A child gets an MMR vaccine at a clinic in Lubbock, Texas, in March 2025. Wisconsin experts say vaccination rates here are lower than they should be to guard against a wider outbreak. (Photo by Jan Sonnenmair/Getty Images)

With three measles cases in three different Wisconsin communities since New Year’s Day, the state could be vulnerable to a larger outbreak, according to public health experts.

“We’ve gotten three cases in the state of Wisconsin so far in 2026, and there’s been many years in which we had zero,” said Dr. Joe McBride, a pediatric infectious disease physician at UW Health Kids and assistant professor of medicine at the University of Wisconsin School of Medicine and Public Health. If the cases spread, “those are incredibly, incredibly difficult for us to slow down and to prevent.”

“There may be only three people with measles, but the cases are occurring in three different places,” said Ajay Sethi, director of the Master of Public Health Program at the UW medical school. “These are three separate public health responses, and that is significant given the potential for spread to others from just one person with measles.”

In January, state health officials reported a measles infection in a Waukesha resident. This month, measles infections have been identified in Dane County and in a person who traveled through Milwaukee County’s Mitchell International Airport to Walworth County. The Wisconsin Department of Health Services has also identified possible locations when other people might have been exposed in the Dane County and Mitchell Airport cases. All three were described as connected to travel. 

“It’s good, in that they don’t seem to be related, and we don’t see an outbreak,” McBride said. “But it’s also bad because that means there’s a lot of measles,” he added. “It’s kind of a tinderbox, and we have large cohorts of our population who are not immune.”

The year 2025 saw a resurgence of measles nationwide, approaching 2,000 cases, Stateline reported in December, with outbreaks in Texas, Arizona, South Carolina, Utah and New Mexico.

Sethi said an August 2025 cluster of cases in Oconto County started with a case in St. Croix County in someone who was visiting from out of state. Across Wisconsin in 2025, “Ultimately 36 people got measles, and two of them needed hospitalization,” he said.

‘Incredibly infectious’ illness

Although most widely known for its trademark rash, the measles virus “is a respiratory virus, just like really any other cough and cold virus that we think about,” said McBride. “However, it’s incredibly, incredibly infectious.”

The virus is airborne, McBride said, and can hang in the air for up to two hours. In one landmark case, at the 1991 Special Olympics at the Minneapolis Metrodome, a participant on the field had measles, McBride said, “and people who were susceptible to the infection got the infection who were sitting in the upper deck.”

Vaccination is the primary tool to stop measles, and in Wisconsin as well as in much of the U.S. vaccination rates are below the 95% that public health practitioners say allows for widespread “herd immunity.”

The measles vaccine is usually given in combination with mumps and rubella vaccines, first at the age of 1 with a booster by the time a child is 5.  

Some people aren’t eligible for the vaccine, either because they’re younger than 6 months old or because they have a compromised immune system due to another illness.

“It’s a live vaccine, and live vaccines have the potential of causing infections in people who are immune-compromised, like bone marrow transplant recipients or a patient with AIDS” or people on medications that suppress the immune system, McBride said.

That makes it even more important for people who are eligible to get the vaccine, public health experts say.

A national map produced by ABC News in collaboration with Boston Children’s Hospital, Harvard Medical School and Icahn School of Medicine at Mount Sinai in New York shows that none of the counties in Wisconsin has as many as 90% of  5-year-olds fully vaccinated for measles.

The lowest rates of measles vaccinations for that age group are in Portage and Columbia counties, with fewer than 60%. A cluster of counties around Oshkosh have vaccination rates in the low 60s; another cluster around Eau Claire in the mid-60s, and Milwaukee, Racine and Waukesha counties have vaccination rates in the high 60s. In the rest of the state, vaccination rates for children 5 or younger are in the range of 70% to more than 80%.

“The decision to get vaccinated is still very nuanced,” Sethi said — influenced by a variety of factors. Those include complacency, which may lead people to dismiss the need for a vaccine, he said. Other factors include how convenient it may be to get the shot, confidence in the vaccine’s effectiveness and a sense of community responsibility.

HHS shift, CDC silence

One source of shakier confidence has been a shift at the U.S. Department of Health and Human Services and the Center for Disease Control and Prevention (CDC), in the agencies’ stance on vaccines under HHS Secretary Robert F. Kennedy Jr., who had a history of anti-vaccine campaigning for years before his appointment.

Kennedy has made some appeals for people to get the measles vaccine, and in an appearance on CNN Sunday, Dr. Mehmet Oz, director of the Centers for Medicare & Medicaid Services, urged viewers, “Take the vaccine, please.”

But researchers at Johns Hopkins University in a report published in December documented that amid the 2025 measles surge, CDC social media accounts “have gone quiet, creating a ‘void’ in online health communication. In this vacuum, measles messaging has been dominated by news media rather than expert health authorities, resulting in polarized and potentially inaccurate information.” 

By the year 2000, measles vaccination had become so widespread that the U.S. was identified as having eliminated the disease. Canada, which also had that status, lost it in 2025, and the U.S. appears to be on the verge of losing it as well, Sethi said.

Yet the measles vaccine is both extraordinarily effective and essentially the only weapon against the virus.

“There isn’t any kind of other medicine that can abort it,” McBride said. “It is completely dependent on either preventing it or having natural infection and supporting the individual through it.”

The infection itself can be extremely serious, however, he said. In addition to fevers, cough and the rash, which is painful, secondary complications can do much more bodily damage. Those can include bacterial infections, pneumonia, vision and neurological damage and cardiovascular system harm as well.

In about one of every 1,000 cases, a delayed neurological condition can arise 10 years after a person is infected “that is completely fatal,” McBride added. Among the hundreds of cases across the U.S. now, “there certainly is somebody who’s walking around today who will be dead of measles in 10 years, who doesn’t know it. And that’s incredibly scary.”

People born before 1957 are more likely to have natural immunity from having been exposed to measles in childhood. “After 1957 we can’t really make that claim for people,” McBride said. “And so our immunity is dependent on vaccine status.”

People living in Wisconsin can look up their immunization status on the Wisconsin Immunization Registry, McBride said. Some people’s records might be incomplete, either because they received a vaccine in another state or because they got a vaccine before 1999, when the registry was launched. Earlier vaccines were logged on paper by health providers, according to the Wisconsin Department of Health Services.

Interest in the MMR vaccine appears to be rising. News reports and public health announcements drawing attention to recent measles cases and the importance of the vaccine “certainly raises new awareness and attention to it,” he said.

More patients are asking about the shot and more doctors and nurses are asking whether there needs to be any changes to the current vaccine schedules recommended by the American Academy of Pediatrics or the state health department.

McBride said the current cases in Wisconsin don’t point to any change in those recommendations, however. For health care providers, “The most helpful interventions would be to evaluate your patients and make sure they are up to date with the measles vaccine.”

Federal agents in fatigues gather in Minneapolis last month. Health care workers in Minnesota and other states say ICE is increasing its presence in health care facilities, deterring people from seeking medical care. (Photo by Nicole Neri/Minnesota Reformer)

Last month, the parents of a 7-year-old girl whose nose wouldn’t stop bleeding took her to Portland Adventist Health in Portland, Oregon, for urgent care. Before the family could get through the doors, federal immigration agents reportedly detained them in the parking lot and took them to a detention center in Texas.

At Hennepin County Medical Center in Minneapolis, workers say U.S. Immigration and Customs Enforcement officers hang around the campus, asking patients and employees for proof of citizenship. Last month, tensions came to a head when ICE agents used handcuffs to shackle a 31-year-old Mexican immigrant to his hospital bed. ICE claimed the man, who had broken bones in his face and a fractured skull, had run headfirst into a wall on purpose while handcuffed and trying to flee.

And last summer, ICE agents chased an immigrant into the Ontario Advanced Surgery Center in Ontario, California, precipitating a confrontation with two surgery center workers wearing scrubs. The two workers were later indicted by a federal grand jury, charged with assaulting and interfering with federal immigration officers.

As the Trump administration intensifies its immigration crackdown, health care workers in multiple states say ICE is increasing its presence in health care facilities, deterring people from seeking medical care and creating chaos that jeopardizes the safety of their patients.

Even before Trump took office last year, Republican-led states such as Florida and Texas began mixing health care and immigration enforcement by requiring hospitals to ask patients about their immigration status. Now that ICE has extended its enforcement activities to hospitals and health care facilities — areas that were largely off-limits during the Biden administration — an increasing number of Democratic-led states are pushing back.

Last month, Massachusetts Democratic Gov. Maura Healey filed legislation “to keep ICE out of courthouses, schools, child care programs, hospitals and churches,” and signed an executive order to limit ICE actions on state-owned property.

In December, Illinois Democratic Gov. JB Pritzker signed a measure that bars health care providers from sharing sensitive health information with federal immigration agents and requires hospitals to develop policies around how they will interact with agents.

And in September, California Democratic Gov. Gavin Newsom signed legislation that makes immigration status and place of birth protected health information, and prohibits agents from entering nonpublic, patient-sensitive areas of health care facilities without a warrant signed by a judge.

Other Democratic states — including Maine, New Jersey, New York, Oregon and Washington — are considering similar bills.

Meanwhile, Republican lawmakers in Arizona are pushing legislation that would require hospitals accepting Medicaid patients to include a question on intake forms about immigration status.

Skipping medical care

Whether or not ICE presence is actually increasing at health care facilities, it’s clear that people living in the country illegally are being deterred from seeking medical care, said Drishti Pillai, director of immigrant health policy at the health policy research group KFF.

A KFF and New York Times survey released last November showed that 43% of respondents identifying as immigrant parents living in the country illegally skipped or delayed health care for their children over a 12-month period because they were concerned about immigration enforcement. Even among lawfully present immigrants,10% said that they avoided seeking medical care for their children due to immigration-related concerns.

Pillai also pointed to the Trump administration’s efforts to consolidate the bits of personal data held across federal agencies, creating a single trove of information on people who live in the United States.

“We are expecting that these fears have further been exacerbated this year since the data sharing agreement was made public, and there are certain concerns around privacy of data going forward,” Pillai told Stateline.

Dr. Paula Latortue, an OB-GYN in Washington, D.C., who volunteers with the Migrant Clinicians Network, a nonprofit group that provides health care to immigrants, said it’s unclear how many people are avoiding health care, and how often.

“The one part that is really hard to know is people who are not showing up to the hospital when they usually would for some sort of urgent or emergency complaint,” Latortue said in an interview. “But I think there’s a concern for many physicians in the community that has happened.”

States step in to protect sensitive locations

The Biden and Obama administrations directed ICE to avoid enforcement activities in “sensitive” places such as hospitals, schools and churches unless it received permission from top leaders at the U.S. Department of Homeland Security.

In January 2025, however, the Trump administration rescinded those guidelines, opening up these spaces to immigration enforcement.

Stateline reached out to the White House and the Department of Homeland Security multiple times but did not receive a response. When the administration changed the guidelines, the Department of Homeland Security said that opening up “sensitive” areas to agents “empowers the brave men and women in CBP [Customs and Border Protection] and ICE to enforce our immigration laws.”

The previous guidelines didn’t prohibit ICE from operating in those locations, but it did “strongly discourage” them, according to Sophia Genovese, a legal fellow specializing in immigration law at Georgetown University.

She added, however, that states and cities can enact laws to protect such spaces, even though they are limited in their capacity to “infringe and engage in immigration lawmaking.”

“Warrants are always needed to conduct searches or investigations in private, nonpublic areas, and these warrants need to be signed by a judge. This is just a basic Fourth Amendment right,” Genovese said. “When it comes to ICE entering hospitals and gaining access to private areas of hospitals, that’s an issue of individual hospital policy.”

Genovese said states also can require that hospitals standardize their policies on where law enforcement agents can go within a medical facility and create protocols to ensure agents are presenting a warrant before entering the premises.

Health care workers want protections

Those moves are exactly what health care workers in many states are asking for.

“There’s a high level of fear and anxiety. Nurses see the videos of what’s happening around the country, and nurses have experienced it themselves,” Peter Starzynski, spokesperson for the Oregon Nurses Association, told Stateline.

Last month’s incident involving the 7-year-old girl and her parents in Portland highlighted the importance of protecting health care spaces from ICE, he said.

“That should never happen. That’s disgusting,” Starzynski said.

The Oregon Nurses Association also has condemned ICE’s presence at Legacy Emanuel Medical Center in Portland, claiming agents are violating hospital policies, including on access to patients. Legacy has disputed the union’s allegations, saying that no ICE officers have entered its facilities “unless accompanying a patient in custody.”

“Nurses in emergency rooms deal with local law enforcement on a regular basis, and those relationships are built on mutual respect, where law enforcement understands what they need to do once they enter a hospital,” Starzynski said. “That has changed with the increase in federal agents in Oregon.”

Stateline reporter Shalina Chatlani can be reached at schatlani@stateline.org.

Roger Williams Medical Center in Providence, R.I. A new study shows that women with breast cancer living in Rhode Island and other states that expanded Medicaid eligibility were less likely to die from the disease. (Photo by Michael Salerno/Rhode Island Current)

Women with breast cancer living in states that expanded Medicaid eligibility were less likely to die from the disease — but not everyone benefited equally, according to a recent study published in the medical journal JAMA Network Open.

