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C矇line Gounder, 窪蹋勛圖厙 News editor-at-large for public health, discussed a recent study that suggests ultraprocessed foods are linked to increased dementia risk on CBS News 24/7’s The Daily Report on June 3. Gounder also discussed the Ebola outbreak in central Africa and the impact of U.S. health funding cuts on CBS News’ CBS Mornings on June 3.
On June 2, Gounder joined CBS News’ CBS Mornings to discuss a study that found women taking GLP-1 drugs had a lower rate of breast cancer diagnoses. She also discussed President Donald Trump’s new medical report and creatine supplements on CBS News 24/7’s Mornings and CBS News’ CBS Mornings, respectively, on June 1.
As the current federal administration rounded up an increasing number of immigrants, with U.S. Immigration and Customs Enforcement holding more than 75,000 in mid-January alone, we heard scattered, localized complaints from detainees alleging medical neglect. We wondered about the extent of the problems and whether the agency and its contractors were keeping pace with detainees medical needs nationwide. But no central repository exists, so we had to get creative and dive into a trove of court records.
Detainees are filing record numbers of habeas corpus petitions in federal court, arguing theyre being held illegally. Sometimes those cases mention medical conditions. But a federal rule makes immigration filings tricky to obtain because theyre usually available only in person at the court where they were filed. The nation has 94 of those courts.
However, a nonprofit collecting such records through a national network of volunteers gave us documents from thousands of those court cases dating to last January. We teamed up with The Associated Press to dive into them.
In analyzing those files, we found that hundreds of detainees in at least 33 states told courts theyd received inadequate medical care. They said that they didnt get their medications on time or at all for everything from diabetes to Parkinsons to HIV. They told courts their requests for medical help had gone unanswered for weeks, that their blood sugars rose, infections festered, and cancers went untreated. Some said they had collapsed and had seizures.
Court filings described how one man had a stroke while on a video call with his daughter and lost his ability to speak for several days. Records show he hadnt been getting all his medications while detained. Another detainee described standing by the door each day waiting for the eye drops he needed to maintain his waning vision, as he worried whether he would be able to see his infant child grow up. Even after being released, a father of six U.S. citizens told us he feared he wouldnt be able to support them because of lingering pain in his leg the leg a doctor told him came close to needing amputation when an infection in ICE custody went untreated until he passed out and was hospitalized.
Such allegations spanned facilities of all types, from county jails to sites like Alligator Alcatraz, as the Department of Homeland Security gutted the office in charge of oversight.
窪蹋勛圖厙 News and AP asked the agency to respond to our findings, but it did not provide comment. DHS acting Chief Medical Officer Sean Conley has previously said, It is both policy and longstanding practice for aliens to receive timely and appropriate medical care from the moment they enter ICE custody.
Detainees families said they feel helpless watching their loved ones deteriorate while in custody and hope they dont join the rising death toll, which has reached 51 since the start of President Donald Trumps second administration.
Immigrant detainees have told courts across the nation that detention officials have failed to treat or stabilize their conditions, from pregnancy to prostate cancer, suggesting that systemic lapses in care extend well beyond record deaths in Immigration and Customs Enforcement custody.
Travel bans and conflict have disrupted supply chains, leaving health workers without Ebola tests and protective gear needed to contain the outbreak.
Harrowing scenes are unfolding at health facilities at the epicenter of an Ebola outbreak in the Democratic Republic of Congo.
A 25-year-old midwife and a doctor in his early 30s are sick with Ebola symptoms, including fevers and severe joint pain, said their colleague Elisabeth Furaha, the medical director at in the northeastern province of Ituri.
They had cared for patients with similar symptoms in early May, before the outbreak was detected. One of the patients is now dead, Furaha said, and none of them has been tested for Ebola, even though samples were taken. The hospital still lacks access to tests, and an adequate supply of protective gowns and plastic masks to keep doctors and nurses safe.
We live with fear in our stomachs, Furaha said, speaking in French. Every day, there are healthcare providers and patients dying.
The outbreak took the world by surprise, with nearly 250 suspected Ebola cases and 80 deaths by the time Ebola was confirmed in Congo. Disturbed by the extent of silent transmission, and by cases in neighboring Uganda, the head of the World Health Organization sounded the groups highest alarm on May 17, declaring the outbreak a public health emergency of international concern. That triggered donations from around the globe, of more than $162 million from the U.S. State Department to stop the outbreak at its source and ensure Ebola does not reach the United States.
But despite international attention, doctors in northeastern Congo say that many clinics lack even rudimentary supplies: gloves, protective gowns, masks, Ebola tests, and even clean water. Without rapid action to bolster those on the front line, researchers say, the outbreak will grow exponentially, costing even more money and risking lives far beyond Congo.
All signs point to this becoming the biggest outbreak weve ever seen in the DRC, said Nahid Bhadelia, the director of Boston Universitys Center on Emerging Infectious Diseases. That could lead to regional instability, and that has repercussions for the world.
Some supplies from the countrys Ministry of Health, the WHO, and other United Nations agencies have landed in northeastern Congo, but not nearly enough to stock hundreds of health facilities where Ebola patients may seek care. Furaha has spent her own money on gloves, masks, and a tarp to build a makeshift tent to isolate patients with Ebola symptoms from the rest of the hospital. But she said its inhumane to put patients there before she can afford a mattress for them to rest on, or reliable access to tests.
Without testing, patients who turn out to have Ebola can infect those who dont. Malaria and other diseases have initial symptoms similar to Ebola, causing fevers, soreness, and gastrointestinal problems.
Aid workers say shipments of medical supplies have been delayed by logistical hurdles, such as suspended flights within Congo and between Congo and neighboring countries.
We need flights to move a lot of things, so this is a big challenge, said Chikwe Ihekweazu, executive director of the WHO Health Emergencies Program. Small planes used in humanitarian crises have been permitted to move, but Ihekweazu said those are insufficient, expensive, and unsustainable.
Moving between remote clinics can be an impossible task because roads are often badly eroded or blocked by armed groups, said Rafaramalala Volanarisoa, a doctor with Catholic Relief Services in Kinshasa, Congos capital. Conflict, combined with the Trump administrations abrupt withdrawal of funds from the U.S. Agency for International Development, has made Congos already ailing health system dysfunctional, Volanarisoa said.
Its very dangerous, she said. There is no medicine, no equipment, no surveillance.
Dilapidated Labs
Researchers at Congos National Institute of Biomedical Research had built a sophisticated molecular biology laboratory for surveillance in Goma, the countrys eastern economic hub. But the lab stopped functioning last year after the Rwandan-backed violently of Goma and , stunting the flow of international aid.
Other cities in Congo lack well-stocked molecular biology labs, so they have instead relied on simple, automated tests that detect only one type of Ebola virus, said Eddy Kinganda-Lusamaki, a microbiologist at the biomedical institute. The shortcomings of these simple tests became obvious when the first samples tested in early May were negative for Ebola. Doctors were still worried, so they collected more samples, packed them in an icebox, and sent them to the institutes main lab, in Kinshasa.
It took the samples six days to get there, traveling over bumpy roads and between storage facilities, Kinganda-Lusamaki said, and many were degraded by the time they reached the institute on May 14. Still, researchers identified an unusual variety of Ebola caused by the Bundibugyo virus, with a fatality rate of up to 50% and with no vaccines or drugs existing to treat it. They alerted authorities.
Later, investigators traced the first confirmed cases back to several deaths from unknown causes in a gold-mining town in Ituri. The Ebola was spreading there as early as March, with three of the groups volunteers dying of unknown causes after burying bodies as part of their humanitarian work.
As of June 3, 363 Ebola cases and 62 deaths had been confirmed in the country, according to Congos . Tallies of suspected cases have fluctuated dramatically, a reflection of gaps in surveillance.
Researchers at the biomedical institute urgently want to improve labs in eastern Congo so they can test for Bundibugyo.
We need support for local staff, training, equipment, consumables, and fuel, for cars and backup generators, Kinganda-Lusamaki said. He also worries that expensive lab equipment could be stolen or destroyed by roving militias if war is permitted to continue in the east. My brothers and sisters are perishing, he said.
Conflict Aids Ebolas Spread
Violence abets Ebola in other ways. As the outbreak was silently spreading in Ituri in late April, caught in the crossfire of armed groups fled, potentially carrying the virus with them. South of Ituri, Maurice Kakule Mutsunga, a doctor at a large general hospital, said hes seen a surge of people by members of the Allied Democratic Forces, an linked to the Islamic State. Every day this week weve received patients massacred by the ADF, Kakule Mutsunga said in French, adding that bodies carried into the hospital have been decapitated by machetes.
People displaced by attacks are living in dense quarters that provide perfect conditions for a virus that spreads through touch. A person sick with Ebola, or recently killed by it, excretes sweat, blood, and other liquids packed with viruses that cause the disease.
Unpredictable attacks have also prevented health workers from tracking down people who may be infected in remote villages, to offer them care and keep the virus from spreading to others, Kakule Mutsunga said. Less than a quarter of contacts that Ebola responders identified had been monitored for signs of infection, the WHO reported on May 21.
Contact tracing and isolation the cornerstones of an Ebola response are also fraught because of the slow turnaround time on tests. Kakule Mutsunga said samples from his hospital in the town of Oicha are shipped to Kinshasa on humanitarian flights that take off only once they are at capacity. Many patients cant or wont isolate themselves for a week while they wait on results, he said, so they may pass the deadly virus to those closest to them.
Congolese researcher Gang Karume said that scientific information about Ebola isnt reaching many communities, partly because of the trauma of daily life. On top of years of conflict, more than 220,000 young children are in provinces where Ebola is spreading. He wasnt surprised to learn that angry youths have set fire to Ebola treatment centers and stolen corpses from morgues.
An empty stomach does not have ears to listen, he said.
To reach people, the is relying on its network of some 250 priests in Ituri. Theyre deeply rooted, said Volanarisoa, with Catholic Relief Services, which partners with Caritas. They understand how to approach communities who refuse to seek treatment.
Through this network, Volanarisoa and her colleagues have gotten in touch with health workers seeking medical advice and protective equipment. With private donations, the Catholic charities have transferred money to priests in the northeast who arrange for jeeps to carry cash and supplies to clinics.
What weve provided will only last for a few weeks, Volanarisoa said. The need is really immense.
Another crippling factor is that the United States is far less involved than in the past, aid workers said. The Trump administration left the WHO, dissolved USAID, and downsized the Centers for Disease Control and Prevention.
The U.S. is just not the player it used to be, said Jeremy Konyndyk, a former USAID official who led the agencys response to the worlds largest Ebola outbreak, in West Africa from 2013 to 2016. We used to have a stockpile of gear for an Ebola response that we could throw on an airplane and get it to where it needs to go, he said.
The U.S. used to give hundreds of millions of dollars to the WHO and nongovernmental organizations with experience fighting outbreaks. Under President Donald Trump, the State Department has announced that it will give $350 million to a pooled fund maintained by the U.N. Office for the Coordination of Humanitarian Affairs, which will then distribute funds to aid groups.
This adds steps, Konyndyk said. The organizations that are ready to roll now are not confident that they will get money, so theyre kind of frozen.
Even then, aid can take weeks to materialize on the front line. During the West Africa outbreak, more than two months passed between the WHOs declaration of an international emergency and significant help arriving. In the interim, the Ebola death count more than quadrupled. Nurses, doctors, and ambulance drivers .
Front-line workers in Congo face a similar fate if help doesnt arrive soon. Furaha said her hospital is running out of clean water. All of this accumulates, she said. Healthcare workers will reach a breaking point.
Chlo矇 Fostier Hern獺ndez helped translate interviews for this report.
have lost insurance since President Donald Trump took office in 2025. Another million could lose it amid the Trump administrations immigration crackdown and new Medicaid eligibility rules. On WAMUs Health Hub on June 3, 窪蹋勛圖厙 News chief Washington correspondent Julie Rovner explained how fear and confusion complicate access to health coverage.
Last years big cuts to federal healthcare programs in the Republicans’ One Big Beautiful Bill Act created an affordability crunch for many Americans. Theyve ushered in higher health insurance premiums and confusion about whos covered under new Medicaid rules.
Another result has been falling enrollment in Affordable Care Act plans and Medicaid. Thats leaving uninsured, according to an analysis by the Georgetown University McCourt School of Public Policy’s Center for Children and Families. 窪蹋勛圖厙 News chief Washington correspondent Julie Rovner appeared June 3 on WAMUs Health Hub to explain whos vulnerable to losing coverage and what it all could mean for the prices Americans pay for health insurance next year.
Having a baby in the United States is about to get more complicated.
Under new billing codes that take effect in January, doctors who manage maternity care will start charging la carte for visits and services related to pregnancy, childbirth, and postpartum care. Its an about-face from recent years, when doctors have often received a single bundled payment for maternity care they provided. Although OB-GYNs strongly and have pushed for it for years, some patient advocates and employers say its an open question whether the new system will result in better care or increased patient costs.
The American College of Obstetricians & Gynecologists says the change is crucial to accurately reflect the care OB-GYNs currently provide, with expectant patients some older and sicker than in decades past more likely to have complex medical and social needs and receive care in multiple settings from multiple practitioners.
For example, under current bundled obstetrics coding, the number of prenatal visits is set at a fairly arbitrary 13, which is not really what most people need, said , chair of the Department of Obstetrics and Gynecology at the University of New Mexico and a member of the ACOG committee that developed the new codes in conjunction with the .
The new fee-for-service codes will better accommodate more or fewer visits, either in person or remotely, based on individual needs.
Under the current system, if someone comes in for a birth, no matter how long or how short their labor or how complicated or uncomplicated their delivery, the global reporting is the same because we only have one code, Hofler said.
The new, more precise codes will help the growing number of medical professionals who may play a role in maternity care such as midwives, hospitalists focused on labor and delivery, and maternal-fetal medicine specialists to account for, and get paid for, the range of services they provide.
For patients, however, especially the growing number with high-deductible health plans, the new system may result in higher out-of-pocket bills, some maternity experts say.
The cost piece is really critical, said , an OB-GYN and the senior vice president for the Achieving Equitable Outcomes initiative at The Commonwealth Fund, a health research nonprofit. There will be more line items. Will that be passed along to patients, particularly those that are in commercial plans, in high-deductible plans?
Whether families will pay more out-of-pocket really comes down to how payers choose to implement these codes, Zephyrin said.
Insurance industry representatives said they are concerned with the implementation timeline, which will require significant operational changes.
Rushed implementation of far-reaching AMA code restructuring will fundamentally change how maternity services are managed and reimbursed, said Chris Bond, a spokesperson for AHIP, which represents insurers. Under federal law, providers and health plans for diagnoses, procedures, services, and supplies. Doctors and other health professionals bill for their services using Current Procedural Terminology codes, which are developed and maintained by the , the main trade group for doctors. The federal Centers for Medicare & Medicaid Services reviews new and revised codes and reimburses clinicians based on a fee schedule, which is updated every year. The CMS review is going on now, and the proposed fee schedule for next year will be published in July.
