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.
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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.
Kaiser Health News
A California Lawmaker Leans Into Her Medical Training in Fight for Health Safety Net
SACRAMENTO, Calif. — State Sen. Akilah Weber Pierson anticipates that California’s sprawling Medicaid program, known as Medi-Cal, may need to be dialed back after Gov. Gavin Newsom releases his latest budget, which could reflect a multibillion-dollar deficit.
Even so, the physician-turned-lawmaker, who was elected to the state Senate in November, says her priorities as chair of a budget health subcommittee include preserving coverage for the state’s most vulnerable, particularly children and people with chronic health conditions.
“We will be spending many, many hours and long nights figuring this out,” Weber Pierson said of the lead-up to the state’s June 15 deadline for lawmakers to pass a balanced budget.
With Medicaid cuts on the table in Washington and Medi-Cal running billions of dollars over budget due to rising drug prices and higher-than-anticipated costs to cover immigrants without legal status, Weber Pierson’s dual responsibilities — maintaining a balanced budget and delivering compassionate care to the state’s poorest residents — could make her instrumental in leading Democrats through this period of uncertainty.
President Donald Trump has said GOP efforts to cut federal spending will not touch Medicaid beyond “waste, fraud, and abuse.” Congressional Republicans are considering going after states such as California that extend coverage to immigrants without legal status and imposing restrictions on provider taxes. California voters in November made permanent the state’s tax on managed-care health plans to continue funding Medi-Cal.
The federal budget megabill is winding its way through Congress, where Republicans have set a target of $880 billion in spending cuts over 10 years from the House committee that oversees the Medicaid program.
Health care policy researchers say that would inevitably force the program to restrict eligibility, narrow the scope of benefits, or both. Medi-Cal covers 1 in 3 Californians, and more than half of its nearly $175 billion budget comes from the federal government.
One of a handful of practicing physicians in the state legislature, Weber Pierson is leaning heavily on her experience as a pediatric and adolescent gynecologist who treats children with reproductive birth defects — one of only two in Southern California.
Weber Pierson spoke to KFF Health News correspondent Christine Mai-Duc in Sacramento this spring. She has introduced bills to improve timely access to care for pregnant Medi-Cal patients, require developers to mitigate bias in artificial intelligence algorithms used in health care, and compel health plans to cover screenings for housing, food insecurity, and other social determinants of health.
This interview has been edited for length and clarity.
Q: You’re a state senator, you practice medicine in your district, and you’re also a mom. What does that look like day to day?
A: When you grow up around someone who juggles a lot, that just kind of becomes the norm. I saw this with my mom [former state Assembly member Shirley Weber, who is now secretary of state].
I’m really happy that I’m able to continue with my clinical duties. Those in the health care profession understand how much time, energy, effort, and money we put into becoming a health care provider, and I’m still fairly early in my career. With my particular specialty, it would also be a huge void in the San Diego region for me to step back.
Q: What are the biggest threats or challenges in health care right now?
A: The immediate threats are the financial issues and our budget. A lot of people do not understand the overwhelming amount of dollars that go into our health care system from the federal government.
Another issue is access. Almost everybody in California is covered by insurance. The problem is that we have not expanded access to providers. If you have insurance but your nearest labor and delivery unit is still two hours away, what exactly have we really done for those patients?
The third thing is the social determinants of health. The fact that your life expectancy is based on the ZIP code in which you were born is absolutely criminal. Why are certain areas devoid of having supermarkets where you can go and get fresh fruits and vegetables? And then we wonder why certain people have high blood pressure and diabetes and obesity.
Q: On the federal level, there’s a lot of conversation happening around Medicaid cuts, reining in the MCO tax, and potentially dropping Affordable Care Act premium subsidies. Which is the biggest threat to California?
A: To be quite honest with you, all of those. The MCO tax was a recognition that we needed more providers, and in order to get more providers, we need to increase the Medi-Cal reimbursement rates. The fact that now it is at risk is very, very concerning. That is how we are able to care for those who are our most vulnerable in our state.
Q: If those cuts do come, what do we cut? How do we cut it?
A: We are in a position where we have to talk about it at this point. Our Medi-Cal budget, outside of what the federal government may do, is exploding. We definitely have to ensure that those who are our most vulnerable — our kids, those with chronic conditions — continue to have some sort of coverage. What will that look like?
To be quite honest with you, at this point, I don’t know.
Q: How can the state make it the least painful for Californians?
A: Sometimes the last one to the table is the first one to have to leave the table. And so I think that’s probably an approach that we will look at. What were some of the more recent things that we’ve added, and we’ve added a lot of stuff lately. How can we trim down — maybe not completely eliminate, but trim down on — some of these services to try to make them more affordable?
Q: When you say the last at the table, are you talking about the expansion of Medi-Cal coverage to Californians without legal status? Certain age groups?
A: I don’t want to get ahead of this conversation, because it is a very large conversation between not only me but also the [Senate president] pro tem, the Assembly speaker, and the governor’s office. But those conversations are being had, keeping in mind that we want to provide the best care for as many people as possible.
Q: You’re carrying a bill related to AI in health care this year. Tell me what you’re trying to address.
A: It has just exploded at a speed that I don’t know any of us were anticipating. We are trying to play catch-up, because we weren’t really at the table when all of this stuff was being rolled out.
As we advance in technology, it’s been great; we’ve extended lives. But we need to make sure that the biases that led to various discrepancies and health care outcomes are not the same biases that are inputted into that system.
Q: How does Sacramento policy impact your patients and what experience as a physician do you bring to policymaking?
