In a humbling exercise, employees were waiting to test whether their entry badges still worked at the Department of Health and Human Services — or whether they’d be walked back out by security because they were among the 10,000 unlucky ones whose jobs had suddenly been eliminated.

I thought back to that day recently as I researched andÌýreported onÌýa significant, under-the-radar proposal from the Office of Personnel Management, which oversees federal workers.Ìý

According to aÌýÌýin December, OPM isÌýseekingÌýpersonally identifiable medical and pharmaceutical claims information on federal employees and retirees, as well as their family members, who are enrolled in the Federal Employees Health Benefits or Postal Service Health Benefits programs. Just over 8 million Americans get coverage through such plans.

Right now, 65 insurance companiesÌýmaintainÌýdata the agency wants, including information on prescriptions, diagnoses, and treatments. That would put a tremendous amount of personal information about federal employees in the hands of an administration that has earned a reputation for takingÌýÌýagainst some workers andÌýsharing sensitive dataÌýacross agencies as part of its immigration and fraud crackdowns.ÌýÌý

My colleague Maia Rosenfeld and I wanted to know what lawyers and ethicists who work on health policy issues think about this proposal.ÌýÌý

On the one hand, sources toldÌýus,Ìýthis sort of detailed data could be used by the federal government to improve the largest employer-sponsored health insurance system in the country.Ìý

But doubts about the Trump administration’s motives percolated through every conversation we had.Ìý

“The concern here is the more information they have, theyÌýcould use it to discipline or target people who are not cooperating politically,” Sharona Hoffman, a health law ethicist at Case Western Reserve University, told me.ÌýÌý

And, though the notice states that insurers are legallyÌýpermittedÌýtoÌýdiscloseÌý“protected health information” to the agency for “oversight,” Hoffman and others raised questions about OPM’s access to such a sweeping database of medical records under federal health privacy laws.ÌýÌý

Insurance companies — several of which declined to comment — would have to provide monthly reports to OPM with data on their members. One insurer, CVS Health, said in a public comment that insurers would be breaking the law by providing the information for OPM’s “vague and broad general purposes.” The association thatÌýrepresentsÌýmany of those companies also has voiced objections to the proposal, which has not yet beenÌýfinalized.ÌýÌý

OPM spokespeople did not respond to our repeated requests for comment.

Â鶹ŮÓÅ Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at Â鶹ŮÓÅ—an independent source of health policy research, polling, and journalism. Learn more about .

USE OUR CONTENT

This story can be republished for free (details).

State governments rely on such companies to design and operate computer systems that assess whether low-income people qualify for Medicaid or food aid through the Supplemental Nutrition Assistance Program, commonly known as food stamps. Those state systems have a history of errors that can cut off benefits to eligible people, a Â鶹ŮÓÅ Health News investigation showed.

States are now racing to update their eligibility systems to adhere to President Donald Trump’s sweeping tax-and-spending law. The changes will add red tape and restrictions. They are coming at a steep price ― both in the cost to taxpayers and coverage losses ― according to state documents obtained by Â鶹ŮÓÅ Health News and interviews.

The documents showÌýgovernment agenciesÌýwill spend millionsÌýto saveÌýconsiderablyÌýmoreÌýbyÌýremovingÌýpeople fromÌýhealth benefits.ÌýWhile statesÌýsignÌýeligibility system contracts with companiesÌýandÌýwork with them to manageÌýupdates, the federal governmentÌýfootsÌýmost of the bill.

The law’s Medicaid policies will causeÌýÌýtoÌýbecome uninsuredÌýby 2034, according to the nonpartisan Congressional Budget Office.ÌýRoughlyÌýÌýwill loseÌýaccess toÌýmonthly cashÌýassistanceÌýforÌýfood, including those with children.Ìý

In five statesÌýalone,ÌýÌýfor state officialsÌýand reviewed by Â鶹ŮÓÅ Health NewsÌýshow that changesÌýwill cost at least $45.6ÌýmillionÌýcombined.Ìý

The lawÌýrequires most statesÌýtoÌýtieÌýMedicaid coverageÌýfor some adultsÌýtoÌýhavingÌýaÌýjob,ÌýandÌýimposes other restrictions that will make it harder forÌýpeopleÌýwith low incomesÌýto stay enrolled.ÌýSNAP restrictions began to take effect in 2025. Major Medicaid provisionsÌýbeginÌýlater this year.Ìý

DocumentsÌýprepared by consulting company DeloitteÌýestimateÌýthat a pair ofÌýcomputer systemÌýchangesÌýforÌýMedicaid work requirementsÌýin WisconsinÌýwillÌýÌý. Two other changesÌýrelatedÌýto the state’s SNAP program will cost an additional $4.2Ìýmillion, according to the documents, which for the Wisconsin Department of Health Services.

