This Memorial Day, President Trump took aim at North Carolina Gov. Roy Cooper and threatened to pull the Republican National Convention out of Charlotte, saying that Cooper couldn't guarantee that the venue would be filled to capacity.
In a series of tweets, Trump said that although he loves the state of North Carolina so much that he "insisted" on having the convention there.
"Unfortunately, Democrat Governor, @RoyCooperNC is still in Shutdown mood & unable to guarantee that by August we will be allowed full attendance in the Arena," he wrote. "In other words, we would be spending millions of dollars building the Arena to a very high standard without even knowing if the Democrat Governor would allow the Republican Party to fully occupy the space."
Trump went on to say that Republicans who are headed to North Carolina "must be immediately given an answer by the Governor as to whether or not the space will be allowed to be fully occupied."
"If not, we will be reluctantly forced to find, with all of the jobs and economic development it brings, another Republican National Convention site. This is not something I want to do. Thank you, and I LOVE the people of North Carolina!" Trump wrote.
According to CNN, Trump's tweets "completely blindsided" GOP officials and other involved in the convention's planning.
CNN reports that RNC Chairwoman Ronna McDaniel said that the Trump campaign, the RNC, and host committee are moving "full steam ahead" in planning the convention but will later assess if any changes need to be made due to the coronavirus.
"We do not think at this time we have to switch to an alternative plan, but of course, we will monitor circumstances and adjust accordingly," she said, adding, "We will not be holding a virtual convention."
Egypt's top medical union on Monday warned of a "complete collapse" of the country's health system, accusing the health ministry of negligence in failing to protect healthcare workers from coronavirus.
"The syndicate is warning that the health system could completely collapse, leading to a catastrophe affecting the entire country if the health ministry's negligence and lack of action towards medical staff is not rectified," the Egyptian Medical Syndicate said in a statement.
COVID-19 has killed 19 doctors and infected more than 350, according to the EMS, a body representing thousands of Egyptian doctors.
"The EMS holds the health ministry entirely responsible for the mounting deaths and infections among doctors due to its negligence... that is tantamount to death through a dereliction of duty," it added.
Egypt, the most populous Arab country, has recorded more than 16,000 COVID-19 cases and over 700 deaths.
The EMS called on the "executive, judicial and legislative" branches of government to force the health ministry to comply with its demands.
These included providing all doctors with personal protective equipment (PPE), training for dealing with coronavirus cases and testing for those with symptoms or who have come into contact with infected people.
Hospitals have been hit by a flight of doctors abroad in recent years while the frontline staff left behind face shortages of medical supplies and protective gear that heightens the risk of infection.
The EMS statement came after 32-year-old doctor Walid Yehia died on Saturday after being unable to secure a bed in an isolation hospital.
The country's 17 isolation hospitals reserved for novel coronavirus patients reached their maximum capacity at the start of the month, deputy health minister Ahmed al-Sobki told local press last week.
A colleague resigned in protest from the same Cairo hospital where Yehia worked.
In a widely shared online post, the co-worker blamed the health ministry for not treating Yehia as soon as he showed symptoms of the virus.
In recent weeks Egypt has sent medical aid to countries including China Italy and the United States, angering many medical professionals, who complain about the lack of PPE domestically.
"The health ministry has an obligation towards doctors and all medics who are sacrificing their lives on the front lines to defend the safety of the homeland," the EMS said.
"It is imperative to provide them with the necessary protection and rapid medical intervention for those who contract the disease".
New comments from the renowned academic come after he accused Trump of wanting "to destroy the prospects for all organized human life... in the near future."
World-renowned intellectual and author Noam Chomsky called U.S. President Donald Trump a "sociopathic megalomaniac" whose leadership drove the U.S. to become "singularly unprepared" for the coronavirus pandemic.
Chomsky's fresh criticism of the president came in an interview with Agence France-Presse published Monday.
"The White House," said Chomsky, "is in the hands of a sociopathic megalomaniac who's interested in nothing but his own power, electoral prospects."
