Private citizens may soon be able to sue people who send abortion pills to patients in Texas, under a recently passed bill that furthers the state’s effort to crack down on abortion.
HB 7 passed both chambers of the Republican-controlled state legislature in recent days, and the bill now heads to the desk of Republican Gov. Greg Abbott, who has publicly expressed anti-abortion views and is widely expected to sign it into law. If he does, the law would go into effect in December, and would be the first of its kind in the country.
“Texas is a first mover here,” says Elizabeth Sepper, a professor at the University of Texas at Austin School of Law. “I think this is yet another tool that probably lots of states will take up and think about in 2026.”
Texas has one of the strictest abortion restrictions in the country: The state has banned abortion in almost all cases, and already allows private citizens to sue people, including providers, who help patients access an abortion after about six weeks of pregnancy. But HB 7 widens the scope of potential lawsuits even further by allowing private citizens to sue abortion pill manufacturers, providers, and others who send the medication to Texas for at least $100,000 in damages. Pregnant people receiving the medication to use themselves wouldn’t be held liable.
The $100,000 in damages could go in full to the pregnant person, the person who impregnated them, or certain close relatives. If someone else files such a lawsuit, they could receive $10,000, and the remaining sum would go to charity.
The awards, Sepper says, are “enormous.” “It creates, I think, a real possibility of essentially harassing lawsuits, fishing expeditions against folks,” she adds.
Anti-abortion activists have argued that the bill would protect women and fetuses. John Seago, the president of the anti-abortion group Texas Right to Life, applauds the bill’s passage, calling it “a phenomenal victory for the pro-life movement here in Texas.”
“It is the most deliberate and aggressive response to the radical trends we’ve seen on the pro-abortion side in the last three years that are mailing abortion pills into Texas and attempting to hide behind a new legal invention called shield laws,” he says, adding that HB 7 would help enforce existing Texas policies.
But abortion rights advocates and state Democrats have condemned the bill, likening it to a “bounty hunter law” that gives anyone the ability to tattle on people who help facilitate access to abortion pills. They have argued that the bill is an attempt to spark fear in out-of-state providers who are protected by abortion shield laws in their own states when sending the medication to patients in states with abortion restrictions.
Molly Duane, senior staff attorney at the Center for Reproductive Rights, calls HB 7 a “fear-mongering” piece of legislation. “They’re trying to scare Texans from seeking medication abortion,” Duane says. “But Texans aren’t scared.”
Medication abortion is the most common method of abortion in the country. And in the three years since the U.S. Supreme Court overturnedRoe v. Wade, clearing the way for states to enact their own bans on abortion, advocates have said that abortion pills prescribed via telehealth have been a “lifeline” for many people living in states with restrictions.
“The extremist anti-abortion advocates who are behind the overturning of Roe, as well as this legislation, will stop at nothing to prevent every single abortion that’s happening in the country, and this is the next step in their long-term battle towards that goal,” Duane says. “But what we know is that people have always had abortions; they will always have abortion. People need abortions to save their lives. They need them to protect their families. They need them to protect their livelihood.”
Shield laws, versions of which have been enacted in 18 states and Washington, D.C., are intended to protect doctors providing medication or in-clinic abortions from their home state. The laws have led to clashes between states that have protected abortion and those that have banned it. Texas, for instance, filed a civil suit against New York Dr. Margaret Daley Carpenter for allegedly prescribing, via telemedicine, abortion pills to a Texas resident. Carpenter is also facing felony charges in Louisiana for allegedly prescribing abortion pills via telemedicine to a resident there. But New York Gov. Kathy Hochul has refused to extradite Carpenter, citing the state’s shield law.
Many states that have banned or restricted abortion have struggled to push back on shield laws and abortion pills, and Sepper says HB 7 is the latest iteration of the effort to do so. Whether other states follow Texas’ example and pass similar bills will depend, she thinks, on how effective HB 7 will be in reducing the use of abortion pills in the state, if Abbott signs the bill as expected.
If the bill is signed into law, Sepper expects that it will spark legal battles between states.
“HB 7 has a number of targets,” Sepper says. “One of those targets are people within the state of Texas to create a climate of fear about aiding anyone in accessing medication abortion. Another target are manufacturers of medication abortion. And then both health care providers who are out of state, who are using telehealth to distribute medication abortion in Texas, and also, frankly, the states they live in.”
“In a sense, HB 7 targets not just providers in other states, but in a fairly real sense, the more abortion friendly states that have laws that allow for abortion to be distributed pretty freely,” she says.
“In the past, we used to say that very rarely people lived to 70, but these days at 70 years old you’re still a child,” a Russian translator of Xi could be heard telling Putin.
“In a few years, with the development of biotechnology, human organs can be constantly transplanted so that people can live younger and younger, and even become immortal,” Putin responded, according to a Chinese translator.
Xi then predicted: “In this century, humans may live to 150 years old.”
Putin later confirmed the conversation at a news conference with Russian reporters, saying that “modern means of health support, medicine, and even some surgeries involving organ transplants allow humanity to hope that the active lifespan will not be like today. It differs from country to country, but there’s hope that our lifespan can increase considerably.”
Here’s what to know about Russia’s and China’s investments in anti-aging.
Russia’s obsession
Putin has a “particularly acute” fear of death, Peter Pomerantsev, a senior fellow at Johns Hopkins University’s SNF Agora Institute, wrote for TIME in 2022.
While there have been unsubstantiated rumors over the years that he has cancer or Parkinson’s disease, the Russian President who is serving his record-breaking fifth term is said to be paranoid about his personal health, reportedly even bathing in Siberian red deer’s blood and subjecting visitors to two-week quarantines to avoid bringing him disease.
His government has also invested heavily in anti-aging research, including via Putin’s eldest daughter, endocrinologist Maria Vorontsova, who has received multi-million grants for her studies into cellular aging and longevity. When the U.S. issued sanctions against Putin’s children in 2022, the Treasury described Vorontsova as someone who “leads state-funded programs that have received billions of dollars from the Kremlin toward genetics research and are personally overseen by Putin.”
Last year, Putin called for a “national project” to “preserve the health” of the country. The result was the New Technologies for Health Preservation program, which has the goal to “increase the efficiency and effectiveness of medical research and development” in several areas, including “regenerative biomedicine, preventive medicine technologies, ensuring active and healthy longevity.” State-run TASS said about 210 billion Russian rubles ($2.6 billion) will be poured into the project through 2030.
Independent Russian news outlet Meduza reported that Mikhail Kovalchuk, who is a close friend of Putin and is “obsessed with immortality and the ‘Russian genome,’” lobbied for the project. Kovalchuk oversees Russia’s genetic research program where Vorontsova works.
Russia’s Health Ministry reportedly asked researchers in a June 2024 letter to provide “proposals for developments” in several longevity-related research areas, including cellular aging, bioprinting and organ printing, and even “correcting” the immune system based on “critical markers identified in the aging process.” One unnamed doctor described to Meduza the apparent urgency of the project: “They asked us to fast-track all of our proposals—it felt like the letter had just arrived today and the deadline was yesterday. To be honest, it was the first time I’d seen anything like it.”
Bioprinting, which Putin seemed to reference to Xi, faces ethical and legal concerns, but Russia has ramped up its investment in it. Rosatom, the state corporation that specializes in nuclear energy but also oversees organ-printing, previously said it hopes to master organ-printing by 2030, including producing blood vessels or even livers. Russian newspaper Kommersantreported in 2023 that the government had spent 57.3 million rubles (almost $700,000) on bioprinters and bioinks, a 47-fold increase from five years prior.
The Russian private sector is also making strides in anti-aging technology and chasing immortality: a 3D printing startup in Skolkovo implanted a 3D-printed thyroid gland into a mouse in 2015 and became the first to create live tissue in space in 2018—as part of a drive towards printing organs for humans. And Russian billionaire Dmitry Itskov founded the 2045 Initiative, a life-extension project that envisions uploading human consciousness into computer avatars.
China’s research
While less obsessed with immortality than Putin’s government, Xi’s China has also invested in aging research, as the country has the world’s largest elderly population.
In 2016, the Chinese government launched the Major Program on Organ Aging and Degeneration, an initiative focused on studying cellular and molecular mechanisms of aging. And the state-funded Chinese Academy of Sciences published studies last year and this year on reversing aging in primates.
Is the U.S. falling behind?
Historically, there’s been concern in the U.S. that China would take the lead in biotechnological advancements. “Currently, the U.S. government has no cohesive, intentional biotechnology strategy,” said the U.S. National Security Commission on Emerging Biotechnology in April, “while China is gaining ground thanks to its aggressive and carefully coordinated state-led initiatives.”
But the Wall Street Journalreported in January that longevity researchers, entrepreneurs, and enthusiasts were hopeful that President Donald Trump’s second-term Administration would put more focus and funding into the once-fringe field.
“The science around aging,” James Peyer, chief executive of longevity biotech Cambrian Bio and board director of a longevity biotechnology nonprofit, told the Journal, “has hit a tipping point where it’s too big and too exciting for any government to ignore.”
California, Oregon, and Washington announced on Wednesday that they are creating a health alliance that will share “credible information” about vaccine safety and efficacy, at a time when the federal health agency tasked with releasing vaccine guidance has been thrown into chaos.
In a joint statement, the Democratic governors of the three West Coast states said the alliance was meant “to ensure residents remain protected by science, not politics.” The governors slammed the Trump Administration’s “dismantling” of the Centers for Disease Control and Prevention (CDC).
“President Donald Trump’s mass firing of CDC doctors and scientists—and his blatant politicization of the agency—is a direct assault on the health and safety of the American people,” the governors said. “The CDC has become a political tool that increasingly peddles ideology instead of science, ideology that will lead to severe health consequences. California, Oregon, and Washington will not allow the people of our states to be put at risk.”
