Democratic States Expanded Medicaid to Undocumented Immigrants. Now They're Rolling It Back.
Progressive governors around the country have extended state-funded healthcare to undocumented immigrants, aiming to get closer to universal insurance coverage.
Now, some are being forced to roll back or freeze the programs because of budget woes and unexpectedly high enrollment.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Medscape
an hour ago
- Medscape
Exceptional Use Recommendation for Nuclear Emergency Drug
The European Medicines Agency's (EMA) Committee for Medicinal Products for Human Use (CHMP) has recommended an exceptional circumstances marketing authorization for Imreplys. The drug — active ingredient sargramostim and manufactured by Partner Therapeutics Ltd — is intended to treat people with hematopoietic acute radiation syndrome (H-ARS) following acute exposure to myelosuppressive doses of radiation. H-ARS occurs when radiation suppresses bone marrow hematopoiesis, leading to an increased risk for infection and bleeding. It occurs after whole-body radiation doses of about 1-6 Gy, most often associated with acute exposure following radiologic or nuclear emergencies. Sargramostim, a granulocyte-macrophage colony-stimulating factor, counteracts H-ARS by inducing the bone marrow to produce immune-protective leukocytes, including granulocytes, macrophages, and monocytes, as well as red blood cells and platelets. The positive opinion means that Imreplys is now indicated for treatment of patients of all ages with H-ARS following acute exposure to myelosuppressive doses of radiation. It has also been used in the US in patients aged 2 years or older to prevent serious infection in conditions such as leukemia, bone marrow transplant, and prechemotherapy blood cell collection. As well as the infection risk, symptoms of H-ARS may include those of anemia, petechiae, and prolonged bleeding, starting 1-6 hours after exposure and lasting up to 2 days. Exceptional Circumstances Authorization Recommended Medicines can be authorized under exceptional circumstances, subject to certain specific obligations where the applicant was unable to provide comprehensive data on the efficacy and safety of the medicine under normal conditions of use. This may be because the condition that the drug is to be used for is too rare for extensive data gathering; because of limited scientific knowledge in the area concerned; or because collection of full information is not possible or is unethical. Exceptional circumstances authorization must be reviewed annually. The CHMP said that three randomized, blinded, placebo-controlled studies in rhesus monkeys who received H-ARS-inducing total body irradiation showed that Imreplys increased 60-day survival rates compared with placebo. Studies had also shown faster recovery of absolute neutrophil counts and platelets, reduced infection rates, and fewer signs of sepsis. The most common side effects with Imreplys include fever, diarrhea, vomiting, skin reactions, rash, asthenia, metabolic laboratory abnormalities, malaise, high glucose, abdominal pain, weight loss, low albumin, pruritus, gastrointestinal hemorrhage, chills, pharyngitis, bone pain, chest pain, hypomagnesemia, hematemesis, arthralgia, anxiety, and eye hemorrhage. Use Governed by Radiologic/Nuclear Emergency Recommendations The EMA said that Imreplys will be available as a 250 μg powder for solution for injection and should be used in accordance with official radiologic/nuclear emergency recommendations. Detailed recommendations for the use of the product will be described in the summary of product characteristics (SmPC), which will be published on the EMA website in all official European Union languages after the marketing authorization has been granted by the European Commission.
Health Line
an hour ago
- Health Line
Coke Zero vs. Diet Coke: What's the Difference?
