By Georgina Boos, Bloomberg News

Who’s paying for Donald Trump’s tariffs? So far, American businesses and consumers.

General Motors Co. was the latest U.S. company to disclose how the levies are raising costs, with the automaker saying Tuesday that the duties dented profits by more than $1 billion as it chose to absorb the blow. That helps explain why car prices didn’t rise in last week’s inflation data, while robust price increases for other commonly imported goods like toys and appliances showed those tariff expenses are being passed on to consumers.

Meanwhile, import prices excluding fuel were up notably in June, suggesting foreign companies aren’t shouldering the burden by offering U.S. firms lower prices — challenging the president’s claims that other countries pay the rate. Trump reiterated that characterization on Tuesday after a meeting with his counterpart in the Philippines, saying that country “will pay a 19% Tariff” in a post on social media.

While customs duties are giving a significant boost to U.S. revenues, the data show that those coffers are being filled domestically.

“The top-down macro evidence seems clear: Americans are mostly paying for the tariffs,” George Saravelos, global head of FX research at Deutsche Bank AG, said in a note Tuesday. “There is likely more pressure on U.S. consumer prices in the pipeline.”

Many economists agree, especially as relatively tame readings in the consumer price index this year underscore firms’ hesitation to pass on tariffs to customers. That’s also been evident in the producer price index, where the rate of increase in a measure of margins for wholesalers and retailers has slowed sharply in recent months.

“With little relief on import prices, domestic firms are stomaching the cost of higher tariffs and starting to pass it on to consumers,” Wells Fargo & Co. economists Sarah House and Nicole Cervi said in a note last week. “The recent rise in import prices points to foreign suppliers generally resisting price cuts.”

Granted, there are some signs that foreign suppliers are absorbing part of the impact to keep goods flowing to the U.S. Export prices in Japan have contracted for three straight months, and the country’s carmakers cut prices to the U.S. in June by a record in data going back to 2016.

But for many foreign companies, the slide in the U.S. dollar has incentivized them to raise their invoice prices to compensate, according to Wells Fargo. And Deutsche Bank’s Saravelos said the pressure on U.S. firms so far to bear tariff costs is another headwind for the greenback, which is already on its worst start to a year since the 1970s.

Forecasters doubt U.S. corporations will sacrifice profits for much longer. 3M Co. raised its earnings outlook last week as shifting production and pricing changes will help mitigate the impact of tariffs. Nike Inc. is planning “surgical” price hikes to help soften the blow, as the company expects the levies to increase costs by about $1 billion.

“If consumers and foreign firms are not bearing tariff costs, domestic firms are. That is something that eventually should be reflected in corporate earnings announcements,” Citigroup Inc. Chief U.S. Economist Andrew Hollenhorst said in a note Tuesday. “We will be listening this quarter, but firms may still emphasize uncertainty and (perhaps rightly) expect that the burden sharing can shift in coming months.”

(With assistance from Catherine Larkin and Carter Johnson.)

©2025 Bloomberg L.P. Visit bloomberg.com. Distributed by Tribune Content Agency, LLC.

By Shalina Chatlani, Stateline.org

States must begin verifying millions of Medicaid enrollees’ monthly work status by the end of next year — a task some critics say states will have a hard time carrying out.

A provision in the tax and spending bill President Donald Trump signed into law July 4 will require the 40 states plus Washington, D.C., that have expanded Medicaid to check paperwork at least twice a year to ensure those enrollees are volunteering or working at least 80 hours a month or attending school at least half time.

The new law provides states $200 million for fiscal year 2026 to get their systems up and running. But some experts say states will have difficulty meeting the deadline with that funding and worry enrollees might lose their health benefits as a result.

A year and a half to comply is likely not going to be enough time for most states, especially since the federal government must craft guidance on how they should implement their programs, said Dr. Benjamin Sommers, a health economist at Harvard T.H. Chan School of Public Health. He predicted it will be difficult to create technology simple enough — such as a phone app — to streamline the process for all enrollees.

“Two hundred million [dollars] is not going to cover the 40 expansion states that we have,” he told Stateline. “There is not a silver bullet here, and there isn’t a single app out there that’s going to keep people who should be in Medicaid from losing coverage. That’s just not realistic.”

A spokesperson for the North Carolina Department of Health and Human Services, Hannah Jones, told Stateline that “it will take a significant amount of time and investment in order to implement work requirements.”

Jones said an estimated 255,000 people in North Carolina could lose coverage because of these requirements and their “administrative burden.”

“More automation reduces manual work on beneficiaries and eligibility case workers, but it requires more time, funding, and staff resources to implement,” Jones wrote in an email.

Emma Herrock, a spokesperson for the Louisiana Department of Health, wrote in an email that the vast majority of the state’s Medicaid enrollees already work, and the agency expects few people to be disenrolled. Herrock said the department will establish work verification systems by the end of 2026.

“The department is taking a thoughtful approach to implementation,” Herrock wrote. “We are already working with several Louisiana agencies … in order to receive data on recipients who are working.”

She added that the department views work requirements “as a means to grow our economy, while reinforcing the value of work and self-sufficiency.”

In New York, it could cost the state $500 million to administer the new requirements, New York Department of Health spokesperson Danielle De Souza wrote in an email.

Between 600,000 and 1.1 million individuals who are eligible for and enrolled in Medicaid could potentially lose coverage because of work reporting requirements, she wrote, based on what happened when states were required to resume checking eligibility after the COVID-19 health emergency ended.

“The department will remain steadfast in its commitment to protecting the health of all New Yorkers and will work to mitigate the impacts of this law,” De Souza wrote.

The new rules apply to states that expanded Medicaid to adults between the ages of 19 and 64 with incomes below 138% of the federal poverty line (about $22,000 for an individual), an option that was made available under the 2010 Affordable Care Act. More than 20 million people were enrolled through Medicaid expansion as of June 2024 — those are the patients who will face work requirements.

Reapplying for Medicaid, which typically has been required once a year, already is burdensome for some patients, said Dr. Bobby Mukkamala, president of the American Medical Association.

“On top of that, now we’re going to be challenging so many people who were at least able to deal with it financially with things like … proving that they got a job,” Mukkamala said in an interview.

Previous attempts at implementing work requirements have ended up costing states millions in administrative and consulting fees. And in some cases, people who were eligible for Medicaid lost their coverage due to paperwork issues.

Arkansas’ example

Several states wanted to implement work requirements during the first Trump administration. But only Arkansas fully did so, in 2018, before a federal judge halted the requirements. More than 18,000 Arkansas residents lost Medicaid coverage during the 10 months the requirements were in effect.

Sommers, of Harvard, noted that most people were disenrolled because they didn’t know about the policy or made paperwork errors, not because they weren’t working.

“Red tape led to people losing their coverage,” he said. “They had more trouble affording their medications. They were putting off needed care.”

Brian Blase, president of the Paragon Health Institute, a conservative policy group that advises congressional Republicans, said he thinks concerns about the new requirements are overblown because there’s more advanced technology now.

“Lots of government programs have initial implementation challenges,” Blase told Stateline. “Arkansas was seven years ago, and if you just think about the change in the technological advancements over the past seven years … we didn’t have artificial intelligence and just the ability of modern tech.”

As it stands, each state has varying technological capabilities, and will have a different timeline and budget, said Michael Heifetz, a managing director at consulting firm Alvarez & Marsal and a former Medicaid director in Wisconsin. His team contracts with states to implement Medicaid, including work requirements, and other programs.

He also noted that the Trump administration can give states a deadline extension on implementing work requirements to Dec. 31, 2028, if they show they are making a “good faith effort.” States will need to share data across agencies in new ways, he said.

“It will require some form of data sharing and communications with educational agencies, workforce training agencies and some other agencies that typically aren’t in the Medicaid ecosystem,” Heifetz said.

State governments may resist hiring full-time positions for those tasks, he said, but “artificial intelligence and other tools can help work through these processes in a smoother fashion.”

Other state efforts

Efforts in other states to implement work requirements have had mixed results.

In Georgia, for example, an experimental work requirement program cost taxpayers more than $86 million in its first 18 months but enrolled just 6,500 people during that time, according to an investigation by ProPublica and The Current published in February. That’s 75% fewer participants than the state had estimated for the program’s first year.

The nonpartisan U.S. Government Accountability Office in 2019 looked at five states that tested systems to track Medicaid work requirements under the first Trump administration. Those demonstration projects were rescinded during the Biden administration.

The states estimated their projected administrative costs for implementing work requirements for one to three years, and the total far surpassed the $200 million Congress has provided in the new law. Kentucky alone estimated $270 million, Wisconsin $70 million, Indiana $35 million, Arkansas $26 million and New Hampshire $6 million.

Susan Barnidge, an assistant director on the GAO health care team and an author of the report, said the agency found that across states there wasn’t much federal oversight of administrative costs on test programs. Oversight will be key as states roll out their work requirement systems, she said.

“We found some weaknesses in [federal] Centers for Medicare & Medicaid oversight of certain federal funding for certain administrative activities. So we found examples of things that states sought federal funding for that didn’t appear to be allowable,” Barnidge said in an interview. “I think that will remain relevant.”

Mukkamala, of the American Medical Association, said the burden will in some ways fall to doctors’ offices to help keep patients enrolled, as they work with patients to check eligibility and possibly help get them on Medicaid. He works in Flint, Michigan, as an otolaryngologist, or ear, nose and throat doctor, and said a third of his patients are on Medicaid.

“As if it’s easy to take care of their health care issue, given things like prior authorization,” Mukkamala told Stateline. “Now to add to the challenge, we have to figure out how to get them covered.”

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

©2025 States Newsroom. Visit at stateline.org. Distributed by Tribune Content Agency, LLC.

By Roberta Burkhart, Pittsburgh Post-Gazette

Many people don’t know it, but men under age 40 are the most likely age group to develop testicular cancer.

Just ask Jay Riepenhoff of Upper Arlington, Ohio, who was 29 and still adjusting to life as a new father when he discovered a suspicious lump.

He wasn’t thinking cancer. In fact, Riepenhoff got up for work the next morning and forgot all about it.

He felt the lump again that night, and thought he’d maybe set an alarm to remind himself to call the doctor the next day.

Riepenhoff didn’t feel the first twinge of worry until his doctor told him to come in immediately. And then sent him the same day for an ultrasound.

“Still, I even thought in my head, ‘I’ll go check it out. It’s not like it’s cancer,’” he said.

Soon, Riepenhoff discovered what many don’t realize: Of the approximately 10,000 cases of testicular cancer diagnosed annually, 51% are diagnosed in young men between the ages of 20 to 34, according to the National Cancer Institute, part of the NIH.

Yet a recent survey from The Ohio State University Comprehensive Cancer Center shows that few Americans — just 13% — associate the disease with young men.

“When you’re young, in your 20s or your 30s, you certainly do think your health is just something you might take for granted,” said Shawn Dason, a urologic oncologist at OSU’s cancer center and an associate clinical professor of urology at The Ohio State College of Medicine. “You’re more focused on other parts of life: your career, your family, your education.”

While 6% of testicular cancer cases are diagnosed in children and teens and another 8% affect those older than age 55, the vast majority of cases affect men aged 20 to 50. The average age of diagnosis is 33, according to the American Cancer Society.

It is the most common form of cancer among men 20 to 40 and the second most common cancer (trailing leukemia) in ages 15 to 19, but it can happen at any time, according to John Hopkins Medicine.

The Ohio State survey questioned 1,008 respondents about their knowledge of testicular cancer and found general awareness lacking in many areas.

While most — 63% — knew that testicular cancer is often curable if caught early, just over half correctly said that self-checks should be conducted every month. Additionally, two-thirds of respondents thought that medical evaluations should be conducted during annual exams after age 40.

But waiting until 40 would miss the men most at risk — young men like Riepenhoff.

Self-exams are most relevant between the ages of 20 and 40 and are especially important for anyone with a family history of testicular cancer or who has had an undescended testicle at any time during their life, Dason said.

A painless lump is the most common first sign that testicular cancer may be present, Dason said. Often, that lump will continue to grow and possibly harden.

Few men report that pain is associated with lumps, he said, adding that many incorrectly assume that the absence of pain means the lumps are harmless.

If the cancer has spread — becoming metastatic — other symptoms could develop, like abdominal and back pain, or a cough and shortness of breath if it has spread to the lungs.

Still, testicular cancer is among the rarer cancers compared to, for instance, prostate cancer, the second most common cancer in men after skin cancer. There are approximately 313,000 new cases of prostate cancer diagnosed annually and nearly 36,000 deaths from it every year, according to the American Cancer Society.

While not as prevalent as other cancers, testicular cancer is a fast-growing one, Dason said, and one that will spread to other parts of the body if left untreated.

The majority of testicular cancer cases are curable, however, especially when they’re caught early.

“Now that might beg the question, ‘Well, if it’s mostly curable, what would be the harm in just finding it later?’ And the harm is really that he might need more treatment to ultimately cure it. And these treatments, they can be pretty serious.”

When testicular cancer metastasizes, it often requires a far more invasive surgery — one with a longer, more challenging recovery, Dason said.

Chemotherapy, too, is generally necessary when the cancer spreads. It is a life-saving measure and “a critical instrument in achieving a cure in many patients,” but it can have a variety of both short- and long-term side effects, many of them unpleasant.

“We really do have evidence that some men will pass away from testicular cancer. And so could those men, if they had presented earlier, have been saved? Very, very possibly,” Dason said.

In Riepenhoff’s case, testing following his radical orchiectomy — the surgery to remove his cancerous testicle — revealed that the cancer had begun to spread, and he underwent three weeks of chemotherapy. All of his treatment took place at the OSU cancer center, although he was not treated by Dason.

Fertility especially becomes a concern when chemotherapy is necessary, Dason said.

Riepenhoff and his wife, Rana, had welcomed their first child, John Patrick Riepenhoff V, just five months before he discovered the cancerous lump. They had long hoped for three children, so before surgery, Riepenhoff chose to freeze sperm in case treatment affected his ability to have more children.

His fertility was not affected, and they expect to welcome their second son in August.

While testicular cancer is highly curable — the 5-year survival rate is 95%, per the National Cancer Institute — dismissing the early symptoms such as a newly discovered lump can make it much more challenging to treat.

Dason pointed out that younger men — and, often, men in general — have acquired a reputation for putting off medical care until absolutely necessary.

In his experience as a physician, Dason said, younger men tend to eschew annual physicals. “When you’re in your 20s and your 30s, there aren’t a lot of chronic health conditions that these young men have, and a lot of them are not regularly visiting their primary care provider.”

Plenty of patients put off seeking care “because they were embarrassed about it, or they were busy or they were hoping it would go away.” Often, a partner is the one who insists they finally see a doctor, he said.

“It’s normal to have a male sexual health complaint. It’s normal to feel something abnormal and go get it checked out. And that’s what our medical practitioners are there for: to help out with all of these concerns, not just a flu or an ankle injury.”

And like Riepenhoff once did, many young men see cancer as a far-off threat. And it’s just not discussed much, Riepenhoff said.

Riepenhoff pointed out that breast cancer awareness is everywhere. “You hear it from parents, schools and physicians,” he said. “But with testicular cancer, I don’t really recall. I’m sure in school we talked about it one time or something, but I don’t ever recall that being hammered into your brain the way that breast cancer is.”

He understands well the reasons men might wait to reach out to a physician.

“I’m sure there are a lot of men out there that got testicular cancer that waited to go to the doctor because they just thought it was an abscess or something. Nothing to be worried about. Had they known that this could be testicular cancer, they may have gone to the doctor earlier, and that can change your diagnosis pretty dramatically.”

Riepenhoff said he asked his doctor what would have happened if he had waited to come in or if he skipped the chemotherapy.

“He said within a year or two, I would have been dead.”

© 2025 the Pittsburgh Post-Gazette. Visit www.post-gazette.com. Distributed by Tribune Content Agency, LLC.

By Bernadette Joy, Bankrate.com

“Renting is throwing money away.” Has anyone ever told you this? Well, I’m here to say: It’s bad financial advice.

My husband and I have owned four different homes in three cities since 2010. If I wanted to, I could buy a house in cash today. But for the last three years, I’ve chosen to rent instead — and my net worth has grown by leaps and bounds because of that choice, not in spite of it.

This is always a hot topic, especially because renting challenges the traditional rhetoric that homeownership is the ultimate path to wealth. And I get it — owning a home is part of the “American Dream.” But if it doesn’t lead to financial freedom, homeownership may be more like a nightmare.

Let me show you how renting, when done intentionally, can actually make you richer.

