A case involving a frozen embryo that’s at the center of a divorce dispute will not be heard by the Michigan Supreme Court. The court declined the case in an order released Friday.
The Supreme Court order leaves in place an appeals court decision that awarded the embryo to ex-husband David Markiewicz. The Michigan Court of Appeals ruled in December of 2023 that he would get custody because he has the closest biological connection to the embryo and should not be forced to have another child with his ex-wife, Sarah Markiewicz. The appeals court panel divided on the question, with one judge ruling the embryo should go to the ex-wife.
Sarah Markiewicz became pregnant three times through in vitro fertilization. The embryo at issue in the court case, as in Sarah’s other IVF pregnancies, was made with the ex-husband’s sperm, while the egg was donated by the ex-wife’s sister. The couple also has one child conceived naturally.
Sarah Markiewicz argued for possession of the frozen embryo because it could be her final opportunity to have another child. She also argued she was entitled to the embryo under the Michigan Reproductive Freedom for All amendment to the state constitution.
David Markiewicz said earlier he would either have the embryo destroyed or donated for scientific use if he won the case.
“My client is very happy and relieved that he can now put this chapter behind him,” said his attorney, Trish Haas, in an email to Michigan Public Radio. “His disposition of the pre-embryo will now be his personal choice.”
The Supreme Court order was unsigned, but Justice Brian Zahra wrote a concurring statement calling on the Legislature to enact standards to avoid future conflicts as IVF becomes more common.
“Broadly speaking, the primary issue is how the law should classify and treat human embryos, frozen or otherwise, which, at a minimum, have the potential to develop into autonomous human beings,” he wrote. “This question implicates some of the most perplexing debates in society, invoking deep-seated and conflicting beliefs about morality, ethics, religion, human life, and personal autonomy.”
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The only thing worse than the need for community food pantries is having a pantry and not being able to store perishable goods.
That’s what makes the food pantry grant for a new refrigeration unit offered by the United Dairy Industry of Michigan in collaboration with Blue Cross Blue Shield of Michigan (BCBSM), Blue Cross Complete of Michigan and the BCBSM Foundation such a blessing.
“Last year we served 75,665 people and because of the refrigeration unit we were able to store milk between pantry days for emergency food,” said Sue Ostosh, executive director of Harvest Time Christian Fellowship Church’s pantry and among the organizations that have received the grant that’s now open for new applicants.
Emergency food as Ostosh explained is a term that pantries use for people who are in a crisis situation.
“They have no food in the house. No food in the cupboards. Their children are hungry and they don’t know what to do,” Ostosh said. “We probably serve three to five families in this situation every week.”
Harvest Time in Warren is one of 179 organizations in 54 counties that have received a grant to help people facing food insecurity, which includes about 14% of people in Michigan or one in seven Michiganders, according to a report by Feeding America. Older adults, seniors over the age of 60, are also at risk with a food insecurity rate of 6.5%.
According to the BCBSM, the situation is even worse for children, with nearly one in six lacking enough to eat and more than 20 counties having 20% or more kids without reliable access to healthy food.
“When families have consistent access to fresh, nutritious foods like milk, cheese and yogurt it supports their health, development and well being,” said Amiee Vondrasek, health and wellness senior manager for the United Dairy Industry of Michigan, in a news release. “Through this grant program, we’re proud to partner with organizations across Michigan to ensure food pantries are equipped to provide the dairy foods their communities want and need, especially for children and seniors facing food insecurity.”
Todd Anderson concurred.
“Access to fresh produce is critically important for growing children and families who are making ends meet with fewer resources,” said the market president for Blue Cross Complete. “Having these basic needs met creates a positive shift in a person’s overall health and wellbeing. It helps bring them out of survival mode, and that ripples out and allows whole communities to thrive.”
The refrigeration units cost $7,000.
In addition to the refrigeration unit, food pantry grantees will also receive personalized technical assistance to enhance pantry operations and $250 in dairy match funding to purchase additional eligible dairy products for their pantry.
“Food pantries play a vital role in providing individuals and families with access to nutritious food and BCBSM and the BCBSM Foundation are proud to offer resources to help expand their reach and impact,” said Tiffany Albert, senior vice president of community relations for BCBSM. “By investing in food pantries, we can address the immediate need of our communities and equip pantries with the necessary resources, tools and support to serve those in need for years to come.”
Ostosh, whose pantry in Warren serves families in Macomb and parts of Oakland and Wayne counties, said she appreciates what BCBSM is doing.
She just wishes more companies were doing it.
“I could use another refrigerator,” she said. “Even a walk-in cooler or freezer would be great.”
Grant applications are due June 22. They must be submitted using the online application.
Harvest Time Christian Fellowship Church food pantry is 8204 East 9 Mile Rd., in Warren.
Sue Ostosh, executive director of Harvest Time Christian Fellowship Church’s food pantry grabs a gallon of milk from the refrigerator unit they received through a grant provided through a collaboration between the United Dairy Industry of Michigan adn Blue Cross Blue Shield of Michigan. Photo courtesy of Harvest Time
Meet the new candidates vying for Michigan’s U.S. Senate seat
How the Keep MI Kids Tobacco Free Alliance is pushing to prevent underage access to tobacco
Michigan’s U.S. Senate race is expanding with new candidates announcing recently, as well as some potential candidates testing out the waters. This week on MichMash, host Cheyna Roth and Gongwer News Service’s Zach Gorchow discuss the current state of the race and who is most likely to ultimately occupy the seat.
Plus, we sit down with Dr. Brittany Tayler of the Keep MI Kids Tobacco Free Alliance to discuss the recent push for the “Protect MI Kids” bill package, which would require a retail license to sell tobacco products, prohibit flavored tobacco sales, increase tobacco taxes and repeal laws that punish kids.
Dr. Tayler shared that there is barely a barrier for youth to get their hands on cigarettes. But she says it’s not necessarily the retail industry’s fault.
“I’m sure the vast majority of our retailers are abiding by the law and not selling to minors, but it only takes one bad store,” she said. “We don’t have a way to monitor this and there isn’t a large penalty… There is not a lot of reason to not sell to youth.”
Dr. Tayler said that her organization has done a lot of outreach efforts to political leaders in Michigan to gain support. State Republicans have been slow to support the cause, but Dr. Tayler said there is at least one Republican member of the legislature who has shown support. The bills passed in the Senate with all Democratic support last legislative session.
