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New Cybersecurity Rules for Healthcare? Understanding HHS’s HIPPA Proposal
Jan 20, 2026
Background
The Health Insurance Portability and Accountability Act (HIPAA) was enacted in 1996 to protect sensitive health information from being disclosed without patients’ consent. Under this act, a patient’s privacy is safeguarded through the enforcement of strict standards on managing, transmitting, and storing health information.
In 2003, the U.S. Department of Health and Human Services published the HIPAA Security Rule. The Security Rule aimed to protect the security of a subset of identifiable patient information called Electronic Protected Health Information, or ePHI. Under this rule, regulated entities, such as providers and hospitals, are required to comply with administrative, technical, and physical requirements.
On January 6, 2025, the Office for Civil Rights within the HHS issued a notice of proposed rulemaking (NPRM) for the HIPAA Security Rule. NPRMs are a part of the federal rulemaking process in which a proposed rule is published in the Federal Register and made public and open to feedback from individuals, organizations, and other stakeholders. After reviewing the comments, agencies like the HHS can revise the rule before finalizing it. The proposed rule to the HIPAA Security Rule comes in response to a surge in data breaches in the healthcare industry. Cybersecurity challenges in healthcare top those of any other industry with over $10.93 million lost to breaches in 2024, a number that has been increasing in the past years. This NPRM seeks to “improve cybersecurity and better protect the American health care system from a growing number of cyberattacks” by strengthening the Security Rule. The Security Rule had only been changed once before, in 2013, under the HIPAA Omnibus Rule, and these changes were also aimed at enhancing the privacy of ePHI.
Arguments in Favor
Supporters of the proposed changes to the HIPAA Security Rule argue that it is a crucial and necessary move to strengthen the privacy of electronic protected health information. They contend that the changes will close existing gaps in security by creating a more consistent defense and also increase the public’s trust in digital health systems. Proponents emphasize the stricter wording and removal of ambiguous language will enhance compliance and reduce vulnerabilities in protecting sensitive information.
Enhanced Privacy of ePHI
The proposed changes would ultimately strengthen protections around ePHI in response to the high utilization of electronic records and the increased risk for cyber incidents associated with electronic records. HHS aims to establish more consistent baseline regulations for all covered entities to ensure proper compliance and enhanced protection. The rule enforces more rigorous safeguards on formerly addressable controls through mechanisms such as a technical inventory, data mapping requirements, and mandatory authenticity controls. Together, these measures will aim to close existing security gaps and create a more uniform defense against cyber threats.
Increased Public Trust
The proposed rule is also expected to increase and restore the public’s trust in the new world of digital health systems. Currently, breach costs and high frequency of attacks constantly put patients’ data at risk. Between 2018 and 2023, breach reports made to OCR doubled and the number of people targeted and affected by these attacks increased by more than tenfold, with over 167 million people affected in total in 2023. In early 2024, over 100 million UnitedHealth patients were victims of cyberattacks that leaked their private information, exposing the vulnerabilities across the healthcare industry. Shortly after this incident, the NPRM was introduced as a direct regulatory response to the growing concerns. Through a multi-lever effort in ensuring heightened security of ePHI, the proposed rule works to rebuild patients’ and other stakeholders’ confidence in the protection of their digital health information.
Decreased Ambiguity
Much of the proposed rule’s efforts are directed toward eliminating the ambiguity and leniency around compliance by enforcing more stringent and defined standards. It amends the “addressable” language in the original Security Rule which offers flexibility to covered entities on implementing safeguards and replaces it with required specifications to ensure that entities do not misinterpret “addressable” as optional. The rule changes reduce uncertainties around regulation for healthcare providers and provide clarity for enforcement agencies via more explicit requirements. This would promote more efficient and consistent interpretation and compliance around cybersecurity.
Arguments in Opposition
Opponents of the proposed changes to the HIPAA Security Rule highlight concerns about the costs and practicality of implementing the new rules. They argue that the more stringent requirements may burden smaller or resource-limited healthcare providers, potentially diverting resources from patient care or creating workflow disruptions. Critics also note potential overlaps with existing cybersecurity frameworks, which could result in redundancy, making compliance more difficult.
