Jill Woodrow reached a tipping point as a caregiver when her mom began struggling to communicate information about her latest doctor appointments.

Woodrow’s 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 mom’s medical care while working, raising three daughters, and coordinating with her husband’s 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 mom’s 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. Here’s 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 wouldn’t 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 they’re 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 employee’s 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.

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LISTEN: After a guilty verdict for negligent homicide, a former nurse has found receptive audiences on the speaking circuit. She says she hopes her story can help shed light on problems in the healthcare industry.

When RaDonda Vaught got her first speaking request, it had been a year since that day in a Nashville courtroom, when she listened as a jury read her guilty verdict for negligent homicide and neglect of an impaired adult.

That was in 2022. Vaught was sentenced to three years of probation for administering the wrong medication and killing a patient at Vanderbilt University Medical Center in 2017.

She also lost her nursing license. So Vaught became a full-time farmer. She and her husband live on a in Bethpage, Tennessee, tucked in the rolling hills north of Nashville. They sell eggs at farmers markets on Saturdays and supply meat to local butchers and restaurants.

The controversial trial had been national news, and now the healthcare industry wanted to hear from her. So Vaught started giving speeches across the country about what happened that day in the hospital. She says her hope is that others in an industry increasingly turning toward automation and artificial intelligence can understand the multiple factors that contributed to the deadly medication mix-up.

She says she’s painfully aware that it could appear she is profiting from a tragedy of her making.

“It wasn’t something that I wanted to happen. It wasn’t even something that was on my radar to think about,” Vaught said of the speaking requests. “The opportunities just kept presenting themselves.”

The speaking engagements provide her with an income that replaces what she made as a nurse, a career she can never return to. Last year, she told her story more than 20 times, and she is paid $5,000 to $10,000 per event.

But her speaking engagements also provoke criticism. After she told her story at length on Nashville Public Radio’s in March, a retired nurse, Gary Wood, fired off an email to the station. Such medical mistakes could never be justified, he wrote: “It put a stain on a proud and dedicated profession.” Yet, Vaught often finds a receptive audience, eager to hear her perspective.

“I’ve seen her a few times now in person, and I’ve never seen RaDonda tell the story and not be upset,” said Charlene Verga, who invited Vaught to be the closing speaker at the ’s clinical nursing conference last year.

“RaDonda speaking the way she is, she literally is transforming her mistake into a teaching moment,” Verga said.

Vaught expected the speaking gigs would be short-lived. But the reviews were good. And she realized she was comfortable in front of a crowd.

“It was emotionally overwhelming and a little cathartic, but I’m going to tell you, you could have heard a pin drop,” Vaught said of her first talk in 2023 to hundreds of industrial professionals at a meeting organized by , a Knoxville, Tennessee-based company that specializes in root cause analysis.

Vaught has turned her story into a cautionary tale that she hopes will make hospitals safer. She says that humans are going to make mistakes and that systems in healthcare need to be designed so people can fail without killing someone.

“This whole mockery of our healthcare system — people feeling afraid to talk about mistakes and come forward when they happen — it doesn’t save people. It kills them,” she said in a presentation to the .

Onstage, Vaught confronts the painful and embarrassing details directly, often choking back tears when talking about the patient who died — Charlene Murphey.

It wasn’t just one mistake that led to the death.

A doctor had ordered a sedative called Versed to settle Murphey’s claustrophobia before an imaging procedure. Vaught typed “VE” into the search function to retrieve Versed from the electronic medicine cabinet. When it did not dispense, she overrode the system.

In Vaught’s trial, fellow nurses testified that during a time when the hospital was upgrading some of its technology, they could use overrides to bypass delays.

When Vaught took that step, one of the drug options available was vecuronium, a powerful paralytic. Vaught overlooked multiple warnings about the danger of vecuronium, including on the bottle’s cap, which said “Warning: Paralyzing Agent,” according to court records.

Vaught administered the vecuronium and also left the patient alone.

While not disputing most of the facts, Vaught pleaded not guilty to all charges, claiming there were other factors, such as a new electronic health record system that was causing widespread problems in the hospital. A lead investigator for the prosecution testified in the criminal case that Vanderbilt also shared some responsibility.

As previously reported by ºÚÁϳԹÏÍø News, Vanderbilt did not initially report the error to regulators as required and told the medical examiner that the patient died of natural causes. The medical center fired Vaught and negotiated a settlement with the Murpheys that keeps the family from talking publicly about her death.

