How Obama’s physician became Biden’s most persistent health critic

Today’s edition: A dispatch from inside a fiery hearing on coronavirus vaccines in the House. Insights from a prominent vaccine expert on his latest book. But first …

The doctor-turned-congressman who wants a Biden checkup

Rep. Ronny Jackson (R-Texas) has emerged as a top critic of President Biden’s fitness to serve, sending five letters to the White House pressing the administration for more disclosure and calling for the 81-year-old president to undergo a cognitive test.

“I’ve been saying individually, for a long time … that this man is not cognitively fit to be our head of state and our commander in chief,” Jackson said Wednesday, joined by House Republican leaders as they pressed the party’s emerging line of attack. It’s also a concern shared by many Americans, with polls showing that most voters question Biden’s physical and mental health. (Biden and his allies insist the questions about his health are baseless.)

Jackson is one of 19 doctors in Congress, but the only one who’s actually served as a physician to presidents, having cared for George W. Bush, Barack Obama and Donald Trump. Now that perch is helping inject the two-term congressman into the 2024 election cycle, particularly in conservative media, where he repeatedly vouches for Trump’s fitness while tearing down Biden’s.

But Jackson, who arrived in Congress amid scandal and scrutiny of his White House medical practices, has been facing renewed questions about his role during the Obama and Trump administrations, as Michael Kranish and I write in The Washington Post today.

It’s a story we began weeks ago, after the Pentagon’s inspector general released a report faulting previous White House military medical teams for widely dispensing sedatives and stimulants, failing to maintain records on potent drugs including fentanyl, providing care to potentially hundreds of ineligible White House staff and contractors, and flouting other federal regulations.

“We concluded that all phases of the White House Medical Unit’s pharmacy operations had severe and systemic problems,” the Pentagon watchdog wrote last month, after reviewing documents and interviewing the unit’s staff during the Obama and Trump administrations.

The Pentagon also said the challenges threatened the unit’s primary mission — to keep the president and vice president healthy and safe.

Former staffers told us the problems went beyond what was captured in the long-delayed report, describing how the team provided complimentary medical equipment and imaging to ineligible staffers, sometimes using aliases in electronic health records to disguise the patients’ identities.

Jackson led the White House Medical Unit for over four years during the Obama administration, and he also served as Obama’s and Trump’s personal doctor. The unit’s problems weren’t all his making, former staffers said — but his influence loomed large, leading to nicknames like “Candyman” for his willingness to give out drugs like Ambien.

Some of Jackson’s practices were detailed in a 2018 whistleblower complaint to Congress after Trump nominated him to be secretary of Veterans Affairs; Jackson withdrew his nomination after Sen. Jon Tester (D-Mont.) shared the complaints with reporters. The Pentagon’s inspector general also issued a 2021 report that substantiated many of the allegations against Jackson; in the wake of that report, the Navy took an unspecified “administrative action” against Jackson, a Defense Department official told us.

Jackson’s practices were also an open secret in the White House, according to Omarosa Manigault Newman, a Trump White House aide and former reality TV star, and other former officials who spoke with us. The White House medical team “would give out anything, right from the bottle, no prescription needed,” Manigault Newman recounted in her memoir “Unhinged.”

Jackson and his office have disputed the reports and complaints, alleging that they’re motivated by his alliance with Trump and because he’s a threat to Biden. They also said the latest report is focused only on years when Trump was president and when Jackson wasn’t in charge of the unit.

“This is nothing more than another desperate attempt to attack President Trump and distract from the fact that he is going to dominate Biden in November,” Jackson said in a statement. 

It’s worth noting that the Pentagon inspector general sought pharmaceutical records dating back to the Obama administration, but the White House Medical Unit said they hadn’t kept them.

One of the more eye-catching notes in the Pentagon’s latest report: the White House medical team was stocking drugs like fentanyl and ketamine. It prompted speculation about who, if anyone, was receiving such powerful medication.

Jackson and his former colleagues told us fentanyl was on hand for emergencies, like a White House fence-jumper being accidentally impaled on a spike, and was never prescribed.

“I would like these morons that are looking into this to explain to me how you provide trauma capability for the commander in chief and for everyone that’s traveling … from the White House, all over the world,” Jackson said in an interview last month.

On the Hill

Public health groups worry as Congress tackles ‘vaccine safety’

The shadow of Rep. Marjorie Taylor Greene (R-Ga.) hung over yesterday’s hearing, after the Georgia congresswoman spent months demanding that the House covid subcommittee focus on coronavirus vaccines’ safety, Dan writes. 

“I’m not a doctor, but I have a PhD in recognizing bulls--- when I hear it,” Taylor Greene said, after more than an hour of testimony from federal officials, accusing them of not being honest about the possibility of coronavirus vaccine injuries.

The comments drew a swift rebuke from Rep. Robert Garcia (D-Calif.), who denounced “conspiracy theories and false accusations.” Other Democrats also said the coronavirus vaccines’ safety had been well-established, and the officials walked through their process to detect possible injuries.

