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xavier becerra
The Uncomfortable Progressive Case for Tom Steyer
Despite being a billionaire himself, Steyer appears to be the only major candidate in California's governor race openly escalating conflict with the monopolies, corporate interests, and institutional failures driving the state's affordability crisis.
Jun 02, 2026
California voters are clearly hungry for change. The real question now is whether Democrats are willing to confront the corporate interests and entrenched systems standing in the way of it.
That is one reason a growing number of progressives, labor organizers, climate activists, and anti-corporate advocates are rallying behind Tom Steyer despite longstanding discomfort with billionaire politics.
At first glance, that coalition can feel contradictory. Progressives have spent years warning, correctly, about the dangers of concentrated wealth and billionaire influence in American politics. Many still believe that billionaires should not exist in a healthy democracy.
So why are so many anti-corporate organizers increasingly rallying behind one now?
The question is not whether candidates are perfect vessels for progressive ideals. The question is whether they are willing to pick the right fights.
Because politics is ultimately about conflict. It is about who is willing to challenge concentrated power, which interests candidates are willing to confront, and whether they are prepared to pursue structural change instead of simply managing decline.
The question is not whether someone benefited from broken systems. The question is whether they are willing to confront the systems that produced their own power in the first place.
And increasingly, Tom Steyer appears to be the only major candidate in California's governor race openly escalating conflict with the monopolies, corporate interests, and institutional failures driving the state's affordability crisis.
That matters because California is not entering a traditional election environment.
Recent polling suggests Xavier Becerra is increasingly likely to secure one of the two spots in California's top-two primary. Whether voters like it or not, that reality changes the strategic conversation.
At a moment when voters are demanding structural change, Becerra increasingly represents continuity politics. He has struggled to articulate a meaningful critique of the status quo or explain what he would fundamentally do differently than Gavin Newsom.
The question facing many progressive voters is no longer simply which candidate they prefer. It is whether a candidate willing to challenge concentrated power, monopoly interests, and entrenched systems will make it into the general election at all.
That matters because Steve Hilton is running aggressively as an anti-establishment change candidate. If Democrats allow this race to become a contest between a candidate associated with continuity and a Republican claiming the mantle of disruption, they risk ceding the language of change to the right.
You cannot defeat a change candidate with a status quo candidate.
You need a competing change agent.
Steyer is increasingly positioning himself as one.
What makes this politically significant is not simply that he uses progressive rhetoric. Plenty of candidates do that. What matters is that he is embracing policies that directly confront concentrated wealth and monopoly power, including support for single-payer healthcare, a billionaire tax, breaking up utility monopolies, lowering energy costs, expanding public education, and building affordable housing at scale.
Those are not symbolic positions. They are direct challenges to entrenched systems of political and economic power.
And increasingly, many progressives believe the clearest indicator of that conflict is not who Steyer is. It is who is lining up against him.
When utility monopolies, fossil fuel interests, anti-tax billionaires, and major corporations begin mobilizing against the same candidate, voters should pay attention.
That does not mean progressives suddenly agree with everything about Tom Steyer or billionaire politics generally. It means many recognize that political alignment matters more than biography alone.
The question is not whether candidates are perfect vessels for progressive ideals. The question is whether they are willing to pick the right fights.
For many progressives, supporting Steyer is not about abandoning skepticism toward wealth or power. It is about recognizing that in moments of deep public frustration, the most important political question becomes who is actually willing to confront the forces making life increasingly unaffordable, unstable, and unequal.
That is the uncomfortable reality reshaping this race.
The question facing California voters is no longer whether the state needs change.
It is whether a candidate willing to fight for that change will still be standing when the general election begins.
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California’s Choice: The Progressive Path or Centrist Stagnation
Today June 2, 2026, in California, voters have an opportunity to alter American history by electing progressives up and down the ballot.
Jun 02, 2026
Within national mythology, California is understood to be a progressive haven—with a ruling Democratic Party passing strong regulations, ever-higher taxes on the wealthy, and supporting unions to its heart’s desire.
Unfortunately, this is far from accurate. The Democratic Party may dominate California politics, but the wealthiest state in the union no longer leads the way with innovative laws and regulations, let alone serving the interests of working people, the poor, and the middle class.
Yes, California still has a progressive income tax, the nation’s highest gas taxes, relatively strong environmental regulations, and the world’s greatest public university system—but these are legacies of bygone eras. The story of the last 20 years of single-party Democratic rule is far less inspiring (unless you’re a Silicon Valley oligarch).
Now, as progressives are making significant gains across the country, revitalizing the Democratic Party in the process, the California party remains dominated by a caste of perennial incumbents committed to neoliberal centrism that, at best, generates incremental change.
Rest assured that progressives on the ballot are part of a national movement that understands that the Democratic Party has bifurcated into a vibrant progressive wing and an increasingly sclerotic moderate establishment.
Perhaps this shouldn’t be surprising. Once Democrats started winning supermajorities in both houses of the state legislature, corporations and big money interests stopped wasting their time courting Republicans. They focused their lobbying on Democrats, and to great effect. California’s Democratic Party, and its leading figures, are more beholden to big business and wealthy donors than almost any state Democratic Party. This, in turn, means Democratic incumbents accrue huge campaign war chests for their re-election.