In Iowa, changes to its Medicaid system are expected to cost at least $20 million, , a consulting company thatÌýoperatesÌýthe state’sÌýeligibility system.Ìý

OptumÌý—ÌýwhichÌýoperatesÌýthe platform Vermont residents useÌýfor Medicaid and marketplaceÌýhealthÌýplans under the Affordable Care ActÌý—ÌýÌýÌýÌýÌýtoÌýevaluate andÌýincorporateÌýnewÌýhealthÌýcoverage restrictions.Ìý

Initial changes in Kentucky, which has had a contract with Deloitte since 2012,ÌýÌýÌýÌýÌý. And in Illinois,ÌýÌýwill cost at least $12 million.

Â鶹ŮÓÅ Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at Â鶹ŮÓÅ—an independent source of health policy research, polling, and journalism. Learn more about .

USE OUR CONTENT

This story can be republished for free (details).

In one example, a dad went to an Immigration and Customs Enforcement office in New Mexico, thinking he was going for an interview about reuniting with his children. Instead, agents put him in chains and sent him to a detention center. His 15-year-old son and 16-year-old daughter have now been in a federal shelter in Texas for more than a year.Ìý

I spoke by phone with the father while he was at an immigration detention center in El Paso, Texas, where he was held for several months. He told me he was tricked. “They used my children to grab me.”Ìý

What happened to him isn’t isolated. My colleagues Renuka Rayasam and Amanda Seitz and I found that federal law enforcement agencies are coordinating with the resettlement office to detain and deport immigrant caregivers. Attorneys say many, like this dad, are being arrested while trying to reunite with their kids.Ìý

HHS, the Department of Homeland Security, and the Justice Department did not respond to questions about caregiver arrests.

Over two decades ago, Congress gave the HHS resettlement office responsibility for caring for children without legal status who arrive at the U.S. border alone or without a legal guardian, often fleeing violence, abuse, or persecution in their home countries.Ìý

The move was intended to protect some of the most vulnerable immigrants. Lawmakers expected children’s well-being to be prioritized over immigration enforcement.Ìý

But since President Donald Trump took office, that priority has shifted. As a result, children are languishing for months in government shelters and foster care, while their relatives are detained and deported. Some children are losing hope.Ìý

In statements shared through attorneys, the daughter in Texas said she no longer wants to be around others and spends most of the time in her room. The son described having panic attacks and feeling that he’s missing out on life, whether it’s the opportunities he longs for — to learn English, to study science — or watching basketball with his family.Ìý

Government shelters often lack sufficient resources, , and social workers say lengthy stays in these facilities can result in additional trauma.Ìý

Their dad was released on bond this month after a federal judge said officials had unlawfully detained him.Ìý

He will have to redo much of the process to reunite with his children.Ìý

“This operation is designed to force parents to make an impossible choice between reuniting with their children and seeking safety,” said one of the dad’s attorneys, Chiqui Sanchez Kennedy of the Galveston-Houston Immigrant Representation Project, a nonprofit that helps low-income immigrants.

Â鶹ŮÓÅ Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at Â鶹ŮÓÅ—an independent source of health policy research, polling, and journalism. Learn more about .

USE OUR CONTENT

This story can be republished for free (details).

“I call it the unaffordable care act,” he said. He reprised the line in his address, blaming “the crushing cost of health care” on Obamacare.Ìý

Trump’s words play off an ongoing congressional debate that began late last year, ahead of the expiration of the enhanced tax subsidies that had lowered the cost of ACA insurance for millions of Americans.Ìý

Democrats, looking toward the November midterm elections, continue to use that lapse to focus public attention on affordability.Ìý

Republicans take a different view, routinely pointing to specific provisions as culprits. Among them, the law’s essential health benefits mandate, which says Obamacare plans must cover certain basic services — including emergency care, hospitalization, maternity care, and prescription drugs — without annual or lifetime dollar limits while enrolled.Ìý

But my colleague Sarah Boden and I found that connecting EHBs to the premium increases consumers are feeling is not a straight line.Ìý

For starters, it’s clear that ACA premiums have increased.Ìý

An analysis by the right-leaning Paragon Health Institute shows that the average Obamacare premium for a 50-year-old since 2014. The average premium for employer-based plans grew 68% during the same period.Ìý

Still, that’s not the whole picture.

