Lifestyle
California and Minnesota Face $1B Medicaid Funding Hold
The Trump administration is withholding more than $1 billion in Medicaid funding from California and Minnesota over disputed medical claims. A social-policy historian examines how concerns about fraud have historically been used to justify funding cuts and undermine public confidence in Medicaid.
Ben Zdencanovic, University of Cambridge
California and Minnesota Face $1B Medicaid Funding Hold
The Trump administration announced on July 21, 2026, that it’s withholding US$867 million in federal healthcare funding for California and $200 million for Minnesota – a total of more than $1 billion.
Federal officials said the two states had failed to provide sufficient evidence that a number of disputed medical claims were legitimate. These include bills for in-home care and other services covered by the two states’ Medicaid programs for low-income residents.
Medicaid administrators say the funds can be recovered if the states supply the requested documentation. But the action is highly unusual: Typically, Medicaid officials partner with states to conduct an audit when they suspect fraud, a careful process that often takes years.
It’s the second time in 2026 that the Trump administration has withheld or deferred federal Medicaid funds for several states, including California and Minnesota, because of alleged fraud and abuse. The Democratic governors of those states have called the decision a politically motivated attack on their constituents.
I’m a historian of social policy who led the first comprehensive historical overview of Medi-Cal, California’s statewide Medicaid system. I’ve found that U.S. leaders have long used the language of fraud and abuse to blur the line between correcting very real failures within Medicaid and – as I believe the Trump administration is currently doing – discrediting and defunding the program itself.
Slashing the safety net
The Medicaid restrictions are part of the Trump administration’s overall efforts to slash federal funding for the safety net.
The large tax-and-spending bill that Trump signed into law in July 2025 as the cornerstone of his second-term agenda pared eligibility for Medicaid by introducing work requirements for some adults. It is cutting close to $1 trillion in federal spending on the program over the next decade.
Researchers estimate that almost 12 million people, on top of the estimated 28 million without health insurance in 2025, could become uninsured by 2034 due to these changes. By mid-2026, more than 3 million people had already lost their insurance coverage due to Republican changes to the Affordable Care Act.
‘Padlocking’ the ‘cookie jar’
In February 2026, Vice President JD Vance, Health Secretary Robert F. Kennedy Jr. and Dr. Mehmet Oz, the administrator of the Centers for Medicare & Medicaid Services, or CMS, announced a new anti-fraud initiative called Comprehensive Regulations to Uncover Suspicious Healthcare.
Also known by its rather unsubtle acronym, CRUSH, this initiative is taking unprecedented steps to withhold and defer funds in response to suspected fraud. “CMS is done trying to catch fraudsters with their hands in the cookie jar,” Oz said in announcing CRUSH’s formation. “Instead, we’re padlocking the jar and letting them starve.”
To be sure, Medicaid fraud, waste and abuse – such as providers billing Medicaid for services that are unnecessary or never rendered – are very real problems that cost taxpayers billions of dollars annually. They do divert funds from the low-income and disabled Americans enrolled in the program.
But the Trump administration’s latest moves are part of a much broader history of weaponizing Medicaid fraud and abuse – both real and imagined. I see them as a politicized attempt to prove that Medicaid itself is wasteful, that state governments cannot be trusted to administer federal money, and that public benefits inevitably invite dishonesty.
Providing little oversight at the start
Medicaid was established, along with Medicare for older adults, in 1965 as part of President Lyndon B. Johnson’s “Great Society” reforms. Despite providing millions of Americans with health insurance coverage for the first time, these programs had few centralized mechanisms for the kind of federal oversight that could prevent and catch fraud and abuse.
And the sheer scale and complexity of the Medicaid system – joint federal-state funding, varying eligibility requirements, millions of enrollees and thousands of providers – created opportunities for questionable billing practices among providers.
The 1970s saw a number of highly publicized Medicaid scandals involving nursing homes, laboratories, pharmacies and so-called “Medicaid mills” – healthcare providers that sought to bill the government for large numbers of Medicaid patients for shoddy and often fraudulent care.
