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April Health And Fitness Tips.
September 08, 2026
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No commentsSeptember 08, 2026RoseHealth News, KFF Health NewsNo commentsAfter a failed round of in vitro fertilization this year, Anne Hug’s fertility doctor said she had a single polyp in her uterus that should be removed to improve the chance of pregnancy. Hug, a professor of radiology, learned that the American College of Obstetricians and Gynecologists says the procedure can be done in a doctor’s office with local numbing.
Her doctor referred her to a physician at the same hospital, which is part of a large Ohio health system. That doctor’s plan was to do the procedure in a hospital operating room, with anesthesia administered by an anesthesiologist.
Hug balked at the $18,000 estimate.
So she found an obstetrician who said he would do it in the doctor’s office. And she took the required two-week course of a hormone in preparation.
But the day before the polyp removal, the doctor’s office called to say, sorry, but he had to do it in a freestanding surgery center owned by the same system. The health system had bought the OB-GYN practice in 2025, so it called the shots. The next day, Hug recalled, “I’m in a venue I didn’t need or use, with surgical techs and OR nurses running around.”
Though she was scheduled for anesthesia or sedation, she wanted none of it. The doctor numbed the cervix and removed the polyp in a few minutes, with “a few seconds of cramping,” she said. Hug remembers watching pictures of the polyp removal and “talking to the OR crew about snorkeling.”
The estimate for the in-office procedure was around $3,000. The bill when she was forced at the last minute to switch to the surgery center was around $6,000. She now wonders, “How is it legal for these hospitals to force patients to have procedures done in a hospital when professional organizations recommend differently?”
Hug’s experience is a classic example of the predicted outcome of “vertical integration” in the healthcare system, when one company owns or controls multiple parts of a supply chain and can therefore direct patients to more expensive treatment options.
KFF Health News agreed not to publish some identifying details about Hug and her healthcare providers, to protect her patient privacy and ongoing relationship with the hospital system.
In any case, such healthcare integration is occurring at a breakneck pace all across the nation, with endless permutations: Hospitals are buying doctors’ practices and surgery and imaging centers. Insurers are buying doctors’ practices and specialty pharmacies and sometimes merging with pharmacy chains. Hospitals are buying or creating insurers. Private equity firms are behind many of the deals, buying practices, reorganizing operations, paring costs, then selling at a profit in a few years to a hospital or insurer higher up the healthcare food chain.
And while the stated purpose is generally greater efficiency, studies have shown that for patients the net result has been higher prices and no benefit, or worse health outcomes. That’s in part because the purchases have been driven by financial efficiency, not more seamless and attentive care, said Soroush Saghafian, an associate professor at Harvard University’s Belfer Center for Science and International Affairs. What’s more, these transactions occur in a gray zone of competition law, and regulators’ tools to examine or stop them are plodding and not up to the task.
“Antitrust laws aren’t fit for purpose at this point, and the agencies that enforce them are under-resourced,” said Zack Cooper, an associate professor of public health and economics at Yale University who has sounded the alarm about the trend. The tools at the agencies’ disposal are limited — warning letters, lawsuits, and consent decrees modifying the terms of a merger to restore competition — and often slow to get results. Meanwhile, the dealmaking is galloping ahead.
Patients like Hug are often directed to a higher-priced location for procedures. They are effectively required to buy from their insurers’ specialty or retail pharmacy, which may not stock the drug the doctor prescribes or provide it at the lowest price.
The Federal Trade Commission and the Justice Department together police mergers in healthcare to protect competition and patient choice. Generally, the FTC oversees hospitals and doctors, while the Justice Department scrutinizes insurers, though their territories overlap and there are gaps. Middlemen like pharmacy benefit managers fall somewhere in between, though in recent years the FTC has taken the lead in this arena. But federal regulators are playing a tough game of catch-up.
Industry Shift
Over the past decade, the number of doctors working for hospitals rather than in private practice has more than doubled. Today 82% of physicians are employed by hospitals, other corporate entities (like insurers), or private equity firms. For example, UnitedHealth Group’s then-CEO said in 2024 that it employed around 10,000 primary care physicians. That did not include UnitedHealth’s 80,000 “affiliated” physicians.
Many of these vertical transactions are too small for the regulatory agencies to spot. Under the 1976 Hart-Scott-Rodino Act, mergers valued over a certain dollar threshold set annually — this year it’s $133.9 million — must be reported for antitrust scrutiny. Many hospital mergers or insurer mergers exceed the threshold. But mergers involving doctors’ practices often do not, leading to consolidation and monopoly by slow accretion.
Cooper and his group, the Health Care Affordability Lab, studied hospital acquisitions of physician practices and found that over 99% of the more than 275 deals examined fell below the reporting threshold. “I’m really struggling with this,” Cooper said. “What you’re talking about is sort of like death by a thousand paper cuts.”