Renting avoids the hidden costs of homeownership

When you own a home, you’re not just paying the mortgage — you’re also responsible for home maintenance, property taxes and insurance. In fact, Bankrate’s 2025 Hidden Costs of Homeownership Study found that the average annual cost of owning and maintaining a single-family home is more than $21,000.

Now, you’ll incur some of these costs when renting, too. Unless your rental unit includes utilities and internet, you’re probably going to have to pay out of pocket. You’ll probably pay less in electricity than you would in a large, single-family home, but for the sake of argument, let’s take these average costs at face value.

Omitting the expenses you’ll still have when renting, homeownership costs an average of $15,391 — that’s almost $1,300 you could free up each month.

While there aren’t any states that require renters insurance, most landlords have a provision in their rental contracts requiring this form of coverage. While typically less expensive than homeowners insurance, renters insurance is another cost to factor into your calculations.

And don’t forget about mortgage interest

My clients are always shocked when I have them review the amortization table for their 30-year mortgage. In the early years of your mortgage, a large percentage of your monthly payment goes toward interest. You’re not really building equity in the first few years of a mortgage — you’re mostly paying interest.

Let’s say you borrowed a $420,000 mortgage. You qualified for a 6.75 percent mortgage rate on a 30-year term. Your monthly payment is $2,724.

Of your first mortgage payment, only $362 pays down the principal balance — a whopping $2,363 goes toward interest. The balance does shift over time, and by the end of your 30-year term, the bulk of your payment goes toward the principal. But how likely is it that you’ll see the mortgage through to the bitter end, without selling or refinancing (and starting the clock all over again)?

I’ve helped five clients make the decision to sell their homes in 2025, and none of them lived there longer than a decade. So much of their money has gone to interest, and they won’t get much equity in return.

After five years of dutifully paying $2,724 every month, you’ve only gained about $25,000 in home equity. Meanwhile, your mortgage servicer will have made nearly $138,000 from your loan interest. Your five years’ worth of mortgage payments cost you $163,440, and in return, you got $25,000 in equity. Hardly seems worth it.

Rather than paying $15,000 per year in homeownership costs and vast sums of mortgage interest, I pay my rent. Sure, I won’t get a return on that money, but more cash stays in my pocket — cash I can put toward investments. Use a mortgage calculator to take a look at your amortization table and crunch the numbers for yourself.

Renting frees up capital for wealth-building

“Real estate always appreciates in value.” This one’s a myth — just ask anyone who sold a home during the 2008 financial crisis. My husband and I paid $10,000 out of pocket to sell his home at the time.

Yes, real estate can appreciate, but it’s also highly market- and location-dependent. In the past three years, the investments I’ve made in the stock market and my financial education business have significantly outpaced the return I would’ve made on a home in my local market — and with much less headache.

Unfortunately, several of my clients bought their homes at the height of the pandemic boom and are now seeing their home values decline from their peaks.

In today’s economy, renting is increasingly the more affordable option.

According to those numbers, you could save more than $9,000 per year by renting. That money could go a long way for many Americans, and even further if you reallocate that money into wealth-building assets.

After selling my home and returning to renting, I took the proceeds of the sale and invested in growing my business — that cash injection allowed me to surpass my first $1 million in revenue. In the time since, my husband and I have also contributed the maximum amount to our 401(k)s and individual retirement accounts (IRAs), allowing us to pursue early retirement.

When I transitioned from homeownership to renting, I used the proceeds from my home sale and invested in low-risk, interest-bearing accounts, like high-yield savings accounts, money market accounts and certificates of deposit (CDs). This passive income has covered my rent and other living expenses.

I have more money working for me as a renter than I did as a homeowner.

Renting can offer new social networks and income opportunities

Some of my older coaching clients tend to wrongly believe that renting equates to a decrease in quality of life. I’ve been happy to dispel that myth when they comment on the dance, improv and travel that my renting lifestyle accommodates.

I live in a one-bedroom rental in a walkable neighborhood filled with restaurants, music, theater and fitness. Post-COVID apartment buildings often feature co-working spaces, gyms and even social events that allow me to meet people from all walks of life. I felt a lot more isolated in the suburb where I used to live, which was more homogeneous, less active, and farther away from cultural events.

I’ve also been able to find more side hustles than when I lived on the outskirts, like teaching financial literacy classes or dog walking and babysitting for neighbors in my building.

The combination of downsizing and renting has also allowed me to pick up and move quickly to capitalize on potential business or job opportunities in other cities. I can afford global travel with business partners using the money I previously spent on lawn care and home DIY projects. I’ve expanded my social and professional networks and spend more time doing things that bring me joy.

Why renting can be strategic

According to Bankrate’s 2025 Emergency Savings Report, fewer than half of U.S. adults have enough emergency savings to cover three months of expenses, and about a quarter have no emergency savings at all. When you don’t have money set aside for a rainy day, it’s especially important to have tight control over your monthly spending — predictable monthly payments are key.

A fixed-rate mortgage may seem stable, but property taxes can always go up. Insurance premiums can rise, and maintenance is always more expensive than you think. Avoiding surprise repairs to water heaters, HVAC systems or roofing can also decrease the anxiety of not having enough cash savings on hand, especially when those repairs cost thousands of dollars.

Your next steps

• What expenses will actually help me build the life I want?
• Do I want a house in the suburbs because I believe it’s what’s expected of me?
• Could my money be better spent elsewhere?
• If I already own a home, have I considered the real-world costs associated with my mortgage, maintenance and other housing costs?
• How do my homeownership costs compare to rentals in my area?

Final thoughts: Owning a home can be great — if it fits your financial plan

As a first-generation American, I felt the weight of my family’s expectation to live out the American Dream — after all, they emigrated here so I could realize it. But I’m living proof that renting isn’t a step back, nor should you feel any shame for choosing to rent.

It’s been a strategic move that’s made me richer — financially, mentally, and emotionally.

Think of rent the same way you think of a gym membership or software subscription — it’s a monthly cost that may support the lifestyle you want. It’s not “throwing money away.” It’s buying peace of mind, freedom of movement and time to grow wealth in other ways.

For me, real wealth isn’t found in square footage. It’s in the daily opportunity to move and live freely according to what aligns with my own version of the American Dream.

©2025 Bankrate.com. Distributed by Tribune Content Agency, LLC.

By Gretchen McKay, Pittsburgh Post-Gazette

June is a great time to fire up your grill and move at least some of your daily or weekly dinner duties to the backyard.

Cooking outdoors is usually cooler, tends to have a better view and is generally a lot more fun for both the cook and those he or she is trying to feed.

Chicken is often a prime choice when it comes to proteins to cook on gas or charcoal because it’s cheaper to feed a crowd with than beef or seafood. It’s also a lot more forgiving since it doesn’t require a lot of technique so long as you 1) cook over a moderate heat, 2) use an instant read thermometer to know when it’s done and 3) remember to let the grilled chicken rest for at least 5 minutes before slicing or serving so it can reabsorb some of its juices.

And if you take the time to soak it in a tasty marinade or stir together a homemade sweet-and-tangy barbecue sauce for basting, it will both elevate the flavor of the finished product and help keep the meat moist and tender.

While chicken breast is often a favorite choice because it’s leaner and has a milder, more subtle flavor, it’s also more expensive than other parts of the bird. Without a whole lot of fat to protect it from flames or heat as you grill it, it’s really easy to overcook and dry out.

That’s why I almost always opt for chicken thigh when I’m planning a cookout. It’s true that, as a fattier meat, dark-colored thigh packs more calories onto your plate than chicken breast. Still, it’s so much juicier and incredibly flavorful.

Grilled boneless, skinless chicken thigh builds the foundation for this summery budget meal for four. A scratch, ketchup-based barbecue sauce sweetened with brown sugar and spiced up with hot sauce and vinegar adds the perfect mix of tang and sugar, and because our recipe makes a lot of it, there’s plenty left over for dipping.

We serve it with a corn salad made with fresh kernels off the cob, salty feta and cherry tomatoes tossed in a simple four-ingredient dressing (if you don’t count the salt and pepper) that can be whisked together in seconds.

Rounding out the meal are roasted sweet potato chips and super-easy brown sugar blondies studded with butterscotch chips and chopped pecans and topped with gooey swirls of homemade strawberry jam.

It’s a feast fit if not for a king or queen (that’d require steak) at the very least a member of a royal family — especially since you’ll probably get some leftovers out of it.

Also impressive: It rings up 28 cents under our budget of $25.

I’m always surprised when a salad dish ends up costing more than dessert, but there’s no getting around the fact that fresh fruits and vegetables are becoming increasingly more expensive. All told, the corn salad added up to $6.55, or almost three times the price of the sweet potatoes ($2.25 for two) and more than half the total cost of the chicken, including the barbecue sauce.

Then again, I went with fresh ears of corn instead of canned or frozen and added not just a nice crumble of feta but also a generous handful of fat and juicy cherry tomatoes I couldn’t resist in the produce aisle.

Thanks in (small) part to the decreasing price of eggs and the fact that I almost always have homemade jam in my refrigerator, the blondies were quite economical, even with the addition of chips and pecans. Where else can you find a decadent, butterscotch-forward dessert for 42 cents a serving but from a home kitchen?

As always, I reached into my pantry and fridge for some of the ingredients most home cooks and/or bakers have on hand — olive oil, baking soda, vanilla, honey, vinegar and mustard — and I also did not calculate the cost of the basil in the salad because as someone who loves Italian cuisine, I am never without it.

Ditto with the red onion, a few of which are always in my refrigerator crisper, and various spices (though I did try to calculate the cost based on price per ounce).

Nothing on the menu takes more than 30 minutes to prepare, and if you get all your ducks in a row before you preheat the grill, you can make everything in one fell swoop.

As always, folks, remember to shop for ingredients at home before heading to the grocery store — it’s amazing how we forget what we already have on hand and then buy in duplicate, or let go to waste.

Corn-Tomato Salad

PG tested

Fresh corn is best for this recipe, but you also can use canned or frozen. I threw it into a hot skillet with a drizzle of olive oil and fried it while continuously shaking the pan until the kernels were charred, about 7 minutes.

The salad is equally delicious warm, at room temperature or chilled, if you want to make it ahead.

For salad

• 4 cups fresh or frozen corn, rinsed and drained if frozen, and steamed, boiled or grilled if fresh
• 1 cup cherry or grape tomatoes, halved or quartered
• 1/3 cup crumbled feta
• 1/4 red onion, finely chopped
• 1/4 cup fresh basil (about a handful), thinly sliced, optional

For dressing

• 3 tablespoons extra-virgin olive oil
• Juice of 1 lime
• 2 teaspoons honey
• 1 small clove garlic, minced
• Kosher salt and freshly ground black pepper

Toss corn, tomatoes, feta, onion and basil in a large bowl and set aside while you make dressing.

In a small jar or bowl, stir together olive oil, lime juice, honey and garlic. Season to taste with salt and pepper

Add dressing to the corn mixture and mix well to combine. Taste and add more salt or pepper, if needed.

Serves 4.

— Gretchen McKay, Post-Gazette

Grilled Barbecue Chicken

PG tested

Chicken thighs are not only cheaper than chicken breast, but they’re also juicier and have a richer flavor. The homemade barbecue sauce that goes on top is spicy-sweet — brush it on while you’re cooking and also serve on the side for dipping.

For chicken

• 2 pounds boneless, skinless chicken breast
• 1 tablespoon dry rub of choice

For barbecue sauce

• 1 cup ketchup
• 2 tablespoons brown sugar
• 1 tablespoon apple cider vinegar
• 1 tablespoon hot sauce
• 1 tablespoon Worcestershire sauce
• 1 tablespoon barbecue rub
• 1 tablespoon mustard
• 1/2 teaspoon each garlic and onion powder

Prepare barbecue sauce: In saucepan over medium-low heat, stir together ingredients until well combined. Simmer for 5-10 minutes and use immediately or transfer when cool to an airtight container and store in refrigerator for up to a month. (Makes about 1 cup.)

Preheat grill to medium-high heat (400 degrees) and lightly oil the grates. If using charcoal, set up the briquettes underneath the grill grate.

Place the chicken on the grill and cook for 3-4 minutes, until grill marks have formed and the chicken is nicely browned.

Flip the thighs over and let cook for 3 minutes. Brush on the side facing up lightly with barbecue sauce and cook an additional 3 minutes.

Flip the chicken again, and brush lightly with more barbecue sauce on this side. Cook for 2 minutes.

Flip one last time, and brush again with barbecue sauce.

Continue to cook until the internal temperature reaches 165 degrees (about 20 total minutes on the grill). Serve immediately, either whole or sliced.

Serves 4.

— Gretchen McKay, Post-Gazette

Roasted Sweet Potato Chips

PG tested

Sweet potatoes are more nutritious than regular potatoes, and they’re also so easy to cook. In this recipe, you just slice, sprinkle with spices and bake.

• 2 large sweet potatoes
• Olive oil, for coating
• Salt and paprika, for seasoning

Preheat the oven to 400 degrees.

Use a mandolin slicer or chefs knife to cut sweet potatoes into paper-thin rounds. Depending on how big your potatoes are, you may also want to then slice then into half-moons.

Pile sweet potato rounds into a large bowl and drizzle with olive oil. Using your hands, gently toss to coat every piece with oil. Lay the rounds out on the baking sheets in a single layer.

Sprinkle the chips lightly with salt and smoked paprika. Bake for 20-25 minutes, or until crisp and golden around the edges.

Serve immediately.

Serves 4.

— Gretchen McKay, Post-Gazette

Strawberry-Pecan Blondies

PG tested

I used strawberry jam and pecans for this recipe, but it’s easy to customize with your favorite flavors. Try almonds and blueberry jam or pistachios and raspberry jam. Perfect for a simple dessert — or breakfast.

• 4 tablespoons unsalted butter, plus more for pan
• 1 cup lightly packed brown sugar
• 1 1/2 teaspoons vanilla extract
• 1 large egg, slightly beaten
• 3/4 cup all-purpose flour
• 1/2 teaspoon salt
• 1/4 teaspoon baking powder
• 1/4 cup butterscotch chips
• 1/4 cup chopped pecans
• 3 tablespoons strawberry jam

Preheat oven to 350 degrees. Line an 8-inch square baking pan with foil, leaving an overhang on 2 sides. (I used parchment paper.) Butter the foil.

Combine butter and brown sugar in a large microwave-safe bowl. Microwave until the butter is melted, about 1 minute.

Stir in vanilla. Let cool slightly, then stir in the egg.

Whisk the flour, salt and baking powder in a bowl. Stir into the butter mixture.

Stir in butterscotch chips and pecans and spread the batter in the pan. Drop dollops of strawberry jam on top and swirl with a knife.

Bake the blondies until set, about 20-25 minutes. Transfer to a rack and let cool 15 minutes, then lift out of the pan using the foil. Transfer to rack to cool completely.

Discard the foil and cut into squares.

Makes 9 blondies.

— adapted from “Baking for Fun: 75 Great Cookies, Cakes, Pies & More” by Food Network Magazine

©2025 PG Publishing Co. Visit at post-gazette.com. Distributed by Tribune Content Agency, LLC.

By Brian Baker, CFA, Bankrate.com

Bitcoin mining is the process of creating new bitcoins by solving extremely complicated math problems that verify transactions in the currency. When a bitcoin is successfully mined, the miner receives a predetermined amount of Bitcoin.

Bitcoin is one of the most popular types of cryptocurrencies, which are digital mediums of exchange that exist solely online. Bitcoin runs on a decentralized computer network, or distributed ledger, that tracks transactions in the cryptocurrency. When computers on the network verify and process transactions, new bitcoins are created, or mined. These networked computers, or miners, process the transaction in exchange for a payment in Bitcoin.

As the prices of cryptocurrencies and Bitcoin in particular have skyrocketed in recent years, it’s understandable that interest in mining has picked up as well. A miner currently earns 3.125 Bitcoin (about $334,375 as of mid-June 2025) for successfully validating a new block on the Bitcoin blockchain. But for most people, the prospects for Bitcoin mining are not good due to its complex nature and high costs.

Here are the basics of how Bitcoin mining works and some key risks to be aware of.

How Bitcoin mining works

Bitcoin is powered by blockchain, which is the technology behind many cryptocurrencies. A blockchain is a decentralized ledger of all the transactions across a network. Groups of approved transactions together form a block and are joined by computers within the network (called miners) to create a chain. Think of it as a long public record that functions almost like a long-running receipt. Bitcoin mining is the process of adding a block to the chain.

Bitcoin miners pick transactions from a group of unconfirmed transactions, called a mempool, to form a block on the blockchain. Before they can add the block securely to the blockchain, miners must solve what’s called a proof-of-work puzzle by guessing a number (also called a nonce). This number is combined with the block’s data and processed through a function called SHA-256.

