Health Rounds: Blood test improves detection of endometriosis

March 18 (Reuters) - A new blood test for the painful uterine disorder endometriosis detected cases missed by ultrasound and MRI, according to results of a study to be presented at a medical meeting this week.

Reuters

Endometriosis, in which cells similar to ‌the lining of the uterus grow outside the uterus, affects about 1 in 10 women of reproductive age, causing pelvic pain, ‌menstrual irregularities, dyspareunia, or pain associated with sexual intercourse, and gastrointestinal discomfort.

Diagnosis can take years, largely because imaging tests don't detect it accurately, and the current gold standard diagnostic method ​involves laparoscopic surgery.

Studying 298 reproductive-age women who had surgery to look for endometriosis, including 177 with confirmed cases, researchers found the blood test accurately identified 80% of those cases and accurately ruled out the disease in 97.5% of individuals who did not have it.

The test developed by HerAnova Lifesciences also correctly identified 61.5% of cases that had been missed on imaging studies, according to a report of the study published in the Journal of Minimally Invasive ‌Gynecology.

"Endometriosis remains profoundly underdiagnosed, and patients deserve better ⁠tools," HerAnova Chief Medical Officer Farideh Bischoff said in a statement.

The researchers are scheduled to report on the study at the American & Global College of Endometriosis Specialists Annual Meeting in Las Vegas.

"We look forward to presenting our findings ⁠to the clinical and scientific community and advancing the conversation around non-invasive approaches for evaluating this disease," Bischoff said.

EXPERIMENTAL DRUG SHOWS PROMISE FOR ALS

An experimental oral medication combining an antibiotic with an anti-inflammatory drug may be useful for patients with amyotrophic lateral sclerosis, a mid-stage trial suggests.

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The randomized trial, designed to prove ​the ​combination pill's safety but not confirm its efficacy, involved 68 participants who received PrimeC ​being developed by NeuroSense Therapeutics and Recipharm, or placebo ‌for six months, followed by a 12-month open-label extension in which all received PrimeC.

PrimeC, a combination of celecoxib and ciprofloxacin, is designed to target the neuroinflammation, excess iron accumulation, and abnormal microRNA gene-regulating activity that occurs in ALS, also known as Lou Gehrig's disease.

Celecoxib is sold under the brand name Celebrex by Viatris.

Although the study was not designed to assess efficacy, participants in the PrimeC arm had better functional outcomes, especially for speech and swallowing, as measured by an ALS Functional Rating Scale Revised score, researchers reported in JAMA Neurology.

On a scale ranging from 0 to 48, ‌with 48 indicating normal functional ability, at 6 months the participants taking PrimeC scored ​2.23 points higher than those taking placebo. By 18 months, participants originally assigned to ​PrimeC scored 7.92 points higher, on average, than their counterparts.

Early, ​continuous treatment was also associated with a 64% reduced risk of ALS-related complications, including hospitalization, respiratory failure or death.

In ‌addition, those initially assigned to PrimeC had lower levels of ​ferritin, a key protein involved in ​storing iron in the body, and lower levels of microRNA molecules that have been linked to ALS, a neurodegenerative disease that causes progressive muscle weakness, paralysis, respiratory failure and eventually death.

"The improved functional and biomarker signals we observed support a Phase 3 study to ​evaluate PrimeC's effectiveness and safety in a larger ‌population," study leader Dr. Merit Cudkowicz of the Mass General Brigham Neuroscience Institute in Boston said in a statement.

"We are determined ​to accelerate the development of therapies for people living with ALS," Cudkowicz added.

(To receive the full newsletter in your inbox ​for free sign up here)

(Reporting by Nancy Lapid; Editing by Bill Berkrot)

Health Rounds: Blood test improves detection of endometriosis

March 18 (Reuters) - A new blood test for the painful uterine disorder endometriosis detected cases missed by ultrasound ...
Arizona 'built for' March Madness, says one expert. Call it proof of Big 12 surge

Fran Franschilla's job calling Big 12 games gives him a front-row seat to the best action incollege basketball, but that's where he stops you. Don't label broadcasting Big 12 hoops work.

