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Accessibility statementSkip to main content Democracy Dies in Darkness SubscribeSign in Democracy Dies in Darkness The Health 202 A newsletter briefing on the health-care policy debate in Washington. Subscribe to the newsletter WHY MEDICAID’S ‘UNDERCOUNT’ PROBLEM COUNTS Analysis by Phil Galewitz with research by McKenzie Beard May 14, 2024 at 8:03 a.m. EDT A newsletter briefing on the health-care policy debate in Washington. Sign upfor The Health 202 newsletter Share Comment on this storyComment35 Add to your saved stories Save Good morning. I’m Phil Galewitz, a senior correspondent at KFF Health News who plays pickleball in his spare time. Send story and pickleball tips to pgalewitz@kff.org Not a subscriber? Sign up here. Today’s edition: The Biden administration is set to unveil new tariffs on Chinese medical supplies. A House panel is pressing the Drug Enforcement Administration for an update on its work to address ongoing shortages of prescription stimulants. But first … Get the full experience.Choose your plan MILLIONS LOST MEDICAID COVERAGE – BEFORE REALIZING THEY HAD IT Experts say the disconnect likely prevented some patients from accessing health-care services. (iStock) Millions of people were surprised to find themselves booted from Medicaid over the past year after pandemic-era protections expired that had prevented states from terminating their coverage. Story continues below advertisement Turns out, millions of them were also unaware they had been covered by the government program. Advertisement Nearly 1 in 3 people enrolled in Medicaid in 2022 — or 26 million people — didn’t know it, according to a study by Harvard and New York University researchers published in Health Affairs this month. The report estimated that of those who didn’t know they were on Medicaid, about 3 million thought they were uninsured. They almost certainly had coverage, though, because the federal government from March 2020 to April 2023 prohibited states from dropping anyone from Medicaid rolls in exchange for billions of dollars in pandemic relief money. “What this means is people could have been accessing health-care services and probably did not because they thought they were uninsured,” said Jennifer Tolbert, deputy director of the KFF Program on Medicaid & Uninsured. “People not understanding that they have Medicaid is not a good thing.” Advertisement Story continues below advertisement This lack of awareness has implications for efforts to predict how much the nation’s uninsured rate has changed as a result of the Medicaid “unwinding” — the process that began last year in which states redetermine whether people enrolled in the program since the pandemic unfolded remain eligible. Follow Election 2024 Follow States have dropped about 22 million people from Medicaid in the past year, often for procedural reasons like failing to return paperwork. A KFF survey in April found about 1 in 4 adults who were disenrolled from Medicaid a year ago remained uninsured. One group enjoys some upside from Americans’ ignorance about their insurance coverage: the companies that administer Medicaid for most states, including UnitedHealthcare and Centene. Story continues below advertisement States pay them a monthly fee for every person enrolled in their plans. But if people don’t know they’re insured, they’re less likely to seek health services — which means higher profits for the companies. Advertisement “Insurers reaped windfalls from this reality,” said Brian Blase, president of the Paragon Health Institute and a former health policy adviser to President Donald Trump. “People who are enrolled but don't know they are enrolled receive no benefit from the program.” In March 2022, the Centers for Medicare & Medicaid Services reported that about 88 million people had Medicaid coverage. But census survey data found about 62 million people self-reported Medicaid coverage — an undercount of 26.4 million, the study said. Story continues below advertisement Several factors explain why enrollees may not realize they’re on Medicaid. They don’t pay monthly premiums, so the cost of the coverage can be invisible. Because it’s administered by private insurers, many Medicaid recipients may believe they have commercial coverage. And states often market their Medicaid programs with a consumer-friendly name, like Husky Health in Connecticut or SoonerCare in Oklahoma. Advertisement “Medicaid having different names should not lead people to think they are uninsured,” said Benjamin Sommers, a health economist at Harvard who was one of the study’s authors. KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — an independent source of health policy research, polling, and journalism. WHITE HOUSE PRESCRIPTIONS BIDEN SET TO ANNOUNCE NEW TARIFFS ON CHINESE MEDICAL SUPPLIES New this a.m.: The Biden administration is flexing its trade muscles by implementing major new tariffs on medical products imported from China. Story continues below advertisement The move follows a three-year review by the Office of the United States Trade Representative, with Biden officials describing the latest tariffs as “carefully targeted” to protect only the strategic sectors that the president seeks to cultivate. The plan includes: Advertisement * A 50 percent tax on Chinese-made syringes and needles. * A 25 percent tariff on certain imported personal protective equipment, including some respirators and face masks, up from 7.5 percent or less. * A 25 percent tax on Chinese-manufactured rubber medical and surgical gloves, more than tripling the current tariff of 7.5 percent. The bigger picture: The move aligns with the administration’s broader strategy to combat what the White House calls “unfair trade practices” by China and to bolster U.S. defenses against supply shortages seen during the coronavirus pandemic. Despite efforts by the federal government and private sector, the administration says American businesses continue to struggle to compete with an influx of low-cost Chinese