A federal judge in Virginia ruled Thursday that the U.S. Food and Drug Administration did not sufficiently justify restrictions imposed in 2023 on a drug used to terminate early pregnancies, adding another layer of complexity to a string of legal cases with opposing goals that could affect future abortion access.  

The lawsuit was filed in 2023 by abortion providers in Kansas, Montana and Virginia to challenge the restrictions as excessive, unwarranted and inconsistent with other legal requirements. A similar case in Hawaii was already decided in October, with a federal judge also finding that the restrictions were arbitrary.

In Virginia, U.S. District Court Judge Robert Ballou, an appointee of former President Joe Biden, said the FDA failed to conduct an appropriate review of the 2023 restrictions on mifepristone, which include rules that prescribing pharmacies and clinicians must be specially certified and prescribers and patients must sign a form acknowledging the medication’s risks.

“The 2023 REMS modification is unlawful and must be remanded to the FDA for review,” Ballou wrote, using the acronym for the FDA’s Risk Evaluation and Mitigation Strategies protocols.

Amy Hagstrom Miller, president and CEO of lead plaintiff Whole Woman’s Health Alliance, based in Virginia, said in a statement Friday that eliminating those three restrictions would help clinic staff focus on patient needs instead of “excessive paperwork.”

“I have worked in abortion care for over 30 years, and I can attest that these regulations serve no medical purpose, nor do they add value to our patients’ experience of abortion,” Hagstrom Miller said in the statement.

The FDA did not immediately respond to a request for comment from Stateline on Friday.

Ballou did not give a timeline for a review of the restrictions, but the FDA has said it is conducting a broader safety review and has sought to dismiss cases related to mifepristone regulation until it completes that review. Trump administration officials told the Wall Street Journal in June that the review was expected to take about six months, meaning it would conclude after the national midterm elections.

Katie Keith, founding director of the Center for Health Policy and the Law at the Georgetown University Law Center, said the Virginia and Hawaii decisions mean the FDA has been ordered by two courts to reconsider its restrictions and more thoroughly explain why they are necessary.

“They’re going to have to look at everything these various courts are telling them to look at,” Keith said.

But the two rulings come at the same time the administration is receiving pressure from anti-abortion groups to further restrict access to mifepristone, even in states where abortion is legal.

The 2023 rules, which were decided under the Biden administration, also eased restrictions to allow mifepristone to be dispensed without an in-person provider for the first time. That helped expand national access to the medication, which is one of two drugs typically used to end a pregnancy before 10 weeks and to treat miscarriages, and allowed people who live in one of the 13 states with near-total abortion bans to continue to receive it by mail.

That expanded access prompted three other lawsuits from attorneys general in states with abortion bans that are still pending in federal courts. In Louisiana, the 5th U.S. Circuit Court of Appeals is considering whether to strike down the provision allowing telehealth prescriptions, and will hear oral arguments in the case in September.

The 5th Circuit initially granted an emergency request from Louisiana to block telehealth access to the medication, but after drug manufacturers appealed the decision to the U.S. Supreme Court, the justices reversed the circuit court ruling. That stay from the high court will remain in place as the case continues.

Two other cases with different implications for the future of mifepristone are ongoing. One is in Missouri, joined by attorneys general from Idaho and Kansas, where they have asked the court to return all of the restrictions to what they were in 2016. The other is in Texas, joined by Florida’s attorney general, asking the federal court to revoke the drug’s approval entirely.

Stateline reporter Kelcie Moseley-Morris can be reached at kmoseley@stateline.org.

The number of cases of cyclosporiasis — a parasitic infection linked to contaminated water or food that causes severe intestinal issues — has more than doubled to over 4,173 cases across 41 states this week, up from the 1,645 confirmed cases in 34 states reported last week by the federal Centers for Disease Control and Prevention.

Cyclosporiasis causes symptoms that include watery or “explosive” diarrhea, nausea and stomach cramps. The surge in cases had made 2026 the worst year for the infection on record.

The CDC estimates that there are likely more than 7,400 additional cases that have not yet been confirmed. No deaths have been reported, but 308 people have been hospitalized, more than double the 141 hospitalizations reported last week.

State and federal officials suspect there are multiple sources of the outbreak, but they had reported that the cases in Indiana, Kentucky, Michigan, Ohio and West Virginia were connected to shredded iceberg lettuce grown in central Mexico and sold by Taylor Farms. On Monday, however, federal officials said tests making the connection were a false positive.

Michigan, the first state to report an outbreak, reported 7,171 cases and 102 hospitalizations as of July 16. Indiana, New York, North Carolina, Ohio, and Indiana also have seen high case counts, alongside New York City.

The Association of State and Territorial Health Officials, which represents public health agencies across the country, said labs have a hard time tracking case connections because cyclospora is a parasitic genome that is more complex than the bacterial pathogens that cause other foodborne illnesses. As a result, state and local heath investigators must resort to reviewing restaurant and grocery receipts, menus and supply chain records, according to the organization.

“Case interviews and traceback investigations are often time intensive, creating a burden on state and local public health infrastructure,” senior analyst Heather Tomlinson and environmental health director Courtney Anderson wrote.

North Carolina had confirmed more than 560 cyclosporiasis cases as of July 20. Dr. Carl Williams, state public health veterinarian for the North Carolina Department of Health and Human Services, told reporters on Tuesday that the state has relied heavily on its 86 local health departments to track cases.

Williams said twice weekly calls with the CDC also have been helpful.

“The CDC has been very responsive to us and the other states,” Williams said during the briefing. “But as you can imagine, I mean, it’s a lot to go through.”

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

Measles cases this year have surpassed all of 2025 to become the worst since the disease was declared eliminated in 2000, with cases now in 44 states and the District of Columbia, according to a federal report released Friday. 

There were 2,318 confirmed cases as of July 23, compared with 2,289 in all of 2025, with 93% of cases for both years being among unvaccinated people, mostly younger than 20. 

There have been fewer hospitalizations this year, 151 compared with 243 last year, and no deaths yet, compared with three in 2025. The highest number of new cases was in mid-January 2026, when there were almost 300 new cases. 

The largest number of current cases are in South Carolina (670), Utah (522), Texas (188), Virginia (176) and Pennsylvania (134). Except for Virginia, all those states have childhood vaccination rates below the 95% level considered necessary to prevent outbreaks among unvaccinated people as of the 2024-25 school year. 

Virginia’s statewide rate was 95.6%, but the measles outbreak was in two rural counties west of Richmond where measles vaccination rates are less than 75%. 

The last time national cases were higher than 2025 and 2026 was in the 1990s as national vaccinations were still ramping up, with 9,643 cases in 1991 and almost 28,000 in 1990. 

Most states now have childhood vaccination rates below the 95% level considered necessary to prevent outbreaks among unvaccinated people, including people who choose not to be vaccinated and small children too young for the shots. 

Oklahoma has a low childhood vaccination rate of 88.7% and saw 20 cases last year, but only one so far this year. A foundation has sent a mobile health van around the state to vaccinate thousands of children. 

Delaware declared a new outbreak this week. The state’s first measles cases in a decade climbed to five cases in a few days. The state’s child vaccination rate is 94.1%. 

“High vaccination coverage has protected even the unvaccinated and undervaccinated because of herd protection, keeping measles at bay for the past few decades,”  said Dr. William Moss, director of the International Vaccine Access Center at Johns Hopkins University, in a published statement. 

“But in communities with pockets of susceptible individuals across a broad age range, measles has been able to take hold, infecting those who are susceptible and spreading rapidly,” he said.

The center used its own measles tracker to declare more cases in 2026 than last year as of July 21. 

The Pan American Health Organization is scheduled to review the U.S. measles status in November and consider revoking “elimination” status as it did for Canada last year.  

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

The union election of nurses at St. Mary’s Hospital in Madison was certified Wednesday after a regional office of the National Labor Relations Board overruled the objections of the hospital’s parent company, SSM Health. 

On June 11, nurses at the hospital voted 89% to form a union. It was the largest representation election in Wisconsin in at least a quarter century. The nursing staff at St. Mary’s previously told the Wisconsin Examiner that they were seeking to form a union over concerns about procedures, staffing and compensation and a lack of responsiveness from hospital management. 

The St. Louis-based SSM Health had objected to the election, arguing that charge nurses at the hospital should not be allowed to vote or join the union because they hold a supervisory role. At the nearby Meriter Hospital in Madison, charge nurses are part of the union. 

The company had filed its objections about the charge nurses prior to the election but the NLRB had decided to delay ruling on the question and the charges nurses were allowed to vote but their ballots were kept separate. 

The hospital system’s objections included claims that the delayed decision affected the election results, that charge nurses engaged in pro-union electioneering, that the union caused disruptions to the hospital’s human resources staff, that a pro-union staffer brought cookies to the voting area and that union supporters tried to enter the voting area. 

Jennifer Hadsall, the director of the NLRB region that includes Minnesota, North Dakota, South Dakota, Wisconsin and parts of Iowa, wrote in her ruling that for most of the objections, the system did not include proof of the complaint or that the activity affected the election results. 

“I have concluded, for the reasons set forth in this decision, that the offer of proof produced by the Employer is not sufficient to meet its burden of showing that the proffered evidence would be grounds for setting aside the election if introduced and credited at a hearing,” Hadsall wrote.

While the election was certified, the board has still not ruled on the question of charge nurses joining the union. 

After the ruling, nurses at the hospital celebrated the decision and urged hospital management to stop working to prevent the unionization and instead start bargaining. 

