Tag Archives: health care

Home & Kitchen

Trump’s “one big beautiful bill” continues GOP efforts to roll back Obamacare

Millions would lose Medicaid coverage. Millions would be left without health insurance. Signing up for health plans on the Affordable Care Act marketplaces would be harder and more expensive.

President Trump’s domestic policy legislation, the One Big Beautiful Bill Act that cleared the House in May and now moves to the Senate, could also be called Obamacare Repeal Lite, its critics say. In addition to causing millions of Americans to lose their coverage under Medicaid, the health program for low-income and disabled people, the measure includes the most substantial rollback of the ACA since Mr. Trump’s Republican allies tried to pass legislation in 2017 that would have largely repealed President Barack Obama’s signature domestic accomplishment.

One difference today is that Republicans aren’t describing their legislation as a repeal of the ACA, after the 2017 effort cost them control of the House the following year. Instead, they say the bill would merely reduce “waste, fraud, and abuse” in Medicaid and other government health programs.

“In a way, this is their ACA repeal wish list without advertising it as Obamacare repeal,” said Philip Rocco, an associate professor of political science at Marquette University in Milwaukee and co-author of the book “Obamacare Wars: Federalism, State Politics, and the Affordable Care Act.”

The GOP, Rocco said, learned eight years ago that the “headline of Obamacare repeal is really bad politics.”

Democrats have tried to frame Mr. Trump’s One Big Beautiful Bill Act as an assault on Americans’ health care, just as they did with the 2017 legislation. 

“They are essentially repealing parts of the Affordable Care Act,” Rep. Frank Pallone Jr. (D-N.J.) said as the House debated the measure in May. “This bill will destroy the health care system of this country.”

Nearly two-thirds of adults have a favorable view of the ACA, according to polling by KFF, a national health information nonprofit that includes KFF Health News. 

In contrast, about half of people polled also say there are major problems with waste, fraud, and abuse in government health programs, including Medicaid, KFF found.

“We are not cutting Medicaid,” House Speaker Mike Johnson said May 25 on CNN’s “State of the Union,” describing the bill’s changes as affecting only immigrants living in the U.S. without authorization and “able-bodied workers” whom he claimed are on Medicaid but don’t work.

The program is “intended for the most vulnerable populations of Americans, which is pregnant women and young single mothers, the disabled, the elderly,” he said. “They are protected in what we’re doing because we’re preserving the resources for those who need it most.” 

The 2025 legislation wouldn’t cut as deeply into health programs as the failed 2017 bill, which would have led to about 32 million Americans losing insurance coverage, the Congressional Budget Office estimated at the time. By contrast, the One Big Beautiful Bill Act, with provisions that affect Medicaid and ACA enrollees, would leave nearly 9 million more people without health insurance by 2034, according to the CBO. 

That number rises to nearly 14 million if Congress doesn’t extend premium subsidies for Obamacare plans that were enhanced during the pandemic to help more people buy insurance on government marketplaces, the CBO says. Without congressional action, the more generous subsidies will expire at the end of the year and most ACA enrollees will see their premiums rise sharply.

The increased financial assistance led to a record 24 million people enrolled in ACA marketplace plans this year, and health insurance experts predict a large reduction without the enhanced subsidies.

Loss of those enhanced subsidies, coupled with other changes set in the House bill, will mean “the ACA will still be there, but it will be devastating for the program,” said Katie Keith, founding director of the Center for Health Policy and the Law at Georgetown University.   

Republicans argue that ACA subsidies are a separate issue from the One Big Beautiful Bill and accused Democrats of conflating them.

The House-passed bill also makes a number of ACA changes, including shortening by a month the annual open enrollment period and eliminating policies from Joe Biden’s presidency that allowed many low-income people to sign up year-round.

New paperwork hurdles the House bill creates are also expected to result in people dropping or losing ACA coverage, according to the CBO.

For example, the bill would end most automatic reenrollment, which was used by more than 10 million people this year. Instead, most ACA enrollees would need to provide updated information, including on income and immigration status, to the federal and state ACA marketplaces every year, starting in August, well before open enrollment. 

Studies show that additional administrative hurdles lead to people dropping coverage, said Sabrina Corlette, a research professor and co-director of the Center on Health Insurance Reforms at Georgetown University.

“Not only do people drop out of the process, but it tends to be healthier, younger, lower-income folks who drop out,” she said. “That’s dumb because they go uninsured. Also, it is bad for the insurance market.”

Supporters of the provision say it’s necessary to combat fraudulent enrollment by ensuring that ACA beneficiaries still want coverage every year or that they are not being enrolled without their permission by rogue sales agents. Most of the Medicaid coverage reductions in the bill, the CBO says, are due to new work requirements and directives for the 21 million adults added to the program since 2014 under an expansion authorized by the ACA.

One new requirement is that those beneficiaries prove their eligibility every six months, instead of once a year, the norm in most states. 

That would add costs for states and probably lead to people who are still eligible falling off Medicaid, said Oregon Medicaid Director Emma Sandoe. Oregon has one of the most liberal continuous eligibility policies, allowing anyone age 6 or older to stay on for up to two years without reapplying. 

