Health
The Three States That Are Especially Stuck if Congress Cuts Medicaid
If congressional Republicans go through with some of the deep Medicaid cuts they are considering, three states would be left in an especially tight bind.
South Dakota, Missouri and Oklahoma have state constitutions requiring that they participate in Medicaid expansion, the part of Obamacare that expanded the health program for the poor to millions of adults.
If Republicans choose to make the projected budget reductions by cutting into Medicaid expansion, the other 37 states (and D.C.) that participate in the expansion could stop covering working-class adults. Nine states have laws explicitly requiring them to stop Medicaid expansion or make significant changes if the federal share of spending drops.
But South Dakota, Missouri and Oklahoma can’t do that. They either need to amend their constitutions, a lengthy process that can take years, or figure out how to fill the budget hole, most likely by cutting other services or raising taxes.
The constitutional amendments were put on state ballots by progressive activists, who wanted to entrench the Medicaid program in places that had been hostile to that part of the Affordable Care Act. The idea was twofold: to get health coverage to more people, and to tether more states and their Republican lawmakers to Medicaid.
The ballot initiatives passed by a wide margin, and now these states have more at stake in the congressional debate over Medicaid. Even some conservative senators, like Josh Hawley of Missouri, are speaking out against reducing funding for the program. The Republican senators from the three states with constitutional amendments could become an unlikely part of the firewall against big cuts to Medicaid.
“Expanding Medicaid anywhere protects it everywhere, which is now what we’re seeing today,” said Kelly Hall, executive director of the Fairness Project, the nonprofit that organized the constitutional amendment campaigns. She noted that her group expected the expansions would broaden support for the program in Washington.
The exact details of any cuts are still unclear, but Republicans in Congress hope to enact a detailed plan by the end of September. A budget resolution that passed the House last month called for at least $880 billion in cuts over a decade from the committee that oversees Medicaid. If all the cuts came from Medicaid, that amount would represent an 11 percent reduction in federal Medicaid spending, and millions would most likely lose coverage. The Senate passed its own budget Saturday that included the House numbers but was less clear on the scope of its preferred spending cuts.
Lawmakers and policy analysts who favor cuts argue that states no longer pay their fair share of Medicaid’s bills. In recent years, the federal share of spending on the program has grown to more than 70 percent overall from around 60 percent. The federal government pays 90 percent of the costs for working-age adults who enroll through the expansion, a high share that the architects of Obamacare meant to ease the burden of expansion from state budgets.
Because states would become responsible for what had once been paid by the federal government, the states with constitutional amendments would have especially high financial stakes. In Missouri, Medicaid funding makes up about 35 percent of the state’s entire budget. If the federal government pulled back, the state would probably have to raise taxes or cut other parts of its budget, like education or transportation.
The last time Republicans attempted major Medicaid changes, as part of their Obamacare repeal push in 2017, some Republican governors lobbied their senators to protect the program, and several voted against the bill. In the years since, seven more Republican-led states have expanded Medicaid by ballot measure, expanding coverage to 950,000 people.
Even after passing at the ballot, Medicaid expansion still faced opposition from elected officials charged with setting up the program. The former Maine governor Paul LePage went the furthest, claiming he would go to jail rather than carry out a Medicaid expansion. (The expansion was implemented after he was replaced by a Democrat.)
That resistance got the progressive activists who organized and funded the ballot initiative campaigns looking for a way to make Medicaid expansion more ironclad. For 2020, they came up with the idea of pursuing voter referendums to enshrine participation in the program in state constitutions. They succeeded in Missouri and Oklahoma in 2020, followed by South Dakota in 2022.
Those ballot initiatives took more work, requiring more signatures to get onto the ballot. Activists decided the extra hurdle was worth it to entrench Medicaid in areas of the country that had been hostile to the program — thus giving it more protection in Washington.
The politics of the Republican Party have changed since 2017, too, shifting from Tea Party austerity toward working class populism. Hospitals have also become more dependent on Medicaid as it has expanded, and more effective at arguing this point to government officials.
“The system is much more firmly in place now than it was eight years ago,” said Brendan Buck, who was an aide for Speaker Paul Ryan during the Obamacare repeal effort in 2017 and is now a partner in a communications firm that does work for health industry clients. “These are our states. These are our voters. And I think they will hear loud and clear if this does become a real threat.”
When he was Missouri’s attorney general, Mr. Hawley led two lawsuits seeking to overturn the Affordable Care Act. But in February and again this past week, he voted with Democrats on budget amendments to protect Medicaid. Those efforts were largely ceremonial. But Republicans may need his vote to advance their larger package of tax cuts and spending reductions later this year.
