By Anna Claire Vollers, Stateline.org

Rural hospitals are less likely to offer obstetric services after they’ve been acquired by a larger health system, leading to mixed outcomes for mothers and babies, according to new research.

It’s part of an accelerating trend that’s reshaped how Americans get health care: Larger health systems gobble up smaller facilities in a bid for financial stability.

“The hospital industry has undergone tremendous transformation over the past few decades, with nearly 1,600 mergers between 1998 and 2021,” said Martin Gaynor, a coauthor of the study and emeritus professor of economics and public policy at Carnegie Mellon, in a statement.

Those large-scale changes to the health system can affect costs, quality and access to care, he said.

Over the past five years, more than 100 rural hospitals have stopped delivering babies or announced they’ll stop in 2025, according to the most recent data from the Center for Healthcare Quality & Payment Reform. Less than half of rural hospitals still offer labor and delivery services.

Gaynor and a team of researchers from Carnegie Mellon, Northwestern University and the University of Georgia examined how hospital mergers have affected access to obstetric care in rural areas, and the quality of that care. They found that rural hospitals were part of more than 450 mergers from 2006-2019.

Once those rural hospitals were acquired by larger systems, they were 30% less likely to still offer labor and delivery services five years later. Many of the shuttered obstetric departments were the sole local source of obstetric care.

That loss translated to fewer resources — such as practicing OB-GYNs — in the county where the acquired hospital was located, researchers found.

The number of births in those counties didn’t change; families just had to go elsewhere for care.

Less access to nearby care could explain those counties’ small increases in health problems among women during or after pregnancy and child birth, and higher rates of smoking among pregnant women, researchers said.

On the flip side, they found that some patients went to higher-quality facilities farther away. And in rural hospitals that didn’t close their obstetric departments following a merger, the quality of care tended to rise.

In recent years, officials in dozens of states have championed laws to increase oversight of mergers and other health care dealmaking.

In the wake of devastating hospital closures tied to corporate financial maneuvering, some states have strengthened their antitrust laws.

Last year alone, 22 states enacted at least 34 laws related to health system consolidation and competition, according to the National Conference of State Legislatures, an advisory think tank for lawmakers. Other states, meanwhile, have paved the way for health mergers in a bid to save failing rural hospitals.

At least 35 states now require hospitals, health systems, providers and private equity firms to notify a state official of proposed mergers or other contracts.

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Earlier this month, California lawmakers passed a bill to expand the state’s authority in overseeing mergers and acquisitions in health care. It’s headed to Democratic Gov. Gavin Newsom’s desk, though Newsom vetoed a similar measure last year.

At the federal level, President Donald Trump’s administration has not signaled an interest in increasing antitrust oversight. But Trump’s recent tax and spending law did include $50 billion in funding over the next decade aimed at helping states strengthen rural health care. Massive cuts to Medicaid also in the law could have devastating impacts on rural hospitals struggling to stay afloat, however.

The Centers for Medicare & Medicaid Services announced that states have until Nov. 5 to apply for rural health funding. States must show that they’ll use the federal dollars in a way that aligns with certain CMS goals, including helping improve access to care and strengthening retention of health care workers.

Stateline reporter Anna Claire Vollers can be reached at avollers@stateline.org.

©2025 States Newsroom. Visit at stateline.org. Distributed by Tribune Content Agency, LLC.

By FARNOUSH AMIRI and LEE KEATH, Associated Press

UNITED NATIONS (AP) — The Palestinian president, speaking over video after the United States revoked his visa, told world leaders Thursday that his people “reject” the 2023 Hamas attack on Israel and pledged that the militant group would have no role in governing Gaza after war ends and must hand over its weapons.

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Mahmoud Abbas told the U.N. General Assembly that Palestinians in Gaza “have been facing a war of genocide, destruction, starvation and displacement” by Israel. His speech came as Israeli Prime Minister Benjamin Netanyahu heads to New York to give his own address in person on Friday.

Despite laying out in gruesome detail the death and destruction in Gaza, Abbas said Palestinian authorities “reject” the action Hamas carried out on Oct. 7 and that it does not represent their people. He also laid out his vision for what government would look like in territories once the war is over, saying that the Palestinian Authority is “ready to bear full responsibility for governance and security. He added that “Hamas will have no role to play in governance,” and will have to hand over their weapons to the Palestinian authorities.

