By Arthur Allen, KFF Health News

While the FDA is streamlining regulation of copycat versions of the expensive drugs that millions take for arthritis, cancer, and other diseases, the U.S. patent office is making it harder for the cheaper medicines to get on the market, industry officials say.

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These officials were thrilled Oct. 29 when FDA Commissioner Marty Makary announced the agency’s plan, which he said would halve the time and money needed to get what are called “biosimilar” drugs to market. Biosimilars are essentially generic versions of biologics — such as Humira, Keytruda, and Xolair — which are made from living organisms. Biosimilars can cost up to 90% less.

Under the guidance the FDA proposed, the agency would begin overseeing biosimilars similarly to the way it regulates generics, which are copies of simpler molecules, usually pills. This change in approach could allow companies to save up to $100 million for each drug they develop, enabling them to make more products for underserved patients, said Stefan Glombitza, CEO of Formycon AG, a maker of biosimilars based in Germany.

But President Donald Trump’s patent office is working at cross-purposes with the FDA, biosimilar makers charge, by narrowing the opportunities for companies that try to challenge the throngs of patents that brand-name drugmakers file to protect their products from competition.

In the past, biosimilar makers have been able to invalidate some of those patents through a sped-up process called “inter partes review,” or IPR. But the new administration has denied most IPR requests and issued a proposed rule in October that makes IPRs harder to get.

Heavyweights on pricing

Biosimilars have the potential to nibble or even gouge away at a major U.S. health care cost. Only 5% of prescriptions are for biologic drugs, but they account for more than half of the$600 billion the nation annually spends on medicines.

“Generic and biosimilar competition is the crucial way that we bring down prescription drug prices,” said William Feldman, a pharmaceuticals policy researcher at UCLA.

The FDA announcement “is a good thing that may ease barriers,” he added, “but there are a lot of caveats.”

In fact, biosimilar industry officials say, FDA regulation is often the least of the three major hurdles they face in marketing their products.

To protect their market share, brand-name biologics makers file scores or even hundreds of patents, continuing to do so long after their drugs hit the market. The “patent dance” that occurs when biosimilar makers seek to launch competitor drugs can drag on for many years.

For example, the FDA approved the first biosimilar of the rheumatoid arthritis drug Humira in 2016, but legal battles delayed competitors from entering the market — until nine FDA-approved products were launched in 2023. At his Oct. 29 news conference, Makary blamed FDA “red tape” for the delay, but it was mostly due to the baffling patent machinery, industry officials say.

The new rules, which could take effect next year, would formalize recent FDA practices aimed at speeding along approval for biosimilars. For example, the FDA has recently allowed drugmakers to waive expensive clinical testing contemplated under a 2009 law. The agency now lets companies employ less costly analytical tests, if they can show that the biosimilar has no clinically meaningful differences from the brand-name drug.

A ‘switching’ burden

Because biologic drugs are large molecules produced from live cells, copies of them cannot be chemically identical. So the FDA had required biosimilars to go through clinical studies like the ones required for the original drugs. But research has shown that analytic techniques can replace the need to test biosimilars on large numbers of patients.

The new rules would also confirm the FDA’s move away from requiring what are known as “switching” tests, in which patients first go on the brand-name drug and then the biosimilar, or vice versa, to see if their responses are the same. Such tests are required in many states for the biosimilar to obtain “interchangeable” status, which enables pharmacists to substitute an often cheaper version for the prescribed brand-name drug.

In short, the new rules would mean biosimilar makers would spend less money getting drugs to market, said Sean Tu, a law professor at the University of Alabama. “What that won’t do is get you on the market earlier,” he added.

After biosimilars launch, it can take years for them to gain a foothold. In 2023, Humira biosimilars made barely a dent in the market, and in 2024 they accounted for only about a quarter of sales, though they cost as little as 10% of the roughly $6,500 monthly price tag for the brand-name drug.

That’s because brand-name drug companies offer lucrative rebates for sales of their drugs to the go-between companies that design formularies — tiered lists that tell doctors and pharmacies which drugs are covered by insurance. These middlemen, pharmacy benefit managers, pass along some of that money to health plans.

Essentially, the insurance plans are “charging higher costs to people who require expensive drugs as a way to subsidize the whole population,” said Wayne Winegarden, an economist at the Pacific Research Institute.

