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Festering Infections to Untreated Cancer: ICE Detainees Describe Medical Neglect Across US

Rae Ellen Bichell — Tue, 02 Jun 2026 13:00:00 +0000

An Albanian man’s pain grew so unbearable, he said, he pulled out his own tooth as he languished for months in a New Mexico immigration detention center. A Honduran mother of two said she was hospitalized for a heart problem after she was denied blood pressure medications while held in Florida. A said his leg grew purple and swollen from flesh-eating bacteria when staffers at a Vermont facility did not bring him to a scheduled doctor appointment.

Hundreds of detainees across at least 33 states allege in federal suits that immigration detention facilities are failing to provide adequate medical care, an investigation by ��ϳԹ�� News and The Associated Press found. Detainees say they didn’t get medications on time — or at all — for conditions including high blood pressure, diabetes, depression, epilepsy, Parkinson’s, and HIV. Requests for help went unanswered for weeks. Blood sugars rose. Infections festered. Cancers remained untreated. Detainees collapsed and had seizures.

U.S. jails and immigration detention centers have to meet the medical needs of the people in their charge. But the system is sagging under an influx of detentions since President Donald Trump returned to office: More than 75,000 immigrants were being detained by U.S. Immigration and Customs Enforcement , up from around 40,000 a year earlier.

��ϳԹ�� News and AP analyzed thousands of court cases filed since Trump’s second inauguration that use a legal route known as habeas corpus to argue people are being held illegally by ICE. The records offer a rare window into how those detained say, often under penalty of perjury, ICE is handling their medical needs. Reporters also interviewed more than 50 detainees, family members, and lawyers.

The investigation revealed that medical neglect is alleged across the sprawling detention system, including in offices not designed to house people, county jails, and quickly staged sites with nicknames such as “Alligator Alcatraz.”

ICE custody is deadlier than it has been in two decades, researchers wrote in April. The Department of Homeland Security reported 51 people had died in detention since the start of Trump’s second administration — with suicides .

��ϳԹ�� News and AP asked DHS to respond to the findings six days before publication, but it did not provide comment. The department’s acting chief medical officer, Sean Conley, has “it is both policy and longstanding practice for aliens to receive timely and appropriate medical care from the moment they enter ICE custody” and that the agency recruits healthcare professionals to maintain high standards. “This is better, more responsive healthcare than many aliens have ever received in their entire lives,” he has said.

Individual facilities and private prison companies contracting with DHS that responded to requests for comment said they follow ICE standards and detainees receive medical care when it is required. Some said they were unfamiliar with the allegations outlined in court documents; others blamed some detainees for lapses in their medical care.

“I have never seen such disregard or medical neglect like this anywhere,” Vardan Gukasian, a political dissident and former paramedic who spent years behind bars in Armenia, wrote in in March to contest his detention in Henderson, Nevada, as it stretched to 13 months despite health problems.

Madeleine Skains, a spokesperson for the city of Henderson, said medical care is always available at the facility and that the court had not ordered changes to his care.

Last June, as Gukasian experienced the symptoms of uncontrolled high blood pressure — dizziness, a nosebleed, and a headache — his cellmate banged on their door for help.

“When it did not arrive, the rest of the block banged on their doors,” he wrote. Gukasian was hospitalized that day.

‘Brazen Indifference to Really Obvious Problems’

The administration’s mass deportation effort has swept up during routine immigration check-ins, at traffic stops, at their homes, and in hospitals.

About have no criminal conviction. Their immigration proceedings are civil, not criminal.

“I couldn’t understand why they treated me so harshly,” said a father of six in Georgia. He said he was injured while shackled in custody when the vehicle transporting him to an Atlanta facility jolted, throwing him out of his seat and into a metal armrest. His wound became infected with E. coli, he said, because he had to sleep on a dirty concrete floor amid leaking toilets.

Like other detainees interviewed, he spoke on the condition of anonymity; they said they fear for their safety, for the safety of their families, or that speaking out would jeopardize their immigration cases. The AP and ��ϳԹ�� News are not naming anyone identified in court documents without their consent.

Staffers at Stewart Detention Center in rural Lumpkin, Georgia, didn’t adequately respond to that man’s request for medical help, , until he passed out and was taken to a hospital about an hour away. There, he said, a doctor told him he’d narrowly escaped amputation of his left leg. Medical staff found no records of a case matching this description, according to Brian Todd, a spokesperson for CoreCivic, which runs the facility.

The 48-year-old, who moved to the U.S. from Guatemala more than two decades ago, was released in October and is now a legal permanent resident. But he is unsure if he’ll be able to return to his job in construction because, he said, he can no longer lift heavy things due to his injury.

A man in the Atlanta area was injured while in U.S. Immigration and Customs Enforcement custody and developed an E. coli infection. “I couldn’t understand why they treated me so harshly,” says the father of six U.S. citizens, who is now a legal permanent resident but did not want to be named to avoid potential retaliation against his family. (Brynn Anderson/AP)

Some detainees or their lawyers said even basic care was denied: gauze to protect an open foot wound, prenatal care for a high-risk pregnancy, a pillow to ease the pain of sleeping with advanced stomach cancer, sanitary pads for postpartum bleeding.

“I would like to believe the government has the best interest of those it holds in detention for whatever period of time,” Judge Benita Pearson, a federal judge in Ohio, said during a hearing in October concerning a 70-year-old who alleged the government lost her glasses during her arrest. “If one is unable to see due to the loss of glasses when detained, that should be fixed.”

, who worked for ICE and now serves as a special adviser to the American Bar Association, said case law requires the government to treat people in immigration detention with the same care it affords those in traditional jails awaiting trial. But administrators are granted discretion and medical care standards vary.

Detainees are frequently moved across the country, often without warning, interrupting treatment. A woman from El Salvador said she missed a week of HIV medication when she was transferred from Colorado to a county jail in Wyoming.

A Russian man wrote that, while detained in Texas, he saw a gastroenterologist about his painful gallstones and scheduled an appointment with a surgeon. “Unfortunately, I never got to see him, due to my being moved around various detention centers.”

Advocates say that even obvious disabilities, like legal blindness, are ignored.

A detainee who lost one eye and had severe glaucoma in the other required twice-daily drops to maintain what vision remained. But, he said, some days the drops never came.

“Now I can only see a little bit straight in front. It now often looks like I’m seeing through gauze,” the man wrote in a court declaration. “This makes me very afraid that one of these times I am going to open my eyes and not be able to see anything at all.”

He wrote that he was scared he wouldn’t be able to see his infant son grow up.

“It’s just sort of brazen indifference to really obvious problems, things you would have thought absurd a decade ago — like the fact that you can’t see,” the man’s attorney, Brian Hoffman, said. “Before, you could attempt to work with folks on the government side and maybe shame them into doing the right thing. Now, it’s sort of like anything you want done you have to go to court and sue over.”

Even court orders aren’t always enough. One California judge ordered the government to take a man showing signs of prostate cancer to a specialist for diagnosis and treatment. Records show they did not take him.

Lawyers representing ICE told the judge that officials missed the appointment because of an “internal scheduling error.” CoreCivic, which runs that facility, said it was unable to comment on active litigation.

A Surge in Cases

When immigrants file habeas corpus petitions, they exercise a right to challenge unlawful imprisonment that dates to .

More than 40,000 such petitions have been filed during Trump’s second term, fueled by decisions last year to deny bond to many people held on immigration charges. Judges are split on whether that’s legal; the question appears headed to the Supreme Court.

Many habeas claims , but judges typically cite reasons unrelated to the medical neglect described in the petitions, such as detainees’ being held too long before being deported.

The more than 300 medical neglect claims found in this investigation represent a fraction of the problem. The details of habeas corpus cases are often hidden due to a federal rule barring the public from viewing such documents online. ��ϳԹ�� News and AP obtained some documents from courthouses and received records on 4,400 cases from , a project of the nonprofit Immigration Justice Transparency Initiative. But tens of thousands more remain largely inaccessible.

Some judges have written that the habeas process is not how to raise allegations of medical neglect and have declined to release detainees over those claims. Not every detainee who believes they experienced medical neglect files a habeas petition or cites their medical issues if they do.

Jose-Antonio Segismundo’s petition made no mention of being unable to see an oncologist for the cancer in his abdomen while detained for more than seven months at the Florida detention facility known as Alligator Alcatraz and Folkston D Ray ICE Processing Center in Georgia. Medical records in his court filings show he was arrested about five weeks before his scheduled appointment with a cancer specialist.

His wife, Maria Jose Gonzalez, said he didn’t receive any treatment even though she sent his medical records and explained his condition to officials at Folkston. When his stomach pain erupted, often suddenly and intensely, she said, they gave him Tylenol.

Geo Group, which runs Folkston, follows ICE standards and provides healthcare and access to off-site medical specialists when needed, spokesperson Christopher Ferreira said.

