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Hospitals Say They Found a Tool To Help Reduce Childbirth Risks: Wristbands

Andrew Jones — Wed, 12 Aug 2026 09:00:00 +0000

Hospitals across the U.S. are trying to reduce maternal deaths and complications after pregnancies using one small tool: a silicone wristband stamped with the declaration “I Gave Birth.”

The wristbands are part of a growing initiative first launched by North Carolina-based ECU Health as Congress sought to address the nation’s growing maternal mortality crisis during the covid pandemic. , and the state’s health department have begun distributing the wristbands, to give mothers and care providers a visual reminder of the life-threatening health risks after birth.

The Connecticut state health department; large health systems in Arkansas, Georgia, and Mississippi; and hospitals in at least 24 other states have also embraced the program. The wristbands are intended to make emergency workers aware of postpartum risks, ensure better treatment, and help lower maternal mortality rates in the U.S., where happen after the day of delivery — and nearly 40% happen after the six-week mark.

This year, North Carolina plans to expand the initiative with part of the through the Rural Health Transformation Program, a provision of President Donald Trump’s signature One Big Beautiful Bill Act, also known as HR 1.

Tamika Auguste, a physician and the board chair at the American College of Obstetricians & Gynecologists Foundation, praised the wristbands as a useful tool “to increase awareness and education around postpartum health.” But she and others who focus on maternal health said efforts like the wristband campaigns are only part of what’s needed to combat the broader maternal mortality crisis in the U.S.

And they noted the wristbands’ popularity is emerging as Trump’s 2025 law is expected to reduce Medicaid spending by over 10 years, according to a Congressional Budget Office analysis. Medicaid, the federal-state program that covers healthcare for low-income families, pays for .

Elisabeth Wright Burak, a policy researcher at Georgetown University’s Center for Children and Families, said Trump’s tax-and-spending law is stifling the momentum states had been gaining with maternal care since 2022. That’s when Congress allowed states to extend postpartum Medicaid coverage , which nearly every state did.

Now, those extensions could end up on the chopping block, Burak said, as states seek ways to manage Medicaid losses.

“There is no question that HR 1 risks setting the clock back for maternal health,” Burak said.

warned that postpartum patients have more to worry about with the new law than simply cuts to Medicaid. States are also setting up systems that may not adequately track pregnant and postpartum enrollees who should be exempt from the law’s new work requirements, erroneously dropping them from coverage, Burak’s report said.

Maternal Mortality

U.S. maternal mortality rates have risen and fallen over the past seven years, with 649 maternal deaths in 2024, according to the most recent . Tennessee had the worst maternal mortality rate in the nation from 2020 to 2024, around 42 deaths per 100,000 births, according an analysis of CDC data by the . North Carolina’s rate was about 29 in 100,000, with a national average of 23.

In its , North Carolina said the initiative creating the “I Gave Birth” wristbands reduced postpartum readmissions by nearly a third at ECU Health Medical Center in Greenville, without elaborating. In online promotions, some hospitals the can , though many have recently launched and their impact has yet to be studied.

“Additional research is needed to conclusively confirm the outcomes of such initiatives,” said Hannah Jones, a spokesperson for the North Carolina health department.

Hospitals to patients who have given birth and instruct them to wear it for weeks or months, hoping they’ll be reminded to check in with a physician if they feel chest pain, have headaches, or start bleeding. The accessory resembles the yellow , part of a cancer awareness campaign launched by cyclist Lance Armstrong’s foundation. A nurse also talks through postpartum risks with the patients, and they’re sent home with pamphlets and guidebooks on how to care for their new child and themselves.

“The bracelet itself is simply a reminder of, ‘Hey, I got education,’” said Jessica Noble, a nurse with East Carolina University-connected ECU Health who pioneered the initiative.

It’s also intended to alert first responders and other healthcare providers that a woman has recently given birth and to check for postpartum complications, such as low blood pressure, bleeding, or infections. and sometimes don’t have adequate training to recognize postpartum complications, research shows, which can be dangerous when those patients end up in an emergency room.

North Carolina and other states have embraced “I Gave Birth” wristbands as a way to encourage women to seek help when they have postpartum complications. They’re gaining steam as the Trump administration’s cuts to Medicaid threaten postpartum care. (University of Arkansas for Medical Sciences)

Postpartum wristbands gained traction across the country through health awareness campaigns fueled by social media posts and evening news segments. New mothers appeared in promotional photos and videos wearing the wristband and raving about the accessory, saying it celebrated childbirth.

Some postpartum patients who faced traumatic births or mental health struggles saw it differently.

‘So Many Risks’

Alexandra Mellon gave birth last year. Her daughter was stillborn. Devastated, she sought out a therapist, donated her breast milk, and tried to find meaning in her circumstances. She spent a year feeling isolated, she said, often because people don’t know what to say.

Mellon said wearing one of the wristbands would have been a painful reminder of her loss.

Now she works as a doula in Asheville, North Carolina. Mellon said what she thinks new moms need most is community and emotional support. The wristband could help encourage that for some patients, she said, but isn’t for everyone.

“There are so many risks, and it’s just like you almost become invisible,” she said.

More than 80% of pregnancy-related deaths , according to the CDC. The Centers for Medicare & Medicaid Services in March , developed during the Biden administration, that urged hospitals to create better emergency department protocols to catch postpartum complications and to measure their work against state and national maternal health data.

But those efforts faced a major threat last year when the Trump administration CDC funding for state-level maternal mortality data in its proposed 2026 budget. While Congress rejected that move, the administration did tracking postpartum patients’ health.

The Trump administration $113.5 million in CDC maternal health research in its proposed 2027 budget. Congress has instead proposed increasing funding to .

