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US states slash Medicaid
By Tom Eley
20 February 2010
US states are imposing major cuts to Medicaid, the health insurance program for low income Americans jointly funded with the federal government. The cuts are being enacted in response to huge budget deficits in states throughout the country and a sharp increase in enrollment fuelled by the unemployment crisis.
Cuts in Medicaid services are a critical component of the attempts by the US corporate and financial elite, led by the Obama administration, to slash government health care costs and reduce care. On Thursday, Obama established a bipartisan panel whose central purpose will be to find ways to decrease spending on government health care and pension programs, including Medicaid.
Some versions of the Democrats' health care overhaul proposals include an expansion of Medicaid eligibility, but without full support for state governments. This will translate into further cuts to services and ensure that larger numbers of Americans have access only to the most limited and inadequate health care coverage, while the wealthy continue to enjoy the best care money can buy.
Enrollment in Medicaid increased by 3.3 million between June 2008 and June 2009 to nearly 47 million cases, according to a study released Thursday by the Kaiser Family Foundation. Caseloads increased in every US state. In thirteen states, enrollment shot up by more than 10 percent. According to a new study by Families USA, for every 1 percentage point rise in the US unemployment rate, 1 million people become eligible for Medicaid and related programs.
With Medicaid already consuming about a fifth of most state budgetsthe same as the average outlay for educationboth Democrat and Republican governors and lawmakers throughout the country are insisting on deep cuts in the services provided to Medicaid recipients.
Medicaid typically provides insurance to those who fall below the official poverty level, but only within certain categories: children, pregnant women, parents of young children, the disabled, and the elderly who require nursing home care. The program's reach varies among the states, but the majority of Americans living in povertythree out of five according to one estimateare not covered by Medicaid.
Because emergency federal stimulus funding for Medicaid bars states from narrowing eligibility requirements, states have instead targeted medical services and payments to doctors for cuts. In recent years the federal government paid between 50 percent and 75 percent of a state's Medicaid coststhe poorer the state, the higher the federal proportionbut the stimulus package increased this share to between 61 percent and 85 percent, at a cost of $87 billion. These funds are set to expire at the end of December unless Congress approves a $25 billion extension.
The additional federal funds have been grossly inadequate, and every state faced Medicaid funding shortfalls in the current fiscal year, according to the Kaiser Foundation study. In response, a number of states are curtailing currently covered "non-essential" services.
Nevada's Republican governor, Jim Gibbons, has proposed cutting all Medicaid funding for adult coverage of eyeglasses, dentures, and hearing aids. In order to save about $830,000, the state will also "reduce the number of diapers provided monthly to incontinent adults (to 186 from 300)," the New York Times reports.
Massachusetts will eliminate coverage for restorative dental service. Last year a similar revocation of dental coverage in Michigan led to the death of a 76-year-old woman, Blanche D. LaVire, who had been diagnosed with abscesses and advanced periodontitis that required surgery. She died while waiting for state bureaucracies to approve an exception due to a mental health condition. (See, "Michigan woman dies after Medicaid dental care is cut").
Michigan, which eliminated not only dental but vision benefits for adult Medicaid recipients in fiscal year 2010, is considering a bevy of new cuts for 2011, including mental health services, prescription drug coverage, treatment for deformities, and artificial limbs.
Similarly, New Mexico's Democratic governor, Bill Richardson, is proposing cuts to Medicaid that could include prescription drug coverage, vision and dental care, hospice care for near-death patients, and physical therapy.
Maine is moving to limit outpatient mental health visits for adult Medicaid recipients to 18 per year and to cap outpatient hospital visits at 15 per year.
Many more states have reduced the amount that they pay to doctors, clinics, hospitals, and nursing homes who treat Medicaid recipients. Already Medicaid is rejected by many health care providers because it tends to pay at a level far below private insurance and Medicare. These reimbursement cuts ensure that fewer Medicaid patients will be able to find treatment, and those clinics and hospitals that do so will be further driven to reduce costs and quality.
Among the states likely to enact major cuts for Medicaid reimbursement are New York, Texas, Pennsylvania, Maine, Louisiana, Maryland, Missouri, Virginia, and Vermont. Maine is contemplating a 10 percent across-the-board cut, and New York Governor David Paterson is proposing to slash $400 million from Medicaid reimbursement.
