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Category: Health

  • Bucks County nursing home had record of safety violations before deadly explosion killed 3

    Bucks County nursing home had record of safety violations before deadly explosion killed 3

    The nursing home in Bucks County where three people died last month in a natural gas explosion had a long track record of safety violations.

    The exact cause of the explosion has yet to be determined, but state regulators cited the 174-bed Bristol Township facility for numerous safety violations in the three years leading up to the tragedy. The nursing home, which changed owners three weeks before the accident, was cited for over 70 health and fire safety violations since 2023, and fined more than any nursing home in the Philly area.

    The Centers for Medicare & Medicaid Services (CMS) slapped a total of $418,000 fines on the facility, then named Silver Lake Healthcare Center, between 2023 and 2025, more than any other facility in Delaware, Chester, Montgomery, Bucks, and Philadelphia Counties. Major fines were issued after a resident overdosed on illegal narcotics on four separate occasions. The new owners renamed it Bristol Health & Rehab Center in 2025.

    The Pennsylvania Department of Health conducts inspections of nursing homes on behalf of the federal government every 15 months, said Neil Ruhland, a spokesman for the Pennsylvania Department of Health. Facilities that repeatedly fail to comply with safety standards can face penalties including fines and, in rare cases, termination from Medicare and Medicaid, he said.

    Across the region, a total of $5.3 million in fines have been issued to nursing homes since 2023. Nearly half the region’s nursing homes had fines, and six-figure penalties are not uncommon in the region. More than 22% of the 85 facilities fined had penalties greater than $100,000.

    Fines for fire safety

    In January 2023, when the facility was known as Silver Lake Healthcare Center, it was cited for a fire safety deficiency during a routine inspection. According to the report, the facility failed to maintain exit signage requirements and fire sprinkler systems. The facility also did not maintain corridor doors, which help resist the passage of smoke, on two floors, and failed to provide the required smoke barrier partitions on two floors.

    These violations led to a single fire safety citation at the nursing home between 2023 and 2025. Other nursing homes in Southeastern Pennsylvania had far more, including one with 60 fire-safety citations during the same period.

    Two months before the explosion, in October 2025, the state completed another inspection of the building. Some of the problems from 2023 were addressed, but not all, the report shows.

    The center again failed to provide required smoke barrier partitions on two of three floors. The nursing home also failed to provide an accurate floor plan that inspectors could carry during a building safety review, failed to maintain portable fire extinguishers on one floor, and did not properly secure a room where oxygen cylinders were stored with smoke-tight doors.

    The inspection report indicates that the center had requested a Fire Safety Evaluation System (FSES), which according to CMS, “may be applicable when a facility has multiple deficiencies that may be cost-prohibitive or infeasible to correct.”

    Silver Lake Healthcare Center did not respond to The Inquirer’s request for comment.

    Citations for narcotics, mental health

    In addition to fire safety violations, the facility has received a high number of health citations — a total of 71 issued by CMS over the past three years.

    A resident overdosed on illegal narcotics on four separate occasions during a seven-month period from December 2023 to July 2024, according to a September 2024 inspection report. One time, the resident reported to investigators buying an unidentified narcotic from another resident of the facility in one incident. On another occasion, the patient obtained fentanyl that led to another overdose and a trip to an emergency department.

    Despite the patient’s “history of heroin and fentanyl abuse,” according to the report, “there was no documented evidence that a consistent psychiatric, psychological counseling to address resident’s addiction was provided.”

    The facility also failed to adequately supervise a resident diagnosed with schizoaffective and bipolar disorders, according to an October 2024 inspection report. An interview with a nurse aide found that the resident left the facility at 11:30 p.m. Staff were unaware until notified by police hours later.

  • Springfield Hospital has a new buyer, for $1 million, after an auction winner didn’t close a deal

    Springfield Hospital has a new buyer, for $1 million, after an auction winner didn’t close a deal

    Springfield Hospital has a new buyer, with the same local investor group that bought Taylor Hospital in September agreeing to purchase it for $1 million.

    Bankrupt owner Prospect Medical Holdings said in a court filing Friday that it now plans to sell Springfield Hospital and an associated parking garage to KQT Aikens Partners 2. The group paid $1 million for Taylor.

    Todd Strine, one of the investors involved in KQT Aikens, declined to comment Saturday on the Springfield development. The company has been trying to find healthcare tenants for Taylor, which is in Ridley Park. Among the goals is reestablishing emergency services there, according to local officials.

    At Springfield, KQT Aikens is replacing a partnership of Restorative Health Foundation and Syan Investments LLC, which won an October auction for the hospital property with a $3 million bid but was not making progress toward closing the deal, Prospect’s filing said.

    Prospect sent a letter on Dec. 11 giving the partners a Dec. 15 deadline to complete the purchase. When that did not happen, Prospect terminated the agreement, the filing said. Restorative did not immediately respond to a request for comment.

    A challenge for any buyer of Springfield Hospital is a deed restriction that requires 24-7 emergency services at the site. The KQT Aikens deal is contingent on township officials removing that restriction. The KQT Aikens agreement also calls for local taxing authorities to set the assessment of the Springfield Township property at the sale price, as happened at Taylor.

    Jeff Rudolph, president of the Springfield Township Board of Commissioners, said in an email that local officials look forward to restoring the property to a productive use.

    “Prospect will determine the ultimate buyer of the property and, while the township plays no role in that process, we look forward to discussions with the new owner about any proposed future use of the site,” he said.

    Taylor and Springfield Hospitals were part of Crozer Health, which was Delaware County’s largest healthcare provider. That was before Prospect’s bankruptcy a year ago led to the closures last spring of Taylor and Crozer-Chester Medical Center, which was an important safety-net provider for low-income Chester residents.

