Epstein Conspiracies, US Drug Manufacturing, Student Loan Overhaul

He's been dead nearly six years. But conspiracy theories about Jeffrey Epstein are stronger than ever.
Will those who believe them be satisfied by any release of information? I'm Scott Simon. And I'm Adrian Ma.
And this is Up First from NPR News. That bottle of pain reliever on our editor's desk? Well, those pills were made in India.
Broadly speaking, we are very dependent on foreign suppliers.

Is that about to change?

President Trump is pressuring drug manufacturers to start making meds in the U.S. or face tariffs.

And major changes to the federal student loan system.

Some repayment plans are getting phased out.

There are limits for some new borrowers.

We have details.

So stay with us.

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Visit a local bike dealer or go to eB.com to learn more about how Bosch e-bike systems keep pace with your life. At President Donald Trump's direction, the Justice Department has asked a federal judge to unseal more records related to Jeffrey Epstein, who died in custody while awaiting trial on sex trafficking charges in 2019.
This follows new reporting from the Wall Street Journal that's renewed scrutiny on the longtime friendship between Trump and Epstein. Trump is dismissing the journal's reporting as fake and is now suing it and its owners, including Rupert Murdoch, for at least $10 billion.
The Epstein case has long been a focus of conspiracy theories, which NPR's Lisa Hagan has covered, and she joins us now. Lisa, thanks for being with us.
Hey there. The president says he wants grand jury evidence related to Epstein released.
Setting aside whether a judge will agree to that or not, how much would that satisfy the people's desire for information on this case? I think the answer to that depends on what gets released, obviously, but it also really depends on who you are. So how about we go through a few different categories of people, like folks with ties to Trump, people with stronger ties to conspiracy communities, and maybe everybody else? Let's begin with people who are tied to Donald Trump.
Will they be satisfied? If you're a media figure or a politician who's risen to prominence supporting Trump and that's your audience, you're probably fairly desperate at this moment for any evidence to hold up and say, see, Trump is keeping his promises to be transparent. As long as it's not forget about Epstein already, you're likely to frame what the administration offers in a flattering light, including reasonable sounding ways to kick the can down the road.
Not all of your audience will buy that, but by now we have more than a decade of Trump-style politics that shows us plenty of people will continue supporting this president. So people who watch and trust pro-Trump media are waiting on cues that it's okay to ignore all the nothing burger hubbub right now and that it's all coming from people who are out to get Trump.
What about people who've bought more seriously into conspiracy theories about Jeffrey Epstein? So we've got people whose livelihoods and communities have come together by searching out cryptic details or internet message boards to interpret future government policy. Let's be clear, there's overlap between these two first categories, which has made the last few weeks pretty uncomfortable for some people.
What I've seen in some of the conspiracy theorist spaces is begrudging coverage of some of these Epstein headlines. Like, okay, we have to talk about this, but here are a bunch of other things we'd rather be talking about.
If you're one of the many people who believe in QAnon style demonic pedophile cabals running the world, the satisfaction you've been

waiting on for years is arresting and executing that cabal, not a grand jury report. But paradoxically,

the narratives that have helped them wait this long for justice are also likely to continue to

hold. So you're also looking for signs like a pregnant pause or a look or a phrase that confirms,

okay, we just have to trust Trump knows what he's doing.

Where does this lead people who aren't in any of these groups and everybody else?

Right, like people who don't like Trump or people who don't mind him either way or like anyone else who's followed the Epstein story. The details of the story are awful, but I look around and I see plenty of people deriving a kind of enjoyment from spinning theories, found it or unfounded.
And some people are currently remembering or learning for the first time that, oh yeah, Donald Trump did have a for real friendship with Jeffrey Epstein in the 1980s and 90s. And you know what? It does seem weird that the president just told everyone to forget about it.
There have always been details about Epstein that raise doubts for people. Having doubts doesn't make you a conspiracy theorist.
Tying those doubts to rigid narratives about good and evil and rejecting

reasonable evidence that contradicts what you want to believe, that's conspiracism. And I think in

this hurricane of politics and speculation, we also have to remember that Epstein hurt real people.

