By NICHOLAS RICCARDI

A federal judge on Tuesday placed on hold much of Donald Trump’s order forbidding the federal government from doing business with anyone who hires the law firm Susman Godfrey, making it the fourth time a judge has found the president’s targeting of law firms is likely unconstitutional.

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“The framers of our constitution would see this as a shocking abuse of power,” District Court Judge Loren AliKhan said as she entered the temporary restraining order on behalf of Susman, which represented a voting machine firm that won a $787 billion settlement from Fox News over its airing of lies about Trump’s 2020 loss.

Trump’s executive order cited the firm’s election work as a reason it was targeted. Several other firms that have been targeted by Trump entered into settlements, promising to provide hundreds of millions of dollars worth of free legal work for the president’s favored causes. Susman and at least three others have chosen to fight, and all have so far won in court.

Don Verrilli, who represented Susman in court on Tuesday, urged the judge to continue that winning streak. “We’re sliding very fast into an abyss here,” he said. “There’s only one way to stop that slide, it’s for courts to act decisively, and to act decisively now.”

Though the restraining order technically is only good for 14 days, the judge left little doubt as to her views on the constitutionality of Trump’s order. She found it likely violates the first and fifth amendments of the U.S. Constitution, saying that “the government cannot hold lawyers hostage to force them to agree with it.”

Richard Lawson, who argued against the order for the Department of Justice, contended it fell squarely in the tradition of presidential decisions regarding contracting and federal facilities that date back to President Lyndon B. Johnson in the 1960s requiring federal contractors to not discriminate. Lawson was unable to convince the judge to wait until federal agencies develop guidance about how to implement Trump’s order.

AliKhan put on hold provisions in the order that ban federal contractors to companies that hire Susman Godfrey and forbids its employees from entering federal buildings. Verrilli said Susman Godfrey received no warning or explanation of the federal order, but noted that Trump signed it a few weeks before the start of another libel trial over his 2020 election lies, this time targeting the conservative network Newsmax, owned by a prominent Trump ally.

Though other firms have also won rulings putting orders targeting them on hold, Attorney General Pam Bondi has sharply criticized at least one of them and told federal agencies they retain the authority to “decide with whom they will work.”

Some 10,000 federal health workers lost their jobs earlier this month — among them, a group of regulators who help new medicines get approved. If Health and Human Services Secretary Robert F. Kennedy Jr. doesn’t reverse course, American patients will suffer and half a century of US leadership in pharmaceutical innovation could come to a precipitous end.

Three decades ago, the US lagged Europe in access to new medications. Respiratory drugs, on average, were available to Britons more than five years before Americans; cardiovascular drugs had a three-year lead. Pressured to narrow this disparity, Congress passed a law in 1992 to speed up drug approvals. The new framework allowed regulators to collect fees from drug companies, which vastly increased resources at the Food and Drug Administration for reviews.

The law — the Prescription Drug User Fee Act — has been a notable success. Median FDA review times fell from 26.6 months between 1980 and 1992 to 9.9 months in the decade through 2022. Today, Americans have access to three-quarters of new medicines, and the US has become a world leader in some of the most advanced treatments, including cell and gene therapies. The promise of such innovations — which can, among other medical miracles, target and destroy cancer cells, potentially reverse hearing loss, and enable sickle-cell patients to live without debilitating pain — can hardly be overstated.

Yet US dominance in such medicine shouldn’t be taken for granted. China’s drug industry is racing ahead, thanks to government investment and ambitious regulatory reform (that included aggressive hiring). Once known for supplying raw ingredients and manufacturing copycat drugs, China is now second only to the US in the development of new medicines. In the past three years, the number of drugs in China’s pipeline has doubled. Recent data show almost a third of clinical trials start in China, roughly on par with the US and up from 5% a decade ago.

