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  • Notable US Supreme Court Decisions Fast Facts | CNN

    Notable US Supreme Court Decisions Fast Facts | CNN

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    CNN
     — 

    Here’s a look at some of the most important cases decided by the US Supreme Court since 1789.

    1803 – Marbury v. Madison
    This decision established the system of checks and balances and the power of the Supreme Court within the federal government.

    Situation: Federalist William Marbury and many others were appointed to positions by outgoing President John Adams. The appointments were not finalized before the new Secretary of State James Madison took office, and Madison chose not to honor them. Marbury and the others invoked an Act of Congress and sued to get their appointed positions.

    The Court decided against Marbury 6-0.

    Historical significance: Chief Justice John Marshall wrote, “An act of the legislature repugnant to the constitution is void.” It was the first time the Supreme Court declared unconstitutional a law that had been passed by Congress.

    1857 – Dred Scott v. Sandford
    This decision established that slaves were not citizens of the United States and were not protected under the US Constitution.

    Situation: Dred Scott and his wife Harriet sued for their freedom in Missouri, a slave state, after having lived with their owner, an Army surgeon, in the free Territory of Wisconsin.

    The Court decided against Scott 7-2.

    Historical significance: The decision overturned the Missouri Compromise, where Congress had prohibited slavery in the territories. The Dred Scott decision was overturned later with the adoption of the 13th Amendment, abolishing slavery in 1865 and the 14th Amendment in 1868, granting citizenship to all born in the United States.

    1896 – Plessy v. Ferguson
    This decision established the rule of segregation, separate but equal.

    Situation: While attempting to test the constitutionality of the Separate Car Law in Louisiana, Homer Plessy, a man of 1/8 African descent, sat in the train car for whites instead of the blacks-only train car and was arrested.

    The Court decided against Plessy 7-1.

    Historical significance: Justice Henry Billings Brown wrote, “The argument also assumes that social prejudice may be overcome by legislation and that equal rights cannot be secured except by an enforced commingling of the two races… if the civil and political rights of both races be equal, one cannot be inferior to the other civilly or politically. If one race be inferior to the other socially, the Constitution of the United States cannot put them upon the same plane.” The Court gave merit to the “Jim Crow” system. Plessy was overturned by the Brown v. Board of Education decision. In January 2022 Louisiana Governor John Bel Edwards granted a posthumous pardon to Homer Plessy. The pardon comes after the Louisiana Board of Pardons voted unanimously in November 2021 in favor of a pardon for Plessy, who died in his 60s in 1925.

    1954 – Brown v. Board of Education
    This decision overturned Plessy v. Ferguson and granted equal protection under the law.

    Situation: Segregation of the public school systems in the United States was addressed when cases in Kansas, South Carolina, Delaware and Virginia were all decided together under Brown v. Board of Education. Third-grader Linda Brown was denied admission to the white school a few blocks from her home and was forced to attend the blacks-only school a mile away.

    The Court decided in favor of Brown unanimously.

    Historical significance: Racial segregation violates the Equal Protection Clause of the 14th Amendment.

    1963 – Gideon v. Wainwright
    This decision guarantees the right to counsel.

    Situation: Clarence Earl Gideon was forced to defend himself when he requested a lawyer from a Florida court and was refused. He was convicted and sentenced to five years for breaking and entering.

    The Court decided in favor of Gideon unanimously.

    Historical significance: Ensures the Sixth Amendment’s guarantee to counsel is applicable to the states through the 14th Amendment’s due process clause.

    1964 – New York Times v. Sullivan
    This decision upheld the First Amendment rights of freedom of speech and freedom of the press.

    Situation: The New York Times and four African-American ministers were sued for libel by Montgomery, Alabama, police commissioner L.B. Sullivan. Sullivan claimed a full-page ad in the Times discussing the arrest of Martin Luther King Jr., and his efforts toward voter registration and integration in Montgomery were defamatory against him. Alabama’s libel law did not require Sullivan to prove harm since the ad did contain factual errors. He was awarded $500,000.

    The Court decided against Sullivan unanimously.

    Historical significance: The First Amendment protects free speech and publication of all statements about public officials made without actual malice.

    1966 – Miranda v. Arizona
    The decision established the rights of suspects against self-incrimination.

    Situation: Ernesto Miranda was convicted of rape and kidnapping after he confessed, while in police custody, without benefit of counsel or knowledge of his constitutional right to remain silent.

    The court decided in favor of Miranda 5-4.

    Historical significance: Upon arrest and/or questioning, all suspects are given some form of their constitutional rights – “You have the right to remain silent. Anything you say can and will be used against you in a court of law. You have the right to an attorney. If you cannot afford an attorney, one will be provided for you. Do you understand the rights I have just read to you? With these rights in mind, do you wish to speak to me?”

    1973 – Roe v. Wade
    This decision expanded privacy rights to include a woman’s right to choose pregnancy or abortion.

    Situation: “Jane Roe” (Norma McCorvey), single and living in Texas, did not want to continue her third pregnancy. Under Texas law, she could not legally obtain an abortion.

    The Court decided in favor of Roe 7-2.

    Historical significance: Abortion is legal in all 50 states. Women have the right to choose between pregnancy and abortion.

    1974 – United States v. Nixon
    This decision established that executive privilege is neither absolute nor unqualified.

    Situation: President Richard Nixon’s taped conversations from 1971 onward were the object of subpoenas by both the special prosecutor and those under indictment in the Watergate scandal. The president claimed immunity from subpoena under executive privilege.

    The Court decided against Nixon 8-0.

    Historical significance: The president is not above the law. After the Court ruled on July 24, 1974, Richard Nixon resigned on August 8.

    1978 – Regents of the U. of California v. Bakke
    This decision ruled that race cannot be the only factor in college admissions.

    Situation: Allan Bakke had twice applied for and was denied admission to the University of California Medical School at Davis. Bakke was white, male and 35 years old. He claimed under California’s affirmative action plan, minorities with lower grades and test scores were admitted to the medical school when he was not, therefore his denial of admission was based solely on race.

    The Court decided in Bakke’s favor, 5-4.

    Historical significance: Affirmative action is approved by the Court and schools may use race as an admissions factor. However, the Equal Protection Clause of the 14th Amendment works both ways in the case of affirmative action; race cannot be the only factor in the admissions process.

    2012 – National Federation of Independent Business et al v. Sebelius, Secretary of Health and Human Services et al

    Situation: The constitutionality of the sweeping health care reform law championed by President Barack Obama.

    The Court voted 5-4 in favor of upholding the Affordable Care Act.

    Historical significance: The ruling upholds the law’s central provision – a requirement that all people have health insurance or pay a penalty.

