SACRAMENTO, Calif. – It's been almost a month since Congress let funding for the Children's Health Insurance Program run out - and now, the State of California says the program known as CHIP will go broke at the end of December. The California Department of Healthcare Services says this unprecedented situation will require some hard decisions in November.

Tricia Brooks, a senior fellow at the Georgetown University Center for Children and Families, says Congress' inaction has forced many states to consider freezing enrollment or cutting benefits.

"States cannot wait until they run out of money to take action; in fact, doing so would be irresponsible," she warns. "But making changes to CHIP coverage, even temporarily, takes time and will further deplete the funds that states have to pay for healthcare for children."

Meanwhile, Brooks says lawmakers in D.C. have spent the past few months trying to repeal the ACA, pass a budget and work on tax reform.

California's CHIP program, which is part of Medicaid, has about 1.9 million children enrolled. The state is required by law to keep the program going, so some federal money would still flow. But the federal reimbursements would drop by 38 percent - leaving the state to try and absorb the rest.

Kristen Golden Testa, California health director for the Children's Partnership, says another program that covers 118,000 women and their newborns, is entirely dependent on federal money. So the state would either have to end it or cover the entire cost.

"It's a difficult situation because they have to balance the responsible program operators with not wanting to unnecessarily distress the families whose children depend on this coverage," she says.

Two committees in Congress have already agreed on CHIP policy going forward, but they haven't figured out how to pay the $8 billion to fund the program for the next five years. Testa says the worry is that people will stop bringing their kids to the doctor, even while the insurance program remains intact.


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A newly installed rooftop solar power system will help the Free Clinic of Simi Valley keep its doors open and the lights on for the area's disadvantaged patients.

The Ventura County facility annually serves more than 10,000 uninsured or underinsured, low-income residents. Funding for the project was provided through a grant from the global nonprofit humanitarian aid organization Direct Relief.

Fred Bauermeister, executive director of the clinic, said being mostly "off the power grid" allows them to fund other priorities.

"Despite the fact that we got this building donated, we still have to pay $3,000 a month in electricity, which from a nonprofit point of view, is hard money to raise," Bauermeister, explained. "It's not very compelling when I go out in the community and say, 'Hey, would you give money so we can pay the electricity bill?'"

He pointed out the solar array, combined with soon-to-be-completed battery backup, will provide 53 kilowatts of power, enough to make the clinic officially net-zero in terms of carbon emissions.

The $165,000 grant from Direct Relief comes through the group's Power for Health Initiative, born amid the aftermath of Hurricane Maria in Puerto Rico.

Sara Rossi, managing director of the group's Health Resiliency Fund, said health providers' biggest need was to get the power back on.

"That could include making them more resilient to the effects of climate change through rooftop solar and battery backups that help them weather power outages," Rossi outlined. "Or helping them increase their ability to store cold chain medications and vaccines."

Bauermeister added Direct Relief's solar power system is a gift to their patients that will keep on giving.

"They were generous enough to give us a grant to install 135 solar panels on our roof," Bauermeister noted. "So far, we saved $8,249.87 and that will go on forever. We're forever going to save money on electricity."

Nebraska was among the states affected by the recent E. coli outbreak traced to onions in McDonald's hamburgers. Federal officials said they are now certain about the source but broader questions about the overlap with beef production linger.

The outbreak caused at least one death and sickened dozens of people. This week, key federal agencies closed the investigation, which pinpointed onions from a Colorado farm, while also ruling out burger patties. Ahead of the conclusion, some food safety experts wondered more about bacteria in manure from factory farms, where livestock is raised, finding its way to produce operations.

Prashant Singh, associate professor of health, nutrition and food science at Florida State University, explained the problem with having the different farming operations so close to each other.

"Manure, sometimes, if not properly processed in large operations, can spill over into a fresh produce area," Singh pointed out.

More specifically, contaminated dust particles from waste at concentrated animal feeding operations can land on fields of lettuce, for example, or get into irrigation canals. Separately, a California carrot company last month launched a voluntary recall because of an E. coli outbreak. Environmental groups noted many carrots in California are grown near factory farms.

Singh emphasized meat production has accelerated under evolving technology, with regulations enforced by the U.S. Department of Agriculture but produce is monitored by the Food and Drug Administration and he said the resources are vastly different.

"On the FDA side, they lack everything," Singh observed. "Their hands are very full. "

Even with the resource imbalance, other food safety experts note the meat lobby has focused heavily on avoiding strict regulations under the USDA, and existing laws have limits. Meanwhile, data from the Centers for Disease Control and Prevention show there have been nine multistate foodborne illness outbreaks in 2024.

This story is based on original reporting by Nina Elkadi for Sentient.


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A new report found New York hospitals are in a precarious financial state.

The New York State Hospitals Fiscal Survey Report showed statewide hospitals are projecting an operating budget margin of 0.0% percent. While it is a slight improvement, hospital administrators said it is still insufficient for hospitals to handle patient care.

Bea Grause, president of the Healthcare Association of New York State, said government reimbursements do not cover the costs of administering health care.

"Those reimbursements are fixed and do not change," Grause pointed out. "They grow a little bit year over year but they're not keeping up with the expense growth that all hospitals are experiencing."

She noted hospitals cannot raise their commercial expenses with the expectation it will make up the difference, arguing the best way to help hospitals is to close the gap on Medicare and Medicaid payments so they keep up with expense growth. Prescription drugs are the largest continuously increasing expense hospitals face since such prices run 83% above the rate of inflation.

Staffing issues are being exacerbated by New York hospital's fiscal challenges. The report found labor expenses have grown more than 36% since 2019. While it is the second year of declining contract labor expenditures, they are double what they were in 2019.

Grause emphasized not having sufficient staff can affect the services hospitals offer.

"If a hospital is going to have a dialysis unit, you need a nephrologist. You'd probably need more than one nephrologist," Grause observed. "But you also need specially trained nurses, you need the right equipment, you need all the medication, you need the IV solution and the peritoneal solution."

Another factor in hospitals' declining operating margins is insurer demands. The report showed some surveyed hospitals project insurers' actions will cut their 2024 operating revenues by 5% or more. Estimates showed it would result in $1.3 billion or more in lost revenue for the hospitals.


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