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U.S. Immigration and Customs Enforcement offers up to $100,000 for vehicle purchases to local law enforcement agencies that assist ICE in apprehending unauthorized immigrants.
ICE announced Sept. 2 that its 287(g) Program also offers other local incentives, including salary and benefits reimbursement for ICE-trained officers and quarterly payments of $500 to $1,000 per officer for finding unauthorized immigrants identified by ICE.
As of Oct. 2, 13 Wisconsin sheriff’s departments, including Brown and Waukesha counties, were working with ICE on unauthorized immigrants in their jails and/or serving immigration warrants on individuals.
The $100,000 is offered to “task force” members. One Wisconsin police department, Palmyra in Jefferson County, is participating. The chief has said his focus is pursuing “criminals.”
ICE says its program targets criminal unauthorized immigrants. Research shows unauthorized immigrants crossing the U.S. border are not more likely than native-born Americans to commit crimes.
This fact brief is responsive to conversations such as this one.
Is ICE offering police departments $100,000 to cooperate in finding unauthorized immigrants? is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.
On Oct. 23, 2024, Samuel Hoffland stopped by Famous Yeti’s Pizza in Stoughton on his lunch break. What happened next is detailed in a previously unreported lawsuit he filed in May in Dane County claiming the restaurant was negligent when it contaminated his pizza with THC.
The lawsuit describes how Hoffland endured a multiple-hour ordeal to get home after feeling “abnormal symptoms associated with THC intoxication.” He crashed his car and ended up in the emergency room. His injuries led to lost work time and ongoing medical issues, according to the complaint.
Two tests a day apart confirmed Hoffland was experiencing THC intoxication. Over 80 people experienced similar symptoms, including 27 who went to the emergency room, some of whom reported concerns it was carbon monoxide poisoning, according to responses to Public Health Madison and Dane County’s final report obtained under the open records law.
In the weeks and months after the incident, the contamination created a stir online with a range of reactions. Some blamed Famous Yeti’s and expressed concern while other comments said “even more reason to eat them” and “who is complaining?” But for Hoffland, the experience was no joke, leading him to file a civil lawsuit against Famous Yeti’s and the owner of Turtle Crossing Cannabis, a company that shared kitchen space with the pizzeria.
Public Health Madison and Dane County investigated the incident and determined the food was mistakenly contaminated with THC oil from a bulk container (though the report doesn’t mention Turtle Crossing Cannabis). But the agency determined there was nothing it could do because Delta-9 THC, the chemical derived from hemp and used to make edible THC products, is not regulated in Wisconsin.
In other words, there are no laws or regulations prohibiting the preparation of THC and non-THC products in the same industrial kitchen.
Nearly a year later, that remains the case.
In Wisconsin, regulatory laws surrounding hemp-derived cannabis are lacking, creating gray areas that make it difficult to enforce any standards surrounding the production and distribution of THC-related products. Wisconsin is one of only six states, along with Alabama, Maine, New Mexico, North Carolina and West Virginia, that neither ban nor regulate or aren’t attempting to regulate Delta-8 THC.
The lack of regulation has put consumer safety at risk. The Famous Yeti’s Pizza incident is one example, but not the only incident. In June, two children in Milwaukee went to the hospital after their mother mistakenly purchased 600 mg of THC gummies from a convenience store. The shop owner received a warning letter, but didn’t receive a citation because the sale wasn’t illegal.
Under the 2018 Farm Bill, the U.S. government authorized commercial hemp production and made it eligible for federal crop insurance. The intended purpose was to provide additional support for people in the agriculture industry.
Hemp under the Farm Bill was defined as cannabis with a tetrahydrocannabinol (THC) concentration of below 0.3% on a dry weight basis. THC is the psychoactive compound present in both hemp-derived and marijuana-derived cannabis. But marijuana-derived cannabis has a higher presence of THC and is federally illegal.
“Cannabis itself is actually the same product, whether it’s hemp-derived or marijuana,” Jason Hunt, CEO and general counsel of DynaVap, said. “Cannabis sativa is actually the product. It’s really the same plant, but it depends on when it’s harvested, as well as the concentration.”
Delta-8 and Delta-9 are similar variations of the same THC compound found in cannabis. Delta-9 is more commonly found in the marijuana plant, while Delta-8 is almost entirely found in hemp and is federally legal.
Delta-8 THC is found in low concentrations, so it is often chemically modified by concentrating Delta-8 from the hemp-derived cannabidiol, according to the U.S. Food and Drug Administration.
“They take a portion of the plant and they chemically modify it to make sure it’s more intoxicating, so it’s a synthesized cannabis product,” Hunt said.
In 2022, Wisconsin’s regulatory hemp program fully transitioned to the federal level, so now the regulatory authority falls under the U.S. Department of Agriculture.
Instead, Wisconsin regulates products with hemp derivatives at the state level through the same laws that govern retail food establishments and food processors. Like other products, hemp-derived products are subject to Department of Agriculture, Trade and Consumer Protection requirements for labeling, weights and measures, consumer safety, misrepresentations, and deceptive advertising.
The state only allows hemp that has been certified by DATCP or another state’s hemp program to be in food products, but food items or ingredients containing hemp manufactured and packaged outside of Wisconsin cannot be sold in Wisconsin. Wisconsin also has “truth in labeling” laws requiring all hemp products to be properly labeled. Knowingly making an inaccurate or misleading claim regarding hemp products is illegal under a state statute.
Dane County Executive Melissa Agard, a Democrat who served in the Legislature for 12 years and authored bills to legalize recreational and medical marijuana, argues that legalization would lead to regulation.
“If we would pass a bill in regards to legalizing and regulating cannabis in Wisconsin, there would be a lot more consumer protections, whether you’re at a restaurant that might be serving cannabis-infused foods or a bar that’s selling cannabis-infused beverages, or at a corner store where you want to buy some edibles or some bud,” Agard said. “Right now, you’re just kind of taking people’s word for it. There’s no checks and balances, there’s no real accountability.”
Minnesota, where marijuana is now fully legal, also regulates hemp products including requiring all consumers to be at least 21 years of age.
In Michigan, only companies licensed through the Michigan Marijuana Regulatory Agency can sell, distribute and manufacture hemp-derived Delta-8 products, and all customers must be 21.
Wisconsin has no specific age requirements for purchasing and ingesting hemp products. Instead, age requirements are left up to localities.
Wood County was the first state locality to set an age restriction on purchasing hemp-related products in 2022. Milwaukee County set an age requirement in July after two children were left hospitalized after being sold THC gummies.
In February, Public Health Madison and Dane County expressed support for implementing an age restriction statewide.
Without a statewide age restriction, many localities have not passed specific requirements, leaving those markets widely unregulated.
In the Famous Yeti’s incident, eight people under 18 were reportedly intoxicated by cannabis oil, but without regulations, there were no citations.
“There are no regulation requirements for products derived from the hemp plant,” Public Health Madison and Dane County said in a blog following the incident. “Unlike commercial tobacco, Public Health cannot issue citations for the sale or distribution of hemp-derived products to minors.”
The Famous Yeti’s Pizza incident shows the consequences of a lack of regulation.
Jason Tarasek, a Minnesota attorney who specializes in cannabis law, explained that people harmed by the contamination would likely need to show monetary consequences to win a lawsuit against the establishment.
“One of those people who were harmed could easily bring a negligence action against that restaurant because it’s a breach of your duty to act as a reasonable restaurant if you’re accidentally slipping THC to people,” Tarasek said.
According to responses to the public health department’s questionnaire accessed via an open records request, respondents did raise concerns about the monetary consequences of the contamination.
“I don’t think I should have to pay for my ambulance ride or my tests that I needed as a result of being drugged,” a female respondent said.
Another female respondent said she was going to have over $1,000 in hospital bills even after her insurance claim.
“The closer you get to pointing at a bill for money, the easier it is to get a judge or jury to award you that,” Tarasek said.
The civil lawsuit against Famous Yeti’s pizza relates to negligence on behalf of the restaurant.
Hoffland claims Famous Yeti’s breached its duty by “negligently preparing, handling, and serving food contaminated with THC” resulting in “physical illness, mental distress, and other injuries requiring medical attention and resulting in damages.” The civil lawsuit also claims Famous Yeti’s is strictly liable for Hoffland’s injuries and damages from consuming “THC-laced” food.
In response to the complaint, Famous Yeti’s said it was not negligent in preparing the food nor at fault for the contamination, but admits the product unintentionally “contained” THC. The restaurant also denied the food was laced, which would imply the food was deliberately infused with THC.
