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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



    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



    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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  • Some auto insurers are refusing to cover certain Hyundai and Kia models | CNN Business

    Some auto insurers are refusing to cover certain Hyundai and Kia models | CNN Business



    CNN
     — 

    Progressive and State Farm, two of America’s largest auto insurers, are refusing to write policies in certain cities for some older Hyundai and Kia models that have been deemed too easy to steal, according to the companies.

    Several reports say the companies have stopped offering insurance on these vehicles in cities that include Denver, Colorado and St. Louis, Missouri. The insurance companies did not tell CNN which cities or states were involved.

    The Highway Loss Data Institute released insurance claims data last September that confirmed what various social media accounts had been saying: Some 2015 through 2019 Hyundai and Kia models are roughly twice as likely to be stolen as other vehicles of similar age, because many of them lack some of the basic auto theft prevention technology included in most other vehicles in those years, according to the HLDI.

    Specifically, these SUVs and cars don’t have electronic immobilizers, which rely on a computer chip in the car and another in the key that communicate to confirm that the key really belongs to that vehicle. Without the right key, an immobilizer should do just that – stop the car from moving.

    Immobilizers were standard equipment on 96% of vehicles sold for the 2015-2019 model years, according the HLDI, but only 26% of Hyundais and Kias had them at that time. Vehicles that have push-button start systems, rather than relying on metal keys that must be inserted and turned, have immobilizers, but not all models with turn-key ignitions do.

    Stealing these vehicles became a social media trend in 2021, according to HLDI, as car thieves began posting videos of their thefts and joyrides and even videos explaining how to steal the cars. In Wisconsin, where the crimes first became prevalent, theft claims of Hyundais and Kias spiked to more than 30 times 2019 levels in dollar terms.

    “State Farm has temporarily stopped writing new business in some states for certain model years and trim levels of Hyundai and Kia vehicles because theft losses for these vehicles have increased dramatically,” the insurer said in a statement provided to CNN. “This is a serious problem impacting our customers and the entire auto insurance industry.”

    Progressive is also cutting back on insuring these cars in some markets, spokesman Jeff Sibel said in an emailed statement.

    “During the past year we’ve seen theft rates for certain Hyundai and Kia vehicles more than triple and in some markets these vehicles are almost 20 times more likely to be stolen than other vehicles,” he wrote. “Given that we price our policies based on the level of risk they represent, this explosive increase in thefts in many cases makes these vehicles extremely challenging for us to insure. In response, in some geographic areas we have increased our rates and limited our sale of new insurance policies on some of these models.”

    Progressive continues to insure those who already have policies with the company, he said. Progressive is also providing them with advice on how to protect their vehicles from theft.

    Michael Barry, a spokesman for the Insurance Information Institute, said it was very unusual for auto insurers to simply stop writing new policies on a given make or model of vehicle.

    “They generally want to expand their market share depending on where they’re doing business,” he said.

    Hyundai and Kia operate as separate companies in the United States, but Hyundai Motor Group owns a large stake in Kia and various Hyundai and Kia models share much of their engineering.

    Engine immobilizers are now standard on all Kia and Hyundai vehicles, the companies said in separate statements. Both automakers also said they are developing security software for vehicles that were not originally equipped with an immobilizer. Kia said it has begun notifying owners of the availability of this software, which will be provided at no charge. Hyundai said its free software free update will be available next month.

    Hyundai also said it is providing free steering wheel locks to some police departments around the country to give local residents who have Hyundai models that could be easily stolen. Hyundai dealers are also selling and installing security kits for the vehicles, the company said.

    Correction: A previous version of this story misstated the cost of Hyundai security kits.

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  • Opinion: The rare bipartisan opportunity House Republicans should take advantage of | CNN

    Opinion: The rare bipartisan opportunity House Republicans should take advantage of | CNN

    Editor’s Note: Patrick T. Brown is a fellow at the Ethics and Public Policy Center, a conservative think tank and advocacy group based in Washington, DC. He is also a former senior policy adviser to Congress’ Joint Economic Committee. Follow him on Twitter. The views expressed in this piece are his own. View more opinion on CNN.



