Trump administration hands over nation's Medicaid enrollee data, including addresses, to ICE
The extraordinary disclosure of millions of such personal health data to deportation officials is the latest escalation in the Trump administration's immigration crackdown, which has repeatedly tested legal boundaries in its effort to arrest 3,000 people daily. Lawmakers and some CMS officials have challenged the legality of deportation officials' access to some states' Medicaid enrollee data. It's a move first reported by the AP last month that Health and Human Services officials said was aimed at rooting out people enrolled in the program improperly. But the latest data-sharing agreement makes clear what ICE officials intend to do with the health data.
ICE will use the CMS data to allow ICE to receive identity and location information on aliens identified by ICE, the agreement says. HHS spokesman Andrew Nixon would not respond to the latest agreement. It is unclear though whether Homeland Security has yet accessed the information. The department's assistant secretary, Tricia McLaughlin, said in an emailed statement that the two agencies are exploring an initiative to ensure that illegal aliens are not receiving Medicaid benefits that are meant for law-abiding Americans.
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Al Arabiya
7 hours ago
- Al Arabiya
Nih cuts spotlight a hidden crisis facing patients with experimental brain implants
Carol Seeger finally escaped her debilitating depression with an experimental treatment that placed electrodes in her brain and a pacemaker-like device in her chest. But when its batteries stopped working, insurance wouldn't pay to fix the problem, and she sank back into a dangerous darkness. She worried for her life, asking herself: 'Why am I putting myself through this?' Seeger's predicament highlights a growing problem for hundreds of people with experimental neural implants, including those for depression, quadriplegia, and other conditions. Although these patients take big risks to advance science, there's no guarantee that their devices will be maintained – particularly after they finish participating in clinical trials – and no mechanism requiring companies or insurers to do so. A research project led by Gabriel Lázaro-Muñoz, a Harvard University scientist, aimed to change that by creating partnerships between players in the burgeoning implant field to overcome barriers to device access and follow-up care. But the cancellation of hundreds of National Institutes of Health grants by the Trump administration this year left the project in limbo, dimming hope for Seeger and others like her who wonder what will happen to their health and progress. An ethical quagmire – Unlike medications, implanted devices often require parts, maintenance, batteries, and surgeries when changes are needed. Insurance typically covers such expenses for federally approved devices considered medically necessary but not experimental ones. A procedure to replace a battery alone can cost more than $15,000 without insurance, Lázaro-Muñoz said. 'While companies stand to profit from research, there's really nothing that helps ensure that device manufacturers have to provide any of these parts or cover any kind of maintenance,' said Lázaro-Muñoz. Some companies also move on to newer versions of devices or abandon the research altogether, which can leave patients in an uncertain place. Medtronic, the company that made the deep brain stimulation or DBS technology Seeger used, said in a statement that every study is different and that the company puts patient safety first when considering care after studies end. 'People consider various possibilities when they join a clinical trial.' The Food and Drug Administration requires the informed consent process to include a description of reasonably foreseeable risks and discomforts to the participant, a spokesperson said. However, the FDA doesn't require trial plans to include procedures for long-term device follow-up and maintenance, although the spokesperson stated that the agency has requested those in the past. While some informed consent forms say devices will be removed at a study's end, Lázaro-Muñoz said removal is ethically problematic when a device is helping a patient. Plus, he said some trial participants told him and his colleagues that they didn't remember everything discussed during the consent process, partly because they were so focused on getting better. Brandy Ellis, a 49-year-old in Boynton Beach, Florida, said she was desperate for healing when she joined a trial testing the same treatment Seeger got, which delivers an electrical current into the brain to treat severe depression. She was willing to sign whatever forms were necessary to get help after nothing else had worked. 'I was facing death,' she said. 'So it was most definitely consent at the barrel of a gun, which is true for a lot of people who are in a terminal condition.' Patients risk losing a treatment of last resort – Ellis and Seeger, 64, both turned to DBS as a last resort after trying many approved medications and treatments. 'I got in the trial fully expecting it not to work because nothing else had. So I was kind of surprised when it did,' said Ellis, whose device was implanted in 2011 at Emory University in Atlanta. 'I am celebrating every single milestone because I'm like: 'This is all bonus life for me.'' She's now on her third battery. She needed surgery to replace two single-use ones, and the one she has now is rechargeable. She's lucky her insurance has covered the procedures, she said, but she worries it may not in the future. 