This spring, Segismundo, 48, was deported to Mexico, a country he left nearly 30 years ago, Gonzalez said. Now, she said, he will have to restart his search for care in the Oaxacan village where he grew up.

Maria Jose Gonzalez of Wimauma, Florida, holds a photo of her husband, Jose-Antonio Segismundo, who was detained in U.S. Immigration and Customs Enforcement custody for more than seven months in Florida and Georgia before being deported to Mexico. Medical records show he was arrested about five weeks before his scheduled appointment with a specialist to treat his abdominal cancer. (Chris O'Meara/AP)

Watching Loved Ones Deteriorate

Detainees receiving inadequate healthcare have little recourse. The Department of Homeland Security last year gutted the Office of the Immigration Detention Ombudsman. In early May, it shut the office entirely, arguing that Congress didn’t fund it.

Previously, ombudsman staffers could help facilitate medical care or look into complaints of neglect, according to Matt Boles, an immigration attorney in Georgia. Now, he said, there’s no one to call.

Meanwhile, detainees’ families said they feel helpless, making desperate calls to facilities, the government, and their legislators while watching their loved ones deteriorate.

Riya Khan saw her mother get sicker at the California City Detention Facility, which is owned by CoreCivic. When she visited a week after her mother arrived at the facility in the Mojave Desert, Riya said, the 64-year-old woman stumbled into her seat. She was shaking and her breathing was labored.

Masuma Khan came to the U.S. from Bangladesh in 1997. She has no criminal history, her records say, and was detained in October when she showed up for her regular ICE check-in.

For the month she was detained, according to her daughter, she only intermittently received her medications for conditions including high blood pressure, hypothyroidism, and prediabetes. CoreCivic treats chronic conditions in line with applicable medical standards, Todd said.

“Nothing matters more to CoreCivic than the health, safety and well-being of the people in our care,” Todd said.

Khan said she got her asthma medication for the first time two days before she was released and that her eye drops for glaucoma never arrived. Staffers told Khan she needed to buy some of her medications from the commissary but it didn’t stock them, her daughter said.

Before ICE detained Masuma Khan, she made friends with everyone, her daughter said. She had worked for years at Lucky Boy, an iconic Pasadena fast-food restaurant, and in her free time fed birds and left out fruit for bees that visited her apartment’s balcony.

Now she’s too scared to go outside. She still must regularly check in with ICE, and she’s terrified each time.

Masuma Khan (center) waits in line with her attorney Laboni Hoq (left of Khan) to enter a federal building in Los Angeles for an appointment on April 21. (Jae C. Hong/AP)

Khan (second from right in the front row) and her daughter, Riya (fourth from right in the front row), pose with supporters outside a federal building in Los Angeles on April 21. (Jae C. Hong/AP)

Khan (right) came to the U.S. from Bangladesh in 1997 and was detained for a month after she showed up for a regular check-in with U.S. Immigration and Customs Enforcement in October. Here, she hugs her daughter, Riya (left). (Jae C. Hong/AP)

A “Welcome Home” balloon that was left at the front door of Khan’s apartment in Altadena, California, after she was released from an immigration detention facility. (Jae C. Hong/AP)

Khan’s daughter says that her mother has nightmares and is scared to go outside after being held at an immigration detention facility for a month in 2025. (Jae C. Hong/AP)

A Stroke on a Video Call

Previously, detainees with serious medical needs would likely have been released on humanitarian parole, in part to avoid the cost of their care, Vermont attorney Andrew Pelcher said.

In fiscal year 2023 — before the detained population soared — ICE spent more than $390 million on healthcare for detained noncitizens, according to its to Congress. In May, Todd Lyons, then acting director of ICE, said at a conference that the agency had already spent “almost half a billion dollars” on detainee healthcare this year.

Now, under “mandatory detention,” people are staying locked up with serious — and expensive — conditions.

A Romanian citizen underwent several heart surgeries, including an emergency triple bypass in April 2025, before he was arrested in July. As part of his recovery, the 52-year-old was required to take 16 daily medications. While at an ICE field office in Baltimore, his court filings allege, he went two days without any medication before officials moved him to a facility in New Jersey.

He was hospitalized three times while detained, complaining of chest pains — in part, medical records and court documents say, because despite “countless requests,” the detention center did not provide all his medications. Hospital discharge papers cited by his lawyer show he received only eight of the 16 medications after his second release from the hospital.

“Can you please talk to the ICE facility to make sure they give him his medications?” his treatment providers wrote in medical records included in his court filings. “He was admitted last week for chest pain and today he was readmitted again for chest pain secondary to non compliance for medications.”

Several weeks later in August, he had a stroke while on a video call with his daughter, according to court filings. “He was struggling to breathe, and was pointing at his chest where he was again experiencing pain, and suddenly stopped speaking.” His daughter screamed for help through the video monitor, according to his petition. “Eventually an officer came in to assist him and cut the feed.”

The man lost his ability to speak for four days, the document says. He was returned to detention, where he remained until a federal judge ordered his release in November.

Khan holds medication she takes daily. While detained, she says, she only intermittently received her medications for multiple conditions including high blood pressure, hypothyroidism, and prediabetes. (Jae C. Hong/AP)

Impossible Choices

Cassandra Amador waits for the phone to ring every morning, desperate to ask her husband the question that’s woken her up every night for months: “Did you get your medicine?”

Her husband, Pedro Javier Amador Gutierrez, 36, has high blood pressure and depends on the state-run facility in Florida nicknamed “Deportation Depot” to administer the prescriptions that have kept him alive for years. Many mornings, he tells his wife he did not get them.

When she talks to him, she said, he sounds weaker and more scared every day, not like the upbeat man who would take her kids out for ice cream.

“You can hear in his voice how he feels,” she said.

Now, she said, he’s considering returning to Cuba, which he fled because of political persecution, out of fear that he will die in detention without his medicines. Amador and her children would go with him, she said, even though she was born in New Jersey, has never been to Cuba, and doesn’t speak much Spanish.

But he’s already collapsed twice at the Baker Correctional Institution in Sanderson, Florida, his wife said. She’s terrified that the next time, he won’t get up.

Methodology

��ϳԹ�� News and The Associated Press sifted through thousands of immigration habeas corpus claims to find allegations of medical neglect from people detained by U.S. Immigration and Customs Enforcement during the second Trump administration.

Without a comprehensive, publicly available dataset of medical complaints by those in ICE custody, we used immigration habeas corpus claims to identify detainees’ healthcare-related allegations raised in federal court. Although the intended purpose of habeas corpus is to challenge the legality of a petitioner’s detention — rather than conditions of their confinement — these filings sometimes include detainees’ claims of inadequate healthcare.

But habeas corpus filings are not always publicly available. Federal rules restrict how members of the public can access habeas petitions filed by people in immigration detention. For most of these cases, court websites publish only court orders and dockets describing other filings. The initial petitions are available only through in-person visits to federal courthouses across the country. Habeas Dockets, a project of the nonprofit Immigration Justice Transparency Initiative, coordinates a nationwide network of volunteers to gather these petitions and make them available online.

��ϳԹ�� News and AP analyzed the dockets of roughly 33,000 cases filed by detainees from Jan. 20, 2025, through March 2026. The vast majority of cases had only basic procedural information, like dates of court filings and rulings. Only about 4,400 included the original petitions.

We also gathered a few dozen case files from courthouses, lawyers, and the Massachusetts federal district court website, which posts most petitions under a unique standing order.

We ran keyword and semantic searches of court records, including petitions, motions, and orders, for terms and phrases potentially related to medical neglect, such as surgery, medications, inadequate medical care, and treatment for chronic conditions such as diabetes and high blood pressure.

We found about 500 cases potentially alleging medical neglect. At least two reporters reviewed each case manually, yielding more than 300 cases containing specific allegations in sworn filings of delayed, denied, or deficient healthcare.

To be conservative, we excluded dozens of cases that alleged inadequate medical care but lacked specifics, for example a petitioner writing, “I have been sick and don’t get proper treatment,” or a judge noting a petitioner “complains that ICE is ignoring his medical problems.” We also excluded cases in which petitioners claimed only that they were denied special diets, exercise, or other accommodations that they said were key to managing their health conditions, such as a petitioner writing, “I suffer from Parkinson’s and cannot properly exercise,” or claiming that the food provided was unfit for a person with diabetes.

The cases we analyzed were neither randomly selected nor representative of immigration habeas filings nationwide. The claims were not independently verified. Many filings are not publicly available, and not all detainees raise medical concerns in court, so our account of cases represents a limited window into the landscape of claims, rather than a comprehensive picture.

Associated Press journalists Garance Burke, Valerie Gonzalez, and Tim Sullivan as well as ��ϳԹ�� News correspondent Kate Wells contributed to this report.

This report is a collaboration between The Associated Press and ��ϳԹ�� News.

��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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Cheaper, Alternative Health Plans Are Having a Moment, but Critics Urge Caution

Sarah Kwon — Tue, 26 May 2026 09:00:00 +0000

When Melanie Miller saw that her health insurance premium payment was set to nearly triple to $914 a month this year, she stopped shopping on the Affordable Care Act marketplace.

The 59-year-old retired teacher, who recently moved from Ohio to Michigan, now pays $341 a month for a pair of plans, one that covers routine and urgent care and another that pays fixed amounts for hospital stays. Neither meets federal standards for comprehensive coverage.

Though she practices yoga and is healthy, Miller said she still feels “vulnerable.” If she lands in the hospital, her plan pays a flat $2,000, a fraction of the of an average hospital stay.

“I don’t gamble. But I may as well,” she said. “This is gambling.”

Congress’ decision late last year not to extend enhanced marketplace tax credits has boosted the appeal of alternatives to comprehensive insurance — plans like Miller’s, which have lower premiums but don’t meet ACA standards for coverage or consumer protections. Unlike plans sold on the exchanges, these options — some sold by major insurers, others by small companies or nonprofits — can deny claims with few or no legal rights for consumers to appeal. The plans are not required to cover “essential health benefits,” such as preventive care, and can impose annual or lifetime caps on benefits.

There is debate over whether these options help or harm patients. Consumer advocates dismiss them as “junk insurance,” while proponents say restricting alternatives to pricey marketplace plans risks driving up the number of uninsured. Some states, including Kansas and Florida, and the federal government itself have eased regulations on such plans or created incentives to join them, while other states, including California and Massachusetts, have tried to deter enrollment in alternative insurance. Those regulatory guardrails, however, are now being stress-tested as premiums blow out household budgets.

Alternative insurance takes many forms, including short-term policies, which were designed to bridge temporary gaps in coverage and often exclude preexisting conditions, and fixed-indemnity plans, which pay a flat rate per service regardless of how high costs go and are intended for supplemental use. Arrangements in which people pool their money to cover one another’s bills, including faith-based “healthcare sharing ministries,” also provide a cheaper alternative to the marketplace options. Because they are not considered insurance under federal or state law, they are not legally bound to pay for even .

Enrollment data for alternative plans is mostly confidential, but several indicators point to shifts in the market. Recent estimates suggest marketplace enrollment from 2025, and a of people on the exchanges last year found that 5% switched to private, nonmarketplace individual coverage, including plans that don’t comply with the ACA. Covered California, the state’s marketplace, plans to survey former enrollees to find out where they went.

Insurance industry insiders also report that, amid the expiration of subsidies, alternative plans are making a marketing push. Colorado insurance broker Samantha Albritton said that before ACA open enrollment, she saw more marketing from fixed-indemnity plans than in previous years. One healthcare sharing plan, Zion HealthShare, had more than 75,000 members in February — a 50% increase since last June, it said in a statement.

Critics of these alternative plans say the major issues occur when people use them as primary insurance and don’t realize the coverage is inadequate until they need it most. “Humans have bodies that can fail them,” said Amy Killelea, an assistant research professor at Georgetown University’s Center on Health Insurance Reforms.

A Premium Spike Drove Her From the Marketplace. An Alternative Left Her Exposed.

Melanie Miller, 59
Harbor Springs, Michigan

To avoid a $553 monthly premium hike this year, retired teacher Melanie Miller replaced her Affordable Care Act coverage with two alternative plans, one that covers preventive services and another that pays fixed amounts for hospital care. She considers her limited hospital coverage a calculated risk given her good health but is now weighing whether to drop the preventive care policy, given her struggles to find in-network providers in her area. “I have not had a good experience with it,” she said.

Killelea and other health insurance experts say that the fine print on these plans can be difficult to parse and that enrollees don’t have the protections of traditional insurance to fall back on. A found that after reading a summary of a sample short-term policy’s benefits and a disclosure that the plan was not ACA-compliant, only half of participants understood that prescription drugs were not covered.

When Jade Ramsey was 24, she declined insurance from her employer due to the cost of the premiums. After experiencing fatigue and unexplained bruising, she sought low-cost coverage from Southern Guaranty Insurance Company through a policy similar to a fixed-indemnity plan.

Two weeks after enrolling, Ramsey, who lives in Arizona, was unable to walk. An emergency room visit led to a six-day hospital stay and a $143,823 bill in 2021. She was diagnosed with acute lymphoblastic leukemia. Her insurer denied coverage for this and other bills, labeling the cancer a preexisting condition and offering no other recourse after rejecting her appeal, she said.

Those bills landed in collections, and her credit score nose-dived. Ramsey said she once visited the ER with chest pain she attributed to the stress of the six-figure debt. She eventually qualified for Medicaid, and her credit score has since recovered even though she never paid off the debt. She said collection agencies still call, but she ignores them.

Southern Guaranty Insurance Company did not respond to requests for comment.

Proponents of alternative insurance argue that stifling these more affordable options will just increase the ranks of those without any coverage.

“People should be able to spend their own money financing healthcare the way that works best for them,” said Brian Blase, president of Paragon Health Institute, an influential conservative think tank. Paragon pushed for ending the enhanced marketplace tax credits, arguing they fueled improper enrollment by heightening incentives for unscrupulous brokers to sign people up without their knowledge.

Robert Godfrey of Clearwater, Florida, appreciates having choices. When Godfrey’s monthly premium payment was slated to jump from $879 to around $1,250 this year, the 64-year-old hair salon owner switched to a $320-a-month membership with Zion HealthShare. Rarely needing medical care, Godfrey viewed the shift to a cheaper plan as a pragmatic choice. “Thank God I’m healthy,” he said.

Healthy and Outraged by Rising Premiums, He’s Betting on Alternative Insurance

Robert Godfrey, 64
Clearwater, Florida

Robert Godfrey, a hair salon owner, says he doesn’t need healthcare beyond preventive services and has never hit his deductible. So last year, when the expiration of enhanced federal subsidies was going to push his marketplace premium payment up 40% — to around $1,250 a month — he walked away. He called it an “outrageous increase.” Just months away from becoming eligible for Medicare, Godfrey opted for a cheaper alternative: a $320-a-month healthcare sharing plan. These arrangements, in which members pool their funds to cover one another’s medical costs, aren’t legally obligated to pay for expenses.

The Trump administration has relaxed regulations on some alternative plans. Last year, federal agencies Biden-era rules on how long short-term plans could last and how they could be marketed, then a marginal advantage in the competition for a share of $50 billion in federal rural health funding if they followed suit.

In a statement, CMS spokesperson Christopher Krepich said the administration is focused on ensuring “access to affordable coverage options, strengthening competition, and reducing unnecessary regulatory burdens, while maintaining appropriate consumer protections.”

State oversight of alternative insurance is a patchwork. In much of the nation, these plans face few restrictions. Many states, including , , and , have eased limits on short-term plans in the wake of the Trump administration’s moves, allowing them to be renewed for up to three years in total.

In Kansas, lawmakers overrode the governor’s veto to in March providing a tax break for people who enroll in healthcare sharing ministries. In her veto, Democratic Gov. Laura Kelly warned that these ministries are unregulated, “which opens the door to all sorts of fraud and abuse.” Kansas House Speaker Daniel Hawkins countered in a news release that “House Republicans believe families should have more flexibility and more control over their healthcare decisions, not fewer options and higher costs.”

Oklahoma weighed a earlier this year, though it did not pass.

Not all states are friendly toward alternative plans. ban short-term policies or have rules restrictive enough to deter insurers from selling them. California and Massachusetts are among the states with the most stringent rules, banning short-term plans and requiring clear warnings to people considering a healthcare sharing ministry in certain circumstances. Both also tax adults who forgo comprehensive coverage, while subsidizing marketplace premiums to encourage enrollment.

Still, the higher premiums will test these guardrails, said Héctor Hernández-Delgado, a director at the National Health Law Program, which advocates for quality healthcare for low-income people. He worries that consumers lured by the plans’ low prices could “be worse off down the road,” saddled with burdensome medical debt.

Now in remission, Ramsey urges those considering cheaper insurance to do careful research. “Make sure it’s covering what you need to be covered,” she said. “It could be too good to be true.”

Are you struggling to afford your health insurance? Have you decided to forgo coverage? Click here to contact ��ϳԹ�� News and share your story.

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Kennedy Swaps Vaccine Rhetoric for Story Time but Can’t Quite Change the Subject

Amanda Seitz — Fri, 15 May 2026 18:30:00 +0000

Here in Washington, we’ve been hearing about tensions between the White House and one of its most controversial — but, at least in some circles, most popular — figures: Robert F. Kennedy Jr.

Polling of likely voters indicates that the Health and Human Services secretary can be an asset to Republicans when he’s talking about improving the nation’s food supply or labeling ultraprocessed foods. But when he’s talking about removing recommendations for routine childhood vaccinations, he can be a detriment.