USA TODAY Sports

"They pay me to travel, not to work," Fraschilla, ESPN's veteran color commentator and a former coach, says affably. "I've been blessed, because I've watched the league grow up over 20 years."

Along the way, Fraschilla became ESPN's voice of the Big 12 and an unofficial conference advocate. It's easy to advocate for the Big 12 in a season when the conference supplied peak entertainment and premier performance.

TheSECled all conferences with 10NCAA Tournamentbids, a show of its depth, but ball-knowers recognize the best batch of hoops lived inside the Big 12.

Now, to back that up on the final exam that is the NCAA Tournament.

Bold predictions:Best March Madness upset picks, Final Four sleeper

Toppmeyer:If Jon Scheyer feels any Duke pressure, at least Coach K can relate

The Big 12 earned eight bids. Fraschilla counts three with Final Four potential: No. 1 seedArizonaand No. 2 seeds Houston and Iowa State.

That list would be bigger, he says, if not for injuries toTexas Tech's JT ToppinandBrigham Young's Richie Saunders, a pair of big-time ballers who went down in February.

As for national championship potential? Start with Arizona.

"I give Arizona as good of chance as anybody in the field to cut down the nets in Indianapolis," Fraschilla, who coached Manhattan toa mammoth NCAA Tournament upsetof Oklahoma in 1995, told me.

Why Arizona is a top March Madness championship contender

Two of Arizona's key bench players started on last year's team that reached the Sweet 16. That speaks to the quality of a starting lineup in which every player averages in double digits scoring.

"They are as complete a team as there is in college basketball," Fraschilla said. "First of all, they are an old-school, bludgeon-you-inside team with three terrific post players. They have as good of a leader at point guard, (Jaden Bradley), as any team in the country."

Oh, we've yet to mention dynamite freshman guard Brayden Burries, the team's leading scorer.

Try to go devil's advocate and point outArizona's history of March Madness shortcomingsthe past 25 years, and Fraschilla uncorks the ultimate comeback.

"I can say the same thing about an entire league: the Big Ten," he says.

Fair point.

Anyway, why should these Wildcats fret about what happened to the 2023 team, which lost to15th-seeded Princetonin the first round? Or, the 2018 team thatgot blasted by 13th-seeded Buffaloin the first round? The past three times Arizona earned a No. 1 seed in the past quarter-century, it got bounced before the Final Four. That's for you to consider as you fill out your bracket, but whispers of the past are not for these Wildcats to fuss over.

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"They play like they're in a cocoon," Fraschilla said, "so I'm not sure how much of the noise they hear."

If you need more than one man's opinion, there's also Ken Pomeroy's rankings. BasketballnerdsciteKenPomas if it's college basketball's holy literature. His metrics rank Arizona, Houston and Iowa State among the six best teams, making the Big 12 the only conference with more than one team tucked inside the top six.

The Big 12's "Big Monday" games, with Jon Sciambi and Fraschilla on the call, showcased premier teams in elite environments with future NBA stars.

"Big Monday has become must-watch TV," Fraschilla said.

The Big 12's TV audience on "Big Monday" doubled this season, according to commissioner Brett Yormark, to average1.7 million viewers.

Consider it evidence of how the Big 12 survived conference realignment.

<p style=University of Akron:
Yvette Nicole Brown, Alexa Bliss, Dominique Moceanu, The Black Keys and George Wallace

" style="max-width:100%; height:auto; border-radius:6px; margin:10px 0;" loading="lazy" /> <p style=California Baptist University: Brent Kutzle, Dustin-Leigh Konzelman, Kay Warren, Rick Warren and Marissa Figueroa (not pictured)

" style="max-width:100%; height:auto; border-radius:6px; margin:10px 0;" loading="lazy" /> <p style=University of Hawaii: Bette Midler, Larry Beil, Jason Elam, Ken Niumatalolo and Barack Obama, Sr.

