September 22, 2026
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Vice President JD Vance said the measure would save the government $2.2 billion.
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September 22, 2026
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Scientists are developing imaging techniques and blood tests that one day may enable doctors to identify the disease definitively in living patients.
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- September 22, 2026
- Rose
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BOISE, Idaho — Joshua and Ashley Durham run a family medicine practice, and for the first time in their lives, they have no health insurance.
When the Durhams began their practice at the end of 2023 — he as a primary care physician and she as a pharmacist who handles the billing — the couple bought coverage for themselves and their two kids on the Affordable Care Act marketplace. But they said their monthly premiums for a similar health plan for this year rose several hundred dollars to nearly $1,600.
They decided to pay out-of-pocket for their medical expenses instead, leaning on $50,000 they had set aside in a health savings account over several years.
“It’s nerve-racking,” said Joshua Durham, 47. “It just takes, you know, one little accident, and then you got a big fat bill.”
The healthcare industry traditionally has more of its workforce on medical insurance than many other fields. Nationwide, 7% of all healthcare workers were uninsured in 2024, compared with 11% of all adults under 65, according to a KFF analysis of the most recent American Community Survey data. And doctors were especially unlikely to forgo health insurance, with just 2% uninsured.
But even healthcare workers are feeling the pinch as health insurance costs rise each year, with employers expecting that costs will jump an additional 8.2% for 2027.
The Republican-led Congress also opted last year not to renew Affordable Care Act marketplace credits enacted during the covid pandemic. While subsidies remain in place for people with low incomes, the pandemic-era credits helped reduce many consumers’ premium payments, especially those working in small businesses such as independent medical practices. Nearly half of marketplace enrollees worked for small businesses or were self-employed in 2024; some of the most common occupations included chiropractic care and dentistry.
Jack Dillon, executive director of the Association for Independent Medicine, which represents 4,000 physician-led practices, said premium increases have become untenable for small businesses, whether employers seek coverage through the marketplace or directly from insurers.
“The cost has become so astronomical,” Dillon said. “You’re looking at it and saying, ‘What’s the value?’”
As health insurance continues to become less affordable, Dillon said, more healthcare employers may seek alternatives to their standard coverage, such as providing higher hourly wages or providing only minimal plans.
The number of people without insurance in the U.S. is expected to increase by roughly 15 million over 10 years because of the expiration of the expanded ACA subsidies and $1.1 trillion in estimated cuts resulting from President Donald Trump’s signature One Big Beautiful Bill Act, according to the Congressional Budget Office.
Healthier people are the most likely to opt out of insurance. That leaves insurance covering a smaller pool of people who tend to be sicker and need more expensive care. So insurers raise prices to cover the remaining enrollees, which fuels even higher premium costs.
‘Healthcare Is a Business’
Samantha LeGault, a nurse practitioner at a health clinic in Boise, said her employer-offered plan’s premium payment rose from $700 to $1,500 a month this year to insure herself, her husband, and four of their kids. LeGault has Crohn’s disease and two of their daughters also have medical conditions, so she said her family has no choice but to continue to pay for that health coverage.
But she decided to skip dental insurance to save money, and she prioritizes dental visits for her children over herself.
She had already struggled to set aside retirement savings and had switched her children from a private school they liked to public school to cut down on costs. Then the new health insurance costs tightened her budget even more. She estimated that about one-fifth of her income now goes toward her monthly premium payments.
“I know how the clinics work, that I am an expensive patient,” LeGault said. “At the end of the day, healthcare is a business in the United States.”
The Durhams have three other employees in their practice. Two of them receive health insurance through their spouses, Ashley Durham said. The Durhams said they pay $420 monthly toward their physician assistant’s premiums.
As a primary care physician, Joshua Durham said he doesn’t need regular doctor visits, because he can diagnose and treat himself — and, if needed, the rest of his family, though he acknowledged that’s frowned upon. The American Medical Association’s code of ethics generally discourages doctors from treating themselves or relatives but makes exceptions for emergency situations or short-term, minor problems. Ashley Durham said she’s filled prescriptions for her family.
Arthur Caplan, a bioethicist and professor emeritus at New York University’s Grossman School of Medicine, said that as more people are “turning toward relatives because they can’t access or easily see a regular doctor,” it may make sense to revisit that aspect of the code of ethics.
Out-of-Pocket Expenses
Healthcare workers with less advanced medical certifications than the Durhams often don’t have the option of treating themselves or family members — or don’t have savings to fall back on for healthcare expenses. And many healthcare professionals, such as Jill Kordick, a 64-year-old retired healthcare executive in Norwalk, Iowa, aren’t willing to go without the safety net of insurance.
In her work, Kordick saw hospitalizations become financially devastating for patients, so she said she would never opt out of health insurance — even for just the 16 months before she’d become eligible for Medicare at age 65.
Last year, she qualified for the enhanced Affordable Care Act tax credits, allowing her to pay $75 a month for health coverage. Her premiums rose to $800 a month this year when those subsidies expired.
Because she has a $10,000 deductible, she put off going to the doctor for weeks when she had a sinus infection this year, until it ultimately evolved into an ear infection. She said she regularly rethinks, and sometimes returns, nonessential groceries in her shopping cart. And she keeps her house’s thermostat at 80 degrees in the summer to cut down on air conditioning costs.
Kordick said healthcare is a universal struggle in this country, regardless of how familiar patients are with the industry. “It’s disheartening that it’s as broken and fragmented as it is,” she said.
The Durhams have seen the impact of unaffordable healthcare on their patients. They said they try to lend some leeway to patients when they can — a luxury they have, operating their own practice. In one case, Ashley Durham said, she wrote off $1,160 in bills for a single father whose son didn’t have health insurance rather than send their bills to a collection agency.
“It’s hard, because as a human I want to help them out,” she said. “At the same time, we need revenue for our office.”
Joshua Durham is more nervous about going uninsured than his wife. As a child, he witnessed his parents struggling to pay medical bills for their family of nine in south-central Idaho. Durham recalled that his dad, who was a carpenter, helped build a surgeon’s house to pay for an operation.
Today, Durham also sometimes exchanges work for care. He said he gets free eye exams from an uninsured optometrist and offers him free primary care.
He worries about a worst-case scenario: a car crash, a sports injury, a serious diagnosis.
“Do I have pancreatic cancer today?” Durham said wryly.
