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Healthcare a Vague but Potent Issue for Election 2026

Thu, 24 Sep 2026 19:05:21 +0000

The Host

Julie Rovner ��ýҕ�l Health News Read Julie's stories. Julie Rovner is chief Washington correspondent and host of ��ýҕ�l Health News’ weekly health policy news podcast, "What the Health?" A noted expert on health policy issues, Julie is the author of the critically praised reference book "Health Care Politics and Policy A to Z," now in its third edition.

Healthcare, in particular its rising costs, is a key issue for voters in both parties this fall. But lawmakers are offering a variety of remedies on the campaign trail, suggesting that neither party has an agreed-upon approach.

Meanwhile, the Trump administration has apparently backed off a plan — for now — to create a political board to review scientific grant awards from the National Institutes of Health. The pause came after public complaints from Senate Appropriations Committee Chair Susan Collins of Maine, who is fighting to retain her seat and, possibly, maintain the GOP majority in the upper chamber.

This week’s panelists are Julie Rovner of ��ýҕ�l Health News, Tami Luhby of CNN, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico Magazine, and Sarah Jane Tribble of ��ýҕ�l Health News.

Panelists

Tami Luhby CNN

Joanne Kenen Johns Hopkins University and Politico

Sarah Jane Tribble ��ýҕ�l Health News Read Sarah's stories.

Among the takeaways from this week’s episode:

A new KFF-AP rural-voter polling project found that affordability issues are central concerns in rural America. Overall, 48% of rural voters say the economy is worse off than it was at the start of President Donald Trump’s term, and healthcare is one of the key pain points. Findings also indicate that among rural voters — historically a strong Trump constituency — about half still approve of the president’s job performance. Some of these voters, though, said they may sit this election out. That’s notable because the midterms are often determined by who shows up.
The Trump administration is pushing its anti-fraud agenda as an election issue, using it as a counternarrative to Democrats’ complaints that Republicans’ refusal to extend covid-era Affordable Care Act subsidies led to a large drop in ACA enrollment this year. This week, Vice President JD Vance announced that the administration was cutting 750,000 more enrollees from Obamacare, alleging they are fraudulently enrolled.
Despite early suggestions that the administration would back away from the anti-vaccine views pushed by Health and Human Services Secretary Robert F. Kennedy Jr., both he and Trump this past week continued to push anti-vaccine efforts. Kennedy was the keynote speaker at the conference of the anti-vaccine organization he helped found, while Trump in an Oval Office event suggested that currently administered childhood vaccines be divided into five separate doses.

Plus, for “extra credit” the panelists suggest health policy stories they read this week that they think you should read, too:

Julie Rovner: ��ýҕ�l Health News’ “The Drugs and Devices Have Been on the Market for Years. But FDA-Ordered Studies Still Aren’t Done,” by David Hilzenrath.

Tami Luhby: The Wall Street Journal’s “,” by Liz Essley Whyte.

Joanne Kenen: Slate’s “,” by Molly Olmstead.

Sarah Jane Tribble: Stat’s “,” by John Wilkerson.

Also mentioned in this week’s podcast:

��ýҕ�l Health News and The Associated Press’ “Economic Frustration Tests Trump’s Standing With Rural Voters, New KFF-AP Poll Finds,” by Sarah Jane Tribble, Ali Swenson, and Linley Sanders.
Axios’ “,” by Caitlin Owens and Adriel Bettelheim.
The Washington Post’s “,” by Dan Diamond and Riley Beggin.
The Washington Post’s “,” by Dan Diamond and Riley Beggin.
KFF’s “,” by Matt McGough, Lynne Cotter, Justin Lo, Imani Telesford, Ashley Ferguson, Avni Gupta, and Juliette Cubanski.

Click to open the transcript Transcript: Healthcare a Vague but Potent Issue for Election 2026

Black Lung Disease Remains a Threat, but Federal Officials Delay Effort To Address It

Taylor Sisk — Thu, 24 Sep 2026 09:00:00 +0000

OAK HILL, W.Va. — Each day at New River Health in Oak Hill, Lisa Emery finds disheartening signs of what she describes as a slow-motion repeat of the Hawks Nest Tunnel disaster.

Emery is director of New River’s Breathing Center and chair of the .

The disaster she’s reminded of started in 1930, when on a 3-mile tunnel through Gauley Mountain in West Virginia. Over the course of 18 months, some 3,000 miners, most of them Black, spent long hours drilling through sandstone, engulfed in a cloud of its toxic byproduct, silica dust. More than 750 men died from that exposure.

The risk still exists, and advocates for workers say the government should do more to rein it in.

In April of last year, the Trump administration paused the enforcement of a rule designed to help protect coal miners from an aggressive form of coal workers’ pneumoconiosis, commonly known as black lung disease, the primary cause of which is exposure to silica dust.

(Other occupations at high risk of include construction, countertop fabrication, and oil and gas work. The new rule would reduce the permissible limit of exposure in coal mining to the existing level in other industries.)

This April, the Labor Department’s Mine Safety and Health Administration announced an indefinite delay in enforcement of the rule.

Gary Hairston sits on New River Health’s board. For decades, Hairston, a retired coal miner and president of the national , has been an advocate for miners struggling with the debilitating effects of black lung, including extreme fatigue, an incessant cough, and a sensation of drowning. He regularly lobbies legislators for improved working conditions and black lung benefits. His entreaties, he said, seem to fall on deaf ears. He rarely gets an audience with the legislators themselves.

“I’d just like them to look me in the face,” Hairston said.

Gary Hairston, president of the Black Lung Association, says his lobbying of legislators for improved working conditions and black lung benefits for coal miners seems to fall on deaf ears. (Taylor Sisk for ��ýҕ�l Health News)

Evidence from just-released research underscores the urgency of his appeals for a safer work environment.

In August, the National Institute for Occupational Safety and Health, an agency within the federal Centers for Disease Control and Prevention, on the results of testing conducted over the past five years on miners in central Appalachia — eastern Kentucky, southwestern Virginia, and West Virginia — with 25 or more years underground. Almost 1 in 3 tested positive for black lung disease, the highest rate in nearly 50 years.

The rate in 2018, the last time the agency reported results, was 1 in 5. The lowest reported rate, in 1999, was less than 1 in 10.

“We knew this would happen,” said Sam Petsonk, a West Virginia attorney who has represented thousands of miners in the region. “It’s surprising to me that they only found one in three.”

Silica Dangers

Exposure to silica has increased as more-accessible coal seams are depleted, requiring mining operations to probe deeper, often through sandstone. The stone breaks into sharp particles that are than a grain of sand and, according to National Institute for Occupational Safety and Health research, are than coal dust. Trapped in lung tissue, those particles can cause a debilitating, sometimes fatal condition.

Kenny Thompson, a retired West Virginia miner who now lives in Richmond, Kentucky, was employed in the mines for 22 years. He would sometimes cut into four feet of sandstone to reach a coal seam.

“You ate a lot of dust,” Thompson recalled. It induced nausea. It took a toll.

In October 2025, he had his left lung removed. Post-surgery, he was in a coma for three months; he flatlined three times, he said. “They were about to really give up on me.”

He had to relearn to walk and to talk. Trekking to the mailbox still leaves him winded, lightheaded, and blurry-eyed.

The new silica rule would cut the allowable level of silica dust in half, thereby meeting the standard of other industries. Miner advocates laud the fact that it would require operators to deploy engineering controls, such as improved ventilation systems and water sprays.

But the National Mining Association and other industry trade groups argue that reaching and maintaining compliance would also require supplementing those controls with workforce measures, such as requiring personal protection equipment and rotating miners from particularly dusty areas. Many miners, and their advocates, say such measures are impractical — because respirators can impede breathing, can limit vision, and often malfunction, and because smaller mines don’t have enough workers to support rotating schedules.

In April 2025, the 8th U.S. Circuit Court of Appeals granted an emergency stay of the rule to give operators more time to comply.

In May of this year, the Labor Department sent the White House Office of Management and Budget a on the proposed rule. And in July, the department’s regulatory agenda included a new , indicating its intent to amend the rule.

The department’s Mine Safety and Health Administration “recognizes it has a clear duty under the law to impose stricter silica standards,” said Petsonk, the attorney representing coal miners. “They’re failing to provide that measure of protection to American coal miners, so they’re going through bureaucratic motions to make it seem like they’re doing something, when, in fact, they’re just perpetuating an illegal and lethal status quo.”

The Labor Department declined to comment on ongoing rulemaking or litigation.

“We knew this would happen,” West Virginia attorney Sam Petsonk says of a recently released report showing that the black lung rate for coal miners in central Appalachia is at a nearly 50-year high. (Taylor Sisk for ��ýҕ�l Health News)

‘It’s On the Books’

The rule is, in fact, in effect, said Chris Williamson, head of the Mine Safety and Health Administration in the Biden administration — it’s just not being enforced. He and his team filed a legal brief in the closing days of the administration defending the rule.

“It’s on the books,” Williamson said, adding that the prohibits weakening existing protections for miners. “I’m just genuinely curious,” he said. “I want to know how they can address the issues that the industry’s raised without weakening protections for miners.”

Meanwhile, younger miners, with a decade or less in the mines, are being diagnosed with advanced stages of black lung. New River Health’s Emery said the youngest person her clinic had diagnosed with was 30. He’d worked underground for 10 years.

This is no longer just your “papaw’s disease,” she said. “It’s your husband’s disease. It’s your son’s disease.” (More than 90% of coal miners are men.)

With families to support, Emery said, “what do these guys do when they’re disabled in their 30s?”

Lisa Emery is director of the New River Health Breathing Center in West Virginia and chair of the National Coalition of Black Lung and Respiratory Disease Clinics. She says the youngest person her clinic has diagnosed with complicated black lung was 30. (Taylor Sisk for ��ýҕ�l Health News)

She told of a man who sat in her office with his wife, describing his symptoms. As he spoke, he began to cry. His wife was taken aback. “‘I didn’t know it was that bad,’” Emery recalled her saying. “And he said: ‘That’s why I haven’t fixed the deck. I haven’t fixed the deck because I can’t breathe, and I’m just so tired.’”

Thompson can relate. “For 22 years, you’re used to getting up, putting your boots on every day, and going to work,” he said. “I’d been in great health shape and 160 pounds. And here I am now, I don’t work at all and I’m 115 pounds.”

Still, he recognizes what the job afforded.

“You know, it put my girls through college,” he said. “And to me, as a dad, that was the best reward that I can give them, to move forward in life, to be successful at what they chose to be and not work like a dog like I had to.”

President Donald Trump said in an : “Our Nation’s beautiful clean coal resources will be critical to meeting the rise in electricity demand due to the resurgence of domestic manufacturing and the construction of artificial intelligence data processing centers.”

Six months later, the Energy Department announced a to “expand and reinvigorate America’s coal industry.”

Should the administration announce a weaker rule, it would be “an unconscionable crime against American coal miners,” Petsonk said. “But I fear that’s going to happen.”

In June, Hairston spoke at a reception for a photo exhibit titled “.”

“It seems like coal miners, we’re just a number,” he said. “Just a number.”

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

This article first appeared on ��ýҕ�l Health News and is republished here under a .

The Drugs and Devices Have Been on the Market for Years. But FDA-Ordered Studies Still Aren’t Done.

David Hilzenrath — Fri, 18 Sep 2026 09:00:00 +0000

When the FDA was deciding whether to approve the drug Tavneos several years ago to treat a set of , agency experts argued that would be a mistake, according to .