    CNN
     — 

    With only a thin and fractious majority in the House, the GOP is facing two years of struggling to set any kind of positive agenda. But one thing every elected Republican would agree on is the need to scrutinize the Biden administration.

    Courtesy Patrick T. Brown

    Rep. James Comer of Kentucky, the new chairman of the House Oversight Committee, has already been hard at work, firing off letters demanding answers to pointed questions on border photo ops, President Joe Biden’s handling of classified documents, presidential visitor logs, remote work among top federal employees and Hunter Biden.

    This is, of course, business as usual. The party that doesn’t control the White House will always seek to score political points on possible bureaucratic scandals. In return, Democrats’ instinctive reaction might be to circle up the wagons and seek to stonewall or downplay as many of these efforts as possible.

    But one area of focus for the Oversight Committee deserves to be taken seriously, not just as a political point-scoring operation, but as an earnest attempt to improve how government works. A genuine bipartisan commitment can and should be made to evaluate the extent of fraud in the pandemic-era safety net measures. A better understanding of where the system failed would not only shine a light on how some funds were misspent but also lay the groundwork for better administration of safety-net benefits, in ways applicable and valuable even outside of the unique circumstances of a global pandemic.

    Recall that as the initial wave of coronavirus cases hit US shores, economists feared we could be headed for an economic meltdown. People stopped going about their daily lives, stay-at-home orders went into effect and businesses responded by laying off workers left and right. The unemployment rate spiked to 14.7% in April 2020, the highest level in the post-World War II era.

    Congress wanted to provide aid as quickly as possible; there simply wasn’t time to sit around and construct the ideal policies. As part of the frenetic response, the federal government used the often-clunky unemployment insurance systems run by states to try to backstop households’ finances.

    Fraud became an issue due to a number of factors, according to a June 2022 report from the Government Accountability Office, including unclear federal guidance, ill-equipped state offices and a relaxation of normal eligibility rules. It didn’t help that 32 states run their unemployment insurance systems on outdated infrastructure, often developed in the 1970s and 1980s, according to that same report. These systems make it difficult for states to have the flexibility and responsiveness necessary to run benefit programs efficiently – even when there isn’t a global pandemic.

    The underlying structure of unemployment insurance may have been an issue as well – the federal government provides support and technical assistance, while states determine eligibility and ensure accurate payments. The jerry-rigged systems in many states couldn’t handle the surge of applicants and a newly created unemployment insurance program relied on self-certification. Without any requirements to prove lost income, the program opened the door to bad actors.

    But some of the headlines about the amount of fraud in pandemic assistance are likely overblown. One widely-repeated claim about the ubiquity of fraud was advanced not by a disinterested party but by a company that sells ID verification systems. The GAO report estimates the amount of unemployment insurance fraud is likely over $60 billion (or about 7% of total $878 billion spent), although the true amount may not be knowable.

    $60 billion sounds like a lot of money, but some could argue the result justified the leaky process. Research by the Brookings Institution found that the expanded unemployment benefits delivered the most aid to lower-income workers, stabilizing the broader economy by keeping consumption stable. At the peak of Covid’s impact, millions of workers every week were applying for unemployment insurance; if excessive concern about fraud had prevented rolling out the federal expansion of benefits, it could have taken a lot longer for the economy to recover.

    But with the worst of the pandemic in the rear-view mirror, cracking down on people who abused the system and making it harder for future scammers to do the same is an appropriate area for the Oversight Committee to focus on. A full, bipartisan Congressional inquiry could spotlight the weaknesses of the current system and where it was taken advantage of in order to lay the groundwork for future efforts to improve the way benefits are disbursed.

