Adam Searing 🇺🇸🏳️🌈🚵
@AdamSearing
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Research Faculty Georgetown University, CCF. Attorney, health policy. Lifelong cyclist, sailor, kayaker and hiker. Current member of Chapel Hill's Town Council.
Washington DC; Chapel Hill NC
Joined May 2009
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Wyoming House passes Medicaid expansion on 3rd reading! 32-28. Now on to the Senate!
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States considering work reporting requirements in Medicaid need to add in the expense + time of dealing with litigation they will likely lose when they consider such proposals. Although it would be nice if they thought about the 1000s who lose coverage too
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Never in history has a health policy issue been researched more than Medicaid expansion.
The results aren’t close.
The 37 states expanding Medicaid have healthier residents, more secure rural hospitals, and more people w/ affordable coverage.
More studies confirm this weekly.
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BIG: Utah’s grassroots effort to get Medicaid expansion on the 2018 ballot was apparently successful today, hitting the 26 district signature requirement. The Lieutenant Governor will officially certify the measure for the ballot btwn May 15 and June 1.
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It sure could. And in the next couple of weeks too, Medicaid included.
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Five times Donald Trump promised he would protect
#Medicaid
from cuts. The GOP health bill he supports cuts Medicaid by $880 billion or 25%
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"Democratic Gov. Laura Kelly released a plan Tuesday for expanding Medicaid in Kansas that revives a bipartisan proposal vetoed two years ago by a Republican predecessor.
Kelly’s legislation would extend state health coverage to another 150,000 adults..."
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1/Dug up a presentation on NC's 2008 health high risk pool. Some highlights: *No one* today would want this plan.
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The bill's back, so the video is back: 5 times Trump promised not to cut
#Medicaid
- now the House health bill cuts it by $839-$880 billion.
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CBO report: higher premiums for elderly, $834 billion Medicaid cut in *all* states, 23M uninsured. *Not* what Reps told their constituents:
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This is a huge deal - despite voters electing a Governor who ran on expansion of affordable health coverage, legislative leaders stonewalled change - but that logjam has broken this afternoon!
BREAKING: Kansas House gives first-round approval to Medicaid expansion in a 70-54 vote
(story will be updated)
#ksleg
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The GOP controls the House, Senate and Presidency and a top priority is taking away the medical expense deduction from Americans to help pay for a corporate tax cut. Unbelievable.
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1/ I’ve collected state stories on the threat to kids if Congress doesn’t renew CHIP
Follow if interested (channelling my inner
@ASlavitt
)
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Side effect of 7 month intense health debate? Medicaid's defenders are organized and ready for inevitable future attempts to gut the program
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“The Senate Republican tax plan gives substantial tax cuts and benefits to Americans earning more than $100,000 a year, while the nation’s poorest would be worse off, according to a report released Sunday by the nonpartisan Congressional Budget Office”
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Every time I say this I wonder why 14 states still haven't expanded affordable Medicaid health coverage:
"If states would expand Medicaid coverage, they would improve the health of mothers and babies and save lives."
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Medicaid is health coverage for kids, parents, elderly, people with disabilities, pregnant women. Some low-income mostly working adults in construction, restuarnts and other industries w/o health coverage can choose to sign up too. Why is Trump proposing billions of $ in cuts?
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"Work requirements" just an excuse for cutting people off of Medicaid, pure and simple. These changes don't make it easier for people with cancer and heart disease to see a doctor - they make it harder. And state efforts don't include ways to create good jobs with health coverage
Arkansas has become the first state to remove people from Medicaid for not complying with work requirements. More than 4,000 just lost safety-net insurance.
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Gallup cites repeal of the individual mandate by Congress and Trump Administration actions like shortening enrollment periods and refusing to implement cost sharing reductions as the likely culprits for this shameful rise in uninsured Americans
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North Carolina House and Senate have come to an agreement on Medicaid expansion, including CON sticking point. Senate+House leaders announcing at press conference now....Med ex effective on passage of NC 2023 budget
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It doesn’t get much more bipartisan than when the Democratic governor Kansas and Republican leader of Kansas Senate start campaigning together for more affordable health coverage through Medicaid expansion.
