California governor’s ‘homelessness tour’ seeks money, solutions to crisis on streets

By Dan Whitcomb

(Reuters) – California’s governor began a week-long “homelessness tour” on Monday seeking $750 million to address growing numbers of people living on the streets, stopping first in a rural community to show his state’s problems extend beyond the big cities of San Francisco and Los Angeles.

Democratic Governor Gavin Newsom last week asked state lawmakers to create the $750 million fund as part of his 2020-21 budget and plans to petition the federal government for additional money to help California’s Medicaid program improve services for the homeless.

“Homelessness isn’t just a concern in our cities, it’s a suburban issue and a rural issue, too. No Californian can say that homelessness is someone else’s problem,” Newsom, 52, said in kicking off his tour in Grass Valley, a town of about 12,000 in the Sierra Nevada mountains northeast of Sacramento.

“Every corner of our state has too many people living on the streets. And the crisis puts stress on public resources, from emergency rooms to jails to public works departments. It takes an unprecedented level of partnership between local, state, and federal government,” Newsom said in a prepared statement.

An estimated 130,000 people are homeless somewhere in California on any given day, more than any other state, according to the U.S. Department of Housing and Urban Development (HUD). California, home to about 39.6 million people, is the most populous state in the United States. Newsom and other California officials have traded barbs with U.S. President Donald Trump over the issue, with Trump blaming state and local leaders for failing to solve the problem.

On a visit to San Francisco and Los Angeles in September, Trump said conditions on their streets including trash, feces, and hypodermic needles left by homeless people were hurting their prestige.

That same month HUD Secretary Ben Carson rejected requests for more federal money.

Los Angeles Mayor Eric Garcetti formally asked the Trump administration for federal assistance on Monday in a letter that indicated the two sides had productive negotiations on the matter.

Newsom, who last week called for the emergency deployment of state-owned travel trailers and tents, was joined by state and local lawmakers on a visit to two homeless shelters in Grass Valley on Monday.

The first-term governor’s tour will also take him to Los Angeles County, the San Francisco Bay area and the Central Valley.

(Reporting by Dan Whitcomb in Culver City, California; Editing by Sonya Hepinstall

Trump enacts anti-opioid abuse package in rare bipartisan step

FILE PHOTO: A syringe filled a narcotic, an empty syringe and a spoon sit on the roof of a car, where a man in his 20's overdosed on opioids in Lynn, Massachusetts, U.S., August 14, 2017. REUTERS/Brian Snyde

By Yasmeen Abutaleb

WASHINGTON (Reuters) – Medical treatment will be more widely available to opioid abusers while mailing illicit drugs will be more difficult under a measure to fight drug addiction that was signed into law on Wednesday by U.S. President Donald Trump.

In a year more typically marked by partisan gridlock, Trump signed the rare bipartisan package passed by Congress earlier this month to tackle a problem that led to a record 72,000 drug overdose deaths in 2017.

The legislation expands access to substance abuse treatment in Medicaid, the government health insurance program for the poor and disabled; cracks down on mailed shipments of illicit drugs such as fentanyl, a synthetic opioid far more powerful than heroin; and provides a host of new federal grants to address the crisis.

The Senate passed the measure by a vote of 98-1 in September after a 353-52 vote in favor in the House. The bill had 252 bipartisan cosponsors in the House, more than almost any other bill in recent years, according to website GovTrack Insider.

Trump declared the opioid epidemic a public health emergency last year, which enabled the government to respond more quickly to crises. But addiction experts, advocacy groups and Democrats said the administration was not doing enough.

On Tuesday, Democratic Senators Elizabeth Warren and Patty Murray released a U.S. Government Accountability Office report that they said showed Trump’s emergency declaration fell short of his promises. The report said the government has used few of the powers it could use, under the declaration.

“Hand waving about faster paperwork and speeding up a few grants is not enough. The Trump administration needs to do far more to stop the opioid epidemic,” Warren said in a statement.

Trump adviser Kellyanne Conway said the criticism from the senators was “predictable and unfortunately very partisan,” noting that both voted for the opioids legislation.