A bill package from last year’s legislative session aimed at improving water affordability has been reintroduced in the Michigan Senate.
Senate Bills 248-256 would cap water rates for some residents living below the federal poverty line and protect them from shutoffs. The legislation also includes a funding mechanism to support water infrastructure.
First-term state Rep. Tonya Meyers Phillips, who represents Hamtramck, Highland Park and parts of Detroit, says water affordability is a moral issue.
“Water shutoffs disproportionately effect low-income families, seniors and communities of color,” Meyers Phillips said. “These are the same communities that already bear the brunt of environmental injustices.”
State Sen. Stephanie Chang (D-Detroit) is a co-sponsor of the bill package. She says around 300,000 Michigan households could benefit from a statewide water affordability program.
“Water is not just a resource,” Chang said. “It’s something that every human being needs in order to live, yet too many families in our state are struggling to afford their water bills or have in the past faced the threat of shutoffs.”
Chang says she expects the bills will receive bipartisan support and make their way to the House in the coming weeks.
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Many have criticized U.S. Health Secretary Robert F. Kennedy Jr. in recent weeks for making sweeping claims about the cause and prevalence of autism and the United States.
At a news conference last week, Kennedy called autism “an epidemic” due to rising diagnosis rates, attributing the rise to “an environmental exposure.” He also called autism “a preventable disease,” promising to launch studies to find out what “caused the autism epidemic” and “eliminate those exposures” by September.
While it’s true that autism rates are on the rise, health experts say the increase is much more likely due to better screenings and higher diagnosis rates in recent years. The definition of autism has also broadened to include a variety of neurodivergent conditions, known as Autism Spectrum Disorders.
“Autism destroys families,” Kennedy said. “More importantly, it destroys our greatest resource, which is our children. These are children who should not be suffering like this.”
Kennedy’s broad claims mirror a larger problem: There are persistent misconceptions about autism that affect autistic people and the way the world interacts with them.
To discuss all of this, Autism Alliance of Michigan President and CEO Colleen Allen joined The Metro. She also founded the Henry Ford Center for Autism and Developmental Disabilities.
Use the media player above to hear the full conversation.
–WDET’s Jenny Sherman contributed to this report.
More stories from The Metro on Wednesday, April 23:
Listen to The Metro weekdays from 10 a.m. to noon ET on 101.9 FM and streaming on-demand.
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The organization’s “State of the Air” report gives the region an “F” grade in ground level ozone pollution, a “D” in particle pollution, and a failing grade overall in pollution levels above federal standards.
The research finds metro Detroit has the sixth worst year-round particle pollution in the U.S.
High levels of air pollution can cause various health issues including asthma attacks and lung cancer, as well as impact other health events such as heart attacks and strokes, the Lung Association reports.
“Unfortunately, too many people in Detroit are living with unhealthy levels of ozone and particle pollution,” said Kezia Ofosu Atta, advocacy director for the Lung Association in Michigan, in a statement. “This air pollution is causing kids to have asthma attacks, making people who work outdoors sick and unable to work, and leading to low birth weight in babies. We urge Michigan policymakers to take action to improve our air.”
Detroit City Council member Gabriella-Santiago Romero has been disqualified from having her name on the city’s August primary election ballot. Wayne County officials say she had an unpaid campaign finance fee, preventing her appearance on the ballot. However, Santiago-Romero issued a release Tuesday saying she has filed all paperwork on time and that the county wrongly assessed the fee.
Henry Ford Health is offering free heart health screenings on Saturday at six Henry Ford Hospitals, including Grand Blanc, Clinton Township, Rochester, Providence Southfield, Warren and Wyandotte.
Efforts to beautify Detroit are showing results, as four million daffodils have bloomed in neighborhoods, parks and medians across the city. The General Services Department’s Floriculture Division says the best showings are in Jayne Playground, Gabriel Richard Park, LaSalle Park and on Oakman Boulevard between Linwood and Dexter. Officials say they hope to have 10 million daffodil bulbs planted in the city one day.
The Detroit Pistons are getting ready for another first round playoff game on Thursday night. The team won its first playoff game since 2008 when they beat the Knicks in New York 100-94 on Monday night. The series is now tied at a game each.
Do you have a community story we should tell? Let us know in an email at detroiteveningreport@wdet.org.
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WDET is embarking on a new project exploring the multifaceted relationship between trees and community health in Michigan.
Amanda Le Claire, lead reporter and managing editor of the tree project, joined The Metro on Earth Day to talk about Detroit’s tree canopy and some of the most recent stories produced by the WDET newsroom.
Le Claire also shared a conversation she had with Andrew “Birch” Kemp, executive director of Arboretum Detroit, about a community forest restoration project on Detroit’s east side.
Studies have shown that urban tree canopies help make communities more climate resilient, reduce air pollution, and combat the urban heat island effect — exposing residents to higher risks of heat-related illness and higher cooling costs.
The tree canopy project will dig into all of these topics and more over 24 months of reporting.
Use the media player above to hear the full conversation.
Listen to The Metro weekdays from 10 a.m. to noon ET on 101.9 FM and streaming on-demand.
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The United States spends more on health care costs than any other rich nation, yet maternal death rates remain alarmingly higher than comparable countries.
Those risks are much higher for Black women, who are three times more likely to die from a pregnancy-related cause than White woman, according the CDC. Racial disparities in quality health care, underlying chronic conditions and social determinants of health are all contributing factors to pregnancy-related complications.
Last week in honor of Black Maternal Health Week, leaders of the Congressional Mamas’ Caucus put up portraits of Black mothers who died from maternal health-related causes outside the offices of over 50 Congressional members at the U.S. Capitol Visitor Center.
The installation, titled “In Her Honor,” was created by Omari Maynard, a visual artist and educator whose partner, Shamony Gibson, died after giving birth in 2019.
Congresswoman Rashida Tlaib, chair of the Congressional Mamas’ Caucus, joined The Metro to discuss the event and help shine a light on maternal health care disparities. Tlaib represents Michigan’s 12th Congressional District, which includes Detroit and Dearborn.
Use the media player above to hear the full conversation.
Listen to The Metro weekdays from 10 a.m. to noon ET on 101.9 FM and streaming on-demand.
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Fentanyl, the deadly synthetic opioid driving the nation’s high drug overdose rates, is also caught up in another increasingly serious problem: misinformation.
