The test questions from a class at Florida International University enraged Randy Fine, a state lawmaker endorsed by President Trump. One of the questions, uploaded onto social media by a student, said that Palestine was a country before Israel was created. Another seemed to suggest that Zionists invented terrorism. To Mr. Fine, they were proof that college textbooks and the test materials that accompany them were awash in antisemitism. Mr. Fine said it made him wonder, “How many other Muslim terror textbooks are being used in our university system?” The sprawling State University System of Florida, which educates more than 430,000 students, has been trying to find out. Advertisement SKIP ADVERTISEMENT Ray Rodrigues, the system’s chancellor, removed the textbook, “Terrorism and Homeland Security,” from use in the system, pending a review. Then in August, he announced a remarkable effort that has worried some professors and advocates of academic freedom: All 12 universities he oversees were to set up faculty panels to vet course materials, including textbooks, for antisemitism and anti-Israel bias. To Mr. Rodrigues, the test questions Mr. Fine objected to were not only biased or antisemitic, they were also illegal under a 2024 Florida statute that defines some criticism of Israel as antisemitic. The subject of the class that sparked the statewide effort might seem unexpected. It was not in one of the disciplines, like sociology, that right-leaning lawmakers have targeted in recent years, arguing that they were bastions of left-leaning ideology. Rather, the course was on terrorism and homeland security, taught by an instructor who had served in the Marines. And the primary author of the textbook is a longtime security researcher who oversaw local antiterrorism training efforts in a Republican administration. “This is such a random, inappropriate choice,” said Martha Schoolman, an English professor who has spoken out against the textbook screening effort. “But it also doesn’t matter. Because once you’ve decided it’s your job to vet everything for antisemitism, nothing’s going to pass.”She added, “This is a policy being made based on screenshot.” The statewide vetting effort is unfolding at a time when academia is still reeling from the Oct. 7, 2023, attack by Hamas and the military response from Israel. Campuses that were roiled last spring by demonstrations protesting Israel’s bombing of Gaza have quieted. But under pressure from lawmakers, many colleges and universities have tightened their rules governing protests, expelled students for conduct violations and scrutinized classes. The Florida effort stands out. At the K-12 level, conservatives have long pushed school districts to ban books and publishers to examine curriculum for inappropriate material. In higher education, though, such scrutiny had been relatively rare. The vetting of course materials has been squarely in the domain of professors and their departments. Mr. Fine, who is Jewish and calls himself “the Hebrew Hammer,” is a rising star in the Republican Party. Mr. Trump endorsed him in November for the seat in Congress that Mike Waltz resigned to become Mr. Trump’s national security adviser. To Mr. Fine, the test questions posted on social media in June were examples of anti-Israel bias. One question read: “In which country did the Zionists purchase land to create their new homeland?” The answer was Palestine. But Palestine was Ottoman territory before the First World War and administered by Britain after that; it was not a country. Advertisement SKIP ADVERTISEMENT Another test question appeared to imply that extremist Zionist organizations invented terrorism. But terrorism existed long before the Middle East conflictMr. Fine began searching for accountability. At first he looked to the course instructor, Mario Reyes, an adjunct professor. Mr. Fine wrote on social media that Mr. Reyes “shouldn’t buy green bananas for his office,” suggesting that his days in the job were limited. But after learning that Mr. Reyes, a Marine veteran who works for the Department of Defense, did not write the test questions, he turned his attention instead to the textbook and its authors. The primary author of the book, Jonathan R. White, has credentials hardly seem associated with a pro-Palestinian bias. He served in the George W. Bush administration after the Sept. 11 terrorist attacks, and taught about terrorism and homeland security for decades at Grand Valley State University in Michigan. He conducted counterterrorism training for police and military forces, according to his biography. Dr. White, who recently retired and became a pastor, did not respond to requests for comment. In an interview, Mr. Fine acknowledged that he had not read the textbook that he described as “pro-Muslim terror.” But he said he was assured by university officials that the book was problematic. Advertisement SKIP ADVERTISEMENT Mr. Rodrigues, who said in an interview that he had reviewed the book, was more tempered. He said the book contained “anti-Israel bias,” though he did not cite specific examples. A review of the textbook by The New York Times found that it was more nuanced than the three test questions. The textbook does not say or imply that Palestine has been an independent country in modern times, nor that Zionists invented terrorism. In a book passage that appears to be the basis of one of the test questions under scrutiny, the author provided an Israeli perspective that terrorism in the region was associated with the Palestine Liberation Organization. It also included a Palestinian perspective that Israelis had used terrorist tactics until they developed a conventional military force. But it appears that the textbook author was not behind the test questions, either. Cengage Group, the book’s publisher, said in a statement that it had used a third-party vendor to write questions intended to quiz students on the material contained in the book. The company said that the questions “did not live up to our standards” and that it had halted digital and print sales of the book while it conducts a “full academic review” to ensure the content is free of bias. Brian Connolly, a history professor at the University of South Florida, said the questions were poorly constructed, but flowed from the textbook’s more nuanced writing.“If we’re going to focus on poorly written multiple-choice questions,” Dr. Connolly said, “then it’s going to take the state university system the rest of their lives to address that.” The book remains under review by the state university system. In August, Mr. Rodrigues gave marching orders to the college presidents to look for other examples of textbooks and teaching materials that contained antisemitism or anti-Israel bias. He said that the materials to be reviewed would be identified by keyword searches of course descriptions and syllabuses. The search words included “Israel,” “Israeli,” “Palestinian,” “Middle East,” “Zionism,” “Judaism” and “Jews.” Mr. Rodrigues said that antisemitism would be identified using a definition put forward by the International Holocaust Remembrance Alliance. Under that definition, calling the creation of Israel a “racist endeavor” or holding Israel to a “double standard” would qualify as antisemitic. The definition has been criticized on college campuses by some who argue that it protects Israel from legitimate criticism. Academic freedom groups like the American Association of University Professors have blasted the state textbook-vetting effort, calling it “thought policing” that “deepens Florida’s increasingly authoritarian approach to higher education.” Faculty members have said that it may violate their collective-bargaining agreement, which grants professors the right to “determine pedagogy.” And the Association of Jewish Studies said the effort disproportionately singles out for scrutiny instructors who teach Jewish Studies and related fields. Laura Leibman, the president of the group, said the effort represented good intentions gone awry. She said she worried about having people without subject-matter expertise vetting course materials based on murky criteria. “That struck at the heart of academic freedom,” she said. Professor Schoolman, who is Jewish, said the entire exercise might seem like a farce. “The whole system has to be turned upside down to find antisemitic needles in a haystack,” she said. But she also worried that it may signal more political battles to come over what professors can say and teach. In the interview, Mr. Rodrigues said that faculty members would conduct the reviews and send their findings to the university system’s Board of Governors before the board meets this week. If bias is identified, he said, experts would be brought in to examine the materials further. “We need to identify whether this was an anomaly,” Mr. Rodrigues said about the homeland security test questions, “or whether it’s part of a broader problem.”

