Texas Dems are exhibiting ‘childlike behavior' with redistricting flee, says GOP strategist
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Miami Herald
6 minutes ago
- Miami Herald
Even in states that fought Obamacare, Trump's new law poses health consequences
GOP lawmakers in the 10 states that refused the Affordable Care Act's Medicaid expansion for over a decade have argued their conservative approach to growing government programs would pay off in the long run. Instead, the Republican-passed budget law that includes many of President Donald Trump's priorities will pose at least as big a burden on patients and hospitals in the expansion holdout states as in the 40 states that have extended Medicaid coverage to more low-income adults, hospital executives and other officials warn. For instance, Georgia, with a population of just over 11 million, will see as many people lose insurance coverage sold through ACA marketplaces as will California, with more than triple the population, according to estimates by KFF, a health information nonprofit that includes KFF Health News. The new law imposes additional paperwork requirements on Obamacare enrollees, slashes the time they have each year to sign up, and cuts funding for navigators who help them shop for plans. Those changes, all of which will erode enrollment, are expected to have far more impact in states like Florida and Texas than in California because a higher proportion of residents in non-expansion states are enrolled in ACA plans. The budget law, which Republicans called the 'One Big Beautiful Bill,' will cause sweeping changes to health care across the country as it trims federal spending on Medicaid by more than $1 trillion over the next decade. The program covers more than 71 million people with low incomes and disabilities. Ten million people will lose coverage over the next decade due to the law, according to the nonpartisan Congressional Budget Office. Many of its provisions are focused on the 40 states that expanded Medicaid under the ACA, which added millions more low-income adults to the rolls. But the consequences are not confined to those states. A proposal from conservatives to cut more generous federal payments for people added to Medicaid by the ACA expansion didn't make it into the law. 'Politicians in non-expansion states should be furious about that,' said Michael Cannon, director of health policy studies at the Cato Institute, a libertarian think tank. The number of people losing coverage could accelerate in non-expansion states if enhanced federal subsidies for Obamacare plans expire at the end of the year, driving up premiums as early as January and adding to the rolls of uninsured. KFF estimates as many as 2.2 million people could become uninsured just in Florida, a state where lawmakers refused to expand Medicaid and, partly as a result, now leads the nation in ACA enrollment. For people like Francoise Cham of Miami, who has Obamacare coverage, the Republican policy changes could be life-altering. Before she had insurance, the 62-year-old single mom said she would donate blood just to get her cholesterol checked. Once a year, she'd splurge for a wellness exam at Planned Parenthood. She expects to make about $28,000 this year and currently pays about $100 a month for an ACA plan to cover herself and her daughter, and even that strains her budget. Cham choked up describing the 'safety net' that health insurance has afforded her — and at the prospect of being unable to afford coverage if premiums spike at the end of the year. 'Obamacare has been my lifesaver,' she said. If the enhanced ACA subsidies aren't extended, 'everyone will be hit hard,' said Cindy Mann, a health policy expert with Manatt Health, a consulting and legal firm, and a former deputy administrator for the Centers for Medicare & Medicaid Services. 'But a state that hasn't expanded Medicaid will have marketplace people enrolling at lower income levels,' she said. 'So, a greater share of residents are reliant on the marketplace.' Though GOP lawmakers may try to cut Medicaid even more this year, for now the states that expanded Medicaid largely appear to have made a smart decision, while states that haven't are facing similar financial pressures without any upside, said health policy experts and hospital industry observers. KFF Health News reached out to the governors of the 10 states that have not fully expanded Medicaid to see if the budget legislation made them regret that decision or made them more open to expansion. Spokespeople for Republican Gov. Henry McMaster of South Carolina and Republican Gov. Brian Kemp of Georgia did not indicate whether their states are considering Medicaid expansion. Brandon Charochak, a spokesperson for McMaster's office, said South Carolina's Medicaid program focuses on 'low-income children and families and disabled individuals,' adding, 'The state's Medicaid program does not anticipate a large impact on the agency's Medicaid population.' Enrollment in ACA marketplace plans nationwide has more than doubled since 2020 to 24.3 million. If enhanced subsidies expire, premiums for Obamacare coverage would rise by more than 75% on average, according to an analysis by KFF. Some insurers are already signaling they plan to charge more. The CBO estimates that allowing enhanced subsidies to expire will increase the number of people without health insurance by 4.2 million by 2034, compared with a permanent extension. That would come on top of the coverage losses caused by Trump's budget law. 