According to the state’s medical and health department authorities, the sub-variant has been reported in Singapore and a few other Southeast Asian countries too. Director of medical education (DME) Dr Vishnuvardhan said the World Health Organization (WHO) is monitoring RF.5 as part of its routine genomic surveillance of SARS-CoV-2.
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The study, conducted on 181 premature babies at JK Lone Hospital in Jaipur, has highlighted the usefulness of the CRIB-II (Clinical Risk Index for Babies-II) score to assess the condition of newborns soon after admission.
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Céline Gounder, KFF Health News’ editor-at-large for public health, discussed the Department of Health and Human Services’ plan to offer compensation for automatic covid vaccine injuries and the drop in enrollment in Affordable Care Act health plans on CBS’ The Takeout With Major Garrett on July 10 and 9, respectively.
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—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Micro- and nano-plastics were detected in 84% of heart attack survivors, 40% of patients with chronic ischemic heart disease and 32% of patients with normal coronary arteries, according to a report in the European Heart Journal.
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One year after the Trump administration announced that dozens of health insurers had signed a six-part pledge promising to reduce barriers to doctor-recommended care, some insurers now say they won’t implement all the promised initiatives.
Meanwhile, patients, their advocates, and clinicians say little has improved.
“It has never been this bad for patients,” said U.S. Rep. Greg Murphy (R-N.C.), a physician who co-chairs the GOP Doctors Caucus.
The overarching intent of the June 2025 pledge was to improve a controversial process called prior authorization, which regularly requires patients or someone on their medical team to seek approval from insurers before proceeding with treatment.
According to AHIP, the health insurance industry trade group, health plans have eliminated 6.5 million prior authorizations for patients — equal to an 11% reduction — since the announcement.
But critics remain skeptical. Sally Nix, a patient advocate who has a chronic disease, described the voluntary pledge as “performative.” And Murphy, who participated in the news conference with Health and Human Services Secretary Robert F. Kennedy Jr. announcing the pledge last year, said it has “no teeth.”
Voluntary insurer pledges rarely make things better for patients, said Sabrina Corlette, a research professor at the Center on Health Insurance Reforms at Georgetown University.
“In the absence of clear rules, policies, standards, and mandates,” she said, insurance companies are “going to do what makes sense for them to do financially.”
The Department of Health and Human Services did not respond to questions for this report. It isn’t clear how, or whether, the Trump administration is holding insurers accountable.
‘Zero Faith’
Prior authorization — sometimes called preauthorization or precertification — has been around for decades. The insurance industry has long argued that the practice, which varies by company, helps control costs, reduces waste and fraud, and prevents potential harm to patients. It’s regularly invoked for a huge swath of services, ranging from low-cost urgent care to expensive cancer treatment.
“Prior authorization is a vital patient safeguard,” said Chris Bond, a spokesperson for AHIP.
The 2024 killing of UnitedHealthcare CEO Brian Thompson sparked a national groundswell of anger about insurance denials, with patients and doctors becoming increasingly vocal about the tactics they say insurance companies use to boost profits at the expense of care.
Prior authorization reform is one of the rare healthcare issues Democrats and Republicans tend to agree on. On July 15, the House Ways and Means Committee unanimously advanced a bill that would force Medicare Advantage plans to provide to the federal government a list of all items and services that are subject to prior authorization, and to report data about denials and grievances, among other requirements.
Last year’s industry pledge was organized as a direct response to public anger, Mehmet Oz, administrator of the Centers for Medicare & Medicaid Services, said when it was announced. “There’s violence in the streets over these issues,” he said.
“Americans are upset about it,” Oz said, later adding, “I’m looking forward to seeing the results.”
Mike Gartner, founder of Health Access Innovation, an organization that helps patients overturn insurance denials, said he doubts that insurance companies are changing their policies in meaningful ways. The 11% reduction in prior authorization cited by AHIP “hides a lot of nuance,” Gartner said.
Patients who need the costliest services, such as cancer treatment, are still being disproportionately denied access to doctor-recommended care, he said.
AHIP said its data included reductions in prior authorization for medical services, not prescription medicines. The trade group didn’t provide details explaining which services have been dropped from prior authorization or how those reductions differ across individual insurers.