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To sum up - Utah (likely), Idaho, Nebraska all passed expansion ballot measures. Maine + Kansas elected Governors promising expansion. NC GOP lost their legislative supermajorities, thus guaranteeing more expansion discussion. It was a great night for affordable health coverage
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Lots of folks outside NC ask me, "Why is Medicaid expansion moving now in NC?" My take:
1. New federal $$ makes expanding very financially attractive
2. Huge increase in rural support from business, hospitals, local officials
3. Removes med ex as political issue in state races
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The methane torches on this section of the awesome Arkansas River bike path in Tulsa are flaming in celebration of Oklahoma's passage of Medicaid expansion by a very small margin - about 6,488 votes. But that's enough to mean new affordable health coverage for working adults
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A major problem with Medicaid "work requirements" is pointed out by my friends
@LittleLobbyists
: Many parents of medically complex kids work 100x as hard as me or anyone I know taking loving care of their children. But some politicians apparently don't consider that "real work".
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North Carolina: Another rural hospital about to close in a state that has refused to expand Medicaid (which takes care of a much higher % of people in rural areas than in urban ones).
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Montana Medicaid expansion report:
"reliance on emergency room for medical care fell significantly, hospitals...saw the amount of uncompensated charity care drop, and the state spent less of its funds than neighboring or comparable states on healthcare."
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My spouse
@MimiVChapman
has often worked 14 hours plus a day, every day, for the last 18 months helping lead our great
@UNC
through this awful pandemic. She’s respected by both Republicans and Democrats. “Perpetual malcontent?” Nope.
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Trump betraying all his health care promises is the biggest Trump scandal of all
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Yes, proposing to take health care away from 23 million kids, parents, elderly, others isn't popular for some reason
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NC Governor on Medicaid expansion:
“It will help rural hospitals to stay afloat”
“It is embarrassing that 30,000 veterans in North Carolina have no health insurance and if we expand Medicaid 23,000 of them will.”
"It will insure anywhere from 5-600,000 North Carolinians"
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Medicaid is what's best about America: Caring for everyone left out, efficient, public/private partnerships, innovative.
#ProtectMedicaid
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“What the hell is going on in Chapel Hill?” New Coalition for Carolina formed to push back against partisan political meddling at UNC. Sounds like a really good idea!
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Don't let anyone talk blithely about
#Medicaid
cuts as "grants/caps/flexibility" - Remind them 1/2 of Americans on Medicaid are kids
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Some personal news: I’m throwing caution to the winds and jumping into local government to run for Chapel Hill Town Council. We need to preserve our public forests, community trails and public open space now and for future generations!
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North Carolina Senate passes Medicaid expansion 2nd reading 44-2. Final vote tomorrow. Now on the the NC House. NC Senate President Berger talked about the effect of Med Ex on helping working folks and financial security. Said he would work hard to help get it through House.
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New CBO projections show **huge** Medicaid cut for states over time. About **half** of people on Medicaid are kids
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New Senate bill on Medicaid expansion provides 100% federal funding again for three years for all states that have expanded or choose in the future to expand.
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In America people with serious disabilities can go to college, become a lawyer, etc - *Medicaid* makes this possible
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5/leave many without coverage. History shows providing our sickest people this option doesn't work and isn't a substitute for real reform.
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Under-appreciated Medicaid news - in North Carolina Republicans look poised to lose their supermajority in the NC House and - possibly - in the NC Senate. With a Governor strongly in support of Medicaid expansion this power shift could help move Medicaid forward like in Virginia.
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With final passage of the budget and a no veto from Governor Cooper, North Carolina’s Medicaid expansion soon will be implemented, meaning over half a million hardworking folks will finally get quality, affordable health coverage after 10 years of debate.
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Instead of new state work “requirements” for Medicaid, Governors should get to work themselves attracting good jobs in rural areas + towns
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Really fun seeing a few of the many, many folks who worked on North Carolina’s Medicaid expansion as Governor Cooper signed the NC bill today. As he said - it is a historic day for NC.
@ncjustice
@thelucygoose
@AdamMLinker
@Sotak1974
Nicole Dozier, Rebecca Cerese, Hyun Namkoong
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I was honored to have my old friend Representative
@verlainsko
swear me in tonight as a new member of the Chapel Hill Town Council.