Once the case became a criminal matter, though, the details entered the public record. Vaught is not bound by the hospital’s settlement, allowing her to share whatever she feels comfortable sharing with whomever she wants.

Vanderbilt spokesperson Craig Boerner declined to comment about Vaught’s public speaking or what the medical center learned from the incident.

The two largest companies that make drug-dispensing cabinets, Omnicell and BD, have updated their machines with recommendations from the . One update requires the user to type in more than the first two letters of a medication to pull up a list of options.

Many hospitals also tweaked their drug administration protocols, such as by requiring wristband barcode checks anywhere a patient gets medication in a hospital.

Reacting to Vaught’s case, the state legislature in Kentucky that became law in 2024 providing immunity for on-the-job healthcare mistakes. Support wasn’t just bipartisan. It was unanimous.

Nursing consultant went to nursing school with Vaught and has worked directly with her as a nurse. Vaught’s criminal case inspired him to go to law school, he said. He now plans to help other nurses defend themselves in similar cases, even though he sees the need for accountability.

If it had been up to him, he also would have fired Vaught, Garvey said. He also thinks that the Tennessee Board of Nursing should have taken action immediately. Only after the patient’s death escalated to a criminal matter did the board revisit the case and revoke Vaught’s license.

But the defendants’ side of the story is rarely ever told, Garvey said, because they are advised by their lawyers not to talk.

Now that she has a platform, Garvey said, it’s therapeutic for Vaught. Her talks resonate with anxious nurses across the nation, he said, and promote a much-needed discussion about collective responsibility.

“We can’t change what happened. We can only change what we do moving forward,” Garvey said. “Having the individual who can tell you the play-by-play — that was there when it actually happened — is incredibly valuable.”

This article is from a partnership that includes ,Ìý, and ºÚÁϳԹÏÍø News.

This <a target="_blank" href="/syndicate/nurse-drug-errors-hospital-safety-radonda-vought-tennessee/">article</a&gt; first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

LISTEN: AI scribes are changing medical care. Here’s what to know if the technology shows up at your next doctor’s appointment.

Family physician Eric Boose has been using an artificial intelligence tool to get back to what he calls “old-fashioned medicine” — talking with patients face-to-face, without having to type into a computer at the same time. 

“I can really just sit there and engage and just focus on them and listen,” said Boose, who . 

Roughly two years ago, he started using an AI notetaker app during patient visits. The tool listens while he talks with patients and then automatically generates a visit summary based on the conversation. The summary is usually ready within seconds after the appointment ends. 

“It’s taking care of all that tedious work of charting and taking notes during the visit,” he said. “It’s just freeing up a lot more time to get that done, and I can get home to my family earlier.” 

Nearly a third of physician practices are using AI scribes and others are working to add the tool, in an effort to cut down on administrative work. 

If your practitioner suggests using an AI scribe at your next appointment, here are three things to keep in mind:

1. Clinicians should ask for your permission. 

At the start of an appointment, your doctor might ask something like, “Are you OK if I use an AI scribe to help me take notes during this appointment?” A common practice is to accept verbal, not written, consent from patients before turning the tool on. However, the legal requirements for getting permission to record a patient conversation vary by state. 

Boose said you can ask to pause the AI scribe at any point, especially to discuss something sensitive. And if you decline altogether, your practitioner will likely return to taking manual notes on a computer. 

2. AI scribes make mistakes too, so check their work. 

Like other AI tools, medical scribes can “hallucinate,” or spontaneously add errors into a record. AI scribes can also omit important information or miss context clues within a conversation. 

Clinicians are supposed to review and edit the AI-generated visit summaries before adding them to a patient’s record. As a patient, it’s a good practice to carefully review your visit summary and contact your health provider if you notice errors. 

3. Yes, the AI company could use your data, with limitations. 

Companies and health systems that offer AI scribe tools have access to medical data and are subject to federal standards about how they use and store patient data, under the Health Insurance Portability and Accountability Act, more commonly known as HIPAA. 

They may use data from your appointment to help improve their software without informing you, said Darius Tahir, who reports on health technology for ºÚÁϳԹÏÍø News. “ If information is ‘de-identified,’ which can mean stripping it of identifiers [and] making sure it’s not personally traceable back to people, then it is more free to be used in more ways,” he said. “There are way fewer regulatory requirements.” 

If you want to know how your data is being used, ask either your practitioner or medical system for more information. But you might not get a clear answer, Tahir said. 

