“When you’re engaged in political work that is as embodied and vulnerable, uncharted and courageous as self-help, you’re really harnessing something like a new world building power,” says Deep Care author Angela Hume. In this episode, Hume and host Kelly Hayes discuss the work of abortion self-help activists who provided illegal abortions in the 1970s, as well as militant clinic defenders…
This post was originally published on Latest – Truthout.
In April the Equal Employment Opportunity Commission (EEOC) finalized its Pregnant Workers Fairness Act (PWFA) regulations, after being criticized by conservative lawmakers and religious organizations. Part of the update included a clarification that accommodations, like a leave of absence, applied to abortion care. But now since the U.S. Supreme Court overturned the Chevron deference…
This post was originally published on Latest – Truthout.
The Biden administration on Friday put in place stringent curbs aimed at thwarting rogue insurance brokers from switching consumers’ Affordable Care Act plans without their consent. The announcement came in response to mounting complaints from consumers. The Centers for Medicare & Medicaid Services said Friday that, in the first six months of the year, more than 200,000 people reported to the…
This post was originally published on Latest – Truthout.
Conservatives have done the United States a huge favor by explaining in detail what they’ll try to do if Donald Trump is reelected. Project 2025, a “presidential transition project” of the Heritage Foundation, helpfully lays out how a group of former Trump officials would like to transform the country into a right-wing dystopia where the rich thrive and the rest of us die aspiring to be rich.
This post was originally published on Latest – Truthout.
Conservatives have done the United States a huge favor by explaining in detail what they’ll try to do if Donald Trump is reelected. Project 2025, a “presidential transition project” of the Heritage Foundation, helpfully lays out how a group of former Trump officials would like to transform the country into a right-wing dystopia where the rich thrive and the rest of us die aspiring to be rich.
This post was originally published on Latest – Truthout.
Sadeq Jaafar Ali (AlSammak) was a 16-year-old Bahraini student from the town of Al Aali when he was arrested by Bahraini authorities on 5 October 2017, while he was on his way to school. The arrest was carried out without a warrant. During his detention, he endured torture, insults, solitary confinement, enforced disappearance, isolation, denial of family contact and visits, denial of access to his lawyer, unfair trials, religious discrimination, reprisals, and medical neglect. He is currently serving a 14-year sentence in Jau Prison.
On the morning of 5 October 2017, Sadeq was walking to school when several civilian cars surrounded him, and their passengers arrested him without a warrant. They took Sadeq to the Ministry of Interior (MoI)’s Criminal Investigation Directorate (CID), where he was held in solitary confinement for two and a half months. On the second day of his arrest, he called his family and informed them of his whereabouts. When Sadeq’s family went to the CID, officers refused to disclose the reason for his arrest, and his lawyer was not able to talk to or meet him. Additionally, officers searched Sadeq’s house three times without presenting a search warrant, seizing his father’s properties, including computers and cars, which were never returned.
Sadeq was previously arrested several times in 2015 and 2016 at AlKhamis Police Station and Roundabout 17 Police Station. During these detentions, at the ages of 14 and 15, he was subjected to torture, beatings, and electric shocks. He was later released due to a lack of evidence supporting the charges against him.
While at the CID, officers interrogated, tortured, and subjected Sadeq to enforced disappearance for two and a half months. The CID officers physically beat him, especially in sensitive areas, and subjected him to prolonged solitary confinement and electric shocks to force him to sign pre-written confessions that were later used against him in trials. During these interrogations, the officers did not allow Sadeq to meet or speak with his legal counsel. Furthermore, Sadeq was taken multiple times to the Public Prosecution Office (PPO), where he denied the charges against him and reported the torture he endured. However, he was returned each time to the CID, where he was further tortured to force a confession. After two and a half months of physical and psychological torture, Sadeq finally signed the confession due to exhaustion and fear of further violence. A forensic doctor later confirmed the physical beatings during a medical examination, which the court did not consider in its ruling. Moreover, his family was not allowed to visit him until three months after his arrest, when he was transferred to the Dry Dock Detention Center.
On 4 January 2018, Sadeq’s family filed a complaint with the Ombudsman about the torture he endured during his interrogations at the CID. His family waited two and a half months after his arrest, after he was transferred from the CID, to file a complaint due to fear of further torture by CID officers. Sadeq informed the Ombudsman’s investigator about the torture he endured, particularly in his private area, and he was checked for injuries after submitting the complaint. On 5 March 2018, the Ombudsman responded, stating that their investigation raised suspicion of a criminal offense that falls within the jurisdiction of the Special Investigation Unit (SIU). Consequently, the case was referred to the SIU on 1 March 2018. Sadeq’s family later contacted the SIU, however, it did not provide them with any information about the investigation.
Sadeq was not promptly brought before a judge, did not have adequate time and facilities to prepare for his trials, and was denied access to his lawyers during the trial period. Despite the evidence provided to the judge and the complaint filed with the Ombudsman concerning the torture Sadeq was subjected to, the confessions extracted from him under torture were used as evidence against him. Between March 2018 and May 2022, Sadeq was sentenced in several cases to a total of 14 years and two months in prison, along with the revocation of his citizenship. He was convicted of various charges, including 1) illegal gathering, 2) rioting, 3) arson, 4) joining a terrorist group, 5) endangering people’s lives, 6) importing and possessing explosives, rifles, or weapons without authorization, 7) manufacturing or possessing explosives, and using them to endanger people’s property, 8) training on using weapons to commit terrorist crimes, 9) placing structures simulating the shapes of explosives, 10) initiating an explosion in one of the petrol lines in Buri Town, 11) kidnapping, and 12) assaulting the bodily integrity of others. His convictions included his alleged participation in and joining of the “Bahraini Hezbollah”, an umbrella group used by the government to convict 137 other individuals in a mass trial on 16 April 2019. While awaiting appeal and cassation, officers have either denied Sadeq’s attendance at the proceedings or brought him to the building but prevented him from entering the courtroom. This resulted in his convictions being upheld due to his “absence,” depriving him of a fair appeals process. For instance, the court of appeal sentenced Sadeq in absentia in the case in which he was denaturalized, even though he was on the bus that transferred detainees outside the courtroom, and despite the lawyer’s request for Sadeq to attend. His nationality was later restored through a royal pardon. On 19 January 2021, Sadeq was transferred to the isolation building in Jau Prison.
Throughout his detention, Sadeq has undertaken numerous hunger strikes to protest the poor prison conditions. The longest of these began on 13 October 2021, lasting approximately 16 days, to protest his transfer to the isolation building on 1 January 2021 in Jau Prison without valid reasons, as well as the medical negligence he endured. On 27 October 2021, 14 days into his hunger strike, Sadeq reported in a voice recording that his blood sugar levels had dropped dangerously to 3.1%. He described facing persecution, harassment, and threats to prolong his isolation. Isolated prisoners faced additional punishment such as chaining of their hands and feet if they objected to being segregated from other political prisoners. Sadeq also stated in the recording that he had met with a media committee of an official human rights institution, which pressured him to end his hunger strike without securing any guarantees, instead of urging the prison administration to end his isolation and respond to his demands.
