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Obama to campaign with El-Sayed in Detroit as ex-president gets more involved in midterms
Obama is upping involvement in the midterm election. He taped two dozen ads last week for Democratic candidates for governor and Senate that will be released in the coming days and weeks.
Apple notifies Apple Cash users about two upcoming changes
Apple Cash’s terms and conditions have just been updated, and Apple is notifying users about two upcoming changes in particular.
Top crypto group to pour millions into bipartisan slate of House races after key legislation stalls
WASHINGTON (AP) — A top cryptocurrency campaign organization is unveiling a bipartisan list of House members that it will support in the November midterms, as o
Democrats release midterms ad featuring family of Epstein victim Virginia Giuffre
The campaign arm working to elect House Democrats released a political advertisement on Monday featuring the family of Virginia Giuffre, who was the first victim of Jeffrey Epstein to go public with allegations of abuse.
Who’s Winning the Battle for Congress?
It’s Oct. 5 — 29 days away from the midterms. Here’s the state of play.
How the Midterms Could Complicate the Supreme Court’s New Term
Even before the justices start their new term on Monday, the court has spent the summer resolving fast-moving requests on election-related disputes.
How the Midterms Could Complicate the Supreme Court’s New Term
Even before the justices start their new term on Monday, the court has spent the summer resolving fast-moving requests on election-related disputes.
Voters are increasingly using AI chatbots to fact-check and compare candidates
Voters are already voting in the midterms. This year, some voters are trying something new to get ready for the election: asking AI to help research their ballot and even decide who to vote for.
Voters are increasingly using AI chatbots to fact-check and compare candidates
Voters are already voting in the midterms. This year, some voters are trying something new to get ready for the election: asking AI to help research their ballot and even decide who to vote for.
3 years after the Oct. 7 attacks, Israel still grapples with its mental health crisis
More than a third of Israelis have shown symptoms of mental health conditions, a report found. Three years after the October 7 attack, the country's health system is still struggling to come to terms with its effects.
Trump takes extraordinary steps to target midterms, alarming critics
Trump's election moves include a redistricting push, seeking to restrict voting and floating a $5,000 payment to every American adult if the GOP wins.
US midterms: 470 seats, $12 billion and one absent president
Americans go to the polls on November 3 for elections that will shape the final two years of Donald Trump's presidency -- although the president himself will not be on any ballot.44: House races on No...
Trump faces midterm verdict as Democrats close in on US Congress
A month before the US midterms, Democrats are eyeing control of Congress -- and the power to put President Donald Trump on the defensive for the rest of his term by investigating his administration an...
At Trump’s Rallies, a Familiar Mix of Rituals and a Plea to ‘Please Pretend’
President Trump is doggedly lending his support to Republican candidates facing a rough midterm season. He is the same campaigner he has always been, but his crowds have changed.
Trump Is Promising Health Care Checks Before the Midterms. How Far Will They Go?
Trump’s promised rebates come as Americans worry about health care costs. For Medicare recipients, a one-time payment may offer limited relief from rising premiums.
Medicare for All remains key pressure point for Democrats ahead of midterms
The idea of universal health coverage in the US is embraced by party’s left but is often considered a liability by centrists
The counties to watch on the massive midterm elections battlefield
The breadth of the public backlash against President Donald Trump’s tumultuous second term is rapidly widening the campaign battlefield for 2026.
How Democrats hope to reverse Trump’s changes to the presidency
As the midterms approach, some of the president’s foes are working to ensure his aggressive approach to executive power doesn’t outlast him.
Some Democrats, Scarred by 2024, Take a Harder Line on Trans Athletes
Democrats competing in historically conservative territory in the midterms are more aggressively responding to Republican attacks casting them as extreme.
'SNL' skewers Trump, Mitch McConnell in midterms-themed cold open
"Saturday Night Live" is ready for the midterms.
Trump, campaigning in Ohio, says the midterms will bring a ‘big surprise’
The president rallied Saturday for Sen. Jon Husted, who faces a tough race against Democrat Sherrod Brown, and for Vivek Ramaswamy, the state’s GOP candidate for governor.
As midterms near, Justice Alito shares his feelings about retirement
Speaking to CBS News, Alito described the calculation as a natural one that comes with age. At 76, Alito is the second-oldest justice on the court.
Trump rally attendees react to war and the economy ahead of the midterms
CNN’s Alayna Treene speaks with Trump supporters about their views on issues like the Iran war, gas prices and the economy, as the US president campaigns in Vandalia, Ohio in a bid to help Republicans retain control of Congress in next month’s midterm elections.
Ted Cruz blasts JD Vance as ‘insecure,’ says he’s focused on helping GOP win midterms
A clash between two potential candidates for the 2028 Republican presidential nomination spilled into public this week.
Trump, Critic of Voting by Mail, Urges Republicans to Do It in Midterms
It was the latest mixed messaging from President Trump, who regularly votes by mail, but has made baseless claims that the practice is “inherently corrupt.”
Republicans tried to punt health care cuts until after the midterms. It didn’t work.
While most GOP-enacted cuts to Medicaid and other safety net programs won’t happen until 2027, Democrats are speaking to the voters already feeling the squeeze.