The alliance, they said, will ensure that public health policies in the three states are based on information from “trusted scientists, clinicians, and other public health leaders.” While each state may embark on independent strategies depending on its own laws, geographies, and residents, the governors said the joint alliance will “start coordinating health guidelines by aligning immunization recommendations informed by respected national medical organizations.”
“This will allow residents to receive consistent, science-based recommendations they can rely on—regardless of shifting federal actions,” the governors said.
The announcement comes amid ongoing turmoil at the CDC. Last week, the White House said that it had fired then-CDC Director Susan Monarez, though she refused to step down from her position. Monarez had only been in the role for about a month. At least four other top officials resigned from the agency after Monarez’s firing. The Trump Administration tapped Jim O’Neill, a former Silicon Valley executive with no formal medical or scientific training and the deputy to Health and Human Services Secretary Robert F. Kennedy Jr., to become the new acting leader of the CDC.
Attorneys representing Monarez said that she was “targeted” after she “refused to rubber-stamp unscientific, reckless directives and fire dedicated health experts.”
Kennedy, a prominent vaccine skeptic, has led a number of changes to the country’s immunization policy since he was confirmed to be the country’s health secretary earlier this year. Last week, the Food and Drug Administration (FDA) said when authorizing updated COVID-19 vaccines that the shots were only approved for people ages 65 and older, or people who have an increased risk of developing severe cases of the virus—a dramatic shift from previous guidance. In May, Kennedy said the CDC would stop recommending COVID-19 vaccines for pregnant women and healthy children. Respected medical associations, such as the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists, have offered their own recommendations, diverging from federal guidance.
In June, Kennedy removed all 17 members of a committee that provides immunization recommendations to the CDC. The governors of California, Oregon, and Washington condemned the move at the time.
Hundreds of public health workers have criticized Kennedy, signing a letter last month that urged him to “stop spreading inaccurate health information” and protect staffers, in the aftermath of a shooting at the CDC headquarters a few weeks earlier. The public health workers said the shooting “came amid growing mistrust in public institutions, driven by politicized rhetoric that has turned public health professionals from trusted experts into targets of villainization—and now, violence.”
Florida’s Surgeon General, Joseph Ladapo, announced on Wednesday that the state would end all vaccine mandates, likening them to slavery.
Lifting the mandates would mean children would not be required to be vaccinated in order to attend school in Florida. It would be the first state to withdraw from the practice, which has been credited with increasing vaccination rates and lowering the risk of infectious diseases like measles spreading.
“Who am I to tell you what your child should put in their body?” Ladapo said.
Florida Governor Ron DeSantis endorsed the move and acknowledged that although the state can eliminate some vaccine mandates, it would need “changes from the legislature” to eradicate them all.
Ladapo is a known vaccine critic and has opposed mainstream scientific research and guidance. In the past, Ladapo has downplayed the importance of COVID-19 vaccines, which public health experts have credited with saving millions of lives during the pandemic, calling them “nothing special.” He also promoted unproven treatments for COVID-19, including hydroxychloroquine, which the World Health Organization has warned is not an effective treatment for the virus. During a measles outbreak in 2024 at an elementary school in Florida, Ladapo said guardians should have the right to decide whether their unvaccinated children are kept home, contrary to federal guidance that children be excluded from schools in such cases.
Ladapo did not provide specifics on the plans to eliminate all vaccine mandates in the state, although he repeatedly said that “every last one of them” would be eradicated, “is wrong and drips with disdain and slavery.”
Florida’s move to end mandates in the states comes as the national Department of Health and Human Services—led by another well-known vaccine skeptic, Health and Human Services Secretary Robert F. Kennedy Jr.—has made a number of controversial changes to the country’s vaccine policies.
The governors of Oregon, California and Washington formed a health alliance on Wednesday to provide health guidance for the residents of their states, including on vaccine safety, in a rebuke against the Trump Administration. The alliance comes in response to what the three governors described as “the blatant politicization” of the CDC following the firing of its former director, Susan Monarez last week.
Meanwhile, anti-vaccine sentiments have been on the rise among the American public. Vaccination exemptions have been increasing in states across the country. During the 2024-25 school year, vaccine exemptions for kindergarteners rose from 3.3% to 3.6%, while 36 states reported overall rising exemptions, according to CDC data. Seventeen states reported exemptions exceeding 5%. Childhood vaccination rates, meanwhile, have been declining: The agency recorded a decrease in vaccine coverage for kindergarteners for all reported vaccines in the 2024-2025 school year.
About 4 million deaths worldwide are prevented by childhood vaccines every year, according to the CDC. The World Health Organization estimated roughly 154 million lives have been saved over the last 50 years from global immunization efforts.
Some Medicare recipients are set to experience a new “prior authorization” measure as the Centers for Medicare & Medicaid Services (CMS) trials its much-discussed “Wasteful and Inappropriate Service Reduction (WISeR)” model.
The initiative, announced by the CMS in June, will require recipients of Original Medicare to receive prior approval before obtaining access to certain medical services. The pilot is only due to run in six states.
Medicare is health insurance for people aged 65 or older. Some younger people are eligible to receive the coverage if they have a disability, End-Stage Renal Disease (ESRD), or ALS. Almost 69 million Americans depend on the federally-funded program for their health insurance needs. As such, the impact of any changes to the program would likely be felt far and wide.
Several Democrat lawmakers in early August wrote a letter to CMS Administrator Mehmet Oz—widely known as Dr. Oz—to raise concerns that the proposed prior authorization practices would “likely limit beneficiaries’ access to care” and “create perverse incentives to put profit over patients.”
As interest mounts, here’s what to know about the Medicare pilot program.
What is the Medicare prior approval pilot?
Per the CMS, the WISeR model, announced on June 27, is intended to “test ways to provide an improved and expedited prior authorization process relative to Original Medicare’s existing processes” in order to “help patients and providers avoid unnecessary or inappropriate care” while also “safeguarding federal taxpayer dollars.”
According to the Medicare Payment Advisory Commission, Medicare spent up to $5.8 billion in 2022 on “unnecessary or inappropriate services with little to no clinical benefit.”
The WISeR model reportedly is aimed to combat this and will employ private companies to test if AI can handle the prior authorization process used to determine if a recipient of Original Medicare, a plan also known as Traditional Medicare, is eligible for funding for a health service. The model will specifically look at services the CMS considers to be “particularly vulnerable to fraud, waste, and abuse.”
“These items and services include, but are not limited to, skin and tissue substitutes, electrical nerve stimulator implants, and knee arthroscopy for knee osteoarthritis,” the CMS notice read.
CMS has confirmed that it will exclude a series of services such as “inpatient-only services, emergency services, and services that would pose a substantial risk to patients if substantially delayed” from the WISeR pilot.
“CMS is committed to crushing fraud, waste, and abuse, and the WISeR Model will help root out waste in Original Medicare,” said Dr. Oz.
The model is not set to impact people enrolled in Medicare Advantage, a separate plan with extra benefits and coverage compared to the baseline Original Medicare scheme, that already has a prior authorization process.
Private companies involved in the program will be paid for their participation, based on their “ability to reduce unnecessary or non- covered services,” essentially how much money they can save in healthcare spending.
The WISeR model is set to be launched on Jan. 1, 2026 and will “run for six performance years” to measure its effectiveness, ending on Dec. 21, 2031.
What states are set to be impacted?
The WISeR pilot will be trialed in six states across the United States, according to the CMS.
Washington, New Jersey, Oklahoma, Ohio, Texas, and Arizona are set to be impacted.
Companies selected to take part in the program and conduct AI-driven prior authorization will be assigned different geographic regions to operate in.
Secretary of Health and Human Services Robert F. Kennedy Jr., President Donald Trump, and CMS Administrator Mehmet Oz participate speak at the White House on July 30, 2025. Jim Watson—Getty Images
What are the criticisms levied at the new Medicare model?
Democrat lawmakers wrote an open letter to Dr. Oz on Aug. 27, voicing their concern that the incoming prior approval practices could result in detrimental delays that negatively impact patients.
“WISeR will likely limit beneficiaries’ access to care, increase burden on our already overburdened health care work force, and create perverse incentives to put profit over patients,” said the 17 Democrat signatories, making reference to how prior authorization has impacted clients putting in claims under Medicare Advantage.
The lawmakers argued that “many patients choose Traditional Medicare because they know their care will be determined by their doctors and not by insurance companies.”
Signed by the likes of California Rep. Ami Bera and Illinois Rep. Bradley Scott Schneider, the letter highlighted concerns over profit incentives associated with prior authorization, a process which is also used by private insurance companies that typically hire outside parties to conduct such reviews.
Democrats criticized the Trump Administration in their address to Dr. Oz, highlighting how government officials had already publicly recognized the issues with prior authorization.
On June 23, Republican lawmakers alongside Health and Human Services Secretary Robert Kennedy Jr. pledged to “fix the broken prior authorization system.”
North Carolina Congressman Greg Murphy drew on his decades-long career as a physician, saying: “I witnessed the ridiculous and ever-increasing obstructions caused by insurance companies to delay or deny care to patients.”
Referencing this acknowledgment from the Republican party, the Democrats wrote: “And yet, not a week after these statements, CMS put forward a new proposal to increase the utilization of prior authorization in a type of health coverage that had seldom used the tactic before, replacing doctor’s medical knowledge with an algorithm designed to maximize care denial in order to increase profits.”
TIME has reached out to CMS for comment regarding these concerns.
More than 750 public health workers sent a letter to Health Secretary Robert F. Kennedy Jr. on Wednesday, urging him to “stop spreading inaccurate health information” and guarantee employees’ safety, in the wake of a shooting at the headquarters of the Centers for Disease Control and Prevention (CDC) earlier this month.
