La Cámara de Representantes, controlada por los republicanos, está ultimando los detalles de un enorme proyecto de ley de financiación que podría someterse a votación en el pleno esta semana.

Los defensores advierten que los recortes propuestos a Medicaid podrían provocar despidos o el cierre de hospitales rurales. La administración Trump busca ahorros para financiar sus recortes de impuestos, que benefician principalmente a los más adinerados.

Joan Alker, del Center for Children and Families de la Universidad de Georgetown, afirma que los hospitales rurales suelen ser la única sala de maternidad en cientos de kilómetros a la redonda.

"No importa cuál sea su aseguradora médica. Si tiene seguro privado, o a través de su empleador, pero si no hay instalaciones, no puede dar a luz de forma segura. Y por eso estos problemas son tan importantes," insistió Alker.

Para reducir el costo de Medicaid, conocido como Medi-Cal en el estado, los republicanos están considerando recortes drásticos en estados como California, que financian la atención médica para inmigrantes indocumentados de bajos ingresos. También buscan reducir el acceso al añadir requisitos laborales y exigir a los estados que verifiquen la elegibilidad con mayor frecuencia.

Alexis Heaton, de California Coverage and Health Initiatives, asegura que, según algunas estimaciones, hasta 13 millones de californianos podrían perder su cobertura. Y esa perspectiva preocupa a los pacientes y proveedores que se manifestaron la semana pasada frente al Hospital Dignity Health Mercy en Folsom.

"Este hospital podría cerrar y despedir, creo que dijeron, a hasta 2000 empleados. Y este es el centro principal que atiende a pacientes del condado de El Dorado que buscan atención de maternidad," expresó Heaton.

Eva Rivera de The Children's Partnership dice que los recortes se sentirían ampliamente.

"En las zonas rurales de California, la mitad de los nacimientos están cubiertos por Medicaid. En California, el 27 % de las mujeres de entre 19 y 44 años dependen de Medicaid como seguro médico. Por lo tanto, una buena parte de la población depende de esta atención," enfatizó también Rivera.

Rivera agrega que la atención primaria financiada por Medi-Cal ahorra dinero a largo plazo porque trata las afecciones a medida que se desarrollan, lo que evita una costosa atención de emergencia más adelante.


get more stories like this via email

Medicare loses $60 billion to $80 billion a year to fraud and this year, for Medicare Fraud Prevention Week, your local Senior Medicare Patrol has good advice on how to spot a con.

There are plenty of scams to be aware of.

Karen Joy Fletcher, communications director with the nonprofit California Health Advocates, said beware if a caller asks to verify your Medicare number, claiming the program needs to send out a new type of card.

"This is just a way for people to steal people's Medicare number," Fletcher explained. "To commit identity theft, and to defraud Medicare, ordering services or items that they most likely will never receive."

Caregivers can be on the lookout for medical equipment arriving at the house even though the beneficiary never ordered it. Another red flag? A stranger may approach you in a parking lot asking you to sign up for new, free Medicare services like house cleaning or meals, which are then fraudulently billed to the government.

Fletcher encouraged people to check their Medicare summary notices online at MyMedicare.gov on a regular basis to make sure everything is in order.

"It's a good way to see if Medicare is being charged for things that maybe somebody never received, or from doctors they've never seen," Fletcher pointed out.

Another scam involves tricking people into unknowingly signing up for hospice care. It is especially dangerous, because once a person is on hospice, Medicare will only approve palliative care and could mistakenly deny an essential surgery or medication.

More than 1.5 million people in Tennessee, or 20% of the state's population, rely on health insurance provided by Medicaid.

Maddie Michael, Tennessee government relations director for the American Cancer Society Cancer Action Network, said access to health care coverage is one of the greatest predictors of whether someone survives their cancer diagnosis. She added cuts to Medicaid, also known as TennCare, could mean people lose access to routine cancer screenings and early detection tests.

"Without this insurance and without access to this care, there will be late-term diagnoses for cancer," Michael asserted. "Which are more costly to the patients, more costly to the state, and have lower survival rates, unfortunately."

Ten Tennessee advocacy groups, including the American Cancer Society Cancer Action Network, gathered Tuesday outside the offices of Sen. Marsha Blackburn, R-Tenn., and Sen. Bill Hagerty, R-Tenn., calling on them to protect Medicaid funding for Tennesseans. The Senate is set to vote on the proposed budget by the end of June.

Michael argued cutting Medicaid will have an especially big effect on cancer patients in Tennessee's rural and low-income areas, which rely heavily on the program for services.

"Rural communities already have higher cancer death rates than their urban counterparts," Michael pointed out. "That's often due to barriers to care, like hospital closures, which we've seen across Tennessee, and transportation issues. When you take away someone's health insurance, you're going to make those challenges in rural areas even worse."

Michael noted Tennesseans can express their concerns at FightCancer.org.


get more stories like this via email

By Anna Gustafson for the Pennsylvania Independent.
Broadcast version by Danielle Smith for Keystone State News Connection reporting for the Pennsylvania Independent-Public News Service Collaboration

Josie Badger doesn't know where she would be without Medicaid.

"I use a ventilator, power wheelchair," said Badger, a disability rights advocate who lives in western Pennsylvania's Lawrence County. "I have 24-hour care. I could not get out of bed every day without that care, let alone work, have a business, be a foster mom, own a home, any of that. So, without that coverage, Josie would not be here."

Badger was born with a physical disability called congenital myasthenic syndrome, which leaves an individual with weakened muscles, and she spent months on end in the hospital as a child. While she was growing up, Badger's parents repeatedly considered getting a divorce solely so they could each have their own private insurance plan that Badger could use.

