By Jim Robbins for KFF Health News.
Broadcast version by Mike Moen for Minnesota News Connection reporting for the KFF Health News-Public News Service Collaboration
Each fall, millions of hunters across North America make their way into forests and grasslands to kill deer. Over the winter, people chow down on the venison steaks, sausage, and burgers made from the animals.
These hunters, however, are not just on the front lines of an American tradition. Infectious disease researchers say they are also on the front lines of what could be a serious threat to public health: chronic wasting disease.
The neurological disease, which is contagious, rapidly spreading, and always fatal, is caused by misfolded proteins called prions. It currently is known to infect only members of the cervid family — elk, deer, reindeer, caribou, and moose.
Animal disease scientists are alarmed about the rapid spread of CWD in deer. Recent research shows that the barrier to a spillover into humans is less formidable than previously believed and that the prions causing the disease may be evolving to become more able to infect humans.
A response to the threat is ramping up. In 2023, a coalition of researchers began “working on a major initiative, bringing together 68 different global experts on various aspects of CWD to really look at what are the challenges ahead should we see a spillover into humans and food production,” said Michael Osterholm, an expert in infectious disease at the University of Minnesota and a leading authority on CWD.
“The bottom-line message is we are quite unprepared,” Osterholm said. “If we saw a spillover right now, we would be in free fall. There are no contingency plans for what to do or how to follow up.”
The team of experts is planning for a potential outbreak, focusing on public health surveillance, lab capacity, prion disease diagnostics, surveillance of livestock and wildlife, risk communication, and education and outreach.
Despite the concern, tens of thousands of infected animals have been eaten by people in recent years, yet there have been no known human cases of the disease.
Many hunters have wrestled with how seriously to take the threat of CWD. “The predominant opinion I encounter is that no human being has gotten this disease,” said Steve Rinella, a writer and the founder of MeatEater, a media and lifestyle company focused on hunting and cooking wild game.
They think, “I am not going to worry about it because it hasn’t jumped the species barrier,” Rinella said. “That would change dramatically if a hunter got CWD.”
Other prion diseases, such as bovine spongiform encephalopathy, also known as mad cow disease, and Creutzfeldt-Jakob disease, have affected humans. Mad cow claimed the lives of more than 200 people, mostly in the United Kingdom and France. Some experts believe Parkinson’s and Alzheimer’s also may be caused by prions.
First discovered in Colorado in captive deer in 1967, CWD has since spread widely. It has been found in animals in at least 32 states, four Canadian provinces, and four other foreign countries. It was recently found for the first time in Yellowstone National Park.
Prions behave very differently than viruses and bacteria and are virtually impossible to eradicate. Matthew Dunfee, director of the Chronic Wasting Disease Alliance, said experts call it a “disease from outer space.”
Symptoms are gruesome. The brain deteriorates to a spongy consistency. Sometimes nicknamed “zombie deer disease,” the condition makes infected animals stumble, drool, and stare blankly before they die. There is no treatment or vaccine. And it is extremely difficult to eradicate, whether with disinfectants or with high heat — it even survives autoclaving, or medical sterilization.
Cooking doesn’t kill prions, said Osterholm. Unfortunately, he said, “cooking concentrates the prions. It makes it even more likely” people will consume them, he said.
Though CWD is not known to have passed to humans or domestic animals, experts are very concerned about both possibilities, which Osterholm’s group just received more than $1.5 million in funding to study. CWD can infect more parts of an animal’s body than other prion diseases like mad cow, which could make it more likely to spread to people who eat venison — if it can jump to humans.
Researchers estimate that between 7,000 and 15,000 infected animals are unknowingly consumed by hunter families annually, a number that increases every year as the disease spreads across the continent. While testing of wild game for CWD is available, it’s cumbersome and the tests are not widely used in many places.
A major problem with determining whether CWD has affected humans is that it has a long latency. People who consume prions may not contract the resulting disease until many years later — so, if someone fell sick, there might not be an apparent connection to having eaten deer.
