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  • Senate confirms Biden’s IRS nominee Daniel Werfel | CNN Politics

    Senate confirms Biden’s IRS nominee Daniel Werfel | CNN Politics

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    CNN
     — 

    The Senate voted Thursday to confirm Daniel Werfel, the former acting commissioner of the Internal Revenue Service, to lead the IRS.

    He was approved on a bipartisan 54-42 vote.

    Werfel’s confirmation to the agency comes after he was grilled by the Senate Committee on Finance last month on how he plans to utilize the money in new funding coming to the IRS over the next decade to revitalize the tax agency as taxpayers could see increased audit rates. Democrats approved the $80 billion for the agency last year when they approved the Inflation Reduction Act in a party-line vote. Democrats backed the funding in its bid to crack down on tax dodgers and to provide better services for taxpayers, arguing that the IRS could boost federal revenue by more than $100 billion over the 10-year time period if they collect more in taxes.

    But Republicans have made the IRS and the new funding a political target, claiming that the money will create additional audits for taxpayers.

    After Republicans took control of the House earlier this year, two of the party’s first legislative votes were aimed at the IRS. One bill called for rescinding roughly all the new funding for the agency and others called for abolishing the IRS altogether. However, it is highly unlikely that either bill will become law because Democrats still control the Senate.

    Werfel said last month he would follow through on Treasury Secretary Janet Yellen’s previous directive that the IRS will not use the new funding to increase audit rates, relative to historic levels, for households making less than $400,000 a year.

    “If I am fortunate enough to be confirmed, the audit and compliance priorities will be focused on enhancing the IRS’ capabilities to ensure that America’s highest earners comply with applicable tax laws,” Werfel said at the February hearing.

    “If poor people are more likely to be audited than the wealthy, that is something I think potentially degrades public trust and needs to be addressed within the tax system,” he added.

    But ranking Republican committee member, Republican Sen. Mike Crapo of Idaho, said at the time he remains “very concerned” about how twhe funds will be used to increase tax enforcement, pointing out that Yellen’s directive “leaves a lot of wiggle room.”

    “I don’t expect to see wiggle room in this commitment,” Crapo told Werfel.

    The Inflation Reduction Act states that the new investment going to IRS is not “intended to increase taxes on any taxpayer or small business with a taxable income below $400,000.” However, there is some uncertainty about how the IRS will decide how it will ramp up audits.

    Moderate Democratic Sen. Joe Manchin of West Virginia voted against Werfel’s nomination. He has also opposed several of President Joe Biden’s other recent nominees.

    Manchin said his vote against Werfel had to do with the Biden administration ignoring the “congressional intent” in implementing the Inflation Reduction Act.

    “As far as the gentleman for the IRS, most qualified, he’ll do a good job. That was a message I’m sending because the president and his administration is not adhering to the piece of legislation called the Inflation Reduction Act,” Manchin said on “CNN This Morning” Thursday ahead of the vote, explaining his reasoning for voting against Werfel. “They have touted that as strictly an environmental bill.”

    Werfel was the acting IRS commissioner for seven months in 2013 during a difficult time for the agency. His predecessor had resigned following revelations that the agency targeted conservative groups seeking tax-exempt status for extra scrutiny.

    Before his stint at the IRS, Werfel worked for nearly 16 years at the White House’s Office of Management and Budget, where he served as deputy controller and later federal controller.

    After he left government, Werfel joined Boston Consulting Group, where he is currently a managing director and partner on the federal and public sector teams.

    This story has been updated with additional developments.

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  • How an old debate previews Biden’s new strategy for winning senior voters | CNN Politics

    How an old debate previews Biden’s new strategy for winning senior voters | CNN Politics

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    CNN
     — 

    In pressing Republicans on Social Security and Medicare, President Joe Biden is reprising one of the most dramatic moments of his long career.

    During the 2012 vice-presidential debate, Biden engaged in a nearly 11-minute exchange with GOP nominee Paul Ryan over Republican plans to reconfigure the two massive programs for the elderly, several of which Ryan had authored himself.

    Biden and many Democrats felt he had won the argument on stage. Yet on Election Day, Ryan and GOP presidential nominee Mitt Romney routed Biden and President Barack Obama among White seniors, and beat them soundly among seniors overall, exit polls found.

    That outcome underscores the obstacles facing Biden now as he tries to recapture older voters by portraying Republicans as threats to the two towers of America’s safety net for the elderly. While polls consistently show that voters trust Democrats more than Republicans to safeguard the programs, GOP presidential nominees have carried all seniors in every presidential election back to 2004 and have reached at least 58% support among White seniors in each of the past four contests, exit polls have found. Democrats have likewise consistently struggled among those nearing retirement, older working adults aged 45-64.

    Those results suggest that for most older voters, affinity for the GOP messages on other issues – particularly its resistance, in the Donald Trump era, to cultural and racial change – has outweighed their views about Social Security and Medicare. Those grooves are now cut so deeply, over so many elections, that Biden may struggle to change them much no matter how hard he rails against a range of GOP proposals that could retrench or restructure the programs.

    Biden’s charge that Republicans are threatening the two giant entitlement programs for the elderly – which triggered his striking back and forth exchanges with GOP legislators during the State of the Union – fits squarely in his broader political positioning as he turns toward his expected reelection campaign.

    As I’ve written, the 80-year-old Biden, at his core, “remains something like a pre-1970s Democrat, who is most comfortable with a party focused less on cultural crusades than on delivering kitchen-table benefits to people who work with their hands.” As president he’s expressed that inclination primarily through what he calls his “blue-collar blueprint to rebuild America” – the planks in his economic plans, such as generous incentives to revive domestic manufacturing, aimed at creating more opportunity for workers without a college degree. Politically, Biden’s staunch defense of Social Security and Medicare, programs critical to the economic security of financially vulnerable retirees, represents a logical bookend to that emphasis.

    “We all know that whose side you are on is a critical debate point for every election and this debate over Social Security and Medicare really helps crystallize whose side Biden is on versus whose side Republicans are on in a very effective way for him,” said Democratic pollster Matt Hogan, who helped conduct an extensive series of bipartisan polls during the 2022 campaign measuring attitudes among seniors for the AARP, the giant lobby for the elderly.

    From Franklin Roosevelt through Hubert Humphrey and Tip O’Neill, generations of Democrats have framed themselves as the defenders of the social safety net for seniors against Republicans who they say would unravel it. Biden showed how comfortable he was stepping into those shoes during his 2012 vice-presidential debate with Ryan, then a young representative from Wisconsin who Romney had selected as his running mate.

    Nearly 30 years Biden’s junior, Ryan was an unflinching advocate of restructuring Social Security and Medicare to reduce costs over time. In particular, Ryan was the principal supporter of a conservative plan to convert Medicare, the giant federal health insurance program for the elderly, into a system called “premium support.” Under that proposal, Medicare would be transformed from its current structure, in which the government directly pays doctors and hospitals who provide care for beneficiaries, into a voucher (or “premium support”) system, in which the government would provide recipients a fixed sum to purchase private insurance. Ryan had also drafted proposals to partially privatize Social Security by allowing workers to divert part of their payroll taxes into private investment accounts, a change that would have reduced the tax dollars flowing into the system and eventually required substantial cuts in guaranteed benefits.

    For nearly 11 minutes during the debate in October 2012, moderator Martha Raddatz of ABC skillfully guided Biden and Ryan through a heated, but civil and substantive, discussion of Social Security and Medicare’s future. Ryan insisted that changes were needed to preserve the programs’ long-term viability and that current seniors and those near retirement would not see their benefits reduced.

    Biden appealed openly to the Democrats’ historic image as the programs’ protectors and condemned Ryan and the GOP for wanting to partially privatize them. At one point in the debate, Biden declared: “we will be no part of a [Medicare] voucher program or the privatization of Social Security.” A few moments later, he insisted: “These guys haven’t been big on Medicare from the beginning. And they’ve always been about Social Security as little as you can do. Look, folks, use your common sense. Who do you trust on this?”

    At the time, Democrats felt Biden had at least held his own, restoring the party’s momentum after Obama’s surprisingly listless performance eight days earlier in his first debate against Romney. And Democrats through the rest of the campaign railed against the Republican ticket as a threat to Social Security and Medicare.

    But on election day, those arguments did not translate into gains for Obama and Biden among seniors or the older working adults (aged 45-64) nearing retirement. As Hogan noted, the newly passed Affordable Care Act, which generated some of its funding through savings in Medicare, was extremely unpopular at the time among older voters. Obama and Biden not only lost seniors and the older working age adults, but actually ran slightly more poorly among both groups in 2012 than they did in 2008.

    In fact, no Democratic presidential nominee since Al Gore in 2000 has carried most seniors in a presidential campaign; Obama in 2008 was the only one since Gore to carry most of the older working age adults. Among older Whites, the Democratic deficit is even more pronounced: the Republican presidential nominee has carried around three-fifths of both White seniors and those nearing retirement in each of the past four elections. Biden in 2020 slightly improved on Hillary Clinton’s anemic 2016 performance with both groups, but still lost to Trump by 15 percentage points among White seniors and by 23 points among the Whites nearing retirement, according to the exit polls conducted by Edison Research for a consortium of media organizations including CNN. Biden performed especially poorly among older Whites without a college degree – an economically stressed group heavily reliant on the federal retirement programs.

    Estimates by Catalist, a Democratic targeting firm, and the Pew Research Center likewise found that Trump in both 2016 and 2020 beat his Democratic opponents among both seniors and the older working adults. Like the exit polls, the Catalist data show the Republican nominees carrying about three-fifths of White seniors and older working adults in each of the past three presidential elections.

    The story is similar in congressional contests. In House elections, the exit polls found Republicans winning all seniors and older working adults comfortably in the 2014 and 2022 midterm campaigns and narrowly carrying them even in 2018 when Democrats romped overall. In all three of those midterm congressional elections, Republicans carried about three-fifths of the near retirement White adults, while they also reached that elevated threshold among White seniors in both the 2014 and 2022 campaigns.

    Republicans have maintained these advantages with older voters despite polls showing that most Americans trust Democrats more than the GOP to protect Social Security and Medicare, and that most Americans, especially seniors, oppose the intermittently surfacing GOP proposals to partially privatize both programs.

    Politically, “Democrats have used Social Security and Medicare really a lot over the past two or three decades, maybe four decades,” said Jim Kessler, executive vice president for policy at Third Way, a centrist Democratic group. “The payoff has been a lot less than Democrats have generally thought it would be.”

    Could this time be different for Biden and the Democrats? Congressional Republicans have certainly provided plenty of evidence for his claim that they still hope to restructure the programs. The proposed 2023 budget by the Republican Study Committee, the members of which include about three-fourths of House Republicans, reprises the ideas of converting Medicare into a premium support system and establishing private investment accounts under Social Security, while also raising the retirement age for both programs and reducing Social Security benefits over time. And although Florida Sen. Rick Scott renounced the idea late last week, his “Rescue America” agenda did include a proposal to require Congress to reauthorize all federal programs, including Social Security and Medicare, every five years.

    These ideas have precipitated an unusual degree of open Republican dissension. Senate GOP Leader Mitch McConnell repeatedly, and unreservedly, denounced the Scott plan until the Florida senator backed off. Trump recently released a video in which he declared the GOP should not cut “a single penny” of Social Security or Medicare benefits – which put him directly at odds with the three-fourths of House Republicans in the Republican Study Committee. House Speaker Kevin McCarthy, bending more toward Trump’s position, seems unlikely to incorporate into the GOP budget plans the RSC’s most sweeping changes in Social Security and Medicare.

    Kessler believes Biden may succeed where other Democrats have failed at hurting the GOP with the issue, and he argued that the conspicuous Republican infighting demonstrates they share that concern. “We are watching a high-profile battle that I’ve never really seen before on these issues in the Republican Party,” Kessler said. “And part of it is clearly they think it’s a problem when they didn’t years ago. If they think it’s a problem, maybe it’s a problem.”

    Stuart Stevens, who served as Romney’s chief strategist in the 2012 campaign but has since become a fierce critic of the Trump-era GOP, also believes the party could face more risk over its entitlement agenda than it did back then. The reason is that he thinks the idea of sunsetting Social Security and Medicare every five years, even if Scott is trying to jettison it, may prove more immediately tangible and understandable to voters than Ryan’s complex ideas of partially privatizing both programs.

    “The question I always ask myself in campaigns is ‘are you talking about something the other side doesn’t want to talk about?’” Stevens said. “That’s probably a good sign that they are losing on the issue.”

    Whether Biden proves more effective than other recent Democrats at attracting older voters around Social Security and Medicare will likely pivot on whether seniors believe the GOP genuinely would cut the programs if given the power to do so, argued Robert Blendon, a professor emeritus at the Harvard School of Public Health, who specializes in public attitudes about the social safety net. “If the senior community actually believes that it’s being threatened it really would affect their votes,” he predicted. But, he added, “as long as they are not threatened, the other values of seniors on top issues more and more correspond with Republicans.”

    There’s no doubt about the second half of that equation. Polling has consistently found that older Whites, in particular, are more receptive than their younger counterparts to hardline Trump-era GOP messages around crime, immigration and the broader currents of racial and cultural change: for instance, about half of Whites older than 50 agree that discrimination against Whites is now as big a problem as bias against minorities, a far higher percentage than among younger Whites, according to a new national survey by the Public Religion Research Institute. Older Whites are also more likely than younger generations to lack a college degree or to identify as Christians, attributes that generally predict sympathy for GOP cultural and racial arguments.

    Through the 21st century, those cultural and racial attitudes among older White voters have consistently trumped any concerns they may hold about the Republican commitment to Social Security and Medicare. Despite Biden’s impassioned articulation of the case against the GOP, that didn’t change even in 2012 when Republicans placed on their national ticket a vice presidential nominee who directly embodied the GOP aspirations to reconfigure and retrench those programs.

    Even small changes in seniors’ preferences could have a big impact in closely balanced states with a large retiree population like Arizona and Pennsylvania. But the entrenched GOP advantage among older voters over the past two decades suggests Biden’s hopes in 2024 may pivot less on improving with the “gray” than maximizing his vote among the “brown”: the diverse, younger generations that recoil from the same Republican messages on culture and race that electrify so many older Whites.

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  • Millions of children are at risk of losing Medicaid coverage starting in April | CNN Politics

    Millions of children are at risk of losing Medicaid coverage starting in April | CNN Politics

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    CNN
     — 

    The majority of American children now receive their health insurance through Medicaid and the Children’s Health Insurance Program, according to a new report published Wednesday by the Georgetown Center for Children and Families.

    But that could change starting this spring. As many as 6.7 million children are at risk of losing that coverage once states restart their reviews of recipients’ eligibility, according to Georgetown.

    Medicaid enrollment ballooned during the pandemic thanks to an early Covid-19 pandemic relief provision passed by Congress that barred states from involuntarily disenrolling beneficiaries in exchange for higher federal matching funds. But lawmakers voted late last year to end that continuous enrollment provision on April 1, freeing states to start winnowing ineligible recipients.

    More than 42 million children were covered by Medicaid and CHIP as of August, up 17.5% from February 2020, just before the pandemic started.

    Ten states plus the District of Columbia have more than 60% of their children insured through the public programs, according to Georgetown. New Mexico leads the nation with more than three-quarters of its kids covered by Medicaid and CHIP.

