The head of Illinois’ Medicaid program told lawmakers Wednesday they are working “really hard and scrambling” on an application to receive a slice of $50 billion in federal funds to support rural health providers affected by the recent tax and spending plan. [Health News Illinois]

Department of Healthcare and Family Services Director Elizabeth Whitehorn told members of the Appropriations-Health and Human Services Committee that the application to the Centers for Medicare and Medicaid Services will highlight the state’s funding needs.

Applications are due by Nov. 5, with winners to be announced by the end of the year.

Whitehorn said the first $25 billion will be awarded to all states that submit an approved application. The second $25 billion will be allocated based on a “complex rubric of factors” that includes rural data and other policies that align with the Trump administration.

“We have been working really hard and scrambling to pull together an application that is reflective of what our stakeholders in Illinois have identified as needed in rural areas, and is responsive to the (notice of funding opportunity) so that we can bring in as much funding as possible to Illinois,” she said.

The application has been crafted through written public comments from over 100 organizations and other stakeholders, Whitehorn said, as well as public listening sessions and calls with organizations affected by the federal cuts.

However, she stressed the funds are far from what is needed to make up for the loss of funds that rural providers are expected to see as part of the cuts to the Medicaid program and other federal reductions.

In order to replace the anticipated state provider tax revenue reductions and loss of federal financial support, Whitehorn said Illinois’ General Revenue Fund contribution to the Medicaid program would need to increase by $1.7 billion annually by the 2031 fiscal year.

She noted a KFF report that found Illinois will be the hardest-hit state by the provider tax changes.

Whitehorn said they are working with Gov. JB Pritzker’s office, the Department of Human Services and other agencies and partners to build an operational plan that aligns with the efforts to implement work requirements for the Supplemental Nutrition Assistance Program, which are set to go into effect in December.

“The principles that will guide us through implementation… (are) ensuring Illinoisans receive and maintain the healthcare coverage and benefits they qualify for, ensuring the Medicaid program maintains the ability to cover as many services as possible and to mitigate as much harm as possible,” Whitehorn said.

She reiterated that they estimate that between 270,000 and 500,000 Illinoisans are expected to lose Medicaid coverage due to the work requirement, many due to the administrative burden.

The provision requires states to implement work requirements for many adults without young children in the program by 2027. Members would have to work 80 hours a month.

An analysis by KFF found Illinois could lose $46 billion in federal Medicaid funding over the next 10 years due to the law. The majority of federal savings stem from Medicaid work requirements for some adults, as well as limits on states’ use of provider taxes to draw down more federal dollars.

HFS has said their internal projects for most of the provisions say the losses over the next decade will be at least $52 billion in Medicaid expenditures.

Lawmakers heard Wednesday morning from health leaders and other individuals set to be impacted by the changing healthcare landscape.

“We continually are asked to do much with less, and we continue to do that,” said Illinois Primary Health Care Association CEO Ollie Idowu. “But even the most efficient organizations cannot, just cannot continue to sustain the continued erosion of funding and patient coverage.”

Along with an estimated hundreds of thousands of community health center patients losing access to primary care, dental care and behavioral health services, Idowu said some of his members face closures if things do not change.

Committee Chair Anna Moeller, D-Elgin, warned of a potentially “grim” future as state lawmakers work through the policy changes and the expected loss of billions to support health services.

“We know there are statistics… mortality rates go up when our uninsured rates go up, and that's a grim reality that we have to deal with,” she said. “And I know that at the state level, we're going to try to do what we can to prevent that.”

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On September 22, the FDA issued an alert to physicians nationwide that the use of acetaminophen by pregnant women may be linked to an increased risk of neurological conditions, such as autism and attention-deficit/hyperactivity disorder (ADHD), in their children. The agency also initiated the process for a label change to products containing acetaminophen, most notably Tylenol, which remains the only over-the-counter medication approved for treating fever in pregnancy.

The FDA cited 2 cohort studies in a press release explaining its change in guidance but acknowledged that a “causal relationship has not been established.” Despite this, it suggested that clinicians should consider recommending that their patients minimize the use of the drug for routine, low-grade fever.

