Health Secretary Robert F. Kennedy Jr. said the new actions — which come after previously announced Medicaid funding deferrals in those states — are part of the administration’s strategy to “stop the fraud before it happens” rather than claw back problematic spending after bad actors are prosecuted, as previous administrations had done.
“We have a duty to stop the payments, demand answers, and then follow the evidence wherever it leads,” Kennedy told a news conference.
The tactic is part of the administration’s sweeping campaign to show it’s cracking down on fraud and saving taxpayers money when rising healthcare costs and other economic stressors have made affordability a top voter concern in November’s midterm elections.
In March, Vice President JD Vance launched a new anti-fraud task force at the request of President Donald Trump, bringing together officials from various departments to use data and technology to identify and investigate suspected wrongful use of federal dollars.
But the federal government hasn’t provided “data or explanation on how the deferral amount was calculated or what it was based on” to Minnesota, said John Connolly, the temporary commissioner and state Medicaid director for Minnesota’s Department of Human Services.
“Today’s actions show that the federal government is acting again in unprecedented and punitive ways as part of their war on Medicaid and its recipients,” he said in a statement. “Partnership — not politics — is required to stop criminals and protect services for the people who need them.”
Minnesota’s Democratic Gov. Tim Walz suggested the Republican administration was deferring the funds to pay for Trump’s tax cuts to wealthy Americans. California’s Democratic Gov. Gavin Newsom accused the administration of targeting it for political reasons.
The Trump administration intensified anti-immigration efforts in Minnesota earlier this year, sending in a robust force of Immigration and Customs Enforcement officers whose actions there caused weeks of counterprotests and included the shooting deaths of two civilians. Trump himself has frequently denounced California as a badly governed state.
States are facing obstacles because of the actions
The strategy has led to some false starts and headaches for states.
In April, for example, the Centers for Medicare & Medicaid Services acknowledged to the Associated Press it made a significant error in figures it used to help justify a fraud probe in New York. Last month, California’s Medicaid director told a congressional committee that CMS had not yet provided “any instances of fraud, waste, or abuse” to the state in its justification of a $1.3 billion Medicaid funding deferral announced in May.
And in Minnesota, state officials have been executing a thorough corrective action plan to defray CMS concerns that have led the agency to defer some $260 million in federal money and to threaten future cuts.
“We have cooperated in good faith and proactively engaged the Centers for Medicare and Medicaid Services to first raise the alarm on fraud in Minnesota’s Medicaid program, to effectively investigate fraud, and to institute further safeguards against future misuse of funds,” Connolly said.
Kennedy didn’t specify in Tuesday’s announcement whether the new deferrals — $867.5 million in federal Medicaid payments to California and $199 million to Minnesota — are in addition to, or overlap with, earlier deferrals announced this year.
CMS Administrator Mehmet Oz didn’t provide concrete examples of fraud in the two states in justifying the deferrals. He did mention some patterns the agency noticed that it found questionable, including that some providers were billing for four or more patients at the same time, or billing after the date of a Medicaid beneficiary’s death.
Oz also highlighted a fast rate of growth in California’s home care program as a reason for concern. California officials have disputed that idea, explaining that the state’s home care program has grown because of an intentional strategy to keep people out of more expensive nursing homes.
Flow of money could be restored — with documentation
Kennedy and Oz said states could restart the flow of federal funding by providing documentation proving the payments in question were legitimate.
A representative for California’s Medicaid program didn’t immediately respond to a request for comment. Officials in the state have previously acknowledged they are working with the federal government to provide the requested information.
Oz said Minnesota had already returned documents to the federal government and they were being “reevaluated very carefully.”
Kennedy also suggested Tuesday that he would extend the power to exclude providers from Medicaid, Medicare, and other federal health programs to CMS. In the past, that authority has rested solely with his department’s Office of the Inspector General.
“This is going to be a full force multiplier,” HHS Inspector General Thomas March Bell told a news conference. “It’s going to create additional momentum, and it’s going to exclude additional bad actors.”
WASHINGTON — The Supreme Court agreed Monday to review an Alaska bush pilot’s claims that state authorities have tried to illegally seize his $95,000 airplane after a passenger brought a six-pack of beer on a flight bound for a dry village.
The pilot, Kenneth Jouppi, sued to block his plane’s seizure after he was convicted of an alcohol-related misdemeanor charge. The Alaska Supreme Court ruled in the state’s favor that Jouppi’s plane was subject to criminal forfeiture laws.
On Monday, however, the nation’s highest court agreed to hear Jouppi’s case. He argues that taking his 1969 Cessna would violate the Eighth Amendment’s Excessive Fines Clause. Arguments are expected in the fall.
“I’m in my 80s now, and I’ve been fighting this for over a decade because I see it as my duty to ensure that the Bill of Rights actually means something in protecting against government overreach,” Jouppi said in a statement released by his attorneys at the Institute for Justice.
In April 2012, Jouppi was preparing to fly a passenger from Fairbanks to a remote village, Beaver, where alcohol was banned. The passenger had packed beer with other groceries in her luggage. State Police troopers searched Jouppi’s plane before it departed and spotted a six-pack of Budweiser in a shopping bag.
Jouppi, his company, and the passenger were charged with a misdemeanor offense of knowingly transporting an alcoholic beverage into a dry community. The passenger pleaded guilty. A jury convicted Jouppi and the company after a trial. A judge sentenced him to three days in jail.
Jouppi’s attorneys say Alaska’s high court examined his conduct “purely in abstract terms” and didn’t evaluate whether it was part of a broader pattern of criminal activity. And they say it wasn’t.
“Few excessive fines cases will present the issue so sharply; a decision upholding the forfeiture of an airplane for a six-pack is a self-recommending candidate for review,” lawyers from the Institute for Justice wrote in their appeal.
In response, lawyers from the Alaska Attorney General’s office argued that the state Supreme Court’s “fact-bound decision” should be allowed to stand.
“Courts across the country apply a multifactor test to determine whether a fine or forfeiture is grossly disproportional to the gravity of the offense,” they wrote. “Jouppi does not claim that the four-part standard applied by the Alaska Supreme Court is wrong, only that the court misapplied settled law by giving too much weight to some factors and not enough weight to others.”
Jouppi’s attorneys argue that the ruling from the state’s highest court conflicts with case law established in other courts, including U.S. Supreme Court precedent.
“The Excessive Fines Clause was built for cases like this,” they said.
Alaska’s attorneys said Jouppi hasn’t shown how punishing him with forfeiture of his plane is “grossly disproportional to the gravity of his offense.”
“Alcohol abuse is a serious problem in rural Alaska, and airplanes are sometimes the only realistic means to commit the crime of alcohol importation,” they wrote.
