The Brief

U.S. Health Secretary Robert F. Kennedy Jr. is pursuing federal government access to most Americans’ medical records, in a quest to research a link between vaccines and autism — a connection the medical establishment studied for decades and flatly rejects.

The Department of Health and Human Services is seeking data from little-known state systems that allow hospitals and clinics to exchange detailed, identifiable patient information, KFF Health News has learned.

In private meetings, some public health leaders have objected to giving Kennedy’s team access to such data, raising doubts that it’s legal or that the information would even be useful.

They have also expressed concerns about allowing the federal government to peer into the minutiae of Americans’ medical records, which could mean viewing anything from doctors’ notes to prescription history. HHS has offered no insight into how it will protect or handle the personal health information it obtains.

But Kennedy told KFF Health News that medical records are key to investigating the cause of autism, vaccine safety, and chronic diseases. And millions of dollars in grant money has poured into a Nebraska nonprofit that has assisted Kennedy’s effort, according to state records.

He and his advisers have been frustrated that federal access to Americans’ medical records has been limited.

“We need a good health record system, and one of the things that really surprised me most when I came into office is that there is — that the systems are broken,” Kennedy said in a May interview. “We’ve had to go to the states and, luckily, we’ve got a lot of cooperation from the states, but we now have databases together that we can actually do the studies on. Those studies are in motion.”

HHS has not publicly announced any new projects involving medical records and autism or vaccine research. Kennedy faced blowback last year when he proposed compiling the medical records of people with autism to create a federal disease registry — which health department officials later disputed was underway.

But Kennedy said in May, “We have a whole pipeline of studies that will be done over the next year.”

Though the White House has steered Kennedy away from further changes to U.S. vaccine policy ahead of November’s crucial midterm elections, President Donald Trump has regularly echoed Kennedy’s doubts about vaccine safety and last week signed an executive order calling for the U.S. to reduce the number of vaccines recommended for children.

Kennedy’s political appointees and allies — including William “Reyn” Archer III, a former Texas health official and vaccine critic whom Kennedy hired as a senior adviser — have led the initiative for the health department to collect and examine medical records.

Federal officials met with leaders of the state-run health information exchange systems several times over the past year and asked how the personal medical records they maintain could be used for vaccine research, according to seven people who participated in the discussions or were familiar with them.

Craig Behm, who runs the Maryland health information exchange, said Kennedy’s team asked about how the vast trove of medical records they store from hospitals and health systems could be used to study vaccines.

“If this administration wants to conduct research on the effectiveness of vaccines, are you saying you all can help us conduct that research?” Behm recalled being asked by a top official at HHS’ health information technology office.

Last June, Behm and leaders of other state exchanges met with Kennedy’s top advisers to discuss sharing more medical data with federal agencies. The state organizations followed up with a pitch in October for a new surveillance system that would give the federal health department “real-time, 24-hour data feeds on opioid and chronic disease trends” within a year, according to a presentation reviewed by KFF Health News. Under the proposal, HHS would get data from 90% of the population’s medical records by 2028.

Administration officials regularly asked during the meetings how the records could be used to monitor vaccine safety. Kennedy has rejected the federal government’s current vaccine-monitoring systems; decades of research has shown immunizations are safe and effective for most people.

“Vaccine safety, or whatever words you want to use, has come up pretty consistently in those conversations,” said John Kansky, CEO of the Indiana Health Information Exchange.

Kansky sees the potential value of sharing information from the exchanges for public health but is worried about the focus on vaccines: “It’s like, oh man, I wish you would have picked something that pushed fewer buttons for people.”

A system to monitor chronic disease

Nearly every state has at least one health information exchange — often regulated by state laws and run by private companies or nonprofits — that enables hospitals and health systems to immediately share patients’ medical records with one another. The systems allow doctors and nurses to quickly pull up nearly anyone’s medical history and records at emergency rooms or share after-visit summaries and notes with patients’ primary care providers, for example.

In certain circumstances — most often dealing with cases of infectious diseases such as measles or flu — the exchanges notify public health authorities, like the state health department or the Centers for Disease Control and Prevention. Using the exchanges for broader public health purposes is not an unusual idea in itself. But it can present privacy, legal, and ethical complications, health officials say.

In the end, Behm said his organization in Maryland declined to share more data with the federal government for vaccine research, noting that sharing medical records for that purpose would require a rash of approvals from hospitals, state political leaders, and research boards. Any new data-sharing agreement should also have a clear, detailed framework outlining what would be shared and with whom, he added.

“A number of us said, ‘We can’t do anything our agreements don’t allow us to do, so no,’” Behm said. Indeed, most health information exchanges have contractual restrictions on who can access clinical data.

Kansky said Indiana is still weighing whether to provide additional data for Kennedy’s project, and that nothing has yet been shared.