We dont know whether CMS will go along with the proposed coding changes, said Barbara Levy, vice chair of the AMAs CPT Editorial Panel. They were at the table as observers and had opportunities to give inputs throughout the entire process, she said. In the meantime, the AMA is educating providers and payers about the new coding structure.
Federal law limits how much expectant parents can be charged in certain instances. Under the ACA, most health plans that is considered preventive at no cost to members. The list of preventive maternity services, set by the federal Health Resources and Services Administration, includes prenatal and postpartum visits and screening for diabetes, anxiety, and HIV, among other things.
The global bundle doesnt cover everything, though, and pregnant people typically already pay some of the cost for certain services, such as ultrasounds, specialist visits, and lab work. Theyre also responsible for their portion of labor and delivery professional fees based on their insurance plan (in addition to hospital charges, which are billed separately).
Still, , in which providers are paid la carte based on the volume of services they provide rather than on health outcomes, has long troubled health policy experts because of its potential to incentivize providers to do more and pricier services. In fact, one of the reasons policymakers moved away from that arrangement for maternity care in recent years was because they believed had the potential to lower costs and improve quality, including reducing the roughly 30% of births in the United States done by cesarean section, which costs significantly more than vaginal birth. (It hasnt worked. The proportion of births by C-section hasnt budged under bundled payment.)
I always worry about anything that is piecemealing our healthcare system even more, said Caitlin Donovan, a senior director at the Patient Advocate Foundation, a nonprofit that provides case management services for sick people in the U.S., of the return to fee-for-service billing.
Even under the current system, patients can get dinged for extra services they may not need. Donovan recalled that when she was 35 and pregnant with her third child, her obstetrician told her that as a geriatric expectant mother she needed weekly ultrasounds after her 20th week.
ACOG recommends a detailed first-trimester ultrasound for pregnant patients 35 or older or with known risk factors, according to spokesperson Jamila Vernon. Subsequent ultrasounds are also based on findings and risk factors. In other words, there is no set number of ultrasounds for all patients, Vernon said.
There was nothing that indicated I needed those scans, Donovan said. It was just a money grab.
With roughly babies born every year in the United States, childbirth is one of the most common medical events that people experience.
Still, having a baby isnt cheap. It costs families with employer coverage , according to an analysis of data from 2021 to 2023 by researchers with the Peterson-窪蹋勛圖厙 System Tracker.
About in the U.S. are covered by the federal-state Medicaid program for low-income people. These families dont generally face out-of-pocket costs for maternity care, and the new billing system wont affect them financially.
However, ACOG hopes that the new system will help doctors and other medical professionals improve maternity care, particularly after a baby is born.
With a bundled system, its often unclear what services were provided during the maternity process, hampering researchers ability to evaluate whether specific services move the needle on maternal mortality rates, in which the U.S. .
Maternity care experts are particularly interested in postpartum care. Forty-eight states and Washington, D.C., now provide a after childbirth, up from 60 days. Under the new codes, physicians will be paid to provide extended postpartum care, rather than the two visits that were recommended under bundled coding.
Its important to track a number of medical issues after birth, including screening for depression, substance use, whether a pregnant mothers gestational diabetes turned into diabetes, or whether cardiac changes returned to normal after birth, said , a Medicaid and maternal-child health expert who is president of Johnson Policy Consulting.
With the new codes, you have that opportunity for ongoing care, and you have a way to finance it, she said.
Experts who represent employers say they understand why ACOG has been pushing for these changes, but they are concerned that they will result in higher costs.
ACOG is saying that obstetricians are being underpaid, and theres probably some truth to that, said Jeff Levin-Scherz, population health leader at WTWs health management practice and an assistant professor at Harvards T.H. Chan School of Public Health.
Levin-Scherz noted reports of increasing visit intensity, reflecting the time and resources a doctor spends on a patient and resulting in higher payment. It’s not likely that this new set of visit codes will be exempt from that, he said. Even though patients may not be on the hook directly for the cost of prenatal and postpartum visits, to the extent that there are more visits and theyre coded at a higher level, if their plan is paying more next year, their insurance premiums will go up more, he said.
Magda Rusinowski, a vice president of the Business Group on Health, which represents midsize and large employers that self-fund employee health benefits, said she is concerned that the new system will encourage the use of additional and more frequent tests and more expensive providers rather than doulas, for example.
Fee-for-service in every discipline incentivizes more tests and higher-level providers because thats what generates higher billing, she said.
Still, its early days, Rusinowski said. Many in the industry are trying to think about how this will unfold.
June 4
Arielle Zionts [arr-ee-ELL ZY-ence] reads the weeks news: For some older adults, the risks of certain preventive screenings might outweigh the rewards. Plus, cost spikes for Obamacare plans have consumers seeking cheaper health coverage, which is often less comprehensive.
May 28
Jackie Forti矇r [FOR-tee-ay] reads this weeks news: Suicide prevention experts argue that improving Americans financial well-being could save lives. Plus, the Trump administration proposes looser artificial intelligence safeguards to speed innovation in healthcare.
The 窪蹋勛圖厙 News Minute is available every Thursday via direct download or the RSS feed.
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, 窪蹋勛圖厙 News has learned.
In private meetings, some public health leaders have objected to giving Kennedys team access to such data, raising doubts that its 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 窪蹋勛圖厙 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 Kennedys 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. Weve had to go to the states and, luckily, weve 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 .
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 Novembers crucial midterm elections, President Donald Trump has regularly echoed Kennedys 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.
Kennedys political appointees and allies including William Reyn Archer III, a former Texas health official and 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 Kennedys 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 Kennedys 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 窪蹋勛圖厙 News. Under the proposal, HHS would get data from 90% of the populations 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 governments 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: Its 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 anyones 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 cant do anything our agreements dont 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 Kennedys project, and that nothing has yet been shared.
HHS spokesperson Emily Hilliard did not answer questions about how many states are participating in Kennedys 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 Kennedys 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 Nebraskas 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 in the state said several states are looking to open up channels to provide more analysis to Kennedys team.
Theyre looking at the data differently and providing some insights back to the CDC, Bland told 窪蹋勛圖厙 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, Nebraskas 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 , which sends money to state and local health departments for lab work, health information enhancements, and solutions for outbreaks.
Nebraskas 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 Kennedys 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 Kennedys 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 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 autisms 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 wasnt 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 dont include patient names or other information that can identify individuals. Jernigan said Kennedy didnt 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 CDCs 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 persons medical history that will not necessarily produce answers to Kennedys questions about vaccines and autism.
If theyre just using the electronic health record data, there are limits to that, Jernigan said. If theyre only looking at electronic health record data, all youre going to get is what was captured in the encounter. Its not going to be very satisfying.
窪蹋勛圖厙 News data reporter Maia Rosenfeld contributed to this article.
Yolibeths 4-year-old daughter scrambled headfirst onto a cushy leather love seat at their home near New Orleans and pushed a hairbrush into the hands of Miriam Romero, a health coordinator who works with the family. Romero placed the girl in her lap and started brushing her dark hair.
Yolibeth, a 38-year-old single mother who moved to South Louisiana from Honduras 15 years ago, watched them, smiling. The daughter is the youngest of five children living in this mixed-status household. Yolibeth and her two oldest kids dont have legal immigration status, but the other three ages 4, 9, and 13 were born in the U.S. and are citizens.
All of her U.S.-born kids were enrolled in Medicaid at birth, which made it affordable for her to take them to the doctor for regular checkups when they were little. Her oldest two, ages 15 and 17, have never had health insurance, so Yolibeth relies on low-cost community clinics when she can afford it.
But now she worries that healthcare access for all of her children is slipping away. Yolibeth has been waiting for months to hear whether any of her childrens Medicaid renewal applications has been approved. She fears they will be denied because of a new Louisiana law targeting noncitizen Medicaid enrollees, even though she isnt applying for herself. She worries particularly about her 4-year-olds access to routine care and required childhood vaccines.
I cannot access the same services, and so my child is not getting what she needs to grow healthy, Yolibeth said in Spanish as her daughter giggled on the love seat.
Verite News and 窪蹋勛圖厙 News agreed to not use Yolibeths full name, because she is worried about repercussions related to her immigration status.
Romero, who works for a local immigrant advocacy group, said that in a single week she received calls from eight immigrant families who had been denied after applying for Medicaid on behalf of children who are citizens.
Because of the law that passed in Louisiana, children are losing their Medicaid every day, Romero said in Spanish. The more time that goes by, the more children are impacted by it.
Romero said that all children from mixed-status families are likely to be denied Medicaid by the end of the year.
Missing Out on Care
Nationally, many immigrants said they skipped or delayed healthcare last year, citing issues including costs, struggles finding services, and fears about their or a family member’s immigration status, by KFF and The New York Times. Immigrants without legal status were the most likely to skip or delay care for themselves or their children. An increasing number of immigrants avoided applying for programs like Medicaid, too scared to risk drawing attention to their or a family members immigration status, even if they were eligible.
In Louisiana, where about a third of residents are enrolled in Medicaid, the has added to those fears. The law requires the Louisiana Department of Health to verify Medicaid applicants U.S. citizenship, terminate coverage for applicants with unsatisfactory proof of status, and report those applicants to U.S. Immigration and Customs Enforcement. Since the measure passed in Louisiana, similar bills have passed in North Carolina, Wyoming, Indiana, and Tennessee. At least three other states were considering similar measures this year.
State Rep. Chance Keith Henry, a Republican who sponsored the Louisiana bill, did not return calls or emails from Verite News seeking comment on the effects of the law. He said in last years state House floor debate that he didnt anticipate any chilling effect on immigrants seeking healthcare. He also said that children born in the U.S. to parents without legal status would still receive Medicaid.
This is making sure that American citizens and our taxpayers are taken care of and not illegal immigrants, he said in the May 2025 floor debate.
State health officials said Medicaid applicants cant be reported to ICE under the law without a formal investigation request by the appropriate authorities. Otherwise, reporting applicants without their consent would violate federal Medicaid and privacy laws.
But immigrant rights advocates say the law has had a chilling effect on applications and has led to immigrant families losing healthcare and resources they qualify for.
They said cutting off that access compounds the fear created by immigration enforcement crackdowns in states including and Minnesota, and by federal policy changes such as between ICE and the Centers for Medicare & Medicaid Services and for Medicaid.
Advocates said its unclear whether the new law has led to any detainments or deportations of people applying for Medicaid or other public benefit programs. But Aaron Moseley-Sald穩var, a legal and public policy adviser with the Louisiana Organization for Refugees and Immigrants, said the legislative and policy changes act as a deterrent to immigrant families, even if they qualify for Medicaid as a legal resident, refugee, or asylum seeker, or have another form of legal status.
People are not applying for things that they probably otherwise would be eligible for, because they are intimidated by these laws and theyre worried that theyre going to get caught up in the system, Moseley-Sald穩var said. You have a large amount of people in Louisiana that are not leaving their homes at all, because theyre afraid of policies like this.
Moseley-Sald穩var said he believes the Louisiana law and similar policies are primarily aimed at removing people from state services. The state legislature passed a on May 27 to build on the 2025 law. It seeks to further narrow which noncitizens are qualified for public benefits in Louisiana, even though such restrictions for Medicaid are typically governed at the federal level.
The Louisiana Department of Healths on the new law does not contain any data on applicants reported to ICE since the law took effect last August. But by February of this year, the state had terminated the coverage of 87% of enrollees who had unverified immigration or citizenship status as of June 2025.
From July 1, 2024, to June 30, 2025, according to the report, 1% of the 1.6 million people in Louisiana enrolled in Medicaid werent citizens, and fewer than 4,000 had an unclear immigration status.
A Double-Edged Sword
Late last year, more than 600 people lined up at 4 a.m. outside a Louisiana Organization for Refugees and Immigrants health fair, hoping to receive a free health checkup, said Sharon Njie, the nonprofits communications and strategic partners director. The fair was scheduled to begin at 9 a.m.
We had to start calling the doctors to see if they could come there at 7 a.m., because these people have been waiting for two hours in the cold, Njie said. We were so overwhelmed.
Romero said some families in the New Orleans area have been waiting six months to vaccinate their children at one of the free events put on by healthcare providers. But she said fewer free health events for children have been scheduled, and even fewer for adults. For many of the residents she works with, Romero said, preventive care such as a Pap smear or prostate screening is out of reach.
The challenge right now is a double-edged sword of people not going to the doctor out of fear but also ending up in an emergency that is too hard to treat, Romero said. Its a life-or-death situation.
For families with no other option, Njie and Romero try to connect people to doctors sympathetic to the immigrants plight and willing to absorb the cost of care or offer a discount, such as medical providers who are immigrants themselves.
But that does not address the systemic problems of immigrant access to healthcare created by the state law and federal immigration policies, or the lower quality of care for those who seek it. For example, one local New Orleans clinic, Lukes House, caters to Spanish-speakers and immigrants, though its staffed largely by medical students, Romero said, so the level of care isnt the same.
While she waits for word on three of her kids Medicaid applications, Yolibeth secured a free insurance plan for them on the Louisiana Affordable Care Act marketplace, she said. But she hasnt found any doctors who will accept the coverage, she said, leaving them effectively uninsured.
When her 13-year-old son recently fell ill, she wanted to take him to a pediatrician. But she said she couldnt afford the $200 the appointment would have cost, plus any tests and medication.
Without a doctors note to provide proof of his illness, she said, she had to send her sick son to school, potentially exposing other children to a virus. Earlier in the school year, she was called into the schools office after he missed five days because of illness. In Louisiana, truancy can be punishable with parental fines, community service, or jail.
Romero said if enough school is missed because of sickness, a criminal case could lead to family separation.
That is unthinkable, she said. All because a family could not afford to take a child to see the doctor as opposed to these things being guaranteed to begin with.
The Trump administrations rollout of a federal mandate that millions of Americans on Medicaid must work or risk losing health benefits will force states to scrap months of preparation, according to advocates for Medicaid enrollees and consultants advising states.
And they say an overhaul less than seven months before states must start enforcing the requirement will be costly.
by the Centers for Medicare & Medicaid Services dictate many granular details about how the new work requirements will play out. They cover how states should check whether Medicaid enrollees are following the rules, and how people can claim an exemption so that their health benefits dont hinge on work, community service, or going to school.
Next year, President Donald Trumps One Big Beautiful Bill Act could require roughly across 42 states and the District of Columbia who receive Medicaid benefits to prove theyre working or participating in a similar activity to keep their health coverage unless they qualify for an exemption.
