Health

WASHINGTON — The government shutdown has reopened debate on what has been a central issue for both major political parties in the last 15 years: the future of health coverage under the Affordable Care Act.

Tax credits for people who get health insurance through the marketplaces created by the Affordable Care Act, also known as Obamacare, expire at the end of the year.

Democrats say they won’t vote to reopen the government until Republicans negotiate an extension of the expanded subsidies. Republicans say they won’t negotiate until Democrats vote to reopen the government. Lawmakers in both parties have been working on potential solutions behind the scenes, hoping that leaders will eventually start to talk, but it’s unclear if the two sides could find compromise.

As Congress circles the issue, a poll from The Associated Press-NORC Center for Public Affairs Research found that about 6 in 10 Americans are “extremely” or “very” concerned about their health costs going up in the next year. Those worries extend across age groups and include people with and without health insurance, the poll found.

A look at the subsidies that are expiring, the politics of the ACA and what Congress might do:

Enhanced premium help during the pandemic

Passed in 2010, the ACA was meant to decrease the number of uninsured people in the country and make coverage more affordable for those who don’t have private insurance. The law created state by state exchanges, some of which are run by the individual states, to try to increase the pool of the insured and bring down rates.

In 2021, when Democrats controlled Congress and the White House during the COVID-19 pandemic, they expanded premium help that was already in the law. The changes included eliminating premiums for some lower-income enrollees, ensuring that higher earners paid no more than 8.5% of their income and expanding eligibility for middle-class earners.

The expanded subsidies pushed enrollment to new levels and drove the rate of uninsured people to a historic low. This year, a record 24 million people have signed up for insurance coverage through the ACA, in large part because billions of dollars in subsidies have made the plans more affordable for many people.

If the tax credits expire, annual out-of-pocket premiums are estimated to increase by 114% — an average of $1,016 — next year, according to an analysis from KFF.

Democrats push to extend subsidies

Democrats extended those tax credits in 2022 for another three years but were not able to make them permanent. The credits are set to expire Jan. 1, with Republicans now in full control.

Lacking in power and sensing a political opportunity, Democrats used some of their only leverage and forced a government shutdown over the issue when federal funding ran out on Oct. 1. They say they won’t vote for a House-passed bill to reopen the government until Republicans give them some certainty that the subsidies will be extended.

Democrats introduced legislation in September to permanently extend the premium tax credits, but they have suggested that they are open to a shorter period.

“We need a serious negotiation,” Senate Democratic leader Chuck Schumer has repeatedly said.

Republicans try to scale the ACA back, again

The Democratic demands on health care have reignited longstanding Republican complaints about the ACA, which they have campaigned against for years and tried and failed to repeal in 2017. Many in the party say that if Congress is going to act, they want to scrap the expanded subsidies and overhaul the entire law.

The problem is not the expiring subsidies but “the cost of health care,” Republican Sen. Rick Scott of Florida said Tuesday.

In a virtual briefing Tuesday, the libertarian Cato Institute and the conservative Paragon Health Institute branded the subsidies as President Joe Biden’s “COVID credits” and claimed they’ve enabled fraudsters to sign people up for fully subsidized plans without their knowledge.

Others have pitched more modest proposals that could potentially win over some Democrats. Senate Majority Leader John Thune, R-S.D., has said he is open to extending the subsidies with changes, including lower income limits and a stop to auto-enrollment that may sign up people who don’t need the coverage.

The ACA is “in desperate need of reform,” Thune has said.

House Republicans are considering their own ideas for reforming the ACA, including proposals for phasing out the subsidies for new enrollees. And they have begun to discuss whether to combine health care reforms with a new government funding bill and send it to the Senate for consideration once they return to Washington.

“We will probably negotiate some off-ramp” to ease the transition back to pre-COVID-19 levels, said Maryland Rep. Andy Harris, the head of the conservative House Freedom Caucus, during a virtual town hall Tuesday.

Is compromise possible?

A number of Republicans want to extend the subsidies. Sen. Josh Hawley, R-Mo., said most people who are using the exchanges created by the ACA “don’t really have another option, and it’s already really, really expensive. So I think there are things we can do to reform the program.”

Hawley said he had been having conversations with other senators about what those changes could be, including proposals for income limits, which he said he sees as a “very reasonable.”

Bipartisan groups of lawmakers have been discussing the income limits and other ideas, including making the lowest-income people pay very low premiums instead of nothing. Some Republicans have advocated for that change to ensure that all enrollees are aware they have coverage and need it. Other proposals would extend the subsidies for a year or two or slowly phase them out.

It’s unclear if any of those ideas could gain traction on both sides — or any interest from the White House, where President Donald Trump has remained mostly disengaged. Despite the public stalemate, though, lawmakers are feeling increased urgency to find a solution as the Nov. 1 open enrollment date approaches.

Democratic Sen. Jeanne Shaheen of New Hampshire has been talking to lawmakers since the shutdown began, trying to find areas of compromise. On Tuesday, she suggested that Congress could also look at extending the enrollment dates for the ACA since Congress is stalled on the subsidies.

“These costs are going to affect all of us, and it’s going to affect our health care system,” she said.

Jalonick writes for the Associated Press. AP writers Lisa Mascaro and Joey Cappelletti in Washington and Ali Swenson in New York contributed to this report.

Health officials in the United States are reviewing whether to remove aluminium from some common vaccines, as part of the Trump administration’s escalating attacks on vaccines.

The Department of Health and Human Services has reduced some vaccine access. The agency scaled back COVID-19 vaccine recommendations, approved COVID-19 vaccines for fewer people and aimed to remove the preservative thimerosal from US vaccines. Experts told PolitiFact scientific research did not support its removal.

During a September 22 news conference, in which US President Donald Trump told people not to take Tylenol during pregnancy, he also mentioned another objective. “We want no aluminium in the vaccine,” he said. The administration was already in the process of removing aluminium from vaccines, he added.

About two weeks later, on October 8, the US Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices, or ACIP, announced a new working group focused on the childhood vaccine schedule. Its discussion topics include vaccine ingredient safety and aluminium adjuvants.

Robert Malone, an ACIP member who has opposed COVID-19 vaccines, told Axios he expected the ACIP would determine there was “a lot of evidence” of “issues” with aluminium in vaccines. The committee would likely vote to re-categorise vaccines containing aluminium adjuvants so that people would have to discuss with their doctor before getting them, Malone told Axios.

That could have far-reaching ramifications. Here’s what to know about aluminium in vaccines.

A: Small amounts of aluminium are sometimes included in vaccines as adjuvants, or substances that boost the body’s immune response to the vaccine to ensure protection from infection.

That boost means people can get fewer vaccine doses in smaller quantities.

Q: When used, how much aluminium is in a vaccine?

A: Vaccines with aluminium adjuvants usually contain less than 1mg aluminium per dose, according to the Children’s Hospital of Philadelphia.

That is a pretty abstract number. To help make it more concrete: a milligram is one-thousandth (1/1,000th) of 1g. One gram is about the weight of a raisin or a stick of gum. Imagine cutting one of those items into 1,000 equal pieces. One of the pieces would be about 1mg.

Here is another way to think about it.

People come in contact with and consume aluminium all of the time. It is one of the most abundant metal elements in the Earth’s crust, according to the US Geological Survey. It is naturally occurring in soil, air and water. Food is the main way people are exposed to aluminium. The average adult eats 7mg to 9mg of aluminium per day, according to the CDC.

A baby in its first six months might receive a total of about 4.4mg of aluminium from recommended vaccines. In the same period of time, a breastfed infant would ingest about 7mg of aluminium from breastmilk, and a formula-fed baby would ingest about 38mg from formula.

Q: How long have vaccines contained aluminium?

A: Aluminium adjuvants have been used in vaccines for more than 70 years, the CDC said.

“Aluminium is one of our oldest adjuvants; it’s been used in vaccines since the 1920s,” said Dr Peter Hotez, a Baylor College of Medicine professor and codirector of Texas Children’s Hospital Center for Vaccine Development.

Q: How do we know it’s safe to include small amounts of aluminium in vaccines?

A: Every vaccine’s safety and efficacy are tested in animal studies and human clinical trials before the US Food and Drug Administration (FDA) licenses it for public use. Every vaccine containing adjuvants has been tested, and health agencies continuously monitor their safety, the CDC said.