The Kansas City Chiefs and the Philadelphia Eagles, who faced off in the 2023 Super Bowl in Arizona, are heading to a rematch in New Orleans. The Eagles lost then 38-35 but are hoping this time to win their second-ever Lombardi Trophy following their 2018 victory over the New England Patriots. Meanwhile, the Chiefs are looking to make history as the first team to win three Super Bowls in a row. Perhaps the biggest sports event in the U.S.—more than 200 million people tuned in last year—takes place this year at the Caesars Superdome on Sunday, Feb. 9. Here’s everything you need to know about the 59th Super Bowl. When and where is the 2025 Super Bowl? Super Bowl LIX will kick off on Sunday, Feb. 9, at 6:30 p.m. ET, at the Caesars Superdome in New Orleans. It’s the eighth time the stadium, which is home to the New Orleans Saints, is hosting the Super Bowl, and the 11th time the city is doing so—matching the Miami metropolitan area for the most Super Bowls hosted in NFL history. How can I watch the 2025 Super Bowl? The Super Bowl will be broadcast nationally on FOX. It will also be broadcast in Spanish on both Fox Deportes and Telemundo. A number of live TV streaming services will also carry the game via FOX, including YouTube TV, Hulu + Live TV, and Fubo TV. NFL games are also available to stream via the NFL App. And this year Fox Sports announced a Super Bowl “takeover” of its ad-supported streamer Tubi, offering free coverage of the game and pregame programming. Outside the U.S., the Super Bowl is available to stream via a DAZN subscription. What are the 2025 Super Bowl betting odds? Gambling has controversially become a huge part of sports in America, and the Super Bowl is no exception. According to betting site aggregator oddschecker, as of Sunday night, Jan. 26, after the Chiefs and Eagles won their respective conference championships to take their spot in the big game, the Chiefs are slight favorites to win the Super Bowl, though that is likely to fluctuate in the run-up to the actual gameday. Who is performing the 2025 Super Bowl halftime show? Grammy Award winning hip-hop artist Kendrick Lamar will headline the Super Bowl LIX halftime show—a musical performance that typically runs for some 12-15 minutes. “Rap music is still the most impactful genre to date. And I’ll be there to remind the world why. They got the right one,” Kendrick Lamar said in an announcement in September 2024. On Jan. 23, Apple Music announced that singer-songwriter SZA will join Kendrick Lamar as a special guest performer. Are tickets still available to go to the Super Bowl? As of Jan. 26, tickets remain available for the Super Bowl, though they are pricey. According to Ticketmaster, the prices range from around $6,000 to $64,000. TickPick says the cheapest tickets hover around $6,000, with the average price at around $11,000. What happened at the 2024 Super Bowl? Last year, the Chiefs beat the San Francisco 49ers in a dramatic overtime finish led by star quarterback Patrick Mahomes.

A slow-moving rainstorm system was bringing a reprieve to Southern California on Monday after a lengthy dry spell, but also caused some mudslides in areas scarred by this month’s wildfires, forcing road closures and making driving hazardous. The storm had dropped about half an inch of rain in downtown Los Angeles by early Monday morning, the most the city has received in about nine months. The rain was easing, and the threat of flooding and mudslides was expected to decrease as the day went on, though some isolated showers were expected into Tuesday. The precipitation had caused some damage and hazards. The Los Angeles Fire Department said there had been “debris flow” and “vehicles in the mud” in Woodland Hills overnight. Local news media showed images of mudslides in Pacific Palisades. The Santa Monica-Malibu Unified School District said its schools in Malibu would be closed on Monday because of dangerous road conditions and challenges accessing the schools. Schools in nearby Santa Monica remained open. Advertisement SKIP ADVERTISEMENT Snow in the Tejon Pass, northwest of Los Angeles, forced the closure of a portion of Interstate 5 on Sunday evening, California’s Department of Transportation said. The highway section, which includes a steep mountain pass known as “the Grapevine,” was reopened on Monday. Part of Canyon Boulevard at Pacific Coast Highway was also closed for safety, the Department of Transportation said. Topanga Creek overflowed, scattering debris across the boulevard, the agency said on social media. The National Weather Service had warned of a 10 to 20 percent chance of significant mudslides in several Los Angeles County burn scars, sensitive areas where fires burned through trees and brush. In the burn scars, the charred soil could act like slick pavement when soaked by rain, creating the conditions for mudslides, said Marc Chenard, a meteorologist with the service. “You just don’t get any absorption of the water,” Mr. Chenard said. “It just all immediately turns into runoff.”The burn scars include areas scorched by the Palisades fire in the Pacific Palisades section of Los Angeles; the Hurst fire near the Sylmar area of the city; the Sunset fire near West Hollywood; the Eaton fire near Pasadena; the Hughes fire near Castaic Lake; and the Franklin fire near Malibu, among others. Burn scars outside Los Angeles County had a 5 to 10 percent chance of experiencing mudslides, the Weather Service said. Residents were urged to stock up on supplies and protect property with sandbags. The Los Angeles region had endured a brutal drought for months, feeding this month’s devastating wildfires, which burned across thousands of acres and displaced more than 100,000 people. The two largest fires were nearly contained on Monday morning, with the rain further helping firefighters. The largest blaze, the Palisades fire near Malibu, was 94 percent contained, and the Eaton fire was 98 percent contained, according to Cal Fire. Before Saturday, there had been no measurable rain in downtown Los Angeles this year, said John Feerick, a senior meteorologist at AccuWeather. He described the rain as welcome news. “In general, this is beneficial rain,” Mr. Feerick said. “It should help with the fire situation immensely.” “Now, with that comes the risk, because there are burn scars,” he added.

