Tag Archives: Medicaid

Reporter’s Notebook: Medicaid cuts and the mental health of men in rural America – CBS News

Watch CBS News

John Dickerson shares the heartbreaking story of Alex Jacobsen as potential Medicaid cuts threaten rural access to mental health services.

Source link

Home & Kitchen

Sen. Joni Ernst defends her “we all are going to die” comments: “I’m very compassionate”

June 2, 2025 Tarun

Republican Sen. Joni Ernst of Iowa defended herself Monday after drawing attention for telling a town hall attendee worried about proposed changes to Medicaid that “we all are going to die.”

“I’m very compassionate, and you need to listen to the entire conversation,” Ernst told CBS News on Monday.

Ernst’s now-viral musings on mortality came during a contentious town hall meeting Friday, as attendees grilled the senator about a GOP-backed domestic policy bill that passed the House last month. The legislation — titled the One Big Beautiful Bill Act, after President Trump referred to the measure that way — would impose work requirements on some Medicaid recipients, among other changes.

At one point, as Ernst defended some of the legislation’s changes to the low-income health insurance program, a person appeared to yell that people will die.

“People are not — well, we all are going to die, so for heaven’s sakes,” Ernst responded.

Ernst went on to say that she will “focus on those that are most vulnerable” and added, “those that meet the eligibility requirements for Medicaid we will protect.”

The senator later dug in and posted a sarcastic apology video to Instagram.

“I made an incorrect assumption that everyone in the auditorium understood that, yes, we are all going to perish from this Earth. So, I apologize,” Ernst said in the video. “I’m really, really glad that I did not have to bring up the subject of the Tooth Fairy as well.”

The town hall comments drew criticism from some opponents of Ernst, who is up for reelection next year. Nathan Sage, who is running for the Democratic nomination for Senate, said Ernst is “not even trying to hide her contempt for us.” And Democratic state Rep. JD Scholten announced Monday he’s entering the race, saying in an Instagram post he wasn’t planning to launch his campaign now but “can’t sit on the sidelines” after Ernst’s town hall.

As passed by the House, the domestic policy bill would add restrictions to Medicaid, including a work, volunteer or schooling requirement for non-disabled adults without children. The bill would also add more frequent eligibility checks, cut funding for states that use the Medicaid system to cover undocumented immigrants, freeze provider taxes and ban coverage for gender transition services.

The bill’s proposed changes to Medicaid and the Supplemental Nutrition Assistance Program, better known as food stamps, could save hundreds of billions of dollars, which would help pay for extending Mr. Trump’s 2017 tax cuts and boosting border security.

But before it reaches Mr. Trump’s desk, the bill still needs to pass the Senate, where some Republicans are pushing to roll back some of the Medicaid cuts. In last week’s town hall, Ernst said she agrees with parts of the legislation passed by the House, but “the bill will be changing.”

Nikole Killion

Nikole Killion is a CBS News congressional correspondent based in Washington D.C. As a correspondent, Killion played a key role in the Network’s 2020 political and election coverage, reporting from around the country during the final stretch of the campaign and throughout the Biden transition.

Source link

Home & Kitchen

Medicaid cuts could push more kids into unpaid family caregiving roles

May 30, 2025 Tarun

ST. PAUL, Minn. — High school senior Joshua Yang understands sacrifice. When he was midway through 10th grade, his mom survived a terrible car crash. But her body developed tremors, and she lost mobility. After countless appointments, doctors diagnosed her with Parkinson’s disease, saying it was likely triggered by brain injuries sustained in the wreck.

At 15, Yang, an aspiring baseball player and member of his school’s debate team, took on a new role: his mother’s caregiver.

Researchers estimate that Yang, now 18, counted among at least 5.4 million U.S. children who provide care to an adult in their home. As state officials eye federal Medicaid funding cuts that could drastically reduce home care services for those who are disabled or have chronic health conditions, many predict that number will rise.

That’s bad news for kids: Studies show that when young people take on care for adults with medical conditions, their health and academic outcomes decline. At the same time, their loved ones receive untrained care.

“It all fell to me,” said Yang, whose sisters were 9 and 10 at the time of their mom’s accident, and whose stepdad worked nights. His grades fell and he quit after-school activities, he said, unable to spare the time.