    By contrast, fewer than a quarter of children in Utah are enrolled in the programs.

    The number of children who gained Medicaid and CHIP coverage during the pandemic varied by state. Indiana had the largest surge, with a nearly 45% increase. Wyoming, North Dakota, Missouri and Georgia saw their child enrollment grow by roughly a third.

    On the flip side, Vermont experienced less than an 8% growth in child enrollment in Medicaid and CHIP.

    More than 83 million people, including more than 34 million children, were covered by Medicaid as of August. And another 4 million children were enrolled in Medicaid financed by CHIP. All will have their eligibility reviewed, and in some cases, the children will continue to qualify even if their parents do not.

    “If they’re getting the message that they’re losing their own coverage, a lot of times a parent understandably thinks that their child is also losing coverage,” said Joan Alker, executive director of the Georgetown Center for Children and Families.

    A total of roughly 15 million people could be dropped from Medicaid when the continuous enrollment requirement ends, according to an analysis the Department of Health and Human Services released in August. About 8.2 million folks would no longer qualify, but 6.8 million people would be terminated even though they are still eligible, the department estimated.

    When states reevaluate families’ eligibility, they need to look separately at adults and children, Alker said. Officials should work with pediatricians, schools, child care centers and others to explain the situation to parents and make sure the children retain coverage if they continue to qualify.

    Nearly three-quarters of the children projected to be dropped will remain eligible for Medicaid but will likely lose coverage because of administrative issues, such as their parents not submitting the necessary paperwork or procedural errors, according to Georgetown.

    Although states have 14 months to complete the unwinding process, some will look to do so more quickly.

    “My concern is that a large number of children could become uninsured in states that do not take their time and pay particular attention to the unique needs of children,” Alker said.

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  • Republican senator warns Congress must take action now to protect Medicare and Social Security | CNN Politics

    Republican senator warns Congress must take action now to protect Medicare and Social Security | CNN Politics

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    CNN
     — 

    Republican Sen. Mike Rounds of South Dakota offered Sunday a stark warning about the future of Social Security and Medicare if Congress fails to take action now.

    “In the next 11 years, we have to have a better plan in place than what we do today. Or we’re going to see – under existing circumstances – some reductions of as much as 24% in some sort of a benefit. So, let’s start talking now because it’s easier to fix it now that it would be five years or six years from now,” Rounds told CNN’s Jake Tapper on “State of the Union.”

    In recent days, President Joe Biden has made a forceful argument against Republicans by highlighting his support for Social Security and Medicare. The president has specifically seized on a proposal from GOP Sen. Rick Scott of Florida to sunset federal legislation – including Social Security and Medicare – every five years and require Congress to pass them again.

    Referencing his “spirited debate” with Republicans at the State of the Union, Biden called Scott’s proposal “outrageous” and vowed he would veto such a plan during a speech in Florida last week.

    “The very idea the senator from Florida wants to put Social Security and Medicare on the chopping block every five years I find to be somewhat outrageous. So outrageous that you might not even believe it,” he said, pulling out a pamphlet detailing Scott’s plan.

    Scott told CNN’s Kaitlan Collins last week that his proposal is intended to eliminate wasteful spending and help ensure the government can “figure out how to start living within our means.”

    “I want to make sure we balance our budget and preserve Medicare and Social Security, and I’ve been clear all along,” he said.

    Rounds also stressed Sunday that Republicans want to better manage Medicare and Social Security in order to improve the programs – not strip them from the American people.

    “We think that there are possibilities out there of long-term success without scaring people and without tearing apart the system and without reducing benefits. But it requires management. And it requires actually looking at and making things better,” he said.

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  • Fact check: Breaking down Biden’s exchanges with Republican senators over Social Security and Medicare | CNN Politics

    Fact check: Breaking down Biden’s exchanges with Republican senators over Social Security and Medicare | CNN Politics

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    Washington
    CNN
     — 

    President Joe Biden has gone on the attack over Social Security and Medicare.

    In speeches and tweets this week, Biden and his White House have singled out particular Republican senators – notably including Sen. Mike Lee of Utah, Sen. Rick Scott of Florida and Sen. Ron Johnson of Wisconsin – over proposals from those senators that could affect the retirement and health care programs.

    The Republican senators have responded forcefully, accusing Biden of deceiving the public about where they stand. Here is a fact-check of the exchanges.

    Biden and his White House targeted Lee on Wednesday over a video clip of Lee saying, “I’m here right now to tell you one thing that you probably have never heard from a politician. It will be my objective to phase out Social Security, to pull it up by the roots and get rid of it.” The clip has gone viral on Twitter this week; a second viral clip features Lee saying moments later, “Medicare and Medicaid are of the same sort and need to be pulled up.”

    The videos are authentic, though Biden didn’t tell his Wednesday speech audience in Wisconsin they are from more than 12 years ago – an event in 2010, when Lee was running for the Senate but before he was first elected. And as Lee noted in Wednesday tweets responding to Biden, Biden didn’t mention that Lee added at the same 2010 event that current Medicare beneficiaries should have their benefits “left untouched” and that “the next layer beneath them, those who will retire in the next few years, also probably have to be held harmless.”

    Still, while Biden could have included more context, he was accurate in saying Lee had called for Social Security to be phased out.

    And while Lee said in a tweeted statement on Wednesday that, during his 12 years as a senator, he has not called for “abolishing” Social Security, Medicare or Medicaid benefits, only for “solutions to improve those programs and move them toward solvency,” he has supported benefit cuts. For example, he has endorsed various proposals over the years to raise the Social Security retirement age.

    Since last year, Biden has criticized Scott over particular components of what Scott calls his “12 Point Plan to Rescue America.”

    In the State of the Union address on Tuesday and in speeches on Wednesday and Thursday, the president referred to a part of Scott’s plan that says, “All federal legislation sunsets in 5 years. If a law is worth keeping, Congress can pass it again.” Biden correctly asserted that “all federal legislation” would include Social Security and Medicare, which do not currently require congressional re-approval.

    Scott responded by accusing Biden of being dishonest and confused. Scott argued on Twitter on Wednesday that while his plan does say that “all” federal legislation should sunset in five years and become subject to a new vote by Congress, “This is clearly & obviously an idea aimed at dealing with ALL the crazy new laws our Congress has been passing of late.”

    But the plan itself doesn’t say that.

    The plan’s official text, which remains online on a dedicated website, says “all federal legislation,” period, should be sunset in five years – not all recent legislation, all crazy legislation or all legislation except for the laws that created Social Security and Medicare. When Senate Minority Leader Mitch McConnell rejected Scott’s plan last year, McConnell too said that the plan “sunsets Social Security and Medicare within five years.”

    Last year, Biden sometimes overstated the support for Scott’s sunset proposal among congressional Republicans, which appears very limited. Biden has been more precise in his speeches this week, attributing the proposal to Scott himself or accurately saying in the State of the Union that “some” Republicans – “I’m not saying it’s a majority” – support it.

    Biden may have created an inaccurate impression, however, by mentioning the sunset proposal during the section of the State of the Union in which he discussed the battle over the debt ceiling. There is no indication that House Republicans are pushing this proposal as part of the current debt ceiling negotiations with the Biden administration, and House Speaker Kevin McCarthy has, more generally, said cuts to Social Security and Medicare are “off the table” in these negotiations.

    Scott, in turn, has tossed a false claim into the debate with Biden this week by repeatedly accusing the president of having cut billions from Medicare in last year’s Inflation Reduction Act. The Inflation Reduction Act did not cut Medicare benefits; rather, it allowed the government and seniors to spend less money to buy prescription drugs – and, in fact, simultaneously made Medicare benefits more generous to seniors. The claim of a Medicare cut was repeatedly debunked last year, when Scott and a Republican campaign organization he chaired used it during the midterm elections.

    On Friday afternoon, the day after McConnell told a Kentucky radio station that Scott’s proposal will be a “challenge” for Scott’s own 2024 re-election campaign in a state with a large population of seniors, Scott announced he is introducing a new bill that would make it more difficult for Congress to make any cuts to Social Security and Medicare and that would send the Inflation Reduction Act’s $80 billion in Internal Revenue Service funding to Social Security and Medicare instead.

    This week and in numerous previous speeches, Biden has castigated Johnson for saying last year that Medicare and Social Security should be treated as discretionary spending, which Congress has to approve every year, rather than as permanent entitlements.

    Biden has accurately cited Johnson’s remarks this week. Here’s what Johnson told a Green Bay radio show in August: “We’ve got to turn everything into discretionary spending, so it’s all evaluated, so that we can fix problems or fix programs that are broken, that are going to be going bankrupt. Because, again, as long as things are on automatic pilot, we just continue to pile up debt.” When Johnson faced criticism for those remarks at the time, he stood by them and said that was his consistent longtime position.

    Johnson, however, claimed Wednesday that Biden was “lying” when the president discussed Johnson’s comments shortly after saying that some Republicans want to “cut” Social Security. Johnson has repeatedly said that his proposal to require annual approval for Social Security spending, and to “fix” and “save” Social Security in light of its poor fiscal shape at present, does not mean that he wants to put the programs on the “chopping block” or even to “cut” it.

    “The Democrats have been accusing me, since the first time I ran for office, of wanting to end Social Security, wanting to cut it, wanting to gut it, wanting to – I’ve never said that. I’ve always been consistent: I want to save it,” he said in a radio interview this week.

    It’s impossible to definitively fact-check this particular dispute without Johnson specifying how he wants to “fix” and “save” the program. His office did not respond to a CNN request for comment.

    White House deputy press secretary Andrew Bates noted in an email to reporters on Thursday that, though Johnson accused Biden this week of lying about his stance on Social Security, Johnson also said in interviews this week that Social Security is a “legal Ponzi scheme” and that “Social Security might be in a more stable position for younger workers” if the government had proceeded with Republican President George W. Bush’s controversial and eventually abandoned proposal in the mid-2000s to allow workers born after 1949 to divert a portion of their Social Security payroll taxes into private accounts in which they could buy into the stock market and make other investments.

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  • Rick Scott: From embattled health care executive to Biden’s top foil | CNN Politics

    Rick Scott: From embattled health care executive to Biden’s top foil | CNN Politics

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    CNN
     — 

    Florida Sen. Rick Scott has emerged as Joe Biden’s top Republican foil in the days since the president’s State of the Union address, with the White House seizing on a year-old Scott proposal that even GOP leaders recognized at the time as politically toxic.

    As a spending fight looms in Washington and Biden moves toward his 2024 reelection bid, the White House is attempting to make Scott the poster child for the president’s accusations that Republicans are seeking to cut entitlement programs, including Social Security and Medicare.

    Scott has responded by accusing Biden of lying, airing a misleading ad that alleges Biden cut Medicare and lambasting the president in a barrage of television interviews.

    Biden traveled Thursday to Florida – where Scott was a health care executive and two-term governor – on the latest leg of his post-State of the Union tour.

    The trip was designed in part to stoke a fight with Scott after Biden in his speech Tuesday night seized on the first-term senator’s proposal to sunset all federal programs – including Social Security and Medicare – every five years unless Congress extends those programs.

    Biden’s assertion that some Republicans are seeking to change entitlement programs was met with jeers from Republican lawmakers, who have said spending cuts should be part of any proposal to raise the debt ceiling.

    The president continued pressing that message Wednesday in Wisconsin, telling union workers, “A lot of Republicans, their dream is to cut Social Security and Medicare.” He waved a pamphlet with Scott’s proposal as he spoke.

    Ahead of Biden’s speech Thursday in Tampa, White House aides placed copies of Scott’s proposal on every seat.

    In an interview with CNN’s Kaitlan Collins on Thursday, Scott said Biden has misrepresented the proposal he put forward ahead of the 2022 midterm elections while serving as head of the National Republican Senatorial Committee, the campaign arm of the Senate GOP.

    “Nobody believes that I want to cut Medicare or Social Security. I’ve never said it,” Scott said.

    Scott said his proposal is intended to eliminate wasteful spending and help ensure the government can “figure out how to start living within our means.”

    “I want to make sure we balance our budget and preserve Medicare and Social Security, and I’ve been clear all along. So what I want to do is get rid of wasteful programs that we never review up here,” he said.

    But Scott’s proposal would sunset all federal legislation – including the two entitlement programs – every five years and require Congress to pass them again.

    Long before he was a US senator, Scott had first-hand experience dealing with America’s federal health care programs – and it became the source of much criticism as he entered the political arena.

    In the 1980s, Scott founded Columbia Hospital Corporation by purchasing a pair of distressed Texas hospitals. He later merged his company with Hospital Corporation of America to create Columbia/HCA, becoming the largest for-profit hospital chain at the time and gaining notoriety on Wall Street for what appeared like cost-cutting in an industry with ballooning expenses.

    In 1997, federal agents unveiled a sweeping investigation into Columbia/HCA that would roil the company for years. On the day the FBI swooped in to seize records from 35 of its hospitals across six states, Scott shrugged off the probe. “It’s not a fun day, but … government investigations are a matter of fact today in health care,” he said on CNN.

    The investigation would unearth what the US Department of Justice later called the “largest health care fraud case in U.S. history.” According to a press release, Columbia/HCA schemed to defraud Medicare, Medicaid and TRICARE, the military’s health care program, of hundreds of millions of dollars. The company pleaded guilty to criminal conduct, including charges related to fraudulent Medicare billing and paying kickbacks to doctors, and it ultimately agreed to pay $1.7 billion in fines, damages and penalties.

    Scott was pushed out as CEO amid the turmoil. He was never charged with a crime, though much of the alleged financial abuses took place during his watch. His time in the corporate world made Scott a wealthy individual, which he would lean on in 2010 when he decided to kickstart a political career by entering the race for Florida governor.

    Scott’s time at the helm of Columbia/HCA was the subject of negative ads from both Republicans and Democrats, but he fended them off with a self-funded campaign that flooded the airwaves with a jobs-focused message. He told the St. Petersburg Times that “mistakes were made” at his former company and that he had “learned hard lessons,” but he also said during a debate that he was “proud of the company I built.” Regardless of the controversy, the little-known Scott defeated a GOP favorite for his party’s nomination, and Floridians narrowly elected him governor that fall.

    During his eight years leading Florida, Scott fought off attempts to extend safety net benefits to Floridians. He frequently challenged the Obama administration over the Affordable Care Act and blocked expansion of Medicaid in Florida. In his first year as governor, he signed a bill to cut unemployment payments and tied benefits to the state’s unemployment rate.

    Democrats continued to make Scott’s time at Columbia/HCA an issue, to no avail. Scott eked out a reelection victory in 2014. He then narrowly unseated longtime Democratic Sen. Bill Nelson in 2018 after spending more than $70 million of his own money on his campaign.

    Marching to the beat of his own drum, Scott declined to be sworn in with his class in January 2019. Instead, he waited until his term as governor had ended and flew to Washington for a separate ceremony. For a time, it made him the country’s most junior senator, but he nevertheless soon found himself in party leadership.

    Scott and other Republicans are aggressively pushing back against Biden’s assertions that the GOP is seeking to cut spending on entitlement programs.

    However, Republican leaders have long recognized Scott’s proposal to sunset all federal programs after five years as rocky political terrain.

