Show notes
Welcome to the Friday News Flyover for November 3, 2023. I’m Sean Diller. This week: Medicaid chaos in red states around the country | Cannabis legalization on the ballot in Ohio | Pennsylvania Democrats have returned triple the mail ballots compared with their Republican neighbors | Colorado voters consider two statewide ballot initiatives, and | It’s Britney
https://missouriindependent.com/2023/11/02/medicaid-unwinding-breeds-chaos-in-states-as-millions-lose-coverage/
Medicaid ‘unwinding’ breeds chaos in states as millions lose coverage
BY: PHIL GALEWITZ, KATHERYN HOUGHTON, BRETT KELMAN AND SAMANTHA LISS - NOVEMBER 2, 2023 11:34 AM
More than two dozen people lined up outside a state public assistance office in Montana before it opened to ensure they didn’t get cut off from Medicaid.
Callers in Missouri and Florida reported waiting on hold for more than two hours on hotlines to renew their Medicaid coverage.
The parents of a disabled man in Tennessee who had been on Medicaid for three decades fought with the state this summer to keep him enrolled as he lay dying from pneumonia in a hospital.
Since the expiration of COVID-era protections earlier this year, states have reviewed the eligibility of more than 28 million people and terminated coverage for over 10 million of them. Millions more are expected to lose Medicaid in the coming months.
The Medicaid disenrollment rates of people reviewed so far vary dramatically by state, largely along a blue-red political divide, from a low of 10% in Illinois to a high of 65% in Texas.
“I feel like Illinois is doing everything in their power to ensure that as few people lose coverage as possible,” said Paula Campbell of the Illinois Primary Health Care Association, which represents dozens of community health centers.
Camille Richoux, health policy director for the nonprofit Arkansas Advocates for Children and Families said, “It’s not just bad, but worse than people can imagine. This has not been about determining who is eligible using all possible means, but how we can kick people off by all possible means.”
The unprecedented enrollment drop comes after federal protections ended this spring that had prohibited states from removing people from Medicaid during the three pandemic years. Since March 2020, enrollment in Medicaid and the related Children’s Health Insurance Program had surged by more than 22 million to reach 94 million people in the U.S.
The process of reviewing recipients’ eligibility has been anything but smooth for many Medicaid enrollees, and some suspect particular states have used the confusing system to discourage enrollment.
But gaps in coverage can jeopardize people’s access to health services - or their financial security - if they get medical bills for care they cannot postpone.
Pam Shaw, a pediatrician in Kansas City, Kansas, who chairs the American Academy of Pediatrics’ state government affairs committee said, “Any type of care that’s put off — whether it’s asthma, whether it’s autism, whether it’s something as simple as an earache — can just get worse if you wait,”
Doctors and representatives of community health centers around the country said they have seen an uptick in cancellations and no-shows among patients without coverage — including children. Nationwide, states have already disenrolled at least 1.8 million children in the 20 states that provide the data by age. Children typically qualify more easily than adults, so child advocates believe many kids are being wrongly terminated based on their parents’ being deemed no longer eligible.
In Texas, 68% of those disenrolled from Medicaid were children, compared with 16% in Massachusetts, according to KFF. In September, President Joe Biden’s administration said most states were conducting eligibility checks incorrectly and inappropriately disenrolling eligible children or household members. The administration ordered states to reinstate coverage for some 500,000 people.
Idaho, one of a few states that completed the unwind in six months, said it disenrolled 121,000 people of the 153,000 recipients it reviewed as of September because it suspected they were no longer eligible. Of those kicked off, about 13,600 signed up for private coverage on the state’s ACA marketplace, according to Pat Kelly, executive director of Your Health Idaho, the state’s exchange. What happened to the rest, state officials say they don’t know.
Nationwide, about 71% of Medicaid enrollees terminated during the unwinding have been cut because of procedural issues - meaning they could actually still qualify for Medicaid, but lost it anyway.
‘People are not getting through’
In many states, enrollees have faced long waits to get help with renewals. The worst phone waits were in Missouri, according to a KFF Health News review of letters the Centers for Medicare & Medicaid Services sent to states in August. In the letter to Missouri’s Medicaid program, CMS said it was concerned that the average wait time of 48 minutes and the 44% rate of Missourians abandoning those calls in May was “impeding equitable access” to assistance and patients’ ability to maintain coverage.
Some people are waiting on hold more than three hours, said Sunni Johnson, an enrollment worker at Affinia Healthcare, which runs community health centers in the St. Louis area. That’s a significant hurdle for people with inflexible jobs and other barriers.
In Florida, which has removed over 730,000 people from the program since April, enrollees earlier this year were waiting almost 2½ hours on a Spanish-language call center, according to a report from UnidosUS, a civil rights advocacy group. The Spanish versions of the Medicaid application, renewal website, and other communications are also confusing, said Jared Nordlund, the Florida director for UnidosUS.
Some Medicaid recipients are seeking help through the courts. In a 2020 class-action lawsuit against Tennessee that seeks to pause the Medicaid eligibility review, parents of recipients describe spending hours on the phone or online with the state Medicaid program, trying to ensure their children’s insurance coverage is not lost.
One of those parents, Donna Guyton, said in a court filing that Tennessee’s Medicaid program, called TennCare, sent a June letter revoking the coverage of her 37-year-old son, Patrick, who had been eligible for Medicaid because of disabilities since he was 6. As Guyton made calls and filed appeals to protect her son’s insurance, he was hospitalized with pneumonia, then spent weeks there before dying in late July.