A: I speak with my colleagues with actual knowledge of what’s happening with our patients, what’s happening in the clinics. My patients and my fellow providers will often come to me and say, “You guys are getting ready to do this, and this is why it’s going to be a problem.” And I’m like, “OK, that’s really good to know.”
I work at a children’s facility, and right after the election, specialty hospitals were very concerned around funding and their ability to continue to practice.
In the MCO discussion, I was hearing from providers, hospitals on the ground on a regular basis. With the executive order [on gender-affirming care for transgender youth], I have seen people that I work with concerned, because these are patients that they take care of. I’m very grateful for the opportunity to be in both worlds.
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.
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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 content leans center-left due to its focus on preserving and protecting Medi-Cal, a Medicaid program serving vulnerable populations, particularly children and immigrants. It highlights concerns about federal budget cuts proposed by Republicans and emphasizes the importance of maintaining social services, healthcare access, and addressing social determinants of health. The perspective is generally supportive of expanding healthcare coverage and cautious about fiscal reductions affecting marginalized groups, which aligns with moderate Democratic and progressive viewpoints.
The Host
Julie Rovner
KFF Health News
Julie Rovner is chief Washington correspondent and host of KFF Health News’ weekly health policy news podcast, “What the Health?” A noted expert on health policy issues, Julie is the author of the critically praised reference book “Health Care Politics and Policy A to Z,” now in its third edition.
After narrowly passing a budget resolution this spring foreshadowing major Medicaid cuts, Republicans in Congress are having trouble agreeing on specific ways to save billions of dollars from a pool of funding that pays for the program without cutting benefits on which millions of Americans rely. Moderates resist changes they say would harm their constituents, while fiscal conservatives say they won’t vote for smaller cuts than those called for in the budget resolution. The fate of President Donald Trump’s “one big, beautiful bill” containing renewed tax cuts and boosted immigration enforcement could hang on a Medicaid deal.
Meanwhile, the Trump administration surprised those on both sides of the abortion debate by agreeing with the Biden administration that a Texas case challenging the FDA’s approval of the abortion pill mifepristone should be dropped. It’s clear the administration’s request is purely technical, though, and has no bearing on whether officials plan to protect the abortion pill’s availability.
This week’s panelists are Julie Rovner of KFF Health News, Anna Edney of Bloomberg News, Maya Goldman of Axios, and Sandhya Raman of CQ Roll Call.
Panelists
Anna Edney
Bloomberg News
Maya Goldman
Axios
Sandhya Raman
CQ Roll Call
Among the takeaways from this week’s episode:
- Congressional Republicans are making halting progress on negotiations over government spending cuts. As hard-line House conservatives push for deeper cuts to the Medicaid program, their GOP colleagues representing districts that heavily depend on Medicaid coverage are pushing back. House Republican leaders are eying a Memorial Day deadline, and key committees are scheduled to review the legislation next week — but first, Republicans need to agree on what that legislation says.
- Trump withdrew his nomination of Janette Nesheiwat for U.S. surgeon general amid accusations she misrepresented her academic credentials and criticism from the far right. In her place, he nominated Casey Means, a physician who is an ally of HHS Secretary Robert F. Kennedy Jr.’s and a prominent advocate of the “Make America Healthy Again” movement.
- The pharmaceutical industry is on alert as Trump prepares to sign an executive order directing agencies to look into “most-favored-nation” pricing, a policy that would set U.S. drug prices to the lowest level paid by similar countries. The president explored that policy during his first administration, and the drug industry sued to stop it. Drugmakers are already on edge over Trump’s plan to impose tariffs on drugs and their ingredients.
- And Kennedy is scheduled to appear before the Senate’s Health, Education, Labor and Pensions Committee next week. The hearing would be the first time the secretary of Health and Human Services has appeared before the HELP Committee since his confirmation hearings — and all eyes are on the committee’s GOP chairman, Sen. Bill Cassidy of Louisiana, a physician who expressed deep concerns at the time, including about Kennedy’s stances on vaccines.
Also this week, Rovner interviews KFF Health News’ Lauren Sausser, who co-reported and co-wrote the latest KFF Health News’ “Bill of the Month” installment, about an unexpected bill for what seemed like preventive care. If you have an outrageous, baffling, or infuriating medical bill you’d like to share with us, you can do that here.
Plus, for “extra credit” the panelists suggest health policy stories they read this week that they think you should read, too:
Julie Rovner: NPR’s “Fired, Rehired, and Fired Again: Some Federal Workers Find They’re Suddenly Uninsured,” by Andrea Hsu.
Maya Goldman: STAT’s “Europe Unveils $565 Million Package To Retain Scientists, and Attract New Ones,” by Andrew Joseph.
Anna Edney: Bloomberg News’ “A Former TV Writer Found a Health-Care Loophole That Threatens To Blow Up Obamacare,” by Zachary R. Mider and Zeke Faux.
Sandhya Raman: The Louisiana Illuminator’s “In the Deep South, Health Care Fights Echo Civil Rights Battles,” by Anna Claire Vollers.
Also mentioned in this week’s podcast:
Credits
Francis Ying
Audio producer
Emmarie Huetteman
Editor
To hear all our podcasts, click here.
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The post Cutting Medicaid Is Hard — Even for the GOP 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 provides a balanced overview of current health policy issues with a slight lean towards framing Republican budget efforts and Medicaid cuts critically, emphasizing the potential negative impacts on constituents reliant on these programs. The coverage fairly presents multiple viewpoints, including fiscal conservatives and moderates within the Republican Party, but the tone suggests some skepticism towards conservative budget priorities and Trump administration policies. Overall, the focus on health care access and concerns about cuts aligns with a center-left perspective without strong partisan language or ideological bias.
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