As Midterms Near, Justice Alito Says He Considers Each Year Whether to Retire
The justice, the second oldest on the court at 76, told CBS News that he decided against stepping down last term. He could face pressure should Democrats win the Senate in November.
Trump makes pitch to Ohio voters as midterms approach
President Donald Trump will lead a rally in a Dayton suburb Saturday in hopes of energizing GOP voters. He'll be joined by Sen. Jon Husted and others.
Our Best Stuff on Politics as the Midterms Draw Near
Could a blue wave prompt multiple impeachments?
As midterms near, some Republicans are starting to question Trump
WASHINGTON — The most striking thing about the U.S. Senate leaving town early to campaign was all the grousing Republicans did about President Donald Trump before going.
A record number of Native Americans are running in the 2026 midterms
At least 355 Native American and Indigenous candidates ran or are running in local, state and federal primary and general elections this year — a record number.
Trump on possibly invoking Insurrection Act around midterms: ‘We’ll see’
As Trump's proposed arch looms over D.C., protesters pin their hopes on the midterms
Democratic lawmakers, veterans and concerned citizens gathered in Memorial Circle to protest the arch Trump wants to build there. Their hopes lie primarily in a lawsuit and next month's midterms.
Hispanic Voters, Souring on Republicans, Could Decide the Midterms
Hispanic voters are souring on Republicans. Here’s why.
Trump revisits the scene of his political ascent as Republicans struggle
A month before the midterms, the president is returning to Alabama and other places where his movement remains strongest.
Midterms monitor: NH and Maine could decide control of the U.S. Senate
As national headlines reverberate at the local level, voters have no shortage of concerns. Journalists from New Hampshire and Maine joined 1A’s weekly news roundup Friday to help take the pulse of the 2026 midterm elections.
The Road to the Texas Midterms
Co-hosts Brandon Rottinghaus and Jeronimo Cortina delve into the latest news in politics
Presidio Investors Sells Podium Entertainment To Flexpoint Ford And Shamrock Capital
Presidio Investors has sold Podium Entertainment to Flexpoint Ford and Shamrock Capital, completing an investment that began in 2019 when Podium was an early-stage, founder-led audiobook publisher. GoldState Music is joining the new ownership group as a minority investor. Financial terms of the transaction were not disclosed.
Bernhard Capital completes exit from inaugural fund with sale of Epic Piping
The sale of United Weld Holdings, the parent company of Epic Piping and BendTec, to One Equity Partners has closed, according to Bernhard Capital Partners. Epic Piping is UWH’s flagship operating company. Financial terms of the deal were not disclosed. Bernhard announced in July it had agreed to a deal to sell UWH. “Epic has […]
National Democrats target Eastern WA House race as ‘in play’
National Democrats see Washington's 5th Congressional District as an opportunity to flip a seat in the midterms in its pursuit of House control.
Is Trump too focused on political content creators as midterms approach?
With Republicans deeply worried about the looming midterms, is President Trump focusing too much on politically obsessed content creators and consumers instead of ordinary voters? Join The Hill’s s…
New Postseason Projections Favor Carolina Panthers
The latest postseason projections are favorable for the Carolina Panthers in terms of the NFC South.
Douglas County should increase number of commissioners
As three former Douglas County commissioners, we endorse the citizen-led initiative to expand Douglas County’s Board of County Commissioners from three members to five. Three ballot questions on the Douglas County ballot address the board’s expansion. Together, we endorse these positions: Our terms as Douglas County commissioners spanned most of the past 30 years. We […]
Trump Puts on a Midterms Show for an Audience That’s Already Sold
President Trump spent the day preaching to his most fervent fans, not the voters he will need to help elect or re-elect a slate of Republicans fighting in states from Alaska to Maine.
The Top Governors' Races to Watch This November
Republicans are on the defensive going into the 2026 midterms, when 36 gubernatorial seats are up for grabs. But it’s not all smooth sailing for Democrats.
GA Sec. State Nominee, NJ-7 & Aviation Politics
GA Sec. State GOP nominee Tim Fleming, the battle for NJ-7 and how aviation is shaping politics—and could be impacted by the midterms.
GA Sec. State Nominee, NJ-7 & Aviation Politics
GA Sec. State GOP nominee Tim Fleming, the battle for NJ-7 and how aviation is shaping politics—and could be impacted by the midterms.
GA Sec. State Nominee, NJ-7 & Aviation Politics
GA Sec. State GOP nominee Tim Fleming, the battle for NJ-7 and how aviation is shaping politics—and could be impacted by the midterms.
Losing Baleba and Champions League ambition
Colin asked: Has the departure of Baleba helped team spirit and what can the club do to start retaining our stars so that we can take the next step to trophy success? Johnny: The midfield has coped really well without Baleba. If he progresses at Manchester United it may be seen as a loss, but in terms of team spirit, I don't think he had a detrimental effect.
Renewable Energy Super PAC Targets 7 Republicans With $15 Million War Chest
Most of the Republicans, such as Lauren Boebert of Colorado and Victoria Spartz of Indiana, are incumbents in districts that President Trump won comfortably in 2024.
What early voting data is showing ahead of the 2026 midterms
It’s possible that as many two-thirds of all votes in the midterm elections will come in the mail or will be cast during early voting.