“The Labor Board has spoken, our community has spoken, elected leaders have spoken, St. Mary’s nurses have spoken, and we have resoundingly declared that it’s time for SSM to respect our union vote so we can start working on solutions for our patients,” Zach Zahalka, a nurse in the hospital’s cardiac catheterization lab, said in a statement. “As nurses, this work is a calling, and our primary role is to be our patients’ advocates. Forming our union is an extension of that patient advocacy, and we urgently have to solve the crisis of understaffing and loss of experienced nurses at St. Mary’s.”

“SSM needs to stop trying to undermine our union,” he added, “and instead focus all their resources on engaging with us productively so that together we can create real solutions for better staffing and retention to provide the best care.”

Lisa Adams, a spokesperson for the hospital, said in a statement that the hospital is reviewing the decision. 

“SSM Health respects the federal labor law process. We have received the National Labor Relations Board (NLRB) staff decision and are reviewing it,” she said.

The Trump administration has a new plan for teenagers learning about pregnancy: Beginning this summer, it will steer millions of dollars toward organizations that focus on anatomy, fertility tracking, hormonal production and “reproductive goals counseling.”

The plan will also emphasize abstinence from sex and the importance of marriage. 

In doing so, it will pivot away from programs that serve populations in areas with the greatest need and that use particular evidence-based programming to reduce teen pregnancies — and some say the new language puts a greater focus on planning for pregnancy rather than preventing it.

The new grant application terms are consistent with an approach called restorative reproductive medicine that has become popular among conservative groups, including those who identify with Make America Healthy Again initiatives.

The approach discourages the use of any type of contraception and instead focuses on fertility awareness methods, usually in the context of couples trying to get pregnant without medical intervention such as in vitro fertilization or other treatments. That typically means not using any birth control and instead tracking indicators such as cervical mucus, body temperature and other physical symptoms to monitor the menstrual cycle. 

Academic studies have repeatedly shown that abstinence-only approaches result in higher rates of teen pregnancy and births, even after adjusting for other socioeconomic factors.

Congress created the Teen Pregnancy Prevention Program in 2010, and has renewed funding for it on a bipartisan basis over the past 16 years, including the 2026 budget bill, despite President Donald Trump’s office targeting the program for defunding. 

During that time, teen birth rates declined by about 72%, according to federal Centers for Disease Control and Prevention data, and much of the drop in the overall national birth rate is because teen birth rates have fallen so sharply. Experts say more comprehensive sex education, better access to contraception for girls and general behavioral trends around sex explain that shift. 

Amy Friedrich-Karnik, director of federal policy at the reproductive rights-focused Guttmacher Institute, said the new language in the teen pregnancy program is similar to the new funding opportunity released for Title X, which is a more than 50-year-old grant program designed to help low-income populations receive reproductive healthcare.

“We do think that fertility awareness-based methods should be explained to patients and they should have the right to understand what those options are,” Friedrich-Karnik said, describing the administration’s approach. “But (patients) need to also be aware of the full options that are available and the pluses and minuses of every option that is out there.”

Body literacy modules

The intent of the program, according to the original law, was for grants to fund “medically accurate and age-appropriate programs that reduce teen pregnancy” and then to continue the programs shown to be most effective through rigorous academic evaluation. According to the Department of Health and Human Services’ Office of Population Affairs, those programs were developed for children and young adults between the ages of 10 and 24 and the people in their lives who support them.

Most of the grants that were canceled this year were programs implementing the methods proven effective in reducing teen pregnancy, while others were more research based, in which additional strategies are tested and refined. Several of those programs were canceled as well in states such as Louisiana, Texas and Washington.

A separate federal grant program called Sexual Risk Avoidance Education exists for abstinence-only programs, but the evidence-based criteria for Teen Pregnancy Prevention is much higher, said Rachel Fey, vice president of policy at national reproductive rights advocacy organization Power to Decide. She sees the new funding opportunity for teen pregnancy prevention as an extension of the sexual risk avoidance program — one of the pillars of the new description tells grantees to “incorporate sexual risk avoidance education.”

The funding notice requires applicants to pass an “alignment review” with agency priorities that is conducted by political appointees, a new process that the U.S. Office of Management and Budget is trying to implement for federal financial assistance across the government.

Applicants for the new teen pregnancy program are required to teach body literacy, including two distinct modules about anatomy and reproduction for girls and boys. 

Grace Stark, editor-in-chief of a Texas-based nonprofit called Natural Womanhood that promotes fertility awareness and restorative reproductive medicine, told Stateline by email that the new funding opportunity’s focus could be helpful, as it “encourages young people of both sexes to consider their reproductive goals now and in the future, and how their current health and lifestyle choices can impact those future goals.”

The female module must include instruction about the menstrual cycle and the patterns and key indicators of the phases of the cycle, and recognize ovulation as the “central event and primary indicator of hormonal health and fertility.” It must also include the advantages and disadvantages of “ovarian suppression” compared to approaches that address “root causes.” 

Restorative reproductive medicine focuses on identifying underlying conditions that contribute to infertility or other reproductive health-related problems, according to the International Institute of Restorative Reproductive Medicine. It refers to conventional approaches that use treatments that “suppress normal physiology,” such as various forms of birth control, and claims that RRM works with the body to treat problems. 

Republican U.S. Sen. Cindy Hyde-Smith of Mississippi introduced a bill in Congress in 2025 that would have directed federal health agencies to promote such training for medical students and professionals through existing funding opportunities in Title X and the HHS Office of Population Affairs. That bill didn’t advance.

Joely Pritzker, who has been a family nurse practitioner for more than 20 years and is the senior director of healthcare for Power to Decide, said the “ovarian suppression” language likely refers to one of the most common ways birth control works, which is to temporarily suppress ovulation. Typically, in medical practice, ovarian suppression refers to lowering the estrogen produced by the ovaries, sometimes to prevent or treat breast cancer.

Pritzker said most people in the reproductive health world would support the idea of teaching young people about their bodies, but said it comes down to how that information is interpreted and applied, and that the new program design is unclear about those intentions. Not wanting to use hormonal birth control is different from discouraging the use of it entirely, she said.

“I genuinely don’t know what (body literacy) means to the folks who wrote these proposals, other than based on everything else we know, there is an assumption that if people knew more about their bodies, they would choose not to use, for example, hormonal birth control,” Pritzker said, adding that the assumption is false.

Stark, of Natural Womanhood, said body literacy can help young people notice signs of reproductive health issues,“which (restorative reproductive medicine)-trained healthcare professionals can help diagnose and treat to improve current health and protect future fertility — and future reproductive health plans.”

The American College of Obstetricians and Gynecologists warns against leaning on restorative reproductive medicine in fertility discussions, saying it can be “ineffective and redundant” and unnecessarily delay a patient in seeking medical treatment when it is presented as the sole or best approach. 

The male health module, according to the federal grant funding notice, includes an emphasis on understanding how testosterone is a hormone that is responsive to sleep, physical activity and environmental factors. Instruction must include the physiology of arousal, and address how “repeated or artificially stimulated arousal may affect neural development and behavior over time,” seemingly referring to masturbation.

Testosterone has been a heavy focus of the Trump administration. HHS Secretary Robert F. Kennedy Jr. frequently refers to lower sperm counts among men, including teen males, despite no scientific evidence backing up those claims when it comes to young men. He cites it as a reason for birth rates that have remained flat or lowered slightly every year since 2015, though experts say the lower national birth rate is actually because of the lower teen pregnancy and birth rates. 

U.S. Department of Defense Secretary Pete Hegseth also announced last week that military men over the age of 30 would receive annual testosterone level checks, which doctors say could actually be counterproductive to military readiness and could risk infertility. 

The teen pregnancy prevention programs must also include counseling on reproductive goals, and “should affirm marriage and parenthood as meaningful and value components of adult life,” the federal description says.

New recipients could include crisis pregnancy centers 

Ginger Mullaney, CEO of former youth services grantee Healthy Futures of Texas, said its nearly $2 million grant funded 11 programs that served various populations, including young in foster care, and runaway and unhoused youth. The grant was cancelled, which shocked her, she said, because the group had already adapted all of its materials and programs to comply with new executive orders around diversity, equity and inclusion and other administration priorities. The new curriculum had been approved.

“We felt like we had already made all the necessary changes to comply,” Mullaney said.

Earlier this month, Healthy Futures was still deciding whether it would apply for the new round of funding. It’s not an easy task, she said, in part because the government documents no longer include a list of approved programs that qualify for the funding. Mullaney said there used to be a list of more than two dozen programs that the agency approved because they had been academically evaluated for effectiveness, but that list is gone now. However, the instructions still tell applicants they must use an evidence-based program. 

“We don’t know what (programs are) considered evidence based,” Mullaney said.

The new funding opportunity also awards more points to applicants that have never been awarded funds before.

Alison Macklin, director of public affairs at sex ed advocacy group SIECUS, said based on what she has seen at the local level, the new funding opportunity is paving the way for crisis pregnancy centers to apply for and receive federal dollars. 

Crisis pregnancy centers are anti-abortion organizations that typically offer free ultrasounds, pregnancy tests and parenting classes with a religious mission, and most often do not provide or refer for contraception. States Newsroom found earlier this year that the centers have received nearly $500 million in taxpayer dollars from state and federal sources since the U.S. Supreme Court’s decision to overturn Roe v. Wade in 2022.

“They’ve been given an inch, so they’re trying to take a mile, is what it seems to me,” Macklin said.

‘Losing trusted relationships’

In mid-May, staff at Children’s Aid said they expected their $936,700 Teen Pregnancy Prevention Program grant to be renewed for another year after meeting with U.S. Health and Human Services and receiving nothing but positive feedback about their program. It was eligible for funding through 2028.

But at the end of June, they received another letter letting them know the grant was canceled, effective immediately.