Illustration by Oona Zenda/KFF Health News

Early on, Yang found reprieve from a personal care nurse who gave them supplies, such as adult diapers, and advice on items to purchase, such as a chair for the shower. And for about a year, Yang was able to work for a personal care agency and earn $1,000 a month caring for his mom — money that went toward her medication and family needs.

But at the beginning of 11th grade, a change to his mom’s insurance ended her personal care benefit, sending him into a runaround with his county’s Medicaid office in Minnesota. “For a solid month I was on my phone, on hold, in the back of the class, waiting for the ‘hello,'” he said. “I’d be in third period, saying, ‘Mr. Stepan, can I step out?'”

A report published in May by the U.S. Government Accountability Office reminded states that National Family Caregiver Support Program grants can be used to assist caregivers under 18. However, the future of those grants remains unclear: They are funded through the Older Americans Act, which is awaiting reauthorization; and the Administration for Community Living, which oversees the grants, was nearly halved in April as part of the reorganization of the Department of Health and Human Services under President Trump.

Additionally, if Congress approves proposed cuts to Medicaid, one of the first casualties likely will be states’ home- and community-based service programs that provide critical financial relief to family caregivers, said Andrew Olenski, an economist at Lehigh University specializing in long-term health care.

Such programs, which differ by state but are paid for with federal dollars, are designed to ensure that Medicaid-eligible people in need of long-term care can continue living at home by covering in-home personal and nursing care. In 2021, they served almost 5% of all Medicaid participants, costing about $158 billion.

By law, Medicaid is required to cover necessary long-term care in a nursing home setting but not all home or community care programs. So, if states are forced to make cuts, those programs are vulnerable to being scaled back or eliminated.

If an aide who makes daily home visits, for example, is no longer an option, family caregivers could step in, Olenski said. But he pointed out that not all patients have adult children to care for them, and not all adult children can afford to step away from the workforce. And that could put more pressure on any kids at home.

“These things tend to roll downhill,” Olenski said.

Some studies show benefits to young people who step into caregiving roles, such as more self-confidence and improved family relationships. Yang said he feels more on top of things than his peers: “I have friends worrying about how to land a job interview, while I’ve already applied to seven or eight other jobs.”

But for many, the cost is steep. Young caregivers report more depression, anxiety, and stress than their peers. Their physical health tends to be worse, too, related to diet and lack of attention to their own care. And caregiving often becomes a significant drag on their education: A large study found that 15- to 18-year-old caregivers spent, on average, 42 fewer minutes per day on educational activities and 31 fewer minutes in class than their peers.

Schools in several states are taking notice. In Colorado, a statewide survey recently included its first question about caregiving and found that more than 12% of high schoolers provide care for someone in their home who is chronically ill, elderly, or disabled.

Rhode Island’s education department now requires every middle and high school to craft a policy to support caregiving students after a study published in 2023 found 29% of middle and high school students report caring for a younger or older family member for part of the day, and 7% said the role takes up most of their day. Rates were higher for Hispanic, Asian, and Black students than their white peers.

The results floored Lindsey Tavares, principal of Apprenticeship Exploration School, a charter high school in Cranston. Just under half her students identified as caregivers, she said. That awareness has changed conversations when students’ grades slip or the kids stop showing up on time or at all.

“We know now that this is a question we should be asking directly,” she said.

Students have shared stories of staying home to care for an ill sibling when a parent needs to work, missing school to translate doctors’ appointments, or working nights to pitch in financially, she said. Tavares and her team see it as their job to find an approach to help students persist. That might look like connecting the student to resources outside the school, offering mental health support, or working with a teacher to keep a student caught up.

“We can’t always solve their problem,” Tavares said. “But we can be really realistic about how we can get that student to finish high school.”

Rhode Island officials believe their state is the first to officially support caregiving students — work they’re doing in partnership with the Florida-based American Association for Caregiving Youth. In 2006, the association formed the Caregiving Youth Project, which works with schools to provide eligible students with peer group support, medical care training, overnight summer camp, and specialists tuned in to each student’s specific needs. This school year, more than 700 middle and high school students took part.

“For kids, it’s important for them to know they’re not alone,” said Julia Belkowitz, a pediatrician and an associate professor at the University of Miami who has studied student caregivers. “And for the rest of us, it’s important, as we consider policies, to know who’s really doing this work.”