Resource and Cost
HHS’s proposed changes to the HIPAA Security Rule may place significant financial burdens on smaller or rural healthcare providers. The more stringent requirements on ePHI regulation can put a strain on these providers who may lack resources to conduct annual audits, risk assessments, and other mandatory procedures. This, in turn, can lead to resources being diverted from clinical care, impacting timely patient care. Furthermore, the new regulations would require a significant portion of employees in a practice to engage in HIPAA training, which can lead to even greater workflow disruptions. These providers will also have to ensure that they have sufficient staffing and procedures to provide records in a shortened timeframe. This further widens the equity gap between large and small healthcare entities.
Complexity of Implementation
The implementation of the new rule changes may potentially be a complex and disruptive process. Training a large number of employees on HIPAA procedures and performing the now required security evaluations may interfere with workflow and delay timely patient care. With an increase in documentation and compliance burden, entities may necessitate the help of third-party legal and IT experts in order to meet the requirements to implement high level security measures under a shorter timespan. Equity concerns may be raised as a result of disproportionate burdens falling on smaller providers who may face more barriers to compliance than larger organizations.
Overlapping Policy Frameworks
Redundancy and misalignment of policies may also pose a problem for healthcare organizations and entities that already adhere to existing cybersecurity frameworks. The NIST Cybersecurity Framework (CSF) and HITRUST Common Security Framework (CSF) are two frameworks that contain similar controls in HIPAA risks as the proposed rule. Many of the changes outlined in the NPRM overlap with the rules that are already in place under these existing frameworks which may create confusion and conflicts that can lead to duplicative efforts. Covered entities may face inefficiencies in complying with the proposed rule without clearer guidance on how the rule changes align with existing regulations.
Conclusion
HHS’s proposed rule to the HIPAA Security Rule is a timely response to the rising concern over cybersecurity vulnerabilities in healthcare. As ePHI use and technology are rapidly evolving, the proposed rule is a necessary effort toward modernizing outdated standards for digital health information. However, despite the rule’s potential for strengthening privacy and public trust in digital health, there are equity concerns regarding the financial burdens and complications that smaller entities may face in implementing these changes. Moving forward, it will be important to strike a balance between security and feasibility in the implementation of the proposed rule in order to effectively protect patient privacy while maintaining an equitable healthcare system.
New Cybersecurity Rules for Healthcare? Understanding HHS’s HIPPA Proposal was originally published by the ACE and is republished with permission.
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A portrait of Renee Nicole Good is pasted to a light pole near the site of her shooting on January 08, 2026 in Minneapolis, Minnesota.
(Photo by Stephen Maturen/Getty Images)
MLK Warned Us About Silence. Minneapolis Is Testing Whether We’ve Learned Anything.
Jan 19, 2026
As we celebrate Martin Luther King Jr. Day, his words echo with a clarity that feels almost unbearable: “In the end, we will remember not the words of our enemies, but the silence of our friends.”
It is a warning meant for moments exactly like this one — moments when people insist they “don’t want to talk politics,” when discomfort becomes an escape hatch, and when silence becomes complicity. And today, that silence is being tested by the Trump administration’s response to the ICE officer shooting death of Renee Good in Minneapolis.
The administration has taken a position that is not only aggressive but also sharply contradicted by available evidence. Vice President JD Vance has repeatedly claimed that Good “tried to ram” an ICE officer with her vehicle and framed the shooting as “a tragedy of her own making.” He has also described Good as part of a “left‑wing network” and suggested she was “brainwashed,” offering no evidence for these assertions. President Trump and Homeland Security Secretary Kristi Noem have echoed these claims, insisting the shooting was an act of self‑defense and even labeling it “domestic terrorism.”
But verified videos contradict the administration’s central allegation that Good deliberately rammed an officer. Minnesota officials — including Gov. Tim Walz and Minneapolis Mayor Jacob Frey — have publicly disputed the federal narrative, saying the videos do not show Good driving her vehicle toward agents.
The facts are not settled, and the Trump Administration’s certainty is not supported by the available evidence.
And yet, many Americans — including people who consider themselves allies, advocates, or simply “good citizens” — are choosing silence. They say they don’t want to talk politics. They don’t want conflict. They don’t want to feel uncomfortable.
But discomfort is not the problem. Silence is.