WASHINGTON — The director of the Smithsonian’s National Museum of American History pushed back Tuesday against a recent White House report that branded the institution’s leadership as radical activists who cannot be trusted.
The testimony from Anthea M. Hartig came as President Donald Trump has engaged in a broad national effort to reshape the stories of America told by cultural institutions controlled or influenced by the federal government and, in particular, to purge diversity, equity, and inclusion elements from those narratives. Many historians are alarmed by the revisionism.
“As we continue to fact check the report, we unwaveringly attest that it does not fairly or accurately characterize the full body of work at the museum,” Hartig told a House Oversight subcommittee. “There is always room for improvement. But I also know the beauty and the inspiration and the expertise that lies in our collections, our exhibits, and our programming.”
Coinciding with the 250th anniversary of American independence, the White House Domestic Policy Council released a report on July Fourth arguing that the museum, a centerpiece of the sprawling Smithsonian complex on the National Mall, doesn’t tell history “in a way that is inspiring, unifying, and worthy of our great republic.”
Republicans on the panel reiterated some of those concerns on Tuesday.
“In the museum’s current telling, history is just an ongoing power struggle between oppressors and the oppressed,” said Rep. Tim Burchett (R., Tenn.). “The report makes clear that the museum’s woke exhibits and materials reflect a broader vision held by the museum leadership.”
Hartig, the first woman to serve as director of the National Museum of American History, said the institution “does not take sides in America’s political debates.” She described the museum’s presentation of the nation’s story as an evolution intended to add voices, not erase history as detractors sometimes argue.
“When historians talk about reframing a traditional narrative, we don’t mean erasing it,” she said. “We mean adding the evidence, the voices, the objects, that earlier tellings left out, so that more Americans can see themselves reflected in the national story.”
The White House report argued that the museum “has refused to celebrate the Nation and its history.”
“It has not created any exhibit dedicated to presenting a general narrative of American history or telling the story of any of our Founding Fathers, the Second Continental Congress, the Declaration of Independence, the American Revolutionary War, or the achievement of independence and the establishment of the constitutional rule of law,” the report said.
But the museum opened an exhibit in May dubbed “In Pursuit of Life, Liberty, and Happiness” that displays 250 objects throughout the building to celebrate America’s 250th anniversary. The artifacts include the desk used by Thomas Jefferson to draft the Declaration of Independence, a Revolutionary War-era gunboat, and the Star Spangled Banner.
Some Republicans on the panel on Tuesday acknowledged that the museum displays important material related to the anniversary but argued it was challenging to navigate. Rep. Michael Cloud (R., Texas) said he expected references to the Declaration of Independence to be more prominent during a recent visit.
“I’m not saying it’s not there, but it’s hard to find,” he said.
Hartig faced particular scrutiny from Republicans over an exhibit entitled “Girlhood (It’s Complicated),” which included a diary from a 13-year-old exploring issues including gender identity. The museum director said the exhibit, which ran from 2020 through 2023, included a label making clear it was not designed for children.
Hartig’s future as the museum’s director hung over the hearing. Trump last year said he was firing the longtime leader of the National Portrait Gallery, another Smithsonian museum that, like the National Museum of American History, operates independently of the executive branch. The National Portrait Gallery’s director, Kim Sajet, nonetheless stepped down from the museum in the face of the White House pressure.
At one point, Burchett asked Hartig why she should continue in her job. She responded simply that overseeing the museum is “the honor of my career.”
KYIV, Ukraine — One is a tech-savvy drone innovator with no military experience who became Ukraine’s youngest defense minister six months ago and was credited with contributing to successes in defending against Russia’s 4-year-old invasion.
The other is a seasoned, Soviet-trained general more at home with traditional top-down command culture who led Ukraine’s armed forces.
When their personalities and policies clashed, President Volodymyr Zelensky decided one of them had to go as part of a wider government reshuffle. He dismissed the popular young upstart, sparking protests across the country.
A look at the contrasting careers of Defense Minister Mykhailo Fedorov and commander of Ukraine’s armed forces, Gen. Oleksandr Syrskyi.
The youthful face of Ukraine’s drone war
The 35-year-old Fedorov was credited with modernizing Ukraine’s drone program and changed military procurement rules in a crackdown on corruption. He argued that the military establishment was resisting changes demanded by the evolving war with Russia.
“We transformed Ukraine into a global tech leader and a defense powerhouse,” he said on social media after he lost his job last week in Zelensky’s government shake-up.
Fedorov also took credit for restricting Russian military access to Elon Musk’s Starlink satellite internet services.
Before becoming defense minister in January, Fedorov headed Ukraine’s digital transformation policies and introduced successful e-government platforms.
Fedorov got that job after running the digital operations of Zelensky’s presidential election campaign in 2019. Before that, he ran a digital marketing company.
After his dismissal, Fedorov publicly accused Syrskyi of blocking military reforms and insisting on a traditional command culture. That criticism echoed complaints from soldiers and veterans over heavy casualties in costly front-line assaults.
Appearing at a news conference in a dark T-shirt and jeans, Fedorov accused Syrskyi of blocking reforms needed because “the war has changed completely” due to new technology.
The Soviet-trained general dubbed ‘the Butcher’
Protesters framed Fedorov’s removal as an example of Zelensky siding in the feud with an entrenched military old guard over a modernizer.
Syrskyi, 60, was born when Ukraine was still part of the USSR. He attended Moscow Higher Military Command School and served in the Soviet Artillery Corps. He has long been associated with a Soviet-style, top-down command culture.
He played a key role in some of Ukraine’s biggest victories in its war, overseeing the successful defense of Kyiv in the early days of the invasion in February 2022. Seven months later, Syrskyi was credited with orchestrating the counteroffensive in the Kharkiv region, one of the most significant Ukrainian victories in the war.
“I’m not fighting the (defense) ministry. I’m fighting Russia,” Syrskyi said in a column published Monday in the Ukrainian military outlet Militarnyi that defended his conduct.
“The General Staff has never opposed the ministry — we have cooperated and will keep cooperating with whichever minister the state appoints. Because in the army, you don’t get to choose who you serve with. In the army, you follow orders and do your job,” he said.
Within the military, Syrskyi earned the nickname of “Butcher,” a label that gained wider currency during his command of the ill-fated defense of Bakhmut, one of the war’s longest battles that killed tens of thousands of people.
His reputation took another hit after the Ukrainian outlet Babel published an investigation last month detailing allegations of abuse within the Skelia assault regiment, a unit closely associated with Syrskyi. It reportedly has suffered higher-than-average losses. The investigation documented dozens of deaths among recruits.