    The tense relationship between Scott and Senate Minority Leader Mitch McConnell burst into public view during the 2022 election cycle as Republicans sought to retake the Senate.

    Scott, as NRSC chairman, released a platform called “Rescue America,” which would have subjected all federally elected officials to a term limit of 12 years and closed the Department of Education, amid a slew of other initiatives. It would also have required millions of low-income and middle-class Americans to pay income taxes, which was later dropped in a revised version of the plan.

    And, in what Democrats immediately recognized as an opening to accuse Republicans of attempting to undercut popular programs, Scott’s plan proposed sunsetting all federal legislation in five years – unless Congress extended it.

    McConnell quickly disavowed Scott’s plan, seeking to make clear that the Florida senator did not speak for Senate Republicans.

    “Let me tell you what would not be a part of our agenda,” McConnell said at a news conference last March. “We will not have as part of our agenda a bill that raises taxes on half the American people, and sunsets Social Security and Medicare within five years.”

    Their frosty relationship did not improve as the 2022 election cycle continued, as the two battled over which candidates to support in primaries and in the general election, and Republicans ultimately fell short of winning a majority.

    After the election, Scott challenged McConnell for the top Senate Republican post but lost.

    The Florida senator said last week that he saw McConnell’s decision to remove him from the Senate Commerce Committee as retribution.

    “He didn’t like that I opposed him because I believe we have to have ideas – fight over ideas,” Scott said on “CNN This Morning.”

    When pressed Thursday by CNN’s Collins about why his proposal left open the opportunity for the government to cut funding for Social Security and Medicare, Scott repeatedly referenced a policy proposal from then-Sen. Biden in 1975 to sunset federal legislation periodically.

    Scott said Biden’s old proposal does less to protect entitlements for seniors than the senator’s plan from last year because “he proposed it year after year after year to reduce Medicare and Social Security. Year after year. I’ve never done that. I don’t believe in that.”

    Asked Thursday about the 1975 proposal mentioned by Scott, White House press secretary Karine Jean-Pierre said, “A bill from the 1970s is not part of the president’s agenda.”

    “The president ran on protecting Medicare and Social Security from cuts. And he reiterated that in the State of the Union,” she said.

    A new ad from Scott released this week in advance of the president’s visit to Florida says that “Joe Biden just cut $280 billion from Medicare” – a claim that was previously debunked when Scott and the NRSC made it in 2022.

    Biden’s Inflation Reduction Act is expected to reduce Medicare prescription drug spending by the federal government by $237 billion, according to the most recent Congressional Budget Office estimate, because the law allows the government to spend less money to buy drugs from pharmaceutical companies and not because it cuts benefits to seniors enrolled in Medicare. The law makes Medicare’s prescription drug program substantially more generous to seniors while also saving them money.

    Scott, in his interview with Collins, also defended his recent call for Biden to resign, labeling him “a complete failure.” He said his resignation calls did not specifically stem from Biden’s use of his proposal as an avenue to attack Republicans but expressed his displeasure with the president’s repeated references to his plan.

    “He lies about what I want to get done, and I don’t appreciate it,” Scott said.

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  • Biden intends to end Covid-19 and public health emergencies on May 11 | CNN Politics

    Biden intends to end Covid-19 and public health emergencies on May 11 | CNN Politics

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    CNN
     — 

    President Joe Biden intends to end the Covid-19 national and public health emergencies on May 11, the White House said Monday.

    The White House, in a statement of administration policy announcing opposition to two Republican measures to end the emergencies, said the national emergency and public health emergency authorities declared in response to the pandemic would each be extended one final time to May 11.

    “This wind down would align with the Administration’s previous commitments to give at least 60 days’ notice prior to termination of the (public health emergency),” the statement said.

    The statement added, “To be clear, continuation of these emergency declarations until May 11 does not impose any restriction at all on individual conduct with regard to COVID-19. They do not impose mask mandates or vaccine mandates. They do not restrict school or business operations. They do not require the use of any medicines or tests in response to cases of COVID-19.”

    The statement came in response to a pair of measures before the House that would end the public health emergency and the Covid-19 national emergency.

    The White House weighed in because House Democrats were concerned about voting against the Republican legislation to end the public health emergency that is coming to the floor this week without a plan from the Biden administration, a senior Democratic aide told CNN.

    “Democrats were concerned about the optics of voting against Republicans winding down the public health emergency, absent an understanding of whether and how we intended to do so from the White House,” the aide said. “As soon as we saw this bill, it obviously concerns the White House. So, it was important for them to weigh in.”

    The administration argues that the bills are unnecessary because it intends to end the emergencies anyway. The White House also noted the passage of the measures ahead of May 11 would have unintended consequences, such as disrupting the administration’s plans for ending certain policies that are authorized by the emergencies.

    The White House said it would extend the Covid-19 emergencies one final time in order to ensure an orderly wind-down of key authorities that states, health care providers and patients have relied on throughout the pandemic.

    A White House official pointed to a successful vaccination campaign and reductions in Covid cases, hospitalizations and deaths as a rationale for lifting the emergency declarations. The official said a final extension will allow for a smooth transition for health care providers and patients and noted that health care facilities have already begun preparing for that transition.

    The administration is actively reviewing flexible policies that were authorized under the public health emergency to determine which can remain in place after it is lifted on May 11.

    The aide told CNN that it will be up to every member to decide what is best for their district and how they will vote on the legislation this week. Declaring an end to the public health emergency will also end the border restriction known as Title 42, which will also likely set up a showdown on Capitol Hill.

    The public health emergency has enabled the government to provide many Americans with Covid-19 tests, treatments and vaccines at no charge, as well as offer enhanced social safety net benefits, to help the nation cope with the pandemic and minimize its impact.

    “People will have to start paying some money for things they didn’t have to pay for during the emergency,” said Jen Kates, senior vice president at the Kaiser Family Foundation. “That’s the main thing people will start to notice.”

    Most Americans covered by Medicare, Medicaid and private insurance plans have been able to obtain Covid-19 tests and vaccines at no cost during the pandemic. Those covered by Medicare and private insurance have been able to get up to eight at-home tests per month from retailers at no charge. Medicaid also picks up the cost of at-home tests, though coverage can vary by state.

    Those covered by Medicare and Medicaid have also had certain therapeutic treatments, such as monoclonal antibodies, fully covered.

    Once the emergency ends, Medicare beneficiaries generally will face out-of-pocket costs for at-home testing and all treatment. However, vaccines will continue to be covered at no cost, as will testing ordered by a health care provider.

    State Medicaid programs will have to continue covering Covid-19 tests ordered by a physician and vaccines at no charge. But enrollees may face out-of-pocket costs for treatments.

    Those with private insurance could face charges for lab tests, even if they are ordered by a provider. Vaccinations will continue to be free for those with private insurance who go to in-network providers, but going to an out-of-network providers could incur charges.

    Covid-19 vaccinations will be free for those with insurance even when the public health emergency ends because of various federal laws, including the Affordable Care Act and pandemic-era measures, the Inflation Reduction Act and a 2020 relief package.

    Americans with private insurance have not been charged for monoclonal antibody treatment since they were prepaid by the federal government, though patients may be charged for the office visit or administration of the treatment. But that is not tied to the public health emergency, and the free treatments will be available until the federal supply is exhausted. The government has already run out of some of the treatments so those with private insurance may already be picking up some of the cost.

    The uninsured had been able to access no-cost testing, treatments and vaccines through a different pandemic relief program. However, the federal funding ran out in the spring of 2022, making it more difficult for those without coverage to obtain free services.

    The federal government has been preparing to shift Covid-19 care to the commercial market since last year, in part because Congress has not authorized additional funding to purchase additional vaccines, treatments and tests.

    Pfizer and Moderna have already announced that the commercial prices of their Covid-19 vaccines will likely be between $82 and $130 per dose – about three to four times what the federal government has paid, according to Kaiser.

    The public health emergency has also meant additional funds for hospitals, which have been receiving a 20% increase in Medicare’s payment rate for treating Covid-19 patients.

    Also, Medicare Advantage plans have been required to bill enrollees affected by the emergency and receiving care at out-of-network facilities the same as if they were at in-network facilities.

    This will end once the public health emergency expires.

    But several of the most meaningful enhancements to public assistance programs are no longer tied to the public health emergency. Congress severed the connection in December as part of its fiscal year 2023 government funding package.

    Most notably, states will now be able to start processing Medicaid redeterminations and disenrolling residents who no longer qualify, starting April 1. They have 14 months to review the eligibility of their beneficiaries.

    As part of a Covid-19 relief package passed in March 2020, states were barred from kicking people off Medicaid during the public health emergency in exchange for additional federal matching funds. Medicaid enrollment has skyrocketed to a record 90 million people since then, and millions are expected to lose coverage once states began culling the rolls.

    A total of roughly 15 million people could be dropped from Medicaid when the continuous enrollment requirement ends, according to an analysis the Department of Health and Human Services released in August. About 8.2 million folks would no longer qualify, but 6.8 million people would be terminated even though they are still eligible, the department estimated.

    Many who are disenrolled from Medicaid, however could qualify for other coverage.

    Food stamp recipients had been receiving a boost during the public health emergency. Congress increased food stamp benefits to the maximum for their family size in a 2020 pandemic relief package.

    The Biden administration expanded the boost in the spring of 2021 so that households already receiving the maximum amount and those who received only a small monthly benefit get a supplement of at least $95 a month.

    This extra assistance will end as of March, though several states have already stopped providing it.

    Congress, however, extended one set of pandemic flexibilities as part of the government funding package.

    More Medicare enrollees are able to get care via telehealth during the public health emergency. The service is no longer limited just to those living in rural areas. They can conduct the telehealth visit at home, rather than having to travel to a health care facility. Plus, beneficiaries can use smartphones and receive a wider array of services via telehealth.

    These will now continue through 2024.

    This story has been updated with additional details.

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  • First on CNN: Biden administration to strengthen Obamacare contraceptive mandate in proposed rule | CNN Politics

    First on CNN: Biden administration to strengthen Obamacare contraceptive mandate in proposed rule | CNN Politics

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    CNN
     — 

    The Biden administration wants to make it easier for women to access birth control at no cost under the Affordable Care Act, reversing Trump-era rules that weakened the law’s contraceptive mandate for employer-provided health insurance plans.

    The proposed rule, unveiled Monday by the departments of Health and Human Services, Labor and Treasury, would remove an exemption to the mandate that allows employers to opt out for moral convictions. It would also create an independent pathway for individuals enrolled in plans offered by employers with religious exemptions to access contraceptive services through a willing provider without charge.

    The proposed rule would leave in place the existing religious exemption for employers with objections, as well as the optional accommodation for contraceptive coverage.

    The administration crafted the proposed rule keeping in mind the concerns of employers with religious objections and the contraceptive needs of their workers, a senior HHS official told CNN.

    “We had to really think through how to do this in the right way to satisfy both sides, but we think we found that way,” the official said, stressing that there should be no effect on religiously affiliated employers.

    Students at religiously affiliated colleges would have access to the expanded accommodation, just like workers in group health plans where the employer has claimed the exemption.

    Now that the proposed rule has been announced, the public will have the opportunity to comment during the next few months. Officials expect there to be many thousands of public comments, and it will be “many months” before the rule could be finalized.

    HHS expects the proposal would affect more than 100 employers and 125,000 workers, mainly through providing the proposed independent pathway for employees to receive no-cost contraception.

    Women using that pathway would obtain their birth control from a participating provider, who would be reimbursed by an insurer on the Affordable Care Act exchanges. The insurer, in turn, would receive a credit on the user fee it pays the government.

    “If this rule is finalized, individuals who have health plans that would otherwise be subject to the ACA preventive services requirements but have not covered contraceptive services because of a moral or religious objection, and for which the sponsoring employer or college or university has not elected the optional accommodation, would now have access,” Centers for Medicare and Medicaid Services Administrator Chiquita Brooks-LaSure said in a news release.

    How many people benefit, however, would depend on whether women and their health care providers know the independent pathway exists and whether providers and insurers are willing to set it up.

    “We’ll just have to see how widely that information is spread and in what way to providers and individuals,” said Laurie Sobel, associate director for Women’s Health Policy at the Kaiser Family Foundation, noting that the proposed rule would not require data collection to show the pathway’s takeup.

    But the Planned Parenthood Federation of America cheered the initiative.

    “Employers and universities should not be able to dictate personal health care decisions and impose their views on their employees or students,” said Alexis McGill Johnson, the group’s CEO. “The ACA mandates that health insurance plans cover all forms of birth control without out-of-pocket costs. Now, more than ever, we must protect this fundamental freedom.”

    The requirement to provide no-cost contraception is not in the Affordable Care Act itself. Instead, HHS under former President Barack Obama included it as one of the women’s preventive services that all private insurance plans must offer without charge.

    The mandate was controversial from the start, sparking lawsuits from religiously affiliated employers and closely held companies that said it violated their beliefs. Exemptions and accommodations have been available for such employers.

    The Trump administration, however, weakened the mandate. Under the rules issued in 2018, entities that have “sincerely held religious beliefs” against providing contraceptives are not required to do so. That provision also extends to organizations and small businesses that have objections “on the basis of moral conviction which is not based in any particular religious belief.”

    The rules also include an optional accommodation that lets objecting employers and private universities remove themselves from providing birth control coverage while still allowing their workers and dependents access to contraception. But the employer or university has to voluntarily elect the accommodation, which risks leaving many without access.

    The Trump administration changes were temporarily blocked after a Pennsylvania district court judge issued a nationwide injunction in 2019. But the following year, the Supreme Court ruled that the administration could expand exemptions for employers who have religious or moral objections to covering contraception.

    At the time, the National Women’s Law Center estimated that the ruling would impact about 64.3 million women in the United States with insurance coverage that included birth control and other preventive services without out-of-pocket costs.

    Employers are not required to notify HHS if they have a moral objection. The agency estimates about 18 employers have claimed that exemption and around 15 employees are affected.

    Still, if the rule is finalized, senior HHS officials say it is “plausible” there could be potential lawsuits brought by religiously affiliated employers – similar to what has been seen in the past.

    “There’s no new obligation on them to participate in any sort of process. This is simply an additional channel for employees in those employer health plans to receive access to contraceptive services,” another senior HHS official said.

    The contraceptive mandate has taken on increased importance now that the Supreme Court has overturned Roe v. Wade, allowing many states to impose severe restrictions on abortion access.

    The Biden administration in turn has focused on continuing access to birth control at no cost. The Health, Labor and Treasury department secretaries last year met with health insurers and issued guidance underscoring Obamacare’s contraceptive coverage requirements for private insurance under the Affordable Care Act.

    “Now more than ever, access to and coverage of birth control is critical as the Biden-Harris Administration works to help ensure women everywhere can get the contraception they need, when they need it, and – thanks to the ACA – with no out-of-pocket cost,” HHS Secretary Xavier Becerra said in a news release.

    This story has been updated with additional information.

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  • Fact check: Biden makes false and misleading claims in economic speech | CNN Politics

    Fact check: Biden makes false and misleading claims in economic speech | CNN Politics

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    Washington
    CNN
     — 

    President Joe Biden delivered a Thursday speech to hail economic progress during his administration and to attack congressional Republicans for their proposals on the economy and the social safety net.

