logo
#

Latest news with #JoanAlker

Millions will lose health insurance under Trump tax bill
Millions will lose health insurance under Trump tax bill

The Herald Scotland

time4 days ago

  • Health
  • The Herald Scotland

Millions will lose health insurance under Trump tax bill

Another 5 million could lose coverage if Congress doesn't extend the COVID-19 pandemic-era tax credits that have made Affordable Care Act plans more affordable for consumers. The legislation amounts to "the biggest rollback in health care coverage in the history of the United States," said Joan Alker, a research professor and executive director and co-founder of Georgetown University's Center for Children and Families. Vice President JD Vance, who cast the tiebreaking vote July 1 to pass the Senate bill 51-50, said in social media posts the Medicaid cuts are "immaterial" compared to savings the bill will fund through bolstered immigration enforcement. The House is scheduled to consider the legislation on July 2 in advance of Trump's self-imposed July 4th deadline for his signature domestic policy legislation. How will the legislation cut Medicaid? The legislation would require states to double eligibility checks to twice a year. And states, which administer Medicaid, would have to set up systems to verify a person's employment or exemption status. The legislation requires "able-bodied" Medicaid recipients to work 80 hours a month or qualify for an exemption, such as being a student, caregiver or having a disability. The original House version limited the work requirement to low-income adults without children, but the Senate version added the work requirement to parents of children older than 13. The legislation defines "able-bodied" people as those not medically certified as physically or mentally unfit for employment. The legislation also would strip coverage from undocumented immigrants who get Medicaid through state-funded programs. Health policy experts say more frequent eligibility checks and red tape will add administrative costs and cut off people who qualify but fall through the cracks because of administrative miscues. What do hospitals and doctors think of bill? Medicaid insures 83 million low-income children and adults, according to KFF, a health policy nonprofit. That represents more than 1 in 5 Americans. Health policy experts have warned the cuts could harm rural hospitals and doctors who serve a higher percentage of people enrolled in Medicaid. The Senate bill added a $50 billion rural health care fund, double the amount that an earlier version of the legislation proposed. Still, hospitals are "deeply disappointed" the bill cleared the Senate, said Rick Pollack, president and CEO of the American Hospital Association, a trade group. Pollack said the $1 trillion in Medicaid cuts would cause "irreparable harm to our health care system," and reduce access to care for all Americans. Hospitals are required to diagnose and stabilize anyone who visits an emergency room. Eliminating coverage of nearly 12 million Americans will "drive up uncompensated care for hospitals and health systems," Pollack said. Pollack said hospitals might be forced to cut services and staff, and patients could face longer wait times in emergency rooms. Some rural hospitals and facilities in underserved communities could close, Pollack said. Dr. Richard Besser, president and CEO of the Robert Wood Johnson Foundation, said the cuts to Medicaid and a federal food assistance program "will make our country sicker, put children at risk of going hungry and make it harder for families to afford basic necessities" while delivering tax cuts. When will the Medicaid cuts take effect? Medicaid recipients won't immediately be impacted by the legislation. The bill sets a Jan. 1, 2027, deadline for states to begin twice-a-year eligibility checks and verify work or exemption status of non-disabled enrollees. However, some states already have submitted waivers to the Centers for Medicare & Medicaid Services to begin Medicaid work requirements. CMS might choose to approve the waivers and allow some states to launch Medicaid work requirements before January 2027, Alker said. A KFF survey found nearly 2 in 3 people on Medicaid are employed full or part time, and others would qualify for an exemption from the work requirement because they are caregivers or students. Just 8% were not working due to inability to find work, retirement or other reasons, KFF said. While the bill doesn't mandate work requirements before January 2027, states will likely need to plan for big changes before then, said Jennifer Tolbert, deputy director of the KFF program on Medicaid and the uninsured. States will need to prepare for smaller Medicaid payments from the federal government while adding the extra administrative duties of verifying an enrollee's work or volunteer status. "Some states are anticipating this reduced revenue," Tolbert said. "At the same time, they are also required to make pretty costly changes to their eligibility systems." 'Death by a trillion cuts': Health care workers lobby Republicans in Congress Johannah Alabi's days usually consist of feeding, bathing, and caring for residents at two nursing homes in Bloomfield, Conn. She said most of her patients depend on government health insurance programs, so she is concerned about what will happen to them and her job if Trump signs the bill into law. Medicaid is the primary payer for 63% of nursing home facility residents and an additional 13% rely on Medicare as their primary payer, according to KFF, a health policy nonprofit headquartered in San Francisco. "If some of that money is going to be taken away, something has to give," Alabi said. "It's going to come down to the resident care. It's going to come down to the food. It's going to come down to the activities." That's why she was inspired to join Service Employees International Union members to lobby lawmakers to vote against the bill last week. They arrived at the Capitol with signs reading, "Death by a trillion cuts," and wearing shirts with the message, "Republican cuts kill." Jennifer Woods, another SEIU member who works in the claims department at Kaiser Permanente, ran into Sen. Ted Cruz, R-Texas, during her trip to Washington. She said she tried to explain how cuts could "ruin people's lives" and potentially lead to some patients' deaths as she followed him through the Capitol building. "He just shook his head and would keep going," Woods said. "He didn't really say anything. None of them did."