    2013 – United States v. Windsor
    This decision ruled that the Defense of Marriage Act, which defined the term “marriage” under federal law as a “legal union between one man and one woman” deprived same-sex couples who are legally married under state laws of their Fifth Amendment rights to equal protection under federal law.

    Situation: Edith Windsor and Thea Spyer were married in Toronto in 2007. Their marriage was recognized by New York state, where they lived. Upon Spyer’s death in 2009, Windsor was forced to pay $363,000 in estate taxes, because their marriage was not recognized by federal law.

    The court voted 5-4 in favor of Windsor.

    Historical significance: The court strikes down section 3 of the Defense of Marriage Act, ruling that legally married same-sex couples are entitled to federal benefits.

    2015 – King et al, v. Burwell, Secretary of Health and Human Services, et al

    Situation: This case was about determining whether or not the portion of the Affordable Care Act which says subsidies would be available only to those who purchase insurance on exchanges “established by the state” referred to the individual states.

    The Court ruled 6-3 in favor of upholding the Affordable Care Act subsidies.

    Historical significance: The court rules that the Affordable Care Act federal tax credits for eligible Americans are available in all 50 states, regardless of whether the states have their own health care exchanges.

    2015 – Obergefell et al, v. Hodges, Director, Ohio Department of Health, et al.

    Situation: Multiple lower courts had struck down state same-sex marriage bans. There were 37 states allowing gay marriage before the issue went to the Supreme Court.

    The Court ruled 5-4 in favor of Obergefell et al.

    Historical significance: The court rules that states cannot ban same-sex marriage and must recognize lawful marriages performed out of state.

    2016 – Fisher v. University of Texas

    Situation: Abigail Fisher sued the University of Texas after her admission application was rejected in 2008. She claimed it was because she is white and that she was being treated differently than some less-qualified minority students who were accepted. In 2013 the Supreme Court sent the case back to the lower courts for further review.

    The Court ruled 4-3 in favor of the University of Texas. Justice Elena Kagan recused herself from the case, presumably because she dealt with it in her previous job as solicitor general.

    Historical Significance: The court rules that taking race into consideration as one factor of admission is constitutional.

    2020 – Bostock v. Clayton County, Georgia

    Situation: Gerald Bostock filed a lawsuit against Clayton County for discrimination based on his sexual orientation after he was terminated for “conduct unbecoming of its employees,” shortly after he began participating in a gay softball league. Two other consolidated cases were also argued on the same day.

    The 6-3 opinion in favor of the plaintiff, written by Justice Neil Gorsuch and joined by Chief Justice John Roberts, states that being fired “merely for being gay or transgender violates Title VII” of the Civil Rights Act of 1964.

    Historical Significance: Federal anti-bias law now protects people who face job loss and/or discrimination based on their sexual orientation or gender identity.

    2022 – Dobbs v. Jackson Women’s Health Organization

    Situation: Mississippi’s Gestational Age Act, passed in 2018 and which greatly restricts abortion after 15 weeks, is blocked by two federal courts, holding that it is in direct violation of Supreme Court precedent legalizing abortion nationwide prior to viability, which can occur at around 23-24 weeks of pregnancy, and that in an “unbroken line dating to Roe v. Wade, the Supreme Court’s abortion cases have established (and affirmed and re-affirmed) a woman’s right to choose an abortion before viability.” The court said states may “regulate abortion procedures prior to viability” so long as they do not ban abortion. “The law at issue is a ban,” the court held. 

    Mississippi appeals the decision to the Supreme Court.

    The 6-3 opinion in favor of the plaintiff, written by Justice Samuel Alito states that “Roe was egregiously wrong from the start…Its reasoning was exceptionally weak, and the decision has had damaging consequences. And far from bringing about a national settlement of the abortion issue, Roe and Casey have enflamed debate and deepened division.”

    In a joint dissenting opinion, Justices Stephen Breyer, Sonia Sotomayor and Elena Kagan heavily criticized the majority, closing: “With sorrow – for this Court, but more, for the many millions of American women who have today lost a fundamental constitutional protection – we dissent.”

    Historical Significance: The ruling overturns Roe v. Wade and there is no longer a federal constitutional right to an abortion, leaving abortion rights to be determined by states.

    1944 – Korematsu v. United States – The Court ruled Executive Order 9066, internment of Japanese citizens during World War II, is legal, 6-3 for the United States.

    1961 – Mapp v. Ohio – “Fruit of the poisonous tree,” evidence obtained through an illegal search, cannot be used at trial, 6-3 for Mapp.

    1967 – Loving v. Virginia – Prohibition against interracial marriage was ruled unconstitutional, 9-0 for Loving.

    1968 – Terry v. Ohio – Stop and frisk, under certain circumstances, does not violate the Constitution. The Court upholds Terry’s conviction and rules 8-1 that it is not unconstitutional for police to stop and frisk individuals without probable cause for an arrest if they have a reasonable suspicion that a crime has or is about to occur.

    2008 – District of Columbia v. Heller – The Second Amendment does protect the individual’s right to bear arms, 5-4 for Heller.

    2010 – Citizens United v. FEC – The Court rules corporations can contribute to PACs under the First Amendment’s right to free speech, 5-4 for Citizens United.

    2023 – Students for Fair Admissions v. Harvard together with Students for Fair Admissions v. University of North Carolina – Colleges and universities can no longer take race into consideration as a specific basis in admissions. The majority opinion, written by Justice John Roberts, claims the court is not expressly overturning prior cases authorizing race-based affirmative action and suggests that how race has affected an applicant’s life can still be part of how their application is considered.

    2024 – Donald J. Trump v. Norma Anderson, et al – The Court rules former President Donald Trump should appear on the ballot in Colorado in a decision that follows months of debate over whether Trump violated the “insurrectionist clause” included in the 14th Amendment.

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  • Georgia is now the only state with work requirements in Medicaid | CNN Politics

    Georgia is now the only state with work requirements in Medicaid | CNN Politics

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    CNN
     — 

    Georgia is now the only state in the US to implement work requirements in its Medicaid program – a feat many Republican lawmakers nationwide will be closely monitoring.

    But unlike GOP-led states’ prior attempts to impose work mandates in Medicaid, Georgia’s effort is expected to increase the number of people with health insurance, rather than strip coverage away from an untold number of low-income residents. That allowed it to pass muster in court, though critics still deride the program as complicated, ineffective and expensive.

    Pathways to Coverage, which began July 1, comes as House Republicans in Congress are pushing to expand work requirements in the nation’s safety net programs, particularly Medicaid and food stamps.

    There is no federal work mandate in Medicaid, but 13 states received permission during the Trump administration to require existing enrollees to work, volunteer or meet other criteria to retain their health insurance. In Arkansas, the only state that implemented work requirements and terminated coverage, more than 18,000 people were disenrolled in 2018 before its waiver was voided by a federal court.

