By LAURAN NEERGAARD, AP Medical Writer

WASHINGTON (AP) — A federal judge ruled Monday it was illegal for the Trump administration to cancel several hundred research grants, adding that the cuts raise serious questions about racial discrimination.

U.S. District Judge William Young in Massachusetts said the administration’s process was “arbitrary and capricious” and that it did not follow long-held government rules and standards when it abruptly canceled grants deemed to focus on gender identity or diversity, equity and inclusion.

In a hearing Monday on two cases calling for the grants to be restored, the judge pushed government lawyers to offer a formal definition of DEI, questioning how grants could be canceled for that reason when some were designed to study health disparities as Congress had directed.

Young, an appointee of Republican President Ronald Reagan, went on to address what he called “a darker aspect” to the cases, calling it “palpably clear” that what was behind the government actions was “racial discrimination and discrimination against America’s LGBTQ community.”

After 40 years on the bench, “I’ve never seen government racial discrimination like this,” Young added. He ended Monday’s hearing saying, “Have we no shame.”

During his remarks ending the hearing, the judge said he would issue his written order soon.

Young’s decision addresses only a fraction of the hundreds of NIH research projects the Trump administration has cut — those specifically addressed in two lawsuits filed separately this spring by 16 attorneys general, public health advocacy groups and some affected scientists. A full count wasn’t immediately available.

While Young said the funding must be restored, Monday’s action was an interim step. The ruling, when formally issued, is expected to be appealed. The Trump administration didn’t immediately respond to a request for comment.

While the original lawsuits didn’t specifically claim racial discrimination, they said the new NIH policies prohibited “research into certain politically disfavored subjects.” In a filing this month after the lawsuits were consolidated, lawyers said the NIH did not highlight genuine concerns with the hundreds of canceled research projects studies, but instead sent “boilerplate termination letters” to universities.

The topics of research ranged widely, including cardiovascular health, sexually transmitted infections, depression, Alzheimer’s and alcohol abuse in minors, among other things. Attorneys cited projects such as one tracking how medicines may work differently in people of ancestrally diverse backgrounds, and said the cuts affected more than scientists — such as potential harm to patients in a closed study of suicide treatment.

Lawyers for the federal government said in a court filing earlier this month that NIH grant terminations for DEI studies were “sufficiently reasoned,” adding later that “plaintiffs may disagree with NIH’s basis, but that does not make the basis arbitrary and capricious.” The NIH, lawyers argued, has “broad discretion” to decide on and provide grants “in alignment with its priorities” — which includes ending grants.

Monday, Justice Department lawyer Thomas Ports Jr. pointed to 13 examples of grants related to minority health that NIH either hadn’t cut or had renewed in the same time period — and said some of the cancellations were justified by the agency’s judgement that the research wasn’t scientifically valuable.

The NIH has long been the world’s largest public funder of biomedical research.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

So little is discussed about “The Change”. That’s right Menopause is not widely discussed and can bring a sense of feeling ashamed. It’s something that’s often held close to a woman’s chest, a secret that only she knows. 

While some do share their experiences, many women continue to struggle with finding community when preparing for and enduring menopause. 

Menopause It’s a biological process when a menstruating woman no longer has periods. Each woman experiences the stage differently, whether it’s with hot flashes, sleep problems or a low libido. But all menstruating women will experience menopause; it’s just a matter of when. 

A new comedy special aims to tackle the inevitable process with laughter. “Confessions of a menopausal femme fatale” is a stand-up storytelling concert by multidisciplinary artist, storyteller, and social entrepreneur Satori Shakoor. 

Shakoor is the founder and Executive Producer of The Secret Society of Twisted Storytellers, host of PBS’s Detroit Performs. The special, which was taped at Detroit Public Theatre will be available to stream Thursday, June 12th.

Listen to The Metro weekdays from 10 a.m. to noon ET on 101.9 FM and streaming  on demand.

Trusted, accurate, up-to-date.

WDET strives to make our journalism accessible to everyone. As a public media institution, we maintain our journalistic integrity through independent support from readers like you. If you value WDET as your source of news, music and conversation, please make a gift today.

Donate today »

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By MATTHEW PERRONE, AP Health Writer

WASHINGTON (AP) — Calley Means has built a following within the “Make America Healthy Again” movement by railing against the failings of the U.S. health system, often pinning the blame on one issue: corruption.

Means, a top aide to Health Secretary Robert F. Kennedy Jr., was hired as a White House adviser in March. He has used that perch to attack the nation’s leading physician groups, federal agencies and government scientists, claiming they only protect their own interests in the nation’s $4.9 trillion-a-year industry.

In recent interviews, speeches and podcasts he has called the American Medical Association “a pharma lobbying group,” labeled the Food and Drug Administration “a sock puppet of industry,” and said federal health scientists have “overseen a record of utter failure.”

Means, however, has his own financial stake in the sprawling health system. He’s the co-founder of an online platform, Truemed, that offers dietary supplements, herbal remedies and other wellness products. Some of the vendors featured on Truemed’s website are supporters of Kennedy’s MAHA movement, which downplays the benefits of prescription drugs, vaccines and other rigorously tested medical products.

Kennedy has pledged to run the Department of Health and Human Services with “radical transparency,” but Means has never had to publicly disclose his own financial details or where exactly they intersect with the policies he’s advancing.

“It reeks of hypocrisy,” said Dr. Reshma Ramachandran, a health researcher at Yale University. “In effect, he is representing another industry that is touting nonregulated products and using his platform within the government to financially benefit himself.”

In a written statement, Means said his government work has not dealt with matters affecting Truemed and has focused on issues like reforming nutrition programs and pressuring companies to phase out food dyes.

“Pursuing these large-scale MAHA goals to make America healthy has been the sole focus in my government work,” Means said.

Truemed helps users take tax-free money out of their health savings accounts, or HSAs, to spend on things that wouldn’t normally qualify as medical expenses, such as exercise equipment, meal delivery services and homeopathic remedies — mixtures of plants and minerals based on a centuries-old theory of medicine that’s not supported by modern science.

The business model caught the attention of the IRS last year, which issued an alert: “Beware of companies misrepresenting nutrition, wellness and general health expenses as medical care.”

