The Viruses Causing New Outbreaks Are Much Less Familiar to Science

The types of Ebola and hantavirus panicking officials are very different from the species identified decades ago, raising new questions about how to respond.

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Readers Address Drugged Driving, Suicide Prevention, Worker Shortages

Letters to the Editor is a periodic feature. We welcome all comments and will publish a selection. We edit for length and clarity and require full names.

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On the Road To Find Out

Your article “Efforts To Understand the Nation’s Drugged Driving Problem Stall Under Trump” (May 19) missed the mark.

There is a real lack of data on drug-impaired driving across the country, but it’s not due to federal policy. The fact is, science has not yet found a simple, accurate way to measure if someone is too high to drive. And many local police departments just lack the resources to test drivers for drugs.

The National Highway Traffic Safety Administration under the Trump administration has prioritized countering drug-impaired driving. The agency continues to be a leading funder of drug-impairment research. To address state and local enforcement shortfalls, NHTSA provides ongoing funding, training, and resources. Unlike the previous administration, we’ve vigorously engaged with law enforcement to encourage road stops to combat drug-impaired driving. And, while some employees voluntarily left the agency last year, NHTSA has ensured that staff resources remain focused on this priority.

— Jonathan Morrison, administrator of the National Highway Traffic Safety Administration; Washington, D.C.

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Shining Light on Suicide Rates and Poverty

I am a professor of risk and policy analysis at Indiana University who recently read Aneri Pattani’s piece entitled “Low Wages, Empty Plates, Heavy Toll: Rethinking Suicide Prevention” (May 12). I found it gracefully written and emotionally moving in its use of real-world stories. But I think the scientific foundations of your piece are, at best, murky. Please let me explain why.

There is no question that when we compare households of different income levels, the suicide rate is much higher in low-income households than in higher-income households. It is tempting to conclude that people living in a low-income household may be inclined to die by suicide because they lack sufficient resources to access life’s necessities. This is what I take to be the premise of your piece, linking suicide prevention to the minimum wage law and policy around the Supplemental Nutrition Assistance Program.

Scientifically, the cross-sectional household comparison does not establish a causal relationship between poverty and risk of suicide. The obvious reason is that there are many other possible explanations for the association: higher rates of mental illness in low-income households, higher rates of substance misuse in low-income households, lower levels of educational attainment in low-income households, and so forth. Poverty itself may be a causal factor, but these other variables matter and may be much more important than poverty per se.

If poverty is a powerful cause of suicide, we should be able to discern changes in the rate of suicide during periods when the rate of poverty changes substantially. Take the period 2010 to 2019, when the U.S. poverty rate declined steadily and substantially (the period of recovery from the financial crisis and the Great Recession of 2007-09). In 2019 (the last year before the covid-19 pandemic), the overall poverty rate, 10.5% — and the elevated rates among Blacks and Hispanics — were the lowest recorded since federal poverty statistics began in 1960 (when it was about 22%). Yet the decade from 2010 to 2019 saw a surge in the nation’s suicide rate. In fact, if you take the longer period of 2000 to 2022, you find steadily rising rates of suicide in the United States, yet virtually no change in overall poverty rates.

Such temporal comparisons do not prove that poverty does not cause suicide. What they show is that poverty is not a highly potent cause of suicide. My guess is that poverty per se is a relatively minor cause of suicide, but even a minor causal role does not suggest that an increase in SNAP or Temporary Assistance for Needy Families benefits would reduce suicide.

One final point is about the large means-tested safety net in the United States. You are on firm ground in raising questions about what the Trump administration is doing to the safety net. But your readers need to appreciate that U.S. taxpayers are supporting a $1 trillion-a-year suite of anti-poverty programs, excluding Social Security and Medicare. The largest of those programs are Medicaid, coupled with the Children’s Health Insurance Program, and SNAP. But there are also the Affordable Care Act premium subsidies, the state block grants for TANF, childcare, job training, the Department of Housing and Urban Development’s rental vouchers, Pell Grants, federal student loans, and more. The means-tested safety net is much larger than the defense spending and growing rapidly as a share of the federal budget.

My view is that these programs are largely worthwhile, but not because they have played a powerful role in preventing suicide. A few budget numbers on the size of the safety net would have strengthened your piece and signaled to readers that you appreciate our country’s major investment in safety net programs.

Obviously, your piece stimulated me, which is a good thing.

— John D. Graham; Bloomington, Indiana

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Single-Payer vs. All-Payer

I’m curious why Xavier Becerra — or any of the other California gubernatorial candidates, for that matter — aren’t talking about an “all-payer” model, similar to what was in place in Maryland (“In California Governor Race, Single-Payer Is a Litmus Test. There’s Still No Way To Pay for It,” May 8). There are many reasons a single-payer model wouldn’t work in one state, only one of which is the difficulties in figuring out reimbursement for people who travel out of state and receive healthcare while traveling. The all-payer model, which is being replaced by the AHEAD (Achieving Healthcare Efficiency through Accountable Design) model from the Centers for Medicare & Medicaid Services, is something worth considering in California. With the sheer size of the population, having unified billing, coding, and metrics across all payers could save millions in administrative costs.

We need to start with ideas that are feasible and then work our way toward something bigger. Let’s at least have a conversation about something that is possible to do.

— Kathryn Peisert; San Rafael, California

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Bolstering the Home Care Workforce

This is another instance of money not being used wisely. In the article “Kids Keep Getting Stuck in Hospitals, Even After Being Cleared for Discharge” (May 18), pediatrician Elaine Lin noted a shortage of home care aides. In some states, private businesses provide home care services. Due to a profit incentive, these businesses often pay home care aides low wages.

