U.S. abortion opponents, increasingly frustrated with the lack of action by the Trump administration to stem the flow of abortion pills prescribed online. Louisiana AG Liz Murrill asked last month that U.S. Food and Drug Administration rules that allow mifepristone to be dispensed through the mail be paused while a challenge to the FDA’s 2023 regulations moves through the courts. Anti-abortion groups have been pushing for years to reinstate the in-person dispensing requirement, alleging that taking mifepristone at home can be dangerous — despite studies that have found it to be safe and effective.

In January, the FDA requested the case be paused until the agency finished conducting its own safety review of mifepristone. Health Secretary Robert F. Kennedy Jr. commissioned the review last year in response to a report that claimed to find a higher rate of serious complications from mifepristone than reported by the FDA. Researchers labelled the new report “junk science” that exaggerated the risks of the medication.

On April 7, a federal judge refused to block filling prescriptions for the abortion pill mifepristone by mail across the US. An appeal was lodged to the notoriously conservative 5th Circuit Court of Appeals; that court holds the contemporary record for the most SCOTUS reversals.

May 1, the 5th Circuit Court of Appeals in Lousiana blocked access to the mailing of mifepristone prescriptions, one of the one of the most common means of abortion in the US. Drug makers Danco and GenBioProOn immediately filed an emergency appeal to SCOTUS, resulting in a temporary stay until at least May 11.

In 2024, the Supreme Court rejected an earlier attempt to overturn the Food and Drug Administration’s approvals for mifepristone. The court said then that those challenging the approvals did not have legal standing.

The new case focuses more narrowly on the Biden administration’s decision the previous year to make permanent Covid-era rules that made it easier to obtain the drug during the pandemic.

What’s next

Judge Alito ordered Louisiana to file its response to the companies’ request by the end of the day Thursday, May 7.

After the May 1 ruling, chaos ensued with some telehealth services immediately halting prescribing. Some switched to sending only misoprostol, which is less effective and more prone to side effects. After today’s pause, shipping of mifepristone was resumed.

NYT notes that “the Trump administration has been silent on the issue and did not file an emergency appeal to SCOTUS when the drug makers did. The administration may have enough to worry about before midterms. “Legal experts say that a court ruling dictating decisions for a federal agency sets a precedent that could open the door for other states to challenge federal agencies if they disagree with their policies and regulation.

“Pharmaceutical companies, as well as health policy experts, have strongly argued against courts shaping F.D.A. policies, saying that it undermines the kind of evidence-based drug regulation that the industry relies on. Notably, in October, under the Trump administration, the F.D.A. granted approval for a new generic version of mifepristone, increasing the number of American manufacturers to three.”

“Administration officials recently told The New York Times that the review would probably be finished toward the end of this year. If the Louisiana case is paused until then, it would likely mean that any outcome of the F.D.A. review would be less of an issue in the midterm elections, at a time when Republicans are struggling to maintain control of Congress and restricting abortion is not considered a broadly winning issue in many races.” See more here. (gift link)

Stay tuned.

UPDATE 5/3 : Dems win. After 75 days of holding out on ICE reforms, Trump finally leaned on the Johnson’s incalcitrant House to pass the bill the Senate had passed twice to fund all of Homeland Security (yes, including TSA) but not ice. Trump signed the bill immediately. Next step: House Republican leaders ultimately clawed together support by promising to facilitate yet another reconciliation bill later this year that could incorporate hard-liners’ policy wishlist — the third this Congress, counting the massive tax-and-spending megabill the GOP enacted last summer. See info on record ICE funding from the OBBB last July below.

UPDATE 4/30: With the WH putting pressure on Johnson and his intransigents, House Republicans stayed late last night to work on a compromise with a possible vote today.

Thought that was solved, right? Wrong. Whatever slush fund Trump et al found is about gone, and this time it’s the House that isn’t budging after two Senate-approved bills. Here’s the recap:

• Feb 14: Dems fund all of government except DHS, holding out for policy reforms to ICE, including accountability, uniforms and ID; banning racial profiling, requiring judicial warrants before entering private property. See the list of demands here.

• That started a partial government shutdown affecting DHS only. (Keep in mind the July 2025 OBBB provided $75B in new funding for ICE over four years, bumping the ICE budget from around $10 billion to over $28B. However, FEMA, CISA, and Coast Guard were left unfunded as well as TSA in this partial shutdown.)

• Mid-March: TSA employees missed their first paycheck. The average TSA salary is $50K—about $25/hour. These are not people with disposable income and lots of savings, and by then we had historic airport wait times as sick calls and resignations hit. (As of now, TSA has lost over 1,100 employees—and that’s before whatever hits this time around. Oh, and the 2027 budget will cut another 10K TSA positions to save $1.5B—undoubtedly another major morale booster for TSA employees.)

• March 26: With negotiations stalled in Congress (but Congressional travel getting impacted), Trump declared an “unprecedented emergency situation," signing an order to pay TSA agents out of DHS funds while the Senate—where all this started—continued to negotiate.

• April 24: Markwayne Mullin (DHS) told FOX News that DHS has used all the available emergency funds and would run out of TSA funding options in early May.

• In the meantime, the sometimes-adults in the Senate passed not one but two bipartisan funding approaches as they tried to corral the House. Both fully funded DHS—first still leaving ICE out, but with a later path to do that, too, leaving room for negotiations on Dem demands, which continue to play well in polls. (And perhaps hoping Mullins will come up with enough moderation to take off the heat). The hold-up now is completely in the House, where a rapidly-losing control Mike Johnson appears unable to get his members to agree on anything. Even the WH is leaning on him in rare display of displeasure with the speaker.

So—stay tuned, particularly if you’re traveling. The only good news is that June starts FIFA World Cup travel to several U.S. host cities, with as many as 7 million visitors expected. That should finally get things moving; you would think even Johnson’s intransigents can’t fight soccer fans.

See footnotes for tips on reading Snippets1 including paywall tricks2 and info on our sources and bias.3 Note articles marked with an asterisk (*) are from professional journals.

This week’s cover image

As John Fugelsang says, this week America got to witness “Future Law School Case Study Pam Bondi” scream that anyone still ‘obsessed’ with the Epstein victims isn’t paying attention to the stock market. If you have a heart or a soul, you headed to the bathroom after that one. Cruella makes me ashamed to be the same gender. If you haven’t seen the Judicial Committee Bondi screaming show hearing, please at least scan it here. Even MAGA was revolted. And kudos to Representative Massie (R-KY)—forced yesterday to notify us what he will not die naturally of, just in case—for ramming this through after decades of every administration ignoring it…what Trump, Bondi et all would dearly love to repeat.

Health advice of the week from the genius running our public health system

“I'm not scared of a germ. I used to snort cocaine off of toilet seats.”

News about our bodies

• Heart health month: 6 surprising tips. Debunking 5 women’s health myths. Stomach bug or norovirus? FDA approves Merck ovarian CA drug. Structural racism in women’s health. EPA ruling defies science. Shoulder pain originating in mouth? )gift article) An insurer finally has to pay for not having enough mental health providers—they’re hardly alone. Harmful chemicals in Black women’s hair products. High deductible plans worsen CA outcomes. Tribal health impacted by end of ACA subsidies. AMA launches own vaccine reviews. Feed a cold, starve a fever? (gift article) Does TrumpRx beat pharmacy prices? *No surprise: AI aids breast CA screening.

• The states: SC measles outbreak larger than TX, spreading quickly in NC. Measles map. Why women can’t report a miscarriage in KY—and here’s what happened the last time KY did this. CA sues over public health cuts to four blue states. Potomac sewage spill in VA. Also in VA, cannabinoid hyperemesis syndrome (CHS). CA: deaths from toxic mushrooms.

- Nutrition, exercise, sleep, and looking great

• Dark or red lettuce healthier than others. 8 best fermented foods. Sourdough bread is having a moment. Scurvy and GLP-1s…really. Why exercise alone won’t yield weight loss.

- Generational and lifestyle health news

• Tippy Toes baby food recall; children being pushed into jail by no mental health help. Risky: stopping antidepressants during pregnancy (gift article). *Minipad screening for cervical cancer? What Gen X, Millennials should watch for about colorectal CA. Flexibility, rising costs keeping mothers at work (gift article). Want more babies? Abolish commutes (opinion; gift article). *Hypothyroidism and women’s urinary incontinence. Healthcare costs eating into Social Security checks. Guthrie kidnapping and senior safety (gift article).

News affecting our lives and families

• Women’s health investment outlook. Without healthcare growth, the labor market looks much worse (gift article). A year of Kennedy upends healthcare—now with yet more HHS leadership chaos. AI-driven job insecurity and mental health. Fact check: is climate change a scam? Women and leadership style: about time we talked about this. Healthcare cost stress fueling Dem campaigns. Health travel warning for Seychelles. FDA refuses to review Modern flu vaccine. Amazon nukes Ring partnership after backlash.

UPDATE 4/22: After months of chaos on this, the occasional-adults in the Senate stopped debate on the SAVE Act, which would have disenfranchised millions before the midterms, particularly women using their married name to vote. the only way in most states to prove citizenship would be a passport, and process that involves weeks—often months—of gathering birth and marriage certificates in order to be able to prove citizenship so they could vote. (Note REAL ID driver’s license do not require proof of citizenship, and therefore would not have met SAVE Act requirements for voting.)

Never fear though—where there’s a will, there’s a way, and Treasury Secretary Scott Bessent is pushing Trump to require proof of citizenship (only passports will do) to open (or keep) bank and presumably credit card accounts. Trump could theoretically do that with an EO; stay tuned.

The Safeguard American Voter Eligibility Act, or SAVE Act, was first introduced by House Speaker Mike Johnson and Rep. Chip Roy (R-TX)1 in May 2024 as HR 8281. Deprioritized for almost two years, it’s now suddenly come alive again, now as HR 22 after its reintroduction by Roy in January 2025 with additional related bills. The current version would require photo ID-accompanied proof of citizenship to vote in federal elections, which sounds bland enough, even patriotic.

If passed, it would immediately affect any voter registration application submitted in any state on or after the date of passage. While the states would be required to make substantive election processing changes, there is no funding for states to do so and no phase-in period. In other words, just in time for midterm chaos. Not to mention the included private ‘right of action’ allowing private individuals to sue their states if they don’t think the state is performing all this correctly.2 There’s a reason state legislatures aren’t enthused.

Why now?

It’s been a media blip on and off in those two years. The Republican House passed it almost a year ago and sent it to the Senate, where nothing happened, partly because of negative pubic reaction. But the coming midterms elections are causing substantial angst in certain DC halls and Dems have built a head of steam aheaad of the midterms on healthcare and ICE reform, bolstered by almost two thirds of the public angered by ICE “going too far” and anger about escalating healthcare costs. So Rep. Anna Paulina Luna (R-FL) is pushing the House to get the Senate to act on the bill as a way to divert Democratic Congressional attention, position Democrats, and distract from Democrats’ growing leverage on ICE reform. There are logistical issues to iron out in the Senate, but after calling for nationalization of elections last week, Trump has already signaled he wants this passed, without which nothing much happens in the Senate.

Well … doesn’t everyone have a photo ID proof of citizenship?

Even the relatively new REAL ID-compliant licenses only require proof of lawful status (such as U.S. citizenship, permanent residency, or valid visa), not exclusively US citizenship. REAL ID was designed back in 2005, although only recently finally implemented. Barring that, the only real one-document citizenship proof right now is passports. Without that, states running elections are stuck looking at multiple documents, a nightmare for millions of volunteer elections staff, not to mention a confused public.

At least half of the population doesn’t have (or otherwise need) a passport, which currently costs $165 new3 with a routine six week wait for the State Department to process after applicants obtain state-verified birth (and any name change/marriage) certificates for proof of citizenship under their current name and get the photos taken. But the biggest passport barrier that no one talks about may be securing the required in-person interview appointment anytime soon at some USPS office, often in the middle of nowhere.4 Of course, good luck wresting your birth (or other) certificates out of your state or country of birth before that at another cost of time and money.5

The Bipartisan Policy Center says these three demographics will be particularly at risk:

• 50% or more of registered voters who do not have an unexpired passport with their current legal name.

• 11% of registered voters who do not have access to their birth certificate.

• 9% of all eligible voters who do not have, or do not have easy access to, documentary proof of citizenship.

Married and voting under your married name?

That won’t work under the current version of SAVE if you don’t also have a passport in your married name OR a birth certificate and valid proof of marriage/name change. If SAVE passes, wandering into a polling station expecting to vote as usual will be a rude awakening. Which is in itself odd: This is a Republican bill, but half or more of those most likely to be affected by this—30 million 45+ currently married women—vote Republican.

In fact, the in person audience for the first night of the Melania film was primarily older, conservative, White women who called it a Republican Girls Night Out. Of course, that was the heavily-publicized first night. Things have changed a bit since.6 But still. Well, perhaps Rs simply overlooked this issue; while almost a third of Congress is female overall, only 15% of Congressional Republicans are women.7

Who else is likely to be disenfranchised?

Anyone who doesn’t have or can’t afford a passport or doesn’t have a birth certificate in their name—and/or doesn’t know how to get one or simply can’t afford the time, hassle or money to do so. The population that will be hit the hardest is the 50% of the US population working multiple jobs to make an average of $50K/year—the people who keep the other 50% fed, vertical, moving, and functioning. As currently written, the SAVE Act nicely supports our recent twist into a plutocracy, with the affluent implementing policies that benefit them at the expense of lower classes.

