Category Archives: Health & Human Services

Trump administration revives “gag rule” on abortion

unborn baby

From NY Post: The Trump administration on Friday resurrected a Reagan-era rule banning federally funded family planning clinics from referring women for abortions or sharing space with abortion providers.

The Department of Health and Human Services announced the proposal Friday in a move aimed at burnishing the formerly pro-choice president’s pro-life credentials in the eyes of his evangelical base.

The policy has been derided as a “gag rule” by abortion rights supporters and medical groups, and it is likely to trigger lawsuits that could keep it from taking effect. But it’s guaranteed to galvanize activists on both sides of the abortion debate going into the congressional midterm elections.

The announcement came as President Trump was scheduled to speak at the Susan B. Anthony List’s “campaign for life” gala on Tuesday night. The group works to elect candidates who want to reduce and ultimately end abortion.

It says it spent more than $18 million in the 2016 election cycle to defeat Hillary Clinton and promote a “pro-life Senate.”

The Reagan-era rule barred family planning clinics from discussing abortion with women. It never went into effect as written, although the Supreme Court ruled that it was an appropriate use of executive power.

The policy was rescinded under President Bill Clinton, and a new rule went into effect that required “nondirective” counseling to include a full range of options for women.

According to a Trump administration summary, the new proposal will roll back the Clinton requirement that abortion should be discussed as an option along with prenatal care and adoption.

Known as Title X, the nation’s family planning program serves about 4 million women a year through clinics, at a cost to taxpayers of about $260 million.

Abortion is a legal medical procedure, but by law, federal family planning funds cannot be used to pay for abortion procedures.

Abortion opponents say a taxpayer-funded family planning program should have no connection to abortion.

Doctors’ groups and abortion rights supporters say a ban on counseling women trespasses on the doctor-patient relationship.

“This is an attempt to take away women’s basic rights, period,” said Dawn Laguens, a senior Planned Parenthood executive who hinted at possible legal action to try to block the Trump administration move, saying, “we will not stand by while our basic health care and rights are stripped away.”

“I cannot imagine a scenario in which public health groups would allow this effort to go unchallenged,” said Jessica Marcella of the National Family Planning & Reproductive Health Association, which represents family planning clinics.

Marcella said requiring clinics to be physically separate from facilities in which abortion is provided is impractical, and would disrupt services for women across the country.

But abortion foes said Trump is merely reaffirming the core mission of the family planning program. “The new regulations will draw a bright line between abortion centers and family planning programs, just as … federal law requires and the Supreme Court has upheld,” said Tony Perkins, president of the Family Research Council, a key voice for religious conservatives.

Kristan Hawkins of Students for Life of America said, “Abortion is not health care or birth control and many women want natural health care choices, rather than hormone-induced changes.”

The Trump administration overview of the proposal said it’s not a “gag rule.”

It “will not prohibit counseling for clients about abortion … but neither will it include the current mandate that (clinics) must counsel and refer for abortion,” said the administration document.

Abortion rights supporters suggest that’s a distinction without a difference, since the ban on referring a woman for an abortion could amount to overriding the judgment of medical professionals. They also say women will have no guarantee of getting a full review of all their options.

The Republican-led Congress has unsuccessfully tried to deny federal funds to Planned Parenthood, and the Trump administration has vowed to religious and social conservatives that it would keep up the effort.

DCG

US government seeking one million volunteers for massive study of DNA, health habits

What could possibly go wrong?

From NY Post: Wanted: a million people willing to share their DNA and 10 years of health habits, big and small, for science.

On Sunday, the US government will open nationwide enrollment for an ambitious experiment: If they can build a large enough database comparing the genetics, lifestyles and environments of people from all walks of life, researchers hope to learn why some escape illness and others don’t, and better customize ways to prevent and treat disease.

“A national adventure that is going to transform medical care” is how Dr. Francis Collins, director of the National Institutes of Health, describes his agency’s All of Us Research Program.

Congress has authorized $1.45 billion over 10 years for the project. It all hinges on whether enough people around the country will sign up, either online or through participating health centers.

There’s already interest: More than 25,000 people got early entry to the project over the past year through an invitation-only pilot test run by participating universities and health providers.