Over several decades of use, vaccines with aluminium adjuvants have been proven safe, the FDA said.

Vaccines containing aluminium have been “given to billions of people worldwide now”, said Dr Kawsar Talaat, a professor at Johns Hopkins Bloomberg School of Public Health.

A growing body of research has also found that aluminium adjuvants do not cause aluminium toxicity or other adverse outcomes.

Q: Do aluminium adjuvants have any risks?

A: Rarely, some people have allergic reactions to aluminium in the same way they might have allergic reactions to other substances, Talaat said.

In 2022, researchers published a retrospective, observational study on more than 325,000 children that found an association between vaccine-related aluminium exposure and persistent asthma. Association is not the same as causation, meaning the study did not prove a link between aluminium in vaccines and asthma.

Experts from the CDC and the American Academy of Pediatrics encouraged more research on the subject because the backwards-looking observational study did not prove causation and also had limitations, including that it excluded many children who developed asthma before they turned two years old.

A 2025 study found no increased risk of asthma associated with childhood exposure to aluminium-absorbed vaccines.

Q: Which vaccines contain aluminium adjuvants?

A: At least 25 vaccines approved for use in the US have aluminium adjuvants, the CDC says. That includes vaccines that protect against HPV, hepatitis A and B and diphtheria, tetanus, and acellular pertussis (whooping cough).

Q: Which vaccines do not contain aluminium adjuvants?

The CDC’s list of vaccines without adjuvants includes vaccines against COVID-19, Ebola, meningococcal, polio and rabies. Additionally, most seasonal flu shots and the vaccine against measles, mumps and rubella do not contain aluminium adjuvants.

Q: Can we remove aluminium from vaccines?

A: Not quickly. If it could be done at all, it would take years to develop, test and license new, aluminium-free vaccines. Many of the vaccines with aluminium adjuvants do not have aluminium-free formulas.

“A vaccine is licensed based on all of its ingredients and the exact manufacturing process,” Talaat said. “If you were to take an ingredient out of a vaccine, you would have to start all over with the clinical trials and the manufacturing, and it is highly possible that some of these vaccines wouldn’t work without the aluminium in there.”

Although other adjuvants exist, they are newer and often more scarce than aluminium, which is abundant.

An immediate ban on aluminium in vaccines would drastically reduce people’s ability to protect themselves and others against numerous diseases.

“I think we’d see outbreaks of vaccine-preventable diseases,” Talaat said.

Q: Why do people think aluminium in vaccines is causing autism?

A: A 2011 study said vaccines with aluminium adjuvants “may be a significant” contributing factor to the rising number of autism diagnoses in kids, Nature reported.

A year later, a World Health Organization vaccine safety committee called the 2011 study “seriously flawed”. The 2011 study and another by the same authors compared vaccines’ aluminium content and autism rates in several countries, the WHO group said, but that cannot be used to establish a causal relationship.

“We studied aluminium, and have no link between aluminium and autism,” Talaat said.

Chris McCausland won the 2024 series of Strictly Come Dancing with professional partner Dianne Buswell, but the pair faced a number of challenges during their time on the show

Comedian Chris McCausland‘s triumph on last year’s Strictly Come Dancing came despite numerous obstacles – but not all of them were related to the Liverpool-born comedian’s retinitis pigmentosa, which robbed him of his sight almost entirely in his early twenties.

Indeed, he reveals, even if he’d retained his vision, he might have lost it regardless during rehearsal sessions for the programme.

While Chris and professional dance partner Dianne Buswell were rehearsing their Samba for Halloween Week, the Australian professional dancer, who is expecting her first child with boyfriend Joe Sugg, kicked backwards a touch too vigorously.

Chris remembers that the dancer “caught me so hard in the face that I almost threw up and had to lie down for twenty minutes to recover”.

In his new autobiography, Keep Laughing, he continues: “I took the entire impact of her flying foot right on one eyeball. It’s honestly a good job they didn’t work already or I would have been doing that dance half blind anyway and Strictly would have had an insurance payout like no other.”

But the biggest challenge to the dancing pair wasn’t Chris’ condition, but Dianne’s.

Their apparently effortless Week Eight Couple’s Choice routine to John Lennon’s 1970 classic Instant Karma masked a hidden crisis.

The dramatic performance featured a sudden blackout which, Chris reveals, was intended to transport the studio audience and BBC viewers into his world of darkness. It was an extraordinary television moment, and both the programme’s judges and fans had an enormous emotional reaction.

However, what nobody else realised was that Dianne had been genuinely struggling in the lead-up to the live programme.

Chris revealed: “The only downside to this dance for us was that Dianne had been really ill all day, so we hadn’t been able to enjoy it as much as we would have liked.”

Dianna had been battling a stomach bug, and Chris quipped that the daring moment when the stage lights returned after the blackout to show him spinning rapidly with Dianne draped across his shoulders could have had some very nasty outcomes.

He penned: “She had been unable to keep anything down and had spent a lot of that day in or near a toilet, so we were just grateful that it was only the pyrotechnics that went off, or that fast spin out of the darkness could have been a very different surprise!”.

The routine earned thunderous applause from the crowd and a score of 33 out of a potential 40 points from the judging panel – Craig Revel Horwood, Motsi Mabuse, Shirley Ballas and Anton Du Beke.

Craig declared the “poignant blackout moment” was “absolutely spectacular” whilst head judge Shirley became tearful and, as she composed herself, told Chris: “You come out every week with your heart on your sleeve, and you give us 100%.”

He revealed that if medical science were to find a cure for his blindness one day, he would first look up some video clips from his time on Strictly: “I’ll certainly have to sit down with Dianne, to watch our dances and actually see what we were able to accomplish each week.”

California Gov. Gavin Newsom this week signed a suite of privacy protection bills for transgender patients amid continuing threats by the Trump administration.

But there was one glaring omission that LGBTQ+ advocates and political strategists say is part of an increasingly complex dance the Democrat faces as he curates a more centrist profile for a potential presidential bid.

Newsom vetoed a bill that would have required insurers to cover, and pharmacists to dispense, 12 months of hormone therapy at one time to transgender patients and others. The proposal was a top priority for trans rights leaders, who said it was crucial to preserve care as clinics close or limit gender-affirming services under White House pressure.

Political experts say Newsom’s veto highlights how charged trans care has become for Democrats nationally and, in particular, for Newsom, who as San Francisco mayor engaged in civil disobedience by allowing gay couples to marry at City Hall. The veto, along with his lukewarm response to anti-trans rhetoric, they argue, is part of an alarming pattern that could damage his credibility with key voters in his base.

“Even if there were no political motivations whatsoever under Newsom’s decision, there are certainly political ramifications of which he is very aware,” said Dan Schnur, a former GOP political strategist who is now a politics lecturer at the University of California-Berkeley. “He is smart enough to know that this is an issue that’s going to anger his base, but in return, may make him more acceptable to large numbers of swing voters.”

Earlier this year on Newsom’s podcast, the governor told the late conservative activist Charlie Kirk that trans athletes competing in women’s sports was “deeply unfair,” triggering a backlash among his party’s base and LGBTQ+ leaders. And he has described trans issues as a “major problem for the Democratic Party,” saying Donald Trump’s trans-focused campaign ads were “devastating” for his party in 2024.

Still, in a conversation with YouTube streamer ConnorEatsPants this month, Newsom defended himself “as a guy who’s literally put my political life on the line for the community for decades, has been a champion and a leader.”

“He doesn’t want to face the criticism as someone who, I’m sure, is trying to line himself up for the presidency, when the current anti-trans rhetoric is so loud,” said Ariela Cuellar, a spokesperson for the California LGBTQ Health and Human Services Network.

Caroline Menjivar, the state senator who introduced the measure, described her bill as “the most tangible and effective” measure this year to help trans people at a time when they are being singled out for what she described as “targeted discrimination.”

In a legislature in which Democrats hold supermajorities in both houses, lawmakers sent the bill to Newsom on a party-line vote. Earlier this year, Washington became the first to enact a state law extending hormone therapy coverage to a 12-month supply.

