Category: Blog

Avian influenza (H5N1), or bird flu, is a highly contagious virus that primarily affects birds but has recently mutated more quickly and spread more aggressively enhancing its ability to infect a wider range of species. Bird flu has adapted to impact mammals, including cattle, felines, raccoons, and sea lions, signaling its potential to cause a broader health crisis. 

One of the most concerning developments is bird flu’s impact on cattle. Infections have been reported in over 950 herds across 16 states, with reinfections in Idaho cattle farms demonstrating the virus’s ability to persist and evolve. These newer mutations raise concerns about bird flu’s ability to spread from cattle to humans.

Scientists worry that further mutations of bird flu could enable increased transmission from human to human. A recent study found that a single mutation significantly increased the virus’s ability to infect human cells. While human infections remain relatively rare, 70 cases of H5N1 have been reported, with one fatality. Most cases present mild symptoms like eye redness, low fever, cough, and muscle aches. However, severe cases—including symptoms of high fever, respiratory distress, altered consciousness, and seizures—have been documented. Symptoms typically appear between 2 to 7 days after exposure. The exact duration of contagiousness remains unclear, though individuals are believed to be most contagious during the early stages, with severe cases potentially contagious for several weeks.

The impact of the bird flu is already being felt in the U.S., particularly in the egg industry, where outbreaks have led to major production losses and price spikes. However, the country’s ability to respond has been weakened by cuts made during the Trump administration, which undermined pandemic preparedness. Key public health programs were scaled back, and the Centers for Disease Control and Prevention (CDC) recently lost one-tenth of its workforce, including staff in the Epidemic Intelligence Service, which monitors disease outbreaks. The National Institute of Health (NIH) also suffered cuts, losing 1,500 employees. Additionally, a Trump-era policy restricting public communications from health agencies delayed the release of crucial information regarding the bird flu outbreak by several weeks.

These federal cuts have left the U.S. vulnerable, with fewer experts monitoring potential outbreaks and limited stockpiles of antiviral medications and vaccines. While a federal stockpile of bird flu vaccines exists, experts warn that they may be outdated and insufficient for large-scale immunization. 

Beyond public health concerns, the bird flu outbreak has significant economic and policy implications. The bipartisan Healthy Poultry Assistance and Indemnification Act (HPAI Act), introduced by Senators Chris Coons and Roger Wicker, aims to provide fair compensation to poultry farmers. The HPAI Act seeks to expand compensation to all affected farms with confirmed infections to include all affected farms in control areas, ensuring equitable relief and strengthening the poultry supply chain.

Regulatory agencies are responding to emerging threats as well. The FDA, under the Food Safety Modernization Act, now requires pet food manufacturers to reassess safety plans for products containing raw poultry or dairy due to bird flu contamination risks. 

Continued collaboration between the USDA, FDA, and CDC remains essential to mitigate risks to both human and animal health. Despite these efforts, administrative failures continue to hinder preparedness. The USDA recently admitted to mistakenly firing key employees involved in the avian flu response, exacerbating concerns about the federal government’s ability to manage the outbreak effectively.

The warning signs of another potential pandemic are evident. The U.S. cannot afford to repeat past mistakes—delays in data, inadequate testing, and slow government response, all echoes of the COVID-19 crisis, are already emerging. Without swift action to restore pandemic preparedness, enhance disease surveillance, and improve public communication, the nation is vulnerable to another health crisis.

On February 14, 2025, a second federal judge halted President Trump’s executive order banning federal support for gender-affirming care for transgender youth under 19. The “denial-of-care” executive order came after a barrage of other orders discriminating against trans and nonbinary Americans in areas like the military, sports, and federal prisons. President Trump’s denial-of-care executive order would cut off federal funding for institutions, such as hospitals, providing gender-affirming care like hormone treatments and puberty blockers for trans and nonbinary youth. The executive order would also force federally funded insurance programs like Medicaid to stop providing coverage for gender-affirming medical care for youth. 

The attorney generals of Washington State, Oregon, and Minnesota sued the Trump administration on the grounds of equal protection and spending power violations. Judge Lauren King from the Western District of Washington granted a temporary restraining order on the executive order for 14 days, which came as a relief to many Americans. The decision came a day after a Baltimore federal judge blocked the same executive order in a case filed by families with transgender or nonbinary children. On February 19, 2025, Colorado joined the three other states in the suit against the Trump Administration.