Trump "doesn't care what happens to the country, the world," though he's still reliant on "his primary constituency, which is great wealth and corporate power," Chomsky said.
The administration has "no coordinated plan" for addressing the pandemic, meaning the nation will see "a lot more" deaths from Covid-19 on top of the nearly 100,000 confirmed fatalities that have already occurred, he added.
Setting the stage for the current situation is that Trump kicked off his administration by moving to take apart "the entire pandemic prevention machinery," including by "canceling programs that were working with Chinese scientists to identify potential viruses," Chomsky said.
Another contributing factor to the flawed response, said Chomsky, is that the nation is "in the stranglehold of private control," an example of which is the lack of a national single-payer healthcare system. "It's the ultimate neoliberal system, actually," he said.
While Chomsky predicted a recovery from the pandemic will come eventually and "at severe cost," the same cannot be said of the climate crisis. "There isn't going to be any recovery from the melting of the polar ice caps and the rising of sea levels," he warned.
Chomsky's fresh comments to AFP follow similarly scathing recent rebukes of the Trump administration.
In an interview earlier this month with the Guardian, Chomsky was asked if Trump was "culpable in deaths of Americans."
"Yes," responded, "but it's much worse than that, because the same is true internationally. To try and cover up his criminal attacks against the American people, which have been going on all of this time, he's flailing about to try and find scapegoats."
Chomsky also recently took aim at Trump's policies that are worsening the climate crisis, telling Canada's National Observer last month that the U.S. president "wants to destroy the prospects for all organized human life. And in the near future. That's what it means to maximize the use of fossil fuels, to cut regulations that might diminish or restrict that danger."
But as bad as Trump is, Chomsky noted that the groundwork was laid well before the failed business owner walked into the Oval Office. In an April interview with Democracy Now!, Chomsky said:
Trump is taking a failing, lethal system and turning it into a monstrosity, but the roots were before him. Just think back to the reason why the pandemic occurred in the first place. Drug companies are following capitalist logic. They don't want to do anything. The neoliberal hammer says the government can't do anything the way it did in the past. You're caught in a vise. Then comes along Trump and makes it incomparably worse. But the roots of the crisis are pre-Trump.
The same with the healthcare system. Like we know that—everyone knows—they should know the basic facts. It's an international scandal: twice the costs of comparable countries, some of the worst outcomes. The costs were recently estimated by a study in The Lancet, one of the world's leading medical journals. They estimated that the costs, the annual—annual costs to Americans are close to half a trillion dollars and 68,000 lives lost. That's not so small.
Going forward, Chomsky suggested there are lessons to be learned from the coronavirus crisis.
"One lesson is that it's another colossal failure of the neoliberal version of capitalism. Massive failure," Chomsky toldEfe last month.
"If we don't learn that lesson," he said, "it's going to recur worse next time."
North Carolina Gov. Roy Cooper's (D) office on Monday responded to President Donald Trump's threat to move the Republican National Convention out of Charlotte if the state does not allow full attendance in the midst of the coronavirus pandemic.
In a series of tweets on Monday, Trump suggested that the convention would be moved unless the party is allowed to "fully occupy" Charlotte's Spectrum Center, which holds nearly 20,000 people.
"Unfortunately, Democrat Governor, @RoyCooperNC is still in Shutdown mood & unable to guarantee that by August we will be allowed full attendance in the Arena," Trump said. "In other words, we would be spending millions of dollars building the Arena to a very high standard without even knowing if the Democrat Governor would allow the Republican Party to fully occupy the space."
In a statement, a spokesperson for Cooper said that the state would be "relying on science and data" to inform public health policy.
"State health officials are working with the RNC and will review its plans as they make decisions about how to hold the convention in Charlotte," the statement said. "North Carolina is relying on data and science to protect our state's public health and safety."
A group of right-wing protesters held a demonstration in front of Kentucky Gov. Andy Beshear's mansion this Sunday, at one point hanging an effigy of the governor on a tree in what looked to be a mock lynching. According to CNN, the protest was advertised on Facebook as a Patriot Day Rally to exercise Second Amendment rights.