Truemed co-founder and CEO, Justin Mares, said in a statement the company is “in full alignment” with IRS guidelines.

“Truemed enables patients to work with providers to use medical funds for root cause interventions like exercise and vitamin D to reverse disease under current law,” Mares said.

The full extent of Means’ potential conflicts — including his personal investments— are unclear because of his status as a special government employee.

Unlike presidential appointees and other senior officials, special government employees are temporary staffers who do not have to leave companies or sell investments that could be impacted by their work. Also, their financial disclosure forms are shielded from public release.

“It’s a big problem,” says Richard Painter, a former White House ethics lawyer under George W. Bush now at the University of Minnesota. Painter and other experts have raised alarms over a whirlwind of Trump administration actions to dismantle the government’s public integrity guardrails.

Still, part-time government employees are subject to the same law that bars all federal staffers from working on issues that could directly benefit their finances. When such cases arise, they must recuse themselves or risk criminal penalties.

Means regularly opines on matters before HHS, including rethinking the use of drugs for depression, weight loss, diabetes and other conditions. Recently he’s been promoting a new government report that calls for scaling back prescription medications in favor of exercise, dietary changes and other alternatives.

“If we rely less on our medical system, less on drugs, it necessitates the spiritual, cultural conversation about what we’re doing to our children’s bodies,” Means said in a recent podcast appearance.

Experts note that government ethics rules are intended to both prevent financial conflict violations, but also the appearance of such conflicts that might undermine public trust in government.

“If I were running the ethics office over at HHS, I sure as heck wouldn’t want anybody going around giving interviews and speeches about government matters that could have an effect on their own financial interests,” Painter said.

A rising star in the MAHA movement

Means’ rapid rise reflects the seeming contradictions within the MAHA movement itself, which urges followers to distrust both big corporations and the government agencies which regulate them.

Means rails against big pharma and food conglomerates, two industries that he says he spent years working for as a consultant in Washington.

Means has no medical training. A graduate of Harvard Business School, he previously ran a bridal gown startup with his wife. On Wednesday, he’s scheduled to be the keynote speaker at FDA’s annual science forum, according to a copy of the program shared with The Associated Press.

He traces his passion for health care reform to the death of his mother from pancreatic cancer in 2021. Shortly thereafter, Means and his sister, Dr. Casey Means, took psychedelics together and had “a mind-blowing, life-changing experience,” which led them to co-author a wellness book, launch separate health startups and begin appearing on podcasts.

Casey Means was recently nominated to be surgeon general and has faced scrutiny over her qualifications, including an unfinished medical residency.

Asked about her nomination, President Donald Trump said: “Bobby thought she was fantastic,” adding that he did not know her.

Meanwhile, her brother has stepped up his rhetoric for the MAHA agenda, recently declaring that Kennedy has “a spiritual mandate to reform our broken system.”

While promoting the administration’s accomplishments, Means does not shy away from plugging his own brand or those of his business partners.

When asked to offer health advice to listeners of a sports podcast, Outkick The Show, in April, Means said: “Read our book, ‘Good Energy.’”

He also recommended blood tests sold by Function Health, which provides subscription-based testing for $500 annually. The company was cofounded by Dr. Mark Hyman, a friend of Kennedy and an investor in Truemed, which also offers Hyman’s supplements through its platform. Casey Means is also an investor in Hyman’s company.

“If you’re sick, most likely you have some kind of nutrient deficiency, some kind of biomarker that you can actually then target with your diet and your supplements,” Calley Means said.

Like dietary supplements, the marketing claims on laboratory tests sold by Hyman are not approved by the FDA. The agency has warned for years about the accuracy of such tests and tried to start regulating them under President Joe Biden.

Experts say MAHA entrepreneurs like Hyman are following a playbook common to the wellness industry: Identify a health concern, market a test to diagnose it and then sell supplements or other remedies to treat it.

“It ends up favoring these products and services that rest on flimsy grounds, at the expense of products that have actually survived a rigorous FDA approval process,” said Dr. Peter Lurie, a former FDA official who is now president of the Center for Science in the Public Interest.

Many of the items sold via Truemed, including sweat tents, cold plunge tanks and light therapy lamps, wouldn’t typically qualify as medical expenses under rules for HSAs, tax-free accounts created by Congress to manage medical costs.

The IRS generally states that HSA purchases must help diagnose, cure, treat, mitigate or prevent disease.

Truemed allows users to request a “letter of medical necessity” from a doctor, stating that the product in question could have medical value for them. Like other telehealth services, there’s usually no real-time communication with the patient. The physician reviews a “simple survey solution,” filled out by the Truemed user, according to the company’s website.

Industry representatives say customers should be careful.

“You need to be prepared to defend your spending habits under audit,” said Kevin McKechnie, head of the American Bankers Association’s HSA council. “Companies are popping up suggesting they can help you manage that process and maybe they can — so the debate continues.”

Americans have an estimated $147 billion in HSA accounts, a potential windfall for companies like Truemed that collects fees for transactions made using their platforms.

Means sees an even bigger opportunity — routing federal funds out of government programs and into more HSAs.

“The point of our company is to steer medical dollars into flexible spending,” Means told fitness celebrity Jillian Michaels, on her podcast last year. “I want to get that $4.5 trillion of Medicare, Medicaid, everything into a flexible account.”

Who benefits most from HSAs?

Means’ pitch for expanding HSAs echoes two decades of Republican talking points on the accounts, which were created in 2003 to encourage Americans in high-deductible plans to be judicious with their health dollars.

But HSAs have not brought down spending, economists say. They are disproportionately used by the wealthiest Americans, who have more income to fund them and a bigger incentive to lower their tax rate.

Americans who earn more than $1 million annually are the group most likely to make regular HSA contributions, according to an analysis by the nonprofit Center on Budget and Policy Priorities. More than half Americans with HSAs have balances less than $500.

Trump’s “One Big Beautiful Bill” would further expand HSA purchases, making gym memberships and other fitness expenses eligible for tax-free spending. That provision alone is expected to cost the government $10 billion in revenue.