“There can be no justice if Palestine is not freed,” Abbas said.

In a short but resolute speech, Abbas thanked the world leaders who have stood up for Palestinians throughout the Gaza war, saying that the recent recognition of Palestinian statehood has presented his people with hope for peace and an end to the conflict. He welcomed the recent announcements from France, the U.K. and Canada to recognize them as an independent state and called for the remains few dozen countries to do the same.

But, he added, that symbolic recognition is not enough to address the present moment.

“The time has come for the international community to do right by the Palestinian people, so that they may obtain their rights for their legitimate rights to be rid of the occupation and to not remain a hostage to the temperament of Israeli politics, which denies our rights and continue in their injustice, oppression and aggression,” Abbas said.

Before concluding, he sent a message of hope to the Palestinian people, saying that no matter how long the suffering continues, “its results will not break our will to live and survive.”

“The dawn of freedom will emerge, and the flag of Palestine will fly high in our skies as a symbol of dignity, steadfastness and being free from the occupation,” Abbas said. “We will not leave our homeland. We will not leave our lands.”

Keath reported from Cairo.

By James Royal, Ph.D., Bankrate.com

While Bitcoin spent the last decade soaring and making millionaires out of many people, other owners of the world’s largest cryptocurrency have missed out. Why? One major reason: They’ve lost access to their account. In fact, more than $400 billion in Bitcoin is estimated to be lost — but some is recoverable, says at least one firm.

A 2023 report from Unchained Capital, a Bitcoin financial services company, estimated that up to 3.8 million bitcoins have been lost. That’s out of a total of about 19.9 million in existence today, and a maximum supply of 21 million tokens when Bitcoin is fully mined. That could mean as much as 19% of today’s supply is gone forever. Or is it?

Traders who have lost access to their Bitcoin or other digital currencies and assets may have the ability to recover them, at least with the help of one high-tech firm.

Bitcoins may be recoverable

Bitcoin’s vaunted security cuts both ways, preventing the bad guys from getting your stash but also — and often — you, too!

One of the most highly touted aspects of Bitcoin and other cryptocurrencies such as Ethereum or Dogecoin is their security. Not only are they nearly impossible to counterfeit, but transactions are almost irrevocable. Once someone has your bitcoins, they own them for keeps. It’s a similar situation if you forget your password, it gets tossed out as part of a move or you throw away a hard drive holding the coins.

But Chris and Charlie Brooks, father-and-son founders of CryptoAssetRecovery.com, have been recovering Bitcoin and other digital assets since 2017 for people who have lost their passwords, despite the high security.

“We estimate that about 2.5% of that approximately 20% of lost coins could still be recovered,” says Chris. The figure amounts to as much as $11 billion in recoverable assets with Bitcoin trading around $115,000.

Of course, not all digital assets are recoverable. Corrupted hard drives or those that were thrown away are likely gone for good. But Crypto Asset Recovery says it has a decent chance of getting your lost loot back if you had encrypted private keys but forgot your password or if you had a failed hard drive with private keys.

However, even if you have a wallet and they are able to pry it open, you may not have any coins in it at all. Former Bitcoin owners who dabbled in the cryptocurrency years ago may simply be hoping that they had long-lost treasure left on that old hard drive but weren’t certain and decided to have a look just in case.

“About half the wallets we crack are empty,” according to Chris and Charlie.

How your trapped crypto can be retrieved from a locked digital wallet

All kinds of digital assets could be trapped on a hard drive somewhere — Bitcoin, Ethereum, Dogecoin or any number of the most popular cryptocurrencies. But also increasingly trapped are NFTs, or non-fungible tokens, which might be digital art, a collectible, music or something else. These are all potentially recoverable.

The typical success story at Crypto Asset Recovery involves “an early Bitcoin adopter with a Blockchain crypto wallet,” says Charlie. These wallets are more than half of what they see. An early enthusiast may have purchased a few coins and then forgotten about them. But now with a single bitcoin trading for big money, even just a few coins could be a nice haul.

Once they’ve been contacted, Crypto Asset Recovery consults with customers, asks their best guesses for passwords and gets to work. Even if you only know part of your password or have a general idea of what it might be, the odds of accessing your lost crypto assets go up significantly.