Such policies help ensure people don’t fall off for paperwork reasons and reduce administrative burden for the state, Sandoe said. Requiring more frequent eligibility checks would “limit the ability of folks to get care and receive health services, and that is our primary goal,” Sandoe said.

The 2017 repeal effort was aimed at fulfilling Mr. Trump’s promises from his first presidential campaign. That’s not the case now. The health policy provisions of the House bill instead would help to offset the cost of extending about $4 trillion in tax cuts that skew toward wealthier Americans. 

The Medicaid changes in the bill would reduce federal spending on the program by about $700 billion over 10 years. CBO has not yet issued an estimate of how much the ACA provisions would save.

Timothy McBride, a health economist at Washington University in St. Louis, said Republican efforts to make it harder for what they term “able-bodied” adults to get Medicaid is code for scaling back Obamacare.

The ACA’s Medicaid expansion has been adopted by 40 states and Washington, D.C. The House bill’s work requirement and added eligibility checks are intended to drive off Medicaid enrollees who Republicans believe never should have been on the program, McBride said. Congress approved the ACA in 2010 with no Republican votes.

Most adult Medicaid enrollees under 65 are already working, studies show. Imposing requirements that people prove they’re working, or that they’re exempt from having to work, to stay on Medicaid will lead to some people losing coverage simply because they don’t fill out paperwork, researchers say.

Manatt Health estimates that about 30% of people added to Medicaid through the ACA expansion would lose coverage, or about 7 million people, said Jocelyn Guyer, senior managing director of the consulting firm.

The bill also would make it harder for people enrolled under Medicaid expansions to get care, because it requires states to charge copayments of up to $35 for some specialist services for those with incomes above the federal poverty level, which is $15,650 for an individual in 2025. 

Today, copayments are rare in Medicaid, and when states charge them, they’re typically nominal, usually under $10. Studies show cost sharing in Medicaid leads to worse access to care among beneficiaries.

Christopher Pope, a senior fellow with the conservative Manhattan Institute, acknowledged that some people will lose coverage but rejected the notion that the GOP bill amounts to a full-on assault on the ACA. 

He questioned the coverage reductions forecast by the CBO, saying the agency often struggles to accurately predict how states will react to changes in law. He said that some states may make it easy for enrollees to satisfy new work requirements, reducing coverage losses. 

By comparison, Pope said, the ACA repeal effort from Mr. Trump’s first term a decade ago would have ended the entire Medicaid expansion. “This bill does nothing to stop the top features of Obamacare,” Pope said.

But McBride said that while the number of people losing health insurance under the GOP bill is predicted to be less than the 2017 estimates, it would still eliminate about half the ACA’s coverage gains, which brought the U.S. uninsured rate to historical lows. “It would take us backwards,” he said.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.

Source link

Home & Kitchen

The Counterargument: Why Texas Should Tread Carefully on Veterinary Telehealth

Unsplash+

A recent Observer article makes the case for expanding veterinary telemedicine in Texas, but many of its interpretations of the data and legal context may not capture the full picture. It omits recent developments in veterinary education, such as the 11 new veterinary colleges planned across the country, which are likely to address regional care gaps. The article closely reflects the arguments of a national advocacy group supporting the same legislation. A closer look at the data suggests a more complex landscape. 

The assertion of a massive shortage of veterinarians in Texas or nationwide, particularly in small animal practice, is not strongly supported. After a spike in visits during the Covid-19 pandemic, office visits are now down. This is not due to a lack of veterinarians, but rather a lack of demand. Studies forecasting a shortage rely on methodologies that likely reflect reflect distribution and access challenges rather than a true national shortfall. One such source, cited by the author, notes that it “provides a relative measure of the accessibility of veterinary care for counties throughout the country. It is not an absolute scale as data do not yet exist to provide reliable benchmarks for such absolute measures.” In other words, the data may reflect rural access issues, but not an overall deficit of qualified professionals. 

Some of the sources cited in the article offer a more nuanced view than its conclusions suggest. For example, one document, presented as evidence of industry support for expanded veterinary telemedicine, begins by cautioning that “veterinarians, patients would see more risk than reward with proposed changes to practice.” Another source, cited in reference to a “critical veterinary shortage,” focuses primarily on rural areas and recommends strengthening the veterinary education pipeline and expanding loan repayment programs for veterinarians who practice in rural Texas, not expanded telehealth, as solutions. 

Additionally, the article references a recent court decision as evidence that Texas’ telehealth requirements are unconstitutional. However, the scope of the ruling was more limited. The court ruled, regarding one veterinarian, that his use of email to offer clinical advice to pet owners was constitutionally protected speech under the First Amendment. As the judge noted, “We specifically conclude that the State of Texas is directly regulating Dr. Hines’s speech and that this regulation fails to survive even intermediate scrutiny. The court did not weigh in on the broader constitutionality of requiring an in-person exam before prescribing medication or other aspects of veterinary medical practice.

