(BREAK) JOHN YANG: Tonight on PBS News Weekend, what billions of dollars in proposed Medicaid cuts could mean for the millions of Americans who are caregivers for loved ones.

Then, a new nationwide study finds a link between preteens use of social media and symptoms of depression.

And how some cities are taxing sodas and other sugary drinks in an effort to boost public health.

WOMAN: The overall effect of the tax in Philly was a 35% reduction in sales of these tax drinks.

I've been working in this area for about 20 years and I have never seen a behavioral effect that large.

Right.

(BREAK) JOHN YANG: Good evening.

I'm John Yang.

As Congress's Memorial Day recess gets underway, House Republicans are catching their breaths after narrowly passing the multitrillion dollar bill advancing President Trump's domestic agenda.

And Senate Republicans are preparing for the battles ahead when they consider the measure next month.

One item that's sure to be debated in the Senate is The House bill's $700 billion in savings in Medicaid, the nation's biggest health insurance program, especially the strict work requirement.

Jason Resendez is the president and CEO of the National Alliance for Caregiving, a coalition of organizations that advocates for the estimated 53 million Americans who serve as caregivers for loved ones.

Jason, I think people think of Medicaid, they think of people going to the doctor.

But explain to us how it benefits or how the family caregivers are supported by this.

JASON RESENDEZ, CEO, National Alliance for Caregiving: Absolutely.

Medicaid is a lifeline for millions of family caregivers who provide ongoing demanding care for aging Americans, people with disabilities or people with a serious illness.

Medicaid is a primary payer for home and community based services like transportation, meal support in home care assistance.

These are services that enable families and family caregivers to keep people with those serious illnesses like Alzheimer's and cancer or with disabilities in the home and in communities instead of having to opt into more costly institutionalized care.

JOHN YANG: And so how would what's in the House bill affect that?

JASON RESENDEZ: The House bill, if enacted, would reshape how care is provided in this country in a couple of key ways.

One, it'll force states to make decisions about its Medicaid program and what to fund because of reduced funding.

Usually historically, what is first on the chopping block are those home and community based services.

So it'll be harder to access those essential home and community based services.

Second is work requirements.

Really strict work requirements would add a really steep administrative burden onto the shoulders of family caregivers.

Family caregivers who are already navigating really complicated bureaucracy.

And then third will be a loss of health care coverage.

The Congressional Budget Office estimates that 14 million folks will lose health care coverage.

We know that over 4 million Americans are family caregivers who rely on Medicaid for their own health care coverage.

So that's at stake.

JOHN YANG: And the additional burden on caregivers because of the work requirement is they have to report what they're that they are working and certified that they are working.

Work requirements are popular with the American people.

There was a recent KFF poll that found that 62 percent of those questions said they supported work requirements.

What do you say to that?

JASON RESENDEZ: I say work requirements simply don't work.

We see that in places like Georgia and Arkansas where we're spending more on administrative costs and actually providing care.

When it comes to the work requirements in the House pass bill, we know that it'll set up really dangerous situation where family caregivers are forced to navigate really strictly and burdensome paperwork on top of the paperwork they're already navigating alongside providing daily care.

So really risking them losing coverage and the people that they're caring for receiving worse care.

JOHN YANG: During the House debate this past week, the House Republicans said that this was a matter for getting rid of waste, fraud and abuse.

Speaker Johnson said it's to return the dignity of work.

What do you say to that?

RESENDEZ: When we actually look at the data of Medicaid recipients who aren't working, what we see is that the majority aren't working because of medical conditions, because of old age, because of disabilities, or because they're providing care.

To say that these Medicaid work requirements are about getting to fraud, waste and abuse is assuming that these folks are out to game the system when that's far from the case.

So Speaker Johnson and the GOP is really out of step with what's planning playing out in American communities and families across the country.

JOHN YANG: Next up is the Senate.

And it's not just moderates like Senators Murkowski and Collins who don't like some of these cuts.

You've got a conservative like Senator Josh Hawley in Missouri who says these cuts go too deep.