Early voting data shows emerging signs of a Democratic advantage in the midterms
Election Day is still a month away, but more than 550,000 Americans have already voted across 29 states. There are signs emerging of the advantage Democrats have in motivating their voters – a trend that’s played out in polling all summer long.
How 16 undecided voters are weighing their 2026 election options
The voters, who participated in a recent NBC News poll and spoke to reporters afterward, are laser-focused on high prices and largely disappointed with both parties.
Trump loses favor with crypto fans who call him out for cashing in
The president’s 2024 campaign leaned into crypto to attract young men, a demographic that is deserting Republicans in the midterms.
September Monthly Review: Health MCP Guy?
For all the time I spend talking about APIs and data exchange, this newsletter has had embarrassingly little interoperability of its own. It’s old-school SaaS, baby - UI or bust. Not all of that is my fault! Substack, for all its popularity, is (as mentioned before) really frustrating as my system of record. The primary user it optimizes towards is the reader, whose attention feeds the app, the Notes feed, and the recommendation network that Substack is actually selling. Health API Guy is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe They’re falling into the same trap that Medium once sprinted into, albeit at a much more glacial speed. Younger generations may not remember (or never knew) it, but Medium once lured publications like The Ringer and Signal v. Noise onto its platform, only to lose them as it rebuilt itself around a paywall and an algorithmic feed. Substack’s original pitch circa 2020 was the antidote (you own your list), but every new feed feature chips away at it. I get it: writers are generic supply in the eyes of the Substack product team. Generic supply follows demand, so the consistent pressure on the PMs is to generate demand, which leads to every product cycle going toward discovery (Notes, recommendations, the app, live video). The end result lackluster author tools (laggy and broken analytics are truly crippling) all despite the premium price point. The archive is where it crosses from authorial gripes to actual reader impact, though. Across Substack and LinkedIn, I’ve published 1,218 posts and nearly 900,000 words since 2018. Substack’s native search can see only the 464 posts that live on Substack, and even there it’s woefully inadequate at surfacing relevant content (even for the guy who wrote it)! Readers have the same problem, writ large. Ask the Archive Fixing search (for both my readers and my own use) turned out to be extremely non-trivial, unfortunately: There’s no public API for readers to access content RSS exists for new content notification, but it only carries the 20 most recent posts and cuts paid ones off at the preview The only Substack MCP is an admin tool for analytics The export exists for authors, but it’s painfully awkward and slow. So I built something to work around that: the Health API Guy MCP. It’s a private MCP server holding the full text of everything I’ve written across Substack and LinkedIn. Add it to Claude or ChatGPT as a connector and you can ask things like: It pairs keyword search (for acronyms and case names, of which we have many) with semantic search. Every post is also labeled by topic, form, and court case, so you can pull a lawsuit’s (or multiple cases’) entire docket across Substack and LinkedIn in one query: Hail, Healthapiguyhydra This is also a bit of me eating my own cooking. I’ve spent the year arguing that headless healthcare is arriving and that developers want primitives over abstractions. Last week in Hail, Benihydra, I watched Salesforce plug its platform into Claude and bet that the records underneath outlive whatever interface sits on top: Salesforce must believe that the Hydra’s immortal head is the records, permissions, and business logic (in that they will survive whatever happens to the interface). It felt a bit hypocritical to keep my own archive behind a Substack search bar. The archive is the body. Substack is one head, and now whatever tool you might use is another. Will the EHRs follow my lead? Probably not imminently, but one can hope! Why Founding Members Only The MCP is available to Founding Member subscribers. A few reasons: It costs money and time to run. Hosting, the database, Clerk usage and AI compute for search and labeling are significant operational costs (that increase with usage). Substack gives me no way to automate access. There’s no API to check whether someone is a paid subscriber, so every user is manual operations for now. It’s a beta. We’ll need to improve things and parts will break. I’d rather they break for a small group of dedicated readers who will tell me about it. The Founding tier deserved a real benefit. Until now it was mostly a generous tip. Now it comes with something. If you’re already a Founding Member, reply to this email with the address you’d like provisioned. If you’re not and want in, upgrade here. Larger teams (such as companies) can get access too: group subscriptions at the Founding tier come with the group discount. The admin for the subscription can reply with the list of addresses to provision. Get 20% off a group subscription Pricing Founding membership is now a flat $200 a year, replacing the old suggested $150 that readers could adjust. Existing Founding Members will have access grandfathered in at their previous rate. Month in Review Articles Published Make Networks Dumb Again (Sep 11): AI is making old analog networks cheaper to use