By MARK SHERMAN

WASHINGTON (AP) — The Supreme Court on Tuesday blocked an order for the Trump administration to return to work thousands of federal employees who were let go in mass firings aimed at dramatically downsizing the federal government.

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The justices acted in the administration’s emergency appeal of a ruling by a federal judge in California ordering that 16,000 probationary employees be reinstated while a lawsuit plays out because their firings didn’t follow federal law.

The effect of the high court’s order will keep employees in six federal agencies on paid administrative leave for now.

A second lawsuit, filed in Maryland, also resulted in an order blocking the firings at those same six agencies, plus roughly a dozen more. But that order only applies in the 19 states and the District of Columbia that sued the administration.

The Justice Department is separately appealing the Maryland order.

By MIKE STOBBE and KASTURI PANANJADY

NEW YORK (AP) — U.S. Health Secretary Robert F. Kennedy Jr. has said he wants communities to stop fluoridating water, and he is setting the gears of government in motion to help make that happen.

Kennedy this week said he plans to tell the Centers for Disease Control and Prevention to stop recommending fluoridation in communities nationwide. And he said he’s assembling a task force of health experts to study the issue and make new recommendations.

At the same time, the U.S. Environmental Protection Agency announced it would review new scientific information on potential health risks of fluoride in drinking water. The EPA sets the maximum level allowed in public water systems.

Here’s a look at how reversing fluoride policy has become an action item under President Donald Trump’s administration.

The benefits of fluoride

Fluoride strengthens teeth and reduces cavities by replacing minerals lost during normal wear and tear, according to the CDC. In 1950, federal officials endorsed water fluoridation to prevent tooth decay, and in 1962 set guidelines for how much should be added to water.

Fluoride can come from a number of sources, but drinking water is the main one for Americans, researchers say. Nearly two-thirds of the U.S. population gets fluoridated drinking water, according to CDC data.

The addition of low levels of fluoride to drinking water was long considered one of the greatest public health achievements of the last century. The American Dental Association credits it with reducing tooth decay by more than 25% in children and adults.

About one-third of community water systems — 17,000 out of 51,000 across the U.S. — serving more than 60% of the population fluoridated their water, according to a 2022 CDC analysis.

A public water fountain is seen Friday, March 28, 2025, in Grosse Pointe Park, Mich. (AP Photo/Paul Sancya)

The potential problems of too much fluoride

The CDC currently recommends 0.7 milligrams of fluoride per liter of water.

Over time, studies have documented potential problems when people get much more than that.

Excess fluoride intake has been associated with streaking or spots on teeth. And studies also have traced a link between excess fluoride and brain development.

A report last year by the federal government’s National Toxicology Program, which summarized studies conducted in Canada, China, India, Iran, Pakistan and Mexico, concluded that drinking water with more than 1.5 milligrams of fluoride per liter — more than twice the CDC’s recommended level — was associated with lower IQs in kids.

Meanwhile, last year, a federal judge ordered the EPA to further regulate fluoride in drinking water. U.S. District Judge Edward Chen cautioned that it’s not certain fluoride is causing lower IQ in kids, but he concluded that research pointed to an unreasonable risk that it could be.

Kennedy has railed against fluoride

Kennedy, a former environmental lawyer, has called fluoride a “dangerous neurotoxin” and “an industrial waste” tied to a range of health dangers. He has said it’s been associated with arthritis, bone breaks, and thyroid disease.

Some studies have suggested such links might exist, usually at higher-than-recommended fluoride levels, though some reviewers have questioned the quality of available evidence and said no definitive conclusions can be drawn.

How fluoride recommendations can be changed

The CDC’s recommendations are widely followed but not mandatory.

State and local governments decide whether to add fluoride to water and, if so, how much — as long as it doesn’t exceed the EPA’s limit of 4 milligrams per liter.

So Kennedy can’t order communities to stop fluoridation, but he can tell the CDC to stop recommending it.