Against this backdrop, these seemingly indiscriminate job cuts are worrisome. In addition to removing the head of the office that reviewed applications for new medicines, the FDA also has eliminated staff who negotiate user fees with drugmakers. Kennedy has long objected to user fees, arguing that the FDA’s reliance on industry funding — which constitutes almost half its budget — compromises its oversight. This is false: Cases of FDA-approved medications causing patients serious harm remain exceedingly rare. More to the point, the only serious alternative — raising taxes to pay for regulatory staff — is a political nonstarter.

Kennedy’s department said that neither drug reviewers nor inspectors would be cut in this reorganization, and that approvals wouldn’t slow down as a result. Recent reports cast doubt on those claims: For example, a government-wide $1 limit on spending cards has already hamstrung field operations; a pilot program for unannounced foreign inspections, meanwhile, has been paused because the staff who’d once secured translators have been fired. Dozens of employees with cross-cutting responsibilities, including those who wrote guidelines for inspectors or compared results across reviews, are gone.

The pharmaceutical industry — quiet, to date, about Kennedy’s potential impact on their business — now appears concerned: “The rapid and substantial changes at FDA  raise questions about the agency’s ability to fulfill its mission to bring new innovative medicines to patients,” a large industry group said after the cuts. Investors have been less ambiguous, with biotech stocks declining sharply after Kennedy’s announcement.

The health secretary has been called to testify before the Senate. He should explain how his cuts will protect American innovation and benefit patients. Otherwise, the public might reasonably conclude that the US is about to squander its hard-won dominance in drug development for no good reason.

— Bloomberg Opinion

By MATT SEDENSKY

NEW YORK (AP) — The latest government waste touted by billionaire Elon Musk’s cost-cutting Department of Government Efficiency is hundreds of millions of dollars in fraudulent unemployment claims it purportedly uncovered.

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One problem: Federal investigators already found what appears to be the same fraud, years earlier and on a far greater scale.

In a post last week on X, the social media site Musk owns, DOGE announced “an initial survey of unemployment insurance claims since 2020” found 24,500 people over the age of 115 had claimed $59 million in benefits; 28,000 people between the ages of 1 and 5 collected $254 million; and 9,700 people with birthdates more than 15 years in the future garnered $69 million from the government.

The tweet drew a predictable party-line reaction of either skepticism or cheers, including from Musk himself, who said what his team found was “so crazy” he re-read it several times before it sank in.

“Another incredible discovery,” marveled Labor Secretary Lori Chavez-DeRemer, who repeated DOGE’s findings to President Donald Trump in a Cabinet meeting last week.

Chavez-DeRemer’s recounting of the alleged fraud, including claims of benefits filed by unborn children, drew laughter in the Cabinet room and a reaction from Trump himself.

“Those numbers are really bad,” he said.

But Chavez-DeRemer needn’t look further than her own department’s Office of the Inspector General to find such fraud had already been reported by the type of federal workers DOGE has demonized.

“They’re trying to spin this narrative of, ‘Oh, government is inefficient and government is stupid and they’re catching these things that the government didn’t catch,’” says Michele Evermore, who worked on unemployment issues at the U.S. Department of Labor during the administration of former President Joe Biden. “They’re finding fraud that was marked as fraud and saying they found out it was fraud.”

The Social Security Act of 1935 enshrined unemployment benefits in federal law but left it to individual states to set up systems to collect unemployment taxes, process applications and mete out support.

Though states have almost complete control over their own unemployment systems, special relief programs — most notably widely expanded benefits enacted by the first Trump administration at the outset of the COVID pandemic — inject more direct federal involvement and a flood of new beneficiaries into the system.

In regular times, state unemployment systems perform “very well, not so well and terribly,” according to Stephen Wandner, an economist at the National Academy of Social Insurance who authored the book “Unemployment Insurance Reform: Fixing a Broken System.” With COVID slamming the economy and creating a flood of new claims that states couldn’t handle, Wandner says many more were “quite terrible.”

Trump signed the COVID unemployment relief into law on March 27, 2020, and from the very start it became a magnet for fraud. In a memo to state officials about two weeks later, the Department of Labor warned that the expanded benefits had made unemployment programs “a target for fraud with significant numbers of imposter claims being filed with stolen or synthetic identities.”