Much of the verification will run through state computer systems that assess whether low-income people qualify for Medicaid and other safety net programs technology often built and run by private companies under contracts routinely worth hundreds of millions of dollars. Many of those systems have a history of errors that can cut off benefits to eligible people.
For months, states have been communicating with federal regulators and rushing to build systems to comply with the looming mandates, said Kinda Serafi, a partner at the Manatt Health consulting and legal firm. The rules released this week represent a significant policy pivot from what states were expecting, Serafi said.
The administration has actually taken what we know to be a tough situation and has just made it even worse, Serafi said. States had already committed to paying contractors tens of millions to adjust their systems.
After Trump signed his signature tax-and-spending bill into law last July, one of the most significant remaining questions was how much discretion the federal government would give states to define exemptions for people too sick to work. The medical frailty exemption allows a person to claim they have a health condition that prevents them from working at least 80 hours a month, as the law requires.
To qualify, a person generally must fit into at least one of five categories: They must be blind or disabled; have a substance use disorder; have a disabling mental disorder; have a physical, intellectual, or developmental disability that significantly impairs their daily life; or have a serious medical condition. States are not allowed to add categories.
Under the new regulations, CMS said having a medical condition alone isnt sufficient to exempt someone from the work requirements. States must assess the severity of an individuals condition to determine whether they can stay on Medicaid without working a standard that makes it more difficult for enrollees to meet the criteria.
CMS officials did not list specific conditions that qualify for exemptions, but the agency did say homelessness cant be a reason to claim that exemption because it is not a medical condition.
To implement the law, states will have to undo work that they did, said , deputy director of Princeton Universitys State Health and Value Strategies program, which works with state governments on various health coverage issues.
The Trump administration previously acknowledged that the work to upgrade state Medicaid eligibility systems to comply with the law is coming at a cost. In January, top CMS officials said government contractors, including Deloitte, Accenture, and Optum, and reduced rates through 2028 to help states adjust their systems.
The discounts may be helpful in some states, but theyre not going to be helpful across the board due to variations in state contracts, said , director of the State Health and Value Strategies program.
Anytime you have to go back and say, Oops, we need to reprogram this one thing, theres a cost, Howard said.
States were prepared to create lists of conditions and diseases to qualify people for work requirement exemptions, according to health care experts advising them. Mining data to verify someones illness was already a tall order for states because the computer systems that determine whether someone is eligible for Medicaid often do not communicate with the systems that track medical claims.
Americas health care payment systems rely on a set of standardized codes that correspond to specific diagnoses.
But theres no code that designates that someone is too sick to work thats a subjective assessment, said Rachel Klein, deputy executive director of , a nonpartisan advocacy group for people with HIV. This is a recipe for disaster.
The new federal standards pose immediate issues for Nebraska, which launched its Medicaid work requirement on May 1, eight months before the federally mandated deadline. Nebraska handles decisions on medical frailty differently than the Trump administration does.
Nebraska officials had already released a nearly of medical conditions that qualify as exemptions, such as types of cancer, dementia, autism, epilepsy, HIV, and Parkinsons disease. The state, which relies on government workers to check Medicaid eligibility, doesnt require a person to prove how sick they are.
But under Trumps rules, people will have to show their qualifying illness is impeding their ability to work.
Now, Nebraska is going to have to go back and figure out how to assess whether all of these people are too sick to meet the requirement, Klein said.
Medicaid enrollees are slated to start losing coverage this summer under Nebraskas early rollout.
Sarah Maresh, a program director with , an advocacy organization for people with low incomes, said the state should refrain from terminating peoples coverage until next year because of the changes it will need to make. State residents are already confused and scared, she said, and the new rule makes matters much worse.
In response to several questions, Jeff Powell, a spokesperson for Nebraskas Department of Health and Human Services, said the state is reviewing the new federal regulation to determine potential impacts.
The new federal standards will limit peoples ability to attest that they are medically frail starting in 2028 and will require documentation as proof, another change states werent expecting, Meuse said. had planned to allow applicants and enrollees to declare conditions themselves to get exemptions, according to KFF.
Striking the right balance of flexibility was an important part of deliberations when crafting these rules, CMS Administrator Mehmet Oz said on a June 1 call with reporters. The mantra we kept coming back to was that were forgiving, but were not foolish, he said.
Trump officials wrote in the regulation that Medicaid work requirements have the potential to empower Medicaid beneficiaries by allowing them to escape isolation and dependency, build confidence, achieve self-sufficiency and prosperity, and improve health.
Stephanie Burdick, a leader of the Protect Medicaid Utah coalition, disputed the premise.
If they want to improve work opportunities or connection and decrease isolation and loneliness, they would be starting job programs and volunteer service programs, Burdick said. They wouldnt just be forcing more administrative burden onto people and then saying that its good for them.
An estimated will become uninsured by 2034 due to Medicaid work requirements, according to the nonpartisan Congressional Budget Office.
But with the new regulations, Howard said, theres a risk of that number being even higher.
About a year ago at Erlanger Baroness, the largest hospital in Chattanooga, anesthesia staff noticed that a nurse was slurring his words and struggling to stay awake while on duty in the surgery center, according to a .
In the days that followed, the nurse failed a drug test and was fired, the order states. The nurse later admitted that for months he had pilfered and abused fentanyl left over after surgeries, sometimes daily, according to the order.
Under most circumstances, this would be a routine case of what is known as drug diversion, the unlawful taking of controlled substances from healthcare facilities believed to be so widespread that it occurs at just about every U.S. hospital.
But the Erlanger case stands out because a high-tech watchdog was supposed to be on guard.
The hospital uses the newest line of defense against drug diversion: Sentri7, powered by artificial intelligence and designed to detect missing drugs faster than any human can. But for months at Erlanger, Sentri7 failed to raise alarms, overlooking missing drugs and other inconsistencies that should have been flagged, the nursing boards order states.
The Erlanger case, which has not been previously reported, offers a rare glimpse at an apparent failure of AI drug diversion software used in hundreds of U.S. hospitals with little transparency or oversight. Healthcare facilities are not required to disclose their implementation of this kind of software or report malfunctions to anyone, so there is no full account of how widely these programs are used or how often they fail.
Erlanger Baroness, also referred to as Erlanger Medical Center, declined to comment on its use of Sentri7 or on the diverted drugs. Andr矇 Rebelo, a spokesperson for the health division at Wolters Kluwer, the Dutch technology company behind Sentri7, declined to answer questions about what happened at Erlanger but said the company remained confident in our software.
Little Transparency
David Rastall, a Johns Hopkins Medicine neurologist and AI researcher, said that because AI technology is heavily proprietary and hospital officials often dont understand how it works, this lack of transparency allows for errors to be buried rather than fixed. That means errors could be repeated at other hospitals, he said.
The ideal for patients, caregivers, and hospital systems would be, Rastall said, when an AI is found to be making some type of error, that becomes very transparent and public.
The Drug Enforcement Administration mandates that hospitals confidentially report lost or stolen drugs. Hospitals can also report stolen drugs to state health agencies, which license medical professionals and investigate wrongdoing.
But these reports are not required to include details about any AI software involved, according to interviews with three drug diversion prevention experts. In interviews, all said they had never seen an AI failure publicly documented like the apparent one at Erlanger.
Ive never myself seen these technologies be called out in that specific way, Jacob Smith, a pharmacist in charge of drug security at Johns Hopkins Medicine, said of the apparent Sentri7 failure. It doesnt make sense to me how you could miss it.
Smith and other experts said the Erlanger case also raises questions because the theft of leftover drugs is one of the most well-known methods of diversion. And fentanyl, a painkiller that can be 50 times as strong as heroin, is one of the most common targets.
Terri Vidals, the founder of , questioned whether the Erlanger case was the result of user error instead of malfunction.
This is the most basics of basics for this software, Vidals said. I find it interesting that theyre saying it wasnt flagged by the software. I think theres maybe more to that story.
The apparent Sentri7 failure at Erlanger was revealed by the Tennessee Department of Health in a routine release of in December. Among those records was the Board of Nursing order, which summarizes a state investigation into nurse anesthetist John Stevenson, who settled the case against him by signing the document in November.
Stevenson declined to comment through his attorney. He has not been charged with any crime related to the Erlanger case. The nursing board put his license on probation while he went to drug counseling.
Bill Christian, a spokesperson for the Department of Health and Board of Nursing, declined to comment on the Erlanger case or Sentri7. In response to public records requests, the Department of Health and the Tennessee Health Facilities Commission each said it possessed no other documents about the apparent Sentri7 failure at Erlanger.
Erlanger spokesperson Charlie Milburn said earlier this year that the hospital had prepared a written statement about its use of Sentri7 in response to questions from 窪蹋勛圖厙 News.
That statement was never released.
Our legal team is debating whether this is something we want to talk about at all, Milburn said in a March email, before later declining to answer any questions.
Kristy Drollinger, a Wolters Kluwer executive who spoke generally about Sentri7 to 窪蹋勛圖厙 News in March, said the software is in high demand because so many hospitals have struggled to secure their drugs.
Sentri7 monitors about 60 attributions of risk that identify red flags for further investigation by hospital employees, Drollinger said.
Its pretty scary, Drollinger said of widespread drug theft. Every health system, every health facility, has had diversion at some point and probably has it now.
The Way of the Future
Drug diversion is a widespread challenge in U.S. medical facilities. It can lead to patients not receiving medication or getting drugs that are contaminated with blood-borne diseases. Its estimated as many as 15% of all healthcare workers divert drugs at least once, according to the nonprofit .
Diversion has been linked to at least causing more than 200 infections, mostly of hepatitis C since 1985, according to the Centers for Disease Control and Prevention.
To prevent this, hospitals attempt to track each pill or vial from the moment it is dispensed to the moment it is given to a patient, by comparing data from electronic medication cabinets and patients health records.
Hospital staff once performed this painstaking process manually, but in the past decade the task has become largely automated by anti-diversion software. After years of mergers and buyouts, two programs now dominate the industry: Wolters Kluwers Sentri7 and Bluesights ControlCheck. Both incorporate AI.
Its definitely the way of the future, said Luke Overmire, owner of .
More than 1,500 hospitals use ControlCheck, according to Bluesight. An additional 700 use Sentri7 Clinical Surveillance programs, which can include its drug diversion software, according to Wolters Kluwer.
Neither company publishes the price of its software. Smith, the drug safety official from Johns Hopkins, said hospitals purchase these expensive technologies because a disastrous diversion case could result in a multimillion-dollar fine from the DEA.
They dont promise a return on investment, Smith said. They promise cost avoidance.
In 2022, a funded by the National Institutes of Health found that Sentri7, then known as Flowlytics, could uncover drug diversion faster than existing methods. The studys primary author worked for Invistics, the company that previously owned Sentri7.
According to that study, researchers tested the software by having it comb through medication data spanning two years and 10 hospitals in search of 22 nurses who were already known to have diverted drugs.
The program not only found them all, the study states, but found them faster than humans by as little as a week and as much as a year and a half.
At Erlanger, the humans spotted the signs of trouble first.
According to the Board of Nursing order, co-workers reported that Stevenson appeared impaired while on duty in the surgery center on or around June 30, 2025.
Stevenson had slurred speech, appeared extremely tired, was seen standing with his eyes closed and swaying, exhibited head nodding while standing upright and appeared to have difficulty keeping his eyes open, according to the order.
When questioned by state investigators, Stevenson admitted that he began diverting unused fentanyl that would otherwise have been wasted after surgical procedures in March 2025, according to the order. Stevenson said he used the fentanyl waste once or twice a week at first, then increasing to daily use by June of that year, the order states.
Erlanger audited Stevensons dispensing record over those four months. It found approximately five instances when Sentri7 didnt flag missing drugs, according to the order.
It adds that the hospital found additional inconsistencies between drug dispensing and waste documentation that should have been flagged by the automated monitoring system.
One possible explanation is provided by the Board of Nursing, which said in the order that Sentri7 was in its initial learning phase at Erlanger, though the board provided no details.
In an interview, without discussing Erlanger specifically, Drollinger said Sentri7 has no learning phase, because it is trained on nine to 12 months of historical data when implemented at a new hospital.
Smith, of Johns Hopkins, had another theory.
In an interview, Smith said his experience with AI drug diversion software had led him to believe that it is effective at monitoring emergency rooms and intensive care units but less so in operating rooms, where drugs are dispensed and charted differently.
These areas can be harder for AI to track, Smith said, and therefore require humans to keep a closer watch.
Weve got people whose entire job is to work with this software, Smith said. The software is a piece of it, but if you rely on the software to give you all your signals, youll miss stuff. Its just not 100%.
PORT HURON, Mich. State health officials urged parents in several counties to vaccinate babies against measles ahead of schedule this spring as cases multiplied in Michigan. The outbreaks of the highly contagious virus which can lead to brain swelling, deafness, and death came as parents are opting school-age kids out of vaccinations at a record-high rate.
Its a situation state officials have spent more than a decade trying to avoid. For years, theyve been trying to make it harder for parents to send their kids to school unvaccinated.
But those efforts have backfired in places like St. Clair County, in Michigans conservative Thumb region. Remington Nevin, the countys medical director, has declared a new era of vaccine choice. Local parents there can now bypass the usual protocols and get school vaccine waivers via email, days after they fill out a brief digital form.
State health officials arent fighting it.
In fact, Michigans health agency has been helping more than 30 counties move away from a state policy once credited with sharply reducing the number of parents who opted their kids out of shots.
In 2015, the state started requiring parents seeking waivers to first attend a vaccine education session, in person, at their local health department.
But in the post-covid era, local health officials say, the sessions became hostile, ineffective, and sometimes even unsafe for staff. One high school called police last fall over an escalating dispute with parents who refused to obtain a state-recognized waiver for their children, with a sheriffs deputy warning the parents that they could face criminal charges.
In response, the state has helped create a hybrid waiver process for dozens of counties, allowing parents to take a brief vaccine education course online while still requiring they get their waivers signed in person. Its part of a broader shift in strategy in a state that had some of the most polarizing and covid restrictions.
At Michigan schools where only 30% to 40% of students are now vaccinated, it is simply not possible to keep diseases like measles at bay, said , the states chief medical officer. And when one of these measles cases ends up in a low-immunization community, that’s when the ember really has a chance to expand and become a wildfire.
A Short-Lived Success Story
In 2014, Michigan had the in the country.
Health officials suspected some parents were just signing waivers during the stress of school registration, not because of a deeply held conviction.
Oops, I forgot to do this. Im just going to sign a waiver and be done with it, said Norm Hess, executive director of the . Thats not really the way we want parents to make decisions on this issue.
Around that time, national headlines were focused on a Disneyland-linked measles outbreak in which were infected. California cracked down, becoming the first state in decades to end .
With Republicans then in control of the Michigan Legislature and governors office, health officials found a side door. They created an saying nonmedical waivers required certification by the local health department that the individual received education on the risks of not receiving the vaccines being waived and the benefits of vaccination to the individual and the community.