Without more research, it’s unclear how effective the wristbands are in encouraging postpartum patients to seek care when they need it. A of mass media campaigns to improve health outcomes, such as preventing risky substance use or encouraging exercise, found that the campaigns didn’t change behaviors. found that the U.S. “Back to Sleep” campaign, which educates parents on safe sleeping practices with babies, dramatically reduced rates of sudden infant death syndrome for several years after it launched in 1994, though rates .

In 2020, the CDC tried , “Hear Her,” aimed at helping women speak up when something felt wrong after delivery.

The CDC released years later that said it “had the unintended consequence of appearing to put the burden on the people who are pregnant or postpartum to speak up.”

ECU Health Medical Center created the wristband initiative in 2021 and . In it the authors noted the pregnancy-related readmission rate at the Greenville hospital fell 0.77%. It attributed the change to the “education provided to patients, family members, and medical personnel” in the initiative, without elaborating.

Campaigns like the “I Gave Birth” initiative are far from a final solution to maternal mortality, said Noble, the campaign’s architect and lead author on the ECU Health study. If she “had a magic wand,” she said, North Carolina would not just have better postpartum care but would also address the root causes of pregnancy complications. “But I don’t have one, and I can’t make system-level change immediately.”

ECU Health in eastern North Carolina created the “I Gave Birth” wristband initiative in 2021 at a time when Congress was seeking to address the nation’s maternal mortality crisis during the covid pandemic. (ECU Health)

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A Federal Policy Is Complicating How Organizations Battle the Opioid Crisis

Scott Maucione, WYPR — Tue, 11 Aug 2026 09:00:00 +0000

Last year, Baltimore had three in the span of three months in its Penn North neighborhood.

In one incident, more than two dozen people were hospitalized after many were , lying in the streets or on sidewalks. No one died, but some came close.

Follow-up that the street drugs of N-methylclonazepam, a benzodiazepine that operates similarly to Xanax or Valium. Like opioids, benzodiazepines suppress breathing. When they’re combined, the goes up. And benzodiazepines don’t respond to opioid overdose reversal drugs.

Afterward, the created test strips specifically for benzodiazepines. The group distributed them — along with test strips that identify other harmful adulterants, such as fentanyl, , and medetomidine — at clinics and neighborhood events. The strips, available at no cost, can also be found in bars and spread out on street corners. People testing drugs mix a small amount with water and then dip a test strip into the liquid. The strip will change color if it identifies an adulterant.

“Nobody really knows what they’re getting whenever they’re getting stuff off of the street,” said Candy Kerr, a spokesperson for the coalition. “Having the test strips available for the general public gives them the option to move slower if they’re going to use whatever they’re going to use.”

A box with free drug test strips, used to detect fentanyl and other harmful adulterants, sits outside the Chesapeake Detention Facility in Baltimore. Many health advocacy groups try to give the strips to people leaving incarceration, to avert overdoses. (Scott Maucione/WYPR)

But a new federal policy could make it harder for organizations such as Kerr’s to give out the test strips, and they’re worried that overdoses could increase. In late April, the Substance Abuse and Mental Health Services Administration banned the use of federal grants for distributing strips to the public and for some other harm reduction practices that have been credited with saving lives. Test strips have been used for to identify adulterants.

sent to local health departments and nonprofits that provide addiction services explained that the Trump administration believes those harm reduction practices “facilitate illicit drug use and are incompatible with Federal laws.”

According to the letter, grants from the Department of Health and Human Services also cannot be used for programs that support the use of clean needles or drug paraphernalia such as pipes, or to fund a type of that people can , so someone is aware and can call for help if they overdose.

The Trump administration wants to focus more on other techniques, such as giving out naloxone, an overdose reversal drug available as a nasal spray, according to Emily Hilliard, an HHS spokesperson.

“It is critical that federal funding provided by the American taxpayer goes to effective, common-sense solutions that have been proven to save lives and keep people out of an endless cycle of addiction and moves them into a life of recovery,” she said.

The new policy does not prohibit federal funds from being used to purchase test strips for use by law enforcement officers, public health officials, EMTs, or other medical professionals.

That creates an important exception for government agencies that test drugs and send out on what adulterants are saturating the drug supply in certain locations.

Still, , who oversaw SAMHSA’s in the Biden and Trump administrations, says there is a substantial body of evidence giving test strips to people who use drugs can change behavior.

“There’s some people deciding not to use the substances, some people deciding to reduce, to use less, or take other types of precautions, including naloxone, and making sure that there are people around that can actually then help in the case of an overdose,” Olsen said.

Kerr said the best approach would be to continue to promote the use of test strips while also continuing to give out lifesaving medications like naloxone. She believes that working on all fronts has helped lead to Baltimore’s decline in overdose deaths, which more than 40% since 2023.

Naloxone, an overdose reversal drug, is spread out on a street corner for people to take after a 2025 mass overdose incident in Baltimore’s Penn North neighborhood. (Scott Maucione/WYPR)

Under the new policy, nonprofits will still be able to hand out test strips, but they will have to find other funding for that work, which Kerr finds worrisome.

“We’ve been making these strides forward because we’ve had these things, because we’ve been funded,” she said. “We’re going to have to pull money from other places.”

To pay for the test strips, Kerr said, the Baltimore Harm Reduction Coalition will have to cut back on services such as giving out hygiene and wound care kits. But she said that option is better than risking another mass overdose in Baltimore — or allowing even just one preventable fatality.

This article is from a partnership that includes , , and ��ýҕ�l Health News.

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Many States Cover Doula Care, but Access to a ‘Birthing Bestie’ Is Often Out of Reach

Rachel Spears — Mon, 10 Aug 2026 09:00:00 +0000

Doula Taja Iglesias and her business partner have built a space in Alexandria, Virginia, that’s all things pregnancy, birth, and childcare.

Comfortable couches in one area invite expectant parents to settle in for birth education classes. In another, a colorful pile of toys await the babies and toddlers. And there’s a free supply of diapers and food. Years ago, as Iglesias was giving birth and expressing her wish not to have an epidural for pain, she felt isolated and that her preferences were dismissed by the medical staff. Today, she works hard to make sure other parents can have the support of a doula.