The backlash against the group's actions was swift, with even Mitch McConnell slamming the move as "unacceptable."
"There is no place for hate in Kentucky," he tweeted.
Responding to the backlash, one of the protest's organizers took to Facebook and said that this is what happens when people have "stood by and watched this Governor drag people thru the mud and do nothing."
"People have had enough, the rallies that you attend and speak at, do absolutely nothing to help the people of this State," Kentucky 3Percenters Inc. State Secretary Patsy Kays Bush on Facebook. "It was not racist it was radical...You can condemn it till the cows come home but screaming and shouting in a microphone is not the answer any longer,....maybe it was in bad taste, maybe it was severe, maybe it was unexpected but at least it was something and I personally will stand by it to the absolute end."
The protesters, who are part of a militia group that advocates for gun rights, were protesting against Beshear's coronavirus restrictions at a Second Amendment rally in Kentucky over Memorial Day weekend.
Journalist Soledad O'Brien fired back at Fox News personality Tomi Lahren after she called Americans "sheep" for following pandemic safety rules on Memorial Day.
"I gotta hand it to COVID-19, you sure did expose the sheep among us," Lahren wrote in a tweet over the Memorial Day weekend.
O'Brien responded with a flurry of tweets making the point that nearly 100,000 Americans have died in the pandemic so far.
"I think she means to say—on a day when we honor those who gave their lives in service, we think of the 100,000 Americans, who have died in the midst of a pandemic," O'Brien wrote. "We think of the millions who have lost their livelihoods, and those who are fearful of what the future holds."
"We reflect with sympathy on those who have lost loved ones—unable to hold their hands or kiss the goodbye one final time," she continued. "We are sympathetic to those trying to juggle their kids’ remote-schooling and work zoom calls and cooking and cleaning and life."
In a column for Washington Monthly, Annie Kim suggested that Donald Trump will likely be handcuffed by his own economic policies as he attempts to deal with the collapse of the U.S. economy in large part due to the coronavirus pandemic that raged out of control on his watch.
With close to 40 million Americans now unemployed and the president's administration pumping trillions into the economy to keep the country afloat as businesses shutter, Kim suggested that Trump is in a major bind of his own making that could cost him re-election.
Noting that the president has already taken to boasting "Vaccine or no vaccine, we’re back," as businesses slowly restart opening after shutdown orders to slow the spread of COVID-19, the columnist stated that the reality on the ground is quite different.
"For all his cheerleading, Trump is unlikely to get the kind of robust rebound he’s hoping for—in large part due to sabotage inflicted by his own policies," she wrote. "Thanks to his administration’s early and ongoing failures to address the coronavirus outbreak, much of the nation still lacks the testing and contact tracing infrastructure necessary to control the virus’s inevitable resurgence. Mixed messaging from federal and state officials and patchwork guidance from location to location have also heightened the anxiety for Americans, most of whom remain reluctant to leave their homes."
Complicating the president's desire for a rapid economic recovery are his own fiscal policies put in place during his three and a half years in office.
"Another handicap will be the fragility of the American economy, brought upon by the Trump’s pre-pandemic fiscal recklessness. When the president assumed office in an emerging recovery from the Great Recession, he had a golden opportunity to shore up the nation’s fiscal reserves and invest in its economic resilience," she explained. "Instead, he pushed through one of the largest corporate tax cuts in history, padding the bank balances of billionaires while miring the rest of the nation in eye-watering levels of debt. As a consequence, America entered the Covid-19 pandemic already financially crippled. Now, in the face of the greatest economic crisis since the Great Depression, it is ill-positioned to aid its citizens, let alone rebuild for the future."
Trump's signing of the 2017 tax bill that "permanently slashed the corporate income tax rate from 35 percent to 21 percent," is proving to be the biggest mistake of his presidency now that country has been ravaged the health crisis, she explains.