The ouster brings protests in Ukraine, glee in Russia
The protests of Fedorov’s ouster and the backlash against Syrskyi reached into the military, with the air force’s deputy commander resigning and warning it would weaken Ukraine’s air defenses. Veterans and soldiers on leave joined the protests. Many demonstrators said they wanted a new generation of generals who would prioritize preserving soldiers’ lives.
The stakes are high for Zelensky. The outcry appeared to leave him open to accusations that by ousting Fedorov, he was trying to get rid of a possible political rival. The episode threatened to undermine his authority.
Ukrainian political analyst Volodymyr Fesenko called Syrskyi “a more convenient and more comfortable” choice for Zelensky to keep in his government, adding that it turned out to be a “major miscalculation.”
Zelensky “underestimated the extent to which part of Ukrainian society had come to see Fedorov as perhaps the main driver of the positive changes in Ukraine’s war against Russia,” added Fesenko, head of the Penta Center think tank.
Russian war bloggers responded to Fedorov’s dismissal with glee, noting his role in masterminding long-range drone strikes on oil facilities that have caused a fuel crisis and midrange attacks that disrupted military logistics.
Syrskyi, some noted with grudging respect, has built a string of defenses that have stalled Russian advances.
Many Moscow commentators voiced hope that the controversy would fuel political infighting in Ukraine and weaken its military.
CAIRO — The Israeli military is quietly but quickly building a giant earthen barrier separating the over 50% of the Gaza Strip it controls from the rest of the territory, according to satellite imagery, further entrenching the division of the tiny Palestinian enclave.
More than 14 miles have been constructed in recent months, running through Palestinian communities demolished by the military. That is equivalent to more than half the length of the coastal strip, which is some 25 miles long and 7 miles wide, and home to over 2 million Palestinians.
When presented with the satellite images, Israel’s military confirmed to the Associated Press it has built a physical barrier in the area of the so-called yellow line, the boundary to which Israeli troops withdrew under the October ceasefire deal with Hamas. The line was envisioned in the U.S.-backed agreement as a temporary division of the territory pending a fuller Israeli withdrawal.
But as the truce stagnates, it appears Israel is digging in, heightening Palestinian fears that the line is morphing into a border. Neither U.S. Central Command, which is tasked with monitoring the ceasefire, nor the Board of Peace, the body led by U.S. President Donald Trump meant to eventually oversee Gaza, would comment on the barrier.
Along with the barrier, the military told AP it has developed a “security zone” around the line, equipped with intelligence and technological assets. It declined to give details on the route of the barrier when asked how far it would be extended. It said the barrier aimed to prevent infiltration and protect Israeli troops and Israeli communities near Gaza.
Construction of the barrier is proceeding rapidly
Since the ceasefire deal took hold, Palestinians in Gaza have feared Israel would not return the area of Gaza it controls. But few appear to be aware of the berms now being built around them — because of the danger of even approaching that area.
A portion of the berm network in southern Gaza was extended by more than 1.2 miles in two weeks this month, according to the satellite images provided by Planet Labs PBC.
If construction continues in its current direction, it will join up with the longest stretch of the barrier, which runs nearly unbroken for around 10 miles from the southern city of Khan Younis to near Gaza City, in the north.
Construction began on that stretch in February, and it appears work to extend it further south is continuing, according to the satellite images. More than 0.6 miles was added between June 21 and July 7, running close to an Israeli military base built on the ruins of the town of Bani Suheila, near Khan Younis.
In the far north of Gaza, several unconnected stretches of berms run just outside the largely leveled town of Beit Lahia.
The height of the berms in each place remains unclear. In some places, the barriers appear to run outside the yellow line.
Israel has mostly destroyed and depopulated the half of Gaza it controls
Gaza’s population has been crowded into the coastal area west of the yellow line, most living in squalid tent camps and dependent on aid.
On the other side of the line, satellite imagery shows that Israeli forces have leveled the vast majority of buildings using bulldozers and explosives, virtually erasing several towns and Rafah, once home to more than a quarter million people.
They have carved new road networks and erected new bases on the ruins of Palestinian towns. Agricultural land has also been destroyed. The Israeli military says it is demolishing infrastructure used by Hamas.
The yellow line was never precisely defined, whether in the ceasefire deal or by Israeli or U.S. officials, and it has been inconsistently marked on the ground. The military told AP it is working to clearly mark the route of the yellow line to “reduce friction and prevent harm to uninvolved individuals.”
Israeli forces have killed Palestinians who came close to the line or crossed it. The Israeli military says it fires on those believed to be militants threatening its troops. But those killed have included children and other civilians seemingly unaware of the line. Some soldiers have said they don’t always know who they are firing on and have orders to kill anyone crossing the boundary.
Israeli strikes have killed hundreds of Palestinians since ceasefire
Israeli forces have killed more than 1,100 Palestinians since the ceasefire began, most in airstrikes and drone strikes around Gaza. Militant attacks have killed five Israeli soldiers in the same period.
Early on Tuesday, an Israeli strike in Gaza City killed Firas al-Masri, his wife, and their four children, ages 6 to 13, according to Shifa Hospital. Israel’s military only said that they conducted a strike on Hamas militants in the area at that time.
Firas’ brother, Ahmad al-Masri, lives nearby and said he heard the children’s voices at the moment of the blast.
“They were calling out to me, ‘Uncle! Uncle!’” he said. “But the fire was raging, and we couldn’t do anything.”
Under the ceasefire deal, Israel is eventually supposed to withdraw its troops further to the very edges of Gaza, to be replaced by an international security force. But implementation of the deal has been stalled for months.
A former U.N. diplomat now in charge of coordinating the ceasefire has blamed Hamas’ failure to disarm. Sporadic talks to reach a formula for decommissioning its weapons appear to have made little progress, and Hamas accuses Israel in turn of violating the ceasefire.
The war began after Hamas-led militants attacked Israeli communities on Oct. 7, 2023, killing around 1,200 people, mostly civilians, and taking 251 others hostage. Israel responded with a punishing military offensive that has killed more than 73,000 people, according to the Gaza Health Ministry.
The ministry, which was part of the recently dissolved Hamas-run government, maintains detailed records viewed as generally reliable by U.N. agencies and international organizations. It does not distinguish between civilians and militants but says women and children make up around half of all fatalities.
WASHINGTON — A federal appeals court has rejected a request by former President Joe Biden to block the release of audio recordings and transcripts of his interviews with a memoir ghostwriter before he was elected president.
A divided three-judge panel from the U.S. Court of Appeals for the District of Columbia Circuit suspended its decision until Aug. 3 to allow more time for Biden to consider another appeal.
