The health giant has rolled out a new suite of note-taking software, made by healthcare AI pioneer Abridge, intended to summarize a patient’s visit at supersonic speed. For many clinicians, the technology soothes one of the persistent headaches of their lives — administration and paperwork.

But the AI scribe caused another headache for Boyer and his colleagues: It is “not super useful.” They end up correcting the computer-written notes.

Abridge is “not good at picking up on clinical nuance, at picking up on the emotional tone” that can be critical in the mental health field, Boyer said. For example, for manic patients, what’s said is less important than how it’s said, Boyer said, and the software struggles with picking up on those cues.

Note-taking software isn’t the wave of the future; it’s the wave of the present. Hospitals nationwide are implementing it. And researchers are finding some benefits. A year after installation, doctors who used these products the most saved more than half an hour of work daily, according to published in April in the Journal of the American Medical Association.

Many doctors love the products where they’re deployed — several to the scribes.

Nevertheless, as Boyer’s example shows, there are persistent questions about the systems’ quality. While Boyer and his colleagues spend time correcting notes, safety researchers worry clinicians might not be diligent about catching errors. That might mean future doctors rely on bad information.

Abridge says it evaluates its scribes at every stage of deployment, including with head-to-head tests against previous versions of the software.

“Following deployment of a model, we monitor clinician edits, star ratings, and free-text feedback from clinician users about note quality,” the company’s director of applied science, Davis Liang, told Ñî¹óåú´«Ã½Ò•îl Health News in a statement.

Artificially intelligent scribe software is part of a swarm of AI-powered tools coming to healthcare. Clinicians and patient-safety advocates say government regulations are not well constructed to guard against the threat that the new technology will miss or obscure important details of patients’ conditions, potentially harming them.

“There is currently no safeguard in place” to vet scribe software at the federal level, said Raj Ratwani, a researcher specializing in human factors — that is, how people interact with technology — at MedStar Health, a large hospital system based in Columbia, Maryland.

Ratwani worries that safeguards on health software will relax even further. from the Office of the National Coordinator for Health IT — the body that regulates electronic health records, the central chronicle of care for patients — could weaken requirements to make medical records understandable, easy to use, and transparent about the use of AI, Ratwani said. And an incomprehensible record could confuse clinicians and lead to errors.

Beginning in the Obama administration, the Health and Human Services Department’s IT office , in which developers try their products on doctors and nurses. Regulators also sought to require more transparency from companies in the surging market in AI tools.

Both of those requirements are axed in the proposed rules from HHS Secretary Robert F. Kennedy Jr.’s health IT office.

Doctors and other health practitioners consult records for clinical information, such as scribe notes summarizing the history of patient care and lists of drugs and therapies their patients have used. Doctors also input orders for care.

Poor or cluttered design of a records system “might make the list of medications so complicated and confusing that the ordering provider selects the wrong medication,” Ratwani said.

Abridge’s general counsel, Tim Hwang, said the company “broadly supports” the government’s rules as a “necessary modernization” that “accommodates the speed at which AI is evolving.”

The old rules “put way too much burden” on electronic health record systems, said Ryan Howells, a principal at Leavitt Partners, which consults for digital health companies. Leavitt supports the proposals.

Dropping requirements, the administration argues, will result in more innovation and competition. The electronic health record market has steadily consolidated, with hospitals and other clinicians choosing from fewer vendors.

A 2022 study found the top two vendors, Epic and Oracle Health, of the hospital market. And Howells argued too many rules burdened providers looking for good record systems. Federal regulations, Howells said, are “the single biggest inhibitor to true clinical innovation.”

The Trump administration proposal to remove requirements governing records is overbroad, some critics say. It removes regulations intended to keep records secure. It also eliminates privacy protections for sensitive medical data they safeguard, overhauls standards governing the formats data is sent in, and more. The rule may give clinicians “more health IT choices to meet their needs through increased competition,” the government wrote in its proposal.

HHS’ health IT office declined comment, noting the proposal is still winding through the regulatory process. Public comment closed in February.

But most concerning to some — even in the hospital and developer sectors — are proposals to scotch prerequisites to ensure new products are tested on actual users, and to ensure AI tech’s decisions are transparent to doctors and nurses.

“Historically, hospitals and health systems have been challenged by the black box nature of certain AI tools and how the algorithms are developed,” the American Hospital Association’s Jennifer Holloman said. And with more AI tools flooding the market, the association , transparency is even more critical.

Complaints about the safety of electronic health records are long-standing, even for seemingly straightforward tasks. Ratwani likes the example of ordering medication for a given condition.

“The physician is trying to order Tylenol, and the medication list can be so confusing that there’s 30 different versions of Tylenol all at a different dose and for different purposes, when in reality that could be designed much more simply and make it easier for the physician to actually pick the right type of Tylenol that they’re ordering,” he said.

Real-world user testing was intended to simplify record design for doctors. But the administration is ending that requirement in a confusing way, said Leigh Burchell, vice president for policy and public affairs at Altera Digital Health, an EHR developer.

In Burchell’s interpretation of the rules, which refer to “enforcement discretion,” a principle in which the government can opt not to enforce certain rules, companies are still required to do the testing — the part that takes work — but are not mandated to report their results to the feds.

The administration is also ending a Biden-era idea to create AI transparency “model cards.” The concept was that clinicians could explore the data used to train AI tools that advise clinicians with a simple mouse click. But few took advantage of the year-old tool, Trump’s regulators say.

Still, hospitals and doctors are wary of removing it. The tool “provides information on how a predictive or generative AI application was designed, developed, tested, evaluated and should be used. These data are critical to foster trust in AI tools and ensure patient safety,” the AHA wrote in a comment letter to the HHS IT office. The American College of Physicians , saying a “lack of clarity could undermine clinician trust, increase liability expense, and erode the patient-physician relationship.”

Even developers aren’t totally sure about the idea. Burchell said the electronic health records trade group she’s part of had “a lot of different perspectives” on the issue. “Normally, we tend to be a bit more aligned on our responses.”

Still, Burchell’s group thought companies should be transparent about the data AI relies on to make decisions and how it comes up with recommendations.

Evidence for AI tools’ effectiveness or contradictory.

A comparing 11 AI scribes for potential use as a pilot in the Veterans Health Administration found the software performed worse than humans across five simulated scenarios. “Although ambient AI scribes can generate complete notes, the overall quality remains broadly below that of human-authored documentation,” the authors noted, with the omission of information being particularly concerning, given the potential to affect follow-up care.

The vendors in the VA study weren’t identified, for what the authors called “contractual reasons.”

And that’s just one type of AI tool. A wave of them is coming, each needing its own evaluation, to say nothing of tools that have already been installed.

Boyer said he can mostly ignore his AI scribe, for the moment. But he worries that management will design his job around the expected time savings and schedule more patients — meaning he’d need to spend more time both with patients and correcting the software’s errors.

