Judge allows Alaska governor to move ahead with Medicaid expansion

29 Aug 2015 | Author: | No comments yet »

Alaska Governor Can Expand Medicaid.

Alaska’s governor won a legal victory Friday that, at least for now, will allow the state to begin next week to sign up more low-income residents for Medicaid — despite objections from state lawmakers. Superior Court Judge Frank Pfiffner denied the request by the Alaska Legislative Council to bar Walker from implementing Medicaid expansion until the merits of the council’s case challenging Walker’s authority to expand Medicaid on his own are decided.JUNEAU, Alaska (AP) — A state court judge in Alaska ruled Thursday that a law further defining what constitutes a medically necessary abortion for purposes of Medicaid funding is unconstitutional.The judge found that measures that were supposed to take effect last year violates equal protection rights, according to a copy of the ruling provided by a lawyer for Planned Parenthood of the Great Northwest.

My organization, Americans for Prosperity, recently launched television and digital advertisements thanking state legislators for not expanding the Affordable Care Act. This most recent skirmish involves a decision that every state has faced in the past three years: whether to expand its Medicaid program, as originally intended by the 2010 law that has been reshaping the health care system.

The Alaska Supreme Court has held that the state must pay for medically necessary abortions if it pays for other procedures deemed medically necessary. When Congress adopted the law, it envisioned that opening Medicaid to people with incomes up to 133 percent of the federal poverty level would be a major way to extend health coverage to people who were uninsured. In a statement, House Speaker Mike Chenault, R-Nikiski, said the lawmakers who supported the lawsuit “continue to feel very strongly about our constitutional argument that was presented. To win a restraining order to stop Medicaid expansion, the Legislative Council had to prove the legislature would face “irreparable harm” if the program went ahead on September 1. In his decision, Suddock said an unwanted pregnancy is a crisis for any woman and for an impoverished woman without recourse to an abortion, the crisis “may be extreme,” noting that indigent women often face stressors such as homelessness, addiction or domestic violence.

Illinois ran $800 million over budget in 2014; Ohio ran $1.5 billion over in its first 18 months; Kentucky is projected to run $1.8 billion over in its first two years; Washington state had to increase its budget by $2.3 billion. Bill Walker, an independent, asked the Republican state legislature to approve a plan that he said would enable 41,000 more residents to join the program. Pfiffner’s ruling means an extra 20,000 Alaskans will be eligible for expanded medical coverage under Obamacare, according to the Juneau Empire newspaper estimates. Lawmakers resisted, and a month ago, Walker announced that he would bypass the legislature and accept federal money to expand the program, starting Sept. 1. Walker this month had asked Judge Pfiffner to issue a temporary restraining order so that expansion did not proceed while the courts deal with the case and likely appeals.

That could mean a serious risk of death or “impairment of a major bodily function” caused by one of 21 different conditions, such as coma, seizures and epilepsy. But the Legislative Council’s attorney Erin Murphy, of Washington, D.C.-based Bancroft PLLC, told the judge the case wasn’t an issue of public health, but of separation of powers. On Monday, Alaska’s legislative council sued the governor to try to block the expansion, arguing that only the legislature had the power to decide who was eligible for the program. He said the state’s Legislative Affairs Committee had advised lawmakers they could pass a bill that affirmatively denied coverage to the newly eligible population under Obamacare, but it “didn’t take the bait.” “Instead, what did the [Legislative] Council do in this case?

It also would deny funding in cases involving fetal anomalies, even situations “where a delivered infant will suffer an inevitable and at times painful death,” or women dealing with mental illness or addiction, he wrote. She says many Alaskans have waited a long time for Medicaid expansion and she’s glad they don’t have to wait any longer: “You know it isn’t about us, it’s about Alaska and Alaskans who are going to get what they need. Medicaid will pay $9,000 in routine prenatal care and $12,000 in routine delivery expenses for a pregnancy where a low-income woman decides to carry to term “in the face of significant risks,” he wrote. It ineffectually and unconstitutionally amended the appropriations bill to attempt to prohibit what the governor is doing here, and it filed this lawsuit,” the judge said. But under the law that was challenged in this case, “it cannot pay $650 for the same poor woman who is unwilling to bear those risks and who exercises her constitutional right to terminate her pregnancy.