    Not doing so would allow distrust around government programs to fester. Some voters who hear stories about fraudsters taking advantage of pandemic-era assistance – especially blatant examples of people who listed their name as “N/A” or claimed that they owned nonexistent farms – may lose faith in government’s ability to function properly. Knowing that the expanded assistance helped the economy does nothing to change or address the fact that some people took advantage of loopholes in the system.

    Some initial steps have been taken to address this lingering concern. The Pandemic Response Accountability Committee, which was created as part of the Coronavirus Aid, Relief and Economic Security (CARES) Act in 2020, has provided publicly available data on how emergency pandemic funds were spent. Last summer, Congress passed bipartisan bills extending the statute of limitations to prosecute individuals who committed fraud through the Paycheck Protection Program or the Economic Injury Disaster Loan Program. And Democrats, such as Rep. Jim Clyburn of South Carolina, who previously served as the chair of a subcommittee on the coronavirus response, have rightly pointed out that small business aid during the pandemic was also plagued by fraud and improper payments.

    Yet more could be done. A GAO report in October 2021 made six recommendations about how the Department of Labor could stem fraud in unemployment insurance programs, but a recent follow-up found the department had not implemented any of them. The deluge of cases has left investigators overwhelmed, and Congress could beef up funding for the agents that investigate pandemic fraud.

    Last year, the Biden administration announced initial steps to combat fraud and identity theft in pandemic relief, but it hasn’t made a priority of supporting bills like the one introduced in 2021 by Sen. Ron Wyden of Oregon, which would have modernized the unemployment insurance program. Helping states develop better systems of determining eligibility and automating basic safeguards could make it easier to keep scammers out and make sure the truly deserving get the benefits they need.

    Republicans are right to put the spotlight on those who took advantage of pandemic-era programs. Democrats should join them. Getting benefits into the hands of people who merit them and keeping them out of the hands of people who don’t should be something both parties agree on. Amid all the other controversies that take up political oxygen, a concerted effort to crack down on wrongdoing and improve how our social safety net functions could be a welcome breath of bipartisan air.

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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


    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


    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


    Washington
    CNN
     — 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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  • 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



    CNN
     — 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


    Washington
    CNN
     — 

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

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

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

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

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

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

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

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

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

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

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

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

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



    CNN
     — 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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  • Social Security will not be able to pay full benefits in 2034 if Congress doesn’t act | CNN Politics

    Social Security will not be able to pay full benefits in 2034 if Congress doesn’t act | CNN Politics



    CNN
     — 

    Americans’ Social Security checks will get a lot smaller in 2034 if lawmakers don’t act to address the pending shortfall, according to an annual report released Friday by the Social Security trustees.

    That’s because the combined Social Security trust funds – which help support payouts for the elderly, survivors and disabled – are projected to run dry that year. At that time, the funds’ reserves will be depleted, and the program’s continuing income will only cover 80% of benefits owed.

    The estimate is one year earlier than the trustees projected last year. About 66 million Americans received Social Security benefits in 2022.

    Medicare, meanwhile, is in a more critical financial condition. Its hospital insurance trust fund, known as Medicare Part A, will only be able to pay scheduled benefits in full until 2031, according to its trustees’ annual report, which was also released Friday.

    At that time, Medicare, which covered 65 million senior citizens and people with disabilities in 2022, will only be able to cover 89% of total scheduled benefits. Last year, Medicare’s trustees projected that the hospital trust fund’s reserves would be depleted in 2028.

    Immensely popular but long troubled, Social Security and Medicare are on shaky financial ground in large part because of the aging of the American population. Fewer workers are paying into the program and supporting the ballooning number of beneficiaries, who are also living longer. Also, health care is becoming increasingly expensive.

    Social Security has two trust funds – one for retirees and survivors and another for Americans with disabilities.

    Looking at them separately, the Old-Age and Survivors Insurance Trust Fund is projected to run dry in 2033, at which time Social Security could pay only 77% of benefits, primarily using income from payroll taxes. The date is one year earlier than estimated last year.