Why study so many? Most of today’s medical care is based on what happened to the average person in short studies of a few hundred or thousand patients with a specific health condition.

And most people who volunteer for those studies are white, leaving questions about the best care for people of different races.

“One-size-fits-all is far from an optimal strategy,” Collins said Tuesday in announcing enrollment for All of Us.

The project involves “precision medicine,” using traits that make us unique to forecast and treat disease. Learning enough to individualize care requires studying a massive number of participants: the healthy and not-so-healthy, young and old, rural and urban, blue-collar and white-collar — and people of all races and ethnicities.

For now, participants must be at least 18. Next year, the study will open to children, too.

While there are other big “biobanks” of genetic data from at least 100,000 people, the NIH project aims to be the largest and most diverse of its kind. At least half of the participants must be from groups traditionally under-represented in medical research, Collins stressed.

Genes aren’t the whole story: Sure, what genes you harbor can raise your risk for various diseases. But other factors can increase or reduce some genetic risks.

So first volunteers will share electronic health records and blood samples, and answer periodic questionnaires about their diet, sleep, environmental exposures and other lifestyle factors. Theymight wear fitness trackers and other sensors.

And later this year they’ll start undergoing genetic testing, initially to look for so-called “variants” in DNA that affect disease risk, similar to what some private companies now sell, Collins said. Fully mapping the genetic code is too pricey now for a million people, but that more comprehensive approach eventually will be used with some participants, too.

Among the first lessons Collins hopes to learn is about resilience: Why do some people stay healthy despite smoking or pollution or poor nutrition? “We have no idea how those people escape those odds,” he said.

Learn your results: Unlike with most medical studies, participants can choose to see their own test results and share them with their physician long before the study reaches any big-picture conclusions. A caution: There are still many questions about how best to use the results of genetic tests. Still, “we will try to help their doctors sort through what it means,” Collins said.

One result that might bring a quick benefit: Genetic variants can signal who is prone to side effects from more than 100 drugs, information that could be used to prescribe a safer drug if only their doctors knew, Collins added.

Protecting privacy: The privacy of DNA databases made headlines last week when investigators used a free genealogy website to track down a suspected California serial killer. That’s pretty different than the security under which medical DNA must be handled.

NIH said it has taken as many steps as possible to safeguard against would-be hackers. Volunteers’ medical data is stripped of identifying information and replaced with a code. Only scientists meeting specific security requirements will be cleared to study the data. NIH also said federal “certificates of confidentiality” prohibit disclosure to law enforcement.

Privacy wasn’t a worry for Michelle McNeely, 41, an early participant at Dallas’ Baylor Scot & White Health System. She underwent breast cancer treatment in 2016 and considers taking part in All of Us a way to give back.

“If they can use my genes and someone’s genes in California and someone’s genes in New York to find some common ground, to help discover some cure — they can use my genes all day long,” McNeely said.

DCG

Congress critters trying to defund Planned Parenthood — and those who are not

It may seem like this:

But there are good people trying to reverse the avalanche-sized tide.

(1) The Trump State Department has removed the term “reproductive rights” — a euphemism for abortion — from its annual human rights report, U.S. Country Reports on Human Rights Practices for 2017, released last week.

Replacing “reproductive rights” is the more accurately-descriptive term, “coercion in population control”. The new “Coercion in Population Control” section is under a larger section of each country’s report, titled “Discrimination, Societal Abuses, and Trafficking in Persons,” which features reports of coerced abortion, involuntary sterilization procedures, and “other coercive population control methods.”

The “reproductive rights” term was first coined by, no surprise, the Obama administration in the 2012 State Department report. (Catholic News Agency)

(2) 41 senators and 153 House members are trying to defund Planned Parenthood via changing the Title X Family Planning Program.

Although both President Trump and the GOP-dominant Congress have made multiple attempts to defund Planned Parenthood, taxpayers are still funding the abortion mill. Planned Parenthood executed an astounding 321,384 abortions in 2016 and still continues to receive an average of nearly $60 million annually from the Title X program.