Last year, Oz said the federal government would be “evaluating progress” toward the pledge and “driving accountability,” and he foreshadowed “public dashboards.” But no such dashboards exist, and federal officials did not respond to questions about how they’re holding companies accountable.
Murphy, the North Carolina congressman, said he has “zero faith” in the industry policing itself.
He didn’t believe insurance companies then, he said, “and I don’t believe them now.”
‘At War’ With an Insurer
In February, days after Betsy Adler and Justin Young’s daughter Coco was born with a serious heart defect, the Stillwater, Minnesota, family received paperwork showing they were racking up out-of-network costs.
During Adler’s pregnancy, the family had switched insurers, moving to Medica, a for-profit company based in Minnetonka, Minnesota, and one of many insurers that initially signed the industry pledge. Adler said she’d checked with her employer’s human resources department and on Medica’s website to make sure her maternal-fetal specialists and hospital were in-network before their new health plan went into effect earlier this year.
But then, the insurance company started processing some claims as out-of-network. By mid-March, the family had accrued more than $4,000 in out-of-network charges, on top of more than $3,000 for in-network bills. And the bills kept coming.
Shortly after Betsy Adler’s daughter Coco was born with a serious heart defect, she started receiving estimates showing her family could owe thousands of dollars in out–of-network costs. (Justin Young)
Adler had switched insurers to Medica during her pregnancy and said she was assured that her care would be covered at in-network rates. (Justin Young)
When Adler, a psychotherapist, called to figure out what was going on, she said, an insurance company representative said she hadn’t submitted a referral from her primary care provider beforehand. Attempts to fix the problem went nowhere. At one point, Adler said, Medica required her to visit a clinic she’d never been to before to obtain a referral. But she said a Medica representative told her the referral was never received, because the insurer’s fax machine was down.
“I have a critically ill child,” Adler remembered thinking shortly after Coco was discharged from the cardiovascular intensive care unit. “I can either spend my emotional energy at war with Medica, or I can let it go and just enjoy my time with my daughter.”
Medica spokesperson Greg Bury said he wouldn’t discuss the case, citing patient privacy rules. In an emailed statement, he wrote the company is “committed to working with her to ensure she understands what is covered under her benefits and our responsibilities.”
One of six specific promises all insurers made when they signed the pledge was to honor a 90-day grace period when patients switch insurance plans, starting Jan. 1 of this year. Often called “continuity of care,” this grace period allows patients to temporarily continue receiving services and medications that were authorized under a previous insurer.
But that applies only in some circumstances, Georgetown’s Corlette said. The wording of the pledge suggests that insurance companies aren’t obligated to honor another company’s network parameters. When Adler and Young switched insurers, for example, Medica was not obligated to cover the cost of out-of-network providers as if they were in-network, even though they were in-network under the family’s old plan.
Adler and Young switched insurance companies again when Coco was a month old, to avoid accruing more out-of-network costs.
Denial After Approval
Sally Nix with her service dog, Jon Snow, at home in Statesville, North Carolina. Nix, a patient advocate, recently had her health insurer process, then later deny, a claim for injections to relieve her chronic nerve pain. She’s skeptical about industry promises to reform the health insurance denial process. (Logan Cyrus for KFF Health News)
The percentages cited by AHIP don’t tell the whole story, said Nix, the patient advocate. Insurers are “not including the data for the loopholes they create,” she said.
For example, nothing in the pledge prevents insurance companies from retroactively denying payment, even when care is preapproved. “Patients are going to see a lot more retroactive denials,” said Nix, who recently had her insurer process, then later deny, a claim for injections to relieve her nerve pain.
Something similar recently happened to Jocelyn Austin, 49, of Amherst, New York. Over the course of nearly 20 years, she developed an addiction to sleeping and anxiety pills prescribed to her by a doctor. Last year, she spent weeks at an inpatient treatment center for substance abuse. Her insurer, Independent Health, had approved the admission. Austin said she has been substance-free since her discharge.