In St. Paul, Joshua Yang had hoped to study civil engineering at the University of Minnesota, but decided instead to attend community college in the fall, where his schedule will make it simpler to continue living at home and caring for his mom.

But he sees some respite on the horizon as his sisters, now 12 and 13, prepare to take on a greater share of the caregiving. They’re “actual people” now with personalities and a sense of responsibility, he said with a laugh.

“It’s like, we all know that we’re the most meaningful people in our mom’s life, so let’s all help out,” 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

Republicans aim to punish states that insure unauthorized immigrants

May 23, 2025 Tarun

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.

Source link

Home & Kitchen

Trump Talks ‘Big, Beautiful Bill’: Don’t F*ck with Medicaid

May 21, 2025 Tarun

President Donald Trump met with House Republicans on Tuesday to get his “big, beautiful” reconciliation budget passed, though several Freedom Caucus and State and the Local Tax (SALT) Caucus members remain unconvinced without further negotiations.

Massie, a staunch fiscal conservative who is no stranger to butting heads with Trump and fellow representatives over his unwillingness to support government spending, said he is still a “hard no” on the bill, the Washington Examiner reported.

He noted that the president was likely able to convince some members of the Freedom and SALT caucuses to “give up their fights”

“I predict they get the bill passed,” the congressman said. “He was very personal, very persuasive.”

Ahead of the conference with the president — where he spoke for over 90 minutes — Trump told reporters that he does not believe that Massie “understands government,” and that he should be “voted out of office.”

Speaking to the press following the meeting, Massie said, “I’m the only Republican right now that you can count on to vote against this vote… It’s not consequential to my vote today, like whether he endorses me or attacks me. It’s just not — doesn’t change the facts.”

The Kentucky Republican added that he was not “offended by anything [Trump] said” about him.

Trump also directed his attention to Rep. Mike Lawler (R-NY), telling him to back off his demand for a higher limit on SALT deductions to be included in the reconciliation bill.

“I know your district better than you do. If you lose because of SALT, you were going to lose anyway,” the president said in the closed-door meeting, sources told the outlet.

Lawler told reporters that while he “respect[st] the president,” he’s “not budging” on the issue as one of just three Republicans representing a blue district.

“Look, the President can say whatever he wants, and I respect him, but the fact is, I certainly understand my district,” he argued. “I’m one of only three Republican members that won in a district Kamala Harris won, and I did so for reasons.”

“And so if they think we’re going to throw our constituents under the bus to appease [the Freedom Caucus], it’s not happening,” he added.

Rep. Nick LaLota (R-NY) was also unconvinced to change his mind regarding the $40,000 SALT cap — while Trump believes raising the cap “benefit[s] Democrat governors.”

“Those numbers last night didn’t work for me and the members of the SALT caucus,” LaLota said. “We need a little more salt on the table to get to yes. And I hope the president’s presence motivates my leadership to give us a number that we can go sell back at home.”

“All they need from this town is [a] little salt. I don’t think that’s unreasonable,” the New York representative added.

On Medicaid, Trump had a simple message: “Don’t f*** around with Medicaid.”

Rep. Don Bacon (R-NE), who has previously shared his concern about cuts to Medicaid, said Trump’s speech was “what the conference needed.”

Rep. David Valadao (R-CA) concurred, saying the president’s stance on Medicaid “reinforced the message I’ve been saying for a while: Don’t touch it.”

While Ralph Norman (R-SC) said he is still not fully a “go” on reconciliation, he told a gaggle of reporters that he thought Trump did a “great job” in the meeting.

“One of the greatest speeches I’ve heard. And it’s real. It was off the cuff. And he said the right things,” the South Carolina congressman noted.

Freedom Caucus Chairman Andy Harris (R-MD) is also unconvinced to go for the bill following the meeting, but said that a solution is possible.

“We’re still a long ways away, but we can get there — maybe not by tomorrow,” he said.

Fellow Freedom Caucus members Reps. Andy Biggs (R-AZ) and Eric Burlison (R-MO) also said they are still a “no,” but both noted that more negotiation is possible to get them on board.

“I think that there’s some things that we could move easily to make it more comfortable for a lot of people like myself,” Burlison said, according to the Washington Examiner.

