Kaiser Health News
Alabama Can’t Prosecute Groups Helping Patients Get Abortions Elsewhere, Judge Rules
Reproductive rights groups in Alabama wasted no time resuming their work after a federal judge ruled in early April that the state’s attorney general can’t prosecute — or threaten to prosecute — people or organizations who help Alabama residents seek an abortion by traveling to another state.
One of the plaintiffs, the reproductive justice nonprofit Yellowhammer Fund, wasted no time in returning to one of its core missions: to provide financial support to traveling patients.
“The decision came at about 5:30. I think we funded an abortion at 5:45 — because that’s how severe the need is, that’s how urgent it is that we get back to the work that we’re doing,” said Jenice Fountain, executive director of Yellowhammer Fund, which advocates for abortion access.
On April 2, the U.S. Supreme Court heard oral arguments on whether South Carolina can remove Planned Parenthood clinics from the state’s Medicaid program. This came just days after Planned Parenthood received notice that the Trump administration would withhold funding from the Title X Family Planning Program for nine of the group’s affiliates.
“We’re just seeing kind of a multiplying of conflicts where we have unanswered questions about the meaning of the First Amendment in this context, about the right to travel in this context, about due process in this context — about these sort of clashing state laws and choosing which one applies,” said Mary Ziegler, a law professor at the University of California-Davis who specializes in the politics and history of reproductive rights.
Alabama has one of the strictest bans on abortion in the country — with no exceptions for rape or incest. The law was approved by the state legislature in 2019 and remained at the ready should Roe v. Wade be overturned. It took effect immediately when the Supreme Court did just that on June 24, 2022, in the Dobbs v. Jackson Women’s Health Organization decision.
At the time, Yellowhammer Fund was getting about 100 calls a week from people seeking financial help with getting an abortion, Fountain said.
For more than two years, the organization has been unable to help such callers.
“The thing with the ban was it was so vague that it was incredibly hard to interpret, especially if you weren’t a person that was legally inclined,” Fountain said. “So the effect that it had, which was its intention, was a chilling effect.”
During that time, Yellowhammer continued to promote reproductive justice and maternal and infant health through community efforts such as distributing diapers, formula, menstrual supplies, and emergency contraception.
Beyond the alarm created by the statutory language in Alabama’s abortion ban, fears were stoked by Alabama’s attorney general, Steve Marshall, Fountain said.
Almost seven weeks after the 2022 Dobbs decision, Marshall said in a radio interview that groups that assist people seeking an abortion in another state could face criminal prosecution.
“There’s no doubt that this is a criminal law and the general principles that apply to a criminal law would apply to this, with its status of the Class A felony, that’s the most significant offense that we have as far as punishment goes under our criminal statue, absent a death penalty case,” Marshall said in the interview with Breitbart TV editor Jeff Poor.
“If someone was promoting themselves out as a funder of abortion out of state, then that is potentially criminally actionable for us,” Marshall said.
Marshall was explicitly referring to such groups as Yellowhammer Fund, Fountain said.
“He mentioned the group from Tuscaloosa that helps people get to care, which is Yellowhammer Fund,” Fountain said. “He all but ‘@’d us.”
Yellowhammer Fund and other abortion rights groups filed the lawsuit against Marshall on July 31, 2023.
In his ruling, U.S. District Judge Myron Thompson of the Middle District of Alabama in Montgomery, agreed with them, saying Marshall would be violating both First Amendment free speech rights and the constitutional right to travel if he tried to bring criminal charges.
Thompson also warned against overlooking the “broader, practical implications of the Attorney General’s threats,” in the matter of Alabama trying to enforce laws outside the state.
“For example,” Thompson wrote in his ruling, “the Alabama Attorney General would have within his reach the authority to prosecute Alabamians planning a Las Vegas bachelor party, complete with casinos and gambling, since casino-style gambling is outlawed in Alabama.”
Another group involved in the case, WAWC Healthcare in Tuscaloosa (formerly West Alabama Women’s Center), also resumed work that had been paused.
“We have spent the last few years worried that if we had provided any form of information to patients about where they could access a legal abortion, that that is something that the attorney general might try to prosecute us over,” said Robin Marty, WAWC’s executive director.