What do you think is going to happen in the Senate?

JASON RESENDEZ: What we're hoping is that folks like Josh Hawley continue to champion the importance of Medicaid for supporting American families, for supporting the health and wellness of American families, and that senators like Susan Collins and Shelley Moore Capito, senators who have a personal connection to caregiving, keep that in mind as they determine the fate of this really drastic bill that would reshape how care is provided in this country.

JOHN YANG: Jason Resendez, thank you very much.

JASON RESENDEZ: Thanks for having me.

JOHN YANG: In tonight's other news, Russia and Ukraine exchanged hundreds of prisoners today just hours after a large scale Russian attack on Kyiv.

At least 15 people were injured when Russia launched ballistic missiles and drones into Ukraine's capital.

The mayor said air raid sirens warned of the incoming attack, which damaged apartment buildings and a mall.

Across Ukraine, 13 people were killed in other ballistic missile attacks.

Russia later said it hit only military targets.

Hours later, the two countries exchanged hundreds of soldiers.

Each side said 300 military personnel were repatriated and that there may be another swap tomorrow.

If there is, it could make this weekend's exchanges the biggest since Russia's full scale invasion three years ago.

There's been a major restructuring of President Trump's National Security Council under interim National Security Adviser Marco Rubio, the secretary of state.

PBS News has learned that dozens of NSC staff members have been removed from their roles, including the deputy National Security Advisor and the senior directors of Europe and the Middle East.

Many of the positions will not be filled.

Since its creation in 1947, the NSC has traditionally played a big role in developing a president's diplomatic and security policies, coordinating with the State and Defense departments.

The U.S. measles outbreak has passed a milestone.

The CDC says that more than 1,000 confirmed cases have been reported in 31 states.

96 percent of the patients are either unvaccinated or their vaccination status is unknown.

Most of the confirmed cases have been in West Texas.

Across Texas, 728 cases have been reported.

The CDC says the MMR vaccine, which protects against measles, is very safe and effective.

And another milestone for tennis star Novak Djokovic, his victory today in the Geneva Open is his 100th career singles title.

Djokovic, who turned 38 on Thursday, powered his way to victory in three sets.

He later said he felt like he was trailing most of the match.

Djokovic is just the third man to win 100 titles in the Open era, after Jimmy Connors and Roger Federer.

And caretakers at a San Diego wildlife center are going to great lengths to rehabilitate a young black bear cub.

The two-month old was found by campers last month, weak and malnourished.

The area was monitored in hopes that his mother would return, but she never did.

Now wildlife center workers are playing that role, giving him around the clock care.

They wear a bear suit so that the cub doesn't bond with humans.

They'll care for the cub for about a year before attempting to release him back into the wild.

Still to come on PBS News Weekend, the effect preteen social media use may have on their mental health and do taxes on sodas and sugary drinks result in better health outcomes.

(BREAK) JOHN YANG: A new study has found a link between preteens use of social media and future depression.

The study was conducted by researchers at the University of California, San Francisco and published this week in the American Medical Journal's association journal JAMA.

The study said more time spent on social media may contribute to increased depressive symptoms over time.

Ali Rogin spoke with the lead researcher, Dr. Jason Nagata.

ALI ROGIN: Dr. Nagata, thank you so much for joining us.

Social media children, lots of questions, few answers.

What did your study find?

DR. JASON NAGATA, University of California, San Francisco: We followed 12,000 preteens over three years and we actually found big rises in social media use.

So during that period, social media on average increased from seven minutes a day to over 70 minutes a day.

So a tenfold increase.

And in our analysis, we actually found that rises in social media from year to year among these 9 then 10 then 11-year olds were actually associated with future depressive symptoms in the following year.

So I think there's a big kind of unknown in the field right now.

Chicken or the egg?

Does social media precede depression or is it maybe just reflection of underlying symptoms?

And I think that our study does show a little bit more stronger evidence that social media is a risk factor for future depression in these kids.

ALI ROGIN: So what you're saying is that you found the correlation here to be with social media use leading to more depressive symptoms, not the other way around.

