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GOP’s Tim Sheehy Revives Discredited Abortion Claims in Pivotal Senate Race

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Matt Volz
Tue, 09 Jul 2024 09:00:00 +0000

“Elective abortions up to and including the moment of birth. Healthy, 9-month-year-old baby killed at the moment of birth. That's what Jon Tester and the Democrats have voted for.”

Tim Sheehy, Montana GOP candidate for U.S. Senate, said in a June 8 debate

Tim Sheehy, the Republican candidate seeking to unseat Democratic Sen. Jon Tester of Montana and give U.S. Senate control to the GOP, is campaigning on what he calls Tester's and Democrats' “extreme” position on abortion. 

In a televised debate June 8, Sheehy accused Tester and Democrats of voting for “elective abortions up to and including the moment of birth.” That statement prompted Tester to respond: “To say we're killing babies at 40 weeks is total BS.”

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Sheehy has made this accusation on his campaign website, which says, “Jon Tester supports elective abortion on demand up until the moment of birth. Think about that again: Jon Tester supports aborting a healthy, full-term baby the day before it's due. That is the extreme position here.” Similar statements have been made in the campaign's social media posts.

Painting the Democratic candidate with, in Sheehy's words, an “extreme” position on abortion is a familiar conservative campaign strategy and campaign talking point this election cycle. But how does it hold up? 

Some Recent History

Asked for evidence to support Sheehy's accusations, Sheehy's campaign spokesperson, Katie Martin, said the Republican candidate was referring to Tester's vote for the Women's Health Protection Act, which failed to pass the Senate in 2022. She cited the bill's provisions that said providers and patients would have the right to perform and receive abortion services without certain limitations or requirements impeding access.

Anti-abortion advocates say the measure, which has been reintroduced in the current Congress, would create a loophole eliminating any limits to aborting a fetus later in pregnancy. And, rather than define when a fetus is viable during pregnancy, the bill would leave the question of viability to the health provider, who is financially motivated to perform abortions, according to Susan B. Anthony Pro-Life America, a nonprofit group supporting anti-abortion candidates, including Sheehy.

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It would impose no-limits abortion on demand in all 50 states at any point in pregnancy,” said Marjorie Dannenfelser, president of SBA Pro-Life America.

In 2022, the legislation failed two votes in the Senate before the U.S. Supreme Court's Dobbs v. Jackson Women's Health Organization decision removed federal protections for abortion access and left the issue to the states to decide. Tester voted for the measure both times, but the bill failed to advance after votes of 46-48 and 49-51.

Alina Salganicoff, a KFF senior vice president and director of the nonprofit's Women's Health Policy Program, said nothing in the Women's Health Protection Act supports an abortion up to the moment of birth. Rather, the legislation would allow a health provider to perform abortions without obstacles such as waiting periods, tests deemed medically unnecessary, unnecessary in-person visits, or other restrictions imposed by states.

The bill would explicitly allow an abortion after a fetus is viable when, according to the legislation, “in the good-faith medical judgment of the treating health care provider, continuation of the pregnancy would pose a risk to the pregnant patient's life or health.”

“This is not abortion on demand until the moment of birth,” Salganicoff said. “Even if politicians and anti-abortion activists make this claim, there are no clinicians that provide ‘abortions' moments before birth.”

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Besides the Women's Health Protection Act, the Sheehy campaign cited Tester's opposition to “born-alive” legislation meant to protect babies who survive botched abortions.

“At what week does he think it's inappropriate for medical providers to perform an abortion?” Martin said of Tester. “That would clear up his stance on the issue. Based on his voting record, it suggests he does, in fact, support abortion on demand up until the moment of birth.”

In 2002, Congress passed a “born-alive” law that gave legal protections to infants who survive abortions. A stalled 2022 bill sought to expand that law to add criminal penalties to health professionals who do not take steps to preserve the life of any child born. Montana voters rejected a similar ballot question in 2022.

Tester was elected to the Senate four years after the first bill passed and a vote was not taken on the 2022 measure.

Looking at the Data

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Instances of fetuses surviving abortions are rare. So are abortions performed later in pregnancy: Just 1% of all abortions in the U.S. happen at or after 21 weeks of gestation. (The percentage of abortions that occur when the fetus is presumed to be viable, 24 weeks or later, is presumably lower, but the Centers for Disease Control and Prevention does not break out abortion rates for that period.)

