When Megan Thomas moved out of the troubled Lowry Apartments in downtown St. Paul, she quickly moved into a 390-square-foot apartment at Summit Hill Senior Living, an assisted living community on the city’s East Side, through the help of Catholic Charities, an administrator of her support services.

“I’m disabled and I can’t work,” said Thomas, 59, who suffered a diabetic seizure a few years ago. “If I didn’t have medical assistance, I’d be dead.”

Megan Thomas shares her in her apartment in a senior living complex with her two cats, Bella, near and Coya, rear, in St. Paul on Tuesday, July 2, 2025. (John Autey / Pioneer Press)

Her Community Access for Disability Inclusion waiver, better known as a CADI waiver, is a state-sponsored program that builds on federal Medicaid benefits, one of the leading ways the federal government helps states support the health needs of disabled and low-income populations. Qualifying for Medicaid is often the threshold for accessing other social service benefits.

“You have to be on Medicaid to qualify for housing stabilization services, which I needed last year,” Thomas said.

Medicaid-sponsored services are an essential safety net for thousands of Minnesotans in need of public medical assistance, from basic health insurance to in-home therapy and nursing home care, according to Thomas, Catholic Charities and other providers.

That safety net is now facing a dramatic challenge as federal lawmakers attempt to cut funding for both Medicaid and public nutrition programs while raising the bar for accessing services.

Added costs of additional screenings

House and Senate versions of the GOP budget bill — dubbed the “One Big, Beautiful Bill” — propose fundamental changes to Medicaid to sharply reduce federal public assistance allotments to states and counties and impose new eligibility requirements, including twice-a-year screenings, at a time when demand for food, medical and emergency assistance is rising.

Some 71 million Americans receive Medicaid benefits, including about 1.16 million Minnesotans, adding up to $12 billion in Minnesota in 2023 alone.

Under the Senate version of the budget bill, 137,000 Minnesotans could lose healthcare in the near term, and another 89,000 residents would have to pay higher insurance premiums through the Affordable Care Act’s marketplace, according to some estimates. Longer-term impacts could touch everything from childbirth deliveries to in-home therapies and housing.

“More than half of Minnesotans in nursing homes rely on Medicaid,” said Laura Mortenson, a spokesperson for the Minnesota Budget Project, a project of the Minnesota Council of Nonprofits, in a conference call with news agencies on Wednesday. “It supports people in our affordable housing and childcare systems.”

Minnesota is one of 10 states where individual counties handle Medicaid screenings, and some counties have already reported being overwhelmed by growing administrative demand in the years since the pandemic. By doubling those annual screenings without compensating for the increased administrative burden, Minnesota counties could shoulder $30 million to $50 million in added costs, said Linnea Mirsch, director of director Community and Human Services in St. Louis County.

“It’s difficult to measure and estimate the impact of this additional workload,” said Mirsch, who predicted those costs will ultimately be passed on to property owners through higher county tax levies.

The goal, said some providers, appears to be to discourage Medicaid recipients like Thomas from wrangling with the added paperwork and to get them instead to simply walk away from the system.

“By making her recertify every six months, you’re just adding to the complexity of a really difficult life already,” said Keith Kozerski, chief program officer with Catholic Charities.

The bill has strong support among Republicans in Congress, including from U.S. Rep. Pete Stauber, who represents Minnesota’s 8th Congressional District. A Duluth News-Tribune story earlier this week included a statement from Stauber in which he said he supports the bill because “it will deliver much-needed economic relief to the American people.”

He cited a figure from the  White House Council of Economic Advisers, which said a family of four could have an after-tax take-home pay increase of $7,600 to $10,900 in the first four years after the bill’s passage.

Some changes delayed to 2027

Meanwhile, certain changes in the “One Big, Beautiful Bill” would be scheduled to roll out gradually, some not taking effect until early 2027, which is after the mid-term elections, Mortenson noted.

Among them, significant cuts proposed to the Supplemental Nutrition Assistance Program — or SNAP, once commonly known as food stamps — could overwhelm an already overburdened emergency food assistance network struggling to keep up with increased demand since the outset of the pandemic, said food shelf providers on the call.