Researchers from Howard University, the University of Alabama, Henry Ford Hospital in Michigan, and others looked at data from about 1.6 million women ages 40 to 64 who were diagnosed with breast cancer between 2006 and 2021.

They compared survival rates among women living in states that expanded Medicaid eligibility under the Affordable Care Act, commonly known as Obamacare, with the rates in states that did not expand. About 58% of the women lived in expansion states, and roughly 42% lived in nonexpansion states. States began expanding Medicaid in 2014.

The researchers found that Medicaid expansion was associated with lower overall mortality — no matter the disease stage, race or ethnicity, or neighborhood income of the women. Women in expansion states whose cancer had spread to other organs — the most advanced stage of disease — saw the most significant decline in deaths.

Among racial and ethnic groups, the largest relative gains were among Hispanic women — they were 19% less likely to die if they lived in an expansion state. There were smaller gains among non-Hispanic Black women and residents of low-income areas. The smallest difference was among white women.

Hispanic women’s large gains could be due to many previously lacking insurance, said Dr. Oluwasegun Akinyemi, senior research fellow at the Howard University College of Medicine’s Clive O. Callender Outcomes Research Center and a coauthor of the study.

Black women have higher breast cancer death rates compared to white women, even though there are fewer cases among them, partly because they are often diagnosed with the disease at a later stage.

Overall, Black women with breast cancer benefitted less from Medicaid expansion than other groups because they are disproportionately located in the South, where most states have not expanded, Akinyemi noted. The expansion holdout states include Alabama, Florida, Georgia, Mississippi, South Carolina, Tennessee and Texas.

The remaining three nonexpansion states are Kansas, Wisconsin and Wyoming.

The researchers also compared mortality rates in low- and high-income neighborhoods. Women living in the highest-income neighborhoods, as well as those who received immunotherapy treatment, had lower mortality rates. Akinyemi said that result suggests that coverage leads to greater access to treatment.

In July, President Donald Trump signed a broad tax and spending bill  that will cut federal Medicaid funding by more than $900 billion over the next decade. As a result, about 15 million people may lose Medicaid coverage, according to estimates by the Center on Budget and Policy Priorities.

Editor’s Note: Because of inaccurate information provided to Stateline, an earlier version of this story misstated the position of Dr. Oluwasegun Akinyemi. Stateline reporter Nada Hassanein can be reached at nhassanein@stateline.org.

Robert F. Kennedy Jr. promotes "real food" at a rally in Harrisburg, Penn., last month. Over the next decade, obesity rates across the nation could surge to close to half of U.S. adults, a new study says. (Photo by Whitney Downard/Pennsylvania Capital-Star)

Over the next decade, obesity rates across the nation could surge to close to half of U.S. adults, a new study published in the medical journal JAMA estimates.

Researchers at the University of Washington conducted the analysis using body mass index data from the National Health and Nutrition Examination Survey and self-reported weight data from a national survey of adults ages 20 and older. They examined the 2022 rates and created estimates for 2035 based on current trends. The researchers also looked at race, ethnicity and state-level data, finding wide disparities across states and racial groups.

About a fifth of U.S. adults were living with obesity in 1990. By 2022, the percentage increased to nearly 43%. Obesity was more prevalent in states in the Midwest and South.

If current trends continue, about 47% of U.S. adults will be living with obesity by 2035, according to the researchers. Obesity rates are projected to increase among Americans of all ages and racial groups.

In 2022, non-Hispanic Black women had the highest age-standardized obesity rate, at about 57%, followed by Hispanic women at 49%. Hispanic males, non-Hispanic white males and females, and non-Hispanic Black males had similar rates, ranging from about 40% to nearly 43%.

The study comes amid exploding demand for weight-loss drugs, and as U.S. Health and Human Services Secretary Robert F. Kennedy, Jr. continues to push his Make America Healthy Again campaign.

HHS and the U.S. Department of Agriculture last month made changes to the federal food pyramid, placing a greater emphasis on animal protein, dairy and fats. Like the previous guidelines, the new pyramid discourages the consumption of processed foods, which can cause weight gain.

Despite disparities between men and women and between racial groups, HHS says its nutrition strategy moves away from the “health equity” focus of the Biden administration, in favor of making “the health of all Americans the primary goal.”

For Hispanic people, obesity rates were generally higher in states in the Midwest and the South in 2022, a pattern that is expected to continue through 2035.

In 2022, the obesity rate for Hispanic women was highest in Oklahoma, at about 54%. For Hispanic men, the rate was highest in Indiana, at roughly 47%. In 2035, Indiana is projected to have the highest rate of obesity among Hispanic men at about 54%, while the highest rate for Hispanic women, nearly 60%, is expected to be in South Dakota.

The Midwest and South also had high rates of obesity for non-Hispanic white men and women. In 2022, West Virginia had the highest obesity rates for white men and women — about 47% and 49%, respectively. In 2022, obesity rates for white men and women were lowest in the District of Columbia, at roughly 24% for men and 26% for women.

Among Black women, obesity rates were over 50% for all states, except Hawaii, in 2022. That pattern is expected to continue through 2035. Black men have lower obesity rates than Black women across all states. In 2022, the highest obesity rate for Black men was in Oklahoma, at about 44%. That rate projected to rise to 49% in 2035.

“While no locations were predicted to have decreases in obesity prevalence between 2022 and 2035, there were many with small increases over this time,” the authors wrote. They pointed to Mississippi, where Black women had the highest obesity rates between 1990 and 2022, but are projected to see one of the smallest changes — an increase of about 1.8% — by 2035.

“Predictions in states with historically high levels of obesity, such as Mississippi, suggest that the prevalence of obesity may be plateauing in some locations,” the researchers wrote.

Stateline reporter Nada Hassanein can be reached at nhassanein@stateline.org.

U.S. Secretary of Health and Human Services Robert F. Kennedy Jr. speaks during a policy announcement event at the U.S. Department of Health and Human Services on Jan. 8, 2026 in Washington, DC.  (Photo by Anna Moneymaker/Getty Images)

WASHINGTON — Congress has approved the first public health funding bill since President Donald Trump began his second term, with lawmakers largely rejecting his proposed spending cuts and the elimination of dozens of programs. 

A bipartisan group of negotiators instead struck a deal to increase funding on several line items within the Department of Health and Human Services’ annual appropriations bill, including for major initiatives at the National Institutes of Health and the Centers for Disease Control and Prevention. 

“When you look at the differences between what was proposed and what was agreed to, it is astonishing,” House Appropriations Committee ranking member Rosa DeLauro, D-Conn., said during a hearing on the bill in late January.

The Trump administration’s budget request, released in May, called on Congress to cut funding for the Department of Health and Human Services by $33 billion, or 26.2%.

The president asked lawmakers to implement an $18 billion funding cut to the NIH, which he argued would bring the agency in line with the Make America Healthy Again agenda. 

The Trump administration proposed a $3.6 billion cut for CDC programs, including the elimination of the National Center for Chronic Diseases Prevention and Health Promotion, National Center for Injury Prevention and Control, and Public Health Preparedness and Response, all of which it said could “be conducted more effectively by States.”

The budget request said more than $1 billion should be cut from the Substance Abuse and Mental Health Services Administration, though it said the administration was “committed to combatting the scourge of deadly drugs that have ravaged American communities.”

Trump also requested lawmakers zero out any funding for the Low Income Home Energy Assistance Program, or LIHEAP, which he deemed “unnecessary.” The federal program helps millions of low-income households meet their home energy needs, via states and tribes.

The final spending bill Congress approved rejected nearly all of the major cuts. 

Collins, Murray both praise final product

Senate Appropriations Committee Chairwoman Susan Collins, R-Maine, said the bills “reflect months of hard work and deliberation and contributions from members of both parties and on both sides of the Capitol.”

“Funding for NIH is not decreased, as was proposed in the administration’s budget,” she said. “Rather, it is increased by $415 million, including increases of $100 million for Alzheimer’s research and $10 million more for diabetes research, with a focus on type 1 diabetes.” 

Collins also touted an increase in “funding for low-income heating assistance, which is absolutely crucial for states like Maine and is an issue that I have worked for years on with my Democratic colleague Jack Reed of Rhode Island.”

Senate Appropriations Committee ranking member Patty Murray, D-Wash., said the difference between Trump’s budget request and the final bills was like the difference between “night and day.”

“Our bill rejects President Trump’s asks to rubber stamp his public health sabotage,” she said. “Instead, it doubles down on lifesaving public health investments. It rejects Trump’s efforts to slash opioid response funds. It rejects his proposal to chop the CDC in half. It rejects his call to end programs like title X, the teen pregnancy program, essential HIV initiatives, and more.” 

Rare bipartisan agreement in Trump’s second term

Senators from both political parties indicated last summer they weren’t fully on board with Trump’s budget proposal and used a hearing with HHS Secretary Robert F. Kennedy Jr. in May and a separate hearing with NIH Director Jay Bhattacharya in June to highlight their concerns. 

The Senate Appropriations Committee approved its HHS spending bill on a broadly bipartisan vote in July, while the House Appropriations Committee approved its funding bill in September without any Democratic support.

Neither of the original bills went to the floor for debate and amendment votes, though negotiations to find compromise on a final bill began late last year after the record-breaking government shutdown ended in November. 

Republicans and Democrats brokered a final agreement on the HHS funding bill in late January, the first time bipartisan agreement was reached during Trump’s second term. 

Congress previously approved a series of stopgap spending bills to keep HHS up and running, mostly on funding levels and policies last set during the Biden administration. 

The House originally voted on Jan. 22 to send the package that included funding for HHS to the Senate. But it stalled after federal immigration agents shot and killed a second U.S. citizen in Minnesota and Democrats demanded changes to the spending bill for the Department of Homeland Security. 

The Senate voted 71-29 on Jan. 30 to send the package back to the House after removing the full-year DHS spending bill and replacing it with a two-week stopgap. The House then voted 217-214 on Tuesday to clear the package for Trump, who signed it later in the day, ending a four-day partial government shutdown.  

The package also holds funding for the departments of Defense, Education, Housing and Urban Development, Labor, State, Transportation and Treasury. 

‘Months of hard work turned into results’

House Appropriations Chairman Tom Cole, R-Okla., said during floor debate last month the process that led to the final bills proved lawmakers “can make tough decisions.”

“This is where months of hard work turned into results,” Cole said. “You see, we aren’t here for just another stopgap temporary fix. We’re here to finish the job by providing full-year funding and specifically this package addresses core areas of national consequence — defense; labor, health and education; and transportation and housing development.”

Congress is supposed to pass the dozen full-year appropriations bills by the start of the fiscal year on Oct. 1, though it hasn’t completed all of its work on time in decades. 

Last fiscal year, it didn’t complete its work at all, making March 2024 the last time Congress approved all of the funding bills. 

Cole said during debate the programs funded “aren’t abstract concepts on a page, they affect how Americans live, work, learn and travel every day.”

DeLauro said the package of bills represents “a strong bipartisan, bicameral agreement that rejects the Trump administration’s efforts to eviscerate public services and reasserts Congress’ power of the purse.”

“It provides funding levels, removing ambiguity that the White House sought to exploit in the past,” DeLauro said. “It establishes deadlines for required spending, provides minimum staffing thresholds to prevent agencies from being hollowed out and increases notification requirements to ensure the administration is complying with the laws that Congress makes.” 

HHS ends up with $210 million bump

The bill provides HHS with more than $116 billion, $210 million more in discretionary funding than the previous level and a rejection of Trump’s request to cut $33 billion, according to a summary from Murray’s office. 

NIH will receive $48.7 billion in funding, $415 million more than its current spending level, showing that lawmakers were unwilling to slice its budget by $18 billion as requested. 

Congress bolstered funding for the Substance Abuse and Mental Health Services Administration by $65 million to a total of $7.4 billion, according to Murray’s summary. Trump asked lawmakers to reduce its allocation by more than $1 billion. 

A $3.6 billion funding cut for the CDC was also rejected, with appropriators agreeing to provide the Atlanta-based agency with $9.2 billion.

A summary of the bill from DeLauro’s office says negotiators were able to keep funding for domestic and global HIV/AIDS activities, Firearm Injury and Mortality Prevention Research and Tobacco Prevention and Control, among other programs that House Republicans originally proposed to zero out. 

The legislation bolstered, instead of eliminated, funding for the Low Income Energy Assistance Program, or LIHEAP, according to a summary from Cole’s office. 

The bill, it said, “reprioritizes taxpayer dollars where they matter most: into lifesaving biomedical research and resilient medical supply chains, classrooms and technical programs that set Americans up for success, and rural hospitals and primary health care to support strong and healthy families.”

CDC program axed

The legislation does eliminate the CDC’s Social Determinants of Health program, which the agency’s website states are “nonmedical factors that influence health outcomes.” Those can include whether a person has access to clean air and water, a well-balanced diet, exercise, a good education, career opportunities, economic stability and a safe place to live.