Targeted solutions already in motion

To be clear, Texas does need more rural and large-animal veterinarians. But the legislature has taken steps to address those areas of need, including supporting new veterinary education programs aimed at rural and large-animal practice. The new Texas Tech School of Veterinary Medicine, which graduated its first class of 61 new veterinarians in May, says 95 percent of those new graduates will be working in rural and regional settings. By 2027, the school aims to train 100 new veterinarians each year with a curriculum emphasizing large and mixed animal practice and recruitment from rural communities. Meanwhile, Texas A&M College of Veterinary Medicine and Biomedical Science has increased its class size from 130 to 180 students in the Class of 2025. Twenty of these students are now training at a West Texas campus that targets rural and large animal practices. Combined, these programs are on track to nearly double Texas’ veterinary graduate output compared to just a few years ago. 

Diagnostic risks of remote-only care

Another fundamental concern that deserves more attention is the clinical risk of prescribing treatment for an animal the veterinarian has not physically seen or examined. In nearly three decades of experience across various veterinary settings, I have often encountered cases where an initial impression, based on a description or visual assessment, changed significantly after conducting a hands-on exam or diagnostic testing. Many potentially serious conditions simply cannot be responsibly differentiated and diagnosed without listening to the animal’s heart and lungs, conducting tests and performing a hands-on assessment. Without these steps, there can be a heightened risk of misdiagnosis, which can delay treatment, increase animal suffering, raise costs and lead to dissatisfaction for pet owners.

Veterinary telemedicine deserves serious consideration. It has significant responsible uses that should be encouraged, such as follow-up care after in-person visits or triage for emergency care. However, broad deregulation raises real clinical and ethical concerns that could carry consequences for Texas pets, livestock and the people who care for them. Any future changes to telehealth policy in the state should be guided by data, animal welfare and the needs of pet owners and rural communities—not by pressure from out-of-state tech firms spearheading deregulation in other states and seeking rapid market expansion in the Lone Star State.



Source link

Home & Kitchen

Planned Parenthood affiliate to close 4 clinics in Minnesota and 4 in Iowa over federal funding cuts

Four Planned Parenthood clinics in Minnesota and four of the six in Iowa will shut down in a year, the Midwestern affiliate operating them said Friday, blaming a freeze in federal funds, budget cuts proposed in Congress and state restrictions on abortion.

Two of the Minnesota clinics closing are in the Twin Cities area, in Apple Valley and Richfield. The others are in Alexandria and Bemidji.

According to Planned Parenthood North Central States, the four closing in Iowa include the only Planned Parenthood facility in the state that provides abortion procedures, in Ames, home to Iowa State University. The others are in Cedar Rapids, Sioux City and the Des Moines suburb of Urbandale.

The Planned Parenthood affiliate said it would lay off 66 employees and ask 37 additional employees to move to different clinics. The organization also said it plans to keep investing in telemedicine services and sees 20,000 patients a year virtually. The affiliate serves five states — Iowa, Minnesota, Nebraska, North Dakota and South Dakota.

“We have been fighting to hold together an unsustainable infrastructure as the landscape shifts around us and an onslaught of attacks continues,” Ruth Richardson, the affiliate’s president and CEO, said in a statement.

Of the remaining 15 clinics operated by Planned Parenthood North Central States, six will provide abortion procedures — five of them in Minnesota. The other clinic is in Omaha, Nebraska.

The affiliate said that in April, the Trump administration froze $2.8 million in federal funds for Minnesota to provide birth control and other services, such as cervical cancer screenings and testing for sexually transmitted diseases.

While federal funds can’t be used for most abortions, abortion opponents have long argued that Planned Parenthood affiliates should not receive any taxpayer dollars, saying the money still indirectly underwrites abortion services.

Planned Parenthood North Central States also cited proposed cuts in Medicaid, which provides health coverage for low-income Americans, as well as a Trump administration proposal to eliminate funding for teenage pregnancy prevention programs.

In addition, Republican-led Iowa last year banned most abortions after about six weeks of pregnancy, before many women know they are pregnant, causing the number performed there to drop 60% in the first six months the law was in effect and dramatically increasing the number of patients traveling to Minnesota and Nebraska.

After the closings, Planned Parenthood North Central States will operate 10 brick-and-mortar clinics in Minnesota, two in Iowa, two in Nebraska, and one in South Dakota. It operates none in North Dakota, though its Moorhead, Minnesota, clinic is across the Red River from Fargo, North Dakota.

The Associated Press

contributed to this report.

Source link

Home & Kitchen

Republicans aim to punish states that insure unauthorized immigrants

President Trump’s signature budget legislation would punish 14 states that offer health coverage to people in the U.S. without authorization.

The states, most of them Democratic-led, provide insurance to some low-income immigrants — often children — regardless of their legal status. Advocates argue the policy is both humane and ultimately cost-saving.

But the federal legislation, which Republicans have titled the “One Big Beautiful Bill,” would slash federal Medicaid reimbursements to those states by billions of dollars a year in total unless they roll back the benefits.

The bill narrowly passed the House on Thursday and next moves to the Senate. While enacting much of Mr. Trump’s domestic agenda, including big tax cuts largely benefiting wealthier Americans, the legislation also makes substantial spending cuts to Medicaid that congressional budget scorekeepers say will leave millions of low-income people without health insurance.

The cuts, if approved by the Senate, would pose a tricky political and economic hurdle for the states and Washington, D.C., which use their own funds to provide health insurance to some people in the U.S. without authorization.