'I can't count on any coverage because there's nothing that says even though I've had this and it works that it has to be covered under my commercial or any other insurance,' said Ellis, who advocates for other former trial participants. Even if companies still make replacement parts for older devices, she added, availability and accessibility are entirely different things given most people can't afford continued care without insurance coverage. Seeger, whose device was implanted in 2012 at Emory, said she went without a working device for around four months when the insurance coverage her wife's job at Emory provided wouldn't pay for battery replacement surgery. Neither would Medicare, which generally only covers DBS for FDA-approved uses. With her research team at Emory advocating for her, Seeger ultimately got financial help from the hospital's indigent care program and paid a few thousand dollars out of pocket. She now has a rechargeable battery, and the device has been working well. But at any point, she said that could change. Federal cuts stall solutions – Lázaro-Muñoz hoped his work would protect people like Seeger and Ellis. 'We should do whatever we can as a society to be able to help them maintain their health,' he said. Lázaro-Muñoz's project received about $987,800 from the National Institute of Mental Health in the 2023 and 2024 fiscal years and was already underway when he was notified of the NIH funding cut in May. He declined to answer questions about it. Ellis said any delay in addressing the thorny issues around experimental brain devices hurts patients. 'Planning at the beginning of a clinical trial about how to continue treatment and maintain devices,' she said, 'would be much better than depending on the kindness of researchers and the whims of insurers.' 'If this turns off, I get sick again. Like, I'm not cured,' she said. 'This is a treatment that absolutely works but only as long as I've got a working device.'
Al Arabiya
4 days ago
- Al Arabiya
The US fertility rate reached a new low in 2024, CDC data shows
The fertility rate in the US dropped to an all-time low in 2024 with less than 1.6 kids per woman, new federal data released Thursday shows. The US was once among only a few developed countries with a rate that ensured each generation had enough children to replace itself–about 2.1 kids per woman. But it has been sliding in America for close to two decades as more women are waiting longer to have children or never taking that step at all. The new statistic is on par with fertility rates in western European countries according to World Bank data. Alarmed by recent drops, the Trump administration has taken steps to increase falling birth rates like issuing an executive order meant to expand access to and reduce costs of in vitro fertilization and backing the idea of baby bonuses that might encourage more couples to have kids. But there's no reason to be alarmed according to Leslie Root, a University of Colorado Boulder researcher focused on fertility and population policy. 'We're seeing this as part of an ongoing process of fertility delay. We know that the US population is still growing and we still have a natural increase–more births than deaths,' she said. The US Centers for Disease Control and Prevention released the statistic for the total fertility rate with updated birth data for 2024. In the early 1960s, the US total fertility rate was around 3.5 but plummeted to 1.7 by 1976 after the Baby Boom ended. It gradually rose to 2.1 in 2007 before falling again aside from a 2014 uptick. The rate in 2023 was 1.621 and inched down in 2024 to 1.599 according to the CDC's National Center for Health Statistics. 'Birth rates are generally declining for women in most age groups–and that doesn't seem likely to change in the near future,' said Karen Guzzo, director of the Carolina Population Center at the University of North Carolina. 'People are marrying later and also worried about their ability to have the money, health insurance and other resources needed to raise children in a stable environment. Worry is not a good moment to have kids and that's why birth rates in most age groups are not improving,' she said. Asked about birth-promoting measures outlined by the Trump administration, Guzzo said they don't tackle larger needs like parental leave and affordable child care. 'The things that they are doing are really symbolic and not likely to budge things for real Americans,' she said. The CDC's new report, which is based on a more complete review of birth certificates than provisional data released earlier this year, also showed a 1 percent increase in births–about 33,000 more–last year compared to the prior year. That brought the yearly national total to just over 3.6 million babies born. But this is different: The provisional data indicated birth rate increases last year for women in their late 20s and 30s. However, the new report found birth rate declines for women in their 20s and early 30s and no change for women in their late 30s. What happened? CDC officials said it was due to recalculations stemming from a change in the US Census population estimates used to compute the birth rate. 'That's plausible,' Root said. 'As the total population of women of childbearing age grew due to immigration, it offset small increases in births to women in those age groups,' she said.
