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- HCA Healthcare now expects ACA exchange impacts to exceed $1B in 2026
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- Lawmakers Look To Make Abortion Shield Laws Less Dependent on Who’s Governor
- Knee Pain? Ragged Cartilage? Research Suggests Surgery’s Not the Best Answer
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- Inside agency view: Havas SO on authenticity, connection and pushing back against the ‘sea of sameness’
- Why policy gaps threaten behavioral health coverage
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Michigan healthcare freedom community forum
Still, the Michigan Department of Health and Human Services could lose a good portion of the $ 26.6 billion it receives from the federal government:
https://www.reuters.com/world/trump-orders-pause-all-federal-grants-loans-2025-01-28/
Trump's funding freeze triggers worry, Democrats say Medicaid affected
By Steve Holland, Andy Sullivan and David Morgan - January 28, 2025Summary
* Foreign aid also frozen, lifesaving medicines withheld
* Memo says spending must align with president's priorities
* Freeze is part of broader campaign to reshape government
* Nonprofits dismayed, Democrats challenge 'unlawful' moveWASHINGTON, Jan 28 (Reuters) - President Donald Trump's administration's order to pause all federal grants and loans starting on Tuesday triggered confusion in the U.S. health system, with Democratic lawmakers saying states were having trouble accessing Medicaid funds, the massive program that provides care for low-income Americans.
U.S. Senator Ron Wyden, the top finance committee Democrat, said his office had confirmed that the portal doctors use to secure payments from Medicaid had been deactivated in all 50 states. Medicaid, which covers about 70 million people, is jointly funded by both the states and the federal government, and each state runs their own program.
White House press secretary Karoline Leavitt said she could not say whether the program had been frozen, telling reporters at her first briefing since Trump took office on Jan. 20, "I'll get back to you."
The order was not limited to the $618 billion Medicaid program, also threatening to disrupt education, anti-poverty programs, housing assistance, disaster relief and a host of other initiatives that depend on trillions of federal dollars.
The freeze followed the Republican president's suspension of foreign aid last week, a move that began cutting off the supply of lifesaving medicines on Tuesday to countries around the world that depend on U.S. development assistance.
The Office of Management and Budget, which oversees the federal budget, said in a memo that grants and loans would be put on hold while the administration ensures they are aligned with the Republican president's priorities, including executive orders he signed ending diversity, equity and inclusion efforts.
The memo said Tuesday's freeze included any money intended "for foreign aid" and for "nongovernmental organizations," among other categories.
The White House said the pause would not impact Social Security or Medicare payments to the elderly or "assistance provided directly to individuals," such as some food aid and welfare programs for the poor.
In a second memo released on Tuesday, OMB officials said funds for Medicaid, Head Start, farmers, small businesses and rental assistance would continue without interruption.
But the order was creating chaos and confusion among an array of non-profits as well as state and local officials on Tuesday, even before it was to take effect at 5 p.m. (2200 GMT).
DISPUTED EFFECTS
In Connecticut, the reimbursement system for Head Start - a government program that provides early education and other benefits to low-income families - was shut down, preventing pre-schools from paying staff, Democratic U.S. Senator Chris Murphy said on X.
Leavitt also would not specifically say whether Head Start or disaster aid would be frozen at the Tuesday briefing.Four groups representing nonprofits, public health professionals and small businesses filed a lawsuit on Tuesday challenging the directive, saying it "will have a devastating impact on hundreds of thousands of grant recipients." Democratic state attorneys general were also preparing to sue the Trump administration.
The OMB order is the latest directive in the Trump administration's campaign to dramatically reshape the federal government, the nation's largest employer.
In a blizzard of executive actions, Trump has shuttered all diversity programs, imposed a hiring freeze, sent national security officials home and sought to strip away job protections from thousands of civil servants.
As part of last week's 90-day foreign aid suspension, the administration moved on Tuesday to stop the distribution of drugs for HIV, malaria and tuberculosis, as well as medical supplies for newborn babies, in countries supported by the United States Agency for International Development. The U.S. is the largest single donor of aid globally, disbursing $72 billion in 2023.
Agencies have until Feb. 10 to submit detailed information on any programs subject to the suspension.
CHAOS, CONFUSION
The federal government provides money to a broad swath of nonprofits, which reacted with dismay and confusion.
