By Michelle Andrews, KFF Health News

Quinn Cochran-Zipp went to the emergency room three times with severe abdominal pain before doctors figured out she had early-stage cancer in the germ cells of her right ovary. After emergency surgery four years ago, the Greeley, Colorado, lab technician is cancer-free.

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The two hospitals that treated Cochran-Zipp at the time determined that she qualified for 100% financial assistance, since her income as a college student was extremely low. Not having to worry about the roughly $100,000 in bills she racked up for her care was an enormous relief, she said.

Then she started receiving unexpected bills from doctors who worked at the hospitals but, because they weren’t on staff there, didn’t have to abide by the facilities’ financial assistance policies.

Those bills, which came from specialists in emergency medicine, anesthesiology, and radiology who treated her, totaled more than $5,000. Although it was a fraction of the total cost of her care, to Cochran-Zipp it was an enormous amount. She went on payment plans and used scholarship and COVID stimulus money to help cover the bills.

Cochran-Zipp, now 25 and working at a community health center, is applying to medical schools and hopes to enroll next fall. Her experience as a patient has shaped how she thinks about becoming a doctor.

“I don’t think that I could be a provider that, in good conscience, charges patients money in addition to the hospital fees,” she said.

Hospital financial assistance programs are commonplace, and many patients rely on them. Most offer varying amounts of financial help to uninsured and lower-income people. Eligibility is typically based on a sliding income scale. Some hospitals apply other tests, such as residency.

But even if people qualify for assistance, they may not get discounts. That’s because many physicians working at but not for a hospital aren’t bound by its financial assistance policies. Hospitals themselves might limit the types of services eligible for discounted or “charity care,” as it’s sometimes called.

“It’s a hole in the system,” said Caitlin Donovan, a senior director at the Patient Advocate Foundation, a nonprofit that helps patients with serious illnesses cover their medical bills. Case managers who work with patients report that they’ve seen these problems repeatedly, Donovan said.

In the coming years, more patients will encounter difficulties as demand for financial assistance grows. More than 14 million people are projected to lose health insurance over the next decade, primarily because of changes to the federal Medicaid program and state insurance marketplaces in recently passed tax and spending legislation championed by the Trump administration. Some of these people will likely qualify for discounted care.

Nonprofit hospitals do not pay taxes on the money they make, but to maintain that tax-exempt status, they are required to have policies to help patients pay for emergency and other medically necessary care. For-profit hospitals are not required to offer financial assistance to needy patients, but many do.

However, physicians and other providers who work in a hospital as independent contractors rather than as employees are often not subject to a hospital’s financial assistance policy. According to an analysis by the Lown Institute, a health care think tank, physician services in the emergency, radiology, anesthesia, and pathology specialties are commonly excluded from hospital charity care.

For example, at Hartford HealthCare, a large nonprofit health system serving Connecticut, Massachusetts, and Rhode Island, services performed by physicians, nurse practitioners, and physician assistants employed by HHC, including emergency department physicians at four of its hospitals, are covered by its financial assistance policy. But treatment by emergency physicians at three HHC hospitals is not covered by the financial assistance policy, since they are not employees. Care by doctors working in radiology, pathology, and anesthesia isn’t covered by the financial assistance policy at any HHC facility.

Hartford HealthCare declined to comment on the record for this article.

Health system researchers have identified another potential barrier to patients’ receiving help from hospital financial assistance policies. IRS rules require that nonprofit hospitals include emergency and medically necessary care in their charity care policies, but they give hospitals substantial leeway to define what “medically necessary” care means.

Historically, excluded care has been limited to services that insurance doesn’t typically cover, like cosmetic surgery or experimental treatment. But in recent years, hospitals appear to be defining medically necessary care more narrowly, eliminating financial assistance for care that is needed but not urgently required. Care that might fall into this category could be a kidney stone removal, a cancer biopsy, or a cardiac valve replacement, according to a study published this year in The New England Journal of Medicine.

Although the study of 209 nonprofit hospitals with more than 200 beds found only isolated examples of hospitals — about 6% of them — that substantially excluded medically necessary care, researchers are concerned that it could be the leading edge of a larger trend, said Mark Hall, a professor of law and public health at Wake Forest University, who co-authored the study.

“There’s not really much in the way of regulatory guidance in what should be in or out” of a financial assistance policy, said Christopher Goodman, a clinical assistant professor at the University of South Carolina School of Medicine, who has published several studies examining hospital financial assistance policies.