So far, the couple has paid around $9,000 total for expenses out of their health savings account this year, including physical therapy to help with the thoracic outlet syndrome that affects Durham’s neck and shoulder, mental health appointments, and contact lenses. The expenses were higher than the Durhams anticipated. But it was still less than what their monthly premiums would have cost them.
Their decision has paid off, Joshua Durham said. At least for now.
Are you struggling to afford your health insurance? Have you decided to forgo coverage? Click here to contact KFF Health News and share your story.
KFF Health 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 KFF.This article first appeared on KFF Health News and is republished here under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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- September 21, 2026
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Paul Nestadt is about as steeped in suicide prevention as a person can be.
He treats suicidal patients as a psychiatrist, has co-authored scores of research papers on how and why people kill themselves, and teaches graduate courses on the subject.
But he’ll be the first to admit: “I can’t tell you which of my patients is likely to die by suicide in the next six months.”
Almost nobody can.
Research shows predictions of who will be suicidal are only slightly better than a coin toss. And they haven’t improved over 50 years.
But that doesn’t make Nestadt hopeless. Instead, it pushes him to pursue interventions that don’t require pinpointing people at risk.
Chief among them: making it harder for people to carry out the act of killing themselves.
“Instead of asking every doctor to figure out which patient will die by suicide and locking that patient up, it might be that we need to make sure there aren’t loaded guns available,” Nestadt said.
In an ongoing series, KFF Health News is examining approaches to suicide prevention that expand beyond providing people at risk with medication and therapy. Although those are lifesaving measures, many clinicians, researchers, and people who have lost loved ones to suicide agree that more is needed. The challenge is that when it comes to firearms, broad policy approaches quickly become constitutionally complicated and politically polarizing.
Research shows that limiting access to lethal means is one of the most promising approaches to save lives. It can involve erecting barriers on buildings and bridges to prevent people from jumping, as well as decreasing the number of pills someone can buy or be prescribed at once.
“That’s the one that will save the most lives,” said Nestadt, medical director at the Johns Hopkins Center for Suicide Prevention.
It may also be the most difficult to achieve.
More than 28,000 people killed themselves with a gun last year, representing more than half of all suicide deaths in the U.S., according to preliminary federal data. Even as overall suicide rates have dipped recently, gun suicides have hit record highs for five years in a row.
Most Gun Deaths in the U.S. Are Suicides
From 2021 to 2025, suicide deaths by gun hit record highs each year, even as homicides by gun decreased.
Source: <a href="https://wonder.cdc.gov/" target="_blank" style="color:#0071ce">CDC WONDER</a> <br> Note: 2025 data is provisional. The following ICD-10 codes identify firearm death types: X93-95 (homicide), X72-X74 (suicide), W32-34, Y22-24, and Y35.0 (other, which includes accident, legal intervention, and undetermined). <br> Credit: Aneri Pattani/KFF Health News
Many of the deaths are among middle-aged white men and veterans, two groups that have had high suicide rates for years. But more recently, gun suicides have risen among women and among some Black and Latino men. Researchers say a surge in first-time gun buyers during the covid pandemic underscores the need for prevention efforts that can be applied widely.
Some people assume it’s futile to restrict access to bridges, pills, or guns. The thinking goes: Those who want to kill themselves will simply find another way.
But research refutes that. Creating barriers for one method doesn’t typically push people to another.
Suicide risk can surge quickly, with people spending less than an hour or even five minutes between deciding to die and acting on it. Anything that delays such action — for example, having to unlock a safe to access a gun — gives them time to reconsider or for someone to intervene.
A Sharp Rise in Gun Suicides Among Black Women
White women had the highest rates of gun suicides by women in 2015 and 2024, but among women of other races and ethnicities, the increase was faster and steeper over that time.
Source: <a href="https://publichealth.jhu.edu/sites/default/files/2026-07/2024-CGVS-gun-violence-in-the-united-states.pdf?nvep=&hmac=&emci=8288e977-1e8c-f111-b337-000d3a1558ce&emdi=ea000000-0000-0000-0000-000000000001&ceid=" style="color:#0071ce">The Firearm Mortality Epidemic: Examining the U.S. Data From 2024, Johns Hopkins Center for Gun Violence Solutions</a> <br> Note: Rates represent gun suicide deaths per 100,000 people. <br> Credit: Aneri Pattani/KFF Health News
However, in the U.S., discussion around guns — even in the context of a traditionally bipartisan topic such as suicide prevention — is a political lightning rod. Mentions of background checks, waiting periods, or red flag laws often send people running to their respective corners. Gun owners and the firearm industry say many of the policies suicide prevention advocates seek threaten their Second Amendment rights, and many policymakers see the topic as a nonstarter.
President Donald Trump has been a strong ally of gun owners. His administration has rolled back dozens of firearms regulations and rescinded a previous surgeon general’s warning that called gun violence a public health crisis. It has also revoked grants focused on addressing community gun violence and cut federal staff working on the issue.
The White House did not respond to specific questions about how these actions may affect the nation’s high rate of gun suicides or what it’s doing to prevent such deaths. But spokesperson Lauren Bis said in a statement that “President Trump is committed to Making America Healthy Again and that includes mental health.” She pointed to the administration’s support for developing psychedelic treatments for mental illness and an announcement of $52.5 million in grants for veteran suicide prevention.
The Limits of Red Flag Laws
One gun policy that has gained some traction, despite pushback, is the extreme risk protection order, more commonly known as a red flag law.
Adopted in some form in 22 states and the District of Columbia, these laws allow judges to temporarily remove a person’s guns when evidence suggests they pose a danger to themself or others.
Although such laws are often passed in the wake of mass shootings, research suggests they’re more effective at preventing suicide.
Still, they require identifying someone at risk.
Someone like Dorothy Paugh’s dad.
In 1965, when Paugh was a young girl, her dad lost his job. He was distressed, not knowing how he’d support his wife and five children, Paugh said. He reviewed his life insurance policy, told his wife where he kept important documents, and bought a handgun.
“If my mom had been able to get an extreme risk protection order or if Dad’s best friend had asked to hold his gun for a while, maybe my dad would not have shot himself. He might have lived,” Paugh said.
Decades later, Paugh advocated for a red flag law in Maryland and sat in the legislative gallery when the measure was passed.
She believes the law is saving lives.
Studies across other states show that for every 10 to 20 guns removed under red flag laws, one suicide is averted, saving a life.