“I think you get the sort of vibe that everybody’s, you know, ‘rah, rah,’ and we’re together, and then everybody walks out of the room,” House Intelligence Committee Chairman Rick Crawford (R-AK) said after the meeting. “We’ll see. I mean, at the end of the day, people have to make a decision on their own, they have to calculate– I guess, the political calculation has to be made at home.”

Trump denied that he is “losing patience” with House Republicans, calling the Tuesday gathering a “meeting of love.”

A White House official told the outlet that the president “made it clear he’s losing patience with all holdout factions of the House Republican Conference, including the SALT Caucus and the House Freedom Caucus.”

“The President is clear: he wants EVERY Republican to vote yes,” the statement reads.

While Speaker Mike Johnson’s (R-LA) goal of getting the budget passed by Memorial Day looks shaky due to the current holdups, the bill has a chance if it passes through the Rules Committee on Wednesday.

Speaking with the press after Trump’s speech, the Speaker said there was “high energy and high excitement” inside the room.

“Failure is not an option,” he said, adding that he would meet with the “small subgroups” and “tie up the remaining loose ends.”

Olivia Rondeau is a politics reporter for Breitbart News based in Washington, DC. Find her on X/Twitter and Instagram.

Source link

Home & Kitchen

Trump won’t force Medicaid to cover GLP-1s for obesity. A few states are doing it anyway.

May 20, 2025 Tarun

CHARLESTON, S.C. — When Page Campbell’s doctor recommended that she try an injectable prescription drug called Wegovy to lose weight before scheduling bariatric surgery, she readily agreed.

“I’ve struggled with my weight for so long,” said Campbell, 40, a single mother of two. “I’m not opposed to trying anything.”

In early April, about four weeks after she’d started taking Wegovy, Campbell said she hadn’t experienced any side effects, such as nausea or bowel irritation. But she doesn’t use a scale at home, so she said she didn’t know whether she’d lost any weight since her most recent medical appointment earlier this year, when she weighed 314 pounds. Still, she was confident about achieving weight loss.

“It’s going to work because I’m putting in the work. I’m changing my eating habits. I’m exercising,” said Campbell, a shipping manager at a Michaels store. “I’m not going to second-guess myself.”

Page Campbell, of Charleston, South Carolina, underwent weight loss surgery in April. Campbell also injects a GLP-1 prescription medication weekly for the treatment of obesity, in addition to prioritizing protein intake and physical movement.

Andrew J. Whitaker for KFF Health News

Wegovy belongs to a pricey class of drugs called GLP-1s (short for glucagon-like peptide-1 agonists) that have upended the treatment of obesity in recent years, offering hope to patients who have tried and failed to lose weight in myriad other ways.

Campbell gained access to Wegovy through South Carolina Medicaid’s decision in late 2024 to cover these weight loss drugs. But the medications remain out of reach for millions of patients across the country who could benefit from them, because many public and private health insurers have deemed the drugs too expensive.

A report published in November by KFF, a health information nonprofit that includes KFF Health News, found only 13 states were covering GLP-1s for the treatment of obesity for Medicaid beneficiaries as of August 2024. South Carolina became the 14th in November.

Liz Williams, one of the report’s authors and a senior policy manager for the Program on Medicaid and the Uninsured at KFF, said she was not aware of any other state Medicaid programs joining the list since then. Looking ahead, the remaining states may be reluctant to add a new, expensive drug benefit while they brace for potential federal cuts coming from Congress, she said.

“As the budget debate, federally, is developing, that may impact how states are thinking about this,” Williams said.

The federal government won’t be helping anytime soon, either. Medicare covers GLP-1s to treat diabetes and some other health conditions, including obstructive sleep apnea and cardiovascular disease, but not obesity. In early April, the Trump administration announced it will not finalize a rule proposed by the Biden administration that would have allowed an estimated 7.4 million people covered by Medicare and Medicaid to access GLP-1s for weight loss. Meanwhile, the Food and Drug Administration is poised to force less expensive, compounded versions of these drugs off the market.

And the barrier to entry remains high, even for Medicaid patients in those few states that have agreed to cover the drugs without a federal mandate.

Case in point: In South Carolina, where more than one-third of all adults, and nearly half of the African American population, qualify as obese, the state Medicaid agency estimates only 1,300 beneficiaries will meet the stringent prerequisites for GLP-1 coverage.

