January, 29 2020, 11:00pm EDT
Trump Administration's Block Grant Guidance Targets Cuts to Medicaid Again And Hurts Families and States
Proposal paints a pretty picture but we are not fooled about the true impact.
WASHINGTON
Families USA executive director Frederick Isasi released the following statement regarding the Centers for Medicare and Medicaid Services' guidance for block-granting Medicaid.
"Families USA vehemently opposes the Trump Administration's Medicaid guidance that would allow states to block grant their programs for potentially large cuts in federal Medicaid support. The concept is very clear: Tempt governors with extra-funding or minor flexibilities upfront and then years later, perhaps under a different governor, "cash the check" and slash federal support for the Medicaid program. Having spent many years working with governors and Medicaid programs, block grants are possibly the worst Medicaid idea ever presented to states by a federal Administration. They would allow the federal government to off-load shared Medicaid responsibility at the expense of deep cuts to state budgets, vital programs supported by states, and the people who rely on those programs.
Today's announcement about the so-called, "Healthy Adult Opportunity," essentially gives states the green light to indiscriminately (or discriminately) cut the Medicaid program, with no oversight and no consequences.
Here is what we know about it:
- All adults under age 65, with few exceptions, are at risk. This means coverage and benefits for our most vulnerable -- pregnant women, children 19 and older, and kids in foster care are on the chopping block; and
- CMS is offering states less oversight and only the potential of savings in exchange for taking on huge amounts of financial risk, putting state taxpayer dollars and constituent lives at risk.
Despite the pretty picture the Trump administration is trying to sketch about putting forth a more patient-centered approach for Medicaid, the truth is this proposal does not put the patient first or strengthen Medicaid. With state budgets already stretched thin, accepting Medicaid block grants could likely amount to willful fiscal malpractice and blatant disregard for the needs and interests of states and families. Any governor or state legislature that accepts this nonsensical offer from the Trump administration could not only hurt the millions of families that rely on Medicaid, they could be pouring gasoline on state budget crises that are already ablaze with cuts and program closures.
In my years of work with governors, Medicaid program directors, and legislatures, their number one Medicaid concern is that the federal government might reduce federal support for their programs. Why in the world would states ever agree to block grants, which could guarantee that such cuts would occur? It is concerning that governors of states where Medicaid expansion has been debated will feel pressure to follow this guidance. One example is Oklahoma, where Medicaid expansion will appear as a ballot initiative this November. Other examples are Alaska and Georgia.
Beyond being morally reprehensible, this guidance is illegal. Period. The Trump administration does not have jurisdiction to waive Medicaid's financing structure by fiat -- that must be done through Congress. Further, block-granting Medicaid fails to promote the fundamental objective of the program, which is to serve low-income and working individuals and families. When President Trump and Republican leaders in Congress tried this in 2017, millions of Americans lifted their voices in opposition. The President lost. Now he is attempting an illegal end-run around his failed political effort and trying to take health care away from millions.
While today's announcement applies directly to non-elderly adults, the Trump administration has proposed mandatory caps on federal Medicaid financing for all Medicaid populations. The 72 million people who depend on Medicaid will suffer because of this terrible vision for Medicaid: parents, children with complex health care needs, pregnant woman, and the elderly in nursing homes. And research indicates that when parents have difficulty accessing healthcare insurance, coverage for their children also becomes difficult. If states allow the federal government to off-load its responsibilities for these people, they are putting wrongheaded ideology ahead of the people's needs. Is this really who we are as a nation?"
Eliot Fishman, Families USA senior director of health policy, added, "Any state taking this offer is engaging in fiscal malpractice. Furthermore the Administration is acting lawlessly. None of the statute regarding Medicaid match rates can be waived administratively."
We are better than this, and we--the American people--must hold the Trump administration and Republican members of Congress accountable."