But the facility sent her a bill for more than $12,000 in December showing her insurer had not paid for the treatment she received, according to documents Austin shared with KFF Health News. This was in addition to the $10,000 she paid at the beginning of her treatment to satisfy her out-of-network deductible. The approval letters from Independent Health had specified that “authorization is not a guarantee of claim payment.”
Frank Sava, a spokesperson for Independent Health, said a denial was issued and upheld in this case because the services provided “were inconsistent with the care that was authorized” and “the medical record did not sufficiently support what was billed.” He said those findings were reviewed and confirmed by an outside consultant.
An explanation of benefits issued by the insurer last summer indicated the “provider,” not the patient, was responsible for the cost of her treatment. And yet the treatment facility has continued to pressure her for payment, she said.
Austin, who has not paid her outstanding bill, said insurance companies “should be held accountable.”
‘Significant Work Ahead’
Another one of the six commitments insurers made last year was to adopt new technology that would standardize the electronic submission of prior authorization requests. During the news conference announcing the pledge last summer, Chris Klomp, the director of Medicare and a deputy CMS administrator, said more than 50% of prior authorizations are still paper-based and processed by phone or fax machine.
In April, AHIP released an update related to that technology initiative, explaining that participating insurers would adopt the new standards on a rolling basis. Health insurers agreed to implement the pledge’s various commitments by predetermined deadlines, and this initiative is scheduled to be operational by Jan. 1, 2027. But eight insurers that initially signed the pledge last year didn’t sign the technology update when it was announced in April, AHIP told KFF Health News.
Those insurers are Alignment Health Plan, EmblemHealth, HealthFirst, Independent Health, Medica, MVP Health Care, Point32Health, and SummaCare. Their beneficiaries span the country, from California to New York. None of those eight insurers agreed to interviews for this report, but most sent KFF Health News emailed statements indicating that they remain committed to prior authorization reform.
AHIP’s approach to continuity of care “would have required the transfer of confidential member health information through a non-standardized process involving third-party participation,” wrote Jerry Slowey, a spokesperson for Alignment Health, which offers Medicare Advantage policies in Arizona, California, Nevada, North Carolina, and Texas. “We do not believe that level of data sharing was contemplated in the original commitment.”
Bury, the spokesperson for Medica, which covers beneficiaries in Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, Oklahoma, South Dakota, and Wisconsin, said the company “supports the goal of these standardization efforts.” But the April update “raised a significant technical and operational hurdle that we are not able to commit to at this time,” he said.
Alex Gomez, a spokesperson for EmblemHealth, said in late June the company “will sign onto the commitment” after KFF Health News posed questions about why it had not endorsed the April update.
“We anticipate more plans will be added over the coming months,” said Bond, the AHIP spokesperson. Health plans are “working continuously to implement their commitments to simplify and improve the experience.” He acknowledged that “there is still significant work ahead.”
The original pledge also included a promise that insurance companies would enhance transparency and use “clear, easy-to-understand explanations” when communicating to patients — something they were already supposed to be doing under the Affordable Care Act.
Yet companies still regularly neglect to explain why care has been denied, and their communications often contain “inconsistent and contradictory information,” said Gartner, of Health Access Innovation. He and Murphy also said they suspect insurance companies are increasingly using artificial intelligence to generate denials.
“They craft the pathways to basically deny things immediately with the hope that people will give up,” Murphy said.
The congressman said he wishes President Donald Trump would sign executive orders addressing some of these issues. “The problem is the insurance industry is the strongest lobby in this town.”
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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—an independent source of health policy research, polling, and journalism. Learn more about KFF.
New WHO guidelines suggest up to 45% of dementia cases are preventable. Tackling risk factors like high blood pressure and air pollution is advised. Healthy lifestyles and managing chronic diseases significantly influence brain health. The guidelines recommend regular physical activity and quitting tobacco use. Routine vitamin and omega-3 supplements are not advised without diagnosed deficiency.
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According to the commissioner, Andhra Pradesh's first Covid-19 infection in 2026 was logged in Kadapa district on June 26 and between July 1 and 16, 11 more infections were reported.
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Erica Schwartz, President Donald Trump’s nominee to lead the Centers for Disease Control and Prevention, expressed support for vaccines — including mRNA-based covid shots — in a Senate hearing on Wednesday, though she didn’t dispel concerns the agency has lost any independence from the White House.
