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The Montana Supreme Court temporarily blocked a ban on transgender medical procedures for minors this week, diverging from a growing national and international trend to restrict such treatments. The ruling comes as the U.S. Supreme Court seems poised to uphold a similar law from Tennessee and as the United Kingdom made efforts this week to ban minors from undergoing such treatments. Justice Beth Baker authored the majority opinion Wednesday, justifying her decision on the basis that the Montana constitution provides robust rights to privacy in medical decision-making. The law in question, Senate Bill 99, prevents "lawful medications and procedures administered by competent and licensed health care providers,” Baker wrote, finding that the law infringes on the ability of minors, their parents, and physicians to make individualized medical decisions. Baker's opinion was joined by five other justices, and one other, Justice Jim Rice, offered a concurrence and a dissent from her majority ruling. Baker also noted that the plaintiffs presented sufficient evidence of potential harm to justify blocking the law. "SB 99 affords no room for decision-making by a patient in consultation with their doctors and parents," she wrote. "The statute is a complete ban, prohibiting individualized care tailored to the needs of each patient based on the exercise of professional medical judgment and informed consent." Lone dissent warns about shifting medical and legal grounds Rice concurred in part with the majority but dissented on specific provisions, particularly regarding Medicaid funding. Rice argued that the state’s prohibition on using Medicaid funds for transgender procedures should be allowed to take effect during the legal proceedings. “There is no current federal mandate for Medicaid funding of transgender procedures,” Rice wrote, adding that funding decisions are within the legislature’s constitutional authority and should be subject only to rational basis review. Rice also expressed concern about the court’s broader reasoning, stating, “The medical and legal grounds regarding the subject treatment of minors addressed by SB 99 are moving under our feet.” He noted recent national and international developments questioning the medical benefits and long-term implications of these treatments. International and national developments on transgender procedures for minors The British government this week indefinitely banned the prescription of puberty blockers for individuals under 18 who identify as transgender. This decision follows a determination by the independent Commission on Human Medicines, which deemed these treatments an “unacceptable safety risk” for children and adolescents. Health Secretary Wes Streeting emphasized the lack of evidence supporting the safety and efficacy of these medications, stating, “It is a scandal that medicine was given to vulnerable young children without proof that it is safe or effective.” The closure of the Tavistock and Portman NHS Trust, the country’s leading gender clinic, earlier this year due to safety concerns preceded this ban. A review led by Dr. Hilary Cass found that the benefits of puberty-suppressing hormones were “remarkably weak,” prompting the government to extend the ban to both NHS and private clinics. In Washington, D.C., the House of Representatives this week approved an $895 billion defense policy bill that includes a provision prohibiting transgender medical treatments for minors. The legislation bans the use of Defense Department funds or facilities to “perform or facilitate sex change surgeries” and restricts TRICARE, the military’s health insurance program, from covering puberty blockers, hormone therapy, or other medical interventions for people under 18. The bill passed with a bipartisan vote of 281-140, with 81 Democrats joining Republicans in favor. Several Democrats, including Rep. Adam Smith (D-WA), criticized the inclusion of the transgender treatment ban, arguing it denies essential medical care to minors dealing with gender dysphoria. These legislative measures in the U.K. and the United States signify a significant shift in policy regarding transgender procedures for minors, reflecting debates over medical ethics, child welfare, and individual rights. Broader legal and social implications The Montana Supreme Court's decision is the latest in a national wave of legal battles over transgender procedures for minors. SB 99, also known as the Youth Health Protection Act, was signed into law by Gov. Greg Gianforte (R-MT) in April 2023 and prohibited surgeries, hormone treatments, and puberty blockers for minors experiencing gender dysphoria. Supporters of the law, including groups such as the American Principles Project, view these restrictions as critical safeguards for children. “Despite their