" style="max-width:100%; height:auto; border-radius:6px; margin:10px 0;" loading="lazy" /> <p style=High Point University: Austin Dillon, Tubby Smith, Donna Fargo, Cody Allen and Charles F. Price (not pictured)

" style="max-width:100%; height:auto; border-radius:6px; margin:10px 0;" loading="lazy" /> <p style=Howard University:
Chadwick Boseman, Thurgood Marshall, Anthony Anderson, Taraji P. Henson and Gus Johnson

" style="max-width:100%; height:auto; border-radius:6px; margin:10px 0;" loading="lazy" /> <p style=Kennesaw State University: Bron Breakker, Jasmine Burke, ReesaTeesa, Larry Nelson and theRadBrad (not pictured)

" style="max-width:100%; height:auto; border-radius:6px; margin:10px 0;" loading="lazy" /> <p style=University of Maryland, Baltimore County: Kathleen Turner, Duff Goldman, Stavros Halkias, Young Mazino and Scott Seiss

" style="max-width:100%; height:auto; border-radius:6px; margin:10px 0;" loading="lazy" /> <p style=University of Pennsylvania: Elon Musk, Donald Trump, Elizabeth Banks, John Legend and Maury Povich

" style="max-width:100%; height:auto; border-radius:6px; margin:10px 0;" loading="lazy" /> <p style=Prairie View A&M University: Megan Thee Stallion, Mr. T., Loni Love, Terry Ellis and Cecil Cooper

" style="max-width:100%; height:auto; border-radius:6px; margin:10px 0;" loading="lazy" />

Actors, athletes and icons: Famous alumni from every NCAA men's tournament team

University of Akron:Yvette Nicole Brown, Alexa Bliss, Dominique Moceanu, The Black Keys and George Wallace

Big 12 basketball emerged strong on this side of realignment

Realignment is bloodsport, and the Big 12 hit an inflection point in 2021 after Oklahoma and Texas set out for the SEC's richer pastures. The impending exodus of the Big 12's two richest brands cast the future of the conference into peril.

Would it be raided for parts? Merge with the Pac-12?

Option 3: Fortify.

The conference steadied by adding BYU, Central Florida, Cincinnati and Houston under outbound commissioner Bob Bowlsby. Then, Bowlsby's successor Yormark secureda media rights extensionwith ESPN and Fox before looting the Pac-12 for Arizona, Arizona State, Colorado and Utah.

While the Pac-12 collapsed into a shell of its former self, the Big 12 went from endangered species to basketball behemoth.

"The league came out much stronger on the basketball side than anybody would have realized," Fraschilla said.

Yormark describes his conference as "the second-best basketball league in America behind the NBA," and he promised to cash in when the conference hits the media rights marketplace again in 2030.

In the meantime, the Big 12 is on national championship watch, with Arizona forming the tip of the spear.

"They have a countenance about them," Fraschilla said of coach Tommy Lloyd's Wildcats, "that is built for the tournament."

Blake Toppmeyeris a columnist for the USA TODAY Network. Email him atBToppmeyer@gannett.comand follow him on X@btoppmeyer.

This article originally appeared on USA TODAY:March Madness will test if Arizona, Big 12 are 'built for' NCAA bracket

Arizona 'built for' March Madness, says one expert. Call it proof of Big 12 surge

Fran Franschilla's job calling Big 12 games gives him a front-row seat to the best action incollege basketball, but t...
TrumpRx isn't doing much for drug prices. What would it take to change that?

Americans are furious about drug prices. The Trump administration's answer? A new website.

NBC Universal A page on the TrumpRx site. (Scott Olson / Getty Images)

Butmore than a month after its launch, the site, TrumpRx.gov, remains small — offering discounts on just 54 prescription drugs. Many of those drugs already have cheaper generic versions or savings programs available elsewhere, and the discounts can't be used with insurance or count toward a deductible. Awareness of the site remains limited.