    The Disability Insurance Trust Fund is expected to be able to pay full benefits through at least 2097, the last year of the trustees’ projection period.

    Merging the two trust funds would require Congress to act, but the combined projection is often used to show the overall status of the entitlement.

    Social Security’s projected long-term health worsened over the past year because the trustees revised downward their expectations for the economy and labor productivity, taking into account updated data on inflation and economic output.

    However, the long-term projection for Medicare’s hospital trust fund’s finances improved, mainly due to lowered estimates for health care spending after the height of the Covid-19 pandemic. Also, the program is projected to take in more income because the trustees estimate the number of covered workers and average wages will be higher.

    Regardless, the bottom line remains that Medicare is not bringing in enough money to pay the costs it is expected to incur, said Cori Uccello, senior health fellow at the American Academy of Actuaries.

    “It’s still not a time to become complacent,” she said. Insolvency “is still less than a decade away.”

    The trustees’ reports are the latest warnings to Congress that they will have to deal with the massive entitlement programs’ fiscal problems at some point soon. But addressing their issues is politically challenging. Elected officials are hesitant to suggest any changes that could lead to benefit cuts, even though that could reduce their options in the future.

    “With each year that lawmakers do not act, the public has less time to prepare for the changes,” the trustees warned in a fact sheet.

    The programs’ shortfalls are back in the spotlight this year as President Joe Biden and House Republicans battle over how to address the nation’s debt ceiling drama and mounting budget deficits. GOP lawmakers want to cut spending in exchange for resolving the borrowing limit, while the White House has said it will not negotiate.

    In a memorable moment in his State of the Union address in February, Biden garnered public acknowledgment from congressional Republicans about keeping Social Security and Medicare out of the debt discussions.

    But “not touching” Social Security means a hefty cut in benefits within a decade or so.

    “Change is inevitable because without changes to current law, both Social Security and Medicare Hospital Insurance would go insolvent, subjecting program participants to sudden and severe payment cuts,” said Charles Blahous, senior research strategist at the Mercatus Center at George Mason University and former Social Security and Medicare trustee. “The outstanding question is whether change will be tolerably gradual, or instead highly damaging because it is too long delayed.”

    Though Biden has repeatedly vowed to protect Social Security, his latest budget proposal did not include a plan to stabilize its finances.

    However, his proposal did call for extending Medicare’s solvency by 25 years or more by raising taxes on those earning more than $400,000 a year and by allowing the program to negotiate prices for even more drugs.

    Spending on the entitlement programs is also projected to soar and exert increased pressure on the federal budget in coming years.

    Mandatory spending – driven by Social Security and Medicare – and interest costs are expected to outpace the growth of revenue and the economy, according to a Congressional Budget Office outlook released in mid-February.

    This story has been updated with additional information.

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  • These 5 states will be the first to kick residents off Medicaid starting in April | CNN Politics

    These 5 states will be the first to kick residents off Medicaid starting in April | CNN Politics



    CNN
     — 

    Millions of Americans are at risk of losing their Medicaid coverage in coming months, but residents in Arizona, Arkansas, Idaho, New Hampshire and South Dakota will be the first to bear the brunt of the terminations.

    States have been barred by Congress from winnowing their Medicaid rolls since the Covid-19 pandemic began. That prohibition ends on Saturday, and some states are moving much more swiftly than others to kick off those deemed ineligible for the public health insurance program for low-income Americans.

    That worries advocates, who say speed will result in eligible residents being incorrectly terminated. Also, it could hamper shifting those who no longer qualify to other types of coverage.

    “This is the fable of the tortoise and the hare,” said Joan Alker, executive director of the Georgetown University Center for Children and Families. “Taking time is absolutely going to result in a better outcome for eligible children and families to remain covered. So speed is a big concern.”

    The five states will start cutting off coverage in April, followed by 14 more states in May and 20 additional states plus the District of Columbia in June. All states must complete their redeterminations over the next 14 months.

