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“Breaking news: The Trump administration just announced that Medicare will stop covering telehealth starting April 1. … We need to stand up to these Medicare cuts.”
Rep. Ro. Khanna (D-Calif.), in a TikTok video posted Feb. 20, 2025
Rep. Ro Khanna (D-Calif.) posted a Tiktok video on Feb. 20 saying he had “breaking news” about the fate of Medicare coverage for telehealth visits, which allow patients to see health care providers remotely from their homes.
“Breaking news: The Trump administration just announced that Medicare will stop covering telehealth starting April 1,” Khanna said. “We need to stand up to these Medicare cuts.”
The same day, the Centers for Medicare & Medicaid Services posted a document online titled “Telehealth” that said, “Through March 31, 2025, you can get telehealth services at any location in the U.S., including your home. Starting April 1, 2025, you must be in an office or medical facility located in a rural area (in the U.S.) for most telehealth services.”
CMS did not respond to requests for comment about the post. The White House also did not respond to requests for comment.
The telehealth benefit was first put in place as a temporary Trump-era addition to Medicare coverage during the covid-19 public health emergency.
Khanna’s statement took on more significance leading up to the threat of a government shutdown, but late last week Congress averted one by approving a stopgap spending bill.
The expiration date for the benefit has been known since December, when Congress extended coverage around telehealth through March 31. The roughly 90-day reprieve was part of a compromise after then-President-elect Donald Trump and his ally Elon Musk criticized a sweeping, end-of-year legislative package that would have, among other things, continued those benefits for two years.
Their opposition forced Congress to pass a stripped-down version of the end-of-year bill. Telehealth’s two-year extension, included in the initial bill, became collateral damage.
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Last week, just as the clock was ticking down, House Republicans passed a spending bill for the rest of the fiscal year that includes another extension of telehealth flexibilities — this one lasting through September. The Senate then cleared the bill for Trump’s signature, with the support of 10 Democrats, including Senate Minority Leader Chuck Schumer.
Regardless, the two-year extension proposed in December — or a permanent extension, as Khanna has urged — looks unlikely.
“President Trump and Elon Musk blew up the continuing resolution last December that would have extended these telehealth authorities by two years,” Khanna told us via email. “Trump should work with Congress to extend telehealth coverage for Medicare beneficiaries.”
It wouldn’t come free. Permanently extending telehealth for medical care under Medicare could cost taxpayers about $25 billion over 10 years, the Congressional Budget Office has estimated. The CBO calculated five months of expanded telehealth coverage as costing $663 million, and calculated that that would total almost $25 billion through fiscal year 2031 if spending remained level, which it may not do.
Also, the agency and the Government Accountability Office have raised concerns about fraud and overuse of the benefit, among other potential issues.
Congress made Medicare coverage of behavioral health services delivered remotelypermanent in December 2020, but left other telehealth benefits hanging on by a string. Instead, lawmakers extended them for short periods during the nearly two years since the public health emergency officially ended in May 2023.
“Now, once again, we’ve got another deadline where, if Congress doesn’t act, our flexibilities go away,” said Kyle Zebley, senior vice president of public policy for the American Telemedicine Association.
And if, at some point, the telehealth benefits aren’t extended, is it fair to describe the policy change as a cut? Khanna, for instance, plans to introduce the Telehealth Coverage Act, which would require Medicare to cover seniors’ telehealth services.
Politically speaking, it’s a powerful question when trying to leverage public support — and politicians in both parties often accuse their opponents of “cutting” federal benefits when they make changes to programs.
“Khanna is overly dramatic,” said Joseph Antos, a senior fellow emeritus at the American Enterprise Institute, a conservative think tank.
If the provision expires, Antos said, “this is not a Trump cut.”
But beneficiaries might have a different experience. Since the early days of the pandemic — five years now — millions of patients have come to rely on telehealth for their medical services. That benefit, even with another temporary reprieve, would still be at risk.
According to CMS, more than 1 in 10 Medicare beneficiaries used virtual care services as of 2023. And, after the Trump administration green-lighted telehealth for Medicare recipients in 2020, many private insurers did the same.
Overall telehealth claims in Medicare rose from fewer than 1% of all claims before the covid pandemic to a peak of 13% in April 2020. Now they stand at close to 5%, according to Fair Health, a nonprofit that tracks health care costs.
Those in the telehealth industry are optimistic about the current extension. The Trump administration, they say, has been sending encouraging signals — even highlighting its previous support of telemedicine in its fact sheet on the launch of the President’s Make America Healthy Again Commission.
“We’ve been sweating bullets,” Zebley said. “But it’s been nerve-wracking before. I think we’re going to get it done.”
Antos said, however, that after the extension in the House-passed spending bill, Medicare’s telemedicine benefits could be dead.
Our Ruling
Khanna said, “Breaking news: The Trump administration just announced that Medicare will stop covering telehealth starting April 1. … We need to stand up to these Medicare cuts.”
The statement is partially accurate, because the Trump administration announced the March 31 sunset of Medicare telehealth visits, and some beneficiaries who were using that benefit could see it as a “cut.” But the claim lacks key context that the expiration date was set by Congress, not the Trump administration.
After Khanna’s claim, Congress extended access to telehealth coverage through September.
Based on information that was available at the time, we rate Khanna’s statement Half True.
Phone interview and follow-up texts with Kyle Zebley, senior vice president of public policy for the American Telemedicine Association and executive director of ATA Action, March 3, 2025.
Email interview with Joseph Antos, senior fellow emeritus for public policy research at the think tank the American Enterprise Institute, March 8, 2025.
A Centers for Medicare & Medicaid Services post CMS post titled “Telehealth” that includes information to recipients about Medicare telehealth benefits ending April 1, 2025.
This article was produced by KFF Health News, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.
Los recortes de gastos, la inmigración y Medicaid están bien arriba en la lista de prioridades en la agenda de Washington. Este clima politico ofrece un terreno fértil para que la desinformación y los mitos se multipliquen en las redes sociales. Algunos de los más comunes se enfocan en los inmigrantes, los latinos y Medicaid.
En las plataformas circulan posts afirmando que los latinos beneficiarios de Medicaid —el programa de salud federal gerenciado por los estados para personas de bajos ingresos o con discapacidades —, “no trabajan” y exageraciones sobre el porcentaje de personas con Medicaid que son latinas.
