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healthcare
'Nebraska Is the Canary in the Coal Mine': Trump-GOP Medicaid Cuts Spark Mass Chaos, Coverage Loss
"Medicaid work reporting requirements are a flawed policy if the goal really is to incentivize work, but they are very effective at taking Medicaid coverage away by tangling folks up in red tape," said one expert.
Oct 01, 2026
Human rights organizations said Thursday that Nebraska should be seen as a bright red warning sign of what's to come for states across the US as they implement the draconian Medicaid work requirements included in the budget legislation that President Donald Trump signed into law last year.
In early May, Nebraska became the first state to implement the new work reporting mandates, which require certain Medicaid recipients to document at least 80 hours of work or other qualifying activities per month to remain enrolled in the program. Republican Gov. Jim Pillen, announced the state's fast-tracked implementation of the requirements at a celebratory press conference late last year alongside Mehmet Oz, head of the Centers for Medicare and Medicaid Services.
Human Rights Watch (HRW), Oxfam America, and Nebraska Appleseed said in a joint report released Thursday that the rush to impose the mandates has had the predicted results of mass confusion and bureaucratic chaos, previewing what millions of Medicaid recipients across the country can expect in the months ahead.
“Nebraska is the canary in the coal mine for issues that most states will face when they begin implementing these work requirements,” said Matt McConnell, a US researcher on economic, social, and cultural rights at HRW. "As they do, they should make sure red tape doesn’t strip people of healthcare."
The trio of advocacy groups interviewed a dozen Nebraskans who have directly experienced or witnessed the unruly rollout of the expanded work requirements. One 64-year-old man "said he lost his Medicaid coverage while undergoing treatment for kidney cancer and multiple chronic health conditions," the groups noted.
"He said a representative of the health plan that managed his Medicaid coverage informed him he lost access because he was not working, even though he is unable to work due to his condition," the groups added. The man said the loss of Medicaid coverage disrupted his care, including an appointment with a cancer specialist.
The Trump administration has said even people with terminal cancer are not necessarily exempt from the new work reporting requirements.
One Medicaid eligibility worker from the Nebraska Department of Health and Human Services told HRW, Oxfam, and Nebraska Appleseed that "poor training, vague and inconsistent guidance, and technical issues, including unprepared software systems, had caused stress and uncertainty for applicants and for state employees."
“We just sometimes don’t know what we’re doing,” the worker said. "I wish the people who make policies knew what they were doing."
It's unclear exactly how many people have lost Medicaid in Nebraska as a result of the new requirements. Sarah Maresh, healthcare access program director at Nebraska Appleseed, said Thursday that obtaining data from the state has been "like pulling teeth."
"Nebraskans deserve access to this information," said Maresh. "You can’t fix problems you refuse to measure."
Earlier this week, following relentless pressure from advocates, Nebraska's health department released preliminary data showing that more than 1,000 Nebraskans have been deprived of Medicaid coverage due to the expanded work requirements—a figure that's believed to be a significant undercount.
"I have been saying for years that Medicaid work reporting requirements are a flawed policy if the goal really is to incentivize work, but they are very effective at taking Medicaid coverage away by tangling folks up in red tape," Joan Alker, executive director of Georgetown University's Center for Children and Families, wrote in a blog post earlier this week. "Unfortunately, Nebraska’s data only reinforces this point."
Nationwide, millions of people have lost Medicaid coverage since Trump signed the GOP budget package, which includes around $800 billion in cuts to Medicaid over the next decade.
States face a January 1, 2027 deadline to implement the expanded work requirements—though states are allowed to move more quickly. Montana and Arkansas have joined Nebraska in implementing the mandates ahead of the federal deadline, resulting in similar chaos and confusion.
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After 50 Years of Anti-Choice Hyde Amendment, Campaigners and Lawmakers Say 'Enough Is Enough'
"Everyone, no matter who they are, where they live, how much money they make, or how they get their insurance, deserves access to abortion care without barriers."
Sep 30, 2026
On Wednesday, reproductive rights groups marked half a century of abortion care being "baselessly set apart from all other healthcare," with coverage for abortions blocked in government-funded healthcare plans like Medicaid, which about 16 million women of reproductive age rely on.
"Our constituents have suffered the consequences," said the Congressional Reproductive Freedom Caucus, chaired by Reps. Diana DeGette (D-Colo.) and Ayanna Pressley (D-Mass.).
For 50 years, the Hyde Amendment—proposed by the late Rep. Henry Hyde (D-Ill.), who expressed his wish to prevent "anybody having an abortion" and said blocking federal funds within the Medicaid program from being used for care was the best way to do so—has stopped hundreds of thousands of people from obtaining abortion care, and has been called by anti-abortion groups "one of the greatest achievements of the pro-life movement to date."
The Reproductive Freedom Caucus denounced the budget rider that has been reeimplemented in appropriations bills every year since 1976 as "a dangerous, racist, and classist abortion ban. An abortion ban for the working class and people of color, who disproportionately receive health insurance through the federal government."
The caucus noted that more than 200 House Democrats have supported efforts to repeal the amendment, and advocacy groups on Wednesday called on Congress to pass the Equal Access to Abortion Coverage in Health Insurance (EACH) Act, which would permanently repeal the Hyde Amendment.
"Without solutions like the EACH Act, the Hyde Amendment will continue to force people with low incomes to struggle for the care they need or carry a pregnancy against their will," said the National Women's Law Center (NWLC). "Everyone, no matter who they are, where they live, how much money they make, or how they get their insurance, deserves access to abortion care without barriers."
