Lately, Priscilla Brown has had to choose between properly managing her Type 2 diabetes and affording other necessities, like gas in her car. Some days, she takes half or a third of her prescribed insulin dose just to stretch it out longer.

Sometimes I dont even take my medicine, said the 48-year-old truck dispatcher in Orlando, Florida. Its so much with insurance, its crazy.

About 8 in 10 Americans, like Brown, who re-enrolled in Affordable Care Act marketplace coverage say their health care costs are higher this year, including about half who say their costs are a lot higher, according to a new survey from the health care research nonprofit KFF. A main reason for increased costs was the Dec. 31 expiration of enhanced tax credits that had offset premiums for most enrollees.

For Brown and others, those spiking costs are having real impacts on daily life. Of the 1,117 Americans surveyed who had ACA marketplace coverage in 2025, including those who dropped coverage or changed plans, about 55% said theyre planning to deal with health care costs by cutting spending on food and other basic household needs.

Democrats in Congress last year had fought to keep the COVID-era subsidies but faced pushback from Republican leadership. In January, momentum toward a bipartisan compromise fell apart leaving some 23 million ACA enrollees without relief as they faced higher premiums or made tough decisions to disenroll or downgrade plans.

The new poll, which was conducted in February and March and followed up with respondents from a survey conducted last year to learn how they're grappling with health insurance now, offers a glimpse at how Congress' unresolved fight continues to strain regular Americans even as many federal lawmakers have, at least for the moment, turned to other priorities.

RELATED STORY | Doctors warn patients are delaying care over costs even with insurance

Many ACA enrollees are anxious about medical costs

Last year, Brown paid zero dollars toward her health insurance premiums. This year, her new plan costs $17 a month and has a higher deductible.

Brown said she learned this week that her new refill of medicine was going to cost more than $150 and almost passed out. She filled her car with only half the gas she needed, knowing shed need money for the medications.

Anxieties about unexpected medical costs are acute, the poll shows. About three-quarters of people who had ACA insurance last year now say they are very or somewhat worried about paying for emergency care or hospitalization, while about half said the same about routine medical visits or prescription drugs.

Some enrollees switch to lower-tier plans, while others drop coverage entirely

Most of last year's enrollees, about 7 in 10, stayed on ACA health insurance but that includes about 3 in 10 who changed plans within the marketplace. Meanwhile, about 2 in 10 became eligible for coverage through their employer, Medicare or Medicaid or purchased insurance outside of the ACA marketplace, which tends to be less comprehensive.

About 1 in 10 of last years enrollees said they dropped coverage altogether and are now uninsured, the poll shows.

Eric LeVasseur, a 63-year-old software developer in Seal Beach, California, was part of that group. He said when he saw his mid-tier, silver-level plan was going to nearly triple to $1,200 per month, it was not something my budget could absorb.

RELATED NEWS | Viral video highlights healthcare costs as Americans cut back on essentials

Many enrollees blame health insurance companies and politicians

About 7 in 10 returning ACA enrollees facing higher costs say they blame health insurance companies a lot," while just over half put a lot of blame on Republican lawmakers, President Donald Trump and pharmaceutical companies. About one-third blamed Democrats in Congress or hospitals a lot, while about 1 in 10 placed this level of blame on doctors or employers.

Respondents who identified with a political party and saw costs rise overwhelmingly blamed the opposing partys lawmakers a lot."

James Mako, an engineer in Boca Raton, Florida, and a political independent, said he blames the Republican Party. His $500-per-month premiums were poised to double this year for his silver-level ACA health plan. So, he downgraded to a bronze-level plan with a higher deductible.

Mako said hes not convinced by the ideas Republicans have floated to fix the problem, like funneling money into health savings accounts.

I think theyre just sales gimmicks, he said. The subsidies should be back.

Performers, including Nina West, testified against an Ohio bill that would ban public drag shows.

Growing up in a conservative family, Andrew Levitt said he hid himself for years. 

"I was also worried that if people truly knew who I was, I would no longer belong or fit in," Levitt said.

But in college, he says he found his identity.

"Drag is something that saved my life," Levitt said. "When I met entertainers who are drag queens, they gave me a place to call home when I didn't have a place to live, when I didn't have the familial support that I was just so desperately needing."

When Levitt gets on stage, he transforms into nationally-awarded drag queen Nina West.

"I'm an entertainer who's proudly worked with incredible companies like Disney," Levitt said. "I've written a children's book. I have released a children's album. I have done library readings."

But he is worried about a newly introduced bill that would impact his art.

State Rep. Josh Williams (R-Sylvania Township) introduced a bill that would ban drag performances in any places other than adult cabarets, which include nightclubs and sex shops. The bill lumps drag performers in with acts that are harmful to juveniles or obscene, such as exotic dancers.

House Bill 249 prohibits "adult cabaret performances in locations other than adult cabarets," and adds to the definition of adult cabaret performances "Performers or entertainers who exhibit a gender identity that is different from the performer's or entertainer's biological sex using clothing, makeup, prosthetic or imitation genitals or breasts, or other physical markers."

This bill has a specific carve-out to say that it wouldn't "prohibit or restrict a bona fide film, theatrical, or other artistic endeavor or performance that is not obscene or harmful to juveniles," meaning musicals at local theatres would not be impacted.

"This statute simply says you can't perform that obscene performance with a minor being present," Williams said.

RELATED: Ohio GOP wants to require biological sex on driver's licenses

The obscenity law is relatively vague, ranging from something that shows lust like a kiss or a character having a crush to intercourse.

"We've seen performances at public parks that cross the line," Williams said.

In recent years, GOP-led states have started to ban drag, arguing that the LGBTQ+ community is inherently sexual and shouldn't be around children. Levitt said this was absolutely false.

"Drag is something that gives people agency and hope, and it makes them feel seen, which is important; it's important to tell people that they matter," Levitt said. "We're providing validity to people's existence and I think that's important and valuable."

Williams says that the bill wouldnt apply to appropriate drag, and its written in a way that obscenity could be determined by individual law enforcement. 

People found guilty of performing in the presence of someone under 18 would get a misdemeanor of the first degree. If the performance involved is obscene, a violation is a felony of the fifth degree. If it is obscene and someone under 13 watches, that would be a fourth-degree felony with up to 18 months in prison.

"Drag is not a crime," Levitt said. "This is a slippery slope to put us in a specific venue or area or part of town where [you're] basically compartmentalizing and dangerously placing people in boxes."

Previously, House Speaker Matt Huffman said he wasnt sure if this bill was constitutional under the First Amendment, but he has changed course. 

"I think local governments, through enabling legislation, have the ability to control these kinds of things exactly where the line is drawn," he said when I asked if he still thought it could be unconstitutional. "It might be unconstitutional depending on how the language is drawn... I think the committee that it's in and the sponsors of it have drawn the lines where I think it should be appropriate."

This type of law has been blocked in other states for violating freedom of speech.

Levitt doesnt want any kid to feel like he did growing up, and says this bill could prevent people from finding their circle.

"What happens if this community goes away?" I asked him.

"This community's never going away," he responded. "We will fight this, and we will overcome. Love always overcomes hate."

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If youve watched any TV lately, theres a chance that youve seen a campaign ad related to Kentucky's 4th Congressional Primary Republican race between incumbent Rep. Thomas Massie (R-Ky.) and former Navy Seal Ed Gallrein.

Dr. Kevin Reuning, an associate professor of political science at Miami University, told us the race has the potential to show how much influence President Donald Trump has over the Republican Party.

Massie, who has gone against the president on several issues, is facing the Trump-endorsed Gallrein.

I think the reason its actually the most heated is that it might mean things for a lot more than just the Northern Kentucky district, Reuning said.

Currently, the race for Kentucky's 4th Congressional District is the most expensive Republican primary race in the U.S.

Reuning said its because this race has the potential to change how other Republicans look at their own elections and the party as a whole.

Its been presented as kind of a race that will speak to Trump's influence within the Republican party, Reuning said.

WATCH: How the race in Kentucky could paint a larger picture for the Republican Party

Reuning said that, in the past, Republican lawmakers who opposed Trump didnt last much longer afterwards. He said if Massie loses, itll show other Republicans that siding with Trump is their best chance at re-election.

But if Massie wins, Reuning said itll be a different story.

Maybe other Republicans see that and say, 'Well, theres actually a way to stay in office without supporting Donald Trump 100% of the time,' Reuning said.

The president plans to stop in Hebron Wednesday to speak at Verst Logistics Contract Packaging Facility about the economy.

On Monday night, we spoke with Massie about the president's visit and his race against Gallrein.

Im actually glad to see the president in our district and paying attention to local issues, Massie said. I suspect hes also going to try and help my opponent, but you know thats really all my opponent has going for him. He's promised to be a rubber stamp when he gets to Washington, D.C., and I dont think people here want a rubber stamp.

Massie said he will not make Trumps visit due to prior commitments. Gallrein's team confirmed that he will be in attendance.

We reached out to Gallrein's team for an interview and were told he was unavailable.

When we asked for a statement about Trump's visit and the race against Massie, Gallrein's team said they could only confirm Gallrein will be at the event on Wednesday, and directed all other questions to the White House.

President Donald Trump will make his first public appearance in the Greater Cincinnati area in more than six years Wednesday, according to a White House spokesperson.

Trump is scheduled to make two stops in the area one in Reading, Ohio, and one in Hebron, Kentucky to highlight economic and health care policies.

At Thermo Fisher Scientific in Reading, Trump is expected to talk about TrumpRx, "one of his most transformational policies: delivering lower prescription drug prices for working families," according to the spokesperson.

"Thanks to President Trumps Most Favored Nation pricing agreements, American patients can now access dozens of medications at massively discounted prices through TrumpRx.govwith more savings in store for American patients when Congress passes the Presidents Great Healthcare Plan," the spokesperson said. "The President will tout that massively popular policy and the rest of his Administrations aggressive efforts to lower prices and make America more affordable."

WATCH: What we know about the president's stop in the Tri-State

Bill Baker, a Trump supporter who lives near Thermo Fisher Scientific, said he was pleasantly surprised by the visit.

"I just can't believe it," Baker said. "(TrumpRx) is going to be awesome, I mean, if it does what they say it's going to do."

We spoke with Reading Mayor Robert "Bo" Bemmes about how the president's visit impacts the city.

"A lot of wonderful things happened at Murrow Down, now Thermo Fisher," Bemmes said. "A lot of our residents work there, and yes, it's incredible what they do, and we are glad that the president is stressing public health. We need it, we see it everywhere."

WATCH: How Trump's visit impacts Reading

TrumpRx is a federal government-run prescription drug website that the Trump Administration launched in February.

According to the White House, the platform currently features brand-name drug offerings from manufacturers AstraZeneca, Eli Lilly, EMD Serono, Novo Nordisk and Pfizer. A recent post by the White House said additional medications will be made available in the coming months.

Emmanuel Ayanjoke, pharmacist and owner of Altev Community Pharmacy in Avondale, said the platform is not quite an online pharmacy but rather a savings aggregator.

"Anything that helps reduce the price our patients pay at the point of sale is always welcome," Ayanjoke said. "I definitely encourage everyone who uses (TrumpRx) to have a candid conversation with their pharmacist, right? It's not for everyone."

The platform works somewhat like a clearinghouse that connects users with manufacturers' websites, offering the lowest cash prices. Ayanjoke said it primarily benefits two groups: people without health insurance and those with insurance copays that are higher than the manufacturer-negotiated cost of a drug.