The same day, during a press conference, Trump urged pregnant women not to take Tylenol and encouraged them to “tough it out.”

Following these developments, the World Health Organization issued a statement emphasizing that, although extensive research—including large-scale studies—looking into links between acetaminophen use during pregnancy and autism has been undertaken during the past decade, no consistent association has been found.

The study published in JAMA in April 2024 is among the most recent to investigate this question. In it, researchers followed up 2.5 million children born in Sweden between 1995 and 2019 for more than 2 decades. Using sibling controls to account for genetic and other environmental cofounding factors, they found no increased risk in autism, ADHD, or intellectual disabilities in the children of women who used acetaminophen during pregnancy.

To provide clarity on this issue, JAMA Deputy Editor Linda Brubaker, MD, MS, an obstetrician-gynecologist, spoke with the study’s senior author, Brian Lee, PhD, a professor of epidemiology at Drexel University Dornsife School of Public Health. They discussed the study’s methods and findings, the importance of scientific rigor in investigating these questions, and the potential effects on patient care that come with discouraging acetaminophen use during pregnancy.

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Illinois falls in the middle of the pack when it comes to state rates of adult obesity, according to a recent report from the Trust for America’s Health. [Health News Illinois]

About 34.2 percent of Illinois adults are obese, tied with Pennsylvania for 24th in the country.

Additionally, 12.9 percent of Illinois adults have diabetes, which is 19th overall. About 22.7 percent of adults are physically inactive. While that places Illinois 14th in the nation, the report indicates the rate is a "significant increase” from the prior year.

Racial disparities remain in Illinois related to obesity.

Just over 43 percent of Black Illinois adults are obese, the 14th highest rate in the nation. Additionally, 38.7 percent of Latino adults in Illinois are obese, which is tied for the sixth-highest rate.

About 33.6 percent of white adults, 34.6 percent of Native Americans and 11.6 percent of Asian adults in Illinois are obese.

West Virginia has the highest rate of adult obesity at 41.4 percent, and Colorado has the lowest at 25 percent. 

According to the report, obesity levels are tied to social and economic conditions, and those with lower incomes are more at risk. People of color, who are more likely to live in places with fewer options for healthy foods and physical activity, are more at risk.

The report also warns that changes coming from the federal government, including cuts to the Medicaid program and Supplemental Nutrition Assistance Program are likely to impact healthcare negatively.

It notes that while there has been a larger focus on ultra-processed foods and other potential causes of obesity by the Trump administration's health agencies, “many recommendations are framed as voluntary actions by industry and other sectors, rather than enforceable policies.”

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Earlier this month, California Gov. Gavin Newsom (D) signed the "Real Food, Healthy Kids Act" into law, directing the state's Department of Public Health to identify "ultra-processed foods" (UPFs) and ban them from schools by 2035. In doing so, the law proposed a new framework for a food category whose definition has been elusive up until now. [MEDPAGE TODAY]

The law is a mixed bag, with helpful and unhelpful aspects. It targets foods high in saturated fat, sodium, or added sugar that also contain certain additives: flavors, colors, non-nutritive sweeteners, emulsifiers, or thickeners. Exempt from the ban are pasteurized milk, raw agricultural products, eggs, and reduced-fat cheese or part-skim mozzarella cheese.

To physicians, broad UPF bans may raise potential red flags.

In reference to the Make America Healthy Again (MAHA) campaign targeting UPFs, David Ludwig, MD, PhD, a professor of Pediatrics at Harvard Medical School, wrote in the Washington Post, "Ultra-processed food has replaced fat as the new dietary villain...The rush to enact these measures could cause more harm than good." The MAHA report on childhood health released in May is a precursor to the nutritional guidelines update expected this fall.

Meanwhile, American Medical Association President Bobby Mukkamala, MD, pointed out that, while some UPFs have little nutritional value, others are beneficial, such as folic acid-enriched cereal. This also applies to grain products that are part of the highly successful FDA-mandated effort to prevent neural tube defects, and vitamin B12 fortification, which is intended to prevent pernicious anemia. UPF bans may target breads, breakfast cereals, and other products that pose no demonstrable health threat, while exempting fat- and cholesterol-laden dairy products and meat, which are, not coincidentally, among California's leading agricultural products.