Following his convictions, Sadeq was subjected to numerous forms of physical and psychological torture. Officers beat him with their hands and other objects such as hoses and wires, insulted him, and subjected him to hanging and crucifixion. They falsely accused him of inciting other prisoners to vandalize the prison building, quarrel with police officers, and go on strike. After every prison incident, Sadeq is summoned, interrogated, and beaten without any clear reason. Reprisals against him continue intermittently, including repeated solitary confinement, isolation, discrimination, humiliation based on religion, denial of his right to practice religious rituals, harassment, assaults, and ill-treatment. For instance, when Sadeq was held in isolation with foreign criminal inmates, he was prohibited from leaving his cell or communicating with anyone outside the cell. He was once moved to the outdoor area while shackled at the hands and legs. He was not allowed to leave his cell and was deprived of many necessities, with a policeman bringing him food and water to his cell.
Since 26 March 2024, following the death of political Husain Khalil Ebrahim due to medical neglect, Sadeq has been participating in an ongoing protest with other prisoners against the medical negligence and poor conditions in Jau Prison, demanding the release of prominent elderly opposition leaders, including Mr. Hasan Mushaima and Dr. AbdulJalil AlSingace. In response, the Jau prison administration has cut off water and electricity to the protesting prisoners, prohibited communication, withheld adequate meals and toiletries, and transferred prisoners who left the building for clinic or court to isolation and solitary confinement, depriving them of their rights. The director of Jau Prison, Hisham AlZayani, has also threatened to forcibly return the protesting prisoners to their cells.
Sadeq continues to suffer from medical negligence in Jau Prison, with his health deteriorating due to untreated eczema spreading throughout his body. He also suffers from acne on his face and back caused by unhealthy meals, despite repeatedly requesting healthier food options from the prison administration, but to no avail. Additionally, he has shrapnel from a shotgun in his body that the prison’s administration has repeatedly promised to remove, but this has yet to be done. Proper treatment is often not provided or is given in very limited quantities, and sometimes the treatment provided is inappropriate for his condition. Furthermore, official visits and communications from Sadeq’s family have been cut off for nearly a year. His family has filed several complaints with the Ombudsman regarding the restrictions, medical negligence, insults, and torture he has endured, but these have yielded no results.
Sadeq’s arrest without a warrant as a minor, torture, insults, solitary confinement, enforced disappearance, denial of family contact and visits, isolation, denial of access to legal counsel, unfair trials, religious discrimination, reprisals, and medical neglect all constitute clear violations of the Convention Against Torture and Other Cruel, Inhuman, or Degrading Treatment (CAT), the Convention on the Rights of the Child (CRC), the International Convention on the Elimination of All Forms of Racial Discrimination (CERD), the International Covenant on Civil and Political Rights (ICCPR), and the International Covenant on Economic, Social, and Cultural Rights (ICESCR), to which Bahrain is a party.
As such, Americans for Democracy & Human Rights in Bahrain (ADHRB) calls on the Bahraini authorities to uphold their human rights obligations by immediately and unconditionally releasing Sadeq. Additionally, ADHRB further urges the Bahraini government to investigate allegations of arbitrary arrest, torture, insults, solitary confinement, enforced disappearance, denial of family contact and visits, denial of legal counsel, isolation, religious discrimination, reprisals, medical negligence, and ill-treatment, and to hold perpetrators accountable. ADHRB advocates for the Bahraini government to provide compensation for the injuries he suffered due to torture. At the very least, ADHRB advocates for a fair retrial for Sadeq under the Restorative Justice Law for Children, leading to his release. Additionally, it urges the Jau Prison administration to promptly provide appropriate healthcare for Sadeq, holding it responsible for any further deterioration in his health condition. Furthermore, ADHRB calls on the Jau Prison administration to immediately allow Sadeq to contact his family and receive visits from them. Finally, ADHRB demands that the Jau Prison administration immediately end its retaliatory and degrading treatment of protesting prisoners, including Sadeq, and meet their demands to end their ongoing strike.
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Updated: Hasan Moosa Jaafar Ali was a 16-year-old Bahraini student with learning disabilities when he was arrested for the first time without a warrant on 23 September 2013. During his detention, he endured torture, enforced disappearance, solitary confinement, denial of attorney access, isolation, reprisals, religious discrimination, and medical neglect. He was sentenced to a total of 32 years imprisonment through a series of unfair trials, including the “Bahraini Hezbollah” case. Hasan is currently imprisoned at Jau Prison. On 18 September 2020, the United Nations Working Group on Arbitrary Detention (WGAD) adopted an opinion regarding nine Bahraini prisoners convicted in the “Bahraini Hezbollah” case, including Hasan, urging Bahrain to release them immediately and unconditionally and to provide them with compensation.
On 5 September 2012, officials raided Hasan’s family home in an attempt to arrest him, but he was not home at the time. Hasan’s mother asked the officers to see the arrest warrant, but they only said Hasan’s name was on a list of wanted fugitives and would not provide her with a warrant.
After being chased by the authorities for over a year, Hasan was arrested for the first time on 23 September 2013 while he was in a car with his cousin. The officers provided no arrest warrant or reason for the arrest. The officers took Hasan to Samaheej police station, where he was forcibly disappeared and tortured by burning the soles of his feet and thighs and by beating him on his head, abdomen, and “sensitive areas.” As a result of the torture, Hasan developed burns on his feet and thighs, along with green bruises on his body. Two days after his arrest, Hasan was transferred to the AlHadd police station, where he was interrogated for a week without the presence of his lawyer. Officials then allowed him to contact his family for the first time. As a result of torture, Hasan was coerced into confessing to fabricated charges against him. Furthermore, he was not examined by a forensic pathologist following interrogations.
Hasan was not promptly brought before a judge, was unable to present evidence and challenge evidence presented against him, did not have adequate time and facilities to prepare for his trials, and was denied access to his lawyer during the trial period. Additionally, the confessions extracted from him under torture were used as evidence against him. On an unknown date, Hasan was charged with illegal assembly and arson. The Bahraini court sentenced him to a total of nine and a half years in prison and a fine of 200 Bahraini dinars. After his conviction, Hasan was transferred to Jau Prison. Hasan appealed his rulings, however, the Court of Appeals rejected all the appeals and upheld the verdicts.
On 10 March 2015, a prison protest broke out when a family was denied access to visit a prisoner. In retribution, at approximately 10:00 P.M., a group of prison guards attacked a group of detainees, including Hasan. The officers tortured Hasan and the other detainees, beating them with batons until they were unable to move. They threw the detainees to the floor, jumped on their bodies, forcibly cut their hair, and refused to give them access to a bathroom. Hasan was also beaten on the head, causing a deep injury. In May 2015, officials transferred him to the New Dry Dock Prison, the section of Jau Prison reserved for inmates under the age of 21.
On 3 June 2016, approximately three years after his arrest, Hasan escaped with some prisoners from the New Dry Dock Prison. On the same day, plainclothes officers and riot police officers raided his home while searching for him. The officers returned several times in search of Hasan, but he remained in hiding for approximately two years.