Pre-ACA, coverage offered by employer plans was generally more generous and, therefore, costlier than coverage under individual market plans. Individual plans were cheaper also because they could bar applicants with health problems. Beginning in 2014, the ACA forced individual policies to look more like employer plans. As a result, premiums rose — sometimes faster than those of job-based plans.Ìý

, however, were on the rise before the ACA took effect.Ìý

An analysis by Jonathan Gruber at the Massachusetts Institute of Technology found that premiums grew by at least 10% a year from 2008 to 2010.Ìý

So do EHBs raise premiums? In some ways, yes, compared with pre-ACA plans that might not have covered now-required services like maternity care or prescription drugs.Ìý

But in other ways, EHBs can save money because they’ve increased access to preventive care, said , a professor of health policy and management at Johns Hopkins University’s Bloomberg School of Public Health.Ìý

Joseph Antos, a senior fellow emeritus at the conservative American Enterprise Institute, said other parts of the ACA — such as requiring insurers to accept anyone, regardless of health status, and limiting insurers’ ability to charge older people more — also played roles in boosting premiums.Ìý

“It’s practically impossible to tease any one thing out,” Antos said.

Â鶹ŮÓÅ Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at Â鶹ŮÓÅ—an independent source of health policy research, polling, and journalism. Learn more about .

USE OUR CONTENT

This story can be republished for free (details).

Yet about 82% of the comments are identical to a letter that appeared on the website of a secretive advocacy group called , a data analysis by Â鶹ŮÓÅ Health News has found.Ìý

The “” group does not reveal its funders or much else — other than to say it is “dedicated to protecting and strengthening Medicare Advantage” and is “powered by hundreds of thousands of local advocates nationwide.”Ìý

“Our campaign provides information and offers tools for concerned Americans to use to reach decision makers,” spokesperson Darren Grubb said in an email. The group has spent more than $3.1 million on hundreds of Facebook ads since September 2024, according to , a database of the social media company’s online ads.Ìý

There’s no doubt health insurers are unhappy with a from the Centers for Medicare & Medicaid Services, or CMS, to keep Medicare Advantage reimbursement rates essentially flat in 2027 — far less than they expected from the Trump administration.Ìý

Medicare Advantage plans offer seniors a private alternative to original Medicare. The insurance plans enroll about members, more than half the people eligible for Medicare.Ìý

CMS is set to announce a final rate decision by early next month. The agency solicited on the proposal from Jan. 26 through Feb. 25 to give interested parties and the public a chance to air their views. As of March 12, CMS said it had received 46,884 comments but had posted only 16,422 online.Ìý

Medicare Advantage Majority, which says the rate proposal amounts to a “cut” in services and warns of dire consequences for seniors should it go through, accounted for at least 13,522 of the 16,422 published comments as of March 12.Ìý

Critics warn that these sorts of campaigns may create a misleading impression of grassroots support, especially when it’s not clear who is financing them.Ìý

“It puts a different spin on a massive groundswell of comments to know all are being driven by one specific organization,” said Michael Beckel, director of money in politics reform for Issue One, a group that seeks to limit the influence of money on government policy and legislation.

Â鶹ŮÓÅ Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at Â鶹ŮÓÅ—an independent source of health policy research, polling, and journalism. Learn more about .

USE OUR CONTENT

This story can be republished for free (details).