    States paused their initiatives because of litigation or the Covid-19 pandemic, and then the Biden administration withdrew the waiver approvals. But Georgia challenged the withdrawal, and a federal judge ruled in the state’s favor in August 2022, allowing it to implement Pathways to Coverage.

    Georgia has among the nation’s strictest eligibility requirements for Medicaid. It is one of 10 states that has not expanded the program to all low-income adults under the Affordable Care Act. Parents only qualify if they make less than 31% of the federal poverty level for a family of three – or about $7,700 this year, according to KFF, a health policy research organization.

    Under Pathways to Coverage, adults making up to 100% of the federal poverty level – about $14,600 for an individual – can enroll if they work, participate in job training or community service, take higher education classes or meet other criteria for at least 80 hours a month.

    “In our state, we want more people to be covered at a lower cost with more options for patients,” Gov. Brian Kemp said in his State of the State address in January.

    Just how many people are expected to gain coverage varies. In his speech, Kemp said up to 345,000 Georgians are potentially eligible for the program, while the state Department of Community Health said the state has budgeted for an estimated enrollment of 100,000 residents in the first year.

    Interest in the program is continuing to grow, said the department, which is working with insurers, community groups and others to get the word out.

    Others, however, estimate far fewer people will gain coverage. The state funds allotted for the program in the current fiscal year will allow about 47,500 to enroll, according to the Georgia Budget and Policy Institute, a left-leaning advocacy group.

    Fully expanding Medicaid would cover far more people and at a lower cost to the state, said Leah Chan, the institute’s director of health justice. Some 482,000 Georgians earning up to 138% of the federal poverty level – or about $20,100 for an individual – could gain coverage.

    Also, the federal government covers a larger share of the costs of the full expansion enrollees and would temporarily provide a boost in federal funding for existing traditional Medicaid participants under a provision of the American Rescue Plan Act aimed at enticing holdout states to expand.

    If Georgia fully expanded Medicaid, each newly eligible enrollee would cost the state about $496, Chan said. But under Pathways to Coverage, each will cost $2,490 because the program does not qualify for the enhanced federal match.

    “It doesn’t make sense for us to implement a program that’s going to cover fewer people at a higher cost when we have an option that could close the coverage gap and draw down millions and millions – some estimates say billions – in federal dollars,” Chan said.

    Plus, it could be tough for low-income residents, particularly those in rural areas of the state where many of the uninsured live, to work enough hours consistently to qualify, she said. And those who do may get tripped up in submitting the necessary monthly documentation.

    Another issue: There are no exemptions for parents of dependent children or other caregivers, said Joan Alker, executive director of the Center for Children and Families at Georgetown University. Other states that sought to implement work requirements during the Trump administration had such exemptions.

    “A small number of people may get coverage, but the likelihood of them retaining that coverage for a while is not very high,” Alker said. “And this is an especially problematic structure for parents.”

    Georgia officials, however, say Pathways to Coverage is the right program for the state.

    “This approach is Georgia-centric and ensures we can expand Medicaid coverage to those who were previously ineligible without forcing others off their preferred private insurance,” the state Department of Community Health said in a statement to CNN. “Unlike the top-down approach of traditional Medicaid expansion, Georgia Pathways was developed by Georgians and is run by Georgians to address our state’s specific needs.”

    This story has been updated with additional information.

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  • YouTube to prohibit false claims about cancer treatments under its medical misinformation policy | CNN Business

    YouTube to prohibit false claims about cancer treatments under its medical misinformation policy | CNN Business

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    New York
    CNN
     — 

    YouTube announced Tuesday that it will start removing false claims about cancer treatments as part of an ongoing effort to build out its medical misinformation policy.

    Under the updated policy, YouTube will prohibit “content that promotes cancer treatments proven to be harmful or ineffective, or content that discourages viewers from seeking professional medical treatment,” Dr. Garth Graham, head of YouTube Health, said in a blog post Tuesday.

    “This includes content that promotes unproven treatments in place of approved care or as a guaranteed cure, and treatments that have been specifically deemed harmful by health authorities,” he said, such as the misleading claim that patients should “take vitamin C instead of radiation therapy.”

    The update is just one of several steps YouTube has made in recent years to build out its medical misinformation policy, which also prohibits false claims about vaccines and abortions, as well as content that promotes or glorifies eating disorders.

    As part of the announcement, YouTube is rolling out a broader updated medical misinformation policy framework that will consider content in three categories: prevention, treatment and denial.

    “To determine if a condition, treatment or substance is in scope of our medical misinformation policies, we’ll evaluate whether it’s associated with a high public health risk, publicly available guidance from health authorities around the world, and whether it’s generally prone to misinformation,” Graham said. He added that YouTube will take action on content that falls into that framework and “contradicts local health authorities or the World Health Organization.”

    Graham said the policy is designed to preserve “the important balance of removing egregiously harmful content while ensuring space for debate and discussion.”

    Cancer treatment fits YouTube’s updated medical misinformation framework because the disease poses a high public health risk and is a topic prone to frequent misinformation, and because there is “stable consensus about safe cancer treatments from local and global health authorities,” Graham said.

    As with many social media policies, however, the challenge often isn’t introducing it but enforcing it. YouTube says its restrictions on cancer treatment misinformation will go into effect on Tuesday and enforcement will ramp up in the coming weeks. The company has previously said it uses both human and automated moderation to review videos and their context.

    YouTube also plans to promote cancer-related content from the Mayo Clinic and other authoritative sources.

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  • Lawsuit seeks to halt Medicaid terminations in Florida | CNN Politics

    Lawsuit seeks to halt Medicaid terminations in Florida | CNN Politics

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    CNN
     — 

    Two consumer advocacy groups filed a lawsuit in a Florida federal court Tuesday seeking to halt the state’s termination of residents’ Medicaid benefits.

    The suit is the first in the nation to challenge states’ resumption of reviewing Medicaid enrollees’ eligibility and dropping those deemed no longer qualified. The process, which Congress had suspended for three years during the Covid-19 pandemic, restarted as early as April, depending on the state.

    The Florida Health Justice Project and the National Health Law Program filed the lawsuit on behalf of three Floridians in US District Court in Jacksonville against the state’s Agency for Health Care Administration and the Department of Children and Families. The residents are a 25-year-old woman and her 2-year-old daughter, who has cystic fibrosis, as well as a 1-year-old girl.

    The plaintiffs argue that the notices the agencies are sending to inform enrollees that they are no longer eligible are confusing and don’t provide sufficient explanation as to why they are losing coverage.