"From pausing research on cures for childhood cancer to halting food assistance, safety from domestic violence, and closing suicide hotlines, the impact of even a short pause in funding could be devastating and cost lives," Diane Yentel, president and CEO of the National Council of Nonprofits, one of the four groups that sued on Tuesday, said in a statement.
Trump's order could also cause turmoil in state and local governments that depend on federal aid for everything from highway construction to school lunches and foster care.
The memo did not appear to exempt disaster aid to areas like Los Angeles and western North Carolina that have been devastated by natural disasters. Trump pledged government support when he visited both places last week.
The memo asserted the federal government spent nearly $10 trillion in fiscal year 2024, with more than $3 trillion devoted to financial assistance such as grants and loans. But those figures appeared to include money authorized by Congress but not actually spent - the CBO estimated government spending in 2024 at a much lower $6.75 trillion.
Trump's Republican allies have been pushing for dramatic spending cuts, though he has promised to spare Social Security and Medicare, which make up roughly one-third of the budget. Another 11% of the budget goes toward government interest payments, which cannot be touched without triggering a default that would rock the world economy.
DEMOCRATS CHALLENGE 'LAWLESS' MOVE
Democrats immediately criticized the spending freeze as unlawful and dangerous.
Senate Democratic Leader Chuck Schumer said the administration did not have the authority to prevent spending approved by Congress.
"This decision is lawless, destructive, cruel," Schumer said in a speech to the Senate. "It's American families that are going to suffer most."The U.S. Constitution gives Congress control over spending matters, but Trump said during his campaign that he believes the president has the power to withhold money for programs he dislikes. His nominee for White House budget director, Russell Vought, who has not yet been confirmed by the Senate, headed a think tank that has argued Congress cannot require a president to spend money.
U.S. Representative Tom Emmer, the No. 3 Republican in the House of Representatives, said Trump was simply following through on his campaign promises.
"You need to understand he was elected to shake up the status quo. That is what he's going to do. It's not going to be business as usual," Emmer told reporters at a Republican policy retreat in Miami.
But at least one Republican centrist, U.S. Representative Don Bacon, said he hoped the order would be short-lived after hearing from worried constituents, including a woman who runs an after-school program that depends on federal grant money.
"We've already appropriated this money," he said. "We don't live in an autocracy. It's divided government. We've got separation of powers."
Spending federal monies is very important to the political acclaim of Michigan politicians. They won't give up the gravy train without a serious fight:
Michigan AG Dana Nessel says she will sue to block Trump's federal funding pause
By Paul EganPaul Egan - January 28, 2025LANSING — Michigan Attorney General Dana Nessel said she plans to file a lawsuit Tuesday to protect programs and "vital services" threatened by a federal funding pause ordered Monday by the Trump administration.
"My team is working at full speed today to discern what these orders mean and the extent of their immediate impacts, and request an immediate legal remedy to restore funding provided by Congress, require this administration to comply with the law, and to stop this absurd and unprecedented attack on these programs," Nessel said in a news release.
The administration of President Donald Trump temporarily paused grant, loan and other financial assistance programs at the Office of Management and Budget, under a memorandum issued Monday.
The memo specifically excluded from the pause "assistance received directly by individuals," including Medicare and Social Security, and also appeared to exclude state welfare payments to needy families, such as food stamps, which account for close to $5.5 billion in federal spending in Michigan.
But Nessel said in a news release it appeared payments under Medicaid could be impacted by the pause, as well as Head Start, which is a preschool program.
"We are receiving reports of critical impacts to significant programs many millions of Michiganders rely upon daily for vital services," Nessel said.
The White House Office of Management and Budget said in a follow-up memo Tuesday that neither Medicaid nor Head Start payments were covered by the pause, despite media reports that some states were having trouble accessing certain payments Tuesday. Nessel's office did not immediately respond to questions about why she believed Medicaid and Head Start payments were impacted by the pause.
The memo referenced executive orders, including those seeking to dismantle programs related to diversity, equity and inclusion (DEI), signed by President Donald Trump since he took office last week.
