Latest news with #FamiliesUSA
Medscape
9 hours ago
- Health
- Medscape
Supreme Court Ruling Preserves Access to Preventive Services
Health advocates welcomed a US Supreme Court decision announced Friday that preserves a federal mandate for insurers to cover, without copays, certain preventive medical tests and treatments. The Supreme Court split 6-3 in the decision announced Friday. While the court ruling was seen largely as a win for medical and consumer groups, some voiced concerns about its impact on the Health and Human Services (HHS) Secretary's power over an influential panel, the US Preventive Services Task Force (USPSTF). Anthony Wright, executive director of the consumer advocacy group Families USA, said the Supreme Court ruling beat back 'yet another challenge' to the Affordable Care Act (ACA) and was a win in terms of guaranteeing more access to care. "While this is a foundational victory for patients, patients have reason to be concerned that the decision reaffirms the ability of the HHS secretary, including our current one, to control the membership and recommendations of the US Preventive Services Task Force that determines which preventive services are covered,' Wright said. Religious Objection to HIV Prevention Treatment The case stems from a complaint filed by Braidwood Management, a Christian-owned firm objecting to how a provision of the 2010 ACA has been implemented. The Texas firm wanted to exclude coverage of pre-exposure prophylaxis for HIV and other preventive health services for religious objections. The ACA requires coverage without copay for tests and treatments that get 'A' and 'B' ratings from the USPSTF. The USPSTF has issued recommendations with these top marks for more than 40 tests and treatments, noted Justice Brett Kavanaugh in the majority opinion in this case. Services with current 'A' and 'B' ratings from USPSTF include cancer and diabetes screenings, nicotine patches for adults trying to quit smoking, statin medications to reduce the risk of heart disease and stroke, and physical therapy to help the elderly avoid falls, he wrote. Major Medical Groups Applaud Ruling The American Medical Association, the American Academy of Family Physicians, the American Cancer Society, and about 30 other patient and medical professional organizations applauded the Supreme Court decision in a joint statement Friday. In February, these groups had filed a brief with the Supreme Court, arguing in favor of the mandate. In it, these groups said almost 152 million people in the US were able to get access to preventive services without cost sharing in 2020 due to the mandate. Reducing insurance coverage for preventive services would 'lead to worsening patient outcomes, resulting in preventable deaths, and creating higher long-term medical costs,' said the groups in the brief. The key question before the Supreme Court in this case focused on the view of authority of the USPSTF. In the majority opinion, Kavanaugh said the plaintiffs sought to portray the USPSTF as an independent agency wielding 'unchecked power in making preventive-services recommendations of great consequence for the healthcare and health-insurance industries and the American people more broadly.' In fact, those challenging the ACA mandate asserted that, with respect to preventive-services recommendations, the Task Force members were 'more powerful' than even the US president or the secretary of the HHS, Kavanaugh wrote. That's not the case, Kavanaugh wrote in the majority opinion. Instead, the USPSTF members serve at the will of the secretary of the HHS, who can remove them, Kavanaugh noted. In addition, federal law allows the HHS secretary to directly review and block USPSTF recommendations before they take effect, Kavanaugh wrote. Some Reservations Family USA's Wright noted how HHS Secretary Robert Kennedy Jr recently replaced members of the CDC's independent vaccine advisory committee as an example of his concerns. The American Gastroenterological Association called the Supreme Court ruling 'positive news for patient care protections.' 'The ruling reiterates the authority that HHS has over the task force and its decisions, and we remain vigilant considering the secretary's recent actions to other expert panels,' the AGA said Friday in a statement. 'We will continue to work with our coalition partners and champions to ensure patients continue to have coverage of essential preventive screenings.' The ACA mandate also has helped make cancer screening more palatable to younger patients, which physicians note is especially important given that more cases seem to be occurring earlier in life. National Institutes of Health researchers recently reported that the incidence of 14 cancer types increased among people under age 50 between 2010 and 2019. 'To convince healthy people to undergo a test when they're feeling fine to prevent a cancer that might or might not develop years in the future, it requires reducing barriers and taking away copays and providing insurance coverage,' Jatin Roper, MD, an assistant professor of medicine at Duke University and AGA spokesman, told Medscape in recent interview. Roper reported no relevant financial disclosures.
