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Chiquita Brooks-LaSure, administrator of the Centers for Medicare & Medicaid Services, leads some of the Biden administration's efforts to expand Medicaid access.; Credit: Caroline Brehman/CQ-Roll Call, Inc via Getty Imag

The Biden administration is quietly engineering a series of expansions to Medicaid that may bolster protections for millions of low-income Americans and bring more people into the program.

Biden's efforts — which have been largely overshadowed by other economic and health initiatives — represent an abrupt reversal of the Trump administration's moves to scale back the safety-net program.

The changes could further boost Medicaid enrollment — which the pandemic has already pushed to a record 80.5 million. Some of the expansion is funded by the COVID-19 relief bill that passed in March, including coverage for new mothers.

Others who could also gain coverage under Biden are inmates and undocumented immigrants. At the same time, the administration is opening the door to new Medicaid-funded services such as food and housing that the government insurance plan hasn't traditionally offered.

"There is a paradigm change underway," said Jennifer Langer Jacobs, Medicaid director in New Jersey, one of a growing number of states trying to expand home-based Medicaid services to keep enrollees out of nursing homes and other institutions.

"We've had discussions at the federal level in the last 90 days that are completely different from where we've ever been before," Langer Jacobs said.

Taken together, the Medicaid moves represent some of the most substantive shifts in federal health policy undertaken by the new administration.

"They are taking very bold action," said Rutgers University political scientist Frank Thompson, an expert on Medicaid history, noting in particular the administration's swift reversal of Trump policies. "There really isn't a precedent."

The Biden administration seems unlikely to achieve what remains the holy grail for Medicaid advocates: getting 12 holdout states, including Texas and Florida, to expand Medicaid coverage to low-income working-age adults through the Affordable Care Act.

And while some of the recent expansions – including for new mothers -- were funded by close to $20 billion in new Medicaid funding in the COVID relief bill Biden signed in March, much of that new money will stop in a few years unless Congress appropriates additional money.

The White House strategy has risks. Medicaid, which swelled after enactment of the 2010 health law, has expanded further during the economic downturn caused by the pandemic, pushing enrollment to a record 80.5 million, including those served by the related Children's Health Insurance Program. That's up from 70 million before the COVID crisis began.

The programs now cost taxpayers more than $600 billion a year. And although the federal government will cover most of the cost of the Biden-backed expansions, surging Medicaid spending is a growing burden on state budgets.

The costs of expansion are a frequent target of conservative critics, including Trump officials like Seema Verma, the former administrator of the Centers for Medicare & Medicaid Services, who frequently argued for enrollment restrictions and derided Medicaid as low-quality coverage.

But even less partisan experts warn that Medicaid, which was created to provide medical care to low-income Americans, can't make up for all the inadequacies in government housing, food and education programs.

"Focusing on the social drivers of health ... is critically important in improving the health and well-being of Medicaid beneficiaries. But that doesn't mean that Medicaid can or should be responsible for paying for all of those services," said Matt Salo, head of the National Association of Medicaid Directors, noting that the program's financing "is simply not capable of sustaining those investments."

Restoring federal support

However, after four years of Trump administration efforts to scale back coverage, Biden and his appointees appear intent on not only restoring federal support for Medicaid, but also boosting the program's reach.

"I think what we learned during the repeal-and-replace debate is just how much people in this country care about the Medicaid program and how it's a lifeline to millions," Biden's new Medicare and Medicaid administrator, Chiquita Brooks-LaSure, told KHN, calling the program a "backbone to our country."

The Biden administration has already withdrawn permission the Trump administration had granted Arkansas and New Hampshire to place work requirements on some Medicaid enrollees.

In April, Biden blocked a multibillion-dollar Trump administration initiative to prop up Texas hospitals that care for uninsured patients, a policy that many critics said effectively discouraged Texas from expanding Medicaid coverage through the Affordable Care Act, often called Obamacare. Texas has the highest uninsured rate in the nation.

The moves have drawn criticism from Republicans, some of whom accuse the new administration of trampling states' rights to run their Medicaid programs as they choose.

