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Coronavirus April 2 Update: Medicaid Enrollments Expected to Jump, School Districts Face Funding Woes, and Doctors Ask Lawmakers to Enforce PPE Requirement
Medicaid enrollment expected to jump; White House considering insurance options
The number of people enrolled in Medicaid is expected to rise due to unemployment during the pandemic, putting a strain on state resources. Some experts are warning that new federal funding provided to states may not be enough to match the increase.
States are eligible for a 6.2 percent increase in the Federal Medical Assistance Percentage, or the state's matching rate from the federal government, under the second coronavirus-related law [PL 116-127].
Enrollment in Medicaid typically spikes during times of financial difficulty. Unemployment numbers have already jumped, with the Department of Labor reporting 3.3 million new unemployment claims filed in the week ending March 28.
Enrollment will differ state by state during the pandemic, as individuals in states that didn't expand Medicaid under the 2010 health care law are more likely to fall into a coverage gap.
Federal response
President Donald Trump on Wednesday said the administration was looking at ways to offer health insurance coverage to people who are currently uninsured. His comments come after the administration opted not to open a special enrollment period to allow people to select a plan on the federal health insurance exchange, HealthCare.gov.
Vice President Mike Pence didn't directly answer a question about how the administration would provide options for people who are uninsured—which earned praise from Trump—but said that Congress and the administration would ensure that patients' costs associated with testing and treatment for COVID-19 are covered. Pence noted that the administration has approved waivers for states seeking flexibility within their Medicaid programs.
"I can assure you that as Congress and the president and the administration begin to discuss the next piece of legislation, we are going to make sure that Americans have those costs compensated and covered," Pence said.
At least three health insurance plans—Cigna, Humana and Anthem—said they would waive co-payments for treatment related to the virus. Some Democrats, including Energy and Commerce Committee Chairman Frank Pallone Jr., have said they want Congress to consider legislation that would cover out-of-pocket costs for treatment for the virus.
Doctors, lawmakers consider reinforcing protective equipment rules
Physicians and lawmakers continue to raise concerns about shortages in personal protective equipment, or PPE, and worker protections for medical workers.
States have reported receiving unequal levels of PPE compared to what they requested from the Strategic National Stockpile, and say some equipment they were given has expired.
House Ways and Means Chairman Richard E. Neal wrote to Pence Wednesday asking for a detailed explanation of the government's decision-making in distributing PPE. "States should not be forced into a bidding war against other states, or even the federal government," he wrote. Two Democrats, Rep. Rosa DeLauro and Sen. Patty Murray are also seeking information about levels of supplies in the stockpile.
Medical workers are also looking for guarantees that Occupational Safety and Health Administration standards requiring employers to provide them with proper protection will be upheld. Thousands of physicians signed an open letter to congressional leaders calling for congressional action to guarantee the standards.
The signees also want independent oversight and a review of any guidance released by the Centers for Disease Control and Prevention dealing with PPE use. The CDC recommended in March that workers could use unproven methods of protection, such as scarves, "as a last resort" when official masks are unavailable.
Next aid package
Speaker Nancy Pelosi has said OSHA protections for health care workers and first responders should be part of the next coronavirus-related legislation. Congressional leaders have proposed including infrastructure as well, which could include health care facilities. House Democrats' infrastructure proposal includes $10 billion for community health centers.
Florida issues stay-at-home orders; VA expands beds for non-vets
Florida joined 32 other states and the District of Columbia in issuing a stay-at-home order Wednesday, though it still allows some activities, including church services.
Democrats in Congress had written to Republican Gov. Ron DeSantis last week, urging statewide action, particularly in a state with a large elderly population. DeSantis said he went ahead with the restrictions after the White House extended social distancing guidelines through April.
"People aren't just going to go back to work. That's a national pause button," he said at a Wednesday news conference.
New York Democratic Gov. Andrew Cuomo said Wednesday he would further tighten restrictions in New York City by shutting down playgrounds, though he is leaving "open spaces" like parks open. "No density, no basketball games, no close contact, no violation of social distancing, period," he said. "That's the rule."
The Department of Veterans Affairs is stepping in to help states like New York with a crush of patients. It's opening 20 beds at its facility in East Orange, N.J., to non-veteran COVID-19 patients at the request of the state and the Federal Emergency Management Agency.
The VA has done the same for 50 beds at two facilities in New York City. More VA beds could be opened up around the country, according to Trump: "We're ready to move very quickly."
The department announced Wednesday that it's increased its ICU and medical bed count by 4,000 to deal with the pandemic.
Coronavirus creates funding time bomb for public schools
The economic pain brought on by the coronavirus pandemic is just about everywhere.
Atlanta businesses that rely on tourism took a huge hit after the NCAA canceled the Final Four college basketball tournament. The iconic Las Vegas strip is shut down. New Orleans’ French Quarter is a virtual ghost town.
But a budgetary time bomb for public schools is likely to explode long after the pandemic ends and lawmakers shift their focus to the next crisis — and the crisis after that.
Many public school districts rely heavily on state sales tax revenues that have already plummeted and may not recover for a very long time. State income taxes and local property taxes are both significant sources of funding and are also likely to dip. Personnel and pension costs could rise at the same time. Even school districts in areas mostly untouched by the virus will feel the economic impact.
For now, many school districts have their hands full closing buildings, moving classes online and figuring out how to provide meals and lesson plans remotely. Many districts haven’t seen an immediate economic impact since budgets tend to be locked in through June. As a recession sets in and state revenues decline, however, school officials worry they could see steep cuts in the years to come.
Federal dollars make up a small but crucial portion of most district budgets. Now, school districts may have nowhere else to turn as state budgets shrink. The recent stimulus package will help, but some experts say public schools will need more federal help in the months ahead.
The looming financial woes for public schools may affect the 2020 election season as well. A bad economy is never good for incumbents, and the current crisis could mean deep cuts to education and other basic public services in battleground states. Nevada, Texas and Florida are just three examples of key states where school districts rely heavily on vulnerable sales tax revenue.
At the end of day, many school officials say that they don’t know what to expect. Decisions about hiring, capital improvements and more that seemed clear a few weeks ago are now in limbo.
“We feel pretty good come June. The question is what happens come July and moving forward,” said Marvin Dereef, chief financial officer for the Fulton County, Georgia, school district. “Our biggest enemy when it comes to making budgets is uncertainty.”
Read the full story on RollCall.com.