“The contamination of the subject product was the result of an intervening cause not due to any negligence or fault on the part of the defendant,” Famous Yeti’s said in its response.
Currently, the civil lawsuit is still pending. Famous Yeti’s, Hoffland and their attorneys did not respond to a request for comment.
Wisconsin’s lack of cannabis regulations continues to leave consumers in the dark when they purchase hemp-derived THC products in Wisconsin.
Gov. Tony Evers has attempted to regulate cannabis in multiple budget cycles, the most recent being the 2025-27 biennium. The marijuana-related provisions would have legalized and set regulatory standards for marijuana.
Evers’ budget recommendations included a section that would have started a program within DATCP to regulate the cultivation, production and distribution of marijuana requiring all producers and processors to hold a permit from DATCP.
The provision would have also set more stringent requirements, such as requiring all purchasers of THC products be 21 or older and banning production or distribution of cannabis near schools, playgrounds, public parks or child care facilities. If passed, it would have also established a training program under DATCP for proper handling of cannabis.
But Republicans removed the provision from the budget bill early in the process.
In 2024, Republicans, who have been otherwise reluctant to support marijuana legalization, introduced a bill to legalize and regulate medical marijuana in Wisconsin, specifically through heavily regulated state dispensaries. The bill was sponsored by 19 Republicans, including Assembly Speaker Robin Vos, R-Rochester, but failed to pass the Legislature. It would not have regulated THC products derived from hemp.
This story was produced in partnership with the University of Wisconsin-Madison’s Investigative Journalism class taught in the School of Journalism and Mass Communication.
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Legal loopholes in Wisconsin cannabis laws leave consumers vulnerable is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.
In public health researcher William Lopez’s new book, he studies worksite raids in small, rural and mostly white communities. In “Raiding the Heartland,” he said immigration enforcement has long-lasting ripple effects that devastated entire communities.
The post What do immigration enforcement raids look like in the Midwest? appeared first on WPR.
For the first time since 2017, Wisconsin's troubled youth prisons are fully compliant with 50 court-ordered reforms aimed at improving how staff treat young inmates.
The post Wisconsin’s youth prisons are in full compliance with court-ordered reforms appeared first on WPR.
Another commercial poultry facility in Jefferson County must cull more than half a million birds due to highly pathogenic avian influenza.
The post Bird flu detected at another Jefferson County poultry facility appeared first on WPR.
Environmental advocates are urging state regulators to bring Wisconsin’s PFAS standards in line with federal drinking water standards for the chemicals despite an ongoing legal challenge.
The post Wisconsin moves to bring PFAS limits in line with contested federal standards appeared first on WPR.
There’s an ongoing debate within Wisconsin government over whether workers who receive federal disability payments should also be eligible to get unemployment benefits from the state — and if so, how much.
The post Draft bill would reduce Wisconsin unemployment aid for workers with disabilities appeared first on WPR.
This summer, the Natural Resources Foundation of Wisconsin hosted a field trip in southwest Wisconsin to see thousands of bats emerge from their roost to feed at sunset, and return as a massive swarm at dawn.
The post A dance of 3,000 bats: Watching the morning swarm at Nelson Dewey State Park appeared first on WPR.
A federal judge dismissed a lawsuit filed by a former first grade teacher who was fired after publicly criticizing the School District of Waukesha for banning a Dolly Parton song.
The post Federal judge dismisses Wisconsin school district’s ‘Rainbowland’ lawsuit appeared first on WPR.
Sarah Elgatian is a graduate student in rural Iowa, who like about 16 million women of reproductive age, uses Medicaid insurance and at times has relied on Planned Parenthood for routine gynecological treatment for infections and birth control, both in person and through its growing telehealth program. (Photo by Todd Welvaert for States Newsroom)
Fourth in a five-part series.
Sarah Elgatian was in too much pain to feel awkward.
That morning in 2019, she was hunched over her toilet, feeling what she described as a “weird burning nausea,” abdominal pain and other symptoms. She remembered the Planned Parenthood telehealth ad she’d seen recently. Elgatian downloaded the app, and within a couple hours from her bathroom, she was video chatting with a health provider. She recalled that the doctor could tell she had a urinary tract infection just by looking at her face.
“They were like, yeah, those are textbook symptoms, and you are cringing,” said Elgatian, 35, who lives on the outskirts of Davenport, Iowa, where the nearest pharmacy is at least a 20-minute drive. But luckily, Elgatian’s spouse was able to get the antibiotics the Planned Parenthood provider prescribed, and with it, relief. “That was really scary, just because, if you’ve ever had a UTI, when they’re bad, they’re so bad.”
Elgatian, like about 16 million women of reproductive age, has Medicaid, the federal and state medical insurance program for people with low incomes, and therefore limited options when it comes to reproductive health. With even fewer options in rural Iowa, Elgatian, who is a graduate student, said at times she has relied on Planned Parenthood for routine gynecological treatment for infections and birth control, both in person and through its growing telehealth program.
Now that a new rule has eliminated hundreds of millions in Medicaid reimbursements to Planned Parenthood, reproductive health providers have turned to telehealth as part of the solution to offer low-cost health services due to reductions in clinic staff and services, or closures.
Telemedicine gained momentum in the wake of the COVID-19 pandemic and the increasing health care deserts around the country. In the reproductive health space, it has expanded in the last few years, as the overturn of Roe v. Wade and the resulting policies prompted the closure of many physical clinics. By the end of 2024, 1 in 4 abortions was provided via telehealth, according to the Society of Family Planning, though there are ongoing efforts at the federal and state level to prohibit telehealth abortions.
“We’ve — overall as a trend — seen more patients taking advantage of telehealth, and I think it’s a combination of factors, particularly in rural areas where access to care can be very, very limited,” said Ruth Richardson, president and CEO of Planned Parenthood North Central States, which covers Iowa, Minnesota, Nebraska, North Dakota (which has no physical clinics) and South Dakota, and recently closed eight clinics after the Trump administration froze their federal family planning Title X grant funding. “That is something that we’ve seen as a trend even before the Medicaid defund occurred.”
At the same time, providers and advocates warn that telehealth — the virtual delivery of care using technology from video conferencing, phone- or computer-based apps, to text messaging — still leaves a huge gap in reproductive health care access, especially for patients without reliable Internet or who don’t have the financial resources necessary to participate, like a debit or credit card. Much of the care cannot be delivered virtually, such as treating certain STIs, intrauterine device insertion, performing vasectomies and procedural abortions, which are optional in the first trimester and necessary later in pregnancy.
“There’s a lot of people for whom telemedicine is not an option, and so I think it’s really important to note that it’s not a quick fix,” said Amy Hagstrom Miller, president and CEO of Whole Woman’s Health, which manages five physical clinics in Maryland, Minnesota, New Mexico, and Virginia that specialize in abortion and offer some gynecology services. It also has a virtual care practice in 10 states that offers primarily medication abortion. “It’s not the only fix, right? It’s got to be both and so that people truly have choice.”
In 2023, one-third of Iowa’s counties were considered maternal health deserts, according to the March of Dimes. That number will likely increase in the nonprofit’s next report. Earlier this year, Planned Parenthood North Central States shrunk its physical presence in Iowa from six to two clinics. The affiliate, Richardson said, stands to lose $11 million from the latest federal Medicaid change, after having served about 27,000 people on Medicaid — about one-third of their total patients — in 2024.
Richardson said the affiliate’s health centers will continue to serve patients regardless of their insurance status and will work with them to understand their payment options. She said she is expecting their telehealth program to keep growing, especially after shuttering clinics in more rural areas like Bemidji, Minnesota.
In the past year, the North Central States affiliate reported it saw 4,204 patients during 8,241 visits on the Planned Parenthood Direct app, a 12.9% increase in virtual care visits, and about 5% of the 87,631 total patients seen. Services offered during telehealth visits include birth control counseling and prescriptions, UTI treatment, gender-affirming care, emergency contraception and the abortion pill. Newer virtual care services were launched this past year, related to menopause, sexual wellness and early pregnancy complications.
Planned Parenthood has increased its telehealth presence across the nation in the last two years. Planned Parenthood Direct, launched about a decade ago and expanded nationally in 2019, is an asynchronous app that provides some services and accepts Medicaid in some states.
