Melissa Nann Burke, Max Reinhart, Anne Snabes and Ben Warren, MediaNews Group

About 1.4 million Michigan residents eligible to receive federal assistance to pay for food should get 65% of their monthly benefits for November, federal officials clarified Thursday morning.

But hours later, a federal judge in Rhode Island ruled late Thursday that the Trump administration must fully cover November benefits, reportedly saying the government had acted “arbitrarily and capriciously” when it moved earlier this week to only partially fund the program.

The competing orders added another day of confusion for Michigan residents who receive government assistance to pay for groceries through the Supplemental Nutrition Assistance Program (SNAP) as the ongoing federal government shutdown passed its record-setting 37th day.

“These benefits are a vital lifeline for many Michigan families, especially with the rising cost of food.”

Hertel’s agency said Michigan recipients who normally get their benefits on the third, fifth, or seventh day of the month will receive their partial SNAP allotment on Saturday. All other SNAP recipients would get their partial benefits on their normally scheduled date.

“I would say that that’s wonderful that they will be getting something,” said Christopher Ivey, a spokesperson for Metro Detroit food rescue organization Forgotten Harvest, of the SNAP news. “It’s unfortunate that that won’t be the full amount.”

The update came as local food pantries are tracking a 30% to 50% increase in the number of individuals seeking aid, according to the Food Bank Council of Michigan. Hertel noted that families can find local food pantries as needed by calling 2-1-1.

The USDA had planned to suspend payments starting Nov. 1 amid the federal government shutdown, but federal officials said Monday the program would be partially funded after two judges required the government to keep SNAP benefits flowing.

The reduction in food aid, while a partial restoration, is “diabolical,” said Natasha Bell, a downtown Detroit resident.

“What they give us is not enough already, and then for them to give us partial … it’s just not right, you know,” Bell said Thursday. “It’s just not right.”

Bell said she has cancer, so she can’t work. Amid the delay in SNAP benefits, she said she has been making more side items to accompany the meat in a meal, which allows her to stretch the meat out over more days.

Bell is also relying on food pantries and preparing meals that last more than one day, such as spaghetti or soup, she said.

“Something is better than nothing,” said Bell of the partial November SNAP benefits.

Brother Gary Wegner, executive director of the Capuchin Soup Kitchen, said he thinks the USDA announcement is “good news.” Sixty-five percent is “certainly better” than 0%, he said.

“One hundred percent would be even better, but for now, at least, it’s going to give the people we serve who depend upon the SNAP benefits a better chance to fulfill what they need,” Wegner said.

Who is affected?

SNAP serves about 1 in 8 Americans, including about 1.4 million Michiganians. In the state, the average household assisted by the program receives about $335 in benefits a month, or about $5.68 per person a day. SNAP benefits support more than 492,000 Michigan children.

In Wayne County, 22.3% of households received food stamps last year, a figure amplified by the nearly 100,000 households in Detroit that benefit from the SNAP program.

A smaller share of the households in Macomb (11.9%) and Oakland (7.6%) received SNAP benefits, according to the Census Bureau’s 2023 American Community Survey, which is the most recent year when full county-level data is available.

Outside of Metro Detroit, Genesee and Saginaw counties outstripped the state average for SNAP participation, with just under 20% of households. On the other end of the spectrum were Leelanau and Livingston counties, which each had 5% or fewer of their households enrolled in the program.

Across nearly every part of Michigan, households with children were far more likely to receive SNAP benefits than households overall. In almost every county, at least a quarter of households with children participated in SNAP, including more than half of those households in counties like Ottawa, Clinton and Gratiot.

About 78% of SNAP households in Michigan are working households, half of households have someone with a disability and 36% of households have seniors, according to state data.

Kate Bauer, a University of Michigan public health professor, said partial funding is better than nothing when it comes to SNAP benefits. It would “ward off, hopefully, the physical experience of hunger,” but leave families already stretched thin to fill the gap, she said.

“Under the current circumstances, what we need to know is that SNAP is critical to our families having enough food, and even the full benefit amounts are not enough,” Bauer said.

“I’m super glad our families are going to get something, but that is not the end of the story,” she added.

SNAP benefits are crucial for families with children, according to Bauer, “because they have more mouths to feed, and mouths that don’t earn an income.” With less money to buy food this month, she said, parents will likely make additional sacrifices, foregoing meals so their kids can eat.

One saving grace for families with children, she said, was free school meals.

“Many families are breathing a sigh of relief that their kid is getting, potentially, up to 10 meals a week.”

Joyce Bowens, a Detroit resident who uses SNAP, said Thursday that she’s “not too happy” with the government’s decision because 65% of benefits is “not enough.” She said some women have seven to 10 children.

“I don’t think it’s fair,” she said. “I don’t think it’s right.”

Bowens, who went grocery shopping at the Capuchin Services Center in Detroit on Thursday, said the past week has been “stressful.” The pause in benefits has affected how she plans meals. She said, “Everything changed just that fast.”

“OK, you would normally cook a meal, don’t worry about making it stretch,” she said. “Now, we have to think about making it stretch to the T.”

Eartha Harris, 45, who is friends with Bowens, said she thinks the government needs to give people their “full amounts when it comes to food.”

“But at least you could give somebody food, so no one go hungry, regardless of what’s going on,” said Harris, a Detroit resident.

The state Department of Health and Human Services said new applications for SNAP benefits filed in October and November still will be processed, but it is unclear whether those applicants will receive any benefits for November.

State aid to last 2 weeks

To help feed families amid the government shutdown, Gov. Gretchen Whitmer last week said the state would provide $4.5 million to the Food Bank Council of Michigan.

Phil Knight, executive director for the Food Bank Council, said Thursday he expects that $4.5 million released by the state to last about two weeks. The $4.5 million allotment represents roughly 6 million meals, Knight said.

Local pantries have seen between a 30% and 50% jump in individuals seeking aid, he said.

“One of the things I think we kind of miss about this population that’s struggling … is that they’re very resilient,” Knight said. “They’re trying to resolve the problem on their own first. They’re turning inward to themselves, their family, whatever, and then they turn out to find resources.”

Gleaners Community Food Bank reported Thursday that its drive-up mobiles and partner network of 350 local pantries in five counties are seeing an increase of up to 50% in requests for help.

A partial restoration of SNAP support is a “positive development,” Gleaners spokeswoman Kristin Sokul said, “but we expect to continue seeing heightened community need while partial benefits catch up and full benefits remain unavailable, as well as while workers’ incomes are impacted by the prolonged government shutdown.”

Ivey, the Forgotten Harvey spokesman, said the last week has been “very difficult” for his organization. He said Detroit alone gets $58 million a month in SNAP benefits.

“Forgotten Harvest is doing everything they can do to fill that gigantic void that’s out there,” he said. “I mean, we’re never going to be able to be the complete supplement for all of that. It’s just too large for any organization to take on.”

He said Forgotten Harvest is receiving around 600 to 1,000 phone calls a day. Some are from people asking where they can find food. Others are from organizations that partner with Forgotten Harvest or are interested in partnering with it.

Knight of the Food Bank Council said he intends to submit a report next week to the governor and House Speaker Matt Hall, R-Richland Township, on how the money was used and what might still be needed.

Hall said Thursday he and Whitmer will review that report and the federal situation to determine whether to release additional funding to the Food Bank Council for distribution to local pantries.

“We’re going to take this from week to week, working with the governor to assess the need,” Hall said.

The Democratic-controlled Senate last week approved a stopgap proposal that would target $50 million to aid low-income individuals and households in buying food and $21 million to food banks and other assistance programs that are expecting an onslaught of food requests.

The Republican-controlled House has not acted on the legislation.

Hall told reporters last week that the Senate bill was “political” since there was no way to act on the legislation before the Nov. 1 cutoff because of a rule requiring a five-day waiting period between chambers. There is not enough state funding to patch every hole that will develop as the federal shutdown continues, the speaker said.

“There’s a time for disagreements in politics,” Hall said then. “It’s not right now when literally people are about to lose their ability to feed their families.”

Beth LeBlanc contributed to this report.

Thousands of women have been in the initial stages of a legal battle over hair products they believe made them sick.

In 2022, The National Institute of Environmental Health Science, found that women who use hair relaxers frequently increase their risk of developing cancer, and now over 10,000 women who have used the treatment are suing the manufacturers. The findings raise important questions about the risks associated with hair products—risks that are present everyday in a city dubbed the “Hair Capital of the World.”

Aisha Langford, a professor of public health at Wayne State University’s School of Medicine joined the show to explains the important takeaways for consumers and stylists who use relaxers.

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By Paula Span, KFF Health News

Kitty Grutzmacher had contended with poor hearing for a decade, but the problem had worsened over the past year. Even with her hearing aids, “there was little or no sound,” she said.

“I was avoiding going out in groups. I stopped playing cards, stopped going to Bible study, even going to church.”

Her audiologist was unable to offer Grutzmacher, a retired nurse in Elgin, Illinois, a solution. But she found her way to the cochlear implant program at Northwestern University.

There, Krystine Mullins, an audiologist who assesses patients’ hearing and counsels them about their options, explained that surgically implanting this electronic device usually substantially improved a patient’s ability to understand speech.

“I had never even thought about it,” Grutzmacher said.

That she was 84 was, in itself, immaterial. “As long as you’re healthy enough to undergo surgery, age is not a concern,” Mullins said. One recent Northwestern implant patient had been 99.

Some patients need to ponder this decision, given that after the operation, clearer hearing still requires months of practice and adaptation, and the degree of improvement is hard to predict. “You can’t try it out in advance,” Mullins said.

But Grutzmacher didn’t hesitate. “I couldn’t go on the way I was,” she said in a postimplant phone interview — one that involved frustrating repetition, but would have been impossible a few weeks earlier. “I was completely isolated.”

Hearing loss among older adults remains vastly undertreated. Federal epidemiologists have estimated that it affects about 1 in 5 people ages 65 to 74 and more than half of those over 75.

