The Headlines
- The Supreme Court allowed the Trump Administration to enforce the "public charge" immigration rule.
- Two House subcommittees held a joint hearing on maternal and infant health.
- The Trump Administration released a plan to block grant the Medicaid program.
- The Centers for Medicare and Medicaid Services will cover diagnostic laboratory tests that use next generation sequencing for some patients.
The Details
1. Public charge rule update
On Monday, the Supreme Court voted 5-4 to lift a nationwide injunction imposed by the U.S. District Court for the Southern District of New York preventing the Department of Homeland Security's public charge final rule from taking effect while legal challenges to the rule proceed. The rule allows the president to proceed with denying green cards to immigrants who have received public assistance like Medicaid and food stamps.
2. Congressional hearing on maternal and infant health
On Tuesday, two subcommittees of the House Education and Labor Committee held a joint hearing entitled, "Expecting More: Addressing America's Maternal and Infant Health Crisis," which focused on strategies to reduce the nation's maternal mortality rate and eliminate racial and ethnic disparities in maternal and infant health. The panel of witnesses included leaders from the March of Dimes, United States Breastfeeding Committee, and National Birth Equity Collaborative.
Proposals included federal, state, and private sector approaches, such as expanding Medicaid postpartum coverage; reducing cost sharing that prevents many women with insurance coverage from accessing necessary services; protecting pregnant women from discrimination in the workplace; addressing workplace barriers to breastfeeding; expanding access to paid family leave; and combating structural racism and implicit bias in health care settings.
Separately, federal officials from the US Department of Health and Human Services’ Health Resources and Services Administration traveled to Raleigh this week as part of a listening tour on how the federal government could help North Carolina address some of its maternal health issues. The Division of Public Health led a discussion about racial disparities in North Carolina’s infant mortality rates and maternal death rates during childbirth.
3. Medicaid block grant proposal
The Trump Administration on Thursday unveiled a plan to change the Medicaid program into a block grant, marking a significant departure in how the program is financed via open-ended matching funds to states. Under the plan, states could request capped funding for Medicaid beneficiaries covered under the Affordable Care Act's Medicaid expansion. States also could limit health benefits and drugs available to some patients. States would be required to report their performance in real time, such as whether Medicaid patients see declines in access to providers or health outcomes.
Groups opposed to block grants argue that the Trump Administration cannot legally cap Medicaid spending without permission from Congress. Litigation is expected to limit an immediate implementation of the plan.
4. Medicare to cover next generation sequencing for some patients
The Centers for Medicare and Medicaid Services issued a national decision to cover diagnostic laboratory tests using next generation sequencing (NGS) for certain Medicare patients with inherited ovarian or breast cancer. As proposed last October, the test must be approved or cleared by the Food and Drug Administration, ordered by a treating physician for a patient not previously tested using the same NGS test, and performed in a laboratory certified under the Clinical Laboratory Improvement Amendments program, among other requirements.
NGS tests provide the most comprehensive genetic analysis of a patient's cancer because they enable simultaneous detection of multiple types of genetic alterations. Medicare began covering the tests in March 2018 for patients with certain advanced cancer.