Health
Cutting Medicaid?
Republican leaders in Congress have directed the committee that oversees Medicaid to cut $880 billion from the next budget. They say these cuts aren’t necessarily aimed at Medicaid, the insurance program for 72 million poor and disabled Americans. The cuts could come from Medicare, for instance. But Trump has vowed not to touch that very popular program. And a sum this large can’t come from anywhere else.
The Republican process is just getting started, and we don’t yet know how lawmakers will change the program. Most Medicaid money goes to states, so the best way to think about the proposal is as a cut to state budgets. State lawmakers could react by dropping coverage, raising taxes or slashing other parts of their budget. In today’s newsletter, I’ll explain a few possible scenarios.
Who’s covered
Medicaid was designed to divide a patient’s medical bills: the federal government and the state would each pay a set share. (A state’s contribution depends on how poor it is.)
The law is precise about what Medicaid must cover — cancer screenings and kidney transplants, for instance, but not prosthetic legs — and Republicans can’t change that with a budget bill. Every state has to cover certain populations, including poor children, pregnant women, people with disabilities and patients in nursing homes who run out of money.
Most states also choose to cover an optional group that was added as part of Obamacare in 2014: anyone who earns less than a certain income (around $21,000 for a single person). Republicans want to impose a work requirement on this group for people who aren’t disabled. That idea is popular with the public but would save the federal government only around $100 billion, not enough to meet the G.O.P. target.
Bigger targets
Anything more to lower the federal government’s share would put the burden on states. And lawmakers there could deal with the problem in their own ways. They could cut optional populations like the Obamacare group. Twelve states have laws that will automatically do this if federal funding drops. If they don’t want to drop people, states can drop optional benefits, such as prescription drug coverage.
After those cuts, states face tough choices.
They could pay doctors, hospitals and nursing homes less for care. But there is a limit. If Mississippi suddenly started paying $50 for an echocardiogram instead of around $160, cardiologists might stop seeing Medicaid patients. (Many Medicaid patients already struggle to find care because the program pays doctors so little.) Cuts like these could also put some nursing homes or rural hospitals out of business.
Even so, states would still need a lot more money for Medicaid, usually their second-largest expense after education.
Where could they get it? They’d have to sacrifice other priorities. One option is to cut education. Another is to raise taxes. None of these would be required by federal legislation; it’s up to the states how they cope. That allows Republicans in Congress to say they are not cutting Medicaid benefits or eligibility, even if that is the inevitable effect in most places.
Too big to fail
Republicans point out that the original pact between Washington and the states has frayed, and feds are covering more than their share. That’s true. Through various accounting gimmicks, states have lowered their Medicaid contributions and now pay about a third of the bill, on average. Plus, Washington assumed almost the whole cost of the 2014 Obamacare expansion.
But that expansion has made Medicaid popular. More than half of Americans say someone in their family has used the program, and only 17 percent support cutting its budget. Local lawmakers also probably won’t win over voters by chopping education or raising taxes to save Medicaid. That’s why Democrats have settled on Medicaid as their top talking point about the G.O.P. budget plan.
Republicans tried to cut Medicaid’s budget in 2017, too. Grassroots opposition helped defeat the effort, as did extensive lobbying by Republican governors, who urged senators not to leave them with a huge fiscal hole.
The unpopularity of that bill — and its failure — helped Democrats retake the House the next year.
Related: Cutting Medicaid, taxing scholarships and killing invasive plants: A guide to the Republican wish list.
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Exercise affects the heart in a hidden, powerful way by rewiring nerves, study finds
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Regular exercise may do more than strengthen the heart. It could also reprogram the nerves that control how the heart beats, new research has found.
The discovery could eventually help doctors better treat common conditions such as irregular heart rhythms, chest pain, angina and stress-related “broken-heart” syndrome, according to scientists at the University of Bristol in the U.K.
The study, which looked at lab rats trained over 10 weeks, found that moderate exercise does not affect the heart’s nerve control system evenly. Instead, it produces distinct and opposing changes on the left and right sides of the body. a split researchers say has gone largely unnoticed until now.
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“The discovery points to a previously hidden left–right pattern in the body’s ‘autopilot’ system that helps run the heart,” Dr. Augusto Coppi, the study’s lead author and a senior lecturer in veterinary anatomy at the University of Bristol, said in a statement.
Regular exercise may “rewire” the nerves that control the heart, the new study found. (iStock)
“This could help explain why some treatments work better on one side than the other and, in the future, help doctors target therapies more precisely and effectively,” Coppi added.
After 10 weeks of aerobic exercise, the researchers examined the animals’ heart control nerves and found left–right differences that did not appear in inactive rats, according to the research published in the journal Autonomic Neuroscience in September.