An analysis by SBA Pro-Life America's research arm, the Charlotte Lozier Institute, concluded that 6% of abortions performed in 2020, or an estimated 55,800 abortions, happened at or after 15 weeks of pregnancy.

“Most late-term abortions are elective, performed on healthy women with healthy babies for the same reasons given for first-trimester abortions,” Dannenfelser said.

SBA Pro-Life cites abortions at 15 weeks and later because that is the stage of development at which a fetus can feel pain, according to the group. That is the same rationale behind Republican Sen. Lindsay Graham's 15-week abortion ban legislation introduced in 2022.

But the American College of Obstetricians and Gynecologists says “the science conclusively establishes” that a fetus does not have the capacity to feel pain until 24 or 25 weeks.

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“Every medical organization that has examined this issue and peer-reviewed studies on the matter have consistently reached the conclusion that abortion before this point does not result in the perception of pain in a fetus,” according to the OB-GYN medical group.

Katrina Kimport, a professor in the University of California-San Francisco's Department of Obstetrics, Gynecology & Reproductive Sciences, said “born-alive” laws are trying to regulate something that doesn't happen.

Kimport, whose research involved interviewing 30 people in 2018 who had abortions after 24 weeks of pregnancy, and 10 more from 2021 to 2022, also criticized Sheehy's use of “elective abortion.” In her view, that terminology reflects a political colloquialism that's come to mean an abortion that is optional. That's different from the medical definition, she said, in which an elective procedure is one that may be necessary but is not an emergency and can be scheduled for a particular date, such as knee surgery.

Women have abortions later in pregnancy either because they find out new information or because of economic or political barriers, Kimport said.

“I have never spoken to somebody whose abortion decision was not informed by deep thought and consideration,” she said.

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Trying to Change the Debate

Mary Ziegler is a University of California-Davis law professor who specializes in the law, history, and politics of reproduction, health care, and conservatism. She said Sheehy's argument reprises a Republican talking point that abortion opponents have made for decades.

Similar arguments are being heard nationwide as 10 states consider ballot measures to constitutionally protect abortion this election cycle.

Republicans such as Sheehy are accusing Democrats of being extreme on abortion partly to steer the discussion away from their own uncertain position, Ziegler said. The anti-abortion bloc is a key part of the GOP base, but since the Dobbs ruling, voters in seven states, including Montana, have added or upheld abortion rights in elections.

“They can't really disavow what pro-life groups want as extreme because many of their base voters would be horrified by that,” Ziegler said. “But they can't embrace it because then many swing voters would be horrified by that.”

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Kimport said Sheehy's statement “reveals a blatant misunderstanding of pregnancy care.”

“What people don't understand about third-trimester abortions is that there aren't very many, but for the people who do need abortions later in pregnancy, the circumstances are often desperate and intense,” she said. “And these are the people who are being maligned in these political conversations.”

Our Ruling

Sheehy's description of Tester's “extreme” position that would allow abortion “up until the moment of birth” simply doesn't hold up.

These statements are rooted in Tester's support for the Women's Health Protection Act. That bill, however, doesn't open the door to abortion on demand later in pregnancy. Instead, it allows for the role of medical judgment. In addition, CDC data indicates that late-term pregnancies are rare. Also, the term “elective abortion” is a political rather than medical phrasing.

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We rate this claim False.

sources:

NBC Montana, “WATCH: Incumbent U.S. Senator Tester debates challenger Tim Sheehy,” July 9, 2024

X social platform, post by @SheehyforMT, June 9, 2024

Tim Sheehy's U.S. Senate campaign website, accessed June 9, 2024

Email interview with Katie Martin, Tim Sheehy's spokesperson, June 11, 2024

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Susan B. Anthony Pro-Life America, “SBA Pro-Life America's Candidate Fund Endorses Tim Sheehy for U.S. Senate,” Jan. 30, 2024

Marjorie Dannenfelser, president of SBA Pro-Life America, in a statement, June 26, 2024

Email interview with Alina Salganicoff, KFF senior vice president and director of the nonprofit's Women's Health Policy Program, June 12, 2024

Phone interview with Katrina Kimport, University of California-San Francisco professor, June 12, 2024

Phone interview with Mary Ziegler, University of California-San Diego professor, June 12, 2024 