Those states would see their federal reimbursement for people covered under the Affordable Care Act’s Medicaid expansion cut by 10 percentage points. The cuts would cost California, the state with the most to lose, as much as $3 billion a year, according to an analysis by KFF, a health information nonprofit that includes KFF Health News.

Together, the 15 affected places cover about 1.9 million immigrants without legal status, according to KFF. The penalty might also apply to other states that cover lawfully residing immigrants, KFF says.

Two of the states — Utah and Illinois — have “trigger” laws that call for their Medicaid expansions to terminate if the feds reduce their funding match. That means unless those states either repeal their trigger laws or stop covering people without legal immigration status, many more low-income Americans could be left uninsured.

The remaining states and Washington, D.C., would have to come up with millions or billions more dollars every year, starting in the 2027 fiscal year, to make up for reductions in their federal Medicaid reimbursements, if they keep covering people in the U.S. without authorization.

Behind California, New York stands to lose the most federal funding — about $1.6 billion annually, according to KFF.

California state Sen. Scott Wiener, a Democrat who chairs the Senate budget committee, said Mr. Trump’s legislation has sown chaos as state legislators work to pass their own budget by June 15.

“We need to stand our ground,” he said. “California has made a decision that we want universal health care and that we are going to ensure that everyone has access to health care, and that we’re not going to have millions of undocumented people getting their primary care in emergency rooms.”

California Gov. Gavin Newsom, a Democrat, said in a statement that Mr. Trump’s bill would devastate health care in his state.

“Millions will lose coverage, hospitals will close, and safety nets could collapse under the weight,” Newsom said.

In his May 14 budget proposal, Newsom called on lawmakers to cut some benefits for immigrants without legal status, citing ballooning costs in the state’s Medicaid program. If Congress cuts Medicaid expansion funding, the state would be in no position to backfill, the governor said.

Newsom questioned whether Congress has the authority to penalize states for how they spend their own money and said his state would consider challenging the move in court.

Utah state Rep. Jim Dunnigan, a Republican who helped spearhead a bill to cover children in his state regardless of their immigration status, said Utah needs to maintain its Medicaid expansion that began in 2020.

“We cannot afford, monetary-wise or policy-wise, to see our federal expansion funding cut,” he said. Dunnigan wouldn’t say whether he thinks the state should end its immigrant coverage if the Republican penalty provision becomes law.

Utah’s program covers about 2,000 children, the maximum allowed under its law. Adult immigrants without legal status are not eligible. Utah’s Medicaid expansion covers about 75,000 adults, who must be citizens or lawfully present immigrants.

Matt Slonaker, executive director of the Utah Health Policy Project, a consumer advocacy organization, said the federal House bill leaves the state in a difficult position.

“There are no great alternatives, politically,” he said. “It’s a prisoner’s dilemma — a move in either direction does not make much sense.”

Slonaker said one likely scenario is that state lawmakers eliminate their trigger law then find a way to make up the loss of federal expansion funding.

Utah has funded its share of the cost of Medicaid expansion with sales and hospital taxes.

“This is a very hard political decision that Congress would put the state of Utah in,” Slonaker said.

In Illinois, the GOP penalty would have even larger consequences. That’s because it could lead to 770,000 adults‘ losing the health coverage they gained under the state’s Medicaid expansion.

Stephanie Altman, director of health care justice at the Shriver Center on Poverty Law, a Chicago-based advocacy group, said it’s possible her Democratic-led state would end its trigger law before allowing its Medicaid expansion to terminate. She said the state might also sidestep the penalty by asking counties to fund coverage for immigrants. “It would be a hard situation, obviously,” she said.

Altman said the House bill appeared written to penalize Democratic-controlled states because they more commonly provide immigrants coverage without regard for their legal status.

She said the provision shows Republicans’ “hostility against immigrants” and that “they do not want them coming here and receiving public coverage.”

U.S. House Speaker Mike Johnson said this month that state programs that provide public coverage to people regardless of immigration status serve as “an open doormat,” inviting more people to cross the border without authorization. He said efforts to end such programs have support in public polling.

A Reuters-Ipsos poll conducted May 16-18 found that 47% of Americans approve of Mr. Trump’s immigration policies and 45% disapprove. The poll found that Mr. Trump’s overall approval rating has sunk 5 percentage points since he returned to office in January, to 42%, with 52% of Americans disapproving of his performance.

The Affordable Care Act, widely known as Obamacare, enabled states to expand Medicaid to adults with incomes of up to 138% of the federal poverty level, or $21,597 for an individual this year. Forty states and Washington, D.C., expanded, contributing to the national uninsured rate dropping to historic lows.

The federal government now pays 90% of the costs for people added to Medicaid under the Obamacare expansion.

In states that cover health care for immigrants in the U.S. without authorization, the Republican bill would reduce the federal government’s contribution from 90% to 80% of the cost of coverage for anyone added to Medicaid under the ACA expansion.

By law, federal Medicaid funds cannot be used to cover people who are in the country without authorization, except for pregnancy and emergency services.