    Prospect had closed Springfield in early 2022, and Delaware County Memorial Hospital in Drexel Hill in the fall of 2022. In both cases, Prospect blamed the closures on staffing shortages during the COVID-19 pandemic.

  • 70,000 Pennie customers have dropped their plans as price hikes loom for health insurance

    70,000 Pennie customers have dropped their plans as price hikes loom for health insurance

    Sasha Kinney fears she cannot afford the $750 a month it will cost to keep her Affordable Care Act health plan in 2026. But she will put the insurance bill on a credit card before risking a medical emergency without access to the doctors she sees regularly.

    The 42-year-old Drexel Hill resident’s insurance costs soared this year, after Congress did not extend a federal incentive program that ensured that no one paid more than 8.5% of income on health coverage.

    She earns enough doing freelance work for nonprofits, while serving as her mother’s primary caregiver, that she is not eligible for Medicaid, the publicly funded health program for low-income people.

    A private health plan through Pennsylvania’s Obamacare marketplace, Pennie, was a major expense, but one she prioritized to help manage her chronic headaches and stress-related pain. But the incentive program expired at the end of last year, leading to skyrocketing ACA insurance costs in Pennsylvania and across the country. Kinney will now pay an extra $250 without the added tax credit.

    “I will go into debt because of these increasing costs,” she said. “But it still seems better than not having coverage.”

    Congress has failed so far to strike a deal to bring back tax credits that have helped record numbers of Americans get health insurance. The U.S. House of Representatives approved legislation last week that would renew the program for three years, but it is unclear if the Senate will act.

    President Donald Trump on Thursday announced a healthcare plan that White House officials said would help address rising healthcare costs by creating new drug price controls and sending health subsidies directly to consumers. The sparsely detailed plan is intended to serve as a framework for Congress, though officials did not say which lawmakers are actively working on new healthcare legislation, the Associated Press reported.

    Meanwhile, people who are covered by Obamacare plans are running out of time to decide how to handle massive price hikes that doubled the average cost of the health plans in Pennsylvania.

    The deadline to enroll in a plan for 2026 in Pennsylvania and other states is Jan. 31. After that date, people can drop their coverage if they find it is too expensive, but they will not be able to select a new plan until the fall enrollment period.

    In Pennsylvania, about 70,000 people who bought Pennie plans in 2025 have decided they cannot afford the price increase and dropped their coverage. The dropout rate is unprecedented — about 1,000 people a day, said Devon Trolley, Pennie’s executive director.

    Nationally, about 800,000 fewer people have selected Obamacare plans compared with this time last year, a 3.5% drop in total enrollment so far, according to the AP.

    With just weeks to go in the enrollment period, marketplace leaders are urging people to think carefully about whether they can afford their plan for the full year and to look at other Pennie plan options. If Congress ultimately renews the enhanced tax credits, they have said, they would work quickly to adjust prices.

    “At this point, we are telling people they should make the best decision for their family based on the current cost,” Trolley said. “We want to make sure people who currently have coverage aren’t staying with a plan they can’t afford.”

    Trolley worries that people will stick with a plan they like, not realizing they can no longer afford it, only to be forced to drop the coverage and become uninsured partway through the year.

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    Congress considering tax credit extension

    The add-on tax credits that expired at the end of 2025 were introduced in 2021 and have been renewed by Congress annually since then.

    In Pennsylvania, the federal incentive program ensured the vast majority of enrollees qualified for at least some amount of financial help, driving peak marketplace enrollment of 497,000 in 2025.

    The program became a major sticking point in federal budget discussions last fall, with Democrats forcing a government shutdown after Republicans refused to include the tax credits without significant restrictions.

    The budget ultimately passed without the tax credits after key Senate Democrats, including Pennsylvania’s John Fetterman, voted with Republicans to end the shutdown.

    Last week, 17 House Republicans — including Pennsylvania Reps. Brian Fitzpatrick, Robert Bresnahan, and Ryan MacKenzie — sided with Democrats to approve legislation that would reinstate the tax credits for three years. The measure must be approved by the Senate, and would need to return to the House to consider any changes.

    While the incentive program’s expiration is a major blow to the Obamacare marketplaces, Trolley, Pennie’s executive director, urged people not to rule out finding affordable coverage.

    President Barack Obama’s landmark health law also included income-based tax credits for people who earn less than 400% of the federal poverty level — about $60,000. These tax credits cannot expire because they are part of the law.

    “We have been encouraging people to not assume it’s too expensive,” Trolley said.

    Devon Trolley, executive director of Pennie, has been outspoken about how cuts to ACA tax credits are affecting people who buy Pennie health plans. Pictured during a 2025 roundtable with Pennsylvania lawmakers, stakeholders, health systems at the University City Science Center in Philadelphia.

    Health insurance decisions

    While some parts of Pennsylvania are seeing prices three to four times higher than in 2025, Philadelphia’s collar counties are seeing more moderate cost increases, ranging from an average 46% price hike in Chester County to a 70% average increase in Delaware County.

    Other factors that affect cost include household size, age, and income. People who are generally healthy and use insurance sparingly may be able to save money by opting for a plan that has a low monthly cost and a higher deductible (the amount of money spent out-of-pocket before the plan begins covering a greater share of costs).

    Sasha Kinney, 42, of Drexel Hill, considered switching to a high-deductible health plan to lower her monthly premium, but ultimately stuck with her old Pennie plan because it offered better coverage.

    In Drexel Hill, Kinney considered switching to a cheaper plan when she saw how much it would cost to keep her current coverage.

    Her current plan has a low deductible, and even so, Kinney said, she still spends hundreds on co-pays and other costs not covered.

    She worried that if she switched to a plan with even higher out-of-pocket costs, she would end up skipping appointments and avoiding needed care.

    She routinely sees doctors and physical therapists, and didn’t want to risk having to find new providers.

