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Political and Economic Pressures Set Up a Healthcare Shift in 2026
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Political and Economic Pressures Set Up a Healthcare Shift in 2026

Healthcare in 2025 was consumed by chaos, conflict and relentless drama. Yet despite unprecedented political turmoil, cultural division and major technological breakthroughs, there was little meaningful improvement in how care is paid for or delivered.

That outcome was not surprising. American medicine is extraordinarily resistant to change. In most years, even when problems are obvious and widely acknowledged, the safest bet is that the care patients experience in January will look much the same in December.

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The Finish Line Is a Commons
Athletes compete in a hyrox event with puma branding.

The Finish Line Is a Commons

A decade ago, bootcamp workouts had little to do with appearance or chasing personal records. For me, they meant survival. They offered a way to manage stress, process grief, and stay upright beneath the weight of vocation and responsibility. Pastoral leadership, specifically during the time of “parachute church-planting,” often convinces a person that stillness is an unattainable luxury and that exhaustion is a sign of virtue. Eventually, my body defied those assumptions. So I went to the workout and may have discovered the “secret sauce” behind such entrepreneurial success. Then I returned. And kept returning. Mornings meant emerging outdoors at first light. I found myself in empty parking lots, on tracks, inside gyms, and eventually in a neighboring storefront home to BKM Fitness, owned by Braint Mitchell. There was no soundtrack, only measured breath and occasional encouragement called out by someone who hardly knew my name.

I could not have predicted that such spaces would become the most honest civic grounds I occupy. Today, my sense of belonging unfolds less in churches, classrooms, or boardrooms, and more in bootcamp circles, running groups, the leaderboard on Peloton, and, more recently, at a Hyrox start line—a hybrid fitness space where community looks and feels different.

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Freezing Child Care Funding Throws the Baby Out with the Bathwater
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Freezing Child Care Funding Throws the Baby Out with the Bathwater

In the South, there is an idiom that says, “Don’t throw the baby out with the bathwater.” It means not discarding something valuable while trying to eliminate something harmful. The Department of Health and Human Services’ (HHS) proposed response to unsubstantiated child care fraud allegations in Minnesota risks doing exactly that.

The Department of Health and Human Services (HHS) has frozen child care and family assistance grants in five states, and reports indicate that this action may be extended nationwide. Fraud at any level is wrong and should be thoroughly investigated, and once proven to be true, addressed. However, freezing child care payments and family assistance grants based on the views of a single social media “influencer” is an overcorrection that threatens the stability of child care programs and leaves families without care options through no fault of their own.

Across the nation, Americans rely heavily on child care. According to the Center for American Progress, nearly 70 percent of children under age six had all available parents in the workforce in 2023, underscoring how essential child care is to family and economic stability.

Child care funding, therefore, is not optional. It is a necessity that must remain stable and predictable.

Without consistent funding, child care operations are forced to significantly reduce capacity, and some are forced to close altogether. In 2025, a longtime family child care owner made the difficult decision to close her business after state budget cuts eliminated critical child care funding. While this example reflects a state-level funding failure, the impact is the same. When funding becomes unreliable, as is the case with the current funding freeze, child care business owners, employees, parents, and children all suffer.

The economic consequences extend well beyond families. According to the U.S. Chamber of Commerce, when parents cannot find or afford child care, they are pushed out of the workforce, and businesses lose skilled employees. Child care gaps disrupt staffing across industries and cost states an estimated $1 billion annually in lost economic activity.

Child care is no longer just a family issue. It is an economic issue. It is one of the few sectors that directly affects every other industry. At a time when women are being encouraged to have more children, a strong support system must also exist, and that includes consistent, reliable child care funding.

Misuse of government funds is not a new concept. During the COVID-19 pandemic, more than $200 billion in federal relief funding across programs was reportedly misused. Fraud occurs in every industry, and no system is immune to it.

If allegations of child care fraud are substantiated, safeguards should absolutely be implemented to prevent future misuse; however, freezing child care funding would further delay payments to a sector already plagued by late reimbursements, disrupt services for children and families, and destabilize small businesses that operate on thin margins.

The solution is straightforward. Strengthen oversight to mitigate risk, without punishing the entire field. We must acknowledge that the vast majority of child care programs operate in good faith and in compliance with the law, providing care to millions of children nationwide. According to a 2020 report by the United States Government Accountability Office, only seven states since 2013 have had errors in more than 10 percent of their child care fund payments.

Yes, accountability matters, but solutions must be precise and measured. Sweeping actions based on unsubstantiated claims destabilize the entire child care system. When child care collapses, families lose care, caregivers lose income, small businesses close, and the economy suffers.

We can strengthen safeguards without dismantling the system that families and the economy depend on. We can address misuse if and where it exists. But we cannot afford to throw the baby out with the bathwater.

Eboni Delaney is the Director of Policy and Movement Building at the National Association for Family Child Care (NAFCC), and a Public Voices Fellow of the OpEd Project in Partnership with the National Black Child Development Institute.

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The ACA’s Missing Mandate: Why Costs Keep Rising

Repealing the ACA’s individual mandate destabilized insurance markets, drove premiums higher, and left families paying the price.

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The ACA’s Missing Mandate: Why Costs Keep Rising

By repealing the Affordable Care Act’s individual mandate, policymakers allowed healthy Americans to walk away—leaving insurers with risk pools dominated by those most likely to need care. The result was inevitable: premiums soared, markets destabilized, and families were left paying the price.

When Congress passed the ACA, its most controversial feature was the individual mandate—the requirement that all Americans carry health insurance or pay a penalty. Critics called it coercion. In reality, it was the glue holding the system together.

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