'That is problematic and scary for us,' said Eric Boley, president of the Wyoming Hospital Association. He said his state, which did not expand Medicaid, has a relatively small population and hasn't been the most attractive for insurance providers — few companies currently offer plans on the ACA exchange — and he worried any increase in the uninsured rate would 'collapse the insurance market.' As the uninsured rate rises in non-expansion states and the budget law's Medicaid cuts loom, lawmakers say state funds will not backfill the loss of federal dollars, including in states that have refused to expand Medicaid. Those states got slightly favorable treatment under the law, but it's not enough, said Grace Hoge, press secretary for Kansas Gov. Laura Kelly, a Democrat who favors Medicaid expansion but who has been rebuffed by GOP state legislators. 'Kansans' ability to access affordable healthcare will be harmed,' Hoge said in an email. 'Kansas, nor our rural hospitals, will not be able to make up for these cuts.' For hospital leaders in other states that have refused full Medicaid expansion, the budget law poses another test by limiting financing arrangements states leveraged to make higher Medicaid payments to doctors and hospitals. Beginning in 2028, the law will reduce those payments by 10 percentage points each year until they are closer to what Medicare pays. Richard Roberson, president of the Mississippi Hospital Association, said the state's use of what's called directed payments in 2023 helped raise its Medicaid reimbursements to hospitals and other health institutions from $500 million a year to $1.5 billion a year. He said higher rates helped Mississippi's rural hospitals stay open. 'That payment program has just been a lifeline,' Roberson said. The budget law includes a $50 billion fund intended to insulate rural hospitals and clinics from its changes to Medicaid and the ACA. But a KFF analysis found it would offset only about one-third of the cuts to Medicaid in rural areas. Trump encouraged Florida, Tennessee, and Texas to continue refusing Medicaid expansion in his first term, when his administration gave them an unusual 10-year extension for financing programs known as uncompensated care pools, which generate billions of dollars to pay hospitals for treating the uninsured, said Allison Orris, director of Medicaid policy for the left-leaning think tank Center on Budget and Policy Priorities. 'Those were very clearly a decision from the first Trump administration to say, 'You get a lot of money for an uncompensated care pool instead of expanding Medicaid,'' she said. Those funds are not affected by Trump's new tax-and-spending law. But they do not help patients the way insurance coverage would, Orris said. 'This is paying hospitals, but it's not giving people health care,' she said. 'It's not giving people prevention.' States such as Florida, Georgia, and Mississippi have not only turned down the additional federal funding that Medicaid expansion brings, but most of the remaining non-expansion states spend less than the national average per Medicaid enrollee, provide fewer or less generous benefits, and cover fewer categories of low-income Americans. Mary Mayhew, president of the Florida Hospital Association, said the state's Medicaid program does not adequately cover children, older people, and people with disabilities because reimbursement rates are too low. 'Children don't have timely access to dentists,' she said. 'Expectant moms don't have access nearby to an OB-GYN. We've had labor and delivery units close in Florida.' She said the law will cost states more in the long run. 'The health care outcomes for the individuals we serve will deteriorate,' Mayhew said. 'That's going to lead to higher cost, more spending, more dependency on the emergency department.' KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism.
New York Times
8 minutes ago
- New York Times
America's Clean Hydrogen Dreams Are Fading, Again
The promise of an abundant and clean-burning alternative to oil and natural gas has captivated generations of politicians, executives and environmentalists. As far back as 1977, when oil prices were a big concern in the United States, a Cadillac Seville fueled by hydrogen drove in President Jimmy Carter's inaugural parade. More recently, a signature law under President Joseph R. Biden Jr. offered generous tax credits to companies that made hydrogen in ways that release little or no carbon dioxide. That spurred a flood of investment announcements by many businesses. But the hype around the fuel is fading fast — and not for the first time. From Arizona to Oklahoma, companies are pulling the plug on clean hydrogen projects after Congress shortened the window for them to qualify for a Biden-era tax credit by five years. Projects now must be under construction by the end of 2027 to qualify, a hurdle that three-quarters of proposals most likely will not meet, according to Wood Mackenzie, an energy consulting firm. Hydrogen is widely used to make fertilizer and to turn oil into gasoline, diesel and other fuels. It can also store energy, much like a battery, and be used to power cars or trucks, though it has long struggled to take off in those applications. The appeal is clear: Using hydrogen produces water vapor instead of greenhouse gases. But the fuel is expensive, is hard to store and transport, and is made using lots of energy. 'The rationale behind it was that green hydrogen was going to be abundant and cheap,' said Matthieu Giard, head of the Americas for Air Liquide, a French industrial gas company. 