One of the survivors of his abuse died by suicide just this April.

And Pierce, Lisa Hagen, thanks so much.

Thank you.

Thank you. President Trump is pushing pharmaceutical companies to move manufacturing back to the U.S.
This week he increased that pressure by saying he would impose tariffs on drug makers as soon as August 1st. The tariffs would start low to give companies a year or so to build factories here and then rapidly increase.
NPR Pharmaceuticals correspondent Sydney Lupkin joins us now. Sydney, thanks for being with us.
Thanks for having me. Help us get hold of the problem.
How many of our medicines are actually made outside the U.S.? A lot of them. Most of them, actually.
Many of the key ingredients are made in China and most generics are made in India. That's according to economist Jeffrey Joyce, the director of health policy at the USC Schaefer Center.
Some final formulation may be done in the U.S., but broadly speaking, we are very dependent on foreign suppliers. It's less intensive for branded or on patent drugs, but still, we are very dependent as well on overseas production.
The United States was really made aware of how vulnerable its drug supply was when COVID hit. Suddenly, Chinese drug factories shut down, India restricted drug exports.
So having more drugs produced in the U.S., especially essential medicines, is broadly considered a good policy. How is it that manufacturing moved outside the U.S.
anyway? Yeah, there are tax incentives for manufacturing overseas. So by manufacturing name-brand drugs in Ireland, for example, companies can report profits there and pay a very low corporate tax rate.
for generics, because they compete mostly on price, companies manufacture in places with lower wages like India and China. The tariffs are an effort to shift production back to the U.S.
soil by basically punishing companies for foreign manufacturing. Will that work? It's complicated.
Joyce says he thinks it would take a lot more incentives to convince companies to do it. Tax breaks, subsidies, things like that.
I also spoke to Chris Middendorf, who spent years at the Food and Drug Administration inspecting factories in India and China, and he's now at the law firm Hogan Lovells. And he says it's a big lift to move factories for even just one drug.
It's not just about putting equipment in and starting a manufacturer. It's like you have to qualify the building.
You have to qualify all your equipment in there. Like you have to establish all your procedures for that site.
It's a lot more than just building a building. Companies need to prove they can correctly make the drug at a new factory because if they can't, the consequences for patients could be dire.
Yeah, of course. The pharmaceuticals could be harmful.
Yeah. All that said, some companies have already announced they're expanding in the U.S.
Eli Lilly is beefing up its domestic manufacturing, including at sites in Indiana and North Carolina. And in February, it said that it would be spending billions more dollars to add for new factories.
But Lilly says it could take as long as five years for these factories to come online. So that's the realistic timeline.
Sydney, could companies just basically ignore the tariffs or absorb them and leave manufacturing overseas? Yes, absolutely. That's an option.
The pharmaceutical tariff doesn't exist in a vacuum. There are a bunch of other tariffs, too.
If a company decides to build a facility in the U.S., it might still get hit with tariffs importing equipment. And for generic manufacturers whose profits are razor thin, a tariff might not be much of an incentive to move production.
They might pass along the tariff costs to consumers or pull out of the market altogether. What would the consequences of that be for patients?

Both Joyce and Middendorf expect drugs would get more expensive for consumers.

Or tariffs could result in access issues if companies stop selling foreign-made products here, especially generics.

The big questions now are, will the drug tariffs really be the 200% President Trump is threatening

or something lower?