El 25 de febrero, la Cámara de Representantes de Estados Unidos votó por un estrecho margen a favor de un plan presupuestario que podría llevar a recortes de Medicaid de hasta $880 mil millones a lo largo de una década.
Medicaid y el Programa de Seguro de Salud Infantil (CHIP) son parte de la red de seguridad nacional, que cubre a unas 80 millones de personas. La inscripción a Medicaid aumentó bajo la Ley de Cuidado de Salud a Bajo Precio (ACA) y después del inicio de la pandemia de covid-19, pero luego comenzó a caer durante los dos últimos años de la administración Biden.
El impacto de los inmigrantes en el sistema de atención médica nacional puede exagerarse en medio de la retórica política acalorada. El actual vicepresidente JD Vance dijo durante la campaña electoral de 2024 que “estamos llevando a la quiebra a muchos hospitales al obligarlos a ofrecer atención a personas que no tienen el derecho legal de estar en nuestro país”. PolitiFact calificó esa declaración como “falsa”.
KFF Health News, en alianza con Factchequeado, recopiló cinco mitos que circulan en las redes sociales y los analizó con expertos.
1. ¿Trabajan los latinos que reciben Medicaid?
La mayoría sí. Un análisis de los datos de Medicaid realizado por KFF reveló que el 67% de los latinos que reciben Medicaid trabajan, “lo que representa la proporción mayor de adultos que reciben Medicaid que trabajan en comparación con otros grupos raciales y étnicos”, dijo Jennifer Tolbert, subdirectora del Programa de Medicaid y Personas sin Seguro de KFF.
“Para muchas personas de bajos ingresos, el mito es que no están trabajando, aunque sabemos por muchos datos recopilados que muchas personas trabajan pero no tienen acceso a un seguro asequible patrocinado a través del empleador”, dijo Timothy McBride, codirector del Centro para el Avance de los Servicios de Salud, Políticas e Investigación Económica, parte del Instituto de Salud Pública de la Universidad de Washington en St. Louis.
Ni la Oficina de Salud de las Minorías del Departamento de Salud y Servicios Humanos (HHS) ni los Centros de Servicios de Medicare y Medicaid (CMS) respondieron a las solicitudes de comentarios.
2. ¿Son los latinos el grupo más grande inscrito en Medicaid?
No. Los blancos no hispanos son el grupo demográfico más grande en Medicaid.
La inscripción en los programas es de un 42% de blancos no hispanos, un 28% de latinos y un 18% de negros no hispanos, con pequeños porcentajes de otras minorías, según indica un documento de los CMS.
La proporción de latinos en la inscripción total de Medicaid “se ha mantenido bastante estable durante muchos años, entre el 26 y el 30% desde al menos 2008”, dijo Gideon Lukens, director de investigación y análisis de datos del equipo de políticas de salud del Center on Budget and Policy Priorities.
En una publicación en un blog del 18 de febrero, Alex Nowrasteh y Jerome Famularo, del libertario Cato Institute, escribieron: “El mayor mito en el debate sobre el uso de la asistencia social por parte de los inmigrantes es que los no ciudadanos, que incluyen a los inmigrantes ilegales y a los que se encuentran legalmente en el país con diversas visas temporales y tarjetas de residencia, utilizan desproporcionadamente la asistencia social. Ese no es el caso”. Incluyeron Medicaid en el término “asistencia social”.
Aunque los latinos no son el grupo más grande en Medicaid, son el grupo demográfico con el mayor porcentaje de personas que reciben Medicaid. Hay alrededor de 65,2 millones de hispanos en el país, lo que representa el 19,5% de la población total de Estados Unidos.
La elegibilidad para Medicaid se basa en factores como los ingresos, la edad y el estatus de embarazo o discapacidad, y varía de un estado a otro, dijo Kelly Whitener, profesora asociada de Prácticas en el Centro para Niños y Familias de la Escuela de Políticas Públicas McCourt de la Universidad de Georgetown.
“La elegibilidad para Medicaid no se basa en la raza o la etnia”, agregó Whitener.
3. ¿La mayoría de los latinos indocumentados utilizan Medicaid?
No. Según la ley federal, los inmigrantes que carecen de estatus legal no son elegibles para los beneficios federales de Medicaid.
A enero, 14 estados y el Distrito de Columbia habían utilizado sus propios fondos para ampliar la cobertura a los niños en el país sin importar su estatus migratorio. De ellos, siete estados y el Distrito de Columbia expandieron la cobertura a algunos adultos sin importar su estatus migratorio.
Los estados cubren en su totalidad el costo de ofrecer atención médica a estos beneficiarios. El gobierno federal no pone ni un centavo.
El gobierno federal sí paga el llamado Medicaid de Emergencia, que reembolsa a los hospitales por la atención de emergencias médicas para personas que, debido a su estatus migratorio u otros factores, normalmente no califican para el programa.
El Medicaid de Emergencia comenzó en 1986 bajo el Emergency Medical Treatment and Labor Act, firmado por el presidente republicano Ronald Reagan.
Algunos legisladores conservadores dicen que los inmigrantes que están en el país sin papeles no deberían recibir ningún beneficio de Medicaid.
“Medicaid está destinado a los ciudadanos estadounidenses que más lo necesitan: personas mayores, niños, mujeres embarazadas y discapacitados”, dijo Dan Crenshaw, representante republicano por Texas, en las redes sociales. “Pero los estados liberales están encontrando formas de jugar con el sistema y hacer que los contribuyentes cubran la atención médica de los inmigrantes ilegales”.
4. ¿Los latinos permanecen en Medicaid por décadas?
Expertos dicen que no hay un análisis por raza o etnia del tiempo que las personas usan el programa.
“Las personas que permanecen en Medicaid por más tiempo son aquellas que tienen Medicaid debido a una discapacidad y que viven con una situación médica que no cambia”, dijo Tolbert.
Los beneficiarios que usan los servicios de apoyo de Medicaid a largo plazo representan el 6% del número total de personas en el programa.
Muchos beneficiarios están en el programa temporalmente, dijo McBride. “Algunos estudios indican que hasta la mitad de las personas en Medicaid lo abandonan en un corto período de tiempo”, dijo, como en un año.