'It's not really what we see today.' Today, hydrogen is produced mostly from natural gas in a process that emits carbon dioxide, the leading cause of climate change. It can be made using electricity to split water molecules into hydrogen and oxygen. But many projects that aimed to do that have been canceled or are on the chopping block. Hydrogen's problems are myriad. Electricity demand is rising rapidly in the United States, as are costs. People are using electricity to power everything from cars to heat pumps. And tech companies are using vast amounts of power to train and run artificial intelligence systems. That all means more competition for the energy required to extract hydrogen from water. In addition, it is getting harder and more expensive to install wind turbines and solar panels in the United States, making fewer such hydrogen projects financially viable. 'It's tough times,' said Bernd Heid, a senior partner at McKinsey & Co. who leads the consulting firm's hydrogen work. 'This market will be flattish in the U.S. for quite some time.' Two Australian companies, Woodside Energy and Fortescue, are among those that recently canceled low-emission hydrogen projects in the United States. Woodside cited cost increases and lower-than-expected demand as reasons to scrap a project near Oklahoma City. Fortescue, a mining giant that bet big on hydrogen, pointed to changes in U.S. energy policy. Its $550 million project outside of Phoenix was supposed to open in 2026. 'The lack of certainty and a step back in green ambition has stopped the emerging green energy markets, making it hard for previously feasible projects to proceed,' Agustin Pichot, Fortescue's chief executive of growth and energy, said on a July conference call with financial analysts. Another type of hydrogen project in which companies use natural gas and then store most of the resulting carbon dioxide emissions underground could ultimately fare better in the United States, energy executives and analysts said. Natural gas-based projects qualify for a different tax credit that gives companies more time to start construction. Gas is also plentiful in the United States, and the Trump administration is remaking federal energy policy to encourage its production and use. 'Every geography is going to play with its own strength and the strength of the U.S. clearly is access to fossil fuels, access to carbon sequestration sinks,' said Mr. Giard of Air Liquide. Even the natural gas path remains daunting. As of last year, fewer than 15 percent of low-emission hydrogen projects announced in the United States since 2015 had reached the critical stage where companies decide to spend hundreds of millions or even billions of dollars to move forward, according to McKinsey. Exxon Mobil, the largest U.S. oil company, is among those weighing whether to commit to making hydrogen with natural gas, while burying the carbon dioxide. The company has announced plans to build outside of Houston what would be one of the largest low-emission hydrogen plants in the world. But it has not made a final investment decision. 'We're concerned about the development of a broader market, which is critical to transition from government incentives,' Darren Woods, Exxon's chief executive, told analysts this month. 'If we can't see an eventual path to a market-driven business, we won't move forward with the project.'
Epoch Times
8 minutes ago
- Epoch Times
Here Are the States That Are Considering Redistricting
The GOP has the advantage when it comes to the redistricting battles, say experts who spoke with The Epoch Times. As Republicans and Democrats look to control the House in the 2026 midterms, an issue that has come to the forefront is the attempt to redistrict seats. 'California is gerrymandered,' President Donald Trump told CNBC on Aug. 5. 'We should have many more seats in Congress in California—it's all gerrymandered. And we have an opportunity in Texas to pick up five seats.' The GOP has the advantage when it comes to the redistricting battles, say experts who spoke with The Epoch Times. Story continues below advertisement 'Republicans definitely hold the edge here, given that so many states where Democrats could try to draw districts in their favor—California, Colorado, New Jersey, New York, Washington—use some type of [independent] commission to draw lines,' said Shawn Donahue, a political science professor at the University at Buffalo. 'If Democrats win the governorship in Virginia this year, that is another state where they would have the trifecta, but it also uses a commission.' Bryan Jones, a public policy professor at the University of Texas at Austin, said that 'Republicans have the votes in theory.' 'It may not come easy, and the more attention, the less likely the success,' Jones said. 'Democrats will be focused on keeping the issue in the limelight, easier during the special sessions than in a general session.' Here are the states that are now considering redistricting. Texas Texas led the trend by calling a special session to not only deal with the aftermath of flooding in the central part of the state but also to add several new Republican districts. The GOP is looking to add five seats to the congressional map, of which the party controls 25 of 38 seats. Story continues below advertisement This would not be the first time the Texas Republicans have redrawn the congressional map outside of the usual time, which is in the aftermath of the census every decade. California In response to Texas's plans to add congressional seats, California is Democratic state lawmakers have fled Texas in an attempt to deny the GOP the presence of a quorum to approve the new response to Texas's plans to add congressional seats, California is looking to 'fight fire with fire,' according to California Gov. Gavin Newsom. 