Certain aspects of the bill are predicted to increase energy costs for many families, which will have a trickle-down effect as households reduce food budgets to compensate, said Zach Rodvold, a spokesperson for Second Harvest Heartland, a hunger-relief organization that supports more than 1,100 food shelves and food programs. For low-income families balancing budget priorities, that means more trips to food shelves to make ends meet.

“Food shelves will see very quickly an increase in demand … and certainly over a period of years, there will be a major increase in demand, barring some other kind of intervention,” Rodvold said.

Some foresee heavy impacts on retailers, especially in poor areas.

More than 3,600 Minnesota retailers — mostly convenience stores and groceries — currently accept SNAP benefits. “On some days, up to 50% of their total sales are SNAP transactions,” said Steve Barthel, a spokesperson for the Minnesota Grocers Association, who predicted store closures. “In lower-income neighborhoods, losing a grocery store means losing access to fresh, vital foods.”

Providers also predicted stark impacts on farm growers, food distributors and hospitals.

“I’m not actually getting money,” said Thomas, interviewed in her apartment at Summit Hill Senior Living, where a majority of residents receive some form of public assistance. “The health aide is getting money. The owner of this building is getting money. … If Medicaid is cut, there are thousands of jobs that would be affected.”

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By JAKE OFFENHARTZ, Associated Press

NEW YORK (AP) — A politically motivated hacker breached Columbia University’s data systems last week, stealing troves of student documents while briefly shutting down the school’s computer systems, a university official said Wednesday.

The June 24 cyberattack prompted widespread network outages on campus, locking students and staff out of their email accounts, coursework and video conference software for several hours. On the same day, images of President Donald Trump’s smiling face appeared on several public monitors across the Manhattan campus.

A spokesperson for Columbia declined to elaborate on the political motivations behind the attack. But officials described a highly sophisticated “hacktivist” who had gained access to private student records in an attempt to further a political agenda.

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The spokesperson said it was unclear if the Trump photo display was connected to the data breach.

“We are investigating the scope of the apparent theft and will share our findings with the University community as well as anyone whose personal information was compromised,” the school said.

The cyberattack comes as Columbia remains in the crosshairs of the Trump administration, which has threatened to pull $400 million in federal funds over what it claims is the school’s failure to protect Jewish students.

Negotiations over a possible settlement are ongoing. The university has already agreed to a host of changes demanded by Trump, including placing its Middle East studies department under new supervision and overhauling its rules for protests and student discipline.

In March, a cyberattack against New York University resulted in student admission records briefly appearing on the school’s website. An online hacker who took credit for that action on social media said the intent was to prove the university was not in compliance with the Supreme Court decision banning affirmative action in college admissions.

An NYU spokesperson said at the time that the data displayed on its webpage was “inaccurate and misleading,” adding that the university “scrupulously complies with the law.”

I’m a finance professor at UCLA, so let’s talk finance. Which numbers are more meaningful to you?

Having $50 to $100 cash in your pocket (rough average for an American) or knowing the total U.S. currency in circulation is $2.4 trillion?

Owing $7,300 on your credit card (average balance of those who don’t pay it off every month) or envisioning the total U.S. credit card debt of $1.2 trillion?

Being $250,000 in debt on your home (average among American consumers with a mortgage) or seeing that the nation’s total residential consumer mortgage debt is $12.8 trillion?

Holding $250,000 in your 401(k) or IRA account (average for baby boomers, now old enough to need it soon) or knowing the total U.S. savings in such accounts is about $27 trillion?

Receiving a monthly Social Security check of $2,000 (the average) or considering the balance of the Social Security trust fund at $2.7 trillion?

I’ve been researching and teaching economics for more than 30 years, and still I can’t wrap my head around trillions of dollars. I’m guessing you can’t, either — and neither can our senators and representatives who determine the federal budget. And yet, our government insists on communicating with us in this unfathomable language.

Worse, even our best media outlets rarely translate the government’s incomprehensible abstractions into understandable numbers, giving us sentences like this one from the Wall Street Journal: “President Trump’s tax-and-spending megabill would increase budget deficits by $2.4 trillion over the next decade, compared with doing nothing, according to a Congressional Budget Office estimate released Wednesday.” (By the way, that figure had been revised to $2.8 trillion as of June 18 — as if the human mind could comprehend the difference between those boggling figures.)