5. ¿Son los latinos en Medicaid el grupo que más usa los servicios médicos?
Los latinos no usan significativamente más servicios de Medicaid que otros, dicen expertos. Reciben servicios preventivos (como mamografías, pruebas de Papanicolaou y colonoscopías), atención primaria y atención de salud mental menos que otros grupos, según documentos de los CMS y la Comisión de Pago y Acceso a Medicaid y CHIP, una organización no partidista que proporciona análisis de políticas y datos.
Los latinos sí utilizan más los servicios de parto y alumbramiento de Medicaid. Las familias latinas y las familias blancas no hispanas representan cada una alrededor del 35% de los nacimientos de Medicaid, aunque los blancos no hispanos constituyen una proporción mayor de la población general.
“En realidad, utilizan los servicios de atención médica menos que otros grupos, debido a barreras sistémicas como el dominio limitado del inglés y la dificultad para navegar por el sistema”, dijo Arturo Vargas Bustamante, profesor de la Escuela Fielding de Salud Pública de UCLA y director de investigación en el Latino Policy and Politics Institute de la universidad.
Los latinos también evitan utilizar los servicios por temor a la regla de “carga pública” y otras políticas, apuntó Vargas Bustamante. El presidente Donald Trump amplió la política de carga pública y la aplicó con firmeza durante su primer mandato, aunque se suavizó bajo el presidente Joe Biden. La regla tenía como objetivo dificultar que los inmigrantes que utilizan Medicaid o programas de asistencia social obtuvieran la residencia permanente o se convirtieran en ciudadanos estadounidenses.
“El efecto amedrentador de la carga pública persiste, pero órdenes recientes como la deportación masiva o la eliminación de la ciudadanía por nacimiento han generado sus propios efectos aterradores”, agregó Vargas Bustamante.
Esta historia es producto de una colaboración entre Factchequeado y KFF Health News.
The Senate Finance Committee got its chance March 14 to question Mehmet Oz, President Donald Trump’s nominee to lead the vast Centers for Medicare & Medicaid Services, the largest agency within the Department of Health and Human Services. Oz, with his long history in television, was as polished as one would expect, brushing off even some more controversial parts of his past with apparent ease. In this special bonus episode of “What the Health?,” KFF Health News’ Rachana Pradhan and Stephanie Armour join host Julie Rovner to recap the Oz hearing. They also provide an update on the progress of nominees to lead the National Institutes of Health, the Food and Drug Administration, and the Centers for Disease Control and Prevention.
This article was produced by KFF Health News, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.
When the FDA announced in January, before President Joe Biden’s term ended, that it would ban a dye called red dye No. 3 in food and ingested drugs, the federal agency cited just one 1987 study on rats to support its action.
The industry-funded study, based on data from two prior studies, was led by a Virginia toxicologist who said then — and still believes today, decades after concerns first arose that the chemical could be carcinogenic — that his research found the petroleum-derived food coloring doesn’t cause cancer in humans.
“If I thought there was a problem, I would have stated it in the paper,” Joseph Borzelleca, 94, a professor emeritus of pharmacology and toxicology at Virginia Commonwealth University, told KFF Health News after the FDA’s announcement. “I have no problem with my family — my kids and grandkids — consuming Red 3. I stand by the conclusions in my paper that this is not a problem for humans.”
Soon after Borzelleca’s paper was published in a scientific journal, Food and Chemical Toxicology, the FDA examined the data his team had collected and reached its own conclusion: that the dye caused cancer in male lab rats. In 1990, the FDA cited the study in banning Red 3 in cosmetics.
In 1992, the FDA said it wanted to revoke approval of Red 3 in food and drugs. But the agency didn’t act at the time, citing a lack of resources.
More than 30 years later, after a renewed push by consumer advocates, the Biden administration announced the ban in its last days in power. The move came just weeks before the Senate confirmed Robert F. Kennedy Jr., President Donald Trump’s nominee to head the Department of Health and Human Services, which oversees the FDA.
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Kennedy has been a vocal critic of food additives, including Red 3. On March 10 he met with top food industry executives and told them if they don’t eliminate artificial food dyes from their products, the federal government will force them to do so, Food Fix reported.
Consumer advocacy groups cheered the Red 3 ban, even as the FDA said there is no evidence that the dye is dangerous to people. “Importantly, the way that FD&C Red No. 3 causes cancer in male rats does not occur in humans,” Jim Jones, FDA deputy commissioner for human foods, said in a statement.
The FDA did not respond to a request for comment, but Marty Makary, Trump’s nominee to lead the agency, said at his Senate confirmation hearing on March 6 that he is concerned about whether food additives such as Red 3 harm children.
“It did not make sense that red dye No. 3 was banned in cosmetics but allowed in the food supply,” Makary told Sen. Tommy Tuberville, who questioned why the FDA ban doesn’t take effect until 2027.
Marty Makary, President Donald Trump’s pick to lead the FDA, at his nomination hearing before the Senate Health, Education, Labor and Pensions Committee on March 6.(Eric Harkleroad/KFF Health News)
“We want to kill people for two more years?” the Alabama Republican said. “I would hope that you would, if you’re confirmed, you’d go in and look at it very quickly and say, ‘Why do we want to put our people in harm’s way?’”
The International Association of Color Manufacturers says Red 3 is safe in the tiny levels typically consumed by humans. The dye was approved for use in foods in the U.S. in 1907, and today it’s an ingredient in thousands of products including cereals, candy, beverages, and cake toppings.
Thomas Galligan, principal scientist for food additives and supplements at the Center for Science in the Public Interest, which petitioned the FDA for a ban, said that a federal regulation known as the Delaney Clause prohibits any ingredient that causes cancer in animals from being included in foods. (The publisher of KFF Health News, David Rousseau, is on the CSPI board.)
“At the end of the day, this is an unnecessary additive,” he said. “It’s a marketing tool for the industry to make foods look more appealing so consumers will buy them. But federal law is clear: No amount of cancer risk is acceptable in foods.”
Galligan said he was not surprised Borzelleca’s opinion on Red 3 had not changed or that the food dye industry has played down the risk.