The ultimate goal: create a block hash, which is a code with enough leading zeros to be less than, or equal to, the network’s target hash. The target hash is what determines how difficult the puzzle is to solve.

Target hash example: 0000000000000000ffff00000000000000000000000000000000000000000000

Block hash example: 0000000000000000057e29f1b57c1a9d5b90a6b7f1b4f0c9e2b0a1d3e4f5c6d7

Remember the block hash must be less than or equal to the target hash. Think of it like a dice game where the only way to win is if you roll a number smaller than or equal to a some number you’re given at the beginning. That number is made mostly of zeros, so you’d need a really insane and rare roll — a hash with tons of zeros in front of it — to win. In this example, the target hash’s “ffff” represents numbers that are non-zero and the block hash is less than the target hash, therefore solving the puzzle.

If you’re wondering whether this process requires a ton of computational power, you’re right. Miners use extremely powerful computers, called ASICs, to make billions — or trillions — of guesses about which nonces could work. One computer can cost up to $10,000. ASICs also consume huge amounts of electricity, which has drawn criticism from environmental groups and limits the profitability of miners. Technically, though, you could mine Bitcoin with, say, a MacBook Pro, but unfortunately you won’t get very far because there’s not enough computing power.

If a miner is able to successfully add a block to the blockchain, they will receive 3.125 bitcoins. The reward amount is cut in half roughly every four years, or every 210,000 blocks. As of mid-June 2025, Bitcoin traded at around $107,000, making 3.125 bitcoins worth $334,375.

Risks of Bitcoin mining

• Regulation: Very few governments have embraced cryptocurrencies such as Bitcoin, and many are more likely to view them skeptically because the currencies operate outside government control. There is always the risk that governments could outlaw the mining of Bitcoin or cryptocurrencies altogether as China did in 2021, citing financial risks and increased speculative trading.
• Price volatility: Bitcoin’s price has fluctuated widely since it was introduced in 2009. Since just January 2023, Bitcoin has at times traded for less than $18,000 and more than $110,000 recently. This kind of volatility makes it difficult for miners to know if their reward will outweigh the high costs of mining.

How to start Bitcoin mining

Here are the basic components you’ll need to start mining Bitcoin.

This is where any Bitcoin you earn as a result of your mining efforts will be stored. A wallet is an encrypted online account that allows you to store, transfer and accept Bitcoin or other cryptocurrencies. Companies such as Coinbase, Trezor and Exodus all offer wallet options for cryptocurrency.

There are a number of different providers of mining software, many of which are free to download and can run on Windows and Mac computers. Once the software is connected to the necessary hardware, you’ll be able to mine Bitcoin.

The most cost-prohibitive aspect of Bitcoin mining involves the hardware. You’ll need a powerful computer that uses an enormous amount of electricity in order to successfully mine Bitcoin. It’s not uncommon for the hardware costs to run around $10,000 or more.

Bitcoin mining statistics

• Creating Bitcoin consumes 184.4 terawatt-hours of electricity each year, more than is used by Poland or Egypt, according to the Cambridge Bitcoin Electricity Consumption Index.
• The price of Bitcoin has been extremely volatile over time. In 2020, it traded as low as $4,107 and reached an all-time high of $111,970 in May 2025. As of mid-June, it traded around $107,000.
• The United States (37.8%), Mainland China (21.1%) and Kazakhstan (13.2%) were the largest bitcoin miners as of December 2021, according to the Cambridge Electricity Consumption Index.

Taxes on Bitcoin mining

It’s important to remember the impact that taxes can have on Bitcoin mining. The IRS has been looking to crack down on owners and traders of cryptocurrencies as the asset prices have ballooned in recent years. Here are the key tax considerations to keep in mind for Bitcoin mining.

• Are you a business? If Bitcoin mining is your business, you may be able to deduct expenses you incur for tax purposes. Revenue would be the value of the bitcoins you earn. But if mining is a hobby for you, it’s not likely you’ll be able to deduct expenses.
• Mined bitcoin is income. If you’re successfully able to mine Bitcoin or other cryptocurrencies, the fair market value of the currencies at the time of receipt will be taxed at ordinary income rates.
• Capital gains. If you sell bitcoins at a price above where you received them, that qualifies as a capital gain, which would be taxed the same way it would for traditional assets such as stocks or bonds.

Check out Bankrate’s cryptocurrency tax guide to learn about basic tax rules for Bitcoin, Ethereum and more.

Is Bitcoin mining profitable?

It depends. Even if Bitcoin miners are successful, it’s not clear that their efforts will end up being profitable due to the high upfront costs of equipment and the ongoing electricity costs.

Worldwide, bitcoin mining uses more electricity than Poland, a nation of 36.7 million people, according to the University of Cambridge’s Bitcoin Electricity Consumption Index.

As the difficulty and complexity of Bitcoin mining has increased, the computing power required has also gone up. Bitcoin mining consumes about 184.4 terawatt-hours of electricity each year, more than most countries, according to the Cambridge index.

One way to share some of the high costs of mining is by joining a mining pool. Pools allow miners to share resources and add more capability, but shared resources mean shared rewards, so the potential payout is less when working through a pool. The volatility of Bitcoin’s price also makes it difficult to know exactly how much you’re working for.

Bottom line

While Bitcoin mining sounds appealing, the reality is that it’s difficult and expensive to actually do profitably. The extreme volatility of Bitcoin’s price adds more uncertainty to the equation.

Keep in mind that Bitcoin itself is a speculative asset with no intrinsic value, which means it won’t produce anything for its owner and isn’t pegged to something like gold. Your return is based on selling it to someone else for a higher price, and that price may not be high enough for you to turn a profit.

(Bankrate’s Logan Jacoby contributed to an update of this article.)

©2025 Bankrate.com. Distributed by Tribune Content Agency, LLC.

By Paula Span, KFF Health News

Kim Beckham, an insurance agent in Victoria, Texas, had seen friends suffer so badly from shingles that she wanted to receive the first approved shingles vaccine as soon as it became available, even if she had to pay for it out-of-pocket.

Her doctor and several pharmacies turned her down because she was below the recommended age at the time, which was 60. So, in 2016, she celebrated her 60th birthday at her local CVS.

“I was there when they opened,” Beckham recalled. After getting her Zostavax shot, she said, “I felt really relieved.” She has since received the newer, more effective shingles vaccine, as well as a pneumonia shot, an RSV vaccine to guard against respiratory syncytial virus, annual flu shots and all recommended COVID-19 vaccinations.

Some older people are really eager to be vaccinated.

Robin Wolaner, 71, a retired publisher in Sausalito, California, has been known to badger friends who delay getting recommended shots, sending them relevant medical studies. “I’m sort of hectoring,” she acknowledged.

Deana Hendrickson, 66, who provides daily care for three young grandsons in Los Angeles, sought an additional MMR shot, though she was vaccinated against measles, mumps, and rubella as a child, in case her immunity to measles had waned.

For older adults who express more confidence in vaccine safety than younger groups, the past few months have brought welcome research. Studies have found important benefits from a newer vaccine and enhanced versions of older ones, and one vaccine may confer a major bonus that nobody foresaw.

The new studies are coming at a fraught political moment. The nation’s health secretary, Robert F. Kennedy Jr., has long disparaged certain vaccines, calling them unsafe and saying that the government officials who regulate them are compromised and corrupt.

On June 9, Kennedy fired a panel of scientific advisers to the Centers for Disease Control and Prevention, and later replaced them with some who have been skeptical of vaccines. But so far, Kennedy has not tried to curb access to the shots for older Americans.

The evidence that vaccines are beneficial remains overwhelming.

The phrase “Vaccines are not just for kids anymore” has become a favorite for William Schaffner, an infectious diseases specialist at Vanderbilt University Medical Center.

“The population over 65, which often suffers the worst impact of respiratory viruses and others, now has the benefit of vaccines that can prevent much of that serious illness,” he said.

Take influenza, which annually sends from 140,000 to 710,000 people to hospitals, most of them seniors, and is fatal to 10% of hospitalized older adults.

For about 15 years, the CDC has approved several enhanced flu vaccines for people 65 and older. More effective than the standard formulation, they either contain higher levels of the antigen that builds protection against the virus or incorporate an adjuvant that creates a stronger immune response. Or they’re recombinant vaccines, developed through a different method, with higher antigen levels.

In a meta-analysis in the Journal of the American Geriatrics Society, “all the enhanced vaccine products were superior to the standard dose for preventing hospitalizations,” said Rebecca Morgan, a health research methodologist at Case Western Reserve University and an author of the study.

Compared with the standard flu shot, the enhanced vaccines reduced the risk of hospitalization from the flu in older adults, by at least 11% and up to 18%. The CDC advises adults 65 and older to receive the enhanced vaccines, as many already do.

More good news: Vaccines to prevent respiratory syncytial virus in people 60 and older are performing admirably.

RSV is the most common cause of hospitalization for infants, and it also poses significant risks to older people. “Season in and season out,” Schaffner said, “it produces outbreaks of serious respiratory illness that rivals influenza.”

Because the FDA first approved an RSV vaccine in 2023, the 2023-24 season provided “the first opportunity to see it in a real-world context,” said Pauline Terebuh, an epidemiologist at Case Western Reserve School of Medicine and an author of a recent study in the journal JAMA Network Open.

In analyzing electronic health records for almost 800,000 patients, the researchers found the vaccines to be 75% effective against acute infection, meaning illness that was serious enough to send a patient to a health care provider.

The vaccines were 75% effective in preventing emergency room or urgent care visits, and 75% effective against hospitalization, both among those ages 60 to 74 and those older.

Immunocompromised patients, despite having a somewhat lower level of protection from the vaccine, will also benefit from it, Terebuh said. As for adverse effects, the study found a very low risk for Guillain-Barré syndrome, a rare condition that causes muscle weakness and that typically follows an infection, in about 11 cases per 1 million doses of vaccine. That, she said, “shouldn’t dissuade people.”

The CDC now recommends RSV vaccination for people 75 and older, and for those 60 to 74 if they’re at higher risk of severe illness (from, say, heart disease).

As data from the 2024-25 season becomes available, researchers hope to determine whether the vaccine will remain a one-and-done, or whether immunity will require repeated vaccination.

People 65 and up express the greatest confidence in vaccine safety of any adult group, a KFF survey found in April. More than 80% said they were “very “or “somewhat confident” about MMR, shingles, pneumonia, and flu shots.

Although the COVID vaccine drew lower support among all adults, more than two-thirds of older adults expressed confidence in its safety.

Even skeptics might become excited about one possible benefit of the shingles vaccine: This spring, Stanford researchers reported that over seven years, vaccination against shingles reduced the risk of dementia by 20%, a finding that made headlines.

Biases often undermine observational studies that compare vaccinated with unvaccinated groups. “People who are healthier and more health-motivated are the ones who get vaccinated,” said Pascal Geldsetzer, an epidemiologist at the Knight Initiative for Brain Resilience at Stanford and lead author of the study.

“It’s hard to know whether this is cause and effect,” he said, “or whether they’re less likely to develop dementia anyway.”

So the Stanford team took advantage of a “natural experiment” when the first shingles vaccine, Zostavax, was introduced in Wales. Health officials set a strict age cutoff: People who turned 80 on or before Sept. 1, 2013, weren’t eligible for vaccination, but those even slightly younger were eligible.

In the sample of nearly 300,000 adults whose birthdays fell close to either side of that date, almost half of the eligible group received the vaccine, but virtually nobody in the older group did.

“Just as in a randomized trial, these comparison groups should be similar in every way,” Geldsetzer explained. A substantial reduction in dementia diagnoses in the vaccine-eligible group, with a much stronger protective effect in women, therefore constitutes “more powerful and convincing evidence,” he said.

The team also found reduced rates of dementia after shingles vaccines were introduced in Australia and other countries. “We keep seeing this in one dataset after another,” Geldsetzer said.

In the United States, where a more potent vaccine, Shingrix, became available in 2017 and supplanted Zostavax, Oxford investigators found an even stronger effect.

By matching almost 104,000 older Americans who received a first dose of the new vaccine (full immunization requires two) with a group that had received the earlier formulation, they found delayed onset of dementia in the Shingrix group.

How a shingles vaccine might reduce dementia remains unexplained. Scientists have suggested that viruses themselves may contribute to dementia, so suppressing them could protect the brain. Perhaps the vaccine revs up the immune system in general or affects inflammation.

“I don’t think anybody knows,” said Paul Harrison, a psychiatrist at Oxford and a senior author of the study. But, he added, “I’m now convinced there’s something real here.”

Shingrix, now recommended for adults over 50, is 90% effective in preventing shingles and the lingering nerve pain that can result. In 2021, however, only 41% of adults 60 and older had received one dose of either shingles vaccine.

A connection to dementia will require further research, and Geldsetzer is trying to raise philanthropic funding for a clinical trial.

And “if you needed another reason to get this vaccine,” Schaffner said, “here it is.”

©2025 KFF Health News. Distributed by Tribune Content Agency, LLC.

By Robbie Sequeira, Stateline.org

The Trump administration is pushing to reshape the federal housing safety net by slashing spending and shifting the burden of housing millions of people to states, which may be ill-equipped to handle the mission.

President Donald Trump’s recent budget request to Congress for fiscal year 2026, a preliminary plan released in early May and known as “skinny” because a more robust ask will follow, outlines a 44% cut to the U.S. Department of Housing and Urban Development, including a 43% reduction in rental assistance programs that support more than 9 million Americans.

Trump also wants to consolidate federal housing aid, which includes programs such as Housing Choice Vouchers and public housing, into block grants — or finite amounts of money that states would administer. The proposal also would cap eligibility for many aid recipients at two years, and significantly limit federal oversight over how states dole out housing aid to low-income, disabled and older renters.

The approach tracks suggestions outlined in the Heritage Foundation playbook known as Project 2025, in which first-term Trump advisers and other conservatives detailed how a second Trump term might look. The chapter on HUD recommends limiting a person’s time on federal assistance and “devolving many HUD functions to states and localities.”

To that end, Trump’s new housing aid budget request would put states in charge, urging them to create new systems and removing federal regulatory certainty that residents, landlords and developers rely on for low-income housing.

Trump’s request also proposes new rules, such as a two-year time limit on the receipt of Housing Choice Vouchers, formerly known as Section 8 vouchers, for households that do not include persons with disabilities or older adults. The vouchers, federal money paid directly to landlords, help eligible families afford rent in the private market.

Trump’s allies call the changes responsible, while detractors worry about rising homelessness among those who now receive aid.

Among the nearly 4.6 million households receiving HUD housing assistance in the 2020 census, the average household was made up of two people, and the average annual income was just under $18,000, according to a department report last year.

In testimony to Congress this month about the proposed fiscal 2026 budget, HUD Secretary Scott Turner said that HUD rental assistance is meant to be temporary, “the same way a treadway facilitates the crossing of an obstacle.”

“The block grant process will empower states to be more thoughtful and precise in their distribution and spending of taxpayer dollars,” Turner said.

The current budget reconciliation package, the tax-and-spending bill named the One Big Beautiful Bill Act, doesn’t address individual Housing Choice Vouchers or send federal housing aid back to states. However, it would offer tax credits to developers of affordable housing and expand areas that could qualify for additional favorable tax cuts. That bill passed the House and is now undergoing consideration in the Senate.

Trump’s hopes for next year

The president’s fiscal year 2026 budget request serves as an outline of the administration’s vision for next year’s federal spending.

Congress — specifically the House and Senate Appropriations committees — must draft, negotiate and pass appropriations bills, which ultimately decide how much funding programs like rental assistance will receive.

Trump’s budget request provides sparse details on how much housing aid the federal government would give to each state, and how it would oversee spending. Housing advocates and state agencies are concerned.

“A big piece of the proposal is essentially re-creating rental assistance as we know it, and turning it into a state rental assistance block grant program,” said Kim Johnson, senior director of policy director at the National Low Income Housing Coalition.

Experts say any resulting aid cuts would disproportionately affect families with children, older adults and individuals with disabilities, many of whom rely on rental subsidies and support to remain stably housed in high-rent markets.

“It would completely change how households might be able to receive rental assistance of any kind,” said Sonya Acosta, a senior policy analyst with the center. “It combines five of these programs that millions of people rely on, cuts the funding almost in half, and then leaves it completely to states to decide how to use that funding.”

That’s a shift most states can’t afford, say housing advocates.