If you want to see what that looks like in data from the Fed, click here and take a look at what’s happened in US wealth distribution since the Reagan administration. The bottom 50% of the population — half of our population — is that tiny red line at the bottom. By chance or intent, that’s who will get left out when it costs too much to vote.

What to do

Learn more about the SAVE Act suite of bills; see some resources below, with many more showing up every day on searches. Decide where you are on the issues; maybe you like some portions of it but not others. Then keep an eye on the news. Let your Congressional representatives know now how you feel about the bills; the House is generating the urgency. Click here to find House reps. And if the Senate gets active on it, call, email or write yours immediately. If it moves in the Senate, it will do so quickly. In the meantime, don’t let up on pressure over ICE. In addition to the midterms, that’s what this is all about. Know how your senators are positioning on the ICE issue and use the same link above to keep pressure on them about that.

More on the SAVE Act:

• National Council of State Legislatures: 9 things to know about the proposed SAVE Act. This has a good list of questions to ask about your state’s process to ensure safe elections.

• League of Women Voters: Tell Congress to oppose the SAVE Act suite of bills.

• The Brennan Center for Justice: New SAVE Act bills would still block millions of Americans from voting.

• The Bipartisan Policy Center: Five things to know about the SAVE Act.

• Chip Roy’s one-pager on the bills

• Axios: SAVE America Act becomes catch-all for Trump’s election demands: Here’s what’s actually in it.

FEB 16 UPDATE: It’s still just a DHS shutdown. Here’s what’s happening.

So far, not much. No negotiating, just noise from both sides. But the word “masks” keeps coming up; I suspect nametags may win but masks might be kept. In the meantime, Homan is getting all the media attention (despite Noem/Lewandowski launching a beauty pageant—see WSJ article). And word of Noem’s long-standing romance with Trump fav Corey Lewandowski (both married to someone else) is now as public as it can get, with even the WSJ discussing it (gift article). The really good news after the WSJ article on the “constant chaos” within DHS? Noem is now protesting she’s “still in charge of DHS.” She doth protest too much? We note “chaos” is not a word Trump likes applied to his departments, and apparently Trump is also averse to [public] sexual affairs. Could Noem finally be on the under-bus short list? Although Lewandowski, a DJT favorite, may still find another place of power, maybe not quite as … cozy. As the WSJ article notes, Noem & Lewandowski were positioning her for the 2028 presidency race. Isn’t that reassuring? With VP Corey Lewandowski… And here you thought we’d seen it all. Silly you!

FEB 13 UPDATE: DHS almost certainly will “shut down” this weekend, but no other departments. Here’s the impact.

What you won’t hear on any R-leaning sites: DHS will shut down because “Trump acquiesced to Democrats’ request that Homeland Security funding be stripped from a broader spending package to allow more time for negotiation over demands for changes to immigration enforcement, like a code of conduct for federal agents and a requirement that officers show identification. Homeland Security was temporarily funded only through Feb. 13.”

Democrats say they won’t help approve more funding until new restrictions are placed on federal immigration operations after the fatal shooting of Alex Pretti and Renee Good in Minneapolis last month. In addition to ICE, DHS is also the home of TSA, FEMA, and the Coast Guard.

Since the OBBB generously funded DHS, and particularly ICE (tripled budget), what does this actually mean?

So far, there are no real talks between Rs and Ds. Rs say Dems’ 10 requests are outrageous; Dems say the requests are no more than what is required of other law enforcement, including wearing identifying badges and uniforms, no non-medical masked, and a requirement for judicial (not just administrative) warrants for home invasions and arrests. Read Dem list of demands here. Keep in mind there are hundreds—if not thousands—of lawsuits pending all over the US relative to the same demands Ds are making about ICE. Yesterday’s Senate Judicial Committee hearing was a great overview of the issues; it’s well worth watching. The passion on the Republican side is very clear;not so much actual data or information. The data, and less heated demands, on the Democratic side are also very clear. The hearing was an outstanding introduction to the fireworks we can expect during this limited shut down.

Where will pushback against the shut down show up first?

Again, this is not the entire government, as it was in late 2025. But Rs will have pushback power. FEMA has already been effectively neutered by Kristi Noem. For instance, her new directive now requires DHS approval for FEMA expenditures over $100,000—which any disaster will quickly cost—extends fund approval time from weeks to months and has stalled >$17B in funds for past disasters. Undoubtedly those delays will be tied to this shutdown as well.

TSA is the most likely pressure point. 95% of TSA employees are considered essential and must continue to work whether they are paid or not—and many are still recovering from the full government shutdown in 2025. Being required to work without pay at that pay level will undoubtedly cause hardship, with workers calls out or taking unscheduled leave, leaving flyers in the lurch. That will be a key leverage point for negotiations.

Stay tuned; we’ll update here.

ORIGINAL POST: Has Stephen Miller’s mass deportation war finally come home to roost?

Events in otherwise staid Minneapolis again unexpectedly struck a major national nerve, forcing us to confront who we are (again) by (again) showing us what we’d hope we are not. The killings of Renee Good and Alex Pretti forced another national reckoning, just like the murder of George Floyd did in Minneapolis in 2020. And while Good and Pretti likely got more attention because they were White Christian1 US citizens, their killings were just the most recent by ICE. Last year was ICE’s deadliest year in two decades, with at least 32 people killed in 2025 and another six killed already in the first month of 2026.

Newly reality-oriented Americans aren’t happy

Despite DHS and the FBI deliberately withholding evidence that ran counter to their narrative, hardy Minnesotans—with deeply-embedded cultural values of civic and community connection—brought those killings live to our screens for us to judge ourselves, and the result wasn’t pretty. Even as anger continues to build, by the end of January 65% of US adults already said ICE had gone too far, including almost a third of Republicans. As potential swing voters, the 71% of Independents calling foul is a critical number, bringing a jolt of reality to Republicans looking at 2026 Midterms.

Anger about ICE is stronger and more widespread than the outcry about ACA subsidies that Democrats leveraged to bring widespread attention to healthcare costs. And while they gave in at the end, disappointing the more fervent, they only supported funding through the end of January 2026, giving Dems another chance at hot button issues after Republicans failed to extend the subsidies. And for the January negotiations, Dems got smarter. Instead of bringing the entire country to a halt, they targeted only increasingly unpopular Kristi Noem’s DHS.

Senate Ds agreed to overall government funding through the end of FY26 (September 30), but excluded DHS. Until that is resolved, DHS will get no further funding, which won’t hurt ICE much directly. The budget bill created an unprecedented ICE funding boost. A significant $75 billion supplement tripled the ICE budget. ICE has substantial funds allocated for detention and deportation through 2026, with more funding than any other federal law enforcement agency.

But it will impact other DHS functions. DHS also runs FEMA, TSA, and the Coast Guard. Republicans can be counted on to focus at least on how funding will disrupt flights and disaster relief, although—at Trump’s direction—Kristi Noem has been making FEMA a non-functioning entity for the last year. Worse, the media will get sucked into significant coverage, and right now it doesn’t look like that will benefit Republicans.

Which is why Republicans have so far been quiescent on the issue, a pretty good indication of the uneasiness they feel about ICE and the impact on midterms, even if they’re not saying much publicly. Expect them to display huge concerns now, of course—after all, Democrats are surfacing a political burn point, with a pubic increasingy in agreement. They’ll have to fight it. And the longer Democrats drag it out, the worse it will get for Trump and Republicans if Ds manage the media like they did on the ACA subsidies.

Even more critically, media coverage promises to flow over into 2027 Federal budget negotations which were scheduled to begin … wait for it … this month. Media coverage now will absolutely play into FY27 budget talks.

For Democrats, that’s definitely a feature, not a flaw. Take a look at how extended media coverage last year on healthcare costs changed Republican and Independent [swing voter] views on the government’s responsibility to ensure universal healthcare coverage.

DHS funding goes into shutdown

Democrats gave Republicans enough votes to fund the government until the end of the FY—except DHS. At 12:01 Saturday, Feb. 1, DHS funding for the rest of the FY stopped. Senate Democrats, in the minority, have very few ways to stall the Trump train, but this is a powerful one, riding even stronger public opinion than the ACA subsidies issue.2

Love him or hate him, Minority Leader Sen. Schumer (D-NY) is so far refusing to budge until Congress passes a law. With plenty of evidence, he doesn’t trust White House pinky promises to deescalate ICE actions. While Gregory Bovino was banished from Minnesota (but not fired) and the WH is signaling ‘nicer,’ nothing has changed. With a move to impeach her, claws-out street fighter Kristi Noem was quick to go public to ensure everyone knows she only does what Stephen Miller and daddy Trump tell her to do, and Miller is still running the ICE show, as both the WSJ and Forbes recently pointed out. Meanwhile, just-put-the-cash-in-a-bag Tom Homan, now leading the Minnesota ICE front after Bovino’s dethroning, isn’t showing any indication of change despite Trump’s promised ‘softening.’

Why aren’t Democrats negotiating? What do they want?

The Senate has until Feb 13 to fund DHS. Democrats published what they want but are not responding to (proforma) requests from Republicans to ‘negotiate.’ That’s in no small part because Democrats—like everyone else on the planet—know what Republican Senators want makes no difference if The Word has not been sent down by Trump. With Trump mum for now, cue the requisite Senate R whining about how Democrats won’t negotiate.

Why would they? No one knows what Trump wants to do, and Democrats are riding public opinion with increasing signs of Republican Midterm angst, now even at the point there is R concern they might actually lose the Senate, not just the House.

Democrats are demanding ten changes, none of which is different than the laws other US police forces must follow: end racial profiling and indiscriminate arrests; stop use of face-coverings to hide identity; require IDs; stop terrorizing sensitive locations (churches, schools, childcare facilities); require uniforms to end paramilitary appearance (and mindset); and require judicial warrants3 that mandate a show-cause for actions like home invasions and arrests. See the ten demands Democrats are making to fund DHS here (WaPo gift article) or here (The Guardian). So far, nothing is happening, with a February 13 deadline to fund DHS, although some Democrats are already talking extending that deadline.

What’s next?

A lot of media exposureon an issue already angering the public, and that arguably benefited Democrats the most during the 2025 Shutdown. (See above.) Proforma R fussing; ditto from some swing state Democrats. As a distraction, Rep. Anna Paulina Luna (R-FL), with Trump’s support, is pushing the House to vote on the SAVE Act to flush out D resistance. Horror stories about terrorists, drug lords, rapists, etc. potentially making it past TSA or the Coast Guard. Increasing pressure from businesses and Fox on Trump to realize mass deportations may be backfiring badly, and equal pressure from Steve Bannon’s guided missile protégé, uber-insider Miller, to keep going. An Axios article noted that Miller specializes in turning the president’s whims and rantings into government policy,” sometimes in hours, albeit “with the bedside manner of Heinrich Himmler.”

After all, Trump thought that’s why he was elected, and now it turns out some “stupid people in Minnesota” didn’t agree with killing people indiscriminately. (SAD) Trump will continue to blame Democrats for everything, although his recent racist nuttiness might indicate a bit of a panic if he has to resort to that ancient overused trope to call his clan.

Of course, as is always the case, he “never saw it” and since it became a problem even with his allies, it was “done by an unauthorized aide,” so why would he apologize? One thing we can all trust about Trump: the buck never stops with him. That’s worked pretty well so far, at least within the likely ~30% of the US that continue to identify MAGA-ish these days.

Another thing we can trust: Trump follows the polls avidly, and the news keeps geting worse. He’s net -36 with Independents, and even Fox can’t create a poll with more than 44% approval. That, more than anything, is causing Trump some equivocating about ICE and even Miller, likely aided and abetted by Miller’s own enemies. Miller’s role in ICE has suddenly become the media story of the month—unusual for a guy who was smart enough previously to stay under the radar. As we know, Trump is not fond of underlings getting media coverage, and Miller has suddenly been getting a lot.

And then we’ll see who wobbles. What happens to Miller’s ICE role. Whether the WH sacrifices the agents who killed Good and Pretti. The next ICE wild card stunt. To what extent Leavitt’s precocious gaslighting skills can muddle the picture. Whether Noem gets the under-bus view many have long predicted—with clasing, kicking, and screeching that may make even Trump deeply regret he ever met her. Quietly hostile Melania she is not.

After protracted writhing and tea leaf readings, finally a decision, with The Word reaching Senate Republicans so they know where, when and how deeply to bow. And, of course, the enduring question of whether Democrats fold and/or eat their own.

Bottom line: stay tuned for February ICE drama filling your screens.

Jake Goodman MD, a board certified psychiatrist, posts on Substack as Mental Health Movement. For most people, psychiatrists—physicians—are the often invisible1 prescriber backing up the counseling frontline of behavior health…the person psychologists, LCSWs, and other mental health therapists call when medication is needed. So I can’t tell you how unusual it is, in my experience, to have an actual MD psychiatrist put themselves out front and center with enthusiasm.

Dr. Goodman focuses on memory, cognition, and dementia prevention, all of which are hot topics, particularly as we age.2 His posts are easy reading, down to earth, and backed by data and references, not the musings of self-help gurus. Here are several posts I really enjoyed…and hope you do, too!

• A quick, easy wrap of the 10 biggest brain health takeaways of 2025. I spent most of the last couple days on web searches for 2025 wraps pertinent to women’s health and didn’t see anything like this.

• The most overlooked dementia risk I see in my clinic every week—and this one is as big a surprise as it is easy to fix.

• What readers described as “the first lists about dementia prevention that actually feel do-able:” 7 boring habits that cut dementia risk, Part 1 and Part 2.

• And, yah, that dark chocolate during the holidays was maybe your best nutritional step: Dark chocolate, dementia, and depression: What you need to know, with info on ever-changing step count recommendations as well.