The panel’s 2-1 ruling late Monday found there is a “substantial” public interest in disclosing the material that Biden wants to keep under wraps. Redactions to the recordings would help protect Biden’s privacy, the majority noted.
“We conclude that any remaining incursion on personal privacy from disclosure of the now-redacted materials likely does not outweigh the public interest in disclosure,” the ruling says.
Judge Florence Pan, who was nominated by Biden, a Democrat, wrote a dissenting opinion in which she said Biden has shown a “substantial privacy interest” in keeping the material hidden.
“The conversations at issue took place in Biden’s home, and the recordings of them were obtained by the government in the course of a criminal investigation that did not lead to an indictment,” she wrote.
The appeal also was heard by D.C. Circuit Chief Judge Sri Srinivasan and Judge Gregory Katsas. Srinivasan was nominated by President Barack Obama, a Democrat who chose Biden as his vice president. Katsas was nominated by President Donald Trump, a Republican who as president lost to Biden in 2020 but was elected again to the White House in 2024.
Mark Zwonitzer, who worked with Biden on two memoirs, 2007’s Promises to Keep and 2017’s Promise Me, Dad, interviewed him at his home in 2016 and 2017. Biden’s lawyers say the conversations were candid, personal, and intended to remain private.
Biden spokesperson T.J. Ducklo said the former president disagrees with the ruling but “respects the courts and the vital role an independent judiciary plays in a healthy democracy.”
“President Biden’s conversations for a book a decade ago that discussed his late son are private, and were provided to the Department of Justice on the express condition they stay that way,” Ducklo said in a statement. “Reversing course and making them public is just the latest example of this administration weaponizing the (Justice Department) for political retribution.”
The recordings were obtained by special counsel Robert Hur, who investigated Biden’s handling of classified documents from his time as a senator from Delaware and as Obama’s vice president. Republicans in Congress demanded the material after Hur declined to file charges against the then-president.
Biden sued and sought an injunction to prevent the Justice Department under Trump from releasing the recordings to Congress and the conservative Heritage Foundation. The department previously argued that the recordings were exempt from disclosure under public records law.
Biden appealed after U.S. District Judge Dabney Friedrich, who was nominated by Trump, ruled in June that the public interest in the material outweighed whatever privacy rights Biden had.
Pan noted that the majority is effectively ruling in favor of immediately disclosing the material by denying Biden’s request for an injunction pending appeal.
“That, of course, will moot this case,” she wrote.
The Trump administration’s disruptions to a global AIDS relief program have forced organizations to close clinics, lay off staff, and cut services, seriously impeding efforts to prevent and treat the disease in dozens of countries, a new report released Tuesday shows.
The President’s Emergency Plan for AIDS Relief, known as PEPFAR, is credited with saving at least 26 million lives since its inception in 2003. But last year, it was impaired by the dismantling of the U.S. Agency for International Development and cuts to thousands of global health grants.
“The disruptions were very widespread,” with services for young women, orphans, and children impacted, said Elise Lankiewicz, policy associate for the nonprofit amfAR, the Foundation for AIDS Research, which released the report.
Researchers contacted groups that got PEPFAR funding to deliver HIV services last year. Nearly a quarter — 166 groups from 46 countries — responded to an electronic survey conducted between last November and April, providing information on their funding, staff, and services.
The survey didn’t reach all PEPFAR groups and certain types of organizations — like those that were most severely disrupted or still receiving U.S. funding — may have been less likely to respond. That could result in an underestimate or an overestimate of disruptions, depending on which organizations were missed. Nevertheless, the findings are a window into the struggles that some groups faced last year.
Some key findings were:
— Most organizations had at least one award terminated or payment delayed last year. Terminations led to the closure of more than 1,700 clinics, drop-in centers, and other service delivery sites, and to the loss of more than 16,000 full-time staff members.
— Even though the U.S. government directed services providing HIV treatment, testing, and prevention of mother-to-child transmission to continue, a majority of partners still reported a disruption to those services.
— Cuts were concentrated on services for populations most impacted by HIV. Most organizations previously serving groups such as sex workers, men who have sex with men, transgender people, and people who inject drugs reported permanently ending a service for these groups. Even among organizations that didn’t lose funding, some reported stopping a service for one of these key populations to comply with U.S. policy.
— HIV prevention has been sharply reduced, with many organizations stopping condom programs or services offering what’s called PrEP, preventive medicines to guard against sexually transmitted HIV. From fiscal years 2024 to 2025, prevention spending fell 51%, according to PEPFAR expenditure data.
— Locally-based partners were much more likely than international organizations to have an award terminated and to close service delivery sites. Funding disruptions also destabilized interconnected HIV service systems.
“Taken together, these results describe widespread degradation of the infrastructure built to deliver HIV services worldwide, with the deepest damage falling on the populations and partners most essential to controlling the epidemic,” the report says.
The survey doesn’t provide data at the country level, but amfAR officials point out that the majority of responses came from African countries.
When asked about the report, a State Department spokesperson said in an email that the Trump administration has “strengthened PEPFAR through clear, strategic direction.”
“As a result, the number of children testing positive and on treatment for HIV has continued to decline,” the spokesperson said.
In April, the U.S. State Department released PEPFAR data for one quarter in 2025: July through September. Officials said PEPFAR-supported programs provided standard HIV treatment for 20.6 million people in more than 50 countries, which they said is stable from the same reporting period in 2024. They also said PEPFAR started 103,000 pregnant and breastfeeding women on PrEP, up from 43,000 the previous year.
The data from that quarter “demonstrates the resilience and strength of the program,” the spokesperson said.
But researchers from amfAR and the International AIDS Society combined that quarter’s data with another data release that included all four quarters and found substantial disruptions across PEPFAR services.
Other research, published in the journal Nature Health in June, specifically examined treatment globally using PEPFAR data. It found that nearly 2 million fewer people living with HIV were receiving PEPFAR-supported antiretroviral treatment in fiscal year 2025 as compared with the previous fiscal year — about a 10% decline.
“That does raise really important questions about program stability,” said Ramona Godbole, an author of that study who wasn’t involved in the latest report.
AmfAR’s report made numerous recommendations to help restore care. It said the U.S. government and PEPFAR leaders should reinstate support for all HIV services, not just treatment. It also called on other national governments to spend more on HIV services and contract with nongovernmental organizations, including those led by people in key vulnerable populations.
But Jennifer Sherwood, amfAR’s director of research and public policy, said even if money is put back into the system, it will take time to get the services up and running and regain the trust of communities.