There isn't much difference between Coke Zero and Diet Coke. You can drink either coke if you want to reduce your sugar intake, as both of them contain artificial sweeteners. You've likely heard that limiting the amount of added sugar in your diet is important for your health. People who regularly consume sodas may try switching to sodas made with artificial or non-nutritive sweeteners to reduce their added sugar intake. These alternatives make products taste sweet but don't lead to the blood sugar increases that traditional sugar may cause. Diet drinks are a way to avoid added sugars in beverages, but more recently, sodas with 'zero' in their name have hit the market alongside them. Coca-Cola is a popular example of a brand with both 'diet' and 'zero' varieties. If you're wondering about the differences between Coke Zero and Diet Coke — and how to determine which is a better choice for you — read on. Nutrition facts and ingredients of Coke Zero and Diet Coke Below are the ingredients and nutrition facts for both Coke Zero and Diet Coke. In this section, we'll break down some of the key differences and similarities you may want to consider. Coke Zero nutrition facts Coke Zero's ingredients include: carbonated water caramel color phosphoric acid aspartame potassium benzoate (to protect taste) natural flavors potassium citrate acesulfame potassium caffeine It also contains the amino acid phenylalanine, so people with phenylketonuria (PKU) should avoid it. A 12-ounce (355-mL) serving of Coke Zero provides: Calories: 0 Total fat: 0 grams (g) Sodium: 40 milligrams (mg) Total carbohydrate s: 0 g Total sugars: 0 g Protein: 0 g Potassium: 60 mg Caffeine: 34 mg Coke Zero contains no added sugars since it uses artificial sweeteners instead. It comes in a variety of flavors, including cherry, cherry vanilla, orange vanilla, and vanilla. Coke Zero also has less caffeine than Diet Coke. Caffeine-free Coke Zero is also available. Diet Coke nutrition facts Diet Coke's ingredients include: carbonated water caramel color aspartame phosphoric acid potassium benzoate (to protect taste) natural flavors citric acid caffeine Like Coke Zero, Diet Coke contains the amino acid phenylalanine, so people with PKU should avoid it. A 12-ounce (355-mL) serving of Diet Coke provides: Calories: 0 Total fat: 0 g Sodium: 40 mg Total carbohydrate: 0 g Total sugars: 0 g Protein: 0 g Caffeine: 46 mg Diet Coke contains no added sugars since it uses artificial sweeteners instead. Regular Diet Coke uses aspartame, but you can also purchase a variety of Diet Coke that's made with Splenda, a brand of sucralose. Flavor varieties of Diet Coke include ginger lime and feisty cherry. Like Coke Zero, Diet Coke also comes in a caffeine-free version. Key differences between Coke Zero and Diet Coke These products are essentially the same, especially regarding their main selling point: not containing sugar. What differs between the two is the type of sweetener they contain, as well as their caffeine content, although these two differences are still unlikely to be significant to most people. While Diet Coke uses aspartame as its sweetening agent, Coke Zero uses both aspartame and acesulfame potassium, also called 'Ace K' or 'acesulfame K.' Acesulfame potassium is another calorie-free sweetener that passes through the body without raising blood sugar levels. Per Diet Coke's ingredient label, its primary sweetener is aspartame, and since ingredients are listed in order by weight, it's reasonable to assume that it contains much less acesulfame potassium. This means that these drinks are quite similar in terms of ingredients. The other key difference is caffeine content. Coke Zero has less caffeine than Diet Coke. However, both beverages are well below the recommended daily caffeine limit of 400 mg per day for adults. One debatable difference is the taste of these two drinks. Some say they cannot taste a difference, while others swear by either Diet Coke or Coke Zero as tasting closest to the 'real deal.' Taste comparison As of late, Coca-Cola writes on its website and in its most recent marketing materials that it has developed a new recipe for Coke Zero. The company doesn't go into detail about how it has changed but maintains that it 'has more real Coca-Cola flavor, still without any sugar'. Coke Zero has a slightly different aftertaste than Diet Coke, likely due to its acesulfame potassium. Diet Coke tastes more like regular Coke to many people. However, for some, it's the reverse. Neither tastes just like the original Coca-Cola. Depending on multiple factors — like whether you get