Health
Supreme Court Weighs South Carolina’s Bid to Defund Planned Parenthood
The Supreme Court heard arguments on Wednesday in a case arising from South Carolina’s attempt to deny funding to Planned Parenthood. But the question the justices grappled with was a relatively narrow one, focused on whether individuals may sue the state to obtain medical services from Planned Parenthood unrelated to abortion.
In 2018, Gov. Henry McMaster of South Carolina, a Republican, ordered state officials to deny Medicaid funds to Planned Parenthood, saying that “payment of taxpayer funds to abortion clinics, for any purpose, results in the subsidy of abortion and the denial of the right to life.”
Medicaid gives federal money to states to provide medical care for poor people, but it sets some conditions. One is that eligible participants may receive assistance from any provider qualified to perform the required services.
Abortions are banned in South Carolina after six weeks of pregnancy, and, even then, federal law prohibits the use of Medicaid funding except in life-threatening circumstances or in cases of rape or incest. But Planned Parenthood clinics in Charleston and Columbia provide services unrelated to abortion, including counseling, physical exams, contraception and screenings for cancer and sexually transmitted infections.
Planned Parenthood and a patient who sought contraception sued under a federal civil rights law, and a federal trial judge blocked the South Carolina directive, saying that it ran afoul of Medicaid’s requirement that patients may choose any qualified provider.
The litigation that followed was convoluted and circuitous, focusing largely on whether that provision created a right that individuals could enforce by filing lawsuits. The Supreme Court has said that federal laws like Medicaid, which give money to states but only if they accept certain conditions, must “unambiguously confer individual federal rights” to give affected individuals the right to sue.
That is a hard test to meet, and the court has ruled that it has been satisfied only rarely, most recently in 2023 in Health and Hospital Corporation of Marion County v. Talevski, a case concerning nursing homes. The statute at issue in that case repeatedly referred to “rights” as such, while the Medicaid provision in the new case used different language.
It said people seeking medical services “may obtain such assistance from any institution” that is “qualified to perform the service or services required.”
Nicole A. Saharsky, a lawyer for Planned Parenthood, acknowledged that the standard was strict.
“It is a high bar to find that Congress put in place an individually enforceable right,” she said. “What we’re saying is that this provision meets the bar.”
Kyle D. Hawkins, a lawyer for the Trump administration, disagreed, saying the Medicaid provision lacked the required “unmistakable rights-creating language.”
Under the Biden administration, the government had taken the opposite position, which Mr. Hawkins acknowledged.
“With the change in administration,” he said, “the federal government re-evaluated its position in this case, and we believe that the view we’re advancing today is the best reading of the statute.”
The justices discussed at length whether Congress had to use “magic words” to allow people to sue. John J. Bursch, a lawyer with the Alliance Defending Freedom, a conservative Christian group that represents South Carolina, proposed a series of words Congress could use to grant an unambiguous right to sue.
“The list I would give you is rights, entitlement, privilege and immunities,” he said, adding that they did not amount to magic words.
In response, Justice Brett M. Kavanaugh said, “I’m not allergic to magic words because magic words, if they represent the principle, will provide the clarity that will avoid the litigation that is a huge waste of resources for states, courts, providers, beneficiaries and Congress.”
Justice Elena Kagan said the language in the Medicaid law could hardly be plainer. “The state has to ensure that individuals have a right to choose their doctor,” she said. “That’s what this provision is.”
Last year, a unanimous three-judge panel of the U.S. Court of Appeals for the Fourth Circuit, in Richmond, Va., ruled that the suit could proceed.
“This case is, and always has been, about whether Congress conferred an individually enforceable right for Medicaid beneficiaries to freely choose their health care provider,” Judge J. Harvie Wilkinson III wrote for the panel. “Preserving access to Planned Parenthood and other providers means preserving an affordable choice and quality care for an untold number of mothers and infants in South Carolina.”
He added that “this decision is not about funding or providing abortions.”
Abortion was mentioned only in passing in Wednesday’s argument in Medina v. Planned Parenthood South Atlantic, No. 23-1275, and the case did not turn on the state’s reason for trying to disqualify Planned Parenthood. But Ms. Saharsky said the dispute presented issues beyond a technical one about who can sue.
Congress, she said, had tried to send a message: “We want people on Medicaid who are insured through Medicaid to have the same right that people who have private insurance enjoy because it’s so foundational to individual dignity and individual autonomy.”
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When someone gets a cancer diagnosis, the initial reaction is usually to undergo treatment as quickly as possible — but for some types of disease, doctors may recommend a more conservative approach.
For certain cancers, immediate or aggressive treatment can cause more harm than good, according to multiple medical experts.
For example, treating slow-growing tumors with surgery, radiation or chemotherapy could create significant side effects without a survival benefit.