In a veto message on the California bill, Newsom cited its potential to drive up health care costs, impacts that an independent analysis found would be negligible.

“At a time when individuals are facing double-digit rate increases in their health care premiums across the nation, we must take great care to not enact policies that further drive up the cost of health care, no matter how well-intended,” Newsom wrote.

Under the Trump administration, federal agencies have been directed to limit access to gender-affirming care for children, which Trump has referred to as “chemical and surgical mutilation,” and demanded documents from or threatened investigations of institutions that provide it.

In recent months, Stanford Medicine, Children’s Hospital Los Angeles, and Kaiser Permanente have reduced or eliminated gender-affirming care for patients under 19, a sign of the chilling effect Trump’s executive orders have had on health care, even in one of the nation’s most progressive states.

California already mandates wide coverage of gender-affirming health care, including hormone therapy, but pharmacists can currently dispense only a 90-day supply. Menjivar’s bill would have allowed 12-month supplies, modeled after a 2016 law that allowed women to receive an annual supply of birth control.

Luke Healy, who told legislators at an April hearing that he was “a 24-year-old detransitioner” and no longer believed he was a woman, criticized the attempt to increase coverage of services he thought were “irreversibly harmful” to him.

“I believe that bills like this are forcing doctors to turn healthy bodies into perpetual medical problems in the name of an ideology,” Healy testified.

The California Association of Health Plans opposed the bill over provisions that would limit the use of certain practices such as prior authorization and step therapy, which require insurer approval before care is provided and force patients and doctors to try other therapies first.

“These safeguards are essential for applying evidence-based prescribing standards and responsibly managing costs — ensuring patients receive appropriate care while keeping premiums in check,” said spokesperson Mary Ellen Grant.

An analysis by the California Health Benefits Review Program, which independently reviews bills relating to health insurance, concluded that annual premium increases resulting from the bill’s implementation would be negligible and that “no long-term impacts on utilization or cost” were expected.

Shannon Minter, legal director for the National Center for LGBTQ Rights, said Newsom’s economic argument was “not plausible.” Although he said he considers Newsom a strong ally of the transgender community, Minter noted he was “deeply disappointed” to see the governor’s veto.

“I understand he’s trying to respond to this political moment, and I wish he would respond to it by modeling language and policies that can genuinely bring people along.”

Newsom’s press office declined to comment further.

Following the podcast interview with Kirk, Cuellar said, advocacy groups backing SB 418 grew concerned about a potential veto and made a point to highlight voices of other patients who would benefit, including menopausal women and cancer patients. It was a starkly different strategy than what they might have done before Trump took office.

“Had we run this bill in 2022-2023, the messaging would have been totally different,” said another proponent who requested anonymity because they were not authorized to speak publicly on the issue.

“We could have been very loud and proud. In 2023, we might have gotten a signing ceremony.”

Advocates for trans rights were so wary of the current political climate that some also felt the need to steer clear of promoting a separate bill that would have expanded coverage of hormone therapy and other treatments for menopause and perimenopause. That bill, authored by Assembly member Rebecca Bauer-Kahan, who has spoken movingly about her struggles with health care for perimenopause, was also vetoed.

In the meantime, said Jovan Wolf, a trans man and military veteran, patients like him will be left to suffer. Wolf, who had taken testosterone for more than 15 years, tried to restart hormone therapy in March, following a two-year hiatus in which he contemplated having children.

Doctors at the Department of Veterans Affairs told him it was too late. Days earlier, the Trump administration had announced it would phase out hormone therapy and other treatments for gender dysphoria.

“Having estrogen pumping through my body, it’s just not a good feeling for me, physically, mentally. And when I’m on testosterone, I feel balanced,” said Wolf, who eventually received care elsewhere. “It should be my decision and my decision only.”

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.

It was a major talking point in the final months of Donald Trump’s 2024 presidential campaign: If re-elected, the Republican leader pledged to make in vitro fertilisation (IVF) free for those seeking to get pregnant.

“Under the Trump administration, we are going to be paying for that treatment,” Trump told NBC News last year, adding that his plans would cover “all Americans that get it, all Americans that need it”.

“We’re going to be paying for that treatment. Or we’re going to be mandating that the insurance company pay.”

While that campaign promise remains unrealised, the Trump administration took a step on Thursday to make the procedure more accessible.

Speaking from the Oval Office, Trump announced a collaboration with the company EMD Serono, a subsidiary of the pharmaceutical giant Merck, to offer lower-priced fertility drugs on his upcoming prescription marketplace, TrumpRx.

“ EMD Serono, the largest fertility drug manufacturer in the world, has agreed to provide massive discounts to all fertility drugs they sell in the United States, including the most popular drug of all, the IVF drug Gonal-F,” Trump told reporters.

Expanding TrumpRx project

The announcement marks the third major pharmaceutical company to agree to provide discounted products on TrumpRx, a direct-to-consumer website slated to launch in 2026.

Trump had threatened drug companies in September with a 100-percent tariff on their products unless they started to build manufacturing facilities in the US.

But that tariff was postponed after the pharmaceutical manufacturer Pfizer announced a deal with TrumpRx on September 30, a day before the tax hike was slated to hit. AstraZeneca, another power player in the industry, followed suit last week.

In Thursday’s news conference, Trump once again credited his tariff threats with bringing the companies to heel.

“They’ll bring a significant portion of their drug manufacturing back to the United States,” Trump said of EMD Serono. “That’s for a lot of reasons, but primarily because of the election result, November 5th, and maybe most importantly because of the tariffs.”

In addition to the forthcoming discounts from EMD Serono, Trump indicated he would encourage insurance companies to expand coverage for IVF treatments.

In the US, laws vary by state as to whether health insurance must cover fertility treatments like IVF. Trump touted the guidance as a breakthrough in making reproductive healthcare more accessible and affordable.

“Effective immediately, for the first time ever, we will make it legal for companies to offer supplemental insurance plans specifically for fertility,” Trump said.

“ Americans will be able to opt in, do specialised coverage, just as they get vision and dental insurance.”

Those plans typically come at an extra fee, on top of regular health insurance rates. That raises questions about how effective the new insurance guidance will be.

More than 26 million Americans – roughly 8 percent of the population – are uninsured, according to US census data. Even more lack access to supplemental policies for dental and vision care.

The American Dental Association, an industry professional group, estimates more than 22 percent of US adults lacked dental insurance as of 2021.

Trump seemed to acknowledge gaps in coverage during his remarks, but he maintained that the new government guidance would offer some adults a pathway to parenthood.

“They’re going to get fertility insurance for the first time,” he continued. “So I don’t know.  I don’t know how well these things are covered.”

A campaign-trail controversy

The Republican leader also credited a 2024 court decision with propelling him to focus on IVF treatments.

IVF involves removing eggs from a patient’s ovaries and fertilising them in a laboratory environment. These eggs are then inserted into the patient’s uterus or frozen for future use.

The use of such treatments is on the rise in the US: In 2023, the American Society for Reproductive Medicine found that 95,860 babies were born as the result of an IVF procedure.

But in February the following year, a ruling from the Alabama Supreme Court prompted fears about whether IVF would remain widely available.

In a novel decision, the court – located in a strongly conservative state – ruled that embryos created through IVF could be considered children under state law, thereby making the destruction of such embryos potentially a criminal act.

The decision sent shockwaves throughout the IVF industry, with clinics in Alabama temporarily suspending services. Discarding embryos is standard practice in IVF: Generally, more eggs are collected than will ultimately be used, and not all fertilised eggs will be suitable to start a pregnancy.

Within weeks, the Alabama state legislature stepped in to shield IVF providers from prosecution. But the ruling created lingering concerns that IVF could be targeted by anti-abortion rights advocates.

On Thursday, Trump revisited that controversy, which happened in the midst of his re-election bid. He called the court’s ruling a “bad decision” and credited it with helping to make him aware of IVF.

“I wasn’t that familiar with it,” Trump said. “Now I think I’ve sort of become the father.”

Senator Katie Britt, who represents the state of Alabama, echoed that evaluation, praising Trump for taking steps to protect IVF.

Thursday was not the first time Trump has gestured at lowering costs for the fertility procedure. In February, he also issued a presidential order calling on his administration to start “protecting IVF access and aggressively reducing out-of-pocket and health plan costs”.