A state-by-state analysis by the National Alliance to End Homelessness shows the highest rates of housing assistance are in the District of Columbia and Puerto Rico, along with a few blue states: Connecticut, Massachusetts, New York and Rhode Island.

“There’s no way to cut 43% of funding for rental assistance without people losing that assistance or their housing security,” said Johnson, of the National Low Income Housing Coalition.

And it’s not just urban centers that would be hit; rural areas of Mississippi and Louisiana also have high rates of federal housing aid.

“A rural community who solely relies on federal funding would be even more impacted,” Johnson added.

While state housing finance agencies proved during the pandemic that they can rapidly deploy federal funding, Lisa Bowman, director of marketing and communications at the National Council of State Housing Agencies, warned that the budget’s shift to block grants would require sufficient funding, a clear transition plan and strong oversight to ensure success.

Housing authorities are requesting further guidance from the feds and members of Congress, and more detail is needed on how any block-grant process would work, Bowman wrote in an emailed statement to Stateline.

“There is still a risk of overregulation and micromanagement with a block grant,” she wrote. “That said, for any type of new block grant to the states to work, there would need to be a transition period both to ensure states can build the necessary infrastructure and oversight and to test and train new systems with the private sector, local government, and nonprofit organizations that would interact with it.”

In New York City, which operates the nation’s largest housing voucher program, officials didn’t outline what steps they would take if Trump’s proposed cuts become reality, but a spokesperson said the plans would hurt residents.

Howard Husock, a senior fellow in domestic policy studies at the conservative-leaning American Enterprise Institute, believes the most innovative aspect of the Trump proposal is the introduction of time limits on housing assistance, a mechanism not currently used in HUD’s rental programs.

But he cautioned that a blanket two-year time limit — especially if applied to existing tenants — would be “a recipe for chaos,” particularly in high-need areas such as New York City. Instead, he supports a phased approach focusing on new, non-disabled, non-elderly tenants.

“Block grants would allow states to move away from one-size-fits-all and apply rules based on their own housing needs,” Husock said to Stateline in an interview.

Affordable housing advocates disagree.

“If passed, the president’s proposed budget would be devastating for all federally assisted tenants,” said Michael Horgan, press secretary for the New York City Housing Authority in a statement to Stateline. “Block grants, program funding cuts, and time limits will only worsen the current housing crisis.”

A recent analysis of 100 metro areas by the Center on Budget and Policy Priorities shows that households using housing vouchers are more likely to live in higher income areas than those with other federal rental assistance.

“There is a high share of these households using (other) federal rental assistance in higher-poverty areas,” Gartland, the center’s researcher, explained, noting that programs such as the Housing Choice Vouchers are a rare but essential tool for expanding housing mobility.

“If you’re cutting the programming by 40%, you’re just putting additional strain on that program and just limiting that potential.”

For housing providers, uncertainty is growing

For property owners and landlords, the proposed shift in federal assistance and housing aid to the states isn’t just a policy question, it’s a business risk.

Alexandra Alvarado, director of education at the American Apartment Owners Association, said many smaller landlords are closely following proposed changes to the voucher program.

“Section 8 is a stabilizing force, especially for mom-and-pop landlords,” she said. “Many have had loyal tenants for years and rely on that steady income.”

According to Alvarado, landlords — especially small operators — have come to view housing vouchers not just as a public good, but also as a reliable business model where rent is often on time and predictable.

But with the proposed changes placing administration in the hands of state governments, landlords fear a breakdown in consistency.

“If the administration is serious about shifting responsibility to states, landlords will need a lot more clarity, and fast,” Alvarado said. “These programs are supposed to offer certainty. If states run them inconsistently or inefficiently, landlords may exit the market altogether.”

The transition itself, she added, may be destabilizing.

“You’re turning an ecosystem upside down. Change too many parts of the system at once, and you risk unintended domino effects.”

While developers may benefit from new tax incentives in the budget, Alvarado said that doesn’t offset the instability small landlords fear.

“Most mom-and-pop landlords don’t want to evict or raise rent, especially during hard times,” she said. “They just want to provide stable housing and be treated fairly.”

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Stateline is part of States Newsroom, a national nonprofit news organization focused on state policy.

©2025 States Newsroom. Visit at stateline.org. Distributed by Tribune Content Agency, LLC.

By Nada Hassanein, Stateline.org

More American children and teens die from firearms than any other cause, but there are more deaths — and wider racial disparities — in states with more permissive gun policies, according to a new study.

The study, published in the medical journal JAMA Pediatrics on June 9, analyzes trends in state firearm policies and kids’ deaths since 2010, after the landmark U.S. Supreme Court decision in McDonald v. City of Chicago. The ruling struck down the city’s handgun ban, clearing the way for many states to make it easier for people to buy and carry guns.

The study authors split states into three groups: “most permissive,” “permissive” and “strict,” based on the stringency of their firearm policies. Those policies include safe storage laws, background checks and so-called Stand Your Ground laws. The researchers analyzed homicide and suicide rates and the children’s race.

Using statistical methods, the researchers calculated 6,029 excess deaths in the most permissive states between 2011 and 2023, compared with the number of deaths that would have been expected under the states’ pre-McDonald rules. There were 1,424 excess deaths in the states in the middle category.

In total, about 17,000 deaths were expected in the post-decision period, but 23,000 occurred, said lead author Dr. Jeremy Faust, an emergency physician at Brigham and Women’s Hospital in Boston, in an interview.

Among the eight states with the strictest laws, four — California, Maryland, New York and Rhode Island — saw statistically significant decreases in their pediatric firearm death rates. Illinois, which was directly affected by the court’s decision in the McDonald case, and Connecticut saw increases in their rates. In Massachusetts and New Jersey, the changes were not statistically significant.

The rate increased in all but four (Alaska, Arizona, Nebraska and South Dakota) of the 41 states in the two permissive categories. (Hawaii was not included in the study due its low rates of firearm deaths.)

Non-Hispanic Black children and teens saw the largest increase in firearm deaths in the 41 states with looser gun laws. Those youths’ mortality rates increased, but by a much smaller amount, in the states with strict laws.

Experts say the study underscores the power of policy to help prevent firearm deaths among children and teens. The analysis comes less than a month after the release of a federal report on children’s health that purported to highlight the drivers of poor health in America’s children but failed to include anything on firearm injuries — the leading cause of death for children and teens in 2020 and 2021, according to the federal Centers for Disease Control and Prevention.

Trauma surgeon Dr. Marie Crandall, chair of surgery at MetroHealth medical center and a professor at Case Western Reserve University School of Medicine in Cleveland, researches gun violence. She previously practiced at a Jacksonville, Florida, urban trauma unit, where she frequently saw children and teens caught in gun violence.

“When I see children come in with 10 holes in them that I can’t save — that is a loss. That is a completely preventable death, and it is deeply emotionally scarring to have to have those conversations with families when we know, as a society, there are things we could do to de-escalate,” said Crandall, who wasn’t involved in the new study.

In her state of Ohio, firearm death rates among children and teens increased from 1.6 per 100,000 kids in the decade before the McDonald decision to 2.8 after it, according to the study. Ohio was categorized in the group with the most permissive laws.

The study adds to previous research that shows state laws around child access to firearms, such as safe storage and background checks, tend to be associated with fewer child firearm deaths.

“We know that child access prevention decreases unintentional injuries and suicides of children. So having your firearms locked, unloaded, stored separately from ammunition, decreases the likelihood of childhood injuries,” Crandall said. “More stringent regulation of those things also decreases childhood injuries.”

But she said it’s hard to be optimistic about more stringent regulation when the current administration dismisses gun violence as a public health emergency. The Trump administration earlier this year took down an advisory from the former U.S. surgeon general, issued last year, that emphasized gun violence as a public health crisis.

Faust, the lead author of the new study, stressed that firearm injuries and deaths were notably missing from the Make America Healthy Again Commission report on children’s health. He said the failure to include them illustrates the politicization of a major public health emergency for America’s kids.

“It’s hard to take them seriously if they’re omitting the leading cause of death,” Faust said. “They’re whiffing, they’re shanking. They’re deciding on a political basis not to do it. I would say by omitting it, they’re politicizing it.”

Faust and pediatric trauma surgeon Dr. Chethan Sathya, who directs the Center for Gun Violence Prevention at the Northwell Health system in New York, each pointed to the development of car seat laws and public health education, as examples of preventive strategies that helped reduce childhood fatalities. They support a similar approach to curbing youth gun deaths.

“We really have to apply a public health framework to this issue, not a political one, and we’ve done that with other issues in the past,” said Sathya, who wasn’t involved in the study and oversees his hospital’s firearm injury prevention programs. “There’s no question that this is a public health issue.”

In Louisiana, which the study categorized as one of the 30 most permissive states, the child firearm mortality rate increased from 4.1 per 100,000 kids in the pre-McDonald period to 5.7 after it — the nation’s highest rate. The study period only goes to 2023, but the state last year enacted a permitless carry law, allowing people to carry guns in public without undergoing background checks. And just last month, Louisiana legislators defeated a bill that would have created the crime of improper firearm storage.

Louisiana Democratic state Rep. Matthew Willard, who sponsored the safe storage legislation, said during the floor debate that its purpose was to protect children. Louisiana had the highest rate of unintentional shootings by children between 2015 to 2022, according to the research arm of Everytown for Gun Safety, which advocates for stricter gun access. Willard cited that statistic on the floor.

But Republican opponents said Willard’s proposal would infringe on residents’ gun rights and make it more difficult for them to use guns in self-defense.

“Nobody needs to come in our houses and tell us what to do with our guns. I think this is ridiculous,” Republican state Rep. R. Dewith Carrier said during the debate.

Another Republican opponent, state Rep. Troy Romero, said he was concerned that having a firearm locked away would make it harder for an adult to quickly access it.

“If it’s behind a locked drawer, how in the world are you going, at 2 or 3 in the morning, going to be able to protect your family if somebody intrudes or comes into your home?” Romero said.

Gun violence researcher Julia Fleckman, an assistant professor, and her team at Tulane University in New Orleans have started to collect data on the impact of the state’s permitless carry law.

“It places a disproportionate impact on really vulnerable people, really, our most vulnerable people,” Fleckman said, noting kids bear the brunt of legislators’ decisions. “They don’t have a lot of control over this or the decisions we’re making.”

In South Carolina, another one of the most permissive states, the mortality rate increased from 2.3 to 3.9 per 100,000 kids in the time before and after the McDonald decision. South Carolina Democratic state Rep. JA Moore, who lost his adult sister in the 2015 racist shooting that killed nine at a Charleston church, said state policy alone isn’t enough. He implored his colleagues to also examine their perception of guns.

“We have a culture here in South Carolina that doesn’t lend itself to a more safe South Carolina,” said Moore, who added he’s been advocating for background checks and stricter carry laws. “There is a need for a culture change in our state, in our country, when it comes to guns and our relationships with guns as Americans, realizing that these are deadly weapons.”

And investing in safer neighborhoods is crucial, he said.

“People are hurt by guns in places that they’re more comfortable, like their homes in their own neighborhoods,” he said.

Community-based interventions are important to stemming violence, experts said. Crandall, the Cleveland surgeon, said there’s emerging evidence that hospital-based and community-based violence prevention programs decrease the likelihood of violent and firearm-related injury.

Such programs aim to break cycles of violence by connecting injured patients with community engagement services. After New York City implemented its hospital-based violence interruption program, two-thirds of 3,500 violent trauma patients treated at five hospitals received community prevention services.

After her 33-year-old son was killed in her neighborhood in 2019, Michelle Bell started M-PAC Cleveland — “More Prayer, Activity & Conversation” — a nonprofit collaborative of people who have lost loved ones to violent crime. She’s encountered many grieving parents who lost their children to gunfire. The group advocates and educates for safe storage laws and holds peer grief support groups.

She also partners with the school district in a program that shares stories of gun violence’s long-lasting impact on surviving children, families and communities and nonviolent interpersonal conflict resolution.

“Oftentimes, the family that has lost the child, the child’s life has been taken by gun violence, there are other children in the home,” she said.

“It’s so devastating. It’s just so tragic that the No. 1 cause of death for children 18 and under is gun violence,” Bell continued.

The decision to “pull a trigger,” she said, changes a “lifetime of not only yours, but so many other people.”

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Stateline is part of States Newsroom, a national nonprofit news organization focused on state policy.

©2025 States Newsroom. Visit at stateline.org. Distributed by Tribune Content Agency, LLC.

By Anna Claire Vollers, Stateline.org

Nine months after Monroe County Hospital in rural South Alabama closed its labor and delivery department in October 2023, Grove Hill Memorial Hospital in neighboring Clarke County also stopped delivering babies.

Both hospitals are located in an agricultural swath of the state that’s home to most of its poorest counties. Many residents of the region don’t even have a nearby emergency department.

Stacey Gilchrist is a nurse and administrator who’s spent her 40-year career in Thomasville, a small town about 20 minutes north of Grove Hill. Thomasville’s hospital shut down entirely last September over financial difficulties. Thomasville Regional hadn’t had a labor and delivery unit for years, but women in labor still showed up at its ER when they knew they wouldn’t make it to the nearest delivering hospital.

“We had several close calls where people could not make it even to Grove Hill when they were delivering there,” Gilchrist told Stateline shortly after the Thomasville hospital closed. She recalled how Thomasville nurses worked to save the lives of a mother and baby who’d delivered early in their ER, as staff waited for neonatal specialists to arrive by ambulance from a distant delivering hospital.

“It would give you chills to see what all they had to do. They had to get inventive,” she said, but the mother and baby survived.

Now many families must drive more than an hour to reach the nearest birthing hospital.

Nationwide, most rural hospitals no longer offer obstetric services. Since the end of 2020, more than 100 rural hospitals have stopped delivering babies, according to a new report from the Center for Healthcare Quality & Payment Reform, a national policy center focused on solving health care issues through overhauling insurance payments. Fewer than 1,000 rural hospitals nationwide still have labor and delivery services.

Across the nation, two rural labor and delivery departments shut their doors every month on average, said Harold Miller, the center’s president and CEO.

“It’s the perfect storm,” Miller told Stateline. “The number of births are going down, everything is more expensive in rural areas, health insurance plans don’t cover the cost of births, and hospitals don’t have the resources to offset those losses because they’re losing money on other services, too.”

Staffing shortages, low Medicaid reimbursement payments and declining birth rates have contributed to the closures. Some states have responded by changing how Medicaid funds are spent, by allowing the opening of freestanding birth centers, or by encouraging urban-based obstetricians to open satellite clinics in rural areas.

Yet the losses continue. Thirty-six states have lost at least one rural labor and delivery unit since the end of 2020, according to the report. Sixteen have lost three or more. Indiana has lost 12, accounting for a third of its rural hospital labor and delivery units.

In rural counties the loss of hospital-based obstetric care is associated with increases in births in hospital emergency rooms, studies have found. The share of women without adequate prenatal care also increases in rural counties that lose hospital obstetric services.

And researchers have seen an increase in preterm births — when a baby is born three or more weeks early — following rural labor and delivery closures. Babies born too early have higher rates of death and disability.

Births are expensive

The decline in hospital-based maternity care has been decades in the making.

Traditionally, hospitals lose money on obstetrics. It costs more to maintain a labor and delivery department than a hospital gets paid by insurance to deliver a baby. This is especially true for rural hospitals, which see fewer births and therefore less revenue than urban areas.

“It is expensive and complicated for any hospital to have labor and delivery because it’s a 24/7 service,” said Miller.

A labor and delivery unit must always have certain staff available or on call, including a physician who can perform cesarean sections, nurses with obstetric training, and an anesthetist for C-sections and labor pain management.

“There’s a minimum fixed cost you incur (as a hospital) to have all of that, regardless of how many births there are,” Miller said.

In most cases, insurers don’t pay hospitals to maintain that standby capacity; they’re paid per birth. Hospitals cover their losses on obstetrics with revenue they get from more lucrative services.

For a larger urban hospital with thousands of births a year, the fixed costs might be manageable. For smaller rural hospitals, they’re much harder to justify. Some have had to jettison their obstetric services just to keep the doors open.

“You can’t subsidize a losing service when you don’t have profit coming in from other services,” Miller said.

And staffing is a persistent problem.

Harrison County Hospital in Corydon, Indiana, a small town on the border with Kentucky, ended its obstetric services in March after hospital leaders said they were unable to recruit an obstetric provider. It was the only delivering hospital in the county, averaging about 400 births a year.

And most providers don’t want to remain on call 24/7, a particular problem in rural regions that might have just one or two physicians trained in obstetrics. In many rural areas, family physicians with obstetrical training fill the role of both obstetricians and general practitioners.