“And unfortunately, with HIV and infectious disease, each day is deadly,” she said. “Each day that we don’t have those systems in place, you see new infections.”
Sam Ato Timaloa, a paroled sex offender who also served time for attempted murder, had dementia and an acute intolerance of noise — especially from roommates at Sunrise Post Acute, a nursing home in Banning, Calif. Over four months in 2025, a state investigative report found, Sunrise switched Timaloa’s room eight times, the last into one occupied by Attilio Cecchetto, 92, a retired tile installer whose dementia led him to frequently moan, mumble, and yell.
Overnight, a nurse aide walked into their room and saw blood splattered on the floor, walls, and ceiling, according to a grand jury transcript. Cecchetto’s face “looked twisted and smashed,” the aide testified. A Banning city police officer testified that Timaloa, 77, told him that he had punched Cecchetto twice.
“He just kept saying that Attilio was being too loud: ‘He talks too much,’” the officer said.
Cecchetto died two days later from blunt force facial trauma.
Attilo Cecchetto (right), a retired tile installer pictured with his son Gino, often moaned or yelled, a symptom of his dementia. His California nursing home assigned him a new roommate, a former convict whose dementia made him react strongly to noise, a state report said.Marco Cecchetto
“You get placed in a facility like this to be taken care of, not to be murdered,” one of his sons, Gino Cecchetto, said in an interview. “This was completely preventable at many different points.”
Timaloa pleaded not guilty to assault. The charges were later upgraded to murder, and a judge ordered a mental health evaluation. The judge will rule as early as August on whether Timaloa is competent to stand trial.
PACS Group, the nursing home chain that owns Sunrise, denied negligence. “We strive to provide quality care to everyone we serve, and our hearts continue to go out to the Cecchetto family for their loss,” PACS spokesman Brooks Stevenson said in an email.
In nursing homes primarily occupied by impoverished people as well as posh assisted living facilities that cost upward of $10,000 a month, agitated residents have shoved, punched, bit, and kicked others. They have wielded canes, walkers, pens, a plate, a mop stick, a shoe, a belt buckle, and even the footrests of wheelchairs as weapons, federal inspection reports show.
How often these altercations take place nationwide is unknown, but an in-depth study of 14 assisted living facilities in New York state led by Cornell University researchers estimated 1 in 7 residents experienced aggression within a month, including verbal, physical, or sexual acts. Their separate study of 10 New York state nursing homes estimated 1 in 5 residents experienced an altercation in a month. Researchers have found that these assailants are disproportionately likely to have dementia.
The diseases that cause dementia can impair brain circuits involved in impulse control and threat perception, raising the risk of aggressive behavior. Residents with Alzheimer’s disease and other dementias constitute more than 900,000 of the 2.2 million people living in these settings, many of which include specialized memory care units.
Often, altercations involving a resident with dementia erupt after danger signals are missed or ineffectively addressed, according to a KFF Health News examination of court records, police reports, and state and federal inspection reports.
Since the start of 2024, the federal Centers for Medicare & Medicaid Services has faulted nursing homes at least 700 times for failing to protect residents from physical, sexual, or verbal abuse by other residents, CMS inspection reports show. The federal records do not include assisted living facilities, which are regulated by states.
In the first three months of this year, CMS cited nursing homes more often for resident-to-resident abuse than for any other type of abuse, neglect, or exploitation, including abuse by employees, the reports show.
The long-term care industry says not every clash can be averted. Presbyterian Homes & Services, a nonprofit Christian chain of senior living facilities, said in a statement: “Caring for individuals living with advanced dementia is complex, and behaviors can change in ways that are difficult to fully predict or prevent, even with clinical interventions in place.”
Eilon Caspi, a dementia consultant and researcher who studies resident-on-resident altercations, said that usually there is a specific unmet need that precedes an altercation. “In the vast majority of incidents,” he said, “there are warning signs in the months, weeks, days, hours, and sometimes minutes and seconds prior.”
Fertile battlegrounds
One psychological theory about Alzheimer’s, the most common dementia disease, holds that as the brain’s networks deteriorate, the balance shifts between the prefrontal cortex, which helps govern judgment and self-control, and limbic regions including the amygdala, which helps process fear and threat responses.
As cognition clouds, people lose the ability to understand what is happening around them and to put distress into words, researchers say. Pain, infection, medication side effects, and other physical and emotional distresses may be expressed through shouting, intimidating gestures, kicking, pushing, or punching. Long-term care facilities can be triggering environments, with intimate care often delivered by a changing stream of aides whom residents can’t recognize. Amid noise, close quarters, and rigid routines, interactions become flash points.
“You don’t feel safe, because you don’t know these strangers who are coming in and taking off your clothes,” said Al Power, a geriatrician and an advocate for alternative models of care for people with cognitive issues. “These things will be distressing to anybody.”
The Cornell researchers found verbal altercations were the most common type of aggressive interaction but estimated 4% of assisted living residents and 5% of nursing home residents in their studies experienced physical assaults in a month.
Another Cornell study found that Connecticut police were called to nursing homes for resident-to-resident clashes more often than allegations of staff abuse, theft, and residents wandering away without supervision combined. A national analysis of survey data from the Centers for Disease Control and Prevention calculated nearly 8% of residents in assisted living facilities engaged in physical aggression or abuse toward other residents or staff members.
Many of the physical aggressions KFF Health News identified in CMS inspection reports were perpetrated by residents with diagnoses of dementia, schizophrenia, or other cognitive disorders. In some physical altercations, both residents were aggressors, while other fights were one-sided. Sometimes the residents were roommates.
Laura Mosqueda, a geriatrician at the University of Southern California’s Keck Medicine in Los Angeles and a senior adviser to the National Center on Elder Abuse, said: “What worries me is that we just end up blaming two people who have either cognitive impairment or severe, uncontrolled mental health issues, when they’re supposed to be in an environment where people are safe.”
‘Only a matter of time’
Gladys Lynch, a retired department store accountant, transferred into the memory care unit at Harbor Crossing in White Bear Lake, Minn., in September 2025. Her monthly cost was more than $10,000, according to an invoice provided by the family.
One of Lynch’s daughters, Rebecca Norton, installed web cameras in her room and often saw another resident inside. “Every day I looked at it, this woman would be walking into my mom’s room, harassing her, digging through her things, using her bathroom, yelling at her,” Norton said in an interview. She informed Harbor Crossing’s administration, and the facility said it would start locking her mother’s door.
Norton emailed a Harbor Crossing administrator a list of issues with her mother’s care. “My biggest concern,” she wrote, was that her mother’s door was not consistently locked and the webcam showed the woman had again entered, rummaged through the bathroom, and taken a couple of adult diapers.