Whether TrumpRx actually lowers drug prices matters in ways that go beyond the success of the website itself. For President Donald Trump, it's tied toa broader push on health care costsas the midterms approach. But for many Americans,the issue taps into something deeper— years of frustration with a system they say feels stacked against them, where prices are hard to track and it's not always clear if they're getting a fair deal.

Health policy experts say that what the administration does next will determine whetherTrumpRx remains just another optionor evolves into something that actually helps make prescription drug costs easier to navigate.

"The idea isn't exactly new, but it does have sort of that Trump branding," said Audrey Kearney, a senior survey analyst at KFF, a nonpartisan health policy research group. "It's another option for consumers, and we'll kind of have to stay tuned to see if it'll make a real difference."

Kearneyco-authored a surveypublished last week by KFF that found that about a third of people who take prescription drugs said they had heard at least something about TrumpRx. Just 7% said they had visited the site to compare prices, rising to about 16% among people who take GLP-1 medications.

Even the White House acknowledges the website is still in its early days. A White House official declined to say how many people have visited the site or how many drugs will be added this month.

The official said IVF treatments andGLP-1 weight loss drugshave been among the most searched medications so far. The administration plans to add "a larger batch" of drugs to the platform soon, the official said, and hopes to work with Congress to codify some of the drug pricing deals into law as part of a broader health care plan.

"We don't see this as the end product," the official said. "The goal here is to pass the president's Great Healthcare Plan to codify these [Most Favored Nation] deals, so if people use insurance to buy these drugs, they can also access the savings."

There are no indications that Congress is taking up the legislation.

What could TrumpRx do differently?

In practice, TrumpRx works like existing discount sites such as GoodRx orMark Cuban Cost Plus Drug Co., letting people compare cash prices for medications, but with fewer tools and less flexibility — and no way to buy directly through the site.

"The fascinating thing about TrumpRx is that it's being touted as this new, innovative thing, when in fact, it's kind of coalescing things that already existed," said Antonio Ciaccia, CEO of 46brooklyn, a nonprofit group that tracks prescription drug prices.

The site relies on GoodRx's pricing data and technology to power many of its listings, Ciaccia said: The coupon cards are processed through GoodRx's network, using the same BIN and PCN numbers — the codes pharmacies use to process drug discounts at the pharmacy counter.

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What TrumpRx needs most is scale, said Geoffrey Joyce, director of health policy at the University of Southern California Schaeffer Center for Health Policy & Economics.

Of the initial batch of drugs on the site, roughly half have generic versions that are often much cheaper, Joyce said. Those generics are also widely available through other discount sites or at local pharmacies.

"In its current form, it's of limited use to uninsured consumers," Joyce said. "If they got rid of all the ones that had generic equivalents, you're looking at a site with 22 drugs. And it's basically a roundup of the usual suspects. It's some IVF, some GLP-1s. It's not a broad scope."

"Fifty-four drugs out of thousands, just proportionally speaking, it's a very small segment of the population," Ciaccia said.

Still, both Joyce and Ciaccia said TrumpRx has the potential — with the right investments — to go beyond existing discount sites.

Ciaccia said the platform could play a bigger role for people with private or job-based insurance, where patients don't always have access to the lowest-cost drug.

Pharmacy benefit managers, who decide which drugs go on insurers' formularies, often favor higher priced brand name drugs to secure larger rebates, sometimes excluding lower cost generics — a practice that can drive up costs for patients.

In those cases, patients could turn to a platform like TrumpRx to find a lower price brand name drug, even if their insurance favors that same medication at a higher cost.

"I think TrumpRx could be not a cure for the problems that exist today, but maybe it could supplant the system that we have," Ciaccia said. "If the discounts start to improve, there could be an option for employers who are already getting the short end of the stick on their benefit designs from PBMs."