Ripple effects

Even before Harrison County Hospital suspended its obstetrical services, some patients were already driving more than 30 minutes for care, the Indiana Capital Chronicle reported. The closure means the drive could be 50 minutes to reach a hospital with a labor and delivery department, or to see providers for prenatal visits.

Longer drive times can be risky, resulting in more scheduled inductions and C-sections because families are scared to risk going into labor naturally and then facing a harrowing hourlong drive to the hospital.

Having fewer labor and delivery units could further burden ambulance services already stretched thin in rural areas.

And hospitals often serve as a hub for other maternity-related services that help keep mothers and babies healthy.

“Other things we’ve seen in rural counties that have hospital-based OB care is that you’re more likely to have other supportive things, like maternal mental health support, postpartum groups, lactation support, access to doula care and midwifery services,” said Katy Kozhimannil, a professor at the University of Minnesota School of Public Health, whose research focuses in part on maternal health policy with a focus on rural communities.

State action

Medicaid, the state-federal public insurance for people with low incomes, pays for nearly half of all births in rural areas nationwide. And women who live in rural communities and small towns are more likely to be covered by Medicaid than women in metro areas.

Experts say one way to save rural labor and delivery in many places would be to bump up Medicaid payments.

As congressional Republicans debate President Donald Trump’s tax and spending plan, they’re considering which portions of Medicaid to slash to help pay for the bill’s tax cuts. Maternity services aren’t on the chopping block.

But if Congress reduces federal funding for some portions of Medicaid, states — and hospitals — will have to figure out how to offset that loss. The ripple effects could translate into less money for rural hospitals overall, meaning some may no longer be able to afford labor and delivery services.

“Cuts to Medicaid are going to be felt disproportionately in rural areas where Medicaid makes up a higher proportion of labor and delivery and for services in general,” Kozhimannil said. “It is a hugely important payer at rural hospitals, and for birth in particular.”

And though private insurers often pay more than Medicaid for birth services, Miller believes states shouldn’t let companies off the hook.

“The data shows that in many cases, commercial insurance plans operating in a state are not paying adequately for labor and delivery,” Miller said. “Hospitals will tell you it’s not just Medicaid; it’s also commercial insurance.”

He’d like to see state insurance regulators pressure private insurance to pay more. More than 40% of births in rural communities are covered by private insurance.

Yet there’s no one magic bullet that will fix every rural hospital’s bottom line, Miller said: “For every hospital I’ve talked to, it’s been a different set of circumstances.”

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©2025 States Newsroom. Visit at stateline.org. Distributed by Tribune Content Agency, LLC.

By Gretchen McKay, Pittsburgh Post-Gazette

Philadelphia is famous for its cheesesteak sandwiches.

Yet, if you’ve ever been to the city’s Reading Terminal Market on Arch Street in Center City (a favorite haunt when I was in paralegal school), you’ve probably also seen the long lines in front of Tommy DiNic’s. (If you know, you know.)

The star of this iconic sandwich counter, which has been drawing crowds since it opened in1977, is a succulent, slow-roasted Italian roast pork sandwich topped with sharp provolone and drippy, garlicky braised broccoli rabe (also known rapini). It’s a decidedly messy nosh as the ingredients can, and probably will, spill out as you eat it.

As tough as it is for a Pittsburgh girl to fall in love with something from Philly (my husband excluded), I have to admit it’s pretty incredible. I get the signature sandwich every time I’m in town, and never regret it.

This sub recipe (or should we say hoagie?) from America’s Test Kitchen is a riff on that storied sandwich served on a sesame-seeded Sarcone’s Bakery roll. Spicy Italian sausage stands in for the thinly sliced roasted pork that is a three-day process at DiNic’s. It also includes savory, tender slices of portobello mushrooms cooked with fennel, fresh rosemary and a touch of soy sauce. Shredded provolone goes right into the pan with the meat and veggies for a melty, we’re-all-friends finish.

Like DiNic’s, this recipe spotlights broccoli rabe. It’s a cruciferous green that looks like leafy broccoli, but as a member of the Brassicaceae family, is actually more closely related to the turnip. Its flavor is more bitter than broccoli, and the greens can also be fibrous, but the two veggies are interchangeable in this recipe. I used long, tender stalks of Broccolini instead of broccoli rabe, which I couldn’t find in my local grocery store.

Don’t skimp on the pickled red cherry hot peppers as a final flourish. They’re only mildly spicy, and you can’t beat that extra kick of flavor.

I used 6-inch (Mancini’s) sausage rolls instead of 8-inch sub rolls, so I had enough filling for five sandwiches. Be sure to toast the bread until it’s quite brown and crispy. Otherwise the filling could turn the sandwich into a (still delicious) soggy mess.

Wrapped in aluminum foil and reheated in a 350-degree oven for a few minutes, any leftovers make a great lunch the next day.

Philly-style Sausage and Broccoli Rabe Subs

PG tested

• 4 8-inch Italian sub rolls
• 3 tablespoons extra virgin oil, divided
• 3 garlic cloves, sliced thin
• 1 pound broccoli rabe, trimmed and cut into 1/2 -inch pieces
• 1/4 plus 1/8 teaspoon salt, divided
• 8 ounces hot Italian sausage
• 1 pound portobello mushroom caps, wiped clean, and sliced 1/4 -inch thick
• 1 teaspoon fennel seeds, cracked
• 1 teaspoon chopped fresh rosemary
• 1 teaspoon soy sauce
• 4 ounces shredded sharp provolone cheese
• 2 tablespoons chopped or slice jarred hot cherry peppers, optional

Adjust oven rack to middle position and preheat to 450 degrees.

If needed, slice rolls to make them easier to open (without slicing all the way through). Use spoon or your fingers to scraped inside of rolls and remove all but 1/4 i nch of interior crumb; discard removed crumb or use to make bread crumbs or croutons. Set aside while you prepare filling.

Heat 1 tablespoon oil and sliced garlic in a 12-inch nonstick skillet over medium heat until garlic is light golden brown, 3-5 minutes.

Add broccoli rabe and 1/4 teaspoon salt and cook, stirring occasionally, until tender, 4-6 minutes. Transfer to bowl and cover to keep warm.

Heat 1 teaspoon oil in now-empty skillet over medium-high heat until just smoking. Add sausage and cook, breaking up meat into small pieces with wooden spoon, until lightly browned, about 5 minutes. Transfer to a bowl.

Add 1 tablespoon oil to fat left in skillet and heat over medium-high heat until shimmering. Add mushrooms and remaining 1/2 teaspoon salt. Cover and cook, stirring occasionally, until mushrooms have released their liquid, 3-5 minutes.

Uncover and continue to cook, stirring occasionally, until mushrooms are well browned, 5-7 minutes. Reduce heat to low.

Clear center of skillet and add remaining 2 teaspoons oil, fennel seeds and rosemary. Stir in soy sauce and cooked sausage, then stir in cheese until melted. Remove from heat and cover to keep warm.

Arrange reserved rolls on baking sheet and bake until lightly toasted, about 3 minutes.

Divide mushroom and broccoli rabe mixture evenly among rolls. Top with cherry peppers, if using, and serve.

Serves 4.

— adapted from “Mostly Meatless” by America’s Test Kitchen

©2025 PG Publishing Co. Visit at post-gazette.com. Distributed by Tribune Content Agency, LLC.

By Barrett Dolata, The Detroit News

After a 20-year hiatus, the Detroit Zoo has brought back its Zoo Keys, sponsored by Fifth Third Bank. These rhinoceros and gorilla-shaped keys can be purchased for $4 and used at 11 different audio boxes located around the zoo to unlock poems about the nearest animal.

The poems are intended to foster both learning and a deeper appreciation for animals, which were written and recited by local youth from the zoo’s education and volunteer programs, including InsideOut Literary Arts and additional afterschool programs.

“They were able to come spend time at the zoo, observing the animals,” said Emily O’Hara, senior director of guest experience at Detroit Zoological Society. “And then work with our team on writing and working through the poetic process.”

O’Hara said with the newly developed audio boxes, the zoo is able to reprogram the messages and poems from each box as needed, offering both messages in English and Spanish. After purchasing a Zoo Key, guests can reuse the key at every box and with every visit.

When guests used their Zoo Keys back in the 1960s-’70s, and again in the early 2000s, the audio boxes were programmed with storybook animal tales — still as a way to engage zoo guests with the animals creatively. While the messages have switched to poetry, guests can use their old Zoo Keys from their early days to prompt the audio boxes.

“You can bring them back if you pull them out of a drawer or an old box that maybe a parent or grandparent or someone else in your life has,” O’Hara said.

The keys that date back to the ‘60s were red and shaped like an elephant, and adapted to a flat shape in the early 2000s. The iconic Zoo Keys were also used at other zoos like the San Francisco Zoo and Cleveland Metroparks Zoo, and are now selling on Ebay for upwards of $30-$50 or more.

“For anyone who grew up with Zoo Keys, we have heard for years guests asking, ‘Are they ever going to come back?’,” O’Hara said. “So we’re really excited to offer this up to guests who come to the Detroit Zoo to be able to come back and live some of that nostalgia.”

With the reintroduction of the Zoo Keys, the zoo also added a limited-time Dragon Forest trail for guests to explore and new penny press machines, featuring eight designs to collect this summer.

They also plan to add a few more audio boxes in the near future, and eventually expand even more down the line. Zoo Keys are available for purchase at the Detroit Zoo Shop, main gate ticket booths and other attractions.

bdolata@detroitnews.com

©2025 The Detroit News. Visit detroitnews.com. Distributed by Tribune Content Agency, LLC.

By Kate Wells, Michigan Public, KFF Health News

On the last day of patient care at the Planned Parenthood clinic in Marquette, Michigan, a port town on the shore of Lake Superior, dozens of people crowded into the parking lot and alley, holding pink homemade signs that read “Thank You!” and “Forever Grateful.”

“Oh my God,” physician assistant Anna Rink gasped, as she and three other Planned Parenthood employees finally walked outside. The crowd whooped and cheered. Then Rink addressed the gathering.

“Thank you for trusting us with your care,” Rink called out, her voice quavering. “And I’m not stopping here. I’m only going to make it better. I promise. I’m going to find a way.”

“We’re not done!” someone called out. “We’re not giving up!”

But Planned Parenthood of Michigan is giving up on four of its health centers in the state, citing financial challenges. That includes Marquette, the only clinic that provided abortion in the vast, sparsely populated Upper Peninsula. For the roughly 1,100 patients who visit the clinic each year for anything from cancer screenings to contraceptive implants, the next-closest Planned Parenthood will now be a nearly five-hour drive south.

It’s part of a growing trend: At least 17 clinics closed last year in states where abortion remains legal, and another 17 have closed in just the first five months of this year, according to data gathered by ineedana.com. That includes states that have become abortion destinations, like Illinois, and those where voters have enshrined broad reproductive rights into the state constitution, like Michigan.

Experts say the closures indicate that financial and operational challenges, rather than future legal bans, may be the biggest threats to abortion access in states whose laws still protect it.

“These states that we have touted as being really the best kind of versions of our vision for reproductive justice, they too struggle with problems,” said Erin Grant, a co-executive director of the Abortion Care Network, a national membership organization for independent clinics.

“It’s gotten more expensive to provide care, it’s gotten more dangerous to provide care, and it’s just gotten, frankly, harder to provide care, when you’re expected to be in the clinic and then on the statehouse steps, and also speaking to your representatives and trying to find somebody who will fix your roof or paint your walls who’s not going to insert their opinion about health care rights.”

But some abortion rights supporters question whether leaders are prioritizing patient care for the most vulnerable populations. Planned Parenthood of Michigan isn’t cutting executive pay, even as it reduces staff by 10% and shuts down brick-and-mortar clinics in areas already facing health care shortages.

“I wish I had been in the room so I could have fought for us, and I could have fought for our community,” said Viktoria Koskenoja, an emergency medicine physician in the Upper Peninsula, who previously worked for Planned Parenthood in Marquette. “I just have to hope that they did the math of trying to hurt as few people as possible, and that’s how they made their decision. And we just weren’t part of the group that was going to be saved.”

Why Now?

If a clinic could survive the fall of Roe v. Wade, “you would think that resilience could carry you forward,” said Brittany Fonteno, president and CEO of the National Abortion Federation.

But clinic operators say they face new financial strain, including rising costs, limited reimbursement rates, and growing demand for telehealth services. They’re also bracing for the Trump administration to again exclude them from Title X, the federal funding for low- and no-cost family planning services, as the previous Trump administration did in 2019.

PPMI says the cuts are painful but necessary for the organization’s long-term sustainability. The clinics being closed are “our smallest health centers,” said Sarah Wallett, PPMI’s chief medical operating officer. And while the thousands of patients those clinics served each year are important, she said, the clinics’ small size made them “the most difficult to operate.” The clinics being closed offered medication abortion, which is available in Michigan up until 11 weeks of pregnancy, but not procedural abortion.

Planned Parenthood of Illinois (a state that’s become a post-Roe v. Wade abortion destination) shuttered four clinics in March, pointing to a “financial shortfall.” Planned Parenthood of Greater New York is now selling its only Manhattan clinic, after closing four clinics last summer due to “compounding financial and political challenges.” And Planned Parenthood Association of Utah, where courts have blocked a near-total abortion ban and abortion is currently legal until 18 weeks of pregnancy, announced it closed two centers as of May 2.

Earlier this spring, the Trump administration began temporarily freezing funds to many clinics, including all Title X providers in California, Hawaii, Maine, Mississippi, Missouri, Montana, and Utah, according to a KFF analysis.

While the current Title X freeze doesn’t yet include Planned Parenthood of Michigan, PPMI’s chief advocacy officer, Ashlea Phenicie, said it would amount to a loss of about $5.4 million annually, or 16% of its budget.

But Planned Parenthood of Michigan didn’t close clinics the last time the Trump administration froze its Title X funding. Its leader said that’s because the funding was stopped for only about two years, from 2019 until 2021, when the Biden administration restored it. “Now we’re faced with a longer period of time that we will be forced out of Title X, as opposed to the first administration,” said PPMI president and CEO Paula Thornton Greear.

And at the same time, the rise of telehealth abortion has put “new pressures in the older-school brick-and-mortar facilities,” said Caitlin Myers, a Middlebury College economics professor who maps brick-and-mortar clinics across the U.S. that provide abortion.

Until a few years ago, doctors could prescribe abortion pills only in person. Those restrictions were lifted during the COVID-19 pandemic, but it was the Dobbs decision in 2022 that really “accelerated expansions in telehealth,” Myers said, “because it drew all this attention to models of providing abortion services.”

Suddenly, new online providers entered the field, advertising virtual consultations and pills shipped directly to your home. And plenty of patients who still have access to a brick-and-mortar clinic prefer that option. “Put more simply, it’s gotta change their business model,” she said.

Balancing Cost and Care

Historically, about 28% of PPMI’s patients receive Medicaid benefits, according to Phenicie. And, like many states, Michigan’s Medicaid program doesn’t cover abortion, leaving those patients to either pay out-of-pocket or rely on help from abortion funds, several of which have also been struggling financially.

“When patients can’t afford care, that means that they might not be showing up to clinics,” said Fonteno of the National Abortion Federation, which had to cut its monthly budget nearly in half last year, from covering up to 50% of an eligible patient’s costs to 30%. “So seeing a sort of decline in patient volume, and then associated revenue, is definitely something that we’ve seen.”

Meanwhile, more clinics and abortion funds say patients have delayed care because of those rising costs. According to a small November-December 2024 survey of providers and funds conducted by ineedana.com, “85% of clinics reported seeing an increase of clients delaying care due to lack of funding.” One abortion fund said the number of patients who had to delay care until their second trimester had “grown by over 60%.”

Even when non-abortion services like birth control and cervical cancer screenings are covered by insurance, clinics aren’t always reimbursed for the full cost, Thornton Greear said.

“The reality is that insurance reimbursement rates across the board are low,” she said. “It’s been that way for a while. When you start looking at the costs to run a health care organization, from supply costs, etc., when you layer on these funding impacts, it creates a chasm that’s impossible to fill.”

Yet, unlike some independent clinics that have had to close, Planned Parenthood’s national federation brings in hundreds of millions of dollars a year, the majority of which is spent on policy and legal efforts rather than state-level medical services. The organization and some of its state affiliates have also battled allegations of mismanagement, as well as complaints about staffing and patient care problems. Planned Parenthood of Michigan staffers in five clinics unionized last year, with some citing management problems and workplace and patient care conditions.

Asked whether Planned Parenthood’s national funding structure needs to change, PPMI CEO Thornton Greear said: “I think that it needs to be looked at, and what they’re able to do. And I know that that is actively happening.”

