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One in seven people who signed up for Affordable Care Act plans this year failed to pay after premium costs rose sharply, according to an analysis that provides the first comprehensive look at the impact of expiring federal subsidies. Nationally, around 14% of those who enrolled in ACA plans this year didn’t pay their first monthly bill for January coverage. In some states, the share was a quarter or more, according to a new analysis from the actuarial firm Wakely Consulting Group, provided exclusively to The Wall Street Journal. (Wilde Mathews, 4/15)

The latest on prescription drug costs —

A prominent physician voice in the House of Representatives has introduced a new bill that would compel insurers to apply the cost for drugs purchased from direct-to-consumer platforms to deductibles and out-of-pocket maximums. North Carolina Republican Greg Murphy, M.D., on Tuesday unveiled the Every Dollar Counts Act, a bill that aims to lower patients' out-of-pocket costs for pharmaceuticals. Murphy, a consistent critic of insurers and pharmacy benefit managers, notes in an announcement that consumers have increasingly embraced DTC offerings as costs rise. (Minemyer, 4/14)

State efforts to regulate pharmacy benefit managers are colliding with federal law, reviving a power struggle over who can police the companies that manage drug benefits for most Americans. (Reed, 4/15)

More news about health care costs and coverage —

The system of paying Medicare agents and brokers more money if they enroll someone in a Medicare Advantage plan rather than traditional Medicare with a supplement plan needs to be changed, according to several members of the Medicare Payment Advisory Commission (MedPAC). (Frieden, 4/14)

���ϳԹ��� News: Medi-Cal Immigrant Enrollment Is Dropping. Researchers Point To Trump’s Policies
For months, a cloud of fear has hovered over the immigrant community in San Bernardino, California, making it hard for María González to do her job as a community health worker in this city where almost a quarter of residents are foreign-born. It started building over the summer, fed by news of immigration raids across Southern California, Trump administration plans to share Medicaid data with Immigration and Customs Enforcement, and the passage of state and federal restrictions on immigrant Medicaid eligibility. Then in November, the federal government released a new “public charge” proposal that, if enacted, could block certain immigrants from obtaining permanent legal residency if they or family members have used public benefits, including Medicaid. (Boyd-Barrett, 4/15)

A new federal class-action lawsuit accuses a company of taking advantage of disabled veterans and their spouses, charging upwards of $20,000 for Veterans Affairs (VA) claims as part of alleged deceptive practices. (Mordowanec, 4/14)

Health systems are increasing their investments in concierge medicine to meet patient demand and keep burned-out doctors practicing. Though typically a small percentage of a health system’s operations, concierge medicine — where patients pay thousands of dollars in membership fees for increased access to primary care physicians — helps diversify revenue and creates growth opportunities in new and existing markets. (Hudson, 4/14)

Policymakers and advocates for decades have touted greater transparency in the healthcare system as a key to unlock major cost savings, with little to show for it. That seems to be changing, employer groups and others say. The trend toward greater price disclosure is accelerating and experts see significant impacts on providers, health insurance companies and government health programs. (McAuliff, 4/14)

���ϳԹ��� News: Listen To The Latest '���ϳԹ��� News Minute'
Zach Dyer reads the week’s news: Rising health costs have some middle-aged adults skipping the doctor until Medicare will pick up the tab. Plus, there’s little evidence that immigrants without legal status are using Medicaid, despite White House claims. (4/14)

The White House is considering selecting Erica Schwartz, who served as deputy U.S. surgeon general during President Donald Trump’s first term, as the new leader of the Centers for Disease Control and Prevention, according to three people who spoke on the condition of anonymity to talk about the planned selection. The potential pick of Schwartz would be the latest attempt to fill a post that has sat largely vacant during Trump’s second term amid political tensions over vaccines and the agency’s role. She left government in January 2021 after the incoming Biden administration told her that she would not be selected to serve as acting U.S. surgeon general. (Diamond and Sun, 4/14)

More vaccine news —

As of July 1, a new law will allow the state of Maryland to determine what vaccines can be administered to individuals at least seven years of age, while also reducing certain out-of-pocket costs for families. Gov. Wes Moore on Tuesday signed the “Vax Act,” officially decoupling the state’s vaccine policy from shifting federal guidelines. (Chingarande, 4/14)

Vaccine skepticism among Americans is widespread, The POLITICO Poll found, indicating that one of Health Secretary Robert F. Kennedy Jr.’s animating priorities is gaining traction. Results from the March poll of 3,851 U.S. adults conducted by Public First show that a plurality of Americans question the safety of vaccines, support reducing the number administered and believe that people’s right to decide what they put in their bodies is more important than preventing the spread of disease. (Gardner, 4/14)