The result is a more conservative party, one that is out of sync with the electorate. Want evidence? Ask yourself how many members of the Squad have come from California? The answer, of course, is zero. Yet all public opinion polling shows that the California electorate is decisively more progressive than the national average.
It’s true that Reps. Ro Khanna and Lateefah Simon are Squad adjacent, and a few others are solid progressives—but given that California represents about 20% of the Democratic Caucus in the US House, the state’s delegation is on balance middle-of-the-road.
This disconnect—between the political beliefs of Californians and the policies supported by their elected representatives at the national, state, and even local levels—is a major barrier to the necessary transformation of the Democratic Party into a force able to vanquish the fascist-authoritarian GOP before it consolidates power and brings down the curtain on American democracy.
Simply put, the American public increasingly understands that the status quo ante of neoliberal policy, which has organized the country’s economy since the 1980s, produces one result: ever-increasing wealth inequality. The Democratic Party must break from the economics of the Clinton and Obama administrations. The Democratic base and the general public want policies that boost the lives of working Americans, just as they want a sane foreign policy and an honest democracy. They want progressive policies.
Today June 2, 2026, in California, voters have an opportunity to alter American history by electing progressives up and down the ballot. This will transform the largest state Democratic Party, bringing it back in sync with the sentiment of the state’s population so that it can lead in the development of a new 21st century social justice compact.
There are many progressive champions with a real chance of victory today—and in the general election runoff on November 3. To start, there is a clear choice at the top of the ticket: Tom Steyer for governor.
Steyer is one of three viable candidates, two of which will make the runoff. In the best circumstance, the two democrats, Steyer and Xaiver Beccera, will take first and second—a result that will translate into more Democratic victories across the state in November. However, MAGA-supporting Republican Steve Hilton still looks likely to disrupt that result. So, it’s essential to vote, and get everyone you know to vote for Steyer by 8:00 pm PT today.
Admittedly, it sticks in the throat to be supporting a billionaire, but the simple truth is that Steyer will pursue a transformative progressive policy agenda. In contrast, Xavier Beccera, who 20 years ago seemed a sincere progressive, long ago redefined himself as an establishment Democrat. Becerra is committed to maintaining Gov. Gavin Newsom’s policies that have left California stranded with the nation’s co-equal highest poverty rate, an affordability crisis that makes New York City residents blush, and a pronounced failure to lead on environmental and social policies in the manner the world expects of California.
Tom Steyer, by contrast, supports a billionaire’s tax, meaningful living wage legislation, aggressive incentives to re-boost green energy production (and film production too), and, most tellingly, a single-payer universal healthcare system for everyone in the state. A top-two finish by Steyer will guarantee a powerful debate about the direction of the state over the next five months
Beyond the governor’s race, in nearly every US house district, state assembly, and senate race, and significant city and local elections, there are strong progressive candidates challenging the dominant California Democratic Party mainstream—many of whom are poised to advance to the November runoff. Still, it’s worth noting that this has been a very confusing election season due to redistricting (and the chaos of the governor’s race), such that down-ballot candidates have had a difficult time attracting adequate attention. But rest assured that progressives on the ballot are part of a national movement that understands that the Democratic Party has bifurcated into a vibrant progressive wing and an increasingly sclerotic moderate establishment. Please do the necessary research to learn who the progressives are in your district.
So far, it’s been a very good year for progressives—let’s continue the momentum tomorrow in New Jersey, Montana, Iowa, New Mexico, South Carolina, and the largest state and soon-to-be truest bastion of progressive public policy, California.
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Federal Judge Tosses Big Pharma Lawsuit Against Medicare Drug Price Negotiations
"Big PhRMA is so desperate to stop the Biden administration from lowering drug costs for seniors that they’re clogging the judicial system with spam lawsuits even in courtrooms they have no jurisdiction in."
Feb 13, 2024
A federal judge on Monday dismissed a lawsuit that the pharmaceutical industry's powerful trade group and allied organizations filed in an attempt to kill Medicare's new drug price negotiation program, which threatens manufacturers' virtually unrestrained power to drive up the prices of lifesaving medicines.
Judge David Alan Ezra of the U.S. District Court for the Western District of Texas tossed the lawsuit on procedural grounds, ruling that the National Infusion Center Association (NICA)—which does not manufacture or sell prescription drugs—lacked standing to sue.
Because NICA was the only plaintiff based in Texas, Ezra—a Reagan appointee—dismissed the lawsuit, which was joined by Pharmaceutical Research and Manufacturers of America (PhRMA) and the Global Colon Cancer Association. The coalition argued that the Medicare price negotiation program is unconstitutional, a claim that advocates have dismissed as cover for the industry's attempt to protect its profits.
A spokesperson for PhRMA, which spends tens of millions of dollars a year lobbying Congress, told Axios in a statement that the group is "disappointed" with the judge's decision and is weighing its next legal steps.
Tony Carrk, executive director of Accountable.US, said in response to Ezra's decision that "Big PhRMA is so desperate to stop the Biden administration from lowering drug costs for seniors that they're clogging the judicial system with spam lawsuits even in courtrooms they have no jurisdiction in."