In October 2023, California became the first state to ban Red 3 in food starting in 2027, superseding the FDA’s earlier rule allowing small amounts in foods as a color additive. The state legislature acted after a state analysis concluded the dye could cause hyperactivity in children.
The European Union, Australia, and Japan are among the locations that already ban the chemical in foods. The EU’s ban also cites hyperactivity in children. The EU requires food makers to include a warning that food dyes that are still allowed may “have an adverse effect on activity and attention in children.”
The IACM points to research by scientific committees operated by the World Health Organization, including a 2018 review that affirmed the safety of Red 3 in food.
Some food manufacturers have already reformulated products to remove Red 3. In its place they use beet juice; carmine, a dye made from insects; or pigments from foods such as purple sweet potato, radish, and red cabbage.
It isn’t clear how the FDA determined that Red 3 can cause cancer in male rats. Borzelleca’s paper said some rats that were fed Red 3 developed polyps in their thyroid gland but doesn’t mention cancer.
Borzelleca, whose study was funded by the IACM, then known as the Certified Color Manufacturers Association, said he was stunned the FDA banned the dye and used his research to back the move.
“I am surprised all this time has gone by and it’s been safe for human use, and now it’s being pulled from the market due to concerns not supported by the data,” Borzelleca said. “Our study did not find this was a carcinogen.”
His study was a response to the FDA’s requirement in the 1980s for additional long-term feeding studies in rats and mice as a condition for the continued provisional approval of several color additives, including Red 3.
Over decades, Borzelleca published dozens of research papers on the toxicology of food additives, pesticides, and water contaminants. He also served on advisory boards for the tobacco industry and represented cigarette maker R.J. Reynolds in negotiations with the Department of Health and Human Services about cigarette additives, according to a 1984 corporate memo. Borzelleca is a former president of the Society of Toxicology and consulted for the National Academy of Sciences and the World Health Organization.
The commonwealth of Virginia gave him a lifetime achievement award in 2001 for his work helping assess dangers in foods, drugs, and pesticides.
This article was produced by KFF Health News, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.
Spending cuts, immigration, and Medicaid are at the top of the Washington agenda. That climate provides fertile ground for misinformation and myths to multiply on social networks. Some of the most common are those surrounding immigrants, Latinos, and Medicaid.
These claims include assertions that Latinos who use Medicaid, the federal-state program for low-income people and those with disabilities, “do not work” and exaggerations of the percentage of people with Medicaid who are Latinos.
The U.S. House voted narrowly on Feb. 25 in favor of a budget blueprint that could lead to Medicaid cuts of up to $880 billion over a decade.
Medicaid and the Children’s Health Insurance Program are part of the national safety net, covering about 80 million people. Medicaid enrollment grew under the Affordable Care Act and after the start of the covid-19 pandemic but then started falling during the final two years of the Biden administration.
Immigrants’ impact on the nation’s health care system can be overstated in heated political rhetoric. Now-Vice President JD Vance said on the campaign trail last year that “we’re bankrupting a lot of hospitals by forcing these hospitals to provide care for people who don’t have the legal right to be in our country.” PolitiFact rated that statement “False.”
KFF Health News, in partnership with Factchequeado, compiled five myths circulating on social media and analyzed them with experts in the field.
1. Do Latinos who receive Medicaid work?
Most do. A KFF analysis of Medicaid data found that almost 67% of Latinos on Medicaid work, “which is a higher share of Medicaid adults who are working compared to other racial and ethnic groups,” said Jennifer Tolbert, deputy director of KFF’s Program on Medicaid and the Uninsured. KFF is a health information nonprofit that includes KFF Health News.
“For many low-income people, the myth is that they are not working, even though we know from a lot of data that many people work but don’t have access to affordable employer-sponsored insurance,” said Timothy McBride, co-director at the Center for Advancing Health Services, Policy and Economics Research, part of the Institute for Public Health at Washington University in St. Louis.
Neither the Department of Health and Human Services Office of Minority Health nor the Centers for Medicare & Medicaid Services responded to requests for comment.
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2. Are Latinos the largest group enrolled in Medicaid?
No. White people who are not Hispanic represent the biggest demographic group in Medicaid and CHIP. The programs’ enrollment is 42% non-Hispanic white, 28% Latinos, and 18% non-Hispanic Black, with small percentages of other minorities, according to a CMS document.
Latinos’ share of total Medicaid enrollment “has remained fairly stable for many years — hovering between 26 and 30% since at least 2008,” said Gideon Lukens, research and data analysis director on the health policy team at the left-leaning Center on Budget and Policy Priorities, a research organization.
In a Feb. 18 blog post, Alex Nowrasteh and Jerome Famularo of the libertarian Cato Institute wrote: “The biggest myth in the debate over immigrant welfare use is that noncitizens — which includes illegal immigrants and those lawfully present on various temporary visas and green cards — disproportionately consume welfare. That is not the case.” They included Medicaid in the term “welfare.”
Although Latinos are not the biggest group in Medicaid, they are the demographic group with the greatest percentage of people receiving Medicaid. There are about 65.2 million Hispanics in the country, representing 19.5% of the total U.S. population.
Approximately 31% of the Latino population is enrolled in Medicaid, in part because employed Latinos often have jobs that do not offer affordable insurance.
Eligibility for Medicaid is based on factors such as income, age, and pregnancy or disability status, and it varies from state to state, said Kelly Whitener, associate professor of practice at the Center for Children and Families at Georgetown University’s McCourt School of Public Policy.
“Medicaid eligibility is not based on race or ethnicity,” Whitener said.
3. Do most Latinos living in the country without legal permission use Medicaid?
As of January, 14 states and the District of Columbia had used their own funds to expand coverage to children in the country without regard to immigration status. Of those, seven states and D.C. expanded coverage to some adults regardless of immigration status.
The cost of providing health care to these beneficiaries is covered entirely by the states. The federal government does not put up a penny.
The federal government does pay for Emergency Medicaid, which reimburses hospitals for medical emergencies for people who, because of their immigration status or other factors, do not normally qualify for the program.
Emergency Medicaid began in 1986 under the Emergency Medical Treatment and Labor Act, signed by President Ronald Reagan, a Republican.
In 2023, Emergency Medicaid accounted for 0.4% of total Medicaid spending.
