KHN’s ‘What the Health?’: Medicaid Machinations


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The lame-duck Congress is again in Washington with a protracted checklist of payments it wish to cross and a short while to do it earlier than Republicans take over the Home majority in January. What number of health-related gadgets may be achieved relies upon largely on how a lot cash Congress agrees to spend total, because it hashes out the annual federal spending payments.

In the meantime, a few of the remaining states that haven’t but expanded the Medicaid program could also be warming as much as the concept, notably North Carolina and Kansas, which have Democratic governors and Republican legislatures.

This week’s panelists are Julie Rovner of KHN, Alice Miranda Ollstein of Politico, Rachel Cohrs of Stat, and Sarah Karlin-Smith of the Pink Sheet.

Among the many takeaways from this week’s episode:

  • How a lot the lame-duck Congress manages to perform will partly hinge on whether or not congressional leaders go for an omnibus spending invoice — which might full the unfinished spending payments via September 2023 — versus a unbroken decision, which might merely prolong what’s already on the books into someday within the new 12 months. Backside line: Well being priorities are competing for a pot of cash, however it’s unclear how massive that pot will probably be. Some insiders describe it as a site visitors jam.
  • On the high of that checklist are FDA reforms that didn’t make it into the prescription drug user-fee reauthorization invoice that handed this 12 months. Lawmakers fought to maintain that measure “clear,” leaving the door open to sort out some leftover points. What, if something, will make the ultimate minimize is but to be seen.
  • Different issues on the lame-duck checklist embrace reversing a 4% scheduled minimize to Medicare suppliers’ reimbursements; weighing proposals associated to pandemic preparedness; addressing Medicaid funding for U.S. territories; addressing the top of the general public well being emergency; and scrutinizing telehealth coverage.
  • Among the many states which have but to increase Medicaid beneath the Inexpensive Care Act, motion is feasible by these with a Democratic governor and Republican legislature — Kansas and North Carolina, specifically. Advocates are focusing on such locations as a result of protection for a whole bunch of 1000’s of individuals may very well be in danger, particularly because the official finish of the general public well being emergency looms. The monetary well-being of some rural and safety-net hospitals is also in jeopardy.
  • Georgia is poised to increase Medicaid eligibility considerably, however solely to individuals who can show they labored or did neighborhood service for 80 hours monthly. This comes after a federal choose dominated that the Biden administration’s transfer to cancel a Trump administration-approved waiver was “arbitrary and capricious.” The one different Medicaid work requirement that has taken impact, in Arkansas, ended up taking protection away from 1000’s of people that had been eligible and dealing, resulting from its difficult reporting system.
  • Anti-abortion teams appear eager on discovering artistic methods to take purpose on the so-called abortion tablet, which just lately grew to become the commonest technique of ending being pregnant in the USA. Medicine abortions are way more tough for anti-abortion teams to focus on, as a result of ladies don’t have to go to a clinic to obtain the medication.
  • One lawsuit sought to power the FDA to rescind its approval of mifepristone, courting to 2000. Anti-abortion teams say the company didn’t have the authority to approve the drug via the “expedited” pathway it selected.
  • One other technique from anti-abortion teams claims that using abortion tablets is contaminating wastewater and groundwater; they search to deploy environmental legal guidelines to dam using the medication.
  • Regardless of People’ want to place the covid-19 pandemic within the rearview mirror, the virus could produce other plans. The Biden administration needs one other $10 billion earlier than the top of the 12 months to pay for its anti-covid marketing campaign, though even Democrats in Congress usually are not pushing exhausting for that funding. In the meantime, governments and social media platforms are nonetheless struggling to deal with covid misinformation and disinformation.

Additionally this week, Rovner interviews KHN’s Fred Clasen-Kelly, who reported and wrote the newest KHN-NPR “Bill of the Month,” a couple of mysterious mishap throughout minor surgical procedure. In case you have an infinite or mystifying medical invoice you’d prefer to share with us, you can do that here.

Plus, for further credit score, the panelists advocate their favourite well being coverage tales of the week they assume it is best to learn, too:

Julie Rovner: Stat’s “Resistance to FDA’s Opioid-Disposal Plan Raises Concerns About CADCA, a Powerful Advocacy Group,” by Lev Facher

Alice Miranda Ollstein: ProPublica and The New York Occasions’ “She Wanted an Abortion. A Judge Said She Wasn’t Mature Enough to Decide,” by Lizzie Presser

Rachel Cohrs: The New Yorker’s “How Hospice Became a For-Profit Hustle,” by Ava Kofman

Sarah Karlin-Smith: The New York Occasions’ “Jail Is a Death Sentence for a Growing Number of Americans,” by Shaila Dewan

Additionally talked about on this week’s episode:

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This story was produced by KHN (Kaiser Well being Information), a nationwide newsroom that produces in-depth journalism about well being points. Along with Coverage Evaluation and Polling, KHN is among the three main working applications at KFF (Kaiser Household Basis). KFF is an endowed nonprofit group offering info on well being points to the nation.

KHN (Kaiser Well being Information) is a nationwide newsroom that produces in-depth journalism about well being points. Along with Coverage Evaluation and Polling, KHN is among the three main working applications at KFF (Kaiser Household Basis). KFF is an endowed nonprofit group offering info on well being points to the nation.

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