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Government shutdown draws closer as congressional leaders head to the White House

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Democratic and Republican congressional leaders are heading to the White House for a meeting with President Donald Trump on Monday in a late effort to avoid a government shutdown, but both sides have shown hardly any willingness to budge from their entrenched positions.

If government funding legislation is not passed by Congress and signed by Trump on Tuesday night, many government offices across the nation will be temporarily shuttered and non-exempt federal employees will be furloughed, adding to the strain on workers and the nation’s economy.

Republicans are daring Democrats to vote against legislation that would keep government funding mostly at current levels, but Democrats so far have held firm. They are using one of their few points of leverage to demand that Congress take up legislation to extend health care benefits.

“The meeting is a first step, but only a first step. We need a serious negotiation,” Senate Democratic leader Chuck Schumer said in an interview Sunday on NBC’s “Meet the Press.”

Trump has shown little interest in entertaining Democrats’ demands on health care, even as he agreed to hold a sit-down meeting Monday afternoon with Schumer, along with Senate Majority Leader John Thune, House Speaker Mike Johnson and House Democratic leader Hakeem Jeffries. The Republican President has said repeatedly that he fully expects the government to enter a shutdown this week.

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“If it has to shut down, it’ll have to shut down,” Trump said Friday. “But they’re the ones that are shutting down government.”

The Trump administration has tried to pressure Democratic lawmakers into backing away from their demands, warning that federal employees could be permanently laid off in the midst of a funding lapse.

“Chuck Schumer said a few months ago that a government shutdown would be chaotic, harmful and painful. He’s right, and that’s why we shouldn’t do it,” Thune, a South Dakota Republican, said Sunday on “Meet the Press.”

Still, Democrats argued that Trump’s agreement to hold a meeting shows that he is feeling the pressure to negotiate. They say that because Republicans control the White House and Congress, Americans will mostly blame them for any shutdown.

But to hold on to their negotiating leverage, Senate Democrats will likely have to vote against a bill to temporarily extend government funding on Tuesday, just hours before a shutdown — an uncomfortable position for a party that has long denounced shutdowns as pointless and destructive.

The bill has already passed the Republican-controlled House and would keep the government funded for seven more weeks while Congress works on annual spending legislation.

Any legislation to fund the government will need support from at least 60 senators. That means that at least eight Democrats would have to vote for the short-term funding bill, because Republican Sen. Rand Paul of Kentucky is expected to vote against it.

During the last potential government shutdown in March, Schumer and nine other Democrats voted to break a filibuster and allow a Republican-led funding bill to advance to a final vote. The New York Democrat faced fierce backlash from many in his own party for that decision, with some even calling for him to step down as Democratic leader.

This time, Schumer appears resolute.

“We’re hearing from the American people that they need help on health care and as for these massive layoffs, guess what? Simple one-sentence answer: They’re doing it anyway,” he said.

Democrats are pushing for an extension to Affordable Care Act tax credits that have subsidized health insurance for millions of people since the COVID-19 pandemic. The credits, which are designed to expand coverage for low- and middle-income people, are set to expire at the end of the year.

Some Republicans are open to extending the tax credits, but want changes. Thune said Sunday that the program is “desperately in need of reform” and Republicans want to address “waste, fraud and abuse.” He has pressed Democrats to vote for the funding bill and take up the debate on tax credits at a later date.

It remains to be seen whether the White House meeting will help or hurt the chances for a resolution. Negotiations between Trump and Democratic congressional leaders have rarely gone well, and Trump has had little contact with the opposing party during his second term.

The most recent negotiation in August between Schumer and the president to speed the pace of Senate confirmation votes for administration officials ended with Trump telling Schumer to “go to hell” in a social media post.

Trump also abruptly canceled a meeting that was planned with congressional leaders last week, calling Democrats’ demands “unserious and ridiculous.”

Schumer argued that the White House coming back to reschedule a meeting for Monday showed that “they felt the heat.”

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Republished with permission of The Associated Press.


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House panel approves bill to expand James Uthmeier’s power to target physicians

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A House subcommittee approved a bill to give Attorney General James Uthmeier expanded power to investigate health care professionals for taking care of transgender youth.

The Criminal Justice Subcommittee passed HB 743 with a 12-5 vote as Democrats and LGBTQ+ advocates rallied against it.

Under the bill, Uthmeier would be allowed to investigate and sue health care practitioners who give puberty blockers, hormones or other prescriptions to minors, or perform surgical procedures. Each violation could bring up to a $100,000 fine.

Uthmeier’s amplified authority would come after the state previously banned gender-affirming care for minors in 2023.