You're saying that depression doesn't necessarily indicate use of social media?

JASON NAGATA: Yes.

In our study, were able to follow these same 12,000 kids year to year.

So were able to look at both their depression and their social media use every single year.

And so we could look at patterns in their use.

And we found that those kids who had big spikes in their social media use from year to year then subsequently had bigger spikes in their depression.

But those kids who started off with increases in depression didn't necessarily use social media more.

So it is indicating a little bit more of directionality that social media could be a risk factor for future depression.

ALI ROGIN: And talk to us about the size and the scope of this study.

This sounds massive.

How did you track this many children and has that been done before?

JASON NAGATA: So, yeah, the data comes from the Adolescent Brain Cognitive Development Study.

It is a national study that follows these 12,000 kids from over 21 different states, study sites across the U.S. and it's funded by the National Institutes of Health and is I think one of the largest studies on child development and social media and brain health ever.

ALI ROGIN: You are a physician, I know you're also a parent.

And I wonder, seeing these results, what does it make you hope policymakers consider when thinking about social media's impact on children?

JASON NAGATA: I think one really important thing for policymakers to know is that technically the minimum age requirement for social media is 13 years.

But this study essentially represented underage use of social media and we found that even among 11 to 12 year olds, over two-thirds had social media accounts and on average they had three or more different accounts.

So these are all kids who had to put in fake dates of birth in order to get access to these sites.

And I think it's just a reminder that there's not really robust age verification.

So any kid, no matter their age, as long as they can put in a fake date of birth currently is able to very easily access these sites.

And many of the kids did report that they had secret accounts that their parents didn't know about.

So I think one thing for policymakers to really understand is that the landscape right now is very easy for kids to get on and there aren't very strong securities for privacy and protection for kids.

ALI ROGIN: That's such a fascinating ancillary piece of information that you found in looking at this data.

I do want to ask though, what is your advice for parents with the understanding that this data brings us to.

JASON NAGATA: Yeah, we actually looked at parent actions for rules and monitoring in the study and we actually found that the biggest predictors of kids screen use was actually their parents screen use.

And as a new parent I think it's really important to practice what you preach.

So if you're going to tell your kids to put down their phones to important that you role model good behaviors otherwise your kids aren't going to follow the rules.

The other two times that it might be really high yield to limit screen use is bedtime to try to promote good sleep and also around meal time to prevent overeating because we know kids tend to overeat while they're distracted in front of screens and also encourage in person connections and conversations around the dinner table.

ALI ROGIN: Limiting social media around our kids.

Something I think most parents, including myself, should, should heed.

Dr. Jason Nagata with the University of California, San Francisco.

Thank you so much for joining us.

JASON NAGATA: Thanks so much for.

JOHN YANG: Experts say drinking a lot of sweetened beverages can lead to obesity, diabetes and heart disease.

This week, the federal government reversed decades of policy and allowed states to ban the use of food stamps to buy soda and other sweetened drinks.

In addition, a handful of cities have put taxes on them over the strong objections of the beverage industry.

To find out more, went to opposite coasts.

JOHN YANG (voice-over): At a corner shop in Philadelphia, steps from the Liberty Bell, a 20 ounce bottle of Coca Cola cost $3.09.

But just a few miles south beyond the city limits, a PBS News producer found a price of $2.79, 30 cents cheaper.

Why the difference?

Since 2017, Philadelphia has taxed sugar sweetened drinks at a rate of 1 1/2 cents an ounce.

The city council imposed the levy as a public health measure.

CHRISTINA ROBERTO, University of Pennsylvania: I did not think a sweetened beverage tax was going to actually impact health.

JOHN YANG: Why not?

CHRISTINA ROBERTO: Well, it's just very difficult to influence weight.

Our bodies are biologically designed to actually help us keep weight once we gain it.

JOHN YANG (voice-over): Christina Roberto and researchers at the University of Pennsylvania track the effects of the tax.

Some of what they found surprised them.