“We kind of created this to fill the gaps that we realized existed because we had to go through it,” Iglesias said. She’s the founder of , a doula agency dedicated to giving parents care throughout the perinatal process.

Iglesias said one of the widest gaps is the lack of access to doula care for parents on Medicaid.

Doula care has been initiation and less maternal anxiety. The perinatal doula care covers education about pregnancy and birth, advocacy for new parents in the hospital, and help after delivery with lactation and recovery. Doulas often work alongside doctors or midwives who provide medical care.

“The doula is the person that already knows what you want. We know what your dream birth is,” Iglesias explained. “We’re somebody that is standing on the side of the parent.”

Doula Taja Iglesias, founder of The Momager Co., a doula agency, offers some of her services from a welcoming space in Alexandria, Virginia. (Lynne Shallcross/��ýҕ�l Health News)

(Lynne Shallcross/��ýҕ�l Health News)

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In 2022, Virginia became the fourth state to start reimbursing doulas through Medicaid. A push to address the country’s maternal mortality rates, which are , has been an engine for lawmakers looking to give women on Medicaid the support of doula care. For example, another hospitals to allow an extra person, other than a family member, in the delivery room.

The services offered and the number of visits covered by Medicaid vary by state, but today doulas are covered in . An additional 20 states have considered proposals or are in the process of implementing similar policies.

In Virginia, doulas say the administrative and logistical challenges they encounter are trickling down to moms. A review of the Virginia Certification Board’s Doula Registry this June found based in Northern Virginia accept payment from Medicaid.

Doulas say that while Medicaid coverage of their services is a good first step, the amount of paperwork required in the approval process and the low reimbursement rates mean that fewer doulas participate in the Medicaid program, reducing access for beneficiaries.

that extended doula benefits to Medicaid enrollees sought to improve the health of Virginia parents and decrease the number of mothers who die during the time surrounding birth. The state’s maternal mortality rate is among .

As co-chair of the state’s task force on doula regulations, Iglesias helps shape policies that make it easier for moms on Medicaid to get doula care through the program.

To access doula services in Virginia, parents on Medicaid must have a referral from a doctor, and their doula must be approved by the state to care for Medicaid beneficiaries. Iglesias would like to see that process be quicker and less costly for doulas, who pay $75-$150 for certification.

While the policy debates continue, Iglesias has decided not to get certified to care for parents on Medicaid. Instead, she raises money to provide doula care for parents on Medicaid outside the system.

“I don’t want to be state-certified with a training that I feel is not full and complete, a training that doesn’t touch on that community aspect of work,” she said.

Iglesias said the services covered are too limited and Medicaid does not allow her to work with clients as she sees fit. Virginia’s payment covers up to eight doula visits. All but the first visit are limited to one hour, which Iglesias said isn’t enough time.

“If you want to actually build a relationship with this person that you’re going to be standing in with in their most vulnerable moment, it ain’t happening,” Iglesias said.

Informational pamphlets are displayed at The Momager Co., which offers appointments and group classes. (Lynne Shallcross/��ýҕ�l Health News)

The Momager Co. operates a store with free postpartum provisions, maternity clothes, baby essentials, and breast/chestfeeding supplies, as well as food and hygiene items. (Lynne Shallcross/��ýҕ�l Health News)

Donated baby clothing is available free to parents at the Alexandria, Virginia-based doula agency. (Lynne Shallcross/��ýҕ�l Health News)

While pursuing her PhD at George Mason University, studied the initial implementation of the doula reimbursement policy in Virginia.

Mensah from 2022 to 2024 for a study published this year. She interviewed doulas eager to serve clients on Medicaid. But some told her they got bogged down in the paperwork and never were certified. Doulas report similar struggles with the certification process today.

Mensah said the mismatch between the size of the Medicaid population in Northern Virginia and the low number of doulas available leads to fewer parents receiving doula care.

Coverage is a good first step, Mensah noted, but it doesn’t translate to enough access. During the first two years of implementation, in Virginia used doula services. That study is the latest available.

Kenda Denia, executive director of , a statewide doula collective in Virginia, welcomed the law at first.

“But now we’re looking at certain logistics that are not working,” Denia said.

Private-pay doulas in Virginia $1,200 to $3,000 per pregnancy. For families wanting more extensive prenatal or postpartum services, the fee can be as much as $6,000. Virginia’s Medicaid program, also known as Cardinal Care, per pregnancy. They receive an additional $100 if their client attends prenatal and postpartum doctors’ visits.

The pay is too low and does not reflect the value of the services they provide, Denia said. “Midwives don’t get paid this. Doctors don’t get paid this,” she explained. “We are driving to people’s homes for postpartum and prenatal care.”

Doulas might wait weeks or months for reimbursement, and the pay is not flexible. The Medicaid reimbursement rate is the same across the state and does not capture the in areas like Alexandria. It’s roughly 32% more expensive in Alexandria than the average cost of living in Virginia, according to ERI Economic Research Institute, a private data analytics group.

Despite the barriers, Denia applauded parts of the policy. Medicaid coverage of doulas means that more parents can have a “birthing bestie,” she said.

Before getting pregnant, Juliana Navia had no idea what doulas did. But while at a free clinic for her prenatal checkups, Navia connected with Iglesias. Later, Iglesias became Navia’s doula and helped her navigate a difficult situation when she wasn’t getting the kind of care she wanted at the hospital.

“I was stressed giving birth, but my doula helped me,” Navia said. “I was advocated for.”

This article first appeared on ��ýҕ�l Health News and is republished here under a .

