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Gavin McKenna will suit up for Canada at the world junior hockey championship. Set to turn 17 next week, the star forward with the Western Hockey League's Medicine Hat Tigers headlines the country's 25-player roster for the annual tournament announced Friday. McKenna, who is projected as the potential top pick at the 2026 NHL draft, will be joined by a pair of fellow youngsters battling for the No. 1 selection spot in June -- 18-year-old winger Porter Martone and 17-year-old defenceman Matthew Schaefer. Five of seven eligible returnees from last year's squad that finished a disappointing fifth in Sweden are back, with forwards Easton Cowan, Brayden Yager and Carson Rehkopf getting the nod, while defencemen Oliver Bonk and Tanner Molendyk will anchor the blue line. The two players unable to hold onto their spots for the event set to run Dec. 26 to Jan. 5 in Ottawa are forward Matthew Wood and goaltender Scott Ratzlaff. Making up the rest of the group up front are Bradly Nadeau, Jett Luchanko, Luca Pinelli, Berkly Catton, Ethan Gauthier, Calum Ritchie, Tanner Howe, Cole Beaudoin and Mathieu Cataford. Nadeau didn't attend selection camp in Ottawa this week, but was guaranteed a spot after being made available by the NHL's Carolina Hurricanes from their American Hockey League affiliate. Canada's defence corps also includes Andrew Gibson, Sam Dickinson, Caden Price, Sawyer Mynio and Beau Akey. The hockey powerhouse's three-headed crease contingent is made up of goaltenders Jack Ivankovic -- another 17-year-old eligible for June's NHL draft -- Carter George and Carson Bjarnason. "We believe we have assembled a competitive and talented roster that will give us the best opportunity to win a gold medal on home ice," Hockey Canada's Peter Anholt, who leads the under-20 program's management group, said in a statement. "We look forward to them wearing the Maple Leaf with pride." The Canadians, who will be looking to add to a record 20 gold medals at the annual showcase, were ousted in last year's quarterfinals thanks to a last-minute loss to Czechia. Among the other notable cuts Friday were Calgary Flames defence prospect Zayne Parekh and Beckett Sennecke, who was selected No. 3 overall by the Anaheim Ducks at the 2024 draft. Both players were late injury additions for selection camp and are eligible to try out again next year. Canada will now hold training camp in Petawawa, Ont., before pre-tournament games against Switzerland, Sweden and Czechia. The hosts open Group A at the Canadian Tire Centre, home of the NHL's Ottawa Senators, on Boxing Day against Finland. The defending champions United States, Latvia and Germany make up the rest of the field. Group B at TD Place, home of the Ontario Hockey League's Ottawa 67's, includes Sweden, Czechia, Slovakia, Switzerland and Kazakhstan. Russia remains banned by the International Ice Hockey Federation due to that country's ongoing war in Ukraine. Ottawa last hosted the world juniors in 2009 when Canada defeated Sweden to secure a record-tying fifth straight gold. Cameron, who guided the country atop the podium in 2022 after winning silver in 2011, was an assistant coach on the staff of the late Pat Quinn at that tournament 15 years ago in the nation's capital. "This group of 25 players is excited for the opportunity to wear the Maple Leaf in front of Canadian fans in Ottawa, and to represent their country in our quest to win a gold medal," he said in a statement. "This is a great accomplishment for these players and their families. "We know they will enjoy the world juniors experience while bringing the competitiveness needed for us to be successful and accomplish our goal." This report by The Canadian Press was first published Dec. 13, 2024.A federal judge in New York on Friday denied former New Jersey Sen. Robert Menendez's bid for a new trial. Menendez was convicted of charges accusing him of corrupting his office but he argued the evidence failed to support those charges. The judge disagreed. "The jury's guilty verdicts were readily supported by the extensive witness testimony and extensive documentary evidence admitted at trial, and there is no manifest injustice requiring a new trial," Judge Sidney Stein decided. MORE: Sen. Bob Menendez found guilty on all counts, including acting as foreign agent, in federal corruption trial A Manhattan federal jury found the New Jersey Democrat guilty on all charges, including bribery, fraud, acting as a foreign agent and obstruction, in July following a two-month-long trial. Federal prosecutors said he accepted hundreds of thousands of dollars in bribes in the form of cash, gold bars, mortgage payments and more in exchange for the senator's political clout. He is scheduled to be sentenced next month and faces decades in prison. Menendez resigned from office in August following the conviction.Social Media Demands Accountability After Photo of Ohio State Fan Goes Viral
Harry, Meghan Markle on ‘last chance’: Royal insider reveals Netflix executives are ‘exhausted’
