The James H. Shannon Building (Building One), on the National Institutes of Health campus in Bethesda, Maryland. (Photo by Lydia Polimeni,/National Institutes of Health)

The Trump administration will review frozen grants to universities without using its controversial standards that discouraged gender, race and sexual orientation initiatives and vaccine research.

In a settlement agreement filed in Massachusetts federal court Monday, the National Institutes of Health and a group of Democratic attorneys general who’d challenged the new criteria for grant funding said the NIH would consider grant applications made up to Sept. 29, 2025, without judging the efforts related to diversity, equity and inclusion, or DEI, or vaccines.

The settlement provides an uncontested path for the agency while courts decide whether the administration can use its controversial analysis. The administration did not agree to permanently ditch its campaign to evaluate health research funding decisions based on schools’ DEI programs.

NIH officials “will complete their consideration of the Applications in the ordinary course of NIH’s scientific review process, without applying the Challenged Directives,” the settlement said, adding that the agency would “evaluate each application individually and in good faith.”

The settlement was signed by U.S. Department of Justice lawyers and the attorneys general of Massachusetts, California, Maryland, Washington, Arizona, Colorado, Delaware, Hawaii, Minnesota, Nevada, New Jersey, New Mexico, New York, Oregon, Rhode Island and Wisconsin.

In a Tuesday statement, Massachusetts Attorney General Andrea Joy Campbell said the agreement commits the Department of Health and Human Services to resume “the usual process for considering NIH grant applications on a prompt, agreed-upon timeline.” 

The 17 attorneys general sued in April over $783 million in frozen grants. 

A trial court and appeals court in Massachusetts sided with the states, but the U.S. Supreme Court ruled in August that the trial judge lacked the authority to compel the grants to be paid, especially in light of a similar decision involving the Education Department.

A U.S. Postal Service employee sorts packages inside the Los Angeles Mail Processing & Distribution Center in December. A new USPS rule on postmarks took effect on Dec. 24 that says mail might not be postmarked on the day it’s dropped off. (Photo by Mario Tama/Getty Images)

The U.S. Postal Service has adopted a new rule that could create doubt about whether some ballots mailed by voters by Election Day will receive postmarks in time to be counted.

A USPS rule that took effect on Dec. 24 says mail might not receive a postmark on the same day the agency takes possession of it. The postal service says it isn’t changing its existing postmark practices and is merely clarifying its policy, but some election officials have looked to postmarks as a guarantee that mail ballots were cast before polls closed.

The new rule holds implications for 14 states and Washington, D.C., that count ballots arriving after Election Day if they are postmarked on or before that day — commonly called a “ballot grace period.” In these states, ballots placed in the mail by voters before the deadline may not be counted if the postal service applies a postmark after Election Day.

The USPS rule says that “the postmark date does not necessarily indicate the first day that the Postal Service had possession of the mailpiece.”

The USPS rule comes as the U.S. Supreme Court prepares to consider a case that could eliminate ballot grace periods nationwide. The court’s decision, expected late this spring or next summer, could render the issues raised by the postmark rule moot.

Mail-in voting surged in 2020’s general election amid the COVID-19 pandemic, when 43% of voters cast their votes by mail. The percentage of voters mailing their ballots has fallen from that peak but remains above pre-pandemic levels. About 30% of voters cast mail ballots in 2024, according to data gathered by the U.S. Election Assistance Commission.

While the vast majority of mail ballots were successfully cast last year, hundreds of thousands weren’t counted. During the 2024 election, 584,463 mail ballots returned by voters were rejected by election officials — 1.2% of returned mail ballots. About 18% of those ballots were rejected because they didn’t arrive on time.

The USPS defended the change in a lengthy response to criticisms published in the Federal Register. The agency emphasized that it does not administer elections and doesn’t advocate for or against voting by mail.

The postal service repeated its advice that voters mail their completed ballots at least a week before Election Day. And it noted that voters may request a manual postmark at their local post office free of charge.

“If customers are aware that the postmark date may not align with the date on which the Postal Service first accepted possession of a mailpiece, they will be better equipped to adjust their plans accordingly,” the response reads.

“And if policymakers or other entities that create rules utilizing the postmark date are aware of what the postmark date signifies, they are better equipped to determine whether their rules adequately serve their purposes.”

Stateline reporter Jonathan Shorman can be reached at jshorman@stateline.org.

Medical bills are spread out on the kitchen table of a cancer patient in Salem, Va. (Photo by Don Petersen/The Associated Press)

This article first appeared on KFF Health News.

As Congress debates whether to extend the temporary federal subsidies that have helped millions of Americans buy health coverage, a crucial underlying reality is sometimes overlooked: Those subsidies are merely a band-aid covering the often unaffordable cost of health care.