“I have been vaccinating people throughout my entire career in uniformed services. I believe in vaccines,” Schwartz said at the hearing. “I do believe that mRNA technology is safe and effective.”
Her position contrasts with that of Health and Human Services Secretary Robert F. Kennedy Jr., who ousted Trump’s previous CDC director, Susan Monarez, after she sparred with him over vaccines. Kennedy, a longtime anti-vaccine activist, has baselessly called mRNA vaccines the deadliest ever made.
Schwartz “has dedicated her career to protecting the health of the American people.” Emily Hilliard, an HHS spokesperson, said in an emailed statement. “The president nominated her because of that exemplary record, and Secretary Kennedy looks forward to working with her to advance the Administration’s public health priorities.”
The CDC has had a Senate-confirmed leader for only about one month during Trump’s second term, and the agency has been roiled over the administration’s cuts to public health funding, firings of scientists and other career employees, and efforts to scale back childhood vaccines and access to covid shots.
Schwartz, who was deputy surgeon general in Trump’s first administration and is a former chief medical officer for the Coast Guard, has support in the public health community, where it’s hoped she can restore credibility at the agency she would lead.
“I will follow the science wherever it leads,” Schwartz told senators. “My first priority will be restoring trust in public health institutions.”
Democrats and some Republicans have expressed doubt that Schwartz will maintain any more independence from Kennedy than Monarez, who has said she was fired in August after refusing to sign off on changes Kennedy demanded to vaccine recommendations and personnel cuts. In a series of emails released by Sen. Bernie Sanders (I-Vt.), it was revealed Kennedy had pressured Monarez to change CDC guidance regarding the universal childhood flu vaccine.
Monarez “refused to act as a rubber stamp for Secretary Kennedy’s very dangerous agenda,” Sanders said July 15 at the Health, Education, Labor and Pensions Committee’s confirmation hearing for Schwartz. “Frankly, she stood up for protecting the well-being of the American people.”
The chairman of the HELP Committee, Sen. Bill Cassidy (R-La.), pressed Schwartz on whether she would push back against rhetoric or policies not based in science.
“We need unbiased leaders who make decisions based upon science, not politics or ideology,” Cassidy said. “This is not a theoretical.”
Cassidy, a physician, has also quarreled with Kennedy over vaccines. He lost a Republican primary for reelection in May after Trump endorsed one of his opponents. Despite his rupture with the White House, Schwartz almost certainly needs Cassidy’s support to win confirmation. That requires publicly committing to support vaccination and mainstream science.
Schwartz told the committee she would “never compromise” on science.
“The president would never ask me to not follow the law,” she said. “But I will always follow the law.”
Sen. Bill Cassidy (R-La.), chairman of the Health, Education, Labor and Pensions Committee, questioned Schwartz on her support of vaccines and her willingness to push back against her would-be boss, health secretary Robert F. Kennedy Jr. (Eric Harkleroad/KFF Health News)
Many Democrats on the committee raised concerns about the administration’s politicization of public health. Sen. Tammy Baldwin (D-Wis.) asked about the “political scrubbing” of research grants. Trump officials have canceled many research grants under the CDC and the National Institutes of Health for political reasons, including targeting diversity, equity, and inclusion efforts.
“Restoring trust to the CDC is my No. 1 priority,” Schwartz said. “Scientific integrity is core.”
The American Public Health Association’s CEO, Georges Benjamin, endorsed Schwartz in April, saying she “possesses the medical background and public health knowledge to understand that the Centers for Disease Control and Prevention must be guided by evidence-based science.”
The APHA has fought many of Trump’s initiatives on public health. After Monarez’s resignation, the organization issued a news release titled “Kennedy’s attack on public health must be stopped.”
Schwartz told the committee that if she is confirmed, she is committed to “radical transparency” and modernization.
Schwartz expressed support for one Kennedy initiative: She told senators she believes nutrition education and physical fitness assessments are important.
“I am all in on the Make America Healthy Again agenda,” she said.
At the July 15 hearing, Schwartz faced questioning alongside Trump’s pick for HHS assistant secretary for preparedness and response, Sean Kaufman.
