a Better Bubble™

Aggregator

If Trump Makes Cuts to Medicaid, Texas Officials Could Seize the Opportunity to Further Slash the Program

1 year 3 months ago

ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published.

This article is co-published with The Texas Tribune, a nonprofit, nonpartisan local newsroom that informs and engages with Texans. Sign up for The Brief Weekly to get up to speed on their essential coverage of Texas issues.

Texas leaders have shown a decadeslong antipathy toward Medicaid, the federal-state health insurance program that covers millions of low-income and vulnerable residents.

They declined additional federal money that, under the Affordable Care Act, would have allowed Medicaid to offer health care coverage to more low-income families. The state was among the last to insure women for an entire year after they gave birth. And when the federal government last year ended a policy that required states to keep people on their Medicaid rolls during the coronavirus pandemic, Texas officials rushed to kick off those they deemed ineligible, ignoring persistent warnings that the speedy process could lead to some people being wrongfully removed.

Come January, when Donald Trump assumes the presidency for the second time, Texas leaders could get another opportunity to whittle down the program — this time with fewer constraints.

Trump has not shared any plans to cut Medicaid, which covers about 80 million Americans, and his campaign did not respond to requests for comment. Health care advocates and experts, however, say that his past efforts to scale back the program, as well as positions taken by conservative groups and Republican lawmakers who back him, indicate that it would likely be a target for severe reductions.

“We expect the Republicans to move very quickly to cut Medicaid dramatically and indeed end its guarantee of coverage as it exists today,” said Joan Alker, executive director of Georgetown University’s Center for Children and Families in Washington, D.C.

Currently, the federal government picks up, on average, nearly 70% of Medicaid spending, with states assuming the remaining costs. (A state’s share varies based mostly on what percentage of its residents are impoverished.) Any decisions to cut federal spending would likely lead states to shrink the number of people they deem eligible and the care that enrollees are entitled to receive, Alker and other experts said.

That would be particularly devastating in Texas, which already has one of the country’s lowest percentages of residents covered through Medicaid and where officials lack the political will to make up the difference in funding with state money, experts say. Parents with two children, for example, must earn less than $285 monthly to qualify for Medicaid for themselves.

“Our elected officials would have to decide whether they want to cut health care for pregnant women, kids, people with disabilities, or seniors because that is essentially who Medicaid covers in Texas,” Adriana Kohler, a policy director for Texans Care for Children, a statewide nonprofit that advocates for families, said in a statement.

Spokespeople for Gov. Greg Abbott, a Republican, and the state’s Health and Human Services Commission did not respond to repeated requests for comment. During Abbott’s prior role as the state’s attorney general, he helped to lead a successful lawsuit against the federal government, ensuring that states did not risk losing Medicaid funding entirely if they didn’t want to cover more residents as part of the Affordable Care Act.

Even when Texas does offer Medicaid coverage to its most vulnerable residents, state officials enabled a system that creates often insurmountable barriers to receiving care. A 2018 Dallas Morning News investigation found that some of the insurance companies Texas hired to administer Medicaid benefits systematically denied expensive and, at times, life-saving treatments to bolster profits. Critics say problems with the system persist despite legislative reforms spurred by that series of stories.

Texas insures more than 4 million residents through Medicaid, which amounts to a smaller percentage of its total population than almost any other state. But given its sheer size, the state still covers the third most people in the nation, behind only California and New York. The program provides health care for 3 in 8 children, 3 in 5 nursing home residents and 2 in 7 people with disabilities in Texas, according to KFF, a national health policy research organization. It is the top funder for nursing homes and long-term care services for the disabled and elderly, and it pays for nearly half of all births in the state.

Michael Morgan, a 75-year-old retired nurse who lives in Fort Worth, is among those who worry that if Trump caps or cuts the amount of money the federal government spends on Medicaid, the state could make it even harder to get coverage for his daughter Hannah. She has Down syndrome and schizencephaly, a brain malformation, and she is deaf and partially blind, she doesn’t speak, and she needs assistance to walk and eat.