Separately, Planned Parenthood affiliates run virtual health centers, which have expanded to more than 50 nationwide, said a Planned Parenthood Federation of America spokesperson. According to Planned Parenthood’s 2023-2024 annual report, patients booked more than 47,000 appointments through virtual health centers in the last fiscal year, and, on average, virtual health center patients are accessing care more than two days sooner than in-person appointments. Across all telehealth platforms, there were 142,000 appointments made, the spokesperson said.
In Michigan the most popular Planned Parenthood clinic has no real walls or windows. The virtual clinic launched in 2023, and now sees the highest number of patients compared to the state’s 10 physical health centers, said Ashlea Phenicie, the chief external affairs officer at Planned Parenthood of Michigan, which in April closed three clinics in underserved areas and consolidated two health centers in Ann Arbor because of Title X cuts.
Phenicie said Michigan’s virtual clinic is always more than 100% booked and offers evening and weekend appointments.
“I think that not only is it filling a need in communities where we don’t have brick-and-mortar health centers, but for many patients, this is how they prefer to access care,” Phenicie said. “It’s convenient. A lot of our patients will do it on their lunch break or, you know, before school or between work and picking up their kids. It lets them fit their health care into their everyday lives. It can also provide a degree of privacy and security. There’s no protesters who walk by when you’re visiting a telehealth provider or getting birth control through the PPDirect app.”
In a new study in the journal Contraception, researchers from the Guttmacher Institute found that while many publicly funded family planning clinics offer some services via telehealth, Planned Parenthood clinics offer telehealth most frequently, and offer a wider variety of services. The researchers, who surveyed nearly 500 publicly supported family planning clinics, wrote that many health departments and federally qualified health centers need more support and infrastructure to implement telehealth, especially for contraceptive care. They noted that while the benefits of telehealth include convenience, low cost, and improved patient outcomes, difficulties include loss of patient-provider rapport, technology and workflow issues, and regulatory barriers.
And they warned: “If telehealth is implemented inequitably, it may deepen existing disparities.”
Research is still limited when it comes to telehealth delivery of broad reproductive health services. A 2023 study by researchers at Oregon Health & Science University found evidence suggesting telehealth care for intimate partner violence and contraceptive care can produce “equivalent clinical and patient-reported outcomes as in-person care.”
But many reproductive health care advocates and researchers agree that telehealth will likely not be enough to fill the gap left by closing physical clinics, and that there remain many barriers to accessing telehealth generally, related to age, language, financial resources, digital literacy, and access to technology and internet.
In 2023, the National Telecommunications and Information Administration reported that roughly 12% of people lived in households with no internet connection, while a National Digital Inclusion Alliance analysis of 2022 data showed that 24% of households lacked a home internet connection.
Last month the Journal of Medical Internet Research published a study examining telehealth usage patterns of nearly 10,000 adults in rural California that found people who are older, speak Spanish or rely on public insurance struggle the most to access virtual care. The researchers reported that rural health disparities are often more pronounced among rural populations of color, who make up about 20% of rural U.S. residents.
For Elgatian, her occasional use of telehealth has not erased her need for affordable in-person reproductive health care, something she’s currently worried is about to change in Iowa following the new Medicaid rule. In a pinch, her fail-safe — at least until recently — had been Planned Parenthood, the closest being more than an hour away in Iowa City, followed by just one other in-state option: the Des Moines clinic nearly three hours away. But it was the latter clinic that Elgatian was closest to while driving through last year and suddenly bleeding vaginally. It turned out to be related to uterine polyps and her IUD, something she likely wouldn’t have discovered via telehealth.
“I don’t yet know, personally, how this will pan out for me, but it seems likely that there will be a time when I will struggle to find care without being able to use Planned Parenthood,” she said.
Since its founding four years ago, telehealth provider Hey Jane, which is not affected by the government’s new Medicaid exclusion, has provided care to more than 100,000 people and expanded beyond medication abortion to provide birth control, emergency contraception, treatment for vaginal infections, herpes, and UTIs, according to co-founder Kiki Freedman. Hey Jane operates in the District of Columbia and 22 states (California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Hampshire, New Jersey, New Mexico, New York, Ohio, Oregon, Rhode Island, Vermont, Virginia and Washington). It recently became a Medicaid provider for people in Illinois.
Freedman said their services are offered on a sliding fee scale. And she said the platform allows patients to text with clinicians, which is popular with patients.
“They could be on their couch, watching a movie with their partner by their side, or whomever they need, and then just be chatting with us,” Freedman said. “That’s not something that you could get if you receive care in person and take the medication home with you, and then don’t have those ongoing touch points.”
Freedman said that Hey Jane has already seen an influx in patients since Congress passed the federal tax and spending cut bill and more clinics have closed, and that they are working on becoming Medicaid providers in more states — something that can be challenging for telehealth businesses without a physical facility.
“We’ve continued to grow really fast over the past several years, and have just been hiring a lot and doing a lot of work on sort of our technical automation so that we can continue to meet the demand that has been rising,” Freedman said. “These acute events, like these terrible clinic closures, have definitely exacerbated that.”
Coming Friday: Democratic-led states try to backfill funding losses.
This story was originally produced by News From The States, which is part of States Newsroom, a nonprofit news network which includes Wisconsin Examiner, and is supported by grants and a coalition of donors as a 501c(3) public charity.
Taylor Swift performs at Soldier Field in Chicago on The Eras Tour on June 5, 2023 (Photo by Baylor Spears/Wisconsin Examiner)
Ahead of Taylor Swift’s latest album being released Friday, Sen. Kelda Roys (D-Madison) is proposing that Wisconsin exile practices in the ticket selling industry that disadvantage fans trying to attend shows and events.
The bill “Stop Wildly Inflated Fees and Ticketing Industry Exploitation” — yes, that really is SWIFTIE for short — would require sellers to disclose the total cost of ticket prices to potential buyers, put a cap on how much resellers can charge for tickets and prohibit ticket-buying bots that resellers use. Sen. Jamie Wall (D-Green Bay) and Rep. Jill Billings (D-La Crosse) are also coauthors on the bill.
The bill comes ahead of Swift releasing her 12th studio album — titled “The Life of a Showgirl” — on Friday.
Many states and lawmakers, including some of Wisconsin’s neighbors, started taking an interest in new laws to help regulate the live event ticket marketplace after Ticketmaster crashed during the initial sale of tickets to Swift’s The Eras Tour. Many of the mega pop star’s huge and dedicated fan base were down bad as secondary ticket prices for her tour soared, with some individual ticket prices rising to even more than $4,000.
The Michigan House passed a proposal in June that would curb bots for hoarding concert and event tickets. The Minnesota state government enacted legislation to help protect online ticket buyers in 2024.
“My daughters and I are Swifties. I would’ve loved to have taken them to see Taylor Swift live on the Eras Tour, but instead we saw the movie,” Roys said in a video with Style (Taylor’s Version) playing in the background and clips from the tour flashing on screen. “I didn’t even try to get tickets because I had heard the horror stories from so many friends of mine. This is not how it’s supposed to be. Live events should be for fans, not for profiteers.”
Roys is also seeking the Democratic nomination in the 2026 election for Wisconsin governor.
Several provisions in the bill seek to prevent fans from encountering a ticket hoax by barring resellers from listing tickets for resale before tickets have been put on sale, from putting tickets on sale if they don’t already own them and by capping secondary ticket sales, prohibiting a fee from exceeding 10% of the ticket’s initial price.
The bill also includes a provision to ensure ticket buyers can feel fearless when they make a purchase on the secondary market. Under it, resellers would be required to issue a full refund within 10 days of a request to a purchaser if a ticket is counterfeit, the event is canceled, the ticket doesn’t fit the description provided or the date or time of the event is moved.
Bots — devices or software that get around security measures or access control systems on a ticket selling platform to bypass purchasing limits — would also be prohibited under the bill from purchasing more than eight tickets for one event and circumventing the ticket queue, presale codes or waiting periods when a sale is going on.
“If you’re a fan, you deserve the chance to go see your favorite artist without being exploited by unscrupulous scalpers, by third-party bot farms that drive up prices and other practices that exploit fans and venues and artists,” Roys said. “All of us deserve to come together and share these wonderful live events without these kinds of consumer protection violations.”
Under the bill, violators would be subject to civil forfeitures of at least $15,000 for each day the violation occurs; $1,000 per ticket listed, advertised, sold or resold in violation of the provisions; and an amount equal to five times the total price of each ticket.
A person could also be subject to a civil forfeiture of at least $10,000 per ticket listed, advertised, sold or resold in violation of the provisions.
GET THE MORNING HEADLINES.