“Our voters voted for it — my constituents — by a decisive margin,” Mr. Hawley said of Medicaid expansion in a recent interview, noting that a fifth of the state gets health insurance through the program.
While Mr. Hawley said he would be comfortable voting to add a work requirement to the program, he was “not going to vote for cut benefits.”
Senator Mike Rounds of South Dakota has also opposed reducing federal funding for Medicaid expansion because of the financial burden it would put on states. “That’s not a cost-cutting measure — that’s a cost transfer,” he told Politico in February.
Even many blue states that passed expansion through their legislatures will probably stop Medicaid coverage for poor adults if cuts go through. Twelve states, including Illinois and Virginia, have passed legislation that would automatically rescind the expansion if federal funding dips.
The states with constitutional amendments are already beginning to prepare for the possibility of a major budget hole. In Oklahoma, for example, federal Medicaid funding makes up almost 30 percent of the state’s entire budget.
A conservative Oklahoma think tank has suggested that the state cut other parts of Medicaid to make up the gap instead of dipping into funding for services like roads or schools.
But reducing Medicaid services alone probably wouldn’t be enough to offset the lost federal funding. There are only a handful of ways states are allowed to cut the program, such as ending coverage for prescription drugs or no longer providing insurance to postpartum women.
In South Dakota, the Legislature passed a law in February that would alter the constitution to leave the program if federal funding dropped.
The new law wouldn’t immediately pull South Dakota out of Medicaid expansion but would give the Legislature the flexibility to do so. To change the constitution, voters would also need to weigh in with a new ballot initiative, scheduled for the state’s next election in 2026 — potentially after Congress passes cuts.
“I’m worried it won’t be soon enough, but that is when our next election is,” said Tony Venhuizen, who introduced the bill in January as a member of the State Legislature. “There isn’t another way.”
Catie Edmondson contributed reporting.
Health
Hantavirus Vaccines and Treatments Are in the Pipeline
The deadly hantavirus outbreak aboard the cruise ship MV Hondius has put the spotlight on a rare pathogen that typically attracts relatively little attention, even from scientists.
There are no targeted treatments for hantaviruses, which are typically carried by rodents, and no widely available vaccines. So when passengers began falling ill in the middle of the Atlantic Ocean, doctors and public health experts were limited in what they could offer.
“It’s kind of a wake-up call,” said Dr. Vaithi Arumugaswami, an infectious disease researcher at the University of California, Los Angeles. “Our tool kit is almost empty.”
That’s not for lack of trying. A handful of scientific teams around the world have been working — for decades, in some cases — to develop hantavirus treatments and vaccines. But it has not been easy to find funding or nurture commercial interest in medical interventions for a type of pathogen that does not infect humans often and does not spread easily between people.
“It’s not an airborne, highly contagious viral threat, so it hasn’t been as high a priority for groups trying to prevent pandemics,” said Jay Hooper, a virologist at the United States Army Medical Research Institute of Infectious Diseases.
But there are promising vaccines and treatments in development. And some of them, experts said, could be moved through the pipeline rapidly if hantavirus interventions became a priority.
“I do think there are things that are sitting there on the bench that could be quickly developed,” said Dr. Ronald Nahass, the president of the Infectious Diseases Society of America. “But nothing is ready.”
Vaccine development
There are two main types of hantaviruses: Old World viruses, which circulate primarily in Asia and Europe, and New World viruses, which are found in the Americas. The cruise ship outbreak has been linked to a New World virus known as the Andes virus, which is endemic to South America and is the only hantavirus known to spread between people.
There are vaccines that target some of the Old World viruses in Asia, but their efficacy is modest, experts said. And there are no licensed vaccines for the New World viruses, which include the Sin Nombre virus endemic to rodents in the western United States.
But there are some in development. Dr. Hooper and his colleagues have developed a DNA vaccine for the Andes virus, which proved promising in a small phase 1 trial. Under certain dosing regimens, the researchers found, more than 80 percent of participants produced neutralizing antibodies. “It’s pretty amazing,” said Dr. Hooper, who is an inventor on multiple hantavirus vaccine patents owned by the U.S. government. “Getting these kinds of neutralizing antibodies in humans is impressive.”
There were drawbacks, including that the vaccine seemed to require at least three doses. But the vaccine is ready for further development “if there’s a need,” Dr. Hooper said. “We’ve done the science. It’s just other forces that are required to move vaccines forward — markets, government demand.”
Other teams have potential vaccines in earlier stages of development. For instance, Bryce Warner, a hantavirus researcher at the University of Saskatchewan, and his colleagues are exploring a variety of approaches, including a nasal vaccine that they hope might spark a more robust immune response in the airway.
