David Machledt

@machledtdc.bsky.social

Give me a bike, time to adventure, and family and friends to share it with. Also, a lot of health policy, but the views here are my own.

When they get back in power, Democrats need to go all-in on higher education. We need a campaign of reinvestment in public universities across the country that makes the Morrill Land-Grant Act look like nothing by comparison *and* a GI Bill of Rights-style program of tuition grants.

The New Republic@newrepublic.com · 2w ago

Trump is banning students majoring in degrees that don’t make enough money from taking out college loans. Degrees for social work, art, religious studies, teaching aides, and music will be hit the hardest. trib.al/kQdKbY1

A KFF analysis finds that 28.5 million people in the U.S. have limited English proficiency. People with limited English proficiency are over 3x as likely to be uninsured as people who are English proficient and report greater challenges accessing care. https://on.kff.org/4xFLrV1

Chart showing health coverage distribution among individuals by English proficiency. English proficient: 36% Medicaid or other public, 57% private, 7% uninsured. Limited English proficient: 40% Medicaid or other public, 37% private, 23% uninsured. Source: KFF, ACS 2024 data.

Amid uncertainty, Elevance Health said they may exit certain Medicaid markets in the coming months. Our new policy watch examines recent and anticipated Medicaid managed care rate setting challenges and the potential implications of MCO exits: https://on.kff.org/4hEOmbK

The image is a pie chart titled "Five For-Profit, Publicly Traded Companies Have Almost Half of the Medicaid MCO Market." It shows the share of total comprehensive Medicaid managed care organization (MCO) enrollment as of July 1, 2024. The chart is divided into sections: Centene (18%), Elevance Health (11%), UnitedHealth Group (9%), Molina (7%), Aetna/CVS (3%), 10 Other Multi-State Parent Firms (15%), and 121 Local/Regional MCOs (36%). The total MCO enrollment is 66.5 million. The source is KFF.

A second lawsuit has been filed with respect to the Trump Administration's flawed interpretation of the medically frail provision of the Medicaid work reporting requirement coming to a neighborhood near you on 1/1/27. Thank you to the plaintiffs and litigators!

National Health Law Program@nhelp.bsky.social · 3w ago

BREAKING🚨@nhelp.bsky.social, @democracyforward.org & our partners filed a lawsuit to protect Medicaid access for people with serious health conditions. Learn more about the case and the people impacted: healthlaw.org/news/medicai...

The multifront effort at HHS “has raised concerns among some officials over the past few months that change is moving too quickly, with inadequate evidence of the technology’s safety and effectiveness… They also worry about outsized influence of Silicon Valley investors”

Trump Administration Moves to Integrate A.I. Into Medical Care Despite Concerns

Federal projects are rolling out A.I. agents that offer therapy and prescribe medicine, raising concerns about safety and the influence of venture capital investors.

nytimes.com

Those who sent remittances contributed over $2.7 trillion, which is 10% of the US GDP in 2023. Remittances represent only 3.5% of all the wealth created by immigrant workers in the U.S., underscoring how much more immigrants give to the US economy than they send abroad. scholars.org/contribution...

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Ernesto Castañeda@drernestocast.bsky.social · last mo.

Remittances are crucial for Latin America, but sending them means family division. While benefiting recipient countries, the US also gains significantly.

BREAKING: The Missouri Supreme Court has placed the redistricting referendum on the ballot. It has also barred the use of the 2025 map in the general election. The 2022 map that almost guarantees Emanuel Cleaver's victory will be in effect. ENORMOUS

The policy most likely to help many states gain the workers they need is also the one many of their elected officials are most likely to resist: more immigration. A new study estimates that a 1% increase in a state’s population from increased immigration would raise private-sector GDP by 1.5 %

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“I ran from bullies as a kid. Many of us did. What 36 years of this fight have taught me is that the bluster is the act itself. [They] never actually chased me. They were [just] hoping I wouldn't turn around and push back.” – James Dale, Lambda Legal board member and former client via @usatoday.com

Hegseth bullied Scouting America. One lawsuit made him fold. | Opinion

Secretary of Defense Pete Hegseth said he forced Scouting America, formerly Boy Scouts, to purge 'an insidious, radical, woke ideology.' I sued.

tinyurl.com

We’ve loved this program, and our daughter knows the books come from “Miss Dolly”. We are about to age out but it’s a wonderful way to introduce your kids to the wonders of reading. Thank you Miss Dolly, your legacy lives on in all of us.

The 51st@51st.news · last mo.

NEW: After family members announced Dolly Parton’s death on Tuesday, tributes immediately came rolling in. One local tribute, in particular, stood out: @dcpubliclibrary.bsky.social's. @ecwilliams.bsky.social reports on the world-famous singer-songwriter and actor's impact in D.C.:

Underappreciated: US farmland *already substantially produces energy, not food*, and does so very inefficiently. Corn ethanol (~40% of all US corn) requires about 100 times more land per vehicle-mile driven than solar photovoltaics -> electric vehicles. Shifting corn to solar *would free up land*.

Cameron 🇺🇸🗽🦅@cameroncorduroy.bsky.social · 2mo ago

anytime people raise concerns about land use for solar projects or anything like that i just want to point out that half the corn we grow in this country gets used to make gasoline slightly worse

When algorithms determine Medicaid funding, transparency matters. Nebraska uses interRAI, a set of assessment tools that evaluates a person’s needs, strengths, and preferences to determine a score that helps set funding levels for people with disabilities. omaha.com/news/state-r...

Nebraska's new disability assessment tool causing troubles for some families

Some families in Nebraska's disability community are frustrated with interRAI, a tool to assess individuals with intellectual or developmental disabilities. Changes from the assessment have been disru...

omaha.com

Here are the 8 states that could see the biggest reductions in Medicaid payments to hospitals: CA ($7.4B), IL ($4B), KY ($3.9B), TB ($3.5B), NC ($3.4B), LA ($3.3B), AZ ($3B) and MI ($2.6B). More in our new analysis: https://on.kff.org/4fYwfgh

At Least 37 States Have Medicaid State Directed Payments for Hospital Services That Could Be Reduced by the 2025 Reconciliation Law Limits. The KFF map shows states with SDPs for hospital services that are likely to decrease because current payment policies exceed limits in the 2025 reconciliation law.

Very interesting. Georgia is requesting the full 90% Medicaid expansion match w/o full expansion. Both Obama and Trump 1 administations said no to similar requests. Georgia officials say new federal Medicaid rules threaten state’s partial expansion program georgiarecorder.com/2026/08/14/g...

Georgia officials say new federal Medicaid rules threaten state’s partial expansion program • Georgia Recorder

New federal guidelines would make the state’s Medicaid program financially unsustainable, state health officials said.

georgiarecorder.com

RFK Jr. and Oz attacked California for its Medicaid home care, citing growth as proof of fraud. For @motherjones.com, I reported on how the growth isn't proof of fraud, and growth of participants is proof the program is more accessible than in other states. www.motherjones.com/politics/202...

California does Medicaid home care well. They're being punished for it.

Republicans are deferring $850 million from the state because of unfounded fraud claims.

motherjones.com

Trump’s changes to SNAP and Medicaid, including new eligibility and work requirements, are poised to cost states billions and have heightened fears that more Americans will lose access to the nation’s safety net. Visit our dedicated trend page for more.

Medicaid/SNAP | News From The States

The Trump administration’s tax and spending plan, signed last year, made major changes to the Supplemental Nutritional Assistance Program (SNAP) and Medicaid, including new eligibility and work…

newsfromthestates.com