HHS’ Office of Disease Prevention and Health Promotion writes that “people who don’t have access to grocery stores with healthy foods are less likely to have good nutrition. That raises their risk of health conditions like heart disease, diabetes, and obesity — and even lowers life expectancy relative to people who do have access to healthy foods.” 

Cole’s summary of the HHS spending bill says that program “promoted social engineering while distracting grant recipients from combating infectious and chronic diseases.” 

The American Public Health Association urged Congress to approve the bill, writing in a statement the compromise “rightly maintains funding for most public health agencies and programs.”

“While the bill is not perfect and we disagree with cuts to several HHS agency programs included, overall, the agreement rejects the devastating cuts and nonsensical agency reorganizations proposed by the Trump administration and is a positive outcome,” APHA wrote. “Importantly, the bill also includes language to ensure that CDC and other health agencies maintain an adequate level of staffing to carry out their statutory responsibilities. 

“The bill will also ensure that Congress exercises its oversight over any future proposed agency reorganizations.”

Rep. Lisa Subeck (D-Madison) is proposing that Wisconsin require crisis pregnancy centers to get express written permission before releasing a person’s private health information. (Photo by Baylor Spears/Wisconsin Examiner)

Rep. Lisa Subeck (D-Madison) is proposing that Wisconsin require crisis pregnancy centers to get express written permission before releasing a person’s private health information. Those who have given permission would also be able to withdraw their permission at any time under the bill. 

“Many people assume that when they seek care for pregnancy or other reproductive health services that that information is protected, just like any other medical records under HIPAA, and while that is true at your doctor’s office or at the hospital, it’s not always true when you visit other providers,” Subeck said at a press conference Thursday.

Concerns about information being gathered about women’s reproductive health, including by crisis pregnancy centers, have surged in the years since Roe v. Wade was overturned by the U.S. Supreme Court, especially in states where abortion has been criminalized. 

A 2022 TIME Magazine report found that crisis pregnancy centers have been collecting information including sexual and reproductive histories, test results, ultrasound photos, and information shared during consultations, parenting classes, or counseling sessions, from women they interact with through telephone and online chats. They are not required to follow federal health data privacy laws. The report led to U.S. Sen. Elizabeth Warren requesting an examination of the practices by crisis pregnancy centers.

The bill, coauthored by Sen. LaTonya Johnson (D-Milwaukee), would also require centers to disclose in “plain language” that they are not a HIPAA-covered entity for the purpose of federal privacy regulations as well as disclosing any data breach that exposes individual digital health information.

Subeck said the centers can “look and feel an awful lot like a traditional medical clinic,” noting that they might offer ultrasounds, pregnancy tests and claim to have counselors on staff. However, she said “many of these centers are not licensed medical providers, and therefore they are not covered by HIPAA privacy protections.”

Subeck said that changes in reproductive health laws have raised concerns about the misuse of health related information and data. She said the bill would not close unregulated pregnancy centers, limit the services they can provide or limit speech. Rather, she said, it “simply sets some basic privacy expectations and protections for unsuspecting individuals.”

Subeck noted that lawmakers in other states, including Pennsylvania, have introduced similar measures, though none have become law.

Subeck said the violations of the provisions in the bill would be treated as “unfair and deceptive practices” under existing state law.

Laura Hanks, an OB-GYN and legislative chair for American College of Obstetricians and Gynecologists, said at the press conference that the bill shouldn’t be political.

“It’s about privacy, honesty and safe, medically accurate care. Unregulated pregnancy centers often look like clinics, but they aren’t held to the basic medical privacy rules,” Hanks said. “This means they lack regulation, medical oversight or standard confidentiality rules. Too many people are walking in and assuming their health care information is protected when it isn’t. This bill sets commonsense guardrails.”

The headline on this report has been revised for clarity. 

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A sign at a University of Utah health clinic warns visitors about the spread of measles. Under the Trump administration, federal health officials have cut back the number of recommended vaccines, and more states are offering exemptions for parents who don't want to vaccinate children entering public schools. (Photo by McKenzie Romero/Utah News Dispatch)

States that were leaders in childhood vaccination before the pandemic are among those losing ground as exemptions and unfounded skepticism take hold, encouraged by the Trump administration’s stance under U.S. Health and Human Services Secretary Robert F. Kennedy Jr.

Expanded exemptions for parents are likely to drop both Mississippi and West Virginia from the top national rankings they held before the pandemic, according to a Stateline analysis of federal data. Other states like Florida, Idaho, Louisiana and Montana also are pushing the envelope on vaccine choice.

At least 33 states were below herd immunity in the 2024-25 school year, compared with 28 states before the pandemic in 2018-2019, the analysis found. Herd immunity refers to the percentage of people who must be vaccinated or otherwise immune from an infectious disease to limit its spread.

Research shows that in the case of measles — a highly contagious disease — states need to maintain at least 95% vaccination rates to protect people who can’t get vaccinated. Other diseases have similar herd immunity rates. People who can’t be vaccinated might include infants too young to receive certain vaccines and those with underlying health conditions.

Misinformation and expressions of distrust from influential leaders have an effect on parents, doctors say, as do new state exemptions making it easier for families to avoid the vaccines.

Some people who never questioned vaccines before notice a national debate and get confused, said Dr. Patricia Tibbs, a pediatrician in rural Mississippi and president of the Mississippi chapter of the American Academy of Pediatrics. New religious exemptions may already be fueling an increase in pertussis, also known as whooping cough, in Mississippi, she said.

“If they hear something about it in the news, then it must be right, they think,” Tibbs said. “We’re just following the guidelines and informing patients that this is a scientific discussion. Nothing has changed about the science. But people who don’t know science are making decisions.”

Under Kennedy’s leadership, federal support for vaccination has continued to slide, and many states have joined a movement to set their own course by following more science-based recommendations from doctors. On Jan. 26 the Governors Public Health Alliance, a group of 15 Democratic governors, endorsed child and adolescent vaccination standards from the American Academy of Pediatrics rather than the federal government.

Federal health officials in Trump’s administration have cut back the number of recommended vaccines. The chair of a vaccine advisory committee, pediatric cardiologist Kirk Milhoan, suggested in a Jan. 22 podcast that individual freedom was more important than protecting community health with vaccines, even for measles and polio.

New leading states

Before the pandemic, Mississippi and West Virginia had the highest kindergarten vaccination rates in the nation, according to the Stateline analysis. About 99% of kindergartners in each state had their required vaccinations before entering public schools in the 2018-2019 school year.

In the latest statistics for the 2024-25 year, Connecticut gained the No. 1 spot, followed by New York and Maine. Those states have reined in exemptions to school vaccine requirements, while Mississippi and West Virginia have begun to allow more exemptions.

West Virginia didn’t report vaccinations to the federal Centers for Disease Control and Prevention for the 2024-25 school year. The state department of health told Stateline the data wouldn’t be available until later this year.

But the state is likely to be pushed out of the top 10. Republican Gov. Patrick Morrisey issued an executive order a year ago giving parents the right to ask for religious exemptions. To date, the state has approved 693 such requests for the current school year, spokesperson Gailyn Markham wrote in an email. That alone is enough to shift the state’s ranking significantly.

Stateline computed an average of required kindergarten vaccination rates to compare states. The analysis uses 2018-19 as a pre-pandemic baseline because a large number of states did not report the information in 2019-20 in the chaos that followed the early COVID-19 spikes and school closings.

A January study published by JAMA Pediatrics found increased vaccination rates among kindergartners in states that had repealed nonmedical exemptions, suggesting the repeals “played a role in maintaining vaccination coverage in repeal states during a period of heightened vaccine hesitancy.”

Requirements and exemptions

All 50 states and the District of Columbia require students to have certain vaccines before attending public school. They also all allow exemptions for children who cannot receive vaccinations for medical reasons, and most states allow nonmedical exemptions, often for religious or sometimes personal reasons. But Florida Republican Gov. Ron DeSantis’ administration has proposed dropping all requirements, and Idaho enacted a 2025 law allowing vaccination exemptions for any reason. Idaho had the lowest rate of kindergarten vaccination, about 80% in the 2024-25 school year before the law took effect in July last year.

Louisiana in 2024 enacted a law dropping COVID-19 vaccine requirements for public schools, and the state has opted to halt publicity about flu vaccination and end public vaccine clinics.

A Florida bill that progressed out of committee in January would maintain school vaccine requirements but expand exemptions to include “conscience” as well as medical and religious reasons.

Dr. Jennifer Takagishi, a Tampa pediatrician and vice president of the Florida chapter of the American Academy of Pediatrics, said the organization opposes both the DeSantis administration proposal to revoke vaccine requirements and the bill that would expand exemptions. Florida’s kindergarten vaccination rate fell from 94% before the pandemic to about 90% in 2024-25, according to the Stateline analysis.

“They’re ignoring the 90% of their constituents who want vaccines and want to stay safe,” said Takagishi. “The legislators are listening to the louder voice of those who want to oppose vaccines instead of the majority. We also know that there are teachers in the school system and school nurses who are fighting this because it puts them at risk.”

All states except Montana report kindergarten vaccine statistics to the federal government. Montana enacted a 2021 law making vaccine status private and unavailable for statistical reports, over the objections of medical experts. The law also made medical exemptions easier for families who think their children have been injured by vaccines.

Dr. Lauren Wilson, a pediatrician and then-vice president of the Montana chapter of the American Association of Pediatrics, said in a hearing that the law would make “vaccination information unavailable for responding to and mitigating public health emergencies.”

“Vaccines have saved millions of lives. I personally have seen cases of tetanus, pertussis, measles and meningitis and the tragedies that these mean for families,” Wilson said in her testimony.

A 2023 court order forced Mississippi to accept religious exemptions. West Virginia allows religious exemptions following the governor’s order last year.

Tibbs, who practices pediatrics in rural Jones County, Mississippi, said she has been seeing more pertussis than usual, and thinks vaccine exemptions could be a factor.

In Mississippi, which reported 394 religious exemptions for the 2024-25 school year, overall rates remained high enough that year, at about 97.8%, to ensure “herd immunity” in most cases.

Mississippi has granted 617 religious vaccination exemptions for kindergartners this school year, about 1.8% of the class, according to Amanda Netadj, immunizations director for the state health department. About 96.3% of kindergartners have all required vaccinations this year.

But the state’s whooping cough cases last year were the highest they’d been in at least decade, and in September health officials announced an infant had died of the disease — the state’s first whooping cough death in 13 years.

“We do have a lot of people getting the religious exemption,” Tibbs said. ”But still, on any given day, the majority of my patients will still get their vaccines. We are keeping our fingers crossed that the numbers stay high enough.”

Stateline reporter Tim Henderson can be reached at thenderson@stateline.org.

The number of people enrolling in health plans through the Affordable Care Act's HealthCare.gov website has fallen in 2026, according to the federal government. (Getty Images)

After a record number of Wisconsin residents signed up for health insurance through the federal health care marketplace in 2025,  enrollment for 2026 is down by 7%, according to the federal government.

Enrollment could fall farther, if people who have signed up decide they can’t afford the cost when the first bill for insurance arrives, an independent analyst warns.

Health insurance — whether purchased through the federal marketplace or elsewhere — is costing people more in 2026. The price of plans purchased through the HealthCare.gov marketplace has gone up. In addition, enhanced federal tax subsidies that became available in 2021 and dramatically lowered the cost for most marketplace customers have expired.

The Affordable Care Act, enacted in 2010, created HealthCare.gov to help reduce the number of Americans without health insurance. The marketplace was designed to make it easier and more affordable for people without health coverage through an employer or through government programs to purchase a health plan for themselves and their families.

After enhanced tax-credit-based subsidies were enacted in 2021, enrollment through the marketplace began setting new records each year, nationally and in Wisconsin. Several efforts by Democrats in Congress last year to extend the subsidies past their Dec. 31, 2025, expiration date failed when the Republican majorities in both houses of Congress declined to take up the proposals.

Legislation that would revive the enhanced subsidies for another three years has now passed the U.S. House, but its future in the U.S. Senate remains uncertain.

“Without the subsidies — that’s what makes it really affordable — many small business owners and others would not have access to health care,” U.S. Rep. Mark Pocan (D-Black Earth) said during a media call in January with Protect Our Care and Main Street Alliance.

Protect Our Care campaigns for preserving and improving the Affordable Care Act and other federal health care programs. Main Street Alliance is a small business organizing group that supports the ACA along with the act’s provision to expand Medicaid by raising the income cap to 138% of the federal poverty guideline.

“We need to keep the Affordable Care Act in place, and the only way you keep it in place so it’s affordable for small business owners and many others is by having those credits,” Pocan said.

Data released last week by the Centers for Medicare & Medicaid Services showed that 291,336 Wisconsin residents had enrolled in plans through HealthCare.gov by Jan. 15, the final open enrollment deadline. That is about 7.1% below 2025 enrollment of 313,579 for the state.

Nationally, 2026 enrollment fell by 1.3 million from 2025, a drop of more than 5%.

Difficult choices for HealthCare.gov customers

For Sydney Badeau, an advocate for people with disabilities, affordable insurance through HealthCare.gov made it possible for her to work part-time for two different Wisconsin advocacy groups. In 2026, that has changed.