“It was an overnight shutdown with no transition period for staff, or for young people that were relying on these resources,” said Rhonda Braxton, vice president of health and wellness at Children’s Aid, a 170-year-old organization in New York City.

It was one of 53 grantees that received letters from the federal government agency notifying them that their funding had been terminated without notice. Most were told their programs were now misaligned with federal agency priorities and that they normalized sexual activity for minors. Three affected grantees and SIECUS: Sex Ed for Social Change filed a lawsuit challenging the action on July 14. 

Braxton said the abrupt termination is expected to result in nine people losing their jobs, six of whom worked full time, and will affect the 1,200 young people who were served each year in areas such as the South Bronx, Harlem and Washington Heights. A group of high school-aged peer educators also found themselves suddenly without the summer job they’d planned to have with Children’s Aid.

“These young people are losing trusted relationships in an era of misinformation and distrust,” Braxton said.

She said they’ve made the decision not to apply for the new funding because it seems to be aligned with promoting abstinence-only initiatives, and, “Our experience has been that that’s not evidence-based programming.”

Stateline reporter Kelcie Moseley-Morris can be reached at kmoseley@stateline.org.

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• UW Health leaders created a new company called WorkForward to help health care systems and state agencies nationwide create their own apprenticeship programs. 
• UW Health officials started offering apprenticeships to their employees in 2018. 
• The program has helped the company fill entry-level roles and retain existing staff while filling gaps for in-demand positions. 
• But experts say apprenticeships aren’t a silver bullet: They require clinical staff to supervise apprentices; employers have to pay staff for hours they’re in school; and each state has its own regulations for apprenticeships.

Violet LaClair was ready to leave her job. 

As a certified nursing assistant at UW Health in Madison, she used the skills she developed while caring for her dying grandmother for nine years. Her co-workers had supported her through her gender transition. She’d even won an award for providing “extraordinary” care. 

She loved her workplace, but after four years, she wanted a change.

“I felt like I’d done it all,” LaClair said. “I felt like at some point I needed to challenge myself more.” 

She thought about going back to school, but that didn’t seem doable. She was already in her 40s and didn’t have time or money to spend.

Then she learned she could get trained to be a medical assistant for free, while working, through an apprenticeship program UW Health started in 2018. She pays no school costs, and she gets paid for the time she spends in class. 

Three days a week, she works at the company’s Union Corners clinic, where she gets patients situated, takes blood pressure, flushes ears and more. 

“I can pretty much do anything the doctor asked me to,” LaClair said. Two days a week, she takes classes on pharmacology, laboratory procedures, and law and ethics.

“I think the program is great,” LaClair said. “It’s given me a whole new chapter in my life, and something to be excited about.” 

Opportunities like these are novel, but increasingly common. The idea is simple: Maybe the country’s next nurses, surgical technologists and medical assistants are already working in hospitals and clinics. The people who’ve spent years booking appointments or drawing blood might jump at the chance to train for new careers — if their employers will help them do it. 

UW Health now offers apprenticeship options for 17 professions, including surgical techs, pharmacy technicians, respiratory therapists and registered nurses. Apprentices pay nothing for their course work, and they get paid to be in class.

To date, more than 1,000 apprentices have graduated. 

Bridgett Willey, who oversaw the launch of those apprenticeships, said they’ve helped fill a critical gap. Wisconsin colleges alone just aren’t graduating enough students to meet the needs of the three major health systems in southern Wisconsin, Willey said. 

The popular programs, which attract far more applicants than they can accommodate, have helped the company fill entry-level roles and hold onto existing staff. Before it began offering apprenticeships, as many as 3 in 10 positions for medical assistants, nursing assistants and pharmacy technicians were unfilled, Willey said. Today, it’s around 1 in 10. 

“We’ve increased our supply by growing our own and training our own folks,” Willey said. 

UW Health isn’t the only health system trying this model. Apprenticeships, once a rarity in health care, have become increasingly common at hospitals and clinics nationwide.

But offering this kind of on-the-job training isn’t always easy. Now, UW Health plans to use what it’s learned to help other states overcome the financial and bureaucratic barriers that can stand in the way. In May, the health system announced it created a separate company called WorkForward to help health systems and state agencies elsewhere set up apprenticeships. Willey, who directs that new project, thinks it’s the first such initiative by a U.S. health care company.

The health care apprenticeship surge

Historically, apprenticeships have been a key on-ramp to technical trades like plumbing and carpentry, allowing trainees to earn as they learn.

Now, apprenticeships are flourishing in U.S. hospitals and clinics, too. In just five years, the number of registered apprentices in the health care field has grown by more than 40%, according to the U.S. Department of Labor, as employers have expanded existing programs and others have started new ones. 

The boom comes as demand for health care workers has shot up across the country, triggered by the growing needs of an aging population and a wave of longtime health care workers retiring. By 2038, the country will be short about 109,000 registered nurses, 61,000 physical therapists, 33,000 pharmacy technicians and 13,000 respiratory therapists, according to projections by the National Center for Health Workforce Analysis.

Meanwhile, vocational and on-the-job training is becoming increasingly popular across the board, said Susan Skillman, senior principal research scientist at the University of Washington Center for Health Workforce Studies. 

“Apprenticeships in general are growing,” Skillman said. “We’re kind of in that place in the nation where the pendulum is moving away from four-year college degrees.”

Staff seize opportunity to advance

Some health apprenticeships last months while others last years. At UW Health, apprentices training to become medical assistants finish in 10 months while future registered nurses train for four years.

No matter the length or industry, all apprenticeships involve a combination of on-the-job training and classroom instruction. In the case of Wisconsin’s registered apprentices, who are approved through the state’s Department of Workforce Development, employers must pay apprentices for the time they spend in class. In some cases, the employer pays for the apprentices’ school costs, too. 

At UW Health, the employer covers tuition. The health system’s staff also coordinate the apprentices’ work and school schedules to avoid conflicts. 

Those were big selling points for Brianna Matheson, 35, who had worked as a medical assistant for 12 years when she learned last spring that UW Health was starting a three-year surgical tech apprenticeship. She’d spent time in the operating room before, and she liked helping with clinical procedures.

“I was just ready for something more,” Matheson said. “I was in clinics for so long, doing the same thing for so long. I wanted to learn again, be a student again, and be a novice.”

When the application opened, she was the first to apply. 

“I had kind of given up on the idea of going back to school because I, like so many others, need full-time income, and I didn’t really want to give up all of my free time to work full time and go to school in the evenings and weekends,” said Matheson, who now processes and delivers supplies to the operating room at Madison’s University Hospital. 

Not only does she not pay tuition, but the Department of Workforce Development offers a stipend for scrubs, reimburses mileage to and from school, and even covers some daycare costs for apprentices with kids, Matheson said. 

The position also let Matheson keep her prior $25 hourly wage, reflecting the raises she’d earned during more than a decade on the job. When Matheson graduates in May 2028, she’ll earn surgical tech wages, which range from around $30 to $44 an hour, according to current UW Health job listings.

“I would not have been going back to school at this point in life to pursue this without the support of specifically the apprenticeship program that UW Health is offering,” Matheson said. “I wouldn’t have done it on my own.”

Apprenticeships attract new job applicants

Offering apprenticeships could help health systems draw entry-level job applicants like 25-year-old DeForest native Alex Lippman. 

Lippman trained as a certified nursing assistant in high school, then worked at a skilled nursing facility in Madison. He started college at Arizona State University with plans to become a doctor, but moved back to Wisconsin when his grandmother fell ill in his sophomore year. He wanted to continue his education but figured he’d missed his chance.

Then, in 2023, UW Health announced it was starting the state’s first apprenticeship for registered nurses. That apprenticeship, like all of UW Health’s multiyear apprenticeships that lead to degrees, are open only to employees who’ve worked for the system for at least six months. 

“I had a plan of trying to get into this program because going back to school on my own was no longer feasible,” Lippman said. He got a job as a certified nursing assistant and began the apprenticeship the next year. 

Today he takes classes at Madison College and works three night shifts a week caring for patients with brain and spine injuries in University Hospital’s neuro intensive care unit. He’s on track to graduate in 2028.

UW Health’s shorter training programs, meanwhile, are open to new applicants as well as current employees. Already, some have finished one and moved onto another, looking to advance their careers, Willey said.

“What we’re seeing is that people come in through one of our entry-level (apprenticeship) programs like medical assistant or nursing assistant, get their feet under them working in that capacity, and then now they’re applying for our degreed registered apprenticeship programs,” Willey said.

This isn’t the first time the company has built its own pipeline of health care workers. In 2013, Willey started a program called Health Occupations and Professions Exploration, or HOPE, where high school students spend a Saturday learning to do CPR, place a breathing tube in a mannequin, and more. The goal, Willey said, is to show students the range of careers available in health care. The program has trained about 6,500 students.

How much can the model grow?

Apprenticeships offer a unique way to address workforce shortages and help employees move up on the job, said Andy MacCracken, who coordinates health workforce planning for North Carolina at the NC Center on the Workforce for Health. That, he said, is one reason the number of apprentices and apprenticeships in the health care field has soared in recent years. 

Still, he said, it’s not clear exactly how much of the health worker shortage can be solved through apprenticeships. 

“We need to have a realistic view about what we’re actually aiming for when deploying apprenticeships as a solution,” MacCracken said. “I think apprenticeships are a really helpful tool in the toolbox. They’re not the only one.”

One challenge: It’s expensive to pay the clinical staff needed to supervise apprentices, so it can be hard for health system leaders to make the business case to their boards. Even health systems that embrace apprenticeships may not be able to accept as many apprentices as they’d like. 

UW Health pays for its apprenticeship program with a mix of its own funds, private donations and public funds, though Willey said the latter is usually only available for starting up a new program.  