The American Hospital Association declined to comment for this article. American Medical Association spokesperson Robert Mills said that the AMA doesn’t have a position on whether all contracted physicians should be required to participate in hospital financial assistance policies.

For-profit hospitals have more latitude to fashion their financial assistance policies as they wish.

At HCA Healthcare, one of the country’s largest for-profit health care systems, with nearly 200 hospitals in 20 states and the United Kingdom, discounted or free care is available only for “emergent or non-elective services.”

“Facility charity policies and uninsured discounts are typically specific to emergency services” at HCA Healthcare, said Harlow Sumerford, an HCA Healthcare spokesperson. “Any third-party providers are independent and would have their own financial policies.”

In recent years, several states have passed medical debt protection laws. A few apply to some doctors and other health care providers who practice at health care facilities and bill patients separately for their care.

Colorado’s is the most expansive. Under its Hospital Discounted Care law that took effect in September 2022, covered hospitals have to screen all uninsured people and others who request it for eligibility for Medicaid and other health programs, and provide discounted care to people whose income is up to 250% of the federal poverty level (about $80,000 for a family of four). There are limits on how much qualifying patients can be billed each month and, after three years, their debt is retired.

Under the Colorado law, licensed health care professionals who work at a covered hospital can charge qualified patients no more than the rates set by the state.

“This rule has been a game changer for folks in Colorado,” said Melissa Duncan, consumer assistance program manager at the Colorado Consumer Health Initiative, which helps patients access health care and cover their bills.

Unfortunately, the law didn’t pass in time to help Cochran-Zipp.

As hospitals grapple with the changes expected under the federal health care legislation passed this summer, discounted care programs may make a tempting target, say some health care financing experts. Facing higher rates of uncompensated care and trouble collecting payments from patients, facilities may reduce the financial assistance that they offer.

Hospitals may say “we are going to do all we can to protect our spending,” said Ge Bai, a professor of accounting and health policy and management at Johns Hopkins University. “In that environment, charity care will be a burden.”

©2025 KFF Health News. Distributed by Tribune Content Agency, LLC.

WASHINGTON (AP) — Federal auto safety regulators have opened yet another investigation into Tesla’s so-called full-self driving technology after dozens of incidents in which its vehicles ran red lights or drove on the wrong side of the road, sometimes crashing into other vehicles and injuring people.

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The National Highway Traffic Safety Administration said in a filing dated Tuesday that it has 58 incident reports of Tesla vehicles violating traffic safety laws while operating in full self-driving mode. In reports to regulators, many of the Tesla drivers said the cars gave them no warning about the unexpected behavior.

The probe covers 2,882,566 vehicles, essentially all Teslas equipped with full self-driving technology, or FSD, of which there are two types. Level 2 driver-assistance software, or “Full Self-Driving (Supervised),” requires drivers to pay full attention to the road. The company is still testing a version that does not require driver intervention, something that the automaker’s owner and CEO Elon Musk has been promising to roll out for years.

The new investigation follows a host of other probes into the FSD feature on Teslas, which has been blamed for several injuries and deaths. Tesla has repeatedly said the system cannot drive itself and human drivers must be ready to intervene at all times.

Tesla is also under investigation by NHTSA for a “summon” technology that allows drivers to tell their cars to drive to their location to pick them up, a feature that has reportedly led to some fender benders in parking lots. A probe into driver-assistance features in 2.4 million Teslas was opened last year after several crashes in fog and other low-visibility conditions, including one in which a pedestrian was killed.

Another investigation was launched by NHTSA in August looking into why Tesla apparently has not been reporting crashes promptly to the agency as required by its rules.

Musk is under pressure to show that the latest advances in its driver-assistance features have not only fixed such glitches but have made them so good drivers don’t even need to look out the window anymore. He recently promised to put hundreds of thousands of such self-driving Tesla cars and Tesla robotaxis on roads by the end of the next year.

Tesla shares fell 1.4% Thursday.