In their amended complaint, the attorney generals assert that President Trump’s executive order violates Constitutional principles on multiple grounds. First, it denies equal protection to transgender and nonbinary people by discriminating against a vulnerable minority group without a legitimate government interest. Second, it usurps congressional legislative and exclusive spending powers. Third, it violates the Tenth Amendment separation of powers doctrine by attempting to unilaterally, and without congressional approval, interfere with the medical profession which is traditionally within States’ police powers.

The Trump administration claims that it has a legitimate interest in protecting children from treatments with negative health consequences, but this rings false. The Trump administration’s true interest is fueling their disinformation campaign characterizing transgender as an “ideology” that must be stopped from taking hold. This characterization paired with far-right social media accounts has led to threats and violence against gender-affirming care providers. For example, the Boston Children’s Hospital received 3 bomb threats and continued online harassment after right-wing social media users made misleading claims that the hospital was performing hysterectomies on children and “needed to be stopped.”

Furthermore, the denial-of-care executive order has had drastic and tangible effects on trans and nonbinary youth across America. According to the APA, about one-third of all trans and nonbinary youth live in a state that has restricted gender-affirming care. 45% of families with trans or nonbinary children at least considered relocating to a state without restrictions on care. Since restrictions on gender-affirming care began rolling out, severe depression, self-harm tendencies, and suicidal ideation have proliferated among trans and nonbinary youth. In a survey of 18,000 American LGBTQ+ youth conducted by The Trevor Project, 36% reported they had seriously considered suicide in the past year, and within the survey, 46% of all trans persons reported they had seriously considered suicide.

Access to gender-affirming care has lifesaving and immediate effects on the mental and physical wellness of trans and nonbinary people. The long-term benefits of gender-affirming care on mental and physical health are well supported, but a recent NIH study showed that after just 12 months of gender-affirming care, the odds of severe depression and suicidality lowered by 60% and 73%, respectively. Other studies have shown significant decreases in gender dysphoria and exceeding low levels (less than 1%) of regret after beginning hormonal treatments and performing gender-affirming surgeries.

The effects of harmful executive orders from Trump’s office are clear. Claims of protecting children from treatments with negative health consequences are unconvincing when opposed by countless scientific studies and personal anecdotes supporting the value of gender-affirming care. However, Republicans in the House of Representatives have crafted a slew of anti-LGBTQ+ riders, such as provisions attached to spending bills that require federal agencies not to support gender-affirming care. These riders will prohibit federal employees and their families from accessing gender-affirming care, even if Trump’s executive orders are struck down. Therefore, creating public pressure on local representatives is vital to protect gender-affirming care from Congressional overreach.

Medicaid work requirements have been proposed over the years by lawmakers at the federal level and in various states to reduce government spending. Work requirements have also been proposed as a means of removing theoretical disincentives for able-bodied adults to seek and maintain employment. 

Work requirements are not a novel concept in safety net programs. They currently exist in the Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF). However, the efficacy of work requirements in Medicaid to promote employment is not a settled debate. 

In 2018, the Trump Administration gave states the flexibility to choose whether to implement work requirements by approving 1115 waivers for states to impose work requirements in their respective Medicaid programs. Thirteen statesincluding Georgia, Arkansas, and Kentucky received approval under this process. However, most of these waivers were struck down in court. More recently, lawmakers in Congress introduced a bill that would implement work requirements for able-bodied adults. The Congressional Budget Office (CBO) estimates under this or a similar proposal, approximately 15 million Medicaid recipients would be subject to work requirements resulting in $109 billion in savings over 10 years. 

Kaiser Family Foundation analyzed the work status and characteristics of Medicaid enrollees in 2023 and found that the majority of adults aged 19-64 covered by Medicaid were working. Additionally, the data indicates that health status and education level are strong predictors of work. In other words, the less healthy you are, the less likely you are to work. This presents an interesting question: could Medicaid work requirements inadvertently make it more difficult for people to get back to work? 

The syllogism goes something like this: Access to health care makes people healthy. Healthy people are more likely to work. Access to health care makes people more likely to work. This is an oversimplification, but it’s also common sense. If Medicaid can provide people with the health care, they need to get healthy, they will be more likely to get back to work. 

According to a 2021 CBO report, work requirements for Medicaid enrollees are less likely to lead to employment and more likely to reduce income, including benefits, when applied to people who have conditions that make it difficult to find and keep a job such as taking care of children or going to school. The report also proposes a different approach: requiring able-bodied adults without dependents to work. The report explains, “Under this policy, which would be similar to the requirements imposed in Arkansas, able-bodied adults who have no dependents and who are between the ages of 19 and 49 would lose Medicaid coverage if they did not participate in work-related activities for at least 80 hours per month for three or more months over the course of a year.” 

