The Week in Brief Archives - �鶹Ů�� Health News

Untreated Cancer, Festering Infections: Immigrant Detainees Detail Medical Care Lapses

Rae Ellen Bichell — Fri, 05 Jun 2026 18:30:00 +0000

As the current federal administration rounded up an increasing number of immigrants, with U.S. Immigration and Customs Enforcement holding more than 75,000 in mid-January alone, we heard scattered, localized complaints from detainees alleging medical neglect. We wondered about the extent of the problems and whether the agency and its contractors were keeping pace with detainees’ medical needs nationwide. But no central repository exists, so we had to get creative — and dive into a trove of court records.

Detainees are filing record numbers of habeas corpus petitions in federal court, arguing they’re being held illegally. Sometimes those cases mention medical conditions. But a federal rule makes immigration filings tricky to obtain because they’re usually available only in person at the court where they were filed. The nation has 94 of those courts.

However, a nonprofit collecting such records through a national network of volunteers gave us documents from thousands of those court cases dating to last January. We teamed up with The Associated Press to dive into them.

In analyzing those files, we found that hundreds of detainees in at least 33 states told courts they’d received inadequate medical care. They said that they didn’t get their medications on time — or at all — for everything from diabetes to Parkinson’s to HIV. They told courts their requests for medical help had gone unanswered for weeks, that their blood sugars rose, infections festered, and cancers went untreated. Some said they had collapsed and had seizures.

Court filings described how one man had a stroke while on a video call with his daughter and lost his ability to speak for several days. Records show he hadn’t been getting all his medications while detained. Another detainee described standing by the door each day waiting for the eye drops he needed to maintain his waning vision, as he worried whether he would be able to see his infant child grow up. Even after being released, a father of six U.S. citizens told us he feared he wouldn’t be able to support them because of lingering pain in his leg — the leg a doctor told him came close to needing amputation when an infection in ICE custody went untreated until he passed out and was hospitalized.

Such allegations spanned facilities of all types, from county jails to sites like “Alligator Alcatraz,” as the Department of Homeland Security gutted the office in charge of oversight.

�鶹Ů�� Health News and AP asked the agency to respond to our findings, but it did not provide comment. DHS acting Chief Medical Officer Sean Conley has previously said, “It is both policy and longstanding practice for aliens to receive timely and appropriate medical care from the moment they enter ICE custody.”

Detainees’ families said they feel helpless watching their loved ones deteriorate while in custody and hope they don’t join the rising death toll, which has reached 51 since the start of President Donald Trump’s second administration.

Festering Infections to Untreated Cancer: ICE Detainees Describe Medical Neglect Across US

Immigrant detainees have told courts across the nation that detention officials have failed to treat or stabilize their conditions, from pregnancy to prostate cancer, suggesting that systemic lapses in care extend well beyond record deaths in Immigration and Customs Enforcement custody.

By Rae Ellen Bichell, Claire Galofaro, The Associated Press, Maia Rosenfeld, Renuka Rayasam, Aaron Kessler, The Associated Press, and Byron Tau, The Associated Press June 2, 2026

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

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Budget-Strapped Montana Will Stress-Test Trump’s Medicaid Work Rules

Katheryn Houghton — Fri, 29 May 2026 18:30:00 +0000

Montana will soon test whether cash-strapped and strained state health departments can carry out federal Medicaid work requirements without ending coverage for eligible adults.

On July 1, Montana plans to become the second state after Nebraska to make Medicaid enrollees prove they’re working to keep their coverage. That’s six months ahead of the federal deadline for states to implement Medicaid work rules for millions of enrollees.

That date is also the start of a new state budget year, as well as the deadline for Montana health officials to climb out of a previous Medicaid-driven spending deficit. Montana lawmakers underfunded the health agency when they set the state budget last year — before congressional Republicans passed President Donald Trump’s One Big Beautiful Bill Act. Health policy analysts say the state’s budget crunch is a hint of the challenges to come nationwide.

That’s because the federal spending law requires states to check every six months whether millions of Medicaid enrollees work, go to school, or volunteer at least 80 hours a month, or qualify for an exemption. Those checks will take time and money. Simultaneously, the law is expected to reduce federal Medicaid spending — the largest pool of federal funding for states — by nearly $1 trillion over 10 years, shift more food assistance costs to states, and add tax breaks that could hit state budgets.

“States are the ones that are��gonna��have to do the dirty work of implementing cuts,” said Joan Alker, a Georgetown University researcher focused on health coverage.��

Part of Montana’s proposed budget fix is to stall rate increases for healthcare providers that were due July 1. Clinicians told me they already struggle to afford hiring staff amid growing waitlists for care, which they blame on low Medicaid payments.