We were not aware of the rule until the day it happened, Suzanne Waltman, president of Michigan for Vaccine Choice, . We thought it was a stealth move.
At first, it seemed to work. Kindergarten waiver rates in 2015. Kids were protected more from these vaccine-preventable diseases, Hess said.
But after that year, waiver rates started rebounding. When the pandemic hit five years later, immunization rates plunged.
An Unsafe Setting for Medical Staff
Juan Marquez is the medical director of a county where a measles outbreak sickened several people this spring, but even he wouldnt want to do those in-person sessions again.
It was really creating an unsafe setting, actually, for our nurses, said Marquez, the medical director for two counties, Livingston and Washtenaw, just west of Detroit.
Our nurses are just trying to do their job, Marquez said. And you can imagine, to have somebody yell at you or just say not nice things to your face and sit through that for hours is demoralizing.
Washtenaw has had seven measles cases since March and is believed to be the source of an eighth case in a neighboring county. As of May 28, the state had a total of 14 cases this year.
Since the start of the pandemic, waiver requests in Michigan have been increasing.
Tensions over public health became especially high during the states covid lockdowns, which critics lambasted as too long and too strict. Republicans , and Donald Trump flipped the state in the 2024 presidential contest.
Some parents felt it was demeaning to have to go in for counseling sessions they perceived as judgmental.
Republican , who represents a district along the states southern border, recalled her session, speaking at a in Lansing last year. I had a very negative experience there, simply because we made decisions as parents and did the research and made the choices that we felt were best for each one of our children.
That resentment has also made it harder to do basic public health work, like contact tracing for measles cases, Marquez said.
Of the 10,000 vaccine waivers Marquezs counties have given out in the past 10 years, he said, the education sessions changed the minds of maybe one or two people.
If were not changing folks minds, can we do this in a safe way? Marquez said. So that was really the idea behind the hybrid model.
The Workaround
At first, state immunizations director Ryan Malosh thought dropping the in-person requirement was a bad idea.
He was skeptical when Livingston County health officials said they wanted to replace in-person sessions with a 20-minute online course about the benefits of vaccines and the risks of vaccine-preventable diseases.
State health department staffers were worried that if the waiver process became more convenient, more people would get exemptions, which could lead to more outbreaks. And because parents could get a waiver from any local health department, people from across the state might start flooding Livingston County with requests.
We were worried that this could be sort of a sinkhole, Malosh said.
It wasnt. Parents took the online course, then made an appointment at the health department to get their nonmedical waivers signed. Waiver rates increased in Livingston County, but at the same rate they were rising in the rest of the state.
So the state turned to the University of Michigan to create a standardized, online course that any county could use. Parents would go through a 20- to 30-minute course, answering questions about the content, and then be able to get their waivers signed at their local health department office.
Michael Rubyan, a public health associate professor at the university, worked with some 40 public health nurses from throughout the state to design it. They wanted it to be simple and fact-based: Heres what you should know about these diseases. Heres how vaccines work. And if there is an outbreak at your school, your kids may have to stay home if theyre not vaccinated.
No judgment. No pressure.
This needed to be a building block in a much longer relationship with local public health, the nurses said. And while this change alone probably wont lead to a dramatic decrease in waivers, Malosh said, it may start to rebuild some trust. That then opens the door for further conversations, which maybe then gets these folks vaccinated, he said.
Hybrid May Not Be Enough
About a third of the states counties have adopted the hybrid approach, but the waiver system is still creating confusion and conflict.
Last fall, a dispute over the waiver process involving a St. Clair County family blew up into a local controversy, and school officials asked local law enforcement to get involved.
Although the family lived in St. Clair, the children attended high school in neighboring Macomb County. Macomb had already switched to the hybrid model, but the parents didnt want to file the documents, because they didnt want their childrens vaccination status to be known by local health officials at all.
The father, Andrew Eberly, said at a that getting a certified waiver forces parents like me to register personal health decisions” with an agency they don’t trust. (Eberly did not respond to multiple attempts to contact him via email, via phone, and at his home.)
At one point during the ongoing conflict, school officials asked the sheriffs department to intervene. A deputys conversation with Eberly on Nov. 5 was captured in body-camera footage obtained by 窪蹋勛圖厙 News through a public records request.
The deputy described the counseling requirement as a set of stupid hoops.
I know its super inconvenient to go into the health department, go through their stupid 10-minute class for them to tell you something you already know, to sign the waiver, the deputy said.
But the deputy went on to warn Eberly that if they continued taking their kids to school, despite being repeatedly informed they couldnt be enrolled without a state-recognized waiver, then they could be charged with contributing to the truancy of minors.
The clash became a local cause c矇l癡bre. Nevin, the St. Clair medical director, seized on it and the states falling immunization rates at a public health board meeting as proof that people who mistrust the states public health establishment have sound reasons for doing so.
So far, state health officials have declined to engage in verbal or legal conflict with Nevin, who has drawn cheers and jeers at public meetings over his vaccine stance. He has also been the subject of at the county health department.
Instead, state officials are stressing the importance of parents understanding the risks that vaccine-preventable diseases, like measles, pose for their kids.
Local health departments get to decide for themselves in a lot of ways whats best for their residents, Malosh said. And I think that whats best is to be as upfront as possible, to be as truthful as possible, and to try to give the best information that we have available to us to parents so that they can actually make an informed decision.
An Albanian mans pain grew so unbearable, he said, he pulled out his own tooth as he languished for months in a New Mexico immigration detention center. A Honduran mother of two said she was hospitalized for a heart problem after she was denied blood pressure medications while held in Florida. A said his leg grew purple and swollen from flesh-eating bacteria when staffers at a Vermont facility did not bring him to a scheduled doctor appointment.
Hundreds of detainees across at least 33 states allege in federal suits that immigration detention facilities are failing to provide adequate medical care, an investigation by 窪蹋勛圖厙 News and The Associated Press found. Detainees say they didnt get medications on time or at all for conditions including high blood pressure, diabetes, depression, epilepsy, Parkinsons, and HIV. Requests for help went unanswered for weeks. Blood sugars rose. Infections festered. Cancers remained untreated. Detainees collapsed and had seizures.
U.S. jails and immigration detention centers have to meet the medical needs of the people in their charge. But the system is sagging under an influx of detentions since President Donald Trump returned to office: More than 75,000 immigrants were being detained by U.S. Immigration and Customs Enforcement , up from around 40,000 a year earlier.
窪蹋勛圖厙 News and AP analyzed thousands of court cases filed since Trumps second inauguration that use a legal route known as habeas corpus to argue people are being held illegally by ICE. The records offer a rare window into how those detained say, often under penalty of perjury, ICE is handling their medical needs. Reporters also interviewed more than 50 detainees, family members, and lawyers.
The investigation revealed that medical neglect is alleged across the sprawling detention system, including in offices not designed to house people, county jails, and quickly staged sites with nicknames such as Alligator Alcatraz.
ICE custody is deadlier than it has been in two decades, researchers wrote in April. The Department of Homeland Security reported 51 people had died in detention since the start of Trumps second administration with suicides .
窪蹋勛圖厙 News and AP asked DHS to respond to the findings six days before publication, but it did not provide comment. The department’s acting chief medical officer, Sean Conley, has it is both policy and longstanding practice for aliens to receive timely and appropriate medical care from the moment they enter ICE custody and that the agency recruits healthcare professionals to maintain high standards. This is better, more responsive healthcare than many aliens have ever received in their entire lives, he has said.
Individual facilities and private prison companies contracting with DHS that responded to requests for comment said they follow ICE standards and detainees receive medical care when it is required. Some said they were unfamiliar with the allegations outlined in court documents; others blamed some detainees for lapses in their medical care.
I have never seen such disregard or medical neglect like this anywhere, Vardan Gukasian, a political dissident and former paramedic who spent years behind bars in Armenia, wrote in in March to contest his detention in Henderson, Nevada, as it stretched to 13 months despite health problems.
Madeleine Skains, a spokesperson for the city of Henderson, said medical care is always available at the facility and that the court had not ordered changes to his care.
Last June, as Gukasian experienced the symptoms of uncontrolled high blood pressure dizziness, a nosebleed, and a headache his cellmate banged on their door for help.
When it did not arrive, the rest of the block banged on their doors, he wrote. Gukasian was hospitalized that day.
Brazen Indifference to Really Obvious Problems
The administrations mass deportation effort has swept up during routine immigration check-ins, at traffic stops, at their homes, and in hospitals.
About have no criminal conviction. Their immigration proceedings are civil, not criminal.
I couldnt understand why they treated me so harshly, said a father of six in Georgia. He said he was injured while shackled in custody when the vehicle transporting him to an Atlanta facility jolted, throwing him out of his seat and into a metal armrest. His wound became infected with E. coli, he said, because he had to sleep on a dirty concrete floor amid leaking toilets.
Like other detainees interviewed, he spoke on the condition of anonymity; they said they fear for their safety, for the safety of their families, or that speaking out would jeopardize their immigration cases. The AP and 窪蹋勛圖厙 News are not naming anyone identified in court documents without their consent.
Staffers at Stewart Detention Center in rural Lumpkin, Georgia, didnt adequately respond to that mans request for medical help, , until he passed out and was taken to a hospital about an hour away. There, he said, a doctor told him hed narrowly escaped amputation of his left leg. Medical staff found no records of a case matching this description, according to Brian Todd, a spokesperson for CoreCivic, which runs the facility.
The 48-year-old, who moved to the U.S. from Guatemala more than two decades ago, was released in October and is now a legal permanent resident. But he is unsure if hell be able to return to his job in construction because, he said, he can no longer lift heavy things due to his injury.
Some detainees or their lawyers said even basic care was denied: gauze to protect an open foot wound, prenatal care for a high-risk pregnancy, a pillow to ease the pain of sleeping with advanced stomach cancer, sanitary pads for postpartum bleeding.
I would like to believe the government has the best interest of those it holds in detention for whatever period of time, Judge Benita Pearson, a federal judge in Ohio, said during a hearing in October concerning a 70-year-old who alleged the government lost her glasses during her arrest. If one is unable to see due to the loss of glasses when detained, that should be fixed.
, who worked for ICE and now serves as a special adviser to the American Bar Association, said case law requires the government to treat people in immigration detention with the same care it affords those in traditional jails awaiting trial. But administrators are granted discretion and medical care standards vary.
Detainees are frequently moved across the country, often without warning, interrupting treatment. A woman from El Salvador said she missed a week of HIV medication when she was transferred from Colorado to a county jail in Wyoming.
A Russian man wrote that, while detained in Texas, he saw a gastroenterologist about his painful gallstones and scheduled an appointment with a surgeon. Unfortunately, I never got to see him, due to my being moved around various detention centers.
Advocates say that even obvious disabilities, like legal blindness, are ignored.
A detainee who lost one eye and had severe glaucoma in the other required twice-daily drops to maintain what vision remained. But, he said, some days the drops never came.
Now I can only see a little bit straight in front. It now often looks like Im seeing through gauze, the man wrote in a court declaration. This makes me very afraid that one of these times I am going to open my eyes and not be able to see anything at all.
He wrote that he was scared he wouldnt be able to see his infant son grow up.
Its just sort of brazen indifference to really obvious problems, things you would have thought absurd a decade ago like the fact that you cant see, the mans attorney, Brian Hoffman, said. Before, you could attempt to work with folks on the government side and maybe shame them into doing the right thing. Now, its sort of like anything you want done you have to go to court and sue over.
Even court orders arent always enough. One California judge ordered the government to take a man showing signs of prostate cancer to a specialist for diagnosis and treatment. Records show they did not take him.
Lawyers representing ICE told the judge that officials missed the appointment because of an internal scheduling error. CoreCivic, which runs that facility, said it was unable to comment on active litigation.
A Surge in Cases
When immigrants file habeas corpus petitions, they exercise a right to challenge unlawful imprisonment that dates to .
More than 40,000 such petitions have been filed during Trumps second term, fueled by decisions last year to deny bond to many people held on immigration charges. Judges are split on whether that’s legal; the question appears headed to the Supreme Court.
Many habeas claims , but judges typically cite reasons unrelated to the medical neglect described in the petitions, such as detainees being held too long before being deported.
The more than 300 medical neglect claims found in this investigation represent a fraction of the problem. The details of habeas corpus cases are often hidden due to a federal rule barring the public from viewing such documents online. 窪蹋勛圖厙 News and AP obtained some documents from courthouses and received records on 4,400 cases from , a project of the nonprofit Immigration Justice Transparency Initiative. But tens of thousands more remain largely inaccessible.
Some judges have written that the habeas process is not how to raise allegations of medical neglect and have declined to release detainees over those claims. Not every detainee who believes they experienced medical neglect files a habeas petition or cites their medical issues if they do.
Jose-Antonio Segismundos petition made no mention of being unable to see an oncologist for the cancer in his abdomen while detained for more than seven months at the Florida detention facility known as Alligator Alcatraz and Folkston D Ray ICE Processing Center in Georgia. Medical records in his court filings show he was arrested about five weeks before his scheduled appointment with a cancer specialist.
His wife, Maria Jose Gonzalez, said he didnt receive any treatment even though she sent his medical records and explained his condition to officials at Folkston. When his stomach pain erupted, often suddenly and intensely, she said, they gave him Tylenol.
Geo Group, which runs Folkston, follows ICE standards and provides healthcare and access to off-site medical specialists when needed, spokesperson Christopher Ferreira said.
This spring, Segismundo, 48, was deported to Mexico, a country he left nearly 30 years ago, Gonzalez said. Now, she said, he will have to restart his search for care in the Oaxacan village where he grew up.
Watching Loved Ones Deteriorate
Detainees receiving inadequate healthcare have little recourse. The Department of Homeland Security last year gutted the Office of the Immigration Detention Ombudsman. In early May, it shut the office entirely, arguing that Congress didnt fund it.
Previously, ombudsman staffers could help facilitate medical care or look into complaints of neglect, according to Matt Boles, an immigration attorney in Georgia. Now, he said, theres no one to call.
Meanwhile, detainees families said they feel helpless, making desperate calls to facilities, the government, and their legislators while watching their loved ones deteriorate.
Riya Khan saw her mother get sicker at the California City Detention Facility, which is owned by CoreCivic. When she visited a week after her mother arrived at the facility in the Mojave Desert, Riya said, the 64-year-old woman stumbled into her seat. She was shaking and her breathing was labored.
Masuma Khan came to the U.S. from Bangladesh in 1997. She has no criminal history, her records say, and was detained in October when she showed up for her regular ICE check-in.
For the month she was detained, according to her daughter, she only intermittently received her medications for conditions including high blood pressure, hypothyroidism, and prediabetes. CoreCivic treats chronic conditions in line with applicable medical standards, Todd said.