The FTC has brought eight actions or suits against healthcare mergers and acquisitions in President Donald Trump’s second term. “The FTC has made healthcare competition one of our top priorities,” said Daniel Guarnera, director of the FTC’s Bureau of Competition. Nonetheless, he said the agency relied on complaints and news reports to learn about smaller mergers.
The Justice Department has brought only two cases, both challenging hospital-insurer contracts rather than mergers. It has also settled a suit brought by the Biden administration that sought to block UnitedHealth’s $3.3 billion acquisition of Amedisys, a home healthcare agency. The 2025 settlement required the divestiture of 164 home health and hospice locations across 19 states.
After KFF Health News requested an interview, the department’s press office replied in an unsigned email: “You’ve emailed the Department of Justice. Please reach out to FTC’s media team to set up an interview.” Further requests went unanswered.
Guarnera, at the FTC, noted that the agencies’ task is to enforce regulations, limiting the challenges they can bring.
“Some of the market distortion is caused by regulations that have anticompetitive effects,” he said.
For example, countless health policy experts have proposed regulations mandating “site-neutral payment,” a system in which providers would get the same amount for a procedure no matter where it was performed. That would prevent predicaments like Hug’s, in which a vertically integrated system effectively backs doctors into directing patients to a more expensive venue for treatment.
Within the government, the FTC has advocated for new pro-competitive regulations, suggestions that are now under review by the White House’s Office of Management and Budget. They are not public, and Guarnera wouldn’t say whether site-neutral payment is included. Meanwhile, the Trump administration in July proposed instituting site-neutral payments for some services for Medicare beneficiaries.
The economic theory adjudicating the pros and cons of vertical integration is “nuanced,” Cooper said.
It is far easier to assess the effects of horizontal integration — when a hospital merges with a hospital or an insurer with an insurer — on patient care and cost. If two hospitals merge and become the only care provider in town, that leaves patients with less choice and can make it easier for the new monopoly to skimp on care and raise prices. There is no way “to walk with your feet” to another hospital system for care, Cooper said.
But with vertical integration, for example, a hospital merger with an insurer and doctors’ practices could in theory diminish friction, compared with a disaggregated system in which every bill is haggled over by different sectors trying to maximize their piece of the pie. Some successful and popular hospital-insurer combinations, such as Kaiser Permanente, are vertically integrated. So merely taking a “sledgehammer” to such mergers could backfire, Cooper said.
But with money on the table and business interests governing healthcare, studies have shown that cons of vertical integration — opportunities for gaming away those beneficial arrangements and raising revenue — prevail.
When Harvard researchers sought to assess the effect of hospital purchases of gastroenterology physician groups on colonoscopy care, the negative impact was clear. “It changed the way they did business,” said Saghafian, the paper’s main author.
All told, quality went down and prices as well as complication rates rose. “What improves is ‘operational throughput,’” or the efficiency with which the system could move patients through colonoscopies fastest with the least staff involvement, Saghafian said. “That’s a financial metric.”
‘It Feels Like Double-Dipping’
While health economists are studying the impacts to help regulators figure out when to act, the horse is out of the barn. All the biggest health insurers have already merged with pharmacy benefit managers, specialty and commercial pharmacies, as well as new lines of businesses that insurers require members to use to manage copay assistance from pharmaceutical companies. For example:
So when patients change insurers, their steady access to longtime drugs at a predictable price can go out the door.
In Florida, Ari H.’s family uses three high-priced specialty drugs for chronic conditions. All three had long been subsidized by patient assistance programs from their manufacturers. KFF Health News agreed to only partially identify him, because he works for a government contractor where policy has become political and he fears retaliation.
Signing up for a $3,000-deductible plan with a new insurer, Aetna, put a new strain on his family’s finances. On his new plan, he was signed up for all Aetna’s pharmacy-related products, too. He could not choose to order elsewhere. Most importantly, his old insurance counted the copay assistance money toward his deductible, but his new insurer did not, scooping up his patient assistance money from pharmaceutical firms.
“I pay substantial premiums, and I pay my deductible and my out-of-pocket maximum — that’s all paid by me,” Ari H. said. “But now all the copay assistance goes back to them. It feels like double-dipping.”
Ethan Slavin, an Aetna spokesperson, said the company “is committed to helping members choose and use health plans that best meet their health, financial, and lifestyle needs.” He added that the insurer offers “supports that may lower out-of-pocket expenses.”
Ari H. is right, said Mark Cuban, the billionaire investor who in 2022 launched the Cost Plus Drugs site, which sells mostly generic drugs to cash-paying patients at a discount — often for less than what they would pay using insurance. “It’s crazy stuff,” he said of vertical integration. “The right pocket gives to the left pocket.”
In July the FTC reached a settlement in a suit against Caremark, requiring it to be more transparent and give patients and pharmacies more choice. It had previously reached such an agreement with Express Scripts and is working on one with Optum.
Academics like Cooper are trying to help clarify “which of these vertical deals are bad.” A clearer economic theory, he said, might help regulators make the patient experience just “a little less worse.”