So, when I learned Kennedy would be taking his show on the road to my home state of Ohio, where populist figures tend to perform well, I knew I had to be there.

How would a politician who built his reputation seeding widespread doubts about routine childhood immunizations stay away from one of the core messages he’s preached for years?

Well, it turns out, he starts by reading a book about a trash truck to preschoolers.

The trip took us across northern Ohio, from a regenerative farm in Huron owned by two brothers who grow colorful vegetables to the Cleveland Clinic, where Kennedy masked up entering an operating room of a heart surgery patient.

In the end, though, Kennedy couldn’t escape the vaccine talk.

Speaking at the City Club of Cleveland, Kennedy raised doubts about the safety of vaccines that had been — up until last year — universally recommended to prevent hepatitis B, an incurable disease.

He called for parents to “be given that choice” on administering the vaccine to newborns, a remark that gave way to cheers and applause from half the room.

The other half groaned and booed.

When I sat down with the health secretary for a few minutes in an Ohio farmhouse, Kennedy ticked off his accomplishments during his first year in office; redesigning federal nutrition guidelines and defining ultraprocessed foods for the American public were among them.

As his list grew longer, I thought about the mothers I’d talked to over the last year who had become increasingly nervous about taking their infants out in crowded places amid a raging measles outbreak and the growing threat from other infectious diseases.

What was his message for those parents, I asked?

“I would say everybody should be vaccinated — against measles,” Kennedy told me. “But we need to pay more and more attention to chronic disease. All of the vaccine-preventable, infectious diseases put together kill probably 10,000 Americans a year.”

The number of deaths is , according to scientific researchers.

RFK Jr. Swaps Vaccine Talk for Healthy Foods and Reading to Tots in Push To Woo Voters

He tested robotic hands on a heart surgery patient and chewed on microgreens in Ohio, but Health and Human Services Secretary Robert F. Kennedy Jr. couldn’t dodge questions about the Trump administration’s more controversial policies.

By Amanda Seitz May 13, 2026

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License To Deliver: Some Midwives Break the Law To Assist With Home Births

Lisa Rab — Thu, 14 May 2026 09:00:00 +0000

GWINNETT COUNTY, Ga. — In a midwife’s suburban Atlanta home with a playground and chicken coop outside, Madie Collins lay on an examination table while the midwife measured her pregnant belly. Unlike at many a doctor’s office, no crinkly paper sheet covered the table and no antiseptic chill lingered in the air. The room next door, where Collins’ appointment began, was filled with children’s toys and scented candles and warmed by a wood-burning stove.

The certified professional midwife pressed the button on a handheld Doppler ultrasound machine she placed on Collins’ belly. “That’s her heartbeat,” she said to Collins’ 3-year-old daughter, who sat beside her mom as a whooshing sound filled the room. “I think Mommy’s baby’s right here.”

The midwife is not licensed as a nurse. In Georgia, that makes what she’s doing illegal. ��ϳԹ�� News agreed not to identify her by name.

Georgia is one of seven states where delivering babies can earn non-nurse midwives, at minimum, a cease-and-desist letter requiring them to end their careers. In North Carolina, it’s a . In New York, .

Meanwhile, demand for their services is increasing. Intended home births rose by 42% nationally from 2020 to 2024, according to the National Center for Health Statistics, and those births are often overseen by certified professional midwives. In Georgia, they rose by 72%. Midwives who assist with home births typically see clients from prenatal appointments through after childbirth, providing more postpartum checkups than most new mothers receive.

Home births make up nationwide. In the eight states where they were most common in 2024 — Hawai‘i, Idaho, Montana, Pennsylvania, Utah, Vermont, Wisconsin, and Wyoming— they made up 3-5% of births.

As that number rises, midwifery advocates said, regulating the practice with licenses would allow home births to be safer. Free birth — without the help of a skilled professional before or after labor — can be .

“People are going to keep having their babies at home, and they deserve a trained provider,” said Missi Burgess, president of the Georgia chapter of the National Association of Certified Professional Midwives.

For decades, professional midwives have been advocating for laws to legalize and regulate their profession. More lawmakers have supported those efforts in the past 15 years, with 36 states and Washington, D.C., allowing them to get licensed to deliver babies. Last year, a wave of state lawmakers — in Georgia, Mississippi, Nebraska, New York, North Carolina, Ohio, and West Virginia — tried to add their states to the list, although none of their bills has become law.

Certified professional midwives deliver babies in homes or birth centers. Rather than attend nursing school — which many can’t afford — they earn a nationally recognized certificate by attending at least 55 births and demonstrating their knowledge. Nurse-midwives more often deliver babies in hospitals or clinics than in patients’ homes.

Some hospitals and doctors oppose midwife licensing proposals without certain guardrails. The American College of Obstetricians and Gynecologists showing that infants are twice as likely to die during planned births at home or in birth centers as in hospitals, while acknowledging that the data remains limited. It doesn’t account for several factors, including who assisted in the birth.

Still, prominent stories of home births with midwives gone wrong contribute to the skepticism around licensing laws. In 2023, The Washington Post of a licensed midwife who pleaded guilty to felonies in Virginia after an infant death and assisted with home births in Maryland in which two more babies died.

In Mississippi, a bill that would have regulated and licensed professional midwives died after a state senator blocked a vote in the committee he chaired. Democratic Sen. Hob Bryan he didn’t “wish to encourage that activity.”

But midwives said they have a sympathetic ear now in the Trump administration, with its Make America Healthy Again movement. Cassaundra Jah, executive director of the , said she has been on calls with midwifery groups pushing for the Department of Health and Human Services to provide legal protections for them, and some midwives have been in contact with the agency.

HHS spokesperson Emily Hilliard declined to comment on policy proposals but told ��ϳԹ�� News that the administration “regularly meets with a wide range of stakeholders to hear input from the American public.”

Hospitals Want Guardrails

Advocates for the license say allowing certified professional midwives to provide care would help address a shortage of maternity care providers.

“Some midwives are leaving our state,” Rep. , a chiropractor who sponsored the Georgia bill, said during a hearing on the measure last year. “They’re being forced to quit. And now we have a shortage of these providers to take care of our pregnant moms.”

A by the March of Dimes found that 35% of counties in the U.S. have no birthing facility or obstetric provider. Georgia has the 13th-highest maternal mortality rate in the nation, according to the .

After the U.S. Supreme Court’s reversal of Roe v. Wade in 2022 eliminated federal protection for abortion, six-week abortion bans prompted more providers to leave states such as Georgia and Texas. Idaho lost by December 2024, two years after its abortion ban took effect. Doctors who left states with such laws cited fear of prosecution and an inability to provide the standard of care.

Of the 13 states with the fewest maternity care providers per capita, nine had a full or six-week abortion ban as of 2024, .

Licensing midwives won’t solve the larger maternity care shortage, but it’s a first step, said , a professor of midwifery and the principal investigator at the Birth Place Lab at the University of British Columbia. Certified professional midwives currently attend only about 1.4% of births in the U.S., according to federal data.

The would have granted certified professional midwives licenses through a state board, allowed them to administer lifesaving medications, and required their services to be covered by private insurance and Medicaid. They would not have needed a physician to supervise them. Without that mandate, giving birth outside of a hospital could be an option for more people.

But the Georgia Department of Public Health and the Georgia Hospital Association opposed the licensing bill, primarily because they wanted more regulations than the midwives were willing to accept — including physician supervision.

Anna Adams, a spokesperson for the hospital association, suggested establishing transfer agreements that required all women planning to have a home birth to register at the hospital first. When a laboring woman is transferred to a hospital, which happens in about , “we have no prior knowledge of this patient,” Adams said. “It’s a tricky situation to inherit when you’re trying to save the mother and the baby without any background.”

Georgia midwives said they planned to bring the licensing proposal back next year.

In early April, three midwives for restricting their ability to practice, arguing that the rules violate the state constitution.

“Every pregnant person should be able to choose where they give birth and with whom,” said Jamarah Amani, a plaintiff in the lawsuit and co-founder of the .

Black women are three times as likely to die during or after childbirth as white pregnant patients. In January, a prominent Black nurse-midwife in South Carolina died after unexpected complications from childbirth.

Today, midwives and their clients are predominantly white, but the home birth rate among Black women rose 42% nationally from 2019 to 2024, according to the Centers for Disease Control and Prevention.

“Ultimately the system has failed us as a people,” said Tina Braimah, a Black nurse-midwife who attended home births for a decade. She then opened a in North Carolina, allowing her to see more clients from a variety of backgrounds. “When the system consistently fails you, you look for other options.”