Schwartz testifies alongside President Donald Trump’s pick for the role of Health and Human Services assistant secretary for preparedness and response, Sean Kaufman. (Eric Harkleroad/KFF Health News)
Cassidy called out Kaufman for past comments casting doubt on the efficacy of vaccines. The senator raised his voice as he accused Kaufman of spreading “those damn lies.”
Kaufman was conciliatory. “Let me be clear: Vaccines save lives,” he said. “They are safe and effective.”
If confirmed by the Senate, Schwartz will replace Jay Bhattacharya, who is performing the duties of CDC director but is not officially the acting director. Bhattacharya is also the director of the NIH.
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—an independent source of health policy research, polling, and journalism. Learn more about KFF.
My husband, Kenney, had chronic obstructive pulmonary disease. On June 7, he fatally shot himself after a COPD exacerbation event.
His pulmonologist had prescribed two new nebulizer prescriptions on June 2. One was a specialty medication that would come directly from the drug company. A couple of days later, we called Walgreens to see why the other one hadn’t been filled. Turns out it required prior authorization.
Why the doctor who prescribed it needed to tell his health insurer that he really did think his patient needed it, I will never understand. The pharmacist said she would send the request to the doctor. And why she hadn’t already done that, again, I do not understand. By June 7, of course, it still wasn’t filled.
That day, a Sunday, Kenney experienced the flare-up when I was out mowing the yard. How terrifying it must have been for him to be unable to breathe and me not being there at least to hold his hand. That night he killed himself, leaving a note saying that he hated to leave me but that he couldn’t keep living like that — with the constant anxiety of not knowing when he wouldn’t be able to draw a breath.
Not long ago, a “welcome” packet came in the mail about the other nebulizer treatment — 25 days after it had been prescribed.
Admittedly, my husband’s health was not great. He did have COPD, but we still went out to eat once in a while, and he didn’t have to take his oxygen on those trips. He rarely used it just walking around the house.
He did make a serious suicide attempt six years ago (our daughter and granddaughter had died), but after seeing what it did to me and our son, he promised he’d never do it again. It was only when these exacerbation/flare-up events started this year that he indicated life was getting bad.
Perhaps, just perhaps, if he had received both medications in a timely manner, he would be here today, and we would have had many more years together. We met when we were 16 and had been together ever since. He was 78 when he died.
— Cindy Clements Blewett; Kyle, Texas
Navigating GLP-1 Coverage
Sydney Lupkin’s thoughtful article about the obstacles in obtaining weight loss drugs was interesting (Healthcare Helpline: “Trouble Getting Weight Loss Drugs Covered by Insurance? Here’s What To Know,” June 26). It would have been more helpful had it included a discussion of Medicare’s decision to cover these drugs as of July 1, 2026, and how to navigate the rocky shores of obtaining a prescription that won’t be denied.
— Sharie Hartman; Manteca, California
Beyond the Veil of Pregnancy Centers
I would like to address the article about a pregnancy resource center providing prenatal care in Sandpoint, Idaho (“Religious Anti-Abortion Center Finds Opportunity in Town Without OB-GYNs,” May 20). It is unfortunate that many still do not understand what pregnancy resource centers do, nor the high-quality care they provide. While there are some “crisis pregnancy centers” that provide limited offerings, most centers are aligned with a national organization like the National Institute of Family and Life Advocates, the Heartbeat Pregnancy Center, or Care Net. All these organizations require centers to have a medical director (a licensed healthcare practitioner) and require that the nurses who perform the ultrasounds have appropriate training. While I am not affiliated with 7B Care Clinic, I am concerned that the article may not have accurately reflected what is provided in such clinics. I offer my experiences to bring further clarity.
I work at a life-affirming women’s clinic. I am a board-certified family physician. I have delivered approximately 1,000 babies in my career. I have been performing ultrasounds for my patients for over a decade, and fought for this ability under the scrutiny of maternal-fetal medicine specialists, spending time alongside their registered diagnostic medical sonographer technicians, and having my scans reviewed by maternal-fetal medicine physicians. I have practiced medicine in three states over three decades.
