About 20% of respondents reported a coverage denial for recommended care

One in five adults with private insurance was denied coverage for themselves or a family member for care their doctors recommended, according to a Commonwealth Fund report published on Thursday. [MEDPAGE TODAY]

Among more than 4,500 adults with private insurance who responded to a healthcare affordability survey, 21% reported a coverage denial in 2025. Of those receiving denials, 13% received prior authorization denials, 8% received claim denials, and 1% received both.

"When delivering healthcare, the goal is to get patients what they need, when they need it -- and decisions about care should be guided by the clinicians and care teams who understand their patients best," said Joseph Betancourt, MD, MPH, president of the Commonwealth Fund, in a press release.

Betancourt, an associate professor of medicine at Harvard Medical School in Boston, noted that he recently recommended an endoscopy for a patient experiencing gastrointestinal problems. A prior authorization request for the procedure was denied twice. After some discussion with the insurer, the procedure was covered -- but with a significant copay.

"For the 5 days that we're waiting for pathology, you're sitting on pins and needles, because you know that denial potentially can cost your patient their life," he said.

Betancourt added that he often sees prior authorization denials for diagnostic procedures, and increasingly for medications, including GLP-1 receptor agonists.

"It's really challenging, because we are seeing the development of these new and very effective therapeutics, but our ability to get them to patients is often limited by these prior authorization approvals, and obviously by the price," he said.

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As America Turns 250 Years Old, the Census is Not Far Behind at 236
For 236 of America’s 250-year history, the census has measured our nation’s population. It has also tracked our values, interests, and changes in the way we live. [United States Census Bureau]

Census questions, how they’re asked and of whom, capture what’s important to American society.

Housing, employment, slavery, manufacturing, immigration, voting access and more. Public demand for information on these topics has fluctuated over the course of American history, punctuated by the census count at the start of each decade.

How did events like the Westward Expansion, the Civil War, the Great Depression and the Civil Rights Movement change the census — and how did it adapt over time?

The framers of the Constitution tied apportionment of the U.S. House of Representatives to a once-a-decade population count, starting with the nation’s first census in 1790.

We view the nation’s evolution through the prism of every decennial census since.

The Census Act of 1790 was passed by the First Congress and signed by the nation’s first president, George Washington.

On August 2, 1790, U.S. Marshals began collecting the names of each head of household along with a count of all free White men age 16 and older, free children under age 16, free White women, and all other free and enslaved people.

Most American Indians were not enumerated between 1790 and 1850. Their relationship to federal census-taking would evolve over American history.
The first census took 18 months to complete.

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Gov. JB Pritzker signed a bill Monday intended to streamline how pharmacists are licensed in Illinois. [Health News Illinois]

The law, effective immediately, eliminates the need for practicing pharmacists to take a multi-state jurisprudence as a condition to receive their pharmacist licensure in Illinois.

Instead, individuals will be required to complete an approved examination program and assessment related to Illinois pharmacy law, which will be developed and provided by the Illinois Pharmacists Association.

Any program, test or assessment must be approved by the Department of Financial and Professional Regulation.

Another provision states that at least two hours of continuing pharmacy education must be in the subject of pharmacy law.

The Illinois Pharmacists Association thanked Pritzker and lawmakers for their support of the “important modernization effort” related to pharmacist licensure.

“Together, we are building a stronger future for pharmacy and the patients we serve,” the association said.

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Hypertensive disorders of pregnancy (HDP), including gestational hypertension and preeclampsia, have been associated with elevated blood pressure and higher risk of hypertension in offspring.¹ Lam et al² extended such observations to quantify the associations between in utero exposure to adverse pregnancy outcomes, including HDPs, and a comprehensive suite of cardiovascular health (CVH) measures in offspring as young adults. Within the Future of Families—Cardiovascular Health Among Young Adults (FF-CHAYA) study, investigators evaluated offspring for 20 years or longer after the original cohort enrollment at birth and linked their current CVH to information obtained from maternal delivery records and baseline questionnaires.³ In the analysis by Lam et al,² the offspring’s CVH measures, not surprisingly, were associated with exposures to HDP and other adverse pregnancy outcomes.

Adult offspring born to mothers who experienced HDP had an increase in mean diastolic blood pressure by 2.29 mm Hg (95% CI, 0.17-4.41 mm Hg) at age 22 years, among other cardiometabolic risk factors, such as an increase of 2.80 (95% CI, 1.07-4.53) in mean body mass index (calculated as weight in kilograms divided by height in meters squared) and 0.21 (95% CI, 0.02-0.41) percentage points in mean glycated hemoglobin level. Additionally, HDP exposure was associated with an increase of 0.02 mm (95% CI, 0.01-0.03 mm) in mean carotid intima-media thickness and a reduction of the mean carotid grayscale median by 3.68 (95% CI, 6.30-1.05), which are established objective measures of arterial injury. Gestational diabetes (GD) and preterm birth were also associated with blood pressure and vascular stiffness measures, although these estimates were imprecise and less consistent than those for HDP. [JAMA Network] 

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The US Centers for Disease Control and Prevention recently removed annual influenza vaccination from its childhood recommendations,¹ citing concerns about lack of contemporaneous randomized data to support annual influenza vaccination and historical reliance on observational data to support vaccine efficacy (ie, annual comparisons of influenza vaccination rates among individuals with influenza-like illnesses testing positive vs negative for influenza), which may be confounded.^2,3 One way to use observational data to assess annual influenza vaccine efficacy in children that is less susceptible to confounding is to identify instances in which some children are, by chance, vaccinated while others are not—a natural experiment.^{4  [JAMA Pediatrics]}