"It's a very bizarre thing in pharmacy and health care in general, where typically, there are many cases that your copay for medication is actually much, much higher than the cost of the actual medication negotiated with the manufacturer, directly," he said. "So in those cases (with) the subset of patients, then it makes a lot of sense to look at things like TrumpRx."

Ayanjoke said the platform raises important questions about pricing transparency in the pharmaceutical industry.

WATCH: The FAA has issued a temporary flight restriction on Wednesday afternoon

"It's really bringing that conversation to light that why do we have a scenario where insurance pricing is way out of whack (in) comparison to what manufacturers actually are willing to charge for those drugs," Ayanjoke said.

The website currently lists over 40 medications treating conditions including obesity, heart disease, diabetes and infertility. However, the platform does not carry generic medications.

"If you're going to go on (TrumpRx) to get a brand-name medication, always ask your pharmacist and see, is there already an available generic for this medication that I'm on? And, will that save me a lot of money?" Ayanjoke said. "In many cases, substantial savings exist for generic medications over brand names."

Trump is also scheduled to speak at the Verst Logistics Contract Packaging Facility in Hebron, where he is expected to discuss the economy, according to the Kentucky Republican Party.

"We're looking forward to hosting a big crowd," Adam Hope, communications director for the Kentucky GOP, said. "He is going to be giving some remarks on the economy to kind of highlight the wins that we've had and where the country is headed as we gear up for midterms."

Hope said the Kentucky GOP does not know the specifics of what Trump will say but touted several fiscal policies from the administration.

"There was a lot of stuff in the 'One, Big, Beautiful Bill' that they passed last year that we believe is going to have tremendous impact on the people of Kentucky," Hope said. "Things like no tax on tips, no tax on overtime, the working families tax cuts and especially with it being tax season, we expect to see a lot of those results really kind of come into fruition and (put) more money back in people's pockets."

Not everyone is looking forward to the president's visit.

We reached out to the Hamilton County Democratic Party.

The chair, Alex Linser, wrote in a statement, "Ohioans know better than to fall for another one of Donald Trumps empty promises. He promised to address the skyrocketing cost of living, threats to public safety, and endless wars and has somehow managed to make each of those problems worse."

Nat Turner, director of communications for the Kentucky Democratic Party, wrote in a statement that Trump, "can't sell his failing economy to Kentuckians struggling to buy groceries and gas."

"From challenges in the bourbon industry to closing rural health care facilities, all of Kentuckys toughest economic struggles of the past year are directly connected to his policies, including his trade wars and hospital-closing federal budget," Turner said. "The only prescription for lowering costs for the American people is to hold Trump accountable by electing more Democrats."

The Ohio Democratic Party also responded to Trump's visit with a statement:

"From gas prices to energy bills to the cost of healthcare, the White House and their allies in Congress and Columbus have not only failed to lower prices, they're actually making things worse," Ohio Democratic Party Chair Kathleen Clyde said. "Republican candidates across Ohio will pay the price this November for raising costs on Ohio families while lining the pockets of billionaires and special interests."

The woman who wants to be the nation's top doctor was grilled on Capitol Hill Wednesday, where she faced criticism from both sides of the aisle.

Wellness influencer Casey Means is a Stanford-educated doctor but has never practiced medicine or held a position in government. She did not finish her surgical residency, but completed enough of medical school to get a medical license.

She defended her medical progress, saying that her license is inactive voluntarily, because she hasn't been seen patients on a regular basis.

"I'm a medical doctor. I graduate from Stanford University School of Medicine. I have a medical license. My professional history is a feature, it's not a bug. I have had a unique history that has merged entrepreneurship, public health advocacy, faculty course direction at Stanford University as well as being an editor of a medical journal and a biomedical to researcher. In these complex times for American health care, that type of multidisciplinary history is going to extremely valuable to the American people."

The surgeon general is known commonly as the nation's doctor, who serves as a leader on public health issues. They may issue public health advisories and calls to action, and explain health-related changes and recommendations for average Americans.

The surgeon general also oversees the Public Health Corps, which is a uniformed healthcare branch. It has 6,000 officers, including doctors, nurses, veterinarians and dentists who work all over the government, from the National Park Service to the VA.

RELATED NEWS | FDA to drop two-study requirement for new drug approvals, aiming to speed access

At Wednesday's hearing, lawmakers said they had concerns about Means' views on vaccines.

Sen. Tim Kaine (D-VA): Do you believe that there's no evidence that the flu vaccine has efficacy in reducing serious injury or hospitalization?

Casey Means: I support the CDC's guidance on the flu vaccine. And I will always be working with the CDC

Kaine: So you believe it is an efficacious vaccine to reduce hospitalization.

Means: Is or is not?

Kaine: Is, you believe it is.

Means: As I said, I support the CDC's guidance on the flu vaccine.

Means gave similar answers when questioned on whether she would recommend the MMR vaccine, which provides protection against infection from measles.

MORE HEALTH NEWS | South Carolinas measles surge shows danger of lower vaccination rates

Means was also questioned on the controversial belief that there is a link between autism and vaccines. She said in the hearing that we don't know what causes autism, but she wouldn't necessarily disagree with that belief.

She said that she would stress that all avenues of scientific study into the potential causes of autism should be open.

State witnesses raised red flags about former FirstEnergy executives and their relationship with an allegedly corrupt utility regulator during the second week of the men's trial.

Former CEO Chuck Jones and VP Mike Dowlings relationship with former Public Utilities Commission Chair Sam Randazzo has been under a microscope in the Summit County Court of Common Pleas.

"It was challenging," Ebony Yeboah-Amankwah, an attorney and former chief ethics officer for FirstEnergy, testified. "Randazzo seemed to have an issue with everything."

The former PUCO chair consistently went over her head to talk to the CEO if he didn't like what she was doing, Yeboah-Amankwah said.

The state accuses Jones and Dowling of paying Randazzo $4.3 million in bribes, along with $61 million spent to create and pass House Bill 6. H.B. 6 was legislation to provide a billion-dollar bailout.

For a more in-depth recap, please click here.

Back in 2019, former Ohio House Speaker Larry Householder took that $61 million bribe in exchange for H.B. 6, all at the expense of the taxpayers.

In March of 2023, a jury found that Householder and former GOP leader Matt Borges, beyond a reasonable doubt, participated in the racketeering scheme that left four men guilty and one dead. Neil Clark, a lobbyist accused of bribery, died by suicide after pleading not guilty in 2021. Householder is now sitting in prison for two years, while Borges is out after serving half of his five-year sentence.

Jones and Dowling face nearly a dozen state charges each, ranging from bribery to corrupt activity. In January of 2025, a federal grand jury indicted them for racketeering.

Yeboah-Amankwah took an immunity deal and testified as a state witness, explaining that she advised against giving Randazzo the settlement, not understanding why they were giving so much money.

"We shouldn't pay out the full amount because we didn't get the benefit of the bargain," she said, recalling her thoughts at the time.

The settlement deal, which the prosecution calls the "magic" consulting agreement, is a sham document "designed to confuse and conceal" money to flow from FirstEnergy to Randazzo's shell companies. It was a relatively blank document that no one had signed, the prosecution said.

Yeboah-Amankwah also noted that Dowling sent privileged legal documents to Randazzo, as well as contacting him while the PUCO was evaluating FirstEnergy's case.

Dead man's fault

Randazzo, who is now dead, was the corrupt one, not the former executives, the defense argued.

Randazzo, facing dozens of charges in federal and state court, became the second defendant in this scheme to kill himself. He committed suicide in 2024, after his joint arraignment with Jones and Dowling, and after pleading not guilty.

Before Randazzo was the top regulator, he was a consultant for clients who worked with FirstEnergy and wanted to get a better deal from them (he was also a consultant for FirstEnergy, as well). Randazzo ran the books for the Industrial Energy Users-Ohio, a legitimate trade group.

The defense said that FirstEnergy was simply paying the former PUCO chair settlement funds owed to IEU-Ohio clients, like witness Matt Brakey, but Randazzo stole that money from them.

"The organization was victimized to a pretty grand scale... There was no rational explanation for this other than misappropriating funds from the organization," Brakey said on the stand.

The money was never intended for Randazzo, the defense said, and the men never knew about the alleged bribe. Jones allegedly, according to his attorney, didn't play a role in even facilitating this settlement, but Yeboah-Amankwah testified differently.

"The decision was deferred to Chuck to make," she said.

Evidence supports Yeboah-Amankwah's testimony that she was out of town when the defendants signed the settlement.

The judge has, on a couple of occasions, allowed witnesses to decline being recorded or photographed. News 5 Cleveland's media partners at the Akron Beacon Journal reported further on what those witnesses, like former FirstEnergy attorney Mark Hayden, have said.

The Beacon Journal reported that Hayden said Randazzo seemed to have a conflict of interest, and said that the settlement details were "so ambiguous" that they couldn't mean anything.

What's to come

Jurors will not be made aware that FirstEnergy, as a company, has already admitted to this bribery.

Major political leaders, like Gov. Mike DeWine and U.S. Senator Jon Husted, could testify.

The trial should last four to six more weeks.

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The chair of the Ohio retired teachers' pension fund board, a former member and a lobbyist will not face criminal charges related to alleged ethics violations after the state referred the case to the Columbus City Attorney's Office.

Through records request, we found that City Attorney Zach Klein's team has decided not to press charges against State Teachers Retirement System (STRS) board chair Rudy Fichtenbaum and former member Wade Steen, saying there is not enough evidence to prove that the men knowingly broke the law by soliciting or accepting money from Ohio Retirement for Teachers Association's (ORTA) Robin Rayfield for their legal defense fund.

Fichtenbaum and Steen are in the center of a legal battle against Ohio Attorney General Dave Yost, who is accusing them of corruption.

In summary, the state is accusing Fichtenbaum and Steen of attempting to contract steer 70% of STRS assets to QED, a startup investment firm. The AG's office says QED's leaders, Seth Metcalf and JD Tremmel, have "backdoor ties" and no track record, clients or capability to invest the $65 billion they were seeking.

A whistleblower document claimed that QED and ORTA had worked together, specifically when it came to elections to get a more sympathetic or willing board.

For more of an in-depth recap, please click here.

Their trial ended in mid-December, and Franklin County Court of Common Pleas Judge Karen Held Phipps is set to decide whether or not she should remove Fichtenbaum from his position, and if he and former board member Wade Steen should be banned from ever returning to public pensions.

RELATED: Judge to rule on retired teachers' pension fund corruption trial, ethics investigation continues

Rayfield's legal fund was made to help both Steen and Fichtenbaum's litigation against the state. ORTA has donated more than $215,000, according to financial forms filed.

In 2024, Legislative Inspector General Tony Bledsoe was amazed by the then-only $115,000 spent by ORTA.

In 23 years of reviewing lobbying expenditures, this is a complete outlier weve seen nothing comparable, Bledsoe said in 2024.

ORTA had not submitted financial filings until our reporting that year.

The trio of men has insisted on their innocence the entire time. When I previously asked each of them about the fund, they said their attorneys gave them clearance to do it. Klein's Criminal Division Chief Melanie Tobias-Hunter seemed to agree.