"At the time, Republicans touted the measure as a bonanza for job growth and worker wages. Predictably, however, companies didn’t respond to the tax cuts by creating more jobs. Instead, they engaged in a record-breaking number of stock buybacks to pump up share prices, while most of the individual tax breaks benefited the nation’s wealthiest families," she wrote. "The only thing the legislation really accomplished was to blow a crater-sized hole in the federal budget, which until then had seen six straight years of declining deficits under President Barack Obama."
"Since the passage of the first tranche of coronavirus relief bills, including the CARES Act, the federal budget deficit is projected to reach a whopping 17.9 percent of GDP this year, according to the Congressional Budget Office (CBO), a level unmatched since World War II. Public debt, meanwhile, will exceed the size of the entire economy, according to the Committee for a Responsible Federal Budget (CRFB)," she elaborated, before adding, "Rather than tax cuts for corporations and the very rich, Trump could have pumped more resources into the nation’s workforce development and adjustment programs. That would have been beneficial no matter what, but it would have cushioned the blow of disruption for the more than 36 million Americans now unemployed since mid-March. He could have restored our infrastructure for public health, so that the nation could in fact have “the best testing in the world,” not just his empty boast to that effect. He could also have continued to pay down the national debt and built a rainy-day reserve for crises precisely like the one we’re facing now."
"As badly bungled as his pandemic response has been, Trump’s pre-pandemic policies and priorities will prove equally destructive," she wrote before concluding, "The result: Whenever the pandemic ends, America’s convalescence will be long and slow."
Two such Trump supporters are Andy and John Schlafly, the sons of the late right-wing anti-feminist icon Phyllis Schlafly who recently wrote a column attacking conservative Texas Gov. Greg Abbott for funding a test-and-trace program instead of simply flooding the state with hydroxychloroquine, the unproven COVID-19 treatment that several studies have found to be ineffective at combating the disease.
"The $295 million that Abbott is spending on contact tracing could have purchased HCQ treatments for half of the entire State of Texas, to reopen the state without the need for oppressive monitoring," they argued.
DeAnna Lorraine Tesoriero, a failed GOP congressional candidate and a QAnon conspiracy theorist, recently went so far as to ask her followers to not get tested for COVID-19 -- because she feared that contact tracers would reach out to her if they tested positive.
"She also appears to misunderstand contact tracing, claiming that contact tracers go through phone 'contact' lists, rather than in-person contacts," writes Sommer, who chalks up Tesoriero's anti-contact tracing rant to "ignorance."
And Fox News host Laura Ingraham even went so far as to compare people working as contact tracers to radical French Jacobins intent on overturning the American Revolution.
According to a report from the New York Times, a substantial amount of federal funds that were designated to support hospitals overwhelmed by the coronavirus pandemic ended up being shipped off to major hospital chains already flush with cash in the bank.
The report begins by noting that Providence Health System, one of the country’s largest and richest hospital chains, was the recipient of $509 million in government aide even though the company is loaded with so much money it invests its excess cash and reaps big rewards.
According to the Times, the Seattle-based hospital chain "invests in hedge funds, runs a pair of venture capital funds and works with elite private equity firms like the Carlyle Group," adding, "It is sitting on nearly $12 billion in cash, which it invests, Wall Street-style, in a good year generating more than $1 billion in profits."
"With states restricting hospitals from performing elective surgery and other nonessential services, their revenue has shriveled. The Department of Health and Human Services has disbursed $72 billion in grants since April to hospitals and other health care providers through the bailout program, which was part of the CARES Act economic stimulus package," the report states before adding, "So far, the riches are flowing in large part to hospitals that had already built up deep financial reserves to help them withstand an economic storm. Smaller, poorer hospitals are receiving tiny amounts of federal aid by comparison."
According to research group Good Jobs First, a review of federal data reveals that twenty large healthcare chains were the recipients of more than $5 billion in recent weeks with the Federal government preparing to pump another $100 into the pipeline.