But Rep. Kelly Skidmore warned lawmakers that it was dangerous to give Uthmeier more power following the Hope Florida scandal.

“No disrespect to the folks who are here about gender-affirming care, but that’s not what this bill is about,” the Boca Raton Democrat said. “It is about giving one individual and maybe his successors authority that they don’t deserve and they cannot manage. They’ve proven that they cannot be trusted. This is a terrible bill.”

Uthmeier, then Gov. Ron DeSantis’ Chief of Staff, chaired a political committee that was funneled millions of dollars from a $10 million state Medicaid settlement. Critics have accused DeSantis and Uthmeier of misappropriating the money to use for political purposes. Uthmeier has denied wrongdoing.

But at Tuesday’s hearing, Rep. Taylor Yarkowsky argued Uthmeier is doing “unprecedented work” to protect kids. The lawmaker added that he is against minors transitioning until they are 18 years old and can legally decide for themselves.

“I understand this is a tough situation and I know that these feelings and emotions are real,” the Montverde Republican said. “But we have to uphold the principles and standards that made this country great, biblical, constitutional law and order at all costs. And sometimes that stings.”

HB 743 would also update the law to add that a health care practitioner who “aids or abets another health care practitioner” giving gender-affirming prescriptions or doing procedures to minors would now be charged with a third-degree felony. That could mean pharmacists filling prescriptions at Publix or Walgreens could potentially be charged for crimes, said Rep. Lauren Melo, the bill sponsor.

Melo said her bill comes as some minors are trying to skirt state law.

“What we’re seeing is there’s coding that’s actually being used that is becoming the problem, and hundreds of thousands of dollars is spent per child for them to transition and codes are being misrepresented where they are saying that it’s an indoctrination disorder instead of saying it’s a gender identity disorder,” Melo said.

Minors who have been receiving gender-affirming care continuously since May 2023 are exempt from state law, so the bill’s changes would only be applied to minors receiving care for the first time, the Naples Republican added.

Rep. Mike Gottlieb, who also believed the bill was giving Uthmeier too much power, said it could have other unintended consequences. The bill could scare doctors from prescribing medicine that helps women with bad menstruation symptoms — which has nothing to do with gender-affirming care, he said.

“You’re going to see doctors not wanting to prescribe those kinds of medications because they’re now subject to a $100,000 penalty,” the Davie Democrat said. “We really need to be cautious. I get where many of us sit in this battle. … We pass some of these laws, it’s a knee-jerk reaction. … We’re really not considering what we’re doing and some of the collateral harms that it’s having.”

He said he worried the bill would force more physicians to leave Florida.

But Melo argued her legislation was important because “unfortunately, what’s happening is there are physicians that are actually committing fraud.”

“This gives us an avenue to pursue and punish the people that are committing fraud against a minor child,” she said.

Shawna Flager, a mom advocating for her child who is transgender, criticized the bill during Tuesday’s debate.

“I feel like it introduces ambiguity. It also uses the government to create fear and intimidate our health care providers,” said Flager, of St. Augustine.



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Florida shouldn’t gamble with patient safety on false promises

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Florida lawmakers are once again being asked to expand unsupervised anesthesia practice, this time under the familiar banner of “access,” “cost savings,” and “modernization.” We are told this is inevitable — that “48 states already have similar laws,” and Florida is simply behind the curve.

That claim collapses under even minimal scrutiny.

Let’s be clear about what is being proposed: allowing Certified Registered Nurse Anesthetists to practice independently, without physician anesthesiologist supervision, in all settings. This is not a minor regulatory tweak. It is a fundamental change in how anesthesia care — one of the riskiest aspects of modern medicine — is delivered.

If lawmakers want to make policy based on evidence rather than talking points, three facts matter most.

Physician-led anesthesia care is the safest model.

Anesthesia is not just about “putting patients to sleep.” It involves managing complex physiology, responding to sudden, life-threatening emergencies, and caring for patients with multiple comorbidities — often when things go wrong quickly. Physicians who practice anesthesiology complete four years of medical school, four years of residency, and often additional fellowship training. That depth of training matters when seconds count.

The safest anesthesia outcomes consistently occur in physician-led teams, where anesthesiologists work alongside Certified Registered Nurse Anesthetists. Team-based care maximizes patient safety by matching expertise to the complexity of each patient’s care. Eliminating physician oversight does not improve safety; it removes a critical layer of protection.

Florida should be strengthening team-based care — not dismantling it.

Unsupervised anesthesia is not more cost-effective.