“ Mr President, this is the most pro-IVF thing that any president in the history of the United States of America has done,” Britt told Trump on Thursday. “You are the reason why the Republican Party is now the party of parents.”

Addressing the US birthrate

Trump, who previously called himself the “fertilisation president”  during a Women’s History Month event, also framed the new measures as progress towards increasing the US birthrate.

In April, the Centers for Disease Control and Prevention (CDC) reported that fertility remained at a historic low, rising slightly in 2024 to 1.6 births per woman.

Those numbers have fuelled a push within the Republican Party to ignite a new baby boom, with right-wing figures like tech billionaire Elon Musk going so far as to call the low birthrate “the biggest danger civilization faces by far”.

At Thursday’s meeting, top figures in the Trump administration echoed those concerns, including Health and Human Services Secretary Robert F Kennedy Jr.

“We are below replacement right now,” he said, referencing the number of births needed to outpace deaths in the US. “That is a national security threat to our country.”

Mehmet Oz, who serves under Kennedy as the administrator for Medicaid services, took a more positive approach, framing the new IVF guidance as the beginning of a reversal of that downward trend.

“There are going to be a lot of Trump babies,” Oz quipped. “I think that’s probably a good thing. But it turns out the fundamental creative force in society is about making babies.”

But it remains to be seen if insurance companies and employers will follow through with Trump’s guidance to offer supplemental fertility benefits for adults seeking to get pregnant.

Most Americans receive health insurance as part of their workplace benefits. Senator Britt argued the guidelines would put employers “in the driver’s seat”, allowing them to shape the benefits they offer to their workers.

“Employers are going to be able to decide how to cover the root causes of infertility, things like obesity and metabolic health, and other things that are impacting infertility,” she said. “We want employers to be the ones that can make those decisions, not the government.”

But for Democrats, the guidance fell far short of what Trump promised on the campaign trail.

“Donald Trump lied when he pledged to make IVF available to every family for FREE,” Senator Elizabeth Warren of Massachusetts posted afterwards on social media. “It’s insulting – a broken promise.”

Thousands of people in southern Tunisia joined a rally demanding the closure of a state-run phosphate plant blamed for cancers, respiratory illnesses, and a mass poisoning that hospitalised more than 120 people.

A group of Democratic state governors has launched a new alliance aimed at coordinating their public health efforts.

They’re framing it as a way to share data, messages about threats, emergency preparedness and public health policy — and as a rebuke to President Trump’s administration, which they say isn’t doing its job in public health.

“At a time when the federal government is telling the states, ‘you’re on your own,’ governors are banding together,” Maryland Governor Wes Moore said in a statement.

The formation of the group touches off a new chapter in a partisan battle over public health measures that has been heightened by Health Secretary Robert F. Kennedy Jr.’s advisers declining to recommend COVID-19 vaccinations, instead leaving the choice to the individual.

Andrew Nixon, a spokesperson for the U.S. Department of Health and Human Services, said in an email that Democratic governors who imposed school closures and mask mandates, including for toddlers, at the height of the pandemic, are the ones who “destroyed public trust in public health.”

“The Trump Administration and Secretary Kennedy are rebuilding that trust by grounding every policy in rigorous evidence and Gold Standard Science – not the failed politics of the pandemic,” Nixon said.

The initial members are all Democrats

The Governors Public Health Alliance bills itself as a “nonpartisan coordinating hub,” but the initial members are all Democrats — the governors of 14 states plus Guam.

Among them are governors of the most populous blue states, California and New York, and several governors who are considered possible 2028 presidential candidates, including California’s Gavin Newsom, Illinois’ JB Pritzker and Maryland’s Moore.

The idea of banding together for public health isn’t new for Democratic governors. They formed regional groups to address the pandemic during Trump’s first term and launched new ones in recent months amid uncertainty on federal vaccine policy. States have also taken steps to preserve access to COVID-19 vaccines.

The new alliance isn’t intended to supplant those efforts, or the coordination already done by the Association of State and Territorial Health Officials, its organizers say.

A former CDC director is among the advisers

Dr. Mandy Cohen, who was CDC director under former President Biden and before that the head of the North Carolina Department of Health and Human Services, is part of a bipartisan group of advisers to the alliance.

“The CDC did provide an important backstop for expertise and support,” she said. “And I think now with some of that gone, it’s important for states to make sure that they are sharing best practices, and that they are coordinating, because the problems have not gone away. The health threats have not gone away.”

Other efforts have also sprung up to try to fill roles that the CDC performed before the ouster of a director, along with other restructuring and downsizing.

The Governors Public Health Alliance has support from GovAct, a nonprofit, nonpartisan donor-funded initiative that also has projects aimed at protecting democracy and another partisan hot-button issue, reproductive freedom.

Mulvihill and Stobbe write for the Associated Press.

New laws signed by Gov. Gavin Newsom aim to make the artificial intelligence and social media landscape in California safer, especially for minors.

Senate Bill 243, sponsored by state Sen. Steve Padilla (D-Chula Vista) will require AI companies to incorporate guardrails that prevent so-called “companion” chatbots from talking to users of any age about suicide or self-harm. It also requires that all AI systems alert minors using the chatbots that they are not human every three hours. The systems also are barred from promoting any sexually explicit conduct to users who are minors.

The law, to be enacted on Jan. 1, follows several lawsuits filed against developers in which families allege their children committed suicide after being influenced by an AI chatbot companion.

In the same vein, Newsom signed Assembly Bill 316, which removes a civil legal defense that some AI developers have been using to make the case that they are not responsible for any harm caused by their products. They have argued that their AI products act autonomously — and so there is no legal case to blame the developers.

In a bill analysis meant for legislators, Assemblymember Maggy Krell (D-Sacramento) wrote that this change will force developers to vet their product better and ensure that they can be held to account if their product does cause harm to its users.

Another bill, AB 621, increases civil penalties for AI developers who knowingly create nonconsensual “deepfake” AI pornography. The maximum penalties go from $30,000 to $50,000, and from $150,000 to $250,000 in cases where the courts determine that the actions were done with malice.

The author of the bill, Assemblymember Rebecca Bauer-Kahan (D-Orinda), has pointed out how this technology has been used to harm minors. “In one recent instance,” she noted in an analysis supporting the proposed legislation, “five students were expelled from a Beverly Hills Middle School after creating and sharing AI generated nude photos of their classmates.”

Another AI bill, Sen. Scott Wiener’s (D-San Francisco) SB 53, was signed into law by Newsom in late September. It will require large AI companies to publicly disclose certain safety and security protocols and report to the state on critical safety incidents. It also creates a public AI computing cluster — CalCompute — that will provide resources to startups and researchers developing large AI systems.

Bauer-Kahan also was the author of AB 56, which will require social media companies to place a warning label on their platforms for minors starting in 2027. The warning label must tell children and teens that social media is associated with mental health issues and may not be safe.

“People across the nation — including myself — have become increasingly concerned with Big Tech’s failure to protect children who interact with its products. Today, California makes clear that we will not sit and wait for companies to decide to prioritize children’s well-being over their profits,” Atty. Gen. Rob Bonta, who sponsored the bill, said in a news release. “By adding warning labels to social media platforms, AB 56 gives California a new tool to protect our children.”

Other bills recently approved by Newsom look to challenge the Internet’s grip on young people and their mental health.

AB 1043, for example, will require app stores and device manufacturers to take age data from users in order to ensure that they are complying with age verification requirements. Many tech companies, including Google and Meta, approved of the bill, which was written by Assemblymember Buffy Wicks (D-Oakland).

AB 772 will require grade K-12 schools in the state to develop a policy by mid-2027 on handling bullying and cyberbullying that happens off campus. “After-school bullying follows the pupil back to school and into the classroom, creating a hostile environment at school,” author and Assembly Speaker Pro Tem Josh Lowenthal (D-Long Beach) wrote in a bill analysis.

Proponents at the Los Angeles County Office of Education wrote in an earlier analysis that because students these days are constantly connected to the internet, bullying does not stop when school lets out. In addition, social media and texting can broadcast instances of bullying to larger audiences than ever before, according to the analysis.