On April 30, 2018, 41 senators and 153 representatives sent a letter to Department of Health and Human Services (HHS) Secretary Alex Azar requesting that the department move swiftly to issue new regulations for the Title X Family Planning Program. Existing Title X regulations blur the line between abortion and family planning.

The letter calls for revised regulations that will require the federally-funded Title X service sites to be physically and financially separate from facilities that provide abortion, and to eliminate the federal mandate requiring Title X providers to refer for abortions.

To read the House letter, click here.

To read the Senate letter, click here.

Below are the names of the senators and representatives who signed and did not sign the letter. You’ll be surprised by some of the “did not sign” names.

The 41 senators, all Republicans, who signed the letter are:

  1. John Barrasso (R-Wyoming)
  2. Roy Blunt (R-Missouri)
  3. John Boozman (R-Arkansas)
  4. Richard Burr (R-North Carolina)
  5. Bill Cassidy, MD (R-Louisiana)
  6. John Cornyn (R-Texas)
  7. Tom Cotton (R-Arkansas)
  8. Mike Crapo (R-Idaho)
  9. Ted Cruz (R-Texas)
  10. Steve Daines (R-Montana)
  11. Michael B. Enzi (R-Wyoming)
  12. Joni K. Ernst (R-Iowa)
  13. Deb Fischer (R-Nebraska)
  14. Lindsey Graham (R-South Carolina)
  15. Chuck Grassley (R-Iowa)
  16. Orrin G. Hatch (R-Utah)
  17. John Hoeven (R-North Dakota)
  18. Cindy Hyde-Smith (R-Mississippi)
  19. James N. Inhofe (R-Oklahoma)
  20. Johnny Isakson (R-Georgia)
  21. Ron Johnson (R-Wisconsin)
  22. John Kennedy (R-Louisiana)
  23. James Lankford (R-Oklahoma)
  24. Michael S. Lee (R-Utah)
  25. Mitch McConnell (R-Kentucky)
  26. Jerry Moran (R-Kansas)
  27. Rand Paul (R-Kentucky)
  28. Dave Perdue (R-Georgia)
  29. Rob Portman (R-Ohio)
  30. James E. Risch (R-Idaho)
  31. Pat Roberts (R-Kansas)
  32. E. Michael Rounds (R-South Dakota)
  33. Marco Rubio (R-Florida)
  34. Ben Sasse (R-Nebraska)
  35. Tim Scott (R-South Carolina)
  36. Dan Sullivan (R-Alaska)
  37. John Thune (R-South Dakota)
  38. Thom Tillis (R-North Carolina)
  39. Pat Toomey (R-Pennsylvania)
  40. Roger F. Wicker (R-Mississipi)
  41. Todd Young (R-Indiana)

10 Republican senators did not sign the letter:

  1. Lamar Alexander (R-Tennessee)
  2. Susan Collins (R-Maine)
  3. Bob Corker (R-Tennessee)
  4. Jeff Flake (R-Arizona)
  5. Cory Gardner (R-Colorado)
  6. Dean Heller (R-Nevada)
  7. John McCain (R-Arizona)
  8. Shelley Moore Capito (R-West Virginia)
  9. Lisa Murkowski (R-Alaska)
  10. Richard Shelby (R-Alabama)

The 153 House representatives (152 Republicans, 1 Democrat) who signed the letter are:

  1. Ralph Abraham, MD (R-Louisiana)
  2. Robert Aderholt (R-Alabama)
  3. Rick Allen (R-Georgia)
  4. Jodey Arrington (R-Texas)
  5. Brian Babin (R-Texas)
  6. Don Bacon (R-Nebraska)
  7. Jim Banks (R-Indiana)
  8. Lou Barletta (R-Pennsylvania)
  9. Andy Barr (R-Kentucky)
  10. Jack Bergman (R-Michigan)
  11. Jaime Herrera Beutler (R-Washington)
  12. Andy Biggs (R-Arizona)
  13. Gus Bilirakis (R-Florida)
  14. Mike Bishop (R-Michigan)
  15. Diane Black (R-South Carolina)
  16. Marsha Blackburn (R-South Carolina)
  17. Mike Bost (R-Illinois)
  18. Kevin Brady (R-Texas)
  19. David Brat (R-Virginia)
  20. Ken Buck (R-Colorado)
  21. Larry Bucshon, MD (R-Indiana)
  22. Ted Budd (R-North Carolina)
  23. Michael Burgess, MD (R-Texas)
  24. Bradley Byrne (R-Alabama)
  25. Earl “Buddy” Carter (R-Georgia)
  26. Steve Chabot (R-Ohio)
  27. Liz Cheney (R-Wyoming)
  28. Tom Cole (R-Oklahoma)
  29. Doug Collins (R-Georgia)
  30. James Comer (R-Kentucky)
  31. K. Michael Conaway (R-Texas)
  32. Kevin Cramer (R-North Dakota)
  33. Rich Crawford (R-Arkansas)
  34. John Culberson (R-Texas)
  35. Warren Davidson (R-Ohio)
  36. Rodney Davis (R-Illinois)
  37. Scott DesJarlais (R-South Carolina)
  38. Ron DeSantis (R-Florida)
  39. Sean Duffy (R-Wisconsin)
  40. Jeff Duncan (R-South Carolina)
  41. Neil Dunn, MD (R-Florida)
  42. Tom Emmer (R-Minnesota)
  43. Ron Estes (R-Kansas)
  44. Drew Ferguson, DMD (R-Georgia)
  45. Chuck Fleischmann (R-South Carolina)
  46. Bill Flores (R-Texas)
  47. Jeff Fortenberry (R-Nebraska)
  48. Virginia Foxx (R-North Carolina)
  49. Matt Gaetz (R-Florida)
  50. Mike Gallagher (R-Wisconsin)
  51. Tom Garrett, Jr. (R-Virginia)
  52. Greg Gianforte (R-Montana)
  53. Bob Gibbs (R-Ohio)
  54. Bob Goodlatte (R-Virginia)
  55. Paul Gosar (R-Arizona)
  56. Garret Graves (R-Louisiana)
  57. Sam Graves (R-Missouri)
  58. Tom Graves (R-Georgia)
  59. Morgan Griffith (R-Virginia)
  60. Glenn Grothman (R-Wisconsin)
  61. Brett Guthrie (R-Kentucky)
  62. Gregg Harper (R-Mississippi)
  63. Andy Harris (R-Maryland)
  64. Vicky Hartzler (R-Missouri)
  65. Jeb Hensarling (R-Texas)
  66. Jody Hice (R-Georgia)
  67. Clay Higgins (R-Louisiana)
  68. Richard Hudson (R-North Carolina)
  69. Bill Huizenga (R-Michigan)
  70. Randy Hultgren (R-Illinois)
  71. Duncan Hunter (R-Calif)
  72. Evan Jenkins (R-West Virginia)
  73. Lynn Jenkins (R-Kansas)
  74. Bill Johnson (R-Ohio)
  75. Mike Johnson (R-Louisiana)
  76. Sam Johnson (R-Texas)
  77. Walter B. Jones (R-North Carolina)
  78. Jim Jordan (R-Ohio)