False and misleading narratives on social media, in news reports, and even in popular television dramas suggesting people can overdose from touching fentanyl — rather than ingesting it — are now informing policy and spending decisions.
In an episode of the CBS cop drama “Blue Bloods,” for instance, Detective Maria Baez becomes comatose after accidentally touching powdered fentanyl. In another drama, “S.W.A.T.,” Sgt. Daniel “Hondo” Harrelson warns his co-workers: “You touch the pure stuff without wearing gloves, say good night.”
While fentanyl-related deaths have drastically risen over the past decade, no evidence suggests any resulted from incidentally touching or inhaling it, and little to no evidence that any resulted from consuming it in marijuana products. (Recent data indicates that fentanyl-related deaths have begun to drop.)
There is also almost no evidence that law enforcement personnel are at heightened risk of accidental overdoses due to such exposures. Still, there is a steady stream of reports — which generally turn out to be false — of officers allegedly becoming ill after handling fentanyl.
“It’s only in the TV dramas” where that happens, said Brandon del Pozo, a retired Burlington, Vermont, police chief who researches policing and public health policies and practices at Brown University.
In fact, fentanyl overdoses are commonly caused by ingesting the drug illicitly as a pill or powder. And most accidental exposures occur when people who use drugs, even those who do not use opioids, unknowingly consume fentanyl because it is so often used to “cut” street drugs such as heroin and cocaine.
Despite what scientific evidence suggests about fentanyl and its risks, misinformation can persist in public discourse and among first responders on the front lines of the crisis. Daniel Meloy, a senior community engagement specialist at the drug recovery organizations Operation 2 Save Lives and QRT National, said he thinks of misinformation as “more of an unknown than it is an anxiety or a fear.”
“We’re experiencing it often before the information” can be understood and shared by public health and addiction medicine practitioners, Meloy said.
Some state and local governments are investing money from their share of the billions in opioid settlement funds in efforts to protect first responders from purported risks perpetuated through fentanyl misinformation.
In 2022 and 2023, 19 cities, towns, and counties across eight states used settlement funds to purchase drug detection devices for law enforcement agencies, spending just over $1 million altogether. Two mass spectrometers were purchased for at least $136,000 for the Greeley, Colorado, police department, “to protect those who are tasked with handling those substances.”
Del Pozo, the retired police chief, said fentanyl is present in most illicit opioids found at the scene of an arrest. But that “doesn’t mean you need to spend a lot of money on fentanyl detection for officer safety,” he said. If that spending decision is motivated by officer safety concerns, then it’s “misspent money,” del Pozo said.
Fentanyl misinformation is affecting policy in other ways, too.
Florida, for instance, has on the books a law that makes it a second-degree felony to cause an overdose or bodily injury to a first responder through this kind of secondhand fentanyl exposure. Similar legislation has been considered by states such as Tennessee and West Virginia, the latter stipulating a penalty of 15 years to life imprisonment if the exposure results in death.
Public health advocates worry these laws will make people shy away from seeking help for people who are overdosing.
“A lot of people leave overdose scenes because they don’t want to interact with police,” said Erin Russell, a principal with Health Management Associates, a health care industry research and consulting firm. Florida does include a caveat in its statute that any person “acting in good faith” to seek medical assistance for someone they believe to be overdosing “may not” be arrested, charged, or prosecuted.
And even when public policy is crafted to protect first responders as well as regular people, misinformation can undermine a program’s messaging.
Take Mississippi’s One Pill Can Kill initiative. Led by the state attorney general, Lynn Fitch, the initiative aims to provide resources and education to Mississippi residents about fentanyl and its risks. While it promotes the availability and use of harm reduction tools, such as naloxone and fentanyl test strips, Fitch has also propped up misinformation.
At the 2024 Mississippi Coalition of Bail Sureties conference, Fitch said, “If you figure out that pill’s got fentanyl, you better be ready to dispose of it, because you can get it through your fingers,” based on the repeatedly debunked belief that a person can overdose by simply touching fentanyl.
Officers on the ground, meanwhile, sometimes are warned to proceed with caution in providing lifesaving interventions at overdose scenes because of these alleged accidental exposure risks. This caution is often evidenced in a push to provide first responders with masks and other personal protective equipment. Fitch told the crowd at the conference: “You can’t just go out and give CPR like you did before.” However, as with other secondhand exposures, the risk for a fentanyl overdose from applying mouth-to-mouth is negligible, with no clinical evidence to suggest it has occurred.
Her comments underscore growing concerns, often not supported by science, that officers and first responders increasingly face exposure risks during overdose responses. Her office did not respond to questions about these comments.
Health care experts say they are not against providing first responders with protective equipment, but that fentanyl misinformation is clouding policy and risks delaying critical interventions such as CPR and rescue breathing.
“People are afraid to do rescue breathing because they’re like, ‘Well, what if there’s fentanyl in the person’s mouth,’” Russell said. Hesitating for even a moment because of fentanyl misinformation could delay a technique that “is incredibly important in an overdose response.”
Portland Police officers look on as American Medical Response paramedics transport a patient after they were administered Narcan brand Naloxone nasal spray for a suspected fentanyl drug overdose in Portland, Oregon, on Jan. 25, 2024. (Patrick T. Fallon/AFP/Getty Images North America/TNS)
By Sam Whitehead, Phil Galewitz and Katheryn Houghton, KFF Health News
For many years, Eric Wunderlin’s health issues made it hard to find stable employment.
Struggling to manage depression and diabetes, Wunderlin worked part-time, minimum-wage retail jobs around Dayton, Ohio, making so little he said he sometimes had to choose between paying rent and buying food.
But in 2018, his CareSource Medicaid health plan offered him help getting a job. It connected him to a life coach, who helped him find full-time work with health benefits. Now, he works for a nonprofit social service agency, a job he said has given him enough financial stability to plan a European vacation next year.
“I feel like a real person and I can go do things,” said Wunderlin, 42. “I feel like I pulled myself out of that slump.”
Republicans in Congress and several states, including Ohio, Iowa, and Montana, are pushing to implement work requirements for nondisabled adults, arguing a mandate would encourage enrollees to find jobs. And for Republicans pushing to require Medicaid enrollees to work, Wunderlin’s story could be held up as evidence that government health coverage can help people find employment and, ultimately, reduce their need for public assistance.
Yet his experience is rare. Medicaid typically does not offer such help, and when states do try to help, such efforts are limited.