All they could grab were stuffed animals, toothbrushes, Barbie dolls and blankets. Their bunk beds, cleats and clothes burned with their houses. The New York Times interviewed 10 children and their parents about what it was like to flee the fires in Los Angeles. They talked about what they are worried about, and what is helping them feel better. Ivy and Ruby Van Kline are twin sisters who just turned 6 this week. They are in kindergarten at Aveson School of Leaders, a charter school in Altadena, Calif. Their house and school both burned down, so the family moved in with their grandparents. Advertisement SKIP ADVERTISEMENT Jet Crawford, 6, was also in kindergarten at Aveson. He is living in a new house with his mom and his sister, Ilana, 3, after their house in Altadena burned. Their new town is about 20 minutes away from home.Kurtis Odom, 9, is in fourth grade at McKinley School of the Arts in Pasadena, Calif. His sister, Kayla Odom, is 12 and in middle school. They are living in a vacation rental after their house burned down, and doing school online. Phoebe Hanelin, 10, is also in fourth grade. Her school, Marquez Charter Elementary, burned down in the Palisades fire. Her home, which was just across the street, is gone. Phoebe’s older sister, Abigail Hanelin, is a sophomore at Palisades Charter High School. Part of her school burned, and now all their classes are online. Lily Yadegar, Alessandra Santini and Yasmine Santini are friends who also go to Pali High. Lily is 14. Alessandra and Yasmine, both 17, are twins. Their homes survived, but they spent more than a week evacuated, staying in hotels and rented houses. The three girls wanted to do something for their friends and neighbors, so they started a GoFundMe to help rebuild their school and a donation drive to help their classmates. What was it like leaving home? Ivy said it was “very, very scary” when the fire came. The power went out. Then the cats started meowing. “My dad said that our house wouldn’t burn on fire,” Ivy said. “But I just knew right before our house would go on fire, because it looked like the fire was, like, right next to our backyard.” Kurtis left his house in Altadena in the middle of the night with his mom, older brother and older sister. He could see the fire getting bigger and bigger. Later, they learned that their house was gone.“I went back to sleep. I woke up. My whole life broke,” Kurtis said. “I thought we were going to be OK.” Though Yasmine and Alessandra are twins, the teens responded differently the night of the Palisades fire. Alessandra cried. She packed baby photos and her perfume collection. She also got the clothes. “We share our clothes majority of the time, even though she doesn’t ask me, and sometimes I don’t ask her,” Alessandra said. Yasmine brought stuff she thought everyone else would forget about, like medicine and food. “And then I brought my baby blanket and my baby stuffed elephant that I’ve always had,” she said. What are your days like right now? Ivy, Ruby and their parents are staying with their grandparents in West Los Angeles. They like that the house is big and has stairs. “You can go down them and up them, and I could even do splits down them,” Ruby said. Kurtis and Kayla are doing school online. Their mom decided to keep them home while she figures out where they are going to live. When Kurtis isn’t doing school work, he plays cards with his family and talks to his friends on his tablet.Jet is staying in a new house with donated furniture. His school remains closed, and his mom is worried. He has autism and had been doing well with the help of his teachers. Phoebe and her sisters have moved twice since their house burned down. And they know they’re going to have to move again. Abigail is worried about where they’ll go next. How are you feeling? Kurtis worries about everything his family lost. “Everything is burned down,” he said. He wonders how his mom can afford to replace his soccer cleats and other sports equipment. His sister, Kayla, says she is shy and worries that she might have to go to a new school. “It’s just going to be awkward for me,” she said. Ivy and Ruby were excited about their 6th birthday party at Chuck E. Cheese this weekend, where they hoped to see friends from their old school. And Ruby is looking ahead to a milestone at her new school: “Going outside in the big kid area when I’m a big kid and going on the monkey bars.”Jet’s mom says he has been really upset. When she asked him about the fire, he buried his head in the cushions of their new couch. “It’s broken,” he said. “Mommy’s house.” Lily misses driving to school with Alessandra and Yasmine, and stopping at Starbucks along the way. “Our whole lives, we’ve been looking forward to going to high school together,” Lily said. “It’s just sad.” Remote learning reminds Abigail of the pandemic, when she was in middle school. This time, it feels worse. Back then, middle schoolers all across the country were in the same boat. “It was fine in Covid because it was everybody. But now it’s just one school,” she said. What was special about your home and your school? Kurtis will miss the house where he got to know his grandma. His grandparents bought it about 50 years ago after moving to California from Haiti. Phoebe used to walk to school by herself sometimes. Now she can’t. She likes her new school, but it’s not the same. “Their yard is so small, our yard was giant, so big,” she said.At Pali High, Lily says everyone knew each other. “I’ve only been there for a semester, and it already feels like a second home to me,” she said. Ivy and Ruby’s school had a “ginormous playground,” a garden, chickens named Sunshine and Marshmallow and a rabbit named Mr. Fluff. “I don’t know if they brought the chickens or the bunny,” Ivy said. Ivy and Ruby’s house was 99 years old. Their dad told them that it had magic from all the people who had lived there and could even grant their wishes. “But it died, so we have to celebrate it,” Ruby said. Did you bring anything with you? Phoebe and Abigail didn’t have time to grab much. Abigail, who loves to read, took only two books and has already finished them. But they were able to get all their pets: a dog, two cats, a beta fish, a dwarf hamster and Turbo the tortoise.“I only brought two stuffies,” Ivy said. “And we brought our toothpaste and toothbrushes and we got our blankets, and we got some of our pillows, and that’s all I brought.” Ruby brought Barbie dolls. But she is sad because “my bunk bed slide that was ours burned down.” Kurtis brought his school Chromebook and a tablet he can use to talk to his friends. “The crazy part is that the trampoline was still standing,” Kurtis said. “And you know what, if the trampoline is standing, I don’t know why the house ain’t standing.”

