For the first time in a quarter century, the U.S. no longer meets a main criterion for having eliminated measles as a public health threat. That status hinges on sporadic outbreaks fizzling out within a year. Utah’s outbreak has lasted for longer, since .

Nearly 400 people have been hospitalized with measles in the U.S. this year and last, three people have died, and at least three suffered with .

This month, the Centers for Disease Control and Prevention is set to finalize a comprehensive study of the nation’s measles situation, examining data from January 2025 through June 2026.

“I don’t think we could say with a straight face that there hasn’t been transmission over the past 12 months,” said a CDC scientist with knowledge of the agency’s measles report. (ºÚÁϳԹÏÍø News agreed not to name the researcher, who is concerned about retaliation.) The researcher said a national committee of measles specialists will review the CDC’s internal report, which then goes to the Pan American Health Organization, a group that evaluates the measles elimination status of countries throughout North, South, and Central America and the Caribbean.

PAHO will make at an annual meeting this fall, but scientists say the writing is on the wall. “The assessment for elimination isn’t until November, but that is a scheduling issue, basically,” said Anne Schuchat, who led the CDC’s immunization and respiratory disease group from 2006 to 2015.

“It’s just so sad, because some people will get brutally ill,” she said of measles’ return. “This is a wake-up call.”

Pediatricians in Utah have been on the front lines as measles and other vaccine-preventable ailments have returned to the U.S. In interviews with ºÚÁϳԹÏÍø News, six doctors shared insights on this new era of vaccine hesitancy — and what could be done to turn the situation around.

The conversations have been edited for clarity.

On Unvaccinated Children Hospitalized With Measles Complications

Emilie Morris, a hospital pediatrician in Salt Lake County and Utah County: When children come in, they’re often bent over. We call it tripoding, which is particular to upper respiratory infections and airway swelling. They have a rash — viruses cause rashes all the time — but in this context, the kid is hunched over, mouth open, drooling, crying, maybe not even producing tears, because they’re so dehydrated. Really labored breathing, kind of tugging in their belly, tugging between their ribs. Their eyes look kind of glazed over. It’s like they’re seeing through you.

Nathan Money, a hospital pediatrician in Salt Lake County and Utah County: If the child has a fever or trouble breathing, and they’re unvaccinated, I have to be way more aggressive from a medical standpoint, because they are at higher risk of having life-threatening illnesses. I have to do more blood work, or lumbar punctures to rule out meningitis. I have to do things which are painful, and it’s traumatic for the families.

I tell them, “Because your child doesn’t have vaccines, I have to be more worried about conditions like sepsis or meningitis, so therefore I need to do more workup.” The last thing I want to do is miss something. These are parents who love their children. They always tell me, “Do what you need to do to make sure my child is safe.”

On Treating Unvaccinated Children Hospitalized for Measles

Trahern W. Jones, a pediatric infectious disease specialist based in Salt Lake City: So I’m coming into a room and just hearing the most awful barking cough, just a cough and a high-pitch stridor as the child is trying to breathe. And he’s just coughing so hard it just makes you feel short of breath. He looks like he’s been beaten down for days, but he can’t rest, because the cough keeps him awake.

The parents tell me they’re not anti-vaccine, but in the past, somebody they know had a reaction to a vaccine — or something they thought was a reaction to a vaccine — and so they paused vaccines when the child was a baby. They were planning to catch up later.

In another case, the parent was stunned by how awful it was. I asked them what they knew about measles before their child was sick, and they said the only person who’d ever taught them anything about measles was their grandmother who had taken care of her kids with measles ages ago. That’s something I’ve heard from other parents. It’s such an awful illness. Even the best possible course is going to be one of the worst diseases most children ever go through.

There are multiple facets to it. Physically, the child has been beat down for multiple days by this virus. The parents don’t get to sleep, because they’re nursing their child. Then there’s the emotional component because the parent is regretting not getting the vaccine, not realizing how bad this was, and then feeling deeply ashamed, trying to reconcile with family members who are really upset at them for not getting their child vaccinated.

Morris: One child was from a family that was uninsured because they didn’t feel that they would need to use the medical system. They were faced with the high burden of cost of our healthcare system. The cost was playing into the parents’ decision on whether or not their child should receive necessary medical care. I said something like: “Please don’t go home. Your child needs oxygen. She has pneumonia. We will figure out a way to pay for this, because we acknowledge what we do is expensive.”

On top of that, the parent had several other children in the home who weren’t vaccinated. It was past the period where we could intervene with vaccines to try to prevent infection, so then our recommendation was to quarantine their children at home for 21 days: “Don’t interact with anybody else in your community. Don’t go to the grocery store, even with a mask. Please take this seriously.”

