Trump readies new round of controversial Medicaid changes

The Trump administration is preparing to let conservative-led states impose additional restrictions on the nation’s health program for the poor that could push tens of thousands of people off coverage, POLITICO has learned.

The high-stakes changes, involving work requirements and questions about illegal drug use, have been the subject of intense behind-the-scenes lobbying in recent months by federal and state lawmakers in the latest chapter of the GOP’s long-running efforts to reshape Medicaid — a policy priority extending back to the Reagan era.

And they are moving forward even after a federal judge blocked Kentucky’s work requirement in June, saying the Trump administration failed to consider how the plan would affect coverage, and new evidence that thousands of Arkansans will lose benefits because of the state’s work requirement. Advocacy groups have sued to stop Medicaid work requirements in both states and threaten further litigation if more changes are OK’d.

Nonetheless, Continue reading “Trump readies new round of controversial Medicaid changes”

Trump policy shop filters facts to fit his message

President Donald Trump’s appointees in the health department have deleted positive references to Obamacare, altered a report that undermined the administration’s positions on refugees and added anti-abortion language to the strategic plan — part of an ideological overhaul of the agency’s research office.

While every administration puts its imprint on the executive branch and promotes ideas that advance its own agenda, this one has ventured several steps further — from scrubbing links to climate change studies from an Environmental Protection Agency website to canceling an Interior Department study on coal mining risks and suppressing reports on water contamination and the dangers of formaldehyde.

Inside the Health and Human Services policy research shop, staffers say the political pressures to tailor facts to fit Trump’s message have been unprecedented.

Several pointed to embarrassments such as PolitiFact grading a lawmaker’s statement, based on the agency’s May 2017 report on Obamacare premium hikes, as Continue reading “Trump policy shop filters facts to fit his message”

HHS official who spread conspiracy theories forced out

Ximena Barreto — a Trump political appointee who used social media to spread conspiracy theories about a supposed pizza shop sex ring and made other inflammatory remarks — was escorted from HHS headquarters Friday, according to an individual with knowledge of the situation.

Barreto resigned, the individual said. HHS did not immediately respond to request for comment. An email sent to Barreto’s HHS account Friday night produced a bounce-back message that the message was “undeliverable.”

Before joining HHS as a deputy communications director in December 2017, Barreto spread conspiracy theories on social media and online videos — among them that Hillary Clinton was engaged in a child-sex ring at a Washington pizza shop, was involved in the murder of aide Seth Rich and employed pedophiles in her campaign. Barreto also repeatedly insulted Islam as a “cult” and shared a post suggesting that “our forefathers would have hung” Barack Obama Continue reading “HHS official who spread conspiracy theories forced out”

Most deported migrants were not asked about leaving children behind, Trump official says

Homeland Security officials may have neglected to give a choice to as many as three-quarters of all migrant parents removed from the United States about leaving their children behind, contradicting repeated public assurances from Homeland Security Secretary Kirstjen Nielsen.

The Trump administration failed to document consent in most such cases, an administration official told POLITICO. That lapse increased the number of departed parents whom officials must now find and contact about whether they wish to be reunited with their children, and, if so, figure out the logistics of how to bring them together. The revelation threatens to delay reunifications one day ahead of a court-ordered deadline to return most migrant children to their parents.

That migrant parents gave consent to leave their children behind has been a key talking point for Trump administration officials defending the deportations. Over the course of several months, thousands of migrant parents and children were Continue reading “Most deported migrants were not asked about leaving children behind, Trump official says”

Trump’s migrant fiasco diverts millions from health programs

The health department has quietly dipped into tens of millions of dollars to pay for the consequences of President Donald Trump’s border policy, angering advocates who want the money spent on medical research, rural health programs and other priorities.

The Department of Health and Human Services has burned through at least $40 million in the past two months for the care and reunification of migrant children separated from their families at the border — with housing costs recently estimated at about $1.5 million per day.

The ballooning costs have also prompted officials to prepare to shift more than $200 million from other HHS accounts, even as the White House weighs a request for additional funding for the Department of Homeland Security — a politically explosive move almost certain to antagonize fiscal hawks in the run-up to the midterm elections.