and flooding them with machine traffic in the process. A plea for agent-native rails with the intelligence at the endpoints, and for Washington to drag them to ubiquity. Interoperability, Unbuttoned (Sep 29): Interoperability is a series of workflows in a trenchcoat, and this post finally takes the trenchcoat off. A color-coded map shows which provider workflows went digital, which are fragmented, and which still run on fax. Video Content Antitrust’s System of Record Problem (Sep 3): The FTC’s investigation into Epic prompted a ninety-minute webinar, now posted with chapters and a smoothed transcript. We get into why market definition, missing B2B share data, and the SSNIP test leave antitrust poorly suited to systems of record, plus why information blocking may be doing more than any pending lawsuit. The Information Exchange: Cerner Milking Edition (Sep 18): This was so fucking fun. Ryan Tucker, Ryan Brickner, Brad Thorson, and I try an Around the Horn format, complete with points, penalties, and a mute button. We debate whether Oracle Health is dead, who would actually buy Cerner (IBM enters the chat), p(Doom), and why the front desk still hands you a clipboard. Regulatory Ask Not What Your Network Can Do (Sep 23): CDC’s RFI on public health data intermediaries lists use cases already served, unevenly, by eCR, lab reporting, IZ Gateway, and syndromic surveillance. The real opportunity sits in one question about AI: a network that can handle the next emergency without another interface project. Court cases Particle v. Epic: The Naughty Schoolteacher (Sep 4): After a summer-long vigil, the answer on Epic’s early summary judgment bid is two paragraphs and a remedial assignment. Particle advances to the next grade, and market definition gets another year of discovery. The Epic Discovery Files (Sep 8): Texas’s motions to compel arrive with a 251-page appendix of requests, objections, and meet-and-confer letters with Cravath. Inside: Epic using generative AI for document review, denied interoperability requests in scope, and Noerr-Pennington raised against lobbying discovery. Epic v. Health Gorilla: “Working as Designed” (Sep 9): Epic wants nothing to do with the data breach MDL, and explaining why puts fresh discovery on the public docket. The spiciest allegation: Health Gorilla told GuardDog to scrub its law firm business from its website instead of cutting off access. Veeva v. Epic: Legal Bypass Surgery (Sep 15): Veeva asks the Wisconsin Supreme Court to skip the Court of Appeals, while law professors and three policy groups line up as amici. Meanwhile, Epic’s lawyers apologize for another round of citation errors, including a quote that never existed. Texas v. Epic: Behind the Black Bars (Sep 17): The court portal served up Epic’s unredacted filings, revealing a $5 million document review budget and the AI workflow behind it. Also inside: the 200-plus company names Texas wants searched, and one very expensive Zoom invitation. OpenEvidence v. Doximity: Consequences Will Follow (Sep 25): OpenEvidence tells the court it will not comply with a discovery order, and its own lawyers at Quinn Emanuel say they won’t defend the choice. Add years of Slack reported unrecoverable, and Rule 37 sanctions come into view. Health Tech Keeps Choosing Violence (Sep 28): Doximity moves to end OpenEvidence’s case, Epic asks Texas to show its work, and a sleepy Audacious Inquiry patent fight sprouts antitrust and information blocking counterclaims. The main event is a long-sealed Cognizant v. Infosys ruling that hints where system of record antitrust claims can survive. EHRs One Verb for Oracle Health (Sep 14): Oracle’s earnings call quantifies every data center to the decimal point, while Oracle Health gets a single verb: “accelerate.” Panning the few healthcare mentions turns up an agentic care management system, a research-to-care ledger play, and the question of whether healthcare gets Larry’s patience. Epic’s Forretress Under Siege (Sep 30): Judy Faulkner tells a panel Epic paused hundreds of projects to harden its software and calls it a “shame,” while a spokesperson insists the roadmap hasn’t changed. Project Glasswing, a Pokémon-branded QAN sprint, and a trove of Jodel grievances reconcile the two Epics and preview the Jevons paradox coming for all software. Industry Analysis Scanning for a Network (Sep 1): Scan.com raises $220M to build the imaging network labs never got, speedrunning Zocdoc’s consumer-to-B2B pivot. Its wedge to network density may be the most American one available: personal injury litigation. The Front Desk Wants the Damn Whole Building (Sep 16): Hello Patient buys Converse Health, pushing its AI front desk into referrals, chart work, and prior auth. The copilot categories keep blurring, and your distribution partner is still your final boss. Cross-industry Comparisons A Different Patchwork Quilt (Sep 10): Healthcare loves to envy open banking, but the US version has no mandate, a toll booth at Chase, and data quality problems of its own. The grass isn’t greener; it’s another American patchwork quilt, and perhaps a worse one. Hail, Benihydra (Sep 21): Salesforce brings its platform into Claude, Slack, and its own agent, inviting the interfaces that might replace it. Cut off one head and more grow back, so long as the records underneath stay put. Living on A Trade Secret Prayer (Sep 22): Six credit unions are suing Fiserv, the Epic of core banking, by claiming their own member records as trade secrets. Banking has no Cures Act, so its lawyers reach for legal alchemy that healthcare has already tried. Other News None this month External Media Nabla Accelerate