A Minnesota investigative report determined Gladys Lynch’s memory care home failed to protect her from another resident known for behaving aggressively. “My mom deserved better than what they gave her,” says her daughter Rebecca Norton, seen here holding a photo of Lynch. The home has asked the state to reconsider its findings.Liam James Doyle / For KFF Health News
Unknown to Norton, Harbor aides had raised concerns about the other resident, who like Lynch was new to Harbor Crossing’s memory unit, according to a Minnesota Department of Health report. Diagnosed with Alzheimer’s, severe dementia with agitation, depression, and anxiety, the woman was confused, had difficulty communicating her needs, and hit aides.
Aides repeatedly reported that the woman had “ongoing aggression, entered other residents’ apartments, invaded others’ personal space, and was difficult to redirect,” the health report said. They said medications had been ineffective and pressed for new ones. The report said one nurse told the woman’s doctor it was “only a matter of time before” she “hurts another resident.”
Captured on camera
On the last day of September, she entered Lynch’s room and resisted leaving, the state report said. The next morning, she reappeared. Video of the incident was described in the police and state reports and reviewed by KFF Health News. It shows Lynch guided the woman out and appeared to attempt to lock the door, but the woman opened it and returned once more.
The woman declared it was her house, went into Lynch’s bathroom, used the toilet, and then returned to the room Lynch was in. Lynch can be seen repeatedly pressing the alert pendant around her neck to signal nurses for help.
The video shows the woman was almost out of her apartment door when she attempted to touch an object near the door. Lynch put her hands up to block her. The woman slapped at her hands and said, “I’m going to kill you if you don’t quit it.” She pushed Lynch, who fell, her head hitting the floor and blood seeping out.
Aides arrived 13 minutes after she had initially pressed her pendant, the state report said. Lynch suffered a brain hemorrhage and fractures to her eye socket and ribs, according to the state report. She died in the hospital five days later at age 96; the medical examiner’s office declared it a homicide.
Norton said her mother was kind and pleasant and never combative. “My mom deserved better than what they gave her,” she said.
Gladys Lynch was a department store accountant who raised three daughters before developing dementia. Here her daughter Rebecca Norton shows a collection of Lynch’s personal letters and photographs at Norton’s home in Hugo, Minn.Liam James Doyle / For KFF Health News
Prosecutors declined to bring charges, according to the police report. The state investigation concluded Harbor Crossing was responsible for neglect because it was aware the woman “exhibited violent and aggressive behaviors” and yet had failed to put in place effective interventions. Harbor Crossing has requested the state reconsider its findings.
In June, Suzanne Scheller, the attorney for Lynch’s family, filed a wrongful-death lawsuit against Presbyterian Homes, which owns Harbor Crossing.
Presbyterian said in a statement: “We are deeply saddened by the loss of Ms. Lynch, and our thoughts remain with her family and all those impacted.” It declined to comment further on the incident or the lawsuit.
Before Gladys Lynch’s death, employees at the memory care unit at Harbor Crossing in White Bear Lake, Minn., struggled to keep the resident who fatally assaulted her from behaving aggressively and wandering into other residents’ rooms, a state report found. Harbor Crossing has asked the state to reconsider its findings of negligence.Liam James Doyle / For KFF Health News
Preventive tactics
Geriatricians, researchers, and resident advocates say long-term care homes should employ strategies to reduce the risk of altercations, including closer supervision of residents at high risk, relocating them closer to nursing stations, separating residents with repeated conflicts, and adjusting roommate assignments or seating in shared spaces.
Each resident should have a care plan, and homes should train staff to be alert to a resident’s triggers and intervene quickly, dementia specialists say. Organized activities are essential to keep residents occupied and engaged. Antipsychotics and other psychotropic medications are often prescribed, but they can increase the risk of falls, strokes, and even death.
An aide can be assigned to watch a particularly challenging resident one-on-one, but many places lack enough staff for protracted, dedicated supervision. Some assisted living facilities will tell a resident’s family they must hire a personal aide, who can cost thousands of dollars extra each month. In extreme situations, facilities might send a resident to an emergency room for evaluation or to a psychiatric hospital, or evict or discharge them.
Camille Russell, who served as Kansas’ long-term care ombudsman until 2024, said she observed nurses and aides were often “woefully undertrained” in basic elements of dementia care.
“We’ve gotten too far away from making decisions that are caring decisions,” Russell said. “There has to be a balance, and the balance has gotten too far to the profit side.”
A debilitating kick
Many physical altercations between residents result in a scratch or a bruise, but nonfatal scraps can leave permanent damage on deeply frail residents.
Linda Twiddy’s first weeks in a Chesapeake, Va., memory care unit in August 2024 were happy, her daughter, Barbara Howerin, said in a May interview. Twiddy, a former church secretary with vascular dementia, sang along with a visiting church choir, decorated pumpkins, and visited a cat café. The facility, The Vero at Chesapeake, charged Twiddy a one-time $6,825 move-in fee and monthly charges of $7,475, according to the lease.
Seven weeks after Twiddy started living there, a nurse called Howerin. She told her that her mother had been kicked in an altercation with another resident and was being sent to the hospital.
When Howerin arrived at the hospital, she was shocked by the extent of the injury. “It was like 10 inches long by 6 inches wide, the whole front of her shin,” she said. “The calf was just like dangling down.”
According to an internal facility incident report the family obtained, an aide heard Twiddy scream for help and raced over to see a male resident with dementia trying to hit Twiddy as she sat on the floor in “a pool of blood.” The report said, “Linda was screaming get him away from me, he pushed and kicked me.”
The man had prior episodes of aggression, according to documents Twiddy’s family obtained in a lawsuit they brought against The Vero in Chesapeake Circuit Court. At his previous facility, a progress note from 2023 stated, he was “becoming very aggressive in tone and actions to residents and staff.” He “grabbed another resident by the wrists and pushed her,” according to the note. He was sent to an emergency room for evaluation of agitation, according to a hospital report. It did not make clear whether he was discharged back to the facility or elsewhere.
Agitation tied to pain
The male resident’s medical records at The Vero said he was diagnosed with late-onset Alzheimer’s disease, agitation, and anxiety, according to his doctor’s deposition. He had chronic pain in his back and trouble sleeping. He could answer simple yes-or-no questions but had trouble providing more extensive answers and couldn’t communicate that he was in pain, she testified. His behavioral changes usually occurred when he had a urinary tract infection, the doctor said.
When he was agitated, aides could sometimes calm him by turning on the television so he could watch his beloved New England Patriots, one aide testified in a deposition. A former aide said she tried to avoid dealing with him altogether. “If you go up to him and he was agitated, he’d reach out to try to grab you,” she testified. “If he had that cane, he would swing that cane or he would punch at you.”