Since ChatGPT’s late-2022 release, countless headlines have prophesized an apocalyptic future for workers:

“We asked ChatGPT which jobs it thinks it will replace — and it’s not good news for data entry professionals or reporters” — Fortune, Feb. 8, 2023
“Goldman Sachs Predicts 300 Million Jobs Will Be Lost or Degraded by Artificial Intelligence” — Forbes, March 31, 2023
“Here’s how many U.S. workers ChatGPT says it could replace” — CBS News, April 5, 2023
“ChatGPT AI lists jobs it can do better than humans as millions could be put out of work” — Fox Business, April 5, 2023
“ChatGPT took their jobs. Now they walk dogs and fix air conditioners” — The Washington Post, June 2, 2023
“This A.I. Company Wants to Take Your Job” — The New York Times, June 11, 2025.

And yet, in the nearly three years since, we have yet to see the kind of massive labor market shake-up that alarmists predicted, according to an Oct. 1 report from Yale Budget Lab.

The report finds that people haven’t shifted between jobs, new roles haven’t emerged at scale and workers haven’t been automated out of their positions. For now, AI has likely not come for your job.

That’s not to say people aren’t worried. An Aug. 13-18 poll by Reuters/Ipsos found that 71% of respondents are concerned AI will be “putting too many people out of work permanently.” The fear is clearly real.

Still, the Budget Lab says it’s not surprising that AI has yet to seriously disrupt the job market. History tells us that new technology typically takes decades to upheave the workplace.

“Computers didn’t become commonplace in offices until nearly a decade after their release to the public, and it took even longer for them to transform office workflows,” the report says. “Even if new AI technologies will go on to impact the labor market as much, or more, dramatically, it is reasonable to expect that widespread effects will take longer than 33 months to materialize.”

Over time AI is expected to unsettle the labor market, but some occupations — and experience levels — are particularly vulnerable to the threat.

Job safety is uneven by field

While AI-induced job displacement and creation isn’t evident, when reshaping does happen, it’s likely to hit some fields more than others. It’s largely dependent on how much of your role can be automated.

A Sept. 8 study from the University of Pennsylvania Wharton School of Business categorized the jobs that are most and least exposed to automation by generative AI.

Highest exposure occupations (Roughly 50% and higher):

Office and administrative support: 75.5%.
Business and financial operations: 68.4%.
Computer and mathematical: 62.6%.
Sales and related occupations: 60.1%.

Moderate exposure occupations (30%-49.9%):

Management occupations: 49.9%.
Legal: 47.5%.
Arts, design, entertainment, sports and media: 45.8%.
Architecture and engineering: 40.7%.
Life, physical and social science: 31%.

Lower exposure (20%-29.9%):

Educational instruction and library: 29.5%.
Community and social service: 27.5%.
Healthcare practitioners and technical: 23.1%.
Protective service: 20.7%.
Transportation and material moving: 20%.

Lowest exposure (less than 20%):

Food preparation and serving: 18.1%.
Personal care and service: 17.5%.
Health care support: 15.5%.
Production: 14.4%.
Installation and maintenance and repair: 13.1%.
Farming, fishing and forestry: 9.7%.
Construction and extraction: 8.9%.
Building and grounds cleaning and maintenance: 2.6%.

An Oct. 6 report from Sen. Bernie Sanders (D-Vt.) used a ChatGPT-based model to find which jobs could be automated or otherwise performed by AI and found that nearly 100 million jobs could be replaced over the next 10 years.

Fast food and counter workers (89%).
Customer service representatives (83%).
Laborers and freight, stock, and material movers (81%).
Secretaries and administrative assistants, except legal, medical, and executive (80%).
Stockers and order fillers (76%).
Bookkeeping, accounting, and auditing clerks (76%).
Office clerks, general (66%).
Teaching assistants, preschool, elementary, middle, and secondary school, except special education (65%).
Accountants and auditors (64%).
Retail salespersons (62%).
Janitors and cleaners, except maids and housekeeping cleaners (61%).
Team assemblers (61%).
Cashiers (59%).
Software developers (54%).
Waiters and waitresses (53%).

Younger workers are most exposed to AI disruptions

Evidence is mounting that younger workers are being hit first and hardest by the effects of AI on their employability.

An August 2025 study from Stanford University found that Gen Z workers (ages 22 to 25) who are in occupations most exposed to AI have experienced a 13% decline in employment since 2022. High exposure fields include software developers, software engineers and those in customer service, call center and support roles.

The Stanford report also found that employment drops are greatest in roles where AI replaces tasks rather than enhancing them. Early career workers tend to perform job functions that have the most potential for automation.