A sign on the entrance to the U.S. National Arboretum says it is closed due to the federal government shut down on Oct. 1, 2025 in Washington, D.C. (Photo by Kevin Dietsch/Getty Images)
WASHINGTON — The first federal government shutdown in seven years has left hundreds of thousands of workers furloughed and members of the public struggling to understand what’s open, what’s closed and what might be delayed.
States Newsroom’s Washington, D.C. Bureau scoured agency plans published by the Trump administration and the courts, and produced this guide to help you understand what’s going on:
The USDA plans to furlough about half, 42,300, of its nearly 86,000 employees, though workers at several programs for farm communities and rural areas will keep working without pay.
Operations will continue on some farm loans, certain natural resource and conservation programs, essential food safety operations related to public health and wildland firefighting activities.
Agriculture Department employees working on animal and plant health emergency programs — including African swine fever, highly pathogenic avian influenza, exotic fruit flies, new world screwworm and rabies — are exempt from furloughs.
But dozens of USDA programs addressing everything from disaster assistance processing to trade negotiations to long-term research on animal diseases will cease until Congress reaches a funding deal.
Employees working on those programs will be furloughed until the government is once again funded, but both working and non-working federal employees in all agencies are required to receive back pay under the law.
Agencies housed within the USDA have varying levels of furloughs. The Food and Nutrition Service, Office of the Inspector General and Natural Resources Conservation Service are among those with higher numbers of furloughed workers.
The Department of Commerce will retain just over 19% of its nearly 43,000 employees during the shutdown, and most will have to stay on without pay, as outlined in its government funding lapse plan.
The department oversees a wide range of federal government activities — weather forecasting, issuing patents and trademarks, regulating fisheries, enforcing export laws, managing government-owned and -controlled spectrum frequencies, and collecting demographics and other population data.
Notably, the department houses the National Oceanic and Atmospheric Administration, and will continue providing “weather, water and climate observations, prediction, forecasting, warning and related support.” But research activities will largely stop.
The U.S. Census Bureau, also part of the department, will cease most operations, including providing monthly economic indicators and updated data about disaster-impacted areas. Certain preparations for the 2030 Census will stop, as will any data collection for the American Community Survey.
Funding outside of annual appropriations may keep some U.S. Patent and Trademark Office units open, but the timelines will be variable, according to the department. When funding runs out, the office will continue “a bare minimum set of activities necessary to protect against the actual loss of intellectual property (IP) rights.”
The Defense Department’s contingency plan calls for the nearly 2.1 million military personnel to keep working as normal and says 406,500 of its roughly 741,000 civilian employees will work without pay, while the others will be furloughed.
The plan says the Defense Department believes operations to secure the U.S. southern border, Middle East operations, Golden Dome for America defense system, depot maintenance, shipbuilding and critical munitions are the “highest priorities” in the event of a shutdown.
Medical and dental services, including private sector care under the TRICARE health care program, would largely continue at the Defense Department, though “(e)lective surgery and other routine/elective procedures in DoW medical and dental facilities are generally not excepted activities, unless the deferral or delay of such procedures would impact personnel readiness or deployability.”
The Department of Education said it would furlough roughly 95% of employees outside its federal student aid unit.
The agency will continue disbursing Federal Direct Loans as well as Pell Grants, which help low-income students pay for college.
Borrowers still have to make payments toward their student loan debt during the shutdown.
Title I and Individuals with Disabilities Education Act, or IDEA, grant funding would continue to be available as usual, according to the department. Title I provides funding for low-income school districts, while IDEA guarantees a free public education for students with disabilities.
But the agency is ceasing several operations, including any new grantmaking activities. Still, the department said the majority of its grant programs “typically make awards over the summer and therefore there would be limited impact on the Department’s grantmaking.”
The agency’s Office for Civil Rights also has to pause investigations of any civil rights complaints.
The Energy Department will furlough a little over 8,100 of its 13,800 federal workers – nearly 60% of its workforce, according to its contingency plan.
The National Nuclear Security Administration would continue maintenance and safeguarding of nuclear weapons.
Some programs, like the medical isotope program, will require DOE to “produce additional isotopes in order to protect human life.”
“The need to do this will depend on the length of the lapse and the stockpile of individual isotopes,” according to DOE.
Certain programs are self-funded, such as the Bonneville Power Administration, which provides hydropower in the Columbia River Basin of the Pacific Northwest.
EPA, according to its contingency plan, will have the biggest percentage of federal employees furloughed. Nearly 90% of its workforce, or 13,400 out of 15,000, will be furloughed.
Only agency activities that revolve around protecting human life, such as monitoring some Superfund sites and responding to emergency environmental disasters, will continue.
Some EPA functions that will halt include issuing of new grants, publishing new research, pausing of cleanup of Superfund sites that don’t pose an imminent threat to human life, enforcement inspections and issuing of permits.
The department, one of the larger ones within the executive branch that houses many of the country’s best-known public health agencies, has furloughed about 32,500 of its nearly 80,000 employees, according to its contingency plan.
Many of HHS’ activities fall under the life and property or even the national security exceptions during a funding lapse, though dozens of programs will still be affected.
HHS officials plan to ensure “minimal readiness” at the Administration for Strategic Preparedness and Response for “all hazards, including pandemic flu and hurricane responses.”
Certain employees at the Centers for Disease Control and Prevention will keep working, albeit without pay, to monitor for any disease outbreaks. But the contingency plan says the CDC’s “communication to the American public about health-related information will be hampered.”
The Centers for Medicare and Medicaid Services plans to keep 3,300, or about 53%, of its employees during the shutdown in order to keep running core programs.
Since many of the country’s major health care programs are funded outside of the annual government funding process, they shouldn’t be affected by the shutdown, even though the employees who run the programs often rely on full-year or stopgap spending bills for their salaries.
CMS’ contingency plan says “the Medicare Program will continue during a lapse in appropriations” and that it has “sufficient funding for Medicaid to fund the first quarter of FY 2026,” which includes October, November and December.
Additionally, it “will maintain the staff necessary to make payments to eligible states for the Children’s Health Insurance Program (CHIP).”
The Department of Housing and Urban Development’s website opens with a message that reads: “The Radical Left in Congress shut down the government. HUD will use available resources to help Americans in need.”
The department says the majority of its annual grant programs, including those that provide for emergency housing for people experiencing homelessness and people living with HIV/AIDS, “continue to operate in States and local communities across the country when such grant funding has already been obligated.”
The agency also said many of its programs “addressing imminent threats to the health and welfare of HUD tenants and children will continue where such grant funding has already been obligated before the lapse occurs.”
For as long as the funding remains available, “monthly subsidy programs such as the public housing operating subsidies, housing choice voucher subsidies, and multifamily assistance contracts will continue to operate,” according to the department.
However, the agency said nearly all of its “fair housing activities” will halt during the shutdown.
The Internal Revenue Service will continue normal operations using supplemental funding enacted under the Democrats’ 2022 budget reconciliation law, known as the Inflation Reduction Act.
The IRS will retain its 74,299 employees, according to the latest available shutdown contingency plan.
The Trump administration has shrunk the IRS significantly this year, down from its roughly 95,000 employees, and has turned over the agency’s top leadership six times.
The agency processes about 180 million income tax returns each year.
The body that independently oversees the IRS will not operate at full capacity during the shutdown. Only 40% of employees in the department’s Treasury Inspector General for Tax Administration will remain on, with a small fraction required to stay without pay if necessary, according to the agency’s plan.
As of Thursday afternoon Eastern time, the home page for that agency, tigta.gov, was blank except for the message “Due to a lack of apportionment of funds, this website is currently unavailable.”
A little more than half of the federal workforce for the Interior Department will be furloughed – 31,000 out of 58,600 employees – according to its contingency plan.
Some services within the agency will continue, such as the Bureau of Indian Affairs’ wildland fire management, but programs that provide social services to foster children and residential adults will pause.
As for national parks, the trails, open memorials and overlooks will generally remain open. The National Park Service will retain minimal staff to allow for visitors. But general maintenance, trash pick-up and educational programs, will cease during the shutdown.
Hunters or people seeking access to public lands will not be able to have their permits processed by U.S. Fish and Wildlife Services.
The Justice Department will keep a majority of its federal workers during the shutdown, according to its contingency plan. Out of roughly 110,000 employees, nearly 13,000 will be furloughed.
Because the judicial branch will continue to function, the Justice Department will retain most of its attorneys for criminal and civil litigation. Federal law enforcement agencies and their agents will continue to work, such as the FBI, Drug Enforcement Administration and Bureau of Alcohol, Tobacco, Firearms and Explosives.