After Kansas's Democratic governor, Mark Parkinson, imposed a 10 percent cut in provider payments beginning January 1, Dr. C. Joseph Beck, a Wichita ophthalmologist, ended treatment for his Medicaid patients. "I'm out, I'm done," Dr. Beck told the New York Times. "I didn't want to. I want to take care of people. But I also have three children and many employees to take care of."
Some states are cutting essential services that, by triggering the removal of federal matching funds, will effectively double the funding cut. Tennessee's Democratic governor, Phil Bredesen, is proposing cuts that would set up a $10,000 limit on inpatient hospital care, a sum easily surpassed by serious car accidents, heart attacks, and treatment for serious illnesses. Bredesen would also impose limits on specific hospital services, including X-rays, laboratory services and doctor's office visits, the Times reports.
Arizona's Republican governor, Jan Brewer, has proposed kicking 310,000 adults without dependent children off Medicaid rolls and scrapping the state's Children's Health Insurance Program (CHIP), a program that secures federal matching funds for states that subsidize health insurance for children from low-income households that earn more than the income cutoff for Medicaid. The state has already frozen enrollment in CHIP.
California governor Arnold Schwarzenegger has proposed reducing adult eligibility for the state's Medicaid program, Medi-Cal, from 133 percent to approximately 72 percent of the official poverty threshold, and to reduce eligibility for children and pregnant women from 200 percent to 133 percent of the poverty level. If enacted, these restrictions would cost an estimated 250,000 people their health insurance within six months.
Schwarzenegger has also threatened to end the state's CHIP program, Healthy Families. The cut would affect nearly 900,000 children now enrolled in the program. California lawmakers are already moving to cut eligibility in CHIP from 250 percent to 200 percent of the federal poverty level and to impose increased premiums of $14 per child, even as private insurance costs in the state skyrocket. The legislature will also likely eliminate CHIP vision coverage.
The cuts enacted against Medicaid and CHIPS will disproportionately affect the most vulnerable sections of the population, especially children.
Yet America's children are in desperate need of high-quality health care. According to a recent study whose results were published in the Journal of the American Medical Association, over half of all US children will suffer from a chronic illness during their childhoods, a two-thirds increase since the 1980s. Much of the increase is associated with obesity, asthma, and diabetes, conditions strongly linked to poverty and other environmental factors. (See, "Majority of US children suffer chronic health conditions, study says")
The reductions to Medicaid services and providers, even as the program's rolls swell, demonstrates the basic incompatibility of the right to decent health care with the profit drive of America's financial aristocracy. Having enriched themselves before, during, and after the financial crisis of their own making, the financial eliteacting through their two partiesare now demanding "tough choices" and "discipline" by cutting what remains of the nation's limited social safety net.
Top DOJer Overruled Finding Of Misconduct For Torture Memo Authors
February 19, 2010
The Justice Department has released the long-awaited report on the torture memos and the conduct of Bush Administration lawyers including John Yoo.
While the final report by the department's internal watchdog, the Office of Professional Responsibility, found that attorneys John Yoo and Jay Bybee engaged in professional misconduct, top DOJ official David Margolis overruled that finding in a memo to Attorney General Eric Holder.
Margolis, associate deputy attorney general, says in the 69-page memo that he did not find OPR's definition of misconduct persuasive. And he blocks the agency from referring the matter to state bar disciplinary authorities where Yoo and Bybee are now licensed. Yoo is a Berkeley law professor and Bybee is a federal judge in the Ninth Circuit Court of Appeals.
Margolis, the most senior nonpolitical official in the Justice Department, has served for many years, including during the Bush Administration.
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FEBRUARY 19, 2010
Lots of Air, No Drama as Shaun White Takes Gold
Shaun White literally soared above his competition in the men's halfpipe event at Cypress Mountain, British Columbia Wednesday, delivering the U.S. its fifth gold medal in 2010, and sealing the snowboarder's legacy as one of the most dominant Olympians in history.
Mr. White, who became the first person to win back-to-back gold medals in the halfpipe, performed his much-hyped, signature move called the "Double McTwist 1260," which involves two off-axis backflips while doing 3.5 full rotations, all in one jump. The trick is so advanced (no other competitor in the event even attempted it) that merely landing it was enough to ensure Mr. White victory. Turns out, however, he never even needed to do it, only performing it on his last run, because it would have been a waste not to.