"There is ample evidence, including email correspondence and witness interviews, demonstrating that Mr. Steen and Dr. Fichtenbaum acted in good-faith reliance on the advice of their counsel that they were permitted to accept contributions to their legal defense fund from ORTA," Tobias-Hunter wrote in the Jan. 16 letter to the Ethics Commission. "Good faith reliance on counsels advice negates the mental state required for the crimes. In addition to negating the mental state element, the advice-of-counsel defense is also a legal defense."

Tobias-Hunter continued that same argument for Rayfield and his belief that he was legally allowed to give the money.

"We do not disagree with [Tobias-Hunter's] conclusion," Ethics Commission Executive Director Paul Nick said.

Working on the advice of their attorney, it would be "unlikely" to prove that they knowingly violated the law, Tobias-Hunter said.

Lets be clear: launching an ethics investigation with no factual foundation, and then allowing its mere existence to be used to suggest wrongdoing, is an abuse of power," a spokesperson for Fichtenbaum and Steen said. "In this country, investigations are meant to uncover factsnot to be wielded as political weapons."

Case Western Reserve University law professor Michael Benza explained that getting bad advice is only criminal if the defendants are knowingly seeking to break the law and if the attorney is purposely giving poor counsel to help them.

"When you're getting legal advice in order to be able to commit a crime, that is when you lose that protection of the attorney-client privilege and the reliance on your counsel," Benza said.

But following Tobias-Hunter's letter, the commission issued a formal opinion regarding defense funds. These advisories are meant to interpret the law for courts and law enforcement.

The opinion clarified that while the law does not completely prohibit contributions to a fund, it does put forward significant limitations.

Ethics law states that "a public official or employee may not solicit or accept contributions for a legal defense fund from any individual or entity that is doing business with, seeking to do business with, regulated by, or has matters pending before the public agency the official or employee serves."

These restrictions are designed to prevent conflicts of interest and preserve public confidence in government decision-making, Nick said. Even in the context of a legal defense fund, public officials must avoid situations where contributors could appear to be seeking influence or favorable treatment.

Moving forward, they added new clarifications to interpreting state law explicitly saying that someone cannot accept contributions from parties who are doing or seeking to do business with, regulated by, or interested in matters pending before the public agency in both criminal and civil cases.

The commission also said that it prohibits any person who is doing or seeking to do business with, regulated by, or interested in matters pending before the agency from promising or giving a contribution to the public officials or employees legal defense fund in a civil case.

The public figures and the lobbyists also need to file financial disclosure statements. A third-party isn't allowed to get money from prohibited sources, either, and funnel that into the legal defense fund, the opinion continued.

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Ohio's Republican legislative leader is rejecting President Donald Trump's push to federalize elections. House Speaker Matt Huffman, known as the most effective lawmaker in the state, categorically shut down any effort by the president to take over Ohio's elections.

Trump said elections should be "nationalized," complaining that blue states and cities can't run elections honestly.

"A state is an agent for the federal government in elections," he told reporters Tuesday. "I don't know why the federal government doesn't do them anyway."

While on CNN on Wednesday, U.S. Senator Jon Husted (R-OH) said Ohio's elections are run well, but pushed for more oversight of other states.

"They don't have photo ID in California," Husted said. "They don't properly maintain their voter rolls in California."

Both he and Sen. Bernie Moreno (R-OH) are backing federal legislation, nicknamed the 'SAVE Act,' that, among other provisions, would require proof of citizenship to register to vote. Individuals would have to produce their birth certificate or a passport.

RELATED: Ohio advocates file lawsuit against new BMV proof of citizenship requirement to register to vote

Senator Moreno is a staunch supporter of measures that protect the integrity of our elections," Moreno's spokesperson, Reagan McCarthy, said when we asked what his thoughts were on federalizing elections. "He is a proud co-sponsor of the SAVE Act and will work with anyone to ensure elections are accurate, fair, and secure.

But stepping out of D.C., Statehouse leaders are pushing back.

"Do you think that Ohio should give up power for the president?" I asked Huffman (R-Lima).

"The state of Ohio should be in charge of the state of Ohio's elections," he said.

While other Republicans danced around Trump's comments, Huffman explicitly said no and that Ohio knows how to run its elections.

"I don't think that the states, in any way, should give up their elections," he said. "For one thing, is the federal government going to come in and run a township trustee election? Are they going to come in and decide who's running for school board or fiscal officer or the thousands and thousands of other elections?"

The speaker has previously been dismissive of Trump's ideas, such as when he said the president wouldn't pressure him to put out the congressional map the White House wanted.

Huffman has, however, been a part of redistricting lawsuits in which he requested help from a federal court to step in and rule that the legislature could control mapmaking. This federal court decision superseded the bipartisan Ohio Supreme Court's ruling that the Republicans needed to stop gerrymandering.

While answering an unrelated question earlier, Huffman made an aside about the separation of Congress and State.

"There are federal things the federal government does and things the state government does..." Huffman said. "There are lots of things the federal government does that are not federal functions, unfortunately."

Case Western Reserve University elections law expert Atiba Ellis explained that Trump doesnt have the authority to federalize elections.

"If Congress chooses to make changes regarding federal elections, and federal elections only, Congress can do so," Ellis said. "The president cannot declare that the Republican Party or whoever can take over elections."

What he can do, the professor said, is push the states to mirror federal law.

"Congress can set law in regards to federal elections, which states would have to follow," he said. "When you bring these together, there is a bit of unification in that sense."

House Minority Leader Dani Isaacsohn (D-Cincinnati) warned that this has happened before.

Several months ago, the state got rid of its four-day grace period for mail-in ballots to arrive, since the Supreme Court is also addressing a similar issue. Ohio Republican Gov. Mike DeWine, who tends to disagree with Trump on most controversial issues (alleged election fraud, COVID, vaccines, LGBTQ+ rights, redistricting, Haitian and Somali immigrants, etc.), said he was "reluctantly" signing the bill, arguing that Ohio's elections are safe and the laws are reasonable.

RELATED: Ohio Gov. Mike DeWine reluctantly signs bill requiring most ballots to be counted on election night

"The current leadership in Ohio has been acting on Donald Trump's orders to restrict the right to vote for people," Isaacsohn said.

Over the past several years, Ohio has passed numerous bills that have impacted voters, including limiting dropbox access and requiring photo ID. Several laws were heard or are currently in federal court.

RELATED: Federal court sides with Ohio voters with disabilities, strikes down state law

"Does it make you feel a little bit assured that Huffman said that 'No, Ohio should not be giving up any power to the feds?'" I asked the minority leader.

"Unfortunately, the leaders in Ohio right now, including and especially the secretary of state, have not shown a willingness and a desire to increase access to the ballot for Ohioans..." he replied. "It does not give me a lot of confidence to hear from the people who've passed bill after bill after bill limiting access to the ballot for the people in Ohio."

Meanwhile, Huffman is adamant that Ohio will keep the reins.

"I don't think it should happen," Huffman said. "I don't think it will happen."

Republican Sec. of State Frank LaRose has touted Ohio as the "gold standard" of elections, with dozens of his audits showing no evidence of widespread voter fraud.

"Ohio is the national model for election administration, but as the President rightly pointed out, some other states are failing to meet minimum standards of election integrity, such as citizenship verification and voter ID," Sec. of State Frank LaRose's spokesperson Ben Kindel said when I asked about letting Trump take over Ohio's elections. "That's why Secretary LaRose is a strong supporter of the federal legislation that sets these minimum standards, especially the SAVE Act."

We reached out to the 2026 secretary frontrunners, ones who have filed campaign finance reports, about Trump's comments.

Future Election Overseer

There are several states that do not take election security seriously like Ohio does," said Dalton Throckmorton, spokesperson of Republican state Treasurer Robert Sprague. "President Trump has been urging Congress to pass legislation that requires a photo ID to vote, and Treasurer Sprague supports that."

The team did not respond when we asked whether that meant the federal government should selectively take over cities or states.

Republican Marcell Strbich, in a longer response, explained that elections are already federalized, due to provisions like the National Voter Registration Act, the Help America Vote Act and the Uniformed and Overseas Citizens Absentee Voting Act.

"The notion that this is solely a state function is simply wrong. That isnt what the Constitution says. The Congress retains authority to enact election statutes," Strbich said. "The Voting Rights Acts, the Civil Rights Act all supersede state law. So its a myth that the states control the elections. They administer the elections."

He added that Trump is trying to get states to comply with voter rolls maintenance.

Democratic House Rep. Allison Russo couldn't disagree more.

"Our U.S. Constitution specifies that the administration of our election process is a state function. President Trumps alarming escalation of attacks on election integrity and his comments about federalizing the election process should be a five-alarm fire to anyone who cares about fair, free and secure elections," Russo said. "It is clear that his intent is to seize control of our elections so that he can manipulate the results to whatever he wants, not what the people decide."

Democrat Bryan Hambley said Trump's statements are indicative of a larger problem.

"Politicians have long used their power to manipulate our elections for their own purposes, and this proposal by President Trump is just that: a power grab to attempt to take control of elections from the states," Hambley said. "Ohios elections are safe and secure, and should continue to be run by our state officials."

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On Thursday, President Trump unveiled his Great Health Care Plan, which aims to lower the cost of health insurance for Americans on the Affordable Care Act.

At the center of the president's plan are health savings accounts for Americans so they can pay down the high cost of healthcare directly.

RELATED NEWS | Trump unveils health care plan that would pay Americans directly to buy coverage

But the president's proposal is separate from bipartisan negotiations on Capitol Hill.

Critically, it doesn't include any extension of expanded Affordable Care Act subsidies, which expired at the end of last year.

A White House official told Scripps News Group that the proposal "does not specifically address those bipartisan congressional negotiations that are going on."

Those talks are led in part by freshman Republican Senator Bernie Moreno of Ohio, who told reporters Thursday ahead of a Senate recess that talks have hit a snag.

"Here's where we're at. So we are in a little bit of a pothole. Democrats that we're talking to are, absolutely they are, in good faith. They absolutely want to get a deal done. They are absolutely willing to do an extension of reforms, but what I've seen in my year here is that unless the Democrat leader wants a deal to happen, it just will not happen," Sen. Moreno said.

The Senator placed the blame squarely on Senate Minority Leader Chuck Schumer, who has advocated with his fellow Congressional Democrats for a three-year extension of credits.

According to Sen. Moreno, bipartisan negotiations have zeroed in on a two-year plan, which would allow for an extension of the expanded expired tax credits, paired with a health savings account option, to put money directly in Americans' pockets in year two.

RELATED NEWS | Fewer Americans sign up for Affordable Care Act health insurance as costs spike

Since open enrollment ended for 2026 on January 15th, Sen. Moreno says an agreement would reopen open enrollment for Americans who get their coverage thru the ACA.

Healthcare is expected to be a major campaign issue in this year's midterm elections.

With negotiations stalled and campaigns ramping up, it's not clear if a bipartisan group of lawmakers will be able to deliver on a plan.

Meanwhile, millions of Americans are projected to lose their health insurance over the expired tax credits, and those who have renewed their plans are now paying significantly more for the same coverage.

President Donald Trump on Friday touted the health care framework he released a day earlier as tremendous, promising it would lead to significant reductions in costs for American consumers.

But pharmaceutical manufacturers and health insurers see it differently as most Americans remain worried about the expiration of expanded government subsidies that helped offset consumers insurance premium payments for plans bought on the Affordable Care Act marketplaces.