    “In the end I think it washes out — you can lower your monthly cost, but if the deductible and co-pays are higher, you’re paying the same,” she said. “There’s basically no way to save money.”

  • CHOP, Nemours targeted by Trump administration over transgender care

    CHOP, Nemours targeted by Trump administration over transgender care

    Escalating President Donald Trump’s fight against transgender rights, a top official at the Department of Health and Human Services on Thursday asked the department’s inspector general to investigate two Philadelphia-area children’s hospitals over their gender-affirming care for transgender children.

    Children’s Hospital of Philadelphia (CHOP) and Nemours Children’s Health in Wilmington are among a dozen hospitals that HHS general counsel Mike Stuart said in posts on X he had referred to the agency’s Office of the Inspector General (OIG) in recent days.

    A CHOP spokesperson declined to comment on Friday, and Nemours did not respond to a request for comment.

    Both hospitals treat children and teens with gender dysphoria — a medical condition in which a person’s body does not match their gender identity. Doctors can prescribe hormone therapy and puberty blockers to treat the condition, although Nemours has already limited its use of these treatments in response to threats from the Trump administration.

    The administration has targeted CHOP and other hospitals that treat transgender youth with subpoenas demanding patients’ medical records, including their dates of birth, Social Security numbers, and addresses, as well as every communication by doctors — emails, voicemails, and encrypted text messages — dating back to January 2020.

    CHOP filed legal action in response, asking a federal judge in Philadelphia to block the parts of the subpoena that sought detailed medical records of patients. In November, the judge ruled in CHOP’s favor.

    The Trump administration appealed the decision Friday. It has argued that it needs the records as part of its investigation into possible healthcare fraud or potential misconduct by the hospitals.

    Stuart said in a Thursday post on X that the administration is investigating hospitals in order to safeguard children from “sex-rejecting procedures,” adding: “There is no greater priority than protecting our children.”

    Corinne Goodwin, executive director of the Eastern Pennsylvania Trans Equity Project, called Stuart’s post part of the Trump administration’s ongoing efforts to intimidate doctors and hospitals that provide gender-affirming care to those under 19.

    “This action by the Department of Health and Human Services is yet another attempt to intimidate healthcare providers and to harm young people who simply want access to proven healthcare that helps them to live happy and productive lives,” said Goodwin, whose nonprofit organization provides services to transgender people in 42 counties, including Montgomery, Bucks, and Delaware.

    In the last year, the president has signed a slew of executive orders aimed at transgender Americans.

    The administration has said it recognizes only two genders, limited research into LGBTQ+ health, and phased out gender-affirming care at the Department of Veterans Affairs.

    Directly targeting children’s hospitals, HHS Secretary Robert F. Kennedy Jr. issued a declaration in December rejecting gender-affirming procedures for minors, including puberty blockers, hormone therapy, and surgeries.

    The American Academy of Pediatrics and other major medical associations, citing research, widely accept such care as safe, effective, and medically necessary for the patients’ mental health.

    HHS’s OIG declined Friday to confirm or deny the existence of an investigation.

    Last month, the U.S. Senate confirmed Thomas “March” Bell to serve as inspector general over HHS. During his confirmation hearing, Bell submitted written testimony saying, “If confirmed as inspector general, I will examine, evaluate, audit, and investigate to support the initiatives of President Trump and Secretary Kennedy.”

    An ongoing legal battle

    CHOP runs one of the nation’s largest clinics providing medical care and mental health support for transgender and nonbinary children and teens and their families. Each year, hundreds of new families seek care at CHOP’s Gender and Sexuality Development Program, created in 2014.

    Nemours’ Gender Wellness Clinic, launched in 2018, provided hormone therapy and puberty blockers, as well as mental health support, to transgender patients in Delaware, and Nemours is the only hospital in the state that provides gender-affirming care for children.

    Starting last July, its clinic began accepting only new patients who need behavioral healthcare. Existing patients receiving hormones or puberty blockers at the clinic were allowed to continue their treatment, the hospital said at the time.

    On Thursday, Stuart wrote on X that CHOP and Nemours “appear to continue to operate outside recognized standards of healthcare and entirely outside @SecKennedy’s declaration that sex-rejecting procedures for children and adolescents are neither safe nor effective.”

    Kennedy’s December declaration says that these procedures “do not meet professionally recognized standards of health care.” Doctors who perform such procedures could be barred from participating in federally funded healthcare programs like Medicaid and Medicare, he said.

    More than a dozen state officials from around the country, including Pennsylvania Gov. Josh Shapiro, filed a lawsuit in late December to block the declaration’s enforcement.

    The lawsuit says that Kennedy has no authority to define “a national standard of care,” and that any substantive changes to Medicare rules are legally required to be subjected to a decision-making process that includes 60 days of public comment.

    Officials at the Centers for Medicaid and Medicare Services have started that process, announcing alongside Kennedy’s declaration that they are proposing a rule that would bar hospitals from Medicaid and Medicare if they offer gender-affirming care to children under 19. They also proposed that Medicaid should not cover gender-affirming care for minors.

    But those rules have not yet been instituted, and the lawsuit alleges that Kennedy’s declaration is skirting the law by immediately imposing restrictions on gender-affirming care in hospitals.

    The Public Interest Law Center, a Philadelphia-based nonprofit that advocates for the civil, social, and economic rights of marginalized communities, is representing five parents of transgender children in legal motions seeking to protect their medical records.

    Mimi McKenzie, PILC’s legal director, said the federal judge in Philadelphia was “very clear and on firm ground” when he ruled in November that the DOJ had no authority to issue the sweeping subpoena and that it violated the privacy rights of children.

    She noted that six other courts around the country have similarly ruled that DOJ “has no right to rifle through children’s medical records.”

    “Gender-affirming care is legal in Pennsylvania and endorsed by every leading medical association,” McKenzie said. “This is just another tactic in their ongoing attack against providers and patients.”