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Email interview with Rachel Kingery, American College of Obstetricians and Gynecologists spokesperson, June 12, 2024

KFF, “Status of Abortion-Related State Constitutional Amendment Measures for the 2024 Election,” updated June 28, 2024

KFF, ”Abortions Later in Pregnancy in a Post-Dobbs Era,” Feb. 21, 2024

Julie Rovner, KFF Health , “Abortion ‘Until the Day of Birth' Is Almost Never a Thing,” Nov. 15, 2023

American College of Obstetricians and Gynecologists, “ACOG Guide to Language and Abortion,” accessed June 11, 2024

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American College of Obstetricians and Gynecologists, “Facts Are Important: Understanding and Navigating Viability,” accessed June 11, 2024 

American College of Obstetricians and Gynecologists, “Facts Are Important: Gestational Development and Capacity for Pain,” accessed June 11, 2024

Charlotte Lozier Institute, Fact Sheet: “Abortions at 15 Weeks in the United States,” updated Jan. 12, 2023

PolitiFact, “Ron DeSantis' False Claim That Some States Allow ‘Post-Birth Abortions. None Do,” July 21, 2023

Women's Health Protection Act of 2021, accessed June 11, 2024

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Women's Health Protection Act of 2022, accessed June 11, 2024

Women's Health Protection Act of 2023, accessed July 2, 2024

Born-Alive Infants Protection Act of 2002, accessed June 11, 2024 

Born-Alive Abortion Survivors Act of 2022, accessed June 11, 2024 

Montana Free Press, “How Montana's LR-131 ‘Born Alive' Referendum Failed,” Nov. 15, 2022 

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Ballotpedia, “History of Abortion Ballot Measures,” accessed June 13, 2024

——————————
By: Matt Volz
Title: GOP's Tim Sheehy Revives Discredited Abortion Claims in Pivotal Senate Race
Sourced From: kffhealthnews.org/news/article/fact-check-senate-race-montana-tim-sheehy-revives-discredited-elective-abortion-claims/
Published Date: Tue, 09 Jul 2024 09:00:00 +0000

Kaiser Health News

Lifesaving Drugs and Police Projects Mark First Use of Opioid Settlement Cash in California

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Aneri Pattani and Don Thompson
Fri, 12 Jul 2024 09:00:00 +0000

SACRAMENTO — Sonja Verdugo lost her husband to an opioid overdose last year. She regularly delivers medical supplies to people using drugs who are living — and dying — on the streets of Los Angeles. And she advocates at Los Angeles City Hall for policies to address addiction and homelessness.

Yet Verdugo didn't know that hundreds of millions of dollars annually are flowing to California communities to combat the opioid crisis, a payout that began in 2022 and continues through 2038.

The money comes from pharmaceutical companies that made, distributed, or sold prescription opioid painkillers and that agreed to pay about $50 billion nationwide to settle lawsuits over their role in the overdose epidemic. Even though a recent Supreme Court decision upended a settlement with OxyContin maker Purdue Pharma, many other companies have already begun paying out and will continue doing so for years.

California, the most populous state, is in line for more than $4 billion.

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“You can walk down the street and you see someone addicted on every corner — I mean it's just everywhere,” Verdugo said. “And I've never even heard of the funds. And to me, that's crazy.”

Across the nation, much of this windfall has been shrouded in secrecy, with many jurisdictions offering little transparency on how they're spending the money, despite repeated queries from people in recovery and families who lost loved ones to addiction.

Meanwhile, there's plenty of jockeying over how the money should be used. Companies are lobbying for spending on products that range from medication bottles that lock to full-body scanners to screen people entering jails. Local officials are often advocating for the fields they represent, whether it's treatment, prevention, or harm reduction. And some governments are using it to plug budget gaps.

In California, local governments must report how they spend settlement funds to the state's Department of Health Care Services, but there's no requirement that the reports be made public.

KFF obtained copies of the documents via a public records request and is now making available for the first time 265 spending reports from local governments for fiscal year 2022-23, the most recent reports filed.

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The reports provide a snapshot of the early spending priorities, and tensions.

Naloxone an Early Winner

As of June 2023, the bulk of opioid settlement funds controlled by California cities and counties — more than $200 million — had yet to be spent, the reports show. It's a theme echoed nationwide as officials take time to deliberate.