This is one of the factors driving worker shortages. Why not try transferring a portion of the money now spent on high-cost hospital stays to better-trained and better-paid home care aides? Of course, each state has its own laws, regulations, and funding sources to navigate. However, it seems the willpower to collaborate is a necessary piece to solve this problem.

Some children could benefit from receiving care in a group home setting or at home with family members. If money can be better spent, let’s start with creating a system to increase the pay of better-trained and better-paid home care aides — a system that should increase the quality of services at reduced costs.

— Russell Anthony; Nashville, Tennessee

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Essential Help While We Age

Your recent article “The Help That Many Older Americans Need Most” (April 27) captures something the healthcare system has been slow to accept: What happens to older Americans’ health is determined less by what happens in the clinic than by what happens at home, in the neighborhood, and at the kitchen table.

The evidence is stark. Nearly 1 in 10 older adults live in poverty, and many face persistent food insecurity. These challenges reinforce one another in a devastating cycle: Loneliness worsens food insecurity, food insecurity accelerates functional decline, and functional decline deepens isolation.

Community health workers are doing essential work to interrupt these cycles. But too much of that work remains invisible. Providers refer patients to community resources with no way of knowing whether anyone followed up. Community organizations serve people without a consistent way to report back. The result is a system that means well but cannot learn from itself, and older adults, especially those in rural areas, are left to navigate the challenges alone.

Technology can change that. Leaders nationwide are turning to closed-loop referral networks that enable community health workers and clinical providers to connect individuals with food assistance, transportation, housing support, behavioral health services, and other essential resources. Importantly, technology helps them track whether those services are actually received.

Beyond the initial referral, these networks monitor improvements in specific health metrics, like A1c levels and hospital readmissions. By identifying unmet needs early and coordinating timely support, they help prevent health crises and alleviate burdens on caregivers.

Both Oregon and Missouri offer strong examples of what this looks like at scale. In Oregon, statewide closed-loop referral technology, available across all 36 counties, served more than 80,000 clients. It also delivered $29 million in health-related social needs (HRSN) benefits to 15,000 Medicaid clients under Medicaid’s 1115 waiver last year alone.

In Missouri, the ToRCH program has seen its participating hospitals and clinics achieve a 19.6% increase in individuals with controlled blood pressure and an 18% increase in behavioral health follow-up after visits to the emergency department.

The Rural Health Transformation Program offers a concrete opportunity to build on this model. Policymakers should seize the opportunity to invest in infrastructure that makes social care coordination real: not just referrals sent, but services confirmed, outcomes tracked, and communities strengthened.

For an older adult in rural America, the difference between knowing where to turn and not knowing can be the difference between staying home and ending up in the emergency room. That’s the gap these systems can close.

— Halima Ahmadi-Montecalvo, vice president of research and evaluation for Unite Us; Washington, D.C.

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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.

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Trump Administration to Send Americans Exposed to Ebola to Kenya

In past outbreaks, Americans exposed to the virus were sent home to be treated in state-of-the-art facilities. The Trump administration has already flown some U.S. citizens to Europe for treatment.

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Eli Lilly to Buy 3 Vaccine Developers

The drugmaker said it would spend up to $4 billion to acquire small companies exploring vaccines for shingles, Epstein-Barr virus and other pathogens.

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

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

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

Though she practices yoga and is healthy, Miller said she still feels “vulnerable.” If she lands in the hospital, her plan pays a flat $2,000, a fraction of the $30,000 price tag of an average hospital stay.

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

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

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

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

Enrollment data for alternative plans is mostly confidential, but several indicators point to shifts in the market. Recent estimates suggest marketplace enrollment declined about 20% from 2025, and a KFF survey of people on the exchanges last year found that 5% switched to private, nonmarketplace individual coverage, including plans that don’t comply with the ACA. Covered California, the state’s marketplace, plans to survey former enrollees to find out where they went.

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

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

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

Melanie Miller, 59
Harbor Springs, Michigan

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

Killelea and other health insurance experts say that the fine print on these plans can be difficult to parse and that enrollees don’t have the protections of traditional insurance to fall back on. A 2023 peer-reviewed study found that after reading a summary of a sample short-term policy’s benefits and a disclosure that the plan was not ACA-compliant, only half of participants understood that prescription drugs were not covered.

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

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

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

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

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

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

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

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

Robert Godfrey, 64
Clearwater, Florida

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

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

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

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

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

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

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

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

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

Are you struggling to afford your health insurance? Have you decided to forgo coverage? Click here to contact 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.

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Lenacapavir, which protects people from H.I.V. infection with twice-yearly shots, is arriving in a country where the health system has been hollowed out by American aid cuts.

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One-and-Done Heart Disease Prevention? Scientists Show It May Be Possible.

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Short Naps, Long Hours: How Autism Clinics Squeeze Medicaid Dollars Out of Preschoolers

The industry has grown rapidly, straining state budgets. A focus on finances has led to overbilling, fraud and even harm.

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The outbreak, with more than 8,000 confirmed cases and another 60,000 suspected infections, has prompted an emergency vaccination drive.

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Trump’s $50B Rural Health Bet Meets a Healthcare Desert in North Carolina

WILLIAMSTON, N.C. — Two years after her brother’s death, Debra Pierce still wonders whether the 50-year-old would have survived his heart attack if her local hospital hadn’t closed.

“The sad thing is we’ll never know if he could have been saved that night or not, because we don’t have a higher level of care in this county,” Pierce said as she stood outside the mobile home where she last hugged her brother.

Emergency crews from a neighboring town worked on Stanley Sears for a half hour but couldn’t revive him for the long drive to the closest hospital, records show.

In the tall grass — which would be mowed if Sears were still alive — Pierce swiped through the photos on her phone. She stopped at a picture that showed Sears smiling. Pierce chuckled and then sighed: “Bless him.”

