ST. PAUL, Minn. – From coast to coast, people who rely on Medicare Part D could be left without their medications if a proposal by the Centers for Medicare and Medicaid Services is adopted.

Medicare Part D is a federal program that subsidizes prescription drug costs for 45 million seniors and people with disabilities. The feds say they want to amend what's called the "six protected classes rule," and allow insurers to exclude many drugs from Part D plans.

Fatima Hyacinthe, trainer and engagement director with the Black AIDS Institute, says people who rely on those medications already report discriminatory practices by insurance companies, despite the rules.

"Situations where people who were in treatment for substance use disorder, and as soon as they were seen to not need that kind of intensive treatment – which is often the best practice for treatment – their insurance stops covering it," says Hyacinthe.

The CMS says the change would save money, but opponents warn that short-term savings could be canceled out by more spending on emergency-room visits.

This month, a California judge ruled against Minnesota's UnitedHealth Group, after determining the insurer discriminated against patients with mental health and substance abuse disorders in order to save money.

The proposal was made late last year but has not yet taken effect. Consumer advocates say removing drug-price protections from people with a serious illness could make a dire situation worse.

Hyacinthe sees the Medicaid Part D proposal as part of a broader attack on equality in health care.

"One day, we're defunding Medicare Part D or taking the teeth out of it," says Hyacinthe. “Another day we're creating work requirements for Medicaid recipients. And these things target the same group of folks – again and again, and again."

The Trump administration's proposal also would allow insurers to require that a patient try cheaper and potentially less effective medications first – and only grant access to newer, more effective prescriptions if the cheaper medications don't work.


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Counterfeit medicine sales are on the rise, in Connecticut and nationwide.

The state faced trouble with growing sales of counterfeit Xanax pills laced with fentanyl in 2021. Raids on two Westbury mini-markets that year uncovered sweeping "pill press" operations. Now, criminals are counterfeiting the weight-loss drug Ozempic. Some variations are insulin pens with an Ozempic label.

Shabbir Imber Safdar, executive director of the Partnership for Safe Medicine, said telehealth pushes people to take medications they would not normally qualify for.

"To do something significant, like to go on an injectable drug for a long period of time that is going to have serious consequences for your health and nutrition and your weight, you really need to see a real doctor, not a computer doctor, not a doctor in a chat room," Safdar contended. "I think some telehealth companies have normalized the fact that that's not important."

Some pharmacies and clinics face lawsuits for selling knockoff drugs through telemedicine. In its efforts to keep people safe, the Food and Drug Administration seized thousands of units of fake Ozempic in late 2023. But research shows numerous lifestyle drugs are being counterfeited daily.

Safdar pointed out a major red flag is when an online ad promises expedited access to a certain drug without a prescription. Social media has only expanded a person's ability to get counterfeit drugs. A Long Island TikTok influencer has been indicted for selling fake medication to her followers.

Though federal agencies and lawmakers issued warnings, Safdar argued the biggest challenge to maintaining public safety is the public.

"When you skip that pharmacist in that white coat and you go online and try to pick a pharmacy yourself, or you pick a telemedicine doctor yourself, you've skipped all of the safety checks," Safdar emphasized.

There are reports some counterfeit Ozempic has led to hypoglycemia or dangerously low blood sugar. Safdar noted some counterfeits are injectables mixed with impurities. The Food and Drug Administration said other side effects like nausea, vomiting, abdominal pain and constipation are consistent with the real drug.

By Haley Miller for Chalkbeat Indiana.
Broadcast version by Joe Ulery for Indiana News Service reporting for the Chalkbeat Indiana-Free Press Indiana-Public News Service Collaboration.

When Alma Figueroa visited the homes of Indianapolis Public Schools students who were pregnant or parenting earlier this year, she noticed hazards that put babies at risk of suffocation or strangulation — from bed-sharing to stuffed animals in the crib.

But Figueroa has a response ready for the upcoming school year.