Among them: scientists who pioneered cancer treatments, researched tick-borne diseases, or worked to prevent tobacco use.Ìý

We spoke to a half dozen scientists who said they left the agency because of the tumult of 2025 and talked about the work they left behind. They say the exodus from the world’s largest public funder of biomedical research will harm the nation’s ability to respond to illness.Ìý

“People are going to get hurt,” said Sylvia Chou, a scientist who worked at the National Cancer Institute in Rockville, Maryland, for over 15 years before she left in January. “There’s going to be a lot more health challenges and even deaths, because we need science in order to help people get healthy.”Ìý

The NIH consists of 27 institutes and centers, each with a different focus. Major research areas include cancer; infectious diseases; aging-related diseases such as Alzheimer’s; heart, lung, and blood diseases; and general medicine.Ìý

Over decades, the value of the NIH may be the one thing everyone in Washington has agreed on. Lawmakers have routinely boosted its funding — even for this fiscal year, in defiance of the White House, which had proposed cutting the agency’s funding by 40%.Ìý

Our reporting showed that, nonetheless, the Trump administration’s actions to curb certain research and push out scientists perceived as disloyal are having far-reaching repercussions. The NIH workforce stands at about 17,100 people — its lowest level in at least two decades.Ìý

Scientists across specializations outlined challenges that made them decide to leave. They included delays in accessing research equipment and supplies, the termination of funds for topics the Trump administration deemed off-limits, and delayed or denied travel authorizations.Ìý

Even research aligned with the Trump administration’s stated priorities has suffered, they said. They questioned whether the NIH could continue to fulfill its mission to “enhance health, lengthen life, and reduce illness.”Ìý

“It’s clear when someone comes out with a drug and now you’ve just cured a disease. But you never know which ones could have been cured,” said Daniel Dulebohn, a researcher who spent nearly two decades at Rocky Mountain Laboratories in Hamilton, Montana. “We don’t know what we’ve lost.”Ìý

Dulebohn left the NIH’s infectious disease and allergy institute in September and is considering leaving the scientific field altogether.

Â鶹ŮÓÅ Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at Â鶹ŮÓÅ—an independent source of health policy research, polling, and journalism. Learn more about .

USE OUR CONTENT

This story can be republished for free (details).

Frye, an emergency room nurse with 25 years of experience, felt that ignoring inequality’s role in health and sickness was an affront to the compassionate soul of the nursing profession.Ìý

“It felt like a stepÌýagainstÌýeverything I believe in,” Frye said. “And I didn’t feel like I belonged there anymore.”Ìý

Now Frye has found a new place to belong. She is part of a surge of American nurses and other health care workers moving to CanadaÌý—Ìýspecifically,ÌýBritish ColumbiaÌý—Ìýto escape the policies of President Donald Trump. Frye settled in Nanaimo on Vancouver Island, where the local hospital has hired 20 American nurses in less than a year.Ìý

“There are so many like-minded people out there,” said Justin Miller, another American nurse who started at Nanaimo Regional General Hospital this month. “YouÌýaren’tÌýtrapped. YouÌýdon’tÌýhave to stay. Health care workers are welcomed with open arms around the world.”Ìý

More than 1,000 U.S.-trained nurses have been approved to work in British Columbia since April, when the province streamlined its licensing process for Americans, then launched an advertising campaign to take advantage of the “chaos and uncertainty happening in the U.S.” Nursing associations in Ontario and Alberta said they too have seen increased interest from American nurses in the past year.Ìý

“Some of them were living in fear of the administration, and they shared a sense of relief when crossing the border,” said Angela Wignall, CEO of Nurses and Nurse Practitioners of British Columbia. “As a Canadian,Ìýit’sÌýheartbreaking. AndÌýalsoÌýa joy to welcome them.”Ìý

The Trump administration, for its part,Ìýdoesn’tÌýseem concerned. When asked to comment, the White House dismissed accounts of nurses moving to Canada as “anecdotes of individuals with severe cases of Trump derangement syndrome.”Ìý

This aligns withÌýan articleÌýwe reported last year that foundÌýAmerican doctors were also relocating northÌýto get away from the Trump administration. According to the Medical Council of Canada, more than 1,200 American doctors created accounts onÌýÌýin 2025Ìý—Ìýtypically the first step to getting licensed in CanadaÌý—ÌýcomparedÌýwithÌýonly about 300 in 2024.

Â鶹ŮÓÅ Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at Â鶹ŮÓÅ—an independent source of health policy research, polling, and journalism. Learn more about .

USE OUR CONTENT

This story can be republished for free (details).