Journalists Cover Cyclospora and Measles Outbreaks, and Changing Health Policies

Sat, 08 Aug 2026 09:00:00 +0000

Céline Gounder, ��ýҕ�l Health News’ editor-at-large for public health, discussed the cyclosporiasis outbreak on CBS News’ CBS Mornings on Aug. 5. Gounder discussed New Mexico’s measles outbreak on CBS News 24/7’s The Daily Report on Aug. 4. She also discussed peptides on Ideastream Public Media/WKSU’s Sound of Ideas on Aug. 3.

��ýҕ�l Health News chief Washington correspondent Julie Rovner discussed the end of a Biden-era Medicare Part D subsidy on WBUR’s Here & Now on Aug. 3.

��ýҕ�l Health News Southern correspondent Sam Whitehead discussed the new medical frailty work requirements on WUGA’s The Georgia Health Report on July 31.

.
Read Whitehead’s “Doctors ‘Cringe’ at Possibility of Documenting Which Medicaid Enrollees Too Sick To Work.”

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Budget Battle Erupts in Nation’s Capital Over Opioid Settlement Money

Rachel Spears and Aneri Pattani — Fri, 07 Aug 2026 09:00:00 +0000

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For years, Washington, D.C., has paid for Medicaid — the state-federal health insurance program for low-income people — out of its general budget. But next year, the city is shifting part of that recurring multimillion-dollar cost to a new funding source: opioid settlement dollars.

That’s raising red flags for addiction recovery advocates, people directly affected by the crisis, and the commission in charge of recommending how the city uses its share of the settlement money.

The come from a host of companies that made or distributed prescription painkillers and were accused of fueling the overdose crisis. State and local governments nationwide are set to receive more than $50 billion over almost two decades. Washington, D.C.’s cut is expected to .

The money is meant to remediate the addiction crisis, often by increasing services or funding new programs.

But many states are facing increasing fiscal pressures as they are squeezed by inflation, federal funding cuts, and rising costs. Some officials have been tempted to turn to opioid settlement cash as a budget stopgap — an idea that can trigger opposition and outrage from recovery advocates and people who have struggled with opioid addiction and their family members.

“These funds were awarded to D.C. for very specific reasons and with a specific mandate, which are to remediate issues related to the opioid crisis in new and innovative ways,” said Queen Adesuyi, a partner at , a consulting group for community-based organizations, who is crying foul over the proposed fiscal year 2027 budget.

A document provided to ��ýҕ�l Health News shows line items in the district’s fiscal 2027 budget that would direct about $2.3 million in opioid settlement funds to help pay for the city’s Medicaid contribution and at least $5.5 million to support addiction treatment centers previously funded through the general budget. Substituting opioid settlement dollars for general funding keeps overall spending on treatment flat instead of increasing.

“Opioid settlement dollars are not meant to be a rainy-day fund for existing government obligations,” said , associate director of the Center on Addiction and Public Policy at Georgetown Law’s O’Neill Institute.

More than 80 individuals and 30 city organizations protesting this use of settlement dollars, saying the district’s planned to spend opioid cash to “pay off its own debts.” The letter was sent to DBH Director Barbara Bazron; the chair of the D.C. Council’s Committee on Health, ; and Attorney General .

Chad Jackson, himself in recovery, chairs the district’s , which was created to advise the city on how to spend its settlement dollars. Jackson called the latest move supplantation, a budgeting tactic that shifts money from one fund to another to free up dollars.

“If the opioid settlement funds were not there, I feel pretty confident that these things would have been funded, because they have to be funded,” Jackson said.

What’s happening now is against the district’s opioid litigation law, he said.

The that money from the district’s opioid abatement fund “shall supplement, and not supplant.”

“It’s a pretty tightly written law where the intent is very clear: Do not supplant,” Weizman said.

Adesuyi, an advocate for programs that help people who use drugs, said the council is flouting that law and that it’s a “slap in the face.”

Queen Adesuyi is a Washington, D.C.-based harm reduction advocate and partner at Reframe Health and Justice, a consulting group for community-based organizations. At the July 15 meeting of the Opioid Abatement Advisory Commission, they speak against the city’s use of opioid settlement dollars to fill budget holes. (Aneri Pattani/��ýҕ�l Health News)

Councilmember Henderson and Attorney General Schwalb weighed in too.

“We are also concerned that DBH may be using the settlement monies for other unauthorized purposes,” they wrote in a to the department. They highlighted the $2.3 million used to cover the city’s Medicaid contribution and asked the department to explain by July 31 how it determined that was legal.

It’s unclear whether the Department of Behavioral Health met that deadline. DBH, Henderson’s office, and the attorney general’s office did not respond to that specific question.

However, DBH spokesperson said in a statement that the department is “committed to compliance with all statutory requirements governing opioid settlement funds.” The department’s general position has been that its budget was approved by the council, and that the funding supports efforts that counter opioid addiction.

The council “passed a legally-certified budget for the next fiscal year that makes the best use of all local resources, including the opioid settlement fund, to award grants to 17 community-based providers who last year served nearly 9,800 residents including 3,500 in medication-assisted treatment for opioid addiction,” Reed told ��ýҕ�l Health News.

The district’s budget is pending a 30-day “congressional review,” which is the last step in its .

Still, some residents like Adesuyi want more accountability for how the opioid money is spent.

“The drug supply is getting a lot more unpredictable, which calls for some nimbleness, and it calls for interventions that are more courageous. Unfortunately, DBH is not meeting the mark when it comes to that,” Adesuyi said, adding, “It’s frustrating, it’s disappointing, and it’s enraging because people are dying unnecessarily in the district to overdose.”

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The Return of ‘Medicare for All’

Thu, 06 Aug 2026 19:23:58 +0000

The Host

Julie Rovner ��ýҕ�l Health News Read Julie's stories. Julie Rovner is chief Washington correspondent and host of ��ýҕ�l 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.