Before the Dobbs decision, WAWCprovided abortion as part of its services. It continues to offer free reproductive health care, including prenatal care, contraception, and HIV testing.
Clinical staffers at WAWC weren’t allowed even to suggest to someone that they could leave the state to get an abortion, Marty said.
“There is nothing harder than looking into somebody’s face when they are in crisis and saying, ‘I’m sorry, I just can’t help you anymore,’” Marty said. “That was really wearing on my staff because our job was to provide the best information possible. And to know that we could not give them the full care that they required was heartbreaking.”
With the ruling, WAWC can now offer “all-options counseling,” which includes information on how and where patients can access abortion services in other states, Marty said.
“If they do not feel like they are able to continue the pregnancy, we can tell them, ‘OK, you are this far along, so you are able to go this clinic in North Carolina, because you’re under their limit” for gestational age, “or you can go to this clinic in Illinois because you’re under their limit,’” Marty said. “We’ll be able to tell them exactly where they can go and even be able to help them with the referral process along the way.”
The attorney general could file an appeal, but now it’s unclear whether his office will do so. Marshall’s office did not respond to NPR’s request for an interview, but in a statement said, “The office is reviewing the decision to determine the state’s options.”
But legal expert Ziegler said she’d be surprised if Marshall didn’t file an appeal, given his office’s vigorous defense in the lawsuit.
In addition, the potential political costs of pursuing that kind of prosecution may have eased, because states like Texas and Louisiana have already taken legal action regarding out-of-state abortion providers, said Ziegler.
On the other hand, the attorney general might not appeal because his office was the defendant in the lawsuit, and he may not want to draw attention to the case, Ziegler said.
If Marshall did file an appeal, it would go to the U.S. Court of Appeals for the 11th Circuit, which Ziegler called conservative-leaning. The case could ultimately go to the U.S. Supreme Court, Ziegler said, which may have to weigh in more on abortion-related cases, such as when it temporarily allowed emergency abortions in Idaho in June 2024.
“I think the takeaway is that the U.S. Supreme Court is going to be more involved than ever in fights about reproduction and abortion, not less, notwithstanding the fact that Roe is gone,” Ziegler said.
This article is from a partnership that includes Gulf States Newsroom, NPR and KFF Health News.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
This article first appeared on KFF Health News and is republished here under a Creative Commons license.
The post Alabama Can’t Prosecute Groups Helping Patients Get Abortions Elsewhere, Judge Rules appeared first on kffhealthnews.org
Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.
Political Bias Rating: Left-Leaning
The content strongly supports reproductive rights, focusing on the challenges faced by organizations that assist women seeking abortions and the legal efforts to overturn restrictive state laws. The tone is sympathetic to the abortion rights movement, highlighting the urgency and emotional impact of the work done by organizations like the Yellowhammer Fund and WAWC. The inclusion of legal experts and references to actions taken by conservative states, particularly Alabama’s attorney general, further emphasizes the ideological divide on abortion issues. While it presents factual events, the framing and choice of language favor a pro-abortion rights perspective.
Kaiser Health News
Newsom’s Pitch as He Seeks To Pare Down Immigrant Health Care: ‘We Have To Adjust’
SACRAMENTO, Calif. — Gov. Gavin Newsom on Wednesday proposed that California roll back health care for immigrants without legal status, saying the state needed to cut benefits for some to maintain core services across the board.
It’s a striking reversal for the Democrat, who had promised universal health care and called health coverage for immigrants the moral and ethical thing to do. But a $12 billion state budget deficit, potential federal spending cuts, and larger-than-expected Medi-Cal enrollment have forced him to dial back.
Newsom said he had no other choice but to call for major cost-cutting measures affecting how some immigrants are covered by Medi-Cal, the state’s Medicaid program, which covers about 15 million Californians.
“The challenge that we face this year and the challenge we will face for many years is on growth of our Medicaid system, Medi-Cal,” Newsom told reporters at his budget presentation. “Instead of rolling back the program, cutting people off for basic care, we have to adjust the comprehensive nature of the care.”