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.
September 05, 2026RoseHealth - The New York Times, NYT > HealthNo commentsSeptember 05, 2026RoseHealth - The New York Times, NYT > HealthNo commentsSeptember 04, 2026RoseHealth - The New York Times, NYT > HealthNo commentsSeptember 04, 2026RoseHealth - The New York Times, NYT > HealthNo commentsSeptember 03, 2026RoseHealth - The New York Times, NYT > HealthNo commentsSeptember 02, 2026RoseHealth - The New York Times, NYT > HealthNo commentsAugust 31, 2026RoseHealth - The New York Times, NYT > HealthNo commentsAugust 31, 2026RoseHealth - The New York Times, NYT > HealthNo commentsAugust 31, 2026RoseHealth - The New York Times, NYT > HealthNo commentsAugust 29, 2026RoseHealth - The New York Times, NYT > HealthNo commentsAugust 29, 2026RoseHealth News, KFF Health NewsNo comments
Céline Gounder, KFF Health News’ editor-at-large for public health, discussed fatal measles cases on CBS News 24/7’s Mornings on Aug. 26. Gounder fact-checked Centers for Medicare & Medicaid Services Administrator Mehmet Oz’s comments about vaccines and drug prices on CBS News 24/7’s The Daily Report on Aug. 24. She also discussed food recalls this summer on CBS News 24/7’s The Takeout With Major Garrett on Aug. 24.
KFF Health News chief Washington correspondent Julie Rovner discussed kindergarten vaccination rates on WNYC’s The Brian Lehrer Show on Aug. 25.
KFF Health News contributor Mark Kreidler discussed the use of artificial intelligence for Medicaid reenrollment on KVPR’s Central Valley Daily on Aug. 24.
KFF Health News senior correspondent Julie Appleby discussed the state of the Affordable Care Act on Vox’s Today, Explained podcast on Aug. 24.
KFF Health News Georgia correspondent Briah Lumpkins discussed the importance of healthcare policy in upcoming elections on WUGA’s The Georgia Health Report on Aug. 21.
This article first appeared on KFF Health News and is republished here under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
August 28, 2026RoseHealth - The New York Times, NYT > HealthNo commentsAugust 28, 2026RoseHealth News, KFF Health NewsNo commentsIn the summer of 2024, Emilie and Justin Solomon found themselves on a top-secret mission in Greece.
Their family and friends thought the adventure-loving couple was on another jet-setting vacation, but they were keeping something else under wraps: They had turned off their phone locations to hide visits to a Greek clinic where they were trying to get pregnant.
The Solomons are among the growing numbers of Americans looking abroad, particularly to Greece and Spain, to escape the high cost of fertility treatments in the U.S., where such procedures are often not covered by insurance. The treatments include in vitro fertilization, which involves ovulation stimulation, retrieving the eggs, fertilizing them in a lab, and transferring the embryos into the uterus. Other less intensive medical therapies also address infertility.
President Donald Trump has made fertility, and IVF in particular, a focus of his administration’s agenda after he promised total coverage for women during his 2024 campaign. His administration proposed a rule in May intended to make it easier for employers to offer fertility coverage, although it has yet to be finalized. So far, the most concrete result has been lower costs for some IVF medications through TrumpRx, a site where cash-paying patients can find some discounted medicines through participating pharmacies. The White House projected that patients could save up to $2,200 per IVF cycle.
While significant, those savings are up against a 90% rise in IVF medication costs since 2014, according to GoodRx, a prescription discount service. A study of insured Americans released in July by Axene Health Partners and the Women’s Reproductive Health Foundation found that the overall cost for a cycle of IVF was over $29,000 — or 35% of the median annual household income in the U.S. Genetic testing, embryo storage, pregnancy care, and delivery costs can push the total over $54,000 per IVF-conceived birth, according to the study. An average patient needs two to three cycles to successfully have a child, so the costs for many patients would be even higher.
Infertility affects nearly 7 million people in the U.S., but only an estimated 24% of treatment needs are met, because of those high costs and limited insurance coverage, according to the American Society for Reproductive Medicine. The condition is believed to be rising partly because of people having children later, as well as environmental factors such as pollution.
Still, more than 100,000 babies were born via IVF in the U.S. in 2024 — a record, according to the Society for Assisted Reproductive Technology. An increasing share of people hoping to be parents are seeking help in Europe: The number of Americans choosing European clinics grew by more than 37% last year, according to Jakub Dejewski, the chair of the European Fertility Society, a group that tracks data on fertility treatment in Europe.
The Solomons knew IVF was their only chance to have children together biologically, because Justin had testicular cancer in his late teens. What the college sweethearts had not expected was the cost — and they learned early in their IVF journey that their insurance would not cover their treatment. While some states have passed laws to require insurers to pay for some fertility care, the coverage varies widely.
When the couple first explored IVF in Florida, where they live, they were quoted $40,000 for one round of treatment. The price shocked them, and Emilie said the clinic’s offer of a spring discount for an embryo transfer felt “off-putting.”