Democratic primary voters in Michigan chose former Detroit public health director Abdul El-Sayed as their Senate nominee this week. El-Sayed is one of several high-profile candidates around the country who have been pushing “Medicare for All,” again elevating the issue, at a time when millions of Americans are losing their health coverage because of high costs.

Meanwhile, the Senate this week confirmed Erica Schwartz to lead the Centers for Disease Control and Prevention, which has been without a permanent leader for almost a year. But it remains unclear whether her support for childhood vaccinations will run afoul of her boss, Health and Human Services Secretary Robert F. Kennedy Jr.

This week’s panelists are Julie Rovner of ��ýҕ�l Health News, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico Magazine, Alice Miranda Ollstein of Politico, and Amanda Seitz of ��ýҕ�l Health News.

Panelists

Joanne Kenen Johns Hopkins University and Politico

Alice Miranda Ollstein Politico

Amanda Seitz ��ýҕ�l Health News Read Amanda's stories.

Among the takeaways from this week’s episode:

El-Sayed’s primary victory in Michigan means a vocal supporter of Medicare for All will be on the ballot this fall. Progressives again are rallying behind universal healthcare as costs spike and more people lose their coverage — although there are few details so far to explain how they would implement such a policy.
New polling shows more people are experiencing “job lock” because of limited options to obtain healthcare coverage outside employer-sponsored insurance. Meanwhile, more hospitals are reporting a sharp rise in the number of uninsured and in the costs to cover them.
A federal judge recently declined to halt the implementation of Medicaid work requirements while considering a case brought by several states challenging the policy’s burden on sick people. And early reports out of Nebraska, the first state to implement the work requirements, show eligible people are losing coverage for administrative reasons.
Kennedy sat down for an interview with CNN, during which he could not articulate specific plans to address disease outbreaks — as multiple outbreaks are ongoing. And a Senate committee voted along party lines Thursday to hold former public health official Anthony Fauci in contempt of Congress over his appearance before the committee last week.

Also this week, as part of the “How Would You Fix It?” series, Rovner interviews Sen. Andy Kim (D-N.J.), who has a new bill that would provide universal health coverage for all children.

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

Julie Rovner: The New York Times’ “,” by Sheryl Gay Stolberg.

Alice Miranda Ollstein: NOTUS’ “,” by Margaret Manto.

Joanne Kenen: The New York Times Magazine’s “,” by Helen Ouyang.

Amanda Seitz: The Wall Street Journal’s “,” by Katherine Long.

Also mentioned in this week’s podcast:

The Bulwark’s “,” by Jonathan Cohn.
The New York Times’ “,” by Reed Abelson.
Politico’s “” by Alice Miranda Ollstein and Josh Gerstein.
Underlying Conditions’ “,” by Céline Gounder.

Click to expand the transcript Transcript: The Return of ‘Medicare for All’

Medicaid Work Rule Leaves Homeless People in the Cold

Katheryn Houghton — Thu, 06 Aug 2026 09:00:00 +0000

MISSOULA, Mont. — Tywon Pugh has seizures that make it hard to find and keep a job.

“They called me a ‘liability to the job site,’” Pugh said, recalling the words of his manager when a seizure cost him his last job at a fast-food restaurant in this western Montana city.

When the 46-year-old lost work in the past, his wife of 10 years covered their rent and he tended to their home until he found another job. But his wife died last year. Soon after, Pugh became homeless. His problem with alcohol became worse, which made managing his seizures more difficult.

“When she died, my whole base was depleted,” Pugh said.

Medicaid pays for the prescriptions that keep Pugh’s seizures at bay. The government-subsidized health coverage would also pay for an addiction treatment program that Pugh said he has tried to get into, but he was told there’s a waitlist.

Pugh’s goal has been to get healthy enough to work again. But he’s worried about being able to keep the Medicaid coverage he needs to get to that point.

Early Embrace of New Rules

In the spring, the federal government finalized regulations requiring millions of people who receive Medicaid benefits to prove they’re working, volunteering, or going to school to keep their coverage. States have until January to begin those checks. Montana, Arkansas, and Nebraska have already started implementing them.

The Trump administration’s federal work requirements exempt certain groups of people: those with disabilities, those older than 64, pregnant people and Native Americans, among others. To receive an exemption, anyone without a clear-cut qualification — such as through their age or disability status — will have to prove they’re too sick to work.

But the administration decided that being homeless isn’t a medical condition and can’t count as an automatic out from having to meet the new requirements. Many conservative policymakers support work requirements, and some states have attempted to implement such rules for years. At least four states — Montana, Arizona, Kentucky, and Utah — previously proposed policies that included homelessness as an exemption.

But federal officials have said that’s not allowed. In an email to ��ýҕ�l Health News, the Centers for Medicare & Medicaid Services declined to provide a comment on the record. But the agency confirmed that states must stick to the federal government’s list of exemptions. Homelessness in the U.S. increased by 27% from 2013 to 2025, from the Department of Housing and Urban Development. Last year, about 746,000 people .

Many, like Pugh, qualified for Medicaid, though the number of enrollees who are homeless is difficult to measure. In 2023, who received medical or behavioral health services through one of the nation’s roughly 300 programs were enrolled in Medicaid.

“My Medicaid is still active, but when are they gonna cut that off from me? I can’t get employed,” says Tywon Pugh, who been homeless in Missoula since his wife’s death in 2025. The federal government does not exempt people who are homeless from Medicaid work requirements. (Katheryn Houghton/��ýҕ�l Health News)

Jennifer Tolbert, deputy director of KFF’s Program on Medicaid and the Uninsured, said the federal regulations are a lot stricter than many states had expected, even those on board with work requirements. (KFF is a health information nonprofit that includes ��ýҕ�l Health News.)

“It took everyone by surprise,” Tolbert said.

Mehmet Oz, who leads CMS, touted the regulations as a “path to prosperity” during a press conference in June.