One problem cited: The manufacturer had provided only

As it often does, the FDA in 2021 approved the drug with a proviso: It required the manufacturer to conduct an additional years-long safety study once the drug was on the market.

Today, like many similar “postmarket” studies mandated by the FDA, that additional study is delayed, according to a . As of last fall, only 21 of the planned 300 patients had been enrolled, the FDA said in an and .

Meanwhile, the FDA has dozens of cases of “possibly” or “probably causally associated” with the drug. That was one of the potential side effects the postmarket study was meant to evaluate.

Tavneos illustrates the perils of the FDA’s approach to many drugs and medical devices — and the frequent lapses in follow-through.

A ��ýҕ�l Health News analysis of Food and Drug Administration data found hundreds of postmarket studies listed as delayed. In some cases, the work was delayed by more than a decade or the manufacturer was still developing a plan for the study.

As a result of delays, patients, doctors, and others could be left in a fog about the risks and benefits of the drugs or devices, even as they stake their money, their health, or their lives on the products.

Postmarket study requirements “have often proven toothless,” said cardiologist , an associate professor of medicine at the University of California-San Francisco who has published .

The FDA’s reliance on postmarket studies reflects a balancing act.

Making new treatments available faster can save or improve lives, especially when patients with grim prognoses and no good options have little to lose. The full risks and benefits may be revealed only over the long term, and when therapies are used by far more people than even large clinical trials enroll.

But relying on post-approval studies to resolve questions risks exposing patients to products that do more harm than good. Whoever is paying the bills — patients, insurance companies, employers, or government health programs such as Medicare and Medicaid — can end up wasting money and rewarding manufacturers for useless or risky products.

“Doctors rely on this evidence, patients rely on this evidence, and if that evidence is not there, it’s going to lead to a lot of uncertainty,” Dhruva said.

Trump administration policy changes designed to hasten drugs through FDA review could leave more riding on postmarket studies, medical researchers say.

For example, in February, that “the default requirement” for agency approvals will be one clinical trial instead of two.

Reducing pre-approval testing “will inevitably put a lot of pressure on the post-approval system,” said , a professor at Harvard Medical School who postmarket studies.

FDA officials said the new policy would “substantially reduce costs” for manufacturers and “speed drugs to market.” Writing in The New England Journal of Medicine, they denied the change would compromise safety or efficacy, saying that “erroneous conclusions may be reached even with two, three, or four studies.”

In response to questions for this article, a spokesperson for the Department of Health and Human Services, which includes the FDA, said postmarket studies can experience delays for legitimate reasons. “Assessing the significance of any delay requires a case-specific review,” said the spokesperson, Emily Hilliard.

The fact that a study is delayed “should not be treated as evidence that a product has an unresolved safety or effectiveness issue,” Hilliard said.

Amgen, the company that makes Tavneos, is still working on the postmarket research the FDA mandated, company spokesperson Alison Chartan said, adding, “We remain committed to completing this important study.”

Amgen’s headquarters in Thousand Oaks, California, in May 2023. (Mario Tama/Getty Images)

Behind Schedule

An FDA database downloaded by ��ýҕ�l Health News in August tracks the progress of postmarket studies that makers of — such as vaccines and gene therapies — were required to perform or promised to perform.

The database showed almost 600 were running behind schedule.

Of those, more than 250 originally had final reports due before July 31, 2026 — the date that, according to an FDA webpage, the database last had been updated.

About a third of ongoing studies were listed as delayed.

In some cases, the FDA has granted extensions. In others, it has denied them. And in rare instances, the products were discontinued before the studies ran their course.

Postmarket studies can involve clinical trials or other analyses of patient data. They can look at safety or efficacy. A product can be the subject of more than one postmarket study.

The nearly 600 delayed studies involved almost 350 products, ��ýҕ�l Health News found.

The FDA has defined delayed as . That can mean off track or overdue.

As of August, other FDA databases tracking listed dozens of postmarket studies as behind schedule.

Products included:

The CustomFlex Artificial Iris, a prosthesis implanted in the eye in place of damaged, defective, or congenitally missing irises. The protocol for a study in children was accepted in 2019, the database said. The study was meant to follow patients for five years. According to an FDA page downloaded in August, zero patients were enrolled.

Barbara Fant of Clinical Research Consultants, to whom the FDA’s 2018 letter approving the product was addressed, said the rarity of an eye disease called aniridia poses challenges for post-approval studies. The German manufacturer, the U.S. distributor, and Clinical Research Consultants are working with the FDA to identify alternative ways to fulfill the postmarket requirements, Fant said.

“Confirming the long-term safety of the device remains a top priority for both the study team and FDA,” Fant said.

Paxlovid, a treatment for covid. A study to assess its safety in pregnant women was originally to be completed by the end of 2024, the FDA database said. “The trial completion and final report milestones were missed,” the database said.

Pfizer, the manufacturer, is working with the FDA and remains committed to “submitting results as soon as practicable,” Pfizer spokesperson Jerica Pitts said.

The Scandinavian Total Ankle Replacement system. The device and the original protocol for the clinical trial were approved in 2009. The study was meant to include a minimum of 500 subjects, the database said, but the actual number enrolled was 142. Almost half those patients had one or more adverse events, with dozens of “reoperations,” “revisions,” or “removals,” the database said.

Rachel Colloff and Cristina Pasquino — spokespeople for Enovis, which markets STAR Ankle — did not respond to multiple inquiries. Jenny Braga, a spokesperson for Stryker, which previously sold the product, did not answer questions about the postmarket study.

Oxaydo (originally named Oxecta), a form of the potentially addictive opioid painkiller oxycodone . When the FDA approved it in 2011, it required the manufacturer, , to conduct a postmarket study to assess whether it reduces “misuse and abuse, and their consequences: overdose, death and addiction.” The final report was originally scheduled to be submitted in 2016.

The FDA database listing the study as delayed said the agency “issued a failure to respond letter” in 2022.

Today the issue may be all but moot.

Control of the product passed from company to company over the years until 2023, when Acura Pharmaceuticals said in a that patents on Oxaydo would begin expiring that year and it didn’t intend to continue marketing the drug.

According to another FDA database, Oxaydo .

The FDA has enforcement powers and uses them “where appropriate,” HHS’ Hilliard said. She did not provide requested details, and she did not answer questions about the studies listed above.

Delay Can Pay

For manufacturers, delay can pay, Harvard’s Kesselheim said. While postmarket studies are ongoing, companies can continue to sell the products.

“Medicare and Medicaid spent more than $18 billion from 2018 to 2021 for accelerated approval drugs with incomplete confirmatory trials past their original planned completion dates,” the HHS Office of Inspector General .

The FDA can demand postmarket studies for a variety of reasons, including to address concerns that arise after a product has been approved. Some look at uses not covered by the original approval, and some are meant to shed light on that are already known.

In April, when it approved Foundayo, a weight loss drug made by Eli Lilly, the FDA required the company to conduct additional research to assess a variety of concerns, including “retained gastric contents,” “major adverse cardiovascular events,” and “drug-induced liver injury,” as well as effects of exposure during pregnancy, such as “major congenital malformations,” “spontaneous abortions,” and “stillbirths.”

The FDA said it approved the drug under the new Commissioner’s National Priority Voucher program, intended for products that “.” The program strives for an “” review, the FDA has said — one to two months, instead of six months or more with other expedited pathways.

“Postmarketing requirements and enhanced safety monitoring are a routine part of the FDA’s approach to evaluating newly approved medicines,” Eli Lilly spokesperson Kristiane Silva Bello said, “including ongoing monitoring in areas identified during clinical development.”

‘False Hope’

The FDA waded into a world of uncertainty in 2016 when it granted accelerated approval to a drug for Duchenne muscular dystrophy, a degenerative disease that primarily affects boys, disabling them at a young age and ultimately killing them.

Agency scientists had found that the drug, Exondys 51, was unproven and argued against greenlighting it.

Ellis Unger, then a senior drug evaluation official at the FDA, that “thousands of patients and their families would be given false hope in exchange for hardship and risk.”

The manufacturer, Sarepta Therapeutics, . “A clinical benefit of EXONDYS 51 has not been established,” it said when the drug, also known by the generic name eteplirsen, was approved.

The drug, the first FDA-approved treatment for Duchenne muscular dystrophy, targeted a subset of patients with the disease.

The FDA required Sarepta to conduct further studies and it could withdraw approval if postmarket trials failed to verify a clinical benefit or were “not conducted with due diligence.”

Unger issued a warning of his own: “FDA has not succeeded in withdrawing the marketing of a single drug for lack of verification of clinical benefit following accelerated approval. The reality is that if eteplirsen is given accelerated approval, it is highly likely to remain on the market indefinitely, irrespective of whether or not efficacy is verified.”

Sarepta was originally required to submit a final report on a postmarket study by a May 2021 deadline, according to an FDA database and a 2016 FDA letter to the company.

Almost a decade after the drug was approved, and more than five years after that deadline, the study was listed in an FDA database as delayed.

“The final report milestone was missed, because the sponsor requested milestone extensions due to study delays,” the database said.

Meanwhile, in 2022 the website ranked Exondys 51 as the second-most expensive drug in the U.S., at an annual cost of $750,000 to $1.5 million.

Last year, the drug generated for Sarepta, according to a company presentation to investors.

Sarepta found it difficult to recruit patients for the postmarket clinical trial, company spokesperson Tracy Sorrentino said. The target population is small, patients were hesitant to enroll, and Sarepta was competing with other clinical trials for participants, Sorrentino said.

The study has been fully enrolled since 2023, Sorrentino said, and the company plans to provide an initial look at the data late this year.

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Amgen is the maker of the drug Tavneos. (Hannah Yoon/Bloomberg via Getty Images)

Amgen has cited similar challenges, even as Tavneos generated $459 million in global sales last year.

When an approved treatment is available, patients may be reluctant to enroll in a study in which they could be given a placebo, Amgen’s Chartan said.

The clinical trial supposed to be done . As of July 24, just 49 patients had been enrolled, Chartan said.

The FDA has said the study was to include , and each patient enrolled must be followed for five years, said Hilliard, the HHS spokesperson.

Tavneos was approved to treat severe cases of a group of diseases — known by the shorthand ANCA-associated vasculitis — in which, as the explains, the immune system inflicts potentially fatal damage on blood vessels and organs.

“As of January 2026, estimated real-world exposure” to Tavneos “exceeds 25,000 patient-years globally, consisting of over 6,500 in the United States and 19,000 abroad,” Amgen has said. (For context, one patient taking a drug for five years would amount to five “patient-years.”)

A clinical trial sponsored by ChemoCentryx to secure approval of Tavneos failed to prove it was effective, the FDA now alleges. Instead of disclosing that outcome to the FDA, company personnel “” the , the FDA alleged in an to Amgen.

Amgen, the parent company of ChemoCentryx, has denied the results were manipulated and has said the data “.”

Nonetheless, the recently of Tavneos.

The FDA is trying to , and Amgen is fighting that effort.

The company has a lot riding on the outcome. Tavneos can cost more than $220,000 per year, according to the , and when Amgen in 2022 for $3.7 billion, Tavneos was the only drug ChemoCentryx had brought to market.

In a June , Amgen said the benefits of Tavneos outweigh the risks.

The FDA disagrees.

The FDA “can no longer conclude that there is, or has ever been, a valid demonstration of substantial evidence of effectiveness for TAVNEOS,” .