California is one of seven states that offer health coverage to low-income adults regardless of immigration status, and that has put the program in the political crosshairs of national Republicans. The latest U.S. House proposal would cut Medicaid funding by 10 percentage points for states that provide coverage for immigrants without legal status — an approach Newsom on Wednesday described as legally questionable. Meanwhile, the Trump administration cited California’s health coverage of noncitizens as an example of states “gaming the system” when it issued a proposed rule Monday to overhaul Medicaid provider taxes.
Some 1.6 million immigrants — most without legal status — are enrolled in Medi-Cal. Federal law prohibits Medicaid dollars from being used to cover unauthorized residents, meaning California must foot the bill for the vast majority of their health care. And those costs have ballooned.
Newsom cautioned that California, like other states, could soon be in a more dire budget situation if Republicans advance their proposal to cut Medicaid. That plan includes work requirements and would cap taxes levied on providers that help states draw additional federal money. However, the governor’s budget proposal was silent on potential federal cuts.
The $321.9 billion budget proposes a freeze in Medi-Cal enrollment for immigrants 19 and older without legal status, starting Jan. 1. Beginning in 2027, immigrants 19 and older in the country illegally, as well as those with legal residency for less than five years, would be required to pay $100 monthly premiums to maintain coverage.
The Newsom administration estimated those two moves would save the state $5.4 billion by the 2028-29 fiscal year. The governor also called for eliminating dental and long-term care benefits for those without legal status and for legal residents who arrived in the U.S. less than five years ago, according to California Department of Finance spokesperson H.D. Palmer.
The changes would not apply to the roughly 217,000 children and young adults without legal status covered by Medi-Cal. Those 18 and under were the first to receive Medi-Cal coverage, in 2016. Children are generally healthier and require less care, and a KFF Health News analysis showed that, in many cases, children lacking legal status were cheaper to cover than citizens.
Maria, a street vendor from Los Angeles, said the monthly premium alone would force her and others to forgo care.
“They say they are one of the largest economies, but they don’t want to help us,” said Maria, who didn’t want to give her full name, out of fear of retaliation from immigration authorities. “We are contributing to the state. It’s not fair that we, the poor, have to pay what we don’t have.”
“Where am I going to get the $100?” Maria asked.
Federal law prohibits charging the poorest Medicaid enrollees a premium, and Newsom’s $100 monthly payment would be considered unaffordable for current beneficiaries, said Laurel Lucia, director of the health care program at the University of California-Berkeley Labor Center.
Newsom is proposing a $194.5 billion Medi-Cal budget for 2025-26. Lawmakers have until June 15 to pass the budget. Democratic leaders signaled their intent to protect health care for the state’s poorest residents.
The governor and Assembly Speaker Robert Rivas blamed fiscal headwinds brought on by President Donald Trump’s tariffs, which they said had led to a massive $16 billion dip in state tax revenue forecasts since April. But Medi-Cal spending surged well before the tariffs took effect. State costs to cover Californians with “unsatisfactory immigration status” — those without status and legal residents who have been here less than five years — is roughly $10.8 billion per year, up from the $6.4 billion officials projected in November. The federal government pays $1.2 billion of that to cover mandated emergency and pregnancy care.
“It’s laughable that he’s trying to blame Trump for anything,” Republican Assembly member Joe Patterson, who sits on the Assembly Budget Committee, said of Newsom. “He overpromised to them, and he’s pulling the carpet out from underneath them.”
Other states that have extended coverage to immigrants are also struggling with escalating costs. Minnesota, for example, originally projected that 5,700 residents without legal status would sign up for the state Medicaid program, known as MinnesotaCare, at a cost of $200 million. Both figures have increased roughly threefold.
Illinois is ending services for adult immigrants, except seniors, on July 1, citing higher-than-anticipated enrollment. The mostly state-funded health plan will stop covering around 30,000 noncitizens ages 42 to 64, including those living in the country without authorization.
Newsom said Wednesday that without a suite of his proposed changes to Medi-Cal, program costs could grow by an additional $10 billion through June 2026 and would “contribute significantly to the structural imbalance in future years.”
But consumer advocates and lawmakers said the move is a betrayal of the governor’s commitment to bring California closer to universal health care and warned it would push immigrants into costly emergency room care. Sen. María Elena Durazo, a Democrat who championed the Medi-Cal expansion, said California shouldn’t single out immigrants to solve its budget deficit.