MLK understood that injustice does not survive because of the loudness of those who commit it, but because of the quiet of those who look away. When a government advances an unverified narrative about a woman’s death — one contradicted by video evidence and disputed by state officials — silence is not neutrality. It is permission.
The Trump administration’s response to the shooting of Renee Good is not just a policy stance; it is a test of whether we are willing to confront power when it distorts the truth. It is a test of whether we will speak when the government blames a dead woman for her own killing before the investigation is complete. It is a test of whether we will challenge narratives that shift responsibility away from the state and onto the vulnerable.
And it is a test many people are failing — not because they support the administration, but because they prefer not to engage.
But MLK did not ask us to be comfortable. He asked us to be courageous.
He asked us to speak when speaking is hard. He asked us to confront injustice even when it is politically inconvenient. He asked us to refuse the easy refuge of silence.
The shooting of Renee Good — and the administration’s rush to justify it — demands that we honor that legacy. It demands that we reject the idea that “not talking politics” is a harmless personal preference. It demands that we recognize silence as a political act with real consequences.
This MLK Day, the question is not whether the administration will continue to push its narrative. It is whether the rest of us will continue to let silence do the work for them.
Hugo Balta is the executive editor of the Fulcrum and the publisher of the Latino News Network
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Americans increasingly distrust the Supreme Court. The answer may lie not only in Court reforms but in shifting power back to states, communities, and Congress.
Getty Images, TGI /Tetra Images
Hypocrisy in Leadership Corrodes Democracy
Jan 19, 2026
Promises made… promises broken. Americans are caught in the dysfunction and chaos of a country in crisis.
The President promised relief, but gave us the Big Beautiful Bill — cutting support for seniors, students, and families while showering tax breaks on the wealthy. He promised jobs and opportunity, but attacked Diversity, Equity, and Inclusion programs. He pledged to drain the swamp, yet advanced corruption that enriched himself and his allies. He vowed to protect Social Security, yet pursued policies that threatened it. He declared no one is above the law, yet sought Supreme Court immunity.
These are not minor contradictions — they are hypocrisy in plain sight. And hypocrisy corrodes democracy by eroding trust, weakening institutions, and betraying the people who believed in those promises.
Trump calls the government corrupt, yet profits from it. His hotels and golf courses abroad benefited from foreign officials seeking favor. He vowed to rid the country of drugs, yet pardoned individuals convicted of drug offenses. He weaponized the Department of Justice against enemies while shielding allies (Reuters). By politicizing prosecutions and dismantling oversight, he eroded the firewall meant to protect democracy.
Freedom of the press is not optional — it is the mechanism that keeps the government honest (Free Speech Center). Yet Trump undermined transparency, intimidating reporters and turning access into leverage. He demonizes immigrants while relying on them to maintain his properties. He punishes states that vote against him. He floats the idea of dictatorship, only to be rejected by Americans who value freedom too much.
Meanwhile, Congress has failed to check him. Instead of protecting the people, it bends in loyalty, shielding him from accountability.
The Supreme Court pretends to uphold the law, yet entertains claims of presidential immunity that would place one man above accountability. At times, it offers silence instead of clarity — leaving Americans to read between the lines. Citizens are not ignorant; we see the contradictions.
Americans need a fair, unbiased, moral Supreme Court — one that upholds the law as intended by the Constitution, not one swayed by billionaires with money. When justices remain seated for decades, they become prey to corruption and influence. Millions favor term limits, and I am one of them.
The late Justice Ruth Bader Ginsburg is deeply missed. She was strong, principled, and often appeared to keep the male justices in check. Her absence is felt in every ruling that bends toward privilege instead of principle.
Hypocrisy corrodes democracy just as surely as broken promises from the president or dysfunction in Congress. It leaves citizens caught in chaos: food insecurity, unaffordable housing, inaccessible health care, and institutions that pretend to care but demonstrate the opposite.
It takes courage, conscience, and sacrifice to confront hypocrisy. Liz Cheney stood as a patriot for justice and was penalized by her own party (MSN, Newsweek). That is not partisan courage; that is moral courage.
This is not a partisan issue. Hypocrisy corrodes democracy, whether it comes from Republicans or Democrats, and Americans must demand honesty from leaders of both parties.