Nearly a third of pregnant rural Arkansans rely on Medicaid, study shows
Nearly a third of pregnant rural Arkansans rely on Medicaid, study shows

Yahoo

time16-05-2025

  • Health
  • Yahoo

Nearly a third of pregnant rural Arkansans rely on Medicaid, study shows

(Getty Images) Pregnant Arkansas women living in rural areas will face even greater challenges obtaining obstetric care if Congress approves proposed cuts in Medicaid, according to health policy experts who discussed a new report Thursday. Arkansas as a whole has the 10th highest share of women of childbearing age covered by Medicaid in rural areas, according to a Georgetown University Center for Children and Families study presented during a webinar Thursday. The report also highlighted 20 U.S. counties where approximately half of their women of childbearing age are covered by Medicaid. One of those counties is in Arkansas, according to the study. Eastern Arkansas' Lee County has about 8,100 residents and a nearly 39% poverty rate, according to the U.S. Census. Medicaid is a significant source of health coverage for women of childbearing age, especially for those living in small towns and rural communities, the report found. The study defines these communities as non-metropolitan counties with urban areas of fewer than 50,000 residents. Bills to improve Arkansas maternal health, change ballot initiative process head to Sanders' desk 'It's absolutely critical for maternal and infant health that women have access to affordable, comprehensive healthcare before, during and after they get pregnant,' said Joan Alker, Georgetown University Center for Children and Families director and lead author of the report. Women in rural areas face greater challenges to accessing care because of a shortage of providers, hospital closures and the loss of labor and delivery units and obstetrical capacity, Alker said. Nationally, 23.3% of women of childbearing age (19 to 44 years old) in rural areas are covered by Medicaid, compared to 20.5% of women in metropolitan areas, according to the report. Louisiana and New Mexico have the highest share of Medicaid-covered women, with just over 40% each. Nearly 28% of women of childbearing age are covered by Medicaid in rural Arkansas. For many Arkansas women, especially those living in rural areas with low-income families, Medicaid may be the only health insurance source to keep them healthy throughout pregnancy, Arkansas Advocates for Children and Families Health Policy Director Camille Richoux said in an interview. 'For me, it's a great thing that we have Medicaid ensuring that women throughout the state have coverage options,' Richoux said. 'It also means that we have more at stake whenever there are threats to Medicaid…this report really makes that case of how any kind of threats or cuts around Medicaid could have the potential to be devastating to a lot of women in the state and especially in a state that has so many challenges in maternal health.' Arkansas has one of the highest maternal mortality rates in the nation and the third-highest infant mortality rate, according to the Arkansas Center for Health Improvement. Access to Medicaid could change under proposed federal legislation. A U.S. House panel approved a plan Wednesday that would reduce federal spending on Medicaid by $625 billion over the next decade. The proposal includes a provision for work requirements. Arkansas implemented a work-reporting requirement in 2018 that led to 18,000 people losing coverage, in part because enrollees were unaware or confused about how to report they were working. A federal judge later ruled the program was illegal. Arkansas officials submitted a request for a new work requirement earlier this year. 'The first time didn't work': Georgia and Arkansas scale back Medicaid work requirements Rural communities have a lot at stake with the congressional Medicaid debate, Alker said, because the loss of Medicaid revenue would place 'additional pressure on a very strained system.' Nearly half of all births in rural areas are covered by Medicaid, and less access to obstetrical care leads to worse outcomes to moms and their babies, she said. According to one study, 293 rural hospitals stopped providing obstetric care between 2011 and 2023. Another study found that more than 52% of rural hospitals did not provide obstetric care by 2022. Arkansas ranks sixth in terms of states with the highest percentage of maternity care deserts, according to the March of Dimes, which defines maternity care deserts as areas with no birthing facility or obstetric clinician. Nearly 51% of Arkansas is a maternity care desert, according to the organization's 2024 report. 'If we see more hospital closures and loss of labor and delivery units, all women living in rural areas are at risk of losing out on the care they need, regardless of who is their insurer, if that care is just not available,' Alker said. 'So these communities will not be able to grow and thrive without a robust system to support women and families.' Beyond reducing healthcare access for all rural community residents, not just those insured through Medicaid, Richoux noted hospital closures can hurt an entire community, especially when it's the area's largest employer. 'Not everybody can just leave…to move out of an area is an easy thing to say, a lot harder to do,' she said. 'And people shouldn't have to be forced to leave their small, rural town because their hospital is unnecessarily closed.' The full Georgetown University report is available here. SUPPORT: YOU MAKE OUR WORK POSSIBLE