The patent thicket thickens

Biosimilar makers are particularly worried about the direction the U.S. Patent and Trademark Office has taken under Trump.

Patent challenges are already 10 to 20 times as expensive in the United States as in Europe, and restricting inter partes reviews is making it worse, said Formycon’s Glombitza.

The FDA recently gave his company a waiver from conducting a costly clinical trial of its biosimilar substitute for Keytruda, a blockbuster cancer drug. But Merck & Co., which got about half of its $17 billion third-quarter revenue from Keytruda, is expected to fight tooth and nail to protect its many patents on the drug. The Trump administration’s new obstacles to challenge them “counteract the waiver,” Glombitza said.

Merck protects its innovations, said spokesperson Julie Marie Cunningham. However, noting that Merck is touting a new, injectable Keytruda formulation, she said the company does not expect it to affect “the potential marketing” of biosimilars for the older, intravenous form of the drug.

The Pharmaceutical Research and Manufacturers of America, or PhRMA, the industry group representing most large brand-name companies, “welcomes the administration’s focus on increasing biosimilar access and affordability,” said spokesperson Alex Schriver.

But Big Pharma companies favor the patent office’s swing toward more protection of filed patents, according to attorneys who work in intellectual property litigation.

“I don’t think the Trump administration has any kind of coherent plan here,” said Mark Lemley, director of the Stanford Program in Law, Science & Technology. While Trump officials want to bring drug costs down, “they also want to make it more expensive to figure out whether patents are valid by effectively eliminating IPRs,” he said.

The patent office did not respond to repeated phone calls and emails.

Patents and patent litigation are the biggest impediments to getting biosimilars onto the market, UCLA’s Feldman said.

For instance, the FDA licensed Sandoz’s biosimilar for Enbrel, a popular drug to treat autoimmune disorders, in 2016, but Sandoz won’t be able to market its competitor in the U.S. until 2029 at the earliest because of patent challenges. Without insurance, Enbrel costs about $7,000 to $9,000 a month.

A patient’s perspective

Judy Aiken, a retired Portland, Maine, nurse who has taken Enbrel since 2007 to treat psoriatic arthritis, would be interested in trying the copycat if it costs her less. After retiring in 2019 and going on Medicare, she has spent thousands each year on the drug.

The Biden-era Inflation Reduction Act capped her out-of-pocket drug costs at $2,000 this year, and Aiken and her husband used the savings to replace their roof and furnace. But with health care changes on the horizon, “now I’m scared the other shoe is going to drop,” she said.

Only about 10% of the 118 biologics set to come off patent in the next decade have biosimilars in development, reflecting poor incentives in a system that biosimilar makers and patient advocates say is stacked against them.

But lower costs could enable companies like Formycon to expand their product lines — focused now on cancer and autoimmune diseases — to less common or even rare conditions, said CEO Glombitza.

“People have talked about the promise of biosimilars reducing out-of-pocket costs and creating more choices for consumers, and I feel like we’re still waiting,” said Anna Hyde, chief of advocacy and access for the Arthritis Foundation, which lobbies for research and treatment.

Although biosimilars could save everyone money, patients generally don’t care whether they get one or not, Hyde noted. Some don’t want to switch if they’ve found a brand-name drug that works for them, since the search can be grueling for people suffering from autoimmune diseases, she said.

“Generally, they can’t access them anyway,” she said, “because they are not available on the formulary.”

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

We all know about points, rebounds, assists, etc.

The counting stats get much of the glory in basketball. But how does your team perform when you’re on the floor?

That’s what net rating measures — the points per 100 possessions for your team versus your opponents. The more positive your number, the better your team is playing with you on the court. The more negative? Well, you get it.

Here are Minnesota’s updated individual numbers, with the offensive rating (points scored per 100 possessions), defensive rating (points allowed per 100 possessions) and net rating (offense and defense combined) through 15 games of the season, with the biggest takeaway from each:

Offensive Ratings

Minnesota Timberwolves forward Julius Randle (30) dunks during the first half of an NBA basketball game against the Washington Wizards, Wednesday, Nov. 19, 2025, in Minneapolis. Randle leads Minnesota in offensive rating through 15 games. (AP Photo/Abbie Parr)

Julius Randle: 125.4

Anthony Edwards: 123.6

Donte DiVincenzo: 120.8

Jaden McDaniels: 119.2

Mike Conley: 114.2

Rudy Gobert: 117.1

Jaylen Clark: 114.3

Naz Reid: 113.4

Bones Hyland: 111.3

Rob Dillingham: 100.3

Takeaway: The Wolves’ offense is dominant when Randle is on the floor. That 125.4 number is tied with Houston’s Josh Okogie (yes, that Josh Okogie) for tops in the NBA among all non-Denver Nuggets.