In addition to low-income people who rely on Medicaid, said the National Network of Abortion Funds (NNAF), the Hyde Amendment blocks abortion care for Indigenous people who use the Indian Health Service, people in federal prisons, disabled people, military service members and their families, and federal employees, among others.
Twenty-nine states follow Hyde Amendment restrictions, which include "exceptions" for pregnancies resulting from rape or incest or cases in which a pregnant person's life is at risk. Twenty-one states use state funds to cover abortion care, but nearly half of US women of reproductive age who use Medicaid live in states that either ban abortion care or bar them from getting abortions using the federally funded healthcare plan.
NNAF highlighted the network's decades of work to counter the Hyde Amendment by ensuring people who need abortions can access funding, which abortion funds across the country obtain through grassroots donations as they also advocate to end the Hyde Amendment.
"By the 1990s—less than two decades after Hyde first passed—28 abortion funds had formed across the country. Twenty-two of those funds started the National Network of Abortion Funds (NNAF) in 1993," said NNAF. "We joined together to build strategic power and end the Hyde Amendment. Today, our network has nearly 100 member abortion funds, and our fight against Hyde continues."
"The fierce abortion funds in our network have raised money, arranged travel, connected folks to clinics, provided practical support, and fought restrictions in their states and communities," the group added. "Despite endless challenges, their tireless work has built power for our collective goal: Make abortion accessible for all."
Abortion funds have helped people obtain care across the country, but the NWLC emphasized that the Hyde Amendment has still left hundreds of thousands of women with no choice but to pay for abortions out of pocket—often pushing them to delay care while they gather funds or to carry a pregnancy to term when they don't want to or can't afford to become a parent.
"While abortion costs vary by location, facility, and stage of pregnancy, the median out-of-pocket costs in 2023 were $563 for medication abortion, $650 for first-trimester procedural abortion, and $1,000 for second-trimester abortion care," said NWLC. "Those costs account for just the procedure itself, not additional expenses. And yet, nearly half of American families cannot afford the true cost of living... So, when the Hyde Amendment denies someone abortion care, the compounding costs can push people further into a struggle to survive and meet basic needs."
Dr. Jamila Perritt, president and CEO of Physicians for Reproductive Health, remembered Rosie Jimenez, a 27-year-old mother and aspiring teacher who died in 1977, almost exactly a year after the Hyde Amendment was passed, after being denied Medicaid coverage for an abortion.
“Hyde has harmed generations of people seeking abortion care," said Perritt. "Women like Rosie Jimenez, the first known person to die because of Hyde Amendment restrictions, should still be here. No one, no matter what insurance they have access to or who they are, should be denied abortion care, full stop."
Stateline reported Tuesday that with weeks to go until the midterm elections and President Donald Trump's approval rating plummeting to record lows, anti-abortion groups are increasingly concerned that a Democratic majority could repeal the amendment, which it came close to doing in 2022.
“If there becomes a pro-abortion majority in Congress, then Hyde is going to be one of the first things to go, probably, especially because it’s been in the spotlight more recently,” Gavin Oxley, spokesperson for Americans United for Life, told Stateline. Particularly since Trump told Republicans to be "a little flexible" on the Hyde Amendment when the party was pushing to end subsidies under the Affordable Care Act, Oxley said "there are some Republicans who may not be as committed to protecting Hyde.”
Perritt expressed hope that Congress could pass the EACH Act, which now "has the highest amount of support... ever seen with over 200 co-sponsors."
"As a DC-based OB-GYN and abortion provider, I see patients burdened with the cost of abortion care, forcing them to choose between basic living needs and lifesaving healthcare," she said. "The Hyde Amendment is a zero-sum constraint that is not about patients’ health and autonomy, but instead about punishing people for making informed decisions about their bodies, families, and futures. Enough is enough."
"We do not need another Hyde Amendment anniversary," said Perritt. "We need to repeal the Hyde Amendment for good.”
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The United States Desperately Needs a Care Package
The care that families provide—raising children, supporting elderly parents, tending to those who cannot fully care for themselves—is among the most economically productive work in any society.
Sep 30, 2026
Every day in the United States, millions of people wake up and face a version of the same impossible arithmetic. They need to earn income. They also need to care for their children, their aging parents, a spouse or sibling with a disability, or themselves—especially when illness strikes. The market offers no solution to this equation. The government offers patchwork. And so families improvise—women in particular absorb the shortfall in unpaid labor, often at permanent cost to their earnings, their retirement security, and their own health.
This is not a private misfortune. It is a public failure, and an expensive one.
The care that families provide—raising children, supporting elderly parents, tending to those who cannot fully care for themselves—is among the most economically productive work in any society. Children who receive attentive, high-quality care in their early years are more likely to become healthy, educated, productive adults. Workers who can take time to recover from illness or to be present at a family crisis return to their jobs more quickly and with greater stability. Caregivers who receive adequate support are less likely to exit the labor force permanently, less likely to fall into poverty in old age, and more likely to participate fully in economic and civic life. The benefits of care are not merely sentimental—they are measurable, and they are large.
Yet the United States persistently underinvests in care and consistently treats it as a personal rather than a shared responsibility. We spend less than half of what comparable wealthy nations spend on early childhood programs as a share of GDP. We are the only high-income country without a national paid parental leave policy. Our system of support for elderly and disabled individuals is means-tested to the point of cruelty, requiring many families to exhaust their savings before receiving assistance and funneling care into nursing homes, even when home-based support would serve people better and cost less. The result is a care deficit that falls hardest on those least able to bear it: low-income families, workers in jobs without benefits, and the women who disproportionately provide unpaid care when public provision falls short.
