Editor’s Note: Iowa Health Care’s cancer network proposal was unanimously approved by The Iowa Board of Regents on Tuesday, Oct. 8.

This story has been updated to include new information.

University of Iowa Health Care and Mission Cancer + Blood plan to join forces to address Iowa’s high cancer rates through its 280 million cancer care network nationwide.

Studies show that Iowa has one of the fastest growing cancer rates in the country.

Mission will soon join UI Health Care to “bring cutting-edge oncology care closer to home for more Iowans, especially in rural areas,” according to a news release.

The son of immigrant parents who came to the United States to escape communism, Yee Leng Xiong said being elected to the 85th Wisconsin Assembly would be “a dream come true.”

First elected to the DC Everest School Board in 2014 at age 19, Xiong went on to win a seat on the Marathon Board of Supervisors in 2016 and on the Village of Weston Board of Supervisors in 2018. He continues to work for the school and the district. board, but now he’s eyeing a new role at the state level.

In an interview with WPR’s Shereen Siewert on “Morning Edition,” Xiong said health care is one of his top priorities if elected in November. He also vowed to work with lawmakers from both parties to address the needs of citizens.

“What I would like to do, without a doubt, is focus on expanding health care and passing bills to address safety and mental health issues in our community here,” said Xiong, who is running for and Democrats. “I think that these are issues that we can all find common ground on. I would also work with people to create consensus and build relationships. Everything depends on building relationships with people along the way. “

Xiong is challenging Republican Pat Snyder for the seat. Snyder has served four terms and was first elected in 2017.

Professionally, he served as the executive director of the Hmong American Center from 2016 until his resignation earlier this year.

This discussion has been edited for clarity and brevity.

Shereen Siewert: The 85th was rezoned in 2023, eliminating other cities in Marathon County. Do you think the marginalization made the race competitive?

Yee Leng Xiong: Indeed, yes. With the change, it is now a 50/50 seat. One of the biggest challenges we’ve had is the fact that Wisconsin was largely built under old maps.

With the new maps now, it makes this seat even more competitive and I’m excited to chat with people at home. We see a lot of progress and a lot of excitement.

SS: How do you plan to address Wisconsin’s current budget challenges, especially in areas like education and health care?

YLX: When it comes to education, we need to be creative. One of the things I learned from my role as a school board member is to be creative in how we fund our programs.

We need to go back and look at how we fund our schools.

In terms of health care, we need to look at expanding BadgerCare and accepting federal dollars to provide health care for more than 89,000 Wisconsinites, allowing federal dollars to return as an investment. in Wisconsin.

SS: What specific steps would you take to improve infrastructure in Wisconsin, including internet access in rural areas?

YLX: For broadband specifically, the Wisconsin Legislature has done nothing to earmark dollars to invest in broadband. The only action in our area made by the Marathon County Board.

The country is very focused on federal dollars and that does not solve the problems that people in their 85s face. One of the things that I like to do is to make sure that we put dollars aside to invest in broadband so that our farmers, the people who live in the countryside, can get the internet.

SS: If elected, how would you work to protect the country’s natural resources?

YLX: One of the things I want to emphasize is supporting policies and initiatives that focus on protecting clean, safe drinking water.

We need to conserve our natural resources while supporting outdoor recreation, while focusing on creating policies and signs that address climate change. At the same time, we need to ensure that our farmers and our agricultural community continue to thrive under those policies.

SS: How can you support initiatives to increase affordable housing options in the district?

YLX: The reason we have high rents and housing prices is because of supply. One of the things we need to do is be creative and make sure we have every option on the table. That includes the ability to look up recommendations for manufacturers or look up area codes.

We need to make sure we’re looking at everything and working with Democrats and Republicans to solve these problems because we can’t afford to let Wisconsin continue to struggle.

This is an issue that affects people very much, whether they belong to the middle class, the upper class or the lower class. We need to do everything we can here to make sure this works.

SS: With the legal system on the rise, what is the most specific way you can work with members of the opposing party on behalf of your district?

YLX: One of the things I’m proud of is the fact that I have a track record of working with people across the board, for example, the school board. We put aside our partisan politics and do what is best for students.

We want to lower the cost of living by addressing child care prices, affordable housing, making sure we protect reproductive rights and keeping our communities safe. I am committed to working with people from all walks of life, Republican and Democrat, to ensure that those issues are resolved.

SS: In September, Wausau Mayor Doug Diny made national headlines when he removed a missing ballot box from the steps of City Hall. The box has been returned. What is your opinion on this matter?