But Paugh also recognizes the law’s limitations.
“It wouldn’t have saved my son,” she said.
Her 25-year-old son, Peter, fatally shot himself in 2012. He’d recently bought a house with his girlfriend and hosted a birthday celebration for his brother. He’d purchased a gift ahead of Mother’s Day — five novels by Charles Dickens, Paugh’s favorite author — that Paugh received after his death.
Unlike in her father’s case, Paugh said, no one saw warning signs for Peter. “I did not know that my son was suicidal. I didn’t have a clue,” she said. Even if a red flag law existed then, she wouldn’t have thought to use it.
The people most vulnerable to firearm suicide usually aren’t identified as such by family members or clinicians, said Michael Anestis, a clinical psychologist and the executive director of the New Jersey Gun Violence Research Center.
Studies have shown that among people who die by suicide, those who used guns were less likely to have sought mental health care in the past. And most veterans and service members who die by gun suicide never tell anyone about their suicidal thoughts in the months leading to their death.
That’s why red flag laws are just a first step in suicide prevention, Anestis said. They target specific individuals at high risk — the aspect that makes such laws more politically palatable — but they do not apply to the many other people who are quietly suicidal.
Lessons From Road Safety
Nestadt, the Johns Hopkins psychiatrist, said the nation needs to approach suicide prevention the way it approaches car accidents.
“You’re not trying to figure out who’s at risk of an accident” by testing people’s reaction time or cataloging who gets into fender benders, Nestadt said.
Instead, governments implemented speed limits, passed seat belt laws, and required auto manufacturers to install air bags and shatter-resistant windshields. The crash death rate declined significantly.
Applying a similar strategy to suicide might involve requiring permits and background checks to buy a gun, as well as instituting waiting periods before completing the purchase.
One study found that enacting a permit-to-purchase law in Connecticut was associated with a roughly 15% decrease in gun suicide rates, while repealing such a law in Missouri was linked to a 16% increase in firearm suicide rates.
Most Suicides in America Involve a Gun
Suicide deaths by gun have been increasing for several years, even as suicides by suffocation — the second most common method — have been decreasing.
Source: <a href="https://wonder.cdc.gov/mcd-icd10-provisional.html" target="_blank" style="color:#0071ce">CDC WONDER</a> <br> Note: 2025 data is provisional. "All other methods combined" includes cut/pierce, drowning, fall, fire/flame, other land transport, other, and unspecified. <br> Credit: Aneri Pattani/KFF Health News
About three dozen states have enacted laws requiring owners to lock up their guns in homes where children live, a practice shown to reduce youth suicides. That’s an issue of particular importance, with gun suicide rates increasing 245% among Black youths and 98% among Latino youths since 2014.
Anestis said laws requiring permits and safe storage can also reduce homicides and other gun injuries.
Those types of violence not only hurt people directly but also increase their risk of suicide. Research suggests people who are exposed to gun violence in their community experience trauma and become habituated to the idea of injury or death. That “double whammy” makes them more likely to kill themselves, Anestis said.
Responsibility, Rights, and Saving Lives
Gun owners and firearm trade associations generally oppose universal measures, such as requiring permits and waiting periods. They prefer education campaigns that teach people how to recognize warning signs, talk about mental health, and safely store guns — initiatives that place responsibility on individuals.
The National Shooting Sports Foundation, which represents the firearms industry, has partnered with the American Foundation for Suicide Prevention to create flyers and brochures to be posted in gun shops.
“Our purpose is to provide educational materials to the firearm-owning community on how to help prevent suicide and save lives,” Bill Brassard, the NSSF’s senior director of suicide prevention initiatives, said in a statement.
The National Rifle Association said policies focused on guns miss deeper concerns that make someone suicidal, such as mental illness.
“Suicide is a serious issue that deserves serious solutions focused on the underlying causes, not on political efforts to restrict the rights of law-abiding Americans,” NRA spokesperson Justin Davis said in a statement. “A truly dangerous individual needs to be incapacitated, not just deprived of one particular means of harm.”
Some initiatives have managed to bring together unlikely bedfellows — gun store owners, public health experts, and even libraries — to provide free locks to secure firearms at home, identify locations that will temporarily store someone’s guns while they’re in crisis, and educate people on how to avoid selling guns to someone who is suicidal.
Those efforts give Paugh hope and fuel her passion to continue advocating for better mental health care, open conversations about suicide, and policies that decrease access to guns.
“It’s not a cure-all,” Paugh said of those policies. But “it does save lives.”
Having lost a parent and a child, she knows how valuable that can be.
“If you’re that one person or that person’s family, it’s all the difference in the world,” she said.
This article first appeared on KFF Health News and is republished here under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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- September 20, 2026
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Patients and workers in one of the country’s largest hospitals sweltered in a heat wave last month. Experts say the whole country must urgently adapt.
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- September 20, 2026
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Federal officials are drafting an executive order that would place grants under review by an outside panel, the latest effort to redirect billions of dollars in research spending.
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- September 19, 2026
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As the oldest baby boomers turn 80, researchers worry there won’t be enough room in nursing facilities for a rapidly graying nation.
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- September 19, 2026
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Céline Gounder, KFF Health News’ editor-at-large for public health, discussed the findings of a recent cancer report on CBS News 24/7’s Mornings on Sept. 16. Gounder also discussed the potential of artificial intelligence to be used in developing biological weapons on CBS News’ CBS Mornings on Sept. 11.
KFF Health News Georgia correspondent Briah Lumpkins discussed a conservative Georgia congressional district that has remained supportive of President Donald Trump despite rising healthcare costs on WUGA’s The Georgia Health Report on Sept. 11.
- Click here to hear Lumpkins on The Georgia Health Report.
- Read Lumpkins’ “Rising Healthcare Costs Have Hit Georgia’s Most Conservative District. But Its Politics Are Unlikely To Change.”
KFF Health News Florida correspondent Daniel Chang discussed in Spanish how gun violence affects children in Florida on Radio Bilingüe’s Línea Abierta on Sept. 10.
- Click here to hear Chang on Línea Abierta, starting at 47:50.
- Read Chang’s reporting in “Where Florida’s Gun Violence Exacts Its Biggest Toll on Black and Latino Children.”
KFF Health 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 KFF.
This article first appeared on KFF Health News and is republished here under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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- September 18, 2026
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Ahead of the midterm elections, the president said that all states had opted in to an effort to align Medicaid’s prices for medicines with those in other wealthy countries.
