Health
Trump Cuts Threaten Agency Running Meals on Wheels
Every Monday, Maurine Gentis, a retired teacher, waits for a delivery from Meals on Wheels South Texas.
“The meals help stretch my budget,” Ms. Gentis, 77, said. Living alone and in a wheelchair, she appreciates having someone look in on her regularly. The same group, a nonprofit, delivers books from the library and dry food for her cat.
But Ms. Gentis is anxious about what lies ahead. The small government agency responsible for overseeing programs like Meals on Wheels is being dismantled as part of the Trump administration’s overhaul of the U.S. Department of Health and Human Services. Roughly half its staff has been let go in recent layoffs and all of its 10 regional offices are closed, according to several employees who lost their jobs.
“I’m just kind of worried that the whole thing might go down the drain, too,” Ms. Gentis said.
In President Trump’s quest to end what he termed “illegal and immoral discrimination programs,” one of his executive orders promoted cracking down on federal efforts to improve accessibility and representation for those with disabilities, with agencies flagging words like “accessible” and “disability” as potentially problematic. Certain research studies are no longer being funded, and many government health employees specializing in disability issues have been fired.
The downsizing of the agency, the Administration for Community Living, is part of far-reaching cuts planned at the H.H.S. under the Trump administration’s proposed budget.
While some federal funding may continue through September, the end of the government’s fiscal year, and some workers have been called back temporarily, there is significant uncertainty about the future. And some groups are reporting delays in receiving expected federal funds.
“There’s a lot of confusion,” said Becky Yanni, the executive director of the Council on Aging in St. Johns County in Florida. She said she has been told that the most recent funding for its Meals on Wheels program and other services might be late.
If the funding does not arrive, “in a lot of communities, you will be looking at cuts in services,” said Sandy Markwood, the chief executive officer for USAging, which represents the network of area agencies of aging.
The community living division helps coordinate services and provide funding for older and disabled Americans so they can stay at home rather than live in a nursing home. With a budget of $2.6 billion, the unit represents a minuscule fraction of total H.H.S. spending.
Under the reorganization introduced by Health Secretary Robert F. Kennedy Jr., the community unit’s responsibilities will be divided among other agencies, including the Centers for Medicare and Medicaid Services and the Administration for Children and Families.
“This consolidation allows the department to better meet the current health needs of vulnerable populations across the country,” a spokeswoman for H.H.S. said in a statement. “This does not impact the important work of these critical programs as it will continue elsewhere within H.H.S.”
So far, several programs under the unit will be eliminated under the proposed budget, including one that provides ombudsmen in nursing homes, to help ensure the safety and welfare of residents, and respite care programs, to provide a break for those caring for an older person or person with disabilities. States would also have more latitude in determining where funds should be allocated.
In addition to meal deliveries, the community living agency supports numerous programs, including the nonprofit Centers for Independent Living, that are staffed by people with disabilities, who help older adults and others with disabilities move out of nursing homes and back into the community, and find services, like transportation and legal assistance.
Theo W. Braddy, the executive director for the National Council on Independent Living, which represents the centers and people with disabilities, said the uncertainty has upended planning.
“Everybody is on edge. We can’t tell them anything because we don’t know anything yet,” he said, adding that no one from the Trump administration or H.H.S. has attempted to contact the group with updates.
Advocates say the recent cutbacks have further marginalized older Americans and those with disabilities. “The bottom line is that people in charge simply don’t care about large swaths of the American people,” said Dr. Joanne Lynne, a clinical professor of geriatrics and palliative care at George Washington University.
“We have made living with disability and old age exceedingly unpleasant,” she said. “We are on course to make it virtually intolerable.”
Community groups like Meals on Wheels are bracing for significant cuts. In addition to the potential loss of funding from the Administration for Community Living, Republican lawmakers are proposing reducing grants to states that use another stream of federal funding. The Trump administration and Republicans are also pushing for significant cuts to the Medicaid program, which provides heath care coverage for low-income Americans.
“We’re concerned about a number of potential threats happening all at once,” said Josh Protas, the chief advocacy and policy officer for Meals on Wheels America, an association of the local nonprofits. About a third of the association’s local units already have waiting lists, he said, and lower funding would result in fewer meals for fewer people.
People who are 60 or older with low incomes, and who have difficulty preparing food for themselves, typically qualify for Meals on Wheels. The demand for services is increasing as food prices rise and more people need assistance. More than two million older Americans receive food deliveries each year, and many say they would have difficulty paying for meals without the program.
“Meals on Wheels is a godsend for me,” said Richard Beatty, a 70-year-old with poor vision and limited mobility living in Baltimore. He receives deliveries four times a week and isn’t sure how he would manage without the program.
If there are cuts in funding, the programs would have to make hard choices about who would be eligible for deliveries. “We would have to make drastic changes to who we were serving,” said Dan Capone, the chief executive of Meals on Wheels South Texas, which serves roughly 300 people a week, including Ms. Gentis. His group also receives private donations, with federal funds accounting for some 40 percent of the budget, he said.