Becoming Part of the System

Many maternal health researchers say mothers fare better when midwives are a key part of the health system. In 2018, researchers at the Birth Place Lab published a study of all 50 states showing that integrating midwives was associated with better outcomes for moms and babies, including lower rates of infant deaths. Integration involves collaboration among all kinds of midwives and doctors so that patients can easily transfer to or from a hospital. It also involves giving all midwives the authority to practice the full range of their skills, including prescribing lifesaving medication.

A by the National Academies of Sciences, Engineering, and Medicine states that data from other countries suggests home births can be as safe as hospital births for low-risk women who are part of an integrated, regulated system.

Washington state has one of the highest rates of in the U.S., according to the . Its home birth rate is consistently higher than the national rate, while its remains lower than the national average.

One in 5 women report being mistreated during maternity care, according to a . Pregnant patients tend to be more satisfied when midwives lead their care, whether at a hospital, a birth center, or home.

Hannah Haynes gave birth to her first three children in a hospital near her home in Jefferson, Georgia. During the third labor, which was induced, she received a catheter that led to a urinary tract infection and then sepsis, a life-threatening condition. She was separated from her newborn for four days while receiving treatment.

“Something has to change,” Haynes said.

Haynes regrets electing to get induced when it wasn’t medically necessary. She gave birth to her fourth child at home, with the help of a certified professional midwife she trusted. She’s pregnant with her fifth and plans to use the same midwife. She said she won’t deliver at a hospital again.

“I was a little nervous,” Haynes said, because she had heard rumors that midwives didn’t know what they were doing. But after meeting the midwife, “I just felt so confident in her.”

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RFK Jr. Swaps Vaccine Talk for Healthy Foods and Reading to Tots in Push To Woo Voters

Amanda Seitz — Wed, 13 May 2026 09:00:00 +0000

TOLEDO, Ohio — The little boy, dressed in a Toy Story sweatshirt, wrapped himself around the nation’s health secretary.

“What do you guys want to be when you grow up?” Health and Human Services Secretary Robert F. Kennedy Jr. asked a carpet full of preschoolers.

“A dinosaur!” the boy replied, squeezing tighter.

Just weeks ago, Kennedy sat before lawmakers on Capitol Hill and about a dangerous uptick in infectious diseases among American children.

Now, with midterm primaries underway, Kennedy was seated in a toddler-sized chair in Ohio, on a mission to change the subject.

Advised to stay away from the anti-vaccine rhetoric that rocketed him to political stardom, Kennedy has been dispatched by the White House to evangelize about the least controversial — and most popular — parts of his agenda. Republicans hope Kennedy’s “Take Back Your Health” tour will help them hang on to voters, many of whom are deeply .

So there Kennedy was in early May, crisscrossing a strip of northern Ohio that includes one of the few congressional districts that Republicans are confident they can flip in November, rotating through a wardrobe of blue suits and blue jeans.

He inspected the kitchen of a Toledo daycare center, where hundreds of the city’s tiniest residents learn and play through the federally funded Head Start program. Under the careful watch of a surgeon, and with the machine disconnected, Kennedy briefly tested the teaching console of the renowned Cleveland Clinic’s robotic hands with a live patient splayed open for heart surgery in the room. And he munched on pesticide-free squash blossoms from a 400-acre farm.

Kennedy samples microgreens at a Huron, Ohio, farm that rejects chemical use in growing its produce. Reducing the use of chemicals in food production is a goal of many supporters of the Make America Healthy Again movement. (Amanda Seitz/��ϳԹ�� News)

“I am dismantling a corrupt system and replacing it with something better, replacing it with something that actually addresses the declining healthy American population,” Kennedy said from the dining room table of a farmhouse during an exclusive interview with ��ϳԹ�� News. He pointed to what he views as his biggest accomplishments over the past year: pressuring some companies to remove dyes from certain foods, updating nutritional guidance, and defining ultraprocessed foods.

“People are paying attention to what they eat, and the industry is listening; the industry is changing.”

But hundreds of miles from Washington’s partisan interrogations, Kennedy couldn’t escape the uncomfortable contradictions and consequences of the Trump administration’s policies.

Taboo Budget Cuts

The classrooms of the Clever Bee Academy displayed freshly printed posters featuring Kennedy’s “Eat Real Food” slogan and the redesigned food pyramid.

Kennedy came with an offering, a $30,000 federal grant to help the center upgrade its kitchen and community garden.

Perched in front of staff and parents, he distanced himself from a last year that could have been devastating to many of Clever Bee’s young students, most of whom live in poverty: the proposal to eliminate the $12 billion Head Start program.

Most of the students at the Toledo childcare center Kennedy visited live in poverty and rely on the federally funded Head Start program, which the Trump administration proposed eliminating last year. (Amanda Seitz/��ϳԹ�� News)

Classrooms at the childcare center displayed posters featuring the “Eat Real Food” slogan and the redesigned food pyramid. (Amanda Seitz/��ϳԹ�� News)

“We were asked to cut our agencies substantially,” Kennedy said. “The two programs that I went to the wall to protect, and find the money somewhere else, was the Indian Health Services, which is always starved for funding, and Head Start.”

The next day, Kennedy stood before goats on a farm in Medina, Ohio, cared for by people sobering up from drug or alcohol misuse at the Hope Recovery Community.

He was there to promise more investments from an administration that has steeply cut staff and budgets over the past year.

Kennedy, who still attends daily Alcoholics Anonymous meetings to cope with a heroin addiction that gripped him for 14 years, said he hopes to replicate the recovery center’s model nationwide, describing it as an “essential role of government to make sure those services are there.”

Broader access to addiction treatment is part of the Trump administration’s newly released . But recovery advocates are skeptical more people will get help, with millions expected to lose health insurance under Trump’s watch because of rising Affordable Care Act premiums and the nearly $900 billion in Medicaid cuts under the One Big Beautiful Bill Act.

Kennedy dismissed those challenges, pointing to a $100 million investment in addiction treatment services, including sober housing, announced this year.

“We’re trying to make it more accessible,” Kennedy told ��ϳԹ�� News.

Trouble in MAHA Paradise

Rows of beds featuring green and purple microgreens awaited Kennedy at The Chef’s Garden, a Huron, Ohio, farm that rejects chemical use in growing its produce.

The health secretary plucked handfuls and tossed them into his mouth, quickly chewing before a new sample was brought before him.

“We are absolutely thrilled that someone at this level of government cares about how food is grown and where it is coming from,” said Bob Jones Jr., a co-owner of The Chef’s Garden.

Seeing more farmers produce chemical-free leafy greens has topped the wish list of those who support Kennedy and the Make America Healthy Again movement, and many who backed Trump in 2024. But in a move that’s threatening to fracture that constituency, Trump has pushed to protect the production of glyphosate, a weed-killing, potentially cancer-causing chemical commonly sprayed on crops and lawns.

Kennedy with his principal deputy chief of staff, Stefanie Spear, as he munches on pesticide-free produce at The Chef’s Garden in Huron, Ohio. (Amanda Seitz/��ϳԹ�� News)

Though the group MAHA Ohio extols Kennedy’s agenda and endorses candidates aligned with his movement, director Elizabeth Frost acknowledged tensions between MAHA and conservative policies.

The glyphosate issue is an example “where you have the conservative interests to look out for the interests of the industry, and you have your MAHA interest to be cognizant of the downstream health impacts,” said Frost, who volunteered on Kennedy’s presidential campaign.

Some prominent MAHA influencers have suggested that Trump’s White House staffers are stopping Kennedy from implementing more aggressive policies on certain issues, including further limiting vaccine use, a notion he dismissed.

“To say the White House has tied my hands — the only people who could say that are people who haven’t been paying attention for a year,” Kennedy said. “President Trump has let me do more than any HHS secretary in history.”

He added: “The only thing that people in the MAHA movement complain about is the president’s glyphosate order.”

Staying on Message

Republicans consider Kennedy an asset in the recently redrawn northern Ohio congressional district that Democrat Marcy Kaptur has represented for more than 40 years, and which as one of the most competitive in the nation.

Fresh off winning the Republican primary for the district last week, Derek Merrin smiled as he shook hands with Kennedy.

“We discussed protecting Lake Erie, strengthening rural hospitals, and our shared vision to improve food quality,” Merrin later posted on Facebook. “Let’s Make America Healthy Again!”

Still, even with Kennedy under advisement to avoid anti-vaccine rhetoric, the issue found him in Ohio. At a forum in Cleveland, family doctor Patricia Kellner said the best way to prevent hepatitis B is by vaccinating newborns — a recommendation that under Kennedy. She told Kennedy about treating patients with the disease.

“Some of them didn’t know because it can be asymptomatic. Some of them found out when they got liver cancer,” Kellner said. “So why are you opposed to a birth dose of hepatitis B?”

Kennedy responded by suggesting that the hepatitis B vaccine was not safe for babies and was necessary only for certain people.

“Hepatitis B is for high-risk groups like drug addicts or prostitutes, or for promiscuous homosexuals,” he added, eliciting gasps from the crowd.