Like all of us, Dr. Goodman hopes you’ll comment, ❤️, restack posts you like, or subscribe, free or paid. Spread the word; it’s a terrific site! And don’t forget to tell us about great Substack sites you use the most! Thanks..on to a great new year for all of us!

Life is short. Have at it full bore, as the woman in our pic did! Eyedrops and nose sprays for quick fixes for minor and major issues? Supplements to avoid if you have hypertension. Lots of great year end reviews: 15 products women loved, breast cancer advances, new types of meditation, women leaders who influenced healthcare, top 5 insurance changes for women, and cool breakthroughs in health innovation and tech. The latest on the healthcare financing fight that’s a mere hundred years old. States with good or strange news, including proposed new laws on AI, teens, and social media. The GDP apparently grew, led by healthcare spending—but was it just the superflu and people scrambling to use paid-up insurance deductibles? Tips for easy nutrition fixes. How ADHD drugs work. Every parent has favorite children—and how that works for the non-favs. New non-hormonal menopause therapies. The wreck of the HHS, and a heartbreaking look at the devastation our cuts wreaked on moms and babies in Kenya.

See below for footnote tips on reading Snippets1 including paywall tricks2 and info on our sources and bias.3 And if you hit problem link, refresh; we correct regularly.

This week’s cover pic:

Iris Apfel, who became a fashion icon in her 90s and died last year at 102, once said, “When you don’t dress like everybody else, you don’t have to think like everybody else.” I’m with her! IMO, one of the very best things about getting to the no-longer-tethered-to-ideal-mom/employee stage is being able to do what I want when I want, ignoring predictable monotony. Life is short—have at it full bore! Celebrate the path Iris created for all of us. Happy new year!

News about our bodies

• A simple eyedrop for far-sightedness, and a nasal spray that fights brain cancer? Patients sue insurance plans that won’t provide mental health options. (Gift article) New books to kickstart health goals. Big advances in breast cancer this year. Needed more than ever? Meditation focusing on loving kindness. Handling outrageous medical bills. (Gift article) FDA approves urinary continence wearable and an at-home brain stimulation device for depression.

• The states: It never stays local: hundreds exposed to measles at Newark airport in New Jersey. What Michiganders need to know about expiring ACA credits. New New York law mandates social media warnings on platforms luring excessive use. Deaths in Missouri as COVID cases increase again nationally. Florida governor emerges as AI skeptic. And while the GDP apparently grew in November, healthcare spending was a primary contributor to that growth, and that may be a more temporary problem than good: this year’s ‘superflu’ cases are skyrocketing in 47 states (breaking records in New York). and it’s very likely those currently on ACA but who plan to go bare or to cheap catastrophic plans in 2026 after an average 114% cost increase moved to use up year end paid-up deductibles for screenings, medications and other large expenses?

- Nutrition, exercise, sleep, and looking great

• Gut healthy packaged snacks? Heart-healthy breakfast swaps. Supplements that are problems with hypertension. Health comparison: parsnips and carrots. An avocado a day to keep doctor away? Wegovy pill approved for weight loss. Foods with healthy-sounding buzzwords and added sugars. A new study argues cheese is healthy. So…which cheese is best? Brown rice or white?

- Generational and lifestyle health news

• How ADHD drugs improve attention. Parenting: favorite (and unfavorite) children. (Gift article) *2025 birth control review. Deep dive: Teens, social media and AI in 2025. Midlife GLP use review, and menopause myths we kicked to the curb. *New non-hormonal menopause therapies. Virtual reality opens doors for older adults. (Gift article) Perks of volunteering with children. Super-agers on a healthy life. (Gift article) Women are twice as likely as men to develop this type of congestive heart failure, and the AHA is investing in a new diagnostic tool. Noom enters longevity market with microdose GLP-1 Program and biomarker testing.

News affecting our lives and families

• Congress takes ACA fight into January, with as much chance of success as we saw in December—and it’s same fight that’s been going on for a hundred years. 2025 year end reviews: standout health news of the year, 15 health products women loved, and women of influence in healthcare. Specific to women, from *Managed Healthcare Executive (an insurance periodical), the year’s top 5 women’s health insurance changes (actually positive), and a take on ACA coverage for women. 5 very cool breakthrough health innovations and healthcare tech start-ups this year.

  • And on the negative side, the docs I’d vote least likely to be trying to get rich, pediatricians, sue Kennedy over Trump-style retaliation cuts that will negatively affect children’s health research for years. Private health insurance costs are also going up in 2026; some options. A year of going back to the 50s with Kennedy’s HHS (Gift article) and 3 things to watch in 2026 as a result. Plus a brutal year for global health, with the US leading the disaster and—particularly if you’re a woman— heartbreaking stories from a maternity ward in Kenya that bring our foreign aid cuts into nightmare focus.

Click for more about subclade K, including symptoms, and read Dr. Jetelina’s excellent summary and more about the map here.

In the news this week for women: Cover pic: She was a moderate before groveling before the Sith Presidency. Now she’s been unceremoniously tossed out of the plane. What’s next? News: Home cures for that sore throat. Why concierge medicine might be right for you. New fixes for autoimmune diseases, much more prevalent in women than men. Dealing with sky-high levels of holiday stress on top of leady-crazed national stress levels. The FDA doesn’t pay much attention to generic drugs; find out what country yours came from. The new leading marker for heart disease isn’t cholesterol. Pharmacist tips on reducing drug costs. Superflu hits the US early and hard. Could higher fat foods—even cheese—be healthy? Retirement age changes in 2026. What’s in the new Marijuana exec order, and social media disinformation set the stage for unplanned pregnancies. Millennial women are the first in almost a hundred years to have declining health. What to ask during that all-important first doctor visit. Sorting out the vaccine recommendation murk. Oh, boy—the boys found a woman’s libido pill (that of course doesn’t involve better male sensitivity). Millennial and Gen X women aren’t buying into hair loss. Study: new tea-coffee delineator on bone density. Alzheimer’s biomarker tests. Kennedy initiates this century’s version of the Tuskegee experiment—in Africa, of course. The scoop on methylene blue. And is traditional medicine finally being seen as valuable? With Femtech woven throughout, and a touch of men’s health (kind of) just to be fair.

Read more

It started with Healthy Seniors founder Diana’s mom telling her, “I don’t need more information. I need someone to help me understand what actually matters for someone my age. Give me steps I can take. And please, treat me like the intelligent adult I am.”

I was drawn to a Healthy Seniors post today on stress after 60, and really liked what I saw. I’ve seen some of the info elsewhere, but not the physiology of stress and aging put together so completely and understandably. Here’s that post and a sample of others:

• The weight no one sees: Understanding stress after sixty. Best explanation yet on why we can’t handle stress like we did in our forties, when stress just made the day more interesting.

• How do you keep going when everyone else is gone? This one’s huge. My mother, aunt and uncle lived to 100. I watched how two of them carefully cultivated friends 20 years younger, thinking ahead to the depression that can come when you’re the only one left. And see more great tips on making new friends after retirement.

• A beginner’s guide to Tai Chi: Simple steps for better stability at home. Women experience more hip fractures than men for a variety of reasons; we’re doing a post soon on that. Tai Chi is one (lovely) way to improving balance, key to avoiding a life altering hip fracture. Here’s a great way to explore Tai Chi without having to first commit to a class.

• When it’s time to hand over the keys: A loving look at safe driving after 70. It’s an issue we’re all going to face. Having watched our older family members go through this one, I’m hoping I can handle it with grace.

There are scores of other really interesting posts on great topics from connecting to purpose and even senior tech. And like all of us, Diana and the folks at Healthy Seniors hope you’ll comment, ❤️, or restack posts you like. Spread the word; it’s a terrific site!

In the news this week for women: Cover pic: Is she a Republican dream, a Democrat nightmare, or exactly what we need? Lots of news this week: Here’s why your GI system may not love December, and get braced for the superflu. Sexism brain scars, and not just from weaponized incompetence. Baby boom tips from abroad? We may be having MJ dreams, and what reclassification might mean. Is there a time limit on anti-depressants? And can the new sexual arousal cream mean we don’t need them? How to skip an 8x greater risk of skin cancer. Is the new autism drug safe? Can you hack gray hair? When is the SS COLA coming (hint: earlier than you thought). Fibroids? They may play out dangerously elsewhere in your body. News flash: if it’s men’s health, it’s not DEI (naturally). India is experimenting with paying women for what we’re all expected to do without pay, and Hallmark comes through with hours of shirtless men…happy holidays!

• Make sure you check our posts and Notes: We’re updating more frequently there to keep Snippets a readable length.

• Tip: If you hit a paywall here or anywhere, copy the URL of the article into archive.ph.1

• See our footnotes and italicized comments for context from our 30+ years in healthcare.

• Articles marked with an asterisk (*) are from professional journals.

• Disclaimer: Listing these headlines does not indicate a recommendation. With so many news items each week, we don’t take the time to review each. Use common sense and dig deeper into any issue that interests you. More on sources and bias.2

This week’s Women in the News cover pic

Jasmine Crockett has more than held her own in the House. Now she’s running for Senate, and will primary against James Talarico, who’s been working very hard for months to get in in a great position for Dems, and she may already be ahead of him less than a week after she announced. Many are cheering; others are enraged. The opinions of others have never bothered Ms. Crockett much, and true to form, she’s going to do what she’s going to do. What’s your read? Comment to tell us.

News about our bodies

• If your GI system is bucking the holidays, it’s not just you—and it’s not a great time for mental health, either. As expected the mutant ‘super flu’ is spreading like crazy in the UK; what to watch for here. How sexism ‘brain scars’ harm our health. Head to head: Newsom or Kennedy on women’s health. What other governments are doing to spark a baby boom. After 40, risk-based screening works as well as annual mammograms (with a lot less radiation). Unlocking zinc for colds. Two new drugs to treat gonorrhea. What if MJ doesn’t do what we thought for sleep or pain? Is Zepbound actually the GLP winner (and for knees, too)? Is there a time limit on anti-depressants? *DARE to PLAY sexual arousal cream becomes available in several states. Better sunscreen—already approved in other countries—gets approval here.

- News by generation/lifestyle

For your skimming convenience, but generation don’t have a ‘hard stop’—they overlap, so scan others, too.

• Gen Z and Millennials

  • The question you never knew you needed to ask: do menstrual cups work in space? Hate getting pap smears? Here’s an alternative. Health-not: Young women now have a 2 to 8 times higher risk of skin cancer, modeled by the guy in charge of the nation’s health. *Monoclonal antibody shows promise for endometriosis pain.

• Pregnancy, birth and parenting

  • Australia acts to protect children online…where’s America? US surrogates carrying babies for Chinese billionaires. (Yes, really.) New autism drug: when Trump says yes but the science isn’t yet there. Pediatricians lay out kid gifting dos and don’t. *Study: COVID vaccine slashes kids’ ER visits by 76%. Hundreds quarantined in SC from completely preventable measles outbreak as only-in-FL push increases to get rid of childhood vaccines. New glasses approved to slow nearsightedness in kids.

• Midlife and better

  • Can you hack gray hair? Social Security COLA: Dec 31. Brain changes aren’t linear; here’s the code. Why waist:hip ratio is an increasingly important measure of health in women. Fibroids linked to women’s heart disease risk.

News affecting our lives and families

• Surprise! When it’s men’s health, it’s not DEI! What the reclassification of marijuana might mean. Dare you to find a woman who doesn’t know what ‘weaponized incompetence’ is. Things you can’t make up: Now Trump wants to work with such a “nice group of Democrats” on healthcare. Catch up here. New 2025 SNAP restrictions. FDA said kids died from COVID vaccines, but provided no data. Now they’re on to adult deaths. Women’s healthcare market value $46B by 2033; here’s why. (The world saying Kennedy’s HHS is wrong, wrong, wrong.) The VA says it has new ‘age-friendly’ teams, but at the same time is eliminating 35K health jobs, including doctors and nurses. India’s sweeping experiment to pay women for homemaking—what a thought. And, finally…tired of the same old Hallmark movies? Hallmark apparently listened, so now we have 8 hours of shirtless men.

In the news this week for women: Cover pic: like Obama, she lives rent-free in Trump’s brain. Seriously this huge organization is finally saying women can go to a GYN doctor without daddy saying it’s OK? 2025 felt awful, but was actually a terrific year for women’s health; see why here. Weird things we never knew vaccines prevented, including one that may decrease dementia. Power up Fluffy’s defluffing? Night trips to the bathroom: what’s too often, and how to decrease trips. Light boxes—do they work? HPV vaccine highly successful in preventing women’s and men’s cancers, and one shot may be OK. Hints for Santa, including vagus nerve stress bio-hacks. More than any of us ever wanted to know about ACIP’s “reckless” play on Hep B vaccine—and the states already bucking it. Lead in cookware? Caffeine drinks and health, and the worst ultraprocessed foods. Med recalls: blood pressure and ADHD meds. Winter holiday sleep hacks. Weird new cancer in young people, and the huge increase in scromiting. Do vegetarian diets change breast milk? AI deepfakes of real doctors selling fake menopause fixes. Music and dementia, and the best exercise routine for older women—hint: not yoga, walking or swimming. 10 days before ACA fail—catch up on the dysfunction here. Chatbots and your medical records: not ready for prime time. And a touch of men’s health just to be fair.

• Make sure you check our posts and Notes: We’re updating more frequently there to keep Snippets a readable length.

• Tip: If you hit a paywall here or anywhere, copy the URL of the article into archive.ph.1

• See our footnotes and italicized comments for context from our 30+ years in healthcare.