The other states that use their own money to cover people regardless of immigration status are Colorado, Connecticut, Maine, Massachusetts, Minnesota, New Jersey, Oregon, Rhode Island, Vermont, and Washington, according to KFF.

Ryan Long, director of congressional relations at Paragon Health Institute, an influential conservative policy group, said that even if they use their own money for immigrant coverage, states still depend on federal funds to “support systems that facilitate enrollment of illegal aliens.”

Long said the concern that states with trigger laws could see their Medicaid expansion end is a “red herring” because states have the option to remove their triggers, as Michigan did in 2023.

The penalty for covering people in the country without authorization is one of several ways the House bill cuts federal Medicaid spending.

The legislation would shift more Medicaid costs to states by requiring them to verify whether adults covered by the program are working. States would also have to recertify Medicaid expansion enrollees’ eligibility every six months, rather than once a year or less, as most states currently do.

The bill would also freeze states’ practice of taxing hospitals, nursing homes, managed-care plans, and other health care companies to fund their share of Medicaid costs.

The Congressional Budget Office said in a May 11 preliminary estimate that, under the House-passed bill, about 8.6 million more people would be without health insurance in 2034. That number will rise to nearly 14 million, the CBO estimates, after the Trump administration finishes new ACA regulations and if the Republican-led Congress, as expected, declines to extend enhanced premium subsidies for commercial insurance plans sold through Obamacare marketplaces.

The enhanced subsidies, a priority of former President Joe Biden, eliminated monthly premiums altogether for some people buying Obamacare plans. They are set to expire at the end of the year.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.

Source link

Home & Kitchen

Outdated Laws Are Holding Back Veterinary Care in Texas

In Texas, veterinary clinics are overburdened, rural communities lack basic care and the state ranks near the bottom in veterinary access. Telemedicine could provide relief. Unsplash+

Veterinary medicine is transforming, not only in how care is delivered, but in how veterinarians practice. The demands on the profession have never been greater, with clinics overburdened, emergency centers overwhelmed and not enough veterinarians to meet rising demand. Texas, like much of the country, faces a critical veterinary shortage, and if we don’t embrace solutions that maximize our workforce, access to care will continue to decline.

One of the most effective ways to address this challenge is to modernize Texas’ outdated laws on veterinary telemedicine. Telemedicine is not a replacement for in-person care—it is a tool that expands how and when veterinarians can serve patients. It provides flexibility for veterinarians who want to practice in a way that fits their skills, lifestyle and patient needs while ensuring that animals receive timely medical attention. Many states have already embraced telemedicine, but Texas has not.

The veterinary profession has changed significantly in recent years. Today, pet ownership is at an all-time high, with nearly 60 percent of households owning at least one pet; yet there aren’t enough veterinarians to meet demand. Texas scores only 36 out of 100 in veterinary accessibility, when looking at issues like income, transportation, language and number of veterinary hospitals—with many rural counties lacking even a single veterinarian. Veterinary ERs are overcrowded, general practice vets have weeks-long waitlists and burnout is driving professionals out of the field entirely. The weight of these challenges falls directly on veterinarians, whose workloads have become unsustainable. The system simply cannot continue operating the way it has been.

For decades, veterinarians have used some form of telemedicine—answering after-hours calls, advising on pet poison hotlines and offering guidance via photos and videos. Technology has evolved, allowing us to integrate virtual care more effectively into modern practice. Yet Texas law still blocks veterinarians from establishing a veterinary-client-patient relationship (VCPR) virtually, even when doing so would improve access to care.

In September 2024, the Fifth Circuit Court of Appeals ruled that Texas’ ban on virtual VCPRs is unconstitutional. The court highlighted the inconsistency of allowing human doctors to establish a telemedicine relationship with patients, while veterinarians remain restricted. Other states, including Florida and Arizona, have already modernized their laws, allowing veterinarians to use their professional judgment in determining when telemedicine is appropriate.

Veterinarians deserve the flexibility to deliver care in ways that align with their expertise, personal circumstances and the needs of their patients. The ability to see patients remotely, when appropriate, reduces unnecessary clinic congestion, helps veterinarians reach underserved areas and provides a lifeline for overwhelmed practitioners. This is especially true for veterinarians who prefer a non-traditional practice model, such as those balancing family obligations, retirement transitions or rural outreach. Expanding telemedicine options also makes the profession more attractive to younger veterinarians, who increasingly seek flexibility in their careers.

Rather than taking business away from in-person clinics, telemedicine helps expand access to care by connecting more pet owners to veterinarians, many of whom might not have sought care otherwise. Instead of replacing hands-on visits, telemedicine works alongside them, ensuring that in-person clinics can focus on the cases that truly require physical exams and procedures. Research suggests that telemedicine can actually increase patient volume by addressing minor concerns early, preventing them from escalating into more serious health problems.

Three national veterinary industry forums in 2022 brought together experts to discuss telemedicine’s role in veterinary practice. The vast majority of participants agreed that a virtual VCPR is both feasible and beneficial when supported by appropriate safeguards, such as veterinarians being licensed in the state where they are practicing and requirements that they follow all federal laws related to prescriptions.