Joyce also said the platform could become more useful by offering more transparency around drug prices, a focus of the Trump administration's health care agenda.

He pointed to Cost Plus Drug Co. as a starting point, where users can see a breakdown of a drug's price, including the ingredient cost, markup and shipping.

Currently, TrumpRx shows what people would pay compared with the drugmaker's list price. That comparison can be misleading, however, because insurance rarely pays that price and even people without insurance typically get discounts.

Improving transparency could include showing how prices vary by pharmacy or region, how discounts are negotiated and how insurance compares with cash prices.

"It's been the uninsured who have been getting screwed the most," Joyce said. "There are lower prices out there, and from an educational and informational perspective, I think that's valuable."

TrumpRx isn’t doing much for drug prices. What would it take to change that?

Americans are furious about drug prices. The Trump administration's answer? A new website. Butmore than a ...
Israel says it killed another Iranian leader, but that doesn't mean it's winning the war

Israel has again shown its unrivaled ability to assassinate high-level enemies,announcing the killing Tuesdayof the man widely seen as running Iran.

NBC Universal

Ali Larijani's death, which was confirmed by Iranian authorities, dealsa significant psychological and logistical blowto the Islamic Republic, already reeling from the killing of Supreme Leader Ali Khamenei,whose successor son has yet to appear in public. But, analysts told NBC News, it may also cause the regime to harden rather than weaken as its opponents may hope.

Ultimately, the apparent killing of Larijani, along with that ofBasij militiachief Gen. Gholam Reza Soleimani, may be little comfort to the rest of the world in the short term as it facesan oil crisisand a global economic shock in the wake of this war waged alongside the United States.

Nevertheless, Israel says it won't stop at Larijani, Soleimani, Khamenei and other senior officials before them.

Israeli Prime Minister Benjamin Netanyahu orders the elimination of senior Iranian regime officials on Tuesday. (@IsraeliPM via X)

Announcing the dual killings after overnight strikes, Israeli Defense Minister Israel Katz said his military would "continue pursuing" Iran's leaders and "repeatedly cut off the head of the octopus and prevent it from regrowing."

Larijani is "a big scalp," said Michael Stephens, a senior associate fellow at the Royal United Services Institute, a think tank based in London. "It's impressive what Israel is able to do. They promised they'd hit the regime, and they're doing it very successfully."

But from a global perspective, "you have to ask: So what?" he added.

Meeting in Tehran (Anadolu / Getty Images file)

Tuesday's dramatic developments lay bare the tension between Israel's apparent war goals and what the rest of the world might want to happen.

Israeli Prime Minister Benjamin Netanyahu says he is pursuing his decades-long aim of toppling the Iranian theocracy, declaring that his country was weakening the regime to give people a chance to oust it.

But Israel and the U.S. are not just hitting Iran's leadership and military, they are bombarding Tehran and other cities.

At least 1,200 Iranians have been killed, the Iranian Red Crescent Society said on March 3. Many more are likely to have died since then. And dozens more have died in Iran's retaliatory strikes against the Gulf states and Israel.

Iran has now taken the conflict to another level by effectively blocking the Strait of Hormuz. With ships unable to cross this vital choke point for oil and other key goods, fearing attack by Iranian missiles and drones, global prices have soared.

"Iran has successfully moved this conflict onto the global level," Stephens said. "All Iran has to do now is survive, and keep upping the cost." Ultimately, Israel "can kill as many Iranian officials as it likes, but it won't change the quagmire we're now in," he added.

Image: IRAN-US-ISRAEL-WAR (Atta Kenare / AFP via Getty Images)

Though plenty of experts warned that Iran could and would likely close the strait if attacked, this crisis seems to have come as a surprise to those prosecuting the war.

President Donald Trump had tried to cajole allies into sending ships to help reopen the strait, something most of them declined to do. In an angry post on Truth Social and later speaking to reporters in the White House, Trump said the U.S. did not need NATO "but they should have been there."