Families USA is a national nonprofit, non-partisan organization dedicated to the achievement of high-quality, affordable health care for all Americans. Working at the national, state, and community levels, we have earned a national reputation as an effective voice for health care consumers for 25 years.
LATEST NEWS
US Voter Registrations Surge as Republicans Try to Limit Ballot Access
One group said it has registered over 100,000 new voters since U.S. President Joe Biden dropped out of the 2024 race.
Jul 26, 2024
The group behind a popular get-out-the-vote technology platform said Friday that it's registered more than 100,000 new U.S. voters since President Joe Biden withdrew from the 2024 presidential race, a surge that came amid mounting Republican efforts to make it harder to register and vote.
Vote.org said that 84% of voters registered in the new wave are under age 35. Nearly 1 in 5 new registrees is 18 years old. Andrea Hailey, the group's CEO, said that "since 2020, we have led the largest voter registration drive in U.S. history," with more than 7.8 million people registered.
After dropping out, Biden endorsed Vice President Kamala Harris to face former Republican President Donald Trump and Sen. JD Vance (R-Ohio) in the November election. The new presumptive Democratic candidate has already earned endorsements from many Democrats in Congress and groups advocating on issues including climate, labor, and reproductive rights.
Vote.org's success comes as Republicans at the federal level are proposing and passing legislation creating obstacles to the ballot box.
Earlier this month, U.S. House Republicans passed Rep. Chip Roy's (R-Texas)
Safeguard American Voter Eligibility (SAVE) Act, which would require proof of American citizenship to vote in federal elections. Republicans claim the bill is meant to fix the virtually nonexistent "problem" of noncitizen voter fraud.
However, Rep. Summer Lee (D-Pa.)
slammed the bill as a "xenophobic attack" meant to silence "Black voices, brown voices, LBGTQIA+ voices, [and] young voices."
Lee said the SAVE Act underscores the need to pass her recently introduced Right to Vote Act, "which would establish the first-ever affirmative federal voting rights guarantee, ensuring every citizen may exercise their fundamental right to cast a ballot."
Earlier this year, U.S. Senate Democrats also reintroduced the John R. Lewis Voting Rights Advancement Act, legislation its sponsors say will "update and restore critical safeguards of the original Voting Rights Act."
Meanwhile, Republican-controlled state legislatures and red-state governors are enacting laws imposing tough restrictions on voter registration, with violations punishable by stiff fines that critics say are meant to dissuade people from registration drives and similar efforts.
Again under the guise of preventing fraud, Republican Florida Gov. Ron DeSantis last year signed legislation limiting voter registration drives, with fines of up to $250,000 for violators.
"These draconian laws and rules are like taking a sledgehammer to hit a flea," Cecile Scoon, an attorney and president of the Florida chapter of the League of Women Voters,
toldThe New York Times in an article published Friday.
Three years after Kansas passed a law making "false representation" of an election official a crime, campaigners say it's become extremely difficult to sign up new voters.
"In 2020, even with the pandemic, we had registered nearly 10,000 Kansans to vote. Now, we haven't been able to register anyone," Davis Hammet, president of the youth voter mobilization group Loud Light, told the Times.
In Louisiana, Republican state lawmakers quietly passed legislation making it easier for election officials to toss out absentee ballots with missing details, limiting how people can mail in other voters' ballots, and restricting the ability to assist people with disabilities with their ballots.
"What we've found is that these measures have a disproportionate impact on voters with disabilities, both Black and white," NAACP Legal Defense Fund senior policy counsel Jared Evans
toldNola.com earlier this week.
"It's clear that their goal is to make it harder to vote, harder for specific communities to vote especially," Evans added. "What they don't realize is that these laws hurt white voters, too."
In Nebraska, Republican Secretary of State Bob Evnen last week
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"We refuse to accept thousands of Nebraskans having their voting rights stripped away," ACLU of Nebraska legal and policy fellow Jane Seu said in a statement. "We are confident in the constitutionality of these laws, and we are exploring every option to ensure that Nebraskans who have done their time can vote."