California, Massachusetts, Connecticut and five other states have set caps on health care spending in a bid to rein in the intense financial pressure felt by many families, individuals and employers who every year face increases in premiums, deductibles and other health-related expenses.

Hospitals and other health care providers are citing Republicans’ One Big Beautiful Bill Act, signed by President Donald Trump in July, as one more reason to challenge those limits.

The law is expected to reduce federal Medicaid spending by more than $900 billion over a decade, which mathematically should help the overall health care system meet the caps. But the law is also expected to increase the number of uninsured Americans, mostly Medicaid beneficiaries, by an estimated 10 million people. Health care analysts predict hospitals and other providers will raise prices to cover the double whammy of lost Medicaid revenue and the cost of caring for an influx of newly uninsured patients.

Whether regulators in some states will allow providers to justify higher prices and exceed the spending caps is unclear. Only California and Oregon can penalize providers financially if they fail to meet targets.

“Are we going to say, ‘That’s OK’? Or are we going to say, ‘Well, you exceeded the target. We’re still going to penalize you for that’?” said Richard Pan, a former state lawmaker and a member of the California Office of Health Care Affordability’s board. “That has not yet been decided.”

The California Hospital Association, the industry’s main state lobbying group, filed a lawsuit in October asking a state court to strike down the spending caps, which it argued fail to account for all the cost pressures hospitals face. Those pressures, it said, include an aging, sicker population; the rising cost of labor; expensive advances in medical technology; large capital outlays on required seismic retrofitting; and changes in federal policy, including the One Big Beautiful Bill Act. The hospital group’s lawsuit also asserted that the state affordability office, by hastily imposing ill-considered cost-cutting targets, was undermining its other key mission of improving health care access, quality and equity.

California’s affordability office last year set a five-year target to cap statewide spending growth, starting at 3.5% in 2025 and declining to 3% by 2029. The annual caps apply to a wide range of health care entities, including hospitals, medical groups, insurers and other payers.

Earlier this year, it imposed much lower spending growth caps — starting at 1.8% in 2026 and declining to 1.6% by 2029 — for seven “high-cost” hospitals.

“The spending caps set by politically appointed bureaucrats could force cuts that result in many Californians traveling farther for care, facing longer emergency room wait times, experiencing more overcrowding and losing access to critical services,” Carmela Coyle, the hospital association’s president and CEO, said in an October press release.

The California attorney general’s office, which will represent the affordability agency, has not yet filed a response to the hospital group’s complaint and did not respond to a request for comment.

Hospitals’ pushback

California is not the only state taking a close look at hospital prices, which are widely considered a primary driver of health care costs.

“States, armed with information that points to payments to hospitals as a driver of what is way beyond affordable commercial premiums, have begun to take increasingly targeted actions focused on commercial hospital prices,” said Michael Bailit, founder of the Needham, Massachusetts-based consultancy Bailit Health, which has advised multiple states, including California, on ways to tame health care spending. “It is not surprising that the hospital industry is going to oppose such state actions.”

In its lawsuit, the California Hospital Association said the affordability office’s own report showed that pharmaceutical and insurance companies are largely responsible for high costs.

Hospitals in some states with cost growth limits, including Connecticut and Massachusetts, have expressed objections similar to the ones raised in the California lawsuit. They could follow their counterparts in California if their lawsuit succeeds, said Peter Lee, who led California’s Affordable Care Act marketplace, Covered California, for over a decade and is now a senior scholar at Stanford Medicine’s Clinical Excellence Research Center.

Lee said the work of California’s affordability office and similar agencies in other states is just about the only systemwide effort being made to cut health care costs. They are basically saying, “‘Look, health care is taking money away from education, it is taking money away from the environment, it is taking money away from everything in the public sector, and in the private sector it is taking money away from wages,’” he said. “‘We don’t know how you, the health system, are going to do it, but it is your job not just to provide quality but to lower costs. Here’s the target.’”

To be sure, achieving the cost savings that California and those other states are seeking is no easy lift. It will ultimately require persuading large, financially powerful players that compete fiercely for health care dollars to adopt a different mindset and begin cooperating to reduce costs instead. And that, in many cases, will mean lower revenue.

But the status quo, as many people know all too well, means continued financial pain for millions.

In early 2020, Estevan Rodriguez, a bartender at California’s Monterey Beach Hotel, had surgery for a staph infection in his leg. The bill came to nearly $168,000. His insurance paid most of it, but he still owed $5,665, which took him two years to pay, more than $200 every month. “It may not be a lot to some people, but it was a lot to me,” Rodriguez said.

He said he dropped his Hulu subscription, switched to a lower-cost cellphone, and got cheaper car insurance. He started going to food banks rather than the grocery store, he said, and had a lot less time with his kids, because he was constantly working to pay off the hospital bill.