attempts to gaslight the country into believing that this dangerous medical malpractice is somehow ‘life-saving care,’ more and more states are seeing through the lies,” American Principles Project President Terry Schilling said at the time of the law’s passage. Opponents, including the American Civil Liberties Union of Montana, argue the law infringes on private medical decisions. ACLU of Montana executive director Akilah Deernose said the state Supreme Court's ruling brought a momentary "sigh of relief." “But the fight for trans rights is far from over," Deernose said. "We will continue to push for the right of all Montanans, including those who are transgender, to be themselves and live their lives free of intrusive government interference.” What’s next The Montana district court injunction blocking SB 99 will remain in place while the case proceeds to a future trial on the merits at the Missoula County District Court. Meanwhile, the U.S. Supreme Court could issue a decision before the end of June 2025 surrounding the fate of Tennessee's similar law protecting minors from undergoing transgender procedures. The law bars minors from undergoing surgeries, cross-sex hormone treatments, or puberty blockers regardless of whether a doctor recommends such treatments or if parents consent to those procedures. The eventual ruling has the chance to affect roughly 24 states with similar laws on the books. Most states include carve-outs allowing minors to undergo treatments if they are experiencing conditions like early puberty. CLICK HERE TO READ MORE FROM THE WASHINGTON EXAMINER South Texas College of Law Houston professor Josh Blackman wrote for Reason last week that he believes the majority on the high court was "prepared to uphold" the Tennessee law. "There may even be seven votes for that outcome," Blackman wrote. "But as always, Justice [Elena] Kagan is in the middle, trying to broker a compromise that preserves future challenges for transgender litigants."maryland live casino zip code 。

Michigan aims to cap lost season by beating Ohio StateDana Announces Leadership Transition and Actions to Accelerate Value Creation

New York Jets interim coach Jeff Ulbrich said Aaron Rodgers “absolutely” will remain the team's starting quarterback and start Sunday against the Seattle Seahawks. Rodgers, who turns 41 next Monday, has been hampered at times during the Jets' 3-8 start by various injuries to his left leg, including a sore knee, sprained ankle and balky hamstring. Ulbrich said Monday the quarterback came back from the team's bye-week break ready to go. “All I can say, and you'd have to ask Aaron if he's fully healthy, but he's better off today than he's been as of late,” Ulbrich said. "So he's definitely feeling healthier than he has probably for the past month. A healthy Aaron Rodgers is the Aaron Rodgers we all love. “So, I'm excited about what that looks like.” NFL Network reported on Sunday that Rodgers, who missed all but four snaps last season with a torn left Achilles tendon, has declined having medical scans on his injured leg so he can continue to play. The New York Jets are turning to one of their former general managers to help them find their next GM and head coach. The franchise announced Monday that The 33rd Team, a football media, analytics and consulting group founded by former Jets GM Mike Tannenbaum, will assist team owner Woody Johnson in the searches. Tannenbaum and Rick Spielman, former GM of the Miami Dolphins and Minnesota Vikings, will be The 33rd Team's primary representatives in helping find replacements for former coach Robert Saleh and GM Joe Douglas. Purdy resumes throwing, status unknown SANTA CLARA, Calif. — San Francisco quarterback Brock Purdy took part in some light throwing on Monday after missing his first career game because of an injury and the 49ers are hoping he can return this week. Purdy hurt his throwing shoulder during a loss to Seattle on Nov. 17. Purdy underwent two MRIs last week that showed no structural damage. But Purdy he felt discomfort after making a few throws at practice on Thursday and was shut down for the game at Green Bay on Sunday that San Francisco lost 38-10. Coach Kyle Shanahan said Monday that Purdy made it through the session without pain and will rest on Tuesday and hopefully be able to return to practice on Wednesday as the Niners prepare to play at Buffalo this coming week. “We rested it throughout the weekend hoping that would help,” Shanahan said. “He threw lighter today to see if that rest helps and the rest did help him. So we’ll see again, going through the same things we did last week. We’re going to let him rest all the way up to Wednesday. We’ll see how it feels on Wednesday and then we’ll take the exact same course throughout the week. Hopefully it responds better this week than it did last week with the rest.” Brandon Allen went 