“The inner ear mechanisms weren’t built for longevity,” said Cameron Wick, an ear, nose, and throat specialist at University Hospitals in Cleveland.

Although hearing loss can contribute to depression, social disconnection, and cognitive decline, fewer than a third of people over 70 who could benefit from hearing aids have worn them.

For those who do, “if your hearing aids no longer give you clarity, you should ask for a cochlear implant assessment,” Wick said.

Twenty-five years ago, “it was a novelty to implant people over 80,” said Charles Della Santina, director of the Johns Hopkins Cochlear Implant Center. “Now, it’s pretty routine practice.”

In fact, a study published in 2023 in the journal Otology & Neurotology reported that cochlear implantation was increasing at a higher rate in patients over 80 than in any other age group.

Until recently, Medicare covered the procedure for only those with extremely limited hearing who could correctly repeat less than 40% of the words on a word recognition test. Without insurance — cochlear implantation can cost $100,000 or more for the device, surgery, counseling, and follow-up — many older people don’t have the option.

“It was incredibly frustrating, because patients on Medicare were being excluded,” Della Santina said. (Similarly, traditional Medicare doesn’t cover hearing aids, and Medicare Advantage plans with hearing benefits still leave patients paying most of the tab.)

Then, in 2022, Medicare expanded cochlear implant coverage to include older adults who could identify up to 60% of words on a speech recognition test, increasing the pool of eligible patients.

Still, while the American Cochlear Implant Alliance estimates that implants are increasing by about 10% annually, public awareness and referrals from audiologists remain low. Less than 10% of eligible adults with “moderate to profound” hearing loss receive them, the alliance says.

Cochlear implantation requires commitment. After the patient receives testing and counseling, the surgery, which is an outpatient procedure, typically takes two to three hours. Many adults undergo surgery on one ear and continue using a hearing aid in the other; some later go on to get a second implant.

The surgeon implants an internal receiver beneath the patient’s scalp and inserts electrodes, which stimulate the auditory nerve, into the inner ear; patients also wear an external processor behind the ear. (Clinical trials of an entirely internal device are underway.)

Two or three weeks later, after the swelling recedes and the patient’s stitches have been removed, an audiologist activates the device.

“When we first turn it on, you won’t like what you hear,” Wick cautioned. Voices initially sound robotic, mechanical. It takes several weeks for the brain to adjust and for patients to reliably decipher words and sentences.

“A cochlear implant is not something you just turn on and it works,” Mullins said. “It takes time and some training to get used to the new sound quality.” She assigns homework, like reading aloud for 20 minutes a day and watching television while reading the captions.

Within one to three months, “boom, the brain starts getting it, and speech clarity takes off,” Wick said. By six months, older adults will have reached most of their enhanced clarity, though some improvement continues for a year or longer.

How much improvement? That’s measured by two hearing tests: The CNC (consonant-nucleus-consonant) test, in which patients are asked to repeat individual words, and the AzBio Sentence Test, in which the words to be repeated are part of full sentences.

At Northwestern, Mullins tells older prospective patients that one year after activation, a 60% to 70% AzBio score — correctly repeating 60 to 70 words out of 100 — is typical.

A Johns Hopkins study of about 1,100 adults, published in 2023, found that after implantation, patients 65 and older could correctly identify about 50 additional words (out of 100) on the AzBio test, an increase comparable to the younger cohort’s results.

Participants over 80 showed roughly as much improvement as those in their late 60s and 70s.

“They transition from having a hard time following a conversation to being able to participate,” said Della Santina, an author of the study. “Decade by decade, cochlear implant results have gotten better and better.”

Moreover, an analysis of 70 older patients’ experiences at 13 implantation centers, for which Wick was the lead author, found not only “clinically important” hearing improvements but also higher quality-of-life ratings.

Scores on a standard cognitive test climbed, too: After six months of using a cochlear implant, 54% of participants had a passing score, compared with 36% presurgery. Studies that focus on people in their 80s and 90s have shown that those with mild cognitive impairment also benefit from implants.

Nevertheless, “we’re cautious not to overpromise,” Wick said. Usually, the longer that older patients have had significant hearing loss, the harder they must work to regain their hearing and the less improvement they may see.

A minority of patients feel dizzy or nauseated after surgery, though most recover quickly. Some struggle with the technology, including phone apps that adjust the sound. Implants are less effective in noisy settings like crowded restaurants, and since they are designed to clarify speech, music may not sound great.

For those at the upper end of Medicare eligibility who already understand roughly half of the speech they hear, implantation may not seem worth the effort. “Just because someone is eligible doesn’t mean it’s in their best interests,” Wick said.

For Grutzmacher, though, the choice seemed clear. Her initial testing found that even with hearing aids, she understood only 4% of words on the AzBio. Two weeks after Mullins turned on the cochlear implant, Grutzmacher could understand 46% using a hearing aid in her other ear.

She reported that after a few rough days, her ability to talk by phone had improved, and instead of turning the television volume up to 80, “I can hear it at 20,” she said.

So she was making plans. “This week, I’m going out to lunch with a friend,” she said. “I’m going to play cards with a small group of women. I have a luncheon at church on Saturday.”

The New Old Age is produced through a partnership with The New York Times.

©2025 Kaiser Health News. Visit khn.org. Distributed by Tribune Content Agency, LLC. ©2025 KFF Health News. Distributed by Tribune Content Agency, LLC.

DENVER — Everything in moderation. Including moderation.

That’s the idea behind the Colorado sober movement, an unofficial yet growing trend away from alcohol, and toward plant-based and psychedelic drugs.

But how can one be considered sober while, for example, smoking pot and taking LSD?

Because “Colorado sober” — a spin-off of the similar term “California sober” — isn’t about abstaining from all substances, but rather the ones that are known to have lasting effects on your body and brain, advocates say. That includes drugs such as cocaine and opioids, but also alcohol, which has waned in recent years as the standard social lubricant for young people.

“Weed and mushrooms have a lot less next-day negative effects than alcohol,” said Marissa Poppens, a Denver resident who considers herself Colorado sober. “I’m new to the term but I think people are starting to realize what it means on their own. It’s a version of ‘natural high.’ “

Poppens regularly uses cannabis and microdoses psilocybin — the active psychedelic ingredient in magic mushrooms — not only for recreation, but also to help treat chronic pain and symptoms of multiple sclerosis (MS).

As executive director of the 9-year-old nonprofit MSterios Miracles, Poppens wants to help advocate for and provide resources to people living with MS. She said a flare-up two years ago led to one of her medical professionals suggesting psilocybin. The drug has proven itself as an effective alternative to psychiatric medication, according to licensed psychedelic therapists and researchers, with studies bearing out its transformative effects on depression, PTSD and addiction.

As of 2025, the state’s Natural Medicine Division has begun licensing psilocybin healing centers, which follows Colorado’s recreational legalization of cannabis for people 21 and over in 2014. The combination of those actions — magic mushrooms have been decriminalized since 2022 so it’s not a crime to grow or ingest them, though retail sales are not yet here (as they are for cannabis) — and cultural acceptance has helped Poppens feel better about abandoning alcohol, she said, and find allies in her quest for nontraditional relief.

“I was able to get off my prescribed depression medication, which I hated taking, after I started microdosing,” she said, adding that her regimen is based around wellness, not recreational highs.

In that way, it’s not just a cheeky term for non-drinkers, said Josh Kesselman, owner of the cannabis magazine High Times. It’s an evolving descriptor for people who want to explore, not pummel, their minds.

Research compiled by the Cleveland Clinic has shown that the movement away from alcohol is rooted as much in alcohol’s deleterious effects as increased emphasis on education, mental wellness and healthier lifestyles.

“Alcohol is a depressant and never the answer to a bad day,” said addiction psychiatrist Dr. Akhil Anand in the Cleveland Clinic report. “Gen Z seems to understand that concept, and they’ve moved in a different direction.”

“It’s a great place for many of us to dwell,” Kesselman said. “Cannabis expands the brain, the neural network fires, and synapses connect. We have an endocannabinoid system for a reason.”

Gen Z’s alcohol consumption is dropping rapidly, with a Journal of American Medicine report showing that the percentage of college students abstaining from alcohol was 28% in 2022, as compared with 20% in 2018. Sales of beer have dropped year-over-year, and Pew Research and other reports have shown that the youth movement away from alcohol has rippled out to all age groups.

“I broke up with wine!” reads a testimonial for Feals cannabis gummies, which is categorized under Health/Beauty on Facebook. The image on its social media campaign shows a spilled glass of red wine next to an orange packet of THC and CBD gummies.

“Ten years ago, I would go visit friends in New York, and I could never handle two nights in a row of drinking, because by the third night I’d be useless,” Kesselman said. “Alcohol is something that takes your life force and gives you nothing in return. Plus, when people drink they do terrible things. Nobody’s like, ‘Let’s get stoned and rob people.’ “

Kesselman, who also founded the Raw Rolling Papers company, has a strong business reason for encouraging others to drop alcohol for cannabis. But it’s no smokescreen, he said: There’s not an objectively right or wrong way to be sober, and that can easily include abstaining from substances altogether.

That would not, however, be considered Colorado sober, or even sober-curious. Rather, Colorado sober describes intentional consumption based around wellness, said Ricardo Baca, who was appointed to the state’s first Natural Medicine Advisory Board last year by Gov. Jared Polis.

“The California sober movement was really born out of recreational cannabis, but also the medical movement before it,” Baca said of that state’s pioneering cannabis laws. “So I was glad when I first heard of the Colorado sober movement, because there was space being carved out for our home state to stake this claim around intentional consumption.

“It’s not about restriction or prohibition or a purity test, because we’ve seen how that goes,” he added, “but about redefining sobriety and aligning with plants and mushrooms and chemical-based alternatives.”

That covers purely synthetic substances that have shown positive, peer-reviewed results as medical treatments — but that can also have their own party-ready uses as recreational drugs. Think ketamine, MDMA (a.k.a. ecstasy or molly), kratom and DMT.