It takes time for parents to understand the level of concern I have, even when their child is physically ill in the hospital requiring ongoing care. It’s pretty indicative of the breakdown of trust between physicians and families. I say, “This is the gravity or severity of your child’s situation and how serious we need to be about protecting other people.”

It’s frustrating. How can I make people understand I have a very genuine concern for their child? And I know they share that concern, but maybe it’s not the same degree of concern, because they don’t understand the illness and how severe it can become.

Money: It’s heartbreaking to see these children struggling to survive when measles could have been easily prevented by a safe mechanism that is readily available and well studied. These are well-meaning parents who love their children, who have gotten bad information from federal leadership or from online sources. The saddest part to me is when I am caring for a child and the parent says, “I didn’t know that this could get so bad.”

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On Conversations With Parents Who Don’t Vaccinate Their Children

Tim Duffy, a pediatrician in Salt Lake County: A lot of families aren’t aggressively anti-vax, but they’re hesitant. Younger parents who grew up in the digital age have done their research — “research” in quotation marks — for months. And they keep getting confirmation of their concerns on social media. They think they’re doing what’s best for their child.

I’ve told families: “You could do nothing I say as a pediatrician. You could sleep your child on their stomach. You could not put them in a car seat or, when they’re older, not use seat belts. You could do nothing I say, and for your individual child, they will probably be OK. But from my standpoint, where I’m taking care of thousands of kids, within a system that takes care of hundreds of thousands of kids, we will have bad outcomes. These children will show up at our facilities, and it’s so sad.”

Pediatrician in southern Utah whom ºÚÁϳԹÏÍø News agreed not to name, because of concerns about harassment after being targeted by anti-vaccine activists in the past: A lot of parents are concerned about autism. I’ve told them that I’d be very concerned if there was any evidence that what we’re doing is causing autism. But if vaccines were causing autism, we should see more cases of autism in vaccinated kids compared to unvaccinated kids, and we’re just not seeing that.

I’ve also had families who say they want to be natural, or that they’re concerned about what is in the shots. A frequently asked question is: “Did you vaccinate your children?” I say that knowing what I know, I’m confident giving this to my kids. They’re all vaccinated.

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On the Influence of Politics on Vaccine Hesitancy

Jones: Vaccines have become a political football. That wasn’t true 20 years ago. But now it’s used to drive a wedge between groups of people, which is unfortunate. Vaccines are one of the main reasons why we don’t have to worry about losing our kids.

Southern Utah pediatrician: People don’t know who to believe. If politics comes up, I tell parents that my messaging on vaccines is not politically motivated. When parents ask about changes to the vaccine schedule, I’m transparent. [In January, the Department of Health and Human Services reducing the number of vaccines given to children. A few months later, a federal judge blocked those changes.]

I’ve said there was a process for the approval of immunizations through ACIP [the Advisory Committee on Immunization Practices], which is made up of scientists, public health experts, and doctors, and all those people were let go, and a new panel was selected. A couple of individuals changed the recommendation outside of the time-tested, evidence-based process for evaluating vaccines. That raises concerns for me as a doctor. I tell parents that the American Academy of Pediatrics, the American Academy of Family Physicians, and several other professional organizations have issued statements saying that these changes are not based on evidence.

Ellie Brownstein, pediatrician in Salt Lake County and president-elect of the Utah chapter of the American Academy of Pediatrics: I avoid talking about politics, but what’s being said has added another layer to our work. One family asked me about changes to vaccine recommendations, so instead of just telling them what immunizations are due, I talk with them about why physicians and researchers have followed a different schedule for years, about the reasoning and the science behind it. I explain that I trust these experts over someone without a lot of experience.

Money: People are not vaccinated, because they’ve lost trust in the medical community. They’re placing trust elsewhere. Rebuilding trust is a complicated process, but it comes from consistent messaging at every level, from the pediatrician to local health departments to community leaders, city leadership, district leadership, religious leadership, educational leadership.

We need consistent messaging from state leadership, which has been pretty absent. I want to see commercials on TV about the safety of the MMR [measles, mumps, and rubella] vaccine and the dangers of the measles, sponsored by my state leadership. I’d like to see this on billboards and in schools, in public buildings and grocery stores. I want to go to a sports event and see messages about the measles and the MMR vaccine. Right now, people have to go out of their way to find information from reputable sources.

We also need policy changes to support vaccination. This train is going in the wrong direction, and it can feel like a helpless situation, because we’re just not seeing the public messaging and leadership that’s needed to turn this around.

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Advice on Talking With Parents Who Don’t Vaccinate Their Children

Jones: Approach them with as much compassion as you possibly can. Ask open-ended questions to learn about their experiences that led them to have these concerns. I think it’s really important to not come down on them, citing facts and figures and pointing to guidelines on why they need to get their kids vaccinated. But try to direct their attention to the fact that you’re a real person with your own real experiences and knowledge. I point out to families that I have my own kids, and I would never recommend something for your kids that I wouldn’t do for mine.