• Articles marked with an asterisk (*) are from professional journals.

• Disclaimer: Listing these headlines does not indicate a recommendation. With so many news items each week, we don’t take the time to review each. Use common sense and dig deeper into any issue that interests you. More on sources and bias.2

This week’s Women in the News cover pic

Rosie O’Donnell was the first very public target of Trump’s loud misogyny. In the 90s, she and Trump were both B-list celebs. Then in 2006, she took on Trump on The View and he immediately retaliated against her, calling her a slob. Two decades later, living an ocean apart, he still can’t get her out of his brain, and he’s become a routine misogynist, particularly if a woman—gasp!—dares to question him. Read this new article about Rosie’s life now in Ireland, where people cheerfully greet her with “we hate him, too.” (Gift article)

News about our bodies

- News on women’s health

• Veterans Affairs joins the 20th century (yes, not even 21st) with Gyn access without PCP referral. Unexpected ways vaccines boost health—and shingles vaccine leads in decreasing dementia. Faulty glucose monitors cause death, injury. A pending announcement on yet more changes to life-saving vaccines is coming, and health leaders are already warning about it, as FDA has yet another personnel rupture, while Kennedy’s top vaccine advisor is caught saying he feels like a puppet on a string. Light boxes and SAD. Waking up to pee: how often and tricks to decrease trips. Could osteoporosis actually be reversed? HPV causes most cervical and other cancers and the vaccine greatly reduces cancer in both women and men. Plus a single dose may be as effective as two shots and new self-collection approved to improve pap access and privacy. Santa? 8 vagus nerve stimulus devices to bio-hack stress levels; here’s more on vagus nerve stimulation. And, finally…oh, boy—Ozempic for fat cats?

• The states: FL issues red tide advisory in winter. CA mushroom foraging poisoning warning. WI, PA , CT, VT and West Coast Health Alliance quickly push back against “reckless” Hep B vaccine announcement.

• Medication recalls: Ziac (high blood pressure); generic form of ADHD med; and more recalls, including compounded GLP-1 warning.

- Nutrition, exercise, sleep, and looking great

• Foreign cookware lead warning. Hands on with new Fitbit personal health coach. Fruit strategies lower kidney risk. Coffee, caffeine products and health. The 6 worst ultraprocessed foods. Tips for better sleep—particularly during winter holidays.

- News by generation/lifestyle

We sort a bit here, but generation don’t have a ‘hard stop’—they overlap, so scan others, too.

• Gen Z and Millennials

  • Diagnosed with cancer in her early 30s, she researches gifts Millennial cancer patients can use. A weird new cancer hits Millennials, and scromiting increases 10-fold among teens and young adults.

• Pregnancy, birth and parenting

  • Kennedy’s HHS puts babies at needless risk for Hepatitis B at “chaotic, combative” meeting; here’s more from Dr. Jetelina. *Study: Black women still at far greater risk during pregnancy, birth; here’s what that looks like. Millions of kids on ADHD meds that can start a drug cascade. *Plant-based diets change fatty acids in breast milk in just 6 days, and *low Vit D in pregnancy leads to dental caries in kids. *Stopping GLP-1 in pregnancy leads to weight gain, complications.

• Midlife and perimenopause

  • AI deepfakes of real doctors spread midlife health misinformation on social media, especially Tik-Tok. Newsom fixing menopause funding after Halle Berry scorched him; the misdiagnosis that kick-started her advocacy. (Gift article) Tricks to slow down aging in your 40s nd 60s. Survey: loneliest people are in 40s, 50s, and men more than women. For the Gen X sandwich generation, what you can do for those caring for adults in your life.

• The free-to-be-me years

  • 70+ music junkie? Good—lower risk of dementia. Deep dive: What drives life expectancy differences between the US and comparable countries? *Study: this exercise routine beats yoga, swimming and walking over 70. Fear of falls is real: here’s why.

News affecting our lives and families

• Only 10 days left for Congress to fix ACA subsidies; catch up here on the latest. 2025 was finally huge for women’s health, with billions committed to overcome decades of research neglect. Be careful: Chatbots aren’t ready for uploaded personal medical records. Three ways US healthcare is getting worse. Deep dive from WHO on tracking universal health coverage worldwide (right—the US isn’t there). Murder of an insurance CEO led companies to promise to streamline prior authorization. A year later, nothing’s changed—except now all the execs have bodyguards. *Study: only 17% of Americans trust DC to do the right thing—an all-time low. UN: 137 women and girls killed every day by partners or family.

• Men’s health: Men’s health by the numbers. Men are at higher risk for severe GI issues; here’s a primer. Is there a low T crisis? Here’s a good overview.

Sunday Snippets is a round-up of the week’s headlines about women’s health and lives that we haven’t covered in our Notes or posts. Snippets goes first to our terrific paid subscribers, then later to free subscribers. It takes a full day each week to search the news and add context. If you find Snippets valuable, give us a shout-out with a❤️ or a share, or reward us one time with a much needed espresso (or snippet of win) or—definitely best of all—a subscription to support what we do. We do it for you.

In the news this week for women: Cover pic: Role model (not) Trump screeches at yet another woman misogyny lives here. A deadly cancer is more prevalent in women, but some vaccines help prevent cancer, heart disease and dementia. Is the flu this year worse than usual? Easy steps to stop snoring. Your fav sleep or arthritis aid could be on the chopping block. How to trust AI on healthcare and not let your phone suck out focus and energy. Red hair strikes again, surprises on causes of non-healing wounds and tendinitis. Pendulum swings anew on OJ and lean beef. Is an occasional holiday binge OK? Lots of news on Ozempic, including a new more powerful version. Multiple news pieces for Gen Z, Millennials, birth and parenting, and midlife/menopause and better. Brain boosts, sleep gifts, and foot massagers. Benefits at 4,000 steps/day for women—that 10K was for men. News on Parkinson’s, mice cured (1) of T1D, and other disease surprises, including big meal dangers. Do world measles outbreaks signal other diseases are next? Updates on ACA subsidies, the infamous Epstein files, and surprisingly quick voter swings. A new category of ‘Seriously?’ and yet more weirdness at Kennedy’s HHS, and lots of news on femtech.

• Make sure you check our new posts and Notes: We’re updating more frequently there to keep Snippets a readable length.

• Tip: If you hit a paywall here or anywhere, copy the URL of the article into archive.ph.1

• See our footnotes and italicized comments for context from our 30+ years in healthcare.

• Articles marked with an asterisk (*) are from professional journals.

• Disclaimer: Listing these headlines does not indicate a recommendation. With so many news items each week, we don’t take the time to review each. Use common sense and dig deeper into any issue that interests you. More on sources and bias.2

This week’s Women in the News cover pic

Katie Rogers, an experienced WH journalist, and Dylan Freedman, an AI analyst journalist, co-authored a data-based piece on Trump aging (gasp! the horror!), including the widely-published video of him dozing through a 20-minute oval office ceremony. Trump went after Ms. Rogers with a vengeance. To make absolutely sure everyone knows it’s fine to bully women, but not men, he didn’t even mention Freedman. That’s the third time in two weeks he’s been awake enough to demo misogyny to his rapt followers, like his Young Republican 24-35 YO male “kid” leaders. Meanwhile, 80% of Americans are not impressed. #whatahero

News about our bodies

- Overall women’s health

• Non-smoker lung cancer is an alarming, unrecognized, growing women’s disease. Female heart surgeons unlock the (male) heart fortress. Is it a cold or the flu? Symptoms and testing. Signs point to an ugly flu season; if you didn’t get a flu shot yet, do it now before holiday parties. First steps to stop snoring. Health insurance costs keep going up, affordability crisis looming. Will your fav sleep or arthritis edible be banned next year? Countdown until $24B hemp products ban. Key vaccines that help prevent cancers, chronic disease, dementia. Building trust in Dr. AI. How checking your phone drains focus and energy. Who knew? HRT + smoking may increase hand-elbow tendinitis, and red hair gene linked to poorly-healing wounds.

- Nutrition, exercise, sleep, and looking great

• The pendulum swings again. Now it’s (rapid rise blood sugar) orange juice. Some lean beef may be OK on heart disease. That Oura ring might do a lot more in the future. Is occasional holiday binge drinking OK? (Gift article)

  • GLP news: Ozempic/diet week off during the holidays? (Gift article) More powerful Ozempic v2 coming? WH negotiates lower Ozempic costs—we think; pharmacies will be the canaries on that and other promised drug costs. What happens when you stop GLP-1s?

News by generation/lifestyle

Generation don’t have a ‘hard stop’—they overlap, so the others, too.

• Gen Z and Millennials

  • Traditional medicine is slowly exploring more botanicals. Here’s a common weed that can help heavy periods. (Related: a list of herbs used in medicines.) Women and IBS.

• Pregnancy, birth and parenting

  • Common pregnancy health issues linked to later heart, metabolic problems. (Gift article) Infant botulism update; all MyHeart formula may be contaminated. Study: Fluoride in drinking water doesn’t lower kids’ IQs. Short term social media breaks can improve kids’ mental health. Policy: WHO calls on countries to make fertility care safer, fairer and more affordable. Other countries may; WHO is unloved currently in DC. *Study: Sadly, no surprise: Black women get more (major surgery) C-sections. *Study: Planned out-of-hospital births as safe as hospital birth when risks identified and acted on. It’s complicated: GLP-1s and pregnancy. Toddler’s costly ambulance ride. Dangerous toys on the holiday market.

• Midlife and perimenopause

  • Activities that can slow down brain aging. (Gift article) Midlife blood platelet screening may ID early risk for Alzheimer’s. 14 sleep gifts and the low down on foot massagers.

• The free-to-be-me years

  • *Study (Where was the trial enrollment??) Fun at home with sex toys. *Study: Women’s heart benefits at 4000 steps/day, not [men’s] 10,000 steps/day. When the pendulum swings, it can really swing (and sometimes too far, again), but there researchers say there may be an HRT role in dementia prevention, and prebiotics might yield a brain boost. Medicare cutting reimbursement for home health less than planned.

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News affecting our lives and families

• Diseases in the news: Experimental hybrid treatment cures(!) T1D in mice. Sleep apnea link to Parkinson’s, and a simple vitamin may help mitigate symptoms. Big meals and heart attacks. Another child dies from (preventable) whooping cough. Deadly, no-cure measles outbreak in SC, but it’s not just in US, and world surge may mean other diseases are next. The good news? Vaccinations are crawling back to pre-pandemic levels. Hog farm run-off and rising cancer rates. Creator warns mental health chatbot danger.

• ACA subsidies stand-off: Republicans continue their mastery of the art of indecision against a Dec. 15 deadline. See the latest here.

• Epstein files. Remember those? They must be released by Dec 19, with a judge just ruling against the DOJ (again) on two related issues. With sloppy DOJ redacting revictimizing the victims, attorneys ask a judge to order the DOJ to immediately improve their review policy.

• An investor says $140K is the new poverty line. Here’s why.

• They experienced near-death. Here’s how it changed their lives. (Gift article) And don’t lose your family history: 5 questions to ask elderly relatives over the holidays. (Gift article)

• Seriously? The market rewards CVS for claim denial. EPA approves new pesticides with forever chemicals and tries to overturn Biden limits on deadly soot pollution, as FDA faces backlash over reluctance to screen cosmetics for asbestos. Medicaid cuts impact rural health3, and abortion legality bounces again in ND, where OB-Gyns get to spend more time figuring out the law of the day than catching up on science. Trump science privatization (my way or the highway) underway.

  • Kennedy’s untrustable HHS: HHS confusion ushers in “off-label” COVID vaccination. Pending “update,” CDC quietly turns off vaccine search tool. Vaccine critic who stopped state vaccine campaign to be new CDC deputy. (Makary replacement?) Anti-vax FDA leader links COVID vaccine to maybe 10 childhood deaths out of 22 million kids vaccinated, but the last thing to trust immediately is a tiny study by a known anti-vaxer. And under pressure, the head of the CDC agrees to tighten vaccine approvals. Finally, shades of MTG: Kennedy undertakes weather modification.

• Femtech and women’s health innovation: Routine screenings arguably hold the most benefit from AI, and a gyn imaging start-up just raised millions. AHA Ventures looks at investing $20M in heart disease for a potential $2B return. A $20M signal women’s support wear is going mainstream—about time! Most healthcare at home in the future? Female-led start-ups break through women’s health inequity.

• Political winds: While young men (but not as many young women) broke somewhat for Trump in 2024, they now are among the strongest who disapprove of him, and Latinos, who also went for Trump, also now strongly disapprove of his policies. Both populations are more likely to be under- or uninsured, so add that to the ACA subsidies bruhaha and escalating health insurance costs as you consider midterms and talk (carefully) with family over the holidays.

Where the nation is because of Trump is actually ugly, but I’ll let others smarter than I detail the very real danger right now of Trump’s flailing, as it is increasingly obvious even to the totally snookered that Trump is not all there mentally.

This post: If you don’t remember the ACA subsidy issue, here’s the backdrop: Republicans are barreling toward an ACA subsidies cliff cleverly created by Senate Dems when they ran up the white flag on the shutdown. The quick update is Rs fussed and fumed and puffed out their chests and then left for their next paid vaca this week. SOP.

So, enter their hero to save the day. Because it’s scary times when tried ‘n true dog whistles—radical left! drug dealers! rapists!—don’t work anymore, when even your MAGA faithful and Fox News say they don’t love you anymore.

What’s a…leader…to do? Switch sides, of course, the grass suddenly looking greener over there on the damn left, where, unfathomably, all the love suddenly seems to be. After all, kidnapping Dem ideas has worked fine before. (Not that Dems haven’t done the same. All’s fair in love, war and politics).

