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Coverage denied: Patients suffer as layers of companies profit

Marcela Villa isn’t a big name in healthcare, but she played a crucial role in the lives of thousands of Medicaid patients in California. Her official title: denial nurse.

Each week, dozens of requests for treatment landed on her desk after preliminary rejections. Her job, with the assistance of a part-time medical director, was to conclusively determine whether the care—from doctor visits to cancer treatment—should be covered under the nation’s health insurance program for low-income Americans.

…“These private entities get very little oversight,” said Linda Nguy, a policy advocate at the Western Center on Law & Poverty in Sacramento, “and there’s real harm being done to patients.”

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Gavin Newsom’s first hires suggest the next California governor has big health care plans

 

Gavin Newsom might not be able to accomplish his ambitious campaign goal of bringing government-funded universal health care to California, but his first hires suggest he’s planning something big.

Incoming chief of staff Ann O’Leary helped develop the Children’s Health Insurance Program when she worked in the Bill Clinton White House.

…Matosantos, who once worked for the Senate Health Committee, will serve as liaison between Newsom and the state agencies and departments he oversees.

Her background at the Department of Finance during the recession might make her more hesitant to increase state spending, said Jen Flory, a policy advocate at the Western Center on Law and Poverty.

“She was in charge of Finance during some really challenging times,” Flory said. “I don’t think that anyone has any blinders that she’s just going to throw money around.”

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Western Center Submits Comments Opposing Public Charge Rule Change

Western Center has submitted comments to the Department of Homeland Security in opposition to the Trump administration’s proposed Public Charge rule changes, joining over 150,000 others. An excerpt from Western Center’s comments are below, and the full comments are available here.

As California’s oldest and largest legal services support center, we have over
50 years’ experience fighting to reduce poverty in our state through the courts, the
legislature, and by working with state and local agencies to ensure our laws are fair and
justly implemented. We can speak directly to which federal and state policies serve to
reduce poverty in our communities thus benefitting our state and country as a whole
and which policies worsen poverty, penalize families struggling to make ends meet, and
hurt us all.

The recent notice of rulemaking proposes sweeping and very harmful changes to the
current public charge test – the test used to determine which immigrants are
inadmissible when they seek to enter the country or adjust their status to that of
permanent residents. The proposed regulations would punish immigrants, mostly those
who are people of color, for any use of a broad swath of public benefits, including
health, nutrition, and housing assistance, and further punish low-to-moderate income
families solely for their lack of wealth. This would be a radical departure from current
agency guidance that limits public charge determinations to those who are primarily
dependent on cash benefits and long term care medical services, and even then, only
after examining the totality of the circumstances.

Simply stated, laws and regulations that increase barriers to safe and affordable
housing, food, and health care are not only harmful in the short run, they have been
proven to have lasting detrimental effects throughout the lifetime of an individual and
even on the next generation. In other words, harsh and punitive short term spending
cuts generally backfire by decreasing the ability for individuals to support themselves
and their families. People cannot go to or do their best at work or school when they are
hungry or sick.