    “As a result, Plaintiffs and class members are losing Medicaid coverage without meaningful and adequate notice, leaving them unable to understand the agency’s decision, properly decide whether and how to contest their loss of Medicaid coverage, or plan for a smooth transition of coverage that minimizes disruptions in necessary care,” the complaint reads. “Without Medicaid coverage, Plaintiffs are unable to obtain care they need, including prescription drugs, children’s vaccinations, and post-partum care.”

    The advocates are asking the court to require the state to stop terminating enrollees until the agencies provide adequate notice and an opportunity for a pre-termination fair hearing.

    Mallory McManus, deputy chief of staff for the Department of Children and Families, called the lawsuit “baseless.” While she said the state cannot comment on pending litigation, she said the letters to recipients are “legally sufficient.”

    The federal Centers for Medicare and Medicaid Services “approved the Department’s redetermination plan based on their regulations. There are multiple steps in the eligibility determination process and the final letter is just one of multiple communications from the Department,” said McManus, adding that the agency “continues to lead on Medicaid determinations and being fiscally responsible.”

    The Agency for Health Care Administration did not immediately return a request for comment.

    Nearly 183,000 Floridians have been issued notices saying they no longer qualify for Medicaid, according to the lawsuit. Hundreds of thousands more will have their coverage reviewed in the coming year.

    In addition to those determined ineligible, nearly 226,000 were dropped for so-called procedural reasons, typically because enrollees did not complete the renewal application, according to KFF, formerly the Kaiser Family Foundation. This often happens because it may have been sent to an old address, it was difficult to understand or it wasn’t returned by the deadline.

    Nearly 898,000 Florida residents have had their coverage renewed, according to KFF.

    Nationwide, more than 5.2 million people have been disenrolled since the so-called Medicaid unwinding began in the spring, according to KFF. Nearly three-quarters of those who have lost coverage were dropped for procedural reasons.

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  • Two hospitals under federal investigation over care of pregnant woman who was refused abortion | CNN

    Two hospitals under federal investigation over care of pregnant woman who was refused abortion | CNN

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    CNN
     — 

    The Centers for Medicare and Medicaid Services is investigating two hospitals that “did not offer necessary stabilizing care to an individual experiencing an emergency medical condition, in violation of the Emergency Medical Treatment and Labor Act (EMTALA),” according to a letter from US Health and Human Services Secretary Xavier Becerra.

    Under EMTALA, health care professionals are required to “offer treatment, including abortion care, that the provider reasonably determines is necessary to stabilize the patient’s emergency medical condition,” Becerra said Monday in his letter to national hospital and provider associations.

    The National Women’s Law Center, which said in a statement that it filed the initial EMTALA complaint on behalf of Mylissa Farmer, identified the hospitals as Freeman Hospital West of Joplin, Missouri, and the University of Kansas Health System in Kansas City, Kansas.

    The patient was nearly 18 weeks pregnant when she had a preterm premature rupture of membranes, Becerra wrote, but she was told that her pregnancy wasn’t viable.

    “Although her doctors advised her that her condition could rapidly deteriorate, they also advised that they could not provide her with the care that would prevent infection, hemorrhage, and potentially death because, they said, the hospital policies prohibited treatment that could be considered an abortion,” Becerra wrote.

    Becerra added in a statement Monday, “fortunately, this patient survived. But she never should have gone through the terrifying ordeal she experienced in the first place. We want her, and every patient out there like her, to know that we will do everything we can to protect their lives and health, and to investigate and enforce the law to the fullest extent of our legal authority.”

    Abortion is banned in Missouri, with limited exceptions, such as to save the mother’s life. State law requires counseling and a 72-hour waiting period. In Kansas, abortion is generally banned at or after 22 weeks of pregnancy, with a 24-hour waiting period and counseling required.

    Passed in 1986, EMTALA requires that hospitals provide stabilizing treatment to patients who have emergency medical conditions, or transfer them to facilities where such care will be provided, regardless of any conflicting state laws or mandates.

    Changes to state laws in the wake of the US Supreme Court decision that overturned the right to an abortion have left many hospitals and providers uncertain or confused about the steps they can legally take in such cases. HHS issued guidance last year reaffirming that EMTALA requires providers to offer stabilizing care in emergency cases, which might include abortion.

    Hospitals found to be in violation of EMTALA could lose their Medicare and Medicaid provider agreements and could face civil penalties. An individual physician could also face civil penalties if they are found to be in violation.

    HHS may impose a $119,942 fine per violation for hospitals with more than 100 beds and $59,973 for hospitals with fewer than 100 beds. A physician could face a $119,942 fine per violation.

    The National Women’s Law Center says the new actions are the first time since Roe v. Wade was overturned that EMTALA has been enforced against a hospital that denied emergency abortion care.

    “The care provided to the patient was reviewed by the hospital and found to be in accordance with hospital policy,” the University of Kansas Health System said in a statement to CNN. “It met the standard of care based upon the facts known at the time, and complied with all applicable law. There is a process with CMS for this complaint and we respect that process. The University of Kansas Health System follows federal and Kansas law in providing appropriate, stabilizing, and quality care to all of its patients, including obstetric patients.”

    Freeman Hospital did not immediately respond to CNN’s request for comment.

    An HHS spokesperson told CNN that both hospitals are working toward coming into compliance with the law.

    In the law center’s statement, Farmer said she was pleased with the investigations, “but pregnant people across the country continue to be denied care and face increased risk of complications or death, and it must stop. I was already dealing with unimaginable loss and the hospitals made things so much harder. I’m still struggling emotionally with what happened to me, but I am determined to keep fighting because no one should have to go through this.”

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  • Federal judge says insurers no longer have to provide some preventive care services, including cancer and heart screenings, at no cost | CNN Politics

    Federal judge says insurers no longer have to provide some preventive care services, including cancer and heart screenings, at no cost | CNN Politics

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    CNN
     — 

    A federal judge in Texas said Thursday that some Affordable Care Act mandates cannot be enforced nationwide, including those that require insurers to cover a wide array of preventive care services at no cost to the patient, including some cancer, heart and STD screenings, and tobacco programs.

    In the new ruling, US District Judge Reed O’Connor struck down the recommendations that have been issued by the US Preventive Services Task Force, which is tasked with determining some of the preventive care treatments that Obamacare requires to be covered.

    The decision applies to task force recommendations issued on or after March 23, 2010 – the day the Affordable Care Act was signed into law. While the group had recommended various preventive services prior to that date, nearly all have since been updated or expanded.

    O’Connor’s ruling comes after the judge had already said that the task force’s recommendations violated the Constitution’s Appointments Clause. The judge also deemed unlawful the ACA requirement that insurers and employers offer plans that cover HIV-prevention measures such as PrEP for free.

    Other preventive care mandates under the ACA remain in effect.

    The full extent of the ruling’s impact and when its effects could be felt are unclear.