    Some of Biden’s claims in the speech were false, misleading or lacking critical context, though others were correct. Here’s a breakdown of the 14 claims CNN fact-checked.

    Touting the bipartisan infrastructure law he signed in 2021, Biden said, “Last year, we funded 700,000 major construction projects – 700,000 all across America. From highways to airports to bridges to tunnels to broadband.”

    Facts First: Biden’s “700,000” figure is wildly inaccurate; it adds an extra two zeros to the correct figure Biden used in a speech last week and the White House has also used before: 7,000 projects. The White House acknowledged his misstatement later on Thursday by correcting the official transcript to say 7,000 rather than 700,000.

    Biden said, “Well, here’s the deal: I put a – we put a cap, and it’s now in effect – now in effect, as of January 1 – of $2,000 a year on prescription drug costs for seniors.”

    Facts First: Biden’s claims that this cap is now in effect and that it came into effect on January 1 are false. The $2,000 annual cap contained in the Inflation Reduction Act that Biden signed last year – on Medicare Part D enrollees’ out-of-pocket spending on covered prescription drugs – takes effect in 2025. The maximum may be higher than $2,000 in subsequent years, since it is tied to Medicare Part D’s per capita costs.

    Asked for comment, a White House official noted that other Inflation Reduction Act health care provisions that will save Americans money did indeed come into effect on January 1, 2023.

    – CNN’s Tami Luhby contributed to this item.

    Criticizing former President Donald Trump over his handling of the Covid-19 pandemic, Biden said, “Back then, only 3.5 million people had been – even had their first vaccination, because the other guy and the other team didn’t think it mattered a whole lot.”

    Facts First: Biden is free to criticize Trump’s vaccine rollout, but his “only 3.5 million” figure is misleading at best. As of the day Trump left office in January 2021, about 19 million people had received a first shot of a Covid-19 vaccine, according to figures published by the Centers for Disease Control and Prevention. The “3.5 million” figure Biden cited is, in reality, the number of people at the time who had received two shots to complete their primary vaccination series.

    Someone could perhaps try to argue that completing a primary series is what Biden meant by “had their first vaccination” – but he used a different term, “fully vaccinated,” to refer to the roughly 230 million people in that very same group today. His contrasting language made it sound like there are 230 million people with at least two shots today versus 3.5 million people with just one shot when he took office. That isn’t true.

    Biden said Republicans want to cut taxes for billionaires, “who pay virtually only 3% of their income now – 3%, they pay.”

    Facts First: Biden’s “3%” claim is incorrect. For the second time in less than a week, Biden inaccurately described a 2021 finding from economists in his administration that the wealthiest 400 billionaire families paid an average of 8.2% of their income in federal individual income taxes between 2010 and 2018; after CNN inquired about Biden’s “3%” claim on Thursday, the White House published a corrected official transcript that uses “8%” instead. Also, it’s important to note that even that 8% number is contested, since it is an alternative calculation that includes unrealized capital gains that are not treated as taxable income under federal law.

    “Biden’s numbers are way too low,” said Howard Gleckman, senior fellow at the Urban-Brookings Tax Policy Center at the Urban Institute think tank, though Gleckman also said we don’t know precisely what tax rates billionaires do pay. Gleckman wrote in an email: “In 2019, Berkeley economists Emmanuel Saez and Gabe Zucman estimated the top 400 households paid an average effective tax rate of about 23 percent in 2018. They got a lot of attention at the time because that rate was lower than the average rate of 24 percent for the bottom half of the income distribution. But it still was way more than 2 or 3, or even 8 percent.”

    Biden has cited the 8% statistic in various other speeches, but unlike the administration economists who came up with it, he tends not to explain that it doesn’t describe tax rates in a conventional way. And regardless, he said “3%” in this speech and “2%” in a speech last week.

    Biden cited a 2021 report from the Institute on Taxation and Economic Policy think tank that found that 55 of the country’s largest corporations had made $40 billion in profit in their previous fiscal year but not paid any federal corporate income taxes. Before touting the 15% alternative corporate minimum tax he signed into law in last year’s Inflation Reduction Act, Biden said, “The days are over when corporations are paying zero in federal taxes.”

    Facts First: Biden exaggerated. The new minimum tax will reduce the number of companies that don’t pay any federal taxes, but it’s not true that the days of companies paying zero are “over.” That’s because the minimum tax, on the “book income” companies report to investors, only applies to companies with at least $1 billion in average annual income. According to the Institute on Taxation and Economic Policy, only 14 of the companies on its 2021 list of 55 non-payers reported having US pre-tax income of at least $1 billion.

    In other words, there will clearly still be some large and profitable corporations paying no federal income tax even after the minimum tax takes effect this year. The exact number is not yet known.

    Matthew Gardner, a senior fellow at the Institute on Taxation and Economic Policy, told CNN in the fall that the new tax is “an important step forward from the status quo” and that it will raise substantial revenue, but he also said: “I wouldn’t want to assert that the minimum tax will end the phenomenon of zero-tax profitable corporations. A more accurate phrasing would be to say that the minimum tax will *help* ensure that *the most profitable* corporations pay at least some federal income tax.”

    There are lots of nuances to the tax; you can read more specifics here. Asked for comment on Thursday, a White House official told CNN: “The Inflation Reduction Act ensures the wealthiest corporations pay a 15% minimum tax, precisely the corporations the President focused on during the campaign and in office. The President’s full Made in America tax plan would ensure all corporations pay a 15% minimum tax, and the President has called on Congress to pass that plan.”

    Noting the big increase in the federal debt under Trump, Biden said that his administration has taken a “different path” and boasted: “As a result, the last two years – my administration – we cut the deficit by $1.7 trillion, the largest reduction in debt in American history.”

    Facts First: Biden’s boast leaves out important context. It is true that the federal deficit fell by a total of $1.7 trillion under Biden in the 2021 and 2022 fiscal years, including a record $1.4 trillion drop in 2022 – but it is highly questionable how much credit Biden deserves for this reduction. Biden did not mention that the primary reason the deficit fell so substantially was that it had skyrocketed to a record high under Trump in 2020 because of bipartisan emergency pandemic relief spending, then fell as expected as the spending expired as planned. Independent analysts say Biden’s own actions, including his laws and executive orders, have had the overall effect of adding to current and projected future deficits, not reducing those deficits.

    Dan White, senior director of economic research at Moody’s Analytics – an economics firm whose assessments Biden has repeatedly cited during his presidency – told CNN’s Matt Egan in October: “On net, the policies of the administration have increased the deficit, not reduced it.” The Committee for a Responsible Federal Budget, an advocacy group, wrote in September that Biden’s actions will add more than $4.8 trillion to deficits from 2021 through 2031, or $2.5 trillion if you don’t count the American Rescue Plan pandemic relief bill of 2021.

    National Economic Council director Brian Deese wrote on the White House website last week that the American Rescue Plan pandemic relief bill “facilitated a strong economic recovery and enabled the responsible wind-down of emergency spending programs,” thereby reducing the deficit; David Kelly, chief global strategist at J.P. Morgan Funds, told Egan in October that the Biden administration does deserve credit for the recovery that has pushed the deficit downward. And Deese correctly noted that Biden’s signature legislation, last year’s Inflation Reduction Act, is expected to bring down deficits by more than $200 billion over the next decade.

    Still, the deficit-reducing impact of that one bill is expected to be swamped by the deficit-increasing impact of various additional bills and policies Biden has approved.

    Biden said, “Wages are up, and they’re growing faster than inflation. Over the past six months, inflation has gone down every month and, God willing, will continue to do that.”

    Facts First: Biden’s claim that wages are up and growing faster than inflation is true if you start the calculation seven months ago; “real” wages, which take inflation into account, started rising in mid-2022 as inflation slowed. (Biden is right that inflation has declined, on an annual basis, every month for the last six months.) However, real wages are lower today than they were both a full year ago and at the beginning of Biden’s presidency in January 2021. That’s because inflation was so high in 2021 and the beginning of 2022.

    There are various ways to measure real wages. Real average hourly earnings declined 1.7% between December 2021 and December 2022, while real average weekly earnings (which factors in the number of hours people worked) declined 3.1% over that period.

    Biden said he was disappointed that the first bill passed by the new Republican majority in the House of Representatives “added $114 billion to the deficit.”

    Facts First: Biden is correct about how the bill would affect the deficit if it became law. He accurately cited an estimate from the government’s nonpartisan Congressional Budget Office.

    The bill would eliminate more than $71 billion of the $80 billion in additional funding for the Internal Revenue Service (IRS) that Biden signed into law in the Inflation Reduction Act. The Congressional Budget Office found that taking away this funding – some of which the Biden administration said will go toward increased audits of high-income individuals and large corporations – would result in a loss of nearly $186 billion in government revenue between 2023 and 2032, for a net increase to the deficit of about $114 billion.

    The Republican bill has no chance of becoming law under Biden, who has vowed to veto it in the highly unlikely event it got through the Democratic-controlled Senate.

    Biden said that “MAGA Republicans” in the House “want to impose a 30 percent national sales tax on everything from food, clothing, school supplies, housing, cars – a whole deal.” He said they want to do that because “they want to eliminate the income tax system.”

    Facts First: This is a fair description of the Republicans’ “FairTax” bill. The bill would eliminate federal income taxes, plus the payroll tax, capital gains tax and estate tax, and replace it with a national sales tax. The bill describes a rate of 23% on the “gross payments” on a product or service, but when the tax rate is described in the way consumers are used to sales taxes being described, it’s actually right around 30%, as a pro-FairTax website acknowledges.

    It is not clear how much support the bill currently has among the House Republican caucus. Notably, House Speaker Kevin McCarthy told CNN’s Manu Raju this week that he opposes the bill – though, while seeking right-wing votes for his bid for speaker in early January, he promised its supporters that it would be considered in committee. Biden wryly said in his speech, “The Republican speaker says he’s not so sure he’s for it.”

    Biden claimed the unemployment rate “is the lowest it’s been in 50 years.”

    Facts First: This is true. The unemployment rate was just below 3.5% in December, the lowest figure since 1969.

    The headline monthly rate, which is rounded to a single decimal place, was reported as 3.5% in December and also reported as 3.5% in three months of President Donald Trump’s tenure, in late 2019 and in early 2020. But if you look at more precise figures, December was indeed the lowest since 1969 – 3.47% – just below the figures for February 2020, January 2020 and September 2019.

    Biden said that the unemployment rates for Black and Hispanic Americans are “near record lows” and that the unemployment rate for people with disabilities is “the lowest ever recorded” and the “lowest ever in history.”

    Facts First: Biden’s claims are accurate, though it’s worth noting that the unemployment rate for people with disabilities has only been released by the government since 2008.

    The Black or African American unemployment rate was 5.7% in December, not far from the record low of 5.3% that was set in August 2019. (This data series goes back to 1972.) The rate was 9.2% in January 2021, the month Biden became president. The Hispanic or Latino unemployment rate was 4.1% in December, just above the record low of 4.0% that was set in September 2019. (This data series goes back to 1973.) The rate was 8.5% in January 2021.

    The unemployment rate for people with disabilities was 5.0% in December, the lowest since the beginning of the data series in 2008. The rate was 12.0% in January 2021.

    Biden said that fewer families are facing foreclosure than before the pandemic.

    Facts First: Biden is correct. According to a report published by the Federal Reserve Bank of New York, about 28,500 people had new foreclosure notations on their credit reports in the third quarter of 2022, the most recent quarter for which data is available; that was down from about 71,420 people with new foreclosure notations in the fourth quarter of 2019 and 74,860 people in the first quarter of 2020.

    Foreclosures plummeted in the second quarter of 2020 because of government moratoriums put in place because of the Covid-19 pandemic. Foreclosures spiked in 2022, relative to 2020-2021 levels, after the expiry of these moratoriums, but they remained very low by historical standards.

    Biden said, “More American families have health insurance today than any time in American history.”

    Facts First: Biden’s claim is accurate. An analysis provided to CNN by the Kaiser Family Foundation, which studies US health care, found that about 295 million US residents had health insurance in 2021, the highest on record – and Jennifer Tolbert, the foundation’s director for state health reform, told CNN this week that “I expect the number of people with insurance continued to increase in 2022.”

    Tolbert noted that the number of insured residents generally rises over time because of population growth, but she added that “it is not a given” that there will be an increase in the number of insured residents every year – the number declined slightly under Trump from 2018 to 2019, for example – and that “policy changes as well as economic factors also affect these numbers.”

    As CNN’s Tami Luhby has reported, sign-ups on the federal insurance exchange created by the Affordable Care Act, also known as Obamacare, have spiked nearly 50% under Biden. Biden’s 2021 American Rescue Plan pandemic relief law and then the 2022 Inflation Reduction Act temporarily boosted federal premium subsidies for exchange enrollees, and the Biden administration has also taken various other steps to get people to sign up on the exchanges. In addition, enrollment in Medicaid health insurance has increased significantly during the Covid-19 pandemic, in part because of a bipartisan 2020 law that temporarily prevented people from being disenrolled from the program.

    The percentage of residents without health insurance fell to an all-time low of 8.0% in the first quarter of 2022, according to an analysis published last summer by the federal government’s Department of Health and Human Services. That meant there were 26.4 million people without health insurance, down from 48.3 million in 2010, the year Obamacare was signed into law.

    Biden said, “And over the last two years, more than 10 million people have applied to start a small business. That’s more than any two years in all of recorded American history.”

    Facts First: This is true. There were about 5.4 million business applications in 2021, the highest since 2005 (the first year for which the federal government released this data for a full year), and about 5.1 million business applications in 2022. Not every application turns into a real business, but the number of “high-propensity” business applications – those deemed to have a high likelihood of turning into a business with a payroll – also hit a record in 2021 and saw its second-highest total in 2022.

    Trump’s last full year in office, 2020, also set a then-record for total and high-propensity applications. There are various reasons for the pandemic-era boom in entrepreneurship, which began after millions of Americans lost their jobs in early 2020. Among them: some newly unemployed workers seized the moment to start their own enterprises; Americans had extra money from stimulus bills signed by Trump and Biden; interest rates were particularly low until a series of rate hikes that began in the spring of 2022.

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  • Why urgent care centers are popping up everywhere | CNN Business

    Why urgent care centers are popping up everywhere | CNN Business

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    New York
    CNN
     — 

    If you drive down a busy suburban strip mall or walk down a street in a major city, chances are you won’t go long without spotting a Concentra, MedExpress, CityMD or another urgent care center.

    Demand at urgent care sites surged during the Covid-19 pandemic as people searched for tests and treatments. Patient volume has jumped 60% since 2019, according to the Urgent Care Association, an industry trade group.

    That has fueled growth for new urgent care centers. A record 11,150 urgent care centers have popped up around the United States and they are growing at 7% a year, the trade group says. (This does not include clinics inside retail stores like CVS’ MinuteClinic or freestanding emergency departments.)

    Urgent care centers are designed to treat non-emergency conditions like a common cold, a sprained ankle, an ear infection, or a rash. They are recommended if patients can’t get an immediate appointment with their primary care doctor or if patients don’t have one. Primary care practices should always be the first call in these situations because they have access to patients’ records and all of their health care history, while urgent care sites are meant to provide episodic care.