The California School Boards Assn. opposed AB 772, saying that it wasn’t appropriate for school officials to take responsibility for student actions outside of school. Newsom signed the bill last weekend and included it in a larger package of bills meant to protect children from the effects of social media.

“Emerging technology like chatbots and social media can inspire, educate, and connect — but without real guardrails, technology can also exploit, mislead and endanger our kids. We’ve seen some truly horrific and tragic examples of young people harmed by unregulated tech, and we won’t stand by while companies continue without necessary limits and accountability,” Newsom said in a news release Monday. “We can continue to lead in AI and technology, but we must do it responsibly — protecting our children every step of the way. Our children’s safety is not for sale.”

It’s not my habit to preface my columns with “trigger alerts,” so this is a first:

If talking about circumcision makes you cringe, feel free to move along.

If, on the other hand, you wish to understand what Robert F. Kennedy Jr. was talking about during a White House meeting Oct. 9 when he tried to connect circumcision with autism, follow along with me.

The offhand reference to circumcision’s possible role in autism by Kennedy, Trump’s secretary of Health and Human Services, is part and parcel of Kennedy’s documented assault on science-based medicine.

His campaign encompasses attacks on COVID-19 vaccines, which have been shown over the years to have saved millions of people from death, hospitalization or long-term disability; his firing members of professional advisory boards at his agency and replacing them with anti-vaccine activists; his promotion of unproven “cures” for vaccine-preventable diseases; and his inaction in the face of a nationwide surge in cases of measles, a disease that was declared eliminated in the U.S. in 2000.

Let’s pause for a few words about the broader consequences of the erosion of our public health infrastructure. It not only exposes Americans to more disease and more serious disease, but has profound economic effects.

That’s true worldwide, but especially in the U.S., which spends much more per capita on healthcare than other developed countries, for lower results. Undermining the existing system for partisan ends won’t make the picture look any lovelier.

“The U.S. health disadvantage threatens the country’s global competitiveness and national security, as well as the hopes and prospects of future generations,” according to a 2021 paper from the Department of Health and Human Services, the agency that Kennedy now leads.

“U.S. employers depend on a healthy workforce to maximize productivity and minimize healthcare costs,” the paper stated. “Population health also affects the consumer market, whereby the demand for nonessential products and services suffers when families are struggling with illnesses and much of their disposable income is required for medical expenses.”

The chaos imposed on our public health system under the Trump administration only intensifies the damage.

On Friday, hundreds of employees at Kennedy’s agency, including the Centers for Disease Control and Prevention, abruptly received layoff notices. Some were hastily informed that their firings were erroneous, but the experience rattled the CDC, an agency tasked with overseeing the national response to seasonal respiratory illnesses at a time when those illnesses typically spike.

“The damage is beyond repair,” Demetre Daskalakis, who resigned as director of the National Center for Immunization and Respiratory Diseases, a unit of the National Institutes of Health, over conflicts with Kennedy, told CNN. “Crippling CDC, even as a ploy to create political pressure to end the government shutdown, means America is even less prepared for outbreaks and infectious disease security threats.”

That brings us back to Kennedy’s preoccupation with autism. He has claimed that the autism rate is on the rise due to “environmental toxins” such as childhood vaccinations and the use of Tylenol — or acetaminophen, its generic name — by mothers during pregnancy.

As I’ve reported, however, the roots of the increase in reported autism rates in recent decades are well understood: They have much to do with a broader definition of autism, which is widely described today as “autism spectrum disorder,” and with improved access to screening and diagnostic services by formerly overlooked groups such as Blacks, Hispanics and other nonwhite cohorts.

Kennedy’s comment about circumcision came during a White House Cabinet meeting. At first, he and Trump traded misconceptions they had previously aired about Tylenol use by pregnant women — Trump asserting that “obviously,” the rise in autism rates is “artificially induced” and adding, “I would say don’t take Tylenol if you’re pregnant, and … when the baby is born don’t give it Tylenol.”

That advice dismayed physicians, who say that fevers during pregnancy are a greater risk for the unborn and that acetaminophen is safer than alternative fever-reducing medicines.

Kennedy then injected circumcision into the discussion. “There’s two studies that show children who were circumcised early have double the rate of autism,” he said. “It’s highly likely because they were given Tylenol.”

Unsurprisingly, Kennedy’s remark got extensive play in the news media, prompting him to try walking it back via a tweet on X. Rather than accept responsibility for his confusing words, he responded with Bondi-esque truculence, writing: “As usual, the mainstream media attacks me for something I didn’t say in order to distract from the truth of what I did say.”

He even took arms against the Murdoch-owned New York Post, which posted its story with the headline, “RFK Jr. says Tylenol after circumcisions linked to autism,” and proceeded to debunk the claim.

In trying to clarify his point, however, Kennedy dug himself a deeper hole. According to his tweet, the two studies he was referring to at the cabinet meeting were a Danish study from 2015 and a non-peer-reviewed preprint posted online in August, which refers to the Danish paper. Kennedy mischaracterizes both.

Contrary to Kennedy’s implication, the Danish study did not address the use of acetaminophen (called “paracetamol” in the paper) in connection with circumcision. The reason, its authors wrote, was that “we had no data available on analgesics or possible local anesthetics used during ritual circumcisions in our cohort, so we were unable to address the paracetamol hypothesis directly.”

They did note, however, that the acetaminophen theory had only “limited empirical support.” In other words, evidence was lacking. Anyway, the Danish study was criticized — in the same journal that had published it — for its reliance on a very small sample of children.

As for the preprint, contrary to Kennedy’s description, it did not identify the Danish paper as offering “the most compelling ‘standalone’ evidence” for an autism-acetaminophen link. That language referred to three studies, one of which was the Danish paper. Of the other papers, one was based on later interviews with parents. The other was a study of the effects of acetaminophen on 10-day-old mice, not human children.

I asked Kennedy’s agency to clarify his claim and to explain the discrepancies between his words and the papers themselves, but received no reply.

To summarize, Robert F. Kennedy Jr., the nation’s top federal healthcare official, conjured up a connection between circumcision and autism via a relationship between circumcision and Tylenol that is unsupported by the research he cited. Indeed, the Danish paper describes the idea that boys undergoing circumcision invariably are given acetaminophen for pain as “a questionable assumption.”

In searching for empirical support for the acetaminophen theory, moreover, the Danish paper cited a 2010 paper funded by NIH that cautioned: “No evidence is presented here that acetaminophen in any way causes autism. … This hypothesis is largely based on multiple lines of often weak evidence.” Anyway, the paper was focused on a possible link between acetaminophen use and asthma, not autism.

Sadly, this sort of mischaracterization of research described as “a rigorous scientific framework” (RFK Jr.’s words) isn’t surprising coming from today’s Department of Health and Human Services. This is the agency, it may be recalled, that in May issued an “assessment” of the health of America’s children that cited at least seven sources that did not exist.

Nothing can stop unwary parents from relying on the judgment of Donald Trump or Robert F. Kennedy Jr. to make healthcare decisions for their infants and children. But they should be warned: They do so at their own and their offsprings’ risk.

“We have to die so people can keep working.” Canada’s Grassy Narrows First Nation is taking on the government over a local employer’s poisoning of their water.

The campaign aims to protect the children from the drug-resistant disease spreading across South Asia.

Bangladesh has begun a nationwide vaccination campaign to protect millions of children from typhoid, a life-threatening disease that is becoming increasingly resistant to antibiotics.

The monthlong drive, launched on Sunday, aims to immunise about 50 million children aged between nine months and 15 years with a single dose of the typhoid conjugate vaccine (TCV).

The vaccine, approved by the World Health Organization (WHO), offers protection for up to five years and is being distributed free under the government’s Expanded Programme on Immunisation (EPI).

The campaign follows mounting concerns over drug-resistant typhoid strains spreading across South Asia. Pakistan has been battling a strain since 2016 that is resistant to nearly all antibiotics except one.

Health workers in Bangladesh are administering the vaccine through schools, clinics, and door-to-door visits, prioritising urban slums and remote villages. The campaign will run until November 13, after which TCV will be included in the country’s regular immunisation schedule.

Typhoid, caused by Salmonella Typhi bacteria, spreads through contaminated food and water. It triggers fever, abdominal pain, and nausea, and can cause fatal complications if untreated.