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- September 18, 2026
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Healthcare prices are likely to keep increasing next year. As midterm elections approach, candidates are laying out their plans to tackle these growing expenses.
KFF Health News chief Washington correspondent Julie Rovner joined WAMU’s Health Hub on Sept. 16 to explain how healthcare could play a critical role in the midterm elections. She said similar cost increases in the early 2000s led to the debate that became the Affordable Care Act.
“We’re seeing people have to pay more in their — not just premiums — but their deductibles, how much they pay before their insurance kicks in, and how much they pay when they go to the doctor,” said Rovner, host of the What the Health? From KFF Health News podcast.
In recent years, it’s not uncommon for healthcare providers to ask for payment upfront.
“Now you get there, and they say, ‘Can we have your credit card?’ before you even get to go in and get your care,” Rovner said.
KFF Health 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 KFF.This article first appeared on KFF Health News and is republished here under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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- September 17, 2026
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The scenario often unfolds like this: Medical researchers investigate a frequently used drug and report that it’s less effective for older patients than previously thought, or that its risks outweigh its benefits in older adults. More studies follow, confirming those findings.
After a few years, medical associations revise their guidelines, warning that the drug in question should be avoided or at least prescribed more selectively. It might be added to the Beers Criteria, an influential list of potentially inappropriate medications for older patients, published by the American Geriatrics Society.
If the drug’s role is preventive, the U.S. Preventive Services Task Force, an independent expert panel, may weigh in with cautions. The FDA may issue “black box” warnings about concerning side effects.
After a few more years, researchers look at broad national data to see whether use of this drug declined. Often, the answer is: Yes, but not enough. Sometimes, though, use didn’t decline much at all or actually increased.
“Medications are like barnacles,” said Michael Steinman, a geriatrician at the University of California-San Francisco and co-director of the U.S. Deprescribing Research Network. “They’re easy to start, but they can be hard to stop.”
This medical inertia partly reflects the time lag involved in disseminating findings. “Clinicians have a million things they need to know and attend to, and information may take a while to get to them,” Steinman said.
But it also reflects the way “clinicians and patients get used to treating conditions in certain ways,” he said. “They become ingrained habits.” Finding alternative approaches is challenging, so “it’s easy to go with what you know.”
Recent studies of three medications or classes of drugs widely used among older Americans illustrate the problem.
The Drawbacks of Benzodiazepines
Scientists began raising alarms about benzodiazepines more than 20 years ago. Prescribed for insomnia and anxiety, “they offer prompt relief,” said Mark Olfson, a psychiatrist and epidemiologist at Columbia University.
The problem? Benzodiazepines (including Valium, Xanax, and Ativan) and the related “Z” drugs (Ambien, Lunesta) “may impair balance, coordination, and cognition that can translate into falls and fractures and motor vehicle accidents,” Olfson said. In patients also taking opioids for pain, benzodiazepines can cause overdoses.
Moreover, “once you’ve taken them for a period of time, you develop a dependence,” Olfson added. “When you come off them, you may develop withdrawal symptoms.”
So what’s happened to benzo use among older adults, who are more sensitive to these effects? In a recent examination of prescribing trends, published in the Annals of Internal Medicine, Olfson and his team reported progress. Among people 65 and older, the rate of patients filling prescriptions for benzos dropped to 11.5% in 2024, from about 14% in 2015.
But that decline has stalled since 2020, perhaps related to the covid-19 pandemic. Moreover, prescribed use actually rose among those over 75, from 12% in 2020 to about 13% four years later. Dispensing through pharmacies in long-term care facilities more than doubled. And about a third of users were taking the drug for longer than six months, increasing the likelihood of dependence. “It’s worrisome,” Olfson said.
But he cautioned that patients shouldn’t stop benzodiazepines suddenly or on their own, which can provoke withdrawal. “It requires supervised tapering” with a medical professional, he said. “It takes many weeks.”
Overprescribing Antibiotics
For years, the standard treatment for diverticulitis, the inflammation or infection of small pouches that form in the colon, was antibiotics, primarily fluoroquinolones (like Cipro and Levaquin) or amoxicillin-clavulanate (Augmentin).
“It was unquestioned,” said Jesse Sutton, a pharmacist and researcher at the Minneapolis Veterans Affairs healthcare system. “Antibiotics are safe and effective, great, lifesaving drugs, so the mindset was: When in doubt, use them.”
But in 2015, the American Gastroenterological Association recommended against routinely prescribing antibiotics for “uncomplicated” diverticulitis, which represents a great majority of cases. Other medical groups followed suit.
Clinical trials had shown that, for this condition, antibiotics had little or no effect on mortality, the need for surgery, complications, or recurrences. “They hadn’t improved anything,” Sutton said.
And as with any drug, “there are downsides, unintended consequences,” he said. “Side effects from antibiotics account for a substantial amount of emergency room visits” for symptoms like nausea, vomiting, and diarrhea. Antibiotics heighten the risk of the virulent C. difficile infection, too.
Plus, “the more you use antibiotics, the less they work in the future,” Sutton said. The World Health Organization has deemed antimicrobial resistance “a major global health threat.”
So Sutton and his colleagues, studying treatment in 70,000 visits to 120 VA facilities, expected to see antibiotic use for uncomplicated diverticulitis decline over 10 years.
Instead, they reported recently in the Annals of Internal Medicine that antibiotic prescriptions remained nearly universal at 97% of visits, guidelines or no guidelines. The patients would most likely have done as well with a few days of Tylenol and a clear liquid diet.
Antibiotic overuse remains common for other conditions of later life, too, including the kind of urinary tract infections that cause no troublesome symptoms and upper respiratory infections that are typically viral, not bacterial.
In such cases, when a doctor prescribes an antibiotic, “I’d encourage patients to say, ‘Please explain the rationale for doing this,’” Sutton said. “If they don’t, it’s OK to press pause.”
When Aspirin Isn’t the Answer
Aspirin is different. Because it’s cheap and sold over the counter, anybody can start taking it on their own — and millions of older Americans do, thinking it will help prevent cardiac problems.
For people who’ve already had a heart attack, stroke, or cardiac intervention like a stent or bypass surgery, daily low-dose aspirin for “secondary prevention” does lower the odds of another event, studies have demonstrated.