"Those hospital chains were already sitting on more than $108 billion in cash, according to regulatory filings and the bond-rating firms S&P Global and Fitch. A Providence spokeswoman said the grants helped make up for losses from the coronavirus," the Times reports. "Those cash piles come from a mix of sources: no-strings-attached private donations, income from investments with hedge funds and private equity firms, and any profits from treating patients. Some chains, like Providence, also run their own venture-capital firms to invest their cash in cutting-edge start-ups. The investment portfolios often generate billions of dollars in annual profits, dwarfing what the hospitals earn from serving patients."
Noting that many of those same hospital groups, including Providence, are nonprofits, and thus "generally don’t have to pay federal taxes on their billions of dollars of income," the Times notes smaller hospitals without the pull in Washington D.C. with the help of lobbyists are barely hanging on as COVID-19 patients overwhelm their capabilities.
The Times reports that the Health and Human Services department "devised formulas to quickly dispense tens of billions of dollars to thousands of hospitals — and those formulas favored large, wealthy institutions."
"One formula based allotments on how much money a hospital collected from Medicare last year. Another was based on a hospital’s revenue. While Health and Human Services also created separate pots of funding for rural hospitals and those hit especially hard by the coronavirus, the department did not take into account each hospital’s existing financial resources," the reports states, adding, "Hospitals that serve a greater proportion of wealthier, privately insured patients got twice as much relief as those focused on low-income patients with Medicaid or no coverage at all, according to a study this month by the Kaiser Family Foundation."
According to Niall Brennan, president of the nonprofit Health Care Cost Institute, “If you ever hear a hospital complaining they don’t have enough money, see if they have a venture fund. If you’ve got play money, you’re fine.”
According to a report from The Guardian, major pharmaceutical companies threw up roadblocks to a plan by the European Union to push forward with a major vaccine research effort well before pandemics hit.
The report notes that back in 2017, the EU's executive branch pushed a proposal to put the development of vaccines on the fast-track only to have major drugmakers reject the suggestion.
"The commission’s argument had been that the research could 'facilitate the development and regulatory approval of vaccines against priority pathogens, to the extent possible before an actual outbreak occurs'. The pharmaceutical companies on the Innovative Medicines Initiative (IMI), however, did not take up the idea," the report states.
According to the report, the IMI includes "representatives of a group that includes GlaxoSmithKline, Novartis, Pfizer, and Johnson & Johnson as members," and receives funding from the EU set at $54.4 billion.
"The world’s 20 largest pharmaceutical companies undertook around 400 new research projects in the past year, according to Bloomberg Intelligence. Around half were focused on treating cancer, compared with 65 on infectious diseases," the Guardian reports. "There are eight potential vaccines for coronavirus in clinical trials, but there is no guarantee of success. One of the most promising, being developed at Oxford University, is said to have only a 50% chance of being approved for use. The COE report says that rather than “compensating for market failures” by speeding up the development of innovative medicines, as per its remit, the IMI has been 'more about business-as-usual market priorities'."
The Guardian report adds, "Minutes of a meeting of the IMI’s governing board from December 2018 reveal that the proposal was not accepted. The IMI also decided against funding projects with the Coalition for Epidemic Preparedness Innovations, a foundation seeking to tackle so-called blueprint priority diseases such as Mers and Sars, both of them coronaviruses."
On Monday morning, MSNBC "Morning Joe" regular Jonathan Lemire claimed that Donald Trump's manic spree of ugly tweets aimed at his critics -- combined with White House attacks on presumptive Democratic presidential nominee Joe Biden -- shows that the president and his campaign are "flailing" because they know the election is likely lost.
With host Joe Scarborough asking, "What is going through the president's mind? What is his state of mind? Why does he seem even more unbalanced and unmoored today than he has over the past three and a half turbulent years?" Lemire stated the combination of the coronavirus pandemic with its mounting death toll and the collapsing economy is more than the president can handle.