Trumps proposal, which did not include any legislative text or timeline for enactment and did not appear to be formally endorsed by Congressional GOP leaders, includes a grab bag of initiatives intended to lower Americans prescription drug and insurance premium costs.

IN CASE YOU MISSED IT | House passes bill to extend ACA subsidies, but it is not likely to survive the Senate

Among the ideas were: redirecting funding previously used to offset insurance premium costs directly into Americans health savings accounts; codifying Trumps push to cut U.S. drug prices by linking them to lower drug costs abroad; restoring the ACAs cost-sharing reduction program; and instituting maximum price transparency by requiring insurers and medical providers to make more information publicly available.

"The big insurance companies lose, and the people of our country win," Trump said in a video announcing the plan.

Indeed, many industry groups quickly came out strongly against the plan - suggesting it would do little to alleviate Americans cost concerns and could instead stifle innovation.

Imposing broad-based price controls does nothing to address insurance barriers and would instead threaten access to breakthrough treatments and undermine critical investments that strengthen the U.S. economy, Alex Schriver, a top official with the pharmaceutical industry group PhRMA, said in a statement to Scripps News. Importing those same flawed policies into the U.S. would undermine our leadership at a time when China is poised to surpass us in medicine development.

IN CASE YOU MISSED IT | More Americans turn to cash-only doctors as health care costs rise

Legislation that codifies most favored nation drug pricing isnt necessary, echoed a spokesperson for Eli Lilly and Company, one of the largest U.S-based pharmaceutical manufacturers. The Administration already successfully negotiated unique voluntary agreements with pharmaceutical manufacturers.

Some health insurers and trade groups representing them were supportive in public statements: a spokesperson for CVS Health Care told Scripps News the company share[s] the Presidents goal to make health care more affordable and are committed to continue doing our part, while an official with America's Health Insurance Plans (AHIP), a political advocacy and trade association of health insurance companies, also signaled support.

Health plans welcome ideas to bring down the unaffordable prices drugmakers charge Americans and to empower consumers to make the best health care decisions for themselves and their families, AHIP spokesman Chris Bond told Scripps News in a statement.

David Merritt, a senior official with the Blue Cross Blue Shield Association (BCBSA) the largest private insurer in the U.S. when considering combined commercial markets said its encouraging that President Trumps plan includes a focus on the root causes driving up health care premiums, like drug prices.

We look forward to continuing to work with Congress and the Administration to deliver more information, more choices and lower costs for the American people, Merritt concluded.

Yet a BCBSA official who declined to speak on the record signaled opposition to the notion of redirecting subsidies to consumers.

100% of the enhanced premium tax credit goes directly to the consumer, the official said.

Though White House officials have stressed that they see the proposal as worthy of bipartisan backing, it received the typical partisan response in Congress: most Democrats panned it while Republicans signaled support.

Every American should be asking themselves a simple question: are you paying more for your health care than you were a year ago?, Sen. Ron Wyden (D-Oreg.) posed. The answer ought to tell you everything you need to know about the Trump-Republican health care agenda.

And though a White House official said the Trump administration didnt believe pursuing the proposal through the budget reconciliation process - which only requires a simple majority to pass in the Senate, instead of the usual 60 votes - would be necessary, House Republican leaders said they were prepared to do just that.

Our framework for a second reconciliation bill includes many of these historic reforms, because that's how we're going to secure real wins for the people who sent us here, Republican Study Committee (RSC) Chairman Rep. August Pfluger (R-Texas) said in a statement.

Asked whether this proposal closed the door on negotiations to extend those enhanced ACA subsidies, a White House official noted it does not specifically address those bipartisan congressional negotiations that are going on.

Sen. Lisa Murkowski (R-Alaska), whos at times broken with GOP leadership, told reporters Thursday shes not giving up on a potential deal to extend the subsidies.

"I don't think it is too late to try to salvage something," Murkowski said.

The cycle is familiar to millions of Americans struggling with their weight. Third-grade teacher Christa Donnelly tried everything, including Weight Watchers, diet routines, and gym memberships. Nothing worked long-term.

"I'd lose some weight, plateau, lots of times, put it back on, maybe lose a little more and then plateau," Donnelly said.

Last February, the Maryland teacher started taking a GLP-1 medication after consulting with her doctor and family. The results have been dramatic.

RELATED STORY | FDA wants suicide warnings removed from weight-loss medications like Zepbound, Wegovy

"I've gone down 4 pants sizes. I feel so much better, you know, I've got so much more energy," Donnelly said. "I'm able to move, you know, I get down on the floor as students, I can get back up easily."

Her blood pressure is now in a healthy, normal range. But Donnelly's success story highlights a growing national crisis: employers can no longer afford to cover these life-changing medications.

Howard County Public School System in Maryland recently announced it will stop covering GLP-1 medications for weight management after costs skyrocketed from $485,000 over three months to more than $3.6 million in just two years.

"They sent us an email stating that they would stop covering any medication as of the end of March of 2026," Donnelly said. "I was devastated. I had absolutely planned on staying on the medication. I still have about the other 30 or 40 pounds I want to lose."

The Maryland district's decision reflects a nationwide trend. A recent survey by KFF, a nonpartisan health policy group, found employers across the country are struggling with the explosive cost of covering GLP-1 weight-loss drugs.

Nearly two-thirds of large employers said covering GLP-1 drugs had a moderate or significant impact on their prescription drug costs. Many are being forced to choose between maintaining coverage and keeping employee premiums affordable.

In Howard County, district leaders say without dropping weight-loss drug coverage, employee premiums would have risen nearly 20 percent. Even with the change, employees still face a 13 percent increase.

RELATED STORY | The clock starts ticking the day you quit your GLP1 medication

The school system will continue covering GLP-1 medications for diabetes treatment, but weight management coverage ends next year.

"They'll cover blood pressure medication. They'll cover cholesterol medication, but they don't want to cover a GLP, and to me that's a preventative medication," Donnelly said.

Federal officials have announced deals aimed at lowering the price of GLP-1 medications, but it's unclear whether those savings will reach employers or when relief might come.

For now, employees like Donnelly are caught in the middle of a healthcare cost crisis that's forcing impossible choices between health and financial stability.

"I want people to look at medication and as needed by the people and not just the bottom line," Donnelly said.

Thousands of nurses went on strike at some of New York City's top hospitals, targeting major medical centers and demanding better working conditions.

The walkout is targeting major medical centers, including NewYork-Presbyterian Columbia, Montefiore Medical Center and Mount Sinai Hospital. According to The Associated Press, the hospitals remained open, hiring droves of temporary nurses to try to fill the labor gap.

Nurses are demanding minimum staffing ratios to prevent being overwhelmed with too many patients. They also want higher wages and more security to reduce violent episodes at hospitals.

RELATED STORY | Future nurses feeling sick over professional degree reclassification of nursing profession

The strike was initiated on Monday after a deal wasn't secured in negotiations over the weekend.

The New York State Nurses Association said about 15,000 nurses are involved in the strike.

Governor Kathy Hochul declared a disaster imminent due to the strike's impact on patient care during what is a particularly severe flu season.

Hospitals have canceled surgeries and transferred patients to prepare for the work stoppage.

With just days left before the January 15 deadline, millions of Americans are scrambling to choose the right health insurance plan amid significant uncertainty over Affordable Care Act subsidies.

ACA premium tax credits expired at the end of last year, causing substantial price hikes for policies and leaving consumers facing difficult decisions about their healthcare coverage.

"People should not just blindly re-enroll in the coverage they had last year, because they might find that that's not affordable at this point," said Katherine Hempstead, senior policy officer with the Robert Wood Johnson Foundation.

RELATED STORY | Millions face higher healthcare costs as ACA subsidies end January 1

Navigating rising costs and plan options

With dozens of plans available, many consumers feel overwhelmed by their choices. However, Hempstead emphasized that all ACA-compliant plans provide the same essential coverage - what differs is how costs are structured across metal levels.

"Higher metal levels mean higher premiums and less cost-sharing. Lower metal levels mean that your premiums are lower, but your deductible is going to be higher," Hempstead said.

She recommended that consumers consider shifting from silver to bronze plans to secure more affordable premiums, despite the trade-off of higher out-of-pocket costs.

"That's an unfortunate trade-off, but I think a lot of people would feel like that's better than having no coverage at all," Hempstead said.

Beyond cost considerations, consumers should examine provider networks and medication formularies when selecting plans - factors that remain important regardless of premium changes.

Where to find help

For Americans seeking personalized guidance, Hempstead recommended starting with healthcare.gov, which directs users to appropriate state resources regardless of location.

"It's really important to make sure you're really there because unfortunately, if you just put in a search term, there's lots of scam websites that try to jump to the top," Hempstead said.

Many consumers also work with insurance brokers for additional guidance between different plans, though Hempstead advised ensuring brokers come with recommendations from trusted sources.

Deadline pressure and potential changes

Missing the January 15 deadline typically requires a qualifying life event for special enrollment, such as moving states, losing employment, or aging out of parental coverage.

However, the situation remains fluid. Some states are exploring extending deadlines to January 30, and potential congressional action on subsidies could trigger new enrollment periods.

RELATED STORY | Don't miss the deadline: Experts urge you to sign up for ACA healthcare to avoid risks

"People should keep watching the news, because this is a fluid situation, and it's possible that there may actually be a fix and that Congress may decide to extend these tax credits in some fashion," Hempstead said.

Congressional action remains uncertain

On Thursday, 17 House Republicans broke ranks with party leadership to support restoring expanded ACA tax credits, joining 213 Democrats in a symbolic vote. However, Senate negotiations for a bipartisan compromise remain stalled over Republican demands to exclude federal funding for reproductive care services.

One potential solution being discussed involves health savings accounts for ACA consumers to manage healthcare costs directly. While Hempstead acknowledged growing interest in giving consumers more agency in healthcare shopping, she questioned the immediate impact.

"Giving a very small number of consumers in the individual market a little bit of money isn't really going to give them any market power," Hempstead said.

Despite the uncertainty, Hempstead urged Americans not to delay their enrollment decisions.

"I wouldn't bank on any of these other things we talked about happening. So I think if you're wondering whether or not you should get coverage and you think you might want to have coverage in the individual market, this is your time to get it," Hempstead said.

Affordable Care Act subsidies have officially expired, affecting tens of millions of Americans who get their insurance through the marketplace. With private and employer-sponsored plan costs also rising, more people are turning to a different kind of system paying cash directly to their doctor.

The direct primary care model, where patients pay a monthly fee for visits, is gaining momentum across the country.

The American Academy of Family Physicians estimates nearly one in 10 of its members operate a direct primary care practice, a number that has tripled in just a few years.

"Eighty-nine dollars a month, unlimited, and you don't get any other bills for any other care. Totally unrestricted and unlimited," said Jacqueline Robson, vice president of member services at Hy-Vee Health Exemplar Care.

Robson spoke to Scripps News during the opening of a new location in Omaha, Nebraska. The organization bills itself as the "Midwest's leading direct primary care provider," with locations in Nebraska, Iowa, Missouri and South Dakota.

The ability to spend more time with patients is what drove Dr. Rahul Iyengar to open his own direct primary care practice in Nashville, Members Health Co.

"As a doctor, I want to talk to you for an hour, hour and half and that's what I do here since I'm outside the system. In the system, doctors don't get to make their schedule. You're an employee and insurance is really what dictates their schedule," Iyengar said.