“Nothing matters more to CoreCivic than the health, safety and well-being of the people in our care,” Todd said.
Khan said she got her asthma medication for the first time two days before she was released and that her eye drops for glaucoma never arrived. Staffers told Khan she needed to buy some of her medications from the commissary but it didn’t stock them, her daughter said.
Before ICE detained Masuma Khan, she made friends with everyone, her daughter said. She had worked for years at Lucky Boy, an iconic Pasadena fast-food restaurant, and in her free time fed birds and left out fruit for bees that visited her apartments balcony.
Now shes too scared to go outside. She still must regularly check in with ICE, and shes terrified each time.
A Stroke on a Video Call
Previously, detainees with serious medical needs would likely have been released on humanitarian parole, in part to avoid the cost of their care, Vermont attorney Andrew Pelcher said.
In fiscal year 2023 before the detained population soared ICE spent more than $390 million on healthcare for detained noncitizens, according to its to Congress. In May, Todd Lyons, then acting director of ICE, said at a conference that the agency had already spent almost half a billion dollars on detainee healthcare this year.
Now, under mandatory detention, people are staying locked up with serious and expensive conditions.
A Romanian citizen underwent several heart surgeries, including an emergency triple bypass in April 2025, before he was arrested in July. As part of his recovery, the 52-year-old was required to take 16 daily medications. While at an ICE field office in Baltimore, his court filings allege, he went two days without any medication before officials moved him to a facility in New Jersey.
He was hospitalized three times while detained, complaining of chest pains in part, medical records and court documents say, because despite countless requests, the detention center did not provide all his medications. Hospital discharge papers cited by his lawyer show he received only eight of the 16 medications after his second release from the hospital.
Can you please talk to the ICE facility to make sure they give him his medications? his treatment providers wrote in medical records included in his court filings. He was admitted last week for chest pain and today he was readmitted again for chest pain secondary to non compliance for medications.
Several weeks later in August, he had a stroke while on a video call with his daughter, according to court filings. He was struggling to breathe, and was pointing at his chest where he was again experiencing pain, and suddenly stopped speaking. His daughter screamed for help through the video monitor, according to his petition. Eventually an officer came in to assist him and cut the feed.
The man lost his ability to speak for four days, the document says. He was returned to detention, where he remained until a federal judge ordered his release in November.
Impossible Choices
Cassandra Amador waits for the phone to ring every morning, desperate to ask her husband the question thats woken her up every night for months: Did you get your medicine?
Her husband, Pedro Javier Amador Gutierrez, 36, has high blood pressure and depends on the state-run facility in Florida nicknamed Deportation Depot to administer the prescriptions that have kept him alive for years. Many mornings, he tells his wife he did not get them.
When she talks to him, she said, he sounds weaker and more scared every day, not like the upbeat man who would take her kids out for ice cream.
You can hear in his voice how he feels, she said.
Now, she said, hes considering returning to Cuba, which he fled because of political persecution, out of fear that he will die in detention without his medicines. Amador and her children would go with him, she said, even though she was born in New Jersey, has never been to Cuba, and doesnt speak much Spanish.
But hes already collapsed twice at the Baker Correctional Institution in Sanderson, Florida, his wife said. Shes terrified that the next time, he wont get up.
Methodology
窪蹋勛圖厙 News and The Associated Press sifted through thousands of immigration habeas corpus claims to find allegations of medical neglect from people detained by U.S. Immigration and Customs Enforcement during the second Trump administration.
Without a comprehensive, publicly available dataset of medical complaints by those in ICE custody, we used immigration habeas corpus claims to identify detainees healthcare-related allegations raised in federal court. Although the intended purpose of habeas corpus is to challenge the legality of a petitioners detention rather than conditions of their confinement these filings sometimes include detainees claims of inadequate healthcare.
But habeas corpus filings are not always publicly available. Federal rules restrict how members of the public can access habeas petitions filed by people in immigration detention. For most of these cases, court websites publish only court orders and dockets describing other filings. The initial petitions are available only through in-person visits to federal courthouses across the country. Habeas Dockets, a project of the nonprofit Immigration Justice Transparency Initiative, coordinates a nationwide network of volunteers to gather these petitions and make them available online.
窪蹋勛圖厙 News and AP analyzed the dockets of roughly 33,000 cases filed by detainees from Jan. 20, 2025, through March 2026. The vast majority of cases had only basic procedural information, like dates of court filings and rulings. Only about 4,400 included the original petitions.
We also gathered a few dozen case files from courthouses, lawyers, and the Massachusetts federal district court website, which posts most petitions under a unique standing order.
We ran keyword and semantic searches of court records, including petitions, motions, and orders, for terms and phrases potentially related to medical neglect, such as surgery, medications, inadequate medical care, and treatment for chronic conditions such as diabetes and high blood pressure.
We found about 500 cases potentially alleging medical neglect. At least two reporters reviewed each case manually, yielding more than 300 cases containing specific allegations in sworn filings of delayed, denied, or deficient healthcare.
To be conservative, we excluded dozens of cases that alleged inadequate medical care but lacked specifics, for example a petitioner writing, I have been sick and dont get proper treatment, or a judge noting a petitioner complains that ICE is ignoring his medical problems. We also excluded cases in which petitioners claimed only that they were denied special diets, exercise, or other accommodations that they said were key to managing their health conditions, such as a petitioner writing, I suffer from Parkinsons and cannot properly exercise, or claiming that the food provided was unfit for a person with diabetes.
The cases we analyzed were neither randomly selected nor representative of immigration habeas filings nationwide. The claims were not independently verified. Many filings are not publicly available, and not all detainees raise medical concerns in court, so our account of cases represents a limited window into the landscape of claims, rather than a comprehensive picture.
Associated Press journalists Garance Burke, Valerie Gonzalez, and Tim Sullivan as well as 窪蹋勛圖厙 News correspondent Kate Wells contributed to this report.
This report is a collaboration between The Associated Press and 窪蹋勛圖厙 News.
Need to take time away from work for caregiving? HealthQs Cara Anthony and Blake Farmer spoke with Jocelyn Frye of the National Partnership for Women & Families to find out how the Family and Medical Leave Act protects your job if you qualify to use it.
Jill Woodrow reached a tipping point as a caregiver when her mom began struggling to communicate information about her latest doctor appointments.
Woodrows mother, a uterine cancer survivor, was seeing specialists to get to the bottom of several new, concerning symptoms. When she would try to tell us about what happened or what the conversation was, she couldn’t remember, Woodrow said.
So Woodrow, a school therapist, started taking her mom to medical appointments. Woodrow was able to ask doctors questions and explain their answers. But it was difficult to juggle her moms medical care while working, raising three daughters, and coordinating with her husbands work schedule.
I was having to leave work early, take sick time, personal time, she said. All of a sudden, my best friend said to me, Jill, have you ever thought about taking FMLA? And honestly, I never did.
FMLA refers to leave protected by the , a federal law that guarantees employees up to 12 weeks of unpaid leave per year for their own serious health condition or to care for a parent, spouse, or child with a serious medical condition.
During eight weeks away from work, Woodrow helped with her moms medical care, cooked meals, and helped with housework. Her mom was later diagnosed with breast cancer and died in 2023.
Taking FMLA really helped me focus on my family and my mom, and it was honestly the best thing that I could have ever done, she said. I have no regrets.
But navigating the intricacies logistical and emotional of this federal policy can be challenging. Heres what to know.
1. Read the fine print.
When FMLA was passed in 1993, it was groundbreaking, said Jocelyn Frye, president of the National Partnership for Women & Families. Before then, there were no federal protections for employees who needed to take time off for medical reasons.
Roughly 60% of workers in the U.S. , according to the Department of Labor. To be eligible, people must have worked for a company with 50 or more employees for at least a year. Within that time, employees must have worked at least 1,250 hours, which translates to working full-time for about seven months.
Keep in mind, FMLA applies only to caregiving if your child, spouse, or parent is facing a serious medical condition, like inpatient care or continuing treatment. If you need to take time from work to care for someone with a short-term illness or routine medical care, you will likely need to use sick leave or some other kind of paid time off. And FMLA generally does not apply to caring for in-laws, siblings, or close friends.
2. Getting paid on FMLA is possible but far from guaranteed.
The federal law requires employers only to provide unpaid leave, which limits how many people consider FMLA. According to the Department of Labor, two-thirds of eligible employees said they wouldnt take FMLA because they to go without pay.
However, some people can still get a paycheck while taking FMLA. now require employers to provide paid family leave programs. Alternatively, you can apply another form of paid time off, like paid vacation or sick leave, to the time you take away from work. This is called concurrent leave. Some employers require employees to apply any available leave they have during the time theyre taking FMLA, which in practice ensures that employees do not take more than the protected 12 weeks of leave within a year.
So why use FMLA instead of just taking PTO or stringing together sick days? Under the federal requirements, FMLA protects an employees job and healthcare, which is not the case for other kinds of leave.
3. Communicating clearly about leave with your employer is key.
In a 2018 survey conducted by the Department of Labor, one-third of FMLA-eligible employees shared that they avoided taking leave because they feared losing their job or being treated differently at work, or because they considered their work too important.
Woodrow had to navigate her own hesitation. I have a lot of students on my caseload, and I felt so guilty about leaving them, she said.
But FMLA advocate Frye said employees should remember that FMLA exists to help them take the time that they need to support their families and not feel like they have to pretend like that’s not a natural part of life. Because it is.
Frye suggests employees be proactive when approaching their manager about planning a leave. I’d say, I want to work with you to make this work for everybody, she said. In that conversation, employees could also offer to support their manager or other co-workers when those colleagues face a caregiving need in the future. Doing so could help shift a workplace culture to be more accepting of caregiving realities and FMLA leave over time, Frye added.
People and Policy
The has had no major updates since it was passed in 1993, although there have been modifications to the leave options available to military service members and their families. A from the Pew Research Center found that 69% of Americans support the federal government requiring employers to provide paid family leave for caregiving for an aging family member.
Emily Siner at Nashville Public Radio contributed to this report.
HealthQ is a health series from reporters Cara Anthony and Blake Farmer, approachable guides to an unapproachable healthcare system. Its a collaboration between Nashville Public Radio and 窪蹋勛圖厙 News.
The Trump administrations deep cuts to federal health agencies have become a political liability after a deadly outbreak of hantavirus aboard a cruise ship and the spread of an even more fearsome disease, Ebola, in Africa.
At least thats the way many Democrats see it.
They have seized on the situation to charge that the U.S. is ill prepared to respond to outbreaks let alone a pandemic after President Donald Trump and funding for public health infrastructure and pandemic preparedness. Infectious disease specialists have called on the White House to reverse cuts and rejoin the World Health Organization.
The White House, meanwhile, is on the defensive, trying to reassure a pandemic-weary public that the federal government can still mount effective responses to infectious disease outbreaks.
The FDA and the Centers for Disease Control and Prevention as part of an effort led by billionaire businessman Elon Musk and the Department of Government Efficiency, or DOGE, that also resulted in the cancellation of billions of dollars in federal contracts and grants.
These outbreaks are unfolding at a time when the U.S. public health infrastructure is under significant strain, said , an emergency medicine physician and former Baltimore health commissioner. The CDC currently lacks a director, the FDA lacks a director, there is no surgeon general, and many leaders with outbreak response management experience have left the federal government.
The U.S. government has and is monitoring potential exposures to hantavirus after an outbreak on a cruise ship. It is also implementing new restrictions for foreign travelers amid an Ebola outbreak in Uganda and the Democratic Republic of Congo that has grown to more than . While neither situation is seen as likely to become a global pandemic, Democrats and infectious disease leaders have seized on the outbreaks to criticize the effects of the DOGE cuts and other administration public health policies.
The hantavirus cluster occurred on the , an expedition ship that left Argentina on April 1 for a monthlong sojourn with almost 150 people aboard. The earliest cases, including two deaths, were on May 2. infected passengers have died. Hantavirus is typically spread to people from rodents, but this version, known as the , can be passed person to person.
The Ebola outbreak has captured public attention, though no cases have been confirmed in the U.S. The virus a rare strain called Bundibugyo, against which there are no proven vaccines or treatments spread undetected for weeks, prompting WHO Director-General Tedros Adhanom Ghebreyesus to say hes concerned about the of the outbreak. , including a doctor exposed to the virus, were evacuated to Germany by the U.S. State Department.
Democrats Criticize Cuts
Some Democrats are pressing the administration to rejoin the WHO and restore funding to federal agencies. A lawsuit is ongoing over the dismantling of the U.S. Agency for International Development, the primary agency for providing foreign assistance. Core USAID activities included efforts to build local outbreak detection and prevention capacity in vulnerable regions, including in the Democratic Republic of Congo.
Sen. Chris Murphy (D-Conn.) noted the emerging threats associated with the rising Ebola case count, posting : We know how to stop outbreaks like this. But Trump chose not to stop it. He destroyed our global health team, deliberately exposing us.
Sen. Dick Durbin (D-Ill.) said May 21 on X that the Trump administrations sweeping and self destructive foreign aid cuts left the U.S. and Congo struggling to contain the Ebola outbreak.
An utterly predictable result from the chaos of DOGE, he said.
And, in the wake of the hantavirus outbreak, Senate Minority Leader Chuck Schumer of New York to rehire fired outbreak-response workers, restore funding at the CDC and Department of Health and Human Services, and rejoin the WHOs global outbreak warning network.
The Trump administrations gutting of Americas public health preparedness has made the recent hantavirus outbreak even more alarming, Schumer said May 12 on the Senate floor.
Federal agencies pushed back on criticisms about the early response to hantavirus, with officials insisting on social media, at press events, and in TV appearances that their work was appropriate and effective.
The federal government is conducting a coordinated, interagency response, HHS spokesperson Emily Hilliard said. Claims that federal cuts have imperiled the response or future pandemic preparedness are completely inaccurate, she said.
The CDC and State Department say they are ensuring rapid viral testing is available for the Ebola outbreak and are actively deploying resources through State Department country offices in Congo and Uganda.
I want to assure you that CDC and our federal partners are working around the clock to ensure our information is accurate and that action plans are being implemented immediately, Satish Pillai, who is leading the CDCs Ebola response, said in a .
Trouble Spots
The criticism isnt coming just from Democrats. Public health officials also say that Trump administration actions have hampered the response to both outbreaks and that the cuts to USAID helped set the stage for the spread of Ebola.
The International Rescue Committee, which helps people affected by humanitarian crises, has said funding cuts by the administration in March 2025 prompted a reduction in disease surveillance systems in the epicenter of the Ebola outbreak.
The U.S. had funded the surveillance, as well as outbreak preparedness efforts to prevent infections, with hand-washing stations, showers, latrines, and waste management. The committee said it had to cut programming.