“They just kind of prey upon your hopes and dreams to be parents,” Emilie said.
Treatment Plus Island-Hopping Tours
The price of IVF and uncertainty around proposed personhood legislation in Florida, which the Solomons feared could jeopardize their control over their embryos, sent them to the Pelargos IVF Medical Group in Athens. There, in the first of two trips, Emilie underwent ovulation stimulation and egg retrieval.
Including medication, fertilization, storage, and the ultimate embryo insertion, the total treatment cost about $12,000, not including travel, according to the Solomons, a fraction of what they might have spent in America. That affordability drew the couple abroad, but so did the allure of sightseeing and experiencing a new country.
On that first trip, they spent a weekend between doctor appointments exploring the Greek island of Milos. Between Emilie’s hormonal injections, they rented a boat to explore the island. Their video from the trip shows them climbing the island’s striking white volcanic cliffs, and Emilie floating in the turquoise water of the Aegean Sea. Despite the emotional and physical toll of the IVF process, the couple remembers being in a little bubble, away from everyone, exploring a beautiful place.
“It was one of the best summers that we’ve had,” Emilie said.
When they traveled back to Greece for their embryo transfer in October 2025, they spent two days in Croatia.
IVF in Greece using a patient’s own eggs typically costs around $3,000 to $4,000, not including medication, so even with travel, it is often a fraction of what patients pay in the U.S.
“Americans choose Greece because they can access treatment that is more affordable, faster to begin, and well supported for international patients,” Dejewski said.
Patients in Greece do face some legal restrictions: Embryo storage is time-limited, donor anonymity is standard, sex selection and embryo-transfer numbers are restricted, surrogacy access is limited for nonresidents, and patients must carefully consider documentation requirements if they plan to move embryos between Greece and the U.S.
Penny Ampatzi said she is clear about these legal differences when Americans consult with her clinic in Athens. Serum IVF offers to schedule airport pickup for patients, as well as island-hopping tours. Ampatzi, the co-founder and clinic director at Serum IVF, said the main draw for the dozen or so American patients her clinic sees each month is the personalized fertility treatment plans. Affordability is close behind. A cycle at her clinic costs just under $6,000, not including embryo freezing. Almost all of Serum’s patients are foreigners, according to Ampatzi.
“You consider that you have a good possibility of success, plus you don’t pay that high amount of money, and you also have combined the treatment with holidays — so it’s a ‘Why not?’” she said.
Not Without Risks
IVF costs in the U.S. have been driven up by a mix of inflation, a shortage of embryologists, a surge in demand after pandemic backlogs, and private equity ownership, Dejewski said.
William Kiltz, vice president of marketing and business development at U.S.-based CNY Fertility, said that the costs are becoming too far out of reach. “IVF is almost a treatment that only the top 1% can afford reasonably,” he said.
Kiltz said CNY’s model — offering IVF for around $8,000, not including embryo storage, at its 18 locations across the country — brings just enough profit to “keep the lights on” and open new locations while keeping its costs lower. “We’re trying to deliver this care at the absolute bare-minimum cost,” he said.
More than half of CNY’s patients travel from out of state in search of those lower-cost options, Kiltz said.
He said he hopes the IVF market will eventually settle out, as happens with many new technologies. But nearly five decades in, that normalization hasn’t come. Kiltz believes that’s because the market is so emotionally driven.
“People will do just about anything,” Kiltz said. “There’s certainly some risk in something like that, where the demand and the desire from a single individual is so strong that they could be taken advantage of.”
Tarita Pakrashi, the head fertility doctor at the CNY location in Norfolk, Virginia, pointed to the difficulties of trying to vet a clinic overseas when one doesn’t speak the language or understand the local IVF regulations. It also can be challenging to transport temperature-sensitive medication back home.
“It’s almost like a full-time job trying to play regulatory expert and inspector all at the same time, while you’re a patient,” Pakrashi said.
She said she also has had patients who sought treatment abroad return to her clinic struggling to transfer records or understand a diagnosis they received overseas. They often have to repeat tests.
And going abroad for IVF is still out of reach financially for many Americans.
The Solomons said seeking treatment overseas takes a certain type of adventurous spirit, too. But for them, all the logistics and travel were worth it. Their one cycle of IVF and two trips to Greece allowed them to welcome a healthy baby boy this summer.
This article first appeared on KFF Health News and is republished here under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
August 27, 2026RoseHealth News, KFF Health NewsNo comments
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Katheryn Houghton [CATH-er-in HOW-tun] reads the week’s news: A wristband with the words “I Gave Birth” could be a lifesaving tool for new moms, and many homeless people will have to prove they’re working to stay on Medicaid.
