Rachel Spears, Author at ��ϳԹ�� News

Amid Ebola, Hantavirus Outbreaks, Democrats Decry Trump’s Health Cuts

Stephanie Armour — Mon, 01 Jun 2026 09:00:00 +0000

The Trump administration’s 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 that’s 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 he’s 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 administration’s “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 WHO’s global outbreak warning network.

“The Trump administration’s gutting of America’s 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 CDC’s Ebola response, said in a .

Trouble Spots

The criticism isn’t 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 committee’s country director in Congo, .

The federal government’s 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. “It’s making it more difficult.”

The United States’ ability to respond to a real pandemic is “a mess” because of the cuts and the administration’s 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 agency’s 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.

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

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That Discount at the Pharmacy Counter May Pack Hidden Costs

Rachel Spears — Thu, 07 May 2026 09:00:00 +0000

Next time you go to the pharmacy, you might be offered a coupon on your prescription drugs. While it may sound like a great deal — with the prospect of saving hundreds of dollars — the decision to accept it is complicated, especially for people with insurance.

Even as prescription drug costs rise, patients with commercial insurance have slowed their use of manufacturer-sponsored drug coupons in recent years, according to April 6 by the Journal of the American Medical Association.

Manufacturers are offering just as many of them, “but still, we see a lot of affordability issues among this commercially insured population,” said So-Yeon Kang, the study’s main author, who is an assistant professor of health management and policy at Georgetown University.

“Patients are at the intersection and battle place between these payers and manufacturers,” she said.

Drug manufacturers distribute copay coupon cards to consumers online or in person at the pharmacy counter. These manufacturer-sponsored coupons are not the same as discount card services from companies like GoodRx, which negotiate lower bulk pricing for prescription drugs, then pass those savings along to the consumer.

Manufacturers issue the coupons to keep their drugs competitive by offering patients short-term savings. Consumers pay less out-of-pocket, often for brand-name drugs. This encourages patients to use the brand-name version of the drug, even when a cheaper, generic version might be available.

Some insurers say this unfairly puts them on the hook for pricier drugs. They say monthly premiums are higher as a result, punishing consumers and patients, not the manufacturers.

So, should you use manufacturer-sponsored prescription drug coupons when they are offered?

The short answer: It depends.

Here are five things to consider:

1. What if you do not have insurance?

If you are uninsured, using a coupon can be a great way to save money, especially if there is no generic version of the drug.

TrumpRx is a new federally funded initiative that acts as a prescription drug coupon dashboard for patients. Some of the coupons come from manufacturers, while others do not. Not every drug has a coupon offer, but the portal will save consumers money on drugs for those that do, especially in the short term.

Michelle Long, a senior policy manager at KFF who studies patient and consumer protections, said people without insurance can save money by using TrumpRx or manufacturer coupons. (KFF is the health policy research, polling, and news organization that includes ��ϳԹ�� News.)

“I wouldn’t brush it off entirely because it’s got Trump’s name on it,” Long said. “For a lot of people who take certain medications, there really could be some real savings.”

Still, Long said, TrumpRx lists only about 85 drugs, among thousands approved by the FDA. It is important to note that drug coupons have limitations and guidelines. They do not last forever. When they are exhausted, uninsured consumers may have to pay full price for the drug.

2. What if you have commercial health insurance?

For people with insurance, the answer is a little more complicated.

If the drug isn’t covered by your insurance plan or if you intend to pay cash, then the coupon may be the way to go. If not, be wary.

Insurance coverage varies for certain kinds of drugs, such as GLP-1 obesity drugs. Kang’s study found that coupon use by commercial insurance holders on obesity drugs dropped from 54.6% of prescriptions in 2017 to only 2.5% in 2024, even though use of the drugs has been rising in the United States.

She said this reflects the growing number of patients paying cash for the drugs as prices decline, along with insurers’ reluctance to cover them and manufacturers’ shifting focus from coupon distribution to marketing campaigns.

3. What should you do if you expect high medical costs this year?

If you have insurance and anticipate meeting your deductible for the year through health care visits and treatments, consider using the coupons.

Coupons let you pay less out-of-pocket when you visit the pharmacy, but your insurer likely won’t count the value of the coupon toward your deductible. Only use a coupon if there is no generic option available and if you know you’d otherwise hit your deductible.

4. What if you have insurance but low overall medical costs?

The answer will almost always be: Don’t use the coupon.

Unless the drug you are looking for is not covered by your insurance plan, using coupons will put you at risk for higher indirect costs. It’s also often more advantageous to spend toward your deductible.

Watch out for copay adjustment programs that insurers use to discourage the use of drug coupons. They come in two common forms, Long said.

“” allow the use of drug coupons up to their full value, but the amount of the coupon won’t count toward patients’ deductibles or out-of-pocket maximums. That makes it harder for them to reach the threshold at which insurers will pitch in on prescriptions and other medical care. It can also mean a patient will eventually start paying the full cost of the drug because they haven’t yet met their annual deductible.

“Copay maximizers” use a similar technique that also prevents the coupon value from counting toward deductibles. Maximizer programs use a third party to over the course of a year to match the amount of the manufacturers’ coupons.

Insurers sometimes offer the programs to consumers under euphemistic names like “Employee Savings Program” that sound good in theory, but, in reality, take away some of the value of the coupons, Long said.