Edwards’ offensive rating ranks 10th in the league.

And since Nov. 1, Randle’s 128.2 offensive rating is tops in the entire NBA. He’s one of four players currently averaging 25-plus points, seven-plus rebounds and six-plus assists, joining Nikola Jokic, Luka Doncic and Giannis Antetokounmpo.

Defensive Ratings

Jaylen Clark: 103.1

Rudy Gobert: 106.1

Bones Hyland: 108.0

Rob Dillingham: 110.9

Donte DiVincenzo: 111.7

Jaden McDaniels: 113.0

Naz Reid: 113.6

Mike Conley: 114.2

Anthony Edwards: 114.7

Julius Randle: 115.7

Takeaway: These are slowly crawling down for everyone as Minnesota looks at least closer to the defensive team it wants to be.. Reid’s defensive rating was north of 119 at the 10-game check in, but the Wolves have found more answers as to how to get stops with the Reid-Randle frontcourt (see: Clark).

McDaniels, Reid, DiVincenzo, Randle and Clark all saw improvements of at least 2.5 points per 100 defensive possessions over the last five games.

Net Ratings

Jaylen Clark: 11.2

Rudy Gobert: 11.0

Julius Randle: 9.7

Donte DiVincenzo: 9.1

Anthony Edwards: 8.9

Jaden McDaniels: 6.2

Mike Conley: 3.7

Bones Hyland: 3.2

Naz Reid: -0.2

Rob Dillingham: -10.5

Takeaway: Clark is king. Minnesota’s reserve defensive stopper now sports the team’s best net rating, though Gobert, Randle, Edwards and DiVincenzo are all in close pursuit.

It does feel notable that Minnesota’s two best defenders top this list at the moment.

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By Claudia Boyd-Barrett, KFF Health News

In July, federal immigration agents took Milagro Solis-Portillo to Glendale Memorial Hospital just outside Los Angeles after she suffered a medical emergency while being detained. They didn’t leave.

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For two weeks, Immigration and Customs Enforcement contractors sat guard in the hospital lobby 24 hours a day, working in shifts to monitor her movements, her attorney Ming Tanigawa-Lau said.

ICE later transferred the Salvadoran woman to Anaheim Global Medical Center, against her doctor’s orders and without explanation, her attorney said. There, Tanigawa-Lau said, ICE agents were allowed to stay in Solis-Portillo’s hospital room round-the-clock, listening to what should have been private conversations with providers. Solis-Portillo told her attorney that agents pressured her to say she was well enough to leave the hospital, telling her she wouldn’t be able to speak to her family or her attorney until she complied.

“She described it to me as feeling like she was being tortured,” Tanigawa-Lau said.

Legal experts say ICE agents can be in public areas of a hospital, such as a lobby, and can accompany already-detained patients as they receive care, illustrating the scope of federal authority. Detained patients, however, have rights and can try to advocate for themselves or seek legal recourse.

Earlier this year, California set aside $25 million to fund legal services for immigrants, and some local jurisdictions — including Orange County, Long Beach, and San Francisco— have put money toward legal aid efforts. The California Department of Social Services lists some legal defense nonprofits that have received funds.

Sophia Genovese, a supervising attorney and clinical teaching fellow at Georgetown Law, said law enforcement officers, including federal immigration agents, can guard and even restrain a person in their custody who is receiving health care, but they must follow constitutional and health privacy laws regardless of the person’s immigration status. Under those laws, patients can ask to speak with medical providers in private and to seek and speak confidentially with legal counsel, she said.

“ICE should be stationed outside of the room or outside of earshot during any communication between the patient and their doctor or medical provider,” Genovese said, adding that the same applies to a patient’s communication with lawyers. “That’s what they’re supposed to do.”

