New York confirms 1st locally acquired case of chikungunya virus in 6 years in US

(NEW YORK) — Four Western U.S. states have come together to issue unified vaccine recommendations for the upcoming respiratory illness season, and California has enacted a new law to base the state’s immunization guidance on independent medical organizations, rather than the U.S. Centers for Disease Control and Prevention.

The West Coast states including California, Washington, Oregon, and Hawaii — all led by Democratic governors — banded together earlier this month to create the West Coast Health Alliance (WCHA), citing what they called an erosion of trust in the CDC.

“The alliance represents a unified regional response to the Trump Administration’s destruction of the U.S. CDC’s credibility and scientific integrity,” stated a press release Wednesday from California Gov. Gavin Newsom.

Also on Wednesday, Newsom signed a new law, which will shift the immunization recommendations the state will recommend from the CDC to independent medical organizations that include the American Academy of Family Physicians (AAFP), American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists (ACOG).

The recommendations issued by the West Coast states on Wednesday include guidance for receiving the COVID-19, flu and RSV vaccines.

“Science matters. We will ensure our policies are based on rigorous science. We stand united with our partner states and medical experts to put public health and safety before politics. I will continue to do everything in my power to protect Washingtonians,” said Washington Gov. Bob Ferguson.

The announcement came the day ahead of a two-day meeting of the CDC’s the Advisory Committee on Immunization Practices (ACIP), during which the panel of advisers recently picked by HHS Secretary Robert F. Kennedy is expected to vote Thursday on some vaccines on the CDC childhood immunization schedule and Friday on recommendations for COVID-19 vaccines.

The FDA has approved the new COVID-19 vaccines only for those at high risk for severe illness including those 65 and older. Anyone who falls out of those categories is allowed to get a prescription for the vaccine after discussing it with their doctor.

The association that represents many insurance companies (AHIP) pledged to cover the cost for any vaccine that is part of the current guidelines before the new ACIP makes their recommendations this week. The current guidelines suggest anyone older than 6 months should consider getting the COVID-19 and annual flu shot until at least the end of 2026.

Several states have also made rules that allow anyone who wants a vaccine to get one at their pharmacy.

In a statement earlier this month, a spokesperson for the U.S. Department of Health and Human Services blasted the West Coast states’ plans for a health alliance, criticizing COVID-era policies in “Democrat-run states.”

The statement added, “ACIP remains the scientific body guiding immunization recommendations in this country, and HHS will ensure policy is based on rigorous evidence and Gold Standard Science, not the failed politics of the pandemic.

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(IDAHO) — More than six months after Idaho’s near-total abortion ban went into effect, a small town nestled in the state’s northern mountain ranges lost its labor and delivery service — and access to such care could now be imperiled further by looming Medicaid cuts.

Bonner General Health, located in Sandpoint, Idaho, announced in March 2023 that it would no longer provide obstetrical care, citing the state’s “legal and political climate” as one of the factors that drove the decision. Abortions in Idaho are illegal except in the cases of rape, incest and the life of the mother.

The hospital in the city of around 10,000 people was one of three health systems in Idaho to shutter their labor and delivery services in recent years. The state has lost over a third of its OB-GYNs — 94 of 268 — since the ban was enacted in 2022, according to a new study in medical journal JAMA Network Open.

Local health care providers and advocates ABC News spoke with said that Medicaid cuts could put additional labor and delivery services at risk of closing — adding further pressure to Idaho’s already strained maternal and reproductive health care system.

More than 350,000 of the state’s residents are insured by Medicaid, including those covered by the expansion plan voters approved through a ballot measure in 2018. Idaho was already seeking federal approval to institute its own work requirements after Gov. Brad Little signed a Medicaid cost bill this spring.

Under the federal changes, the state could lose $3 billion in funding over the next decade and 37,000 residents could lose coverage, according to analysis by KFF.

“We are living with the consequences of when you criminalize practicing medicine, you lose doctors, and I think that, coupled with these cuts at the federal level, are going to prove devastating for Idaho’s already precarious rural health system,” Melanie Folwell, the executive director of Idahoans United for Women and Families, the group spearheading a ballot initiative to restore abortion rights, told ABC News.

