Md. poised to become first state to use insurance surcharge for abortions
The Maryland Senate passed a bill Monday to allow the state to use a $25 million pot of money to fund abortion services, paving the way for the state to become the first in the country to use money collected from a surcharge on insurance plans sold under the Affordable Care Act to pay for reproductive health care.
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CBS News
6 hours ago
- CBS News
The price you pay for an Obamacare plan could surge next year
Miami — Josefina Muralles works a part-time overnight shift as a receptionist at a Miami Beach condominium so that during the day she can care for her three kids, her aging mother, and her brother, who is paralyzed. She helps her mother feed, bathe, and give medicine to her adult brother, Rodrigo Muralles, who has epilepsy and became disabled after contracting COVID-19 in 2020. "He lives because we feed him and take care of his personal needs," said Josefina Muralles, 41. "He doesn't say, 'I need this or that.' He has forgotten everything." Though her husband works full time, the arrangement means their household income is just above the federal poverty line — too high to qualify for Florida's Medicaid program but low enough to make Muralles and her husband eligible for subsidized health insurance through the Affordable Care Act marketplace, also known as Obamacare. Next year, Muralles said, she and her husband may not be able to afford that health insurance coverage, which has paid for her prescription blood thinners, cholesterol medication, and two surgeries, including one to treat a genetic disorder. Extra subsidies put in place during the pandemic — which reduced the premiums Muralles and her husband paid by more than half, to $30 a month — are in place only through Dec. 31. Without enhanced subsidies, Affordable Care Act insurance premiums would rise by more than 75% on average, with bills for people in some states more than doubling, according to estimates from KFF, a health information nonprofit that includes KFF Health News. Florida and Texas would be hit especially hard, as they have more people enrolled in the marketplace than other states. Some of their congressional districts alone, especially in South Florida, have more people signed up for Obamacare than entire states. Like many of the more than 24 million Americans enrolled in the insurance marketplace this year, Muralles was unaware that the enhanced subsidies are slated to expire. She said she cannot afford a premium hike because inflation has already eaten into her household's budget. "The rent is going up," she said. "The water bill is going up." Low-income enrollees like the Muralles couple would see the biggest percentage increases in premiums if enhanced subsidies expire. Middle-income enrollees who earn more than four times the federal poverty line would no longer be eligible for subsidies at all. Those middle-income enrollees (who earn at least $62,600 for a single person in 2025) are disproportionately older, self-employed, and living in rural areas. Julio Fuentes, president of the Florida State Hispanic Chamber of Commerce, said many of his organization's members are small business owners who rely on Obamacare for health coverage. "It's either this or nothing," he said. The Congressional Budget Office estimated that letting the enhanced subsidies expire would, by 2034, increase the number of people without health insurance by 4.2 million. In tandem with changes to Medicaid in the House of Representatives' reconciliation bill and the Trump administration's proposed rules for the marketplace, including toughening income verification and shortening enrollment periods, it would increase the number of uninsured people by 16 million over that time period. A study by the Urban Institute, a nonprofit think tank, found that Hispanic and Black people would see greater coverage losses than other groups if the extra subsidies lapse. Fuentes noted that about 5 million Hispanics are enrolled in the ACA marketplace, and that President Trump won the Hispanic vote in Florida in 2024. He hopes the president and congressional Republicans see extending the enhanced subsidies as a way to hold on to those voters. "This is probably a good way, or a good start, to possibly grow that base even more," he said. Enrollment in the marketplace has grown faster since 2020 in the states won by Mr. Trump in 2024. A recent KFF survey found that 45% of Americans who buy their own health insurance identify as or lean Republican, including 3 in 10 who identify as Make America Great Again supporters. Smaller shares identify as Democrats or Democratic-leaning independents (35%) or do not lean toward either party (20%). Kush Desai, a White House spokesperson, said the rules proposed by the Trump administration, combined with the provisions in the House-passed budget bill, would "strengthen the ACA marketplace." He noted that the CBO projects the legislation would reduce premiums for some plans about 12% on average by 2034 — but out-of-pocket costs would rise or remain the same for most subsidized ACA consumers. "Democrats know Americans broadly support ending waste, fraud, and abuse, as The One, Big, Beautiful Bill does, which is why they are desperately trying to change the conversation," Desai said. But Lauren Aronson, executive director of Keep Americans Covered, a group in Washington, D.C., representing health insurers, hospitals, physicians, and patient advocates, said it is critical to raise awareness about the likely impact of losing the enhanced subsidies, which are also known as advanced premium tax credits. She is encouraged that Democrats have proposed legislation to extend the enhanced tax credits, and that some Republican senators have voiced support. What worries Aronson most is that the Republican-controlled Congress is more focused on extending tax cuts than enhanced subsidies, she said. The current bill extending the 2017 tax cuts would increase the federal deficit by about $2.4 trillion over the next decade, according to the CBO, while making the enhanced subsidies permanent would increase the deficit by $358 billion over roughly the same period. "Congress is moving forward on a tax reconciliation package that purports to benefit working families," Aronson said. "But if you don't take care of the tax credits, working families will be left holding the bag." Brian Blase, president of Paragon Health Institute, a conservative health policy think tank, said the enhanced subsidies were supposed to be a temporary measure during the COVID-19 pandemic to help people at risk of losing coverage. Instead, he said, the enhanced subsidies facilitated fraud because enrollees did not need to verify their income eligibility