    Urgent care sites are often staffed by physician assistants and nurse practitioners. Many also have doctors on site. (One urgent care industry magazine says, in 2009, 70% of its providers were physicians, but that the percentage had fallen to 16% by last year.) Urgent cares usually offer medical treatment outside of regular doctor’s office hours and a visit costs much less than a trip to the emergency room.

    Urgent care has grown rapidly because of convenience, gaps in primary care, high costs of emergency room visits, and increased investment by health systems and private-equity groups. The urgent care market will reach around $48 billion in revenue this year, a 21% increase from 2019, estimates IBISWorld.

    The growth highlights the crisis in the US primary care system. A shortage of up to 55,000 primary care physicians is expected in the next decade, according to the Association of American Medical Colleges.

    But many doctors, health care advocates and researchers raise concerns at the proliferation of urgent care sites and say there can be downsides.

    Frequent visits to urgent care sites may weaken established relationships with primary care doctors. They can also lead to more fragmented care and increase overall health care spending, research shows.

    And there are questions about the quality of care at urgent care centers and whether they adequately serve low-income communities. A 2018 study by Pew Charitable Trusts and the Centers for Disease Control and Prevention found that antibiotics are overprescribed at urgent care centers, especially for common colds, the flu and bronchitis.

    “It’s a reasonable solution for people with minor conditions that can’t wait for primary care providers,” said Vivian Ho, a health economist at Rice University. “When you need constant management of a chronic illness, you should not go there.”

    Urgent care centers have been around in the United States since the 1970s, but they were long derided as “docs in a box” and grew slowly during their early years.

    They have become more popular over the past two decades in part due to pressures on the primary care system. People’s expectations of wait times have changed and it can be difficult, and sometimes almost impossible, to book an immediate visit with a primary care provider.

    Urgent care sites are typically open for longer hours during the weekday and on weekends, making it easier to get an appointment or a walk-in visit. Around 80% of the US population is within a 10-minute drive of an urgent care center, according to the industry trade group.

    “There’s a need to keep up with society’s demand for quick turnaround, on-demand services that can’t be supported by underfunded primary care,” said Susan Kressly, a retired pediatrician and fellow at the American Academy of Pediatrics.

    Health insurers and hospitals have also become more focused on keeping people out of the emergency room. Emergency room visits are around ten times more expensive than visits to an urgent care center. During the early 2000s, hospital systems and health insurers started opening their own urgent care sites, and they have introduced strategies to deter emergency room visits.

    Additionally, passage of the Affordable Care Act in 2010 spurred an increase in urgent care providers as millions of newly insured Americans sought out health care. Private-equity and venture capital funds also poured billions into deals for urgent care centers, according to data from PitchBook.

    Urgent care centers can be attractive to investors. Unlike ERs, which are legally obligated to treat everyone, urgent care sites can essentially choose their patients and the conditions they treat. Many urgent care centers don’t accept Medicaid and can turn away uninsured patient,s unless they pay a fee.

    Like other health care options, urgent care centers make money by billing insurance companies for the cost of the visit, additional services, or the patient pays out of pocket. In 2016, the median charge for a 30-minute new insured patient visit was $242 at an urgent care center, compared with $294 in a primary care office and $109 in a retail clinic, according to a study by FAIR Health, a nonprofit that collects health insurance data.

    “If they can make it a more convenient option, there’s a lot of revenue here,” said Ateev Mehrotra, a professor of health care policy and medicine at Harvard Medical School who has researched urgent care clinics. “It’s not where the big bucks are in health care, but there’s a substantial number of patients.”

    Mehrotra research has found that between 2008 and 2015, urgent care visits increased 119%. They became the dominant venue for people seeking treatment for low-acuity conditions like acute respiratory infections, urinary tract infections, rashes, and muscle strains.

    Some doctors and researchers worry that patients with primary care doctors – and those without – are substituting urgent care visits in place of a primary care provider.

    “What you don’t want to see is people seeking a lot care outside their pediatrician and decreasing their visits to their primary care provider,” said Rebecca Burns, the urgent care medical director at the Lurie Children’s Hospital of Chicago.

    Burns’ research has found that high urgent care reliance fills a need for children with acute issues but has the potential to disrupt primary care relationships.

    The National Health Law Program, a health care advocacy group for low-income families and communities, has called for state regulations to require coordination among urgent care sites, retail clinics, primary services, and hospitals to ensure continuity of patients’ care.

    And while the presence of urgent care centers does prevent people from costly emergency department visits for low-acuity issues, Mehrotra from Harvard has found that, paradoxically, they increase health care spending on net.

    Each $1,646 visit to the ER for a low-acuity condition prevented was offset by a $6,327 increase in urgent care center costs, his research has found. This is in part because people may be going to urgent care for minor illnesses they would have previously treated with chicken soup.

    There are also concerns about the oversaturation of urgent care centers in higher-income areas that have more consumers with private health care and limited access in medically underserved areas.

    Urgent care centers selectively tend not to serve rural areas, areas with a high concentration of low-income patients, and areas with a low concentration of privately-insured patients, researchers at the University of California at San Francisco found in a 2016 study. They said this “uneven distribution may potentially exacerbate health disparities.”

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  • Fact check: McCarthy’s false, misleading and evidence-free claims since becoming House speaker | CNN Politics

    Fact check: McCarthy’s false, misleading and evidence-free claims since becoming House speaker | CNN Politics

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    Washington
    CNN
     — 

    Since winning a difficult battle to become speaker of the House of Representatives, Republican Kevin McCarthy has made public claims that are misleading, lacking any evidence or plain wrong.

    Here is a fact check of recent McCarthy comments about the debt ceiling, funding for the Internal Revenue Service, the FBI search of former President Donald Trump’s resort and residence in Florida, President Joe Biden’s stance on stoves and Democratic Rep. Adam Schiff.

    McCarthy’s office did not respond to a request for comment.

    McCarthy has cited the example of Rep. Nancy Pelosi, his Democratic predecessor as House speaker, while defending conservative Republicans’ insistence that any agreement to lift the federal debt ceiling must be paired with cuts to government spending – a trade-off McCarthy agreed to when he was trying to persuade conservatives to support his bid for speaker. Specifically, McCarthy has claimed that even Pelosi agreed to a spending cap as part of a deal to lift the debt ceiling under Trump.

    “When Nancy Pelosi was speaker, that’s what transpired. To get a debt ceiling, they also got a cap on spending for the next two years,” McCarthy told reporters at a press conference on January 12. When Fox host Maria Bartiromo told McCarthy in a January 15 interview that “they” would not agree to a spending cap, he responded, “Well Maria, I don’t believe that’s the case, because when Donald Trump was president and when Nancy Pelosi was speaker, that’s exactly what happened for them to get a debt ceiling lifted last time. They agreed to a spending cap.”

    Facts First: McCarthy’s claims are highly misleading. The deal Pelosi agreed to with the Trump administration in 2019 actually loosened spending caps that were already in place at the time because of a 2011 law. In other words, while congressional conservatives today want to use a debt ceiling deal to reduce government spending, the Pelosi deal allowed for billions in additional government spending above the pre-existing maximum. The two situations are nothing alike.

    Shai Akabas, director of economic policy at the Bipartisan Policy Center think tank, said when asked about the accuracy of McCarthy’s claims: “I’m going to steer clear of characterizing the Speaker’s remarks, but as an objective matter, the deal reached in 2019 increased the spending caps set by the Budget Control Act of 2011.”

    The 2019 deal, which was criticized by many congressional conservatives, also ensured that Budget Control Act’s caps on discretionary spending – which were created as a result of a 2011 debt ceiling deal between a Democratic president and a Republican speaker of the House – would not be extended past 2021. Spending caps vanishing is the opposite of McCarthy’s suggestion that the deal “got” a spending cap.

    Pelosi spokesperson Aaron Bennett said in an email that McCarthy is “trying to rewrite history.” Bennett said, “As Republicans in Congress and in the Administration noted at the time, in 2019, Speaker Pelosi and Democrats were eager to reach bipartisan agreement to raise the debt limit and, as part of the agreement, avert damaging funding cuts for defense and domestic programs.”

    In various statements since becoming speaker, McCarthy has boasted of how the first bill passed by the new Republican majority in the House “repealed 87,000 IRS agents” or “repealed funding for 87,000 new IRS agents.”

    Facts First: McCarthy’s claims are false. House Republicans did pass a bill that seeks to eliminate about $71 billion of the approximately $80 billion in additional Internal Revenue Service funding that Biden signed into law in last year’s Inflation Reduction Act – but that funding is not going to hire 87,000 “agents.” In addition, Biden has already made clear he would veto this new Republican bill even if the bill somehow made it through the Democratic-controlled Senate, so no funding has actually been “repealed.” It would be accurate for McCarthy to say House Republicans “voted to repeal” the funding, but the boast that they actually “repealed” something is inaccurate.

    CNN’s Katie Lobosco explains in detail here why the claim about “87,000 new IRS agents” is an exaggeration. The claim, which has become a common Republican talking point, has been fact-checked by numerous media outlets over more than five months, including The Washington Post in response to McCarthy remarks earlier this January.

    Here’s a summary. While Inflation Reduction Act funding may well allow for the hiring of tens of thousands of IRS employees, far from all of these employees will be IRS agents conducting audits and investigations. Many other employees will be hired for the non-agent roles, from customer service to information technology, that make up the vast majority of the IRS workforce. And a significant number of the hires are expected to fill the vacant posts left by retirements and other attrition, not take newly created positions.

    The IRS has not yet released a detailed breakdown of how it plans to use the funding provided by the Inflation Reduction Act, so it’s impossible to say precisely how many new “agents” will be hired. But it is already clear that the total won’t approach 87,000.

    In his interview with Fox’s Bartiromo on January 15, McCarthy criticized federal law enforcement for executing a search warrant at Trump’s Mar-a-Lago resort and residence in Florida, which the FBI says resulted in the recovery of more than 100 government documents marked as classified and hundreds of other government documents. Echoing a claim Trump has made, McCarthy said of the documents: “They knew it was there. They could have come and taken it any time they wanted.”

    Facts First: It is clearly not true that the authorities could somehow have come to Mar-a-Lago at any time, without conducting a formal search, and taken all of the presidential records they were seeking from Trump. By the time of the search, the federal government – first the National Archives and Records Administration and then the Justice Department – had been asking Trump for more than a year to return government records. Even when the Justice Department went beyond asking in May and served Trump’s team with a subpoena for the return of all documents with classification markings, Trump’s team returned only some of these documents. In June, a Trump lawyer signed a document certifying on behalf of Trump’s office that all of the documents had been returned, though that was not true.

    When FBI agents and a Justice Department attorney visited Mar-a-Lago without a search warrant on that June day to accept documents the Trump team was returning in response to the subpoena, a Trump lawyer “explicitly prohibited government personnel from opening or looking inside any of the boxes that remained in the storage room,” the department said in a court filing after the August search. In other words, according to the department, the government was not even allowed to poke around to see if there were government records still at Mar-a-Lago, let alone take those records.

    In the August court filing, the department pointedly called into question the extent to which the Trump team had cooperated: “That the FBI, in a matter of hours, recovered twice as many documents with classification markings as the ‘diligent search’ that the former President’s counsel and other representatives had weeks to perform calls into serious question the representations made in the June 3 certification and casts doubt on the extent of cooperation in this matter.”

    McCarthy wrote in a New York Post article published on January 12: “While President Joe Biden wants to control the kind of stove Americans can cook on, House Republicans are certainly cooking with gas.” He repeated the claim on Twitter the next morning.

    Facts First: There is no evidence for this claim; Biden has not expressed a desire to control the kind of stove Americans can cook on. McCarthy was baselessly attributing the comments of a single Biden appointee to Biden himself.

    It is true that a Biden appointee on the United States Consumer Product Safety Commission, Richard Trumka Jr., told Bloomberg earlier this month that gas stoves pose a “hidden hazard,” as they emit air pollutants, and said, “Any option is on the table. Products that can’t be made safe can be banned.” But the day before McCarthy’s article was published by the New York Post, White House press secretary Karine Jean-Pierre said at a press briefing: “The president does not support banning gas stoves. And the Consumer Product Safety Commission, which is independent, is not banning gas stoves.”

    To date, even the commission itself has not shown support for a ban on gas stoves or for any particular new regulations on gas stoves. Commission Chairman Alexander Hoehn-Saric said in a statement the day before McCarthy’s article was published: “I am not looking to ban gas stoves and the CPSC has no proceeding to do so.” Rather, he said, the commission is researching gas emissions in stoves, “exploring new ways to address health risks,” and strengthening voluntary safety standards – and will this spring ask the public “to provide us with information about gas stove emissions and potential solutions for reducing any associated risks.”

    Trumka told CNN’s Matt Egan that while every option remains on the table, any ban would apply only to new gas stoves, not the gas stoves already in people’s homes. And he noted that the Inflation Reduction Act makes people eligible for a rebate of up to $840 to voluntarily switch to an electric stove.

    Defending his plan to bar Democratic Rep. Adam Schiff from sitting on the House Intelligence Committee, a committee Schiff chaired during the Democratic majority from early 2019 to the beginning of this year, McCarthy criticized Schiff on January 12 over his handling of the first impeachment of Trump. Among other things, McCarthy said: “Adam Schiff openly lied to the American public. He told you he had proof. He told you he didn’t know the whistleblower.”

    Facts First: There is no evidence for McCarthy’s insinuation that Schiff lied when he said he didn’t know the anonymous whistleblower who came forward in 2019 with allegations – which were subsequently corroborated – about how Trump had attempted to use the power of his office to pressure Ukrainian President Volodymyr Zelensky to investigate Biden, his looming rival in the 2020 election.

    Schiff said last week in a statement to CNN: “Kevin McCarthy continues to falsely assert I know the Ukraine whistleblower. Let me be clear – I have never met the whistleblower and the only thing I know about their identity is what I have read in press. McCarthy’s real objection is we proved the whistleblower’s claim to be true and impeached Donald Trump for withholding millions from Ukraine to extort its help with his campaign.” Schiff also made this comment to The Washington Post, which fact-checked the McCarthy claim last week, and has consistently said the same since late 2019.

    The New York Times reported in 2019 that, according to an unnamed official, a House Intelligence Committee aide who had been contacted by the whistleblower before the whistleblower filed a formal complaint did not inform Schiff of the person’s identity when conveying to Schiff “some” information about what the person had said. And Reuters reported in 2019 that a person familiar with the whistleblower’s contacts said the whistleblower hadn’t met or spoken with Schiff.

    McCarthy could have fairly repeated Republican criticism of a claim Schiff made in a 2019 television appearance about the committee’s communication with the whistleblower; Schiff said at the time “we have not spoken directly with the whistleblower” even though it soon emerged that the whistleblower had contacted the committee aide before filing the complaint. (A committee spokesperson said at the time that Schiff had been merely trying to say that the committee hadn’t heard actual testimony from the whistleblower, but that Schiff acknowledged his words “should have been more carefully phrased to make that distinction clear.”)

    Regardless, McCarthy didn’t argue here that Schiff had been misleading about the committee’s dealings with the whistleblower; he strongly suggested that Schiff lied in saying he didn’t know the whistleblower. That’s baseless. There has never been any indication that Schiff had a relationship with the whistleblower when he said he didn’t, nor that Schiff knew the whistleblower’s identity when he said he didn’t.