Baca has long studied the subject, both as the former editor of The Denver Post’s groundbreaking Cannabist journalism site, as well as founder and owner of Denver’s Grasslands PR and marketing agency. His clients include cannabis, psilocybin, kratom and other companies — including High Times’ Kesselman. He’s delivered TEDx Talks and keynotes at South by Southwest and other conferences detailing how cannabis works in pain management and the effects of its legalization.

He acknowledged his company benefits by boosting the Colorado sober trend, but said that it’s more about harm reduction than profit.

“We’ve seen the California sober movement co-opted by brands and businesses, and we will absolutely see the Colorado sober movement co-opted by similar brands,” Baca said. “I don’t see anything wrong with it, that myself and other marketers and businesses will take advantage of this to help tell their own stories. It’s still an organic trend that came from the community.”

On the other hand, the idea of being Colorado sober soft-pedals the potentially addictive effects of cannabis and psychedelics, said Alton P. Dillard II, a media consultant for the One Chance to Grow Up nonprofit. The Colorado organization includes a number of top medical and academic advisors advocating against drug use for young people.

“We recognize the intense toll of alcohol addiction and understand that adults make choices that they think best support their health,” he said. “The problem for youth is that they are already getting confusing messages that marijuana and psilocybin mushrooms are healthy, natural medicines.

“In fact, they both present significant risks to young brains, which are growing until age 25,” he continued. “When weed and mushrooms are presented as part of a ‘sober’ lifestyle, teens may get the impression that they’re harmless. They’re not.”

High Times’ Kesselman said the Colorado sober movement is not about pushing anyone toward drugs.

“Just like with anything else, people have to consume within their own limits, and we at High Times do not recommend any kind of overconsumption,” he said. “But what that means to one person might be different than someone else, and you have to find that balance in your own life. This is a way to change your thinking, not just your chemistry.”

One of the biggest issues Detroiters face has to do with their homes. There are a fair number of homes in the city, but over 20,000 of them are in dire need of repairs. That includes leaky roofs, electricity issues, and asbestos in the walls. 

The problem is large, but one retired firefighter, Gary Ringer, is trying to chip away at it. The Detroiter, who mostly helps people on the West Side, has been spending a lot of his time going to peoples’ homes, and assisting them with repairs. 

What inspires Gary’s volunteerism? What are the repairs people need? And, with the mayoral election next week, what kinds of investments does he think the next mayor should make to facilitate more home repairs? 

 

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

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By John Tozzi, Bloomberg News

Cigna Group will eliminate prescription drug rebates in many of its commercial health plans in 2027, upending an opaque, controversial practice that’s drawn the ire of President Donald Trump.

The insurer will expand the rebate-free model to clients of its pharmacy benefits business starting in 2028. The plan to eventually phase out rebates more broadly portends a seismic shift in the flow of billions of dollars among drugmakers, insurers and employers.

Cigna said it aims to lower patients’ costs at the pharmacy counter with up-front discounts rather than rebates collected from drugmakers long after a medication is dispensed. The company, which has faced criticism over rebates for years, said it’s responding to changes in the marketplace, including the Trump administration’s efforts to lower prices in the U.S.

“The dynamic has changed in terms of where the market is headed,” Adam Kautzner, president of Cigna’s Express Scripts pharmacy benefits division, said in an interview. “We see this as an opportunity to lower the costs for Americans on branded drugs.”

Pharmacy benefit managers, or PBMs, contract with drugmakers and pharmacies to run prescription drug plans for employers, health plans and government programs. That system has long relied on rebates — payments drugmakers make to the PBM after a prescription is filled. The value of drug rebates and other discounts reached $356 billion last year, according to researcher Drug Channels Institute.

Pharmaceutical companies pay the rebates in order to get favorable placement on PBMs’ lists of covered drugs, a practice that critics have likened to kickbacks. The two industries have been embroiled in a vitriolic fight, with each side blaming the other for inflated U.S. drug prices that far outstrip costs in other wealthy countries.

Drugmakers complain that patients don’t see the full benefit of rebates. PBMs say they pass nearly all of the money back to their clients, who can use it to lower premiums or offset other costs. Some employers say rebates create warped incentives, because PBMs are collecting money from the drugmakers with which they’re supposed to be negotiating.

Patients who have high-deductible plans can wind up paying the full cost of their medications when they fill prescriptions, while the rebate from that drug goes to their employer later on.

Kautzner said Cigna aims to eventually do away with all that for its private prescription drug plans. People with high-deductible plans will see a 30% discount on average for brand medications, he said.

The change will initially apply to about 2 million of Cigna’s fully insured health plan members. In 2028, it will become the standard option for Express Scripts clients, though they’ll be able to continue with rebate-based models if they choose. It won’t apply to drug benefits for government programs like Medicare and Medicaid.

Health and Human Services Secretary Robert F. Kennedy Jr. praised Cigna in a social media post for what he said was “greater transparency and lower drug prices on brand-name medicines” that aligns with administration’s vision.

The move is part of an industry effort to get ahead of regulations, and “could pave way for formal agreement” between the industry and Washington, TD Cowen analyst Charles Rhyee wrote. He said Cigna’s plan “strikes many similar notes” to prior announcements by CVS Health Corp.

Cigna shares rose 2% at 12:37 p.m. in New York.

Trump target

The announcement comes months after Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services, urged PBMs to voluntarily do away with what he called the “rebate-slash-kickback system.”

During his first term, Trump tried to do away with rebates by regulation. The effort faltered after court challenges. He attacked PBMs after he was reelected last year, calling them the “horrible middleman” and saying that they “don’t do anything.”

Cigna’s Express Scripts is the largest of the three leading PBMs, along with CVS’s Caremark unit and UnitedHealth Group Inc.’s Optum Rx. All three have been targeted by lawmakers and the Federal Trade Commission, which sued the companies last year alleging that rebates drove up the cost of insulin. The companies dispute that and the litigation, in an internal FTC tribunal, is pending.

Cigna Chief Executive Officer David Cordani praised Trump “for taking decisive action to help lower costs for brand-name medicines that have long been controlled by drug companies,” in a statement to Bloomberg News.

Cajoling from the Trump administration has led pharmaceutical companies including Pfizer Inc. and AstraZeneca Plc to offer some of their products at lower prices to government programs in exchange for a reprieve on potential tariffs. Drugmakers have also tested some “direct-to-consumer” programs for popular weight-loss medications and other products meant to offer discounts for people paying cash.

Cigna said it will ensure members don’t pay more than the discounted direct-to-consumer or cash prices offered by drug companies, if those are less than the company’s negotiated rate. It’s also expanding a program meant to ensure fair reimbursements to pharmacies.

Other PBMs have made moves to head off a tougher crackdown from Washington. Earlier this year, Optum Rx said it would move to pass 100% of rebates to clients. CVS Caremark has promoted a model intended to give rebates to patients when they fill prescriptions.

Replacing rebates

For Cigna to replace rebates with up-front discounts, it will have to renegotiate contracts with drugmakers, employers and health plans. Kautzner said drugmakers will welcome the change, because reducing out-of-pocket costs will make it more likely patients fill their prescriptions and stay on their medications.

“They would also like to see a lower patient out-of-pocket cost,” he said. Kautzner said he expects Cigna will be able to negotiate better discounts with pharmaceutical companies going forward.

The goal is to get half of employer and health plan clients to adopt the model within three years, Kautzner said. Express Scripts has about 100 million members.

Because some clients use rebate payments to offset premium costs, eliminating rebates could risk raising premiums. Kautzner disputed that it would lead to higher costs.

“We do not expect that there will be any raising of premiums,” he said.

Rebate benefits

PBMs have spent years defending the rebate system. The website of Cigna’s Evernorth division, which includes the PBM, says that “without the ability to deliver rebates, health care costs would be much higher.”

Kautzner said that rebates will continue to exist “for the foreseeable future,” though the company wants to move the industry to a simpler, more transparent approach. It’s one some smaller PBMs have long attempted to implement.

Cigna and its larger rivals have also opened up new revenue streams from drugmakers in recent years, in the form of other fees that aren’t called rebates but look similar. These fees, collected by affiliates called group purchasing organizations, are often structured as a percentage of the drug’s list price. Kautzner said other compensation the company gets from drugmakers would no longer be linked to list prices.

Kautzner said Cigna is “making investments” in the new model but declined to say how the change would affect its business going forward.

“We think it’s completely manageable,” he said. “We remain confident in the long-term durability of our margin profile.”

(With assistance from Phil Kuntz.)

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

By Chabeli Carrazana for The 19th

In America, diapers have long been treated as a luxury good rather than a necessity.

Half of families with young kids struggle to afford all the diapers they need. A quarter of families miss work as a result, often because they don’t have enough diapers to send with their children to child care.

It’s a largely invisible issue with enormous consequences for the health of parents and children. Studies have found that diaper need is a greater contributor to postpartum depression than food insecurity and housing instability. And when parents don’t have enough diapers, they make do with sanitary pads, rags or other materials. Some report having to leave their children in soiled diapers for extended periods, raising the risk for urinary tract infections and diaper rash.

So Amy Kadens, who has worked in the diaper space for nearly 15 years, wondered: What if diapers were free for the parents who need them most? For decades, the United States has not had a good answer. So she came up with her own The 19th reports.

Diaper banks started popping up across the nation in 2011, collecting donations and dispersing diapers to families through a complex network of local partnerships. They are one of the few lifelines for parents.

Kadens, who co-founded a nonprofit that provides diapers called Share our Spare in 2011, knew that diaper banks often operate with limited staff and resources, and operationally can only address a small percentage of a massive need. Without more government support, they can only get at a slice of the problem.

Federal assistance programs that help low-income families, such as food stamps and the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), have never allowed families to use those funds to purchase diapers.

“Diaper banks are doing heroic work with very little. I didn’t want to reinvent the wheel,” Kadens said. But, “I wanted to continue to sink my teeth into this.”