"The big drug industry will say or do anything to strip away Medicare's new negotiation powers so that they can go back to business-as-usual price-gouging seniors on life-saving medicines," Carrk added.
The Lower Drug Prices Now campaign called on the "rest of the Big Pharma corporations suing Medicare" to stop fighting the program and "start negotiating."
The judge's ruling marks the second setback the pharmaceutical industry and its allies have faced in court since unleashing a barrage of lawsuits last year against the Medicare drug price negotiation program, which was launched under the Inflation Reduction Act. In late September, a federal judge allowed Medicare to continue implementing the program amid a legal challenge brought by the U.S. Chamber of Commerce and its affiliates.
Earlier this month, the Biden administration made its opening price offers to the manufacturers of 10 high-priced prescription drugs, including Pfizer, Merck, and Johnson & Johnson—each of which is suing over the Medicare program.
The companies now have less than a month to either accept the administration's offer or put forth a counter.
Xavier Becerra, secretary of the Health and Human Services Department, said Monday that the Texas judge's ruling "offers more reason for optimism that our work driving down the cost of prescription drugs will build."
"We will continue to implement the president's historic prescription drug price law, which is already delivering for the American people," said Becerra.
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Wyden Says GOP Medicaid Purge Puts 'Politics Before Children's Health'
New government data indicates that just nine Republican-led states are responsible for 60% of Medicaid and Children's Health Insurance Program disenrollments since April.
Dec 19, 2023
U.S. Sen. Ron Wyden ripped GOP governors on Monday for endangering the well-being of kids in their states for political purposes as they gut their Medicaid and Children's Health Insurance Program rolls at an alarming clip, sparking pushback from the Biden administration and healthcare advocates.
"Unfortunately, it's clear that too many Republican governors have chosen to put politics before children's health," Wyden (D-Ore.), chairman of the Senate Finance Committee, said in a statement after the U.S. Department of Health and Human Services (HHS) released new data showing that a small handful of GOP-led states account for the majority of Medicaid and CHIP disenrollments since April.
That month, the federal government began allowing states to resume eligibility checks and disenrollments that were paused during the Covid-19 pandemic. The health policy nonprofit KFF has estimated based on available data that 71% of those kicked off Medicaid across the U.S. since April have lost coverage for procedural reasons, such as a paperwork error.
Wyden said it's "encouraging" that HHS is giving governors "the opportunity to do right by the families they cover" and pledged to work with President Joe Biden's administration to "ensure everything possible is done to protect coverage for families walking an economic tightrope."
According to the HHS analysis, nine Republican-led states are responsible for roughly 60% of Medicaid and CHIP disenrollments this year: Arkansas, Florida, Georgia, Idaho, Montana, New Hampshire, Ohio, South Dakota, and Texas. Additionally, HHS said the 10 states that have not expanded Medicaid under the Affordable Care Act "have disenrolled more children than those that have expanded combined."
"States must take bold action to prevent a large increase in their uninsured child population. Three million losing Medicaid and counting is a terrible way to ring in the new year."
In letters to the nine states' GOP governors, HHS Secretary Xavier Becerra urged them to "ensure that no child in your state who still meets eligibility criteria for Medicaid or CHIP loses their health coverage due to 'red tape' or other avoidable reasons as all states 'unwind' from the Medicaid continuous enrollment provision that was in place during much of the Covid-19 public health emergency."
"HHS takes its oversight and monitoring role during the renewals process extremely seriously," Becerra added, "and will not hesitate to take action to ensure states' compliance with federal Medicaid requirements."
Becerra suggested a few strategies aimed at improving the states' often byzantine renewal processes, including boosting auto-renewals and engaging in more active outreach efforts to make sure families know how to keep their coverage.
At least one state leader, Republican Gov. Sarah Huckabee Sanders of Arkansas, signaled she has no intention of acting on Becerra's recommendations.
"The failing Biden admin sent letters to GOP-led states in a politically motivated PR stunt, accusing us of restricting Medicaid access. That's false," Sanders, who served as former President Donald Trump's press secretary, wrote on social media in response to Becerra's letter. "Arkansas is in compliance with state and federal law, while Biden plays politics at Christmas."
Arkansas has worked aggressively to curb its Medicaid rolls this year, stripping more than 427,000 people of coverage in just six months. In September alone, more than 21,000 people were removed from the program for not returning their enrollment paperwork, according to state data.
The nationwide Medicaid purge that began in April has been described as "the largest concentration of health insurance loss in American history," and both Republican governors and the Biden administration have faced criticism for failing to prevent disaster.
Georgetown University's Center for Children and Families (CCF) estimates that, as of Monday, more than 3 million children have been disenrolled from Medicaid since eligibility checks resumed in the spring.
"In 2022, 3.9 million children were uninsured, so even if the majority of children losing Medicaid have other sources of coverage, the number of uninsured children is rising sharply," CCF executive director Joan Alker wrote in a blog post on Monday. "States must take bold action to prevent a large increase in their uninsured child population. Three million losing Medicaid and counting is a terrible way to ring in the new year."
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'Rescheduling Is Not Enough,' Advocates Say of HHS Cannabis Recommendation
"The goal of any federal cannabis policy reform ought to be to address the existing, untenable chasm between federal marijuana policy and the cannabis laws of the majority of U.S. states," said NORML's deputy director.