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It seems a bit unfair to label a regular American this way and not explain why. Here’s the hit piece CNN did on me. How is registering voters “controversial”? I must be doing something right. pic.twitter.com/GC4Pc4WlFn Shouldn't CNN give some reason for tagging Presler with this pejorative? CNN labels Presler "controversial" in chyron but doesn't explain why at any point during this segment. They have the Vice News voiceover but never explain this label throughout the entire segment. https://t.co/2XtE50jOFG Look at @ScottPresler ! Getting cnn's knockers twisted! This is just another way to verify that Scott is doing good things and making a positive difference in the world. Well done, sir! https://t.co/kn4SstqlcP Basically, he's 'controversial' because he is helping the GOP win. Honestly, it's surprising they haven't tried to have him arrested yet. You know, Stacey Abrams not only refused to concede to Brian Kemp, but she then started a get out the vote organization that ended in financial scandal. Not once do I remember CNN describing her as “controversial.” Weird. https://t.co/EGFJCJ2Zhd Say it together now, 'That is (D) Different'! I've been saying it for years: Play the Democrat's game. Organize, influence, bring people into the right, and worm our way back into every institution just like the left. The @GOP could learn a lot from studying their tactics. https://t.co/qdzUTmijos CNN doesn't like that Scott is beating them at their own game. It's not a hit piece it's just... a piece. I appreciated you talking to us and think we had a good conversation https://t.co/9wVlwvoWRc A CNN employee tried to claim the story was neutral. Labeling someone just doing election work a 'provocateur' is hardly being neutral. Sorry, not sorry. You will be in the history books one day. Your story is far from complete! 🇺🇸🫡 @ScottPresler https://t.co/QnVDilN4x8 He helped save the country from the commies. This is actually awesome @ScottPresler !! It’s a “hit” piece, as in you’re certified platinum!! 🙌🏾❤️ https://t.co/3c9BEXwsEr CNN: Scott Pressler registering voters: "controversial", "provocateur" CNN: Bucks County Dem saying they would ignore election law and flout courts: "frustrated" See how they use language to poison the well? Erin Burnett can flap her gums for an entire hour, but her real opinions reside in the chyron. It's not just her opinion. It's the opinion of all of CNN. Any effective modern conservative voice is automatically deemed "controversial". Also, be very aware ... CNN knows Presler is often alone or with just a few people. They are intentionally trying to stir up their Leftist rage machine against him. Scott Pressler is the least controversial figure in politics. God CNN are desperate liars. They won't stop until they make him 'controversial'. It's what they do.
Pay first, deliver later: Some women are being asked to prepay for their baby
HOUSTON (AP) — The Astros welcomed first baseman Christian Walker to the team Monday, in one of two moves that almost certainly marks the end of Alex Bregman’s time in Houston. Walker signed a $60 million, three-year contract that will pay him $20 million annually just more than a week after the Astros acquired infielder Isaac Paredes from Cubs in the trade that sent outfielder Kyle Tucker to Chicago . “The way I view it right now is Paredes is going to play third base and Walker is going to play first base,” general manager Dana Brown said Monday. “And Bregman’s still a free agent.” The Astros had hoped to re-sign Bregman, the team’s third baseman for the last nine seasons, but Brown said the negotiations stalled. “I thought we made a really competitive offer, showing that we wanted him back,” he said. “But we had to pursue other options. We couldn’t just sit there. We locked in Paredes early in that trade, knowing that he could play third or first and then when the opportunity to add another bat came up we just jumped on it.” The addition of a first baseman was a priority this offseason for the Astros after they released struggling first baseman José Abreu less than halfway through a $58.5 million, three-year contract. RELATED COVERAGE Phillies have no plans to start pitching prospect Andrew Painter in spring training following injury Phillies add depth to bullpen with 1-year deal for reliever Joe Ross Andrew McCutchen, confident he can be difference maker, returns to Pirates on $5M, 1-year deal “We knew we had to get better at first base,” Brown said. “We pursued (Walker) and we’re excited to have him because we know that we’re going to have a really good first baseman that can defend and also hit the ball on the seats from time to time.” Walked was attracted by the sustained success of the Astros, who won their first two World Series titles in 2017 and ’22. “I’ve been watching this team for a while now, and that edge, the energy, the expectation, you can tell that they’re going out there with a standard,” he said. “And I’m very excited to be a part of it.” Walker is looking forward playing on an infield with star second baseman Jose Altuve. He’s fascinated by the success and consistency Altuve has had over his 14-year career. “I get a chance to learn from Jose Altuve,” Walker said. “Nothing really