Stanley Sears and sister Debra Pierce at a Walmart. Sears died after a heart attack in North Carolina’s Martin County the year after the 2023 closure of Martin General Hospital. (Stanley Sears)

The local hospital had closed a year before Sears’ death, leaving behind a gutted healthcare system. Martin County does not have paramedics on its ambulances, and it can be 20 miles or more to the closest — and often overcrowded — emergency rooms.

The healthcare gaps in Martin County illustrate the finite reach of a $50 billion rural health fund that Republicans crafted to strengthen support for President Donald Trump’s signature tax and spending measure, the One Big Beautiful Bill Act, last year. Though the cash has not been doled out, Republican candidates in competitive midterm elections — including the closely watched battle for the congressional district that encompasses Martin County — are casting the fund as a lifeline that will shore up critical rural health services across America.

The money has been highly anticipated in North Carolina, where most residents live in rural counties. Pierce, a Republican who blames county officials for the hospital closure, said she has faith Trump will help them. “Old man’s doing his job up in there,” she said.

On paper, Martin County — home to about 22,000 people — looks like a top contender to receive at least some of the $213 million that’s been earmarked for North Carolina.

Yet County Manager Drew Batts said it won’t be the answer for his residents.

“The $50 billion is not something that is specifically going to help our situation,” Batts said as he walked into the shuttered hospital in April. “It’s not going to help us get this place reopened.”

Martin County won’t get direct relief from Trump’s rural health fund — because its hospital isn’t open. North Carolina is distributing the money among existing health and social service organizations. Plus, federal regulators set limits on how much can be spent on construction and building renovations.

Martin County Manager Drew Batts stands inside the shuttered Martin General Hospital in Williamston, North Carolina, and points to a picture of his wife, who worked there as operating room nurse manager. (Sarah Jane Tribble/KFF Health News)

‘We Can Only Pray’

Martin General Hospital closed abruptly in 2023, surprising employees and shocking patients, who had to be wheeled out on stretchers and transported elsewhere to finish treatment. The closure even stunned local elected leaders, who say the company operating the county-owned hospital, Quorum Health, did not notify them it intended to shut down operations and file for bankruptcy. Quorum spokesperson Lisa Anderson said the company had told county commissioners of the hospital’s ongoing financial challenges.

Politicians have spent the years since trying to reopen the hospital, with county taxpayers pouring an estimated $2.9 million into maintenance, utilities, and other costs in the hopes of resuming operations, Batts said.

The county is now considering spending at least $1.5 million, he said, to create two higher-level paramedic units with quick-response vehicles, specially equipped with electrocardiogram equipment or other “advanced lifesaving support.”

Pierce said she is praying the county can add paramedics and reopen the hospital.

“There’s some answered prayers happening every day,” she said. “So, we can only pray and hope, you know?”

Debra Pierce holds up a picture of Stanley Sears, her brother, while standing in the yard of the mobile home he was renovating before his death in 2024. Pierce believes North Carolina’s Martin County needs higher-level emergency services and a hospital. (Sarah Jane Tribble/KFF Health News)

‘They Just Want To Not Die’

With its nine hospitals, the region’s largest health system is ECU Health, connected to East Carolina University. The system has become a de facto safety net for 29 counties. Batts and Brian Floyd, the Greenville-based system’s chief operating officer, have lobbied state and federal lawmakers, walking them through the shuttered hospital and asking for help.

“It’s a real healthcare crisis that has already proven itself to have lost lives that perhaps didn’t have to be lost,” Floyd said. “They just want to not die because there’s nowhere to go when you have an emergency.”

Eleisa Ann Evans drove 2½ hours from a small town near the Outer Banks on a recent evening so her aunt could get care at an ECU Health ER in Greenville. Once there, Evans said, staff told her to leave her 79-year-old aunt in the waiting room and wait outside because of capacity issues.

Evans said she was outraged at the way the staff treated her. She said she had been standing behind her aunt’s wheelchair while inside and “wasn’t using nobody’s chair.”

With Martin General gone, all the surrounding counties are “also in jeopardy,” Floyd said. “No one knows what to do” with that large of a healthcare “desert,” he said.

What healthcare is left in the county includes one urgent care center, run by a private company, and a nonprofit health clinic, operated by Agape Health Services, which accepts patients from five counties and plans to build another primary care clinic to meet demand.

ECU Health signed a letter of intent last year to reopen Martin General as a rural emergency hospital that would provide outpatient care as well as an ER. Under the terms of the deal, Martin County would pay to refurbish the hospital, and the North Carolina General Assembly would have to give ECU Health $210 million, of which $150 million would pay for the construction of a new inpatient tower at ECU’s Beaufort Hospital.

The health system, through its affiliate Access East, won a portion of North Carolina’s $213 million first-year payout from the rural fund. But the federal money can’t be used to reopen Martin General, Floyd said.

The five-year Rural Health Transformation Program is slated to be delivered in $10 billion annual increments to states, which applied and competed for the money.

North Carolina’s plan creates a hub-and-spoke model that allots money to six large regional leads, including nonprofits such as Access East. Those hubs will distribute money to local entities and coordinate broad initiatives such as improving primary care and fortifying the healthcare workforce, as well as developing “digital solutions,” according to the state’s hub application.

An Election Issue

The lack of emergency care in the region has emerged as a top talking point in a close U.S. House race between Rep. Don Davis, a Democrat who represented the district when Martin General closed and is seeking his third term, and Republican Laurie Buckhout.

The rural health fund was added at the last minute in 2025 to win votes for the One Big Beautiful Bill Act, which is expected to reduce federal Medicaid spending by more than $900 billion over a decade — cuts that are projected to hit rural hospitals and clinics especially hard. Rural health executives say the fund won’t come close to offsetting those losses.

Matt Mercer, a spokesperson for the North Carolina Republican Party, called the rural fund a “once in-a-generation opportunity” for the state.