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"You thought Project 2025 was just a threat after the election? It's actually happening *right now,*" said one climate campaigner.
Jul 26, 2024
Climate and environmental defenders on this week implored U.S. senators to block a permitting reform bill introduced this week by Sens. Joe Manchin and John Barrasso that campaigners linked to Project 2025, a conservative coalition's agenda for a far-right overhaul of the federal government.
Common Dreamsreported Monday that Manchin (I-W.Va.) and Barrasso (R-Wyo.)—respectively the chair and ranking member of the Senate Energy and Natural Resources Committee—introduced the Energy Permitting Reform Act of 2024.
The Natural Resources Defense Council (NRDC) noted that although the proposal "includes several positive reforms for the accelerated development of transmission projects," it also advocates "limiting opportunities for communities to challenge projects, loosening oversight for drilling and mining projects, extending drilling permits and fast-tracking [liquified natural gas] permits, and several other provisions friendly to fossil fuel giants."
"This dangerous bill doesn't deserve a floor vote."
These are nearly identical policies to what's proposed in Project 2025's Mandate for Leadership. The plan, which was spearheaded by the Heritage Foundation, calls for "unleashing all of America's energy resources," including by ending federal restrictions on fossil fuel drilling on public lands; limiting investments in renewable energy; and rolling back environmental permitting restrictions for new oil, gas, and coal projects, including power plants.
While Manchin has been trying—and failing—to pass fossil fuel-friendly permitting reform legislation for years, Brett Hartl, director of public affairs at the Center for Biological Diversity, said that his "Frankenstein legislation is taken straight from Project 2025, and it's the biggest giveaway in decades to the fossil fuel industry."
Hartl said the bill "deprives communities of the power to defend themselves and gives that power to Big Oil by making it harder for communities to challenge polluting projects in court," and "prioritizes the profits of coal barons over public health."
"And it mandates oil and gas extraction in our oceans," he continued. "The insignificant crumbs thrown at renewable energy do nothing to address the climate emergency."
"Monday was the hottest day in recorded history," Hartl noted. "It's shocking that as the climate emergency continues to break records around us, the Senate continues to fast-track the fossil fuel expansion that is killing us. This dangerous bill doesn't deserve a floor vote."
Hartl added that "to preserve a livable planet," Senate Majority Leader Chuck Schumer (D-N.Y.) "must squash this legislation now."
Manchin—who has said this will be his last term in office—has been a steadfast supporter of the fossil fuel industry, partly because his family owns a coal company. The senator says his permitting reform bill "will advance American energy once again to bring down prices, create domestic jobs, and allow us to continue in our role as a global energy leader."
However, Allie Rosenbluth, Oil Change International's U.S. manager, warned Thursday that "this bill is yet another dangerous attempt by Sen. Manchin to line the pockets of his fossil fuel donors, sacrificing communities and our climate along the way."
"Don't be fooled: The Energy Permitting Reform Act is another dirty deal to fast-track fossil fuels above all else," she continued. "It would unleash more drilling on federal lands and waters, unnecessarily rush the review of proposed oil and gas export projects, and lift the Biden administration's pause on new LNG exports."
"We urge Congress to reject this proposal and commit to action that protects frontline communities from the impacts of fossil fuel development and the climate crisis," Rosenbluth added.
"Don't be fooled: The Energy Permitting Reform Act is another dirty deal to fast-track fossil fuels above all else."
NRDC managing director of government affairs Alexandra Adams said Wednesday that "this bill is a giveaway for the oil and gas industry that will ramp up drilling and environmental destruction at a time when we need to be putting a hard stop to fossil fuels."
"We cannot afford to roll back so many of our bedrock environmental and community legal protections and offer a blank check to the oil and gas industry," she stressed. "We need new solutions for permitting if we are going to meet our clean energy potential and address the climate challenge. But this is not it."