People and Policy 

The U.S. health care system will likely continue to integrate AI technology into patient care. The Trump administration strongly supports the development and use of AI, especially in health care. In early 2025, President Donald Trump issued  reducing existing regulations on AI to help the U.S. “retain global leadership of artificial intelligence.” In December, the U.S. Department of Health and Human Services released an  stating that the department supports “integrating AI to modernize care and public health infrastructure to improve health at the individual and population levels.” 

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 health care system. It’s a collaboration between Nashville Public Radio and ºÚÁϳԹÏÍø News.

This <a target="_blank" href="/health-industry/healthq-ai-scribes-notetaker-doctor-visit-data-privacy/">article</a&gt; first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

LISTEN: Taking a GLP-1? Doctors say don’t forget to move your body and tend to your mental health, too.

Severe ankle pain drove Jelon Smart to start taking a weight loss injection a year and a half ago.

Smart was 285 pounds and worked as a caterer in Savannah, Georgia. After she’d been standing on her feet for long hours, her ankles would be “as swollen as a football,” she said. She was walking with a limp. An orthopedic doctor diagnosed her with Achilles tendinitis and recommended losing weight to mitigate the symptoms. Smart began taking the brand-name GLP-1 Ozempic.

The appetite suppression resulted in her shedding pounds quickly, at first.

“I lost 30 pounds initially without changing anything,” said Smart, 48. But then she found herself unable to shed additional pounds.

GLP-1s have quickly become one of the most popular types of weight loss drug in America. Nearly 1 in 5 people have taken them at some point, , a health information nonprofit that includes ºÚÁϳԹÏÍø News. But doctors say it takes more than a regular shot for patients to achieve their weight goals in the long run.

Here’s what to know.

The Old-School Rules of Weight Loss and Health Still Apply

Regular exercise, smart food choices, plenty of sleep — those basic, healthy lifestyle choices are not only going to help you lose weight on a weight loss drug but also help you keep it off, said Dafina Allen, an  obesity medicine physician who runs a clinic in Saginaw, Michigan. For example, some people find that they eat less on a GLP-1, “but they’re not improving their health because they’re not exercising. They’re not improving the quality of the food they’re eating,” Allen said. The path to weight loss is also guided by hormones, metabolism, and genetics.

After her weight loss on Ozempic plateaued, Smart realized she needed to start moving her body, too.  “I’m in the gym now six days a week,” she said. “I went from 285 to 175” pounds. The swelling and pain in her ankle went away as well.

Mental Health Matters, Too

The mind and body are deeply connected. Food and body image can be especially emotional, Allen said. “I can tell you about the patients that I helped lose 50 pounds, that I helped lose 100 pounds, and they still look in the mirror and are not happy.”

The key is seeking help for mental health along the way, said Gerald Onuoha, who practices internal medicine in Nashville, Tennessee. “Making sure that you’re talking to people about your problems, whether it’s a family member or a licensed professional, I think goes a long way,” he said.

Work With a Doctor To Closely Monitor Your Dosage

Onuoha said people can run into serious problems if they increase their GLP-1 dosage too quickly or don’t follow the recommended schedule. He’s seen patients come to the hospital with pancreatitis, gallstones, or acute kidney injury.  “I always ask patients that are on GLP-1s: How long have they been on them?” he said. “Are they adhering to the directions? Because those things determine whether or not you’re going to have those complications.”

Part of the issue, Allen said, is that GLP-1s are relatively easy to access — and often much cheaper — through online pharmacies or websites, but those providers may not educate patients about their dosage or side effects. “So they might just go online, find a random company that will ship it to their house, where they don’t even know what dose of the medication they’re taking, or even if the medicine is safe for them as the patient with the medical conditions they have,” she said.

People and Policy

GLP-1 drugs can be costly, and most insurance programs — public or private — don’t cover the medications for weight loss. Medicaid, the government program that covers 69 million Americans, covers GLP-1s for medically accepted conditions like diabetes, but only about a dozen state Medicaid programs cover GLP-1s for obesity treatment, . For older Americans with Medicare, the federal government is planning to allow temporary coverage of GLP-1s for weight loss starting in July.

Katherine Ruppelt 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 health care system. It’s a collaboration between Nashville Public Radio and ºÚÁϳԹÏÍø News.

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LISTEN: Your dental insurance might not cover what you expect.

Russell Anthony made eight trips to the dentist last year. The 65-year-old retiree in Nashville, Tennessee, hopes to go less often in 2026, but he’s already made a few visits.

“I had a root canal just last week that was like $500,” he said. “The week before that, I had a crown that cost me several hundred dollars. And as we speak, I have a broken tooth, and I have to go and see the dentist soon.”