But U.S. Sen. Thom Tillis, who was one of three Republican senators to vote against the bill — and who announced shortly before the final vote that he planned to retire from Congress — warned of devastating consequences ahead for healthcare in his state.

Buckhout, who declined an interview, plans to attack Davis — a vulnerable incumbent whose district was recently redrawn to favor GOP candidates — for voting against the bill.

“Martin County lost its hospital on his watch, and he still opposed the funding meant to help communities like it,” Buckhout campaign spokesperson Stephen Gallagher said in a statement to KFF Health News. The campaign did not respond to additional queries about her plans for healthcare access, if elected.

An empty waiting room inside the shuttered Martin General Hospital. The hospital’s closure in 2023 surprised employees and patients, who had to be wheeled out on stretchers and transported elsewhere to finish treatment. (Sarah Jane Tribble/KFF Health News)

Davis, who signed a letter from lawmakers in support of North Carolina’s rural health fund application, said the money “is essentially putting a band-aid on a much, much broader situation that needs dire help.” He has introduced legislation that would increase Medicaid reimbursements for rural hospitals, though it has not moved forward.

During recent testimony on Capitol Hill in Washington, ECU Health CEO Michael Waldrum said his system expects to lose a billion dollars over the next 10 years from the looming Medicaid cuts.

Overnight Waits for Emergency Care

The region’s emergency rooms offer a stark glimpse of a healthcare system in crisis.

Martin General’s ER treated about 11,000 patients annually before it closed, according to state data. A sign still hangs in the staff break room showing that 23 patients were seen in the ER the day it closed.

ECU Health, which owns all but one of the rural hospitals around Martin General, reported a 132% increase in its daily ER visits since the hospital’s closure. The company’s nearly 1,000-bed hospital in Greenville, about 40 minutes from Williamston, is the state’s only Level 1 trauma center east of Raleigh.

The Greenville hospital’s median patient ER wait and treatment time was nearly 4½ hours, according to the most recent federal data. That’s longer than 96% of thousands of hospitals reporting nationwide. The wait times “don’t reflect poor care,” ECU Health spokesperson Brian Wudkwych said in an emailed statement. He said the system’s ERs treat nearly 300,000 patients annually.

While the system has seen an increase in Martin County patients, the wait times primarily stem from shortages of inpatient and behavioral health beds, Wudkwych said.

Floyd, the ECU Health chief operating officer, said many rural patients who arrive at the system’s ERs have multiple chronic conditions that require longer visits. Often doctors start treating one problem and then find the patient’s “blood sugar is out of control, your hypertension is far out of control,” he said.

ECU staff encourage people who are not too sick to skip Greenville and, instead, seek care at one of the system’s community hospitals, which aren’t as busy, Floyd said.

A security officer guarded the Greenville emergency department’s doors on two nights in April. The “capacity notice” sign near the entrance meant family members of patients had to wait in cars or on benches outside.

“We’ve only been here six hours,” Tonya Miles said after bringing her mother for a potential blood clot in her leg. The family had left the day before after waiting for two hours, because her mom “wasn’t prepared” for such a delay in treatment, Miles said.

Tonya Miles (right) sits with family outside ECU Health Medical Center in Greenville, North Carolina. Miles said they had “only been here six hours” after bringing her mother to the emergency room for a potential blood clot in her leg. (Sarah Jane Tribble/KFF Health News)

On another evening, Olivia Lewis said she had brought her mother two nights previously and left without care after their wait stretched from 10:30 p.m. to 7 a.m.

“She tore off her hospital bracelet and said: ‘I’m out. I’m done,’” she said. Now, they were back.

On a recent Friday in Martin County, Vannessa Little was sitting at a McDonald’s with her kids just down the street from the closed hospital. Little pointed to one of her girls and wondered how her care would have been different if the hospital had been open.

Her daughter, then 6, suffered severe burns over 30% of her body in 2024, and the journey to treatment was “just crazy,” Little said. An ambulance arrived at her Williamston home from neighboring Bertie County to transport them to ECU’s Greenville ER.

“That was a long time,” Little said of the 30-mile drive. The girl was ultimately airlifted more than 100 miles to Chapel Hill. Little said she hadn’t heard of Trump’s rural health investment. “The only changes that people are making is they’re taking away everything.”

She voted against Trump in 2024 and said she didn’t think she would vote this year.

“It’s a waste of my time.”

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 <a target="_blank" href="https://kffhealthnews.org/rural-health/rural-health-fund-hospital-closures-north-carolina-martin-general/">article</a&gt; first appeared on <a target="_blank" href="https://kffhealthnews.org">KFF Health News</a> and is republished here under a <a target="_blank" href="https://creativecommons.org/licenses/by-nc-nd/4.0/">Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="https://kffhealthnews.org/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

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Experimental Drug Yields Dramatic Weight Loss

People who got the injection, retatrutide, lost 28 percent of their body weight on average after 80 weeks, Eli Lilly said.

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Colorado Charts Its Own Course on Vaccines Amid Federal Pullback

In response to abrupt and politicized changes to federal vaccine policy, concerned Coloradans have taken several steps to shore up support for vaccine science.

A bill passed by the state legislature in March then signed into law by Democratic Gov. Jared Polis allows Colorado to further uncouple itself from federal guidance.

The law allows health officials to follow the recommendations of national medical groups when making decisions such as purchasing bulk vaccines for the Medicaid program.

“We are insulating our state from the dysfunction coming out of Washington,” said Democratic state Sen. Kyle Mullica, a co-sponsor of the bill and a registered nurse. “We’re going to rely on science.”

“From fighting during the pandemic for Coloradans to get vaccines as quickly as possible to combating the Trump Administration’s barriers to getting vaccinated, we have expanded access to vaccines for Coloradans who want them,” Polis said in a statement when he signed the law.