The costs of this deficit are not borne equally. Research consistently documents that inadequate support for caregiving suppresses women’s labor force participation and depresses their lifetime earnings. Mothers who leave employment during their children’s early years—often because affordable care is simply unavailable—face lasting wage penalties that compound over careers and into retirement. Families caring for an elderly or disabled adult spend on average more than a quarter of their income on that care, a burden that falls with particular force on Black and Hispanic families, who have less accumulated wealth to draw upon. Children growing up in poverty face developmental disadvantages with lifelong consequences, yet more than one in four American children under seventeen are excluded from the full benefit of the primary federal child support program by restrictions that penalize the families who need help most.
These are not the inevitable features of a wealthy society. They are the results of specific policy choices—and they can be changed.
This week, as part of the Game Changers Webinar series, Nancy Folbre, Kate Bahn, Jaimie Worker, and Pilar Gonalons-Pons participated in this online discussion about how the "US Needs a Care Package" as they offered an overview of specific policy proposals for funding universal childcare, paid family leave, increased support for the elderly and disabled, and a guaranteed minimum income for children.
- YouTube
The Game Changers Care Package
Three bold, interconnected proposals—universal child care, paid family and medical leave plus long-term care support, and a monthly child allowance—would transform life for American families. Together, they form a coherent package that addresses caregiving at every stage of life: from infancy through old age. Other wealthy nations have already figured this out. It’s long past time the United States did too.
These proposals would work together to give families the flexibility they need. They build on policies that have already been put in place by individual states or experimented with at the federal level. They are game-changers because they are all conceived as free, universal benefits that would be funded by taxes on income from capital, rather than from labor. They all promise social benefits that far exceed their cost.
Other comparable nations have demonstrated this. Countries that have invested in universal child care, paid family leave, and adequate support for aging and disabled individuals have not sacrificed economic dynamism to do so. They have expanded women’s workforce participation, reduced child poverty, improved population health, and in many cases generated public returns that substantially exceed the cost of the investment. The evidence from states within the United States that have implemented paid family leave programs, expanded child care access, and shifted long-term care toward home- and community-based services confirms the same pattern: these policies pay for themselves in reduced poverty, improved health outcomes, and increased labor supply, while also producing something harder to measure but no less real—a reduction in the daily stress and insecurity that care gaps impose on ordinary families.
The three proposals developed in this Game Changers Care Package—universal child care, paid family and medical leave combined with expanded long-term care support, and a universal monthly child allowance—form a coherent response to this failure. They address caregiving across the full life course, from infancy through old age. They are designed to work together, with each reinforcing the others: affordable child care enables parents to work and earn; paid leave allows them to respond to family needs without permanent economic penalty; a child allowance provides a universal floor of support that no family falls below. Taken together, they represent not an expansion of welfare as it is conventionally understood, but a fundamental reorientation of how we value and support the work of care—recognizing it, at last, as the indispensable foundation of everything else the economy produces.
The time for modest adjustments has passed. The following pages make the case for something bolder.
Important synergies between the elements of this portfolio of proposed policies can
help overcome potential tensions between reducing child poverty, advancing gender equality, and rewarding family and community care provision in the U.S. Fully universal child care services address an immediate problem for parents of small children seeking to earn sufficient income to support their families and have long-run implications for women’s lifetime earnings trajectories. Paid family and medical leave, like home and community based long-term care for disabled individuals and the elderly, provides support for in-home care of dependents. A universal basic income for children in the U.S., which could also be referred to as a family allowance, builds on and expands current tax subsidies in ways that could dramatically reduce child poverty in the short run.
Advancing these policies in concert leads to a more complicated picture than choosing to prioritize one or the other (especially in terms of funding details) but it is more likely to help us achieve important common goals.[1] All three policy proposals emphasize the public-good argument for financing, and refer, where relevant, to social-cost-benefit analysis. Public expenditures on care provision are often interpreted as a drag on economic growth because growth is defined almost entirely in terms of Gross Domestic Product (the final value of all goods and services purchased in a country), and investment is defined in ways that largely exclude investments in the production, development, and maintenance of human capabilities.[2]
Policy issues vital to the care economy extend well beyond the three proposals here, inviting collaboration with other game-changing policy groups. The two most direct overlaps lie with the health care working group, and the labor working group. Out of respect for an initial division of labor we have omitted consideration of the health care system as a whole, policies regarding job flexibility, penalties for part-time employment, and rights to remote access to employment from home.
Note: The author is grateful for the assistance of Kate Bahn, Jennifer Glass, James Heintz, Julie Kashen, Katherine Moos, Laura Valle-Gutierrez and Jaimie Worker
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Mental Health Is Worker Health
It is clear from occupational health research that work does impact mental health, and this impact should compel politicians to explicitly legislate and develop regulations to protect workers' mental health.
Sep 29, 2026
Over the summer, the Fifth Circuit Court, in a case brought by ExxonMobil, ruled that the Occupational Safety and Health Administration, or OSHA, had “exceeded its statutory authority” by citing Exxon for failing to record a work-related mental illness.