Dr. Rachel Dhani, who owns House of Valor in Tampa, transitioned to direct primary care early in her career after working in a traditional hospital and insurance-based setting.

"Freedom is everything. I have joy when I take care of patients and my colleagues who are in insurance-based models, they don't have joy. They are just completely drained from the administrative pressures of these insurance models and patients aren't happy," Dhani said.

Dhani explained that direct primary care allows for more personalized and coordinated care.

"Health care shouldn't be expensive. And the misnomer is that all your money is going towards a provider, and it's not. We are getting capped and like not getting compensated appropriately," Dhani said.

Dr. Noor Ali, a healthcare consultant, said the idea isn't new. In Bangladesh, where she studied medicine, the system is common and can lead to disparities - if you have money, you can get healthcare. If you don't, you can't.

The interest in direct primary care in the U.S started with providers, Ali said.

"And this really started happening when insurance wasn't doing a great job of paying their providers," Ali said. "I just want to do my job as a doctor and give my patients the care they deserve and I want to do it directly."

According to the Direct Primary Care Coalition, there are more than 2,300 direct primary care practices in the U.S., caring for an estimated 300,000 people.

However, Ali cautioned that the model isn't suitable for everyone.

"The best type of candidate for this is someone who's not chronically ill, who's healthy and they don't want to pay insurance big bucks," Ali said. "But if you have that unexpected car accident where you have to go to the nearest emergency room, your direct provider, they're not there for emergency care services."

Iyengar compared health insurance to car insurance, emphasizing that while it's necessary for emergencies, it's not designed for routine maintenance.

"Insurance is great, it has a role, but it's not designed to keep you healthy. It's more designed for when something breaks," Iyengar said.

As health insurance premiums continue to climb, the direct primary care model is likely to attract more patients seeking affordable alternatives to traditional healthcare.

"So you see this kind of cyclical economic impact of this legislation on insurance, on the provider and the consumer, that triangle of health care that we see," Ali said.

The Trump administration is facing a new legal complaint from a group of government employees who are affected by a new policy going into effect Thursday that eliminates coverage for gender-affirming care in federal health insurance programs.

The complaint, filed Thursday on the employees' behalf by the Human Rights Campaign, is in response to an August announcement from the Office of Personnel Management that it would no longer cover "chemical and surgical modification of an individual's sex traits through medical interventions" in health insurance programs for federal employees and U.S. Postal Service workers.

The complaint argues that denying coverage of gender-affirming care is sex-based discrimination and asks the personnel office to rescind the policy.

RELATED STORY | Trump administration seeks nationwide ban on gender-affirming care for minors

"This policy is not about cost or care it is about driving transgender people and people with transgender spouses, children, and dependents out of the federal workforce," Human Rights Campaign Foundation President Kelley Robinson said in a statement announcing the move.

The complaint, filed with the Equal Employment Opportunity Commission, includes testimonies from four current federal workers at the State Department, Health and Human Services and the Postal Service who would be directly affected by the elimination of coverage.

For instance, the Postal Service employee has a daughter whose doctors recommended that she get puberty blockers and potentially hormone replacement therapy for her diagnosed gender dysphoria, which would not be covered under the new OPM policy, according to the complaint.

The complaint notes that the workers are making the claim on behalf of themselves and a "class of similarly situated federal employees."

RELATED STORY | Democrat-led states sue HHS over a move to block youth gender-affirming care

The Trump administration has taken other steps to restrict care for transgender Americans, particularly minors. In December, the U.S. Department of Health and Human Services released proposals that would block gender-affirming care to minors, including a policy that would bar Medicare and Medicaid dollars to hospitals that provide such care to children.

Senior Trump officials, such as Health and Human Services Secretary Robert F. Kennedy Jr., call gender-affirming care "malpractice" for minors. But such restrictions go against recommendations from major medical groups such as the American Medical Association and the American Academy of Pediatrics.

All 50 states will receive grants under the Centers for Medicare and Medicaid Services (CMS) new Rural Health Transformation Program designed to modernize health care in rural communities.

CMS Administrator Dr. Mehmet Oz spoke with the Scripps News Group about this new $50 billion initiative from the Trump administration that he said will impact over 60 million Americans.

"We want the money to be used to change the way we envision health care in rural America, not just to pay bills on programs getting created 60-70 years ago that don't seem to be working," said Oz.

WATCH | Centers for Medicare and Medicaid Services says Rural Health Transformation Program will help all states

RELATED STORY | House members leave DC for the year without a deal to extend ACA subsidies

On average, each state will receive $200 million to "strengthen the rural health workforce, modernize rural facilities and technology, and support innovative models that bring high-quality care closer to home." However, officials said the first-year awards for each state will range between $145 millon to $280 million.

Oz said, "This is not just about throwing more money at the problem; it's about addressing the root cause of these issues."

He added that there's a large emphasis on updating and modernizing technologies used at rural hospitals and doctors' offices.

"For example, a lot of smaller hospitals have trouble keeping up with the costs of bringing data systems into their institution. We don't have the information networks that link up doctors' offices and hospitals and insurance companies well," said Oz. "So oftentimes, there will be illnesses that we're not finding until later on and we're not treating them as effectively."

Officials said the grants would allow states to offer more mental health and substance abuse services that are critically lacking in rural areas specifically more certified community behavioral health clinics.

The program wants states to expand more affordable treatment alternatives, like shifting from emergency care to more "treat-in-place" options that would save on costly ambulance and emergency room visits or even telehealth options.

CMS said the program will provide the grants to "approved states" over five fiscal years. Half of the funding will be distributed equally among states, the announcement said. The other half of the funding will be allocated based on a variety of factors, the agency said.

"As described in the notice of funding opportunity, those factors include individual state metrics around rurality and a states rural health system, current or proposed state policy actions that enhance access and quality of care in rural communities, and application initiatives or activities that reflect the greatest potential for, and scale of, impact on the health of rural communities," the announcement stated.

RELATED STORY | Pediatricians group sues federal government over cuts to child health funding

The scoring system will be renewed each year.

Oz said they challenged states to come up with ideas for addressing their unique rural health care challenges as part of the process.

"And we had some wonderful ideas, including, for example, in Alaska, which is a big state, it's hard to deliver medications. They're going to use drones to do that. In some parts of the southeast, they want to use robotic ultrasound devices to see how a pregnant woman is doing if she lives in a rural area and can't get to a doctor. These ideas were an effort by us to pull out the best thoughts possible, and it's working," he said.

Ohio's labor unions have traditionally supported Democratic candidates, but in recent years, some have started shifting to the right. Despite this, former Senator Sherrod Brown is still outperforming his party.

Ohio's major gems, like the Rock Hall of Fame, each football stadium and entertainment districts were all built by the state's union workers.

"Labor's the center of it," union worker Austin Keyser said.

Ohio unions also helped build the careers of Keyser and Michael Bertolone.

"I'm very grateful for everything I've got up to this point because of Local 18," Bertolone said.

Bertolone is the business manager of the International Union of Operating Engineers, Local 18 (IUOE Local 18) with 16,000 fellow workers, while Keyser is the international vice president of the International Brotherhood of Electrical Workers (IBEW), but is based out of the union's fourth district in Ohio. Total, IBEW has about 860,000 members.

Keeping labor rights and access to projects is guiding the pair when it comes to the 2026 US Senate race.

"Having strong, strong advocates is very, very important," Keyser said.

But theyve come to different conclusions when deciding between Democrat Sherrod Brown and Republican Jon Husted.

"Sherrod Brown has done it for decades; there's no better advocate," Keyser said. "He is literally the conscience of labor."

IBEW's national overall and so far six of its local branches, 21,000 Ohioans, have endorsed Brown.

IUOE Local 18 endorsed Husted.

"Jon has put in the time and effort with the operating engineers to earn that endorsement," Bertolone said. "He's done so much in the state of Ohio."

Historically, labor unions have voted for Democrats. Over the past decade, Case Western Reserve University business law professor Eric Chaffee explained that there has been a move to the right.

"There's been really a shift in values in regard to Republicans," Chaffee said. "They've tried to tap into populism, the everyday person, what they might want."

Many union workers have felt left behind by progressive candidates, he said.

"The Democrats have definitely become more coastal than what they were, more focused on big cities, more focused on certain identities," the professor said.

This is why Local 18 went for Husted, Bertolone said. Its one of the few endorsements that Husted snatched from Brown ones that the Democrat won in 2024.

"We haven't developed a relationship with Sherrod Brown," Bertolone said. "The time and the effort just was not put in."

Brown pushed back against that.

"Husted has been gaining more union support in recent months than other Republicans" I started to say when talking to Brown at a Columbus event in December.

"What are those?" he asked, to which I responded about one of the Cleveland unions.

Brown wasn't impressed.

"Well, he just really doesn't; that's his spin," Brown said. "One endorsement of one union and then a regional kind of I've overwhelmingly got support of unions because I've worked with unions."

Brown outperformed Democrats all across the country in 2024, barely losing to U.S. Senator Bernie Moreno despite the Red Wave. Ohioans we spoke to said he was popular with each side of the aisle due to his focus on working families.

While Husted has gained five labor endorsements with a membership of 70,000 workers nationally, Brown has seven times the number of unions backing him, representing millions of laborers. His support ranges from builders to airline workers to teachers.

"I've worked alongside them, I've promoted supporting workers and giving them a fair shake," Brown continued.

Husted argued that many of Browns endorsements come from national unions.

"I wanna get endorsed by Ohio unions, the people who actually live and work in Ohio, and that's where we're doing quite well," Husted said.

But just looking at local endorsements, Brown eclipses Husted with 15 Ohio-based endorsements to his four.

Even though Husted may support unions and did help labor during his time as lieutenant governor, Keyser said, he votes for policies in the U.S. Senate that don't.

"Husted has now voted several times for these tariffs," Keyser said. "It's terrible for our economy, it's terrible for workers, and it's terrible for Ohio."

RELATED: U.S. Sen Jon Husted not in lockstep with Trump on tariffs

Both candidates will continue courting workers as affordability has become, so far, the top issue in this election.

Gubernatorial

While Brown is the reigning king when it comes to labor endorsements, it's because of who he is not his party affiliation, Keyser said. Even Bertolone admitted that Brown has spent decades working for unions.

The gubernatorial race is another story, though.

At least one union has endorsed both Brown and the GOP-endorsed candidate for governor, Vivek Ramaswamy.

As of November, Ramaswamy had 10 labor endorsements overlapping Brown with the Central Midwest Regional Council of Carpenters (CMRCC).

Democratic candidate Amy Acton has also gained nine labor endorsements, including both manufacturing and education unions.

IUOE Local 18 decided to endorse Ramaswamy, while IBEW hasn't chosen yet. Keyser believes they are leaning toward Acton, because she has strong labor beliefs and isn't a "billionaire."

He accused Ramaswamy of being "anti-labor" due to his previous comments advocating for cuts to federal workers and the abolishment of teachers' unions. Bertolone defended their choice.

"The teachers' union I am not sure what issues are on that side of the aisle," Bertolone said. "Those are not our issues. We don't focus on any of those."

Keyser said that comment goes directly against what unions are about.

"The unions who are good citizens of the labor movement and understand the fight and the struggle that we're all in together, understand strength and unity in numbers," Keyser said. "It's the purpose of a labor union, and to walk away from that principle is kind of scary."