And opponents point out that most Medicaid recipients already have jobs and say such a mandate would only kick eligible people off Medicaid, rather than improve their economic prospects. Nearly two-thirds of Medicaid enrollees work, with most of the rest acting as caregivers, going to school, or unable to hold a job due to disability or illness, according to KFF, a health information nonprofit that includes KFF Health News.
Existing efforts to help Medicaid recipients get a job have seen limited success because there’s not a lot of “room to move the needle,” said Ben Sommers, a professor of health care economics at the Harvard T.H. Chan School of Public Health. Most Medicaid enrollees already work — just not in jobs with health benefits, he said.
“The ongoing argument that some folks make is that there are a lot of people freeloading in Medicaid,” he said. “That’s just not supported by the evidence.”
Using health programs to encourage work
The GOP-controlled Congress could allow or require states to implement a Medicaid work requirement as part of revamping and downsizing Medicaid. The first Trump administration encouraged those work mandates, but many were struck down by federal judges who said they were illegal under federal law.
Policy experts and state officials say more attention should be paid to investments that have helped people find better jobs — from personalized life coaching to, in some cases, health plans’ directly hiring enrollees.
They argue work requirements alone are not enough. “The move to economic mobility requires a ladder, not a stick,” said Farah Khan, a fellow with the Brookings Institution, a nonpartisan think tank.
While Medicaid work requirements have been debated for decades, the issue has become more heated as 40 states and Washington, D.C., have expanded Medicaid eligibility under the Affordable Care Act to the vast majority of low-income adults. More than 20 million adults have gained coverage as a result — but Republicans are now considering eliminating the billions in extra federal funding that helped states extend eligibility beyond groups including many children, pregnant women, and disabled people.
Only Georgia and Arkansas have implemented mandates that some Medicaid enrollees work, volunteer, go to school, or enroll in job training. But a study Sommers co-authored showed no evidence work requirements in Arkansas’ program led to more people working, in part because most of those who could work already were.
In Arkansas, more than 18,000 people lost coverage under the state’s requirement before the policy was suspended by a federal judge in 2019 after less than a year. Those who lost their Medicaid health care reported being unaware or confused about how to report work hours. Since 2023, Arkansas has been giving Medicaid health plans financial incentives to help enrollees train for jobs, but so far few have taken advantage.
Some plans, including Arkansas Blue Cross and Blue Shield’s, offer members $25 to $65 to complete a “career readiness” certificate. In 2024, some Arkansas health plans offered enrollees educational videos about topics including taxes and cryptocurrency.
Health plans don’t have an incentive to help someone find a better-paying job, because that could mean losing a customer if they then make too much to qualify for Medicaid, said Karin VanZant, a vice president at Clearlink Partners, a health care consulting company.
Rather than offering incentives for providing job training, some states, such as California and Ohio, require the insurance companies that run Medicaid to help enrollees find work.
In Montana, where some lawmakers are pushing to implement work requirements, a promising optional program nearly collapsed after state lawmakers required it be outsourced to private contractors.
Within the program’s first three years, the state paired 32,000 Medicaid enrollees with existing federally funded job training programs. Most had higher wages a year after starting training, the state found.
But enrollment has plummeted to just 11 people, according to the latest data provided by the state’s labor department.
Sarah Swanson, who heads the department, said several of the nonprofit contractors that ran the program shuttered. “There was no real part in this for us to deliver direct services to the folks that walked through our door,” she said. The state hopes to revive job training by allowing the department to work alongside contractors to reach more people.
The hunt for results
State officials say they don’t have much data to track the effectiveness of existing job programs offered by Medicaid plans.
Stephanie O’Grady, a spokesperson for the Ohio Department of Medicaid, said the state does not track outcomes because “the health plans are not employment agencies.”
Officials with CareSource, which operates Medicaid plans in multiple states, say it has about 2,300 Medicaid and ACA marketplace enrollees in its JobConnect program — about 1,400 in Ohio, 500 in Georgia, and 400 in Indiana.
The program connects job seekers with a life coach who counsels them on skills such as “showing up on time, dressing the part for interviews, and selling yourself during the interview,” said Jesse Reed, CareSource’s director of life services in Ohio.
Since 2023, about 800 people have found jobs through the program, according to Josh Boynton, a senior vice president at CareSource. The health plan itself has hired 29 Medicaid enrollees into customer service, pharmacy, and other positions — nearly all full-time with benefits, he said.
In 2022, California started offering nontraditional health benefits through Medicaid — including help finding jobs — for enrollees experiencing homelessness or serious mental illness, or who are otherwise at risk of avoidable emergency room care. As of September, it had served nearly 280,000 enrollees, but the state doesn’t have data on how many became employed.
The University of Pittsburgh Medical Center, which is among the largest private employers in Pennsylvania, running both a sprawling hospital system and a Medicaid plan, has hired over 10,000 of its Medicaid enrollees since 2021 through its training and support services. Among other jobs, they took positions as warehouse workers, customer service representatives, and medical assistants.
The vast majority left low-paying jobs for full-time positions with health benefits, said Dan LaVallee, a senior director of UPMC Health Plan’s Center for Social Impact. “Our Pathways to Work program is a model for the nation,” he said.
Josh Archambault, a senior fellow with the conservative Cicero Institute, said Medicaid should focus on improving the financial health of those enrolled.
While the first Trump administration approved Medicaid work requirements in 13 states, the Biden administration or federal judges blocked all except Georgia’s.
“I don’t think states have been given ample chance to experiment and try to figure out what works,” Archambault said.
KFF Health News senior correspondent Angela Hart contributed to this report.
Eric Wunderlin was on Medicaid for many years while working minimum-wage jobs around Dayton, Ohio. ((Maddie McGarvey for KFF Health News)/KFF Health News/TNS)
Republicans in Congress are eyeing $880 billion in cuts to Medicaid, the joint federal-state government health care program for lower-income people.
Depending on how states respond, a Republican proposal that would slash the 90% federal contribution to states’ expanded Medicaid programs would end coverage for as many as 20 million of the 72 million people on Medicaid — or cost states $626 billion over the next decade to keep them on the rolls. More than 5 million people could lose coverage if the feds impose work requirements.
In recent months, this complicated government program has increasingly come under the spotlight, so Stateline has put together a guide explaining what Medicaid is and how it operates.