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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.This article first appeared on KFF Health News and is republished here under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
August 26, 2026RoseHealth - The New York Times, NYT > HealthNo commentsAugust 26, 2026RoseHealth News, KFF Health NewsNo commentsAt Chain of Lakes Elementary School in Winter Haven, Florida, Josette Smith’s 9-year-old son, Ethan, gets to do what he loves most: crafts, math, and science. That is, when he isn’t being pulled out of class.
Ethan has autism and attention-deficit/hyperactivity disorder. He was diagnosed with autism in kindergarten after displaying behavior that concerned his relatives: He paced, flapped his arms, and became consumed with highly specific interests, such as Martin Luther King Jr. and dachshunds.
In a meeting with school administrators and the district to develop his individualized education program, a legal agreement that outlines the support Ethan requires, the team agreed he required a trained paraprofessional to help him regulate his emotions and remain in class, according to complaints Smith filed against the school. However, the complaints alleged, administrators were unwilling to provide the dedicated aide. Instead of implementing the supports her son needed, his school repeatedly removed him from instruction, suspended him, and even called police on him when he was in third grade, Smith wrote.
Smith, a seventh grade science teacher, said she first filed complaints with the school district and the state with these allegations. But when problems persisted, she turned to the U.S. Department of Education’s Office for Civil Rights, the federal agency tasked with resolving complaints like hers. Smith’s federal complaint included the same account and alleged that the school discriminated against her son because of his disability and race, including deploying pressure tactics to push her Black son out of the public school. In May, the office said it would investigate several of her allegations.
For families who believe their child’s rights were violated based on race, disability, or gender in school, the federal agency often has been one of the main places to turn. But the White House cut its offices and weakened its ability to follow up with cases, as well as slashed funding to research on disparities that people of color face in getting diagnosed and attaining resources for disabilities.
About 1 in 31 U.S. kids by age 8 had been diagnosed with autism spectrum disorder as of 2022. Although previous research on disparities in childhood autism diagnoses has had mixed results, a recent study from the State University of New York at Albany’s Institute for Social and Health Equity found that race, gender, and socioeconomic gaps persist. Among fourth graders from 2003 to 2022, students of color, girls, low-income students, and multilingual learners were less likely than peers to be identified with autism in school, even as diagnoses rose among children from historically marginalized groups, the study found. A large forthcoming study by the same researchers found the biggest gaps among overlapping identities. Black and Hispanic girls were especially unlikely to be identified.
All this has happened as President Donald Trump’s second administration has put autism in the spotlight. In early August, Trump signed an executive order to whittle down routine immunizations for kids while falsely tying vaccines to autism. He has presented it as a personal priority and one of “the most alarming public health developments in history.” Health and Human Services Secretary Robert F. Kennedy Jr. in April 2025 called autism a “tragedy” that “destroys families,” and he’s lent credence to ungrounded claims of autism’s causes, including unfounded links to childhood vaccines and Tylenol during pregnancy.
“This administration is taking us backwards,” said Camille Proctor, founder and executive director of The Color of Autism Foundation.
HHS spokesperson Emily Hilliard said in an email that Kennedy’s statements last spring “emphasized the need for increased research into environmental factors contributing to the rise in autism diagnoses, not to stigmatize individuals with autism or their families.” She added that the agency changes are “about making federal support systems work better for children and families.” White House spokesperson Kush Desai did not respond to a request for comment. Neither did the press office for the Department of Education.
The cuts to agencies and research have affected parts of the federal government focused on students with disabilities. In March 2025, Trump signed an executive order to dismantle the Department of Education and closed seven of its Office for Civil Rights’ 12 regional offices. This June, his administration largely shifted special-education oversight to HHS and the Office for Civil Rights to the Department of Justice.
“On paper, it’s a reorganization,” said Nancy Potter, a former supervising attorney at the Office for Civil Rights who now runs her own education law firm. In practice, she said, it could leave families whose complaints involve overlapping harms — such as race and disability discrimination — caught between agencies built for different jobs. “The hardest thing to prove in these cases is now the thing with no obvious home.”
In April, a year after the order, a Senate committee report from Sen. Bernie Sanders (I-Vt.) concluded that the Office for Civil Rights had reached a 12-year-low in resolutions to discrimination complaints and had a backlog of nearly 12,000 civil rights cases. A recent Washington Post investigation found that the Trump administration “indefinitely froze” many of these cases.
On top of those cuts, the White House vowed to stop “equity” investigations in areas such as school discipline despite research showing that nonwhite and low-income kids disproportionately face barriers to being identified with autism and attaining resources for the condition and other neurodevelopmental diagnoses.
It also decimated the Institute of Education Sciences, the Department of Education’s research arm, canceling roughly $900 million in funding for research, including long-standing data collection in schools. The administration further proposed ending data collection on racial disparities in school discipline. The National Institutes of Health and National Science Foundation have purged projects referencing terms including “race” and “gender,” gutting research focused on diversity, equity, or inclusion.
“If we’re cutting any data collection that helps us understand the problem, we’re not going to fix it,” said Paul Morgan, director of the Institute for Social and Health Equity at SUNY-Albany, who led the studies on disparities in autism diagnoses. “All we’re doing right now is making the situation worse.”
