POLITICO NIGHTLY: The red lights are flashing in our health care system

 

View in browser   BY JOANNE KENEN Residents and staff gather and dance during an Easter concert at the Ararat Nursing Facility in Los Angeles, Calif. in 2021. Nursing homes around the country continue to experience huge staffing shortages. | Mario Tama/Getty Images HELP DESPERATELY WANTED — Health care is recovering unevenly from the pandemic. Eldercare and care for the disabled are among the hardest hit. How bad is it? The number of nursing home employees dropped from 1.5 million in February 2020 to 1.3 million in December 2022 — a level not seen since 1994 . And it’s not just nursing homes that are precariously short-staffed. Community adult day programs. Home care. Assisted living. Even hospice. Care for our most fragile and vulnerable — an essential social good — is in the midst of a years-long crisis. That has ripple effects throughout health care. When LeadingAge, the trade association for nonprofit aging providers, did a snap poll of its members recently, they all reported that worker shortages are just as challenging now as they were a year ago, when the pandemic was far worse. They don’t have enough workers. And they don’t retain workers; turnover is very, very high . Ruth Katz, the organization’s vice president for policy, told Nightly that the only long-term care provider she’s come across recently that doesn’t have a staffing crisis was a nursing home run entirely by Mennonite volunteers. Some nursing homes aren’t even filling all their beds, because they don’t have enough people to provide care. “They aren’t even keeping waiting lists,” Katz said. Elder care is hard. It requires patience. It requires attention to detail. It is physically difficult and includes lots of lifting and moving. Those who take care of the elderly are not well-paid. One woman I spoke to recently in Texas said the aide who helps her mom, a stroke victim with dementia, makes “about what I made per hour part-time in high school.” Much of the burden falls on families — some 53 million Americans are family caregivers. Many give up paid jobs, or downshift to part-time. The squeeze from the professional workforce shortage only makes the family tasks bigger. Right now, several factors are making the care workforce shortage even more acute. In the overall U.S. economy, there are around 1.7 jobs open for every one person looking , meaning people who might have worked as caregivers now have other options, with better pay. To attract or retain workers, a retail chain or a fast food joint can add a few pennies to the price of Band-Aids or burgers. In fact, that’s exactly what they are doing, one contributor to the inflation we’re experiencing. But much of elder care — whether long-term care or shorter-term rehab and recovery — is paid by Medicaid and Medicare, and the government sets the rates. Congress is utterly disinterested in spending more on health at the moment. Another potential solution is giving special visas to more nurses or other caregivers to enter the country. A recent study for the National Bureau of Economic Research, co-authored by Harvard’s David Grabowski, one of the top experts on nursing homes, found that immigration has “a very positive effect” in nursing homes. Patients get more care, and they get better care. Katz also noted that many elder care workers are already foreign born. But pretty much anything to do with immigration is a nonstarter on Capitol Hill. Soon, the problem might get more complicated. The Center for Medicare and Medicaid Services, which has stepped up oversight after Covid infections tore through nursing homes, plans to release nursing home staffing requirements this spring — which some in the industry say will just make matters worse. In the process, CMS has heard from relatives of people in nursing homes who “voiced concerns related to residents not receiving adequate care due to chronic understaffing in facilities.” Families reported that their loved ones go entire shifts without even the most basic assistance, like help getting to the bathroom. That leads to falls, when fragile people try to get up themselves, or to hard-to-heal pressure ulcers — aka bed sores — if they are left lying in one position for too long. For Katz, the workforce crisis is the flashing red light signaling that we just aren’t facing up to the demographics of an aging America. That requires a culture shift, she said, respecting the hard work caregiving entails as well as better understanding our elders. “Whether you are working in a department store or Disneyland,” she said, “you are going to need to know how to deal with older people.” Welcome to POLITICO Nightly. Reach out with news, tips and ideas at nightly@politico.com . Or contact tonight’s author on Twitter at @JoanneKenen .   STEP INSIDE THE WEST WING : What's really happening in West Wing offices? Find out who's up, who's down, and who really has the president’s ear in our West Wing Playbook newsletter, the insider's guide to the Biden White House and Cabinet. For buzzy nuggets and details that you won't find anywhere else, subscribe today .     