  • Fewer Pennsylvania nursing homes closed last year than in 2024

    Six Pennsylvania nursing homes closed last year, down from 10 in 2024, according to data provided to The Inquirer by the Pennsylvania Department of Health.

    None of last year’s closures were in the Philadelphia area. The most recent closure in Southeastern Pennsylvania was at Main Line Health’s Riddle Hospital, which shuttered its very small, 23-bed facility in early 2023. That year, five nursing homes closed statewide.

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    But this year is starting with the loss of a Philadelphia facility. Monumental Post-Acute Care at Woodside, formerly called Bala Nursing & Rehabilitation Center, notified state official last month that the 180-bed facility will close next month.

    Officials there could not be reached for comment about why nursing home is closing after 37 years. More than 90% of the facility’s patients had Medicaid insurance for low-income people.

    Monumental is among the larger nursing homes to close recently. About half of the nursing homes that closed during the last three years had 50 or fewer beds. The statewide average is 127 beds.

    Smaller facilities have a harder time covering their costs.

    The county hardest hit by nursing home closures was Allegheny, which is home to Pittsburgh. Four nursing homes closed there. The counties that are home to Scranton and Wilkes-Barre each lost two facilities.

  • Federal substance abuse and mental health grants were cut and then restored with little explanation

    Federal substance abuse and mental health grants were cut and then restored with little explanation

    Physicians Zsofi Szep and Judy Chertok have spent the last three years working to connect Penn Medicine patients with addiction treatment — with the help of a federal grant that they learned was terminated in a form letter Tuesday.

    They rushed to find a way to keep caring for their patients, many with HIV or hepatitis C and needing supports such as housing and food after treatment. The salaries of two staffers helping to connect people with such resources had been entirely grant-funded.

    “To stop this from one day to the next was obviously devastating,” Szep said. “It’s not possible to stop patient care. We continued to do what we were doing.”

    The Substance Abuse and Mental Health Services Administration had abruptly rescinded funding for thousands of grants dealing with mental health and addiction treatment, only to reverse itself a day later with little explanation.

    NPR reported that some $2 billion in grants were cut off, and grantees like Szep and Chertok received form letters that said only that their projects no longer aligned with agency priorities.

    The move sparked immediate outrage from providers and legislators alike. U.S. Rep. Madeleine Dean (D., Montgomery) helped marshal 100 congressional representatives to sign a bipartisan letter to Health and Human Services Secretary Robert F. Kennedy Jr., demanding the funding be restored.

    By Wednesday night, it had been, The Associated Press reported — still with little explanation from federal officials. HHS did not return a request for comment Thursday. The agency also declined to answer questions about the reasons for the rescissions from The Associated Press.

    But providers at the programs affected by the whiplash of rescinded, then restored, funding said they were shaken by a chaotic 24 hours and worried about what the move signaled.

    Since President Donald Trump took office last January, his administration has fired thousands of federal workers and attempted to slash federal grants at unprecedented levels, creating chaos among researchers, health providers, and nonprofits.

    As of late Thursday, one Philadelphia provider who receives SAMHSA grants said she had not yet received notice from the agency that funding had been restored.

    “It’s a message that what we’re doing is not important,” said Barbara Schindler, the medical director of the women’s addiction treatment program Caring Together.

    “The people that work day to day on the front lines, we’re dealing with folks that are living on the edge and need all the help they can get. To feel like your rug can get pulled out from underneath you at any one point, both as a provider as well as a participant, is very upsetting.”

    Uncertainty amid attempted cuts

    It’s unclear how many programs in the Philadelphia area were affected.

    Gaudenzia, an addiction treatment provider with locations across Pennsylvania, Maryland, and Delaware, had grants rescinded, then restored, that were related to expanding treatment access, addiction prevention, and support services, a spokesperson said.

    Gaudenzia’s president and CEO, Deja Gilbert, said she understood the need for “fiscal responsibility at the federal level,” but funding changes should be made in collaboration with providers.

    “Abrupt funding actions — even when reversed — create uncertainty for providers and the people we serve,” she said in a statement.

    Szep and Chertok’s program at Penn, which has served about 125 patients over the last few years, is aimed at some of the health system’s most vulnerable patients, connecting patients in the hospital or outpatient clinics with addiction treatment.

    “It’s a very sick and complicated group of patients, who are specifically referred to an extra-specialized team,” Chertok said.

    They were relieved when their funding was restored on Thursday but remain worried about the future.

    “So many other people have similar grants in our city through SAMHSA — the amount of people that are getting care through these types of programs is really dramatic, and we don’t have other ways of getting them care,” Chertok said.

    Schindler, a professor of psychiatry and pediatrics at Drexel University, said SAMHSA funding through two grants allows her 36-year-old clinic to support medication for women with opioid use disorder and a reentry program for women incarcerated for drug-related crimes.

    “It allows us to have more addiction counselors and staff that can address the incredible needs these ladies have,” she said. “It really enhances the program.”

    She said she was “on pins and needles” waiting to hear that her funding had been restored.

    ‘Incompetence and cruelty’

    Dean said she learned of the cuts when a staffer pulled her aside to share a news article, reporting that SAMHSA had abruptly rescinded $2 billion in funding from more than 2,000 grants. Almost immediately afterward, the head of a Pennsylvania network of addiction treatment providers called her.

    They began working to determine how many local grants had been affected, an effort that’s still ongoing.

    “Immediately, what I thought was, this will cost lives. People will die as a result of this level of incompetence and cruelty,” Dean said.

    She said she had not received answers from the administration on the reasoning behind the cuts.

    Dean called the terminations hypocritical, noting that President Donald Trump has justified military operations in Venezuela as an effort to combat drug trafficking even as his administration attempted to cut billions in drug treatment funding at home.

    “It’s incompetent, illegal, unconstitutional, and we got no notice,” she said.