Badeau calculated that her 2026 premium would cost her around $450 a month — more than she could afford. She told the Wisconsin Examiner she was able to shift her work arrangement, taking a full-time position with one of her employers, The Arc Wisconsin, which now provides her health benefits, while remaining as a part-timer for her other employer, People First Wisconsin.

Most health plans sold at HealthCare.gov are classified Gold, Silver or Bronze based on a combination of their coverage, premium cost and the out-of-pocket costs that patients incur.

Nancy Peske, a Milwaukee-area freelance writer, editor and consultant, said she has always purchased a bronze plan with a $7,500 deductible. Thanks to the enhanced subsidy, her insurance cost her $370 a month in 2025, she said, instead of about $900 a month.

For 2026, her premium has risen to $1,164 a month — with no subsidy any more.

Peske has stopped contributing to her retirement account. “It will probably push back retirement for a couple of years for me,” she said.

Amanda Sherman, a Mequon real estate broker’s assistant, purchased a mid-level Silver plan in 2025 with a $7,500 deductible. Enhanced subsidies reduced her monthly premium by about $250, to $222 a month.

The health plan also helped cover some expensive medications for her complex autoimmune disorder, Sherman said.  

For 2026 she wound up with a Bronze plan that has a $9,500 deductible. Although she no longer has an enhanced subsidy, she does qualify for a smaller subsidy that still exists, of about $185 dollars — lowering her premium that would have been $538 a month to $353 a month — $120 more than she was paying in 2025.

When she went to enroll for 2026, Sherman’s previous insurer had left the HealthCare.gov marketplace where she lived. In picking a replacement plan, she said, she found herself having to choose between an option with better coverage for her medications — or one that included the same providers and specialists she had grown to trust.

Making that choice was a struggle, but keeping that care team was important, she decided. “I feel like that’s invaluable,” Sherman said.

Enrollment could fall off further

Nationally and in Wisconsin, the total HealthCare.gov enrollment numbers could still shrink further, according to Charles Gaba, an independent researcher who monitors enrollment and coverage under the Affordable Care Act.

In addition to monitoring open enrollment data at his website, acasignups.net, Gaba regularly posts information on a number of other data points. One of those is “effectuated enrollment” — active coverage for which the person enrolling has paid the monthly premium. Effectuated enrollment data lags by several months.

In a post Jan. 29, Gaba wrote that “it’s important to remember that up to 10 MILLION of the [approximately] 19.6M enrollees who re-enrolled did so by passively auto-renewing, which means millions of them received massive sticker shock when they received their January invoice.”

Gaba told the Wisconsin Examiner that for Wisconsin — which uses the federal HealthCare.gov marketplace rather than standing up its own state marketplace — the first batch of effectuated enrollment data might not be available until July at the earliest.

In the Jan. 29 post, however, Gaba wrote that in states with their own marketplaces, “at least a half-dozen of the state-based exchanges have warned that they’re already seeing much higher cancellations than they usually do, and that they expect this trend to continue as people are no longer able to keep up with the dramatically higher premium payments.”

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• Federal immigration officials could gain access to sensitive Medicaid data — but not yet. A judge has temporarily limited what information the Department of Homeland Security can access in states, like Wisconsin, that are suing to block a data-sharing agreement. 

• Advocates warn the data-sharing risks chilling health care access — potentially even discouraging some from enrolling in programs for which they’re eligible. 

• Undocumented immigrants are categorically ineligible for full Medicaid, but two narrower options exist. In Wisconsin, emergency care and prenatal coverage are available regardless of immigration status, covering about 3,200 people as of late 2025.

• State Republicans unsuccessfully sought to ban any public funding for health care for people without legal immigration status, citing rising Medicaid costs. Gov. Tony Evers vetoed the proposal, arguing it would create confusion and solve problems that don’t exist.

Can federal immigration officials access personal data on every Wisconsinite enrolled in Medicaid? 

Not for now, but the question is winding its way through federal courts.  

The U.S. Department of Health and Human Services last summer signed an agreement with the Department of Homeland Security to give immigration enforcement officers broad access to Medicaid data, which includes names, addresses, claim information and banking details. Trump administration officials claim the agreement is needed “to ensure that Medicaid benefits are reserved for individuals who are lawfully entitled to receive them.”

Wisconsin joined 21 other states in a lawsuit challenging the agreement last year. 

“Millions of individuals’ health information was transferred without their consent,” the lawsuit argues. “In doing so, the Trump administration silently destroyed longstanding guardrails that protected the public’s sensitive health data.” 

In December, a federal judge in California ordered that, in states involved in the lawsuit, DHS can only access the names and contact information of undocumented immigrants in states involved in the lawsuit. 

But patient advocates say it’s unclear how the agency could separate the records of undocumented immigrants from those of immigrants with legal status.

“The sharing of data is dangerous for all of us at the end of the day,” said Esther Reyes, movement-building director with the national advocacy group Protecting Immigrant Families. 

How does immigration status affect eligibility for Medicaid and other health programs? 

Federal law bars undocumented immigrants and many other recent immigrants from receiving full-benefits Medicaid coverage. Most legal permanent residents and new arrivals with legal status become eligible for full Medicaid coverage only after five years in the U.S. A list of exceptions to that rule shrank last year when President Trump signed his trademark “big beautiful bill” into law. 

But the White House claims many undocumented immigrants still access Medicaid benefits, largely citing state-funded health care programs — including a now-shuttered program in Illinois — that provided coverage for undocumented adults. While those programs must operate without federal dollars to avoid running afoul of federal law, the Trump administration argues a tax “loophole”, which it moved to close last week, made them possible.

Medicaid rules make one exception for immigrants ineligible for full coverage: Under federal law, hospitals must provide emergency care for any uninsured patient. Emergency Medicaid coverage can reimburse hospitals for those costs, meaning people of any legal status can receive temporary coverage in dire circumstances — though receiving that emergency coverage is not guaranteed.

“Emergency Medicaid is exclusively available when you go to the emergency room if you don’t qualify for Medicaid because of your immigration status, and it covers services that states by law are required to cover — life or death situations,” Reyes said.

Absent that reimbursement, hospitals may distribute the costs of emergency care for people without insurance across other patients. 

Some states also rely on the federal Children’s Health Insurance Program, which is separate from Medicaid, to cover prenatal care for pregnant patients regardless of immigration status. 

How do those programs work in Wisconsin, and how much do they cost?

In Wisconsin, those two options are called Medicaid Emergency Services and BadgerCare Plus Prenatal, respectively. The prenatal program is open both to immigrants ineligible for other coverage and to pregnant inmates in Wisconsin’s prisons and jails.

Immigrant patients can receive emergency services coverage until their “condition is no longer considered an emergency,” according to state guidelines. Patients enrolled in the prenatal plan remain covered through their pregnancy, though many then become eligible for two months of emergency care coverage.

Roughly 3,200 people were enrolled in the two programs combined in October 2025, according to Wisconsin’s Department of Health Services’ data. That marked the programs’ lowest monthly enrollment since the start of the COVID-19 pandemic.

The state paused reviews of Medicaid recipients’ eligibility during the pandemic, allowing some enrollees in the emergency services and prenatal programs to remain insured beyond the standard cutoff, but enrollment plummeted after Wisconsin DHS resumed reviews in June 2023 in a process often called the “unwinding.”

Not all patients enrolled in the programs are undocumented, and Wisconsin DHS records do not break down enrollment by legal status.

Spending on the two programs dipped from about $60 million in fiscal year 2024 to about $57 million in 2025 — less than 0.4% of the state’s overall medical assistance spending that year.

Why did Wisconsin Republicans try to block state-funded health care for undocumented immigrants last year?

The Republican-controlled Legislature voted last year to bar Wisconsin agencies and local governments from funding any form of health services for undocumented immigrants. 

Rep. Alex Dallman, R-Markesan, one of the bill’s co-sponsors, pointed to Illinois’ expansion of health coverage to some undocumented adults as reason for Wisconsin to preemptively block any similar expansion; the Illinois program’s costs consistently exceeded projections, prompting the state to end the program last year.

“We’re in such a deficit on Medicaid already that it’s hard to keep up as it is,” he told Wisconsin Watch. Wisconsin is on track to overspend its Medicaid budget by $213 million by the end of the current budget cycle, state DHS Secretary-designee Kirsten Johnson wrote in a letter to state lawmakers at the end of December.

Dallman noted that the bill made an exception for health care spending required under federal law. “If they go to the emergency room, they are still going to get emergency care,” he said. As he understood it, Dallman said, that language in the bill would have shielded emergency Medicaid.

But opponents say it isn’t clear that Wisconsin’s emergency services program would have been left untouched. Some also argue that the proposal could also require immigration status checks to access any form of subsidized health care, spanning far beyond hospitals alone.

“If a child is at school and they’re sick… does the school nurse need to figure out how to verify their status before they provide health care?” asked William Parke-Sutherland, government affairs director of Kids Forward, which advocates for low-income and minority families.  

“It would have affected health care services for people if they are in need of emergency services like EMTs,” he added. “We have a primarily county-based crisis mental health system — I think that this would have applied to those as well.”

Gov. Tony Evers vetoed the bill in December, arguing that it sought to solve problems that “do not exist.” 

Could sharing Medicaid data deter patients from seeking health care?

Health outreach workers warn that giving federal immigration officials access to even some Medicaid patient data could discourage people from enrolling in programs for which they are eligible — including U.S. citizens.

The database shared with immigration authorities, called the Transformed Medicaid Statistical Information System, doesn’t clearly distinguish between undocumented immigrants and immigrants with legal status who are ineligible for full-coverage Medicaid for various reasons.

In December, U.S. District Court Judge Vince Chhabria of northern California ruled that immigration authorities may access data only on undocumented immigrants — and only if it can be separated from data on citizens and eligible immigrants. 

It’s still unclear whether officials can do that.

Regardless, the data-sharing agreement alone is enough to make many immigrants — and some citizens with immigrant family members — “think twice about whether they actually access programs like Medicaid,” Reyes said.

But health care navigators say skipping coverage can be far riskier than the potential for their address to land in the hands of immigration enforcement officers.

“You’re protecting the life of your child — and yours” by enrolling in the prenatal program, said Francisco Guerrero, a health coverage navigator with the Wisconsin Institute for Public Policy and Service.

For now, advocates are urging people to be cautious when deciding whether to drop their coverage. If people are already enrolled in the emergency or prenatal programs and haven’t changed their address, leaving the program won’t wipe their information from the database, Reyes said. U.S. citizens don’t have to disclose the immigration status of anyone in their household, she added, and immigrant parents enrolling U.S.-born children do not need to share their own legal status.

“We want people to make informed decisions and understand the risks,” Reyes said. “We understand, though, that it’s really critical to get the care that you need for yourself and for your children.”

Can immigration officials access your Medicaid data? What it means for Wisconsin patients 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.

A Planned Parenthood clinic in Salt Lake City on Wednesday, July 31, 2024. (Photo by McKenzie Romero/Utah News Dispatch)

WASHINGTON — A federal judge on Monday closed the lawsuit Planned Parenthood filed last summer after Republicans’ “big, beautiful” law blocked Medicaid patients from visiting its clinics for any health care appointments for one year. 

Planned Parenthood filed notice with the court Friday that it had dismissed “without prejudice all claims against” the Trump administration in the case. Massachusetts District Court Judge Indira Talwani issued an electronic order Monday closing the case “Pursuant to Plaintiffs’ Notice of Voluntary Dismissal without Prejudice.”

The law prevents people on Medicaid from being seen at Planned Parenthood facilities through early July, when the one-year period would expire.

Planned Parenthood Federation of America President and CEO Alexis McGill Johnson wrote in a statement released last week that President Donald Trump “and his allies in Congress have weaponized the federal government to target Planned Parenthood at the expense of patients —  stripping people of the care they rely on. 

“Through every attack, Planned Parenthood has never lost sight of its focus: ensuring patients can get the care they need from the provider they trust. That will never change. Care continues, as does our commitment to fighting for everyone’s freedom to make their own decisions about their bodies, lives, and futures.”

The Department of Justice did not immediately respond to a request for comment from States Newsroom. 

Talwani originally ruled for Planned Parenthood in the case, temporarily blocking the defunding provision from taking effect. But an appeals court later overturned that decision, allowing the Trump administration to legally withhold Medicaid funding from going to Planned Parenthood. 

Talwani was nominated by former President Barack Obama.

The provision in Republicans’ “big, beautiful” law that blocks all Medicaid funding from going to Planned Parenthood was originally slated to last for a decade, but the final version covered one year. 

Federal law for decades has barred spending from covering abortions with limited exceptions for rape, incest, or the woman’s life. 

So the new language prevented Medicaid patients from scheduling appointments at Planned Parenthood for other types of health care, like annual physicals, cancer screenings, or birth control appointments. 

Shireen Ghorbani, president and CEO of Planned Parenthood Association of Utah, which filed the lawsuit along with Planned Parenthood League of Massachusetts and Planned Parenthood Federation of America, wrote in a statement that its health care providers would “continue to see patients and deliver on our mission to provide high-quality care and education to everyone who needs it, no matter where they live or how much money they make.” 