  79. Mike Kelly (R-Pennsylvania)
  80. Trent Kelly (R-Mississippi)
  81. Steve King (R-Iowa)
  82. David Kustoff (R-South Carolina)
  83. Raúl Labrador (R-Idaho)
  84. Darin LaHood (R-Illinois)
  85. Doug Lamborn (R-Colorado)
  86. Doug LaMalfa (R-Calif)
  87. Robert Latta (R-Ohio)
  88. Daniel Lipinski (D-Illinois)
  89. Billy Long (R-Missouri)
  90. Barry Loudermilk (R-Georgia)
  91. Mia Love (R-Utah)
  92. Blaine Luetkemeyer (R-Missouri)
  93. Kenny Marchant (R-Texas)
  94. Roger Marshall, MD (R-Kansas)
  95. Mark Meadows (R-North Carolina)
  96. Kevin McCarthy (R-Calif)
  97. Michael McCaul (R-Texas)
  98. Tom McClintock (R-Calif)
  99. Patrick McHenry (R-North Carolina)
  100. David McKinley (R-West Virginia)
  101. Luke Messer (R-Indiana)
  102. Paul Mitchell (R-Michigan)
  103. Alex Mooney (R-West Virginia)
  104. Kristi Noem (R-South Dakota)
  105. Ralph Norman (R-South Carolina)
  106. Peter Olson (R-Texas)
  107. Steven Palazzo (R-Mississippi)
  108. Gary Palmer (R-Alabama)
  109. Steve Pearce (R-New Mexico)
  110. Robert Pittenger (R-North Carolina)
  111. Ted Poe (R-Texas)
  112. Bill Posey (R-Florida)
  113. John Ratcliffe (R-Texas)
  114. Jim Renacci (R-Ohio)
  115. Martha Roby (R-Alabama)
  116. Cathy McMorris Rogers (R-Virginia)
  117. David Phil Roe, MD (R-Tennessee)
  118. Mike D. Rogers (R-Alabama)
  119. Dana Rohrabacher (R-Calif)
  120. Todd Rokita (R-Indiana)
  121. Francis Rooney (R-Florida)
  122. Peter Roskam (R-Illinois)
  123. Keith Rothfus (R-Pennsylvania)
  124. Steve Russell (R-Oklahoma)
  125. John Rutherford (R-Florida)
  126. David Rouzer (R-North Carolina)
  127. Steve Scalise (R-Louisiana)
  128. Austin Scott (R-Georgia)
  129. James Sensenbrenner, Jr. (R-Wisconsin)
  130. John Shimkus (R-Illinois)
  131. Bill Shuster (R-Pennsylvania)
  132. Adrian Smith (R-Nebraska)
  133. Christopher H. Smith (R-New Jersey)
  134. Jason Smith (R-Missouri)
  135. Lloyd Smucker (R-Pennsylvania)
  136. Chris Stewart (R-Utah)
  137. Claudia Tenney (R-New York)
  138. Michael Turner (R-Ohio)
  139. David Valadao (R-Calif)
  140. Ann Wagner (R-Missouri)
  141. Tim Walberg (R-Michigan)
  142. Mark Walker (R-North Carolina)
  143. Jackie Walorski (R-Indiana)
  144. Randy Weber (R-Texas)
  145. Daniel Webster (R-Florida)
  146. Brad Wenstrup, MD (R-Ohio)
  147. Bruce Westerman (R-Arkansas)
  148. Roger Williams (R-Texas)
  149. Joe Wilson (R-South Carolina)
  150. Robert Wittman (R-Virginia)
  151. Robert Woodall (R-Georgia)
  152. Kevin Yoder (R-Kansas)
  153. Ted Yoho, DVM (R-Florida)