it from a beverage fountain, in a can, or in a bottle — each type may have a slightly different taste. Potential side effects For most, not many harmful side effects come from drinking carbonated beverages in moderation. However, caffeine and artificial sweeteners may negatively affect some people, even at moderate intake levels. The United States Department of Agriculture (USDA) recommends that adults have no more than 400 mg of caffeine per day. That's about 4 cups of coffee, or nine or eleven 12-ounce (355-mL) cans of Diet Coke or Coke Zero, respectively. So, you're unlikely to exceed the limit by drinking these sodas in moderation. If you're highly sensitive to caffeine, though, you may want to watch your intake of these beverages. Otherwise, they contain a relatively low amount of caffeine. Aspartame may cause headaches for some people, according to the American Migraine Foundation. While this effect may vary, it's good to know ahead of time so you can connect the dots if you start experiencing headaches after drinking these beverages. In addition, some research has indicated that aspartame may be carcinogenic. More long-term, high quality human studies are necessary before we can connect aspartame to cancer. A concluded that products containing aspartame are safe to consume by the general population at current levels. However, it may pose certain health risks for certain populations, such as: people with seizures neurological conditions people with phenylketonuria people who are pregnant Those who take a more cautious approach to ingredients in foods may want to avoid aspartame, and that's OK. However, it's worth noting that the Food and Drug Administration (FDA) considers aspartame safe. Similar to aspartame, acesulfame potassium has been evaluated for potential carcinogenic effects. Again, however, the evidence is unclear, and more long-term, high quality human studies are necessary. Acesulfame potassium is FDA approved. Which is a better choice? There are very few differences between Diet Coke and Coke Zero. As such, there is no concrete, measurable reason to suggest that one is superior to the other. Nutritionally, there are no significant differences. Their ingredient and caffeine contents are similar as well, so neither is healthier than the other. Remember that diet soda is not considered a healthy drink. It's a fun treat that can be consumed in moderation — and switching from original sodas to diet ones is a great starting place if you're trying to cut back on added sugars. Whichever you choose will depend largely on which tastes better to you. Coke Zero has been said to taste more like regular Coke, but some people feel differently and even prefer Diet Coke over regular Coke. Tips for reducing diet soda intake With the conflicting evidence surrounding artificial sweeteners, you may be wondering how you can get your fizzy fix while limiting your artificial sweetener intake. Here are some ideas you can try: Flavored waters: Calorie-free flavored waters can be refreshing and hydrating. Consider them as a healthy addition to your fridge or cooler. Kombucha: Kombucha is a probiotic-filled beverage that promotes healthy gut bacteria and is naturally fizzy due to the fermentation process. Most kombuchas have less sugar than regular sodas, but compare labels to ensure you're not overdoing it on added sugars. Probiotic sodas: Some brands of probiotic 'soda' are similar to kombucha. They're designed to taste similar to soda but have far less sugar. Their benefits are similar to those of kombucha due to the probiotics. Stevia sodas: Several brands of fizzy drinks mimic popular soda flavors and contain no artificial sweeteners. Instead, these sodas use plant-based alternative sweeteners like stevia or monk fruit. They still taste similar to soda but have no sugar or artificial sweeteners. Sparkling water: If it's fizz you're after rather than the sweetness, sparkling waters may come to your rescue. While they're not always sweet, they still provide carbonation without any sugar or artificial sweeteners. The bottom line If you want to limit added sugars, sodas made with artificial sweeteners — like Diet Coke and Coke Zero — may seem like a good choice. While some of the artificial sweeteners in these two drinks have faced controversy over their potential negative health effects, consuming either beverage in moderation should not be a concern, especially when compared with the negative effects of their sugar-laden alternative. Coke Zero and Diet Coke are essentially the same nutritionally. They differ mostly in their flavor.