"These are the things the president knows are going to very much damage his re-election chances," Lemire reported. "Obviously, he's never been one to show much in the way of empathy. He struggled with previous tragedies. a hurricane or forest fire but he's rarely talked about that in terms of this pandemic. He's rarely offered sympathy to those gone."
Continuing in that vein, while discussing the president's ugly Twitter smears over the weekend, he offered, "What we're seeing here is a frustration from a president who is not overseeing the country that he wanted."
"More than that, [he] is unable to run the campaign he wanted," he added. "He thought, as of a couple months ago, he'd be running a campaign on the back of a robust economy, he'd be able to talk about Obamagate and deep state. He'd be able to dwell on Joe Biden's latest gaffe and none of that is in the cards right now."
"We're seeing him desperate, he and his allies trying to revive that over the weekend with seizing upon the Biden joke.," he continued. "There is this frustration here, this flailing from the White House, from his campaign team, knowing that right now, his own internal polls say if the election were held today, he would lose."
"That has led to, more than anything, a sort of unmoored, unhinged Twitter spree that we saw this weekend, instead of a focus on those who have died in the pandemic," he concluded.
Texas had the highest uninsured rate of any state before the outbreak. It's also among a minority of states that have declined to expand Medicaid coverage to people with incomes near or below the poverty line.
Laci Crosson’s son doesn’t have pills to manage his attention deficit disorder.
Betty Canales is worried about how she’ll pay for her diabetes medication.
Stevie Smith saw a doctor after she was furloughed — and paid more than double her usual price.
With the U.S. economy flailing as the country contends with the coronavirus pandemic, more than 1 million Texans havelikely suffered the double whammy of losing their jobs and their employer-based health insurance. Some have landed in the state’s patchy health care safety net, where advocates say they could be cut off from physical and mental health services while facing the economic strain of a public health crisis.
Researchers estimate that between 25 million and 43 million people in the U.S. will lose health insurance through their employers in the coming months if the unemployment rate grows to 20%. It’s already near 15%, a record high since the Great Depression.
The situation is particularly dire in Texas, where state officials have restricted access to publicly funded health insurance programs for the poor and have led the charge to toss the Affordable Care Act in court.
Already home to more than 5 million uninsured residents — or about 18% of its population, the highest uninsured rate of any state — Texas is in the minority of states that have declined to expand Medicaid coverage to people with incomes near or below the poverty line.
The result: Of 1.6 million Texans who have likely lost employer-sponsored health insurance during the pandemic, 30,000 would be eligible for Medicaid if the state expanded the program, according to recent estimates from the Kaiser Family Foundation.
Instead, they’re uninsured, and many more are expected to join them.
Texas’ approach stands in contrast to the 36 states that have expanded Medicaid to cover adults who earn less than 138% of the poverty line, about $36,000 a year for a family of four.
More than half of the newly uninsured residents in those states will qualify for Medicaid, leaving less than one quarter of unemployed workers without insurance, according to projections from the Urban Institute.
In Texas and the other states that rejected Medicaid expansion, one-third of the newly jobless are estimated to get Medicaid, with 40% becoming uninsured.
Among the affected is Crosson, 35, a stay-at-home mom whose husband was laid off in March from his job as a heavy equipment mechanic.
Crosson hustled to get her two youngest children enrolled in Medicaid. But for the adults, including her eldest son, who has ADHD and takes Adderall, there was nothing, said Crosson, who moved to Fort Worth last fall.
Her son’s been without his medication.
Crosson herself recently had a medical emergency, coming down with a bad bout of pneumonia just weeks after her husband was laid off. Bedridden for days, and with her husband worried she had the coronavirus, Crosson went to the hospital and was quickly asked, “Do you have health insurance?”
She received a flu test, strep test, chest X-ray, electrocardiogram and a bill she fears she won’t be able to pay. The family’s already lost a storage unit because they couldn’t afford the payments, and they are downsizing to a smaller house.
Her husband seemed depressed at first. “I can't blame him. I was like that for a little while myself,” Crosson said.
A lack of options
There are few choices for adults who lose their job-based health insurance.