This case followed an incident in Baytown, Texas where an explosion and fire occurred during repairs on a hydro-desulfurization unit, injuring multiple workers. After the explosion, a technician volunteered to lead firefighters to several valves that needed to be shut off to prevent the fire from continuing. While receiving treatment after his first excursion to assist the firefighters, he courageously agreed to lead the first responders to another valve.
Following this incident, the technician experienced anxiety and was later diagnosed with Post-Traumatic Stress Disorder (PTSD) by two professionals. Despite these diagnoses, Exxon did not accept the determination that his PTSD was work-related and requested that the technician see another provider, which the technician refused. The union that represented workers at the Baytown location reported the incident to OSHA, which then issued a penalty against Exxon for failing to record the technician’s PTSD as work related.
It is also important to acknowledge that there is not a clear distinction between physical injury or illness and mental illness.
After Exxon challenged the penalty, the Fifth Circuit Court canceled the penalty based on a narrow reading of OSHA’s authority under the Occupational Safety and Health Act of 1970 to “prescribe regulations requiring employers to maintain accurate records of, and to make periodic reports on, work-related deaths, injuries and illnesses,” concluding that the “illnesses” referred to in the act do not include mental illnesses.
While others have questioned the soundness of the legal reasoning in the decision, it is clear from occupational health research that work does impact mental health, and that this impact on mental health has consequences for the life, well-being, and indeed physical health of workers. This impact should compel politicians to explicitly legislate and develop regulations to protect workers' mental health.
Recognizing the impact of work on mental health is nothing new. In an 1844 issue of the Lowell Offering—the publication created by Lowell Mill Girls in the early days of the industrial revolution in the United States—Harriet Farley speculated on how the nature of the toil in work at the Lowell Mills could have contributed to the recent suicides of two of her comrades:
In factory labor it is sometimes an advantage, but also sometimes the contrary, that the mind is thrown back upon itself—it is forced to depend upon its own resources, for a large proportion of the time of the operative. Excepting by sight, the females hold but little companionship with each other.
Specific work-related factors associated with adverse health consequences include long work hours, shift work, bullying, harassment, workplace violence, traumatic events, low control over work, and job insecurity. These factors stem from the work environment and are not just a concern because of their impact on workers' mental health, although this connection is clear. These sources of stress in the work environment can also increase the risk of physical health outcomes, including cardiovascular disease, hypertension, diabetes, musculoskeletal disorders (such as carpal tunnel syndrome and low back pain), and acute traumatic injuries. The burden of exposure to these workplace factors is not borne equally by all workers. Due to occupational segregation, exposure to these workplace stressors is often higher among Black and Hispanic workers, thereby contributing to health disparities.
A large proportion of workplace fatalities are also tied to mental health. In 2024, in the US, there were reported 410 workplace drug overdoses and 263 workplace suicides. The role of the workplace in these causes of death, both of which are among the leading causes of death in the United States, even when they occur outside of the workplace, has become clear. One recent study estimated that work-related factors, including chemical exposures, lack of social support, and long work hours, contribute to 10-13% of suicides. Similarly, research has revealed that the mental health impacts of factors like workplace stress and job insecurity contribute to the risk of drug overdoses. The role of the workplace in this risk for drug overdoses is seen in the fact that the loss of manufacturing jobs at the county level is associated with increases in drug overdose mortality.
It is also important to acknowledge that there is not a clear distinction between physical injury or illness and mental illness, as the Fifth Circuit Court Ruling suggests. Indeed, the very event that prompted the ruling was both a physical hazard, as shown by the resulting injuries, and a mental health hazard, as shown by the technician’s PTSD. Injuries at work have negative consequences for mental health. Research suggests that both physical and psychosocial hazards at work affect the risk of musculoskeletal disorders.
A variety of methods exist to protect workers’ mental health. In Australia, workplaces are required to minimize psychological hazards “so far as is reasonably practicable.” Reducing occupational psychosocial risks is an imperative under the European Agency for Safety and Health at Work. Denmark requires that “[a]t all stages, the work must be planned, organised and carried out in a responsible way to ensure that its impact on the psychosocial working environment is safe and healthy, individually and collectively, in both short and long term.” In the US, some states have addressed parts of the problem by including work-related PTSD in workers' compensation laws; workplace violence regulations; laws that require minimum nurse staffing levels or ban mandatory overtime for nurses; and paid sick leave, paid family leave, or coverage of domestic workers under labor laws.
Workplaces can also implement policies and programs to protect workers’ mental health. MATES in Construction is an Australian program that has since been adopted elsewhere and seeks to prevent suicide in the construction industry—an industry with the highest suicide risk in the United States—by increasing awareness of mental health challenges, reducing stigma, and connecting workers to support resources. In a similar way, Recovery Friendly Workplaces seek to create work environments that support people with substance use challenges in receiving the support and treatment they need.
While the prospect of similar regulations being applied nationally in the United States may seem bleak in the current political environment, especially following the recent Fifth Circuit Court ruling, the need to address the impact of work on mental health remains.
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AI Battle Between Insurers and Hospitals Jacked Up Patient Prices by Nearly $1 Billion
"Not exactly the cancer cure we were promised," quipped one critic.
Sep 24, 2026
Artificial intelligence proponents claim AI will make healthcare more efficient, but an analysis published Wednesday suggests that the burgeoning technology is instead helping hospitals identify more lucrative diagnoses—and is driving nearly $1 billion in additional costs for patients and insurers.