Still, there are always far more applicants than openings. When the registered nursing apprenticeship launched in 2023, 200 employees applied for 16 slots. Last year, 70 people applied for 40 medical assistant apprenticeships.

Another challenge: Each state has its own laws about what counts as an apprenticeship and what standards an employer must meet when offering one. Likewise, the regulations for each profession may vary from state to state too. And then there are the accrediting agencies that approve educational programs, which are still getting used to the idea that students might get paid for their clinical training hours.

Willey said WorkForward will publish research on apprenticeship approaches that work, lobby for resources to support such programs and help other states identify potential funding sources. The company is a nonprofit, she said, which will apply for private and public grants. It will not receive direct funding from UW Health. 

Currently, she said, WorkForward is working in Massachusetts with Tufts Medicine and Mass General Brigham — the state’s largest health care employer — and 12 of the state’s community and technical colleges.

“It would be great if we could take the solutions that we’ve built and spread (them at) scale across the U.S. … Health care continues to be a driver of new jobs for the U.S. economy,” Willey said, “and we have an aging population who needs more care, and so we need to be addressing these things now.”

MacCracken said he hasn’t heard of another health care employer taking on this role, but he thinks it makes sense, as employers may be more willing to listen to other employers. 

In North Carolina, he said, he’s already seen how a few model programs can pave the way for others. 

“I think because of the successes of some of the early adopters who have put these programs in action, we’re seeing great results, and so that’s helping inspire more action and scalability and replication.” MacCracken said. 

Natalie Yahr reports on pathways to success statewide for Wisconsin Watch, working in partnership with Open Campus. Email her at nyahr@wisconsinwatch.org.

Can Wisconsin’s health apprenticeships become a national model? UW Health thinks so 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.

The Trump administration announced Tuesday that it is freezing more than $1 billion in Medicaid payments to California and Minnesota in an effort to crack down on fraud.

Medicaid is the public health insurance for people with low incomes, including some disabled and elderly people, jointly funded by state and federal dollars.

The U.S. Department of Health and Human Services and the Centers for Medicare & Medicaid Services deferred more than $867 million to California and $199 million to Minnesota. The feds say they need more documentation from those states to support some Medicaid claims for services that are at high risk for fraud.

The freeze marks the latest round of withheld payments as the Trump administration continues its crackdown on suspected fraud in publicly-funded social service programs, mostly focusing on Democratic-led states. Earlier this year, the Trump administration launched a fraud task force to look into potential waste or abuse in publicly-funded benefits programs, explicitly naming states such as California, Colorado, Illinois, Maine, Minnesota and New York.

The Trump administration has already deferred Medicaid payments in Minnesota twice this year, totaling nearly $400 million. The deferral process, under which the federal government can withhold funding when questioning claims already billed to Medicaid, had never been used to deny funding for entire service areas until a $243 million deferral in February, the Minnesota Attorney General noted.

A letter delivered Tuesday from CMS to the Minnesota Department of Human Services stated that $195 million of the deferred $199 million comes from specific providers that CMS identified as high-risk for fraud or “aberrant billing practices” based on historical billing and analysis. The money comes from services delivered from January through March and has already been paid. States will have to provide documentation backing up the claims or be forced to reduce future billing to the federal government.

The Trump administration has also threatened to withhold $2 billion in annual Medicaid funding to Minnesota in a separate process. The funding fight in Minnesota centers on 14 Medicaid services deemed high-risk to fraud and are largely designed to give long-term care for elderly and disabled people. But state officials have said that funding freezes could deliver a serious blow to the state’s Medicaid program more generally, which cost $18 billion in 2024 and covers other low-income Minnesotans.

John Connolly, temporary commissioner and state Medicaid director for the Minnesota Department of Human Services, said in a statement that Tuesday’s deferral reflects the federal government’s “unprecedented and punitive ways as part of their war on Medicaid and its recipients.”

“CMS touts their new fraud-detection capabilities, yet has not provided data or explanation on how the deferral amount was calculated or what it was based on. I respectfully ask the federal government to partner with us and share any information about their methods to identify potentially fraudulent providers in Minnesota,” Connolly said.

The federal-state fight over Medicaid funding has affected thousands of Medicaid providers in Minnesota, who were abruptly cut off from funding as the state raced to reach a federal deadline to screen all providers in the “high-risk” services. Providers and their advocates said the process was rushed and left legitimate providers unable to get paid for delivering services to vulnerable Minnesotans.

HHS Secretary Robert F. Kennedy Jr. said the Trump administration’s goal is to strengthen the integrity of the Medicaid program and make sure federal funds are spent appropriately.

“States that receive federal Medicaid funding must demonstrate that every dollar meets federal requirements,” Kennedy said in a news release on the deferred funds. “When they cannot, we will not release federal funds until they do.”

California Gov. Gavin Newsom, a Democrat, called the withheld funds a “recycled political stunt” in a post on X, and said his state was being targeted for political reasons.

Minnesota Democratic Gov. Tim Walz rejected the Trump administration’s framing of the situation in a post on X: “This isn’t about fraud — it’s about cutting your healthcare so that Trump can afford the tax cuts he gave to billionaires.”

CMS said it identified unusually high growth in spending on certain in-home care programs in California, triggering the hold on that state’s funds. It has not provided proof of fraud.

Newsom countered in his X post, arguing that California is saving taxpayer money “by keeping seniors and people with disabilities out of far more expensive nursing homes.”

In Minnesota, a CMS review flagged expenditures that raised “potential eligibility or billing concerns.”

“CMS is done trying to chase down stolen and misused funds after they’ve already left the building,” Dr. Mehmet Oz, CMS administrator, said in a news release, adding that the deferred payments are part of a “proactive new approach to program integrity.”

The pauses in funding don’t affect who is eligible for Medicaid, and they’re not permanent cuts.

Alyssa Chen of the Minnesota Reformer contributed to this story. Stateline reporter Anna Claire Vollers can be reached at avollers@stateline.org.

The tiniest menace of summer doesn’t care if you’re hiking through the woods, walking the dog or pulling weeds in your backyard.

It just wants a ride and a meal.

As ticks spread into new parts of the country and emergency room visits for tick bites climb higher than usual, states are scrambling to monitor where the pests are showing up, what diseases they may be carrying and how to warn residents before a bite turns into something far more serious.

The federal Centers for Disease Control and Prevention reported in April that emergency department visits for tick bites were higher than expected across much of the United States and at their highest levels for that point in the year since 2017. 

In June, there were 112 tick-related ER visits per 100,000 people, compared with 110 per 100,000 during the same period last year, according to the CDC’s online tick bite tracker. That suggests this year’s summer trend may be in line with 2025.

Nationwide, the latest available data show an estimated 65 tick bite-related emergency department visits per 100,000 people, up from 47 per 100,000 last year. This year’s current figures are preliminary and subject to change, but if they hold, this year’s rate may be the highest since 2017.

Health officials say the trend reflects a combination of expanding tick populations, changing environmental conditions and increased human exposure during warmer months.

The concern extends well beyond Lyme disease.

The lone star tick, once found primarily in the Southeast, has steadily expanded its range and is known for its aggressive host-seeking behavior, often actively crawling toward people and animals. An adult female is distinguished by a white dot or “lone star” on her back.

The species has been linked to alpha-gal syndrome, an allergy that can cause people to develop severe reactions after eating beef, pork and other mammalian products. Researchers also continue to monitor ticks that carry Rocky Mountain spotted fever, anaplasmosis and other illnesses.

Tick surveillance by state health officials varies widely across the country. Some states maintain active surveillance programs that collect and test ticks to identify where disease-carrying species are becoming established. Other states rely more heavily on human disease reports or passive tick submissions, making it harder to detect changes before infections begin to rise.

Those differences can leave public health officials with an incomplete picture of how quickly tick populations are changing — and where people may face the greatest risk.

Several states, including Massachusetts, Missouri and Oklahoma, have expanded surveillance efforts in recent years or launched public education campaigns as tick habitats shift. All three joined the list of states that now or will soon mandate reporting of alpha-gal syndrome. Other states are studying the spread of lone star ticks and the increasing recognition of the syndrome, which experts believe remains underdiagnosed. 

Some experts say warmer winters in many parts of the country have allowed ticks to remain active for longer periods each year while expanding into regions where they were once uncommon. At the same time, growing white-tailed deer populations and changing land use have created more opportunities for people and ticks to cross paths.

Public health officials say the best defense remains preventing bites altogether. They recommend using insect repellents registered by the Environmental Protection Agency, wearing permethrin-treated clothing, including long sleeves and pants in wooded or grassy areas, checking people and pets for ticks after spending time outdoors and removing attached ticks as soon as they’re found.

For states, the challenge is becoming less about responding to tick season and more about adapting to a future in which, in many places, the season is lasting longer — and the tiny hitchhikers are turning up in places they never did before.

Stateline reporter Amanda Watford can be reached at awatford@stateline.org.

As federal officials consider whether to reclassify marijuana under federal drug law, a new study has found that more American teenagers seeking treatment for cannabis use disorder, known as CUD, are facing longer wait times before receiving care.

The study, published in the American Journal of Preventive Medicine, analyzed national data from more than 124,000 adolescent admissions to publicly funded substance use treatment facilities between 2012 and 2022. Researchers found that after several years of decline, the share of young people experiencing delays in accessing treatment increased sharply.

While overall adolescent cannabis use has leveled off or declined slightly over the past decade, some young people who use cannabis regularly develop CUD that requires treatment. 