"Biden is reasserting a larger federal role and not deferring to states," said Josh Archambault, a senior fellow at the conservative Foundation for Government Accountability.

But Biden's early initiatives have been widely hailed by patient advocates, public health experts and state officials in many blue states.

"It's a breath of fresh air," said Kim Bimestefer, head of Colorado's Department of Health Care Policy and Financing.

Chuck Ingoglia, head of the National Council for Mental Wellbeing, said: "To be in an environment where people are talking about expanding health care access has made an enormous difference."

Mounting evidence shows that expanded Medicaid coverage improves enrollees' health, as surveys and mortality data in recent years have identified greater health improvements in states that expanded Medicaid through the 2010 health law versus states that did not.

Broadening eligibility

In addition to removing Medicaid restrictions imposed by Trump administration officials, the Biden administration has backed a series of expansions to broaden eligibility and add services enrollees can receive.

Biden supported a provision in the COVID relief bill that gives states the option to extend Medicaid to new mothers for up to a year after they give birth. Many experts say such coverage could help reduce the U.S. maternal mortality rate, which is far higher than rates in other wealthy nations.

Several states, including Illinois and New Jersey, had sought permission from the Trump administration for such expanded coverage, but their requests languished.

The COVID relief bill — which passed without Republican support — also provides additional Medicaid money to states to set up mobile crisis services for people facing mental health or substance use emergencies, further broadening Medicaid's reach.

And states will get billions more to expand so-called home and community-based services such as help with cooking, bathing and other basic activities that can prevent Medicaid enrollees from having to be admitted to expensive nursing homes or other institutions.

Perhaps the most far-reaching Medicaid expansions being considered by the Biden administration would push the government health plan into covering services not traditionally considered health care, such as housing.

This reflects an emerging consensus among health policy experts that investments in some non-medical services can ultimately save Medicaid money by keeping patients out of the hospital.

In recent years, Medicaid officials in red and blue states — including Arizona, California, Illinois, Maryland and Washington — have begun exploring ways to provide rental assistance to select Medicaid enrollees to prevent medical complications linked to homelessness.

The Trump administration took steps to support similar efforts, clearing Medicare Advantage health plans to offer some enrollees non-medical benefits such as food, housing aid and assistance with utilities.

But state officials across the country said the new administration has signaled more support for both expanding current home-based services and adding new ones.

That has made a big difference, said Kate McEvoy, who directs Connecticut's Medicaid program. "There was a lot of discussion in the Trump administration," she said, "but not the capital to do it."

Other states are looking to the new administration to back efforts to expand Medicaid to inmates with mental health conditions and drug addiction so they can connect more easily to treatment once released.

Kentucky health secretary Eric Friedlander said he is hopeful federal officials will sign off on his state's initiative.

Still other states, such as California, say they are getting a more receptive audience in Washington for proposals to expand coverage to immigrants who are in the country without authorization, a step public health experts say can help improve community health and slow the spread of communicable diseases.

"Covering all Californians is critical to our mission," said Jacey Cooper, director of California's Medicaid program, known as Medi-Cal. "We really feel like the new administration is helping us ensure that everyone has access."

The Trump administration moved to restrict even authorized immigrants' access to the health care safety net, including the "public charge" rule that allowed immigration authorities to deny green cards to applicants if they used public programs such as Medicaid. In March, Biden abandoned that rule.

KHN correspondent Julie Rovner contributed to this report.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

This content is from Southern California Public Radio. View the original story at SCPR.org.

Location: Government Information - J 1.42/3:SD-J-4

El Litoral prison is notorious for its deadly confrontations between members of rival gangs.

Official figures show for the first time the true scale of offending by criminals who were born male but were allowed to move into female jails after changing gender. Convicted rapist Karen White pictured.

Official figures show for the first time the true scale of offending by criminals who were born male but were allowed to move into female jails after changing gender. Convicted rapist Karen White pictured.

The new start-up SimpliMingle has taken the inmate penpal industry, and made it an over the phone affair instead.

