SCOTUS just heard oral arguments in Trump v. Barbara, AKA the Birthright Citizenship case. As we now know (if we didn’t before), the 14th Amendment’s Citizenship Clause grants birthright citizenship to all persons born or naturalized in the US and “subject to the jurisdiction thereof.” That clause raises some interesting questions: Can someone be subject to the jurisdiction of two countries? Can someone hold allegiance to two sovereigns?
In her questioning of Cecillia Wang, the ACLU lawyer, Justice Jackson tried to magically concoct two types of jurisdiction: permanent and local. In her strained example, a foreigner traveling in Japan is temporarily subject to local jurisdiction—if the traveler’s wallet is stolen, for example, Japanese authorities have jurisdiction to investigate the crime. Nevertheless, that traveler is still subject to the permanent jurisdiction of their home country.
Here’s where the crafty concoction becomes a stretch: Jackson implied that temporary sojourners (parents on a Birth Tourism escapade, perhaps) might be subject to local jurisdiction (e.g., in the U.S.); their babies, having been born here, are subject to our permanent jurisdiction. The implication of Jackson’s argument is that parents have temporary allegiance; babies have permanent allegiance.
Huh? Except in rare juvenile delinquency and runaway cases, children usually owe allegiance to their parents up until the age of majority. But there is a potentially craftier deceit: Wang and the seemingly complicit Jackson seem to suggest one can hold allegiance to two sovereigns. Therefore, even if a “sojourner” (aka illegal alien) is subject to a foreign potentate, the illegal can still be under our jurisdiction—temporarily, at least.
In essence, they hold allegiance to two sovereigns and abide by the 14th Amendment’s requirements. Furthermore, their offspring are presumed to have allegiance to the jurisdiction of their birth, even if their sojourning parents are from an enemy country, and an enemy country is where Birth Tourism is out of control.
Justice Jackson used Japan as her example, but China may better demonstrate the incongruity between permanent and local jurisdiction and its ramifications for allegiance.
It is China (one wonders if someone named “Wang”—representing the ACLU and referring to “white people” during arguments—can be objective), where birth tourism to the U.S. is rampant. Some of our territories, including the Northern Mariana Islands, may not require a visa.
There are indications that the CCP facilitates the practice, even as part of an invisible coup. Moreover, Chinese nationals who are naturalized over here hardly demonstrate their allegiance to our jurisdiction. In fact, they are renowned for spying, stealing secrets, and sowing anti-American discord despite their domicile and so-called “permanent allegiance.”
Based on abundant empirical evidence, China is adversarial to the U.S. Justice Jackson and her ilk may be skilled at twisting words, willfully misinterpreting framers’ intentions, and convoluting meanings to suit their activism, but this is just commonsense for average folk: it is impossible to have dual allegiance to two sovereigns when they are enemies.herefore, it is common sense (whether or not it is currently legal to carve out exceptions) to end birthright citizenship for Chinese sojourners daring to game the system. Their allegiance is to their parents and the CCP (who probably sponsored them), not to the last great hope of Earth.
Last August, law enforcement in the German state of Saarland responded to a call of armed robbery at a local convenience store, where they came upon the suspect, a knife-wielding Turkish teenager who’d just bagged around €600—the teen attacked and during the scuffle, “seized a service weapon from a trainee, and opened fire.” (I would like to know if that “trainee” who couldn’t keep hold of the firearm was a woman.) Ahmet G., the 19-year-old miscreant, hit 34-year-old Police Chief Inspector Simon Bohr with a spray of bullets, and Bohr died at the scene after being shot in “the head, face, neck, shoulder, abdomen, and back.” Bohr also left behind a wife and child(ren).
But, Ahmet was feeling grumpy that day, in a “bad mood” because he was a total loser with a “lack of prospects,” so instead of the death penalty—a life for a life is the only equitable response—or even a life sentence, Ahmet has been acquitted, and will spend just the briefest time in a psychiatric care facility to convalesce.
From Thomas Brooke at Remix News:
The Saarbrücken Regional Court ruled that the 19-year-old gunman, Ahmet Gürsel, bore diminished responsibility at the time of the killing of Police Chief Inspector Simon Bohr, 34, and instead convicted him only of aggravated robbery, ordering his placement in a secure psychiatric facility.
The court found that due to his “anxiety” and mental faculties, “his ability to control his actions” was “significantly impaired,” but meanwhile, they jail native Germans who post online about the migrant problem.
So apparently being too low-IQ and stressed is a legitimate defense for criminal behavior, which seems to be a valid defense for everyone except…white people. Sure this was Germany, but we see it in the U.S. all the time; we all know there’s a different justice system for non-whites, who are all too often held to different standards, recipients of “reparative” (in)justice. (For a brief and recent list of examples, see a related blog on that here.)
A tiered justice system is no justice system at all.