    Dean said she was pleased that programs were seeing their funding restored, although she was still unsure what had prompted the decision, and was concerned about the precedent the move set.

    “I’m of the mind that it will happen again. And there is real harm — I don’t care if the interruption is 24 hours,” she said. “Interruptions can have large impacts.”

  • Trump announces outlines of healthcare plan he wants Congress to consider

    Trump announces outlines of healthcare plan he wants Congress to consider

    WASHINGTON — President Donald Trump on Thursday announced the outlines of a healthcare plan he wants Congress to take up as Republicans have faced increasing pressure to address rising health costs after lawmakers let subsidies expire.

    The cornerstone is his proposal to send money directly to Americans for health savings accounts so they can handle insurance and health costs as they see fit. Democrats have rejected the idea as a paltry substitute for the tax credits that had helped lower monthly premiums for many people.

    “The government is going to pay the money directly to you,” Trump said in a taped video the White House released to announce the plan. “It goes to you and then you take the money and buy your own healthcare.”

    Trump’s plan also focuses on lowering drug prices and requiring insurers to be more upfront with the public about costs, revenues, rejected claims and wait times for care.

    Trump has long been dogged by his lack of a comprehensive healthcare plan as he and Republicans have sought to unwind former President Barack Obama’s signature legislation, the Affordable Care Act. Trump was thwarted during his first term in trying to repeal and replace the law.

    When he ran for president in 2024, Trump said he had only “concepts of a plan” to address healthcare. His new proposal, short on many specifics, appeared to be the concepts of a plan.

    Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services, described it to reporters on a telephone briefing as a “framework that we believe will help Congress create legislation.”

    It was not immediately clear if any lawmakers in Congress were working to introduce the Republican president’s plan. A White House official who was not authorized to speak publicly and described some details on condition of anonymity said the administration had been discussing the proposal with allies in Congress, but was unable to name any lawmakers who were working to address the plan.

    Few specifics on health savings accounts

    The White House did not offer any details about how much money it envisioned being sent to consumers to shop for insurance, or whether the money would be available to all “Obamacare” enrollees or just those with lower-tier bronze and catastrophic plans.

    The idea mirrors one floated among Republican senators last year. Democrats largely rejected it, saying the accounts would not be enough to cover costs for most consumers. Currently, such accounts are used disproportionately by the wealthiest Americans, who have more income to fund them and a bigger incentive to lower their tax rate.

    White House press secretary Karoline Leavitt was asked at her briefing Thursday whether the president could guarantee that under his plan, people would be able to cover their health costs. She did not directly answer, but said, “If this plan is put in place, every single American who has health care in the United States will see lower costs as a result.”

    Enhanced tax credits that helped reduce the cost of insurance for the vast majority of Affordable Care Act enrollees expired at the end of 2025 even though Democrats had forced a 43-day government shutdown over the issue.

    Sen. Bernie Moreno (R., Ohio) has been leading a bipartisan group of 12 senators trying to devise a compromise that would extend those subsidies for two years while adding new limits on who can receive them. That proposal would create the option, in the second year, of a health savings account that Trump and Republicans prefer.

    The White House official denied that Trump was closing the door completely on those bipartisan negotiations, and said the White House preferred to send money directly to consumers.

    Plan follows massive cuts to health programs

    Trump’s plan comes months after the Republicans’ big tax and spending bill last year cut more than $1 trillion over a decade in federal healthcare and food assistance, largely by imposing work requirements on those receiving aid and shifting certain federal costs to the states.

    Democrats have blasted those cuts as devastating for vulnerable people who rely on programs such as Medicaid for their healthcare. The GOP bill included an infusion of $50 billion over five years for rural health programs, an amount experts have said is inadequate to fill the gap in funding.

    The White House said Trump’s new proposal will seek to bring down premiums by fully funding cost-sharing reductions, or CSRs, a type of financial help that insurers give to low-income ACA enrollees on silver-level, or mid-tier plans.

    From 2014 until 2017, the federal government reimbursed insurance companies for CSRs. In 2017, the first Trump administration stopped making those payments. To make up for the lost money, insurance companies raised premiums for silver-level plans. That ended up increasing the financial assistance many enrollees got to help them pay for premiums.

    As a result, health analysts say that while restoring money for CSRs would likely bring down silver-level premiums, as Trump says, it could have the unwelcome ripple effect of increasing many people’s net premiums on bronze and gold plans.

    Lowering drug prices is a priority

    Oz said Trump’s plans also seeks to have certain medications made available over the counter instead of by prescription if they are deemed safe enough. He mentioned higher-dose nonsteroidal anti-inflammatory drugs and peptic ulcer drugs as two examples.

    It was unclear whether the White House is asking Congress to take steps to make more prescription drugs available over the counter. For decades, the Food and Drug Administration has had the ability to do that.

    The heartburn drug Prilosec, as well as numerous allergy medications, are among those the FDA has approved for over-the-counter sales. The FDA only approves such changes if studies show patients can safely take the drug after reading the package labeling. Companies must apply for the switch.

    The White House said Trump’s plan would also codify his efforts to lower drug prices by tying prices to the lowest price paid by other countries.

    Trump has already struck deals with a number of drugmakers to get them to lower the prices. As part of that, the drugmakers have agreed to sell pharmacy-ready medicines directly to consumers who can shop online at the White House’s website for selling drugs directly to consumers, TrumpRx.gov.

    TrumpRx did not yet have any drugs listed on Thursday. Oz said drugs will be available on the website at the end of the month.

  • Your body doesn’t need a detox cleanse. Do this instead.

    Your body doesn’t need a detox cleanse. Do this instead.

    The question: Do detox cleanses really work?

    The science: Detox cleanses are all over social media, with people claiming the diets remove toxins, help you lose weight, and supposedly reset your body using a strict regimen of juices, herbal teas, or other liquids; supplements; or fasting or eliminating certain foods.