The short‑term goal is to remedy the immediate problem by controlling leaders through enforceable ethics codes, ensuring ethical leadership in both Congress and the Supreme Court. Measures such as the Supreme Court Ethics, Recusal, and Transparency Act and a strengthened Ethics in Government Act can provide these safeguards, backed by independent oversight to monitor compliance and impose sanctions.
Once in place, Ethics Committees in Congress must monitor compliance, investigate misconduct, and enforce sanctions against violators. But Congress’s responsibility does not end with enactment. It must also review these codes regularly, legislate updates, and close loopholes as new abuses arise. Citizens must demand that Congress legislate binding ethics codes for the Supreme Court as well. That process begins with bills introduced in Congress, debated in Judiciary Committees, passed by both chambers, and signed into law by the President. Only then do ethics codes become binding safeguards. Such laws must also establish independent oversight — an inspector general or judicial ethics panel — to investigate violations and enforce compliance, because voluntary guidelines are not enough.
Americans must write, call, and attend town halls to demand that ethics codes be enforced. Citizens must contact their representatives and insist that Congress introduce, debate, and pass legislation requiring enforceable codes of conduct for both Congress and the Supreme Court. Once enacted, citizens must monitor congressional dockets and roll‑call votes to ensure leaders have followed through and continue to uphold these standards.
This is active citizenship — government of the people, by the people. Americans cannot sit by and expect leaders to do what is right; we must take a role to make sure they do. Not all leaders practice moral and ethical leadership, which is why vigilance is essential. In my former world, we adopted the Effective Schools motto: “What gets monitored, gets done.” The same principle applies to democracy. Americans must pay attention, help monitor, and speak out when promises are broken or ethics ignored. We cannot afford to be silent when democracy itself is at stake.
In the long term, Americans must recognize that legislation alone will not suffice. Age limits and term limits demand constitutional amendments. That process begins with a joint resolution introduced in Congress, requiring a two‑thirds vote in both the House and Senate. From there, three‑fourths of the states must ratify the amendment before it becomes law. Citizens must become advocates and lobbyists, working directly with their representatives, senators, and state legislators to demand that this be done. They must build coalitions across governments, press candidates to pledge support for reform, and monitor roll‑call votes and ratification debates to ensure momentum is not lost.
Citizens must lobby for measures like H.J.Res.5, which proposes limiting Representatives to three terms and Senators to two. They must also advocate for fixed terms for Supreme Court justices — such as 18 years — to ensure renewal and prevent entrenched influence. Congress must legislate binding ethics codes for the Court, enforced by independent oversight, while citizens insist that the Court itself accept renewal as a safeguard against corruption and bias.
Ultimately, democracy’s survival depends not only on laws but on a culture of accountability — citizens who demand integrity, leaders who honor their oaths, and institutions that adapt to protect the people rather than themselves.
Americans value freedom and want to feel safe enjoying it without fear. We need peace, opportunity, and justice. We want leaders who value diversity, show empathy, and exercise moral judgment. Above all, we need leaders willing to put country over self‑ambition, who honor their oaths and hold themselves accountable.
Democracy is not just the absence of dictatorship; it is the presence of integrity, equality, and courage. It means leaders who honor their oaths, citizens who can trust their institutions, and a press free to ask hard questions without fear. It means a country where immigrants are valued for their contributions, not demonized for political gain. It means billionaires cannot buy silence or power, because the people themselves hold the final say. That is the vision worth fighting for — and it is slipping away unless we act. Integrity is not red or blue. It is the foundation of democracy, and both parties must recommit to it.
The weight of hypocrisy and authoritarian ambition is heavy and dangerous. If leaders will not honor their oaths, uphold the Constitution, and place the people first, then the people must hold them accountable. Promises made must be promises kept — or democracy itself will collapse under that weight.
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Police tape and a batch of flowers lie at a crosswalk near the site where Renee Good was killed a week ago on January 14, 2026 in Minneapolis, Minnesota.
Getty Images, Stephen Maturen
ICE Shooting of Renee Good Revives Kent State’s Stark Warning
Jan 19, 2026
On May 4, 1970, following Republican President Richard Nixon’s April 1970 announcement of the expansion of the Vietnam War into Cambodia, the Ohio National Guard opened fire on a group of Kent State students engaged in a peaceful campus protest against this extension of the War. The students were also protesting the Guard’s presence on their campus and the draft. Four students were killed, and nine others were wounded, including one who suffered permanent paralysis.
