The Revolving Door Comes For The CDC
Josh Walkos on X | WeTheFree.substack.com
When Erica Schwartz left federal service in April 2021, she cashed in quickly.
Within weeks, the former Deputy Surgeon General joined the board of Aveanna Healthcare. By September, she had secured another board seat at medical-technology company Butterfly Network. In October, she became President of Insurance Solutions for UnitedHealthcare’s Medicare and Retirement business.
In roughly six months, Schwartz moved from the upper reaches of the federal public-health establishment into three lucrative positions within the corporate healthcare economy. She received executive compensation, corporate retainers, stock awards and substantial equity interests. Now, President Trump has nominated her to return to government as director of the Centers for Disease Control and Prevention.
The revolving door has completed another rotation.
That does not prove corruption. It does not establish that Schwartz violated federal law, secretly worked for Pfizer or personally manipulated public-health policy to enrich a corporation. The concern is more structural and therefore more difficult to dismiss.
Schwartz spent decades acquiring authority inside government. She then converted that experience into considerable value inside industries heavily shaped by government policy. If confirmed, she will return to federal power after receiving financial benefits from companies whose operations intersect with insurance, Medicare Advantage, prescription drugs, medical devices, Medicaid, home healthcare and federal public-health guidance.
The question is not whether she possesses the credentials to lead the CDC.
The question is whose instincts, loyalties and interests those credentials have been trained to serve.
A Résumé Built for Institutional Power
Schwartz is, on paper, extraordinarily qualified.
She earned a degree in biomedical engineering and a medical degree from Brown University, followed by a Master of Public Health from the Uniformed Services University of the Health Sciences. She later obtained a law degree from the University of Maryland and was admitted to the District of Columbia Bar.
She began her medical career in the Navy, later transferred to the United States Public Health Service Commissioned Corps and was detailed to the Coast Guard. She ultimately reached the rank of rear admiral and served as the Coast Guard’s Chief Medical Officer, overseeing a healthcare system that included 41 clinics and approximately 150 sick bays. She became Deputy Surgeon General in March 2019 and remained in that position until April 2021.
Her career was not centered on bedside medicine. It was rooted in preventive medicine, occupational health, emergency response, disease surveillance, medical readiness and the administration of large health systems.
That distinction matters because the CDC is not merely a laboratory or collection of scientists. It is a massive administrative institution whose guidance can influence clinical practice, insurance coverage, vaccine policy, emergency powers, data collection and billions of dollars in public and private healthcare spending.
Schwartz’s background is therefore highly relevant. She understands how the federal health apparatus operates because she spent most of her adult life inside it.
Vaccination as Command Policy
Vaccination was not a peripheral feature of Schwartz’s government career.
While serving in the Navy, she was chief of both an occupational medicine clinic and an immunization clinic. At the Coast Guard, she instituted an adenovirus vaccination program and helped establish disease-surveillance, serology-screening and respiratory-illness programs.
Her official biography also credits her with writing the Coast Guard’s first force-health policies governing anthrax vaccination, smallpox vaccination and pandemic influenza, along with policies covering quarantinable diseases, HIV and medical readiness.
This does not mean she designed civilian COVID vaccine mandates. The most controversial federal employment and military COVID vaccination requirements were enacted after she left government in April 2021.
It does, however, establish her underlying philosophy.
Schwartz came from a command-oriented medical system in which vaccination, quarantine and disease surveillance were instruments of operational readiness. In a military environment, individual consent is often subordinate to the perceived needs of the mission.
Whether that mindset translates appropriately to civilian public health is a legitimate question. The CDC does not command American citizens as an admiral commands a force. Yet the agency’s pandemic-era behavior repeatedly blurred the distinction between issuing public guidance and imposing a national medical doctrine through employers, schools, travel restrictions and government contractors.
Schwartz’s record suggests she is not a traditional vaccine skeptic. Before her nomination, Reuters reported that she had no public history of opposing vaccination. Her career instead reflects conventional institutional confidence in vaccines as tools of population health and operational control.
Her Role During COVID
Schwartz served as Deputy Surgeon General when COVID arrived in the United States.
In her confirmation testimony, she identified national testing access as one of her central pandemic responsibilities. She told senators that her team designed and operated federal drive-through testing sites across all 50 states, Puerto Rico and Washington, D.C., ultimately testing nearly 11.5 million people.
That is substantial operational experience, and supporters can reasonably point to it as evidence that she understands emergency response.
It also means the testing system cannot be treated as something that merely occurred somewhere in the federal bureaucracy while Schwartz happened to hold an impressive title. By her own account, she helped design and operate it.