Some conservative lawmakers say immigrants in the country illegally should not get any Medicaid benefits.
“Medicaid is meant for American citizens who need it most — seniors, children, pregnant women, and the disabled,” Rep. Dan Crenshaw (R-Texas) said on social media. “But liberal states are finding ways to game the system and make taxpayers cover healthcare for illegal immigrants.”
4. Do Latinos stay on Medicaid for decades?
Experts say there is no analysis by race or ethnicity of the length of time people use the program.
“The people who stay on Medicaid the longest are people who have Medicaid due to a disability and who live with a medical situation that does not change,” Tolbert said.
People who use long-term Medicaid support services represent 6% of the total number of people in the program.
Many beneficiaries are in the program temporarily, McBride said.
“Some studies indicate that as many as half of the people on Medicaid churn off of Medicaid within a short period of time,” he said, such as within a year.
5. Are Latinos on Medicaid the group that uses medical services the most?
Latinos do not use significantly more Medicaid services than others, experts say. Latinos receive preventive services (such as mammograms, pap smears, and colonoscopies), primary care and mental health care less than other groups, according to documents from CMS and the Medicaid and CHIP Payment and Access Commission, a nonpartisan organization that provides policy and data analysis.
Latinos do account for a disproportionate share of Medicaid labor and delivery services. Latino families and white families each represent about 35% of Medicaid births, although white people make up a bigger share of the overall population.
While Latinos represent 28% of all Medicaid and CHIP enrollees, they account for 37% of beneficiaries with limited benefits that cover only specific services.
“They actually use health care services less than other groups, because of systemic barriers such as limited English proficiency and difficulty navigating the system,” said Arturo Vargas Bustamante, a professor at UCLA’s Fielding School of Public Health and the faculty research director at the university’s Latino Policy and Politics Institute.
Latino people also avoid using services out of fear of the “public charge” rule and other policies, Vargas Bustamante said. President Donald Trump expanded the public charge policy and strongly enforced it during his first term, though it was softened under President Joe Biden. The policy was intended to make it harder for immigrants who use Medicaid or welfare programs to obtain green cards or become U.S. citizens.
“The chilling effect of public charge persists, but recent orders such as mass deportation or the elimination of birthright citizenship have generated their own chilling effects,” Vargas Bustamante added.
This article was produced by KFF Health News, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.
National Institutes of Health officials have urged scientists to remove all references to mRNA vaccine technology from their grant applications, two researchers said, in a move that signaled the agency might abandon a promising field of medical research.
The mRNA technology is under study at the NIH for prevention and treatment of infectious diseases, including flu and AIDS, and also cancer. It was deployed in the development of covid-19 vaccines credited with saving 3 million lives in the U.S. alone — an accomplishment President Donald Trump bragged about in his first term.
A scientist at a biomedical research center in Philadelphia wrote to a colleague, in an email reviewed by KFF Health News, that a project officer at NIH had “flagged our pending grant as having an mRNA vaccine component.”
“It’s still unclear whether mRNA vaccine grants will be canceled,” the scientist added.
NIH officials also told a senior NIH-funded vaccine scientist in New York state, who does not conduct mRNA vaccine research but described its efficacy in previous grant applications, that all references to mRNA vaccines should be scrubbed from future applications.
Scientists relayed their experiences on the condition of anonymity for fear of professional retaliation by the Trump administration.
A senior official at the National Cancer Institute confirmed that NIH acting Director Matthew Memoli sent an email across the NIH instructing that any grants, contracts, or collaborations involving mRNA vaccines be reported up the chain to Health and Human Services Secretary Robert F. Kennedy Jr.’s office and the White House.
Memoli sent a similar message ahead of the agency canceling other research, such as studies of vaccine hesitancy.
Memoli’s email on that topic bluntly stated that NIH was not interested in learning why people shun vaccines or in exploring ways to “improve vaccine interest and commitment.”
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The National Cancer Institute official, who also spoke on the condition of anonymity for fear of reprisals, said that “it is reasonable to assume mRNA vaccine work is next.”
The official said a similar memo also went out regarding NIH-funded work in South Africa, which the White House has targeted over false claims that the country’s government is persecuting white people. More recently, another one went out regarding all global research collaborations, the official said.
Spokespeople for the White House, HHS, and the NIH did not respond to requests for comment.
The NIH, whose latest annual budget was $47 billion, is one of the world’s most critical sources of funding for basic biomedical research. Its mission and programs are under unprecedented scrutiny from Trump’s White House and the Department of Government Efficiency, the Elon Musk-led agencycreated by a Trump executive order that has directed federal agencies to prepare for widespread layoffs.
The NIH is funding at least 130 studies involving the mRNA technology in covid vaccines produced by Pfizer-BioNTech and Moderna that have been administered to billions of people worldwide.
A former government official familiar with internal discussions said that the Trump administration intends to cut some grants for mRNA vaccine research but that the timing is unclear. The person spoke on the condition of anonymity to protect relationships with the administration.
Political conservatives in the U.S. have promulgated conspiracy theories, unsupported by scientific evidence, that the shots and their relatively new technology are dangerous. This has undermined public support for covid vaccinations and mRNA research.
“There will not be any research funded by NIH on mRNA vaccines,” the scientist in New York said in an interview. “MAGA people are convinced that these vaccines have killed and maimed tens of thousands of people. It’s not true, but they believe that.”
Meanwhile, hundreds of other vaccine-related studies are in limbo. Kawsar Talaat, a vaccine researcher at the Bloomberg School of Public Health at Johns Hopkins University, has been waiting since the fall for money needed to recruit subjects for a study of an antidiarrheal vaccine.
“NIH approved our funding,” she said, “and now we’re waiting, and we don’t know if it’s going forward or going to be killed.”
The scientist in Philadelphia signaled that he believes Kennedy, a longtime anti-vaccine activist, is responsible for the NIH’s turn against mRNA research.
“Kennedy’s war on vaccines has started,” the scientist told his colleague.
The scientist in New York said that it was “ridiculous” to remove mRNA language from the grant applications. But “if my grant is rejected for any reason,” the scientist said, “people in my lab will lose their jobs.”
“I’ve worked with some of them for 20 years,” the scientist added. “They have children and families. There is a real climate of fear in academia about this now, especially among vaccine scientists.”