After Bonner General closed its obstetric services, Kootenai Health, located an hour south, inherited its patients, which included residents across the northern tip of the state. Some women now have to drive two to three hours to get prenatal care or to deliver at Kootenai, according to one of its OB-GYNs, Dr. Brenna McCrummen.

Traveling that far for care, especially in cases of complications, can endanger women and infants, McCrummen noted.

“There have been patients that have delivered on the side of the road because they’re not able to get to the hospital in time. There have been babies that have gone to the NICU who didn’t do as well as they probably would have had they not had to travel long distances,” she told ABC News.

The loss of OB-GYNs in the state has hit rural areas like those in the north especially hard, the JAMA Network Open study noted. A vast majority of the remaining physicians providing obstetric care are concentrated in Idaho’s seven most populated counties, leaving only 23 OB-GYNs to serve a population of over half a million across the rest of the state, according to the study.

Those giving birth aren’t the only ones affected by the shortage of physicians. OB-GYNs like McCrummen have packed schedules, leading to long wait times for other reproductive care. Patients seeking annual exams, for instance, often have to book five months in advance, McCrummen explained. These exams provide vital preventive health services, such as screenings for cervical and breast cancer.

Across the U.S., more than 35% of counties are maternity care deserts — areas that lack obstetrics clinicians — according to Dr. Michael Warren, the chief medical and health officer of the March of Dimes, a nonprofit focused on maternal and infant health.

Reductions to Medicaid funding could exacerbate the problem, Warren told ABC News.

“The worry is that as these changes are happening in the Medicaid space, it’s going to be harder, particularly for rural hospitals, to maintain those obstetric services, and if they discontinue those, we’ve got more maternity care deserts, and we’ve got a greater risk of both moms and babies having worse outcomes,” Warren said.

The Medicaid cuts were passed into law in July as part of President Donald Trump’s massive tax and policy bill. Idaho Sen. Mike Crapo, a Republican who serves as chairman of the Senate Finance Committee, defended the bill in a press release earlier this month, saying that “targeting waste, fraud and abuse in the program ensures that it stays financially viable for the populations who need it most.” Crapo has also argued that the legislation’s $50 billion rural hospital fund is the “largest investment in decades in rural health care.”

In Idaho, Medicaid covers around a third of births, according to data from March of Dimes. Even before cuts to coverage, labor and delivery units were difficult to keep open, Toni Lawson, a vice president of the Idaho Hospital Association, told ABC News.

Lawson explained that such units require “special equipment” and “specially trained staff” on call, which is expensive to maintain — especially in rural areas with lower birth volumes and where Medicaid reimburses less than cost. Additionally, she said, hospitals have had difficulty recruiting and retaining qualified OB-GYNs amidst Idaho’s abortion restrictions.

As a result, looming reductions to Medicaid funding could push these healthcare systems over the edge, according to Lawson.

“What you’ll see in Idaho, before you see hospitals close, is we’ll have more closures of labor and delivery services,” she said.

These cuts could also worsen outcomes for the women who lose coverage, physician assistant specialist Amy Klingler explained.

“If patients don’t have access to insurance and they don’t have access to Medicaid, sometimes they delay prenatal care, we don’t catch complications early enough, and it puts the baby and the mother’s lives at risk,” Klingler, who works in a small mountain town in central Idaho, told ABC News.

The two problems can compound — Klingler noted that the risk of not catching complications early on is heightened when the same women also have to travel further to receive care.

While she is able to provide prenatal care to her patients, the closest hospital that can deliver babies is a 60-mile drive from her clinic — a route she says that lacks cell service for 45 miles.

“So in the best circumstances, it takes planning and forethought. And then when things are serious and complicated, it’s much more dangerous,” Klingler said.

“Complicated pregnancies in Idaho are the scary ones right now,” she added.

In cases when the mother’s health becomes at risk, health providers say that the state’s abortion ban limits the emergency care they are able to provide. A state court issued a ruling in April slightly expanding the medical exception to the ban in response to a lawsuit filed by the Center for Reproductive Rights, but advocates still argue the existing law constricts physicians’ ability to supply adequate care.