In a court filing, The Vero denied allegations by Twiddy’s family that it should have protected residents from him. The filing said The Vero complied with all standards of care and that any injuries Twiddy sustained “were caused by her own negligence” or acts of others.
In their investigation of the incident, Virginia regulators alleged The Vero had failed to assume responsibility for the health, safety, and well-being of its residents. The inspection report said The Vero pledged to appropriately staff the memory care unit based on the number of residents and to ensure someone completed rounds at least every two hours during sleeping hours.
Twiddy underwent three surgeries at the hospital for her leg, including a skin graft, then spent a month in rehabilitation. “She was never able to walk again,” her son, Doug Twiddy, said in a May interview.
The family moved Linda Twiddy to a different memory care facility where the nursing station had a clear view of all the rooms. She lived there until her death earlier this year.
The lawsuit was settled on confidential terms in early June. Carlton Bennett, the family’s attorney, declined to comment. In an email, Lauren Rogers, a spokesperson for Sinceri Senior Living, which operates The Vero, said the company was pleased the legal case had been resolved but could not comment further, citing confidentiality and patient privacy.
“The Vero at Chesapeake is committed to providing a caring, supportive environment where resident health, safety, and well-being remain our highest priorities,” she said.
A history of violence
After Attilio Cecchetto was fatally bludgeoned at Sunrise Post Acute, his adult children and their attorney, Jody Moore, discovered disturbing details about Sam Ato Timaloa. He had been imprisoned in 1999 after being convicted of raping an underage girl and sentenced in 2008 to 24 years in prison for attempted murder involving domestic violence, according to Riverside County court records. His public defender declined to comment.
Cecchetto’s sons, Moore, and her colleagues at Moore Hutchins Moore also learned more about the home’s owner, PACS Group, a publicly traded company with more than 300 long-term care facilities. Last year, PACS earned $191 million on revenue of $5.3 billion, according to its annual securities filing.
In the lawsuit the Cecchettos and their father’s widow filed against PACS, they accused the company’s founders, Jason Murray and Mark Hancock, of draining resources from their nursing homes to pay for the chain’s expansion and swell their personal wealth.
The two had earned more than $650 million through stock sales since taking the company public and bought two private luxury jets, according to the lawsuit and securities filings. PACS has also purchased corporate sponsorships for Utah sports teams even though it owns no nursing homes in the state, the lawsuit said.
California regulators fined Sunrise $120,000 for failing to protect Cecchetto and for not taking Timaloa’s articulated dislike of noise into account when assigning rooms. Medicare issued its own $62,810 fine.
In legal papers responding to the Cecchettos’ lawsuit, PACS denied negligence for his death and alleged he “failed to exercise ordinary care on his own behalf for his own safety.” It has sued to overturn the $120,000 state fine, saying it was issued too late and that Sunrise “did what might reasonably be expected of a long-term healthcare facility licensee acting under similar circumstances” to comply with state rules.
The Cecchettos’ lawsuit asks for a judge to impose robust procedures PACS homes must follow for admissions, staff training, room changes, and the reporting of altercations between residents. The suit asks for a court-appointed monitor to oversee compliance. In its written statement to KFF Health News, PACS said “important context” would come out during the process and declined further comment.
In an interview, Cecchetto’s three sons, Dino, Gino, and Marco Cecchetto, described their father’s life. He spent his childhood on a farm in Italy, growing up under Benito Mussolini. After World War II he moved to Canada, where he learned to tile and lay marble and terrazzo, a decorative flooring material made of chips of stone, glass, or other materials embedded in cement or resin. He relocated to California in the early 1960s, became naturalized, and worked as a tile journeyman and a contractor for decades.
“We don’t want this to happen to somebody again,” Gino Cecchetto said. “With the life he led, he deserved a quiet, dignified death. Instead, he ended his life in pain and fear.”
Data methodology
KFF Health News’ analysis of federal nursing home inspection reports focused on citations for violations of Medicare and Medicaid regulations stating that each resident has the right to be free of abuse, neglect, and exploitation.
The analysis looked at the most serious levels of citations, those in which inspectors determined that one or more residents had been harmed, or that the facility’s actions caused — or were likely to place residents in immediate jeopardy of — serious injury, harm, impairment, or death. We reviewed the reports since January 2024 and tallied those that explicitly described resident-to-resident altercations.
We conducted a more granular analysis of a subset of the inspection reports from January through March 2026 involving harm or immediate jeopardy. Each report was reviewed and categorized by the type of abuse, neglect, or exploitation.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.
The Trump administration is seeking to loosen federal rules intended to protect historic sites, alarming outside groups who say the changes would allow government agencies and developers to pursue major projects — such as President Donald Trump’s planned triumphal arch — without soliciting public input.
The Advisory Council on Historic Preservation, a low-profile federal agency that oversees preservation reviews and advises the president and Congress, on Friday proposed significant revisions to a federally required process that governs changes to landmarks such as the National Mall, sites that are significant to Indigenous tribes, and other properties eligible for listing on the National Register of Historic Places. The process currently applies to any construction projects that are on federal land or receive federal funding, as well as private projects that require any type of federal approval.
Under the current rules, federal agencies must undertake a multistep Section 106 review assessing the potential effects of construction projects and soliciting public input, among other requirements. The revised rules would let federal agencies build their own projects or grant approval for construction by private developers without public input, according to a proposed rule and an accompanying document obtained by the Washington Post.
Trump officials have previously said the 60-year-old rules can hamper development projects and needed renovations and had called for the regulations to be overhauled. But the timing of the administration’s announcement and the breadth of the proposed changes caught many historic preservation groups off guard.
“What is going to happen regularly is communities are not going to know that major projects are happening in their backyard until the bulldozers show up,” said Marion F. Werkheiser, a founding attorney at Cultural Heritage Partners, who has reviewed the proposed changes. Werkheiser’s firm is involved in litigation against the Trump administration over plans to alter the Eisenhower Executive Office Building and the Kennedy Center.
Sara Bronin, who led the ACHP under the Biden administration, called the proposed rules a “sloppy, ill-conceived draft” and predicted they would be challenged in court.
Travis Voyles, a Trump appointee who serves as the council’s vice chairman, asked council members to vote on the proposed changes to Section 106 by this coming Friday, according to an email obtained by the Post. If council members support the new regulations, they could advance to the White House for the next step in the formal rulemaking process, Voyles wrote.
ACHP did not immediately respond to questions about the planned changes and whether the White House had directed them. The White House declined to comment. The Atlantic previously reported the proposed changes.