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Medicaid expansion study, this time showing heart attack reduction:
"expansion states had a significant reduction in the proportion of uninsured hospitalizations for major cardiovascular events within 1 year of Affordable Care Act Medicaid expansion"
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Kentucky Gov race a big deal for Medicaid. KY’s expansion of affordable care was popular and the losing incumbent Governor Bevin really suffered from his attacks on Medicaid and attempts to limit coverage. Big sign to other red states that opposing Med Ex is a losing issue.
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One last
#Medicaid
thought: It's the largest source of federal funds for states, so federal cuts hurt not just health care but all programs
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Really good news. Maine's Medicaid expansion (approved by voters, blocked by current Gov) will go into effect Feb 1, 2019 with retroactive benefits to July 2, 2018. The new Governor, supportive of Medicaid, will oversee expansion of affordable health care
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Medicaid helps Americans in ways most don't realize. *Excellent* from
@AlexiaCampbell
quotes
@GeorgetownCCF
T Brooks
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The state of North Carolina literally has a current $6.5 billion budget surplus. The “budget challenge” here is a purely political one created by the current NC General Assembly as an attack on one of the historic key drivers of NC economic growth - UNC
As part of the UNC's efforts to address its budget challenge, the Libraries will absorb approximately $5 million in cuts over the next 2 years. Members of the Carolina community are invited to information sessions to learn more. Register:
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Utah Medicaid expansion leading 63%-37%....mirroring lead in Nebraska. Apparently voters like more affordable health care.
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"Success [on Medicaid expansion ballots] in Florida, Mississippi and South Dakota would further demonstrate the popularity of Medicaid expansion even in Republican-dominated states and put pressure on lawmakers in other holdout states to follow suit."
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In the Missouri vote count there’s a huge split between rural counties less likely to support Medicaid expansion and urban counties with much stronger support. Similar to other states. Ironically, Med ex is hugely important to rural hospitals and helps people more in rural areas.
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4/I will never forget those people and the immense pain in our conversations. A high risk pool is a mirage that will serve very few and
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Instead of a bill cutting billions from Medicaid + coverage for millions, here are four bipartisan ideas the Senate could work on this week:
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Wyoming advances bill on Medicaid expansion - will be considered this session in January. Lots of thoughtful comments from former Republican opponents who now support the concept.
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I stand with Roy (a good place for a two time UNC alum to be) — Let’s expand Medicaid in North Carolina!
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CHART: President Trump’s reported work schedule would not come close to meeting Medicaid work requirements he just approved for poor people in Kentucky. [4hr/day (80hr/mo) of “employment, education, job skills training, and community service.”]
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Supermajority vote in NC makes Gov. Roy Cooper more relevant - and Medicaid expansion more likely. Add N.C. to the list of states to watch on this issue.
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Fun watching the NC House take the final vote to approve NC Medicaid expansion this morning. Ran in to some of the amazing advocates who helped make this happen
@abster_eman
Rebecca Cerese, Hyun Namkoong
@ncjustice
@care4carolina
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Extra$ for states to expand Medicaid
@CBPP
$Billions:
Florida $3.5B
Texas $5.97B
N. Carolina $2.4B
Georgia $1.8B
Missouri $1.7B
Tennessee $1.6B
Wisconsin $1.3B
$Millions:
S. Carolina $960M
Alabama $940M
Mississippi $890M
Oklahoma $860M
Kansas $330M
S. Dakota $180M
Wyoming $120M
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People with Medicaid don't need a political work "requirement," they need access to good jobs, especially in rural areas + small towns.
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Don't be fooled.
#Medicaid
, other "block grants" just a sneaky way to cut federal funding for states + transfer cost to state govt+taxpayers
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My colleagues
@GeorgetownCCF
asked me to write a few words about our friend Rob Restuccia and I was very happy to try and do so
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NC Sheriffs’ Association told "House and Senate leadership that expanding Medicaid would fight crime by providing professional care to the “significant percentage” of people in county jails suffering from mental illness and substance abuse disorders.""
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Virginia, Kansas, North Carolina, Tennessee, Georgia - get ready for some serious discussion on Medicaid expansion after Maine's yes vote tonight
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The North Carolina Medicaid expansion bill has passed its final vote (44-1) in the NC Senate and is off to the NC House today, facing a more difficult atmosphere. As debate continues, the huge effect passage would have on rural hospitals+folks in small towns will be v. important.
