unraveled

How Trump’s cuts are reshaping America’s health system

Ashley L. Conti for STAT

The full impacts of the incoming Medicaid cuts won’t be felt for years, but many parts of the health care system are already racing to prepare — especially in rural states, where changes are expected to hit the hardest.

Take Maine, for instance. The state has the nation’s highest proportion of its population living in rural areas and an above-average share of Medicare and Medicaid beneficiaries. STAT’s Daniel Payne visited health systems in “vacationland,” and everyone he spoke to expected the state to end up with fewer hospital services once the cuts are fully enacted. Some had seen an impact already.

“The capabilities in the little hospitals just keep declining,” said Tom Judge, the founding executive director of LifeFlight of Maine. “Demand is going to keep going up.”

Daniel traveled to Louisiana and Maine and interviewed dozens of executives, doctors, and policymakers for STAT’s latest series, Unraveled. His stories will explore the consequences of President Trump’s unprecedented cuts to the health care safety net. Read the first installment now.

science

Turning island life into a laboratory

Cases of — and news about — alpha gal syndrome have surged over the last decade or so. You’ve likely heard of it: the tickborne red meat allergy. Researchers at Massachusetts General Brigham are launching what they call a first-of-its-kind study focused on who develops the syndrome after a tick bite, and why. The study, based on Martha’s Vineyard, will recruit up to 300 island residents and follow them for two years. The island has been transformed by the syndrome in recent years, per Boston Globe reporting.

It’s not the first time a storied Massachusetts island has forged new ground when it comes to tickborne diseases. In 2016, former STAT reporter Ike Swetlitz wrote about how scientists on Nantucket had proposed genetically modifying tens of thousands of mice to stop the spread of Lyme disease. “If we don’t change how we do science for this, we will be violating our democratic ideals,” MIT researcher Kevin Esvelt told Ike at the time. He’s still working on the project, called Mice Against Ticks. Now, the team will reportedly study the mice on a remote island before moving on to Nantucket and Martha’s Vineyard.

first opinion

Reflecting on cancer screening in long-term care 

As a cancer epidemiologist, Kim Johnson knows that a diagnosis of stage 4 breast cancer is not very common. So when her aunt, at 78, died of stage 4 breast cancer just three weeks after her diagnosis, Johnson knew that something was off. Her aunt lived in a long-term care facility, but it turns out that there are no major national cancer screening guidelines written for older individuals living in these facilities.

“In reading literature on this topic, I came away feeling that substantial attention was devoted to the harms of screening residents of long-term care facilities, with much less attention to identifying those residents for whom screening may still provide meaningful benefit,” Johnson writes in a new First Opinion essay. Read more about how her aunt’s death made her reevaluate existing guidelines.