On 23 January 2018, officers in plain clothing forcibly entered Hasan’s grandfather’s home, arrested Hasan, and took him to the Criminal Investigations Directorate (CID), where he was subjected to enforced disappearance for two days. He was charged with prison break, hiding from arrest, and for his alleged participation in the Bahraini Hezbollah case. The officers called Hasan’s family two days later to inform them of his arrest and to tell them that he was “fine.”
Officials interrogated Hasan at the CID for 45 days and tortured him to coerce a confession. Hasan did eventually confess to the charges against him, and his confession was used against him during his trial. His lawyer was not allowed to be present during his interrogation. After 45 days at the CID, Hasan was transferred to the “isolation building” of Jau Prison.
The Bahraini court sentenced him to an additional 23 years in prison, a fine of 100,000 Bahraini dinars, and revoked his citizenship, resulting in a total sentence of 32 years. One of the verdicts against him was issued during the “Bahraini Hezbollah” mass trial on 16 April 2019. Hasan was denied access to his attorney and did not have adequate time or facilities to prepare for his trial. The court rejected all of Hasan’s appeals and upheld his convictions. On 21 April 2019, Hasan’s nationality was restored by royal order.
On 21 April 2019, Hasan stated in a voice recording shared on social media that he was isolated from other prisoners, prohibited from interacting with them, and deprived of basic rights such as medical care and religious rituals. He mentioned that he had not met with any prison administrative officials, and his requests to do so were consistently denied.
On 15 August 2019, Hasan joined other detainees at the “isolation building” in a hunger strike to protest poor prison conditions. They demanded to be moved from the isolation building and placed with other prisoners, allowed to practice their religious rituals, and have the restrictions on their phone calls and outdoor time removed. They also protested against constant surveillance of their movements, conversations, and personal belongings by prison officers. The strike continued until the first week of September when the prison administration promised to fulfill their demands. However, after the strike ended, the administration refused to keep its promises, leading the prisoners to resume the strike. In response, prison officers tied Hasan’s hands behind his back and forced him into his cell to prevent him from reciting Ashura’s eulogies with his fellow inmates in the corridor, threatening him with further sanctions if he attempted to recite these eulogies. The prison administration also denied him family visits and placed him in solitary confinement for a few days. Hasan remained in the isolation building of Jau Prison for three years before being moved to another building in 2021.
On 18 September 2020, the United Nations Working Group on Arbitrary Detention (WGAD) adopted an opinion regarding nine Bahraini prisoners convicted in the “Bahraini Hezbollah” case, including Hasan, determining their detention to be arbitrary. The WGAD urged Bahrain to release them immediately and unconditionally and to provide them with compensation.
In September 2020, scabies spread among prisoners in Jau Prison due to a new inmate suffering from it, resulting in Hasan becoming infected. In August 2021, Hasan contracted COVID-19. Between 2015 and 2024, he has been repeatedly placed in solitary confinement. Throughout his detention, he has been repeatedly denied medical treatment for a knee injury, sinusitis, and a deviated septum, and has been denied three necessary nose surgeries for four years. Recently, in March 2024, an officer at Jau Prison prevented Hasan from attending a scheduled ENT appointment for his nose issues under the pretext of his “inappropriate hairstyle”, though his hairstyle complied with prison regulations. He has also been denied follow-up ophthalmology appointments. Hasan’s family has submitted numerous complaints to the Ombudsman, requesting medical care. Although the Ombudsman promised to follow up on the issue, no action has been taken, and the family has yet to receive a response. Additionally, traces of cigarette burns on the soles of Hasan’s feet, inflicted during the interrogation period, are still visible.
Hasan’s first warrantless arrest as a minor, torture, enforced disappearances, solitary confinement, denial of attorney access, unfair trials, isolation, reprisals, religious discrimination, and medical neglect all constitute clear violations of the Convention Against Torture and Other Cruel, Inhuman, or Degrading Treatment (CAT), the Convention on the Rights of the Child (CRC), the International Convention on the Elimination of All Forms of Racial Discrimination (CERD), the International Covenant on Civil and Political Rights (ICCPR), and the International Covenant on Economic, Social, and Cultural Rights (ICESCR), to which Bahrain is a party.
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Year after year, while Roe v. Wade was the law of the land, Texas legislators passed measures limiting access to abortion — who could have one, how and where. And with the same cadence, they added millions of dollars to a program designed to discourage people from terminating pregnancies. Their budget infusions for the Alternatives to Abortion program grew with almost every legislative session…
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ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published. This story was reported in partnership with CBS News.
Year after year, while Roe v. Wade was the law of the land, Texas legislators passed measures limiting access to abortion — who could have one, how and where. And with the same cadence, they added millions of dollars to a program designed to discourage people from terminating pregnancies.
Their budget infusions for the Alternatives to Abortion program grew with almost every legislative session — first gradually, then dramatically — from $5 million starting in 2005 to $140 million after the U.S. Supreme Court overturned the right to an abortion.
Now that abortion is largely illegal in Texas, lawmakers say they have shifted the purpose of the program, and its millions of dollars, to supporting families affected by the state’s ban.
In the words of Rep. Jeff Leach, a Republican from Plano, the goal is to “provide the full support and resources of the state government … to come alongside of these thousands of women and their families who might find themselves with unexpected, unplanned pregnancies.”
But an investigation by ProPublica and CBS News found that the system that funnels a growing pot of state money to anti-abortion nonprofits has few safeguards and is riddled with waste.
Officials with the Health and Human Services Commission, which oversees the program, don’t know the specifics of how tens of millions of taxpayer dollars are being spent or whether that money is addressing families’ needs.
In some cases, taxpayers are paying these groups to distribute goods they obtained for free, allowing anti-abortion centers — which are often called “crisis pregnancy centers” and may be set up to look like clinics that perform abortions — to bill $14 to hand out a couple of donated diapers.
Distributing a single pamphlet can net the same $14 fee. The state has paid the charities millions to distribute such “educational materials” about topics including parenting and adoption; it can’t say exactly how many millions because it doesn’t collect data on the goods it’s paying for. State officials declined to provide examples of the materials by publication time, and reporters who visited pregnancy centers were turned away.
Funding for Texas’ Anti-Abortion Program Has SkyrocketedAs they restricted access to abortion, lawmakers also poured money into a program that was first called Alternatives to Abortion and recently rebranded as Thriving Texas Families. The program funds counseling, baby items and brochures, but not medical care.
Note: Data represents the amounts budgeted for Alternatives to Abortion, now called Thriving Texas Families, for each two-year budget period, including amendments made in that period. Sources: Alternatives to Abortion annual reports and the 2024-25 Texas budget bill (Lucas Waldron/ProPublica)For years, Texas officials have failed to ensure spending is proper or productive.
They didn’t conduct an audit of the program in the wake of revelations in 2021 that a subcontractor had used taxpayer funds to operate a smoke shop and to buy land for hemp production.
