Latest news with #FrankPallone
Yahoo
a day ago
- Health
- Yahoo
US health care is rife with high costs and deep inequities, and that's no accident
House Committee on Energy and Commerce Chairman Brett Guthrie, R-Ky., left, and ranking member Frank Pallone, D-N.J., right, speak during a markup of Medicaid budget cuts, May 13, 2025 in Washington, D.C. (Photo by) A few years ago, a student in my history of public health course asked why her mother couldn't afford insulin without insurance, despite having a full-time job. I told her what I've come to believe: The U.S. health care system was deliberately built this way. People often hear that health care in America is dysfunctional — too expensive, too complex and too inequitable. But dysfunction implies failure. What if the real problem is that the system is functioning exactly as it was designed to? Understanding this legacy is key to explaining not only why reform has failed repeatedly, but why change remains so difficult. I am a historian of public health with experience researching oral health access and health care disparities in the Deep South. My work focuses on how historical policy choices continue to shape the systems we rely on today. By tracing the roots of today's system and all its problems, it's easier to understand why American health care looks the way it does and what it will take to reform it into a system that provides high-quality, affordable care for all. Only by confronting how profit, politics and prejudice have shaped the current system can Americans imagine and demand something different. My research and that of many others show that today's high costs, deep inequities and fragmented care are predictable features developed from decades of policy choices that prioritized profit over people, entrenched racial and regional hierarchies, and treated health care as a commodity rather than a public good. Over the past century, U.S. health care developed not from a shared vision of universal care, but from compromises that prioritized private markets, protected racial hierarchies and elevated individual responsibility over collective well-being. Employer-based insurance emerged in the 1940s, not from a commitment to worker health but from a tax policy workaround during wartime wage freezes. The federal government allowed employers to offer health benefits tax-free, incentivizing coverage while sidestepping nationalized care. This decision bound health access to employment status, a structure that is still dominant today. In contrast, many other countries with employer-provided insurance pair it with robust public options, ensuring that access is not tied solely to a job. In 1965, Medicare and Medicaid programs greatly expanded public health infrastructure. Unfortunately, they also reinforced and deepened existing inequalities. Medicare, a federally administered program for people over 64, primarily benefited wealthier Americans who had access to stable, formal employment and employer-based insurance during their working years. Medicaid, designed by Congress as a joint federal-state program, is aimed at the poor, including many people with disabilities. The combination of federal and state oversight resulted in 50 different programs with widely variable eligibility, coverage and quality. Southern lawmakers, in particular, fought for this decentralization. Fearing federal oversight of public health spending and civil rights enforcement, they sought to maintain control over who received benefits. Historians have shown that these efforts were primarily designed to restrict access to health care benefits along racial lines during the Jim Crow period of time. Today, that legacy is painfully visible. States that chose not to expand Medicaid under the Affordable Care Act are overwhelmingly located in the South and include several with large Black populations. Nearly 1 in 4 uninsured Black adults are uninsured because they fall into the coverage gap – unable to access affordable health insurance – they earn too much to qualify for Medicaid but not enough to receive subsidies through the Affordable Care Act's marketplace. The system's architecture also discourages care aimed at prevention. Because Medicaid's scope is limited and inconsistent, preventive care screenings, dental cleanings and chronic disease management often fall through the cracks. That leads to costlier, later-stage care that further burdens hospitals and patients alike. Meanwhile, cultural attitudes around concepts like 'rugged individualism' and 'freedom of choice' have long been deployed to resist public solutions. In the postwar decades, while European nations built national health care systems, the U.S. reinforced a market-driven approach. Publicly funded systems were increasingly portrayed by American politicians and industry leaders as threats to individual freedom – often dismissed as 'socialized medicine' or signs of creeping socialism. In 1961, for example, Ronald Reagan recorded a 10-minute LP titled 'Ronald Reagan Speaks Out Against Socialized Medicine,' which was distributed by the American Medical Association as part of a national effort to block Medicare. The health care system's administrative complexity ballooned beginning in the 1960s, driven by the rise of state-run Medicaid programs, private insurers and increasingly fragmented billing systems. Patients were expected to navigate opaque billing codes, networks and formularies, all while trying to treat, manage and prevent illness. In my view, and that of other scholars, this isn't accidental but rather a form of profitable confusion built into the system to benefit insurers and intermediaries. Even well-meaning reforms have been built atop this structure. The Affordable Care Act, passed in 2010, expanded access to health insurance but preserved many of the system's underlying inequities. And by subsidizing private insurers rather than creating a public option, the law reinforced the central role of private companies in the health care system. The