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In other words, younger workers are most exposed in these roles because they have more “book-learning” and less job experience, according to the Stanford study. AI can more readily replace the more codified facets of their work — rules, step-by-step processes and formal education teachings. But it struggles with the type of work requiring “tacit knowledge” that older workers have, like making judgement calls, having intuition and knowing shortcuts.

There’s more evidence that AI seems to be creating a seniority bias in hiring. A Sept. 8 study from Harvard University examined a massive dataset of U.S. resumes and job postings to see whether AI is disrupting work for junior employees versus senior ones. Researchers found that in early 2023, junior hires at firms using AI dropped compared to senior ones. The decline was mainly due to companies slowing down hiring of early career workers. The study found that the fields where young workers are most impacted are wholesale and retail trade.

Early career workers have taken notice of hiring changes and are growing uneasy about their future prospects. Nearly a quarter of workers ages 18 to 34 in the U.S. and across Europe are concerned that AI will put them out of work within the next two years, according to a Sept. 23 report by Deutsche Bank.

We don’t yet fully know how AI is changing work

The trouble with measuring the impact of AI on the workplace is we don’t have fully accurate data yet on exposure, the Budget Lab report says.

Data from Large Language Models (LLMs) like Anthropic and OpenAI are useful, but incomplete. They don’t account for all tasks, occupations, AI tools, real-world constraints or barriers to adoption. All that is to say, take conclusions about AI’s labor impact with a grain of salt.

For now, what we do know is that AI is steadily seeping into many workplaces. Another Stanford University report from this year found that LLM adoption at work has increased from 30.1% in December 2024 to 45.6% as of June and July 2025.

The article Is AI Really Coming After Your Job? originally appeared on NerdWallet.

WASHINGTON — La Nina, the cooler and at times costlier flip side of El Nino, has arrived to warp weather worldwide, meteorologists said Thursday. This natural weather phenomenon often turbocharges the Atlantic hurricane season, but this La Nina may be too weak and fleeting to cause much trouble.

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In the United States, La Nina often means more precipitation — including possible snowstorms — in northern areas and winter dryness in the South. It can bring heavier rains in Indonesia, the Philippines, parts of Australia, Central America, northern South America and southeastern Africa. It also can mean drought in the Middle East, eastern Argentina, eastern China, Korea and southern Japan, meteorologists said.

A La Nina occurs when certain parts of the Central Pacific Ocean cool by 0.9 degrees Fahrenheit compared to normal. The world had been flirting with one this year and the National Oceanic and Atmospheric Administration declared Thursday that La Nina conditions have formed. But it’s likely to be not very strong and may disappear in the next few months, based on multi-factor computer model forecasts by NOAA and Columbia University, said Michelle L’Heureux, lead scientist on the NOAA team that studies both La Nina and El Nino.

“There is a three out of four chance it will remain a weak event,” L’Heureux said in an email. “A weaker event tends to exert less of an influence on the global circulation, so it’s possible there will be surprises ahead.”

Surprising already describes the 2025 Atlantic hurricane season, which was forecast to be stronger than normal, but so far is a tad below average in activity. Traditionally, during a La Nina, there’s a weakening of the wind shear that hampers hurricane formation and strengthening, allowing more and bigger storms, especially later in the year, such as late October and into early November and in the Caribbean, said University of Albany hurricane expert Brian Tang.

But Brian McNoldy, who studies tropical cyclones, sea level rise and extreme heat at the University of Miami, said he thinks this La Nina is too late and too little to do much.

The conditions, especially wind shear, favor more hurricane activity, yet it’s not happening and long-range computer models don’t show much forming for the next couple weeks, said Colorado State University hurricane expert Phil Klotzbach.

Winter a year ago had a similar weak La Nina but there were still some signs of its impact, L’Heureux said.

FILE – People clear a sidewalk during a winter snowstorm in Philadelphia, Feb. 13, 2024. (AP Photo/Matt Rourke, File)

Some studies have shown that in the United States, La Nina can be more costly than its warmer El Nino cousin. A 1999 economic study found that drought from La Nina cost U.S. agriculture between $2.2 billion to $6.5 billion, which is far more than the $1.5 billion cost of El Nino.

A cold La Nina is not always the more expensive version, but it is often the case, said research scientist Azhar Ehsan, who heads Columbia University’s El Nino/La Nina forecasting.

The Associated Press’ climate and environmental coverage receives financial support from multiple private foundations. AP is solely responsible for all content. Find AP’s standards for working with philanthropies, a list of supporters and funded coverage areas at AP.org.