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On the right side, the nerve hub that sends “go faster” signals to the heart developed many more nerve cells, suggesting increased wiring. On the left side, however, the number of nerve cells did not rise as much. Instead, the existing cells grew significantly larger, indicating a different kind of adaptation.
The findings could help explain why some heart treatments work better on one side than the other. (iStock)
The findings show that exercise reshapes the heart’s nerve control system in a side-specific way rather than affecting both sides equally, the researchers said. Understanding that process could help doctors better target treatments, especially for patients who cannot exercise or whose symptoms persist despite lifestyle changes.
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Researchers compared the nerve clusters, known as the stellate ganglia, to a “dimmer switch” that fine-tunes how strongly the heart is stimulated. That fine-tuning is important because overstimulation of these nerves is linked to chest pain and dangerous heart rhythm problems.
Scientists caution more studies are needed to determine whether the same effects occur in humans. (iStock)
The findings are early stage and based on animal research, however. So, they do not prove the same effects in people. More studies are needed before they could affect patient care.
Researchers say future studies will explore whether similar left–right nerve changes occur in people and whether they could help explain why some heart treatments work better on one side than the other, potentially paving the way for more precise, personalized care for angina and heart rhythm disorders.
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The study was conducted in collaboration with researchers from University College London, the University of São Paulo and the Federal University of São Paulo in Brazil.
Researchers discovered distinct left-right changes in heart-control nerves after 10 weeks of aerobic exercise. (iStock)
The findings add to growing evidence that regular, moderate exercise benefits the heart in ways scientists are beginning to understand better.
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Fox News Digital has reached out to the study authors for comment.
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Seniors taking multiple medications may face unexpected health effects
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Older adults discharged from hospitals on multiple medications are less likely to regain independence during rehabilitation, a new study suggests.
The Japanese study, published in the journal BMC Geriatrics Dec. 17, explored the effects of polypharmacy — defined as taking six or more regular medications on a regular basis — at a convalescent rehabilitation hospital in Japan.
The retrospective observational study looked at 1,903 patients 65 and older who underwent rehabilitation at the hospital from April 2017 to March 2024, according to a press release.
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The patients had one of three conditions: cerebrovascular disease (a disorder of the brain’s blood vessels that reduce or block blood flow), motor disorder (a condition that affects movement and muscle control) or disuse syndrome (inactivity leading to muscle weakness and physical decline).
Of the total group, 62.1% of the patients were taking six or more medications when they were discharged from the hospital, and more than 76% of them were 80 or older.
Older adults discharged from the hospital on multiple medications are less likely to regain independence during rehabilitation, a new study suggests. (iStock)
Those taking multiple medications were also more likely to be taking benzodiazepine receptor agonists (taken for anxiety or insomnia), laxatives and psychotropic medications (mainly used for depression, anxiety, psychosis and other mood disorders).
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The researchers determined that those with polypharmacy who had cerebrovascular disease and disuse syndrome scored significantly lower in the functional independence measure (FIM), which assesses how independently a person can perform everyday activities, especially after illness, injury or hospitalization. Those in the motor disorder group didn’t show any link between polypharmacy and FIM.
The negative effects were stronger among adults over 80 and those recovering from stroke-related conditions or general weakness due to inactivity.
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Based on these findings, the researchers suggest that reviewing and reducing unnecessary medications could help improve recovery for those undergoing rehabilitation.
Dr. Marc Siegel, Fox News senior medical analyst, refers to polypharmacy with seniors as a “risky proposition.”
The retrospective observational study looked at 1,903 patients 65 and older who underwent rehabilitation at a hospital from April 2017 to March 2024. (iStock)
“Even though each medication may have a purpose, often important, we must keep in mind that the ability to tolerate various medications and metabolize them efficiently diminishes as you get older,” he told Fox News Digital.
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“For example, a med that sedates you or even has the potential to disorient you may be more likely to do so as you become elderly.”
Drug interactions also tend to increase as patients grow older, Siegel added.
“This must all be monitored carefully by your physician, and, sometimes, less is more,” he said.
Based on these findings, the researchers suggest that reviewing and reducing unnecessary medications could help improve recovery for those undergoing rehabilitation. (iStock)
The study did have some limitations, the researchers acknowledged. Due to its retrospective and observational design, it does not prove that the medications caused the outcome.
The researchers also lacked data on specific doses of the medications and the intensity of the rehabilitation, they noted. Also, the study was conducted at just a single hospital, so the results may not apply to more general populations.
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Future research is needed to determine which specific medications most affect recovery and to explore the best approaches for reducing prescriptions.
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