“We need to get people to try to work,” Oz said. In June, 25 mostly Democratic-led states over the regulations, arguing the medical frailty standard would be too hard for enrollees to meet — and for states to assess. The work requirements are projected to increase the number of uninsured people nationwide by by 2034, according to the Congressional Budget Office.

Most states will begin to implement the Medicaid work requirements in January.

Montana plans to begin booting Medicaid enrollees from coverage this October if they can’t prove they’re in compliance with the work requirement.

“My Medicaid is still active, but when are they gonna cut that off from me?” Pugh said. “I can’t get employed. How am I supposed to survive?”

The differences between the states’ and federal government’s exemption lists don’t end with people who are homeless. In Montana, lawmakers also planned to excuse people fleeing domestic violence and caregivers of hospitalized family members — two other groups left off the federal exemption list.

“These are simply parties that, due to a number of conditions, cannot meet those requirements,” Republican state Rep. Ed Buttrey said in 2019 when the Montana Legislature passed its first Medicaid work requirement bill. Buttrey did not comment for this article.

Federal officials have said many people who are homeless could fall under another exemption, such as being too sick to work. But, like many states, Montana’s system to automatically conduct those checks through existing medical records isn’t ready, though health department spokesperson Jon Ebelt said it should be in place by October. Anyone not automatically exempted by the state would have 30 days to prove their case.

Flyers at Partnership Health Center locations in Montana announce eligibility changes to Medicaid. (Katheryn Houghton/��ýҕ�l Health News)

Partnership Health Center is one of roughly 1,400 health centers nationwide that receive federal funding to serve patients based on what they can afford. (Katheryn Houghton/��ýҕ�l Health News)

A Possible Exemption for Health

Pugh might qualify for a pass due to his seizures. But getting to doctor appointments the past year has been hard for him.

The anniversary of his wife’s death just passed. Typically, Pugh has to find a new place to sleep outside each night. One night while camping, Pugh lost his wallet and important documents. And with the addiction treatment centers that accept Medicaid patients overbooked, Pugh has had to rely on willpower to avoid drinking.

“I’m taking it one day at a time,” he said.

A little over two hours north, in Kalispell, Dustin Goss, a case manager at a homeless shelter called Samaritan House, said Pugh’s experience reflects why he’s worried that people who qualify for an exemption will get tangled in bureaucratic tape.

“You can’t really worry about getting paperwork done when you don’t know where you’re eating today,” Goss said.

Cassidy Kipp, who heads Samaritan House, said once people find shelter and start to stabilize, they typically find work. But even then, meeting the new requirements can be challenging. Clients often start with temporary and informal jobs — such as cleaning out a storage unit — that don’t come with a pay stub, Kipp said.

Kaitlyn Bosshardt, a social worker at Partnership Health Center, a health clinic in Missoula, has seen more people priced out of longtime rentals as housing costs outpace people’s paychecks. Meanwhile, affordable housing and rental aid are limited.

Kaitlyn Bosshardt, a social worker at Partnership Health Center in Missoula, counts letters about Medicaid that the state’s health department sent to clinic patients who don’t have a steady address. (Katheryn Houghton/��ýҕ�l Health News)

Partnership Health is one of roughly 1,400 health centers nationwide that receive federal funding to serve patients based on what they can afford — meaning even those who lose Medicaid can receive care. But organizations representing health centers have said if too many patients lose the coverage, some clinics won’t be able to fill the financial hole.

The other problem is that these clinics generally don’t provide specialty care.

One day in June, as temperatures hovered around 90, Pugh visited Watershed Navigation Center, a refuge run by Partnership for people without steady housing to have a meal or see a doctor. His doctor, Atarah Sidey, told Pugh that the neurology clinic that managed his seizures had dismissed him from their care after he missed three appointments.

She referred Pugh to the other neurologist in town and talked about trying to find treatment for his addiction.

“It’s just that if I don’t make the effort at changing, it ain’t gonna happen and I’m gonna end up found on the side of the road somewhere,” Pugh told Sidey.

“You got this, though, Tywon,” she responded as Pugh nodded his head. “You can do this.”

Pugh has connected with a social worker for help keeping his Medicaid. By late July, he was waiting for space to open at a Missoula addiction treatment center and waiting on responses from two job applications.

In the hard moments, Pugh imagines his wife telling him to stay calm, that things will get better.

“I just don’t wanna lose hope in the meantime,” he said.

This article first appeared on ��ýҕ�l Health News and is republished here under a .

Watch: Democratic Senator Proposes a Fix for American Healthcare — Covering All Kids

Thu, 06 Aug 2026 09:00:00 +0000

In this “How Would You Fix It?” interview, Julie Rovner, ��ýҕ�l Health News’ chief Washington correspondent and host of the What the Health? podcast, sat down with Sen. Andy Kim, a New Jersey Democrat, to discuss his proposal to grant all kids access to health coverage.

Kim, who serves on the Senate Health, Education, Labor and Pensions Committee, said it is “a real dereliction of our duty that we have not found a way to be able to ensure that every child is able to go see a doctor when they need to without breaking the bank.”

Under the senator’s proposal, children would be automatically enrolled at birth in the public program, which he . Parents would have the option to opt their kids out, though they could reenroll them at any time until age 26, Kim told Rovner.

“You want to make sure that all of these kids are able to get the care that they need as their bodies are and their brains are developing and that you don’t see the kind of withdrawal of or restriction of care that could have real consequences down the road,” he said.

Kim said offering comprehensive, universal coverage to American children would help them avoid chronic conditions in adulthood, in addition to providing broader societal benefits, such as a healthier workforce.

He added that he hopes his idea could gain traction should Democrats claim a majority in Congress in the midterm elections, as well as foster an important discussion about healthcare in the 2028 presidential race.

An abbreviated version of this interview aired Aug. 6 during Episode 458 of What the Health? From ��ýҕ�l Health News: “The Return of ‘Medicare for All.’”

