Health Equity blog

A study published in Health Affairs found that a significant number of physicians enrolled in Medicaid never see a Medicaid patient – so-called “ghost” physicians. The research indicated participation in Medicaid varied widely by specialty. For example, more than 40% of psychiatrists were “ghost” physicians who saw no Medicaid enrollees in a given year, in contrast to primary care physicians, who were most likely to be high-volume “core” Medicaid participants. Other research has noted that Medicaid enrollees have a disproportionately higher need for mental health services compared to the overall patient population, which makes this statistic even more daunting.

Entering into the third year of a 5-year cooperative agreement executed by the Centers for Disease Control and Prevention (CDC), American Indian and Alaska Native (AI/AN) tribes across the country have received $82.5 million in funding to strengthen the performance, quality, and infrastructure of their tribal public health systems. The funds enable recipient tribes to improve their capacity to implement, develop, and evaluate public health programs and services for their communities.

On Feb. 3, the President signed into law a funding bill that largely left intact the Department of Health and Human Services’ (HHS) FY 2025 budget heading into FY 2026. Notably, the bill also included extensions for several expiring health care provisions including telehealth waivers, delay of Medicaid Disproportionate Share Hospital (DSH) cuts, extension of community health center funding, and the hospital at home program.

Although there have been numerous developments in the gender-affirming care space, two recent California-specific updates involve litigation in this area grounded in distinctly different legal theories. On Jan. 2, the Department of Justice (DOJ) reached an agreement with families who sued over DOJ’s subpoena of medical and personal information, among other records, for more than 3,000 pediatric patients seeking transgender care from Children’s Hospital Los Angeles. Under the agreement, the DOJ agreed to accept deidentified documents, as defined under the HIPAA Privacy Rule, and to provide advanced notice if it seeks these records (either through a new Subpoena or rescinding its instructions to CHLA to redact information) prior to Feb. 1, 2029. Later in January, the California Attorney General (AG) filed a lawsuit against Rady Children’s Health located in San Diego, alleging that Rady violated its commitment to continue providing gender-affirming care to its pediatric patients through 2034. The agreement was one of the requirements the AG’s office placed upon Rady in approving its merger with Children’s Hospital of Orange County in Nov. 2024. Most recently, the court granted the AG’s request for an order requiring Rady’s to continue to provide certain gender-affirming care through March 10, when another hearing will occur.

Adolescents and young adults are increasingly turning to AI chatbots in hopes of addressing their mental health issues. A recent study published in JAMA Network Open found that amid the ongoing youth mental health crisis – 13.1% of youths (≈ 5.4 million) relied upon generative AI for mental health advice. But such reliance on chatbots is concerning, particularly for youth with more critical and complex mental health needs, because, as the study noted, there is little benchmarking or insight into how the underlying models and algorithms are derived. Recent lawsuits claiming ChatGPT directly caused patients’ suicides highlight the controversy surrounding these largely untested approaches to self-help treatment.

The Department of Justice (DOJ) released a memo on Dec. 18, 2025, that prohibited the Department of Veterans Affairs (VA) from providing any abortion services to veterans and their dependents, even those previously excluded from the VA abortion ban when their health is threatened by carrying a pregnancy to term or if the pregnancy is due to rape or incest. Subsequently, the VA allegedly issued its own internal memo, advising VA officials that it must comply with the DOJ policy. This is consistent with the VA’s Aug. 2025 proposed rule (which has not yet been finalized) to reinstate its full exclusion on abortions and abortion counseling from the VA’s medical benefits package. Until 2022, this exclusion was consistently in place since the VA first offered this medical benefits package in 1999.

A recent study published in JAMA Surgery determined that, among working-aged adults, uninsured and privately insured patients face severe financial hardships following surgery, whereas Medicaid beneficiaries are largely shielded from these effects. These findings indicate that, without changes to improve financial risk protection, restrictive policies on Medicaid eligibility may increase financial hardship among working-aged surgical patients.

On Jan. 14, 2026, the Centers for Medicare & Medicaid Services (CMS) published a “notice of opportunity for hearing”, which would allow Minnesota representatives to appear before CMS to respond to its findings that Minnesota has fallen substantially out of compliance with federal Medicaid requirements due to numerous instances of fraud and waste, particularly among its social services offerings. CMS’ findings will be the basis for withholding federal financial participation from Minnesota’s Medicaid program, which will only end when Minnesota’s Medicaid agency implements an acceptable corrective action plan to bring its program integrity back into compliance with federal requirements concerning the identification, reporting, and investigation of suspected fraud.

GLP-1s (e.g., Ozempic) have been widely praised for their use in treating Type 2 diabetes and for their weight loss benefits. However, new reporting indicates that older adults are stopping these drugs at unusually high rates, often within just a few months of starting them. Many adults 65 and older discontinue GLP‑1s due to high costs and limited insurance coverage, particularly because Medicare generally does not cover these medications when prescribed solely for weight loss. Others stop because of gastrointestinal side effects and concerns about losing muscle and other lean mass, a risk that is especially significant for older adults who already experience age‑related declines in muscle strength. As a result, many older patients who discontinue GLP‑1 therapy regain weight and lose associated health benefits, underscoring the need for careful clinical monitoring and more sustainable coverage pathways for this population.

CMS announced the ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model, which will run for 10 years nationwide. The voluntary model will focus on a payment approach designed to expand access to technology-supported care in patients with chronic conditions initially including early cardio-kidney-metabolic, cardio-kidney-metabolic, musculoskeletal, and behavioral health. More information will be released the coming months, but a detailed FAQ is available. This model can be followed through our Digital Health Blog.