Aug 30, 2023
Cannabis reform advocates and industry representatives on Wednesday renewed demands for legalizing marijuana at the federal level as U.S. Health and Human Services Secretary Xavier Becerra confirmed his department's rescheduling recommendation.
Marijuana is currently a Schedule I drug—the most restricted category under the Controlled Substance Act (CSA)—but President Joe Biden ordered Becerra and Attorney General Merrick Garland to initiate a review last October, when he issued a mass pardon for simple federal cannabis possession.
Bloomberg initially reported Wednesday that a Department of Health and Human Services (HHS) official on Tuesday wrote to Drug Enforcement Administration (DEA) chief Anne Milgram to recommend reclassifying cannabis Schedule III, a development Becerra confirmed on social media at 4:20 pm ET.
"Following the data and science, HHS has expeditiously responded to President Biden's directive to HHS Secretary Becerra and provided its scheduling recommendation for marijuana to the DEA on August 29, 2023," an HHS spokesperson told Marijuana Moment. "This administrative process was completed in less than 11 months, reflecting this department's collaboration and leadership to ensure that a comprehensive scientific evaluation be completed and shared expeditiously."
A DEA spokesperson confirmed to the outlet that it received the HHS letter and said: "DEA has the final authority to schedule or reschedule a drug under the Controlled Substances Act. DEA will now initiate its review."
Asked about Bloomberg's reporting on Wednesday, White House Press Secretary Karine Jean-Pierre stressed to reporters that Biden requested the scheduling review, "it's going to be an independent process," and "it's going to be guided by evidence." She declined to comment regarding Biden's position on decriminalization.
NORML declared in an email that "rescheduling is not enough," and in response to the letter, deputy director Paul Armentano said that "it will be very interesting to see how DEA responds to this recommendation, given the agency's historic opposition to any potential change in cannabis' categorization under federal law. Further, for decades, the agency has utilized its own five-factor criteria for assessing cannabis' placement in the CSA—criteria that as recently as 2016, the agency claimed that cannabis failed to meet. Since the agency has final say over any rescheduling decision, it is safe to say that this process still remains far from over."
Armentano argued that "the goal of any federal cannabis policy reform ought to be to address the existing, untenable chasm between federal marijuana policy and the cannabis laws of the majority of U.S. states," and rescheduling "fails to adequately address this conflict."
"Just as it is intellectually dishonest to categorize cannabis in the same placement as heroin, it is equally disingenuous to treat cannabis in the same manner as anabolic steroids," he added. "The majority of Americans believe that cannabis ought to be legal and that its hazards to health are less significant than those associated with federally descheduled substances like alcohol and tobacco. Like those latter substances, we have long argued the cannabis plant should be removed from the Controlled Substances Act altogether, thereby proving state governments—rather than the federal government—the ability to regulate marijuana in the manner they see fit without violating federal law."
Medicinal use of cannabis is allowed by 38 states, three U.S. territories, and the District of Columbia while recreational adult use is permitted in 23 states, two territories, and D.C., according to the National Conference of State Legislatures.
Under the HHS plan, "state medical and adult-use marijuana programs will still remain federally illegal, meaning patients, consumers, and workers would remain subject to federal arrest; noncitizens would remain subject to deportation simply for possessing marijuana or working in the industry; and federal marijuana arrests and prosecutions will continue, previous arrests will not be expunged, and thousands will remain incarcerated in federal prison for marijuana violations," emphasized Cat Packer, director of drug markets and legal regulation at the Drug Policy Alliance.
"It also means that federal benefits, such as housing and nutritional assistance, will still be denied to certain people with previous marijuana convictions and the federal government will continue to be unable to foster a fair business environment that allows small and minority-owned marijuana businesses to compete with large corporate marijuana operators," noted Packer, urging the president to "limit the harms of marijuana criminalization" and work with Congress to pass the Cannabis Administration and Opportunity Act (CAOA).
U.S. Senate Majority Leader Chuck Schumer (D-N.Y.)—an advocate of federally legalizing cannabis and an original CAOA co-sponsor—said in a statement that "HHS has done the right thing and DEA should now quickly follow through on this important step to greatly reduce the harm caused by draconian marijuana laws."
"While this is a step forward, there is still much more that needs to be done legislatively to end the federal prohibition on cannabis and roll back the War on Drugs," Schumer added. "I am committed to continuing to work in Congress to pass important marijuana legislation and criminal justice reform."
U.S. Cannabis Council "enthusiastically" welcomed the HHS recommendation, saying on social media: "We believe that rescheduling to Schedule III will mark the most significant federal cannabis reform in modern history. President Biden is effectively declaring an end to [former President Richard] Nixon's failed war on cannabis and placing the nation on a trajectory to end prohibition."
While recognizing the range of benefits from the potential rescheduling—from making research easier to tax deductions for businesses—the industry group also emphasized its commitment to full cannabis legalization at the federal level.
National Cannabis Industry Association CEO Aaron Smith said that "moving cannabis to schedule III could have some limited benefit but does nothing to align federal law with the 38 U.S. states which have already effectively regulated cannabis for medical or adult use. The only way to fully resolve the myriad of issues stemming from the federal conflict with state law is to remove cannabis from the Controlled Substances Act and regulate the product in a manner similar to alcohol."