News you don't want to miss for April 14:

1. Six of the 15 confirmed covid-19 cases at Santa Rita Jail have recovered, the East Bay Times reports.…

CoreCivic runs the facility that houses inmates for the U.S. Marshals Service, city of Mesa, U.S. Immigration and Customs Enforcement and the Federal Bureau of Prisons.

Queensland's Corrective Services Investigation Unit is examining the deaths of three prisoners over the past five days — two of which occurred at the same facility in 24 hours.

Rowena has been in and out of jail a handful of times — she says she is doing her best to stay out, but adds "when something bad happens on the outside, you just want to run back to jail and be safe".

DAILY BRIEFING: Inmates involved in an escape from prison allegedly tried to get out earlier the same morning, and the Tasmanian Mayor defends renting a short-stay property to staff.

Police storm Kariong's Frank Baxter Centre, bringing all offenders off the rooftop to end a riot at the facility that lasted for almost 24 hours.

Children as young as 10 years old are being routinely strip searched in juvenile detention in NSW with minimal or no contraband found, according to new data, and former inmates claim the searches trigger mental illness issues.

Five inmates and one correctional officer have died.

Five inmates and one correctional officer have died.

When Deirdre Von Dornum and the others arrived at the Metropolitan Detention Center, a federal Bureau of Prisons staffer wearing no gloves or mask greeted them in the lobby, according to the email.

The fourth-year DA told the Daily News in an interview that his focus has shifted dramatically during the crisis, as trials and grand juries have been put on hold across the state.

These are the first confirmed coronavirus cases at the Johnson County Jail.

Plainfield Correctional Facility inmates grow produce in a garden to give to needy.

Plainfield Correctional Facility inmates donate fruits and vegetables from their garden to community organizations.

Coronavirus infections explode at a Lompoc federal prison with 792 testing positive, making it the largest federal penitentiary outbreak in the nation.

While at least 19 000 inmates inside South Africa's prisons will be eligible for special parole to curb the spread of Covid-19, those sentenced for a range of serious crimes will not make the cut.

Other defendants plea to drug, weapons, and robbery charges A Superior Court judge sentenced three inmates Friday for their roles in the 2017 Vaughn prison riot, which resulted in the murder of correctional officer Lt. Steven Floyd. Dwayne Staats, 37, sentenced to two life sentences in prison plus 153 years for his conviction on 2 […]

SMYRNA, Del. – This week, three dozen inmates who are employed in the James T. Vaughn Correctional Center garment shop began producing cotton face masks for the correctional system and first responders as the Delaware Department of Correction steps up to support the First State’s COVID-19 response. These skilled inmate workers normally cut and sew material from large rolls of red and […]

[News24Wire] While at least 19 000 inmates inside South Africa's prisons will be eligible for special parole to curb the spread of Covid-19, those sentenced for a range of serious crimes will not make the cut.

An Israeli military order forbids banks in the occupied West Bank from processing payments that the Palestinian Authority distributes to the families of Palestinians who have spent time in Israeli jails. ......

Turkish prosecutors on May 8 said that 44 inmates in an Istanbul prison have tested positive for COVID-19.

Title: Thousands of COVID-19 Cases Among Inmates and Staff at U.S. Prisons and Jails: CDC
Category: Health News
Created: 5/7/2020 12:00:00 AM
Last Editorial Review: 5/8/2020 12:00:00 AM

Some 138 prison staff have also contracted the virus in 49 prisons as well as seven prisoner escort and custody services staff.

The United States has entered into a comprehensive, cooperative agreement with Cook County, Ill., and the Cook County Sheriff that resolves previous findings of unconstitutional conditions at the Cook County Jail.

The Department has filed a stipulated settlement agreement resolving a portion of its lawsuit against Erie County, N.Y, regarding the limited issue of suicide prevention and related mental health care.

Vernon Wilson, former Chief Deputy of the Washington County Sheriff’s Department in Potosi, Mo., was sentenced today in U.S. District Court in St. Louis, for violating the civil rights of four former inmates of the Washington County Jail on four separate occasions.