In addition to educating the public and expanding access to treatment, Conway said the administration was also focused on securing the border with Mexico to stop drugs from coming into the United States.

(Reporting by Yasmeen Abutaleb; Editing by Kevin Drawbaugh and Cynthia Osterman)

Soaring costs, loss of benefits top Americans’ healthcare worries: Reuters/Ipsos poll

An examination room is seen at an onsite health clinic at the Intel corporate campus in Hillsboro, Oregon, U.S., April 25, 2018. REUTERS/Caroline Humer

By Maria Caspani

(Reuters) – For over a year now, Americans have listed healthcare as the most important problem facing the country, according to Reuters/Ipsos polling.

When asked what concerns them about U.S. healthcare, this is what they had to say:

TOTAL COST OF HEALTH INSURANCE

Sixty-five percent of Americans said in the poll that they are “very concerned” about the overall cost of health insurance, including premiums, deductibles and copays.

This concern is consistent throughout the country: A majority of both millennials and baby boomers, whites and minorities, Democrats and Republicans were worried about healthcare costs.

PRESCRIPTION DRUGS

Nearly three in four Americans use prescription drugs, and 58 percent said they are “very concerned” about the cost of paying for them, according to the Reuters/Ipsos poll. These drugs are expected to see the fastest annual growth over the next decade, rising an average of 6.3 percent per year, according to the U.S. Centers for Medicare and Medicaid Services (CMS).

CHOOSING CARE

Sixty-six percent of U.S. adults who took part in the survey said they were concerned about their ability to see a doctor of their choice going forward.

MEDICARE AND MEDICAID

About one in three U.S. adults said they were “very concerned” about losing benefits from government-run programs Medicare and Medicaid.

Enrollment in Medicare is expected to increase as baby-boomers reach retirement age, according to CMS projections, which will contribute to growing healthcare spending.

The poll also showed that 58 percent of Americans think Congress should keep the Affordable Care Act either entirely as it is, or with some fixes, while 24 percent think lawmakers should repeal it once an alternative law is passed and 18 percent want the ACA to be repealed immediately.

The Reuters/Ipsos poll surveyed 3,982 people in English in the United States from May 22 to June 3 and it has a credibility interval of about 2 percentage points.

For more Reuters polling, visit http://polling.reuters.com/

(Reporting by Maria Caspani, Editing by Chris Kahn and Chizu Nomiyama)

Voters in Maine approve expansion of Medicaid under Obamacare

Voters in Maine approve expansion of Medicaid under Obamacare

By Brendan O’Brien

(Reuters) – Voters in Maine on Tuesday approved a ballot initiative to expand the state’s Medicaid program under Obamacare, sending a clear signal of support for the federal healthcare law to lawmakers in the state and Washington D.C.

The approval of the ballot question in Maine comes after Republicans in Washington failed several times over the last few months to pass legislation that would dismantle the Affordable Care Act, former President Barack Obama’s signature healthcare law.

Maine has recently figured prominently in the nation’s debate on how to reform healthcare. U.S. Senator Susan Collins, a moderate Republican from Maine, helped block her party’s efforts to repeal Obamacare this year, which angered President Donald Trump.

Maine, which becomes the first U.S. state to approve Medicaid expansion by ballot initiative, is one of 19 states that has not expanded Medicaid under the Affordable Care Act.

About 60 percent of voters in Maine approved the ballot initiative, according to the Bangor Daily News newspaper.

Tuesday’s ballot asked Maine voters to approve or reject a plan to provide healthcare coverage under Medicaid for adults under the age of 65 with incomes at or below 138 percent of the federal poverty level, which in 2017 is about $16,000 for a single person and about $22,000 for a family of two.

The state’s Republican governor, Paul LePage, staunchly opposes expansion of federal health care insurance, vetoing legislation to do so on several occasions.

“I’ve said it before, “free” is very expensive to somebody,” LePage said in a radio address last week.

About 70,000 residents in Maine would be eligible for the state’s Medicaid program when and if state officials certify the results of the election. Lawmakers could vote to repeal or alter the referendum, much like they have recently for several citizen-initiated referendums, the Bangor Daily News reported.