Health policy experts are weighing in on the future of Medicaid work requirements under President Trump’s second term. The President of Paragon Health Institute, and former Special Assistant for Economic Policy to President Trump in his first term, acknowledged the legal challenges that would accompany these efforts are probably not worth the effort. However, it is unclear at this time whether the Trump Administration will revive previous efforts or take a different approach. 

On January 20th, 2025, President Trump issued Executive Order 14168, titled “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government”. With this executive order, Trump has made it the policy of the United States to recognize only two sexes, male and female. On February 19th, 2025, the U.S. Department of Health and Human Services took action to support this executive order and provided a list of definitions the federal government must use regarding sex-based legislation and policy. HHS guidance now defines sex as “a person’s immutable biological classification as either male or female”, a female as “of the sex characterized by a reproductive system with the biological function of producing eggs (ova),” and a male as “a person of the sex characterized by a reproductive system with the biological function of producing sperm.” 

Trump intends for this executive order and associated policy changes within HHS and other areas of the federal government to restrict ideas of fluid sex and gender expression that were embraced by the prior administration. Theexecutive order states, “This unhealthy road is paved by an ongoing and purposeful attack against the ordinary and longstanding use and understanding of biological and scientific terms, replacing the immutable biological reality of sex with an internal, fluid, and subjective sense of self unmoored from biological facts.” However, this executive order may be further from biological reality than the Trump administration asserts. District Judge Ana Reyes recently questioned Trump’s legal team regarding the order and its effect on transgender people serving in the military, arguing that the order fails to acknowledge that some people are born intersex due to various biological differences in their chromosomes, hormone expression, and hormone metabolism. On this point, Trump’s lawyers admitted they lacked knowledge of how chromosomes can differ among individuals and struggled to answer questions on the motive behind the executive order.

Judge Reyes’ criticism of the order highlights the main issues of Trump’s order not only from a medical and biological perspective but also from a policy perspective. First, the order does not make any mention of naturally occurring conditions that would put someone outside the male/female gender binary. Some individuals are born with chromosomes other than XY or XX, such as XXX (Trisomy X), XXY (Klinefelter Syndrome), or XO (Turner Syndrome). Some individuals may also have conditions that affect their ability to express or metabolize hormones including androgens and estrogens (such as congenital adrenal hyperplasia or complete androgen insensitivity syndrome), which then influences how their sex organs develop internally and externally. This wide range of biological differences provides scientific support to the idea that biological sex naturally falls along a spectrum rather than being solely restricted to two options. 

Second, Trump’s attempt to make policies in the name of biological facts that are not based on real medical science may create more problems than it solves. Judge Reyes highlighted the issues this executive order creates with the ability of transgender people to serve our country in the military, but the order will likely affect the ability of transgender and intersex people to participate in competitive sports and will cause problems for female transgender prisoners who will now need to be moved from women’s prisons to male prisons. Although transgender and intersex individuals make up a small portion of athletes or prisoners, these changes will cause a significant disturbance in their lives and send a message to all Americans who fall outside the male/female gender binary that the government has no interest in acknowledging the struggles they face that stem from sex and gender identity. This decision sets a dangerous precedent in federal policymaking that the current administration will commandeer science in order to engrain conservative ideals into society. This strategy may also be used to tackle other controversial health law issues, such as hindering federal approval for certain vaccines. Although this executive order is already facing numerous legal challenges with several different plaintiffs moving for preliminary injunctions, the decision to use science as a guise to pursue cultural change is a bold step during Trump’s first several months in office this term.

“No one should have to be fighting and insurance at the same time,” said Arete Tsoukalas, a 26-year-old who was diagnosed with leukemia. Tsoukalas’ treatment came at a hefty price, as she was forced to shell out a $13,000 per month copay for the treatment drug she required, a copay she simply could not afford as a college student. Isaac Rosenbloom, 43, doesn’t even know if he has cancer because his insurance company won’t approve an MRI for the “nodules on his lungs.” Melanie Duquette, 70, underwent an intense back surgery, after which she was sent to recover at a rehab center, at the behest of her doctor. However, after six weeks of coverage, her insurance company has denied her to stay any longer, even though “her medical team argued she should remain.” Duquette, speaking out against her insurer, said, “[t]hey deny people care while they’re making millions of dollars.”

Sadly, the denials that Tsoukalas, Rosenbloom, and Duquette have faced are just the tip of the insurance denial iceberg – with over 850 million insurance claims denied per year. According to appeals company, Claimable, and data from the health-policy nonprofit, Kaiser Family Foundation, over five billion payment claims are processed annually. Although almost twenty percent of claims are denied, “less than 1% of patients appeal.”