A 2020 Reuters investigation documented serious failures at federal testing sites in New Orleans. Patients waited extended periods for results, local authorities struggled to determine which patients had been notified and state officials complained that the federal notification system left them without the information necessary to conduct public-health follow-up.
Reuters identified Schwartz as the ordering physician for federal drive-through testing in the region. When Louisiana official Joseph Kanter raised concerns in a March 23, 2020 email, Schwartz reportedly responded that the federal call center would not communicate with state or local health departments and that Louisiana should use its ordinary procedures for notifying patients.
The problem was that local authorities said they did not possess all the federal testing information and had believed the federal call center was handling those notifications.
It was a bureaucratic circle familiar to anyone who has watched government institutions fail under pressure. One arm collected the samples, another processed the tests, a contractor notified some patients, local departments were expected to conduct follow-up, and nobody appeared to possess a complete picture of what the others were doing.
The available evidence does not support claiming that Schwartz single-handedly sabotaged the testing program. Federal officials defended the initiative, Louisiana desperately needed more testing capacity and some local officials described Schwartz and federal testing coordinator Brett Giroir as helpful.
The reasonable conclusion is narrower. Schwartz occupied a direct operational role in a federal testing system that experienced documented communication and notification failures. That record deserves scrutiny when she now promises that her leadership of the CDC will be defined by transparency, speed and accountability.
The Corporate Landing
Schwartz left the federal government in April 2021.
In May, Aveanna Healthcare appointed her to its board of directors. Aveanna provides pediatric and adult home nursing, therapy, home health and hospice services. Its business is affected by government reimbursement systems, including Medicare and Medicaid.
In September 2021, Schwartz joined the board of Butterfly Network, which develops semiconductor-based handheld ultrasound technology and associated software.
The following month, she became President of Insurance Solutions at UnitedHealthcare. Corporate materials described her role as part of UnitedHealthcare’s Medicare and Retirement business, placing her inside a division intimately connected to federal healthcare programs and regulation.
This was not an incidental consulting arrangement.
Schwartz became a senior executive at America’s largest healthcare conglomerate while simultaneously serving on the boards of two publicly traded healthcare companies.
The same public-health expertise accumulated through decades of government service had become a valuable corporate commodity.
Again, there is nothing inherently illegal about that. Companies routinely recruit former government officials because they understand regulation, procurement, institutional culture and the complex relationship between government and industry.
That is precisely the problem.
The revolving door does not require a briefcase of cash passed beneath a restaurant table. Its currency is access, experience, relationships and the ability to anticipate how government will behave. Officials learn the system from the inside, convert that knowledge into private compensation, then sometimes return to government with deeper connections to the industries affected by their decisions.
The arrangement may be perfectly legal while remaining corrosive to public trust.
Fun Fact:
— Champagne Joshi (@JoshWalkos) July 17, 2026
Erica Schwartz’s husband currently works as a BIOETHICS PATENT ATTORNEY.
Just something to consider along with the other information in the thread below. https://t.co/pcfdZqTpAQ pic.twitter.com/UTfpCg8oO6
UnitedHealth and the Pharmaceutical Machine
The strongest version of the conflict-of-interest argument is not that Schwartz directly worked for Pfizer, Moderna or another drug manufacturer.
I found no public evidence that she was employed by a major pharmaceutical manufacturer or personally negotiated vaccine contracts.
Her connection to the pharmaceutical economy runs through UnitedHealth Group, the corporate parent of UnitedHealthcare and Optum.
Optum owns Optum Rx, one of the country’s dominant pharmacy-benefit managers. Pharmacy-benefit managers sit between insurers, pharmacies, drug manufacturers and patients. They negotiate formularies and rebates and play an enormous role in determining which drugs are covered, how they are priced and what patients ultimately pay.
UnitedHealth’s 2025 annual report states that Optum Rx managed approximately $188 billion in pharmaceutical spending, including nearly $87 billion in specialty-drug spending.
That is not a minor commercial relationship with the drug industry. It is one of the largest pharmaceutical-financing operations in the world.
The Federal Trade Commission has accused Optum Rx and other major pharmacy-benefit managers of using rebate and formulary practices that artificially inflated insulin list prices. The FTC alleges that the companies favored highly rebated products and contributed to a system in which some patients paid deductibles or coinsurance based on inflated list prices. The allegations remain the subject of legal proceedings and should not be presented as proven findings against Schwartz personally.
There is no evidence in the reviewed documents that Schwartz ran Optum Rx, negotiated pharmaceutical rebates or directed insulin-formulary decisions.
But she was not employed by an unrelated neighborhood insurance agency. She was a senior executive inside the same corporate empire.