"In the interim, to the extent permissible under applicable law, federal agencies must temporarily pause all activities related to obligation or disbursement of all federal financial assistance, and other relevant agency activities that may be impacted by the executive orders, including, but not limited to, financial assistance for foreign aid, nongovernmental organizations, DEI, woke gender ideology, and the green new deal," Matthew J. Vaeth, the acting director of the Office of Management and Budget, wrote in the memo.
The suspension goes into effect Tuesday, Jan. 28 at 5 p.m., according to the memo.
Agencies have until Feb. 10 to submit detailed information on any programs, projects or activities subject to the pause, the memo states. Michigan's 2025 budget totals about $81.2 billion, of which just under $33.9 billion, or 42%, comes from the federal government, according to the House Fiscal Agency.
But not all of that federal money has been paused.
By state agency, the biggest recipients of federal funding are the Department of Health and Human Services ($26.6 billion); the Michigan Department of Transportation ($2.3 billion); School Aid ($2.3 billion); and the Department of Labor and Economic Opportunity ($1.2 billion). Next are the Department of Lifelong Education, Advancement and Potential ($505.4 million) and the Department of Environment, Great Lakes, and Energy ($463.8 million).
"The potential impact is huge," said Bob Schneider, a senior research associate at the Citizens Research Council of Michigan. But it is quite possible the freeze applies to a more limited range of federal spending programs, he said, noting the qualifier in the memorandum "to the extent permissible under federal law."
Programs delivered through the states that are already provided for under federal law, such as Medicaid, may not be covered by the pause, Schneider said.
Senate Minority Leader Aric Nesbitt, R-Porter Township, criticized Nessel on X for proposing "another frivolous taxpayer funded lawsuit attacking President Trump’s agenda."
Earlier Tuesday, New York Attorney General Letitia James, a Democrat, said she plans to ask a Manhattan federal court to block the Republican president’s moves.
For a change, it wasn't a Hawaiian judge. The National Council of Nonprofits got an injunction from a Pakistani-American female judge: U.S. District Judge Loren L. Ali Khan:
Federal judge halts Trump freeze on federal grants and loans for a weekAssociated Press writers JoNel Aleccia, Moriah Balingit, Collin Binkley, Matthew Daly, Lisa Mascaro, Adithi Ramakrishnan, Amanda Seitz, Michael Sisak, Lindsay Whitehurst and Tammy Weber contributed to this report.
January 28, 2025
WASHINGTON (AP) — A federal judge on Tuesday temporarily blocked a push from President Donald Trump to pause federal funding while his administration conducts an across-the-board ideological review to uproot progressive initiatives.
The Trump administration plan plunged the U.S. government into panic and confusion and set the stage for a constitutional clash over control of taxpayer money.
The order from U.S. District Judge Loren L. AliKhan came minutes before the funding freeze was scheduled to go into effect. The administrative stay lasts until Monday afternoon and applies only to existing programs.
Administration officials said the decision to halt loans and grants — a financial lifeline for local governments, schools and nonprofit organizations around the country — was necessary to ensure that spending complies with Trump’s recent blitz of executive orders. The Republican president wants to increase fossil fuel production, remove protections for transgender people and end diversity, equity and inclusion efforts.
But a vaguely worded memo issued by the Office of Management and Budget, combined with incomplete answers from the White House throughout the day, left lawmakers, public officials and average Americans struggling to figure out what programs would be affected by the pause. Even temporary interruptions in funding could cause layoffs or delays in public services.
“This sort of came out of the blue,” said David Smith, a spokesperson for the Shawnee Mission School District in Kansas, one of countless districts that receive federal funding. Now they’re trying to figure out what it means “based on zero information.”
AliKhan, who was appointed by President Joe Biden, said in halting the freeze, “It seems like the federal government currently doesn’t actually know the full extent of the programs that are going to be subject to the pause.”
Jessica Morton, an attorney for the National Council of Nonprofits which brought the suit, said the group has tens of thousands of members around the country that could be affected.
“Our client members have reported being extremely concerned about having to shutter if there’s even a brief pause,” Morton said.
Justice Department attorney Daniel Schwei said the plaintiffs hadn’t identified anyone specifically who would lose funding right away if the pause does go into effect.
Trump administration officials said programs that provide direct assistance to Americans would not be affected, such as Medicare, Medicaid, Social Security, student loans and food stamps. They also defended the funding pause, saying Trump was following through on his promise to turn Washington upside down if elected to a second term.