The organization Idahoans United for Women and Families is currently gathering signatures to get a measure on the ballot in 2026 to return the state to the standard of abortion access it had before the Supreme Court overturned Roe v. Wade in 2022.

However, Lawson said “there is no silver bullet” to solve depleted access to maternal and reproductive care.

“It is going to have to be a combination of things and certainly removing barriers to recruitment is an important part of that,” she said, adding that the state must also address rural hospitals’ precarious financial position amid the projected loss of Medicaid funding.

Breana Lipscomb, the senior manager of maternal health and rights at advocacy group the Center for Reproductive Rights, noted that all of these factors are “working in tandem” to restrict access.

“It’s making health care even further out of reach for people, and this is particularly concerning for Black people, for people living in rural areas, for low income folks and for people with capacity to birth,” Lipscomb said.

“I am really afraid of what we might see,” she added.

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(NEW YORK) — During a speech earlier this week, Secretary of Defense Pete Hegseth announced the implementation of new fitness standards for the military.

In addition to the newly proposed annual fitness exam, Hegseth’s speech emphasized “gender-neutral” testing with men and women required to meet the same minimum physical performance benchmarks.

Speaking to hundreds of high-ranking military officials in Quantico, Virginia, Hegseth said it was important that certain combat positions return “to the highest male standard,” acknowledging that it may lead to fewer women serving in combat roles.

The current training is not different for male and female servicemembers.

“If women can make it, excellent. If not, it is what it is,” he said on Tuesday. “If that means no women qualify for some combat jobs, so be it. That is not the intent, but it could be the result.”

“I don’t want my son serving alongside troops who are out of shape or in [a] combat unit with females who can’t meet the same combat arms physical standards as men,” Hegseth added.

Before becoming secretary, Hegseth had spoken out against women in combat roles, but softened his stance during his confirmation hearings, saying he supports women serving in combat roles so long as they meet the same standards as men — an approach the military says has been in place for nearly a decade.

Some experts in exercise science and in the history of women’s service in the military told ABC News that while there is room for improvement in military fitness, they are concerned there’s a false narrative that female servicemembers are the only ones not meeting certain fitness standards.

“To me, Hegseth wants a military that looks a certain way … which [is] definitely male and muscular,” Jill Hasday, a professor at the University of Minnesota Law School with expertise in sex discrimination in the military, told ABC News. “It seems like his expectation is that once they enforce more ‘rigorous standards,’ more women will be pushed out.”

In response to a request for comment, a spokesperson for the Department of Defense said they did not “have anything to provide beyond Secretary Hegseth’s remarks.”

President Donald Trump also addressed officials at the Tuesday meeting, saying that “together, we’re reawakening the warrior spirit.”

Combat roles for women

In 2016, when the military opened certain high-intensity combat jobs to women, including the special operations forces, then-Secretary Ash Carter stated the importance of making sure female servicemembers “qualify and meet the standards.”

However, during his speech, Hegseth said the Department was issuing a directive that each military branch would ensure each requirement for “every designated combat arms position returns to the highest male standard only.”

In a follow-up memo from Hegseth, he stated the annual service test will require a passing grade of 70% and will be “sex-neutral” and “male standard.”

Additionally, beginning in 2026, the U.S. Army’s new fitness standards will require both male and female soldiers to meet the same minimum physical performance benchmarks for the demands of the battlefield.

Shawn Arent, a professor and chair in the department of exercise science at the University of South Carolina’s Arnold School of Public Health, said there’s nothing wrong with enforcing standards, but that there is a contradiction in Hegseth saying the tests will be “sex-normed” and also “male standard for combat roles.”

“I think we need to get away from referencing ‘male standards,'” Arent told ABC News. “They’re either standards or they’re a sex-specific standard. … I think there’s one really important caveat to this: those standards then need to make sense. In other words, what are they based on? And, if they’re arbitrary standards, then that feels certainly discriminatory.”

Arent said the standards need to be evidence-based and that it is possible the current standards need to be lowered or raised.

“It makes it sound like there’s this dramatic change, and that everything’s based on what a male can accomplish,” he said. “It should be what a combat soldier, Marine, sailor, airman, whatever, what they can accomplish in that particular role, male or female.”

