Latest news with #vulnerablePopulations
CBC
2 days ago
- Health
- CBC
All aboard: Health P.E.I.'s newest dental clinic is coming to you this summer
Health P.E.I. is rolling out a new mobile dental clinic. The large RV-style clinic has two treatment rooms and an X-ray machine. Officials say it could be a gamechanger for getting dental care to vulnerable people. CBC's Connor Lamont has the story.
CNN
21-05-2025
- Business
- CNN
House GOP lawmakers are proposing $1 trillion in cuts to Medicaid and food stamps. Here's who could be impacted
House Republicans are pushing to slash nearly $1 trillion from two of the nation's bedrock safety net programs, Medicaid and food stamps, as part of their sweeping package aimed at enacting President Donald Trump's agenda. If the legislation is approved, millions of Americans could lose access to these benefits as a result of a historic pullback in federal support. Trump has repeatedly vowed not to touch Medicaid, while GOP lawmakers insist that their proposals would largely affect adults who could – and should, in their view – be employed. But the actual impact would likely hit a far broader range of Americans, including some of the most vulnerable people the GOP has promised repeatedly to protect, experts say. They include children, people with disabilities and senior citizens. A sizeable share of the US population depends on these programs. More than 71 million people are enrolled in Medicaid, and roughly 42 million Americans receive food stamps, according to the federal agencies that oversee them. Hospitals would also feel the financial fallout of the Medicaid cutbacks, which could prompt some to raise their rates for those with job-based insurance and others to close their doors. States would have to shoulder more of the costs of operating these programs, which could force them to make some tough decisions. Among their options could be slashing enrollment, benefits and provider rates in Medicaid or pulling back on residents' access to food stamps. They might also shift spending from other state-supported programs such as education and infrastructure or hike taxes. In addition, grocery store owners are warning that cuts to the Supplemental Nutrition Assistance Program, or SNAP, as food stamps are formally known, could harm local economies and cost jobs. 'We've never in history experienced coverage cuts of this size, and that makes it really difficult to predict how states, providers and patients will respond,' said Alice Burns, an associate director of Program on Medicaid and the Uninsured at KFF, a nonpartisan health policy think tank. 'For the past 50 years, there have been these incremental increases in the availability and access to health care and health insurance coverage. So moving backwards and taking coverage away … This isn't something we've seen before.' What proposals actually make it to the House floor for a vote remain to be seen since conservative and moderate factions of the caucus are currently battling to make changes to the provisions – and more alterations are expected in the Senate before a final bill is enacted into law. The House GOP package would reduce federal support for Medicaid by nearly $700 billion over a decade, according to an updated Congressional Budget Office analysis released on Tuesday. (CBO has yet to release a final analysis of the full legislation.) The proposals would strip Medicaid coverage from more than 10 million people over 10 years, though some are expected to find health insurance elsewhere, such as through their jobs or the Affordable Care Act exchanges, according to an earlier CBO analysis released last week. Overall, an additional 7.6 million Americans are projected to be uninsured in 2034 because of the Medicaid provisions. (Democrats have released a CBO analysis showing even greater potential coverage losses, but that also takes into account the Affordable Care Act provisions in the package and the expiration of the enhanced Obamacare premium subsidies at the end of this lawmakers did not extend those more generous subsidies in this legislation.) The package's most consequential provision is instituting work requirements in Medicaid, a longtime GOP goal. For the first time in Medicaid's 60-year history, certain recipients ages 19 to 64 would be required to work at least 80 hours a month to retain their benefits. They could also meet the mandate by engaging in community service, attending school or participating in a work program. The requirement would not apply to parents, pregnant women, medically frail individuals and those with substance-abuse disorders, among others. It would take effect in 2029, though conservative lawmakers are hoping to push up the start date. However, many people who already are working or who qualify for exemptions could wind up losing their coverage, experts say. That's because they may get caught up in the red tape of regularly reporting their work hours or applying for an exemption. For instance, the mandate could affect low-income people with chronic conditions that make it hard to work if they are enrolled through Medicaid expansion, not the disability pathway. These folks would have to apply for an exemption and prove they are too frail to hold a job. Caregivers and students could also get bogged down in the procedural requirements and wind up kicked out of the program. 