public option – a government-run insurance plan intended to compete with private insurers and expand coverage – was ultimately stripped from the Affordable Care Act during negotiations due to political opposition from both Republicans and moderate Democrats. When the U.S. Supreme Court made it optional in 2012 for states to offer expanded Medicaid coverage to low-income adults earning up to 138% of the federal poverty level, it amplified the very inequalities that the ACA sought to reduce. These decisions have consequences. In states like Alabama, an estimated 220,000 adults remain uninsured due to the Medicaid coverage gap – the most recent year for which reliable data is available – highlighting the ongoing impact of the state's refusal to expand Medicaid. In addition, rural hospitals have closed, patients forgo care, and entire counties lack practicing OB/GYNs or dentists. And when people do get care – especially in states where many remain uninsured – they can amass medical debt that can upend their lives. All of this is compounded by chronic disinvestment in public health. Federal funding for emergency preparedness has declined for years, and local health departments are underfunded and understaffed. The COVID-19 pandemic revealed just how brittle the infrastructure is – especially in low-income and rural communities, where overwhelmed clinics, delayed testing, limited hospital capacity, and higher mortality rates exposed the deadly consequences of neglect. Change is hard not because reformers haven't tried before, but because the system serves the very interests it was designed to serve. Insurers profit from obscurity – networks that shift, formularies that confuse, billing codes that few can decipher. Providers profit from a fee-for-service model that rewards quantity over quality, procedure over prevention. Politicians reap campaign contributions and avoid blame through delegation, diffusion and plausible deniability. This is not an accidental web of dysfunction. It is a system that transforms complexity into capital, bureaucracy into barriers. Patients – especially the uninsured and underinsured – are left to make impossible choices: delay treatment or take on debt, ration medication or skip checkups, trust the health care system or go without. Meanwhile, I believe the rhetoric of choice and freedom disguises how constrained most people's options really are. Other countries show us that alternatives are possible. Systems in Germany, France and Canada vary widely in structure, but all prioritize universal access and transparency. Understanding what the U.S. health care system is designed to do – rather than assuming it is failing unintentionally – is a necessary first step toward considering meaningful change. This article is republished from The Conversation under a Creative Commons license. Read the original article.
Bloomberg
21-05-2025
- Business
- Bloomberg
Trump's Hill Visit Ends Without A Deal
"Balance of Power: Late Edition" focuses on the intersection of politics and global business. On today's show, Doug Heye, Former RNC Communications Director, on Speaker Johnson's tax bill progress. Kori Schake, Senior Fellow & Director of Foreign and Defense Policy Studies at the American Enterprise Institute, shares her thoughts on talks between President Trump & President Putin. Rep. Frank Pallone (D) New Jersey discusses the tax bill and talks about how the tax cuts in the proposed legislation will benefit large corporations with cuts to Medicaid paying for them. (Source: Bloomberg)
Bloomberg
20-05-2025
- Business
- Bloomberg
Real Problem Is Medicaid Cuts: Rep. Pallone on Tax Bill
Rep. Frank Pallone (D) New Jersey discusses the tax bill and states the focus on SALT is "misplaced." He goes on to talk about how the tax cuts in the proposed legislation will benefit large corporations with cuts to Medicaid paying for them, what he can still do to prevent cuts to Medicaid, and shares his thoughts on the DOJ charging New Jersey Representative LaMonica McIver with assault after a confrontation outside an ICE detention facility. Rep. Pallone speaks with Kailey Leinz and Joe Mathieu on the late edition of Bloomberg's "Balance of Power." (Source: Bloomberg)
Yahoo
17-05-2025
- Health
- Yahoo
Florida seniors could lose access to healthcare if Congress moves ahead with Medicaid cuts
Congress is treating the Medicaid budget like a line item on a balance sheet instead of what it really is — cuts to senior citizen healthcare. Earlier this week, after over 24 hours of debate, the House Energy and Commerce Committee passed a reconciliation bill. Based on the draft proposal released by the Congressional Budget Office, initial estimates show that federal spending on Medicaid would be slashed by $625 billion over 10 years. Congressman Frank Pallone (D-NJ), who sits on the committee, released a statement outlining the bleak reality if the bill passes. 'In no uncertain terms, millions of Americans will lose their healthcare coverage, hospitals will close, seniors will not be able to access the care they need, and premiums will rise for millions of people if this bill passes.' Under the proposed budget cuts, Florida is likely to see a $4 billion reduction in Medicaid. In Miami-Dade County, 58% of seniors are on Medicaid. In fact, Miami-Dade has the highest percentage of seniors covered by Medicaid in the entire state of Florida. Holly Bullard, chief strategy and development officer for Florida Policy Institute, told the Miami Herald Editorial Board, 'Miami-Dade is the tip of the spear for Medicaid in Florida, especially when it comes to seniors.' For Florida seniors, medicaid pays for in-home care, nursing homes and other services. Without it, seniors would lose access to these services and more, leaving them stranded and without assistance. In Florida, nursing-home care is primarily paid for by Medicaid, and for two-thirds of nursing home residents, it's the only way they can afford help with daily tasks many of us take for granted such as, bathing