    It is likely the case will be appealed, and the Justice Department has the option to ask that O’Connor’s ruling be put on pause while the appeal is litigated.

    The Justice Department did not immediately respond to a CNN request for comment, nor did the US Department of Health and Human Services.

    White House spokesperson Karine Jean-Pierre called the case “yet another attack on the Affordable Care Act” and said that DOJ and HHS were reviewing Thursday’s ruling.

    The decision, in a case brought by employers and individuals in Texas, represents the latest legal affront to the landmark 2010 health care law. It is unclear what immediate practical effect O’Connor’s new ruling will have for those with job-based and Affordable Care Act policies because insurance companies will likely continue no-cost coverage for the remainder of the contracts even though the Obamacare requirements in question have been blocked. Contracts often last one calendar year.

    O’Connor’s Thursday ruling is expected to kick off a new phase of the legal battle over Obamacare’s preventive care measures. The judge rejected other claims that the ACA’s foes brought against the law – including challenges to the entities that determine no-cost coverage mandates for vaccines, an assortment of women’s health preventive care treatments, and services for infants and children. It’s possible that the plaintiffs appeal those aspects of O’Connor’s handling of the case, which could put at risk coverage requirements for additional preventive services at no cost.

    A lawyer for the challengers did not respond to CNN’s inquiry about Thursday’s decision.

    O’Connor is a George W. Bush-appointee who sits in the Northern District of Texas and who has issued anti-Obamacare rulings in major challenges to the law in the past. An appeal of the current case would head to the 5th US Circuit Court of Appeals, perhaps the most conservative federal appeals court in the country.

    While the case does not pose the existential threat to the Affordable Care Act that previous legal challenges did, legal experts say that O’Connor’s ruling nonetheless puts in jeopardy the access some Americans will have to a whole host of preventive treatments.

    “We lose a huge chunk of preventive services because health plans can now impose costs,” said Andrew Twinamatsiko, associate director of the O’Neill Institute for National and Global Health Law at Georgetown University. “People who are sensitive to cost will go without, mostly poor people and marginalized communities.”

    Thursday’s ruling, if left standing, could have significant consequences for Americans nationwide by limiting access to key preventive services aimed at early detection of diseases, including lung and colorectal cancer, depression and hypertension.

    Some of the US Preventive Services Task Force’s recommendations – including lung and skin cancer screenings, the use of statins to prevent cardiovascular disease and the offer of PrEP for those at high risk of HIV – were issued after the ACA’s enactment.

    Certain older recommendations have been updated with new provisions, such as screening adults ages 45 to 49 for colorectal cancer.

    “It would effectively lock in place coverage of evidence-based prevention with no cost sharing from 13 years ago,” said Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation.

    Some of the cost-sharing for these preventive services can be substantial. PrEP, for instance, can cost up to $20,000 a year, plus lab and provider charges, according to Kaiser.

    In an earlier ruling, the judge upheld certain free preventive services for children, such as autism and vision screenings and well-baby visits, and for women, such as mammograms, well-woman visits and breastfeeding support programs.

    O’Connor also upheld the mandate that provides immunizations at no charge for the flu, hepatitis, measles, shingles and chickenpox.

    These services are recommended by the Health Resources and Services Administration and the Advisory Committee on Immunization Practices.

    Insurers will have to continue to cover preventive and wellness services since they are one of the Affordable Care Act’s required essential health benefits. But under O’Connor’s ruling, they could require patients to pick up part of the tab.

    Insurers’ trade associations stressed there would be no immediate disruption to coverage.

    “It is vitally important for patients to know that their care and coverage will not change because of today’s court decision,” said David Merritt, senior vice president of policy and advocacy for the Blue Cross Blue Shield Association. “Blue Cross and Blue Shield companies strongly encourage their members to continue to access these services to promote their continued well-being. We will continue to monitor further developments in the courts.”

    More than 150 million people with private insurance can receive preventive services without cost-sharing under the Affordable Care Act, according to a 2022 report published by HHS.

    Overall, about 60% of the 173 million people enrolled in private health coverage used at least one of the ACA’s no-cost preventive services in 2018 prior to the Covid-19 pandemic, according to a recent Kaiser analysis. These include some services that will continue to be available at no charge under the judge’s ruling.

    The most commonly received preventive care includes vaccinations, not including Covid-19 vaccines, well-woman and well-child visits, and screenings for heart disease, cervical cancer, diabetes and breast cancer, according to Kaiser. The most commonly used preventive services will continue to be covered at no cost.

    Studies have shown the Obamacare mandate prompted an uptake in preventive services and narrowed care disparities in communities of color.

    “There’s plenty of evidence that people responded to this incentive and started using preventive care more often,” said Paul Shafer, assistant professor of health policy at Boston University.

    This story has been updated with additional details.

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  • Why is it difficult for children to get a bed at pediatric hospitals? It’s more complicated than you think | CNN

    Why is it difficult for children to get a bed at pediatric hospitals? It’s more complicated than you think | CNN

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    CNN
     — 

    Effie Schnacky was wheezy and lethargic instead of being her normal, rambunctious self one February afternoon. When her parents checked her blood oxygen level, it was hovering around 80% – dangerously low for the 7-year-old.

    Her mother, Jaimie, rushed Effie, who has asthma, to a local emergency room in Hudson, Wisconsin. She was quickly diagnosed with pneumonia. After a couple of hours on oxygen, steroids and nebulizer treatments with little improvement, a physician told Schnacky that her daughter needed to be transferred to a children’s hospital to receive a higher level of care.

    What they didn’t expect was that it would take hours to find a bed for her.

    Even though the respiratory surge that overwhelmed doctor’s offices and hospitals last fall is over, some parents like Schnacky are still having trouble getting their children beds in a pediatric hospital or a pediatric unit.

    The physical and mental burnout that occurred during the height of the Covid-19 pandemic has not gone away for overworked health care workers. Shortages of doctors and technicians are growing, experts say, but especially in skilled nursing. That, plus a shortage of people to train new nurses and the rising costs of hiring are leaving hospitals with unstaffed pediatric beds.

    But a host of reasons building since well before the pandemic are also contributing. Children may be the future, but we aren’t investing in their health care in that way. With Medicaid reimbursing doctors at a lower rate for children, hospitals in tough situations sometimes put adults in those pediatric beds for financial reasons. And since 2019, children with mental health crises are increasingly staying in emergency departments for sometimes weeks to months, filling beds that children with other illnesses may need.

    “There might or might not be a bed open right when you need one. I so naively just thought there was plenty,” Schnacky told CNN.

    The number of pediatric beds decreasing has been an issue for at least a decade, said Dr. Daniel Rauch, chair of the Committee on Hospital Care for the American Academy of Pediatrics.