'We also will punch above our weight in terms of the impact of what we're doing,' he told reporters on Aug. 4. 'And I think that should be absorbed by those in the Texas delegation. Whatever they are doing will be neutered here in the state of California.' But this is easier said than done. Story continues below advertisement California's redistricting map is drawn by an independent commission. Newsom announced on Aug. 8 that he will call a special election to redraw California's congressional map and therefore go around the commission. 'We are talking about emergency measures to respond to what's happening in Texas, and we will nullify what happens in Texas,' he told reporters. 'We will pick up five seats with the consent of the people, and that's the difference between the approach we're taking and the approach they're taking. We're doing it [on a] temporary basis.' Story continues below advertisement Democrats control 43 of the Golden State's 52 congressional seats. New York New York wants to join California in the redistricting resistance against Republicans, but, like California, it has an independent commission that draws the congressional maps. 'Democratic states have gone to independent redistricting,' Assembly Speaker Carl Heastie said at an Aug. 4 press briefing. 'It's difficult to ask New York, California, and other Democratic-leaning states to play nonpartisan while Republicans play very partisan.' New York Gov. Kathy Hochul seems to want to go around the independent commission. 'We're sick and tired of being pushed around when other states don't have the same aspirations that we always have,' she said at the same press briefing. which she hosted alongside Texas Democrats who fled their state over the GOP-led redistricting map. 'And I hold those dear. But I cannot ignore that the playing field has changed dramatically, and shame on us if we ignore that fact and cling tight to the vestiges of the past. That era is over—Donald Trump eliminated it forever.' Story continues below advertisement At least one Republican in the state is against the redistricting battle. 'I think it's wrong, what Texas is doing,' Rep. Mike Lawler (R-N.Y.) said on CNN. 'I don't support it. I think it is wrong.' Democrats control 19 of the 25 congressional districts in the Empire State. Indiana Another red state, Indiana, may add a seat or two to help Republicans keep control of Congress. The GOP already controls seven of the state's nine congressional districts. 'Some Republicans are thinking about redistricting, but geography makes it hard,' William Bianco, a political science professor at the University of Indiana, told The Epoch Times. Story continues below advertisement 'There are two Democratic areas in the state—Indianapolis and the northwestern area near Chicago. 'At most, they might get one more Republican seat, but at the cost of making two or three existing Republican incumbents significantly more vulnerable.' Vice President JD Vance has met with Indiana Gov. Mike Braun to discuss the possibility. Braun has not committed to redistricting mid-decade. Story continues below advertisement 'Whatever we discuss there, if that topic comes up, is exploratory,' he told the press ahead of meeting Vance. 'So there's been no commitments made other than that.' Ohio Ohio will have no choice but to redraw its map due to its 2021 version not receiving bipartisan support. Following the meeting, Braun did not specifically comment on the will have no choice but to redraw its map due to its 2021 version not receiving bipartisan support. The GOP controls 10 of the state's 15 congressional seats. Maryland State Rep. David Moon, a Democrat, said he would put forth legislation to redistrict in the Old Line State if Texas goes through with its redistricting. 'I'm introducing legislation to redraw Maryland congressional districts if any other state cheats & draws new maps outside of the census period,' he wrote on X. 'Seems Trump has convinced Texas, Missouri & others, and FWIW TX did it years ago & got away with it because nobody responded.' Story continues below advertisement The Democrats control all but one congressional district in Maryland. Florida The speaker of the Sunshine State's House, Daniel Perez, announced on Aug. 7 that he is creating a select committee to consider redrawing the congressional map this fall. State senate leaders have not yet disclosed similar plans. Florida Gov. Ron DeSantis previously said he's 'very seriously' looking at a mid-decade redistricting. The GOP controls 20 of Florida's 28 congressional seats. Wisconsin Wisconsin state Democrats have turned to the courts to try to force a redrawing of districts before the 2026 midterms. The state Supreme Court declined to hear their challenge, and lawsuits have since been filed. The GOP controls six of the Badger State's eight congressional districts. Missouri The Missouri Legislature could be called into special session in order to draw a district that favors Republicans. This would be done by splitting up a district that includes Kansas City and is represented by Rep. Emanuel Cleaver (D-Mo.). Were it successful, Cleaver would likely be pushed out of office. The GOP controls all but two of Missouri's eight congressional districts.