1. Medicaid is not Medicare.
Medicaid serves people with lower incomes or who have a disability. Medicare focuses primarily on older people, no matter their income.
Medicaid and Medicare were created in 1965 under President Lyndon B. Johnson. Medicare is the federal health insurance program for people who are 65 or older, though younger people with special circumstances, such as permanent kidney failure or ALS, may be eligible earlier.
Medicare is a supplemental insurance program that’s limited in scope. It doesn’t pay for long-term care, most dental care or routine physical exams. Around 68.4 million people are enrolled in Medicare.
Medicaid is a more comprehensive government insurance plan that’s jointly funded by the federal government and states. Medicaid covers most nursing home care as well as home- and community-based long-term care. People on Medicaid generally don’t have any copayments. Only people and families with incomes under certain thresholds are eligible for Medicaid. About 72 million people, or a fifth of people living in the United States, receive Medicaid benefits.
2. Medicaid eligibility varies from state to state.
In its original form, Medicaid was generally only available to children and parents or caretakers of eligible children with household incomes below 100% of the federal poverty line ($32,150 for a family of four in 2025). Over the years, the program was expanded to include some pregnant women, older adults, blind people and people with disabilities.
States have to follow broad federal guidelines to receive federal funding. But they have significant flexibility in how they design and administer their programs, and they have different eligibility rules and offer varying benefits.
In 2010, President Barack Obama signed into law the Affordable Care Act, also known as Obamacare, which allowed states to expand their eligibility thresholds to cover adults with incomes up to 138% of the federal poverty line (about $21,000 for one person today), in exchange for greater federal matching funds. The District of Columbia covers parents and caretakers who earn up to 221% of the federal poverty line.
Only 10 states (Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin and Wyoming) have chosen not to expand coverage. In the non-expansion states, eligibility for caretakers and parents ranges from 15% of the federal poverty line in Texas to 105% in Tennessee. In Alabama, people can only get Medicaid if they earn at or below 18% of the federal poverty line — $4,678 a year for a three-person household.
3. Traditional Medicaid exists alongside a health insurance program for children called CHIP.
Low-income children have always been eligible for Medicaid. But in 1997, Congress created CHIP, or the Children’s Health Insurance Program. The law gave states an opportunity to draw down enhanced federal matching funds to extend Medicaid coverage to children within families who earn too much money to qualify for traditional Medicaid coverage, but make too little money to afford commercial health care.
Like Medicaid, CHIP is jointly funded by the federal government and states, but it’s not an entitlement program. CHIP is a block grant program, meaning states receive a fixed amount of federal money every year and aren’t obligated to cover everyone who meets the eligibility requirements. States get to decide, within broad federal guidelines, how their CHIP programs will work and what the income limits will be. Some states have chosen to keep their CHIP and Medicaid programs separate, while others have decided to combine them by using CHIP funds to expand Medicaid eligibility.
4. Medicaid and CHIP are significant portions of state budgets.
In 2024, the federal government spent less on Medicaid and CHIP than on Medicare, with Medicare spending accounting for 12%, or $847.5 billion, of the federal benefit budget, and Medicaid and CHIP accounting for 8%, or $584.5 billion.
But at the same time, Medicaid is the largest source of federal funds for states, accounting for about a third of state budgets, on average, and 57% of all federal funding the states received last year.
5. Federal funding varies by state.
Before the Affordable Care Act, federal Medicaid funding to states mostly depended on a formula known as the FMAP, or the federal medical assistance percentage, which is based on the average personal income of residents. States with lower average incomes get more financial assistance. For example, the federal government reimburses Mississippi, which is relatively poor, nearly $8 for every $10 it spends, for a net state cost of $2. But New York is only reimbursed $5. By law the FMAP can’t be less than 50%.
The ACA offered states the opportunity to expand eligibility and receive an even greater federal matching rate. In expansion states, the federal government covers 90% of costs for expansion adults. If Republicans in Congress reduce that percentage, states would have to use their own money to make up for lost federal dollars. They might have to scale back Medicaid coverage for some groups, eliminate optional benefits or reduce provider payment rates. Alternatively, they could raise taxes or make cuts in other large budget items, such as education.
Another possibility is that states that have adopted Medicaid expansion would reverse it. Nine states (Arizona, Arkansas, Illinois, Indiana, Montana, New Hampshire, North Carolina, Utah and Virginia) already have “trigger” laws in place that would automatically rescind expansion if the federal match rate dips below 90%. Other states are considering similar legislation.
One new analysis from KFF, a health research policy group, found that if Congress reduced the federal match for the expansion population to the percentages states get for the traditional Medicaid population— 50% for the wealthiest states and 77% for the poorest ones — it would cost states $626 billion over the next decade to keep everyone eligible under Medicaid expansion on the rolls.
6. Medicaid is the largest source of health coverage, especially for people with low incomes.
Medicaid is the single largest health payer in the nation, and is particularly important for people in poverty. Almost a fifth of people living in the United States are covered through Medicaid. But nearly half of all adults with incomes at or below the federal poverty line are insured through the program. Medicaid covers 4 out of every 10 children overall, but it covers 8 out of every 10 children below the federal poverty line. Medicaid also provides coverage for people experiencing homelessness or who are leaving incarceration.
7. Medicaid covers essential services, such as childbirth.
In exchange for receiving federal funds, states are obligated to cover essential health care services, including inpatient and outpatient hospital services, doctor visits, laboratory work and home health services, among other things. States get to decide which optional services, such as prescription drugs and physical therapy, they want to cover.
Medicaid is a significant payer of essential services. For example, the program covers 41% of all childbirths in the U.S. and covers health care services for the 40% of all adults ages 19-65 with HIV.
8. The majority of Medicaid spending goes to people with disabilities and to pay for long-term care.
ACA expansion adults — about 1 out of every 4 enrollees — accounted for 21% of total Medicaid expenditures in 2021. Children, who make up about 1 out of every 3 enrollees, only accounted for 14% of spending.
People who qualify for Medicaid because of a disability or because they are over the age of 65 make up about 1 out of every 4 enrollees. But they accounted for more than half of all Medicaid spending. That’s because these populations typically experience higher rates of chronic illness and require more complex medical care. Older people are also more likely to use nursing homes and other long-term care facilities, which can be expensive.
Cuts could also mean that older people relying on Medicaid for home-based care and long-term nursing home services could be significantly affected.