A KP spokesperson, Vincent Staupe, said the company does not require its clinicians to use AI.

“When I am correcting that note, I feel like this is too much work,” Boyer said. “This is definitely making this worse, and this is taking up time that I need to not be spending on correcting an AI tool.”

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“What do you guys want to be when you grow up?” Health and Human Services Secretary Robert F. Kennedy Jr. asked a carpet full of preschoolers.

“A dinosaur!” the boy replied, squeezing tighter.

Just weeks ago, Kennedy sat before lawmakers on Capitol Hill and about a dangerous uptick in infectious diseases among American children.

Now, with midterm primaries underway, Kennedy was seated in a toddler-sized chair in Ohio, on a mission to change the subject.

Advised to stay away from the anti-vaccine rhetoric that rocketed him to political stardom, Kennedy has been dispatched by the White House to evangelize about the least controversial — and most popular — parts of his agenda. Republicans hope Kennedy’s “Take Back Your Health” tour will help them hang on to voters, many of whom are deeply .

So there Kennedy was in early May, crisscrossing a strip of northern Ohio that includes one of the few congressional districts that Republicans are confident they can flip in November, rotating through a wardrobe of blue suits and blue jeans.

He inspected the kitchen of a Toledo daycare center, where hundreds of the city’s tiniest residents learn and play through the federally funded Head Start program. Under the careful watch of a surgeon,Ìýand with the machine disconnected,ÌýKennedy brieflyÌýtestedÌýtheÌýteaching consoleÌýof the renowned Cleveland Clinic’s robotic handsÌýwithÌýa live patient splayed open for heart surgery in the room.ÌýAnd he munched on pesticide-free squash blossoms from a 400-acre farm.

“I am dismantling a corrupt system and replacing it with something better, replacing it with something that actually addresses the declining healthy American population,” Kennedy said from the dining room table of a farmhouse during an exclusive interview with Ñî¹óåú´«Ã½Ò•îl Health News. He pointed to what he views as his biggest accomplishments over the past year: pressuring some companies to remove dyes from certain foods, updating nutritional guidance, and defining ultraprocessed foods.

“People are paying attention to what they eat, and the industry is listening; the industry is changing.”

But hundreds of miles from Washington’s partisan interrogations, Kennedy couldn’t escape the uncomfortable contradictions and consequences of the Trump administration’s policies.

Taboo Budget Cuts

The classrooms of the Clever Bee Academy displayed freshly printed posters featuring Kennedy’s “Eat Real Food” slogan and the redesigned food pyramid.

Kennedy came with an offering, a $30,000 federal grant to help the center upgrade its kitchen and community garden.

Perched in front of staff and parents, he distanced himself from a last year that could have been devastating to many of Clever Bee’s young students, most of whom live in poverty: the proposal to eliminate the $12 billion Head Start program.

“We were asked to cut our agencies substantially,” Kennedy said. “The two programs that I went to the wall to protect, and find the money somewhere else, was the Indian Health Services, which is always starved for funding, and Head Start.”

The next day, Kennedy stood before goats on a farm in Medina, Ohio, cared for by people sobering up from drug or alcohol misuse at the Hope Recovery Community.

He was there to promise more investments from an administration that has steeply cut staff and budgets over the past year.

Kennedy, who still attends daily Alcoholics Anonymous meetings to cope with a heroin addiction that gripped him for 14 years, said he hopes to replicate the recovery center’s model nationwide, describing it as an “essential role of government to make sure those services are there.”

Broader access to addiction treatment is part of the Trump administration’s newly released . But recovery advocates are skeptical more people will get help, with millions expected to lose health insurance under Trump’s watch because of rising Affordable Care Act premiums and the nearly $900 billion in Medicaid cuts under the One Big Beautiful Bill Act.

Kennedy dismissed those challenges, pointing to a $100 million investment in addiction treatment services, including sober housing, announced this year.

“We’re trying to make it more accessible,” Kennedy told Ñî¹óåú´«Ã½Ò•îl Health News.

Trouble in MAHA Paradise

Rows of beds featuring green and purple microgreens awaited Kennedy at The Chef’s Garden, a Huron, Ohio, farm that rejects chemical use in growing its produce.

The health secretary plucked handfuls and tossed them into his mouth, quickly chewing before a new sample was brought before him.

“We are absolutely thrilled that someone at this level of government cares about how food is grown and where it is coming from,” said Bob Jones Jr., a co-owner of The Chef’s Garden.

Seeing more farmers produce chemical-free leafy greens has topped the wish list of those who support Kennedy and the Make America Healthy Again movement, and many who backed Trump in 2024. But in a move that’s threatening to fracture that constituency, Trump has pushed to protect the production of glyphosate, a weed-killing, potentially cancer-causing chemical commonly sprayed on crops and lawns.

Though the group MAHA Ohio extols Kennedy’s agenda and endorses candidates aligned with his movement, director Elizabeth Frost acknowledged tensions between MAHA and conservative policies.

The glyphosate issue is an example “where you have the conservative interests to look out for the interests of the industry, and you have your MAHA interest to be cognizant of the downstream health impacts,” said Frost, who volunteered on Kennedy’s presidential campaign.

Some prominent MAHA influencers have suggested that Trump’s White House staffers are stopping Kennedy from implementing more aggressive policies on certain issues, including further limiting vaccine use, a notion he dismissed.

“To say the White House has tied my hands — the only people who could say that are people who haven’t been paying attention for a year,” Kennedy said. “President Trump has let me do more than any HHS secretary in history.”

He added: “The only thing that people in the MAHA movement complain about is the president’s glyphosate order.”

Staying on Message

Republicans consider Kennedy an asset in the recently redrawn northern Ohio congressional district that Democrat Marcy Kaptur has represented for more than 40 years, and which as one of the most competitive in the nation.

Fresh off winning the Republican primary for the district last week, Derek Merrin smiled as he shook hands with Kennedy.

“We discussed protecting Lake Erie, strengthening rural hospitals, and our shared vision to improve food quality,” Merrin later posted on Facebook. “Let’s Make America Healthy Again!”

Still, even with Kennedy under advisement to avoid anti-vaccine rhetoric, the issue found him in Ohio. At a forum in Cleveland, family doctor Patricia Kellner said the best way to prevent hepatitis B is by vaccinating newborns — a recommendation that under Kennedy. She told Kennedy about treating patients with the disease.

“Some of them didn’t know because it can be asymptomatic. Some of them found out when they got liver cancer,” Kellner said. “So why are you opposed to a birth dose of hepatitis B?”

Kennedy responded by suggesting that the hepatitis B vaccine was not safe for babies and was necessary only for certain people.

“Hepatitis B is for high-risk groups like drug addicts or prostitutes, or for promiscuous homosexuals,” he added, eliciting gasps from the crowd.

While the risk of contracting hepatitis B is higher for those who inject drugs or men who have sex with men, the disease can be transmitted in other ways, including through contact with contaminated surfaces or childbirth.