ICE guidelines

When it comes to communication and visits, ICE’s standards state that detainees should have access to a phone and be able to receive visits from family and friends, “within security and operational constraints.” However, these guidelines are not enforceable, Genovese said.

If immigration agents arrest someone without a warrant, they must tell them why they’ve been detained and generally can’t hold them for more than 48 hours without making a custody determination. A federal judge recently granted a temporary restraining order in a case in which a man named Bayron Rovidio Marin was monitored by immigration agents in a Los Angeles hospital for 37 days without being charged and was registered under a pseudonym.

In the past, perceived violations by agents could be reported to ICE leadership at local field offices, to the agency’s headquarters, or to an oversight body, Genovese said. But earlier this year, the Department of Homeland Security cut staffing at ombudsman offices that investigate civil rights complaints, saying they “obstructed immigration enforcement by adding bureaucratic hurdles.”

The assistant secretary for public affairs at DHS, Tricia McLaughlin, said that agents arrested Marin for being in the country illegally and that he admitted his lack of legal status to ICE agents. She said agents took him to the hospital after he injured his leg while trying to evade federal officers during a raid. She said officers did not prevent him from seeing his family or from using the phone.

“All detainees have access to phones they can use to contact their families and lawyers,” she said.

McLaughlin said the temporary restraining order was issued by an “activist” judge. She did not address questions about staffing cuts at the ombudsman offices.

DHS also said Solis-Portillo was in the country illegally. The department said she had been removed from the United States twice and arrested for the crimes of false identification, theft, and burglary.

“ICE takes its commitment to promoting safe, secure, humane environments for those in our custody very seriously,” McLaughlin said. “It is a long-standing practice to provide comprehensive medical care from the moment an alien enters ICE custody. This includes access to medical appointments and 24-hour emergency care.”

Protections in California

Anaheim Global Medical Center did not respond to a request for comment. In a statement, Dignity Health, which operates Glendale Memorial Hospital, said it “cannot legally restrict law enforcement or security personnel from being present in public areas which include the hospital lobby/waiting area.”

California enacted a law in September that prohibits medical establishments from allowing federal agents without a valid search warrant or court order into private areas, including places where patients receive treatment or discuss health matters. But many of the most high-profile news reports of immigration agents at health care facilities have involved detained patients brought in for care.

Erika Frank, vice president of legal counsel for the California Hospital Association, said hospitals have always had law enforcement, including federal agents, bring in people they’ve detained who need medical attention.

Hospitals will defer to law enforcement on whether a patient needs to be monitored at all times, according to association spokesperson Jan Emerson-Shea. If law enforcement officers overhear medical information about a patient while they’re in the hospital, it doesn’t constitute a patient-privacy violation, she added.

“This is no different, legally, from a patient or visitor overhearing information about another patient in a nearby bed or emergency department bay,” Emerson-Shea said in a statement.

She didn’t address whether patients can demand privacy with providers and attorneys, and she said hospitals don’t tell family and friends about the detained patient’s location, for safety reasons.

Sandy Reding, who is president of the California Nurses Association and visited the Glendale facility when Solis-Portillo was there, said nurses and patients were frightened to see masked immigration agents in the hospital’s lobby. She said she saw them sitting behind a registration desk where they could hear people discuss private health information.

“Hospitals used to be a sanctuary place, and now they’re not,” she said. “And it seems like ICE has just been running rampant.”

The Los Angeles County Board of Supervisors is scheduled to vote Nov. 18 on a proposal to provide more protections for detainees at county-operated health facilities. These include limiting the ability of immigration officials to hide patients’ identities, allowing patients to consent to the release of information to family members and legal counsel, and directing staff to insist immigration agents leave the room at times to protect patient privacy. The county would also defend employees who try to uphold its policies.

Solis-Portillo’s lawyer, Tanigawa-Lau, said her client ultimately decided to self-deport to El Salvador rather than fight her case, because she felt she couldn’t get the medical care she needed in ICE custody.

“Even though Milagro’s case is really terrible, I’m glad that there’s more awareness now about this issue,” Tanigawa-Lau said.

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

By Jonathan Shorman, Stateline.org

A day after President Donald Trump took office, U.S. Immigration and Customs Enforcement issued a new directive to its agents: Arrests at courthouses, restricted under the Biden administration, were again permissible.