This article first appeared on ��ýҕ�l Health News and is republished here under a .

Baltimore Is Rethinking What It Means To Call 911 — And Who Responds

Scott Maucione, WYPR — Wed, 05 Aug 2026 09:00:00 +0000

BALTIMORE — In March in a McDonald’s parking lot off a busy street, mental health clinician Michala Williams met a 38-year-old woman in a car.

“So, you called the police for help?” Williams asked the woman, who was sobbing uncontrollably and said she sometimes thinks about harming herself.

She told Williams she has children ranging from age 2 to 22, she was dealing with health issues, and that her fiancé had recently been jailed. She felt so overwhelmed she couldn’t eat.

The woman, who asked not to be named so that she could freely discuss her mental health, explained she’d tried to get help the previous month by driving to the hospital but got pulled over on the way because her car registration had expired.

“I don’t care if I get pulled over,” she said. “But I was saying, ‘I don’t know what to do. I just want to go to the hospital.’”

The officer arrested her for acting erratically, so instead of going to the hospital she went to jail.

“I had to sit inside of a cold cell. I couldn’t use the bathroom or anything,” the woman said.

On the day she met Williams, she’d decided to call 911. The dispatcher recognized the woman didn’t need a police response but instead needed one of Baltimore’s mobile crisis teams, which send a clinician and a peer counselor to meet people in mental health distress.

By the end of an hourlong conversation, Williams set the woman up with referrals to a psychiatrist, a therapist, legal help, and a case manager to determine if her child with autism was eligible for government services.

“She’s been through a lot of trauma, and no one is going to deny that,” Williams said. “But I now have to take all of that and decide, ‘OK, here’s steps 1, 2, and 3,’ because we got to find a little bit of sliver of something to give her some hope that there’s help out here.”

For years, the mobile crisis teams, which are overseen by , a nonprofit that acts as the city’s mental health department, have diverted calls from police to mental health professionals. However, the units have a limited scope, focused on people in mental health crises.

Now Baltimore is tapping into some of the roughly $400 million from opioid-related legal settlements to build out a broader service to operate around the clock and respond to other kinds of crises when police aren’t needed.

Baltimore logged to 911 in 2024, but tens of thousands of them didn’t require traditional emergency services, like police, firefighters, or EMTs, according to , an expert in community safety at Georgetown Law.

Instead, the calls were about, for example, a homeless person who fell asleep in a store, a person who seemed confused in a public park, and someone who was yelling at passersby on the street.

Such calls “don’t require a badge, a gun, and handcuffs to resolve,” Duckett said.

Often those people end up in jail instead of getting the help they need, he said. A study that when a non-law enforcement team responded to 911 calls in Durham, North Carolina, it resulted in fewer arrests than when police responded — especially for callers who were Black, men, or ages 25-39. Police responses can also lead to trauma for that person or a less satisfactory outcome than another community service response would produce, Duckett said. The idea behind the Baltimore mobile crisis teams — and the new service — is to find out what people in crisis may need and how to connect them to those resources instead of arresting them.

From 2021 to 2025, Baltimore’s homicide rate decreased by 60%, setting records for the drop in violence. But at the same time, drug overdoses made national records, as about 1,000 people here each year from 2020 to 2023.

In 2018, Baltimore opted out of a global settlement that other jurisdictions made with opioid makers and distributors and instead sued them independently. As the opioid-related lawsuits were settled, city officials decided that the settlement awards it receives must be spent on drug-related harms — or on services that help prevent addiction, such as housing support, healthcare, and education.

One seeks to directly address overdoses by placing boxes of the overdose reversal drug naloxone at every subway stop. Expanding 911 services is part of a larger strategy to beef up city services, with $15 million in settlement funds allocated so far, according to Sara Whaley, Baltimore’s director of overdose response. Whaley hopes the expansion will help the city think differently about how it responds to residents in crisis — regardless of why they’re calling 911.

She views the calls as an opportunity to help solve a problem rather than be punitive. “What are the wraparound services and support that can help prevent them from being involved in this, in that emergency system?” she said.

For example, the person falling asleep in a store may need connection to community housing. The goal is to reduce violence, get people proper resources, and avoid the cycle of incarcerating people dealing with poverty, addiction, and mental health.

, executive director of the Health Lab at the University of Chicago, of services like these. She said they offer peace of mind for callers that “they’re going to be met with the right response at the right time.”

“We also see responders themselves feeling like they have a better toolbox in their ability to pursue actual resolution to these calls,” she said.

To expand its system, Baltimore looked to cities — including Durham — that have adopted similar models to reroute callers who don’t need emergency responders.

Durham’s diversion program is called the , or HEART. The program estimates it has diverted more than 12,000 calls in four years. It said police backup was needed for only 0.02% of those calls and that response times have improved for all types of 911 calls.

Durham has of the HEART calls, showing that nonpolice responders in Durham have helped with everything from finding housing for a woman fleeing domestic violence to setting up medical appointments for a homeless veteran.

In one case, a hotel manager called 911 asking for help finding a blind man housing for the night, since the hotel didn’t have accessible rooms available. The HEART responders booked him a room and the next day provided a ride to meet with an organization that could help secure housing.

This article is from a partnership that includes , , and ��ýҕ�l Health News.

This article first appeared on ��ýҕ�l Health News and is republished here under a .

Pediatricians and Health Departments Sidestep Trump’s CDC on Vaccine Guidance

Karen Brown, New England Public Media — Wed, 05 Aug 2026 09:00:00 +0000

AMHERST, Mass. — For the last 30 years, whenever pediatrician wanted to find the most up-to-date research on treating young patients, he would turn to the Centers for Disease Control and Prevention.

If he wanted to learn more about an outbreak of measles or hantavirus, he would pore over the weekly CDC report that came by email. If a patient’s family was traveling to Africa or Asia, he would check the latest CDC vaccine recommendations for overseas travel. And if a family was worried about potential side effects from a shot, he could always send them to the CDC’s website to bolster his argument to get the immunization.