“These are really just tax breaks in the guise of health policy that overwhelmingly benefit people with high incomes,” said Gideon Lukens, a former White House budget official during the Obama and Trump administrations, now with the Center on Budget and Policy Priorities.

Expanding HSA eligibility was listed as a goal for a coalition of MAHA entrepreneurs and Truemed partners, founded by Means, which lobbied Congress last year, according to the group’s website.

Means said in a statement that the group focused only on broad topics like “health care incentives and patient choice — but did not lobby for specific bills.”

In total, the HSA expansions in Trump’s bill are projected to cost the federal government $180 billion over the next 10 years. As HSAs expand to include more disparate products and services, Lukens says the U.S. government will have fewer dollars to expand medical coverage through programs like Medicaid.

“We have a limited amount of federal resources and the question is whether we want to spend that on health and wellness products that may or may not be helpful for wealthy people,” Lukens said.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

By KATHERINE ROTH, Associated Press

NEW YORK (AP) — My first tip-off were the little things, the high-pitched little things: the doorbell and ringtones my kids could hear but I could not.

Then it was the garbled-sounding conversations, and the accompanying annoyance of having to ask people to repeat themselves. Or worse, giving up and just playing along without being able to follow everything that was being said.

Even then, I stalled for years before finally going through the process of getting a hearing aid. How do you even begin? Will it look clunky and make me feel like a dinosaur? And the cost!

Getting a hearing test, and confirmation that I needed a hearing aid, was just the beginning.

Finding an expert

The doctor handed me a list of places I could go to get fitted. I made some calls and narrowed it down to the places that took my insurance and my zero-interest health care credit card.

The first couple places were demoralizing: I walked in, was told it’d be $7,000 for the “best” option (they mysteriously didn’t happen to have any other options handy), then marched right back out the door, utterly discouraged.

I started asking friends and neighbors whether they wore a hearing aid, or knew anyone at all with a hearing aid, and could point me to a good audiologist.

It took a lot of poking around, but I found one — and it made all the difference.

The joy of reconnecting with the world

I’ve been wearing my hearing aids for several months now, and they are as easy as slipping on a pair of glasses, are almost invisible, have reconnected me with the world, and, as crazy as this may sound, they bring me joy.

After talking with a few audiologists around the country, it turns out that my experience is pretty typical.

“There are a lot of people who stall before getting one,” says Meagan P. Bachmann, director of audiology at Atrium Health Wake Forest Baptist, in North Carolina.

“Hearing is important because it connects us with people,” she says. “Multiple studies show that not hearing can affect your ability to connect with others and participate in life, so you have to think of it in terms of overall health. Maybe you no longer go to family events, or you don’t understand your doctor. People start to withdraw. A lot of people come in because it’s gotten so bad that it is impacting their relationships.”

Steps to take

To speed up the process and make it less frustrating, here’s what the pros recommend:

1. Get tested, take the results seriously, and know that many if not most hearing aids these days are small, nearly invisible, rechargeable, and pretty easy to wear and maintain. And believe it or not, hearing aids can be fun — these days, there are colors to choose from and ways to bejewel them. One company, Deafmetal, makes jazzy-looking “safety rings” to help keep hearing aids in place.

2. Shop for an expert audiologist. Look for someone who takes your insurance or any sort of medical credit card you might have, or has a payment plan of some kind, if needed. This is a world at the awkward juncture of consumerism and medical care, but a good audiologist should come across as a medical provider, not a salesperson. And a good audiologist should take the time to work with you to find a hearing aid that meets your individual needs, and also fits your budget.

A good place to start is often with your doctor; with the American Academy of Audiologists, which lists providers on its website; or by word of mouth.

“Although all hearing aids are amplifiers, not everybody needs the same thing,” says Bachmann. “Fitting a hearing aid is an art. It changes the acoustics, and everyone is different. You want someone who listens to your lifestyle needs. Do you have a lot of difficulty with noise? Are you mostly in quiet situations? How much technology do you need, and what kind?”

Greta Stamper, an audiologist at the Mayo Clinic in Jacksonville, Florida, agrees. “Hearing loss is not a one-time thing. It’s a chronic health condition. It should be a partnership between you and your audiologist,” she said. “It’s someone asking you what you’re looking for and how it’s going. You shouldn’t feel pressured or pushed.”

3. A note on cost. Although hearing aids can be pricey, there are affordable options, and a good audiologist should be able to let you try out options at several price points. Insurance often covers much of the cost, and there are ways to pay for the remaining cost in installments. Also, avoidance has pretty high costs as well, audiologists say, and the longer the wait, the harder it may be to solve the problem with a hearing aid. Although there are cheaper hearing aids at big box stores, Bachmann warns that it’s good to check with your audiologist before taking that route. “Some of those hearing aids are locked, so that you’re not allowed to have them programmed by an outside audiologist,” she says.

Remember, says Stamper, that hearing aids are an investment, and usually last between five and six years.

4. Know your rights. “We select what is the most likely to be successful, and if it doesn’t work out you come back and do something else,” says Stamper. She said most states mandate a trial period. In some cases, hearing-aid companies also cover the cost of multiple visits to your audiologist while you are getting used to your new hearing aid and get training in how to use and maintain it.

5. Embrace the process, and expect it to take a little time and a few expert tweaks. Audiologists say your brain needs time to adjust to a hearing aid, and that hearing-aid settings should be adjusted little by little as your brain adapts to them.

“A big misconception is that you can just wear them a couple hours a day. Your brain does better with it if you use them most of the day. Your brain needs to adapt to hearing sounds it hasn’t heard for a while, and it takes the brain awhile to relearn how to process all those sounds,” says Stamper.

6. Be realistic. “Although hearing aids can be enormously beneficial, they may not give you back your normal hearing,” says Stamper. Depending on the situation, there might be limitations to what a hearing aid can do.

“It might just be lots of improvement in the key areas in which you’re struggling,” said Stamper.

Using hearing aids is a process, the audiologists say, and although it requires some patience, it can be well worth the journey.

A cancer treatment center in Grand Rapids is bringing the future of medicine into the present. 

BAMF Health, founded and led by Anthony Chang, PhD, is one of the world’s largest Theranostics centers — considered a groundbreaking and less traditional approach to cancer treatment.