Meanwhile, there are some red flags in the state’s Medicaid data from recent years: People often face long waits to access public assistance, and many can lose coverage at renewal time because of paperwork issues.

All these problems reflect a national challenge to connect people to care through strained public assistance programs. Our reporting has long shown how states have struggled to process Medicaid applications.

“Our concern is, is the department ready?” Jean Branscum, CEO of the Montana Medical Association, said of the state health agency. “Does the capacity exist for all this to be done right and ensure that patients don’t pay the price?”

State officials have said they’ll scan existing data to try to automatically confirm whether people meet the work rules. And they’ve been building up their public assistance team for months.

But they’ve had to wait on unanswered questions from the federal government that are key to exempting especially vulnerable people from the incoming rules. And now, they’ve got a lot more work to do with less money.

Montana Hurries To Adopt Trump’s Medicaid Work Rules Amid Budget Woes

The state is ramping up to implement the federal work requirements six months ahead of the deadline. But Montana is one of several states already struggling to pay for health services.

By Katheryn Houghton May 27, 2026

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Trump Bought Stock in Eli Lilly as His Policies Gave the Drugmaker a Big Boost, Documents Show

Darius Tahir — Fri, 22 May 2026 18:30:00 +0000

President Donald Trump has long bantered about GLP-1s, the breakthrough medicines that have changed care for diabetes and obesity. Sometimes he calls them “the fat drug.” In an interview with the in January, he mused that “I probably should” take them.

A few days before the Times published that story, Trump invested in Eli Lilly, the nearly $1 trillion drugmaker whose fortunes are closely tied to its blockbuster GLP-1s, Zepbound and Foundayo — and to government reimbursement for the medicines.

This week we reported on several Lilly stock purchases made by Trump or his brokers from January to March, totaling as much as $680,000, according to a disclosure signed by the president. He also purchased stock worth $250,000 to $500,000 in West Pharmaceutical Services, a company that manufactures devices for injectable drugs. It, too, is benefiting from the GLP-1 surge.��

As the purchases occurred, the Trump administration was undertaking an agenda that boosted the GLP-1 market, including advancing Medicare reimbursement for the drugs to treat obesity, a long-held goal for Lilly. The deadline for drug manufacturers to get involved in a reimbursement project was Jan. 8.��

The administration also intensified a crackdown on “compounded” GLP-1s — cheaper, copycat medications made by pharmacies that critics (and brand-name drugmakers) claim are unsafe. That knocked out competitors to Lilly’s products. Trump’s FDA also rapidly approved Lilly’s GLP-1 pill, Foundayo.��

The timing of the Lilly purchases — among more than 3,600 trades Trump or his representatives made in the first quarter of the year — troubled government ethics experts.��

“A president who buys or sells the stock of a company whose value is affected by his administration’s actions undermines the public’s trust in two ways,” said Kathleen Clark, a legal ethicist at Washington University in St. Louis.

First, she said, the public should believe government actions are motivated by common good, not personal enrichment. Second, the public should believe that those within government aren’t benefiting from inside information.

The disclosures have also intensified criticism from Trump opponents who say he’s trying to profit from the presidency.

Congressional Democrats are calling for legislative action. “Trump is the ultimate con man — rig the game, manipulate the rules, and reap the benefits,” Sen. Andy Kim (D-N.J.) , highlighting our report. “It’s long past time we ban presidents from owning and trading stocks.”��

Democrats might have their shot at a bill in 2027. Public opinion is increasingly swinging in their direction, and taking both chambers of Congress is a possibility. (Of course, even if Democrats claimed those majorities and passed a bill, it would have to be signed by Trump.) If they were determined to pursue anti-corruption measures relating to health issues, they would have targets beyond Trump’s stock trading. Democrats have also questioned corporate contributors’ influence on changes in FDA tobacco regulation, for example.��

Trump Bought Stock in Drugmaker as His Government Boosted Its Obesity Drugs

New ethics disclosures show the president invested in Eli Lilly and a company that manufactures injectable devices as his health agencies implemented policies that benefited them.

By Darius Tahir May 18, 2026

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Kennedy Swaps Vaccine Rhetoric for Story Time but Can’t Quite Change the Subject

Amanda Seitz — Fri, 15 May 2026 18:30:00 +0000

Here in Washington, we’ve been hearing about tensions between the White House and one of its most controversial — but, at least in some circles, most popular — figures: Robert F. Kennedy Jr.

Polling of likely voters indicates that the Health and Human Services secretary can be an asset to Republicans when he’s talking about improving the nation’s food supply or labeling ultraprocessed foods. But when he’s talking about removing recommendations for routine childhood vaccinations, he can be a detriment.