    Around 15 million people could be dropped from Medicaid, according to various estimates, though several million folks could find coverage elsewhere. Others may still be eligible but could be terminated for procedural reasons, such as not completing renewal forms. Those at risk include at least 6.7 million children, according to a Georgetown analysis.

    Medicaid enrollment has ballooned since March 2020, when lawmakers passed the Families First Coronavirus Response Act, which prevented states from involuntarily removing anyone from coverage. In exchange, Congress boosted states’ federal Medicaid match rates by 6.2 percentage points.

    The provision was initially tied to the national public health emergency, but lawmakers changed that as part of the federal spending bill that passed in December. In addition to being able to start conducting terminations in April, states will receive an enhanced federal match through the rest of this year, though it will phase down over time.

    More than 92 million Americans were enrolled in Medicaid and the Children’s Health Insurance Program in December, up 31% since February 2020, according to the most recent data available from the Centers for Medicare and Medicaid Services.

    Reviewing the eligibility of all those enrollees will be a monumental task for state Medicaid agencies, many of which are also contending with slim staffing. To gear up, they are hiring new employees, temporary workers or contractors or bringing back retirees, according to a recent survey conducted by Georgetown and the Kaiser Family Foundation.

    Most states can automatically renew coverage for at least some of their enrollees using other data, such as state wage information. But agencies must get in touch with others in their Medicaid programs, which proved challenging even prior to the pandemic. Most states are using multiple methods to update enrollees’ contact information, including working with insurers that provide Medicaid coverage to residents.

    If notices sent by mail are returned, states must make good faith attempts to contact enrollees through at least two other methods before cutting them off. And states have to adhere to additional requirements to continue to qualify for the enhanced match. If they don’t, CMS also could suspend their terminations, require they take corrective action or impose monetary penalties.

    Of the roughly 15 million people who could lose Medicaid coverage, about 8.2 million will no longer qualify, according to a Department of Health and Human Services analysis released in August. Some 2.7 million of these folks would qualify for enhanced federal subsidies for Affordable Care Act policies that could bring their monthly premiums to as low as $0.

    Some 6.8 million people, however, will be disenrolled even though they remain eligible.

    Though the federal government has given states more than a year to conduct the eligibility reviews and terminations, some plan to move much more quickly.

    Idaho, which has been monitoring enrollees’ eligibility throughout the pandemic, plans to complete its reevaluations by September, which it touts as one of the fastest timelines in the country.

    Of the nearly 450,000 Idahoans in the program, about 150,000 of them either don’t qualify or haven’t been in touch with the state in the past three years. The state began sending notices in February to those who face termination. People have 60 days to respond before they are removed.

    Those that are not eligible have 60 days from their termination date to enroll in Idaho’s state-based Obamacare exchange, Your Health Idaho. The exchange receives information nightly from the state Medicaid agency about residents who no longer qualify for public coverage but may be eligible for federal subsidies for Affordable Care Act policies.

    The exchange is reaching out to those folks weekly while they still have Medicaid and then every 15 days during the two-month special enrollment period via various methods, including mail, email and text messages, said Pat Kelly, Your Health Idaho’s executive director.

    The exchange works with 900 agents, brokers and enrollment counselors who can help folks sign up for policies. And it plans to start an advertising campaign this month highlighting the hefty subsidies.

    “We have to really help Idahoans know and understand that low-cost options are available, and most importantly, that it’s comprehensive health insurance that they can get for $0 a month,” Kelly said.

    Still, advocates in Idaho are concerned that the state’s push to unwind quickly will result in eligible residents losing coverage.

    Many people are not aware that they once again need to prove that they qualify, and the state agency is understaffed and underfunded, said Hillarie Hagen, health policy associate at Idaho Voices for Children. Renewal letters may not make it to enrollees, and those who need help may not be able to get through to customer service.