Yahoo
5 days ago
- Health
- Yahoo
Republican senators' proposed Medicaid cuts threaten to send red states ‘backwards'
Advocates are urging Senate Republicans to reject a proposal to cut billions from American healthcare to extend tax breaks that primarily benefit the wealthy and corporations. The proposal would make historic cuts to Medicaid, the public health insurance program for low-income and disabled people that covers 71 million Americans, and is the Senate version of the 'big beautiful bill' act, which contains most of Donald Trump's legislative agenda. 'With the text released earlier this week, somehow the Senate made the House's 'big, bad budget bill' worse in many ways,' said Anthony Wright, the executive director of Families USA, a consumer healthcare advocacy group, in a press call. The Senate's version makes deeper cuts to Medicaid and so-called Obamacare (Affordable Care Act) plans, 'both by expanding paperwork requirements and making it harder for states to fund Medicaid coverage for their residents', said Wright. Related: Democratic senators call on private firm to reveal how it will profit from Trump's Medicaid cuts If passed, the House-passed bill would have already made the biggest cuts to Medicaid since the program's enactment in 1965. With red tape and an expiration of additional healthcare subsidies to Obamacare, the Congressional Budget Office (CBO) estimated that the House version would leave 16 million people without health insurance by 2034. CBO has not yet released estimates, or 'scored', the impact of the Senate proposal, but advocates and experts said the cuts are more draconian, 'punish' states that expanded Medicaid, and attack Medicaid by going after its byzantine financing structures. 'If we look at the big picture of our healthcare system that's where the inefficiencies are – not in Medicaid – but in all the groups profiting off the system,' said David Machledt, a senior policy analyst at the National Health Law Program, referring to Republicans' assertions that they are targeting 'waste, fraud and abuse' with cuts. 'What these cuts are going to do is look at the most cost-efficient program and squeeze it further, and take us backwards, and put us back at a system where the people at the low end are literally dying to fund these tax cuts for rich people and businesses.' A recent study found that expanding Medicaid, as was done during the Obama administration, probably saved an additional 27,400 lives over a 12-year period, and did so cheaper than other insurance programs. The same study found that about a quarter of the difference in life expectancy between low- and high-income Americans is due to lack of health insurance. Republicans, such as Senator John Thune of South Dakota, argue that their bill 'protects' Medicaid by 'removing people who should not be on the rolls', including working-age adults, legal and undocumented immigrants; by adding work requirements and by going after a tax maneuver states use to bring in more federal Medicaid funding. Related: 'Fiscally irresponsible': Trump's 'big, beautiful bill' benefits the rich at the expense of the poor 'Removing these individuals is just basic, good governance,' said Thune. But experts and advocates argue the cuts will not only remove the targeted individuals, including many who are working but struggle to get through red tape, but will also place states in impossible situations with potentially multibillion-dollar shortfalls in their budgets. Both versions contain so-called work requirements, which analyses show will cause people to lose coverage even if they are eligible, experts said. Instead, the largest difference between the Senate and House versions of the bill is the Senate's attack on Medicaid's complex financing arrangements. Medicaid is jointly financed by states and the federal government, making it simultaneously one of states' largest expenditures and sources of revenue. The Senate's version specifically attacks two ways states finance Medicaid, through provider taxes and state-directed payments. With a provider tax, states bring in additional federal revenue by increasing payments to providers. Because the federal portion of Medicaid is based on a percentage rate, increasing payments to providers in turn increases the amount that federal officials pay the state. States then tax those same providers, such as hospitals, to bring the funding back to the state. Although this maneuver has been criticized, it has also now been used for decades. It's in place in every state except for Alaska, is legal and openly discussed. The Senate bill caps this manuever by cutting the tax rate by about half, from 6% to 3.5%, according to Machledt. [Cuts will] put us back at a system where the people at the low end are literally dying to fund these tax cuts for rich people and businesses David Machledt, National Health Law Program In a 2024 analysis, the Congressional Research Service estimated that lowering the provider tax cap to 2.5% would effectively cut $241bn from Medicaid payments to states. Although the exact impacts of the Senate tax cap are not yet known, Machledt expects it would be in the billions, which states would then be under pressure to make up. 'We took great pains to close a $1.1bn shortfall caused by rising healthcare costs,' said the Colorado state treasurer, Dave Young, in a press call. 