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  • Open enrollment for 2023 health insurance through the public exchange ends Sunday

    Open enrollment for 2023 health insurance through the public exchange ends Sunday

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    Hoxton/Tom Merton | Hoxton | Getty Images

    If you don’t have health insurance for 2023, you may still be able to get it through the public marketplace.

    Open enrollment for the federal health-care exchange ends Sunday, with coverage taking effect Feb. 1. If your state operates its own exchange, you may have more time.

    Most marketplace enrollees — 13 million of 14.5 million in 2022 — qualify for federal subsidies (technically tax credits) to help pay premiums. Some people may also be eligible for help with cost sharing, such as deductibles and copays on certain plans, depending on their income.

    More from Personal Finance:
    3 key moves to make before tax filing season opens
    Here’s how to best prepare for home repair expenses
    The best way to pay down high-interest credit card debt

    So far, nearly 15.9 million people have signed up through the exchange during this open enrollment, which started Nov. 1. Four out of 5 customers can find 2023 plans for $10 or less per month after accounting for those tax credits, according to the Centers for Medicare & Medicaid Services.

    After the sign-up window closes, you’d generally need to experience a qualifying life event — i.e., birth of a child or marriage — to be given a special enrollment period.

    For the most part, people who get insurance through the federal (or their state’s) exchange are self-employed or don’t have access to workplace insurance, or they don’t qualify for Medicare or Medicaid.

    The subsidies are still more generous than before the pandemic. Temporarily expanded subsidies that were put in place for 2021 and 2022 were extended through 2025 in the Inflation Reduction Act, which became law in August.

    This means there is no income cap to qualify for subsidies, and the amount anyone pays for premiums is limited to 8.5% of their income as calculated by the exchange. Before the changes, the aid was generally only available to households with income from 100% to 400% of the federal poverty level.

    The marketplace subsidies that you’re eligible for are based on factors that include income, age and the second-lowest-cost “silver” plan in your geographic area (which may or may not be the plan you enroll in).

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  • 74 Things That Blew Our Minds in 2022

    74 Things That Blew Our Minds in 2022

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    The writers on The Atlantic’s Science, Technology, and Health desks have learned a lot this year. Our coverage of the ongoing coronavirus pandemic has continued, but this year, more so than in 2020 and 2021, we’ve also had the chance to report on topics that have filled us with awe and delight. Though the past 12 months have not been free of concerns about infectious disease, climate change, and even nuclear war, we’ve embraced more fascination and curiosity in our coverage this year, and we wanted to share and reflect on some of the most compelling tidbits we’ve stumbled across. We hope you find these facts as mind-blowing as we did.

    1. Days on the moon are hot enough to boil water, and nights are unfathomably cold, but at least one spot on the lunar surface stays a pleasant 63 degrees Fahrenheit.
    2. Actually, snakes do have clitorises.
    3. Scientists don’t know where the virus in the smallpox vaccine came from.
    4. Sour or curdled milk is often perfectly safe to consume.
    5. The bone of a mastodon named Fred preserved memories from its life 13,200 years ago.
    6. The most common phrase on Facebook in several French-speaking countries is “Have a nice day!”
    7. Most people with diabetes should not receive insulin as a first-, second-, or even third-line treatment.
    8. There might not be a theoretical limit to the height from which a cat can fall and survive.
    9. Beyond a certain temperature—as low as 95 degrees, by some estimates—fans do more harm than good.
    10. About 10 percent of the bills introduced in Congress in the past two years have been titled with reverse-engineered acronyms, including the ZOMBIE Act.
    11. The notes your doctor writes about you probably don’t look the same now as they did a year and a half ago.
    12. It takes at least seven years to train the muscles and tendons in your elbow that will make you a great arm wrestler, according to the arm wrestler Jack Arias, who was in the 1987 arm-wrestling movie Over the Top with Sylvester Stallone.
    13. American Express started making metal cards in 2004 because of an urban legend about its most exclusive card being titanium.
    14. The first-of-its-kind electric Hummer weighs as much as an ambulance and accelerates like a Formula 1 race car.
    15. Woodpeckers have small brains, which is why they can smash their heads against trees unharmed.
    16. A toaster-size device inside a rover on Mars can convert Martian air, made almost entirely of carbon dioxide, into breathable oxygen.
    17. Parrot theft is weirdly common.
    18. Lactose-intolerant people have been throwing back dairy for thousands and thousands of years.
    19. The provision in the Affordable Care Act that requires health insurance to cover contraception does not require coverage for vasectomies.
    20. Pawpaws tend to stay green throughout their life cycle, so in order to tell if they’re ripe, you have to individually caress every fruit on a tree.
    21. The metal that makes up a nickel has long been worth more than the coin itself.
    22. The Presidential Fitness Test was developed because the federal government worried that postwar children were too soft to defeat communism when they grew up.
    23. The iPhone is the only major Apple product that doesn’t support charging with the now-ubiquitous USB-C cable.
    24. The oldest clam ever lived to 507.
    25. The word sure was once pronounced more like syoor.
    26. Some of YouTube’s earliest hits got popular thanks to “coolhunters,” a group of editors who individually picked videos for the site’s homepage.
    27. In 1918, California conscripted children into a week-long war on squirrels.
    28. Some baby cameras feature artificial intelligence that will recognize when your baby’s face is covered or when the baby has coughed.
    29. Extreme heat and specific pressure conditions on WASP-96b, an exoplanet about 1,150 light-years from Earth, mean that rock can condense in the air like water does on Earth, producing clouds made of sand.
    30. In 2021, a full quarter of single-family homes sold in America went to buyers with no intention of living in them, such as house flippers, landlords, Airbnb hosts, and other investors.
    31. Apple has released 38 distinct models of the iPhone since 2007.
    32. Slurpees and Icees are the exact same “frozen carbonated beverage,” sold under different trademarks.
    33. The agricultural revolution is a myth.
    34. Hypoallergenic dogs are also a myth.
    35. Reindeers’ eyes change color—from blue to gold, and then back to blue again—twice a year to cope with the Arctic’s strange light schedule.
    36. If current trends hold, half of the world’s population could be nearsighted by 2050.
    37. A 2006 effort to automatically take down internet pornography by detecting repetitive noises ended up catching a lot of tennis videos.
    38. Some minerals in rechargeable batteries can be recycled indefinitely.
    39. Julius Caesar reportedly announced his conquest of Gaul via pigeon.
    40. The Japanese makers of Hi-Chew candy were persuaded to push into the mainstream American market because of the candy’s enduring popularity among missionaries from the Church of Jesus Christ of Latter-day Saints who had returned home after time in East Asia.
    41. Secondhand-smoke inhalation causes more than 41,000 deaths annually in the U.S., more than some flu seasons.
    42. The Microsoft Excel World Championship: (1) exists, (2) streams on ESPN3, and (3) is legitimately exciting.
    43. Saturn’s trademark rings will disappear in about 300 million years.
    44. But, on the bright side, Neptune has rings too.
    45. China’s zero-COVID policy may be largely responsible for gas prices falling from a March peak to below $4 a gallon in August.
    46. Polar bears in Southeast Greenland are homebodies.
    47. The world’s best chess player, Magnus Carlsen, has, by one calculation, a 98 percent chance of losing and a 2 percent chance of drawing against the world’s best chess-playing computer program; victory is basically impossible.
    48. Earlier this year, Moonbirds NFTs—basically colorful little pixelated owls—generated $489 million in trading volume in their first two weeks of existence.
    49. In 1975, the average grocery store stocked 65 kinds of fruits and veggies. By 1998, that number had reached 345.
    50. Octopuses all over the sea starve for years on end while brooding.
    51. Government spending on climate change over the next decade could end up more than double what Democratic senators predicted for the Inflation Reduction Act.
    52. Robusta coffee—whose taste has been likened to “rotten compost … with a hint of sulfur”—can actually be delicious.
    53. Journals can be big business: One collector sold a diary from a 1912 Machu Picchu visitor and another by an 1868 Missouri River traveler for about $9,000 each.
    54. There is such a thing as a reformed parasite.
    55. In Wordle, just one correct letter in the right spot and one in the wrong spot can eliminate 96 percent of possible solutions.
    56. A major obstacle to meeting the United States’ clean-energy goals is that we have to double the rate at which we build the giant cables that transmit power between regions.
    57. Little kids who grew up amid intense COVID restrictions might have different microbiomes than those born several years earlier—and whether that’s good or bad is unclear.
    58. Militaries are developing swarms of starling-size drones that will be able to fly and attack together with the use of artificial intelligence.
    59. Psychedelics seem to quiet a network in our brain that is most active when we focus on ourselves.
    60. The cryptocurrency exchange FTX, once valued at $32 billion before a spectacular collapse, used QuickBooks for accounting.
    61. A product needs to be just 10 percent cocoa to be called “chocolate” by the FDA.
    62. Gophers … might … farm?
    63. While asleep, teeth-grinders can clench down with up to 250 pounds of force.
    64. In 2021, 95 of the United States’ 100 most-watched telecasts were sporting events.
    65. You can pay hundreds of dollars an hour for cow-hug therapy.
    66. Male widow spiders will somersault into a female’s mouth to be cannibalized while they’re mating.
    67. Ninety percent of people report having at least one memory in which they can see themselves as if watching a character in a movie.
    68. Offices are designed to be inefficient.
    69. Climate-minded architectural firms in Senegal are pushing the country to reclaim mud construction.
    70. Rats can learn to play hide-and-seek, and they have fun doing it.
    71. A cat kidney transplant costs $15,000.
    72. The Apollo 11 moon lander will sit on the moon for millions of years because there’s no wind or water to erode it away.
    73. Your smart thermostat mostly exists to help the utility company, not your wallet.
    74. The cocaine-eating bear that died in 1985 and inspired the upcoming film Cocaine Bear is stuffed, mounted, and on display at a mall in Lexington, Kentucky.

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  • Senior citizens will soon get that big hike in their Social Security benefits | CNN Politics

    Senior citizens will soon get that big hike in their Social Security benefits | CNN Politics

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    CNN
     — 

    Senior citizens and other Social Security recipients will start getting a heftier monthly benefit next month due to an 8.7% annual cost-of-living adjustment aimed at helping them cope with high inflation.

    The increase, the largest in more than 40 years, will boost retirees’ monthly payments by more than $140 to an estimated average of $1,827 for 2023.

    The adjustment is the highest that most current beneficiaries have ever seen because it is based on an inflation metric from August through October, which was also around 40-year highs. Inflation has cooled somewhat since then, though prices remain elevated.

    “I’m sure everyone is anxiously awaiting because prices are still high,” said Mary Johnson, a Social Security and Medicare policy analyst at The Senior Citizens League, an advocacy group. “Just shopping for food to feed people during the holidays is going to be a huge challenge.”

    Roughly 70 million people will receive the increase, which follows a 5.9% adjustment for 2022.

    Many senior citizens depend heavily on Social Security. Some 42% of elderly women and 37% of elderly men rely on the monthly payments for at least half their income, according to the Social Security Administration.

    Just when the beefed-up payment will arrive depends on recipients’ ages and birth dates. Those who received Social Security before May 1997 get their monthly benefit on the 3rd of each month. For more recent retirees, those whose birth dates are the 1st through the 10th of the month receive it on the second Wednesday, while those born on the 11th to 20th and the 21st to 31st of the month are paid the third and fourth Wednesdays, respectively.

    Even though recipients received a sizable adjustment for this year, inflation ate away at the boost.

    The increase fell short of actual inflation by an average of more than $42 – or 46% – every month or roughly $508 for the year, Johnson said.

    Many retirees have been forced to turn to their savings or public assistance. One-third of seniors reported signing up for food stamps or visiting a food pantry over the past 12 months, compared with 22% in 2020, according to recent surveys by The Senior Citizens League. Also, 17% have applied for assistance with heating costs, compared with 10% in 2020.

    This is not a new problem. Benefits have not kept up with the rising cost of living for years, even with the annual adjustments.

    As of March, inflation has caused Social Security payments to lose 40% of their buying power since 2000, according to a study released earlier this year by the league. Monthly benefits would have to increase by $540 to maintain the same level of buying power as in 2000.

    Senior citizens will also see their Medicare Part B premiums drop in 2023, the first time in more than a decade that the tab will be lower than the year before, the Centers for Medicare and Medicaid Services announced in the fall. It’s only the fourth time that premiums are declining since Medicare was created in 1965.

    The standard monthly premiums will be $164.90 in 2023, a decrease of $5.20 from 2022.

    The reduction comes after a large spike in 2022 premiums, which raised the standard monthly premium to $170.10, up from $148.50 in 2021. A key driver of the 2022 hike was a projected jump in spending due to a costly new drug for Alzheimer’s disease, Aduhelm. However, since then, Aduhelm’s manufacturer cut the price and the Centers for Medicare and Medicaid Services limited coverage of the drug.

    Also, spending was lower than projected on other Part B items and services, which resulted in much larger reserves in the Part B trust fund, allowing the agency to limit future premium increases.

    The big annual adjustment could end up hurting some seniors, Johnson said.

    For instance, the resulting increase in income could push them above the thresholds for certain government benefits, such as Medicare Extra Help, Medicaid, food stamps and rental assistance, leaving them eligible for less or no aid. Or they could have to pay more for their Medicare Part B premiums, which are adjusted for income.

    Also, they could have to start paying taxes – or owe higher levies – on their Social Security benefits if their income rises above a certain level.

    Further, the increase could leave Social Security’s finances on even shakier ground. The combined trust funds that pay benefits to retirees, survivors and the disabled will be depleted by 2035 and only able to distribute roughly three-quarters of promised payments unless Congress addresses the program’s long-term funding shortfall, according to the most recent Social Security trustees’ report.

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  • Justice Department sues pharmaceutical company for allegedly failing to report suspicious opioid sales | CNN Politics

    Justice Department sues pharmaceutical company for allegedly failing to report suspicious opioid sales | CNN Politics

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    Washington
    CNN
     — 

    The Justice Department on Thursday alleged that the AmerisourceBergen Corporation, one of the country’s largest pharmaceutical distributors, and two of its subsidiaries failed to report hundreds of thousands of suspicious prescription opioid orders to pharmacies across the country.

    The lawsuit, which spans several states, alleges that AmerisourceBergen disregarded its legal obligation to report orders of controlled substances to the Drug Enforcement Agency for nearly a decade. The company ignored “red flags” that pharmacies in West Virginia, New Jersey, Colorado and Florida were diverting opioids into illegal drug markets, the suit says.

    “The Department of Justice is committed to holding accountable those who fueled the opioid crisis by flouting the law,” Associate Attorney General Vanita Gupta said in a statement Thursday.

    “Companies distributing opioids are required to report suspicious orders to federal law enforcement. Our complaint alleges that AmerisourceBergen – which sold billions of units of prescription opioids over the past decade – repeatedly failed to comply with that requirement,” she added.

    If AmerisourceBergen is found liable at trial, the company faces billions of dollars in financial penalties, the Justice Department said.

    Lauren Esposito, a spokesperson for AmerisourceBergen, countered on Thursday in a statement that said the Justice Department’s complaint rested on “five pharmacies that were cherry picked out of the tens of thousands of pharmacies that use AmerisourceBergen as their wholesale distributor, while ignoring the absence of action from former administrators at the Drug Enforcement Administration – the DOJ’s own agency.”