Colorado is one of at least 29 states that, along with Washington, D.C., have taken steps to bypass the new federal recommendations amid worries that the changes could chip away at public trust in vaccines and erode broad vaccine coverage.

Previously, Colorado, like most states, had followed federal guidance set by the Centers for Disease Control and Prevention. In January, CDC advisory panelists, selected by Health and Human Services Secretary Robert F. Kennedy Jr., removed six pediatric immunizations from the agency’s universal recommendation list.

Last year, doctors, scientists, local leaders, and other supporters came together to form an outreach and advocacy coalition called Colorado Chooses Vaccines.

The group aims to offer a clear, unified voice on the proven benefits of vaccines and reassure residents confused by the many federal changes.

Carol Boigon, a former Denver City Council member, joined the group because she wants more people to hear her own chilling story about vaccine-preventable illness.

“Every summer everybody got sick,” Boigon said, recounting her childhood in 1950s Detroit.

The illness was polio, a highly contagious viral disease that attacks the nervous system, sometimes causing partial or full paralysis.

During the summer of 1953, “the whole block was sick and some of us got crippled, and that was just the way it was,” she said.

New Group Steps Up

Boigon’s personal history will be part of the coalition’s work to educate new generations about the dangers of infectious diseases that were once common in the U.S. but are now relatively rare.

The group, which formed last September, will also compile vaccine information from medical groups and the state health department and advocate for policy proposals with the state government.

Boigon shows memorabilia from her life and career. (Kevin J. Beaty/Colorado Public Radio/Denverite)

“It was in direct response to the federal threats,” said another coalition member, former state lawmaker Susan Lontine. She leads the nonprofit Immunize Colorado.

Another member, public relations specialist Elizabet Garcia, wants more outreach to Hispanics, whose vaccination rates lag behind other groups’.

“A lot of time it’s this fear that they’re going to have to pay out-of-pocket, that their insurance doesn’t cover it, that they might not even have insurance in general,” Garcia said.

Boigon was 5 when she got sick and was hospitalized for six weeks with a fever. The virus attacked her spine.

“None of my limbs worked immediately afterwards,” Boigon said.

Although she regained function in her other limbs, her right arm never fully recovered. She had to adapt, relearning everyday tasks such as reaching out to shake hands with people with her left hand.

In 1955, not long after she got sick, the new polio vaccine became more widely available to the public. As vaccinations took off, U.S. cases of polio, once one of the nation’s most feared diseases, dropped by an estimated 85%-90%.

Increasing Public Trust

State leaders have taken other steps to promote public health. After the Trump administration pulled the U.S. out of the World Health Organization, several states, including Colorado, decided to join the WHO’s Global Outbreak Alert and Response Network on their own.

Colorado also joined a multistate lawsuit challenging the Trump administration’s changes to the childhood vaccine schedule.

And the new state law has provisions besides allowing the state to diverge from federal recommendations. It codifies pharmacists’ ability to prescribe and give vaccines themselves. It also increases legal protections for healthcare workers who give vaccines.

“This law will provide more clarity to guide all Coloradans, including providers who administer vaccines,” Lontine said.

But the legislation has opponents who say it would interfere with parental choice and claim vaccines might be unsafe or ineffective.

“I just want to make sure we’re not just getting into a big political dispute between the federal recommendations — the CDC and so forth — and different political views in Colorado here,” said Republican state Sen. John Carson, who voted against the vaccine bill.

NPR contacted the U.S. Department of Health and Human Services about Colorado’s new law. Spokesperson Emily Hilliard answered in an email: “The updated CDC childhood schedule continues to protect children against serious diseases.”

Preventable Illnesses Surge

The flurry of statewide activity comes as Colorado and the nation have seen surges in illnesses such as flu and measles.

As of mid-May, Colorado had recorded 22 measles cases this year. In 2025, it registered 36 cases, according to the state health department, far surpassing totals from previous years.

Across Colorado, kindergarten vaccination rates for measles were 88% last school year — with only a few counties achieving rates of 95%, the level needed for herd immunity, according to data published by The Washington Post in December.

This has also been Colorado’s worst flu season in recent years.

Vaccination rates for both flu and covid-19 have dropped slightly in Colorado, according to the state health department.

Eight children in Colorado have died this season from flu; one from covid; and one from RSV, or respiratory syncytial virus. Vaccines for all three are available for children and recommended by the state’s health department.

Kennedy, a longtime anti-vaccine activist, has defended his decisions to overhaul the recommended schedule for childhood vaccinations.

In March, a federal judge put on hold many of the changes.

“We’re not taking vaccines away from anybody. If you want to get the vaccine, you could get it. It’s going to be fully covered by insurance just like it was before,” Kennedy told CBS News in January.

When a reporter suggested the new changes could result in fewer people getting a flu vaccine, Kennedy said: “Well, that may be, and maybe that’s a better thing.”

Boigon is sometimes incredulous at everything that has happened.

“It’s like we’re going backwards,” she said. “It’s like we have decided we don’t want a modern life; we want to be back in the 1950s, where children are sick and dying.”

Boigon at home in Denver. (Kevin J. Beaty/Colorado Public Radio/Denverite)

This article is from a partnership with Colorado Public Radio and NPR.

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 <a target="_blank" href="https://kffhealthnews.org/public-health/colorado-vaccine-law-coalition-cdc-acip-infectious-disease-prevention-polio/">article</a&gt; first appeared on <a target="_blank" href="https://kffhealthnews.org">KFF Health News</a> and is republished here under a <a target="_blank" href="https://creativecommons.org/licenses/by-nc-nd/4.0/">Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="https://kffhealthnews.org/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

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Ebola Containment Efforts May Have Been Hindered by USAID Shutdown and CDC Cuts

Aid cuts by the Trump administration have shut down crucial disease surveillance networks and medical supply chains in East Africa.