A series of high-profile congressional investigations spurred demand for stronger Medicaid oversight and enforcement. That led to the Medicare-Medicaid Anti-Fraud and Abuse Amendments of 1977, which established the national Medicaid Fraud Control Units program.
The state-run Medicaid Fraud Control Units received generous federal matching funds to investigate and prosecute fraud.
The most serious Medicaid fraud was generally committed by healthcare providers and contractors, not patients. Medicaid Fraud Control Units were principally responsible for investigating providers, while also prosecuting the abuse and neglect of patients whose care was billed to Medicaid.
At the same time, however, Medicaid was becoming entangled in a broader political debate over social spending, whether many Americans were becoming too dependent on government benefits, and the alleged use of benefits by people who should not have received them. In the 1980s and 1990s, widely circulated stories about Medicaid exposed fraud and malfeasance by providers.
But disproportionately, they also highlighted the comparatively few instances of fraud by people enrolled in the program, such as cases where they submitted false receipts for covered medically related travel or sold drugs they obtained through Medicaid for free or at low cost.
Using Medicare fraud to justify spending cuts
The distinction between Medicaid and cash assistance programs, such as the Aid to Families with Dependent Children “welfare” program, frequently disappeared in political rhetoric. False or exaggerated stories that portrayed African American single mothers living extravagantly while fraudulently claiming welfare benefits became potent symbols of supposed government failure.
While campaigning as a presidential candidate, Ronald Reagan seized on this trope of the “welfare queen” in his attacks on social spending.
By the mid-1990s, opposition to welfare programs had become increasingly bipartisan. Politicians in both parties often used tales of Medicaid fraud on the part of providers and recipients to justify tighter eligibility rules and spending cuts.
Federal oversight expanded further with the Deficit Reduction Act of 2005, which created the Medicaid Integrity Program and strengthened federal oversight of state programs. The Affordable Care Act, the landmark healthcare legislation Congress passed in 2010, added new measures to screen providers and verify billing.
Concerns about Medicaid’s “integrity” became highly politicized in the debates surrounding the ACA. Critics of Medicaid expansion argued that increasing the number of people who could get health insurance through the program would increase fraud and improper enrollment. Supporters of expanding Medicaid to help more Americans gain health insurance maintained that anti-fraud rhetoric often disguised ideological opposition to the program’s expansion.
Blurring distinctions then and now
For the six decades that this program has helped millions of low-income Americans get healthcare, politicians have blurred the distinction between protecting Medicaid from abuse and using abuse to discredit Medicaid itself.
In my view, the Trump administration’s campaigns against California and Minnesota continue that pattern. It is using real weaknesses within Medicaid to advance much broader political arguments: that Democratic states cannot be trusted, that public benefits naturally invite abuse, and that withholding funds is itself a form of reform.
The result will no doubt be that fewer low-income Americans will be able to get the healthcare they need.
Ben Zdencanovic, Assistant Professor of U.S. History, University of Cambridge
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Lifestyle
How to Manage Symptoms of Heart Failure
Symptoms of Heart Failure: Managing heart failure is a significant expense to the U.S. healthcare system, costing the nation approximately $40 billion in 2020 and expected to increase to approximately $142 billion a year by 2050. If you (or a loved one) are living with the condition, consider these tips to help manage it.
How to Manage Symptoms of Heart Failure
(Feature Impact) Americans are facing a growing health challenge, with 1 in 4 adults at risk of heart failure, according to the Heart Failure Society of America. Additionally, approximately 6.7 million U.S. adults who are 20 years old or older are currently living with heart failure, and that number is projected to reach 8.7 million by 2030.
Managing heart failure is a significant expense to the U.S. healthcare system, costing the nation approximately $40 billion in 2020 and expected to increase to approximately $142 billion a year by 2050.
If you (or a loved one) are living with the condition, consider these tips to help manage it.