85 House Republicans did not sign the letter:

  1. Justin Amash (R-Michigan
  2. Mark Amodei (R-N
  3. Joe Barton (R-Texas)
  4. Rob Bishop (R-Utah)
  5. Rod Blum (R-Iowa)
  6. Moe Brooks (R-Alabama)
  7. Susan Brooks (R-Indiana)
  8. Vern Buchanan (R-Florida)
  9. Ken Calvert (R-Calif)
  10. John Carter (R-Texas)
  11. Mike Coffman (R-Colorado)
  12. Chris Collins (R-New York)
  13. Barbara Comstock (R-Virginia)
  14. Paul Cook (R-Calif)
  15. Ryan Costello (R-Pennsylvania)
  16. Carlos Curbelo (R-Florida)
  17. John Curtis (R-Utah)
  18. Jeff Denham (R-Calif)
  19. Charles Dent (R-Pennsylvania)
  20. Mario Diaz-Balart (R-Florida)
  21. Daniel Donovan (R-New York)
  22. John Duncan Jr. (R-South Carolina)
  23. John Faso (R-New York)
  24. Brian Fitzpatrick (R-Pennsylvania)
  25. Rodney Frelinghuysen (R-New Jersey)
  26. Louie Gohmert (R-Texas)
  27. Trey Gowdy (R-South Carolina)
  28. Kay Granger (R-Texas)
  29. Karen Handel (R-Georgia)
  30. French Hill (R-Arkansas)
  31. George Holding (R-North Carolina)
  32. Trey Hollingsworth (R-Indiana)
  33. Will Hurd (R-Texas)
  34. Darrell Issa (R-Calif)
  35. David Joyce (R-Ohio)
  36. John Katko (R-New York)
  37. Ruben Kihuen (R-Nevada)
  38. Pete King (R-New York)
  39. Steve Knight (R-Calif)
  40. Adam Kinzinger (R-Illinois)
  41. Leonard Lance (R-New Jersey)
  42. Jason Lewis (R-Minnesota)
  43. Frank LoBiondo (R-New Jersey)
  44. Frank Lucas (R-Oklahoma)
  45. Tom MacArthur (R-New Jersey)
  46. Tom Marino (R-Pennsylvania)
  47. Thomas Massie (R-Kentucky)
  48. Brian Mast (R-Florida)
  49. Martha McSally (R-Arizona)
  50. Pat Meehan (R-Pennsylvania)
  51. John Moolenaar (R-Michigan)
  52. Markwayne Mullin (R-Oklahoma)
  53. Dan Newhouse (R-Washington)
  54. Devin Nunes (R-Calif)
  55. Erik Paulsen (R-Minnesota)
  56. Scott Perry (R-Pennsylvania)
  57. Bruce Poliquin (R-Maine)
  58. Tom Reed (R-New York)
  59. David Reichert (R-Washington)
  60. Tom Rice (R-South Carolina)
  61. Harold Rogers (R-Kentucky)
  62. Tom Rooney (R-Florida)
  63. Ileana Ros-Lehtinen (R-Florida)
  64. Dennis Ross (R-Florida)
  65. Ed Royce (R-Calif)
  66. Paul Ryan (R-Wisconsin)
  67. Mark Sanford (R-South Carolina)
  68. David Schweikert (R-Arizona)
  69. Pete Sessions (R-Texas)
  70. Mike Simpson (R-Idaho)
  71. Lamar Smith (R-Texas)
  72. Elise Stefanik (R-New York)
  73. Steve Stivers (R-Ohio)
  74. Scott Taylor (R-Virginia)
  75. Scott Tipton (R-Colorado)
  76. Glenn Thompson (R-Pennsylvania)
  77. Mac Thornberry (R-Texas)
  78. Dave Trott (R-Michigan)
  79. Fred Upton (R-Michigan)
  80. Greg Walden (R-Oregon)
  81. Mimi Walters (R-Calif)
  82. Steve Womack (R-Arkansas)
  83. David Young (R-Iowa)
  84. Don Young (R-Alaska)
  85. Lee Zeldin (R-New York)

Pray for the good people who are trying to reverse the tide.

~Eowyn

Thousands mistakenly enrolled in California’s Medicaid expansion

you don't say

Shocker, not.

From CNN Money: California signed up an estimated 450,000 people under Medicaid expansion who may not have been eligible for coverage, according to a report by the U.S. Health and Human Services’ chief watchdog.

In a Feb. 21 report, the HHS’ inspector general estimated that California spent $738.2 million on 366,078 expansion beneficiaries who were ineligible. It spent an additional $416.5 million for 79,055 expansion enrollees who were “potentially” ineligible, auditors found.

Auditors said nearly 90% of the $1.15 billion in questionable payments involved federal money, while the rest came from the state’s Medicaid program, known as Medi-Cal. They examined a six-month period from Oct. 1, 2014, to March 31, 2015, when Medicaid payments of $6.2 billion were made related to 1.9 million newly eligible enrollees.

There were limitations to the California review, however. The audit extrapolated from a sample of 150 beneficiaries. The authors reported a 90% confidence level in their results — whereas 95% would be more common. That meant that the number of those ineligible could have been as low as 260,000 or as high as 630,000.

“If HHS has a strong reason to believe that California is systematically making enrollment errors, it would be helpful to show that in a more robust analysis,” said Ben Ippolito, a health care economist at the American Enterprise Institute, a conservative think tank. “The federal government should ensure that states are being good stewards of federal money.”

Nonetheless, the audit highlighted weaknesses in California’s Medicaid program, the largest in the nation with 13.4 million enrollees and an annual budget topping $100 billion, counting federal and state money. Medicaid covers one in three Californians.

