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For many families across the Midwest, discussing end-of-life planning is about as comfortable as a January blizzard on Highway 175. However, proactive planning is a final act of care that prevents legal headaches and ensures a legacy stays within the family. In Wisconsin, specific statutes — ranging from marital property laws to unique transfer-on-death rules — make it essential to use the right tools. Whether you are a young parent or assisting aging parents, these are the legal and financial cornerstones for a solid plan.

Write a will and consider a living trust

A last will and testament is the traditional bedrock of any plan. In Wisconsin, a will allows you to name an executor (the person who will manage your estate) and a guardian for minor children. Without a will, a state judge — not your family — decides who raises your kids and how your assets are split.

For many Wisconsin families, a revocable living trust is a powerful alternative or supplement.

Benefit: Unlike a will, which must go through the public, often costly probate court process, a trust allows assets to pass privately and immediately to heirs.

Midwest reality: If you own property in multiple states (like a cabin in Michigan’s Upper Peninsula or a farm in Iowa), a trust can prevent your family from having to open probate cases in every state where you own land.

Assign power of attorney: health care and finances

Control is often lost not at death, but during a period of incapacity. Wisconsin law recognizes two distinct roles:

• Financial power of attorney: This grants a “trusted agent” the authority to pay your mortgage, manage your taxes and handle your bank accounts. Under Wisconsin Chapter 244, these are “durable” by default, meaning they remain valid even if you lose mental capacity.
• Health care power of attorney: This allows someone to make medical decisions if you cannot. In Wisconsin, your spouse is not automatically authorized to make all medical decisions for you without this document. It requires two witnesses who are not related to you or responsible for your health care costs.

Create an advance directive (living will)

While a health care power of attorney names who makes decisions, an advance directive (often called a “declaration to physicians” in Wisconsin) tells them what those decisions should be. This document outlines your wishes regarding life-sustaining treatments, such as ventilators or feeding tubes, specifically if you are in a terminal condition or a persistent vegetative state.

For Wisconsin residents, the Department of Health Services provides standard forms that are legally recognized across all state health systems.

Name beneficiaries for accounts and insurance

One of the most common mistakes is assuming a will covers everything. In reality, beneficiary designations on life insurance policies, 401(k)s and IRAs “trump” what is written in a will. If your will says your estate goes to your children, but your 20-year-old life insurance policy still lists an ex-spouse, that money will likely go to the ex-spouse.

To keep things simple, many Wisconsin banks offer payable-on-death (POD) options for checking and savings accounts, which keeps that cash out of the probate court’s hands.

Transfer-on-death deeds

Wisconsin is one of the states that allow a transfer-on-death (TOD) deed for real estate. This is a game changer for the “family home.”

How it works: You file a TOD deed with your local register of deeds (such as the one in Juneau for Dodge County). It names who inherits your home, but it has no effect while you are alive. You can still sell the house or change your mind at any time.

The catch: Because Wisconsin is a marital property state, if you are married, your spouse generally must sign the TOD deed even if the spouse’s name isn’t on the original title.

Note: For small estates, Wisconsin offers a “transfer by affidavit” process for estates valued under $50,000. This allows heirs to collect assets without a full court proceeding, provided they follow strict notification rules for the state’s Medicaid Estate Recovery Program.

This story is published in collaboration with Multi-Media Channels. It originally appeared in Multi-Media Channels’ print “Dignity in Care” publication.

Don’t leave a mess: What Wisconsin families should know about wills, trusts and end-of-life planning 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.

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Hi, Wisconsin! Health reporter Addie Costello here. 

I spent last Saturday with around 80 attendees of a senior breakfast in Merrill, and it was one of my best-spent weekends so far in 2026. 

Northwoods residents packed a banquet hall to eat, talk with neighbors and list the biggest issues they face as older adults. 

The Senior Empowerment Project, an organizing group focused on issues impacting older people in rural areas and small towns, organized the event and asked me to give a short presentation about my reporting on long-term care issues. The most exciting part? Once I finished talking, a microphone was passed from table to table as older adults shared the questions and issues they think about the most. 

Where can they get transportation on the weekends? How can older adults afford to stay in their homes as property taxes increase? Where can they get nutritious food? 

I left the event with a long list of questions I plan to answer in a new project. We’re calling it Q&Aging, a series of short stories where I interview experts to answer your questions about getting older in Wisconsin — whether about health care, housing or what comes next.

If you’re a diligent reader of Wisconsin Watch newsletters, you may remember us asking people last year to share their experiences with hospice. Or last month, when I asked for questions about long-term care. 

We’re now getting back to you with answers. Here’s a look at our first installments of Q&Aging: 

Can you tour long-term care facilities without an appointment? 

A reader’s email inspired this story. The short answer is yes. Read on for more specific tips from experts.  

What to know about hospice and palliative care in Wisconsin

I reported this as part of our collaboration with several Multi-Media Channels, which cover swaths of northeast and central Wisconsin. Find the full Dignity in Care project here.

Don’t leave a mess: What Wisconsin families should know about wills, trusts and end-of-life planning

Here, Multi-Media Channels Editor Taylor Hale reports on the important paperwork we all need to stop avoiding — for the benefit of our loved ones.

If you have a question or a suggestion for the series, fill out this form or contact me directly at acostello@wisconsinwatch.org or 608-616-5239.

Q&Aging tackles your questions about aging in Wisconsin 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.

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Choosing a long-term care provider is an important, expensive decision. Like test-driving a car, unannounced visits can provide helpful insight. 

So what should someone do before a “walk-in” visit?

Wisconsin Watch asked two experts to weigh in:

• Devon Christianson, director of the Aging and Disability Resource Center of Brown County. 
• Mike Pochowski, president and CEO of the Wisconsin Assisted Living Association. 

Here’s what they recommend: 

Start with a scheduled tour. The person giving tours likely has important information about a facility’s care and costs. The state health department provides a guide for comparing assisted living providers, and the federal government has a similar guide for nursing homes. ADRCs can also help people prepare for tours. 

Ask about “walk-in” visits. Facility staff might list certain times that are not ideal or explain security concerns, especially in a facility that offers memory care. But if the answer is an absolute no, that is something to consider when comparing providers.

Be transparent. The goal of drop-in visits is not to catch a provider doing something bad. Prospective residents or their family members should tell staff who they are and go through the normal guest registration process. 

Be respectful. Nursing and assisted living facilities are people’s homes. Visit at a reasonable time and stay in common areas. 

Ask residents and their families if they would be open to talking, Christianson said. Don’t base your decision around one resident’s experience. Use these conversations as a tool to help inform your decision. 

This article was inspired by a reader sharing an experience touring facilities for a loved one. Do you have something to share? Please reach out.

Can you tour long-term care facilities without an appointment? 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 coalition of 22 states told a federal court that the Trump administration appears to have violated a court order that limited the types of health data that could be shared with U.S. Immigration and Customs Enforcement for deportation proceedings.

Back in December, a court allowed ICE to pull some basic information from Medicaid, the state-federal health insurance program that primarily covers people with low incomes, to help the agency find people who are in the country illegally.

That ruling was a partial win for the administration in a lawsuit in which the 22 states and the District of Columbia had sued to block information sharing between ICE and Medicaid.

But the court also placed restrictions on ICE, saying it could only pull basic data such as addresses, phone numbers, birth dates and citizenship or immigration status. And the ruling barred ICE from collecting information on lawful permanent residents or citizens.

Advocates warned that even the sharing of that partial information would prompt immigrants, including those in the country legally, to forgo health coverage for fear that enrolling in Medicaid could make them or their family members easier for ICE to find.

Now, in a new filing, the states say the Trump administration appears to have ignored the court’s order limiting what information ICE is allowed to have. They claim the U.S. Department of Health and Human Services, which oversees Medicaid, has admitted to sharing with ICE “a large and complex” set of data on Medicaid recipients, even though the court said the data of citizens and lawful permanent residents is off limits.

The states claim the federal government hasn’t clarified how it determines who is “lawfully present,” nor has it confirmed whether it’s filtering out protected individuals from the data it gives to ICE.

The states are asking the court to formally bar the sharing of protected health care information for people lawfully residing in the United States. They’re also asking the court to confirm that “lawfully residing” includes noncitizens who have legal status, such as refugees and asylees. And they want the court to allow the states to examine the data that’s been shared with ICE so far, and how it has been used.

The Trump administration has not yet responded. The plaintiff states are scheduled to appear in a San Francisco federal court on April 30 for a hearing.

The states involved in the suit are those with Democratic attorneys general: Arizona, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, Oregon, Rhode Island, Vermont, Washington, Wisconsin.

The court’s orders preventing Medicaid data sharing won’t apply to states not involved in the lawsuit.

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

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People cannot avoid death, but they often avoid talking about it. That’s why many people don’t receive as much — or any — hospice care they qualify for, experts say. 

“There’s a real taboo in society that hospice equals death,” said Alisa Gerke, the board chair of Wisconsin Hospice and Palliative Care Collaborative and executive director at Unity Hospice and Palliative Care, a nonprofit provider that serves 14 northeast Wisconsin counties.

The goal of hospice isn’t to speed up the dying process; it’s to make people more comfortable — treating the symptoms of an illness instead of trying to cure it. 

Once families enroll in hospice, Gerke said, they often ask: “How come nobody told us about this sooner?”

When to talk about hospice

Don’t wait for your provider to bring up hospice.

Patients and providers often wait for the other person to bring hospice up, said Angela Novas, an advanced certified hospice and palliative care nurse and consultant at the nonprofit Hospice Foundation of America. Let providers know that’s something you might be interested in. 

Patients or their loved ones can also reach out to hospice providers directly and ask for an eligibility assessment, Novas said.

The basic requirements for adults to receive hospice care under Medicare include:

• Verification from two physicians that a patient has a life expectancy of six months or less. 
• A patient’s willingness to pursue treatments to provide comfort instead of treatments aimed at extending life expectancy. 

Clearing up misunderstandings about hospice

Some people may have misperceptions about hospice. Here is what it is not: 

• A place. Instead, it’s a model of care, Gerke said. While some providers may run facilities, hospice care can be provided at home and in nursing homes, assisted living facilities, hospitals and other settings.
• Constant nursing care. Hospice is meant to supplement care from family or facility caregivers, Novas said. But providers should be readily accessible for questions and concerns.
• Stopped if someone lives longer than six months. Instead, providers work to re-certify that someone is still likely to die within the next six months, Gerke said. Patients are no longer eligible for hospice if their life expectancy unexpectedly improves.
• Permanent. Patients can decide to stop hospice and try curative treatment. If their outlook doesn’t improve, they can return to hospice, Gerke said. They can also freely switch providers.

So what’s palliative care?

Palliative care is a philosophy and medical speciality focused on alleviating suffering, according to Dr. Sara Johnson, a palliative care physician and University of Wisconsin School of Medicine and Public Health professor.

Hospice is a form of palliative care for people at the end of life. But people with a serious illness can access palliative care earlier in their diagnosis and while receiving curative treatments.

Palliative care services are becoming more accessible, Johnson said. 

Palliative care specialists add a layer of support for patients and their families, Johnson said.

There is no harm in asking a provider about palliative care options, Johnson said. “If you’re thinking about it, just ask.”

How to find the right provider

Ask local providers for hospice care recommendations, Novas said. But don’t be afraid to shop around. Experts recommend asking these questions before choosing a provider:

1. How long have you served this area, and where are your staff located? 
   
   “Having staff that know that community, live in that community, are a part of that community is huge,” Gerke said.
   
   
2. What is your response time?
   
   A patient’s condition can quickly change, making it important to know how quickly staff will answer calls or arrive in those cases.
   
   
3. What is your relationship with nearby providers?
   
   If you know you want to use a particular nursing home, hospital or physician, it helps to know whether hospice providers have relationships and contracts with them.

4. What grief support do you offer?
   
   Medicare requires hospice companies to provide families with bereavement services. But the level of those services can range widely.
   
   
5. What is your Medicare rating?
   
   Medicare.gov offers a hospice look-up tool with quality care ratings. The federal agency provides comparative ratings based on family surveys and metrics like nursing visits in patients’ last days before death.

6. Are you for-profit or nonprofit?
   
   Private equity and publicly traded companies are increasingly taking hold of the hospice industry. Those providers have been associated with lower quality of care, according to a Cornell University study.
   
   For-profits face expectations around financial performance and typically have obligations to shareholders, Gerke said.
   
   But a nonprofit status does not guarantee better care, Novas said. People should prioritize whether a provider fits their specific needs.