17 for 29 for 199 yards with a touchdown, an interception and a lost fumble in his first start since the 2021 season. Allen would play once again if Purdy is unable to go on Sunday at Buffalo. Patriots' Peppers cleared to practice, play FOXBOROUGH, Mass. — The NFL removed New England Patriots safety Jabrill Peppers from the commissioner exempt list on Monday, making him eligible to participate in practice and play in the team’s games. Peppers missed seven games since being placed on the list on Oct. 9 after he was arrested and charged with shoving his girlfriend’s head into a wall and choking her. The league said its review is ongoing and is not affected by the change in Peppers’ roster status. Braintree, Massachusetts, police said they were called to a home for an altercation between two people on Oct. 7, and a woman told them Peppers choked her. Police said they found at the home a clear plastic bag containing a white powder, which later tested positive for cocaine. Peppers, 29, pleaded not guilty in Quincy District Court to charges of assault and battery with a dangerous weapon and possession of a Class “B” substance believed to be cocaine. At a court appearance last week a trial date was set for Jan. 22. Raiders' Minshew out for season HENDERSON, Nev. — Las Vegas Raiders quarterback Gardner Minshew is out for the rest of the season with a broken collarbone, coach Antonio Pierce said Monday. Minshew was injured with 3:12 left in Sunday's 29-19 loss to the Denver Broncos. Pierce will have to decide whether Aidan O'Connell or Desmond Ridder will start Friday's game at Kansas City. The Raiders, who have lost seven consecutive games to fall to 2-9, could use a spark. Minshew's grip on the starting job was tenuous even before he was injured. He threw 10 interceptions to just nine touchdown passes this season and Minshew also lost four fumbles. Jaguars' Lawrence hopes for return JACKSONVILLE, Fla. — Jacksonville Jaguars quarterback Trevor Lawrence will practice Monday and “we'll see where he's at from there,” coach Doug Pederson said. Lawrence missed the past two games, losses to Minnesota and Detroit, with a sprained left shoulder. Lawrence had extra time to rest during Jacksonville's bye week. The Jaguars (2-9) host AFC South-leading Houston (7-5) on Sunday and need a victory to avoid being eliminated from playoff contention. Pederson said Lawrence is “feeling better" and they will know more about his playing status following practice Wednesday. Lawrence took a hit to his left shoulder while scrambling at Philadelphia on Nov. 3. Instead of sliding, he chose to go head-first and got hammered by linebacker Zack Baun. Lawrence has practiced some in a limited role since, but was inactive for both games.

Julie Appleby | KFF Health News Unauthorized switching of Affordable Care Act plans appears to have tapered off in recent weeks based on an almost one-third drop in casework associated with consumer complaints, say federal regulators . The Centers for Medicare & Medicaid Services, which oversees the ACA, credits steps taken to thwart enrollment and switching problems that triggered more than 274,000 complaints this year through August. Now, the annual ACA open enrollment period that began Nov. 1 poses a real-world test: Will the changes curb fraud by rogue agents or brokerages without unduly slowing the process of enrolling or reducing the total number of sign-ups for 2025 coverage? “They really have this tightrope to walk,” said Sabrina Corlette, co-director of the Center on Health Insurance Reforms at Georgetown University. “The more you tighten it up to prevent fraud, the more barriers there are that could inhibit enrollment among those who need the coverage.” CMS said in July that some types of policy changes — those in which the agent is not “affiliated” with the existing plan — will face more requirements, such as a three-way call with the consumer, broker, and a healthcare.gov call center representative. In August, the agency barred two of about a dozen private sector online-enrollment platforms from connecting with healthcare.gov over concerns related to improper switching. And CMS has suspended 850 agents suspected of being involved in unauthorized plan-switching from accessing the ACA marketplace. Still, the clampdown could add complexity to enrollment and slow the process. For example, a consumer might have to wait in a queue for a three-way call, or scramble to find a new agent because the one they previously worked with had been suspended. Given that phone lines with healthcare.gov staff already get busy — especially during mid-December — agents and policy analysts advise consumers not to dally this year. “Hit the ground running,” said Ronnell Nolan, president and CEO of Health Agents for America, a professional organization for brokers. Meanwhile, reports are emerging that some rogue