Proponents often claim that removing physician supervision lowers costs. The data do not support this. Medicare pays the same for anesthesia services regardless of whether a physician anesthesiologist is involved. Further, having an anesthesiologist present to manage complications helps control costs by reducing hospital stays and downstream medical expenses.

The cheapest anesthesia is the one that goes right the first time — and the safest model is also the most cost-effective in the long run.

These laws do not help rural communities.

This is where rhetoric diverges most sharply from reality. State “opt-out” laws allowing unsupervised anesthesia have been studied for more than a decade. The conclusion is consistent: they do not increase access to anesthesia services in rural or underserved areas.

Certified Registered Nurse Anesthetists, like all health care professionals, tend to practice where hospitals are well-resourced and professionally supportive. Opt-out states did not see a meaningful expansion of anesthesia services in rural hospitals. Workforce shortages remained unchanged.

If unsupervised practice were the solution, rural access problems would already be solved. They are not.

Supporters now claim that nearly every state has “similar” laws — a creative redefinition that lumps together wildly different regulatory frameworks. Supervised practice, delegated authority, limited opt-outs, and emergency exceptions are being counted as “unsupervised care.” Florida should not make major patient-safety decisions based on inflated numbers and fuzzy definitions.

This proposal is not about modernization. It is not about rural access. And it is not about saving money. It is about replacing the safest, most cost-effective anesthesia model with one that offers no proven benefit — and real risk.

Florida’s patients deserve policies grounded in evidence, not exaggeration. Lawmakers should reject unsupervised anesthesia and instead invest in physician-led, team-based care that puts safety first — every time.

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Rebekah Bernard, M.D., is a family physician in Fort Myers and a Board member of Physicians for Patient Protection.



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Adam Anderson’s push for more genetic counselors in Florida clears first hurdle

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Rep. Adam Anderson has successfully ushered through its first committee stop legislation that would address a shortage of genetic counselors and strengthen the state’s capacity for advanced medical care and genetic research.

Anderson’s bill (HB 1115) cleared the Careers and Workforce Subcommittee. It would establish the Genetic Counseling Education Enhancement Grant Program within Florida’s State University System to support the development of American Board of Genetic Counseling-accredited graduate-level genetic counseling programs to eliminate Florida’s status as a genetic counseling desert.

“The need for health care professionals in the Sunshine State cannot be understated,” Anderson said.

“But specialization is the true hurdle for families praying for the next innovation that will help their child. Genetic counselors guiding difficult diagnoses are in short supply. However, Florida aims to right-set our specialization efforts at the intersection between education and employment. We’re standing by Florida families and those students willing to take the next step.”

With just 179 licensed genetic counselors in the state, patient demand is not being met. Genetic counselors guide families facing complex genetic diagnoses, and they serve as essential partners in research, innovation and precision medicine.

Sen. Danny Burgess is sponsoring an identical measure (SB 1376) in the upper chamber, though it has not yet been heard in committee. Still, he celebrated initial support for the measure in the House.

“This is legislation every Floridian can get behind,” Burgess said. “Developing our workforce is step one, but retaining specialized genetic counselors in the State of Florida to help Floridians is the entire picture. Aid shouldn’t be a state away. This grant program realizes that comfort and care for Florida families should be available within Florida.”

The bill would allow grant funds to be used to recruit and retain qualified faculty, provide financial aid to students, and establish or expand clinical rotations required to obtain a master’s degree in genetic counseling. The funds would be barred from use for general administrative costs, new facility construction and non-program-related activities.

Participating universities under the bill would be required to maintain detailed compliance records and submit annual reports on expenditures and program outcomes. The state Board of Governors would then compile the information from reports into a statewide submission.

“The progress Representative Anderson has ignited is contagious. Florida is on the cusp of developing a genetic counseling workforce that meets a crucial need for families facing uncertainty,” said Dr. Pradeep Bhide, Director of the Florida State University Institute for Pediatric Rare Diseases. “FSU is all for it.”

Under Bhide’s leadership, the Institute is developing a new master’s degree program in genetic counseling.

Currently, the University of South Florida is the only state school with an active genetic counseling program, with FSU’s program awaiting approval.

“New education programs are what drive the innovations and patient care required to address complex genetic issues. Rep. Anderson and the State of Florida have time and time again seen the value in the educational framework that leads to great progress,” said Charles J. Lockwood, executive vice president at USF Health and dean of the USF Health Morsani College of Medicine.

“USF Health has long understood the need for genetic counselors in Florida, and we are excited at the prospect of further collaboration with Florida’s other universities.”

Anderson’s bill heads next to the Higher Education Budget Subcommittee. If approved by the full Legislature and signed by Gov. Ron DeSantis, the measure would take effect July 1.



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