But it was not Mr. White's McTwist that awed the crowd Wednesday night. It was the sheer distance he traveled into the air. He jumped so high on his first jump during the finals that the crowd let out a sudden gasp. Everyone went silent for a moment before Mr. White exploded into an blur of acrobatics. His first run, even without his most awe-inspiring stunt, was so devastating that the race from then on was for second place. Asked why he performed the death-defying trick for seemingly no reason, Mr. White responded, "I just felt like I didn't come all the way to Vancouver not to pull out the big guns. I put down the tricks I've worked so hard on."
While rainy, mushy snow created some sub-par practices leading up to the competition, Wednesday's halfpipe final went down in ideal conditions. It was the clearest, sunniest day of the Olympics so far, and in the afternoon, Cypress Mountain offered spectators unobstructed views of the surrounding mountains and the bay.
The competition was not as crisp as the weather, with many riders missing landings during qualifying rounds and the semifinals. Some favorites didn't even make it to the semifinals. The Americans once again dominated the event, with Mr. White's gold and teammate Scott Lago snatching the bronze. Finnish rider Piiroinen Peetu took silver, but was still more than three points off Mr. White's score of 48.4. American Louie Vito (of Dancing with the Stars fame) took fifth place, with a conservative run that failed to wow judges.
American supremacy over this event looked like it might be waning in the semifinals. Although Mr. White dominated on his first qualifying run with a score of 45.8, in what looked like an effortless display of his dominance, three of the top five spots in the final were taken by Japan and Finland. Japanese boarders Ryo Aono and Kazuhiro Kokubo faltered, however, allowing Mr. Lago to sneak into bronze with a surprisingly solid first run.
There was no question the level of competition had jumped by leaps and bounds since Torino four years ago. As more countries, like Japan, have focused their efforts on snowboarding, increased competition has pushed the sport's growth curve ever steeper, toward more dangerous tricks.
Though Mr. White's Double McTwist 1260 sounds similar to something that might come in a Happy Meal, it is anything but happy. Mr. White has admitted to being "scared" practicing for it and last month, at the X Games, he hit his head so hard attempting it that his helmet flew off and into the air. He returned to win the gold medal in that competition, but it was a reminder of exactly how much bigger and higher snowboarders are going these days. Olympic hopeful Kevin Pearce is still recovering from severe brain injury after a December crash that left him impaired.
"With these type of corks you need to realize you're putting your life on the line," said Ben Mates of Australia, who did not make the final run. Mr. Mates decided to play it safe, rather than try one of the sideways back flips that the top riders were completing. "It definitely crossed mind whether to do that trick, and I just decided to land on my feet," he said after his final run.
All the high-flying daredevil tricks are somewhat lost on the broader sports watching public. Most people in the stands Wednesday had trouble describing the tricks they had come to see. Noel Castellanos, a jewelry designer from Saratoga, Calif., tried to describe Mr. White's signature McTwist this way: "A couple of twists, spin around, some somersaults. I'm not actually sure. All I know is it looks pretty impressive."
John Murray, a translations engineer from Atlanta, Georgia, said he loves to watch Mr. White and has seen him compete five times, but still doesn't actually know what he's watching. "My guess is that a Double McTwist is when he gets to his apex, he's going to do like a 720 around and then also twisting and tumbling at the same time. Well, I can guess at it. There's a lot going on."
Mr. White's competitors say they are falling farther behind the world's best halfpipe rider because they lack the facilities to train at his level. "We try to do the same tricks, but every year he advances more compared to us," said Gary Zebrowski of France. "Especially to the French guys because we don't have special halfpipes to try the tricks. That's why we are less better."
"We don't have pipes like this," said Markus Malin of Finland. "We have only the small pipes and they are not in really good shape." Mr. Malin hopes that by earning a silver and getting three riders into the final round Wednesday, Finland might embrace snowboarding. "Maybe it's like they woke up and will build some kind of pipe there," he said.
When asked how Mr. White gets so much higher than everyone else, Justin Lamoureux of Canada responded "A half a million dollar pipe all to yourself. That would be a good start," referring to Mr. White's personal halfpipe built with the help of sponsor Red Bull.