"We have a public health emergency like Ebola, Zika, hurricanes Continue reading “Trump’s migrant fiasco diverts millions from health programs”

Trump administration expedites reunifications for 2551 migrant children

The Trump administration said Friday night it would speed up the process to reunify thousands of migrant children that were separated from their parents at the border — nearly three weeks after a federal judge ordered officials to put families back together as soon as possible.

In a court filing, the administration for the first time specified that HHS has custody of 2,551 migrant children age 5 to 17 who were separated from their parents. The health department earlier had estimated only that "under 3,000 children" were separated from their parents as they reviewed the records of thousands of children in custody.

In a concession to the court, the administration said it would truncate the process it used to reunify younger migrant children, which involved fingerprinting and DNA testing to confirm parentage and check for criminal history.

HHS is facing a July 26 court-ordered deadline to reunite all of Continue reading “Trump administration expedites reunifications for 2551 migrant children”

Officials depart HHS after incendiary social media posts

Two HHS political appointees who worked on President Donald Trump’s campaign were forced out this week in response to a series of inflammatory tweets and other behavior detailed in a recent POLITICO report.

Tim Clark, the agency’s White House liaison, is resigning and will depart the agency in the coming weeks, according to an internal email sent to staff and shared with POLITICO. He has been replaced by Trent Morse, who joined HHS from the Department of Housing and Urban Development.

Gavin Smith, a policy adviser who used his Twitter account to publicly mock elected officials and reporters, also departed HHS this week. Three individuals with knowledge of the situation said he was escorted from the building, but an HHS official said on Friday that Smith resigned.

Clark and Smith’s departures come after HHS leadership spent months embarrassed by stories about political appointees’ controversial behavior on social media. The moves Continue reading “Officials depart HHS after incendiary social media posts”

Federal auditor calls for recouping $341K Tom Price spent on flights

Former HHS Secretary Tom Price took 20 trips that violated federal requirements, according to a federal auditor that urged the department in a Friday report to recover at least $341,000 in wasted spending.

Price, who was forced out last year following a POLITICO investigation into his extravagant use of private and military aircraft, has already voluntarily repaid the government around $60,000. It was not immediately clear how or if he might be forced to repay the rest. A department spokesman said HHS will seek guidance from the Justice Department “whether there is legal basis for recoupment.”

A spokesman for Price declined to say if he would pay back the government.

The audit from the HHS inspector general, which came about 10 months after Price’s resignation, found he and his staff spent more than $1.2 million on travel during his tenure at HHS. The report identified roughly $480,000 in Continue reading “Federal auditor calls for recouping $341K Tom Price spent on flights”

Federal officials launch two reviews into Trump’s handling of migrant children

The GAO and the Health and Human Services inspector general both launched reviews Wednesday into the Trump administration’s handling of thousands of migrant children separated from their families at the border.

The GAO told Rep. Frank Pallone (N.J.) that it will audit the systems and processes used to track families as they were separated, including how the HHS Office of Refugee Resettlement monitored each minor in its care, according to a letter obtained by POLITICO.

Pallone, the top Democrat on the House Energy and Commerce Committee, last week urged GAO to audit HHS and the Department of Homeland Security as the agencies work to reunite children in their custody with their parents. President Donald Trump issued an executive order last week purporting to rescind the separation policy, but agencies said they lacked the authority to put families back together.

Meanwhile, the HHS inspector general announced that it will Continue reading “Federal officials launch two reviews into Trump’s handling of migrant children”

HHS creates task force to reunify migrant families

HHS on Friday created an "unaccompanied children reunification task force," a first step toward reunifying thousands of migrant children in the agency’s custody with their families, according to an internal document obtained by POLITICO.

The task force was established by the assistant secretary for preparedness and response — the arm of the agency that responds to public health disasters, and an indication that the challenge of reunifying thousands of families is likely beyond the capabilities of the refugee office.

"The Secretary of Health and Human Services has directed the Assistant Secretary of Preparedness and Response assist the ACF Office of Refugee Resettlement with Unaccompanied Children Reunification," the order reads. The agency’s Emergency Management Group, which operates out of the HHS secretary’s operations center, also was activated.

HHS did not immediately respond to request for comment.

President Donald Trump on Wednesday signed an executive order halting family separations, telling reporters that Continue reading “HHS creates task force to reunify migrant families”

Health and Human Services secretary hospitalized

HHS Secretary Alex Azar was admitted to a hospital after suffering "a minor infection" and treated with intravenous antibiotics, the agency told reporters Sunday night

HHS said Azar was admitted "out of an abundance of caution" to undergo observation.