While the risk of contracting hepatitis B is higher for those who inject drugs or men who have sex with men, the disease can be transmitted in other ways, including through contact with contaminated surfaces or childbirth.

Public health researchers that dropping the universal hepatitis B recommendation will result in hundreds of new infections in children, costing millions of dollars in additional health care costs.

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Low Wages, Empty Plates, Heavy Toll: Rethinking Suicide Prevention

Aneri Pattani — Tue, 12 May 2026 09:00:00 +0000

If you or someone you know may be experiencing a mental health crisis, contact the 988 Suicide & Crisis Lifeline by dialing or texting “988.”

As a teenager, Rei Scott spent several weeks living out of a car with four family members and their dog. Each day, Scott worried about where they would spend the following night.

One day at school, Scott snuck away to the bathroom and called the national suicide hotline.

Scott, who is transgender and nonbinary, explained to the hotline counselor that the family had struggled with poverty for years. They had lived in crumbling homes with water leaks, or a family member’s basement with no privacy. Sometimes the family worried about having enough food. The stress and anxiety were constant, and Scott had been suicidal many times.

The counselor seemed shocked into silence, Scott said. Eventually, the person provided reassurance and kindness.

But what Scott really needed that day a decade ago and many times since was a fix for the economic difficulties that had become an unbearable weight.

“It can definitely help to have someone who can listen, but when you’re struggling to eat and you don’t have a roof to be under, I honestly don’t think words can go as far as you need them to,” said Scott, who now studies social work at Capital University in Columbus, Ohio.

Over the years, Scott has been directed to hospitals and therapists. But those generally don’t address core problems, such as a broken-down car or an eviction notice.

“There’s so many times in my life where I’ve thought if I had $5,000, I wouldn’t even be suicidal right now,” Scott said.

People don’t typically think of suicide as an issue of economics, but it often is.

Decades of research shows that , , , , and make people more likely to kill themselves. Conversely, things that bring down people’s cost of living — such as , , , and — are linked to lower suicide rates.

It makes sense. If someone can cover their basic needs, their life will feel better.

Other countries have been incorporating this understanding into their efforts for some time. But because suicide prevention in the U.S. has historically been seen as a medical issue — the responsibility of clinicians who can provide medication or therapy — economic solutions are frequently left out of the equation.

Some advocates and people with suicidal experiences, like Scott, are trying to change that. They say traditional approaches to suicide prevention haven’t succeeded. For decades, the U.S. has had among high-income countries.

To move the needle, “we all need to be challenged to broaden our aperture, to broaden the lens of what is mental health,” said , a national expert in mental health policy and an adjunct professor at the Stanford University School of Medicine.

The highest-impact interventions may not be adding crisis lines or screening more people in emergency rooms, Miller said, though those can be helpful. If he had to pick one strategy, it would be alleviating poverty.

That “allows us to reconcile and solve for these conditions that put people in places of despair,” he said. “I don’t know what stronger intervention one could possibly have.”

To be sure, suicides also occur among wealthy people. It’s a complex issue and almost never boils down to one reason. For most people, the decision to hurt themselves results from an intricate interplay of biological factors, relationship concerns, finances, trauma or abuse, and access to lethal means. That means suicide prevention requires a variety of approaches.

The argument for including economic policy as one of those approaches, many advocates and researchers say, is that policies affect entire populations. So even a small effect can save a significant number of lives.

Scott, who is transgender and nonbinary, has had suicidal thoughts since childhood. Scott says that’s in part due to a lack of a safe or consistent place to live. (Maddie McGarvey for ��ϳԹ�� News)

‘Economic Uncertainty’ Builds

However, the push for an economic lens on suicide prevention is encountering gale-force headwinds from Trump administration policies.

and the have contributed to economic pressures. Meanwhile, the administration has increased hurdles for safety net programs such as the , often called food stamps, and , the state-federal health insurance program for low-income people. Experts estimate will over the coming years.

The administration has also , saying people who are homeless to receive support. The president’s 2027 budget request, which signals his priorities, that helps low-income people pay for heat and air conditioning.

Research suggests increase people’s risk for suicide.

“Anytime there is economic uncertainty, people will fear for their future and livelihood,” Miller said, and “this last few months have been terrifying.”

Notably, the administration’s actions directly contradict strategies that the promotes as having “the best available evidence to reduce suicide.” No. 1 on the page is “Strengthen economic supports.” It lists SNAP benefits and housing-first policies as examples.

, director of the CDC’s injury center, said the agency doesn’t work on economic policy directly but encourages state and local governments to look at the relationship between health and economics.

The Department of Health and Human Services supports suicide prevention through the 988 national crisis hotline, investments in treatment, and the Rural Health Transformation Program, which states can use to expand mental health care in rural areas, HHS spokesperson Emily Hilliard said.

Alec Varsamis, a spokesperson for the Agriculture Department, said the agency is providing states guidance on SNAP changes and “remains deeply committed to supporting the health and mental well‑being of all Americans.”

It’s too soon to tell how recent actions may affect suicide rates. And given the unique combination of factors at play in each death, it’s challenging to draw direct causal links.

The most recent data available shows nearly 49,000 people died by suicide in 2024 — a slight dip from previous years but still among the highest tolls since the late 1990s.

The concept of suicide prevention writ large has historically drawn bipartisan support, said , a New York University researcher who last year highlighting public policies shown to reduce suicide.

The details are where things get murky. For example, strong evidence suggests that increasing the minimum wage reduces suicides. (The is $7.25 per hour, with higher rates in certain states.) But such increases are often a hard sell for lawmakers facing the realities of balancing a budget and small-business owners struggling to stay afloat.

Closely tying suicide prevention initiatives to such politically charged and complicated issues could undermine their chances, Purtle said, adding, “We’ll see suicide get polarized.”

That’s why the focus often stays on areas of agreement, such as funding crisis hotlines.

Kacy Maitland is the chief clinical officer at Samaritans, a Boston-based nonprofit that has operated a suicide crisis hotline for more than 50 years and fields upward of 10,000 calls a month. (Janna Mach)

View From a Crisis Line

is the chief clinical officer at Samaritans, a Boston-based nonprofit that has operated a suicide crisis hotline for more than 50 years and fields upward of 10,000 calls a month, including local calls to 988.

Although people might assume every call is an imminent crisis, Maitland said, many callers are struggling with everyday needs — financial problems, housing concerns, or unemployment.

“Whatever is going on in the world, we absolutely hear about that in real time,” Maitland said.

In November, when during a government shutdown, people affected called Samaritans.

“That in and of itself was a hit to suicide prevention,” Maitland said. “If people don’t have access to eat, to feed their children, to be alive, quite frankly, how are they able to move further through anything else?”

Samaritans volunteers are trained to listen with compassion and make callers feel less alone in what they’re going through. That validation and caring are powerful, Maitland said.

But she often wants to do more, to “dig in and fix” the root issue.

Research supports her instincts. found that increasing the number of people who receive SNAP benefits by 5% could have prevented nearly 32,000 suicides over 15 years. And a $1 increase in minimum wage roughly 8,000 fewer suicide deaths over a decade.

Although Maitland can’t change federal welfare policies, she and her co-workers are applying this approach locally. They recently started an initiative to provide blankets, socks, and water to people living on the streets of Boston.

“Suicide prevention doesn’t always look like a crisis helpline,” she said. “That’s what we imagine it as.” But “having your basic needs is also a form of suicide prevention.”

Scott now studies social work at Capital University in Columbus, Ohio, and wants to help others with mental health challenges. (Maddie McGarvey for ��ϳԹ�� News)

Continuing To Live

In the years since calling the suicide hotline in high school, Scott has turned to a number of resources to help overcome recurring thoughts of suicide. Crisis lines, hospitalization, medication, and therapy have all played a role.

But, Scott said, the biggest impact came from programs that helped fulfill daily needs — for example, a housing program for LGBTQ+ youths and another for former foster care children attending college.

Scott, who now lives close to campus because of the foster care program, said the ability not to “worry about ‘Where am I going to sleep tomorrow night?’” has provided a significant mental health boost.

Although some programs like those are under threat from the Trump administration, Scott is hopeful they will persist and rebuild.

Surviving difficult times has given Scott confidence to persist through more potential challenges ahead.

Despite “the policies and legislation that harm us, we continue to live, and I think that’s really important,” Scott said. “It gives me a lot of hope that things can be different.”

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Medigap Premiums Leap, and Consumers Have Few Alternatives

Julie Appleby — Thu, 23 Apr 2026 09:00:00 +0000

After decades of selling insurance, Illinois-based broker John Jaggi had never seen anything like it.

More than 80 of his customers who were enrolled in the same Medicare supplemental plan from the insurer Chubb got hit last August with a 45% increase.