CNN
an hour ago
- CNN
Focus more on strength and mobility and less on weight
Food & health Wellness Chronic diseasesFacebookTweetLink Follow Editor's note: Shift Your Mindset is an occasional series from CNN's Life, But Better team. We talk to experts about how to do things differently to live a better life. Anti-aging aspirations have turned longevity products and services into a wellness-industry gold mine. But who wants to add on years only to spend them struggling to move, dependent on others and unable to enjoy basic activities? What's the point of sticking around longer if you can't actually live life? Building and maintaining strength and mobility helps preserve the independence you need to age with dignity — and the actions you take now make all the difference. In their new book 'The Complete Bone and Joint Health Plan: Help Prevent and Treat Osteoporosis and Arthritis,' dietitian and personal trainer Sydney Nitzkorski and orthopedic surgeon and sports medicine specialist Dr. Jocelyn Wittstein share the strategic diet and exercise choices you can make now to help maintain your quality of life well into your later years. Nitzkorski is a sports dietitian at Marist University in Poughkeepsie, New York, and she runs a private fitness and nutrition practice. Wittstein is an associate professor at Duke University School of Medicine in Durham, North Carolina. This conversation has been edited and condensed for clarity. CNN: What's the biggest misconception about bone and joint health? Dr. Jocelyn Wittstein: Most people don't realize that bone mineral density (BMD) peaks at around age 30. After that, your goal is to maintain your BMD and try to slow down bone loss. For women, bone density decreases about 1% annually until menopause and then accelerates to 2% a year. Men experience a roughly 1% annual decline. The key is to build a strong foundation early and continue supporting your bone and joint health throughout your life. Another misconception is that cardiovascular exercise alone is enough to preserve mobility, but strength training and light impact exercises are critical, too. These activities can elevate the peak bone density of people in their teens and 20s, while people older than 30 need those same exercises to minimize loss. This is important considering that 1 in 4 adults will get osteoarthritis, and anyone older than age 50 has a heightened risk for both arthritis and osteoporosis, women in particular. A full 77% of postmenopausal women reported joint pain in a randomized study. Sydney Nitzkorski: As a dietitian, I find that people don't think enough about how much calcium they're taking in, and most people are not getting enough. Your body can't make the calcium it needs, not just for bones and teeth but also heart, muscle and nerve function. If you're not consuming enough, your body will raid the reserves in your skeleton to meet its requirements. This is why everybody, at every age, needs to get enough calcium. If you have kids, make sure they're consuming enough now, because this is when they're building bone mass. But sufficient calcium is still important even if you're 60 or beyond. Boosting your bone health is incredibly important at every age, and it's never too late to start taking proactive steps. CNN: Are calcium supplements necessary? Nitzkorski: Whole foods are the best sources for calcium, with supplementation as a secondary option. I recommend that people track their intake for a typical week and then adjust accordingly. Adults need 1,000 to 1,200 milligrams of calcium daily. Good sources include milk, fortified plant milks, broccoli and kale, as well as sardines and anchovies because you eat the bones. Wittstein: Plus bok choy, which I consider a superfood. It's the green vegetable with the highest bioavailability of calcium. The calcium your body gets from a food depends on two factors: the total calcium the food contains and the bioavailability of that calcium, or how well the body absorbs and uses the mineral. A cup of milk has 300 milligrams of calcium that is 30% bioavailable, while a cup of bok choy has 160 milligrams that is 55% bioavailable. Yet, each one provides the body with an equivalent amount of calcium: about 87.5 milligrams. Along with bok choy's excellent calcium bioavailability, it also provides fiber and vitamins A and C. I love to prepare this green vegetable superfood with garlic, ginger and olive oil, making it an excellent anti-inflammatory food for joints and overall health. CNN: Pressing question: Can we count the calcium from milk in coffee? Nitzkorski: Yes! In the book, Jocelyn and I share that we both nail our calcium targets by drinking a lot of milk with a little bit of coffee. It's true that consuming more than 300 milligrams per day of caffeine lowers your body's calcium absorption — but that's a high bar when you consider an 8-ounce cup of coffee contains around 100 milligrams and a double shot of espresso contains about 140 milligrams. Wittstein: Milk, whether it's from cows or a plant-based type that's been supplemented, is a good source of vitamin D, too. We know that consuming 2,000 IU of vitamin D a day can benefit bone health and may help decrease joint pain. When it comes to coffee, people are often glad to learn that it is rich in anti-inflammatory antioxidants. It contains the polyphenol quercetin, which may help alleviate pain and has anti-inflammatory properties. I like to add cinnamon to my coffee for added anti-inflammatory effect and glucose control. You can also add whey protein — which provides amino acids that your body uses to build muscle — and/or collagen supplements, which