HHS spokesperson Emily Hilliard did not answer questions about how many states are participating in Kennedy’s project, what new data the agency is collecting, how much the federal government is spending on the initiative, how it is protecting patient privacy, or who has access to the data.

“HHS is strengthening public health surveillance and modernizing data systems to better understand and combat the childhood chronic disease epidemic as part of Secretary Kennedy’s Make America Healthy Again agenda,” Hilliard said in an emailed statement. “Americans deserve robust systems to monitor the drivers of chronic illness.”

Kennedy has asserted, without evidence, that vaccines can cause chronic illness.

A Kennedy partner in Nebraska

At least one state has been cooperative.

The former leader of Nebraska’s state health information exchange has led the effort to share data from medical records with the federal government.

Jaime Bland, former CEO of CyncHealth — the Nebraska health information exchange used by most hospitals and health systems in the state — said several states are looking to “open up channels” to provide more analysis to Kennedy’s team.

“They’re looking at the data differently and providing some insights back to the CDC,” Bland told KFF Health News.

Bland was among a group who proposed that CyncHealth would help kick off the initiative, according to a 43-slide PowerPoint presented to federal officials during an October meeting.

CyncHealth and other state health information exchanges would “ingest data from hospitals, clinics, laboratories, pharmacies, payers, and social services agencies,” then “link claims and clinical records through a master patient index.”

Data from the exchanges “will be deidentified where appropriate,” according to one slide.

The federal government would pay the exchanges for furnishing the records, according to the proposal: $3 a person, annually.

Officials would “frame publicly that this is not a new database, but a federated trust model that delivers real-time data for all HHS missions,” the presentation reads.

After the meeting, Nebraska’s health department was awarded a large grant from the CDC, and CyncHealth in turn got millions of dollars from the state.

On Dec. 19, the CDC announced new funding under its Epidemiology and Laboratory Capacity program, which sends money to state and local health departments for lab work, health information enhancements, and solutions for outbreaks.

Nebraska’s state health department was awarded $18.7 million — the most of any state last year, though Nebraska is the 38th most populous state. By comparison, Texas received $9.2 million, and California got $10.8 million.

CyncHealth was then awarded three contracts totaling $13.6 million from the state health department just weeks later, on Jan. 9 and Jan. 16, according to a publicly accessible database of state contracts.

Grace McNamara, a spokesperson for CyncHealth, said it retained $2.4 million of the funding for Kennedy’s project; the remaining money was distributed to “other participating states and various vendor organizations for implementation support.”

A former CDC official who was aware of the transaction, but not authorized to speak publicly about it, confirmed the money was intended for CyncHealth to supply data for Kennedy’s initiative to look at vaccines and autism. McNamara said that the “work is focused on improving outcomes related to acute and chronic illnesses.”

“The referenced project is not research, but rather a proof-of-concept project on how health information exchange and public health can work together to improve health outcomes and is not specific to autism,” she said in an emailed statement.

McNamara did not answer questions about what type of medical data is being provided to the federal health department or whether patients’ identifying information is removed.

Bland left her post at CyncHealth — where she was paid nearly $420,000 a year — in December. She was named in April as the chief data strategist for the MAHA Institute — a think tank founded by allies of Kennedy and Trump to advance their Make America Healthy Again movement.

Bland agreed with Kennedy that data from state health information exchanges could provide more insight into autism’s causes or vaccine injuries.

"The data is so fragmented, so modeled when it comes to population health and public health, that we lose sight of the individual stories,” Bland said. She told a story she had heard about a woman who had a seizure after receiving the HPV vaccine.

“You know, the vaccine is safe — it absolutely is — but it wasn’t safe for her,” Bland said. “As public health officials, we say the vaccine is safe. But there are cases where it is not.”

Daniel Jernigan, a former top CDC official who left the agency last summer, said he tried to point Kennedy to data that would help the health secretary study vaccine safety and autism.

After 31 years at the CDC overseeing public health surveillance, emerging infectious diseases, and the influenza divisions, Jernigan thought the solution was simple. The secretary could work with researchers to obtain huge databases pulled from health systems nationwide and maintained by major electronic health records companies.

Those databases are deidentified, meaning they don’t include patient names or other information that can identify individuals. Jernigan said Kennedy didn’t seem interested.

Instead, as The New York Times first reported, the health secretary dispatched two top advisers — Archer and Hannah Anderson, his former deputy chief of staff — to the CDC’s headquarters in Atlanta last July to download millions of identifiable patient records directly from the Vaccine Safety Datalink, the system the health agency uses to investigate complications from vaccines. The records, though, were decades old.

Jernigan said the federal government has limited legal authority to access medical records from state health information exchanges. In any case, examining those records may provide a view of a person’s medical history that will not necessarily produce answers to Kennedy’s questions about vaccines and autism.