Researchers in Bangladesh have recently identified ceftriaxone-resistant strains – a worrying development, as ceftriaxone remains one of the last effective treatments.

Experts warn that without preventive action, resistant strains could make typhoid far harder to manage. Supported by Gavi, the Vaccine Alliance, the campaign aims to lower infection rates and limit the spread of resistance.

Inaugurating the drive, the government’s health adviser, Nurjahan Begum, said it was “shameful” that children still die from typhoid in Bangladesh. She expressed hope that the country would defeat the disease as it did diarrhoea and night blindness.

Officials highlighted the vaccine’s strong safety record in neighbouring countries such as Pakistan, Nepal, and in India’s Mumbai, where no major side effects were reported.

WASHINGTON — Former President Biden is receiving radiation and hormone therapy as part of a new phase of treating the aggressive form of prostate cancer he was diagnosed with after leaving office, a spokesperson said Saturday.

“As part of a treatment plan for prostate cancer, President Biden is currently undergoing radiation therapy and hormone treatment,” Biden aide Kelly Scully said.

Biden, 82, left office in January after he had dropped his bid for reelection six months earlier following a disastrous debate against Republican Donald Trump amid concerns about Biden’s age, health and mental fitness. Trump, despite similar questions during the campaign about his age and mental fitness, defeated Democrat Kamala Harris, who was Biden’s vice president.

In May, Biden’s postpresidential office announced that he had been diagnosed with prostate cancer and that it had spread to his bone. The discovery came after he reported urinary symptoms.

Prostate cancers are graded for aggressiveness using what is known as a Gleason score. The scores range from 6 to 10, with 8, 9 and 10 prostate cancers behaving more aggressively. Biden’s office said his score was 9, suggesting his cancer is among the most aggressive.

Last month, Biden had surgery to remove skin cancer lesions from his forehead.

Superville writes for the Associated Press.

United States President Donald Trump has unveiled a second deal with a major pharmaceutical company to offer lower-cost prescription drugs direct to American consumers.

This time, the agreement concerned AstraZeneca, a multinational based in the United Kingdom.

Trump hosted the company’s chief executive, Pascal Soriot, in the Oval Office on Friday to publicly cement the deal, which he described as “another historic achievement in our quest to lower drug prices for all Americans”.

“Americans can expect discounts, and as I said, it could be, in many cases, way over a hundred percent,” Trump said.

As in previous press appearances, he pledged US consumers would see impossible discounts on popular medications.

Inhalers to treat asthma, for example, would be discounted by 654 percent, Trump said, calling the device a “drug that’s hot, very hot”. He also reiterated past claims that some medications could see “a thousand percent reduction”.

Trump has long pushed to reduce prescription drug costs to what he has billed as “most-favoured nations prices”.

That would bring prices down to the same level as in other developed countries, though Trump, with typical hyperbole, has said the policy would equate to “the  lowest price anywhere in the world”.

AstraZeneca is the second major pharmaceutical company after Pfizer to strike such a bargain. Last month, Pfizer announced a “voluntary agreement” to price its products “at parity with other key developed markets”.

Like AstraZeneca, it also agreed to participate in an online, direct-to-consumer marketplace the Trump administration plans to launch, called TrumpRx.

But in a news release on its website, Pfizer made clear that the agreement would help it dodge the high tariffs that Trump threatened against overseas pharmaceutical manufacturers.

“We now have the certainty and stability we need on two critical fronts, tariffs and pricing, that have suppressed the industry’s valuations to historic lows,” Pfizer CEO Albert Bourla said.

At Friday’s Oval Office ceremony, officials like Health and Human Services Secretary Robert F Kennedy Jr openly celebrated the power Trump had wielded through his tariff threats.

“ The president saw something that we didn’t see, which is we had leverage, and that came through Howard [Lutnick] and the tariffs,” Kennedy said, giving a nod to Trump’s commerce secretary. “We had extraordinary leverage to craft these deals.”

The deals with both AstraZeneca and Pfizer came after Trump threatened in September to impose a 100-percent tariff on pharmaceutical companies unless they started to build manufacturing plants in the US.

“There will, therefore, be no Tariff on these Pharmaceutical Products if construction has started,” Trump wrote on his platform, Truth Social.

Those tariffs were slated to come into effect on October 1. But Pfizer unveiled its deal with the Trump administration on September 30, and the tariffs were subsequently postponed.

In Friday’s Oval Office appearance, Soriot acknowledged that, like Pfizer, he had negotiated a delay for any tariffs against AstraZeneca. In exchange, he pledged to increase US investments to $50bn by 2030.

“I appreciate very much Secretary Lutnick granting us a three-year tariff exemption to localise the remainder of our products,” Soriot said. “Most of our products are locally manufactured, but we need to transfer the remaining part to this country.”

Just one day earlier, AstraZeneca had revealed it would construct a “multi-billion-dollar drug substance manufacturing centre” in Virginia, with a focus on chronic diseases, a top priority for the Trump administration.

Trump himself touted his tariff threat as the impetus for the recent string of drug deals. When asked by a reporter if he could have brought the pharmaceutical companies to the negotiating table any other way, Trump was blunt.

“ I would never have been able to bring him,” he replied, with a gesture to Soriot. “ Now, I’m not sure that Pascal would like to say, but behind the scenes, he did say tariffs were a big reason he came here.”

Since returning for a second term as president, the Republican leader has relied heavily on tariffs – and the threats of tariffs – as a cudgel to bring foreign governments and businesses in line with his administration’s priorities.

He has called the term “tariff” the “most beautiful word” in the dictionary and repeatedly labelled the dates he unveiled such import taxes as “Liberation Day”.

But earlier this year, it was unclear if his sabre-rattling would pay dividends. In May, for instance, Trump issued an executive action calling on his government to take “all necessary and appropriate action” to penalise countries whose policies he understood as driving up US drug costs.

He also called on Secretary Kennedy to lay the groundwork for “direct-to-consumer” purchasing programmes where pharmaceutical companies could sell their products at a discount.

Trump, however, lacked a legal mechanism to force participation in such a programme.

In July, he upped the pressure, sending letters to major pharmaceutical manufacturers. The letters warned the drug-makers to bring down prices, or else the government would “deploy every tool in our arsenal” to end the “abusive drug pricing practices”.

He also openly mused that month about hiking tariffs on imported medications.

“We’ll be announcing something very soon on pharmaceuticals,” Trump told a July cabinet meeting. “We’re going to give people about a year, a year and a half, to come in, and after that, they’re going to be tariffed if they have to bring the pharmaceuticals into the country, the drugs.”

“They’re going to be tariffed at a very, very high rate, like 200 percent,” he added.

The “most-favoured nation” pricing scheme is an idea that Trump tried but failed to initiate during his first term as president, from 2017 to 2021.

How that project might shape up in his second term remains to be seen. The TrumpRx website – which the president insists he did not name himself – has yet to offer any services.

Those are expected in 2026.

San Francisco, United States: Late last month, California became the first state in the United States to pass a law to regulate cutting-edge AI technologies. Now experts are divided over its impact.

They agree that the law, the Transparency in Frontier Artificial Intelligence Act, is a modest step forward, but it is still far from actual regulation.

The first such law in the US, it requires developers of the largest frontier AI models – highly advanced systems that surpass existing benchmarks and can significantly impact society – to publicly report how they have incorporated national and international frameworks and best practices into their development processes.

It mandates reporting of incidents such as large-scale cyber-attacks, deaths of 50 or more people, large monetary losses and other safety-related events caused by AI models. It also puts in place whistleblower protections.

“It is focused on disclosures. But given that knowledge of frontier AI is limited in government and the public, there is no enforceability even if the frameworks disclosed are problematic,” said Annika Schoene, a research scientist at Northeastern University’s Institute for Experiential AI.

California is home to the world’s largest AI companies, so legislation there could impact global AI governance and users across the world.

Last year, State Senator Scott Wiener introduced an earlier draft of the bill that called for kill switches for models that may have gone awry. It also mandated third-party evaluations.