The federal community unit under the ax also plays a key role in supporting disabled Americans, including older individuals.
“So much of the work we do is about giving people dignity in their lives,” said Karen Tamley, the chief executive of Access Living, a Chicago-based center, one of 400 across the United States.
The centers connect people with a variety of services, and offer job and skills training to young adults with disabilities. They may teach someone to drive, or help them find affordable housing.
The Administration for Community Living has helped organizations navigate the state and local bureaucracies responsible for doling out federal funds. When Mr. Capone wanted more clarity as to how Texas was distributing the money, he got in touch with the unit’s regional office in Dallas. “We just started building that relationship with the field office, and that field office is gone,” he said.
“It is frustrating on a practical level,” said Fay Gordon, one of the regional administrators who was let go earlier this month. “These programs are live and need direction.”
Some groups are not waiting before starting to take steps to reduce costs. Brittany Boyd-Chisholm, the chief executive of the Center for Independent Living of Central Pennsylvania, said that more than half of her funding comes through the federal agency. She has asked all the managers, herself included, to take a cut in salary of between 5 and 10 percent and is weighing other actions. She said her center was already underfunded.
No one has provided her with any information about future grants, and her emails have not been returned. “It makes you feel completely on your own,” Ms. Boyd-Chisholm said.
Created under the Obama administration, the agency was intended to unify the work of three other agencies: the Administration on Aging, the Office on Disability and the Administration on Developmental Disabilities.
“These programs being together and working together was about efficiency and was about coordination,” said Alison Barkoff, the former acting administrator under President Biden, who stepped down last fall.
During the first Trump administration, at the height of the pandemic, the agency worked with the department’s Office for Civil Rights to ensure hospitals and doctors had clear guidelines so that if staffing fell short they wouldn’t deny care to those with disabilities.
“We had found common ground and issues to work on together,” said Daniel Davis, who worked for the agency’s Center of Policy and Evaluation, whose entire staff was laid off, according to former employees.
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Research continues to uncover new details on how fasting may help extend life.
A new study published in the journal Nature Communications investigated how intermittent fasting can boost longevity in small worms often used in aging research.
Researchers from the University of Texas Southwestern Medical Center in Dallas compared worms that were fed normally to those that underwent a 24-hour fast in early adulthood and were then fed again, according to a press release.
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The scientists measured a variety of factors, including stored fat, gene activity related to fat metabolism and lifespan.
The results showed that the life-boosting benefit did not depend on the fasting itself but on the body’s behavior after eating again.
Experts say sustainability is key when choosing a long-term weight-loss strategy. (iStock)
Study lead Peter Douglas, associate professor of molecular biology and a member of the Hamon Center for Regenerative Science and Medicine at UT Southwestern, suggested that these discoveries “shift the focus toward a neglected side of the metabolic coin – the re-feeding phase.”
“Our data suggest that the health-promoting effects of intermittent fasting are not merely a product of the fast itself, but are dependent on how the metabolic machinery recalibrates during the subsequent transition back to a fed state,” he said.
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“Our findings bridge a gap between lipid metabolism and aging research,” he added. “By targeting aging, the single greatest risk factor for human disease, we move beyond treating isolated conditions toward a preventive model of medicine that enhances quality of life for all individuals.”
Lauri Wright, director of nutrition programs at the University of South Florida’s College of Public Health, called this a “high-quality” study that adds an “important nuance to how we think about fasting and longevity.”
Intermittent fasting typically involves limiting meals to an eight-hour daily window or fasting every other day. (iStock)
The benefits of the refeeding phase after fasting were “especially interesting,” Wright, who was not involved in the study, told Fox News Digital.
“The researchers showed that longevity was linked to the body’s ability to turn off fat breakdown after fasting, allowing cells to restore energy balance,” she reiterated.
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“From a scientific standpoint, that’s a meaningful shift because it suggests fasting is not just about burning fat, but about metabolic flexibility.”
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Fasting may support longevity through triggering metabolic switching, enhancing cellular repair and stress resistance and improving markers like insulin sensitivity, research shows.
Limitations and cautions
Although this study provides “important insight” on the power of refeeding, Wright noted that the findings should be approached with caution, as the study was done on worms and cannot always be translated to humans.
“Additionally, it explains how a process might work in a controlled lab condition rather than real-world eating behaviors,” she added as a limitation. “Finally, the study is short-term and doesn’t give us the long-term translation on lifespan outcomes.”
The review found intermittent fasting was barely more effective than doing nothing, according to the study authors. (iStock)
Wright cautioned that fasting is “not a magic solution for longevity, and how you eat overall matters more than when you eat.”
“I advise, first and foremost, to focus on diet quality, including a variety of fruits and vegetables, healthy fats and minimally processed foods,” she said.