They ramped up funding to the program in 2022 even after some contractors failed to meet their few targets for success.
After a legislative mandate passed in 2023, lawmakers ordered the commission to set up a system to measure the performance and impact of the program.
One year later, Health and Human Services says it’s “working to implement the provisions of the law.” Agency spokespeople answered some questions but declined interview requests. They said their main contractor, Texas Pregnancy Care Network, was responsible for most program oversight.
The nonprofit network receives the most funding of the program’s four contractors and oversees dozens of crisis pregnancy centers, faith-based groups and other charities that serve as subcontractors.
The network’s executive director, Nicole Neeley, said those subcontractors have broad freedom over how they spend revenue from the state. For example, they can save it or use it for building renovations.
Pregnancy Center of the Coastal Bend in Corpus Christi, for instance, built up a $1.6 million surplus from 2020 to 2022. Executive Director Jana Pinson said two years ago that she plans to use state funds to build a new facility. She did not respond to requests for comment. A ProPublica reporter visited the waterfront plot where that facility was planned and found an empty lot.
Because subcontractors are paid set fees for their services, Neeley said, “what they do with the dollars in their bank accounts is not connected” to the Thriving Texas Families program. “It is no longer taxpayer money.”
The state said those funds are, in fact, taxpayer money. “HHSC takes stewardship of taxpayer dollars, appropriated by the Legislature, very seriously by ensuring they are used for their intended purpose,” a spokesperson said.
None of that has caused lawmakers to stop the cash from flowing. In fact, last year they blocked requirements to ensure certain services were evidence-based.
Leach, one of the program’s most ardent supporters, said in an interview with ProPublica and CBS News that he would seek accountability “if taxpayer dollars aren’t being spent appropriately.” But he remained confident about the program, saying the state would keep investing in it. In fact, he said, “We’re going to double down.”
What’s more, lawmakers around the country are considering programs modeled on Alternatives to Abortion.
Last year, Tennessee lawmakers directed $20 million to fund crisis pregnancy centers and similar nonprofits. And Florida enacted a 6-week abortion ban while including in the same bill a $25 million allocation to support crisis pregnancy centers. John McNamara, a longtime leader of Texas Pregnancy Care Network, has been working to start similar networks in Kansas, Oklahoma and Iowa. He’s also reserved the name Louisiana Pregnancy Care Network.
And U.S. House Republicans are advocating for allowing federal dollars from the Temporary Assistance for Needy Families program — intended to help low-income families — to flow to pregnancy centers. In January, the House passed the legislation, and it is pending in the Senate. Rep. Elise Stefanik, R-N.Y., castigated Democrats for voting against the bill.
“That’s taking away diapers, that’s taking away resources from families who are in need,” she said in an interview with CBS News after the vote.
But, as Texas shows, more funding doesn’t necessarily pay for more diapers, formula or other support for families.
Lawmakers rebranded Alternatives to Abortion as Thriving Texas Families in 2023. The program is supposed to promote pregnancies, encourage family formation and increase economic self-sufficiency.
The state pays four contractors to run the program. The largest, which gets about 80% of the state funding, is the anti-abortion group Texas Pregnancy Care Network.
Human Coalition, which gets about 16% of the state funding, said it uses the money to provide clients with material goods, counseling, referrals to government assistance and education. Austin LifeCare, which gets about 3% of the state funding, could not be reached for comment about this story. Longview Wellness Center in East Texas, which receives less than 1% of the funds, said the state routinely audits its expenses to ensure it’s operating within guidelines.
Texas Pregnancy Care Network manages dozens of subcontractors that provide counseling and parenting classes and that distribute material aid such as diapers and formula. Parents must take a class or undergo counseling before they can get those goods.
The state can be charged $14 each time one of these subcontractors distributes items from one of several categories, including food, clothing and educational materials. That means the distribution of a couple of educational pamphlets could net the same $14 fee as a much pricier pack of diapers.
A single visit by a client to a subcontractor can result in multiple charges stacking up. Centers are eligible to collect the fees regardless of how many items are distributed or how much they are worth. One April morning, a client at McAllen Pregnancy Center, near the Texas-Mexico border, received a bag with some diapers, a baby outfit, a baby blanket, a pack of wipes, a baby brush, a snack and two pamphlets. It was not clear how much the center invoiced for these items.
McAllen Pregnancy Center and other Texas Pregnancy Care Network subcontractors were paid more than $54 million from 2021 to 2023 for distributing these items, according to records.
How much of that was for handing out pamphlets? The state said it didn’t know; it doesn’t collect data on the quantities or types of items provided to clients or whether they are essential items like diapers or just pamphlets, making it impossible for the public to know how tax dollars were spent.
Neeley said in an email that educational materials like pamphlets only accounted for 12% of the money reimbursed in this category last year, or roughly $2.4 million out of $20 million. She did not respond to questions from ProPublica and CBS News about evidence that would corroborate that number.
The way subcontractors are paid, and what they’re allowed to do with that money, raised questions among charity experts consulted for this investigation.
In the nonprofit sector, using a fee-for-service payment model for material assistance is highly unusual, said Vincent Francisco, a professor at the University of Kansas who has worked as a nonprofit administrator, evaluator and consultant over the past three decades. It “can run fast and loose if you’re not careful,” he said.
Even if nonprofits distribute items they got for free or close to it, the state will still reimburse them. Take Viola’s House, a pregnancy center and maternity home in Dallas. Records show that it pays a nearby diaper bank an administrative fee of $1,590 for about 120,000 diapers annually — just over a penny apiece. Viola’s House can then bill the state $14 for distributing a pack of diapers that cost the center just over a quarter.
But before they can get those diapers, parents must take a class. The center can also bill the state $30 for each hour of class a client attends.
Rep. Donna Howard, a Democrat from Austin, said the program could be more efficient if the state funded the diaper banks directly. Last year, she proposed diverting 2% of Thriving Texas Families’ funding directly to diaper banks, but the proposal failed.
Records show that in fiscal year 2023, Viola’s House received more than $1 million from the state in reimbursements for material support and educational items plus another $1.7 million for classes. Executive Director Thana Hickman-Simmons said Viola’s House relies on funding from an array of sources and that just a small fraction of the diapers it distributes come from the diaper bank. She said the state money “could never cover everything that we do.”
In some cases, reimbursements have created a hefty cushion in the budgets of subcontractors. The state doesn’t require them to spend the taxpayer funds they get on needy families, and Texas Pregnancy Care Network said subcontractors can spend the money as they see fit, as long as they follow Internal Revenue Service rules for nonprofits.
McAllen Pregnancy Center received $3.5 million in taxpayer money from Texas Pregnancy Care Network over three years, but it spent less than $1 million on program services, according to annual returns it filed with the IRS. Meanwhile, $2.1 million was added to the group’s assets, mostly in cash. Its executive director, Angie Arviso, asked a reporter who visited in person to submit questions in writing, but she never responded.