A shutdown typically means that immigration cases would be rescheduled and courts not located in an Immigration and Customs Enforcement detention center will be shut down. But the Trump administration has prioritized the Executive Office for Immigration Review, housed within the Department of Justice, as essential.
The contingency plan points to the president’s national emergency, “citing the threat to the national security and economy of the United States caused by illegal migration.”
More than 75% of the Department of Labor’s employees will be furloughed, according to the agency’s contingency plan.
Several units will come to a halt, such as the Bureau of Labor Statistics, Veterans’ Employment and Training Service, Office of Federal Contract Compliance Programs, Office of Disability Employment Policy, Women’s Bureau, Office of Administrative Law Judges, Administrative Review Board, and Benefits Review Board, as well as the Employees’ Compensation Appeals Board.
The agency said it will continue to support states and other agencies when it comes to administering and paying unemployment insurance benefits.
The department notes that “unless excepted or exempt, agencies’ technical assistance, compliance assistance, regulatory, policy, research, advisories, responding to inquiries, most oversight, hearing preparation, and cooperative activities will cease.”
Job Corps centers that house students “will remain in operation while funds remain available,” and “federal oversight of those centers related to safety and property will continue,” per the department.
Homeland Security will retain most of its workforce without pay. About 14,000 employees will be furloughed among its nearly 272,000 workforce, according to its contingency plan.
That means ports of entry will remain open for inspections from Customs and Border Protection, but there could be delays in paperwork at U.S. borders.
Most federal workers responsible for security at airports across the country – more than 61,000 Transportation Security Administration employees – would be required to work without pay.
Another agency within DHS that will remain most of its workforce is the Federal Emergency Management Agency, or FEMA. About 21,000 employees out of 24,000 will continue to work.
The office involved in departmental oversight, the Office of Inspector General, will pause its work on reports and investigations.
And the Trump administration’s aggressive immigration crackdown will continue, with nearly all employees from Immigration and Customs Enforcement considered non-exempt, about 19,600 out of 21,000.
Several agencies within the Department of Homeland Security will remain running because they are fee-based, such as U.S. Citizenship and Immigration Services. Some visa programs within USCIS are tied to appropriations funding, so those programs will be suspended.
That includes E-Verify, which verifies immigration status; visas for foreign doctors; and visas for non-minister religious workers.
A little more than half the employees in the State Department will be furloughed, about 16,600 out of its nearly 27,000-employee workforce, according to its contingency plan.
Because visa and passport services are fee-funded, they will likely not be impacted. Consular operations will be affected and diplomatic visas will only be issued in “life or death” emergencies.
The program for America’s seniors and some people with disabilities is largely funded outside of the annual government spending process, which makes it mostly exempt from shutdowns.
One big caveat is that the federal workers who administer the program are paid through one of the 12 congressional appropriations bills, which can cause issues during a funding lapse.
SSA’s contingency plan says it will furlough about 6,200 of its nearly 52,000 employees until the government is fully operational again.
The agency plans to continue “accurate and timely payment of benefits” as well as taking applications, requests for appeal, issuing and replacing Social Security cards and fraud prevention activities, among others.
The SSA during the lapse will not conduct certain activities, including benefits verification, replacement of Medicare cards, or addressing overpayments processing during the funding lapse.
Slightly more than 11,000 of the department’s nearly 45,000 employees will be furloughed for the remainder of the government shutdown, but its leaders plan to keep several activities essential for the traveling public going during a shutdown, according to its contingency plan.
Air traffic control services and hiring, hazardous materials safety inspections, airport inspections and much more will continue, though many activities will cease.
Some agencies within the Transportation Department will see little impact on their staffing, even though workers will not be paid until the shutdown ends.
For example, no one at the Federal Highway Administration, the Federal Motor Carrier Safety Administration, the National Highway Traffic Safety Administration, the Federal Transit Administration, or the Great Lakes St. Lawrence Seaway Development Corporation will be furloughed.
The department has individual contingency plans for its various components, including departmental offices, the Alcohol and Tobacco Tax and Trade Bureau, the Bureau of the Fiscal Service, the Financial Crimes Enforcement Network, the Internal Revenue Service, the Office of the Inspector General and the Treasury Inspector General for Tax Administration.
Treasury officials expect to keep about 1,850 of its more than 2,700 employees working in the departmental offices without pay during the shutdown, in part to “support the president” with “market and economic updates, economic policy options and recommendations, including those related to national security incidents.”
The Office of Inspector General, which oversees officials’ actions for waste, fraud and abuse, will keep about 30 of its roughly 150 employees working throughout the shutdown and furlough the rest.
Large parts of the Department of Veterans Affairs, including the processing and payout of benefits, are funded outside of the annual appropriations process and will continue through the shutdown.
The department projects 97% of its staff will continue to work, and most will be paid, according to its latest publicly available shutdown contingency plan.
Health care will continue uninterrupted at VA medical centers and outpatient clinics, and vets will still receive benefits, including compensation, pension, education and housing.
Veterans suicide prevention and homelessness programs will remain in operation, and the Veterans Crisis Line will continue to answer calls. The crisis line can be reached by dialing 988 followed by pressing 1, or by texting 838255.
The MyVA411 and PACT Act call centers will operate “as necessary to prevent disruption to mandatory VA benefit programs,” according to the department’s guide.
The National Cemetery Administration will continue to inter veterans and eligible family members, as well as schedule burials, determine eligibility and process headstone applications. However, headstone and marker installation and groundskeeping will cease, and the application assistance unit call center will be closed.
All Transition Assistance Programs, including career and financial counseling, are suspended, and the GI Bill hotline is not taking calls.
The department’s whistleblower program is also not accepting or investigating complaints.
The first Trump administration posted a contingency plan in March 2018, though it doesn’t appear there is a current one and the White House did not respond to a request from States Newsroom about how it’s implementing the shutdown.
The earlier three-page plan said the president planned to place “1068 of the 1759 EOP staff in furlough status (“Non-Excepted Staff’), while an estimated 691 EOP staff would continue to report to duty.”
President Donald Trump continues to be paid during a shutdown, as are members of Congress, under the law.
The Supreme Court will remain functioning during the shutdown, as well as the federal courts.
By using court fees, the judiciary branch can continue with paid operations until Oct. 17, according to the Administrative Office of the U.S. Courts. Most proceedings and deadlines set in cases will continue, but if Department of Justice attorneys representing the executive branch are furloughed, then those cases will be rescheduled.
Supreme Court judges and federal judges will continue to be paid due to Article III of the U.S. Constitution that specifies judge’s compensation “shall not be diminished” during their term.
“We don't have a direct way to overrule what the Republican regime has done in the big, ugly bill,” Sen. Kelda Roys said. “We certainly can do everything we can in Wisconsin to make sure that the existing two independent clinics that provide abortion services are able to see as many patients as they possibly can." (Photo by Baylor Spears/Wisconsin Examiner)
Planned Parenthood of Wisconsin paused abortion services Wednesday at its Madison, Milwaukee and Sheboygan locations due to the megabill signed by President Donald Trump in July. The law — officially titled the “One Big Beautiful Bill” Act — included a provision that would take away federal funding from the organization if it continues providing abortion services.
The organization announced the pause last week, saying that it was looking to see as many patients as possible before the Oct. 1 deadline. Wisconsin is the first state in the country where Planned Parenthood has taken this step in response to the federal law.
In reaction, Democratic lawmakers called Wednesday morning for the state to reverse other restrictions on the books to help increase accessibility to the remaining independent abortion providers in the state.
“We’re sounding the alarm, but we’re also saying we can do something about this,” Rep. Lisa Subeck (D-Madison) said at a press conference. “We know that this is going to be a legal battle, and there will be other means by which Planned Parenthoods are fighting this change, but in the meantime, we cannot let Republicans block access for Wisconsin women to the care that they need.”
This is the second time that Planned Parenthood is halting abortion services in Wisconsin since Roe v. Wade was overturned by the U.S. Supreme Court, ending federally protected abortion rights. The group stopped providing abortions from June 2022 until September 2023, when a Dane County court held that a 19th century state statute did not ban abortions. The Wisconsin Supreme Court also ruled in July that the same 19th century law was invalid and unenforceable and had effectively been repealed by other laws passed after it.
Planned Parenthood’s decision to pause services again leaves just two independent clinics that provide abortion care in Milwaukee. Abortion providers in neighboring Illinois have declared that they are prepared to provide services for Wisconsin women.