Cuts to Medicaid would have dire consequences for Native American population, experts say
Cuts to Medicaid would have dire consequences for Native American population, experts say

Yahoo

time08-02-2025

  • Health
  • Yahoo

Cuts to Medicaid would have dire consequences for Native American population, experts say

As concerns over whether cuts to Medicaid could occur, medical professionals say that rural areas and especially tribal communities would be in 'big trouble.' Communities with populations under 50,000 rely heavily on Medicaid and already face shortages in services and transportation, according to Joan Alker, executive director of the Georgetown University Center for Children and Families and a research professor at the Georgetown McCourt School of Public Policy. 'If Congress moves ahead to make large cuts to these areas … Indian Country, more generally, will be in big trouble,' said Alker. 'Already rural areas face greater challenges. Families and people there have lower incomes, they have higher rates of disabilities, there are acute provider shortages and additional barriers like lack of transportation and internet connectivity, which make it harder to access health care services.' With over 70 million individuals enrolled, Medicaid plays a crucial role in supporting vulnerable populations by covering a significant portion of care for children, maternal health services, nursing home care, disability services, substance abuse treatment and behavioral health, Alker said. Together, Medicaid and the Children's Health Insurance Program, or CHIP, which primarily serves about 8 million enrolled children represent the largest federally supported health insurance programs in the country. Although seniors and individuals with disabilities make up only about 20% of Medicaid enrollees, they account for 51% of its spending, a demand that will only grow with an aging population. Medicaid also supports seniors, particularly those with low incomes who are eligible for both Medicaid and Medicare. Alker noted that while Medicare is often associated with elder care, Medicaid provides essential financial assistance for cost-sharing and wraparound benefits for the most vulnerable seniors. Additionally, Medicaid serves as the primary payer for long-term care, covering five out of eight individuals in such facilities. 'So to the extent that Congress is putting Medicaid right at the top of the list for large cuts when it's serving the most vulnerable populations, it's already a relatively efficient payer, with not a lot of room to squeeze,' said Alker. 'It is extremely troubling.' In both small-town and rural areas, as well as metro areas across all age groups — except for seniors in metro areas — there is a greater reliance on Medicaid as a primary source of health insurance for Native peoples. In Arizona and New Mexico, at least half of children in rural areas are covered by Medicaid/CHIP. Counties such as Apache County in Arizona and McKinley County in New Mexico, which have a predominantly Native American population, are two of the top 20 counties in the country with the highest number of children covered by Medicaid/CHIP. The counties also have the most non-elderly adults covered by Medicaid. Apache County has the highest share of elders covered by Medicaid. 'Medicaid plays a really critical role in the Indian health system,' said Winn Davis, congressional relations director for the National Indian Health Board. 'The tribal health system is funded at around $7 billion to $8 billion annually, but the actual funding needed to provide care is in the tens of billions of dollars. Medicaid, which is authorized expressly to help fill this funding need and meet the trust responsibility to tribes in healthcare, provides significant resources to this effect.' Nationally, 48.7% of Native American children up to age 19 rely on Medicaid for health care coverage. For many Indian health facilities, Medicaid accounts for 30-60% of total funding. Based on data from the American community survey in 2023, some 31% of American Indian and Alaska natives were enrolled in Medicaid compared to 20% for the general population. Among children up to age 18, that rises to 48.7% nationally. 'Medicaid is also the largest third-party payer for Indian health facilities,' said Davis. 