Texas Taxpayers Gave One Crisis Pregnancy Center $3.5 Million Over Three Years. It Spent Less Than $1 Million on Programs.The nonprofit McAllen Pregnancy Center is a case study showing how anti-abortion centers can amass a surplus from the Alternatives to Abortion program, which is now called Thriving Texas Families
Note: Figures are rounded to the nearest thousand. Sources: McAllen Pregnancy Center Form 990 for 2020, 2021 and 2022, and Texas Health and Human Services Commission records obtained by ProPublica and CBS News. (Lucas Waldron/ProPublica)“This is a policy choice Texas has made,” said Samuel Brunson, associate dean for faculty research and development at the Loyola University Chicago School of Law, who researches and writes about the federal income tax and nonprofit organizations. “It has chosen to redistribute money from taxpayers to the reserve funds of private nonprofit organizations.”
Tax experts say that’s problematic. “Why would you give money to a recipient that is not spending it?” said Ge Bai, a professor of accounting and health policy at Johns Hopkins University.
The tax experts disagree with Texas Pregnancy Care Network’s argument that the money is no longer taxpayer dollars after its subcontractors are paid.
“It’s still the government buying something,” said Jason Coupet, associate professor of public management and policy at Georgia State University, who has studied efficiency in the public and nonprofit sectors. “If I were in the auditor’s office, that’s where I would start having questions.”
State legislators and regulators haven’t installed oversight protections in the program.
Three years ago, The Texas Tribune spotlighted the state’s refusal to track outcomes or seek insight into how subcontractors have spent taxpayer money.
Months later, Texas Pregnancy Care Network cut off funding to one of its biggest subcontractors after a San Antonio news outlet alleged the nonprofit had misspent money from the state.
KSAT-TV reported that the nonprofit, A New Life for a New Generation, had used Alternatives to Abortion funds for vacations and a motorcycle, and to fund a smoke shop business owned by the center’s president and CEO, Marquica Reed. It also spent $25,000 on land that was later registered by a member of Reed’s family to produce industrial hemp.
In an interview with ProPublica, a former case manager recalled how Reed would get angry if employees forgot to bill the state for a service provided to a client.
The former case manager, Bridgett Warren Campbell, said employees would buy diapers from the local Sam’s Club store, then take apart the packages. “We’d take the diapers out and give parents two to three diapers at a time, then she would bill TPCN,” said Campbell.
Reed declined to comment to a ProPublica reporter or to answer follow-up questions via email or text. Neeley, the Texas Pregnancy Care Network’s executive director, said the pregnancy center was removed from the program because its nonprofit status was in jeopardy, not because it had used money on personal spending. She said the network wasn’t responsible for monitoring how A New Life for a New Generation spent its dollars: “The power to investigate these matters of how nonprofits manage their own funds is reserved statutorily to the Texas Attorney General and the IRS.”
The Texas attorney general’s office would not say whether it has investigated the organization. Records show that after KSAT’s story, state officials referred the case to an inspector general and that the Texas Pregnancy Care Network submitted a report detailing how it monitored the subcontractor.
The state requires contractors to submit independent financial audits if they receive at least $750,000 in state money; Texas Pregnancy Care Network meets this threshold. However, its dozens of subcontractors don’t have to submit these audits — something experts in nonprofit practices said should be required. In the fiscal year before the alleged misspending came to light, A New Life for a New Generation received more than $1 million in reimbursements from the state, records show.
When ProPublica and CBS News asked how the Health and Human Services Commission detects fraud or misuse of taxpayer funds, Jennifer Ruffcorn, a commission spokesperson, said the agency “performs oversight through various methods, which may include fiscal, programmatic, and administrative monitoring, enhanced monitoring, desk reviews, financial reconciliations, on-site visits, and training and technical assistance.”
Through a spokesperson, Rob Ries, the deputy executive commissioner who oversees the program at Health and Human Services, declined to be interviewed.
The agency has never thoroughly evaluated the effectiveness of the program’s services in its nearly 20 years of existence.
It is supposed to make sure its contractors are meeting a few benchmarks: how many clients each one serves and how many they have referred to Medicaid and the Nurse-Family Partnership, a program that sends nurses to the homes of low-income first-time mothers and has been proven to reduce maternal deaths. The Nurse-Family Partnership does not receive Alternatives to Abortion funding.
In 2022, the Texas Pregnancy Care Network failed to meet two of three key benchmarks in its contract with the state: It didn’t serve enough clients and it didn’t refer enough of them to the nursing program. The state didn’t withhold or reduce its funding. McNamara disputed the first claim, saying the state changed its methodology for counting clients, and said the other benchmark was difficult to hit because too few clients qualified for the nursing program.
In May 2023, when lawmakers passed the bill rebranding the program, the state also ordered the agency to “identify indicators to measure the performance outcomes,” “require periodic reporting” and hire an outside party to conduct impact evaluations.
The agency declined to share details about its progress on those requirements except to say that it is soliciting for impact evaluation services. Records show the agency has requested bids.
Lawmakers decided last year against enacting requirements that would ensure certain services were evidence-based — proven by research to meet their goals — instead siding with an argument that they would be too onerous for smaller nonprofits.
Texas’ six-week abortion ban took effect in 2021, and more than 16,000 additional babies were born in the state the following year. Academics expect that trend to continue.
But the safety net for parents and babies is paper thin.
Texas has the lowest rate of insured women of reproductive age in the country and ranks above the national average for maternal deaths. It’s last in giving cash assistance to families living beneath the poverty line.
Mothers told reporters they are struggling to scrape together enough diapers and wipes to keep their babies clean. A San Antonio diaper bank has hundreds of families on its waitlist. Outside an Austin food pantry, lines snake around the block.
Howard, the Austin state representative, said ProPublica and CBS News’ findings show that the program needs more oversight. “It is unconscionable that a [Thriving Texas Families] provider would be allowed to keep millions in reserve when there is a tremendous need for more investment in access to health care services,” she said.
Do you have any tips on state-funded anti-abortion programs? Cassandra Jaramillo can be reached by email at cassandra.jaramillo@propublica.org or by Signal at 469-606-9665.
Caroline Chen and Kavitha Surana contributed reporting.
This post was originally published on ProPublica.
Osama Nezar AlSagheer was a 19-year-old Bahraini student when he was arrested in 2017 during the suppression of peaceful protests in Duraz, which concerned the denaturalization of prominent Shia religious figure Sheikh Isa Qasim. During his detention, he was subjected to torture, enforced disappearance, solitary confinement, religious-based insults, religious discrimination, isolation, retaliation, medical neglect, unfair trials, harassment, assaults, and ill-treatment. He is currently serving a 61-year prison sentence in Jau Prison. Osama went on several hunger strikes during his detention to protest his ill-treatment and medical neglect but to no avail.
On 20 June 2016, Bahraini citizens started a sit-in in solidarity with prominent Shia religious figure Sheikh Isa Qasim in front of his house in Duraz. on 23 May 2017, the Bahraini authorities’ violent dispersion of protesters in front of Sheikh Qasim’s house resulted in the death of five people, the injury of more than 100 people, and the arrest of 286 people, including Osama.