    “We are very concerned about families, and particularly children, losing health coverage without their knowledge – that they will find out when they show up to the doctor,” Hagen said.

    Aware that many people don’t know they’ll have to renew their eligibility, Arizona’s Medicaid agency last summer sent text messages and letters and made robocalls to enrollees, asking them to update their contact information. It is also working with community partners, health care providers, pharmacies and insurers. And it’s ramping up another text campaign since the prior one was so successful, said Heidi Capriotti, public information officer for the Arizona Health Care Cost Containment System.

    While the state can automatically redetermine the eligibility of about 75% of its Medicaid participants, it still has to connect with about 670,000 residents who could lose coverage because they are no longer eligible or they haven’t responded to the agency’s requests. The state plans to take 12 months to assess whether its enrollees still qualify.

    South Dakota will start terminating Medicaid enrollees in April, though some low-income adults may become eligible again in July, when the state’s Medicaid expansion program begins.

    Voters approved the broadening of Medicaid to low-income adults at the ballot box in November, over the objections of the Republican governor and legislature.

    Nearly 152,000 residents were enrolled in Medicaid in January, an increase of more than 30% from March 2020, according to the state’s Department of Social Services. But more than 22,000 people appear to be ineligible currently.

    The agency said in an FAQ that it will prioritize reviewing folks who are most likely to be ineligible because they no longer meet a coverage group or their income has increased, among other reasons.

    Those who are not eligible will be disenrolled with 10-days’ notice. If they appear eligible for expansion in July, they’ll receive a notice about it when they are terminated and sent a reminder in June. The agency is encouraging any enrollees who are determined to be ineligible to reapply after Medicaid expansion takes effect.

    But that three-month gap can wreak havoc on low-income residents’ health, said Jen Dreiske, deputy director of South Dakota Voices for Peace, which is working with the state’s immigrants and refugees to inform them of the unwinding. These folks may have to go without their heart medication or their cancer treatment. They may also be afraid to go to the doctor because of the cost.

    “Why can’t we just wait until July 1?” Dreiske said. “Our concern is that people are going to get sick or die because they’re not going to be able to access the health care that they so desperately need.”

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  • Here’s what you can do if you lose Medicaid coverage | CNN Politics

    Here’s what you can do if you lose Medicaid coverage | CNN Politics



    CNN
     — 

    Though millions of Americans are expected to be kicked off of Medicaid in coming months, they don’t all have to be left uninsured.

    But it could take some work to regain health coverage.

    “For a lot of people, this can be a very disruptive period of time,” said Sabrina Corlette, co-director of the Center on Health Insurance Reforms at Georgetown University. “There is a significant time and paperwork burden being placed on families – a lot of them very low income, a lot of them medically vulnerable.”

    States are now free to terminate the Medicaid coverage of residents they deem ineligible. States had been barred from involuntarily removing anyone for the past three years as part of an early congressional Covid-19 pandemic relief package, causing enrollment in Medicaid and the Children’s Health Insurance Program to balloon to more than 92 million people.

    Of the roughly 15 million people who could lose Medicaid coverage over the next 14 months, about 8.2 million would no longer qualify, according to a Department of Health and Human Services analysis released in August.

    Some 2.7 million of these folks would qualify for enhanced federal subsidies for Affordable Care Act policies that could bring their monthly premiums to as low as $0.

    Another 5 million are expected to secure other coverage, mainly through employers.

    Some 6.8 million people, however, will be disenrolled even though they remain eligible for Medicaid.

    Check out Obamacare policies: Folks who lose their Medicaid coverage can shop for health insurance plans on the Affordable Care Act exchanges.

    Those whose annual incomes remain below 150% of the federal poverty level – $20,385 for a single person and $41,625 for a family of four in 2023 – can obtain enhanced federal assistance to lower their premiums to as little as $0 a month. That beefed-up subsidy is in place through 2025.

    Many people with higher incomes can find subsidized policies for $10 or less.