The Gaps That Telehealth Can’t Fill

When the Marquette clinic’s closure was announced, dozens of patients voiced their concerns in Google reviews, with several saying the clinic had “saved my life,” and describing how they’d been helped after an assault, or been able to get low-cost care when they couldn’t afford other options.

Planned Parenthood of Michigan responded to most comments with the same statement and pointed patients to telehealth in the clinic’s absence:

“Please know that closing health centers wasn’t a choice that was made lightly, but one forced upon us by the escalating attacks against sexual and reproductive health providers like Planned Parenthood. We are doing everything we can to protect as much access to care as possible. We know you’re sad and angry — we are, too.

“We know that telehealth cannot bridge every gap; however, the majority of the services PPMI provides will remain available via the Virtual Health Center and PP Direct, including medication abortion, birth control, HIV services, UTI treatment, emergency contraception, gender-affirming care, and yeast infection treatment. Learn more at ppmi.org/telehealth.”

PPMI’s virtual health center is already its most popular clinic, according to the organization, serving more than 10,000 patients a year. And PPMI plans to expand virtual appointments by 40%, including weekend and evening hours.

“For some rural communities, having access to telehealth has made significant changes in their health,” said Wallett, PPMI’s chief medical operating officer. “In telehealth, I can have an appointment in my car during lunch. I don’t have to take extra time off. I don’t have to drive there. I don’t have to find child care.”

Yet even as the number of clinics has dropped nationally, about 80% of clinician-provided abortions are still done by brick-and-mortar clinics, according to the most recent #WeCount report, which looked at 2024 data from April to June.

And Hannah Harriman, a Marquette County Health Department nurse who previously spent 12 years working for Planned Parenthood of Marquette, is skeptical of any suggestion that telehealth can replace a rural brick-and-mortar clinic. “I say that those people have never spent any time in the U.P.,” she said, referring to the Upper Peninsula.

Some areas are “dark zones” for cell coverage, she said. And some residents “have to drive to McDonald’s to use their Wi-Fi. There are places here that don’t even have internet coverage. I mean, you can’t get it.”

Telehealth has its advantages, said Koskenoja, the emergency medicine physician who previously worked for Planned Parenthood in Marquette, “but for a lot of health problems, it’s just not a safe or realistic way to take care of people.”

She recently had a patient in the emergency room who was having a complication from a gynecological surgery. “She needed to see a gynecologist, and I called the local OB office,” Koskenoja said. “They told me they have 30 or 40 new referrals a month,” and simply don’t have enough clinicians to see all those patients. “So adding in the burden of all the patients that were being seen at Planned Parenthood is going to be impossible.”

Koskenoja, Harriman, and other local health care providers have been strategizing privately to figure out what to do next to help people access everything from Pap smears to IUDs. The local health department can provide Title X family planning services 1½ days a week, but that won’t be enough, Harriman said. And there are a few private “providers in town that offer medication abortion to their patients only — very, very quietly,” she said. But that won’t help patients who don’t have good insurance or are stuck on waitlists.

“It’s going to be a patchwork of trying to fill in those gaps,” Koskenoja said. “But we lost a very functional system for delivering this care to patients. And now, we’re just having to make it up as we go.”

This article is from a partnership with Michigan Public and NPR .

©2025 KFF Health News. Distributed by Tribune Content Agency, LLC.

By Sheila Yasmin Marikar, Bloomberg News

At Nashik International Airport, there are so many posters advertising vineyards and wine tastings, you could be forgiven for thinking you’ve landed in California’s wine country rather than India’s west, 100 miles north of Mumbai.

Yet in the past two decades, Indian wine production has, in fact, become a thing, and Nashik is its epicenter. The greater wine industry is taking notice: Sula Vineyards, India’s leading winemaker, won the gold medal for cabernet sauvignon from the Global Wine Masters last May, the highest honor an Indian bottling has received at that annual competition. A viognier from Grover Zampa, which has vineyards in Nashik as well as Bangalore, in India’s south, was named best of show at January’s Wine & Spirits Wholesalers of America competition.

Beyond winning awards, Nashik is fueling a thirst for wine in a country where alcohol consumption is restrained and mostly limited to whiskey. Its recent successes are not only resonating with locals but also generating renewed interest in international travel to India and bringing a new audience to the region. Ten years after Chandon, part of the LVMH-owned Moët Hennessy portfolio, opened its first winery in Nashik, the brand’s president, Arnaud de Saignes, touts the region’s “potential to produce premium grape varieties” and calls India a “dynamic market,” “with a growing appreciation for high-quality wines.”

Why travelers should go

“The concept of wine in India doesn’t make sense, initially,” says Lisa Alam Shah, the director of Micato Safaris India, a luxury tour operator that’s arranged subcontinental adventures for the likes of Hillary Clinton and the Ambani family. Part of that, she says, is because India heavily taxes alcoholic beverages, which makes it difficult for residents to access quality wines and spirits made abroad.

But her clients are increasingly “looking for something new beyond the Taj Mahal and the palaces of Rajasthan.” So Shah has helped develop Micato’s new tour to Nashik, on offer since last year. “The word ‘authentic’ is overused, but that is what people want, whether they completely understand it or not,” she says. “Nashik, right now, feels quite authentic.”

The highway that leads from Mumbai to the vineyards is modern, but sections of it involve winding dirt roads and wayward cows. (It’s a good idea to hire a driver, as Micato does for its guests.) And while wine is central to the experience, it’s hardly the full extent of what to do there. This is a place to sample brut rosé and cabernet-shiraz and then take a sunset boat ride on the reservoir of Gangapur Dam, one of Asia’s largest. The region also houses Trimbakeshwar, a revered and architecturally significant shrine to Shiva that dates to 1755 and contains a special three-faced representation of the Hindu god, and the 2,000-year-old Pandav Leni Caves, once frequented by Buddhist monks.

The game changer

Chandon may be a name known around the world, but Sula Vineyards has put Nashik on the map for international wine lovers. Founded in 1999 by Rajeev Samant, a former Oracle engineer who returned home after quitting his Silicon Valley job, it produces more than 50% of the wine consumed in India.

Sula’s production is encyclopedic: It makes more than 70 labels, from a pineapple-y sparkling rosé to an oaky chardonnay to a tannin-thick cabernet sauvignon that could pass for something out of Napa. Sula’s Nashik tasting room— billed as India’s first when it opened in 2005 — features a bar that can easily accommodate 100, a gift shop filled with kitschy T-shirts (think: “Partners in Wine”) and a theater that plays a short movie about Sula’s rise.

Since 2010 it’s also operated a vineyard resort, the Source, which looks like a cross between a Spanish hacienda and a Tuscan villa — albeit with an intricately painted elephant sculpture in the lobby. Suites look out onto vineyards of chenin blanc and groves of queen of the night, intoxicatingly redolent when they blossom after dark. Instead of mimosas at breakfast, there’s a “build your own chai” bar and an accompanying “chaiwala,” which is essentially a mixologist but for tea. The rates start at about $100 per night.

“My dad was born in Nashik,” says Samant of his connection to the land. While attending Stanford University in the 1980s, he visited Napa Valley. A decade later, his father showed him a parcel of land he was thinking of selling. “It reminded me of California,” Samant says of the area’s verdant rolling hills and dirt roads. “I said, ‘I don’t think you should sell this. I‘m going to try to do something here.’”

Now more than 350,000 visitors pass through the tasting room each year — as of April, more than 331,774 have come through in 2025 alone. “The notable spike reflects the growing popularity of wine tourism in India,” says Sula representative Kinjal Mehta, as well as the fact that the cooler months are the most popular time to visit Nashik.

While the majority of visitors are domestic, Sula says that the share of international visitors is growing. On a recent Thursday evening, the tasting room was packed with swillers of all stripes, from sari-clad grandmothers to polo-shirt-wearing bros broadcasting big bachelor party energy. A sign hung near the cellar door bears a believable, albeit unverifiable claim to fame: “More people taste their first wine here than any other place in the world.”

A caveat of selling wine experiences to a new-to-wine market, however, is that the 30-minute tastings feel very Wine 101. “Don’t drink it like a shot,” one employee admonishes during my visit, dispensing sparkling rosé into proffered glasses, then clarifying that it’s not in fact made from roses. Around a horseshoe-shaped bar, heads reverently nod. Afterward, many guests head to an on-site pizzeria bustling with parents and kids, washing down slices of paneer-topped pies with jammy zinfandel. Instagram opportunities abound.

A wild west for world-class wines

Sula is not the only game in town. About a half-hour drive from the Source is Vallonné, a humble winery producing some of the best wines in the region, owned and operated by Sanket Gawand. A Nashik native, Gawand cut his teeth at wineries in Bordeaux, France, and Bologna, Italy, before opening his own outfit. He also serves as Vallonné’s winemaker and runs its tastings, which take place in the cellar amid stainless steel tanks. He manages a team of 10 that harvests nine lakefront vineyards by hand. Vallonné’s viognier and Anokhee cabernet sauvignon stand up to their French inspirations more so than any other wines sampled in Nashik this fall — in my opinion — but Gawand admittedly lacks the public-relations prowess of more popular neighbors like Sula.

“We’re not good at marketing,” he says, with an amiable shrug.

Maybe he doesn’t need to be. The four rooms at Vallonné’s upstairs inn — quaint furnishings, vineyard views, priced at about $70 per night — are consistently booked, and its restaurant serves what might be the best food in the region. The all-day menu, which is also available to walk-in guests, includes succulent lamb kebabs and toothsome Hakka noodles made all the better with a glass of Vallonné’s crisp chenin blanc.

Diamonds in the rough such as Vallonné are best reached with the help of a local guide like Manoj Jagtap, a Nashik native who began conducting tours 10 years ago under the moniker “The Wine Friend.”

“I’ve got a group of eight Aussies coming tomorrow,” Jagtap tells his charges — me, my mother and a family friend — midway through a recent day trip that included Vallonné, Chandon and Grover Zampa. “During the winter harvest season, it’s nonstop.”

When to go

Fall and winter are prime time for the region, and the success of the past season signals that planning for next year will be more essential than ever. Since 2008, Sulafest, a wine and music festival akin to Coachella, has brought about 20,000 visitors to Nashik every February. Hotels drive up their rates; locals sell yard space to day trippers in need of parking. It’s the marquee event for Sula Vineyards and Nashik as a whole.

“There is potential for India to produce far, far better wines,” says Gawand, who believes that he and his peers are just getting started. “Many Indians are traveling abroad,” tasting quality wines and returning home with an elevated thirst. “Once consumers start understanding quality, the winemakers here will be forced to level up.”

A sip of Vallonné’s 2016 cabernet sauvignon — rich, smooth and redolent of sun-ripened red fruit — suggests that India’s winemakers are well on their way. To his competitors, Gawand raises the proverbial glass.

“We are a dense population,” he says. “Even if there are another 1,000 wineries, everyone will be well. There is more than enough business to go around.”

©2025 Bloomberg L.P. Visit bloomberg.com. Distributed by Tribune Content Agency, LLC.

By Alyssa Bereznak, Los Angeles Times

It was, of all things, a Reddit post that changed the trajectory of Casey Johnston’s life in 2013. Up until that point, her workouts and diet were informed by tips from magazines, radio and other media that promised she’d look good and stay fit if she watched her calories and kept up her cardio. But the post she stumbled upon, in which a woman shared results from her new weightlifting workout, seemed to contradict that advice.

“Here’s this person who’s doing everything the opposite of what I was doing,” Johnston said. “She wasn’t working out that much. She was eating a lot. Her workout seemed pretty simple and short and she was not trying to lose weight. But aesthetically, she looked smaller and more muscular. I though you could only make that change by working out more and more and by eating less.”

That was enough to plunge Johnston into an entire subculture of women who were trading the latest exercise trend for a barbell. When Johnston decided to follow in their path, she was not only surprised by how her body changed, but the mental shift that came along with it. That journey inspired her to create her long-running “She’s a Beast” newsletter, and more recently, a book.

“A Physical Education: How I Escaped Diet Culture and Gained the Power of Lifting,” (Hachette) charts Johnston’s transformation through weightlifting in captivating scientific and emotional detail, articulating the sneaky ways that gender can inform body image, and what women in particular can do to reclaim both their literal and figurative strength.

The Times spoke with Johnston, an L.A. resident, about how she braved the weightlifting gym as a beginner, her previous misconceptions about caloric intake and the way building muscle gave her the confidence to reshape other parts of her life.

This interview has been condensed and edited for clarity.

Your book describes the journey you took to make your body stronger alongside your own mental evolution. Why was it important for you to tell both of those stories?

There’s so much more interplay between our bodies and our minds and our personal backgrounds than we afford it in our day-to-day life. As I was getting more into health, I realized that I hate the way we talk about it. It’s a lot of shoving it into corners. Like, Oh, it should be easy. Just eat less, or just take the stairs instead of the escalator. The more I thought about it, I was like, these are big forces in my life: How I’ve been made to think about food, or made to think about exercise.

Let’s say you maybe you don’t like your bank, but how often do you deal with your physical bank location? Not that much, twice a year for me, maybe. But stuff like eating breakfast, or you’re supposed to work out a few times a week. These are everyday things. It’s like a cabinet that you have to open every day, but it’s broken. It’s worth trying to understand it and have a good relationship with it, because it’s something that you’re doing all of the time. We’re so, so used to shutting it down.

Because of that, I spent a lot of time digging into my own personal background, being like: Why do I think about food the way that I do, or exercise? I think that there’s an important aspect of accountability there too. You have somebody who’s telling you it’s easy, like, Just do X, Y, Z. Well, it’s not easy for me. Why is it easy for you? Those are valuable questions that people don’t ask, or are discouraged from asking. And then when it’s not easy for them, they just feel guilty that it’s not easy, and then they blame themselves. We are all bringing different stuff to this, so to show somebody what I’m bringing to it will help, hopefully help them think about: What are they bringing to it?

Your book talks about the belief system that dictated your exercising and dieting habits. Where did it come from?

Magazines, for whatever reason, played such a big role in my conception of how bodies work. But also TV and infomercials and Oprah and even radio.

I mentioned in the book a SELF magazine cover. There was a whole study about disordered eating in there, how prevalent it was. It was all the way in the back of the magazine. The conclusions of it were something like, three quarters of women have some form of self-chiding that they’re doing about, you know, oh, I ate too much. Or, I need to lose weight, or I hate the way my stomach looks. And that study was not on the cover of the magazine. Everything on the cover was about how to lose weight, how to eat fruit to lose weight, 26 tricks to fit in your bikini. I don’t remember what it was exactly, but that was the conversation. Even with awareness of things going on under the surface, it was still this overwhelming amount of messaging about it.

It was, of all things, a Reddit post that challenged these ideas for you. What did your subsequent research reveal to you?

There were a lot of posts like that. It was not just her, it was this whole subculture. There’s this middle ground of people who have this relationship with lifting weights that’s more normal than I thought it could ever be. I was used to people lifting weights who need to be extremely strong or extremely huge and muscular, because they’re bodybuilders. I had not really heard of anyone lifting weights if they weren’t trying to be one or both of those things. So I didn’t know that this was an available modality to me.

What are some misconceptions that you were harboring about muscles and caloric intake?

I had not been aware that by eating too little, you can deplete your muscle mass. Muscle mass is like the main driver of our metabolism. So the less muscle mass you have, the more you destroy through dieting. The lower your metabolism is, the harder it is to lose weight. Also, the longer you’ve been dieting, the lower your metabolism is going to be. So it becomes this vicious cycle of the more you diet, the harder it is to diet, and the less results — as they would say — you’re going to have.

I was like, O kay, that’s really bad. But you can also work that process in reverse. You can eat more and lift weights and build back your muscle, restore your metabolism. So I had been asking myself, W hy does it feel like I have to eat less and less in order to stay the same way? Am I just really bad at this? Am I eating more than I thought? And it was like, No, I’m not. I’m neither bad at this nor imagining it. It’s literally how things work.

It was very gratifying to find out, but then also a relief that I could undo what I had done. And the way to do it was by lifting and by eating more protein.

Muscles are protein, basically. So by lifting weights, you cause damage to your muscles. And after you’re done working out, your body goes in and repairs them with all the calories and protein that you eat, and repairs them a little bit better than they were the next time. And you could just do this every time you work out. That same cycle repeats. Your muscles grow back. You get stronger and you feel better.

People are really intimidated by gyms. Even more so when it comes to weightlifting in them. You pinpoint this feeling in your book when you describe the moment you realize you would have to “face the bros.” How were you able to overcome your fears in that department?