The city and county of Los Angeles accounted for nearly one-fifth of that unspent total, nearly $39 million, though officials say that since the report was filed they've begun allocating the money to recovery housing and programs to connect people who are homeless with residential addiction treatment.

Among local governments that did use the cash in the first fiscal year, the most popular object of spending was naloxone, a medication that reverses opioid overdoses and is often known by the brand name Narcan. The medication accounted for more than $2 million in spending across 19 projects.

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One of those projects was in Union City, in the San Francisco Bay Area. The community of about 72,000 residents had five suspected fentanyl overdoses, two of them fatal, within 24 hours in September.

The opioid settlement money “was invaluable,” Corina Hahn, the city's director of community and recreation services, said in her report. “Having these resources available helped educate, train and distribute the Narcan kits to parents, youth and school staff.”

Union City bought 500 kits, each containing two doses of naloxone. The kits cost about $13,500, with an additional $56,000 set aside for similar projects, including backpacks containing Narcan kits and training materials for high school students.

Union City also plans to expand its outreach to homeless people to fund drug education and recovery services, including addiction counseling.

Those are the sorts of lifesaving services that Verdugo, the Los Angeles advocate, said are desperately needed as deaths of people living on the streets pile up.

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She lost her 46-year-old husband, Jesse Baumgartner, in June of last year to an addiction that started after he was prescribed pain medications for a high school wrestling injury. He tried kicking his habit for six years using methadone, but each time prescribers lowered his dosage the cravings drove him back to illicit drugs.

“It was just this horrible roller coaster of him not being able to get off of it,” Verdugo said.

By then the couple had survived 4½ years of being homeless and had been in stable housing for about two years.

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Fentanyl use, particularly among homeless people, “is just rampant,” she said. People sometimes are initially exposed to the cheap, highly addictive substance unknowingly when it is mixed with something else.

“Once they start using it, it's like they just can't backtrack,” said Verdugo, who works as a community organizer for Ground Game LA.

So she leaves boxes of naloxone at homeless encampments in the hope of saving lives.

“They definitely use it, because it's needed right then — they can't wait for an ambulance to come out,” she said.

Cities Backtrack on Spending for Law Enforcement

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By contrast, the cities of Irvine and Riverside, both in Greater Los Angeles, listed plans to prioritize law enforcement by buying portable drug analyzers, though neither city did so in the first fiscal year, 2022-23. Their inclination mirrored patterns elsewhere in the country, with millions in settlement funds flowing to police departments and jails.

But such uses of the money have stirred controversy, and both cities backed away from the drug analyzer purchase after the Department of Health Care Services issued rules that opioid settlement funds may not be used for certain law enforcement efforts. The rules specifically excluded “equipment for the purpose of evidence gathering for prosecution, such as the TruNarc Handheld Narcotics Analyzer.”

In Hawthorne, also near Los Angeles, the police department had already spent about $25,000 of settlement funds on an initial installment to buy 80 BolaWraps, devices that shoot Kevlar tethers to wrap around a person's limbs or torso.

After the state said BolaWraps were not an allowable expense, the city said it would find other funding sources to pay the remaining installments.

Santa Rosa, in California's wine country, spent nearly $30,000 on police officer wellness and support.

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The funds allowed the police department to boost its contracted wellness coordinator from a part-time to a full-time position, and to buy a mobile machine to measure electrical activity in the brain, said Sgt. Patricia Seffens, a spokesperson.

The goal is to use the technology on police officers to help “assess the traumatic impact of responding to the increasing overdose calls,” Seffens said in an email.

In Dublin, east of San Francisco, officials are using part of their $62,000 in settlement cash for a D.A.R.E. program.

D.A.R.E., which stands for Drug Abuse Resistance Education, is a series of classes taught by police officers in schools to encourage students to resist peer pressure and avoid drugs. It was initially developed during the “Just Say No” campaign in the 1980s.

Studies have found inconsistent results from the program and no long-term effects on drug use, leading many researchers to dismiss it as “ineffective.”

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But on its website, D.A.R.E. cites studies since the program was updated in 2009, which found “a positive effect” on fifth graders and “statistically significant reductions” in drinking and smoking about four months after completing the program.

“The D.A.R.E. program when it first came out looks a lot, lot different than what it looks like right now,” said Nate Schmidt, the Dublin police chief.