So Kadens started to work on a solution that could give people the funds to get whatever diapers they needed, without the warehouses to store donations or the teams to get those donations out.

That solution was Diaper Dollars, a $40 e-card that users get in their email every month. The virtual card comes with a barcode they can scan at checkout at most major retailers, including Walmart, CVS and Walgreens, that will cover the cost of diapers. So far, users in Illinois and Ohio can access the program.

The idea, Kadens said, was to make it as simple as possible, while also giving parents the ability to choose what brands they preferred.

“Families have brand loyalty,” Kadens said. “I wanted to keep dignity and choice at the forefront of everything we did.”

The Diaper Dollars team went through months of market research to refine the tech to work well for participants. They didn’t want coupons because there was too much fraud in the system, and gift cards meant users could be limited on where to shop.

Instead, they landed on a system that allowed them to build out a catalog of diapers at 6,200 retail locations in the country. The bar code on the digital card recognizes the diapers when it’s scanned and deducts the price from the total purchase. That catalog of diapers is monitored daily and updated in case brands come out with new box sizes or products. It also works for online purchases.

The system does have some limitations. It’s not valid in Amazon or Target, two retailers that don’t yet accept that form of payment. And it also likely only covers a portion of the need: The average family spends about $100 on diapers a month, but families earning a median income can only afford to cover about $65, according to an analysis by the Urban Institute. It’s also more expensive — parents are paying retail prices plus sales tax (23 states charge sales tax on diapers, including Illinois). By contrast, products at diaper banks are donated or sold to the banks from the manufacturer at deeply discounted rates.

To find participants, Diaper Dollars partners with organizations such as WIC clinics and local hospitals to refer people to the program, which is funded from a mix of philanthropy and financial support from those same partners. Partners establish the eligibility criteria, how long participants can be a part of the program, and whether the stipend will be higher for those with multiple babies.

A pilot program launched in 2023 with 100 people, then in 2024 the Illinois Department of Human Services dedicated $1 million to run its own pilot at a larger scale. Nearly 8,000 people have been served so far, with 10,000 projected by 2026.

Illinois Lt. Gov. Juliana Stratton told The 19th that she had been looking for solutions that could support people in the postpartum period, when maternal mortality is high, particularly for Black women. Diaper need, specifically, is linked to maternal mental health and considered a potential risk factor for moderate to high maternal depressive symptoms. According to the Centers for Disease Control and Prevention, in 2023, the maternal mortality rate for Black women was 50.3 deaths per 100,000 live births. For White women it was 14.5 deaths.

So when Illinois launched a birth equity initiative to address the needs of postpartum parents, from a home visiting program to better diaper access, it chose to partner with Diaper Dollars.

“Giving someone a card where they can go to the store of their choice, decide what’s best, that is what’s part of dignity,” Stratton said. “Every woman deserves to bring life into this world safely and with dignity.”

Brendan Kitt, Diaper Dollars’ program director, said the program was able to offer an operational solution to a problem the state wanted to address but didn’t have a mechanism for. The system works similarly to a universal basic income, where people in need are given a cash stipend, but it’s more targeted.

“Both for funders and supporters, it’s always a question when you talk to people about where the money goes,” he said. “The fact that we can limit the transactions to the specific needs that we’re trying to serve, I think, is one of the biggest things that legitimized our operation over just giving basic cash assistance.”

Parents who benefited from Diaper Dollars told the organization in testimonials that they’ve had to turn to using underwear or old T-shirts when they didn’t have the money for diapers, often making decisions between paying for rent or diapers.

After going through the program, parents reported that the funds gave them the wiggle room to buy their children other essentials or to make them better meals.

About 90 percent of those who went through the program reported being able to better afford essentials like food, rent and other bills. Some 95 percent felt less stressed about not having enough diapers.

Joanne Samuel Goldblum, the CEO of the National Diaper Bank Network, which has more than 240 partners nationwide, said a model like Diaper Dollars can address unmet needs, particularly in rural areas where it’s harder for diaper banks to distribute products.

“The need is really so big, and it’s not going to be addressed through just one sort of answer or one type of program,” Samuel Goldblum said. “It’s really important to have ways to reach people in all sorts of different communities.”

The Diaper Dollars program has raised about $2 million so far — 45 percent from the state of Illinois, 35 percent from philanthropic donors and 20 percent from grants from community partners. It is now also running in Ohio and expected to expand to Washington soon.

Kadens’ dream is to take the program to every state. Since Roe v. Wade was overturned and some red states instituted abortion bans, conservative lawmakers have been looking for ways to support postpartum parents.

In Tennessee, for example, where abortion was banned in 2022, the state rolled out a new policy in 2024 that allowed families enrolled in Tennessee’s Medicaid program to receive up to 100 free diapers a month for the first two years of life.

Samuel Goldblum said the National Diaper Bank Network has seen more bipartisan support for addressing diaper needs this year “than we’ve ever seen before.”

It should be that simple, Kadens said: “It doesn’t matter if you’re blue or red. Babies need diapers.”

This story was produced by The 19th and reviewed and distributed by Stacker.

By ADRIANA GOMEZ LICON, Associated Press

The U.S. Department of Agriculture has posted a notice on its website saying federal food aid will not go out Nov. 1, raising the stakes for families nationwide as the government shutdown drags on.

The new notice comes after the Trump administration said it would not tap roughly $5 billion in contingency funds to keep benefits through the Supplemental Nutrition Assistance Program, commonly referred to as SNAP, flowing into November. That program helps about 1 in 8 Americans buy groceries.

“Bottom line, the well has run dry,” the USDA notice says. “At this time, there will be no benefits issued November 01. We are approaching an inflection point for Senate Democrats.”

The shutdown, which began Oct. 1, is now the second-longest on record. While the Republican administration took steps leading up to the shutdown to ensure SNAP benefits were paid this month, the cutoff would expand the impact of the impasse to a wider swath of Americans — and some of those most in need — unless a political resolution is found in just a few days.

The administration blames Democrats, who say they will not agree to reopen the government until Republicans negotiate with them on extending expiring subsidies under the Affordable Care Act. Republicans say Democrats must first agree to reopen the government before negotiation.

Democratic lawmakers have written to Agriculture Secretary Brooke Rollins requesting to use contingency funds to cover the bulk of next month’s benefits.

But a USDA memo that surfaced Friday says “contingency funds are not legally available to cover regular benefits.” The document says the money is reserved for such things such as helping people in disaster areas.

It cited a storm named Melissa, which has strengthened into a major hurricane, as an example of why it’s important to have the money available to mobilize quickly in the event of a disaster.

The prospect of families not receiving food aid has deeply concerned states run by both parties.

Some states have pledged to keep SNAP benefits flowing even if the federal program halts payments, but there are questions about whether U.S. government directives may allow that to happen. The USDA memo also says states would not be reimbursed for temporarily picking up the cost.

Other states are telling SNAP recipients to be ready for the benefits to stop. Arkansas and Oklahoma, for example, are advising recipients to identify food pantries and other groups that help with food.

Sen. Chris Murphy, D-Conn., accused Republicans and Trump of not agreeing to negotiate.

“The reality is, if they sat down to try to negotiate, we could probably come up with something pretty quickly,” Murphy said Sunday on CNN’s “State of the Union.” “We could open up the government on Tuesday or Wednesday, and there wouldn’t be any crisis in the food stamp program.”

NEW YORK (AP) — The stunning indictment that led to the arrest of more than 30 people, including Miami Heat guard Terry Rozier and other NBA figures, on charges of illegal sports betting has drawn new scrutiny of the booming business of professional sports gambling across the U.S.

Since widespread legalization, the multibillion-dollar industry has made it easy to place wagers on everything from the outcome of games to that of a single play with just a few taps of a cellphone. It’s just about impossible to go to a basketball, football, baseball or other pro game today — or watch a matchup on TV — without seeing ads for sports betting.

Fans can place wagers from their stadium seats, while “Bet” tickers scroll on TV sports broadcasts. Star athletes are frequently at the center of ads promoting it all.

Regulating sports wagering has proven to be a challenge — and experts warn about the ramifications for gamblers who typically lose money. Professional leagues’ own role in promoting gambling has raised eyebrows.

Sports betting also faces criticism for opening the door to addictive gambling.

“The fact that it’s normalized, the advertising is aggressive, it’s available 24/7, the micro bets — all of this is adding up to tremendous increase in usage across individuals,”  Wayne Taylor, a professor of marketing at Southern Methodist University, told the Associated Press, citing algorithms and other incentives betting platforms use to increase engagement.

Isaac Rose-Berman, whose research focuses on sports betting as a fellow at the American Institute for Boys and Men, noted that platforms make the most off of returning “biggest losers.” Recent research suggests that young men in low-income communities are particularly affected by financial consequences tied to sports gambling.

“Upwards of 90% of sports bettors are not really going to experience significant negative impacts — but it’s really concentrated among those big losers and it’s going to be devastating for them,” he said.

So, how do you know if you have a gambling problem?

If you’re hiding the fact that you gamble to your friends and family, do it when you’re stressed and experience mood changes, you may be showing warning signs of a gambling addiction. The Associated Press explains in the video below:

Kim Kardashian got candid about a recent health scare, revealing on the season 7 premiere of “The Kardashians” that she’d been diagnosed with a brain aneurysm.

The SKIMS founder fought back tears while talking about the diagnosis in a trailer that played at the beginning of Thursday’s season opener.

In the clip, the 45-year-old can be seen lying in an MRI machine and later telling her family the scan found “a little aneurysm.”

According to the Mayo Clinic, a brain aneurysm is “a bulge or ballooning in a blood vessel in the brain.” Though most aren’t serious, especially if they’re small, the condition can become life-threatening if an aneurysm ruptures, causing bleeding in the brain.

Kardashian went on to tell her family that her doctor blamed the aneurysm on stress. Elsewhere in the premiere, she admitted that a lot of her stress comes from her ex-husband, Kanye West, with whom she shares four kids between the ages of 6 and 12.