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In Connecticut, a group of observers who keep watch on ICE activity in and around Stamford Superior Court have since witnessed a series of arrests. In one high-profile case in August, federal agents pursued two men into a bathroom.

“Is it an activity you want to be interfering with, people fulfilling their duty when they’re called to court and going to court? For me, it’s insanity,” said David Michel, a Democratic former state representative in Connecticut who helps observe courthouse activity.

Fueled by the Stamford uproar, Connecticut lawmakers last week approved restrictions on civil arrests and mask-wearing by federal law enforcement at state courthouses. And on Monday, a federal judge tossed a lawsuit brought by the U.S. Department of Justice that had sought to block similar restrictions in New York.

They are the latest examples of a growing number of Democratic states, and some judges, pushing back against ICE arrests in and around state courthouses. State lawmakers and other officials worry the raids risk keeping people from testifying in criminal trials, fighting evictions or seeking restraining orders against domestic abusers.

The courthouse arrests mark an intensifying clash between the Trump administration and Democratic states that pits federal authority against state sovereignty. Sitting at the core of the fight are questions about how much power states have to control what happens in their own courts and the physical grounds they sit on.

In Illinois, lawmakers approved a ban on civil immigration arrests at courthouses in October. In Rhode Island, lawmakers plan to again push for a ban after an earlier measure didn’t advance in March. Connecticut lawmakers were codifying limits imposed by the state Supreme Court chief justice in September. Democratic Gov. Ned Lamont is expected to sign the bill.

States that are clamping down on ICE continue to allow the agency to make criminal arrests, as opposed to noncriminal civil arrests. Many people arrested and subsequently deported are taken on noncriminal, administrative warrants. As of Sept. 21, 71.5% of ICE detainees had no criminal convictions, according to the Transactional Records Access Clearinghouse, a data research organization.

Some states, such as New York, already have limits on immigration enforcement in courthouses that date back to the first Trump administration, when ICE agents also engaged in courthouse arrests. New York’s Protect Our Courts Act, in place since 2020, prohibits civil arrests of people at state and local courthouses without a judicial warrant. The law also applies to people traveling to and from court, extending protections beyond courthouse grounds.

“One of the cornerstones of our democracy is open access to the courts. When that access is denied or chilled, all of us are made less safe and less free,” said Oren Sellstrom, litigation director at Lawyers for Civil Rights, a Boston-based group that works to provide legal support to immigrants, people of color and low-income individuals.

But in addition to challenging the New York law, the Justice Department is prosecuting a Wisconsin state judge, alleging she illegally helped a migrant avoid ICE agents.

“We aren’t some medieval kingdom; there are no legal sanctuaries where you can hide and avoid the consequences for breaking the law,” U.S. Department of Homeland Security Assistant Secretary for Public Affairs Tricia McLaughlin said in a statement to Stateline. “Nothing in the constitution prohibits arresting a lawbreaker where you find them.”

Some Republican lawmakers oppose efforts to limit ICE arrests in and near courthouses, arguing state officials should stay out of the way of federal law enforcement. The Ohio Senate in June passed a bill that would prohibit public officials from interfering in immigration arrests or prohibiting cooperation with ICE; the move came after judges in Franklin County, which includes Columbus, imposed restrictions on civil arrests in courthouses.

“The United States is a nation of immigrants, but we are also a nation of law and order. To have a civilized society, laws must be respected, this includes immigration laws,” Ohio Republican state Sen. Kristina Roegner, the bill’s sponsor, said in a news release at the time.

Roegner didn’t respond to Stateline’s interview request. The legislation remains in a House committee.

Knowing where a target will be

Courthouses offer an attractive location for ICE to make immigration arrests, according to both ICE and advocates for migrants.

Court records and hearing schedules often indicate who is expected in the building on any given day. Administrative warrants don’t allow ICE to enter private homes without permission, but the same protections don’t apply in public areas, such as courthouses. And many people have a strong incentive to show up for court, knowing that warrants can potentially be issued for their arrest if they don’t.

“So in some respects, it’s easy pickings,” said Steven Brown, executive director of the ACLU of Rhode Island.

In June, ICE arrested Pablo Grave de la Cruz at Rhode Island Traffic Tribunal in Cranston. A 36-year-old Rhode Island resident, he had come from Guatemala illegally as a teenager.