7. What services do your volunteers provide?
   
   Medicare requires hospice providers to have a volunteer program. Do volunteers play games with patients? Provide pet therapy? Read to people? Some volunteer programs are more robust than others, Novas said.

8. What medications do you not cover?
   
   Not all medications and supplies are covered under the Medicare hospice benefit, Novas said. It’s important to know what you might have to pay for out-of-pocket or with other health coverage.

More resources on what to ask providers and know about hospice can be found through the Hospice Foundation of America’s website.

What to know about hospice and palliative care in Wisconsin 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.

Connection, compassion and hope — those are the three key elements members of the Milwaukee Overdose Response Initiative (MORI) say helped lower overdose deaths to levels unseen in Milwaukee County since 2016. “It’s MORI in conjunction with this whole community,” Jonathan Belott, a lieutenant with the Milwaukee Fire Department, told the Wisconsin Examiner. 

“We don’t live in a silo,” said Belott, who’s led the overdose response initiative since its inception in 2019. “We have so many of our different partners that we have come to rely on to get people the help that they need throughout this community.” 

Last year there were 383 fatal overdoses in Milwaukee, the lowest number in a decade, according to the county’s overdose dashboard. That marked a significant reversal of the recent overdose epidemic that peaked in 2022, with 674 fatal overdoses in Milwaukee, fueled by widespread contamination of cocaine, heroin, prescription pills, and other substances with the powerful synthetic opioid fentanyl.

As the crisis accelerated in 2019, Belott was assigned to head a new strategy. “I didn’t even know what I was getting into in that moment,” he told the Examiner, sitting beside fellow firefighter and team supervisor Robert Rehberger and peer support specialist Amy Molinski — both members of the overdose response initiative — at the team’s homebase fire station on Fiebrantz Avenue. 

“I didn’t understand even the full impact of what it was,” said Belott. “I was kind of just told, ‘Hey, you’re going to be this guy.’ But the more you get into it, the more you see how it has been impacting people’s lives over these years…We watched those numbers go up and up…Just a crazy amount of people.”  

Between 2017 and 2025, 4,582 people died across Milwaukee County. Nationwide, overdose deaths became more common than those caused by homicide, car accidents or suicide. The people who died were brothers and sisters, fathers and mothers. Some were children younger than 5, others were elders in their 70s. Most were people between 20 and 60 years old. They were unhoused, working class and wealthy people from numerous ethnic and racial backgrounds. Even in Milwaukee — one of America’s most segregated cities — addiction and death have never discriminated.

Every year seemed worse than the last as record-breaking numbers of Milwaukeeans died. “And then we saw just a little decline,” said Belott. Overdose deaths fell by more than 30% in 2024, followed by a sharp drop in 2025. “You’re talking 50% less people dying over the course of the three years,” Rehberger said of the most recent numbers.  

“I’ll say it’s bittersweet,” said Molinski. “And I’ll say that because the number of deaths that we have are still too many. It’s unfortunate that it had to get as high as it did before people were willing to do anything about it.”

Milwaukee’s sharp decrease in overdose deaths mirrors a nationwide trend, tied to stepped-up treatment and harm reduction efforts as well as a shrinking fentanyl supply.

Building a program from scratch

Belott credited Michael Murphy, who served on the common council, with helping steer the first $100,000 to the fire department to start an overdose reduction program. “To his credit, he recognized that we had to do something different than what we were doing,” Belott told the Examiner. 

Although it was just enough money to get a program off the ground, there were questions about what such a program would actually look like. “We had to make the program from absolutely nothing,” said Belott. “Like this didn’t exist anywhere that we knew. …We didn’t base it off anything.” The team itself started off very small. “It was like three hours a day for Monday through Friday,” said Rehberger. “And now we got four teams going out every day doing this work. And it’s just proud to see like,  something come from it.”

The Milwaukee Overdose Response Initiative started by using the fire department’s access to 911 call data to identify people who had survived an overdose within the last 24-48 hours. From there, team members would go out to find those people, and see whether there was any help they could provide. “Help” doesn’t have to mean pressuring someone to go into rehab — although the Milwaukee overdose team also regularly works to get people into treatment programs. With time, the team realized that “help” can also mean getting someone clothes, food, providing them with narcan and other harm reduction supplies, and offering compassionate and non-judgmental support.

Molinski recalled one girl who called the overdose response team because she needed a ride to her psych appointment. “It’s cold, she didn’t want to walk,” Molinski recalled. “So we picked her up and we took her there. We stopped at the food pantry along the way so that she could get some food.”

“Help” can also mean checking in on family members who recently lost a loved one to the overdose crisis, and ensuring they have access to the resources they’ll need to process their loss. Belott said that acts like these are about providing “basic humanity for the people that we work with.” Molinski echoed the sentiment. “It’s helping to eliminate some of the struggle,” she told the Examiner. “We all want to quit when it’s hard.”

The Milwaukee overdose team also had to focus on how it would grow to meet those needs. Like Belott, Rehberger didn’t know what to expect when he joined the team. “I volunteered but I didn’t really know exactly what I was volunteering for at the time,” he told the Examiner. When the team decided to add addiction peer support specialists, Molinski, who is employed by Community Medical Services, a medication-assisted treatment clinic, was brought on. The team’s vehicles, modestly marked with the fire department’s logo and “community paramedics” on the trunk, usually carry two firefighters and one peer supporter.

Working on the overdose response team, Molinski grew to understand just how much people respected the Milwaukee Fire Department. “These guys [firefighters] got rolled into it, and I don’t think that there’s any way that you can’t say that that helped impact the success that we see today,” Molinski, who got into the peer support field after enduring her own battles with addiction, said. When overdose survivors “get greeted by someone in a uniform that doesn’t judge them, tries to take the shame out of what they’re doing and say ‘your life is worth saving, like not just on the street last night but moving forward,’ that means a lot,” she said.

As the overdose response effort evolved, so did team members’ understanding of the epidemic, themselves, and each other. “There was a lot of humility in the beginning,” said Molinski. “There was a lot of us having to look at one another and sometimes kindly, sometimes very directly, [saying] like, ‘Hey, what you just did wasn’t right.’” 

Molinski admitted that “I’m a little rough around the edges” and “I’ve kind of always done things my own way.” She grew to appreciate what representing the fire department meant. “So you can be you, just tone down just a little bit,” she said. “And I needed to hear that. …We learned from one another.” The firefighters learned how to loosen up and Molinski learned how to tighten up, she said, “and we were kind of able to share that with everybody as they came.” 

A conversation, not an interrogation

Firefighters who joined the team also often had to rethink how they approach people struggling with addiction. As emergency responders, Belott and Rehberger were trained to stabilize people, patch them up, and transport them to a hospital in the middle of a crisis. In order to succeed, however, the overdose response effort demanded a completely different modus operandi.

“For us, we’re not there in the crisis moment,” Belott explained. “We’re there following the crisis moment. So we have time…we sit down and we have a conversation, not an interrogation, which is what I used to do at the beginning.” 

“If you have a conversation with somebody, you learn about them…Because a conversation flows,” Molinski said. Rehberger called it “asking a question in a different way, and listening.”

This allowed team members, especially those with no personal experience with addiction, to see a whole new side of the epidemic and what it meant for people fighting to stay alive. The conversations they had affected them deeply, allowing them to experience the gratitude the people they tried to help felt  for anyone willing to treat them with dignity. “Before I came here, one of the things that I wasn’t expecting was how much relationship you grow with the people that we’re meeting,” said Rehberger. “I feel like I was just thinking that it was going to be mostly like a 911 call, you know? Like you’re helping the person in that moment.” Rehberger wasn’t used to people being so grateful on calls that they gave him giant hugs. “Never did I think that I was going to be hugging someone while on the fire department. Ever.” 

Molinski recalled her first month with the overdose response team. “It was in the middle of the summer, it was hot, they didn’t have air conditioning,” Molinski recounted. “He was wearing no shirt, he was smoking cigarettes in his apartment, and it was a lot. And as we left, I hugged him goodbye.” Belott was taken aback, quipping that Molinski was “all in.” The peer support specialist explained that it may have been a very long time since that man had felt “a caring human touch.” 

What winning looks like

Even for Molinski, who’d experienced her own addiction to heroin and other drugs, the conditions people survived day-to-day were startling. “Our stories of addiction while we were in active addiction are insane,” Molinski told the Examiner. People living with an active addiction may or may not have stable housing, regular access to food, hygiene products, transportation, work, or even trustworthy people. Sometimes, the overdose response team would find people only to lose track of them again for over a year.

“They probably lost three phones in those 18 months,” said Molinski. Yet, out of the blue, the same person who couldn’t hold onto a phone might call the overdose response team for help because they had managed to keep a team member’s business card. “I mean, think about that for a second,” said Molinski, “how hard it is to keep track of your property when you’re in active addiction, but somehow a business card was still there to call.” 

Other times, team members learned firsthand just how hard it is for people to stop using drugs. “People are trying,” said Molinski. “… not everybody is just choosing to stay in their addiction. Some of them don’t see a way out. They’ve tried and they can’t get out. And when you see that, it’s easier to treat people with a little bit more compassion. Give somebody a little bit of grace as to why they’re still in that situation.”

Rehberger remembered checking on a woman, who contacted the team saying that she didn’t have any clothes. “I didn’t know what that meant, honestly,” said Rehberger. When team members met the woman they realized that she literally didn’t have clothes to wear. So they got her clothes, then food, and then they returned to see if she’d go into treatment. When they did, the woman told them, “Honestly, I would never have gone in for treatment the next day had you not gotten me the food first,” Rehberger recounted. 

Belott said that simply getting through the door to have a conversation was a success. “If they’re willing to sit down and talk with some strangers in uniform, that’s an amazing thing,” he said. “And we show up and they know, OK, somebody’s following up, somebody gives a crap about me.” 

Team members have dropped off birthday cupcakes to people living in homeless encampments, and celebrated “clean days,” marking milestones for people who’ve quit drugs. Molinski recalled one unhoused man the team had been trying to locate for a long time. After connecting with his grandparents, the team was able to arrange for him to get into detox before going off to a residential facility. It turned out the man was living near an alley. He conveyed to the team that he didn’t want members to park too close to the site.  So they stood near a pizza sign, yelled his name, and he came out accompanied by a friend. “My buddy needs help, too,” he said. 

The overdose response team’s efforts were the subject of intense debate in the community. Team members often found themselves fighting the stigma and shame attached to addiction. Some people were confused about why the team tried so hard, even questioning whether the city would be better off just letting people die. With patience and much labor, however, some people’s minds changed. Belott wondered, “How many 10-minute conversations have we had over the years? And how many minds [were] changed by doing that?” 

Success can be measured in concrete results like the lower number of fatal overdoses. But not every achievement can be recorded on a spreadsheet, and not every good deed results in a life saved.

About eight months into the program, team members were working with a young woman they had come to know well.  “We actually got told that we weren’t allowed to see her anymore,” said Molinski. “We were too invested…She saw us a lot. She was not in good shape. This girl was struggling. And we just kept going to see her. And we didn’t know how we were going to help her, if we could help her. We had no idea what to do.” First they tried reaching her parents, who were exhausted by their daughter’s  addiction. The mother hadn’t seen her in over 200 days, and the father didn’t want her back home because she was prone to stealing. 

Team members eventually found out that she was sustaining herself as a sex worker on Milwaukee’s North Side. Besides her addiction, she also suffered from the condition endocarditis which causes inflammation of the heart. Team members accompanied her to the hospital so that she could get a Peripherally Inserted Central Catheter (PICC) line, a procedure which frightened her.

Then one day the team got a call from a man she was staying with, saying that she was lying in the bathroom and couldn’t get up. She was rushed to the emergency room. She asked team members to bring some of her favorite treats, a Sprite and Reese’s Peanut Butter Cups, when they visited. 

It was her thirtieth birthday when the team visited the hospital and brought her a blanket and a book to read. “She was completely unconscious, unable to speak in any way,” said Molinski. “And then the day after that, her family called [Belott] and I and said, ‘We’ve made the decision to take her off of life support. And we would like to invite you guys to come and say goodbye if you would like.’” 