Public health researchers that dropping the universal hepatitis B recommendation will result in hundreds of new infections in children, costing millions of dollars in additional health care costs.

This <a target="_blank" href="/public-health/rfk-make-america-healthy-again-tour-midterms-ohio-food-head-start-vaccines/">article</a&gt; first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

Recently divorced, the former stay-at-home mother had started working again in her mid-40s, taking a human resources job that paid $41,000 a year. Then, despite having insurance, she was hit with more than $8,000 in medical bills.

“I had my car and a basket of clothes,” Roberts recalled. “Medical bills were not something I could have afforded.”

Roberts sought financial assistance from CentraCare, the St. Cloud-based health system that treated her. It’s a nonprofit charity that receives millions of dollars in federal, state, and local tax breaks. In exchange, it’s obliged to offer charity care to patients who can’t afford their medical bills. But Roberts said CentraCare told her she made too much to qualify.

Roberts instead scrimped on groceries and Christmas gifts for her kids and paid off more than $6,000 over two years. Then CentraCare sued her last year because she hadn’t paid off all the debt.

“They’re supposed to be a nonprofit,” Roberts said. “It’s like, ‘Come on!’”

CentraCare earmarks a tiny fraction of its budget for helping patients with medical bills they can’t pay, but it’s not alone, a Minnesota Star Tribune-Ñî¹óåú´«Ã½Ò•îl Health News investigation found.

Minnesota’s hospitals and health systems are among the least charitable in the country, the investigation found, providing less financial aid as a percentage of their operating budgets on average than hospitals in almost every other state, including Illinois, Iowa, Nevada, and Texas.

The investigation drew on a detailed review of every hospital charity care program in the state, an analysis of five years of hospital financial data, and dozens of interviews with patients, hospital executives, and state officials.

Nationally, hospitals spend an average of about 2.4% of their operating budgets on charity care, according to federal hospital data compiled by Hossein Zare, a researcher at Johns Hopkins University. Minnesota hospitals spend about a third of that, on average.

Some spend considerably less. Of Minnesota’s 123 general hospitals, 62 devoted less than 0.5% of their operating budgets to charity care from 2020 through 2024, the Star Tribune-Ñî¹óåú´«Ã½Ò•îl Health News investigation found.

“The system is not working,” said Erin Hartung, director of legal services at Cancer Legal Care, a Minnesota nonprofit that helps patients with medical debt and other financial challenges. “And the burden is falling hardest on the people who are least able to bear it.”

CentraCare’s flagship St. Cloud Hospital spent less than 0.25%, according to the analysis. That works out to $25 in patient aid for every $10,000 spent on hospital operations.

Charity care will become even more vital in coming years as Minnesotans lose health coverage or can’t afford rising copays and deductibles. The state’s uninsured rate rose sharply last year, since 2017, and it’s expected to increase further as budget cuts pushed by President Donald Trump force states to pare Medicaid and other safety net programs. Charity care is also critical to many people with health insurance who can’t afford their bills.

Hospital officials say it’s unfair to expect them to solve this affordability problem when many of their facilities are financially strained. “No amount of charity care from hospitals will ever fully meet the needs of uninsured or underinsured Minnesotans. The need is simply too great,” Minnesota Hospital Association spokesperson Tim Nelson said in a statement.

But state Attorney General Keith Ellison said hospitals have a duty to boost charitable help for all needy patients in exchange for the tax breaks they receive.

“There is a benefit you get from being a nonprofit hospital in the state of Minnesota,” he said. “But do the people get the benefit?”

Several small Minnesota hospitals give financial aid to fewer than two dozen patients a year. Mahnomen Health Center, which recently converted to a rural emergency center, didn’t provide any charity care in eight years, despite serving one of Minnesota’s . Other hospitals serving large low-income populations were among those providing the least charity care, the analysis found.

Several factors help explain why Minnesota hospitals provide so little financial aid. For one, job-based insurance and an expanded Medicaid program offer broad coverage. Hospitals in states with less government assistance and more uninsured people typically spend more on charity care.

But Minnesota patients also face significant barriers accessing financial aid at many hospitals, including inconsistent eligibility standards and extensive applications, the Star Tribune-Ñî¹óåú´«Ã½Ò•îl Health News investigation found.

To qualify at many hospitals, patients must submit detailed personal information, including bank statements, retirement accounts, mortgage documents, and estimates of other assets such as cars, homes, or livestock.

And because Minnesota has not standardized the criteria for charity care, patients might receive aid at one hospital but not another. The investigation found that some hospitals give free care to patients with an annual household income of $47,000, while others cap it at about $15,000.

Had Roberts driven 30 miles east to Princeton or 35 miles north to Little Falls, she would have found medical providers with more generous financial aid policies than CentraCare. But she didn’t know to look.

Roberts, now 49, has remarried and lives in a split-level home in St. Cloud decorated with inspirational plaques such as “Faith, Family, Friends.” CentraCare recently dropped the lawsuit against her, but only after she took out a loan against her retirement plan to pay off the medical debt. “It just feels very unfair,” she said.

‘We Have To Defend Being Paid’

CentraCare spokesperson Karna Fronden said medical privacy laws prevented her from discussing Roberts’ case. She also declined interview requests about the health system’s charity care spending.

In a statement, Fronden said CentraCare provides assistance in addition to charity care, such as helping enroll patients in insurance. “This helps provide broader, longer-term protection for patients,” she said.

Other hospital leaders said they serve their communities in ways besides forgiving medical bills, including training doctors and nurses and preserving money-losing services such as obstetrics and mental health care.

“Rural hospitals like ours are often portrayed as though we are sitting on piles of cash and simply choosing not to spend it on charity care. That is far from the reality,” said Robert Pastor, chief executive of Rainy Lake Medical Center in International Falls.

“We are the second- or third-largest employer in town, running on razor-thin margins while navigating escalating labor and supply costs and routine underpayment by public programs,” Pastor said. “Meanwhile, many health insurers post billions in profits.”

Hospitals typically are paid less for care provided to Medicare and Medicaid patients. More than 80% of Rainy Lake’s patients are on one of those government programs.

Minnesota hospitals collectively write off about $200 million of what’s deemed bad debt every year after trying unsuccessfully to collect unpaid bills from patients through calls, letters, and even lawsuits. By comparison, they devote about $163 million annually to charity care, state figures show. In 2024, hospitals collectively posted $2.4 billion in net income.

“I feel like I’m put in the position, being the hospital, where we have to defend being paid,” said Patti Banks, the head of Ely-Bloomenson Community Hospital and a senior Minnesota Hospital Association board member.

Some hospitals face intense financial pressures. Thirty-one have lost money on operations in four of the past eight years. HCMC in Minneapolis — the state’s largest safety net hospital, which provides the most charity care — is losing so much money that, without additional taxpayer support, .