CMS ispilotinga new program that permits some clinicians to offer certain hemp-derived products to Medicare patients as part of their care plans.
The new Substance Access Beneficiary Engagement Incentive is part of CMS’ Innovation Center model-testing framework, designed to evaluate whether hemp-derived products can improve patient outcomes when integrated into coordinated, clinician-led care plans.
The initiative operates under the 2018 Agriculture Improvement Act’s hemp provisions and aligns with an executive order President Donald Trump signed in December, supporting hemp innovation. The move does not legalize or authorize any drug that is otherwise prohibited under federal drug law.
Five things to know:
1. The option is only available to physicians and Medicare beneficiaries participating in the ACO REACH Model and the Enhancing Oncology Model. In 2027, the incentive will expand to the Long-Term Enhanced ACO Design Model.
2. Five ACOs in the REACH Model have submitted plans to begin offering the incentive as soon as April 1, pending CMS approval, with additional organizations able to join over time. Eligible patients may receive up to $500 per year in approved hemp-derived products if their clinician determines it is safe and appropriate. Participants must ensure products meet quality and safety standards, including third-party testing for potency and contaminants.
3. Clinicians may only offer federally legal hemp items containing no more than 0.3% delta-9 THC. Prohibited products include inhalable items (such as vapes), oral products containing more than 3 mg per serving of tetrohydrocannabinols, and products with cannabinoids not naturally produced by cannabis plants.
4. CMS will not pay for or reimburse providers for these products, and the initiative does not change Medicare coverage.
5. The agency will monitor implementation and evaluate whether the products deliver cost-effective improvements in patients’ symptoms and quality of life.
“CMS is committed to innovation that meets patients where they are while maintaining strong safeguards and clinical oversight,” said CMS Administrator Mehmet Oz, MD, in an April 1 release. “Under the President’s leadership, we’re expanding the tools available to improve patients’ health while generating important insights into how providers can use these tools safely and effectively in real-world care settings.”
Hospitals and health systems continue to sever ties with certain Medicare Advantage plans in 2026, citing persistent frustrations with prior authorization denials and slow reimbursement from insurers.
MA now covers more than half of the nation’s older adults, making these contract terminations increasingly consequential for patient access. Becker’s has tracked these decisions since 2023; our 2025 coverage is here.
Nineteen health systems dropping Medicare Advantage plans: Editor’s note: This is not an exhaustive list and includes contract breaks effective in 2026. It will continue to be updated this year.
Tampa, Fla.-based Moffitt Cancer Center went out of network with Aetna MA in December 2025 and will go out of network with Humana MA in July 2026.
NewYork-Presbyterian and UnitedHealthcare MA will go out of network on May 1 without a new agreement in place, following an extension of the original January deadline.
Tacoma, Wash.-based MultiCare no longer contracts with any nongroup MA PPO plans in the Puget Sound region.
Rochester, Minn.-based Mayo Clinic went out-of-network with most MA plans from UnitedHealthcare and Humana, per the Star Tribune.
Irvine, Calif.-based Providence Clinical Network, which includes 15 hospitals across California, went out of network with UnitedHealthcare MA in January.
New York City-based Mount Sinai went out of network with Anthem MA in January.
Chapel Hill, N.C.-based UNC Health went out of network with Humana, WellCare (Centene), and Health Care Service Corp. (formerly Cigna) MA plans in January.
Houston-basedMemorial Hermann and BCBS Texas MA went out of network in January.
Allentown, Pa.-based Lehigh Valley Health Network went out of network with UnitedHealthcare MA on Jan. 25, 2026.
Lynchburg, Va.-based Centra Health dropped Humana MA in January.
Most primary care providers at Somerville, Mass.-based Mass General Brigham are no longer in network with MA plans from UnitedHealthcare or BCBS Massachusetts.
PMGC Holdings (NASDAQ: ELAB) filed its Form 10-K for fiscal year ended December 31, 2025, reporting a year of capital deployment and asset growth. Total assets rose 43% to approximately $12.87M and shareholders' equity increased to about $7.84M.
The company completed three acquisitions in 2025 (Pacific Sun Packaging on July 7, AGA Precision Systems on July 18, and Indarg Engineering on Oct 26) to expand precision manufacturing and specialty IT packaging operations, and advanced biopharma subsidiary Northstrive with clinical and preclinical programs targeting muscle preservation alongside GLP-1 therapies.
For decades, many pediatricians havereassured worried parentsthat children who stutter will likely outgrow it. Although that’s usually true, this approach — while statistically grounded — can miss children who would benefit from early evaluation and support.
“About 75% of the time, a child will stop stuttering,” said speech-language pathologist J. Scott Yaruss, PhD, professor of communicative sciences and disorders at Michigan State University in East Lansing, Michigan, and president/co-owner of Stuttering Therapy Resources, Inc., in McKinney, Texas. “But you can’t tell which child will continue, based only on statistics. That’s the key problem pediatricians face.”
