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     By Kate Queram


It’s a gloomy Monday, which seems fitting for a newsletter filled with lapsing insurance coverage, lagging benefits and a big tangle of bureaucracy.

 The Big Takeaway

A quick recap to start us off: In the early days of the COVID-19 pandemic, Congress approved a sweeping relief bill to shore up the sizable gaps in the American health-care system. Among the bill’s provisions was the so-called “continuous coverage” rule, which allocated extra funding to state-administered Medicaid programs in exchange for ensuring uninterrupted enrollment for recipients until the conclusion of the federal public health emergency.

Insurance = paperwork. (Photo by Getty Images)

Insurance = paperwork.
(Photo by Getty Images)

The provision worked, and it worked well. By the beginning of 2022, 5.2 million people had gained Medicaid coverage, plunging the rate of uninsured Americans to an all-time low of 8%. And not everyone saw that as a positive. By the end of last year, Republican governors were pushing to end the program, telling the Biden administration that the requirement was “negatively affecting states” by increasing the number of enrollees without a concurrent boost in federal funding.

“This is costing the states hundreds of millions of dollars,” 25 GOP governors wrote in a Dec. 19 letter. “Since the beginning of the pandemic, states have added 20 million individuals to the Medicaid rolls (an increase of 30%) and those numbers continue to climb.”

They got their wish days later when congressional lawmakers tweaked the policy, clearing the way for states to begin culling Medicaid rolls in April regardless of the status of the (since renewed) public health emergency. As many as 15 million people could lose their health insurance as a result. Some will be dropped because they’re no longer eligible, but others will lose coverage for procedural mistakes, like failing to update their contact information or return phone calls from health agencies.

States are aware of that possibility, even if they’re unprepared to handle it. From now through July, officials in Idaho plan to man the phones to alert Medicaid recipients of their impending lapse in coverage — an effort that will require 30,000 calls each month. Statewide, around 150,000 people are expected to lose their insurance, though many of them will likely have other options for coverage, per the Idaho Capital Sun.

Insurance = paperwork. (Photo by Getty Images)

Insurance = paperwork.
(Photo by Getty Images)

It’s a massive undertaking that seems destined to encounter backlogs almost immediately. That’s never ideal, but it’s especially problematic in Idaho, where residents will have just 60 days to either contact Medicaid for a re-evaluation or enroll in a state-based insurance plan. It's a far shorter timeline than in states that use the federal exchange, where residents have until July 2024 to select a new plan.

And the situation could get even more complicated as lawmakers begin evaluating the state’s Medicaid expenditures and the effects of its 2018 expansion. The program gobbles up more funding than any other budget allocation, a fact that was expected to draw scrutiny this week at hearings focused on cost containment.

Food assistance recipients are in a similar state of limbo in Missouri, where the state Department of Elementary and Secondary Education is still determining eligibility for a one-time payment that was supposed to offset grocery costs last summer. Officials said last week they still have no estimate for when those benefits might be issued, the Missouri Independent reported.

“As I have shared several times, we don’t have a set timeline,” said Mallory McGowin, a spokeswoman for the department. The agency, she added, is in the “final testing stages” of data and “anticipate[s] administering benefits in the coming weeks.” 

“I’d like to buy milk, but knowing that the state is in the ‘final testing stages’ is almost as nourishing.” (Photo by Bruce Bennett/Getty Images)

“I’d like to buy milk, but knowing that the state is in the ‘final testing stages’ is almost as nourishing.”
(Photo by Bruce Bennett/Getty Images)

The delay isn’t unique to Missouri — multiple states had similar problems issuing the summer Pandemic EBT, a federal program that provided a one-time $391 per-child grocery benefit to cover food costs last summer. Officials said that was mostly due to the bureaucratic complexities of administering an emergency program with shifting guidelines that required collaboration between multiple agencies. 

Most of those states resolved their delays months ago, but the lag persists in Missouri. Officials said last fall the grocery payments could not be administered until the state implemented a new data collection portal to issue a separate benefit for children with COVID-related school absences. The state did not sign a contract for that project until last August, according to documents obtained by the Independent. 

The federal government approved the plan in October; a month later, the state began teaching school districts how to submit student data files, which are now undergoing testing. District officials said they had not received a timeline for when that process might conclude.

“When families ask,” said Michelle Baumstark, a spokesperson for Columbia Public Schools, “we tell them we don’t know.”