The Santa Ana winds that have fueled wildfires for weeks in Southern California finally stopped blowing on Friday, and an unusually long period of dry weather was on track to end in Los Angeles County as a cold storm arrived late Saturday. The system was expected to deliver light to moderate rain that will fall intermittently through Monday. The weather will give the arid landscape and withered vegetation a much-needed soaking and benefit firefighting crews. Still, the forecast showed a small risk that bursts of heavy rain could cause flash floods and mudslides around areas of Los Angeles County recently scarred by wildfires, including the northwest (Hughes fire), east (Bridge fire), southwest (Franklin and Palisades fires) and especially the central area where the Eaton fire burned. The National Weather Service issued a flood watch for those areas from 10 a.m. Sunday to 4 p.m. Monday, when there is the highest chance for rain and risk for thunderstorms. Kristan Lund, a meteorologist with the Weather Service, called flooding the worst-case scenario for the conditions in Los Angeles, where there is up to a 20 percent chance that debris flows could damage roads and structures. “What we’re telling people is to avoid the area during the watch period,” Ms. Lund said. “Use sandbags to protect your property, and if residents decide to stay, make sure to stock up on supplies in case road access is blocked.” The Los Angeles area has seen its driest start to the rainy season on record and has not measured significant rainfall since last spring. Since May 1, the Weather Service’s gauge in downtown Los Angeles has measured just a little more than a quarter-inch of rain. This weekend’s expected storm has the potential to bring nearly four times that amount. The burn scars in Los Angeles County, where trees and brush were devoured by flames, are most likely to benefit from the rain. “If we get gentle rains, it’s going to help make those burn areas recover and re-vegetate,” said Jayme Laber, a hydrologist with the Weather Service. The first drops of rain began to fall Saturday night, with showers expected to increase Sunday into Monday. Most locations across the county, including downtown Los Angeles, are expected to record up to an inch of rain in the storm. But isolated showers and thunderstorms could bring rain that falls at three quarters of an inch an hour, and the heavier rains could lead to debris flows Sunday afternoon through Monday afternoon. The thunderstorms could also kick up strong, damaging winds, drop small hail and cause water spouts over the ocean, the Weather Service said. The weather is expected to temporarily lower the risk of wildfires, but this one storm won’t fully end it. “It’s only going to help things out for a couple weeks,” Matt Shameson, a meteorologist with the U.S. Forest Service, said of the storm. “If we get another one or two decent systems, that will help us out significantly.” The good news is that another set of showers could come over the region sometime next week, Mr. Shameson said.

Everything is negotiable, as the saying goes—and that includes medical bills. Although many people assume their health care bills are binding, there’s often more wiggle room than one would think. “Never pay any bill right away,” says Caitlin Donovan, a senior director at Patient Advocate Foundation (PAF), a nonprofit that helps patients afford medical care. Prices that are incorrect, unaffordable, or simply higher than you think are fair can often be changed with a little effort. A recent report by the Commonwealth Fund, a health care research organization, found that about 40% of people who challenged an unforeseen medical bill ultimately secured a price reduction or even had their balance forgiven entirely. Erin Duffy, a research scientist at the University of Southern California’s Leonard D. Schaeffer Center for Health Policy and Economics, found an even higher percentage when she surveyed a small group of U.S. consumers who received medical bills they disagreed with or couldn’t afford. About 40% of those people didn’t bother to contest their bills, often thinking it wouldn’t make a difference. But in reality, roughly 75% of those who challenged an unaffordable bill got financial relief, Duffy found. “It’s worth the call,” she says. Making that call, however, can feel uncomfortable. Here’s how to do it. Branded Content XPRIZE at the 2025 TIME100 Summit: Making the Impossible, Possible By XPRIZE Step one: Read the bill carefully “Your first step is to really understand the bill,” says Jeremy Gurewitz, CEO of Solace, a company that connects consumers with health care advocates. Before you pay a cent, read over your bill and its accompanying explanation of benefits (EOB), the document your insurance company sends to summarize how it processed and covered the care you received. Make sure you understand what you’re being charged for and why. Just as important, confirm that nothing is inaccurate, Donovan says. Errors on these documents are very common, she says, and can lead to overpaying. “Any time you get any medical bill in the mail, assume there’s a mistake and it’s your job to find it,” she says. Make sure all of the basics—names, dates, and so on—are right. This may sound silly, but even glaring mistakes happen. “We’ve seen scenarios where people get bills for different people’s names” or for procedures they didn’t have, Gurewitz says. Read More: How to Get Better at Doing Things Alone Next, confirm that the amount on the bill matches the one specified on the EOB, Donovan says. Your EOB should also list the specific services for which you were billed. These billing codes can be hard to