“I don’t agree that we should be isolating and abandoning and separating a particular group of Californians, as if they are responsible for the problem,” Durazo said. “I don’t care what you call them, they work, they contribute.”
This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
USE OUR CONTENT
This story can be republished for free (details).
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
This article first appeared on KFF Health News and is republished here under a Creative Commons license.
The post Newsom’s Pitch as He Seeks To Pare Down Immigrant Health Care: ‘We Have To Adjust’ appeared first on kffhealthnews.org
Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.
Political Bias Rating: Center-Left
The article provides a factual, balanced overview of Governor Newsom’s proposal to reduce health care benefits for undocumented immigrants amid budget shortfalls. It highlights the governor’s previous commitment to universal health care and the difficult fiscal constraints prompting the policy shift, while including perspectives that criticize the proposed cuts as a betrayal of progressive values. The coverage references Democratic leaders and immigrant advocates who emphasize inclusivity and fairness, alongside Republican criticism of Newsom’s decisions. Overall, the piece reflects a slight left-of-center leaning through its emphasis on social welfare and immigrant rights, typical of many public health-focused news sources, yet it maintains an objective tone with multiple viewpoints presented.
Kaiser Health News
Luego de prometer atención médica universal, el gobernador de California debe reconsiderar la cobertura para inmigrantes
SACRAMENTO, California — El gobernador Gavin Newsom no esperaba enfrentarse a otra crisis sanitaria.
En marzo, mientras el presidente Donald Trump y los republicanos del Congreso intensificaban el debate nacional sobre la posibilidad de recortar la atención médica para los estadounidenses pobres y con discapacidades, el gobernador demócrata tuvo que informar a los legisladores estatales que los costos del cuidado de salud en California se habían descontrolado.
Esto debido a las grandes iniciativas de Medicaid que Newsom apoyaba, incluyendo la mayor expansión del país de la atención médica financiada con fondos públicos para inmigrantes que viven en Estados Unidos sin papeles.
Sus altos funcionarios del Departamento de Finanzas estatal revelaron con discreción a los legisladores californianos en una carta que el estado había solicitado un préstamo de $3.400 millones para pagar a las aseguradoras, médicos y hospitales que atendían a los pacientes inscritos en el programa estatal del Medicaid, conocido como Medi-Cal.
Ante el aumento de los costos de la atención en medio de una crisis presupuestaria estatal cada vez más profunda, Newsom ahora debe considerar la posibilidad de reducir la cobertura y los beneficios.
El gobernador, en su segundo mandato, se enfrenta a una difícil decisión política: no cumplir con su promesa de lograr una atención médica universal y retirar la cobertura a millones de inmigrantes sin estatus legal, o buscar recortes presupuestarios en otros lugares.
Con casi 15 millones de residentes inscritos en Medi-Cal, California tiene más que perder en materia de atención médica que cualquier otro estado. Sin embargo, aunque Newsom ha condenado la estrategia de Trump sobre los aranceles y las políticas ambientales, se ha mantenido hermético en materia de política de salud.
Para complicar su situación política, las encuestas muestran que brindar cobertura médica a inmigrantes sin papeles cuenta con escaso apoyo. Y cualquier problema presupuestario resultante podría perjudicar su legado político si se postulara a la presidencia en 2028.
“Todos sabemos que los recortes definitivamente se avecinan”, dijo Carlos Alarcón, analista de salud y beneficios públicos del California Immigrant Policy Center, que ha ayudado a impulsar una campaña de una década en el estado para expandir Medicaid a los inmigrantes sin documentos elegibles.
“El gobernador debe cumplir su compromiso; nos decepcionaremos mucho si vemos recortes y reducciones. En tiempos difíciles, siempre son nuestras comunidades marginadas y desatendidas las que salen perdiendo”, agregó.
California permite a cualquier adulto de bajos ingresos inscribirse en Medi-Cal si gana el 138% del nivel federal de pobreza, o $21.597 al año o menos, independientemente de su estatus migratorio. Sin embargo, los costos han sido mucho más altos de lo esperado.
El gobernador demócrata Jerry Brown amplió Medi-Cal a las personas de 19 años o menos sin papeles, pero expresó su reticencia a extenderlo más allá de ese grupo debido a los posibles costos.
