Health Equity blog

A study by the West Health-Gallup Center on Healthcare in America released on March 12 found that as many as one-third of U.S. citizens – including many with six-figure incomes – are facing growing financial challenges with continuing to afford vital health care services. Rapid inflation in recent years, as well as looming loss of coverage due to Affordable Care Act (ACA) subsidies sunsetting and cuts in Medicaid, are all combining to create a cauldron of economic woes. A third of the individuals surveyed reported making at least one trade-off with daily living expenses, such as skipping meals and reducing utility usage, to pay for their health care.

A new JAMA Internal Medicine study found that a national policy correcting race-based kidney function estimates was associated with higher kidney transplant rates for Black patients. After implementation of Organ Procurement and Transplantation Network (OPTN) wait time modifications in 2023, transplant rates among Black candidates increased by 5.3 transplants per 1,000 listings—without reducing access for other racial or ethnic groups. The authors suggest these findings that targeted policy changes to remedy harms from race-based medicine can meaningfully reduce inequities in kidney transplantation.

Health systems and physicians are reporting concerns that crackdowns by Immigration and Customs Enforcement (ICE), particularly in metropolitan areas, such as Minneapolis, are making immigrants afraid to leave their home. This fear has led to a significant increase in missed medical appointments and fewer vaccines administered to immigrant populations. Some providers are turning to telehealth and even in-home visits to provide necessary care. In a recent press conference held in Minnesota, physicians described instances of adults and children foregoing care, which can result in worse and costlier health outcomes. The American Medical Association (AMA) expressed serious concerns with ICE enforcement activities in and around hospitals, saying these actions are preventing immigrants from seeking vital medical care.

A new Fitch Ratings report foreshadows that many hospitals in states that did not expand Medicaid under the Affordable Care Act (ACA) will likely see a surge of uninsured patients. This is because, starting Jan. 1, 2026, enhanced premium tax credits expired, making Marketplace plans no longer financially feasible for such individuals. Limited Medicaid eligibility and lack of safety-net and other government subsidized backstop programs in many of these states is expected to exacerbate the problem.

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.