Schmidt said additional settlement money will be used to distribute naloxone to residents and stock it at schools and city facilities.

Other local governments in California spent modest sums on a wide range of addiction-related measures. Ukiah, in Mendocino County, north of San Francisco, spent $11,000 for a new heating and air conditioning system for a local drug treatment center. Orange and San Mateo counties spent settlement funds in part on medication-assisted treatment for people incarcerated in their jails. The city of Oceanside spent $16,000 to showcase drug prevention art and made by middle school students in local movie theaters, in public spaces, and on buses and taxis.

The Department of Health Care Services said it plans to release a statewide report on how the funds were spent, as well as the individual city and county reports, by year's end.

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This article was produced by KFF Health News, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism. 

——————————
By: Aneri Pattani and Don Thompson
Title: Lifesaving Drugs and Police Projects Mark First Use of Opioid Settlement Cash in California
Sourced From: kffhealthnews.org/news/article/drugs-police-projects-first-california-opioid-settlement-spending/
Published Date: Fri, 12 Jul 2024 09:00:00 +0000

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Kaiser Health News

KFF Health News’ ‘What the Health?’: GOP Platform Muddies Abortion Waters

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Thu, 11 Jul 2024 20:00:00 +0000

The Host

Julie Rovner
KFF


@jrovner


Read Julie's stories.

Julie Rovner is chief Washington correspondent and host of KFF ' weekly health policy news , “What the Health?” A noted expert on health policy issues, Julie is the author of the critically praised reference book “Health Care Politics and Policy A to Z,” now in its third edition.

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Republicans released a draft party platform in advance of the GOP national convention next week, and while it is being described as softening the party's stance opposing abortion, support from major groups that oppose abortion suggests that claim may be something of a mirage.

Meanwhile, the Federal Trade Commission is taking on the pharmacy benefits management industry as it prepares to file suit charging that the largest PBMs engage in anticompetitive behavior that raises patients' drug costs.

This week's panelists are Julie Rovner of KFF Health News, Jessie Hellmann of CQ Roll Call, Shefali Luthra of The 19th News, and Sandhya Raman of CQ Roll Call.

Panelists

Jessie Hellmann
CQ Roll Call


@jessiehellmann

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Read Jessie's stories.

Shefali Luthra
The 19th


@shefalil


Read Shefali's stories.

Sandhya Raman
CQ Roll Call

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@SandhyaWrites


Read Sandhya's stories.

Among the takeaways from this week's episode:

  • For the first time in decades, the GOP presidential platform will not include a call for a national abortion ban. But Republicans are hardly soft-pedaling the issue: The new platform effectively asserts that abortion violates the 14th Amendment, which guarantees equal protection under the law for all citizens — including, under their reading, human embryos. Under that argument, abortion opponents may already have the constitutional justification they need to defend in court further restrictions on the procedure.
  • Lawmakers in Washington are making early progress on government spending bills, including for the Department of Health and Human Services. Some political issues, like access to gender-affirming care for service members and minors, are creating wrinkles. Congress will likely need to pass a stopgap spending measure to avoid a government shutdown this fall.
  • And a new report from the Federal Trade Commission illuminates the sweeping control of a handful of pharmacy benefits managers over most of the nation's prescription drugs. As the government eyes lawsuits against some of the major PBMs alleging anticompetitive behavior, the findings bolster the case that PBMs are inflating drug prices.

Also this week, Rovner interviews Jennifer Klein, director of the White House Gender Policy Council, about the Biden administration's policies to ensure access to reproductive health care.

Plus, for “extra credit” the panelists suggest health policy stories they read this week that they think you should read, too:

Julie Rovner: STAT News' “Troubled For-Profit Chains Are Stealthily Operating Dozens of Psychiatric Hospitals Under Nonprofits' Names,” by Tara Bannow.

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Jessie Hellmann: North Carolina Health News' “N.C. House Wants to Spend Opioid Money on Multiple Abstinence-Based Recovery Centers, While Experts Stress Access to Medication,” by Grace Vitaglione.

Shefali Luthra: The Washington Post's “These GOP Women Begged the Party to Abandon Abortion. Then Came Backlash,” by Caroline Kitchener.

Sandhya Raman: Roll Call's “For at Least One Abortion Clinic, Dobbs Eased Stressors,” by Sandhya Raman.