Newsom promulgó leyes que incluyen a las personas de 20 años o más. Se estima que 1.6 millones de inmigrantes sin estatus legal ahora están cubiertos, y los costos se han disparado a $9.500 millones al año, en comparación con los $6.400 millones estimados en noviembre. El gobierno federal aporta aproximadamente $1.1 mil millones de ese total para atención médica del embarazo y emergencias.
“Podemos expandirnos por pura generosidad a todas partes, pero en cuanto estos recursos se agoten, todos perdemos. Estamos llegando a un punto crítico”, dijo el asambleísta de California David Tangipa (republicano de Fresno). “O asumimos la responsabilidad fiscal, o no habrá servicios para nadie, incluyendo a los californianos y a los inmigrantes indocumentados”.
Los líderes demócratas responsables de aprobar el presupuesto estatal no aceptaron entrevistas. En un comunicado, la senadora estatal María Elena Durazo (demócrata de Los Ángeles) quien defendió la expansión en la Legislatura, declaró: “Revertir este progreso sería una decisión perjudicial y obtusa”.
Los legisladores están considerando congelar la inscripción de inmigrantes sin papeles, imponer medidas de costos compartidos como copagos o primas sobre los medicamentos, o restringir los beneficios, según personas familiarizadas con el tema, que pidieron no ser identificadas para proteger sus relaciones en el Capitolio estatal.
Sin embargo, es poco probable que Newsom recorte drásticamente los fondos en su revisión presupuestaria, publicada el 14 de mayo. En cambio, los recortes se producirían si los republicanos del Congreso aprueban un acuerdo presupuestario con importantes reducciones al gasto federal en Medicaid.
“Esto va a ser muy problemático para el gobernador. Los recortes del presupuesto afectarán la vida de millones de inmigrantes que recién comienzan a tener atención médica, pero el gobernador tiene que hacer algo, porque esto no es sostenible”, dijo Mark Peterson, experto en atención médica y política nacional de la UCLA.
“La posibilidad de recortar otros gastos para apoyar a los inmigrantes que viven en el país sin autorización sería una estrategia política difícil; no creo que eso suceda”, dijo.
Si Newsom, junto con la Legislatura controlada por los demócratas, se viera obligado a realizar recortes, podría argumentar que no tenía otra opción. Trump y los republicanos del Congreso han amenazado a estados como California con la última propuesta de la Cámara de Representantes de EE.UU. de recortar la financiación de Medicaid en 10 puntos porcentuales para los estados que ofrecen cobertura a inmigrantes sin papeles.
Para Newsom, Trump podría ser un chivo expiatorio fácil, dicen analistas.
“Puede culpar a Trump; el dinero disponible es limitado”, dijo Mike Madrid, analista político republicano anti-Trump en California, especializado en temas latinos. “Esto está haciendo que la gente vea la atención médica que no puede pagar y se pregunte: ‘¿Por qué demonios se la damos gratis a quienes están aquí sin documentos?’”.
El costo exorbitante ha sido una sorpresa.
En la primera propuesta presupuestaria de Newsom como gobernador, en la que propuso ampliar Medi-Cal a los adultos jóvenes sin documentos, su administración estimó que extender los beneficios a todas las personas elegibles, independientemente de su estatus, costaría aproximadamente $2.4 mil millones anuales. Pero la última cifra reportada a los legisladores fue casi cuatro veces mayor.
Newsom se negó a responder preguntas de KFF Health News, y en su lugar hizo referencia a comentarios anteriores que dejan la puerta abierta a la posibilidad de reducir Medi-Cal. El gobernador destacó las conversaciones “serias” con los legisladores y afirmó que recortar el programa es una “pregunta abierta” en la que el presidente influirá considerablemente.
“¿Cuál es el impacto de Donald Trump en muchos de estos temas? ¿Cuál es el impacto del vandalismo federal en muchos de estos programas?”, se preguntó Newsom retóricamente en diciembre, sugiriendo que no está claro si podrá sostener la expansión para los inmigrantes sin papeles en los próximos años.
Newsom expandió Medi-Cal en tres fases, comenzando con los inmigrantes de 19 a 25 años, quienes se volvieron elegibles en 2020, resistiendo la presión de los defensores de la atención médica para una expansión grande y costosa. Argumentó que hacerlo de forma gradual, en última instancia, ahorraría dinero a California.