But for “primary prevention” in people who haven’t had one, the guidelines changed in 2019, when the American College of Cardiology and the American Heart Association recommended against aspirin for this purpose in those 70 or older. The U.S. Preventive Services Task Force went further, warning against aspirin for primary prevention starting at age 60.
Large clinical trials had shown scant benefit for aspirin as a primary prevention measure, but there were harms, notably gastrointestinal bleeding. “As we age, the risks of bleeding go up,” said Timothy Anderson, an internist at the University of Pittsburgh who co-directs its Prescribing Wisely Lab. More rarely, but more seriously, aspirin can cause bleeding in the brain.
In a JAMA study published last year, Anderson and his co-author found the message was getting through: Aspirin use for primary prevention, as reported in the National Health and Nutrition Examination Survey, had dropped substantially from 2011 to 2023. But more than a third of those 70 or older were still taking it.
Some caveats: A subgroup of older adults with high risk factors for cardiovascular disease may benefit from aspirin for primary prevention. And, confusingly, some evidence suggests that older patients already taking aspirin face a higher risk of cardiovascular disease if they discontinue it.
“Step 1 is a conversation with your primary care physician” about aspirin, Anderson said. “‘Is this still right for me as I get older?’”
Older patients taking aspirin, many without any medical guidance, “are interested in reducing their risk of heart attack and stroke,” he said. “They’re trying to be proactive and healthy.” But with blood pressure medications and statins for cholesterol, “we have better strategies than aspirin for that.”
The New Old Age is produced through a partnership with The New York Times.
KFF Health 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 KFF.This article first appeared on KFF Health News and is republished here under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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- September 16, 2026
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Surging drug use has contributed to an epidemic in the Pacific island nation, where one in 60 adults is estimated to be living with the virus.
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- September 16, 2026
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A long-running lawsuit challenging what it means to be an employee and therefore have access to work-based health plans is being closely watched by health policy analysts. Its outcome could spur the availability of lower-cost but potentially skimpier health coverage that skirts some consumer protections.
Court papers indicate a settlement in the case against the Department of Labor may be in the works, although the parameters of any such deal are unknown.
It would come amid premium surges on Affordable Care Act marketplaces that have led millions to drop coverage this year. The Trump administration has also been sharply focused on expanding access to alternative coverage, such as short-term plans that avoid ACA rules on preexisting conditions and benefit requirements.
“Depending on what happens with the settlement, this could be an even bigger expansion,” said Katie Keith, director of the Center for Health Policy and the Law at the Georgetown University Law Center. “People are worried that it is the opening salvo into promoting junk plans that don’t meet the ACA requirements.”
The plaintiff, Data Marketing Partnership, filed its case against the Department of Labor in 2019, during the first Trump administration. It wants official recognition as an employer so it can continue to allow its limited partners to buy into a type of job-based health insurance that doesn’t have to comply with state insurance rules or offer coverage as robust as required under the ACA.
But to grasp the claim, one also has to understand how the coverage works.
A consumer shopping for health insurance may come across information online or from a marketer about this concept, sometimes called “limited partnership” coverage. The pitch? Buy insurance offered through Data Marketing Partnership and handled by LP Management Services. To qualify, the consumer must download an app that tracks their internet searches. The company could then sell that data.
Some potential consumers may be turned off by the thought of their internet searches being tracked, but others may find it appealing because it allows them to become a limited partner eligible to buy into the company’s employee health insurance plans. But can these partners be considered employees?
The court’s answer has potential implications for regulators and consumers. Some health policy and market experts warn that a green light could lead to a proliferation of aggressively marketed and potentially questionable insurance with limited recourse for consumers because the plans would be exempt from state oversight.
“If this took off, you logically could see the rise of a whole bunch of what, functionally, would be unregulated insurance companies,” said Ali Khawar, who was the principal deputy assistant secretary of the Department of Labor’s Employee Benefits Security Administration during Joe Biden’s presidency and now runs his own consulting outfit.
No one knows if the department is going to change its long-running stance defending the case. But any settlement could add more uncertainty to insurance markets.
Already insurers are requesting double-digit increases in ACA premiums again next year, partly because declining enrollment often means that the healthiest policyholders are leaving. That trend could accelerate in coming years as more people are drawn into alternatives such as limited-partnership policies.
States Act as Federal Case Plays Out
The Department of Labor defended the case throughout the first Trump administration and the Biden era, issuing a sharply worded advisory opinion in early 2020 stating that people who simply download software to “capture data as they browse the Internet” are not “employees or bona fide partners.”
A district court judge in Texas, who had previously ruled the ACA unconstitutional in a decision ultimately rejected by the Supreme Court, called the advisory opinion “arbitrary and capricious” in a 2020 ruling in favor of the data marketer. The U.S. Court of Appeals for the 5th Circuit largely upheld the lower court’s decision but ordered it to reconsider whether someone who downloads software is either a “working owner” or a “bona fide partner.”
The employer-employee relationship is at the heart of the case because of a 1974 federal law designed to help large, self-insured employers offer retirement and health benefits to workers without having to meet varying rules from multiple states.
That law — the Employee Retirement Income Security Act — allows such plans to avoid most rules set by the states, which generally regulate most other types of insurance and assist consumers who report problems with their policies. As self-insured employer plans, the policies also don’t have to comply with some ACA rules, such as the requirement to cover 10 broad categories of “essential health benefits.”
“If the case goes the wrong way, it could impact consumers or hamstring the states,” said Marie Grant, Maryland’s insurance commissioner.
Arguments over what constitutes an employer plan are not new, and other organizations have tried offering such coverage. Some states have taken action against purveyors of limited-partner policies.
Maryland in 2024 fined a company, The Vitamin Patch, for offering limited-partnership insurance after investigating complaints and determining it was not licensed to sell coverage in the state.
Washington in 2021 ordered another company to stop offering its plans in the state and fined it $25,000.
Maine and Connecticut in 2024 warned consumers about this type of coverage.
“These plans do not provide comprehensive medical coverage and can leave consumers with large, unpaid medical bills,” according to Connecticut’s notice.
Maine’s announcement noted that entities offering these types of health insurance included The Vitamin Patch as well as Affiliated Workers Alliance, Consumer Data Partners, Employers Business Alliance, Socios Buenos, and Strategic Limited Partners.
State insurance commissioners filed legal arguments in the Department of Labor case citing their concerns about losing the ability to enforce consumer protections.