“In my 49 years of doing biz as a broker, I’ve never seen a premium increase be effective immediately on everyone, instead of on their policy anniversary,” said Jaggi, whose brokerage scrambled to find more affordable options for clients. The policies pick up deductibles and other costs not covered in traditional Medicare, and without one there is no upper limit on how much a consumer might owe each year.

While 45% was an unusually big jump, Jaggi and other brokers say double-digit premium increases for Medicare supplemental, or Medigap, policies are becoming the norm.

A Chubb spokesperson did not respond to requests for comment on the increase.

More than 12 million people — of those in traditional Medicare — buy a Medigap policy. Others rely on some sort of retiree employer coverage or a different backup. About 13% of people in traditional Medicare don’t have supplemental coverage, according to KFF, meaning they could be vulnerable to large costs if they have a serious illness.

In the supplemental market, following big increases last year, rates appear to be rising again. In early 2026 filings with state insurance commissioners from Aetna, Blue Cross Blue Shield, Cigna, Humana, Mutual of Omaha, and UnitedHealthcare, rate increases for Plan G policies — the most commonly purchased supplement type — ranged from just in the first quarter, according to Nebraska-based consulting firm Telos Actuarial.

“While this is a small dataset across a select number of states, it’s an indication that carriers are looking to correct their premium rates in light of upward pressure on their claims experience,” said Brett Mushett, a consulting actuary with Telos.

Climbing Numbers

Premium rates vary based on the type of coverage chosen, where a beneficiary lives, and their age. For Plan G coverage, beneficiaries paid an in 2023, according to KFF. That amount has likely risen since.

“In some states, like Ohio, Medicare supplements for years would have a 3% to 5% year-over-year increase. Now it’s 10% to 15%,” said Amanda Brewton, owner of Medicare Answers Now, a marketing organization whose clients are sales agents.

In Alaska, Premera Blue Cross raised the premiums on its Plan G policies by nearly 12% for this year, according to rate sheets provided to ��ϳԹ�� News by insurance agent Patricia Mack, who said another insurer raised rates by nearly 13%.

For example, a 65-year-old woman who last year would have been charged $172 a month for a Plan G policy would now face a monthly rate of $192, said Mack, who owns Alaska Insurance Benefits in Wasilla.

Premera spokesperson Courtney Wallace said in an email that Medicare makes changes to deductible and copayment rates each year, which affects supplemental plans that cover those increasing amounts.

Wallace also noted that the insurer saw higher medical service use among its members, “which further drove claims costs and ultimately impacted premiums.”

Agents and policy experts blame a range of factors for rising premiums: an increase in the use of medical services by beneficiaries; the aging of the population; increases in labor and medical costs; rules in some states governing Medigap plans; and people’s enrolling in — or getting out of — private Medicare Advantage plans.

“Five years ago, it was exceedingly uncommon to have a carrier with a rate increase of more than 10%. Now it’s very uncommon to see a rate increase below 10%, and it’s not uncommon to see it over 20%,” said Chalen Jackson, vice president for government affairs at Integrity, a Dallas-based company that sells life and health insurance.

Jaggi, who co-owns Jaggi Petry Insurance & Investments in Forsyth, Illinois, along with his daughter, said he eventually found other options for many of those 80-plus clients with the large increase, which came from an insurer that had previously been the lowest-cost option. But it wasn’t easy — and continuing increases are expected.

“These are unbelievable increases,” said Jaggi, who said he is seeing premium hikes exceeding 15% this year across a range of insurers.

Policy experts have outlined possible solutions, including for Congress to cap out-of-pocket costs for Medicare beneficiaries or subsidize the purchase of Medigap coverage.

“Traditional Medicare is the only federal health insurance program without an out-of-pocket cap,” Sen. Ron Wyden (D-Ore.) wrote in an email, adding that the program “needs to be updated and strengthened to protect the Medicare guarantee for American seniors.”

But making changes to Medicare that require congressional approval is unlikely in the current legislative environment, especially because adding an out-of-pocket cap would add costs to the federal budget.

How This Plays Out

People generally qualify for Medicare when they turn 65. Beneficiaries after they initially enroll in the traditional fee-for-service program to purchase a Medigap plan at standard rates without having to answer health-related questions.

Strict rules then kick in around when beneficiaries can enroll in or switch Medigap coverage and options become much more limited, with each one generally involving trade-offs or tough choices.

have what’s known as a “birthday rule,” which requires insurers once a year to allow people enrolled in a Medigap plan to change to different supplemental coverage — usually around their birthdays — without being medically underwritten. Those rules can help consumers, including those with health conditions, to switch.

An additional — Connecticut, Massachusetts, Maine, and New York — require insurers to offer at least one Medigap policy to all applicants either year-round or during an annual enrollment period, depending on the state. Changes are allowed no matter the person’s health.

Another option for those facing high Medigap costs is to leave traditional Medicare and enroll in a private-sector Medicare Advantage plan, which have out-of-pocket caps. But joining one means beneficiaries must generally rely on a set of in-network doctors and hospitals. And if they change their mind and want to go back to traditional Medicare, they have only a 12-month window in which to purchase a Medigap plan without passing health questions. After that, it can be more difficult.

“A lot of people don’t know that if they are in Medicare Advantage for a year, they can get turned down by a Medigap plan or charged really high premiums because of a preexisting condition, which for many people effectively traps them in MA plans,” said , a research associate at the liberal Center for American Progress and co-author of a on the issue.

There are some exceptions. For example, if a Medicare Advantage plan withdraws from a market or leaves the Medicare program, its enrollees can qualify for a supplemental plan without being asked health questions or charged more for having preexisting conditions.

For this year alone, about 2.6 million people when their insurer pulled out of their markets, according to KFF, and more than a million lost coverage for 2025. Many switched to other MA plans, but “somewhere around 440,000 of those people did go to a Medicare supplement policy,” sometimes because there was no other MA plan in their area, said George Dippel, president of Deft Research, a Minneapolis-based market research organization focused on insurance for older people. Deft is part of Integrity, the Dallas company.

Some Medicare experts note that anytime insurers enroll people whose health status they can’t consider — whether because of birthday rules or because their Medicare Advantage plan left the market and thus qualified them for an exemption from medical underwriting — it potentially exposes them to more health care utilization and higher costs, making them more likely to increase premiums across the board to offset the possible financial hit.

Another option mentioned by brokers for people looking to lower their costs is to consider one of the two types of Medigap plans that come with a deductible, which is currently just under $3,000 for a year. Those plans charge far lower monthly premiums than Medigap plans that pick up a much larger portion of annual amounts people must pay toward their Medicare services.

Still, “a lot of people are not comfortable with a $3,000 deductible,” Mack said.

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Farm Bureau Health Plans Beat the ACA on Prices With an Age-Old Tactic: Rejecting Sick People

Michelle Andrews — Thu, 09 Apr 2026 09:00:00 +0000

Robin Carlton pays about $650 a month for a plan on the Missouri health insurance exchange that covers him and his two teenage kids.

That monthly total is $200 higher than what he paid last year, due in part to the expiration in December of covid pandemic-era premium tax credits. But the self-employed St. Louis property manager isn’t in any hurry to investigate a new type of coverage that might be cheaper than his marketplace plan: farm bureau health plans.

“Although I’m not a fan of rising costs, I’m not going to sacrifice coverage for my kids to save a buck,” Carlton said.

Carlton finds himself among a growing number of Americans who have confronted difficult choices because of rising Affordable Care Act premiums and other affordability issues. For instance, a found that many returning marketplace enrollees reported higher costs this year.

In addition, most expressed worry about affording routine and unexpected medical care, as well as the cost of prescription drugs. Worries were greater among those with lower incomes and chronic health conditions. And about 5% of respondents said they had switched to some type of non-ACA coverage.

Health policy experts say such concerns are giving new legs to alternative forms of coverage — for instance, farm bureau plans.

As of this year, that allow health coverage through state farm bureaus, grassroots membership organizations that advocate for the agricultural industry and rural interests. An annual membership in the bureau typically costs $30 to $50, and in many of the states anyone can join. With membership comes the option of buying into the health plan.

Plan details vary by state, but they typically share many features of marketplace plans, including coverage of a wide range of services, a broad practitioner network, and a way to file complaints.

But because states have passed laws exempting from health insurance requirements, they don’t offer many of the coverage protections provided by insurance. That means their benefits and coverage rules may be less generous or predictable than Obamacare plans.

Crucially, farm bureau plans don’t have to accept everyone who applies for coverage. People must pass underwriting first, a process in which plans evaluate applicants’ medical history and health conditions and decide whether to offer them coverage. This practice was routine before the ACA passed, and people were often rejected due to preexisting medical conditions.

Because farm bureau plans can turn down people with expensive chronic conditions or a history of cancer or other medical issues, farm bureau plans may be than unsubsidized marketplace plans, plan managers say.