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Watch: The Tug-of-War Over Taxpayer Dollars

Julie Rovner, KFF Health News’ chief Washington correspondent and host of the What the Health? podcast, recently spoke with Sen. Tammy Baldwin (D-Wis.) about the ongoing fight between President Donald Trump and Congress over control of federal spending.

Baldwin, who is a member of the Senate Appropriations Committee and the Senate Health, Education, Labor and Pensions Committee, said lawmakers have been forced to take unprecedented action to ensure the Trump administration properly spends taxpayer dollars.

“In this most recently passed bill that Donald Trump signed into law, we had to put guardrails that we’ve never had to put into our appropriations laws before to enforce our spending bills,” Baldwin said. “And those laws have made it clear that we expect that they must spend what we have appropriated, and not just all of it at the end of the fiscal year, but in a timely manner throughout the year.”

The conversation also addressed the success — and Trump-imposed limitations — of the 988 Suicide & Crisis Lifeline. The resource, which was created through a bipartisan effort, has led to a notable reduction in youth suicide, according to research published last month in the Journal of the American Medical Association.

“It’s heartwarming to know that this work matters,” Baldwin said.

This interview aired May 14 on Episode No. 446 of What the Health? From KFF Health News: “In Search of a New FDA Commissioner.”

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 <a target="_blank" href="https://kffhealthnews.org/news/podcast-interview-senator-tammy-baldwin-taxpayer-dollars-988/">article</a&gt; first appeared on <a target="_blank" href="https://kffhealthnews.org">KFF Health News</a> and is republished here under a <a target="_blank" href="https://creativecommons.org/licenses/by-nc-nd/4.0/">Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="https://kffhealthnews.org/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

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The prehistoric hominins “apparently were very adept at what we would consider invasive medicine,” said the anthropologist John Olsen.

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Eroding ACA Enrollment Portends Higher Insurance Rates

Enrollment in the Affordable Care Act continues to erode as some customers struggle to make premium payments, with the declining numbers churning market uncertainty for insurers. In response, insurers are likely to raise rates again next year, following this year’s larger-than-typical hikes.

Sign-ups were already down in January by about 1.2 million from last year’s record enrollment. For this year, enrollees then faced premiums that increased, on average, by 26%. On top of that, subsidies that help people purchase coverage shrank or vanished.

Now experts are watching how many of the approximately 23 million people who enrolled will fail to pay their share of premiums.

While available data on premium payments is mainly from January, a few states that run their own ACA markets have released information for later months. The sharpest drop in people paying premiums, based on limited data, is in Georgia, which saw a 28% drop in April compared with the same period a year ago, according to an analysis by Charles Gaba, a healthcare policy analyst and blogger who specializes in the ACA.

The news website NOTUS reported May 12 that it had internal Centers for Medicare & Medicaid Services data showing that roughly 21% of people using the federal ACA marketplace — 30 states — failed to pay their share of January premiums, which, if correct, is far higher than at the same time last year.

CMS did not answer questions from KFF Health News about the enrollment data.

In looking at the early numbers analysts released, “we can’t yet quantify how much worse it will be than in previous years, but it will absolutely be worse because of the sticker shock,” said Ellen Montz, a managing director with consulting firm Manatt Health, who helped oversee the ACA during her tenure with the Biden administration.

The initial results come amid rising public concern about affordability, with polls showing that healthcare costs are often top of mind for voters.

A KFF analysis released May 19, for instance, found that the average ACA plan deductible saw the steepest increase in history — growing by 37%, or over $1,000, from $2,759 in 2025 to $3,786 in 2026 as enhanced premium tax credits expired.

Those rising costs pose a political challenge for President Donald Trump and the broader GOP, which has opposed enhanced subsidies to help people purchase Obamacare coverage. Republican lawmakers also passed a spending package last year — enacted as the One Big Beautiful Bill Act — that included provisions expected to reduce ACA enrollment and was cited among factors fueling higher premiums this year.

The enrollment reductions “are real people with real consequences,” Montz said. “The Affordable Care Act is a political lightning rod, but it’s a critical component of the coverage landscape.”

Following the Numbers

Right now, the drop-off rate aligns with what some policy experts predicted, partly because Congress did not extend generous benefits that expired at the end of last year. Those enhanced subsidies had been in place since 2021.

“Overall, the individual market does appear to be trending toward a significant contraction in 2026, and may well resemble” drops projected by the Congressional Budget Office, said a report from the Wakely Consulting Group, an analysis arm of the HMA Co.

Based on its analysis, drawn from data provided by 75 insurers, Wakely estimates that average ACA enrollment will end up being 17% to 26% lower this year than last.

So far, the Wakely report says, an average 86% of enrollees made their first payment in January.

Failure to pay premiums varied by state. Those with the lowest drop-off rates had enacted additional help — such as backfilling part or all of the reduced subsidy amounts with state money — or experienced lower premium increases. States that run their own exchanges had higher payment rates (92%) than those served by the federal marketplace (82% to 84%).

Gaba’s initial analysis of data includes more recent numbers from nine of the 20 states that run their own Obamacare marketplaces.

“Georgia could be fairly representative” of other states that did not enact additional protections, Gaba said. For example, payment failure rates, year over year, were 11.6% as of April in New Jersey, and, as of February, 15.7% in Washington state and 8.5% in California.

Only one state in his sample — New Mexico — saw an increase in the percentage of people making premium payments, according to the latest available monthly data. Unlike most, it had set aside state money to fully make up for the lower federal subsidy amounts.

Enrollment figures for the ACA are never static. Traditionally, more people sign up — either through auto reenrollment or by taking initiative to shop — than actually pay premiums, so the numbers tend to be higher at the start of the year.