Sen. Nathan Johnson and Rep. Janie Lopez have introduced Senate Bill 1442 and House Bill 3364, offering a measured, veterinarian-led approach to legalizing virtual VCPRs in Texas. These bills do not force veterinarians to practice telemedicine, nor do they replace in-person care. Instead, they give veterinarians the choice to use telemedicine where it makes sense—just as physicians do in human medicine.

The veterinarian profession is at a crossroads, where workforce shortages, increasing demand and technological advancements require us to think differently about how we provide care. Telemedicine is already working—it’s time for Texas law to recognize that reality.



Source link

Home & Kitchen

Regeneron to buy 23andMe out of bankruptcy for $256 million

Regeneron has agreed to buy 23andMe, the once buzzy genetic testing company, out of bankruptcy for $256 million under a court-supervised sale process.

23andMe declared bankruptcy in March and announced it would seek a buyer, while also saying that co-founder and CEO Anne Wojcicki would resign. 

Under the proposed agreement with Regeneron, the Tarrytown, New York, drugmaker will acquire 23andMe’s assets, including its personal genome service and total health and research services. Regeneron said Monday that it will abide by 23andMe’s privacy policies and applicable law to protect customer data. 

Data privacy experts had raised concerns about 23andMe’s storehouse of data for about 15 million customers, including their DNA. 

23andMe’s consumer-genome services will continue interrupted, the purchaser said. Regeneron will not acquire 23andMe’s Lemonaid Health telehealth business.

“We have deep experience with large-scale data management,” Regeneron co-founder George Yancopoulos said in a statement. The company “has a proven track record of safeguarding the genetic data of people across the globe, and, with their consent, using this data to pursue discoveries that benefit science and society.”

23andMe offers consumer services that provide customers with information on their ancestry and genetic health profile, including the risk of passing on certain conditions to their children. It also has a therapeutics arm that researches and develops treatments for cancers, immune diseases and other conditions.

“We are pleased to reach an agreement with a science-driven partner that maintains our team and helps ensure our mission will carry forward,” 23andMe interim CEO Joe Selsavage said in a statement. “With the support of Regeneron and their deep experience in genetic sequencing, testing and discovery, we look forward to continuing to help people access and understand the human genome for the benefit of customers and patients.” 

Megan Cerullo

Megan Cerullo is a New York-based reporter for CBS MoneyWatch covering small business, workplace, health care, consumer spending and personal finance topics. She regularly appears on CBS News 24/7 to discuss her reporting.

Source link

Home & Kitchen

California Gov. Gavin Newsom proposes pausing immigrant health care coverage expansion

California Gov. Gavin Newsom has proposed a pause to the enrollment of more low-income immigrants without legal status for state-funded health care benefits in 2026 as the state faces economic uncertainty. 

Newsom outlined his nearly $332 billion state spending plan on Wednesday, revealing that California is facing a $12 billion budget deficit. 

“California is under assault,” Newsom said. “We have a president that’s been reckless in terms of assaulting those growth engines.”

The Democratic governor noted that the freeze does not mean California is backing away from its support for immigrants.

“No state has done more than the state of California, no state will continue to do more than the state of California by a long shot. And that’s a point of pride,” Newsom said.

The decision, the details for which were revealed before Wednesday’s budget revision presentation, is driven by a higher-than-expected price tag on the program and economic uncertainty from federal tariff policies, Newsom said. It also comes as Newsom faces his final years in the governor’s office, with speculation continuing to mount about his future political prospects. 

California’s push to offer free health care benefits to all low-income adults, regardless of their immigration status, was announced in late 2023. Newsom touted the planned expansion as “a transformative step towards strengthening the health care system for all Californians.”

However, the cost has exceeded the state’s initial $6.4 billion estimate by more than $2 billion.

Still, as late as March of this year, Newsom suggested to reporters he was not considering rolling back health benefits for low-income people living in the country illegally — even with California grappling with a $6.2 billion Medicaid shortfall. He also repeatedly defended the expansion, saying it saves the state money in the long run. The program is state-funded and does not use federal dollars.

Under Newsom’s plan, low-income adults without legal status will no longer be eligible to apply for Medi-Cal, the state’s Medicaid program, starting in 2026. Those who are already enrolled won’t be kicked off their plans because of the enrollment freeze, and the changes won’t impact children. Newsom’s office didn’t say how long the freeze would last.

Starting in 2027, adults with “unsatisfactory immigration status” on Medi-Cal, including those without legal status and those who have legal status but aren’t eligible for federally funded Medicaid, will also have to pay a $100 monthly premium. The governor’s office said that is in line with the average cost paid by those who are on subsidized heath plans through California’s own marketplace. There’s no premium for most people currently on Medi-Cal.

“We believe that people should have some skin in the game as it relates to contributions,” Newsom said.

In total, Newsom’s office estimated the changes will save the state $5.4 billion by 2028-2029.

The Medi-Cal expansion, combined with other factors such as rising pharmacy costs and larger enrollment by older people, has forced California to borrow and authorize new funding to plug the multibillion-dollar hole earlier this year. California provides free health care to more than a third of its 39 million people.

The proposals come ahead of Newsom’s scheduled presentation on the updated budget. Recovery from the Los Angeles wildfires, changing federal tariff policies, and the expensive health care expansion are putting a strain on California’s massive state budget. Lawmakers are expecting a multibillion-dollar shortfall this year, and more deficits are projected for several years ahead.