That same memo offered an option for states trying to protect a person whose identity was stolen to fraudulently collect unemployment benefits. To preserve a record of the fraud but keep innocent people from being linked to it, states could create a “pseudo claim,” the memo advises.

Those “pseudo claims” led to records of toddlers and centenarians getting checks. The Labor Department’s inspector general tallied some 4,895 unemployment claims from people over the age of 100 between March 2020 and April 2022, but another departmental memo explained that the filings stemmed from states changing dates of birth to protect people whose identities were used.

“Many of the claims identified … were not payments to individuals over 100 years of age, but rather ‘pseudo records’ of previously identified fraudulent claims,” the 2023 memo says.

A Labor Department spokeswoman did not respond to questions about Musk’s findings and DOGE gave no details on how it came to find the supposed fraud or whether it duplicates what was already found.

Though DOGE ostensibly looked at longer timeframe than federal investigators previously had, it tallied just $382 million in fake unemployment claims, a tiny fraction of what investigators were already aware.

In 2022, the Labor Department said suspected COVID-era unemployment fraud totaled more than $45 billion. The Government Accountability Office later said it was far worse, likely $100 billion to $135 billion.

“I don’t think it’s news to anyone,” says Amy Traub, an expert on unemployment at the National Employment Law Project. “It’s been widely reported. There’ve been multiple congressional hearings.”

If DOGE’s newest allegations have an air of familiarity, it’s because they echo its prior findings of about Social Security payments to the dead and the unbelievably old. Those were false claims.

That makes DOGE an imperfect messenger even when fraud has occurred, as with unemployment claims.

Jessica Reidl, a senior fellow at the conservative think tank The Manhattan Institute, is a fiscal conservative who so champions rooting out federal waste she has written 600 articles on the subject. Though she believes unemployment insurance fraud is rife, she has trouble accepting any findings from DOGE, which she says has acted ineffectively and possibly illegally.

“When DOGE says impossibly old dead people are collecting unemployment in huge numbers, I become skeptical,” Reidl says. “DOGE does not have a good track record in that area.”

Traub said the burst of pandemic-era unemployment fraud led states to implement new security measures. She questioned why Musk’s team was trumpeting old fraud as if it’s new.

“Business leaders and economists are warning about a national recession, so it’s natural to think about unemployment,” says Traub. “It’s an attack on the image of a critically important program and perhaps an attempt to undermine public support on unemployment insurance when it couldn’t be more important.”

Matt Sedensky can be reached at msedensky@ap.org and https://x.com/sedensky.

Robert F. Kennedy Jr. has never been afraid to challenge conventional wisdom — sometimes aligning with scientific consensus, often rejecting it.

Now, as secretary of Health and Human Services, Kennedy has the power to shape national health care policy. And many will measure his leadership with one critical question: Can he reverse America’s alarming decline in life expectancy?

For decades, the United States has spent more on health care than any other nation, yet health outcomes continue to lag behind global peers. According to the Peterson-KFF Health System Tracker, Americans now live four years less than citizens of other high-income countries. The U.S. premature death rate is nearly double that of comparable nations, a gap that has widened in recent years.

Peterson-KFF data points to three primary drivers for this, which together account for 68% of the gap:

— Chronic disease (32% of the gap)

— Deaths of despair, including those from substance abuse (12%)

— The lingering effects of the COVID-19 pandemic (24%)

Of course, Kennedy can’t address every factor contributing to premature death. Many “social determinants of health” (e.g., income, education, and housing), would require sweeping reforms across multiple government agencies, well beyond the scope of HHS.

But when it comes to direct medical interventions, Kennedy can enact meaningful reforms, ones that directly address the leading causes of premature death:

According to the Peterson-KFF report, “About a third (32%) of the difference in premature death between the U.S. and similar countries is due to deaths from cardiovascular diseases, chronic respiratory diseases, and chronic kidney diseases.”