About 11% of adolescents who use cannabis or marijuana develop CUD within a year, according to the study. With continued use, that risk rises to about 20%. Other research suggests that about 4.7% of adolescents aged 12-17 meet the diagnostic criteria for CUD, a condition in which marijuana use becomes difficult to control and begins interfering with daily life.

According to the study, nearly 34% of adolescents, defined as children aged 12-17, seeking treatment for cannabis use disorder in 2022 experienced an admission delay — defined as waiting several days to more than a month after their initial request for treatment. The authors noted that elevated wait times in 2020 through 2022 may partly reflect COVID-19-related disruptions to treatment services, as well as increased demand for care.

“Just to address these delays, it will require coordinated efforts across health care,” said Yiota Kitsantas, the lead author of the study. Kitsantas is a professor of biostatistics and epidemiology, and interim chair of the Department of Health Administration and Policy at George Mason University. 

“Having proactive screening in primary care and school settings could promote early identification and hopefully then ensure timely access to care,” Kitsantas said. 

The percentage of adolescents reporting delayed treatment represents a significant increase from a low of about 25% in 2015. Longer waits also became more common: The share of adolescents waiting a week or more peaked in the years following the COVID-19 pandemic, with about 5% waiting at least 30 days to enter a treatment facility in 2022.

Adolescents referred to long-term rehabilitation or intensive outpatient programs had significantly higher odds of experiencing delays compared with those entering acute detoxification services.

The study also found differences in treatment delays based on living arrangements and referral sources. Youth living with parents or guardians experienced longer waits than unhoused youth, while adolescents referred by health care providers faced higher odds of delays compared with those who sought treatment themselves.

Male adolescents had 11% higher odds of experiencing treatment delays compared with female adolescents. While older teens ages 15 to 17 accounted for most admissions, the increase in wait times from 2018 to 2022 was more pronounced among younger adolescents ages 12 to 14, according to the study.

Non-Hispanic white adolescents had 29% higher odds of experiencing an admission delay compared with Hispanic adolescents. Black, Asian, and American Indian or Alaska Native youth had lower odds of experiencing delays than their Hispanic peers, according to the study.

While moving marijuana from Schedule I to Schedule III could ease research restrictions, it would not immediately address local shortages or capacity issues within treatment systems. The potential shift also comes as states grapple with how to regulate increasingly potent cannabis products and address concerns about their potential links to cannabis use disorder and other public health impacts.

During this year’s legislative sessions, several states considered proposals to change or lower cannabis potency limits, though most did not advance.

In Connecticut, lawmakers reinstated a 35% THC cap on cannabis flower just weeks after removing it, citing concerns about the public health effects of increasingly potent products. And Oklahoma approved new packaging and labeling requirements aimed at preventing cannabis products from resembling candy or appealing to children.

Stateline reporter Amanda Watford can be reached at awatford@stateline.org.

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In early May, as I sat waiting for a connecting flight at O’Hare, I decided to finally do something that had been on my list for far too long: schedule a checkup.

It had been years since I’d seen a primary care doctor. I had a baby the year before, and with all the pregnancy appointments, I felt like I was getting enough checkups. But when I called my clinic, I learned that I’d been away long enough to be considered a new patient, and they didn’t have space for me. 

No problem, I thought. I looked up other primary care providers on my insurance company’s website and chose one more or less at random. I called to schedule an appointment.

The person who answered the phone warned me that the doctor was booking “quite far out.” I wasn’t shocked: I’ve heard that a shortage of primary care doctors is leading to long wait times. I waited to hear just how long it would be.

I don’t recall if the next available appointment was in August or October. I do recall that it was in 2027, more than a year away.

“Let’s try someone else,” I said. I scheduled an appointment with another doctor for August 2026, about three months out. 

What about you? How long have you had to wait to see a doctor recently, and how does that wait compare with years past? 

As a pathways to success reporter, I report on how workers get trained for the jobs Wisconsin needs most. I’m interested in the steps Wisconsin is taking to help more people become primary care providers, and whether those efforts are working. Drop me a note at nyahr@wisconsinwatch.org or call or text me at ‪608-620-5610‬.

How long have you waited for a doctor’s 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.

As state and federal officials work to identify the source of the recent outbreak of the intestinal illness cyclosporiasis, Michigan health officials have identified lettuces or salad greens as one potential culprit.

“Early information has shown lettuce as a common product that regularly comes up during the investigation,” said Dr. Natasha Bagdasarian, chief medical executive at the Michigan Department of Health and Human Services, in a news release. “We will continue to provide updates as we learn more.”

Officials cautioned they haven’t ruled out other food items as the source. The U.S. Centers for Disease Control and Prevention (CDC) has confirmed 1,645 cases in 34 states, but that is a significant undercount based on the numbers being reported by state health officials.

Cyclosporiasis is caused by the parasite cyclospora. Symptoms include watery or “explosive” diarrhea, nausea and stomach cramps. It’s often contracted by eating or drinking something contaminated with the parasite, which lives in feces.

Michigan first reported an outbreak of cyclosporiasis on July 1 after nearly 200 cases were reported across seven counties. The state now leads the nation in cases, with the state health department reporting 2,640 cases Monday and 44 hospitalizations. The case numbers jumped 69% from Friday.

New York, Ohio, Illinois, Indiana and Kentucky also have reported a higher than usual number of cases. New York City alone has seen 403 cases this year, most of them since May 1. The New York City Health Department said in a statement to Stateline that it’s working with partners to determine a common source.

Ohio health officials reported 177 cases as of July 2, with 28 hospitalizations.

“Fortunately there have been no deaths in Ohio, as is consistent with our past experiences with this illness,” said Dr. Bruce Vanderhoff, director of the Ohio Department of Health, in a statement.

“Nevertheless, this is a serious illness that can cause dehydration and require people to seek emergency medical care, and it should be taken seriously.”

The CDC expects case numbers to continue rising, given a typical six-week lag between the onset of illnesses and when cases are typically reported to the CDC. The New York Times reported it has independently confirmed at least 4,800 cases this year.

States such as  Michigan are rushing to do their own sleuthing after cutbacks have reduced surveillance capabilities at the federal level. Last year, the CDC scaled back its surveillance program that monitors foodborne illnesses. It no longer requires monitoring for six pathogens, including cyclospora, only requiring reporting for two: salmonella and Shiga toxin-producing E.coli.

The CDC acknowledged that while it’s working to collect and analyze data at the national level, “State health departments may have more timely information about the situation in their jurisdictions.”

The Trump administration said on social media on Monday that the CDC is working with 3,000 health departments to gather data, and that the U.S. Food and Drug Administration is investigating the outbreak alongside the CDC and state and local partners.

Local health departments in Michigan have conducted more than 1,000 interviews of those who’ve tested positive for cyclosporiasis, to try to trace the source of the outbreak, state officials said.

But in many states, the risk to the public remains low.

It’s  not uncommon for states to see at least a few cases of cyclosporiasis each year. Michigan typically identifies 40-50 each year, while Rhode Island documented six cases last year and 12 in 2024. Because it can take up to two weeks for symptoms to develop after a person is exposed to the parasite, state officials say it takes time to investigate the source.

There’s currently no evidence that links recreational water exposure, such as swimming in lakes, as a risk factor for the illness. And in none of the cases confirmed by the CDC did the affected person report any travel during the two weeks prior to falling ill.

In previous cyclosporiasis outbreaks, bagged salad mixes and kits were identified as the culprit, along with fresh cilantro, basil, raspberries, snow peas and green onions. One of the largest outbreaks of cyclosporiasis was in 2020, which resulted in 701 people falling ill in 14 states, and which the CDC linked to Fresh Express bagged salads.

The CDC has identified cases in the current outbreak in the following states: Alaska, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Nebraska, New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, Tennessee, Texas, Utah, Virginia, West Virginia and Wisconsin.

This story was updated to reflect new numbers from the Centers for Disease Control and Prevention. Janine Weisman of the Rhode Island Current, Kyle Davidson of the Ohio Capital Journal and Jon King of the Michigan Advance contributed to this report. Stateline reporter Anna Claire Vollers can be reached at avollers@stateline.org.

Fifteen states on Friday sued the Trump administration to prevent millions of dollars in cuts to school-based mental health funding.

The new lawsuit is part of an ongoing legal battle between Democratic-led states and the U.S. Department of Education over a mental health grant program that Congress established following the 2018 school shooting at Marjory Stoneman Douglas High School in Parkland, Florida.

At stake is a $1 billion program that offers grants to school districts across the country to help them hire and train more mental health professionals to work in schools.

Democratic attorneys general in 15 states say the Trump administration, in defiance of a December 2025 court order, plans to unlawfully terminate the grants at the end of this month, resulting in millions in lost funding.

“Our children deal with a unique set of problems which arise from growing up in 2026 — from loneliness to substance use disorder to the ever-present fear of violence — and the programs funded through these grants are designed to help them cope and hopefully thrive,” said Rhode Island Attorney General Peter F. Neronha, a Democrat, in a statement announcing the lawsuit.

In 2022, after a school shooting in Uvalde, Texas, claimed the lives of 19 students and two teachers, Congress allocated $1 billion to the Mental Health Service Professional Demonstration Grant Program to increase the number of school-based mental health professionals.

That funding effort was bipartisan; at the time Republican U.S. senators including John Cornyn of Texas, Susan Collins of Maine and Thom Tillis of North Carolina publicly supported it. And within a year, the grants had funded mental and behavioral health services to nearly 775,000 students nationwide.

But in April 2025, under President Donald Trump, the U.S. Department of Education told grantees the funding would be halted because their programs conflicted with Trump administration priorities. At that time, the grants were supporting efforts in 49 states to prepare thousands of mental health professionals to work in K-12 schools.

Trump administration officials told the media that the grants were cut over what the administration saw as connections to diversity, equity and inclusion initiatives.