Presidential

Working-class voters also were key to helping elect President Donald Trump, Chaffee said.

"Whoever really captures the next presidential election probably is going to have to figure out how to tap into labor," the professor said.

In a break from endorsing Democrats, the International Brotherhood of Teamsters didn't endorse in 2024.

Although union members mainly voted for former Vice President Kamala Harris, Chaffee said that Trump's labor support helped him win swing states.

Interests

So why would people vote or endorse against their own interests? Chaffee said it's complicated.

"The Republican party is not monolithic," Chaffee said. "There are different factions of it; some of them are more pro-labor than others."

Examples of mainly pro-labor Republicans include Husted, he added.

"Labor is moving towards candidates who show up," Bertolone said. "For Local 18 to look at it from a Democratic or a Republican standpoint, that just isn't good politics and that's not going to benefit our members."

If workers believe there are two pro-union candidates, some may vote based on other stances that the politician has, Chaffee said.

But Keyser accuses unions that endorse Republicans of caving. Due to how districts are drawn in the state, sometimes endorsing is about survival, he said.

"You have to work with who's there, we're not trying to march our members into a massacre, we're trying to get policy outcomes," Keyser said. "I'd much rather play offense than defense."

Chaffee said there is truth to Keyser's assertion.

"There are going to be instances where they make choices based upon who they think is going to win, even if that candidate may not be the candidate that they would ideally like to win," the professor said. "Sometimes you just have to accept that one candidate is gonna win over the other and then try and make the best of the situation."

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U.S. regulators on Monday gave the green light to a pill version of the blockbuster weight-loss drug Wegovy, the first daily oral medication to treat obesity.

The U.S. Food and Drug Administrations approval handed drugmaker Novo Nordisk an edge over rival Eli Lilly in the race to market an obesity pill. Lillys oral drug, orforglipron, is still under review.

Both pills are GLP-1 drugs that work like widely used injectables to mimic a natural hormone that controls appetite and feelings of fullness.

In recent years, Novo Nordisks injectable Wegovy and Lillys Zepbound have revolutionized obesity treatment globally and in the U.S., where 100 million people have the chronic disease.

The Wegovy pills are expected to be available within weeks, company officials said. Availability of oral pills to treat obesity could expand the booming market for obesity treatments by broadening access and reducing costs, experts said.

RELATED STORY | Medicare Part D recipients to see lower prices on Ozempic, Wegovy and more

About 1 in 8 Americans have used injectable GLP-1 drugs, according to a survey from KFF, a nonprofit health policy research group. But many more have trouble affording the costly shots.

Theres an entire demographic that can benefit from the pills, said Dr. Fatima Cody Stanford, a Massachusetts General Hospital obesity expert. For me, its not just about who gets it across the finish line first. Its about having these options available to patients.

The Novo Nordisk obesity pill contains 25 milligrams of semaglutide. That's the same ingredient in injectables Wegovy and Ozempic and in Rybelsus, a lower-dose pill approved to treat diabetes in 2019.

In a clinical trial, participants who took oral Wegovy lost 13.6% of their total body weight on average over about 15 months, compared with a 2.2% loss if they took a placebo, or dummy pill. Thats nearly the same as injectable Wegovy, with an average weight loss of about 15%.

Chris Mertens, 35, a pediatric lung doctor in Menomonee Falls, Wisconsin, joined the Novo Nordisk trial in 2022 and lost about 40 pounds using the Wegovy pill. The daily medication worked to decrease his appetite and invasive thoughts of food, he said.

If there were days where I missed a meal, I almost didnt realize it, Mertens said.

Participants in a clinical trial who took the highest dose of Lillys orforglipron lost 11.2% of their total body weight on average over nearly 17 months, compared with a 2.1% loss in those who took a placebo.

Both pills resulted in less weight loss than the average achieved with Lillys Zepbound, or tirzepatide, which targets two gut hormones, GLP-1 and GIP, and led to a 21% average weight loss.

All the GLP-1 drugs, oral or injectable, have similar side effects, including nausea and diarrhea.

Both daily pills promise convenience, but the Wegovy pill must be taken with a sip of water in the morning on an empty stomach, with a 30-minute break before eating or drinking.

Thats because Novo Nordisk had to design the pill in a way that prevented the drug from being broken down in the stomach before it could be absorbed by the bloodstream. The drugmaker added an ingredient that protects the medication for about 30 minutes in the gut and makes it easier to take effect.

RELATED STORY | White House announces more deals to bring down prescription drug prices

By contrast, Lillys orforglipron has no dosing restrictions. That drug is being considered under the FDAs new priority voucher program aimed at cutting drug approval times. A decision is expected by spring.

Producing pills is generally cheaper than making drugs delivered via injections, so the cost for the new oral medications could be lower. The Trump administration earlier this year said officials had worked with drugmakers to negotiate lower prices for the GLP-1 drugs, which can cost upwards of $1,000 a month.

The company said the starting dose would be available for $149 per month from some providers. Additional information on cost will be available in January.

Its not clear whether daily pills or weekly injections will be preferred by patients. Although some patients dislike needles, others don't seem to mind the weekly injections, obesity experts said. Mertens turned to injectable Zepbound when he regained weight after the end of the Wegovy pill clinical trial.

He said he liked the discipline of the daily pill.

It was a little bit of an intentional routine and a reminder of today Im taking this so that I know my choices are going to be affected for the day, he said.

Dr. Angela Fitch, an obesity expert and chief medical officer of knownwell, a health care company, said whatever the format, the biggest benefit will be in making weight-loss medications more widely accessible and affordable.

Its all about the price, she said. Just give me a drug at $100 a month that is relatively effective.

The White House announced new agreements with nine pharmaceutical companies to lower prescription drug prices Friday, as part of President Trumps broader effort to cut healthcare costs in line with other nations.

This is the biggest thing having to do with drugs in the history of the purchase of drugs, Trump said.

The agreements lower drug prices for state Medicaid programs to most favored nation prices, offer discounts for direct consumer purchases from the administrations website, TrumpRX.com, and require companies to remit part of increases in foreign revenue for American benefit, according to the administration.

The President said, before we start passing laws and beating these folks, just look at them in the eyes. Be tough, but say, are you willing to work with us? Are you willing to allow us to convene the industry and get the right pricing for the American people in a way it doesn't destroy your ability to innovate and create life saving solutions? Today's announcement is a combination of that effort, said Dr. Mehmet Oz, the administrator of Centers for Medicare and Medicaid Services said in an interview with Scripps News.

The agreements with Amgen, Bristol Myers Squibb, Boehringer Ingelheim, Genentech, Gilead Sciences, GSK, Merck, Novartis and Sanofi mean 14 companies of the 17 Trump sent letters to earlier in the year requesting such a move have signed on. The administration previously announced agreements with Pfizer, AstraZeneca, EMD Serono, Novo Nordisk and Lilly.

Senior administration officials say their inboxes are overflowing with more companies seeking to sign agreements.

What started as a trickle now is a flood. This signifies the entire industry is coming in, Dr. Oz said. Well help Americans who have cancer, diabetes, heart disease, a slew of problems now will be more easily affordable, and the American people won't be turned away at the pharmacy because they don't have the money, which happens one in three times.

The agreements impact drugs with prices higher than what other European nations are paying, according to a senior administration official noting it is not an issue of the average, its an issue of variability.

The agreements impact drugs used for treatment for diabetes, rheumatoid arthritis, multiple sclerosis, asthma, COPD, Hepatitis B and C, HIV and some cancers, according to the White House.

It includes, for example, a discount from $330 to $100 for diabetes medication Januvia from Merck through the direct-to-consumer website that senior administration officials expect to be available early next year.

RELATED STORY | President Trump reclassifies marijuana, making it easier for medical use

We've consistently said that we support the notion that we have to find ways to make drugs most more affordable and accessible in the United States, and also we need to address the pricing disparities around the world and make sure that countries other than the United States are paying their fair share. And we saw this agreement as a way to take an important step in that regard, said the companys Chairman and CEO, Rob Davis, in an interview with Scripps News.

The agreements also bring most favored nation pricing to new medicine companies bring to market.

Davis pointed to the companys investigation drug waiting on potential approval, Enlicitide, as an example.

What this agreement allows us to do is to not only have an easy to take oral pill, but get that pill to patients in an accessible way and at an affordable cost through trumprx.com, and so I use that as an example, just to say that's going to bring access, it's going to bring affordability, and it's going to bring a drug, assuming it's approved, they'll have a meaningful benefit for patients, Davis said, noting theyll look for other drugs to bring in moving forward.

Drugs that are injectable or need an infusion wont be on TrumpRX, an official noted, citing the need for them to be administered by providers.

While Davis noted there is an impact to margins, he dismissed any concerns.

Obviously there is an impact, but credit to the administration, I think they've helped us ensure it's manageable in the short and the long term, and importantly, over time, if we can get foreign prices up, that can help offset it. So it will impact us, but it's not going to stop us from pursuing our mission to to discover, develop and deliver life saving medicines. That continues. and in that in that sense, I feel quite good that as I look forward for my company, we continue to be quite confident in our long-term growth prospects even taking into account what we're doing here today, Davis said.

Officials expect the agreements to represent more than $150 billion in new investment in manufacturing, research and development in the U.S. as well.

The agreements also include donations to the strategic active pharmaceutical ingredients reserve for emergencies, including donations of ertapenem, apixaban and albuterol. Some manufacturers will also convert raw ingredients into finished medicine during emergencies, according to senior administration officials.

MORE ON MEDICINE | Medicare Part D recipients to see lower prices on Ozempic, Wegovy and more

But as the administration touts efforts to lower prices, millions of Americans are facing the potential for higher premiums with the expiration of enhanced Affordable Care Act subsidies at the end of the year and no deal or consensus in Congress on an extension or health plan.

Trump has said he wants money sent directly to Americans rather than insurance companies, for example through a health savings account, though he hasnt offered specific details.

It is not the Republicans fault, it's the Democrats fault. It's the Unaffordable Care Act and everybody knew it, Trump said during an address to the nation Wednesday.

Dr. Oz sought to offer assurance.

What may have happened with all this debate is a awareness of the American people that this is a really good deal. Maybe it's not 95% subsidized, but it's 80% subsidized. Well, you go to a restaurant, they pay 80% of the bill, you're still pretty happy, even if you didn't get the whole bill paid for. So the fact that we have only dropped about 2.8% roughly from the norm, you know, that we had last year. I mean, we're right in the ballpark. We could even be more than last year. We will have to see. But the American people aren't running from the exchanges. The folks who want the exchange, who like the exchanges, are staying the exchanges. We need to innovate to make the service even better, Dr. Oz said.

The expiration of the enhanced premium tax credits is estimated to have a114 percent increase for what subsidized enrollees annually pay for premiums, according to KFF.

As Congress left town Friday without an agreement, Trump suggested he would call a meeting with insurance companies in the near future.

There's another way of doing it, and that's getting the insurance companies to ease up and to cut their pricing way, way down, and stay part of the system, Trump said.

I'm going to call a meeting of the big insurance companies that have gotten so rich by receiving money, and really much, far, far more money than they're entitled to, he added.

Millions who rely on health insurance through the Affordable Care Act have until Monday, Dec. 15, to enroll in coverage for next year.

Even though Congress is still deadlocked over how to move forward with pandemic-era tax credits that helped keep costs low, health experts said you should still sign up for an ACA plan before the deadline.