medical supplies saturating the market. Some products are poor quality, Biden officials say, raising safety concerns for health-care workers and patients. ON THE HILL FIRST IN THE HEALTH 202: HOUSE REPUBLICANS PUSH DEA FOR INFORMATION ON CONTROLLED SUBSTANCES SHORTAGES New this a.m.: Republicans on the House Committee on Oversight and Accountability are pressing the DEA for an update on its effort to tackle ongoing shortages of Adderall and other controlled substances like it. Advertisement Story continues below advertisement In a letter sent yesterday to DEA Administrator Anne Milgram, lawmakers noted that the agency hasn’t adjusted the caps it imposes on the annual production of the prescription stimulants, despite a rise in demand and fewer manufacturers. The decision, they argue, has exacerbated shortages that have persisted for over 18 months. Next steps: The committee is asking the DEA for information about its quota-setting process, as well as access to documents and communications related to the agency’s response to the shortages, in particular Adderall, Vyvanse and related generics. The letter was signed by full committee Chair James Comer (R-Ky.) and health subcommittee Chair Lisa C. McClain (R-Mich.). The DEA didn’t immediately respond to a request for comment. IN OTHER NEWS FROM CAPITOL HILL … On our radar: A bipartisan group of senators led by Majority Leader Charles E. Schumer (D-N.Y.) are set to unveil a long-awaited “road map” this week for regulating artificial intelligence, including in the health-care industry, The Post’s Cat Zakrzewski reports. Advertisement Story continues below advertisement The initiative is intended to provide direction to the Senate committees increasingly crafting bills regulating the technology. The plan is expected to call for individual sectors to develop specific rules for AI, as well as the development of testing and transparency measures to help explain its potential harms. The road map will also call for about $32 billion in funding for AI research and development. DEEP DIVE BIDEN NEARLY DIED OF AN ANEURYSM. RISKY SURGERY CHANGED HIS LIFE. The Post’s Michael Kranish is out with a deep dive this morning into the aneurysms that nearly killed President Biden in 1988 and the risky procedure that saved him – and how the incident helps explain the 81-year-old’s motivations today. Story continues below advertisement Why it matters: The near-fatal experience highlights the depth of Biden’s resilience. But it also underscores how he initially downplayed a serious health issue for fear of the political repercussions and, as he later acknowledged, sometimes failed to heed the advice of his doctors. Advertisement The politics: For years, Biden’s triumph over the aneurysms was the subject of bipartisan applause. But during the 2020 campaign, Trump began raising doubts about Biden’s mental acuity. Now, as Biden seeks reelection amid voter concerns about his health and age, 78-year-old Trump has alleged without medical evidence that his Democratic opponent is “cognitively impaired.” Doctors who treated Biden dismissed the allegation, saying he fully recovered and suffered no brain damage. And while some people who have had aneurysm surgery experience longer-term health repercussions, experts say, there is no evidence that Biden has suffered such consequences — though he has said it significantly changed his outlook on life. STATE SCAN ARIZONA SUPREME COURT DELAYS ENFORCEMENT OF NEAR-TOTAL ABORTION BAN The Arizona Supreme Court granted Attorney General Kris Mayes’s (D) request to delay the enforcement of a 160-year-old abortion ban, giving her time to consider appealing the case to the nation’s top court, Stacey Barchenger reports for the Arizona Republic. Yesterday’s ruling said the earliest the Civil War-era law could be enforced would be Aug. 12. Combined with a separate court order, that could mean the ban repealed by the state legislature earlier this month is never enforced — though that depends on when lawmakers wrap up their work for the year. * Planned Parenthood Arizona said after the court's ruling it would continue providing abortions up to 15 weeks of pregnancy at its clinics in the state “for the next several months.” IN OTHER HEALTH NEWS * On the move: The Food and Drug Administration’s Center for Tobacco Products has selected John Verbeten as the next director of its Office of Compliance and Enforcement. Verbeten most recently served as deputy director for import operations enforcement at the agency’s Office of Regulatory Affairs. * The FDA is urging health-care providers and consumers not to use at-home coronavirus tests manufactured by Cue Health, following a warning letter to the company last week that said the product could deliver false results. * About 63 percent of Americans say abortion should be legal in all or most cases, according to a new Pew Research Center survey that represents a 4 percent increase since 2021, the year before the Supreme Court overturned Roe v. Wade. HEALTH READS What the results of Wegovy’s longest clinical trial yet show about weight loss, side effects and heart protection | CNN (By Meg Tirrell | CNN) After decades fighting Big Tobacco, Cliff Douglas now leads a foundation funded by his former adversaries (By Nicholas Florko | Stat) Mississippi lawmakers move to limit the jail detentions of people awaiting mental health treatment (By Kate Royals | ProPublica and Mississippi Today) SUGAR RUSH Thanks for reading! See you tomorrow. Share 35 Comments By McKenzie Beard McKenzie Beard is a researcher for The Health 202, a morning newsletter and daily guide to Washington's health-care policy debate. She started at the Post as an American University practicum student on the investigative desk in 2021 and has previously reported for Voice of America and Teen Vogue. Twitter NewsletterFridays Fact Checker Count the pinocchios: A weekly review of what’s true, false or in-between in politics, from The Post’s famous fact-checking team. 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