Citing 76 cases of DILI — — the agency said it was “increasingly concerned about the safety profile of TAVNEOS.” Without proof of effectiveness, at least for its approved use, “the drug’s benefits its known risks,” the FDA wrote.

Data reporter Maia Rosenfeld contributed to this report.

This article first appeared on ��ýҕ�l Health News and is republished here under a .

The Health Risks of AI

Thu, 17 Sep 2026 18:45:00 +0000

The Host

Reports from a top artificial intelligence company that it stopped several attempted uses of its product that could assist in manufacturing a bioweapon caught the attention of lawmakers in Washington this week. But it is still unclear whether or when Congress will act to regulate the fast-moving industry — and the House has left town until after Election Day.

Meanwhile, with many voters expressing anger over the rising cost of healthcare, President Donald Trump is proposing to send $500 checks to some people enrolled in Affordable Care Act insurance plans before the election. But even if those checks materialize, in most cases they will be smaller than the increases many policyholders have already seen.

This week’s panelists are Julie Rovner of ��ýҕ�l Health News, Anna Edney of Bloomberg News, Tami Luhby of CNN, and Alice Miranda Ollstein of Politico.

Panelists

Anna Edney Bloomberg News

Tami Luhby CNN

Alice Miranda Ollstein Politico

Among the takeaways from this week’s episode:

Anxieties about AI reached a fever pitch this week, with a few leading developers calling to slow the pace of innovation amid troubling reports about AI’s progress and use, including reported attempts to misuse AI for biological warfare. Meanwhile, the Trump administration is pressing to incorporate AI into healthcare.
Federal lawmakers are exploring changes to the independent arbitration system created by the No Surprises Act, which took effect in 2022. While the law has cut down on patient exposure to surprise out-of-network medical bills in emergencies, the system has resulted in far larger paydays than anticipated for many doctors — which, in turn, has prompted a sizable increase in coverage costs, including for employers.
Some cities and states are suing to block implementation of the latest public charge rules from the Trump administration, arguing they could have a chilling effect for some who are entitled to public benefits, such as the eligible children of immigrants. They allege that could leave cities and states on the hook and harm local economies.
Abortion opponents are claiming victory as the Environmental Protection Agency moves to test water for remnants of abortion pills, among other chemicals and drugs. California’s attorney general is wrapping up a lawsuit against two nonprofits offering what they describe as abortion pill reversals, despite a lack of evidence the method works or is safe. And the family of a Texas woman who died after being denied an abortion is suing her doctors and the state’s attorney general, Ken Paxton.

Also this week, Rovner interviews Sabrina Corlette of the Georgetown University Center for Health Insurance Reforms, discussing some potential short-term fixes to the nation’s health system.

Plus, for “extra credit” the panelists suggest health policy stories they read this week that they think you should read, too:

Julie Rovner: KJZZ Phoenix’s “,” by Camryn Sanchez.

Tami Luhby: The Washington Post’s “,” by Erica Sloan.

Anna Edney: Bloomberg News’ “,” by John Tozzi, Tanaz Meghjani, and Ike Swetlitz.

Alice Miranda Ollstein: ��ýҕ�l Health News’ “Indigenous Groups Are Exempt From Medicaid Work Rules, but Native Hawaiians Aren’t,” by Ashley Mizuo.

Also mentioned in this week’s podcast:

Science’s “,” by Jocelyn Kaiser.
The New York Times’ “,” by Christina Jewett.
Roll Call’s “,” by Ariel Cohen.
��ýҕ�l Health News’ “A Generation of Kids Suffer as Trump Destabilizes Immigrant Families,” by Claudia Boyd-Barrett.
Politico’s “,” by Miranda Willson, Alice Miranda Ollstein, Ariel Wittenberg.
Politico’s “,” by Rachel Bluth and Alice Miranda Ollstein.

Click to open the transcript Transcript: The Health Risks of AI

California Eyes Prison Heat Protections That Fall Short of Workplace Standards

Erin Rode, Capital & Main — Thu, 17 Sep 2026 09:00:00 +0000

As Californians have weathered relentless heat waves, state workplace safety regulators have employers to protect employees from heat illness by providing water, shade, cooldown areas, and additional rest breaks when temperatures climb.

But there’s a notable exception in the state’s heat safety rules: Not covered are the nurses, guards, staff, and tens of thousands of incarcerated people who work in California’s aging correctional facilities, which are .

In 2024, California adopted landmark rules intended to protect more than 1 million workers who toil in sweltering warehouses, kitchens, factories, and other indoor workplaces. But the state Occupational Safety and Health Standards Board exempted prisons and local government detention and juvenile facilities after Democratic Gov. Gavin Newsom’s administration warned the rules could cost the state billions.

Two years later, the Newsom administration has put forward weaker indoor heat standards for California’s correctional facilities, alarming worker advocates and public health experts who argue they would provide inadequate protections from extreme heat as the risks worsen due to climate change. Regulators with the state’s Division of Occupational Safety and Health, or Cal/OSHA, have proposed protections that wouldn’t kick in until temperatures reach 87 degrees — 5 degrees higher than for other indoor workplaces, according to released in May.

“It’s basically a second-class standard, and we don’t accept that correction workers get weaker protections than everybody else, with no scientific or medical basis,” said Stephen Knight, co-executive director of Worksafe, a California nonprofit that pushes for workplace health and safety protections. “The human body doesn’t handle heat differently in a prison than, you know, an Amazon warehouse.”

Extreme heat is the in the U.S., with spiking during heat waves as elevated temperatures exacerbate other health problems, including cardiovascular and respiratory diseases. Even among people without preexisting conditions, prolonged exposure to heat without the opportunity to cool off can cause , which can lead to death.

State agencies have estimated the price tag to cool California’s prisons could run from to in upfront costs, although the Newsom administration has refused to provide detailed information and declined interview requests.

“These facilities were exempted from the indoor heat standard due to the unique challenges in the correctional institutions with complying,” Eric Berg, Cal/OSHA’s deputy chief of health, research, and standards, told stakeholders at a recent meeting. He added that “we’re creating a separate standard to kind of address their unique conditions they have in those facilities.”

Heat Health Risks

California’s average temperature across an entire year is about than it was in 1895. At least nine of the 10 warmest years on record have occurred since 2014, and scientists project 2026 could be .

That warming, driven by the burning of fossil fuels, has accelerated in the decades since many of California’s 31 adult state prisons were built. Many of those facilities are located in some of the state’s hottest areas, including the Central Valley and inland areas of Southern California, where temperatures can soar into the triple digits. Fewer than a quarter of the prison system’s 791 housing units have any type of mechanical cooling such as air conditioning, according to a January released by the California Department of Corrections and Rehabilitation. Instead, institutions rely on fans and swamp coolers, but the uninsulated concrete walls mean these ad hoc solutions often face a losing battle.

“The best way to describe it is like someone turned on the microwave, and then they put you in it,” said Leonard Brown, a community organizer with Worksafe who spent over 30 years incarcerated in 10 state prisons, including in Lancaster and at the now-closed Chuckawalla Valley State Prison in Blythe, communities where triple-digit outdoor temperatures are common.

The lack of insulation in buildings makes it difficult to keep temperatures below 89 degrees even in facilities with air conditioning, according to California’s corrections department. The aging institutions, which average 52 years old, were mostly built when “comfort level of the incarcerated population and staff was not a consideration or a priority,” according to a . In 2024, the department tallied 86 days when indoor temperatures reached 90 degrees or above in at least one institution, and 46 days when indoor temperatures reached 95 degrees or more.

Health experts say people are particularly vulnerable to heat while at work because they’re not in control of their surrounding environment. They can’t always leave work for a cooling center, crank up the air conditioning, or jump in the shower, and their ability to protect themselves from heat depends on their type of job, income, and an array of other factors.

“Say you’re working in a warehouse or an agricultural field. It can be really hard to walk away because you need the money for yourself or for your family. But you can, right? It’s an option,” said Bharat Venkat, director of the UCLA Heat Lab, which studies the unequal effects of extreme heat. “If you’re incarcerated, you can’t really say no.”

And because incarcerated workers often make less than 50 cents an hour, it could take weeks to make enough to purchase a personal fan or a cooling towel, a from Venkat’s lab found.

Separate Standards

Newsom, who has been exploring a presidential run, has sought to position himself as a climate leader and in August released an , which touted the state’s 2024 indoor worker heat protections and noted that rules for correctional workers were in development.

“Californians are feeling the impacts of extreme heat earlier, longer, and more intensely than ever before,” Newsom said in a statement when he released the plan. He added: “We’re setting the path for the next chapter of our hotter, drier future.”

California is among a handful of states that have sought to protect indoor and outdoor workers from extreme heat over the past two decades. After multiple farmworkers died of heat-related causes in 2005, California adopted emergency standards for outdoor workers and made them permanent the following year. In 2024, the Biden administration for indoor and outdoor workers, but the Trump administration .

Still, Newsom has faced criticism from worker advocates and public health experts for his administration’s slow embrace of indoor heat protections, which took roughly and approve. And protections for prison workers are still years away, with the timeline “still being determined,” Cal/OSHA spokesperson MariCarmen Estudillo said in an email.

The 2024 rules require employers to provide cooldown areas and take other protective steps once indoor temperatures reach 82 degrees. They also require employers to keep both the indoor temperature and heat index, which factors in humidity, below 87 degrees, or below 82 degrees when employees are wearing heat-restrictive clothing or working near a heat source like an oven.

Under the proposed rules for prisons, safety standards wouldn’t kick in until temperatures reach 87 degrees. And employers would not be required to factor in the heat index, radiant heat, and humidity — all of which can make the temperature feel even hotter.

“Temperature alone does not accurately measure how dangerous working conditions are in these facilities,” said Janice O’Malley, a legislative advocate with the American Federation of State, County & Municipal Employees, which represents many of the medical and mental health staff within CDCR, as well as employees at local detention centers and juvenile facilities across the state.

“The heat index accounts for humidity and reflects how hot conditions actually feel to the human body, and it’s incredibly difficult to cool down through sweating in the correctional facilities where our folks work,” O’Malley said, adding that CDCR employees work in buildings with poor ventilation, often while wearing protective clothing that traps heat.

CDCR declined requests for an interview, but at a meeting in May, Alex Norring, assistant secretary for legislative affairs, said the unique staffing needs of state prisons would make it difficult to comply. For example, guards would need to be relieved by additional personnel to get their cooldown breaks.

“The biggest challenge is the direct fiscal impact because staff provide guarding for the incarcerated population, and we need to ensure that there is appropriate staffing in order to cover that and comply with providing the relief,” Norring said.

The also warned that establishing cooldown areas at some juvenile halls “may require system redesign, supplemental cooling equipment, and portable AC units which come with security risks.”

Unclear Costs

The state’s cost estimates to cool state prisons have varied widely since the worker safety board received its first assessment in 2023 and the price tag hovered at about $900,000 in the first year and less than $500,000 each year after. A year later, the sticker price skyrocketed to “billions of dollars” after the state Department of Finance said it had received revised estimates from the corrections department.

The state has provided few details and little clarity since. The Department of Finance and CDCR have denied Capital & Main’s requests for the details of the cost estimate under the California Public Records Act.

Labor unions and safety advocates, meanwhile, say workers in California prisons have waited too long for protections — while the state further defers the costs.

“You’re leaving a very important population uncovered. That’s very unjust. There’s no argument for that,” said Laura Stock, from the Occupational Safety & Health Standards Board after she publicly criticized his administration for delaying protections to prison workers.