gets better than that.” Brown was asked what he would tell fans disappointed to see the Astros lose another star after George Springer and Carlos Correa left as free agents in recent years. “I would just tell the fans that look, we are very focused on remaining competitive,” he said. “We’re very focused on winning division and going back to the World Series, and I think with these additions that we have the ability to do that. So, I feel strongly that we’re going to be picked to win the division first off. And if our pitching holds up, which I feel strongly about, as well, I think we’ll get deep into the postseason.” The Astros won the AL West for a fourth straight year this season before being swept by the Tigers in an AL Wild Card Series. Walker, who turns 34 during the opening week of the season, hit .251 with 26 homers, 84 RBIs, 55 walks and 133 strikeouts this year. That was down from 2023, when he batted .258 with 33 homers and 103 RBIs as the Diamondbacks reached the World Series. Walker played in 130 games this year, down from 157 in 2023 and 160 in 2022. He was sidelined between July 29 and Sept. 3 by a strained left oblique. He spent the last eight seasons with the Diamondbacks, where he hit 146 homers with 442 RBIs and a .251 batting average. He didn’t secure a full-time job in the big leagues until 2019. He’s provided consistent power over the past six seasons and has grown into an elite defensive first baseman, winning Gold Gloves in each of the past three seasons. Walker played college ball at South Carolina and was drafted by the Baltimore Orioles in 2012. He made his big league debut with the Orioles in 2014 but couldn’t stick in the majors and was claimed off waivers by Atlanta, Cincinnati and Arizona in a five-week span. Walker’s contract has a limited no-trade provision allowing him to block deals to six teams without his consent. He would earn $200,000 for winning an MVP, $175,000 for second, $150,000 for third, $125,000 for fourth and $100,000 for fifth. Walker also would get $100,000 for World Series MVP, $50,000 for League Championship Series MVP and $75,000 apiece for making the All-Star Game or winning a Gold Glove or Silver Slugger Award. Infielder Grae Kessinger was designated for assignment to open a roster spot. ___ AP Baseball Writer Ronald Blum contributed to this report. ___ AP MLB: https://apnews.com/mlbCalifornia GOP flip second state legislative seat, 3 weeks after election
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The 2024 Imperial Springs International Forum is held in Madrid, Spain on December 12, 2024. Photo: Wang Wenwen/GT Chinese President Xi Jinping on Thursday sent a congratulatory letter to the 2024 Imperial Springs International Forum held in Madrid, Spain. Xi pointed out that since its establishment 10 years ago, the forum has adhered to advocating multilateralism, conducted in-depth discussions on global governance issues, actively shared China's propositions, and played a positive role in enhancing exchanges and understanding between China and countries worldwide, Xinhua News Agency reported. Xi emphasized that in a world marked by intertwined changes and turmoil, peace and development remain the shared aspirations of all peoples. China stands ready to work with other countries in the spirit of "promoting global solidarity," upholding fairness and justice to safeguard global peace and stability, adhering to win-win cooperation to promote sustainable global development, and committing to inclusiveness and mutual learning to advance human civilization to new heights, Xi said. The 2024 Imperial Springs International Forum was held in Madrid, Spain on Wednesday and Thursday under the theme "Collective Action for One Future." In his opening remarks, Yang Wanming, president of the Chinese People's Association for Friendship with Foreign Countries, said that facing the future, all parties should take practical actions to strengthen unity and cooperation, work together to respond to global challenges, defend and practice true multilateralism, stand on the right side of history, promote the building of a community with a shared future for mankind in the spirit of "promoting global solidarity," and contribute to promoting world peace, stability and prosperity. Xue Lan, dean of the Schwarzman College, Tsinghua University who was present at the forum, noted that Xi's letter shows that the Chinese government has utmost sincerity in cooperating with the international community to cope with challenges. "China has accumulated enough experience to fully understand the problems faced by today's world. The key is consensus and the will to solve the problems. It is easier for countries to make a statement on international occasions, but actions matter the most - that's why the theme of this year's forum is significant," Xue told the Global Times on the sidelines of the forum. More than 200 participants from the political, academic, and business circles in over 50 countries from Asia, Europe, Africa, America and Oceania, including over 50 former heads of state, heads of government, and leaders of international organizations, and over 90 internationally