But larger health systems such as Mayo Clinic, Essentia Health, and Sanford Health have remained financially sound. And the operating margins at most CentraCare hospitals exceeded 10% in 2024, state data shows.

Medical Debt’s High Toll

Nationwide, health care debt — much of it from hospitals — burdens an estimated 100 million people, increasing their stress and even leading to premature deaths, .

Abby Kelley-Hands, a special education coordinator in St. Paul, has a rare immune condition that causes frequent, severe allergic reactions. Her illness can be controlled only with a costly drug, which a Mayo Clinic doctor prescribed.

When Kelley-Hands briefly lost health coverage in 2021 in an insurance mix-up, she was hit with more than $20,000 in bills. And although she and her husband earned less than $100,000 a year, Kelley-Hands said Mayo denied her financial assistance because she earned too much.

“I was in tears,” Kelley-Hands said. “It was so scary and so hard. And it causes all of this additional stress, which then makes you sicker and less able to even figure things out.”

Kelley-Hands and her husband sold a car and agreed to a payment plan before Mayo would resume her treatment, she said. Her husband now bikes 5 miles to work. They have no dishwasher. And she and her husband took a honeymoon only last fall, seven years after their wedding. “We live very simply,” she said.

Mayo spokesperson Kristyn Jacobson declined to discuss Kelley-Hands’ case.

In 2024, state lawmakers from denying care to patients with outstanding debt. And in 2025, Attorney General Ellison reached an agreement with Mayo to overhaul its charity care program after an investigation found the multibillion-dollar institution was systematically discouraging patients from applying.

After the state began investigating Mayo, the system’s , topping 1.5% of operating expenses in 2024.

‘Optimized To Get Payment’

Complying with a 2023 , Minnesota hospitals now post their financial aid policies online, although several, including CCM Health in Montevideo and Northfield Hospital, did so only after being contacted by the Star Tribune or Ñî¹óåú´«Ã½Ò•îl Health News.

But many hospitals make financial aid more difficult to find than information about paying bills, said Jared Walker, founder of Dollar For, a nonprofit that helps patients nationally apply for charity care.

“Hospitals have optimized to get payment,” he said. “If you want to get on a payment plan, if you want to get on a credit card, it’s so easy.”

Glacial Ridge Health System in Glenwood posts a “Bill Pay” tab at the . But it takes several clicks to find the hospital’s financial assistance plan. The information couldn’t be found on the site searching for “charity care” or “financial assistance.” The public hospital 130 miles northwest of Minneapolis devoted less than 0.7% of its operating budget to charity care from 2019 to 2024.

Patients in interviews frequently said they weren’t told about charity care.

Joe Robling, 29, was treated at St. Francis Regional Medical Center in Shakopee for a broken pelvis and fractured spine after a 2024 motorcycle accident. His mother, Janet, who helped him navigate the bills, said the hospital never informed him about financial aid.

“They didn’t offer any of that,” she said.

Robling, a construction worker in Henderson, was between jobs and uninsured. “He had zippo,” Janet Robling said. “What he had in reserves were all depleted.”

The Allina Health-affiliated hospital billed him more than $19,000, the Roblings said.

An internet ad connected the family to Dollar For, which helped Robling qualify for charity care five months after his accident.

Allina spokesperson Jennifer Steingas declined to comment on the case, citing medical privacy restrictions, but said the health system has since reached out to the family.

In another case, M Health Fairview’s University of Minnesota Medical Center didn’t offer financial aid to an unemployed and uninsured man from Idaho while he was hospitalized for two months for psychiatric care and amassed $150,000 in bills.

Attorney Margaret Henehan, who represented the man, said the hospital instead offered him a two-year payment plan at $6,500 a month. “He had no income, which he told Fairview,” Henehan said.

The man, who is not identified because of his mental health condition, eventually received charity care after his sister, a doctor, reached out to Henehan for help.

Aimee Jordan, a Fairview spokesperson, said she couldn’t comment on the case because of patient privacy laws, but she said patients who are offered payment plans can always apply for charity care, even after a hospitalization.

A Maze of Standards

State law prohibits hospitals from making “unreasonable” demands of patients when they apply for charity care. But the law sets few specific standards.

The result is a dizzying array of policies, including 11 income thresholds used by Minnesota hospitals to determine whether patients qualify for free care, the Minnesota Star-Tribune-Ñî¹óåú´«Ã½Ò•îl Health News review found.

HCMC parent company in Minneapolis and Olmsted Medical Center in Rochester offer the highest threshold for free care, at — almost $48,000 a year for an individual.

Sometimes standards vary even between neighboring hospitals. Madelia Health in south-central Minnesota to patients who make less than twice the federal poverty level. About 13 miles away at Mayo’s hospital in St. James, can qualify for aid.

To determine eligibility, some Minnesota hospitals consider only income, but most demand information about patients’ bank accounts as well. More than two-thirds require even more information, including the value of retirement accounts, life insurance policies, property, and vehicles. Madelia’s “may be required to sell recreational vehicles.”

Stringent requirements ensure that limited resources go to patients who need them, said Travis Olsen, chief executive of Hendricks Community Hospital, near the South Dakota border. “We don’t feel it’s fair for someone with lower annual income but yet owns numerous acres of land, debt-free, to be able to qualify for charity care.”

In addition to copies of tax returns, W-2 forms, pay stubs, and bank statements, 53 questions about their finances. These include questions about the make, model, and value of vehicles; the current market value of farm equipment, livestock, and land; and the purchase price and square footage of homes.

Other hospital applications ask patients to detail their monthly spending on food, utilities, and other medical bills.

Olsen said community pressure is more of a deterrent to applying for aid than the application: “People are too proud to pick up an application. We all know each other.”

But Walker at Dollar For said the biggest barrier is complexity. “The drop-off rates are much higher the more questions you ask and the more documentation you have to provide,” he said.

Arleen Mullenax had a cancerous tumor removed from her neck at Mayo in Rochester. Assembling her aid application and following up with the hospital billing department amid her “cancer fog” was almost more than she could take, she said.

“I knew as a former office manager I had to stay on top of it,” she said. “But it was the most daunting thing I had to do as a patient.”

Fixing the System

Ellison and several state lawmakers say Minnesota’s hospitals should make it simpler for patients to access charity care.

They’ve called for, among other things, common eligibility standards and a standard application across hospitals. New York and Maryland already have both.

“Eliminating as many barriers as possible for people is really important,” said state Sen. Liz Boldon, who also said she hopes lawmakers can enact these standards next session.

The Minnesota Hospital Association has opposed standardizing financial assistance, saying hospital boards are in the best position to assess the need for charity care in their communities. “Adding mandates for providers across the state will not close that gap, and will only increase bureaucratic and procedural barriers to patient care,” spokesperson Nelson said.

Ellison also has pushed to require hospitals to use a process that automatically screens and qualifies low-income patients for financial aid without requiring an application.