The letter—signed by both named and anonymous current and former staffers at the U.S. Department of Health and Human Services (HHS), CDC, and National Institutes of Health who noted they signed the letter in their “own personal capacities”—said the attack on the CDC’s headquarters in Atlanta on Aug. 8 “was not random.”
“The attack came amid growing mistrust in public institutions, driven by politicized rhetoric that has turned public health professionals from trusted experts into targets of villainization—and now, violence,” public health workers said in the letter, which was also addressed to members of Congress. “CDC is a public health leader in America’s defense against health threats at home and abroad. When a federal health agency is under attack, America’s health is under attack. When the federal workforce is not safe, America is not safe.”
The public health workers went on to accuse Kennedy, a prominent vaccine skeptic, of being “complicit in dismantling America’s public health infrastructure and endangering the nation’s health by repeatedly spreading inaccurate health information.” They cited several statements and actions that Kennedy has made in recent months, pointing to his claim that mRNA vaccines “fail to protect effectively” against upper respiratory infections such as COVID-19—despite years of research showing that the shots are both safe and effective—and his announcement that HHS would be winding down mRNA vaccine development. They also condemned his decision to remove all the experts from a critical vaccine advisory committee. And they said some of Kennedy’s past comments—such as claiming that there is a “cesspool of corruption at CDC”—were “sowing public mistrust” in the health agency.
The public health workers expressed their wish to honor police officer David Rose, who was killed while responding to the attack on the CDC headquarters in August.
HHS said in a statement to TIME that Kennedy “is standing firmly with CDC employees—both on the ground and across every center—ensuring their safety and well-being remain a top priority.” The agency added that, after the shooting earlier this month, Kennedy traveled to Atlanta and called the CDC “a shining star” among the world’s health agencies.
“For the first time in its 70-year history, the mission of HHS is truly resonating with the American people—driven by President Trump and Secretary Kennedy’s bold commitment to Make America Healthy Again,” HHS said. “Any attempt to conflate widely supported public health reforms with the violence of a suicidal mass shooter is an attempt to politicize a tragedy.”
Law enforcement officials said they found evidence that the suspect in the August shooting, who they identified as Patrick Joseph White of Georgia, blamed the COVID-19 vaccine for his health ailments. White was found dead at the scene, and authorities later said that he died of a self-inflicted gunshot wound.
CDC Director Susan Monarez noted the dangers posed by misinformation in a staff meeting in the wake of the attack. “We know that misinformation can be dangerous,” she said, according to NBC News. “Not only to health, but to those that trust us and those we want to trust. We need to rebuild the trust together.”
The day after the shooting, Kennedy expressed his condolences to Rose’s family in a post on X.
“We know how shaken our public health colleagues feel today. No one should face violence while working to protect the health of others,” he said. “We are actively supporting CDC staff on the ground and across the agency. Public health workers show up every day with purpose—even in moments of grief and uncertainty. We honor their service. We stand with them. And we remain united in our mission to protect and improve the health of every American.”
In their letter, public health workers claimed Kennedy’s “dangerous and deceitful statements and actions have contributed to the harassment and violence experienced by CDC staff.” They implored him to take three steps by Sept. 2 to “uphold his pledge to safeguard the health of the American public,” including asking him to “stop spreading inaccurate health information,” particularly regarding vaccines, infectious disease transmission, and the country’s public health institutions. They also urged him to affirm the scientific integrity of the CDC and guarantee the safety of HHS employees, such as through emergency procedures and alerts.
“The deliberate destruction of trust in America’s public health workforce puts lives at risk,” they wrote in the letter. “We urge you to act in the best interest of the American people—your friends, your families, and yourselves.”
The Food and Drug Administration has warned the public not to consume certain frozen shrimp products sold at Walmart due to possible contamination with Cesium-137, a radioactive isotope.
It said the warning affects the Great Value brand of raw frozen shrimp sold at the superstore, adding that anyone who purchased the products should dispose of them.
A statement from the agency said the FDA was “actively investigating reports of Cesium-137 (Cs-137) contamination in shipping containers and frozen shrimp products” shipped from Indonesia.
It said that the U.S. Customs & Border Protection (CBP) had detected Cs-137 in shipping containers at four U.S. ports: Los Angeles, Houston, Savannah, and Miami. Containers that tested positive for the isotope have been denied entry to the U.S.
The FDA added that although it had not confirmed the presence of contamination in any commercial product in the United States, the shrimp products appear “to have been prepared, packed, or held under insanitary conditions whereby it may have become contaminated with Cs-137 and may pose a safety concern.”
“If you have recently purchased raw frozen shrimp from Walmart that matches this description, throw it away. Do not eat or serve this product,” the FDA statement added.
The FDA said limited exposure to Cs-137 can cause “an elevated risk of cancer, resulting from damage to DNA within living cells of the body.”
The amount of Cs-137 the FDA detected is below its “levels of concern” for imported foods, it said. Even so, the agency said that the recall attempts to address concerns related to “longer term, repeated low dose exposure.”
The FDA recommended that anyone who has bought or who sells the products throw them out. Walmart similarly advised customers with the products in their possession to discard them. The company confirmed to TIME that it immediately recalled the products from impacted stores and said customers who had already purchased them could visit any Walmart store for a full refund.
“The health and safety of our customers is always a top priority,” a Walmart spokesperson said in a statement. “We have issued a sales restriction and removed this product from our impacted stores. We are working with the supplier to investigate.”
Cs-137 is the most common radioactive isotope of Cesium, according to the U.S. Environmental Protection Agency (EPA). It is produced via nuclear fission in order to be used in medical devices and gauges, and it is often used in radiation therapy to treat cancer.
Cs-137 can also be a waste product of nuclear reactors and has been found near nuclear accidents.
People are often exposed to small quantities of Cs-137 due to the isotope remaining in the environment following nuclear weapons testing in the mid-20th century. Cs-137 can last in soil for years, which means that it often ends up in the food cycle and in foods that people ingest. Typically this is at extremely low levels that are not harmful to people—though as the FDA emphasized in its statement, even low levels of Cs-137 radiation can eventually build up and become harmful.
Texas health officials declared on Monday that the measles outbreak that has sickened more than 700 people in the state and killed two children is over—though they warned that the threat posed by the disease is not.
It’s been more than 42 days since a new measles case has been reported in the West Texas outbreak that began in late January, according to the Texas Department of State Health Services (DSHS). Public health experts generally consider that to be the marker of the end of a measles outbreak, DSHS said, because 42 days is double the maximum amount of time it can take for a person to show symptoms of measles after being exposed to the virus.
There have been 762 confirmed measles cases in the state this year, as of Monday, according to DSHS. The outbreak began in undervaccinated Mennonite communities in Gaines County, and was later linked to measles cases in other states, including New Mexico and Kansas. Two unvaccinated girls in Texas died of measles-related causes earlier this year.
In announcing the end of the Texas outbreak, DSHS applauded the state’s health care professionals, many of whom had never seen a measles case before this year, for their work. But the department also warned: “The end of this outbreak does not mean the threat of measles is over.”
Measles is highly contagious and can be fatal, though it is vaccine preventable through the measles, mumps, and rubella (MMR) vaccine. The disease was declared eliminated from the U.S. in 2000, an achievement public health experts largely attributed to a successful vaccination program. But MMR vaccination rates have declined in recent years, and measles cases have increased. This year, largely due to the Texas outbreak, the number of measles cases hit a 33-year record high in the U.S.
As of Aug. 5, there have been 1,356 confirmed measles cases across the country this year, according to the Centers for Disease Control and Prevention (CDC). Of those, 92% were people who were either unvaccinated or their vaccination status was unknown. In total, there have been three confirmed measles deaths this year: the two unvaccinated children in Texas, and one unvaccinated adult in New Mexico. Before this year, the last time a person was known to have died of measles-related causes in the U.S. was in 2015.
Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, says that it’s reasonable to say that the current Texas outbreak has subsided based on the available data. But he also expresses concern that the official figures are undercounts. Many people in the Mennonite community typically don’t seek medical care, he says, so it’s possible that some people contracted measles who public health officials weren’t aware of. Offit also criticizes the Trump Administration’s cuts to the CDC, which he worries could have affected the agency’s ability to track cases.
Historically, Offit says, measles cases have peaked in the winter months and abated in the spring and summer months, so he fears that the numbers will increase again in a few months.
“I don’t think this is the end at all,” Offit says. “This should be a warning to parents that, if they haven’t vaccinated their children, that now’s the time.”
Concerns about the potential consequences of declining vaccination rates extend beyond measles, as well. Because measles is one of the most contagious viruses, it’s often the first to experience a resurgence when vaccination rates fall, public health experts have told TIME, cautioning that the rise in cases could be a sign that other diseases may become more prevalent too.
Offit also says that getting measles causes “immune amnesia,” meaning that after being infected with the disease, a person is more susceptible to other pathogens—even ones that the person’s immune system was able to fight off before.
Offit calls the Texas outbreak “a warning shot.” The outbreak, he says, showed that many parents have chosen not to vaccinate their children against measles—and the consequences of that.
“On the one hand it’s fine to say that the fear that we all have now can be relaxed by the fact that the virus doesn’t appear to be spreading now [in Texas],” Offit says. “But really, I think the messaging should be one of: that was a warning shot, and several people, including two little girls, paid the price.”
“We can’t let that happen again,” he continues. “It’s unconscionable to have a child die of something that is entirely preventable.”
DUBAI, United Arab Emirates — Iran’s supreme leader on Saturday threatened Israel and the U.S. with “a crushing response” over attacks on Iran and its allies.