YLX: I contacted the leaders in my area here to condemn and condemn the act. I think it is a violation of democratic rules. We need to make sure that everyone has the opportunity to vote. It is not a side issue. It is about protecting and supporting democracy.

SS: What will it mean to the Hmong community as a whole if you are elected?

YLX: I want to emphasize that if I am elected, I will represent everyone. For me it can only be a dream. I was a child of refugees who came to the United States to escape communism and persecution, and came to the United States to pursue the American dream that I live in.

I am able to do what I do because of the sacrifices of my parents and those who came before me. But I also live my life and I live the American dream on behalf of many who could not come to the United States, who passed by, like my aunt, who stepped on a land mine with me. elder brother, who was buried on the banks of the Mekong River.

I’m doing what I can here and living this dream in the land of opportunity. Thanks to my parents and those who came before me who made this possible.

SS: What makes you a good candidate for the seat?

YLX: I am a person who wants to do things. I want to make sure that I am a person of action. I’m looking for solutions instead of partisan politics, you know, and I’ve done that many times in my career as a school board member and county board member.

I am a good listener. I know the problems we face. That is what makes me the best candidate for this position.

Get all of WPR’s election coverage, including presidential, congressional and legislative races, at wpr.org/election2024.

Among the election ads flooding TV, social media, and street corners, you won’t see any opposition to a ballot measure that recommends spending billions of dollars to pay more doctors for treating low-income patients.

But opponents of Proposition 35 have a warning even if they don’t have the money to pay for ads: The measure could backfire and cost the state billions in federal funding.

Prop. 35 would take existing taxes on health insurance plans and use the money to increase payments to doctors and other providers who see Medi-Cal patients. Its supporters have raised $50 million, from groups representing hospitals, doctors and insurers.

Medi-Cal, the subsidized insurance plan that serves about 14 million Californians, has grown in size over the past decade with increased eligibility and benefits. But those changes did not come with a commensurate increase in payment to doctors.

As a result, health care providers and advocates say very few doctors accept Medi-Cal, leaving patients with nowhere to turn.

According to the California Public Policy Institute, this measure is leading and likely to pass.

But opponents, represented by a small coalition of public health advocates, senior citizens and good government activists, say the details of the proposal put the state at risk of losing billions in federal funding.

That’s because the federal government under the administration of Biden and Trump has warned California that its tax on health plans to support Medi-Cal services takes unfair advantage of a loophole in state law. The federal Centers for Medicare and Medicaid Services is committed to closing that gap, officials wrote in a letter to California officials late last year.

“This is a terrible mistake for this plan,” said Kiran Savage-Sangwan, executive director of the California Pan-Ethnic Health Coalition, which is leading the opposition. “We can all have ideas on how to spend the money, but we have to raise the money first.”

The problem, opponents say, is how California taxes health plans and whether Prop. 35 how does it reduce changes in the future.

Currently, the Management System Tax, also known as the MCO Tax, raises money for Medi-Cal by charging health insurers who serve Medi-Cal and commercial patients. The federal government gives California a dollar match for any revenue generated by the tax. For Prop. 35 is an estimated $7 billion to $8 billion annually through 2027.

However, California has historically placed a higher tax burden on Medi-Cal insurers than commercial insurers. In its letter to federal officials, federal officials said Medi-Cal plans represent 50% of all insured people but bear “99% of the total tax burden.” That goes against the spirit of the law, which is intended to redistribute money from commercial insurers to Medi-Cal plans, officials wrote.

Prop. 35 would cover the tax on commercial insurers at a lower rate. Any attempt to change the tax would have to go back to the ballot box or be approved by three-fourths of the Legislature. Opponents say that means changes in the federal government that require business taxes to be more equal to Medi-Cal taxes will force the state to cut taxes on Medi-Cal plans.

“The result of this is if the federal government follows through on their promise to change the tax laws, the money we collect from this tax will be significantly reduced and we will be leaving billions of dollars on the table,” Savage-Sangwan. said.

Proponents of the measure say the argument is bogus but provide no evidence. They say Prop. 35 will make the Medi-Cal program more stable and higher rates will encourage more providers to see low-income patients.

California’s Medi-Cal reimbursement rates fall in the bottom third of the rest of the state, according to the Kaiser Family Foundation, and rates for specialty services like maternity are among the lowest. the most in the country.

“Prov. 35 is a much-needed investment to protect and expand access to care for Medi-Cal patients and all Californians,” said Molly Weedn, spokeswoman for the E on Prop. campaign. 35, in the sentence. “The primary purpose of Prop. 35 is to provide stability and predictability … to address the significant shortage of providers who can see Medi-Cal patients.”