First it was his 180 on releasing the Epstein files after months/years of fighting that. Then it was Mamdani, whose election, as we all knew, was the start of the end of the free world. I particularly like this pre-Mamdani meeting post from one of my all-time favorite how-to-make-your-healthcare-work-for-my-bank-account experts, Sen. Rick Scott (R-FL. Of course).1

Oops. Didn’t quite work out that way. And when Ms. Marjorie split, things got even worse. Who knew it might not actually be Trump who hung the MAGA moon?

But no matter, no subsidies!!! He was ALL CAPS CLEAR about that on Nov. 8. Send “money”(cash2) to Americans to buy their own healthcare…from, well, the same “fat cat” insurance companies. There were some issues, to say the least, with that “money” idea, which we covered previously. Congress, knowing that, pretended they didn’t hear that part.

That was then. Congress was supposed to fix a clear Catch 22.

But wait! They left town. So now we have the I-suddenly-love-subsidies idea.

It was only a month ago Johnson exalted that the House had a lot of really great ideas on healthcare. But after Scott and others promoted some HSA-ish proposals that didn’t hold water because, as this article points out, the average person can’t put enough money in an HSA for anything serious. The HSA idea is only useful if you’re a very wealthy individual. You know—like Scott. So Republicans just…gave up. Again. They’ve been actively doing that since Obamacare (ACA) passed 15 years ago. All hat, no cattle.

In the meantime, someone(s) finally got through to Trump on how the subsidies expiration might just be a problem for the 2026 midterms. (No kidding.) Not to mention the huge budget bill Medicaid cuts would have begun by then, too. And the really, really bad news it’s not just Congress that’s in a tailspin about all this. The public, including MAGA, has also figured it out.

So this week, just as lawmakers, tails tightly tucked, were fleeing for Thanksgiving, he teased yet another 180: Extend the subsidies for two years. Yes, really.

Not surprisingly, there are…issues:

• The instant reaction of Congress was not receptive. Johnson immediately said the House wasn’t interested. After all, his Freedom Caucus has never been shy about how they feel about the ACA. Give Johnson plenty of legality-tweaking excuses and a few months, and maybe he could deal with them. Two weeks? Not so much.

• Fortune says the cost would be $50 billion.

So, the White House is back to the drawing table. After all, this should be easy, right? There’s that concept of a plan, ready to just be tweaked, right? Uh-huh.

Stay tuned. We’re watching. And we hope you have, hopefully, a wonderfully politics-free Thanksgiving. Alternatively, there’s this:

1

Scott, the financial healthcare genius who led the then-largest ever Medicare fraud penalty at the for-profit national healthcare company he headed, ColumbiaHCA. Just look at him. I ask: Would you trust this guy to get us out of our healthcare fiasco? You’re right. Do not. His wife needs a new fur coat. In Florida.

I don’t know which made me sadder to post in yesterday’s Snippets: that the US again has been rated D+ grade in maternity care, or a story that never should have needed to be published: “I cover women’s health. Here’s my plan to ensure hospital staff listen when I’m in labor.”

But what bothers me the most is so few women know there’s an easy way to take control of your pregnancy—and how well you and your baby do—right from the start. As this study in the American Journal of Obstetrics and Gynecology shows, moms who choose care from midwives have better experiences than women in even the same hospital who are cared for exclusively by doctors. Midwife moms also tend to have fewer cesareans and prematures, shorter labors, and much greater freedom of choice and support on how their births take place—in addition to knowing physicians are always available should a complication occur. For the record: Midwives prevent complications. Physicians fix them. Use of both at the right time means the best possible opportunity for a health mom and baby.

But another reason women love midwifery care? This one thing—birth—that women can do that men can’t is a hotbed of competition, myths, and judgment from every woman who’s ever even thought about having a baby. Midwives like Ann manage to balance logic and love, helping moms and parents stay sane.

Ann Lederer is a CNM in who somehow balances being a wife, mom of three, CNM, and writing her very active Substack, A Moderate Midwife, as well. She’s walked the walk, which—for a CNM—includes being with moms during labor and sticking with them in early motherhood, not just showing up for delivery. Whether you’re thinking about having a baby, pregnant, getting through parenting while keeping your sanity—or a grandmother trying to keep up—here are four of Ann’s recent posts. Take a peek at her Notes as well; she’s in a community of terrific writers about this emotionally-fraught but ultimate incredibly-rewarding lifestage.

Some things don’t change about birth and mothering—but fortunately, others do, and Ann keeps it all in great perspective. Enjoy!

This will surprise many: The case for evidence-based birth and why midwifery matters, with important, very real data that you may not hear from anyone else.

A Moderate Midwife

You May Want To Give Birth With A Midwife

Back in my short-lived tweeting days, one particular tweet got a lot of attention. To this day, I’m not sure what was so special about this tweet in comparison to my other hot takes, but somehow the algorithm decided that 5 million people were going to be exposed to it. Weird…

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6 months ago · 46 likes · 22 comments · Ann Ledbetter

Before epidurals, the battle was over Twilight Sleep, and before that, it was ether and chloroform—and I’d bet this fight was over thousands of other ideas eons before that. This is one of the great all-time maternal battles, often more resplendent with judgement and righteousness than data. Here’s a nicely balanced perspective, combining evidence, experience, and empathy.

A Moderate Midwife

You May Want To Give Birth Without An Epidural

I’m always hesitant to wade into the waters of the “natural childbirth,” debate, at least when it comes to the over-simplified version of it contained in the so-called “Mommy Wars.” A recent example is this Babylon Bee article…

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6 months ago · 152 likes · 100 comments · Ann Ledbetter

Every mom of a baby boy feels like she’s the first ever to face the Circumcision-or-Not Dilemma—and for her, she is. This is not a minor decision, and it easily becomes the only battle that can get more heated than the My Birth Was Far Harder/Easier Than Yours competition. Data—scant anyway—usually takes a very back seat to “What does dad look like?” and every other strongly held and voiced emotional theory in the family, the neighborhood, the grocery store, childbirth classes, church—everywhere a mom turns. And everyone’s an expert...except her.

A Moderate Midwife

Should You Circumcise Your Baby Boy?

In the spirit of “strong opinions, loosely held” and inspired by Nancy Reddy who, like me, doesn’t know a lot of things, this post is about a topic on which I hold very uncertain, conflicting opinions: circumcision of newborn baby boys…

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8 months ago · 24 likes · 48 comments · Ann Ledbetter

And once women escape the I Birthed Better Than You Battle, lurking in wait to make at least the next two decades crazed is the I’m a Better Mother Than You Prize Fight—never worse than when your child just. won’t. sleep, leaving mom exhausted and vulnerable to everyone with an N of 1 who believes they know better.

A Moderate Midwife

OK, But My Kids Are Harder Than Yours

A recent conversation with my son’s pediatrician at his 10 year-old well-child check gave me mind-blowing insight that I wish I’d had approximately 9 years early. It went sort of like this…

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5 months ago · 135 likes · 72 comments · Ann Ledbetter

• Make sure you check our posts and Notes: We’re updating more frequently there to keep Snippets a readable length.

• Tip: If you hit a paywall here or anywhere, copy the URL of the article into archive.ph.1

• See our footnotes and italicized comments for context from our 30+ years in healthcare.

• Articles marked with an asterisk (*) are from professional journals.

• Disclaimer: Listing these headlines does not indicate a recommendation. With so many news items each week, we don’t take the time to review each. Use common sense and dig deeper into any issue that interests you. More on sources and bias.2

This week’s Women in the News pic

Remember when you could point to a president and tell your kids they could grow up to be like him? Or watch a speech that brought tears to your eyes—and not because you were enraged? The genius in the White House reached new misogyny lows this week, telling journalist Catherine Lucey, “Quiet, Piggy” on Air Force 1, surrounded by other reporters and his usual syncophants. Ms. Lucey, pictured in this post, is an experienced, smart, professional journalist, who was doing her job: asking the questions all of us want answered. ABC’s Mary Bruce was doing the same thing this week when Trump lambasted her on national television while also (unconstitutional and likely illegally) threatening her employer, showing off his power to the smirking man honored in the Oval Office, the same man who ordered another journalist murdered and dismembered. The nation is so inured to Trump’s degeneration, we barely blinked. But this article in the LA times has it right: ‘Quiet, piggy’ wasn’t a joke. It’s a dangerous invitation to violence. And it’s a key, well-recognized move in authoritarian playbooks and an on-message call to yet more female violence for his MAGA followers, already primed for exactly that. Ask MTG, now on the receiving end of the death threats she herself frequent created for others.

On multiple fronts (here and here and here and here) there’s an increasing sense the wheels are coming off this mess. In fact, MAGAs may be the only ones whose heads are finally spinning more than the rest of us after a month of chaotic 180s: Israel and Epstein—both huge MAGA priorities, and the big MTG-Trump break-up, with MAGA goddess MTG ultimately quitting Congress. This week, MAGA also watched Trump tell his new BFF Zohran Mamdani that it was OK to call Trump a fascist and then saying he—Trump—would be happy to live in NYC under Mamdani, the same guy Trump’s been calling a communist and threatening to arrest.

More than ever, political news is intersecting with women’s health and lives. This Substack isn’t primarily about politics. It’s about women’s health and lives. But all our lives as women, mothers, and leaders are being massively impacted by politics. There are excellent political writers on Substack who follow the political muck far better than we can. So we’ll try to leave it to them to cover the depths our current political cluster and get back to our mission once we talk about the CDC…again. But do stay keenly tuned on politics right now. As a nation, we haven’t been in a place this dangerous since Nixon.3

Women’s health

Why you won’t see a whole lot of actual women’s health news today:

1. Scan any health news site and you’ll see it’s consumed by the new chaos in the CDC. The lede is Kennedy’s change to the CDC pages on vaccines and autism, which he directed himself because, well, he says. This is a new and devastating turn by the CDC, which has been effectively dismantled by the Secretary of HHS. Behind that story is the power struggle between Kennedy and Marty Makary, an actual physician and public health expert hired by Kennedy to head the CDC. I can’t find anyone who actually says it out loud, but IMO the CDC vaccine-autism dictum from Kennedy was likely because Makary wouldn’t link vaccines and autism. Given Makary was hired in part by Kennedy because of Makary’s own vaccine skepticism, it that’s the case, it says a lot. Kennedy, via Trump, went after Makary’s top policy and research aid this week a time-honored way to undermine a powerful foe’s org structure.

   1. “We can no longer trust the CDC website.” For nearly 80 years, the CDC was respected around the world for its authoritative, evidence-based leadership in public health. After unprecedented autism-vaccine messaging change, scientists, advocates say CDC no longer trustworthy. See this excellent commentary from Dr. Katelyn Jetelina, a former CDC advisor whose advice is followed worldwide by over a half billion people. For anyone like Dr. Jetelina who’s spent a lifetime in healthcare, this is a heart-breaking statement.

2. The ACA bruhaha in Congress, Trump’s malfeasance, undoubtedly the new CDC chaos, and another upcoming paid vaca have stalled the (alrady weak) possibility of any other health news from there.

3. Health reporters have already abandoned ship for the holiday. The good news is that also means there are more in-depth pieces filling the health news that are not time-sensitive that often our affect our lives even more than the headline of the day, below.

Health call-outs by generation and lifestyle

Remember, these issues often overlap generations. the generations before and after yours.

• Gen Z and Millennials

  • 9 easy brain executive function tips for organizing work, ADHD, brain fog and more.

  • More Millennials are being diagnosed with colon cancer. What to know about your risk.

• Pregnancy, birth and parenting. I wish this were a happier section today.

  • The Senator who is actually a physician: “I’m a doctor who has seen people die from vaccine-preventable diseases. What parents need to hear right now is vaccines for measles, polio, hepatitis B and other childhood diseases are safe and effective and will not cause autism. Any statement to the contrary is wrong, irresponsible, and actively makes Americans sicker.”

  • The good news? * Yet another study says Tylenol is not linked to autism or other neurodevelopmental disorders.

  • Because our peer affluent countries do so much better, it’s even more alarming that the US just received another D+ on maternal health. We’re the ones who decide whether we tolerate this—and you start to do that with your vote. (#midterms) We’ve known how to fix this for years. Great maternal and infant health scores are not a mystery; see more below. Coming tomorrow in WomenUnbroken: A good place to start on better health for your own pregnancy and to fix our internationally-embarrassing maternal and infant health grades.

    • A new state ‘leader’ with worst maternal health in US—and among the worst in infant health.

    • How we differ from other developed countries.

    • Related: How you can protect yourself: “I cover women’s health. Here’s my plan to ensure hospital staff listen when I’m in labor.” (Gift article and I can’t believe I even have to post something like this. Women are incredibly vulnerable and dependent during birth; NO woman should have to “protect” herself then. It’s we as a nation who should be protecting her as she does the incredibly difficult work of birthing our nation’s future.)

• Midlife and perimenopause

  • Walking backwards: Unexpected power move for midlife strength. I learned a while ago from an aquatic physical therapist that walking backwards in water—a pool—is great prevention for sciatica attacks. This is the ground version.

  • NSFW: * Kinsey Institute: Free, age-old fix for menopause symptoms.

    • Related and definitely do not open at work: (Womanizer).

  • SFW: *Another old, easy, free trick to reduce hot flashes.

    Tossing and turning: New science on sleep issues during menopause.

• The free-to-be-me years

  • The best books of 2025 about healthy aging.

  • * Study: Is ‘time poverty’ the hidden barrier to dementia risk reduction?