As the case manager for the IPS Stronger Tomorrows program for pregnant and parenting students, she plans to give them the items to guard against babies sleeping at angles in car seats or swings, sharing beds with adults or pets, and sleeping with loose objects. Figueroa wants the additional resources she’ll hand out, like sleep sacks and portable cribs, not only to lower the infant mortality rate in Marion County, but also help the parents feel secure enough to stay in school and on track to graduate.

“If their babies are not OK or if something is not going well at home, then we know that’s really going to affect their success at school,” Figueroa said. “Making sure that their babies are well is essential for them to be successful in the classroom.”

The resources Figueroa will distribute are supported through a $10,000 donation from the Shepherd Community Center.

In the 2023-24 school year, IPS had around 60 students who were pregnant or parenting, according to Figueroa; in the past school year, 14 IPS students who were pregnant or parenting graduated.

She said many of the students didn’t know about safe-sleep practices, or they didn’t have the money or space to provide a secure sleeping environment.

Figueroa also hopes the increased access to safe-sleep items will help reduce Marion County’s high infant mortality rate. In 2022, the county had an estimated 8.1 deaths for every 1,000 live births, compared to the statewide rate of 7.2 and the national rate of 5.6 in the same year.

“Do you have a place for the baby to sleep is a big thing,” Figueroa said. “A lot of our students were not prepared.”

A report released last year by the Indiana Department of Health found that 528 babies died suddenly and unexpectedly from 2015 to 2019, and 99% of the deaths had at least one unsafe sleep risk factor present.

In Figueroa’s experience, providing resources like safe-sleep items for pregnant students before they give birth is key to help them feel prepared when the baby comes and stay on track to graduate.

Figueroa noted that the district created the Stronger Tomorrows program to ensure pregnant and parenting students know their rights under Title IX — a civil rights law that prohibits sex-based discrimination by schools that receive federal funding — and remove barriers to their education.

The program helps students receive accommodations from their school, like excused absences, and connects them to organizations in the community where they can access support for young parents.

The Shepherd Community Center received grant funding specifically to promote safe-sleep initiatives on the eastside of Indianapolis, said Jay Height, the group’s executive director.

“We believe IPS is doing a great job, and it’s important for our neighborhood to have strong schools,” Height said. “This is one of many ways that we support them and our students.”


Haley Miller wrote this article for Chalkbeat Indiana.


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In Pennsylvania, a unique mobile van brings reproductive resources to communities across Western Pennsylvania. A new podcast, called "(In)Accessible," explores the challenges people have in finding reproductive healthcare, including abortion, in the state.

Podcast host Rebecca Susman, communications and development director for the Keystone Progress Education Fund, said it features guests doing innovative work to address these barriers, with topics like fertility treatments and menopause care. Susman describes one of the conversations.

"I spoke with Alecia Ott from The Auto(nomous) Body Shop or the 'auto body shop,' which is an amazing mutual aid van, where she brings it all over the place, to universities, to events. And she gives out information about birth control and emergency contraception - as well as harm reduction, such as Narcan," she said.

In Pennsylvania, abortion remains legal until 24 weeks of pregnancy, and it's one of the closest locations to receive care for people living in many nearby states with abortion bans.

In the podcast, Alecia Ott explains that when she parks the van, she puts out a chalkboard inviting people to stop by for free information and contraception. The eye-catching orange van often sparks curiosity.

"You'd be surprised at how quickly somebody is telling me a story about how they accessed care, or they had to help somebody else find a place to have an abortion or emergency contraception or, you know, fertility help. People are sharing really intimate stories very quickly," Ott said.

Ott points to a few resources, like the Steel City Access Network in Pittsburgh, that provide transportation for abortion seekers, while the Western PA Fund for Choice offers financial assistance. She also envisions a collaborative network of mobile units to strengthen her advocacy.

Susman said the podcast also has covered the impact of the Dobbs decision, and the confusion people may have about their options, with ever-changing legal challenges in nearby states. She sees Pennsylvania's current abortion access as the result of strong political leadership, but acknowledges it could be under threat.

"Every single seat in the House, the Pennsylvania House, is up for grabs this fall. And we have another state Supreme Court election as well. This could all change. And these decisions happen because of who we elect into office and who they appoint, so it's very, very important that we all show up this November," Susman explained.