This post has been updated with comment from the Drug Policy Alliance.
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Sanders Raises Fresh Concerns Over 'Outrageous' Price of New Alzheimer's Drug
"Not only does the high price of Leqembi threaten Medicare's finances, it will also negatively impact seniors on fixed incomes suffering from Alzheimer’s who simply cannot afford to pay."
Jul 10, 2023
Sen. Bernie Sanders on Monday reiterated his concerns over the staggering price tag of a newly approved Alzheimer's medication after the Biden administration failed to respond to his letter last month urging swift executive action to force down the cost.
In a new letter to Health and Human Services Secretary Xavier Becerra, Sanders (I-Vt.) wrote that the current $26,500 list price for Leqembi is "outrageous" and demanded that the Biden administration explain "why the cost of this drug cannot be reduced to $8,900—which is the price independent experts believe it should cost based on its effectiveness."
Sanders, the chair of the Senate Health, Education, Labor, and Pensions (HELP) Committee, raised particular alarm over the drug's possible impact on Medicare's finances.
Shortly after the Food and Drug Administration (FDA) approved Leqembi last week, the Centers for Medicare and Medicaid Services announced that Medicare will cover the treatment "broadly"—a contrast from its decision last year to limit coverage of Aduhelm, a different high-priced Alzheimer's drug.
KFF estimates that if 5% of people with Alzheimer's disease use Leqembi—also known as lecanemab—Medicare's annual outlays for the IV infusion treatment would be $8.9 billion, a spending increase that could push premiums up for all Medicare recipients.
As Sanders wrote, "Not only does the high price of Leqembi threaten Medicare's finances, it will also negatively impact seniors on fixed incomes suffering from Alzheimer’s who simply cannot afford to pay the 20% co-payment of more than $5,000 a year for this drug."
"With a median income of about $30,000 a year for seniors on Medicare the purchase of this one drug would amount to over one-
sixth of their limited income. For one drug! That is unacceptable," the senator continued. "A prescription drug is not effective if a patient who needs that drug cannot afford it."
"If I do not receive an adequate and timely response, I will be inviting you to attend a HELP Committee hearing so that you can explain to the American people why we pay, by far, the highest prices in the world for prescription drugs."
Sanders first wrote to the Biden administration about Leqembi's cost on June 7, when he warned that the price tag proposed by manufacturers Biogen and Eisai was "unconscionable" and "grossly unfair to seniors suffering from Alzheimer's disease."
But Becerra never responded to Sanders' June letter, the senator wrote Monday.
Sanders requested in his new letter that Becerra provide answers to the fresh series of questions by July 21.
Among the questions Sanders wants answered is whether Becerra is "prepared to use [his] existing authority, under 28 U.S.C. Section 1498, to break the patent monopoly on exorbitantly priced prescription drugs."
"If I do not receive an adequate and timely response," Sanders wrote, "I will be inviting you to attend a HELP Committee hearing so that you can explain to the American people why we pay, by far, the highest prices in the world for prescription drugs and how those outrageous prices threaten Medicare beneficiaries and patients throughout the country."
On top of concerns about its potential harms to Medicare's financial health, experts and consumer advocates have said they're worried about the Leqembi's effectiveness and safety for Alzheimer’s patients, citing the drug's impacts on some trial subjects.
Dr. Robert Steinbrook, director of Public Citizen's Health Research Group, said in a statement last week that "the FDA's decision to grant full approval for lecanemab to treat adult patients with Alzheimer’s disease is misguided and very disappointing."
"The evidence for the drug's clinical benefits does not outweigh its substantial health risks," Steinbrook argued. "The fact that a black box warning for brain swelling and bleeding risks has been added to the prescribing information for lecanemab underscores the substantial safety concerns."
"Patients with Alzheimer's disease and their families are understandably desperate for better treatments," he added. "When it approves drugs for Alzheimer's disease with little or no benefit and significant health risks, the FDA fails patients and the public."
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Biden Administration Urged to Act as States Throw 1.2 Million Off Medicaid
"We never got anything telling us to recertify," said one Florida resident whose children lost coverage. "We never got anything saying we were booted out of the system."
Jun 16, 2023
A healthcare catastrophe is unfolding across the U.S. as states—now unrestrained by coverage rules enacted early in the coronavirus pandemic—continue to remove people from Medicaid at an alarming clip, mostly for procedural reasons unrelated to their eligibility for the program.
The Kaiser Family Foundation (KFF), which has been tracking Medicaid disenrollments since Congress and the Biden White House agreed late last year to begin unwinding pandemic-era coverage protections in April, estimates based on state data that more than 1.2 million people have been removed from the program in 21 states as of Thursday.
KFF found that in the states with available numbers, "76% of all people disenrolled had their coverage terminated for procedural reasons." Such disenrollments, KFF noted, "can occur when the state has outdated contact information or because the enrollee does not understand or otherwise does not complete renewal packets within a specific timeframe."
Eligibility checks and renewal procedures, which vary by state, are a bureaucratic maze in which many are bound to get lost.