“My grant does not involve a request for funds to conduct mRNA vaccine experiments,” the scientist said, “so my principal concern was to avoid word-search flags that, at minimum, would lead to delays in any funding.”
While tenured research professors at universities generally receive a salary from their institution, the staffers who work in their labs and offices are often paid through NIH grants. The 2023 Nobel Prize in physiology or medicine was given to two scientists for developing mRNA vaccines, through work that relied on pharmaceutical companies and on NIH scientists working under infectious disease specialist Anthony Fauci.
According to Sen. Bill Cassidy, a Louisiana Republican who chairs the chamber’s Health, Education, Labor and Pensions Committee, Kennedy promised during his Senate confirmation process that he would protect “the public health benefit of vaccination” and “work within the current vaccine approval and safety monitoring systems, and not establish parallel systems.”
Cassidy, a physician, had expressed reservations about confirming Kennedy to the HHS post and challenged his anti-vaccine views during a confirmation hearing. He ended up voting for him, he said, because Kennedy had agreed to work closely with Cassidy and his committee.
However, Kennedy has faced scrutiny in his first weeks in office for his handling of a large measles outbreak among mostly unvaccinated people in Texas that has led to the death of a child, the first U.S. measles death in more than a decade. A patient who tested positive for measles died in New Mexico, but the cause hasn’t been confirmed. Instead of urging vaccination against the disease, an almost surefire way to prevent infection, Kennedy has blamed malnourishment for the outbreak, promoted unproven treatments for measles, and falsely claimed in one Fox News interview that the vaccine is ineffective and even dangerous.
Cassidy did not respond to a request for comment on the NIH’s potential abandonment of mRNA vaccine research.
As part of the Trump administration’s push to examine spending on mRNA vaccines, health officials are reviewing a $590 million contract for bird flu shots that the Biden administration awarded to Moderna, Bloomberg News has reported. Legislation introduced by GOP lawmakers in at least seven states is aimed at banning or limiting mRNA vaccines. In some cases, the measures would hit doctors who give the injections with criminal penalties, fines, and the possible revocation of their licenses.
Stephanie Armour and Céline Gounder contributed to this article.
This article was produced by KFF Health News, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.
BOSTON — On days when the sun was shining and the air was warm with a gentle, cooling breeze, Ateiya Sowers-Hassell liked to keep the salon door open. Labor Day was one of those days. Sowers-Hassell was tending to two clients at Salvaged Roots, the natural hair salon and spa in the Four Corners section of Boston’s Dorchester neighborhood where she works as a stylist. She was in a groove, soothing music playing in the background, when gunshots boomed through the air.
She saw people running from Exclusive Barbershop next door. She heard a voice telling a 911 operator that someone had been shot in the head. Her hands shook as she ventured outside. Then she saw 20-year-old Elijah Clunie slumped in a barber’s chair, haircut unfinished.
In the chaos, a 7-year-old boy stood in shock, eyes bulging at Clunie’s body. Sowers-Hassell asked the boy to come with her and sheltered him at the salon until his father arrived. “He kept going, ‘I can’t breathe. I can’t breathe,’” she said, and he later told her he never wanted to get his hair cut again.
Barbershops and salons are regarded in the Black community as safe, sacred spaces, where men and women gather to laugh, debate, and see their unofficial therapists: the barbers and stylists. When those refuges are violated by gun violence, an unspoken bond is broken.
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Clunie’s killing cost Dorchester more than his own young life. Shootings send ripples of trauma through communities that can carry across generations. A 2020 study found that exposure to gun killings was linked to higher levels of depression, suicidal ideation, and other mental health difficulties. Children and young adults were the most susceptible, and Black youth were disproportionately affected.
When economists calculate the societal costs of gun violence, “what they find is that much bigger than hospital treatment or criminal justice response or anything, is the fear and trauma and how it affects individuals and businesses,” said Daniel Webster, a professor and distinguished scholar with the Johns Hopkins Center for Gun Violence Solutions.
Four Corners — home largely to African American, Caribbean, and Puerto Rican families — is not a destination neighborhood. A historic Methodist church is one of the few attractions. There aren’t any major supermarkets, fine dining restaurants, or hospitals. Of the businesses that do exist, many cover their doors and windows in plexiglass and metal bars.
“We talk about these food deserts of good, healthy food; the truth of the matter is, it’s a desert for everything,” Webster said. “Businesses generally don’t want to be there.”
The owner of Salvaged Roots, Shanita Clarke, said she intended her salon to stand out as an oasis in the community.
Nailah Carter rinses the hair of client Sahadia Berthaud in front of a photo of Shanita Clarke, the owner of Salvaged Roots, at the salon.(Sophie Park for KFF Health News)Barbershops and salons are regarded in the Black community as safe, sacred spaces.(Sophie Park for KFF Health News)
Clarke was planning to take her then-13-year-old son to the salon to get his hair done when she got a phone call about the shooting. She rushed to work to check on her stylists. Clarke, her staff, and clients spent the next three hours waiting while officers collected evidence. In the weeks that followed, calls came in to push back appointments. Clarke said she could sense her clients’ anxiety and understood it. Even though she wasn’t in the shop when Clunie was shot, she experienced the incident vicariously through the sound of gunshots captured on the salon’s security footage and accounts from her employees.
A case statement from the commonwealth of Massachusetts alleges the suspect in Clunie’s killing, Diamond Jose Brito, entered Exclusive Barbershop wearing all black clothing and a ski mask. Brito walked to the back of the shop, where Clunie was seated, and asked his barber how long the wait was for a haircut. About 45 minutes later, the statement alleges, Brito returned, walked to Clunie’s chair, shot him in the back of the head with a small silver revolver, then shot another victim multiple times.
Brito, of Canton, Massachusetts, was arrested in Mattapan in October and is being held without bail. He pleaded not guilty to all the charges against him, including murder.
“Mr. Brito maintains his innocence and we are looking forward to presenting his defense at trial,” Brito’s attorney, David Leon, said in a statement to KFF Health News.
Boston City Councilor Brian Worrell’s office is around the corner from Salvaged Roots and Exclusive Barbershop. The neighborhood requires investment and initiatives by elected officials and policymakers, he said. Residents have to feel that homeownership and stable careers are possible.