'We expect that millions of adults will lose coverage under work requirements, including many who are working, who are looking for a job, who are unable to work because of a health condition or disability or who are meeting some other qualifying activity, but just don't successfully report it because they just have difficulty dealing with the bureaucracy of the new work reporting system,' said Michael Karpman, a principal research associate at the Urban Institute, a think tank. Hospitals and nursing homes could also take a financial hit because the legislation would limit states' ability to levy taxes on health care providers. States often use this revenue to boost provider rates and fund health-related initiatives, among other but one state levy at least one type of provider tax, which some Republicans claim is a scheme by states to get more federal matching funds. Also, with more people expected to be uninsured, hospitals could see their uncompensated care costs rise. While states have typically helped cover the added expense, they may not be in a position to do so if they are receiving less federal funding for Medicaid, Burns said. These budget strains could prompt some hospitals and nursing homes to curtail services, increase rates for other patients or, in the worst case scenario, shut down. The impact may fall even more heavily on providers in rural areas and low-income communities. 'These hospitals, which already operate on thin margins, cannot absorb such losses without reducing services or closing their doors altogether,' Bruce Siegel, CEO of America's Essential Hospitals, a trade group for hospitals that treat many uninsured or lower-income patients, said in a statement. The bill could also hurt those who qualify for both Medicare and Medicaid, the latter of which helps cover their Medicare premiums and out-of-pocket costs, as well as pay for long-term care. One of the provisions would postpone the implementation of a Biden administration rule aimed at streamlining Medicaid eligibility and enrollment until 2035. Such a delay could make it harder for people to enroll in the program and renew their coverage. Some 2.3 million people could lose their Medicaid coverage from this provision, according to a CBO estimate sent to Democratic leaders. They would include senior citizens, people with disabilities and children, in addition to adults, Burns said. More broadly, states would have to decide how to cope with the loss of hundreds of billions of federal dollars. Medicaid is the largest single source of federal funding for state budgets, and the second largest expenditure for states, behind K-12 a reduction in federal support will be felt, especially in states that are already facing budget shortfalls. (Unlike the federal government, nearly all states must approve balanced budgets.) How state lawmakers handle the loss will vary. They might pull back on optional benefits, such as dental care, physical therapy and home and community-based services, which help keep senior citizens and people with disabilities out of nursing homes. One unpalatable option: If states decide to fill the gap by raising taxes, they would need to hike state levies by 4% overall, with the increases ranging from 1% in Kansas and Wyoming to 11% in Louisiana, according to KFF. Under the GOP package, more food stamp recipients would have to work to qualify for benefits. Currently, adults ages 18 to 54 without dependent children can only receive food stamps for three months over a 36-month period unless they work 20 hours a week or are eligible for an exemption. The legislation would extend the work requirement to those ages 55 to 64, as well as to parents of children between the ages of 7 and 18. Plus it would curtail states' ability to receive work requirement waivers in difficult economic times, limiting them only to counties with unemployment rates above 10%. The bill would also require states to pay for a portion of the benefit costs – at least 5% – for the first time, starting in fiscal year 2028. States with higher payment error rates would have to shoulder more of the burden – as much as 25% of the costs for those with error rates of at least 10%. Plus, states would have to pick up 75% of the administrative costs, rather than 50%. The work requirements could put 11 million people at risk of losing their nutrition assistance, said Ty Jones Cox, vice president for food assistance for the left-leaning Center on Budget and Policy Priorities. That includes 4 million children who live in families that could see reduced aid if their parents no longer qualify. And as with Medicaid, states will have to decide how to handle the federal funding loss. Some may try to limit enrollment or even exit the program since it's not mandatory that states participate in food stamps. 'They have more incentive to want to make it harder for people to get food assistance because they're on the hook to pay for the benefit and they're worried about their error rate,' Cox said. Grocery store owners are also sounding the alarm, highlighting that food stamp recipients plow their benefits back into the local economy. Food stamps funding supports about 388,000 jobs and more than $20 billion in wages, and results in more than $4.5 billion in state and federal tax revenue, according to the National Grocers Association, which represents independent grocers. 'SNAP is not just food assistance for families — it's an economic engine that bolsters jobs on Main Street,' Stephanie Johnson, the association's group vice president for government relations, said in a statement. 'This data confirms what independent grocers see every day: SNAP dollars circulate directly through local businesses, helping to pay local wages, keep shelves stocked, and support essential services in communities nationwide.'