The Blue Cross Blue Shield Association (BCBSA) analysis found that the share of inpatient cases billed as "medically complex" rose from 37% at the beginning of 2023 to 40% by the end of 2025. While that may seem like a small increase, it translated into an estimated $942 million in additional costs for Blue Cross plans over two years, including $653 million attributable to secondary diagnoses that pushed hospital claims into higher-paying categories.
“Critically, what we found is underneath all of that data [was] no change in corresponding care for a more complex patient,” Luke Chalker, BCBSA’s senior vice president of product and data science and a co-author of the analysis, told reporters. “We find no evidence of a corresponding change in care.”
The analysis' findings underscore an intensifying battle between hospitals seeking maximum reimbursement and insurers trying to contain payouts—a conflict increasingly mediated by AI. AI-powered coding systems can scan medical records, doctors' notes, and laboratory results for additional diagnoses that can increase the amount hospitals are paid. Ambient AI systems can also listen to clinician-patient conversations and automatically document them.
While AI can have legitimate benefits—like reducing paperwork and administrative burdens—BCBSA contends that the financial incentives built into the nation's fee-for-service healthcare system can turn those capabilities toward maximizing profits.
"Not exactly the cancer cure we were promised," More Perfect Union quipped on social media.
In one example, the analysis examined secondary diagnoses like anemia following major bowel surgery.
“If patients are truly sicker, we'd expect to see more treatment,” Chalker said. “For example, we're seeing significantly more anemia diagnoses at these hospitals without a corresponding increase in transfusions. The disconnect between diagnoses and treatment suggests that AI is identifying more billable conditions, not sicker patients.”
The analysis' findings echo an earlier BCBSA study of maternity care, which found that some hospitals dramatically increased diagnoses of acute posthemorrhagic anemia, while transfusion rates barely changed. BCBSA estimated that the increase in that single diagnosis alone added $22 million to maternity admission costs in one year.
Progressive healthcare advocates argue that the problem cannot be solved by tweaking the current system. Advocates for a Medicare for All-type system, including US Sen. Bernie Sanders (I-Vt.) and Rep. Pramila Jayapal (D-Wash.), propose replacing the for-profit insurance system with a universal public program.
In August, Sanders cited a Yale study estimating that his Medicare for All legislation could save 114,000 lives each year, while reducing national healthcare spending by more than $1 trillion annually.
“We do not suffer from scarcity in this country; we suffer from greed,” Jayapal said at a July Medicare for All shadow hearing.
"Medicare for All is the path to fix the broken healthcare system that has let corporate interests determine who lives and dies," Jayapal added. "The reality is that Medicare for All is the only solution that guarantees care for everyone in the US, brings down costs for working families, and generates savings for the country.
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As El-Sayed Champions Medicare for All, Michiganders Can't Afford Basic Needs Due to Health Insurance Costs
“With everyday costs getting higher and higher, it is clear that we need a system like Medicare for All," said the director of the group behind a new survey.
Sep 24, 2026
Nearly half of Michiganders surveyed for a poll published this week said they're struggling to pay for groceries and gas because of the high and rising cost of health insurance, underscoring an affordability crisis that Democratic US Senate candidate Abdul El-Sayed has cited as one of the reasons why the United States needs Medicare for All.
Forty-nine percent of Michigan voters queried by Progress Michigan and Public Policy Polling said the cost of health insurance affects their ability to afford basic necessities at least some of the time. Twenty-four percent said it happens “all the time,” while another 25% said it happens “sometimes.” Among Black Michiganders, the figures were substantially higher, with 34% reporting the problem occurs all the time and 31% saying it happens sometimes.
“Half of Michigan is already struggling with the cost of health insurance,” Progress Michigan executive director Justin Mendoza said Thursday in a statement. “With everyday costs getting higher and higher, it is clear that we need a system like Medicare for All to help Michiganders improve their health and afford their lives.”
El-Sayed, a physician and former Detroit health official, has made universal healthcare one of the three policy pillars of his campaign, alongside getting money "out of politics” and putting it "in your pocket.”
At a Monday "Students vs. Billionaires" town hall at Western Michigan University in Kalamazoo, El-Sayed argued that healthcare should be treated as a basic public investment rather than a commodity.
"You need good healthcare. You need a good education. We need childcare. We need good roads and bridges," he said. "We don’t need to send our money to big corporations to subsidize them, we need to be invested in people so they have the human capital to be able to do all the things as they graduate and come out. That's how the system should work."
El-Sayed has also repeatedly highlighted the plight of families who are insured but still cannot afford care because their deductibles are prohibitively expensive, and others who worry what will happen to their families' healthcare if they lose their jobs—an increasingly likely prospect as artificial intelligence usurps human workers.
“Medicare for All would allow us to actually provide every single person cradle-to-grave insurance,” El-Sayed said in a recent CBS interview, “without having to worry about losing it” after changing jobs, losing employment, getting married, or reaching retirement age.
The health insurance affordability crisis is likely to worsen in 2027. Healthinsurance.org reports that insurers are proposing a median increase of roughly 15% for individual market premiums nationwide, with Michigan insurers seeking an average 14.2% increase. The final rates could change before approval.
“Imagine not having to pay that," El-Sayed told CBS.
A new New York Times/Siena poll of Michigan voters found that 57% of respondents believe El-Sayed would do a better job on healthcare than Republican opponent Mike Rogers. Only 33% said Rogers would do a better job. Among all surveyed women, 67% said El-Sayed would be better for healthcare.