A Planned Parenthood spokesperson, who did not want to comment on the record, said that certain clinics may choose to cover the cost of treating Medicaid patients, even though the clinic will not receive reimbursement from the federal government under the law. 

Angela Vasquez-Giroux, vice president of communications at Planned Parenthood Federation of America, wrote in a statement that the organization’s “health centers initially shielded the overwhelming majority of patients who rely on Medicaid from the harm of this cruel law. Unfortunately, the consequences for patients will worsen considerably over time as health centers close, costs rise, and access to their trusted provider is pushed further out of reach.”

Wisconsin health officials have confirmed the first measles case in the state in 2026. (Photo by George Frey/Getty Images)

Wisconsin’s first case of measles in 2026 was confirmed this week in a Waukesha resident, state health officials have reported.

The Wisconsin Department of Health Services (DHS) reported that the individual’s illness was “related to international travel.” Citing privacy concerns, the department withheld all other information, including demographic information about the patient and whether or not the individual was vaccinated.

DHS and the Waukesha County Health and Human Services department are working to identify and notify people who might have been exposed to the individual. DHS reported that no public places where others might have been exposed have been identified.

The illness was the first confirmed case of measles in Wisconsin for 2026, according to DHS, and was confirmed by the Wisconsin State Laboratory of Hygiene. 

The department is urging state residents to get a measles vaccination if they haven’t done so already.

A report in mid-December from the federal Centers for Disease Control and Prevention found there had been 1,958 confirmed cases of measles in 43 states last year through Dec. 16, and a sharp increase in December raised concerns for holiday travelers, Stateline reported.

State health officials are urging Wisconsin residents to check their vaccination status “to make sure they are protected from measles.” The department is advising people with winter vacation plans to check measles activity in the places they plan to visit and confirm that they and any traveling companions are up to date on needed vaccines.

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In Walworth County, Wisconsin, a grassroots effort is reimagining what care can look like across generations. A local community group has launched the “Nursery to Nursing Home” campaign, a proposal to transform a vacant wing of the county’s nursing home into a combined child care center and living space for older adults, addressing caregiving shortages.

“Some of the issues we’ve seen as top concerns in Walworth County include a lack of child care, a lack of senior care and the loneliness that comes with living in a rural community with an aging population and harsh winters. Together, it all creates a perfect storm for feeling isolated,” said Maddie Sweetman, who lives in Walworth County. “(The intergenerational care center) would be a beautiful way to not only address the need for seats and beds, but also to bring these two vulnerable communities together.”

The Lakeland Health Care Center, a county-owned skilled nursing facility in Elkhorn, has had a vacant wing since 2019 when staff shortages forced the facility to downsize. Now, Groundswell Collective, a local community group with a track record of advocating for older residents, is leading an effort to turn that space into 12 apartments for older people and a child care center that serves 60 to 70 children. After nearly a year of community organizing around the proposal, the Walworth County Board approved funding for a feasibility study in November for the intergenerational care center, a major step in advancing the project.

“In Walworth County, all 2,240 licensed child care slots, spread across the 35 active centers listed on the DCF (Department of Children and Families) website, are already full. That leaves nearly 2,680 children without stable care,” said Abriana Krause, who lives and works in East Troy as a child care provider, at a board committee meeting. “At the same time, Wisconsin is projected to need 30,000 additional senior beds by 2030 .… We are facing two parallel crises, child care and senior care, and the vacant wing at Lakeland Health Care Center offers us a rare opportunity to address both at once.”

As part of the proposal, county employees would get priority for child care slots.

Sweetman, a mother of two who is a full-time student and employee at the University of Wisconsin-Whitewater, knows firsthand how valuable this benefit could be for parents. When Sweetman’s children were younger, her husband worked at Lakeland Health Care Center as a certified nursing assistant while he completed nursing school. Unable to afford child care, Sweetman stayed home with her young children.

“I wonder whether having a child care facility under the same roof would have given me more access to child care, allowing me to return to school work sooner, graduate sooner, and be working full time now,” Sweetman said. “I also think about how that might have changed our overall trajectory, and what it would have meant for me personally as I managed two kids under two on my own and all the mental health challenges that came with that.”

Now, Sweetman is part of Groundswell Collective and advocating for other families to have the opportunity she did not.

“That (child care opportunity) didn’t happen for us, but I think about how it could happen for people going forward and for our community, not just for those who have children but also for seniors and for people who may soon need assisted living,” Sweetman said.

Groundswell Collective has leaned heavily on research to make its case.

“We have looked into the evidence-based benefits of intergenerational care,” said Deb Gill-Dorgan, a retired speech language pathologist and member of Groundswell Collective. “We know that adults report less loneliness, better health, a renewed sense of purpose in life, and it improves children’s social skills and educational outcomes.”

Research shows that intergenerational care sites boost well-being for both children and older people, reducing isolation, improving cognitive and physical health for older people, and cultivating empathy and connection in young children. Studies also find that these programs create cost efficiencies, especially when facility expenses and other operational costs can be shared.

Jill Juris, Ph.D., professor and chair of the Department of Recreation Management and Physical Education at Appalachian State University, is seeing these benefits through her research with BRIDGE2Health, an intergenerational mentoring program. The program is a collaboration between the Cooperative Extensions in Ohio and Virginia that connects high school students with older adults and is generating qualitative and quantitative data demonstrating increases in social connections and life skills.

“These findings align with other research indicating intergenerational interaction improves empathy, peer relationships and academic performance in younger populations, while increasing the quality of life and sense of purpose for older adults,” Juris said. “By bridging the gap between ages, these programs truly make a difference, improving the all-around well-being of everyone involved.”

Sheri Steinig, director of strategic initiatives and communications at Generations United, said that intergenerational care fosters relationships that transcend age that can serve the community as a whole.

“There’s a breakdown of age stereotypes that we see at a very young age when babies and toddlers are around older people,” Steinig said. “There are these characteristics of care, compassion and empathy that ripple out into both the families and the communities.”

In intentionally creating spaces that bring older and younger people together, these benefits organically emerge in daily interactions.

“By eliminating or reducing barriers that we’ve unintentionally put up between connecting younger and older people, there’s just a wealth of benefits that we can see in terms of educational outcomes, well-being, physical and mental health,” Steinig said.

“Intergenerational spaces offer opportunities for meaningful interactions through repeated connections that foster lasting relationships,” Juris said. “Children and older adults seeing each other within a daily routine allows for magical moments of interaction to occur.”

Those benefits extend to the caregiving staff. Steinig said that daily interaction with both children and older adults can enhance the work environment and make intergenerational centers more rewarding for staff.

Gill-Dorgan said she hopes that prioritizing county employees for child care placements at the proposed intergenerational center will help retain nursing staff, who can experience high turnover while managing their own family caregiving responsibilities.

For many involved in Groundswell Collective, the intergenerational center proposal offers a path forward on common ground at a time of uncertainty.

“As gaps widen at the federal level, I feel like there’s this turn to local solutions and our local government, and how can we fill the gaps? I see this intergenerational facility as part of that effort,” Sweetman said.

Pastor Lily Brellenthin, a mother of three who leads a Lutheran church in Walworth that serves an older congregation, has found hope through her community work with Groundswell Collective.

“In a world that’s so divided, to have some people now linking arm and arm to come together in our little place of the world is so uplifting,” said Brellenthin. “I feel like it’s proving that we are stronger in community.”

“We hope this is just the beginning,” Gill-Dorgan said. “We hope something like this will be seen as being beneficial and a wonderful idea, and hopefully other people will get involved and build more such centers.”

This article was written with the support of a journalism fellowship from The Gerontological Society of America, The Journalists Network on Generations, and The Commonwealth Fund.

This article first appeared on The Daily Yonder and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

‘Nursery to nursing home’: Walworth County group envisions shared care across generations 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.

A masked U.S. Immigration and Customs Enforcement agent knocks on a car window in Minnesota on Jan. 12. A new court ruling allows ICE to use Medicaid data, alarming some states and advocates who warn it could have a chilling effect on immigrant families accessing health care. (Photo by Nicole Neri/Minnesota Reformer)

In a win for President Donald Trump’s immigration crackdown, a recent court ruling has cleared the way for U.S. Immigration and Customs Enforcement to resume using states’ Medicaid data to find people who are in the country illegally.

The case is ongoing. But for now, immigrants — including those who are in the country legally — will have to weigh the benefits of gaining health coverage against the risk that enrolling in Medicaid could make them or their family members easier for ICE to find.

Last summer, 22 states and the District of Columbia sued the Trump administration to block information sharing between ICE and Medicaid, the state-federal health insurance program that primarily covers people with low incomes. But at the end of December, a federal judge ruled that ICE can pull some basic Medicaid data to use in its deportation proceedings, including addresses, phone numbers, birth dates and citizenship or immigration status.

The court ruled that in the states that sued, ICE is not allowed to collect information about lawful permanent residents or citizens, nor records about sensitive health information. In the 28 states that didn’t sue, however, the court did not place any limits on the Medicaid information ICE can access.

The U.S. District Court in San Francisco essentially said that government agencies can share some data, including basic identifying information. “That kind of data sharing is clearly authorized by statute,” the decision states.

But the court also ruled that agencies can’t share more sensitive data without adequately explaining why they need it. In his ruling, U.S. District Judge Vince Chhabria wrote that ICE and federal Medicaid information-sharing policies were “totally unclear and do not appear to be the product of a coherent decisionmaking process.” He said the states had shown they would “suffer irreparable harm from these vague and likely overbroad” policies.

By law, federal Medicaid money cannot be used to cover people who are in the country illegally.

But in recent years, nearly half of states, including some led by Republicans, have chosen to use their own Medicaid money to extend coverage to certain groups of people, such as children and pregnant women, regardless of immigration status.

Advocates for immigrants and some state officials worry that ICE’s use of Medicaid data will cause widespread fear among immigrant families, keeping them from seeking the health care that states have said they’re eligible to receive. California’s health department recently called the administration’s actions “a grave breach of public trust.”

“States have constantly reassured people that their health care information won’t be used against them, and that’s changed,” said Tanya Broder, senior counsel for health and economic justice policy at the National Immigration Law Center, an advocacy organization focused on immigrant rights.

Court filings in the lawsuit illustrate the potential impact of the ruling.

In Chicago, for example, a patient at an Esperanza Health Center delayed her first prenatal visit until her third trimester because she worried enrolling in Medicaid could put her husband at risk of deportation, the clinic reported in a December court filing. By the time she received care, she had complications that could have been addressed with earlier health visits. Another patient refused to apply for Medicaid for her child, a U.S. citizen, because she worried that seeking benefits would allow ICE to locate her.

“The expectation of privacy that we all have when we seek to enroll in a health care program has been compromised,” said Broder.

“Not only undocumented immigrants but people who live in families with immigrants and the broader community are going to feel less comfortable in applying for these health programs, over concerns their information is going to be weaponized against them or their family members.”

An about-face

Several months into Trump’s second term, ICE gained access to the personal data of 79 million Medicaid enrollees as part of its efforts to find people who may be living illegally in the United States.

Data on Medicaid enrollees is routinely exchanged between states and the feds, including to verify eligibility to receive federal funding. But the new agreement marked an about-face from past federal policies of not using such information for immigration enforcement.

The effort is unprecedented at the national level, said Medha Makhlouf, a law professor at Penn State Dickinson Law who specializes in health and immigration.

“Previously the federal government has balanced immigration enforcement interests with the protection of health-related interests,” she said. “Now they’re weighing much more heavily the interests of immigration enforcement.”

That puts the federal government at odds with states that have expanded health coverage as a matter of public health and economic policy, she said. Many states have extended coverage to a wider swath of people on the premise that broader coverage helps prevent the spread of disease, prioritizes preventive care over more costly emergency treatment and reduces economic losses when employees miss work because of illness.

The judge’s order will stand until the case is resolved, as the judge considers what kinds of data can be released for use in immigration enforcement.

California Attorney General Rob Bonta, a Democrat, said in a July statement that the Trump administration’s data-sharing move was illegal and “created a culture of fear that will lead to fewer people seeking vital emergency medical care.”

Federal officials say they’re allowed to use lawfully collected information for immigration enforcement purposes.

The Department of Homeland Security and ICE did not respond to requests for comment.

Broder, of the National Immigration Law Center, said it isn’t clear whether the limited information the court has allowed the Department of Homeland Security to use can be cleanly separated from data belonging to citizens and lawful permanent residents. The ruling says that if that basic data can’t be separated from data that’s still protected, Medicaid can’t share it with ICE.

California’s Department of Health Care Services, which administers the state’s Medicaid program, emphasized that concern in a statement updated earlier this month. The department said the feds haven’t provided any information about how they plan to implement the court’s order.

Meanwhile, some states are looking at their options for protecting their Medicaid data. Oregon Health Authority Director Dr. Sejal Hathi called the move to use Medicaid data for immigration enforcement “disappointing, to say the least” in a public board meeting earlier this month.