"Fortunately, that didn't happen," Badger said of her parents divorcing. "Now, as an adult, I receive waiver through Medicaid home-based services, and it is my lifeline."

Now, however, Badger is fighting to keep that lifeline.

In an effort to pay for President Donald Trump's tax cuts for the wealthiest Americans, House Republicans on May 22 passed legislation, which they named the "One Big Beautiful Bill Act," that would carve about $700 billion from Medicaid, add approximately $3.3 trillion to the national debt over the next decade, and cause about 13.7 million people to lose health care coverage nationwide. The bill passed the House by a vote of 215-214, with all but five Republicans voting for it and no Democratic support. Every Republican House member from Pennsylvania supported the bill, which is now before the Senate. Trump is expected to sign the bill if it passes the Senate. If the Senate changes anything in the House bill, the two chambers must work out those differences and vote on the final legislation before sending it to the president.

In Pennsylvania, where close to one-quarter of the population is enrolled in Medicaid, the federal Medicaid cuts could strip health coverage from hundreds of thousands of residents, including people with disabilities, individuals in nursing homes, and children. About 750,000 people with disabilities use Medicaid in Pennsylvania.

"We're at a place where we need to become very public about what's going on, because I don't think enough people realize that these cuts are going to affect them," Badger said. "They don't realize that Medicaid pays for services in schools. They don't realize that the Affordable Care Act that they're buying, those services could go away."

'I become paralyzed with the fear'

For Badger, a loss of Medicaid or reduced benefits would be life-changing. Currently, she is able to afford six nurses and three home-care attendants who provide around-the-clock services through her Medicaid plan. It's this kind of care that keeps her out of a nursing home and living in her own house with her family, running her own consulting firm, which works to empower people with disabilities, and generally living a life she loves.

As Republicans push for the largest cuts to Medicaid in the program's 60-year history, Badger is trying to focus less on how her own personal life would be affected by the GOP's plan and more on galvanizing people to fight for the public health insurance program that covers about 80 million people nationally, or about 20% of the country's population.

"For me, I can't think a lot about it in terms of my own life because I become paralyzed with the fear, with the anxiety, and so I have to go and activate other folks to get involved," Badger said. "The community is really what keeps me going and realizing why it's important that there's hope. And so a lot of my work time I've been donating towards trying to elevate people's voices for a lot of issues, not just Medicaid. I'm not even sure I can process it on a personal level."

Should the House bill be signed into law, Badger said, she expects her home caregivers could lose their jobs, or leave them, because of a lack of funding. That, then, could leave older people and people with disabilities with no option but to go into a nursing home.

"Nursing homes, historically, have been last resort, even though they are one of the most expensive options, and so I think that there's going to be a come-to-Jesus moment when we start seeing millions of folks with disabilities and older adults needing care not being able to get it and ending up in nursing homes that are also underfunded," Badger said.

Losing home- and community-based services

Jennifer Garman, the president of Disability Rights Pennsylvania, is also deeply worried about cuts to home- and community-based services that are funded by Medicaid, including housing and employment support. Through those services, people with disabilities are able to live in their own homes as well as work.

"We already also have a waiting list for home- and community-based services for people with intellectual disabilities," Garman said. "And so we would also be concerned that waiting lists will grow for services and that people will have to wait a longer time than they're already waiting."

"It will just be a tremendous strain on the commonwealth and really deeply impact the community and people accessing the services that they need," Garman continued.

Cutting or decreasing those services would be disastrous, said Christie Cyktor, the youth leadership and training coordinator for western Pennsylvania at the PEAL Center. The PEAL Center works with youth with disabilities and their families to help them advocate for themselves in a variety of settings, such as school or the workplace.

Cyktor, who has a congenital disability that affects her joints and has used a power wheelchair since the age of 8, explained the youth she works with want to go to college, be in the workforce and live independently. In order for them to do that, they need to have a direct-care worker who helps them with various tasks, depending on their needs, such as dressing themselves, she explained.

Cutting those services would harm people who want to contribute to their families, communities and economy, Cyktor said.

"They want to contribute to the workforce and economy and give back that way, but they're like, How am I going to afford this if I can't fund a direct-care worker?" Cyktor said.

Cyktor doesn't currently have a direct-care worker, but she did in college, and she said that support allowed her to graduate.

"There's no way that I would have been able to go live independently at college if I did not have this woman," Cyktor said. "She was the sweetest woman and would come in the morning, help me get up, get dressed for the day, get me set up, and I could go do things independently during the day. And then she'd come back at night, and, same thing, sort of helped me get ready for the night and everything. And that enabled me to go get my degree."

Support at school

Medicaid also funds school-based services, which is the only way that many school districts are able to afford means of support for students with disabilities, such as occupational therapy, nurses, mental health care, and specialized equipment such as wheelchairs.

Cuts to those services could have lifelong consequences for students, Cyktor said. In addition to working at the PEAL Center, Cyktor also provides virtual occupational therapy for students across Pennsylvania.

"So many school-based services are funded by Medicaid, and so it's already something I've sort of been thinking about for these families who I see all across Pennsylvania, in very rural areas, and really the cyber platform is maybe the only time they have access to occupational therapy, any other service," Cyktor said. "So if that gets cut, these kids are going to be losing out on these vital services and doing this really important development at such a young age."

Cyktor works with students in kindergarten through 12th grade on fine motor skills, such as handwriting and typing, as well as executive functioning skills like daily activity scheduling. Without those skills, it will be difficult to enter the workforce, she emphasized.

"If they're cut now, the future impacts are going to be huge for them," she said.


Anna Gustafson wrote this article for the Pennsylvania Independent.


get more stories like this via email