So, when I learned Kennedy would be taking his show on the road to my home state of Ohio, where populist figures tend to perform well, I knew I had to be there.

How would a politician who built his reputation seeding widespread doubts about routine childhood immunizations stay away from one of the core messages he’s preached for years?

Well, it turns out, he starts by reading a book about a trash truck to preschoolers.

The trip took us across northern Ohio, from a regenerative farm in Huron owned by two brothers who grow colorful vegetables to��the Cleveland Clinic, where Kennedy masked up��entering an operating room��of��a heart surgery patient.

In the end, though, Kennedy couldn’t escape the vaccine talk.

Speaking at the City Club of Cleveland, Kennedy raised doubts about the safety of vaccines that had been — up until last year — universally recommended to prevent hepatitis B, an incurable disease.

He called for parents to “be given that choice” on��administering��the vaccine��to newborns,��a remark that gave way to cheers and applause��from��half the room.

The other half groaned and booed.

When I sat down with the health secretary for a few minutes in an Ohio farmhouse, Kennedy ticked off his accomplishments during his first year in office; redesigning federal nutrition guidelines and defining ultraprocessed foods for the American public were among them.

As his list grew longer, I thought about the mothers I’d talked to over the last year who had become increasingly nervous about taking their infants out in crowded places amid a raging measles outbreak and the growing threat from other infectious diseases.

What was his message for those parents, I asked?

“I would say everybody should be vaccinated — against measles,” Kennedy told me. “But we need to pay more and more attention to chronic disease. All of the vaccine-preventable, infectious diseases put together kill probably 10,000 Americans a year.”

The number of deaths is , according to scientific researchers.

RFK Jr. Swaps Vaccine Talk for Healthy Foods and Reading to Tots in Push To Woo Voters

He tested robotic hands on a heart surgery patient and chewed on microgreens in Ohio, but Health and Human Services Secretary Robert F. Kennedy Jr. couldn’t dodge questions about the Trump administration’s more controversial policies.

By Amanda Seitz May 13, 2026

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The Make America Healthy Again Movement Comes for Hospital Food

Stephanie Armour — Fri, 08 May 2026 18:30:00 +0000

Hospital food rarely draws rave reviews. But efforts by the Trump administration to get hospitals to ditch unhealthy fare are facing criticism for going too far.��

The Department of Health and Human Services to hospitals asking them to align their food purchases with the administration’s 2025-30 dietary guidelines to ensure continued eligibility for Medicaid and Medicare payments. “We commend the many hospitals who have made commitments to improve their food offerings, and expect every hospital system to do so,” HHS spokesperson Andrew Nixon said.��

Top Kennedy adviser Calley Means took to social media to explain the initiative, urging the public to report hospitals that don’t comply with the guidance. The comment included a link to an HHS webpage with a toll-free number for reporting complaints typically used for medical bills.

The warnings drew sharp rebukes from critics who said the directive fails to consider that the specific dietary needs of patients are often different from those of the rest of the population.��

“It’s always a struggle to get people to eat. Losing weight in the hospital raises the risk of mortality,” said Mary Talley Bowden, a sleep medicine specialist, who has with Make America Healthy Again causes but on X, posting: “Give me a break Calley. A hospital snitch line for soda?”��

“It’s a little tyrannical,” she said in an interview.

HHS can withhold or threaten federal funding if hospitals violate mandatory minimum health and safety standards set by the agency. The standards stipulate that hospitals must protect patient privacy, for example, and uphold infection control.

The standards do address hospital food, but they don’t explicitly refer to the 2025-30 established by the U.S. Department of Agriculture.��

Rather, the standards require that “individual patient nutritional needs must be met in accordance with recognized dietary practices,” and list other requirements for hospitals, such as having access to a qualified dietitian.��

HHS Secretary Robert F. Kennedy Jr. “doesn’t have a legal basis to do this, but hospitals and nursing homes can’t afford to ignore it altogether because of what it signals about potential enforcement action,” said Nicholas Bagley, a University of Michigan law professor.

HHS’ Healthy Food Agenda Puts Hospitals on Notice About Patients’ Meals

The backlash was immediate after the Trump administration served notice that hospitals and nursing homes should limit sugary drinks and dietary supplements in favor of what the Department of Health and Human Services terms “real food.”

By Stephanie Armour May 4, 2026

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Prevention Efforts Increasingly See Suicide Through a Broader Lens

Aneri Pattani — Fri, 01 May 2026 18:30:00 +0000

If you or someone you know may be experiencing a mental health crisis, contact the 988 Suicide & Crisis Lifeline by dialing or texting “988.”

Someone in America dies by suicide every 11 minutes. It’s that common. But that doesn’t make it normal.