She said her agency is “committed to doing all that we can within our authority to protect the health privacy of our members” and is working with health providers to “ensure that Oregonians, no matter their background, can continue to seek and receive quick and responsive health care without worrying about the safety of their health information.”

States step up

In recent years, an increasing number of states have used their own money to extend health insurance coverage under their Medicaid programs to some noncitizens, such as people with green cards, refugees and those with temporary protected status.

For example, 14 states and the District of Columbia cover income-eligible children regardless of immigration status, while seven states and the district offer state-funded coverage to some adults with low incomes, regardless of immigration status. Nearly half of states — including a handful of red states — cover income-eligible pregnant women, regardless of their immigration status.

Makhlouf, of Penn State, directs a legal clinic at her law school where law students assist people who face legal barriers to getting health care and other public benefits. The students have fielded questions from parents — even those who are in the country legally — who have asked if applying for Medicaid for their children, who are U.S. citizens, jeopardizes their own legal status or exposes household members to scrutiny from ICE.

“We see the chilling effects directly,” Makhlouf said. “Folks have many more questions about the risks versus the benefits of applying for government programs. It should be an easy decision for families to accept help, but it’s not easy anymore.”

In the past year, the Trump administration also has ordered states to hand over personal data from sources including voter rolls and food stamps, even as it consolidates information held across federal agencies into a trove of information on people who live in the United States.

In November, a federal judge blocked the IRS from sharing taxpayer information for immigration purposes.

Stateline reporter Anna Claire Vollers can be reached at avollers@stateline.org.

Many candies contain Red No. 40, Yellow No. 5 and Yellow No. 6. They are among the food dyes banned in West Virginia by a measure signed into law in March. Such bans are just one example of how the "Make America Healthy Again" movement has made inroads in state legislatures. (Photo by Carol Johnson/Stateline)

This article first appeared on KFF Health News.

When one of Adam Burkhammer’s foster children struggled with hyperactivity, the West Virginia legislator and his wife decided to alter their diet and remove any foods that contained synthetic dyes.

“We saw a turnaround in his behavior, and our other children,” said Burkhammer, who has adopted or fostered 10 kids with his wife. “There are real impacts on real kids.”

The Republican turned his experience into legislation, sponsoring a bill to ban seven dyes from food sold in the state. It became law in March, making West Virginia the first state to institute such a ban from all food products.

The bill was among a slew of state efforts to regulate synthetic dyes. In 2025, roughly 75 bills aimed at food dyes were introduced in 37 states, according to the National Conference of State Legislatures.

Chemical dyes and nutrition are just part of the broader “Make America Healthy Again” agenda. Promoted by Health and Human Services Secretary Robert F. Kennedy Jr., MAHA ideas have made their deepest inroads at the state level, with strong support from Republicans — and in some places, from Democrats. The $50 billion Rural Health Transformation Program — created last year as part of the GOP’s One Big Beautiful Bill Act to expand health care access in rural areas — offers incentives to states that implement MAHA policies.

Federal and state officials are seeking a broad swath of health policy changes, including rolling back routine vaccinations and expanding the use of drugs such as ivermectin for treatments beyond their approved use. State lawmakers have introduced dozens of bills targeting vaccines, fluoridated water and PFAS, a group of compounds known as “forever chemicals” that have been linked to cancer and other health problems.

In addition to West Virginia, six other states have targeted food dyes with new laws or executive orders, requiring warning labels on food with certain dyes or banning the sale of such products in schools. California has had a law regulating food dyes since 2023.

Most synthetic dyes used to color food have been around for decades. Some clinical studies have found a link between their use and hyperactivity in children. And in early 2025, in the last days of President Joe Biden’s term, the Food and Drug Administration outlawed the use of a dye known as Red No. 3.

Major food companies including Nestle, Hershey  and PepsiCo have gotten on board, pledging to eliminate at least some color additives from food products over the next year or two.

“We anticipate that the momentum we saw in 2025 will continue into 2026, with a particular focus on ingredient safety and transparency,” said John Hewitt, the senior vice president of state affairs for the Consumer Brands Association, a trade group for food manufacturers.

This past summer, the group called on its members to voluntarily eliminate federally certified artificial dyes from their products by the end of 2027.

“The state laws are really what’s motivating companies to get rid of dyes,” said Jensen Jose, regulatory counsel for the Center for Science in the Public Interest, a nonprofit health advocacy group.

Andy Baker-White, the senior director of state health policy for the Association of State and Territorial Health Officials, said the bipartisan support for bills targeting food dyes and ultraprocessed food struck him as unusual. Several red states have proposed legislation modeled on California’s 2023 law, which bans four food additives.

“It’s not very often you see states like California and West Virginia at the forefront of an issue together,” Baker-White said.

Although Democrats have joined Republicans in some of these efforts, Kennedy continues to drive the agenda. He appeared with Texas officials when the state enacted a package of food-related laws, including one that bars individuals who participate in the Supplemental Nutrition Assistance Program — SNAP or food stamps — from using their benefits to buy candy or sugary drinks. In December, the U.S. Department of Agriculture approved similar waivers sought by six states. Eighteen states will block SNAP purchases of those items in 2026.

There are bound to be more. The Rural Health Transformation Program also offers incentives to states that implemented restrictions on SNAP.

“There are real and concrete effects where the rural health money gives points for changes in SNAP eligibility or the SNAP definitions,” Baker-White said.

In October, California Gov. Gavin Newsom signed a bill that sets a legal definition for ultraprocessed foods and will phase them out of schools. It’s a move that may be copied in other states in 2026, while also providing fodder for legal battles. In December, San Francisco City Attorney David Chiu sued major food companies, accusing them of selling “harmful and addictive” products. The lawsuit names specific brands — including cereals, pizzas, sodas and potato chips — linking them to serious health problems.

Kennedy has also blamed ultraprocessed foods for chronic diseases. But even proponents of the efforts to tackle nutrition concerns don’t agree on which foods to target. MAHA adherents on the right haven’t focused on sugar and sodium as much as policymakers on the left. The parties have also butted heads over some Republicans’ championing of raw milk, which can spread harmful germs, and the consumption of saturated fat, which contributes to heart disease.

Policymakers expect other flash points. Moves by the FDA and the Centers for Disease Control and Prevention that are making vaccine access more difficult have led blue states to find ways to set their own standards apart from federal recommendations, with 15 Democratic governors announcing a new public health alliance in October. Meanwhile, more red states may eliminate vaccine mandates for employees; Idaho made them illegal. And Florida Gov. Ron DeSantis is pushing to eliminate school vaccine mandates.

Even as Kennedy advocates eliminating artificial dyes, the Environmental Protection Agency has loosened restrictions on chemicals and pesticides, leading MAHA activists to circulate an online petition calling on President Donald Trump to fire EPA Administrator Lee Zeldin.

Congress has yet to act on most MAHA proposals. But state lawmakers are poised to tackle many of them.

“If we’re honest, the American people have lost faith in some of our federal institutions, whether FDA or CDC,” said Burkhammer, the West Virginia lawmaker. “We’re going to step up as states and do the right thing.”

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.

A patient registers for care at a mobile dental and medical clinic in August 2025. Nationwide, the number of people buying health plans on Obamacare insurance marketplaces is down by about 833,000 compared with a year ago, according to state and federal data. (Photo by Spencer Platt/Getty Images)

Nationwide, the number of people buying health plans on Obamacare insurance marketplaces is down by about 833,000 compared with a year ago, according to federal data released this week.

Many states are reporting fewer new enrollees, more people dropping their coverage, and more people choosing cheaper and less generous health insurance plans with higher deductibles.

Across most states, Thursday was the last day to enroll for plans that start in February. But nine states and Washington, D.C., have deadlines later this month, so the numbers could change.

There are 21 states with state-run health insurance marketplaces, and the rest use the federal website. The vast majority of states have seen declines in enrollment so far, compared with around this time last year.

Preliminary data released Monday by the federal Centers for Medicare & Medicaid Services shows 22.8 million enrollees, down from a record total of 24.3 million last year.

Premiums have surged as a result of the expiration of enhanced federal subsidies first made available by the American Rescue Plan Act in 2021 and later extended through the end of 2025 by the Inflation Reduction Act. The availability of the subsidies spurred a sharp increase in the number of people buying health plans on the marketplaces. In 2020, 11.4 million people were enrolled in marketplaces through Obamacare, formally known as the Affordable Care Act. More than double that amount enrolled last year.

Congress failed to reach an agreement on extending the subsidies before the end of last year and still hasn’t reached one. As a result, premiums were expected to increase this year by 114% on average — from $888 last year to about $1,904, according to estimates made in September by health policy research organization KFF.

The higher costs appear to be driving many people to forgo insurance or opt for cheaper, less generous plans this year, health officials and analysts say. Several states with state-based marketplaces — including Georgia, Illinois, Minnesota, New York, Vermont, Virginia and Washington — are reporting fewer enrollments this year in comparison with enrollments through early January 2025, according to early data. Other states, such as California, are reporting fewer new enrollees.

“It’s important to consider that this is preliminary data, so this represents people who have signed up and selected the plan — but they probably haven’t received their first premium bill,” said Elizabeth Lukanen, executive director of the health policy research organization State Health Access Data Assistance Center at the University of Minnesota. “Once that happens, I think there’s concern — and it seems very possible — that people may decide to drop coverage. So, the decline could get bigger.

“On the other hand, open enrollment hasn’t closed, so you have two things sort of competing. It seems pretty likely that there will be a decline,” she said.

If the downward trend continues, the nation could see the first decline in enrollment since 2020, Lukanen said, adding that a full picture of income levels and demographics of people who have dropped coverage won’t be clear until the summer.

In Pennsylvania, data updated through Tuesday shows more than 15,000 previously enrolled adults between the ages of 55 and 64 have dropped coverage entirely — the most of any age bracket.

Pennsylvania’s state-based exchange, Pennie, has seen about 15% fewer new enrollments compared with last year. The state is also reporting 1,000 residents dropping coverage per day during open enrollment — with the most coverage losses among people with incomes 150% to 200% of the poverty level. These could include families of two adults and two children with an income between $48,225 and $64,300.

The state is seeing an “unprecedented” number of previously enrolled people dropping coverage, said Devon Trolley, executive director of the Pennsylvania Health Insurance Exchange Authority.

California is reporting 31% fewer new enrollees this year compared with last year, and more than a third of new enrollees are choosing bronze plans — the lowest, least generous coverage tier — up from less than a quarter at this time last year.

In Minnesota, data as of Dec. 3 shows more than half of active enrollees are opting to keep their coverage tier. But of those changing plans, more than a third — 37% — are going to cheaper plans. The state notes a full picture won’t be available until March.

Meanwhile, some states are seeing roughly the same number of enrollees or more. Texas, for example, is reporting about 4.1 million people enrolling this year compared with 4 million last year.

Charles Miller, health and economic mobility policy director at Texas 2036, a policy research nonprofit, said it’s unclear why enrollments are up, but pointed to some clues.

“Texas had a uniquely large population of uninsured individuals eligible for free and inexpensive plans that hadn’t enrolled previously … [and] has more affordable bronze and gold plans than many states,” he said.

He attributes that to a bipartisan state law, enacted in 2021, that had the effect of increasing subsidies for those plans, Miller said.

Nevada is seeing fewer enrollees overall. But compared with this time last year, the state is seeing 29% more people who are actively shopping the website to explore plans, said Katie Charleson, communications officer at the Nevada Health Authority Division of Consumer Health Services.

The state introduced a new public option, according to the Nevada Current, and health officials told lawmakers last week that about 1 in 5 active shoppers are opting for that plan.

In addition to the expiration of the subsidies, the cost of coverage has risen because of other factors, according to insurers. They say they’ve had to raise premiums because of rising prescription drug costs, inflation and workforce challenges, such as provider shortages.

But the enhanced premium tax credits were aimed at buffering those year-to-year changes for Americans with lower incomes, said Trolley, adding that the tax credit structure “helps make sure that [enrollees] don’t see those really larger drops that happen from time to time, sort of from those market forces.”

“When there are broader rate increases of … the total cost of the coverage, the tax credits are structured so that people who get a tax credit don’t feel a lot of that increase. They’re sort of sheltered from it on a year to year basis,” Trolley said. “The tax credit is tied to someone’s income and limits what they pay as part of their income, not necessarily tied to the cost of the coverage.”

She added that she’s also heard from some residents who say they are waiting to enroll in a plan to see if Congress takes action.

“People are leaving the ACA marketplace because the trade-offs have just become harder to justify,” Lukanen said. “What worries me is that when the coverage becomes unaffordable, it isn’t that people suddenly stop needing care. They just lose the protection that insurance offers, and those health care costs don’t go away.”

Lukanen added that if more people forgo coverage, health care services may end up costing the nation more overall.

“If people are going to the doctor and they don’t have insurance, these costs are then just shifted. They’re shifted to hospitals, ultimately to the community and the taxpayer.”

Trolley echoed that, saying she’s concerned about the overall burden on providers in rural counties, which are seeing the highest drops in Obamacare coverage in Pennsylvania.