Years of underinvestment and recent funding cuts have left many health facilities without adequate protective equipment, surveillance capacity, or frontline support needed to respond quickly and safely, Heather Reoch Kerr, the committees country director in Congo, .
The federal governments overall response to the outbreak, including the decision not to fly Americans exposed to Ebola to the U.S. for treatment, stands in sharp contrast with previous responses to Ebola, some epidemiologists and former health officials say. It also could discourage other medical professionals from traveling to the region to help.
During the 2014-15 outbreak in West Africa, the federal government eventually deployed Army and Navy technicians and other service members to process blood tests, build medical labs, and train local healthcare workers.
USAID emergency response teams also played a key role in the on-the-ground response to that Ebola outbreak, from building treatment rooms to handling burial of the dead, Ron Klain, during the Obama administration, said on NPR.
Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said USAID was a key support for programs.
The infrastructure in Africa has been cut with the cuts at USAID, he said. Its making it more difficult.
The United States ability to respond to a real pandemic is a mess because of the cuts and the administrations stance on mRNA vaccines, the technology behind covid shots, Osterholm said. The White House last year canceled nearly for mRNA vaccine development despite a lack of evidence of any health risks.
The rapid technology would enable faster worldwide vaccine production in the case of a pandemic compared with more traditional vaccine development, Osterholm said.
have also over the U.S. response to hantavirus. For example, the CDC on May 8 issued a about the cluster of hantavirus cases on the cruise ship in the Atlantic, but the alert came after some passengers had already . in late April on commercial flights.
And the agencys on the outbreak aboard the took place May 9. The phone briefing with reporters came five days after the WHO had alerted the public about the situation.
The first press conference was after this was international news, said Wen, the former Baltimore health official.
The CDC has defended its response to hantavirus. It has required U.S. passengers of the cruise ship to remain in a quarantine facility and has assured the public that the overall health risk here at home is low.
The country is prepared. The CDC is focused on it, Mehmet Oz, a physician and head of the Centers for Medicare & Medicaid Services, on May 11.
Within 24 hours of injecting the first dose of a weight loss medication she received following a visit with a telehealth doctor, Karleigh McClain was admitted to the hospital, she said.
The 31-year-old compliance consultant from Hendersonville, Tennessee, said she couldnt stop vomiting.
Sunday morning, it all hits, McClain recalled, as she described what happened that weekend in January. I cant keep anything down.
McClain said she thought the dosage the telehealth company had prescribed seemed too high. She tried to contact her doctor, but when she didnt get an immediate response, she said she called the company and a care team representative confirmed the instructions which said to inject 2.21 milligrams of the semaglutide medication once a week were correct.
It turned out, however, that was nearly nine times the amount patients are typically told to take for their first dose.
Nearly a month after she was diagnosed with an overdose, McClain said she was still dealing with the residual side effects, including an elevated heart rate and vision problems she felt were tied to the medication.
Most patients who have taken a GLP-1 received their prescription through a primary care doctor or a specialist, shows. But as the uptake of telehealth has grown substantially since the start of the covid pandemic, McClain is one of millions of Americans who have used online companies to meet a variety of their medical needs.
Many of the companies have started offering GLP-1 medications for weight loss as demand for these drugs has exploded. But certain medication errors tied to GLP-1s have exploded too, according to a 窪蹋勛圖厙 News review of Food and Drug Administration data, and physicians and telemedicine researchers worry that adverse experiences tied to telehealth companies are becoming more common.
Bad outcomes arent unique to telehealth providers or to the compounded weight loss drugs many of them offer. In fact, product liability lawsuits alleging patient injuries have been filed overwhelmingly against pharmaceutical giants Eli Lilly and Novo Nordisk, which manufacture name-brand weight loss drugs, court data shows. The drugmakers have defended their products.
However, some critics are also concerned that getting a weight loss prescription online is usually much easier than getting one through an in-person appointment. Not only do many telehealth companies write quick prescriptions for GLP-1s, but they often sell the medications, too, allowing patients to bypass in-person pharmacy visits. This one-stop shopping isnt necessarily a good thing, according to critics who say some telehealth providers are writing prescriptions for people who should not be taking GLP-1s and then providing little or no follow-up care.
It gives a black eye to telemedicine, said Elizabeth Krupinski, an experimental psychologist at Emory University who has conducted research on the effectiveness of telehealth.
Telemedicine stands to benefit so many people, Krupinski said, particularly when the technology is integrated within a larger healthcare system. That way, patients benefit from the convenience of telehealth while maintaining a connection with their in-person providers.
But some telehealth companies are marketing GLP-1s as an easy way to lose weight sometimes with the help of paid celebrity endorsements without emphasizing the importance of healthy eating and exercise, she said.
They may be following the letter of the law, Krupinski said. But writing prescriptions while skimping on care is not in the Hippocratic oath.
The Perfect Storm
Starting around 2020, many states loosened restrictions on telehealth, which allowed online companies to proliferate. This helped accommodate patients who could not, or chose not to, be seen in person at the height of covid transmission.
Expanded telehealth access was also intended to lower barriers in rural communities, as well as mitigate doctor and nurse shortages. In many places, telehealth doctors and nurses are legally allowed to treat patients across state lines. But the way telemedicine is practiced , and state laws largely dictate rules that telehealth providers must follow.
Some companies, such as Mochi Health, require patients to meet virtually with a provider, such as a doctor, nurse practitioner, or physician assistant, before they can get a GLP-1 prescription.
But others, including Ro, sometimes require nothing more of patients than an asynchronous evaluation, which does not include a live conversation with a healthcare provider. During this type of evaluation, customers are typically asked to fill out an intake form and answer a medical history questionnaire before they are evaluated for a prescription. Ro requires a conversation in real time when required by state law, or when requested by a patient or clinician, said Nicholas Samonas, a spokesperson for the company.
Every patient is counseled by their provider on the potential benefits and risks of treatment based on their individual medical history, Samonas said. Ros clinicians can order lab work when necessary and, when appropriate, may recommend patients seek in-person care, he said.
But some medical experts are concerned that virtual care may be insufficient for prescribing weight loss drugs.
Patients with a history of pancreatitis, for example, should be counseled about potential complications, medical studies show. The same goes for people with a condition called gastroparesis, which affects stomach nerves and muscles, and those susceptible to medullary thyroid cancer.
Some patients may also benefit from blood work or muscle mass screening before starting a GLP-1.
But not all telehealth companies are adequately evaluating patients before writing prescriptions, said Marc-Andre Cornier, an endocrinologist at the Medical University of South Carolina and the immediate past president of The Obesity Society.
When it comes to parsing the good from the bad, whose job is it to police that? he asked. The problem, he said, is there aren’t criteria written by a government agency or a medical society to determine which providers are treating patients appropriately and which arent.
While the first GLP-1 was approved by the FDA more than 20 years ago, to treat Type 2 diabetes, the use of these drugs took off in 2021 when Novo Nordisk received approval for a semaglutide drug to treat obesity, with the brand name Wegovy. In a 2025 KFF poll, said they had taken a GLP-1.
In a in The New England Journal of Medicine, physician Amanda Banks noted that the proportion of GLP-1 prescriptions written for people who were not diabetic, obese, or overweight increased from 4.5% in 2018 to 17% in 2023.
In the paper, Banks called it troubling how easy it is to obtain a prescription for weight loss drugs and worried they might exacerbate existing eating disorders or cause new cases, including of anorexia.
Cornier, who has received compensation from Novo Nordisk for serving as a consultant, echoed some of Banks concerns. It’s not just filling out a form online and then having some random healthcare provider sign off on it, he said. There are concerns with some of these online programs that there’s not a proper evaluation, there’s not a baseline, and there’s not proper supervision.
The American Telemedicine Association, which advocates for the expansion of digitally enabled care, has not addressed how telehealth providers prescribe GLP-1s, spokesperson Gina Cella said.
This is a bit out of our scope, Cella said, when asked if the association had addressed the topic of telehealth providers and GLP-1 prescriptions.
The lack of clarity makes choosing a company potentially confusing for patients, and the medical profession is partly to blame, said Jamy Ard, an obesity doctor and researcher at Wake Forest University School of Medicine in Winston-Salem, North Carolina.
Doctors have historically done a bad job counseling patients about weight loss, and many people arent comfortable talking to their primary care doctor about it, Ard said. Patients think, Why would I go to my doctor and have them say, Eat less and move more, when I have heard that a million times and I don’t want to have that lecture again?” Ard said.
This problem, combined with past shortages of name-brand versions of GLP-1s, such as Ozempic, Mounjaro, and Trulicity, has created a perfect storm for telehealth companies to flourish, said Ard, who has received support from pharmaceutical and telehealth companies.
While some telehealth companies prescribe only name-brand weight loss drugs, many also offer cheaper, compounded versions. They act as intermediaries between customers and mail-order compounding pharmacies, which create GLP-1s by mixing active ingredients, such as semaglutide, with additives. The ingredients for compounded drugs are commonly sourced from overseas suppliers, and the formulations are not reviewed by the FDA for safety.
The environment is very much uncontrolled and poorly, if at all, regulated, Ard said. There is just no standard of care.
Emily Hilliard, a spokesperson for the Department of Health and Human Services, told 窪蹋勛圖厙 News that compounded drugs should only be used in patients whose medical needs cannot be met by an FDA-approved drug.
Hilliard said the agency urges consumers to be vigilant and know the source of their medicine.
Understanding the Risks
While weight loss drugs have helped millions of people lose weight, theyre not without risk, the data shows.
A 窪蹋勛圖厙 News data analysis of the FDAs Adverse Event Monitoring System found that medication errors made by providers or patients with popular weight loss drugs exploded from just over 2,000 reports in 2020 to over 25,000 in 2025. Those self-reported events involved semaglutide, tirzepatide, dulaglutide, and liraglutide, the generic names for leading GLP-1s.
Among frequent issues cited in the adverse event reports were administration of an extra or incorrect dose, issues with communication about a product, and prescribing errors.
Since 2019, the National Poison Data System has fielded a related to overdoses or side effects from injectable weight loss drugs. The data does not distinguish between overdoses tied to a telehealth prescription and those stemming from an in-person medical appointment, but it is a reflection of how prevalent these drugs have become.
Yet data on potential medication errors and adverse reactions to GLP-1 medications is incomplete, because many issues are never reported to federal officials.
For example, in a , the FDA accused drugmaker Novo Nordisk, the maker of Wegovy and Ozempic, of failing to report some adverse events to the federal government, including suicidal ideation and death.
Nobody knows how often adverse events occur, said Kristen Nixon, a Johns Hopkins University researcher who has studied posts about weight loss drugs on Reddit, a popular online forum.
Her team analyzed hundreds of Reddit posts from 2020 through last August and identified frequent mentions of drug reactions and user errors, such as patients not knowing how to correctly dose and inject the medication.
But another finding also stood out to her.
Wow, there are a lot of people talking about telehealth, Nixon recalled thinking. Reddit commenters said they got GLP-1 prescriptions from scores of telehealth platforms, Nixon found. Commenters also mentioned several dozen compounding pharmacies often in the same posts about telehealth.
Pharmacies are typically required to counsel patients on medications they receive. But Nixons research found that telehealth companies often mail the medications directly, meaning patients do not need to go to a pharmacy.
Anecdotally, it seems like the telehealth companies are really facilitating access to compounded medications, Nixon said.
Leslie Gammon, 54, an office manager from Wendell, North Carolina, said she turned to a telehealth company called Amble Health for a weight loss drug prescription. She was given a GLP-1 after filling out an online form, she said.
Like McClain, when she received her mail-order compounded medication in late October, she thought the dosage that accompanied it seemed too high. Shed received a box of semaglutide earlier in the month with a much lower dose. But the refill she received was a stronger formulation, and the instructions told Gammon to inject three times the volume she had been taking in previous weeks.
Even though she injected slightly less than that recommended amount before bed on a Sunday evening, she woke up in the middle of the night throwing up every 20 to 25 minutes, she said. And it didnt stop until Tuesday. She was eventually admitted to a hospital in Raleigh and now owes the hospital over $9,000, a medical bill shows.
Amble Health did not respond to questions for this article.
The delivery system for injectable versions of weight loss drugs is more complicated than for a pill. In its National Poison Data System alert, Americas Poison Centers noted that some people reported accidentally taking 10-times the recommended dose due to confusing measurement units while using a syringe.
And people who are eager to lose extra weight before a wedding or a vacation, for example may choose to self-administer a higher-than-recommended dose, said Arthur Caplan, a bioethics professor at New York Universitys Grossman School of Medicine.
Some telehealth companies arent doing enough, he said, to make sure patients understand the risks or the complex delivery system associated with the injectable drugs.
The consent is not adequate, Caplan said. Theres no probing to see if you understood anything.
Cella, with the American Telemedicine Association, said the group has not addressed the difficulty of educating patients about the risks of injecting weight loss drugs. But she pointed to the associations , which states that telehealth business models must put the patient first.
Proceed With Caution
Pharmaceutical companies must list potentially harmful side effects when they advertise the name-brand versions of their FDA-approved medications. Potential include nausea, vomiting, changes in vision, low blood sugar, and, in rare cases, thyroid cancer. Meanwhile, telehealth companies have not historically followed the same rules that drugmakers have in disclosing medication risks in advertisements. But the FDA has started cracking down on misleading drug ads.
A national shortage of weight loss medications in 2022 opened the door for compounding pharmacies to manufacture these drugs. But since the FDA declared the shortage over last year, companies that offer compounded drugs are increasingly facing legal and regulatory challenges related to their marketing tactics.
Mounjaro manufacturer Eli Lilly and other drugmakers are suing multiple telehealth companies for promoting compounded versions of their drugs. In one legal complaint, Eli Lilly alleged Mochi Health had engaged in deceptive business tactics. In a motion to dismiss the lawsuit last year, lawyers for Mochi Health called the complaint part of a nationwide campaign to bolster Lillys profits by dictating patient care through the elimination of compounded drugs as a treatment option for weight management. The lawsuit is ongoing.
Eli Lilly spokesperson Michael Jamison said in a written comment that telehealth companies sued by the drug manufacturer threaten patient safety by falsely promoting supposedly personalized compounded tirzepatide and mislead consumers about the safety, clinical testing, and effectiveness of their compounded knockoffs.
Meanwhile, Novo Nordisk has filed 130 lawsuits against entities engaged in unlawful marketing and sale of knockoff semaglutide drugs, said Liz Skrbkova, a spokesperson for the drugmaker.
She said the company is committed to protecting patients from unapproved knockoff drugs made with foreign, inauthentic active pharmaceutical ingredients that pose significant safety and efficacy risks.
The Trump administration sent a in September and February to online companies such as , , , and . The FDA said these and other companies had made false or misleading claims related to compounded versions of weight loss drugs.