'To protect healthcare and education, we had to cut transportation projects, maternal health programs and even $1m in aid to food banks.' Because of taxing provisions in Colorado's state constitution, Young said: 'It will be nearly impossible to raise taxes or borrow money to make up the difference.' Similarly, the Senate bill goes after 'state-directed payments'. To understand state-directed payments, it's helpful to understand a big picture, and often hidden, aspect of American healthcare – health insurance pays providers different rates for the same service. Providers are almost universally paid the worst for treating patients who have Medicaid. Medicare pays roughly the cost of providing care, although many doctors and hospitals complain it is still too little. Commercial insurance pays doctors and hospitals most handsomely. To encourage more providers to accept Medicaid, lawmakers in some states have chosen to pay providers treating Medicaid patients additional funds. In West Virginia, a federally approved plan allows the state to pay providers more for certain populations. In North Carolina, state-directed payments allow the state to pay hospitals rates equal to the average commercial insurance rate, if they agree to medical debt forgiveness provisions. The first state-directed payment plan was approved in 2018, under the first Trump administration. These kinds of payments were criticized by the Government Accountability Office during the Biden administration. Related: Trump's 'big, beautiful' spending bill, from tax cuts to mass deportations However, the Senate bill goes after these rates by tying them to Medicaid expansion – a central tenet of Obamacare – and gives stricter limits to the 41 states that expanded the program. Doing this will effectively be 'punishing them', Machledt said, referring to states that participated in this key provision of Obamacare, 'by limiting the way they can finance'. Advocates also warned of unintended knock-on effects from such enormous disruption. Medical debt financing companies are already readying new pitches to hospitals. Even people who don't lose their insurance and are not insured through Medicaid could see prices increase. When Medicaid is cut, hospital emergency rooms are still obliged to provide stabilizing care to patients, even if they can't pay. Hospitals must then make up that shortfall somewhere, and the only payers they can negotiate with are commercial: for example, the private health insurance most people in the US rely on. 'Folks who do not lose their health insurance will see increased costs,' said Leslie Frane, the executive vice-president of SEIU, a union that represents about 2 million members, including in healthcare. 'Your copays are going to go up, your deductibles are going to go up, your bills are going to go up.' Republicans hope to pass the bill by 4 July.
The Guardian
5 days ago
- Health
- The Guardian
Republican senators' proposed Medicaid cuts threaten to send red states ‘backwards'
Advocates are urging Senate Republicans to reject a proposal to cut billions from American healthcare to extend tax breaks that primarily benefit the wealthy and corporations. The proposal would make historic cuts to Medicaid, the public health insurance program for low-income and disabled people that covers 71 million Americans, and is the Senate version of the 'big beautiful bill' act, which contains most of Donald Trump's legislative agenda. 'With the text released earlier this week, somehow the Senate made the House's 'big, bad budget bill' worse in many ways,' said Anthony Wright, the executive director of Families USA, a consumer healthcare advocacy group, in a press call. The Senate's version makes deeper cuts to Medicaid and so-called Obamacare (Affordable Care Act) plans, 'both by expanding paperwork requirements and making it harder for states to fund Medicaid coverage for their residents', said Wright. If passed, the House-passed bill would have already made the biggest cuts to Medicaid since the program's enactment in 1965. With red tape and an expiration of additional healthcare subsidies to Obamacare, the Congressional Budget Office (CBO) estimated that the House version would leave 16 million people without health insurance by 2034. CBO has not yet released estimates, or 'scored', the impact of the Senate proposal, but advocates and experts said the cuts are more draconian, 'punish' states that expanded Medicaid, and attack Medicaid by going after its byzantine financing structures. 'If we look at the big picture of our healthcare system that's where the inefficiencies are – not in Medicaid – but in all the groups profiting off the system,' said David Machledt, a senior policy analyst at the National Health Law Program, referring to Republicans' assertions that they are targeting 'waste, fraud and abuse' with cuts. 