It’sÌýa bold-sounding promise, and a familiar one;Ìýpoliticians from both parties have been repeatingÌýit for years now. Both TrumpÌýadministrationsÌý—ÌýandÌýtheÌýBiden administrationÌýin betweenÌý—ÌýhaveÌýtakenÌýwhacksÌýat makingÌýmedicalÌýprices more accessible, with the goal of empowering patients toÌýshop forÌýbetter deals.Ìý

TheÌýideaÌýmakesÌýintuitiveÌýsense. Why shouldn’t you be able to compare the prices of MRI scans, for instance?Ìý

The fedsÌýhaveÌýmade some strides.ÌýPricesÌýareÌýavailable, albeit in confusing or fragmentary form. ButÌýthere’sÌýoneÌýbigÌýproblem:Ìý“There’s no evidence that patients use this information,”Ìýsaid Zack Cooper, a health economist at Yale University.Ìý

Health care isÌýanÌýinherentlyÌýcomplicatedÌýmarketplace.ÌýFor one thing,Ìýit’sÌýnot as simple as one price for one medical stay. Two babies might be delivered by the same obstetrician, for example, but the mothers could be chargedÌývery differentÌýamounts. One patient might be given medications to speed upÌýcontractions; another might not. Or one might need an emergency cesarean section — one of many cases in medicine in which obtaining the service simplyÌýisn’tÌýa choice.ÌýPlus,Ìýthe same hospitalÌýtypicallyÌýhasÌýdifferent contract terms withÌýeach insurer,Ìýmaking comparing pricesÌýeven moreÌýdifficult for patients.Ìý

InsteadÌýofÌýhelping consumers sort things out, thisÌýfederally mandatedÌýprice dataÌýlargelyÌýhasÌýbecomeÌýaÌýtoolÌýforÌýproviders and insurers, looking for intel about their competitorsÌý—Ìýso they can use it at the negotiating table in a quest for moreÌýadvantageousÌýrates.Ìý

“We use the transparency data,”Ìýsaid Eric Hoag, an executive at Blue Cross Blue Shield of Minnesota, noting that the insurer wants to make sureÌýhealth careÌýprovidersÌýaren’tÌýbeing paidÌýsubstantiallyÌýdifferent rates.ÌýIt’sÌý“to make sure that we are competitive, or, you know, more than competitive against other health plans.”Ìý

For all those tugs-of-war,Ìýit’sÌýnot clear these policies have had much of an effectÌýoverall.ÌýResearch shows that transparency policies can have mixed effects on prices, withÌýof a New York initiative finding a marginal increase in billed charges.Ìý

PriceÌýisn’tÌýthe only piece of information negotiationsÌýhingeÌýon. Hoag said Blue Cross Blue Shield of Minnesota also considers quality of care, rates of unnecessary treatments, and other factors. And sometimes negotiators feel they keep up with their peers — claiming a need for more revenue to match competitors’Ìýsalaries, for example.Ìý

Hoag said doctors and otherÌýcareÌýproviders often look at the data from comparable health systems and say,Ìý“‘I need to be paid more.’”

Â鶹ŮÓÅ Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at Â鶹ŮÓÅ—an independent source of health policy research, polling, and journalism. Learn more about .

USE OUR CONTENT

This story can be republished for free (details).

While more Americans enrolled thanÌý, the numberÌýwasÌýÌýwhatÌýit wasÌýat the same time last year. And experts sayÌýit willÌýbeÌýmonthsÌýuntilÌýthe numbersÌýare final.ÌýThe timingÌýwill depend onÌýhow many of those peopleÌýwho signed up for coverageÌýactually pay their premiums and remain enrolled.Ìý

In coming weeks, “consumers may find they really can’t afford the premiums and cancel their plans, while carriers may also cancel coverage for nonpayment,” said Pat Kelly, executive director of Your Health Idaho, a state-based ACA marketplace, during a Jan. 22 call with reporters.Ìý

The drop comes after several years of record-breaking enrollment, withÌý24.2ÌýmillionÌýsign-ups for the 2025 enrollment year.ÌýEnrollment growth took off after enhanced subsidiesÌý—Ìýwhich lowered the amount most households had to payÌýoutÌýof their own income toward premiums and removed anÌýupper-incomeÌýcapÌý—Ìýwent into effect during the Biden administration. Lawmakers, in adopting theÌýenhanced subsidies, setÌýan expirationÌýdate of Dec. 31, 2025.Ìý

Congressional debateÌýover extendingÌýthoseÌýmore generous subsidiesÌýwas heated, evenÌý.ÌýNow, the subsidies are back to their original level,Ìýand people who earn more thanÌýfourÌýtimes the federal poverty rate (aboutÌý$62,600Ìýfor an individual orÌý$84,600Ìýfor a couple)Ìýcan’tÌýqualify for any at all.Ìý

