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The Trump administration's rollback of a policy that prohibited immigration enforcement in hospitals is sparking fear and confusion in exam rooms and emergency departments amid a surge in ICE arrests.

Why it matters: Health care workers say stepped-up enforcement is interfering with care in some instances, and lawyers say it has created enough privacy concerns that some are erasing whiteboards on patient floors and concealing medical records.

• Many hospitals don't have clear protocols, Sandy Reding, president of the California Nurses Association and vice president for National Nurses United, told Axios.
• That's put nurses and other health workers in situations in which they have to confront ICE agents carrying warrants in unauthorized areas.

State of play: A Homeland Security Department directive in January rescinded a Biden administration policy that designated hospitals, schools and churches "sensitive locations" that were off limits to immigration enforcement.

• That had the effect of giving Immigration Customs and Enforcement more leeway to detain individuals in hospitals. They are also able to closely monitor people in their custody who are brought in for medical care.
• Health systems have been seeking legal advice and stepping up training for employees about what's permissible in public and private spaces.
• "The judicial warrant needs to be specific as to the place and who you're looking for. It's not going to say you can just walk into the ICU and check everybody," Douglas Grimm, head of ArentFox Schiff's national health care practice and a former hospital administrator, told Axios.

Zoom in: The stakes were driven home by physicians at a Los Angeles hospital who told LAist that ICE personnel interfered with the care of a detainee. Medical personnel were not able to call the patient's family, even to find out health history, and agents refused to leave during confidential medical conversations.

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If you had trouble keeping track of the state of the CDC after this weekend's mass layoffs followed by abrupt reversals of many terminations, our reporting shows that about 600 agency employees will end up out of work.

• The offices losing workers include those dealing with injury and violence prevention, health statistics, congressional outreach and human resources, sources familiar said.

Why it matters: Although more than half of the roughly 1,300 notices originally sent to the agency workforce have been rescinded, the upheaval from the layoffs that are still taking effect could undermine efforts to protect public health.

• They've also become a flashpoint in broader shutdown-related layoffs that are being challenged in court by federal workers unions.

Driving the news: The cuts have hit offices including the National Center for Injury Prevention and Control, the National Center for Health Statistics and the CDC's Washington office, which is the channel for communications with Congress, sources said.

• Also hit was the National Health and Nutrition Examination Survey, which supports Kennedy's "Make America Healthy Again" initiative, and an ethics office that reviews conflicts of interest, Debra Houry, who recently resigned as the agency's chief medical officer, told Axios.
• Two unions — the American Federation of Government Employees and the American Federation of State, County and Municipal Employees — are asking the U.S. District Court for the Northern District of California to invalidate the firings.

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Prescription drug policy and tariffs are big priorities for the Trump administration. But after the two issues collided in a conflicting series of White House messages recently, President Trump set aside the tariffs idea, which could have made drugs more expensive for many Americans.

Why it matters: Trump's uneven management style — particularly surrounding tariffs — shadows a White House in which policies can be made on the fly, change suddenly at the president's whim, and then be fine-tuned as conflicts are resolved in real time.

Friction point: Trump Cabinet secretaries sometimes operate with such independence that they encroach on one another's turf.

• In this case, it was Commerce Secretary (and tariffs cheerleader) Howard Lutnick on one side initially, and Health Secretary Robert F. Kennedy Jr. on the other.
• Kennedy's department has been negotiating with drug companies as part of Trump's "most favored nation" prescription drug plan to lower drug costs for Americans.
• The conflict came to a head Sept. 25, when a previously scheduled Oval Office meeting about tariffs on heavy trucks and furniture segued into a discussion about pharmaceuticals tariffs.

At 7:24pm, Trump posted that he'd impose the 100% tariff on prescription drugs produced outside the country.

• That blindsided Kennedy, Medicare and Medicaid Administrator Mehmet Oz, senior White House officials and drug companies negotiating with them. None had been consulted about the announcement.
• Five days later, Lutnick made clear that Trump's tariff plan had been paused.

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Tell Congress: Protect Access to 24/7 Care — because when the doors close, it is too late.

More than 300 hospitals are now at risk of closure, threatening access to critical care. We’re here to heal, but we need your help to stay here.

Help keep hospitals running.

Kennedy has been portrayed as dietary supplements' savior, but his FDA plans may not go down easy for the industry.

Why it matters: Kennedy has directed FDA to require review of the "Generally Recognized as Safe" (GRAS) standard — a process companies use to affirm that a substance is safe to eat or consume without needing full agency approval.

Potential changes, which are being closely watched by food manufacturers, will also impact companies making supplements.

• GRAS has become a big target of Kennedy's "Make America Healthy Again" movement, viewed as a loophole that enables companies to use unhealthy ingredients with little oversight.
• Food and supplement makers say they already follow strict protocol for ensuring that ingredients are safe or have a history of being safe and that self-certifying allows them to more quickly create products in a dynamic marketplace.
• A comment period on the standard closed last month, and industry is awaiting a proposed rule expected this month. Officials have indicated that the revisions are expected to be implemented ahead of the midterms and possibly as soon as March 2026, SupplySide Supplement Journal reported.

What they're saying: Natural Products Association CEO Daniel Fabricant says the proposal could drive up supplement prices and limit consumer choice.

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