They can pay the full premium, an expensive option called COBRA that temporarily extends their coverage. The average annual cost is about $7,200 for a single person or $21,000 for a family of four, according to the Kaiser Family Foundation.
If their annual income is above the poverty line — about $26,000 for a family of four — they can purchase a plan on the Affordable Care Act’s health insurance marketplace, which offers a subsidy to offset some of the cost.
And in limited circumstances in Texas, there’s Medicaid.
Texas has the strictest Medicaid eligibility in the country, and adults are unlikely to qualify for the public insurance program unless they are pregnant or have a disability that keeps them from working. A single parent with two kids could not make more than $300 or so a month.
The restrictive criteria have left a gaping health insurance hole for people who aren’t poor enough to qualify for Medicaid but make too little to get subsidies in the federal marketplace.
Before the pandemic, about 761,000 Texans, many of them working, fell into this coverage gap. Another 382,000 could soon join their ranks because of soaring unemployment, according to estimates from the Kaiser Family Foundation.
The impact may not be felt fully for months, when the unemployment benefits that have buoyed Texans’ incomes — in some cases allowing them to get subsidies in the marketplace — expire this year.
But already, health centers have reported hearing more and more from people asking what to do if they’ve lost their job and benefits.
At People’s Community Clinic, which treats underserved and uninsured Central Texans, there’s been an influx of calls from established patients who say they’ve lost insurance and want to talk to a financial counselor, said Chief Executive Officer Regina Rogoff.
“I think we’re beginning to capture the beginning of this unemployment wave,” said Rhonda Mundhenk, chief executive officer of Lone Star Circle of Care, which has clinics in Central Texas and Houston. “We have always existed to catch folks who fall into the uninsured category. But the scale of what the entire nation is experiencing now is what is radically different and requires different solutions, particularly if the economy doesn’t recover quickly.”
“We have always existed to catch folks who fall into the uninsured category. But the scale of what the entire nation is experiencing now is what is radically different and requires different solutions, particularly if the economy doesn’t recover quickly,” says Rhonda Mundhenk, CEO of Lone Star Circle of Care. Photo credit: Angela Piazza for The Texas Tribune
Lone Star clinics offer financial screenings to see if patients qualify for federal, state or county health programs — including one in Travis County for low-income residents. Not everyone will be eligible.
Among the newly uninsured is Canales, 52, who hasn’t had coverage since she was laid off from her job as a receptionist for a large Dallas-area restaurant company in late April. She and her partner have an 18-year-old daughter who can likely be covered by Medicaid until her 19th birthday, but Canales has not found an affordable source of coverage for herself.
She is diabetic and typically visits the doctor every three months to get bloodwork and prescriptions for the six medications she takes for various conditions: blood pressure, diabetes, cholesterol, neuropathy.
The diabetes medications alone cost more than $1,000 for a 90-day prescription, an out-of-pocket cost Canales said she can’t afford.
Her medicine cabinet is stocked for about a month.
“I worry, because where am I going to get the money to get my medicine?” she said. “People like me, [who] work and lose what they had, we need something to be able to fall back on until we can get back on our feet and regain everything.”
Effect on mental health services
Mental health professionals and advocates worry the loss of insurance will further hurt Texans already grappling with depleted incomes, home schooling and other demands brought on by the pandemic.
The cost to buy treatments and services out of pocket can be prohibitively expensive without insurance — and losing access to that medical care can be devastating, said Greg Hansch, executive director of the National Alliance on Mental Illness Texas.
Hansch spoke with one man who has a schizoaffective disorder, was furloughed and might not be able to afford a medication, Latuda, which can cost upwards of $1,300 for 30 tablets.
He “expressed extreme distress, frustration and worry. The medication that he was receiving through his health insurance plan is fundamental for his recovery,” Hansch said. “All of a sudden, the rug is swept out from under his feet, and he's not just worried about his quality of life. He's worried about his life itself — it’s a matter of life and death for him.”
Hansch is trying to help him find prescription assistance programs.