    But despite the hype, there is little evidence that these cleanses do what they claim, and they can be risky for people with eating disorders and other health issues such as heart and kidney diseases, experts said.

    “This has become a multibillion-dollar industry because people are looking for quick fixes,” said Tinsay Woreta, an associate professor in gastroenterology and hepatology at Johns Hopkins University. “But a quick detox for three to seven days is not going to have the same benefits as a long-term healthy lifestyle.”

    Detox cleanses are touted as a way to remove toxic substances in our bodies from sources such as ultra-processed foods, alcohol, microplastics, air pollution and household cleaners.

    Some juice cleanses, often built around lemon juice or apple cider vinegar, claim to improve liver function, remove toxins, and boost metabolic function, among other things. Others may call for food restriction or a complete fast, herbal teas and supplements, even laxatives or what are known as colon cleanses. Depending on the detox, it may last a couple of days or up to three weeks or so. By the end, you’re told to expect more energy, glowing skin and stronger nails, and a smaller waist. But although you might see short-lived weight loss, you’re unlikely to get actual detoxification, experts said.

    Your body already has a well-established filtration system. Your lungs trap and expel airborne toxins, your intestines remove foodborne organisms, and your kidneys filter your blood and eliminate waste through urine. Your body’s main detox center, however, is your liver, which processes blood from your digestive system and converts toxins such as alcohol into waste products that can be safely eliminated from your body, Woreta said.

    “We don’t have any evidence that if you eat a well-balanced diet that these cleanses are adding anything” — and they can’t undo damage that already has been done to your body, she said.

    A 2014 research review concluded that there was “very little evidence” to support the health claims of detox diets, and favorable studies of commercial ones were “hampered by flawed methodologies and small sample sizes.” In a 2022 review of fad diets, researchers found no clinical evidence proving or disproving weight loss effectiveness of commercial detox diets but noted that “the success rate of dieting, in general, is only 20%.”

    In 2017, researchers reported that juicing or “detoxification” diets may lead to short-term weight loss because of low caloric intake, but the weight often returns once a normal diet is resumed.

    For instance, the popular lemonade diet or lemon detox diet is usually done for a couple of days to a few weeks and excludes solid food. People begin their day with salt water; drink several glasses of a beverage made of lemon juice, maple syrup, water, and cayenne pepper throughout the day; and have a cup of herbal tea at night. This diet provides somewhere between 600 and 1,200 calories per day when adult women need 1,600 to 2,400 calories and men need 2,200 to 3,000 calories, according to the most recent government dietary guidelines.

    More recently, in 2024, researchers analyzed TikTok videos promoting detoxes and other diets and found that the most popular posts frequently made unsubstantiated health claims, which the authors said posed potential risks to users, including disordered eating.

    Juice cleanses can be risky for people who are vulnerable to eating disorders as they can trigger episodes of undereating or, on the flip side, severe overeating, said Rhonda Merwin, a professor in psychiatry and behavioral sciences at Duke University, who was not involved in the study. Cleanses may also lead to other behaviors to get rid of perceived toxins, such as using laxatives or diuretics, which can become frequent and dangerous, she said.

    Fruit and vegetable juices do contain vitamins and minerals and can be a source of antioxidants, though they lack the fiber found in whole fruits and vegetables. But juice cleanses may lack protein, essential fats, soluble vitamins, and fiber, leading to electrolyte and blood sugar imbalances, which can cause lightheadedness, dizziness, and headaches, said Julia Zumpano, a registered dietitian with the Cleveland Clinic’s Center for Human Nutrition.

    This is especially a concern for people with cardiovascular or kidney disease and taking medications for those conditions because imbalances of sodium and potassium electrolytes can lead to dangerous arrhythmias, said Wendy Weber, the acting deputy director of the National Center for Complementary and Integrative Health at the National Institutes of Health.

    Additionally, juices high in certain vegetables may increase the risk of kidney stones for those who are prone to them. Spinach, for instance, can be high in oxalates, compounds that bind to minerals such as calcium and can exacerbate kidney stones, Weber said.

    And although some fruit juices, such as most orange juice brands, don’t contain added sugars, high levels of natural sugars aren’t good for your health. Dietitians recommend one or two glasses of fruit juice a day, and not eight.

    What else you should know

    You may feel better after a cleanse because you’ve cut out processed foods, added sugars, and alcohol. But a cleanse is of short duration. A more sustainable long-term approach is to limit these items and eat healthy whole foods, Weber said.

    Here are more tips from experts:

    • Eat a balanced diet. A balanced diet — such as the Mediterranean diet — of fruit, vegetables, nuts, grains, and lean protein such as fish and chicken and that avoids processed and fatty foods, added sugars, and artificial sweeteners can reduce your risk of liver disease and other health problems, Woreta said. Also, follow nutrition labels for proper portion sizes. Most people eat larger portions than recommended, Weber said, explaining that one serving size of protein should be no larger than the size of your palm.
    • Be physically active. Adults should get at least 150 minutes per week, or 30 minutes five days per week, of moderate-intensity aerobic activity, according to recommendations from the American Heart Association. “Being physically active as much as you’re able to do so, whether walking or taking up a new exercise routine — anything you can really sustain and stick to — that’s what’s going to have long-term benefit,” Weber said.
    • Limit alcohol intake. Even moderate drinking — defined as up to two drinks per day for men and one for women — is linked to a higher risk of developing certain cancers such as breast, colorectal, and esophageal cancers, as well as brain changes and dementia, heart problems, and sleep problems.

    The bottom line: While some detox diets contain vitamins and minerals and can be a source of antioxidants, they don’t meet all your daily nutritional needs and don’t lead to the same long-term benefits as adopting a healthy diet and lifestyle.