Morgan is depleting his limited savings to pay for Hannah’s health care expenses after she lost Medicaid coverage earlier this year when she turned 19. He submitted a new application for her in May — she should qualify for Medicaid because of her disabilities. State officials denied her coverage in November, arguing that Morgan did not meet the deadline to return a form providing his consent for the agency to access his daughter’s medical and financial records. Morgan, who plans to appeal the denial, said in an interview that he received the form a day before the deadline.

“I don’t know how much more they can cut it,” he said of Medicaid in Texas.

During his first term, Trump tried unsuccessfully to repeal the Affordable Care Act, which provides health coverage to 45 million Americans. His administration also repeatedly supported spending caps for Medicaid, including block grants that would give states a fixed amount of federal funding, no matter how many people needed the insurance or how much their health care cost. Currently, Medicaid covers all people who qualify, no matter the expense.

While those efforts did not significantly advance during Trump’s first term, Republicans will hold majorities in both the House and the Senate come January, and they have signaled an openness to impose caps on spending and establish requirements that most adults in the program hold jobs. They argue that Medicaid spending is unsustainable and that the program is susceptible to waste, fraud and abuse.

Republicans who have supported such measures include U.S. Sen. John Cornyn and U.S. Rep. Jodey Arrington, a Lubbock Republican who leads the House Budget Committee.

GOP policy primers — including Project 2025, published by the conservative think tank The Heritage Foundation, and one from the Republican Study Committee, a conservative congressional caucus — have also called for cutting Medicaid.

Arrington, whose spokespeople did not respond to repeated requests for an interview, told reporters last month that he supported a “responsible and reasonable work requirement.” Harvard University health professors who studied a previous work mandate in Arkansas that Trump allowed during his first term found that most adults using Medicaid were already employed or qualified for an exemption, but thousands of residents still lost health care, at least in part because of the onerous process of continuously proving their eligibility.

This is not the first time Arrington has pushed work requirements and sought to lower the share of health care costs that the federal government pays to states. He previously proposed cutting federal Medicaid spending by more than a quarter, or $1.9 trillion.

Cornyn, whose spokespeople also repeatedly declined to comment, said last month that he would not support cuts to Medicare, the federal health insurance program for seniors and the disabled, or to Social Security. Still, he suggested that Medicaid cuts were on the table.

“We can’t just keep doing things the way we’ve been doing them,” Cornyn told Politico Pro, adding that “block grants make a lot of sense.”

William T. Smith, a 65-year-old retired construction worker who lives along the U.S.-Mexico border in Brownsville, said that he voted for Trump partly because he agrees that “there’s too much fat” and supports cutting some federal programs.

Smith has chronic obstructive pulmonary disease, which affects his lungs and makes it difficult to breathe. He said he also has bipolar disorder, sleep apnea and chronic pain after decades of performing manual labor.

Smith said Medicaid, which he has been trying to get since the summer, should not be where the federal government looks to reduce expenses. Instead, he said, the federal government should take savings from cutting other programs and put the money toward more people’s care.

“I don’t think they’re going to yank health care away from people,” he said. “If they do, I’d be really angry.”

Caught in Texas’ Medicaid and Food Stamp Application Backlog? Know Someone Who Is? Help Us Report.

Dan Keemahill contributed reporting.

by Lomi Kriel and Jessica Priest

State prisons turn to extended lockdowns amid staffing shortages, overcrowding

1 year 3 months ago
Across the United States, state prison systems are grappling with chronic understaffing and overcrowding — dual crises that are keeping incarcerated people confined to their cells for far longer periods than in recent decades. Lockdowns are common in jails and prisons nationwide, but most usually last only a few hours or days. During lockdowns, access […]
Amanda Hernandez