Judge Pfiffner still must weigh the lawsuit’s merits, and lawmakers have made it clear they intend to fight the case to the highest courts, setting aside up to $400,000 for the Bancroft law firm out of D.C. and $50,000 to the Holmes, Weddle and Barcott law firm in Anchorage to pursue their claims. Supreme Court decision did not strike down the provision expanding eligibility but instead struck down the penalty for states that do not comply with it. For “all residents of the state for whom the Social Security Act requires Medicaid coverage,” Alaska offers mandatory coverage, while for those “groups or persons for whom the state may claim federal financial participation,” coverage is optional. In court papers, the lawmakers argued it would be unfair to insure thousands, only to reel it back in if that coverage is deemed unlawful, and that enrolling thousands more “significantly diminish the quality of care” provided to current enrollees. Sixty-three of our state’s 67 counties already report medical provider shortages, and nearly 40 percent of physicians either do not accept or limit the number of new Medicaid patients they see.

Administration officials have acknowledged the current Medicaid program isn’t sustainable, but they see expansion as a way to get federal dollars to help finance reform efforts. They say every dollar diverted to Medicaid expansion could be spent on a program the legislature “actually has authorized,” and complained the governor planned to divert $1.6 million from the state Mental Health Trust Fund to cover implementation costs.

Walker has said he is “disappointed” with the legislature’s decision to sue, noting the state can withdraw from the expansion if the federal government does not hold up its end of the funding. Walker in July said he planned “to begin enrolling Alaska residents who fall within Medicaid expansion population,” despite the bill’s death in committee, the lawsuit states. Chief among them was to increase low-income Floridians’ access to “Direct Primary Care.” Unlike traditional practices that accept Medicaid or insurance, DPC has flat monthly fees averaging between $50 and $125. If the court later decides that expansion is unlawful, it can halt expansion then and the coverage will stop, they wrote. “The only ‘harm’ that will have occurred in the interim is that some indigent Alaskans will have received federally funded health care that they would not have otherwise received,” they wrote.

Now he’s taken on his former party members, saying, “At a time when the state is facing a $3.5 billion deficit, 10 legislators chose to spend $450,000 to hire an outside law firm to block what more than 60 percent of Alaskans want.” “They chose to sue to prevent $145 million in federal dollars from being injected into our economy to provide lifesaving care for our fellow Alaskans.” In answer to Judge Pfiffner’s question “Why can’t the governor act for at least 2016?” Murphy responded that it’s a question of legislative privilege, that the governor cannot expand Medicaid to “optional” classes of people. This covers all the primary care a patient needs, from preventive services like checkups and vaccinations to casts for broken bones — in other words, the vast majority of medical needs. The savings were especially high for patients with chronic conditions, who had 56 percent fewer non-elective hospital admissions, 49 percent fewer avoidable admissions, and 63 percent fewer admissions for non-avoidable medical issues. This requires health care providers to obtain government permission before opening or expanding facilities, or even adding new equipment like hospital beds. No one is suggesting these individual free market reforms, taken in isolation, are the elixir of life — neither is expanding Medicaid, as the evidence shows.

But they have the potential to provide high quality, affordable health care at far lower costs than today, thus reducing the burden on our social safety net. No matter how nasty the debate over Medicaid expansion gets, we will continue encouraging lawmakers to support free market policies that strengthen health care for all Floridians.

Police: Student stabbed at Baltimore high school dies

20 Jan 2016 | Author: | No comments yet »

Police Identify Student Killed In City School Stabbing.

Baltimore police spokesman T.J. The teen had been in class on the third floor of the school building in the 1300 block of McCulloh Street when a sophomore went into the classroom and stabbed him at approximately noon on Tuesday, Nov. 24, police reported. Police said Sunday that investigators are collaborating with the state’s attorney’s office to file additional charges now that the victim has died. Crawford remains in police custody, officials reported. “It’s a tragedy anytime we have someone killed in an act of violence, even moreso when it’s a child.

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