Al Arabiya
6 days ago
- Al Arabiya
As Trump's raids ramp up, a Texas region's residents stay inside — even when they need medical care
These days Juanita says a prayer every time she steps off the driveway of her modest rural home. The 41-year-old mother who crossed into the United States from Mexico more than two decades ago and married an American carpenter fears federal agents may be on the hunt for her. As she was about to leave for the pharmacy late last month her husband called with a frantic warning: 'Immigration enforcement officers were swarming the store's parking lot.' Juanita who is prediabetic skipped filling medications that treat her nutrient deficiencies. She also couldn't risk being detained because she has to care for her 17-year-old daughter who has Down syndrome. 'If I am caught who's going to help my daughter?' Juanita asks in Spanish through an interpreter. Some people quoted in this story insisted that The Associated Press publish only their first names because of concerns over their immigration status. As the Trump administration intensifies deportation activity around the country some immigrants – including many who have lived in Texas's southern tip for decades – are unwilling to leave their homes even for necessary medical care. Tucked behind the freeway strip malls roadside taquerias and vast citrus groves that span this 160-mile stretch of the Rio Grande Valley are people like Juanita who need critical medical care in one of the nation's poorest and unhealthiest regions. For generations Mexican families have harmoniously settled – some legally some not – in this predominately Latino community where immigration status was once hardly top of mind. A very dangerous situation White House officials have directed federal agents to leave no location unchecked including hospitals and churches in their drive to remove 1 million immigrants by year's end. Those agents are even combing through the federal government's largest medical record databases to search for immigrants who may be in the United States illegally. Deportations and tougher restrictions will come with consequences says Mark Krikorian the director of the Center for Immigration Studies a think tank that favors restrictive immigration policies. 'We shouldn't have let it get out of hand the way we did,' Krikorian says of the previous administration's immigration policies. 'Some businesses are going to have difficulties. Some communities are going to face difficulties.' Federal agents raids began reaching deeper into everyday life across the Rio Grande Valley in June just as the area's 1.4 million residents began their summer ritual of enduring the suffocating heat. This working-class stretch of Texas solidly backed Trump in the 2024 election despite campaign promises to ruthlessly pursue mass deportations. People here who once moved regularly from the US to Mexico to visit relatives or get cheap dental care say they didn't realize his deportation campaign would focus on their neighbors. But in recent weeks restaurant workers have been escorted out mid-shift and farmers have suddenly lost field workers. Schoolchildren talk openly about friends who lost a parent in raids. More than a dozen were arrested last month at local flea markets according to local news reports and Border Patrol officials. 'Immigrants are staying shut inside their mobiles homes and shacks that make up the colonias zoning-free neighborhoods that sometimes don't have access to running water or electricity,' says Sandra de la Cruz-Yarrison who runs the Holy Family Services Inc. clinic in Weslaco Texas. 'People are not going to risk it,' de la Cruz-Yarrison says. 'People are being stripped from their families.' Yet people here are among the most medically needy in the country. Nearly half the population is obese. Women are more likely to be diagnosed with cervical cancer and elderly people are more likely to develop dementia. Bladder cancers can be more aggressive. One out of every four people lives with diabetes. As much as a third of the population doesn't have health insurance to cover those ailments. And a quarter of people live in poverty more than double the national average. Now many in this region are on a path to develop worse health outcomes as they skip doctors appointments out of fear says Dr. Stanley Fisch a pediatrician who helped open Driscoll Children's Hospital in the region last year. 'We've always had unfortunately people who have gone with untreated diabetes for a long time and now it's compounded with these other issues at the moment,' Fisch says. 