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“The fact that so many cancers will never kill you is not a justification for not knowing, because there is still plenty of room for ‘watchful waiting,’ as well as interventions that may improve quality of life even if they don’t extend life,” Dr. Marc Siegel, Fox News senior medical analyst, told Fox News Digital.
This is especially true as targeted cancer treatments emerge, which are more personalized and less likely to cause severe side effects, according to the doctor.
For precancerous, very early-stage breast conditions, careful monitoring may be more prudent than immediate surgery, research shows. (iStock)
“The fact that cancers are occurring earlier is a justification for heightened screenings, not the opposite,” Siegel added. “Information is power — what you do with that information is based on clinical judgment and the art of medicine.”
Below are some types of cancer that may not warrant treatment, according to research and doctors’ guidance.
No. 1: Prostate cancer (low-risk)
While some types of prostate cancer should be treated right away, others are better addressed by “watchful waiting,” according to Sanoj Punnen, M.D., a urologic oncologist with Sylvester Comprehensive Cancer Center, part of the University of Miami Health System.
“With respect to prostate cancer, for most low-risk cancers (Gleason 6 or grade group 1), we recommend initial observation and surveillance rather than immediate treatment,” he told Fox News Digital.
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The Gleason score is a grading system that ranks prostate cancer cells in terms of how abnormal they are, with 6 being the lowest grade and 10 being the highest grade (barely resembling normal cells).
“For high-grade tumors like Gleason 8, 9 or 10, we believe they progress quickly, so we recommend treatment to prevent the risk of metastasis,” said Punnen, who is also vice chair of research and a professor with the Desai Sethi Urology Institute at UHealth. “For low-risk tumors, we think they pose little risk, so we recommend just observation.”
“The fact that cancers are occurring earlier is a justification for heightened screenings, not the opposite.”
“But in the end, we can’t be sure, so our approach to observation includes serial monitoring of cancer status with PSA, MRI and occasional biopsy to ensure the tumor isn’t progressing.”
No. 2: Ductal carcinoma in situ (DCIS)
Also known as stage 0 breast cancer, DCIS is a non-invasive disease marked by abnormal cells in the lining of the breast milk ducts. The “in situ” is Latin for “in the original place,” which indicates that the cancer has not spread outside the milk ducts.
For this precancerous, very early-stage breast condition, careful monitoring may be more prudent than immediate surgery, research shows.
While some types of prostate cancer should be treated right away, others are better addressed by “watchful waiting,” according to a urologic oncologist. (iStock)
A 2024 study by the Dana-Farber Cancer Institute found that active monitoring for DCIS resulted in similar quality of life, mental health and symptom progression over a two-year period compared to a standard surgical approach.
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“These results suggest that in the short term, active monitoring is a reasonable approach to management of low-risk DCIS,” the lead researcher said in a press release. “If longer-term follow-up supports the safety of active management from a cancer outcome standpoint, this approach could be considered as an option for women with this condition.”
“But it is also critical that we understand how women feel when they are living with this ‘watch and wait’ approach and how it impacts their overall quality of life.”
Other research has suggested that women with low-risk DCIS did not have a higher rate of invasive cancer after two years of active monitoring, although each patient should discuss their individual risk level with an oncologist.
No. 3: Indolent (slow-growing) lymphomas
Non-Hodgkin lymphoma (NHL) is a type of cancer that starts in the lymphatic system, which includes the lymph nodes, spleen, thymus, bone marrow and other tissues.
Indolent lymphomas are those that “grow and spread slowly,” according to the American Cancer Society.
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The National Comprehensive Cancer Network (NCCN) recommends watchful waiting for asymptomatic, slow-growing follicular lymphoma, as a means of avoiding the toxicity of chemotherapy and immunotherapy until it’s absolutely necessary.
The Lymphoma Research Foundation confirms that doctors recommend “active surveillance” for some patients with slow-growing lymphoma.
Indolent lymphomas are those that “grow and spread slowly,” according to the American Cancer Society. (iStock)
“This approach may be started after the initial diagnosis or after relapse, depending on the situation,” the foundation states on its website. “Active treatment is started if the patient begins to develop lymphoma-related symptoms or if there are signs that the disease is progressing.”
Treatment should be started right away for aggressive (fast-growing) lymphomas.
No. 4: Chronic lymphocytic leukemia
One of the most common adult leukemias, chronic lymphocytic leukemia (CLL) originates in white blood cells (lymphocytes) in the bone marrow and then spreads to the bloodstream, according to the American Cancer Society.
CLL tends to grow slowly, with many patients experiencing no symptoms for years. Eventually, the cancer calls can spread to the lymph nodes, liver and spleen.
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Some studies have shown that early treatment for CLL does not improve survival rates compared to observation, and that the benefits may not outweigh the risks.