The inspector general found deficiencies in the state’s computer system for verifying eligibility and discovered errors by caseworkers. The Medicaid payments cited in the report covered people in the state’s fee-for-service system, managed-care plans, drug treatment programs and those receiving mental health services.

California’s Department of Health Care Services, which runs Medi-Cal, said in a statement that it agreed with nearly all of the auditors’ recommendations and that the agency “has taken steps to address all of the findings.”

In a written response to the inspector general, California officials said several computer upgrades were made after the audit period and before publication of the report that should improve the accuracy of eligibility decisions.

Among the 150 expansion enrollees analyzed in detail, 75%, or 112, were deemed eligible for the Medicaid program in California. Auditors discovered a variety of problems with the other 38 enrollees.

During the audit period, 12 enrollees in the sample group had incomes above 138% of the federal poverty line, making them ineligible financially for public assistance, according to the report.

In other instances, beneficiaries were already enrolled in Medicare, the federal health insurance for people 65 and older or who have severe disabilities, and did not qualify for Medi-Cal. Onewoman indicated she didn’t want Medi-Cal but was enrolled anyway.

In 2014, the state struggled to clear a massive backlog of Medi-Cal applications, which reached about 900,000 at one point. Many people complained about being mistakenly rejected for coverage, or their applications were lost in the state or county computer systems.

California was one of 31 states to expand Medicaid under the 2010 Affordable Care Act. The health law established a higher federal reimbursement for these newly eligible patients, primarily low-income adults without children. After expansion started in 2014, the HHS inspector general’s office began reviewing whether states were determining eligibility correctly and spending taxpayer dollars appropriately.

Read the rest of the story here.

DCG

Trump letter enables states to require Medicaid recipients to work

Medicaid is a 1960s-era Lyndon Johnson anti-poverty Great Society government program that provides free health insurance (as well as benefits not normally covered by Medicare, like nursing home care and personal care services) to low-income adults, their children, and people with disabilities, totaling 74 million recipients in 2017. Jointly funded by the state and federal governments, Medicaid is managed by the states, with each state currently having broad leeway to determine eligibility. Although states are not required to participate in the program, all have since 1982. Medicaid recipients must be U.S. citizens or legal permanent residents.

The Affordable Care Act, i.e., Obamacare, significantly expanded both federal funding and eligibility for Medicaid, to include all U.S. citizens and legal residents with income up to 133% of the poverty line.

The U.S. Department of Health and Human Services (HHS) determines the poverty thresholds, updated each year by the Census Bureau. For the 2017 poverty thresholds, go here. As an example, the poverty threshold for a family of four is $24,600. That means a family of four with an annual income of $32,718 (133% of $24,600) or lower is eligible for Medicaid.

Like Medicare and Social Security, the federal government’s spending on Medicaid has burgeoned since the 1990s. If nothing is done, Medicaid spending will balloon to $1½ trillion in 2022.

↓Click image to enlarge↓

The Trump administration has signaled from the outset that it wanted to set a more conservative tone for Medicaid. On the day in March when she was sworn in as administrator of the Centers for Medicare and Medicaid Services (CMMS), Seema Verma dispatched a letter to governors encouraging “innovations that build on the human dignity that comes with training, employment and independence.”

Currently, 10 states intend to impose work requirements on able-bodied adults who are receiving Medicaid, but they need federal permission to do so. The 10 states are Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah, and Wisconsin. Three other states are contemplating the work requirement — Alabama, Idaho, and South Dakota. (Washington Post)

Today, the Trump Administration issued a letter to state Medicaid directors which, for the first time in Medicaid’s half-century history, enables states to cut off Medicaid benefits to Americans unless they have a job, are in school, are a caregiver or participate in approved forms of community service — an idea that the Obama administration had consistently rejected.

To those who, predictably, will accuse President Trump of hard-heartedness, the letter specifies that:

“States must comply with federal civil rights laws, ensure that individuals with disabilities are not denied Medicaid for inability to meet these requirements, and have mechanisms in place to ensure that reasonable modifications are provided to people who need them.