    By 2018, almost a quarter of children in America had to travel farther for pediatric beds as compared to 2009, according to a 2021 paper in the journal Pediatrics by lead author Dr. Anna Cushing, co-authored by Rauch.

    “This was predictable,” said Rauch, who has studied the issue for more than 10 years. “This isn’t shocking to people who’ve been looking at the data of the loss in bed capacity.”

    The number of children needing care was shrinking before the Covid-19 pandemic – a credit to improvements in pediatric care. There were about 200,000 fewer pediatric discharges in 2019 than there were in 2017, according to data from the US Department of Health and Human Services.

    “In pediatrics, we have been improving the ability we have to take care of kids with chronic conditions, like sickle cell and cystic fibrosis, and we’ve also been preventing previously very common problems like pneumonia and meningitis with vaccination programs,” said Dr. Matthew Davis, the pediatrics department chair at Ann & Robert H. Lurie Children’s Hospital of Chicago.

    Pediatrics is also seasonal, with a typical drop in patients in the summer and a sharp uptick in the winter during respiratory virus season. When the pandemic hit, schools and day cares closed, which slowed the transmission of Covid and other infectious diseases in children, Davis said. Less demand meant there was less need for beds. Hospitals overwhelmed with Covid cases in adults switched pediatric beds to beds for grownups.

    As Covid-19 tore through Southern California, small hospitals in rural towns like Apple Valley were overwhelmed, with coronavirus patients crammed into hallways, makeshift ICU beds and even the pediatric ward.

    Only 37% of hospitals in the US now offer pediatric services, down from 42% about a decade ago, according to the American Hospital Association.

    While pediatric hospital beds exist at local facilities, the only pediatric emergency department in Baltimore County is Greater Baltimore Medical Center in Towson, Maryland, according to Dr. Theresa Nguyen, the center’s chair of pediatrics. All the others in the county, which has almost 850,000 residents, closed in recent years, she said.

    The nearby MedStar Franklin Square Medical Center consolidated its pediatric ER with the main ER in 2018, citing a 40% drop in pediatric ER visits in five years, MedStar Health told CNN affiliate WBAL.

    In the six months leading up to Franklin Square’s pediatric ER closing, GBMC admitted an average of 889 pediatric emergency department patients each month. By the next year, that monthly average jumped by 21 additional patients.

    “Now we’re seeing the majority of any pediatric ED patients that would normally go to one of the surrounding community hospitals,” Nguyen said.

    In July, Tufts Medical Center in Boston converted its 41 pediatric beds to treat adult ICU and medical/surgical patients, citing the need to care for critically ill adults, the health system said.

    In other cases, it’s the hospitals that have only 10 or so pediatric beds that started asking the tough questions, Davis said.

    “Those hospitals have said, ‘You know what? We have an average of one patient a day or two patients a day. This doesn’t make sense anymore. We can’t sustain that nursing staff with specialized pediatric training for that. We’re going to close it down,’” Davis said.

    Registered nurses at Tufts Medical Center hold a

    Saint Alphonsus Regional Medical Center in Boise closed its pediatric inpatient unit in July because of financial reasons, the center told CNN affiliate KBOI. That closure means patients are now overwhelming nearby St. Luke’s Children’s Hospital, which is the only children’s hospital in the state of Idaho, administrator for St. Luke’s Children’s Katie Schimmelpfennig told CNN. Idaho ranks last for the number of pediatricians per 100,000 children, according to the American Board of Pediatrics in 2023.

    The Saint Alphonsus closure came just months before the fall, when RSV, influenza and a cadre of respiratory viruses caused a surge of pediatric patients needing hospital care, with the season starting earlier than normal.

    The changing tide of demand engulfed the already dwindling supply of pediatric beds, leaving fewer beds available for children coming in for all the common reasons, like asthma, pneumonia and other ailments. Additional challenges have made it particularly tough to recover.

    Another factor chipping away at bed capacity over time: Caring for children pays less than caring for adults. Lower insurance reimbursement rates mean some hospitals can’t afford to keep these beds – especially when care for adults is in demand.

    Medicaid, which provides health care coverage to people with limited income, is a big part of the story, according to Joshua Gottlieb, an associate professor at the University of Chicago Harris School of Public Policy.

    “Medicaid is an extremely important payer for pediatrics, and it is the least generous payer,” he said. “Medicaid is responsible for insuring a large share of pediatric patients. And then on top of its low payment rates, it is often very cumbersome to deal with.”

    Pediatric gastroenterologist Dr. Howard Baron visits with a patient in 2020 in Las Vegas. A large portion of his patients are on Medicaid with reimbursement rates that are far below private insurers.

    Medicaid reimburses children’s hospitals an average of 80% of the cost of the care, including supplemental payments, according to the Children’s Hospital Association, a national organization which represents 220 children’s hospitals. The rate is far below what private insurers reimburse.

    More than 41 million children are enrolled in Medicaid and the Children’s Health Insurance Program, according to Kaiser Family Foundation data from October. That’s more than half the children in the US, according to Census data.

    At Children’s National Hospital in Washington, DC, about 55% of patients use Medicaid, according to Dr. David Wessel, the hospital’s executive vice president.

    “Children’s National is higher Medicaid than most other children’s hospitals, but that’s because there’s no safety net hospital other than Children’s National in this town,” said Wessel, who is also the chief medical officer and physician-in-chief.

    And it just costs more to care for a child than an adult, Wessel said. Specialty equipment sized for smaller people is often necessary. And a routine test or exam for an adult is approached differently for a child. An adult can lie still for a CT scan or an MRI, but a child may need to be sedated for the same thing. A child life specialist is often there to explain what’s going on and calm the child.

    “There’s a whole cadre of services that come into play, most of which are not reimbursed,” he said. “There’s no child life expert that ever sent a bill for seeing a patient.”

    Low insurance reimbursement rates also factor into how hospital administrations make financial decisions.

    “When insurance pays more, people build more health care facilities, hire more workers and treat more patients,” Gottlieb said.

    “Everyone might be squeezed, but it’s not surprising that pediatric hospitals, which face [a] lower, more difficult payment environment in general, are going to find it especially hard.”

    Dr. Benson Hsu is a pediatric critical care provider who has served rural South Dakota for more than 10 years. Rural communities face distinct challenges in health care, something he has seen firsthand.

    A lot of rural communities don’t have pediatricians, according to the American Board of Pediatrics. It’s family practice doctors who treat children in their own communities, with the goal of keeping them out of the hospital, Hsu said. Getting hospital care often means traveling outside the community.

    Hsu’s patients come from parts of Nebraska, Iowa and Minnesota, as well as across South Dakota, he said. It’s a predominantly rural patient base, which also covers those on Native American reservations.