Ayatollah Ali Khamenei spoke as Iranian officials are increasingly threatening to launch yet another strike against Israel after its Oct. 26 attack on the Islamic Republic that targeted military bases and other locations and killed at least five people.
Any further attacks from either side could engulf the wider Middle East, already teetering over the Israel-Hamas war in the Gaza Strip and Israel’s ground invasion of Lebanon, into a wider regional conflict just ahead of the U.S. presidential election this Tuesday.
“The enemies, whether the Zionist regime or the United States of America, will definitely receive a crushing response to what they are doing to Iran and the Iranian nation and to the resistance front,” Khamenei said in video released by Iranian state media.
The supreme leader did not elaborate on the timing of the threatened attack, nor the scope. The U.S. military operates on bases throughout the Middle East, with some troops now manning a Terminal High Altitude Area Defense, or THAAD, battery in Israel.
The USS Abraham Lincoln aircraft carrier likely is in the Arabian Sea, while Pentagon press secretary Maj. Gen. Pat Ryder said Friday that more destroyers, fighter squadrons, tankers and B-52 long-range bombers would be coming to the region to deter Iran and its militant allies.
The 85-year-old Khamenei had struck a more cautious approach in earlier remarks, saying officials would weigh Iran’s response and that Israel’s attack “should not be exaggerated nor downplayed.” Iran has launched two major direct attacks on Israel, in April and October.
But efforts by Iran to downplay the Israeli attack faltered as satellite photos analyzed by The Associated Press showed damage to military bases near Tehran linked to the country’s ballistic missile program, as well as at a Revolutionary Guard base used in satellite launches.
Iran’s allies, called the “Axis of Resistance” by Tehran, also have been severely hurt by ongoing Israeli attacks, particularly Lebanon’s Hezbollah and Hamas in the Gaza Strip. Iran long has used those groups as both an asymmetrical way to attack Israel and as a shield against a direct assault. Some analysts believe those groups want Iran to do more to back them militarily.
Iran, however, has been dealing with its own problems at home, as its economy struggles under the weight of international sanctions and it has faced years of widespread, multiple protests. After Khamenei’s speech, the Iranian rial fell to 691,500 against the dollar, near an all-time low. It had been 32,000 rials to the dollar when Tehran reached its 2015 nuclear deal with world powers.
Gen. Mohammad Ali Naini, a spokesman for Iran’s paramilitary Revolutionary Guard which controls the ballistic missiles needed to target Israel, gave an interview published by the semiofficial Fars news agency just before Khamenei’s remarks were released. In it, he warned Iran’s response “will be wise, powerful and beyond the enemy’s comprehension.”
“The leaders of the Zionist regime should look out from the windows of their bedrooms and protect their criminal pilots within their small territory,” he warned. Israeli air force pilots appear to have used air-launched ballistic missiles in the Oct. 26 attack.
Khamenei on Saturday met with university students to mark Students Day, which commemorates a Nov. 4, 1978, incident in which Iranian soldiers opened fire on students protesting the rule of the shah at Tehran University. The shooting killed and wounded several students and further escalated the tensions consuming Iran at the time that eventually led to the shah fleeing the country and the 1979 Islamic Revolution.
The crowd offered a raucous welcome to Khamenei, chanting: “The blood in our veins is a gift to our leader!” Some also made a hand gesture — similar to a “timeout” signal — given by the slain Hezbollah leader Hassan Nasrallah in 2020 in a speech in which he threatened that American troops who arrived in the Mideast standing up would “return in coffins” horizontally.
Iran will mark the 45th anniversary of the U.S. Embassy hostage crisis this Sunday, following the Persian calendar. The Nov. 4, 1979, storming of the embassy by Islamist students led to the 444-day crisis, which cemented the decades-long enmity between Tehran and Washington that persists today.
The end may not be near, but the end is clear—according to those who have kept a close eye on Myanmar’s ongoing civil war, since a military coup toppled its civilian government in 2021. While the fighting between the junta and armed resistance groups was locked in a stalemate for the first two years of the conflict, observers note that the third year has seen the military on the back foot.
The protracted conflict has been estimated to have killed over 50,000 people and displaced around three million. But while much of the violence since the 2021 coup has been marked by a sense of intractability, and global attention has been overshadowed by wars in the Middle East and Ukraine, a series of resistance victories in the past year have rattled the Myanmar junta’s once ironclad grip on power, marking what seems to be a turning point.
One of the numerous camps scattered all over the region where between 150,000 and 250,000 internally displaced people have taken shelter after Myanmar military airstrikes and artillery forced them to leave their towns and villages, in Karenni State on Feb. 15, 2024. Thierry Falise—LightRocket/Getty Images
“The end of the war is clear-cut. The only thing that is not clear is the means by which it’s achieved and the timing,” Chris Sidoti, an international human rights consultant and a founding member of the Special Advisory Council for Myanmar (SAC-M), tells TIME. “One way or another, at some point the military will collapse.”
TIME spoke to eight experts, all of whom painted a similar picture of where the conflict stands—and where it may go from here. Here’s what to know:
Feb. 2021
The Tatmadaw, Myanmar’s military, stages a coup to overthrow the civilian government—on the same day the parliament is set to swear in the winners of the 2020 election, in which Aung San Suu Kyi’s National League for Democracy won by a landslide. As the military accuses the party of election fraud and promises to hold new elections, power is transferred to military commander-in-chief Min Aung Hlaing, and the country is declared to be in a year-long state of emergency.
This is met with international condemnation and pro-democracy protests across the country, and the junta in turn responds with a brutal crackdown. (As people took to the streets, more than 500 are killed within two months of the coup.) Thousands of civil servants go on strike as part of a nationwide civil disobedience movement. The junta doubles down on its campaign of intimidation by killing civilians, burning villages in resistance strongholds across the country, and forcibly disappearing hundreds of its critics.
Smoke rises after protesters burn tires as they gather to continue their protest against the military’s coup and detention of elected government members, in Thakeyta Township, Yangon, Myanmar, on March 27, 2021.Stringer—Anadolu Agency/Getty Images
April 2021
A coalition of ousted lawmakers, protest leaders, and ethnic minorities form the National Unity Government, which aims to end military rule, restore democracy, and establish a federal system.
May 2021
The NUG announces its armed wing, the People’s Defence Force (PDF), and calls for a “people’s defensive war” against the junta across the country—a call that’s backed by ethnic armies, which have for decades fought against the military for self-determination in their home states.
August 2021
Min Aung Hlaing names himself the Prime Minister, announces a potential extension to the state of emergency, and repeats his pledge to hold elections.
General Min Aung Hlaing attends a military parade to mark the 78th Armed Forces Day in Nay Pyi Taw, Myanmar, on March 27, 2023. Myo Kyaw Soe—Xinhua/Getty Images
2022
Resistance forces become more united, with many PDF units and ethnic armies forming partnerships to launch joint attacks against junta troops.
The Three Brotherhood Alliance, a coalition of ethnic armies, launches Operation 1027 in northern Shan state, seizing control of key areas from the military, marking a key victory for the resistance and a turning point in the war.
January 2024
China brokers a ceasefire between the junta and the Three Brotherhood Alliance during negotiations held in the Chinese city of Kunming. While China has refrained from openly criticizing Min Aung Hlaing’s regime, it has also balanced unofficial relationships with ethnic armed groups in a bid to safeguard trade and security along its border with Myanmar.
February 2024
In what’s widelyseen as a sign of desperation, the junta announces mandatoryconscription for all men between 18 and 35 years old and all women between 18 and 27. This sparks panic among young people, many of whom swarm passport offices and embassies in effort to leave the country, while others opt to join the resistance and take up arms against the junta.
People gather outside the embassy of Thailand to get visas, in Yangon on Feb. 16, 2024, after Myanmar’s military government said it would impose mandatory military service.STR/AFP/Getty Images
April 2024
Myawaddy, a border township in the southeastern Kayin state and a strategically important trading hub with Thailand, finds itself at the center of offensives launched by resistance forces and the junta—amid a series of resistance victories.
June 2024
The Three Brotherhood Alliance launches the second phase of Operation 1027 in northern Shan State and Mandalay, after accusing the junta of violating the terms of the China-brokered ceasefire by bombing ethnic militia territory.
September 2024
The embattled military proposes a peace agreement with the resistance, urging them to “solve political problems politically,” but it is widelysnubbed by the NUG and ethnic armies who want the junta held accountable for their brutality and barred from politics.
The disintegration of the junta seems to be well underway, as it faces pressure on all fronts—from rumors of internal strife to territorial losses to fallout from the ongoing humanitarian crisis across the country.
The Tatmadaw may be the most powerful institution in Myanmar and has ruled the country for many of the years since its independence—by decree, political maneuvering, and constitutional provisions—but the military leadership, analysts say, has a history of botching things. After the military seized power in a coup in 1962, Myanmar became internationally isolated, its economy floundered, and insurgencies grew—which ultimately resulted in the resignation of military leader Ne Win in 1988.
“The military has always been totally incompetent,” says Sidoti from the SAC-M. “They destroyed the economy. They have left Myanmar politically infantile. They have exacerbated internal conflicts, and they have not won a single war against any of the ethnic armies with which they have been fighting for 65 or 70 years.”
Indeed, the junta has been steadily losing ground, especially in the north. In the northeastern town of Laukkai, near the Chinese border, nearly 2,500 junta soldiers surrendered in January to the Three Brotherhood Alliance after weeks of fighting; the junta lost its first regional command base when its headquarters in Lashio fell to the resistance in August; and counter offensives launched by the junta this year to wrest back control of lost territories have struggled to make inroads.
