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Overhaul of Medicaid expansion could cost states $32 billion: report

A woman picks up a leaflet at a health insurance enrollment event in Cudahy, California March 27, 2014. REUTERS/Lucy Nicholson

By Hilary Russ

NEW YORK (Reuters) – Proposals in Congress that would effectively end Medicaid expansion in 31 U.S. states would cost those states at least $32 billion altogether in 2019, according to a report released on Friday.

“Few, if any, states could absorb such new costs,” the Center on Budget and Policy Priorities, a Washington-based, left-leaning think tank, said in its report.

Republican President Donald Trump has pushed to fulfill a campaign promise to replace Obamacare, his Democratic predecessor’s signature healthcare plan, with the help of a Republican-controlled Congress.

More details of potential replacements by U.S. House Republicans for former President Barack Obama’s Affordable Care Act emerged on Friday, though they have yet to agree on a single detailed policy proposal to repeal and replace the healthcare law.

One scenario to phase out enhanced federal funding would convert the current system, in which states share the cost of Medicaid enrollees with the federal government, into fixed payments, or block grants, sent to the states.

But that would dramatically affect the 31 states and the District of Columbia that chose to expand Medicaid, the government health insurance program for low-income Americans, and collect extra dollars that came with expansion.

Those states would have to find the extra $32 billion themselves to maintain their expansions, the center said in its report.

The block grant conversion would “shrink federal Medicaid funding over time, result in even deeper funding cuts when needs increase, and ultimately place coverage for tens of millions more Americans at risk,” the center said in its report.

The reduced federal funding would cause the automatic end of the expansion in seven states. Other expansion states would “almost certainly drop or substantially scale back their expansions,” the report said.

Medicaid sits at the heart of the federal-state fiscal relationship. Over $330 billion in federal Medicaid dollars flowed to states in fiscal year 2016, accounting for more than half of all federal grants sent to state and local governments and the largest individual program, according to Standard & Poor’s.

(Reporting by Hilary Russ; Editing by Jonathan Oatis)

U.S. judge blocks Texas plan to cut Planned Parenthood Medicaid funds

FILE PHOTO - Planned Parenthood South Austin Health Center is seen in Austin, Texas, U.S. on June 27, 2016. REUTERS/Ilana Panich-Linsman/File Photo

By Jon Herskovitz

AUSTIN, Texas (Reuters) – A U.S. judge in Austin issued a preliminary injunction on Tuesday halting Texas’ plan to cut Medicaid funding for Planned Parenthood, saying the state did not present evidence of a program violation that would warrant termination.

U.S. District Judge Sam Sparks said state health officials “likely acted to disenroll qualified health care providers from Medicaid without cause.” He said the preliminary injunction will preserve the court’s ability to render a meaningful decision on the case’s merits.

“Such action would deprive Medicaid patients of their statutory right to obtain health care from their chosen qualified provider,” wrote the judge who was appointed by Republican former President George H.W. Bush.

The reproductive healthcare group has said the threatened funding cut, by terminating Planned Parenthood’s enrollment in the state-funded healthcare system for the poor, could affect nearly 11,000 patients across Texas as they try to access services such as HIV and cancer screenings.

Texas and several other Republican-controlled states have pushed to cut the organization’s funding since an anti-abortion group released videos it said showed Planned Parenthood officials negotiating prices for fetal tissue collected from abortions.

Texas investigated Planned Parenthood over the videos and a grand jury last January cleared it of any wrongdoing. The grand jury indicted two anti-abortion activists who made the videos for document fraud but the charges were dismissed.

The state took no further criminal action against Planned Parenthood after that but has repeated its accusations that the abortion provider may have violated state law.

Planned Parenthood has denied any wrongdoing and sued the anti-abortion activists who made the videos.

Texas Republican Attorney General Ken Paxton said his office would appeal.

“Today’s decision is disappointing and flies in the face of basic human decency,” he said in a statement.

In fiscal 2015, Planned Parenthood affiliates across Texas received about $4.2 million in Medicaid funding, the state’s Health and Human Services Commission said. Planned Parenthood said the amount for 2016 was estimated at around $3 million.

None of the money that the group received went for abortions, plaintiffs in a lawsuit against Texas and the Medicaid defunding plan have said.

Planned Parenthood has 34 health centers in Texas, serving more than 120,000 patients, 11,000 of whom are Medicaid patients, it said.

(Reporting by Jon Herskovitz; Editing by Grant McCool and James Dalgleish)

U.S. healthcare costs to escalate over next decade: government agency

WASHINGTON (Reuters) – The cost of medical care in the United States is expected to grow at a faster clip over the next decade and overall health spending growth will outpace that of the gross domestic product, a U.S. government health agency said on Wednesday.

A report by the U.S. Centers for Medicare and Medicaid Services (CMS) cited the aging of the enormous baby boom generation and overall economic inflation as prime contributors to the projected increase in healthcare spending.