And so I want to help people understand both our federal budget deficit and the resulting national debt, as well as our government’s free-spending ways. (Both parties are to blame; no need for politics here.)

The national debt today stands at about $37 trillion. This means that each of our 347 million people is on the hook for about $110,000, or about 2.75 years the median income of $40,000 per year.

Of course, not every U.S. resident earns income or pays income tax. With “only” 154 million taxpayers, this means that the average taxpayer’s piece of the $37-trillion federal debt is about $240,000, or six years of the median income.

Think of this as your share of our federal debt. The government may have borrowed it, but ultimately you are on the hook for it. Feel better now? Probably not. For most people, learning that you owe $240,000 is a lot more concerning than hearing that the national debt is $37 trillion.

And your piece of our collective problem is still growing. Each year, our federal government takes in about $35,000 per taxpayer ($5 trillion) and spends about $45,000 per taxpayer ($6.75 trillion). Lawmakers are currently not paying down our debt but adding about $10,000 per taxpayer every year to our already outstanding balance of about $240,000.

Unfortunately, we have another problem. Our outstanding debt was issued at low interest rates (around 2.3% per year). This is about to change. When it comes due, refinance interest rates will likely be more like 4% per year. Federal spending on interest will rise from the current level of about $6,000 a year per taxpayer to more like $10,000.

Back to the “One Big Beautiful Bill Act” that the Wall Street Journal was reporting on. Roughly speaking, over 10 years, the Congressional Budget Office estimates the legislation would add a total deficit of $18,000 per taxpayer. Whatever debt balance we expected to reach in about 10 years, under this new budget, we would be expected to reach that debt in nine years.

In itself, debt isn’t so bad. For instance, as your home’s value grows, the mortgage percentage shrinks. If your income rises, that helps, too. Our 25-year-old business school students, who have no current income but take on a six-figure debt, can typically comfortably pay off their debts and support a nice lifestyle, too.

Unfortunately, not so for our federal malaise. Our income and tax bases are growing nowhere near as fast as our obligations.

With growing deficits and rising interest rates, we are instead accelerating our obligations. Today, we are spending about $850 billion a year on our military, or about $5,500 per taxpayer. Interest payments are just about to exceed that.

Adding in our running deficits, even if we assume that we can greatly increase our economic output, tax base and tax intake, and that there will be no recession, and that tariffs will cover about one-third of our deficits (a combination that few economists believe), we are still heading straight for a date with a metaphorical bankruptcy judge. Fortunately, this is legally impossible.

So what can possibly happen?

First, we could get exceedingly lucky: Economic growth could reach higher than it has ever been. Maybe we can all collectively become more innovative (and less hamstrung by our abundant self-inflicted inefficient policies, rules and regulations). I wouldn’t count on it.

Second, our politicians could raise taxes, curb spending or do both. However, we have no collective appetite for this. (Those actions could slow growth to the point that they become counterproductive.)

Third, we could “print” money. However, this would leave us in a fiscal situation similar to that of many developing nations, with galloping inflation and untrustworthy currency. Who would then lend us money? It surely wouldn’t “make America great again.”

Living beyond our means is not a Republican or a Democratic problem. Our parties may disagree about what to spend the money on, but both show by their actions that they agree spending more is better than spending less. Politicians are reflections of their electorates, and we the people are not ready for any pain. If our voters can begin to comprehend our problem, we’ll be on our first step toward a solution.

Ivo Welch is a professor of finance and economics at the Anderson Graduate School of Management at UCLA. He wrote this column for the Los Angeles Times.

It’s not always obvious which of the multitude of species of bacteria riding around in us should be classified as germs and attacked, and which are essential workers that should be nurtured.

One that’s particularly hard to classify is H. pylori, which was the subject of the 2005 Nobel Prize for the discovery that it causes peptic ulcers. But more recent studies have connected it with benefits, including lowering the risk of esophageal cancer. In a paper published in Science Advances, researchers in Sweden described how the bacteria can inhibit the formation of amyloid deposits, which are found in the brains of individuals with Alzheimer’s and Parkinson’s disease.

