SCOTT DETROW, HOST:
What began as COVID vaccine skepticism is quickly becoming federal policy and a major point of political contention. Under Health and Human Services Secretary Robert F. Kennedy Jr., the federal government is restricting approval for COVID vaccines and packing advisory boards with vaccine skeptics.
In response, many states with Democratic governors on both the West Coast and in the Northeast are beginning to form coalitions. Their goal is to fill in the gap on health care policy and try to shield themselves from these sweeping federal changes. One of the states leading the way is Massachusetts. Yesterday, Massachusetts Governor Maura Healey spoke with NPR's Here And Now.
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MAURA HEALEY: States have had to step forward basically into the breach and fill the void left by a gutted CDC and the dismantling of public health infrastructure at the federal government level.
DETROW: For more on what it looks like in Massachusetts and other states that are pushing back against the Trump administration's public health overhaul, we are joined by Jason Laughlin, who covers public health for the Boston Globe. Welcome.
JASON LAUGHLIN: Thanks for having me, Scott.
DETROW: I want to talk about the way that Massachusetts is working with other states. First, walk me through the steps that Governor Healey has taken on her own, the ways that Massachusetts is kind of responding to federal policy changes.
LAUGHLIN: Yeah, so it turns out that a lot of the way vaccines are administered and licensed in the states is tied to the CDC and their advisory council on vaccines. So there has been a lot of legal maneuvering to sort of disentangle Massachusetts from those ties and shift the authority for recommending vaccines from the CDC to the state Department of Public Health, specifically the public health commissioner, Robbie Goldstein.
Among the issues that have come up have been insurance coverage. The governor issued an order that required insurers in Massachusetts to cover vaccines recommended by the public health commissioner. There was licensing issues with pharmacies to assure them that they would have liability coverage if they administer these vaccines without federal recommendations they usually rely on. Massachusetts is among the first, but it's a thing that states around the country are going to, in some way or another, have to replicate if they're going to have independence from the CDC and that advisory committee.
DETROW: As we mentioned, Massachusetts has been working with and talking to other Northeastern states. What are the goals of these emerging coalitions?
LAUGHLIN: The idea is that if you have a patchwork of states, each of them having a different vaccination policy, you just get chaos and confusion. To some extent, creating a regional coalition doesn't totally negate that possibility, but it's an improvement if all the states in the geographic area have essentially the same vaccination policies.
Massachusetts has been talking with most of the states in New England - Pennsylvania, New York, New Jersey, Delaware. And the idea would be that these states would all look to medical societies for guidance and then release vaccine recommendations for their populations that are aligned with each other so there's not going to be confusion from one state to another.
DETROW: I want to ask a couple of different questions about where this could come short. First of all, is it sustainable? Is it durable? Like you said, four or five states is better than just one state, but at a certain point, there's just this broad patchwork of policies that seems to be falling into place across the country.
LAUGHLIN: I mean, you have to bring up what happened in Florida...
DETROW: Yeah.
LAUGHLIN: ...A few days ago where they said their intention is to get rid of all childhood vaccination mandates. So it's not a perfect solution. And even if a group of contiguous states have the same vaccine policy, it's a big country. And you still end up with confusion and haves and have-nots.
There's - one of the things we've been talking about, and it's kind of unclear whether this will happen or not - right now, New Hampshire is not as far along with these conversations as some of the other states. They haven't been named as one of the states that is really interested in doing this coordination. So would that mean that people from New Hampshire, which is - you know, shares a border with Massachusetts, would come right across to get their vaccines, and does that create complications for pharmacists? It is really not a perfect solution.
And what's, I think, difficult and sad about this is the country had a good, consistent system. Just about every state looked to the CDC. They issued recommendations that were reliable. And more or less, the country - their vaccination requirements were more or less the same from coast to coast.
DETROW: The state officials that you're talking to and covering, do they feel like they can trust the CDC at this point? If the CDC puts out an advisory or a report, do they feel like it's trustworthy?
LAUGHLIN: No. They don't. And the people from within the CDC, you know - some people, some top officials resigned last week - they are saying, don't trust what's coming out of the CDC. Don't count on the CDC to be relying on science.
DETROW: I mean, that has a lot of long-term repercussions, given how much not just around the country, but around the world, people look to the CDC to set a baseline for so many different things.
LAUGHLIN: It's an extraordinary situation to be in. I mean, I think this regional coalition, if it does kind of cohere, they're talking about coordinating on disease tracking. They're talking about coordinating on emergency response. These are things the CDC did, that - if something happened in Massachusetts that was concerning, they would, as a matter of course, contact the CDC, the Public Health Department in the state. They'd contact the CDC. The CDC would let them know not just what's happening elsewhere in the country, but elsewhere in the world. And that information, through the CDC, was disseminated pretty much worldwide, and that network is breaking down at this point.
So even with collaboration, there's something that's lost, and in a sense, there's a certain blindness that public health officials didn't have to worry about before because they could count on the CDC to reliably tell them about what's going on elsewhere in the world.
DETROW: One other question about Massachusetts, though - President Trump has made it very clear that he retaliates against political opponents, against schools or cities or states who oppose his policies. Has the federal government taken any steps to punish Massachusetts for being so outspoken on health policy?
LAUGHLIN: This is a really important question. As of now, no, there hasn't been. But right now, Massachusetts - of all the states that are considering this regionalization, Massachusetts has been far and away the most vocal. The other states have been fairly reticent to talk about it, and I think one of the reasons is exactly what you're talking about, that they could end up being a target of the federal government. So right now, Massachusetts is putting itself out there as a leader and is being very bold in its statements. That's not been the case from any of the other states that are part of these conversations.
DETROW: Jason Laughlin covers public health for the Boston Globe. Thanks so much for talking to us.
LAUGHLIN: Thanks, Scott.
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