The nation’s influential federal autism panel also appears to lack prominent scientists and Black members and has fewer autistic self-advocates than before, said Proctor of The Color of Autism Foundation, who served on the panel before the Trump administration took over. The panel has also been criticized for including vaccine opponents.
HHS’ Hilliard said the members “bring decades of experience in autism research and clinical care” and are committed to aligning “federal policy with gold-standard science.”
Disability advocates say federal officials are focused on the wrong priorities.
“All of it creates chaos where chaos is not necessary,” said Cameron Lynch, a former policy analyst for the Autistic Self Advocacy Network.
Disability rights advocates fear the changes to special education oversight weaken the federal safety net for autistic students and others with disabilities, making these systems more confusing when families need help enforcing students’ rights.
David Sitcovsky, Autism Speaks’ vice president of advocacy, said families, especially those from marginalized communities, already often lack support for their children to receive a timely diagnosis or services in their school systems.
“The common thread across these issues is access,” Sitcovsky said. “If their child’s rights are not being upheld, do they have a clear path to get help?”
Smith awaits a decision about her federal civil rights case, which she was told could take more than a year amid the backlog, as Ethan has started fourth grade. She wants Ethan transferred to a school better equipped to support him. She has also requested an expedited hearing for a due process complaint she filed with the state.
The family is also navigating battery charges against Ethan, the first of which was filed in March after the school called police on him for allegedly hitting staff. A police report and an email provided by Smith showed that police arrived at her door hours after Smith informed the school district in writing that she had filed a federal discrimination complaint. Smith also pointed out the timing in several of her complaints.
A Polk County Public Schools spokesperson declined to comment, citing student confidentiality. The Florida Department of Education did not respond to a request for comment.
“As a Black mom, you dare not complain about anything,” Smith said. “Once you start advocating for your kids, it’s a problem. But it’s not these kids’ fault that they have a disability.”
Without timely assessments and interventions, studies show, children of color with disabilities such as Ethan are disproportionately at risk of being funneled out of public schools and into the juvenile and criminal justice systems.
Catherine Lhamon led the Education Department’s Office for Civil Rights in the Obama and Biden administrations and is now executive director of the Edley Center on Law & Democracy at the University of California-Berkeley School of Law. She said it’s a scary time for families who want to protect their children’s rights.
“People speed if they don’t see a police car,” Lhamon said. “If they think that there’s no one at the federal government watching them in school, we will see an increase in discrimination.”
This article first appeared on KFF Health News and is republished here under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
August 25, 2026RoseHealth - The New York Times, NYT > HealthNo commentsAugust 25, 2026RoseHealth News, KFF Health NewsNo commentsIn January, Jeff La Marca got a prescription for the popular weight loss drug Zepbound. But he couldn’t afford the $750 monthly price tag.
Then Medicare launched an 18-month pilot program that offers GLP-1 medications to some enrollees for only $50 a month. La Marca thought he might finally be able to afford the drug.
“I thought, ‘Thank God, there’s a path,’” said La Marca, who lives in Basking Ridge, New Jersey, and has tried numerous diets and exercise regimes.
But the 68-year-old’s celebration was short-lived.
His application to the pilot program was denied.
La Marca has severe obstructive sleep apnea, one of several diagnoses that exclude patients from the Bridge program’s $50 monthly price. The notification didn’t say why he was rejected. He thinks that if he didn’t have that diagnosis, he would qualify due to his weight.
“I’m obese, morbidly obese, BMI 42. I had quadruple heart bypass surgery. I’m at risk for stroke. I’m prediabetic. And yet I can’t get it. I’m livid,” he said.
A Temporary Patch for a Long-Standing Gap
About 1 in 5 American adults have taken a GLP-1 medication, and most of them, including those with health insurance, say the drugs are difficult to afford. Federal law has long barred Medicare from covering drugs prescribed solely for weight loss, which is why the Medicare GLP-1 Bridge program made a big splash when it launched in July.
It’s a short-term pilot program in which Medicare is offering coverage of three GLP-1s for weight loss and management, to see if that would save Medicare money later. Eligible patients must be enrolled in Medicare Part D, a prescription drug coverage add-on to Medicare. Even though people must have Part D insurance to qualify, the preauthorization request doesn’t go through the insurer; it’s instead submitted to a separate system run by a contractor for the Centers for Medicare & Medicaid Services.
The pilot includes Wegovy, the KwikPen formulation of Zepbound, and the oral medication Foundayo.
Under the pilot, many Medicare beneficiaries with a body mass index of 35 or higher — the upper range of obesity — qualify for coverage of one of those drugs, if prescribed. Those otherwise eligible who have a BMI of 27 to 34 can qualify if they also have certain health conditions, such as prediabetes or cardiovascular disease.