renowned experts, scholars, and business leaders attended the forum. Inaugurated in 2014, the Imperial Springs International Forum is now jointly organized by the Chinese People's Association for Friendship with Foreign Countries, the Australia China Friendship and Exchange Association, the People's Government of Guangdong Province, and World Leadership Alliance-Club de Madrid. This year's forum mainly focused on the following topics: global strategic stability, financing for development, enhancing global cooperation, traditional and non-traditional challenges to global security, tackling challenges facing the world economy, United Nations Summit of the Future, the Future of Global Governance, AI and green technology, sustainable development, and people-to-people exchanges and mutual learning among civilizations. The Imperial Springs International Forum has been held for eight consecutive sessions, and has become a new type of high-end platform for China to conduct in-depth communication with the rest of the world. This year was the first time that the forum has been held abroad. Josipovic, the former president of Croatia, said that this change is significant as it shows the will to cooperate is even more intensive. Csaba Korosi, a Hungarian diplomat who served as president of the 77th United Nations General Assembly, was also a participant of the forum. He believes that the zero-sum game mentality prevailing in the world is starting to overshadow the necessity of global cooperation on global common goods, and the Imperial Springs International Forum with this year's theme of "Collective Action for One Future" provides an inspiring platform to discuss how countries can tackle it. "The result is a lose-lose game. So it cannot be an alternative for us. It cannot be an acceptable outcome for us. Our responsibility is the collective action, where we can still have a kind of race, but where we have to find the ways of cooperation," Korosi told the Global Times. Maria Fernanda Espinosa, former minister of foreign affairs of Ecuador, told the Global Times that cooperation fits into today's world. "When you think about the security challenges that the world faces, the conflicts that we are experiencing, the environmental crisis, the crisis of poverty and inequalities, all of these challenges require more cooperation in a multilateral system, and that's what it's all about at the end." She expressed appreciation for China's efforts to gather global voices. "China has shown that the voices of the world are important, bringing a community of current and former leaders to discuss the challenges of our times to come up with innovative ideas and solutions. It's really valued," she noted.Regrets? Joe Biden may have a few.
Saquon Barkley has become the Shohei Ohtani of the NFL. There's no better home run hitter playing football right now. Barkley had touchdown runs of 72 and 70 yards for the Philadelphia Eagles in a 37-20 victory over the Los Angeles Rams on Sunday night. He now has five runs of 50-plus yards this season and is on pace to break Eric Dickerson's single-season record of 2,105 yards set in 1984. Barkley's historic performance against the Rams — his 255 yards set a team record — captivated a national audience and turned him into a fan favorite for the AP NFL MVP award. He's not the betting favorite, however. Josh Allen has the best odds at plus-150, according to Bet MGM Sportsbook. Two-time MVP Lamar Jackson is next at plus-250 followed by Barkley at plus-400. People are also reading... Running backs have won the award 18 times, including three-time winner Jim Brown, who was the AP's first NFL MVP in 1957. Quarterbacks have dominated the award, winning it 45 times. Only three players who weren't QBs or RBs have been MVP. It takes a special season for a non-QB to win it mainly because the offense goes through the signal caller. Quarterbacks handle the ball every offensive snap, run the show and get the credit when things go well and the blame when it doesn't. Adrian Peterson was the most recent non-QB to win it when he ran for 2,097 yards and 12 touchdowns for the Minnesota Vikings in 2012. Playing for a winning team matters, too. Nine of the past 11 winners played for a No. 1 seed with the other two winners on a No. 2 seed. The Vikings earned the sixth seed when Pederson was MVP. Barkley is a major reason why the Eagles (9-2) are leading the NFC East and only trail Detroit (10-1) by one game for the top spot in the conference. Does he have a realistic chance to win the MVP award? Kicker Mark Moseley was the MVP in the strike-shortened 1982 season when he made 20 of 21 field goals and 16 of 19 extra points in nine games for Washington. If voters once selected a kicker, everyone has a chance, especially a game-changer such as Barkley. Defensive tackle Alan Page was the MVP in 1971 and linebacker Lawrence Taylor won it in 1986. Running back Christian McCaffrey finished third in voting last year and wide receiver Justin Jefferson placed fifth in 2022. The Offensive Player of the Year award and Defensive Player of the Year award recognize the best all-around players on both sides of the ball, allowing