Massachusetts advocates fear Trump's bill will unravel health safety net in Obamacare's model state
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Winnipeg Free Press
8 hours ago
- Winnipeg Free Press
Medicaid, food aid recipients worry about safety net cuts in bill sent to Trump
JEFFERSON CITY, Mo. (AP) — Supporters of the sweeping tax and spending legislation that Congress has sent to President Donald Trump say the changes to Medicaid, food aid and other programs will encourage personal responsibility and halt those scamming the system. Critics of the bill, given final congressional approval Thursday, say the requirements will upend lives. Here's a look at what people are saying about the bill. Work requirements added for accessing more federal benefits To enroll and stay on Medicaid, many ages 19 through 64 would be required to work, go to school or perform at least 80 hours of community service a month. The Medicaid work requirement would apply to people in 40 states who are enrolled through expanded access that states agreed to put in place since 2014. Ten states, including Texas and Florida, did not expand the program. For the Supplemental Nutrition Assistance Program, or SNAP, which already requires adults ages 18 to 55 to work, working would become mandatory for many until they turn 65. For both benefits, there would be exceptions, including for parents who are caregivers to children under age 14. Most people covered by Medicaid already meet the work requirement or qualify for an exception. The requirements are sparking worry for some enrollees Theresa Gibbs, who lost her job as a school bus driver, is enrolled in both Medicaid and SNAP. She likely would be exempt from the work mandate because she has three children under age 14. But Gibbs said she is applying for jobs anyway. 'I don't think people should just live off the state if they're perfectly capable to work,' said Gibbs, 34, of Jefferson City, Missouri. But the changes worry others. Amanda Hinton, 39, of St. Martins, Missouri, receives Medicaid and SNAP benefits. She puts in enough hours at a part-time gas station job to likely meet the new requirements but is concerned should her fibromyalgia, which causes pain and fatigue, keep her from working for a time. 'I'm panicked. I mean I have some chronic health conditions that are not curable, and I rely on my medication to help me just get through the day,' she said. 'And without my Medicaid, I couldn't afford these.' Brittany Phillips, 32, of Greensboro, North Carolina, said being on Medicaid has helped her stay afloat both financially and health-wise while she works a temporary, remote medical services job paying about $600 weekly. 'I do believe that Medicaid should be available for everyone regardless of who they are — regardless of capacity, faculty — everyone should have Medicaid,' she said. It's not just the work requirement; it's also the paperwork The nonpartisan Congressional Budget Office estimates that 11.8 million fewer people could have health insurance by 2034 because of the changes, which also include booting off non-citizens who are not in the U.S. permanently and legally. And that doesn't include those who could lose coverage for other reasons. Advocates say that even people who are covered by exceptions to the work requirement could lose their Medicaid coverage. One major reason is a requirement that people's eligibility would be assessed at least every six months. 'Every additional paper someone has to submit separately from their application,' said Deborah Steinberg, a senior health policy analyst at the Legal Action Center, 'you lose people.' Julia Bennker, who runs an in-home daycare in Eau Claire, Wisconsin, relies on SNAP and Medicaid and has had paperwork issues under existing Medicaid requirements. She said that earlier this year, she didn't have health coverage for a month after she was told her forms were late — though she believes she submitted them on time. That meant going a month without therapy and needing to reschedule another appointment with a prescriber. Some of the conditions that would trigger exceptions — mental illness or substance use disorder — are not currently tallied in Medicaid computer systems. 