As people struggle to keep family farms afloat, they may face Obamacare premiums totaling thousands of dollars a month, leading some to forgo coverage, said Missouri Farm Bureau president Garrett Hawkins.

“We’re trying to present another option,” he said.

Sowing Choices

In 2026, with the expiration of enhanced premium tax credits, average ACA premium payments were estimated to for subsidized enrollees who retained their marketplace plan, according to KFF.

Last year, was one of four states that passed laws permitting farm bureau health plans. The others were , , and .

Although the number of states offering them has ticked up in recent years, farm bureau health plans aren’t new. Tennessee has been offering the coverage . Tennessee’s Farm Bureau Health Plans administers the plans in 10 of the 14 states that permit them.

In Missouri, the farm bureau offers with varying deductibles, copayments, and annual limits on out-of-pocket spending. Many of the benefits and cost-sharing amounts look like the coverage someone might get on the state health insurance exchanges or through an employer. They include emergency care and hospitalization, physician office visits, prescription drugs, free preventive care, and dental and vision services. Members have access to providers through the UnitedHealthcare Choice Plus national network.

Hawkins said he’s pleased with the interest the plans are generating. People could apply for coverage through the website starting Jan. 1, and by mid-March, 520 people had submitted applications, he said.

It’s uncertain how many of those people will clear the underwriting hurdle and buy a farm bureau plan, however. Farm bureau health plans can deny coverage for any reason. Even if coverage is offered, plans in Missouri don’t cover any for at least six or 12 months. In addition, plans may exclude coverage of any benefits related to a “known risk” for two to seven years, depending on the issue. So people with a range of conditions, such as diabetes, high cholesterol, heart problems, or successfully treated cancer, may be turned down or have to pay out-of-pocket for any related care for at least a year and possibly as long as seven years.

“People don’t like that we underwrite, but if we did everything like the ACA, we’d be just like an ACA plan,” said , general counsel and chief compliance and privacy officer at Tennessee’s Farm Bureau Health Plans. “We’re trying to be an option for folks that would otherwise not have coverage.”

Staying Rooted in Coverage

Under the Missouri law, once someone is covered by a farm bureau plan, they can’t be kicked off or charged a higher rate if they get sick. That’s also true for the nine other states where Tennessee administers the plans, Beard said.

“We do not contractually have the right to raise premiums or cancel plans based on [an individual’s] health experience,” he said.

And yet, “it can be really confusing to people” because the plans look like insurance products, but they don’t have the same protections, said , principal for policy development, access to, and quality of care at the American Cancer Society Cancer Action Network.

Someone with a history of cancer would be unlikely to get approved for a farm bureau plan in the first place, Howard said. If they were accepted, the services they might need would likely be excluded from coverage, she said.

“We’re just concerned that there’s going to be more people enrolled in these plans now because there’s so many more states that are allowing them,” Howard said.

Carlton, the self-employed property manager, knows firsthand how underwriting can limit coverage options. Before the Affordable Care Act required that anyone be accepted regardless of health status, Carlton, who has diabetes, had to buy coverage through his state’s high-risk pool, which was often the only option for people with preexisting conditions.

Meanwhile, policy experts share Howard’s concerns.

Insurance companies in the ACA marketplaces “have to offer maternity coverage, and they have to give you benefits on day one for a preexisting condition, and they can’t charge you more because you have that condition,” said , vice president for health policy at the Center on Budget and Policy Priorities. This creates an uneven playing field for insurers and drives up premiums for the people who can’t get into farm bureau plans.

Farm bureau plans “get to use, you know, the standard market as a high-risk pool, essentially, if they want to,” Lueck said.

Still, with the huge jump in premiums that many people are facing for ACA coverage, it’s easy to understand the appeal of farm bureau plans.

“I’m not saying it’s a good thing that states have abdicated their regulatory responsibility here,” said , co-director of the Center on Health Insurance Reforms at Georgetown University. “I’m just saying that there are a lot of people out there who are struggling, who need health care, and simply can’t afford the premiums in these ACA marketplaces anymore.”

Are you struggling to afford your health insurance? Have you decided to forgo coverage? Click here to contact ��ϳԹ�� News and share your story.

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Can I Opt Out of Having My Doctor Take Notes With AI?

Katherine Ruppelt, Nashville Public Radio — Tue, 07 Apr 2026 09:00:00 +0000

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 ��ϳԹ�� 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 ��ϳԹ�� News.

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Trump’s Hunt for Undocumented Medicaid Enrollees Yields Few Violators

Phil Galewitz — Tue, 31 Mar 2026 09:00:00 +0000

Last August, as part of the federal government’s crackdown on people in the country illegally, the Trump administration of hundreds of thousands of Medicaid enrollees with orders to determine whether they were ineligible based on immigration status.

But seven months later, findings from five states shared with ��ϳԹ�� News show that the reviews have uncovered little evidence of a widespread problem.

Only U.S. citizens and some lawfully present immigrants are eligible for Medicaid, which covers health care costs for people with low incomes and disabilities, and the closely related Children’s Health Insurance Program. Both programs are administered by states.

Spokespeople from Pennsylvania’s and Colorado’s Medicaid agencies said, as of March, the states had found no one who needed to be terminated from Medicaid. That was after checking a combined 79,000 names.

Texas has reviewed records of more than 28,000 Medicaid enrollees at the Trump administration’s request and terminated coverage for 77 of them, according to Jennifer Ruffcorn, a spokesperson for the Texas Department of Human Services.

Ohio has checked 65,000 Medicaid enrollees, of which 260 people were disenrolled from the program, said Stephanie O’Grady, a spokesperson for the Ohio Department of Medicaid.

In Utah, 42 of the 8,000 enrollees identified by the Trump administration had their Medicaid coverage terminated, said Becky Wickstrom, a spokesperson for the state’s Department of Workforce Services.

In announcing the reviews, Health and Human Services Secretary Robert F. Kennedy Jr. said: “We are tightening oversight of enrollment to safeguard taxpayer dollars and guarantee that these vital programs serve only those who are truly eligible under the law.”

Leonardo Cuello, a research professor at Georgetown University’s Center for Children and Families, said the reviews ordered by the federal Centers for Medicare & Medicaid Services were unneeded because states check immigration status when people sign up.

“It is entirely predictable that all of these burdensome reviews that the federal government is forcing upon states would yield no pay dirt,” Cuello said. “The states had already done the reviews once, and CMS was just making them reverify the same information they had already checked. Making states go through the same bureaucratic process twice is incredibly wasteful and inefficient.”

CMS spokesperson Chris Krepich said in a statement to ��ϳԹ�� News that the ongoing checks are verifying eligibility “for certain enrollees whose status could not be confirmed through federal data sources.”

“CMS provides states with regular reports for follow-up review, and states are responsible for independently verifying eligibility and taking appropriate action consistent with federal requirements,” he said.

But the findings shared with ��ϳԹ�� News also suggest that many of the enrollees whose eligibility the Trump administration said it could not confirm are indeed U.S. citizens. O’Grady said Ohio found that, of the 65,000 names referred by the federal government, the state already had information on 53,000 confirming them as citizens and an additional 11,000 showing appropriate immigration status for Medicaid.

Caseworkers then worked on the remaining 1,000 names to review their information or reach out for more details, she said.

CMS did not answer questions about the findings from the states sampled by ��ϳԹ�� News or provide information about responses it received from all 50 states and the District of Columbia, which were instructed to perform verification checks.

The agency also did not respond to a question about whether it’s forwarding the names of those whose Medicaid coverage was terminated to federal immigration officials.

In June, advisers to Kennedy ordered CMS to share information about Medicaid enrollees with the Department of Homeland Security, prompting a lawsuit by some states alarmed that the administration would use the information for its deportation campaign against residents living in the U.S. without authorization.

A federal judge that Immigration and Customs Enforcement workers could access information only about people in the country unlawfully in the Medicaid databases of the states that sued.

CMS continues to send states lists of names at least every few months, though state officials say the numbers have declined since the first batch last summer.

People without legal status are ineligible for federally funded health coverage, including Medicaid, Medicare, and plans through the Affordable Care Act marketplaces. Medicaid does reimburse hospitals for providing emergency care to people without legal status if they meet income and other program requirements.

Seven states and the District of Columbia provide health coverage regardless of immigration status, funding the programs with their own money.

In March 2025, CMS began financial reviews of those programs. “CMS has identified over $1.8 billion in federal funds that are being recouped through voluntary returns and deferrals of future federal Medicaid payments,” Krepich said. He did not answer how much has been collected so far or from which states.

Medicaid’s overall spending topped $900 billion in fiscal year 2024.

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Farm Bureau Health Plans Beat the ACA on Prices With an Age-Old Tactic: Rejecting Sick People

Can I Opt Out of Having My Doctor Take Notes With AI?

Trump’s Hunt for Undocumented Medicaid Enrollees Yields Few Violators

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