“It is now the responsibility and the duty of the governor and the legislature to fully and faithfully implement this law,” the state’s Speaker of the House, Sara Gideon, said in a statement.

The Legislature’s Office of Fiscal and Program Review in Maine estimated that expansion of Medicaid would cost the state about $55 million and bring in about $525 million of federal money to the state each year, according to the Bangor Daily News.

(Reporting by Brendan O’Brien in Milwaukee; Editing by Nick Macfie)

House Republicans seek $1 billion in Medicaid funds for Puerto Rico

A local resident sits on the roof of his home that was damaged by Hurricane Maria in Guaynabo, Puerto Rico, October 2, 2017. REUTERS/Alvin Baez

WASHINGTON (Reuters) – Puerto Rico, struggling to recover from hurricane damage, could receive $1 billion in additional funding for the Medicaid health insurance program for the poor under a proposal from a U.S. House of Representatives panel, a congressional aide said on Tuesday.

Republicans who lead the House Energy and Commerce Committee included the request for more Medicaid funding for Puerto Rico as part of a separate bill to reauthorize the Children’s Health Insurance Program. It is scheduled to be considered and voted on in committee on Wednesday.

The U.S. territorial island, hard-hit by Hurricane Maria, already had faced a drop-off of Medicaid funding at the end of the year, according to the Washington Post, which first reported Republicans’ plan.

Now Puerto Rico also faces massive damage from Maria that wiped out much of its infrastructure, left hospitals struggling and residents without clean water, electricity and cellphone service.

Committee spokeswoman Jennifer Sherman said the panel would take up the bill on Wednesday as part of its effort to renew funding for the larger U.S. children’s insurance program, which saw its funding expire during the weekend.

Under the proposal, Puerto Rico would receive $880 million through 2019. It also would get another $120 million if its financial oversight board certified that the joint federal-state program there had taken steps to prevent fraud and abuse and improve efficiency, among other oversight steps.

Lawmakers sought to pay for the additional Medicaid funding by charging higher premiums on wealthier people in the Medicare health insurance program for seniors, and redirecting some prevention health funding from community-based health centers, among other changes, according to a copy of the plan.

Republican U.S. President Donald Trump visits the island on Tuesday amid criticism over his administration’s response to the storm. [nL2N1ME09T]

About 3.4 million people live in Puerto Rico, which in recent years had faced recession and, in May, bankruptcy.

(Reporting by Susan Cornwell; Writing Susan Heavey; Editing by Bill Trott)

Illinois Republican governor signs controversial abortion bill

FILE PHOTO - Bruce Rauner talks to the media at the White House in Washington December 5, 2014. REUTERS/Larry Downing/File Photo

By Chris Kenning

CHICAGO (Reuters) – Illinois Republican Governor Bruce Rauner signed a controversial bill into law on Thursday to expand state-funded coverage of abortions for low-income residents on Medicaid and state employees.

The bill, approved by the state legislature in May, would also keep abortions legal in Illinois if the U.S. Supreme Court follows President Donald Trump’s call to overturn its landmark Roe v. Wade ruling that made abortions legal 44 years ago.

Illinois’ Medicaid program has previously covered abortions in cases of rape, incest and when a mother’s life or health is threatened.

The expansion would enable poor women to obtain elective abortions. The bill would allow state employees to have the procedures covered under state health insurance.

Rauner, who had earlier suggested he would veto the measure, said in a statement that he had talked to woman around the state before making his decision.

“I understand abortion is a very emotional issue with passionate opinions on both sides. I sincerely respect those who believe abortion is morally wrong,” he said.

“But, as I have always said, I believe a woman should have the right to make that choice herself and I do not believe that choice should be determined by income,” Rauner added. “I do not think it’s fair to deny poor women the choice that wealthy women have.”

The decision comes as conservative legislatures and other Republican governors have sought in recent years to tighten regulations on abortion clinics and forced closures in states such as Texas and Kentucky.

The move by Rauner upset conservatives.

“Taxpayers should not be forced to fund something as controversial and culturally divisive as abortions,” Republican state Senator Dan McConchie told the Chicago Tribune.