  • The anti-aging gold rush should focus on quality of life, not just quantity.

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Women’s lives - news that affects our lives and those we love

• SC tried—again—to make women who get an abortion chargeable for murder. Again, it didn’t make it out of committee. That didn’t stop the state from charging a woman who attempted an abortion for murder.

• Looming affordability crises set to impact Americans with employer insurance plans.

• Unheard. Unserved: Black women face added healthcare barriers as race, gender intersect.

• The Trump administration is turning drug reviews into make-a-deal. Surprised? Not.

• Pediatrician: 5 common mistakes grandparents make. (Gift article)

• The rise of the ‘just in case’ MRI.

• Why embracing technology as we age is a good thing. (Gift article)

• Exactly as expected: With huge increases in ACA costs, Americans searching for cheap health plans are getting scammed.

  • Wonder where your health dollars go? Here you are. Or this.

  • How patients are using AIA to fight denied insurance claims.

• In the midst of worsening physician and nursing shortages, Trump administration changes limit physician and nursing student access to scholarship funds. Guaranteed that if you think healthcare is a problem now, you will absolutely feel this, personally and in caring for those you love.

• We thought the threat was gone, but new bird flu death is a brand new strain. If only we had a functioning CDC.

• How putting thoughts into words can shift brain from despair, overwhelm to clarity.

• Study: Data center pollution health impact tripled in four years.

• Most and least dependable airlines for holiday travel. (Now they tell us.)

3

As The Bulwark wrote this week, we’re at a time more dangerous than the last months of Nixon, this time without the people in Nixon’s WH who backstopped his worst impulses. Generations theory—which looks at five centuries of history—also holds this is a very dangerous time.

Laurie Marbas, MD, MBA is one of my favorite substackers. A double board-certified family medicine and lifestyle medicine physician who has been utilizing food as medicine since 2012, Dr. Marbas is on Substack as The Habit Healers, focusing on helping people rebuild their energy, metabolism, and confidence using one simple principle: healing happens through habits, not willpower.

Here are three of her all-time most-viewed posts. While she has detailed packages limited to paid subscribers, the meat of what and why are always free to all. Enjoy!

Why Aging Is an Art—And How You Can Master It

The Habit Healers

10 Powerful Habits of People Who Age Well

The Woman Who Redefined Aging…

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a year ago · 7109 likes · 322 comments · Laurie Marbas, MD, MBA

If You Can Do These 9 Moves, You Can Handle Almost Anything

The Habit Healers

Want to Be the 80-Year-Old Who Still Hikes? Start Here.

Sometimes a reader sends a message that stops you in your tracks…

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10 months ago · 829 likes · 17 comments · Laurie Marbas, MD, MBA

No prescription. No side effects. And yet no doctor prescribes it. The one habit that protects your metabolism, bones, brain, and balance—and how to make it stick.

The Habit Healers

The Most Overlooked Medical Intervention After 50

Let’s play a quick game…

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10 months ago · 553 likes · 20 comments · Laurie Marbas, MD, MBA

They’ve all gone home, tails tucked, avoiding the double debacle of the ACA and the Epstein release. Read below, though, to see how 4 House Republicans staged a revolt to get a subsidy vote in January. Here’s how the end of ACA subsidies could affect you. Finally, WaPo has a piece on how insurance brokers gamed the system, roiling the debate. (Surprised? Not.)

Update 12-18:

As expected, a vote on extending the ACA subsidies this year is rapidly swirling down the drain. But it’s definitely not business as usual. In what media consensus calls a “stunning” move, four Rs in the House joined with Ds to force [yet another leadership-defying] discharge petition to get a—vote vote on subsidies in January after Johnson brought forth a subsidies-free ‘healthcare’ bill. Even R senators aren’t happy with Johnson’s hardline approach. The move means the House is required to vote on the measure, although almost certainly not until January. Johson’s bill is DOA in the Senate, and a bipartisan group of House and Senate lawmakers met this morning to begin exploring a compromise.

Don’t make the mistake of thinking the discharge petition is an isolated event. The “revolt” rocked the establishment, but that’s on top of Susie Wiles’ [superficially disingenuous] 11 hours of Vanity Fair interviews (keeping in mind Wiles is anything but naive), news that 10% of Congress plans to bail in 2026, Jack Smith testifying this week he had proof beyond a reasonable doubt that Trump conspired to overturn the 2020 election, Bongino (and rumored others) emptying his office this week ahead of a January-of-course-not-Epstein-files retirement, all on top of Epstein Files Release D-Day—tomorrow. Even an attempt at Congressionally-unauthorized warring—historically a great way to rouse the nation behind the administration and boost the economy—hasn’t diverted attention. Trump’s plan from last night is very simple: It’s Biden’s fault. Do a Google search (or read anything from The Bulwark substack or many others) and you’ll see the phrase “25th Amendment” is trending. 1,129 days left. Buckle up.

Update 12-16:

“I am p‑‑‑ed for the American people. This is absolute bulls‑‑‑-,” Rep. Mike Lawler (R-N.Y.) thoughtfully articulated. “The idea [of a subsidy fix] just seemed to dawn on leadership … like, in December,” Rep. Kevin Kiley (R-CA) piled on. piled—on

And, yah, that’s pretty much what it looks like on the outside, too.

The deadline was Monday for people on ACA plans who want to enroll in coverage that begins Jan. 1. For plans beginning Feb. 1, the deadline is Jan. 15 and Rs in Congress appear as broken as usual.

A couple of ideas are still reverberating around like 22 cal bullets inside an otherwise empty skull. 20 senators met Monday night at the invitation of Sen. Susan Collins (R-ME AKA zzzzz). “It’s perilously close to something called legislating, which used to be common in the Senate and hasn’t been in a long time,” Dick Durbin (D-IL) says. And vulnerable House reps screamed some more at Johnson on Tuesday. No word yet from Trump on the subsidies, and media are openly noting his… umm…engagement “might be unproductive.” In the meantime, Trump doesn’t seem happy about anything, particulary his SCOTUS request for divine intervention on tariffs and Susie Wiles’ remarkably unwily Vanity Fair interview has multiple WH “junkyard dog” brains smoking. Finish up your gift list; we’ll keep watching Congressional Rs for signs of subsidy life. Breath holding unwise.

Update 12-14:

After the Senate came away empty, increasingly restive and vulnerable House members came up with a subsidy-free proposal they’ll try to launch this week. Red states like ground-zero FL will be hit hard by cost increases, and Congress is already worried about another shutdown in January over the subsidies. A huge new PRC poll (N=10,000+) indicates 2/3 of Americans say it’s the federal government’s responsibility to make sure all Americans have healthcare coverage in addition to another quarter saying both Medicaid and Medicare should be continued. Only 7% said the government shouldn’t be in the healthcare business. (Apparently if we call it something like Ensure Care, it’s not socialism, and we need it yesterday.) Another survey shows a third of Americans had trouble paying for health needs last year. Trump remains hands-off (because there is no problem), a growing problem for Rs. But behold! In the spirit of governing and Christmas or something, Trump now says he’s open to working with Ds: “What a nice group of Democrats. I think we’re going to start working together on health care.” Ds, of course have full faith and trust in that. /S And now Cassidy is muttering about another possible deal. Stay tuned.

Update 12-13:

As expected, it was same-old in the Senate, with dueling votes that went nowhere (see more below). In an overview of the underlying GOP issues, the WSJ notes, “Republicans are caught between the belief among many GOP lawmakers that markets, rather than expensive government programs, should play the leading role in providing coverage and the fact that many GOP voters have come to rely on coverage from the law, often called Obamacare.” With only 5 working days left, vulnerable and increasing rebellious House members are designing…something. Read more about the emerging House proposal here. And of course, the House couldn’t talk about the going to the theatre without bringing up abortion, so it’s in play on this as well.

Update 12-12:

As expected, both the R and D Senate proposals failed Dec. 11, with a vote of 51-48 for each; 60 votes were required for passage. Predictable posturing on both sides followed. KFF polls continue to show broad support (75%) for the subsidies. Given there are only 6 days until Congress recesses again, the likelihood of anything else happening is low, with massive hikes taking place on Jan 1. In the House, a bipartisan group launched a long-shot effort at a compromise bill. Stay tuned on that.

Update 12-11:

The senate is expected to vote on dueling R and D proposals today, with both likely to fail. Watch live on PBS or CSPAN. In the meantime, restive House members on both sides of the aisle are working on a bill that extends the subsidies for two years with new income limits and antifraud measures—and, as we’re seeing increasingly, talking about using discharge petitions to get around Johnson. There may also be some cracks in D unity on the 3-year extension.

Upddate 12-10:

Senate votes are likely this week on dueling proposals, neither likely to pass. Senate Rs are solidifying behind a Cassidy/Crapo HSA-lite approach kinda-supported by Trump; here’s the Cassidy/Crapo happy-happy announcement. (The nation has been there, and it doesn’t work for non-millionaires although many would likely find cash appealing just before major gift-giving holidays and unpaid bills—never mind cash would likely never see an HSA account.1 Vulnerable senators aren’t happy with any of it. Senate Ds are staying focused on 3 year extension, and so far, it looks like they will win politically, pass or fail. The House in the meantime is bringing a ‘real’ healthcare solution (after only 15 years!) to the floor next week that ignores the subsidies. In the meantime, with 41% of ACA enrollees blaming him and another 35% blaming Rs, Trump is throwing Congress under the bus prophylactically with “It’s their decision.”

Update 12-8:

WSJ says some Rs are panicking; we’ll see if that holds water. With only 9 days left to their next vaca, some kind of voting in Senate and/or House is possible this week. Ds built in a requirement for a Senate vote when they agreed to end the Shutdown, and see whatever happens as a political win: If the subsidies get extended, millions of Americans get lower healthcare costs. If the subsidies don’t get extended, Ds plan on riding a lot of anger into the midterms. Polls continue to show that anger is aimed at Rs, and. Sen. Josh Hawley (R-MO) alone says a half million people in his state are affected.

Dems have their version: extend the subsidies for three years, which the R-leaning CRFB says will add $300B to the deficit. Senate Rs are pushing either an extension of subsidies with limitations or a high-deductible HSA-augmented option. The problem with the latter is that, unlike the multi-millionaires writing that version, people who qualify for ACA are lower income, which means they’re very unlikely to be able to put away enough in an HSA to deal with even a low-level problem 4-digit surgery cost, let alone 5-digits for something more serious. Meanwhile, still luring is the issue of some Rs wanting every bill about anything to include more abortion restrictions. More on that and the HSA idea below.

Update 12-6:

10 working days left, with no progress but much fretting. Spin is still the R mantra, while Ds are firmly backing a 3-year extension and ready to force a vote. Several Rs are suggesting using HSAs; here’s a good substack on why that doesn’t hold water. Trump, apparently preoccupied with other issues and in need of sleep, is punting to Congress. His indecision leaves Rs in Congress directionless and looking at the underside of the midterms bus. In the meantime, a new survey says 72% of MAGA and everyday R enrollees want the subsidies extended and improved. R states have had the largest increases in ACA enrollment…

…and the ACA issue is adding insult to injury, as R states are at least as affected by budget bill Medicaid cuts as D states.

Update 12-3:

Despite some Dem optimism Monday, spin is back for Republicans, the party that hasn’t been able to formulate an alternative to the ACA for 15 years. Oz says the WH is waiting for Congress, and Congress says they’re waiting for the WH. (Busy sign at WH this week: What war crime?) In the meantime, Rs admit Ds will “pummel Republicans in 2026” by highlighting “a number of sympathetic cases,” although “number” doesn’t begin to describe it. 24M lower income ACA enrollees will be told to pay double; another 10M poor will be dumped from Medicaid via budget bill cuts; and 86M Medicare recipients are getting nailed with a 10% increase and scaled-back benefits. Did we mention another 165M with employer-provided insurance will see costs twice inflation in 2026? Added on, of course to other inflation. Of course, the shutdown stopped release of the consumer price index (sure it did 😁), but if doubts, check with a neighbor.

The current focus might be on ACA, but there’s a reason so many people are paying attention and not liking what they’re feeling. That’s a total of 285M—or 82% of the population—about to be nailed by increased healthcare costs few can afford. “Number,” indeed. And here’s who they blame:

Talk about material for political ads. The inability of Rs to comprehend the anger of non-millionaire Americans about health care boggles the mind, even though every health care exec in America now has legions of bodyguards since Brian Thompson. I recently spoke at an event for 600 healthcare leaders; the CEO’s grim bodyguard, font and center every day, loomed over every minute of the conference.

Bottom line today from The Hill: “Senate Republicans don’t see a bipartisan deal to extend enhanced health insurance premium subsidies coming together before the Christmas deadline, given the complexity of the issue and a growing fight over abortion, an issue that deeply divides both parties.”

Update 12-1:

They’re baaack, with just 30 real days (but only 15 of their days before another vaca) to decide on ACA subsidies. They’re waiting for marching orders from their hero, without which all is likely in vain after Johnson nuked Trump’s 180 on subsidy extension he ALL-CAPPED SCREAMED to never do. Currently, Trump is being coy: he really doesn’t want to extend the subsidies, but, you know…midterms. Lurking: House intransigence about anything that doesn’t further limit abortion. Sen. Amy Klobuchar (D-MN) says there will be a Senate vote by Dec. 31, but Mike Johnson is not yet showing much interest. Forbes talked to multiple Rs over the weekend and says an extension is gaining ground. More background: a quick read on why Rs have to do something now, or re-commit to a policy of indecision.