Twenty years after the approval of the first vaccines against human papillomavirus (HPV), studies continue to find new benefits. Although HPV vaccines are best known for preventing cervical cancer in women, a large new study shows that the shots are also associated with a dramatic drop in the risk of HPV-related cancers in men and boys, too. (Szabo, 4/14)

On measles, Valley fever, and drug-resistant shigella —

A measles outbreak in the Sacramento region, the third and largest in California so far this year, has brought the state’s year-to-date measles cases to 39 — far surpassing yearly totals for the last several years. The ongoing outbreak in Sacramento and Placer counties, which began in late February and has grown to 17 cases — including four new cases over the past week — will likely continue another 21 days, the incubation period for measles, state health officials said Tuesday. (Ho, 4/14)

A sustained drop in childhood vaccinations could cost the US about $7.8 billion in measles outbreaks over five years, a new study found. The warning comes as vaccine policy and public confidence face fresh pressure under the second Trump administration. Health Secretary Robert F. Kennedy Jr. has moved to reshape a key federal vaccine advisory panel, raising concerns among public health experts, while the US is already seeing more than 1,700 measles cases this year. (Gale, 4/15)

Coccidioidomycosis, or Valley fever, is increasingly prevalent in California, but cases in children are not as well described as those in adults. Two recent studies describe the clinical features of the disease in pediatric patients and the clinical picture of treatment. (Soucheray, 4/14)

Cases of extensively drug-resistant shigella infections rose from 0% in 2011 to 8.5% in 2023, according to an April 9 CDC brief. Shigellosis is a diarrheal illness caused by bacteria that is spread through fecal-oral transmission and sexual contact. Antibiotics are indicated for severe illness or to reduce high-risk for spread, though most cases are self-limited. Currently, there are no FDA-approved oral treatments available. (Taylor, 4/14)

A federal judge in Oregon ruled Tuesday that a state law requiring insurance plans to cover abortions and contraception violates the Constitutional rights of Oregon Right to Life. The full scope of U.S. District Court Judge Mustafa Kasubhai’s ruling won’t be known until next week at the earliest, though his temporary ruling represents a win for the anti-abortion nonprofit. (Wilson, 4/14)

An Iowa bill that would restrict access to abortion pills by mail drew divided opinions from people during a House Appropriations subcommittee Tuesday, with supporters calling it a safety measure and opponents arguing it would spread misinformation and further limit abortion access. During a packed room Tuesday, Iowans urged lawmakers to either reject or advance the proposal, House File 2563, which focuses on the abortion medications like mifepristone and misoprostol, who can administer the medications, what legal options there are for patients, and more. (4/14)

The group behind a proposed ballot initiative to end Idaho’s strict abortion ban says it is close to qualifying the initiative to be on ballots this November. Idahoans United for Women and Families Executive Director Melanie Folwell said Tuesday that organizers have gathered nearly 100,000 signatures so far.  To qualify for the ballot, the initiative needs at least 70,725 qualifying signatures from Idaho registered voters. Ballot initiative organizers often gather more signatures than needed. (Pfannenstiel, 4/14)

A program that covers the cost for low-income patients seeking reproductive health care in California will run out of money without an amendment in this year’s state budget. (Gurevich, 4/14)

The Justice Department accused the Biden administration of unfairly prosecuting anti-abortion activists the day after it fired at least four attorneys who were involved in prosecuting those cases. (Luthra, 4/14)

The Trump administration’s mixed messaging on federal family planning funds has anti-abortion groups simultaneously outraged and optimistic, after the administration rolled out widely divergent goals over a matter of days during the spring Congressional recess. (Cohen, 4/14)

In other reproductive health news —

Seasonal shifts in behavior — not temperature — may subtly influence sperm motility. Whether this variation in sperm quality influences fertility remains to be seen. (Brincat, 4/13)

A new baby gets all the attention, as they should. Eventually, the focus turns to mom, and then to dad. As CBS News New York's Cindy Hsu reports, some fathers may suffer from a form of depression that is treatable. Mental health experts say 1 in 10 men suffer from paternal postpartum depression, and it is not a sign that you don't love your baby or partner. The symptoms in men usually occur during the first year after the baby is born, and they're at higher risk if the mother is suffering from postpartum depression. (Hsu, 4/14)