"This bill would altogether be a leap backward on climate, health, and justice if passed into law," Adams added. "The Senate should reject it and look toward alternative solutions already being considered."
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'Nothing To Eat': War-Torn Sudan Faces Mass Famine as Military Delays Aid
Both parties in Sudan's civil war are to blame for a looming mass famine, experts say, and the military's blocking of U.N. aid at a border crossing with Chad exacerbates the problem.
Jul 26, 2024
Sudan's military is blocking United Nations aid trucks from entering at a key border crossing, causing severe disruptions in aid in a country that experts fear may be on the brink of one of the worst famines the world has seen in decades, The New York Timesreported Friday.
The border city of Adré in eastern Chad is the main international crossing into the Darfur region of Sudan, but the Sudanese Armed Forces (SAF), the state's official military, which is engaged in a civil war with a paramilitary group called the Rapid Support Forces (RSF), has refused to issue permits for U.N. trucks to enter there, as it's an RSF-controlled area.
U.S. and international officials have issued increasingly alarmed calls for steady aid access to help feed the millions of severely malnourished people in Darfur and other areas of Sudan.
Last week, Linda Thomas-Greenfield, the United States ambassador to the U.N., said that the SAF's obstruction of the border was "completely unacceptable."
Both warring parties in Sudan continue to perpetrate brazen atrocities, including starvation of civilians as a method of warfare. This piece focuses on the SAF's ongoing obstruction of essential aid. The situation is catastrophic. The policy is criminal. https://t.co/FKhqQh3EI9.
— Tom Dannenbaum (@tomdannenbaum) July 26, 2024
The Sudanese who've made it out of the country and into Adré reported dire and unsafe conditions in their home country.
"We had nothing to eat," Bahja Muhakar, a Sudenese mother of three, told the Times after she crossed into Chad, following a harrowing six-day journey from Al-Fashir, a major city in Darfur. She said the family often had to live off of one shared pancake per day.
Another mother, Dahabaya Ibet, said that her 20-month-old boy had to bear witness to his grandfather being shot and killed in front of his eyes when the family home in Darfur was attacked by gunmen late last year.
Now the mothers and their families are refugees in Adré, where 200,000 Sudanese are living in an overcrowded, under-resourced transit camp.
In addition to those that have made it out of the country, there are 11 million people internally displaced within Sudan, most of whom have become displaced since the civil war began in April 2023.
An unnamed senior American official told the Times that the looming famine in Sudan could be as bad as the 2011 famine in Somalia or even the great Ethiopian famine of the 1980s.
In April, Reutersreported that people in Sudan were eating soil and leaves to survive, and The Washington Postcalled it a nation in "chaos," reporting that World Food Program trucks had been "blocked, hijacked, attacked, looted, and detained."
In late June, a coalition of U.N. agencies, aid groups, and governments warned that 755,000 people in Sudan faced famine in the coming months.
The U.S. last week announced $203 million in additional aid to Sudan—part of a $2.1 billion pledge that world leaders made in April, which some countries have not yet delivered on.
Some officials including Thomas-Greenfield, who has dubbed the situation in Sudan "the worst humanitarian crisis in the world," have called for the U.N. Security Council to allow aid delivery into the country even in the absence of SAF approval; it's believed that Russia would veto such a measure.
Sudan's civil war has seen a great deal of international interference. Amnesty International on Thursday published an investigatory briefing showing that weapons from Russia, China, Serbia, Turkey, Yemen, and the United Arab Emirates (UAE) had been identified in the country. And The Guardian on Friday reported that the passports of Emirati citizens had been found among wreckage in Sudan, indicating the UAE may have troops or intelligence officers on the ground, though the UAE denied the accusation.
The International Service for Human Rights on Friday warned that both the SAF and RSF were engaged in wrongful killings and arrests, especially targeted at lawyers, doctors, and activists. The group called for an immediate cease-fire.
The SAF and Sudanese government figures have cast doubt on international experts' claims about famine in the country.
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