a day ago
Medicaid cuts' disproportionate toll
Driving the Day
ADVOCATES WORRY — Medicaid cuts in President Donald Trump's tax and spending law could disproportionately harm Black women and children who depend on the program, advocates warn.
And the looming changes in the One Big Beautiful Bill Act could worsen already disparate health outcomes among Black Americans, POLITICO's Cheyanne M. Daniels reports.
Although Black people represent about 14 percent of the U.S. population, they account for more than 20 percent of Medicaid enrollees, according to Pew Research Center — and almost 60 percent of all Black children are enrolled in Medicaid, according to a recent analysis from the NAACP and other advocacy organizations.
Why it matters: Advocates say the enacted megabill's Medicaid cuts could limit resources in schools with high percentages of students eligible for free or reduced-price lunch, exacerbate maternal mortality rates and leave Black families without critical care.
'States right now are having to make decisions on what services they're going to cut ... and their allocation of funding toward this population,' said Patrice Willoughby, chief of policy and legislative affairs for the NAACP. 'It is unconscionable that Congress would leave American children, which are the future of the country, without the supports that they need and the interventions that they need to contribute meaningfully to develop to their fullest potential.'
Background: Medicaid — which is the fourth largest federal funding source for K-12 schools, according to a 2025 report by the School Superintendents Association — supports more than $7.5 billion of school-based health services each year for low-income students, including screenings for learning disabilities.
Thirty-seven percent of Black students attend high-poverty schools, according to a 2023 analysis by the National Center for Education Statistics.
Through Medicaid, high-poverty schools are also able to provide medical care. They can also provide insight into whether a student needs additional screening for a more accurate diagnosis.
But one report from a coalition of education groups earlier this year found that the Medicaid cuts could force schools to reduce the number of school nurses, limit access to early intervention programs or impact funding for special education programs for those with learning disabilities.
Zooming out: Advocates say the cuts are part of a broader pattern of the American medical system inadequately serving Black patients.
'These cuts really are continuing a pattern of forcing Black families to take care of ourselves without the proper support,' said Brittany Packnett, an equity strategist who co-founded Campaign Zero, a police reform initiative, and supported Vice President Kamala Harris in the 2024 presidential campaign.
In a statement to POLITICO, HHS said the claims 'misrepresent' the One Big Beautiful Bill Act.
'The OBBB is a decisive step toward building a stronger, more resilient healthcare system,' an HHS spokesperson said. 'This legislation modernizes Medicaid to deliver greater efficiency and long-term sustainability, while expanding access to high-quality care for those most in need, in every community across the nation.'
A spokesperson for the White House also dismissed the worries of advocates, arguing they were coming from supporters of Trump's defeated 2024 opponent.
Even so: It remains to be seen what the long-term impacts of the cuts will be. Many of the cuts aren't set to go into effect for years, and Congress has a track record of approving reductions and changing eligibility rules, only to later extend deadlines or revise the law entirely.
WELCOME TO TUESDAY PULSE. HHS is tracking its Make America Healthy Again wins with a new online tool. Send your tips, scoops and feedback to khooper@ and sgardner@ and follow along @kelhoops and @sophie_gardnerj.
In Congress
FIRST IN PULSE: MEGABILL HOSPITAL IMPACTS — Liberal nonprofit Protect Our Care is teaming with Sen. Chris Murphy (D-Conn.) to unveil a new report today that details how hospitals could be impacted by the GOP's recently enacted One Big Beautiful Bill Act.
Why it matters: The megabill includes more than $1 trillion in health care cuts, mostly to Medicaid. The new law will take a $340 billion bite out of hospital budgets over a decade to pay for tax cuts and other Trump priorities — though hospitals and their lobbyists and allies on Capitol Hill are gearing up to use the next two and a half years to persuade lawmakers to rescind the provisions, most of which don't go into effect until 2028.
As part of that effort, Protect Our Care is working with Murphy to relaunch its 'Hospital Crisis Watch' tracker, which monitors the impact of the megabill on hospitals and care facilities across the country, including whether they're closing or making cuts.
The findings: The group highlights its findings in a report out today, shared first with POLITICO, that found more than 330 hospitals are at immediate risk of closing or scaling back their services, and more than 750 hospitals are at risk of closing in the years to come because of the new law. An estimated 477,000 health workers will lose their jobs because of the Medicaid cuts, according to the report.
What's next: Murphy and Protect Our Care will present the report during a virtual press conference today at 11 a.m.
At the Agencies
DEFUNDING MRNA TECHNOLOGY — NIH Director Jay Bhattacharya agrees with HHS Secretary Robert F. Kennedy Jr.'s decision last week to defund research into the mRNA technology that produced Covid-19 vaccines in record time, he told POLITICO in an interview.
Vaccine experts argued the move would put at risk America's leading position in vaccine development and potential cures for diseases from cancer to diabetes by pulling the government's $500 million. But Bhattacharya said Kennedy's critics have the story backward.
Here's some of Bhattacharya's conversation with our Axel Springer colleague Tim Röhn, edited for length and clarity.
Paul Offit, the leading vaccine expert, told me the mRNA funding cuts were 'politicization of science.' Is he right?
No, he's not right. In my view, the key question for any vaccine platform that we fund and support is: How acceptable is it to the public? If you have the very best science in the world, but the public doesn't trust it, then it's useless as a vaccine platform.
Your boss, Robert F. Kennedy Jr., called the Covid vaccines in December 2021 'the deadliest vaccine ever made.' Couldn't statements like this be the reason for the public distrust?
Secretary Kennedy's statement before he was appointed reflects the distrust of the population, rather than the cause of it. More important were the disastrous and unscientific vaccine mandates and exaggerated claims of Covid vaccine efficacy by high public health officials in power at the time.
Aren't we potentially slowing our response to the next pandemic by not investing in mRNA?
We have other new technologies that we're working on. Why marry yourself to a single platform when the platform has lost trust with the public? We're not saying we're not going to do vaccinations. We're saying that we're moving to a different platform that is more promising.
Public Health
A DECLARATION IN TEXAS — Texas's measles outbreak has ended, the state health department said Monday, Sophie reports.
The outbreak, which spurred nationwide fears about a resurgence of the disease, infected at least 762 people and caused two deaths in school-age children. A third person, from a New Mexico county near the outbreak's Texas epicenter, tested positive for measles after his death.
New cases haven't been reported in more than 42 days in any of the counties that had ongoing transmission, the health department said in a statement. That's twice the disease's maximum incubation period, or the longest time it can take between exposure to the virus and illness onset.
Even so: The department noted it would continue watching the situation closely.
'The end of this outbreak does not mean the threat of measles is over,' the department said. 'Since there are ongoing outbreaks of measles in North America and around the world, it is likely that there will be additional cases of measles this year in Texas.'
Zooming out: As of Aug. 5, the CDC has recorded 1,356 measles cases this year — more than any year since 1992.
Public health experts point to waning measles, mumps and rubella vaccination rates as a factor in the high measles case count. Some blame Health Secretary Robert F. Kennedy Jr. — who has spent much of his career questioning vaccine safety — for sowing distrust in the MMR vaccine.
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