CHRISTINA ROBERTO: The overall effect of the tax in Philly was a 35 percent reduction in sales of these tax drinks.

Now, I've been working in this area for about 20 years.

And I have never seen a behavioral effect that large.

Right.

Like eating behavior is so hard to change, let alone change it over the long term.

And so to me, I just felt like, oh my gosh, this is an incredible intervention to actually get people to, you know, stop or consume fewer of these drinks that we know are making us sick.

JOHN YANG: So people buying less, drinking less, you wanted to find out what that translated into.

CHRISTINA ROBERTO: The rate at which they were gaining weight in Philadelphia was a bit slower than in these places nearby that weren't subject to the tax.

You're seeing a health effect on an outcome that is incredibly difficult to move.

JOHN YANG: Philadelphia is the biggest U.S. City with a sugar sweetened beverage tax on the books.

Here, 3,000 miles away, the beach town of Santa Cruz, California has become the latest city to approve one.

MARTINE WATKINS, Former Mayor, Santa Cruz, California: It's a great place to be.

Yeah, I really enjoyed it.

JOHN YANG (voice-over): Martine Watkins, former mayor of this city of about 60,000 people, began pushing the tax in 2016 when she first ran for city council.

The idea came from her brother, who works in health policy.

He also urged her to think about health in all policy decisions.

MARTINE WATKINS: He was like teens.

That's what he calls me.

You got to do this.

Learning about that framework really resonated with me.

And that health is more than hospitals, health is more than healthcare.

Health is the environment in which we're able to thrive in.

And how I, at the local level, could influence that.

JOHN YANG (voice-over): Beginning in 2014, when Berkeley voters passed the nation's first modern soda tax, similar levies were approved in other California cities.

In the face of this building momentum at the ballot box, the beverage industry turned to state lawmakers.

In Sacramento, a lobbying effort won passage of a law banning local soda taxes until 2031.

Despite that, last year, led by current Santa Cruz mayor Fred Keeley and Vice Mayor Shebreh Kalantari-Johnson, the city council put a 2 cent an ounce tax on sugar sweetened soft drinks on the ballot.

JOHN YANG: Were you looking to challenge the state law?

SHEBREH KALANTARI-JOHNSON, Vice Mayor, Santa Cruz: We were looking to do what is within our rights as a charter city to raise revenue for our community and invest it back in health.

That's what were looking to do.

JOHN YANG: And Mr. Mayor, what were your thoughts about this?

I mean, I would imagine a more cautious mayor might have said, I don't want to get into this fight.

I see court challenges ahead.

I see rough waters ahead.

MAYOR FRED KEELEY, Santa Cruz: The thought that the city has is that, to put it bluntly, this is the right thing to do and not to be scared off by an industry with a very large war chest and a very determined approach to smothering these in the cradle every time they get a chance to do so.

JOHN YANG (voice-over): The opposition in Santa Cruz was a replay of what the beverage industry did in Philadelphia in 2016.

Back then, it organized a broad coalition that included the Teamsters Union and characterized the soda tax as a regressive tax on groceries.

Even in much smaller Santa Cruz, the industry went all out.

JOHN YANG: Talk a bit about what the beverage industry did with all that money.

How did they deliver their message?

FRED KEELEY: Well, I would think a shorter answer is what didn't they do?

I think the only thing they didn't do was skywriting.

Other than that, they did everything.

And I think that's part of why they lost, Frankly.

They spent $2.8 million to get 7, 8, 9,000 votes.

They could have walked around handing out hundred dollar bills to people.

That may have been a better outcome for them.

WOMAN: So don't swallow the spin.

Vote no on Measure Z. JOHN YANG (voice-over): The campaign against the tax, which was on the ballot as Measure Z, drew on the high cost of living in Santa Cruz.

FAITH, Santa Cruz Educator: Santa Cruz just hiked the sales tax on groceries.

Now they want to hit us again.

JOHN YANG (voice-over): The coalition the beverage industry organized was called the Campaign for an Affordable Santa Cruz.