Molinski said that she and Belott “were too invested…We were all f-ing in…And we went, and we cried over her bed, and we said goodbye to her, and her family took her off life support, and that sucked.” Yet, Molinski also had texts that the young lady sent her saying that she loved them, and that knowing them was the first time in years that she felt that anyone cared about her. “And she died,” Molinski said, shedding tears, “but she died feeling loved.” Her parents saw that love, too. “I don’t care what anybody says…The numbers say that was a fail,” said Molinski. “They weren’t there. It wasn’t a fail. …We made that girl feel like she was worth something before she left the world. We met her too late, we couldn’t help her. But she felt loved when she left.”

Despite the loss, the team knew that they’d done something good that day. “I think about her all the time,” said Molinski. Belott, the team leader who was sitting near her and Rehberger, wiped tears from his eyes. 

“I still have a list of the books that she wanted me to bring her when she was in the hospital. I can’t delete it off my phone,” said Molinski. “She made an impact on me. And we were told to stop. And we didn’t stop.” 

What Milwaukee needs to keep overdose deaths down

Since the Milwaukee Overdose Response Initiative began its work in 2019, Milwaukee County has made great strides against the overdose and addiction epidemics. Narcan — the crucial spray-medication used to revive an overdose victim — can be found in bars, grocery stores, hospitals, restaurants, and free-to-use vending machines. Not only is Narcan carried by firefighters and other emergency responders, but ordinary people can be trained to use it. “Keep that Narcan flowing out there,” Belott stressed. 

Several Milwaukee County communities have adopted their own kinds of overdose response teams. The West Allis fire department, which recently integrated with Wauwatosa’s, has launched one such effort. The state of Wisconsin also legalized testing strips both for fentanyl and xylazine — a potent tranquilizer — allowing people to check drugs for dangerous substances before using them. New treatment centers have opened in parts of the county. Even within local jails, people are able to access medication-assisted treatment and take the first steps towards recovery.

Many of those resources are also distributed by the Milwaukee Overdose Response Initiative  for free in the form of “Hope Kits.” Similar to a small plastic purse, with the word “Hope” printed on it in bright red lettering, the kits are stocked with Narcan, testing strips and contact information for treatment centers, therapy, and groups like Narcotics Anonymous and Alcoholics Anonymous. All frontline firefighters are deployed with Hope Kits.

The Milwaukee overdose response team’s work is funded by opioid settlement funds, paid out by the pharmaceutical companies that helped spark the opioid epidemic. With those funds, and additional grants, the team is able to keep the lights on and grow its coterie of firefighters, peer support specialists, vehicles, and harm reduction resources. “We’re proud of MORI,” Belott told the Examiner. 

Treatment is still in short supply. Often, the team is forced to look for residential treatment beds outside of Milwaukee County. Sometimes that’s a good idea for people who need to sever their old connections. But for those facing transportation challenges, it can be difficult. Molinski, Belott and Rehberger also said no residential treatment centers in Milwaukee have proper accommodations for people with disabilities.

“There is none. Zero,” said Molinski. “Not a single place where someone can get help in a wheelchair. Or somebody that simply hurt themselves while using and is on crutches, they also can’t go.” 

Ultimately, the greatest resource the overdose response team can provide is hope. Regardless of what they’ve done, or experienced, people’s lives are worth saving, team members said. In Molinski’s case, it was disconnection and feeling empty that led her into drug use, and it was connection and hope that pulled her out of it.  

“My life was worth saving,” said Molinski. “It would’ve been really hard to convince someone of that back in 2006, 2007…That would’ve been a tough sell. My parents were starting to wonder if it was worth it for them to keep fighting. But it was worth it!” Today, she is raising a teenage daughter, and works in a field where she can help people who struggle like she did. But to get there, Molinski had to keep trying. “I never dreamt that this was waiting for me,” she said.

This article has been edited to reflect that Ald. Michael Murphy helped steer funds to get the overdose team started, not Ashanti Hamilton.

All 41 states that expanded Medicaid eligibility under the Affordable Care Act will see fewer people covered due to new federal work requirements and more frequent eligibility checks. But the percentage of recipients who lose coverage will vary greatly from state to state, depending on how state officials implement the new rules, according to a new report.

The report, released this week by the Urban Institute with support from the Robert Wood Johnson Foundation, projects that in 2028, between 4.9 million and 10.1 million people will lose coverage as a result of the federal policy changes included in the broad tax and spending measure President Donald Trump signed last summer. That prediction is roughly in line with estimates by the Congressional Budget Office, which projected last fall that the changes would increase the number of people without health insurance by 7.5 million in 2034.

Whether the actual number ends up at the low end or the high end of that estimate will depend on state policy, according to the researchers. States that automatically check eligibility using data-matching, impose the minimum work requirements allowed under federal law and broadly define certain exemptions, such as those for “medical frailty,” will minimize the number of people who lose coverage.

On the other end of the spectrum, states that require stricter documentation of work hours and implement narrower exemptions will see more people dropped from the rolls.

With stricter state policies, the report projected that eight states — Connecticut, Massachusetts, Maryland, Minnesota, Missouri, New York, Vermont and Wisconsin — would see a decline in enrollment of 60% or more. (Wisconsin hasn’t expanded Medicaid under the ACA, but it was included in the study because it received a federal waiver that makes some of its Medicaid enrollees subject to work requirements.)

Arkansas, Idaho, Montana, North Dakota, Nebraska, New Mexico, Oklahoma and Oregon would have the smallest declines under strict policies, but would still see losses ranging from 37% to 46%.

With the least stringent policies, North Dakota and South Dakota would have the smallest declines — 18% and 19%, respectively. Even under lax rules, six states — Connecticut, Massachusetts, Maryland, New York, Virginia, Vermont —- would see declines of 30% or more.

Nationwide, between 19% and 37% of people who already work will lose Medicaid coverage, according to the analysis, due to challenges such as fulfilling the documentation requirements to prove that they work.

States have to enforce work requirements by next January. They may enforce them earlier via a waiver or state plan amendment, but so far only one state, Nebraska, has announced a plan to implement the requirements earlier, in May.

Some groups are exempt from the work requirements, including American Indian and Alaska Natives, people deemed “medically frail,” households receiving benefits through the Supplemental Nutrition Assistance Program, caretakers for children under age 13 or for those with disabilities, foster care youth and former foster care youth under age 26, among others.

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

When an Alabama clinic’s only OB-GYN left the state to provide abortion care in Colorado, the head of operations thought the facility would have to close. 

But Robin Marty, executive director at WAWC Healthcare in Tuscaloosa, hired a doctor in August who she called a “unicorn” — someone who’s from Alabama and, after training outside of the state, returned home to practice medicine. 

Marty said Alabama’s near-total abortion ban could cause physicians to practice elsewhere after they finish their residencies. 

“Doctors don’t want to worry about surveillance, potential arrests and other legal issues,” she said. 

A study published this month found that applications to medical residency programs in states with abortion restrictions have declined compared to states where abortion remained mostly legal. The findings are an “early signal” that the U.S. Supreme Court’s decision nearly four years ago overturning federal abortion rights protections may exacerbate health care shortages, said lead author Dr. Anisha Ganguly.

A majority of doctors end up practicing medicine in states where they trained. Obstetrician and gynecology training programs typically take four years to complete, so the full scope of how abortion restrictions affect where physicians work after they complete their residencies remains to be seen. 

Still, experts said the findings could spell trouble for the future of the reproductive health care workforce in states with abortion restrictions, some of which are already plagued with maternity care deserts. 

Doctors say bans limit training, standards of care

OB-GYNs affiliated with Physicians for Reproductive Health who either trained or work in states with abortion bans told States Newsroom that restrictions after the Supreme Court decision hamstrung their ability to offer reproductive care and affected the education of medical residents. 

Dr. Neha Ali grew up in Texas and trained there, too. But by the end of her OB-GYN residency’s second year, the state enacted SB 8, a six-week abortion ban that allowed residents in the state to sue providers or anyone who helped someone terminate a pregnancy. After the Dobbs decision in June 2022, a near-total abortion ban took effect in Texas.

“I knew I wanted to be an abortion provider before I started OB-GYN residency, and I chose to be in Texas for my residency training because I wanted to experience what that’s like in a state with barriers. But ultimately, the barriers became too large,” Ali said. 

After she finished residency in 2024, Ali moved to Colorado, a state with strong abortion-rights protections, where she practices complex family planning.

Ali said she talks to medical students about her experience training in Texas, where she was not able to perform any dilation and evacuations — a second-trimester abortion procedure — during residency. 

“I do think it’s very valuable to see what it’s like to be in a restrictive state and understand what that is like to be a provider there, but that doesn’t sell people on a residency for four years,” she said.

OB-GYN Dr. Louis Monnig trained in Kentucky before the state banned abortion. 

“Making it difficult or putting up barriers to that training just limits the abilities of any doctor who provides reproductive care to have opportunities to get exposure and experience, and just get better at what they’re doing,” he said. 

Monnig completed his residency in June 2023 and moved back to his home state of Louisiana because of his connections to the region and its health care disparities. “It felt like it was worth it to come back,” he said. 

In October 2024, a Louisiana law classifying mifepristone and misoprostol as controlled dangerous substances took effect. 

“It made me lose faith that lawmakers were doing any of these things to actually protect patients or patient safety,” he said. 

The medications are used not only for abortions, but miscarriages and other conditions, too. The law has sowed confusion among health care providers and led some to practice emergency drills to access the drugs during obstetric emergencies, Louisiana Illuminator reported. Monnig said the law has “changed some of the day-to-day operational workflow for patient care,” especially for situations where misoprostol is used, such as labor induction and postpartum hemorrhaging. 

Patients have faced issues when trying to get prescriptions filled: Pharmacists have called Monnig’s office to make sure a patient wasn’t having an abortion after he prescribed misoprostol for conditions such as cervical stenosis — when it’s difficult to insert a medical instrument in the cervical canal.

Drop in applications to ban states’ residency programs

Out of more than 22 million applications to 4,315 residency programs across the U.S., 67% were submitted to programs in states without abortion restrictions between 2018 and 2023, the new research showed. Thirty-three percent went to programs in states with restrictions. 

Fewer women than men applied to train in states with abortion restrictions before the Supreme Court’s landmark abortion ruling, according to the study, and that disparity widened after more than a dozen states enacted abortion bans. The number of men applying to residency programs in states with abortion restrictions — mostly in the South and the Midwest — also decreased significantly. 

“When there’s a decreased level of interest in these states, it suggests to us that there’s an evolving health care workforce shortage in these states,” said Ganguly, an internal medicine physician and an assistant professor at University of North Carolina’s Division of General Medicine and Epidemiology. 

Many states with abortion bans — Idaho, Iowa and Georgia, for example — are also facing labor and delivery unit closures, particularly in rural areas where hospitals struggle with provider recruitment. Health officials in these states listed improvements to maternal health as a priority in their applications to the federal Rural Health Care Transformation Program, but solutions will take years to implement. 

Shortages affect more than one specialty. Ganguly said OB-GYNs have historically offered the bulk of abortion-related care in the U.S., but it’s increasingly important in emergency medicine, family medicine and internal medicine. Primary care providers and emergency medicine doctors often diagnose pregnancy complications such as miscarriages, and internists help women who have chronic disease manage and plan for pregnancy. 

Dr. Hector Chapa, an OB-GYN who teaches obstetrics and gynecology at Texas A&M University and is a member of the American Association of Pro–Life Obstetricians and Gynecologists, took issue with the study’s approach. 

“It’s essential to understand that this study is not specific to OB‑GYN residency programs, and by grouping OB‑GYN with family medicine, internal medicine and emergency medicine, the study assumes that all specialties are affected equally, despite their very different levels of involvement in abortion. This broad grouping risks introducing bias into the results,” he said in a statement. 

Ganguly said her team did examine applications to OB-GYN residency programs in isolation to affirm findings of a decline among applicants in abortion-restricted states. Looking at other specialties, too, was meant to provide clarity about how bans affect the health care workforce more broadly.

OB-GYN education and the maternal health care workforce 

The latest study adds to a body of research examining how the Supreme Court’s decision on abortion in 2022 affected training after medical school, particularly for those specializing in reproductive health care. 

In the 2023-2024 application cycle, the number of applicants to training programs in states with abortion bans decreased by 4.2% compared to the previous cycle, while there was less than a 1% decrease in applications to residency programs in states where abortion is legal, according to the American Association of Medical Colleges. 

In some states, abortion bans have definitively led to an exodus of OB-GYNs and maternal fetal medicine specialists. Idaho lost 35% of its doctors who provide obstetrics between August 2022 and December 2024, according to a study published in July. 

Having reproductive health providers flee states with abortion bans is “devastating,” according to Pamela Merritt, the executive director of Medical Students for Choice. 