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Francis Ying
Audio producer

Emmarie Huetteman
Editor

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To hear all our click here.

And subscribe to KFF Health News' “What the Health?” on SpotifyApple PodcastsPocket Casts, or wherever you listen to podcasts.

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Title: KFF Health News' ‘What the Health?': GOP Platform Muddies Abortion Waters
Sourced From: kffhealthnews.org/news/podcast/what-the-health-355-gop-platform-abortion-gender-july-11-2024/
Published Date: Thu, 11 Jul 2024 20:00:00 +0000

Did you miss our previous article…
https://www.galvestontrendingnews.com/kaiser-health-news/colorado-dropped-medicaid-enrollees-as-red-states-have-alarming-advocates-for-the-poor/

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Kaiser Health News

Colorado Dropped Medicaid Enrollees as Red States Have, Alarming Advocates for the Poor

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Rae Ellen Bichell
Thu, 11 Jul 2024 09:00:00 +0000

Colorado stands out among the 10 states that have disenrolled the highest share of Medicaid beneficiaries since the U.S. government lifted a pandemic-era restriction on removing people from the insurance program.

It's the only blue state in a cluster of red states with high disenrollment rates — a group that includes Idaho, Montana, Texas, and Utah — in the Medicaid “unwinding” underway since spring 2023.

Colorado also is the only state that had all the policy ingredients in place to cushion the fallout from the unwinding, according to Medicaid policy analysts at KFF.

But it seems the cushion hasn't been deployed.

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“There's really a divide in Colorado between our progressive policies and our underfunded and fragmented administration,” said Bethany Pray, chief legal and policy officer at the Colorado Center on Law and Policy, a Denver-based legal aid group.

According to KFF data, during the unwinding Colorado has seen a bigger net drop in enrollment in Medicaid and the Children's Health Insurance Program than any state except Utah.

Advocates for health care access, researchers, and county administrators — the administrators handling the bulk of the Medicaid redeterminations in Colorado — say that the major issues involve outdated technology and low rates of automatic renewals. Both create obstacles to enrollment that undercut the state's progressive policies.

State officials have a rosier view. They say the drop in enrollment is a sign that they did a good job enrolling people at the height of the covid-19 pandemic. Secondly, they say Colorado's economy is doing well, so more people can get insurance through their jobs.

“When we have a really stellar unemployment rate, not as many people need safety-net programs, and we're proud of that. Our people are rising and thriving,” said Kim Bimestefer, who leads the Department of Health Care Policy and Financing and is the state's top Medicaid official. Her department has also said that some people choose not to fill out their eligibility paperwork because they know their incomes are too high to qualify.

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Bureau of Labor Statistics data shows that while it's true Colorado's unemployment rate is lower than the nation's as a whole, it's higher than it was before the pandemic.

State officials say they believe Medicaid enrollments dropped because many of those people found jobs, as reflected by the lower unemployment rates. But that scenario happened in fewer than half of the state's counties, a KFF Health analysis found. Notably, in 11 counties where unemployment stagnated or increased from January 2020 to April 2024, the share of the population covered by Medicaid shrank. A low unemployment rate does not necessarily mean there is less of a need for Medicaid coverage, because many employed people earn wages low enough to still qualify for the program.

Colorado increased enrollment in Medicaid and the related Children's Health Insurance Program by 35% during the covid public health emergency, compared with about 30% nationally and among Medicaid expansion states.

“We grew more, which means, logically, we're going to disenroll more,” said Bimestefer.“We went up higher, we're going to come down lower, because our economy is stellar.”

Her department's website initially claimed Colorado's Medicaid enrollment grew more than any other Medicaid expansion state except Hawaii. But data from the Centers for Medicare & Medicaid Services shows pandemic enrollment growth in other states, including Indiana, North Dakota, Virginia, and Nevada, also exceeded that of Colorado.

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Even if it had grown the most, the argument that what comes up must come down doesn't hold water, Medicaid policy analysts said.

“A counterargument to that is we know that there was never a full participation in Medicaid prior to the pandemic,” said Jennifer Tolbert, deputy director of the KFF Program on Medicaid and the Uninsured.

Tolbert said she was surprised by the extent of Colorado's Medicaid enrollment losses, given it was the one state in the nation that met all the criteria that KFF expected would cushion the effects of the unwinding. Those policies include adopting the Affordable Care Act's Medicaid expansion and the automatic processing of renewals.