    State Medicaid agencies are tasked with easing residents’ transfer from Medicaid to the Obamacare marketplaces, but the smoothness of the process will vary greatly by state. Once someone is determined to no longer qualify for Medicaid, the agency must assess his or her eligibility for Affordable Care Act coverage and transfer the resident’s information to the exchange.

    Some states that run their own Obamacare exchanges are taking extra steps to ensure their residents remain covered. Rhode Island, for instance, is automatically enrolling certain people in marketplace coverage. It’s also paying the first two months of premiums for some residents who actively select policies.

    Those who lose Medicaid coverage and live in the 33 states covered by the federal marketplace, healthcare.gov, can apply for Affordable Care Act policies through a special enrollment period that runs through July 2024. State-based exchanges have their own deadlines, with some mirroring the federal exchange and others providing much shorter windows.

    Navigators and insurance brokers can help consumers select plans.

    Historically, very few people who lose Medicaid coverage wind up in Obamacare plans. About 4% of adults who were terminated from Medicaid enrolled in exchange policies in 2018, according to the Medicaid and CHIP Payment and Access Commission.

    The coverage differs too. Those that switch to the marketplace may have to find other doctors that are in their insurers’ networks and may face out-of-pocket costs.

    Consider job-based coverage: A number of people who are terminated from Medicaid may already be covered by their employers, particularly those who started new jobs during the pandemic. Others have the option of obtaining coverage through work, though it will almost certainly be more expensive than Medicaid since it will likely entail premiums, deductibles and copays.

    Workers may find they can afford coverage for themselves but not for their families. If the premiums for family policies cost more than 9.12% of household income, spouses and children may be able to get subsidized coverage on the Affordable Care Act exchanges.

    Employees should contact their human resources departments to sign up. Typically, they’ll have to enroll within 60 days of losing Medicaid, but those who are terminated from the program between now and July 10 will have until early September to sign up.

    See if you or your children remain eligible for Medicaid: Millions of Americans who still qualify for Medicaid may lose coverage for procedural reasons. For example, they may have moved so they don’t receive the redetermination notices. Or they may not return the necessary paperwork to prove their eligibility.

    So it’s crucial that folks update their contact information with their state agencies and reply to the letters they receive about renewing their Medicaid eligibility.

    “When you get that packet in the mail, respond to it promptly,” Corlette said.

    Those who are dropped have 90 days to submit their renewal paperwork to their state agency, which is required to reinstate them if they are found eligible. Beyond that time period, people may reapply. In most states, your coverage can be made retroactive for up to three months if you were eligible and received Medicaid-covered services.

    Parents who no longer qualify and are terminated should check if their children remain eligible. As many as 6.7 million kids are at risk of losing Medicaid coverage, according to Georgetown’s Center for Children and Families.

    Nearly three-quarters of the children projected to be dropped will remain eligible for Medicaid or CHIP but will lose coverage mainly because of administrative issues. Black and Latino children and families are more likely to be erroneously terminated, according to the center.

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  • Biden administration moves ahead with Medicare drug price negotiations amid industry lawsuits | CNN Politics

    Biden administration moves ahead with Medicare drug price negotiations amid industry lawsuits | CNN Politics



    CNN
     — 

    Undeterred by a growing number of lawsuits, the Biden administration on Friday released revised guidance for Medicare’s new drug price negotiation program.

    The latest guidance outlines how the Centers for Medicare and Medicaid Services will negotiate with drugmakers to reach agreement on a maximum fair price for a selected medicine, the agency said. It was informed by public input on the initial guidance the agency released in March, which explained how it will select the drugs and how the negotiations will be conducted.

    The program, which was authorized by the Inflation Reduction Act that congressional Democrats passed last year, has prompted a fierce backlash from the pharmaceutical industry. Two drug manufacturers and two industry groups have filed lawsuits, arguing the measure is unconstitutional.