Southern Utah pediatrician: I’ve learned that if you come down hard, you’re going to lose people who need care. My number one goal now is to build bridges and maintain a relationship with families, because that’s what’s going to allow me to convince some of them.

I approach people differently depending on where they are. Parents who are very skeptical or anti-vax will say no when I tell them their child is due for immunizations. I’ll say: “Fine. You guys get to choose. You’re the parents. But I’m curious to know what your reasoning is.” Sometimes they’re just like, “It’s something I’ve decided.” They don’t want to have a conversation.

It’s a good day if I can have a conversation with someone who doesn’t want to vaccinate, even if I don’t convince them. I try to help them think through things rather than shoving anything down their throat. When they’re done talking, I’ll ask, “Can I share my perspectives on this?” Some will say yes enthusiastically, and others will say yes because they’re being polite.

A lot of parents aren’t sure what to do, and those are the people I focus most of my time on. I focus our conversation on their specific concerns, and I’m open about specific side effects that different immunizations can have. For example, I’ll tell them that some children get a fever after a vaccine, which is OK. The fever is not harmful, but it can make babies feel crummy as their body is building up antibodies against viruses and bacteria.

Brownstein: I don’t like the idea of excluding unvaccinated kids from my practice. I know some do that. But what that does is it ends any future discussion. I can’t keep talking with parents about vaccines if I kick them out of my practice, and if these parents find like-minded doctors, this situation will get worse.

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On Being on the Front Lines of Measles’ Comeback in the U.S.

Money: I wish that people could see what I see. Everyone else sees what people post on Instagram. Or they think, “Someone I know had measles when they were a kid and they were fine.” But as a hospital-based pediatrician, I see what happens when things go poorly. I see what happens when children with measles aren’t able to breathe on their own, and they’re in a hospital bed with a cannula in their nose, struggling to breathe, an IV in their arm because they can’t drink on their own. And the child is terrified, and the parents are scared that their child might die.

It’s heartbreaking as a pediatrician and as a father to know that the entire situation could have been easily prevented.

Duffy: Even though parents say vaccination is their choice, I still feel personally responsible if something bad happens that’s preventable, because I feel like I didn’t say the right thing, I didn’t ask the right questions. Maybe I let it drop because of the look on a parent’s face.

Morris: Every pediatrician I know cares so deeply about what they do. Sometimes people forget that we are human beings practicing this discipline, and we bring all our concerns for our community into this space. I’m trying to navigate a lot of complex human emotions, like how it feels to hold grief with a family when something bad happens that was preventable — which is the worst situation, because you think, “Could I have done something differently?”

Jones: I think we’ll see more diseases start coming back that we thought we had gotten rid of. I think it’s going to take dramatic changes to actually prevent those outcomes. I’m not necessarily seeing those changes being done by those in power.

I think of that quote from The Lord of the Rings. It’s something like, you don’t get to choose the time that you’re born into, but you get to choose what you’re going to do about it. And if there’s any comfort that I have, it’s in knowing that there are right decisions to make and that I’m going to make them, and I’m going to help others make them, too.

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .

The ºÚÁϳԹÏÍø News Minute is available every Thursday via direct download or the RSS feed.

July 23

Jackie Fortiér reads this week’s news: Coverage disruptions can have fatal consequences when switching health plans. Plus, more states are shaming employers that use your tax dollars to cover health costs for their low-income workers.

Can’t see the audio player? Visit kffhealthnews.org to listen.

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Can’t see the audio player? Visit kffhealthnews.org to listen.

When Gov. Gavin Newsom, using his , refused to extradite a physician accused of prescribing and mailing abortion pills to a Louisiana woman, he said California would “not ever” allow “extremist politicians” to punish its doctors.

Newsom, who is considering a run for president, has long championed reproductive rights, but state lawmakers in the Democratically controlled California legislature know future governors might not have the same political beliefs.

Republican gubernatorial candidate Steve Hilton, a former Fox News host endorsed by President Donald Trump, has vowed to honor these types of extradition requests from other states if he’s elected, Louisiana “is trying to uphold what its people voted for, and California is undermining it.” His opponent, Democrat Xavier Becerra, has said he would deny the requests.

Legislation advancing in Sacramento is the latest chapter in a tit for tat that’s been happening between conservative and liberal states since 2022, when the U.S. Supreme Court overturned Roe v. Wade, ending federal legal protections for abortion.

by state Assembly member Rebecca Bauer-Kahan, which is being heard in committee, would take some decisions out of the governor’s hands, requiring governors to deny extradition requests for healthcare providers who prescribe abortion medication or administer gender-affirming care. It would also shield anyone in California who helped patients travel to California or another state to receive legal care. While opponents cast “shield laws” as an incursion on other states’ authority, supporters of the bill view it as insurance — even with Becerra leading Hilton 52% to 31%, according to by the University of California-Berkeley Institute of Government Studies.