Fast forward. On January 7, 2026, Renee Good, a 37-year-old U.S. citizen, was fatally shot by United States Immigration and Customs Enforcement (ICE) agent Johathan Ross in Minneapolis, Minnesota. Ross was described by family and friends as a hardcore conservative Christian, MAGA, and supporter of Republican President Donald Trump.
Good was a writer and poet and lived with her wife and 6-year-old child; she had just dropped her child off at school.
Including the recent Portland, Oregon, shootings on January 8, 2026,[1] Good’s killing was the eleventh time ICE agents had opened fire on people since September 2025. Four other people had been killed during the Trump administration’s deportation operations.
A number of videos of the shooting show that Good was in her vehicle, bantering with the ICE agents engaged in these operations. When she attempted to drive slowly away from the ICE agents, Ross fired three shots point-blank, killing Good.[2] One video showed that Good was denied medical care even after the person offering her help identified himself as a physician. An ICE agent responded, “I don’t care.”[3]
President Trump, Homeland Security Secretary Kristi Noem, and their associates defended the shooting as one of “self-defense”—i.e., that Good was trying to run over the agent with her vehicle. Indeed, Noem went so far as to characterize Good as a “domestic terrorist.”[4]
By any fair view of the videos, it is clear that Good was trying to slowly and carefully drive away from the ICE agent(s), not toward or into any of them.[5]
Mark Twain noted that if history doesn’t repeat itself, it often rhymes. And there are a couple of obvious parallels between the Kent State and Renee Good killings.
First, both military and law enforcement authorities were, among other things, forcibly trying to prohibit ordinary people from exercising their rights of free speech, to peaceably assemble, and to petition their government with their grievances, all guaranteed by the First Amendment of the federal Constitution. Whether it be an unpopular military war or Trump’s war on immigrants, people have the right to raise their voices in opposition and interject their personal presence against such government actions without threat of being attacked or killed by their government’s agents.
Second, while it would be unfair to paint all of these agents with the same brush (and I do not), it is impossible to ignore that some are acting with a level of aggression and recklessness that endangers the very people they are supposed to protect. The issue is not simply that individuals prone to overzealous or militaristic behavior find their way into federal enforcement ranks—especially in the absence of meaningful screening—but that their leaders, supervisors, and at times even courts and juries, implicitly condone this “shoot first, justify later” posture. What we are witnessing is not merely individual misconduct but a systemic failure of supervision and accountability.
Let us not have history repeat itself. The Kent State Guardsmen were acquitted of criminal responsibility for their conduct, notwithstanding that trial evidence showed that none were ever in danger from the students.[6] With the killing of Renee Good, the President and Homeland Security Secretary Noem (and their sycophants) immediately rallied around the ICE agents with the false narrative that she was trying to run over the agent(s) when the actual video evidence is clearly to the contrary.
In short, when government agents violate constitutional rights without consequence—when accountability is absent and misconduct is met with institutional silence or even tacit approval—public safety and the rule of law are placed in jeopardy. When those entrusted with authority operate beyond meaningful oversight, every one of us is at risk.
What few of us will risk speaking out, marching, or engaging in peaceful protest when doing so carries the possibility of being seriously harmed—or even killed—by an inadequately supervised government agent acting with undue aggression, and with little fear of facing consequences. The mere perception that such force may be used without accountability is enough to silence many who would otherwise exercise their constitutional rights.
The bottom line is this: if one cannot exercise a Constitutional right, it is, for all intents and purposes, chilled; it is effectively extinguished.
Kent State and the killing of Renee Good both stand as stark warnings about how quickly the First Amendment can be imperiled when government force is used without restraint. We should have learned that lesson the first time. Because we didn’t, Renee Good ended up a corpse in her car—the victim of an overzealous government agent whose actions were defended, or at least excused, by the President of the United States and the Secretary of Homeland Security, who branded her a “domestic terrorist.” When leaders signal that such conduct is acceptable, the message is unmistakable: constitutional rights can be overridden, and those who exercise them do so at their peril.
James C. Nelson is a retired attorney and served as an associate justice of the Montana Supreme Court from 1993 through 2012.
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