In Republican-led Florida, the state with the most disenrollments thus far at close to 250,000, some residents say they've been removed from Medicaid without receiving any notice from the government, finding out about their lack of coverage only when they attempted to schedule a doctor's appointment or pick up a prescription.
"We never got anything telling us to recertify," said one Florida resident whose children recently lost their Medicaid coverage. "We never got anything saying we were booted out of the system."
Similar reports are emerging from Arkansas, where Republican Gov. Sarah Huckabee Sanders is publicly bragging about the pace of her state's Medicaid purge. Federal guidance gives states up to 14 months to complete their Medicaid eligibility screenings, which were paused during the coronavirus pandemic to limit coverage disruptions.
But Sanders has pledged to finish the process in half that time—and many are falling through the cracks as a result.
More than 110,000 thousand Arkansans have lost Medicaid since April, the third-largest disenrollment total in the country behind Florida and Arizona, according to data compiled by KFF.
Politico reported earlier this week that "seven in 10 Arkansans who have lost their insurance have been dropped for procedural or administrative reasons," meaning "the government hasn’t determined someone makes too much money to qualify for Medicaid, but rather that the person failed to respond to a letter or provide extra information to renew their coverage."
"In some cases, people are losing coverage because of system glitches," the outlet added. "What's happening in Arkansas is unique in its speed but the state’s early efforts are a cautionary tale for the roughly 93 million Americans on Medicaid who are expected to go through the renewal process during the next year."
"These numbers are staggering and suggest excessively high rates of denials on procedural grounds that could severely harm access to care for children."
Despite the worrying statistics and anecdotes, the Biden administration has declined to intervene or criticize the Medicaid redetermination process of any specific state.
Earlier this week, Health and Human Services Secretary Xavier Becerra sent a letter to the governor of every U.S. state expressing concern over the "high number of people losing coverage due to administrative processes" and reminding officials that they "must comply with federal rules regarding how they conduct" Medicaid renewals, including affording due process to those kicked off the program.
Becerra sent the letter after Rep. Frank Pallone (D-N.J.) and Sen. Ron Wyden (D-Ore.) implored federal health officials to "ensure states are held accountable for complying with federal law, and step in to protect vulnerable populations from being improperly disenrolled from Medicaid."
"We urge you to move swiftly to use these tools to prevent more coverage losses among eligible children and adults in Florida, Arkansas, and other states," the lawmakers wrote, citing a " disturbing report" that "described a family of a five-year-old with cancer spending hours on the phone with Florida's Medicaid agency to determine if their son had lost coverage after the website indicated he had."
"In the first month of redeterminations in Florida, over half of the people whose eligibility was checked were terminated," wrote Pallone and Wyden. "Over 80% were for procedural reasons and most are likely to be children and parents given that Florida has not expanded Medicaid to adults. These numbers are staggering and suggest excessively high rates of denials on procedural grounds that could severely harm access to care for children."
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Sanders to Biden: Don't Let Big Pharma Bankrupt Medicare With 'Unconscionable' Price of Alzheimer's Drug
"We must substantially lower the price that Medicare pays for prescription drugs like Leqembi," said the Vermont Independent, "and HHS has the power to do just that."
Jun 07, 2023
U.S. Sen. Bernie Sanders on Wednesday urged the Biden administration to use the "full extent" of its executive authority to lower the "outrageously high" price of a new Alzheimer's treatment being reviewed by federal regulators.
"Alzheimer's is a horrible disease," Sanders (I-Vt.), chair of the Senate Health, Education, Labor, and Pensions (HELP) Committee, wrote in a
letter to Xavier Becerra, secretary of the U.S. Department of Health and Human Services (HHS). "We must do everything possible to find a cure for the millions of people who suffer from it. But we cannot allow pharmaceutical companies to bankrupt Medicare and our federal government in the process."
At issue is Leqembi, a drug developed by Eisai, a Japanese pharmaceutical corporation, and Biogen, a U.S. company that previously sought to charge $56,000 for an annual supply of a different Alzheimer's treatment called Aduhelm. Following a pressure campaign led by Sanders and other drug affordability advocates, Biogen reduced the price of Aduhelm—whose efficacy and safety have been questioned by doctors—to $28,200 per year.
"A prescription drug is not effective if a patient who needs that drug cannot afford to take it."
"Despite concerns among the scientific community about the clinical benefit of Leqembi, its manufacturers... plan to charge $26,500 per year for this drug even though the Institute for Clinical and Economic Review, an independent non-profit organization, has estimated that this drug should be sold for as little as $8,900 per year based on its effectiveness," Sanders wrote.
"If just 10% of the 6.7 million older adults with Alzheimer's disease take Leqembi, the Kaiser Family Foundation has estimated that it would cost $17.8 billion—or nearly half of what Medicare Part B spent on all drugs in 2021," noted the Vermont Independent. "And this is just for one drug. As you know, many of the new drugs coming onto the market are even more expensive. This is not sustainable."
Moreover, "the introduction of Leqembi at this unconscionable price would be grossly unfair to seniors suffering from Alzheimer's disease who simply could not afford to pay the 20% co-payment of more than $5,000 a year for this drug," the progressive lawmaker continued. "With a median income of about $30,000 a year for seniors on Medicare the purchase of this one drug would amount to over one-sixth of their limited income."