'This is a very dangerous situation for people. The population is suffering accordingly.' Trepidations about going to clinics are spreading Elvia was the unlucky – and unsuspecting – patient who sat down for the finger prick the clinic offers everyone during its monthly educational meeting for community members. As blood oozed out of her finger the monitor registered a 194 glucose level indicating she is prediabetic. She balked at the idea of writing down her address for regular care at Holy Family Services clinic. Nor did she want to enroll in Medicaid the federal and state funded program that provides health care coverage to the poorest Americans. Although she is a legal resident some people living in her house do not have legal status. Fewer people have come to Holy Family Services clinic with coverage in recent months says billing coordinator Elizabeth Reta. Over decades the clinic's midwifery staff has helped birth thousands of babies in bathtubs or on cozy beds in birthing houses situated throughout the campus. But now Reta says some parents are too scared to sign those children up for health insurance because they do not want to share too much information with the government. 'Even people I personally know that used to have Medicaid for their children that were born here – that are legally here but the parents are not – they stopped requesting Medicaid,' Reta says. Their worry is well-founded. An Associated Press investigation last week revealed that US Immigration and Customs Enforcement officials have gained access to personal health data – including addresses – of the nation's 79 million Medicaid and Children's Health Insurance Program enrollees. The disclosure will allow ICE officials to receive identity and location information of aliens documents obtained by the AP say. In Texas the governor started requiring emergency room staff to ask patients about their legal status a move that doctors have argued will dissuade immigrants from seeking needed care. State officials have said the data will show how much money is spent on care for immigrants who may not be here legally. Federal law requires emergency rooms to treat any patients who come to the doors. Visits to Holy Family Services mobile clinic have stopped altogether since Trump took office. The van which once offered checkups at the doorsteps in the colonias now sits running on idle. Its constant hum is heard throughout the clinic's campus to keep medical supplies fresh in the 100-degree temperatures. 'These were hard-hit communities that really needed the services,' de la Cruz-Yarrison says. 'People were just not coming after the administration changed.' A mother almost loses a son. A daughter is too scared to visit the doctor Immigrants were less likely to seek medical care during Trump's first term multiple studies concluded. A 2023 study of well-child visits in Boston Minneapolis and Little Rock Arkansas noted a 5 percent drop for children who were born to immigrant mothers after Trump was elected in 2016. The study also noted declines in visits when news about Trump's plans to tighten immigration rules broke throughout his first term. 'It's a really high-anxiety environment where they're afraid to talk to the pediatrician go to school or bring their kids to child care,' says Stephanie Ettinger de Cuba a Boston University researcher who oversaw the study. A delayed trip to the doctor almost cost 82-year-old Maria Isabel de Perez her son this spring. He refused to seek help for his intense and constant stomach pains for weeks instead popping Tylenol daily so he could still labor in the farm fields of Arkansas she says. He put off going to the hospital as rumors swirled that immigration enforcement officials were outside of the hospital. 'He waited and waited because he felt the pain but was too scared to go to the hospital,' she explains in Spanish through an interpreter. 'He couldn't go until the appendix exploded.' Her son is still recovering after surgery and has not been able to return to work she says. Perez is a permanent resident who has lived in the United States for 40 years. But all of her children were born in Mexico and because she is a green card holder she cannot sponsor them for citizenship. Maria meanwhile only leaves her house to volunteer at Holy Family Services food bank. She's skipped work on nearby farms. And after last month's arrests she won't sell clothes for money at the flea market anymore. So she stuffs cardboard boxes with loaves of bread potatoes peppers and beans that will be handed out to the hungry. Before the raids began about 130 people would drive up to collect a box of food from Maria. But on this sweltering June day only 68 people show up for food. She brings home a box every week to her children ages 16 11 and 4 who are spending the summer shut inside. Her 16-year-old daughter has skipped the checkup she needs to refill her depression medication. The teenager who checks in on friends whose parents have been arrested in immigration raids through a text group chat insists she is doing OK. Maria left Mexico years ago because dangerous gangs rule her hometown she explains. She's married now to an American truck driver. 'We're not bad people,' Maria says from her dining room table where her 4-year-old son happily eats a lime green popsicle. 'We just want to have a better future for our children.' Juanita the prediabetic mother who hasn't filled her prescriptions out of fear was not sure when she would brave the pharmacy again. But with a cross hanging around her neck the devout Catholic says she will say three invocations before she does. Explains her 15-year-old son Jose: 'We always pray before we leave.'