“Es lo correcto moral y éticamente”, dijo Newsom en 2020. “También es lo financieramente responsable”.
Los superávits presupuestarios récord de los últimos años permitieron que los demócratas continuaran. Los adultos mayores de 50 a 64 años comenzaron a ser elegibles en 2022, y Newsom cerró la brecha al año siguiente, aprobando la cobertura para el grupo más numeroso, el de 26 a 49 años, a partir de 2024.
Sin embargo, los costos han aumentado muchísimo, mientras que el panorama presupuestario se ha deteriorado, según un análisis de KFF de los registros más recientes de 2023 disponibles del Departamento de Servicios de Atención Médica del estado, que administra Medi-Cal.
Por fuera de los niños, fue más caro brindar cobertura de Medicaid a los inmigrantes sin estatus legal que a los residentes legales. Por ejemplo, Medi-Cal pagó a L.A. Care, una gran aseguradora de salud en Los Ángeles, un promedio de $495.32 mensuales por brindar atención a un adulto sin hijos sin papeles, y $266.77 por un residente legal sin hijos.
No solo fue más caro para los inmigrantes sin estatus legal, sino que California asumió la mayor parte del costo.
El estado pagó aproximadamente entre el 60% y el 70% de los costos de atención médica para un inmigrante adulto sin hijos cubierto por L.A. Care, y alrededor del 10% para un residente legal sin hijos. Estos costos no abarcan el costo total de la atención, que puede variar según en donde viven los pacientes de Medi-Cal, y aumentar al surtir recetas, ir al dentista o buscar atención de salud mental.
Estos pagos también varían según la aseguradora, pero la tendencia se mantiene en todos los planes de Medi-Cal. En la mayor parte del estado, los pacientes pueden elegir entre más de un plan de salud.
En muchos casos, la cobertura para los niños sin estatus legal fue más económica que la de los niños con residencia legal. Generalmente, los niños son más saludables y necesitan menos atención.
Mike Genest, quien se desempeñó como director de finanzas durante el gobierno del ex gobernador republicano Arnold Schwarzenegger, argumentó que el estado debería haber previsto el enorme costo.
“La idea de que a largo plazo podamos pagar la atención médica para todas estas personas indocumentadas es insostenible”, dijo Genest.
Si bien ahora los costos son altos, la expansión de Medi-Cal generará ahorros a largo plazo para los contribuyentes y el sistema de salud, afirmó Anthony Wright, quien anteriormente presionó a favor de la expansión como director de la organización sin fines de lucro Health Access y ahora lucha contra los recortes a Medicaid como director ejecutivo de Families USA, con sede en Washington, D.C.
“De todas formas, seguirán acudiendo a nuestro sistema de salud”, afirmó Wright. “Dejarlos sin seguro médico solo resultará en salas de emergencia más congestionadas y costará aún más. No tiene sentido económico que no tengan seguro; eso les quita ingresos cruciales a clínicas y hospitales, lo que solo causa más problemas”.
Esta historia fue producida por KFF Health News, que publica California Healthline, un servicio editorialmente independiente de la California Health Care Foundation.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
This article first appeared on KFF Health News and is republished here under a Creative Commons license.
The post Luego de prometer atención médica universal, el gobernador de California debe reconsiderar la cobertura para inmigrantes appeared first on kffhealthnews.org
Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.
Political Bias Rating: Center-Left
This article provides an in-depth analysis of California Governor Gavin Newsom’s Medicaid expansion policies for undocumented immigrants, focusing on the financial challenges and political pressures involved. It frames Newsom as a Democrat supportive of progressive healthcare expansion but facing budgetary constraints partly due to federal policies under Republican leadership, notably former President Trump. The piece highlights the tension between progressive social goals and fiscal responsibility, with critical voices on both sides. The nuanced presentation, emphasis on social welfare expansions, and critique of Republican federal policies position the article on the center-left of the political spectrum, reflecting moderate Democratic concerns without overt partisan advocacy.
Kaiser Health News
Medicaid Payments Barely Keep Hospital Mental Health Units Afloat. Federal Cuts Could Sink Them.