In all, Anthony — uncle of HealthQ host Cara Anthony — expects to pay about $2,000 for dental care this year, even though he has dental insurance.

“Trying to weigh the cost of when to go to get dental care and paying for it, versus the other needs that I have, is something that’s very important,” Russell Anthony said.

The American Dental Association reported that had dental insurance in 2021. But that coverage does not necessarily protect against large bills. In fact, 1 in 4 adults with dental insurance reported costs as a barrier to care, according to a by KFF, a health information nonprofit that includes ºÚÁϳԹÏÍø News.

Here are three things to know to better understand your insurance plan and keep your dental costs as low as possible:

1. Even With Dental Insurance, You’ll Have To Pay for Procedures

Dental plans typically cover routine care in full but pay only a portion of additional work. Benefits vary, but many plans follow the “100/80/50” rule, covering 100% of preventive care like cleanings and exams, 80% of basic procedures like fillings and root canals, and 50% of other major procedures.

Plus, dental plans often have a maximum annual payout, usually between $1,000 and $2,000. Patients are responsible for any costs above that. For example, if your plan maxes out at $1,500 and you need $4,000 of dental treatments, you will be on the hook for the difference of $2,500.

2. Facing a Big Dental Bill? You Have Options

It might feel uncomfortable to talk about finances directly with a dentist, but it’s helpful to be up-front about what you can afford.

Many dentist offices offer financial options to help patients manage the cost of care, including pretreatment estimates and payment plans. If you get an estimate that seems especially high, talk through the items and consider getting a second opinion. It never hurts to ask the office for a discount.

If you need a lower-cost alternative, consider looking into dental schools, which often offer discounted care, or , which use sliding scales based on a patient’s income.

3. Seeing Your Dentist Regularly Can Help Keep Costs Low

Sarah Olim, a general dentist in Katy, Texas, encourages her patients to come in for visits every six months.

“The best thing that you can do to mitigate the cost of going to the dentist is make sure that you are going regularly and trying to take care of things early,” she said.

Olim welcomes patients no matter how long it’s been since their last visit. But she cautioned that patients who wait a few years between visits may find their appointments are more expensive and more uncomfortable.

The reason? Dental problems often don’t resolve on their own. For example, a small cavity that needs a quick filling might cost $200. If left untreated, it could turn into a larger issue requiring a root canal and crown — and cost thousands.

Your dentist will also encourage you to follow the best preventive maintenance: brushing your teeth for two minutes twice a day. Olim tells her patients to use a timer or listen to a favorite song to make sure they brush long enough.

People and Policy

Federal lawmakers have tried to increase children’s access to dental insurance. Under the Affordable Care Act, dental care is considered , so health insurance plans on the individual marketplace must offer dental coverage for those 18 or younger. State Medicaid programs are also for children.

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 health care system. It’s a collaboration between Nashville Public Radio and ºÚÁϳԹÏÍø News.

This <a target="_blank" href="/health-care-costs/healthq-dental-care-insurance-large-bills/">article</a&gt; first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

LISTEN: Is it worth it to set up a health savings account? HealthQ has answers.

When Mike McKee thinks about saving money for the future, he has a few priorities. Maxing out his retirement is one. Building up his kid’s college fund is another.

Opening up a health savings account? Not so much, even though he qualifies because of his high-deductible health plan.

“I’m so frustrated with the system that has anything to do with medical savings,” said McKee, 42, a self-employed musician in Nashville, Tennessee. “I’m just so turned off emotionally that I have to be really careful to be logical about it.”

More Americans are eligible to open an HSA — a kind of tax-free savings account that lets them sock away money for medical expenses — after changes that were part of new legislation last year. But an HSA can be a headache to set up and navigate.

Here’s what to know about how they work and when they’re worth it.

Like a Tax-Free Investment Account for Medical Expenses

With an HSA, you set aside money from your paycheck before taxes, and you can use that money to pay for medical expenses later. , including medications, glasses, orthodontia, and many kinds of therapy.

You have options for the money in the account, including investing it. Some people call HSAs a “triple tax advantage”: There are no taxes on the money that goes in, no taxes on any interest earned, and no taxes on the money that comes out for medical expenses.

Pro tip: An HSA is not the same as an FSA, or flexible spending account, even though it sounds similar. An FSA also lets you put pretax income into an account for medical expenses, but you typically lose unspent money at the end of the calendar year. By contrast, HSA money stays in your account until you spend it. Think F for “forfeit” and H for “hold on to.”