'It's not like you wave a magic wand and everyone who should be exempt is exempt,' said Hannah Wesolowski, chief advocacy officer for the National Alliance on Mental Illness. States will face pressure – and deadlines – to revamp their programs State health care and social services agencies will have to rework their computer systems to account for the various changes while also dealing with federal funding reductions. That's cause for concern for some health care advocates. The legislation requires all states to shoulder more of the administrative costs of SNAP starting in 2027 and, for the first time, could force some states to pay for a portion of food assistance benefits starting in 2028. States also must implement the Medicaid work requirement by 2027. 'It will be a very tight and difficult timeline for many of these states,' said Sophia Tripoli, senior health policy director at Families USA, a health care advocacy organization. 'There's a huge cost burden on states from the administrative side just to stand up these systems.' Julieanne Taylor, a lawyer at the Charlotte Center for Legal Advocacy in North Carolina, said her organization's clients already face delays in verifications for the food program. 'To add more to them, it's going to be a disaster,' she said. 'It's going to cause people to drop off because they're like, 'I don't want to have to do this every year or every six months.'' Rural hospitals could face financial struggles The bill could also put rural hospitals at financial risk, experts say, because it seeks to cap the taxes that states impose on hospitals and other health care providers in a way that boosts Medicaid funding. The nonprofit KFF, which studies health care issues, estimates that Medicaid spending in rural areas would decrease by $155 billion over the next decade under the bill. 'While there are already a number of small and rural hospitals that are vulnerable,' said R. Kyle Kramer, CEO of Day Kimball Hospital in Putnam, Connecticut, 'it's going to lead to a lot of closures.' The bill includes a $50 billion fund to partially offset those reductions. Planned Parenthood would lose federal money Federal taxpayer money is already barred from paying for abortions in most cases. Wednesdays Columnist Jen Zoratti looks at what's next in arts, life and pop culture. The bill would also ban federal funds going to Planned Parenthood, the nation's largest abortion provider, for other purposes like family planning programs and cancer screenings. The group says that one-third of its roughly 600 clinics across the U.S. could face closure as a result of the legislation, and that states where abortion is legal would be hardest hit. At least one other group says it also stands to lose funding because of the provision. Maine Family Planning has 19 sites and subcontracts with other health care organizations, including Planned Parenthood, to provide services at other locations across the rural state. ___ Mulvihill reported from Cherry Hill, New Jersey. Susan Haigh in Hartford, Connecticut, and Gary D. Robertson in Raleigh, North Carolina, contributed to this report.
Winnipeg Free Press
9 hours ago
- Winnipeg Free Press
Joe Giordano, surgeon who helped save President Reagan's life after assassination attempt, has died
WASHINGTON (AP) — Dr. Joseph Giordano, a surgeon who played a central role in saving President Ronald Reagan's life after an assassination attempt in 1981, has died. He was 84. He died on June 24 at a hospital in Washington, D.C. from an infection related to a lengthy illness, his family said. Giordano was in charge of The George Washington University Hospital's trauma teams that treated Reagan after the president had been shot and badly wounded on March 30, 1981. Over the course of several dramatic hours, doctors stabilized Reagan, retrieved a bullet an inch from his heart and stanched massive internal bleeding. 'Dr. Giordano and the doctors at GW, without them, Ronald Reagan would have died,' said Jerry Parr, the president's lead Secret Service agent at the time, in a 2010 interview for the book ' Rawhide Down.' Revamps GW emergency room Giordano, the grandson of Italian immigrants, was born and raised in New Jersey. He graduated from Georgetown University in 1961 and six years later obtained a medical degree from Jefferson Medical College in Philadelphia. After a stint in the U.S. Army, he joined GW as a vascular surgeon. A few weeks before he started in 1976, GW's chief of surgery told Giordano that he would have another job — fixing and managing the emergency room. 'The handling of trauma patients down there is a real mess,' his boss said. Giordano quickly discovered that assessment was correct. Inexperienced doctors were leading inefficient medical teams. Care was haphazard. Giordano watched as at least one patient died because treatment was rendered too slowly. Seeking out experts, he spent a month working at what would become the R Adams Cowley Shock Trauma Center at the University of Maryland. The teams at Shock Trauma operated with speed and precision. They were methodical. He brought the approach to GW. Soon, the hospital's trauma center was regarded as among the best in the country. 