Kwaneta Harris suddenly developed intense shoulder pain in 2019. Incarcerated in Texas, she began the process of requesting a specialized medical visit, certain she needed to see an orthopedist. Then, she started having heart palpitations and tachycardia, an abnormally fast resting heart rate, and requested a visit to the cardiologist. (McCray, 4/14)

Artificial intelligence-driven chatbots are giving users problematic medical advice about half the time, according to a new study, highlighting the health risks of the technology that’s becoming increasingly integral in day-to-day life. Researchers from the US, Canada and the UK evaluated five popular platforms — ChatGPT, Gemini, Meta AI, Grok and DeepSeek — by asking each of them 10 questions across five health categories. Out of the total responses, about 50% were deemed problematic, including almost 20% that were highly problematic, according to findings published this week in medical journal BMJ Open. (Kan, 4/14)

When Tiffany Davis has a question about a symptom from the weight-loss injections she’s taking, she doesn’t call her doctor. She pulls out her phone and consults ChatGPT. ... Turning to artificial intelligence tools for health advice has become a habit for Davis and many other Americans, according to a Gallup poll published Wednesday. The poll, conducted in late 2025 and backed up by at least three other recent surveys with similar findings, found that roughly one-quarter of U.S. adults had used an AI tool for health information or advice in the past 30 days. (Swenson and Sanders, 4/14)

In a CT scan, coronary artery calcium shows up as distinct, bright pixels. It looks like salt in the pepper of the heart. The more calcium, the higher a patient’s risk of a heart attack. Often, a cardiologist looks for those bright spots on purpose: They’ll grab snapshots of the heart between beats, to get the clearest possible view of the coronary arteries. But calcium is also visible on zoomed-out chest CTs that aren’t synchronized with the heart. (Palmer, 4/15)

In news about health care workers —

The American College of Emergency Physicians (ACEP) and Emergency Medicine Residents' Association (EMRA) are calling for the release of a South Texas doctor who was detained by the Department of Homeland Security (DHS). In a statement, the organizations said they were deeply concerned about the detention of Rubeliz Bolivar, MD, an emergency medicine resident at South Texas Health System in McAllen, Texas, and an ACEP member. (Henderson, 4/14)

When an Alabama man visited a hospital in Florida in August 2024, he reported a pain in his left side, near the spleen. Three days later, he died on the operating table, missing a different organ, his liver, on his right side. A grand jury in Walton County, Fla., on Monday indicted a surgeon, Dr. Thomas Shaknovsky, 44, on a charge of second-degree manslaughter in the death of the patient, William Bryan, the Office of the State Attorney for the First Judicial Circuit said. (Isai, 4/14)

A former longtime University of California, Los Angeles gynecologist at the center of a sexual misconduct scandal that prompted the school to pay $700 million to settle hundreds of claims pleaded guilty Tuesday to sexual abuse charges and now faces 11 years in prison. The plea by James Heaps was unexpected -– earlier this year an appeals court threw out a conviction on the charges and his lawyer said it was only a matter of time before he was exonerated. Instead, the 69-year-old admitted his guilt to 13 felony counts, six of which involved sexually abusing an unconscious person. (Ding, 4/15)

Triage nurse Tammy Scott said she was helping a man with chest pains when she was stabbed in the head. The blow came out of nowhere, she said Monday. She looked around and saw a woman with a butcher knife coming at her inside the SSM Health DePaul Hospital emergency department. (Rieck, 4/13)

More health industry updates —

A state board approved the sale of Franciscan Health Olympia Fields hospital to Prime Healthcare for nearly $7 million on Tuesday despite concerns from some in recent months over Prime’s changes to other Illinois hospitals. (Schencker, 4/14)

The new owners of the shuttered Crozer Health system say they hope to reopen a primary care clinic within nine months — marking the first concrete step toward restoring health care services in Delaware County. Representatives from Chariot Allaire shared that timeline Tuesday evening during a packed town hall at Widener University, where residents pressed for answers about what comes next after the closure of Crozer-Chester Medical Center and other facilities. (Andersen, 4/14)

Fallout continued this week from the abrupt closure of West Suburban Medical Center last month, with the hospital’s owner suing his business partner over eviction notices issued to the hospital, and doctors asking Gov. JB Pritzker to intervene and reopen the facility. (Schencker, 4/14)

Within 15 minutes of meeting then-new Tampa General Hospital President and CEO John Couris, Dr. Peter Chang was sharing his dream of building a command center. ... The Florida-based health system opened its command center in 2019. The Care Coordination Center, or C3, is a sleek, no-nonsense space on the main campus. Screens showing various data points line the front wall. The neutral gray floors are complemented by a black ceiling with exposed piping. C3 uses artificial intelligence-powered applications to track patient status, show bed availability, expedite diagnostic testing and optimize surgical schedules. (Hudson, 4/14)