A member of the Karenni Resistance Force scouts the movement of the military junta in the frontline of Shadaw township on Feb. 3, 2024. Thu Myae—SOPA Images/LightRocket/Getty Images
Compared to the resistance forces fighting for self-determination and control over their home region, the junta troops, who increasingly include civilians who were forcibly conscripted to support the war effort, are from the outset less motivated to fight. “I think the resistance has a good chance of winning if they keep up the pressure, because the morale is very different for the resistance. The fighting spirit is strong,” says Mike, a member of the anonymous Myanmar Film Collective, which documents and protests the aftermath of the 2021 coup through film. “[The] junta’s side, they don’t even know what they’re fighting for.”
A key battle lies in the junta strongholds of Mandalay, located west of Lashio, where ethnic groups from the Brotherhood Alliance forces are pushing in. “They’re on the cusp of losing Mandalay, and if they do, then that’s going to be a huge blow to the entire military morale,” says Yanghee Lee, another member of the SAC-M and a former U.N. special rapporteur on the situation of human rights in Myanmar.
The junta has also lost control over critical infrastructure. While it still maintains predominant control over airspace, large swathes of the country’s townships that share land borders with China, Thailand, and India are now controlled by the resistance. A SAC-M report in May determined that the junta “does not control enough of the territory of Myanmar to uphold the core duties of the state,” having lost authority in townships spanning over 80% of the country’s territory, which houses nearly 70% of its population. The NUG runs a network of education and healthcare services in resistance-controlled areas, staffed with personnel who refuse to work under the military government. And despite the junta’s tight grip over the internet, people have found ways to bypass censors.
Perhaps most crucially, the economic pressure of the protracted conflict is building: Half the population is in poverty, inflation is soaring, and one in four people are plagued by food insecurity. And since the coup, Myanmar has become the subject of international sanctions designed to punish members of the junta and curb the flow of weapons into the country.
A member of the ethnic armed group Ta’ang National Liberation Army (TNLA) keeps watch as people buy groceries at a street market in Kyaukme in Myanmar’s northern Shan State on July 3, 2024.STR/AFP/Getty Images
Such mounting economic troubles may compel the junta to change course. “But one thing we have to remember is the sanctions, of course, affect everyone,” says Amara Thiha, a doctoral researcher of Myanmar politics at Peace Research Institute Oslo. “So economic pressure may [bring the junta to] the table for certain forms of changes, but at what cost? The cost of millions of people.”
The collapse of social and economic order in Myanmar is watched carefully by its neighbors, fearful that instability will spill over. (Immigration and drugs—trafficked to fund rebel weapon purchases—have already surged along the Thai border.) And China, which is mostly concerned about the economic fallout of the Myanmar conflict, has been exerting influence over Myanmar’s ethnic armies while appearing to be running out of patience with the junta, with which it maintains high-level diplomatic engagements.
Members of the TNLA walk next to trucks in Hsipaw on Oct. 15, 2024. Fighters from the Myanmar ethnic armed group have seized another town along a strategic highway to China, the group and a resident said, in the latest setback for the embattled junta.STR/AFP/Getty Images
So how will this end?
The resistance may be making important gains, but it doesn’t mean that defeating the junta will be a walk in the park. Despite a grim outlook for victory, the junta has refused to concede in conflict zones. (In Lashio, where resistance forces have made major advances, the military has resorted to regular, indiscriminate aerial bombardment to destroy the city.) Its desperate conscription drive also has the power to prolong its capacity to fight. And on the other side, ethnic armed groups are unlikely to extend their support outside of their territories and to fight the junta in their strongholds.
“Ethnic armed groups are still not going to be fighting outside their ethnic territories primarily,” says Thomas Kean, analyst on Myanmar at International Crisis Group. “Ultimately, it will be up to PDFs and resistance forces to take the fight to the military in lowland areas, and I think they just don’t have the resources to match the military. That’s going to be a really hard struggle, so I think the military will be able to hold on in those areas.”
Already, the military has been retreating to its strongholds in urban central Myanmar, including Yangon and Naypyidaw. This could result in a scenario where the military retains control over a rump state—a remnant of a once larger territory—while the rest of the country is divided into various ethnic army-controlled regions.
Soldiers from the Karenni Nationalities Defence Force (KNDF) prepare on a map a military operation against the Myanmar military in southern Shan State.
The KNDF, mostly constituted of local young civilians, was created in May 2021, a few months after the coup perpetrated by the Burmese military. Thierry Falise—LightRocket/Getty Images
Another scenario could see the junta completely removed from power, though there are different ways that could come about—whether by complete military defeat and surrender, or more likely, through internal power struggle and external negotiations to cede power.
“It may be that they fight to the bitter end,” says Sidoti. “It may be that there is an internal implosion long before the war is finished and the military recognizes and accepts the inevitable.”
In a sign of desperation, the junta offered an unprecedented olive branch in September, urging resistance groups to participate in elections next year and “solve political problems politically.” That ceasefire proposal was rejected by both the NUG and ethnic armed groups, who have made clear their desire for the military to have no role in politics. The elections promised by the junta, slated for 2025, have also been denounced both domestically and internationally as a sham that would grant the junta the guise of legitimacy but offer little actual democracy.
What experts agree on is that the junta’s leadership turmoil, along with steady defections on the ground, spell impending collapse one way or another. But that won’t be the end of the story just yet.
An unexploded projectile stuck on the roof of a house following fighting between Myanmar’s military and the Kachin Independence Army (KIA) in Nam Hpat Kar, Kutkai township in Myanmar’s northern Shan State, on Feb. 4, 2024.STR/AFP/Getty Images
Even when the junta falls, experts warn that democracy—and even stability—in Myanmar will be far from guaranteed.
“On the resistance side, we see all these different groups having a hard time governing territories that they control. They’re very good at fighting against the military, but governance requires a different skillset,” says a photojournalist who spent the first two years of the war embedded with ethnic armed groups in Karenni state and spoke to TIME on the condition of anonymity for their safety. “There hasn’t been any cohesive, collected effort from the anti-military or the resistance side.”
Unlike the NUG, ethnic armed groups appear to be more guided by ethnocentric nationalism than actually implementing a democratic system—such as holding free and fair elections, legitimizing a central administration, and being transparent over their finances, says Amara. “These are the very basic three principles of democracy: election, control and accountability,” he adds. “If you’re putting on these lenses, it is very difficult to say that EROs [ethnic resistance organizations] are functioning on democratic principles.”
“The struggle against the junta and today’s civil war will not be resolved with a big group hug,” reads an op-ed published in January in The Irrawaddy, echoing a sentiment shared by many political observers. “And if care is not taken, regime collapse could simply lead to more war, with the same belligerents but new alliances.”
There have long been differing interests among different ethnic armed groups, which have fought one another before and during the ongoing civil war. Such tensions are likely to resurface. In Shan state, ethnic armed groups which had allied against military forces last year have increasingly found themselves at odds with one another over territorial disputes.
“The thing that holds all this together is a common enemy, the Myanmar military. But beyond that, there’s lots of divisions and disagreements,” says Kean.
Soldiers from the Karen National Liberation Army (KNLA)—the armed wing of the Karen National Union (KNU), an ethnic Karen movement created in 1947 that is generally considered as the “oldest guerrilla movement in the world”—and members of the KNDF sit in the back of a pick-up truck on their way to a military operation, in Loikaw on Feb. 10, 2023.Thierry Falise—LightRocket/Getty Images
To be sure, there have been sustained efforts to enact a vision of governance in post-junta Myanmar. Many in the resistance have committed to the idea of a federal state—though agreement on the specifics of that vision of federalism remains wanting.
One prominent proposal came in the form of the Federal Democratic Charter introduced just one month after the coup by the National Unity Consultative Council, the advisory body of the NUG. A separate proposal backed by 12 political parties was introduced in February. Neither has managed to garner broad enough support among the resistance.
“The National Unity government and many of the resistance organizations talk about a Federal Democratic Myanmar, and that is a strong and essential commitment, but there has been too little work done so far on fleshing that out, on giving it substance,” says Sidoti. “It needs to be an equal society in which there is a high level of autonomy at the regional level, but international leadership through a national government.”
In at least one state, a hybrid model of governance is already being experimented—to significant success. The Karenni State Interim Executive Council has established administrations in 16 townships across the state, all elected by residents and consisting of leaders representing civil society and ethnic communities. This model of decentralized authority is unprecedented in the state, which before the coup had local leaders appointed by the central government.
“We call it bottom-up federalism,” says Khu Plu Reh, general secretary of the Karenni State Interim Executive Council. “It is very important, the recognition of the self-determination of each ethnic group.”
Khu Plu Reh says he’s not sure if this model can be replicated across the country—only that it is a “very suitable model for the Karenni state right now.” Still, the political innovation has sparked intrigue from other ethnic leaders, who Khu Phu Reh says have contacted them to learn more about their vision of governance.
Soldiers from the KNDF walk along a row of apartments bombarded by the Myanmar military in Loikaw on Feb. 19, 2024. Loikaw was partly seized during an offensive in November 2023 dubbed 11.11.Thierry Falise—LightRocket/Getty Images
There are doubts as to whether the NUG is capable of leading the charge to bring lasting peace to Myanmar. It has limited influence on the ground, where it has partnered with different ethnic armed groups to fight the junta but has not managed to strike a political consensus among its partners.
Many in ethnic rebel groups are cautiously skeptical of NUG leaders, who have not proven to be the biggest champions of ethnic minorities in the country. For all Aung San Suu Kyi’s government was associated with the fight for democracy and human rights, it was also criticized for its conspicuous silence on the military’s brutal campaign against the Rohingya, a predominantly Muslim ethnic group in Rakhine state that now makes up one of the world’s largest refugee groups, most residing in exile in camps in neighboring Bangladesh.