From there the team tries to “brute force” your account, trying all kinds of potential passwords based on your suggestions.

“We might run tens of millions to hundreds of billions of password variations before we get it, or we decide that it’s not worth putting more computational resources into it,” says Chris Brooks.

Watch out for scammers advertising asset recovery services

Given the sensitive nature of the work, you may have to trust an asset recovery firm with potential passwords to your crypto account, which you may also be using elsewhere.

The promise of getting access to your lost bitcoins may entice even the most cynical owner to let down their guard around those who promise to help them retrieve their money. That’s easy to do if you may have hundreds of thousands, even millions of dollars, locked in a digital wallet somewhere.

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But officials caution consumers to carefully verify any asset recovery firm they hire. Many supposed firms are simply scammers who access your account and then run off with the proceeds, if they can even access your account. They may ask for a fee upfront to do the work, with the promise that you’ll eventually get your cryptocurrency and then run off with that cash.

The scams are highly sophisticated, according to the Commodity Futures Trading Commission (CFTC). Scammers may even issue press releases and fake testimonials that seem to vouch for their asset recovery services.

Officials point to several red flags that consumers should pay attention to:

—You’re charged a fee before any services are provided.

—The physical address for the firm is not provided or it’s located outside the U.S.

—The firm does not have a phone number and you’re asked to communicate through chat apps.

—The firm asks for your bank account details so that the recovered money can be deposited there.

Those are some of the most important signs, though the CFTC offers other warning signs and tips to stay safe.

3 common ways crypto traders lose access to their coins

Cryptocurrency has grown immensely popular over the last few years, and it’s a trendy trading vehicle for many young people who are new to investing. A 2025 Bankrate survey revealed that one-third of millennial Americans were at least somewhat comfortable with cryptocurrencies. But regardless of age, crypto traders may be unfamiliar with the different ways these digital assets can be held, meaning they could lock themselves out of their account.

Cryptocurrency owners can lose access to their assets in a variety of ways, and here are some of the biggest.

1. Not fully understanding how custody works

Unlike traditional assets such as stocks or bonds that are always held for you at a brokerage, cryptocurrency can be held directly by owners using a cryptocurrency wallet or a trading firm may hold them on your behalf. But this difference is crucial to recovering your assets.

If a firm has custody of digital assets for you, then you can work through its system to recover access to your assets. So it’s like a traditional investment firm in this way. You can verify your identity and the company will reset your password, and you’re ready to roll again.

But if you take custody of your digital assets, you won’t have that luxury. Unfortunately, many of those who are new to cryptocurrency don’t understand when they’ve taken custody of their assets and the responsibilities that entails. To access your self-custodied assets you’ll need your seed phrase, a collection of 12 to 24 words generated by your crypto wallet.

Because of the potential dangers of holding assets yourself, Chris and Charlie Brooks strongly recommend that those new to cryptocurrency sign up with a custodial wallet. With a custodial wallet, you could contact your trading firm and access your cryptocurrency relatively easily.

“Understand what is required to manage a Bitcoin wallet before diving in,” says Charlie.

2. Losing your seed phrase

People misunderstand the risks with crypto, says Charlie. “The much more likely risk for most people is that they lose their seed phrase — not that it’s stolen from a hacker, though that happens, of course.”

“The largest misconception that gets people into trouble is not understanding that the seed phrase is a representation of your private key,” says Chris Brooks. “If you lose that, you’re in trouble.” Many people don’t realize that the seed phrase is that important, he says.

The seed phrase unlocks your wallet as well as all your crypto in the wallet. So it’s vital that you maintain access to this seed phrase. “It’s not like a bank account with a password that they can just reset,” says Chris.

Moving is a really common time for someone to lose their seed phrases, they say, but there’s a simple solution.

“Buy a $30 safe from Amazon and store your seed phrases in there,” says Charlie. “You need a place to keep them so that no one will think ‘Hey, I need to throw this away.’”

3. Self-sabotage

“One of the biggest hurdles we face is that clients self-sabotage,” says Chris.

Self-sabotage occurs when people try to fix the issues themselves and only succeed in making things worse.