Lead paint is falling from six Baltimore-area bridges, contaminating waterways, according to the Maryland Department of the Environment (MDE). ... "We are reviewing response plans from the city and SHA and will work with them to be sure they are taking action both short-term and long-term," a spokesperson for the MDE said. "This includes identifying bridges and surrounding areas with peeling lead paint and chips, taking action to prevent more chips from falling, and collecting fallen paint chips that can be a health hazard if ingested and can potentially pollute waterways." (Thompson and Foreback, 4/14)

More environmental health news from across the U.S. —

After Canadian wildfires brought extremely poor air quality to Detroit in the summers of 2023 and 2025, Michigan is updating how it communicates air quality risks to residents this year. The state is streamlining a system that has evolved with the emergence of severe smoke impacts. The state will issue an air quality alert anytime fine particulate matter or ozone levels climb into the federal Air Quality Index’s “unhealthy for sensitive groups,” or orange range, said Jim Haywood, senior meteorologist with the Michigan Department of Environment, Great Lakes, Energy (EGLE). (Allnutt, 4/14)

Belinda Daniels panicked in 2018 when the pediatrician said her 1-year-old son, Jovanni, had lead in his body. The toxic metal could stunt his brain, the doctor told her, but catching it early meant she could prevent more damage. Daniels moved out of her Omaha, Nebraska, apartment that had chipping lead paint. The doctor continued testing Jovanni periodically while Daniels followed instructions on cleaning, handwashing and keeping Jovanni away from contaminated dirt. (Bowling, 4/15)

Tropical Storm Helene’s impact on western North Carolina was felt acutely in the days, weeks and months after the storm, including in the region’s hospitals and clinics. New research shows how pregnant patients and people with anxiety and other health issues turned to emergency departments for treatment when primary care practices were closed. (Atwater, 4/15)

In other state news —

The justices on Colorado’s highest court struggled Tuesday with questions about what happens when a state antidiscrimination law collides with federal threats against people the law protects. (Ingold, 4/15)

As Tennessee State Senators came to the floor on Monday afternoon, about two dozen activists formed a wall in the hallway, singing to the lawmakers. “Whether you’re cisgender “Whether you’re trans “Equal protection is the law of this land.” The group, led by the Tennessee Equality Project (TEP), was there to protest Senate Bill 676, a proposed state law that will likely require doctors to report on transgender related healthcare, ahead of its near-final vote. (Taylor, 4/14)

It's been two months since the state dropped a suit against the federal government that was supposedly delaying the changes that would open health coverage to more than 42,000 children. Why? That's a mystery. (Pedersen, 4/14)

A new preliminary report from a state-funded research group identifies “key pressure points that need to be addressed” to fully implement Iryna’s Law, which passed quickly late last year. The report also outlines some initial recommendations for lawmakers to help address existing gaps in North Carolina’s mental health and criminal justice systems. (Crumpler, 4/14)

Massachusetts’ highest court heard oral arguments Friday in the state’s lawsuit arguing that Meta designed features on Facebook and Instagram to make them addictive to young users. The lawsuit, filed in 2023 by Attorney General Andrea Campbell, alleges that Meta did this to make a profit and that its actions affected hundreds of thousands of teenagers in Massachusetts who use the social media platforms. (Casey, 4/14)

���ϳԹ��� News: Rural Nebraska Dialysis Unit Closes Despite The State’s $219M In Rural Health Funding 
The sun was just warming the horizon as Mark Pieper left his house near his cattle ranch on a crisp February morning. It’s not unusual for the rancher to wake up early to tend to livestock, but at 5:45 a.m. this day his cattle wouldn’t come first. For the past 3½ years, three days a week, Pieper has made an early-morning commute to get dialysis at the nearest hospital. (Zionts, 4/15)

Earlier this year, Naida Rutherford, the coroner in Richland County, South Carolina, was helping investigate what appeared to be a mysterious overdose. The case had many of the hallmarks of a typical fentanyl death. "Every sort of physical manifestation, like the foam coming from the mouth and nose, as if they had an overdose," Rutherford said. "Their blood tested negative for any substance, which was very odd." (Mann, 4/14)