The California Association of Health Plans said it did not request a business tax break for the proposal and that it has always supported this tax structure to fund Medi-Cal. Higher taxes on business plans can increase fees.

Where is Newsom’s government on Prop. 35?

The largest donors to the campaign are the California Hospital Association, Global Medical Response, and the California Medical Association, which collectively gave $38 million. The opposition has not raised any money, according to state campaign finance reports.

Gov. Gavin Newsom hasn’t taken a formal position on the measure, though he said at a press conference in July that he was concerned about how it would freeze tax revenue for one project. The federal budget he signed that month shifted most of the tax revenue from a tax on health insurers to the general fund to pay for the Medi-Cal program.

If voters approve Prop. 35, the state will face a deficit of $ 2.6 billion in the current budget, which depends on taxes to fill the gaps. That deficit will rise to $11.9 billion over the next three budget cycles, according to an analysis from the Treasury Department.

“This effort is hindering our ability to have the kind of flexibility that’s needed in this time that we live in. But I’m just giving an opinion. Maybe you can read between a lot of the lines,” Newsom said at the conference. the media.

Newsom’s office did not respond to multiple requests about whether he would legally oppose the measure.

Savage-Sangwan said the opposition has not asked for money for its campaign.

“We’re using the smallest megaphone we have to get information,” he said.

Businesses in 2024 measure health care options

Political divide over Prop. 35 is not common. Opponents of the measure are often on the same side as its supporters when it comes to health policy issues in the Capitol. But public health advocates say they’re speaking out because the project’s implications are too dangerous.

“We want to make it clear that the prop’s goals are goals that we agree with. We recognize that our Medi-Cal providers are underpaid and that disproportionately affects people of color, especially children of color,” said Mayra Alvarez, president of The Children’s Partnership, another opposition group.

Some lawmakers agree. During the many budget discussions, Sen. Caroline Menjivar, a Democrat from Van Nuys, came to oppose the proposal in part because the industry groups negotiating who will get the money from the tax have been left out by “public donors” and ” who do not have high-paid investors.”

“By listening to those with boots on the ground, the legislature created a plan to address many of Medi-Cal’s problems fairly over the next several years,” Menjivar said in a statement from the opposition campaign.

The tax is expected to generate more than $30 billion over the next four years. The budget Newsom signed puts most of the money in the state’s general spending account, but sets aside about $2 billion to increase fees for services including public health workers, private nursing , centers for adults and children and children at risk for Medi-Cal. not registered. If Prop. 35 can pass, different groups will be promoted.

Weedn with the Yes on Prop. 35 campaign said that this plan will not cause a reduction if it passes. It will be up to the Legislature to decide how to pay for the programs that opponents are concerned about, he said, and that the measure provides about $2 billion in variable funding each year. year for legal priorities.

It is supported by the California Health Care Foundation (CHCF), which works to make sure people get the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.

Health care is already complicated, expensive and confusing for many people in the US, and it is one of the biggest issues in the 2024 election. Vice President Kamala Harris and former president Donald Trump has both vowed to take this on if he wins—and to do so with policies ranging from reducing drug costs to ensuring access to care. But there are big differences over how their various plans would affect the economics of the US health care system — and the people who face its mandate every day.

Harris says his administration will strengthen the Affordable Care Act (ACA) and expand the savings provisions of the IRA’s. Trump’s presidential record on health care has been mixed, filled with attacks on the ACA and significant cuts to health insurance programs.

Drug Price

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People in the US pay more for medicine than people in other very wealthy countries. Both presidential candidates have emphasized lowering drug prices prominently in their programs, and each has made related policy moves during their time in the White House.

During President Joe Biden’s administration, Harris cast a strong vote to pass the IRA Act of 2022 that sets new limits on drug price increases. The IRA gave Medicare (the federal insurance program for adults 65 and older) the ability to negotiate lower prices for certain drugs. The biggest talking point in Harris’ campaign is the $35 insulin hike. It also made Medicare-covered vaccines free and expanded subsidies to help low-income people pay for better coverage. And it would put $2,000 out of pocket in annual prescription drug spending under Medicare starting in 2025. Cancer drugs, for example, can now cost patients more than $10,000 a year. But the IRA will lower this to $2,000, explains Stacie B. Dusetzina, a health policy and drug price researcher at Vanderbilt University School of Medicine. “This is a huge increase in benefits coming to seniors,” Dusetzina says.