Some hospital systems, including South Dakota-based Sanford Health, already use software that checks patients’ eligibility based on information such as their credit history, said Nick Olson, the system’s chief financial officer. At Sanford Health’s 10 hospitals in Minnesota, about a quarter of the patients who receive financial aid get it this way, he said.

Nearly all Sanford hospitals devote more than 1% of their operating expenditures to charity care — higher than most hospitals in the state.

Screening software can be costly. Several executives at small Minnesota hospitals said they can’t afford it. But there are other options. In California, Los Angeles County is developing a public system to allow hospitals to quickly assess patients’ eligibility so they don’t have to buy a system themselves.

Other states — including Texas and Nevada — have laws requiring hospitals to provide minimum amounts of charity care.

Back in St. Cloud, Roberts said that when she drives past CentraCare’s $200 million expansion at its Plaza campus in St. Cloud, she wonders why Minnesota hospitals don’t live up to higher standards themselves.

“They have all the money,” she said. “But they can’t grant a good person some grace?”

Minnesota Star Tribune staff writers Bill Lukitsch and Victor Stefanescu contributed to this report.

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The Department of Health and Human Services to hospitals asking them to align their food purchases with the administration’s 2025-30 dietary guidelines to ensure continued eligibility for Medicaid and Medicare payments. “We commend the many hospitals who have made commitments to improve their food offerings, and expect every hospital system to do so,” HHS spokesperson Andrew Nixon said.Ìý

Top Kennedy adviser Calley Means took to social media to explain the initiative, urging the public to report hospitals that don’t comply with the guidance. The comment included a link to an HHS webpage with a toll-free number for reporting complaints typically used for medical bills.

The warnings drew sharp rebukes from critics who said the directive fails to consider that the specific dietary needs of patients are often different from those of the rest of the population.Ìý

“It’s always a struggle to get people to eat. Losing weight in the hospital raises the risk of mortality,” said Mary Talley Bowden, a sleep medicine specialist, who has with Make America Healthy Again causes but on X, posting: “Give me a break Calley. A hospital snitch line for soda?”Ìý

“It’s a little tyrannical,” she said in an interview.

HHS can withhold or threaten federal funding if hospitals violate mandatory minimum health and safety standards set by the agency. The standards stipulate that hospitals must protect patient privacy, for example, and uphold infection control. 

The standards do address hospital food, but they don’t explicitly refer to the 2025-30 established by the U.S. Department of Agriculture.Ìý

Rather, the standards require that “individual patient nutritional needs must be met in accordance with recognized dietary practices,” and list other requirements for hospitals, such as having access to a qualified dietitian.Ìý

HHS Secretary Robert F. Kennedy Jr. “doesn’t have a legal basis to do this, but hospitals and nursing homes can’t afford to ignore it altogether because of what it signals about potential enforcement action,” said Nicholas Bagley, a University of Michigan law professor.

HHS’ Healthy Food Agenda Puts Hospitals on Notice About Patients’ Meals

The backlash was immediate after the Trump administration served notice that hospitals and nursing homes should limit sugary drinks and dietary supplements in favor of what the Department of Health and Human Services terms “real food.”

By Stephanie Armour May 4, 2026

This <a target="_blank" href="/health-industry/the-week-in-brief-maha-movement-hospital-food/">article</a&gt; first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

Privacy between doctors and patients is . But the Trump administration is, in effect, trying to peek into the exam room. The Office of Personnel Management is seeking unredacted federal worker health data from insurers. The unusual request, which would give the government detailed personal and health information, alarmed health policy and legal experts, lawmakers, and insurance executives.

Ñî¹óåú´«Ã½Ò•îl Health News Washington health policy reporter Amanda Seitz appeared on WAMU’s Health Hub on April 29 to discuss why the government’s request has many worried about how this personal information would be handled.

Maia Rosenfeld contributed to this report.

This <a target="_blank" href="/health-industry/wamu-health-hub-opm-federal-worker-unredacted-medical-records-hipaa-audio/">article</a&gt; first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

Julie Rovner Ñî¹óåú´«Ã½Ò•îl Health News Read Julie's stories. Julie Rovner is chief Washington correspondent and host of Ñî¹óåú´«Ã½Ò•îl Health News’ weekly health policy news podcast, "What the Health?" A noted expert on health policy issues, Julie is the author of the critically praised reference book "Health Care Politics and Policy A to Z," now in its third edition.

A decision Friday night by a federal appeals court not only has raised new questions about the continued availability of the abortion pill mifepristone but has also thrust the abortion issue back into the spotlight. That’s something the Trump administration had hoped to avoid during the midterm elections.

Meanwhile, this week Food and Drug Administration Commissioner Marty Makary, the agency’s scientists, and President Donald Trump tussled over whether to approve fruit-flavored vapes, which might help adults quit smoking but also might attract youths to vaping.

This week’s panelists are Julie Rovner of Ñî¹óåú´«Ã½Ò•îl Health News, Jessie Hellmann of CQ Roll Call, Shefali Luthra of The 19th, and Sandhya Raman of Bloomberg Law.

Panelists

Jessie Hellmann CQ Roll Call

Shefali Luthra The 19th

Sandhya Raman Bloomberg Law

Among the takeaways from this week’s episode:

• It is unclear whether the abortion pill mifepristone will continue to be available through telehealth prescribing — currently the way more than a quarter of all abortions in the U.S. are obtained. The Supreme Court this week temporarily restored access after a lower court blocked it, but it remains to be seen what the high court will do next. The justices could decide to hear the case, potentially reviving abortion as a campaign issue in the midterm elections. Regardless, the case has the power to undermine not only abortion access, even in states where it is legal, but also the pharmaceutical industry’s ability to develop new drugs.
• Makary’s job as FDA commissioner is reportedly in limbo, now over flavored vape products, after Trump reportedly pressured Makary to clear them through agency approval. Trump talked on the campaign trail about preserving the vapes — considered by some a useful smoking cessation tool — yet that perspective runs afoul of public health concerns about the risk to children of keeping fruit-flavored tobacco products on the market.
• Also, the White House pulled Casey Means’ nomination to become U.S. surgeon general, replacing her with Nicole Saphier, a radiologist and commentator who has criticized Health and Human Services Secretary Robert F. Kennedy Jr.’s policies. Saphier is Trump’s third nominee for the post.
• And the United States, having pulled out of the World Health Organization under Trump’s leadership, finds itself sidelined as the global body responds to a cruise ship with a deadly hantavirus outbreak, with potentially serious ramifications for public health.

Also this week, Rovner interviews Ñî¹óåú´«Ã½Ò•îl Health News’ Andrew Jones, who wrote the latest “Bill of the Month” feature, about an emergency room bill for a visit that wasn’t an emergency — but could have been.

Plus, for “extra credit” the panelists suggest health policy stories they read this week that they think you should read, too: 

Julie Rovner: Ñî¹óåú´«Ã½Ò•îl Health News’ “HHS’ Healthy Food Agenda Puts Hospitals on Notice About Patients’ Meals,” by Stephanie Armour.