It uses full-body scans and smart AI tools to spot disease earlier and choose the right treatment for each patient. The AI algorithms analyze images in seconds, which helps doctors identify tumors, plan therapies, and adjust care on the fly. Researchers at the National Cancer Institute have called it “the next big shift in precision medicine.” 

So, is this kind of technology the future of health care? And where does it fall short?

Chang joined The Metro on Tuesday to discuss how AI and advanced imaging are changing health care, and his plans to open a BAMF Health facility in Detroit this fall.

–WDET’s Jenny Sherman contributed to this report.

Use the media player above to hear the full conversation.

Listen to The Metro weekdays from 10 a.m. to noon ET on 101.9 FM and streaming on-demand.

Trusted, accurate, up-to-date.

WDET strives to make our journalism accessible to everyone. As a public media institution, we maintain our journalistic integrity through independent support from readers like you. If you value WDET as your source of news, music and conversation, please make a gift today.

Donate today »

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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 MIKE STOBBE, AP Medical Writer

NEW YORK (AP) — The nation’s top public health agency posted new recommendations that say healthy children may get COVID-19 vaccinations, removing language that said kids should get the shots.

The change comes days after U.S. Health Secretary Robert F. Kennedy Jr. announced that COVID-19 vaccines will no longer be recommended for healthy children and pregnant women.

But the updated guidance on the Centers for Disease Control and Prevention’s website does not appear to end recommendations for vaccination of pregnant women, a change that was heavily criticized by medical and public health experts.

CDC and HHS officials did not immediately respond to questions about the new guidance.

Kennedy announced the coming changes in a 58-second video posted on the social media site X on Tuesday. No one from the CDC was in the video, and CDC officials referred questions about the announcement to Kennedy and the U.S. Department of Health and Human Services.

On Thursday, the CDC updated its website. The agency said that shots may be given to children ages 6 months to 17 years who do not have moderate or severe problems with their immune systems. Instead of recommending the shots, the CDC page now says parents may decide to get their children vaccinated in consultation with a doctor.

That kind of recommendation, known as shared decision-making, still means health insurers must pay for the vaccinations, according to the CDC. However, experts say vaccination rates tend to be lower when health authorities use that language and doctors are less emphatic with patients about getting shots.

Childhood vaccination rates for COVID-19 are already low — just 13% of children and 23% of adults have received the 2024-25 COVID-19 vaccine, according to CDC data.

Talk of changing the recommendations has been brewing. As the COVID-19 pandemic has waned, experts have discussed the possibility of focusing vaccination efforts on people 65 and older — who are among those most as risk for death and hospitalization.

A CDC advisory panel is set to meet in June to make recommendations about the fall shots. Among its options are suggesting shots for high-risk groups but still giving lower-risk people the choice to get vaccinated. A committee work group has endorsed the idea.

But Kennedy, a leading anti-vaccine advocate before becoming health secretary, decided not to wait for the scientific panel’s review.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

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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?

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

By Sarah Jane Tribble, KFF Health News, Holly K. Hacker, Lydia Zuraw, KFF Health News, KFF Health News

BRANCHLAND, W.Va. — Ada Carol Adkins lives with her two dogs in a trailer tucked into the timbers off Upper Mud River Road.

“I’m comfortable here, but I’m having health issues,” said the 68-year-old, who retired from her job as a school cook several years ago after having a stroke. “Things are failing me.”

Her trailer sits halfway up a ridge miles from town and the local health clinic. Her phone and internet are “wacky sometimes,” she said. Adkins — who is fiercely independent and calls herself a “Mountain Momma” — worries she won’t be able to call for help if service goes out, which happens often.

To Frontier Communications, the telecommunications company that owns the line to her home, Adkins says: “Please come and hook me right.”

But she might be waiting years for better service, frustrated by her internet provider and left behind by troubled federal grant programs.

A quarter of West Virginia counties — including Lincoln, where the Mud River bends its way through hollows and past cattle farms — face two barriers to health care: They lack high-speed internet and have a shortage of primary care providers and behavioral health specialists, according to a KFF Health News analysis.

Years of Republican and Democratic administrations have tried to fix the nation’s broadband woes, through flawed attempts. Bad mapping, weak standards, and flimsy oversight have left Adkins and nearly 3 million other rural Americans in dead zones — with eroded health care services and where telehealth doesn’t reach.

Blair Levin, a former executive director of the Federal Communications Commission’s National Broadband Plan, called one rural program rollout during the first Trump administration “a disaster.”

It was launched before it was ready, he said, using unreliable federal maps and a reverse-auction process to select internet carriers. Locations went to the lowest bidder, but the agency failed to ensure winners had the knowledge and resources to build networks, said Levin, who is now an equity analyst with New Street Research.

The fund initially announced awards of $9.2 billion to build infrastructure in 49 states. By 2025, $3.3 billion of those awards were in default and, as a result, the program won’t connect 1.9 million homes and businesses, according to a recent study.

A $42 billion Biden-era initiative still may not help Adkins and many others shortchanged by earlier federal broadband grants. The new wave of funding, the Broadband Equity, Access, and Deployment Program, or BEAD, has an anti-waste provision and won’t provide service in places where previous grants were awarded — even if companies haven’t delivered on their commitments.

The use of federal money to get people connected is “really essential” for rural areas, said Ross DeVol, CEO and chairman of the board of Heartland Forward, a nonpartisan think tank based in Bentonville, Arkansas, that specializes in state and local economic development.

“Internet service providers look at the economics of trying to go into some of these communities and there just isn’t enough purchasing power in their minds,” DeVol said, adding that broadband expansion is analogous to rural electrification. Without high-speed internet, “you’re simply at a distinct disadvantage,” he added. “I’ll call it economic discrimination.”

‘I Got Books Full’

Adkins keeps spiral-bound notebooks and calendars filled with handwritten records of phone and internet outages.

In January, while bean soup warmed on the stove, she opened a notebook: “I got books full. Hang on.”

Her finger traced the page as she recounted outages that occurred about once a month last year. Adkins said she lost connectivity twice in November, again in October, and in July, May, and March. Each time she went for days without service.