Currently, 15 other states allow Medicaid to pay for abortion, including some required by courts, according to the Kaiser Family Foundation.

But Illinois is the first state in decades to voluntarily lift its restriction on Medicaid coverage of abortion, according to National Asian Pacific American Women’s Forum.

“Under the Trump administration, we are potentially facing the greatest threat to reproductive rights in more than a generation. HB 40 ensures that abortion will remain legal in Illinois, regardless of what happens at the federal level,” the forum’s executive director, Sung Yeon Choimorrow, said in a statement.

(Reporting by Chris Kenning; Editing by Diane Craft)

U.S. Senate Republicans to issue revised health bill to win support

Speaker of the House Paul Ryan (R-WI) speaks after Senate Republicans unveiled their version of legislation that would replace Obamacare on Capitol Hill in Washington, U.S.

By Yasmeen Abutaleb and Richard Cowan

WASHINGTON (Reuters) – U.S. Senate Republicans plan to issue a revised version of their healthcare bill on Monday, according to a Republican Senate aide, as the chamber’s leaders scrambled to get legislation passed ahead of a July 4 holiday recess starting on Friday.

The aide, who is familiar with the plan, did not provide details of changes in the works. Politico reported that a likely change to the bill would be to add a provision to encourage people, mainly those who are young and healthy, to enroll in insurance plans.

President Donald Trump and his fellow Republicans in Congress have been pushing to repeal and replace Obamacare, Democratic former President Barack Obama’s signature domestic legislation. The House of Representatives passed its version of a healthcare bill last month.

The Senate bill unveiled last week was immediately criticized by both conservatives and moderates in the party. With Republicans holding only a 52-seat majority in the 100-seat Senate, the bill was unlikely to win passage in its initial form.

At least four conservative Republicans have expressed opposition to the draft legislation, saying it does not go far enough in repealing Obamacare.

A spokesman for Senate Majority Leader Mitch McConnell would not comment on whether a vote on a bill would be held in the full Senate on Thursday, as originally anticipated.

The nonpartisan Congressional Budget Office later Monday might release its assessment of the bill’s cost and impact on future budget deficits. It was not clear whether the report will also estimate how many people might lose healthcare coverage under the legislation or whether that estimate would come later.

Meanwhile, some moderate Republicans have either withheld judgment or expressed doubts about replacing Obamacare with legislation that is similar to the House version.

They are concerned that the party’s approach to healthcare would cause too many people, and especially those with low incomes, to lose insurance. Trump touted passage of the House bill as a victory but later called it “mean.”

Republicans have targeted Obamacare since it was passed in 2010, viewing it as costly government intrusion and saying individual insurance markets are collapsing. The legislation expanded health coverage to some 20 million Americans, through provisions such as mandating that individuals obtain health insurance and expanding Medicaid, the government program for the poor.

TRUMP’S INVOLVEMENT

As he did during the House negotiations, Trump has personally pushed for a Senate bill, calling fellow Republicans to mobilize support.

In the efforts by Senate Republicans to push through a bill, the party has split over a provision in the draft bill ending federal funding of Planned Parenthood, the women’s healthcare provider, for one year.

Moderates are wary of this, while conservatives have called for an end to federal funding of Planned Parenthood because it provides abortions, even though they are not performed with taxpayer dollars.

Health insurance companies are concerned about the bill’s plan to cut Medicaid and any impact on state governments as well as the prospect of losing Obamacare’s mandate on individuals to buy insurance without creating alternative incentives for people to stay in their plans.

If the Senate passes a bill, it will either have to be approved by the House, the two chambers would have to reconcile their differences in a conference committee, or the House could pass a new version and bounce it back to the Senate.

The House is also controlled by Republicans but faced a similar balancing act between moderates and conservatives to pass its version.

A Republican leadership aide in the House said if the Senate manages to pass a healthcare bill this week, no decision has been made on when the House might schedule a vote on it or whether House Republicans might seek any changes to the Senate measure.