The Admin Work of an HSA Can Be a Real Barrier

First, you have to find out whether your health plan allows for an HSA. Most high-deductible health plans do, but with these plans you might have to spend thousands of dollars before most benefits kick in. Starting this year, plans on the individual Affordable Care Act marketplace that are categorized as “bronze” or “catastrophic” are also eligible. (The easiest way to find out whether you qualify is to call the number on the back of your insurance card and ask.)

Then, you have to open the HSA on your own through a financial institution — although if you get health insurance through a job, your employer might have preferred institutions. And finally, you have to keep track of your qualified medical expenses. You pay for them using a special debit card or by submitting claims for reimbursement, usually through an online portal. Either way, it’s smart to hold on to receipts.

People and Policy

If you’re living paycheck to paycheck, you may find it difficult to take advantage of the tax savings that come with an HSA. “HSAs, in this way, tend to benefit more the higher-income enrollees, because those are the ones who have the disposable income to set aside at the end of the month,” said Michelle Long, a policy researcher at KFF, a health information nonprofit that includes ºÚÁϳԹÏÍø News. Plus, people with higher incomes and higher tax brackets have more to gain from getting discounts on their taxes, which is basically what an HSA provides.

Katherine Ruppelt 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 health care system. It’s a collaboration between Nashville Public Radio and ºÚÁϳԹÏÍø News.

This <a target="_blank" href="/health-care-costs/healthq-hsa-health-savings-accounts-insurance-high-deductible-plans/">article</a&gt; first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

LISTEN: If you’re newly pregnant and not able to afford health insurance, you may qualify for Medicaid. Reporters Cara Anthony and Blake Farmer — hosts of the new series “HealthQ” — explain that every state has a program to provide coverage for pregnant people.

When she noticed an unusual craving for hot dogs, Matte’a Brooks suspected her body was telling her something, so she decided to take a pregnancy test. She took two just to be sure. Both were positive.

“I was definitely scared,” said Brooks, 23, who was uninsured. “I was like, OK … I’m pregnant, so where do I go from here?”

Until then she hadn’t thought much about health care, but that changed when she found out that her daughter was on the way.

Brooks got that news last winter. The mix of joy, anxiety, and excitement she felt mirrors what many new parents feel at this time of year. Many Americans find out in January or February that they’re expecting, because in the U.S., August has consistently high birth rates.

A growing body of research shows that prenatal care can make a huge difference to the long-term health of both the parent and baby. This is part of why offers health coverage to pregnant women who meet income requirements and might otherwise go uninsured.

As a result, Medicaid pays for more than 40% of births in the U.S. and an even higher percentage in rural areas, according to KFF. But Medicaid also comes with limitations, and providers may restrict how many Medicaid patients they take, since the payments are than other insurers’.

Here are three things to know about signing up for Medicaid when pregnant.

1. Pregnancy Makes You a Priority

To sign up for government health care, you have to meet a number of requirements that vary widely by state. Most importantly, your income has to be below a certain threshold. In several states, most adults cannot qualify, regardless of income, if they’re not disabled or the parent of a child.

But the math is different for pregnancy. In Tennessee, for example, the eligibility cutoff in pregnancy is the income threshold for some other residents. So if you didn’t qualify for Medicaid previously and are now pregnant, it’s worth double-checking your state’s requirements.

2. Getting Covered Can Be Surprisingly Easy

To apply, you’ll likely proof of income, your Social Security number, and proof of residency. Brooks, an Illinois resident, told HealthQ that she found the sign-up process surprisingly easy. She learned about Medicaid from the provider at her initial prenatal visit.

“They asked if I had insurance. I didn’t know anything at the time,” she said. The nonprofit clinic gave her some phone numbers for the state Medicaid agency. She called and went to an in-person appointment to complete her application. She walked out of the office with coverage. In , pregnancy results in “presumptive eligibility,” which provides immediate coverage — even without confirmation of the pregnancy — while the application goes through the approval process.

3. Coverage Can Go Beyond Standard Medical Care

Medicaid provides all prenatal care at no out-of-pocket cost and usually a of postpartum care. That’s what happened to Brooks: Her appointments, medications, and delivery were free.

States cover dental, vision, and mental health care to varying degrees. Ashley Farrell, who lost her job when she was pregnant and applied to Medicaid in Georgia, said she received “rewards for going to your appointments,” including . Benefits vary by state.