“I feel more stressed probably just because I have to protect my kids,” she said. “Everyone around can handle (the drama), but I want to protect my babies.”

She noted that for years she’s been “able to hide” her ex-husband’s controversies and public outbursts from their kids, but it’s getting harder to do so as they get older. Kardashian later said her relationship with West feels like “a little bit of Stockholm syndrome.”

“I always felt really bad and always wanted to help,” she explained. “(People think) I should have stuck it out and I could have helped. … (But) as much as people think that I have the luxury of walking away and not dealing ever again, that’s not my reality. This person — we have four kids together.”

Kardashian also partly blamed her ongoing psoriasis flare-ups to the stress of co-parenting with West.

“I haven’t had psoriasis since my divorce (in 2021), but it’s starting to come back,” Kardashian told a producer while looking at the red rashes on her legs. “It always flares up whenever I start feeling stressed.”

Still, the mother of four said she isn’t looking for an apology from her ex and just wants to find peace no matter how he behaves.

“I’m not looking for it,” she explained. “I don’t care. Is it sad, it’s so f—ing sad. But I can’t stress too much about that. I have to worry about other things.”

By Tony Leys, KFF Health News

Companies running private Medicare and Medicaid insurance plans inaccurately list many mental health professionals as being available to treat the plans’ members, a new federal watchdog report says.

The investigators allege that some insurers effectively set up “ghost networks” of psychologists, psychiatrists, and other mental health professionals who purportedly have agreed to treat patients covered by the publicly financed Medicare and Medicaid plans. In fact, many of those professionals do not have contracts with the plans, do not work at the locations listed, or are retired, the investigators said.

The Office of Inspector General for the Department of Health and Human Services, which oversees the giant Medicare and Medicaid health programs, released its findings in a recent report.

The report focuses on insurers the government pays to cover people in Medicare Advantage plans and in privately managed Medicaid plans. About 30% of all Americans are covered by such insurance, the report says. The government pays the insurers hundreds of billions of dollars annually.

The companies are paid set rates per person they cover and are allowed to keep whatever money they don’t spend on patient care. The insurers are required to have adequate numbers of health care professionals under contract to serve patients in each region they cover.

But the new report found that 55% of mental health professionals listed as in-network by Medicare Advantage plans were not providing such care to any of the plans’ members. The figure was 28% for Medicaid managed care plans.

Some mental health professionals told investigators they shouldn’t have been listed as in-network care providers for the insurers’ members, because they no longer worked at the locations listed or because they didn’t participate in the Medicare Advantage or Medicaid managed care plans. Others said they were working as administrators and no longer providing patient care.

In one case, the report says, a private Medicaid plan listed a mental health professional as providing care in 19 practice locations. But when the investigators checked, a receptionist at one of the clinics said the person had retired a few years ago.

Jeanine Simpkins of Mesa, Arizona, learned how skimpy the networks can be when a 40-year-old family member was in crisis this fall. Simpkins struggled to find a drug rehabilitation program that would accept the Medicare Advantage insurance the relative is on because of a disability.

Simpkins said she contacted about 20 rehab programs, none of which would take the Medicare insurance plan. “You feel kind of dropped,” she said. “I was pretty surprised, because I thought we had something good in place for her.”

Simpkins’ relative eventually enrolled in part-time hospital care instead of an inpatient rehabilitation center.

It can be challenging for patients to find timely, nearby care, for all kinds of health problems, from colds to cancer.

But Jodi Nudelman, a regional inspector general who helped write the federal report, said in an interview that the stakes can be especially high for patients seeking mental health care.

“They can be particularly vulnerable,” she said. It can be daunting for people to acknowledge they need such care, and any roadblock can discourage them from trying to find help, she said.

She added that taxpayers aren’t getting their money’s worth if insurers fail to meet obligations to provide sufficient care options for Medicare and Medicaid participants in the plans.

The federal report focused on a sample of 10 counties in five states: Arizona, Iowa, Ohio, Oregon, and Tennessee. It included urban and rural areas. It did not identify the insurers whose networks were checked.

Susan Reilly, vice president of communications for the Better Medicare Alliance, a trade group representing Medicare Advantage plans, said managed care companies support federal efforts to improve access to mental health services. “While this report looks at a small sample of plans, we agree there’s more work to do and are committed to continuing that progress together with policymakers,” she said in a statement.

The report’s authors said their sample was a good representation of the national situation. It looked at 40 Medicare Advantage plans and 20 Medicaid managed care plans.

The report recommends government administrators make more use of medical billing data to confirm whether health professionals listed as in-network are providing care to patients covered by private Medicare and Medicaid insurance plans.

The watchdogs also recommend that federal regulators create a national, searchable directory of mental health providers, listing which Medicare and Medicaid insurance plans each one accepts. Such a directory would help patients find care and would make it easier to double-check the accuracy of plans’ listings of in-network providers, they said.

Federal administrators overseeing Medicare and Medicaid have taken steps toward creating such a directory, the authors said. Reilly, the industry representative, said managed care companies support the effort.

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

By Stephanie Armour, KFF Health News

While plowing a wheat field in rural Washington state in the 1990s, William Wallace spotted a gray plane overhead that he believed was releasing chemicals to make him sick. The rancher began to suspect that all white vapor trails from aircraft might be dangerous.

He shared his concern with reporters, acknowledging it sounded a little like “The X Files,” a science fiction television show.

Academics cite Wallace’s story as one of the catalysts behind a fringe concept that has spread among adherents to the Make America Healthy Again, or MAHA, movement and is gaining traction at the highest levels of the federal government. Its treatment as a serious issue underscores that under President Donald Trump, unscientific ideas have unusual power to take hold and shape public health policy.

The concept posits that airplane vapor trails, or contrails, are really “chemtrails” containing toxic substances that poison people and the terrain. Another version alleges planes or devices are being deployed by the federal government, private companies, or researchers to trigger big weather changes, such as hurricanes, or to alter the Earth’s climate, emitting hazardous chemicals in the process.

Several GOP lawmakers and leaders in the Trump administration remain convinced the concepts are legitimate, though scientists have sought to discredit such claims.

Health and Human Services Secretary Robert F. Kennedy Jr. is planning to investigate climate and weather control, and is expected to create a task force that will recommend possible federal action, according to a former agency official, an internal agency memo obtained by KFF Health News, and a consultant who helped with the memo.

The plans, along with comments by top GOP lawmakers, show how rumors and conspiracy theories can gain an air of legitimacy due to social media and a political climate infused with falsehoods, some political scientists and researchers say.

“When we have low access to information or low trust in our sources of information, a lot of times we turn to our peer groups, the groups we are members of and we define ourselves by,” said Timothy Tangherlini, a folklorist and professor of information at the University of California-Berkeley. He added that the government’s investigation of conspiracy theories “gives the impression of having some authoritative element.”

HHS is expected to appoint a special government employee to investigate climate and weather control, according to Gray Delany, former head of the agency’s MAHA agenda, who said he drafted the memo. The agency has interviewed applicants to lead a “chemtrails” task force, said Jim Lee, a blogger focused on weather and climate who Delany said helped edit the memo, which Lee confirmed.

“HHS does not comment on future or potential policy decisions and task forces,” agency spokesperson Emily Hilliard said in an email.

The memo alleges that “aerosolized heavy metals such as Aluminum, Barium, and Strontium, as well as other materials such as sulfuric acid precursors, are sprayed into the atmosphere under the auspices of combatting global warming,” through a process of stratospheric aerosol injection, or SAI.

“There are serious concerns SAI spraying is leading to increased heavy metal content in the atmosphere,” the memo states.

The memo claims, without providing evidence, that the substances cause elevated heavy-metal content in the atmosphere, soil, and waterways, and that aluminum is a toxic product used in SAI linked to dementia, attention-deficit/hyperactivity disorder, asthma-like illnesses, and other chronic illnesses. The July 14 memo was addressed to White House health adviser Calley Means, who didn’t respond to a voicemail left by a reporter seeking comment.

High-level federal government officials are presenting false claims as facts without evidence and referring to events that not only haven’t occurred but, in many cases, are physically impossible, said Daniel Swain, a climate scientist at the University of California.

“That is a pretty shocking memo,” he said. “It doesn’t get more tinfoil hat. They really believe toxins are being sprayed.”

Kennedy has previously promoted debunked chemtrail theories. In May, he was asked on “Dr. Phil Primetime” about chemicals being sprayed into the stratosphere to change the Earth’s climate.

“It’s done, we think, by DARPA,” Kennedy said, referring to a Department of Defense agency that develops emerging technology for the military’s use. “And a lot of it now is coming out of the jet fuel. Those materials are put in jet fuel. I’m going to do everything in my power to stop it. We’re bringing on somebody who’s going to think only about that.”

DARPA officials didn’t return a message seeking comment.

Federal messaging

Deploying chemtrails to poison people is just one of many baseless conspiracy theories that have found traction among Trump administration health policy officials led by Kennedy, a longtime anti-vaccine activist before entering politics. He continues to promote a supposed link between vaccines and autism, as well as make statements connecting fluoride in drinking water to arthritis, bone fractures, thyroid disease, and cancer. The World Health Organization says fluoride is safe when used as recommended.

Delany, who was ousted in August from HHS, said Kennedy has expressed strong interest in chemtrails.

“This is an issue that really matters to MAHA,” said Delany, referring to the informal movement associated with Kennedy that is composed of people who are skeptical of evidence-based medicine.

The memo also alleges that “suspicious weather events have been occurring and have increased awareness of the issue to the public, some of which have been acknowledged to have been caused by geoengineering activities, such as the flooding in Dubai in 2024.” Geoengineering refers to intentional large-scale efforts to change the climate to counteract global warming.

“It is unconscionable that anyone should be allowed to spray known neurotoxins and environmental toxins over our nation’s citizens, their land, food and water supplies,” Delany’s memo states.

Scientists, meteorologists, and other branches of the federal government say these assertions are largely incorrect. Some points in the memo are accurate, including concerns that commercial aircraft contribute to acid rain.