“Any increase in the uninsured rate is going to further strain providers that are in rural areas, especially — further strain their financial situation,” she said. “We are very concerned about that in Pennsylvania.”

Stateline reporter Nada Hassanein can be reached at nhassanein@stateline.org.

A young woman asks AI companion ChatGPT for help this month in New York City. States are pushing to prevent the use of artificially intelligent chatbots in mental health to try to protect vulnerable users. (Photo by Shalina Chatlani/Stateline)

Editor’s note: If you or someone you know needs help, the national suicide and crisis lifeline in the U.S. is available by calling or texting 988. There is also an online chat at 988lifeline.org.

States are passing laws to prevent artificially intelligent chatbots, such as ChatGPT, from being able to offer mental health advice to young users, following a trend of people harming themselves after seeking therapy from the AI programs.

Chatbots might be able to offer resources, direct users to mental health practitioners or suggest coping strategies. But many mental health experts say that’s a fine line to walk, as vulnerable users in dire situations require care from a professional, someone who must adhere to laws and regulations around their practice.

“I have met some of the families who have really tragically lost their children following interactions that their kids had with chatbots that were designed, in some cases, to be extremely deceptive, if not manipulative, in encouraging kids to end their lives,” said Mitch Prinstein, senior science adviser at the American Psychological Association and an expert on technology and children’s mental health.

“So in such egregious situations, it’s clear that something’s not working right, and we need at least some guardrails to help in situations like that,” he said.

While chatbots have been around for decades, AI technology has become so sophisticated that users may feel like they’re talking to a human. The chatbots don’t have the capacity to offer true empathy or mental health advice like a licensed psychologist would, and they are by design agreeable — a potentially dangerous model for someone with suicidal ideations. Several young people have died by suicide following interactions with chatbots.

States have enacted a variety of laws to regulate the types of interactions chatbots can have with users. Illinois and Nevada have completely banned the use of AI for behavioral health. New York and Utah passed laws requiring chatbots to explicitly tell users that they are not human. New York’s law also directs chatbots to detect instances of potential self-harm and refer the user to crisis hotlines and other interventions.

More laws may be coming. California and Pennsylvania are among the states that might consider legislation to regulate AI therapy.

President Donald Trump has criticized state-by-state regulation of AI, saying it stymies innovation. In December, he signed an executive order that aims to support the United States’ “global AI dominance” by overriding state artificial intelligence laws and establishing a national framework.

Still, states are moving ahead. Before Trump’s executive order, Florida Republican Gov. Ron DeSantis last month proposed a “Citizen Bill of Rights For Artificial Intelligence” that, among many other things, would prohibit AI from being used for “licensed” therapy or mental health counseling and provide parental controls for minors who may be exposed to it.

“The rise of AI is the most significant economic and cultural shift occurring at the moment; denying the people the ability to channel these technologies in a productive way via self-government constitutes federal government overreach and lets technology companies run wild,” DeSantis wrote on social media platform X in November.

‘A false sense of intimacy’

At a U.S. Senate Judiciary Committee hearing last September, some parents shared their stories about their children’s deaths after ongoing interactions with an artificially intelligent chatbot.

Sewell Setzer III was 14 years old when he died by suicide in 2024 after becoming obsessed with a chatbot.

“Instead of preparing for high school milestones, Sewell spent his last months being manipulated and sexually groomed by chatbots designed by an AI company to seem human, to gain trust, and to keep children like him endlessly engaged by supplanting the actual human relationships in his life,” his mother, Megan Garcia, said during the hearing.

Another parent, Matthew Raine, testified about his son Adam, who died by suicide at age16 after talking for months with ChatGPT, a program owned by the company OpenAI.

“We’re convinced that Adam’s death was avoidable, and because we believe thousands of other teens who are using OpenAI could be in similar danger right now,” Raine said.

Prinstein, of the American Psychological Association, said that kids are especially vulnerable when it comes to AI chatbots.

“By agreeing with everything that kids say, it develops a false sense of intimacy and trust. That’s really concerning, because kids in particular are developing their brains. That approach is going to be unfairly attractive to kids in a way that may make them unable to use reason, judgment and restraints in the way that adults would likely use when interacting with a chatbot.”

The Federal Trade Commission in September launched an inquiry into seven companies making these AI-powered chatbots, questioning what efforts are in place to protect children.

​​“AI chatbots can effectively mimic human characteristics, emotions, and intentions, and generally are designed to communicate like a friend or confidant, which may prompt some users, especially children and teens, to trust and form relationships with chatbots,” the FTC said in its order.

Companies such as OpenAI have responded by saying that they are working with mental health experts to make their products safer and to limit chances of self-harm among its users.

“Working with mental health experts who have real-world clinical experience, we’ve taught the model to better recognize distress, de-escalate conversations, and guide people toward professional care when appropriate,” the company wrote in a statement last October.

Legislative efforts

With action at the federal level in limbo, efforts to regulate AI chatbots at the state level have had limited success.

Dr. John “Nick” Shumate, a psychiatrist at the Harvard University Beth Israel Deaconess Medical Center, and his colleagues reviewed legislation to regulate mental health-related artificial intelligence systems across all states between January 2022 and May 2025.

The review found 143 bills directly or indirectly related to AI and mental health regulation. As of May 2025, 11 states had enacted 20 laws that researchers found were meaningful, direct and explicit in the ways they attempted to regulate mental health interactions.

They concluded that legislative efforts tended to fall into four different buckets: professional oversight, harm prevention, patient autonomy and data governance.

“You saw safety laws for chatbots and companion AIs, especially around self-harm and suicide response,” Shumate said in an interview.

New York enacted one such law last year that requires AI chatbots to remind users every three hours that it is not a human. The law also requires the chatbot to detect the potential of self-harm.

“There’s no denying that in this country, we’re in a mental health crisis,” New York Democratic state Sen. Kristen Gonzalez, the law’s sponsor, said in an interview. “But the solution shouldn’t be to replace human support from licensed professionals with untrained AI chatbots that can leak sensitive information and can lead to broad outcomes.”

In Virginia, Democratic Del. Michelle Maldonado is preparing legislation for this year’s session that would put limits on what chatbots can communicate to users in a therapeutic setting.

“The federal level has been slow to pass things, slow to even create legislative language around things. So we have had no choice but to fill in that gap,” said Maldonado, a former technology lawyer.

She noted that states have passed privacy laws and restrictions on nonconsensual intimate images, licensing requirements and disclosure agreements.

New York Democratic state Sen. Andrew Gounardes, who sponsored a law regulating AI transparency, said he’s seen the growing influence of AI companies at the state level.

And that is concerning to him, he said, as states try to take on AI companies for issues ranging from mental health to misinformation and beyond.

“They are hiring former staffers to become public affairs officers. They are hiring lobbyists who know legislators to kind of get in with them. They’re hosting events, you know, by the Capitol, at political conferences, to try to build goodwill,” Gounardes said.​​

“These are the wealthiest, richest, biggest companies in the world,” he said. “And so we have to really not let up our guard for a moment against that type of concentrated power, money and influence.”

Stateline reporter Shalina Chatlani can be reached at schatlani@stateline.org.

A trial over Missouri’s abortion regulations began Monday at the Jackson County Courthouse in Kansas City, Mo. Experts are watching the case, which could impact abortion access across the Midwest and South. (Photo by Kevin Hardy/Stateline)

KANSAS CITY, Mo. — The outcome of a trial over Missouri’s abortion regulations could ripple far beyond the state, potentially creating new availability for women in the Midwest and South who can’t access abortion close to home.

As a judge weighs the constitutionality of a litany of state restrictions on abortion, the stakes are clear for Missouri women: The decision could hamper access for nearly everyone in the state — or greatly broaden it in ways not seen in decades. That would allow women in a dozen nearby states with abortion bans to travel a shorter distance to access the procedure.

“Opening and reestablishing rights in the state of Missouri would help to alleviate some of the pressure that other states have since so many Southern states have banned abortion,” said Julie Burkhart, the co-owner of Hope Clinic in Granite City, Illinois. “It just seems logical that we would see a shift in migration patterns of patients in the country.”

At her clinic, about a 15-minute drive from downtown St. Louis, Missourians account for about half of all patients, Burkhart said. Though Missouri voters in 2024 enshrined a right to abortion in the state constitution, access has remained highly limited because of restrictive state laws. Only procedural abortions are available on a limited basis across three Planned Parenthood clinics in the state.

Many of those state laws face legal scrutiny this week as a Missouri judge weighs the constitutionality of regulations targeting abortion providers. Those include a 72-hour waiting period between initial appointments and procedures, mandatory pelvic exams for medication abortions and a ban on telemedicine appointments for medication abortions.

Planned Parenthood affiliates in Missouri argue state restrictions are unconstitutional under 2024’s voter-approved constitutional amendment. Over decades, state restrictions have gutted Missouri’s provider networks, limited appointment availability and ultimately forced abortions to a halt in 2022, before a limited number resumed after the 2024 vote.

Experts and advocates are closely monitoring the Missouri case, which is expected to be appealed regardless of the outcome, because of its practical implications on access in the region. While many women now rely on abortion medication, procedural abortion is still crucial for those seeking later-term abortions or who prefer an in-clinic procedure.

But the two-week bench trial in downtown Kansas City also tests lawmakers’ ability to put in place rules so restrictive that they effectively ban abortion — a practice used by anti-abortion lawmakers in other states looking to limit access to the procedure.

“Judges do not operate in a vacuum,” Burkhart said, “ … and we know for a fact that judges look outside the borders of their state for information and for guidance. I do see this as having national importance.”

That’s especially true in other states also litigating abortion access, including Arizona, Michigan and Ohio, said Rebecca Reingold, an associate director at Georgetown University’s O’Neill Institute for National and Global Health Law.

While state judges are not bound by the decisions of judges in other states, their deliberations can be informed by court rulings, particularly involving novel legal questions or areas of the law that are evolving.

“There is little doubt that advocates and decision-makers in other states navigating similar legal challenges are closely monitoring the litigation over Missouri’s abortion regulations,” Reingold said.

Restrictions targeting abortion

In the first days of the trial, Planned Parenthood leaders argued that ever-changing state laws and agency regulations have drastically limited access, caused needless red tape and posed privacy risk for their patients.

Dr. Margaret Baum, chief medical officer with St. Louis-based Planned Parenthood Great Rivers, said the Missouri requirements specifically target abortion rather than all other kinds of medical care.

“I provide vasectomies routinely. … And I am not required to have a complication plan, contact a primary care physician, even ask the patient how many miles they live from the health center.”

Opening day of Missouri abortion-rights trial focuses on decades of state restrictions

Baum said state-mandated reporting rules unique to abortion require clinicians to ask the race, education level, marital status and specific location of each patient — none of which is relevant to their care.

Planned Parenthood Great Rivers would like to offer abortion services in Springfield, Baum testified. Access in that region would provide an option for rural Missourians, and also could help serve residents in nearby Arkansas, Oklahoma and Texas, where abortion is almost universally banned.

But the organization’s facilities there do not meet state abortion regulations for physical attributes, including hallway size, doorway size and the number of recliners in recovery rooms, Baum testified.

Lawyers for the state defended Missouri’s restrictions as commonsense safeguards aimed at protecting vulnerable women. The attorney general’s office argued that complication risks of abortion justify additional state regulation — despite professional medical associations saying it’s generally safe. The AG’s office also maintained that Planned Parenthood faced a conflict of interest because of its financial motivations.

“Abortion is a business,” Deputy Solicitor General Peter Donohue said during a procedural argument on Monday. “Your Honor, the plaintiffs are asking to deregulate their profession in order to make more money.”

The state was expected to call as witnesses anti-abortion doctors and activists later in the trial.

Patients traveling for care

Since the U.S. Supreme Court’s ruling that overturned federal constitutional protections for abortion in June 2022, the number of abortions has increased slightly across the country, according to the health research nonprofit KFF.

The group points to expanded telehealth, which can offer medication abortion more affordably through virtual appointments.

Since the 2022 ruling and subsequent state abortion bans, patients have experienced higher travel costs for abortions and delays in care, according to research published in the American Journal of Public Health in July.

Researchers from the University of California, San Francisco found that travel time to access abortion increased from 2.8 hours to 11.3 hours for residents in states with abortion bans. Travel costs increased from $179 to $372. And more than half of survey respondents said their abortion care required an overnight hotel stay, compared with 5% before an abortion ban.

In 2024, an estimated 7,880 Missourians traveled to Illinois and 3,960 traveled to Kansas to access abortion, according to the Guttmacher Institute, a research and policy organization focused on advancing reproductive rights.

Those Missourians were among the approximate 155,000 people who crossed state lines to access abortion care that year, representing 15% of all abortions provided in states without total bans.

Ongoing uncertainty

Regardless of its outcome, the Missouri case is expected to be appealed. Even if the plaintiffs are ultimately successful, it may take a long time to restore care networks across the state, said Isaac Maddow-Zimet, a data scientist at the Guttmacher Institute.

“And that’s particularly the case when there are states that have a lot of legal uncertainty or restrictions coming into effect and then coming out of effect,” he said. “It’s not quick to open up a clinic. It’s not quick to even necessarily expand the kinds of services, or the kinds of the number of people that a clinic can see.”