voters to recognize non-QBs if they choose. Wide receivers and running backs have won the AP OPOY award seven times over the past 11 seasons. McCaffrey was the 2023 winner. The AP's new voting format introduced in 2022 also gives non-QBs a better opportunity to get MVP recognition. Voter submit their top five picks for each award, with a weighted point system. Previously, voters made one choice for each award. A nationwide panel of 50 media members who regularly cover the league vote for MVP and seven other awards. The awards are based on regular-season performance. Clinching scenarios The Chiefs (10-1) and Bills (9-2) already are in position to lock up postseason berths right after Thanksgiving. Kansas City clinches a playoff berth with a win over Las Vegas on Black Friday and a loss by Miami on Thursday night, or a win plus a loss by Denver on Monday night. Buffalo can wrap up a fifth straight AFC East title with a victory over San Francisco on Sunday and a loss by the Dolphins. Status quo in Dallas? It's not a given that the Dallas Cowboys will be looking for a new head coach after this season. Owner Jerry Jones said Tuesday on local radio that Mike McCarthy could end up getting a contract extension. "I don't think that's crazy at all. This is a Super Bowl-winning coach. Mike McCarthy has been there and done that. He has great ideas. We got a lot of football left," Jones said. McCarthy led the Cowboys (4-7) to three straight 12-win seasons, but they went 1-3 in the playoffs and haven't reached the NFC championship game since winning the Super Bowl 29 years ago. Injuries have contributed to the team's struggles this season, but Dallas was just 3-5 before Dak Prescott was lost for the rest of the season. The Cowboys upset Washington last week and their next four games are against teams that currently have losing records. If they somehow end up 9-8 or even 8-9, Jones could make a case for keeping McCarthy. Be the first to know
ORLANDO, Fla. — UCF coach Gus Malzahn is resigning after four seasons with the school. ESPN’s Pete Thamel was the first to report the move, which will see Malzahn to leave to take the offensive coordinator job at Florida State. Malzahn previously worked with FSU coach Mike Norvell during their time at Tulsa under then-coach Todd Graham from 2007-08. The Knights ended a disappointing 4-8 season in which they lost eight of their last nine games, the longest losing streak since 2015. Malzahn, 59, was in the fourth year of a contract through 2028. His buyout, it is reported, would have been $13.75 million. He finished 27-25 at UCF but lost 16 of his last 22 games and was a dismal 4-14 in two seasons in the Big 12. After back-to-back nine-win seasons in 2021-22, the Knights went 6-7 in 2023 and 4-8 in 2024. This season started with high expectations as Malzahn made sweeping changes to the program. He retooled the strength and conditioning department and hired Ted Roof and Tim Harris Jr. as defensive and offensive coordinators, respectively. He also added nearly 50 new players to the roster, leaning heavily on the transfer market. UCF started by winning its first three games against New Hampshire, Sam Houston and a thrilling comeback at TCU, but offensive struggles saw the Knights tumble through a TBD-game losing streak to finish the season. Terry Mohajir hired Malzahn on Feb. 15, 2021, six days after he was hired to replace Danny White. The move came eight weeks after Malzahn had been fired at Auburn after eight seasons of coaching the Tigers. The two briefly worked together at Arkansas State in 2012 before Malzahn left for the Auburn job. “When he [Mohajir] offered the job, I was like, ‘I’m in.’ There wasn’t thinking about or talking about ...,” Malzahn said during his introductory press conference. “This will be one of the best programs in college football in a short time. This is a job that I plan on being here and building it.” UCF opened the 2021 season with non-conference wins over Boise State and Bethune-Cookman before traveling to Louisville on Sept. 17, where quarterback Dillon Gabriel suffered a fractured collarbone in the final minute of a 42-35 loss. Backup Mikey Keene would finish out the season as Gabriel announced his intention to transfer. The Knights would finish the season on the plus side by accepting a bid to join the Big 12 Conference in September and then by defeating Florida 29-17 in the Gasparilla Bowl. Malzahn struck transfer portal gold in the offseason when he signed former Ole Miss quarterback John Rhys Plumlee. Plumlee, a two-sport star with the Rebels, helped guide UCF to the American Athletic Conference Championship in its final season. However, Plumlee’s injury forced the Knights to go with Keene and freshman Thomas Castellanos. The team finished with losses to Tulane in the conference championship and Duke in the Military Bowl. Plumlee would return in 2023 as UCF transitioned to the Big 12 but would go down with a knee injury in the final minute of the Knights’ 18-16 win at Boise State on Sept. 9. He would miss the next four games as backup Timmy McClain took over the team. Even on his return, Plumlee couldn’t help UCF, on a five-game