A weekly roundup of public health news
Health insurance coverage declining as Americans struggle with costs
Millions of Americans have lost health insurance in recent years, and many of those who do have coverage are underinsured, new data from the Commonwealth Fund show.
The findings, released October 22 as part of the fund’s biennial survey, add to the growing evidence that health care is becoming more unaffordable and less accessible to many Americans.
The share of working-age U.S. adults without health insurance rose from about 9% in 2024 to just over 11% in 2026, according to the latest survey, which was fielded this summer. Nearly half of adults ages 19 to 64 lacked adequate coverage at some point during the year.
The findings mark a reversal after years of expanding insurance access. Between 2010 and 2025, the national uninsured rate fell by half, largely because of the Affordable Care Act, which expanded Medicaid eligibility and made private insurance more affordable through federal subsidies.
Recent coverage losses have been especially pronounced among young adults and people with lower incomes. Enrollment in Medicaid and private plans purchased through ACA marketplaces has declined as costs for the latter have risen significantly. The changes follow the expiration of pandemic-era Medicaid protections and enhanced federal subsidies that helped people afford insurance premiums.
Having insurance does not necessarily mean people can afford health care. Among working-age adults who maintained coverage throughout the year, 30% were underinsured, including about half of those with marketplace plans. People are considered underinsured when they have coverage but deductibles and other out-of-pocket costs are so high that they hinder their access to care.
Half of working-age adults reported skipping or delaying needed medical care because of costs, up from 46% in 2022. A third were paying off medical debt.
Whether Americans have insurance varies widely by where they live, according to new data from the U.S. Census Bureau. The agency’s latest report on state-by-state coverage, released October 29, shows that uninsured rates in 2025 ranged from about 3% in Massachusetts to a high of 16% in Texas. Nationally, about 8% of people lacked coverage.
States that expanded Medicaid eligibility under the Affordable Care Act generally had lower uninsured rates. The average was 7% in expansion states, compared with 12% in states that had not expanded eligibility. In Texas, a non-expansion state, nearly 22% of adults 19 to 64 lacked health insurance coverage.
Children also faced substantial differences in coverage. Nationally, 6% of children younger than 19 were uninsured, including about 13% in Texas. Children in states without Medicaid expansion had nearly twice the uninsured rate of those in expansion states.
The census numbers reflect the state of the nation in 2025. Rates of uninsurance are expected to skyrocket in the U.S. in coming years under policy changes since made by the Trump administration and Congress, including Medicaid work requirements that take effect next year.
Family caregivers face soaring out-of-pocket costs
Caring for aging parents, spouses and other loved ones is taking an increasingly heavy financial toll on American families, new AARP research finds.
Released October 28, the research showed costs have risen nearly 60% over the past five years for family caregivers, a group that includes 63 million Americans.
Family caregivers now spend an average of $11,500 annually on caregiving expenses, up from about $7,200 five years ago. The total amounts to nearly a third of household income, according to the report, which was based on a survey of U.S. adults conducted this summer.
The financial burden is especially heavy for lower-income families. Caregivers with household incomes below $40,000 spend an average of 76% of their income on caregiving.
Caregivers spend an average of nearly $4,800 annually on housing and household needs, including groceries and home modifications. Medical expenses average more than $3,300, including insurance premiums, prescriptions and payments to health care providers.
Caring for someone with Alzheimer’s disease or another form of dementia is particularly expensive, averaging nearly $16,000 annually.
Costs vary by race and ethnicity. Black caregivers spend an average of 52% of their household income on caregiving, while Asian American and Pacific Islander caregivers have the highest annual expenses, averaging nearly $17,000.
Family caregivers provide support that allows older adults and people with disabilities to remain in their homes. Responsibilities range from preparing meals and managing medications to providing personal care and transportation to medical appointments. Nationwide, their unpaid work is valued at about $1 trillion annually, the report said.
New report documents more than 900 pregnancy-related prosecutions
More than 900 women across the U.S. have faced criminal charges related to their pregnancies in just three years, a new update from Pregnancy Justice shows.
Most of the cases, filed between June 2025 and June 2022 — when Roe v Wade was overturned — involved allegations of drug use. In 70 cases, women were charged after they experienced a pregnancy loss. Thirteen cases included allegations of obtaining, attempting or researching an abortion.
Criminal charges were filed in 23 states, with the largest numbers in South Carolina, Oklahoma and Alabama. Together, the three states — which each have strong restrictions on abortion — accounted for nearly 90% of cases.
Prosecutors tended to apply existing criminal laws to actions that allegedly occurred during pregnancy, the research found. Of 955 documented charges, 92% were brought under child abuse, neglect or endangerment laws.
Medical settings, which are generally considered to be safe and confidential environments for patients, played a significant role in the prosecutions. Information obtained or disclosed during medical care was involved in 700 of the cases, researchers found.
Despite the focus on alleged pregnancy-related harm, prosecutors generally did not have to prove that a fetus or infant had been injured. Nearly 90% of the charges were brought under laws that didn’t require that evidence.
Other recent public health news of note:
• Americans continue to experience a range of health hazards on the job, new research says. An October 21 review in Frontiers in Public Health found health workers in pathology labs and autopsy rooms can be exposed to high levels of formaldehyde, which is associated with nasopharyngeal cancer. Workers in the construction industry, who are often exposed to airborne particles, organic solvents and metals, have elevated risks for chronic kidney disease, reports new research in the American Journal of Industrial Medicine. And findings in the same journal show heat-related deaths are more common in men who work outdoors, with more than 300 reported heat deaths in California alone over about 10 years.
• The Eaton fire in Los Angeles, which devastated much of Altadena and surrounding areas, exposed residents to a plume of chemicals, a new study in Science Advances reports. The January 2025 fire burned buildings, vehicles and infrastructure, releasing high amounts of lead, chlorine and arsenic, researchers found. At the peak of the burning, nearly 7 million people were exposed to lead concentrations that were 80 times higher than typical.
The Watch is written by Michele Late, who has more than two decades of experience as a public health journalist. than two decades of experience as a public health journalist.