"People with Alzheimer's disease deserve a drug that is safe, effective, and affordable," he added. "A prescription drug is not effective if a patient who needs that drug cannot afford to take it."
Sanders pointed out that the U.S. Food and Drug Administration (FDA) plans to convene an advisory meeting on Leqembi this week.
"As it considers whether to grant full approval of this drug, FDA has a special responsibility to restore the public trust after its inappropriate relationship with Biogen during the agency's review" of Aduhelm, wrote Sanders, alluding to evidence that the pharmaceutical firm and those tasked with regulating it collaborated before the medicine received a green light.
If the FDA approves Leqembi, HHS "must protect patients and substantially reduce the price," Sanders stressed.
The senator went on the remind Becerra—who routinely expressed support for invoking executive authority to rein in soaring drug prices before he joined the White House—of the powers at his disposal:
Under current law, Medicare has the responsibility to determine whether Leqembi is "reasonable and necessary" for the treatment of Alzheimer's. In my view, charging an outrageously high price for this drug is not reasonable. It will prevent seniors who need this drug from receiving treatment. It will undermine the finances of Medicare. And it will increase the premiums of over 60 million seniors who receive Medicare whether they need to take this drug or not.
If Biogen and Eisai refuse to lower the price of this drug, HHS has the authority (under 28 U.S.C. Section 1498) to break the patent monopoly on Leqembi. Further, HHS can direct the Center for Medicare and Medicaid Innovation to launch a new demonstration project that would limit payment for Leqembi to reflect the drug's actual benefit.
Sanders told Becerra that he and other HELP committee members "look forward to discussing this important issue with you as soon as possible." The panel "would like to know how Biogen and Eisai came up with a cost of $26,500 and what the cost of this drug will mean to the finances of Medicare," Sanders wrote. It "would also like your estimate as to how much Medicare premiums will go up for all seniors if Biogen and Eisai are allowed to charge $26,500 for Leqembi, as well as how many seniors who need this drug would not be able to afford to pay a 20% co-payment for it."
Sanders' letter comes one day after the pharmaceutical giant Merck sued the Biden administration over an Inflation Reduction Act provision that empowers Medicare to directly negotiate the prices of a small number of ultra-expensive prescription medicines with drugmakers.
It also comes less than a month after Sanders condemned Big Pharma CEOs for years of deadly price gouging and reiterated the need to make all prescription drugs affordable at a HELP committee hearing.
"I know that our guests from the drug companies will tell us how much it costs to develop a new drug and how often the research for new cures is not successful," Sanders said in May. "I get that. But what they are going to have to explain to us is why, over the past decade, 14 major pharmaceutical companies... spent $747 billion on stock buybacks and dividends."
"They will also have to explain how as an entire industry pharma spent $8.5 billion on lobbying and over $745 million on campaign contributions over the past 25 years to get Congress to do its bidding," Sanders continued. "Unbelievably, last year, drug companies hired over 1,700 lobbyists including the former congressional leaders of both major political parties—that's over three pharmaceutical industry lobbyists for every member of Congress."
As Sanders put it, "That could well explain why we pay the highest prices for prescription drugs in the world and why today drug companies can set the price of new drugs at any level they wish."
"While Americans pay outrageously high prices for prescription drugs, the pharmaceutical industry and the [pharmacy benefit managers] make enormous profits," the lawmaker lamented. "In 2021, 10 major pharmaceutical companies in America made over $100 billion in profits—a 137% increase from the previous year. The 50 top executives in these companies received over $1.9 billion in total compensation in 2021 and are in line to receive billions more in golden parachutes once they leave their companies."
"In other words, Americans die, get sicker than they should, and go bankrupt because they cannot afford the outrageous cost of prescription drugs, while the drug companies and the PBMs make huge profits," he added. "That has got to change and this committee is going to do everything possible to bring about that change."
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'Heartbreaking and Unconscionable': Biden Admin Ignored Warnings of Migrant Child Labor
"I feel like short of protesting in the streets, I did everything I could to warn them," said one former official. "They just didn't want to hear it."
Apr 18, 2023
The Biden administration received repeated warnings from both within and outside of the federal government in recent years about a rise in the exploitation of migrant children for child labor, but ignored the evidence it was presented with and in some cases retaliated against whistleblowers, an extensive report by The New York Times showed late Monday.
According to the report, officials in the Biden administration including Susan Rice, director of the U.S. Domestic Policy Council, oversaw the loosening of restrictions on vetting potential sponsors for unaccompanied migrants under the age of 18 as emergency shelters that were set up to house the minors struggled to meet demand in 2021. Reports of the problem also reached Health and Human Services Secretary Xavier Becerra.
At least five staffers at the the U.S. Department of Health and Human Services (HHS) told the newspaper that they raised concerns about the welfare of children who were sent to live with improperly vetted sponsors, and that they were retaliated against by officials who were growing "exasperated" with employees who insisted the department take steps to protect the minors in its care.
The report includes accounts from a former official at HHS who oversaw the government's program for unaccompanied migrants under the age of 18, a senior employee at an immigrant rights advocacy group, and an immigration lawyer who worked in 2021 vetting prospective sponsors for unaccompanied minors.