Update 11-28:

Congress, of course, is on yet another paid vaca, fresh off their 2-month paid shutdown vaca. Congress—particularly Johnson—doesn’t like Trump’s idea of expanding the subsidies to get past the midterms, so the WH is ‘revising.’ But no matter what the WH comes up with, one sticking point is likely Congress’ allergy to any proposal that does not also prevent abortion access—a barrier Dems counted on. The key problem is whether to extend subsidies for the reviled ACA or face retribution in the midterms. Everyone wanders back Monday; we’ll see what emerges then. But they all leave for their next paid vaca Dec 19. After 15 years of hating on ObamaCare without proposing an alternative, it’s hard to believe they can pull off something cogent in three weeks.

Update 11-22:

Remember when Dems capitulated on the shutdown, but as a condition got the Senate to promise they’d reconsider subsidies before Dec 15? that’s now looking like a nicely-laid trap because, no surprisingly, prospects for a fix are dimming. Republicans are having trouble getting it together on Obamacare or any kind of alternative this month. (See why below.) That’s very likely going to bite them in a soft, tender spot for midterms: imagine the Dem ads. Retiring Sen. Tillis (R-NC): “If we don’t address the subsidies issue in December, I don’t think it’s going to get addressed next year. I see the political shop on the Democrat side just churning up all the very sympathetic stories that are going to result if we don’t come up with a reasonable plan.” No kidding—and polls already show Americans (even Rs) blame Trump and the WH, not Dems. Buckle up.

Quick overview for all y’all TLDR peeps

1. When Dems raised the shutdown surrender flag, Rs agreed to “reconsider” ACA subsides by Dec 15.

2. Rs hate ACA (Obamacare—a clue is in the name). But they haven’t been able to do anything better after 15 years of trying. Now they’re dashing toward an immediate cliff with no easy options in sight.

3. Americans like ACA, and ACA growth in red states since 2020 dwarfs that in blue states. Worse for Rs: their reliably red rural voters are getting hit more by budget bill Medicaid cuts and huge ACA cost increases than Dem voters. Voters get it and polls consistently show they blame Congress and Trump.

4. If Rs don’t figure it out, it’s likely to be huge Dem midterm leverage.

5. Refreshed after a two-month paid shutdown vacation,2 the Senate in particular is looking at possible outs, right now focused on band-aid HSA-like savings accounts, which would have the additional benefit for them of undermining ACA. Democrats so far are holding out for subsidy extension, with a decent rationale. More below.

Bonus points: Cool graphics. And did the super slick dealmaker find yet another way to get us to pay for tariffs? And is he also truly, finally losing it? (Very strong water!)

Stay tuned. We’ll watch it here.

Remember two months ago

…when Democrats brought on the entire, record-setting longest shutdown ever over expiration of ACA pandemic-era subsidies, hitting at least 24 million people? Yes, a couple other issues, but that one stuck. And then they folded when the shutdown started seriously affecting wallets and air travel again, this time for America’s biggest holiday travel season.3

When Dems flew the surrender flag, they forced a reconsideration of the ACA subsidies

—not an extension of the subsidies, but a promise from the Senate to reconsider the subsidies by mid-December. Rs agreed to look at the issue, in no small part due to their constituents actually being hit harder than Dem populations by both the upcoming budget bill hits to Medicaid and the expiration of the pandemic-era ACA subsidies. More than half of ACA enrollees live in Republican Congressional districts. Even more startling, since 2020, ACA enrollment in red states grew much faster than in blue states, accounting for 88% of the total national enrollment growth and increasing by an average of 157% in those states, compared to a 36% increase in states that voted for a Democratic candidate.

Congressional Republicans have definitely been hearing from them about ACA cost increases exceeding $1,000 a month for the average enrollee, and many times that for some. These are not people in top income brackets. Half of enrollees have an individual annual income under $24,000.4

Governing being a taxing endeavor, these days it doesn’t happen until much until polls force an issue, so increasingly negative ratings for both Congress and the White House on healthcare have created consternation in the R caucus. Whoda thunk after their “landslide” 2024 win, right?

The problem with mandate thinking when reality is 50/50

...is that Americans aren’t buying it. Polls5 indicate Americans continue to like the ACA, the reason dozens of Republican attempts to repeal it didn’t fly.6 Another recent poll says about 8 in 10 rate the issue of health care “extremely” or “very” important to them personally. That includes about 9 in 10 Democrats and three-quarters of Republicans, and it puts health care next to the economy among Americans’ top issue priorities. And polling indicates citizens are particularly unhappy with Republicans—not Democrats—about what’s happening on healthcare.

Trump’s approval ratings tanked even more as tariffs hit and the shutdown went on…

..and surprisingly7, Americans are aware of—and very displeased with—what they see as excessive spending and misplaced priorities from this administration.

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So, fresh from a two-month paid vacation, the scramble is on in the Senate to fix healthcare in a month

…something no party has been able to do for over a century. You remember “concept of a plan”? It hasn’t even made it to ‘concept’ in the House, and the Senate is focused on band-aids that just move money around to the same insurance companies, but without the detested “Obama” in the name. Democrats have a fixed—if tenuous—goal in mind.

As of today…

Yesterday Trump’s show-and-tell praise of the man the CIA says ordered the murder and dismemberment of Jamal Khashoggi8 was front and center.9 Between that and the post-yowling “we wanted it all along” near unanimous Epstein voting, you may have missed intense action on the ACA subsidies. If the Senate honors their promise to “reconsider” ACA subsidies, the pressure is on. There are less than six weeks before the subsidies expire, with cost-revealing open enrollment underway (and their next paid vaca right around the corner10). Here’s the score so far; we’ll update over the next month as events unfold.

To say Republicans hate the ACA—well, anything including the word Obama—would be an understatement. And while voters may not fully understand it yet, Medicaid and the ACA are inextricably linked; there’s worse coming as the full impact of ACA hits the public. With polls saying their constituents are no longer being successfully gaslighted on the issue, they know a major storm is coming just before midterms.

• The House is just getting started. They’re way behind the Senate on this and worried about the Senate rolling them, and some moderate and vulnerable Republicans have already banded together to push for a temporary, possibly one-year, extension to avoid political fallout from the premium spikes. The House meets Thursday morning to start coming up with their…concept. Here’s a good summary of just how badly they’re behind, and what’s ahead.

• In the Senate, where several members understand healthcare better and have had longer tenures to consider it, alternatives to extending the subsidies are quickly emerging. Trump is against the subsidies ths week, of course, and says he will only support a plan to “send the money directly back to the people.” At least two senators were immediately ready with dusted-off proposals for HSA-like savings accounts that have the additional benefit of a potential ACA death spiral.11 Sen. Rick Scott (R-FL)—a long time genius at manipulating government funds into investor profits12—has proposed an HSA-like saving account approach. So has Sen. Bill Cassidy (R-LA), the physician who was the final wobbly vote to approve RFK Jr. for HHS, for which he’s had some recent regrets.13 He’s shown flashes of a conscience on occasion in the past—like his vote to impeach Trump—but he’s up for re-election in his deep red state and loves being a Senator.

So far, Democrats remain focused on extending the subsidies. They are banking on several obstacles for Rs: polling—including this remarkable new one today, recent double digit election wins, R intransigence on tying everything to abortion, R blindness about ACA popularity, the very short time frame, and the l.o.n.g. Republican history of inability to come up with anything cogent on healthcare. Division in the caucus was a problem two months ago and it hasn’t gone away. We’ll see how the Dem plan flies in the face of organized HSA-like plans from the Senate that follow Trump’s command at a time there are indications Trump’s political grip (and his mind14) may be unraveling.

You knew there would be head-shaking irony in all this somewhere

Here you go. Trump’s directive to Congress health care was actually to pay “large amounts of dollars back to the people.” Specifically, he said “The insurance companies are making a fortune. Their stock is up over a thousand percent over a short period of time. They are taking in hundreds of billions of dollars, and they’re not really putting it back, certainly like they should.”

The obvious irony, of course, is that those same insurance companies are the ones who would benefit from the Senate HSA plans.

But wait! There’s more on this special! Reading Trump’s statement carefully, he didn’t say anything about HSAs. He said to send “large amounts of dollars back to the people.” People on ACA are not affluent; there are income limitations for qualification. So, let’s see. If you were a lower income family and received actual cash right around Christmas, would you spend it on a healthcare plan you hope you won’t need in the coming year? Or on an overdue mortgage or rent? Or rapidly escalating utility bills, with electricity up 6% and gas up 14% this year? Or food? Or how about gifts for the kids? In other words, would people use cash to pay, at least in part, for tariff-created inflation? Genius, really…although the Senate was quick to a different translation.

14

Psychologists and psychiatrists have long speculated on Trump’s mental health—or lack of it. Most frequently mentioned are dementia (which his father had) or [malignant]narcissistic personality disorder. But others also show up in psych literature: antisocial personality disorder (your basic sociopath), paranoid personality disorder, and sadistic personality disorder. As is often the case, whatever is going on is most likely a combination; click here for more. Trump’s niece Mary (a psychologist) and nephew Fred have both recently reiterated the increasing similarity between the president’s behavior and his father ‘s dementia symptoms. Even Epstein apparently weighed in back in 2018 on Trump having early dementia. (More irony: here’s what’s still on our very own HHS NIH website has about all this. Likely not personally approved by RFK Jr. Catch it before it gets taken down.)

Frontotemporal dementia (FTD) symptoms, in particular, are frequently mentioned. Mainstream media, happy to go after Biden’s brain health, aren’t touching that of the retribution-minded current president, but Newsom and Crockett have taken off the gloves very publicly. The denizens of The Bulwark are hardly unbiased, but as former Republicans now followed by millions, they have no difficulty saying what mainstream media won’t. Here’s their post from yesterday. Don’t miss the included video of a Trump’s unhinged ‘speech’ this week.

The Bulwark

Trump is not have all the mentals. McDonald’s. Water. Sir! (Very strong.)

Quick preview: I’m working on a banger for tomorrow. My operating thesis is that 2025 was the period of maximum danger for democracy and I can’t believe I’m saying this but . . . maybe we’ve made it through the crucible…

Read more

6 months ago · 1356 likes · 639 comments · Jonathan V. Last

In the news this week for women: Cover pic: The Big Breakup…who knew? And can it be true…the you-know-who files finally released this week? And a new discharge petition goes after ACA subsidies. Is intermittent fasting good for the brain? Where you live may determine whether you find breast cancer early enough. Tips on avoiding holiday crud. Terrific new clues on diagnosing chronic fatigue syndrome, why younger women are getting colon cancer, and maybe even how Lupus develops. A death from tick-caused meat allergy. Cheetos color goes away—but the jokes and health issues won’t change. Managing winter skin, and the new breed of skin evangelists. A coffee a day to keep AFib away? Bonus: $20 wines for T-Day. GLP-1s in the news, ByHeart formula and botulism, and parenting communities. No Rx, no FDA, no insurance—but testosterone is all the rage. HRT and HRT options. Skip weight and BMI—there’s a new measure of health on the horizon. And some terrific new tech, including an FDA-approved device for home use that combines an electrocardiogram and digital stethoscope, and a virtual support program that may decrease NICU stays and C-sections.

• Tip: If you hit a paywall here or anywhere, copy the URL of the article into archive.ph.1

• See our footnotes and italicized comments for context from our 30+ years in healthcare.

• Articles marked with an asterisk (*) are from professional journals.

• Disclaimer: Listing these headlines does not indicate a recommendation. With so many news items each week, we don’t take the time to review each. Use common sense and dig deeper into any issue that interests you. More on sources and bias.2

This week’s Women in the News cover pic

Trump and Marjorie breaking up sure wasn’t on our bingo card. But here we are: more 2025 governing chaos as MTG purports to be confused about why Trump doesn’t seem to want to publish the Epstein files, reportedly unleashing death threats to her from his very peaceful and loving followers. The Big Vote is scheduled for Tuesday, with “scores of Republicans” expected to support the following floor vote, now that Speaker Johnson finally ran out of excuses to deny a feisty Adelita Grijalva the House seat she won 50 days ago. Trump is burning up the phones, putting on any pressure he can to quash release of the files. Buckle up and stay tuned. We’ll follow it here.

Our bodies

- News on women’s health

• Melinda Gates names 80+ non-profits for $250M in grants.

• The battle on discharge petitions switches to extension of ACA subsidies as Dems propose 3-year extension.

  • Healthcare organizations urge Congress to act quickly.

• If you feel more awake and alive using intermittent fasting, you’re not alone.

• Tips on keeping yourself and the family from getting sick over the holidays.

• Where you live can determine access to reliable screening for breast cancer.

- Trending

• Finally!!! A new blood test identifies chronic fatigue syndrome (CFS)—and maybe long COVID, too.

• New clues on women’s colorectal cancer <50: Ultraprocessed foods…again.

  • 50-80 YO women twice as likely as men to be addicted to ultraprocessed food.

• Hemp industry plans next move after Trump signs THC ban that could outlaw gummies, vapes, drinks and creams.

• Scientists trace Lupus to one of the world’s most common viruses.

  • Lifelong drugs for autoimmune diseases—experienced more by women—doesn’t work. Scientists are trying something new.

• First person dies from meat allergy from tick bite.

- Nutrition, exercise, sleep, and looking great

• Cheetos are going colorless, but don’t expect them to make the health food list.3

• Dermatologists on how to manage winter skin conditions.

• *Study: A coffee a day to keep AFib away?

• Nutrition-ish? $20 wines for the Thanksgiving table. (Gift article…you’re welcome!)

- GLP-1 news

• GLP-1s linked to lower colon cancer mortality rates.