I wanted so much to see if this worked and how it worked, that I was able to get to the point of OK, I’m gonna give this a try and accept that I might be accosted in an uncomfortable way, or not know what I’m doing, and I will figure it out at some point. I was definitely very scared to go into [a weightlifting] gym, because it felt like the worst thing in the world to be in someone’s way, or be using the equipment wrong, or to be perceived at all.

But I was buoyed along by wanting to give all of this a chance, and I knew that I couldn’t give it a chance if I didn’t get in there. That doesn’t mean that I didn’t get in there and immediately was like, Oh, I’m too afraid to use the spot racks. There was an on-ramp.

But what I tell people now in my capacity as an advice-giver is you have to give yourself that space to get used to something. It’s like starting a new school or starting a new job. You don’t know where the pens are. You have to give yourself a few days to figure it out.

You’ve written so much in your newsletter about functional fitness and compound movements. Why is that so much more valuable than machine lifting?

Machines are designed to work usually a limited amount of muscles, or even one muscle at a time. And they do that by stabilizing the weight for you in this machine. You’re moving on a gliding track for almost everything you could do. When we are handling weights, loads of things, like a child, groceries, boxes of cat litter, bags of dog food, I hear often you’re not doing it on like a pneumatic hydraulic. Your body is wiggling all over the place if you’re not strong. So learning to stabilize your body against a weight is sort of an invisible part of the whole task. But that’s what a free weight allows you to learn: to both hold a heavy weight and move in a particular direction with it, like squat, up and down with it, but at the same time, your body is doing all this less visible work of keeping you upright, keeping you from falling over. And your body can’t learn that when a thing is like holding the weight in position for you while you just move it in this one very specific dimension.

One of the uniting themes of your book is this idea of fighting against your body versus trusting it. Would it be safe to say that you began your fitness journey in the former and landed in the latter?

I definitely started off fighting my body. I just thought that’s what you do with your body. All of the messaging we get, it’s like deep in our American culture, this Protestant denial of your physical self and hard work. If it’s not hard, you’re not doing it right. And I did make a transition from it being hard to listening to my body, trusting it. Just by learning that there was this different dynamic between food, working out and myself that I wasn’t aware of for most of my life.

And once I got into lifting, I learned that all of these things can work better together. But an integral part of it was: You can’t get into lifting without [asking], That rep that I just did — how did that feel? Was it too hard? Was it too easy? Was the weight too high? Is my form weird? I ate a little more yesterday … do I feel better in the gym?

Running had been about pushing down feelings in the way that I was accustomed to from my personal life. You’re pushing through, you’re feeling pain, but trying to ignore it and go faster and faster. It was a lot of like, You got to unplug and disconnect.

So lifting, the dynamic of lifting through asking how do things feel, refracted into the rest of my life. How does it feel when somebody doesn’t listen to you at work? Or your boyfriend argues with you at a party? Lifting opened me up to this question in general, of how things made me feel.

A lot of us are used to thinking of ourselves as your brain is this and your body is that. You are your brain and all of the horrible parts that are annoying and betray you are your body. But there’s so much interplay there. It’s like your body is the vector that tells you, and when you learn to ignore it, you don’t learn to really meaningfully understand your own feelings. I had learned in my life to ignore those signals. When lifting built up my sense of: How does my body feel when it does certain things? It opened up my awareness of the experience of: How does my body feel when bad things or good things happen in the rest of my life?

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©2025 Los Angeles Times. Visit at latimes.com. Distributed by Tribune Content Agency, LLC.

By Ariana Arghandewal, Bankrate.com

Credit cards are widely accepted in most parts of the world, which is great for those who want to maximize rewards on their trips abroad. Not only do many cards offer generous rewards on travel spending, but they also provide convenience and an added layer of protection in case your trip doesn’t go as planned.

Using a credit card is better than using cash in most cases. However, you may still encounter issues when attempting to use your credit card abroad, so make sure to plan accordingly.

Can I use my credit card abroad?

In most cases, yes! The country you’re visiting may have different banks, but many of the payment networks common in the U.S. are widely accepted around the globe. Some credit cards, most commonly travel credit cards, even have no foreign transaction fees and earn rewards on specific purchases worldwide, such as restaurants. This helps you save money and earn more in rewards when you travel.

However, it’s important to know that while your card can be used abroad, it doesn’t mean it will always work. If your card is worn down or tends to be a little faulty at home, it can be just as finicky outside the country. Or if your credit card issuer is unaware that you’re traveling, they may assume your identity is stolen and decline your purchases. Some payment networks are also less common abroad. Luckily, there are workarounds to a few of the most common issues you may come across.

Bankrate tip

See Bankrate’s Travel Toolkit for tips and insights to boost your savings and maximize your travel.

How to make sure your credit card works abroad

A handful of factors may prevent your credit card from working overseas. Most of them have simple solutions and require just a bit of advance planning.

—Use a widely accepted issuer. Visa and Mastercard are the most widely accepted credit card payment networks worldwide. While American Express and Discover can come in handy in many situations, you may want to bring a backup Visa or Mastercard while traveling abroad, just in case.

—Use chip and PIN cards or a digital wallet. In many countries around the world, chip and personal identification number (PIN) cards are the norm. These cards use a microchip and PIN to validate transactions, instead of a cardholder’s signature. Rather than swiping the magnetic stripe through the card reader, consumers insert the card into the machine and enter the PIN associated with the chip. If you have a card with a chip in your wallet, set a PIN so you don’t run into trouble using it abroad.

Digital wallets are also becoming the norm for storing credit cards, debit cards, and even boarding passes for your flight. They often lead to faster, more secured payments with a lower risk of being lost or stolen. So, it may be beneficial to set one up and add your card. This way, you can keep the physical card tucked away as a backup.

—Notify your bank of your travel plans. If you’ve booked any part of your trip on your credit card, notifying your bank isn’t usually required. If you did not use your credit card for any bookings, then providing advance notice of your travel plans reduces the odds of your bank declining your transactions abroad. Knowing that you’ll be in Paris for a week, your bank is less likely to reject your purchases at patisseries. They’ll know your credit card isn’t compromised — you’re just being a tourist.

Is it worthwhile to use a credit card abroad?

Yes, using your credit card abroad provides security and convenience that cash does not. You’ll potentially earn rewards on every purchase, which you can save and redeem toward future travel experiences. The items you buy may also be covered by purchase protection, giving you extra peace of mind. More importantly, you won’t have to carry large amounts of cash and worry about the security risk it poses.

While you should bring some cash for smaller purchases or in a city where it’s the main form of payment accepted, a credit card provides stronger protection and other added benefits.

Are there fees for using a credit card abroad?

You’ll encounter two types of fees when using a credit card abroad — foreign transaction fees and merchant fees. Foreign transaction fees are around 3% and can be avoided since many travel rewards cards waive them.

Merchant fees can include surcharges or convenience fees for using your card. These fees help to offset the merchant’s processing costs and can vary from 3% to 8%. These fees help offset the costs of the added protection you receive from a credit card.

Unfortunately, there isn’t much consumers can do about these fees. You can either pay the fee, use cash or shop somewhere else to get around them. Still, there is a small way to save some money when using your card.

If a merchant asks whether you want to pay in U.S. dollars or the local currency, always opt for the local currency. Your credit card issuer is likely to give you a much better conversion rate than the local business owner will.

Also, always opt out of dynamic currency conversion, which allows cardholders to handle transactions in their home currency when shopping or taking money from an ATM. While you may be able to know the actual price of your purchase, the additional fee often makes the purchase higher than it would be otherwise.

The bottom line

What you pack in your wallet matters as much as what you put in your carry-on when you travel abroad. You’ll want to bring one or more credit cards with a widely accepted payment network. Even better, bring one that offers purchase and travel protection, generous rewards and travel perks. You may encounter a few issues when using a credit card to pay for purchases, but there are workarounds. By following safe use practices, you won’t have to carry large sums of cash or worry about your transactions getting declined.

©2025 Bankrate.com. Distributed by Tribune Content Agency, LLC.

By Melissa Nann Burke, The Detroit News

Oakland County Sheriff Mike Bouchard pressed lawmakers on Capitol Hill this month to grant state and local law enforcement the authority to disable drones when they pose a threat to the public or are operating illegally.

Bouchard and U.S. Rep. Lisa McClain, R-Bruce Township, recently spoke with The Detroit News about the issue. Bouchard lamented that U.S. lawmakers haven’t taken action despite widespread reports of mysterious drones in New Jersey and other communities last year and the safety risks that unmanned aircraft may pose to airports and large public gatherings like concerts and football games.

Opponents have raised concerns about the change infringing on First Amendment and civil liberties protections, government surveillance and property rights.

McClain’s office said she’s having conversations about potential legislation to address the drone issue.

In the Senate, Sen. Gary Peters, D-Bloomfield Township, has pushed bipartisan legislation for the last two sessions of Congress that would grant the Department of Homeland Security, Department of Justice and local law enforcement more authority to combat potential threats posed by drones.

The Safeguarding the Homeland from the Threats Posed by Unmanned Aircraft Systems Act would allow DHS and DOJ to disable drones determined to pose a security risk. The legislation would also establish a pilot program that allows state and local law enforcement to help mitigate an urgent drone threat, according to a bill summary.

The bill, which hasn’t passed Congress, also would allow critical infrastructure owners and operators — like stadium operators — to detect, identify and track a drone threat so they can report it to state and local law enforcement for further investigation.

The following partial transcript has been edited for clarity.

Question: Sheriff, what are you talking about with the chairwoman this week and the other lawmakers that you’re visiting (in Washington, D.C.)?

Bouchard: First and foremost, it is because of Police Week. We’re very connected to that on lots of levels, but especially because we had Deputy Bradley Reckling ambushed and murdered less than a year ago.

This week is dedicated to not just police officers in general, but today is Police Memorial Day, so it’s especially heartbreaking. I was with his widow a number of times. I was with her last night ― four kids under the age of 7. We’re talking about the risk that our people face day in day out.

I’m reiterating that to the members (of Congress) that I meet with that we need their support to lift up families that are hurting, but also to support the ones that are going on every day to face the same threats.

The Michigan state trooper that was shot multiple times recently was trailing a car that my same auto-theft team was on when (Reckling) was murdered. They had been trailing it the night before. So that could have been the very same unit in a shootout less than a year later. Thankfully, the trooper wasn’t killed, but that could have been a dead trooper or could have been one of my deputies on the same team. …

I’m part of the Joint Terrorism Task Force: You saw that an individual wanted to commit a terrorist attack on behalf of ISIS in Warren, and he wanted to use drones?

Q: That was front-page news. … He launched a drone to try to carry out an attack at the Army’s TACOM (Tank-Automotive & Armaments Command) facility.

McClain: But talk about the drone issue, because that’s really what we in Congress need to do a better job of. And this is where I appreciate the relationship and the partnership that I have with Sheriff Bouchard ― he is not afraid to call me and tell me what he needs, what he’s dealing with, and the resources that he needs. And it’s our job to legislate.

We need to have a paradigm shift up here in D.C. We need to fund the police, and we need to make sure that we respect them, but also give them the resources they need, whether it’s for mental health, whether it’s for drones, whether it’s for retirement. They put their lives on the line, day in and day out, to make sure that they have our backs. I think the least we can do is make sure we have theirs.

And I appreciate the relationship, because he will call and advocate ― very sternly, I might add.

Bouchard: That attack (in Warren) in particular was going to be kicked off with a drone, right? And we have been banging the drum very loudly about the threats of drones, and it’s not a case of if but when. It’s going to happen here.

We’ve seen it operationally already ― dropping weapons and contraband into prisons and jails. It’s almost a regular thing now, but we have no ability to intervene. We’ve seen it used as weapons all over the world ― Ukraine, Israel ― with great effect. But even closer, Mexican cartels attacked a Mexican general’s convoy and blew it up with drones.

You can buy these things off the shelf and weaponize them very cheaply.

Q: What are you asking Congress to do?

Bouchard: Give us the authority to intervene that they have held only to federal agencies.

So for example, you have certain events. They’re called SEAR events, or national security events: The Republican National Convention, Democratic National Convention, the Super Bowl, things like that. It gets a supreme level of security and safety, including air restrictions, and it also gets counter-drone capability.

So my drone unit managed, with the federal government, the air operations over the NFL Draft when it was in Detroit last year. But the feds are the only ones that have the ability to take intervention action against a hostile or even a bad hobbyist that doesn’t understand that they could cause a very big problem. We don’t have the authority to do that, and there’s only a very limited number ― typically about two teams that are operating anywhere in the country ― that can do those kinds of things.

So my worst nightmare is, you know, we have the Dream Cruise every year: 1.3 million people in a 13-mile stretch. We run drone and counter drone and crude aircraft and air assets during it. Last year, we had like 96 interventions in our airspace over the Dream Cruise that were illegal.

McClain: And they can’t do anything.

Bouchard: We can’t do anything about it. Other than we can see the drone on our drone-detection systems that we already have. We can see where the operator launched from, but we don’t have the systems to intervene ―

McClain: Or the authority really, to intervene, right?

Bouchard: And three of those went past my crude aircraft to 1,480 feet. Had that hit the cockpit of our helicopter, you’d have a catastrophic crash over the Dream Cruise into the crowd. And it was not by intervention that didn’t happen, it was by luck. We can’t survive on luck in my world.

If you look at the California wildfires, they had a plane that was distributing water and putting out fires that was pierced by a hobbyist drone and had to make an emergency landing. It took it out of commission. And we’ve got records of Life Flights that can’t land because drone operators are curious what’s going on.

All we’re asking for is pretty simple: Allow us, local and state law enforcement, to have the same authority that the federal government has to intervene when a drone is operating illegally and or is an immediate threat to the public. Those are the only circumstances we want to intervene. That’s all we’re asking for.

Q: Which federal agencies are opposed to this?

Bouchard: It has to come from Congress. The federal agencies support us. DHS and I did a press conference three years ago. They said they want us to have it. And the best we’ve gotten so far is a proposal to do a pilot in five sites in the country. Well, a pilot is going to be, what, three years, and then by the time you’re talking seven years out. The threat’s today.

McClain: Congress definitely needs to act on this. There is no question in my mind that we need to do that. We need to act on it.

My frustration is nothing moves quick, and my frustration is instead of being proactive or preemptive, what’s going to happen is we’re going to have a tragedy happen, and then all of a sudden, we’re going to end up over-regulating this, when, if we just did our job, we could do this now.

The problem gets into First Amendment rights. … I mean, I’m all for First Amendment rights. I’m all for the property rights. I’m all for that. But at the end of the day, if there’s a threat, I want my local police officers to be able to protect me and the 1.3 million people that are in a 13-mile radius to keep us safe. I think if the public knew how dangerous it was, they would be lobbying us a lot more to take care of this.

Q: Where is your bill on this? Is it in committee?

McClain: We’ve had a couple bills on it, but it gets stalled because they get hung up on one little thing.

And remember, you got to have 60 votes in the Senate, and we have a whole pocket of people that aren’t real pro-law enforcement. It’s not me, and it’s not a lot of my colleagues, but they’re out there. So we got to make sure that we raise awareness to this. … It’s a very important subject that the sheriff and I have been working on.

Bouchard: It’s one of the issues that Police Week kind of gives us a chance to talk about it. What are the threats we see and what are the ways that the federal government, in particular Congress, can help us face those? Some of it, it’s not money. It’s partnership or authorization or integration of effort, things like that.

Q: In the Senate, Gary Peters is on the Homeland Security Committee. He used to be the committee’s chair, and he has an interest in this drone issue and a bill on this.

Bouchard: Yeah, we supported his bill. And the senator who kind of tied things up was (Kentucky Republican Sen.) Rand Paul, which makes our leap a little harder. (Paul is now the committee chair.)

I think a lot of it is some of the members are so busy, they don’t take the moment to sit down and listen to somebody that’s actually on the ground doing the job. It’s very different to imagine than it is to operate. And the concerns about civil liberties or spying or First Amendment, they vanish when we tell them how it’s utilized.

It’s not utilized to spy or to do surveillance because battery life, No. 1, is very small. If you’re going to do surveillance, you’re going to do it from a high-altitude, crewed aircraft that has loiter capability. If you’re swapping batteries every 15 to 20 minutes, and the law requires us, like anybody else, to be 400 feet or below ― that’s visible, and it can even be heard most of the time. So it’s not a surveillance tool. We use it for emergencies or to keep an eye on a situation as it develops.

The second thing is intervention would only come when the drone is a danger or it’s breaking the law. People say, ‘What if it’s being used to monitor the police?’ We don’t care. We’re the most monitored profession on the planet. We have body cameras. We have dash cameras.