Osama had previously participated in demonstrations and had been arrested on multiple occasions when he was a minor for exercising his rights to freedom of expression and assembly. He was first arrested in February 2013 when he was only 14 years old and was detained for 11 days. He was re-arrested during a demonstration in December 2014 and was heavily beaten.
On 23 May 2017, riot police (Special Security Force Command officers) and officers in plain clothing arrested Osama after shooting him during the demonstration with expanding bullets, which led to shrapnel scattering throughout his body. The officers beat him before transporting him to the Criminal Investigations Directorate (CID) and forcibly disappearing him for 45 days. After detaining Osama for 20 days, officers took him to the Public Prosecution Office (PPO) without providing him with adequate time or facilities to prepare for trial. Authorities charged Osama with multiple crimes, including the attempted murder of a policeman.
During Osama’s detention in the CID, officers repeatedly beat him on the head and both hands, which had been injured by pellets during his arrest, in order to extract a confession. They also forced Osama to insult his Shia beliefs, imitate animal noises as a form of degradation, and utter obscenities. Officers allegedly prevented Osama’s family from visiting him for two and a half months until visible injuries had subsided, in order to conceal evidence of torture.
As a result of the torture, Osama suffers from chronic headaches and has lost mobility in his right ring finger. When transferred to the prison clinic on four different occasions, he did not receive effective treatment. Even during one hospital examination, he was still denied treatment despite having shrapnel scattered throughout his body, causing severe pain. After submitting a complaint to the Ministry of Interior Ombudsman, Osama went an additional 19 months without receiving medical treatment but was forced to sign a form stating that he had received treatment.
The court convicted and sentenced him in several cases, totaling 71 years in prison on multiple charges, including 1) illegal assembly, 2) assaulting security forces, 3) possession and use of Molotov cocktails, iron bars, knives, and unlicensed axes to assault police officers for a terrorist purpose, and 4) destroying police cars. He was also stripped of his nationality twice. Throughout these trials, Osama was denied access to his attorney and reported that he was unable to prepare for trials or present evidence in his defense. One of these trials was the mass trial, the rulings of which were issued on 27 February 2019 against 171 Bahraini citizens, known as the “Duraz case.” Osama appealed the various convictions against him, resulting in the reduction of his sentence to 61 years, and his citizenship was restored.
On 14 March 2019, Osama began a hunger strike demanding his right to treatment, the removal of shrapnel from expanding bullets in his body, and his transfer from the ward he shared with ISIS terrorist prisoners who were convicted of rape. He also sought to improve prison conditions and protest against the ill-treatment he had endured from a policeman who entered Osama’s cell several times, shouting, mocking, insulting, and cursing at him for no reason. During this strike, there was no news of him for more than a week.
On 11 September 2019, Osama began another hunger strike, demanding that he be able to have a private visit after refraining from meeting his family, who had come to visit him in prison since 28 January 2019 due to intense pressure and humiliating inspections. He also requested a special visit for his mother, who has heart disease, to ensure she would not be treated harshly. Ten months prior to this strike, Osama had submitted a request for a private family visit that would take place without a barrier separating him from his visitors, but it was not approved. During this strike, he also demanded a quilt and a coat to protect himself from the cold, as the shrapnel from expanding bullets in his body caused him pain accompanied by cold. On 24 September 2019, 13 days after starting his hunger strike, the New Dry Dock Prison administration deprived Osama of his right to call his family and go out to access sunlight in the prison’s outdoor yard as an additional punishment for continuing his strike. During this strike, his blood sugar level dropped to 3.8, and he fainted in the bathroom, suffering a head bleed. This was compounded by ongoing feelings of cold and an inability to sleep due to his deteriorating health condition. On 3 October 2019, after entering the 23rd day of his hunger strike, Osama was transferred to solitary confinement in retaliation for continuing his strike. From his cell, he complained about the extreme cold he was enduring, saying, “I am freezing from the cold, I need a quilt and medical care! Convey my voice to the world!”
On 25 December 2019 and 13 February 2020, the New Dry Dock Prison administration refused to transfer Osama to pre-scheduled medical appointments to address the issue of shrapnel from expanding bullets in his body, without providing reasons.
In May 2020, Osama was transferred from New Dry Dock Prison to Jau Prison. On 15 December 2020, he was transferred from Building 12 of Jau Central Prison to isolation in Building 23 without knowing the reason, but he was returned to Building 12 three days later. On 3 January 2021, Osama was transferred to solitary confinement for unknown reasons.
On 22 March 2021, Osama spoke in an audio recording about being severely beaten and injured in his head, eye, face, and back. He described being dragged down the corridor on 17 March 2021 by prison police officers while staging a peaceful sit-in in Building 12 inside Jau Prison in solidarity with prominent religious figure and political prisoner Sheikh Zuhair Abbas (Ashoor), who was subjected to a violent and sudden beating by a criminal prisoner, which may amount to attempted murder. He mentioned that there was video footage of the incident captured by surveillance cameras in the prison and demanded his right to file a torture report, but the Jau Prison administration did not respond to his requests. Following the spread of the audio recording on social media platforms, the prison administration deprived Osama of his right to contact his family for a month.
On 7 July 2021, a group of Jau Prison officers took Osama out of the ward where he was held and transferred him to solitary confinement without mentioning the reason. He remained there for 14 days, bound with iron shackles, and there was no news of him during this period. On 21 July 2021, officers moved Osama to isolation in Building 12 of Jau Prison, placing him in a small cell where he could not see anyone in retaliation for his persistent demands for his most basic rights as a prisoner. The officers then placed a mentally ill foreign criminal prisoner in the same cell with Osama. While he was in this cell, Osama’s cellmate – who did not speak Arabic and did not share Osama’s religion- harassed him, intruded on him while he was in the bathroom multiple times, and engaged in repeated altercations with him. Osama feared being harmed during his sleep by his cellmate due to the ongoing harassment. Throughout this period, Osama was deprived of prayer as he was unable to hear the call to prayer, and the prison administration refused to provide him with a watch to know the prayer times. Contact between Osama and his family was cut off for over a month after he was transferred to isolation. On 1 September 2021, during a phone call with his family, Osama mentioned being deprived of contact with them for no reason. He also reported harassment from an officer in prison named Ahmed. When Osama asked the officer for the reason behind this treatment, Officer Ahmed stated it was ordered by the prison administration. The officer also threatened and insulted Osama, saying, “You will see when they attack you with a group of police officers and beat you for no reason,” and “You are not even worthy of a shoe!”
On 27 January 2022, Osama was transferred to Building 3 of the Jau Prison, where he was once more placed in isolation with foreign criminal prisoners and drug addicts, despite his refusal to sign the transfer to this building. In March 2022, Osama was placed for several weeks in solitary confinement, and there was no news of him until the end of his solitary confinement on 3 April 2022.
On 18 July 2022, the Special Forces assaulted the prisoners in Building 7 of the Jau Prison who were protesting the deteriorating prison conditions, most notably medical negligence. Osama was among them. The Special Forces sprayed prisoners with pepper spray and tried to force them into their cells. The next day, Osama was transferred to Salmaniya Hospital with his hands handcuffed and his legs chained. On 30 July 2022, Osama spoke in an audio recording about being deprived, along with all Shia prisoners in Jau Prison, of practicing their religious rites and being targeted sectarianly, contrary to allegations published in the official Bahraini media.