Newsom blamed President Donald Trump’s tariff policies for the shortfalls, estimating that the polices have cost the state $16 billion in tax revenues. California is also bracing for major budget hits if Republicans in Congress follow through with a plan to slash billions of dollars in Medicaid and penalize states for providing health care to immigrants without legal status.

Newsom now opens budget negotiations with lawmakers and it’s unclear how Democrats who control the Legislature will react to his plan to freeze new Medi-Cal enrollment for some immigrants. A final budget proposal must be signed by June. California’s budget is by far the largest among states.

“This is going to be a very challenging budget,” Assemblymember Jesse Gabriel, who chairs the budget committee, said before Newsom’s proposals were announced. “We’re going to have to make some tough decisions.”

The budget proposals presented this week will build on some of the impacts of federal policies, but many unknowns remain.

The governor already said he’s planning to scale back on baseline spending this year. Analysts and economists also warn that California will face bigger deficits in the tens of billions of dollars in the coming years due to economic sluggishness and stock market volatility brought on by the tariff war.

The budget Newsom first proposed in January included little new spending. But it allows the state to fully implement the country’s first universal transitional kindergarten program and increase the state’s film and TV tax credit to $750 million annually to bring back Hollywood jobs that have gone to New York and Georgia. He recently called on Trump to pass a $7.5 billion film tax credit at the federal level.

Last year, Newsom and the Legislature agreed to dip into the state’s rainy day fund, slash spending — including a nearly 10% cut for nearly all state departments — and temporarily raise taxes on some businesses to close an estimated $46.8 billion budget deficit.

Source link

Home & Kitchen

After promising universal health care, California Gov. Gavin Newsom must reconsider immigrant coverage

SACRAMENTO — Gov. Gavin Newsom didn’t expect to be reckoning with another health care crisis.

In March, as President Trump and congressional Republicans escalated a nationwide debate over whether to slash health care for poor and disabled Americans, the Democratic governor had to tell state lawmakers that California’s health care costs had spiraled out of control due to major Medicaid initiatives he backed — including the nation’s largest expansion of taxpayer-financed health care for immigrants living in the U.S. illegally.

His top officials at the state Department of Finance quietly disclosed to California lawmakers in a letter that the state had borrowed $3.4 billion to pay health insurers, doctors, and hospitals caring for patients enrolled in California’s Medicaid program, known as Medi-Cal. Facing rising health care costs amid a deepening state budget crisis, Newsom now must contemplate rolling back coverage and benefits.

The second-term governor faces a tough political decision: renege on his promise to achieve universal health care and strip coverage from millions of immigrants who lack legal status or look elsewhere for budget cuts. With nearly 15 million low-income or disabled residents enrolled in Medi-Cal, California has more to lose on health care than any other state. Yet even as Newsom has condemned Mr. Trump’s approach to tariffs and environmental policies, he has been tight-lipped on health policy.

Complicating his political tightrope: Polling shows that providing health care coverage for immigrants without legal status has tepid support. And any resulting budget trouble could harm his political legacy should he run for president in 2028.

“We all know that the cuts are definitely coming,” said Carlos Alarcon, a health and public benefits analyst with the California Immigrant Policy Center, which has helped spearhead a decadelong campaign in California to expand Medicaid to eligible immigrants without legal status. “The governor should keep his commitment — we’ll be very disappointed if we see cuts and rollbacks. When times get hard, it’s always our marginalized and underserved communities that lose out.”

California allows any low-income adults to enroll in Medi-Cal if they earn 138% of the federal poverty level, or $21,597 a year or less, regardless of immigration status. But the costs have been dramatically higher than expected.

Democratic Gov. Jerry Brown first expanded Medi-Cal to people age 19 and younger without legal status, but he expressed reluctance to go further because of potential costs. Newsom signed bills into law adding people age 20 and older. An estimated 1.6 million immigrants without legal status are now covered, and costs have soared to $9.5 billion per year, up from $6.4 billion estimated in November. The federal government chips in roughly $1.1 billion of that total for pregnancy and emergency care.

“We can expand out of the graciousness of our heart to everywhere and anywhere, but the moment these resources run out, now everybody loses. We’re hitting that breaking point,” said California Assembly member David Tangipa (R-Fresno). “Either we get fiscally responsible, or there’s not going to be services for anybody — and that includes the Californian and the undocumented immigrant.”

Democratic leaders responsible for approving the state budget declined interviews. In a statement, state Sen. María Elena Durazo (D-Los Angeles), who championed the expansion in the legislature, said, “Rolling back this progress would be a harmful and shortsighted decision.”

Lawmakers are considering freezing enrollment for immigrants without legal status, imposing cost-sharing measures such as drug copays or premiums, or restricting benefits, according to people familiar with the matter, who asked not to be identified to protect relationships at the state Capitol.

However, it’s unlikely Newsom will slash funding in his budget revision set for release on May 14. Instead, cuts would follow if congressional Republicans approve a budget deal with major reductions in federal spending on Medicaid.