SPENCER, Iowa — This town’s hospital is a holdout on behalf of people going through mental health crises. The facility’s leaders have pledged not to shutter their inpatient psychiatric unit, as dozens of other U.S. hospitals have.
Keeping that promise could soon get tougher if Congress slashes Medicaid funding. The joint federal-state health program covers an unusually large share of mental health patients, and hospital industry leaders say spending cuts could accelerate a decades-long wave of psychiatric unit closures.
At least eight other Iowa hospitals have stopped offering inpatient mental health care since 2007, forcing people in crisis to seek help in distant facilities. Spencer Hospital is one of the smallest in Iowa still offering the service.
CEO Brenda Tiefenthaler said 40% of her hospital’s psychiatric inpatients are covered by Medicaid, compared with about 12% of all inpatients. An additional 10% of the hospital’s psychiatric inpatients are uninsured. National experts say such disparities are common.
Tiefenthaler vows to keep her nonprofit hospital’s 14-bed psychiatric unit open, even though it loses $2 million per year. That’s a significant loss for an organization with an overall annual budget of about $120 million. But the people who use the psychiatric unit need medical care, “just like people who have chest pains,” Tiefenthaler said.
Medicaid covers health care for about 72 million Americans with low incomes or disabilities. Tiefenthaler predicts that if some of them are kicked off the program and left without insurance coverage, more people would delay treatment for mental health problems until their lives spin out of control.
“Then they’re going to enter through the emergency room when they’re in a crisis,” she said. “That’s not really a solution to what we have going on in our country.”
Republican congressional leaders have vowed to protect Medicaid for people who need it, but they also have called for billions of dollars in cuts to areas of the federal budget that include the program.
The U.S. already faces a deep shortage of inpatient mental health services, many of which were reduced or eliminated by private hospitals and public institutions, said Jennifer Snow, director of government relations and policy for the National Alliance on Mental Illness. At the same time, the number of people experiencing mental problems has climbed.
“I don’t even want to think about how much worse it could get,” she said.
The American Hospital Association estimates nearly 100 U.S. hospitals have shuttered their inpatient mental health services in the past decade.
Such closures are often attributed to mental health services being more likely to lose money than many other types of health care. “I’m not blaming the hospitals,” Snow said. “They need to keep their doors open.”
Medicaid generally pays hospitals lower rates for services than they receive from private insurance or from Medicare, the federal program that mostly covers people 65 or older. And Medicaid recipients are particularly likely to need mental health care. More than a third of nonelderly Medicaid enrollees have some sort of mental illness, according to a report from KFF, a nonprofit health policy organization that includes KFF Health News. Iowa has the highest rate of mental illness among nonelderly Medicaid recipients, at 51%.
As of February, just 20 of Iowa’s 116 community hospitals had inpatient psychiatric units, according to a state registry. Iowa also has four freestanding mental hospitals, including two run by the state.
Iowa, with 3.2 million residents, has a total of about 760 inpatient mental health beds that are staffed to care for patients, the state reports. The Treatment Advocacy Center, a national group seeking improved mental health care, says the “absolute minimum” of such beds would translate to about 960 for Iowa’s population, and the optimal number would be about 1,920.
Most of Iowa’s psychiatric beds are in metro areas, and it can take several days for a slot to come open. In the meantime, patients routinely wait in emergency departments.
Sheriff’s deputies often are assigned to transport patients to available facilities when treatment is court-ordered.
“It’s not uncommon for us to drive five or six hours,” said Clay County Sheriff Chris Raveling, whose northwestern Iowa county includes Spencer, a city of 11,000 people.
He said Spencer Hospital’s mental health unit often is too full to accept new patients and, like many such facilities, it declines to take patients who are violent or charged with crimes.
The result is that people are held in jail on minor charges stemming from their mental illnesses or addictions, the sheriff said. “They really shouldn’t be in jail,” he said. “Did they commit a crime? Yes. But I don’t think they did it on purpose.”
Raveling said authorities in many cases decide to hold people in jail so they don’t hurt themselves or others while awaiting treatment. He has seen the problems worsen in his 25 years in law enforcement.
Most people with mental health issues can be treated as outpatients, but many of those services also depend heavily on Medicaid and could be vulnerable to budget cuts.