While there are law firms that specialize in insurance claim denials and understand the detailed appeals process for various insurers, attempting to appeal your claim denial as a customer – especially without the information, expertise, and resources these firms possess – can be a daunting task. 

Why is it so daunting you may ask. Cheryl Clark, a veteran health care reporter sought to answer this question. In her quest to create a guide for appealing insurance claim denials, she was met with the same response from insurance experts, lawyers, and physicians: “[g]reat idea. But almost impossible to do.” Clark noted that this project was essentially impossible because:

There are many kinds of insurance in the U.S., and they have different processes for appealing a denial. And no lawmakers or regulators in state and federal governments have forced all insurers to follow one simple standard.

Although the appeals process can be daunting, especially for individuals facing challenges such as battling cancer or being denied rehabilitative care (all while fighting the insurance company), the “few who appeal often win.” According to a report by the Wall Street Journal, the appeals process labors can prove worthwhile, with “up to three-quarters of claim appeals [being] granted.” 

While a one-size-fits-all guide to insurance denials is likely impossible to produce, some steps can be taken to appeal a denied health insurance claim. The Wall Street Journal suggests the following five steps:

1. Read up

   • Understand your coverage and benefits. 

2. Take note

   • Log dates of calls to your insurer, who you spoke with, billing codes for denied services, etc. 

3. Fight back

   • Call your insurance company and ask why your service was denied. 
   • Ask how to appeal. 

4. Get help

   • Nonprofits such as the Patient Advocate Foundation and the Medicare Rights Center may help craft appeals on your behalf. 

5. Escalate 

   • Write a letter explaining why your denied claim was not warranted. Have your doctor write to the insurance company explaining that the treatment prescribed was medically necessary. Appeal to a higher authority within the insurance company. 

By reading this article, you likely know more about insurance claim appeals than your counterparts. Although less than 1% of insurance patients appeal denied claims, over three-quarters of these appeals are approved. If the insurance company is not willing to fight for your health, you must fight for yourself. 

Artificial intelligence (AI) is significantly transforming the pharmaceutical industry by enhancing various aspects of drug discovery and development. Traditionally, bringing a new drug to market has been an arduous, costly, and time-consuming process, often taking more than a decade and requiring billions of dollars in investment. The high failure rate of drug candidates, coupled with the extensive trial-and-error approach in drug formulation, has long been a barrier to innovation in medicine. By analyzing complex biological data, AI accelerates the identification of potential drug candidates, thereby reducing both the time and costs associated with bringing new medications to market. 

Traditionally, drug discovery is a lengthy and expensive endeavor, often taking over a decade and costing approximately $2 billion, with a high failure rate in clinical trials. AI addresses these challenges by analyzing complex biological systems, identifying disease biomarkers, and simulating drug-target interactions, which streamlines the early stages of drug development.  

One notable advancement is the use of AI in predicting protein structures, a critical aspect of understanding disease mechanisms and developing targeted therapies. For instance, AI models have been developed to accurately predict the three-dimensional structures of proteins, facilitating the design of drugs that can effectively interact with specific biological targets. Moreover, AI algorithms can process extensive patient data, including genetic information, medical records, and lifestyle factors, to create personalized treatment plans.  By analyzing patterns and correlations within this data, AI can identify hidden insights and predict individual treatment responses with unprecedented accuracy. 

Clinical trials are essential for evaluating the safety and efficacy of new drugs but are often time-consuming and costly. AI streamlines this process by improving patient selection, predicting drug responses, and automating data analysis. By analyzing electronic health records and genetic information, AI identifies suitable candidates for trials more efficiently, potentially reducing trial durations and costs. Additionally, AI can enhance the design of clinical trials by simulating various scenarios and optimizing protocols to increase the likelihood of success. Machine learning models can predict potential outcomes based on historical data, allowing researchers to make informed decisions about trial designs.  

While AI offers numerous benefits, its successful application in drug development depends on the availability of high-quality data and the careful consideration of ethical concerns. Ensuring data privacy and addressing biases in AI models are critical for the reliable and equitable development of new therapies. Integrating AI into existing pharmaceutical workflows requires collaboration between data scientists, clinicians, and regulatory bodies to establish standardized practices and guidelines. As AI continues to evolve, ongoing research and development are essential to fully realize its potential in revolutionizing drug discovery and development. 

AI is poised to revolutionize pharmaceutical development by expediting drug discovery and enhancing the efficiency of clinical trials. As technology continues to advance, integrating AI into pharmaceutical research holds the promise of delivering more effective and personalized treatments to patients worldwide.