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It would be customary to convene a panel of experts to comb through the research and assess the evidence that speak to the pros and cons of water fluoridation. But Kennedy has the power to stop or change a CDC recommendation without that.

“The power lies with the secretary,” but public trust would erode if recommendations are changed without a clear scientific basis, said Lawrence Gostin, a public health law expert at Georgetown University.

“If you’re really serious about this, you don’t just come in and change it,” he said. “You ask somebody like the National Academy of Sciences to do a study — and then you follow their recommendations.”

On Monday, Kennedy said he was forming a task force to focus on fluoride, while at the same time saying he would order the CDC to stop recommending it.

HHS officials did not answer immediately questions seeking more information about what the task force would be doing.

Some places are already pulling back on fluoridation

Utah recently became the first state to ban fluoride in drinking water, and legislators elsewhere are looking at the issue.

An Associated Press analysis of CDC data for 36 states shows that many communities have halted fluoridation in recent years.

Over the last six years, at least 734 water systems that consistently reported their data in those states have stopped fluoridating water, according to the AP’s analysis.

Mississippi alone accounted for more than 1 in 5 of those water systems that stopped. Most water systems that discontinued fluoridation mainly did so to save money, said Melissa Parker, the Mississippi state health department’s assistant senior deputy.

During the pandemic, Mississippi’s health department allowed local water systems to temporarily cease fluoridating because they could not purchase sodium fluoride in the midst of global supply chain issues. Many never restarted, Parker said.

CDC funding for fluoride is typically a small factor

Since 2003, CDC has funded a limited number of state oral health programs through cooperative agreements. The agreements run in cycles, and at the beginning of this year 15 states were each receiving $380,000 over three years.

The money can be used on a number of things, including collecting data on people with dental problems, dental care and technical assistance for community water fluoridation activities.

The current oral health funding is going to Iowa, Kansas, Louisiana, Maryland, Michigan, Minnesota, Missouri, Ohio, Nevada, New York, North Dakota, Pennsylvania, South Carolina, Virginia and Wisconsin.

The states are told not to use the money for chemicals, because the funding is intended to help set up fluoridation, not for everyday expenses, federal officials have said. South Carolina, for example, sets aside up to $50,000 to help communities in that state fluoridate. Iowa spends about $65,000 to promote community water fluoridation.

Earlier this year, CDC officials declined to answer questions about how much of the total oral health money has been going toward fluoridation.

Now, there is no one to ask: Last week, the CDC’s entire 20-person Division of Oral Health was eliminated as part of widespread government staffing cuts.

Congress appropriated money to CDC specifically to support oral health programs, and some congressional staffers say the agency must distribute those funds no matter who is running the HHS or CDC. But Trump-driven budget cuts have struck at a number of programs that Congress had called for, and it’s not clear what will happen to the CDC oral health funding.

Fluoridation is relatively cheap compared with other water department expenses, and most communities simply incorporate the cost into the water rates charged to customers, according to the American Water Works Association.

In Erie, Pennsylvania, for example, fluoridating water for 220,000 people costs about $35,000 to $45,000 a year and is entirely funded by water rates, said Craig Palmer, the chief executive of the Erie Water Authority.

So cutting off the CDC money would not have much impact on most communities, some experts said, although it could be more impactful for some smaller, rural communities.

Pananjady reported from Philadelphia.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

By CHRIS MEGERIAN, JOSH BOAK and STEPHEN GROVES

WASHINGTON (AP) — Less than one hour before the stock market closed on Monday, journalists gathered in the Oval Office for their only chance of the day to ask President Donald Trump about the turmoil caused by his tariff plans.

Are the new tariffs, scheduled to take effect on Wednesday, a bargaining chip to reach better trade deals? Or are they etched in stone in a mission to revamp the global economy?

Investors around the world were hanging on Trump’s every word, but he did little to clear up the situation.

“It can both be true,” he said. “There can be permanent tariffs, and there can also be negotiations.”