People drop out over the course of a year for many reasons, such as finding other coverage through a job or by marrying someone with insurance.

Cost, of course, is a factor. This year, because premiums went up and subsidies went down, many people faced costs at least double what they previously paid toward their coverage.

And the Trump administration ended a special enrollment program that let low-income people enroll year-round.

Some ACA critics say enrollment drops should not be seen solely in the context of rising costs. Paragon Health Institute, a free-market think tank that has become influential among conservatives on Capitol Hill, has long argued that record enrollment numbers in recent years were fueled by fraudulent sign-ups, perhaps in the millions.

Insurers, hospitals, and policy experts took issue with the methodology Paragon used to estimate improper enrollments, saying they likely were vastly overestimated.

In a recent Paragon newsletter, the organization’s president, Brian Blase, doubled down on the fraud findings. Using data that detailed how many people failed to make premium payments each year, on average, from 2014 to 2019 — the year before covid emerged and two years before enhanced subsidies kicked in — he offered this prediction for 2026: About 19 million people would be enrolled by year’s end. Even at that, the note says, the “market would be 90% higher than the pre-COVID average.”

For other experts, however, the biggest explanation for falling enrollment is cost.

Some people had never experienced the ACA before the enhanced tax credits kicked in, so they faced extra sticker shock.

“In economic theory, no matter whether one is left, right, or center, it’s a simple fact that when you raise prices of something, fewer people will buy it,” said Sabrina Corlette, co-director of the Center on Health Insurance Reforms at Georgetown University.

The Long View

The expectation of a lower enrollment trend holding up is one of the key factors likely to translate into higher cost estimates as insurers draw up 2027 rates.

For one thing, though it is still unclear how many people will stay enrolled, it is also unknown whether those enrollees will submit more medical claims than insurers projected. It’s generally thought that younger or healthier people are more likely to drop coverage when faced with growing premiums.

Secondly, there has been a sharp shift by consumers to purchase bronze-level plans, which have smaller monthly premiums but higher deductibles — the amount people must pay out-of-pocket for most treatment, except preventive care, before insurers pitch in. The KFF analysis found that sign-ups for bronze plans jumped from 30% to 40% of total plan selections — growing from 7.3 million in 2025 to 9.2 million people this year. Will they pay? Or will hospitals and doctors be on the hook for uncollected copays or deductibles, and then raise prices to compensate?

Insurers base their premiums, in part, on such analyses.

Another troubling factor for actuaries is the late posting of a key regulation that sets the next year’s rules for ACA health plans. The initial 2027 proposal from the Trump administration came out in mid-February and included aggressive new ideas — such as sharply increasing deductibles for certain types of ACA plans or allowing insurers to offer plans with no set networks of medical providers. It was not finalized until May 15, well into the time when insurers are calculating premiums for the following year. Many of the proposed changes, with some modifications, were approved, such as allowing for higher annual deductibles in some types of coverage.

“This is definitely a challenging year to be an actuary,” said Louise Norris, a health policy analyst for healthinsurance.org, a consumer information and referral website affiliated with Trove Group, an insurance agency.

“We know for sure that the individual market has gotten smaller and almost certainly sicker, as the people dropping coverage are more likely to be healthy.”

While they “aren’t waving huge red flags” yet, insurers are closely watching trends, said Michelle Anderson, a director at Wakely and co-author of the recent report.

Anderson does not expect an average 26% premium increase like the one seen this year.

Still, Anderson expects the ongoing uncertainty and predicted decline in enrollment, which will vary by state and insurer, to play a role in setting next year’s premium rates.

“It would not surprise me if there were some double-digit increases,” Anderson said.

KFF Health News reporter Rachel Spears contributed to this article.

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.

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Trump Bought Stock in Drugmaker as His Government Boosted Its Obesity Drugs

President Donald Trump earlier this year bought as much as $680,000 in stock of Eli Lilly, the maker of blockbuster obesity drugs, as the agencies he oversees undertook an agenda that largely benefited the company.

On May 14, the federal government released ethics disclosures revealing a list of stock and bond trades made on Trump’s behalf from January to March of this year. They included extensive trades across the economy, including investments in tech giants such as Microsoft and Nvidia, aerospace firms such as Boeing, and household-name companies such as Target and Chipotle.

In healthcare, however, the trades for Lilly — a company valued by the stock market at just under $1 trillion — stand out. That’s because the timing of Trump’s purchases coincides with several favorable government decisions benefiting the drugmaker’s GLP-1 business, including progress toward a long-held goal: qualifying the drugs for reimbursement from Medicare, the government health insurance program primarily serving seniors, when they are prescribed for weight loss.

The disclosure forms — which bear Trump’s distinct signature — give ranges rather than exact dollar amounts for the trades. They show seven purchases of Lilly stock made on the president’s behalf through the end of March, the first of which occurred on Jan. 6.

During that period, and just afterward, several Trump administration initiatives ultimately benefited Lilly. Perhaps the biggest was an initiative from the Centers for Medicare & Medicaid Services, which was proposing a pilot program — a temporary “bridge,” potentially followed by permanent reimbursement — through which Medicare patients would pay $50 a month for GLP-1 drugs.

The deadline for drug manufacturers to submit applications indicating their interest in participating was Jan. 8. Lilly has since been named as a participating manufacturer in the program, calling it a “significant milestone.”

Another purchase on Feb. 10, of West Pharmaceutical Services stock valued between $250,000 and $500,000, was similarly a bet on the GLP-1 market. The company, which manufactures injectable devices for drugs, credited growth in its GLP-1 business with driving increased revenue in its most recent quarter.

Lilly declined to comment. West Pharmaceutical Services did not immediately respond to a request for comment.

A spokesperson at the Department of Health and Human Services declined to comment, referring KFF Health News to the White House. A White House spokesperson referred questions to the Trump Organization — the holding company for most of the president’s businesses — which did not immediately respond to a request for comment.