Jon Ulven, a psychologist who practices in Moorhead, Minnesota, and neighboring Fargo, North Dakota, said he’s particularly worried about patients who develop psychosis, which often begins in the teenage years or early adulthood. If they’re started right away on medication and therapy, “we can have a dramatic influence on that person for the rest of their life,” he said. But if treatment is delayed, their symptoms often become harder to reverse.
Ulven, who helps oversee mental health services in his region for the multistate Sanford Health system, said he’s also concerned about people with other mental health challenges, including depression. He noted a study published in 2022 that showed suicide rates rose faster in states that declined to expand their Medicaid programs than in states that agreed to expand their programs to cover more low-income adults. If Medicaid rolls are reduced again, he said, more people would be uninsured and fewer services would be available. That could lead to more suicides.
Nationally, Medicaid covered nearly 41% of psychiatric inpatients cared for in 2024 by a sample of 680 hospitals, according to an analysis done for KFF Health News by the financial consulting company Strata. In contrast, just 13% of inpatients in those hospitals’ cancer programs and 9% of inpatients in their cardiac programs were covered by Medicaid.
If Medicaid participants have mental crises after losing their coverage, hospitals or clinics would have to treat many of them for little or no payment. “These are not wealthy people. They don’t have a lot of assets,” said Steve Wasson, Strata’s chief data and intelligence officer. Even though Medicaid pays hospitals relatively low rates, he said, “it’s better than nothing.”
Birthing units, which also have been plagued by closures, face similar challenges. In the Strata sample, 37% of those units’ patients were on Medicaid in 2024.
Spencer Hospital, which has a total of 63 inpatient beds, has maintained both its birthing unit and its psychiatric unit, and its leaders plan to keep them open. Amid a critical shortage of mental health professionals, it employs two psychiatric nurse practitioners and two psychiatrists, including one providing care via video from North Carolina.
Local resident David Jacobsen appreciates the hospital’s efforts to preserve services. His son Alex was assisted by the facility’s mental health professionals during years of struggles before he died by suicide in 2020.
David Jacobsen knows how reliant such services are on Medicaid, and he worries that more hospitals will curtail mental health offerings if national leaders cut the program. “They’re hurting the people who need help the most,” he said.
People on Medicaid aren’t the only ones affected when hospitals reduce services or close treatment units. Everyone in the community loses access to care.
Alex Jacobsen’s family saw how common the need is. “If we can learn anything from my Alex,” one of his sisters wrote in his obituary, “it’s that mental illness is real, it doesn’t discriminate, and it takes some of the best people down in its ugly swirling drain.”
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
This article first appeared on KFF Health News and is republished here under a Creative Commons license.
The post Medicaid Payments Barely Keep Hospital Mental Health Units Afloat. Federal Cuts Could Sink Them. appeared first on kffhealthnews.org
Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.
Political Bias Rating: Center-Left
The content presents a focus on the critical importance of mental health services, particularly highlighting the role of Medicaid in supporting vulnerable populations. It critiques proposed Medicaid funding cuts and emphasizes the consequences for individuals relying on public health programs. While the piece acknowledges efforts by Republican leaders to protect Medicaid, it frames these efforts as insufficient in the face of larger budget cuts. The tone advocates for sustained government support for healthcare, a perspective more aligned with center-left political views that prioritize social welfare and public health investment.
-
News from the South - North Carolina News Feed6 days ago
Change to law would allow NC families to reconnect after children are in foster care
-
News from the South - Texas News Feed6 days ago
Man killed by stray bullet while in bed with wife: Dallas PD
-
News from the South - Texas News Feed6 days ago
Teen killed in crash when other juvenile lost control of car, slammed into tree, police say
-
News from the South - Alabama News Feed5 days ago
Speed Limit Changes | May 11, 2025 | WHNT News 19 Sunday Evening
-
News from the South - Florida News Feed2 days ago
South Florida married couple separated after ICE detains husband, wife says
-
Mississippi Today7 days ago
Even in red America, clean energy is booming. But now, huge renewable projects are dead.
-
News from the South - Florida News Feed1 day ago
State shutdown looms as Florida braces for active hurricane forecast
-
News from the South - West Virginia News Feed7 days ago
Students enrolled in public schools can be exempt from mandatory vaccines on religious grounds