parse, but if any of them seem off, call your insurer to clarify. If necessary, you can ask for your bill to be reprocessed with the correct information. It’s also worth confirming that your insurance benefits were applied correctly. Make sure that your insurance was billed at all; that services weren’t processed as out-of-network when they should have been in-network; and that your documents accurately list how much you’ve paid toward your deductible, if you have one. In some cases, you may receive a letter saying that your insurer is denying coverage altogether, which can result in high out-of-pocket expenses. If you believe a denial is wrongful, you may have to appeal the company’s decision. Here’s a guide to doing so. Step two: Do your homework Before making any calls, calculate how much you can comfortably pay right away, as well as how much you can afford to pay over time, Donovan says. Keep those numbers in mind. It’s also helpful to do some research on typical pricing for the services you received, Donovan says. This information isn’t always easy to pin down, since prices can vary widely by geographic area, provider, patient insurance status, and more. But tools like Medicare’s price database can help give you a frame of reference, she says. You can also try to find hospitals or health systems in your area that post their price lists online. Step three: If necessary, enlist others Successful negotiation “really does take some boldness,” Duffy says. “Some people feel a stigma or shyness about picking up the phone and saying, ‘I can’t afford this bill.’” If you know that negotiating isn’t your strong suit—or if you’re dealing with a health issue that’s making you feel lousy—get help. A loved one may be able to handle the call on your behalf, or join you by three-way call or speaker phone. Pick someone who can be “assertive but diplomatic,” Donovan recommends. “The way you’re not going to win is having someone who’s screaming, because you’re trying to convince another person to help you.” Read More: 11 Ways to Respond When Someone Insults a Loved One’s Disability If you don’t have a loved one who is an ace negotiator, you can look into groups like PAF, Solace, and the nonprofit Dollar For, all of which offer patient assistance. You can also request a three-way call with your provider’s billing office and your insurance company if you’re hearing different things from each side, Donovan says. Step four: Ask about financial assistance If your bill is correct but higher than you can afford or think is appropriate, it’s time to negotiate. First, call your provider’s billing department and ask whether they offer financial assistance, since many hospitals and health systems provide free or discounted care to certain patients. Eligibility for these programs can be surprisingly broad, sometimes including people whose incomes put them several times above the federal poverty level. Nonprofit hospital systems tend to have particularly robust charity-care programs, Duffy says. It’s smart to start by asking whether you qualify for financial assistance, Donovan says. They may “say yes, and maybe you end up having no out-of-pocket costs,” she says. But even if they say no, “it preps the conversation. If you’re asking about financial assistance, it’s not going to be a shock to them” if you proceed to other negotiations. Step five: Ask about payment plans or discounts If you’re not eligible for a formal financial-aid program, you still have options. Many health care providers offer payment plans that allow you to pay off your balance in small chunks over time, sometimes without interest. Others may agree to “prompt pay” discounts, accepting a smaller lump sum right away rather than waiting for the full amount. But you might not know about these options unless you ask. Duffy’s research has shown that many hospitals offer payment plans, but far fewer publicly list that information online. Read More: The Surprising Benefits of Talking Out Loud to Yourself Here’s where your previous calculations about how much you can afford to pay will come in handy. “You can say something like, ‘I can’t afford the full price of what you’re charging, even after insurance,'” Donovan says. Then, either suggest a smaller, immediate lump-sum payment, or an amount that you can pay each month for a set amount of time. “They know on some human level that not very many people can afford a, say, $10,000 bill,” Donovan says. “They want to get paid,” even if the payment is less than what they originally charged, “and you should use that to your advantage.” If you feel your bill was improper—if, for example, you were led to believe that a service would be covered by insurance and it wasn’t—you should also mention that to strengthen your case, Gurewitz says. And if you’re really nervous about what to say, AI programs like ChatGPT can help you come up with a script, he notes. Step six: Escalate If negotiating didn’t work, consider ramping up your efforts, Gurewitz says. Advocates at his company have succeeded by sending letters to a health system’s billing department, as well as the organization’s CEO and legal team. If you try that approach yourself, use your letters to “lay out the situation and say, ‘I’m unable to pay this. I feel this payment is inappropriate and excessive. Here’s what I’m able to pay,’” and note that you’re also sending letters to other people within the organization, Gurewitz says. He recommends using certified mail so there’s a trackable paper trail. And in really egregious cases, Gurewitz says, alerting the media can also be effective. Once a journalist starts looking into an astronomical bill, he says, it often disappears.