NYC: I kicked off fall conference season at Nabla’s Accelerate event in New York, where Delphine Groll opened by asking the room to picture the company it wants to become and the one it doesn’t. I liked her framework of bureaucracy, fear, and ego as the blockers. I also love vendor conferences/events in general - different vibe than industry biggies. Healthcare 101 with Nikhil Krishnan: I briefly guest lectured Out-Of-Pocket’s Healthcare 101 class. Appreciated Nikhil’s takeaways cover whether AI doctors can query HIEs, why healthcare’s data-liberation rules beat most industries’, and the hi-res graphic is in the comments. HCN: Epic Probed by the FTC: I joined the HCN guys to talk through the FTC’s investigation into Epic. Cedric’s new hairdo was an unexpected plot twist. The episode also covers MFN drug pricing, healthcare M&A and Eli Lilly’s acquisition streak. Fall Conferences: At eHealth Exchange’s Annual Meeting in Austin on Oct 27, I’ll moderate a panel on the tensions between AI, HIEs, and timely patient access with Jean Ross (Primary Record), Therasa Bell (Kno2), Byron Crowe (Doctronic), and Michael Marchant (Freenome). Here’s the rest of my schedule if you want to meet up: CommonWell (Redwood Shores, CA): Oct 13-14 Will be participating in a fun Jeopardy event Open@Epic (Madison, WI): Oct 20-23 Will be enjoying Verona, Willy Street, and other local adventures eHealth Exchange and Sequoia Project (Austin, TX): Oct 27-29 Yeehaw HLTH (Vegas): Nov 15-18 Groundhog Day, Venetian Edition RSNA (Chicago): Nov 30-Dec 2 See me at “Governing AI in Breast Imaging: What Health Systems Are Actually Doing” Digital Health Counsel 2026 AI Summit (Seattle): December 2-3 Will likely be speaking to a bunch of lawyers about information blocking Posts I Liked ChatGPT’s Epic integration: game changer or nothing burger?: Joshua Liu, MD offers five thoughts on OpenAI’s Epic launch, starting from the point that it rides the same open APIs available to anyone. He argues read-only access leaves ordering to Art and the ambient startups, and asks why HCA is piloting it alongside Commure. He’s sorta a must-follow at this point - consistently excellent, thought-provoking takes. Epic, Lilly, and the Discovery pass: Seth Chaney reads Epic’s first major Discovery deal (with Eli Lilly), as well as its revised developer terms on commercial displays, as the pipe finally opening between EHRs and pharma. Life sciences and health continue to collide. Scott Rossignol on EHR payer platforms and ePA fees: Scott argues the top ambulatory EHR vendors are turning the prior auth mandate into a per-member-per-year toll on payers, for an API whose operating cost has nothing to do with covered lives. His fix is two lines of regulatory text: put the CRD/DTR/PAS certification criteria in the Base EHR definition, and bring payer-facing ePA connectivity under § 170.404’s cost-based fee rules. It’s a good solution. Health API Guy is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe
Senate leaves town until after the midterms as final bills founder
Democrats block several pieces of legislation pushed by Republicans looking for victories ahead of Election Day.
Senate blocks data center, stock trading bills ahead of November midterms
Battleground Republicans were hoping to campaign on the bills, but Democrats blocked both measures, saying they don’t go far enough
Editor's picks: Highlights in Bend music, art events
First Friday Art Walk You can’t do much better in terms of free entertainment than heading to downtown Bend or the Old Mill District for the monthly First Friday Art […]
Democrats block data centers bill, derailing Senate GOP bid to act on affordability ahead of midterms
Senate Democrats on Wednesday blocked a GOP-led bill to combat rising energy costs driven by the data center boom, thwarting a last-ditch effort by Republicans to show they are taking voter concerns about affordability seriously.
Congress Set to Leave Washington for the Midterms With No A.I. Progress
Senate Democrats were expected on Wednesday to block a measure that would encourage, but not require, states to protect consumers from power rate hikes as a result of data center growth.
Congress Set to Leave Washington for the Midterms With No A.I. Progress
Senate Democrats blocked a measure that would encourage, but not require, states to protect consumers from power rate hikes tied to data center growth, and had no limits on A.I. use or deployment.
Monitoring the Midterms: Health care costs a major concern for voters ahead of midterms
Learn about the rise in healthcare costs and thousands losing their coverage
Stop the Bleed: Cut Costs, Not Care Gets Candidates on the Record on High Cost of Health Care Ahead of Midterms
What will you do to hold health care corporations accountable for high costs? For more information, learn more with Stop the Bleed.
We are capitalists: US Democrats push back against communist label ahead of midterms
Sixty national, state and local candidates, including 10 sitting members of Congress, have signed a pledge with a new group, Promise to America
Ron DeSantis’ 2 terms in office fundamentally altered Florida’s political landscape, cementing conservative policies through strategic control of state institutions
After eight years in office, Gov. Ron DeSantis leaves Florida much more conservative than he found it.
U.S. ends health aid to Zimbabwe after ‘America First’ deal is spurned
The African nation refused to make an agreement with the Trump administration, which has sought to slash foreign assistance and impose new terms on recipients.
When “DEI” research is cut, what happens to community health?