The federal officials, who included top Food and Drug Administration vaccine official Peter Marks, also fielded questions such as why the FDA accelerated its vaccine-approval timeline in 2021 over the objections of two officials who later resigned.

“We moved with all due haste not because of any kind of external pressure, but because of internal pressure,” Marks said. “We felt compelled to try to save American lives because thousands of people were dying.”

Thursday’s hearing came amid warnings from dozens of health groups, including the Association of State and Territorial Health Officials, who urged the covid panel to tread lightly. 

“Our country is at a tipping point in immunization,” more than 50 public heath groups and medical associations wrote to the panel’s leaders, Chair Brad Wenstrup (R-Ohio) and ranking member Rep. Raul Ruiz (D-Calif.), calling on Congress to focus on helping “expand and better support our vaccine safety system.”

Rep. Marjorie Taylor Greene (R-Ga.):

Rep. Robert Garcia (D-Calif.):

From our reporters' notebooks

Three questions for vaccine expert Paul Offit

Pediatric infectious-disease specialist Paul Offit is a renowned virologist, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia and a member of the Food and Drug Administration’s Vaccine Advisory Committee. This week, Offit published his latest book, “Tell Me When It’s Over: An Insider’s Guide to Deciphering Covid Myths and Navigating our Post-Pandemic World.” 

Yesterday, he spoke with our colleague Lena H. Sun. Here’s a snapshot of the interview highlights, edited for clarity and length:

Why did you write this book? This pandemic was for me a dramatic series of contradictions. By January of 2020, we had isolated and sequenced the virus so it was possible to make a vaccine. Eleven months later, using a technology that had never been used before to try to defeat a virus that had unusual biological and clinical characteristics, we had data that showed the vaccine was clearly effective, much more effective than people imagined at preventing severe disease. 

[We were able] to mass distribute and mass administer in the United States, which didn’t have an infrastructure for mass vaccinating adults … By July, we had vaccinated 70 percent of the population. And then we hit a wall. Thirty percent of the population simply would not get this vaccine.

Why did vaccinations plateau, and what are the policy lessons here? I think generally, especially on the right, there is this anti-institutionalist anti-federal government backlash. That spilled over certainly to the Centers for Disease Control and Prevention and the FDA. We were hammered with a flood of misinformation and disinformation on the internet. 

The hardest part is to explain to the public that we acquire knowledge over time, that we learn as we go, and that learning curve is often steep, and worse, often associated with the human price. We should ask more from our public health agencies. When we follow the science, what we mean is we’re learning as we go, and we may find that the data that we have now is not what we hoped.

Agency alert

The Department of Health and Human Services will fill eight vacancies on an important vaccine advisory panel that was down to less than half its normal roster, Stat’s Helen Branswell reports. 

Helen Keipp Bredenberg Talbot, an infectious diseases researcher at Vanderbilt University, will be reappointed to the CDC’s Advisory Committee on Immunization Practices and serve as its chair, according to a senior HHS official. Talbot previously served as a member of the panel for five years, with her term ending late last year. 

The size of the committee will also be expanded by one, taking the panel to 16 voting members, the official said. 

Meanwhile …

The Centers for Medicare and Medicaid Services issued additional draft guidance yesterday for Medicare prescription drug plans participating in a new program that will allow beneficiaries to pay their out-of-pocket costs in monthly installments starting in 2025. 

State scan

Iowa medical board approves guidance for six-week abortion ban

Iowa’s medical board approved administrative rules yesterday on implementing the state’s still-pending ban on most abortions after six weeks, Michaela Ramm reports for the Des Moines Register. At the moment, the ban is on hold and awaiting review by the state’s supreme court.  

Yes, but: The guidance provides little insight into the penalties doctors could face for violating the law. Also missing are specific instructions on what counts as a medical exception under the state’s vaguely worded ban. 

The rules are now headed to the Iowa Legislature’s Administrative Rules Committee, which will vote on final approval. If the high court sides with Republican Gov. Kim Reynolds’s appeal and allows the abortion ban to take effect, those rules would then become enforceable by the state’s medical board. 

Quote of the week

“In making recommendations to the public today, we have to try to get the most out of what people are willing to do. … You can be absolutely right in the science and yet accomplish nothing because no one will listen to you.”

— Michael T. Osterholm, an infectious-disease expert at the University of Minnesota, on the CDC’s plans to loosen coronavirus isolation guidance.

Health reads

IG report finds deadly culture of negligence and staffing issues at federal prisons (By Perry Stein | The Washington Post)

VA considers using psychedelic drugs to fight PTSD among veterans (By Joe Davidson | The Washington Post)

NC Medicaid rolls grow by 1,000 people a day as smooth expansion rollout continues its third month  (By Jaymie Baxley | North Carolina Health News)

Sugar rush

Thanks for reading! We’ll see you on Tuesday.