When Vanessa Walilko was in her late 20s, she got strep throat—and then she got it again and again. Because she’s allergic to strep bacteria, she says her illness turned into scarlet fever several times within a few months. Soon, she started having heart issues. After spending a day in the sun selling jewelry at an art fair, she nearly passed out. A friend rushed her to the emergency room, where a doctor asked if she had a family history of people dropping dead in their 20s. When Walilko said no, the doctor told her to learn to better manage her stress and sent her home. “I don’t know if I can convey how smug and flippant he was,” recalls Walilko, 41, who lives in Evanston, Ill. “It was unreal—I was so glad my friend was there with me, because I was pretty delirious. I had to check with her: ‘Did I catch all that?’” Walilko knew something was wrong—yet says clinicians continued to brush off her symptoms. After doing internet research, she figured out that her boyfriend was likely a strep carrier, which meant he was harboring strep bacteria in his throat while remaining asymptomatic. Seven different doctors dismissed her theory, she says, before one finally agreed to test Walilko’s boyfriend—who was positive for strep. Read More: What to Do If Your Doctor Doesn’t Take Your Symptoms Seriously Branded Content XPRIZE at the 2025 TIME100 Summit: Making the Impossible, Possible By XPRIZE That unlocked the key to her physical recovery, though the emotional scars lingered. “We should be able to put our faith in doctors,” she says. “If something is cut-and-dried, like a broken bone, a heart attack, or cancer, doctors are like, ‘Great. We have a plan.’ But if it’s something that requires nuance and thinking outside their training, they kind of freak out and dismiss it.” Walilko’s experience isn’t unique: Researchers, clinicians, and patients alike have found that doctors routinely dismiss real medical symptoms that have nothing to do with mental health as anxiety. Across the internet, people have shared viral stories about medical gaslighting, describing the ways that doctors chalked up their symptoms of appendicitis, heart conditions, or even cancer to anxiety. Why do doctors assume it’s anxiety? There are a variety of reasons why this is a common occurrence, says Dr. Robert Gee, assistant dean of student affairs and a behavioral sciences professor at Ross University School of Medicine. Anxiety symptoms overlap with those of other medical issues, which makes it easy for both patients and clinicians to mistake a physical condition for one related to mental health, he points out. And if a patient has a history of anxiety, their provider will typically be even quicker to assume that physical symptoms are a recurrence, rather than a sign of something new. Other research has found that clinicians’ lack of knowledge is partly to blame. Limited time with patients also plays a role. “This is a huge factor for physicians,” Gee says. Some might lean toward an anxiety diagnosis because it seems like the simplest explanation, especially when symptoms are vague—like “I’m so tired all the time”—and when diagnostic tests don’t provide a clear explanation. “It’s complicated,” he says. “Some illnesses begin with mild symptoms that look a lot like anxiety before clearer signs appear.” Read More: When Should I Go to the Doctor With Cold Symptoms? The consequences of a misdiagnosis can be significant. “Patients may suffer longer, without proper treatment, which can make their health worse,” Gee says. “Ironically, being told it’s ‘just anxiety’ can make them even more anxious, since they have to worry that their concerns aren’t being taken seriously.” This loss of trust can dissuade people from seeking further care, he adds. We asked experts which symptoms are most likely to be misdiagnosed as anxiety. Digestive problems Anxiety can cause your stomach to lurch up and down, making you nauseous and leading to cramping, bloating, or diarrhea. But so can food-borne illnesses, gastroesophageal reflux disease (GERD), gallbladder problems, irritable bowel syndrome, peptic ulcers, and any number of other gastrointestinal issues. An endoscopy, stool test, or ultrasound can help pinpoint an accurate diagnosis. So can asking the right questions, says Dr. Monika Roots, a psychiatrist who’s co-founder and president of Bend Health, which provides pediatric mental-health care. Roots often sees kids who have been referred by their pediatrician for anxiety—but who are actually experiencing something else, like a stomach issue. She makes it a point to ask: “Do you feel like this all the time, or only when you’re stressed, like if you have a test at school? Are there specific foods you've noticed that change how your stomach feels? Are you super tired all the time? Are you vomiting?” The answers can help reveal whether something else is being overlooked. If she suspects mental health is not the culprit, she collaborates with the patient’s primary care doctor to ensure the child receives more in-depth testing. A racing heart If your heart is pounding rapidly—more than 100 beats per minute—or feels like it’s fluttering, you very well might be experiencing anxiety. When you’re in a state of high arousal and stress, your fight-or-flight response kicks in, leading to an uptick in heart rate. Yet it’s also possible you’re experiencing a cardiac issue, says Dr. Saima Shikari, a women's health cardiologist at the VCU Health Pauley Heart Center. “It could indicate an arrhythmia or an issue with your thyroid," she says. (People with hyperthyroidism often experience a rapid heartbeat.) Many of Shikari’s patients are women with symptoms of heart disease who were initially misdiagnosed with anxiety. “Unfortunately, a lot of women get told that when they're having palpitations, they're having anxiety,” she says. “If you happen to go to the doctor when you're not having your symptoms at that moment, I can understand how people would say, ‘Well, maybe it isn't coming from your heart.’” That's why it's helpful to track your symptoms, especially by using a wearable. You’ll be able to tell your doctor, “‘This is what my Apple Watch showed,’” she adds. Chest pain Anxiety can make your chest feel tight, like your insides are burning or being squeezed. But chest pain could also indicate a heart attack, or it might be caused by acid reflux, a lung condition, or even asthma, Gee says. Clinicians can use EKGs, chest scans, or tests for acid levels to rule out these conditions—while also checking in on stress levels. Read More: How Stress Affects Your Heart Health “This is something I think clinicians in general struggle with: asking the patient’s perspective," Gee says. “What we want is for patients to tell us, in their own words, what they think might be happening with their chest pain: any alleviating factors, any aggravating factors, any antecedents, any consequences from their various activities, and how it’s impacting them at home and at work and their activities." Fatigue or weakness Feeling tired all the time is one of the most common—and vague—symptoms that patients describe. There’s no single test to determine the root cause of fatigue, which is why doctors often blame it on anxiety or depression. “Fatigue is unfortunately a sign of multiple different things,” Shikari says. “You can have fatigue because you have congestive heart failure, and you're not pumping blood as efficiently as you need to. You can have fatigue because you have an arrhythmia, and your heart is in overdrive. You can have fatigue because your thyroid isn’t working the way that it needs to, so you're really tired. You can have fatigue because you have a GI disorder and you're malabsorbing things and are nutritionally deficient.” Read More: What to Do if You Have Sleep Apnea Relentless fatigue could also indicate diabetes, insomnia, or chronic fatigue syndrome, among other conditions. Ideally, an exam will include a thyroid test, blood sugar check, and sleep study to zero in on what’s really driving it. Shortness of breath If you’ve ever had intense anxiety or a panic attack, you understand what it’s like to feel like you're gasping for air. While shortness of breath is a common mental-health symptom, it can also indicate a respiratory condition like