While you may be undecided, experts said you can cancel a plan at any time and there are bigger risks for not having a plan at all.

IN CASE YOU MISSED IT | You can now check 2026 Obamacare plan prices but costs could still rise

If you miss Monday's deadline to enroll, you can still sign up through ACA marketplace until Jan. 15, but your coverage will not start until February which means you will be uninsured for the first month of the year.

Last week, the Senate rejected a pair of proposals aimed at lowering the health care costs before the January expiration.

It appears legislators won't reach a deal before the end of the year as they head into their holiday recess.

Lawmakers on Capitol Hill are expected to vote Thursday on competing health care proposals as Affordable Care Act (ACA) subsidies near expiration at years end.

Without action from Congress, millions of Americans could face a roughly 26% spike in health care costs. Democrats are unified behind a plan to extend those subsidies for three years, while GOP lawmakers plan to bring a counter-proposal to the floor.

Senate Majority Leader John Thune said that Senators will vote on a proposal from Republican Sens. Bill Cassidy and Mike Crapo, while blasting Democrats ACA-subsidy vote as extending the status quo."

RELATED STORY | Premium Pain: Why your health care monthly premium is going up & what you can do about it

"Democrats' great scheme to fix health care Obamacare has failed," Thune said on Monday. "... They proposed a clean, three-year extension of the enhanced Obamacare subsidies. Clean, Mr. President. No reforms, no revisions."

The GOP-led "Health Care Freedom for Patients Act" proposes sending money directly to patients rather than insurance companies and lowering insurance premiums and health care costs. It also seeks to expand Health Savings Account (HSA) eligibility, which is intended to help Americans cover out-of-pocket costs.

However, one part of the proposal that is likely to draw criticism from Democratic lawmaker, is that it calls for ending taxpayer-funded abortion or transgender services. The Republican plan also calls for reducing Medicaid funding to states that provide health insurance coverage to migrants who are in the country illegally and requires states to verify citizenship or immigration status before providing Medicaid coverage.

IN CASE YOU MISSED IT | You can now check 2026 Obamacare plan prices but costs could still rise

While 60 votes are required to pass the vast majority of legislation in the Senate, Sen. Cassidy believes he does have enough support from his colleagues to get this legislation across the finish line.

"There are some dances you can do by yourself, well passing a health care bill is not one of them," Cassidy said. "And so we've got to have [Democrats] willing to do something different. And giving all the money to the insurance plans and leaving the consumer with a policy which has a $6,000 deductible that does not work for families."

The ACA subsidies, currently in place, are set to expire Dec. 31. Democratic leaders believe every member of their caucus will vote for the extension Thursday.

Up to this point, the lack of Republican consensus on health care has lingered, posing a political challenge as the 2026 midterm elections approach and swing district Republicans brace for possible political fallout if those ACA tax subsidies expire.

Attorneys are asking for a timeout arguing in federal court Monday that the public's money shouldn't be given to the Cleveland Browns, especially without telling Ohioans.

From a few dollars to nearly $300,000 for a Northeast Ohio animal shelter, unclaimed funds contain money left behind.

It's money that attorney Jeff Crossman says belongs to its rightful owners the people of Ohio.

"Taking someone's property and giving it to somebody else, a private owner, for some other private use is unconstitutional," Crossman said in an interview. "It's a handout to the Cleveland Browns."

This summer, the state lawmakers decided to give the Browns a $600 million performance grant for their new Brook Park stadium using unclaimed funds. Ohio's Division of Unclaimed Funds currently oversees about $4.9 billion in funds, including forgotten bank accounts, utility deposits, uncashed checks and more.

RELATED: Ohio lawmakers settle on unclaimed funds to put $600M into new Browns stadium

To check for unclaimed funds, visit unclaimedfunds.ohio.gov.

Crossman asked U.S. District Court Judge Edmund Sargus, Jr. to prohibit the state from using the cash while the legal fight plays out.

"It's kind of similar to an eminent domain situation," Crossman said. "If they're going to take your house, they're supposed to send you notice and give you an opportunity to object. They're not doing that."

In testimony on Monday, Unclaimed Funds Finance Director Amy Schellhammer admitted that they have not provided any direct notice to Ohioans, nor is it listed on their website, that $1.7-1.9 billion in unclaimed funds will be taken on Jan. 1, 2026.

Witnesses on each side debated the efficacy of the website, with one calling it the equivalent of a "local dog shelter's" website. There were thousands of entries that the expert witness analyzed that had addresses that were possibly outdated, non-existent zip codes, and frequently misspelled names.

RELATED: Ohio is making it easier to grab unclaimed funds if you're owed money

The errors on the website were all due to people entering their information wrong to the banks or other holders of money, a witness for the defense said.

The states attorneys declined to do an interview, but previously, Senate President Rob McColley (R-Napoleon) argued that it's constitutional and that press coverage has helped raise awareness for the unclaimed funds process.

"Kind of having this as a PSA 'Hey, we have an unclaimed fund, go check, get your money out,'" McColley said in June.

Republicans argue that they are taking funds that have been unclaimed since before Jan. 1, 2016, and that this will help economic development.

RELATED: National experts raise red flags about Ohio lawmakers' plan to take unclaimed funds

"It's not just a Browns deal," Senate Finance Chair Jerry Cirino (R-Kirtland) said. "It is a setting aside of money from the unclaimed funds for other projects in the future, some that we don't even know about at this point."

That is exactly the problem, Crossman said.

"There are a lot of professional sports teams in Ohio, right here in Columbus, you have the Blue Jackets, you have the Bengals down the road, and there are minor league teams, and there are a lot of businesses that might have their hand out, too," Crossman said.

"You say that this sets a bad precedent," I said to Crossman.

"Terrible precedent," he responded. "I understand the legislature was trying to be creative, and they're pounding their chest and saying, 'Hey, we're not raising taxes.' Well, no, they're not raising taxes, they're just taking your property and that's worse."

During the summary portion of the day-long hearing, the plaintiffs argued that the state was "money laundering," and the judge needed to issue the preliminary injunction because the defendants were unlawfully taking money without notification.

Defense attorney Aneca Lasley, representing the state, argued that there was no merit to the case, the law doesn't require notification, and the "passage" of H.B. 96 was enough notice. The public "is required" to be aware of what the legislators are doing, she added.

Judge Sargus went back and forth with each side, but told Crossman and his team that they had a "hill" to climb to get the injunction.

The judge said he was to determine if the law was constitutional, and "not here to decide if it's a good idea or not."

He may have a ruling as soon as Tuesday on whether the preliminary injunction will be granted, he said.

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With Affordable Care Act tax subsidies set to expire at the end of the year, many Marketplace enrollees say they will either shop for a cheaper plan or drop health insurance altogether if the subsidies disappear.

According to new data from KFF, one in four Marketplace enrollees said they would be very likely to go without insurance if their premiums were to double next year. KFF also found that a third of enrollees would shop for a cheaper plan.

KFF says that 22 million of the 24 million Americans enrolled in the Marketplace exchange receive tax subsidies. Those 22 million Americans would see their premium payments jump from $888 to $1,904 per year.

RELATED STORY | Congress has just weeks to decide whether to extend Affordable Care Act subsidies

The survey found that 58% of enrollees said they could not afford a $300 annual increase in premiums.

The poll shows the range of problems Marketplace enrollees will face if the enhanced tax credits are not extended in some form, and those problems will be the poster child of the struggles Americans are having with health care costs in the midterms if Republicans and Democrats cannot resolve their differences, KFF President and CEO Drew Altman said.

Those who use Affordable Care Actsubsidized plans have had their premiums capped based on total income. If a plan exceeded that cap, the enrollee received a tax credit.

RELATED STORY | White House circulates a plan to extend Obamacare subsidies as Trump pledges health care fix

The tax credit is set to expire because a provision in the Inflation Reduction Act of 2022 ends this year. Democrats have sought to extend the provision, but many Republicans have opposed continuing the subsidies.

Senate Democrats are poised to vote next week on extending the tax credits, but the bill is unlikely to gain traction in the House.

KFFs poll of enrollees found that 95% of Democrats, 84% of independents and 72% of Republicans favor extending subsidies.

Lawmakers on both sides of the aisle agreed during a Senate hearing Wednesday that something has to change to make health care affordable. But time is rapidly dwindling to reach a bipartisan fix.

"We've got to have a solution for three weeks from now," said Sen. Bill Cassidy (R-LA).

At the end of the year, Biden-era subsidies are set to expire for millions of Americans who receive their health care through the Affordable Care Act.

According to the nonpartisan Congressional Budget Office, without those subsidies 4.2 million more Americans will go without health insurance over the next decade.

Democrats largely want to extend those subsidies.

And some Republican lawmakers support extending the subsidies with changes, but the party in power hasn't agreed on a broader health care plan that could replace the Affordable Care Act.

Some, including Sen. Cassidy, are proposing a plan that would offer Americans more flexibility in how they use their health savings accounts.

RELATED STORY | Scripps News/Talker Research poll: Most Americans fear they cant afford health care

With just weeks before the deadline there's some pessimism that a deal can come together.

SCRIPPS NEWS' NATHANIEL REED: is there a bipartisan middle ground that could be reached with Republicans?

SEN. CATHERINE CORTEZ MASTO (D-NV): always. But it has to start on both sides, and right now the Republicans are in control.

"I think we'll probably have some vote of some kind on two dueling provisions, but again I'm not very optimistic that the Democrats are willing to reform a broken system," said Sen. Eric Schmitt (R-MO).

As lawmakers debate a path forward, health care will continue to stay in the spotlight.

A Scripps News/Talker Research poll found one in four Americans say health care is the most important issue facing the country today.

You may have heard reports hinting that President Donald Trump was open to extending subsidies for people on Affordable Care Act health insurance plans. He hasnt announced anything yet.

The Scripps News Group in Cleveland took a deeper look into how eliminating government funds for the ACA will affect real people. Around dining room tables across Ohio, people like Anne Griffith are trying to figure out health insurance for next year.

All rightlet me get into the website, she said while looking at her laptop screen.

FROM $240 TO NEARLY $1700

We first heard from Griffith about a month ago, when she thought her ACA premiums would go from $240/month to $1,200/month. However, after looking into it further, she said its closer to $1,700/month.

Health care should never be a political issue, said Griffith. It should be affordable. People in this country need health care. If you dont have it, you go bankrupt.

RELATED STORY | Congress has just weeks to decide whether to extend Affordable Care Act subsidies

Griffith said she retired a bit early to take care of her mom. She said that if the proposed ACA government subsidies are cut, theyll have to find the money somewhere else.

Well have to go into savings. Well have to look at retirement accounts, said Griffith.

REPUBLICANS SAY ACA IS NOT WORKING

Republicans have said the ACA isnt working, its not affordable, and taking away the subsidies proves that. Theyve said the added government money doesnt bring down the overall increasing costs of healthcare.

Kaiser Family Foundation reports ACA premiums were already going up 26% on average next year, but if there are no subsidies, its more like 114%.

DEMOCRATS FILED 'DISCHARGE PETITION'

This month, Democrats filed whats called a discharge petition, which, if they get enough representatives signatures, would force a vote on the House floor to extend the subsidies for the ACA.

We do need to find ways to make it more efficient and more affordable but whats happening with the end of these tax credits does neither one, said Representative Emilia Sykes (D-Ohio).

