Morning Briefing
Summaries of health policy coverage from major news organizations
Medicaid Work Requirement Suits Tossed By Supreme Court As Moot
The Supreme Court on Monday tossed out cases challenging Medicaid work requirements in Arkansas and New Hampshire. The justices said lower courts should vacate their prior rulings nixing the work requirements, as the cases are moot. But work requirements are still being debated in the lower courts, since Georgia sued the Centers for Medicare and Medicaid Services over the agency's decision to pull approval for the state's planned requirements. (Goldman, 4/18)
In other Medicaid and Medicare news 鈥
More than 400,000 Ohioans may lose Medicaid聽coverage 鈥 government-paid health insurance for low-income or disabled people聽鈥撀爐his summer when the聽federal government's COVID-19 emergency declaration聽ends,聽according to the Commonwealth Fund. Under the declaration,聽Ohio and other states were unable to take聽people off Medicaid,聽even if they聽became ineligible. Around 3.3 million Ohioans were enrolled in Medicaid this fiscal year as of February, an increase from around 2.8聽million from 2020. But that declaration is set to end July 15, and many don't expect it to be renewed.聽(Wu, 4/19)
The formal end of the pandemic could swell the ranks of uninsured children by 6 million or more as temporary reforms to Medicaid are lifted. Gaps in coverage could limit access to needed care and widen health disparities, by hitting lower-income families and children of color the hardest, experts say. A requirement that states keep Medicaid beneficiaries enrolled during the public health emergency in order to get more federal funding is credited with preventing a spike in uninsured adults and kids during the crisis. (Bettelheim, 4/18)
When 13-year-old CJ gets mad, he gets really mad, really, really mad.聽鈥淗ave you ever heard the term blind rage?鈥 He asks on a thick spring morning in Asheville. His dog, Jake, who鈥檚 also around 13 years old, sits at CJ鈥檚 feet, waiting for another half of a biscuit.聽鈥淚t鈥檚 like a movie. It鈥檚 like you鈥檙e watching it, but you can鈥檛 do anything.鈥澛燘ecause he is a minor, North Carolina Health News is using CJ鈥檚 initials, rather than his full name. This anger, this rage, it forces CJ outside of his body. It stops him from seeing, feeling, or doing anything else. The only way CJ has found to push the anger out of his body, and put himself back in, is to run around, yell, scream and push people. (Donnelly-DeRoven, 4/19)
When Commonwealth Care Alliance nurses visit Cynthia Monty鈥檚 home, she likes that they don鈥檛 talk rough. Instead, the providers always ask about her cats and her art projects. The not-for-profit insurer鈥檚 employees ask what she needs. They never rush when taking her blood pressure. CCA paid for the 68-year-old鈥檚 walker, wheelchair and in-home hospital bed, which helps keep her feet elevated so they don鈥檛 swell up from chronic obstructive pulmonary disease while she sleeps. When Monty complained the bed was uncomfortable, CCA bought her a mattress cushion. 鈥淚 am just so thankful for CCA because I鈥檇 still be struggling if it wasn鈥檛 for them,鈥 said Monty, a retired nurse鈥檚 aide from Boston who CCA connected to Modern Healthcare. (Goldman and Tepper, 4/19)
The Centers for Medicare and Medicaid Services on Monday proposed bumping up inpatient hospital payments by approximately $1.6 billion in fiscal 2023. The proposed Hospital Inpatient Prospective Payment System rule represents a 3.2% increase in fiscal 2023 payments from the year before. CMS also wants to add health equity measures to the hospital inpatient quality reporting program, including one that tracks hospital commitment to health equity, and officially suggested the "birthing friendly" hospital designation it announced last week. CMS asked for feedback last year on how to advance health equity through quality measurement. (Goldman, 4/18)
In related Medicare news about nursing homes and the elderly 鈥
A 99-bed nursing home in one of Cleveland's poorest neighborhoods will close its doors in less than two months. Like many nursing homes in urban and rural pockets of America, Eliza Bryant Village has struggled to maintain operations during the COVID-19 pandemic. Costs are too high and reimbursement isn't enough. The home loses more than $100 each day for every resident covered by Medicaid, which represents about 95% of the home's population.聽So the home that describes itself as the oldest, continually聽operating, African American-founded nursing home in the U.S.聽will close June 8. Most elderly residents, some聽having聽lived there for several years, already have found new facilities. As of April 15, 17 residents聽were still searching for their next home. (Alltucker, 4/18)
Two years after the pandemic, nursing facilities are still experiencing significant workforce challenges. The Centers for Disease Control and Prevention鈥檚 recommendation issued in December 2021 allows organizations to bring back medical staff who鈥檝e tested positive for COVID-19 after five days of isolation, even if they鈥檙e still symptomatic, and without providing a negative test. 鈥淓ven with this revised guidance, we are seeing high levels of staffing shortages that prevent many nursing homes from accepting new patients or assisting overwhelmed hospitals,鈥 the American Health Care Association/National Center for Assisted Living said in a statement. 鈥淪o, while we support the CDC guidance, it鈥檚 not enough to stem the tide of this historic labor crisis.鈥 (Cohen, 4/19)
The disease took Noemi Fleming鈥檚 elderly mother slowly, the first hints in repeated anecdotes or phrases. Then misplaced keys and bills. Then, Fleming caught her mother walking outside in the middle of the night, looking for the newspaper. 鈥淢ama, it鈥檚 1 o鈥檆lock in the morning,鈥 Fleming would tell her. 鈥淭he newspaper doesn鈥檛 get here until 8.鈥 Fleming鈥檚 mother died at 91 in their hometown of Rio Grande City after a two-decade battle with Alzheimer鈥檚, a brain disorder that slowly destroys memory and thinking skills. The family鈥檚 story is a familiar one in Starr County, a mostly rural, heavily Hispanic county of about 65,000 on the Texas-Mexico border, where about 26 percent of Medicare beneficiaries have been diagnosed with Alzheimer鈥檚 and related dementias. That rate is the second highest among all U.S. counties, according to Medicare data. (Gill, 4/18)