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The effects of lead on child mental and behavioral problems have been the subject of considerable research for decades. Numerous meta-analyses have summarized the adverse effects of lead exposure, concluding a likely causal relationship between prenatal or early childhood lead exposure and various intellectual and psychological outcomes in childhood and adolescence.^1-6 [JAMA]

Early lead exposure is also known to increase the risk of attention-deficit/hyperactivity disorder (ADHD) in children,⁶ a condition that is an established risk factor for adult depression.⁷ However, no studies have directly examined whether early lead-related psychological concerns persist into later adulthood, where psychiatric disorders are major risk factors for disability and mortality. Since early lead exposure can cause deficits in brain structure and function in limbic system structures, like the frontal cortex, amygdala, and basal ganglia,^8-11 regions that are implicated in behavioral regulation and mood, it is biologically possible that such exposures could have long-lasting effects on psychopathology, such as depression and anxiety, which cause substantial morbidity in the general adult population.^12,13

^{...Conclusions and Relevance  Third-trimester lead exposure was associated with higher risk of major depressive disorder and anxiety symptoms in later adulthood. These findings emphasize the importance of factoring in later life health outcomes when considering the benefits of lead exposure interventions in childhood and suggest investment in screening and mental health services may be needed to address the long-term burden of historical lead exposure.}

Full article, more>

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Keeping your mouth healthy may help keep your heart and brain healthy too, according to new research. [CBS]

In a study published Wednesday in Neurology Open Access, researchers found adults with gum disease may be more likely to have signs of damage to the brain's white matter than people without gum disease.

"Gum disease is associated with a higher chance of inflammation, and inflammation has been tied to atherosclerosis as well as hardening of the small blood vessels, as we saw in this study," study author Dr. Souvik Sen told CBS News. Arteriosclerosis is a disease that causes abnormal thickening of the artery walls.

In another study led by Sen and published in the same journal Wednesday, researchers found having both gum disease and cavities is linked to an 86% increased risk of stroke compared to people with healthy mouths.

"What the study suggested was that if you have cavities on top of gum disease, it is double trouble. It means your risk of stroke or adverse heart event doubles," Sen said.

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A state health committee to set guidance on vaccine policy will continue to meet and respond to potential changes coming from the federal government. [Health News Illinois]

Dr. Arti Barnes, the chief medical officer at the Illinois Department of Public Health, said during a Tuesday Health News Illinois event on vaccine policy that the agency’s Immunization Advisory Committee will continue to discuss recommendations made at the federal level and whether those guidelines “will work for the people of Illinois.”

Last month, IDPH’s Immunization Advisory Committee approved new fall vaccine guidance that recommended COVID-19 vaccines for all adults and most children.

It also recommended COVID-19 vaccine recommendations for those between 6 and 23 months old, and for children between 2 and 17 years old if they are in a higher-risk category or if parents want them to have the vaccine.

The guidance also covers RSV immunization and flu vaccinations.

The guidance, adopted by IDPH, contrasts with that from the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices, which voted on a more restrictive approach to coronavirus vaccines by recommending that everyone consult a clinician before getting a shot. 

The federal committee is expected to meet later this year and could potentially approve delaying the birth dose of the hepatitis B vaccine.

“Whether the Illinois organization decides to meet and when will really hinge on the need to react and respond to what's happening at the federal level,” Barnes said.

The expansion of the state committee is among the steps the Pritzker administration has taken to expand Illinois’ role in vaccine policy.

Gov. JB Pritzker issued an executive order last month that orders IDPH to develop contingency plans to maintain access to vaccines for eligible children “if federal disruptions threaten inventory.” 

They were also tasked with issuing a standing order to allow eligible providers in pharmacies and other clinical settings to administer vaccines recommended by the agency.

Barnes said Tuesday that there was a “lot of hesitation” about IDPH taking more of a role in issuing vaccine guidance, but the feedback from providers and patients has been overwhelmingly positive.