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Rouzbeh Parsi, an adjunct lecturer at Sweden's Lund University, agreed that the assassinations "will most likely not affect the operational side of the war."

But the targeted killings will likely hamper the effectiveness of Iran's internal operations, according to Michael A. Horowitz, a geopolitical and security analyst.

"They can scramble command, slow decision-making, force successors into hiding, and demoralize both leadership and foot soldiers alike," he said.

He described Larijani as "an important piece of that puzzle, as someone who acted as a coordinator between different actors within the Islamic Republic." His death "could increase internal tensions in the short term, even if it ends up reinforcing the IRGC in the longer term."

That point is key, and one that has been made throughout this conflict since the killing of Khamenei. Many Western observers fear that, by taking out Iran's current leaders, it will only create a vacuum to be filled by the powerful Islamic Revolutionary Guard Corps, the country's feared paramilitary, political and economic behemoth.

"If you look at how the assassination of Ali Khamenei empowered the most hard-line and security elements within the Islamic Republic of Iran, then Larijani's death could act as an accelerator to that path," said Ellie Geranmayeh, a senior policy fellow at the European Council on Foreign Relations.

One of the many hats worn by the pragmatist Larijani was his role as a leading negotiator tasked with finding common ground with Washington.

"Israel seems to be turning its attention to targeting those that could push for a political solution to overcome Iran's troubles at home and abroad," Geranmayeh said.

The Israeli government did not immediately respond to a request for comment on this allegation.

Israel's war was launched from a place of international fragility after its deadly assault on the Gaza Strip.

A new NBC News poll showedmore registered American voters view Israel negatively than positively, a change from a few years ago. And Iran's retaliatory attacks on surrounding Arab Gulf states may not win Tehran any new regional friends, but could also further harden dismay at Israel's actions.

It also remains to be seen what internal strife and machinations are triggered by the U.S.-Israeli campaign.

Israel has deployed its assassination strategy with dramatic but mixed results in Lebanon and Gaza, killing Hassan Nasrallah and Yahya Sinwar, the leaders of Iranian proxies Hezbollah and Hamas.

"Losing Nasrallah was a major blow to the group's ability to maneuver a far more complicated landscape in Lebanon in the long term," Horowitz said.

But, he said, "the group is still fighting."

Israel says it killed another Iranian leader, but that doesn't mean it's winning the war

Israel has again shown its unrivaled ability to assassinate high-level enemies,announcing the killing Tuesdayof the man w...
Can desalinization plants solve the west's water problem? | The Excerpt

On the Wednesday, March 18, 2026, episode of The Excerpt podcast:A critically important source of water for seven western states,the Colorado River is now running out of water. What's the solution?USA TODAY National Reporter Trevor Hughes joins The Excerpt to break down the issues and what's at stake.

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Hit play on the player below to hear the podcast and follow along with the transcript beneath it.This transcript was automatically generated, and then edited for clarity in its current form. There may be some differences between the audio and the text.

Podcasts:True crime, in-depth interviews and more USA TODAY podcasts right here

Dana Taylor:

Antelope Point Marina once sat near the shore of Lake Powell, the nation's second-largest reservoir. Instead, the sparkling Colorado River now sits more than 180 feet below, completely invisible from a dock that once floated on top of the water. A critically important source of water for seven Western states, the Colorado River is running out of water. The solution, a public lands access group has proposed an ambitious plan to build eight massive desalination plants off the California coastline, turning ocean water into freshwater for farming and reducing demand on the ailing Colorado River. Will it work?

Hello, and welcome to USA TODAY's The Excerpt. I'm Dana Taylor. Today is Wednesday, March 18th, 2026. Joining me now to break down the issues and what's at stake is USA TODAY National Reporter Trevor Hughes. It's great to have you here, Trevor.

Trevor Hughes:

Yeah, good to be here.