Adkins pays Frontier Communications $102.13 a month for a “bundle” that includes a connection for her house phone and wireless internet access on her cellphone. Frontier did not respond to requests for comment on Adkins’ and other customers’ service.

Adkins, a widow, spends most of her time at home and said she would do video calls with her doctors if she could. She said she still has numbness on one side of her body after the stroke. She also has high blood pressure and arthritis and uses over-the-counter pain patches when needed, such as after she carries 30-pound dog food bags into the house.

She does not own a four-wheel-drive truck and, for three weeks in January, the snow and ice were so severe she couldn’t leave. “I’m stranded up here,” she said, adding that neighbors check in: “‘Do you have electric? Have you got water? Are you OK?’”

The neighbors have all seen Adkins’ line. The pale-yellow cord was tied off with green plastic ties around a pole outside her trailer. As it ran down the hill, it was knotted around tree trunks and branches, frayed in places, and, finally, collapsed on the ground under gravel, snow, and ice at the bottom of the hill.

Adkins said a deer stepping on the line has interrupted her phone service.

David and Billi Belcher’s double-wide modular home sits near the top of the ridge past Adkins’ home. Inside, an old hunting dog sleeps on the floor. Belcher pointed out a window toward where he said Frontier’s cable has remained unrepaired for years: “It’s laying on the ground in the woods,” he said.

Frontier is West Virginia’s legacy carrier, controlling most of the state’s old landlines since buying them from Verizon Communications in 2010. Twelve years later, the company won nearly $248 million to install high-speed internet to West Virginia through the Rural Digital Opportunity Fund, an initiative launched during President Donald Trump’s first term.

“Big Daddy,” as local transit driver Bruce Perry called Trump, is popular with the people of Lincoln County. About 80% of the county’s voters picked the Republican in the last election.

The Trump administration awarded Frontier money to build high-speed internet to Upper Mud River Road residents, like Adkins, according to state mapping. Frontier has until Dec. 31, 2028, to build.

But the Belchers needed better internet access for work and could afford to pay $700 for a Starlink satellite internet kit and insurance, they said. Their monthly Starlink bill is $120 — a price many cannot manage, especially since Congress sunset an earlier program that helped offset the cost of high-speed plans for consumers.

Meanwhile, the latest broadband program to connect rural Americans is ensnared in Trump administration policy shifts.

The National Telecommunications and Information Administration, which administers the program, in April announced a 90-day extension for states to finalize their plans during a “comprehensive review” of the program.

West Viriginia Gov. Patrick Morrisey, a Republican, announced his state would take an extension. The move, though, doesn’t make a lot of sense, said Evan Feinman, who left the agency in March after directing the broadband program for the past three years.

Calling the work already done in West Virginia an “incredible triumph,” Feinman said the state had completed the planning, mapping, and the initial selection of companies. The plan that was in place would have brought high-speed fiber lines to homes ahead of schedule and under budget, he said.

“They could be building today, and it’s just deeply disappointing that they’re not,” Feinman said.

When Feinman resigned in March, he sent a lengthy email stating that the new administration wants to take fiber away from homes and businesses and substitute it with satellite connections. The move, he said, would be more expensive for consumers and hurt rural and small-town America.

Morrisey, whose office declined to respond to requests for comment, said in his announcement that he wants to ensure West Virginia spends the money in a manner “consistent with program changes being proposed by the Trump Administration” and “evaluate a broader range of technology options.”

Commissioners from Grant County responded with a letter supporting fiber-optic cables rather than satellite-based connections like those provided by Elon Musk’s Starlink. Nationwide, 115 lawmakers from 28 states sent a letter to federal leaders stating that changes could “delay broadband deployment by a year or more.”

For Adkins and others, the wait has been long enough.

While legislators in Washington and across the country bickered over the broadband program, Adkins went without phone and internet. By late March, she said, her 42-year-old son was increasingly worried, noting “you’re getting up in age.” He told her: “Mom, move out, get off of that hill.”

Worst-Case Scenario

A few miles from Upper Mud River Road, past the McDonald’s and across the road from the local library, Brian Vance sat in his downtown Hamlin, West Virginia, office. He said his company has been trying to “build up there for a while.”

Vance is a general manager for Armstrong Telephone and Cable, a regional telecommunications provider that competes with Frontier. He grew up in the community, and parents of a high school friend live off Upper Mud River. But he said “it’s very difficult” to build fiber along the rocky terrain to homes where “you are hoping that people will hook up, and if they don’t, well, you’ve lost a lot of money.”

A 2022 countywide broadband assessment found that stringing fiber-optic lines along telephone poles would cost more than $5,000 per connection in some areas — work that would need big federal subsidies to be feasible.

Yet Vance said Armstrong cannot apply for the latest BEAD funding to help finance connections. And while he likes that the federal government is “being responsible” by not handing out two federal grants for the same area, Vance said, “we want to see people deliver on the grants they have.”

If Frontier hadn’t already gotten federal funds from the earlier Trump program, “we definitely would have applied to that area,” Vance said.

The 2022 assessment noted the community’s economy would not be sustainable without “ubiquitous broadband.”

High-speed internet brings more jobs and less poverty, said Claudia Persico, an associate professor at American University. Persico, who is also a research associate with the National Bureau of Economic Research, co-authored a recent paper that found increased broadband internet leads to a reduction in the number of suicides as well as improvements in self-reported mental and physical health.

More than 30% of Lincoln County’s population reports cases of depression, according to data from the Centers for Disease Control and Prevention. The rate of opioid prescriptions dispensed in Lincoln County is down about 60% from 2014 to 2024 — but still higher than the state average, according to the West Virginia Board of Pharmacy.

Twenty percent of the county’s population lives below the poverty line, and residents are also more likely than the national average to experience heart disease, diabetes, and obesity.

Lincoln Primary Care Center offers telehealth services such as electronic medical records on a patient portal and a pharmacy app, said Jill Adkins, chief quality and risk officer at Southern West Virginia Health System, which operates the clinic.

But because of limited access, only about 7% of patients use telehealth, she said.

Della Vance was a patient at the clinic but said she has never used a patient portal. If she could, Vance said, she would check records on the baby she is expecting.