Ìýin most states this year, withÌýthe biggest drop in North Carolina, where sign-ups fell byÌýnearly 22%,Ìý.Ìý

In a few places — including New Mexico, Texas, and Maryland, as well as the District of Columbia — the number of people selecting ACA plans increased.Ìý

The jump was largest in New Mexico, with itsÌýtallyÌýof people selecting plans up byÌýnearlyÌý18%. Increases were in the single digits in the otherÌýstatesÌýand Washington, D.C.Ìý

New Mexico — uniquely — used its own tax dollars to fully offset the loss of the more generous federal tax subsidies for all consumers.Ìý, including California, Colorado, Maryland, and Washington, used state money to help some enrollees.Ìý

We’llÌýkeep watching to see how this unfolds over the coming weeks.

Â鶹ŮÓÅ Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at Â鶹ŮÓÅ—an independent source of health policy research, polling, and journalism. Learn more about .

USE OUR CONTENT

This story can be republished for free (details).

TheÌýCaliforniaÌýDemocratÌýcame into office promising to fight forÌý“,”Ìýand he came close to achieving it. Really close. But as it turns out,Ìýthat’sÌýeasier said than done whenÌýyou’reÌýjugglingÌý,Ìý,ÌýandÌýshrinking federal support.Ìý

NowÌýhe’sÌýwalking the fine line betweenÌýkeepingÌýhisÌýÌýand being tarred asÌýa recklessÌýstateÌýexecutive who has stretched California’sÌýspendingÌý.Ìý

AfterÌýyears of politicalÌýinfighting,ÌýNewsomÌýand the Democratic-controlledÌýlegislatureÌýin 2024ÌýbroadenedÌýCalifornia’s Medicaid program, Medi-Cal, toÌýÌýregardless of immigration status.Ìý

Now,Ìýhe’sÌýrollingÌýback those expansions in the name of “fiscal prudence.”Ìý

This year, CaliforniaÌýfrozeÌýMedi-CalÌýenrollmentÌýforÌýmostÌýadultsÌýwithout legal status, justÌýtwo years afterÌý. On July 1, immigrants not eligible forÌýfederal MedicaidÌý—Ìýboth legal residents and those without authorizationÌý—Ìýwill lose access toÌýstateÌýdental coverage.ÌýNext year,Ìýthey’llÌýhave to start paying monthly premiums.Ìý

Last month, Newsom proposedÌýlettingÌýroughly 200,000Ìýlegal immigrantsÌý—Ìýasylees, refugees,Ìýand othersÌý—ÌýgetÌýcutÌýoff from Medi-Cal after Sept. 30, when the federal government will stop paying for them.Ìý

Advocates are livid.Ìý

ProgressivesÌýsayÌýNewsom’s political ambitionsÌý—Ìýand perceived need to distance himself from theÌýpolarizedÌýtopic of immigrant health careÌý—Ìýgo againstÌýhis earlyÌýpledges.Ìý

“You’re clouded by what Arkansas is going to think, or Tennessee is going to think, whenÌýwhat California thinks is something completely different,” said CaliforniaÌýstate Sen. Caroline Menjivar, chairÌýof theÌýbudget subcommittee on healthÌýand human services.Ìý

Meanwhile, Republicans and fiscal hawksÌýhaveÌýpaintedÌýNewsom as aÌýÌýDemocrat prioritizingÌýuse ofÌýlimited state funds on free health care for noncitizens.ÌýAnd Newsom has taken hits fromÌýtheÌýTrump administration accusing California ofÌý“”Ìýto use federal funds for immigrant health services.Ìý

He’sÌýnot the only governor grappling with this dilemma.ÌýAnd all 50 states,ÌýwhichÌýareÌýcurrentlyÌýrequired toÌýprovide health coverage toÌýrefugees, asylees,ÌýandÌýothers,Ìýwill have toÌýdecide whether toÌýbackfill that coverage for some 1.4 million legal immigrants starting Oct. 1, whenÌýÌýofÌýthe One Big Beautiful Bill ActÌýkicks inÌýand leaves states without federal reimbursement for their care.

Â鶹ŮÓÅ Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at Â鶹ŮÓÅ—an independent source of health policy research, polling, and journalism. Learn more about .

USE OUR CONTENT

This story can be republished for free (details).