Dana Taylor:

Trevor, let's start by laying out, if you could, the issue for us. The Colorado River has been a plentiful source of water for the Western U.S. for over a century. Why is this happening, and why now?

Trevor Hughes:

So the Colorado River supports the economies of seven Western states as it flows downstream, with Lake Mead and Lake Powell providing hydropower but then also water for irrigation, for farming, for growing alfalfa, for growing all the food that we eat, and for drinking water. And the river is what powers, in part, the Western economy. But as climate change makes the area warmer, it's making the area drier, and that means less and less water falling out of the sky as snow, which means less water in the Colorado River all year long. And that means Lake Powell and Lake Mead have been dropping for quite a long time at this point.

Dana Taylor:

So which seven states are dependent on the river now, and what do they primarily use the water for?

Trevor Hughes:

I'm going to have to count this on my fingers, because I always forget one of them. We've got Colorado, Wyoming, Utah, New Mexico, Nevada, Arizona, and California. This is a hugely important source of water. I mean, in Denver where I live, the Colorado River water isn't as important because it's on the other side of the Continental Divide. But for those people in the West, in the western half of the United States, it's a hugely important part of what makes their economy work. In California, it's used to grow everything from alfalfa to feed cows to the cows themselves, to almonds. Arizona's Central Valley has huge croplands where they grow lots of fruit. Same kind of thing. This also is an important part of the drinking water supply for millions and millions and millions of Americans. And so when there's less water in the Colorado River, it starts to raise questions about how our economy works and how people can live in the West.

Dana Taylor:

So I know that water issues are complicated in the West because of an agreement between all the states that access the water. Tell me about that.

Trevor Hughes:

So there was an agreement in 1922 between those seven basin states, and they basically divided up the water in the Colorado River and said, "This is the water that exists, and this is how we'll all use it." The problem was those estimates were optimistic, to say the least, back then, and so there has never been as much water in the Colorado River as that agreement thought there was going to be. And so as a result, you have this need for conservation, this need for using less water than people are legally entitled to, because there just isn't that much water.

Dana Taylor:

Let's pivot to the proposed solution here. What is it?

Trevor Hughes:

When I first heard about this, it's one of those things where you think, "Wow, that is just audacious," and the idea is to build eight desalinization plants. These are huge facilities that use technology to take salt out of ocean water and make it freshwater. It's widely used as a technology, used all over the world. In fact, Israel depends very, very heavily on it. It uses a ton of energy. And so in order to power these desalinization plants, you would have to add a massive amount of solar, a massive amount of wind, or maybe a bunch of new nuclear power plants, which has been a push by the Trump administration.

Dana Taylor:

And then how much will these desalinization plants cost, and who's going to pay for them?

Trevor Hughes:

The one estimate that I've heard is $40 billion, which is a lot of money. That may not necessarily be grounded in reality, because it takes a very long time to build these things. But you also have to remember, because there's not enough water in the Colorado River, federal taxpayers, we, have been paying farmers, particularly in California and Arizona, to not farm. We have been paying them to just not. And so the backers of this plan, who are a public lands advocacy group that's called the Blue Ribbon Coalition, their idea is, what if we take this money that we're paying farmers to not farm and make it so that they can farm? And so the idea would be create massive amounts of freshwater, use that water in California, maybe in Arizona, and then that would sort of free up the rest of the Colorado River for the other states.

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Dana Taylor:

Let's talk about their location, the location of these desalinization plants. Where do they want to put them, and what are the issues there?

Trevor Hughes:

You need salt water to make freshwater with a desalinization plant, which means off the Pacific Coast. Now, that could mean California. That could also mean Baja California and Mexico. When I was reporting out this story, the first question I had was there's no way that California would ever allow a nuclear-powered desalinization plant to sit off their coastline, and there's a couple things that are interesting about that. First, they could be off the coast of Mexico. Second, they could be off federal enclaves, which would be exempt from California's environmental regulations. But what's really interesting is that Governor Gavin Newsom of California recently sent a letter to the other governors of the basin states saying desalinization was something that needed to be considered as part of a greater look at how to have more water in the system.