“I’m just going to run to the grocery store!” How many times have we said this without thinking about it? For most of us, it's usually an easy walk or a short drive to get the cheese we forgot. In reality, though, 13% of the U.S. population (about 39 million people) live in “food deserts,” which means living more than a mile from a grocery store in urban areas and more than 10 miles in rural areas. This was the case for people in Pittsburgh’s Hill District, where a quick run to buy food wasn’t an option. In the 1930s, federal maps marked the Hill as "hazardous" for lending, a practice known as redlining that steered investment away from Black neighborhoods. Decades of disinvestment followed, and residents went about 30 years without a nearby grocery store. This made it hard to keep healthy eating habits and contributed to chronic disease. When a grocery store finally opened in the area in 2013, researchers saw the opportunity and launched the PHRESH study, which initially compared the health of participants from the Hill district to those in the Homewood district. Over time, the study expanded to other factors such as brain health and Alzheimer's risk. Residents like Roderick Blair overcame initial hesitation to share their health data, trusting it would benefit their neighborhood. Then, in August 2026, the NIH abruptly canceled the study’s grant, citing that it was “subjective” and fell outside their scientific scope—an effect of the administration’s interpretation of diversity, equity and inclusion (DEI). Research like PHRESH can help determine what changes in a neighborhood actually improve health, so cutting it has left that question unanswered. Other canceled studies have examined health issues like maternal health, preterm birth rates, or sickle cell disease. Courts have reversed some of these grant cancellations, but not all of them. If we really want America to be healthier, research into why some communities get sicker than others is absolutely critical. The law that created the federal minority health research institute passed with bipartisan support in 2000. But these days, as evidenced by grant cancellations, the political shift in attitudes toward DEI means we often lose access to the health information we need to help all communities thrive. DEI vs. health equity vs. equality and the overlap (or lack thereof) The letters “DEI” evoke very different reactions depending on who you are in the U.S. DEI programs can address gender, disability, age, and other factors, but the fiercest debate centers on race. For some people, hearing DEI brings to mind policies that may have cost them a job or a college seat because they are white. Others see DEI as a matter of justice: a way to expand representation and opportunity for groups that have been historically marginalized. Both perspectives are rooted in lived experience, and both center on the same question: whether hiring and admissions practices are fair. Hiring and admission practices, though related, are not the same as health equity. Health equity is “the attainment of the highest level of health for all people.” It’s the recognition that some groups of people consistently experience worse health outcomes than others. For instance, black mothers die from pregnancy-related complications at three times the rate of white mothers, and rural Americans are more likely to die from issues such as heart disease and cancer. Equity is also often conflated with “equality,” which leads to misunderstanding of how to actually best support communities. Equality ignores the fact that we aren’t all starting life with the same resources or circumstances, whereas equity is about helping people get what they specifically need based on their situation so they have the chance to achieve the same outcome as anyone else. For example, if every household in Pittsburgh got a $30 grocery gift card, that would be equal. But during the decades the Hill District went without a grocery store, that card wouldn’t have helped much. Equity means making sure everyone can actually access a store in the first place. DEI policies can overlap with health equity in many ways. For example, they may help expand access to quality education and stable, well-paying jobs, which in turn can provide health insurance, safer housing, and improved finances—all of which can reduce health disparities. But to make that happen, we first need data to identify disparities in communities and to develop solutions that effectively address them. What we lose when the research stops Community data is important to health equity because: You can’t fix what you don’t see: Data show which communities are most affected by health factors such as infection, heart disease, and cancer. If we don’t know what is happening and where, then we can’t develop interventions to help. Poor health costs everyone: Chronic disease is expensive—both to the individual person and to the overall economy. Understanding what groups of people are most at risk allows us to develop interventions that can save everyone money. Disparities exist for many communities: Health equity includes disparities that exist due to a whole host of factors, such as family background, race and ethnicity, rural vs. suburban residence, gender and sexual orientation, veteran status, disability, and lower income. This means many Americans can benefit from research into differences in health outcomes and how to improve them. Trust is easy to lose: Some participants in the PHRESH study were initially vocal about their concerns about participating. But that trust was earned because the researchers kept their promises and centered their work on the community. When projects are canceled mid-cycle, researchers have no choice but to leave behind communities they had promised to help. This hurts trust in the long run. It’s also a very inefficient use of resources, and it will take significant time and effort to redo the work when the government realizes this work is important again. How should we talk about health equity? This is hard because the words “equity” and “DEI” are currently very politically charged. So whether you’re a public health professional, teacher, or friend, how we talk about this topic matters. The right framing can help people who might otherwise be skeptical see why health equity research is important and deserves funding. Here are some suggestions to help your conversations: Choose your words strategically: Who are you trying to reach with your message? Are they likely to be resistant to terms like “diversity” and “equity”? If so, find alternative words to use to still get the message across. It is frustrating to be in that position, but the goal of improving health is too important not to try to make inroads. Sometimes simply reframing can help the message reach those who need to hear it. Focus on the problem: The terms “health equity” and “DEI” are abstract. Make it more specific. For example, discuss differences in maternal death or ways to improve health outcomes in rural communities. These still have equity at their core but will likely be better understood by those you’re talking with. Focus on systems: Disparities exist, but if they are communicated poorly, people can mistakenly think the issue is the