“About 30% to 40% of the folks that we can work with have hard drive issues from an old laptop,” says Chris. “They reformatted it or gave it away, for example.”

But the solution here is relatively simple: “Stop touching stuff — don’t reformat or reinstall a wallet,” says Chris. Resist the urge to try to fix something, because you will likely end up making it worse.

Bottom line

While it appears that a substantial portion of Bitcoin is lost to the sands of time, your crypto stash may not be a casualty. So it may be worth your time to see if you can recover your lost assets. And it’s certainly always worthwhile to understand what you need to do to correctly manage your account so that you don’t run into trouble in the future. Furthermore, as trendy and popular as cryptocurrencies are, they aren’t backed by any other asset, so their prices are volatile. Only invest what you’re willing to lose.

Bankrate’s Logan Jacoby contributed to an update of this story.

©2025 Bankrate.com. Distributed by Tribune Content Agency, LLC.

By KEN MORITSUGU, Associated Press

SHANGHAI (AP) — The head of a U.S. congressional delegation visiting China said he backed renegotiating the rules governing the global economy to take into account China’s rise and that of others such as India and Brazil.

Rep. Adam Smith, a Democrat from Washington state, told the mayor of Shanghai on Thursday that the U.S.-led post-World War II order has worked well for many countries, including China, but that “we understand that things have changed.”

US Representative Adam Smith speaks during a press conference at the American Chamber of Commerce (AmCham) in Shanghai, China, Thursday, Sept.25, 2025. (Jade Gao/Pool Photo via AP)

His remarks, at end of a five-day trip to China, dovetailed with Chinese leader Xi Jinping’s recent announcement of an initiative to build a more equitable global governance system. They also reflected the reality that though the U.S. remains the most powerful country in the world, China is emerging as a potential challenger for global leadership.

The delegation of three Democrats — Smith, Rep. Ro Khanna from California and Rep. Chrissy Houlahan from Pennsylvania — and Republican Rep. Michael Baumgartner from Washington state, wrapped up their trip in Shanghai after three days of meetings with government leaders in Beijing.

The main purpose of the visit — the first by members of the U.S. House of Representatives since 2019 — was to open up lines of communication between the governments, Smith said. A U.S. Senate delegation visited in 2023.

Citing the expansion of McDonald’s outlets in China, Smith said his biggest takeaway from the trip was that a lot of business is going on between the two economies despite the ongoing trade and tariff war.

“We have a lot of work to do to resolve those issues,” he told a small group of journalists after a meeting with the American Chamber of Commerce in Shanghai. The trade conflict is creating difficulties for companies on both sides of the Pacific, he said.

The lawmakers were later seen at a Starbucks, another U.S.-headquartered company, in the lobby of the office building.

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The exchange with the Shanghai Mayor Gong Zheng started after Smith politely interrupted Gong about 10 minutes — including time for translation — into the mayor’s introduction to Shanghai as an economic and financial center.

How is the U.S.-China tariff war impacting Shanghai’s economy, Smith wanted to know, and how does the mayor think it should be resolved.

Gong said that Shanghai, a major shipping port, is among those most affected because of its high exposure to international trade.

“We’re very glad to see that we already have talks and negotiations,” Gong said, citing the four rounds of meetings since May in Geneva, Stockholm, London and, most recently, Madrid.

He stated the Chinese government position that there are no winners in trade wars, but China will fight back if there is a war while remaining open to negotiation.

Smith expressed hope that both tariffs and other barriers to imports would be reduced. He then called for a robust debate about how to renegotiate the rules governing the economy.

“China and the U.S. are the two most important players in how we resolve that,” he said. “How do we get to an international rules based order that is more agreeable to everyone?”

China maintains that the current international order favors the U.S. and other rich nations. The government says it doesn’t want to overturn that order but make it better serve the interests of all countries, particularly developing ones.

“The collective rise of emerging markets and developing countries necessitates boosting the representation of the Global South,” a Foreign Ministry document says, using a catch-all term for those nations.

The three Democrats in the delegation are members of the House Armed Services Committee, and Smith repeated his call from the outset of the trip for more communication between the U.S. and Chinese militaries.

“Two of the largest nuclear powers in the world need to be talking to each other, particularly considering the fact that we do have some disagreements,” he said.