Shefali Luthra: ProPublica’s “,” by Duaa Eldeib.

Sandhya Raman: The Cut’s “,” by Juno DeMelo.

Jessie Hellmann: Nature’s “,” by Max Kozlov, Alexandra Witze, and Dan Garisto.

Also mentioned in this week’s podcast:

• The Wall Street Journal’s “,” by Philip Wegmann, Liz Essley Whyte, and Jennifer Calfas.
• The New York Times’ “,” by Christina Jewett.
• The New York Times’ “,” by Reed Abelson and Margot Sanger-Katz.
• CNN’s “,” by Andrew Kaczynski and Meg Tirrell.

Credits

Click here to find all our podcasts.

And subscribe to “What the Health? From Ñî¹óåú´«Ã½Ò•îl Health News” on , , , , , or wherever you listen to podcasts.

This <a target="_blank" href="/podcast/what-the-health-445-abortion-pill-mifepristone-makary-may-7-2026/">article</a&gt; first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

Even as prescription drug costs rise, patients with commercial insurance have slowed their use of manufacturer-sponsored drug coupons in recent years, according to April 6 by the Journal of the American Medical Association.

Manufacturers are offering just as many of them, “but still, we see a lot of affordability issues among this commercially insured population,” said So-Yeon Kang, the study’s main author, who is an assistant professor of health management and policy at Georgetown University.

“Patients are at the intersection and battle place between these payers and manufacturers,” she said.

Drug manufacturers distribute copay coupon cards to consumers online or in person at the pharmacy counter. These manufacturer-sponsored coupons are not the same as discount card services from companies like GoodRx, which negotiate lower bulk pricing for prescription drugs, then pass those savings along to the consumer.

Manufacturers issue the coupons to keep their drugs competitive by offering patients short-term savings. Consumers pay less out-of-pocket, often for brand-name drugs. This encourages patients to use the brand-name version of the drug, even when a cheaper, generic version might be available.

Some insurers say this unfairly puts them on the hook for pricier drugs. They say monthly premiums are higher as a result, punishing consumers and patients, not the manufacturers.

So, should you use manufacturer-sponsored prescription drug coupons when they are offered?

The short answer: It depends.

Here are five things to consider:

1. What if you do not have insurance?

If you are uninsured, using a coupon can be a great way to save money, especially if there is no generic version of the drug.

TrumpRx is a new federally funded initiative that acts as a prescription drug coupon dashboard for patients. Some of the coupons come from manufacturers, while others do not. Not every drug has a coupon offer, but the portal will save consumers money on drugs for those that do, especially in the short term.

Michelle Long, a senior policy manager at KFF who studies patient and consumer protections, said people without insurance can save money by using TrumpRx or manufacturer coupons. (KFF is the health policy research, polling, and news organization that includes Ñî¹óåú´«Ã½Ò•îl Health News.)

“I wouldn’t brush it off entirely because it’s got Trump’s name on it,” Long said. “For a lot of people who take certain medications, there really could be some real savings.”

Still, Long said, TrumpRx lists only about 85 drugs, among thousands approved by the FDA. It is important to note that drug coupons have limitations and guidelines. They do not last forever. When they are exhausted, uninsured consumers may have to pay full price for the drug.

2. What if you have commercial health insurance?

For people with insurance, the answer is a little more complicated.

If the drug isn’t covered by your insurance plan or if you intend to pay cash, then the coupon may be the way to go. If not, be wary.

Insurance coverage varies for certain kinds of drugs, such as GLP-1 obesity drugs. Kang’s study found that coupon use by commercial insurance holders on obesity drugs dropped from 54.6% of prescriptions in 2017 to only 2.5% in 2024, even though use of the drugs has been rising in the United States.

She said this reflects the growing number of patients paying cash for the drugs as prices decline, along with insurers’ reluctance to cover them and manufacturers’ shifting focus from coupon distribution to marketing campaigns.

3. What should you do if you expect high medical costs this year?

If you have insurance and anticipate meeting your deductible for the year through health care visits and treatments, consider using the coupons.

Coupons let you pay less out-of-pocket when you visit the pharmacy, but your insurer likely won’t count the value of the coupon toward your deductible. Only use a coupon if there is no generic option available and if you know you’d otherwise hit your deductible.

4. What if you have insurance but low overall medical costs?

The answer will almost always be: Don’t use the coupon.

Unless the drug you are looking for is not covered by your insurance plan, using coupons will put you at risk for higher indirect costs. It’s also often more advantageous to spend toward your deductible.

Watch out for copay adjustment programs that insurers use to discourage the use of drug coupons. They come in two common forms, Long said.

“” allow the use of drug coupons up to their full value, but the amount of the coupon won’t count toward patients’ deductibles or out-of-pocket maximums. That makes it harder for them to reach the threshold at which insurers will pitch in on prescriptions and other medical care. It can also mean a patient will eventually start paying the full cost of the drug because they haven’t yet met their annual deductible.

“Copay maximizers” use a similar technique that also prevents the coupon value from counting toward deductibles. Maximizer programs use a third party to over the course of a year to match the amount of the manufacturers’ coupons.

Insurers sometimes offer the programs to consumers under euphemistic names like “Employee Savings Program” that sound good in theory, but, in reality, take away some of the value of the coupons, Long said.

Initially, consumers will see savings at the pharmacy counter, but they may end up paying more in the long run.

5. What if you’re on Medicaid or Medicare?

Medicare and Medicaid beneficiaries are prohibited from using manufacturer-sponsored coupons.

A federal anti-kickback law makes it illegal to give someone anything of value to influence their decision to purchase something that will ultimately be paid for by a federal health care program. The law also prevents remuneration, which includes waiving copays and charging less than fair-market value for a product.

Manufacturer drug coupons categories.

Some states, notably California and Massachusetts, prohibit or limit the use of manufacturer drug coupons when a generic version of the drug is available — highlighting the tension among manufacturers, health plans, and the government.

This <a target="_blank" href="/health-care-costs/pharmacy-discount-coupons-hidden-costs/">article</a&gt; first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

The 152-bed hospital, which sits on a sprawling medical campus close to the predominantly Latino and Black neighborhood of Watts, is struggling for financial stability. Its patients are poorer and sicker than average, many of them are uninsured, and three-quarters of MLK’s patient care revenue comes from Medi-Cal, the state’s version of the Medicaid program, which pays low rates. For hospitals statewide, by comparison, less than one-third of patient revenue comes from Medi-Cal.

And MLK Community Healthcare, which comprises the hospital and two nearby clinics, is independent, so it cannot fall back on a larger chain to absorb some of the financial pressure.  

Similar problems plague hospitals around the country, in rural and urban areas. And their financial woes are about to get worse.