This article was produced in collaboration with Capital & Main, an independent, California-based nonprofit investigative news publication that reports on inequality, climate change, and other issues.

This article first appeared on ��ýҕ�l Health News and is republished here under a .

Anger Over Health Costs Clouds Midterms

Thu, 10 Sep 2026 19:05:00 +0000

The Host

Affordability is top of mind for most voters this fall, and the high cost of healthcare is near the top of affordability complaints. And the news keeps getting worse: All indications are that insurance premiums will go up and benefits will go down in 2027.

Meanwhile, a U.S. appeals court this week heard arguments in a case that could severely limit the availability of the abortion pill mifepristone, not just in states with abortion bans but also in those where abortion is still legal.

This week’s panelists are Julie Rovner of ��ýҕ�l Health News, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico Magazine, Sandhya Raman of Bloomberg Law, and Amanda Seitz of ��ýҕ�l Health News.

Panelists

Joanne Kenen Johns Hopkins University and Politico

Sandhya Raman Bloomberg Law

Amanda Seitz ��ýҕ�l Health News aseitz@kff.org Read Amanda's stories.

Among the takeaways from this week’s episode:

Inflation, rising rates of uninsured Americans, as well as industry consolidation are contributing to some of the steepest increases in healthcare costs since the early 2000s. Frustrations back then built momentum for passage of the Affordable Care Act. Today, they’re the backdrop for the midterm elections, though the GOP is focusing on fraud and most Democrats are campaigning on adjustments to existing programs such as the ACA and Medicaid.
Several recent news stories have shed light on controversies at the intersection of health and politics. Sen. Roger Marshall (R-Kan.), a physician who could lead the Senate’s health committee next year, is facing scrutiny for suing hundreds of patients over unpaid medical debts, some of whom were arrested for missing court dates. Other stories document allegedly disparaging remarks by Sen. John Fetterman (D-Pa.) to staff about meeting with representatives of a children’s hospital and, separately, a call by Sen. Ron Wyden (D-Ore.) for Health and Human Services Secretary Robert F. Kennedy Jr. to be criminally investigated for allegedly lying to Congress.
Meanwhile, a federal appeals court in Louisiana continues to consider a case challenging regulations on the abortion pill mifepristone as President Donald Trump’s latest nominee to lead the Food and Drug Administration awaits confirmation.
And the fallout continues from two measles-related deaths in Pennsylvania, leaving Americans with further mixed signals about how to protect themselves and their children.

Also this week, Rovner interviews ��ýҕ�l Health News’ Lauren Sausser, who wrote the latest “Bill of the Month,” about when a preventive service isn’t preventive enough to qualify for zero-cost coverage. If you have a bill that’s baffling, infuriating, or indecipherable, you can share it with us here.

Plus, for “extra credit” the panelists suggest health policy stories they read this week that they think you should read, too:

Julie Rovner: NBC News’ “,” by Mike Hixenbaugh.

Sandhya Raman: Bloomberg Government’s “,” by Erin Durkin and Claire Hebert.

Joanne Kenen: ProPublica’s “,” by Audrey Dutton.

Amanda Seitz: ��ýҕ�l Health News’ “A NY Hospital Tried To Close Its Birthing Center. This City United To Fight Back,” by Noam N. Levey and Hannah Norman, and Stat’s “,” by Daniel Payne.

Also mentioned in this week’s podcast:

The Wall Street Journal’s “,” by Peter Loftus.
The New York Times’ “,” by Sarah Kliff.
The Wall Street Journal’s “,” by Will Hobson and Siobhan Hughes.
The Guardian’s “,” by Michelle R Smith.
Nature’s “,” by Max Kozlov.
ProPublica’s “,” by Andrea Suozzo and Agnel Philip.

Click to open the transcript Transcript: Anger Over Health Costs Clouds Midterms

Trump and Kennedy’s Health Industry Deals Haven’t Been Enforced and Are at Risk of Vanishing

Stephanie Armour — Fri, 28 Aug 2026 09:00:00 +0000

In the thick of his competitive reelection race in Michigan, Republican Rep. joined Health and Human Services Secretary Robert F. Kennedy Jr. at a sprawling 400-acre . They touted Trump administration efforts to improve the American diet, including the removal of some artificial dyes from processed foods.

“We had a great discussion about healthy options for all Americans and taking back control of our healthcare,” Barrett said in a June , after sampling the farm’s apple cider.

Like the focus on artificial dyes, however, many of the administration’s highest-profile health initiatives rely on voluntary agreements. The goals, such as lower drug prices and nutrition classes for doctors, have widespread appeal, cutting across party lines and economic divisions.

But the administration-industry deals lack the enforcement teeth of more traditional federal regulation. Their details are vague, and minimal oversight makes it hard to monitor progress. In some cases, the administration has claimed victories that have yet to materialize.

Republicans consider the dealmaking a winning strategy. It fits with the party’s anti-regulatory stance, they say, and enables the administration to quickly forge agreements President Donald Trump and his allies can tout as accomplishments. In the run-up to the midterm elections, some, like Barrett, hope to woo voters by trumpeting the Trump administration’s efforts to shape health policy.

The practice also raises questions. Though the deals are announced with great fanfare — often during televised events on stages, with live audiences — there’s little documentation or follow-through, creating doubts about whether the administration’s health agenda will lead to lasting change or unravel once the political attention fades.

The distinction could prove important to voters as Republicans defend their health records in November’s midterm elections.

“These deals are often not transparent, so there’s no way for the public to judge how meaningful they are,” said Larry Levitt, executive vice president for health policy at KFF, a health information nonprofit that includes ��ýҕ�l Health News.

Dealing With Dyes

The push to remove certain artificial dyes from food and drugs, for example, was a headline grabber. In April 2025, Kennedy to announce deals with food makers. He was flanked by young children and mothers holding placards reading “Make America Healthy Again.”

He and former FDA commissioner drew a standing ovation from an audience selected by Kennedy’s staff as they said companies had pledged to phase out all petroleum-based synthetic dyes from the nation’s food supply and medicines. They targeted nine synthetic dyes for removal.

Voters love the idea of stopping the use of such dyes. In a nationally representative March survey by Consumer Reports, said they were at least somewhat concerned about synthetic dyes, and two-thirds said companies should be required to phase them out.

A year after making the first announcement at HHS, during a discussion at the Conservative Political Action Conference, an annual political event.

“We’ve gotten rid of the nine synthetic-based food dyes,” he said.

Not quite. At the initial HHS event, federal officials said companies would voluntarily stop using six specific synthetic dyes . (The administration has also revoked or proposed revoking authorization for two other synthetic food dyes.)

Later, the FDA on its website quietly to the end of 2027. So, most are still in use.

In fact, the FDA posted a list of 27 companies it said had made voluntary pledges as of December 2025 to remove six synthetic dyes from products such as Doritos and Kellogg’s Froot Loops. More than a year and a half later, — fewer than 30% of those who bought in — had met their promised goals.

Many major food makers, such as the Coca-Cola Co. and Unilever, have made “” to remove the synthetic dyes, according to Consumer Reports. In addition, no pharmaceutical companies have publicly said they have plans to remove dyes from drugs.

“It’s just all talk,” said Leslie Dach, who chairs , a healthcare advocacy group that supports the Affordable Care Act. “They just govern for a day of publicity, and then it’s over. None of it happens. Yet the people don’t know because they have busy lives, so they think, ‘Just look at all these initiatives.’”

In fact, the administration , allowing companies to say their products contain no artificial colors — as long as they don’t use petroleum-based dyes. Previously, food makers could not make that claim unless their products contained no added colors. Some food dyes made from natural ingredients can contain contaminants and may pose their own health risks, .

“The federal government hasn’t taken any regulatory action on food dyes, for the most part, since the beginning of this administration,” said , vice president for government affairs at the Environmental Working Group, an advocacy group.

HHS said the voluntary approach has yielded significant action, including commitments to remove synthetic dyes from products sold in schools for the 2026–27 school year.

“HHS and the FDA are moving forward with clear timelines and concrete industry commitments, with major changes expected in foods served in schools during the coming school year and across full product portfolios by the end of 2027,” HHS spokesperson Emily Hilliard said in an email.

At the same CPAC convention event, Kennedy said “the MCAT testing companies are going to put nutrition on the MCAT for the first time, so the students will actually want to do it.” MCAT refers to the Medical College Admission Test, an exam required for admission to medical schools.

Again, not quite.

The Association of American Medical Colleges administers the MCAT. Spokesperson said Kennedy misspoke and may have meant to refer to a test taken by students to be licensed as doctors.

An Insurance Deal Falls Short of Promises

Kennedy again took to the HHS stage in June 2025, this time with Centers for Medicare & Medicaid Services Administrator Mehmet Oz, to make what was billed as a game-changing announcement. to reduce the volume of healthcare services subject to prior authorization, a practice widely used by the insurance industry that often requires patients or their medical teams to seek preapproval before undergoing treatment.

The administration said 80% of insurers pledged changes to preauthorization requirements for 80% of diseases and injuries . The administration also promised “” to track progress.

“It will happen very quickly,” Oz said at the event. “Necessary care will be delivered when it’s needed, in the right way.”

As of July, months past that January target date, health plans had reduced prior authorization for medical services by about 11%, according to AHIP, the insurer trade group. But no public dashboards have debuted to track the deal, and some insurers that signed the pledge last summer told ��ýҕ�l Health News this year that they will not implement all the promised reforms as outlined by AHIP.

Hilliard did not respond to questions about the pace of progress.

The American Medical Association, in a 2025 web-based survey, asked 1,000 practicing doctors whether they believed the voluntary pledges would make a meaningful difference. said they believed they would.

Insurers made a , during the previous Trump administration. The next year, more than 80% of doctors said the number of prior authorization requests for drugs and medical services had been increasing, based on .

Meanwhile, the administration is testing an artificial intelligence-powered for Medicare, the federal health program for people 65 and older or with disabilities. In six states, Medicare beneficiaries must get preapproval for a few treatments that CMS considers to have little clinical benefit and to be susceptible to fraud or waste, including skin substitutes and knee arthroscopy for arthritis. The program began in January, the same deadline insurers had set for curtailing preauthorization delays.

Deals and Deregulation

The healthcare industry’s voluntary agreements appeal to voters who feel government regulation drives up costs and places unnecessary burdens on businesses, some supporters say.

“Secretary Kennedy is the antithesis of a public health industry that uses coercion over communication — and has demonstrated this by taking the time and effort to push voluntary initiatives over the typical approach of governmental mandates,” said , a political consultant who was a political appointee at HHS in Trump’s first term.

But voluntary agreements with the health industry can prove ineffective. Former President Jimmy Carter in 1977 proposed a legislative plan to curb rising hospital costs. Hospitals fought back, and Congress rejected the proposal, instead favoring a desired by the industry. It ultimately failed once public attention faded.

One upside: Deals are fast. can take two to three years. And some health analysts say the tempo of the agreements advanced by Kennedy and Trump may help take voters’ attention off the Trump administration’s inability so far to produce a long-promised health plan.

Instead, Republicans can point to the array of accords reached with industry, including the with drugmakers so they’re in line with lower amounts charged in peer countries. The White House calls it the “most-favored-nation” prescription drug pricing policy.

Seventeen companies, including Pfizer and AstraZeneca, with the administration to lower prices for Medicaid enrollees and cash-paying consumers using , a narrow, government-run consumer platform.