Overall healthcare spending will comprise 19.9 percent of the economy in 2025, up from 17.8 percent in 2015, the report forecast. The pace of growth in U.S. spending on health is expected to pick up in 2017, increasing 5.4 percent over 2016. That compares with an estimated 4.8 percent spending uptick in 2016. Spending for 2016 was estimated at $3.4 trillion.

When the final numbers are in, the growth in prescription drug spending for 2016 is expected to have slowed to 5 percent from 9 percent in 2015. However, CMS has forecast growth of 6.4 percent per year between 2017 and 2025, in part because of spending on expensive newer specialty drugs, such as for cancer and multiple sclerosis.

The projections for 2016 to 2025 were made assuming that the Affordable Care Act (ACA), former President Barack Obama’s signature healthcare law widely known as Obamacare, would remain intact. It does not take into account likely changes to the law.

The Republican-led Congress and President Donald Trump have vowed to repeal and replace the ACA, but a viable replacement plan has yet to emerge.

Trump signed an executive order on his first day in office last month to freeze regulations and enable government agencies to take other steps to weaken Obamacare.

The ACA expanded Medicaid, the government health insurance program for the poor, in more than 30 states and set up private healthcare exchanges that enabled previously uninsured people to buy health insurance. After high enrollment between 2014 and 2015, Medicaid and private health insurance spending were expected to have slowed in 2016.

But spending on Medicare, the government health insurance program for the elderly, is expected to grow between 2017 and 2025 as a larger elderly population requires more medical services.

The overall insured rate of the population is expected to reach 91.5 percent in 2025, up from 90.9 percent in 2015, the report said.

(Reporting By Yasmeen Abutaleb; Editing by Tom Brown)

Iowa moves to cut Medicaid funding for Planned Parenthood

By Timothy Mclaughlin

(Reuters) – The Republican-controlled Iowa state senate voted on Thursday to cut Medicaid funding for family planning services to abortion providers including Planned Parenthood.

State senators passed the bill 30-20, advancing it to the Republican-controlled House. The vote was along party lines, with one independent voting in favor of the measure.

Republican Governor Terry Branstad has said he supports the bill.

Planned Parenthood draws the ire of many Republicans because it provides abortions, and Republican President Donald Trump has pledged to defund the organization.

“This change will allow Iowa to restrict government funding to family planning services away from organizations that perform abortions that are not medically necessary,” Republican Senator Amy Sinclair, one of the bill’s sponsors, said on Thursday before the vote.

Planned Parenthood denounced the vote.

“The Republican lawmakers who continue to advance this bill should be ashamed of themselves. They are playing political games, with the lives of low-income Iowans at stake,” Planned Parenthood of the Heartland said in a statement.

“This bill does nothing to advance their extremist agenda to limit access to abortion. Instead, it blocks access to crucial family planning services for thousands of Iowans – the very services that most effectively prevent abortion. It’s a self-serving, misleading and dangerous political game.”

The bill directs the Iowa Department of Human Services to discontinue the Medicaid family planning network waiver on July 1 and replace it with a state family planning services program.

Eligibility requirements for the new network would remain the same, but no funding would be provided to organizations that provide abortions or maintain facilities where abortions are carried out.

Planned Parenthood is Iowa’s largest abortion provider with 12 clinics in the state, but no public money is used for abortions, according to the Des Moines Register.

Branstad has proposed paying for the new state-run program by shifting $2.8 million in funds from services for vulnerable adults, families and children, the newspaper reported.

Planned Parenthood is also facing a funding cut in Texas, where a judge is considering the move, which the organization has challenged in court.

(Reporting by Timothy Mclaughlin in Chicago; Editing by Cynthia Osterman)

Texas Planned Parenthood asks judge to block Medicaid funding cut

By Jon Herskovitz

AUSTIN, Texas (Reuters) – The leaders of Texas Planned Parenthood asked a federal judge on Tuesday to block the state’s bid to halt Medicaid funding for the healthcare group, which has long been targeted by Republicans for providing abortions.

Planned Parenthood has said the threatened funding cut, by terminating Planned Parenthood’s enrollment in the state-funded healthcare system for the poor, could affect nearly 11,000 patients across Texas.

It is seeking an injunction from Judge Sam Sparks in federal court in Austin to stop the cutoff, part of a protracted legal and political fight.

The defunding efforts could gain traction now that Republicans, who already control the U.S. House and Senate, are expanding their powers with this week’s inauguration of President-elect Donald Trump.

Ken Lambrecht, chief executive of Planned Parenthood of Greater Texas and a plaintiff, testified his group does not participate in fetal tissue donation for medical research.

Planned Parenthood has denied wrongdoing nationally, saying the videos were heavily edited and misleading.

The Medicaid cut was “unconscionable,” Lambrecht testified, adding it would make it more difficult for some of the state’s poorest people to access services his affiliate provides, such as cancer screenings and HIV testing.