Adhere to the Treatment and Follow-Up Plan
Ongoing outpatient care is important when managing heart failure. Understand the treatment plan provided by your healthcare team, make diet and lifestyle changes, take medications as directed and keep recommended follow-up appointments.
Pay attention to changes in symptoms and communicate with your healthcare provider if treatment does not seem to be working as expected. If their conditions are left unmanaged, patients can experience a range of heart-failure-related symptoms such as shortness of breath, fatigue, buildup of fluid and more.
Understand Challenges with Diuretic Treatment
Diuretics help the body remove excess fluid and are commonly used to treat swelling, or edema, associated with heart failure. Your provider may try different diuretics, sometimes referred to as “water pills,” to manage your heart failure symptoms. However, intravenous (IV) diuretic therapy may be required for some patients if symptoms continue.
Ask About Treatment Options Before IV Care Is Needed
For some adults, a healthcare provider may consider recommending an at-home, non-oral diuretic option prior to escalating to IV therapy.
For example, ENBUMYST™ (bumetanide nasal spray) is a prescription diuretic used in adults to treat edema associated with congestive heart failure. It’s administered as a nasal spray for short-term use to manage excess fluid with the goal of transitioning to oral diuretic therapy when appropriate.
Talk with your healthcare provider to learn more and visit enbumyst.com. Read the full Prescribing Information and Patient Information.
Photo courtesy of Shutterstock
Important Safety Information
What is ENBUMYST?
ENBUMYST is a prescription medicine used in adults to treat swelling caused by excess fluid in the body (edema) from congestive heart failure, liver disease, and kidney disease.
What is the most important information I should know about ENBUMYST?
- ENBUMYST is a diuretic that helps your body remove fluid. Losing too much fluid can cause dehydration, low blood volume, and increase the risk of blood clots. Blood abnormalities may include decreased salts (electrolytes), and increased nitrogen, glucose and uric acid. The risk of these abnormalities is higher in elderly people, those using higher doses, or those who do not get enough electrolytes by mouth.
- You should not use ENBUMYST if you have severe electrolyte loss. Tell your healthcare provider if you experience unusual thirst; dizziness or lightheadedness; weakness or tiredness; fast heart rate; dry mouth or tongue; sudden pain; redness or swelling in your joints; pain, swelling, redness, or warmth in your leg; shortness of breath or fast breathing; high blood sugar; dark urine; pale, tight, cool or clammy skin; muscle cramps; confusion.
Do not use ENBUMYST if youhave low or no urine production or are allergic to bumetanide or to any of the ingredients in ENBUMYST.
Before using ENBUMYST, tell your healthcare provider if you have low electrolytes, are on a low-salt diet, have diarrhea, diabetes, nasal problems such as a runny or stuffy nose or polyps, a history of nasal injury or surgery, are or plan to become pregnant, are or plan to breastfeed.
Tell your healthcare provider about all the medicines you take, including prescriptions, over-the-counter medicines, vitamins, and herbal supplements.
ENBUMYST may cause serious side effects, such as worsening kidney function and ringing in the ears or hearing loss.
The most common side effects of ENBUMYST include dehydration, headache, muscle cramps, dizziness, low blood pressure, nausea, and abnormal brain functioning with certain liver problems.
These are not all the possible side effects of ENBUMYST. Talk to your healthcare provider for more information.
Call your healthcare provider for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
US-ENBU-2600110
SOURCE:
Esperion
financial wellness
Investing in Education: 5 Ways to Prepare Students for the Jobs of Tomorrow
Jobs of Tomorrow: A diploma is still an important milestone, but what matters more than the piece of paper is whether graduates have the knowledge, skills and confidence to take meaningful next steps in pursuing further education or building careers. Students, families, educators, employers and policymakers all have a role to play in cultivating these opportunities.