losing streak to open conference play. The Knights got their first Big 12 win at Cincinnati on Nov. 4 and upset No. 15 Oklahoma State the following week, but the team still needed a win over Houston in the regular-season finale to secure a bowl bid for the eighth straight season. From the moment Malzahn stepped on campus, he prioritized recruiting, particularly in Central Florida. “We’re going to recruit like our hair’s on fire,” Malzahn said at the time. “We’re going to go after the best players in America and we’re not backing down to anybody.” From 2007 to 2020, UCF signed 10 four-star high school and junior college prospects. Eight four-star prospects were in the three recruiting classes signed under Malzahn. The 2024 recruiting class earned a composite ranking of 39 from 247Sports, the highest-ranked class in school history. The 2025 recruiting class is ranked No. 41 and has commitments from three four-star prospects. Malzahn has always leaned on the transfer market, signing 60 players over the past three seasons. Some have paid huge dividends, such as Javon Baker, Lee Hunter, Kobe Hudson, Tylan Grable, Bula Schmidt, Amari Kight, Marcellus Marshall, Trent Whittemore, Gage King, Ethan Barr, Deshawn Pace and Plumlee. Others haven’t been as successful, such as quarterback KJ Jefferson, who started the first five games of this season before being benched for poor performance. Jefferson’s struggles forced the Knights to play musical chairs at quarterback, with true freshman EJ Colson, redshirt sophomore Jacurri Brown and redshirt freshman Dylan Rizk all seeing action at one point or another this season. This season’s struggles led to several players utilizing the NCAA’s redshirt rule after four games, including starting slot receiver Xavier Townsend and kicker Colton Boomer, who have also entered the transfer portal. Defensive end Kaven Call posted a letter to Malzahn on Twitter in which he accused the UCF coaching staff of recently kicking him off the team when he requested to be redshirted. Get local news delivered to your inbox!Exclusive-Major cloud providers could get key role in AI chip access outside the US, sources sayHow missing teen's incredible rescue unfolded
In April, just 12 weeks into her pregnancy, Kathleen Clark was standing at the receptionist window of her OB-GYN’s office when she was asked to pay $960, the total the office estimated she would owe after she delivered. Clark, 39, was shocked that she was asked to pay that amount during this second prenatal visit. Normally, patients receive the bill after insurance has paid its part, and for pregnant women that’s usually only when the pregnancy ends. It would be months before the office filed the claim with her health insurer. Clark said she felt stuck. The Cleveland, Tennessee, obstetrics practice was affiliated with a birthing center where she wanted to deliver. Plus, she and her husband had been wanting to have a baby for a long time. And Clark was emotional, because just weeks earlier her mother had died. “You’re standing there at the window, and there’s people all around, and you’re trying to be really nice,” recalled Clark, through tears. “So, I paid it.” On online and other , pregnant women say they are being asked by their providers to pay out-of-pocket fees earlier than expected. The practice is legal, but patient advocacy groups call it unethical. Medical providers argue that asking for payment up front ensures they get compensated for their services. How frequently this happens is hard to track because it is considered a private transaction between the provider and the patient. Therefore, the payments are not recorded in insurance claims data and are not studied by researchers. Patients, medical billing experts, and patient advocates say the billing practice causes unexpected anxiety at a time of already heightened stress and financial pressure. Estimates can sometimes be higher than what a patient might ultimately owe and force people to fight for refunds if they miscarry or the amount paid was higher than the final bill. Up-front payments also create hurdles for women who may want to switch providers if they are unhappy with their care. In some cases, they may cause women to forgo prenatal care altogether, especially in places where few other maternity care options exist. It’s “holding their treatment hostage,” said Caitlin Donovan, a senior director at the . Medical billing and women’s health experts believe OB-GYN offices adopted the practice to manage the high cost of maternity care and the way it is billed for in the U.S. When a pregnancy ends, OB-GYNs typically file a single insurance claim for routine prenatal care, labor, delivery, and, often, postpartum care. That practice of bundling all maternity care into one billing code began three decades ago, said Lisa Satterfield, senior director of health and payment policy at the . But such bundled billing has become outdated, she said. Previously, pregnant patients had been subject to copayments for each prenatal visit, which might lead them to skip crucial appointments to save money. But the Affordable Care Act now requires all commercial insurers to fully