“We know that people in Wisconsin can go to other states that do not have these restrictions to access abortion care, but we think that that’s unacceptable, and that no matter who you are or where you’re from you deserve the freedom to get the health care that you need here in Wisconsin,” Sen. Kelda Roys (D-Madison) said at the press conference.
The public health department for Madison and Dane County offered to help patients in need of services navigate their limited options.
“Losing Planned Parenthood clinics as an option for abortion care means the full spectrum of reproductive health care will become very difficult to access in Wisconsin,” said Public Health Supervisor Sarah Hughes. “We know this changing landscape can be confusing and overwhelming, that’s why our Nurse Navigators are standing by to help people understand all options around pregnancy and reproductive health care.”
Planned Parenthood has been able to use federal funds via Medicaid payments and Title X, a federally funded family planning program, to help provide services other than abortion care, including contraceptives, STI testing, pregnancy testing, and gynecological services to low-income and uninsured individuals. The Hyde Amendment has barred federal money from being used to fund abortion care across the country for decades.
The new federal law puts the other services that Planned Parenthood offers at risk by barring Medicaid payments for one year for organizations that received more than $800,000 in Medicaid reimbursements in fiscal year 2023 and primarily engage in family planning services and reproductive health and provide abortions.
“This was targeted directly at Planned Parenthood,” Subeck said.
“Let me be clear, Republicans in the federal and state governments will stop at nothing short of a full abortion ban,” she added.
Planned Parenthood Federation of America and its member organizations in Massachusetts and Utah filed a legal challenge in July, but an injunction that was blocking the law from taking effect was lifted in September.
Attorney General Josh Kaul has also joined with other state attorneys general on a legal motion that argues the provision “impermissibly and unconstitutionally targets Planned Parenthood health centers for their advocacy and their exercise of associational rights” and also that “Congress ran afoul of limits on its spending power” because of its ambiguity. It argues the provision “fails to adequately define the scope of providers who qualify as “prohibited entities”; fails to provide clear notice of the timing of its implementation; and constitutes a change that [states] could not have anticipated when joining Medicaid.”
Planned Parenthood of Wisconsin has said that ongoing litigation could change what the organization is allowed to do and that it will continue to monitor the legal landscape and will be prepared to act the moment it is able to resume care.
Roys and Subeck introduced legislation Wednesday to help the last two clinics in Milwaukee take in patients.
The Democratic bill would repeal several of the other restrictions on the books in Wisconsin, including a requirement that patients attend two appointments with the same physician 24 hours apart before receiving care, requirements that a patient have a physical exam and that a physician be physically present when medication is taken, and a requirement for an ultrasound. It would expand the number of providers allowed to provide abortion care from just physicians to physician assistants, nurse practitioners and advanced practice registered nurses.
The lawmakers said the bill would help the two independent Milwaukee clinics — Care for All Community Clinic and Affiliated Medical Services — reach as many patients as possible while Planned Parenthood no longer offers services by removing barriers to providing access.
“We don’t have a direct way to overrule what the Republican regime has done in the big, ugly bill,” Roys said. “We certainly can do everything we can in Wisconsin to make sure that the existing two independent clinics that provide abortion services are able to see as many patients as they possibly can and try to absorb some of the loss of service [provided by] Planned Parenthood, and open the door to make sure that patients in Wisconsin don’t suffer access restrictions that patients in other states don’t have to suffer.”
Roys said the purpose of the restrictions “has always been to make abortion as onerous and as difficult for people to access as possible. It has nothing to reduce the need for abortion.” By lifting the restrictions, she said, the bill could help “increase abortion access, despite the federal backdoor abortion ban.”
However, in a Republican-led Legislature, the bill is unlikely to move ahead.
Conservative groups and some Republican lawmakers celebrated the news of the pause in abortion services last week. Rep. Joy Goeben (R-Hobart) called the pause in services at Planned Parenthood of Wisconsin a “hopeful moment” in a statement last week.
“Every heartbeat silenced by abortion was a life full of possibility,” Goeben said. “This pause means more of those lives may now have a chance.”
Goeben and 11 of her Republican colleagues recently introduced a bill that seeks to narrow the definition of abortion in Wisconsin. According to a bill summary, it would amend the definition of abortion to make an exception for “physician’s performance of a medical procedure or treatment designed or intended to prevent the death of a pregnant woman and not designed or intended to kill the unborn child, including an early induction or cesarean section performed due to a medical emergency or the removal of a dead embryo or dead fetus, or an ectopic, anembryonic, or molar pregnancy, which results in injury to or death of the woman’s unborn child when the physician makes reasonable medical efforts under the circumstances to preserve both the life of the woman and the life of her unborn child according to reasonable medical judgment and appropriate interventions for the gestational age of the child.”
“Democrats should be lining up to sign on to this bill,” Goeben said in a statement about the bill. “This is what liberals have been shouting about from the rooftops for decades. However, they continue to perpetuate the notion women are not going to get the care they need in a heart wrenching emergency situation.”
Physicians, Democratic lawmakers and others have spoken to concerns since the overturn of Roe v. Wade that restrictive state laws governing abortion would result in women not receiving adequate medical care, even when there is an emergency. ProPublica has reported on the preventable deaths of Amber Thurman and Candi Miller, both of whom were denied timely care due to confusion created by Georgia’s six-week abortion ban. It has also reported on two women in Texas, Josseli Barnica and Nevaeh Crain, who died under the state’s restrictive abortion ban after care was delayed for their miscarriages.
Roys said the bill is an example of Republicans trying to distance themselves from the impact of restrictive abortion policies.
“Republicans know that their abortion bans hurt women, and they kill women, and Americans are horrified to see women being arrested and jailed instead of taken to the hospital for treatment when they have a miscarriage. They are horrified to see pregnant people turned away from emergency rooms so that they can bleed out and almost die in Walmart parking lots… and now Republicans are desperately searching for a way to distance themselves from the terrible effects of the laws that they passed. And [to] simply say if you need to end your pregnancy, we’re going to call it something different than abortion is nonsense.”
Roys said the bill is “pernicious” because it would essentially tell providers to provide a C-section or induce labor rather than provide an abortion. Those procedures, she said, are “much more difficult, painful, and risky and invasive than doing an abortion.”
“It affects a woman’s future ability to birth and be pregnant the way that she wants to be, and it is incredibly cruel,” Roys said.
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A nurse holds a vial of COVID-19 vaccine and syringe. (Getty Images)
Wisconsin clinics and hospitals are stepping up the rollout of the newest version of the COVID-19 vaccination.
UW Health started offering the new edition vaccine to patients Wednesday and will start scheduling COVID-19 shots beginning Monday.
The Madison-based hospital and clinic system previously began giving the vaccine to people older than 65, considered the highest-risk population for the respiratory infection, according to Dr. Jim Conway, an infectious disease specialist and medical director for the UW Health immunization program.
The 2025-26 version of the vaccine is “built around the most current, circulating strains of COVID that are out there,” Conway said in an interview Wednesday. “As we all learned during the entire pandemic, these strains are mutating constantly, and so they’re constantly changing . . . You try to keep up with what’s the most prevalent.”
Major pharmacy chains typically get the first available allotments of the vaccine and have already, Conway said. In the meantime, UW Health and other health systems have been preparing to offer the shot and preparing their scheduling systems.
The vaccine’s components are developed following discussions among health experts for the World Health Organization and other agencies, Conway said. Both the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) take part in those discussions.
In the weeks leading up to Sept. 19, when the CDC’s Advisory Committee on Immunization Practice (ACIP) opened its most recent meeting, public health professionals were apprehensive that the body might limit access to the COVID-19 vaccine.
Robert F. Kennedy Jr., secretary of the Department of Health and Human Services, has a long history of embracing unfounded claims critical of vaccines. Kennedy replaced the members of the ACIP with people viewed as skeptics of vaccination. Susan Monarez, appointed CDC director earlier this year by President Donald Trump, testified at a congressional hearing in September that Kennedy fired her for refusing to agree to his demand that she endorse ACIP’s recommendations without reviewing them.
Ahead of ACIP’s meeting, “we were all really nervous,” Conway said. Medical professional groups emphasized their endorsement of the COVID-19 shot to counter messaging from Kennedy and other HHS officials that appeared to cast doubt on the vaccine.
“Our professional societies make recommendations every year, but this year we really leaned into making sure people were aware of those and really were promoting those as … evidence-based, data driven,” he said.