In a 2023 study presented at the European Hematology Association 2023 Congress in Frankfurt, Germany, researchers found that early treatment did not prolong overall survival compared to a placebo in patients with early, asymptomatic CLL.
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“I believe it’s fair to conclude that ‘watch-and-wait’ should remain the standard of care in the era of targeted drugs,” said researcher Petra Langerbeins, M.D., when presenting the findings.
No. 5: Low-grade endometrial cancer
For most patients with endometrial cancer, surgery is the first treatment, which entails removing the uterus, fallopian tubes and ovaries, according to the American Cancer Society.
However, in certain patients with low-grade cancer, such as older people, those with “frailty” and people with major health issues, doctors may recommend deferring surgery, which can pose a high risk.
The American Thyroid Association’s guidelines officially recommend active surveillance for very low-risk microcarcinomas. (iStock)
In cases where the patient has medical comorbidities or wants to preserve fertility, hormone treatment may be used instead of surgery, per the ACS.
“It’s usually also considered for cancer that is lower-grade, low-volume and slow-growing,” the above source stated.
No. 6: Some early kidney cancers
In cases of kidney cancer with small tumors (≤3 cm) or benign lesions, doctors may recommend monitoring them instead of undergoing surgery for removal.
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The American Urological Association confirms that active surveillance is an option for some small renal masses (localized tumors).
“I believe it’s fair to conclude that ‘watch-and-wait’ should remain the standard of care in the era of targeted drugs.”
Deferred treatment is particularly recommended for older patients or those with “significant comorbidities,” research shows.
“Shared decision-making about active surveillance should consider risks of intervention/competing mortality versus potential oncologic benefits of intervention,” the UAU states in its guidance.
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Data from the Delayed Intervention and Surveillance for Small Renal Masses (DISSRM) Registry showed that patients with active surveillance had a 99% or greater cancer-specific survival rate — virtually the same as patients who received immediate treatment.
No. 7: Small papillary thyroid cancers
Papillary thyroid cancer (PTC), the most common type of thyroid cancer, may not warrant treatment for small tumors measuring 1 centimeter (10 mm) or less, which are called microcarcinomas.
A young multiracial female is undergoing a diagnostic medical imaging procedure in a state-of-the-art hospital setting with CT simulator. The image illustrates the use of cutting-edge technology for healthcare and treatment in a modern medical environment. The portrayal highlights precision, care, and the sophistication of contemporary medical practices. (iStock)
Research found that when using active surveillance for 10 to 20 years, less than 10% experienced significant growth, only 5% developed lymph node spread and there were no thyroid-cancer deaths.
The American Thyroid Association’s guidelines officially recommend active surveillance for very low-risk microcarcinomas.
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While many patients with low-risk tumors can safely delay treatment, this does not apply to all cancers or all patients.
As cancer behavior and personal health factors vary widely, patients should consult their doctor to determine the most appropriate course of care based on their individual risk level.
Welcome to the Brain Health Challenge! I’m Dana Smith, a reporter at The New York Times, and I’ll be your guide.
To live a healthy life, it’s crucial to have a healthy brain. In the short term, it keeps you sharp and firing on all cylinders. In the long term, it can reduce your risk of cognitive decline, dementia and stroke.
Practicing basic healthy behaviors, like eating nutritious food and getting regular exercise, is the best way to enhance your brain power and protect the longevity of your neurons. These types of lifestyle habits can benefit the brain at any age. And while they won’t guarantee that you’ll never develop dementia or another brain disease, several clinical trials have shown that they can improve cognition or slow decline.
Every day this week, you’ll do an activity that’s good for your brain, and we’ll dig into the science behind why it works. Some of these activities can provide a small immediate cognitive benefit, but the bigger reward comes from engaging in them consistently over time. So along with the neuroscience lessons, we’ll include a few tips to help you turn these actions into lasting habits.
To keep you accountable, we’re encouraging you to complete this challenge with a friend. If you don’t have a challenge buddy, no problem: We’re also turning the comments section into one big support group.
There are so many fascinating ways your daily behaviors affect your brain. Take sleep, for example.
Lots of studies have shown that getting a good night’s rest (seven to eight hours) is associated with better memory and other cognitive abilities. That’s because sleep, especially REM sleep, is when your brain transfers short-term memories — things you learned or experienced during the day — into long-term storage.
Sleep is also when your brain does its daily housekeeping. While you rest, the brain’s glymphatic system kicks into high gear, clearing out abnormal proteins and other molecular garbage, including the protein amyloid, which is a major contributor to Alzheimer’s disease. A buildup of amyloid is one reason experts think that people who routinely get less sleep have a higher risk of dementia.
What other behaviors play a big role in brain health? For today’s activity, we’re going to test your knowledge with a quiz. Share your score with your accountability partner and in the comments below — I’ll be in there too, cheering you on.
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An often-overlooked part of the body may reveal important clues about overall health.