Young children tend to have annual well-child visits timed around their birthday. This visit can be a convenient opportunity for influenza vaccination among children with birthdays in the fall, when the vaccine for the upcoming season is available at a well-child visit. In contrast, children with summer birthdays (and summer well-child visits) must make an additional appointment to get vaccinated, leading summer-birthday children to be effectively randomized to a more burdensome pathway to vaccination compared with otherwise similar children with fall birthdays. Prior research has shown that children aged 2 to 5 years who have a fall birthday are both more likely to receive influenza vaccination and less likely to be diagnosed with influenza compared with children with summer birthdays, despite both groups of children being similar on a broad range of observable characteristics—quasi-experimental evidence of vaccine efficacy.⁴ We used this natural experiment to assess the efficacy of influenza vaccination in several recent individual influenza seasons.

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The US Centers for Disease Control and Prevention (CDC) reported that drug overdose deaths decreased in 2025, marking the third consecutive year of decline. [JAMA Network and CDC]

According to provisional data from the CDC’s National Center for Health Statistics, fewer than 70 000 drug overdose deaths occurred in the US during 2025, a decrease of nearly 14% from the 81 000 deaths estimated in 2024. Almost all states experienced reductions, with deaths in Alabama, New York, North Carolina, Rhode Island, and Vermont declining 25% or more. In Arizona, Colorado, and New Mexico, however, drug overdose deaths increased by 10% or more from 2024 to 2025.

The downward trend was driven by a reduction in deaths involving opioids, which decreased from about 55 000 in 2024 to less than 45 000 in 2025. Overdose deaths involving cocaine and psychostimulants—such as methamphetamine—also declined.

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Health care costs in the U.S. have steadily increased over time. For instance, Americans’ average annual out-of-pocket health care spending has risen from $811 to $1,514 over the past two decades, outpacing inflation. [WalletHub  & Becker's Hospital Review] 

To identify where residents spend the largest share of their income on health care, WalletHub analyzed the prices of five key health care components across all 50 states, then combined those costs and compared them with each state’s median household income.

“Sharp increases in health care costs in recent years have made it difficult for some people to seek essential care. Even in states with lower-than-average health care prices, residents’ incomes may not be enough to keep up with the cost, especially since virtually every part of Americans’ budgets have been impacted by inflation over the past few years.”

Chip Lupo, WalletHub Analyst

FYI - Illinois...

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Becker's Hospital Review> 

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Gov. JB Pritzker joined health officials Wednesday to discuss the state's ongoing efforts to address youth mental health challenges. [Health News Illinois]

“Mental health will be defined as one of the most impactful issues of our time, and I am committed to ensuring Illinoisans can access the care they deserve,” Pritzker said. “As we continue to develop new policies to protect and support our people, it’s vital to hear from youth across the state about their unique experiences and uplift their voices.”

Among the state efforts highlighted include the creation of the Division of Mental Health and Recovery within the Department of Human Services to unify mental health and substance use prevention programs.

Illinois has also appointed Dana Weiner as the chief officer for Children’s Behavioral Health Transformation, who has helped to launch a statewide portal to connect families with youth mental health services.

The state is also working to implement free universal mental health screenings in Illinois public schools by the 2027 school year.

“Young people across Illinois are facing real mental health challenges, and it’s our responsibility to make sure support is accessible, coordinated, and centered around their needs,” Weiner said. “Bringing partners together in this way helps ensure students and families can get connected to the right supports.”

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GENEVA — The number of cases of hantavirus linked to a cruise ship at the center of an outbreak has increased to 13, the head of the World Health Organization said on Wednesday. [NBC News] 

“Spain reported a new case among the passengers who are in quarantine, which brings the total number of cases to 13,” WHO chief Tedros Adhanom Ghebreyesus said in a post on X.

Among them, three died, but there have been no new deaths since May 2, Ghebreyesus said.

“The situation remains stable. Passengers who got sick are receiving needed care, while others remain in quarantine,” Ghebreyesus said.

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Other news- Ebola Virus>

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The FDA's vaccine advisors will meet Thursday to vote on whether an XFG monovalent vaccine should be preferred for COVID-19 shots for the 2026-2027 season. [MEDPAGE TODAY]

The Vaccines and Related Biological Products Advisory Committee (VRBPAC) will also discuss what circumstances would warrant a non-JN.1 lineage variant -- such as BA.3.2, also called "Cicada" -- for next season's vaccines.

In an FDA briefing document, the agency noted that in the U.S., descendants of the JN.1 variant of Omicron remain prominent and have diversified into multiple lineages, including XFG, NB.1.8.1, and LF.7.

All major manufacturers (Pfizer, Moderna, Sanofi) have indicated they are "prepared to produce an XFG vaccine" for the 2026-2027 season, according to the agency.

While XFG variants remain dominant, the BA.3.2 variant began to pick up steam globally last fall and reached a prevalence of 30% in some European countries, even though it remains a minor variant in the U.S.

BA.3.2 has more than 70 substitutions and deletions in the spike protein relative to JN.1 descendants, according to FDA staff. Yet available phenotypic data suggest that its "limited expansion is consistent with reduced intrinsic fitness, including weaker ACE2 binding, lower infectivity ... and modest replication capacity relative to [JN.1 variants], despite substantial antigenic drift and antibody escape."

The FDA document also noted that datasets show a higher proportion of BA.3.2 sequences from pediatric patients.

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