9. Some state Medicaid programs cover people who are living in the country illegally.
People who are in the country illegally are ineligible for traditional Medicaid or CHIP. But some states have carved out exceptions to extend coverage to them using state dollars.
As of January, 14 states and the District of Columbia provide Medicaid coverage to children regardless of their immigration status. And 23 states plus the District of Columbia use CHIP to cover pregnant enrollees regardless of their immigration status.
Also, seven states provide Medicaid to some adults who are here illegally. New York opted to cover those who meet the income requirements and are over the age of 65, regardless of immigration status And California provides coverage to any adults ages 19-65 who are under the income threshold, regardless of immigration status.
10. The majority of the public holds favorable views of Medicaid.
According to surveys from KFF, two-thirds of Americans say that someone close to them has received health coverage from Medicaid at some point in their lives. Half of the public also say they or someone in their family have been covered through Medicaid.
Generally, around 3 out of every 4 people — regardless of political party — say that Medicaid is very important, though Republicans are less likely than Democrats and independents to share that opinion. At the same time, a third or less of people want to see any decrease in spending on the Medicaid program. In fact, the majority of people living in states that have not expanded Medicaid under the ACA want their states to do so.
US Representative Sara Jacobs holds a “Save Medicaid” protest sign as US President Donald Trump addresses a joint session of Congress at the U.S. Capitol in Washington, D.C., on March 4, 2025. (Win McNamee/Pool/AFP/Getty Images North America/TNS)
NEW YORK (AP) — Her first panic attack came at a company-wide meeting, right before her scheduled presentation. Carolina Lasso had given many similar talks about her marketing team’s accomplishments. When her name was called this time, she couldn’t speak.
“I felt a knot in my throat,” Lasso said. “My head, it felt like it was inside a bubble. I couldn’t hear, I couldn’t see, and it felt like an eternity. It was just a few seconds, but it was so profound, and in a way earth-shattering to me.”
Lasso was struggling after a cross-country move followed by a divorce. Her boss suggested a mental health leave, a possibility she didn’t know existed. She worried whether taking time off would affect how her team viewed her or cost her a future promotion, but in the end she did.
“I’m thankful for that opportunity to take the time to heal,” Lasso, 43, said. “Many people feel guilty when they take a leave of absence when it’s mental health-related. … There is some extra weight that we carry on our shoulders, as if it had been our fault.”
Despite a fear of repercussions, more adults are recognizing that stepping back from work to deal with emotional burdens or psychological conditions that get in the way of their lives is a necessary choice, one that a growing number of employers recognize.
ComPsych Corp., a provider of employee mental health programs and absence management services, encourages its business clients to make the well-being of workers a priority before individuals get to a breaking point while also having processes in place for those who require leaves of absence.
“Since the start of the COVID-19 pandemic, collectively we’ve just been in this constant state of turmoil,” Jennifer Birdsall, the senior clinical director at ComPysch, said. “We just have had this barrage of change and uncertainty.”
Depression, anxiety and adjustment disorder, which involves excessive reactions to stress, were the top three diagnoses of employees who took mental health leaves in the past two years among clients of Alight, a Chicago-based technology company which administers leaves and benefits for large employers.
Structuring a leave
A mental health leave can last weeks or months. In some cases, workers get approval to work a reduced schedule or to take short periods of time off when needed, using an approach called “intermittent leave.”
At most U.S. organizations with 50 or more employees, people can request leaves through the Family and Medical Leave Act. The federal law entitles workers with serious health conditions to paid or unpaid leaves of up to 12 weeks, depending on state and local laws.
Some employers require people to use sick days or accumulated vacation days to continue receiving a paycheck while out. For longer leaves, workers can access short-term disability plans, if their employer offers one.
Lasso’s leave lasted six months, and included therapy and travel to India for additional treatment. She returned to her job but decided after a year to leave for good. She later launched a business to train people on fostering a more humane work culture.
A mental health leave is “not only OK, but it can really unlock new possibilities once we have the time to do the work — therapy, medication, whatever it is — and have enough distance from work to be able to reconnect with ourselves,” Lasso said.
Talking openly about struggles
A social stigma around mental health challenges causes many people to avoid seeking treatment or requesting a leave of absence. Newton Cheng, director of health and performance at Google, hopes to change that by sharing his own struggles.
His first self-disclosure happened during the pandemic, when a senior manager invited employees at a meeting to share how they were doing. When it was his turn, Cheng started crying.
He explained he was struggling to live up to his expectations of himself as a father and didn’t know how to turn things around.
“It was just totally horrifying to me because, one, I had just cried in front of my coworkers and I was definitely taught as a professional — and as a man — you do not do that,” Cheng recalled. “And then two, I had never really articulated and said out loud those words. I hadn’t even allowed myself to think that. But now they’re out there and I had to face them.”
Colleagues responded by relaying their own struggles, but Cheng’s difficulties continued. By February 2021, he couldn’t get out of bed because he felt paralyzed by dread, he said. A therapist said he was showing symptoms of major depression and anxiety.
“I just realized, ‘I’m struggling a lot and this goes pretty deep. I don’t think I can keep just putting duct tape on this. I probably need to take some leave,’” Cheng recalled.
Hoping his decision would benefit others, he announced to 200 people at a conference that he planned to take mental health leave. Instead of derailing the gathering as he feared, his honesty inspired fellow conference attendees to open up.
“It was like a fireworks show,” Cheng said. “They’re like, ‘Wow, I can’t believe he did that.’ Then they forgot about me. But the tone was set. It was like ’Oh, this is what we’re doing. Let me talk about what’s going on with me, too.’”
Take the time you need
While balancing classes and a full-time job during her last year of college, Rosalie Mae began struggling to get out of bed and crying uncontrollably. Yet she felt like she had “to keep it together” to avoid burdening her colleagues at the University of Utah bookstore, where Mae worked as an accounting clerk.
Then she found herself calling a suicide hotline. “Once it reached that point, I knew, especially at the urging of my husband, we need to do something more,” Mae, 24, said.
In her case, that meant taking a five-week work leave to put her own health and well-being first. She recommends the same for others who find themselves in a similar position.
“Taking a mental health leave is not necessarily a cure-all, but it is important to give yourself a break and allow yourself to regroup, make a plan of how to proceed and take the steps to work towards feeling better,” Mae said.