Prions are extremely persistent in the environment. They can remain in the ground for many years and even be taken up by plants.
Because the most likely route for spillover is through people who eat venison, quick testing of deer and other cervid carcasses is where prevention is focused. Right now, a hunter may drive a deer to a check station and have a lymph node sample sent to a lab. It can be a week or more before results come in, so most hunters skip it.
Montana, for example, is famous for its deer hunting. CWD was first detected in the wild there in 2017 and now has spread across much of the state. Despite warnings and free testing, Montana wildlife officials have not seen much concern among hunters. “We have not seen a decrease in deer hunting because of this,” said Brian Wakeling, game management bureau chief for the Montana Department of Fish, Wildlife & Parks. In 2022 Montana hunters killed nearly 88,000 deer. Just 5,941 samples were taken, and 253 of those tested positive.
Experts believe a rapid test would greatly increase the number of animals tested and help prevent spillover.
Because of the importance of deer to Indigenous people, several tribal nations in Minnesota are working with experts at the University of Minnesota to come up with ways to monitor and manage the disease. “The threat and potential for the spread of CWD on any of our three reservations has the ability to negatively impact Ojibwe culture and traditions of deer hunting providing venison for our membership,” said Doug McArthur, a tribal biologist for the White Earth Nation, in a statement announcing the program. (The other groups referenced are the Leech Lake Band of Ojibwe and Red Lake Band of Chippewa.) “Tribes must be ready with a plan to manage and mitigate the effects of CWD … to ensure that the time-honored and culturally significant practice of harvesting deer is maintained for future generations.”
Peter Larsen is an assistant professor in the College of Veterinary Medicine at the University of Minnesota and co-director of the Minnesota Center for Prion Research and Outreach. The center was formed to study numerous aspects of prions as part of the push to get ahead of possible spillover. “Our mission is to learn everything we can about not just CWD but other prionlike diseases, including Parkinson’s and Alzheimer’s disease,” he said. “We are studying the biology and ecology” of the misfolded protein, he said. “How do prions move within the environment? How can we help mitigate risk and improve animal health and welfare?”
Part of that mission is new technology to make testing faster and easier. Researchers have developed a way for hunters to do their own testing, though it can take weeks for results. There’s hope for, within the next two years, a test that will reduce the wait time to three to four hours.
“With all the doom and gloom around CWD, we have real solutions that can help us fight this disease in new ways,” said Larsen. “There’s some optimism.”
Jim Robbins wrote this story for KFF Health News.
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Nearly 1,000 New Mexicans have already accessed a new online portal which provides transparency about how much the cost of prescriptions and medical procedures vary from one location to another.
Introduced in 2024, the state service now has been updated to include costs in Spanish for the first time.
Ervin Garcia, health systems epidemiology program manager for the New Mexico Department of Health, said in addition to prescriptions, the portal shows the average costs for doctor visits and medical procedures.
"They can compare how much it would cost in one city versus the other because when you search you can put in your ZIP code and it tells you the closest around you," Garcia explained.
Research suggests health care quality is enhanced when people know what they will pay ahead of time. It also shows most people take at least one prescription drug, and lower prices help people better maintain overall health and wellness.
Garcia noted the online service could be a lifesaver for folks prescribed medicines or procedures who do not feel comfortable revealing their financial or insurance status to medical professionals.
"This kind of helps ease the health care procedures that way, so that they can kind of get a familiarity on how much it would cost," Garcia added.
Americans do not necessarily take more medications than people in other wealthy countries but federal government data from 2022 show U.S. prices across all drugs including generics were three times as high as prices in comparable countries.
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By Marilyn Odendahl for The Indiana Citizen.
Broadcast version by Joe Ulery for Indiana News Service reporting for the Indiana Citizen-Free Press Indiana-Public News Service Collaboration.
In a move applauded by advocates and lawmakers alike, the Indiana General Assembly will be taking a closer look at the estimated $2.2 billion in medical debt that is saddling many Hoosiers and often causing a devastating impact beyond the household budget.