When ACIP met just two days after Monarez’s testimony, the panel left in place the CDC’s recommendation for COVID-19 vaccinations from the age of six months to 64. While the panel’s recommendation highlighted concerns about risk, ACIP rejected a proposal to require a prescription for the shot.
“It’s actually in some ways reassuring that even people that may come across as skeptics and doubters at some level as they were repopulating the ACIP — even they couldn’t be swayed from how clear the evidence and the data is that these vaccines are really valuable and really safe,” Conway said. “It was a very pleasant surprise.”
Wisconsin Gov. Tony Evers issued an executive order to ensure COVID-19 vaccine access and the state Department of Health Services followed up with a health order that functions as a statewide prescription for the shot. The Office of the Commissioner of Insurance also issued guidance that insurance companies in Wisconsin are expected to cover the vaccine without requiring a patient co-pay.
Conway said with those actions insurers began announcing in the last week their coverage plans, which set the stage for providers to set up their vaccine programs.
The first objective of a vaccine is “to prevent you from getting serious disease,” Conway said, so patients don’t have to go to a doctor, “or aren’t getting admitted to the hospital or aren’t getting in the ICU [intensive care unit] or aren’t going on a ventilator or, God forbid, aren’t dying. That’s the ultimate goal, and that’s what the vaccines are really very good at.”
If the shot prevents a person from getting sick from the virus at all, that’s a bonus, “but we know that that’s never completely possible with these kinds of respiratory viruses,” he added. “But we know that even if you get ill, you’re much more likely to have a very, very mild case.”
Vaccination also helps prevent the spread of disease as it reduces the amount of virus infected people are shedding, Conway said. That can reduce the chances that others will be exposed to the virus, helping to protect people whose immune systems are suppressed due to age or an underlying medical condition.
With enough people vaccinated, that allows community immunity — “what used to be called herd immunity” — to develop, Conway said. That reduces the risk of outbreaks, “but it also starts to protect the really vulnerable parts of your population.”
The vaccine’s availability came as good news Wednesday to Patricia Fisher, a graduate student and the mother of a six-month-old. Fisher was disappointed this week when the vaccine wasn’t available at her baby’s check-up.
“It’s not just about my baby,” said Fisher, who is enrolled in a sociology Ph.D. program at the University of Wisconsin. “The community is safer if more people are vaccinated.”
Fisher has a master’s degree in public health. While her own research focuses on food systems, climate change and health, she said she’s learned enough about population health outcomes to make her alarmed at the prevalence of anti-vaccine attitudes.
“I find it really, really frightening how anti-vaccine some people are, and that people are particularly worried about [vaccines for] COVID, flu and RSV [respiratory syncytial virus],” Fisher said. “COVID is a very clear and present threat to infant health and so it’s very worrying to me.”
Between the national upsurge in measles that has surfaced in Wisconsin, surges in pertussis (whooping cough) in the last couple of years, influenza and COVID-19, “there’s a lot of threats out there,” she said. “I just didn’t think that infectious disease would be the thing about parenting that would be the most stressful, but it definitely is.”
On Wednesday she made an appointment for her child’s COVID-19 shot in mid-October. “I’m thrilled it’s going to be available,” she said.
Conway said the flood of both information and misinformation about the vaccine can overwhelm people. “Sometimes the natural human response is to just hunker down and do nothing,” he said.
He counsels patience and keeping messaging simple: pointing to the decades of data on the safety and effectiveness of vaccines along with the number of professional medical organizations that have made recommendations on the basis of scientific evidence.
“I think people should understand that there’s an opportunity here to protect themselves and their families from these really potentially very unpredictable diseases that can devastate individuals, families and communities,” Conway said.
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Jess Deis, a nurse practitioner and nurse midwife in Kentucky and Indiana, learned she had cervical cancer after she qualified for Medicaid insurance in 2014. (Sarah Ladd/Kentucky Lantern)
Third in a five-part series.
It had been a decade since Jess Deis’ last women’s wellness exam when Kentucky expanded Medicaid and she finally qualified for the state insurance program.
Physicians recommend a cervical cancer screening — also referred to as a Pap smear, which is a swab of the cervix — as part of a wellness exam once every three to five years for women between the ages of 21 and 65. Deis, 43, was in her last semester of nursing school in 2014 when the test came back with abnormal results. Her doctor ordered additional testing.
“Then I got a call on a Sunday evening from a physician letting me know I had cervical cancer and I needed to see a specialist,” Deis said.
Cervical cancer is one of few cancers that has a known path of prevention after the approval of the first HPV vaccine in 2006. But that also means it falls at the intersection of three cultural issues that are facing strong political opposition — broad access to low-cost or free reproductive health care, access to vaccines for children, and sex education.
Kentucky had the highest cervical cancer incidence rate in the country between 2015 and 2019, according to medical research, and a mortality rate twice as high as the rest of the country. The state tied with West Virginia for the second-highest rate of 9.7 cases per 100,000 residents between 2017 and 2021. Oklahoma topped the list for that five-year period with 10.2 cases per 100,000, according to the National Cancer Institute.
Deis delayed the surgery to remove her uterus until after graduation, and later became a certified nurse practitioner. Now she provides Pap smears to patients multiple times a day at Planned Parenthood clinics in Kentucky and Indiana and other care via telehealth. She recently helped a patient who hadn’t been seen for a screening in 15 years discover she had advanced cervical cancer.
She is troubled by what could happen in the wake of the new Medicaid rule passed by Congress and signed by President Donald Trump in July that barred nearly all Planned Parenthood affiliates from receiving Medicaid reimbursements because some clinics in the nonprofit network provide abortions. Kentucky and Indiana both have abortion bans, but still have Planned Parenthood clinics to provide other reproductive health care.
“I don’t just worry; I know that there’s going to be more folks with stories like mine, but without the happy ending,” Deis said.
The American Cancer Society recently reported the number of early cervical cancer cases has declined sharply among young people since the vaccine’s introduction nearly 20 years ago. But vaccine adoption rates for children are low in the states where rates are highest — about one-third of boys and girls between the ages of 13 and 17 were vaccinated in Mississippi as of 2020.
The vaccine is most effective when given before engaging in any kind of sexual activity for the first time, because it can prevent the sexually transmitted strains of HPV that present the highest risk of cervical cancer. More than 98% of cervical cancer cases are caused by HPV, and a 2024 study from the Journal of the National Cancer Institute found zero cases of cervical cancer in Scottish women born between 1988 and 1996 who were fully vaccinated against HPV between the ages of 12 and 13.
“We could make (cervical cancer) an eradicated disease,” said Dr. Emily Boevers, an Iowa OB-GYN. “But everything is falling apart at the same time.”
Boevers said limitations on Medicaid coverage and the loss of Title X family planning funding will make screenings and vaccines less accessible for the populations that need them the most, even if clinics don’t close as a result. But it will take years to see the consequences of these changes, she said, because it takes about 15 years on average for HPV to become cancer.
“So what we’re really talking about is our daughters getting cervical cancer,” she said.
Kentucky’s legislature acknowledged the importance of HPV vaccines as recently as 2019, when representatives passed bipartisan House Resolution 80, which encouraged females and males between the ages of 9 and 26 to get the HPV vaccine and everyone to “become more knowledgeable of the benefits of the vaccine.” Only four legislators voted against it.
But today, the U.S. Department of Health and Human Services is led by Secretary Robert F. Kennedy Jr., who has made false statements about the HPV vaccine’s safety and effectiveness and played a leading role in organizing a mass lawsuit against one of the vaccine’s manufacturers, Merck. The Associated Press reported the judge dismissed more than 120 claims of injuries from Gardasil, the name of one HPV vaccine, because of a lack of evidence.
“Secretary Kennedy supports renewing the focus on the doctor-patient relationship and encourages individuals to discuss any personal medical decisions, including vaccines, with their healthcare provider,” a Health and Human Services spokesperson wrote to States Newsroom in September. “The American people voted for transparency, accountability, and the restoration of their decision-making power, and that is exactly what HHS is delivering.”
The response did not clarify whether Kennedy still thinks the vaccine is unsafe and what basis there is for that claim.
Dr. Linda Eckert, a University of Washington School of Medicine professor and practicing OB-GYN, has an extensive background in immunizations and cervical cancer prevention. She served as a liaison for the American College of Obstetricians and Gynecologists to the CDC’s Advisory Committee on Immunization Practices until 2024. Members of the committee were recently dismissed by Kennedy’s agency and replaced by new members, several of whom have reportedly expressed anti-vaccine views. Eckert said the group had plans in motion to present to the ACIP in June a case for administering the HPV vaccine at the earliest age of 9 before it was disbanded.