'What these cuts are going to do is look at the most cost-efficient program and squeeze it further, and take us backwards, and put us back at a system where the people at the low end are literally dying to fund these tax cuts for rich people and businesses.' A recent study found that expanding Medicaid, as was done during the Obama administration, probably saved an additional 27,400 lives over a 12-year period, and did so cheaper than other insurance programs. The same study found that about a quarter of the difference in life expectancy between low- and high-income Americans is due to lack of health insurance. Republicans, such as Senator John Thune of South Dakota, argue that their bill 'protects' Medicaid by 'removing people who should not be on the rolls', including working-age adults, legal and undocumented immigrants; by adding work requirements and by going after a tax maneuver states use to bring in more federal Medicaid funding. 'Removing these individuals is just basic, good governance,' said Thune. But experts and advocates argue the cuts will not only remove the targeted individuals, including many who are working but struggle to get through red tape, but will also place states in impossible situations with potentially multibillion-dollar shortfalls in their budgets. Both versions contain so-called work requirements, which analyses show will cause people to lose coverage even if they are eligible, experts said. Instead, the largest difference between the Senate and House versions of the bill is the Senate's attack on Medicaid's complex financing arrangements. Medicaid is jointly financed by states and the federal government, making it simultaneously one of states' largest expenditures and sources of revenue. The Senate's version specifically attacks two ways states finance Medicaid, through provider taxes and state-directed payments. With a provider tax, states bring in additional federal revenue by increasing payments to providers. Because the federal portion of Medicaid is based on a percentage rate, increasing payments to providers in turn increases the amount that federal officials pay the state. States then tax those same providers, such as hospitals, to bring the funding back to the state. Although this maneuver has been criticized, it has also now been used for decades. It's in place in every state except for Alaska, is legal and openly discussed. The Senate bill caps this manuever by cutting the tax rate by about half, from 6% to 3.5%, according to Machledt. In a 2024 analysis, the Congressional Research Service estimated that lowering the provider tax cap to 2.5% would effectively cut $241bn from Medicaid payments to states. Although the exact impacts of the Senate tax cap are not yet known, Machledt expects it would be in the billions, which states would then be under pressure to make up. 'We took great pains to close a $1.1bn shortfall caused by rising healthcare costs,' said the Colorado state treasurer, Dave Young, in a press call. 'To protect healthcare and education, we had to cut transportation projects, maternal health programs and even $1m in aid to food banks.' Because of taxing provisions in Colorado's state constitution, Young said: 'It will be nearly impossible to raise taxes or borrow money to make up the difference.' Similarly, the Senate bill goes after 'state-directed payments'. To understand state-directed payments, it's helpful to understand a big picture, and often hidden, aspect of American healthcare – health insurance pays providers different rates for the same service. Providers are almost universally paid the worst for treating patients who have Medicaid. Medicare pays roughly the cost of providing care, although many doctors and hospitals complain it is still too little. Commercial insurance pays doctors and hospitals most handsomely. To encourage more providers to accept Medicaid, lawmakers in some states have chosen to pay providers treating Medicaid patients additional funds. In West Virginia, a federally approved plan allows the state to pay providers more for certain populations. In North Carolina, state-directed payments allow the state to pay hospitals rates equal to the average commercial insurance rate, if they agree to medical debt forgiveness provisions. The first state-directed payment plan was approved in 2018, under the first Trump administration. These kinds of payments were criticized by the Government Accountability Office during the Biden administration. However, the Senate bill goes after these rates by tying them to Medicaid expansion – a central tenet of Obamacare – and gives stricter limits to the 41 states that expanded the program. Doing this will effectively be 'punishing them', Machledt said, referring to states that participated in this key provision of Obamacare, 'by limiting the way they can finance'. Advocates also warned of unintended knock-on effects from such enormous disruption. Medical debt financing companies are already readying new pitches to hospitals. Even people who don't lose their insurance and are not insured through Medicaid could see prices increase. When Medicaid is cut, hospital emergency rooms are still obliged to provide stabilizing care to patients, even if they can't pay. Hospitals must then make up that shortfall somewhere, and the only payers they can negotiate with are commercial: for example, the private health insurance most people in the US rely on. 'Folks who do not lose their health insurance will see increased costs,' said Leslie Frane, the executive vice-president of SEIU, a union that represents about 2 million members, including in healthcare. 'Your copays are going to go up, your deductibles are going to go up, your bills are going to go up.' Republicans hope to pass the bill by 4 July.