“We all want to be able to care for ourselves and our loved ones, but medical debt poses undue financial hardship that prevents this from being a reality for countless Hoosiers,” Zia Saylor, researcher at the Indiana Community Action Poverty Institute, said in a press release. “It is important that lawmakers recognize the medical debt crisis we have and the urgent need for policies to address it.”
The Legislative Council included medical debt among the 22 topics that it assigned for further examination by the interim study committee process this summer and fall. On Wednesday, the council members unanimously passed a resolution that divided the topics between more than a dozen interim committees.
Initially, the Legislative Council began with 100 proposals for study topics this summer, plus 300 agency reports that presented more topics for possible review, according to George Angelone, executive director of the Legislative Services Agency. Through a “bipartisan process,” the list was whittled down to less than two dozen.
Other subjects scheduled for study include the economic value of Indiana’s public land for recreation, barriers to entering licensed professions, teaching water safety as part of the K-12 curriculum, salaries for K-12 administrators, the usage and cost of long-term-care insurance, and pollution caused by improperly discarded cables. Also, the Government Reform Task Force has been charged with reviewing the “efficiency and effectiveness” of various state boards, commissions and councils, and the Artificial Intelligence Task Force, established by state statute in 2024, will continue to examine the use of AI technology and the potential effects on Indiana residents’ constitutional rights, employment and economic welfare.
After the council hearing, Senate President Pro Tempore Rod Bray, R-Martinsville, said the work of the interim study committees are an important part of the legislative process. It allows state representatives and senators to dive into the topics and enables the public to provide input as well, which is helpful, he said. Bray and House Speaker Todd Huston, R-Fishers, serve as chair and vice chair, respectively, of the Legislative Council, which is comprised of eight members of the Indiana Senate and eight members of the House.
“Maybe it doesn’t end up in a proposed bill for the next legislative session, but people are always going to walk away with more facts and more information about that particular subject,” Bray said.
Democratic lawmakers were upbeat about the assignments to the committees. Senate Minority Leader Shelli Yoder, D-Bloomington, said the Democrats pushed topics that focused on improving Hoosiers’ lives. Many families, she said, are struggling to raise their children, care for their aging parents and stretch their wages to cover rising costs.
“That why our caucus fought very hard to make sure that this year’s study committee didn’t just check a box (but) that they had something meaningful to offer to Hoosiers,” Yoder said after the hearing. “We pushed hard for real topics, real impact and we have many successes to point to.”
‘Medical debt is no-fault debt’
For Democrats, the legislature’s decision to study medical debt is a win.
The interim study committee on the courts and the judiciary has been tasked with examining medical debt, the only topic on its agenda. As part of its study, the committee will look at financial protections for individuals through caps on monthly payments for such debt and limitations on collections or liens on property, along with restrictions on garnishment of wages. Also, the committee will focus on nonprofit and county hospitals by reviewing the definition for charitable care and the requirement to offer payment plans in addition to notices about medical bills to patients.
Speaker Huston and Sen. Fady Qaddoura, D-Indianapolis, both suggested the medical debt topic.
Huston said the topic was spurred by the many different constituents who reached out, telling their stories of the immense financial burden that overdue medical bills can be.
“We will at least take a look at it and understand it, particularly for low-income folks or people that have had some kind of… large, expensive medical procedures,” Huston said of medical debt. “How do you help them get out from behind the eight ball? We’ll take a look at that and see what the options are.”
During the 2025 legislative session, Qaddoura introduced Senate Bill 317 which sought to address medical debt by offering protections similar to those that will be studied by the committee. The measure died after it was narrowly defeated in a 26-to-23 vote in the Senate.
“We should stop penalizing people for getting sick,” Qaddoura said in a statement. “Medical debt is often unavoidable and disproportionately affects those already struggling. Our goal should be to create a path forward that lifts people up, not holds them back.”