Many details remain unknown, but the lower prices apply only to new drugs and existing drugs available through Medicaid. And prices at TrumpRx aren’t as low as out-of-pocket prices for most consumers with insurance. But the voluntary deals appeal to an industry that has railed against mandatory approaches drugmakers deride as harmful price controls.

“Each company makes its own decisions about how it prices medicines, and our industry is committed to working with the Trump administration to ensure Americans have access to affordable medicines,” said Chanse Jones, a spokesperson for PhRMA, a pharmaceutical industry trade group.

Policies that lead to reductions in drug prices typically worry investors because profits also can drop. But rather than seeing their stock prices fall after the agreements were announced, the drugmakers saw largely .

Analysts say that’s partly because the deals are narrow in scope, largely exist only in principle, and don’t apply to existing drugs used by the more than 200 million Americans with commercial or private health insurance.

The Trump administration, however, is .

“The most-favored-nation agreements on drug prices that we just did are delivering the largest drug price cuts in history,” Trump said in June at a in Pennsylvania. “That alone should win us the midterms.”

This article first appeared on ��ýҕ�l Health News and is republished here under a .

A State Gave Sheriffs 20% of Its Opioid Settlement Cash. We Followed the Money.

Aneri Pattani — Thu, 27 Aug 2026 09:00:00 +0000

��ýҕ�l Health News worked with three Louisiana news outlets — , , and — to ask all 64 sheriffs in the state how they’ve spent their opioid settlement funds. The responses were shared and presented in a data table for all four newsrooms to use. Reporters then conducted individual reporting for separate articles.

Every state is from companies accused of flooding the nation with prescription painkillers and fueling overdose deaths. But only one state is directing 20% of those payouts to sheriffs — the largest carve-out for law enforcement nationwide.

In Louisiana, sheriffs are elected, do not serve at the pleasure of another local official, and have independent budgets. They’re also not required to proactively report to the public or another authority how they spend billions in opioid settlement cash.

Short of filing public records requests or waiting for official audits, that has made it difficult for the average person to track the windfall. Many consider the dollars to be “blood money” and believe the spirit of the settlements is to spend it all on abating the addiction crisis.

��ýҕ�l Health News worked with three Louisiana news outlets — , , and — to track those dollars. The newsrooms contacted all 64 Louisiana sheriffs over five months, often filing public records requests, to produce the first detailed accounting of millions spent.

The findings include:

Thirty-eight sheriffs reported spending more than $8.1 million total. Much of it went to crime-fighting equipment, such as surveillance cameras and drug detection products, though smaller amounts funded mobile apps, addiction treatment in jails, and educational programs for youth.
$5.4 million, about 66% of reported spending, was deemed inappropriate by a three-person review panel. The panel, assembled by ��ýҕ�l Health News and its partners, included a Louisiana resident in recovery who lost his son to a fentanyl overdose, an addiction medicine doctor, and a public health policy analyst who has been tracking settlement dollars since 2022. They judged the expenditures using their professional and personal expertise. Expenditures the panel disapproved of included salaries and overtime pay for homicide detectives and officers conducting jail shakedowns to find contraband.
$4.7 million, nearly 60% of reported spending, went to items or services that other states say should not be purchased with opioid cash. Six states have , such as technology to extract data from cellphones and automated external defibrillators, which are . Although Louisiana does not have its own “unallowable” list, the state’s — a five-member body that advises sheriffs and parishes but does not control the money — said it has shared the guidance from other states.
Nine sheriffs stood out for promising uses: All of their expenditures, totaling nearly $1.8 million, were deemed appropriate by the review panel and allowable in other states. These included providing addiction treatment in jail, training officers to respond to overdoses, and increasing public awareness of addiction resources.
Twenty sheriffs did not provide their expenditures, leaving roughly $10.7 million that hidden from public view. The Jefferson Parish Sheriff’s Office, which covers an area just outside New Orleans and was allotted the highest amount — nearly $4 million through 2025 — did not respond to more than a dozen calls and emails.

Nationwide, debates over law enforcement’s role with opioid settlement money have been underway since the funds began flowing significantly in 2022 and have continued as the pool of money has grown. Purdue Pharma, , finalized its this year, and various settlements are set to pay out for an additional decade-plus.

Since the earliest days, these dollars have been viewed across government agencies and the private sector as a pot of gold for which many are vying.

Law enforcement agencies are part of this scrum. They say seizing drugs and arresting dealers save lives, but that costs money and the addiction crisis has burdened their budgets. However, many recovery advocates staunchly oppose any opioid cash flowing to what they see as the .

Since there are few guardrails on how the money is spent, decisions often come down to how local politicians and residents see addiction and what type of approach they believe will be effective in combating it.

Louisiana provides a natural experiment to see which priorities prevail when money is handed directly to sheriffs.

First Public Look at How Louisiana Sheriffs Have Spent Over $8M in Opioid Settlement Cash

In Louisiana, sheriffs receive 20% of the state's opioid settlement cash — the largest carve-out for law enforcement nationwide. But since sheriffs are not required to proactively report how they spend the money, it's hard to track. Reporters from ��ýҕ�l Health News, The Current, Gulf States Newsroom, and Verite News contacted all 64 sheriffs to uncover spending details.

Click column headings to sort the table.

Note: In some cases, the amount of money spent exceeds the amount allocated because sheriffs may have reported spending that included their 2026 allocations or because sheriffs combined their opioid settlement dollars with the share received by parish governments or other funding sources. Descriptions of spending are based on emails or phone calls with the sheriffs' offices and have been lightly edited.
Source: The money allocated to sheriffs was obtained by summing values for years 1-5, representing 2021-2025, from the Louisiana Opioid Abatement Task Force’s public spreadsheet. Data on money spent was collected by ��ýҕ�l Health News, The Current, Gulf States Newsroom, and Verite News. • /download-the-data-louisiana-sheriffs-opioid-settlement-expenditures/" target="_blank" style="color:#0071ce">Download the data.
Credit: ��ýҕ�l Health News' Lydia Zuraw and Aneri Pattani, The Current’s Alena Maschke, Gulf States Newsroom’s Drew Hawkins, and Verite News’ Katie Jane Fernelius

The state’s agreement with parishes and sheriffs receiving settlement cash contains broad categories for , including “law enforcement expenditures relating to the opioid epidemic.”

But even if the sheriffs’ spending is legal, that doesn’t mean it’s appropriate or effective, addiction and public health experts say.

“What’s happening here is they have a lot of money and they want to distribute it to all the wrong places,” said Danny Bolner Jr., a Jefferson Parish resident who has been in recovery from addiction for more than two decades and lost his 28-year-old son to a fentanyl overdose in 2016. On the panel that reviewed expenditures, Bolner represented the view of families who have lost loved ones to the crisis.

The purchase of drones and vehicles struck a nerve for him. He’d prefer for opioid cash to support programs that educate youth about healthy ways to process emotions, provide job training to people in recovery, and distribute overdose reversal medications.

“This money is what we have to save lives,” he said. If sheriffs use it in other ways, the finite pot “is going to be gone and then they won’t have nothing to help.”

Danny Bolner Jr. is a Jefferson Parish, Louisiana, resident who has been in recovery from addiction for more than two decades. Bolner lost his 28-year-old son to a fentanyl overdose in 2016. (Christiana Botic/Verite News and CatchLight Local/Report for America)

A Safe, a Scanner, and Surveillance Cameras

For , a public health policy analyst and national opioid settlement expert who was a member of the review panel, determining if expenditures fit the spirit of the settlements often centered on whether they facilitated arrests or prevented overdoses.

“The impetus of this opioid settlement money is to spend on innovative ways to not let this happen again,” she said, referring to the overdose crisis that has claimed since 2000. She said sheriffs should be asking, “How could we use this to reinvest in the community, not just build up our office?”

Many of the sheriffs’ equipment purchases didn’t meet her bar.

For example, the East Baton Rouge Sheriff’s Office bought a safe to store evidence from opioid investigations and a scanner for their traffic division to identify narcotics in hidden compartments. The Terrebonne Parish Sheriff’s Office spent $465,000 on , which are automated license plate readers that capture data about passing vehicles and share them with law enforcement agencies nationwide. The Bossier Parish Sheriff’s Office purchased 130 body cameras and 50 dash cameras.

Sheriffs already receive taxpayer dollars and federal grants to buy law enforcement tools, Christensen said. Opioid cash, which is finite and has a specific purpose, should not be used for that, she and the other reviewers said. In fact, some states don’t allow it.

13 Louisiana Sheriffs Spent 100% of Opioid Settlement Money Inappropriately, per an Expert Panel

The expenditures were reviewed by Tricia Christensen, a public health policy analyst who has been tracking opioid settlement spending since 2022; Stephen Loyd, an addiction medicine doctor and a person in recovery who serves as West Virginia's drug czar; and Danny Bolner Jr., a person in recovery who lost his son to a fentanyl overdose and is raising his son’s daughter in Jefferson Parish, Louisiana. A majority vote determined which expenditures were appropriate.

The map depicts the percentage of money each sheriff spent on expenditures disapproved by the reviewers.

Note: The reviewers voted on the propriety of each expenditure based on their own views of the purpose of opioid settlement money. The rates of opioid-involved deaths are age-adjusted. Rates based on counts <5 were suppressed by the Louisiana Department of Health to protect privacy. "Opioid-involved deaths" include deaths in which opioids were present in the body and/or contributed to death, even if they were not the sole cause of death.
Sources: Settlement spending and reviewer opinions collected by ��ýҕ�l Health News, The Current, Gulf States Newsroom, and Verite News; opioid-involved death rates from the Louisiana Department of Health
Credit: ��ýҕ�l Health News' Lydia Zuraw and Aneri Pattani, The Current’s Alena Maschke, Gulf States Newsroom’s Drew Hawkins, and Verite News’ Katie Jane Fernelius

But taxpayer money may not cover everything sheriffs need, said , executive director of the Louisiana Sheriffs’ Association. “Our budgets are overloaded,” he said.

Complex investigations to dismantle drug trafficking syndicates can require advanced equipment, , a spokesperson for the East Baton Rouge Sheriff’s Office, wrote in a statement.

“While treatment and recovery services are indispensable components of addressing opioid addiction, they address the consequences of addiction after these drugs have already reached our community,” she wrote. “Law enforcement has a different, but equally essential, responsibility: preventing those deadly drugs from reaching potential victims in the first place.”

First Lt. Blake Tabor, a spokesperson for the Terrebonne sheriff’s office, similarly wrote, “Our role as a law enforcement agency is primarily focused on disrupting the criminal activity that fuels addiction in our community.” That effort complements other entities’ work in prevention, treatment, and recovery, he added.

The Bossier Parish Sheriff’s Office declined to comment.

Where Public Health Meets Public Safety

Not all sheriffs spent the money on enforcement.

Acadia Parish Sheriff directed all his settlement cash to provide treatment in jail. He said he hopes to break cycles of addiction and crime.

“I want people back into society, being productive,” he said.

Research shows for opioid use disorder behind bars and .

In St. Martin Parish, settlement funds helped launch a of officers that connects people with substance use disorders or related mental illness to treatment, said Chester Cedars, chief legal counsel for its sheriff’s office. Officers also try to coordinate support services for family members and assist with questions around paying for care.

“We’re not clinicians,” Cedars said, but we “serve as a broker” between people who need services and those who provide them.

, an addiction medicine doctor and the West Virginia drug czar, who was the third member of the review panel, said he loved the comprehensive nature of the program. Addiction “is a family issue,” he said. “Every time that phone rings, it’s a potential family crisis.”