Some temporary partnerships with the NUG are already falling apart. In September, the Myanmar National Democratic Alliance Army (MNDAA), a powerful pro-China ethnic armed group that’s part of the Three Brotherhood Alliance, publicly rejected the idea of working militarily or politically with the NUG and said that it would not help anti-junta efforts in the Shan state capital of Taunggyi or Mandalay.
A general view of Mandalay, the second-largest city in Myanmar, on July 5, 2024.Sai Aung Main—AFP/Getty Images
Time is ticking for the NUG, whose work analysts say is set to get more difficult as the junta weakens. “The NUG will no longer have this kind of a central power after the military collapses,” says Lee from the SAC-M. “And they cannot wait until, for instance, winning the war, until the military collapses, then think of how to form a new future Myanmar.”
There’s a lot of uncertainty, observers all agree—but there’s also hope. The past three years of fighting the junta have fostered new bonds across different factions of the resistance, even as negotiations among various stakeholders for a post-war Myanmar remain challenging.
“We can see tensions in the future, but the commitment to a Federal Democratic Myanmar now is so widespread and so deeply grounded in the people’s aspirations that there is an opportunity like never before, and there are signs like never before of a commitment to national unity,” says Sidoti. “That’s what needs to be fostered. That can be built on, and I think it will be built on, but it’s going to require hard work.”
Climate change is increasingly disrupting people’s sleep.
High nighttime temperatures led to 5% more hours of sleep lost worldwide over the past five years compared to the period between 1986 and 2005, according to the latest edition of the Lancet’s study of climate and health. It marks the first time the prestigious medical journal has examined this metric. Sleep loss peaked in 2023, the hottest year on record, when there was a 6% rise.
The eighth annual Lancet Countdown on health and climate change report, authored by 122 global experts, found that high temperatures, drought and heavy rainfall are increasingly impacting people’s health. In 2023, a record 512 billion potential hours of labor were lost globally due to high temperatures. Heat-related deaths in people over the age of 65 reached the highest levels on record, 167% higher in the 1990s.
“This isn’t just about extreme weather events,” said Jeremy Farrar, chief scientist at the World Health Organization. “This is about every week, every month of the year, and the impact on all of our health.”
In many places, nighttime temperatures are rising faster than daytime temperatures. As well as impacting sleep, overheating at night reduces the body’s ability to cool down and recover from the heat of the day, exacerbating heat wave deaths, especially among people with pre-existing heart and respiratory problems.
The study used historic sleep-tracking and temperature data to estimate the effects on sleep from high nighttime temperatures across different years. The biggest increases in lost sleep were in the Middle East and sub-Saharan Africa.
Even in more temperate climates, overheating at night can be exacerbated by poor building design that leaves indoor temperatures warmer than outdoor temperatures. Buildings can be better ventilated or shaded to reduce how much they heat up during the day and how much they retain that heat. Power demand from air conditioning use is expected to triple by 2050.
A lack of sleep negatively affects attention span and quality of life and can also have knock-on effects for other health conditions. Kevin Lomas, a professor of building simulation at Loughborough University who studies the relationship between heat and sleep, has found in the UK that bedroom temperatures higher than about 27C (80.6F) is the threshold at which people struggle to cool themselves down. “Once you start tinkering with how much sleep people get, then the consequences aren’t just relatively trivial things,” said Lomas, who wasn’t involved in the Lancet study. “They can be long term.”
Open enrollment is when you can sign up for health insurance, make changes to your plan, or cancel your plan—whether that plan is through your job, Medicare, or the Affordable Care Act (ACA) marketplace. It’s important to be prepared for it because it only happens once a year, and if you miss it, you may have to wait until next year if you want to adjust your health insurance plan.
Here’s everything you need to know about open enrollment.
How long is open enrollment?
Your open enrollment period depends on where you get your insurance from. For ACA Marketplace plans, open enrollment is running from Nov. 1, 2024 to Jan. 15, 2025 in most states (some states have different periods). For Medicare plans, it’s running from Oct. 15, 2024 to Dec. 7, 2024. The open enrollment period for employer-sponsored insurance plans varies, but typically, it starts in the fall and lasts for a few weeks.
How do I prepare for open enrollment?
Before making changes to your plan, make sure you review your existing plan. Consider your current medical needs, and assess if there are things you need that your plan isn’t covering.
Try to think about what medical needs you may have in the coming year. Obviously, there will be situations you won’t be able to predict, but if you know that you’ll be having medical procedures done or will need medications, for instance, take that into account.
Who should choose a high-deductible plan?
High-deductible health plans (HDHPs), just as they sound, have higher annual deductibles than other health plans—that means that you’ll have to pay more out-of-pocket costs before your insurance will start covering medical expenses. That being said, many HDHPs fully cover in-network preventive care even before you hit your deductible, so you wouldn’t have to pay out-of-pocket for those kinds of services (for instance, a routine annual physical), but you would have to pay out-of-pocket for non-preventive care, like visits to urgent care, if you haven’t hit your deductible. HDHPs also have lower monthly premiums, which is the amount you pay each month for your health insurance.
Generally speaking, if you’re relatively healthy and don’t expect to have a lot of medical needs—for instance, if you typically only have routine physicals or preventive care appointments—an HDHP might be a good option for you.
Who should not choose a high-deductible plan?
For some, the con of HDHPs is that you have to pay out-of-pocket for non-preventive care until you hit your deductible. If you expect to have more non-preventive care needs—for instance, you’re planning on having a baby soon or you have a chronic condition for which you’re undergoing treatment—an HDHP may not be the best option for you. Also, if you know that you wouldn’t be able to afford the plan’s full deductible if you had a medical emergency early on in the coming year, you may want to consider other health insurance plans instead.
What is an FSA?
FSA stands for Flexible Spending Account (sometimes Flexible Spending Arrangements), which is an employer-owned savings account that allows employees to reserve a portion of their pre-tax income for eligible medical expenses. Some employers may also make contributions to your FSA.
The money in the account usually has to be used within your health insurance plan year, but employers sometimes provide a grace period that can last up to an additional two and a half months or allow you to carry over up to $640 to the next year.
The amount of money you decide to contribute to your FSA will be available for you to use as soon as your plan coverage starts. But you generally can’t adjust how much money is in the account until the following plan year. There’s also a limit to how much you can contribute to your FSA per year, which can change from year to year.
What is an HSA?
HSA stands for Health Savings Account. Like an FSA, an HSA allows you to save money before taxes to pay for qualified medical expenses. You have to be covered under an eligible HDHP in order to contribute to an HSA. Your employer can contribute to your HSA as well. But unlike an FSA, an HSA is employee-owned, meaning that it’ll stay with you even if you change jobs. The money in your HSA also stays in there even if you don’t use it up by the end of the plan year, allowing you to save up to pay for medical needs that may come up further down the line.
Unlike an FSA, the funds in your HSA accumulate throughout the plan year, so you can only use the amount that you’ve contributed to date. That said, you can change your contribution amount at any time during the year. HSAs also have a limit to how much you can contribute per year, depending on a variety of factors.
When can I enroll in Medicare?
Most people enroll in Medicare—Part A, which is hospital insurance, and Part B, which is medical insurance—when they first become eligible for it, which is generally at the age of 65. That’s called the Initial Enrollment Period. The Initial Enrollment Period lasts for seven months, typically starting around three months before you turn 65 and ending about three months after your 65th birthday. You can look up your birth date on the Social Security Administration’s website so you can see the earliest date you can sign up.
If you miss your Initial Enrollment Period, you may also be able to sign up for Medicare, without paying a penalty, during a Special Enrollment Period, in certain qualifying situations—for instance, if you have or had health insurance coverage from your job (learn more about the Special Enrollment Period on Medicare’s website).
If you miss both those periods, you can sign up for Medicare in the General Enrollment Period, between Jan. 1 and March 31 each year, though that may carry some kind of monetary penalty.
What are the requirements for Medicare?
To be eligible for Medicare, you either have to: be 65 or older, have a disability, have End-Stage Renal Disease, or have ALS (also known as Lou Gehrig’s disease). Medicare also has residency requirements, but people who are non-U.S. citizens may still qualify, if they meet certain requirements.
The good news: You will get a glorious extra hour of sleep. The bad: It’ll be dark as a pocket by late afternoon for the next few months in the U.S.
Daylight saving time ends at 2 a.m. local time next Sunday, Nov. 3, which means you should set your clock back an hour before you go to bed. Standard time will last until March 9 when we will again “spring forward” with the return of daylight saving time.
That spring time change can be tougher on your body. Darker mornings and lighter evenings can knock your internal body clock out of whack, making it harder to fall asleep on time for weeks or longer. Studies have even found an uptick in heart attacks and strokes right after the March time change.
“Fall back” should be easier. But it still may take a while to adjust your sleep habits, not to mention the downsides of leaving work in the dark or trying exercise while there’s still enough light. Some people with seasonal affective disorder, a type of depression usually linked to the shorter days and less sunlight of fall and winter, may struggle, too.
Some health groups, including the American Medical Association and American Academy of Sleep Medicine, have said it’s time to do away with time switches and that sticking with standard time aligns better with the sun — and human biology.
Most countries do not observe daylight saving time. For those that do — mostly in Europe and North America — the date that clocks are changed varies.
Two states — Arizona and Hawaii — don’t change and stay on standard time.
Here’s what to know about the twice yearly ritual.
How the body reacts to light
The brain has a master clock that is set by exposure to sunlight and darkness. This circadian rhythm is a roughly 24-hour cycle that determines when we become sleepy and when we’re more alert. The patterns change with age, one reason that early-to-rise youngsters evolve into hard-to-wake teens.
Morning light resets the rhythm. By evening, levels of a hormone called melatonin begin to surge, triggering drowsiness. Too much light in the evening — that extra hour from daylight saving time — delays that surge and the cycle gets out of sync.