“You can’t really get on if you don’t have good service and no internet,” she said. “It makes me angry, honestly.”

Vance and her husband, Isaiah, live off a gravel road that veers from Upper Mud River. There is a tall pole with black wires dangling across the road from their small home. Pointing to the cables, Isaiah Vance said he couldn’t get phone service anymore.

Verizon announced plans last year to buy Frontier for an estimated $20 billion. The deal, which must be approved by federal and state regulators, is expected to be completed in early 2026, according to an investor’s press release.

In its federal merger application, Frontier stated that it had taken on too much debt after emerging from bankruptcy and that debt would make it difficult to finish the work of installing fiber to customers in 25 states.

In West Virginia, Frontier’s Allison Ellis wrote in March 3 testimony, seeking approval for the merger from state regulators, that Verizon will honor the rural program commitments. The previous month, in February, Frontier filed a motion with the state public service commission to keep the number of customers using copper lines and the faster fiber-optic lines confidential.

Kelly Workman, West Virginia’s broadband director, said during a November interview that her office has asked federal regulators for “greater visibility” into Frontier’s rural program construction, particularly because those locations cannot win the Biden-era infrastructure money when it’s available.

“The worst-case scenario would be for any of these locations to be left behind,” Workman said.

‘Money Cow’

Frontier’s progress installing fiber-optic lines and its unreliable service have frustrated West Virginians for years. In a 2020 letter to the FCC, U.S. Sen. Shelley Capito (R-W.Va.) cited “the failure of Frontier to deliver on promises to federal partners” and its “mismanagement” of federal dollars, which forced the state to pay back $4.7 million because of improper use and missed deadlines.

Michael Holstine, a longtime member of the West Virginia Broadband Enhancement Council, said the company has “just used West Virginia as a money cow.” Holstine has been fighting for the construction of fiber-optic lines in Pocahontas County for years. “I really just hope I get it before I die.”

Across the state, people like Holstine and Adkins are eager for updated networks, according to interviews as well as letters released under a public records request.

Chrissy Murray, vice president of Frontier’s external communications, acknowledged that the company was “building back our community efforts” in West Virginia after a bankruptcy filing and reorganization. She said there has been a “notable decline” in consumer complaints, though she did not provide specific numbers.

Murray said Frontier built fiber-optic cables to 20% of its designated rural funds locations as of the end of 2024. It has also invested in other infrastructure projects across the state, she said in a January email, adding that the company donated high-speed fiber internet to West Virginia University’s rural Jackson’s Mill campus.

According to data tracked by a federal agency, Frontier has connected 6,100 — or fewer than 10% — of the more than 79,000 locations it was awarded in the Rural Digital Opportunity Fund program.

The FCC oversees the rural fund. The agency did not respond to a request for comment. Frontier expects to receive $37 million annually from the agency through 2032, according to a federal filing.

In April, a new batch of letters from West Virginia residents filed as “support” for Frontier’s merger with Verizon appeared in the state regulatory docket:

“My support for this case depends on whether Verizon plans to upgrade or replace the existing Frontier infrastructure,” wrote one customer in Summers County, in the far southern corner of the state, adding, “West Virginians in my neck of the woods have been held hostage by Frontier for a generation now because no other providers exist.”

A customer from Hardy County, in the state’s northeastern corner, wrote: “This is [a] move by frontier to to [sic] escape its responsibility to continue services.”

‘Deep-Rooted’

Adkins moved to Upper Mud River with her husband, Bobby, decades ago.

For years, Bobby and Ada Carol Adkins ran a “carry-out” on Upper Mud River Road. The old building is still at the rock quarry just down the hill and around the curve from where her trailer sits.

It was the type of store where locals kept a tab — which Bobby treated too much like a “charity,” Adkins said. They sold cigarettes, beer, bread, bags of chips, and some food items like potatoes and rice. “Whatever the community would want,” she said.

Then, Bobby Adkins’ “health started deteriorating and money got tighter,” Adkins said. He died at 62 years old.

Now, Adkins said, “I’m having kidney problems. I got arthritis, they’re treating me for high blood pressure.”

Her doctor has begun sending notes over the internet to refill her blood pressure medicine and, Adkins said, “I love that!”

But Adkins’ internet was out again in early April, and she can’t afford Starlink like her neighbors. Even as Adkins said she is “deep-rooted,” her son’s request is on her mind.

“I’m having health problems,” Adkins said. “He makes a lot of sense.”

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

By LEANNE ITALIE, Associated Press

NEW YORK (AP) — Marian Rivman is pushing 80. Harriet Luria is a proud 83. In this trio, Carol Leister is the baby at 62. Together, they have decades of experience with yoga. Only now, it involves a chair.

Chair yoga adapts traditional yoga poses for older people and others with physical challenges, but the three devotees said after a recent class that doesn’t mean it’s not a quality workout. As older adults have become more active, chair yoga has grown in popularity.

“You’re stretching your whole body,” Rivman offered. “What you can do in the chair is a little bit more forgiving on the knees and on the hips. So as you age, it allows you to get into positions that you were doing before without hurting yourself.”

Sitting down to exercise, or standing while holding onto a chair to perform some poses, may not sound like a workout, but Rivman, Luria, Leister and practitioners everywhere see a world of benefits.

“I took it up because I have osteoporosis and the chair yoga is much easier,” Luria said. “You don’t have to worry as much about falling and breaking anything. It’s not as difficult as I thought it would be, but it’s not easy. And you really do use your muscles. It’s an excellent workout.”

Yoga with a chair isn’t just for older people

Chair yoga is clearly marketed to older women, who made up the class where the three yoga friends got together at the Marlene Meyerson JCC on the Upper West Side of Manhattan. But the practice also has a lot to offer others, said their instructor, Whitney Chapman.

Desk workers can squeeze in 15 minutes of chair yoga, for instance. Many companies offer it as a way to cut down on stress and improve overall health. And people recovering from surgery or injuries may not be ready to get down on a yoga mat, but they can stretch in a chair.

“I’ve known these ladies probably 18 to 20 years. And the very first time in a yoga class that I brought in the chair, all of my students said I don’t want geriatric yoga. I’m not an old person,” Chapman said.