Dana Taylor:

Trevor, I mean, this is an interesting potential solution, but are these desalinization plants even realistic?

Trevor Hughes:

I mean, it all comes down to money and will. And what's been really interesting is thatPresident Trumphas repeatedly talked about how we used to be a country that built things. This story is based out of Page, Arizona, where I went. That's what Lake Powell is. There's a lake in the middle of the desert. That lake shouldn't be there. There's a giant dam that impounds the Colorado River. It's the same thing with the Hoover Dam and Lake Mead. Those were vastly expensive, vastly complicated projects, but we as a nation decided that we would build those things. We would assume those costs because we felt that it would make our economy stronger, make our country better.

And so it's an interesting conversation about the cost and the time and the magnitude of this, because the Colorado River isn't getting more water. And so conservation advocates would say, "We need to be better at conserving. We need to think about how we're farming. We need to think about how we're using this water that does exist." But advocates like Blue Ribbon Coalition would say, "Why don't we just make some more?"

Dana Taylor:

Well, have any alternative solutions been proposed here?

Trevor Hughes:

This is an issue that there is no easy answer. There is no cheap answer. As the climate warms, there will be less water in the Colorado River. We've seen that trend. It is accelerating. This year has been unusually dry, and we're expecting to see Lake Powell in particular drop to very, very low levels this year. Conservation has often been the first thing that people come to. We've been paying farmers not to farm. We've been telling people to, out here in the West, don't plant turf. Instead, maybe use gravel, maybe use xeriscaping, which is the term for using native plants and grasses instead of that turf. And so you see these very strong conservation measures come in, but when the crisis passes each year or every couple of years, they sort of ease back off again. But at the end of the day, this is a problem we have known has been coming for decades, and the states just can't agree on a solution.

Dana Taylor:

How much time do these seven states have, though? What's the timeline here?

Trevor Hughes:

I mean, depending on predictions, very, very little. The federal water scientists last week just predicted that Lake Powell may see one of its lowest inflow years in history, which mean the level will just drop and drop and drop. There comes a point in which the water level drops so low, the dam can no longer generate hydroelectricity, which is critically important for all the people who live there, and that's how they get their power. If it drops even further, it will actually drop below the level at which the water can flow through the dam and down the Colorado River through the Grand Canyon. That's called deadpool. We're not expecting deadpool this year, but there are fears it is coming.

Dana Taylor:

So what happens if the timeline isn't met? Is it deadpool?

Trevor Hughes:

The federal government has some levers it can still pull. There are reservoirs scattered all over the Western United States upstream of the Colorado River, upstream of Lake Powell in particular, and so the federal government can pull water from those reservoirs. It did this a couple of years ago and those reservoirs have been slowly refilling ever since, but that's more like going to the bank, taking money out from the ATM. At some point the bank account will be empty, and we'll be left with a crisis in which there isn't enough to go around. There have actually been books written about this idea that eventually in the West we will start having wars over water, because it is so important. And there's a famous quote attributed to Mark Twain, which is, "Whiskey is for drinking. Water is for fighting."

Dana Taylor:

Trevor Hughes is a national reporter for USA TODAY. Trevor, it's always good to speak with you.

Trevor Hughes:

Good to be here.

Dana Taylor:

Thanks to our senior producer, Kaely Monahan, for her production assistance. Our executive producer is Laura Beatty. Let us know what you think of this episode by sending a note to podcasts@usatoday.com. Thanks for listening. I'm Dana Taylor. I'll be back tomorrow morning with another episode of USA TODAY's The Excerpt.

This article originally appeared on USA TODAY:The audacious western water solution to fix the Colorado River | The Excerpt

Can desalinization plants solve the west’s water problem? | The Excerpt

On the Wednesday, March 18, 2026, episode of The Excerpt podcast:A critically important source of water for seven western...

 

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