individual’s fault. Disparities are largely driven by failures of the system—such as lack of access to health care and a long legacy of racism. When discussing the disparities, frame them around these systemic issues to ensure blame isn’t placed on the individuals impacted. Tell stories: Personalize these policies by using stories from those impacted that connect to the data you’re trying to convey. This helps make the policies and outcomes more concrete and meaningful. Bottom line Some communities end up sicker than others. That’s just the facts. We can argue about the best way to do that research, but canceling it simply because it may be linked to DEI doesn’t make anyone healthier. It just leaves communities like the Hill district behind. And in the end, it causes us all to move backward in our efforts to improve health in this country. Love, EM Big thanks to MacKenzie Isaac & Legairre Radden, who reviewed this piece and generously shared their expertise and lived experience to help improve it. Dr. Liz Marnik, PhD, is Executive Director of The Evidence Collective and a science communicator and immunologist working at the intersection of public trust, science, and public health. To discuss communication training on topics like health equity and storytelling, email Liz at liz@yle.health or learn more on our website. Your Local Epidemiologist (YLE) comprises a team of experts, ranging from physicians to immunologists to epidemiologists to nutritionists, working together with one goal: to “translate” ever-evolving public health science so that people are well-equipped to make evidence-based decisions. The YLE suite of newsletters reaches over 475,000 people across more than 132 countries. This newsletter is free to everyone, thanks to the generous support of fellow YLE community members. To support the effort, subscribe or upgrade below: Your Local Epidemiologist is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe
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The message I had received was unsettling—for a moment. Then it was just really confusing. Back on January 20 of this year, at 5:15pm ET, I received an email with the subject line “Legal Correspondence re Bobby Kotick.” It was from the law firm Clare Locke, a firm I’d heard had been emailing reporters in recent years about their coverage of Kotick, the former, longtime CEO of Activision Blizzard. The letter was threatening. A lawyer from the firm introduced themselves as “defamation counsel to Bobby Kotick.” They issued a “demand” that I “correct” a Game File article I’d published a week prior. The article that had irked them had been a scoop of sorts. I’d written about a a 2022 lawsuit brought by a Swedish pension fund, AP7, over Microsoft’s purchase of Activision Blizzard. The suit wasn’t news, but I was first to review and report about Kotick’s extensive pushback to the fund’s claims. The pension fund’s core contention was that the sale had been rushed by Kotick to avoid the consequences of sexual misconduct scandals swirling around the company in 2021. (He’d not been accused of misconduct himself in those suits, to be clear.) As I wrote at the time, Kotick had denied the allegations of the rushed sale. Beyond that, Kotick used a December 2025 reply to the Swedish fund’s lawsuit to assign blame for those workplace scandals, the bad press and even for the AP7 lawsuit. I’d found Kotick’s arguments novel and newsworthy. Across nearly 3,000 words, I explained Kotick’s take: that a Swedish gaming company was behind the Swedish fund’s lawsuit (the Embracer group; they denied it); that the Microsoft-Activision deal was not rushed and was secured at what Kotick felt history had proven to be an optimal price for shareholders; that he believed a conspiracy of people at unions government agencies, PR firms and the media had spun up claims of widespread workplace misconduct at Activision Blizzard in 2021. The article gave context for all of this, letting readers assess the claims and weigh their credibility. As I’d later write to Kotick’s lawyers: I would be surprised if you could point to any news article about Bobby Kotick in the last five years that has spent more of its wordcount articulating his point of view. He is welcome to do an interview with Game File any time. Nonetheless, there they were in my inbox that Tuesday evening: Clare Locke, the law firm that secured a $787.5 million settlement from Fox News over false statements about voting machines. They were emailing me, threatening that failure to comply with their demand could support a claim of “actual malice,” a legal standard for libel. Unless… Unless, they said, I added a key paragraph to my article. This was a paragraph that I already knew Kotick’s lawyers had been emailing reporters about for at least a year, and it was a paragraph that was already in my article. The paragraph they wanted is from a 2023 settlement that California’s Civil Rights Department struck with Activision Blizzard. The settlement had closed a two-year-old lawsuit over alleged sexual discrimination at the game maker. The paragraph basically said that claims of systemic or widespread sexual harassment—or of execs like Kotick tolerating such behavior—had never been proven. I’d already seen proof that Kotick’s lawyers had pushed for the settlement’s language to be added to reports about 2021 sexual discrimination and misconduct lawsuits brought against Activision Blizzard by California and, separately, by the U.S. federal government (both suits were since settled). I knew that Kotick and his lawyers felt that the California settlement language should be mentioned in the same breath as references to an article he hated and denied, a November 2021 Wall Street Journal article claiming Kotick knew “for years” of sexual misconduct at Activision Blizzard. So, in the Game File article that Clare Locke emailed me about, in the interest of ensuring I was being fair and balanced regarding the person I was covering, I had already included the following excerpt from the California settlement [emphasis added in bold]: (Kotick has repeatedly pushed back against that November article in the Wall Street Journal, citing among other things, language from a court-approved consent decree as part of Activision’s 2023 $54 million settlement over the California suit. It states: “no court or any independent investigation has substantiated any allegations that: there has been systemic or widespread sexual harassment at Activision Blizzard [or] that Activision Blizzard senior executives ignored, condoned, or tolerated a culture of systemic harassment, retaliation, or discrimination.”) On the evening of January 20, I was incredulous. How do you write a four page legal threat about a week-old article and miss this? While scrambling to also make my kids dinner, I wrote a lengthy reply to Clare Locke’s lawyers, basically asking them to cool it with the threats and to start making sense. In part, I wrote: I hope you can understand why I am having trouble understanding what you’re asking for, when the statement you’re demanding to see in Game File’s article already appears in Game File’s article. Actual malice, as you know, refers to a reckless disregard for the truth. I’m not sure what your argument is when