However, the effects were being felt far from the nation’s capital. Organizations like Meals on Wheels, which receives federal money to deliver food to the elderly, were worried about getting cut off.
“The lack of clarity and uncertainty right now is creating chaos,” spokeswoman Jenny Young said. She added that “seniors may panic not knowing where their next meals will come from.”
The National Science Foundation postponed this week’s panels for reviewing grant applications. Officials in Prichard, Alabama, feared they wouldn’t receive infrastructure funding to fix their leaking drinking water system. Republican leaders in Louisiana said they were “seeking clarity” to ensure nothing was “jeopardizing financial stability of the state.”
“Trump’s actions would wreak havoc in red and blue communities everywhere,” said Sen. Patty Murray of Washington, the top Democrat on the Senate Appropriations Committee. “We are talking about our small towns, our cities, our school districts.”
The full scope of the administration’s review was spelled out in a 51-page spreadsheet sent to federal agencies and viewed by The Associated Press. Each line was a different government initiative, from pool safety to tribal workforce development to special education.
Officials were directed to answer a series of yes or no questions for every item on the list, including “does this program promote gender ideology?” or “does this program promote or support in any way abortion?” Responses are due by Feb. 7.
Trillions of dollars are potentially under review. Grants that have been awarded but not spent are also supposed to be halted if they might violate one of Trump’s executive orders.
“The use of Federal resources to advance Marxist equity, transgenderism, and green new deal social engineering policies is a waste of taxpayer dollars that does not improve the day-to-day lives of those we serve,” wrote Matthew Vaeth, the acting director of the Office of Management and Budget, in a memo distributed Monday.
Vaeth wrote that “each agency must complete a comprehensive analysis of all of their Federal financial assistance programs to identify programs, projects, and activities that may be implicated by any of the President’s executive orders.” He also wrote that the pause should be implemented “to the extent permissible under applicable law.”
The pause on grants and loans was scheduled to take effect at 5 p.m. ET, just one day after agencies were informed of the decision.
Democrats described the Trump administration’s decision as capricious and illegal. They argued that the president had no right to unilaterally stop spending money appropriated by Congress.
New York Attorney General Letitia James planned to ask a Manhattan federal court to block the funding pause.
“There is no question this policy is reckless, dangerous, illegal and unconstitutional,” she said.
Separately, a group of nonprofit organizations filed a lawsuit in Washington saying that the funding pause is “devoid of any legal basis or the barest rationale.”
The issue dominated the first briefing held by White House press secretary Karoline Leavitt. She said the administration was trying to be “good stewards” of public money by making sure that there was “no more funding for transgenderism and wokeness.”
She denied that Trump was deliberately challenging Congress to establish his dominance over the federal budget.
“He’s just trying to ensure that the tax money going out the door in this very bankrupt city actually aligns with the will and the priorities of the American people,” she said.
The Environmental Protection Agency confirmed that it would implement the pause to “align federal spending and action with the will of the American people as expressed through President Trump’s priorities.” The Department of Energy also said it was conducting a review of its spending.
The funding pause is the latest example of how Trump is harnessing his power over the federal system to advance his conservative goals. Unlike during his first term, when Trump and many members of his inner circle were unfamiliar with Washington, this time he’s reaching deep into the bureaucracy.
For example, federal employees are being asked to report their colleagues if they try to continue diversity, equity and inclusion initiatives.
“They are pushing the president’s agenda from the bottom up,” said Paul Light, an expert on the federal government and professor emeritus of public service at New York University.
He also said there are risks in Trump’s approach, especially with so many voters reliant on Washington.
“You can’t just hassle, hassle, hassle,” Light said. “You’ve got to deliver.”
Fears about interruption in government services were exacerbated as states reported problems with the Medicaid funding portal, where officials request reimbursement for providing healthcare to poor residents.
Democrats condemned the Trump administration, connecting the issue to the funding pause.
But Leavitt said the portal would be back online soon.
“We have confirmed no payments have been affected — they are still being processed and sent,” she posted on social media.
Praise the Lord for the first step to getting government bureaucrats out of healthcare.
What's the path to bypassing the swamp for those in genuine need?
Disabled children (for example) could thrive with a fully funded HSA card. The market would never be the same again.
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