Newsom spokesperson Marissa Saldivar said the governor doesn’t comment on pending legislation. Hilton and Becerra didn’t return calls for comment.

“Protecting providers from prosecution should not rely on shifting political winds or a single person’s decision,” said Alyssa Sherer, a nurse practitioner who spoke in support of the bill at a Senate committee hearing in June. Sherer is also the medical director at Hey Jane, a telehealth medication abortion provider. 

Thirteen states have banned abortion outright, and 28 other states ban abortion somewhere between six weeks and viability. At the same time, other states that allow abortion have enacted shield laws to protect doctors and nurses from liability when they prescribe across state lines.

People living in states with total abortion bans are increasingly getting abortion pills prescribed via telehealth, from 74,000 abortions in 2024 to 92,000 abortions in 2025, according to the Guttmacher Institute, citing numbers from its Monthly Abortion Provision Study.

Critics of shield laws say that states have a legitimate interest in enforcing their own statutes and that such laws represent an attempt by some states, like California, to nullify the legal decisions of others.

“If California says, ‘We’re not going to honor any other state’s laws. We’re going to ship abortion pills into your states. You can’t have a law that says abortion is illegal,’ I don’t know — that doesn’t seem like a workable situation,” said Greg Burt, who is vice president of the California Family Council and has spoken in opposition to shield laws at the State Capitol.

Twenty-one other states and Washington, D.C., have similar shield laws, but Arizona, California, Michigan, North Carolina, and Pennsylvania’s rely on an executive order, which could be reversed by a successor, according to the Guttmacher Institute.

Amanda Barrow, a senior staff attorney at the Center on Reproductive Health, Law, and Policy at UCLA Law, said passing extradition protections would put California on firmer footing, because an executive order “could be revoked by a governor who is anti-abortion or anti-gender-affirming-care.”

Hilton has said he would do just that if elected.

“Just as I wouldn’t want to see Louisiana coming in and undermining something that we voted for here in California,” the GOP candidate told KQED in January. 

During a , Becerra said he was strident about protecting reproductive rights as the state’s attorney general. “Absolutely no,” Becerra said of allowing California physicians to be extradited. 

This year, Hawai‘i to its existing shield laws. And Oregon , including banning law enforcement from cooperating with out-of-state or federal investigations into care that’s legal in the state.

But Republican legislators in conservative states have cast telehealth visits as an end run around their laws. And some have moved to restrict abortion pill access.

The governors of , , and have signed bills this year that criminalize the sale, purchase, or distribution of medication that induces an abortion. Those states make it a felony to provide medication abortion drugs to people who are seeking to end a pregnancy. The laws impose up to 10 years in prison with potentially tens of thousands of dollars in fines.

Mississippi amended the state’s controlled substances code to add abortion pills as a criminal category. Although the state already prohibits abortion broadly, the measure specifically addresses distribution, which could subject out-of-state providers to prosecution.

In January, Louisiana a California doctor, Remy Coeytaux, mailing abortion pills to a patient. Newsom denied the request. Likewise, New York Gov. Kathy Hochul denied Louisiana’s February 2025 extradition request for a .

Texas has taken a slightly different legal tact. Attorney General Ken Paxton, a Republican running for the U.S. Senate, obtained a default judgment of more than $100,000 against the New York doctor targeted by Louisiana, but a , citing New York’s shield law. Neither Paxton nor Louisiana Attorney General Liz Murrill responded to requests for comment. 

Fear of being charged with a crime for providing quality medical care is contributing to physicians leaving medicine, said Sacramento emergency room doctor Kamara Graham, who is vice president of the California chapter of the American College of Emergency Physicians, which is supporting the bill.

“It’s really conflicting and hard for us to weigh that concern of: Will I get extradited and charged and potentially be taken away from my family? Or do I do the right thing for my patient?” Graham said.

The availability of medication used in most abortions could soon change nationwide. Under the leadership of Health and Human Services Secretary Robert F. Kennedy Jr., the Food and Drug Administration it is conducting a safety review of mifepristone, one of two medications in pill form that is used in most U.S. abortions. The FDA maintains the drug is safe and effective.

If the FDA were to decide that mifepristone is not safe, such a ruling would supersede state laws, even in states where abortion is legal. If mifepristone is restricted, many telehealth groups have said they would switch to using only the other medication, misoprostol.

“The elephant in the room is whether the Trump administration, particularly after the midterms, makes some kind of move to put national limits on access to abortions,” said Mary Ziegler, a law professor at UC-Davis who has written several books on reproductive health law.