“And then they saw that having a chair is just as good as a yoga strap, a yoga block. It’s another prop that’s going to help you do what you want to do. So it’s not necessarily because you’re older, but that it can be helpful. And it doesn’t mean you’re geriatric just because you’re sitting in a chair.”

The benefits are many, Chapman said: improved flexibility, strength, balance. And there’s the overall emotional well-being that yoga practitioners in general report. It’s particularly useful for people with mobility issues or chronic ailments like arthritis or back pain. Chapman also teaches yoga to cancer and Parkinson’s disease patients.

In addition to restorative and other benefits, the practice of chair yoga can help improve posture for people of all ages and abilities, and help older people prevent falls.

A physical practice that can last a lifetime

Leister recently retired.

“I’ve been looking for all different kinds of exercises to do and this is one of them,” she said. “This is the one that I could see doing for the rest of my life, where some that are a little more strenuous I may not be able to do in the future.”

Traditional yoga originated more than 5,000 years ago in India. Many of the poses used today are also that old. It can be as much spiritual as physical, and that also goes for its chair descendant. The precise movements are tied to deliberate, cleansing breathwork.

Rivman has been doing yoga for about 50 years.

“Once you start and you get what it does for your body, you don’t want to give it up. And if there’s a way that you can keep doing it and keep doing it safely, that’s a choice you’re going to make,” she said.

Yoga by the numbers, including chair yoga

The practice of yoga, including chair yoga, has been on the rise in the U.S. over the last 20 years. In 2022, the percentage of adults age 18 and older who practiced yoga in the past 12 months was 16.9%, with percentages highest among women ages 18–44, according to the U.S. Centers for Disease Control and Prevention.

Women are more than twice as likely as men to practice yoga, the data showed. The percentage of adults who practiced yoga to treat or manage pain decreased with increasing family income.

The CDC, didn’t break out chair yoga for analysis but recommends that adults 65 and older focus on activities that improve balance and strength. That, the health agency said, can be achieved through various exercises, including chair yoga.

Why don’t more men do yoga?

Chapman and her students have thoughts on why more men don’t practice yoga. Traditionally, Chapman said, the practice was reserved for men, but as yoga became more westernized, women took over.

“Women tend to be more group-oriented. I would love to see more men in class. I do have a few. I don’t know if they’re intimidated, but you know, it’s a great way to meet women if everybody’s single,” Chapman said with a chuckle.

Luria theorizes that fewer men are drawn to yoga because it’s not a competitive sport.

“You’re really working at your own level,” she said. “Take out the competition and it’s not their thing.”

These chair yoga practitioners have lots of advice. Rivman summed it up best: “Get into a chair and do some yoga. You don’t have to stand on your head, but you have to move. You’re never too old to start.”

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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?”

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

Not so long ago, Lillian Kahan would’ve been an oddity.

She’s 104 years old (“104 and a half,” she corrects), and, until recently, a life of such length was a statistical quirk, rare enough to warrant news coverage or scientific research or at least a cupcake at the local senior center.

These days that’s only half true. Kahan’s age still makes news, and scientists increasingly are interested in people like her. She still gets the odd cupcake.

But the attention isn’t coming because she’s so uncommon. It’s because she’s not.

In fact, being a Kahan – living to 100 and beyond – might be a glimpse of the future.

“Being this old is fun,” Kahan said. “I recommend it.”

Welcome to Ageville

The number of centenarians worldwide has more than doubled over the past 25 years and demographers at the United Nations project that the 100-something crowd will quadruple by mid-century. Today, the biggest centenarian populations are in Japan (146,000) and the United States (108,000). But, soon, countries like China and India, where the overall populations are huge but the aging curve is only now starting to trend upward, will have even bigger 100-something age bubbles. By 2054, nearly 4 million people around the world will be 100 or older.

The trend is expected to be even more pronounced locally. The state projects that from now until 2050, the ranks of centenarians will jump more than fivefold in each of Los Angeles, Orange, Riverside and San Bernardino counties.

Of course, centenarians are just the tip of a bigger demographic spear.

Populations are aging up in most advanced economies, at a rate never before seen in human history. In many countries, older people already outnumber children or they’re expected to in the near future. Aging demographics are reshaping everything from retirement plans and immigration patterns to diaper sales and popular ideals about beauty.

Like many aspects of the aging boom, the rise of centenarians is a mixed bag.

For example, it’s unambiguously good that lifestyle changes and cancer prevention and medical sciences have all improved enough to make it possible for so many people to live so long and, often, so well.

“Every centenarian I’ve met is exceptional,” said Stacy Andersen, who, as co-director of the New England Centenarian Study at Boston University, has met a lot of centenarians.

“These people have delayed chronic, age-related diseases. That’s the baseline. But many also continue to live vibrant lives, to stay engaged in their community and with their families,” she added. “It’s a wonderful view of what aging can be.”

It’s also unambiguously great that younger relatives and friends – everybody under 100, really – can, if they listen, pick up some life hacks that come with living 100 or more years.

“I still love waking up,” said Kahan, her New York accent still thick after six-plus decades in Mission Viejo and other parts of Southern California.

“You should try to do that. It’s pretty important.”

But good things often come with a cost, and the rise of centenarians presents some huge challenges.

Money, health, family hassles; the same issues that plague younger people don’t go away when someone turns 100. But the ability to leap over those hurdles – or, perhaps, to worry about them at all – drops considerably when you become a centenarian.

“I don’t necessarily want to make it to 100,” said Margo Carle, an ombudsman with the Council on Aging Southern California who works as an independent advocate for older people who live in nursing homes and other facilities.

“I see too much of how it can be,” Carle said.

“If you don’t have money, being 100 can be … Well, it’s not always pretty.”

Stresses for all

For Kahan and her 100-something cohorts, the cost of living isn’t cheap.

Though studies show centenarians generally are more physically robust than other older people, age is still age. About half of the 100-something crowd in the United States has some form of dementia, and most of those people need full-time care.

And even among those with little or no cognitive decline, only a small fraction can live on their own without someone – paid or otherwise – checking in every day to help them.