Bolner and his granddaughter sit on a bench dedicated to his son and her father, Daniel, at Lafreniere Park in Metairie, Louisiana. Daniel died of a fentanyl overdose in 2016 on his 28th birthday. (Christiana Botic/Verite News and CatchLight Local/Report for America)

It’s not a coincidence that these parishes earned top marks from the reviewers. Cedars is the former chair of the , and Gibson is the current chair. That’s the body meant to guide others on priority uses of settlement cash.

Cedars was clear that the St. Martin sheriff’s office was not using “one penny for any enforcement activity,” because that’s not what the settlement “intended to accomplish.”

Gibson was more hesitant, saying the legal guidelines are broad and “I’m not here to criticize anybody.”

He has advised about a dozen sheriffs who have reached out with questions, but he knows they’re not required to heed his guidance.

A from the Louisiana Legislative Auditor found that the task force has no teeth to enforce its recommendations.

If people want stronger guardrails on the opioid cash, state lawmakers need to enact new rules, Gibson said.

Stepping Up Oversight

The Louisiana state legislature in May calling for the legislative auditor to review how all parishes and sheriffs are handling their opioid settlement money and report to lawmakers prior to the 2027 legislative session.

State Sen. , a Republican who co-authored the resolution, said the goal is to shed light on where dollars are flowing, if jurisdictions are spending them at all, and which funded programs are effective.

With that information, Myers said, he and others could “absolutely” introduce bills “to tighten up how funding is spent.”

Louisiana Sheriffs Spent $4.7M in Opioid Settlement Cash on Items, Activities Deemed Unallowable in Other States

Six states — California, Indiana, Kansas, Michigan, South Carolina, and Virginia — have created lists of items and services that they say opioid settlement funds should not be spent on, including surveillance cameras and vehicles. Although Louisiana does not have its own "unallowable" list, the state's Opioid Abatement Task Force said it has shared other states' guidance with some sheriffs. Yet nearly 60% of the sheriffs' spending involves items found on such lists.

Note: Unallowable lists may not be legally binding in each state but are considered strong guidance.
Source: Data collection by ��ýҕ�l Health News, The Current, Gulf States Newsroom, and Verite News
Credit: ��ýҕ�l Health News' Lydia Zuraw and Aneri Pattani

Meanwhile, the Louisiana Opioid Abatement Task Force is trying to strengthen its oversight.

Curtis Nelson is executive counsel for the Louisiana Opioid Abatement Administration Corporation, a nonprofit that supports the task force. He said the body is seeking quotes from accountants to conduct ongoing forensic audits of parishes and sheriffs. The goal is to audit 10 to 15 entities annually, starting with those receiving the most money. If the audits turn up misuse, the task force could withhold future payments from those parishes or sheriffs, Nelson said.

The task force is also exploring creating its own unallowable list, like those in other states, Nelson said.

Louisiana Gov. Jeff Landry and Attorney General Liz Murrill did not respond to questions about whether they’d support an unallowable list or take other actions to address opioid settlement spending.

But many advocates are hopeful that an unallowable list could curb spending they found concerning.

“You’re keeping them on the track when you tell them what they can’t use it for,” said Bolner, the Jefferson Parish resident who lost his son to overdose and is raising his son’s daughter.

While he awaits greater oversight for sheriffs, Bolner plans to continue the work he’s been doing for years: distributing overdose reversal medications at schools, hospitals, and bars; participating in grief support groups with other families; and showing up at community events to raise awareness about addiction. He said he’ll keep speaking with sheriffs and parishes about what he considers the best use of settlement money.

“If I save one life, it’s accomplished,” he said.

Methodology

Reporters from ��ýҕ�l Health News, The Current, Gulf States Newsroom, and Verite News worked together to contact all 64 sheriffs’ offices in Louisiana and ask how they’d spent opioid settlement funds. The outreach involved dozens of emails and phone calls from March to July.

If a sheriff’s office did not respond or did not provide specific dollar amounts spent on programs or services, it was labeled “Did not provide expenditures.” All other responses were summarized in a data table.

The amount of settlement money each sheriff’s office received through 2025 was obtained from the Louisiana Opioid Abatement Task Force’s . Allocations for years 1 through 5 were summed, representing 2021 through 2025.

In the few cases in which a sheriff’s office reported spending more money than the task force said it had been allocated, it was often because the sheriff’s office had combined its share of opioid settlement dollars with the share received by the parish government or another funding source. Some sheriffs may have also reported money spent from their 2026 allocation.

Once all the data was collected, the reporters used two methods to analyze the results.

For the first, the reporters created an unduplicated list of expenditures and de-identified them by removing the sheriffs’ offices names. That list was shared with three reviewers: , a public health policy expert who has been tracking opioid settlement spending since 2022; , an addiction medicine doctor and a person in recovery who previously served as chair of Tennessee’s Opioid Abatement Council and is currently West Virginia’s drug czar; and Danny Bolner Jr., a person in recovery from addiction who lost his son to a fentanyl overdose and is raising his son’s daughter in Jefferson Parish, Louisiana.

Each reviewer voted on each expenditure description as an appropriate or inappropriate use of opioid settlement money. The majority vote determined the final designation.

Reporters calculated how much of the money spent by each sheriff’s office went to expenditures the review panel deemed inappropriate. This value was divided by the total spent to determine the percentage of expenditures deemed inappropriate by the panel. The second approach to analyzing the sheriffs’ spending was as follows: Six states (, , , , , and ) have created lists of items and services that they say opioid settlement funds should not be spent on, often known as “unallowable lists.” ��ýҕ�l Health News calculated how much money spent by each Louisiana sheriff’s office went to expenditures on one of these lists. This value was divided by the total spent to determine the percentage of expenditures that would have been unallowable or not recommended in one or more of these states.

The Current’s Alena Maschke, Gulf States Newsroom’s Drew Hawkins, and Verite News’ Katie Jane Fernelius contributed to the database featured in this article.

This article first appeared on ��ýҕ�l Health News and is republished here under a .

Where Florida’s Gun Violence Exacts Its Biggest Toll on Black and Latino Children

Tue, 25 Aug 2026 09:00:00 +0000

JACKSONVILLE, Fla. — Just west of the St. Johns River, which divides this sprawling city racially and economically, 2-year-old A’mahri Robinson was murdered in his mother’s arms.

Ladonna Johnson was rocking A’mahri to sleep in March when he was shot in the head with a gun she kept for protection.

A’mahri loved going outdoors and taking rides in his pull-along wagon. His mother called the toddler “sweet” and “affectionate.” When he was around, she said, “you just felt love.”

The child was close with Steven Dodson Jr., his mother’s boyfriend, who had reached for the gun during an argument. Dodson, 21, in June to murder and aggravated child abuse and was sentenced to life in prison.

A’mahri died in one of Florida’s most violent places for children: Jacksonville. This city has three ZIP codes that rank among the 10 worst in the state for firearm injuries involving children.

Two-year-old A’mahri Robinson was murdered while in his mother’s arms in March. (Ladonna Johnson)

Every year, hundreds of children are hospitalized in Florida with gunshot wounds, and overwhelmingly, they come from a tiny number of ZIP codes, an exclusive analysis of hospital data by ��ýҕ�l Health News and The Trace found.

Hospital billing data obtained from the Florida Agency for Health Care Administration shows that from 2018 to 2024 more than 4,000 children 17 or younger were hospitalized for firearm injuries — a rate of about 1.5 a day.

The newsrooms gathered data that the state’s hospitals use to collect payments from insurance companies or the government. The information does not identify patients but includes details about where they lived and their age, race, and other demographics.

The number of children killed in Jacksonville has grown so large that , Families of Slain Children, built a “Wall of Compassion” memorial listing hundreds of people killed by gunfire in the city. Memorial organizers have stood up a second wall nearby that is filling with names.

The Jacksonville nonprofit Families of Slain Children has built a memorial called the “Wall of Compassion” that lists the names of hundreds of people who have been killed by gun violence in the city. (Daniel Chang/��ýҕ�l Health News)

The numbers reflect how Florida’s long history of racial discrimination and permissive gun laws undermine public health, said researchers, public officials, community activists, and grieving parents.

Jacksonville kids were shot most often in racially segregated neighborhoods — a legacy from the early 20th century of state-sanctioned discrimination in housing, banking, and investment. These areas today are plagued by pollution from defunct city-run trash incinerators, garbage-strewn lots, dilapidated housing, poverty, and other problems that local leaders have been promising to fix for more than 50 years.

Nearly all the Florida ZIP codes with the highest rates of firearm injuries for children have large Black or Latino populations.

Perhaps nowhere is the toll of gun violence more evident than at UF Health Jacksonville, a safety net hospital and the only Level I trauma center in northeastern Florida.

As chief of acute care surgery, sees firsthand the toll exacted by guns.

“You see it day in and day out,” Madbak said. “I’m working tonight, and I suspect I’ll see a couple victims.”

Florida ZIP Codes With Highest Youth Gunshot Wound Hospitalizations

A table of Florida zip codes with city and county columns, ranked by the number of under-18 gunshot wound patients from 2018 through 2024. A column of the rate of U18 GSW patients per 100k children per year is shaded blue, darker for higher rates, lighter for lower ones.

ZIP codes with 1-10 youth GSW hospitalizations over the 2018-2024 period are omitted due to privacy laws.

GSW = gunshot wound

Florida Agency for Health Care Administration

, a UF Health pediatrician and former health director for Duval County, which includes Jacksonville, said state and local leaders have failed to address what he called the “root causes” of preventable firearm injuries and deaths, such as poverty, lack of opportunity, and neglect.

“The bottom line is nobody gives a flying f— about these young men,” Goldhagen said.

Gun violence victims and their families of depression, anxiety, post-traumatic stress disorder, and other mental health problems.

Throughout U.S. history, local governments have pushed industrial plants, , and highways through Black neighborhoods even as to increased risks of cardiovascular and respiratory diseases, cancer, preterm births, and gun violence.

But the Florida Department of Health does not focus on gun violence as a public health threat, Goldhagen said, despite its being the nation’s for children and teens.

The , a set of goals developed by the health department and an advisory committee, does not mention guns, the toll they take on children, or efforts to reduce firearm deaths and injuries to young people.

Instead, its goals include preventing or reducing sudden unexpected infant deaths and youth drownings, emergency room visits for motor vehicle crashes, and hospitalizations for traumatic brain injuries.

And yet, no one with the authority to address this public health crisis would agree to talk to ��ýҕ�l Health News about gun violence and its toll on Jacksonville’s children — not the Florida health department, Gov. Ron DeSantis, Mayor Donna Deegan, or 18 of 19 members of the Jacksonville City Council.

()

Only Council member Jimmy Peluso responded. Peluso said the city has long ignored the needs of neighborhoods with high rates of firearm injuries among children.

“A lot of these neighborhoods have just felt like the wealth has left them,” he said, “and the city didn’t come in to put in the amount of work they needed to.”

DeSantis, a Republican, in public comments has called for few limits on how people purchase or carry firearms. He to allow Floridians to carry concealed weapons without a permit.

When then-U.S. Surgeon General Vivek Murthy declared firearm violence a public health crisis in 2024, DeSantis called the advisory an “.”

DeSantis said Florida would not follow the advisory, which recommended policies including universal background checks for gun purchases and requirements for secure storage.

DeSantis spokesperson Molly Best declined an interview request and to answer questions about the governor’s gun policies.