The overwhelming majority of voters ages 18-29 (86%) and Black voters (82%) agreed. Just 4% of Black respondents said Rogers would be better on healthcare. Among young voters, none—0%—said Rogers is the better choice for healthcare.
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58% of US Women Who Need Cheap Birth Control Could Lose Access Due to GOP Attacks on Planned Parenthood
"There is no replacement for Planned Parenthood health centers or the essential, lifesaving care they provide. Women, their families, and entire communities will suffer.”
Sep 23, 2026
Data released Wednesday by the Guttmacher Institute and Power to Decide shows "the stark and brutal reality that awaits patients across the country" if Republican lawmakers in Congress fulfill their goal of "defunding" Planned Parenthood, which provides contraceptive counseling and services to millions of patients per year, as well as other essential healthcare services.
As part of the publicly funded contraceptive care network that's been in place for over half a century, the Guttmacher Institute said, Planned Parenthood's healthcare centers served 1.6 million—roughly a third—of the 4.7 million patients who needed access to affordable family planning centers in 2020.
But with the Trump administration and Republicans in Congress aiming to remove Planned Parenthood facilities from the network, as many as 12.4 million women who need low-cost or free birth control could have their access sharply reduced, as they live in counties that would be affected by the GOP cuts.
Millions in the US rely on @ppfa.org for affordable birth control. If Planned Parenthood was removed from the publicly funded contraceptive care system, 12.4 million women in need of low- or no-cost #BirthControl would be affected.More in our research with @powertodecide.bsky.social: gu.tt/4y5ai5M
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— Guttmacher (@guttmacher.org) September 23, 2026 at 4:17 PM
The One Big Beautiful Bill Act brought the GOP "closer than ever" to stripping Planned Parenthood of funding—which comes not from a "blank check from the federal or state government," as Republicans have often suggested, but largely from reimbursements for care clinics provide to patients who have Medicaid or who are eligible for free or reduced-fee services through Title X.
The law included an effective ban on Medicare reimbursements to Planned Parenthood clinics for one year, and just over a year since its passage, nearly 30 of the organization's health centers have closed.
If Republicans succeed in further cutting off funds to Planned Parenthood, 58% of women who need access to affordable or free birth control would be affected, said Guttmacher.
The West would be the hardest-hit region in the country, with 4.1 million women losing access to contraceptives in 94 counties.
Nearly 30 counties across the US would be left with no publicly funded contraceptive provider at all.
“When President [Donald] Trump and his backers in Congress say they want to shut down Planned Parenthood, they mean it," said Alexis McGill Johnson, president and CEO of Planned Parenthood Action Fund. "And when we say the consequences of stopping people from being able to get the healthcare they need are catastrophic, we mean it too."
"This is not a hypothetical, and we’re not playing make-believe," she added. "There is no replacement for Planned Parenthood health centers or the essential, lifesaving care they provide. Women, their families, and entire communities will suffer.”
Amy Friedrich-Karnik, director of federal policy for Guttmacher, said the data released by the group "demonstrates why policymakers and advocates must stand together in strong defense of Planned Parenthood and all providers of quality and affordable sexual and reproductive healthcare.”
“As politically motivated attacks against Planned Parenthood have resulted in shuttered clinics and real harms to patients," she said, "it is increasingly important to study the critical role that Planned Parenthood plays in the publicly funded healthcare system and why attacks on these health centers are so devastating."
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'Sickening and Unacceptable': Anger Mounts as Trump and Vance Gleefully Rip Healthcare From 750,000
"Just six weeks out from the election, the Trump administration continues to kick working Americans while they’re down."
Sep 23, 2026
Anger and alarm are growing over the Trump administration's Tuesday announcement that it is removing at least 750,000 people from their Affordable Care Act coverage because they were "fraudulently" enrolled, a claim that drew deep skepticism from health policy experts and advocates.
Cynthia Cox, senior vice president at KFF, said fraud undoubtedly exists in the ACA marketplaces, noting that "some brokers have enrolled people without their knowledge or switched their plans so the broker could get a commission on the sale." But she warned that at least some of the hundreds of thousands of people targeted by the Trump administration "were likely legitimately enrolled."
Leading Trump administration officials, including Vice President JD Vance and Centers for Medicare and Medicaid Services Administrator Mehmet Oz, announced the large-scale disenrollment during a celebratory press conference on Tuesday, proclaiming that the ACA purge would save American taxpayers $2.2 billion.
“Rather than addressing rising healthcare costs, the administration is forcing more Americans to become uninsured, live sicker, die younger, and risk being one emergency away from financial ruin," said Anthony Wright, executive director of the advocacy group Families USA. "People are uninsured because of this administration’s own aggressive policies to push and price people out of their health plans, making it harder to get on and stay on coverage."
Among the criteria the administration used to determine whether someone was fraudulently enrolled in the ACA, according to Oz, was if they had "never filed a claim." But health policy experts say it is hardly uncommon for healthy people to not use their insurance in a given year.
The Trump administration did not provide specific breakdowns of why the roughly 750,000 people were stripped of ACA coverage. Vance said during Tuesday's press conference that the federal government uncovered a "fraud ring" involving 40 brokerage agents who funneled around 50,000 people into market place coverage—but the vice president admitted that "some of those people were probably legitimate."
Oz and Vance insisted that the administration went to great lengths to contact those they suspected were enrolled without their knowledge or consent. The officials also said the administration was scrutinizing more than 400,000 additional ACA enrollees for purported fraud, potentially pushing the number of people removed from the program above 1 million.