Tolbert was among several policy researchers who said that even if unemployment returned to pre-pandemic levels, they would expect a higher, not lower, share of Coloradans to be enrolled in safety-net coverage.

Ally Sullivan, a spokesperson for Gov. Jared Polis, a Democrat, said one complicating factor in Colorado's system is that it's among the handful of states where most of the eligibility verification work falls on counties, “which added complexity to the state's unwind process.”

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“Colorado is committed to ensuring that Coloradans who no longer qualify for Medicaid coverage are connected to other affordable sources of coverage as soon as possible, and the state is going to great lengths to do so,” the statement said.

Minnesota is another state where verifying eligibility is largely left to the counties. Yet it disenrolled just 26% of its Medicaid population in the unwinding, compared with Colorado's 48%. Like Colorado, Minnesota is led by a Democratic governor. Minnesota also mirrors Colorado in its population, pandemic-era increase in enrollment, the percentage of its residents living in prosperous areas, and its better-than-national unemployment rate. But Bimestefer dismissed any comparison.

“I don't care about Minnesota,” Bimestefer said. “This is Colorado. I don't care what Minnesota did.”

Advocates for health care access and researchers said a cluster of technological and administrative issues have contributed to Colorado's high disenrollment rate.

First, Colorado's eligibility database, the Colorado Benefits Management System, is outdated and clunky, according to people who use it or are familiar with systems in other states.

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“It's like still using the old flip phone where you're trying to play Snake,” said Sarah Grusin, an attorney at the National Health Law Program. “We have better stuff.”

Grusin and Pray's organizations filed a civil rights complaint with several federal agencies saying that the system issues that terminated disabled Coloradans' coverage amounted to discrimination.

“It took many months to fix something that doesn't sound that complicated,” Pray said.

Bimestefer said her department is working on a plan to improve the system, which is managed by Deloitte under a $354.4 million contract that lasts until 2027. A recent KFF Health News investigation of eligibility systems managed by Deloitte found widespread problems. In Colorado, a state-commissioned audit in 2020 found that many Medicaid beneficiaries were sent incorrect notices and deadlines.

Kenneth Smith, a Deloitte executive who leads its national human services division, said that Deloitte is one player among many who together administer Medicaid benefits, and that the states own the technology and make the decisions about their implementation.

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Colorado's technology woes have also weakened its ability to use a powerful tool in enrollment: automatic renewal.

Last fall, Bimestefer said, her agency had to choose between fixing the system so that it would stop disenrolling children who shouldn't lose coverage, or start automatically renewing people with no income or with income below the federal poverty level. It couldn't do both, she said.

Experts such as Tricia Brooks, a research professor with the Center for Children and Families at Georgetown University, said it's especially important to increase automatic renewals in states like Colorado where most of the renewal work falls on county government staff.

“What happens when you're not getting a high rate of automated renewals? You're sending out those renewal forms,” Brooks said — meaning more disenrollments. “They didn't get the mail. The notice was confusing. They tried to get help through the call center. The list goes on as to why people don't renew.”

Indeed, two-thirds of disenrolled Coloradans lost coverage for procedural reasons. That's in line with the national average, according to KFF. But paired with Colorado having disenrolled so many people overall, that means more than 500,000 Coloradans, or about 9% of the state's people, were disenrolled for procedural reasons — more than the population of its second-largest city, Colorado Springs.

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At least a third of those disenrolled were later determined to be eligible for Medicaid.

Officials at Colorado community health centers and mental health centers say they're seeing a rise in uninsured patients coming through their doors — a sign, they say, that Coloradans dropped from Medicaid aren't necessarily moving on to greener health insurance pastures.

Fifty-eight percent of those who were disenrolled have returned to Medicaid, or now have another form of insurance. But the state doesn't yet know what happened to the remaining 42% of people who were dropped and said it would conduct a survey to find out.

——————————
By: Rae Ellen Bichell
Title: Colorado Dropped Medicaid Enrollees as Red States Have, Alarming Advocates for the Poor
Sourced From: kffhealthnews.org/news/article/colorado-medicaid-unwinding-blue-red-states/
Published Date: Thu, 11 Jul 2024 09:00:00 +0000

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