MARTINE WATKINS: If you're looking on YouTube, on the TV or on just the local news station, there's just advertisements, mailers.

I have some here if you want to see.

JOHN YANG: Please show it to us.

MARTINE WATKINS: Yeah, I mean, every day, nearly you would get a mailer coming in to your home and talking about why you should vote no on Measure Z. JOHN YANG: And how did they characterize it?

What was their argument?

MARTINE WATKINS: You know, their argument was, I think they had sort of two.

Well, it looks like they had more or less three, failed, regressive and illegal.

LOLIS RAMIRES, California: We would show up and everyone would get a clipboard with a hefty packet of information.

JOHN YANG (voice-over): The yes side relied on a small group of canvassers led by Lolis Ramirez, a veteran of California grassroots campaigns, and Blythe Young of the American Heart Association.

BLYTHE YOUNG, American Heart Association: We found that giving people their neighborhoods to go talk to their neighbors about this tax and explain why it was important to them, what brought them to this issue was really compelling.

LOLIS RAMIRES: My father has type 2 diabetes.

My grandmother has type 2 diabetes.

You know, I am a Latina.

I'm likely to have it in my life if I don't make good choices for myself.

JOHN YANG (voice-over): Organizers behind the tax said it was crucial to have some small business owners on their side.

Damani Thomas, head chef and owner of Oswald, a downtown restaurant, said he'd seen and experienced the effects of sugary drinks firsthand.

DAMANI THOMAS, Owner, Oswald: Being a black person, I know a lot of people are pre-diabetic.

A lot of the youngsters are pre diabetic.

When I was a young person, me and My friends, we would get this thing that was called the Thirsty 2 Ouncer.

It's a 32 ounce soda, and we would get every flavor and we call it a suicide.

And you know, at the end of the day, you know, if you keep going with that, it is suicide.

JOHN YANG: And since sugary drinks are a major contributor tooth decay, the most common childhood disease, dentists were natural allies.

WOMAN: Yes.

Thank you.

LAURA MARCUS, CEO, Dientis: Speaking to as many people as possible is the way that these grassroots movements actually work.

JOHN YANG: Laura Marcus is the CEO of Dientis, a Santa Cruz nonprofit providing affordable dental care for low income residents.

LAURA MARCUS: We saw what happened when the tobacco tax was passed in our state and the profound impact it had on smoking rates.

It was incredible.

People stopped smoking.

A small 2 cent tax is something that won't have a profound impact on the individual, but yet could in the end have a large impact on the community.

JOHN YANG (voice-over): In fact, the Penn study of the Philadelphia tax found a large impact on the very type of patient that Dientis serves.

CHRISTINA ROBERTO: When we broke our sample down by people who were on Medicaid or not, that group had a 20 percent reduction in dental caries.

And we saw the same thing in adults as in kids.

JOHN YANG (voice-over): In the end, the no side spent $2.8 million.

The yes side less than $100,000.

JOHN YANG: Going into the election day.

Were you confident?

Were you worried?

MARTINE WATKINS: I'm always worried.

JOHN YANG: What was the margin?

MARTINE WARKINS: Slim.

You were about 52.

About 52 percent.

JOHN YANG (voice-over): On May 1, Santa Cruz began collecting the tax in defiance of the statewide ban.

City officials are braced for a court fight with the beverage industry.

In a statement to PBS News, the American Beverage Association said, we are assessing our next steps to as Santa Cruz implements its illegal tax.

Despite the prospect of rough legal seas ahead, Santa Cruz officials hope their new tax will encourage actions by other states and cities.

JOHN YANG: Now on the NewsHour Instagram account, Kermit the Frog gives this year's University of Maryland graduates and advice on staying together and following their dreams.

All that and more is on the Instagram account.

And that is PBS News Weekend for this Saturday.

Tomorrow, an endurance swimmers plan to circle Martha's Vineyard to change perceptions about sharks 50 years after the premiere of the movie Jaws.

I'm John Yang.

For all of my colleagues, thanks for joining us.

See you tomorrow.

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