“Not everything is something that the legislature can solve for,” Ziegler said, “because there’s some uncertainty about how the federal courts are going to react to all of this.”

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .

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Too sick to work? You may have to prove it. Next year, Medicaid recipients will have to start showing documentation such as a doctor’s note to avoid a new work requirement. ºÚÁϳԹÏÍø News correspondent Sam Whitehead broke down the rule and exceptions on WAMU’s Health Hub on July 1.

Study, work, or volunteer: That’s what many people will have to do to keep their Medicaid starting next year, according to new rules issued by the Trump administration. But consumer advocates worry the new requirements will catch many recipients flat-footed.

ºÚÁϳԹÏÍø News correspondent Sam Whitehead joined WAMU’s Health Hub on July 1 to explain who will be affected, who can get an exemption, and what enrollees can start doing now to prepare.

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .

We’re expecting our first baby boy in end of August. And when I think about what it’s going to feel like to take care of my wife and my new son and my mom, it’s a bit overwhelming.

If you are taking care of a child and you have a parent over 65, you’re among millions across the U.S. in the same life stage.

Nearly a quarter of all American adults — and half of all adults in their 40s — fall into this “sandwich generation” category, . And being in the middle of that sandwich can feel … intense.

“I have kind of prided myself on being self-sufficient. And in this season of life, that’s almost been laughable,” said Jason McAnally, a Nashville father of two who helps care for his aging dad.

HealthQ hosts Cara Anthony of ºÚÁϳԹÏÍø News and Blake Farmer of Nashville Public Radio, both in the sandwich generation themselves, are your approachable guides to an unapproachable healthcare system. In this one-hour special about navigating health and caregiving, they tap researchers, physicians, experts, and their own personal experience to explore:

• Identity: When to start calling yourself a caregiver, and why it matters.
• FMLA: How to start a conversation with your boss about taking federally protected leave from work.
• Kids and mental health: How to know it’s time to take an anxious child to therapy.
• Early-onset cancer: What you need to know about spotting diseases that are on the rise among people under 50.

The HealthQ team acknowledges the messiness, the humor, and the beauty of this season of life. Come on the journey with us.

Can’t see the audio player? Visit kffhealthnews.org to listen.

This installment is part of HealthQ’s reporting on caregiving among the sandwich generation. For more, check out the series archive.

HealthQ is a health series from reporters Cara Anthony and Blake Farmer, approachable guides to an unapproachable healthcare system. It’s a collaboration between Nashville Public Radio and ºÚÁϳԹÏÍø News.

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .

WINSTON-SALEM, N.C. — Some issues, like immigration or student loans, are too divisive to unite Trinity Moravian Church.

“We’ve got quite a spread of political beliefs,” said the Rev. John Jackman, who leads this 114-year-old red-brick church near Winston-Salem’s old textile mills. Conservative Republicans sit with liberal Democrats. Supporters of President Donald Trump mix with his fierce critics. “It’s definitely a purple congregation,” Jackman said.

But four years ago, when Jackman suggested a new church mission to alleviate medical debt for residents of the wider Winston-Salem area, there was no dissent. “This is the easiest money I’ve ever raised,” he said. “All I do is tell people what we’re doing, and they write me a check.”

Few issues have been more politically explosive in recent years than healthcare, pitting Democrats and Republicans in bitter debates over the Affordable Care Act, Medicaid, and other flash points.

Yet moved by the sense that the medical debts their neighbors faced were deeply unfair, members of Trinity Moravian, no matter their politics, rushed to write $25 or $50 checks to pay off the bills.

They helped advance a movement by churches across the state and the country and inspired North Carolina government officials to tackle medical debt. The effort drew plaudits from conservative radio host Glenn Beck.

The little church’s success also highlighted a patch of common ground in American healthcare — widespread anxiety and frustration that so many patients are ending up in debt.

Earlier this year, Trinity wrapped up its eighth medical debt campaign, part of what the church calls its Debt Jubilee Project. This one raised more than $17,000. That helped retire more than $2.2 million in debt. Medical debt can be bought for pennies on the dollar because creditors believe most debts won’t be paid.

Nationwide, an estimated 100 million adults have some form of healthcare debt. More than half of U.S. adults have had such debt at some point.

At Trinity Moravian Church, which has about 200 members, it wasn’t hard to find stories of crushing medical bills.

“I see people going into debt every minute of every day,” said Catherine Coe, who works in the accounting department of a hospital system. “We’re all just one medical bill from financial ruin.”

Coe grew up coming to Trinity with her grandmother. She drifted away from the church as an adult before rejoining the congregation last year. Coe, who describes herself as a conservative, voted for Trump.

Terri Mabe, who’s been coming to Trinity for decades, is on the other side of the nation’s political divide. She said she can’t stand the president, who she said “had no real concern for the people of this country.”

