This week at Unbreaking, December 11
This week’s updates focus on the ways federal agencies and Congress are working together to make America sicker and weaken access to healthcare.
In food safety, we see variations on the same themes repeating: disorganized communication to local and state officials, delays for rules meant to improve the efficiency and transparency of food safety efforts, and a lack of clarity about what a promise to Make American Healthy Again actually means.
According to the latest FDA figures, a total of 51 babies have been hospitalized with suspected or confirmed botulism after exposure to recalled ByHeart formula — 10 between December 2023 and August 2025, and 41 since then. The FDA delayed key communication about the contamination for six days, hampering recall efforts. “We wasted almost a week,” the head of the Association of Food and Drug Officials told a reporter.
The mass firings of experienced staff may be partly to blame for the delays — the FDA reportedly took four days to figure out how to use the internal process that allows them to share information without first obtaining signed privacy agreements. (The agency currently considers a food manufacturer’s distribution list “confidential business information,” and sporadic legislative efforts to reduce such bureaucratic hurdles haven’t produced a fix.) The FDA reported that on November 26, 18 days after the manufacturer’s recall announcement, the formula was still on store shelves. The number of sick infants is expected to rise: It can take up to a month for a baby to show symptoms after exposure to botulism spores.
The Republican-controlled Congress also isn’t using enforcement tools that could improve responses to outbreaks across the food supply chain — and it has acted to limit states’ ability to fill gaps left by federal inaction.
When Congress passed legislation to reopen the government in November, it included industry-friendly changes to food safety rules. The legislation paused a traceability rule that established new standards requiring companies to track their products across the supply chain, which now won’t go into effect until 2028. Congress also temporarily barred states from regulating which foods manufacturers can label as “healthy” and suspended new listeria-fighting regulations. This comes after a deadly listeria outbreak and the CDC’s removal of listeria from its mandatory disease surveillance system earlier this year. A 2025 GAO report estimates that tens of millions of people in the US get sick from foodborne illnesses every year.
While the administration undermines systems designed to keep our food safe, the MAHA movement declares symbolic victories: Under pressure from MAHA figureheads, health non-profits, and state leaders, Senator Roger Marshall (R-KS) struck Big Food–backed language that would have barred states from passing truth-in-labelling laws from his own proposed Better Food Disclosure Act. But this “win” came a week before the GOP passed the legislation that reopened the government and derailed rules that would have fought outbreaks, sped up recalls, and allowed states to regulate labeling when federal rules fell short.
Our Food Safety team tracks these struggles and more in our timeline and explainer.
In healthcare, the fallout from the budget reconciliation bill’s Medicaid funding cuts is getting clearer. Policymakers and media initially focused on the real and potentially disastrous effects on rural hospitals, leading to the inclusion of a GOP-backed $50 billion “Rural Health Transformation Fund” that will not, as it turns out, rescue rural hospitals facing devastating losses. And a new New York Times/Harvard study shows that 56% of the hospitals in danger of cutting back on care or shutting down are in urban areas.
Elsewhere, KFF Health News is tracking states’ struggles with forthcoming Medicaid work requirements. While the new law exempts “medically frail” people from the work mandate, federal authorities have given no guidance on how to define medical frailty. KFF has also rolled out a work-requirement implementation tracker that should be very helpful as the states roll out new systems on a tight timeline.
Finally, a preliminary injunction will keep Medicaid payments flowing to Planned Parenthood in 22 states — for now. The federal government has appealed the injunction in California v. Department of Health and Human Services, one of two legal challenges to the reconciliation bill’s ban on Medicaid reimbursements for non-abortion care provided by Planned Parenthood. We track these suits and all the major changes in Medicaid — including the way cuts are affecting the entire landscape of healthcare in the US — in our Medicaid explainer.
We don’t yet have a team covering the dismantling of the Affordable Care Act’s coverage for millions — maybe you’d like to join us to build one? — but we’d be remiss if we didn’t note that the Senate just blocked both a Democrat-backed bill to extend ACA subsidies and a Republican bill to give US residents $1,500 to spend on healthcare to make up for losing those (often vastly larger) subsidies.
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