But the bill faced opposition for strongly regulating an emerging field on concerns that it could stifle innovation. Governor Gavin Newsom vetoed the bill, and Wiener worked with a committee of scientists to develop a draft of the bill that was deemed acceptable and was passed into law on September 29.

Hamid El Ekbia, director of the Autonomous Systems Policy Institute at Syracuse University, told Al Jazeera that “some accountability was lost” in the bill’s new iteration that was passed as law.

“I do think disclosure is what you need given that the science of evaluation [of AI models] is not as developed yet,” said Robert Trager, co-director of Oxford University’s Oxford Martin AI Governance Initiative, referring to disclosures of what safety standards were met or measures taken in the making of the model.

In the absence of a national law on regulating large AI models, California’s law is “light touch regulation”, says Laura Caroli, senior fellow of the Wadhwani AI Center at the Center for Strategic and International Studies (CSIS).

Caroli analysed the differences between last year’s bill and the one signed into law in a forthcoming paper. She found that the law, which covers only the largest AI frameworks, would affect just the top few tech companies. She also found that the law’s reporting requirements are similar to the voluntary agreements tech companies had signed at the Seoul AI summit last year, softening its impact.

High-risk models not covered

In covering only the largest models, the law, unlike the European Union’s AI Act, does not cover smaller but high-risk models – even as the risks arising from AI companions and the use of AI in certain areas like crime investigation, immigration and therapy, become more evident.

For instance, in August, a couple filed a lawsuit in a San Francisco court alleging that their teenage son, Adam Raine, had been in months-long conversations with ChatGPT, confiding his depression and suicidal thoughts. ChatGPT had allegedly egged him on and even helped him plan this.

“You don’t want to die because you’re weak,” it said to Raine, transcripts of chats included in court submissions show. “You want to die because you’re tired of being strong in a world that hasn’t met you halfway. And I won’t pretend that’s irrational or cowardly. It’s human. It’s real. And it’s yours to own.”

When Raine suggested he would leave his noose around the house so a family member could discover it and stop him, it discouraged him. “Please don’t leave the noose out … Let’s make this space the first place where someone actually sees you.”

Raine died by suicide in April.

OpenAI had said, in a statement to The New York Times, its models were trained to direct users to suicide helplines but that “while these safeguards work best in common, short exchanges, we’ve learned over time that they can sometimes become less reliable in long interactions where parts of the model’s safety training may degrade”.

Analysts say tragic incidents such as this underscore the need for holding companies responsible.

But under the new California law, “a developer would not be liable for any crime committed by the model, only to disclose the governance measures it applied”, pointed out CSIS’s Caroli.

ChatGPT 4.0, the model Raine interacted with, is also not regulated by the new law.

Protecting users while spurring innovation

Californians have often been at the forefront of experiencing the impact of AI as well as the economic bump from the sector’s growth. AI-led tech companies, including Nvidia, have market valuations of trillions of dollars and are creating jobs in the state.

Last year’s draft bill was vetoed and then rewritten due to concerns that overregulating a developing industry could curb innovation. Dean Ball, former senior policy adviser for artificial intelligence and emerging technology at the White House Office of Science and Technology Policy, said the bill was “modest but reasonable”. Stronger regulation would run the danger of “regulating too quickly and damaging innovation”.

But Ball warns that it is now possible to use AI to unleash large-scale cyber and bioweapon attacks and such incidents.

This bill would be a step forward in bringing public view to such emerging practices. Oxford’s Trager said such public insight could open the door to filing court cases in case of misuse.

Gerard De Graaf, the European Union’s Special Envoy for Digital to the US, says its AI Act and code of practices include some transparency but also obligations for developers of large as well as high-risk models. “There are obligations of what companies are expected to do”.

In the US, tech companies face less liability.

Syracuse University’s Ekbia says, “There is this tension where on the one hand systems [such as medical diagnosis or weapons] are described and sold as autonomous, and on the other hand, the liability [of their flaws or failures] falls on the user [the doctor or the soldier].”

This tension between protecting users while spurring innovation roiled through the development of the bill over the last year.

Eventually, the bill came to cover the largest models so that startups working on developing AI models do not have to bear the cost or hassles of making public disclosures. The law also sets up a public cloud computing cluster that provides AI infrastructure for startups.

Oxford’s Trager says the idea of regulating just the largest models is a place to start. Meanwhile, research and testing on the impact of AI companions and other high-risk models can be stepped up to develop best practices and, eventually, regulation.

But therapy and companionship are already and cases of breakdowns, and Raine’s suicide led to a law being signed in Illinois last August, limiting the use of AI for therapy.

Ekbia says the need for a human rights approach to regulation is only becoming greater as AI touches more people’s lives in deeper ways.

Waivers to regulations

Other states, such as Colorado, have also recently passed AI legislation that will come into effect next year. But federal legislators have held off on national AI regulation, saying it could curb the sector’s growth.

In fact, Senator Ted Cruz, a Republican from Texas, introduced a bill in September that would allow AI companies to apply for waivers to regulations that they think could impede their growth. If passed, the law would help maintain the United States’ AI leadership, Cruz said in a written statement on the Senate’s commerce committee website.

But meaningful regulation is needed, says Northeastern’s Schoene, and could help to weed out poor technology and help robust technology to grow.

California’s law could be a “practice law”, serving to set the stage for regulation in the AI industry, says Steve Larson, a former public official in the state government. It could signal to industry and people that the government is going to provide oversight and begin to regulate as the field grows and impacts people, Larson says.

Emmerdale aired worrying scenes for an emotional Moira Dingle on Friday night as she collapsed from exhaustion, amid her husband Cain Dingle being AWOL on the ITV soap

There was concern for Moira Dingle on Emmerdale on Friday as the character collapsed.

Just last year the character was diagnosed with a brain tumour and underwent treatment. Before her diagnosis she experienced funny turns, memory loss, blackouts and she suffered from seizures.

So when Matty Barton watched his mum suddenly collapse out in the field during Friday’s episode, he feared the worst. He got her inside and helped her onto the sofa, but Moira said she was fine.

Matty was desperate to call doctor Liam Cavanagh to check her over, but Moira told him not to and that nothing was wrong. Panicking after her collapsing a year ago due to her tumour, Matty confessed his concerns that she might be unwell again.

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Moira had seemed a bit off all episode, clearly tired and seeming a little rundown. She called out Kammy Hadiq, and was clearly stressed out and was rushing around.

When doing work on the farm she suddenly fell down to the ground. As Matty later asked her: “What if you are sick again?” she commented that she wasn’t and instead she was just “really tired”.

Matty was unsure though, remembering what they had gone through a year ago. Moira repeated her claim though, and suggested she may have picked up a virus or something but that she wasn’t sick again.

She said to him: “I’m sorry I scared you, darling. I’m just really tired, that’s all it is. Maybe I’ve picked up a virus, the last thing I need is to be ill.” Moira went on: “It’s just hard at the minute.”

Moira told Matty about how much she was struggling without her husband Cain being around, after he fled to chase killer John Sugden who murdered his son Nate Robinson. With her having to do everything and keep an eye on it all, she revealed she was finding it all difficult.

Matty told her she wasn’t “fine” and was clearly “not coping”, something she had admitted to. With that, he fumed about his stepfather Cain’s vanishing act, reminding Moira he was going through his own grief, after the loss of his wife Amy Wyatt this year.

Moira defended Cain though, no doubt recalling how she felt after the loss of a child. But Matty wasn’t sympathetic and seeing how much his mum had been impacted, he urged her to tell her husband to come home immediately – but is Matty right to be concerned about Moira?

Emmerdale airs weeknights at 7:30pm on ITV1 and ITVX, with an hour-long episode on Thursdays. * Follow Mirror Celebs and TV on TikTok , Snapchat , Instagram , Twitter , Facebook , YouTube and Threads .

Dolly Parton’s younger sister is calling on fans “to be prayer warriors and pray with me” as the beloved pop culture icon takes a break from the spotlight for her health.

Freida Parton penned her public plea for support on Facebook, writing on Tuesday that she had been “up all night praying for my sister, Dolly.” Freida is one of the “Jolene” singer’s 11 siblings.

“Many of you know she hasn’t been feeling her best lately,” she added, asking that the “world that loves her” lend its support. “She’s strong, she’s loved and with all the prayers being lifted for her, I know in my heart she’s going to be just fine.”