Indiana residents are some of the most burdened with medical debt in the country. A 2022 study by the Indiana Community Action Poverty Institute, Grassroots Maternal and Child Health Initiative, and Prosperity Indiana, found that residents of the Hoosier state had the 11th highest share of medical debt in collections nationwide, which equals $2.2 billion outstanding and was the highest among the state’s Midwestern neighbors.
Delinquent or high medical debt contributes to a number of harmful consequences, according to the report. More than negatively impacting the financial health of a household, medical debt can degrade an individual’s physical and mental health. Also, unpaid medical bills can create barriers to credit and housing and can lead to garnishment of wages, property liens and reduced access to health care services.
“Medical debt is no-fault debt,” Dave Almeida, director of state government affairs for the Leukemia & Lymphoma Society, said in a press release. “It’s different from other debt because no one chooses to become sick, which means that no one should have to choose between putting food on the table, paying the rent, putting the kids through college, or engaging in life-saving treatment.”
Council bypasses some committees
Six study committee created by statute were not assigned any topics, including the elections body.
The interim study committee on elections has not met since 2017. However, bills that mostly restrict voting and elections have been introduced each legislative session, culminating in a flood of legislation this year that one voting-rights advocate described as “an assault on democracy.”
Bray did not express any concern about not giving any topics to elections and other committees, including education, public policy and public safety, and military affairs.
“We had a lot of legislation in those areas this last session and sometimes you’ve got to let some of those issues bake a little while … before you have a new issue that you really have to grapple with,” Bray said.
Yoder said she was disappointed that the Child Welfare Task Force was not assigned any topics. Passed this session with strong bipartisan support, House Enrolled Act 1273, authored by Rep. Dale DeVon, R-Granger, created the 22-member task force to study child welfare topics. The law requires the task force to submit two reports in October 2026 and October 2027, but does not specify any areas or subjects that should be studied.
Sen. Andrea Hunley, D-Indianapolis, was hopeful the study committees’ examination of the issues most concerning to families, such as clean water, maternal health and medical debt, would yield some legislation addressing key concerns in the 2026 General Assembly session.
“We also know that a single study in the interim isn’t going to fix everything,” Hunley said. “But we also know that it can spark the change that is necessary. It can be the momentum builder that we need to make sure that we’ve got the momentum going into session, so that we can have the bipartisan support necessary to pass important legislation that this is the time where that happens.”
Marilyn Odendahl wrote this article for The Indiana Citizen.
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A Pennsylvania nurse is sounding the alarm about proposed cuts to Medicaid funding now in Congress, cuts she said could jeopardize care for her son as well as millions of Americans.
The House version of the budget reconciliation bill would slash federal Medicaid spending by at least $700 billion to fund a tax-cut extension and other Trump administration priorities.
Jennifer K. Graham Partyka, a registered nurse in Northeast Pennsylvania, joined the "Fair Share for Americans" bus tour in Scranton this week. She said Medicaid is a lifeline for her 28-year-old son living with Crohn's disease.
"We were lucky, because when he was very sick, he qualified for Medicaid," Partyka recounted. "He was fully disabled until he started getting the treatments and started getting better. There's a version of that Medicaid called, like, 'Medicaid for working disabled people.'"
Medicaid covers about one in four Pennsylvanians, including 750,000 with disabilities. Partyka pointed out her son, who works full-time, would not be affected by the work requirements Congress wants to add for Medicaid eligibility. It would mean adults without children would need to work or volunteer 80 hours a month to keep their coverage. Republicans are pushing to pass the reconciliation bill by July 4 but debate could delay it.
Partyka emphasized Medicaid is one of the top five sources of payment to every hospital in the nation. With many already struggling to stay open and fully staffed, she thinks cutting Medicaid would also be disastrous for people's access to care.
"My professional experience with Medicaid is that most of the recipients of Medicaid are children," Partyka stressed. "I'm also going to share that 60% of people in nursing homes list Medicaid as their primary payer."
She added voters ultimately have the power to hold lawmakers accountable for the fallout from major budget decisions, noting many congressional seats will be up for grabs in 2026.
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