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States Update Guardianship Laws To Keep Children of Immigrants Out of Foster Care

Jazmin Orozco Rodriguez — Fri, 17 Apr 2026 18:30:00 +0000

As family separations caused by immigration enforcement ramped up last year under President Donald Trump, I wondered what happens to the children whose parents are detained or deported. I found that some have been placed in foster care if they don’t have other family or friends to assume responsibility for them — but it’s not known how many.

The federal government doesn’t track what happens to children after their parents are detained or deported, and state data varies. Independent news reports are scarce and likely undercount the issue. But there’s evidence that in many states some of the children are being placed in foster care.

In Oregon, for example, there have been at least two cases in which children who were separated from their parents were placed into foster care by the state. Jake Sunderland, press secretary for the state Department of Human Services, said that before last fall, this “simply had never happened before.”

Separation from a parent can be deeply traumatic for children and lead to a broad range of , including post-traumatic stress disorder. Some states have responded by updating their temporary guardianship laws to help immigrant parents better prepare care for their children in the event of their detention or deportation.

Lawmakers in New Jersey are to allow parents to nominate standby, or temporary, guardians in the event of death, incapacity, or debilitation. The proposal adds separation caused by federal immigration enforcement as another allowable reason.

Nevada and California passed similar laws last year.

Yet some parents are hesitant to participate, said Cristian Gonzalez-Perez, an attorney at Make the Road Nevada, a nonprofit that provides resources to immigrant communities. The hesitancy is out of fear that Immigration and Customs Enforcement agents could access their personal information and use it to target them for detention or deportation.

My colleagues Claudia Boyd-Barrett, Renuka Rayasam, and Amanda Seitz reported on a case in which ICE used data from the Department of Health and Human Services’ Office of Refugee Resettlement to detain parents under the impression they were reuniting with their children, highlighting the precarious situation for immigrant parents.

Additionally, ICE detention makes it difficult to reunite parents with their children if they’ve been placed in foster care because reunification often requires court-ordered programs, said Juan Guzman, director of children’s court and guardianship at the Alliance for Children’s Rights, a legal advocacy organization in Los Angeles. Nominating a guardian is one way to ease immigrants’ feelings of helplessness when facing the threat of detention or deportation, Gonzalez-Perez said.

As President Donald Trump’s heightened immigration enforcement continues across the country, some states are updating temporary guardianship laws to keep the children of detained and deported immigrants out of state custody.

April 14, 2026

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The Trump Administration Is Seeking Federal Workers’ Sensitive Medical Data.��That’s��Raising Alarms.

Amanda Seitz — Fri, 10 Apr 2026 18:30:00 +0000

About a year ago, I was stationed in downtown D.C. on an especially chilly spring day, watching hundreds of federal employees line up outside their office buildings.

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 and reported on a significant, under-the-radar proposal from the Office of Personnel Management, which oversees federal workers.

According to a in December, OPM is seeking personally 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 companies maintain data 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 taking against some workers and sharing sensitive data across agencies as part of its immigration and fraud crackdowns.

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

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

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

“The concern here is the more information they have, they could 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.

And, though the notice states that insurers are legally permitted to disclose “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.

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 that represents many of those companies also has voiced objections to the proposal, which has not yet been finalized.

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

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How Medicaid Contractors Stand To Gain From Trump’s Policy

Samantha Liss — Fri, 03 Apr 2026 18:30:00 +0000

States are paying contractors such as Deloitte, Accenture, and Optum millions of dollars to help them comply with the One Big Beautiful Bill Act — a law that will strip safety-net health and food benefits from millions.

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 �鶹Ů�� 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 �鶹Ů�� Health News and interviews.

The documents show��government agencies��will spend millions��to save��considerably��more��by��removing��people from��health benefits.��While states��sign��eligibility system contracts with companies��and��work with them to manage��updates, the federal government��foots��most of the bill.

The law’s Medicaid policies will cause��to��become uninsured��by 2034, according to the nonpartisan Congressional Budget Office.��Roughly��will lose��access to��monthly cash��assistance��for��food, including those with children.��

In five states��alone,��for state officials��and reviewed by �鶹Ů�� Health News��show that changes��will cost at least $45.6��million��combined.��

The law��requires most states��to��tie��Medicaid coverage��for some adults��to��having��a��job,��and��imposes other restrictions that will make it harder for��people��with low incomes��to stay enrolled.��SNAP restrictions began to take effect in 2025. Major Medicaid provisions��begin��later this year.��

Documents��prepared by consulting company Deloitte��estimate��that a pair of��computer system��changes��for��Medicaid work requirements��in Wisconsin��will��. Two other changes��related��to the state’s SNAP program will cost an additional $4.2��million, 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 that��operates��the state’s��eligibility system.��

Optum��—��which��operates��the platform Vermont residents use��for Medicaid and marketplace��health��plans under the Affordable Care Act��—��to��evaluate and��incorporate��new��health��coverage restrictions.��

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

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How the Trump Administration Uses Migrant Kids To Find and Detain Family Members

Claudia Boyd-Barrett — Fri, 27 Mar 2026 18:30:00 +0000

The Trump administration is using migrant children held by the Department of Health and Human Services’ Office of Refugee Resettlement to lure parents and relatives into immigration detention, whether or not they have a criminal record.

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.

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.”

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.

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.

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

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.

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.

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

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

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

“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.