'These Medicaid dollars don't just fill a funding need. They also help with regular IHS annual appropriations, making those dollars go further without third-party revenues like Medicaid service dollars that the IHS receives, and the purchased referred care program would not cover all of the need to provide care in Indian country.' Medicaid funding is essential for individuals who cannot obtain third-party health coverage, allowing them to access a range of services, including referred specialty care. This support is crucial for maintaining stability within the Indian health system, Davis said. 'We're concerned that Medicaid cuts can exacerbate health disparities in tribal communities,' said Davis. 'Medicaid reforms, if not done through a deliberative process could inadvertently impact tribal communities which rely on these dollars to furnish critical health care services.' Budget issues: Rural Arizonans could feel outsized burden of proposed Medicaid cuts Any reduction in Medicaid funding could prompt state Medicaid agencies to reassess eligibility criteria and optional service levels, Davis said. Changes to these two factors alone could result in thousands of American Indian and Alaska Native beneficiaries losing access to coverage or essential services. Medicaid cuts could put rural tribal communities at significant risk. In Indian Country, such changes may lead to workforce shortages at Indian health facilities, reduced operating hours and staff layoffs. Additionally, they could result in the elimination of critical care programs and medical services, including mental health care, maternal and child health programs, and other specialty services that rely on Medicaid funding for support. Among the risks, Davis said: 'Exacerbation of chronic conditions, such as diabetes, asthma, and hypertension, which would get worse if they didn't have regular access to treatment, and finally, in some cases it can lead to shutting down rural facilities entirely.' The Indian Health Service in Arizona includes the Phoenix Area Indian Health Service and the Navajo Area Indian Health Service. The Navajo Area has 12 health care centers. The Indian health system itself is not an insurance program, according to Meredith Raimondi, vice president of policy and communications for the National Council of Urban Indian Health. That's why Medicaid plays a crucial role in supporting both the system and the beneficiaries who rely on Indian Health Service, tribal facilities or urban Indian organizations. Urban Indian organizations, established under the Indian Healthcare Improvement Act, serve over 500 tribes across 22 states. Additionally, Medicaid reimbursements are essential for providing care to American Indian and Alaska Native populations living in metro areas. As of 2022, eight out of the 10 areas with the highest number of American Indian and Alaska Native Medicaid enrollees were served by an urban Indian organization. 'The Indian health system is critically underfunded, and the amount appropriated for the Indian Health Service does not even come close to the actual need for urban Indian health or the Indian Health Service overall,' said Raimondi. At urban Indian organizations, in 2019, nearly $90 million in Medicaid reimbursements were provided. Urban Indian organizations serve a significant number of patients, with up to 59% of their patient population consisting of Native people enrolled in Medicaid. Medicaid is also the largest funding source for these organizations outside of the Indian Health Service. In 2023, 2.7 million Native people were enrolled in Medicaid, including 1.9 million American Indian and Alaska Native individuals across the 22 states with urban Indian organizations, according to a National Council of Urban Indian Health analysis of the 2023 American Community Survey. The findings are based on one-year estimates, and include individuals who identified as American Indian or Alaska Native alone or in combination with other races. 'Indian Health Service was authorized to build Medicaid initially in 1976, and this was designed to enable Medicaid funds to flow into IHS institutions that would be the tribal programs, the IHS and Urban Indian organization,' said Raimondi. 'These were considered to be a much needed supplement to the healthcare program and to fulfill the trust responsibility and the Federal Government is the one with the Federal Trust responsibility.' Arlyssa D. Becenti covers Indigenous affairs for The Arizona Republic and Send ideas and tips to This article originally appeared on Arizona Republic: Cuts to Medicaid would have 'dire consequences' for Native populations

DOWNLOAD THE APP

Get Started Now: Download the App

Ready to dive into a world of global content with local flavor? Download Daily8 app today from your preferred app store and start exploring.
app-storeplay-store