"The Secretary is being treated for a minor infection," HHS spokesperson Caitlin Oakley said in response to questions from POLITICO about the nature of Azar’s condition and where he was hospitalized. "We cannot disclose the hospital location due to privacy and security concerns."

White House tweaks plan to seek death penalty as part of opioid response

President Donald Trump’s plan to fight the opioid epidemic will call for the death penalty in some cases, White House officials said Sunday, scaling back the administration’s plan to punish drug dealers.

“The Department of Justice will seek the death penalty against drug traffickers when appropriate under current law,” said Andrew Bremberg, the White House’s director of the Domestic Policy Council. White House officials referred follow-up questions to DOJ.

An earlier version of the plan, obtained by POLITICO last week, would have called for the death penalty in some cases involving drug dealers, too.

Trump will announce his opioid plan on his visit to New Hampshire on Monday. POLITICO first reported on Thursday that the White House was finalizing its opioid plan, which includes a mix of administration actions and initiatives that would require new funds or laws from Congress.

There were more than 64,000 drug overdose deaths in 2016, Continue reading “White House tweaks plan to seek death penalty as part of opioid response”

Exclusive: Trump finalizing opioid plan that includes death penalty for dealers

The Trump administration is finalizing a long-awaited plan that it says will solve the opioid crisis, but it also calls for law enforcement measures — like the death penalty for some drug dealers — that public health advocates and congressional Republicans warn will detract from efforts to reverse the epidemic.

The ambitious plan, which the White House has quietly been circulating among political appointees this month, could be announced as soon as Monday when President Donald Trump visits New Hampshire, a state hard hit by the epidemic. It includes a mix of prevention and treatment measures that advocates have long endorsed, as well as beefed-up enforcement in line with the president’s frequent calls for a harsh crackdown on drug traffickers and dealers.

The White House’s most concrete proposal yet to address opioids comes after complaints from state health officials and advocates that Trump has moved too slowly to combat the Continue reading “Exclusive: Trump finalizing opioid plan that includes death penalty for dealers”

HHS official who spread conspiracy theories allowed back on job

Jon Cordova, the HHS principal deputy assistant secretary for administration, will formally resume his duties on Wednesday after being placed on a two-week administrative leave while leaders reviewed his use of social media to promote conspiracy theories.

“Mr. Cordova has expressed sincere and deep apology for those statements and for any harm or injury he may have caused to readers of any of his social media posts,” an HHS spokesperson told POLITICO. “While he continues to work at HHS, Mr. Cordova – along with all department employees – will be expected to demonstrate a full commitment to inclusiveness and respect for all Americans that we serve.”

Cordova, a former Trump campaign staffer, shared false stories about former President Barack Obama, Hillary Clinton, Sen. Ted Cruz (R-Texas) and others, CNN reported last month. For instance, he suggested that Cruz frequented prostitutes, and he called for a boycott on Budweiser because Continue reading “HHS official who spread conspiracy theories allowed back on job”

Trump administration dismantles LGBT-friendly policies

The nation’s health department is taking steps to dismantle LGBT health initiatives, as political appointees have halted or rolled back regulations intended to protect LGBT workers and patients, removed LGBT-friendly language from documents and reassigned the senior adviser dedicated to LGBT health.

The sharp reversal from Obama-era policies carries implications for a population that’s been historically vulnerable to discrimination in health care settings, say LGBT health advocates. A Health Affairs study last year found that many LGBT individuals have less access to care than heterosexuals; in a Harvard-Robert Wood Johnson-NPR survey one in six LGBT individuals reported experiencing discrimination from doctors or at a clinic.

The Trump administration soon after taking office also moved to change the agency’s LGBT-related health data collection, a window into health status and discrimination. Last month it established a new religious liberty division to defend health workers who have religious objections to treating LGBT patients.

Continue reading “Trump administration dismantles LGBT-friendly policies”

The religious activists on the rise inside Trump’s health department

A small cadre of politically prominent evangelicals inside the Department of Health and Human Services have spent months quietly planning how to weaken federal protections for abortion and transgender care — a strategy that’s taking shape in a series of policy moves that took even their own staff by surprise.