And will they stick? NPR Pharmaceuticals correspondent Sidney Lupkin, thanks so much. You bet.
If you have student loans or hope to take out student loans in the next few years, you may want to listen extra closely to this next conversation. That's because among the many changes in the big spending package President Trump recently signed into law, there's also a complete overhaul of the federal student loan system.
Places new limits on loans for many borrowers, and it ends most current repayment plans. For more on what these changes mean, we're joined by NPR education correspondent Corey Turner.
Thanks for being here, Corey. Thank you, Adrian.
Let's start off talking about new borrowers, folks who may be taking out their student loans next year. What do they need to know? Yeah, so for anyone taking out loans after July 1st, 2026, they need to know that this law includes a handful of new limits on how much money certain borrowers can actually take out from the government.
The good news for undergrads is those limits aren't changing. For graduate students, though, it's a different story.
There will be new, stricter limits. Also, for parents and caregivers who take out what are called parent plus loans to help their kids pay for college, new strict limits as well.
And I will say one fear I heard from borrower advocates is that these new limits could drive some lower income borrowers into the private loan market where there really aren't as many consumer protections. So for these newer borrowers, what kind of options will they have when it comes to repaying their loans? Sure.
Well, this new Republican law is shifting the system from at least seven loan repayment plans down to two. And again, this is for new loans starting next summer.
There is an updated version of a standard plan, which is your repayment window is based on how much debt you have and your monthly payments are all the same, like a home mortgage. The other option is a little more complicated.
It's something Republicans are calling their Repayment Assistance Plan, or RAP, and it bases monthly payments on a borrower's income. It waives interest that a borrower's monthly payment does not cover, so loans aren't going to be ballooning over time.
It also comes with a new idea, Adrienne. It's a matching principal payment.
Basically, for folks whose monthly payments barely make a dent in their principal balance. Here's one explanation from Roxanne Garza.
She's director of higher ed policy at the liberal-leaning Ed Trust. If your monthly payment does not reduce your principal by at least $50, the federal government will essentially top you off to reduce that principal by $50.
Think of it as like small-scale loan forgiveness on a monthly basis. And it will even mean the lowest-income borrowers actually see their balances go down, which is a big deal.
One more change I need to mention here is the RAP plan will require even those lowest income borrowers to make at least a $10 monthly payment. What about the bigger kind of loan forgiveness? Does this RAP plan offer anything like that? It does, but not for 30 years.
Here's Preston Cooper at the conservative-leaning American Enterprise Institute. He's been crunching the numbers on this.
Borrowers who have typical levels of debt and typical incomes for their degree level are almost always going to pay off well before they hit that 30-year mark. So going into RAP, I wouldn't be thinking about forgiveness because you're probably going to pay it off before you hit 30 years.
A few caveats though, Adrian. Borrowers can still

qualify for public service loan forgiveness. That program has not gone away.
There is also

one loan forgiveness option, but it's only available to current borrowers, not new borrowers.

What about people with loans right now? What do they need to know?

Current borrowers, legacy borrowers will have several options from older plans that are not going away. Before I get to those, though, I want to call out one plan in particular, the Biden era save plan.
Eight million people are enrolled in it. It was the subject of lawsuits.
Those borrowers are currently in a really weird legal limbo where they're not required to make payments. But we know the Education Department just announced their loans will once again be accruing interest as of August 1st.
So this law winds the save plan down by 2028. So these borrowers are going to need to find an alternative repayment plan.
Now, the extra options that are available to these legacy borrowers, one of them that might make a lot of sense to folks, including some of these saved borrowers, is something called IBR. It stands for Income Based Repayment.
It's just an older income plan compared to the new RAP plan, and it does still promise loan forgiveness after 20 or 25 years. So it might be a good option for folks on Save or even other legacy borrowers who are trying to figure out what plan makes sense for them.
One last question for you, Corey. President Trump has been talking a lot about trying to close the education department.
So who would actually make all these huge changes to the loan programs? We know the Trump administration is exploring moving student loans either to the Small Business Administration or to Treasury. And at the same time, they're pushing really deep staffing cuts.
The Education Department and specifically the Office of Federal Student Aid, or FSA, which oversees student loans, their staffing levels have been cut roughly

in half. And so department staff are really in this kind of surreal, liminal space right now,

where earlier this week, the Supreme Court just gave President Trump the green light

to keep gutting the Education Department. At the same time that Congress has just passed this new

law, essentially telling these same department workers, boy, do we have a job for you. NPR's education correspondent, Corey Turner, thanks for your reporting.
Thanks for having me, Adrian. And that's up first for July 19th, 2025.
I'm Adrian Ma. And I'm Scott Simon.
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