    “These kids are traveling 100, 200 miles within their own state to see a subspecialist,” Hsu said, referring to patients coming to hospitals in Sioux Falls. “If we are transferring them out, which we do, they’re looking at travels of 200 to 400 miles to hit Omaha, Minneapolis, Denver.”

    Inpatient pediatric beds in rural areas decreased by 26% between 2008 and 2018, while the number of rural pediatric units decreased by 24% during the same time, according to the 2021 paper in Pediatrics.

    Steve Inglish, left, and registered nurse Nikole Hoggarth, middle, help a father with his daughter, who fell and required stiches, inside the emergency department at Jamestown Regional Medical Center in rural North Dakota in 2020.

    “It’s bad, and it’s getting worse. Those safety net hospitals are the ones that are most at risk for closure,” Rauch said.

    In major cities, the idea is that a critically ill child would get the care they need within an hour, something clinicians call the golden hour, said Hsu, who is the critical care section chair at the American Academy of Pediatrics.

    “That golden hour doesn’t exist in the rural population,” he said. “It’s the golden five hours because I have to dispatch a plane to land, to drive, to pick up, stabilize, to drive back, to fly back.”

    When his patients come from far away, it uproots the whole family, he said. He described families who camp out at a child’s bedside for weeks at a time. Sometimes they are hundreds of miles from home, unlike when a patient is in their own community and parents can take turns at the hospital.

    “I have farmers who miss harvest season and that as you can imagine is devastating,” Hsu said. “These aren’t office workers who are taking their computer with them. … These are individuals who have to live and work in their communities.”

    Back at GBMC in Maryland, an adolescent patient with depression, suicidal ideation and an eating disorder was in the pediatric emergency department for 79 days, according to Nguyen. For months, no facility had a pediatric psychiatric bed or said it could take someone who needed that level of care, as the patient had a feeding tube.

    “My team of physicians, social workers and nurses spend a significant amount of time every day trying to reach out across the state of Maryland, as well as across the country now to find placements for this adolescent,” Nguyen said before the patient was transferred in mid-March. “I need help.”

    Nguyen’s patient is just one of the many examples of children and teens with mental health issues who are staying in emergency rooms and sometimes inpatient beds across the country because they need help, but there isn’t immediately a psychiatric bed or a facility that can care for them.

    It’s a problem that began before 2020 and grew worse during the pandemic, when the rate of children coming to emergency rooms with mental health issues soared, studies show.

    Now, a nationwide shortage of beds exists for children who need mental health help. A 2020 federal survey revealed that the number of residential treatment facilities for children fell 30% from 2012.

    “There are children on average waiting for two weeks for placement, sometimes longer,” Nguyen said of the patients at GBMC. The pediatric emergency department there had an average of 42 behavioral health patients each month from July 2021 through December 2022, up 13.5% from the same period in 2017 to 2018, before the pandemic, according to hospital data.

    When there are mental health patients staying in the emergency department, that can back up the beds in other parts of the hospital, creating a downstream effect, Hsu said.

    “For example, if a child can’t be transferred from a general pediatric bed to a specialized mental health center, this prevents a pediatric ICU patient from transferring to the general bed, which prevents an [emergency department] from admitting a child to the ICU. Health care is often interconnected in this fashion,” Hsu said.

    “If we don’t address the surging pediatric mental health crisis, it will directly impact how we can care for other pediatric illnesses in the community.”

    Dr. Susan Wu, right, chats with a child who got her first dose of the Pfizer-BioNtech Covid-19 vaccine at Children's Hospital Arcadia Speciality Care Center in Arcadia, California, in 2022.

    So, what can be done to improve access to pediatric care? Much like the reasons behind the difficulties parents and caregivers are experiencing, the solutions are complex:

    • A lot of it comes down to money

    Funding for children’s hospitals is already tight, Rauch said, and more money is needed not only to make up for low insurance reimbursement rates but to competitively hire and train new staff and to keep hospitals running.

    “People are going to have to decide it’s worth investing in kids,” Rauch said. “We’re going to have to pay so that hospitals don’t lose money on it and we’re going to have to pay to have staff.”

    Virtual visits, used in the right situations, could ease some of the problems straining the pediatric system, Rauch said. Extending the reach of providers would prevent transferring a child outside of their community when there isn’t the provider with the right expertise locally.

    • Increased access to children’s mental health services

    With the ongoing mental health crisis, there’s more work to be done upstream, said Amy Wimpey Knight, the president of CHA.

    “How do we work with our school partners in the community to make sure that we’re not creating this crisis and that we’re heading it off up there?” she said.

    There’s also a greater need for services within children’s hospitals, which are seeing an increase in children being admitted with behavioral health needs.

    “If you take a look at the reasons why kids are hospitalized, meaning infections, diabetes, seizures and mental health concerns, over the last decade or so, only one of those categories has been increasing – and that is mental health,” Davis said. “At the same time, we haven’t seen an increase in the number of mental health hospital resources dedicated to children and adolescents in a way that meets the increasing need.”

    Most experts CNN spoke to agreed: Seek care for your child early.

    “Whoever is in your community is doing everything possible to get the care that your child needs,” Hsu said. “Reach out to us. We will figure out a way around the constraints around the system. Our number one concern is taking care of your kids, and we will do everything possible.”

    Nguyen from GBMC and Schimmelpfennig from St. Luke’s agreed with contacting your primary care doctor and trying to keep your child out of the emergency room.

    “Anything they can do to stay out of the hospital or the emergency room is both financially better for them and better for their family,” Schimmelpfennig said.

    Knowing which emergency room or urgent care center is staffed by pediatricians is also imperative, Rauch said. Most children visit a non-pediatric ER due to availability.

    “A parent with a child should know where they’re going to take their kid in an emergency. That’s not something you decide when your child has the emergency,” he said.

    Jaimie and Effie Schnacky now have an asthma action plan after the 7-year-old's hospitalization in February.

    After Effie’s first ambulance ride and hospitalization last month, the Schnacky family received an asthma action plan from the pulmonologist in the ER.

    It breaks down the symptoms into green, yellow and red zones with ways Effie can describe how she’s feeling and the next steps for adults. The family added more supplies to their toolkit, like a daily steroid inhaler and a rescue inhaler.

    “We have everything an ER can give her, besides for an oxygen tank, at home,” Schnacky said. “The hope is that we are preventing even needing medical care.”

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  • Biden and Trump agree on one big thing | CNN Politics

    Biden and Trump agree on one big thing | CNN Politics

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    CNN
     — 

    Joe Biden and Donald Trump are bizarrely on the same page on the top issue so far in the 2024 White House race, as they aim huge, possibly campaign-defining swings at Republicans who they claim will shred retirement benefits.