Wall Street Journal
12-05-2025
- Health
- Wall Street Journal
Time to Reform the Medicaid Funding Racket
Your editorial 'The Moral Case for Reforming Medicaid' (April 15) is exactly right in arguing that work requirements should be a prerequisite to receive aid for those who are neither elderly nor disabled. Why? Because such provisions have proven successful in other welfare programs, such as Temporary Assistance for Needy Families and food stamps. Yet the case for reforming Medicaid on moral grounds is even more important than you suggest, because the current system is rife with inequities that undermine its original intent as a safety net for the truly needy. As you note, voters support work requirements. But I suspect few realize that the federal government provides states with more generous reimbursements for able-bodied, childless adults than it does for people with disabilities. This perverse incentive structure encourages states to prioritize coverage for healthy adults without dependents—many of whom could reasonably be working—while deprioritizing vulnerable populations, including disabled people urgently in need of essential services like home healthcare.
WIRED
08-05-2025
- Politics
- WIRED
US Customs and Border Protection Quietly Revokes Protections for Pregnant Women and Infants
May 8, 2025 6:00 PM CBP's acting commissioner has rescinded four Biden-era policies that aimed to protect vulnerable people in the agency's custody, including mothers, infants, and the elderly. A mother and child pause on the bank of the Rio Grande after a smuggler rowed them across the U.S.-Mexico border in Roma, Texas, on April 9, 2021. Photograph:US Customs and Border Protection (CBP) has quietly rescinded several internal policies that were designed to protect some of the most vulnerable people in its custody—including pregnant women, infants, the elderly, and those with serious medical conditions. The decision, outlined in a memo dated May 5 and signed by Acting Commissioner Pete Flores, eliminates four Biden era policies enacted over the last three years. These policies were intended to address CBP's long-standing failures to provide adequate care for detainees who are most at risk—failures that have, in some cases, proved fatal. The May 5 memo was distributed internally to top agency leadership but was not announced publicly. CBP justified the rollback by stating in the memo–titled Rescission of Legacy Policies Related to Care and Custody–that the policies were 'obsolete' and 'misaligned' with the agency's current enforcement priorities. Together, the now-rescinded policies laid out standards for detainees with heightened medical needs—requiring, for instance, access to water and food for pregnant people, ensuring privacy for breastfeeding mothers, and mandating diapers and unexpired formula be stocked in holding facilities. They also instructed agents to process at-risk individuals as quickly as possible to limit time in custody. 'It's appalling and it's just an extension of the culture of cruelty that the administration is trying to perpetrate,' says Sarah Mehta, deputy director of Government Affairs for the ACLU's Equality Division. Rescinding the policies, she says, 'is a damning statement about the way that this administration thinks and cares about people with young children.' CBP did not immediately respond to WIRED's request for comment. One of the world's largest law enforcement agencies, CBP is primarily responsible for apprehending and detaining individuals who cross the US border without authorization. While Immigration and Customs Enforcement (ICE) oversees longer-term detention and deportation proceedings, CBP handles the earliest stages of custody, when migrants are held and processed in short-term facilities that have repeatedly drawn criticism for poor medical care and overcrowding In January the Senate Judiciary Committee issued a damning report revealing dysfunction in CBP's medical operations. The investigation revealed chronic understaffing, improper use of medical records systems, and vague or nonexistent guidance for treating children, pregnant individuals, and others with complex medical needs. The report was prompted by the death of 8-year-old Anadith Danay Reyes Álvarez, who died in May 2023 at a CBP facility in Harlingen, Texas. The Panamanian girl, who had a known history of heart problems and sickle cell anemia, reportedly pleaded for help along with her mother. Both were ignored. She died in custody, her final hours spent in a facility whose staff were unequipped—and seemingly unwilling—to provide critical care. Policy reversals have come to define the Trump administration's immigration tactics, from attempts to revoke the status of 500,000 immigrants from Cuba, Haiti, Nicaragua, and Venezuela living legally in the US to purging student visas. In January, a day after President Donald Trump's inauguration, the Department of Homeland security reversed a Biden-era policy that forbade ICE and CBP officers from arresting people in "protected areas," including schools, places of worship, and hospitals. As the number of people held in ICE detention has climbed–reaching roughly 47,928 in April, according to the Transactional Records Access Clearinghouse–apprehensions at the southern US border have fallen sharply, dropping to levels not seen in decades. CBP says that its personnel will continue to follow broader standards under the National Standards on Transport, Escort, Detention, and Search (TEDS), and remain bound by the Flores agreement, which requires that children be given safe and sanitary quarters. The Trump administration has previously argued that the original settlement does not require that children be allowed to sleep or wash themselves with soap.