“There isn’t an agenda to end gun violence in the state of Florida,” said Jean Francis, a former pediatric nurse who leads the Jacksonville chapter of Moms Demand Action, part of a nonprofit that advocates for stronger firearm laws.

Research has linked increases in pediatric gun deaths from 2011 to 2023 to state-level gun policies.

States with permissive gun policies, such as “stand your ground” and open carry laws, reported higher rates of firearm deaths among children than states with strict regulations, such as weapon and age restrictions, according to a .

The study ranked Florida among a group of 30 states with the most permissive gun policies. Four states with comparatively strict gun laws — California, Maryland, New York, and Rhode Island — saw a decrease in pediatric gun deaths over the same time period.

prevents cities and counties from enacting stricter gun safety measures.

kids in disadvantaged neighborhoods are up to 20 times more likely to suffer firearm injuries than their peers in the most advantaged areas.

“It’s disheartening,” Madbak said. UF Health Jacksonville treated 255 patients for gunshot wounds in 2024, including 32 who were 17 or younger, he said.

In Some Florida Neighborhoods,
Child Gunshot Hospitalizations Are Common

A zip code choropleth map of Florida shaded in blue by gunshot hospitalizations per 100k children. Shade buckets are: No cases, 0-7, 7-21,21-44,44-79,79-140, Population too small. Click the city names to visit those regions and see zip codes with smaller geographic areas.

ZIP codes with 1-10 hospitalizations have data suppressed or represented as ranges to comply with privacy laws.

GSW = gunshot wound

Florida Agency for Health Care Administration

In Some Broward County Neighborhoods,
Child Gunshot Hospitalizations Are Common

A zip code choropleth map of the Fort Lauderdale area shaded in blue by gunshot hospitalizations per 100k children. Shade buckets are: No cases, 0-7, 7-21, 21-44, 44-79, 79-140, Population too small. Click the city names to visit those regions and see zip codes with smaller geographic areas.

ZIP codes with 1-10 hospitalizations have data suppressed or represented as ranges to comply with privacy laws.

GSW = gunshot wound

Florida Agency for Health Care Administration

In Some Duval County Neighborhoods,
Child Gunshot Hospitalizations Are Common

A zip code choropleth map of the Jacksonville area shaded in blue by gunshot hospitalizations per 100k children. Shade buckets are: No cases, 0-7, 7-21,21-44,44-79,79-140, Population too small. Click the city names to visit those regions and see zip codes with smaller geographic areas.

ZIP codes with 1-10 hospitalizations have data suppressed or represented as ranges to comply with privacy laws.

GSW = gunshot wound

Florida Agency for Health Care Administration

In Some Miami-Dade County Neighborhoods,
Child Gunshot Hospitalizations Are Common

A ZIP code choropleth map of the Miami area shaded in blue by gunshot hospitalizations per 100k children. Shade buckets are: No cases, 0-7, 7-21,21-44,44-79,79-140, Population too small. Click the city names to visit those regions and see zip codes with smaller geographic areas.

ZIP codes with 1-10 hospitalizations have data suppressed or represented as ranges to comply with privacy laws.

GSW = gunshot wound

Florida Agency for Health Care Administration

In Some Orange County Neighborhoods,
Child Gunshot Hospitalizations Are Common

A zip code choropleth map of the Orlando area shaded in blue by gunshot hospitalizations per 100k children. Shade buckets are: No cases, 0-7, 7-21,21-44,44-79,79-140, Population too small. Click the city names to visit those regions and see zip codes with smaller geographic areas.

ZIP codes with 1-10 hospitalizations have data suppressed or represented as ranges to comply with privacy laws.

GSW = gunshot wound

Florida Agency for Health Care Administration

In Some Palm Beach County Neighborhoods,
Child Gunshot Hospitalizations Are Common

A zip code choropleth map of the Palm Beach area shaded in blue by gunshot hospitalizations per 100k children. Shade buckets are: No cases, 0-7, 7-21, 21-44, 44-79, 79-140, Population too small. Click the city names to visit those regions and see zip codes with smaller geographic areas.

ZIP codes with fewer than 10 hospitalizations are suppressed or represented as ranges to comply with privacy laws.

GSW = gunshot wound

Florida Agency for Health Care Administration

In Some Escambia County Neighborhoods,
Child Gunshot Hospitalizations Are Common

A zip code choropleth map of the Pensacola area shaded in blue by gunshot hospitalizations per 100k children. Shade buckets are: No cases, 0-7, 7-21, 21-44, 44-79, 79-140, Population too small. Click the city names to visit those regions and see zip codes with smaller geographic areas.

ZIP codes with 1-10 hospitalizations have data suppressed or represented as ranges to comply with privacy laws.

GSW = gunshot wound

Florida Agency for Health Care Administration

In Some Manatee and Sarasota County Neighborhoods,
Child Gunshot Hospitalizations Are Common

A zip code choropleth map of the Sarasota area shaded in blue by gunshot hospitalizations per 100k children. Shade buckets are: No cases, 0-7, 7-21, 21-44, 44-79, 79-140, Population too small. Click the city names to visit those regions and see zip codes with smaller geographic areas.

ZIP codes with 1-10 hospitalizations have data suppressed or represented as ranges to comply with privacy laws.

GSW = gunshot wound

Florida Agency for Health Care Administration

In Some Pinellas County Neighborhoods,
Child Gunshot Hospitalizations Are Common

A zip code choropleth map of the Saint Petersburg area shaded in blue by gunshot hospitalizations per 100k children. Shade buckets are: No cases, 0-7, 7-21, 21-44, 44-79, 79-140, Population too small. Click the city names to visit those regions and see zip codes with smaller geographic areas.

ZIP codes with 1-10 hospitalizations have data suppressed or represented as ranges to comply with privacy laws.

GSW = gunshot wound

Florida Agency for Health Care Administration

In Some Leon County Neighborhoods,
Child Gunshot Hospitalizations Are Common

A zip code choropleth map of the Tallahassee area shaded in blue by gunshot hospitalizations per 100k children. Shade buckets are: No cases, 0-7, 7-21, 21-44, 44-79, 79-140, Population too small. Click the city names to visit those regions and see zip codes with smaller geographic areas.

ZIP codes with 1-10 hospitalizations have data suppressed or represented as ranges to comply with privacy laws.

GSW = gunshot wound

Florida Agency for Health Care Administration

In Some Hillsborough County Neighborhoods,
Child Gunshot Hospitalizations Are Common

A zip code choropleth map of the Tampa area shaded in blue by gunshot hospitalizations per 100k children. Shade buckets are: No cases, 0-7, 7-21, 21-44, 44-79, 79-140, Population too small. Click the city names to visit those regions and see zip codes with smaller geographic areas.

ZIP codes with 1-10 hospitalizations have data suppressed or represented as ranges to comply with privacy laws.

GSW = gunshot wound

Florida Agency for Health Care Administration

In 2025, the hospital treated 269 patients for firearm injuries, including 22 who were under 18, according to Dan Leveton, a hospital spokesperson. As of Aug. 19, the hospital has treated 137 patients for gunshot wounds this year, including 18 who were 17 or younger.

Preventing gun violence “shouldn’t be a political issue, even though it is,” Madbak said, adding that there is a lot of room for more effective advocacy for violence prevention.

“It’s really an American issue,” Madbak said, “and our state has been impacted tremendously by this kind of violence.”

The Pain of Mothers, Grandmothers, and Aunts

Kim Crow, grandmother of Bryce Williams, who died at age 17 from being shot in a neighborhood park in an Orlando suburb in 2018. Crow says her grandson’s death has left a void in her life. “I’m not me anymore,” she says. (WFTV)

In Orlando, one ZIP code — 32805 — had the state’s highest rate of children under 18 hospitalized for a gunshot wound from 2018 through 2024, with a total of 25 children, or 125.8 per 100,000.

On New Year’s Day 2018, Bryce Williams, 17, was in Casselberry, an Orlando suburb. He was found dead after crashing his blue Kia into a home near the park.

Williams’ death devastated his family, his grandmother Kim Crow told WFTV in Orlando.

“First off, you can’t believe that someone is taken from you so violently,” Crow said. “It’s heartbreaking.”

In April, Daesean Moctezuma Orland, 18, was while attending a house party outside Orlando. Two others wounded in the shooting were taken to the hospital. Police arrested a 16-year-old boy about a month after the shooting and charged him with Moctezuma Orland’s death.

Moctezuma Orland’s grandmother Iveliz Moctezuma told WFTV that a friend of her grandson’s called her and daughter Noemi Moctezuma to tell them that he had been shot. The women drove to four hospitals, including one in Tampa, searching for him.

Iveliz Moctezuma, grandmother of Daesean Moctezuma Orland, who was shot and killed at age 18 at a house party in Davenport, Florida, in April. “It was the hardest night of my life,” she says. “They ripped him away from us.” (Keary Croskrey/WFTV)

“My every day is crumbled,” Iveliz Moctezuma said. “It’s hard to work. You sit there and you watch the news. You’re like, oh my God, there goes another kid getting killed by gun violence.”

“It’s a hole in my chest, a hole in my mind,” Noemi Moctezuma said. “It’s like the biggest void that you could ever possibly imagine, that not even the happiest moments can fill a void like that.”

Jacksonville, a city of about 1 million, is particularly treacherous for children living in areas north and west of downtown.

The victims include a gunned down while playing in front of a house, a fatally wounded coming home from a football tryout, and a killed by a stray bullet as she sat in a parked car.

Advocates for victims said that gun violence has ripped any sense of normalcy from families and entire neighborhoods. Grieving mothers fear fireworks and other loud noises that sound like gunshots. Grappling with their own emotions, they said, they sometimes struggle to help their surviving children cope with the loss.

“When you hear their stories, you think, ‘This is the worst thing I have ever heard,’” Francis said, “until you hear the next one.”

Hours after graduating from Jacksonville’s Raines High School in May 2022, , 18, was shot and killed while arriving at a friend’s celebration. Fields was walking into the party when a car pulled up and opened fire, his mother, Yvonne Fields, told Action News Jax in an interview.

A defensive lineman on his high school football team, Fields had been offered a full scholarship to play for Keiser University in West Palm Beach. His parents were planning a party for the following day to celebrate his graduation.

“Everybody loved him,” Yvonne Fields said of her youngest son, calling him “the life of the party.”

Yvonne Fields of Jacksonville talks about the death of her son, Rashaud Fields, 18, who was shot and killed in May 2022 at a high school graduation party. (Kevin Jordan/Action News Jax)

“Rashaud loved to dance. He was a joke teller. He was funny,” Fields said.

At the time, Rashaud Fields was at least the ninth 17- to 19-year-old homicide victim in the city that year, according to the , the local newspaper. Yvonne Fields said she has kept her son’s room exactly as he left it the day he was killed. She smells his shirt every day.

“I know he’s not coming back,” she said, “but I can feel the spirit.”

Two days after celebrating his 18th birthday, Maurice Hobbs was fatally shot in January 2017 as he waited for his mother to pick him up.

“I was not even a block away,” Latasha Hobbs said to Action News Jax.

Latasha Hobbs receives a hug at a gathering to end gun violence in Jacksonville on Aug. 27, 2018. Her son, Maurice Hobbs, was shot and killed two days after celebrating his 18th birthday in January 2017. (Joe Raedle/Getty Images)

A singer, rapper, and poet, Maurice Hobbs wanted to perform and launch a clothing line. He dreamt of making enough money to give homes to everyone in his family so they could all live on the same street.