In response to other outlets’ questions about Trump’s stock trades, the Trump Organization has said the investments are controlled by independent brokers.

It is unclear from the disclosures whether Trump directed any of the trades himself. Four of the Lilly stock purchases are marked “unsolicited,” though the Office for Government Ethics did not immediately respond to a request for clarification on the use of that term.

Trump’s assets are in a trust held by his children, and Trump Organization spokespeople have said in the past that neither the president nor his children play a role in “selecting, directing, or approving” specific investments.

Eric Trump, the president’s son and a Trump Organization executive, said May 15 on X: “To suggest that individual stocks are being bought or sold, at the discretion of any member of the Trump family, would be a lie and blatantly false.”

He claimed the purchases of index funds account for the investments. The disclosures record purchases of funds and individual stocks.

Lilly had a strong 2025, finishing with $65 billion in revenue, up $20 billion from the year before. GLP-1 drugs accounted for a substantial portion of that total.

At the beginning of 2026, the drugmaker said it expected another surge in revenue this year, above $80 billion. It was a “stunning” projection, analysts at the bank Citi said.

Analysts for the financial services firm TD Cowen said the Medicare and Medicaid market would be critical to making it happen. “Guidance anticipates favorable impact from Medicare coverage of obesity medications by 7/1/26,” the analysts noted.

Historically, Medicare hasn’t covered obesity drugs. In a May 2025 open letter, noting unfavorable reimbursement decisions across government and private-run insurance, Lilly said: “This isn’t about just one medicine, formulary, or insurance plan. It’s about a system that limits patients’ and health care providers’ ability to choose an obesity management treatment plan that is best for them.”

Key to that market was the pilot program rolled out by CMS, called BALANCE, aimed at helping Medicare and Medicaid beneficiaries improve their health. Last fall, 12% of U.S. adults reported currently using GLP-1s, according to a KFF poll, and 56% of those who had used GLP-1s found the medications — prescribed to treat diabetes and aid weight loss — hard to afford.

The appearance of a potential conflict of interest is enough to trouble ethics experts.

“A president who buys or sells the stock of a company whose value is affected by his administration’s actions undermines the public’s trust in two ways,” said Kathleen Clark, a legal ethicist at Washington University in St. Louis.

First, she said, the public should believe government actions are motivated by common good, not personal enrichment. And second, the public should believe that those within government aren’t benefiting from inside information.

A ban on stock trading by the president would require an act of Congress, though some lawmakers have resisted such legislation. Members of Congress are also permitted to buy and sell stocks.

Trump’s White House and HHS boosted GLP-1s throughout the first few months of the year. In February, the government unveiled TrumpRx, a web portal directing patients to lower-price versions of some drugs, with some terms and conditions.

The website offers Zepbound for as low as $299 a month and points patients to LillyDirect, the drug company’s telemedicine service prescribing the drug. Company executives haven’t commented on TrumpRx specifically, but they have touted the telemedicine service. Lilly’s 2025 annual filing to the Securities and Exchange Commission said LillyDirect was a “growing portion of our business.”

Also, in February the FDA intensified a broad crackdown on “compounded” GLP-1s — drugs manufactured by pharmacies that are cheaper and, critics charge, often unsafe alternatives to Lilly’s branded products.

The agency made another favorable decision for Lilly in April, approving its Foundayo weight loss pill under its Commissioner’s National Priority Voucher program. The program was launched by FDA Commissioner Marty Makary, who had promised to approve high-priority drugs in record time. Foundayo was approved in 50 days after filing.

“This approval demonstrates what the FDA can achieve when we eliminate delays and prioritize fast and thorough work from the agency and industry partners,” Makary, who stepped down last week, said in an April news release.

Not all agency decisions were favorable. The FDA asked Lilly to provide additional safety data regarding liver toxicity in Foundayo, though analysts don’t appear particularly troubled. The company has told news outlets that no negative safety signals have been observed.

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 <a target="_blank" href="https://kffhealthnews.org/health-industry/trump-stock-trades-eli-lilly-glp-1-weight-loss-drugs-invest-ethics-disclosures/">article</a&gt; first appeared on <a target="_blank" href="https://kffhealthnews.org">KFF Health News</a> and is republished here under a <a target="_blank" href="https://creativecommons.org/licenses/by-nc-nd/4.0/">Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="https://kffhealthnews.org/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

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How a Nature Cruise Turned Into a Nightmare

The hantavirus outbreak on the MV Hondius set off alarms for a world still traumatized by Covid. For those on board, the danger was much closer.

from NYT > Health https://ift.tt/aVAhZQq

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Straus Family Creamery Issues Voluntary Ice Cream Recall

Straus Family Creamery asked customers to throw out some tubs sold in May across 17 states. No injuries have been reported, the company said.

from NYT > Health https://ift.tt/oHK9tQ8

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Journalists Unpack Latest on Vaccines, Vaping, and TrumpRx

KFF Health News chief Washington correspondent Julie Rovner discussed federal policy on vaccine research, vaping, and drug access on Science Friday on May 8. Rovner also discussed the Supreme Court decision on the abortion pill mifepristone on NPR’s Morning Edition on May 5.

• Click here to hear Rovner on Science Friday.
• Click here to hear Rovner on Morning Edition.

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Céline Gounder, KFF Health News’ editor-at-large for public health, discussed the rising cost of drug prices, despite hopes about TrumpRx, on CBS News’ The Daily Report on May 7.

• Click here to watch Gounder on The Daily Report.

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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.

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Medicare Coverage for GLP-1 Weight Loss Drugs: Cost, Eligibility and What to Know

What you should know about the federal government’s pilot program offering GLP-1s solely for weight loss.

from NYT > Health https://ift.tt/yUr8v97

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