And that circadian clock affects more than sleep, also influencing things like heart rate, blood pressure, stress hormones and metabolism.
How do time changes affect sleep?
Even an hour change on the clock can throw off sleep schedules — because even though the clocks change, work and school start times stay the same.
That’s a problem because so many people are already sleep deprived. About 1 in 3 U.S. adults sleep less than the recommended seven-plus hours nightly, and more than half of U.S. teens don’t get the recommended eight-plus hours on weeknights.
Sleep deprivation is linked to heart disease, cognitive decline, obesity and numerous other problems.
How to prepare for the time change
Some people try to prepare for a time change jolt by changing their bed times little by little in the days before the change. There are ways to ease the adjustment, including getting more sunshine to help reset your circadian rhythm for healthful sleep.
Will the U.S. ever get rid of the time change?
Lawmakers occasionally propose getting rid of the time change altogether. The most prominent recent attempt, a now-stalled bipartisan bill named the Sunshine Protection Act, proposes making daylight saving time permanent. Health experts say the lawmakers have it backward — standard time should be made permanent.
TALISAY, Philippines — The number of dead and missing in massive flooding and landslides wrought by Tropical Storm Trami in the Philippines has exceeded 100 and the president said Saturday that many areas remained isolated with people in need of rescue.
Trami blew away from the northwestern Philippines on Friday, leaving at least 81 people dead and 34 others missing in in one of the Southeast Asian archipelago’s deadliest and most destructive storms so far this year, the government’s disaster-response agency said. The death toll was expected to rise as reports come in from previously isolated areas.
Dozens of police, firefighters and other emergency personnel, backed by three backhoes and sniffer dogs, dug up one of the last two missing villagers in the lakeside town of Talisay in Batangas province Saturday.
A father, who was waiting for word on his missing 14-year-old daughter, wept as rescuers placed the remains in a black body bag. Distraught, he followed police officers, who carried the body bag down a mud-strewn village alley to a police van when one weeping resident approaching him to express her sympathies.
The man said he was sure it was his daughter, but authorities needed to do checks to confirm the identity of the villager dug up in the mound.
In a nearby basketball gym at the town center, more than a dozen white coffins were laid side by side, bearing the remains of those found in the heaps of mud, boulders and trees that cascaded Thursday afternoon down the steep slope of a wooded ridge in Talisay’s Sampaloc village.
President Ferdinand Marcos, who inspected another hard-hit region southeast of Manila Saturday, said the unusually large volume of rainfall dumped by the storm — including in some areas that saw one to two months’ worth of rainfall in just 24 hours — overwhelmed flood controls in provinces lashed by Trami.
“The water was just too much,” Marcos told reporters.
“We’re not done yet with our rescue work,” he said. “Our problem here, there are still many areas that remained flooded and could not be accessed even big trucks.”
His administration, Marcos said, would plan to start work on a major flood control project that can meet the unprecedented threats posed by climate change.
More than 4.2 million people were in the path of the storm, including nearly half a million, who mostly fled to more than 6,400 emergency shelters in several provinces, the government agency said.
In an emergency Cainet meeting, Marcos raised concerns over reports by government forecasters that the storm — the 11th to hit the Philippines this year — could make a U-turn next week as it is pushed back by high-pressure winds in the South China Sea.
The storm was forecast to batter Vietnam over the weekend if it would not veer off course.
The Philippine government shut down schools and government offices for the third day on Friday to keep millions of people safe on the main northern island of Luzon. Inter-island ferry services were also suspended, stranding thousands.
Weather has cleared in many areas on Saturday, allowing cleanup work in most areas.
Each year, about 20 storms and typhoons batter the Philippines, a Southeast Asian archipelago which lies between the Pacific Ocean and the South China Sea. In 2013, Typhoon Haiyan, one of the strongest recorded tropical cyclones, left more than 7,300 people dead or missing and flattened entire villages.
SEOUL, South Korea — South Korea’s president on Thursday raised the possibility of supplying Ukraine with weapons while stressing that his government “won’t sit idle” as North Korea allegedly sends troops to support Russia’s aggression toward its neighbor.
South Korean President Yoon Suk Yeol spoke to reporters after a meeting with Polish President Andrzej Duda that came a day after U.S. and South Korean officials said they believe around 3,000 North Korean troops have been deployed to Russia and are training at several locations. South Korea’s spy agency told lawmakers that North Korea likely aims to send a total of 10,000 troops to Russia by the end of the year.
Yoon’s meeting with Duda was focused on expanding defense cooperation between the countries amid the ongoing conflict. Poland has signed a series of arms deals with South Korea in the last two years to acquire tanks, howitzers and missile launchers in an effort to bolster its military capabilities following Russia’s invasion of Ukraine.
Both Moscow and Pyongyang have denied the presence of North Korean troops.
Yoon said South Korea will work with allies and partners to prepare countermeasures that could be rolled out in stages depending on the degree of military cooperation between Pyongyang and Moscow.
Seoul’s steps could potentially include sending weapons to Ukraine, which would mark a departure from a long-standing policy of not supplying weapons to countries actively engaged in conflict, Yoon said. He said North Korea’s alleged troop deployment to Russia is a “provocation that threatens global security beyond just the Korean Peninsula and Europe.”
“If North Korea dispatches special forces to the Ukraine war as part of Russia-North Korea cooperation, we will support Ukraine in stages and also review and implement measures necessary for security on the Korean Peninsula,” Yoon said during a joint press conference with Duda.
“While we have maintained our principle of not directly supplying lethal weapons, we can also review our stance more flexibly, depending on the level of North Korean military activities,” Yoon said.
Yoon’s comments aligned with what a senior presidential official told reporters on condition of anonymity earlier this week. That official said South Korea is considering various diplomatic, economic and military options, including supplying Ukraine with both defensive and offensive weapons systems.
South Korea, a growing arms exporter, has provided humanitarian aid and other non-lethal support to Ukraine and joined U.S.-led economic sanctions against Moscow. It has so far resisted calls by Kyiv and NATO to directly supply Ukraine with weapons.
During their summit, Yoon and Duda agreed to “actively support” additional deliveries of South Korean military equipment to Poland, including a new deal for Korean K-2 tanks the governments hope to finalize within this year, Yoon’s office said.
Tensions on the Korean Peninsula have worsened since 2022 after North Korean leader Kim Jong Un used Russia’s invasion of Ukraine as a distraction to accelerate the growth of his nuclear weapons and missile program.
Seoul also worries as experts say the North may seek major technology transfers in return for sending troops, including Russian know-how on intercontinental ballistic missiles and submarines that would advance the threat posed by Kim’s nuclear arsenal.
Experts say it’s unclear how effective the North Korean soldiers would be in combat, considering their lack of active battlefield experience, outdated conventional weaponry and training experience with Russian forces. Kim may see the troop dispatch as a crucial opportunity to expose his soldiers to modern warfare and technologies, said Hong Min, an analyst at Seoul’s Korea Institute for National Unification.
During a parliamentary hearing, South Korean Defense Minister Kim Yong Hyun said that North Korean troops would likely become “cannon fodder” when deployed in combat in Ukraine and denounced Pyongyang’s leadership for “selling away its troops to an illegal invasion.”
“Troop deployment is just a phrase, and it would be more appropriate to call them as mercenaries,” he said. “The North Koreans are disguising themselves in Russian uniforms and operating under Russian control with no operational autonomy, just simply following orders.”
From smartwatches to fitness trackers, wearable technologies have the opportunity to transform how patients understand their health—long after they leave their doctor’s office. But adoption of the technology, for both patients and healthcare professionals, has been slow going.
Shyamal Patel and Dr. David Agus gathered at the TIME100 Health Leadership Forum in New York City on Oct. 22 to discuss the state of emerging technologies in healthcare and the impact they stand to have in a panel moderated by TIME senior health correspondent Alice Park.
Wearable technology could help patients monitor their sleep patterns, blood pressure, or menstrual cycle, but it’s yet to be widely adopted by the healthcare sector, says Agus, founding director and co-CEO of the Ellison Institute of Technology. “It still has not been normalized.”
In part, it’s because many healthcare providers are not yet trained in how to analyze the data. “We just haven’t built the muscle on the healthcare side to truly think about how we ingest this data and make sense of it,” says Patel, senior vice president and head of science at ŌURA, a sponsor of the TIME100 Health Leadership Forum. “If you had continuous health blood pressure data, how do you know, what do you do with it? Our practice of healthcare is built around one blood pressure measurement in your clinic.”
There also isn’t enough communication between the healthcare technology industry and healthcare providers, says Patel. “In the U.S., you have this fairly complex ecosystem of payers, providers, [and] patients. Now you can add health technology companies to that mix,” he says. “The interests of all of these players are not necessarily always aligned. So I think there is a real need for strong partnerships between these stakeholders to focus on driving better health outcomes.”
Agus points to several obstacles standing in the way of widespread adoption of wearable tech.The price point of consumer-focused wearable technology can often be inaccessible, and many products don’t have a CMS billing code for insurance reimbursement. Many healthcare professionals also still want to see studies that prove that the data from wearable tech is accurate and can encourage a change in a patient’s behavior.
“Interventions that can affect outcome are what we need, and we need companies to put the capital up front and do the studies to show they can affect outcome,” says Agus. “And once we do that, those are the technologies that we should all push and enable our patients to use, and they have to be accessible.”
It’s been a little over a decade since consumer-focused wearable technologies like fitness trackers and smart rings first became mainstream, but the industry has plenty of room to grow. “One aspect is this evolution of the technology and what we can do with it and how many aspects of our health we can understand better because we have access to this personal health technology,” says Patel. “And the second aspect is, how do we make sense of it and bring it into the practice of health care?”
The TIME100 Health Leadership Forum was presented by Merck, Deloitte, ŌURA, and PhRMA.