On 13 August 2023, during Osama’s participation in a mass hunger strike that lasted 40 days with more than 800 prisoners in Jau prison to protest the poor conditions, Osama fainted and fell to the ground.
Osama continues to suffer from medical negligence for injuries sustained from fissionable bullets fired at him during his arrest, as well as from injuries and health problems resulting from the torture he endured. Moreover, reprisals against him continue intermittently, including repeated solitary confinement, isolation, humiliation, enforced disappearance, and denial of contact with his family. In addition, he still faces discrimination and humiliation based on religion, reprisals, harassment, assaults, and ill-treatment. Since his last arrest, Osama’s family has filed several complaints about the abuse their son endured with the Ombudsman, but to no avail.
Osama’s arbitrary arrest for participating in a peaceful demonstration, enforced disappearance, torture, unfair trials, solitary confinement, sectarian-based insults, deprivation of practicing his religious rituals, reprisals, isolation, denial of contact with his family, medical negligence, harassment, assaults, and ill-treatment violate the Bahraini Constitution as well as Bahrain’s obligations under international law to which it is a party, including the Universal Declaration of Human Rights (UDHR), the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (CAT), the International Convention on the Elimination of All Forms of Racial Discrimination (CERD), the International Covenant on Civil and Political Rights (ICCPR), the International Covenant on Economic, Social and Cultural Rights (ICESCR), and the United Nations Standard Minimum Rules for the Treatment of Prisoners, known as the Nelson Mandela Rules. Furthermore, Osama’s previous arbitrary detentions for participating in peaceful demonstrations when he was a minor and the torture he endured back then are clear violations of the Convention on the Rights of the Child (CRC), to which Bahrain is a party.
As such, Americans for Democracy & Human Rights in Bahrain (ADHRB) calls on the Bahraini authorities to uphold their human rights obligations by immediately and unconditionally releasing Osama and investigating all allegations of arbitrary arrest, enforced disappearance, solitary confinement, torture, sectarian-based insults, denial of his right to perform his religious rituals, isolation, reprisals, denial of family contact, medical negligence and ill-treatment, and to hold perpetrators accountable. Furthermore, ADHRB calls on Bahrain to provide Osama with immediate treatment for all his health problems, including those resulting from the torture he suffered in prison and the injuries he sustained from fission bullet fragments during his arrest. ADHRB urges Bahrain to compensate him for those injuries that were worsened by medical negligence or, at the very least, to grant him a fair retrial, leading to his release. ADHRB also sounds the alarm about Osama’s numerous hunger strikes, which have exacerbated his health issues, and highlights the repeated attacks he has been subjected to by prison officers and fellow criminal prisoners, warning of any dangerous developments that may occur as a result. Finally, ADHRB calls on the Bahraini authorities to conduct transparent investigations into these allegations of ill-treatment and abuse, to identify and hold perpetrators accountable, and end the policy of impunity.
The post Profile in Persecution: Osama Nezar AlSagheer appeared first on Americans for Democracy & Human Rights in Bahrain.
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A landmark Supreme Court decision that reins in federal agencies’ authority is expected to hold dramatic consequences for the nation’s health care system, calling into question government rules on anything from consumer protections for patients to drug safety to nursing home care. The June 28 decision overturns a 1984 precedent that said courts should give deference to federal agencies in legal…
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The Texas Supreme Court found that parents in the state do not have the constitutional right to seek gender-affirming care for their children. The court on Friday upheld the state’s ban on gender-affirming care for transgender youth in a ruling that pushed the state’s interpretation of parental rights into a more limited scope when it comes to medical decision-making. Texas parents are guaranteed…
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Deloitte, a global consultancy that reported revenue last year of $65 billion, pulls in billions of dollars from states and the federal government for supplying technology it says will modernize Medicaid. The company promotes itself as the industry leader in building sophisticated and efficient systems for states that, among other things, screen who is eligible for Medicaid. However…
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On June 1, approximately 50 medical students from Washington University in St. Louis, Saint Louis University, and others interested in the topic gathered at a public library in St. Louis’s Central West End near both campuses to hear neonatal specialist Yassar Arain describe the medical apartheid he experienced while volunteering in a neonatal intensive care unit in Gaza this spring.
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In 2020, Congress passed the No Surprises Act to protect patients from exorbitant medical bills that had burdened Americans with tens of thousands of dollars in debt. The law was designed to decrease the charges for patients treated by an out-of-network doctor during medical emergencies. Such ER visits often left people vulnerable to so-called surprise bills, in which their insurer would only pay a portion of the expensive treatment.
One of the biggest health care reforms since Obamacare, the No Surprises Act appears to have worked in one important sense. Patients have reported fewer crippling bills. Although little hard data exists, an insurance industry survey found that consumers avoided some 10 million surprise bills in the first nine months of 2023. A think tank report also suggests that people are paying less for the care they receive in the ER and other medical situations covered by the law, such as air ambulance trips.
But a cumbersome government system to resolve payment disputes between doctors and insurers now threatens to undermine the law’s promise, according to interviews with industry players, recent data analyses and government documents.
One potential outcome: higher insurance premiums for everyone.
Another: fewer physicians available to treat rural populations.
Doctors said that insurance companies have been abusing the system to lower payments, stiff medical practices and kick physicians out of their networks.
“I’m trying to think of a polite word to describe the experience, but it has been just chaotic and inefficient,” said Dr. Andrea Brault, the head of the Emergency Department Practice Management Association, a physicians’ trade group. “It’s a costly, lengthy process.”
Insurers, however, charged that big physician groups — some of them owned by private equity investors — are trying to manipulate the process to squeeze out higher payments. “A small but significant number of bad actors” have flooded the system with cases “as a way to maximize revenue,” said Kelly Parsons, a spokesperson for the Blue Cross Blue Shield Association. “Should this trend continue, health care costs are likely to rise unnecessarily.”
An official at the Centers for Medicare & Medicaid Services said the rising number of disputes was a byproduct of the law’s success.
“The No Surprises Act is protecting millions of patients from surprise medical bills when they experience an emergency or get care from an out-of-network provider at an in-network facility,” said Jeff Wu, the deputy director of policy of CMS’ Center for Consumer Information and Insurance Oversight. “The incredibly large volume of disputes submitted since the law’s surprise billing protections became effective demonstrates the need for this law.”
For decades, private insurance customers had to worry about receiving giant bills from using out-of-network doctors, who typically charge more for services. This was especially true when they had to go to an emergency room, where people have little ability to choose which doctor or hospital to treat them. The No Surprises Act aimed to fix the problem by protecting ER patients so that they would get billed essentially the same as if they received care from in-network physicians and hospitals.