  • Vaccines are helping older people more than we knew

    Vaccines are helping older people more than we knew

    Let’s be clear: The primary reason to be vaccinated against shingles is that two shots provide at least 90% protection against a painful, blistering disease that a third of Americans will suffer in their lifetimes, one that can cause lingering nerve pain and other nasty long-term consequences.

    The most important reason for older adults to be vaccinated against the respiratory infection RSV is that their risk of being hospitalized with it declines by almost 70% in the year they get the shot, and by nearly 60% over two years.

    And the main reason to roll up a sleeve for an annual flu shot is that when people do get infected, it also reliably reduces the severity of illness, though its effectiveness varies by how well scientists have predicted which strain of influenza shows up.

    But other reasons for older people to be vaccinated are emerging. They are known, in doctorspeak, as off-target benefits, meaning that the shots do good things beyond preventing the diseases they were designed to avert.

    The list of off-target benefits is lengthening as “the research has accumulated and accelerated over the last 10 years,” said William Schaffner, an infectious disease specialist at Vanderbilt University Medical Center in Nashville, Tenn.

    Some of these protections have been established by years of data; others are the subjects of more recent research, and the payoff is not yet as clear. The first RSV vaccines, for example, became available only in 2023.

    Still, the findings “are really very consistent,” said Stefania Maggi, a geriatrician and senior fellow at the Institute of Neuroscience at the National Research Council in Padua, Italy.

    She is the lead author of a recent meta-analysis, published in the British journal Age and Ageing, that found reduced risks of dementia after vaccination for an array of diseases. Given those “downstream effects,” she said, vaccines “are key tools to promote healthy aging and prevent physical and cognitive decline.”

    Yet too many older adults, whose weakening immune systems and high rates of chronic illness put them at higher risk of infectious diseases, have not taken advantage of vaccination.

    The Centers for Disease Control and Prevention reported last week that about 31% of older adults had not yet received a flu shot. Only about 41% of adults 75 and older had ever been vaccinated against RSV, or respiratory syncytial virus, and about a third of seniors had received the most recent COVID-19 vaccine.

    The CDC recommends the one-and-done pneumococcal vaccine for adults 50 and older. An analysis in the American Journal of Preventive Medicine, however, estimated that from 2022, when new guidelines were issued, through 2024, only about 12% of those 67 to 74 received it, and about 8% of those 75 and older.

    The strongest evidence for off-target benefits, dating back 25 years, shows reduced cardiovascular risk following flu shots.

    Healthy older adults vaccinated against flu have substantially lower risks of hospitalization for heart failure, as well as for pneumonia and other respiratory infections. Vaccination against influenza has also been associated with lower risks of heart attack and stroke.

    Moreover, many of these studies predate the more potent flu vaccines now recommended for older adults.

    Could the RSV vaccine, protective against another respiratory illness, have similar cardiovascular effects? A recent large Danish study of older adults found a nearly 10% decline in cardiorespiratory hospitalizations — involving the heart and lungs — among the vaccinated versus a control group, a significant decrease.

    Lowered rates of cardiovascular hospitalizations and stroke did not reach statistical significance, however. That may reflect a short follow-up period or inadequate diagnostic testing, cautioned Helen Chu, an infectious disease specialist at the University of Washington and co-author of an accompanying editorial in JAMA.

    “I don’t think RSV behaves differently from flu,” Chu said. “It’s just too early to have the information for RSV, but I think it will show the same effect, maybe even more so.”

    Vaccination against still another dangerous respiratory disease, COVID, has been linked to a lower risk of developing long COVID, with its damaging effects on physical and mental health.

    Probably the most provocative findings concern vaccination against shingles, aka herpes zoster. Researchers made headlines last year when they documented an association between shingles vaccination and lower rates of dementia — even with the less effective vaccine that has since been replaced by Shingrix, approved in 2017.

    Nearly all studies of off-target benefits are observational, because scientists cannot ethically withhold a safe, effective vaccine from a control group whose members could then become infected with the disease.

    That means such studies are subject to “healthy volunteer bias,” because vaccinated patients may also practice other healthy habits, differentiating them from those not vaccinated.

    Although researchers try to control for a variety of potentially confounding differences, from age and sex to health and education, “we can only say there’s a strong association, not a cause and effect,” Maggi said.

    But Stanford researchers seized on a natural experiment in Wales in 2013, when the first shingles vaccine, Zostavax, became available to older people who had not yet turned 80. Anyone who had was ineligible.

    Over seven years, dementia rates in participants who had been eligible for vaccination declined by 20% — even though only half had actually received the vaccine — compared with those who narrowly missed the cutoff.

    “There are no reasons people born one week before were different from those born a few days later,” Maggi said. Studies in Australia and the United States have also found reductions in the odds of dementia following shingles shots.

    In fact, in the meta-analysis Maggi and her team published, several other childhood and adult vaccinations appeared to have such effects. “We now know that many infections are associated with the onset of dementia, both Alzheimer’s and vascular,” she said.

    In 21 studies involving more than 104 million participants in Europe, Asia, and North America, vaccination against shingles was associated with a 24% reduction in the risk of developing dementia. Flu vaccination was linked to a 13% reduction. Those vaccinated against pneumococcal disease had a 36% reduction in Alzheimer’s risk.

    The Tdap vaccine against tetanus, diphtheria, and pertussis (whooping cough) is recommended for adults every 10 years, with vaccination among older adults often prompted by the birth of a grandchild, who cannot be fully vaccinated for months. It was associated with a one-third decline in dementia.

    Other researchers are investigating the effects of shingles vaccination on heart attacks and stroke and of COVID vaccination on cancer survival.

    What causes such vaccine bonuses? Most hypotheses focus on the inflammation that arises when the immune system mobilizes to fight off an infection. “You have damage to the surrounding environment” in the body, “and that takes time to calm down,” Chu said.