“They pulled up on him like he was a murderer or a rapist,” friend Brittany Donohue told the Rhode Island Current, which chronicled de la Cruz’s case. “He was leaving traffic court.”

An immigration judge has since granted de la Cruz permission to self-deport.

McLaughlin, the Homeland Security assistant secretary, said in her statement that allowing law enforcement to make arrests “of criminal illegal aliens in courthouses is common sense” — conserving law enforcement resources because officers know where a target will be. The department said the practice is safer for officers and the community, noting that individuals have gone through courthouse security.

Still, ICE’s directive on courthouse arrests sets some limits on the agency’s activity.

Agents “should, to the extent practicable” conduct civil immigration arrests in non-public areas of the courthouse and avoid public entrances. Actions should be taken “discreetly” to minimize disruption to court proceedings, and agents should generally avoid areas wholly dedicated to non-criminal proceedings, such as family court, the directive says.

Crucially, the directive says ICE can conduct civil immigration arrests “where such action is not precluded by laws imposed by the jurisdiction.” In other words, the agency’s guidance directs agents to respect state and local bans on noncriminal arrests.

Trump administration court actions

But the Trump administration has also gone to court to try to overcome state-level restrictions.

The Justice Department sued in June over New York’s Protect Our Courts Act, arguing that it “purposefully shields dangerous aliens” from lawful detention. The department says the law violates the U.S. Constitution’s supremacy clause, under which federal law supersedes state law.

New York Democratic Attorney General Letitia James argued the state law doesn’t conflict with federal law and sought the lawsuit’s dismissal.

U.S. District Court Judge Mae D’Agostino, an appointee of President Barack Obama, on Monday granted James’ motion. The judge wrote that the “entire purpose” of the lawsuit was to allow the federal government to commandeer New York’s resources — such as court schedules and court security screening measures — to aid immigration enforcement, even though states cannot generally be required to help the federal government enforce federal law.

“Compelling New York to allow federal immigration authorities to reap the benefits of the work of state employees is no different than permitting the federal government to commandeer state officials directly in furtherance of federal objectives,” the judge wrote.

The Justice Department didn’t immediately respond to a request for comment.

The department is also prosecuting Wisconsin Judge Hannah Dugan, who prosecutors allege helped a person living in the country illegally avoid ICE agents in April inside a Milwaukee courthouse by letting him exit a courtroom through a side door. (Agents apprehended the individual near the courthouse.) A federal grand jury indicted Dugan on a count of concealing an individual and a count of obstructing a proceeding.

In court documents, Dugan’s lawyers have called the prosecution “virtually unprecedented and entirely unconstitutional.”

Dugan has pleaded not guilty, and a trial is set for December.

Lawmakers seek ‘order’ in courthouses

Rhode Island Democratic state Sen. Meghan Kallman is championing legislation that would generally ban civil arrests at courthouses. The measure received a hearing, but a legislative committee recommended further study.

Kallman hopes the bill will go further next year. The sense of urgency has intensified, she said, and more people now understand the consequences of what is happening.

“In order to create a system of law that is functioning and that encourages trust, we have to make those [courthouse] spaces safe,” she said.

Back in Connecticut, Democratic state Rep. Steven Stafstrom said his day job as a commercial litigator brings him into courthouses across the state weekly. Based on his conversations with court staff, other lawyers and senior administration within the judicial branch, he said “there’s a genuine fear, not just for safety, but for disruptions of orderly court processes in our courthouses.”

Some Connecticut Republicans have questioned whether a law that only pertains to civil arrests would prove effective. State Rep. Craig Fishbein, the ranking Republican on the House Judiciary Committee, noted during floor debate that entering the United States without permission is a criminal offense — a misdemeanor for first-time offenders and a felony for repeat offenders. Because of that, he suggested the measure wouldn’t stop many courthouse arrests.

“The advocates think they’re getting no arrests in courthouses, but they’ve been sold a bill of goods,” he said.

Stafstrom, who chairs the Judiciary Committee, said in response that he believed the legislation protects many people who are in the country illegally because that crime is often not prosecuted.

“All we’re asking is for ICE to recognize the need for order in our courthouses,” Stafstrom said.

Stateline reporter Jonathan Shorman can be reached at jshorman@stateline.org.

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