Telling managers and colleagues
Before broaching the subject of a mental health leave with a manager, consider the workplace culture and the strength of your professional relationships, Cheng said. He recalls saying, “For my health and well-being, and the sake of my family and what’s best for the business, the least risky thing for me to do is to go on leave soon.”
Individuals who suspect an unsympathetic reception can simply say, “I need to go on medical leave. I need time to recover,” he advised.
There’s also no legal or ethical requirement to tell everyone you work with the nature of your leave.
“Your coworkers don’t need to know why,” said Seth Turner, co-founder of AbsenceSoft, a leave and accommodation management solutions provider. “They just need to know, ‘I’m going to be here at this time, and I’m going to be gone at this time, and I’ll be back.’”
Have you overcome an obstacle or made a profound change in your work? Send your questions and story ideas to cbussewitz@ap.org.
The federal Family and Medical Leave Act entitles workers at most U.S. organizations with 50 or more employees to up to 12 weeks of leave for serious health conditions. (AP Illustration / Annie Ng)
Gov. Gretchen Whitmer signed an executive directive Thursday calling on the state health department to create a report on how big proposed cuts to the federal Medicaid program would affect Michigan.
The executive directive instructs the Michigan Department of Health and Human Services (MDHHS) to create a report within 30 days detailing the effects of a congressional Republican proposal that could cut $880 billion from Medicaid over 10 years. Whitmer wants data and personal stories to help congressional Democrats shut down a Republican budget resolution if it includes Medicaid cuts. But she said it is already clear the impact in Michigan would be huge.
“Statewide, Medicaid covers 2.6 million people,” she said. “That’s over a quarter of our population. “That number includes a million children, nearly 170,000 seniors and 300,000 people with disabilities.”
Whitmer was flanked by health care workers as she signed the directive at a hospital in Royal Oak. She said hospitals, clinics and other providers would have to reduce services and find other ways to make up for lost funding if Medicaid is slashed.
Whitmer said rural hospitals, which are also large local employers, would likely be the hardest hit. She said using Medicaid cuts to extend tax cuts and reduce the federal budget is a bad deal for taxpayers.
“This won’t make government more efficient,” she said. “It’ll just raise your costs, eliminate local jobs and put lives in danger.”
“There’s simply no way to do it without drastic cuts to Medicaid,” said U.S. Rep. Debbie Dingell (D-Ann Arbor), who serves on the GOP-led congressional committee that is supposed to come up with health care cuts and savings. “And let me make this very clear, we will make sure every Republican is on record on what they are cutting.”
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Detroit’s General Service Department is looking to increase the tree canopy across the city to improve citizens’ quality of life. The department is accepting requests from residents for tree plantings in their neighborhoods.
The free program is open to residents and small businesses to plant a tree on the berm in front of their property.
Savion Stephens, tree planting program manager for the city of Detroit, says trees can help improve residents’ quality of life.
“And what that looks like is improving air quality over time, conserving water, reducing soil erosion, filtering runoff, reducing flooding, and even things like lowering energy costs and raising property values,” he said.
Trees are also known to trap pollutants such as dirt, ash, pollen and smoke which can help those with asthma.
Stephens says the city plants over 50 different species of tree throughout the city.
“They’re primarily urban tolerant trees for public and private property, including some native species like oak and elm,” he said.
The planting process involves three phases: utility marking, tree location marking, and tree planting. Eligibility for a tree is assessed based on site conditions, including utility lines and soil quality.
The city has planted up to 14,000 trees annually through this program.
Residents who would like to request a tree must fill out this form.
Detroit’s five reasons to plant a tree
Clean air. Trees absorb pollutants and improve air quality, reducing respiratory issues.
Cooler summer. A single tree can lower temperatures by up to 10°, providing shade and cutting cooling costs.
Stronger neighborhoods. Tree-lined streets increase property values and create a more welcoming community.
Flood prevention. Trees absorb excess rainwater, reducing the risk of street flooding.
Wildlife Habitat. Trees support birds, bees, and other beneficial wildlife, keeping our ecosystem balanced.
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The Detroit Documenters play a crucial role in improving our access to public information. They’re at Detroit’s public meetings, taking thorough notes on what local officials and community members are saying.
But their coverage also includes Highland Park, the small city surrounded by Detroit. Water has been an ongoing problem for Highland Park and it’s in the early stages of replacing its 115-year-old water system.
Residents faced two boil water advisories in the last month, but still remain hopeful that system updates can lead to a more reliable system and cheaper water bills.
Metro Producer Jack Filbrandt talked to Documenters Coordinator Noah Kincade and Michigan Public Data Reporter Adam Rayes to learn more about Highland Park’s system updates and water history.
Rayes is also a Highland Park resident. Out of the many places he’s lived, he says the water bill has been the highest in Highland Park.
Residents are charged about $90 in additional fees that goes to system repairs and paying off the city’s Great Lakes Water Authority debt.
“I’m looking at a bill of over $100 and if it wasn’t for those fees, I’d be paying way less,” Rayes said. “So it’s quite a hefty fee.”
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Over the weekend, the 17th annual Muslim Mental Health Conference took place at the Soho Banquet Center in Westland and online.
Aquila Hussain is on the board of directors and the chair of the volunteer subcommittee. She says it’s the longest-running academic conference dedicated to mental health care for Muslim communities.
“It’s very much on what is the research showing in clinical setting, what is the research showing behind the scenes, and really kind of bringing in a lot of academic merit to the study of this very diverse demographic,” she said.
Hussain said the conference helps to bring awareness to Muslim mental health needs.
Clinician Aquila Hussain is a board member of the Muslim Mental Health Conference.
“We want to get Muslim mental health practitioners, clinicians, researchers, medical professionals, to come together and talk about what is happening. We like to call it like the meeting of the minds, where we bring everyone together to kind of have these important conversations,” she shared.
Hussain said it’s also a chance for people to network.
This year the theme was resilience, resistance and collective care.
“We as a society, are resilient, and we can show resistance and very you know, it doesn’t have to be these grandiose gestures. It can be smaller gestures. And so bringing everyone together to kind of talk about that. And so this compassionate care and cultivating focusing on tradition,” she said.
Muslim Mental Health Conferences attracts researches from around the world to discuss Muslim mental health topics.
Hussain said, despite a large Muslim population in Michigan, it isn’t reflected in the research.
“I think Muslims are very marginalized population, especially in Michigan. We make a large… make up a large percentage of the population, when looking at minority populations, yet we don’t really get representation equal to that,” she said.