The Republican budget measure known as the One Big Beautiful Bill Act, signed into law by President Donald Trump last July, is expected to cut federal Medicaid spending by $911 billion over 10 years. And it could contribute to an increase of in the number of uninsured people, many of whom will go to already crowded emergency rooms to get care they can’t pay for.

The law does include a special fund to boost rural healthcare, totaling $50 billion over five years. But that’s far less than it is expected to cut from rural health spending over the next decade. And the rural health fund does little or nothing to help the numerous that also face serious financial troubles.

MLK, like many other hospitals, is scrambling to secure outside financing to avert serious disruptions of medical services when the brunt of the policies contained in the federal law begins to hit early next year. The hospital’s leadership team projects a revenue hole of $80 million to $100 million annually for the foreseeable future. It would be MLK’s largest budget gap since it opened in 2015.

“Even if we cut services that our community needs — maternity care, behavioral healthcare, diabetes management — it wouldn’t make a significant dent in the gap we’re facing,” said Elaine Batchlor, the CEO of MLK Community Healthcare. ”Many of those same people would still come to us through our emergency department, only they’d be in worse shape and might need more expensive care.”

Across the U.S., hospitals and patient advocates are looking to state lawmakers and local officials to help shore up shaky finances. In California, Assembly member Esmeralda Soria, a Democrat representing Fresno, is to expand a 2023 “distressed hospital loan fund” that allocated nearly $300 million in zero-interest loans to in the state, including $14 million to MLK. The state would pony up another $300 million under Soria’s bill.

At least two other states are weighing similar programs. A would create a $100 million “distressed hospital grant” program. And a funding bill for the Illinois Department of Healthcare and Family Services contains a provision to create for troubled hospitals.

Carmela Coyle, the CEO of the California Hospital Association, said the original $300 million disbursed by the state legislature helped but was not enough.

“This program is focused on those who are standing on the edge of that financial cliff, and it’s intended to give them a little space, brush them a little bit back from the edge,” Coyle said. “But we’ve got many more hospitals that are taking giant leaps toward the edge of that cliff every day.”

Despite the association’s influence, an expansion of the loan program is far from certain, given fiscal constraints that have already induced state leaders to roll back California’s ambitious healthcare agenda, with restrictions on coverage for immigrants and funding cuts for community clinics. Democratic Gov. Gavin Newsom recently warned lawmakers to expect more cuts in his revised May budget — and that’s before the main federal spending reductions kick in.

“This is a very difficult budget environment,” said Kristof Stremikis, director of market analysis and insight at the California Health Care Foundation, a nonprofit that advocates for healthcare improvement. “It is hard to come up with funding for new programs and even existing programs right now.”

Some lawmakers noted skeptically that the initial loans are now on their way to at which is allowed under existing law. Soria’s bill spells out a clearer path to loan forgiveness.

“Are these loans or are these grants? Because they seem to be turning, really, into grants,” Assembly member Pilar Schiavo, a Democrat in Santa Clarita, said during an April 21 hearing on the bill.

Ultimately, it might not be desirable to save struggling institutions by pouring dollars into them, because care is increasingly offered outside of hospitals, Stremikis said.

In the short term, though, the financial health of hospitals that received loans appears to have improved, according to a Ñî¹óåú´«Ã½Ò•îl Health News analysis of state data. The average operating margin of the 15 loan recipients for which comparable data is available shifted from a loss of 15.4% the year before the program to a gain of 2.3% after the money was disbursed.

It is unclear how much of the improvement can be attributed to the loans. Hospitals also secured other sources of funding, and they adopted efficiencies as a condition for the interest-free money.

MLK reduced the use of high-cost temporary labor by hiring more permanent staff, cut the average length of patient hospital stays to decrease staffing hours, streamlined billing, and negotiated more-favorable contracts with insurers, said Atul Nakhasi, a practicing physician who is also MLK’s vice president of government affairs and community relations. Batchlor said that the loan helped MLK get through a cash flow crunch and that a second loan, if it became available, would be used for the same purpose.

This summer, MLK expects to open a psychiatric assessment unit, where patients in mental distress can be stabilized in an environment replete with plush reclining chairs and “calming” rooms. Hospital executives hope the new unit will provide a significant new source of revenue, while taking pressure off the emergency department.

in Visalia, California, suspended some services, temporarily stopped contributing to employees’ retirement, and briefly froze wages in exchange for a loan of just under $21 million, said the organization’s CEO, Marc Mertz.

Madera Community Hospital got a $57 million loan — the largest disbursement from the state fund — to reopen after being shuttered for more than two years. The hospital reopened early last year, but it has not yet stabilized financially, said Matthew Beehler, the chief strategy officer at American Advanced Management, a privately held company that bought Madera out of bankruptcy.

“You can definitely say the hospital would not have been opened without the distressed hospital loan,” though the company has also invested more than $50 million, Beehler said. He said Madera would hope for another loan if the program were extended.

This <a target="_blank" href="/health-care-costs/medicaid-cuts-distressed-hospitals-aid-california/">article</a&gt; first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

It is urging the public to report hospitals and nursing homes that serve sugary drinks, nutrition shakes, or meals that it says don’t meet dietary guidelines established last year by the U.S. Department of Agriculture, with officials vowing to withhold millions of dollars in federal funding if violations occur.

The initiative from Health and Human Services Secretary Robert F. Kennedy Jr. is spurring backlash from some doctors and medical providers who say it fails to account for patients’ unique dietary needs and is anathema to Republicans who have long embraced an anti-regulatory stance.

It’s also not clear that HHS has the regulatory authority to enforce its threat without going through a formal rulemaking process, lawyers and dietitians say.

“Most of this is political theater. HHS doesn’t have the power to do much,” said , a dietitian and research scientist who is an assistant professor at the University of Toronto. “Also, if it’s to the point that you’re trying to control people’s choices, well, you look a little fascist.”

The agency to hospitals asking them to align their food purchases with the administration’s 2025-30 dietary guidelines to ensure continued eligibility for Medicaid and Medicare payments, Kennedy said at a March 30 press event.

“We are going to bring all the hospitals in the country in line with good food,” he said, describing the instructions as “essentially a .”

“If a hospital is serving patients sugary drinks, they are out of compliance with government standards and are putting their reimbursements in jeopardy,” top Kennedy adviser Calley Means “If you see patients being served sugary drinks, please post information below or let CMS know.”

The comment included a link to an HHS webpage with a toll-free number for reporting complaints typically used for medical bills. Withholding federal funding from hospitals is one of the most extreme enforcement tools available to regulators, one the Centers for Medicare & Medicaid Services has seldom deployed.

Even serving liquid nutrition products like Ensure to patients could put hospitals in jeopardy, Means warned. “They need to change or lose reimbursement. Please report them if you see it,” he told an X user.

Medicare and Medicaid, combined, are the of hospital expenditures.

The notice came in the form of a “Conditions of Participation” update released by CMS to ensure hospital patients’ food adheres to the dietary guidelines, HHS spokesperson Andrew Nixon said. “We commend the many hospitals who have made commitments to improve their food offerings, and expect every hospital system to do so,” he said.