States must also create exemptions for individuals determined by the state to be medically frail and should also exempt from the requirements any individuals with acute medical conditions validated by a medical professional that would prevent them from complying with the requirements . . . . As many Medicaid beneficiaries live in areas of high unemployment, or are engaged as caregivers for young children or elderly family members, states should consider a variety of activities to meet the requirements for work and community engagement . . . . States will be required to describe strategies to assist beneficiaries in meeting work and community engagement requirements and to link individuals to additional resources for job training or other employment services, child care assistance, transportation, or other work supports to help beneficiaries prepare for work or increase their earnings.”

CMMS could approve the first Medicaid work requirement waiver — probably for Kentucky — as soon as tomorrow!

Please keep President Trump in your prayers.

~Eowyn

Big rate hikes for health insurance will slam Washingtonians

O laughs

Obamacare going as planned…

This is not happening just in Washington. I have health insurance with BCBS OK and pay $550/month – up from $380/month last year. I have no co-pays (I pay the full contracted price when I walk through the doctor’s door) and a $6,800 annual deductible. BCBS informed me that my wonderful plan is being eliminated and I will soon receive my options for next year. I can hardly wait to see how much I get slammed.

From MyNorthwest.com: Open enrollment for health insurance in 2018 starts on Nov. 1 and thousands of people in Washington state will see big increases in their premiums.

The state’s insurance commissioner will officially release rates next week, and his office is warning that hundreds of thousands of people who do not get their insurance through an employer, will see a rate hike in the double digits.

Some 330,000 Washingtonians don’t get health insurance through an employer.

“I’m one of the folks who has to go out and get insurance on my own,” said Edward Weatherly, who is currently working a temp job. His monthly premiums?  “It costs me about $430 a month,” Weatherly said.

And the state’s insurance commissioner, Mike Kreidler, says rates for 2018 will go up – by a lot. “We’re looking at rate increases that are going to be in the 20s (percentage). We haven’t seen that, except going back before the Affordable Care Act,” Kreidler said.

The ones hardest hit will be the middle class – people who don’t qualify for a subsidy.

“It’s that person who doesn’t receive any help that I’m worried about. That’s going (to) say, ‘I’m going to hit the wall and I can’t afford this any longer,’” Kriedler said.

Weatherly is one of those individuals. He says it’s already difficult to make ends meet. “In addition to the rent, it’s pretty tough every month,” Weatherly said. “And there have been a couple of times I’ve thought about letting the insurance go.”

It gets worse – the insurance commissioner says people who are not subsidized with the most popular “Silver Plan” could see even more dramatic rate hikes. “On top of the mid-20 percent rate increase, they could see a 9 to 27 percent (increase) on top of that,” Kreidler said.

He says one reason for the steep increases is the uncertainty coming out of Washington, D.C. “I don’t care if they call it ‘Trumpcare’ whatever it is. But you’ve got to do something to make sure you’re taking care of the people. Access to affordable quality health insurance,” he said.

Weatherly says he’s hoping for a change.

I’m hoping we just get to a point where it becomes a right. So many things that we argue about, at both the national and the state level, that to me in the overall scheme of things don’t mean anything. It’s not life and death. Whereas health insurance, to me, is life and death,” Weatherly said.

The state insurance commissioner plans to release official rate hikes Thursday. Where you live could also impact how much your rates will go up, and the rates will be broken down by region, insurer and plan.

DCG

Washington state’s health-exchange rates to jump 24 percent

Shocker, not.

From Seattle Times: Washingtonians buying insurance through the state’s health-insurance exchange will see the largest premium increases next year since the exchange was created in 2013.

The Washington Health Benefit Exchange board this week approved rate increases averaging 24 percent. The rates, first approved by the state’s Office of the Insurance Commissioner, will impact about 180,000 customers.

“We at the exchange understand that, yes, this is going to create a challenging environment that is going to be difficult” for customers, said Michael Marchand, chief marketing officer and spokesman for the Washington Health Benefit Exchange, which was created after the Affordable Care Act (ACA) passed in 2010.

Customers of the exchange will also have fewer insurance providers to choose from in 2018. In King and Pierce counties the number drops from seven to four, Snohomish County goes from six to three and Kitsap County from four to three.

Rate increases averaged 11 percent last year, 4 percent in 2016 and 1 percent in 2015.

Read the rest of the story here.

DCG