NEW YORK -- Two Republican senators are working on a new bill to "repeal and replace" Obamacare, and analysts say it would hit New Yorkers hard.

Sens. Bill Cassidy, R-La., and Lindsey Graham, R-S.C., reportedly are working with the White House on a bill that would cut Medicaid, institute a per capita cap on Medicaid benefits, and replace health insurance marketplace subsidies and the Medicaid expansions with diminishing block grants that would end totally in 2026.

According to Jacob Leibenluft, senior advisor with the Center for Budget and Policy Priorities, the plan would devastate health coverage in states such as New York that have succeeded in enrolling many low- and moderate-income people in Medicaid and marketplace plans.

"What you see in New York is in 2026, $22 billion would be cut from federal support for health care,” Leibenluft said. “And what that means is that New York in many ways would be a victim of its own progress with much larger cuts than many other states."

Under the Cassidy-Graham bill, some states, such as Alabama and Mississippi, initially would get more federal health care money, but that would disappear when the block grants ended.

Liebenluft pointed out that, on top of the overall cuts, the bill would redistribute the reduced federal funds across the states, based largely on criteria unrelated to actual spending needs or gains under the Affordable Care Act.

"What you see under this plan,” he said, "is some states are really devastated in the near term, some states are just hurt some in the near term, but in the long run every state would lose out significantly."

He said once the block grants end, the bill essentially would be a repeal of the ACA, without a viable replacement.

But the Cassidy-Graham bill is not the only option to reform the health care system. Leibenluft noted that, after the July vote that stalled efforts to repeal Obamacare, several senators from both sides of the aisle committed to work together on a solution.

"This is an effort to stabilize the Affordable Care Act, improve the health care system and try to find ways to work in a bipartisan manner to lower costs and improve coverage,” he said.

The Senate will be holding hearings on the bipartisan effort to fix the health care system early next month.


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Toughing it out during spring allergy season is not in your best interest if you want to avoid asthma later in life.

New Mexico has plenty of grass and weed pollens carried by the wind which contribute to itchy, watery eyes, a stuffy nose and sneezing fits this time of year.

Dr. Osman Dokmeci, associate professor of internal medicine at the University of New Mexico, suggested for those who suffer acutely, seek an allergy test and possibly medication to prevent asthma from taking hold.

"One out of 10 has asthma in America," Dokmeci pointed out. "Having seasonal allergies increases your chance of developing asthma at least fivefold."

He recommended treating allergies early and as aggressively as possible. May is "Asthma Awareness Month," which aims to bring attention to the health issue and highlight improvements in care and quality of life. Nationwide, asthma affects more than 25 million Americans, including 4 million children, and disproportionately affects certain racial and ethnic groups.

Allergies do not "cause" asthma but people who have allergies, or have family members who have allergies, are more likely to get asthma than those who do not. Research shows allergy season is starting earlier and lasting longer. A 2022 study from the University of Michigan found pollen count could increase by 200% by the end of the century due to climate change, which is why Dokmeci stressed it is important not to ignore the problem.

"There's no treatment that actually makes your asthma not happen," Dokmeci explained. "But once you develop asthma, there are good treatment options."

The estimated economic impact of asthma is more than $80 billion per year from direct and indirect costs, such as missed school and workdays.

Recent research shows approximately half of people who die by suicide had contact with a health care professional within the month prior to their death.

However, a recent study shows only 8% of hospitals are currently implementing all four recommended suicide prevention practices: safety planning, warm handoffs to outpatient care, patient follow-up and lethal means counseling.

Melissa Tolstyka, director of Behavioral Health Services for Trinity Health Ann Arbor, said a seamless transition from inpatient to outpatient care is critical. At Ann Arbor, she saw a 46% increase in compliance with comprehensive suicide risk assessments and patients discharged on the suicide care pathway now receive a safety plan, which she sees as progress.

"We continue to see a need for really robust programming," Tolstyka explained. "Not just within the behavioral health world, but in the medical world as well. Our organization really wanted to focus on bringing the behavioral health and the medical services together to enhance our safer suicide care practices for our patients."

The initiative is being piloted across various units at Trinity Hospitals in Ann Arbor and Grand Rapids including the emergency department, psychiatric medical and inpatient nursing units. If you or anyone you know is struggling or in crisis, help is available 24 hours a day, seven days a week, by calling or texting 988, the Suicide and Crisis Lifeline.

Casie Sultana, clinical nurse leader for Trinity Health Grand Rapids, prioritizes patient well-being, emphasizing support and improvement over solely managing risks within the facility.

"We want to be someplace that people feel welcome to come to who are dealing with suicide," Sultana emphasized. "You feel so alone. It's a very lonely journey and we want people to come seek help and feel welcomed when they do that."

Susan Burchardt, clinical services manager at Trinity Grand Rapids, advised other hospitals considering a similar program to learn from organizations already using it.

Support for this reporting was provided by The Pew Charitable Trusts.


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Access to reduced-price medication is a necessity for many rural Missourians with low income.

Rep. Cindy O'Laughlin, R-Shelbina, the Senate Floor Leader, said Big Pharma is trying to confuse legislators with unrelated hot-button topics such as abortion access and illegal immigration in a last-ditch effort to stop the state from joining a program to force drugmakers to sell medicines at a discount.

"Appealing to nuclear topics, which really do not apply in this situation, is a disingenuous way to try to defeat a bill that is actually good for Missouri," O'Laughlin asserted.

O'Laughlin pointed out the program is transparent, and uses the tax money saved to help low-income families deal with chronic conditions such as diabetes.

The drugmakers object to the government forcing them to give significant discounts, arguing hospitals' and for-profit pharmacies' bottom lines, particularly those owned by pharmacy benefits managers, are being exploited. Nationally, 46% of contract pharmacy agreements involve pharmacies linked to the three largest benefits managers.

Rep. Tara Peters, R-Rolla, introduced the 340B contract pharmacy access billand said the lobbying is absurd.

"Federally, 340B program does not allow for abortion drugs," Peters stressed. "Why would any legislation that we're trying to pass in the state allow for that? I mean, the thought of that even being in existence is absolutely ludicrous."

The Missouri Senate passed the bill 27-3 on Monday and it now goes to the House.


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