Outspoken nurses in hot water | Population growth slowdown | Hospitals becoming Medicare Advantage carriers | and more news & views of note

How politically heated is the present moment? Enough to elicit verbal violence from trusted nurses.  

Consider three developments from this week: 

• In videos posted to social media and then deleted after drawing wide attention, Malinda Rose Cook, CRNA, a nurse anesthetist at VCU Health (VCU for Virginia Commonwealth University), encouraged demonstrators to physically harm ICE agents. In one video she suggested injecting the agents with succinylcholine. That’s an anesthetic that quickly paralyzes every muscle in the body, including muscles needed to breathe. 
   
  • A VCU spokesperson tells the Daily Mail the health system has placed Cook on administrative leave while it conducts an investigation with assistance from the VCU Police Dept. “The content of the videos is highly inappropriate and does not reflect the integrity or values of our health system,” the spokesperson says. “VCU Police are assisting with [an] investigation.”  
     
• Alexis ‘Lexie’ Lawler, a now-former labor and delivery nurse in Boca Raton, Florida, wished severe childbirth injuries on White House Press Secretary Karoline Leavitt, who is pregnant. Lawler was fired by Baptist Health Boca Raton Regional Hospital soon after her seriously vile TikTok video went viral. She responded by posting another video. 
   
  • “They murdered a man in Minnesota, and you [bleep] are coming after me because I use bad language. [Bleep] you,” Lawler says in the post-firing video. “I’m on the right side of this.”
     
  • Channel 12 News in West Palm Beach reports that Lawler’s husband has since launched a GoFundMe campaign seeking $14,000 for legal expenses. “The fundraiser frames her firing as retaliation for political speech and says the money will go toward employment and civil rights counsel,” the news operation adds. 
     
• Erik Martindale, an anesthesia nurse in Florida with a degree from the University of Miami, posted and deleted a morally and ethically disturbing message on Facebook. “I will not perform anesthesia for any surgeries or procedures for MAGA [supporters],” he stated. “It is my right, it is my ethical oath and I stand behind my education. I own all of my businesses and I can refuse anyone!” 
   
  • The International Business Times reports that Martindale’s words have drawn condemnation from certain quarters of social media—and support from certain others. “[S]ome commentators have pointed out that Martindale’s declaration may technically be legal under Florida law,” the outlet notes. “In 2023, Governor Ron DeSantis signed Senate Bill 1580, also known as the ‘Protections of Medical Conscience Act,’ which allows medical providers and health insurers to deny patient care based on their own religious, moral or ethical beliefs.” 
     
    • Given the polarization sharply dividing the American body politic—and the approach of the 2026 midterm elections—we probably shouldn’t be surprised if lawsuits fly in both directions. If that’s what it takes to keep the violence merely verbal in U.S. healthcare, let it be: Suits vs. countersuits might be a best-case scenario. 
       

The nation’s population seems to be growing at a slower rate now than at any time since the early days of the COVID-19 pandemic. 

The Census Bureau highlights this finding in its latest estimates of how many people are here. The agency attributes the slowdown mainly to a “historic” decline in net international migration. That figure fell from 2.7 million to 1.3 million in the one-year period under review, July 2024 through June 2025. Since birth rates and death tallies stayed about the same during that stretch, plummeting immigration is the obvious explanation for the phenomenon, explains Christine Hartley, assistant division chief for estimates and projections at the Census Bureau, in an announcement.

If the trend gains steam in consecutive years, the economic implications for Social Security and Medicare would be worrisome. 

More findings from the Census Bureau: 

• Slower population growth was felt across the country. All four census regions and every state except Montana and West Virginia saw their growth slow or their decline accelerate.
   
• The Midwest was the only region in which all states gained population. In addition, after experiencing population decline in 2021 and small growth in 2022, the Midwest’s population grew solidly in 2023, 2024 and 2025. “Slight gains in natural change (births minus deaths) for some of the states in the Midwest contributed to their population growth,” the Census Bureau reports. 
   
• The nation’s fastest-growing state in South Carolina. The Palmetto State grew its population by 1.5%, That was down from 1.8% the previous year but still enough to edge out Idaho (1.4%) and North Carolina (1.3%). All three saw robust migration from other states as well as from other countries. 
   
• The bureau now estimates total U.S. population at 341.8 million. Some 1.8 million more people were born here or entered here than died or left between July 1, 2024 and July 1, 2025. 
   
• All but five states grew between July 2024 and July 2025. States that experienced population decline were California, Hawaii, New Mexico, Vermont and West Virginia.
   
  • Full Census Bureau announcement here.
     

Some hospitals are so tired of arguing with Medicare Advantage carriers that they’re becoming Medicare Advantage carriers. 

“Like any other health insurer, hospitals entering the business need a back-office infrastructure to enroll patients, sign up providers, fill prescriptions, process claims, hire staff and—most importantly—assure state regulators they have a reserve of money to pay claims,” KFF Health News reports. “Once they get a state insurance license, they need approval from the federal Centers for Medicare & Medicaid Services to sell Medicare Advantage policies.” 

• Some systems affiliate with or create an insurance subsidiary while others do most of the job themselves, the outlet notes. Either way, “It’s a ton of work,” one source says. 
   
  • To some, the yield is worth the toil. Read the whole thing. 
     

Also of interest:

• Nearly 800 cases in South Carolina’s record-breaking measles outbreak … At least 557 people are currently in quarantine across the state. (ABC News) 
   
• Another strike sends 31,000 Kaiser Permanente healthcare workers to picket lines ... Registered nurses and other frontline employees launched an open-ended strike this week in California and Hawaii to demand better wages and staffing. (AP via WRAL News)
   
• What Mamdani gets wrong about the NYC nurses strike: State regulations, not greed, are the problem ... Nearly 15,000 New York City nurses have been striking since January 12, leaving operations at several major private hospitals severely reduced or altogether shuttered. (Reason)  

From HealthExec’s sibling news outlets:

• Radiology practice prepares to ditch hospital partner 3 years before new contract ends (Radiology Business)
   

• Faster treatments, better outcomes: 5 key takeaways from new stroke guidelines (Cardiovascular Business)