asthma, chest infection, or an array of heart problems, among other potential concerns. “Shortness of breath is what we call an anginal equivalent,” Shikari says. “Some people don’t have chest pain—they have shortness of breath, and that's a sign of having a heart attack. Shortness of breath can also come along with heart failure or an arrhythmia.” That’s why it’s so crucial for doctors to run thorough tests, she says. Migraines or severe headaches Headaches can certainly be stress-related; how many times have you had to pop a Tylenol after a rough day at work? But they “can also signal vascular issues,” says Dr. Sam Setareh, a staff cardiologist at Cedars-Sinai Medical Center and senior clinical researcher at the National Heart Institute. For example, a headache could point to a transient ischemic attack or a condition like epilepsy, multiple sclerosis, or fibromyalgia. Head pain is also associated with sinus problems, vision issues, and high blood pressure—which is why it’s important for doctors to take a detailed history and order tests like an MRI or CT scan, Setareh says. If you suffer from frequent headaches, tracking details like when they start, how long they last, and how severe they get can help your doctor pinpoint the cause. Dizziness or lightheadedness In the throes of anxiety, you might feel like the world is spinning. But vertigo can also point to inner-ear issues, low blood sugar, anemia, or a sudden drop in blood pressure. “There could be a neurological basis or some kind of nerve issue or a syndrome like epilepsy," Gee says. Read More: Long Dismissed, Chronic Lyme Disease Is Finally Getting Its Moment Plus, dizziness is associated with conditions that are traditionally difficult to diagnose, like multiple sclerosis. Ideally, doctors should test your ear function, check your blood pressure, and look into your blood sugar and iron levels, Gee adds. Sweating, flushing, or feeling hot Anxiety can trigger sweating and flushing, especially during panic attacks. But conditions like an overactive thyroid, menopause, or early onset of a serious infection can, too, Gee says. Blood work, including a thyroid test and hormone test, can help doctors figure out the best course of action. So can active listening. “Communication skills are absolutely critical in this,” he says. Gee recommends doctors ask open-ended questions and make it clear that they’re hearing what patients say while remaining nonjudgmental. That can encourage people to share not only the details of their current illness, but also their social history, family history, and past medical history, he says—all of which can be illuminating. “I’m a seasoned clinician, and I myself have to catch myself in making a quick judgment about, ‘Oh, I've seen this before,’” he says. “You have to keep an open mind.”

The Supreme Court agreed on Friday to consider a high-profile case that could open the door to allowing public dollars to directly fund religious schools. The widely watched case out of Oklahoma could transform the line between church and state in education, and it will come before a court whose conservative majority has broadly embraced the role of religion in public life. The case centers on a proposal for the nation’s first religious charter school, St. Isidore of Seville Catholic Virtual School. The school would be online, and its curriculum would embed religious teachings throughout lessons, including in math and reading classes. As a charter school, it would be run independently from traditional public schools. But public taxpayer dollars would pay for the school, and it would be free for students to attend. Advertisement SKIP ADVERTISEMENT The question of whether the government can fully finance a religious school has proved especially divisive within the school choice movement and across Oklahoma. Some conservative Christian leaders, including Gov. Kevin Stitt and Ryan Walters, the firebrand state superintendent who has sought to require teaching from the Bible in public schools, have backed St. Isidore’s creation. They urged the Supreme Court to take up the case, believing the conservative-leaning court would decide in the school’s favor. A coalition of religious leaders, advocates of public schools and some other state Republicans say the proposal is unconstitutional. Oklahoma’s Republican attorney general, Gentner Drummond, argued it would “open the floodgates and force taxpayers to fund all manner of religious indoctrination, including radical Islam or even the Church of Satan.” After St. Isidore was approved by a state board in June 2023 in a narrow 3-to-2 vote, the Oklahoma Supreme Court blocked its creation. The justices wrote in a majority opinion that the school would “create a slippery slope” that could lead to “the destruction of Oklahomans’ freedom to practice religion without fear of governmental intervention.” Still, as more Republican state legislatures move to support school vouchers and other options for parents to use public money to educate their children in private schools, including religious schools, some legal experts believe that charter schools would become another major arena in the debate. Justin Driver, a professor at Yale Law School, said that a Supreme Court decision that allows religious charter schools “would represent nothing less than a sea change in constitutional law.” “It is difficult to overstate the significance of this opinion for our constitutional order and the larger American society,” Mr. Driver said. The case will present new education questions for the U.S. Supreme Court’s 6-to-3 conservative majority, which has shown an openness to religion in the public sphere. Justice Amy Coney Barrett, a member of the conservative bloc, recused herself from the case. She did not explain why, but Justice Barrett is close friends with a Notre Dame law professor who has helped advise the St. Isidore team. In a 2022 ruling, the court ruled that a high school football coach had the right to pray on the field after his team’s games. Other recent cases have barred Maine and Montana from excluding religious schools from state tuition programs or scholarships to students in private schools. Chief Justice John G. Roberts Jr. wrote in both cases that states are not required to support religious education, but that those that opt to subsidize private schools cannot discriminate against religious ones. Supporters of St. Isidore argue that blocking a religious charter school from receiving funding violates the First Amendment’s protection of religious freedom. Jim Campbell, the chief legal counsel for Alliance Defending Freedom, a legal group representing the Oklahoma state charter board, praised the court’s decision to hear the case. “Oklahoma parents and children are better off with more educational choices, not fewer,” Mr. Campbell said in a statement. “There’s great irony in state officials who claim to be in favor of religious liberty discriminating against St. Isidore because of its Catholic beliefs.” The school was initially set to open in August and would be managed by the Roman Catholic Archdiocese of Oklahoma City and the Diocese of Tulsa. Leaders of the school say it would accept students of all faiths. But opponents say that it would run into conflict with the constitutional prohibition on government establishment of religion, infringing on religious freedom. “Converting public schools into Sunday schools would be a dangerous sea change for our democracy,” several organizations, including Americans United for Separation of Church and State, said in a joint statement on Friday. For decades, the hybrid nature of charter schools — sharing features of both public schools and private institutions — has made it difficult for courts to determine how different education issues should apply to them, according to Preston Green, a professor at the University of Connecticut who studies educational law. Still, Mr. Green said he believes St. Isidore’s argument “could be very attractive” to the conservative justices — and that if the court ultimately sides with the charter school, “the implications are potentially huge.” In the movement to remove barriers to funding religious education, “charter schools are really the next frontier,” Mr. Green said. “And it doesn’t end here.”