The markets skidded to a close. At a time when foreign leaders and business executives are desperate for clarity, the White House is sending mixed messages as it pursues conflicting goals.

Advisers have tried with some success to tamp down a days-long stock selloff by talking up tariffs as a starting point for negotiations, which could mollify Wall Street and jittery Republicans in Congress. The S&P 500 stock index opened up 3.4% on Tuesday. But the president continues to insist that he can raise hundreds of billions of dollars in revenue with his new taxes on foreign imports, and he’s shown no willingness to back down from an agenda that he’s advocated for decades, even before entering politics.

The ongoing paradox could erode confidence in Trump’s leadership at home and abroad after he promised a booming economy and tax cuts, not depleted retirement accounts and fears of a recession. For now, as the tariffs are set to kick in, there’s no clear resolution for what could be the most significant overhaul of international trade in a generation.

Sen. Thom Tillis, a North Carolina Republican, urged the White House to “settle the situation.”

He said the “perception as to whether or not there’s an end game is very important.” Tillis said he is “giving the administration the benefit of the doubt” for now. But he added: “You’ve got to get it done as quickly as you can get it done.”

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The administration has yet to articulate its goals for any talks with trading partners, other than to suggest that negotiations could take several months and that nations might also need to dramatically overhaul their tax systems and regulations to satisfy Trump’s demands. Canadian and European officials are uncertain about how to proceed even as Trump administrations officials insist that as many as 70 nations are looking to start negotiations.

Trump insists that he wants to erase trade deficits that have developed as the U.S. buys more products from other countries than it sells. On Tuesday morning, Trump posted on Truth Social that he spoke with South Korea’s acting president, Han Duck-soo, about “their tremendous and unsustainable” surplus.

“We have the confines and probability of a great DEAL for both countries,” he wrote. “Their top TEAM is on a plane heading to the U.S., and things are looking good.”

But on Monday, when Israeli Prime Minister Benjamin Netanyahu said he would “eliminate the trade deficit with the United States,” Trump appeared unmoved.

Asked if he would hold off on new tariffs on Israel, the president said “maybe not.”

“Don’t forget, we help Israel a lot,” he said, citing billions of dollars in military assistance to the country.

Trump has long advocated for tariffs as the solution to economic challenges, and his insistence that other countries are ripping off the United States is one of his most consistently expressed beliefs over the years.

Last Thursday, while flying to Florida aboard Air Force One, Trump told reporters that “the tariffs give us great power to negotiate.”

On the flight back to Washington on Sunday, Trump described the tariffs as a necessity and said he was undeterred by the cratering stock market, adding that “sometimes you have to take medicine to fix something.”

Peter Navarro, a leading trade adviser, has also taken a hard line.

“This is not a negotiation,” Navarro wrote in the Financial Times. “For the U.S., it is a national emergency triggered by trade deficits caused by a rigged system.”

But other officials like Kevin Hassett, the top White House economic adviser, and Scott Bessent, the Treasury secretary, said scores of countries are lining up to negotiate with Trump over tariffs.

“It’s going to be a busy April, May, maybe into June,” Bessent told Fox News. He said Trump “gave himself maximum negotiating leverage, and just when he achieved the maximum leverage, he’s willing to start talking.”

Speaking Monday at the Hudson Institute, a conservative think tank, Stephen Miran, chairman of Trump’s Council of Economic Advisers, said the mixed messages over the purpose of the tariffs reflected a “healthy” internal debate.

“There are conflicting narratives because everybody has got an opinion,” he said. “And that’s fine. Disagreement is how you can enhance your arguments and avoid groupthink, and I think that’s very healthy.”

As for whether any deals could be reached before the tariffs take effect, Miran said, “that choice will ultimately remain with the president.”

Sen. John Kennedy, a Louisiana Republican, said some of Trump’s aides “just like to talk.”

“There’s some uncertainty about what the president’s objective is and I think that’s a product of some of his aides, who gave conflicting reports on TV this weekend,” he said.