Researchers from the University of Westminster in the U.K. discovered that the shape of the gluteus maximus muscle in the buttocks changes with age, gender, lifestyle and frailty, as well as certain conditions like osteoporosis and type 2 diabetes.
Using advanced MRI scans that create 3D images, researchers revealed “distinct” patterns in the gluteus maximus associated with type 2 diabetes.
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This suggested that the shape of the muscle, rather than the size, may “reflect underlying metabolic differences,” a press release stated.
The findings were presented in December at the annual meeting of the Radiological Society of North America (RSNA) in Chicago.
Butt shape may indicate underlying health conditions, according to new research. (iStock)
Unlike previous studies looking at muscle size or fat, the 3D imaging identified exactly where the muscle changes occur, according to the researchers.
As one of the largest muscles in the human body, the gluteus maximus “plays a key role” in metabolic health, according to lead study author E. Louise Thomas, Ph.D., professor of metabolic imaging at the University of Westminster’s School of Life Sciences.
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The researchers analyzed more than 61,000 MRI scans from a large UK health database to better understand the muscle’s structure.
The data also included the participants’ physical measurements, demographics, disease biomarkers, medical history and lifestyle habits. The researchers studied how these variables were linked to muscle shape over time.
An infographic from the Radiological Society of North America presentation displays research findings on the shape of the gluteus maximus. (RSNA)
“People with higher fitness, as measured by vigorous physical activity and hand grip strength, had a greater gluteus maximus shape, while aging, frailty and long sitting times were linked to muscle thinning,” study co-author Marjola Thanaj, Ph.D., a senior research fellow at the University of Westminster’s Research Centre for Optimal Health, said in the release.
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The researchers concluded that butt shape changes may indicate an “early functional decline” and “metabolic compromise” in type 2 diabetes patients.
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Men with type 2 diabetes showed muscle shrinkage, while women displayed enlarged muscle, likely due to “infiltration of fat” within it, according to the researchers.
These results suggest that men and women have “very different biological responses to the same disease,” Thanaj suggested.
Butt shape changes may indicate an “early functional decline” and “metabolic compromise” in type 2 diabetes patients. (iStock)
Men who were categorized as “frail” were recognized as having more “general shrinkage” across the gluteus maximus, but women experienced a “limited” frailty effect.
Building strong glutes for better health
Strengthening the glutes is an “investment in long-term health,” according to Tanya Becker, co-founder of Physique 57 in New York City.
“While full-body strength training is essential, focusing on your glutes — the largest muscle group in your body — deserves special attention,” she told Fox News Digital.
“While full-body strength training is essential, focusing on your glutes — the largest muscle group in your body — deserves special attention.” (iStock)
Becker refers to the glutes as the body’s “shock absorbers,” because they protect the lower back, knees and hips from taking on stress they weren’t designed to handle.
Larger muscle groups also burn more calories and help regulate blood sugar, the expert added, noting that muscles are often referred to as the “organ of longevity.”
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Strengthening the glutes also helps to protect the lower back, hips and knees, and also improves posture and balance, reducing the risk of falls and improving mobility.
“People with higher fitness, as measured by vigorous physical activity and hand grip strength, had a greater gluteus maximus shape.”
Becker recommends traditional weighted exercises like squats, lunges and bridges, although they are not suited for everyone, especially older adults with injuries and joint pain.
“Pilates and barre classes offer bodyweight exercises that are ideal for beginners or individuals with physical limitations,” she suggested. “They can be done anytime, anywhere, making them accessible for beginners before progressing to weighted versions.”
Glute bridges (demonstrated above) are a recommended exercise for strengthening those muscles. (iStock)
Becker shared the following three glute exercises that improve hip mobility, stability and overall strength.
No. 1: Quadruped leg lifts (strengthens entire core and glutes)
Start on the hands and knees, engage your core, and lift one leg off the floor (bent or straight). Pulse up and down a few inches for 30 to 60 seconds, then repeat on the other leg.
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No. 2: Clamshells (strengthens gluteus medius)
Lie on your side with knees bent at 90 degrees in front of you. Lift your top knee away from your bottom knee, then lower slowly.
For an increased challenge, lift both feet off the ground while keeping the heels together. Repeat for 30 to 60 seconds per side.
Strong muscles are responsible for maintaining metabolic health, according to Becker. (iStock)
No. 3: Glute bridges (strengthens lower back and glutes)
Lie on your back with knees bent and feet parallel, a few inches from your hips. Engage your abs, and squeeze your glutes to lift your hips toward knee height, then lower.
If you feel pressure in your neck, you’ve lifted too high. Perform for 30 to 60 seconds. Complete three sets with 30-second rests between them.
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Those looking to start a new fitness routine should first consult with a doctor.
Fox News Digital reached out to the study authors for comment.
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