'We had everything going like clockwork,' said Dr. David Gens, who helped treat Reagan and went on to a long career in trauma surgery. 'Joe had us properly trained. We had the right protocols. Everyone had a job. Organization and time are essential. So that when something happened, when the president came in, we were well organized. Thanks in part to Joe's foresight, we saved the president's life.' 'STAT to the ER' It was a typical March Monday for Giordano when a would-be assassin, John Hinckley, Jr., opened fire on Reagan as the president left a speech at the Washington Hilton Hotel. Parr, the Secret Service agent, shoved Reagan into a limousine, and it hurtled from the scene. On the ride back to the White House, Parr realized Reagan had been hurt, perhaps from being flung into the armored Lincoln. Not knowing the extent of the injuries — doctors would soon discover he had been shot — Parr directed the limousine to the hospital. At GW Giordano was treating a patient when the intercom began blaring: 'Dr. Giordano, STAT to the ER. Dr. Giordano, STAT to the ER.' Though he had turned over responsibility for running the emergency room to another doctor, Giordano was still in charge of the trauma teams. He knew something must be terribly wrong for him to be summoned that way. In the ER, he found a man he recognized as the president on gurney. Nurses had already cut off Reagan's clothes and inserted IV lines. Strangely, the first thing that Giordano noticed about the president was his dark hair. It seemed so natural. 'I wondered,' Giordano recalled in a 2010 interview, 'if he dyed it.' 'How are you doing, Mr. President?' he asked. 'I'm having trouble breathing,' Reagan replied. Bleeding won't stop Gens, a chief surgical resident, provided Giordano a quick summary of the situation: The president had been shot in the left side, his chest was filling with blood and they were about to insert a chest tube to drain the chest cavity. Giordano did not hesitate. 'You better let me do this one.' He typically would have let a resident handle such a procedure, but he felt it would be irresponsible to put such pressure on young doctors. He made an incision eight inches below Reagan's left armpit and inserted the tube. It relieved pressure on Reagan's lung and allowed him to breathe more easily. But the bleeding did not stop. Doctors decided they had to operate. Giordano and Gens performed a peritoneal lavage — known as a 'belly tap' — and ensured that Reagan's abdomen was clear of blood. They then turned over the patient to a chest surgeon, Dr. Benjamin Aaron, who halted the bleeding and retrieved the bullet. Reagan spent 11 days at GW and fully recovered from his wounds. Three others were injured in the shooting: White House Press Secretary Jim Brady; Secret Service agent Timothy McCarthy; and Thomas Delahanty, a police officer. Hinckley was found not guilty by reason of insanity. He was confined at a psychiatric hospital until a federal judge in 2022 ordered his unconditional release. 'Today, Mr. President, we are all Republicans' Giordano would go on to become GW's chairman of surgery, a post he held for 18 years before retiring in 2010. That same year, he joined the board at Partner for Surgery, a nonprofit group that arranges surgery for people living in rural Guatemala. Tapping his contacts in the medical community, Giordano recruited doctors and nurses to travel to the Central American country to provide the badly needed medical services, said Frank Peterson, the group's founder. Giordano also led several medical teams on such missions. Wednesdays Columnist Jen Zoratti looks at what's next in arts, life and pop culture. 'The one word I would use to describe him is humanitarian,' Peterson said. 'He had the skills and capabilities that made a world of difference to people who were in need.' Though Giordano played a decisive role in saving Reagan's life, the physician may best be remembered for a line he delivered in the operating room. Just before he was administered anesthesia, Reagan dramatically got up on an elbow, took off his oxygen mask and said, 'I hope you are all Republicans.' Giordano, a staunch liberal, didn't miss a beat: 'Today, Mr. President, we are all Republicans.' Years later, the surgeon jokingly reflected that 'it was okay to be a Republican for a day, especially that day.'
