• Illinois: Residents and fellows at University of Chicago Medicine on Monday voted in favor of forming a union, with 98% of the more than 1,000 residents voting to join the Committee of Interns & Residents, a division of the Service Employees International Union. A spokesperson for UChicago Medicine said the health system respects the ballot process and the results of the vote and "will, in the near future, begin the collective bargaining process with CIR-SEIU Healthcare in order to craft a fair and equitable contract that supports the needs of our trainees, our patients and our institution." (Davis, Crain's Chicago Business/Modern Healthcare, 5/6)
• Massachusetts: Steward Health Care System on Monday filed for chapter 11 bankruptcy, marking one of the largest hospital bankruptcies in decades, as the health system's physicians provide care for 2.2 million patients a year. In response, Massachusetts, where Steward owns nine hospitals, has launched emergency operations plans to ensure patients receive quality care through any future transitions, Gov. Maura Healey (D) announced. These plans include an incident command center, which will allow for better communication between the state, healthcare providers, and investors. "This is the next step and the responsible step in terms of making sure that we are prepared to do what we need to do when it comes to ensuring that patients have access to care and that the health care market is stable," Healey said. (Cole, CBS News, 5/3; Evans/Scurria, Wall Street Journal, 5/6)
• Virginia: The U.S. Court of appeals for the 4th Circuit last month became the first court in the country to rule that state healthcare plans must pay for gender-affirming surgeries. Writing for the majority, Judge Roger Gregory said that restrictions on gender-affirming care were "obviously discriminatory" based on both sex and gender. "In this case, discriminating on the basis of diagnosis is discriminating on the basis of gender identity and sex" because "gender dysphoria is so intimately related to transgender status as to be virtually indistinguishable from it," Gregory wrote. (Weiner, Washington Post, 4/29)

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