Jennie Pinkwater, CEO of the Illinois Chapter of the American Academy of Pediatrics, said the move has allowed their members to “feel comfortable” providing vaccines to patients, including those off-label.

She said they will continue to push policymakers to support vaccine policies, but they recognize the challenges at the federal level.

“There is an attack on the entire process around vaccinations, which just can be very hard to influence,” she said.

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In their public pledges to tackle chronic disease in the United States, federal health leaders have made few mentions of women’s health. As a clinician who has spent a career focused on how science can better serve women, I have found this lack of attention unsurprising. Reference to the female reproductive tract still too often provokes discomfort among decision-makers, leading women’s health to be deprioritized, then ultimately neglected. Within the National Institutes of Health (NIH), despite decades of policy to advance the topic, research specific to the health needs of women has remained an afterthought. Support for women’s health research from the NIH, consistently less than 10% of the overall budget, has been declining.¹ 

[JAMA]

For the NIH to continue to overlook women’s health, when a primary goal of the “MAHA” movement is to end rising rates of chronic disease, would be a tragic missed opportunity. Women are more likely than men to be diagnosed with a chronic illness or multimorbidity—the coexistence of 2 or more unrelated chronic diseases. Women also uniquely experience chronic gynecologic disorders that have historically been dismissed as a niche concern by the biomedical community.²

Women’s health was at one time considered a crucial component of medicine. In 1893, when the Johns Hopkins School of Medicine was founded as the model for modern medical education, gynecology was 1 of 4 original pillars.³ Alongside medicine, surgery, and pathology, the field was delineated as essential for a complete understanding of the human body. While other specialties subdivided and grew increasingly subspecialized, the scope of gynecology broadened. Its first merger was with obstetrics, and the second was with primary care for women. The ostensible goal was comprehensive care for women. But within the persistently male-dominated world of medicine, gynecology has been diluted, siloed, and diminished in stature.⁴

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Each year, National Lead Poisoning Prevention Week (NLPPW) is a call to bring together individuals, organizations, industry, and state, tribal, and local governments to increase lead poisoning prevention awareness to reduce childhood exposure to lead. Review activities and resources for the 25th annual National Lead Poisoning Prevention Week. [CDC]

IOMC -Pathways to Lead Exposure- Protecting Children, Family and Communities is one of IOMC's programmatic areas of focus. Visit this page>

IOMC is pleased to support its strategic partner, The LARC Foundation in their effort of 'progress against childhood lead poisoning.'

From lead pipes and drinking water to paint, there's a wealth of information available. 

WEBINAR: You are invited to attend the webinar on October 30, 2025, at 7:00 PM CT - "Don't Be Mis-Lead: Pathways to Lead Exposure – Protecting Children, Families & Communities." Free Webinar. More details and to register>

In children especially, a positive blood lead level results in cognitive impairment and a lifetime of mental and physical health challenges. There is no acceptable level of lead exposure.

The Lead Abatement Resource Center Foundation (LARC Foundation) is an independent nonprofit organization (501c3) dedicated to eliminating positive blood levels in children. LARC does this through education, advocacy, and research on the child, the family, and the community.

The LARC Foundation is engaged in a broad lead awareness campaign focused on communities where there is a known propensity of measured blood lead levels in children.

CDC has information available and activities this week. Visit this page>

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The city has adopted a ‘multifactorial approach to a multifactorial problem’ and has seen a 37% reduction in deaths since the national peak of the crisis {KFF Health News & The Guardian]

 Overdose in America: analysis reveals deaths rising in some regions even as US sees national decline. 

Among US counties containing the nation’s 10 largest cities, Cook county, Illinois – where Chicago  is located – has seen the largest reduction in overdose deaths since the national peak of the crisis in 2023, by 37%, according to an exclusive Guardian analysis.

Chicago has one of the most robust drug supply surveillance and overdose prevention response systems in the nation. Jenny Hua, medical director for the Chicago department of public health, hesitated to take full credit for the progress, explaining that many factors influencing overdose deaths are beyond any one health department’s control. It’s also easier to have a coordinated response in a big city, where people and resources are concentrated. Changes to the drug supply are also affecting regions differently.

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