But critics say the memo builds on kernels of truth before veering into unscientific fringe theories. Efforts to control the weather are being made, largely by states and local governments seeking to combat droughts, but the results are modest and highly localized. It isn’t possible to manipulate large-scale weather events, scientists say.

Severe flooding in the United Arab Emirates in 2024 couldn’t have been caused by weather manipulation because no technology could create that kind of rainfall event, Maarten Ambaum, a meteorologist at the University of Reading who studies Gulf region rainfall patterns, said in a statement on the floods. Similar debunked claims emerged this year after central Texas experienced devastating floods.

The Government Accountability Office concluded in a 2024 report that questions remain as to the effectiveness of weather modification.

Research into changing the climate has been conducted, including work by one private company that engaged in field tests. Still, federal agencies say no ongoing or large-scale projects are underway. Study of the concept remains in the research phase. The Environmental Protection Agency says there are no large-scale or government efforts to affect the Earth’s climate.

“Solar geoengineering is not occurring via direct delivery by commercial aircraft and is not associated with aviation contrails,” the agency says on its website.

Widespread misinformation

Misperceptions about weather, climate control, and airplane contrails extend beyond the Trump administration, scientists said.

In September, a congressional House committee hearing titled “Playing God With the Weather — A Disastrous Forecast” involved two hours of debate on the once-fringe idea. Rep. Marjorie Taylor Greene (R-Ga.), who chaired the hearing, has introduced legislation to ban weather and climate control, with a fine of up to $100,000 and up to five years in prison.

Some Democrats objected to the nature of the discussion. Rep. Melanie Stansbury (D-N.M.) accused Greene of using “the platform of Congress to proffer anti-science theories, to platform climate denialism.”

Frequently citing chemtrails, GOP lawmakers have introduced legislation in about two dozen states to ban weather modification or geoengineering. Florida passed a bill to establish an online portal so residents can report alleged violations.

“The Free State of Florida means freedom from governments or private actors unilaterally applying chemicals or geoengineering to people or public spaces,” GOP Florida Gov. Ron DeSantis said in a press statement this spring.

Meanwhile, the chemtrail conspiracy has permeated popular culture. The title track on singer Lana Del Ray’s seventh studio album is entitled “Chemtrails Over the Country Club.” Bill Maher dove into the chemtrail myth on his podcast “Club Random,” saying, “This is nuts. It’s just nuts.” And “Chemtrails,” a psychological thriller, wrapped filming in July.

Social media has given wing to the chemtrails concept and other fringe ideas involving public health. They include an outlandish belief that Anthony Fauci, who advised both Trump and President Joe Biden on the government response to the covid-19 pandemic, created the AIDS epidemic. There is no evidence of such a link, public health leaders say.

Researchers say another false belief by those on the far right holds that people who received covid vaccines could shed the virus, causing infertility in the unvaccinated. There is no evidence of such a connection, scientists and researchers say.

More severe weather events due to global warming may be driving some of the baseless theories, scientists say. And risks occur when such ideas take hold among the general population or policymakers, some public health leaders say. Climate researchers, including Swain, say they’ve received death threats.

Lee, the blogger, said he disagrees with some of the more far-fetched beliefs and is aware of the harm they can cause.

“There are people wanting to shoot down planes because they think they are chemtrails,” said Lee, adding that some believers are afraid to venture outside when plane vapor trails are visible overhead.

There is also no evidence that plane contrails cause health problems or are related to intentional efforts to control the climate, according to the EPA and other scientists.

The memo and focus at HHS on climate and weather control are alarming because they perpetuate conspiracies, said David Keith, a professor of geophysical sciences at the University of Chicago.

“It’s unmoored to reality,” he said. “I expected there were documents like this, but seeing it in print is nevertheless shocking. Our government is being driven by nonsensical dreck from dark corners of social media.”

©2025 Kaiser Health News. Visit khn.org. Distributed by Tribune Content Agency, LLC. ©2025 KFF Health News. Distributed by Tribune Content Agency, LLC.

It’s flu season, and that means public health departments are promoting vaccinations. Over the past few years,  local vaccination rates have been down, and more people have become wary of vaccines. 

Before the pandemic hit, Oakland County’s approach to getting people vaccinated had been to focus on vaccine science and facts. In other words, tell people that vaccines are essential and encourage local pediatricians to maintain high vaccination rates. 

But in the last few years, the county has changed its approach to vaccine hesitance; it’s now trying to be more open, curious and empathetic towards those who have concerns. 

What else is different about Oakland County’s approach? And has it been working?

Oakland County Health Officer Kate Guzman spoke with Robyn Vincent about this and more.

 

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By Nada Hassanein, Stateline.org

CHANDLER, Ariz. — Art Martinez has seen the power of ceremony.

Martinez, a clinical psychologist and member of the Chumash Tribe, helped run an American Indian youth ceremonial camp. Held at a sacred tribal site in Northern California, it was designed to help kids’ mental health. He remembers a 14-year-old girl who had been struggling with substance use and was on the brink of hospitalization.

On the first day of the four-day camp, Martinez recalled, she was barely able to speak. In daily ceremonies, she wept. The other kids gathered around her. “You’re not alone. We’re here for you,” they’d say.

Traditional tribal healing practices are diverse and vary widely, unique from tribe to tribe. Many include talking circles, sweat lodge ceremonies with special rituals, plant medicine and herb smudging, along with sacred ceremonies known only to the tribe.

Martinez and the girl’s counselor saw her mental health improve under a treatment plan combining tribal traditional healing and Western medicine.

“By the end of the gathering, she had broken through the isolation,” Martinez said. “Before, she would barely shake hands with kids, and she was now hugging them, they were exchanging phone numbers. Her demeanor was better, she was able to articulate.”

Indigenous health advocates have long known the health benefits of integrating their traditional healing practices, and studies have also shown better health outcomes.

Now, for the first time, tribal traditional healing practices are eligible for Medicaid coverage in California and three other states under a new initiative. Last October, the federal government approved Medicaid and Children’s Health Insurance Program coverage of traditional healing practices at tribal health facilities and urban Indian organizations in Arizona, California, New Mexico and Oregon.

These were approved under a federal program that allows states to test new pilot health programs and ways to pay for them.

Arizona’s waiver went into effect this month. While California’s waiver currently only covers patients with substance use disorder, like the girl in Martinez’s camp, any Medicaid enrollee who is American Indian or Alaska Native is eligible in the other three states. Officials have said California’s program will expand to have such coverage in the future.

Under the waivers, each tribe and facility decides which traditional healing services to offer for reimbursement. Services can also take place at sacred sites and not necessarily inside a clinic, explained Virginia Hedrick, executive director of the California Consortium for Urban Indian Health.

“If a healing intervention requires being near a water source — the ocean, creek, river — we can do that,” said Hedrick, who is of the Yurok Tribe and of Karuk descent. “It may involve gathering medicine in a specific place on the land itself.”

Tribes long had to practice out of sight. The U.S. government’s assimilation policies had targeted tribal languages, cultural and religious practices — including healing. It wasn’t until 1978, when the American Indian Religious Freedom Act was enacted under President Jimmy Carter, that they regained their rights.

“It was illegal to practice our ways until 1978 … the year I was born,” said Dr. Allison Kelliher, a family and integrative medicine physician, who is Koyukon Athabascan, Dena. “Traditional healing means intergenerational knowledge that have origins in how our ancestors and people lived generationally to promote health, so it’s a holistic way of looking at well-being.”

Last month, Kelliher and hundreds of others gathered at the National Indian Health Board’s health conference on Gila River Indian Community land in Chandler, Arizona. During a panel discussion about the waivers, tribal members discussed how health centers will bill for services, ways to protect the sacredness of certain ceremonies, and how to measure and collect data around the effectiveness of the treatments, a federal requirement under the waivers.

But teasing out those new protocols didn’t dull the enthusiasm.

“This is where we really start intersecting the Western medicine as well as traditional healing, and it’s exciting,” said panelist Dr. Naomi Young, CEO of the Fort Defiance Indian Hospital Board in Arizona.

The Trump administration announced earlier this year that it doesn’t plan to renew certain other Medicaid waiver programs approved under the Biden administration. But it hasn’t announced any changes around the traditional healing waivers.

Studies have found that incorporating sweat lodge ceremonies and other cultural practices in treatments led to substance use recovery and emotional health, and better quality diets when incorporating traditional foods, according to analyses of research by the National Council of Urban Indian Health.

“When there is an opportunity to braid traditional healing with Western forms of medicine, it’s very possible, and the research is indicating, we may get better health outcomes,” Hedrick said.

Traditional practices

Decades of historical trauma, such as displacement and forced assimilation in boarding schools — where American Indian and Alaska Native people were forbidden from speaking their languages — are behind their disproportionate rates of chronic illness and early deaths today, tribal health experts say.

Tribes have long offered traditional healing — both outside brick-and-mortar health care settings as well as within many clinics. But health centers have been paying out of pocket or budgeting for the services, said retired OB-GYN Dr. John Molina, director of the Arizona Advisory Council on Indian Health Care and member of the Pasqua Yaqui and Yavapai Apache Tribes.

Molina said the new Arizona waiver may help clinics afford to serve more patients or staff more traditional healers, and build infrastructure, including sacred spaces and sweat lodges. For other clinics, “They’ve been wanting to start, but perhaps don’t have the revenue to start it,” he said.

“I’m hoping that when people engage in traditional healing services, a lot of it is to bring balance back into the lifestyle, to give them some hope,” Molina said.

That’s the effect traditional healing practices have had on Harrison Jim, who is Diné. Now a counselor and traditional practitioner at Sage Memorial Hospital in Arizona, Jim, 70, said he remembers his own first all-night sweat lodge ceremony when he returned from a military tour.

“I [felt] relieved of everything that I was carrying, because it’s kind of like a personal journey that I went through,” he said. “Through that ceremony, I had that experience of freedom.”