Ailen Arreaza, executive director of ParentsTogether, said in a statement Tuesday that "while millions of families across the country struggle to afford groceries, housing, childcare, and healthcare, this administration is celebrating taking health coverage away from three-quarters of a million people."
"That tells us everything we need to know," Arreaza added.
Analysts estimate that around 10 million people have lost health insurance coverage since the start of President Donald Trump's term, due in large part a Republican budget package that slashed Medicaid by around $800 billion and did nothing to extend enhanced ACA subsidies, sending premiums soaring for millions of marketplace enrollees—and pricing many people out of coverage.
American voters have consistently ranked healthcare costs as a top concern heading into the 2026 midterm elections. Joel Payne, chief communications officer at MoveOn Political Action, said Tuesday that "just six weeks out from the election, the Trump administration continues to kick working Americans while they’re down."
"It is sickening and unacceptable for this administration to boot 750,000 Americans off their healthcare instead of focusing on lowering costs and ending the war in Iran," said Payne. "The American people and MoveOn members won't forget this betrayal when polls open in November."
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Vance Fraud Task Force Condemned as ‘Smokescreen’ for Booting 700,000 More People Off Healthcare
"This so-called task force is nothing more than a bullshit distraction."
Sep 22, 2026
The Trump administration is planning to boot more than 700,000 people from their Affordable Care Act coverage as part of a purported initiative to root out fraud in the program—an effort that campaigners said is nothing more than a pretext to kick more people off healthcare.
Vice President JD Vance, who is leading the White House's "Task Force to Eliminate Fraud," announced the planned ACA purge during a press conference on Tuesday alongside Centers for Medicare and Medicaid Services Administrator Mehmet Oz, whose agency has touted a right-wing think tank's dubious claim that millions of ACA enrollees are on the program improperly.
Vance insisted during Tuesday's press conference that the administration is putting itself "under an extraordinary burden of proof" to ensure its mass removal doesn't impact people who are eligible for ACA coverage, but advocates were not convinced.
"Vance's task force is a smokescreen for kicking people off coverage," declared the advocacy group Protect Our Care. The organization's president, Brad Woodhouse, said in a statement that Vance's task force "is nothing more than a bullshit distraction—a political stunt designed to throw even more people off their coverage while pretending to save taxpayers’ money."
"At a time when millions of Americans are already losing coverage and facing skyrocketing costs, Vance and this administration are making the crisis exponentially worse," said Woodhouse. "They are piling on more red tape, more confusion, and more opportunities for people to lose the coverage they rely on. Families need coverage they can afford and count on when they get sick. Vance’s task force won’t accomplish that. It’s a smokescreen for an administration whose sole mission is to make it harder to get and stay covered but to shower billionaires with tax breaks instead."
Millions of people have lost ACA and Medicaid coverage since the start of President Donald Trump's second White House term, due in large part to a Republican budget law that cut Medicaid by more than $800 billion and did nothing to extend enhanced ACA subsidies, sending premiums soaring.
Trump administration officials have baselessly claimed that their anti-fraud efforts were the key driver of ACA enrollment declines this year.
The word ‘fraud’ here obscures a lot.
Many of them may have been accidentally committing ‘fraud’ bc they live in a state that didn’t expand Medicaid and earn too little to qualify for ACA subsidies. There have been cases of brokers signing those folks up for the commission. pic.twitter.com/ek8gaVzJ7g
— Jordan Weissmann (@JHWeissmann) September 22, 2026
The mass disenrollment push comes less than two weeks after the Trump administration said it would send $500 rebate checks to some Americans who were allegedly "overcharged" under the ACA. Critics noted that the checks would only go to a small sliver of ACA enrollees and would do virtually nothing to offset premium hikes that are hitting millions of Americans.
Vance indicated Tuesday that the roughly 750,000 individuals who will soon be removed from the ACA due to alleged fraud are just the start of a broader purge. Around 19 million people are currently enrolled in ACA marketplace coverage.
"We're gonna do some additional verification," said Vance, who suggested the administration is using artificial intelligence tools to identify purported fraud. "We expect that most of these people are fraudulently enrolled, but we're gonna do some additional verification on about 419,000 people."
Democrats on the House Energy and Commerce Committee, which has jurisdiction over the ACA, wrote Tuesday that "people losing healthcare isn't a bug, it's [Trump and the GOP's] plan."
"First Republicans stripped Medicaid from millions," the Democrats wrote on social media. "Then they let premiums spike for millions more. Now JD Vance is using claims of 'fraud' to take coverage from hundreds of thousands more."
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Improved Medicare for All Will Save Our Rural Hospitals
At long last, the nation’s healthcare plan will guarantee that not only is everyone covered for care, free at the point of service, but that there is a place within reasonable distance to find that care.
Sep 19, 2026
After a century of providing healthcare to this rural, southeast Michigan community, Sturgis Hospital closed in June with only 70 hours warning.
The hospital was not on the at-risk-of-closing list that had been published by Sen. Ed Markey (D-Mass.) a year earlier.
Over 300 Sturgis Hospital employees are scrambling to find work. Registered nurse Beth Kelley, who had worked at Sturgis for 32 years, described the meeting room as filled with “shock” and “devastation” when management announced that the hospital was closing.
Nationwide more than 700 rural hospitals are at risk of closing, over half at immediate risk within the next two to three years. The 700 hospitals represent about one-third of all rural hospitals.