“It’s a public health disaster that we’re going to see the consequences of decades to come,” she said. 

Merritt’s organization has chapters at several medical schools in states with abortion bans. She said students are not getting adequate training, and some are even discouraged from discussing abortion. 

In February, Texas Tech University Health Sciences Center canceled a Medical Students for Choice chapter’s talk with an OB-GYN who wrote a book about providing abortion care later in pregnancy. School officials told The Texas Tribune hosting the event on campus was not in the university’s best interests.   

“Everybody who graduates from medical school in Texas should know that there’s this thing called third-trimester abortion, that when the life of the mother is at risk, you legally can provide this care,” Merritt said. 

Republican Gov. Greg Abbott signed legislation last year clarifying that doctors can offer pregnant women abortions during medical emergencies. The Texas Medical Board released guidelines for the abortion law this year, nearly half a decade after the state banned most abortions and at least four Texans died after being denied prompt abortion care, ProPublica reported. 

Program helps residents in restrictive states get abortion care training 

“Every single physician, nurse and health care provider needs to be educated about abortion care,” said Dr. Jody Steinauer, an OB-GYN and the director of the Bixby Center for Global Reproductive Health at the University of California in San Francisco. “This is a huge crisis in OB-GYN specifically: All OB-GYNs must have the competence and the skill to safely empty the uterus. Even if the individual is personally uncomfortable providing abortion care, they have to be able to empty the uterus to save someone’s life in an emergency.”

Steinauer leads the Ryan Residency Training Program, which works with OB-GYN residencies across the country to ensure comprehensive abortion and family planning rotations. Nearly a dozen states lack Ryan programs, and most of them have near-total abortion bans. 

She said residencies in states with abortion bans are struggling to make sure their students have the skills to provide abortion: “We’re at risk of having a whole generation of OB-GYN graduates who are not skilled to provide the care they need to provide.” 

To remedy this issue, the Ryan Program has helped to establish 20 partnerships with schools in abortion-restrictive states to train OB-GYN medical residents in states with reproductive rights protections. 

Steinauer said the rotations are between two to four weeks and complicated to plan, but they help doctors learn procedural skills, how to manage medication abortions and counseling. 

The rotations also help OB-GYNs navigate pain management during obstetric procedures, communicate effectively with abortion patients and familiarize themselves with ultrasounds, she said. These skills are important for providing the full spectrum of reproductive health care, from inserting IUDs to treating miscarriages, the doctor said. 

“It’s such a refreshing experience for them to be working in a state without a ban, and they get to see abortion as normal health care,” she said. 

On this Sunday, March 29 — Palm Sunday on the Christian calendar — the Rev. Rachel Kirk will be among a procession of Christians gathering at the state Capitol building in Madison to assert their spiritual resistance to the actions of the administration of President Donald Trump.

Kirk, associate pastor for Community and Faith Formation at Middleton Community United Church of Christ, is one of the organizers for the Palm Sunday Path in Madison, an initiative promoted by the Wisconsin Council of Churches that will have variations across the state. 

It will take place the day after Saturday’s No Kings rallies across the country protesting Trump, and Kirk says the two events share similar objectives: “to challenge unjust power structures and the deterioration of democracy.” But she expects the Palm Sunday Path to offer a different experience — “a celebratory, but also a serious thing, more prayer than protest,” she says.

“The story of Palm Sunday is of Jesus processing into Jerusalem in what would become the final week of his life, and it’s a story told in all four of our gospels,” says Kirk. Some religious scholars have suggested that the Palm Sunday procession in the Bible purposefully echoed another parade: a triumphal march through the city by the Roman leaders whose army occupied the land of Israel.

In that light, for Christians such as Kirk, Jesus’ ride on a donkey has a pointed, anti-imperial meaning.

“Palm Sunday is his journey into that center of power to assert a different kind of power — one that doesn’t dominate and doesn’t exclude,” Kirk says. “We are trying to echo that original message of Palm Sunday — that it is Jesus’ legacy of confronting power that oppresses and excludes and is violent, and we’re trying to assert what we believe is the message of Christ, which is love and inclusion and belonging and peace.”

‘I cannot turn aside…’

The first year of Trump’s second administration has generated  recurring protests of increasing size, channeling public opposition to the administration’s sweeping attacks on immigrants, the reversal of policies that promote diversity and inclusion, the promotion of discrimination against LGBTQ and transgender people and cuts to health care and social supports for poor people. 

Among those resisting the Trump administration’s policies, faith groups and faith leaders have taken an increasingly high profile — across the country and in Wisconsin.

“My baptismal promises include following the works and words of Jesus and to resist evil. The ordination promises by which I became a minister echo that,” says the Rev. Kerri Parker, executive director of the Wisconsin Council of Churches, an ecumenical organization representing churches from more than 20 distinct Christian traditions.

“It means I cannot turn aside when I see evil being perpetrated, when I see vulnerable people being actively victimized by power, by what I would at this point call Capital E Empire,” adds Parker. “I have a duty to engage the tools of my faith, what platform I have, the skills I have been given, to say this is not right.”

At the height of the occupation in Minneapolis this winter by federal immigration agents, hundreds of faith leaders gathered in the city  to join the community’s resistance to the federal incursion. Among them was the Rev. Zayna Thomley, the lead pastor at the Middleton Community UCC church.

She attended a mass gathering of clergy in a large Minneapolis church and joined a protest in the lobby of the Target corporate headquarters the next day criticizing the store chain’s cooperation with Immigration and Customs Enforcement agents. 

“It felt really powerful to know that everybody who was in the room and who was on the street had the understanding to be a part of a bigger vision of what it means to be part of community, what it means to be held by God and what it means to show up for justice,” she says. “It was a deeply holy experience.

Religion and social justice

Religious groups have long taken part in social justice movements. The Rev. Martin Luther King Jr. was a Baptist minister who invoked his faith in his commitment to nonviolence as essential to the struggle for civil rights for Black Americans.

In Milwaukee, the interfaith organization MICAH — Milwaukee Inner-city Congregations Allied for Hope — has operated for nearly four decades, working to address the issues of justice in “a city afflicted with radicalized and concentrated poverty,” in the words of the organization’s website.

MICAH’s president, Rev. Richard Shaw, says he has seen more faith leaders and organizations getting involved in pushing back on federal policies in the current administration, as they are “looking at the families being broken up, looking at innocent people being arrested and put in detention without due process.”

He welcomes newcomers to the work. “I do believe that there’s power in numbers,” says Shaw, pastor of St. Matthew C.M.E. Church in Milwaukee. “If we truly follow the Jesus of scripture, to not get involved is to deny the earthly ministry of Christ.”

Christian groups are part of a broader coalition of faith groups standing up to the Trump administration. In January the Interfaith Conference of Greater Milwaukee, which represents 22 faith organizations — Jewish, Christian, Muslim, Buddhist, Sikh, Hindu and more — issued a statement in defense of immigrants and of peaceful protest after the fatal shooting of Renee Good in Minneapolis by a federal agent. 

“We consider the exploitation of human beings, the separation of families, and the use of violence and intimidation, to offend the human dignity not only of the oppressed but the oppressor,” the Interfaith Conference statement declared. “The rights of all people, including neighbors, immigrants and asylum-seekers, to humanitarian treatment is explicit in our national foundation, and our international treaty obligations.”

“There is a deep respect for human dignity in all of our religious traditions, and what has been happening on our streets is something that is observable to all people of faith who care about human rights and respect dignity,” says Ahmed J. Quereshi, the Interfaith Conference executive director.

At a vigil in Minneapolis for Renee Good after she was killed, Imam Mowlid Ali told Good’s neighbors, “Today is the day that we send a message to everyone in this nation. That we are united. We reject any dehumanization of any person in this city, in this state, or anywhere in our nation.”

“We Jews know from history what happens when people are kidnapped, deported, detained, and given no human dignity or rights,” Rabbi Sharon Kleinbaum said at a flash mob protest at a Minneapolis Target store. “We know what God demands of us. God demands that we be with the worker, with the vulnerable, with the immigrant … We are all created in God’s image, without exception.”

The morning after inauguration

Religious individuals, groups and leaders were among those who stood up to the policies and practices of the first Trump administration. Their role in response to Trump’s second term has been even more prominent.

“It arguably began the first day of Trump’s second term,” said Jack Jenkins, a Washington, D.C.-based reporter for Religion News Service, during an online round table discussion RNS conducted March 24.

At a prayer service the morning after Trump was inaugurated, Bishop Mariann Budde spoke directly to the president from the pulpit, urging him to “have mercy” on frightened gay, lesbian and transgender children as well as on “the vast majority” of immigrants, regardless of documentation, who are not criminals.

“That sermon that was given to him at the Washington National Cathedral by Bishop Mariann Budde, the Episcopal Bishop of Washington, made clear very quickly that there was going to be religious pushback to several parts of his agenda,” Jenkins said.

Trump was elected in 2024 with the support of more than 80% of white evangelical Protestant Christians, 60% of white Catholics and 57% of white non-evangelical Protestants, according to data compiled by the Public Religion Research Institute. And Trump has garnered favor among Christian groups that oppose abortion and LGBTQ+ rights.

But Christians cover a much broader spectrum of ideologies and perspectives on social issues.

“The loudest voice of Christianity in the United States is what we’re starting to really understand as white Christian nationalism,” says the Rev. Julia Burkey, senior pastor at Orchard Ridge United Church of Christ on the west side of Madison.

Burkey sees a religious revival emerging among Christian traditions that emphasize “the beloved community that we’re working towards, which includes all people,” regardless of gender, sexual orientation or other dividing categories.

When the immigrant advocacy group Voces de la Frontera and U.S. Rep. Mark Pocan (D-Black Earth) decided to hold a news conference in late January to announce their intentions for a peaceful but firm resistance to a possible federal immigration enforcement surge in Wisconsin, they chose the Orchard Ridge church for the event.

Burkey says engagement with social justice has been a core part of her ministry and faith since her seminary years in New York City.

“So it doesn’t feel new to me necessarily,” Burkey says — but, she adds, people may be noticing it more now.

“I just think it’s so important that we’re speaking up for human dignity and for just very basic things that are tenets of our religious faith, like loving one another,” Burkey says. “That golden rule of treating each other like we would like to be treated is a very deeply agreed upon value in the world and all faith traditions, and it’s being violated right now.”

Protests, lawsuits, immigrant support, nonviolence training

The faith-based resistance to the Trump administration has taken many forms.

During the Minneapolis gathering, nearly 100 faith leaders were arrested at the Minneapolis-St. Paul airport on Jan. 23 after going there to protest the ICE detention of workers and commuters as well as the involvement of airlines in transporting people taken into ICE custody.

After Trump reversed a 30-year policy that put schools and houses of worship largely off-limits for immigration raids, the Greater Milwaukee Synod of the Evangelical Lutheran Church in America joined the Religious Society of Friends (Quakers) and other church groups in a lawsuit to block the change.

A federal court ruling in February that granted the groups a preliminary injunction against the administration’s change is currently under appeal.

The Milwaukee synod joined the suit because church officials could see the impact of the administration’s aggressive stance towards immigrants on their congregations, says Bishop Paul Erickson.

“People were not coming to church because they’re afraid of ICE. People were not going to the food pantry at the church because they’re afraid of ICE,” Erickson says. “We felt a strong belief that the behavior of our federal government was interfering with the free expression of religion.”

At Christ Presbyterian Church in Madison, church members were among people in the community who years ago identified the need for an immigration legal aid service and helped raise the funds for it to operate, says the Rev. Will Massey, an associate pastor at the church. The church went on to host the service, the Community Immigration Law Center.

That relationship has gone back more than a decade. In the last year, however,  CILC has been ramping up its operations significantly in response to the Trump administration’s policies to remove immigrants. 

“Right now one of the church’s highest priorities is providing for the work of the law center — making sure that we are acting and we are managing our building in ways that allow their work to continue,” Massey says.

The Rev. Jennifer Nordstrom, senior minister at the First Unitarian Society in Milwaukee, helped lead a training in non-violent civil resistance for faith leaders in January.

“We have a long tradition as people of faith of being the moral voice in society against unjust laws and being willing to take a moral stand, a non-violent moral stand, against injustice in the world — even when it’s our government promoting that injustice, which is what we’re seeing today,” Nordstrom says.