That is the documented Pharma nexus. It is institutional rather than personal, but it is hardly imaginary.
When people hear the phrase “Big Pharma,” they tend to picture drug manufacturers. The modern healthcare machine is much larger. It includes insurers, pharmacy-benefit managers, hospital systems, medical-device companies, government contractors and companies whose profitability depends upon federal reimbursement and public-health policy.
Schwartz’s corporate résumé crosses several of those sectors.
The Butterfly Network Relationship
Schwartz joined Butterfly Network’s board in September 2021 and later chaired its nominating and corporate-governance committee. She also served on its technology committee.
According to Butterfly’s 2026 proxy statement, Schwartz received $252,498 in board compensation during 2025. That included $67,500 in cash fees and stock awards with a grant-date value of $184,998.
The same filing reported that she beneficially owned 295,818 Butterfly shares.
Butterfly develops portable, point-of-care ultrasound technology. The Food and Drug Administration, not the CDC, directly regulates medical devices. It would therefore be inaccurate to claim that Schwartz would control regulatory approval of Butterfly products as CDC director.
The relationship remains relevant because the CDC influences disease-detection strategies, emergency preparedness, surveillance systems, clinical recommendations and the direction of public-health programs. Those policies can influence institutional demand for diagnostic technologies.
A conflict does not have to involve direct regulatory authority to create an appearance problem. It can arise whenever an official’s decisions are capable of affecting a former employer, a former board or an industry in which that official recently held substantial equity.
The Aveanna Relationship
Schwartz also joined Aveanna Healthcare’s board almost immediately after leaving government.
Aveanna’s 2026 proxy statement reported that she received $212,000 in board compensation during 2025, including $82,000 in fees and $130,000 in stock awards. It also reported that she beneficially owned 257,498 company shares.
Between Butterfly and Aveanna alone, Schwartz received more than $464,000 in reported 2025 board compensation. That was separate from her UnitedHealth executive compensation.
Aveanna’s operations depend heavily on the broader government healthcare environment. Its home-health, pediatric-nursing, hospice and therapy businesses are influenced by Medicare and Medicaid rules, infection-control requirements, emergency policies, workforce standards and public-health guidance.
The CDC does not determine Medicare reimbursement rates. Still, its policies concerning respiratory diseases, vaccination, outbreak response and infection control can materially affect home-health providers and the patients they serve.
None of this proves that Schwartz would deliberately manipulate CDC policy to benefit Aveanna.
It demonstrates that the nominee arrives with recent and substantial financial ties to companies living downstream from federal health policy.
Her government disclosure placed her Aveanna stock in the $1 million to $5 million range and listed unvested restricted stock units between $100,001 and $250,000.
— Champagne Joshi (@JoshWalkos) July 16, 2026
Aveanna has agreed to accelerate the vesting of those units when she leaves for government.
Aveanna also prepaid…
The Exit Package
Schwartz has promised to resign from UnitedHealth and her corporate boards if confirmed. She has also pledged to sell relevant healthcare holdings and observe applicable recusals.
Those are necessary steps. They do not make the underlying arrangements irrelevant.
According to her ethics disclosures, UnitedHealth agreed to provide Schwartz with a cash payment equal to one year of salary and an incentive payment based on her prior compensation before she assumes the CDC position. The company also agreed to cash out certain unvested restricted stock units and options that otherwise would have vested between August 2026 and August 2027.
She has agreed to dispose of UnitedHealth shares obtained through vested options and recuse herself for two years from certain specific-party matters involving the company after receiving her final payment. She also agreed to resign from Butterfly and Aveanna, divest the shares and comply with additional recusal obligations connected to compensation and accelerated equity awards.
This may comply fully with federal ethics law.
But legality is not the only issue.
Why should a corporation financially cushion an executive’s return to federal power? Why should unvested compensation, which ordinarily rewards continued corporate service, be converted into cash when that executive departs to assume a powerful government position?
Defenders may argue that such payments merely prevent nominees from being financially punished for accepting public service. That argument is not frivolous. Highly compensated executives often must surrender unvested awards when entering government, and requiring complete forfeiture could discourage qualified candidates from accepting public positions.
The counterargument is equally obvious.
A generous exit payment from a healthcare giant creates precisely the appearance of continuing obligation that ethics rules are supposed to prevent. The recipient may sell the shares, but she cannot sell the relationships, professional loyalties and institutional worldview formed while working inside the company.
A recusal can remove someone from a specific contract or enforcement proceeding. It cannot surgically remove years of corporate socialization from the mind of an agency director.