“That can’t be some far-off thinking,” said Worrell, who represents District 4, which includes that part of Dorchester. “They have to be able to see it, and it has to show up in their lives, in a real, tangible way.”
Sowers-Hassell was at work on Labor Day, soothing music playing in the background, when gunfire pierced the air and she saw people running from Exclusive Barbershop next door. A patron had been shot in the head.(Sophie Park for KFF Health News)Sowers-Hassell wears a shirt commemorating her friend Dawnn Jaffier, who was killed by gun violence in 2014.(Sophie Park for KFF Health News)
Clunie had been a student at TechBoston Academy and a basketball player who was named player of the game after a big win his senior year, in 2022. But in a draft senior presentation uploaded to the presentation site Prezi in June of that year, a user presumed to be Clunie wrote: “When I first moved to the Dorchester area I thought I was going to die,” noting “the killings on the news” every day.
Moments after the shooting, an unknown person walked into the barbershop and recorded a graphic video of Clunie’s body, which was then uploaded to social media platforms. It spread on Facebook and X, leading users to find Clunie’s personal accounts, on which some commenters made light of his death. He would have turned 21 the Saturday following his killing.
Worrell called the video especially inappropriate and callous. But apathy in the face of violence, he said, isn’t hard to imagine in a community suffering food and housing insecurity, struggling schools, and a persistent lack of opportunity.
Clarke said she’s torn on how to move forward. Loud noises and being alone trigger anxiety, and she now sometimes locks the salon doors once clients are in for their appointments. She’s felt anger and isolation, she said.
Recovering from the trauma of witnessing gun violence is often more difficult for onlookers when they still live and work where the shootings happened.
“We want to address the mental health trauma from gun violence, but let’s not kid ourselves,” Webster said. “If we don’t actually address gun violence, we’re swimming against a really strong tide.”
Since she opened her salon almost six years ago, Clarke has been active in community efforts to make the neighborhood safer, attending civic association and neighborhood meetings and speaking with police and local politicians.
Clarke believes efforts to clean up nearby Melnea Cass Boulevard moved more drug users into Dorchester. Salvaged Roots is next to a commuter rail station, which Clarke said attracts transients who set up camps and leave behind trash and sometimes drug paraphernalia. Only a week before Clunie’s killing, there was a fatal shooting across the street from the salon.
Signs prohibiting ski masks are seen on Feb. 14 in the windows of the space that was previously Exclusive Barbershop, where 20-year-old Elijah Clunie was shot last year, next door to Salvaged Roots salon.(Sophie Park for KFF Health News)
A person walks past a mural highlighting Black leaders with connections to Boston at a post office near the city’s Dorchester neighborhood. (Sophie Park for KFF Health News)
Pigeons fly over Beulah Pilgrim Holiness Church near Dorchester. (Sophie Park for KFF Health News)
In 2024, there were about 20 shootings in the police district that includes Four Corners, five of them fatal. Most of the victims were Black men, according to a KFF Health News analysis of Boston Police Department data.
Though gun violence overall is at a record low in Boston since 2023 and the city has invested more in investigative resources — including police detectives, management, and oversight — a disproportionate amount occurs in Boston’s historically Black communities.
Since Clarke opened Salvaged Roots, she feels Four Corners has gotten both better and worse. “If other businesses leave, then where do people that live in the community — where are the nice places that they get to go to?” she asked.
Residents of neighborhoods with frequent gun violence and crime can mistakenly be perceived as being desensitized, but “we can never accept the violence as normal,” Boston City Council President Ruthzee Louijeune said. She’s volunteered and worked in Four Corners and said tackling the violence takes a multipronged approach, including getting guns off the street and providing access to affordable housing, secure jobs, and good health care.
In communities of color, she said, intergenerational trauma from racism and poverty must also be addressed.
In Dorchester, Louijeune said, a high number of residents resort to visiting emergency rooms for mental health issues. The neighborhood needs more access to health care, she said, especially for young people. Across Boston, Black residents were nearly twice as likely to go to the ER for mental health care than white residents, according to the Boston Public Health Commission’s 2024 Mental Health Report.
Months later, attention and curiosity over the shooting had died down, but the trauma remained. Sowers-Hassell continues to work at Salvaged Roots, and though the city sent a trauma team to meet with the stylists after the shooting, she still has flashbacks. She said the influx of resources was helpful and that Four Corners has been a little quieter. But she’s skeptical the reprieve will last.
“Everybody talks a good game,” she said, “but when it’s time to get something done, what’s going to happen?”
Sowers-Hassell at Salvaged Roots.(Sophie Park for KFF Health News)
This article was produced by KFF Health News, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.
Health and Human Services Secretary Robert F. Kennedy Jr. is already acting on his anti-vaccine views, ordering an end of research into why people become vaccine-hesitant and requesting new research on the long-debunked theory that vaccines can cause autism in children. Coincidentally, the Trump administration at the last minute pulled the nomination of former GOP congressman and vaccine skeptic Dave Weldon to head the Centers for Disease Control and Prevention, perhaps signaling that Republicans in the Senate are growing uncomfortable with the issue.
Meanwhile, Congress continues to contemplate how to cut as much as $880 billion in spending — possibly from Medicaid — at a time when more beneficiaries of the government health program for those with low incomes and disabilities have become Republican voters.
This week’s panelists are Julie Rovner of KFF Health News, Anna Edney of Bloomberg News, Shefali Luthra of The 19th, and Alice Miranda Ollstein of Politico.
Among the takeaways from this week’s episode:
The Trump administration’s last-minute decision to pull the nomination of Dave Weldon to head the CDC — shortly before his confirmation hearing before the Senate Health, Education, Labor and Pensions Committee was set to begin Thursday morning — has fueled speculation that Weldon’s anti-vaccine views meant he didn’t have enough Senate support to win confirmation. Weldon, a physician and former Florida congressman, has advanced debunked theories about vaccines and autism.
Senate Democrats threatened to vote against a continuing resolution, or CR, to fund the government through Sept. 30. The measure passed narrowly in the House, with just one Democrat, Jared Golden of Maine, voting for it. Senate Democrats oppose the stopgap spending bill on many fronts, including its proposed cuts to medical research and its lack of a “fix” to prevent payment cuts to doctors who accept Medicare patients. The Democrats propose a 30-day government funding bill to allow negotiations on a bipartisan measure. The House adjourned after passing the CR on Tuesday and is not scheduled to return to Washington until March 24.