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Stunning: Kentucky counties w/ highest
#Medicaid
rates backed Bevin, who plans to cut Medicaid
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@SeemaCMS
If one of the thousands of people who just lost health coverage for months because of the changes you approved was sitting in your office asking you how they would now afford their cancer treatment what would you say to them face to face?
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When I worked on starting CHIP in North Carolina, one parent's speech in the legislature made a difference. She explained her husband was an auto mechanic but they could only afford to insure 2 of their 3 kids each year. She didn't want to keep choosing which one.
#WellnessWed
Q9: How is CHIP uniquely situated to meet the needs of kids and working families?
#SaveCHIP
#WellnessWed
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This quote from Ohio Gov. John Kasich (R) to
@jameshohmann
sums up the Senate's health care debate perfectly
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2/In 2008 as a health advocate people w/ MS or hemophilia would call me looking for insurance help – I would explain the risk pool. Silence
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Over a decade ago, I wrote an op-ed about why expanding Medicaid in North Carolina ought to be a "no-brainer." It's been a long ten years, but glad my prediction is finally happening!
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Arkansas: Traditional Medicaid cheaper per person, even for frail, than using Medicaid $ to buy private health plans
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I can tell you from personal experience Medicaid expansion has been the
#1
political issue in NC for several years. NC’s legislature has blocked expansion since 2014. This year more than ever voters realize the path to change leads through the ballot box.
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Excellent paper. Medicaid expansion makes a difference for moms and babies.
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Wyoming - some movement on Medicaid expansion in the legislature.
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Repealing Obamacare w/o a real replace plan isn't a "transition" or a "delay"- it's taking health coverage away from Americans - period.
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3/would result on the phone as we contemplated my inability to help and their inability to get lifesaving treatment and/or go bankrupt.
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@SenateMajLdr
1. GOP controls the House, the Senate and the Presidency.
2. CBO says CHIP reauthorization for 10 years actually saves $.
3. Democrats and Republicans agree on the policy behind renewing CHIP.
**You could fund children's health coverage this afternoon if you wanted to.**
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I hope to see more efforts as in Kansas right now where Democrats and Republicans are working together to expand and improve health coverage
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NC Med ex bill passes first vote in House. Final vote tomorrow!
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My volunteer-run grassroots campaign for Chapel Hill Town Council was based on our public parks and forests having a higher priority in our town debates. Voters agreed! I look forward to making our community first in parks instead of last in green space.
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“And a provision...to make Medicaid expansion more fiscally appealing has convinced deep-red Alabama and Wyoming to consider expanding the program to residents whose incomes are too high to qualify now but too low to afford private health plans.”
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4 recent studies show
#Medicaid
expansion = 29%-48% reduction in uninsured/uncompensated care for hospitals/FQHCs
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Today because of Medicaid more kids w/ complex medical needs can be home with their families;
@Chelmariejo
's story
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I think there should be a complete shutdown of votes on health bills until our country's representatives can figure out what is going on.
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Troubling attempt today to allow sale of health plans in North Carolina that don't include protections for pre-exisiting conditions. For example, pregnancy, cancer treatment, people with heart conditions or other problems could be "underwritten" or in English, excluded.
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I worked with one of our nation's top infectious disease/HIV physician leaders, Dr. Adaora A. Adimora, to pull together a policy paper on why Medicaid expansion, especially in the South, is critical to ending the HIV epidemic for individuals and families
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States taking a sucker bet on Medicaid from Trump Administration on work requirements, lockouts, lifetime limits. These cut people off Medicaid + feds pay 50-75% of Medicaid costs. Cutting a patient's Medicaid doesn't mean cancer, etc goes away - states just pay more to treat it.
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Significant NC Senate leader stmt on details of poss Medicaid expansion:
"Republican Sen. Ralph Hise, a key budget writer in the chamber, said senators may add the bill to the annual state budget, which would increase the pressure on House Republicans.."
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You often hear about what a priority it is to "make government more efficient." Amazing how inefficient government suddenly gets when voters approve an affordable health plan opposed by Nebraska's Governor.
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Trump personal White House work schedule (11am - 4.15pm with frequent TV breaks) wouldn’t be enough work to meet proposed Medicaid job mandates his adminstration is encouraging states to require of lower income people who need health care.
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I will just note the first bad health bill I blocked as a nonprofit advocate was strongly backed by legislative leadership, had passed both House and Senate and lacked only a final conference committee vote everyone told me was a foregone conclusion.....
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