The termination of care at Sturgis Hospital overloads the city’s emergency medical services. Director of public safety Ryan Banaszak said, “What was once approximately a 2-mile transport for patients has now become closer to 25 miles, which takes ambulance personnel and equipment out of service for a much longer period of time.”
The impact is great on Michigan Medicaid patients, who cannot use the closest hospital because it is across the state line in Indiana.
“Rural hospital closures lead to significant increases in mortality, and birthing outcomes and obstetric care suffer following closures,” said Michael Shepherd, University of Michigan health policy researcher. The risk increases with every additional mile for emergencies like strokes and heart attacks.
A few weeks later the rural River District Hospital in St. Clair County northeast of Detroit announced the closing of its inpatient and emergency services. Four more rural Michigan hospitals—in Mt. Pleasant, Carson City, Ontonagon, and Dowagiac—are in danger of closing with the upcoming Medicaid cuts.
Rural Americans live sicker and die younger than those in urban areas. Life expectancy is about three years shorter in rural communities. When a rural hospital closes, the mortality rate rises by 5.9%. Rural hospital closures increase mortality for emergencies such as heart attacks and strokes by about 10%.
“There are two kinds of Americans: those who live 12 minutes from an emergency department and those who live 72,” writes Ayla Ellison who grew up in Carmi in southern Illinois. “Whether you survive a heart attack, deliver a healthy baby, or die from something entirely treatable increasingly depends not on the severity of your illness, but on the distance to the nearest hospital,” she continues. She explores the consequences of rural hospitals folding in a country where no one is responsible for assuring help is close enough for a chance at life. The hospital in Carmi closed 20 years ago. Nine more Illinois hospitals are at risk of closure, most of them in southern Illinois.
Other states are worse off. In Mississippi, 51% of the rural hospitals are at risk of closing; in Alabama, 52%; in Arkansas, 68%.
Dr. Kenneth Williams battled for decades to sustain the hospital (Alliance Healthcare System) in Holly Springs, Mississippi. Rapid expansion of Medicare Advantage plans reduced reimbursement and increased denials of payment to the hospital. In 2023, facing financial desperation, the hospital converted to Rural Emergency Hospital status, a federal program designed to stabilize struggling rural hospitals. The Center for Medicare and Medicaid Services (CMS) later removed that designation, leaving the hospital again fighting to stay open.
Nationwide more than 700 rural hospitals are at risk of closing, over half at immediate risk within the next two to three years. The 700 hospitals represent about one-third of all rural hospitals. That report was prior to the passage of HR 1, the “One Big Beautiful Bill” that slashes $1 trillion from Medicaid. The crisis escalates from grim to disastrous with the looming Medicaid cuts.
Federal efforts to save our rural hospitals have been pitifully inadequate in the face of the towering problem.
Critical Access Hospitals, created by Congress in 1997, allow small rural hospitals to receive cost-based Medicare reimbursement. The plan was designed to stem the tide of closures.
Between 2010 and 2025, 152 rural hospitals closed. Of these, 52 were Critical Access Hospitals.
In 2021 Congress created Rural Emergency Hospitals. This designation provides for enhanced Medicare payments allowing rural hospitals to continue with outpatient and emergency services only, instead of closing.
In 2023, Sturgis hospital was “saved” by conversion to a Rural Emergency Hospital, delaying its shutdown by three years.
Neither these nor any other federal plans are big enough or thorough enough to work.
CMS Director Mehmet Oz recently visited Kentucky, home of 35 rural at-risk hospitals. He touted the $50 billion in Rural Health Transformation Funds as the solution. The assertion is absurd.
At best, Kentucky will get $1 billion from the rural transformation funds as it loses $21 billion in Medicaid funds. Not even a wizard can turn that into a winner.
As Boston University professor Alan Sager notes, no US entity is responsible for sustaining or building or financing hospitals based on community need.
“The whole Appalachian area has been abandoned, but its hospitals should be funded and improved, as a necessity of life—like the post office,” says Dare Cima, who is from southeastern Kentucky.
With passage of H R 3069, Improved Medicare for All, finally, the nation will take responsibility for assuring that rural areas have adequate facilities. Hospitals will be paid quarterly, in advance, with a global budget that provides operating expenses.
The allocation to hospitals ensures proper staffing with safe nurse-to-patient ratios and optimal staffing for physicians and other healthcare workers. Physician salaries can be included in the global budget. Adjustments to the operating budget will be made “to decrease healthcare disparities in rural or medically underserved areas.”
Special projects funds will be used to end discrimination based on race or other underserved categories including geography. Funds will be allocated for construction of new facilities where needed. At long last, the nation’s healthcare plan will guarantee that not only is everyone covered for care, free at the point of service, but that there is a place within reasonable distance to find that care.
The late Dr. Ewell Scott, Medical Staff president of St. Clair Regional Medical Center in Morehead in the mountains of eastern Kentucky, predicted that if current policy continued, it was just a matter of time until all of Kentucky’s hospitals east of I-75 would be closed.
Sadly, that prediction is breathtakingly close as 16 of east Kentucky’s hospitals in the 5th Congressional District, including Dr. Scott’s beloved St. Clair hospital, are on the list of those endangered with closing by the passage of HR 1.
But Dr. Scott was fighting for a different future. He persuaded the City of Morehead to pass a resolution supporting Improved Medicare for All, a national single-payer plan that would cover us all and fund the hospitals.
Dr. Scott urged all who would listen to tell their congresspersons: “We know the solution. You’ve got to have the guts to stand up and do it.”
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