“This is not a Republican-Democrat thing,” Khawar said. “It’s really a story about state authority, the way such authority would be significantly undermined in insurance markets.”
What’s the Risk?
Still, these limited-partnership plans are viewed by proponents as a needed additional choice for consumers, at potentially lower cost than ACA plans.
When the case was filed, attorneys general from seven right-leaning states, for example, urged the Department of Labor to back Data Marketing’s request to designate its limited partners as employees. That would provide an option for people who “earn too much to qualify” for ACA subsidies and be an interim solution until the ACA could be repealed and replaced, they wrote. They argued that states would retain some regulatory authority and added that the Department of Labor, which oversees self-insured employer plans, could set requirements to “encourage” stable companies to enter the market.
Critics, the attorneys general wrote, might fear that ACA alternatives will draw away younger or healthier people, thus affecting those who remain, but they argued that had already happened.
Data Marketing’s attorneys emailed KFF Health News that they could not provide a comment for this article because the case is in active litigation. Neither the White House nor the Centers for Medicare & Medicaid Services, which oversees the ACA marketplaces, responded to questions from KFF Health News about whether the Department of Labor has changed its stance and how the administration views limited-partnership health plans.
In court filings, however, Data Marketing said that without an employer designation, it would have to end the insurance coverage, affecting about 50,000 policyholders. That would also hurt its ability to generate revenue, it argued, because offering insurance is “a significant attractor” to get people to join its partnership and let it access their electronic data.
Ellen Montz, who helped oversee ACA implementation in the Biden administration and is now a managing director at consultancy Manatt Health, had a different take. “The only reason why these sorts of products exist is because they aren’t beholden to consumer protection rules of the ACA and can essentially make money by attracting good risk, people who are healthy,” she said.
Maryland’s Grant echoed this warning, saying that proliferation of such plans could lead to even higher premiums in the ACA markets, if those who remain are older or sicker than those who leave.
Nineteen patient advocacy groups sent a letter to the Department of Labor Aug. 11 urging it to continue its defense in the case, warning that a settlement that says such arrangements create an employer-employee relationship could “significantly” undermine “both state regulatory authority and decades of bipartisan efforts to promote stable, well-functioning health insurance markets.” Some of those groups had filed a legal brief in support of the department in 2021.
Days after the August letter, U.S. Rep. Bobby Scott (D-Va.), the ranking member of the House education and workforce committee, warned the department against increasing the availability of “questionable employment relationships” and the insurance they offer.
He cited reports of call centers’ misleading consumers “who think they are enrolling in comprehensive health insurance but instead sign up for junk coverage under the guise of creating an employment relationship with what the consumer believed to be a traditional health insurer.”
KFF Health 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 KFF.This article first appeared on KFF Health News and is republished here under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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- September 15, 2026
- Rose
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He developed a program that became a model for hospitals around the world, making it easier for poor Black patients to navigate an onerous bureaucratic system.
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- September 15, 2026
- Rose
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Taya Hailstone has been in remission from childhood Hodgkin lymphoma for five years. But the cancer’s lasting damage to her organs and nerves can make basic tasks, like loading a dishwasher, hard.
Still, Montana’s health department decided last year that Hailstone is no longer eligible for low-cost disability health coverage through Medicaid. The department switched her coverage to the state’s Children’s Health Insurance Program, another Medicaid program — three months before she aged out.
Before making the decision, the state didn’t seek records from the medical team treating Hailstone, according to letters from those doctors reviewed by KFF Health News. Rather, the administrative ruling came after state officials learned the now-19-year-old had stopped receiving Social Security disability payments. She said she did that because she hoped to get healthy enough to work and save some money — beyond what’s allowed under the strict income caps tethered to those payments. But her health changes day to day, and she said for now she’s still too sick to consistently work.
Hailstone, who lives with her mom, has been able to keep Medicaid coverage while they appeal the case. She said that without Medicaid she can’t afford the treatment to manage the aftermath of her cancer.
“It feels like this process was made to make you give up,” Hailstone said.
Patients with disabilities have long struggled with administrative hoops, blunders, and confusion when trying to qualify for federally subsidized health coverage because of their illness. Now, new federal Medicaid work requirements mean states face the additional task of deciding who qualifies for a medical exemption. That means reviewing medical cases for an even larger swath of Medicaid enrollees.
Attorneys, researchers, and advocates who specialize in public aid said disability cases like Hailstone’s — though separate from the incoming work requirements — are an indication that states aren’t ready. As a result, they said, more people will be denied coverage in an opaque process.
“This will be the story of millions of people,” said Anthony Wright, who heads Families USA, a national nonprofit that advocates for ways to make healthcare more accessible.
Jon Ebelt, a spokesperson with the Montana Department of Public Health and Human Services, said the state doesn’t comment on individual Medicaid cases.
An estimated 18.5 million people will have to meet the new rules requiring them to prove they’re working, going to school, or volunteering to keep their Medicaid coverage, according to the Congressional Budget Office. More than 40% of those enrollees live with a chronic health condition, according to KFF. Some will be excused from those rules if they can prove they’re too sick to work.
More than 5 million people are expected to lose Medicaid coverage by 2034 because of the work requirements, according to the CBO.
Work Requirements Become Law
Many Republican policymakers and the Trump administration have touted Medicaid work requirements to preserve coverage for the neediest. Congress made that national policy through last year’s One Big Beautiful Bill Act and gave states until January 2027 to implement work-for-coverage rules.
Some states are starting those checks early. Montana began in July. Nebraska initiated work requirements in May.
In the federal law creating the work requirements, Congress allowed states to exempt people who have an illness that qualifies them as “medically frail.” Many states created plans for those judgment calls, only to be surprised when federal officials released rules for the requirements that went beyond what Congress outlined, by also requiring enrollees to prove their illness makes it too hard to work.
Families USA and other organizations have argued the new rules force states to set up a patchwork of systems that, together, would be larger and more complicated than the Social Security Administration’s own disability review system. Last year, that federal program cost more than $5 billion to administer to roughly 7 million people nationally. For comparison, Wright said, the federal law provided $200 million for states to share as they implement the work requirements. States are paying contractors millions of dollars to prepare often already flawed public aid systems to meet the new standards.
In June, 25 states sued the Trump administration over the medical frailty rules, arguing they’re too hard for patients to meet and for states to assess. That case is ongoing.