The Medicaid program may be garnering more support as Republicans continue to debate how to cut federal spending to finance a major tax cut package. The impact of Medicaid funding cuts on rural hospitals and on the Medicaid expansion population that gained coverage as part of the Affordable Care Act are two areas of discussion as House Republicans deliberate.
Continued staffing reductions at federal agencies are stoking concerns about lower levels of service to constituents and worsening mental health in the federal workforce. If federal workers are dismissed for poor performance — a charge many federal employees have called false because they received positive job performance reviews — then they don’t receive severance and cannot collect unemployment. With 8 in 10 federal workers employed outside the Washington, D.C., area, the sweeping impacts of reductions in the federal workforce are being felt far beyond the Beltway.
The Trump administration’s decision to cancel $250 million in National Institutes of Health grants to Columbia University is the latest in an ongoing campaign to cut federal research funding. The uncertainty in federal funding has caused several schools to freeze hiring and rescind some graduate student admissions, raising concerns that the Trump administration’s policies are disrupting scientific research. Recent moves from HHS to allow new rules and regulations without public comment and new restrictions from the National Cancer Institute on what topics require review before publication (vaccines, fluoride, and autism are now on the list) are raising concerns that politics is playing a larger role in federal health policy.
Also this week, Rovner interviews Jeff Grant, who recently retired from CMS after 41 years in government service.
This article was produced by KFF Health News, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.
California’s Medicaid program has borrowed $3.4 billion from the state’s general fund — and will likely need even more — to cover ballooning health expenses for 15 million residents with low incomes and disabilities.
The state Department of Finance disclosed the loan to lawmakers in a letter late Wednesday, noting funds were needed to make critical payments to health care providers in Medi-Cal, the state’s version of Medicaid. In recent months, Gov. Gavin Newsom’s administration has warned of skyrocketing health care costs, including higher prescription drug prices and increased enrollment by newly eligible seniors and immigrants without legal status.
Finance spokesperson H.D. Palmer said the loan will cover Medi-Cal obligations through the end of the month. He declined to specify the total of the program’s potential shortfall. However, a document circulated by state Senate leaders warns that additional funding may be needed to cover expenses through June 30, the end of the fiscal year.
The cost overrun adds a new layer of difficulty for Democrats who control the legislature and are already grappling with congressional budget plans that could slash Medicaid funding, which accounts for 60% of Medi-Cal’s $174.6 billion budget. President Donald Trump and Republican lawmakers have also criticized California Democrats for covering residents regardless of their immigration status.
Newsom spokesperson Izzy Gardon downplayed the loan. “Rising Medicaid costs are a national challenge, affecting both red and blue states alike,” Gardon said. “This is not unique to California.”
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Health officials last year said the state would spend roughly $6.4 billion in the 2024-25 fiscal year to cover immigrants without legal status, which the Democratic governor has hailed as a key step toward his goal of providing “universal coverage” for Californians. In recent testimony, however, finance staff told legislators that benefits to all income-eligible Californians are projected to cost roughly $9.5 billion, of which $8.4 billion will come from the general fund.
Republicans called for fresh scrutiny of the state’s decision to cover residents without legal status. “This program is out of control,” Senate Minority Leader Brian Jones posted on the social platform X. “We are demanding a full hearing and a full cost analysis so the public knows exactly where their tax dollars are going.”
Patient advocates objected to Republicans singling out the expansion for immigrants.
“Health care costs are influenced by many factors including prescription drugs, hospital costs, and more,” said Rachel Linn Gish, a spokesperson for Health Access California, a consumer health advocacy group.
According to a fall update from the Department of Health Care Services, Medi-Cal spending grew due to higher-than-expected enrollment of seniors, fewer Californians losing Medi-Cal coverage than anticipated, and increased pharmaceutical spending, as well as expanding coverage of immigrants. For instance, the state is spending $1.1 billion more on residents who were expected to lose coverage after the covid-19 pandemic, and an additional $2.7 billion more than anticipated to cover unauthorized residents.
Assembly Speaker Robert Rivas said he’s committed to maintaining the state’s expansions of Medi-Cal services.
“There are tough choices ahead, and Assembly Democrats will closely examine any proposal from the Governor,” he said in a statement. “But let’s be clear: We will not roll over and leave our immigrants behind.”
Senate leaders said they were looking closely at the state’s estimated costs and caseloads and would recommend cost containment measures as part of their budget proposal in the coming weeks.
Scott Graves, budget director at the California Budget & Policy Center, said it’s not unusual for the state government to make adjustments when spending doesn’t line up with projections.
Last year, for instance, the state borrowed $1.75 billion against its general fund when revenues from a state provider tax were delayed. Prior to that, Department of Finance officials said, California took out a similar loan in 2018 for $830 million.
“The reality is all of these are just estimates, especially with a very complicated program like Medi-Cal,” Graves said, noting that $3.4 billion is roughly 2% of the state’s overall Medi-Cal budget. “It seems like we’re on the verge of making a mountain out of a molehill.”
Mike Genest, who served as finance director under Republican Gov. Arnold Schwarzenegger, agreed that adjustments can be routine. But he said the magnitude of Medi-Cal’s current overrun was not.
“For this to happen in the middle of the year — we’re only in March — I mean, that’s pretty astounding,” Genest said.
California Democrats continue to characterize Trump and congressional Republicans as the biggest threat, pointing to the House budget plan to shrink Medicaid spending by as much as $880 billion. They say cuts of that magnitude would leave millions of residents uninsured, reducing access to preventive care and driving up costlier emergency room services.
They cautioned that some short-term cost increases could be driven by newly eligible residents seeking long-delayed care, which could level off in coming years. However, some acknowledge difficult decisions ahead.
“We definitely have to ensure that those who are our most vulnerable — our kids, those with chronic conditions — continue to have some sort of coverage,” said Democratic Sen. Akilah Weber Pierson, a San Diego County physician. “The question is, what will that look like? To be quite honest with you, at this point, I don’t know.”