Yahoo
27-03-2025
- Health
- Yahoo
Hundreds of advocacy groups call on Thune to reject House Republicans' budget blueprint
Hundreds of advocacy organizations have called on Senate Majority Leader John Thune (R-S.D.) to reject a budget blueprint from House Republicans. A letter sent to Thune, led by the liberal health care advocacy group Families USA, features more than 300 organizations, such as Planned Parenthood Federation of America, the NAACP and the American Civil Liberties Union. 'We write to share our deep concerns about the House-passed budget reconciliation resolution—specifically the catastrophic health care cuts it would require and the resulting harm it would impose on families and communities across the country,' according to the letter, sent Wednesday. The budget resolution from the House, passed last month, puts forth a $1.5 trillion minimum for spending cuts across committees, featuring a target of $2 trillion. It also places a $4.5 trillion cap on the deficit impact of any Republican plan to continue with President Trump's 2017 tax cuts and includes an extra $300 billion in spending for the border and defense. The resolution has also put the job on the House Energy and Commerce Committee of identifying a minimum of $880 billion in cuts to programs under its jurisdiction. In early March, the Congressional Budget Office issued a report finding the savings cannot be reached without affecting Medicaid and Medicare. 'At a time when families are already struggling to access affordable health care, moving forward with these cuts would be a betrayal of the very voters that sent leaders to Washington to lower costs, not to shred our nation's social safety net,' the letter reads. The groups pushed the upper chamber to 'not to take up the House's budget bill and instead commit to protecting Medicaid and the other critical health care programs on which your constituents rely for their health and well-being.' The Hill has reached out to Thune's office for comment. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
The Hill
27-03-2025
- Health
- The Hill
Hundreds of advocacy groups call on Thune to reject House Republicans' budget blueprint
Hundreds of advocacy organizations have called on Senate Majority Leader John Thune (R-S.D.) to reject a budget blueprint from House Republicans. A letter sent to Thune is led by the liberal health care advocacy group Families USA and features more than 300 organizations, such as Planned Parenthood Federation of America, the NAACP and the ACLU. 'We write to share our deep concerns about the House-passed budget reconciliation resolution—specifically the catastrophic health care cuts it would require and the resulting harm it would impose on families and communities across the country,' the letter, sent Wednesday, reads. The budget resolution from the House, passed last month, puts forth a $1.5 trillion minimum for spending cuts across committees, featuring a target of $2 trillion. It also places a $4.5 trillion cap on the deficit impact of any Republican plan to continue with President Trump's 2017 tax cuts and includes an extra $300 billion in spending for the border and defense. The resolution has also put the job on the House Energy and Commerce Committee of identifying a minimum of $880 billion in cuts to programs under its jurisdiction. In early March, the Congressional Budget Office issued a report finding the savings cannot be reached without Medicaid and Medicare. 'At a time when families are already struggling to access affordable health care, moving forward with these cuts would be a betrayal of the very voters that sent leaders to Washington to lower costs, not to shred our nation's social safety net,' the letter reads. The groups pushed the upper chamber to 'not to take up the House's budget bill and instead commit to protecting Medicaid and the other critical health care programs on which your constituents rely for their health and well-being.'