my article already states your client’s position. Here is where I should remind you, the reader, that I am an independent journalist. I publish on Substack, and have availed myself of the Substack Defender program that provides writers on the platform with legal support. But I’m no Wall Street Journal or New York Times, nor even IGN or GameSpot when it comes to such things as, well, having a legal department. There are more fun things for me to do as an independent journalist than writing back to a powerful law firm representing a very rich person. On the evening of January 20th, I was just trying to cook some pasta, broccoli and chicken nuggets for hungry twins. Nevertheless, I wrote back to them. Two hours later, I got a reply. Summarizing: A lawyer for Clare Locke said they’d “reviewed an incomplete version” of my article and they “apologize for the confusion.” (My guess: Someone didn’t read past the piece’s paywall, even though they’d had a full week to scrounge up the funds to do so. What I’d published above the paywall was balanced, as was what came after.)1 That was almost that, but something about the situation bothered me. The letter had been marked “confidential.” I hadn’t agreed to that, and I disliked the idea that powerful people on the beat that I cover would act like they could unilaterally control what I might tell my readers about. On the morning of the 21st, having already gotten the powerful law firm to back off, I oh-so-wisely re-approached them with just one more thing. I thanked them for clearing things up the night before but noted that I’d never agreed to keep their letter confidential. I’m all for agreeing with a source to keep things off the record, but that’s the thing. We have to agree. You can’t just declare it. I’m not bound by that. I wrote to Clare Locke’s lawyer and said, in part: I trust the matter is resolved. It was disappointing to have to spend less time with my kids last night in order to address your legal letter. Family time’s precious. I will add, for clarity’s sake, that, while your letter stipulated that it was confidential, I did not agree to those terms. In the future, should you wish to communicate with me confidentially, I am happy to agree to classifying our communication as “off the record” prior to the actual communication—as is standard with any professional journalist. The firm’s lawyer replied, not directly addressing the confidentiality issue but asserting that the matter was resolved. Why I didn’t write about this until now In May, I told this story on an episode of Simon Parkin’s podcast My Perfect Console, but I held off on sharing it directly with Game File readers. I held off to avoid stepping on the toes of another reporter, the journalist Mikhail Klimentov. He’d interviewed me in the spring of 2025 about an investigation he was working on regarding Bobby Kotick lawyers pressing the media to add the California settlement language to stories referencing the 2021 lawsuits. And about how some outlets had changed their stories and how some simply deleted them. Initially, I was a third-party source for Klimentov’s reporting, providing on-the-record context about the state of the games media. I’d heard about the letters but hadn’t put the time into pursuing the story. I thought it was interesting, and I was glad he was covering it. When the outlet that Klimentov was going to run his reporting in dropped the story, I began talking to him about potentially publishing his reporting on Game File. This was tentative. Then, in January, when I got my own Clare Locke letter, I told Klimentov that I didn’t think it would make sense for me to publish him, not with me now being part of the story. I had my own version of this situation to tell. But I wished him well and said I’d refrain from telling my tale until he could get his reporting out there. Last Friday, Klimentov finally ran his investigation, in a nearly 48-minute video report for People Make Games. It covers various Clare Locke letters, how media outlets reacted to them and what to make of all this. His video weighs the merits of Kotick’s request and looks at some of the articles that were changed (one of which had a glaring error). I highly recommend watching it: (Note, I did some editorial consulting for a People Make Games video last year but nothing to do with this report.) While many outlets haven’t left any public evidence that they updated their Kotick coverage at Kotick’s counsel’s request, at least one has. Back in October 2025, the mainstream outlet Reuters applied the most transparent article update I’ve seen. On the 3rd of the month, they published an article about the state of the Swedish pension fund’s lawsuit. Days later, they added this: In an October 7 letter sent after publication of this article, Kotick’s defamation counsel disputed claims of widespread harassment at Activision. “Not a single investigation, court finding, verdict, or ruling ever concluded that there was any merit” to the allegations of widespread harassment at Activision, Tom Clare and Nick Brechbill of Clare Locke wrote. I’ve never added a statement to my article on Game File, because none was needed. Not for fairness’ sake, nor to meet any demands of Kotick’s lawyers. I’ve nevertheless wanted to be transparent with Game File readers. If someone powerful is questioning my reporting, is threatening a lawsuit over it… if that threat is part of a pattern involving other games media outlets and if, in my case, the whole thing ran into a ridiculous ditch, I want you to know about it. I also share this as a real example of how I handle threats to Game File. I stand up for my own reporting, even when it’s not comfortable to do so. (In that same category of standing up for the work I do, I’ll point to an incident in late August. Asocial media post I published to X/Twitter regarding reporting I did about Take Two and GTA VI was hit by bogus copyright claim by a firm working for the publisher. I pushed back and got it reversed; even while a bigger games media outlet let themselves be censored. This is the other reason I’m sharing this story: To emphasize that dealing with threats from powerful people is one of the costs of covering the video game industry independently and as fearlessly as possible. This is where you come in. Your support, through free and paid subscriptions (sign up here!), can help me keep doing that. It can ensure that I’ve got the back-up I need. And it can help make fiascoes like this even less of a worry, so I can spend my evenings dealing with more important things, such as making sure I steam the kids’ broccoli just right. 1 That pension fund lawsuit I wrote about in January has all but gone away. In May, the fund and Activision Blizzard owner Microsoft agreed to settle. Lawyers for the fund brokered a $250 million settlement for former Activision Blizzard shareholders. In the settlement, the fund’s lawyers changed their rhetoric. Where once they’d questioned the meaning of the California settlement language, they adopted a version of it for themselves. Several weeks ago, while seeking to get a court to sign off on the terms of the settlement, they proposed their fee for their work in the case: $60 million.
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