    But the administration is not backing down from implementing its historic new power. It intends to keep its timeline of announcing the first 10 drugs that will be selected for negotiation by September 1. CMS and the drugmakers will negotiate during 2023 and 2024. The prices will be effective starting in 2026.

    “The Biden-Harris Administration isn’t letting anything get in our way of delivering lower drug costs for Americans,” Secretary of Health and Human Services Xavier Becerra said in a statement. “Pharmaceutical companies have made record profits for decades. Now they’re lining up to block this Administration’s work to negotiate for better drug prices for our families. We won’t be deterred.”

    The initial set of drugs will be chosen from the top 50 Part D drugs that are eligible for negotiation that have the highest total expenditures in Medicare. CMS will consider multiple factors when developing its initial offer, including the drugs’ clinical benefits, the price of alternatives, research and development costs and patent protection, among others.

    If drugmakers don’t comply with the process, they will have to pay an excise tax of up to 95% of the medications’ US sales or pull all their drugs from the Medicare and Medicaid markets. The pharmaceutical industry contends that the true penalty can be as high as 1,900% of sales.

    CMS said it received more than 7,500 comments on its initial guidance from patient groups, drug companies, pharmacies and others.

    The changes it is making are aimed at improving transparency while keeping confidentiality in mind, as well as fostering “an effective negotiation process,” the agency said.

    They include revising the confidentiality process to state that CMS will release information about the negotiations when it publishes the explanations of the prices. Also, drug companies may publicly discuss the negotiations – the prior secrecy requirement had been a point of contention among manufacturers that was mentioned in the lawsuits. And they won’t be required to destroy data relating to the negotiations.

    In addition, CMS will hold patient-focused listening sessions to provide drug companies and the public more opportunities to engage with the agency. The sessions – which will give patients, caregivers and others the chance to share input on how a medication addresses unmet needs, how it impacts specific populations and what therapeutic alternatives exist – will be held in the fall for the first round of drugs.

    Merck, Bristol Myers Squibb, the Pharmaceutical Research and Manufacturers of America, known as PhRMA, and the US Chamber of Commerce have all recently filed lawsuits in federal courts across the US. They each argue the program is unconstitutional in various ways.

    The challengers also say that the negotiation provision will harm innovation and patients’ access to new drugs.

    Among the arguments are that the program violates the Fifth Amendment’s “takings” clause because it allows Medicare to obtain manufacturers’ patented drugs, which are private property, without paying fair market value under the threat of serious penalties.

    Plus, the negotiations process violates the First Amendment, the challengers say, because it coerces manufacturers into saying that they agree to the price that the government has dictated and that it’s fair.

    Another argument is that the process violates the Eighth Amendment by levying an excessive fine if drugmakers refuse to negotiate and continue selling their products to the Medicare market.

    Merck expects its diabetes drug Januvia to be among the drugs named in September and its blockbuster cancer treatment Keytruda and diabetes drug Janumet to be subject to negotiation in the future. Bristol Myers Squibb believes its blood thinning medication, Eliquis, will be subject to negotiations this year, and its cancer medication, Opdivo, will be selected in a subsequent round.

    The changes in the revised guidance did not allay the complaints of the pharmaceutical industry. PhRMA said that transparency remains “severely limited,” patients’ views are not being taken into account and Medicare beneficiaries could have less access to drugs.

    “The very few substantive changes to the final guidance demonstrate CMS saw this as a box checking exercise, not an opportunity to mitigate the negative impacts this price setting policy will have on patients or the broader health care sector,” PhRMA said in a statement.

    “The approach CMS took in this final guidance confirms what we claimed in our lawsuit – Congress’ unconstitutional shortcuts taken in the law have given the administration far too much flexibility to set prices at their whim without any oversight or accountability to anyone,” the group continued.

    The Biden administration will “vigorously defend” the drug price negotiation program, said CMS Administrator Chiquita Brooks-LaSure.

    “We feel the law is on our side,” she said in a call with reporters Friday.

    This story has been updated with additional information.

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