“I see faith leaders who have always been siding with love, faith leaders who have always understood God and the Holy as a loving God that believes that all human beings are made in the image of God,” Nordstrom observes. “And in this moment, because the assault on human dignity is so pointed and aggressive, those folks are bringing that Imago Dei — the image of God, the holiness and sacredness of every human being — theology out into the community and even out into the streets.”

‘Loving our neighbor’

Other forms of support are less visible, but participants say, no less important. Some of it grows out of a longer history of assistance to refugees and immigrants in less fraught times.

“There’s been work that has happened quietly in an everyday manner that people have been proud of and comfortable participating in,” says Parker of the Wisconsin Council of Churches. “The everyday work of resettling refugees, feeding hungry people, helping folks learn the language of the place where they’re living now.”

In the current political climate, “folks who have been doing this quietly are being more direct and public about the need,” Parker adds. “And folks who may not have been engaged in it before are diving in.”

Much of that work now has also become much more discreet, to protect families and individuals who those involved fear could be targeted indiscriminately  by immigration authorities.

“I see so much organizing happening locally,” says the Rev. Kendra Grams, a Presbyterian pastor in Hudson. “It just doesn’t get as much visibility for various reasons. But it is happening and from my perspective that’s been wonderful to see.”

Erickson says friends, colleagues and family members in the Twin Cities, where he previously lived and worked for 13 years, have told him that protests and other public actions are only a fraction of the work people are undertaking to help the most vulnerable people in the community. 

“It’s the networking of providing mutual aid and food and money and support,” Erickson says. “Helping people get rides to the doctor’s office because they’re afraid to go out by themselves, and showing up in restaurants and committing to eat in the same restaurant every day and spend two hours there just in case ICE shows up in an immigrant-owned restaurant or a restaurant that employs significant numbers of migrants.”

Those are not “a centralized, coordinated, highly orchestrated effort,” Erickson says. “It’s simply baked into the fabric of how do I love my neighbor?”

That underlying tenet is found in “any religion that I’m aware of, whether it be Christian, Muslim, Buddhist, Jewish,” he says.  “And so I think that’s really what we’re trying to lean into and recognize, that the actions of the federal government are getting in the way of us loving our neighbor. And we’re not going to sit back quietly and let that continue.”

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Nine of Wisconsin’s 72 counties are “maternity care deserts”: no hospitals and birth centers offering obstetric care and no obstetric providers such as obstetricians.

The nine, according to the latest March of Dimes report (2024), are largely rural: 

Adams, Douglas, Forest, Kewaunee, Lafayette, Marquette, Oconto, Pepin and Rusk.

Maternal care deserts drive maternal mortality rates, which generally are higher for Black women and women in rural areas, according to a 2025 study by Brown University researchers.

Individuals in states with a high prevalence of maternity care deserts had 34.2% greater risk of maternal mortality and 18.3% greater risk of infant mortality, Yale University researchers found in 2025.

The Wisconsin Office of Rural Health at the University of Wisconsin-Madison recommended extending pregnant women’s Medicaid coverage to 12 months postpartum, from two months, to improve care and hospital finances.

Gov. Tony Evers recently signed legislation for that extension.

This fact brief is responsive to conversations such as this one.

Sources

• March of Dimes: Maternity Care Desert
• Journal of the American Board of Family Medicine: Maternity Care Deserts: Key Drivers of the National Maternal Health Crisis
• AJPM Focus: State-Level Prevalence of Maternity Care Deserts: Association With Healthcare Access, Utilization, and Outcomes Among Medicaid Recipients
• Wisconsin Office of Rural Health: Obstetric Delivery Services and Workforce in Rural Wisconsin Hospitals 2024
• Milwaukee Journal Sentinel: Lawmakers vote to extend postpartum Medicaid coverage to a full year
• The Commonwealth Fund: Positive Outliers: How Some Rural Communities Maintain Access to Labor and Delivery Services
• National Rural Health Association: Maternal health in rural America
• University of Wisconsin-Madison Collaborative for Reproductive Equity: New CORE brief explores Dobbs decision’s impact on the ob-gyn workforce in Wisconsin
• PBS Wisconsin: Maternal health care in Wisconsin and the future of Medicaid

Do some Wisconsin counties have no maternal health care providers? 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.

From 2021 to 2024, a new report reveals there was a dramatic increase in the number of incarcerated residents of Wisconsin’s jails and prisons accessing medications for opioid use disorder.

“Treatment Behind Bars: Medication for Opioid Use Disorder in Wisconsin’s Jails and Prisons” by the Wisconsin Policy Forum was released Wednesday at a press conference hosted by Vital Strategies Overdose Prevention Program, a global public health organization that has been working since 2018 to use “advanced evidence-based strategies on overdose prevention and to expand access to harm reduction and treatment, particularly for populations at highest risk,” said Giavana Margo, program manager.

The report notes that “medications for opioid use disorder are an important tool to help people manage symptoms of opioid withdrawal, as well as recover from symptoms of active opioid addiction. Research also shows that individuals who are newly released from prison are at elevated risk for overdose fatalities.”

The report said there are three factors that have “likely” resulted in the higher use of opioid use disorder medications  in carceral settings:

1. The high number of opioid deaths in the state that reached a peak in 2024
2. The availability of opioid lawsuit settlement dollars from pharmaceutical companies to address treatment.
3. Federal and professional agencies promoting the medications, and pressure from the U.S. Department of Justice to offer them to carceral residents under the Americans with Disabilities Act.

A fourth factor discussed during the press conference is the higher percentage of jail and prison facilities offering the medications, encouraging wider acceptability.

Jason Stein, president of the Wisconsin Policy Forum, said that even though the number of opioid deaths has dropped noticeably since 2024, the number of overdose deaths statewide is slightly higher than vehicle deaths, making overdoses a “significant public policy issue.”

He noted that of 71 jails in the state, 58 filled out a 42-question survey fully and seven answered partially, resulting in a 97% reporting rate for the jails, while the Department of Corrections (DOC) reported data via its central pharmacy that serves all the state prisons.

The primary two opioid use disorder medications used by facilities are methadone and buprenorphine.

“Both of those medications are associated with a decrease in overdose deaths as well as improvements in other important indicators such as recidivism,” he said.

The study also looked at the use of naltrexone, another medication that is not strictly for opioid use disorder, and it also looked at the prevalence of naloxone or Narcan, which is used to reverse opioid overdoses.

The report notes that only four residents in the DOC system took buprenorphine in 2021, but 148 were receiving it in 2024, and 44 took naltrexone in 2001 — a number  that increased to 154 in 2024.

Stein said a 2021 Department of Health Services (DHS) report showed that only one-third of prisons offered any medication for opioid addiction, but by 2025 all 36 prisons were offering at least one medication.

Currently, Stein said, most Wisconsin jails — 53 of 65 that responded or 81.5% — offer one form of opioid medication. That is more than double the 25 jails, or 41%, that reported at least one medication in 2021.

“It’s more common for jails in the central and southeastern parts of our state to have multiple forms available,” he said of opioid medication. “In northern Wisconsin, it’s typically one form … such as buprenorphine.”

The report notes that offering the medications to those in jails and prisons results in a reduction of overdose deaths after release, as well as a decreased risk of death for any cause and a lower risk of reincarceration.

“We want to note that there is increased availability of these medications in both county jails and prisons around the state, making it available to thousands of individuals in 2024 at a substantial increase from 2021, but at the same time, there are some gaps, meaning access at the county level,” Stein said. “We had eight counties that stated they did not currently provide any access to these medications. We had five more counties that did not answer the survey. There are now 24 counties that provide some access to methadone, but that is still a minority, and we have a number of jails that, while they may provide continuation of existing prescriptions, they do not initiate individuals on those medications.”

He added, “We do see some opportunity … despite the challenges that may exist, to increase access; we do see some tools that local counties can turn to. One, there are more counties and private providers that are offering this service around the state, so there’s the potential for partnership, and then, as well, the availability of opioid settlement funds also makes the possibility of funding this service more practical in some cases for counties.”

Joanna Hernandez of Milwaukee shared her experience of struggling with addiction while incarcerated and the importance of continuing medication.

She recounted being arrested in 2013 in Walworth County while possessing a valid prescription for Suboxone (a medication to treat opioid addiction).

“The jail verified my prescription, but even after confirming it, they refused to give me my medication,” she said. “I was there for five days and went through very severe withdrawal. I was extremely sick and eventually segregated to a single cell. I remember guards telling me, ‘You know, this isn’t a hospital.’ As soon as I was able to post bail and get out, I used immediately. If I had been able to continue my prescription while incarcerated, I could have focused on healing and making sure my mental health medications were the right fit for me. Mental health plays a huge role in withdrawal.”

She added, “Experiences like mine show why access to medications for opiate use disorder is so important. Withdrawal in jail does not treat addiction. It actually increases the risk of relapse and overdose when people are released. Jails and correctional facilities need to treat opiate use disorder like the medical condition it is. Access to medications for opiate use disorder is about dignity, medical care and saving lives.”

Kenosha County Sheriff David Zoerner said an important part of his jail’s intake is an initial screening, so the residents get the resources they need and they also have those resources when they leave.

He noted it was a grant that provided the dollars to do the initial screening, and also stressed the limiting factor on how much his office can do is money, mostly from tax levies.

Zoerner said the most efficient way to offer methadone would be at the jail but he fears methadone could be “diverted nefariously,” so instead those who need it are driven daily to a facility, but that is also costly because it requires a deputy to transport the residents.

“My hope, based on what we’re doing right now with the early screens, is being able to work with the affected population while they’re in our custody, getting them peer support and some need therapy,” he said.  “You understand that drug addiction, behavioral health issues, mental health, they all go hand in hand, so to facilitate that through and then with new legislation, hopefully we’re going to be able to get these folks prescriptions, a 30-day supply, before they leave.”

The new legislation Sheriff Zoerner referred to is AB 604, which passed the Legislature and is waiting for Gov. Tony Evers’ signature. It would allow the state to apply for Medicaid coverage for incarcerated people, including a 30-day supply of opioid medication prior to release.

At the press conference, Adriena Hust, state team leader of Vital Strategies, shared recommendations for expanding opioid use disorder medication access in Wisconsin jails and prisons.

“The first recommendation, incarceration is not treatment,” she said.  “More should be done to avoid reincarceration. Most admissions to prison in Wisconsin are due to supervision and technical violations, rather than a new crime. While reforms are in progress, Vital Strategies recommends that Wisconsin continue to minimize revocation and eliminate incarceration sanctions for drug use while on supervision, considering reoccurring drug use is a common part of substance use treatment. Although today’s study did not deal with the issue of revocations, we know they are costly, and the savings to minimize them can go toward medication and staffing.”

Another recommendation is to make methadone and buprenorphine standard treatments for opioid use disorder.

And she said counseling should be optional and not a condition to receive medication because it is the medication that saves lives.

 “As mentioned, people are at extreme risk of dying by overdose in the first few weeks after leaving carceral settings,” she said. “It is important that re-entry planning focus on seamless continuation of medication in the community, which greatly reduces this mortality risk.”

And she noted that those incarcerated who have a right to medication under the Americans with Disabilities Act should have “recourse against violations without fear of retaliation,” in demanding medication. Lastly, she said, the state and counties should prioritize opioid settlement dollars for “opioid use disorders in jails and prisons.”

Federal Medicaid cuts could exact a heavy toll on psychiatric units at hospitals across the country, many of which are already struggling to keep their doors open but provide essential mental health care to people who need it.

Psychiatric units are costly and, like labor and delivery services, typically lose money for hospitals and tend to be reimbursed at lower rates than other health services. In contrast, some specialty units, such as cardiovascular care, are lucrative: Cardiologists can generate up to seven times their salaries for hospitals.

Between 2023 and 2024, 126 hospitals across the U.S. shut down their inpatient psychiatric units, according to data provided to Stateline by the American Hospital Association.

“(Psychiatric units) are often in the red, and, for lack of a better word, kind of subsidized by the rest of the health system,” said Sarah Steverman of the National Association for Behavioral Healthcare. Steverman oversees regulatory affairs and is the liaison for a committee of hospital psychiatric unit administrators and clinicians.

The One Big Beautiful Bill Act that President Donald Trump signed into law last year will add to the strain, Steverman and other experts say.

The law is projected to cut federal Medicaid spending by an estimated $886.8 billion over the next decade, largely because new work requirements will push people off the rolls, according to estimates by the Congressional Budget Office. CBO estimates that it could increase the number of people without health insurance by 7.5 million in 2034.