Mabe, 70, has also seen medical debt up close. She used to work in the construction industry.

“In between projects you are a lot of times without a job,” she said. “Then you get sick. Next thing you know, you owe $5,000, $10,000 that you cannot pay. You’re barely paying your home bills. Then you’re like: ‘I can’t pay it. What do I do now?’”

Both Coe and Mabe said partisan differences don’t matter. “There isn’t a political divide when it comes to medical debt,” Coe said. “It all brings us together.”

Jackman said he got the idea to do something about medical debt during the pandemic, when growing numbers of people turned to the church for help.

“I was hearing about the reason they couldn’t pay their electric bill was because they’d had a few days in the hospital and then they got hit with this huge bill and it snowballed,” he recalled. “And I started hearing this again and again and again.”

Jackman learned about a nonprofit called Undue Medical Debt that buys unpaid medical bills from hospitals and debt collectors so the debts can be retired.

The church’s first campaign, in 2022, set a goal of raising $5,000 to retire about $500,000 in medical debt owed by residents of surrounding Forsyth County. The campaign hit its goal in just six weeks, fueled mostly by donations of less than $50.

Jackman, who’s been a pastor for more than four decades, attributed part of the success to an ethos of the church. “One of our ideas is that we cannot fix everything, but we have to fix what we can in the place where we’re planted,” he said.

Trinity members, no matter their political leanings, also said they see something broken in a system that pushes sick people into debt.

Paul Sluder, 78, who doesn’t identify with a political party, used to work for a credit union. He said he did a lot of debt collecting before he retired.

Most people, he said, wanted to pay what they owed. If they got sick, they often had no choice but to go into debt.

“You have kind of no control. You have to take care of yourself or your loved ones,” Sluder said. “It’s incredibly unfair, and I think the system’s out of whack.”

Polls suggest there’s a lot of common ground around medical debt.

In a for Undue Medical Debt, more than 75% of Republicans and Democrats said collection agencies shouldn’t be allowed to garnish patients’ wages to pay medical debt. And in recent years, bipartisan measures to expand protections from medical debt have passed in blue and red states.

Coe, a Republican, said she would support even more limits on how much medical debt people could be forced to carry. “Why can’t we cap medical debt at a certain dollar amount, and after that it’s either written off or forgiven?” she asked.

After completing the most recent debt campaign, Trinity hosted a special ceremony, assisted by kids from a local Scouting group.

Jackman stood before the congregation and held up a piece of paper with a long list of names, people in the county whose debt had been bought and retired by the church.

“On this day of Jubilee,” Jackman announced, “we act to forgive the debts of many of our neighbors as God has forgiven our debts.”

As the congregation stood, Jackman flicked on a lighter and burned the list of 1,631 names. The paper was consumed by yellow flame. The scouts set off confetti poppers. The choir sang, and the congregation erupted in cheers.

Afterward, members went downstairs for a spaghetti lunch in the church basement, served by the scouts.

Reflecting on the day’s festivities, many members of the congregation said they hoped their work on medical debt could inspire others to bridge political differences and work together.

“There’s just so much division, so much anger,” said Cynthia Tesh, 72.

“We need to look out for one another,” she said. “If we start looking out for one another, things will change. If we start considering other people and not just ourselves, things will change.”

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .

A professional in-home caregiver lost her coverage for Zepbound. She soon realized getting it back was not straightforward.

“I was like: ‘What am I going to do? Hopefully I can just continue keeping this weight off.’”

— Deborah Finley, 50, of Lodi, California

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Deborah Finley, 50, of Lodi, California, said her weight started to worry her during the early days of covid. That’s when she noticed a lot of the people who were on ventilators or dying had something in common: obesity.

“It was a scary time,” she said. As a single mom, she was afraid “that I wouldn’t be here for my daughter.”

Finley had been diagnosed with sleep apnea and nonalcoholic fatty liver disease, and she was prediabetic. Her pulmonologist suggested bariatric surgery but couldn’t get Finley’s insurer to cover it.

She exercised and watched what she ate, but she wasn’t losing weight and her mental health suffered.

She remembers telling her doctor: “Look, I’m at 223 pounds. I feel like I’m hitting this wall. I don’t know what else I can do.” That’s when he suggested Zepbound, a GLP-1 drug for obesity.

Finley said she still had to put in a lot of work to get healthy. But the drug helped. Her sleep apnea improved dramatically. She lost weight.

Then her insurance plan stopped covering Zepbound for weight loss at the end of last year. That’s become common because GLP-1 drugs are expensive for health plans and the employers that pay for them.

“They started sending out notices to all the patients,” Finley said. “And they said: ‘Look, we’re pulling this medication. We’re giving you 90 days’ notice to figure out what you want to do.”