to receive zero-premium plans if they reported incomes at or near the federal poverty level. The enhanced subsidies also worsen health inflation, discourage employers from offering health insurance benefits, and crowd out alternative models, such as short-term insurance and Farm Bureau plans, Blase said. "Permitting these subsidies to expire would just be going back to Obamacare as it was written," Blase said. "That is a more efficient program than the program that we have now." New rules for the marketplace proposed by the Trump administration in March are already designed to address fraud, said Anna Howard, a policy expert with the American Cancer Society Cancer Action Network, which advocates for increased health insurance coverage. Howard said extending the enhanced tax credits would help ensure that people who are legitimately eligible for coverage can get it. "We don't want to see over 5 million people be kicked off their health insurance coverage out of fears of fraud when the policies being proposed don't necessarily address fraud," she said. Without affordable premiums, many consumers will turn to short-term health plans, health care cost-sharing ministries, and other forms of coverage that do not have the benefits or protections of the health law, she said. "These are plans that don't provide coverage for prescription drugs, or they have lifetime and annual limits," she said. "For a cancer patient, those plans don't work." Though the enhanced subsidies do not expire until the end of the year, the Blue Cross Blue Shield Association would prefer Congress to act by fall to avoid confusion during open enrollment, said David Merritt, a senior vice president. Insurers are preparing rates to meet state deadlines. By October, consumers will receive 60-day plan renewal notices with their 2026 premiums. Without enhanced subsidies, Merritt said, competition in the marketplace will wither, leading to fewer coverage options and higher prices, especially in states that have not expanded Medicaid eligibility and where Obamacare enrollment spiked during the past four years, like Florida and Texas. "Voters and patients are really going to see the impact," he said. Republican and Democratic representatives for some of the Florida congressional districts with the highest numbers of people in the marketplace did not respond to repeated interview requests. Muralles, of North Miami, Florida, said she wants her representatives to work in the interest of constituents like herself, who need health insurance coverage to care for their families. "Now is the time to prove to us that they are with us," Muralles said. "When everybody's healthy, everybody goes to work, everybody can pay taxes, everybody can have a better life." 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 — the independent source for health policy research, polling, and journalism.
San Francisco Chronicle
18 hours ago
- San Francisco Chronicle
Vaccines could get more expensive and harder to access after RFK Jr. purged a CDC panel
U.S. Health Secretary Robert F. Kennedy Jr. shook up a key federal vaccine advisory committee this week, ousting its sitting 17 members Monday and naming eight new individuals Wednesday, including ones known for anti-vaccine views and for spreading misinformation. The changes could potentially impact vaccine cost and availability in California and the uncertainty is making families anxious, experts say. 'I've been having several conversations every day with families who are trying to get their children vaccinated early because parents are worried that these vaccines will not be available for their children in the near future,' said Eric Ball, chair of the American Academy of Pediatrics in California. The Advisory Committee on Immunization Practice provides vaccine recommendations to the U.S. Centers for Disease Control and Prevention. The group's guidance doesn't just have medical implications; it also has financial consequences for people seeking vaccinations. 'Under the Affordable Care Act, if ACIP recommends a vaccine, insurance companies have to cover it,' said Dorit Reiss, a professor of law at UC College of the Law San Francisco, who specializes in vaccine-related law and policies. The federally funded Vaccines for Children program also covers recommended vaccines for uninsured and underinsured children, Reiss said. Potentially, the new ACIP members could alter recommendations, which would in turn affect coverage for vaccines. Nothing is certain, however: 'We don't know how this (newly) constituted committee will vote,' Reiss said. The advisory committee is scheduled to meet on June 25 to review scientific data and vote on vaccine recommendations. If problems do arise around vaccine access, there could be additional issues for California's immunization mandates for schools. 'How can you mandate a vaccine if people can't access it?' Reiss said. The sweeping changes to ACIP, established in 1964, are unprecedented, experts say. 'I can't even think of a time when an individual member has been removed from the committee,' said Yvonne Maldonado, a professor of global health and infectious diseases at Stanford and one of the 17 experts removed from the vaccine advisory committee this week. 'We are really in uncharted territory here, in terms of the membership changing so radically and so quickly,' Maldonado said. Maldonado explained that the existing process for evaluating vaccine safety and effectiveness is 'incredibly rigorous,' with numerous safety checkpoints. 'Vaccines are foundational to public health,' Maldonado said. 'They save millions of lives.' Reiss added that the United States has a system that allows people who experience problems due to a CDC-recommended vaccine to seek compensation from the government. This limits the liability of vaccine companies. If new advisory committee members remove current vaccine recommendations, Reiss said she is concerned 'that some manufacturers might leave the vaccine market.' In an editorial published Monday in the Wall Street Journal, Secretary Kennedy wrote that the 17 ACIP members were 'retired' because 'the committee has been plagued with persistent conflicts of interest.' Experts roundly disagreed with the claims and numerous medical organizations quickly spoke out. 'That's very telling,' said Catherine Flores, executive director of the California Immunization Coalition, a statewide nonprofit advocacy and education organization around immunizations. While past ACIP vaccine experts were thoroughly vetted, details about the process for the newly announced group aren't clear, Flores said. Flores is concerned some committee members may lack the previous ACIP members' level of expertise about vaccines. 'We are very concerned about what's next,' Flores said.