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For those who are considering fasting, it’s better to stick with a moderate plan — like a 12- to 14-hour overnight fast — rather than going to extremes, Wright said. After fasting, she recommends focusing on well-balanced meals.
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Several groups of people should be cautioned against fasting, according to Wright, including those with diabetes who are on insulin or hypoglycemic medications, those who are pregnant or breastfeeding, anyone with a history of eating disorders and older adults at risk of malnutrition.
Anyone considering intermittent fasting should consult with a doctor before starting.
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More than three million people travel to undergo cosmetic surgery each year, statistics show — but the potential savings come at a cost.
Most people opting to pursue this so-called “medical tourism” are chasing budget-friendly price tags.
International surgeries, such as hair transplants in Turkey, can cost as little as $4,000 to $5,000 compared to $20,000 to $30,000 in the U.S., but often come with extreme risks, according to board-certified plastic surgeon Dr. Sheila Nazarian of California.
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The doctor recently joined Lisa Brady on the “The FOX News Rundown” podcast to discuss the rising trend of medical tourism. One of the biggest risks, she said, is the lack of safety regulations in popular destinations like Mexico and Turkey.
As demand spikes in these medical tourism “mills,” there have been reports of non-medically trained staff performing procedures like hair transplants.
Most people opting to pursue “medical tourism” are chasing budget-friendly price tags. (iStock)
“I’ve heard that they [international clinics] are even recruiting people who maybe were taxi drivers and then putting them through their own training program … to become hair transplant technicians,” Nazarian said. “That’s how high the demand has become.”
In the U.S., medical school graduates are granted a “physician and surgeon” license, which means doctors — including pediatricians or OB-GYNs — can legally perform cosmetic surgeries, even if they didn’t receive specialized training for those procedures during residency, Nazarian noted.
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Instead of pinching pennies, the doctor recommended paying whatever amount is necessary to ensure quality treatment.
“People think of it as, you know, going to the mall. … It’s surgery, and surgery has risks,” she said. “You need to be with someone who not only can perform a beautiful surgery, but who can handle possible complications well.”
“You need to ask them: ‘What was your residency training in? And if you wanted to, would you be allowed to do this procedure in a hospital?’”
Aftercare is another critical factor in the success and safety of a cosmetic procedure, as the doctor emphasized that 20% of a surgical result depends on post-operative care.
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This can be difficult or even impossible to manage when a doctor is in a different time zone, she cautioned, or if the clinic disappears shortly after the procedure.
Nazarian also noted the importance of addressing the psychological component of plastic surgery, noting that no procedure will fix underlying unhappiness. The doctor said she uses screening questionnaires to ensure that patients are truly seeking self-improvement rather than a “cure” for deeper issues.
International surgeries, such as hair transplants in Turkey, can cost as little as $4,000 to $5,000 compared to $20,000 to $30,000 in the U.S., but often come with extreme risks. (iStock)
“If you’re not already generally very content with your life, a knife in my hand is not going to bring you there,” Nazarian said.
“The analogy I always give is you don’t want a paisley couch — you want a neutral couch and you can put paisley pillows on it,” she said, noting that a procedure should “make you look normal, God-given, athletic. And then you can change your clothes when the trends come and go.”
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Samuel Golpanian, M.D., a double board-certified plastic surgeon in Beverly Hills, said he has also seen an increasing number of patients undergoing cosmetic procedures abroad, sometimes with “devastating consequences.”
“The key is being extremely careful before embarking on this journey.”
“I’ve seen a wide range of complications, including infections, poor wound healing, significant scarring and tissue necrosis (skin death),” he told Fox News Digital. “These complications often lead to prolonged pain, ongoing medical problems, and significant additional costs to repair the damage.”
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Golpanian said he’s treated patients who received unsafe or non-medical-grade injectable materials, which can lead to serious long-term health issues.
One surgeon said he’s treated patients who received unsafe or non-medical-grade injectable materials, which can lead to serious long-term health issues. (iStock)
“I’ve also seen damage to underlying structures, asymmetry and results that are extremely difficult — sometimes impossible — to correct.”
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“That said, I’ve also seen some good outcomes, so it’s not all bad,” he noted. “The key is being extremely careful before embarking on this journey.”
Quick tips for safe ‘medical tourism’
Fully vet the surgeon. “Most surgeons will provide information about their education and training, but it’s important not to accept these claims at face value,” Golpanian said. “Verify them directly by contacting the institutions where they trained.”
Ask for references from prior patients. Ideally, it’s best to get references from U.S.-based patients who can speak candidly about both their experience and their results, the surgeonsaid.
Think beyond the cost. Golpanian emphasized the adage “you get what you pay for.” “Cost should take a back seat to experience, training, judgment and proven results,” he advised.
Be cautious about relying on before-and-after photos. These can be selective or even enhanced, Golpanian warned.
Keep aftercare in focus. “Make sure the practice emphasizes comprehensive follow-up care and has a clear, realistic post-operative plan in place.”
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