and dressing. Cutting Medicaid is not only harmful, it's borderline inhumane. Seniors who suffer from dementia, those who rely on weekly visits from a home health aide or need life saving medication would be among those suffering the most, along with other vulnerable groups. Elderly patients could lose access to doctors, lose out on necessary medication and help with tasks such as personal hygiene. Under the current proposal, if Medicaid is cut, the question becomes who will help Florida seniors? Where will the money come from? Not every lawmaker is on board with the proposed cuts. In fact, some Republicans are pushing back. Sen. Josh Hawley, a Republican from Missouri, is among them: 'I continue to maintain my position we should not be cutting Medicaid benefits.' While Congress considers slashing Medicaid, the impact would be felt beyond Florida seniors. Nursing homes and other healthcare facilities could be forced to lay off staff or shut down. And the cuts would also likely harm the job market. A recent analysis by the Commonwealth Fund estimates that Florida could lose about 17,000 jobs in the healthcare sector. Florida would experience an economic loss of $3 billion to its gross domestic product as well as a loss of $177 million in state and local tax revenue, the Commonwealth Fund estimated. The cuts would force Florida lawmakers to make some tough decisions, especially since Florida remains one of 10 states that has not adopted Medicaid expansion, a provision of the Affordable Care Act. Hospitals and nursing homes could be heavily impacted since they rely heavily on funding from Medicaid. 'The bill is bad for funding because it limits the use of provider taxes, which sounds great to most people,' Bullard explained, 'but that's how we fund our hospitals and nursing homes in Florida, because we haven't expanded Medicaid.' Medicaid is more than a government program. It's a lifeline for many Americans, especially Florida seniors citizens. While balancing the budget is important, Congress shouldn't do it at the expense of senior citizens. Click here to send the letter.
Miami Herald
17-05-2025
- Health
- Miami Herald
Florida seniors could lose access to healthcare if Congress moves ahead with Medicaid cuts
Congress is treating the Medicaid budget like a line item on a balance sheet instead of what it really is — cuts to senior citizen healthcare. Earlier this week, after over 24 hours of debate, the House Energy and Commerce Committee passed a reconciliation bill. Based on the draft proposal released by the Congressional Budget Office, initial estimates show that federal spending on Medicaid would be slashed by $625 billion over 10 years. Congressman Frank Pallone (D-NJ), who sits on the committee, released a statement outlining the bleak reality if the bill passes. 'In no uncertain terms, millions of Americans will lose their healthcare coverage, hospitals will close, seniors will not be able to access the care they need, and premiums will rise for millions of people if this bill passes.' Under the proposed budget cuts, Florida is likely to see a $4 billion reduction in Medicaid. In Miami-Dade County, 58% of seniors are on Medicaid. In fact, Miami-Dade has the highest percentage of seniors covered by Medicaid in the entire state of Florida. Holly Bullard, chief strategy and development officer for Florida Policy Institute, told the Miami Herald Editorial Board, 'Miami-Dade is the tip of the spear for Medicaid in Florida, especially when it comes to seniors.' For Florida seniors, medicaid pays for in-home care, nursing homes and other services. Without it, seniors would lose access to these services and more, leaving them stranded and without assistance. In Florida, nursing-home care is primarily paid for by Medicaid, and for two-thirds of nursing home residents, it's the only way they can afford help with daily tasks many of us take for granted such as, bathing and dressing. Cutting Medicaid is not only harmful, it's borderline inhumane. Seniors who suffer from dementia, those who rely on weekly visits from a home health aide or need life saving medication would be among those suffering the most, along with other vulnerable groups. Elderly patients could lose access to doctors, lose out on necessary medication and help with tasks such as personal hygiene. Under the current proposal, if Medicaid is cut, the question becomes who will help Florida seniors? Where will the money come from? Not every lawmaker is on board with the proposed cuts. In fact, some Republicans are pushing back. Sen. Josh Hawley, a Republican from Missouri, is among them: 'I continue to maintain my position we should not be cutting Medicaid benefits.' While Congress considers slashing Medicaid, the impact would be felt beyond Florida seniors. Nursing homes and other healthcare facilities could be forced to lay off staff or shut down. And the cuts would also likely harm the job market. A recent analysis by the Commonwealth Fund estimates that Florida could lose about 17,000 jobs in the healthcare sector. Florida would experience an economic loss of $3 billion to its gross domestic product as well as a loss of $177 million in state and local tax revenue, the Commonwealth Fund estimated. The cuts would force Florida lawmakers to make some tough decisions, especially since Florida remains one of 10 states that has not adopted Medicaid expansion, a provision of the Affordable Care Act. Hospitals and nursing homes could be heavily impacted since they rely heavily on funding from Medicaid. 'The bill is bad for funding because it limits the use of provider taxes, which sounds great to most people,' Bullard explained, 'but that's how we fund our hospitals and nursing homes in Florida, because we haven't expanded Medicaid.' Medicaid is more than a government program. It's a lifeline for many Americans, especially Florida seniors citizens. While balancing the budget is important, Congress shouldn't do it at the expense of senior citizens. Click here to send the letter.