Public trust in the CDC has in the road , but for medical professionals, Snyder said, “the CDC used to be, worldwide, the most trusted source of information pertaining to public health and infectious disease.”

Yet even doctors began losing trust, Snyder said, after Donald Trump was elected president again. Trump quickly tapped longtime anti-vaccine activist Robert F. Kennedy Jr. as his nominee to lead the Department of Health and Human Services, which oversees the CDC.

Within months of his confirmation as secretary, Kennedy had of the CDC’s vaccine advisory board and replaced them with , some of them prominent vaccine skeptics.

“It turned into a completely unreputable source of information,” Snyder said.

This rupture of scientific trust in the CDC has put many pediatricians like Snyder in a bind, as they no longer turn to the country’s preeminent public health agency and instead search for ways to fill the information gap. Some doctors are launching their own vaccine education efforts, sometimes in collaboration with local public health departments.

On Jan. 5, the CDC from the recommended for all children — against the advice of major medical groups like the . The as the agency dropped rotavirus, covid-19, influenza, hepatitis A, hepatitis B, and meningococcal disease from the list. The agency did not respond to a request for comment for this article.

In March, after , a federal judge to revert to the previous guidelines. The administration the judge’s decision.

The storeroom of childhood vaccines at Amherst Pediatrics. (Karen Brown/New England Public Media)

The back-and-forth “creates a whole bunch of confusion in the public,” Snyder said. “And it’s very confusing even for healthcare providers.”

So he’s trying to be clear to patients about what the evidence shows, even if that means going against the federal government. His practice, Amherst Pediatrics, to say: “The CDC is no longer considered to be a reliable or legitimate source of information.”

“It’s shocking that we have to say that,” Snyder said. Instead, the site directs families to get information from their own doctor, the state of Massachusetts, or nongovernmental medical organizations including the AAP.

In the exam room, Snyder is having more tense conversations with families. He said some parents are explicit that they want to hew to what the CDC recommends. “Even if they don’t say that, we have definitely seen increasing hesitancy and questions,” he said. “All of that interferes with us protecting children.”

On a spring afternoon, several of Snyder’s young patients came into Amherst Pediatrics for routine visits.

“Let’s talk about vaccines,” Snyder said to one mother, Tenzin Dekey, who was there with her 1-year-old. Snyder explained that her son was due for the , which protects against measles, mumps, and rubella, in addition to the chickenpox, hepatitis A, and flu vaccines.

“So that’s four shots, two in each leg,” he said, as he handed Dekey CDC information sheets about the vaccines. She glanced at them and agreed to the shots.

Pediatrician John Snyder gives vaccine information to Tenzin Dekey, who had brought her 1-year-old son to Amherst Pediatrics for an annual exam. She accepted the vaccines Snyder recommended. (Karen Brown/New England Public Media)

Ironically, the information sheets are stamped with the CDC’s logo — — even though Amherst Pediatrics has explicitly directed patients away from the CDC. Snyder said he hates that disconnect.

“This has been a source of heated discussion,” he said. “How can we be saying, ‘Do not trust the CDC when it comes to vaccines,’ yet here is the information we’re giving our own patients when they’re in the office about vaccines?”

Another mother brought her 14-year-old son for his annual physical. She asked to be identified by only her first name, Melissa, so she could freely discuss her family’s private health issues.

Snyder recommended the , which helps . Although Melissa had refused the HPV vaccine in a previous visit, this time she left the decision up to her son. He agreed to it. But for other vaccines, she wouldn’t budge.

“I’m a hard ‘no’ on the covid,” she told Snyder.

“We could talk about that if you want,” he suggested.

“I don’t need to talk about it,” she replied.

After the appointment, Melissa said she just doesn’t know whom to trust anymore when it comes to vaccine safety. She used to get information from the CDC but no longer does.

“I worry that it’s been politicized a lot, and I don’t like politics,” she said. “Now I prefer to hear things from people, healthcare professionals.”

Such distrust and confusion inspired Snyder to join an independent vaccine information campaign, along with other pediatric practices and health departments in the Connecticut River Valley of Western Massachusetts.

The campaign’s website, which is promoted in Snyder’s waiting room, is called . It sidesteps the CDC and highlights advice from local doctors and national medical groups, . Valley Vax bought ads on the sides of buses in Western Massachusetts to promote the site, with the faces and testimonials of local doctors including Snyder.

“We wanted something that felt familiar and appealing and that they might be more likely to trust,” said , director of Amherst’s public health department, who coordinates the Valley Vax effort.

The independent health website Valley Vax is advertised on the sides of buses in Western Massachusetts. (Kiko Malin)

She said the organizers decided not to criticize the CDC outright.

“Some information from the CDC is reasonable. Like they are doing a good job of tracking influenza-like illness rates in the country,” Malin said. “It’s important not to discount an organization completely.”

Still, she said it’s the first time she’s had to contradict health information from the CDC. “That’s not a comfortable place to be in at all,” she said.

Other health leaders are also banding together to get out evidence-based information. At the state level, California, Hawai‘i, Oregon, and Washington — frustrated with the CDC — operate the to “ensure the public has access to credible information.” And governors of 14 states and Guam set up the in response to declining trust in federal health agencies.

Locally, some public health departments are partnering with community leaders to reach people who have stopped listening to government institutions but “do have strong connections within their faith community or do have strong connections within their neighborhood,” said , a spokesperson for the .

Like Amherst, many local health departments now direct people to professional medical organizations instead of the CDC, Casalotti said, because advice from those groups may change slightly as the science evolves, but it’s unlikely to change with each lawsuit against the government.

This article is from a partnership that includes , , and ��ýҕ�l Health News.

This article first appeared on ��ýҕ�l Health News and is republished here under a .

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