The attorney, Linda Brandmiller, told the Times that she immediately flagged at least two suspicious potential sponsors who had contacted HHS to offer to take in some of the unaccompanied minors, allowing them to leave the emergency shelters that had been set up for an influx of young migrants over the U.S.-Mexico border.
One person explicitly said they planned to employ three underage boys at a construction company, and another said they could take in two children who would then have to work off the cost of their travel.
Brandmiller told the shelter she was working at in Texas that no children should be sent to the sponsors and warned that a 14-year-old boy had already been sent to one of the people, as well as emailing HHS supervisors and saying, "This is urgent."
At least one boy was sent to one of the sponsors despite Brandmiller's warnings, and she was abruptly fired from her job with no explanation a few days later.
As such instances of retaliation have been taking place, said Times reporter Hannah Dreier, "the number of children being trafficked or exploited has skyrocketed."
As Common Dreams has reported, companies including Packers Sanitation Services Inc. and Hyundai have been found in recent months to rely on the labor of migrants under the age of 18, in violation of child labor laws. According to the Times, Rice's team was briefed regularly for several months on Packers' employment of more than 100 Spanish-speaking children in meatpacking facilities where they operated the industrial cleaning company's equipment and in some cases were injured while using Packers' sanitation chemicals.
Former U.S. Labor Secretary Martin Walsh told the Times that his department frequently included data about skyrocketing levels of child labor in weekly cabinet-level meetings at the White House, and the agency updated its official data in December to show that child labor law violations had soared by 69% since 2018.
"We sent reports to the White House, so they knew we were working on this stuff," Walsh told the Times.
According to the Times, officials at the Labor Department and HHS each said that the other department was responsible for ensuring that unaccompanied minors were not being exploited for child labor.
Jallyn Sualog, a former career HHS employee who helped oversee the division responsible for migrant children, warned her superiors in 2021 that she had heard reports of children who had been sent to sponsors who'd lied about their identities or who planned to exploit them.
"If nothing continues to be done, there will be a catastrophic event," Sualog told her supervisors, before filing a complaint with the HHS Office of the Inspector General—after which she was removed from her position.
"I feel like short of protesting in the streets, I did everything I could to warn them," Sualog told the Times. "They just didn't want to hear it."
The result of the administration's refusal to listen to whistleblowers including Sualog and Brandmiller was called "heartbreaking and unconscionable" by the Center for Law and Social Policy (CLASP), an economic justice nonprofit group.
Former U.S. Housing and Urban Development Secretary Julián Castro decried the "stunning lack of oversight and accountability by the Biden administration."
"Imagine if our government spent its time and energy protecting immigrant children from being exploited through child labor," said progressive policy group Justice Democrats, "instead of on separating families and putting immigrants in cages."
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Jayapal Applauds Biden for DACA Healthcare Expansion
While continuing to push Congress to establish a pathway to citizenship for undocumented immigrants, said Biden, "we need to give Dreamers the opportunities and support they deserve."
Apr 13, 2023
U.S. Rep. Pramila Jayapal was among the immigrant rights advocates who praised an announcement by the Biden administration on Thursday regarding a rule change that will allow immigrants who arrived in the U.S. as children to obtain health coverage under the Medicaid and Affordable Care Act programs—a move that could benefit up to 580,000 people who are recipients of the Deferred Action for Childhood Arrivals program, or DACA.
President Joe Biden announced that the Department of Health and Human Services (HHS) will move to change the definition of people who have a "lawful presence" in the U.S. for the purposes of obtaining healthcare under the ACA and Medicaid—amending it to include DACA recipients.
The change is expected to be final "by the end of the month," said the president.
Jayapal called the proposal "a long overdue step toward justice."
The Washington Democrat chairs the Congressional Progressive Caucus, which released its 2023 Executive Action Agenda last month that included a call for the administration to "eliminate all eligibility barriers to health services under the Affordable Care Act for DACA recipients."
The president emphasized that he is still pushing the U.S. Congress to establish a pathway to citizenship for undocumented immigrants including DACA recipients, but said that in the meantime, "we need to give Dreamers the opportunities and support they deserve," referring to the name rights advocates use for people who benefit from the Obama-era program.
Nearly half of undocumented immigrants lack health insurance, and HHS Secretary Xavier Becerra noted Thursday that number includes about one-third of the 580,000 people who are currently enrolled in DACA.
"Today's rule would change that," said Becerra.
The national advocacy group Mi Familia Vota said the "expansion of critical healthcare programs to DACA recipients" was a positive step as advocates "work to create structural changes to fully include all immigrants."
"While we continue fighting for a pathway to citizenship for DACA recipients, it's important to ensure they have access to the healthcare they deserve," said Cristina Tzintzún Ramirez, president of Next Gen America. "This will improve the way of life of hundreds of thousands of people."
The new proposed rule comes nearly three years after the U.S. Supreme Court rejected former Republican President Donald Trump's attempt to dismantle the DACA program.
Republican plaintiffs won a case in Texas in 2021 in which they claimed former Democratic President Barack Obama acted unlawfully when he created the program without an act of Congress. The Biden administration appealed that ruling and a federal appeals court sent the case back the the lower court in October, but allowed current DACA recipients to renew their status and retain the work permits and deportation protections the program affords them.
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