Global News
9 hours ago
- Global News
Hakeem Jeffries breaks speech record in bid to delay Trump's megabill vote
Republicans in the U.S. House of Representatives are ready to vote on President Donald Trump's so-called 'Big, Beautiful Bill,' but they had to wait for House Minority Leader Hakeem Jeffries to wrap things up first. Jeffries, the Democratic leader, took to the House floor early Thursday morning to rail against the legislation he and other Democrats have warned will pull the social safety net from under millions of Americans and their children — and his speech lasted almost nine hours. Jeffries began speaking just after 5 a.m. Thursday, delaying the final vote in the chamber. According to ABC News, he picked apart the bill and some Republicans who voted for it, as stacks of binders sat next to the podium. 'I've been given 15 minutes each on a bill of such significant magnitude as it relates to the health, the safety and the well-being of the American people and because that debate was so limited, I feel the obligation, Mr. Speaker, to stand on this house floor and take my sweet time to tell the stories and that's exactly what I intend to do,' Jeffries said, before launching into a speech criticizing Republicans' deference to Trump, reading through personal accounts of people concerned about losing their health care coverage, and recounting American history. Story continues below advertisement 'People will die. Tens of thousands, perhaps year after year after year, as a result of the Republican assault on the health care of the American people,' Jeffries said, focusing much of his speech on the bill's potential to impact Medicaid, the federal program that primarily protects senior adults and people with disabilities. 'I'm sad. I never thought I would be on the House floor saying this is a crime scene.' It's reported that the House stayed up all night debating Trump's agenda, and Jeffries used a tool known as the 'magic minute' that permits leaders to speak for an unlimited time, racking up a total of eight hours and 44 minutes of speaking time. Jeffries blew past the record for a 'magic minute' speech, set by then-House minority leader Kevin McCarthy, who spoke for eight hours and 32 minutes in 2021 when debating then-president Joe Biden's Build Back Better Act. Get breaking National news For news impacting Canada and around the world, sign up for breaking news alerts delivered directly to you when they happen. Sign up for breaking National newsletter Sign Up By providing your email address, you have read and agree to Global News' Terms and Conditions and Privacy Policy Three years before McCarthy's record-setting speech, Rep. Nancy Pelosi spoke for just over eight hours while serving as minority leader, speaking about undocumented immigrants who were brought to the U.S. as children. Jeffries' speech was reminiscent of a record-setting April speech by Democratic Sen. Cory Booker that accused Trump of 'recklessly' challenging the nation's democratic institutions. After 25 hours and five minutes, Booker broke the record for the longest individual floor speech in Senate history. Story continues below advertisement 0:50 Cory Booker lambasts Trump for 25 hours, breaks 1957 record for longest Senate filibuster Now, Republicans will move to final passage of the bill. What's in the One Big Beautiful Bill Act At some 887 pages, the legislation includes tax breaks, spending cuts, a rollback of solar energy tax credits and new money for national defence and deportations. The bill does not eliminate taxes on Social Security benefits, despite what Trump says. The bill rolls back past presidential agendas. In many ways, the package is a repudiation of the agendas of the last two Democratic presidents, a chiselling away at the Medicaid expansion from Barack Obama's Affordable Care Act, and a pullback of Joe Biden's climate change strategies in the Inflation Reduction Act. The non-partisan Congressional Budget Office said Sunday that the bill would pile nearly US$3.3 trillion onto the nation's debt load from 2025 to 2034, a nearly $1-trillion increase over the House-passed version of the bill. The analysis also found that 11.8 million Americans would become uninsured by 2034 if the bill passed. Story continues below advertisement 1:58 'Deal with the devil': AOC slams Trump's megabill in House speech Republicans broadly support the bill, which contains most of Trump's domestic priorities, saying it would spur economic growth and deliver tax breaks to Americans across the economic spectrum. Democrats are united in opposition to the bill but lack the votes to stop it, as Republicans control both the House and the Senate by slim margins. Republicans can afford no more than three defections in either chamber to get a final bill passed. The past two weeks have shown deep Republican divides on the bill, and a handful of Republican holdouts have objected to the bill. One, Sen. Thom Tillis, opted not to seek re-election after voting against it. Nonetheless, Trump has succeeded in getting the votes to advance the legislation at each step. The Senate passed it by the narrowest possible margin on Tuesday. Story continues below advertisement Votes in the House, which Republicans control by a 220-212 margin, were held open for hours on Wednesday during the day and overnight as House Speaker Mike Johnson and the White House talked with reluctant members. Republican leaders said Trump made late-night phone calls to win over wavering Republicans, but they predicted that some would still vote against it. 'Nothing has been unanimous in this for process, and that's going to hold true on the floor,' Rep. Steve Scalise, the No. 2 House Republican, told reporters. During the marathon overnight session, lawmakers cleared a final procedural hurdle needed to begin debate on the bill in a 219-213 vote at around 3:30 a.m. ET Thursday. 'This disgusting abomination is not about improving the quality of life of the American people,' Jeffries said in his speech Thursday. 'The focus of this bill, the justification for all of the cuts that will hurt everyday Americans, is to provide massive tax breaks for billionaires.' — With files from Reuters and The Associated Press