Kim Russell, the hospital’s policy adviser, who also spoke on the panel about the traditional healing waivers, told Stateline her team hopes to bring on another practitioner along with Jim.

Tribal health leaders have expressed concern about people without traditional knowledge posing to offer healing services. But Navajo organizations, including Diné Hataałii Association Inc., aim to protect from such co-opting as it provides licensures for Native healers, Jim said.

Push in Washington

Facilities covered under the new waivers include Indian Health Service facilities, tribal facilities, or urban Indian organization facilities. In Arizona, urban Indian organizations can get the benefit only if they contract with an Indian Health Service or other tribal health facility.

In Oregon, Yellowhawk Tribal Health Center spokesperson Shanna Hamilton said that while the center can’t speak on behalf of other tribes or clinics, many are still in the early stages of developing programs and protocols. She called the waivers a “meaningful step forward in honoring Indigenous knowledge and healing practices.”

Meanwhile, in neighboring Washington state, a bill that would have required the state to submit an application for a waiver by Sept. 1 died in committee.

But the state doesn’t need the legislative OK to apply. It’s still going to submit an application by the end of the year, the Washington State Health Care Authority told Stateline in a statement, emphasizing that each tribe would determine its own traditional health services available for reimbursement.

Azure Bouré, traditional food and medicine program coordinator for the Suquamish Tribe, a community along the shores of Washington’s Puget Sound, called the waivers “groundbreaking.”

“We’re proving day in and day out that Indigenous knowledge is important. It’s real, it’s worthy, and it’s real science,” Bouré said.

On a brisk summer day in 2009, Bouré recalled, she had attended a family camp hosted by Northwest Indian College. It was then she tasted the salal berry for the first time. A sweet, dark blue berry, it’s long been used by Pacific Northwest tribes medicinally, in jams, and for dyeing clothing.

“It was just that one berry, that one day, that reignited that wonderment,” Bouré said. For her, it unlocked the world of Indigenous plant medicine and food sovereignty, a people’s right to the food and food systems of their land.

She got her bachelor’s in Native American environmental science and now runs an apothecary, teaches traditional cooking classes, recommends herbs to members with ailments and processes foraged foods.

One day she could be chopping pumpkins or other gourds and the next, cleaning and peeling away the salty-sweet meat from dozens of sea cucumbers harvested by shellfish biologist divers employed by the tribe.

Bouré’s grandmother died when her mom was 12 years old. “That’s a whole generation of knowledge that she lost,” she said. One way she unearths that lost knowledge is by learning tribal medicine and teaching it, and holding on to memories like watching her great-grandmother Cecelia, who wove traditional sweetgrass dolls even when she was blind.

“I think that I come from a long line of healers,” she said.

Dr. Gary Ferguson, who is Unangax̂ (Aleut), is the director of integrative medicine at the Tulalip Health Clinic about 40 miles north of Seattle. He’s certified in naturopathic medicine in Washington and Alaska.

His health center already has a variety of integrative medicine offerings, he said, including traditional ones grounded in Coast Salish traditions of the Pacific Northwest. He said he hopes the waivers and continued support for Indigenous ways of healing will help tribes address health disparities.

“These ceremonies and ways are part of that deeper healing,” he said.

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

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

By Rae Ellen Bichell, KFF Health News

Stacey Knoll thought the court summons she received was a scam. She didn’t remember getting any medical bills from Montrose Regional Health, a nonprofit hospital, after a 2020 emergency room visit.

So she was shocked when, three years after the trip to the hospital, her employer received court orders requiring it to start funneling a chunk of her paychecks to a debt collector for an unpaid $881 medical bill — which had grown to $1,155.26 from interest and court fees.

The timing was terrible. After leaving a bad marriage and staying in a shelter, she had just gotten full custody of her three children, steady housing in Montrose, Colorado, and a job at a gas station.

“And that’s when I got that garnishment from the court,” she said. “It was really scary. I’d never been on my own or raised kids on my own.”

KFF Health News reviewed 1,200 Colorado cases in which judges, over a two-year period from Feb. 1, 2022, through Feb. 1, 2024, gave permission to garnish wages over unpaid bills. At least 30% of the cases stemmed from medical care — even when patients’ bills should have been covered by Medicaid, the public insurance program for those with low incomes or disabilities. That 30% is likely an underestimate since medical debt is often hidden behind other types of debt, such as from credit cards or payday loans. But even that minimum would translate to roughly 14,000 cases a year in Colorado in which courts approved taking people’s wages because of unpaid medical bills.

Among the other findings:

• Patients were pursued for medical bills ranging from under $30 to over $30,000, with most of the bills amounting to less than $2,400. As the cases rolled through the legal system, accumulating interest and court fees, the amount that patients owed often grew by 25%. In one case, it snowballed by more than 400%.
• Cases trailed people for up to 14 years after they received medical care, with debt collectors reviving their cases even as they moved from job to job.
• Medical providers of all stripes are behind these bills — big health care chains, small rural hospitals, physician groups, public ambulance services, and more. In several cases, hospitals won permission to take the pay of their own employees who had unpaid bills from treatment at the facilities.

Colorado has company. It is one of 45 states that allow wage garnishment for unpaid medical bills. Only Delaware, New York, North Carolina, Pennsylvania, and Texas have banned wage garnishment for medical debt.

As KFF Health News has reported, medical debt is devastating for millions of people across the country. And now the problem is likely to grow more pressing nationwide. Millions of Americans are expected to lose health insurance in the coming years due to Medicaid changes in President Donald Trump’s tax and spending law and if Congress allows some Affordable Care Act subsidies to expire. That means health crises for the newly uninsured could lead them, too, into a spiral of medical debt.

And the hurt will linger: Large unpaid medical bills are staying on credit reports in most states after a July decision from a federal judge reversed a new rule aimed at protecting consumers.

“If you can’t maintain your health, how are you going to work to pay back a debt?” said Adam Fox, deputy director of the Colorado Consumer Health Initiative, a nonprofit aimed at lowering health costs. “And if you fundamentally can’t pay the bill, wage garnishment isn’t going to help you do that. It’s going to put you in more financial distress.”

Flying blind on medical debt

When someone fails to pay a bill, the creditor that provided the service — whether for a garage door repair, a car loan, or medical care — can take the debtor to court. Creditors can also pass the debt to a debt collector or debt buyer, who can do the same.

“At any given point, about 1% of working adults are being garnished for some reason,” said Anthony DeFusco, an economist at the University of Wisconsin-Madison, who studied paycheck data from ADP, a payroll processor that distributes paychecks to about a fifth of private sector U.S. workers. “That’s a big chunk of the population.”

But specific research into the practice of garnishing wages over medical debt is scant. Studies in North Carolina, Virginia, and New York have found that nonprofit hospitals commonly garnish wages from indebted patients, with some studies finding those patients tend to work in low-wage occupations.

Marty Makary, who led research on medical debt wage garnishment in Virginia at Johns Hopkins University before joining Trump’s cabinet as Food and Drug Administration commissioner, has called the practice “aggressive.” He co-authored a study that found 36% of Virginia hospitals, mostly nonprofit and mostly in urban areas, were using garnishment to collect unpaid debts in 2017, affecting thousands of patients.

The Colorado findings from KFF Health News show that hospitals are far from the only medical providers going after patients’ paychecks, though.

Researchers and advocates say that, in addition to a dearth of court case data, another phenomenon tends to obscure how often this happens. “People find debt shameful,” said Lester Bird, a senior manager at the Pew Charitable Trusts who specializes in courts. “A lot of this exists in the shadows.”

Without data on how often this tactic is employed, lawmakers are flying blind — even as a 2024 Associated Press-NORC poll showed about 4 in 5 U.S. adults believe it’s important for the federal government to provide medical debt relief.

‘Blood from a turnip’

Colorado was among the first of 15 states to scratch medical debt from credit reports. Debt buyers in the state aren’t allowed to foreclose on a patient’s home. If qualified patients opt to pay in monthly installments, those payments shouldn’t exceed 6% of their household income — and the remaining debt gets wiped after about three years of paying.

But if they don’t agree to a payment plan, Coloradans can have up to 20% of their disposable earnings garnished. The National Consumer Law Center gave the state a “D” grade for state protections of family finances.

Consumer advocates said they aren’t sure how well even those Colorado requirements are being followed. And people wrote letters to the courts saying wage garnishment would exacerbate their already dire financial situations.

“I have begun to fall behind on my electricity, my gas, my water my credit cards,” wrote a man in western Colorado in a letter to a judge that KFF Health News obtained in the court filings. Court records show he was working in construction and at a rent-to-own store, with about $8,000 in medical debt. He wrote to the judge that he was paying close to $1,000 a month. “The way things are going now I will lose everything.”

The people being sued in KFF Health News’ Colorado review worked in a wide array of jobs. They worked in school districts, ranching, mining, construction, local government, even health care. Several worked at stores such as Walmart and Family Dollar, or at gas stations, restaurants, or grocery stores.

“You’re really kicking people when they’re down,” said Lois Lupica, a former attorney working with the Denver-based Community Economic Defense Project and the Debt Collection Lab at Princeton. “They’re basically suing the you-can’t-get-blood-from-a-turnip population.”

In 2022, court records show, Valley View health system based in Glenwood Springs was allowed to garnish the wages of one of its patients over a $400 medical bill. The patient was working at a local organization that the health system supported as part of the community benefits it provides to keep its tax-exempt status. Nonprofit hospitals like Valley View are required to provide community benefits, which can also include charity care that covers patients’ bills.

Stacey Gavrell, the health system’s chief community relations officer, said it offers options such as interest-free payment plans and care at reduced or no cost to families with incomes up to 500% of the federal poverty level.

“As our rural region’s largest healthcare provider, it is imperative to the health and well-being of our community that Valley View remains a financially viable organization,” she said. “Most of our patients work with us to develop a payment plan or pursue financial assistance.”

The collection agency that took the employee to court, A-1 Collection Agency, advertises itself on its website as empathetic: “We understand times are tough and money is tight.”