Hailstone was diagnosed with blood cancer at age 10. Her intestines tore, which led to their partial removal. As a result, her body struggles to process food and she can face severe dehydration. She said lingering side effects from her cancer treatment can leave her mind foggy and cause her hands and feet to swell enough that it’s hard to grip a fork or walk across a room.
Cancer dominated nearly half her life. It left mental scars, too.
“Some days you feel fine and then you suddenly crash,” Hailstone said.
Hailstone and her mom live in Roundup, a central Montana town of roughly 2,000 people. They regularly make the nearly two-hour round-trip drive to Billings for specialized care. She typically has three medical appointments a week to see her physical and occupational therapists and a mental health counselor.
Hailstone said she’s lucky she has her mother’s help navigating Medicaid. Her mom, Kyla Hailstone, said that the state hasn’t clearly defined how it determined her daughter’s disability status and that its appeal process has been slow and dysfunctional.
Taya Hailstone would qualify for Medicaid based on her income if she can’t prove her eligibility for disability coverage. But that would mean proving she’s too sick to meet the work requirement — putting her in the same position of having to rely on a state review of her illness.
“If I lose this, this is life-changing,” Hailstone said.
‘Things Fall Through the Cracks’
Hailstone qualified as disabled through the federal government as recently as 2024, about a year before the state said it was dropping her coverage. State officials can do their own medical review to determine whether someone meets the federal definition of a disability to access Medicaid.
“Whether that happens is always a bit of a crapshoot just based on state capacity,” said Megan Dishong, deputy director of the Montana Legal Services Association, which helps low-income people navigate public programs. “Things fall through the cracks.”
Ebelt said the state health department accepts disability decisions from the Social Security Administration. The state agency can conduct an internal disability determination if a person doesn’t have one from the SSA, but Ebelt said it doesn’t have to if a person qualifies for coverage another way.
“We are committed to treating every client with respect and helping those who are eligible receive appropriate Medicaid coverage,” Ebelt said.
Montana instituted a three-month grace period for the work requirements. State officials won’t begin disenrolling people for noncompliance until October.
Pamela Herd, a University of Michigan social policy professor who has studied bureaucratic obstacles to public benefits, said convoluted disability cases are common enough for attorneys to specialize in accessing aid.
“When we’ve designed public programs in ways that people can’t figure out whether they’re eligible without consulting lawyers, we’ve done something wrong,” Herd said. “That has huge, huge implications for what’s to come.”
Montana officials have said they’ll automatically review medical records that could help patients qualify for an exemption. Even so, the federal guidelines released in June mean patients will probably still face additional steps to guarantee an exemption.
Meanwhile, already overstretched doctors worry they’ll face the burden of judging whether someone’s illness qualifies them for a work exemption.
Dishong said that between now and October, Montana officials could offer more clarity on how the process will work. She said she’s worried the state will end up “with a slow-roll mess” instead.
“This is a problem that’s just starting,” Dishong said.
As for Hailstone, she’s now reapplying for Social Security disability payments. That aid would limit how much she can work. But it would also guarantee access to Medicaid.
Have you tried to prove your eligibility for Medicaid under new rules that require people to show they are working, going to school, or participating in another qualifying activity? Click here to contact KFF Health News.
KFF Health 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 KFF.This article first appeared on KFF Health News and is republished here under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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- September 14, 2026
- Rose
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The little girl stared up at Norma Gómez from the doorway of her neighbor’s apartment, her sad, brown eyes suddenly flashing with hope.
“Are you the person who’s going to bring my mom back?” she asked.
Gómez struggled to find an answer. It was a December morning, and she’d brought food, diapers, baby wipes, and clothes — items she hoped would help the 6-year-old girl, her baby brother, and the neighbor who had stepped in to care for them. The children were left alone after federal immigration agents arrested their parents outside their apartment in Oxnard, a mostly Latino agricultural community on the Southern California coast. But Gómez had no power to bring the parents back.
“We’re working on that,” Gómez recalled telling the girl. In reality, she was at a loss for how to answer truthfully without upsetting her.
As a project manager for a nonprofit that provides food assistance to immigrant families affected by Immigration and Customs Enforcement raids, Gómez has witnessed the tumult and pain that have roiled the lives of millions of immigrant families since President Donald Trump returned to office, with devastating consequences for children’s health. They include an estimated 205,000 children with at least one parent detained by immigration authorities through April, a number that has undoubtedly climbed since. Separation from parents harms children psychologically. It destabilizes families, often leaving the remaining parent or caregiver scrambling to stay housed, buy food, and fulfill kids’ medical needs. Some kids are left alone to care for themselves.
Many kids whose parents aren’t detained are experiencing threats to their health and well-being too. Two children in the South died by suicide in February 2025 after reportedly being bullied over their family’s alleged immigration status.
Millions of children live in families losing access to medical care, food, tax credits, and other supports as federal and state governments roll back eligibility for immigrants with and without legal status. Fear of federal enforcement has pushed parents to avoid taking kids to school, going to the doctor, and engaging in social activities. Some have disenrolled from or avoided signing kids up for health and nutrition programs.
Children from immigrant backgrounds are also living in fear. They’re experiencing more emotional distress, increased bullying in school, and anxiety about racial profiling by ICE, even when they or their family members are citizens or legal residents.
Most of these children are American citizens. About 1 in 4 U.S.-born kids have an immigrant parent, including around 4.6 million with a parent who lacks legal status.
“I’m really concerned about how long it’s going to take for us as a country to address all of the harm that’s happening to this generation of kids,” said Wendy Cervantes, director of immigration and immigrant families at the Center for Law and Social Policy. “This type of stress can have long-term developmental harm and can really inhibit their ability to do well in school, to have good health outcomes, and to grow into thriving, stable adults.”
Curbing Public Benefits
Trump has made cracking down on immigrants — including the children of immigrants — a priority since his second term began last year. On Inauguration Day, he issued an executive order purporting to end birthright citizenship for kids born to parents without legal status or in the country on temporary visas, an attempt ultimately blocked by the Supreme Court.
His administration, with the approval of Republicans in Congress, has poured billions of dollars into immigration enforcement, detaining the parents of an estimated 145,000 U.S. citizen children as of April, and, according to an analysis by nonprofit newsroom The Marshall Project, over 6,200 children. It’s sought to rescind temporary protected status, or TPS, for over 1 million immigrants, tens of thousands of whom have U.S. citizen children, and stalled renewals in the Deferred Action for Childhood Arrivals program, which includes the parents of about 300,000 citizen children.