People and Policy

Some maternal health advocates about how Medicaid cuts in the One Big Beautiful Bill Act will affect pregnancy coverage. Though it’s unclear when or how, states might scale back eligibility or offerings for expectant mothers.

Katherine Ruppelt 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 health care system. It’s a collaboration between Nashville Public Radio and ºÚÁϳԹÏÍø News.

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It’s feeding time for the animals on this property outside Nashville, Tennessee. An albino raccoon named Cricket reaches through the wires of its cage to grab an animal cracker, an appetizer treat right before the evening meal.

“Cricket is blind,” said Robert Sory, who is trying to open a nonprofit animal sanctuary along with his wife, Emily. “A lot of our animals come to us with issues.”

The menagerie in Thompson’s Station includes Russian foxes, African porcupines, emus, bobcats, and some well-fed goats.

The Sorys are passionate about their pets and seem to put the animals’ needs before their own.

Both Robert and Emily started 2026 without health insurance.

Robert had been covered through a marketplace plan subsidized through the Affordable Care Act. His share of the monthly premiums was $0. When he looked up the rates for 2026, he saw that a barebones “bronze”-level plan would cost him at least $70 a month. He decided to forgo coverage altogether.

“When you don’t have any income coming in, it doesn’t matter how cheap it is,” he said. “It’s not affordable.”

Dumping Coverage

Marketplace plans from the Affordable Care Act no longer feel very affordable to many people, because Congress did not extend a package of enhanced subsidies that expired at the end of 2025. Last week, the House did pass legislation to extend the expired subsidies, and negotiations have moved to the Senate. Without a deal, an estimated will go without coverage this year.

But even without a health plan, people will still need medical care. Many, like the Sorys, have been thinking through their plan B to maintain their health.

The Sorys both lost jobs in November, within days of each other. Robert worked as a farmhand. Emily worked at a staffing firm and lost her insurance along with her position.

“It’s a horrible, horrible market right now. Really tough,” she said.

The first time she had to pay out-of-pocket for her three monthly prescriptions, the cost was $184.

“To equate that to kind of how we think about it, you’re talking about 350 pounds of food for these animals,” Robert said. He pointed to his bobcats, who eat only meat.

Workarounds for the Newly Uninsured

To keep kibble in the food bowls, the Sorys are prepping for an uninsured future. They see the same psychiatrist and met with him to make a plan. He was willing to work with them by charging $125 per visit. They’ll have to go every three months to keep their prescriptions current.

And if other medical problems emerge? They’re hoping for the best.

“I’m not somebody who gets sick super often, thank God,” Robert said. “And if I do, generally I go to an emergency room where they’re going to bill me later.” Robert said he would arrange a repayment plan for bills like that.

Emily has costly health conditions and has already taken on substantial medical debt. “It’s just sitting there, and I’ve racked up money,” she said. “But I’ve had to go to the doctor.”

Donated Drugs and Sliding Scales

Hospitals and clinics are of newly uninsured patients. They’re also concerned that people won’t know about alternative ways to get medical care.

“We don’t have marketing dollars, so you’re not going to see big billboards or radio ads,” said , CEO of in Nashville. It’s one of the country’s 1,400 federally qualified health centers, also called FQHCs.

FQHCs are by the federal government. Although they do not usually offer free care, their fees tend to be lower or on a sliding scale.

Uninsured people who get care receive a bill, Beard said, “but the bill will be based on their ability to pay.”

FQHCs often have on-site pharmacies, and some offer prescription medications free of charge through a partnership with the , a Nashville-based nonprofit.

Many hospital pharmacies also partner with the nonprofit, which has donated by pharmaceutical companies to 277 sites in 38 states. must make the medicine available free of charge to people without insurance who have annual incomes below 300% of the federal poverty limit.

The organization primarily sources medications for chronic conditions such as high blood pressure, diabetes, and mental health. Demand is expected to outstrip supply in the new year, according to .

“We’re projecting and engaging with our manufacturers and asking them, ‘Are you willing to help support, for this future status that we are anticipating?’” he said. “By and large,” he said, pharmaceutical companies have said they’re willing to step up.

“It’s a continuous conversation that we’re having,” Cornwell said.

A Medicaid ‘Gap’ in 10 States

Hospitals will also have to find a way to care for more patients who cannot pay. Industry groups such as the have been vocal about the threat to hospitals’ financial health and have urged Congress to extend the enhanced subsidies, which take the form of tax credits.

The impact might be most acute in states like Tennessee that have not expanded Medicaid to cover people who work but do not have job-based insurance and cannot afford it on their own.