A coalition of 17 Democratic state attorneys general sued last July, and a court ruled in their favor, ordering the Trump administration to stop the grant discontinuation. In the months since the order, the education department has threatened to withhold funding or terminate the grants altogether.

The Democratic attorneys general said they filed the new lawsuit to cover gaps in the previous court order that could allow the Trump administration to follow through on its desire to halt the funding.

“The courts have repeatedly ruled that the Trump Administration does not have the power to arbitrarily revoke grant funding that provides critical mental health services to our students,” said Massachusetts Attorney General Andrea Joy Campbell, a Democrat, in a statement about joining the lawsuit.

“Still, the federal government continues its attempts to terminate funding.”

Stateline reached out to the U.S. Department of Education for comment but did not receive a response before publication.

Attorneys general participating in the lawsuit are from California, Colorado, Connecticut, Delaware, Illinois, Maine, Maryland, Massachusetts, Michigan, New Mexico, New York, Oregon, Rhode Island, Washington and Wisconsin.

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

Health insurance premiums are likely to grow more expensive next year for those who buy Marketplace plans, after increases this year.

Affordable Care Act Marketplace insurers are proposing a median premium increase of 14% for 2027, which would be a double-digit hike for the second year in a row, according to a new analysis of preliminary rate filings.

Insurers must submit their requested premium changes to state regulators by July 15, per Centers for Medicare and Medicaid Services deadlines. Rates should be finalized later this summer.

Released Wednesday by the Peterson Center on Healthcare and healthcare research group KFF, the analysis looked at proposed rate changes among 77 Marketplace insurers across 16 states and Washington, D.C., that have made proposed rates publicly available. Those are Connecticut, Hawaii, Illinois, Indiana, Iowa, Kentucky, Maine, Maryland, Massachusetts, Minnesota, New York, Oregon, Rhode Island, Texas, Vermont and Washington state.

The majority of insurers across those states are proposing a median ACA Marketplace premium increase between 10% and 20%, while 20 insurers are requesting premium increases of more than 20%. None included in the analysis proposed a decrease in premiums. 

Along with the expiration of enhanced premium subsidies, insurers are also citing rising healthcare costs and changes in federal regulations as reasons behind the increases.

At the end of last year, enhanced premium tax credits expired, leading to more out-of-pocket costs for some people enrolled in Marketplace plans. Premiums increased especially for those with incomes at 400% or more of the federal poverty level — or roughly $63,000 for a single person — who completely lost subsidies. That caused many healthier enrollees to leave the Marketplace, leaving behind enrollees who are more expensive to cover, according to KFF.

While the proposed increases are lower than last year’s median nationwide proposed rate change of 18% — the finalized change was 20% — it’s the second-highest requested change since 2018, according to the report.

ACA Marketplace enrollments have seen a steep drop, with 2.6 million fewer Americans on the rolls in February compared with the same time last year, The Associated Press reported.

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

The Trump administration has rolled back teen pregnancy prevention grants and repurposed a program designed to reduce unintended pregnancies so that it promotes childbearing. But several states, including Republican-led ones, have protected or expanded access to contraception in recent months.

Georgia Republican state Rep. Beth Camp sponsored a bill to expand contraceptive access in her state after her daughter faced a two-month delay renewing her birth control prescription. The new law, passed in April and signed in May by Republican Gov. Brian Kemp, allows pharmacists to prescribe contraception methods such as birth control pills and shots directly to patients without a doctor’s signature.

Current Georgia law requires patients to receive a birth control prescription from a doctor, which they can then fill at a pharmacy. Camp has said the new policy could help increase access to contraception in areas with primary care provider shortages.

“In our state, we have such a challenge with access for medical professionals,” Camp told the House Health Committee earlier this year. “This is just really, to me, opening up a whole new stream of opportunities for women to be able to access contraception.”

In Maryland, Democratic Gov. Wes Moore in May signed a measure that requires public higher education institutions and community colleges to annually submit a report on contraception access to the Maryland Higher Education Commission. It also requires the commission  to submit a report on contraception access to the General Assembly and requires each community college to provide students with access to all methods of over-the-counter contraception.

Tennessee Republican Gov. Bill Lee in March signed into law a bipartisan bill that requires private health care plans to cover a yearlong supply of birth control. The state’s Medicaid program, TennCare, already provides a 12-month supply of birth control. The measure is set to take effect July 1, 2027.

And Democratic Virginia Gov. Abigail Spanberger in April signed a new law establishing the right to contraception and allowing people to sue if their rights are violated. Spanberger also signed another law requiring health insurance companies to cover both prescription and over-the-counter contraceptives without cost-sharing. Both laws went into effect this month.

Stateline reporter Sofia Resnick can be reached at sresnick@stateline.org.

One year ago, President Donald Trump signed the first piece of legislation Republicans in Congress had introduced at the start of his second term.

Passed using the complicated budget reconciliation process that enabled GOP lawmakers to enact the legislation without Democratic votes, HR 1 paired $4.5 trillion in tax cuts over 10 years with $1 trillion in cuts to federal healthcare programs as well as other initiatives to cut federal spending.

With the legislation’s first birthday on July 4, critics of the Trump administration and Democratic politicians have been using every opportunity to highlight the legislation’s role in driving unpopular results.

Healthcare cuts are among the most prominent of those outcomes. They include a series of changes to Medicaid — the state-federal health insurance program for people at or below the federal poverty guideline, with annual incomes of just under $16,000 per year for a single person or $33,000 for a family of four.

For medical and hospital care, Medicaid is called BadgerCare in Wisconsin. Medicaid also covers long-term care services for people who qualify, including home healthcare for the elderly and people with disabilities, and goes under a variety of names including Family Care and IRIS.

On Tuesday, the anti-Trump political activist group Indivisible and members of the healthcare union SEIU Wisconsin gathered in front of the Wisconsin Republican Party headquarters in Madison with an out-of-service ambulance to denounce  cuts to healthcare attributed to HR 1.

“We are here to give voice to the millions of Americans who have lost access to healthcare and to the tens of thousands of Wisconsinites who have lost healthcare,” said Jean Grow, co-leader of Indivisible’s Milwaukee chapter.

The group aimed its barbs not just at Trump but at Republican U.S. Rep. Tom Tiffany, the party’s nominee for governor in the November 2026 election, who voted with the rest of his party in the U.S. House of Representatives for HR 1.

“Who in this state is primarily responsible for these cuts? Tom Tiffany,” Grow said, to hearty jeers from the crowd of about two dozen during the lunchtime protest.

HR 1 also cut the federal nutrition assistance program SNAP — known as FoodShare in Wisconsin — by 20% by 2034, about $187 billion.

The changes will pass on to most states a portion of the program’s costs, which the Center on Budget and Policy Priorities in Washington says could lead “the lowest-income people, including children, older adults, veterans, and people with disabilities” in every state to lose access to food assistance.

The so-called One Big Beautiful Bill Act “has been brutal for Wisconsin families,” said Secretary of State Sarah Godlewski, a Democrat who is running for lieutenant governor, at a press conference Wednesday at the Democratic Party’s Capitol Square offices that focused on Tiffany’s record.

“We know that the impact it’s going to cause — things like potentially 270,000 Wisconsinites are going to lose healthcare,” said Godlewski. “We know tens of thousands of Wisconsinites are going to lose access to FoodShare.”

While Trump and GOP congressional leaders initially called HR 1 the “One Big Beautiful Bill Act,” critics quickly mocked it as “the Big Ugly Law” or variations on that theme. In September, the Republicans rebranded the bill as “The Working Families Tax Cut.”

The CBPP, however, found that the tax cuts are “tilted to the wealthiest households.”

The Congressional Budget Office “finds that the new law’s program cuts and tax cuts will make households with incomes in the bottom 20 percent of the income scale worse off: they will lose more from the cuts in health coverage, food assistance, and other programs than they will gain in tax cuts,” the  CBPP reported in February.

For the bottom 10% by income, average annual incomes will fall by $1,200 — 3.1% — the CBPP reported, citing the CBO. Meanwhile, the top 10% will see their annual incomes rise $13,600 on average.

HR 1’s advocates said the healthcare spending reductions would only address waste, fraud and abuse.

Sen. Tammy Baldwin (D-Wisconsin) said during a virtual press conference in June that the changes — such as new work-reporting requirements for some Medicaid participants — would impose administrative burdens and red tape that will block people who are qualified to receive benefits.

“They’re trying to kick people who are fully eligible off the program,” Baldwin said. The press conference was organized by the advocacy groups Protect Our Care and Main Street Alliance.

Most of the Medicaid changes won’t take effect until 2027. Enrollment in the program has already been dropping, however. Federal data tracked by the Georgetown University Center for Children and Families show that in Wisconsin, more than 75,000 Medicaid recipients had left the program in the first five months of 2026.

Dr. Kristen Dall-Winther, a family physician in Birchwood, Wisconsin, also took part in the press conference with Baldwin.

“I see how access to affordable healthcare can make the difference between something that’s a manageable condition and a medical crisis. I also see the difficult choices patients are forced to make when healthcare becomes too expensive, which it generally, universally is now,” Dall-Winther said. “When funding is reduced, healthcare providers face greater financial strain, especially in rural areas where many of our facilities are already operating on razor-thin margins.”

WASHINGTON — The prime time for ticks is here in the United States, and after an especially active start to the season, experts are urging the public to stay alert and take preventive measures. 

Monthly emergency department visits for tick bites in April spiked to their highest level since 2017 and continued to remain high throughout May and June, according to the Centers for Disease Control and Prevention’s tick bite tracker.