Come back when you’ve got ’em! (Photo by Getty Images)

Come back when you’ve got ’em!
(Photo by Getty Images)

The never-ending wait is disheartening for parents, who have formed online groups to cobble together what little information they’ve gleaned about the benefits. Some have reached out to state and school officials, only to be redirected; others have received the same non-answers (“We’re working on it”) for months.

“It’s like nobody knows what’s going on, and there’s a lot of families destitute and needing a lot of help with food right now,” said Aimee Antrim, a single mom from Springfield. “It’s just desperately needed or we wouldn’t be reaching out to find out where it’s at. My standpoint is that they’re leaving us all out in the cold — no answers.”

Information, please: (Arkansas) UAMS researchers test app designed to prevent opioid use relapseSecrecy in Georgia’s medical cannabis regulation still frustrates efforts to deliver relief to patientsKentucky nurse volunteered at anti-abortion pregnancy center, discovered infection control problemsLouisiana issues new emergency rule on abortion ban exceptions(Montana) Government lets health plans that ripped off Medicare keep the money(Montana) Doctors tell Congress it’s telehealth vs. no care(Montana) Nursing home owners drained cash during pandemic while residents deteriorated(New Hampshire) Bill would end school-day clinics for all vaccinesBill to protect abortion rights and transgender health care in New Mexico takes a step forward(South Dakota) Workforce woes, nursing home closures pressure sustainability of long term care(Vermont) Lawmakers consider interstate compact for mental health counselors(Wisconsin) New state plan emphasizes root causes behind public health conditions and outcomes

  State of Our Democracy

A Republican lawmaker in Arizona is attempting to bestow a host of benefits on fetuses, an anti-abortion fever dream he insisted is totally not related to abortion. 

“The theme that I sought to achieve with these bills is to support women and children and families,” state Rep. Matt Gress told the Arizona Mirror.

If that support were a bridge. (Photo by spiritofamerica/Adobe Stock)

If that support were a bridge.
(Photo by spiritofamerica/Adobe Stock)

Here’s what those pro-women-and-children-and-families proposals would do: Allow retroactive child support payments beginning from the date of a positive pregnancy test; allow pregnant people to use the carpool lane; compensate rape victims who carry their resulting pregnancies to term; increase penalties for domestic violence against pregnant victims, and extend child tax credits to families that include a pregnant person. 

It’s a pretty blatant attempt at establishing “fetal personhood,” a long-term goal of the anti-abortion movement that aims to confer legal rights from the moment of conception as part of a broader effort to classify abortion as murder. But it’s less blatant than the previous attempt, in which Arizona Republicans passed a bill granting constitutional rights to fetuses of every gestational age, only to have it blocked by a federal judge. 

Gress’ proposals are likely to face a similar fate at the hands of Democratic Gov. Katie Hobbs, but they’re advancing through the legislature anyway. Three of the bills garnered approval from legislative committees after hearings where Gress gave non-answers to detailed questions about his true intentions. For example, when asked at a hearing last week whether he was prepared for his child-support proposal to be struck down in court, Gress said, “I am not interpreting the legislation at all relating to that.”

That response was confusing for state Rep. Melody Hernandez, the Tempe Democrat who’d asked the question.

“He’s either pretending to not understand or he truly doesn’t understand the fetal personhood concept,” she said. “He either genuinely doesn’t know or he’s pretending to not know, because it’s a strategy being used by the GOP to incrementally get us to the point where abortion is no longer legal in Arizona at all.” 

Gress shrugged it off. It’s all a matter of opinion (or something).

“If someone thinks it’s doing something different than what the initial purpose is, that’s up to them to interpret what they think the bill accomplishes,” he said. 

That’s just, like, your opinion, man: (Florida) House Democrats ‘cannot see any logical reason’ for a special session catering to Gov. DeSantis(Michigan) Dems propose $180 ‘inflation relief’ checks, increasing EITC, repealing retirement taxVacancies, turnover leave thousands of jobs unfilled in Missouri state government(Montana) Gianforte’s nomination for top political cop has a long history of political activityNebraska’s costliest governor’s race left wild numbers in its wakeMost Nebraska legislative races in 2022 exceed $100,000 in spending(New Jersey) Legislative retirements up over recent years with weeks left until filing deadlineNew Republican majority on the North Carolina Supreme Court agrees to rehear voter ID and redistricting casesAt nearly $14M, fight for 7th Congressional District was Pennsylvania’s priciest House raceMomentum growing behind changing Wisconsin’s shared revenue system


   From The Newsrooms

One Last Thing

Ben Affleck had a very bad time at his wife’s work thing.

This all could have been an email. (via Giphy)

This all could have been an email.
(via Giphy)


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