But buried in the fine print is a distinction that’s tripping up patients like La Marca: The $50 price under Bridge applies only to people using the drug solely for weight loss. Anyone who has a qualifying medical condition that the Food and Drug Administration has approved GLP-1s to treat, such as Type 2 diabetes or moderate to severe obstructive sleep apnea, is instead routed back to their Medicare Part D prescription drug plan, which can require copays of hundreds of dollars a month for GLP-1s.
“The Bridge program was designed to target those people who can’t get GLP-1 coverage through Part D but would benefit from taking one for weight loss,” said Juliette Cubanski, who directs the Program on Medicare Policy at KFF, a health information nonprofit that includes KFF Health News.
The cost to Medicare of subsidizing the drugs will depend largely on how many people use the program, and the federal government hasn’t released an estimate.
Cubanski has estimated that 3.8 million people qualify and that, if a quarter of them enroll in Bridge and remain on treatment for the program’s full 18 months, it will cost Medicare about $3.3 billion. If three-quarters enroll, costs could rise to $10 billion.
If the government expanded the program to include the additional 5.9 million people who are overweight and already eligible for GLP-1 coverage through Medicare Part D, it would add billions more to the program’s cost.
The demonstration’s initial weeks have been positive, and most prior authorization requests have been completed in under 12 hours, CMS spokesperson Timothy Foster said.
“This has allowed thousands of eligible beneficiaries to access GLP-1 medications for weight loss at pharmacies nationwide,” Foster said.
GLP-1s Aren’t Covered
Patients like La Marca are left in a tough spot, qualifying for Part D coverage of a GLP-1 but facing much higher cost sharing.
“‘Coverage’ doesn’t always mean ‘affordable,’” said primary care physician Taylor Lacy, who describes herself as a “big proponent” of GLP-1s and practices at Sunflower Medical Group in Roeland Park, Kansas.
The Bridge program is leaving behind patients with the greatest medical need, she said. She noted that many Medicare patients already must navigate prior authorization and spend months trying alternate, often cheaper treatments, a process known as step therapy, before finally getting approval — only to arrive at the pharmacy counter and discover that their GLP-1 copays will run them $200 to $600 a month, if not more.
Researchers studying how Medicare insurers cover GLP-1s have found that recipients have faced increases in out-of-pocket costs and that almost all plans now require prior authorization, which can make getting the drugs more difficult.
Chris Bond, a spokesperson for insurance industry trade group AHIP, blamed drugmakers’ prices, “which they alone set and they alone can lower.”
La Marca’s insurer declined to answer specific questions about La Marca’s case.
Left Waiting
For now, La Marca’s GLP-1 prescription remains unfilled. The severe sleep apnea diagnosis that helps establish his medical need is also what excludes him from the discount program that would bring the cost within his reach.
As he reflected on his appeals and the dead ends, La Marca paused, his eyes filling with tears of frustration.
“This is now my quest, because it’s my only chance to improve my health,” he said. “It’s the only thing left. I’ve tried everything.”
This article first appeared on KFF Health News and is republished here under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
August 24, 2026RoseHealth - The New York Times, NYT > HealthNo commentsAugust 24, 2026RoseHealth News, KFF Health NewsNo commentsMisinformation and distrust are among the challenges facing public health workers in the Democratic Republic of Congo as they confront the second-deadliest Ebola outbreak on record. Even though the virus has faded from U.S. headlines, key organizations are still at work providing medical care and training to counter the spread of the disease.
Since the World Health Organization’s May 17 declaration of a public health emergency, over 5,200 cases of the Bundibugyo strain of the Ebola virus have been confirmed and more than 2,500 people have died in Congo, according to the U.S. Centers for Disease Control and Prevention.
More than 550 people were in isolation with Ebola in Congo as of Aug. 7, the country’s National Public Health Institute said. Twenty cases and two deaths were reported in neighboring Uganda as well, but no new cases have been reported there since June 21, the World Health Organization said.
The worst Ebola outbreak in history, which hit several countries in West Africa from 2014 to 2016, claimed over 11,300 lives.
The current outbreak is only the third of the Bundibugyo strain in central Africa. Congo officials are reporting a 44% fatality rate for the rare strain, which does not yet have a vaccine. Military conflict in eastern Congo, where the outbreak is centered, has made the medical response more difficult.
“When everybody became aware of what was happening, we were already months behind where we should have been as a global community in stopping the spread of this disease,” said Erica Tavares, a senior director of the International Medical Corps.
The U.S. has pledged $512 million in direct aid in response to the outbreak and enacted a travel ban, temporarily preventing non-U.S. citizens traveling from the affected region from entering the country.
Meanwhile, public health workers in Congo continue to toil against Ebola.
Below, KFF Health News profiles five organizations involved in the ongoing public health work there. A fraction of the groups working in Congo, they’re a mix of smaller, local organizations and larger, internationally known groups.
1. Africa Centres for Disease Control and Prevention
Africa CDC is the African Union’s public health agency, in charge of helping health institutions in its member states with disease threat detection and response. With the WHO, Africa CDC announced a joint Ebola response plan on June 5. The organizations said they would need more than $500 million over the following six months for the effort.