Although Black and Hispanic women are affected by cervical cancer at disproportionate rates because of systemic inequities, Eckert said the fastest rising group experiencing late-stage cancer is white women in the Southeast. But she added that Alabama was the first state in the country that launched a targeted campaign to eliminate cervical cancer.
Treatment for the cancer once it develops can also be difficult to obtain, Eckert said. It can be expensive and require many follow-up visits, and usually leads to infertility either through hysterectomy or invasive radiation treatments.
“It is a really devastating disease to treat,” Eckert said. “Even if you live, you are permanently changed.”
Dr. Aisha Mays, founder and CEO of a Dream Youth Clinic in Oakland, California, said the services her clinic offers to young people for free includes most of the same services that Planned Parenthood clinics provide, including the HPV vaccine.
“That’s the work of Planned Parenthood and clinics like mine that are encouraging and doing regular Pap smear screenings and vaccines, and having really clear conversations with young people around the importance of these procedures,” Mays said.
The recent turn against vaccines by some segments of the public and members of President Donald Trump’s cabinet who doubt their effectiveness and baselessly claim that they cause injury and developmental issues like autism has made the promotion of HPV vaccines more difficult for Mays. Overwhelming evidence, including from the Centers for Disease Control and Prevention, shows that they are safe and effective.
The vaccine can also protect against genital warts, anal cancer and oropharyngeal cancer, Mays said. There are about 40 strains of HPV in total that are known to infect the genitals, and more that can attach to certain patches of skin. Most people who have sex will come in contact with one or more of the strains by the time they reach their mid-20s or early 30s.
Mays’ clinic is largely funded by state and local grants, but it received more than $100,000 in federal funding for a sexual health education program through the U.S. Department of Health and Human Services’ Office of Population Affairs. It was a nationally distributed podcast hosted by adolescents, Mays said, and they chose topics to talk about related to sexual health, including HPV.
The program’s grant was one of many that have been cancelled under the Trump administration. An objective laid out in Project 2025, the blueprint document for the next Republican presidency written by conservative advocacy group the Heritage Foundation, was to ensure no subgrantees of sex education programs were promoting abortion or “high-risk sexual behavior” among adolescents. It also stated that any programming should not be used to “promote sex.”
HHS also terminated funding for one of California’s sexual health programs in August over the state’s refusal to remove references in the programming related to gender, including the idea that biological sex and gender identity are distinct concepts. Another directive of Project 2025 was to make sure biological sex is never conflated with gender identity or sexual orientation.
States with the lowest incidences of cervical cancer, including Massachusetts, New Hampshire, Connecticut and Minnesota, also have the highest density of physicians per capita. According to the Association of American Medical Colleges’ state physician workforce data, Massachusetts has the highest number of physicians per 100,000 people, and Oklahoma ranks in the bottom three.
Kentucky is in the bottom 15, and so is Indiana, where Marissa Brown works as a Planned Parenthood health center manager in Bloomington. Brown described her clinic as “an oasis in a desert” because there are few options for gynecological care in the area, and even fewer for obstetrics. Brown said they routinely see patients from rural areas two or more hours away, and many of them are coming for wellness exams that include cancer screenings.
Indiana used to have 38 Planned Parenthood clinics, but through 15 years of funding cuts and targeted anti-abortion legislation, the organization closed 21 of them between 2002 and 2017. In the years since then, another seven shut down to consolidate services. Many of them did not provide abortions.
“We hear a lot about patients coming in who can’t get into their gynecologist for four to 12 weeks,” Brown said. “We can do that in a few days to two weeks, and we have walk-in appointments too.”
Health Imperatives, a nonprofit network of seven community health clinics in southern Massachusetts, can no longer bill for Medicaid because they provide medication abortions and received about $800,000 in reimbursements for other services in 2023, like Planned Parenthood. One of Health Imperatives’ clinics is in Martha’s Vineyard, whose working-class residents have to work three to four jobs just to afford to live on the affluent island, said Julia Kehoe, the organization’s president and CEO.
More than a decade ago, she said she noticed a pattern: Their patients would come in for an annual gynecological exam, receive an abnormal cervical cancer screening, but not follow up, because the closest available specialist would require expensive travel off the island. Kehoe said that once their Martha’s Vineyard clinic purchased a colposcopy machine, from privately raised funds, in 2012, they started diagnosing some of their regular patients with now-advanced cancer.
“In the first year that we did colposcopies, we found four individuals who had stage three or four cancer, who we luckily were then able to connect up to Boston for critical care,” she said. “But if we had had that capacity earlier … we would have caught it earlier.”
States Newsroom reproductive rights reporter Sofia Resnick contributed to this report.
Coming Thursday: Telemedicine could help narrow the care gap in rural communities.
This story was originally produced by News From The States, which is part of States Newsroom, a nonprofit news network which includes Wisconsin Examiner, and is supported by grants and a coalition of donors as a 501c(3) public charity.
Stephanie Johnson, whose husband died after living with Parkinson's Disease for 13 years, speaks at a news conference Wednesday, Oct. 1, about legislation to create a state Parkinson's registry. (Photo by Erik Gunn/Wisconsin Examiner)
A bipartisan group of Wisconsin lawmakers announced legislation Wednesday to create a statewide registry for Parkinson’s Disease.
Parkinson’s, a neurological condition that is characterized by tremors, but also by a variety of other symptoms, has been increasing disproportionately, according to Dr. Brian Nagle, a movement disorder specialist.
“It’s the second most common neurological disease after Alzheimer’s disease, but it’s the fastest growing,” Nagle said in an interview Wednesday.
The speed with which Parkinson’s diagnoses are increasing is outpacing the aging of the population, “which suggests that it’s not just due to our population getting older, but that there may be some sort of risk factor that is causing it to grow more rapidly,” Nagle said.
A statewide registry of Parkinson’s patients could help provide clues about factors, such as environmental conditions, that may be at the root of the illness, he said.
State Sen. Rachael Cabral-Guevara (R-Fox Crossing) and state Rep. Lisa Subeck (D-Madison) began circulating a draft bill Wednesday to create the proposed state registry.
“Right now, when patients and their doctors are looking for answers, we struggle a little bit,” said Cabral-Guevara, who is a nurse practitioner, at a press conference to announce the legislation.
“We simply don’t have the data that we need,” she said. “We don’t know who is infected. Where the disease is hitting the hardest. Are there environmental factors that impact this, that cause this, that make it progress even faster? That lack of the clear picture of this is a barrier.”
The legislation was the brainchild of Stephanie Johnson, director of the Parkinson’s Disease Alliance of Wisconsin. Johnson told reporters Wednesday that her husband, Rick, was diagnosed with Parkinson’s 15 years ago when he was 61. After living with the illness for 13 years, he died in December 2023.
“I think we typically think of Parkinson’s as tremors or shuffling,” Johnson said, “but Rick had dangerously low blood pressure that would cause him to pass out. He had cognitive changes that made it very, very challenging for him to communicate. And he had visual hallucinations and many other non-motor symptoms.”
Johnson said she was also diagnosed with Parkinson’s three months after her husband’s death — a finding that astonished her. Then she learned that in the neighborhood where they had previously lived for 20 years, they were two of six residents who developed Parkinson’s disease, she said.
“And I thought, this can’t be a coincidence,” Johnson said, “And I wondered, is this a disease cluster? I didn’t know.”
“We don’t have a systematic way of tracking the incidence and prevalence of Parkinson’s in Wisconsin,” Johnson said.
The proposed legislation is aimed at filling that gap. The bill’s authors have named it in memory of Johnson’s husband at her request.
Fourteen U.S. states have some form of registry for Parkinson’s Disease, with some tracking other conditions as well, according to the Michael J. Fox foundation, a national research nonprofit named for the TV actor who was diagnosed with Parkinson’s disease when he was 30.
The draft legislation calls for the establishment of a registry at the Department of Population Health Sciences at the University of Wisconsin-Madison School of Medicine and Public Health. The registry would include a website with annual reports on the incidence and prevalence of Parkinson’s Disease in Wisconsin.
Health care providers would file information with the directory about patients they treat for Parkinson’s or closely related conditions. If patients don’t consent for their information to be shared, the incidence would be reported and nothing else, according to the bill.
Parkinson’s Disease is the subject of “a lot of mysteries,” Subeck said. “The reality is we are not going to get closer to curing Parkinson’s unless we do the research, unless we collect the data, and unless we enable that data to be used in meaningful ways.”
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