Too many people are seeing their gas, groceries, goods, housing, rent, utilities are all going up and now were going to add healthcare on top of that? questioned Representative Shontel Brown (D-Ohio).

IN CASE YOU MISSED IT | White House circulates a plan to extend Obamacare subsidies as Trump pledges health care fix

The Scripps News Group in Cleveland reached out to several Republican U.S. House representatives from Northeast Ohio, only Representative Dave Joyce replied, saying, in part, We need a model that actually delivers affordable, high-quality carenot one that allows insurance companies to keep driving premiums higher.

For Griffith, she said the lower-cost ACA plan has been a lifeline for her and so many others that Congress has to figure out soon.

They cant just rip stuff away from people andtoss em out, she told us.

WHAT WILL THE PRESIDENT DO?

Reports claimed the president had been open to extending the ACA subsidies for two years while capping income requirements and adding policies to address fraud.

Another idea has been to create health savings accounts, and government funds would be placed into those accounts for people to pay down on their premiums.

Scripps News Group in Cleveland.

The Ohio legislature is putting $40 million in cash into a state fund that promises direct financial help for firefighters, police and EMS first responders who suffer from a post-traumatic stress injury.

The measure was included in a broad spending bill known as House Bill 184, which awaits a signature from Gov. Mike DeWine before its confirmed into law.

Section 12 of the bill mandates the state, on July 1, 2026, or as soon as possible thereafter, to transfer $40,000,000 cash from the General Revenue Fund to the State Post-Traumatic Stress Fund, which lawmakers said was created in 2020 but has sat idle and unfunded ever since.

The fund, which H.B 184 will move under the Ohio Department of Public Safety, is designed to help cover wages for responders who become disabled by post-traumatic stress disorder incurred on the job, and to help cover the medical expenses incurred over the course of treatment.

Still, despite passing the appropriation, legislators on both sides of the aisle say theres plenty more work to do to actually get that assistance to afflicted first responders, given that theres no formal instruction in either administrative code or Ohio law that dictates how first responders can apply for help, or for how the fund should determine claims.

We are finally getting money into that fund, and this is important. But its also important that we dont go out and send out press releases saying that we fixed this problem, Rep. Bride Rose Sweeney, D-Westlake, said on the House floor before the vote.

Volunteer firefighter and local state Rep. Thomas Hall, R-Madison Twp., told this outlet he agreed with Sweeneys characterization on the floor. Still, he called the step a huge deal.

First responders see a lot of trauma, almost on a daily basis in some communities, Hall said in an interview. A lot of the stress and a lot of the trauma goes untreated.

He said the fund, once operational, will fill a gap present in Ohios Bureau of Workers Compensation program, which financially supplements employees physically injured on the job, but doesnt offer relief for mental trauma.

Ohio was one of the few states that didnt recognize the post-traumatic stress injury part of it for first responders, Hall said. So, these $40 million will go towards that, towards these traumatic scenes and situations these first responders respond to and have to leave there and deal with what theyve just seen.

Hall, who is one of a bipartisan group of lawmakers to recently champion the cause, said the next logical step is to hold discussions with first responders and their advocacy groups to determine how to set up a framework for the fund.

This was a huge step getting the funds, and after we got the funds its now, How do we actually see this working? Hall said, adding that he hopes to start discussions in the next few weeks and have a framework up within a year, year and a half, thats my goal.

Most pressingly, lawmakers will have to nullify a provision in the law that states there shall be no payments made from the state post-traumatic stress fund and that no person is eligible for any claims.

It is disturbing that were going to let this issue continue to go on, and I want to commend this body for moving this forward, Sweeney told her peers, but I urge all of us to give that commitment that were not just funding this, its not just another (instance of) moving-the-goal-line.

When lawmakers return to D.C. on December 1st, they'll have less than three weeks to debate and potentially extend Biden-era Affordable Care Act subsidies, which are set to expire at the end of this year.

The Senate is guaranteed to take a vote in the first two weeks of December on an extension of those subsidies, but it's not clear if that vote will pass. There's also no guarantee that bill comes up for a vote in the House of Representatives.

President Donald Trump told reporters this week he may be open to an extension for the subsidies. But in the same breath he criticized the act, which was one of former President Barack Obama's signature legislative accomplishments.

"Somebody said, I want to extend it for 2 years. I don't want to extend it for 2 years. I'd rather not extend them at all. It may be some kind of an extension may be necessary to get something else done because the "Unaffordable Care Act" has been a disaster," President Trump said.

RELATED STORY | White House circulates a plan to extend Obamacare subsidies as Trump pledges health care fix

Republicans have long targeted the Affordable Care Act, seeking in President Trump's first term to repeal and replace it, but ultimately coming up short.

One solution Republicans have recently explored is putting funds directly into health savings accounts for Americans to help them pay down the higher premiums of Affordable Care Act plans without subsidies. But it's not clear that solution would be able to pass Congress with the bipartisan support needed to get to President Trump's desk before open enrollment expires.

According to an analysis by the nonpartisan Congressional Budget Office, if Congress does not pass an extension of the current subsidies, millions could lose their health insurance over the next decade, in part due to the higher price for insurance premiums.

The Trump administration announced this week that it will continue a Biden-era policy of negotiating lower medication costs for Medicare Part D recipients.

The Inflation Reduction Act, passed by Congress in 2022, allowed Medicare to negotiate drug prices. The law also set a $2,000 annual cap on out-of-pocket drug expenses for Medicare Part D enrollees.

After the federal government announced price caps on 10 popular medications in 2024, the Centers for Medicare & Medicaid Services said Tuesday it has negotiated lower prices for 15 drugs.

RELATED STORY | This Medicare tweak may save you $11 per month, but youll still pay more next year

The 10 drugs that the Biden administration said would be subject to price caps are scheduled to take effect in 2026. The 15 drugs announced by the Trump administration could see lower prices in 2027.

Among the medications the Centers for Medicare & Medicaid Services will negotiate lower prices for are popular weight-loss and diabetes drugs such as Ozempic, Rybelsus and Wegovy. The list price for a 30-day supply is $949; the agency said it has negotiated the cost down to $274 for Medicare Part D recipients.

Almost 2.3 million Medicare Part D recipients received these medications in 2024.

Another popular drug, Trelegy Ellipta, was among those with lower negotiated prices. The Trump administration said the list price for a 30-day supply is $654, but it will fall to $175 for Medicare Part D enrollees.

Drugmakers that do not participate in negotiations would be required to withdraw their drugs from the Medicare program or pay an excise tax of at least 65% of their U.S. sales.

Companies can either accept the government's proposed prices or submit a counteroffer.

After the first round of negotiations in 2024 and the second round in 2025, the government plans to negotiate prices for 15 additional drugs in 2026 and 20 more in 2027. Medicare is expected to reach pricing agreements on 60 drugs over four years, with new prices taking effect by 2029.

A full list of drugs is available and their negotiated prices are on the Centers for Medicare and Medicaid Services website. 

President Donald Trump appears to have a health care plan one he teased during the debates but pushback from some Republican lawmakers has stalled its rollout.

Reports indicated the plan would be announced this week. However, House Speaker Mike Johnson was reportedly part of the opposition to Trumps proposal, which included a two-year extension of certain Affordable Care Act tax credits. That same extension has been the focus of Democratic-led legislation on Capitol Hill, though efforts have not yet succeeded.

RELATED STORY | White House circulates a plan to extend Obamacare subsidies as Trump pledges health care fix

Currently, a petition in the House seeks to force a vote on the ACA tax credit extension. However, support within the Republican conference appears fractured.

"We need a longer-term plan because health care is unaffordable," Nebraska Congressman Don Bacon told Scripps News. "I mean, the ACA keeps requiring more and more tax dollars to prop it up."

Bacon said any extension should come with income caps and accountability for premium reductions.

"If we're going to do an extension, we're going to have to have some kind of income caps, I believe, and somebody to assure that every dollar spent on these premiums or these tax credits lowered premiums," he said. "And right now about a third of that money is not."

RELATED STORY | Premium Pain: Why your health care monthly premium is going up & what you can do about it

Republican Congressman Mike Flood, who chairs the Republican Main Street Caucus, expressed support for Trumps efforts to address the expiring ACA tax credits.

"Any effort to address this cliff needs to include income caps and make serious reforms to the credits, including addressing the rampant fraud and abuse in the program," Flood said in a statement. "Our caucus is committed to working with President Trump, our House leadership, and the committees of jurisdiction to find a solution that can pass Congress before the end of the year.

Democrats, meanwhile, will need to back any deal to pass legislation by years end.

A new bill proposed by an Ohio Republican lawmaker would revoke the brand new ability for high school athletes to be compensated for their Name, Image and Likeness. Just Monday, the state's student athletic association announced it had voted to allow for the NIL deals.

The legislation, shared with us, is sponsored by state Rep. Adam Bird (R-New Richmond). It states that high schoolers can't participate in NIL deals like basketball superstar Marcus Johnson.

"Its a blessing from God," Johnson told us earlier this year about his athletic ability and winning awards.

He has national recognition, fans screaming for him at games and tens of thousands of followers on Instagram.

"We have received a lot of offers from clothing lines to drinks, drink companies," Sonny Johnson, Marcus' father and coach, said.

But he hasnt accepted any deals, since hes only a senior at Garfield Heights. But Sonny is thrilled that athletes like Marcus and their families will now get a chance for a slam dunk.

"If you can get a kid that could get a couple thousand dollars without the parents having to give it to him, it saves us some groceries," Sonny said, laughing.

The Ohio High School Athletic Association (OHSAA) announced Monday that it passed new bylaws that allow the high school athletes to be compensated through appearances, licensing, social media, endorsements and/or the use of branding based on their public recognition or notoriety.

RELATED: OHSAA membership high schools approve name, image and likeness proposal

It also establishes limitations so that athletes do not hurt their eligibility when it comes to recruiting.

"Having NIL in Ohio would definitely be great for me and my family," Marcus said.

But those opportunities may be blocked.

"Earning money is not what Ohio high school sports is about," Rep. Bird said.

Less than 24 hours after the announcement, the Republican lawmaker proposed a bill to ban NIL deals for high school student-athletes.

"We want our sports to be about character development and leadership and fitness and social connections and all of those kinds of things and not creating even more pressure for our students," Bird continued.

Students shouldnt be earning more than coaches and referees, he said, and the athlete's focus shouldn't be on endorsements.

"When you're using public money to create gymnasiums and stadiums and weight rooms, we should be using that publicly paid-for facility for those kinds of things and not for the athlete to be earning NIL money," the lawmaker said.

Sonny said opponents to NIL dont understand. Marcus added that 44 other states already approve of NIL for high schoolers.

"I've just seen a lot of talent leave Ohio... A lot of talent that want to experience other places because they have NIL," Marcus said.

The bill is in the early stages and isnt expected to be heard for several months. Still, athletes hope it's an airball.

This debate stems from a court case.

A Franklin County high school football player's mother filed a lawsuit against the OHSAA in mid-October, arguing that students should be permitted to make money from their image. Her son had already missed out on more than $100,000 in potential NIL deals, the mom said.

RELATED: For 45 days, Ohio high school athletes can cash in on Name, Image and Likeness deals

Franklin County Common Pleas Court Judge Jaiza Page issued an order in late October, allowing students to make money.

Thus, OHSAA had an emergency referendum vote. It passed.

WEWS

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