Humans have evolved over centuries to survive. So when people try to kill themselves, something has gone wrong. Typically, the assumption is that something happened in the person’s mind — a mental illness.

That’s led prevention efforts to typically focus on connecting people with treatment in moments of crisis.

But that’s changing. There’s a growing movement asking a different question: What went wrong in the world around that person?

During the covid pandemic, rates of anxiety and depression spiked — not because everyone’s brain chemistry suddenly changed but because the world changed. People were out of work, isolated, struggling to make ends meet.

That led many people in the mental health advocacy world to call for a broader approach. Treatments and crisis care are vital, they say, but the goal of suicide prevention needs to expand beyond stopping people from dying to also��giving��them reasons to live.

Decades of research��supports��this idea. Interventions that improve people’s lives and prospects, such as running food banks to ensure families��don’t��go hungry or hosting weekly book clubs for homebound seniors to make friends, can reduce suicide.

I spoke with Chris Pawelski, a fourth-generation farmer in Orange County, New York, for this story. He told me how his dad’s passing, caring for his mom with dementia, and the struggling finances of his family’s onion farm brought him to consider suicide.

“It’s all stuff collapsing down upon you,” he said. “It’s weeks, months, years of dealing with all sorts of pressures that you can’t alleviate.”

What helped him through that time was not just family support and therapy. It was also an economic plan. He worked with an organization called NY��FarmNet, which provided a free financial consultant who helped Pawelski transition from farming onions for wholesale to a new model, growing varied produce to sell directly to consumers.

Today, Pawelski’s business has stabilized, and he and his wife are��paying down��debt. He��advocates for��programs to help others in similar situations.

That can mean crisis hotlines and access to affordable therapy, Pawelski said. But what he really wants are policy changes that help people address underlying hardships before a crisis strikes.

“We need to think broader and longer-term than a helpline,” he said. That’s “a band-aid on a gunshot wound.”

ELEVEN MINUTES

Saving Lives by Changing Lives: The Next Frontier in Suicide Prevention

Someone in America dies by suicide every 11 minutes. It’s a tragic and entrenched problem. A new approach to prevention shifts the focus from stopping harm in moments of crisis to upstream policies that give people reasons to live.

By Aneri Pattani April 29, 2026

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In Connecticut, Doctors and Dentists Are More Likely Than Hospitals To Sue Patients

Noam N. Levey — Fri, 24 Apr 2026 18:30:00 +0000

How often do hospitals, physicians, and other providers sue patients over unpaid bills?��

That’s a question we’ve asked a lot over the last several years at �鶹Ů�� Health News. Since 2022, we’ve been working with newsrooms around the country, such as the Connecticut Mirror, to explore the scale and impact of America’s medical debt crisis. It’s part of a project we call “Diagnosis: Debt.”��

We know that this type of debt burdens many people — about 100 million adults, according to a nationwide survey we did. But in most states, it’s almost impossible to gauge how many patients are getting taken to court over health care debt.��

Connecticut’s court data is different.��

It offered an opportunity to explore just how many people are being sued over medical and dental bills, who is suing patients, and for how much. Over the past year, I’ve collaborated with CT Mirror reporters Katy Golvala and Jenna Carlesso to learn more about the people facing legal actions.

What we found was surprising … and sad. This week, we shared the first of our articles, which explores how hospitals have been supplanted by physician groups and other medical and dental providers as the most aggressive bill collectors.

That’s a major reversal from five years earlier, when hospital system lawsuits made up three-quarters of health-related collection cases in the state’s courts.

The shift is moving medical debt collections into a less regulated realm. Most hospitals, because they are tax-exempt nonprofits, must make financial aid available to low-income patients and follow federal regulations that limit aggressive collection activities. Other medical providers, such as private medical groups, are generally exempt from these rules.��

Lawsuits can lead to garnished wages, liens on homes, and hundreds of dollars of added debt from interest and court fees. They also pile additional financial strains on struggling families, prevent patients from getting needed care, and sap trust in medical providers.

“It’s really messed up,” said Allie Cass-Wilson, a nurse in Bristol, Connecticut, who was sued over a $1,972 debt by an OB-GYN practice where she’d been a patient years earlier. She did not contest the lawsuit, court records show. Still, she asked: “How can they do that to people?”

Diagnosis: Debt

In Connecticut, Doctors Now Sue Patients Most Over Medical Bills, Surpassing Hospitals

Physicians, dentists, and other nonhospital providers account for more than 80% of health care debt collection cases in Connecticut courts, a CT Mirror-�鶹Ů�� Health News investigation finds.

By Noam N. Levey, Katy Golvala, CT Mirror, and Jenna Carlesso, CT Mirror April 20, 2026

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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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