(Writing by Richard Cowan and Frances Kerry; Editing by Jeffrey Benkoe)

After weeks of secrecy, U.S. Senate to unveil healthcare bill

FILE PHOTO - U.S. President Donald Trump (C) acknowledges House Speaker Paul Ryan (3rdL) as he gathers with Congressional Republicans in the Rose Garden of the White House after the House of Representatives approved the American Healthcare Act, to repeal major parts of Obamacare and replace it with the Republican healthcare plan, in Washington, U.S., May 4, 2017. REUTERS/Carlos Barria

By Susan Cornwell and Richard Cowan

WASHINGTON (Reuters) – U.S. Senate Republicans plan to unveil the text of their draft healthcare bill on Thursday as senators struggle over issues such as the future of the Medicaid program for the poor and bringing down insurance costs.

Republicans in the chamber have been working for weeks behind closed doors on legislation aimed at repealing and replacing major portions of the Affordable Care Act, former Democratic President Barack Obama’s signature healthcare law, popularly known as Obamacare.

The effort has been plagued from the start by tensions between moderates and conservatives, which surfaced again on Tuesday. Democrats have also criticized the behind-the-scenes meetings, staging a protest on the Senate floor on Monday.

“Republicans are writing their healthcare bill under the cover of darkness because they are ashamed of it,” Senate Democratic leader Chuck Schumer charged.

President Donald Trump campaigned on a promise to repeal Obamacare. The 2010 law extended insurance coverage to millions of Americans through both subsidized private insurance and an expansion of Medicaid.

The Republican-controlled House of Representatives narrowly approved its version of repeal last month.

Trump has urged the Republican-led Senate to pass a more “generous” bill than that approved by the House, whose version he privately called “mean,” according to congressional sources.

An estimated 23 million people could lose their healthcare under the House plan, according to the non-partisan Congressional Budget Office. Senate Majority Leader Mitch McConnell said on Tuesday the Senate healthcare bill would be different from the House version, but he did not elaborate.

In the Senate, moderates including Senator Shelley Moore Capito have argued for a long, seven-year phase-out to the Medicaid expansion that happened under Obamacare. But Senator John Thune, a member of the Republican leadership, said on Tuesday the phase-out in the bill might just be three years.

Capito said on Tuesday she was also concerned the Senate healthcare plan might cap Medicaid spending and shift it to a lower growth rate in 2025. “That’s an issue,” she said.

CONSERVATIVES WARY

Senate conservatives also seemed wary of the emerging bill. Ted Cruz, a member of a core group of 13 Republicans who have been working on the legislation, told reporters the bill did not yet do enough to lower health insurance premiums. “If it is going to pass, the bill is going to have to make meaningful steps to reduce premiums,” he said.

Given the opposition of all Senate Democrats to repealing Obamacare, Republican leaders will need the support of at least 50 of the chamber’s 52 Republicans to ensure passage.

McConnell announced a discussion draft would be laid out on Thursday. The bill will be brought to the Senate floor once the CBO has assessed its cost and impact, “likely next week,” McConnell said.

Thune said the bill was not yet finalized, saying: “We’re trying to get definitive determinations” on a range of issues.

Vice President Mike Pence predicted that new healthcare legislation would be enacted this summer.

“I want to assure you, before this summer is over … President Donald Trump and this Congress will keep their promise to the American people, and we will repeal and replace Obamacare,” Pence told a meeting of the National Association of Manufacturers.

(Editing by Caren Bohan and Peter Cooney)

U.S. hepatitis C cases soar on spike in heroin use

FILE PHOTO - A man injects himself with heroin using a needle obtained from the People's Harm Reduction Alliance, the nation's largest needle-exchange program, in Seattle, Washington April 30, 2015. REUTERS/David Ryder/File Photo

(Reuters) – U.S. health officials said new cases of hepatitis C rose nearly 300 percent from 2010 to 2015, despite the availability of cures for the liver disease, fueled by a spike in the use of heroin and other injection drugs, according to a report released on Thursday.

In 2015, the national reported rate of hepatitis C was 0.8 per 100,000 persons with nearly 34,000 new infections, according to the report by the Centers for Disease Control and Prevention.