The Education Department said on Friday that it would no longer investigate schools that remove books from their libraries, emphasizing its new stance by dismissing 11 pending civil rights complaints related to book bans in public schools. The move, immediately hailed by conservative groups, represents a significant whittling-down of the department’s traditional authority as President Trump’s incoming administration makes rapid strides toward its goal of relinquishing oversight of education to the states. Reacting to an aggressive wave of book challenges in public schools, particularly to books about sexual and racial identity, the Biden administration in 2023 created a book ban coordinator role intended to monitor what experts called an alarming trend. That coordinator also had oversight of the department’s response to the challenges, as the Education Department is generally legally required to pursue investigations into complaints that allege civil rights violations. Under the new Trump administration, that role no longer exists, the Office for Civil Rights announced, and said that it “has rescinded all department guidance issued under the theory that a school district’s removal of age-inappropriate books from its libraries may violate civil rights laws.” “By dismissing these complaints and eliminating the position and authorities of a so-called ‘book ban coordinator,’ the department is beginning the process of restoring the fundamental rights of parents to direct their children’s education,” Craig Trainor, the acting assistant secretary for civil rights, said in a statement accompanying the announcement. Under Mr. Biden, the department got involved in cases that were tossed out on Friday after receiving civil rights complaints that schools had removed books that covered topics such as teenage pregnancy, L.G.B.T.Q. relationships or sexual violence. In one prominent case in Forsyth County, Ga., the department found that the school district had “created a racially and sexually hostile environment” for its students when it removed a number of titles, including Toni Morrison’s “The Bluest Eye,” and George M. Johnson’s “All Boys Aren’t Blue.” According to the announcement, incoming officials reviewed all pending complaints immediately after Mr. Trump took office on Jan. 20 and then moved to dismiss them. PEN America, a nonprofit organization dedicated to free expression by journalists and authors, has documented more than 10,000 instances of individual book bans across the country since the 2023-24 school year. In many cases, books singled out for removal have shared common themes such as featuring L.G.B.T.Q. characters or delving into discussions of race and racism in American history. Conservative groups that have fought for more localized control over schools applauded the decision. “For years, parents have said they deserve to know if sexually explicit materials were available to young children, and they were maligned by the media and the Biden Administration for it,” Nicole Neily, the president of Parents Defending Education, said in a statement. “This debate has always been about the age appropriateness of available materials and transparency, two things parents have demanded.” By proclaiming that the department would not intervene in cases where students or parents felt they were harmed by the removal of certain titles, the announcement appeared to clear the way for states to enact more restrictive policies. “The department adheres to the deeply rooted American principle that local control over public education best allows parents and teachers alike to assess the educational needs of their children and communities. Parents and school boards have broad discretion to fulfill that important responsibility,” Mr. Trainor said in the statement. “These decisions will no longer be second-guessed by the Office for Civil Rights at the U.S. Department of Education.”

When two men bearing federal badges showed up at the entrance of a Chicago public school on Friday morning, school employees did what they had been trained to do. Believing that the men were U.S. Immigration and Customs Enforcement agents, the employees refused to allow them into the school, John H. Hamline Elementary, which enrolls children in kindergarten through eighth grade in a mostly-Latino neighborhood on the city’s southwest side. The school immediately notified officials at Chicago Public Schools, which quickly released a statement. “The ICE agents were not allowed into the school and were not permitted to speak to any students or staff,” the statement said. Advertisement SKIP ADVERTISEMENT But the school was mistaken: The agents were actually from the Secret Service, not ICE. They were investigating a threat against someone their agency had been assigned to protect, relating to the TikTok ban, a Secret Service spokesman said hours later. The spokesman, Anthony Guglielmi, declined to name the person who was threatened. The agents had gone to a nearby home to try to speak to a minor, and then had tried the school, unsuccessfully. But the correction came too late to stem the panic and fear that had already set in around Chicago over rumored immigration raids. All week, many residents had been on edge over the Trump administration’s vows to deport unauthorized immigrants, worried that ICE agents might at any moment arrive at workplaces, churches, even schools. “It seems that this was a very large miscommunication,” Mr. Guglielmi said in an interview.Mr. Guglielmi said that the agents had identified themselves as being from the Secret Service, and that their badges had been stamped with the words “Department of Homeland Security.” Advertisement SKIP ADVERTISEMENT “I just want to make it clear — the Secret Service will never investigate immigration matters,” he said. He noted that the agency had a consistent presence in Chicago, where former President Barack Obama still owns a home. A spokeswoman for ICE said that there had been no immigration enforcement action at or near the school. Some school systems in states like New York, California, New Jersey and Illinois reached out to parents on Friday to try to reassure them that federal agents would not be allowed on school grounds without a judicial warrant. In Chicago, as in other jurisdictions that limit how much local officials can cooperate with federal efforts to deport undocumented immigrants, schools do not ask parents about their children’s immigration status. Outside of John H. Hamline Elementary in the Back of the Yards neighborhood, several parents arrived to pull their children out of class early, as erroneous reports spread in texts and on Facebook that immigration agents were at the school. Even Gov. JB Pritzker chimed in on social media, referring to reports of “raids” at an elementary school. Advertisement SKIP ADVERTISEMENT “Within an hour of what was happening, the community got together,” said Berto Aguayo, a community organizer who rushed to the school as soon as he heard that ICE agents had been there. Mr. Aguayo handed out leaflets in English and Spanish advising people of their rights, which immigration advocates have been doing all week. “We want to make sure parents feel safe sending their kids to school,” he said.