Ten states have chosen not to expand Medicaid to uninsured, low-income adults — an optional provision of the ACA that is mainly paid for by federal funds.

This Medicaid “gap” is , at the high end of the spectrum, by as much as 65% in Mississippi and by 50% in South Carolina, according to the Urban Institute.

As Emily Sory pets a Russian fox, she admits she is keenly aware that she will soon become part of this growing population. After all, her last job involved health care staffing. Her mother is a nurse.

“I understand the system. And I get it’s people like me that don’t pay their bill are why it suffers. And I feel bad,” she said. “But at the same time, I don’t have the money to pay it.”

This article is from a partnership that includes , , and ºÚÁϳԹÏÍø News.

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Parents in Massachusetts, Texas, Ohio, and Georgia are their districts to revive strict rules on nits and live lice. They blame recent outbreaks on the from the Centers for Disease Control and Prevention that allow students with live lice to remain in class. Before the start of this school year, the Hernando County School District, north of Tampa, Florida, acted to reinstate a policy abandoned in 2022.

“It’s a reinfestation, over and over and over,” said Shannon Rodriguez, who chairs the Hernando school board. In July, she told fellow board members that she’s seen the vicious cycle among families. “What do you do as a parent? Put them back in school with the same kid or kids that are in the classroom who have it? It’s just a never-ending battle.”

Public health officials consider lice a nuisance, not a health threat. Outside of small studies, data collection is scarce. With very little data on infestations, it’s hard to know whether more inclusive policies have anything to do with isolated outbreaks.

The of annual infestations in the U.S. are broad and unreliable since so many cases go unreported. The CDC puts the number between 6 million and 12 million, affecting mostly preschoolers and elementary-age children.

“It really is about education because there are so many myths and so many misunderstandings about lice out there,” said of the chapter in Tennessee. “This isn’t a topic that most people talk about.”

NASN and the American Academy of Pediatrics have supported since at least 2002. But the recommendations were taken more seriously after the covid-19 pandemic affirmed the importance of face-to-face schooling.

“I think that people are starting to realize the value of in-person school and that really anything that takes them out of that should be scrutinized,” pediatrician of told NPR and ºÚÁϳԹÏÍø News. “Head lice is not a valid reason to keep a kid out of school or be dismissed from school.”

Nolt co-authored the issued by the AAP in 2022, which incorporated new research but largely echoed prior recommendations. It discourages widespread lice checks in schools, as published in the Pediatric Infectious Disease Journal found that lice are frequently misidentified, which leads to unnecessary treatment and isolation of lice-free children.

It takes four to six weeks for lice to go from nits to a full-blown infestation. Only then would a child be seen head-scratching uncontrollably, caused by an allergic reaction to the parasites’ saliva.

“Kicking them out on a Wednesday when they’ve been having it for the past four to six weeks is not going to do anything. But it’s going to take that kid out of school and shame that kid and shame that family,” Nolt said. “I just think that’s not acceptable.”

Inclusion is the priority, even if it may inconvenience others or sow financial costs. Over-the-counter remedies, such as creams, gels, or shampoos, can add up. Professional treatment, which often involves manually picking out lice and nits, can run into the per person. And sometimes lice hits an entire household. 

This summer, a preschool outside Nashville, Tennessee, endured its biggest outbreak yet. Roughly a third of the kids at the ended up with lice.

Owner knew the latest recommendations were to play it cool. So she kept everyone in school, and they faced the dreaded four-letter word together. And then she .

“It’s not as bad as you think it is,” Bryson said. “I mean, yes, we had quite a few kids with it, and it went to parents and siblings. But it’s manageable.”

Among the affected families was Stephanie Buck, who also teaches at the day care. Lice ran through her household, requiring pricey treatments to rid them all of the infestation.

Buck said she’s torn about the best approach to combat lice, balancing the shame and stigma with the practical matter of containing an outbreak.

“Because my daughter was really embarrassed when she found out that she was the first one who got checked and she had it,” Buck said. “It’s hard. You want to protect your babies’ hearts, but you also want to keep them from getting lice.”

This article is from a partnership with and .

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Life was upended for LaShonia Ingram over the past year, and a shadow still follows her around.

Search her name online, and the first result includes the words “fraud” and “most wanted.”

“It was horrible. I couldn’t get a job,” said the 42-year-old mother from Memphis, Tennessee. “All doors were being closed in my face.”

Ingram resorted to selling purses out of her trunk to support her family. She said even DoorDash and Uber wouldn’t allow her to work with a felony charge. Her alleged crime? Fraud.