Your claims imply that your products are the same as an FDA-approved product when they are not, the agencys Center for Drug Evaluation and Research on Sept. 9. HHS later referred the company to the Department of Justice after it announced the launch of a $49 version of Novo Nordisks Wegovy pill.
When asked about the FDA warning, Abby Reisinger-Moley, a spokesperson for Hims & Hers, pointed to a announcing a shift away from compounded weight loss drugs. The company said in the press release that it had entered into an agreement with Novo Nordisk to sell name-brand versions.
Alex Smith, CEO of Join Josie, an online platform that helps women in menopause lose weight by prescribing GLP-1s, said his company also made changes in response to an FDA letter, to include removing Join Josies name from medication vials. Which I agree with, Smith said, because you dont want patients thinking youre the compounding pharmacy.
SkinnyRx and Genesis Health International did not respond to requests for comment.
But these warnings arent the first time the federal government has stepped in to ensure that telemedicine is being used appropriately, said Mei Wa Kwong, executive director of the Center for Connected Health Policy.
Prior cases involved attention-deficit/hyperactivity disorder medications and other controlled substances prescribed by telehealth providers, she said. While those drugs pose more risk to patients than GLP-1s, the companies were also accused of improperly screening potential customers.
The onus still falls on consumers to research companies before signing up for their services, Kwong said.
Always approach anything on the internet with a hint of skepticism, Kwong said.
Keeps Getting Worse
McClain, the Tennessee woman hospitalized this year after a GLP-1 overdose, said she lost 50 pounds a few years ago by taking a name-brand GLP-1 prescribed by her doctor.
At the time, the medication was covered by her health insurance. This year, when she was ready to take a GLP-1 again following a pregnancy, the drug was no longer covered for weight loss.
To save money by obtaining a cheaper, compounded GLP-1, McClain signed up for Mochi Health after doing her own research. That was just the most affordable option, she said.
But within hours of her first dose, she said, she found herself on the phone with poison control.
After her overdose, McClain said, she spoke to a clinical director at Mochi Health, once by phone but mostly via email, about her lingering symptoms before communication paused.
David Pilip, a spokesperson for Mochi Health, said in a statement that the company would not discuss individual patients due to privacy obligations. But he said adverse events are immediately flagged and investigated with extreme precision.
Mochi Health takes patient safety extremely seriously, Pilip wrote in an email. We promptly initiated a review and have been in direct and ongoing communication with the patient to reach a resolution. We remain committed to doing so.
McClain anticipates her healthcare bills related to the hospital stay will total at least $900. She said that to get the $159 refund for her three-month membership and reimbursement for the hospital expenses, she has been asked to sign a document saying she wont take legal action against the company. Her experience, she said, just keeps getting worse.
NBC News producer Jessica Herzberg and 窪蹋勛圖厙 News senior correspondent Fred Schulte contributed to this report.
Do you have an experience using an online company for healthcare services or medicinal products that you think others should know about? Click here to contact our reporting team.
As part of a yearlong investigation, the Connecticut Mirror and 窪蹋勛圖厙 News interviewed more than three dozen patients in Connecticut who were sued by hospitals and physician groups over medical bills.
When Christine Wood received a $12,000 bill from Bristol Hospital, she thought it must be a mistake. It was more than she and her husband made in a month combined.
Im freaking out, said Wood, who lives in a 1,700-square-foot home in Terryville, a village just outside Bristol, Connecticut. I dont understand it.
Wood, 52, had weight loss surgery at Bristol Hospital in 2022, hoping it would help with her sleep apnea and the pain in her knees and back. Before scheduling the procedure, she checked with her insurer, she said, and was told the surgery would cost $5,000 out-of-pocket. She paid in advance.
More than six months later, Bristol sent Wood another bill that pushed the cost of her surgery to more than $17,000. Wood said she tried to dispute the charge. The hospital sued her.
Thats ridiculous. I was told so many times by Aetna: $5,000 out-of-pocket, Wood said. I never would have had the surgery had I known it was going to cost almost 20 grand.
Wood is among more than three dozen Connecticut patients the Connecticut Mirror and 窪蹋勛圖厙 News interviewed over the past year who were sued by their hospital or physician over unpaid bills.
The patients include teachers, small-business owners, a postal worker, a retired nursing home aide, a nurse, and a hotel bellhop. Most had jobs and health insurance. Nearly all said they wanted to pay what they owed.
Patients taken to court described baffling bills, confusing health plan rules, and frustrating and fruitless telephone calls to hospital billing offices and health insurers customer-service lines. Even when they tried to resolve their outstanding bills, many said they couldnt get answers.
Their experiences encapsulate breakdowns in the healthcare system that trap patients in debt. Health insurance didnt cover care for reasons they couldnt understand. Several patients did not qualify for financial assistance from providers, despite modest incomes. If they committed to pay, patients were hit with liens on their homes or interest payments and court fees that piled new debt onto their medical bills.
The industrys key players blame one another for a broken system. Providers say insurers saddle patients with massive bills even when they have coverage. Insurers say at rates that outpace inflation.
Meanwhile, patients are stuck with the fallout. In 2022, about carrying medical or dental debt.
Its bad enough that I have bad health and have to pay mountains of medical bills, said Samantha Mantiera, whom Danbury Hospital sued in 2024 over $10,000 she said she was erroneously charged. Then to constantly be dealing with incorrect bills and then a lawsuit on top of it took me over the top.
Mantiera said she spent months trying to explain to the hospital and then a collection agency that her insurance statements indicated she owed just $260. She was sued anyway.
After Mantiera contested the lawsuit, Danbury Hospital withdrew it, court records show.
Mantiera said she and her husband now travel up to an hour from their Brookfield, Connecticut, home to avoid hospitals owned by Danburys parent company, now called Northwell Health.
Kathy Holt, who leads the state Office of the Healthcare Advocate, said that in the past several decades healthcare has only gotten harder for patients to navigate. The agency fields thousands of calls every year from residents looking for help with medical billing questions.
Ive talked to too many people who have just given up, Holt said. The system has been made so hard for them, and I feel like its deliberate.
They Would Not Talk to Me
Debt collection lawsuits against patients have declined in Connecticut since 2019, a CT Mirror-窪蹋勛圖厙 News analysis of state court records found. And court records show most Connecticut hospital systems have stopped suing patients, including the states two largest systems, Yale New Haven Health and Hartford HealthCare.
Most hospitals stopped suing patients during the covid-19 pandemic as they reevaluated their collection practices, said Sarah Ginnetti, chief revenue cycle officer at UConn Health. The system ceased lawsuits in 2022, records show.
In some of those circumstances, it just felt misaligned with our mission as an organization, Ginnetti said. For the small handful of cases that we might gain some type of legal victory, we really didnt feel as though that would be our best path forward.
Yale New Haven Health and Hartford HealthCare would not discuss why they stopped suing patients, instead issuing statements about their financial assistance programs.
Scores of medical providers including physician groups, dentists, and hospitals , data shows. The CT Mirror-窪蹋勛圖厙 News analysis found more than 1,500 healthcare-related debt cases filed in Connecticut courts in 2024.
This included lawsuits by Bristol Health, an independent local health system that includes Bristol Hospital, and Nuvance Health, a chain of seven hospitals recently acquired by Northwell Health, a multibillion-dollar system based in New York.
Nuvance hospitals filed over 4,000 collection lawsuits from 2019 to 2024, records show. Over the five years, the health system accounted for more than a quarter of the roughly 16,300 medical debt collection lawsuits against patients identified in state court records.
Hospital officials and other medical providers say they try to work with patients who have trouble paying their bills. Nikki Schulz, chief revenue officer for Northwells Connecticut hospitals, said in a statement that years ago the system eased its collection practices, leading to a precipitous decline in medical debt referred to collections.
We fundamentally retooled our approach to align with industry best practices, Schulz said. Records show the health system sued about 200 patients in 2024, down from 2,200 in 2019.
Healthcare executives also say they have a responsibility to try to collect.
I dont have a choice, said Bristol Hospital CEO Kurt Barwis. What were trying to do is sustain a mission of taking care of this community.
Bristol Health is one of Connecticuts most financially strained systems, and executives are currently in talks with the administration of Democratic Gov. Ned Lamont about an . The proposed deal is, in part, an effort to keep the hospital afloat.
Barwis said the hospital has taken steps to help patients with unexpected bills, including enlisting financial counselors to reach out to patients before elective procedures to discuss cost and financial assistance.
But Wood, who was sued by Bristol, said no one from the hospital talked to her before her surgery. When she called the hospital after receiving the $12,000 bill, she said she was told there was nothing they could do because her insurance had denied the claim.
They would not talk to me about it, Wood said. They wanted their money.
Bristol spokesperson Albert Peguero also blamed Woods insurer and said the hospital worked with Wood as she went through numerous insurance appeals with Aetna.
Wood didnt fare any better with Aetna. It turned out that her health plan covered only $15,000 worth of bariatric surgery, meaning she was responsible for any bills that exceeded that.
Aetna spokesperson Shelly Bandit said Wood had been notified of this provision, though Wood disputes this.
The back-and-forth with the hospital and the insurer enraged Wood. But after she was sued, she concluded she had no more options. She settled with Bristol, agreeing to pay the full balance on a payment plan of $150 a month, court records show. Under the agreement, it would take Wood almost seven years to pay off the debt.
Last year, Wood faced additional financial challenges after her mother died and her husband lost his job and was unemployed for six months.
Wood said shes regained about a third of the 100 pounds she lost after her surgery because of the stress. Some months she pays Bristol less than $150. In January, the hospital placed a lien on her home.
We dont have savings. We dont have the extra money. Were living check by check, Wood said. Were working-class people trying to make a living, trying to do the right thing. And we always get screwed.
I Dont Have Hours on End
Its difficult to know how many medical debt lawsuits arise from disputed bills. But most U.S. adults with healthcare debt say theyve received a bill in the past five years that they thought contained an error, according to a .
The prevalence of disputed medical bills is one reason many advocates for patients say hospitals and other healthcare providers shouldnt sue people they treat.
Understanding insurance to begin with and then navigating denials or bills that are not plainly understood leaves patients stuck in an opaque system where they have the least leverage and power, said Eva Stahl, a vice president of Undue Medical Debt, a nonprofit that has worked with states to buy and retire debt including for more than 150,000 Connecticut residents.
Patients understandably are left with questions and confusion, Stahl said.
Timothy Bigham, who owns a construction company and was sued in 2023 by Danbury Hospital, said he never understood why he was billed more than $64,000 after he was hospitalized following a 2019 heart attack.
Bigham, who lives in Danbury, Connecticut, said he was insured at the time. But soon after he got home, Bigham began getting regular calls from the hospital. He was told his insurer wasnt paying the bill because he refused to release medical records, he recalled.
I had insurance when I had the heart attack, but its my job to get the insurance company to pay? Bigham said. Im self-employed. I work in construction. I dont have hours on end to sit on the phone trying to talk to somebody at an insurance company.
Bigham said he ultimately stopped dealing with it because he didnt know what else to do.
Then, in 2023, Danbury Hospital sued him. A judge dismissed the case in 2025, citing the hospitals failure to prosecute with reasonable diligence, according to court records. But by then, the alleged debt had devastated Bighams credit score, tanking it by over 100 points, he said.
Northwells Schulz declined to comment on any specific patient cases, citing privacy laws.
Connecticut barring medical debt from consumer credit reports.
A handful of states have tried to protect patients from lawsuits through limiting when hospitals can pursue legal action. Illinois, for example, prohibits lawsuits against uninsured patients who prove they cant afford their unpaid bills. Nevada, New York, North Carolina, Maryland, and Virginia prohibit liens and foreclosures for medical debt.
It Was a Nightmare
Dominique Jean Pierre was equally surprised by the $20,000 bill he got after he was hospitalized at Norwalk Hospital with a urinary tract infection in July 2020.
Jean Pierre, 66, had worked for nearly two decades as a bellhop at a Hilton hotel in Stamford owned and operated by Atrium Hospitality, a Georgia-based company. When he got sick, the hotel was temporarily closed because of covid lockdowns.
What Jean Pierre didnt realize, he said, was that the hotel had also cut off employee health benefits. He said he was told by the hospital that hed be responsible for the bill.
It was a nightmare, he said.
Jean Pierre said he begged his manager for help but was told there was nothing the company could do. Atrium Hospitality did not respond to requests for comment.
Two years after Jean Pierres hospitalization, Norwalk Hospital sued him for more than $20,000, court records show.
Jean Pierre said he tried twice to apply for financial assistance, but the hospital told him he and his wife made too much to qualify, even though his medical bills totaled almost a quarter of their annual income of about $87,000.
With nowhere to turn, Jean Pierre settled with Norwalk Hospital, now part of the Northwell system, in 2025, agreeing to pay the full bill in $100 monthly installments, records show. At that rate, he will be paying off the debt until 2042.
After the settlement, he said, the judge encouraged him to reach out to elected officials to try to get the debt canceled. Jean Pierre was exhausted.
He says to me, You have to go to your senators. Go to the governor. I said, Thats too much. [Im just going to] let it go.
Jean Pierre has left the Hilton and now works as a personal care attendant, as does his wife. But he said it still nags him that businesses and healthcare providers received millions of dollars in government aid during the pandemic, while he was left with $20,000 in medical debt.
They gave money for the hotel. They gave money for the hospital. They gave money for a lot of stuff, he said. But we dont see none.
Im Not Trying To Run Away
Other patients said they felt trapped, even if they tried to do the right thing.
Deneen Brown, who runs a small daycare out of her home in Norwalk, was sued by Norwalk Hospital in 2024 for $7,200 over bills she allegedly incurred on or about 2019 and 2020, according to the lawsuit.
Brown said she was stunned by the lawsuit, as she believed shed had health insurance at the time. But as a small-business owner who took pride in maintaining good credit and staying on top of her finances, she said she committed to taking care of it.
Im not trying to run away from something that may be my responsibility, Brown said. If you say I owe it, Im going to figure it out, and Im going to pay it.
In January 2025, she agreed to a nearly 13-year payment plan of $50 a month, court records show. Often she pays more, she said.
The following month, the hospital placed a lien on her home. Brown said she never realized the hospital would continue to penalize her, even after she agreed to a payment plan.
Had I known that, I would have never settled," she said.
This article was produced in partnership with , a statewide nonprofit newsroom that covers public policy and politics.
C矇line Gounder, 窪蹋勛圖厙 News editor-at-large for public health, discussed recent warnings about research-grade peptides and new colorectal cancer screening guidelines on CBS News’ CBS Mornings on May 27. She also discussed the Ebola outbreak centered on the Democratic Republic of Congo and whether it’s expected to spread on May 26.
Montana will soon test whether cash-strapped and strained state health departments can carry out federal Medicaid work requirements without ending coverage for eligible adults.