Kennedy said he supports Trump’s trade goals. But he’s also getting calls from businesses in his state, and he’s had no answers for them on what to expect.

Trump is constitutionally barred from running for president again, despite his talk about serving a third term. However, Republicans face elections next year that could reshape control of Congress, and they’ve been more nervous about the president’s plans.

Bessent visited with lawmakers on Friday, the day after the tariff announcement. Sen. John Barrasso of Wyoming said Bessent told them that the tariffs were a “high level mark with the ultimate goal of getting them reduced” unless other countries retaliated.

“The president is a dealmaker if nothing else, and he’s going to continue to deal country by country with each of them,” Barrasso said afterward.

But China already retaliated with plans for its own 34% tariffs, prompting Trump on Monday to threaten additional 50% tariffs against the country.

The U.S. president had a positive enough conversation with Japanese Prime Minister Shigeru Ishiba that the Nikkei stock index jumped 6% on Tuesday, yet it was still unclear how a deal would work.

Trump placed a 24% tariff on Japan and a separate 25% tariff on auto imports, much higher than the 1.9% average tariff rate charged by Japan, according to World Trade Organization data. Trump has called the auto tariffs “permanent” and also installed a permanent 10% baseline tariff on most countries, suggesting a limit as to how much rates could fall through negotiations.

But Senate Majority Leader John Thune of South Dakota made it clear he hopes the tariffs are part of a flexible strategy that leads to the reciprocal dropping of tariffs.

“I think most people here, like most Americans, are watching and waiting to see what the ultimate policy implementation will be,” he said Monday.

On the other side of the Capitol, House Speaker Mike Johnson of Louisiana emphasized his trust in the president.

Johnson argued the country had a $1.2 trillion trade deficit last year and Americans understand Trump is trying to address that.

“We are going to give him the space necessary to do it,” he said Monday.

By JAMIE STENGLE

A day care facility in a Texas county that’s part of the measles outbreak has multiple cases, including children too young to be fully vaccinated, public health officials say.

West Texas is in the middle of a still-growing measles outbreak with 481 cases Friday. The state expanded the number of counties in the outbreak area this week to 10. The highly contagious virus began to spread in late January and health officials say it has spread to New Mexico, Oklahoma, Kansas and Mexico.

Three people who were unvaccinated have died from measles-related illnesses this year, including two elementary school-aged children in Texas. The second child died Thursday at a Lubbock hospital, and Health Secretary Robert F. Kennedy Jr. attended the funeral in Seminole, the epicenter of the outbreak.

As of Friday, there were seven cases at a day care where one young child who was infectious gave it to two other children before it spread to other classrooms, Lubbock Public Health director Katherine Wells said.

“Measles is so contagious I won’t be surprised if it enters other facilities,” Wells said.

There are more than 200 children at the day care, Wells said, and most have had least one dose of the measles, mumps and rubella vaccine, which is first recommended between 12 and 15 months old and a second shot between 4 and 6 years old.

“We do have some children that have only received one dose that are now infected,” she said.

The public health department is recommending that any child with only one vaccine get their second dose early, and changed its recommendation for kids in Lubbock County to get the first vaccine dose at 6 months old instead of 1. A child who is unvaccinated and attends the day care must stay home for 21 days since their last exposure, Wells said.

Case count and hospitalization numbers in Texas have climbed steadily since the outbreak began, and spiked by 81 cases from March 28 to April 4, with 16 more people hospitalized in that time.

The U.S. Centers for Disease Control and Prevention met with Texas officials Monday to determine how many people it would send to West Texas to assist with the outbreak response, spokesman Jason McDonald said Monday. He expected a small team to arrive later this week, followed by a bigger group on the ground next week.

The CDC said its first team was in the region from early March to April 1, withdrawing on-the-ground support days before a second child died in the outbreak.

AP reporter Amanda Seitz in Washington contributed to this report.