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In the Affordability Alphabet Soup of the ACA and EHBs, a Link to Higher Premiums Isn’t Clear-Cut

Julie Appleby — Fri, 20 Mar 2026 18:30:00 +0000

When President Donald Trump unveiled his one-page outline to address health care spending, dubbed “,” he specifically mentioned the Affordable Care Act’s role in driving up costs.

“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.

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.

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

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.

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

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

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.

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.

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

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.

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.

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.

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.

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

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‘Dark Money’ Group Angles for Higher Medicare Advantage Payments

Fred Schulte — Fri, 13 Mar 2026 18:30:00 +0000

If you judged by the more than 16,400 comments posted on a federal government website, you’d think there was a groundswell of older Americans demanding that federal officials hike payments to their Medicare Advantage health insurance plans.

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 �鶹Ů�� Health News has found.

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.”

“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.

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.

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.

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.

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.

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.

“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.

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The NIH Workforce Is Its Smallest in Decades. Here’s the Work Left Behind.

Rachana Pradhan — Fri, 06 Mar 2026 19:30:00 +0000

The National Institutes of Health has lost thousands of workers since President Donald Trump began his second term.

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

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.

“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.”

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.

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%.

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.��

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.

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.”

“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.”

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

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A Canadian Hospital Scoops Up Nurses Who No Longer Feel Safe in Trump’s America

Brett Kelman — Fri, 27 Feb 2026 19:30:00 +0000

Last year, as the California hospital where she worked was appeasing the Trump administration by erasing words like “equity” and “diversity” from its paperwork, Brandy Frye had seen enough.

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.

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

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 Canada��—��specifically,��British Columbia��—��to 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.��

“There are so many like-minded people out there,” said Justin Miller, another American nurse who started at Nanaimo Regional General Hospital this month. “You aren’t trapped. You don’t have to stay. Health care workers are welcomed with open arms around the world.”

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.

“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, it’s heartbreaking. And also a joy to welcome them.”

The Trump administration, for its part, doesn’t seem 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.”

This aligns with an article we reported last year that found American doctors were also relocating north to get away from the Trump administration. According to the Medical Council of Canada, more than 1,200 American doctors created accounts on in 2025 — typically the first step to getting licensed in Canada — compared with only about 300 in 2024.

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Trump’s Transparent Hospital Pricing Pays Off for Industry — But Not So Much for Patients

Darius Tahir — Fri, 20 Feb 2026 19:30:00 +0000

“We’re going to post that, all the prices for everything,” Health and Human Services Secretary Robert F. Kennedy Jr. held by the conservative Heritage Foundation in Washington.

It’s a bold-sounding promise, and a familiar one; politicians from both parties have been repeating it for years now. Both Trump administrations — and the Biden administration in between — have taken whacks at making medical prices more accessible, with the goal of empowering patients to shop for better deals.

The idea makes intuitive sense. Why shouldn’t you be able to compare the prices of MRI scans, for instance?

The feds have made some strides. Prices are available, albeit in confusing or fragmentary form. But there’s one big problem: “There’s no evidence that patients use this information,” said Zack Cooper, a health economist at Yale University.

Health care is an inherently complicated marketplace. For one thing, it’s not 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 charged very different amounts. One patient might be given medications to speed up contractions; another might not. Or one might need an emergency cesarean section — one of many cases in medicine in which obtaining the service simply isn’t a choice. Plus, the same hospital typically has different contract terms with each insurer, making comparing prices even more difficult for patients.

Instead of helping consumers sort things out, this federally mandated price data largely has become a tool for providers and insurers, looking for intel about their competitors — so they can use it at the negotiating table in a quest for more advantageous rates.

“We use the transparency data,” said Eric Hoag, an executive at Blue Cross Blue Shield of Minnesota, noting that the insurer wants to make sure health care providers aren’t being paid substantially different rates. It’s “to make sure that we are competitive, or, you know, more than competitive against other health plans.”

For all those tugs-of-war, it’s not clear these policies have had much of an effect overall. Research shows that transparency policies can have mixed effects on prices, with of a New York initiative finding a marginal increase in billed charges.

Price isn’t the only piece of information negotiations hinge on. 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’ salaries, for example.

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

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ACA Subsidies Expired. Open Enrollment Ended. But It Will Still Take Awhile To Register the Results.

Julie Appleby — Fri, 13 Feb 2026 19:30:00 +0000

It’s February, so open enrollment for the Affordable Care Act is over. We’re getting the first glimpses of how sign-ups are shaking out after the expiration of enhanced subsidies that helped most people with their premium costs.

While more Americans enrolled than��, the number��was��what��it was��at the same time last year. And experts say��it will��be��months��until��the numbers��are final.��The timing��will depend on��how many of those people��who signed up for coverage��actually pay their premiums and remain enrolled.��

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.

The drop comes after several years of record-breaking enrollment, with 24.2 million sign-ups for the 2025 enrollment year. Enrollment growth took off after enhanced subsidies — which lowered the amount most households had to pay out of their own income toward premiums and removed an upper-income cap — went into effect during the Biden administration. Lawmakers, in adopting the enhanced subsidies, set an expiration date of Dec. 31, 2025.

Congressional debate over extending those more generous subsidies was heated, even . Now, the subsidies are back to their original level, and people who earn more than four times the federal poverty rate (about $62,600 for an individual or $84,600 for a couple) can’t qualify for any at all.

in most states this year, with the biggest drop in North Carolina, where sign-ups fell by nearly 22%, .

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.��

The jump was largest in New Mexico, with its tally of people selecting plans up by nearly 18%. Increases were in the single digits in the other states and Washington, D.C.

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

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

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