Yahoo
2 days ago
- Yahoo
Kansas faces $3.77B in Medicaid cuts, thousands to lose coverage under Trump's bill: report
KANSAS CITY, Mo. — Kansas will lose more than $3 billion in Medicaid funding, and thousands of Kansans will lose access to health insurance under Trump's proposed bill, according to a new report. New modeling shows 13,000 fewer Kansans would be able to enroll in Medicaid under the 'One Big Beautiful Bill' recently passed by the U.S. House, and the state would lose $3.77 billion in total Medicaid funding. Man charged in death of Platte County sports reporter shot on I-29 The modeling showed $2.29 billion in lost federal Medicaid funding alone—and $3.77 billion when combined with associated state funding losses over a 10-year period. Such losses would likely lead to higher uninsured rates and more financial struggles for rural hospitals already on the brink of closure. These results were recently released by Manatt Health, which conducted the analysis at the request of Kansas health philanthropies United Methodist Health Ministry Fund and REACH Healthcare Foundation. The two organizations wanted to better understand the financial and enrollment impacts of the bill, which would cut $700 billion from Medicaid and is awaiting a vote in the Senate. Medicaid, the public health insurance program that covers more than 366,000 Kansans, is funded jointly by the state and federal government. It provides low-income parents, children, seniors and people with disabilities with health insurance. Adults who do not have children do not qualify for Medicaid in Kansas. 'If this bill passes, it will cause long-lasting harm to thousands of families across Kansas and seriously threaten the survival of rural hospitals across the state,' said Brenda Sharpe, president and CEO at REACH Healthcare Foundation. The analysis shows Kansas will face significant coverage losses and funding reductions over the next 10 years. Manatt said the losses are even greater than shown in the analysis, as data limitations made it unable to model all the provisions in the bill. The estimates do not account for prohibitions on states setting up any new provider taxes or increasing assessments for other providers. That will cause Kansas health care providers, including nursing homes and other health providers, to lose critical funding over time and cause them to become even more financially vulnerable, Manatt said in a news release Wednesday. Coverage losses due to the bill's changes to the Affordable Care Act's Health Insurance Marketplace also couldn't be modeled. However, they will result in additional Kansans losing health insurance, according to Manatt. Not only will the bill remove people's health insurance, it also will remove food assistance. The bill includes $300 billion in cuts from the Supplemental Nutrition Assistance Program (SNAP). 'Congress is trying to rush a plan through the process that will take health care and food assistance away from tens of thousands of Kansans, including children, seniors and people with disabilities,' said David Jordan, president and CEO at the Health Fund. 'At a time when hospitals are trying to keep their doors open and working families are struggling to keep a roof over their heads and food on their tables, we cannot afford these cuts.' Kansas already has more hospitals at risk of closure than any other state in the country. A recent report from the University of Kansas School of Nursing highlights the growing 'maternal care desert' in Kansas. Manatt said 63 rural hospitals are currently at risk, and 87% of Kansas rural hospitals are operating in the red. These hospitals struggle to survive with existing federal funding – and provisions in the bill would cause them to lose billions, making it even harder to stay open. When rural hospitals close, it removes job opportunities and access to health care, creating a ripple effect in small communities, Manatt said. You can read the full report below or by clicking here. Medicaid-Cut-Impacts-to-KansasDownload Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