Ten drugs have already been listed for price negotiations, but people won’t start seeing price changes at the pharmacy until January 2026. Harris says, if elected, he will further strengthen the IRA, lower costs of additional drugs under Medicare-even expansion. providing drug coverage under private insurance and Medicaid, the federal insurance program that covers some people with low incomes, certain disabilities or pre-existing conditions. It is uncertain what the fate of the IRA will be under the Trump administration.

“One of the reasons why drug price negotiations have become such a hot topic is that there is concern among Republicans that companies do not have the incentives to invent and develop new drugs” if they can’t find the potential profit, Dusetzina says. . “Many Republican members of Congress have pushed to stop drug price negotiations, and we know that pharmaceutical companies have … sued the government to stop negotiations on select products.” (Several companies have lost their lawsuits, and other lawsuits are ongoing.) If a second Trump administration were to act quickly, it might try to block or to undo the policy before the new prices take effect in 2026, Dusetzina says.

In Trump’s final months in 2020, he issued two executive orders to help lower the cost of prescription drugs. He tried to prevent pharmacy benefit managers—third-party companies that negotiate prices and discounts between drugmakers and consumers—from collecting reimbursement checks on discounted drugs sold to the public. elderly with Medicare to ensure that these people get full money from drug manufacturers. He also tried to push through the “Most Favored Nation”, which would have put certain prescription drugs under Medicare at low costs, close to those paid in other developed countries.

Critics said the Most Favored Nation model would give other countries more control over drug prices. The Biden administration pulled the plug on the order in 2022. In his campaign, Trump initially supported restoring the Most Favored Nation model, but has recently walked back those statements. Dusetzina says there is bipartisan support for reducing drug patents, which would enable generic drugs to enter the market, thus reducing prices.

Affordable Care

In last month’s presidential debate, Trump falsely said he had “saved” the Obama-era ACA, which provides health insurance to more than 21 million people. During the Trump administration, he has repeatedly tried to delete it. Ultimately, he failed, although he persuaded Congress to repeal the ACA’s individual tax penalty, which encouraged people to enroll in health insurance programs. While Trump has been in office, ACA insurance enrollment has dropped from 12.7 million people to 11.4 million, raising premiums for those who remain.

As president, Trump also proposed funding plans that would have cut $1 trillion from Medicaid if approved. The ACA supports a federal funding program that matches 90 percent of the costs to say they choose to expand Medicaid; this extends access to health care services to people below 138 percent of the poverty line. States that accepted the expansion saw a 41.7 percent increase in insurance enrollment as of 2020. Ten states have not expanded Medicaid, creating coverage gaps that studies have shown disproportionately affect people with colors. People with low-wage jobs may also not qualify for Medicaid because their income is still too high by individual states’ standards.

In an attempt to fill these gaps, Trump allowed states to use work requirements—which force Medicaid recipients to prove they work 20 hours a week, participate in community service or otherwise. are eligible for exemption. But mandatory pilot programs in states without Medicaid expansion, such as Arkansas and Georgia, have seen poor enrollment rates and high government costs, says Stephen W. Patrick, a pediatrician and chair of Emory University’s Department of Health Policy and Management. Patrick notes that polls suggest a majority of Georgians favor Medicaid expansion. While the Trump administration has suppressed such requirements, the Biden administration has moved to roll them back, saying work and employment should not be tied to access to health care.

Trump’s position on the ACA has been inconsistent and ambiguous throughout his campaign. He has said he will keep the ACA and strengthen it. In other words he promised to replace it with something better. During his September 2024 interview with Harris, Trump said he had “planning ideas” but did not provide specifics. Trump’s ally, Senator JD Vance of Ohio, recently proposed major changes to insurance risk pools that would make coverage more affordable for those with less medical needs — and it’s expensive. weight for those with higher. This may undo ACA protections that prevent insurers from discriminating against people with disabilities or pre-existing conditions, including chronic conditions or disabilities, or people who are pregnant.

Trump has tried to deal with the medical bill, a byzantine process – and sometimes collapses – for many in the US – online services. However, it may raise some costs.

The Biden-Harris administration has actively promoted insurance enrollment and advocated for ways to strengthen and protect the ACA, Patrick says. On his campaign trail, Harris also strongly touted a proposal that would use unused COVID relief funds to remove $7 billion in medical debt from people’s credit reports. “No one should be denied access to economic opportunity simply because they have a medical emergency,” Harris said in a June press release.

