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Good morning. An Australian musician recently spent nearly two weeks in an American hospital after breaking her back on tour. Her dispatch is surprisingly heartwarming, except for the quintessentially American medical bill she received.
Inside the lucrative ERs that can turn you away
For decades, it’s been illegal in the U.S. for emergency departments to turn away patients just because they can’t pay. But that applies only to hospitals that contract with Medicare. In a new investigation, STAT’s Tara Bannow uncovers how Nutex Health, a Houston-based system, exploits this loophole to enrich itself and its investors.
At one Nutex emergency room, a receptionist turned away an uninsured patient who arrived with the telltale signs of a heart attack but was unable to pay upfront. At another facility, a family of five realized their insurance was charged $21,000 for Covid shots that had been advertised as free. And in recent years, almost all of Nutex’s bills have been funneled through the No Surprises Act federal arbitration process, which is meant to be a last resort.
This latest strategy is actually producing so much revenue that several investors are suing Nutex over what they call an unsustainable reliance on arbitration. (If you read Tara’s story from March on how a Texas couple is getting rich off the same process — Nutex works with that company.) Read more in Tara’s thorough workup about how all this moneymaking can affect patients.
Court blocks Trump’s definition of ‘professional’
Last week, a federal judge in D.C. temporarily blocked new regulations restricting the amount of federal loans that students pursuing nonprofessional degrees can take out, while also drastically redefining what counts as a professional degree. Importantly, U.S. District Judge Beryl Howell did not rule on the legality of differentiated loan caps overall, but focused specifically on the Trump administration’s definition of a professional degree. That definition is likely inconsistent with the way Congress defined it when creating the loan caps last summer, she wrote in the decision.
The rule, set to take effect Wednesday, will be paused as judicial review continues. In the meantime, health care workers continue to push back. On Thursday, more than 500 nurses arrived at Capitol Hill for a day of advocacy. One of their talking points: the Nursing is a Professional Degree Act, which aims to change the field’s position within the policy via legislation.
What’s next for 988 LGBTQ+ services?
Specialized LGBTQ+ youth services will return to the national suicide and crisis hotline by the end of the year, the Trump administration confirmed this month. But it’s unlikely to return just as it was before. Officials also noted that they are working to ensure that the services comply with last year’s executive order that attempts to make gender binary again. And the Trevor Project, which previously answered more than half the calls for that service, may be shut out of the revived line entirely.
The nonprofit seems to be excluded on a technicality: A call for applications to manage the return of LGBTQ+ “press 3” lines is limited to “current and active” members of the 988 network, the AP reported Friday. The Trevor Project isn’t active, but only because the administration canceled the services to begin with.
It’s still unclear exactly how the LGBTQ+ services could be altered to comply with the executive order — whether that’s in name only, or in the actual counseling provided to young callers. LGBTQ+ advocates say that altered 988 specialty services may be worse than none at all.
“If it comes back, and there is a denial of trans identities, is it even worth being there?” Aaron Almanza, executive director at the LGBT National Help Center, told me. “Because it’s going to cause more harm than good.”
The death of a child after rabies exposure
The Canadian Medical Association Journal has published a heartbreaking account of an 11-year-old boy from Ontario who died from rabies. During a family visit to a cottage in 2024, the boy woke up one morning to discover a bat was nestled on his nose and mouth. He shooed it away; his father caught the bat in a pot and released it. The boy bore no signs of scrapes or skin punctures, so the family initially didn’t take him for medical care.
Within three weeks, the boy started to develop neurological symptoms. At first doctors thought he had Bell’s palsy, a temporary paralysis of facial muscles. Later he was diagnosed with herpes gingivostomatitis, an infection of the lips and mouth. Doctors knew about the bat exposure and asked public health whether rabies post-exposure prophylaxis (PEP) ought to be administered. But given that the boy already had rabies symptoms and that post-exposure prophylaxis actually can be harmful once symptoms set in, it was decided not to use PEP.
Rabies is preventable if this regimen is administered quickly but is almost invariably fatal once symptoms manifest. The boy’s condition quickly deteriorated, and he died 17 days after being admitted to the hospital.
The boys’ parents agreed to share his story to promote awareness of the risk from rabies, the authors said, noting that in summer, the frequency of bat-human encounters rises. “Any direct human contact with a bat, even in the absence of a visible bite or scratch, is an indication for PEP and should be discussed with public health authorities,” they wrote. — Helen Branswell
A mystery patient has pulmonary hypertension. What is that?
Last week, STAT’s Lizzy Lawrence reported on a mystery patient with obesity, sleep apnea, and pulmonary hypertension who’d received a powerful weight loss drug not yet approved by federal regulators. The White House has said that the patient isn’t President Trump. But the story generated a lot of interest, and skepticism. While the political ramifications play out, our colleague Elizabeth Cooney has provided a helpful rundown on pulmonary hypertension and how a GLP-1 drug might help to treat it.
Depending on the type of pulmonary hypertension that somebody has, it “can be something that is very serious and life-threatening and life-altering, or it can be a whole lot of nothing,” cardiologist Paul Forfia told Liz. Read more on common symptoms and treatment.
What we’re reading
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Could Massachusetts become the first state to reverse marijuana legalization? Boston Globe
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Support builds on the right for prosecuting women who get abortions, New York Times
- Opinion: The U.S.-China biotech crackdown may hurt the scientists America needs the most, STAT
- Efforts to end school vaccine mandates hit a wall in Florida, KFF Health News
- Opinion: Supreme Court ruling on Roundup points to a confusing difference between the law and science, STAT