Vaccines, Kennedy and the Test of Independence
At her July 15 confirmation hearing, Schwartz promised “radical transparency” and said she would never “betray the science.”
Yet senators repeatedly struggled to obtain direct answers about whether she would exercise genuine authority over the CDC or defer to Health and Human Services Secretary Robert F. Kennedy Jr.
Schwartz said she accepted the evidence that vaccines do not cause autism. However, she would not commit to removing CDC website material suggesting such a relationship, saying she would review it and consult with Kennedy.
When asked whether she would have opposed rolling back the military flu-vaccine mandate, she declined to engage with the question. When pressed on whether she would stand up to Kennedy over vaccine policy, she repeatedly returned to carefully prepared assurances about science and transparency rather than identifying a specific line she would refuse to cross.
This produced an unusual political spectacle.
Traditional public-health advocates worried Schwartz would not be sufficiently independent from Kennedy’s vaccine agenda. Vaccine-mandate critics could look at Schwartz’s career and see a longtime architect of military immunization, quarantine and surveillance policy.
Both concerns can exist simultaneously.
Schwartz’s record is pro-vaccine by conventional public-health standards. I found no substantial public statement in which she directly assessed the Pfizer or Moderna mRNA products, discussed their adverse-event profiles or explained her views on COVID vaccine mandates. The hearing’s most direct questions about canceled mRNA research were aimed at fellow nominee Sean Kaufman, not Schwartz.
The uncertainty surrounding her position is therefore not whether she accepts vaccination in principle. Her career answers that question.
The uncertainty is whether she will apply independent scrutiny to specific products, manufacturers and recommendations when powerful institutional interests demand agreement.
CDC Director nominee Dr. Erica Schwartz states LAUGHING, “I do believe that mRNA technology is safe and effective.”
— Vaccine Safety Research Foundation (@VacSafety) July 16, 2026
She’s being nominated to LEAD the agency responsible for our public health, disease prevention, vaccine recommendations, safety monitoring, outbreak response, and… pic.twitter.com/c7RuS4DqQS
The Conflict that Survives Divestment
It is important not to overstate the case.
There is no public evidence that Schwartz committed a crime, concealed a pharmaceutical payment or agreed to serve as a corporate operative inside the CDC. Her supporters can plausibly argue that she has precisely the management experience needed to stabilize a battered agency. Some senators described her as exceptionally qualified, and her decades in emergency response are unquestionably relevant to the position.
But conflicts of interest are not limited to provable bribery.
They concern incentives, relationships, access and the reasonable possibility that private financial history may shape public judgment.
If confirmed, Schwartz would lead an agency whose policies influence vaccination, disease surveillance, outbreak response, medical guidance, state funding and public-health procurement. Its announcements can alter consumer behavior, insurance coverage, clinical protocols and investment markets.
She would assume that authority shortly after leaving positions at UnitedHealth, Butterfly Network and Aveanna Healthcare, companies that paid her substantial compensation and provided her with corporate equity.
The public is therefore entitled to more than assurances that the appropriate forms have been filed.
It is entitled to know whether she communicated with UnitedHealth before leaving federal service. It is entitled to know the final value of every cash payment and accelerated award she will receive before taking office. It is entitled to understand the exact scope of her recusals and whether they cover only narrow company-specific matters or broader policies affecting insurers, pharmacy-benefit managers, medical-device companies and healthcare providers.
Most importantly, the public is entitled to ask whether a director drawn so recently from the corporate healthcare establishment will possess the independence to challenge it.
Divesting a stock portfolio may remove a legal conflict.
It does not erase a career path.
The revolving door is not merely a metaphor in Erica Schwartz’s case. It is the route by which she traveled from government authority to private wealth and now back toward government power.
The only remaining question is what, and whom, she will represent when the door stops spinning.
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References
[2] Erica Schwartz, written confirmation testimony
[3] U.S. Coast Guard, official biography of Rear Admiral Erica Schwartz
[4] Reuters, Trump CDC nominee Schwartz to resign posts and sell holdings if confirmed, June 22, 2026
[5] Reuters, Trump CDC nominee sidesteps questions on standing up to Kennedy on vaccines, July 15, 2026
[6] Associated Press, CDC nominee declines to challenge Kennedy’s actions, July 15, 2026
[7] Butterfly Network, 2026 definitive proxy statement
[8] Aveanna Healthcare, 2026 definitive proxy statement
[9] UnitedHealth Group, 2025 annual report
[10] Federal Trade Commission proceeding involving Optum Rx and other pharmacy-benefit managers
[11] Reuters, Schwartz set for July 15 Senate hearing, July 8, 2026