“If they’re just using the electronic health record data, there are limits to that,” Jernigan said. “If they’re only looking at electronic health record data, all you’re going to get is what was captured in the encounter. It’s not going to be very satisfying.”

KFF Health News data reporter Maia Rosenfeld contributed to this article.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

This article first appeared on KFF Health News and is republished here under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

At Chopin Noodle House in Monterey Park's Atlantic Times Square, the dining room is small. But there's still room for a baby grand piano.

If you’re lucky, you might catch owner Zi Yang playing for customers as they work through bowls of Lanzhou beef noodle soup. A few feet away, cooks pull a fresh batch of noodles by hand, made to each diner’s preferred thickness.

The traditional beef noodle soup at Chopin Noodle House in Monterey Park comes with clear broth, chili oil, sliced beef, leeks, and cilantro.

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Gab Chabrán

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LAist

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Noodles are pulled by hand to order at Chopin Noodle House.

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Gab Chabrán

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LAist

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Pianists turned chefs 

Yang and his wife, Mimi Song, are both former piano teachers who met through music.

After moving from China to the U.S., they hoped to make a living teaching piano, but it didn’t pay the bills. So they turned to another love: noodles.

Co-founders Mimi Song (left) and Zi Yang, both former piano teachers, have grown Chopin Noodle House to five locations.

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Courtesy Chopin Noodle House

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The couple opened the first Chopin Noodle House in Catonsville, Maryland, in 2023. They later expanded to Southern California, starting in Chino, and opened in Monterey Park in March. The chain now has five locations in Maryland, Virginia and Southern California.

When I visited, Yang stepped out from behind the counter, sat down at the baby grand and played Frédéric Chopin’s Waltz in C-sharp minor, its soft, rolling melody filling the small dining room. A group of diners in the corner looked up from their bowls of noodles, watched and cheered when he finished.

The restaurant name comes from the Polish composer. “We both love Chopin,” Yang said.

The Lanzhou connection

Yang is from Lanzhou, the capital of Gansu province in northwest China, and the birthplace of the signature beef noodle soup.

“I was born in Lanzhou, a city along China’s ancient Silk Road,” he writes on the restaurant’s website. “Every morning, the streets fill with the scent of beef broth and the rhythm of pulled noodles slapping the counter.”

“Maybe 80% of the people eat it for breakfast or lunch,” he told me.

Before opening the restaurant, he returned to China for a crash course in its creation.

“I went back to learn how to pull the noodles and how to make the very delicious beef noodle soup,” he said.

The piano started as a practical idea.

“We saw that restaurant life would be so boring, so we decided to put a piano in our restaurant. So sometimes if there’s no customer, we can practice the piano,” Yang said.

What’s in the bowl

The most popular order is the traditional beef noodle soup ($14.99). It's made from beef bones and beef shank.

Diners choose from eight noodle styles, from extra-thin to extra-wide, plus knife-sliced and gluten-free rice noodles. The bowl follows what the restaurant calls Lanzhou’s five signature elements: clear beef broth, white radish, red chili oil, green cilantro and leek, as well as golden hand-pulled noodles topped with thinly sliced beef.

For sipping alongside the noodles, order the eight treasures tea, known in Lanzhou as san pao tai. It’s served in a lidded bowl called a gaiwan and brewed with green tea, dried red dates, goji berries, longan, raisins, rose petals, chrysanthemum and rock sugar. You use the lid to keep the fruit and leaves in place as you drink. It’s naturally sweet, a nice counterpoint to the chili oil.

An open bench

Anyone who visits is welcome to play the piano. Yang said they’ve had everyone from kids learning to play to professional musicians, including members of the San Gabriel Valley Symphony.

Some of the players are so good that Yang admits he’s now a little shy about taking his turn.

“I’m afraid to play because they are so good,” he said.

Longer droughts, more extreme heat, greater wildfire risk and more beach erosion: A new state-commissioned report finds that climate change is likely to reshape the Southern California landscape and way of life.

The study, which comes as part of California’s fifth statewide climate change assessment, includes more detailed models than previous reports.

“What we want to highlight with this report is not how doom and gloom everything is, but just to look at climate change in the L.A. area as something that is inevitable, but which we can adapt to, and in particular, protect the most vulnerable,” said UCLA climate researcher Jesse Norris, the lead author of the report focused on Los Angeles.

Sea level rise and beach erosion

If the recent stories of beach and coastline erosion have you concerned, buckle up. The report notes local coastal erosion rates are expected to triple by 2050.

Citing past research, the authors also note that coastal flooding is expected to quickly intensify in the mid-2030s and become a yearly event by the mid-21st century.

Between one-third and two-thirds of the region’s beaches are expected to be lost in the next 75 years.