Those cuts will have a significant effect on mental health care because Medicaid, jointly funded by the federal government and the states, covers more people with mental illness than any other public or private insurer — roughly 29% of the estimated 52 million nonelderly adults with mental illness, or about 15 million people, according to health research group KFF.

Behavioral health policy experts say the Medicaid changes will force hospital psychiatric units to provide care to many more people who don’t have insurance. Even before the law, Medicaid often didn’t fully reimburse hospitals for the cost of mental health care, unit administrators said.

Along with increasing the number of people without insurance, the One Big Beautiful Big Act places new limits on states’ ability to maximize federal funding and reimburse providers.

The federal government allows states with contracted Medicaid managed care organizations running their Medicaid programs to direct them to pay providers more. But beginning in 2028, the One Big Beautiful Bill Act will cap these state-directed payments, forcing state Medicaid programs to reduce reimbursement rates by 10 percentage points each year until they reach either 100% or 110% of what Medicare pays.

The federal law also caps provider taxes, a strategy states have used to boost the Medicaid dollars they get from the federal government.

As a result, states will face the choice of replacing the lost federal money with state dollars, scaling back services or providing coverage to fewer people.

Conservatives who have backed the Medicaid cuts say such tools are accounting tricks that states have used to draw down more federal money. Some have even called the provider taxes a “money laundering” scheme. Eliminating them, they say, will force states to be more accountable for their Medicaid spending.

“States are gaming the system — creating complex tax schemes that shift their responsibility to invest in Medicaid and rob federal taxpayers,” Dr. Mehmet Oz, the administrator of the federal Centers for Medicare & Medicaid Services, said in a news release last year.

But Angela Kimball, chief advocacy officer at Inseparable, a mental health advocacy organization, said the tools are essential, and that the cuts will be detrimental.

“For the mental health system, and particularly for facility-based care, it (Medicaid) is the financial foundation. And when you simultaneously reduce who’s covered, what providers get paid, and limit the tools states have to make up the difference, you’re not just trimming around the edges; you’re undermining the whole structure,” Kimball said.

The mental health field is also struggling with workforce shortages across states, especially in rural areas. As of December 2024, more than 122 million Americans lived in designated mental health professional shortage areas.

Dr. Arpan Waghray, a psychiatrist and CEO of Providence’s Well Being Trust, serves as a member of the American Psychiatric Association’s Council on Healthcare Systems and Financing. Providence has 16 psychiatric units across Alaska, California, Oregon and Washington state, and Medicaid and Medicaid HMOs account for 42% of patients across those units. That number increased as the states expanded eligibility under Obamacare.

In contrast, Medicaid pays for roughly 13% of oncology inpatients and about 10% of cardiology inpatients across the hospital systems.

“Inpatient psychiatric units, especially when they’re part of larger hospitals and academic centers, like our community hospitals … they generally tend to operate on a loss,” Waghray said. “We are no exception to that.”

He noted that estimates show psychiatric units have a negative operating income of about 37%.

“We don’t want to make a profit on psychiatric units,” he said, adding the goal is to at least “break even.”

Waghray said if more units are forced to shutter, that will lead to more crowding in emergency rooms and jails. Often, jails and prisons — facilities with inadequate care — end up being mental health care providers for people who lacked access to care. People in crisis also may be forced to wait for a psychiatric bed to open up elsewhere.

“It has this cascading effect that touches everyone’s lives,” Waghray said. “The two places where people get care if they don’t get care in the right setting is the inpatient (psychiatric) unit, and you cut that, then essentially you have emergency departments that are overcrowded or jails that are overcrowded.”

Health economist John McConnell, director of the Center for Health Systems Effectiveness at Oregon Health and Sciences University, said “the whole mental health system is really going to get hit with a shock here.”

“Crisis care funding is all over the place, and there’s not really a consistent way of funding it, and it’s often underfunded,” he said. “You had a fragile system … made more fragile with a lot of the executive orders from the Trump administration — and then (the new federal law) has sort of further chipped away at it.”

Steverman said that people with severe mental health emergencies — such as acute psychosis, mania or suicidality — who need urgent treatment after emergency room intake often require multiple clinical staff and observation.

Gretchen Clark Bower, senior director of Behavioral Health Services at Providence Regional Medical Center Everett, in Washington state, said the hospital’s inpatient psychiatric unit, which opened about five years ago, relies heavily on Medicaid: Roughly 80% of psychiatric inpatients are covered by Medicaid, and many have severe illnesses.

“It has been a stretch financially for a long time,” Bower said. “The costs of providing care are far more than what we’re getting reimbursed. And that is extremely challenging.”

Everett’s average psychiatric hospitalization is about 16 days. But sometimes, insurers will only cover up to a certain number of hospitalization days for mental health, Bower said. That leaves the hospital to absorb the rest of the costs.

“We want to make sure that we are discharging people when they are safe to discharge — not just when their insurance stops paying,” Bower said.

Bower said she worries the cuts will destabilize people if their care gets interrupted after losing coverage, putting more pressure and costs on the health system.

“It worries me a lot,” she said. “How do we continue to take care of our community into the future, and how do we sustain ourselves financially as we do that? It’s an incredibly difficult task.”

A report from the American Psychiatric Association found that states that had expanded Medicaid eligibility saw smaller increases in suicide compared with nonexpansion states: Medicaid expansion was associated with about 0.4 fewer suicides per 100,000 people yearly.

“Combined with workforce shortages and long-standing insufficient reimbursement for psychiatric services, further reductions in Medicaid will increase pressure on already struggling facilities,” said Ben Teicher, spokesperson for the American Hospital Association. “Our members have been worried about their psych units for a long time, and any further erosion of what Medicaid pays for would make it even worse.”

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

The Wisconsin State Senate passed a bill last week that will request funding for health care coverage for incarcerated people from the federal government. State Assembly lawmakers had already passed the bill last month. 

In a Facebook post last week, Sen. Jesse James (R-Thorp) celebrated the measure and said he hopes Gov. Tony Evers will sign it into law. 

James said that “as people leave our correctional system, they have a 40 TIMES higher risk of overdose death within the first TWO weeks after release.” This appeared to be a reference to a North Carolina study of opioid overdose death rates between 2000 and 2015. 

“This bill is a great step forward for Wisconsin as it ensures we become a healthier, safer community,” James said.  

The vote was nearly unanimous, with only Sen. Steve Nass (R-Whitewater) voting no. 

A federal “inmate exclusion policy” limits incarcerated people’s ability to use Medicaid, but the bill seeks to have the state apply for a waiver under an exception outlined by the federal government. 

Under the bill, the state’s Department of Health Services would submit a request to conduct a demonstration project to provide 90 days of prerelease coverage to incarcerated people for case management services, medication-assisted treatment for all types of substance use disorders and a 30-day supply of prescription medications. Incarcerated people would have to be otherwise eligible for coverage under the Medical Assistance program, which provides health services to people with limited financial resources.  

The advocacy organization WISDOM celebrated the Senate’s passage of the bill in an email newsletter signed by Mark Rice, the group’s transformational justice campaign coordinator. 

Rice said that full implementation of the bill would reduce needless suffering and the number of people being detained, benefit public safety, save resources and put more people on a path to successful reentry into society. 

In written testimony dated Oct. 31, director Dawn Buchholz of the Juneau County Department of Health Services said that passing the bill “will help us provide crucial services to inmates reentering our communities.”

“In the past, our agency literally completed hundreds of suicide and other behavioral health assessments for inmates experiencing emergency mental health and substance use crises in the Juneau County Jail,” Buchholz testified. “This was a frustrating process because while we can assess inmates, we cannot provide them with mental health or substance abuse treatment due to Medicaid rules.”

Buchholz testified that providing prerelease coverage to incarcerated people, along with a 30-day supply of prescription medications, “will help our agency work more effectively with our jails and prisons, result in a seamless reentry into community behavioral health services and decrease recidivism.”

DOC communications director Beth Hardtke referred the Examiner to the DOC fiscal estimate for information on what the agency is currently able to provide and the potential impact of the legislation. 

The department estimated it may have over $750,000 in potential cost savings if the waiver is approved and implemented, allowing the state to expand health care access for incarcerated people. 

The Examiner reported last month that in the fiscal estimate, the DOC said that in FY 2025, the agency spent $500,000 on the 30-day medication supply dispensed for incarcerated people before they were released, $300,000 on pre-release medication assisted treatment medications and $3.9 million on the Opening Avenues to Reentry Success (OARS) program. The OARS program supports the transition from prison to the community of incarcerated people living with a severe and persistent mental illness who are at medium-to-high risk of reoffending. 

Because not all incarcerated people will qualify, the estimate assumes that half of the medication and medication assisted treatment medications costs will be reimbursed, as well as 10% of the OARS program costs. There may be other costs DOC can have reimbursed. 

The Examiner previously reported that states have to reinvest federal matching funds received for carceral health care services currently funded with state or local dollars. Reinvested money must go toward activities that increase access or improve the quality of health care services for people who are incarcerated or were recently released, or for health-related social services that may help divert people released from incarceration from involvement in the criminal justice system. 

In the fiscal estimate, the DOC said that incarcerated people in local detention facilities may also be eligible for the services. This could result in local cost savings in addition to DOC cost savings. The department couldn’t estimate the potential local cost savings of the bill because not all local detention facilities provide the same type or level of services.  

Hardtke noted that the bill only allows the state to apply for the federal waiver, and it isn’t guaranteed that a waiver would be approved. 

As of Nov. 21, 19 states had approved waivers, according to the health policy research organization KFF. Nine, including the District of Columbia, had pending waivers. 

In an email to the Examiner in November, the Wisconsin Department of Health Services said the bill requires the three services that the waiver would need to include to be submitted to the Centers for Medicare and Medicaid Services. The bill doesn’t require other criteria for the project, aside from current Medicaid eligibility requirements. 

Beyond those requirements, the department said it needs the authority that the bill would provide before it starts work on putting together the details of the waiver. The bill requires the department to submit the request for a waiver by Jan. 1, 2027. 

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A federal district court judge granted a motion for summary judgment in favor of Michigan Attorney General Dana Nessel and a coalition of 21 states and the District of Columbia blocking a declaration from the U.S. Department of Health and Human Services that would pressure health care providers to stop providing care to transgender youth. 

In a press release from her office on Monday morning, Nessel said that Judge Mustafa Kasubhai, in federal district court in the District of Oregon, ruled that the administration cannot threaten to cut off hospitals and clinics from Medicare and Medicaid, for providing this type of care.

“Politicians should never drive medical decision-making,” Nessel said in the press release. “I am relieved that the Court has affirmed that the federal government cannot unlawfully interfere with doctors providing essential healthcare, including treatments like puberty blockers and hormone therapy. My office remains committed to protecting access to necessary care for young transgender individuals.”

The lawsuit, first filed in late December 2025, challenged a “declaration” posted to the U.S. Department of Health and Human Services website by Secretary Robert F. Kennedy Jr. titled “Safety, Effectiveness, and Professional Standards of Care for Sex-Rejecting Procedures on Children and Adolescents,” which says that gender-affirming health care procedures “are neither safe nor effective as a treatment modality for gender dysphoria, gender incongruence, or other related disorders in minors, and therefore, fail to meet professional recognized standards of health care.”

The declaration continues to say that “the Secretary ‘may’ exclude individuals or entities from participation in any Federal health care program if the Secretary determines the individual or entity has furnished or caused to be furnished items or services to patients of a quality which fails to meet professionally recognized standards of health care.”

The lawsuit argues that the declaration “exceeds the Secretary’s authority and violates the Administrative Procedure Act and the Medicare and Medicaid statutes,” making it illegal.

In the states’ motion for summary judgment in early January, they argue that “Excluding children’s hospitals and providers (including pediatricians and endocrinologists) would devastate States’ provider networks, strain the capacity of the remaining providers, and harm the large number of residents in each State that depend on Medicare and Medicaid,” and because of its impact on states, could be blocked by a motion for summary judgment.

Since their peak less than three years ago, opioid overdose deaths dropped nearly by half as of October, according to a Stateline analysis. The drop comes as a shrinking fentanyl supply has made the drug weaker and less deadly and volunteer efforts get more people into treatment.

The weaker fentanyl tracks to a crackdown on materials used to make fentanyl in China around the time U.S. deaths started dropping in 2023. Some experts see it as a welcome, but possibly temporary, break for states in a scourge that boosted crime as people who are using the drugs sometimes fall into homelessness and steal to support fentanyl habits.