San Francisco will pay $750,000 to a former city employee who says she was wrongly fired after she complained that her boss, the director of the city’s Office of the Chief Medical Examiner, likely threw out a human skull. San Francisco supervisors voted unanimously on Tuesday to approve the settlement, resolving a lawsuit filed by Sonia Kominek-Adachi, a former autopsy technician, in 2024. (McFadden, 4/14)

New Haven, Connecticut's police chief, Karl Jacobson, resigned abruptly after his deputies saw red flags, including missing money. He has pleaded not guilty to embezzling city money to gamble on sports. (Meko, 4/14)

The image looks like a slice of highly marbled flesh, reminiscent of a high-end steak with abundant fine-grained streaks of fat. But that’s not dinner. It’s an MRI scan of the thigh of a 62-year-old woman who obtained 87% of her annual calories from ultraprocessed food. (LaMotte, 4/14)

More on nutrition and weight loss —

Updated for the first time in six years, clinical guidelines for screening and managing cholesterol now recommend earlier screenings — as young as 9 years old — for those with a family history of heart disease, among other standards of care. (Hille, 4/14)

Weight management is often treated as a "middle-age" problem, but new research suggests that the pounds you pack on in your 20s may be the most dangerous of your life. A massive study of more than 620,000 individuals found that the damage from early weight gain is disproportionately high and surprisingly permanent. According to the findings, the younger someone is when obesity sets in, the higher the risk of early mortality. (Quill, 4/14)

For the majority of people who start using GLP-1 medicines with the hope of losing weight, the drugs can feel almost miraculous: Cravings are quieted. Exercise can become easier and more fun. Pounds that stubbornly remained for years finally dissipate. But for a smaller subset of people, the medicines don’t help with weight loss. (Tirrell, 4/14)

It's quite common for people to start on GLP-1 drugs like Ozempic and Zepbound, especially as the diabetes and obesity treatments become more ubiquitous. They're designed to treat chronic conditions, so the medicines are intended for lifelong use; yet a high percentage of people who start them also quit. "We found that fewer than one in four patients remained on a GLP-1 medication after a year," says Dr. Jaime Almandoz, an obesity medicine specialist at the University of Texas Southwestern Medical Center. (Noguchi, 4/15)

The Food and Drug Administration is asking Eli Lilly to gather more safety data on its new weight loss pill, Foundayo, including whether it could be linked to liver and heart problems, according to the approval letter published online Tuesday. Foundayo won FDA approval this month under the Commissioner’s National Priority Voucher, a pilot program intended to fast-track drug reviews. (Lovelace Jr., 4/14)

A major new review found that the timing of exercise can, in some instances, meaningfully influence how that exercise affects us. (Reynolds, 4/16)

More health and wellness news —

As more states legalize recreational marijuana use, here’s what the research says about what cannabis is really doing to your brain. (Klein, 4/14)

If you’re avoiding small talk or casual chats because you think they’ll be boring, you may be missing out on meaningful connections, new research finds. People consistently underestimate how interesting and enjoyable these conversations will be, said Elizabeth Trinh, the study’s lead author and a doctoral student in management and organization at the University of Michigan’s Ross School of Business. (Mantel, 4/13)

The U.S. Food and Drug Administration (FDA) has classified a nationwide recall of multiple cough drop products as a Class II recall, which means they could pose a moderate risk to consumers. According to the FDA’s latest Enforcement Report, the recall falls under a Class II classification, meaning use of the affected products may cause “temporary or medically reversible adverse health effects,” though the likelihood of serious harm is considered relatively low. (Greenwood, 4/14)

Constitutional law on vaccines was long settled. Now, the Supreme Court favors religious exemptions. (Zalman Rothschild, 4/15)

Millions of Americans are experimenting with the drugs. Science can’t keep up. (Julia Belluz, 4/14)

File this under “hiding in plain sight.” Last fall, the Journal of the American Academy of Child & Adolescent Psychiatry issued a so-called expression of concern about a controversial study that was published in 2001 about the widely prescribed antidepressant known as Paxil. (Ed Silverman, 4/15)

I could never forget this patient. I knew him well. I was in my second year of a grueling emergency medicine residency, and he came to the ER often. Each time, he was sent from an outpatient clinic with dangerously high blood pressure. And each time, we treated him and discharged him home. (Uche Blackstock, 4/15)

Connecticut has been at the forefront of patient rights and access to health care, and of evidence- and compassion-based public policy․ And so today, as we again consider legislation to allow medical aid in dying, the question is simple and obvious: should terminally ill adults be permitted to leave this life peacefully and on their own terms, under strict safeguards? (Destiny Jones, 4/15)