    The effects of inflammation can far outlast the initial illness. It may allow other infections to take hold, or cause heart attacks and strokes when clots form in narrowed blood vessels. “If you prevent the infection, you prevent this other damage,” Chu said.

    Hospitalization itself, during which older patients can become deconditioned or develop delirium, is a risk factor for dementia, among other health problems. Vaccines that reduce hospitalization might therefore delay or ward off cognitive decline.

    Health officials in the Trump administration have assailed childhood vaccines more than adult ones, but their vocal opposition may be contributing to inadequate vaccination among older Americans, too.

    Many will not only miss out on the emerging off-target benefits but will remain vulnerable to the diseases the vaccines prevent or diminish.

    “The current national policy on vaccination is at best uncertain, and in instances appears anti-vaccine,” said Schaffner, a former member of the CDC’s Advisory Committee on Immunization Practices. “All of us in public health are very, very distressed.”

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

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

  • The healing power of televised resuscitation | Expert Opinion

    The healing power of televised resuscitation | Expert Opinion

    Television characters who experience cardiac arrest outside a hospital are more likely to receive CPR than people in real life. But the CPR on these shows often depicts outdated practices and inaccuracies about who is most likely to experience cardiac arrest and where, according to newly published research from my team at the University of Pittsburgh.

    How CPR is portrayed in the media is important to understand because research has shown that health content on screen can influence viewers. When Buffalo Bills player Damar Hamlin suffered cardiac arrest during a game in January 2023, the world watched as medical professionals swiftly performed cardiopulmonary resuscitation. Hamlin went on to make a full recovery, and in the aftermath, a team of emergency medicine professionals and I at the University of Pittsburgh — where Hamlin is an alumnus — worked to teach all Division I athletes hands-only CPR.

    During the CPR training we held at Pittsburgh area middle schools and college athletic programs, participants frequently asked whether they should check for a pulse or give rescue breaths. Many mentioned seeing CPR on television shows like “Grey’s Anatomy.” While these are steps that medical professionals do when giving traditional CPR, hands-only CPR is an effective version recommended for untrained bystanders. After determining the person needs help and the scene is safe, hands-only CPR has just two steps: Calling 911 and giving hard and fast chest compressions.

    As someone who researches how medical topics on screen influence viewers, this piqued my curiosity. I wondered whether participants asked about checking a pulse or giving breaths in part because they saw these practices on screen.

    The power of media

    In 2022, my team and I analyzed 165 studies on the effects that health and medical content on scripted television has on viewers. We found that TV stories can influence viewers’ health-related attitudes, knowledge, and behaviors. Sometimes this influence can be harmful, such as exposing viewers to inaccurate information about organ donation from television. But sometimes it can be positive — one study found that viewers of an “ER” storyline about breast cancer were more likely to recommend screening and a patient navigator who supports patients through treatment.

    However, we hadn’t found any studies examining how seeing CPR on screen influences viewers. While previous studies on in-hospital cardiac arrest and CPR found inaccuracies with chest compression technique and survival rates in media, none had looked at portrayals of cardiac arrest that occur outside of hospitals and CPR conducted by a lay rescuer.

    Performing CPR on TV

    My team searched the internet Movie Database to identify episodes in American TV shows that depict out-of-hospital cardiac arrest or hands-only CPR. We limited our results to episodes released after 2008 — the year the American Heart Association first endorsed hands-only CPR. Of the 169 episodes that fit our criteria, we documented the sociodemographic characteristics of the character experiencing cardiac arrest and the primary witnesses, as well as whether, how, and where hands-only CPR was administered.

    On a positive note, we found that over 58% of on-screen characters who experienced cardiac arrest outside a hospital had a layperson perform CPR. But in real life, fewer than 40% of people who suffer cardiac arrest outside a hospital receive CPR. Seeing such high rates of CPR being performed on screen could motivate viewers to act, as in the case of a 12-year-old boy who saved a life in 2023 using the CPR techniques he saw on “Stranger Things.”

    However, fewer than 30% of episodes showed hands-only CPR being performed correctly. Almost 50% of episodes showed characters giving rescue breaths, and 43% of episodes had characters checking for a pulse. While we didn’t directly assess whether these episodes influence how viewers behave, based on our observations while conducting CPR training, it’s clear that these depictions may mislead viewers about how to administer hands-only CPR.

    Who gets CPR and where on screen

    Our findings also raise concern that how cardiac arrest is depicted on TV may mislead viewers about where cardiac emergencies happen and who may need CPR the most.

    Of the on-screen cardiac arrests that didn’t occur at a hospital, we found that only 20% happened at home. In real life, over 80% of nonhospital-based cardiac arrests occur at home.

    Additionally, those experiencing cardiac arrest on screen were younger than those in real life, with over 50% of characters under age 40. In real life, the average age is about 62.

    Lastly, we found that almost 65% of the people receiving hands-only CPR and 73% of rescuers performing CPR were white and male. This is consistent with real-world statistics, where people of color and women who experience cardiac arrest outside the hospital are less likely to receive CPR from a layperson.

    Accurate TV to save lives

    The American Heart Association’s 2025 guidelines for CPR and emergency cardiovascular care emphasized the need to help the general public envision themselves performing hands-only CPR and improve CPR education to ensure all people who need CPR receive it.

    Our team is working to understand what viewers take away from TV depictions of CPR, with the goal of collaborating with public health and medical professionals to improve how CPR is portrayed in Hollywood.

    Previous research has shown that entertainment narratives have the power to inspire altruistic behavior, and news reports have documented instances of people who perform CPR after seeing it on screen. Similarly, I believe scripted, compelling television may be a powerful, cost-effective way to improve CPR education and ultimately save lives.

    Beth Hoffman is an assistant professor of behavioral and community health sciences at the University of Pittsburgh.

    Reprinted from The Conversation.