Investing in Education: 5 Ways to Prepare Students for the Jobs of Tomorrow
(Feature Impact) The landscape of modern work is changing rapidly, leaving many uncertain about whether they’re adequately equipped to face the future. Even though America invests roughly $1 trillion in education every year, it’s difficult to know whether that investment is truly preparing young people for what comes next.
“Our education system isn’t evolving quickly enough to prepare our students for the jobs of tomorrow,” said Amit Sevak, CEO of ETS, a global education and talent solutions organization working with more than 30 million students a year to measure learning success and power human progress at every stage of life. “Students only get one chance at an education, and we have a responsibility to understand what’s working, what’s not and where additional support is needed.”
A diploma is still an important milestone, but what matters more than the piece of paper is whether graduates have the knowledge, skills and confidence to take meaningful next steps in pursuing further education or building careers. Students, families, educators, employers and policymakers all have a role to play in cultivating these opportunities.
Start the Conversation Early
Success isn’t a single path anymore, so young people may benefit from thinking outside the traditional pipeline of high school to college to a good job to retirement. By prompting early conversations, parents can help their children begin sorting through their options well in advance. Encourage dinner table talks about favorite school subjects, what kind of work seems interesting and alternative pathways to build careers. The goal isn’t necessarily to choose a life track immediately – just to start exploring ideas before the time arrives to lock in a decision.
Learn to Work with AI
In the age of AI, there’s a balance to be found between fully embracing or avoiding it. Parents and educators can encourage thoughtful, responsible use of the AI tools reshaping modern workplaces – without sanctioning them as a way to get out of doing homework. Students should think critically about both the uses and limitations of AI, learning how these systems work but still recognizing when human judgment matters.
Get Real-World Experience Before Graduation
Textbooks and classrooms can teach a lot, but some of the most valuable lessons come from the real world. Summer jobs, internships, volunteering, co-op programs, job shadowing or small-scale forays into entrepreneurship can help kids discover where their talents and passions fit. It’s also a chance to develop the soft skills that make great employees, like being punctual, working well with others and adapting to new situations.
Build Human Skills
There are certain abilities technology just can’t replace, making them vital pieces of future-proof training. Strong communication, teamwork mindsets, critical thinking skills, civic reasoning and empathy translate well to many careers. Rather than focusing strictly on academics, teachers can shift lesson plans to encourage growth in these areas. Specialized hands-on talents and trades are also more insulated from technological disruptions.
Measure Progress Beyond Grades
Grades and test scores don’t tell the whole story about career readiness, yet they’re often treated as the only metric that matters in educational success. Policymakers have the opportunity to change how schools measure student progress, including by trading the one-size-fits-all rubrics for more personalized assessments that demonstrate proficiency in more comprehensive ways. Education is on the ballot this election season, so ask your local and state elected leaders about whether today’s graduates are ready to face the future.
For information about a system that gives students, educators and employers clear evidence that learning is leading to opportunity, visit ETS.org.
Photos courtesy of Shutterstock
SOURCE:
ETS
recipes
Keeping the Love of Food with Type 2 Diabetes
Living with Type 2 diabetes often means making adjustments to your daily routine, especially when it comes to food. Although adjusting to life with diabetes may take time, you don’t have to give up your favorite foods and flavors. In fact, it can be an opportunity to discover meals that support your health goals while still enjoying the foods you love.
(Feature Impact) Living with Type 2 diabetes often means making adjustments to your daily routine, especially when it comes to food. Whether you’re living with the condition or supporting someone who is, it can influence everything from meal planning to dinners out and everyday activities. Although adjusting to life with diabetes may take time, you don’t have to give up your favorite foods and flavors. In fact, it can be an opportunity to discover meals that support your health goals while still enjoying the foods you love.
That’s what professional chef and TV show host Kardea Brown did, alongside her husband Bryon Smith, who was recently diagnosed with Type 2 diabetes at age 38.
“When my husband was diagnosed with Type 2 diabetes, it didn’t mean the end of the foods we love,” Brown said. “It meant I had to get creative. I started reimagining my recipes, so they still carry that same soul, that same comfort, just with ingredients that love him back a little better.”