Under one of those requirements, Medicaid beneficiaries who wish to access these drugs to lose weight must attest to “increased exercise activity,” said Jeff Leieritz, a spokesperson for the South Carolina Department of Health and Human Services.

Campbell, who is insured by Medicaid, was granted coverage for Wegovy based on her body mass index. First, though, she was required to submit six months’ worth of documentation proving that she’d tried and failed to lose weight after receiving nutrition counseling and going on a 1,200-calorie-a day diet, said Kenneth Mitchell, one of Campbell’s doctors and the medical director for bariatric surgery and obesity medicine at Roper St. Francis Healthcare.

Campbell’s Wegovy prescription was approved for six months, Mitchell said. When that authorization expires, Campbell and her health care team will need to submit more documentation, including proof that she has lost at least 5% of her body weight and has kept up with nutrition counseling.

“It’s not just, ‘Send a prescription in and they cover it.’ It’s rather arduous,” Mitchell said. “Not a lot of folks are going to do this.”

Mitchell said South Carolina Medicaid’s decision to cover these drugs was met with excitement among those working in his medical specialty. But he wasn’t surprised that the state anticipates relatively few people will access this benefit annually, since the approval process is so rigorous and the cost high. “The problem is the medicines are so expensive,” Mitchell said.

Novo Nordisk, which manufactures Wegovy, announced in March that it was cutting the monthly price for the drug from $650 to $499 for cash-paying customers. The price that health insurance plans and beneficiaries pay for these drugs varies, but some GLP-1s cost more than $1,000 per patient per month, Mitchell said, and many people will need to take them for the rest of their lives to maintain weight loss.

“That is a tremendous price tag that someone has to foot the bill for,” Mitchell said.

That’s the reason the North Carolina State Health Plan Board of Trustees voted last year to end coverage of GLP-1s for state employees, after then-North Carolina Treasurer Dale Folwell’s office estimated in 2023 that the drugs were projected to cost the State Health Plan $1 billion over the next six years. The decision came only a few months after a separate North Carolina agency announced it would start covering these drugs for Medicaid beneficiaries. North Carolina Medicaid has estimated it will spend $16 million a year on GLP-1s.

South Carolina Medicaid, which insures fewer than half the number of people enrolled in North Carolina Medicaid, anticipates spending less. Leieritz estimated GLP-1s and nutrition counseling offered to Medicaid beneficiaries in South Carolina will cost $10 million a year. State funding will cover $3.3 million of the expense; the remainder will be paid for by matching Medicaid funds from the federal government.

In a recent interview, Health and Human Services Secretary Robert F. Kennedy Jr. didn’t rule out the possibility that Medicare and Medicaid might cover GLP-1s for obesity treatment in the future as costs come down.

They’re “extraordinary drugs” and “we’re going to reduce the cost,” Kennedy told CBS News in early April. He said he would like GLP-1s to eventually be made available to Medicare and Medicaid patients who are seeking obesity treatment after they have tried other ways to lose weight. “That is the framework that we’re now debating.”

Meanwhile, public health experts have applauded South Carolina Medicaid’s decision to cover GLP-1s. Yet the new benefit won’t help the vast majority of the 1.5 million adults in South Carolina who are classified as obese, according to data published by the South Carolina Department of Public Health.

“We still have some work to do,” acknowledged Brannon Traxler, the public health department’s chief medical officer.

But the state’s new “Action Plan for Healthy Eating and Active Living,” written by a coalition of groups in South Carolina, including the Department of Public Health, makes no mention of GLP-1s or the role they might play in lowering obesity rates in the state.

The action plan, underwritten by a $1.5 million federal grant, isn’t meant to lay out an overarching approach for lowering obesity in South Carolina, Traxler said. Instead, it promotes physical activity in schools, nutrition, and the expansion of outdoor walking trails, among other strategies. A more comprehensive obesity plan might address the benefits of surgical intervention and GLP-1s, but those also carry risk, expense, and side effects, Traxler said.

“Certainly, I think, there is a need to bring it all together,” she said.

Campbell, for one, is taking the comprehensive approach. On top of injecting Wegovy once weekly, she said, she is prioritizing protein intake and moving her body. She also underwent weight loss surgery in late April.

“Weight loss is my biggest goal,” said Campbell, who expressed appreciation for Medicaid’s coverage of Wegovy. “It’s one more thing that’s going to help me get to my goal.”