McClain: Everybody’s out there with their cellphone.

Bouchard: Everybody’s got a cellphone. There’s cameras on every corner. That’s not our concern. If we’re doing something wrong, we own it and have to fix it, and we should be held accountable. We get that.

But the drone would never be interfered with because you’re watching us. It would only be interfered with if it was breaking the law or was an immediate threat. That’s it. The other misnomer is that, well, what if you’re going to intercept the video feed? There’s no technology to do that. That’s not why we would intervene. And why do we need your feed if we have our own air assets?

Q: Wasn’t there a Green Day concert last year at Comerica Park where drones were an issue?

Bouchard: There were two events in Michigan where they rushed people off the stage, and people panicked, because of a drone. Thankfully, it was not an adversary but a hobbyist that did stupid things. So far, we’ve been lucky, because they’ve been people that are either uneducated about the law or don’t care. But they’re not adversarial.

Take, for example, President Trump’s assassination attempt last summer. We did a lot of the drone detection and drone work around the (presidential candidate) visits to Michigan, because we have one of the most advanced air capabilities in the country.

That individual flew a drone for pre-op surveillance of where the president was going to speak and probably determined the line-of-sight location that he chose to shoot from. What if instead, he did a pre-op surveillance with that drone and geo-marked that stage and then went back a half a mile or a mile, and waited for the president to take the stage, as he could see on live TV, and launched a drone that was explosive-bearing right to the stage?

These are all things I wake up in the night going, this is not if, it’s when, and we need to do something. And you can take it to everyday examples: UM and Michigan Stadium and Spartan Stadium, Comerica Park are having games every day.

And if you have these new pilot programs ― pick which one of the three you want to be at. You only get one.

By Breana Noble, The Detroit News

Hundreds of used vehicles rolled through the auction aisles of Manheim Detroit on Thursday as dealers in person and online scrambled to make their bids to shore up inventories in anticipation of price increases.

Average used vehicle list prices are up slightly year-over-year at $25,547, according to Cox Automotive Inc., a dealer digital services provider that owns Manheim and its 79 U.S. auction sites, which handle more than 7 million vehicles per year. The increase represents a reversal as used prices had fallen over the past couple of years after hitting a peak during the pandemic. But President Donald Trump’s tariffs have spooked buyers, prompting a surge in new and used vehicle purchases with consumers hoping to get ahead of larger price increases.

“We’re trying to get caution out there, but we’re not trying to spread any kind of concern that there’s a collapse coming,” said Charlie Chesbrough, a senior economist at Cox, which is forecasting a 1% increase in used vehicle sales in 2025 compared to last year. “It’s just going to be a challenging couple of months here over the summer.”

The Manheim Used Vehicle Value Index that assesses the wholesale prices of used vehicles at Manheim auctions reversed course in April after declining in February and March. It spiked 2.7% month-over-month compared to a typical monthly movement of about 0.3%, as prices rose almost 5% on average. The frenzy has slowed a bit since April with the index falling 1.1% in a mid-May report shared this week. But the index still remains 4.4% higher than it was a year ago.

It typically takes four to six weeks before changes at auction are reflected in retail transactions, Chesbrough said: “Our expectation is over the course of the summer, those prices are going to rise even more quickly.”

In Carleton on Thursday morning, auctioneers rambled 250 to 400 words per minute to secure bids within 1 minute from dealers across the country for used vehicles from automakers like Ford Motor Co. and General Motors Co., rental car companies, banks and other dealers. About 72% of Manheim’s vehicle sales are done online.

Established in 1992, the 250-acre Manheim Detroit has three sales days per week for licensed dealers. Whether a company vehicle, a trade-in, a repossession or a fleet retirement, 1,800 vehicles or more hit the block each of those days. Vehicles sell anywhere from $200 to salvage dealers to $450,000 for a Lamborghini recently. Most vehicles passing through are about three years old.

“Every car will sell,” said Keith Winningham, assistant general manager at Manheim Detroit. “It may not be today. Maybe it’s next week. The market’s constantly changing.”

Manheim Detroit is unique because of the business it does with manufacturers and the Canadian dealers that sell in its auction. Despite tariffs and trade tensions between the United States and Canada, sales from Canadian dealers are up this year, said Noel Kitsch, general manager of Manheim Detroit Market Center.

Most vehicles sold in Canada are made in the United States (designated by their vehicle identification numbers beginning with a one, four or five). Those can return to the United States tariff-free, Kitsch said, while more Canadian- and Mexican-built vehicles are staying in Canada because of Trump’s 25% auto tariff.

“They started adjusting in October,” Kitsch said about the Canadian sellers. “We have not seen a decrease in Canadian vehicles. As a matter of fact, we’re up year over year in Canadian sales in the Michigan area.”

High interest rates, improved new-vehicle inventories and inflation on other goods contributed to falling used vehicle prices over the past couple of years. The spring usually sees an increase in demand with tax returns hitting consumer pockets, Chesbrough said, and prices have stayed high.

“The used vehicle market is still looking very, very strong in terms of sales out there,” he said. “But the inventory has been drawn down, and that’s creating a situation where the inventory is lean on dealer lots, and they’re going to be less likely to make a deal, because their sales have been going quite well, and their existing inventory is now worth more money, because they know the incoming replacement inventory is going to cost a little bit more.”

Days of used-vehicle supply nationwide is in the 40s, he said, which is down about 20% from recent weeks.

More than a third — 34% — of Americans plan to buy a car in the next 12 months, the highest since 2023, according to auto lender Santander Consumer USA’s Paths to Prosperity survey. Some have pulled ahead those purchases in anticipation of increased prices, said Betty Jotanovic, the lender’s president of auto relationships.

But this comes as auto loan delinquency rates have returned to pre-COVID levels. Default rates remain below the norm, but it’s an indication of consumer economic stress, Jotanovic said.

“The consumer is getting behind on their payments,” she said, “but still prioritizing the auto loan over their mortgage or credit card.”

Adding in the uncertainty around tariffs, buyers may adjust their purchases, Jotanovic said: “You’re going to see a shift where maybe your typical new buyer goes to a one- or two-year-old used car, or maybe that one- or two-year-old used buyer goes to a three- or four-year-old used vehicle.”

Fewer younger vehicles are returning to dealer lots in 2025. A sharp drop in leasing through 2022 and 2023 amid a microchip shortage and other supply-chain disruptions, Ivan Drury, director of insights for auto information website Edmunds.com Inc., wrote in a report released Thursday.

In the first three months of 2025, the average sales price of a three-year-old used vehicle surpassed $30,000 for the first time since the second quarter of 2023.

“Due to unexpected market swings,” Drury wrote, “3-year-old lease-return values are coming in higher than automakers originally forecasted — offering some drivers unexpected trade-in advantages.”

That’s incentive for vehicle sellers to send their inventory to auction, and it’s keeping the 320 Manheim Detroit employees busy. The facility has a mechanic shop, a body shop to repair dented and scratched panels, and a paint shop able to spruce up as many as 50 vehicles per day. Manheim inspects about 150 vehicles to grant AAA certification daily.

“If there’s heavy collision on a vehicle, most of those assets are going to be sold as is,” Winningham said. “Most of what we do are cosmetic repairs. If a dealer is out in the lanes, and they’re looking at the car, and the bumper is scratched, it’s got a dent in the door, he’s got to calculate in his head what he’s got to spend on that car No. 1. No. 2, he has to get it repaired. Most body shops at most dealerships are very, very busy. And for him to have to get that into a shop and get it sold takes time. Obviously when they buy a car, the whole concept is to sell it as quickly as possible.”

Ninety-five percent of auctioned vehicles here are detailed on-site. Fixed imaging tunnels leverage 44 cameras and artificial intelligence to help identify damage on the vehicles and pick the best dozen of 2,000 photos captured as the vehicle travels under 10 mph through the tunnel. The chosen images are uploaded within minutes to Manheim’s website for dealers to check out.

Vehicles on average spend less than 30 days at Manheim before heading to a buyer. If a vehicle doesn’t sell, it might go to an auction next week or at another location. Certain electric vehicles stick around longer because of lower demand and to balance out losses for the seller, Kitsch said.

Whether buying at auction or from a trade-in, dealers like Walt Tutak, general manager at Matthew Hargreaves Chevrolet in Royal Oak, have upped their supply of used vehicles. Tutak is at 200 vehicles and could increase his stock to 225, up from a typical 150, in anticipation of tariffs affecting new-vehicle inventories.

“It hasn’t affected (demand) for used cars,” Tutak said about tariffs. “But we need to pay our bills one way or another. If inventories are going to get lowered, we want to be covered selling used cars.”

Tutak isn’t the only one thinking like that, and he recognized that used car prices are going up. But he said he’s willing to compromise on margins per vehicle if he’s selling more of them, he noted, seeing it as a long-term investment in the business.

“They’re going to come back to our dealership,” he said, “and tell friends and family and come to our service department and body shop and parts department. It’s a snowball effect.”

By Jackie Fortiér and Arthur Allen, KFF Health News

In the dim basement of a Salt Lake City pharmacy, hundreds of amber-colored plastic pill bottles sit stacked in rows, one man’s defensive wall in a tariff war.

Independent pharmacist Benjamin Jolley and his colleagues worry that the tariffs, aimed at bringing drug production to the United States, could instead drive companies out of business while raising prices and creating more of the drug shortages that have plagued American patients for several years.

Jolley bought six months’ worth of the most expensive large bottles, hoping to shield his business from the 10% across-the-board tariffs on imported goods that President Donald Trump announced April 2. Now with threats of additional tariffs targeting pharmaceuticals, Jolley worries that costs will soar for the medications that will fill those bottles.

In principle, Jolley said, using tariffs to push manufacturing from China and India to the U.S. makes sense. In the event of war, China could quickly stop all exports to the United States.

“I understand the rationale for tariffs. I’m not sure that we’re gonna do it the right way,” Jolley said. “And I am definitely sure that it’s going to raise the price that I pay my suppliers.”

Squeezed by insurers and middlemen, independent pharmacists such as Jolley find themselves on the front lines of a tariff storm. Nearly everyone down the line — drugmakers, pharmacies, wholesalers, and middlemen — opposes most tariffs.

Slashing drug imports could trigger widespread shortages, experts said, because of America’s dependence on Chinese- and Indian-made chemical ingredients, which form the critical building blocks of many medicines. Industry officials caution that steep tariffs on raw materials and finished pharmaceuticals could make drugs more expensive.

“Big ships don’t change course overnight,” said Robin Feldman, a UC Law San Francisco professor who writes about prescription drug issues. “Even if companies pledge to bring manufacturing home, it will take time to get them up and running. The key will be to avoid damage to industry and pain to consumers in the process.”

Trump on April 8 said he would soon announce “a major tariff on pharmaceuticals,” which have been largely tariff-free in the U.S. for 30 years.

“When they hear that, they will leave China,” he said. The U.S. imported $213 billion worth of medicines in 2024 — from China but also India, Europe, and other areas.

Trump’s statement sent drugmakers scrambling to figure out whether he was serious, and whether some tariffs would be levied more narrowly, since many parts of the U.S. drug supply chain are fragile, drug shortages are common, and upheaval at the FDA leaves questions about whether its staffing is adequate to inspect factories, where quality problems can lead to supply chain crises.

On May 12, Trump signed an executive order asking drugmakers to bring down the prices Americans pay for prescriptions, to put them in line with prices in other countries.

Meanwhile, pharmacists predict even the 10% tariffs Trump has demanded will hurt: Jolley said a potential increase of up to 30 cents a vial is not a king’s ransom, but it adds up when you’re a small pharmacy that fills 50,000 prescriptions a year.

“The one word that I would say right now to describe tariffs is ‘uncertainty,’” said Scott Pace, a pharmacist and owner of Kavanaugh Pharmacy in Little Rock, Arkansas.

To weather price fluctuations, Pace stocked up on the drugs his pharmacy dispenses most.

“I’ve identified the top 200 generics in my store, and I have basically put 90 days’ worth of those on the shelf just as a starting point,” he said. “Those are the diabetes drugs, the blood pressure medicines, the antibiotics — those things that I know folks will be sicker without.”

Pace said tariffs could be the death knell for the many independent pharmacies that exist on “razor-thin margins” — unless reimbursements rise to keep up with higher costs.

Unlike other retailers, pharmacies can’t pass along such costs to patients. Their payments are set by health insurers and pharmacy benefit managers largely owned by insurance conglomerates, who act as middlemen between drug manufacturers and purchasers.

Neal Smoller, who employs 15 people at his Village Apothecary in Woodstock, New York, is not optimistic.

“It’s not like they’re gonna go back and say, well, here’s your 10% bump because of the 10% tariff,” he said. “Costs are gonna go up and then the sluggish responses from the PBMs — they’re going to lead us to lose more money at a faster rate than we already are.”

Smoller, who said he has built a niche selling vitamins and supplements, fears that FDA firings will mean fewer federal inspections and safety checks.

“I worry that our pharmaceutical industry becomes like our supplement industry, where it’s the wild West,” he said.

Narrowly focused tariffs might work in some cases, said Marta Wosińska, a senior fellow at the Brookings Institution’s Center on Health Policy. For example, while drug manufacturing plants can cost $1 billion and take three to five years to set up, it would be relatively cheap to build a syringe factory — a business American manufacturers abandoned during the covid-19 pandemic because China was dumping its products here, Wosińska said.

It’s not surprising that giants such as Novartis and Eli Lilly have promised Trump they’ll invest billions in U.S. plants, she said, since much of their final drug product is made here or in Europe, where governments negotiate drug prices. The industry is using Trump’s tariff saber-rattling as leverage; in an April 11 letter, 32 drug companies demanded European governments pay them more or face an exodus to the United States.

Brandon Daniels, CEO of supply chain company Exiger, is bullish on tariffs. He thinks they could help bring some chemical manufacturing back to the U.S., which, when coupled with increased use of automation, would reduce the labor advantages of China and India.

“You’ve got real estate in North Texas that’s cheaper than real estate in Shenzhen,” he said at an economic conference April 25 in Washington, referring to a major Chinese chemical manufacturing center.

But Wosińska said no amount of tariffs will compel makers of generic drugs, responsible for 90% of U.S. prescriptions, to build new factories in the U.S. Payment structures and competition would make it economic suicide, she said.

Several U.S. generics firms have declared bankruptcy or closed U.S. factories over the past decade, said John Murphy, CEO of the Association for Accessible Medicines, the generics trade group. Reversing that trend won’t be easy and tariffs won’t do it, he said.

“There’s not a magic level of tariffs that magically incentivizes them to come into the U.S.,” he said. “There is no room to make a billion-dollar investment in a domestic facility if you’re going to lose money on every dose you sell in the U.S. market.”

His group has tried to explain these complexities to Trump officials, and hopes word is getting through. “We’re not PhRMA,” Murphy said, referring to the powerful trade group primarily representing makers of brand-name drugs. “I don’t have the resources to go to Mar-a-Lago to talk to the president myself.”

Many of the active ingredients in American drugs are imported. Fresenius Kabi, a German company with facilities in eight U.S. states to produce or distribute sterile injectables — vital hospital drugs for cancer and other conditions — complained in a letter to U.S. Trade Representative Jamieson Greer that tariffs on these raw materials could paradoxically lead some companies to move finished product manufacturing overseas.

Fresenius Kabi also makes biosimilars, the generic forms of expensive biologic drugs such as Humira and Stelara. The United States is typically the last developed country where biosimilars appear on the market because of patent laws.

Tariffs on biosimilars coming from overseas — where Fresenius makes such drugs — would further incentivize U.S. use of more expensive brand-name biologics, the March 11 letter said. Biosimilars, which can cost a tenth of the original drug’s price, launch on average 3-4 years later in the U.S. than in Canada or Europe.

In addition to getting cheaper knockoff drugs faster, European countries also pay far less than the United States for brand-name products. Paradoxically, Murphy said, those same countries pay more for generics.

European governments tend to establish more stable contracts with makers of generics, while in the United States, “rabid competition” drives down prices to the point at which a manufacturer “maybe scrimps on product quality,” said John Barkett, a White House Domestic Policy Council member in the Biden administration.

As a result, Wosińska said, “without exemptions or other measures put in place, I really worry about tariffs causing drug shortages.”

Smoller, the New York pharmacist, doesn’t see any upside to tariffs.

“How do I solve the problem of caring for my community,” he said, “but not being subject to the emotional roller coaster that is dispensing hundreds of prescriptions a day and watching every single one of them be a loss or 12 cents profit?”

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©2025 KFF Health News. Distributed by Tribune Content Agency, LLC.