“My sons are all teachers. And they’ve arranged their schedules, they rotate, so they can stay with me,” said Rudolph Marcus, a 101-year-old chemist and former Caltech professor who won the Nobel Prize for Chemistry in 1992.

“That helps me continue with my work,” Marcus said. “I still think about my work every day, to be honest. Some problems I can still solve, some I can’t.

“But I could not do any of that without their help.”

Marcus, who won the Nobel for his work on how electrons jump from atom to atom (something that affects the functionality of solar panels and electric cars, among other things), is an outlier. He lives in the same Pasadena house he shared with his late wife, Laura, who died in 2003. Most people his age live in some kind of congregate setting, which in Southern California can run $5,000 to $15,000 a month.

Given that many newly minted centenarians have outlived their retirement savings, or didn’t have much to begin with, the cost of that care often falls to families and the government.

Soon, half of that equation might change.

A proposal being debated in Congress this month could include big cuts to Medicaid, the federal program that helps pay the costs of long-term care for, among others, centenarians. Those cuts, if passed, could result in lower-quality care or, in some cases, displacement. Other proposed Medicaid adjustments could reduce compensation for in-home care, making it tough for centenarians to live without family help.

For families who don’t want to hire out, or who can’t, the costs of centenarian care can run deeper than money.

Unlike younger retirees, whose adult children typically are young enough to still be working, the children of centenarians often are aged themselves – typically in their 70s or 80s. For them, providing care for an aging parent can be devastating, financially and otherwise.

“In many of the cultures that are common in Los Angeles, it’s an honor to care for your aging relatives,” said Heather Cooper Ortner, chief executive of Alzheimer’s Los Angeles, a nonprofit that helps provide services to people and families battling dementia.

“So it isn’t about people being unwilling to do this, or seeing it as a burden. That’s not always the case,” she said.

“But caring for older people can present an incredible level of stress for family caregivers,” Cooper Ortner added. Food, medical questions and appointments, bathing, bathroom help, fall prevention – caring for a centenarian is, literally, a full-time job. For a child in her 80s, it can be too much.

“It’s not uncommon to see a caregiver pass away before the person they’re caring for,” Cooper Ortner said.

“It’s a very complicated dynamic.”

Survive, delay, escape

The first public service messages warning Americans that smoking causes cancer started airing on television in 1967. A few years later, jogging became a national craze and, over the next two decades, about 25 million Americans started going for a run as a regular part of their lives. Less red meat. More sunblock. Meditation. All of it means one thing:

If you’re on deck to turn 100 this year, you’ve spent about half your life in a world where the phrase “healthy lifestyle” wasn’t a punchline.

It’s one reason, though not the biggest, that explains why so many people are living so long. People who study centenarians – and there are hundreds of aging experts looking into the topic in the United States, Japan and Europe – say genetics and the sheer power of population numbers are even bigger factors.

“At the turn of the last century, life expectancy was about 50. But a lot of things – cleaner water, prevention of infant deaths, antibiotics – made it so a lot more people made it into adulthood. That just means there are a lot more people who are going to have the opportunity to hit 100,” said Andersen, of the New England Centenarian Study.

But at least one projection suggests population numbers alone are only part of the broader trend. Even as more people, overall, hit 100, the ratio of people who reach that age is skyrocketing. According to United Nations data, Japan currently has about 12 centenarians for every 10,000 residents (the ratio in the U.S. is about 3 in 10,000). By 2050, the ratio in Japan will be about 40 out of every 10,000, and in the U.S., it’ll be about 14 out of 10,000.

“Having good, healthy habits can get you about 10 years longer. And it definitely makes those years better, which is important,” Andersen said. “But it doesn’t necessarily get you to 100.”

Genes might.

Andersen said there is no single “centenarian gene.” Instead, researchers have identified about 200 different genes to date that do age-related things like reduce inflammation and boost immune systems. People who have certain combinations of those genes have significantly better odds of making it to 100.

“We’re still trying to understand the relationships between protective genes,” Andersen said. “But it’s more about genetics than we once believed. And we’re learning more about that all the time.”

The New England Centenarian Study, which started in 1994, has tracked the lives of more than 1,800 centenarians, including 123 so-called “supercentenarians,” meaning people who made it to 110 or older. It’s also looked at more than 600 of their children, and more than 400 so-called “controlled” subjects, (usually spouses and relatives of spouses), as a way to identify the balance between genetics, lifestyle and other factors when it comes to cracking 100.

They’ve learned, so far, that so-called “exceptional longevity” – meaning the likelihood of making it to 100 — runs in families. They’ve also learned that many people who tend to live so long hit age-related illnesses later in life, and that they often compress their debilitations into shorter windows.

“Centenarians spend about 10% of their lives with a chronic illness. Others spend about 20% of their lives in that kind of situation, on average,” Andersen said.

The study has identified three basic types of centenarians. About 4 in 10 (43%) are “delayers,” meaning they didn’t experience age-related diseases, like dementia, until age 80 or later. Another 4 in 10 (42%) are “survivors,” meaning they made it to 100 even though they’ve been battling some kind of disease since before their 80th birthday. And about 1 in 7 (15%) are “escapers,” or people who, even at 100, don’t have any age-related disease.

Marcus, the chemist from Caltech, is probably an escaper.

“I don’t play tennis anymore. And I don’t ski. My sight doesn’t really allow it. But otherwise I feel pretty much the same,” he said.

When asked if he’s still learning about himself, at age 101, or if he’s got any advice to someone hoping to live well at his age, Marcus said yes and demurred.

“I’m learning every day. I try to live in the moment. I’d like to think I don’t live in the past and I never thought too much about the future, even when I was younger. And I definitely don’t do it now, at my age,” Marcus said, laughing.

“But I wouldn’t know if that’s what other people should or shouldn’t do,” he added. “It’s just the way I’ve always been.”

Kahan is probably a delayer. She doesn’t have dementia, but she said she battles health issues she declined to offer in detail.

She did offer one tip.

“Every day. I watch some TV, I talk with my friend. I enjoy my day,” Kahan said.

“But time passes very quickly,” she added. “Even at my age, it doesn’t slow down. And I think that means something.”

Anyone interested in participating in the New England Centenarian Study can call 888-333-6327 or email agewell@bu.edu.

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