Trump administration to lower some of their drug prices. Trump Rx is basically a distribution website where you can go on the website, look up a drug that you might need or might want, and it will direct you to the pharmaceutical companies or a telehealth pharmacy where you can actually buy it.

11:11Brooke Masters: This is also part of Trump's broader campaign to address affordability, which is a huge huge political issue in the U.S. right now, which is that Americans, after having had lots of inflation right after the recovery from COVID, are still very angry and feel that their life is too expensive. And drug prices, under the best of circumstances, are very high in the U.S. And so this is a visible way where he says, I'm bringing down drug prices. As a practical matter, of course, most Americans who have health insurance actually don't buy drugs directly from the manufacturer. they get negotiated deals which actually are probably lower than a lot of these Trump Rx prices.

11:51Brooke Masters: So it's visual like, come here, see what I'm doing for you. But actually, in practical effect, most people aren't getting much benefit.

11:57Patrick Temple-West: Except for the weight loss drugs. People did pay out of pocket for the weight loss drugs because they weren't. I mean, the coverage is getting better for them. And that was part of the deal with Novo Nordisk and Eli Lilly with the Trump administration was to lower the weight loss drugs and get them included in Medicare. But a lot of people were paying out of pocket because their insurance wasn't going to cover them. So for Trump to be able to bring what he describes as the fat shot to American people for less money is pretty dramatic.

12:27James Politi: As someone who's somewhat familiar with these storylines and coming to you for expert analysis, from my perspective, it feels like the Trump administration kind of picks on the pharmaceutical industry.

12:41Patrick Temple-West: is that a fair assessment i think that it's pretty bipartisan to beat up on the pharmaceutical companies i haven't been in this role too long but just looking back in in history there was a big congressional hearing launched by the democrats into a drug called humira from abvi which they were doing all sorts of you know pushing the envelope on on patents if you can protect your drug with patents before it can go generic and the prices come down so there have been investigations into the high cost of drugs before. So it is a bipartisan election issue to run against high drug prices in this country.

13:20Brooke Masters: Remember, one of Biden's signature programs was to use the power of the Medicare program to negotiate lower prices for Medicare-related drugs, which again, people who have Medicare, those are older people, most of their health care is covered by the government, but they do pay their own drugs in many cases. And Biden was really proud of having forced down the prices.

13:40Patrick Temple-West: And it was in the Inflation Reduction Act as well. We've written about that, mostly from some of the climate efforts that that law included. But there was also a provision in there that for the first time, the government would start negotiating with pharmaceutical companies to lower, again, a handful of drugs. And Trump Rx and what the president started to do last year with the pharmaceutical companies builds upon that.

14:34James Politi: Thank you. and get started in as little as two days. There are no subscriptions, no long-term commitments. You just pay per session. Grow helps you find therapy on your time. Whatever challenges you're facing, Grow Therapy is here to help. Grow accepts over 100 insurance plans, including Medicaid in some states. Sessions average about$21 with insurance, and some pay as little as$0, depending on their plan. Visit growtherapy.com slash start now to get started. That's growtherapy.com slash start now. growtherapy.com slash start now. Availability and coverage vary by state and insurance plan.

15:18James Politi: So, okay, this is, as you've kind of described it, an easy political win for anybody on the political spectrum. But to me, it's kind of interesting because the president has kind of characterized himself as being very pro-business. and to intervene this way is maybe a little bit surprising, Brooke. I mean, does this surprise you at all?

15:39Brooke Masters: Trump considers himself pro-business in some ways, but he's also incredibly interventionist. I mean, he basically believes in picking winners and picking losers. And in all kinds of sectors, whether it is energy or chips or, frankly, TikTok, he picks companies where he gets deeply involved with what's going on. or U.S. Steel. Remember, they were trying to sell that to a Japanese company. He is much more interventionist in the economy, certainly than any traditional Republican would be because they are traditionally quite market friendly. Trump is a guy who believes in cutting deals and getting involved.

16:15Brooke Masters: And he doesn't see any problem with doing that as president with companies. And so basically, I think if you're the drug companies and privately in your own home, you may be saying like the guy is basically holding us up. In public, you say, oh, we love negotiating with the president.

16:32Patrick Temple-West: Exactly. And that was the conversation, again, sort of behind the scenes and off the record, all of last year leading up to the pharmaceutical deals with the White House. I mean, it was a kind of a game of chicken about whether anyone would do these deals with Trump. And then once one did, it sort of broke through and everybody followed suit. But there was a lot of hand-wringing behind the scenes.

16:53James Politi: Patrick, some more health-related news this week. The head of the Centers for Disease Control and Prevention was ousted and on Thursday replaced, at least temporarily, by Jay Bhattacharya, an ally of RFK Jr. Why does this matter?

17:06Patrick Temple-West: He's an ally, but maybe not as close as the man he replaced, Jim O 'Neill, who was also an ally of RFK. And it sounds like in the Washington intrigue circles that this might have had to do with Moderna and sort of deemphasizing RFK's influence over HHS, specifically in the drugs and vaccine space. So yes, there was a bit of change over it. Now, these are acting people, the CDC position, CDC director, Senate confirmed role. So whomever it is will need to go through the Senate to get confirmed. But for now, it is a bit of a changing of the guard.