Scientists are just beginning to understand the microbes that have been with us for millennia — the so-called microbiome, which is being drastically depleted as an unintended consequence of antibiotic use, dietary changes, and other aspects of modern life.

Until the start of the 20th century, we all carried H. pylori. Now, it’s headed for global extinction. But before it disappears, it’s worth understanding what it does and why we all once carried it.

While many doctors are happy to say good riddance to H. pylori — which also has been associated with stomach cancer — scientists are discovering more positive benefits, including a few studies that have shown it might also lower the risk of asthma and allergies and help protect against obesity and Type 2 diabetes. As I’ve written previously, this stomach bug is a feature of our biology, not just a problem that needs to be eliminated.

These newest findings on its effects related to amyloid deposits identified a protein called CagA — secreted by most strains of human H. pylori — as the key component. That doesn’t necessarily mean CagA protects us against Alzheimer’s; scientists don’t know whether amyloid deposits are a cause of the disease, a symptom, or an attempt by the body to slow its progression.

Still, researchers continue to study the protein, which may lead to new strategies for preventing the disease. The findings also add to a growing understanding of the connection between the microbiome and the risk of developing Alzheimer’s and other neurodegenerative diseases.

They also serve as a warning: we don’t know enough about the unintended consequences of eradicating H. pylori. Genetic comparisons suggest that the bacteria have been residing in the human stomach for at least 60,000 years, and likely much longer.

Biologist Martin Blaser of Rutgers University has been one of the most vocal advocates for understanding the pros and cons of H. pylori, which he describes in his 2014 book, Missing Microbes: How the Overuse of Antibiotics is Fueling Our Modern Plagues. He said every mammal has some stomach bacteria — a relative of our H. pylori.

He was particularly excited by the findings on CagA. It was his work that initially identified the protein and showed that the only so-called CagA-positive strains were more closely connected to all health risks and benefits, including ulcers and stomach cancers, as well as a decreased risk of asthma and esophageal cancer. He later collaborated on a study that suggested a connection between the CagA-positive strains and decreased risk of stroke. “The protein is a double-edged sword,” he said.

Biologist Gefei Chen of Uppsala University in Sweden, one of the amyloid study researchers, said the CagA protein prevents other bacteria from forming communities called biofilms. This ability gives H. pylori an edge over competitors by preventing would-be rivals from forming the biofilms they would need to colonize the stomach. The effect on our health may be either beneficial, detrimental, or a combination of both.

The biofilms are held together with a scaffolding that is similar to the deposits found in the brains of Alzheimer’s patients. Chen said he wanted to see if the protein from the bacteria could also affect amyloid deposits in the brain. He and his colleagues created deposits in the lab and exposed them to CagA. “It works so well, it’s so efficient … that’s a big surprise for us.”

He’s currently using gene editing to modify H. pylori to determine whether it can be altered to control its function in the body. CagA could also be used to break up bacterial biofilms, which, like walled cities for bacteria, can prevent antibiotics from reaching infections. Harmful biofilms can also coat medical devices, such as catheters, and they form the stubborn plaque on our teeth.

Blaser said H. pylori is quickly disappearing — even without our help. He anticipates there may come a time when we’ll attempt to regain it. Perhaps it will be an edited version that highlights the benefits of the bacteria without its downsides.

It was an oversimplification to consider that microbes are all either good or bad. Our microbes are evolving in ways that help them to survive and reproduce, which may benefit or harm us depending on our stage of life and other environmental factors. They might be good in one part of the body and one stage of life, but bad in another part at another stage. It’s not in their evolutionary interest to kill us, their hosts.

Perhaps someday doctors will be able to tip the balance toward the bacteria’s benefits — with probiotics, perhaps, or even with gene editing. However, our microbial diversity is half of what it was in pre-industrial societies, and it is declining rapidly. Scientists must act quickly to understand what these bugs do while we still have them.

F.D. Flam is a Bloomberg Opinion columnist covering science. She is host of the “Follow the Science” podcast.