His mom recalled celebrating his birthday with cake and dancing in the kitchen and his reaction to turning 18.

“He was like, ‘Oh my God, Mom, I made it to 18,’” Latasha Hobbs said. “So it’s hard to swallow knowing that my baby didn’t make it to 19. It’s not fair. My baby deserves to be here.”

Pamela Howard has struggled for nearly two decades with the pain of the killing of her son Derrell Baker at age 17.

Howard, a mother of five, called her son energetic and an anchor for his younger siblings. Baker excelled at football, she said, and was on track to graduate high school despite having severe attention-deficit/hyperactivity disorder.

Someone shot Baker in September 2008 as he walked to school. A passerby found him by the road.

Pamela Howard has spent nearly two decades trying to help police find the person who killed her son Derrell Baker, 17, as he walked to school in 2008. (Malcolm Jackson for ��ýҕ�l Health News)

Howard said she thought Baker was at school and later football practice. The family learned something might be wrong only when a sibling heard that Baker had been shot.

Howard called area hospitals in search of her son. By the time she found him at UF Health Jacksonville, it was too late, she said: He had died hours earlier.

“I don’t remember anything after they told me” he was dead, Howard said. “My friends say they just heard me scream.”

For the mothers Fields, Hobbs, and Howard, the sudden, unexpected death of their children cut deep. The lack of closure is painful. Police have not made an arrest in any of the cases.

“When I get justice,” Yvonne Fields said, “maybe I’ll be a little at peace.”

()

Leading Cause of Death

, chief of pediatric surgery and trauma at Children’s Hospital of Philadelphia, said there has to be an appetite in state capitals to regulate firearms and protect children from gun violence.

Nance co-authored a in JAMA Pediatrics finding that the number of states where guns were the leading cause of death for children and teens increased from zero over the period 2004 to 2008 to 24 from 2019 to 2023.

Motor vehicle deaths among children, once the leading cause of death in that group, have declined primarily because of safety interventions undertaken by governments and car manufacturers, he said, from seat belt laws and speed limits to air bags and antilock brakes.

“That progress has been pretty universal across the U.S.,” he said, “but firearm stuff is just all over the map.”

Guns don’t have federal safety standards, Nance noted. They aren’t regulated by the Consumer Product Safety Commission, a federal agency that protects the public from dangerous products, and they can’t be recalled the way unsafe toys or cars can be.

“We’ve really done almost nothing to change the trajectory of firearm injuries in kids,” Nance said.

Goldhagen, the UF Health pediatrician, said Jacksonville leaders tried to address gun violence through the Jacksonville Journey, an initiative launched in 2008 — when Duval County was the murder capital of Florida — under former Mayor John Peyton.

The program for children at risk of violence provided mentorship, summer camps, job training, and nonpolice strategies such as neighborhood beautification projects and community center programs. The Journey also partnered with the Jacksonville Sheriff’s Office on gang intervention focused on young people.

Officials credited the effort with a nearly 40% reduction in homicides in Duval County in its first four years.

After Peyton left office in 2011, program spending of about $15 million was slashed to $8.6 million in 2012 and about $2.3 million in 2014. The scaled-back program was eventually combined with another children’s initiative to form the , which uses city, state, and federal grants to fund youth services and intervention programs.

Duval County is the only large county in Florida that does not have a child services tax dedicated to programs for children, including efforts to reduce youth crime.

City leaders believe “public safety is about fire and police, but not social services,” said Vicki Waytowich, executive director of the , a nonprofit funded through grants and contracts that provides health and juvenile justice services for children and families in Jacksonville.

“There is absolutely zero political will to do anything that remotely resembles a child services tax,” she said.

In 2024, on a gun violence prevention program called Cure Violence, which tried to squash beefs between youths before they escalated to shootings. A city Office of Inspector General report and sound financial practices.

“We have a public health system that doesn’t focus on this as a public health or population health issue,” Goldhagen said.

Waytowich said crime is a symptom of much deeper problems on the north side of Jacksonville, from neighborhood decay to generational trauma and lack of job opportunities.

“We don’t really have the funds to address the root causes,” she said. “What we’re doing is slapping a band-aid on things.”

Unlike in Mandarin, a predominantly white neighborhood on the south side of Jacksonville with easy access to about seven grocery stores, children of the city’s north side have poor nutrition, Waytowich said, and many walk more than a mile to get to school.

“We can see that kids don’t have hope,” Waytowich said. “When kids believe they’re going to die at 21, then what’s the use of goal-setting and résumé-building workshops?”

In 2025, Jacksonville Mayor Deegan launched a program to address gun violence called .

But like its predecessor, Journey Forward does not have a dedicated, ongoing source of funding.

Hard Memory

On March 22, Ladonna Johnson said, she broke up with Dodson because she saw that he was sharing location information with other women on his cellphone.

She said she went into a bedroom where A’mahri and his sister were watching television and put her son on her lap. Dodson followed Johnson into the room, she said, then went into a closet and retrieved the gun.

“He just kept asking me, ‘What are we doing?’” Johnson said.

Moments later, Johnson said, she heard a loud bang. Her daughter started to cry.

They will both need therapy, she said. She is dedicated to preserving A’mahri’s memory: “I want people to know how adorable and sweet my son was.”

Still, she said, “I feel like I will never be OK.”

Methodology

To find that more than 4,000 children under 18 had been treated in Florida hospitals for gunshot wounds from 2018 to 2024, The Trace and ��ýҕ�l Health News analyzed two datasets obtained from the Florida Agency for Health Care Administration via a data request:

In the emergency department file, which contained records of 67,565,314 ER visits that did not result in an inpatient admission, we identified 37,415 gunshot wound cases using the Centers for Disease Control and Prevention’s .
In the inpatient file, which contained records of 21,857,664 hospital visits in which patients were admitted, we identified 28,149 gunshot wound cases using the CDC definition.

We defined children as 17 and under and filtered the patient age column to find that 2,340 children had been treated in ERs and 1,684 admitted to hospitals with gunshot wounds. To avoid double-counting, we excluded patients from the emergency department file whose records indicated that they were transferred to a different inpatient facility.

Demographic breakdowns were generated using the race and ethnicity columns in the datasets.

To examine the geographic distribution of the burden of gun violence, we grouped child gunshot wound victims by the ZIP code provided. Importantly, this ZIP code is the location not of the shooting but of the child’s residence. A small number of children in the data had out-of-state ZIP codes, or placeholder ZIP codes indicating they were homeless or from a foreign country. These children are included in statewide totals as children treated in Florida hospitals but not in ZIP-level results.

This data does not include children who were shot but died at the scene or before reaching the hospital or who never received medical treatment.

��ýҕ�l Health News data editor Holly K. Hacker contributed to this report.

This report was produced by ��ýҕ�l Health News, The Trace, Action News Jax in Jacksonville, and WFTV in Orlando.

This article first appeared on ��ýҕ�l Health News and is republished here under a .

Ebola Is Still Killing in Central Africa. These Groups Are Working To Save Lives.

Rachel Spears — Mon, 24 Aug 2026 09:00:00 +0000

Misinformation and distrust are among the challenges facing public health workers in the Democratic Republic of Congo as they confront the on record. Even though the virus has faded from U.S. headlines, key organizations are still at work providing medical care and training to counter the spread of the disease.

Since the World Health Organization’s of a public health emergency, over 5,200 cases of the Bundibugyo strain of the Ebola virus have been confirmed and more than in Congo, according to the U.S. Centers for Disease Control and Prevention.

More than 550 people were in isolation with Ebola in Congo as of Aug. 7, the country’s National Public Health Institute said. Twenty cases and two deaths were reported in neighboring Uganda as well, but no new cases have been reported there since June 21, the World Health Organization said.

The in history, which hit several countries in West Africa from 2014 to 2016, claimed over 11,300 lives.

The current outbreak is only the third of the Bundibugyo strain in central Africa. Congo officials are reporting a for the rare strain, which have a vaccine. Military conflict in eastern Congo, where the outbreak is centered, has made the medical response more difficult.

“When everybody became aware of what was happening, we were already months behind where we should have been as a global community in stopping the spread of this disease,” said Erica Tavares, a senior director of the International Medical Corps.

The U.S. has pledged in response to the outbreak and enacted a , temporarily preventing non-U.S. citizens traveling from the affected region from entering the country.

Meanwhile, public health workers in Congo continue to toil against Ebola.

Below, ��ýҕ�l Health News profiles five organizations involved in the ongoing public health work there. A fraction of the groups working in Congo, they’re a mix of smaller, local organizations and larger, internationally known groups.

1. Africa Centres for Disease Control and Prevention

Africa CDC is the , in charge of helping health institutions in its member states with disease threat detection and response. With the WHO, Africa CDC announced a on June 5. The organizations said they would need more than $500 million over the following six months for the effort.

Their primary goal is to strengthen cross-border communication and collaboration under a unified “One Response” plan. Africa CDC has for travel and public gatherings, urging people to implement prevention methods including avoiding contact with bodily fluids instead of issuing blanket travel restrictions to affected areas.

This subagency within the Congolese Ministry of Public Health is tasked with monitoring and documenting the virus. Institute officials are conducting on-the-ground testing and have set up laboratories in Ituri province, the area hardest hit by the virus.

In July, the agency said it had also stepped up detection and monitoring of the virus’s evolution. Genomic surveillance, or analyzing the virus’s genetic code, is an “essential tool” for containing the virus, officials said in a news release. It also helps with vaccine development, which is underway of potential vaccines.

3. Doctors Without Borders

has worked in Ituri for over two decades responding to humanitarian and medical crises. The well-known international organization provides emergency medical aid, as well as disease surveillance.

Kate White, an emergency medical coordinator for the organization, is working in Bunia, the capital of Ituri. In a phone interview, she said the financial stability and size of MSF, the abbreviation for the group’s French name, enable it to work with partner organizations in the region to distribute resources and care. More than 1,400 MSF workers are responding to the current Ebola outbreak.

Looking forward, she said, MSF will reinforce some of its existing programs, including providing general healthcare, to prepare for any additional spread of the Ebola virus.

4. International Medical Corps

Since mid-May, members have provided case management and community education specific to Ebola and the current outbreak.

IMC operates rapid response teams in the region and has established treatment centers where patients can receive medicine and other care, as well as centers where people await test results.

“We’re also supporting the continuity of primary healthcare in the most at-risk regions,” Tavares said in an interview. “We want people to continue to come to facilities.”

The training of local health professionals is a focus of IMC’s work in Congo. It is also one way the organization partners with other entities, such as .

“Historically, we’ve always had training as part of our response program,” Tavares said. “It means that [other organizations] will just have that much more capacity in the future and looking forward.”

Eventually, IMC-run facilities will be turned over to local healthcare leaders, Tavares said, and her hope is that the communities will then be better equipped to respond to future outbreaks. IMC also focuses on improving hygiene and water sanitation, she said.

5. SOFEPADI

is a Congolese nonprofit that primarily serves women and girls. The women-led organization works to prevent gender-based violence, reduce inequality, and help women take charge of their own healthcare.

In the Ebola outbreak, SOFEPADI officials say, they are working to protect women. During past outbreaks, women have been due to their increased exposure as caregivers in their communities. The functioning of communities, in turn, is dependent on the health of women. “If the women fall, the whole community falls with them,” SOFEPADI officials wrote in French in a June 1 post on their website.

This article first appeared on ��ýҕ�l Health News and is republished here under a .

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