On July 1, Montana plans to become the second state after Nebraska to make Medicaid enrollees prove theyre working to keep their coverage. Thats six months ahead of the federal deadline for states to implement Medicaid work rules for millions of enrollees.
That date is also the start of a new state budget year, as well as the deadline for Montana health officials to climb out of a previous Medicaid-driven spending deficit. Montana lawmakers underfunded the health agency when they set the state budget last year before congressional Republicans passed President Donald Trumps One Big Beautiful Bill Act. Health policy analysts say the states budget crunch is a hint of the challenges to come nationwide.
Thats because the federal spending law requires states to check every six months whether millions of Medicaid enrollees work, go to school, or volunteer at least 80 hours a month, or qualify for an exemption. Those checks will take time and money. Simultaneously, the law is expected to reduce federal Medicaid spending the largest pool of federal funding for states by nearly $1 trillion over 10 years, shift more food assistance costs to states, and add tax breaks that could hit state budgets.
States are the ones that aregonnahave to do the dirty work of implementing cuts, said Joan Alker, a Georgetown University researcher focused on health coverage.
Part of Montanas proposed budget fix is to stall rate increases for healthcare providers that were due July 1. Clinicians told me they already struggle to afford hiring staff amid growing waitlists for care, which they blame on low Medicaid payments.
Meanwhile, there are some red flags in the states Medicaid data from recent years: People often face long waits to access public assistance, and many can lose coverage at renewal time because of paperwork issues.
All these problems reflect a national challenge to connect people to care through strained public assistance programs. Our reporting has long shown how states have struggled to process Medicaid applications.
Our concern is, is the department ready? Jean Branscum, CEO of the Montana Medical Association, said of the state health agency. Does the capacity exist for all this to be done right and ensure that patients dont pay the price?
State officials have said theyll scan existing data to try to automatically confirm whether people meet the work rules. And theyve been building up their public assistance team for months.
But theyve had to wait on unanswered questions from the federal government that are key to exempting especially vulnerable people from the incoming rules. And now, theyve got a lot more work to do with less money.
The state is ramping up to implement the federal work requirements six months ahead of the deadline. But Montana is one of several states already struggling to pay for health services.
SOCIAL CIRCLE, Ga. Until recently, this rural city about 45 minutes east of Atlanta was best known for its Blue Willow Inn cookbooks featuring recipes for Southern dishes such as baked pineapple casserole and kudzu blossom jelly.
Lately, however, the community has been trying to stave off a new identity of prison town as it fights the opening of what could become the nations largest immigration detention center, holding up to 10,000 people.
Walton County, home to this city of about 5,500, voted overwhelmingly for President Donald Trump in 2024. But, as the administrations mass deportation strategy hits closer to home with plans moving forward to transform a more than 1 million-square-foot warehouse into a holding pen locals say the citys infrastructure just cant handle such an influx of people.
This month, Social Circle in federal court against U.S. Immigration and Customs Enforcement. The citys complaint argues that the operation of a detention facility, what it calls a mega center, would harm public health, strain the local freshwater and sewage treatment systems, and overburden emergency medical services due to Social Circles modest EMS capacity and DHS nebulous plan for emergency transport, referring to the Department of Homeland Security, which oversees ICE.
The community is very unified, City Manager Eric Taylor said. We want them to go away.
Social Circle is one of several communities across the country thrust into a charged national debate about the administrations mass immigrant deportation strategy. On the campaign trail, Trump said migrants were . But local leaders, , advocacy groups, and others in , , , , and claim the administration is doing the same thing by plopping detention centers into communities without the capacity to handle a surge of people.
Last year, Todd Lyons, who is serving as acting director of ICE , described a goal to have the mass deportation operate with the . Deportations would move like Prime, but with human beings, he said at a border security expo in Phoenix.
ICE is now putting every person they seek to deport in detention, including those with no criminal records, without the possibility of release on bond. In January, the agency held almost twice as many people as it had that same month in 2024 under President Joe Biden.
However, while many supporters remain aligned with Trumps immigration stance, some locals fear their citys stability will be jeopardized. Social Circle is not exactly flourishing, but its making it, said Gareth Fenley, a retired social worker who ran for state Senate in 2024 as a Democrat and was not among the locals who voted for Trump.
If Social Circle becomes a prison town, she said, were gonna lose what we have.
I Thought It Was a Joke
In February, DHS purchased the 235-acre site in Social Circle for nearly five times its assessed value. It plans to house more people there than at the Rikers Island Correctional Facility in New York City, and nearly triple the number of people now housed at the countrys biggest immigration detention facility, which is in El Paso, Texas.
I thought it was a joke, said John Miller, when he first read about the plans last year. He and his wife, Kathlene, have lived in Social Circle for 21 years. When they bump into neighbors, Kathlene knows their childrens names, and John can cite the kids baseball stats. Their 50-acre horse farm is less than a mile from the elementary school, and right across the street from the detention center site.
The Millers support Trumps stance on immigration but feel that turning the vacant warehouse into a detention center would re-create the very problems his administration is trying to solve. Whether people are concentrated in a detention center or out in the public, theyre still there, John Miller said.
DHS estimates that the facility would require about 1 million gallons of water daily, according to the citys suit, which alleges that volume would bleed residents taps dry and contaminate local streams with sewage. Emergency medical calls from the detention center, the lawsuit claims, would overwhelm the citys first responders, which Taylor said clock in at 14 firefighters, 15 police officers, and two school resource officers. The city relies on Walton County for ambulance services.
Additionally, Social Circle would live under an ever-present threat of a major disease outbreak, the lawsuit said, adding that the federal government didnt conduct the needed environmental reviews or solicit community input beforehand.
Taylor said federal officials had only one meeting with local leaders and brushed off concerns about water, sewage, and emergency care, which administration officials said the site wouldnt need to use. I dont buy that, Taylor said. And thats the problem.
Supercharging Health Concerns
Current DHS Secretary Markwayne Mullin has said he is reviewing , Kristi Noem, to transform warehouses like this one into detention facilities. And the departments whether the federal government overpaid for some of the buildings. Mullin also said officials are reviewing agency policies and working with community leaders. We want to be good partners, said Lauren Bis, a DHS spokesperson.
Still, the administrations swift escalation of immigrant detention has exacerbated long-standing allegations of medical neglect for those in custody across the country and led to the in at least two decades.
Three detention facilities in Folkston, Georgia, about an hour north of Jacksonville, Florida, issued 130 emergency calls from Feb. 4, 2025, to Feb. 3, 2026, according to dispatch reports obtained by 窪蹋勛圖厙 News through a public records request. The calls from the facilities, which hold about 2,000 people, were for wide-ranging reasons, including anaphylaxis, assaults, suicide attempts, overdoses, seizures, strokes, head injuries from falls, and other health issues.
GEO Group, ICEs largest contractor, which runs the Folkston facility, provides around-the-clock access to medical care and relies on emergency medical services as needed, said Christopher Ferreira, director of corporate relations.
ERO El Paso Camp East Montana, built on a Texas military base, is currently the nations largest detention center and holds about 2,500 people. In the five months from Aug. 17, 2025, to Jan. 20, 2026, about 130 emergency medical calls were made from the site, according to city records. Several detainees have died at the facility; several others have for tuberculosis, measles, or covid-19.
Amentum Services, which recently took over management of the facility, did not respond to questions about emergency calls.
Even bigger detention facilities, such as the mega center planned in Social Circle, would only supercharge those health issues and bring them to new communities, said , who was immigration ombudsman at the Department of Homeland Security under Biden. Existing facilities already suffer from staffing shortages, poor ventilation and hygiene, and insufficient medical care, she said.
The proposed facilities are enormous and generally built for boxes, not people, she said. Theres no way, without extreme cost, both to the community and just in dollars, to make these safe for humans, she said.
In the meantime, people such as Kathlene Miller said they feel that Social Circle has become collateral damage in the larger debate over immigration. Were like the children in a divorce, she said.
But Social Circle may face an uphill battle. Taylor said Walton County leaders and the state of Georgia have been silent on the center.
They say its federal issues, that they have no jurisdiction, he said. They dont have any interest in helping us.
On April 10, 2025, several hours after finishing a hike in Sedona, Arizona, Jan Anderson started repeating herself.
Did we hike this morning? she asked.
Yes, we hiked, said her husband, Steve Francks. And you did really well.
But 15 seconds later, she asked the same question: Did we hike today?
Anderson, 65, a retired finance executive, doesnt remember any of it. She can recall what happened that afternoon only because her husband started recording her on his cellphone.
I was just on this nonstop loop, she said.
Almost immediately, Francks knew something was wrong. Jan was out of it, he said.
He took her to an emergency room in Sedona, where staff initially thought she might be having a stroke. Because the facility wasnt fully equipped to evaluate or treat stroke patients, Francks said, she was airlifted to a Phoenix-area hospital, where she was admitted.
It turned out she wasnt having a stroke. Her medical team eventually determined she was probably experiencing , a rare, temporary, and benign memory disorder.
The good news was that her symptoms didnt last long, and she has suffered no long-term effects from the episode. It took about 24 hours before she was able to start forming new memories, and she was discharged the next day. Anderson and Francks, who split their time between Sedona and Edmonds, Washington, returned to the Pacific Northwest a few weeks later.
Then the bill came.
The Medical Service
The sudden confusion associated with transient global amnesia can also be a sign of a more common neurological condition, so its important to rule out other possible causes such as a stroke, for which timely emergency care can spell the difference between life and death.
Andersons records show her care at Abrazo Healths Arrowhead Campus in Glendale, Arizona, included an electrocardiogram, which can detect underlying cardiac abnormalities, and imaging, which would rule out any vessel blockages that might cause a stroke. She also underwent various lab tests commonly used to diagnose a stroke.
The Bill
$59,181: $35,302 for diagnostic/therapeutic imaging, $8,147 for laboratory services, $8,146 for a special care unit, $5,532 for EKG services, and $2,054 for pharmacy. Andersons first bill from Abrazo Health said she owed $15,312.43, citing an insurance adjustment of $43,868.57, even though her insurer had not covered any of the charges.
Anderson said her insurer covered separate charges for the ER and helicopter transfer.
The Billing Problem: Communication Breakdown
The federal No Surprises Act bans out-of-network bills for most emergency services, even if those services are received at an out-of-network facility and are not preapproved by the insurer.
That means the cost of Andersons hospital care should have been covered as though it were in-network. At the time, she was insured by Molina Healthcare, through a plan purchased on the federal Affordable Care Act marketplace.
But for a year, Molina declined to pay for her care in Glendale, at one point arguing that her hospital stay required authorization when, or even before, she was admitted.
I cant get anyone to resolve it, Anderson said. Its almost $60,000 hanging over my head.
The first problem arose about two weeks after she was discharged, when Abrazo Health sent Anderson a bill indicating she was a self-pay patient.
The hospital didnt request her insurance information at any point during her stay, Francks said. He assumed, at the time, that his wifes financial paperwork had been transferred from the ER in Sedona. It had not.
She called the Glendale hospital and corrected the error.
Then, in late June, Anderson received notice from the hospital indicating she was not a Molina member.
Your insurance company notified our office that the patient was not a covered member for the services provided by Abrazo Arrowhead Campus on the above referenced service date(s), the notice said. It showed the total charges for her stay exceeded $59,000.
But when Anderson called Molina to confirm her coverage, she said, the insurance company assured her the claim was being processed.
That didnt mean Molina was willing to cover her hospital bill.
Anderson spent months trying to resolve the balance. She filed complaints with members of Congress, the Arizona Department of Insurance and Financial Institutions, and the Office of the Insurance Commissioner in Washington state.
In an October letter to Washingtons insurance commissioner, an appeal and grievance specialist for Molina wrote that the claim was denied because inpatient stays require prior authorization, or notification at the time of admission. No notification of admission or prior authorization was received from the hospital, so the claim was denied.
It continued: Molina covers out of network emergency services but since this was an inpatient admission authorization is required.
Nicole Broadhurst, who focuses on medical billing issues as CEO of a , said this dispute appears to rest between the insurer and the medical provider.
She said that Andersons insurance information should have been transferred between the first ER and the Glendale hospital. Since it wasnt, Broadhurst said, Anderson shouldnt be held liable for her hospital bill. (Broadhurst was not involved in efforts to resolve Andersons billing dispute.)
Unfortunately, Broadhurst said, these situations are not uncommon, even though we have the No Surprises Act.
The Resolution
Anderson said she was told by Abrazo Health for months that it was working with Molina to resolve the bill. She said she was also told that even if Molina did not cover the full cost of her hospital care, she would not be liable for the balance but she never received that assurance in writing.
Meanwhile, Molina continued to uphold its decision to deny payment.
After 窪蹋勛圖厙 News contacted the insurer and the hospital with questions about her case, Molina told Anderson it had launched an internal review of her claim, and a revenue director with Abrazo Health told her the company was treating this as a high-priority matter, she recalled.
Anderson said the revenue director for the health system assured her that if Molina continued to deny payment, the balance will be written off on the hospitals end, she said. I will not be responsible for any balance not even the $15,312.43 the hospital initially billed her after the hospitalization.
Linda Nofer, a spokesperson for Abrazo Health, would not answer questions about Andersons bill. In a statement, she said the hospital system is committed to working closely with our patients to resolve billing questions and concerns.
Molina spokesperson Caroline Zubieta would not discuss or respond to questions about Andersons case on the record.
The Takeaway
The flurry of insurance paperwork and medical bills patients receive after a hospital stay can be overwhelming and may sometimes appear contradictory.
Broadhurst said its important for patients to focus on the patient responsibility portion of an insurance document called an explanation of benefits.
Patients should not pay a bill if their explanation of benefits indicates they arent responsible for the amount charged.
In this case, Anderson had received a bill from the hospital saying she owed money. And her explanation of benefits from Molina confirmed shed racked up more than $59,000 in hospital charges.
But that document also indicated her patient liability was $0.00. Anderson said the hospital was not pressuring her to pay the $15,312.43 bill or any of the charges tied to her account, but she was worried she would eventually owe a large sum because the charges remained unresolved for more than a year.
The question I kept asking them was, How much am I going to owe? said Anderson, who is now insured by Medicare. It could be anywhere from that $15,000 adjusted amount to the full balance of $59,000.
Broadhurst said she tells patients facing similar situations to send the hospital a copy of the EOB and ask them to correct the account to $0 patient responsibility.
Even if no one is actively trying to collect, Id still push for written closure so it doesnt keep hanging over them, she said.
Bill of the Month is a crowdsourced investigation by 窪蹋勛圖厙 News and that dissects and explains medical bills. Since 2018, this series has helped many patients and readers get their medical bills reduced, and it has been cited in statehouses, at the U.S. Capitol, and at the White House. Do you have a confusing or outrageous medical bill you want to share? Tell us about it!