Source link

Home & Kitchen

Housing, nutrition in peril as Trump pulls back Medicaid social services

May 19, 2025 Tarun

During his first administration, President Trump’s top health officials gave North Carolina permission to use Medicaid money for social services not traditionally covered by health insurance. It was a first-in-the-nation experiment to funnel health care money into housing, nutrition, and other social services.

Some poor and disabled Medicaid patients became eligible for benefits, including security deposits and first month’s rent for housing, rides to medical appointments, wheelchair ramps, and even prescriptions for fresh fruits and vegetables.

Such experimental initiatives to improve the health of vulnerable Americans while saving taxpayers on costly medical procedures and expensive emergency room care are booming nationally. Without homes or healthy food, people risk getting sicker, becoming homeless, and experiencing even more trouble controlling chronic conditions such as diabetes and heart disease.

Former President Joe Biden encouraged states to go big on new benefits, and the availability of social services exploded in states red and blue. Since North Carolina’s launch, at least 24 other states have followed by expanding social service benefits covered by Medicaid, the health care program for low-income and disabled Americans — a national shift that’s turning a system focused on sick care into one that prioritizes prevention. And though Mr. Trump was pivotal to the expansion, he’s now reversing course regardless of whether evidence shows it works.

In Mr. Trump’s second term, his administration is throwing participating states from California to Arkansas into disarray, arguing that social services should not be paid for by government health insurance. Officials at the Centers for Medicare & Medicaid Services, which grants states permission to experiment, have rescinded its previous broad directive, arguing that the Biden administration went too far.

“This administration believes that the health-related social needs guidance distracted the Medicaid program from its core mission: providing excellent health outcomes for vulnerable Americans,” CMS spokesperson Catherine Howden said in a statement.

“This decision prevents the draining of resources from Medicaid for potentially duplicative services that are already provided by other well-established federal programs, including those that have historically focused on food insecurity and affordable housing,” Howden added, referring to food stamps and low-income housing vouchers provided through other government agencies.

Mr. Trump, however, has also proposed axing funding for low-income housing and food programs administered by agencies including the departments of Housing and Urban Development and Agriculture — on top of Republican proposals for broader Medicaid cuts.

The pullback has led to chaos and confusion in states that have expanded their Medicaid programs, with both liberal and conservative leaders worried that the shift will upend multibillion-dollar investments already underway. Social problems such as homelessness and food insecurity can cause — or worsen — physical and behavioral health conditions, leading to sky-high health care spending. Medical care delivered in hospitals and clinics, for instance, accounts for only roughly 15% of a person’s overall health, while a staggering 85% is influenced by social factors such as access to healthy food and shelter for sleep, said Anthony Iton, a policy expert on social determinants of health.

Health care experts warn the disinvestment will come at a price.

“It will just lead to more death, more suffering, and higher health care costs,” said Margot Kushel, a primary care doctor in San Francisco and a leading researcher on homelessness and health care.

The Trump administration announced in a March 4 memo that it was rescinding Biden-era guidance dramatically expanding experimental benefits known as health-related social needs. Federal waivers are required for states to use Medicaid funds for most nontraditional social services outside of hospitals and clinics.

Last month, the administration told states that these services, which can also include high-speed internet and storage units, should not be part of Medicaid.

Future waiver requests allowing Medicaid to provide social services — a liberal philosophy — will be considered on a “case-by-case basis,” the administration said. Rather, it has signaled a conservative shift toward requiring most Medicaid beneficiaries to prove that they’re working or trying to find jobs, which puts an estimated 36 million Americans at risk of losing their health coverage.

“What they’re arguing is Medicaid has been expanded far beyond basic health care and it needs to be cut back to provide only basic coverage to those most desperately in need,” said Mark Peterson, a health policy expert at UCLA. “They’re making the case, which is not widely shared by specialists in the health care field, that it’s not the job of taxpayers and Medicaid to pay for all this stuff outside the traditional heath care system.”

Although states have not received formal guidance to end their social experiments, Peterson and other health policy researchers expect the administration not to renew waivers, which typically run in five-year intervals. Worse, legal experts say programs underway could be halted early.

Evidence supporting social investments by Medicaid is still nascent. An expansion in Massachusetts that provided food benefits reduced ER visits and hospitalizations, for instance. But often, it’s a mixed bag.