Godfrey Approves Limit On Video Gaming Licenses

1 year 3 months ago
GODFREY - Godfrey trustees voted on Tuesday to limit the number of video gaming establishments allowed in the village at one time. Village Board members unanimously approved an ordinance limiting the total number of video gaming licenses issued in the village to 24. Village Attorney Phil Lading said this number corresponds to Godfrey’s current number of gaming establishments, effectively banning any more from opening or operating. As was previously the case, only businesses with certain liquor licenses can legally operate gaming machines. This new limit doesn’t apply to all liquor licenses, just those that allow gaming - Class E and Class N. However, the ordinance states that if 24 Class E and/or N licenses have already been issued, all additional licenses are ineligible for video gaming. After some further clarification from the village attorney, trustees agreed that a limit was urgently needed on such establishments. Mayor Mike McCormick added that while exception

Continue Reading

Duckworth Asks Trump To Prevent GOP From Blocking IVF Coverage For Service Members and Military Families

1 year 3 months ago
WASHINGTON, D.C. – Today, combat Veteran and U.S. Senator Tammy Duckworth (D-IL)—who served in the Reserve Forces for 23 years and is a member of the U.S. Senate Armed Services Committee—called on President-elect Donald Trump to prove that he is serious about keeping his bold promise that he would mandate the federal government and insurance companies pay for all costs associated with IVF services. The House-passed NDAA, as it currently stands, would provide our nation’s servicemembers with the same level of IVF coverage that Members of Congress receive in 2025—though some Republicans in Congress are quietly attempting to remove that coverage after the House voted 217-199 to pass it. Trump could begin keeping his promise by simply telling those Republicans to end their efforts and ensure IVF is covered for servicemembers and military families. “Although the NDAA will be finalized by the 118th Congress, the fate of one key provision in H.R.

Continue Reading

GoFundMe Organized For East St. Louis McDonald's Employee Killed At Work

1 year 3 months ago
EAST ST. LOUIS - A GoFundMe campaign has been organized for Dionna Samuels, an East St. Louis McDonald's employee who was shot and killed while at work in the drive-thru window. The fundraiser is organized by Chatyvia Franklin, an East St. Louis McDonald's cashier and “one of many friends, family members, and supporters” of Samuels, as she wrote on the GoFundMe page . “Dionna was a daughter, auntie, cousin, and sister. This is a devastating loss,” Franklin wrote. “Dionna was a very smart and lovable person; she did not deserve any of this. Nobody deserves to have to bury their child so suddenly because of gun violence. “She touched a lot of people and made so many bonds while working for the McDonald's company. She made sure everyone was doing their job the right way but also made sure everyone was comfortable and happy.” She added that contributions will help support the family and ensure Samuels is given a proper burial. &ldquo

Continue Reading

First Fridays Late Night Art and Shopping Experience In Alton Set For Dec. 6

1 year 3 months ago
ALTON - Alton Main Street presents First Fridays, a late night art and shopping experience which spans 15 locations across the Downtown Alton district. This event was held on the First Friday of October and November and will enjoy its final installment on December 6, 2024, providing you with an opportunity to check out new shops and galleries and visit familiar favorites to experience art and great specials at each business. Participants are offering a variety of discounts, refreshments, and giveaways. Everyone who has their passport stamped at a minimum of 8 locations will be entered into a drawing for a $100 gift certificate to any participating business. Free parking is available in the lot next to FLOCK Food Truck Park & Bar, located at 210 Ridge Street, and a free shuttle bus will be provided from 5:00-8:00 p.m., running a continuous loop between all participating locations. Start your evening by picking up your First Friday passport at any participating location, then hop

Continue Reading

GCSD9 Partners With All God's Children Shall Have Shoes

1 year 3 months ago
GRANITE CITY – Granite City Community School District #9 is partnering with All God's Children Shall Have Shoes for its annual event held Friday, Dec. 6, 2024, at Famous Footwear at the Alton Square Mall. All God's Children Shall Have Shoes is an annual free socks and shoes program for local schools in the metro area. Students from Frohardt, Grigsby, Lake, Maryville, Mitchell, Prather and Wilson are participating in the event. Volunteers will assist the children in picking out a pair of shoes and a package of socks to take home. Buses were donated from First Student, Inc. to transport the students to and from Famous Footwear. Attached is a short video recap of the event from 2023: https://www.youtube.com/watch?v=6vt_5HdIDsY

Continue Reading