To remove the guesswork about how certain ingredients affect Smith’s glucose levels, the couple relies on Abbott’s FreeStyle Libre 3 Plus sensor with Libre Assist*, a feature within the accompanying Libre app**. The technology provides real-time glucose insights and can help predict how certain foods may affect his glucose^ levels before a meal.
“I open the Libre Assist feature in the app, snap a photo and instantly see how that food might affect me before I even take the first bite,” Smith said. “It even suggests healthier swaps to help lower the impact.”
Small lifestyle changes can also make a difference in diabetes management. Brown recommends:
- Building balanced meals that prioritize non-starchy vegetables, lean proteins and healthy carbs for added fiber.
- Reading labels carefully to ensure you choose ingredients with little or no added sugars.
- Boosting fiber intake with ingredients like lentils, oats, beans and whole fruits.
- Cooking smarter at home by using simple methods like grilling, baking or sauteing with healthy fats, such as olive or canola oil.
- Planning and preparing for success by shopping with a list and planning meals in advance so you always have nutritious ingredients ready to cook.
To learn more about Libre Assist and to see if you qualify for a free† sensor, visit freestylelibre.us/LibreAssist.
The views expressed in this article should not be used for medical diagnosis or treatment or as a substitute for professional medical advice. Individual symptoms, situations and circumstances may vary.
* Libre Assist is a feature within Libre app that uses generative artificial intelligence to provide information on how foods could impact your glucose levels. Generative artificial intelligence may not always be accurate, and it should not be used to make treatment decisions.
** The FreeStyle Libre systems apps are only compatible with certain mobile devices and operating systems. Please check the Support section of our website for more information about device compatibility before using the apps. Use of the FreeStyle Libre systems apps may require registration with LibreView.
^Predicted glucose impact is based on user-provided food data and may differ from actual impact, which depends on sensor readings and factors like activity, stress, medication and alcohol. For personalized advice, consult your healthcare provider.
†Offer available for people who qualify. Visit MyFreeStyle.us to see all Terms and Conditions. Certain exclusions apply. Medicare and Medicaid patients are not eligible. See MyFreeStyle.us for more information.
Important Safety Information: Product for prescription only, for Important Safety Information visit FreeStyleLibre.us.
Shrimp Scampi and Cauliflower Grits
Recipe courtesy of Kardea Brown on behalf of Abbott
Prep time: 15 minutes
Cook time: 25 minutes
Servings: 4
Grits:
- 3 cups low-sodium chicken broth
- 1 cup light cream
- 1 cup stone-ground grits
- 1 cup cauliflower rice
- 2 tablespoons butter
- 1/2 cup shredded Parmesan cheese
- 1/4 teaspoon salt
- 1/4 teaspoon black pepper
Shrimp Scampi:
- 2 tablespoons butter
- 2 tablespoons olive oil
- 4 cloves garlic, minced
- 1/2 teaspoon red pepper flakes (optional)
- 1 pound large shrimp, peeled and deveined
- 1/2 cup low-sodium chicken broth
- 2 tablespoons dry white wine
- 1 lemon, juice only
- 1 teaspoon lemon zest
- salt, to taste
- pepper, to taste
- 2 tablespoons chopped parsley
- To make grits: Bring broth and cream to gentle boil; whisk in grits. Cook 10-15 minutes. Stir in cauliflower rice and cook 5-7 minutes. Add butter, cheese, salt and pepper.
- To make shrimp scampi: In pan, heat butter and oil; saute garlic and red pepper flakes, if desired, 30 seconds. Add shrimp, cook 1-2 minutes per side and remove.
- Add broth, wine, lemon juice and lemon zest; simmer 2-3 minutes. Return shrimp; toss; season with salt and pepper, to taste; and stir in parsley.
- Serve shrimp over creamy grits.