But the research, which is being conducted in hamsters, is still in early stages, and hantavirus vaccine candidates can be challenging to move forward. Scientists lack good large-animal models for hantaviruses, Dr. Warner said, and human cases are rare enough to make trials tricky. “It’s very difficult to conduct a clinical trial when you only have a limited number of cases annually,” he said. “You don’t have the numbers of people to really show a robust effect.”
Drug hunting
Currently, the primary treatment for hantavirus infection is supportive care, which may include supplemental oxygen or heart-lung bypass machines. Doctors also sometimes prescribe an existing antiviral drug, called ribavirin, but there is not strong evidence that it is effective for New World viruses, scientists said.
The hunt for new drugs is underway, though. At U.C.L.A., Dr. Arumugaswami and his colleagues found that favipiravir, an antiviral approved to treat influenza in Japan, inhibited the Andes virus in human cells. They also identified several compounds that had broad antiviral activity, blocking hantaviruses as well as other types of viruses, in human organoids, miniature clusters of tissue that mimic the function of organs.
Other teams have been working to develop therapeutic antibody treatments, often working from blood samples collected from hantavirus survivors. “We were able to isolate the natural antibodies that people are making and basically winnow them down and find one that was really good,” said Kartik Chandran, a virologist at the Albert Einstein College of Medicine in New York. “We actually found several.”
When Dr. Chandran and his colleagues tested these antibodies in hamsters, one produced especially encouraging results: It seemed to work against both Old and New World hantaviruses and was effective even when given relatively late in the course of infection, Dr. Chandran said.
(Dr. Chandran is listed as an inventor on patents for hantavirus antibodies.)
Several other teams have also produced antibodies that were broadly effective in small animals, but that is where a number of potential products have stalled, experts said.
“We have a lead drug, and now what we need is someone to pay the money, which would be something like $40 million, to go the next step,” said Dr. James Crowe, director of the Vanderbilt Center for Antibody Therapeutics. “We have neither government nor foundation nor company support to do that. So we’re just waiting to find a partner.”
(Vanderbilt University has applied for patents related to these antibodies; Dr. Crowe is listed as the inventor.)
Experts said that they hoped the current outbreak might help bring attention to a family of often-overlooked viruses.
“Certainly judging by just my inbox and text messages, there’s a renewed interest in these agents, and renewed interest in maybe at least revisiting where they are in the priority list,” Dr. Chandran said.
Whether that interest can be sustained after the virus fades from the headlines remains to be seen, experts acknowledged.
“Raising awareness never hurts,” Dr. Warner said. “We’ll see whether or not it leads to anything tangible, at least in terms of funding and resources for advancing some of these things that are lacking for hantavirus.”
Health
Fitness expert visits gyms nationwide, shouts out 4 clubs for ‘getting it right’
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Gym membership in the U.S. hit a record high in 2025, according to the Health & Fitness Association, giving consumers more workout options — and more choices to sort through when picking the right fitness space.
Amid today’s wellness renaissance, many gyms and fitness clubs can cost hundreds of dollars per month, depending on the level of access and amenities offered.
In an interview with Fox News Digital, Kenny Santucci — New York City fitness trainer, gym owner and host of the “Strong New York” podcast — revealed the attributes of a great gym.
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“A lot of people traditionally look at gyms [as if] they have to have all the bells and whistles,” he said. “Spa, bathrooms, all these things. For me, a gym is a gym. I go there for the equipment, I go for the culture, I go for the look and feel of the place.”
He added, “You can have an incredible gym [that’s] a garage gym, and you can have an incredible gym [that] somebody could have built for $10 million.”
Amid today’s wellness renaissance, many gyms and fitness clubs can cost hundreds of dollars per month, depending on the level of access and amenities offered. A New York City fitness trainer (not pictured) has a different view of what makes the best gyms.
Santucci, who visits new gyms across the country and posts his experiences on social media, said he looks for a balance between aesthetics and equipment quality, as well as “great people.”
“I think you could go and get in a sweat or a workout anywhere — but if the people are great, that’s what creates that great culture,” he said.
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“If you ask the average person who goes to most big-box gyms, the things they tell you they love about the gym are, ‘Oh, I love the showers. They have really nice towels.’ It’s nothing that actually pertains to the gym, and I believe that people should go to the gym to progress and get better,” he added.
With these goals in mind, Santucci revealed some of his top-rated gyms in the U.S.
Life Time Fitness
Life Time is a chain of luxury health clubs in the U.S., offering amenities like indoor courts, swimming pools, saunas and group fitness classes.
Santucci applauded the gym’s founder and CEO, Bahram Akradi, for being a “very hands-on owner and operator,” overseeing hundreds of gyms across the country.