Researchers found that in L.A. County, about 1,700 housing units are at risk of being permanently inundated. But if sea levels rise by 3.3 feet — which is possible by 2100 — 9,000 units would be at risk of being permanently flooded.

And if sea levels rise by 6.6 feet, which researchers described as an “extreme” scenario, flooding could be widespread during a 100-year wave event. In this scenario, large swaths of urban L.A. and Orange counties could be flooded, though it’s important to note the projections don’t account for any future infrastructure that may be built.

Extreme heat

Temperatures are expected to rise 4 degrees Fahrenheit between 2041 and 2070 — adding to the 4 degrees of warming that have already happened since 1900.

Researchers say those effects are more pronounced in inland areas, which are also projected to see more days of extreme heat. The average hottest day of the year is expected to rise to 115 degrees by midcentury.

Microclimates play a role

Most of the hazards predicted in the report will be familiar to Southern Californians, even as the effects are expected to intensify and become more common during climate change.

“It was quite striking to see how much more vulnerable certain locations are than others to different climate hazards,” Norris said. “In particular, the more inland areas being far more vulnerable to the increase in extreme heat, mountain communities being far more vulnerable to the impacts of extreme rain and flooding as well as reduced snowpack, and coastal areas being obviously far more vulnerable to the impacts of rising seas.”

Planning

Norris stressed that planning for these effects can be undertaken now. One example: increasing tree cover to mitigate heat.

“A lot of inland cities are thinking very seriously about increasing their tree canopies, increasing the ability for people to have shade as they're going about their business,” Norris said.

Norris highlighted the importance of protecting the most vulnerable in these situations, including people experiencing homelessness and those who work outdoors, and ensuring access to air conditioning and cooling centers.

Norris also said continuing and improving initiatives like active wildfire management, water management and coastal adaptation will be vital in the years to come.

Two weeks from the midterm elections, Democratic Party leaders are suing in federal court to block President Donald Trump’s administration from usurping states’ authority to administer elections or trying to intimidate state and local election officials into complying with illegal demands.

The lawsuit, filed Tuesday in Washington, seeks a court order barring the administration from purging legally registered voters from statewide voter registration lists or denying ballots to legally registered voters.

The plaintiffs, including Sen. Chuck Schumer and Rep. Hakeem Jeffries, also ask for a ruling that the administration has illegally threatened state election officials with prosecution before the Nov. 3 election.

The lawsuit cites the Justice Department’s recent actions in California, where it sued to block state election officials from counting mail-in ballots cast by people whom the federal government has identified as “likely” noncitizens until their immigration status can be confirmed.

“For over a decade now, President Donald J. Trump has bombarded the American people with lies and misinformation about American elections and voter fraud,” the suit says. “While these lies have been debunked at every turn, that has never deterred the President from employing them as a pretext to seize control over elections, even as courts overwhelmingly reject that effort.”

The Justice Department said in a statement that election integrity is a top priority for the administration and the department’s actions on that front are grounded in law and under court litigation.

The Democratic leaders’ lawsuit was assigned to Chief Judge James Boasberg, who has been vilified by the White House for rulings against the Trump administration since the start of the Republican president’s second term.

The suit’s other plaintiffs are the Democratic Senatorial Campaign Committee, the Democratic Congressional Campaign Committee and the Democratic Governors Association. Its named defendants are Trump, the Justice Department, Attorney General Todd Blanche, the Department of Homeland Security and DHS Secretary Markwayne Mullin.

Tom Cruise is being celebrated with a life achievement award from the American Film Institute, AFI’s board of trustees said Wednesday. The award will be handed out at a gala tribute in Los Angeles at the Dolby Theatre on April 24 next year.

“Tom Cruise is a global icon,” said Kathleen Kennedy, chair of AFI’s board of trustees, in a statement. She praised Cruise’s commitment as an actor and producer and his belief in movies’ ability to bring people together.

Cruise, 64, has worked in film for more than four decades, starring in movies including “Risky Business,” “A Few Good Men,” “Jerry Maguire,” “Minority Report” and the “Mission: Impossible” series. He has received three Academy Award nominations for acting: best actor in “Born on the Fourth of July” and “Jerry Maguire” and supporting actor for “Magnolia.”

As a producer, Cruise was nominated when “Top Gun: Maverick” received a best picture nomination.

Last year, he received an honorary Oscar at the Academy of Motion Picture Arts and Sciences’ Governors Awards.

The AFI Life Achievement Award, established in 1973, recognizes a person whose work has advanced film and stood the test of time. Cruise will join a roster that includes John Ford, Bette Davis, Sidney Poitier, Steven Spielberg, Denzel Washington, Nicole Kidman and Eddie Murphy, who received the honor earlier this year.

Proceeds from the tribute gala support AFI’s education and arts initiatives.