Texas has said other medical facilities could provide similar services as Planned Parenthood.

Planned Parenthood affiliates across Texas received about $4.2 million in Medicaid funding during the 2015 fiscal year, the state’s Health and Human Services Commission said.

None of that money went to abortions, plaintiffs in the lawsuit against Texas and the Medicaid defunding plan have said.

Sparks said he does not see the videos as a central to the hearing, which opened Tuesday and is scheduled to run through Thursday. He called on the state to present evidence to back up its allegations that Planned Parenthood violated the law.

Texas investigated Planned Parenthood over the videos and a grand jury last January cleared it of any wrongdoing. The grand jury indicted two people who made the videos for document fraud but the charges were later dismissed.

The state took no further criminal action against Planned Parenthood after that but has repeated its accusations that the abortion provider may have violated state law.

Planned Parenthood gets about $500 million annually in federal funds across the United States, largely in reimbursements through Medicaid.

(Reporting by Jon Herskovitz; Editing by Tom Brown and Lisa Shumaker)

Texas moves to cut Medicaid funding for Planned Parenthood

By Jon Herskovitz

AUSTIN, Texas, Dec 21 (Reuters) – Texas plans to block about $3 million in Medicaid funding for Planned Parenthood operations in the state, according to a legal document obtained on Wednesday, a move the reproductive healthcare group said could affect nearly 11,000 low-income people.

Planned Parenthood said it would seek court help to block the funding halt, which would cut cancer screenings, birth control, HIV testing and other programs.

Planned Parenthood gets about $500 million annually in federal funds, largely in reimbursements through Medicaid, which provides health coverage to millions of low-income Americans.

Texas and several other Republican-controlled states have tried to cut the organization’s funding after an anti-abortion group released videos last year that it said showed officials from Planned Parenthood negotiating prices for fetal tissues from abortions it performs.

Texas sent a final termination notice to Planned Parenthood in the state on Tuesday to alert it of the funding cut, the document showed, saying the basis of the termination was the videos.

Planned Parenthood has denied wrongdoing, saying the videos were heavily edited and that it does not profit from fetal tissue donation. It has challenged similar defunding efforts in other states, calling them politically motivated.

Republican President-elect Donald Trump has pledged to defund Planned Parenthood, and at least 14 states have tried to pass legislation or taken administration action to prevent the organization from receiving federal Title X funding.

“Texas is a cautionary tale for the rest of the nation,” Cecile Richards, president of the Planned Parenthood Action Fund, said in a statement. “With this action, the state is doubling down on reckless policies that have been absolutely devastating for women.”

The Texas governor’s office was not immediately available for comment. The state investigated Planned Parenthood over the videos. A grand jury in January cleared Planned Parenthood of any wrongdoing and indicted the anti-abortion activists who made the videos for tampering with government records.

About a year ago, the Texas health department cut funding to a Houston Planned Parenthood affiliate for a nearly three-decade-old HIV prevention program. The contract was federally funded through the Centers for Disease Control and Prevention but managed by the state.

(Reporting by Jon Herskovitz; Editing by Lisa Von Ahn)

Judge sides with Planned Parenthood over Mississippi abortion law

(Reuters) – A federal judge on Thursday sided with women’s health provider Planned Parenthood in a lawsuit aiming to block a Mississippi law that barred medical providers that perform abortions from participating in the state’s Medicaid program.

The decision by U.S. District Judge Daniel Jordan III is the latest in a string of rulings striking down similar laws elsewhere in the country against the women’s health provider.

Jordan’s two page order noted a ruling from the 5th U.S. District Court of Appeals that rejected a similar law in Louisiana, saying “essentially every court to consider similar laws has found that they violate” federal law.

Medicaid is a health insurance program for the poor run jointly by the federal government and individual states.

Planned Parenthood said in its complaint that the law, which went into effect in July, unconstitutionally limited patients’ rights to choose the healthcare provider of their choice and would have stopped it from serving low-income patients.

“Yet another court has said it is unacceptable for politicians to dictate where women can go for their health care,” Planned Parenthood Federation of America President Cecile Richards said in a statement. “Planned Parenthood will fight for our patients at every turn.”

Mississippi’s Republican Governor, Phil Bryant, expressed disappointment with the ruling, saying in a statement on Facebook: “I believe the law was the right thing to do and I will continue to stand with the legislature and people of Mississippi who do not want their hard-earned money going to the largest abortion provider in the nation.”

Mississippi was among many states adopting new abortion laws as conservatives have sought to chip away at the U.S. Supreme Court’s landmark 1973 Roe v. Wade decision legalizing abortion.

In August, a federal judge prevented Ohio from cutting federal taxpayer funding from 28 Planned Parenthood clinics in the state, setting back the governor’s hopes of stopping the women’s health services group from providing abortions.

(Reporting by Curtis Skinner in San Francisco; Editing by Simon Cameron-Moore)

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