At the first-ever TIME100 Health Leadership Forum in New York City on Tuesday night, TIME correspondent Eliana Dockterman began a panel conversation about women’s health by mentioning that one of the speakers—Dr. Natalia Kanem, executive director of the United Nations Population Fund—gave her a bracelet backstage.
“This bracelet has 28 beads, and five of them are red, representing the days that a girl might miss school. Why? Because of period poverty,” Kanem said. “So we wear it to remind each other that there’s things that we could do to help her out, make sure she finishes her education.”
“I thought that that was a very apt symbol for what we are going to talk about today,” Dockterman said.
Kanem was joined on stage by Dr. Tlaleng Mofokeng, the U.N. special rapporteur on the right to health, and Dr. Asif Dhar, vice chair and U.S. Life Sciences and Health Care Industry Leader for Deloitte Global Consulting Services. (Deloitte is a sponsor of the TIME100 Health Leadership Forum). Mofokeng spoke about how she worked to make young women feel welcome in healthcare spaces, after noticing that some were not coming into clinics in South Africa. She said she tried to make consultation settings more relaxed, even using pop culture references to make her patients feel comfortable. She emphasized the need to approach sexual health and gender identity with patients in a “non-stigmatizing way.”
“We take for granted that the actual physical architecture of a clinic is conducive, and often that’s what turns young people away,” Mofokeng said. “It got me thinking very intentionally about the spaces we are creating within the health system for people to access care—that even that in its design has to change to be conducive for establishing therapeutic conversations about services.”
The panelists focused on how many women have shared that they distrust the healthcare system. Dockterman pointed to a recent Deloitte report, which cited a 2019 survey that found that one in five women said they felt that a medical provider had either ignored or dismissed their healthcare concerns. Dhar added that heart attacks are misdiagnosed in women more often than they are in men.
“Trust is built on experience, and if a person has a negative experience, it takes quite a while to rebuild that type of trust,” Dhar said. He referenced how actress and healthcare advocate Halle Berry described at a TIME100 event in May that her doctor initially thought she had herpes, when in reality, she was experiencing perimenopause and vaginal atrophy. “You could imagine the profound erosion of trust,” Dhar said.
The solution, he said, is to teach people in the healthcare space “to be able to have great capacity to listen.” He said technology can also be used to help address this problem, but that it must be “engineered with health equity in mind.”
“It’s just as important that those teams are infused with health equity officers, with the voice of the patient and the voice of women,” Dhar said.
Dockterman raised another example of the medical industry dismissing women’s pain that was described on the podcast “The Retrievals,” which shared the true story of how women complained of pain during their egg-retrieval surgeries but were ignored by the clinic. Later, it was revealed that a nurse had been stealing fentanyl and that the women had been enduring the procedure without painkillers.
Kanem said that many systems are male-dominated but that we’re now in a moment in time “where it is within our power to make certain changes” to combat this issue. She stressed the importance of listening to patients and taking their concerns seriously.
“Part of human rights is understanding your own value and your own worth, and it starts with a girl. So I think the expectation that we should listen to girl children, make sure that they’re educated and they’re not hiding when they have their periods and on and on, up until we build a better health system where, of course it’s automatic that we listen to everyone,” Kanem said.
Dockterman also asked Mofokeng about a brief she had filed in a U.S. court in the lead-up to the U.S. Supreme Court hearing arguments in Dobbs v. Jackson Women’s Health Organization. In the brief, Mofokeng argued that restricting abortion rights would violate international human rights treaties that the U.S. had ratified.
“The right to have autonomy and make decisions on your health care is a right, especially in the context of abortion, that should be discussed between physician or caregiver and the woman—there should be no other interference,” Mofokeng said.
She went on to say that the federal government doesn’t interfere in other medical procedures, like a knee or heart transplant. “Doctors are trusted and patients are trusted to make the right decisions, and so the use of criminal legal frameworks in this instance of abortion further stigmatizes, discriminates, and pushes people further to the margins,” Mofokeng said.
Mofokeng added that when people start taking away one right, it often makes it easier to take away others—for instance, access to contraception.
According to a 2017 study by the World Health Organization and the Guttmacher Institute, about 25 million unsafe abortions occurred globally each year between 2010 and 2014.
“When we see maternal mortality, we know that women’s health is global health,” Kanem said. “All of this can be avoided if we have a caring healthcare system.”
The TIME100 Health Leadership Forum was presented by Merck, Deloitte, ŌURA, and PhRMA.
Dr. Uché Blackstock, Adrelia Allen, and Ai-jen Poo gathered at the TIME100 Health Leadership Forum in New York City on Oct. 22 to discuss the need to create equitable access to health care during a panel moderated by TIME health correspondent Jamie Ducharme.
There’s an overarching lack of support in the U.S. when it comes to making sure everyone has equal access to health care—especially when it comes to supporting caregivers, says Poo, president of the National Domestic Workers Alliance and executive director of Caring Across Generations. “Our country was never fully … invested in caregiving, the non-medicalized care that we need to live well,” she said.
It’s an oversight that has meant that many people fall through the gaps. Blackstock, an author and the founder and CEO of Advancing Health Equity, cited a recent study from the Commonwealth Fund that found that the U.S. continues to have the highest rate of maternal deaths of any high-income nation—with two-thirds of deaths occuring during the postpartum period.
“That caregiving in the postpartum period for people who give birth is just absent in our country,” Blackstock said. “People need the most support … with small babies. You need a village, but you also need a system that’s going to make sure that you are not only psychologically OK, but you’re physically OK.”
When it comes to clinical trials, Allen, executive director of clinical trial patient diversity at Merck, a sponsor of the TIME100 Health Leadership Forum, said that there is work to be done to ensure that all clinical trials are accessible to all communities—whether that be by enrolling more diverse populations or training researchers in cultural competency. She stressed the importance of shifting perspectives from “equal to equity” to ensure meaningful steps are taken to be inclusive of all communities. Allen says that a new FDA requirement, which requires pharmaceutical companies to create Diversity Action Plans to support some clinical trials, means that we “are on the cusp” of seeing clinical trials become more accessible.
Poo noted that governmental action is essential to making sure everyone, everywhere has access to the health care they deserve. “There’s some basic policies in the country that we need to make in our ability to take care of ourselves and the people we love,” she said. “And if we do that, I think you can be transformative in overall health outcomes.”
The TIME100 Health Leadership Forum was presented by Merck, Deloitte, ŌURA, and PhRMA.
WASHINGTON — Millions of people with private health insurance would be able to pick up over-the-counter methods like condoms, the “morning after” pill and birth control pills for free under a new rule the White House proposed on Monday.
Right now, health insurers must cover the cost of prescribed contraception, including prescription birth control or even condoms that doctors have issued a prescription for. But the new rule would expand that coverage, allowing millions of people on private health insurance to pick up free condoms, birth control pills, or “morning after” pills from local storefronts without a prescription.
The proposal comes days before Election Day, as Vice President Kamala Harris affixes her presidential campaign to a promise of expanding women’s health care access in the wake of the U.S. Supreme Court’s decision to undo nationwide abortion rights two years ago. Harris has sought to craft a distinct contrast from her Republican challenger, Donald Trump, who appointed some of the judges who issued that ruling.
“The proposed rule we announce today would expand access to birth control at no additional cost for millions of consumers,” Health and Human Services Secretary Xavier Becerra said in a statement. “Bottom line: women should have control over their personal health care decisions. And issuers and providers have an obligation to comply with the law.”
The emergency contraceptives that people on private insurance would be able to access without costs include levonorgestrel, a pill that needs to be taken immediately after sex to prevent pregnancy and is more commonly known by the brand name “Plan B.”
Without a doctor’s prescription, women may pay as much as $50 for a pack of the pills. And women who delay buying the medication in order to get a doctor’s prescription could jeopardize the pill’s effectiveness, since it is most likely to prevent a pregnancy within 72 hours after sex.
If implemented, the new rule would also require insurers to fully bear the cost of the once-a-day Opill, a new over-the-counter birth control pill that the U.S. Food and Drug Administration approved last year. A one-month supply of the pills costs $20.
Federal mandates for private health insurance to cover contraceptive care were first introduced with the Affordable Care Act, which required plans to pick up the cost of FDA-approved birth control that had been prescribed by a doctor as a preventative service.
The proposed rule would not impact those on Medicaid, the insurance program for the poorest Americans. States are largely left to design their own rules around Medicaid coverage for contraception, and few cover over-the-counter methods like Plan B or condoms.
MIAMI — Hurricane Oscar formed Saturday off the coast of the Bahamas, the National Hurricane Center in Miami said. It characterized the storm as “tiny.”
The government of the Bahamas has issued a hurricane warning for the Turks and Caicos Islands and the southeastern Bahamas. The government of Cuba has issued a hurricane watch for the provinces of Guantanamo, Holguin, and Las Tunas.
The storm’s maximum sustained winds were clocked at 80 mph (130 kph) with higher gusts. Its center was located about 165 miles (260 kilometers) east-southeast of the southeastern Bahamas and about 470 miles (755 kilometers) east of Camaguey, Cuba.
Hours earlier, Tropical Storm Nadine formed off Mexico’s southern Caribbean coast and was moving inland across Belize. Heavy rain and tropical storm conditions were occurring over parts of Belize and the Yucatan peninsula.
A tropical storm warning is in effect for Belize City and from Belize to Cancun, Mexico, including Cozumel.
The hurricane center said Nadine was located about 20 miles (35 kilometers) east of Belize City, with winds of 13 mph (20 kph). Its maximum sustained winds were at 50 mph (85 kph).
Nadine was expected to move across Belize, northern Guatemala, and southern Mexico through Sunday, the center added.