From 2025 to 2026, 12 million people were on plans that for Zepbound and 12 million had plans that dropped Wegovy, another GLP-1, according to , a website that helps patients find discounts on prescription drugs.

If you find yourself in this situation, these tips can help. 

1. Read the fine print on coverage.

While many plans don’t cover GLP-1 drugs for weight loss alone, they may make exceptions if you have other conditions.

That was Finley’s situation. She learned that her insurer would cover Zepbound if it was used to treat obstructive sleep apnea, or MASH, a fatty liver disease. GLP-1s are also covered for people with Type 2 diabetes.

You can work with your doctors to screen for qualifying conditions, said , a professor of epidemiology and medicine at the Johns Hopkins Bloomberg School of Public Health.

Undiagnosed diabetes, he said, is “the most likely scenario that would allow for someone to go from not being qualified to being qualified.”

Since Finley had sleep apnea and testing showing that the drug helped, she learned it could still be covered with a prior authorization — that’s when you have to get approval from your health insurance before it will cover .

Finley said her physician told her a prior authorization was on file, but when she tried to refill her prescription, the pharmacist told her Zepbound was denied.

2. File an appeal — and get some help from your doctor.

Don’t give up if your medication is denied, said , the obesity medicine director for UVA Health, the health system affiliated with the University of Virginia in Charlottesville. Sometimes your insurer will relent on appeal, if you make a good case.

Finley made several frustrating phone calls and eventually went digging through her online medical records.

“I had to do my own investigative work,” she said.

Those records showed that Zepbound was indeed denied. Her doctor had applied for prior authorization, but it did not go through, because her insurer said there was not sufficient data to back up the request. Somehow, her health information, including the sleep apnea testing results, hadn’t made it to the right people.

Finley eventually got her hands on the 17-page report and got a little help from ChatGPT to write an appeal, showing that the drug was necessary for her based on her diagnosis and covered under her policy.

This kind of appeal can be a lot of work. Luckily, many doctors’ offices will help and know how the system works, Alexander said.

“I don’t think that patients should be expected to navigate these waters on their own,” he said.

3. Carefully document your care.

Sometimes you may have to file multiple appeals if the first one is unsuccessful, said , the vice president for advocacy and research at the nonprofit Obesity Action Coalition, which receives financial support from drugmakers including Zepbound maker Eli Lilly and Wegovy producer Novo Nordisk.

Zvenyach also recommends keeping meticulous records. Some plans require something called step therapy, meaning patients have to try and fail on other drugs or treatments before getting covered for the one their doctor wants them to take.

“Keep a history of other meds you’ve taken so you can provide documentation for step therapy requirements,” she said. “Document dates of participation in any nutrition and physical activity program or membership.”

Finley filed an appeal on Feb. 4, and although she expected a hearing within 90 days, it hadn’t been scheduled yet as of mid-June.

She said it’s been stressful because she hasn’t been able to get new injections of Zepbound since mid-January.

4. Look for discounts if you pay out-of-pocket.

The drugmakers that make Zepbound and Wegovy sell the medicines at a discount to people who pay out-of-pocket instead of using insurance. (Try discount sites like TrumpRx or GoodRx.)

Even with discounts, the drugs are not affordable for everyone. If you have a or a flexible spending account, you can use it to pay for them with pretax dollars.

5. If you’re considering compounded GLP-1s online, watch for red flags.

You might have seen ads for affordable off-brand obesity drugs prescribed by online providers. These are compounded products — that is, made by specialized pharmacists instead of a drug company.

Compounded medicines are prepared using the same active ingredient as the brand-name drugs. But they aren’t approved by the Food and Drug Administration.

Look out for . Check the National Association of Boards of Pharmacy’s . Make sure the pharmacy preparing your drug is . If it’s not, it may not be undergoing inspections or complying with other laws.

After stretching out her remaining supply of Zepbound as long as she could, Finley is taking a compounded version of the drug while she continues the insurance appeals process.

6. Be persistent. And remember to breathe.

Being told no by an insurer is maddening. But Alexander said you often have other options.

“If any appeal that we make is unsuccessful, there are other treatments that we can use,” he said — for example drugs like Contrave, or a cheaper combination of generic naltrexone and bupropion.

UVA Health’s Varney, who has consulted for Eli Lilly, said not to give up on trying to get GLP-1s covered. “Take a breath, but go right back to it,” she said, adding that GLP-1s are superior to the older drugs on the market.

Alexander said he thinks obesity drugs will eventually become affordable — cheap even. Statins, which are used to treat high cholesterol, were once expensive and hard to get covered. Now, Alexander notes, they’re generic and often cost just a few bucks.

“I know it’s hard to imagine,” he said. “But there will come a day when we no longer see these access barriers for GLP-1s.”