The state of Tennessee accused Ingram of living in nearby Horn Lake, Mississippi, while still enrolled in the state’s Medicaid program, known as TennCare. It all turned out to be a mix-up, but the damage to her reputation and finances was done.

Every state has to investigate Medicaid fraud committed by doctors and other health care providers, since that’s usually where the most money can be recovered. Few states crack down on patients as Tennessee does. Tennessee posts the names and photos of people arrested for alleged fraud on a government website and social media. Some even wind up on a “most wanted” list.

The list is maintained by Tennessee’s Office of Inspector General. The office was launched in 2005 when most of the cases involved drug diversion: People were accused of using TennCare benefits to acquire massive quantities of narcotics to sell on the street. But as federal rules have slowed the illegal prescription drug market, arrests related to Medicaid are instead sweeping up people accused of moving out of state — often within the same community — without canceling their benefits.

Ingram was one of 28 Medicaid beneficiaries in Tennessee charged in 2022, according to the Tennessee OIG; more than a third of them were accused of not being a Tennessee resident, with many cases originating in the Memphis area, where suburbs extend into Mississippi.

In Ingram’s case, Tennessee announced her arrest in a , which said she eluded authorities for nearly a year. Ingram said she didn’t have a clue about the charges until she got a ticket for not wearing her seat belt.

“They pulled me over, and they said, ‘You have a felony warrant.’ And I said, ‘Quit lying,'” she recalled. “I’ve never been in trouble a day in my life.”

It took $2,000 to bond out of jail and even more to hire an attorney. Not until more than six months later did prosecutors show her the evidence so she could refute the charges and clear her name.

The explanation ended up being pretty straightforward. During the time she was on Tennessee’s Medicaid program and living in Memphis, she filed for divorce from her husband who lived nearby in Mississippi. Ingram said they had been separated for years, but her driver’s license still had the outdated Mississippi address.

After her arrest, Ingram showed her Tennessee lease and electric bills, and the Shelby County district attorney dropped the felony charges.

“We try to apply the law compassionately,” , who leads the TennCare OIG, told KHN.

Other states have fraud investigation units focused on patients, but they don’t necessarily name the accused publicly, which happens in Tennessee. For example, keeps the accused anonymous even after they’ve agreed to reimburse the state.

Holman defends Tennessee’s practice of posting a “most wanted” list for its Medicaid program. He said it’s supposed to be a deterrent: “It’s not to blast anyone or defame anyone. It’s to simply take care of the business that’s at hand, hold people accountable, and do what we’re here to do,” he said.

As drug-related cases have diminished, enforcement has increasingly focused on ensuring that people enrolled in TennCare live in the state. In Memphis, 20 of the 27 Medicaid fraud cases since 2019 involved questions of state residency, according to the Shelby County district attorney. And prosecutors have dropped at least a half-dozen of those cases because the evidence was so weak.

Holman said his office won’t overlook low-level offenses.

“This is not murder,” he said. “But the legislature classified it as a felony, and that’s the law that I’m here to enforce.”

Holman acknowledged it costs far more to run the TennCare fraud unit than the office will ever recoup from people on Medicaid, who are usually low-income. Even if the state recovered every dollar from charges brought against beneficiaries in 2022, the total would amount to less than $900,000. The office has a . Since its creation in 2005, the OIG has brought in less than $10 million and charged nearly 3,200 people with fraud, according to its .

The rate of arrests has slowed dramatically. It now arrests fewer people in a year than it previously did in a .

About 1 in 4 Americans are on Medicaid or CHIP — the Children’s Health Insurance Program. The by more than 20 million since early 2020. And for the first time since the start of the pandemic, states will resume and addresses over the next year. Millions of Americans could lose their Medicaid coverage as a result. It’s up to each state to determine who is eligible and how to deal with potential fraud in the program.

, executive director of the Tennessee Justice Center, said policing fraud among TennCare beneficiaries takes time and money that otherwise could be spent on something more helpful.

“It’d be great if our leaders would get out of the ‘gotcha game’ and get into the ‘getting people healthy game,’” she said.

As Medicaid programs restart checks on eligibility, Johnson said, recipients shouldn’t have to worry that a mistake could eventually get them arrested.

Despite her ordeal, Ingram is bouncing back. Still, she has legal bills to pay and has grown more frustrated at being ensnared by the state’s Medicaid dragnet.

“They made a big mistake,” she said.

This story is part of a partnership that includes , , and .

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