White House officials say the immigration crackdown benefits American citizens by freeing up resources such as jobs and housing, reducing pressure on public coffers, expelling criminals, and restoring integrity to the immigration system. (Studies have shown that mass deportations harm U.S. workers.) Trump and other Republican leaders have argued that birthright citizenship encourages unauthorized immigration and “birth tourism,” and that TPS has allowed immigrants from “dangerous, third-world countries” to remain in the United States indefinitely under what is supposed to be a temporary program.
In a statement, White House spokesperson Lauren Bis did not directly address whether the administration is concerned about long-term harm to children and increased healthcare costs because of its immigration policies. Instead, she repeated past White House criticisms that President Joe Biden’s immigration policies allowed children to be trafficked across the U.S. border.
“The real story is the psychiatric impact on the tens of thousands of children who were smuggled across the border — many by human and sex traffickers,” she wrote in an email.
Only 39% of Americans approve of Trump’s handling of immigration, according to a recent Associated Press-NORC Center for Public Affairs Research poll.
Stephen Miller, the chief architect of Trump’s immigration policies, has accused the children of immigrants of draining public resources and perpetuating problems from their parents’ home countries. Research, however, shows that immigrants earn more and do better the longer they live in the United States and that they and their children assimilate rapidly. Data also shows they rely less on welfare than native-born Americans.
“This is the great lie of mass migration,” Miller wrote on the social platform X in November. “You are not just importing individuals. You are importing societies. No magic transformation occurs when failed states cross borders. At scale, migrants and their descendants recreate the conditions, and terrors, of their broken homelands.”
The Republican tax-and-spending law enacted last summer curbs immigrant eligibility for health and food assistance programs. And this July, the administration issued new “public charge” rules that give immigration officers broad discretion to deny green cards to lawfully present immigrants if they or family members have used public benefit programs, a move that could result in over a million U.S. citizen children disenrolling from safety net healthcare programs.
Together but Afraid
Separation from parents is traumatic for children and can lead to lifelong health problems, including anxiety, depression, cardiovascular disease, and learning difficulties. Children separated from their parents at the border during the first Trump administration were found to exhibit lasting trauma. Researchers have also tied deportations and detentions of immigrant parents — as well as the threat of them — to widespread emotional trauma, higher school dropout rates, housing instability, and hunger among both immigrant and U.S.-born children.
It’s also costly to society. A 2024 study by federal researchers estimated that health conditions related to childhood trauma accounted for $292 billion in healthcare spending in 2021 alone, including by taxpayer-funded programs such as Medicaid and Medicare.
Emmanuel, a 13-year-old in Oxnard, gets anxious every time his dad goes to work as a farm laborer, his mother, Ana, said. He asks her for reassurance that his father will return, and about what would happen to him if his parents got detained. He tries to hurry Ana up when they’re out in public, worried that ICE could suddenly appear. KFF Health News is not using their full names because they fear deportation.
Doctors and therapists interviewed by KFF Health News said they have observed a notable increase in mental health problems, especially anxiety, in children from immigrant families. Kimberly McNally, a pediatrician at Venice Family Clinic’s Inglewood South La Brea Health Center, said she’s regularly referring children of all ages for mental health services related to fears that their parents will be taken away. At daycares, kids have been showing up with an extra bag in case their parents don’t pick them up, said Liza Davis, advocacy director for Children in Immigrant Families at The Children’s Partnership, which works with a coalition of early childhood educators.
Sometimes, the distress leads young people to take extreme actions. In June, 19-year-old Eliel José took his own life after his father was deported from the Atlanta area to Mexico, according to Univision.
Rosie Harrison, executive director of Grow Initiative GA, a community organization that serves low-income families, said she’s received calls over the past year from immigrant parents seeking help for suicidal and depressed kids. Their situations are often made worse because many lack health insurance and can’t afford to pay for therapy. That’s often because parents have lost jobs that came with health insurance due to worksite raids or because of eligibility changes imposed by the Trump administration.
“I’m concerned about the families that are going to be burying their child,” Harrison said. “I’m concerned that we are going to miss out on having an amazing person do amazing things for our community, for our country, because they took their life.”
Strength Under Pressure
Many children are showing resilience, though.
In a role reversal, some children have become their parents’ protectors. They go grocery shopping and take their younger siblings to school so that their parents don’t have to leave the house.
Giselle Gonzalez, a university student and volunteer with the immigrant protection network VC Defensa in Ventura County, California, said she’ll never forget the morning last summer when she woke up to the sound of kids on bicycles pedaling through her immigrant-heavy neighborhood in Thousand Oaks, yelling “La migra! La migra! Don’t come out!” They’d spotted ICE agents grabbing factory workers and gardeners on their way to work, she said.
Neighbors, community groups, health providers, and others have also stepped up in a variety of ways to support children and families affected by immigration enforcement. They deliver groceries, provide free therapy, walk kids to school, and help parents create emergency childcare plans in case they get detained or deported.
Ultimately, more humane immigration policies and enforcement tactics will be required to end the harm being done to children, academic experts and advocates said.
Researchers at Arizona State University point to a pilot called the Family Case Management Program as a model for keeping families together while also enforcing immigration laws. Launched in January 2016 under President Barack Obama, the program allowed families seeking asylum to remain in the community while awaiting resolution of their cases. Through a case manager, they received support in meeting the obligations of their immigration cases and preparing for deportation if needed. The program, which proved successful and cost-effective, was terminated by the first Trump administration.
At Venice Family Clinic in Los Angeles, case manager Mabel Alavez sees the pressures facing families who are still together but worried they could be separated. Many of the people are parents or grandparents who have been in the U.S. for decades. Some are afraid to take their children to school, the park, or the beach. They ask whether it’s safe to enroll their U.S.-born kids in Medicaid. She helps families who are facing eviction because they’re afraid to go to work and can no longer afford rent. She often helps them create plans for who will look after their children if they get detained.
Raised in an immigrant family herself, Alavez knows how challenging it can be for kids who are first-generation Americans to navigate growing up, going to school, and finding a sense of belonging in a country their parents aren’t from.
“It’s hard for me to imagine how they could possibly do that in addition to what’s going on now,” she said. “I do feel like there will be a big impact on them. What that might look like, I’m not exactly sure.”
KFF Health 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 KFF.This article first appeared on KFF Health News and is republished here under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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