Access to clean syringes and a limit on Medicaid barriers to curative treatments for hepatitis C can reduce rates of death from the disease and transmission of the virus to others, the CDC said.

New treatments for hepatitis C with a cure rate of over 95 percent from Gilead Sciences <GILD.O>, AbbVie <ABBV.N> and other drugmakers have the ability to virtually wipe out the disease, which can lead to cirrhosis, cancer, the need for a liver transplant or death.

But the opioid addiction epidemic appears to be creating tens of thousands of new cases, with unclean needles the leading cause of infections. Some experts say that one reason heroin use has soared is because the illegal drug has become much cheaper than prescription opioid painkillers and due to new limits on dispensing of the addictive legal pain medicines.

The CDC conducted a state-by-state analysis of reported cases of the hepatitis C virus (HCV), as well as a review of laws related to access to clean needles for individuals who inject drugs, and levels of restriction on Medicaid access to treatments.

In 2015, it found HCV rates in 17 states exceeded the national average.

The analysis found only Massachusetts, New Mexico and Washington had both a comprehensive set of laws and a permissive Medicaid treatment policy that could help prevent the spread of HCV and provide treatment services for those who inject drugs.

Twenty-four states had policies that require some period of sobriety to receive HCV treatment through Medicaid, potentially limiting access to cures, compared with 16 states without such restrictions.

Among the best ways of preventing spread of the virus are public health laws that allow access to clean syringes for drug users, such as needle exchange programs, decriminalization of the possession of syringes, and allowing the retail sale of syringes without a prescription.

Eighteen states had no such programs, the report found, while Maine, Nevada and Utah had the most comprehensive laws related to prevention, including syringe exchange without limitations.

(Reporting by Bill Berkrot; Editing by Leslie Adler)

Republicans to press ahead with plan to dismantle Obamacare health plan

File photo: Information cards are stacked on a table during an Affordable Care Act outreach event for the Latino community in Los Angeles, California September 28, 2013. REUTERS/Jonathan Alcorn

WASHINGTON (Reuters) – U.S. President Donald Trump and his Republicans were set to press ahead in Congress on Thursday with a plan to dismantle Obamacare, negotiating changes as they go, with their bill slated to move to the budget committee on its way to a crucial vote soon by the full House of Representatives.

Conservatives have demanded a quicker end to the expansion of the Medicaid program put in place under the Affordable Care Act, the healthcare overhaul approved under former Democratic President Barack Obama.

They also want to add work requirements for some recipients of Medicaid, the government health insurance program for the poor.

The White House said it was discussing such tweaks with House Republican leaders, including Speaker Paul Ryan.

“There’s no perfect piece of legislation. There’s gonna be this framework that’s going to be added to or subtracted to during the process, and eventually it’s going to pass the House and it’s going to pass the Senate,” White House budget director Mick Mulvaney told Fox News in an interview on Thursday.

Mulvaney acknowledged the difficulty the draft legislation could face in the Senate, where Republicans hold a slimmer majority and several of them have already voiced doubts.

On Wednesday, Trump held a campaign-like rally in Tennessee as he tried to build momentum for his first legislative initiative to make good on his campaign promise to repeal and replace Obamacare.

Trump administration officials and House Republican leaders have not given a timetable for a vote on the legislation, although Ryan has said he wants to pass it by lawmakers’ mid-April recess.

Two House committees approved the bill’s provisions with no changes last week. On Thursday, the Budget Committee will try to unify the plan into a single bill for consideration on the House floor.

Signs have emerged that the White House was winning over reluctant conservatives who initially questioned the legislation on the grounds that it too closely resembled Obamacare. But Republican moderates have raised concerns that tax credits in the bill will not be enough to help people buy health insurance.

Senate Republicans have also voiced dissatisfaction with the bill.

“As written, the House bill would not pass the Senate. But I believe we can fix it,” Senator Ted Cruz said on Wednesday.

Republican Senator Rand Paul, a fierce critic of the House plan, also said the White House has been more open to negotiation than House leaders.

(Writing by Susan Heavey; Editing by Bernadette Baum)