Compared to citizens of peer nations, Americans are 2.5 times more likely to die from diabetes and nearly four times more likely to die from kidney disease. Preventable cardiovascular disease remains the nation’s leading cause of death.

These problems represent system-wide failures in prevention and management. According to CDC data, if every clinician and health system delivered care at the level of today’s top performers, the nation could prevent 30–50% of the complications tied to chronic conditions, including heart attacks, strokes, cancer, and kidney failure.

Kennedy has led in this area, repeatedly emphasizing the urgency of addressing chronic disease in America. During his Senate confirmation hearing, he stated, “We need to refocus (on chronic disease) if we are going to save our country. This is an existential crisis.”

His Make America Healthy Again (MAHA) initiative promotes shifting the health care system’s focus from disease intervention to prevention. This plan encourages community-based programs that improve diet, increase physical activity, and expand preventive screenings.

RFK has also advocated for expanding primary care access, a move that’s well-founded by research. Adding 10 primary care doctors to a community increases life expectancy 2.5 times more than adding 10 specialists, according to a Harvard-Stanford study. To that end, he has talked about shifting health care dollars from specialists to primary care physicians.

Approximately 12% of the U.S. life expectancy gap can be attributed to “deaths of despair,” which include deaths from drugs, suicides, and alcohol consumption. Combined, they account for 160,000 preventable deaths annually, disproportionately affecting rural and underserved communities, where access to mental health care and addiction treatment is more limited.

While some clinicians see these deaths as primarily societal, the Drug Enforcement Administration (DEA) considers substance-use disorder treatment a core medical responsibility and requires all physicians to complete eight hours of training to identify and manage patients with these problems.

Kennedy has long been outspoken about addiction treatment reform, shaped in part by his own personal struggles. He has criticized pharmaceutical companies for fueling the opioid epidemic and vowed to address predatory business practices in addiction treatment.

During his Senate confirmation hearing, Kennedy emphasized the role of technology in expanding health care access, particularly in underserved areas. He has advocated for the use of artificial intelligence and telemedicine to bring advanced medical care to rural areas, stating that such innovations could provide “concierge care to every American in this country, even remote parts.”

However, significant advances will require FDA approval of new generative AI tools and Congressional action to allow the provision of telemedicine across states, along with guaranteed Medicare funding for these services.

The COVID-19 pandemic led to over 1 million American deaths and a historic drop in U.S. life expectancy. While every nation suffered, the United States was hit particularly hard. As of 2024, the U.S. has regained only half of the lost years, lagging far behind peer countries.

A major driver of the nation’s high mortality rate was widespread vaccine hesitancy. Though COVID-19 vaccines weren’t a flawless solution, they significantly reduced the risk of hospitalization and death. Still, many Americans — distrustful of public health agencies or swayed by misinformation — chose to forgo them, particularly in more conservative states.

To prevent future infectious disease epidemics, Kennedy will need to reconsider his unscientific views on vaccine risks — whether or not he remains uncertain.

During the Texas measles outbreak, he was slow to endorse vaccination as the best solution, though he eventually acknowledged that “vaccines not only protect individual children from measles but also contribute to community immunity.” While his administration recently removed a fake CDC website spreading vaccine misinformation, Kennedy also appointed a vaccine safety researcher with a history of promoting discredited theories that linked vaccines to autism.

Kennedy has a rare opportunity to improve American longevity and to position the United States as a global health care leader.

By expanding preventive care, strengthening primary care access, and supporting evidence-based mental health and addiction treatments, he could reduce chronic disease and deaths of despair. Science-based interventions would also ensure the nation is better prepared to combat infectious disease threats.

However, if Kennedy undermines public trust in health institutions, promotes unproven treatments, or weakens vaccine programs, preventable deaths will rise and U.S. life expectancy will continue to fall.

The health of millions hinges on the path he chooses.

Dr. Robert Pearl is a Stanford University professor, Forbes contributor, bestselling author, and former CEO of The Permanente Medical Group. He wrote this for The Fulcrum, a nonprofit, nonpartisan news platform covering efforts to fix our governing systems.