Initially, consumers will see savings at the pharmacy counter, but they may end up paying more in the long run.

5. What if you’re on Medicaid or Medicare?

Medicare and Medicaid beneficiaries are prohibited from using manufacturer-sponsored coupons.

A federal anti-kickback law makes it illegal to give someone anything of value to influence their decision to purchase something that will ultimately be paid for by a federal health care program. The law also prevents remuneration, which includes waiving copays and charging less than fair-market value for a product.

Manufacturer drug coupons categories.

Some states, notably California and Massachusetts, prohibit or limit the use of manufacturer drug coupons when a generic version of the drug is available — highlighting the tension among manufacturers, health plans, and the government.

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States Rush To Figure Out How To Enforce Trump’s Medicaid Work Requirements

Rachel Spears — Thu, 30 Apr 2026 09:00:00 +0000

State officials remain uncertain on how to enforce a requirement that many adult Medicaid enrollees show they’re working — even as one state launches its program this week — and they’re taking a variety of approaches to the job, including, in a handful of states, using artificial intelligence.

A from 42 states and the District of Columbia offers insights into key policy decisions state officials face as the Jan. 1, 2027, deadline for implementing the work requirement nears. Lingering questions include which diseases and illnesses will qualify Medicaid beneficiaries for exemptions and how to automate compliance verification.

Federal guidance is not expected to be released until June. But some states are moving forward with their own definitions of “medical frailty,” which under congressional Republicans’ One Big Beautiful Bill Act will allow Medicaid enrollees to escape the requirement.

The law, President Donald Trump’s signature domestic achievement, revamps Medicaid in more than 40 states that, along with Washington, D.C., fully or partially expanded the program for low-income people to cover adults without children who don’t get insurance through a job. While most adult Medicaid beneficiaries already work or are disabled, caregivers for other people, or in school, many Republicans contend that people enrolled in the program who don’t work sap resources that ought to support low-income children, pregnant women, and disabled people.

gained Medicaid coverage from the expansion, created by the Affordable Care Act — a law that most Republicans still oppose.

The new work rules require that a person be a student at least part-time or work or participate in other qualifying activities, such as community service, for at least 80 hours each month. The requirement could potentially reshape who is eligible for Medicaid and applies to people who are already enrolled.

The Congressional Budget Office will reduce federal Medicaid spending by about $326 billion over 10 years. The agency also estimates that 4.8 million more people will be uninsured in 2034 because of the work requirement.

“A lot of states are working on a super-condensed timeline,” said Amaya Diana, a policy analyst at KFF who worked on the survey. They are “still making these big decisions with less than a year before implementation.”

KFF is a health information nonprofit that includes ��ϳԹ�� News.

The law permits short exemptions from work requirements for enrollees experiencing certain hardships — natural disasters, residing in a county with a high unemployment rate, admission to a hospital or nursing home, or having to travel for an extended period to obtain medical care.

While 28 states and Washington, D.C., will offer hardship exemptions, three of those states won’t adopt all four exemptions allowed by the law and two — Iowa and Indiana — don’t plan to adopt any.

People can also be exempted from the work requirements if they are “medically frail.” But the federal government has not told states how to define that term or how to determine whether an enrollee falls into the category.

The survey showed that 21 states, as of March, had not defined medical frailty. Nebraska, which is implementing its work requirement May 1, recently issued a list of thousands of health conditions that could qualify enrollees as “frail” and exempt them from working.

Some states plan to allow patients to self-attest to medical frailty, while others will require confirmation by a medical professional. The most common way of verifying medical frailty, which will be used in just over 30 states, is by examining Medicaid claims data.

Mehmet Oz, administrator for the federal Centers for Medicare & Medicaid Services, told ��ϳԹ�� News in an interview this week that “we don’t like self-attesting” and that “documentation is critical.”

Many beneficiaries and their advocates have expressed concerns about losing coverage for administrative reasons. When Arkansas briefly implemented Medicaid work rules, for instance, most lost coverage not because they did not meet the requirements but for failing to correctly submit paperwork in time.

Six states plan to use AI to assist with the work requirement implementation in some way, such as for document processing or comparing beneficiary data from different sources, KFF found. Two states, Maryland and New Mexico, plan to use AI to analyze claims data.

Three states — Arkansas, Missouri, and Oklahoma — plan to use AI to interact directly with people on Medicaid and assist them with identifying and uploading verification documents and data.

Adults on Medicaid will have to reverify that they’re working, or that they’re exempt from the requirement, at least every six months. Some states plan to check quarterly.

When possible, states must use available data sources to verify exemptions or compliance with work requirements.

For example, data from the National Student Clearinghouse will be used by about 10 states to verify school attendance. Some states also plan to tap sources including the Department of Veterans Affairs, AmeriCorps, and service commissions.

But more than half of states told KFF’s researchers that they have insufficient time to add new data sources and cited ongoing costs as a challenge.

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Rachel Spears, Author at ���ϳԹ��� News

Amid Ebola, Hantavirus Outbreaks, Democrats Decry Trump’s Health Cuts

That Discount at the Pharmacy Counter May Pack Hidden Costs

States Rush To Figure Out How To Enforce Trump’s Medicaid Work Requirements

Rachel Spears, Author at ��ϳԹ�� News