Their primary goal is to strengthen cross-border communication and collaboration under a unified “One Response” plan. Africa CDC has released guidelines for travel and public gatherings, urging people to implement prevention methods including avoiding contact with bodily fluids instead of issuing blanket travel restrictions to affected areas.
2. Congo’s National Institute for Biomedical Research
This subagency within the Congolese Ministry of Public Health is tasked with monitoring and documenting the virus. Institute officials are conducting on-the-ground testing and have set up laboratories in Ituri province, the area hardest hit by the virus.
In July, the agency said it had also stepped up detection and monitoring of the virus’s evolution. Genomic surveillance, or analyzing the virus’s genetic code, is an “essential tool” for containing the virus, officials said in a news release. It also helps with vaccine development, which is underway with trials of potential vaccines.
3. Doctors Without Borders
Doctors Without Borders has worked in Ituri for over two decades responding to humanitarian and medical crises. The well-known international organization provides emergency medical aid, as well as disease surveillance.
Kate White, an emergency medical coordinator for the organization, is working in Bunia, the capital of Ituri. In a phone interview, she said the financial stability and size of MSF, the abbreviation for the group’s French name, enable it to work with partner organizations in the region to distribute resources and care. More than 1,400 MSF workers are responding to the current Ebola outbreak.
Looking forward, she said, MSF will reinforce some of its existing programs, including providing general healthcare, to prepare for any additional spread of the Ebola virus.
4. International Medical Corps
Since mid-May, International Medical Corps members have provided case management and community education specific to Ebola and the current outbreak.
IMC operates rapid response teams in the region and has established treatment centers where patients can receive medicine and other care, as well as centers where people await test results.
“We’re also supporting the continuity of primary healthcare in the most at-risk regions,” Tavares said in an interview. “We want people to continue to come to facilities.”
The training of local health professionals is a focus of IMC’s work in Congo. It is also one way the organization partners with other entities, such as Africa Humanitarian Action.
“Historically, we’ve always had training as part of our response program,” Tavares said. “It means that [other organizations] will just have that much more capacity in the future and looking forward.”
Eventually, IMC-run facilities will be turned over to local healthcare leaders, Tavares said, and her hope is that the communities will then be better equipped to respond to future outbreaks. IMC also focuses on improving hygiene and water sanitation, she said.
5. SOFEPADI
SOFEPADI is a Congolese nonprofit that primarily serves women and girls. The women-led organization works to prevent gender-based violence, reduce inequality, and help women take charge of their own healthcare.
In the Ebola outbreak, SOFEPADI officials say, they are working to protect women. During past outbreaks, women have been overrepresented in Ebola deaths due to their increased exposure as caregivers in their communities. The functioning of communities, in turn, is dependent on the health of women. “If the women fall, the whole community falls with them,” SOFEPADI officials wrote in French in a June 1 post on their website.
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.
August 23, 2026RoseHealth - The New York Times, NYT > HealthNo commentsAugust 23, 2026RoseHealth - The New York Times, NYT > HealthNo commentsAugust 22, 2026RoseHealth News, KFF Health NewsNo commentsCéline Gounder, KFF Health News’ editor-at-large for public health, discussed the potential of Moderna’s melanoma vaccine breakthrough on CBS News 24/7’s The Daily Report on Aug. 19, drawing on her experience as a former melanoma patient.
KFF Health News senior correspondent Rachana Pradhan discussed how an issue with Deloitte-run information technology systems denied Medicaid coverage to disabled Michiganders on NPR’s Stateside on Aug. 18.
KFF Health News senior correspondent Renuka Rayasam discussed how hospitals are using wristbands to help reduce maternal deaths on WUGA’s The Georgia Health Report on Aug. 14.
KFF Health News chief Washington correspondent Julie Rovner discussed President Donald Trump’s executive order on childhood vaccines on Slate’s What Next podcast on Aug. 13. Rovner also discussed Medicare on Attitude With Arnie Arnesen on Aug. 11.
KFF Health News ethnic media editor Paula Andalo discussed how an uninsured patient saved thousands by shopping around for the best surgery price on Radio Bilingüe’s Línea Abierta on Aug. 12.
This article first appeared on KFF Health News and is republished here under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
August 21, 2026RoseHealth - The New York Times, NYT > HealthNo commentsAugust 21, 2026RoseHealth News, KFF Health NewsNo commentsPeople with disabilities have long fought for the right to live at home rather than in institutions. Now, the Department of Justice says states don’t have to help make that happen.
The decision by the Trump administration comes amid massive cuts in federal funding for Medicaid. Advocates worry this could be a one-two punch for disabled Americans who want to live independently.
KFF Health News senior correspondent Stephanie Armour joined WAMU’s Health Hub on Aug. 19 to explain what this change means for Americans with disabilities and their loved ones.
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.