Though it’s hard to predict what the rest of the season will look like, given that tick activity depends on a number of different factors, there has definitely been a recent geographic expansion of the area ticks inhabit, said Pilar Fernandez, a disease ecologist and assistant professor at Washington State University. 

The tiny blood-suckers, which tend to thrive in warmer climates, are spreading to places that used to be too cold for their existence, she said during a July 1 SciLine media briefing, as temperatures rise in the United States and around the world.

With more ticks comes a greater risk of individuals developing tick-borne diseases such as Lyme disease, Alpha-gal syndrome and anaplasmosis. That’s why researchers are encouraging people to know their facts and learn how to protect themselves from bites as they venture outdoors. 

What’s going on this year?

According to the CDC, an estimated 31 million people are bitten by ticks each year, with most encounters taking place between April and October. But in 2026, ER visits began rising as early as March. 

Weekly ER trips for tick bites are also up in every U.S. region except for South Central as of June 28, the online tick tracker shows. 

Global warming is certainly one reason behind this recent surge in tick activity, though Fernandez said the whole picture is much more complicated.

Because ticks can live for up to two to three years, it’s difficult to understand the delayed seasonal effects of increased temperatures or precipitation on their population, she said.

Other factors including local environmental conditions and how much time people spend outside can have an impact on annual tick encounters, she added. 

Every spring and summer, she said, people ask her if it’s going to be a “big year” for ticks, which is “a really hard question to answer, because it’s not equal across all locations.” 

Most tick cases are recorded in the Northeast and Midwest, but different species of ticks are found in every region of the country. And as the population expands into areas where people are unaware of how to protect themselves and unaccustomed to checking for bites, the threat of contracting a tick-borne infection grows, Fernandez said. 

Tick-borne diseases

Ticks carry pathogens that they then pass on to humans by biting into their skin and feeding on their blood. An untreated tick bite can lead to the development of one of nearly 20 different human diseases in the U.S., the most common of which is Lyme disease — about 476,000 patients are treated annually, according to the CDC. 

Another tick-borne infection that has been on the rise is Alpha-gal syndrome, which causes people to experience a serious allergic reaction after they eat red meat or other animal products that contain the sugar molecule alpha-gal. It is most commonly associated with the lone star species of tick distributed throughout the Northeastern, Southern and Midwestern United States. 

Initial symptoms of tick-borne illnesses are unspecific and often the same as those that come with regular sickness, such as a fever, headache, muscle aches and joint pain, according to Alvaro Toledo, an associate professor in the Department of Entomology at Rutgers who also spoke at the July 1 media briefing. 

“Physicians need to be vigilant and aware if they receive a patient with symptoms that are compatible with a tick-borne disease,” he said.

What if you find a tick?

If one discovers a tick on the skin, Toledo said the proper response is to first quickly remove the tick with tweezers by pinching and pulling it up in a vertical motion, then disinfecting the area and monitoring for signs of sickness. 

People should not, on the other hand, deal with a tick by burning it off or applying petroleum jelly to the bite, said University of Wisconsin-Madison Assistant Professor Adela Oliva Chavez, a tick researcher, at the briefing. 

“Those are myths,” she warned. 

Ticks typically do not transmit infection until after they have been attached to the skin for 24 hours, which is why the CDC recommends people aim to remove the pests as soon as possible within the first day.   

However, experts say the most effective way to prevent tickborne disease in humans is by limiting exposure to ticks in the first place.  

Toledo said people should use chemical sprays such as permethrin on their clothing and classic bug repellents on their skin to keep ticks away. It’s also a good idea to wear long, light-colored clothing when spending time in forests and other highly vegetated areas where ticks are abundant. 

But, he added as a reminder to the public, there is “no zero-risk zone anywhere when you go out … even in your backyard, risk is not zero.” 

Individuals can further reduce their chance of acquiring a tick bite by checking their pets just as often themselves, according to Oliva Chavez. Dogs and cats can easily bring ticks into the house from outside, and if they aren’t yet attached to the animal’s flesh, they can make their way onto humans, she said. 

WASHINGTON — Republicans celebrated last year when they barred Medicaid payments from going to Planned Parenthood for one year, predicting the financial impact would hollow out the organization. 

A year later, with that section of the “big, beautiful” law set to expire July 4, GOP lawmakers are trying to find a way to keep the nationwide prohibition in place, though they won’t be able to accomplish that before the deadline. 

That means states will now determine whether people enrolled in the program for lower-income individuals can, once again, get routine healthcare services from the Planned Parenthood clinics that remain open.  

Nora Walsh-DeVries, vice president of political and legislative affairs at Planned Parenthood Action Fund, said the law forced the organization to close nearly 30 of its healthcare centers.

“The impact is really horrible for us and some of it is unfortunately irreversible,” she said. “And it’s tough to try to deal with what’s happened in this past year, kind of also knowing that there is an intention from Republicans to permanently defund us.”

Some Planned Parenthood clinics, she said, tried to find ways to keep treating Medicaid enrollees, but ultimately that was “unsustainable” and not something every affiliate could manage. 

The result meant “tens of thousands of patients have been denied access to basic care services like cancer screenings, which I think we can all agree is something we should want people to get when they need it, where they need it, how they need it,” Walsh-DeVries said. 

The impact was ultimately less widespread than Planned Parenthood originally predicted, when its president said in a statement just days before the law took effect that “nearly 200 Planned Parenthood health centers in 24 states across the country are at risk of closure.”

The expiration won’t have an impact on abortion access for Medicaid enrollees, since a decades-old rider on government spending bills, which blocks taxpayer dollars from going to abortion with limited exceptions, remains in place. 

Republicans view the closures as a victory and are trying to renew the provision in an attempt to shutter more Planned Parenthood clinics. They believe any healthcare organization that provides abortions, even if those largely aren’t covered by taxpayer dollars, shouldn’t be included in any federal health programs. 

Pressure from conservatives

The House Freedom Caucus, a collection of far-right Republicans, wrote to Speaker Mike Johnson in late June, pressing him to include a similar prohibition in another party-line bill. 

“The American people rightfully expect a Republican-led Congress to deliver real results, not excuses or half-measures,” they wrote. “After years of broken promises, voters have entrusted us with majorities in both the House and Senate. This is our last and best chance to prove they were right to send us here to fight for them.”

They added that another reconciliation bill must prohibit “federal funding for abortion providers to ensure that taxpayer dollars are not being used to subsidize the radical abortion industry.”

Susan B. Anthony Pro-Life America President Marjorie Dannenfelser and other anti-abortion organizations are lobbying Republicans to again block Medicaid funding from going to Planned Parenthood.

“Defunding Big Abortion is now the default expectation of the pro-life movement,” Dannenfelser wrote in a statement. “When they return to D.C., Republicans must do all they can through reconciliation to once again block taxpayer dollars from Planned Parenthood and abortion businesses.”

Republicans used the complex budget reconciliation process to enact their “big, beautiful” law and the $70 billion package to fund immigration enforcement. The special process allowed GOP leaders to get around procedural votes in the Senate that would otherwise require bipartisanship as long as each provision has an impact on federal revenues or spending that is not deemed “merely incidental” by that chamber’s parliamentarian.

Strained system

Subasri Narasimhan, research director at the Center on Reproductive Health, Law, and Policy at UCLA Law School, said there often aren’t other health centers to cover the gaps left when a Planned Parenthood closes or is no longer reimbursed for treating a Medicaid enrollee. 

“We have a pretty strained healthcare system in so many different respects, but we’re looking at an extremely strained system when it comes to reproductive healthcare,” Narasimhan said. 

Some state governments, she said, tried to cover the budget holes created during the last year, though ultimately weren’t able to fully replace the loss of federal funding. 

Republicans reinstituting the same prohibition on Medicaid payments for non-abortion healthcare services, she said, would likely lead more people on the program to delay or skip preventative care altogether. 

“We’re looking at folks who are quite vulnerable and often use Planned Parenthood as their primary source of care,” she said. “And so there’s no option to look for another health center.”

Kathleen Adams, professor in the Rollins School of Public Health at Emory University, said that if a program can vary state to state, it will, and this was no exception. 

“What I’m seeing is the states are finding emergency funds, other ways to channel funds to Planned Parenthood to sort of keep that part of their system active,” she said. 

There are also other programs and clinics, like federally qualified health centers and safety-net providers, that Adams said could play a part in filling some of the gaps.

“I don’t lose heart so much as we might otherwise about these provisions to Planned Parenthood because states are aware of these issues,” she said. “And if they don’t provide access to contraceptives, they’re more likely to get unintended pregnancies, or pregnancies amongst uninsured women.”

State action

Laurie Sobel, associate director for Women’s Health Policy at KFF, wrote in a post that after the nationwide moratorium expires, a Supreme Court ruling from late June 2025 will allow state governments to block certain healthcare providers, like Planned Parenthood, from participating in their Medicaid programs. 

“This ruling marked a significant departure from longstanding interpretations of the Medicaid ‘free choice of provider’ provision, which guarantees enrollees the right to obtain care from any qualified and willing Medicaid provider,” Sobel wrote.

Alabama, Arizona, Arkansas, Florida, Iowa, Kansas, Louisiana, Mississippi, Missouri, Nebraska, Oklahoma, South Carolina and Texas have either blocked or tried to block Medicaid reimbursements to Planned Parenthood, according to Sobel’s analysis.

Other states, she wrote, “may follow suit” once the nationwide Medicaid prohibition expires July 4.

State Medicaid agencies are concerned that many sick and disabled enrollees will lose their coverage because the Trump administration is narrowing the definition of who is “medically frail” enough to get an exemption from new work requirements.

