A newsletter briefing on the health-care policy debate in Washington.
with research by McKenzie Beard
A newsletter briefing on the health-care policy debate in Washington.
Good Tuesday morning, everybody. Here’s an unnerving graphic detailing the 200 mass shootings so far this year.
Today’s edition: The need for mental health care is high in Uvalde, Tex., but limited resources coupled with a lack of insurance could keep care out of reach for many. The White House slammed the latest antiabortion bill from Louisiana. But first …
In South Dakota, it’s a big day for the fate of Medicaid expansion.
Voters are heading to the polls today to decide whether to require certain ballot initiatives pass with 60 percent support instead of a simple majority. The adoption of such a rule would make it much harder for South Dakotans to approve a ballot measure expanding Medicaid come November.
Since 2017, advocates have used voter referendums to extend the safety net program in six states with steadfast Republican opposition. They’ve never failed. But only once — in Idaho — have they won with over 60 percent approval.
A dozen mostly GOP-led states have long refused Medicaid expansion, which was originally included in the 2010 Affordable Care Act but made voluntary for states by the Supreme Court. South Dakota has the highest chance of adopting Medicaid expansion this year than any other holdout state.
But if today’s ballot measure passes, Medicaid supporters will face an uphill climb to extend the health insurance program to roughly 42,000 South Dakotans. The push to get the 60 percent vote threshold — known as constitutional “Amendment C” — on the June ballot was, in part, a GOP effort to stymie Medicaid expansion.
The rule, if passed, would apply to measures that raise taxes or require $10 million or more from the state over the next five years. Medicaid expansion would do the latter.
One high-ranking Republican, state Sen. Lee Schoenbeck — who was instrumental in expediting the Amendment C vote — has acknowledged he was motivated by the Medicaid expansion campaign, the Associated Press reported last year. Schoenbeck declined to comment to The Health 202.
Here’s the argument from Amendment C supporters: It should be difficult to raise taxes, and boosting the threshold brings the issue closer in line with the requirements of the state legislature, where two-thirds support among lawmakers is needed to increase taxes.
But those who oppose the effort have accused lawmakers of changing the rules of the game. They argue it’s a veiled attempt to make it harder to expand Medicaid after seeing the success of other statewide voter referendums.
Either way, the Medicaid expansion campaign says it’s readying a fight, while acknowledging the challenge of a higher threshold. Supporters are making the case that Medicaid expansion brings federal taxpayer dollars back to the state, while also focusing on telling stories of those who could gain coverage.
“We are in this campaign to bring Medicaid expansion and all of those benefits to South Dakota, and we’re not going to let this or anything else stand in our way,” said Zach Marcus, the campaign manager for South Dakotans Decide Healthcare.
Two weeks after a gunman opened fire at an elementary school in Uvalde, Tex., experts are raising alarm bells about limited mental health resources and insurance access in the area that could keep the community from receiving the care it needs, The Post’s Paulina Villegas reports.
Therapists flooded the town offering their services in the days following the mass shooting that left 19 students and two teachers dead, but many will leave in the next few weeks or months. Yet, mental health professionals say it will take years of sustained attention for the community to recover.
While there are some clinics that offer mental health services locally, experts say the town needs more psychiatrists specializing in children and adolescents. There is also a lack of inpatient treatment options.
Lack of insurance also compounds the issue. Nearly 1 in 4 residents in Uvalde County don’t have health coverage, according to the Census Bureau. Texas leads the country in both the number and percentage of uninsured residents, but the state has repeatedly resisted expanding Medicaid eligibility to cover more uninsured Texans.
Texas Gov. Greg Abbott (R) has pledged significant support to address the “magnitude” of mental health challenges facing Uvalde, but ramping up state resources could be difficult in Texas. The state currently ranks last in the nation on access to mental health care, according to a recent poll by the nonprofit Mental Health America.
More from Gov. Greg Abbott (R):
Texas is investing an initial $5M into establishing a long-term Family Resiliency Center in Uvalde County.
The center will help ensure every member of the Uvalde community has access to the critical mental health resources they need as they process & heal during this time. pic.twitter.com/blsBmeU7px
The White House yesterday sharply rebuked “extreme” legislation in Louisiana that would ban almost all abortions in the state and impose criminal penalties for physicians who perform the procedure. It includes no exceptions for rape or incest.
The bill, authored by state Sen. Katrina R. Jackson (D), won final passage in the state legislature on Sunday, and now sits on the desk of Gov. John Bel Edwards. The Democratic governor — who opposes abortion — is expected to sign the legislation, which would go into effect if the Supreme Court decides to overturn Roe v. Wade this summer.
President Biden is “committed to protecting the constitutional rights of Americans afforded by Roe for nearly 50 years,” press secretary Karine Jean-Pierre said in a statement. “An overwhelming majority of the American people agree and reject these kinds of radical measures.”
Vice President Kamala Harris:
If the Supreme Court overturns Roe, abortion could be banned in states across the country, putting women’s lives at risk.
Since day one, our position has been clear: We will defend women’s constitutional rights and fight to protect the right to self-determination.
The Centers for Disease Control and Prevention estimates the country wasted more than 82 million doses of coronavirus vaccines from December 2020 through mid-May, or just over 11 percent of the shots distributed by the federal government since the start of the pandemic, NBC News reports.
Key takeaways:
The millions of wasted doses include some that expired before they could be used, others that were spoiled when they couldn’t be kept under appropriate conditions and numerous that were tossed at the end of the day when there wasn’t a demand for the last few doses in an opened vial, NBC’s Joshua Eaton reports.
Covid update: Reported infections are up roughly 15 percent over the past week. But the virus is showing signs of abating in parts of the Northeast, where cases originally started ticking up again following the winter omicron surge.
The Supreme Court ruled 7-to-2 that state Medicaid agencies can seek reimbursements from funds won by beneficiaries in personal injury litigation allocated to cover the costs of future care, Reuters reports.
The federal Medicaid statute forbids local agencies from placing a lien on an accident victim’s property in most cases. But it requires programs to seek reimbursements from third-party settlements.
Dissenting Justice Sonia Sotomayor, joined by Justice Stephen G. Breyer, said the ruling could allow Medicaid programs to recover settlement funds for “future medical care for which Medicaid has not paid and might never pay.”
Caitlin Shortell, civil rights lawyer:
Medicaid recipients, who don’t have $ & usually get a lawyer on contingency, will have an even harder time getting representation. This allows a state to take from an award for future meds. I used to do this work for the AG. Cases settle at discount by no fault of counsel. https://t.co/pTTwijvZx0
AARP’s Billion-Dollar Bounty (By Fred Schulte | Kaiser Health News)
A Mental Health Clinic in School? No, Thanks, Says the School Board (By Ellen Barry | The New York Times)
A mother’s desperate bid to save her anguished teen ends in gunfire (By Justin Jouvenal | The Washington Post)
Today’s second @washingtonpost TikTok features Novavax https://t.co/3O4rBfWU0t pic.twitter.com/pIygi1FD3S
Thanks for reading! See y’all tomorrow.