cover certain prenatal services. Plus, it’s become more common for pregnant women to switch providers, or have different providers handle prenatal care, labor, and delivery — especially in rural areas where patient transfers are common. Some providers say prepayments allow them to over the course of the pregnancy to ensure that they are compensated for the care they do provide, even if they don’t ultimately deliver the baby. “You have people who, unfortunately, are not getting paid for the work that they do,” said Pamela Boatner, who works as a midwife in a Georgia hospital. While she believes women should receive pregnancy care regardless of their ability to pay, she also understands that some providers want to make sure their bill isn’t ignored after the baby is delivered. New parents might be overloaded with hospital bills and the costs of caring for a new child, and they may lack income if a parent isn’t working, Boatner said. In the U.S., having a baby can be expensive. People who obtain health insurance through large employers pay an average of nearly $3,000 out-of-pocket for pregnancy, childbirth, and postpartum care, according to the . In addition, many people are opting for high-deductible health insurance plans, leaving them to shoulder a larger share of the costs. Of the with health care debt, 12% attribute at least some of it to maternity care, according to . Families need time to save money for the high costs of pregnancy, childbirth, and child care, especially if they lack paid maternity leave, said , CEO of the Policy Center for Maternal Mental Health, a Los Angeles-based policy think tank. Asking them to prepay “is another gut punch,” she said. “What if you don’t have the money? Do you put it on credit cards and hope your credit card goes through?” Calculating the final costs of childbirth depends on multiple factors, such as the , plan benefits, and health complications, said , a health policy researcher at the University of Southern California’s Schaeffer Center for Health Policy and Economics. The final bill for the patient is unclear until a health plan decides how much of the claim it will cover, she said. But sometimes the option to wait for the insurer is taken away. During Jamie Daw’s first pregnancy in 2020, her OB-GYN accepted her refusal to pay in advance because Daw wanted to see the final bill. But in 2023, during her second pregnancy, a private midwifery practice in New York told her that since she had a high-deductible plan, it was mandatory to pay $2,000 spread out with monthly payments. Daw, a health policy researcher at Columbia University, delivered in September 2023 and got a refund check that November for $640 to cover the difference between the estimate and the final bill. “I study health insurance,” she said. “But, as most of us know, it’s so complicated when you’re really living it.” While the Affordable Care Act requires insurers to cover some prenatal services, it doesn’t prohibit providers from sending their final bill to patients early. It would be a challenge politically and practically for state and federal governments to attempt to regulate the timing of the payment request, said , a co-director of the Center on Health Insurance Reforms at Georgetown University. Medical lobbying groups are powerful and contracts between insurers and medical providers are proprietary. Because of the legal gray area, , an insurance broker at Rapha Health and Life in Texas, advises clients to ask their insurer if they can refuse to prepay their deductible. Some insurance plans prohibit providers in their network from requiring payment up front. If the insurer says they can refuse to pay up front, Marshall said, she tells clients to get established with a practice before declining to pay, so that the provider can’t refuse treatment. Clark said she met her insurance deductible after paying for genetic testing, extra ultrasounds, and other services out of her health care flexible spending account. Then she called her OB-GYN’s office and asked for a refund. “I got my spine back,” said Clark, who had previously worked at a health insurer and a medical office. She got an initial check for about half the $960 she originally paid. In August, Clark was sent to the hospital after her blood pressure spiked. A high-risk pregnancy specialist — not her original OB-GYN practice — delivered her son, Peter, prematurely via emergency cesarean section at 30 weeks. It was only after she resolved most of the bills from the delivery that she received the rest of her refund from the other OB-GYN practice. This final check came in October, just days after Clark brought Peter home from the hospital, and after multiple calls to the office. She said it all added stress to an already stressful period. “Why am I having to pay the price as a patient?” she said. “I’m just trying to have a baby.” ©2024 KFF Health News. Distributed by Tribune Content Agency, LLC.On November 21, the Russian Armed Forces struck an area near a defense industry facility in Dnipro, Ukraine, with an experimental Oreshnik medium-range ballistic missile. Russian President Vladimir Putin claimed in a video address the day