Future of health policy in the United States
Director of Health Care Reform and Senior Fellow, The Century Foundation
Drew Altman
President and CEO, KFF
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The following content is produced and paid for by a Washington Post Live event sponsor. The Washington Post newsroom is not involved in the production of this content.
Mark Bertolini
CEO, Oscar Health
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Miami Herald
3 hours ago
- Miami Herald
Chicago's safety net hospitals face potential service cuts, layoffs after signing of ‘big, beautiful' tax bill
Christine Mertzelos is trying to avoid having her leg amputated. Twice a week, a hospital van carries her from her home in Wrigleyville to the wound clinic at Humboldt Park Health, where a diabetic ulcer on her ankle is cleaned, treated and dressed. At one point, the ulcer wrapped nearly all the way around her lower leg - a situation that can lead to amputation if not controlled. The ulcer, however, has shrunk significantly. "This place has been a lifesaver for me," said Mertzelos, 61. "Without this clinic I don't know what I would do." She and others, however, are worried they may have to find out in coming years. The recent signing of the "One Big Beautiful Bill" has thrown into question the future of services at safety net hospitals like Humboldt Park Health that care for large numbers of people on Medicaid. The new law will slash an estimated $1 trillion from Medicaid over the next 10 years to help pay for tax cuts and enhanced border and national security, according to the Congressional Budget Office. Humboldt Park Health will likely see an additional $5 million to $7 million in losses annually once the changes go into effect, said CEO Jose Sanchez. The hospital typically has an operating margin of about $1 million annually. "I came in this morning and met with senior leaders and said, 'We've got to begin to think about how do we position ourselves to face the potential cuts we'll have,'" Sanchez said earlier this week. About 75% to 80% of Humboldt Park Health's patients are on Medicaid, and the hospital employs about 1,000 people, he said. "When you absorb the magnitude of those cuts, that means now you are beginning to make a decision of what services you are not going to provide," Sanchez said. "When you eliminate services, you eliminate people as well." As a state, Illinois stands to lose about $48 billion in federal funding for Medicaid over 10 years, according to KFF, a nonprofit organization focused on health policy. More than 330,000 Illinois residents - or nearly 11% of those now on Medicaid - are at risk of losing their health care coverage over the decade, according to Manatt Health, which provides legal and consulting services in health care. New work requirements for certain adults on Medicaid don't go into effect until late December 2026, and major changes to provider taxes - a mechanism states use to help fund their Medicaid programs - won't take effect until fiscal year 2028. But hospitals aren't waiting to start making plans. "Undoubtedly the hospitals can't wait until the policies are fully implemented," said Dr. Ben Sommers, a professor of health policy and economics at Harvard T.H. Chan School of Public Health. "They need to start planning now." Patient Maria Fuentes worries about what will happen if Humboldt Park Health has to cut its offerings. Fuentes has been going to the hospital, which was previously called Norwegian American Hospital, for decades, and gave birth to all four of her kids there. "It's my hospital," said Fuentes, 52, of Dunning, as she visited on a recent day for a checkup. Sinai Chicago will also face difficult decisions in coming years as the law's provisions take effect. Sinai, which includes Mount Sinai Hospital on the West Side and Holy Cross Hospital on the South Side, has been running in the red, and about 70% of its patients are on Medicaid, said CEO Dr. Ngozi Ezike. It's too early to say exactly how much money Sinai will lose as a result of the new law, but "going forward there will be services that will have to be adjusted," Ezike said. "There are a lot of things that will have to be looked at, including layoffs, everything that we don't want to do, those are all things that have to be on the table," Ezike said. Cook County Health also expects to take a hit, including a loss of about $88 million a year once the work requirements go into effect, with an estimated 10% of its Medicaid patients potentially losing coverage, said CEO Dr. Erik Mikaitis. Many people are expected to lose Medicaid not because they don't qualify, but because of increased paperwork-related challenges. Cook County Health isn't planning on any layoffs or service changes for now, as it works through a projected budget gap for 2026, Mikaitis said. But in coming years, "the more that things happen, the more likely there may be a time we'll have to make difficult decisions," Mikaitis said. Mostly, he worries about how the new law will affect patients who may lose their health coverage. "As people lose coverage they stop engaging in preventative care, and instead of seeing patients in the office to manage blood pressure and diabetes, we're going to see them in the emergency room to manage strokes and heart attacks," Mikaitis said. Lurie Children's Hospital also sees potential trouble ahead. About half of Lurie Children's Hospital's patients are on Medicaid. Though those patients are children and won't be subject to work requirements, hospital leaders worry about how other cuts to federal Medicaid dollars for Illinois might affect its offerings. The hospital is already limited by the gap between what Medicaid reimburses it for services versus what that care actually costs to provide, said Lurie CEO Dr. Tom Shanley. The question, he said, is, "Are we going to be able to continue the degree of the services we have today as we move forward?" As Mertzelos finished her treatment at Humboldt Park Health on a recent day, she wondered aloud what would happen to people like her if the hospital had to cut its offerings. "It literally scares me to hear something like services might be cut because I don't know what I would do," Mertzelos said. Dr. Ann Marie Kulekowskis, who is medical director of the hospital's wound clinic, overheard her. "I don't know what we would all do," the doctor replied. _____ Copyright (C) 2025, Tribune Content Agency, LLC. Portions copyrighted by the respective providers.
