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10 percent of airspace could close if shutdown continues

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Savewith a NBCUniversal ProfileCreate your free profile or log in to save this articleNov. 5, 2025, 4:14 PM ESTBy Camila Bernal and David DouglasMinutes before a 10-hour surgical procedure, 8-year-old Olivia Olson sat on a hospital bed grinning. With quiet confidence she explained why the operation was so important to her.“I think I look beautiful, and I don’t really care what other people think of me,” Olivia said. “I just want to get a big ear so people don’t bully me in the future.”Olivia was born with a rare congenital condition, microtia, that prevents the development of the outer ear. Fewer than 200,000 people in the U.S. have microtia, according to the National Institutes of Health. Olivia’s right ear developed normally, but her left was never fully formed. Her parents, Annie and Dave Olson, of Oro Valley, Arizona, knew from birth she would need surgery to reconstruct her ear. But up until the day of the operation last month, their insurance provider, Anthem Blue Cross and Blue Shield, had repeatedly refused to approve coverage for the procedure with the surgeon the Olsons wanted to use. Dr. Sheryl Lewin holds up the 3D-printed ear implant to Olivia’s right ear. The implant would become her left ear.Courtesy David OlsonOnly a handful of doctors in the U.S. regularly perform the operation Olivia needed. Most of them — including Dr. Sheryl Lewin, a pediatric craniofacial plastic surgeon in private practice based in Torrance, California — were out of network for the Olsons. “The anatomy of an ear, it’s very complex, lots of detail, shadows, highlights, etc., so just physically recreating something that complex is very difficult. It’s rare to have a surgeon that specializes in it,” Lewin said. “If you don’t have a lot of experience, you’re going to end up with a lot of problems with this complicated of a surgery.”The family chose Lewin after years of research. They believed her reconstruction method, which involved using a 3D-printed implant to rebuild the ear, was best for Olivia. (Another technique involves using the patient’s rib cartilage to reconstruct the ear.)“We got a denial letter, and it was literally like a stab in the heart,” said Annie Olson. “We’re like, what are we going to do now?”The family requested what’s known as a “gap exception,” which allows a patient to use in-network benefits for an out-of-network provider. The request was initially denied; instead, Anthem gave them a list of six in-network doctors, the Olsons said. NBC News reached out to all six. Not a single one said they performed the surgery.If you are dealing with bills that seem to be out of line or a denial of coverage, care or repairs, whether for health, home or auto, please email us at Costofdenial@nbcuni.com.“Very few programs really offer somebody enough surgical time experience to when they leave the program and go out in private practice, where they’ll feel comfortable enough to do this kind of surgery,” said Dr. Arturo Bonilla, a pediatric microtia reconstructive surgeon in San Antonio. “It’s very specialized.”Bonilla, who performs the rib-graft method for reconstructing ears, said he regularly requests gap exceptions for his patients — and while sometimes requests need to be appealed, they’re almost always approved by all insurers, including Anthem Blue Cross and Blue Shield. “Rarely will we get somebody that says, ‘No, we’re still not going to approve it,’” he said.The Olsons debated canceling the surgery but ultimately decided to keep the date and shield Olivia from the challenges they faced paying for it. Lewin prepares the 3D-printed ear in the operating room.NBC Nightly NewsAfter multiple appeals and denials, the Olsons fundraised, borrowed money from family members and turned to credit cards. But that was not enough. Eventually, Dave Olson pulled a huge portion of the surgery’s roughly $100,000 cost from his 401(k).He said he didn’t hesitate to take the money out of his retirement fund. “It is my responsibility as a parent to make sure that my kids have everything they need,” he said.“If we knew that this was going to be the outcome, we would have been responsible people and started saving since the day she was born, versus finding out last minute, and then also having to be penalized because of pulling out of your 401(k) early,” Annie Olson said.NBC News reached out to Anthem a couple days before Olivia’s surgery and was waiting for a complete response. On the day of the surgery, with Olivia on the operating table, the Olsons finally received word that Anthem would grant the gap exception — a change the Olsons attributed to NBC News’ involvement.“We went through literally what felt like a battle every day, day in and day out,” Dave Olson said. “Then at the 11th hour during the surgery, you say they’re gonna cover it. It’s like, what? Like, why? Why? Why now?”In a statement to NBC News nearly two weeks after Olivia’s surgery, Anthem Blue Cross and Blue Shield said: “We are happy that the member was able to receive the treatment she needed. Even though the member’s plan does not cover out-of-network providers when an in-network provider is available, we were able to make a unique one-time exception to ensure her care was not delayed.”Lewin shows Olivia her new ear for the first time.NBC Nightly NewsLewin, who performs about 120 microtia surgeries a year, said that in 2025, getting denials overturned and getting gap exceptions approved for microtia surgery has been a lot more challenging. She said in 2024, more than 90% of her Anthem patients’ gap exceptions were approved, or denied and overturned. In 2025, with the exception of Olivia, none of her Anthem patients have been approved.“It’s just become kind of a very slow trend that’s very much peaked in the last year,” Lewin said. “It’s been rough, and we’ve had to work much harder to get a negotiation agreed upon.”Anthem Blue Cross and Blue Shield didn’t respond to questions about Lewin’s claim that her patients have been denied gap exceptions this year. However, it said it is reaching out to Lewin to offer a potential in-network arrangement.The financial details for Olivia’s case are still being finalized, but she said she is already excited for the future.“When it’s fully recovered, I’m gonna be like, ‘OK, that was just a short little bump,’ and then I’ll just go on with the rest of my life,” she said.Camila Bernal David DouglasDavid Douglas is a supervising producer for NBC News based in Los Angeles.