The facade of an upscale Lifetime gym is shown in Walnut Creek, California, on April 8, 2025. (Smith Collection/Gado/Getty Images)
“[Bahran’s] mentality and belief system around the fitness space, I absolutely love,” he said.
“I give a lot of credit to the guys who are owners and operators,” Santucci added. “They’re in the space, they’re making sure things are going really well. I think if you’re going to be in the gym business, you should be one of those people.”
Anatomy Gyms (Florida)
Santucci also shouted out Marc Megna, co-founder and co-CEO of Florida-based Anatomy Fitness for building a must-visit space.
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“It’s an incredible culture there, and I think that’s what they really push at that gym,” he said.
“The way the gym’s set up, the cleanliness of it, the aesthetics – you walk in that place, and you want to train … and those are things you can’t just buy … You have to live it, love it and be involved in the day-to-day operations.”
Powerhouse (New York/New Jersey)
In a newer recommendation, Santucci said he’s enjoyed stopping into Powerhouse Gym in New York City.
The New York- and New Jersey-based gym focuses on weight training and bodybuilding, including a powerlifting room and boxing rig at its locations.
“I just started going there, once or twice a week,” he said. “I really love the people and the culture.”
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The Training Lab (NYC)
For more of a group fitness and Hyrox training experience, Santucci recommends The Training Lab in New York City. (Hyrox is a global fitness racing brand and training system with affiliated gyms and training clubs.)
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“The guys over at Training Lab are incredible,” he told Fox News Digital. “Another owner-operator who’s involved in the business, who partakes in everything. I think they’re another great gym.”
“If you’re looking for group training, Training Lab’s a great space.”
Participants compete in the burpee broad jumps event during the Hyrox fitness race at the Bangkok International Trade and Exhibition Centre in Bangkok on March 21, 2026. (Amaury Paul/AFP)
The price of wellness
While some premier gym memberships can cost upward of $300 a month, Santucci said it isn’t necessary to spend a lot to get results, although it may result in more of an “experience.”
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“We need to restructure the way we think about health and wellness,” he said. “People aren’t going out as much anymore. They’re not spending as much on alcohol.
“It’s all what you prioritize. I prioritize fitness,” he went on. “I belong to multiple gyms. I have a membership to TMPL Gym here in [New York City]. I have a membership to Renzo Gracie’s. That’s what I like to do with my money.”
While some premier gym memberships can cost upward of $300 a month, Santucci emphasized that it isn’t necessary to spend a lot to get results. (iStock)
Santucci said what he’s paying for goes beyond the equipment — pointing to the staff, community and overall atmosphere as part of the value.
“If you want that elevated experience, you’re going to pay for that just like you would at a hotel or a restaurant or anything else,” he said.
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The expert suggested that wellness has recently become a “third form of hygiene.”
“It’s like you take a shower, you brush your teeth and you go to the gym,” he said. “I think those are three non-negotiables for almost everybody on a daily basis when it comes to your hygiene.”
Health
There Are Ants in This Canadian Hospital. Again.
Ants can be a nuisance. Just ask officials at a hospital in Canada who are dealing with an “appearance of ants within the operating room” that has forced them to indefinitely suspend some surgeries there.
The ants appeared recently at Carman Memorial Hospital in Carman Manitoba, according to a statement from Southern Health-Santé Sud, the provincial authority that oversees the hospital.
It was not clear when the hospital would resume operations, but Southern Health said on Friday that a “limited number of elective surgeries” had been postponed and that the hospital was working with patients to reschedule them. Portage Online, a local news website, reported that 16 operations had been postponed, citing information from Southern Health.
It’s not the first time ants have disrupted operations at the hospital. The insects appeared there in August 2024, but “the issue resolved within a few weeks,” Southern Health said. They returned last summer. But with their reappearance this week, the hospital said it was taking more drastic measures. The hospital serves the area around Carman, a town with a population of around 3,000 residents about 47 miles southwest of Winnipeg.
“Any factor that could impact the safety or integrity of the operating room environment requires the suspension of surgical activity until the issue can be resolved,” Southern Health said. “The safety of patients, staff and physicians is paramount.”
The hospital is working with exterminators “to identify the source of the ants and implement additional measures and support a long-term resolution.” Southern Health told Portage Online that exterminators had “surveyed and cleaned drains, opened walls and sealed cracks.”
“Several methods have been used to bait the ants in an effort to find where they are originating from,” the authority said.
In a separate statement to the CBC, Southern Health said that it believed that an ant colony had made its home near the hospital and that they appeared to be “simply seeking food sources inside buildings as ants are known to do.”
The hospital also told the CBC that the ant problem at the hospital did not amount to an “infestation.”
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