after the attack that the Oreshnik hypersonic ballistic missile could not be intercepted: There are “no means of countering such weapons today. Missiles attack targets at a speed of Mach 10, which is 2.5 to 3 kilometers per second. Air defense systems currently available in the world and missile defense systems being created by the Americans in Europe cannot intercept such missiles. It is impossible." The claim is likely false. While hypersonic weapons present unique challenges to missile defense, experts and available evidence suggest that Putin’s claim is an exaggeration of the current technological realities. Ukraine’s Main Intelligence Directorate reported that the Oreshnik missile was launched from Russia's Kapustin Yar 4th Missile Test Range in the Astrakhan region. The missile traveled for approximately 15 minutes before striking the city of Dnipro. The missile was equipped with six nonnuclear warheads, each containing six submunitions, and it achieved a speed of Mach 11 during its flight. The Pentagon has described the Oreshnik as a new, experimental intermediate-range missile derived from the RS-26 Rubezh intercontinental ballistic missile . Speed and maneuverability challenges Hypersonic missiles travel “at speeds greater than Mach 5” while maneuvering unpredictably, making them far more difficult to track and intercept than conventional ballistic missiles. Their speed and agility significantly cut the time defense systems have to respond, posing a serious challenge to current radar and sensor technologies. However, describing interception as “impossible” ignores ongoing advancements in missile-defense technology. Systems such as the U.S. Terminal High Altitude Area Defense (THAAD) and Aegis Ballistic Missile Defense are designed to counter fast-moving threats, including some hypersonic missiles. While not foolproof, these systems are continually being upgraded to address evolving threats. According to Fabian Hoffmann, a doctoral research fellow at the Oslo Nuclear Project, the U.S. and Israel possess anti-missile systems capable of shooting down an Oreshnik. “Systems like SM-3 from Aegis or Aegis Ashore, as well as most likely Arrow 3 and THAAD, can absolutely deal with this type of threat,” Hoffmann told CNN on November 22. Emerging countermeasures Several countries, including the United States, are developing technologies specifically aimed at countering hypersonic threats. Key initiatives include: Testing and real-world evidence Despite Putin’s claim, Russia has not provided conclusive evidence that the Oreshnik missile is operationally deployed or that it has been tested in conditions replicating modern Western missile defense environments. So far, Russia has used Oreshnik once and against a country that does not have Western air defense systems capable of shooting down hypersonic missiles. According to Maxim Starchak , an expert on Russian nuclear policy and strategic weapons, Moscow tends to exaggerate its capabilities and “itself may not actually know if air defense systems can intercept this [Oreshnik] missile. These claims remain unsubstantiated without tests or real combat attempts to shoot it down.” Previous tests of Russian hypersonic weapons, such as the Avangard glide vehicle , have demonstrated capabilities but also faced skepticism regarding their real-world applicability and effectiveness. Furthermore, the United States and its allies have conducted successful interceptions of fast-moving targets in controlled environments. For example, tests of THAAD and Aegis systems have demonstrated their ability to intercept medium-range ballistic missiles, albeit inconsistently against hypersonic targets. Other Russian hypersonic missiles ‘impossible to intercept’ Putin’s statement fits a pattern of emphasizing Russia’s advanced military capabilities to assert strategic dominance and influence international perception. Previously, he made similar claims about the impossibility of intercepting other weapons systems, including the Sarmat intercontinental ballistic missile and the Zircon hypersonic missile. Despite Russian claims that the missile is on "combat alert," the Sarmat has faced significant setbacks since its 2022 flight test, with four failed launches, the latest occurring on September 21, 2024 . The Zircon missile, capable of reaching speeds up to Mach 9, is one of the fastest hypersonic weapons. Nevertheless, when Russia launched two Zircon missiles at Kyiv on March 25, according to Ukrainian sources, both were intercepted by air defense systems. Photographs of missile debris were later published. Ukrainian officials, including Major Illia Yevlash, spokesperson for the Ukrainian Air Force, assert that systems like the Patriot and the SAMP/T can destroy the Zircon in its terminal phase, slowing to Mach 4.5, a view supported by Western analysts such as former Royal Navy Commander Tom Sharpe. “The good news is that in missile warfare, especially dealing with Russian weapons, ‘claimed’ and ‘actual’ capabilities are often very different. ... Is Zircon an undefeatable superweapon: no. Is learning how to counter it difficult, yes,” Sharpe wrote April 3 in The Telegraph .