Those officials include Roger Severino, an anti-abortion lawyer who now runs the Office of Civil Rights and last week laid out new protections allowing health care workers with religious or moral objections to abortion and other procedures to opt out. Shannon Royce, the agency’s key liaison with religious and grass-roots organizations, has also emerged as a pivotal player.

"To have leaders like Roger, like Shannon, it’s so important," said Deanna Wallace of Americans United for Life, an anti-abortion group that was frequently at odds with the Obama administration. "It’s extremely encouraging to have HHS on our side this time."

Continue reading “The religious activists on the rise inside Trump’s health department”

First There Was Prince. Now Tom Petty. When Will America Finally Wake Up to the Opioid Crisis?

When pop star Prince died in April 2016, a gaggle of health care researchers and reporters—including me—tried to see the silver lining in his surprising, opioid-linked death. If even Prince, a famous teetotaler with access to the best medical care, could end up addicted to painkillers, surely that would show that the opioid epidemic was reaching every corner of America. Maybe in death, his celebrity could illuminate the high stakes of the crisis and force a reckoning.

We were very wrong. More than 55,000 Americans—rich, poor, famous and not—have since died from their own opioid overdoses. The latest data from the Centers for Disease Control and Prevention (CDC) suggests that the death rate in 2018 could be even worse. And Friday night’s news that rock star Tom Petty died from his own preventable painkiller overdose, more than a year after Prince, underscores how far there is to go.

In Continue reading “First There Was Prince. Now Tom Petty. When Will America Finally Wake Up to the Opioid Crisis?”

Anti-birth control official who led Title X departs HHS

Teresa Manning, the controversial official in charge of the Title X federal family planning program, was escorted from HHS premises on Friday.

Two sources with knowledge of Manning’s departure tell POLITICO that she was fired by HHS. An HHS spokesperson disputed that account, saying that Manning resigned.

"HHS is very grateful for her service," the spokesperson said. "Her departure after resignation was not unusual in any way."

Manning could not be reached for comment.

Manning, who previously worked for anti-abortion groups including the Family Research Council and National Right to Life, had been serving as deputy assistant secretary for HHS’ Office of Population Affairs. In that role, she was responsible for helping set national policy around family planning, contraception and teen pregnancy — a development that alarmed abortion-rights groups worried about Manning’s history of statements and actions opposing birth control and abortion.

Manning stated in a 2003 public radio Continue reading “Anti-birth control official who led Title X departs HHS”

A tarnished hospital tries to win back trust

NEW HAVEN, Conn.. — Fifteen years ago, this city’s flagship hospital became a national punching bag.

Yale New Haven Hospital — a teaching hospital that got big tax breaks because it was supposed to be serving the community — was found to be hounding low-income patients, suing them for unpaid bills, even putting liens on their houses and hoarding money meant to help them. The hospital’s nearly two-century-old reputation as a charitable organization was ruined overnight. What followed instead: embarrassing billboards, vocal protests and a wave of angry lawmakers, as hospital leaders worked to survive the mushrooming scandal.

"We learned a lot about ourselves," said Marna Borgstrom, who took over as CEO in 2005 and worked to repair the hospital’s broken reputation.

Today, both the hospital and its community partners see a remarkable success story, one that’s helping revitalize New Haven’s dilapidated neighborhoods. The hospital has poured millions of dollars Continue reading “A tarnished hospital tries to win back trust”

GOP fails to pressure hospitals on community benefits

Despite Republicans’ boasts about closing tax loopholes, there’s one sector that the sweeping tax reform bill mostly leaves alone: The tax-exempt hospital sector, which enjoys billions of dollars in tax breaks even as big hospitals raise prices and perform less free care.

Mayo Clinic, a nonprofit health system, cleared more than $1 billion in profit between 2015 and 2016. Cleveland Clinic, another nonprofit hospital, topped more than $715 million in profits in that span.

Congress’ most significant overhaul of the tax code in more than 30 years — finalized on Wednesday — protects those hospitals’ multibillion-dollar tax exemptions, an outcome that frustrates consumer advocates, officials and researchers who say that hospitals are taking advantage of rules that fail to adequately define the benefits they must provide to their communities in order to remain tax-exempt.

“It was, in my view, a missed opportunity,” said Daniel Skinner, an Ohio University political scientist Continue reading “GOP fails to pressure hospitals on community benefits”