The numbers and rates of opioid overdose deaths fell for all races between 2023 and 2026, according to more detailed data from the federal Centers for Disease Control and Prevention analyzed by Stateline. That’s in contrast to an earlier trend from 2019 to 2023, when rates dropped only among white people and rose sharply among Black and Indigenous Americans.

Ohio had the nation’s largest decrease since mid-2023, when the nation’s opioid overdose deaths peaked. Ohio has seen fewer deaths but more risky behavior lately as fentanyl supplies dry up and people turn to substitutes tainted by animal tranquilizers.

Ohio is seeing a difference in the bottom line, said Erin Reed, director of RecoveryOhio, the state agency charged with reducing overdose deaths.

“We’re seeing things you would expect — like reductions in emergency department visits and reductions in Medicaid costs,” Reed said. “But we’re also seeing a positive impact on violent crime and recidivism, and I think this is really, really encouraging. At the end of the day, people want to be safe.”

Sarah Beckman, 36, stopped using illicit drugs 11 years ago when she learned she was pregnant with her first child. Now she works through Hamilton County’s Quick Response Team to help Ohio residents who use fentanyl.

When overdoses peaked a few years ago, the team started spending more time talking to people after overdoses.

“We saw overdoses were going up and up, and going out two days a week was not enough. We expanded it to full time,” Beckman said. “That window is so small. It has to be kind of a perfect storm for an individual to be, like, ‘OK, I’m ready.’”

Even if people aren’t ready for treatment, kindness can help build trust and prevent some of the thefts and arrests that lead to police involvement, as it did for her when she stole to get money for drugs and was charged with resisting arrest, she said.

“When you’re in the midst of addiction you need help with everything. For us it’s just meeting people where they are and saying, ‘Hey, are you hungry? Do you have enough clothes?’” Beckman said. “You’re showing consistency and empathy, and by doing that you can slowly move someone closer toward accepting overdose prevention materials or hopefully, eventually, treatment.”

Nationally there were 46,066 opioid overdose deaths in the year ending with October, barely more than half the peak of 86,075 in June 2023 and the lowest since April 2017. The numbers, often delayed because of the process of determining overdose deaths, were released this month based on information available March 1 by the federal National Vital Statistics System.

Deaths fell the most in Ohio, West Virginia, Virginia and Florida since June 2023, but increased in Alaska, Arizona and Nevada.

In Ohio, annual deaths fell 63% from about 4,300 in June 2023 to about 1,600 as of October 2025.

As in many other states, deaths in Ohio started falling before 2023, but then dropped more sharply — 34% in that year alone, said Reed.

Arizona and Nevada, however, saw deaths increase since the national peak in 2023. Arizona’s border crossings with Mexico are among the largest fentanyl smuggling points in the country, with fentanyl traffic dominated by the Sinaloa Cartel in Mexico. One Arizona crossing, the Port of Lukeville, was the site of the largest fentanyl seizure in U.S. Customs and Border Protection history: 4 million fentanyl pills hidden in a trailer brought to the border by a 20-year-old U.S. citizen in July 2024.

The state’s notorious summer heat exacerbates overdose deaths, according to recent research.

Plentiful supply from the border may help explain continued increases in Arizona, said Will Humble, executive director of the Arizona Public Health Association, a public health workers organization.

Political infighting over how to spend the state government’s share of $1.2 billion in opioid settlement money hasn’t helped, he said. The state attorney general, governor and legislature have gone to court over plans to use some of the money to balance the state budget.

“Many other states are way ahead of Arizona when it comes to distributing the state portion of the opioid settlement dollars,” Humble said. “It could be there are fewer interventions because the state dollars are locked up. There’s this dispute in Arizona over who gets to decide. Many other states are not having this jurisdictional issue.”

On the national stage, opioid overdose deaths fell across demographic groups. Even older Americans, whose overdose death numbers had surged earlier even as they fell for other groups, saw a 25% decline from 2023 to 2025, about half the national decrease, according to the Stateline analysis.

In a sign of a weaker fentanyl supply, the Drug Enforcement Administration said in December that 29% of the pills it seized in fiscal 2025 contained a lethal dose of fentanyl, down from 76% in fiscal 2023.

“These reductions in potency and purity correlate with a decline in synthetic opioid deaths,” the DEA said.

Keith Humphreys, a health policy professor at Stanford University who testified to the U.S. Senate in 2023 about increases in accidental overdose deaths among older adults, told Stateline that a “fentanyl supply shock” originating in China made fentanyl supplies weaker. That would include fentanyl-tainted cocaine, which had caused many deaths among older Black men, Humphreys said.

“This likely includes some long-term cocaine users who had the bad luck to get cocaine that had fentanyl in it,” Humphreys said in an interview. White women are more likely to overdose on prescription drugs in order to commit suicide, a trend that would be less likely to be affected by fentanyl supply, he added.

Humphreys and a team of other researchers, in a Science magazine report published in January, found a “drought” of fentanyl that could be traced on the social media platform Reddit.

Elevated mentions of a “drought” started in May 2023, nearly the same time as overdoses began to drop, their research found. Also, the Drug Enforcement Administration reported decreasing potency in seized fentanyl and fewer seizures, both indicating a shortage of supply.

“Drug dealers often adapt to supply shortages by lowering purity more than raising prices,” the report stated. The likely reason: China cracked down on source chemicals for making illicit fentanyl. Such “precursor” chemicals typically arrive from China and are processed in Mexico before being smuggled into the U.S. as illicit fentanyl.

“Actions by the government of China that resulted in greater scrutiny of production and export of precursor chemicals, including the removal of online advertisements and several marketplaces,” may have been what caused the drought in fentanyl and thus saved lives, the report concluded.

The DEA concluded that Mexican fentanyl producers were cutting potency because they were having a hard time finding source chemicals from China, the report noted. That makes it likely supply is the biggest reason for the drop in deaths, not enhanced U.S. border searches or other actions such as the Trump administration’s attacks on drug boats off the South American coast. Those boats are typically used to transport cocaine rather than fentanyl.

Data shows a similar drop in overdose deaths in Canada, where fentanyl supplies are usually produced from Chinese chemicals inside the country rather than smuggled in. That’s another reason to suspect that China’s crackdown affected both countries, despite differing policies and law enforcement strategies.

In their Science article, Humphreys and the other researchers noted that the recent decline in deaths offers the chance to prepare for future opioid-related problems.

“The incentive to restore the fentanyl trade will persist as long as there is demand for the drug,” the authors wrote. “It may be wise to use the current drought as an opportunity to ramp up the prevention and treatment programs that have evidence of decreasing demand.”

There have been some more recent upticks in death numbers.

Colorado saw an increase in synthetic opioid overdose deaths starting in late 2024, according to a Common Sense Institute report released this month. The institute is nonpartisan but has ties to the Republican Party, and concluded the state needs stiffer penalties for fentanyl possession and distribution, similar to Texas law. Opioid overdose deaths in Colorado are down 9% since the national peak in 2023, according to the Stateline analysis.

In Ohio, the recent trend among people who use fentanyl is to find pills spiked with an animal tranquilizer that causes severe addiction, said Beckman, of the Hamilton County Quick Response Team. Three recent clients survived overdoses but required emergency treatment, she said.

“We can educate people in the community: ‘Hey, your drugs are not what you thought they were, that’s why you’re experiencing all these weird side effects,’” Beckman said. “These substances are so severe that a traditional detox hasn’t been able to handle them.”

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

Visits for contraception and cancer screenings at Planned Parenthood clinics have dropped by double-digits after Congress passed a bill cutting off Medicaid funding to certain reproductive health care providers last year, according to a new Democratic congressional report.

Between July 1 and the end of December, the report said emergency contraception distribution fell 10%, oral contraception distribution fell 27%, and IUD insertions fell 10%.

Republican members of the House and Senate passed a sweeping budget reconciliation bill in July that included a one-year provision barring clinics from receiving federal Medicaid reimbursement if they offered abortion services and billed Medicaid more than $800,000 in fiscal year 2023. The rule largely affected Planned Parenthood because of the high dollar amount, but some large independent clinics were also affected, such as Maine Family Planning and Health Imperatives in Massachusetts.

Since July, Planned Parenthood reported 20 clinics were forced to close because of the cuts. That was in addition to numerous clinics that had to close after the loss of Title X funds and other factors, bringing the total to 51 last year. The report said nearly 75% of those closures were in rural, medically underserved areas. About half were in the Midwest, including Indiana, Michigan and Ohio, affecting about 25,000 patients.

“Almost all, 48 of 51, that closed between January and December offered primary care, and nearly half were in primary care shortage areas,” the report said.

In recent months, the decline in services grew. The report also notes there were 20% fewer visits for birth control pills in November, and a drop of 36% for intrauterine devices in December, the steepest decline out of all services measured. Some clinics have reported dropping their IUD offerings because it is a costly birth control device to obtain that was normally covered by Medicaid, but it is also the most popular and preferred form of birth control.

The number of visits for breast cancer screening exams fell by 25% in December, according to the report, and testing for sexually transmitted infections fell 11% in November, both of which could result in delayed treatment that increases overall health care costs.

Twelve states have committed their own funding to help address the gap from federal Medicaid cuts, amounting to about $300 million, according to the report. That includes California, Colorado, Connecticut, Hawaii, Illinois, Massachusetts, Maine, Nevada, New Jersey, New Mexico, New York, Oregon, and Washington. But advocates for Planned Parenthood say it still leaves a significant shortfall, because health centers nationwide provided an estimated $700 million in care annually to Medicaid patients before the law went into effect.

U.S. Sen. Ron Wyden, a Democrat who represents Oregon and a ranking member of the Senate Finance Committee, said at Thursday’s press conference that he will vigorously oppose any reconciliation efforts to make the cuts permanent.

“We’re here to tell people who are opposing access to health care for women, no way. It’s not going to happen on my watch at the Finance Committee, period. Not going to happen,” Wyden said.

Federal law already prohibits providers from using federal dollars to pay for abortion care, with limited exceptions. Medicaid dollars paid for all of the other types of care that clinics provide, including contraception, testing and treatment for sexually transmitted infections, and screenings for breast and cervical cancer. Maine Family Planning also provided primary care services to about 1,000 patients statewide, but had to halt that program in October because of the cuts.

“The report makes clear that it actually costs money to see all these Planned Parenthood offices or providers close, and once they’re closed, it’s not as though you can just bring them back up,” said U.S. Sen. Mazie Hirono, a Democrat who represents Hawaii, at a news conference Thursday morning. “But once they’re closed, people still need this kind of care, and so they’re going to go to other providers, or they will go without — which results in undiagnosed illnesses and health care needs.”

Planned Parenthood Federation of America and two of its affiliates sued to block the law, but the effort was unsuccessful. Republicans in Congress have signaled a goal of extending the cuts and making them permanent, as outlined in the Republican Study Committee’s framework for the next budget reconciliation bill, released in January.

A coalition of major anti-abortion advocacy organizations, including Live Action, Heritage Action, National Right to Life and Susan B. Anthony Pro-Life America, signed a letter sent to House Republican leadership urging them to immediately begin the reconciliation process and make the cuts permanent.

“Since the enactment of the 2025 reconciliation law, multiple abortion businesses have already closed facilities or scaled back operations, demonstrating the measurable impact of the defunding provision,” the letter said.

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The Versiti Blood Center of Wisconsin is experiencing a major decline in organ donors while waitlists for patients in need of transplants grow. 

There are 1,450 Wisconsin patients awaiting an organ transplant, but there’s been a 350% increase in the number of people removing themselves from the Wisconsin donor registry, according to Colleen McCarthy, vice president of organ and tissue donation at Versiti.

“Organ donation is built on public trust, and we are losing it,” McCarthy said. “There is much national news with misinformation that creates fear in people.” 

McCarthy wants people to understand that an organ donation specialist’s role includes supporting families, medically managing donated organs, allocating them based on priority and offering public education. 

Especially on misconceptions. 

Some people worry that their life won’t be saved if they become an organ donor or that they’re too old to donate one. 

“We make every effort to save a life,” McCarthy said. “The oldest organ donor in the United States is 96 years old, so we evaluate all ages regardless of medical history.” 

McCarthy emphasizes that if you have multiple health conditions like diabetes, hepatitis C or HIV, there are other organs in the body that can be safe for a transplant. 

“There’s very few rule-outs in organ donation,” she said. “We just have to make sure that those organs are matched with the right recipient.”

Navigating life without a kidney

Versiti Blood Center of Wisconsin is in need of kidneys, livers, hearts, lungs and other organs to save lives.