Healthcare Helpline helps you navigate the health system hurdles between you and good care. Send us your tricky question and we may tap a policy sleuth to puzzle it out. Share your story. The crowdsourced project is a joint production of NPR and ºÚÁϳԹÏÍø News.

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Cara Anthony tries to convince her HealthQ co-host Blake Farmer that there are benefits to embracing the caregiver identity when helping an aging parent.

When his father was diagnosed with gallbladder cancer in 2025, William Morrison immediately went into caregiving mode.

“We were in the hospital every day,” he said. “I was really playing the intermediary between the medical staff and our family and kind of helping have those conversations and push for those answers.”

One in 10 Americans say they are a caregiver for a parent 65 or older, . And many people in the sandwich generation — those who have both children and aging parents — start their caregiving journeys like Morrison: stepping up during a medical crisis and becoming a family caregiver essentially overnight.

For other people, taking on the role and identity of a caregiver happens more slowly.

Researchers and experts say the spectrum of caregiving is broader than many people realize and that embracing the caregiver title before there’s a crisis can make a significant difference in this phase of life.

Worry Comes First

Being a caregiver can start long before you go to a doctor appointment with a loved one or move your parents into your house. “Oftentimes what we see out in the world is a very limited definition of who a family caregiver is,” said Denise Brown, a caregiving coach and the founder of Caregiving Years Training Academy in Illinois. Being a caregiver is “not necessarily around defining caregiving by tasks and chores, but about that emotional impact.”

Brown created a framework that defines caregiving as a . She said the first stage — the “expectant caregiver” — begins the moment you start to feel concerned about a loved one.

“ You look into the future and you think, ‘Oh, I think someone’s going to need help in the family,’” Brown said.

When you start to get actively involved in a loved one’s care, that triggers the second stage, what Brown calls the “freshman caregiver”: “You’re learning the lay of the land. You’re learning the language of all the systems that you now manage. The best thing to do in this stage is to get comfortable experimenting.”

Caring for Parents Brings Different Stressors

The kind of care that Morrison provided — responding to an immediate medical crisis — catapulted him into the third stage of caregiving, the “entrenched caregiver.” By the time you hit this point, Brown said, “you can feel completely overwhelmed and swallowed up by the experience.”

that the stress is especially acute for people taking care of parents. The role reversal stresses the relationship: Caregivers who focus solely on children don’t deal with the tension linked to shifting power dynamics and other changes that happen when an adult child starts to care for a parent.

Burnout, defined by physical and psychological fatigue, was higher among caregivers of aging parents than among caregivers caring only for children. And for caregivers in the “sandwich generation,” who were taking care of both children and aging parents, personal burnout scores were even higher.

The Title Makes a Difference

Many people who perform care tasks don’t consider themselves caregivers, , but those who do are more likely to access support services and feel a sense of community with other caregivers.

“Anyone in a caregiving situation deserves support and help,” Brown said.

Embracing the role of caregiver early also allows you to have “really good conversations with people in your life” about their desires — and yours — as you enter this phase, Brown said.

Morrison, whose father died earlier this year, is about to enter his own sandwich generation era: He and his wife are expecting a baby boy in August, and he’s been stepping in to help his mom with housework and administrative tasks.

Morrison and his wife have already had conversations about making time for themselves and each other after their son is born. Morrison also wants to be more intentional with his own health, even if that means just going for walks.

People and Policy

Beyond the emotional strain, caregiving comes with substantial costs. On average, caregivers spend more than $7,000 a year on medical and other expenses to support a loved one, according to in 2021.

Some efforts aim to mitigate the financial burden. In most states, family members can get paid to take care of relatives who qualify for Medicaid. But state Medicaid programs face new pressure from federal cuts, and some states have pulled back funding for home-care programs designed to help residents with disabilities.

Meanwhile, a handful of states for unpaid caregivers. For example, starting in 2027, Connecticut will allow family caregivers who make less than $50,000, or couples who make under $100,000, to apply for a tax credit up to $2,000.

This installment is part of HealthQ’s reporting on caregiving among the sandwich generation. For more, check out the series archive.

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .

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Being a family caregiver is hard work. On June 17, ºÚÁϳԹÏÍø News Midwest correspondent Cara Anthony joined WAMU’s Health Hub to discuss her experience with parenting while also caring for aging parents. Listen in as she shares tips for other members of the “sandwich generation.”

Are you juggling the responsibilities of raising children and having aging parents?

Navigating that role can come with new responsibilities, stressors, and unexpected expenses, but claiming the caregiver identity can help. Researchers have found that people who identify as caregivers are more likely to use support services and feel a sense of community with others.

ºÚÁϳԹÏÍø News correspondent Cara Anthony joined WAMU’s Health Hub on June 17 to share her experiences as a parent with aging parents.

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Vaught administered the vecuronium and also left the patient alone.

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

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

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

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

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

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

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

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

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

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

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

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

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

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