entities are already figuring out workarounds that could undermine some of the anti-fraud protections CMS put in place, Nolan said. “Bottom line is: Fraud and abuse is still happening,” Nolan said. Brokers assist the majority of people actively enrolling in ACA plans and are paid a monthly commission by insurers for their efforts. Consumers can compare plans or enroll themselves online through federal or state marketplace websites. They can also seek help from people called assisters or navigators — certified helpers who are not paid commissions. Under a “find local help” button on the federal and state ACA websites , consumers can search for nearby brokers or navigators. CMS says it has “ramped up support operations” at its healthcare.gov marketplace call centers, which are open 24/7, in anticipation of increased demand for three-way calls, and it expects “minimal wait times,” said Jeff Wu, deputy director for policy of the CMS Center for Consumer Information and Insurance Oversight. Wu said those three-way calls are necessary only when an agent or a broker not already associated with a consumer’s enrollment wants to change that consumer’s enrollment or end that consumer’s coverage. It does not apply to people seeking coverage for the first time. Organizations paid by the government to offer navigator services have a dedicated phone line to the federal marketplace, and callers are not currently experiencing long waits, said Xonjenese Jacobs, director of Florida Covering Kids & Families, a program based at the University of South Florida that coordinates enrollment across the state through its Covering Florida navigator program. Navigators can assist with the three-way calls if a consumer’s situation requires it. “Because we have our quick line in, there’s no increased wait time,” Jacobs said. The problem of unauthorized switches has been around for a while but took off during last year’s open enrollment season. Brokers generally blamed much of the problem on the ease with which rogue agents can access ACA information in the federal marketplace, needing only a person’s name, date of birth, and state of residence. Though federal regulators have worked to tighten that access with the three-way call requirement, they stopped short of instituting what some agent groups say is needed: two-factor authentication, which could involve a code accessed by a consumer through a smartphone. Unauthorized switches can lead to a host of problems for consumers, from higher deductibles to landing in new networks that do not include their preferred physicians or hospitals. Some people have received tax bills when unauthorized policies came with premium credits for which they did not qualify. Unauthorized switches posed a political liability for the Biden administration, a blemish on two years of record ACA enrollment. The practice drew criticism from lawmakers on both sides of the aisle; Democrats demanded more oversight and punishment of rogue agents, while Republicans said fraud attempts were fueled by Biden administration moves that allowed for more generous premium subsidies and special enrollment periods. The fate of those enhanced subsidies, which are set to expire, will be decided by Congress next year as the Trump administration takes power. But the premiums and subsidies that come with 2025 plans that people are enrolling in now will remain in effect for the entire year. The actions taken this year to thwart the unauthorized enrollments apply to the federal marketplace, used by 31 states . The remaining states and the District of Columbia run their own websites, with many having in place additional layers of security. Related Articles Health | Do not wash your turkey and other Thanksgiving tips to keep your food safe Health | Feds suspend ACA marketplace access to companies accused of falsely promising ‘cash cards’ Health | Delaware County restaurant inspections: The problems with PICs; expired licenses; gnats, fruit flies and open doors for pests Health | Even with access to blockbuster obesity drugs, some people don’t lose weight Health | More foods are making us sick: What to know as foodborne outbreaks hit For its part, CMS says its efforts are working, pointing to the 30% drop in complaint casework. The agency also noted a 90% drop in the number of times an agent’s name was replaced by another’s, which it says indicates that it is tougher for rival agents to steal clients to gain the monthly commissions that insurers pay. Still, the move to suspend 850 agents has drawn pushback from agent groups that initially brought the problem to federal regulators’ attention. They say some of those accused were suspended before getting a chance to respond to the allegations. “There will be a certain number of agents and brokers who are going to be suspended without due process,” said Nolan, with the health agents’ group. She said that it has called for increased protections against unauthorized switching and that two-factor authentication, like that used in some state marketplaces or in the financial sector, would be more effective than what’s been done. “We now have to jump through so many hoops that I’m not sure we’re going to survive,” she said of agents in general. “They are just throwing things against the wall to see what sticks when they could just do two-factor.” The agency did not respond to questions asking for details about how the 850 agents suspended since July were selected, the states where they were located, or how many had their suspensions reversed after supplying additional information.NoneAnti-fraud efforts meet real-world test during ACA enrollment period

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Julia Wick | (TNS) Los Angeles Times As California politicos look ahead to 2025, the biggest question looming is whether Vice President Kamala Harris — a native daughter, battered just weeks ago by presidential election defeat — will enter the 2026 California governor’s race. Related Articles National Politics | Trump taps immigration hard-liner Kari Lake as head of Voice of America National Politics | Trump invites China’s Xi to his inauguration even as he threatens massive tariffs on Beijing National Politics | Pressure on a veteran and senator shows what’s next for those who oppose Trump National Politics | What Americans think about Hegseth, Gabbard and key Trump Cabinet picks AP-NORC poll National Politics | Trump is named Time’s Person of the Year and rings the New York Stock Exchange’s opening bell Harris has yet to give any public indication on her thoughts and those close to her suggest the governorship is not immediately top of mind. But if Harris does ultimately run — and that’s a massive if — her entrée would seismically reshape the already crowded race for California’s highest office. Recent polling suggests Harris would have a major advantage, with 46% of likely voters saying they were somewhat or very likely to support her for governor in 2026, according to a UC Berkeley Institute of Governmental Studies survey co-sponsored by The Times. “If Vice President Harris were to choose to run, I am certain that that would have a near field-clearing effect on the Democratic side,” Rep. Katie Porter, D-Irvine, said during a recent UC Irvine panel interview . Porter, a high-profile Democrat who has been eyeing the wide-open governor’s race, has yet to say whether she plans to run. Porter’s point was broadly echoed in conversations with nearly a dozen California political operatives and strategists, several of whom requested anonymity to speak candidly. Most speculated that a Harris entry would cause some other candidates in the race to scatter, creating further upheaval in down-ballot races as a roster of ambitious politicians scramble for other opportunities. “In politics, you always let the big dogs eat first,” quipped Democratic political consultant Peter Ragone. The current gubernatorial field is a who’s who of California politicians, but lacks a clear favorite or star with widespread name recognition. The vast majority of California’s 22 million voters have yet to pay attention to the race and have little familiarity with the candidates. The list of Democratic candidates includes Los Angeles’ first Latino mayor in more than a century ( Antonio Villaraigosa ); the first female and first out LGBTQ leader of the state Senate ( Toni Atkins ); the sitting lieutenant governor and first woman to hold that post ( Eleni Kounalakis ); the state superintendent of public instruction ( Tony Thurmond ) and the former state controller ( Betty Yee ). Democratic Gov. Gavin Newsom is serving his second term as California governor, meaning he is ineligible to run again. Several other Democrats, including Porter, outgoing Health and Human Services Director Xavier Becerra and state Atty. Gen. Rob Bonta have also publicly toyed with the idea of a run. They could be less likely to enter the fray should Harris decide to run. What the billionaire mall mogul Rick Caruso — who has also been exploring a run — would choose to do is an open question, as Caruso might contrast himself with Harris as a more centrist candidate. The real estate developer was a registered Republican until November 2019. It’s unlikely that Harris will proffer a public decision in the immediate term, leaving plenty of time for political insiders to game out hypotheticals in the weeks and months to come. Harris’ office did not respond to a request for comment. “I think every candidate for governor is trying to get some kind of intel,” Mike Trujillo, a Los Angeles-based Democratic political consultant and former Villaraigosa staffer, said of a potential Harris run. Trujillo speculated that Harris’ current state was probably similar to Hillary Clinton’s hiking sojourns in the Chappaqua woods after losing to Donald Trump in 2016, or Al Gore growing a beard in the bruising aftermath of his 2000 defeat. “The first thing she’s probably thinking about is, ‘Well, can I run again for president in four years?’ Not, ‘Do I run for governor in two years?’” said one political operative who’s worked with Harris in the past. Harris maintains a home in Brentwood and previously served as California’s senator and attorney general. A successful run for governor in 2026 would almost certainly impede a grab for the presidency in 2028. (Though if history is any guide, an unsuccessful run for California governor does not definitively preclude a bid for the Oval Office: Two years after losing the White House to John F. Kennedy, Richard Nixon lost the 1962 contest for governor to Pat Brown . The Yorba Linda native became the nation’s 37th president in 1969.) As the chief executive of a state that doubles as the world’s fifth-largest economy, Harris would have more power to steer policy and make changes as a California governor than she did as vice president, where her job required deference to President Biden. But leading a state, even the nation’s most populous, could feel like small potatoes after being a heartbeat (and a few dozen electoral votes) from the presidency. The protracted slog to November 2026 would also be a stark contrast to her ill-fated 107-day sprint toward the White House, particularly for a candidate whose 2020 presidential primary campaign was dogged by allegations of infighting and mismanagement. “I don’t think Kamala Harris has a deep psychological need to be governor of California, or to be in elective office in order to feel like she can contribute to society,” said the operative who’s worked with Harris in the past. “I think some of these people do, but she’s somebody who has enough prominence that she could do a lot of big, wonderful things without having to worry about balancing California’s budget or negotiating with Assemblyman Jesse Gabriel,” the Encino Democrat who chairs the Assembly’s budget committee. Technically, Harris has until March 2026 to decide whether she enters a race. But political strategists who spoke to The Times theorized that she probably would make a move by late spring, if she chooses to do so. “People will be more annoyed if she drops in in June,” a Democratic strategist involved with one of the gubernatorial campaigns said. Sending a clear signal by February would be more “courteous,” the strategist continued, explaining that such a move would give candidates more time to potentially enter other races. Kounalakis is a longtime friend and ally of Harris’ , and the vice president also has long-term relationships with some of the other candidates and potential candidates. California has eight statewide elected offices and campaign finance laws allow candidates to fundraise interchangeably for them, meaning money already raised for a candidate’s gubernatorial campaign could easily be redirected should they decide to run for, say, lieutenant governor instead. There are already a number of candidates running for lieutenant governor, including former Stockton Mayor Michael Tubbs, former state Sen. Steven Bradford and former state Treasurer Fiona Ma. But that office probably would see even more interest should Harris enter the gubernatorial race. It’s a largely ceremonial position, but one that has served as a launching pad for the governorship. Still, even if Harris does enter the race, Republican political strategist Mike Murphy threw cold water on the idea that she would have an automatic glide path to the governor’s office. “It’s like Hollywood. Nobody knows anything. She’s famous enough to look credible in early polling. That’s all we know for sure,” Murphy said. “Does that predict the future? No. Are there a lot of downsides (to a potential Harris candidacy)? Totally, yes.” ©2024 Los Angeles Times. Visit latimes.com. 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WASHINGTON — For someone who has made winning a key part of his personal, professional and political brand, Donald Trump is set to rely on a large stable of losers in his second term. The president-elect has tapped more than a dozen people who previously lost elections to join his administration next year. Even though both parties love to deride unsuccessful candidates who run again, the term “loser” doesn’t have to be a pejorative. Losing candidates regularly get elected later, including in the 2014 and 2020 election cycles. It also isn’t a disqualifying factor to serve a president, or even to serve as president. Javascript is required for you to be able to read premium content. Please enable it in your browser settings.Zeta Global Holdings Corp. Shareholder Notice: Robbins LLP Reminds Investors of the ZETA Class Action Lawsuit