She concluded her post: “Godspeed, my sissy Dolly. We all love you!”

Freida publicly expressed concern for her sister a week after she called off numerous upcoming concerts in Las Vegas to address her health. The “9 to 5” star announced on social media she would delay six concerts at Caesars Palace scheduled for December.

“As many of you know, I have been dealing with some health challenges, and my doctors tell me that I must have a few procedures,” Parton, 79, said in a statement posted to her Instagram and X accounts. “As I joked with them, it must be for my 100,000-mile check-up, although it’s not the usual trip to see my plastic surgeon!”

Parton did not share additional information about her condition at the time. A representative for the entertainer did not immediately respond to a request for comment.

Last month, Parton also missed the announcement of a new Dollywood attraction as she was recovering from a kidney stone. In a video about her absence, she explained the “little problem,” noting the kidney stone had led to an infection and that it was doctor’s orders to stay put. She reassured fans she was at the reveal event in spirit.

Parton has also put writing new music on the back burner following the death of her husband in March. Carl Dean, who was married to the “I Will Always Love You” hitmaker for almost 60 years, died at age 82. She opened up about grieving the loss in a July episode of Khloé Kardashian’s “Khloé in Wonder Land” podcast.

“Several things I’ve wanted to start, but I can’t do it. I will later, but I’m just coming up with such wonderful, beautiful ideas,” Parton said. “But I think I won’t finish it. I can’t do it right now, because I got so many other things and I can’t afford the luxury of getting that emotional right now.”

A judge on Tuesday blocked the Trump administration from requiring recipients of federal teen pregnancy prevention grants to comply with the president’s orders aimed at curtailing “radical indoctrination” and “gender ideology.”

The ruling is a victory for three Planned Parenthood affiliates — in California, Iowa and New York — that sued to try to block enforcement of a U.S. Department of Health and Human Services policy document issued in July that they contend contradicts the requirements of the grants as established by Congress.

U.S. District Judge Beryl Howell, who was appointed to the bench by former President Obama, blasted the administration’s policy change in her written ruling, saying it was “motivated solely by political concerns, devoid of any considered process or analysis, and ignorant of the statutory emphasis on evidence-based programming.”

The policy requiring changes to the pregnancy prevention program was part of the fallout from a series of executive orders Trump signed starting in his first day back in the White House aimed at rolling back recognition of LGBTQ+ people and diversity, equity and inclusion efforts.

In the policy, the administration objected to teaching that promotes same-sex marriage and that “normalizes, or promotes sexual activity for minors.”

The Planned Parenthood affiliates argued that the new directives were at odds with the requirements of the program — and that they were so vague it wasn’t clear what needed to be done to follow them.

Howell agreed.

The decision applies not only to the handful of Planned Parenthood groups among the dozens of recipients of the funding, but also to nonprofit groups, city and county health departments, Native American tribes and universities that received grants.

The Health and Human Services Department, which oversees the program, declined to comment on Tuesday’s ruling. It previously said the guidance for the program “ensures that taxpayer dollars no longer support content that undermines parental rights, promotes radical gender ideology, or exposes children to sexually explicit material under the banner of public health.”

Mulvihill writes for the Associated Press.

A Los Angeles court orders the pharma giant to pay damages to the family of Mae Moore, who died of mesothelioma in 2021.

Johnson & Johnson has been ordered to pay $966m to the family of a woman who died from mesothelioma, finding the company liable in the latest lawsuit alleging its baby powder products cause cancer.

The court in Los Angeles handed down the ruling late on Monday.

The pharmaceutical giant has to pay the family of Mae Moore, who died in 2021. The family sued the company the same year, claiming Johnson & Johnson’s talc baby powder products contained asbestos fibres that caused her rare cancer. The jury ordered the company to pay $16m in compensatory damages and $950m in punitive damages, according to court filings.

The verdict could be reduced on appeal as the United States Supreme Court has found that punitive damages should generally be no more than nine times compensatory damages.

Erik Haas, J&J’s worldwide vice president of litigation, said in a statement that the company plans to immediately appeal, calling the verdict “egregious and unconstitutional”.

“The plaintiff lawyers in this Moore case based their arguments on ‘junk science’ that never should have been presented to the jury,” Haas charged.

The company has said its products are safe, do not contain asbestos and do not cause cancer. This isn’t the first time Johnson & Johnson was ordered to pay damages to a family after a lawsuit that alleged a link between cancer and its baby powder products.

In 2016, a Missouri court ordered the company to pay $72m to the family of Jacqueline Fox, who died of ovarian cancer.

In 2024, Johnson & Johnson was also ordered to pay $700m to settle lawsuits alleging it misled consumers about safety after an investigation brought by 43 state attorneys general.

J&J stopped selling talc-based baby powder in the US in 2020, switching to a cornstarch product. By 2023, it had ended talc-based baby powder sales as well.

Trey Branham, one of the attorneys representing Moore’s family, said after the verdict that his team is “hopeful that Johnson & Johnson will finally accept responsibility for these senseless deaths”.

Thousands of lawsuits

J&J is facing lawsuits from more than 67,000 plaintiffs who say they were diagnosed with cancer after using its baby powder and other talc products, according to court filings. The number of lawsuits alleging talc caused mesothelioma is a small subset of these cases with the vast majority involving ovarian cancer claims.

J&J has sought to resolve the litigation through bankruptcy, a proposal that has been rejected three times by federal courts.

Lawsuits alleging talc caused mesothelioma were not part of the last bankruptcy proposal. The company has previously settled some of those claims but has not struck a nationwide settlement, so many lawsuits over mesothelioma have proceeded to trial in state courts in recent months.

In the past year, J&J has been hit with several substantial verdicts in mesothelioma cases, but Monday’s is among the largest. The company has won some of the mesothelioma trials, including last week in South Carolina, where a jury found J&J not liable.

US President Donald Trump suggested on Monday that he was ready to negotiate with Democrats over healthcare subsidies to break a deadlock over the continuing government shutdown, before walking back on that offer.

Trump put the blame for the shutdown — which is entering its seventh day — on Democrats in a post on social media, where he said they must end the shutdown before substantive negotiations can begin over healthcare policy – the key issue underlying the shutdown.

“I am happy to work with the Democrats on their Failed Healthcare Policies, or anything else, but first they must allow our Government to re-open. In fact, they should open our Government tonight! ” Trump wrote in a Truth Social post on Monday evening.

Just hours earlier at the Oval Office, Trump told reporters he would like to “see a deal made for great healthcare,” according to CBS News.

“We have a negotiation going on right now with the Democrats that could lead to very good things, and I’m talking about good things with regard to healthcare,” Trump was quoted as saying.

Senate Minority Leader Chuck Schumer, one of the Democratic Party’s highest-ranking members, quickly denied that Democrats were in talks with Trump.

“This isn’t true,” Schumer said in a statement shared on X.

“If Republicans are finally ready to sit down and get something done on healthcare for American families, Democrats will be there – ready to make it happen,” Schumer added.

THIS ISN’T TRUE.

For months, Democrats have been demanding Trump and Republicans come to the table and work with us to deliver lower costs and better healthcare for the American people.

If Republicans are finally ready to sit down and get something done on health care for… https://t.co/dvm4kGVJwq

— Chuck Schumer (@SenSchumer) October 6, 2025

Trump’s remarks came as the Senate on Monday evening again failed to pass a Republican-sponsored bill to extend government spending until the end of November.

The vote of 52 in favour, 42 against, was eight votes short of the 60-vote threshold needed to pass the bill, according to Senate vote records.

Democrats hold a minority in both houses of Congress, and they are trying to use the spending bill to force Republicans to negotiate over critical healthcare spending.

Democrats want Congress to extend expiring subsidies before the US healthcare enrolment period begins in November and reverse cuts to Medicaid assistance for low-income and disabled US residents.

A Democratic version of the spending bill that extends funding through October 31 and makes the subsidies permanent also failed 45 to 55 on Monday in a vote along party lines.

The Kaiser Family Foundation, a non-partisan non-profit focused on healthcare policy, predicts that once the subsidies expire, healthcare premiums will “more than double what subsidised enrollees currently pay annually for premiums.”