• New drug reduces side effects of GLP-1s.

Note we often group some articles in generational/lifestyle categories for easier reading, but generations don’t have a ‘hard stop’—they overlap, so check topics. Also check the Femtech section, below, for more news that can apply to your generation and interests.

- Gen Z and Millennials

• The acne evangelists: Making skin care as easy as a Drybar blow-out. (Gift article)

• What we know about DINKs in the US: Are you one?

- Pregnancy, birth and parenting

• Too few women get easy prevention for serious pregnancy complication.

• ByHeart recalls all baby formula as botulism investigation proceeds.

  • How parents discovered their baby had botulism from MyHeart products.

• Pew Research: How parents use online communities.

• Preterm, cesarean births more common in myasthenia gravis.

- Midlife and perimenopause

• The FDA hasn’t approved it, many doctors won’t prescribe it, and insurance won’t pay for it…but women are on fire about testosterone.

• HHS “rights a 20-year wrong” and removes black box warning for HRT. (If only I trusted this crew.)

  • Related: Can’t take HRT? Non-HRT approaches for menopause.

• *Study: 40% of perimenopausal women misdiagnosed.

- The untethered-to-my-uterus years

• *Study: Sleep problems tied to higher blood pressure in postmenopausal women.

• Body composition—not weight or BMI—may be more important for women’s health and longevity.

• Regularly listening to music or playing a musical instrument may protect against cognitive decline.

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Deeper dives | policy

• Health Policy Watch: How intimate partner violence affects children.

Femtech and women’s health innovation

We’re way past time for innovation in women’s health, and Femtech is hoping to fill the gap. Don’t miss this free post with tips on investing in women’s health and see more about why investors are excited, but also why femtech can be the new Wild West. And see more about why we have a special section on femtech.4

• *Study: Overdue advances in biomonitoring tech for women’s health.

• Herself Health and Midi Health partner to delivery hybrid care for midlife and older women.

• Finally: A new device that combines an electrocardiogram, digital stethoscope, and thermometer all in one gets FDA approval for home use.

  • See Beamo here.

• New AI-enabled population health Maven Clinic offering may prevent up to 27% fewer NICU stays and 15% fewer C-sections.

In the news this week for women: Elections: Gen X, Millennial women leaders rising with unusual double digit victory margins…smart tide turning? Comprehensive shutdown update, including Nov 10 vote to start ending it—and an interesting theory on why Congressional Rs may have preferred not opening before December 2. Open enrollment cost calculators, info and tips on changes and costs. Melatonin and heart failure? Maybe not. GLP-1 price wars. Rings, watches and … toilets? Golden age for hair loss—what works for the 3 types. Finally: clues on lupus, where women are 90% of cases. Ways to fend off SAD. Peleton recall. New meds and gene editing: goodbye cholesterol? Lots of women’s health news by generation: Gen Z, Millennials, pregnancy and parenting, midlife, and the kiss-those-periods-goodbye crowd. News influencer fact sheet. The latest health warps from Kennedy—including a ‘study’ conducted by civilians with no medical training. The Medicaid program that saved money, turned people’s health around—and got killed. A brain app that can reverse delines, 6 solid tips on cutting through the noise on femtech, and much, much more.

• Tip: If you hit a paywall here or anywhere, copy the URL of the article into archive.ph.1

• See our footnotes and italicized comments for context from our 30+ years in healthcare.

• Articles marked with an asterisk (*) are from professional journals.

• Disclaimer: Listing these headlines does not indicate a recommendation. With so many news items each week, we don’t take the time to review each. Use common sense and dig deeper into any issue that interests you. More on sources and bias.2

This week’s Women in the News photo

From a generations theory perspective, in our self-inflicted crisis era—predicted by authors Strauss and Howe to occur by 2025—Gen X emerges as pragmatic midlife leaders in crisis and Millennials resolve the crisis, defining their lives. And right now terrific, experienced women leaders in both generations are winning political battles with highly unusual double digit margins: not an ambiguous message. Pictured from upper left, clockwise: Gen Xers Adelita Grijalva, US House of Representatives (when Mike Johnson finally admits her) and Abigal Spanberger, governor-elect of Virginia; Millennial Mary Sheffield, the first female mayor of a major American city; and Gen Xer Mikie Sherrill, governor-elect of New Jersey. Celebrate them…we need their strengths and leadership badly!

Still front and center: The Shutdown, now the longest ever … and the E word emerges. Again.

UPDATE 11/10: The shutdown endgame appears near. Here’s what to expect next, and here’s how the the 8 Dems who voted with Republicans to end the shutdown explain their thinking.

ORIGINAL POST: Republicans have insisted on funding government before considering extending ACA tax credit and—surprise!—Democrats don’t trust Trump to follow through if they vote to fund government first. Chuck Schumer (D, NY) called that card yesterday on the Senate floor with a win-win offer: a one-year extension of the ACA tax credits and a spending bill to “honor both positions.” Rs barely paused for a breath before voting it down as a “no-starter,” making it clear they currently have no intention of assisting the 24 million terrified limited-means Americans whose insurance costs are increasing 300% or more, well beyond their ability to afford health insurance. See an emerging possibly-related issue below on what may actually be behind this immediate no: If the Shutdown ended now, Congress would have to return to normal business—and that may not be something Congress can afford to have happen until after Dec. 2.

There are already indications the Shutdown could go beyond Thanksgiving as both sides leverage American pain, with the WH threating flight cancellations of up to 20%, sure to anger millions of travelers—although pressure tactics are surprisingly falling flat. On the Dem side, ACA members are discovering the reality right now (open enrollment) of significant insurance premium increases. Air traffic controller passive resistance (sick calls) planed a key role ending the prior longest shutdown during Trump I, and that Rs have tried (and failed) to kill off ACA hundreds of times before. Further stirring the pot, still with only "concepts” of an alternative, Trump threw a new cash idea into the plot yesterday morning. Thune: “Maybe later.”

The Senate is at least working on it this weekend, with some moderate Ds pushing a short-term plan, although it’s unclear whether it would be supported by more Ds. Republican leaders only need five additional votes to fund the government, and the group involved in the talks has ranged from 10 to 12 D senators. But the elections strengthened D resolve, and with their long-standing hyperallergy to the ACA, Rs are also digging in. They’re at it again today, with flight cancellations mounting and Trump avoiding all of it while going to football games while noting the new Commander stadium should obviously be named…you guess it…Trump stadium.

In the meantime, polls this week indicate majorities of the public continue to support extending ACA credits. A third of the public says the Shutdown is affecting them personally, with Trump’s approval sinking like a rock and the public still blaming Rs more than Ds for the Shutdown.

With nothing else making a whole lot of sense, some intriguing timeline speculation is emerging about Johnson’s ever-evolving excuses to delay swearing in Rep. Adelita Grijalva (D, AZ), elected to the House 6 weeks ago and expected to be the needed 218th vote to release the infamous Epstein files. The theory is that Johnson needs to stall until after the Dec 2 Tennessee 7th District special Houe election, where an R candidate is polling better than the D and could “neutralize” Grijalva’s impact on Epstein release and “rebalance” funding votes. Some Rs with ties to the FBI or DOJ are also now saying the Epstein files are worse than Michael Wolff’s description of Epstein photos showing Trump with half-naked teen girls—a description even Pam Bondi refuses to confirm or deny, causing speculation and rumors to “sweep through the GOP caucus.” If true, Epstein is exactly the kind of news you’d want to bury in, say, the December holiday hubbub—so any delay now on Epstein helps, and re-opening the House for business now would not. The 7th District R candidate wins, and Johnson may be able to stall again until midterms (or beyond). The R guy loses, and any new Epstein headlines get lost in the holidays. Win-win for Johnson and Trump, lose-lose for accountability.

Particularly after Britain’s royals hid Prince Andrew even further out of sight this week over new Epstein details, you really do have to wonder just how bad those files are to generate so many release games here. [Related: Ds have invited Andrew for a chat. No kidding.]

- Open enrollment: More on health insurance news

• WaPo: In depth graphical look at exactly how much and where ACA premiums are rising and the impact on the lives of 8 Americans. (Gift article)

• ACA open enrollment

  • 8 things to watch for now during ACA open enrollment.

  • Four tips for navigating higher ACA premium costs.

  • ACA premium calculator.

• It’s not just the ACA. Here’s why health insurance costs are going up and Medicare benefits are going down.

• 70% of Americans worry they can’t afford healthcare in our for-profit system.

• Investopedia: 9 major Medicare changes: Premiums, drug prices, program cuts.

• Yes, someone 65+ can be on Medicaid. Here’s why cuts to that program matter.

• News flash: Seniors on Medicare are not luddites. A huge issue. Medicare insurers are firmly stuck in 1980s digital offerings.

Our bodies

- Trending

• Don’t lose sleep for now over headlines linking melatonin to heart failure.

• Price wars on popular obesity drugs.

• Science is finally unearthing secrets of lupus, a woman’s disease with “1000 faces.”

• Women at the center of community health: How hunger relief groups say we can help feed your neighbors during the shutdown.

- Nutrition, exercise, sleep, and looking great

• Digitizing the daily … deposit. Data from watches, rings, phones and beds yield health insights. Plumbing new depths, WSJ looks at three devices that aim to analyze our daily output. (Gift article)

• A “golden age” of hair: 3 types of hair loss—and what actually helps.

• Why going outside is good for you—even when it’s dark.

• How to avoid SAD, according to the psychiatrist who named it.

• Bad air is one of the biggest health threats; here’s how to protect yourself.

• Is sour dough bread a new health fix-ish?

• Peleton recalls almost a million bikes for broken seat risk. (Gift article)

- New meds, prevention, and treatments

• Minimally invasive coronary calcium CT scans for heart disease risk reveal other potential health problems.

• New med may reduce triglycerides and improve cholesterol, liver health.

• New Merck pill could slash cholesterol levels

• Gene editing could reduce cholesterol permanently.

Note we often group some articles in generational/lifestyle categories for easier reading, but generations don’t have a ‘hard stop’—they overlap, so check topics. Also check the Femtech section, below, for more news that can apply to your generation and interests.

- Gen Z and Millennials

• Gen Z wants schools and hospitals, not superyachts and helicopters.

• Social psychologist warns Gen z’s brains are ‘growing around their phones’ the way a tree warps around a tombstone. Well, OK, he’s definitely not a Gen Z. Just sayin.’ FWIW, my experience is Gen Z does real life as well—completely integrated.

• How Millennials and Gen Z are driving evidence-based wellness trends.

• *Study: PCOS: Why type do you have? It makes a difference in treatment.

- Pregnancy, birth and parenting

• High costs, low guarantee: Freezing the biological (egg) clock. (Video)

• We’ve written about how women have been misled into thinking C-sections are problem-free and routine. They’re not: C-sections are major abdominal surgery, from which we don’t give women nearly enough time or support for recovery. (If men had cesareans…) Side effects—when they occur—can be life-threatening and physically damaging. And now a grave side effect of C-sections is on the rise. (Gift article) Don’t be afraid of cesareans; they save lives. But do get educated long before your due date about potential issues for you and your baby. Know what to avoid and your rights, because we do know how to prevent unnecessary cesareans. Start here and here.

• *Study: Prenatal COVID linked to adverse infant neurodevelopment.

  • *Related meta-analysis study: Safety of COVID vaccine during pregnancy. A meta-analysis is a study that combines the results of multiple independent studies on the same topic to produce a more precise and powerful conclusion.

• Pregnancy and breastfeeding reduce the risk of cancer. Now we have clues why.

• Indianapolis launches cash infant mortality prevention program.

• The importance of iron in pregnancy: what you should know.

- Midlife and perimenopause

• Largest study of its kind focusses on midlife sexual dysfunction.

• Mayo Clinic: Most midlife women with menopause symptoms don’t seek care.

• Demand for testosterone is growing—but do midlife women need it?

• Only 21 of 5 midlife women meet Heart Association Essential 8 scores. Here’s what’s missing.

- The untethered-to-my-uterus years

• Who will care for me when I’m old—a question more of us are asking.

• Independent research: App “reverses 10 years of of brain decline.” Yes, the app developer funded the research, but McGill is a respected research institution.

• Pew Research: How Americans are thinking about aging.

• Why most people fall off a ‘health cliff’ at 75—and 5 ways to avoid it.

• Study: Minimum steps for longevity and heart health benefits in older women.

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News impacting our health and lives, and those we love and guide

- RFK Jr’s HHS and related Trump administration health news

• Minority health researchers walk tightrope amid NIH funding cuts.

• WH adds new ways to refuse immigration applications.

• Bloomberg (opinion): FDA chaos threatens medical innovation and patient health.

• Senate Dems demand answers on abortion pill ‘study’ authored by people with no medical training after 20+ years of FDA safety data.

Deeper dives | policy

• Politico: The Medicaid program that saved money, turned people’s health around—and got killed.

• Pew Research: One of five US adults (and 4 of 10 Gen Zs) regularly get news from social media influencers. Here’s a fact sheet on news influencers.

Femtech and women’s health innovation

We’re way past time for innovation in women’s health, and Femtech is hoping to fill the gap. Don’t miss this free post with tips on investing in women’s health and see more about why investors are excited, but also why femtech can be the new Wild West. And see more about why we have a special section on femtech.3

• Strong growth at Establishment Labs as Mia femtech product does well.

• Noom launches diabetes lifestyle program and AI-powered glucose forecasting tool. Timely retooling from this weight-loss site.

• How femtech Uresta is changing the future of women’s bladder care.

• Good summary of 6 tips on cutting through the noise in femtech: key takeaways from Women’s Health Week 2025.