Politico
6 hours ago
- Politico
Democrats thought they found their midterm message on the megabill — but it could hit some snags
'We will need to remind voters that the impact is going to kind of come in waves, and that a lot of the brunt of the damage won't be felt until next year, or even after the midterms,' Stevenson said. 'We just will have to remind them that provisions of the bill are still coming, that deadlines are looming.' But the bulk of the health care cuts Republicans built into their megabill — including reductions to the so-called provider tax many states use to help fund their Medicaid programs and new work requirements that could cost millions of people their coverage — won't kick in until after the midterms. Republicans have signaled they'll use the popular parts of the legislation like a tax deduction on tips to go on offense against Democrats. NRCC spokesperson Mike Marinella said Democrats were using 'desperate and disgusting fear-mongering tactics' and added the GOP would 'use every tool to show voters that the provisions in this bill are widely popular.' Polling shows voters are receiving mixed messages on Medicaid. A tracking survey from nonprofit health policy group KFF shows 63 percent of independents said they believe the bill will strip health care coverage from people who need it, but they also broadly support adding work requirements to the program. 'If Republicans are able to characterize these changes as simply fraud and waste, there may not be as drastic political implications,' said Ashley Kirzinger, associate director of KFF's Public Opinion and Survey Research Program. Another potential pitfall for Democrats: States use different names for the Medicaid programs — Medi-Cal in California, SoonerCare in Oklahoma, Health First Colorado — that could leave some voters unaware that the cuts are from national Republicans. Democrats will get a trial run for their Medicaid messaging in this year's gubernatorial races in New Jersey and Virginia. Rep. Mikie Sherrill, New Jersey Democrats' nominee to succeed term-limited Democratic Gov. Phil Murphy, has attacked her opponent for being 'fully on board' with Republican cuts, and argued that New Jersey is 'the first chance to hold them accountable at the ballot box.' Laura Matos, a Democratic strategist in New Jersey, noted that Republicans are 'counting on people not paying attention' to the impact of the bill, but also warned Democrats not to get too bogged down in national issues. 'For Mikie, it's this nebulous thing,' she said. 'You can talk about national issues, but what she really needs to do is pivot to the things she's going to do here to improve affordability and quality of life.' Rep. Mikie Sherrill, D-N.J., speaks at a 'Get Out the Vote' rally, June 7, 2025, in Elizabeth, New Jersey. | Heather Khalifa/AP But other Democrats are brushing aside concerns that voters won't register the impacts of the bill, pointing to substantial news coverage of its cuts to Medicaid and the more immediate changes to Affordable Care Act tax credits that could dramatically increase some Americans' health insurance costs.
Yahoo
6 hours ago
- Yahoo
Social Security recipients: Why your payment might be cut in half
Social Security payments for July are being distributed as scheduled, reaching over 71 million Americans. But if you've been overpaid by the Social Security Administration (SSA) and haven't started repaying, your monthly benefit could be noticeably smaller starting this month. The SSA is expected to begin withholding 50% of monthly benefits from individuals with outstanding overpayments beginning in late July 2025. This marks a new phase in the agency's effort to recover billions in accidental overpayments. While the SSA hasn't publicly confirmed how many beneficiaries are affected, records obtained via a Freedom of Information Act request show the agency attempted to reclaim overpayments from about 2 million people in the fiscal year ending September 2023, according to KFF and Cox Media Group. If you received more money than you were entitled to through Social Security or Supplemental Security Income (SSI) and haven't arranged a repayment plan, your benefits could be reduced by half starting this month. This applies even if the overpayment wasn't your fault. Under its new policies, the SSA said it would begin issuing overpayment notices on April 25, 2025 and would start withholding 50% of the recipient's benefits after about 90 days (or approximately July 24, at earliest), until the overpayment is repaid. Withholding begins: Around July 24, 2025, depending on when you received your overpayment notice. Repayment options: Online bill pay, credit card, or check. Waiver requests: You can ask the SSA to waive the repayment if: The overpayment wasn't your fault You can't afford to repay Repayment would be unfair Waiver and repayment information is available on the SSA website. Most Social Security retirement benefits will follow the regular July distribution calendar: Thursday, July 3: For those who began receiving benefits before May 1997 Wednesday, July 9: Birthdates between the 1st and 10th Wednesday, July 16: Birthdates between the 11th and 20th Wednesday, July 23: Birthdates between the 21st and 31st Supplemental Security Income (SSI) benefits for July were distributed on Tuesday, July 1. SSI recipients include people 65 or older or those with a qualifying disability and limited income or resources. The SSA recommends allowing up to three additional mailing days past your scheduled date before contacting them. About 99% of recipients now receive payments electronically, which helps reduce delays. If you believe your check is smaller due to an overpayment or have questions about your status, contact the SSA directly by phone at 1-800-772-1213 (TTY: 1-800-325-0778) or visit a local SSA office. For those looking to visit an SSA office, here are some locations in New York (excluding NYC and Long Island): Westchester County: 1 Park Place, Peekskill; 297 Knollwood Road, White Plains; 20 S. Broadway, Suite 500, Yonkers Albany County: 11 A Clinton Ave., Room 430, Federal Building Broome County: 2 Court St., Suite 300, Binghamton Erie County: 478 Main St., Suite 200, Buffalo; 1900 Ridge Road, Suite 120, West Seneca Monroe County: 200 E. Main St. (second floor), Rochester; 4050 W. Ridge Road (second floor), Greece Onondaga County: 100 S. Clinton St., Federal Building (fourth floor), Syracuse Contributing: USA Today Network This article originally appeared on Rockland/Westchester Journal News: Social Security recipients: Why your payment might be cut in half