California is going the biggest, investing $12 billion over five years to provide a slew of new services, from intensive case management to help people with severe behavioral health conditions to housing and food assistance through a pair of federal waivers. The most popular benefits provided by health insurers are those that help homeless people on Medicaid by placing them in apartments or securing beds in recovery homes, covering up to $5,000 for security deposits, and preventing eviction.

Since the CalAIM program launched in 2022, it has served only a small fraction of the state’s nearly 15 million Medicaid beneficiaries, with roughly 577,000 referrals for benefits. Yet it has improved and even saved the lives of some of those lucky enough to get help, including Eric Jones, a 65-year-old Los Angeles resident.

“When I got diabetes, I didn’t know what to do and I had a hard time getting to my medical appointments,” said Jones, who lost his housing this year when his mom died but received services through his Medi-Cal insurer, L.A. Care. “My case manager got me rides to my appointments and also helped me get into an apartment.”

California is considering making some of its social services permanent after the CalAIM waivers expire at the end of 2026. Gov. Gavin Newsom’s administration is adding more housing services, including up to six months of free rent under a third waiver approved by the Biden administration. Medi-Cal officials contended early evidence shows CalAIM has led to better care coordination and fewer hospital and ER visits.

“We are fully committed,” said Susan Philip, a deputy director for the state Department of Health Care Services, which administers the program. “We have invested so much.”

In this 2022 photo, Frances De Los Santos of Victorville, California, opens a medically tailored meal delivered to her home as part of a state Medicaid initiative to improve the health of the program’s sickest patients. The Trump administration is now arguing that social services, including housing and nutrition, should not be paid for by government health insurance.

Heidi de Marco/KFF Health News

Health insurers, which deliver Medicaid coverage and receive greater funding to cover these additional benefits, say they’re worried the Trump administration will end or curtail the programs. “If we do things the same old way, we’re just going to generate the same old results — people getting sicker and health care costs continuing to rise,” said Charles Bacchi, president and CEO of the California Association of Health Plans, which represents insurers.

Industry leaders say the expansion is already changing lives.

“We believe wholeheartedly that housing is health, food is health, so seeing these programs disappear would be devastating,” said Kelly Bruno-Nelson, executive director of Medi-Cal for CalOptima Health, a health insurance provider in Orange County.

Oregon is also providing low-income Medicaid patients with a range of new services, including home-delivered healthy meals and rental payment assistance. Residents can even qualify for air conditioners, heaters, air filters, power generators, and mini fridges. State Medicaid officials say they remain committed to providing the benefits but worry about federal cuts.

“Climate change and housing instability are huge indicators of poor health,” said Josh Balloch, vice president of health policy and communications at AllCare Health, a Medicaid insurer in Oregon. “We hope to prove to the federal government that this is a good return on their investment.”

But even as the Trump administration curtails waivers, it is retaining discretion to provide social services in Medicaid, just on a smaller scale. Supporters say it’s fair to scrutinize where to draw the line on taxpayer spending, arguing that there isn’t always a direct health connection.

“We’re seeing these things increase, with the free rent, and we’re seeing some states pay for free internet, paying for furniture,” said Kody Kinsley, who previously served as North Carolina’s top health official. “We know there’s evidence for food and housing, but with all of these new benefits, we need to look closely at the evidence and the linkage to what actually drives health.”

Current North Carolina officials say they’re confident the new social services Medicaid provides in their state have resulted in better health and lower overall spending on expensive and acute care. Medicaid recipients there can even use the program to buy farm-fresh produce.

While it’s too soon to know whether these experiments have been effective elsewhere in the United States, early evidence in North Carolina shows promise: The state had saved $1,020 per participant a year into its experiment — operating in mostly rural counties — by reducing ER trips and hospitalizations.

State health officials also touted the economic benefits of driving business to family farms, home improvement contractors, and community-based organizations providing housing and social services.

“I welcome the challenge of demonstrating the effectiveness of our programs. It’s making for healthier people and healthier budgets,” said Jay Ludlam, deputy secretary for North Carolina’s Medicaid program. “Family farms that were on the verge of collapse after Hurricane Helene are now benefiting from a steady income while they also serve their community.”

Source link

Home & Kitchen

Trump Administration Lays Out Five Reasons to Back ‘One Big Beautiful Bill’

May 17, 2025 Tarun

The White House is pointing to five key reasons it believes lawmakers should support the “One Big Beautiful Bill,” which is headlined by tax cuts.