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Savewith a NBCUniversal ProfileCreate your free profile or log in to save this articleOct. 2, 2025, 6:00 AM EDT / Updated Oct. 2, 2025, 8:41 AM EDTBy Jared PerloSam Altman singing in a toilet. James Bond playing Altman in high-stakes poker. Pikachu storming Normandy’s beaches. Mario jumping from his virtual world into real life.Those are just some of the lifelike videos that are rocketing through the internet a day after OpenAI released Sora, an app at the intersection of social media and artificial intelligence-powered media generation. The app surged to be the most popular app in the iOS App Store’s Photo and Video category within a day of its release.Powered by OpenAI’s upgraded Sora 2 media generation AI model, the app allows users to create high-definition videos from simple text prompts. After it processes one-time video and audio recordings of users’ likenesses, Sora allows users to embed lifelike “cameos” of themselves, their friends and others who give their permission. The app is a recipe made for virality. But many of the videos published within the first day of Sora’s debut have also raised alarm bells from copyright and deepfake experts.Users have so far reported being able to feature video game characters like Lara Croft or Nintendo heavyweights like Mario, Luigi and even Princess Peach in their AI creations. One user inserted Ronald McDonald into a saucy scene from the romantic reality TV show “Love Island.” The Wall Street Journal reported Monday that the app would enable users to feature material protected by copyright unless the copyright holders opted out of having their work appear. However, the report said, blanket opt-outs did not appear to be an option, instead requiring copyright holders to submit examples of offending content.Sora 2 builds on OpenAI’s original Sora model, which was released to the public in December. Unlike the original Sora, Sora 2 now enables users to create videos with matching dialogue and sound effects.AI models ingest large swaths of information in the “training” process as they learn how to respond to users’ queries. That data forms the basis for models’ responses to future user requests. For example, Google’s Veo 3 video generation model was trained on YouTube videos, much to the dismay of some YouTube creators. OpenAI has not clearly indicated which exact data its models draw from, but the appearance of characters under copyright indicates that it used copyright-protected information to design the Sora 2 system. China’s ByteDance and its Seedance video generation model have also attracted recent copyright scrutiny.OpenAI faces legal action over copyright infringement claims, including a high-profile lawsuit featuring authors including Ta-Nehisi Coates and Jodi Picoult and newspapers like The New York Times. OpenAI competitor Anthropic recently agreed to pay $1.5 billion to settle claims from authors who alleged that Anthropic illegally downloaded and used their books to train its AI models. In an interview, Mark McKenna, a law professor and the faculty director of the UCLA Institute for Technology, Law, and Policy, drew a stark line between using copyrighted data as an input to train models and generating outputs that depict copyright-protected information.“If OpenAI is taking an aggressive approach that says they’re going to allow outputs of your copyright-protected material unless you opt out, that strikes me as not likely to work. That’s not how copyright law works. You don’t have to opt out of somebody else’s rules,” McKenna said.“The early indications show that training AI models on legitimately acquired copyright material can be considered fair use. There’s a very different question about the outputs of these systems,” he continued. “Outputting visual material is a harder copyright question than just the training of models.”As McKenna sees it, that approach is a calculated risk. “The opt-out is clearly a ‘move fast and break things’ mindset,” he said. “And the aggressive response by some of the studios is ‘No, we’re not going to go along with that.’”Disney, Warner Bros. and Sony Music Entertainment did not reply to requests for comment.In addition to copyright issues, some observers were unsettled by one of the most popular first-day creations, which depicted OpenAI CEO Sam Altman stealing valuable computer components from Target — illustrating the ease with which Sora 2 can create content depicting real people committing crimes they had not actually committed. Sora 2’s high-quality outputs arrive as some have expressed concerns about illicit or harmful creations, from worries about gory scenes and child safety to the model’s role in spreading deepfakes. OpenAI includes techniques to indicate Sora 2’s creations are AI-generated as concerns grow about the ever-blurrier line between reality and computer-generated content.Sora 2 will include moving watermarks on all videos on the Sora app or downloaded from sora.com, while invisible metadata will indicate Sora-generated videos are created by AI systems.However, the metadata can be easily removed. OpenAI’s own documentation says the metadata approach “is not a silver bullet to address issues of provenance. It can easily be removed either accidentally or intentionally,” like when users upload images to social media websites.Siwei Lyu, a professor of computer science and the director of the University of Buffalo’s Media Forensic Lab and Center for Information Integrity, agreed that multiple layers of authentication were key to prove content’s origin from Sora. “OpenAI claimed they have other responsible use measures, such as the inclusion of visible and invisible watermarks, and tracing tools for Sora-made images and audio. These complement the metadata and provide an additional layer of protection,” Lyu said.“However, their effectiveness requires additional testing. The invisible watermark and tracing tools can only be tested internally, so it is hard to judge how well they work at this point,” he added.OpenAI addressed those limitations in its technical safety report, writing that “we will continue to improve the provenance ecosystem to help bring more transparency to content created from our tools.” OpenAI did not immediately reply to a request for comment.Though the Sora app is available for download, access to Sora’s services remains invitation-only as OpenAI gradually increases access. Jared PerloJared Perlo is a writer and reporter at NBC News covering AI. He is currently supported by the Tarbell Center for AI Journalism.
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