The law radically changed the dynamics of billing disputes. “Before the No Surprises Act, you had doctors and physicians fighting, with patients stuck in the middle. Now you just have doctors and insurers fighting,” said Zack Cooper, a professor of public health and economics at Yale whose research helped shape the law.
Under the law, out-of-network doctors or hospitals invoice insurers, which counter with their own offer. Some 80% of claims are resolved this way, according to the survey conducted by the insurance trade groups.
But when the two sides can’t agree, they go to battle in a system created by the CMS and other government agencies. There, an independent arbiter weighs various factors and determines the final payment amount. This arbitration is at the heart of many of the law’s unintended consequences.
Originally, the government estimated there would be about 17,000 cases a year. But in 2023, almost 680,000 were filed, according to data released in June. The result is an enormous backlog that has slowed payments to doctors, hospitals and medical groups. Decisions are supposed to take 30 days. Since 2022, however, more than half of the cases remain unresolved. Some have lasted more than nine months. Wu said that arbiters have “scaled up their operations” to reduce the delays.
In addition, the law has been challenged repeatedly in court — health care provider associations and air ambulance groups have filed nearly 20 lawsuits involving the No Surprises Act, according to legal experts at the O’Neill Institute for National and Global Health Law. Two cases have overturned the initial CMS guidelines governing the arbitration. The agency has been forced to make numerous adjustments to the process that have contributed to the long delays.
The most heated debate over the dispute system surrounds the payment and enforcement of arbiters’ decisions.
Federal health officials at first thought that the law would help lower the cost of medical care. Instead, arbiters have awarded higher amounts to doctors and other providers than expected — potentially driving up insurance premiums.
“The most likely outcome is that this law doesn’t save consumers on net and potentially pushes in the opposite direction,” said Loren Adler, a researcher at the Center on Health Policy at Brookings, which issued a recent study on the possibility.
While the amounts are higher than expected, they remain lower than what doctors’ groups have billed. Doctors charge that insurance companies are submitting artificially low payment amounts. As proof, they point to data from June that shows arbiters rule in favor of doctors the vast majority of the time.
Still, overall, providers have seen nearly a 40% decrease in reimbursements since the law took effect in 2022, according to a recent survey by the emergency physicians trade group. At least one doctors’ group, Envision Healthcare, mentioned the No Surprises Act as one of the reasons it filed for bankruptcy. (The company has since emerged from court oversight.)
If revenue decreases continue, some doctors’ groups may have to cut back on services. This would most likely be felt in rural hospitals, which often operate with thin profit margins and already have difficulty recruiting ER doctors. “This is threatening to the sustainability of many, many practices,” said Randy Pilgrim, the enterprise chief medical officer for SCP Health, which provides doctors to emergency rooms across the country. “There have been few practices in the over 30 states where we operate that haven’t been affected by this.”
Doctors have also said that insurance companies are making late or incomplete payments after decisions by the arbiter. Complaints to CMS have been ignored, doctors said. Wu, the CMS official, said the agency actively investigates complaints under its jurisdiction.
It is also not clear whether courts can force an insurance company to pay. Pilgrim said his company had submitted almost 75,000 letters to insurance companies pleading for reimbursements after winning an arbitration decision.
“There’s very little teeth” in the process, he said. “You just continue to plead your case and hope you get somewhere.”
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Los Angeles County supervisors voted unanimously Tuesday to buy up and forgive millions of dollars in medical debt as part of a comprehensive plan to tackle a $2.9 billion burden that weighs on almost 800,000 residents. The measure, authored by supervisors Janice Hahn and Holly Mitchell, allows the county to enter into a pilot program with Undue Medical Debt, previously known as RIP Medical Debt…
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Two years after the Supreme Court overturned Roe v. Wade, the number of abortions performed in the country is up. But that’s only part of the story. In many places, they are also much harder to get or provide. Clinicians nationwide provided more than a million abortions in 2023 — the highest in the country’s recorded history — in the first full year since Roe’s fall, according to the nonpartisan…
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Two years after the Supreme Court decision Dobbs v. Jackson Women’s Health Organization ended federal protections for the legal right to abortion, the number of people traveling across state lines to access abortions has more than doubled. Within the six-month period immediately after the decision, an estimated 27,838 more people accessed abortion outside the formal medical system than would have…
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Unknowns loom, and uncertainty lingers. It’s been two years since the U.S. Supreme Court overturned Roe v. Wade, striking down the federal right to an abortion, limiting access in many states, and potentially exacerbating disparities in who’s most likely to suffer severe complications in maternal health and die. Women wonder whether their doctors should know when they see traces of blood or…
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Sen. Bernie Sanders (I-Vermont) is calling on federal investigators to open a probe into insurance companies that are denying coverage for contraception despite a federal mandate that contraception be free of cost to patients. In a letter sent to the Government Accountability Office (GAO) on Monday, Sanders, the chair of the Senate Health, Education, Labor and Pensions (HELP) Committee…
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A federal analysis released this week projects that U.S. healthcare spending is set to rise to $7.7 trillion by 2032 and account for nearly 20% of the nation’s economy, findings that single-payer advocates described as yet another indictment of the country’s for-profit system and further evidence of the need for Medicare for All. The Centers for Medicare and Medicaid Services’ (CMS) Office of the…
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Private equity’s entrance into health care since 2000 has been dramatic. Both the number of private equity (PE) deals and annual PE investments in health care increased tenfold between 2001 and 2020, and peaked in 2021. Until now, lax corporate transparency and accountability regulations meant that there was nothing anyone could do when corporate owners of health care companies enriched themselves…
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A federal judge has ruled that Florida’s ban on gender-affirming care for transgender children is unconstitutional, invalidating a state law and various other boards of health rules restricting access to such treatments. A law passed by Florida’s Republican-controlled state legislature and signed by Gov. Ron DeSantis (R) last year banned all health providers in the state from providing gender…
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More than eight months into Israel’s devastating assault on Gaza, the territory’s healthcare system is barely functioning, with the World Health Organization reporting this week that there have been 464 Israeli attacks on Gaza’s healthcare system since October 7, affecting 101 health facilities. Gaza’s Health Ministry warns that the few remaining hospitals still partially functioning could…
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When powerful wind gusts created threatening wildfire conditions one day near Boulder, Colorado, the state’s largest utility cut power to 52,000 homes and businesses — including Frasier, an assisted living and skilled nursing facility. It was the first time Xcel Energy preemptively switched off electricity in Colorado as a wildfire prevention tool, according to a company official. The practice…
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One of Montana’s largest health clinics that serves people in poverty has cut back services and laid off workers. The retrenchment mirrors similar cuts around the country as safety-net health centers feel the effects of states purging their Medicaid rolls. Billings-based RiverStone Health is eliminating 42 jobs this spring, cutting nearly 10% of its workforce. The cuts have shuttered an inpatient…
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Louisiana suffers some of the nation’s highest maternal mortality, infant mortality, and incarceration rates, particularly among Black and Brown people, and people living in rural areas. Instead of addressing these problems by funding public hospitals and clinics, anti-abortion politicians are restricting and even criminalizing reproductive health care. Last week, Louisiana’s Republican Gov.
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