Means did not respond directly to requests for comment from Ñî¹óåú´«Ã½Ò•îl Health News, instead posting on X shortly after he was contacted: “‘Trump Derangement Syndrome’ has led Democrats to defend the medical importance of mass-serving soda and junk food to American patients.” In a text with Ñî¹óåú´«Ã½Ò•îl Health News, he said, “That’s to cite if you want. I don’t have a comment.”

Still, some administration officials have made it clear they will not shy away from halting federal funding, a rarely taken step that can imperil the ability of a hospital to remain open.

A Carrot and a Stick

HHS can withhold or threaten federal funding if hospitals violate mandatory minimum health and safety standards set by the agency. The standards stipulate that hospitals must protect patient privacy, for example, and uphold infection control.

The standards do address hospital food, but they don’t explicitly refer to the 2025-30 established by the USDA.

Rather, the standards require that “individual patient nutritional needs must be met in accordance with recognized dietary practices,” and list other requirements for hospitals, such as having access to a qualified dietitian.

“CMS has never before interpreted this requirement as mandating adherence to any set of dietary guidelines,” according to an from law firm .

The CMS memo shows the agency is taking the “notable step” to incorporate the dietary guidelines “into the hospital regulatory framework without new rulemaking,” according to the brief.

Hospitals are likely to comply because they are loath to cross the federal government and want to avoid a legal tussle or enforcement action by Kennedy, some lawyers say.

“He doesn’t have a legal basis to do this, but hospitals and nursing homes can’t afford to ignore it altogether because of what it signals about potential enforcement action,” said , a University of Michigan law professor.

If federal funding were withheld, hospitals could always sue to try and challenge HHS’ authority.

“When the agency goes to the hospital and says, We’re going to take away your money for this, the hospital can sue and say, Look, nothing requires us to fry our fries in beef tallow or whatever,” Bagley said.

For hospitals looking to comply, the agency’s memo provides examples of what should and shouldn’t be served to patients.

Food as Medicine

What the guidance calls “don’ts”: sugar-sweetened beverages or juice. And “do’s”: water, unsweetened tea, milk, or coffee. Meals suggested in the memo include grilled salmon with quinoa or bean-based entrees with leafy greens.

Some nutritionists welcomed the focus on hospital food for patients. Marion Nestle, a public health advocate and molecular biologist, lauded the initiative, saying, “These sound terrific!” in an on her blog, .

Other health leaders and doctors pushed back, noting hospitalized patients often have more individualized nutrition needs that may not conform to federal dietary recommendations.

For “a patient struggling to swallow from just having a stroke, salmon and quinoa is the worst thing for them. They’re going to risk aspirating on it,” said Klatt, the University of Toronto dietitian.

Hospitals that neglect to provide certain standards of care, such as protein shakes to treat malnutrition or an unhealthy weight loss, could open themselves up to possible legal liability. Eighty percent of malnourished elderly patients gained weight and improved muscle mass on nutritional supplements such as Ensure, according to the published in Nutrición Hospitalaria, a peer-reviewed scientific journal.

Abbott, which , makes a range of products including shakes for people who “could be malnourished due to medical treatments, such as chemotherapy, and not be getting the calories they need because they don’t have much of an appetite,” company spokesperson John Koval said in a statement.

“It’s always a struggle to get people to eat. Losing weight in the hospital raises the risk of mortality,” said Mary Talley Bowden, a , who has with Make America Healthy Again causes but on X, posting: “Give me a break Calley. A hospital snitch line for soda?”

“It’s a little tyrannical,” she said in an interview.

The focus on hospital food came in late March as part of Kennedy’s MAHA initiative, in which he has touted changes to federal dietary guidelines that emphasize protein and healthy fats while eschewing processed foods.

Kennedy has leaned heavily into his work on changing eating habits, which fits into the MAHA gestalt and polls well with both Democratic and Republican voters. Eighty-six percent of registered voters surveyed said it should be easier for every American family to access fresh fruits and vegetables, released in September by Navigator Research.

This <a target="_blank" href="/health-industry/hhs-healthy-hospital-food-patient-dietary-guidelines-backlash/">article</a&gt; first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

If you or someone you know may be experiencing a mental health crisis, contact the 988 Suicide & Crisis Lifeline by dialing or texting “988.”

Someone in America dies by suicide every 11 minutes. It’s that common. But that doesn’t make it normal.

Humans have evolved over centuries to survive. So when people try to kill themselves, something has gone wrong. Typically, the assumption is that something happened in the person’s mind — a mental illness.

That’s led prevention efforts to typically focus on connecting people with treatment in moments of crisis.

But that’s changing. There’s a growing movement asking a different question: What went wrong in the world around that person?

During the covid pandemic, rates of anxiety and depression spiked — not because everyone’s brain chemistry suddenly changed but because the world changed. People were out of work, isolated, struggling to make ends meet.

That led many people in the mental health advocacy world to call for a broader approach. Treatments and crisis care are vital, they say, but the goal of suicide prevention needs to expand beyond stopping people from dying to alsoÌýgivingÌýthem reasons to live.

Decades of researchÌýsupportsÌýthis idea. Interventions that improve people’s lives and prospects, such as running food banks to ensure familiesÌýdon’tÌýgo hungry or hosting weekly book clubs for homebound seniors to make friends, can reduce suicide.

I spoke with Chris Pawelski, a fourth-generation farmer in Orange County, New York, for this story. He told me how his dad’s passing, caring for his mom with dementia, and the struggling finances of his family’s onion farm brought him to consider suicide.

“It’s all stuff collapsing down upon you,” he said. “It’s weeks, months, years of dealing with all sorts of pressures that you can’t alleviate.”

What helped him through that time was not just family support and therapy. It was also an economic plan. He worked with an organization called NYÌýFarmNet, which provided a free financial consultant who helped Pawelski transition from farming onions for wholesale to a new model, growing varied produce to sell directly to consumers.

Today, Pawelski’s business has stabilized, and he and his wife areÌýpaying downÌýdebt. HeÌýadvocates forÌýprograms to help others in similar situations.

That can mean crisis hotlines and access to affordable therapy, Pawelski said. But what he really wants are policy changes that help people address underlying hardships before a crisis strikes.

“We need to think broader and longer-term than a helpline,” he said. That’s “a band-aid on a gunshot wound.”

ELEVEN MINUTES

Saving Lives by Changing Lives: The Next Frontier in Suicide Prevention

Someone in America dies by suicide every 11 minutes. It’s a tragic and entrenched problem. A new approach to prevention shifts the focus from stopping harm in moments of crisis to upstream policies that give people reasons to live.

By Aneri Pattani April 29, 2026

This <a target="_blank" href="/mental-health/the-week-in-brief-suicide-prevention-efforts-broader-approach/">article</a&gt; first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">