Gerald A. Maguire, MD
According to Gerald A. Maguire, MD, founder and chair of the Stuttering Treatment and Research Society (STARS), pediatricians should take an active, informed role not only in identifying stuttering but also in coordinating care, screening for comorbidities, and guiding families through this frequently misunderstood condition.
Clinicians and parents should understand that stuttering, formally known as childhood-onset fluency disorder, is not typically caused by parenting style, emotional trauma, or low intelligence — misconceptions that continue to shape public perception and even clinical responses. Pediatricians should reassure parents that stuttering need not limit their child’s potential for future accomplishments, Maguire said.
“Stuttering isn’t a modern-day phenomenon. It’s been around for centuries, since the dawn of recorded history, affecting historical figures such as Moses and Demosthenes and perhaps even Alexander the Great,” Maguire, staff psychiatrist at the Maguire Neuropsychiatric Institute of Oroville Hospital in Oroville, California, told Medscape Medical News. This history is encouraging because “we see that stuttering didn’t stop them from becoming tremendous leaders and communicators.”
What Is Stuttering?
The definition of childhood-onset fluency disorder found in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, is “a disturbance in the normal fluency and time pattern of speech that is inappropriate for the individual’s age and persists over time.”
The age of onset is most often between 2 and 7 years, with up to 90% of affected children showing symptoms by age 6. Stuttering affects an estimated 5%-10% of preschoolers. Although it typically self-resolves, stuttering can persist into adolescence and beyond, affecting about 1% of the adult population.
“Children between ages 2 and 5 may have dysfluency or disruption in the flow of speech that improves with time as part of typical development,” said Yi Hui Liu, MD, MPH, section head of developmental-behavioral pediatrics and professor of pediatrics at the University of California, San Diego. “This developmental dysfluency occurs as the child attempts to convey their ideas in longer sentences and usually presents as repetition of words or phrases.”
Stutter-type dysfluencies include blocks, in which the child is unable to articulate; broken words; prolongations of a syllable; or part-word or single-word repetition. Other dysfluencies include frequent interjections, multisyllable repetitions, or revised/abandoned utterances.
Liu, a member of the executive committee for the American Academy of Pediatrics’ Section on Developmental and Behavioral Pediatrics, said stuttering “may occur by itself or with other speech/sound disorders, language disorders, or developmental disabilities.”
Stuttering often occurs with attention-deficit/hyperactivity disorder (ADHD), tic disorders, and obsessive-compulsive disorder. Social anxiety disorder, which affects 80% of children who stutter, can begin early and often results from the stigma and social difficulties stuttering creates.
The most common stutter-type dysfluencies are developmental, Liu added. Neurogenic stuttering, which is less common, is due to neurologic conditions or brain trauma, whereas psychogenic stuttering, which is rare, is associated with psychological trauma.
Multifactorial and Neurodevelopmental
Modern understanding of stuttering has shifted away from outdated notions like those promulgated by psychoanalytic theory, which framed stuttering as stemming from unconscious neurotic need fulfillment and unresolved oral conflict arising during early parent-child interactions, according to Maguire. “Now, we recognize stuttering as a neurologic disorder affecting the primary speech centers in the brain. We also understand that it’s multifactorial, often with a genetic basis.”
Twin studies suggest genetics may account for between 50% and 80% of stuttering cases, with as much as a threefold higher risk in those with first-degree biological relatives who stutter than in the general population.
Imaging and neurophysiologic studies have pointed to brain regions that might play a role in stuttering, including left-sided cortical sites associated with speech processing. Dysfunction in basal ganglia areas has been associated with the timing and coordination of motor function and the activity of the inner subcortical speech loop, which includes the striatum of the basal ganglia. Low function of the striatum in those who stutter is associated with an overactive presynaptic dopamine system that disrupts motor sequences necessary for speech production.
“Because many young children in preschool tend to have disruptions in speech when learning to talk, it’s important to differentiate between stuttering vs planning what to say, learning new words, or new sentence structures,” Yaruss said.
J. Scott Yaruss, PhD
Liu advised pediatricians to “conduct a complete history and physical examination, with attention to the oral, auditory, and neurologic components and use validated standardized tools to screen for potential co-occurring developmental conditions, such as speech/language disorders and developmental disabilities.”
Yaruss recommended the Childhood Stuttering Screening for Physicians, a validated tool “that’s not only billable but also convenient. It can be administered by other staff members, not necessarily the physician, and is designed to prevent both under- and over-referral.”
Other medical professionals who might play a role in evaluating the child and weighing in on a treatment plan include pediatric neurologists, child psychotherapists, pediatric otolaryngologists and audiologists, and, of course, speech-language pathologists. “Stuttering is best treated multimodally and treatment should be individualized,” said Maguire.