“This is going to be very problematic for the governor. Budget cuts will disrupt the lives of millions of immigrants who just got health care, but the governor has got to do something, because this is not sustainable,” said Mark Peterson, an expert on health care and national politics at UCLA. “The prospect of cutting other places in order to support immigrants living in the country illegally would be a hard political sale; I don’t see that happening.”

Should Newsom, along with the Democratic-controlled legislature, be forced to make cuts, he could argue he had no choice. Mr. Trump and congressional Republicans have threatened states like California with the latest U.S. House proposal cutting Medicaid funding by 10 percentage points for states that provide coverage for immigrants without legal status. For Newsom, political analysts say, Mr. Trump could make an easy scapegoat.

“He can blame Trump — there’s only so much money to go around,” said Mike Madrid, an anti-Trump Republican political analyst in California who specializes in Latino issues. “It’s making people look at the health care that they can’t afford and ask, ‘Why the hell are we giving it for free to people who are here illegally?'”

The exorbitant cost has come as somewhat of a surprise.

In Newsom’s first budget proposal as governor — in which he called for expanding Medi-Cal to young adults without legal status — his administration estimated it would cost roughly $2.4 billion annually to extend benefits to all eligible people regardless of status. But the latest figure reported to legislators was nearly four times as much.

Newsom declined to respond to questions from KFF Health News, instead referencing previous comments that leave the door open to scaling back Medi-Cal. The governor noted “sober” discussions with lawmakers and said cutting Medi-Cal is “an open-ended question” that the president will heavily influence.

“What’s the impact of Donald Trump on a lot of these things? What’s the impact of federal vandalism to a lot of these programs?” Newsom asked rhetorically in December, suggesting it’s unclear whether he’ll be able to sustain the expansion to immigrants without legal status in future years.

Newsom expanded Medi-Cal in three phases, starting with immigrants ages 19 to 25, who became eligible in 2020, resisting pressure from health care advocates for one big, costly expansion. He argued doing it incrementally would ultimately save California money.

“It is the right thing morally and ethically,” Newsom said in 2020. “It is also the financially responsible thing to do.”

Record budget surpluses in recent years allowed Democrats to continue. Older adults ages 50 to 64 became eligible in 2022, and Newsom closed the gap the following year, approving coverage starting in 2024 for the biggest group, those ages 26 to 49.

But the costs have grown tremendously while the budget picture has soured, according to a KFF analysis of the most recent 2023 records available from the state Department of Health Care Services, which administers Medi-Cal.

Aside from children, it was more expensive to provide Medicaid coverage to immigrants without legal status than to legal residents. For instance, Medi-Cal paid L.A. Care, a major health insurer in Los Angeles, an average of $495.32 monthly to provide care for a childless adult without legal status and $266.77 for a legal resident without kids.

Not only were immigrants without legal status more expensive, California footed most of the cost. The state paid roughly between 60% and 70% of health care costs for a childless adult immigrant covered by L.A. Care, and about 10% for a legal resident without kids. Those costs don’t encapsulate the entire cost of providing care, which can vary depending on where Medi-Cal patients live, and grow higher when filling prescriptions, going to the dentist, or seeking mental health care.

These payments also differ by insurer, but the trend holds across the state’s Medi-Cal health insurance plans. Patients in most of the state can choose from more than one health plan.

Children without legal status in many cases were cheaper to cover than children who were legal residents. Generally, kids are healthier and require less care.

Mike Genest, who served as finance director under former Republican Gov. Arnold Schwarzenegger, argued that the state should have planned for the immense price tag.

“The idea that we’d be able to afford in the long run paying for health care for all these undocumented people — it’s beyond unsustainable,” Genest said.

While costs are high now, the expansion of Medi-Cal will result in long-term savings to taxpayers and the health care system, said Anthony Wright, who previously lobbied for the expansion as the head of the nonprofit Health Access and is now fighting Medicaid cuts as the executive director of Families USA, based in Washington, D.C.

“They’re going to be showing up in our health care system regardless,” Wright said. “Leaving them without health insurance is just going to end in more crowded emergency rooms, and it’s going to cost even more. It doesn’t make any sense economically for them to be uninsured; that takes critical revenue from clinics and hospitals, just causing more problems.”

This article was produced by KFF Health News, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism. KFF Health News is the publisher of California Healthline, an editorially independent service of the California Health Care Foundation.

Source link

Home & Kitchen

Medical school fully embraces AI tools for students



Medical school fully embraces AI tools for students – CBS News










































Watch CBS News



Artificial intelligence is quickly becoming a part of our daily lives — whether in the office or the classroom. Tom Hanson reports on one medical school that has become the first in the nation to incorporate AI fully into its doctor training program.

Be the first to know

Get browser notifications for breaking news, live events, and exclusive reporting.


Source link

Home & Kitchen

How Trump plans to lower drug costs



How Trump plans to lower drug costs – CBS News










































Watch CBS News



President Trump called on drugmakers to lower their prices in the U.S. within the next month to be closer to costs in other high-income countries. The president threatened to subject the companies to steep caps on how much they can earn from Medicare if they fail to do so. Dr. Celine Gounder explains.

Be the first to know

Get browser notifications for breaking news, live events, and exclusive reporting.


Source link