Under the tax and spending law President Donald Trump signed a year ago, states that have expanded Medicaid to cover more adults under the Affordable Care Act — 40 states plus the District of Columbia — must mandate that those adults work, go to school or volunteer for at least 80 hours a month.

The so-called One Big Beautiful Bill Act exempts Medicaid recipients who are “medically frail,” with serious illnesses or disabilities. However, on June 1 the Trump administration published interim guidelines for implementing the law that specify that in order to qualify for the “medically frail” designation, a person must have a significant health condition and be significantly impaired in their ability to work.

“This rule helps Americans build skills and independence through work, education, job training, or community service, creating new opportunities for themselves and their families,” said Dr. Mehmet Oz, director for the federal Centers for Medicare & Medicaid Services, in a statement earlier this month announcing the new guidance.

But states had been operating under the assumption that they would use the federal government’s traditional “medically frail” designation, which includes five distinct categories of disabilities and illnesses but does not require Medicaid agencies to determine whether the person can work.

States already were scrambling to set up systems to enforce the new work rules by the January 2027 deadline, according to Jocelyn Guyer, senior managing director at Manatt Health, a consulting firm that advises state Medicaid agencies.

“Now, it’s not enough just to have that diagnosis. You may need to go to your doctor and get a special note,” Guyer said. “So, it’s turned it from a very straightforward protection of people with disabilities and significant health conditions into a paperwork morass, where all of a sudden they have to get their healthcare providers involved in documenting and assessing their capacity to work.”

Earlier this week, 25 Democratic-led states plus the District of Columbia sued the Trump administration over the work requirement, largely on the basis of the changed “medically frail” guidelines.

Several state Medicaid agencies said they’re struggling to understand what they’ll have to do to comply. Even before the “medically frail” change, states were hiring consultants and creating IT systems to verify and track enrollees’ working status, which they never had to do before.

“Most states were working on identifying a number of diagnoses that may be able to meet that definition in hopes that that would align with what the final guidance said,” Melanie Bush, deputy secretary for the North Carolina Medicaid Division of Health Benefits, said. “But the layering in of impaired ability to work — there’s not necessarily a data source that aligns with that.”

Bush said states are focused on figuring out how to prevent eligible people from dropping off the rolls just because of paperwork and logistical challenges. One analysis estimates that five million people could lose coverage from the original work requirements alone. State leaders and consultants worry that figure could rise significantly with the new guidance.

Healthcare providers are worried, too.

“This is not what we’re trained to do. Most of us do not do disability determinations and employability assessments regularly, and even if we do feel comfortable with that role, we don’t have time, we’re not like we’re not paid to do that,” said Dr. Benjamin Sommers, a health economist at the Harvard T.H. Chan School of Public Health.

“Primary care providers, in particular, are already overworked and burning out.”

Still, Medicaid directors have experience in dealing with major shifts within the program, according to Michael Heifetz, a managing director at consulting firm Alvarez & Marsal and a former Medicaid director in Wisconsin. Heifetz said states regularly face major rule changes and tight timeline challenges, and with greater access to advanced technology to help automate some tasks, he’s confident they will be able to mitigate enrollment losses.

Another big help, he said, is that Medicaid enrollees will be allowed to “self-attest” to their eligibility for an exemption through 2027.

“States will work through it, and they will again work with the advocacy community to minimize the impact on beneficiaries,” Heifetz said. “There is still some ambiguity in the rule about how self-attestation will work in 2027, because the rule reads that other sources of information and documentation must still be sought, but in the end, self-attestation will prevail.”

Jennifer Tolbert, an expert on state health policy at health research group KFF, said there are several data sources states might tap to determine a person’s ability to work, such as insurance claims, prescriptions and a person’s use of durable medical equipment.

She cautioned, however, that it will be a challenge to use such data to make thoughtful determinations, especially for people with substance use disorders and mental health issues.

To keep eligible people enrolled, California will use text message alerts, mailed notices, and electronic reminders to make sure recipients meet verification deadlines, according to Anthony Cava, a spokesperson for California Department of Health Care Services. Nevertheless, Cava said, the state is concerned that people, including those with serious illnesses and disabilities, will drop off the rolls “solely due to paperwork barriers.”

Adela Flores-Brennan, Colorado’s Medicaid director, said states could come under fire for making errors.

“We’re also worried about audits,” Flores-Brennan said. “There are new penalties for states, bigger penalties for states related to error rates, and the level of complexity that is being introduced into eligibility right now is making an environment that is ripe for errors because it’s confusing and it’s complex.”

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

Legislators in at least six states this year have approved measures related to patient medical debt, according to a report on legislative policy trends released Wednesday by United States of Care, a nonpartisan think tank.

Many Americans are struggling to afford healthcare. A recent survey found that 46% of adults, regardless of their health care insurance status, reported struggling to pay for medical care last year.

Indiana, Louisiana, Maine, Oregon and Washington enacted laws this year related to medical debt. Hawaii legislators have approved a measure that is awaiting the governor’s signature, and other states have bills in committee.

In 18 states, legislators introduced or approved measures related to preserving no-cost preventive care, and a dozen states weighed legislation related to hospital facility fees, according to the report.

Louisiana enacted a law that limits the interest that providers and debt collectors can charge on medical debt. The new rule caps the annual interest rate on medical debt for “medically necessary care” at 3%. The law defines such care as services or medications deemed necessary by a licensed health care provider to prevent, diagnose or treat an illness or disease symptoms.

Under Washington’s new law, unpaid medical bills can’t be assigned to a debt collector for at least 120 days after the first billing statement in situations where the patient is a pedestrian or bicyclist who has been struck by a motor vehicle. Maine’s law prohibits debt collectors from salary or wage garnishing for medical debt. And Hawaii’s legislature passed a medical debt forgiveness bill that is awaiting the governor’s signature.

Indiana enacted a bipartisan measure that requires hospitals to inform patients of financial assistance programs for which they might be eligible before debt collection begins. The law also requires such information to be posted inside hospitals. It also prohibits health care providers from using automated tools to submit health benefits claims without a provider first reviewing the claims.

Last year, Alaska Democratic state Rep. Genevieve Mina introduced legislation that prevents medical debt from showing up on patients’ credit reports. Michigan lawmakers introduced a similar bill, which has been referred for a second reading. And on Tuesday, Massachusetts Democratic Gov. Maura Healey proposed an action  that would stop medical debt from being reported to consumer credit agencies.

New Mexico enacted a law prohibiting hospitals from charging patients facility fees for preventive outpatient care, vaccinations and telehealth, but preserves facility fees for inpatient and emergency care.

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

More than a dozen Wisconsin organizations are affected by the Trump administration’s move last week to cut grants for teen pregnancy prevention programs, Wisconsin’s health department confirmed Wednesday.

The programs were expecting to share in almost $1 million per year over the next two years — the remaining period in the five-year grants that were cut off abruptly by the federal government in June.

The U.S. Department of Health and Human Services, which has administered the Teen Pregnancy Prevention grant program in the Office of Population Affairs through several presidential administrations, notified 53 out of 67 grant recipients on Friday, June 26, that their grants were being canceled, Stateline reported.

The Wisconsin Department of Health Services was among the agencies with canceled grants. DHS was just finishing the third year of a five-year grant period.

The DHS grant totaled $1.162 million per year, and the department was expecting a similar amount for the next two fiscal years, 2026-27 and 2027-28.

Britt Cudaback, communications director for Gov. Tony Evers, said Thursday that filing a lawsuit in response to the grant terminations is “a potential option currently under consideration.”

Most of the DHS grant — $986,375 — was distributed as subgrants to local or statewide organizations and agencies. Another $175,530 was set aside for DHS to cover grant administration costs.

“All Wisconsin funding was cancelled,” DHS spokesperson Elizabeth Goodsit told the Wisconsin Examiner in an email message Wednesday.

DHS is exploring whether the department can get funding elsewhere to replace the grants the federal government canceled, and DHS is “assessing all avenues possible to ensure the federal government is following all requirements in this funding agreement,” Goodsit said.

Goodsit said the DHS teen pregnancy prevention program aimed to reduce unintended pregnancies as well as sexually transmitted infections (STIs) among teenagers. Sexual health data demonstrates a need for those programs, she said.

According to CDC data, the teen birth rate in Wisconsin in 2024 was about 10 per 1,000 girls, with the rate dropping steadily in recent decades from a high of nearly 45 births per 1,000 girls in 1991.

“The overall rate is below the national average, but there are several counties with high rates,” Goodsit said. “We know the birth rates for Hispanic, American Indian/Alaska Native, and non-Hispanic Black teens were more than two times higher than the rate for non-Hispanic White teens.”

Across all racial groups, the STI rate is 1,979 per 100,000, but rates for Black, Native American, and Hispanic youth are especially high, Goodsit said.

Teen pregnancy prevention cuts hit Wisconsin program connecting health providers and teens

The grants DHS made with the federal money supported programs for teens “in a variety of settings including clinics, schools, community-based organizations, juvenile justice settings, and shelters — with the goal of decreasing unintended youth pregnancy rates, reducing STI rates among Wisconsin adolescents, and increasing the number/percent of youth who feel connected to their community and have access to youth-friendly services and resources,” Goodsit said.

The 13 grants went to nonprofit education programs, three county public health departments, one public school district, the Department of Public Instruction and the University of Wisconsin Population Health Institute. Individual agency grants ranged from $7,500 per year to $130,375 per year.

“They are focused on populations with the highest teen birth rates and highest STI rates,” Goodsit said. “Along with youth programming, organizations were also focused on family/parent/caregiver programming and engagement.”

From July 1, 2025 through May 31, 2026, the Wisconsin organizations reached 942 youth participants and 17 non-youth participants. “But without this grant funding, these activities will stop,” Goodsit said.