Community Hospital of the Monterey Peninsula, where Rodriguez had his surgery, is one of the seven hospitals identified by California’s affordability office as high-cost. A study by the office attributed high hospital prices in Monterey County to a lack of market competition “rather than higher operating costs or superior quality of care.”

The Monterey hospital referred a request for comment about its “high-cost” designation to the California Hospital Association. CHA spokesperson Jan Emerson-Shea declined to comment beyond the language of the lawsuit and Coyle’s press release statement.

Reduced competition

Health care analysts worry the One Big Beautiful Bill Act will reduce market competition even further by stressing already weak hospitals, leading some to shut services, merge with larger health systems, or close. One study estimates 338 rural hospitals are at risk of closing nationwide.

Less competition, in addition to fewer Medicaid dollars and an increase in uninsured patients, will only strengthen the incentive of health systems with the requisite market clout to raise their commercial prices, increasing premiums for employers and individuals.

“We think commercial prices will continue to increase as health care providers, and hospitals in particular, will seek to preserve or increase their revenue,” said Rachel Block, a program officer at the Milbank Memorial Fund, a foundation that focuses on health equity.

That in turn could pose a challenge to state affordability regulators tasked with overseeing compliance with growth targets for health care spending.

California’s affordability office is required to consider mitigating factors, including changes in federal and state laws. But some of its board members have expressed skepticism about letting hospitals offset Medicaid losses with higher commercial prices.

“There’s a lot of talk about using HR 1 and other federal policies as an excuse to raise prices on commercial payers,” Ian Lewis, an affordability office board member and policy director for UNITE HERE Local 2, a hospitality workers union in the Bay Area, said at the agency’s July board meeting, referring to the One Big Beautiful Bill. “There’s no more blood to be squeezed from this stone.”

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — an independent source of health policy research, polling and journalism. Learn more about KFF.

Thanks to Einstein’s relativity, time flows differently on Mars than on Earth. NIST scientists have now nailed down the difference, showing that Mars clocks tick slightly faster—and fluctuate over the Martian year. These microsecond shifts could play a big role in future Mars navigation, communications, and even a solar-system-wide internet. It’s a small time gap with big consequences for space exploration.

A randomized trial from Vanderbilt-Ingram Cancer Center reveals that magnesium may be the missing key to keeping vitamin D levels in balance. The study found that magnesium raised vitamin D in people who were deficient while dialing it down in those with overly high levels—suggesting a powerful regulating effect. This could help explain why vitamin D supplements don’t work the same way for everyone and why past studies linking vitamin D to cancer and heart disease have produced mixed results.

Scientists have uncovered an extensive underwater vent system near Milos, Greece, hidden along active fault lines beneath the seafloor. These geological fractures act as pathways for hot, gas-rich fluids to escape, forming clusters of vents with striking visual diversity. The discovery surprised researchers, who observed boiling fluids and vibrant microbial mats during deep-sea dives. Milos now stands out as one of the Mediterranean’s most important sites for studying Earth’s dynamic interior.

New research suggests that even light alcohol use may carry serious risks. A large study in India found that drinking just one standard drink a day is linked to a roughly 50% higher risk of mouth cancer, with the greatest danger tied to locally brewed alcohol. When alcohol use overlaps with chewing tobacco, the effect becomes especially severe, potentially explaining nearly two-thirds of all cases nationwide.

A spectacular fossil trove on the Arctic island of Spitsbergen shows that marine life made a stunning comeback after Earth’s greatest extinction. Tens of thousands of fossils reveal fully aquatic reptiles and complex food chains thriving just three million years later. Some predators grew over five meters long, challenging the idea of a slow, step-by-step recovery. The find rewrites the early history of ocean ecosystems.

Environmental change doesn’t affect evolution in a single, predictable way. In large-scale computer simulations, scientists discovered that some fluctuating conditions help populations evolve higher fitness, while others slow or even derail progress. Two populations facing different kinds of change can end up on completely different evolutionary paths. The findings challenge the idea that one population’s response can represent a whole species.

New research shows that women living near Superfund sites are more likely to develop aggressive and metastatic breast cancers. The studies found higher risks for hard-to-treat subtypes like triple-negative breast cancer, especially in areas with greater air pollution. Scientists also discovered molecular tumor changes linked to neighborhood deprivation. The findings point to environmental exposure and social conditions as key factors shaping cancer outcomes.

Cannabis products with higher THC levels may slightly reduce chronic pain, particularly nerve pain, according to a review of multiple clinical trials. The improvement was small and short-lived, while side effects were more common. Products with little or no THC, including CBD-only formulations, showed no clear benefit. Researchers say more long-term studies are needed.

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