Second, while I am life-affirming, I am not “anti-abortion.” I happen to believe that there are better choices, and I know that some women will still choose abortion, even after hearing all their options. I will gladly see those women for follow-up to answer questions and evaluate for complications — something that the abortion clinics in my area apparently will not do. I say this because that is what the women I see tell me. The clinic that performed the procedure or gave them the pills will not see a patient after the abortion for any follow-up. I have always willingly seen patients for any reason, whether I was working at a private clinic or hospital-owned clinic. That is no different now that I work for a life-affirming women’s clinic.
We provide a variety of services — free of charge. We are also stepping up to provide prenatal care up to 20 weeks because there is a shortage of obstetrical clinicians in our county. We encourage women to see a clinic where they can be followed throughout the entire pregnancy, if possible, and we are in no way marketing ourselves as competition. We are stepping in to fill the large gap that exists.
Just because the clinic in Sandpoint chooses to respect life does not make it a fake clinic. This clinic seeks to bring in physicians to provide prenatal care. They are bringing in OB-GYNs from Washington state, which has no restrictions on abortion. With this information taken into consideration, I ask you to reconsider any concerns about a clinic bringing board-certified OB-GYNs into an area where there is a shortage.
— James Heid, Vancouver, Washington
The Root of All Good
The article Claudia Boyd-Barrett wrote about how immigrant parents’ arrests are creating a mental health crisis for children was moving and brought awareness to the mental health challenges faced by them (Growing Up Scared: “Arrests of Immigrant Parents Create Mental Health Crisis for Children,” June 18). It was important to note how every story was different but focused on how much children missed and yearned for their parents to come back home. You also wrote about how it affected them by not having a parental figure in the home. That really touched me. Specifically, Jacob’s story and when he listed all the things he missed about his mom but especially being close to her.
I am currently a master’s student in social work working to become a better ally to the Hispanic immigrant community. I’ve seen how being afraid and sad over the immigration policies has affected my friends in this community. Losing a close parent and not being able to have that security with them anymore is hard to go through, and trauma affects children as they grow.
In this article, you have recognized the worth of a person, which is a core principle in social work. These children are worthy and have the right to feel taken care of and secure.
I would love to see more mental health services accessible to immigrant communities and their families. This would benefit children as they learn to cope with their feelings and how to make sense of a new world.
— Stacy Xiong, Athens, Georgia
Bagging a Bargain
Author Susan Jaffe mentioned GoodRx in the article “Thousands of Medicare Beneficiaries Thought Their Drug Plan Was Free. Then They Lost It” (July 7), but she failed to mention a much better discount drug site, Mark Cuban’s costplusdrugs.com, where a 90-day supply of 2.5 milligrams of rivaroxaban, a generic for Xarelto, is available for under $50. This could help the thousands of people who lost coverage through unpaid premiums from Wellcare Value Script obtain their medications. The problem of yearly increasing penalties for losing Part D coverage is something that has to be addressed by the Centers for Medicare & Medicaid Services.
Thanks to KFF Health News for the relevant coverage.
— Jackie Button; Miami
Fleshing Out the Details
Your report identifying alpha-gal syndrome as a red meat allergy is accurate in that respect but inadequate in its breadth (“Would Hunters Take a Lyme Disease Vaccine? We Asked,” June 30). Alpha-gal is an allergic reaction to virtually all mammalian products. If you explore that, you’ll find an interesting story, as mammalian products are everywhere, including in pharmaceuticals, cosmetics, and other non-meat products. Alpha-gal is growing rapidly, and too many people, including doctors, do not realize that AGS is far worse than just a red meat allergy.
I suggest you help build understanding of the threat by describing the allergy in the future as an allergy to mammalian products. If you do not think your audience will understand that term, perhaps you can explain that it includes pork and anything derived from animals with hooves. As a former and now retired reporter, I encourage you to cover this allergy because its implications are surprising and scary.
— John Varner, Surry, Virginia
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—an independent source of health policy research, polling, and journalism. Learn more about KFF.
The lenses have so far been tested only in lab experiments. The researchers have filed a provisional patent for their hydrophilic silicone material and are preparing to test the lenses in actual eyes.
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