can improve both bone density and joint pain, depending on the type. CNN: What's the connection between inflammation and joint health? Wittstein: Inflammation can break down cartilage and contribute to joint pain. Chronic inflammation accelerates joint deterioration. Anti-inflammatory nutrition taken in through diet and supplements like omega-3 fatty acids and curcumin, for example, can help ease symptoms like pain and swelling. CNN: What does an anti-inflammatory diet look like? Nitzkorski: What I love about recommending anti-inflammatory foods is that they provide so many other benefits, too, such as decreasing heart attack risk, increasing longevity, improving digestion and giving you more energy. An anti-inflammatory diet is rich in lean proteins, which could be animal-based — such as non- or low-fat dairy, eggs, fish, chicken or turkey — or plant-based like beans, lentils and soy as well as pea proteins, which are found in a lot of protein powders. An anti-inflammatory diet also includes healthy fats, such as olive oil and foods containing omega-3 fatty acids like fish as well as walnuts and flax, chia and basil seeds. Alliums — including garlic, onion, leeks and shallots — are flavorful plants that have multiple anti-inflammatory properties. And there's a whole spectrum of spices including turmeric, cayenne, black pepper and ginger. Wittstein: Also important is dietary fiber from fruits, vegetables, beans and whole grains that provides short-chain fatty acids, higher levels of which are associated with lower levels of inflammation. Fruits and vegetables also contain myriad anti-inflammatory phytochemicals — naturally occurring compounds that provide an array of health benefits. Avoiding or limiting inflammatory ingredients like processed meats, red meat, fried foods, saturated fats and processed carbohydrates is also important. CNN: What types of exercise promote bone and joint health? Wittstein: It's critical to incorporate resistance training and impact exercises. The goal is to work into your 150 minutes of weekly activity a combination of the following: three days of weight-bearing aerobic exercise, two days of resistance training, and two days of balance work and light-impact exercises. That might sound like a lot, but these don't have to be long, intense sessions, and several of these types of conditioning can be combined. Standing on one leg and doing an overhead press counts as resistance training as well as balance work, for example. There are multiple things we want you to do to stimulate your bones and your muscles in different ways, but some of these activities can count as two. Nitzkorski: You can also integrate little exercises into your daily life. Just as we lose muscle and bone mass with age, we also lose our ability to balance. Practice intentionally throwing yourself off balance a little bit so your body must work to find its equilibrium again. Stand on one foot while brushing your teeth. Instead of sitting while watching TV, stand on one leg. Pretend a paintbrush is strapped to your toe and try to write your name or the alphabet. Write A through M on your right leg, and then switch and do N through Z on your left. To work on muscular endurance, do little arm circles. These start out super easy, but if you do them for two or three minutes it becomes exhausting. CNN: What do you mean by light-impact exercises? Wittstein: These include small jumps, jumping jacks or jumping rope. Studies show that doing 10 to 50 jumps three times a week is enough to stimulate your bone density. I encourage people to weave them into their day. By doing a little bit of hopping while you're waiting for the bus, you're getting your heart rate up and getting in some light-impact conditioning. CNN: Do you recommend jumping if it causes knee pain? Nitzkorski: No, people should listen to their joint pain! If jumping hurts your knees, focus on other kinds of conditioning like shallow squats, for example. You can also spread out your jumps over the course of the day or a week so you are not doing too many in a row. Or you can modify jumping exercises by using the back of a chair, or something else, for balance. Wittstein: Or try modifications like pool jumping, which adds resistance and partly reduces impact. Water-based exercises are not as effective as land-based jumping exercises, but they are definitely beneficial for bone mineral density. Although the gains from some of these exercise-based interventions may seem small, they actually translate to big risk reductions. We know from studies of pharmaceutical interventions that a 2% increase in lumbar-spine-bone density reduces spine fracture risk by 28%. A 4% improvement in hip-bone density decreases hip fracture risk by 32%. So even small improvements matter significantly. CNN: Is it ever too late to start boosting your bone and joint health? Nitzkorski: Absolutely not. While it's ideal to start early, you can always benefit from improving your diet and exercise routine. Start small — even 10 minutes of activity is better than nothing. Over time, small dietary changes can become a habit that sticks. The goal is consistency and gradual improvement so you can enjoy the life you live for that much longer. Editor's note: Sign up for CNN's Fitness, But Better newsletter series. Our seven-part guide will help you ease into a healthy routine, backed by experts. Jessica DuLong is a Brooklyn, New York-based journalist, book collaborator, writing coach and the author of 'Saved at the Seawall: Stories From the September 11 Boat Lift' and 'My River Chronicles: Rediscovering the Work That Built America.'