17:47Brooke Masters: It's also worth remembering that the new person also spoke really positively about the measles vaccine. Yes. The U.S. has a horrible measles outbreak going on all over the place. And there are certainly some political analysts who believe that the vaccine skepticism is turning into a loser issue because children are dying and that the Trump administration is to a certain extent trying to reduce the conversation about that.

18:14James Politi: I fully support children being vaccinated for diseases like measles that can be prevented with the vaccination efforts. That was Bhattacharya. Does this signal that the Trump administration is on the whole becoming more pro-vaccine?

18:29Patrick Temple-West: The measles situation is bad for them, especially because these cases are in red states. What people in Washington say is if the measles situation, which is bad, if it gets worse, that could topple RFK. He is a vaccine skeptic. He hasn't been as vocal against measles as he has against COVID and just sort of other vaccines in general. But if these cases really add up and there are tragedies, that could be the straw that breaks Kennedy and severs his ties with the Trump administration.

19:05Brooke Masters: I think the issue of RFK's impact on the nation's health matters as we approach the midterms because in all of the by-elections we've seen up to now, you know, the sort of state legislatures, you know, special elections kind of thing, there's been a massive swing against Republicans in a lot of the special elections that we've seen. Republican candidates are polling 10 points below where they did in 2024. And if that continues, that's really bad news for the midterms because, of course, the Republicans have a very, very narrow majority in the House. And if people are getting sick in red states and they cannot count on their safe red states, they're going to really, really struggle to keep their majority.

19:45Patrick Temple-West: I agree with that. I think that's why you might see a shifting of focus away from vaccines and pharmaceutical regulations toward things like the ultra processed foods, toward things like lowering drug prices for people. Those are definitely more popular.

20:03James Politi: I want to just end here by asking, what do these things tell you about Trump's approach to big business, food, pharmaceutical, all of it?

20:13Brooke Masters: I mean, he wants to be popular and he's populist and populists in general are skeptical of very large companies. At the same point, his administration has a stated purpose of being deregulatory. And so I think what's interesting about food and pharma is that they are not benefiting from this larger deregulatory effort that has been great news for things like banks. And I think that is partly because people and Trump's base in particular are a field taken advantage of by big whatever it is, but particularly big food and big pharma who are charging high prices that are higher than they were four years ago and are a big part of what people feel as inflationary pressure.

20:55Patrick Temple-West: From an investor perspective, they hate the uncertainty that the FDA and the Moderna case have highlighted here. And this isn't the only one. It's probably the most high profile. But other biotechs have been similarly whipsawed by the FDA saying, OK, you can do things one way and then a year into the Trump administration. Well, no, you can't do it that way. Investors, biotechs, they'll adapt pretty much no matter what, but they just can't have the goalposts moving back and forth on them like this.

21:29James Politi: Okay, guys, I actually lied. I do have one more fun bonus question. And it has to do with a video that RFK Jr. shared on social media this week.

21:41Brooke Masters: The northern lights in the southern comfort. And it don't even matter. What is good? The posture, all the crackheads, the critics, the cynics, and all my heroes at the methadone clinic.

21:52James Politi: The video is of him working out shirtless with Kid Rock and the message, get active, eat real food. Did you guys see this video? I've seen pictures. Not only are they shirtless, but they're both wearing long pants and they're in a sauna, which is just a kind of an added bonus to all this. What did you guys think?

22:09Brooke Masters: You know, I have to say, like, this is not a site for sore eyes, to put it mildly. I mean, neither RFK nor Kid Rock are, shall we say, pinup guys.

22:21James Politi: Patrick, what do you think?

22:23Patrick Temple-West: I think it strongly suggests that RFK wants to run for president again. He ran the first time around and then came on to endorse Trump. I think what he's done in the food sector, calling out ultra-processed foods, getting people to think about their health again, it's a popular message. And I think he's leaning into that. and building his social media following is a great way to build a base of followers if you do ultimately run for the White House again.

22:56James Politi: Yeah, I mean, we're talking about it, right? So I want to thank our guest, Patrick Temple West. He's the FT's U.S. Pharmaceuticals correspondent. Thanks, Patrick. Thank you, Mark. And Brooke Masters, the FT's U.S. Managing Editor. Thanks, Brooke.

23:07Brooke Masters: Thanks for having me.

23:17James Politi: This was Swamp Notes, the U.S. politics show from the FT. If you want to sign up for the Swamp Notes newsletter, we've got a link to that in the show notes. Our show was produced by Henry Larson. It was mixed by Sam Giovinco. They helped this week from Lauren Fedor and Manuela Saragossa. Special thanks to Pierre Nicholson. I'm your host, Mark Filippino. Our executive producer is Topher Forges, and the FT's global head of audio is Cheryl Brumley. Original music by Hannes Brown. Check back next week for more U.S. political analysis from the Financial Times.

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