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Jonathan Cohn Profile picture
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7 Sep, 8 tweets, 4 min read
Over the weekend I wrote about the national shortage of caregivers and how it’s affecting people with disabilities.

There’s a story behind the story (1) huffpost.com/entry/disabili…
A few weeks ago @jmartinwrites got in touch with me, because he wanted to share his story — about his efforts to take grad classes at Vanderbilt, part of pursuing his dream of becoming a high school English teacher (2) huffpost.com/entry/disabili…
I first wrote about @jmartinwrites during the ACA repeal debate.

He has cerebral palsy. Medicaid pays for supports and services that enabled him to attend college. And cuts in the GOP legislation would have jeopardized that funding. (3) huffpost.com/entry/medicaid…
Opposition to those cuts was one reason repeal failed. And protests by disability rights advocates were a big part of that. (4) vox.com/policy-and-pol…
Advocates were careful to say that while protecting current programs is vital, those programs are not nearly sufficient.

One big issue was a caregiver shortage, a byproduct of low wages and poor working conditions. (5) phinational.org/wp-content/upl…
The pandemic has made the problem worse, as I explain in the new article. And it’s why Justin isn’t in Nashville for classes this fall: he couldn’t find care providers (6) huffpost.com/entry/disabili…
His only option was to attend virtually and arranging that was difficult, for reasons that the article explains. I suspect the saga will sound familiar to anybody who works on disability rights and access. (7) huffpost.com/entry/disabili…
The underlying problem — the caregiving shortage — is something the federal government could address. An initiative in the spending bill Democrats hope to pass would bolster home care.

Here’s an article on that proposal and one of its champions. (8) huffpost.com/entry/home-car…

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More from @CitizenCohn

Jonathan Cohn Profile picture
8 Sep
Today I wrote about pressure to cut funding for a key Dem initiative in half -- and, more broadly, about the internal dynamics as leaders choose from among popular, substantively important proposals.

A bit like “The Hunger Games,” one operative said. (1) huffpost.com/entry/caregivi…
To be clear, champions of different initiatives have not for generally attacked one another, publicly or even privately.

A big reason for that is that they are allies, and have a broadly shared enthusiasm for pretty much everything on the agenda. (2) huffpost.com/entry/caregivi…
Still, there’s only so much money to go around. And there will be even less if Manchin, Sinema and some other more conservative Democrats get their way.

See, for example, this new @Axios report (3) axios.com/scoop-manchin-…
Read 12 tweets
Jonathan Cohn Profile picture
23 Aug
This breakdown of hospital prices is so, so interesting. Great work from @sarahkliff @jshkatz @adamplayford @morghend @MorganeMouslim

nytimes.com/interactive/20…
As @zackcooperYale notes, the findings raise questions about how well insurers are negotiating prices -- which, after all, is a big part of the value they are supposed to bring to the health care system. nytimes.com/interactive/20…
One thing that stands out is the sheer magnitude of price variation, even for relatively standard/low-tech care.

Here is what three different insurers are paying for rabies vaccines (for people bitten by animals) at a Utah hospital. nytimes.com/interactive/20…
Read 4 tweets
Jonathan Cohn Profile picture
18 Aug
A theory about this progress, which really is something to cheer… (1)
Racial gap is closing bc low rates among Blacks, Hispanics included many people who feared vaccine but were also in the “wait and see” category.

Plus there were real access problems. (2) huffpost.com/entry/black-am…
Still some access issues in these communities. Still plenty of people afraid of the shots.

But outreach, public education and targeted clinics are all making a difference. So are mandates and changing expectations.

Fear of delta is a factor, as is sheer passage of time. (3)
Read 4 tweets
Jonathan Cohn Profile picture
9 Aug
Update on the DeSantis/Florida legislature effort to stop businesses -- including cruise lines -- from requiring customers show proof of vaccination.

Norwegian Cruise Lines sought an injunction blocking the law. Tonight they got it. (1)

politico.com/states/florida…
One part of the ruling from Judge Kathleen Williams jumped out at me:

"The unvaccinated population is not a protected class that enjoys a fundamental Constitutional right to remain unvaccinated." (2)

politico.com/states/f/?id=0…
Notable because I've heard this argument in a few places now, not just from DeSantis -- i.e., that vaccine requirements are discriminatory.

It didn't persuade Judge Williams and I'm guessing it won't persuade others on appeal -- though, to be clear, I'm not a legal expert. (3)
Read 4 tweets
Jonathan Cohn Profile picture
25 Jul
ACA improvements?
Medicaid for holdout states?
Dental coverage for seniors?

There’s a case for all of the items on the Democratic health agenda. But probably not enough money — or votes.

A look at the tough choices ahead:
huffpost.com/entry/biden-ob…
Two key questions will help define boundaries of what’s possible:

1. To what extent are Dems determined to finance new health care spending w/savings they find elsewhere in health care?

2. How willing are Dems to find those savings from Rx reform?

huffpost.com/entry/biden-ob…
The importance of those Rx savings to other initiatives is one reason I continue to think — and continue to hear from some veteran operatives and staff — that ambitious reforms could actually pass despite all of the familiar obstacles
huffpost.com/entry/prescrip…
Read 6 tweets
Jonathan Cohn Profile picture
16 Jul
Via multiple sources, Dem budget negotiators may scale back funding increase for home and community-based care. Like, by more than half -- from $400B, which was what Biden proposed, to below $200B.

Very much in flux, nothing decided. (1)
This is the initiative to boost funding of home care aides and other services that let the elderly, people w/disabilities live at home, stay in labor force, etc. (2)

huffpost.com/entry/joe-bide…
Medicaid funds these services, but with limited allotments. That creates long waiting lists, plus the care workers are famously underpaid. huffpost.com/entry/joe-bide… (3) Image
Read 8 tweets

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