The Trump adminsitration issued a press release Friday afternoon underscoring the tax overhaul, as well as the measures to boot illegal aliens off of Medicaid, to make permanent President Donald Trump’s border security measures, modernize air traffic control, and to halt tax dollars from going to child sex change procedures.

On the tax front, the White House touts that the bill includes permanent tax cuts, which it estimates will save Americans an additional $5,000 on average. The bill also includes Trump’s key campaign promises of nixing taxes on overtime and tips, while also cutting taxes on social security benefits for seniors.

Workers making $30,000-$80,000 annually would see about a 15 percent drop in taxes under the bill’s current form.

The administration points to a provision that would remove 1.4 million illegal aliens from Medicaid rolls as a second reason to back the bill.

Thirdly, the release underscores how “The One Big Beautiful Bill” addresses the southern border, including the hundreds of miles of border wall it would greenlight if it becomes law.

“As a result, 701 miles of primary wall, 900 miles of river barriers, 629 miles of secondary barriers, and 141 miles of vehicle and pedestrian barriers will be constructed — along with cutting-edge technology that will secure our homeland for generations to come,” the White House notes.

The White House also touts that the bill would give the necessary resources to Border Patrol and Immigration and Customs Enforcement (ICE) to carry out “at least one million annual removals.” Additionally, it would direct the hiring of “10,000 new ICE personnel, 5,000 new customs officers, and 3,000 new Border Patrol agents.”

As a fourth reason to back the bill, the White House notes that it includes a major update of air traffic control systems. Finally, it would block Medicaid funding for sex change treatments on children.

Source link

Home & Kitchen

Trump budget package in danger as it hits GOP opposition

May 16, 2025 Tarun

Washington — House Republicans have yet to resolve several major disputes that threaten to derail President Trump’s domestic policy bill as more conservative members and blue-state Republicans dig in on their demands.

House Speaker Mike Johnson remains committed to putting the legislation, which would extend tax cuts from Mr. Trump’s first term while temporarily enacting new ones, on the floor before Memorial Day. The tax measures, as well as increased spending on the military and border security, would be offset partly by cuts to Medicaid, food stamps and clean energy subsidies.

But first, it will have to get through the House Budget Committee starting Friday, where a handful of conservatives have said the legislation does not go far enough to slash federal spending. Rep. Ralph Norman of South Carolina said Thursday that he and Rep. Chip Roy of Texas would vote against advancing the bill.

“We’ve got a spending problem. We’ve got a deficit problem, and it doesn’t address that,” Norman said.

Rep. Jodey Arrington of Texas, the Republican chairman of the Budget Committee, said he was confident there are enough votes to advance it when the committee meets Friday to merge the various parts of the reconciliation package that have been produced by other committees into a single bill. If it can get out of the Budget Committee, the plan is for the Rules Committee to meet Monday to tee it up for a floor vote later in the week.

Meanwhile, a group of Republicans from blue states have threatened to withhold their support in a floor vote if the bill does not raise a cap on state and local taxes that can be written off on federal tax returns. The bill increases the cap on the deduction from $10,000 to $30,000, but several New York Republicans have insisted on raising it even further.

Rep. Mike Lawler, a New York Republican, on Thursday called the cap “unacceptable” and said the group has made clear to leadership that “none of us are going to support that as it currently stands.”

Among the demands conservative members have made are moving up the work requirements for Medicaid recipients without disabilities and children. The requirements would not set in until 2029 under the current bill and conservatives want them to kick in as soon as the legislation becomes law.

House Majority Leader Steve Scalise, a Louisiana Republican, said Thursday that they are considering moving up the effective date for the work requirements to get more members on board with the final product, but added that the final details have not been worked out.

Johnson, a Louisiana Republican, spent Thursday meeting with the opposing factions and said they would continue to negotiate through the weekend to resolve the remaining differences. He can afford just three defections, if all members are voting, in a floor vote.

Caitlin Yilek

Caitlin Yilek is a politics reporter at CBSNews.com, based in Washington, D.C. She previously worked for the Washington Examiner and The Hill, and was a member of the 2022 Paul Miller Washington Reporting Fellowship with the National Press Foundation.

Ellis Kim

contributed to this report.

Source link