Kimya Forouzan, the organization’s principal state policy adviser, said Missouri’s landscape is evidence that lawmakers can drastically curb abortion access without total bans. And despite an overwhelming vote to amend the constitution, legal battles can follow.

Even if the state’s laws are found unconstitutional, Forouzan said, lawmakers will likely still push anti-abortion measures. She noted that several bills have already been introduced in this year’s just-convened legislative session, and that Republican lawmakers are pushing a ballot measure to repeal 2024’s reproductive rights amendment.

“There’s very much a push to pass as many restrictions as possible and kind of see what happens later and how things shape up later. … Time will tell, but we do know that they’re still pushing forth restrictions,” she said.

Stateline reporter Kevin Hardy can be reached at khardy@stateline.org. Missouri Independent reporter Anna Spoerre can be reached at aspoerre@missouriindependent.com.

President Donald Trump addresses the Detroit Economic Club at the MotorCity Casino on Jan. 13, 2025. (Photo by Ben Solis/Michigan Advance)

WASHINGTON — President Donald Trump outlined his health care proposals to Congress on Thursday, asking lawmakers to approve several broad policy changes “without delay” — but left out any mention of enhanced tax credits whose expiration has left some Americans with skyrocketing costs. 

Health care costs, especially the rising price of health insurance, have become a frequent talking point for politicians from both political parties following last year’s government shutdown, when Democrats repeatedly called on Republicans to extend the now-expired enhanced tax credits for Affordable Care Act marketplace plans. 

Trump reiterated in a five-minute video that he wants Congress to give Americans money directly so they can use it to offset the cost of health insurance or health care, a proposal that has so far been unable to get the traction needed to advance on Capitol Hill. 

Trump didn’t detail any income caps on the direct payments, which would likely be sent to Health Savings Accounts as opposed to a simple check. He also didn’t say how much per month or annually he wants lawmakers to provide Americans, leaving it for members of Congress to hash out. 

“The government is going to pay the money directly to you. It goes to you, and then you take the money and buy your own health care,” Trump said. “Nobody has ever heard of that before, and that’s the way it is. The big insurance companies lose and the people of our country win.”

The enhanced ACA marketplace tax credits, first implemented by Democrats during the coronavirus pandemic, expired at the end of 2025. The subsidies helped to keep premiums lower than they would have otherwise been for about 22 million Americans on those health insurance plans. 

The House voted earlier this month to keep the enhanced tax credits going for another three years, but the bill has stalled in the Senate as a bipartisan group of lawmakers tries to reach consensus on two more years of the subsidies with significant changes. 

Lower drug prices

Trump said in the video that Congress should approve legislation that requires prescription drug companies to ensure Americans pay the lowest price in the world for pharmaceuticals, a policy known as “most favored nation” that he has pursued during his second term. 

“So instead of Americans paying the highest drug prices in the world, which we have for decades, we will now be paying the lowest cost paid by any other nation,” he said. “So any other nation that’s paying the lowest cost, that’s what we’re going to pay. And the American people will get the savings.”

Trump said the legislative request, which he dubbed “The Great Health Care Plan,” would require health insurance companies and health care providers to publicly share easy-to-understand information about what they charge and how much they make in profit.  

“As the saying goes, sunlight is the best disinfectant. That is why my plan orders all insurance companies to publish rate and coverage comparisons in very plain English,” Trump said. “It requires insurers to publish detailed information about how much of your money they’re going to be paying out in claims versus how much they’re taking in in profits.” 

Health insurance companies, he said, would be required to detail how many claims they deny and whether those refusals to pay for health care were overturned on appeal. 

“And most importantly, it will require any hospital or insurer who accepts Medicare or Medicaid to prominently post all prices at their place of business so that you are never surprised and you can easily shop for a better deal or better care,” Trump said, though a 2019 rule created a similar requirement. “We will have maximum price transparency and costs will come down incredibly.”

Path through Congress

A one-page outline of the proposal posted to the White House website doesn’t detail whether Trump wants Congress to approve the policy requests through the complex budget reconciliation process that Republicans used to approve the “big, beautiful” law this summer or to negotiate a bipartisan bill with Democrats. 

A White House official, speaking on background on a call with reporters to detail the plan and the next steps, said the administration believes the “proposals all have broad support from the American people.”

“We expect both Republicans and Democrats to be able to embrace them, so reconciliation would not be necessary,” the official said.

The framework is intended to provide “broad direction” to lawmakers, leaving negotiators the ability to take any bill they may write in different directions, the official said, adding the administration is “open to working” with Congress on the details. 

“We want to make progress,” the official said. “We’re not laying out a specific path.”

The official said the president leaving out any mention of the expired enhanced tax credits for people who purchase their health insurance from the Affordable Care Act marketplace was not intended to cut off ongoing bipartisan talks in the Senate. 

“This does not specifically address those bipartisan congressional negotiations that are going on,” the official said. “It does say that we have a preference that money goes to people, as opposed to insurance companies.”

Engaging drugmakers

Centers for Medicare & Medicaid Services Administrator Dr. Mehmet Oz said on the same call with reporters that the framework focused on “four pillars” the administration believes must be codified into law — solidifying most favored nation drug pricing, lowering health insurance costs, transparency from health insurance companies and more pricing information from health care providers. 

“Although we’re taking major action at CMS, including fines and the like, having Congress say, ‘This is how it’s going to be, this is a law of the land’ is important,” Oz said, adding that he really does believe there can be bipartisan support for at least some of the proposals. 

Oz said the administration’s approach to bring down the cost of prescription drugs to the lowest level offered anywhere in the world is not intended to impede innovation and reiterated that lawmaking is crucial for longer-term stability. 

“We believe by codifying it, we’ll make sure that the drug companies stay engaged for future administrations,” Oz said. “We also believe that by doing it correctly, we’ll not overreach and create challenges to life-saving drugs being continually evolved and developed in the United States.”

The Trump administration, he said, wants Congress to give the Food and Drug Administration more leeway to convert prescription medications to over-the-counter availability, possibly increasing competition and decreasing prices. 

Oz said the price transparency portion of the request would help Americans to have more information about how long it takes to get routine appointments and whether health insurance companies are able to keep their rates down by frequently denying claims.

(Darwin Brandis | iStock Getty Images Plus)

UPDATE 1/15/26: The Trump Administration has reportedly reversed up to $2 billion in cuts to grants that fund addiction treatment, after sending termination letters to programs across the country on Tuesday night. 

Nonprofits that address housing, addiction, mental health and other human service needs were notified this week that they will lose up to $2 billion in federal grant money, in a wave of termination letters issued to programs across the country. 

The cuts will make it more difficult for frontline groups to provide treatment and harm reduction care that has been crucial to combating overdose deaths, and breaking the cycles of addiction and housing insecurity. Resources like Narcan medication used to save lives by reversing overdoses, peer support, and treatment access could dry up, just as communities nationwide began to see reductions in overdose deaths.

The U.S. Substance Abuse and Mental Health Services Administration (SAMHSA), which issued the letters, hasn’t yet commented on the cuts. There are 30 SAMHSA-funded opioid treatment programs scattered across Wisconsin including in Appleton; Beloit, Eau Claire, Fond Du Lac, Green Bay, Madison, Milwaukee, Oshkosh, Kenosha, and others, according to the agency’s website. One of those programs, Vin Baker Recovery, is named after a Milwaukee Bucks basketball team player and assistant coach.

Milwaukee County Executive David Crowley condemned the sudden funding cuts. “The Trump administration’s cuts are not just numbers on a budget sheet; they are threats to the wellbeing of real people — our neighbors, our families, and our loved ones,” Crowley said in a statement. “While I will continue fighting for funding and resources to deliver results for our most vulnerable communities, the federal government must recognize the urgent need to preserve these vital services. These cuts cannot stand, because the lives of Wisconsinites depend on it.” 

A Milwaukee County Department of Health and Human Services (DHHS) spokesperson said that so far, no termination letters have been sent to the county. DHHS received $13.9 million in direct SAMHSA funds, with $6.2 million remaining as of December. The county also receives another $15.3 million in state mental health and substance use disorder grants which  partially consist of federal funding through SAMHSA.

In an emailed statement the spokesperson said that “any termination of SAMHSA funding would result in immediate termination of mental health and substance use services in Milwaukee County.” Wisconsin’s most populous county has no other funding alternatives, and the loss of federal grant money would lead to more hospitalizations and higher incarceration rates, the spokesperson warned.

Elizabeth Goodsitt, a spokesperson for Wisconsin’s Department of Health Services (DHS) wrote in an email statement Wednesday that the department was “notified late yesterday that effective January 13, the Tribes of Wisconsin Prescription Drugs/Opioid Overdose-Related Deaths Prevention Program (PDO) grant has been terminated by the federal government.” Goodsitt described this as “part of a much larger set of cancellations across the country for federally funded projects that provided life-saving mental health and substance use disorder services.” 

Wisconsin had received nearly $1 million to operate the PDO until August 2026. The program was in the third year of a five-year grant. “The goal of the PDO is to save lives,” said Goodsitt. “The funding supports training first responders and other key community sectors on overdose prevention strategies, and it supports the purchase and distribution of naloxone, the overdose reversal medication for opioids.” 

For now the Bad River Band of Lake Superior Chippewa, the Lac Courte Oreilles Band of Lake Superior Chippewa, Menominee Indian Tribe of Wisconsin and the University of Wisconsin Board of Regents have not received termination letters regarding SAMHSA funding. Native American communities are disproportionately affected by overdose deaths in Wisconsin at a rate of 75.4 people per 100,000 in 2023, as compared to a rate of 20 people per 100,000 for white Wisconsin residents. 

“We are assessing all avenues possible to ensure the federal government is following all requirements in these existing funding agreemets,” said Goodsitt. “While there continues to be much uncertainty about this evolving situation, we will keep working to serve Wisconsinites and support their behavioral health needs. We will continue to closely monitor this situation and will share more information as it becomes available.” 

This story was updated Thursday morning to reflect the Trump Administration’s decision to reverse the grant cuts. 

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Planned Parenthood and other providers got word in March that millions they anticipated in Title X funding would be withheld. The money was eventually released last year, though some providers say damage was still done. (Getty Images)

Planned Parenthood clinics in Utah resumed family planning services after the Trump administration unfroze millions in federal funds.

The American Civil Liberties Union on Tuesday submitted a brief to dismiss a lawsuit filed on behalf of the National Family Planning and Reproductive Health Association after the federal government notified nine Planned Parenthood affiliates and other family planning providers in March it would withhold annual Title X funding. 

Shireen Ghorbani, president and CEO of Planned Parenthood Association of Utah, said in a statement Monday that the restored funding does not erase all of the damage caused by nine months without it. Title X funds are meant to provide affordable family planning services, such as birth control, cancer screening, and STI tests and treatment. 

Ghorbani noted that the Utah affiliate has been the only Title X grant recipient in the state since 1985. 

“We are thrilled that Title X funding is restored to Utah for now, allowing more Utahns to get critical family planning services,” Ghorbani said. “But we cannot ignore the fact that too many Utahns have already felt the devastating effects of the Trump administration’s unwarranted decision to withhold this funding for the last nine months. Many of the 26,000 Utahns who rely on the program were forced to pay more for their health care or go without care altogether.”

Crucially, she said, the affiliate closed two health centers, in St. George and Logan, among dozens that have closed because of the withheld Title X funding and are unlikely to reopen, according to Planned Parenthood. 

Some grantees had their funding restored over the summer, Politico reported, while others remained under investigation for possibly violating the Trump administration’s new rules around so-called diversity, equity and inclusion practices until December. That’s when the U.S. Department of Health and Human Services informed Planned Parenthood affiliates that they would receive their promised funds dating back to last April, with no explanation beyond unspecified “clarifications made by, and actions taken by, the grantees.” 

Planned Parenthood’s Utah affiliate said that on Jan. 9 it received $2 million in Title X funding for the current grant year that had been withheld since April.

In the lawsuit over the Title X funding, plaintiffs argued that the federal government withholding 22 federal Title X grants from Planned Parenthood and other family planning organizations was illegal and unjustified. 

“Our lawsuit succeeded in holding the administration accountable for its unlawful acts, and today, NFPRHA members’ grants have been restored. We are relieved all of our members now have access to their promised funds, but we know the fight for contraceptive access in this country goes on,” said Clare Coleman, president & CEO of the National Family Planning and Reproductive Health Association, in a statement Tuesday. 

She estimated that 865 family planning service sites were unable to provide Title X-funded services to an estimated 842,000 patients across nearly two dozen states.

While some states have fought to restore Title X family planning funding, Idaho last year declined its annual $1.5 million federal Title X funding, leaving patients statewide without free and low-cost contraception and reproductive health care services.

At least 20 more Planned Parenthood clinics have also closed because of last year’s budget reconciliation bill, which effectively blocked Planned Parenthood and other nonprofit reproductive health care providers from being able to participate in Medicaid, reducing low-income health care options throughout the country. Litigation remains ongoing in several cases over that Medicaid rule.