Stewart Smith, a former Navy SEAL and current fitness trainer, including for those looking to enter the military, agreed, saying gender-neutral doesn’t equate to male standards.

“I don’t want to singularly say women can’t do these because there will be women that can, but I don’t think it’s a necessary focus,” Smith told ABC News. “Should [all servicemembers] be in shape and healthy and look good in a uniform? 100%. But … statistically speaking, these [maximum] standards are at a level that most men aren’t getting.”

He went on, “Saying something is gender-neutral doesn’t mean it’s the maximum male standard, right? Because, once again, if that’s the case, most males aren’t reaching that maximum male standard.”

What it would take to improve standards, according to experts

Smith and Arent said they are in favor of improving fitness standards across the military, but that Hegseth’s speech did not take into account all of the additional steps it would take to improve physical performance.

For example, Smith said improving fitness standards needs to come with improving food quality and sleep quality in the military.

“There’s a lot more problems than just high fitness standards,” he said. “Nutrition and sleep are required for that level of physical performance. … Those are the two biggest components to optimal performance that we’re stressing is you need to sleep well, you need to eat well, and you need time to train. All three are not a current priority in the military.”

Arent said this change in standards presents an opportunity for the military to examine how it can train people up to the new standards it will set.

He added that there’s a plethora of information on human performance and human optimization compared to even a decade ago

“As somebody who works with a lot of female athletes, there are ways to absolutely train them to be beasts,” Arent said. “Women are incredibly resilient, cognitively capable, and I think if you start thinking about combat roles, tactical decision-making, the ability to handle stress under these pressure situations — yes, physical fitness is a component to that, but what else are we assessing that goes with these roles?”

“We have a real opportunity here, if they lean into it to rather than setting these standards, like, ‘If you can’t meet it, too bad you suck. You’re out,'” he continued. “What are we going to do to modify how we’re approaching this to actually get more people to hit those standards?”

Too much focus on physical fitness and not other skills

The experts told ABC News that Hegseth’s speech did not focus on the other components that make people qualified to take on military combat roles.

“There’s more to leadership and service than the highest of [physical training] scores,” Smith said. “There’s learning tactics and leadership, and there’s more to leadership than great fitness tests.”

“Obviously, physical fitness can be important for many military roles, but it’s not the only thing that’s important. You don’t win a war through push-ups,” Hasday added. “Even when women were officially barred from combat, there were a lot of female troops that were essentially co-located with the troops, and they would go around with the combat troops.”

Hasday explained that in some countries where troops have been stationed, female civilians are not allowed to speak to men who are not members of their family. Having female service members with the male combat troops allowed the military to speak to female civilians to get information or to provide help.

“So, the idea, again, that you’re going to win a war by going outside someone’s house and doing push-ups, it just doesn’t seem realistic,” she said.

Female veterans hit back at Hegseth

Hegseth’s comments drew criticism from female veterans, particularly those who held combat roles.

Rep. Mikie Sherrill, a Democrat from New Jersey and a former Navy helicopter pilot, released a statement saying there is “no evidence that women cannot ably serve in combat positions.”

“Eliminating the current highly rigorous standards for women in combat positions has nothing to do with increasing lethality and everything to do with forcing women out of the Armed Forces,” she said.

Amy McGrath, a former Marine fighter pilot and Democratic Senate candidate in Kentucky, posted a video on Facebook stating there is no male standard or female standard for roles, including flying a fighter jet or being an artillery officer.

“Since combat roles have been open for qualified women, there have always been one standard for those jobs,” she said. “It’s a slap in the face and offensive to suggest otherwise.”

Arent said he can understand why this would be upsetting to former female servicemembers who held combat roles, particularly in reference to Hegseth’s comments about not wanting his son to be in a combat unit with women who weren’t meeting the same physical standards as men.

“Because of the way it [was] said, it makes it sound like it’s the females that are deficient,” he said. “But I would argue, by the same token, if they are physically capable, what if they’re more cognitively capable, more tactically capable, you would want them alongside your son, if that’s the case.”

Arent went on, “It’s not just women that aren’t meeting these standards. We have a whole lot of men that can’t meet some of these standards.”

 

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