Bulwark Takes: Episode Summary - "We’re Losing the Next Pandemic Fight (w/ Jonathan Cohn)"

Release Date: June 1, 2025

In this insightful episode of Bulwark Takes, host Bill Kristol engages in a comprehensive discussion with healthcare expert Jonathan Cohn. The conversation delves into the critical developments surrounding RFK Jr.'s confirmation and his subsequent impact on U.S. vaccine policy, the broader implications for the biomedical research enterprise, and the contentious reconciliation bill affecting Medicaid. Below is a detailed summary capturing all key points, discussions, insights, and conclusions from the episode.

1. Introduction to RFK Jr.’s Confirmation and Early Actions

[00:00 - 02:10]

Bill Kristol opens the episode by introducing his guest, Jonathan Cohn, highlighting Cohn's extensive experience in healthcare debates spanning decades. The primary focus is RFK Jr.'s recent confirmation and the unexpected direction his policies have taken, particularly concerning vaccine programs.

Notable Quotes:

• Bill Kristol [00:50]: "There’s been a lot going on...how’s that working out?"
• Jonathan Cohn [01:34]: "That’s not at all what he’s doing."

2. RFK Jr.’s Divergence from Promised Transparency and Science

[02:10 - 05:22]

Cohn critiques RFK Jr.'s failure to adhere to his confirmation promises of enhancing transparency and upholding scientific integrity. Instead, RFK Jr. has been imposing his views, especially anti-vaccine stances, undermining established vaccine programs.

Notable Quotes:

• Jonathan Cohn [02:07]: "He's imposing his views on a whole variety of issues, but especially on vaccines."
• Bill Kristol [05:22]: "That’s kind of amazing...more substantial concerns beyond just rhetoric."

3. The Moderna Vaccine Project Cancellation

[05:22 - 08:59]

A significant part of the discussion centers on the termination of Moderna’s contract to develop an MRNA-based platform for rapid vaccine deployment against potential pandemics like bird flu. Cohn explains the technology's importance and the ramifications of its abrupt cancellation.

Notable Quotes:

• Jonathan Cohn [03:12]: "MRNA technology...allows you to make a vaccine much more quickly."
• Bill Kristol [05:48]: "He canceled the contract...talks about being anti-vaccine, not cautious."

4. Shifting COVID Vaccine Guidance for Children and Pregnant Women

[08:59 - 19:56]

Kristol and Cohn analyze RFK Jr.’s controversial decision to withdraw vaccine booster recommendations for healthy children and pregnant women. They discuss the confusing and inconsistent updates from federal agencies, the lack of clear communication, and the ensuing confusion among healthcare providers and the public.

Notable Quotes:

• Jonathan Cohn [09:23]: "Kennedy says there's no CDC director...guidelines are murky."
• Bill Kristol [14:20]: "Real world effects...insurers might not cover it."

5. Implications for the U.S. Biomedical Research and Vaccine Enterprise

[19:56 - 29:21]

The conversation shifts to the broader impact of RFK Jr.’s policies on the U.S. biomedical research landscape. Cohn expresses concern over reduced government support for vaccine development and scientific research, highlighting potential shifts of investment and innovation overseas, particularly to China.

Notable Quotes:

• Jonathan Cohn [25:12]: "The entire biomedical research and development enterprise of the United States is taking this huge hit."
• Bill Kristol [27:13]: "Medicaid...are hurting our future innovation."

6. The Reconciliation Bill and Medicaid Cuts

[29:21 - 36:14]

Kristol and Cohn delve into the reconciliation bill passed by the House, which proposes significant cuts to Medicaid. They discuss the Congressional Budget Office's projections that over 10 million people could lose insurance, contradicting government assurances that no one will be affected.

Notable Quotes:

• Jonathan Cohn [31:22]: "More than 7 million people will end up uninsured because of that."
• Bill Kristol [33:01]: "They defend the proposition...a bold and blatant lie."

7. Debating Work Requirements for Medicaid

[36:14 - 38:33]

The discussion explores the controversial work requirements tied to Medicaid cuts. Cohn explains the practical and ethical challenges of implementing such requirements, citing evidence that Medicaid can help individuals maintain employment by providing necessary healthcare.

Notable Quotes:

• Bill Kristol [34:40]: "It's hard to believe many 25-year-olds are losing jobs just to be on Medicaid."
• Jonathan Cohn [37:27]: "There’s a lot of evidence that giving people Medicaid helps them stay on the job."

8. Political and Media Reactions to Policy Changes

[38:33 - 42:21]

Kristol and Cohn assess the lack of significant pushback from Republicans and conservative media regarding RFK Jr.’s actions and the proposed Medicaid cuts. They express concern that the medium-term consequences of these policies may not elicit immediate political backlash, allowing substantial damage without swift corrective measures.

Notable Quotes:

• Jonathan Cohn [39:05]: "There are some, they tend to be the conservative outlets that were angry about Kennedy in the first place."
• Bill Kristol [41:38]: "Tariffs have immediate effects, but these policies have more medium-term impacts."

9. Conclusions and Future Outlook

[42:08 - End]

In concluding the episode, Kristol emphasizes the crucial role of journalism in highlighting policies with long-term repercussions. Cohn echoes this sentiment, expressing hope that ongoing coverage will bring greater public awareness and accountability. Both hosts underscore the importance of maintaining robust scientific and healthcare infrastructures to safeguard against future pandemics and uphold public health.

Notable Quotes:

• Bill Kristol [41:41]: "One job of journalism is to bring stuff that's otherwise not obvious...to voters."
• Jonathan Cohn [42:08]: "Hopefully, we’re doing that. Hopefully, we'll keep doing that."

Key Takeaways

1. RFK Jr.’s Policies Undermining Vaccine Programs: Contrary to his promises, RFK Jr. has been actively undermining vaccine initiatives, particularly impacting programs crucial for pandemic preparedness.

2. Impact on Biomedical Research: The cancellation of Moderna’s project and broader cuts to scientific funding threaten the U.S.'s leadership in biomedical innovation, potentially driving investments overseas.

3. Medicaid Cuts and Insurance Losses: The proposed reconciliation bill threatens the health coverage of over 10 million Americans, challenging government assurances and exposing vulnerable populations.

4. Challenges with Work Requirements: Implementing work requirements for Medicaid is fraught with practical difficulties and may inadvertently harm those it intends to help.

5. Lack of Immediate Political Pushback: The medium-term nature of the consequences of these policies may result in insufficient immediate political and media responses, allowing significant impacts to unfold with limited public scrutiny.

6. Role of Journalism: Continuous and vigilant journalism is essential to inform the public about policies with long-reaching effects, ensuring accountability and fostering informed discourse.

This episode of Bulwark Takes provides a critical examination of the intersection between healthcare policy, government accountability, and scientific innovation. Through the expertise of Jonathan Cohn and the incisive questions of Bill Kristol, listeners gain a nuanced understanding of the challenges facing the U.S. in maintaining its healthcare infrastructure and preparedness for future public health crises.