Pandemic Preparedness

The Trump administration has created a Coronavirus Task Force to oversee public health efforts during the COVID pandemic, and has also pushed Operation Warp Speed ​​to rapidly develop life-saving mRNA COVID vaccines by the end of 2020. Although even so, many experts say that the country was not well prepared for this epidemic. because of some of the moves that Trump has made. At the height of the outbreak, he repeatedly downplayed and dismissed advice from public health officials, banned mask mandates and continued to hold large rallies during his presidential campaign. 2020. Since then he has promoted anti-vaccine sentiment; many experts agree that many of the COVID-19 deaths among Trump supporters could have been avoided.

Biden’s American Rescue Plan, created in 2021, helped mobilize the public health response to this epidemic. Federal funds have provided free COVID vaccines, tests and treatment. The project also aims to reduce the racial injustice that has arisen during this epidemic. In 2023 Biden signed legislation to help the country prepare and plan for future pandemics. It also created the White House pandemic preparedness office, which Trump shut down in 2018, to monitor biological threats and diseases — such as the H5N1 bird flu, which recently infected dairy cattle and poultry. US, along with other people. The next administration will have to face the potential threat of an H5N1 outbreak.

Editor’s Note: The Ideas Lab asked Democrat and Republican candidates for the U.S. Senate to submit 1,000-word essays on how they would deal with health care, an issue Wisconsinites surveyed as part of the Main project Street Agenda says it is the third biggest problem they face going forward. The Nov. 5 election

When I was 9 years old, I got very sick and ended up spending three months in the hospital. At the time, my grandparents were taking care of me, and their insurance wouldn’t cover me because I wasn’t their child. After I recovered, my grandparents started looking for insurance that would help me. But no insurance company would cover me at any price, because I was called by those scary words: “pre-existing condition.”

PENTAGON –

The Department of Defense (DOD) today announced a one-year program to provide health support services to DOD civilian employees serving in Japan following a year-long effort to identify and solving problems related to getting medical care.

“The Department recognizes the valuable contributions of our DoD personnel around the world,” said Ashish Vazirani, acting Defense Officer for Personnel and Intelligence. “Following Secretary of Defense Lloyd J. Austin III’s commitment to care for all of our people, we have a responsibility to our citizens to make it easier for them to access health care no matter where they are. Support from this program of airlines will help improve the patient experience for the approximately 11,000 residents of Japan with the new aircraft.

The pilot is called the Pilot Health Insurance Enhancement for DOD Civil Employees in Japan, and it will help civil servants manage their health insurance and the upfront costs associated with obtaining health care services. Japan.

To be eligible, an employee must be enrolled in a health plan that participates in the Federal Employees Health Benefits (FEHB) program. The enrollment window for eligible workers will be the Federal Benefits Open Season, which will begin this Nov. 11 to Dec. 9. Federal Benefits Open Season allows federal residents to enroll or change health care options.

Services provided under this trial will begin on January 1, 2025, when participants can use the services and receive support through a call center. The call center will be open 24/7 and staffed with bilingual service representatives who will assist callers in identifying their needs, making appointments with provider offices, and providing assurances. of advance payment. Dependents are not eligible for services during the trial period, which runs until September 29, 2025.

Employees working in Japan and the following military departments, defense agencies and DoD field operations are eligible for this additional service:

• Department of the Air Force
• Department of the Army
• Department of the Navy
• Defense Information Management Agency
• Defense Management Agency
• Department of Defense Education Work
• Defense Commission Agency
• Defense Contract Management Agency
• Financial Security and Accounting Service
• Defense Health Center
• Operation of Security Systems
• Security Risk Reduction Agency
• National Defense Agency
• Defense Intelligence Agency
• National Center for Geospatial Intelligence

“We are pleased to offer this program,” said Seileen Mullen, who is the Deputy Assistant Secretary of Defense for Health Affairs. “This is a free complementary service, and we encourage Japanese public servants to use it.”

The Office of the Assistant Secretary of Defense for Health Affairs will oversee the pilot program and awarded a $4.2 million contract to International SOS Government Services Inc., which is also the prime contractor for the TRICARE Overseas Program. . The aircraft contract is funded by the military departments, defense agencies and key DoD missions with civilian employees working in Japan.

Active duty service members and primary TRICARE beneficiaries have priority access to health care at military hospitals and clinics in accordance with current federal law and DoD policy. DoD citizens who are not TRICARE beneficiaries may use military health services at an available location.

Agreements with FEHB insurance companies that currently provide coverage for Japanese DoD national employees will be established to provide direct indemnity agreements. Employees of the Provident Fund (NAF) are eligible for this program if they are enrolled in an Aetna International plan.

More details on this pilot program will be announced before the Federal Benefits Open Season begins. This information will be posted on the websites of Japanese military hospitals and clinics in their “Getting Care” section.