The man, a Pflugerville resident, said he has enrolled in an insurance plan on the federal marketplace that kicks in next month. In the meantime, he worries he’ll end up in a psychiatric ward. He’s already called several in Austin to see what precautions they’re taking to prevent the spread of COVID-19.
The rising unemployment rate and loss of job-based insurance could also deter Texans from seeking mental health services like therapy or counseling, said Alison Mohr Boleware, government relations director for the Texas chapter of the National Association of Social Workers.
“When people lose jobs or part of their household income, mental health treatment can be seen as a luxury that ‘can wait,’” she said.
There are free counseling services available, including through employers.
Some newly uninsured people have paid out of pocket for medical care they don’t want to postpone.
Smith, for example, spent $73.50 for a telehealth visit to keep a prescription filled, well above the price she paid while insured.
Before the pandemic, she worked in two bars and a coffee shop. When she was furloughed in March, one of her bosses gave her paperwork to help her enroll in a new health plan. But when Smith saw the options would cost between $174 and $250 a month, she thought, “I can’t pay that,” and declined.
Stevie Smith saw a doctor after she was furloughed — and paid more than double her usual price. Photo credit: Ben Torres for The Texas Tribune
She quickly applied for unemployment, food stamps and Medicaid, listing her income as $0. She was rejected for Medicaid.
“The fact that the better plans are only available through work, but then they’re precarious because of that, doesn’t make any sense,” Smith said.
Medicaid expansion
Texans who’ve lost health insurance this year have fewer options than their neighbors in states like Louisiana and New Mexico, said Anne Dunkelberg, a health policy expert for the left-leaning Center for Public Policy Priorities.
“Essentially everyone in the health care world sees [Medicaid expansion] as essential for a million reasons,” she said.
For adults covered by the expanded program authorized under former President Barack Obama’s signature health law, the federal government pays 90% of costs. In Texas, the federal government pays about 60% of the costs of the more limited program, which mainly covers low-income children, pregnant women and adults with disabilities.
Supporters of expanding Medicaid say the state’s share of the program would pay for itself by creating new health care jobs, boosting tax collections and reducing state spending on other safety-net health programs that many uninsured Texans rely on. And many counties in Texas already raise property taxes to fund health programs for the poor and uninsured.
But Medicaid expansion has been a tough sell for Texas Republicans since 2012, when the U.S. Supreme Court ruled that the federal government could not require states to opt into the program. With the pandemic tanking Texas sales tax collections, the state’s conservative leadership may be even less keen to spend new funds to cover 10% of the program’s costs.
Abbott has mostly remained mum on the subject since the virus reached Texas this spring. A spokesman for the governor did not respond to emailed questions for this story.
A porous safety net
Even Texans who should have qualified for Medicaid have struggled to get coverage and are buckling under the added strain of the pandemic.
Deborah Durst, a single mom with two daughters, one with a heart defect, has been out of work since September. Her unemployment benefits ran out in February. Although she was able to get both her children on Medicaid, her application for the same program has been held up for months. In the meantime, she’s struggled to find work, homeschool her kids and navigate the state’s meager safety net.
The stress began to affect her health, Durst feared. She paid out of pocket to see a cardiologist in March after she began convulsing one night, feeling tingling in her extremities and having heart palpitations.
“It’s on top of looking for work, on top of dealing with medical issues or trying to deal with insurance, on top of dealing with unemployment. It’s on top of dealing with this virus — it's so many stress factors, all at once,” Durst said. “That's what I think caused me to have a heart issue … and being a single mom being on my own. There's no partner; there's no break.”
National Suicide Prevention Lifeline: 800-273-8255
Texas COVID-19 Mental Health Support Line: 833-986-1919
This story was produced in part with funding from the Ravitch Fiscal Reporting Program at the Newmark Graduate School of Journalism and is part of a national project on how adequate state safety nets are for the pandemic recession.
Disclosure: The Center for Public Policy Priorities has been a financial supporter of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.
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