Former Tuscaloosa, Ala., Sheriff’s Sergeant, Althea Mallisham, 52, pleaded guilty today in a federal court in Birmingham, Ala., to three counts of assault with a dangerous weapon while acting under color of law for wrongfully using a Taser during three separate incidents over a four month period in 2008.

Willie Redden, 24, of Albany, Ga., a former member of the Correctional Emergency Response Team (CERT) at Macon State Prison in Oglethorpe, Ga., pleaded guilty today to conspiring with other correctional officers to violate the civil rights of inmates in 2010.

The Justice Department announced today that former Wilcox County, Ga., Jailer Casey Owens pleaded guilty to a misprision of a felony in connection with an incident in which several people, including law enforcement officials, assaulted three inmates inside of the Wilcox County Jail in Abbeville, Ga.

Darren Douglass-Griffin, 35, a former member of the Correctional Emergency Response Team (CERT) at Macon State Prison (MSP) in Oglethorpe, Ga., pleaded guilty to a two-count bill of information charging him with conspiracy to violate the civil rights of inmates and falsification of records in a federal investigation, the Justice Department and the U.S. Attorney for the Middle District of Georgia announced today.

Emmett McKenzie, 31, from Montezuma, Ga., formerly a sergeant at Macon State Prison in Oglethorpe, Ga., pleaded guilty to conspiring with other correctional officers to violate the civil rights of an inmate in 2010, the Justice Department Announced today. McKenzie, who most recently served as a lieutenant at Dooly State Prison in Unadilla, Ga., is the third officer to plead guilty in the course of the ongoing federal investigation.

Deputy Warden James Hinton and seven former members of the Correctional Emergency Response Team at Macon State Prison in Oglethorpe, Ga., were charged with federal civil rights, conspiracy or obstruction offenses arising out of incidents in which inmates were allegedly assaulted by officers in order to punish the inmates for prior misconduct.

The Justice Department announced today that it has reached a settlement with the South Carolina Department of Corrections (SCDC) and its director, to resolve alleged violations of Title II of the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act of 1973 (Section 504).

Today, a federal jury in the U.S. District Court for the Eastern District of Oklahoma in Muskogee, Okla., convicted Raymond A. Barnes, 43, and Christopher A. Brown, 32, the former jail superintendent and assistant jail superintendent, respectively, of the Muskogee County Jail on multiple counts of civil rights offenses related to allegations of excessive force on inmates at MCJ on or between August 2009 and May 2011.

A former state marshal and a correctional officer in Puerto Rico were sentenced today for attempting to smuggle heroin to inmates in exchange for payment.

In a new step to further the Justice Department’s efforts towards enhancing reentry among formerly incarcerated individuals, Attorney General Eric Holder announced Monday that the Bureau of Prisons (BOP) will impose new requirements on federal halfway houses that help inmates transition back into society.

A federal grand jury in Albuquerque, N.M., indicted John Greene, 70, a former captain at the Gallup-McKinley Adult Detention Center, on charges related to the sexual assaults of women inmates in his custody.

Two inmates of the U.S. Medical Center for Federal Prisoners in Springfield, Missouri, who were convicted by a federal jury for murdering another inmate at the facility were sentenced to death late yesterday.

Attorney General Eric Holder and United States Attorney for the Southern District of New York Preet Bharara announced today the completion of the Justice Department’s multi-year civil investigation pursuant to the Civil Rights of Institutionalized Persons Act (“CRIPA”) into the conditions of confinement of adolescent male inmates on Rikers Island. The investigation, which focused on use of force by staff, inmate-on-inmate violence, and use of punitive segregation during the period 2011-2013, concluded that there is a pattern and practice of conduct at Rikers Island that violates the rights of adolescents protected by the Eighth Amendment and the Due Process Clause of the Fourteenth Amendment of the United States Constitution. The investigation found that adolescent inmates are not adequately protected from physical harm due to the rampant use of unnecessary and excessive force by New York City Department of Correction (“DOC”) staff and violence inflicted by other inmates

Three more inmates died of coronavirus and the number who are infected has more than doubled at the California state prison in Chino, officials said.