Children can be referred for speech therapy while the broader workup is underway so intervention can be initiated as soon as possible, he added.
STARS is developing open-access multidisciplinary guidelines on stuttering management for physicians, which will be available at no cost once published in peer-reviewed literature, he said. The guidelines will include evidence-based tools for physicians and speech-language pathologists to use in screening, as well as an algorithm for diagnostic purposes and further steps to take in collaborative care.
Treatment Approaches
Speech therapy is the “most established nonpharmacologic treatment that’s supported by a large evidence base,” Maguire said. Other beneficial nonpharmacologic interventions include psychotherapy — particularly cognitive-behavioral therapy, which also addresses the social anxiety that frequently accompanies stuttering.
The FDA has yet to approve medications specifically to treat stuttering, Maguire said. Aripiprazole, approved for Tourette, has shown some efficacy in stuttering, although akathisia is a potential side effect. Newer agents investigated for stuttering include ecopipam — a dopamine D1 receptor agonist with a different mechanism of action than the dopamine D2 receptor agonists — which showed encouraging results in adults who stutter. A new category of medication under review, the vesicular monoamine transporter-2 inhibitors, have demonstrated efficacy in Tourette and tardive dyskinesia and may have utility in stuttering too.
Medications to avoid include those often prescribed for coexisting conditions, such as stimulants for ADHD, which can worsen stuttering because they can cause disturbances in the dopamine regulation pathway, Maguire said.
Be the Quarterback
Yaruss believes the “wait and see” approach, still common among clinicians, does children a disservice. “Intervention should be started as soon as possible,” he said. “We know we can decrease the likelihood that the child will struggle with stuttering. And the earlier we can provide families with ways of supporting their child, the better.”
Even if the interventions don’t completely stop the stuttering, they can diminish the adverse impact, according to Yaruss. “We can help these children know they can communicate freely without tension in their muscles and without struggle,” he said. “They may stutter a bit, but that may not necessarily be a ‘stuttering problem.’”
Parents should be advised that children with a stuttering disorder qualify as having a “disability” under Section 504 of the Rehabilitation Act of 1973 and are entitled to educational accommodations in school, including extra time when speaking in class, as well as help addressing disability-based bullying and discrimination.
The role of pediatricians doesn’t stop when children have been referred for intervention, Maguire said. “Yes, it takes a knowledgeable, collaborative, multispecialty care team, but the pediatrician is the one who needs to be the quarterback.”
Maguire reported receiving research grant support from Emalex, Noema, Johnson & Johnson, Otsuka, Biohaven, Vistagen, Bristol Myers Squibb, Eli Lilly, and Neurocrine. He reported being on the speakers bureau of Johnson & Johnson, Otsuka, Bristol Myers Squibb, Neurocrine, Teva, Alkermes, and Axsome and being the chief medical officer of AdhereTech and the principal investigator of CenExel California. Yaruss reported owning Stuttering Therapy Resources, which publishes the CSS-P screening tool. Liu reported having no relevant financial relationships.
The Walt Disney Company announced through its Disney Branded Television Discovers Voice Talent Search that it is looking for emerging voice actors, with a focus on the art of animation.
“Extraordinary performers are already out there — it’s our responsibility to discover them,” said Brenda Kelly Grant, Senior Vice President of Casting and Talent Relations at Disney Branded Television. “By intentionally widening our search, creating direct connections with our casting and creative teams, and investing in meaningful training, we’re ensuring that distinctive new voices will continue to define Disney storytelling for years to come.”
Disney
Ten voice actors aged 18 and older will be selected to participate in a workshop and may eventually be featured in an 11-minute Disney animated short that will be released on its platforms. Participants are encouraged to submit through the official application link, and individuals with strong comedic, musical, and improv skills are especially sought after.
The selected group of 10 will take part in a complimentary, weeklong workshop at Disney Television Animation studios in Glendale. During the program, participants will gain hands-on experience while learning directly from and collaborating with seasoned casting professionals and creative executives.
“Our goal is to find the best voices, and shorts are the perfect experimental canvas to help us do that. Over the course of the week, they’ll learn from our seasoned storytellers, gain experience in the recording booth, and see their performances evolve as we use improvisation techniques to create characters,” said Gino Guzzardo, VP of Multiplatform Content at Disney Branded Television.
“We’ll end the week with proof-of-concept character shorts, the best of which will be featured in a fully produced shorts variety special — a tangible example of what happens when new talent is given the space and support to find their voice,” he added.
Some famous Disney voice actors include legends like Jim Cummings (Winnie the Pooh, Tigger), Robin Williams(Genie), and Jodi Benson (Ariel), along with iconic stars such as James Earl Jones (Mufasa) and Tom Hanks (Woody).