“While Patrick was fighting for his life, TennCare was threatening to take away his health insurance coverage and the services he relied on,” she said in a court filing. “Though we should have been able to focus on Patrick’s care, our family was required to navigate a system that kept denying his eligibility and putting his health coverage at risk.”
TennCare said in a court filing Patrick Guyton’s Medicaid coverage was never actually revoked — the termination letter was sent to his family because of an “error.”
Phil Galewitz in Washington, D.C., wrote this article. Daniel Chang in Hollywood, Florida; Katheryn Houghton in Missoula, Montana; Brett Kelman in Nashville, Tennessee; Samantha Liss and Bram Sable-Smith in St. Louis; and Bernard J. Wolfson in Los Angeles contributed to this report.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
https://ohiocapitaljournal.com/2023/11/01/marijuana-legalization-would-add-260m-to-ohio-economy-study-predicts/
Smoke ‘em if you got ‘em. Or when you get ‘em anyway.
Issue 2, an initiative that would legalize recreational marijuana for people over 21 in Ohio, is on the ballot in next Tuesday’s election.
An economic analysis released last week found that the benefits of legalizing cannabis in Ohio would outweigh the costs by a quarter-billion dollars a year.
A study by Columbus-based Scioto Analysis attempts to identify the pluses and minuses that would come with legalization.
To do the analysis, the group used studies from states such as Washington and Colorado, where recreational weed has long been the law. To examine how the pros and cons identified in those states might play out in Ohio, the researchers looked at economic and census data, as well as crime statistics.
with its 10% excise tax on top of Ohio’s normal sales tax, passage of Issue 2 would produce $190 million a year, according to the report.
Then there are the jobs the new industry would create.
The report predicts that Ohio will add roughly 3,300 new jobs in the first year after legalization. Assuming these jobs are full time and pay matches the average wage across the state of Ohio, this will amount to about $190 million in wage benefits for workers across the state.
And if weed is no longer illegal for adults over 21, it stands to reason that there will be fewer arrests.
The report said using data from the FBI’s Uniform Crime Report on the number of cannabis-related arrests in Ohio, they estimate there would be about 4,400 fewer arrests per year if recreational cannabis were legalized.
Adding up the cost of those arrests, and assuming that 6% of those people would have been convicted of felonies, this amounts to over $38 million in savings for Ohio.”
Overall, study estimated Ohioans would receive $260 million in annual benefits if Issue 2 passes this coming Tuesday.
https://www.penncapital-star.com/blog/mail-in-ballot-returns-top-half-a-million-2023-election-mailbag/
Dems far outpacing Republicans in mail and absentee ballots returned
Mail-in ballot returns top half a million | 2023 Election Mailbag
BY: CASSIE MILLER - NOVEMBER 1, 2023 2:00 PM
Here are the numbers: As of Nov. 1, Pennsylvania voters requested a total of 1,026,227 absentee and mail-in ballots.
Of that number, 90% requested a mail-in ballot and 10% requested an absentee ballot ahead of the municipal election.
Registered Democrats requested 723,746 mail-in and absentee ballots compared to 215,286 Republicans and 87,195 requests from “other” registered voters. So about 3 of every 4
Of the 570,000 ballots returned so far statewide, 417,829 - or about 3 of every 4 - were ballots from registered Democrats and 114,149 were from those registered as Republicans.
https://coloradonewsline.com/2023/10/01/proposition-hh-proposition-ii/
Colorado voters will decide on two statewide measures this election, both of which were referred to the ballot by the state Legislature.
First, Proposition HH
If approved, Proposition HH would lower property tax rates over the next 10 years and allow the state to keep more money than it would otherwise be obligated to return to taxpayers.
If Proposition HH passes, the residential assessment rate would be reduced to 6.7% from 6.765% until 2032.
Proposition HH would also raise the amount of tax revenue the state can keep — set by the Taxpayer’s Bill of Rights — by 1%. The new revenue allowed would be used to backfill property tax revenue that local governments would miss out on, for things like public education. $20MM would also be set aside for a rental assistance program.
The proposition is backed by the Democratic lawmakers who voted to put it on the ballot and by Demoratic Gov. Jared Polis, as well as by other liberal groups, unions, AARP and the League of Women Voters. They say the proposal is a responsible solution to rising property taxes while still keeping schools funded.
https://variety.com/2023/music/news/britney-spears-memoir-the-woman-in-me-sales-publisher-1235768414/
It’s Britney
Britney Spears‘ long-awaited memoir “The Woman in Me” — which details her fight for freedom and tumultuous relationships with the men in her life — has sold 1.1 million copies in its first week across print, pre-sales, e-books and audiobooks in the United States.
“The Woman in Me” was released on Oct. 24 and has officially been out for just over a week.
The memoir is 275 pages long and the audiobook is read by actress Michelle Williams. The book featured a wild assortment of revelations that touched on Spears’ career, family, conservatorship and high profile relationships. Among them, Spears revealed that she and her ex-beau Justin Timberlake had gotten an abortion and she also claims Timberlake cheated on her with unnamed celebrities.
Spears landed the publishing deal for a tell-all last February, just a few months after her conservatorship was terminated. Simon & Schuster acquired the rights to Spears’ book last year after a bidding war that involved multiple publishers, though the financial terms of the transaction have not been revealed.
That’s it for me, from Denver I’m Sean Diller. Stories featured in today’s show were originally reported in the Missouri Independent, Ohio Capital Journal, Pennsylvania Capital Star, Colorado Newsline, and Variety. Thanks for listening, see you next time.
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