Experts said the rules govern changes to 1.4 million properties across the country, ranging from several thousand national landmarks to local historic districts and sites in many communities.
Several Trump administration projects, such as the president’s planned triumphal arch near Arlington National Cemetery, have been bound up in the ACHP’s historic-preservation reviews. Outside groups have said that the rules are essential to protecting key sites and public spaces and warned that the planned changes would undercut decades of precedent.
“This is not only a massive assault on laws that have benefited that nation for some 60 years, it almost completely eliminates the role of the public,” Charles A. Birnbaum, the CEO of the Cultural Landscape Foundation, an education and advocacy organization, said in a statement. “The proposal actually eliminates language that says: ‘The views of the public are essential to informed Federal decision making in the section 106 process.’ How un-American is that?”
The proposal narrows what is considered a “historic property” that can be protected, tightens the scope on what is considered an “undertaking” affecting that property under the law, and makes the process of consulting states and the public optional. What qualifies as a historic property is now limited to places that are “geographically compact” and have been improved by humans at some point.
“For the avoidance of doubt, noncompact, unimproved natural features such as mountains, valleys, bodies of water, or landscapes, including ethnographic landscapes, do not qualify as property,” according to the proposal.
Outside groups said they had little chance of stopping this week’s vote. Twenty of the 24 seats on the ACHP are either directly appointed by the president or are reserved for the heads of federal agencies, such as the Interior Department, which are controlled by Trump.
The Trump administration has separately remade other federal panels, such as the Commission of Fine Arts and the National Capital Planning Commission. Those panels have swiftly advanced some of Trump’s pet projects, such as his planned White House ballroom.
Several Trump officials at an ACHP meeting last month shared their frustration about the existing Section 106 rules and said they supported reforms.
Michael Boren, an Agriculture Department official who oversees the Forest Service, said that some efforts to replace unsafe, decades-old infrastructure at ski areas that are on national land had been stymied by the regulations.
“When they’re over 50 years old, they’re historic structures and when we’re trying to replace them, we sometimes are delayed for years just by the historic piece,” Boren said.
Werkheiser said the change would exclude landscapes that tribes hold sacred that would have been previously considered under the existing rules, potentially opening them up to development and destruction by industry. That could also remove the law’s protections against projects such as one that would build power lines near Thomas Jefferson’s Monticello estate and spoil the view from the historic site, she said.
Bronin said that provision would allow the Trump administration to expedite some controversial projects, such as a planned copper mine in Arizona located on a sacred Apache site known as Oak Flat. Democrats and historic preservationists have said that the planned mine will destroy the site.
“In the urban context, taken to the extreme, this phrase may be used to limit protected properties to just a building or a handful of buildings — making larger historic districts, like the French Quarter in New Orleans or historic Savannah vulnerable to needless destruction,” Bronin wrote in a message.
The proposal would also give federal agencies a new way to approve projects without reaching agreement with states, tribes, or other parties involved in the review process. Historically, those decisions were memorialized through a “memorandum of agreement” negotiated with state or tribal authorities and other interested parties.
The new rules would create an alternative called a “memorandum of decision,” allowing an agency to move forward on its own, without consultation with the states or the public. States and tribes would no longer be able to try to block a project or invoke a dispute-resolution process if they object. Agencies would still have to consult affected tribes but would not have to incorporate their feedback.
Several experts also noted that the current Section 106 rules have required the Trump administration to take public feedback on some of Trump’s projects. Under the new regulations, the federal government could unilaterally decide that public input is not in the general interest, exclude the public from the process, and issue its decision unilaterally.
“The agency is going to decide if it’s in the public interest to inform the public about what they’re getting ready to do in that public’s local community. And that just seems so Orwellian to me,” Werkheiser said.
A U.S. soldier killed in Iraq during a controlled detonation of an Iranian drone was a 30-year-old father from North Carolina who had served for nearly a decade, according to a military statement Tuesday and his family.
Sgt. Michael Emmanuel Swinton, of Fayetteville, will receive a Bronze Star, Purple Heart, and Combat Action Badge, and will be promoted posthumously to staff sergeant. The Army said it was investigating the circumstances of his death Sunday at an air base in Irbil.
He leaves behind a 6-year-old son and a 4-year-old daughter, his mother said.
“I will never recover from this, you should be home,” his wife, Mia Gonzalez-Swinton, posted Monday on Facebook. “We had so many plans for when you got back, I’m sick to my stomach.” She said she was notified Sunday that he had been killed.
Two U.S. Army soldiers were also killed in Jordan last week while defending against Iranian ballistic missile and drone attacks. They were the first U.S. troop deaths from direct Iranian fire since the opening days of the war.
Swinton’s mother, Christel Swinton Andujar, told WRAL-TV on Tuesday that her son’s family was “the center of his world.”
“Every decision he made and every sacrifice he endured was with them in his heart,” she told the television station from her home near Fort Bragg.
Swinton enlisted in the Army in 2017 and was assigned to the 55th Air Defense Artillery Regiment, 108th Air Defense Artillery Brigade, out of Fort Bragg, N.C.
“Sgt. Swinton was an experienced noncommissioned officer who took great pride in his work and the people around him,” said Brig. Gen. John L. Dawber, commanding general of the Army Air and Missile Defense Command. “He answered the call to duty with courage, honor, and selfless dedication.”
Renewed fighting between the U.S. and Iran is now in its 10th day, with both sides launching barrages of strikes. Iran has attacked U.S. allies in the region, and American soldiers are stationed across the Middle East.
The Defense Department identified the soldiers killed in Jordan as 1st Lt. Tyler James Feehan, 25, of Ewa Beach, Hawaii, and Pvt. Isabella Gonzales, 19, of Carrollton, Texas. They were also with Army Air and Missile Defense Command units.
A third service member was reported missing after the attack. U.S. Central Command, which oversees the Middle East, said “unidentified remains” have been found and were being examined.
Iranian authorities say U.S. strikes in just the past three weeks have killed at least 50 people and wounded more than 500 others.
Both sides have targeted civilian infrastructure relied on by millions of people. Workers on ships, as well as foreign workers and others in Gulf nations, Israel and Lebanon have also died in the conflict.
The U.S. State Department said in a new warning to Americans that “Iran and groups supportive of Iran may target other U.S. interests overseas or at locations associated with the United States and Americans throughout the world.”
U.S. President Donald Trump has said the war is necessary to stop Iran from developing nuclear weapons. Trump, a Republican, now faces political pressure to bring the war to a close and avoid the kind of prolonged Middle East conflict he had campaigned against. The escalation has pushed oil prices higher in recent weeks.