Macaroni and Cheese with Chickpea Pasta
Recipe courtesy of Kardea Brown on behalf of Abbott
Prep time: 20 minutes
Bake time: 30 minutes
Servings: 4-6
Pasta:
- 8 ounces chickpea-based, gluten-free pasta
Bechamel Sauce:
- 2 tablespoons butter
- 3 tablespoons almond flour
- 1 cup half-and-half
- 1/2 cup heavy cream
- 1/2 cup low-sodium chicken or vegetable broth
- 1 teaspoon Dijon mustard
- 1/4 teaspoon garlic powder
- 1/4 teaspoon smoked paprika
- salt, to taste
- black pepper, to taste
Cheese Blend:
- 1 cup medium cheddar cheese, shredded
- 1/2 cup Gruyere cheese, shredded
- 1/4 cup Parmesan cheese, grated
Topping:
- 1/2 cup shredded cheddar and Gruyere cheese
- 2 tablespoons almond flour (optional)
- chopped parsley
- Preheat oven to 375 F and grease baking dish.
- To make pasta: Cook pasta al dente.
- To make bechamel sauce: Melt butter and whisk in almond flour, 1-2 minutes. Slowly add half-and-half, heavy cream and broth. Stir until thickened. Season with mustard, garlic powder, smoked paprika and salt and pepper, to taste. Remove from heat.
- To make cheese blend: Mix cheddar, gruyere and Parmesan. Stir half the cheese blend into bechamel sauce until smooth. Stir in pasta.
- Layer pasta and cheese sauce in dish: half pasta, half cheese and repeat. Top with reserved cheese and almond flour, if desired.
- Cover with foil and bake 15-20 minutes. Remove foil and bake 10-15 minutes uncovered until golden.
- Rest 5 minutes, garnish with parsley and serve warm.
Red Velvet Layer Cake with Almond Flour
Recipe courtesy of Kardea Brown on behalf of Abbott
Prep time: 25 minutes
Bake time: 20 minutes
Chill time: 30-60 minutes
Servings: 12
Cake:
- 2 cups almond flour
- 1 cup whole-wheat pastry flour
- 1 tablespoon unsweetened cocoa powder
- 1 1/2 teaspoons baking powder
- 1/2 teaspoon baking soda
- 1/2 teaspoon salt
- 1 1/2 cups monk fruit-allulose blend
- 3 large eggs
- 1/2 cup plain unsweetened Greek yogurt
- 1/3 cup avocado oil
- 3/4 cup buttermilk
- 1 tablespoon distilled vinegar
- 2 teaspoons vanilla extract
- red food coloring (optional)
Whipped Cream:
- 6 ounces cream cheese, softened
- 1/3 cup powdered monk fruit
- 1 1/2 cups cold heavy whipping cream
Berry Drizzle:
- 1/2 cup no-sugar-added wild berry jam
- 1-2 tablespoons water
- 1 teaspoon lemon juice (optional)
Filling and Topping:
- 2 cups mixed berries (strawberries, blueberries, raspberries)
- Preheat oven to 350 F and grease or line three 8-inch pans.
- To make cake: In bowl, mix almond flour, pastry flour, cocoa powder, baking powder, baking soda, salt and monk fruit-allulose blend. In separate bowl, mix eggs, Greek yogurt, avocado oil, buttermilk, distilled vinegar, vanilla extract and red food coloring, if desired. Combine dry and wet ingredients until smooth. Divide evenly into pans and bake 18-22 minutes. Cool completely.
- To make whipped cream: Whip cream cheese and monk sugar until smooth. Add cream gradually and whip to medium-stiff peaks. Chill.
- To make berry drizzle: Warm berry jam with water and lemon juice, if desired, until pourable; cool slightly.
- To assemble cake: Layer cake, whipped cream, jam and berries; repeat for three layers. Top with berries and drizzle.
- Chill 30-60 minutes before slicing.
Photo courtesy of Abbott (Bryon Smith and Kardea Brown, a paid partner)
SOURCE:
Abbott