    The current and former presidents – bitter rivals who agree on little else – are both forcing their foes into political retreats and attempts to whitewash past support for changes that could cut Medicare and Social Security payouts.

    Their strategy is reinforcing a truism of presidential election campaigns that candidates who even entertain the notion of “reforming” these cherished entitlement programs for seniors are playing with fire.

    With typical bluntness, Trump has blasted his potential top rival, Florida Gov. Ron DeSantis, as a “wheelchair over the cliff kind of guy” after he voted, as a member of the US House, for non-binding resolutions that would have raised the age at which most seniors can collect their benefits to 70. As a 2012 congressional candidate, he supported privatizing Social Security, CNN’s KFile has reported. But trying to ease his vulnerability on the issue, DeSantis insisted in a Fox News interview last week: “We’re not going to mess with Social Security.”

    Despite his own proposed cuts to these programs as president, Trump has kept up the attacks. “We’re not going back to people that want to destroy our great Social Security system – even some in our own party; I wonder who that might be – who want to raise the minimum age of Social Security to 70, 75 or even 80 in some cases, and who are out to cut Medicare to a level that will be unrecognizable,” he said at the Conservative Political Action Conference last Saturday.

    A few days later, another Republican hopeful gave both Biden and Trump a new opening to exploit.

    Former South Carolina Gov. Nikki Haley was forced to make clear Thursday that her striking and unspecific call the day before for raising the retirement age was only supposed to refer to Americans currently in their 20s, who are in effect a half century away from drawing their pensions. But her clarification won’t protect the former ambassador to the United Nations from Trump, who is splitting his party down the middle, yet again, by pouncing on competitors who have voiced traditional conservative orthodoxy on cutting or changing the programs. Biden is sure to also highlight Haley’s remarks as he claims only he can thwart a secret GOP agenda to kill off the vital programs.

    “I guarantee you, I will protect Social Security and Medicare without any change. Guaranteed,” the president vowed in Philadelphia on Thursday. “I won’t allow it to be gutted or eliminated as MAGA Republicans have threatened to do.”

    Biden browbeat Republicans during his “State of the Union” address last month to confirm on camera that they support shoring up Social Security and Medicare. And he’s anchoring his likely reelection bid on the most forceful campaign by a Democratic candidate in years on the issue. Some of his attacks are fair; others take statements by GOP leaders out of context. But they’re still potent – since both he and Trump know that when conservatives are explaining that they don’t plan to cut Medicare or retirement benefits, they are usually trying to dig out of a losing position.

    And Biden has public opinion on his side. A Fox News poll last month, for instance, showed that Democrats are preferred over Republicans to better handle Medicare (by 23 points) and Social Security (by 16 points). No wonder Biden seems to relish this particular political battlefield.

    The odd confluence of approaches – from a former president who sought to overturn an election and a successor who sees his administration as vital to saving democracy – says so much about each man’s political instincts, backgrounds and campaign strategy. It is also reflects the shifting character of the Republican Party, which Trump has torn from its corporate, ideologically pure conservative roots to build a new coalition that includes working class voters, often in the Midwest, that Biden is battling hard to win back.

    In one sense, possibly the most thorny domestic issue of the years to come should, of course, have a place in a presidential campaign. But when candidates use it to inflame their political bases, it only makes it harder to address in government. This is especially the case with entitlements since they cut into the DNA of each party and have defined the dividing lines between them for decades – at least until Trump came along and took over the GOP.

    Ever since the New Deal reforms of Franklin Roosevelt, who was president from 1933 to 1945, Democrats – through presidents Lyndon Johnson, Barack Obama and Biden, especially – have sought to use government power to secure the living standards and health care of less well-off and elderly Americans. Republicans, from 1980s President Ronald Reagan onwards, have increasingly sought to find ways to shift the burden of some of this care to the private sector and to reduce or eliminate government’s role in an attempt to whittle away the New Deal reforms of FDR and the Great Society program of LBJ, who was president in the 1960s. They have often paid a heavy price. Republican President George W. Bush’s failed attempt to partially privatize Social Security contributed to a disastrous second term. And Trump still rails against former House Speaker Paul Ryan, who promoted a similar plan.

    While raising the alarm about threats to social programs for seniors might be a shrewd political tactic – especially in mobilizing older voters more likely to show up at the polls – it usually does nothing to address the program’s increasingly dire solvency challenges.

    The latest Congressional Budget Office projection found that Social Security’s retirement trust fund could be exhausted by 2032. At that point, with fewer workers paying into the program and with a rapidly aging population, benefits could be cut by at least 20%, CNN’s Tami Luhby reported. Medicare is even more precarious since its hospital insurance trust fund, known as Part A, will only be able to fully pay scheduled benefits until 2028, its trustees said in their most recent forecast.

    Biden, who released a new budget on Thursday that will help shape the message of his likely reelection bid, has proposed a plan to raise taxes on people earning more than $400,000 a year to shore up the program and would expand the range of drugs for which its managers can negotiate prices. He says the move would keep Medicare solvent until 2050 and would involve no cuts in benefits. The president also wants to target those who earn more than $400,000 with increasing payroll taxes to secure Social Security for the future. There is an infinitesimal chance, however, that the Republican-led House will agree to tax increases, so Biden’s plan represents more a device to deliver a political message than a viable plan.

    Despite warning his fellow Republicans to avoid cutting these programs, it’s unclear how Trump would save them if he wins back the White House – and doing nothing isn’t an option. And while other Republicans insist they don’t want to cut benefits or raise taxes, it’s unclear how they can square the circle.

    Florida Sen. Rick Scott has now excluded Social Security and Medicare from his proposal for all spending programs to be reviewed every five years. His original plan, released when he was leading the Senate GOP’s campaign arm, sparked the ire of his Republican Senate colleagues, including Minority Leader Mitch McConnell, who quickly identified it as a political liability. That hasn’t stopped Biden from repeatedly claiming that it represents Republican policy.

    House Speaker Kevin McCarthy has, meanwhile, said that cuts to Social Security and Medicare are “completely off the table” in what he insists must be negotiations with Biden over raising the government’s borrowing limit later this year. But that position has put him in a bind because it means that in order for the GOP to honor their pledge to slash spending, they will probably have to take aim at other social programs that could also prove unpopular with voters.

    America is not the only country staring down a crisis.

    French President Emmanuel Macron sparked nationwide strikes and protests with his plan to raise the retirement age to 64 from 62. Even China’s Communist Party is struggling as a falling birthrate threatens to inflict severe costs on the world’s most dynamic emerging economy.

    Back in the US, whoever wins the 2024 elections for the White House and Congress, there seems no easily identifiable solution to safeguard these vital programs on which millions of Americans depend. And time is running out.

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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
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    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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  • 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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