    She added: “With the vast quantity of information that AmerisourceBergen shared directly with the DEA with regards to these five pharmacies, the DEA still did not feel the need to take swift action itself – in fact, AmerisourceBergen terminated relationships with four of them before DEA ever took any enforcement action while two of the five pharmacies maintain their DEA controlled substance registration to this day.”

    Yet AmerisourceBergen was allegedly aware that in two of the pharmacies, drugs it distributed were likely being sold in parking lots for cash, the Justice Department said. In another pharmacy, the company was allegedly warned that patients likely suffering from addiction were receiving opioids, including some people who later died of a drug overdose.

    The Justice Department also noted in its lawsuit that AmerisourceBergen’s reporting systems for suspicious opioid orders were deeply inadequate, and that the company intentionally changed its reporting systems to reduce the number of orders flagged as suspicious amid the opioid epidemic.

    Even when orders were flagged as suspicious, AmerisourceBergen often didn’t report those orders to the DEA, according to the complaint.

    Opioids are involved in the vast majority of drug overdose deaths, though synthetic opioids – particularly fentanyl – have played an outsized role. Synthetic opioids – excluding methadone – were involved in more than 72,000 overdose deaths in 2021, about two-thirds of all overdose deaths that year and more than triple the number from five years earlier.

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  • House investigation says FDA approval process of Alzheimer’s drug was ‘rife with irregularities’ | CNN

    House investigation says FDA approval process of Alzheimer’s drug was ‘rife with irregularities’ | CNN

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    CNN
     — 

    A congressional investigation found that the US Food and Drug Administration’s “atypical collaboration” to approve a high-priced Alzheimer’s drug was “rife with irregularities.”

    The report, released Thursday, was the result of an 18-month investigation by two House committees. It is sharply critical of Biogen, maker of the medication Aduhelm.

    The report says Biogen set an “unjustifiably high price” for Aduhelm to “make history” for the company, and thought of the drug as an “unprecedented financial opportunity.” Biogen priced Aduhelm at $56,000 per year, even though its actual effects on a broad patient population were unknown.

    More than 6.5 million people in the US live with Alzheimer’s, and that number is expected to grow to 13.8 million by 2060, according to the Alzheimer’s Association. The disease is the sixth leading cause of death in the United States. There is no cure, and effective treatments are extremely limited. Before Aduhelm’s approval in June 2021, the FDA had not approved a novel therapy for the condition since 2003.

    The investigation found that Biogen planned an aggressive marketing campaign to launch the drug, intending to spend more than $3.3 billion on sales and marketing between 2020 and 2024 – more than 2½ times what it spent to develop Aduhelm.

    Dementia, including Alzheimer’s, is one of the “costliest conditions to society,” according to the Alzheimer’s Association. In 2022 alone, Alzheimer’s and other dementias cost the US $321 billion, including $206 billion in Medicaid and Medicare payments, the association says.

    Aduhelm’s cost to patients and to Medicare would be significant, the new report says. It was one of the key factors behind a big increase in Medicare premiums in 2022, according to the Centers for Medicare and Medicaid Services.

    In anticipation of “pushback” from providers and payers, the report says, Biogen also prepared a narrative to sell the value of the drug.

    The Committee on Oversight and Reform and the Committee on Energy and Commerce found that the collaboration between the FDA and Biogen in the approval process of the drug “exceeded the norm in some respects.”

    Biogen had initially discontinued Aduhelm’s clinical trials in March 2019 after an independent committee found that it probably would not slow the cognitive and functional impairment – the decline in memory, language and judgment – that comes with Alzheimer’s. But in June 2019, the FDA and Biogen started a “working group” to see whether the effort could be saved.

    The investigation found that the FDA and Biogen engaged in at least 115 meetings, calls and substantive email discussions from July 2019 to July 2020, including 40 meetings to guide Aduhelm’s potential approval. There may have been even more meetings, but the committees say the FDA failed to follow its own documentation protocol.

    The agency then collaborated with Biogen to draft a document used to brief an independent advisory committee that met in November 2020. The trial results were mixed, with only one showing a small benefit to patients.

    At that meeting, none of the committee’s members voted to say that the studies presented strong evidence that the drug was effective at treating Alzheimer’s.

    The meeting was unusual, according to one former FDA adviser who had sat on the committee for several years. Dr. Aaron Kesselheim told CNN in 2021 that the relationship between the FDA and the company was out of the ordinary.

    “There was a strange dynamic compared to the other advisory committee meetings I’ve attended,” the professor at Harvard Medical School said. “Usually, there’s some distance between the FDA and the company, but on this one, the company and the FDA were fully in line with each other in support of the drug.”

    When the FDA approved the drug, Kesselheim and two other members of the advisory committee resigned in protest. He later labeled it “probably the worst drug approval decision in recent US history.”

    The FDA often follows the independent committee’s recommendations, but in this case, it changed course and used its accelerated approval pathway, which sets a different standard of proof that a treatment could work.

    The committee members said senior FDA leadership told them that the shift in how the drug would be approved came after an FDA expert council meeting in April 2021 provided “unfavorable feedback” for the traditional approval process, according to the new report.

    The FDA also approved the drug for “people with Alzheimer’s disease,” a far broader population than was studied in Biogen’s clinical trials.

    Internal documents from the company said that Biogen accepted this broader indication “despite internal reservations about the lack of evidence of clinical benefit for patients at disease stages outside of the clinical trials and an unknown safety profile,” the report says. Leaders expressed concern that the company could lose credibility, and it developed a communications strategy to deal with the “anticipated fallout,” the report says.

    The committees recommended that the FDA document all of its meetings with drug sponsors, establish a protocol for briefing documents and advisory committees, and update its guidance for how Alzheimer’s drugs are developed and reviewed.

    The committees also recommended that companies clearly communicate safety and efficacy concerns to the FDA and consider the value assessments made by outside experts when setting drug prices.

    “The American people rely on FDA for assurance on the safety and efficacy of the medications they take. The number of patients and families impacted by Alzheimer’s disease will continue to increase, and it is crucial that FDA and drug companies adhere to established procedures and conduct themselves with the transparency necessary to earn public trust,” the report says.

    The FDA said in a statement that its “decision to approve Aduhelm was based on our scientific evaluation of the data contained in the application, which is described in the approval materials.”

    The agency says it is reviewing the committees’ findings and recommendations and says its own review found that the interactions with Biogen were appropriate.

    “It is the agency’s job to frequently interact with companies in order to ensure that we have adequate information to inform our regulatory decision-making. We will continue to do so, as it is in the best interest of patients. That said, the agency has already started implementing changes consistent with the Committee’s recommendations.”

    Biogen said in a statement Thursday that it has been working “cooperatively” with the investigation.

    “Biogen has been committed to researching and developing treatments for Alzheimer’s disease for more than a decade. We have been focused relentlessly on innovation to address this global health challenge, and have adapted to both successes and setbacks,” it said. “Biogen stands by the integrity of the actions we have taken.”

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  • Language Barriers Hold Back Many Asian Americans From Good Health Care

    Language Barriers Hold Back Many Asian Americans From Good Health Care

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    By Cara Murez 

    HealthDay Reporter

    WEDNESDAY, Dec. 28, 2022 (HealthDay News) — Many Asian American and Native Hawaiian/Pacific Islander adults may have trouble accessing health care and insurance because of language barriers, a new analysis indicates.

    In a new report by the Urban Institute and supported by the Robert Wood Johnson Foundation, researchers found that more than 30% of people in this group had limited English proficiency in 2019. The rate was similar to that of Hispanic adults, but with more varied languages communication may be more challenging for this group.

    While most Hispanic adults in the United States speak Spanish, Asian American and Native Hawaiian/Pacific Islander (AANHPI) adults in those same circumstances speak a wide variety of languages and dialects.

    “These findings show the need for greater language accessibility for this group in health care settings and when enrolling in and renewing health insurance coverage — particularly as some pandemic-related health coverage protections expire,” said Jennifer Haley, a senior research associate at the Urban Institute.

    Haley noted that the White House Advisory Commission on Asian Americans, Native Hawaiians and Pacific Islanders is considering recommendations on accessibility for those in this community with limited English proficiency.

    “Despite stereotypes of some AANHPI people being a ‘model minority’ and not facing disadvantages, many in this community face several barriers that could reduce their access to health insurance,” Haley said in a Robert Wood Johnson news release.

    Other findings include that 15% of Asian American adults live in a household in which all members ages 14 and older report limited English proficiency.

    Rates of limited English proficiency vary among different AANHPI subgroups. For example, those rates are about 12% for Native Hawaiian/Pacific Islander adults, yet much higher, at 40%, for Chinese, Bangladeshi, Vietnamese, Nepalese and Burmese adults.
     

    Those who have limited English proficiency are more likely not to be U.S. citizens and to have lower incomes, less education and higher insurance rates than those proficient in English, the analysis found.

    “As health care systems identify and work to address systemic drivers of racial inequity, it’s clear that resources must be culturally appropriate and linguistically responsive to improve access to coverage and care for individuals with limited English proficiency,” said Gina Hijjawi, senior program officer at the Robert Wood Johnson Foundation.

    “State and federal officials must develop and target culturally and linguistically responsive resources to ensure that more people, including those with [limited English proficiency] have the opportunity to improve their health and the health of their communities,” Hijjawi said in the release.

    More information
     

    KFF has more on disparities in health and health care.

     

    SOURCE: Robert Wood Johnson Foundation, news release, Dec. 13, 2022

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  • Millions suffer from long Covid — and it costs them $9,000 a year in health-care expenses, on average

    Millions suffer from long Covid — and it costs them $9,000 a year in health-care expenses, on average

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    The Covid-19 unit at United Memorial Medical Center in north Houston.

    Carolyn Cole | Los Angeles Times | Getty Images

    Long Covid has affected as many as 23 million Americans to date — and it’s poised to have a financial impact rivaling or exceeding that of the Great Recession. By one estimate, the chronic illness will cost the U.S. economy $3.7 trillion, with extra medical costs accounting for $528 billion.

    Costs on a household and national scale are tough to quantify because the illness — also known as long-haul Covid, post-Covid or post-acute Covid syndrome — is so new. Anyone with a prior Covid-19 infection is susceptible, regardless of factors such as age, health or vaccine status.

    Symptoms, which number in the hundreds, can range from mild to severe and may persist for months or even years.

    David Cutler, an economist at Harvard University who projected the $3.7 trillion economic cost of long Covid, estimates the individual medical costs of the disease to be about $9,000 a year, on average. However, typical costs can range from roughly $3,700 up to almost $14,000, Cutler said.

    More from Your Health, Your Money

    Here’s a look at more stories on the complexities and implications of long Covid:

    Costs can be much higher, depending on the severity of illness. And because symptoms often impact a person’s ability to work, someone suffering from long Covid may not be able to lean on a regular paycheck — or employer-sponsored health insurance — to help cover those medical bills.

    Cutler’s financial estimate draws on prior research into treatment for myalgic encephalomyelitis, a condition also known as chronic fatigue syndrome, or ME/CFS.

    Dr. Greg Vanichkachorn, medical director of the Mayo Clinic’s Covid Activity Rehabilitation Program, said those estimates are the best approximation right now, since treatment and evaluation for long Covid are similar to those for ME/CFS. There is no cure or approved treatment for ME/CFS; as with long Covid, patient symptoms are merely treated or managed.

    “I think it is important to note that this, again, is an estimate,” Vanichkachorn said. “As new treatment measures come out, things could get more expensive or, hopefully, more affordable.”

    “That’s the nature of the word ‘long-haul’ — it can be an open box of costs for a while,” Vanichkachorn said.

    ‘People are trying all sorts of treatments’

    Getting an official long Covid diagnosis can be challenging, which can compound early expenses.

    The afflicted may undergo a battery of tests to rule out other ailments, for example. Or doctors may refer patients to specialists for treatment if they’re unfamiliar with long Covid or unwilling to entertain it as a possibility.

    Medical professionals typically treat infectious disease by identifying the invasive organism and attacking it. But that’s not what’s happening with long Covid.

    Instead, doctors treat symptoms of the disease, not the disease itself, said Dr. Jeff Parsonnet, an infectious disease physician who started the Post-Acute Covid Syndrome clinic at Dartmouth Hitchcock Medical Center.

    Some of the most common long Covid symptoms include fatigue, post-exertional malaise, chronic pain, cognitive dysfunction (also known as “brain fog”), neurological tremors, depression, anxiety and cardiac or pulmonary impairment, according to the U.S. Department of Health and Human Services. Long Covid can also cause other chronic conditions such as diabetes, myalgic encephalomyelitis or chronic fatigue syndrome and heart disease, HHS said.

    Treatment is more about symptom management: If a patient experiences fatigue, doctors may recommend physical therapy; if pain, then pain medication; if brain fog, perhaps speech or occupational therapy; if depression or insomnia, perhaps sleep studies, counseling or psychiatric evaluation.

    “The real difficulty in treating patients with long Covid is, we don’t know what causes it,” Parsonnet said. “People are trying all sorts of treatments, but it’s guesswork at this point.

    “They don’t cure anything, but they help people cope better,” he said, describing the treatments as “labor intensive and expensive.”

    Health insurance is essential — if you can get it

    Health insurance may cover some or most expenses associated with diagnosis and treatment — that is, for those who have it.

    Here’s what that looks like for three patients with long Covid:

    Uninsured and weighing specialist visits against rent

    Rosa Santana

    Source: Julia Santana

    Rosa Santana, 56, is a self-employed yoga instructor in south Florida. She doesn’t have health insurance, and so she can’t afford to visit specialists, despite feeling like she’s “been living in a different body” since a Covid infection in May 2020.

    “Every time I go somewhere, I know it’s going to be $300 or $400, and [I wonder], ‘Will I make my rent?’” Santana said of doctor visits.

    Yoga used to be a form of health care for her. Now, it doesn’t offer the relief it used to; doing a headstand can cause heart palpitations and dizziness for days afterward.

    Long Covid has impacted Santana’s ability to work, and her income stream to cover any medical bills. Before, she was like the “Energizer bunny”; now, she schedules two private yoga sessions with clients and it’s “time to rest,” she said.

    Hitting annual out-of-pocket max with a single infusion

    Donna Pohl

    Source: Donna Pohl

    Donna Pohl hits her insurance plan’s yearly out-of-pocket maximum — about $3,500 — after just one infusion for common variable immunodeficiency, or CVID.

    Pohl, 56, was healthy before a severe case of Covid, for which she was hospitalized in fall 2021. Now, CVID — a complication resulting from long Covid — puts her at increased risk of infections. Without insurance, Pohl would pay more than $10,000 for each infusion; she needs them monthly.  

    Pohl, who lives in Bettendorf, Iowa, has a roster of 10 doctors, including a primary care physician and nine specialists.

    In early 2022, she was diagnosed with Mast Cell Activation Syndrome, a disease that causes severe allergic reactions. She’s had pneumonia three times in a year. Pohl falls often due to “neuropathy,” a type of nerve damage; she ruptured a ligament in her left hand in a recent fall and needs surgery to repair it.  

    “I’m a year out, and I’m still getting new symptoms,” she said.

    Pohl, a nurse practitioner at a hospital, counts herself lucky in one sense: She can’t work her grueling emergency-room shifts right now, but the hospital kept her job (and her employer-sponsored health insurance) intact.