“The kidney is the organ in most need,” McCarthy said. 

Among the patients waiting for a kidney transplant is Kelly Norlander, who has known since she was a teenager that she’d be in need of a kidney one day.   

“It’s never easy when you know it’s coming, but I was able to wrap my head around it and process it all,” she said. 

Norlander has a genetic condition called polycystic kidney disease, which causes continuous growth of cysts in the kidney.

She was put on the transplant list two years ago and has been receiving dialysis treatments three times a week for four hours each day for the past year and a half. 

Dialysis is a process that filters toxins from the body when kidneys stop working. 

Although Norlander works full time remotely, she’s stuck bringing her computer to dialysis with her most days. 

“Dialysis feels like a part-time job within itself,” Norlander said. “The longer dialysis is, the harder the transplant will be on your body.”

Long wait times for a transplant

According to Froedtert & Medical College of Wisconsin, the wait time for a kidney could be up to five years. 

“I hope people think about Kelly and the others who are waiting on a transplant,” McCarthy said. “We understand that donating is a personal choice, but I think people need to spend some time thinking about getting accurate information on organ donation.”

Norlander’s father passed away seven years ago from the same condition because he didn’t qualify for a transplant. 

Norlander also wants people to consider the life-saving impact they can have by becoming an organ donor. 

“You’re not just saving one life, you’re saving several,” she said. 

Keeping a consistent blood supply

The harsh winter, including the most recent blizzard, is causing residents to donate less blood this year, which has led to a blood supply shortage for Versiti. 

According to Versiti, 11 of its donor centers and six mobile drives were canceled on Monday. Versiti was hoping to schedule 450 appointments to make up for the ones that were canceled. 

Versiti is also trying to prepare for the warmer seasons, as sometimes the supply can drop during good weather, too.

“It doesn’t take much to disrupt the supply,” said Lauren Patzman, recovery services supervisor at Versiti. “When people are traveling and getting ready to go somewhere for spring break or the holidays, those are the times we see declines in donations.”

Throughout the year, Versiti relies heavily on high school students, as many of their schools host blood drives. But when school is out, finding volunteers becomes harder. 

Patzman said the organization attends festivals and local events during the summer to spread awareness about blood, organ and eye donation. However, sometimes it’s hard to utilize its mobile bus because people aren’t always prepared to give blood. 

“It’s hot, people are walking around all day and may not be hydrated or had a good breakfast beforehand,” Patzman said. 

The organization is urging more residents to donate blood to prevent another shortage. 

It’s in need of all donated blood types, especially donors with a rare blood type called Ro.

According to Versiti Research Blood Institute, Ro blood is found only within 4% of donors and is often given to sickle cell patients. Many sickle cell patients in Milwaukee require blood transfusions every three to four weeks and need over 60 red blood cell units each year. 

Other individuals, including burn victims, cancer patients, a mother giving birth and more can receive donated blood. 

Patzman said the organization tries to keep three to five days of blood supply available to share with hospitals.

“If and when a blood shortage happens, hospitals do have to make difficult decisions that may include delaying surgeries and adjusting treatments,” she said. 

Taking next steps with a quick visit

Patzman reminds individuals there’s always room to put donating blood on your to-do list.  

“People don’t realize how easy it is to just walk in and out within an hour, and it’s not as scary as people think it is,” Patzman said. “Blood is perishable and it has a shelf life.”

If you are interested in donating blood, click here to enter your ZIP code to find nearby donor centers or mobile drives.

To become an organ, tissue and eye donor, click here for more details.

More people in Wisconsin are removing themselves from the organ donor registry; fewer are donating blood 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.

Wisconsin will now require additional coverage of breast cancer screenings for women with dense breast tissue, which puts them at a higher risk for cancer. 

Gov. Tony Evers signed SB 264, now Wisconsin Act 103, in the state Capitol Thursday while surrounded by the family of Gail Zeemer, a Neenah woman who advocated for the measure before she died in June 2024 at the age of 56 and for whom the law is named.

“The system failed Gail. However, in the face of adversity and unimaginable struggle, she chose to persevere,” Evers said. “Now, thanks to Gail, Wisconsin will have not one, but two laws on the books to protect women’s health.” He added that the bill would ensure that women at higher risk won’t “be left behind.”

Zeamer was diagnosed with Stage 3 breast cancer in 2016. According to WPR, she had been getting annual mammograms, but she was never told she had dense breast tissue or of the increased risks associated with breast density. According to the Breast Cancer Research Foundation, nearly half of women over 40 have dense breast tissue.

Zeamer headed up an advocacy effort for a measure that became law in 2017 that requires health care facilities to notify women if they have dense breast tissue. When they are notified, women are also encouraged to follow up to discuss risk and the potential need for further screening. 

According to a 2019 study from Susan G. Komen, the average out-of-pocket cost of a diagnostic mammogram was $234 on average and the average cost for a breast MRI was $1,021 on average. 

“Despite its prevalence, roughly a quarter of women with breast cancer are not diagnosed until the cancer has progressed to stage three. As a cancer survivor myself, my family and I were blessed to have caught it, but anyone who has faced this terrible disease knows that the key is getting as far ahead of it as you can,” said Evers, who was diagnosed with esophageal cancer and  underwent treatment for it in 2008. “Breast cancer is already one of the costliest cancers to treat. With these changes today, we’re ensuring no woman slips through the cracks because they weren’t able to afford additional tests that were covered by insurers.”

The law will require health insurance policies to provide coverage for diagnostic breast examinations and for supplemental breast screening examinations for women with dense breast tissue with no patient cost-sharing requirements.

The bill received unanimous support in the Assembly despite having previously been held up due to opposition from Assembly Speaker Robin Vos (R-Rochester). Vos had said recent federal changes made changes in breast cancer screening coverage unnecessary. Advocates disagreed.

Zeamer’s daughters, Claudia and Sophie, spoke about their mother’s strength in advocating for changes even as she battled cancer. 

“I feel very lucky knowing that my mom is now part of history, and I miss her more than ever, but I also know that she’s looking down on all of us with that big, beautiful smile of hers, knowing that we finished this for her,” Claudia said. “I wish more than anything that she could be here to see what she started and to see how many lives she’s going to help in the future.”

The American Cancer Society estimates that more than 6,000 women in Wisconsin will be diagnosed with breast cancer this year, and more than 600 lose their lives to cancer annually. Women with dense breast tissue are at higher risk and dense breast tissue can make it harder for radiologists to see cancer on mammograms, meaning that additional screening could help catch cancer earlier. 

“There was no doubt after she lost her battle, we would finish this for her,” Claudia said.  “She wasn’t doing it for attention or recognition. She did it because she cared so deeply about other people.” 

“My mom taught me what it really means to be selfless to do something,” she added, “not because you’ll get anything out of it, but because, you know, it might make someone else’s life better.” 

Sophie thanked the lawmakers, including bill coauthors Sen. Rachael Cabral-Guevara (R-Appleton) and Rep. Cindi Duchow (R-Town of Delafield), and advocacy groups including the American Cancer Society and Susan G. Komen.

“My family would like to extend our most heartfelt gratitude to everyone who helped make my mom’s final life’s work come to fruition,” she said. “This has been an emotional roller coaster for our family and for all involved, but persistence and the determination to make Wisconsin better for everyone has gotten us to this point today.”

The Early Detection Saves Lives Coalition, which advocated for the legislation, celebrated the signing in a statement. 

“Gail’s Law is a decisive step toward closing a critical gap in women’s health,” said Jyoti Gupta, who is the president and CEO of women’s health and X-ray for GE HealthCare. “No woman should face delays in breast cancer diagnosis because she cannot afford the imaging needed to complete her screening. By removing cost barriers to medically necessary exams, Wisconsin is helping ensure breast cancers are detected earlier, when treatment is most effective and survival rates are highest.”

As Evers signed the bill, Zeamer’s husband, Steve, wiped away tears. The crowd of advocates and lawmakers cheered.

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Gov. Tony Evers signed SB 23, now 2025 Wisconsin Act 102 on Wednesday, officially making Wisconsin the 49th state to provide a year of coverage for postpartum mothers on Medicaid. 

“It’s been a long time coming, but I’m darn proud we got it done,” Evers, who signed the bill at Children’s Hospital in Milwaukee, said in a statement. 

Evers first proposed Wisconsin submit a waiver to the federal government to extend Medicaid coverage from 60 days to 12 months in his 2019 state budget, but years of legislative gridlock on the issue made Wisconsin the second to last state to make the change. 

According to KFF, the Medicaid program pays for about four in 10 births in the U.S. and federal law had required states to provide Medicaid coverage for postpartum mothers through 60 days. The American Rescue Plan Act gave states the option to extend Medicaid postpartum coverage to 12 months, and most states took steps towards expansion.

“We knew from the get-go that getting this passed was an uphill battle, but we also weren’t going to let partisanship or politics stop us from continuing our work to build support for this important proposal, because we know just how high the stakes are,” Evers said in a statement. 

Assembly Speaker Robin Vos (R-Rochester), who is retiring, was the main reason for the hold up. Articulating his opposition to the expansion, which he previously refused to bring to the floor, he said he was opposed to expanding “welfare.” A group of Republican lawmakers, including lead authors Sen. Jesse James (R-Thorp) and Rep. Patrick Snyder (R-Weston), lobbied for Vos to let the bill through as Democratic lawmakers applied pressure through procedural moves to try and force votes on the legislation. A breakthrough came the night before Assembly lawmakers’ final regular floor session this year. 

The bill passed in the Assembly 95-1. It passed the Senate 32-1. Rep. Shae Sortwell (R-Two Rivers) and Sen. Chris Kapenga (Delafield) were the sole opposing votes.

The expanded coverage, which will be available starting on July 1, means low-income mothers on Medicaid and their babies, who automatically get a year of coverage, will have Medicaid coverage for the same length of time. The only state in the U.S. left that has not implemented the expansion is Arkansas. 

According to the Wisconsin Department of Health Services, about half of pregnancy-related deaths occur in the postpartum period and 95% of those deaths are preventable. Black mothers are more than twice as likely as their white, non-Hispanic peers to die from complications of pregnancy and childbirth.

“Research has shown us that expanding postpartum coverage leads to improved maternal and birth outcomes, thanks to more folks being able to access the care they need when they need it — and without breaking the bank,” Evers said. “Now more than ever, we should be working to make healthcare more affordable and more accessible, not making it more expensive and harder for folks — including new moms and families — to get the care they need.”

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A federal judge in Massachusetts has halted enforcement of several key vaccine policies imposed by Health Secretary Robert F. Kennedy Jr., ruling that the Trump administration illegally overhauled a Centers for Disease Control and Prevention committee dedicated to issuing immunization recommendations.

The decision, which comes in response to a lawsuit filed by the American Academy of Pediatrics last July, temporarily blocks the enforcement of all recommendations voted on by the panel. That includes the overhaul of a decades-old recommendation that all newborn babies receive a vaccine against hepatitis B, a push to emphasize the risks of COVID-19 vaccines and a ban on vaccine preservatives like thimerosal. 

The ruling also temporarily halts participation from 13 of the panel’s 15 members, complicating a meeting that was scheduled to begin later this week.

The CDC’s committee, known as the Advisory Committee on Immunization Practices, is charged with setting national guidelines around which people should be vaccinated against a wide range of preventable diseases and when those vaccines should be administered. The recommendations play a key role in determining which vaccines insurance companies are willing to cover and how accessible those immunizations are to the public.

Last June, Kennedy abruptly dismissed all 17 members of the committee and replaced them with a slate of hand-picked appointees, many of whom are seen as vaccine skeptics. In his Monday decision, District Court Judge Brian E. Murphy ruled that the Trump administration likely violated the Administrative Procedure Act by failing to appoint qualified, nonpartisan experts, as the panel’s charter requires.

By ignoring those requirements, “the Government has disregarded those methods and thereby undermined the integrity of its actions,” Murphy’s ruling reads.

Dr. Andrew Racine, the president of the American Academy of Pediatrics, celebrated the ruling, calling it “a historic and welcome outcome for children, communities, and pediatricians everywhere.”

“For decades, the AAP partnered closely with the federal government to advance our mission of attaining the optimal health and well-being of children and youth,” Racine added. “We would much prefer to return to that partnership and collaborate with federal healthcare agencies instead of litigating against them.”

A spokesperson for the U.S. Department of Health and Human Services did not immediately reply to a request for comment.