Pilar Mank, who oversees operations at A-1’s parent company, Healthcare Management, said it accepts payment plans as small as $50 a month and that most of the hospitals it works with allow it to offer a discount if patients pay all at once.

“Suing a patient is the absolute last resort,” she said. “We try everything we can to work with the patient.”

If you can’t maintain your health, how are you going to work to pay back a debt?

Hospitals sometimes also garnish wages from their own employees for care they provided them. In one case, a hospital employee worked her way up from housekeeper to registrar to quality analyst. She even participated in public events representing her employer and appeared on the hospital’s website as a featured employee — while the court issued writs of garnishment until her $10,000 in medical bills from the hospital was paid off.

“Hospital care costs money to deliver,” said Colorado Hospital Association spokesperson Julie Lonborg about hospitals’ garnishing their own employees’ wages. “In some ways, I think it’s funny to be asked the question. I would understand if someone said, ‘Why aren’t you garnishing their wages?’”

Studies show that hospital debt collection efforts through wage garnishment bring in only about 0.2% of hospital revenues, said April Kuehnhoff, a senior attorney with the National Consumer Law Center, which advocates for people with low incomes.

“We also know that there are states that don’t allow this at all,” she said. “Hospitals are continuing to provide medical care to consumers.”

Smooth sailing for collectors —but not for patients

Health care providers appeared as the plaintiffs in only 2% of the medical debt cases. Instead, cases were filed almost entirely by third-party debt collectors and buyers, with BC Services and Professional Finance Company behind more than half of the cases, followed by A-1 Collection Agency and Wakefield & Associates.

Debt buyers make money by buying debt from providers who’ve given up on getting paid then collecting what they can of the money owed, plus interest. Debt collectors get paid a percentage of what they recover. Some companies do a bit of both.

BC Services declined to comment, and Wakefield & Associates did not respond to questions.

Charlie Shoop, president of Professional Finance Company, said his company initiates wage garnishment on less than 1% of all accounts placed with it for collection.

Health care providers in Colorado can no longer hide behind debt collectors’ names when they sue people, according to a 2024 state law prompted by a 9News-Colorado Sun investigation in partnership with a Colorado News Collaborative-KFF Health News reporting project.

In many states, the path for filing a case against a debtor and garnishing their wages is relatively smooth — especially if the debtor doesn’t appear in court.

“It’s unbelievably easy,” said Dan Vedra, a lawyer in Colorado who often represents consumers in debt cases. “If you have a word processor and a spreadsheet, you can mass-produce thousands of lawsuits in a matter of hours or minutes.”

Within KFF Health News’ sample, nearly all the medical debt cases were default judgments, meaning the patient did not defend themselves in court or in writing. Missing a court date can happen for a variety of reasons, such as not receiving the notice in the mail, assuming it was a scam, knowingly ignoring it, or not having the time to take off from work.

Vedra and other debt law experts said a high rate of default judgments indicates a system that favors the pursuers over the pursued — and increases the chances someone will be harmed by an erroneous bill.

But in New Hampshire, creditors now have to keep going to court for each paycheck they want to garnish, because the state allows creditors to garnish only wages that have already been earned, said Maanasa Kona, an associate research professor at the Center on Health Insurance Reforms at Georgetown University.

“It might not look like much on paper,” she said. “It’s just not worth it if they have to keep going back to court.”

If you have a word processor and a spreadsheet, you can mass-produce thousands of lawsuits in a matter of hours or minutes.

Wrongly pursued for bills

The nation’s medical billing setup is already prone to errors due to its complexity, according to Barak Richman, a law professor at George Washington University and a senior scholar at Stanford Medicine who has studied medical debt collection practices in several states. “Bills are not only noncomprehensible, but often wrong,” Richman said.

Indeed, Colorado’s Health Care Policy & Financing Department, which runs Medicaid in the state, said it sent out nearly 11,000 letters in the past fiscal year to health providers and collectors that erroneously went after patients on Medicaid. Bills for Medicaid recipients are supposed to be sent to Medicaid, not the patients, who typically pay a nominal amount, if anything, for their care.

Shoop said his industry has pushed Colorado, without success, for access to a database that would allow them to confirm if patients had Medicaid coverage.

Colorado’s Medicaid program declined to comment.

Patricia DeHerrera in Rifle, Colorado, had to prove that she and her children had Medicaid when they received care at Grand River Health — but only after A-1 contacted her employer at the time, the gas station chain Kum & Go, with court-approved paperwork to take a portion of her paychecks.

She contacted the state, which sent letters to the hospital and the collector notifying them they were engaging in “illegal billing action” and telling the collector to stop. The companies did.

Theresa Wagenman, controller for Grand River Health, said if a patient can present a letter from a Medicaid caseworker saying they’re eligible, then their bills get removed from the collections pipeline. Wagenman also said patients get at least eight letters in the mail and several phone calls before Grand River gives the go-ahead for the collector to send them to court.

DeHerrera’s main advice to others in this situation: “Know your rights. Otherwise, they’re going to take advantage of you.”

Yet fighting back isn’t easy.

Nicole Silva, who lives in the 900-person town of Sanford in south-central Colorado, said she and her family were all on Medicaid when her daughter was in a car crash. Still, court records show, her wages were garnished for a $2,181.60 ambulance ride, which grew to more than $3,000 from court fees and interest.

She tried to prove the bill was wrong, contacting her county’s social services office, but Silva said it wasn’t helpful and she wasn’t able to reach the right person at a state office. The state Medicaid program confirmed to KFF Health News that her daughter was covered at the time of the wreck.

Fighting the bill felt like too much for Silva and her husband to handle while parenting a growing number of kids, one of them severely disabled, and working — she as a preschool teacher and he as a rancher.

Not receiving the roughly $500 a month that she said came out of her pay was enough to affect their ability to pay other bills. “It was deciding to buy groceries or pay the electric bill,” Silva said.

When their electricity got shut off, she said, they had to scramble to borrow money from colleagues and friends to get it turned back on — with an extra fee.

She said the saga makes her hesitant to call an ambulance in the future.

Fox, of the Colorado Consumer Health Initiative, said consumers often think they cannot do anything to stop their wages from being garnished, but they can contest it in court, for example by pointing out they should have qualified for discounted — or charity — care if the hospital that provided the treatment is a nonprofit.

DeFusco, the economist, believes filing for Chapter 7 bankruptcy is an underused option for debtors. It halts garnishment in its tracks, though not always permanently, and it comes with other consequences. But he understands it’s a Catch-22: It’s a complex process and typically necessitates hiring a lawyer.

“To get rid of your debt, you need money,” he said. “And the whole reason you’re in this situation is because you don’t have money.”

Methodology

We wanted to know how often Coloradans get their wages garnished due to medical debt. Courts don’t compile this information, and researchers and advocates haven’t tracked it systematically.

So we created our own database. We requested a list of all civil cases across the state in which judges gave permission for a person’s earnings to be garnished — known as writs of garnishment in court lingo — from Feb. 1, 2022, through Feb. 1, 2024. The Colorado Supreme Court Library provided a list from all courts except for Denver County Court, which provided its own records. The combined list comprised nearly 90,000 unique court cases. We split up the cases by county population — small (fewer than 10,000 people), medium (10,000 to 100,000 people), and large (more than 100,000 people) — then generated a random sample of 400 cases from each group to ensure we evaluated medical debt across counties of all sizes.

To identify medical debt cases, we looked at the original creditors named in court records, primarily the complaints or affidavits of indebtedness. Often, this information was available through a state website. When it wasn’t available online, we asked county courthouses to send us supporting documents. We counted dentists as medical providers. We excluded 14 cases in which the debt wasn’t exclusively medical.

We looked only at cases in which courts approved money to be garnished from someone’s paycheck, as opposed to from other sources such as their bank accounts. We did not review garnishment cases involving child support, taxes, or federal student loans.

KFF Health News intern Henry Larweh, data editor Holly K. Hacker, Mountain States editor Matt Volz, and web editor Lydia Zuraw contributed to this report.

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

October is Domestic Violence Awareness Month, and one local non-profit is recruiting men to help end the abuse.

While men are typically the perpetrators of violence, 23% of men in Michigan experience intimate partner violence, rape or stalking. This places men in a very unique place in which they can discuss, amongst themselves, both the impacts of violence on victims and discuss how their experiences could lead to violence.

Haven, a non-profit in Oakland County, has been calling on men to raise their voices on this issue. The organization aims to eliminate domestic violence and sexual assault and provides resources to survivors in their time of need.

Haven is currently recruiting 100 men to lend their voices and support their communities in eliminating domestic violence. There’s a Men of Haven recruitment event coming up on Thursday, Oct. 23 from 6-8 p.m. at Haven’s headquarters in Pontiac.

Christine Kinal is the CEO of Haven. She joined the show to discuss men’s roles in addressing this very important issue.

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

Subscribe to The Metro on Apple Podcasts, Spotify, NPR.org or wherever you get your podcasts.

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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The post The Metro: Non-profit calls on men to address domestic violence appeared first on WDET 101.9 FM.

A few years out of the pandemic, overdose deaths continue to drop. 

A new report found that overdose deaths declined by 37 percent from 2023 to 2024. Local EMS calls related to drug overdoses dropped as well.

What are Southeast Michigan government officials doing to try to continue lowering addiction and overdose rates since the numbers hit all-time highs?

Narcan availability is a big reason for this drop. But local governments are making more investments in physical and mental health care too. Oakland County just opened its 360 Care Center, which offers same-day services for non-emergency medical needs. 

Why is addiction a big problem for so many people in the first place? And what can health professionals and everyday folks do to try to stop it from ruining peoples’ lives? Producer Sam Corey spoke with Deputy County Executive for Oakland County Madiha Tariq to learn more.

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

Subscribe to The Metro on Apple Podcasts, Spotify, YouTube, or NPR or wherever you get your podcasts.

 

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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The post The Metro: Why an Oakland County official believes empathy can help prevent death from overdose appeared first on WDET 101.9 FM.