    I’m a year out, and I’m still getting new symptoms

    Donna Pohl

    nurse practitioner

    Without insurance coverage, costs for Pohl’s 156 medical claims through October this year would have amounted to more than $114,000, records show.

    Like many who suffer from long Covid, Pohl seeks relief from crippling symptoms wherever it’s available.

    That means she pays about $300 to $400 a month, on average, for many supplements and therapies that aren’t covered by insurance: chiropractic work, nutrition consultations and hyperbaric oxygen, which has “by far” been the best treatment, she said.

    She lives on 60% of her prior income from a long-term disability insurance policy — which, in the best-case scenario, will continue until early 2024.

    COBRA coverage and a $4,000 deductible

    Sam Norpel and her family. Norpel, 48, second from the right, got Covid-19 in December 2021 and hasn’t recovered. This chronic illness, known as long Covid, impacts up to 23 million Americans.

    Kirstie Donohue

    Sam Norpel, 48, lost her job in June. Debilitating symptoms — including unpredictable bouts of broken speech, cognitive issues, chronic fatigue and severe migraines with prolonged screen time — made it impossible for the former e-commerce executive to keep working.

    Norpel, who lives outside Philadelphia, was able to negotiate that the employer pay her COBRA premiums for a year so she could keep her employer-sponsored health insurance.

    Even with the health plan, the family paid roughly $4,000 out of pocket to hit the plan’s annual deductible. Norpel’s husband, who’d been out of work to care for their kids, is planning to return to the labor force partly to avoid losing workplace health coverage.

    ‘People … do get better,’ but it’s hard to see specialists

    There are nearly 250 post-Covid clinics in the U.S., according to Survivor Corps data as of early November. (A provider with multiple physical clinics is only counted once.) The list is growing steadily: There were 178 in January.

    Even so, skyrocketing demand for specialists to treat long Covid means the afflicted can spend up to a year waiting for an appointment, according to the U.S. Department of Health and Human Services.

    Norpel reached out to the Mayo Clinic in April, but the next available consultation was about four months later, in August.

    That’s the nature of the word ‘long-haul’ — it can be an open box of costs for a while.

    Dr. Greg Vanichkachorn

    medical director of the Mayo Clinic’s Covid Activity Rehabilitation Program

    An additional hurdle: She also had to pay her way to get there — a hotel room for a week and round-trip airfare from Pennsylvania to Minnesota. She also can’t get a follow-up appointment with a neurologist until February next year.

    “There are so many of us now that it’s taking months to see professionals,” she said of long Covid patients.

    When it comes to treatment, however, time is of the essence. Early intervention — generally less than four months from infection — has yielded better outcomes for patients, Vanichkachorn said.

    “Despite all the doom and gloom out there, people actually do get better,” he said.

    Patients at his clinic typically return to their normal, baseline function four to six months after treatment starts, he explained.

    New study raises serious concerns over long Covid impact

    Time alone generally doesn’t cure long Covid symptoms; it often requires some form of rehabilitation. Months of low activity can lead to serious physical deconditioning, compounding patients’ malaise. Physical and occupational rehab helps strengthen muscles and aids patients in reframing their daily lives as they recover, Vanichkachorn said.

    “People are really sick of being sick,” he said. “They try to push themselves way too hard. “It’s really difficult to tell people we have to go slower, and that’s the only way we can get you better as fast as you can.”

    Treatment delays can have broader financial impacts, too. Patients are more likely to be denied financial assistance from disability insurance without a diagnosis and certifications from specialists, HHS said. They may also face more challenges requesting workplace accommodations.

    Despite slow progress, patients and medical experts remain optimistic. The U.S. government has more than 72 active long Covid research programs in place, according to HHS. One of them, the RECOVER initiative, led by the National Institutes of Health, has about 7,000 patients enrolled at clinical sites. The CDC’s Innovative Support For Patients with SARS-CoV-2 Infections (or, INSPIRE) is enrolling up to 6,000 adults.

    “The scale of long Covid morbidity and the breadth of its clinical manifestations represent an unprecedented, but not insurmountable, challenge,” according to the HHS’ National Research Action Plan on Long COVID.

    The research is still in its early stages, Vanichkachorn said.

    “We may have a brand-new treatment regimen two months from now and people can get suddenly get better,” he said.

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  • Divided government is more productive than you think | CNN Politics

    Divided government is more productive than you think | CNN Politics

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    A version of this story appeared in CNN’s What Matters newsletter. To get it in your inbox, sign up for free here.



    CNN
     — 

    Now that CNN has projected Republicans will win the House of Representatives, it’s time to consider a Washington where both parties have some control.

    Despite underperforming on Election Day, the GOP gains will have a major impact on what’s accomplished in the coming two years.

    Additional climate change policy? Don’t count on it. National abortion legislation? Not a chance. Voting rights? Not likely.

    Plus, Republicans have indicated they will use any leverage they can find – including the debt ceiling – to force spending cuts.

    While you might immediately think this is all a recipe for a stalemate in Washington, I was surprised to read the argument, backed up by research, that the US government actually overperforms during periods of divided government.

    Those periods are coming more and more frequently, by the way. While there used to be relatively long periods of a decade or more during which one party controlled all of Washington, recent presidents have lost control of the House.

    Barack Obama, Donald Trump and George W. Bush each saw their party lose the House. President Joe Biden will join that club.

    The two Republicans in the ’80s and ‘90s – Ronald Reagan and George H.W. Bush – both had productive presidencies and never enjoyed a sympathetic congressional majority. The last president to enjoy unified government throughout his presidency was Democrat Jimmy Carter, and voters did not look very kindly on him in the final analysis.

    What’s below are excerpts from separate phone conversations conducted before the midterm election with Frances Lee and James Curry, authors of the 2020 book, “The Limits of Party: Congress and Lawmaking in a Polarized Era.” Lee is a professor of politics and public affairs at Princeton University, and Curry is a political science professor at the University of Utah. What led me to them was their 2020 argument that divided government overperforms and unified government underperforms expectations.

    What should Americans know about divided government?

    LEE: It’s the normal state of affairs in our politics in the modern era. Since 1980, something like two-thirds of the time we’ve had a divided government.

    And yet you think about all the things that government has undertaken in the years since the Second World War. The role and scope of the US government is so much greater now than it was then. And a lot of that happened in divided government. Most of that has been under divided government time. …

    Unified government usually results in disappointment for the party in power, which is just exactly what we’ve seen here in (this) Congress. Democrats were unable to deliver on their bold agenda, and that’s not different than what Republicans faced when they had unified government and couldn’t pass repeal and replace of Obamacare.

    Now hold on. Republicans passed a massive tax cut bill with unified government. Democrats passed the Affordable Care Act and the Inflation Reduction Act, which included spending to address climate change. Those are the major accomplishments of recent years, no?

    CURRY: I think we’re making a mistake when we say that those are the three biggest things that have happened. For instance, earlier you talked about the American Rescue Plan (another Covid relief bill passed with only Democratic support) – it is not as significant as the CARES Act, which was the first major Covid relief legislation passed by Congress. It passed in March of 2020, and it passed on an overwhelming bipartisan basis.

    A lot of what was included in the American Rescue Plan were things that were initially set out under the CARES Act. Arguably the CARES Act was the single most important legislative accomplishment that we’ve had in this country in several decades.

    And there are other examples too … things like criminal justice reform that was passed with bipartisan support in 2018, and many others things that are just as significant from a public policy standpoint, including also the bipartisan infrastructure bill that Congress passed last year.

    They don’t have as much political significance, foremost because they were passed on a single-party basis. But I don’t think you can make the case that they’re necessarily more significant in terms of policy consequences for the country.

    (In a follow-up email, Curry said that Congress often flies its bipartisanship accomplishments under the radar as part of larger bills, which means they don’t get as much attention. He pointed to big-ticket items that passed quietly in 2019 as part of larger spending bills, including raising the age to buy tobacco to 21, pushing through the first major pay raise for federal employees in years and repealing unpopular Obamacare taxes. He has similar examples for each recent year. But if they are not contentious, they get less attention, he said.)

    Your argument is counter to the current narrative of American politics – that parties enact more on their own. Is that a media problem? A partisanship problem?

    LEE: I’m still blown away by how much was done on Covid. Basically the United States government spent 75% more in 2020 than it spent in 2019. All that was Covid.

    You’re talking about New Deal levels of spending and yet people just didn’t even seem to notice it because it was done on a bipartisan basis. We basically had a universal basic income in response to Covid and all the small business aid – it’s just extraordinary – and yet, it just seemed to pass people by as though nothing important occurred.

    I don’t think it’s just a media story. The media wrote stories about the Covid aid bills, but it just didn’t capture people’s attention.

    And I think that’s because it didn’t cut in favor of or against either party. When you don’t have a story that drives a partisan narrative, most people are just not that interested in it. Most people that pay attention to politics are not that interested in it. It lacks a rooting interest.

    What about the big things that need action? Immigration reform has eluded Congress for decades and climate change is an existential threat. How can divided government be preferable if Congress can’t come together to address these problems?

    CURRY: I’m not saying divided government is preferable, which I think is important. I’m just saying it doesn’t make that big a difference on a lot of these issues.

    So we’ve seen that list of issues you just mentioned – climate change, immigration, etc. These are issues that Congress has equally struggled to take big, bold action on under divided or unified government.

    On climate change, for instance, Democrats want to do big, bold things, but they aren’t able to go as far as they want to, because not only are there disagreements between the parties on how to address climate change, there are disagreements among Democrats about the best way to address climate and environmental legislation.

    On immigration, you have clear divisions across party lines, but also divisions within each party.

    LEE: Congress can pass legislation spending money or cutting taxes. The problem is it’s difficult to do things that create backlash. It’s hard to do serious climate legislation without being prepared to accept a backlash.

    Isn’t this just a structural problem then? If there was no requirement for a filibuster supermajority, couldn’t a simple majority of lawmakers be more effective?

    LEE: On the two examples that you just put forward – on immigration and climate – the filibuster has not been the obstacle to recent efforts.

    In immigration reform that Republicans attempted to do (under Trump), they couldn’t get majorities in either the House or Senate. Democrats were way short of a Senate majority when they tried to do climate legislation under Obama. They barely got out of the House.

    (Curry and Lee’s research shows the filibuster is not the primary culprit standing in the way of four out of five of the priorities that parties have failed to enact since 1985.)

    CURRY: We found a more common reason why the parties fail on the things that can be accomplished is because they are unable to unify internally about what to do. The filibuster matters, but it is far from the most significant thing.

    But certainly the legislation that passes under divided government is different than what would have passed under a unified government. The parties must compromise more. Whether the government is unified or divided matters, right?

    CURRY: It makes a difference certainly for precisely what is in these final policy bills. It certainly makes a difference for the politics of the moment. It really makes a difference for each side of the aisle in terms of being able to say, we got this much done or that much done that matches my hopes and dreams as a Democrat or a Republican.

    But it’s just sort of an overstated story that unified government means big, bold things happen and divided government means they don’t.

    Wouldn’t Washington work better if one party was more easily able to deliver on its goals when voters gave it power?

    CURRY: Whether it would be better if we had a situation like you have in more parliamentary-style governments where a party takes control, they pass what they will and stand to voters, I think it’s just in the eye of the beholder.

    On one hand, potentially, yes, because it’s very clear and clean from a party responsibility or electoral responsibility standpoint, where parties pass things and then voters can hold them accountable or not. On the other hand, then you would see more wild swings in policy from election to election.

    Does the growing number of swings in power in Congress mean American voters consciously prefer divided government?

    CURRY: I don’t think that Americans necessarily have a preference for divided government. That’s something that people sometimes say. It sounds nice.

    But the reality is that roughly since the 1980s and early 1990s, it’s been the case that electoral margins are really tight – you have relatively even numbers of Americans that prefer Democrats and Republicans. And so from election to election, based on turnout and swings back and forth, you get this constant back and forth of our electoral politics where one party is in control for two to four years and then the other party is in control.

    That’s really important because it has massive implications for our politics. If you have a political system and political dynamic like we have today, where each party thinks they can constantly win back control or lose control of the House, the Senate and the presidency, it ups the stakes for every single decision that’s going to be made.

    Everything is considered through a lens of how will this affect our partisan fortunes in the next election, and that makes things just naturally more contentious.

    Can we agree that ours is not a very effective way to govern?

    CURRY: It is certainly the case that Congress does not pass every single thing that every person wants it to. But I don’t think that is ever true of any government. Nor do I think that’s a reasonable bar to set a government against.

    The reality is Congress does a lot of stuff and does a lot more than people give it credit for, but it also fails to take action on a lot of policies. I think that’s just politics. That’s just government. It’s not just an American problem, and it’s not just a facet of our specific political system.

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  • Ask Money Today: Can diabetes, hypertension or high BP lead to the rejection of your health insurance claim?

    Ask Money Today: Can diabetes, hypertension or high BP lead to the rejection of your health insurance claim?

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    Question: Is diabetes, hypertension or high BP, considered a pre-existing ailment? Can it lead to a rejection of claims for complications arising out of them? What happens if one didn’t know or didn’t have the condition at the time of buying the policy?

    Preeti, Mumbai

    Vivek Chaturvedi, CMO and Head of Direct Sales, Go Digit General Insurance

    Before buying a health insurance policy, it is imperative to understand the importance of disclosing your pre-existing conditions or diseases. Insurance works on the principle of utmost good faith and therefore, it is expected of the insured and the insurer to disclose all essential information before closing the transaction.

    Note that pre-existing diseases (PED) are conditions that exist at the time of buying a health insurance policy. High blood pressure, diabetes, asthma, hypertension etc., fall under PEDs and must be disclosed to the insurer when you are buying health insurance. Non-disclosure of PEDs can lead to a rejection of claims as most policies have a specific waiting period for existing diseases.

    Waiting periods for pre-existing conditions could range anywhere from 1-4 years. Despite declaring your PED, insurers could still choose to cover you, perhaps at a relatively higher premium (loading). However, if one fails to be transparent, the consequences could be as harsh as the cancellation of the policy altogether. Any claim arising out of an unrelated illness also could get repudiated if the PED is discovered at the time of the investigation.

    If you think you may have a PED, it’s advisable to get the relevant tests done and share the results with the insurer should you get diagnosed with a disease. This not only gives the insurer an opportunity to make necessary amends in the policy but also protects you from having your claims rejected.

    Further, if you get diagnosed with a disease after buying the policy and are hospitalised for the same, your insurer will accept the claim. Note that it is also not mandatory to disclose new diseases at the time of renewing the policy because all conditions except the exclusions in the policy will be covered. However, if you choose to disclose the PED at the time of renewal (which should’ve been done while buying the policy), then the insurer may either cancel the policy or apply some restrictions or a waiting period.

    Given the importance of health insurance in today’s day and age, it’s advisable to be transparent and disclose all details honestly instead of bearing the brunt of rejected claims or policy cancellations.

    (Views expressed by the investment expert are his/her own. E-mail us your investment queries at askmoneytoday@intoday.com. We will get your queries answered by our panel of experts)

    Also read: Ask Money Today: Will my lost luggage be covered under travel insurance and is there any time limit for filing the claim?

    Also read: Ask Money Today: How much maximum tax benefit can I claim on home loan?

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