Hussain said the conference allows diverse Muslim populations — Black, LatinX, South Asian, Arab American — to discuss mental health in the Muslim community.
“The Muslim population is large enough. It’s a diverse group of us. We range all over the world, and we’ve had such different experiences and different ways of living that it’s hard to kind of just lump us into one large group and just say like this is what happens to Muslims,” she said.
Hussain said, although she doesn’t have stats, adequately she knows there’s a growing need for Muslim mental health counselors.
“I always have a wait list, and it’s almost always of Muslim people. So personally, yeah, I think like people are reaching out exponentially, especially people teens to like, mid-30s, are a lot more open to therapy, are a lot more interested in kind of understanding their line of thinking and reflecting on these things,” she said. “I think that has a lot to do with this conference and how the systemic like destigmatization of mental health in Muslim communities.”
She said it’s important to have safe spaces to discuss world matters.
The Muslim Mental Health Conference took place April 11-12.
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They say beauty is in the eye of the beholder and that beauty is more than skin deep. Your presentation, build, attire and demeanor shapes how others perceive who you are and what you care about.
The people we surround ourselves with influence our taste which forms our opinion on what we deem as cool or beautiful. The media we consume is powerful too; the mind is a really powerful thing. It encourages us to change the way we look to fit the latest fashion and beauty trends.
Two guests joined The Metro on Thursday to help us better understand the pressure of America’s beauty standards and their effect on women.
Rokeshia Ashley is a professor of health communication at Florida International University and a researcher focusing on body image, body modification and maternal health.
Dr. Alexandra Sowa is an obesity and internal medicine physician and the author of the book, “The Ozempic Revolution.”
Use the media player above to hear the full conversation.
More stories from The Metro on Thursday, April 10:
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More Americans are getting sick from preventable illnesses, especially kids.
Here in Michigan, measles cases have recently been confirmed in Oakland, Macomb, and Kent counties. In Texas, two children have died from measles. Both were unvaccinated.
Health experts say measles deaths could become more common, marking a shift backwards. Measles was declared eradicated in the U.S. 25 years ago following what state officials describe as “a highly effective vaccination program in the U.S.” along with better measles control across North, Central and South America.
But the landscape for infectious diseases is changing. Vaccine skepticism and hesitancy are on the rise. So far this year, over 600 confirmed measles cases have been reported across multiple states. For comparison, there were 285 measles cases reported for all of 2024.
Outbreaks are on the rise as well. The vast majority of measles cases are outbreak-associated, which is defined as three or more related cases.
The nation’s hub for addressing infectious diseases — the Department of Health and Human Services — has faced major cuts under the Trump administration. Experts say those cuts could affect the response to infectious diseases at the local, state and national level.
Dr. Teena Chopra, infectious disease specialist and assistant dean at Wayne State University’s School of Medicine, joined The Metro to help us understand the situation.
Use the media player above to hear the full conversation.
More stories from The Metro on Wednesday, April 9:
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WASHINGTON (AP) — Secretary Robert F. Kennedy Jr. offered no new details Wednesday about his massive restructuring of the U.S. Department of Health and Human Services, the day after thousands of layoffs ricocheted through its agencies, hollowing out entire offices around the country in some cases.
Kennedy’s silence is prompting questions from Republican and Democratic lawmakers alike, with a bipartisan request for President Donald Trump’s health secretary to appear before a Senate committee next week to explain the cuts.
As many as 10,000 notices were sent to scientists, senior leaders, doctors, inspectors and others across the department in an effort to cut a quarter of its workforce. The agency itself has offered no specifics on which jobs have been eliminated, with the information instead coming largely from employees who have been dismissed.
“This overhaul is about realigning HHS with its core mission: to stop the chronic disease epidemic and Make America Healthy Again,” Kennedy said on social media, in his only comments addressing the layoffs so far. “It’s a win-win for taxpayers, and for every American we serve.”
The move, the department has said, is expected to save $1.8 billion from the agency’s $1.7 trillion annual budget — about one-tenth of 1%.
The department has not released final numbers but last week said it planned to eliminate 3,500 jobs from the Food and Drug Administration, 2,400 jobs at the Centers for Disease Control and Prevention, and 1,200 from the National Institutes of Health. Public health experts and top Democrats have raised alarms about how the deep cuts — about 25% of the department — will affect food and prescription drug safety, medical research and infectious disease prevention.
Still unclear is why certain jobs were eliminated and others were spared.
As the cuts were underway on Tuesday, Louisiana Sen. Bill Cassidy, a Republican, and Vermont Sen. Bernie Sanders, an independent who caucuses with Democrats, sent a letter to Kennedy calling him before the Senate’s health committee. In a statement, Cassidy said Kennedy’s appearance is part of his promise to appear quarterly before the committee.
“This will be a good opportunity for him to set the record straight and speak to the goals, structure and benefits of the proposed reorganization,” Cassidy’s statement said.
Rep. Diana Harshbarger, a Republican from Tennessee, said the House’s health subcommittee also has questions about job cuts.
“We’re going to find out what the layoffs were all about — 10,000 — we didn’t know it,” Harshbarger said Wednesday at a health care forum hosted by Politico. “We’re going to find out what the premise was for those layoffs.”
At the same event, special government employee Calley Means, a close adviser to Kennedy who is working at the White House, defended the cuts. He struggled, however, to offer an explanation on how the overhaul will improve Americans’ health. Some of his claims were met with shouts and hisses.
“The system is really on the wrong track,” Means said, later adding that he wants to see more research from the NIH.
Politico’s Dasha Burns pressed Means on how the NIH would conduct more research with fewer employees at the agency, which had fired more than 1,000 NIH scientists and other staff before this week’s layoffs. Trump’s Republican administration has yanked hundreds of NIH grants and delayed hundreds of millions of dollars in continuing or new research funds including for studies of cancer and to keep Alzheimer’s centers around the country running.
Means responded by asking: “Has NIH funding been slashed?”
This story has been corrected to show the savings is about one-tenth of 1%, not about 1%.
Associated Press writer Lauran Neergaard in Washington contributed.
FILE – Robert F. Kennedy Jr., speaks after being sworn in as Health and Human Services Secretary in the Oval Office at the White House, Thursday, Feb. 13, 2025, in Washington. (Photo/Alex Brandon, File)
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