Jake Burton, credited with creating modern snowboarding and whose company designed the red, white and blue plaid outfits worn by the American team, said Mr. White has paid his dues. "He started at the bottom" said Mr. Burton. "He's taken his spoils and is using them to make him better." Mr. Burton says Mr. White's ability to get so much higher than his competitors comes from his skateboarding practice, which helps develop the skill of propelling the board into the air.
After ending up in ninth place Wednesday, Japan's Mr. Aono said he has finally figured out what it will take to beat Mr. White. "Big Air," he said. With a smirk and a thumbs up sign, he said "I need speed."
Write to Reed Albergotti at reed.albergotti@...
FBI investigates allegations webcam used to monitor student
February 20, 2010
Parents sue over spy computers
FBI will try to determine whether wiretap, computer intrusion laws were violated
Pennsylvania family claims assistant principal watched boy through laptop's webcam
Official: It was mistake not to tell families of feature allowing school to monitor hardware.
District only accesses laptop if it's reported lost, stolen or missing, school spokesman says
(CNN) -- The FBI has opened an investigation into allegations that a Pennsylvania school official remotely monitored a student at home, a law enforcement official with knowledge of the case told CNN on Saturday.
The official, who asked not to be identified, said the FBI became involved in the case after a family filed a lawsuit against the Lower Merion School District, located outside of Philadelphia, Pennsylvania.
The family accused an assistant principal at Harriton High School of watching their son through his laptop's webcam while he was at home and unaware he was being watched. The family also says the school official used a photo taken on a laptop as the basis for disciplining the student.
In a statement issued late Friday, District Superintendent Christopher McGinley rejected the allegations.
"At no time did any high school administrator have the ability or actually access the security-tracking software," he said. "We believe that the administrator at Harriton has been unfairly portrayed and unjustly attacked in connection with her attempts to be supportive of a student and his family. The district never did and never would use such tactics as a basis for disciplinary action."
A school official said it was a mistake not to make families aware of a feature allowing the school to monitor the computer hardware.
The law enforcement official with knowledge of the case told CNN that the FBI will try to determine whether federal wiretap or computer intrusion laws were violated.
But FBI spokesman J.J. Klaver said he could not disclose the existence of an investigation.
In a lawsuit seeking class-action status filed Wednesday in U.S. District Court for the Eastern District of Pennsylvania, Michael and Holly Robbins of Penn Valley are suing the school district, its board of directors, and the superintendent. They claim that the district unlawfully used its ability to remotely access a webcam on their son's laptop computer, which was issued by the district.
The lawsuit says that on November 11, 2009, the plaintiff's son was told by the assistant principal at Harriton High School that he was caught engaging in "improper behavior" in his home which was captured in an image via the webcam. According to the Robbins' complaint, neither they nor their son were informed of the school's ability to remotely access the webcam. It is unclear what the boy was doing in his room or if any punishment was given out.
Doug Young, spokesman for the Lower Merion School District, told CNN that the district would only remotely access a laptop if it was reported lost, stolen or missing.
If that happened, the district would first have to request access from its technology and security department and receive authorization, he said. Then it would use the built-in security feature to take over the laptop and see whatever was in the webcam's field of vision, potentially allowing them to track down the missing computer.
During the 2009-2010 school year, 42 laptops were reported lost, stolen or missing, and the tracking software was activated by the technology department in each instance, according to McGinley's statement. A total of 18 laptops were found or recovered.
McGinley said the parents and students were not explicitly told about this built-in security feature.
"Despite some reports to the contrary, be assured that the security-tracking software has been completely disabled," McGinley said in the statement.
"This feature was limited to taking a still image of the computer user and an image of the desktop in order to help locate the reported missing, lost, or stolen computer (this includes tracking down a loaner computer that, against regulations, might be taken off campus)."
In order to receive the laptop, the family had to sign an "acceptable-use" agreement. In order to take the laptop home, the family would also have to buy insurance for the computer.
In the "acceptable-use" agreement, the families are made aware of the school's ability to "monitor" the hardware, Young said, but it stops short of explicitly explaining the security feature. He said that was a mistake.
Young told CNN that the district is very proud of the laptop program and its ability to close the technology gap between students who have computers at home and those who don't. He acknowledged that the schools have to take a step back to re-evaluate the policies and procedures surrounding the program.
Multiple requests for further comment from the lawyer for the Robbins', Mark Haltzman of Lamm Rubenstone LLC, went unanswered.
CNN's Susan Candiotti and Nicole Bliman contributed to this report.