WHAT'D I MISS? — FBI makes arrest in investigation of suspected leaker of classified intelligence: The FBI said it has made an arrest and is conducting a search of a home at a residence in Massachusetts , according to a statement by the agency. It appears to be the home of the mother of the suspected leaker of the classified documents that have circulated on social media in recent days. The home is located in North Dighton, Massachusetts, the FBI said — the same town where the potential leaker and his mother live, according to a review of public records by POLITICO. The New York Times was the first to report that the leaker is likely Jack Teixeira, 21, a member of the Massachusetts Air National Guard. — Appeals court keeps abortion pill on the market but sharply limits access: A federal appeals court ruled late Wednesday that an abortion pill can remain on the market but only under strict conditions that prohibit its use beyond seven weeks of pregnancy and bar its distribution by mail. In a 42-page decision, a three-judge panel of the 5th Circuit Court of Appeals agreed to temporarily block the central aspect of a Texas-based federal judge’s ruling that suspended the FDA’s 2000 approval of the drug, mifepristone. But by a 2-1 vote, the panel permitted other aspects of that ruling to take effect that would block a seven-year effort by the FDA to widen access to the drug. — Capitol Police officer who sought to protect Jan. 6 rioter sentenced to home incarceration: A Capitol Police officer who tried to help a Jan. 6 rioter avoid detection from law enforcement was sentenced today to 120 days of home incarceration for obstructing justice . Michael Riley, a decorated 25-year veteran of the Capitol Police who was one of the first officers to respond to pipe bombs found at the RNC and DNC on Jan. 6, delivered a tearful apology in the courtroom, describing “awful judgment” in the days following the attack that led him to attempt to aid a member of the mob. NIGHTLY ROAD TO 2024 MYSTERY MAN — Sen.Tim Scott (R-S.C), who announced an exploratory committee on Wednesday, remains a mysterious factor in the Republican primary field , reports POLITICO’s Natalie Allison. Donors float him as a potential alternative to Donald Trump, should Florida Gov. Ron DeSantis stumble. And Scott’s genteel personality and lack of past Trump entanglements could give him unique appeal to independents and a newer swath of GOP voters. A foregone conclusion, though, is that evangelicals — with all their subsets and denominations — will be his top constituency. TRIPPED UP — Tim Scott has quickly discovered how tricky abortion politics can be when forced to discuss them on the national stage. POLITICO’s Natalie Allison and Lisa Kashinsky write. On his second day of campaigning since announcing a presidential exploratory committee, the South Carolina Republican senator pivoted, deflected and avoided specifics when repeatedly pressed on where he stood on federal abortion restrictions. THE BOT PRIMARY — Coordinated groups of inauthentic accounts have been attempting to influence online conversations around the 2024 elections for the better part of a year , reports ABC News. According to the Israel-based, social analysis firm Cyabra, someone created thousands of automated Twitter accounts that appear to be praising Trump and criticizing his political rivals on both sides of the aisle. AROUND THE WORLD U.S. President Joe Biden shakes hands with Brazilian President Luiz Inacio Lula da Silva at the White House. | Alex Wong/Getty Images ORGANIZING WITHOUT BORDERS — Luiz Inácio Lula da Silva arrived in Washington earlier this year in the glow of a glorious comeback, writes Alexander Burns . Freed from prison, elected to a new term as president of Brazil and triumphant over a Jan. 6-style insurrection, the left-wing populist seemed to embody the endurance of democracy in an era of extremism. But in private meetings with progressive lawmakers and labor leaders, Lula delivered a dire message , according to four people present for the discussions. Though poisonous demagogues had fallen in both Brazil and the United States, Lula warned that a global web of right-wing forces continued to threaten political freedom. Voters crushed by economic inequality and confused by a torrent of social-media disinformation remained vulnerable to figures like Donald Trump and Jair Bolsonaro, the brutish strongman whom Lula barely defeated last fall. In Washington, the 77-year-old Brazilian leader issued a call to battle: The left needed to build its own transnational network, Lula said, to fight for its political values and take on crises like economic deprivation and climate change. In Lula’s meeting with congressional progressives, Rep. Ro Khanna (D-Calif.) said Lula described a certain form of progressive politics — focused on economic advancement for the working class and fighting climate change — as the antidote to a mood of despair that feeds authoritarian politics. “One of the interesting insights he had was that there was a movement, not just in Brazil but around the world, of anti-politics,” Khanna said, “and that people have so lost faith in organizing and political activity, they have bought into the narrative that everything is corrupt, everything is broken and politics doesn’t matter.”   GO INSIDE THE 2023 MILKEN INSTITUTE GLOBAL CONFERENCE:  POLITICO is proud to partner with the Milken Institute to produce a special edition "Global Insider" newsletter featuring exclusive coverage, insider nuggets and unparalleled insights from the 2023 Global Conference, which will convene leaders in health, finance, politics, philanthropy and entertainment from April 30-May 3. This year’s theme, Advancing a Thriving World , will challenge and inspire attendees to lean into building an optimistic coalition capable of tackling the issues and inequities we collectively face. Don’t miss a thing — subscribe today for a front row seat .     NIGHTLY NUMBER $6.05 billion The sale price of the NFL's Washington Commanders , a record amount of money for a North American sports franchise. Current Commanders owner Dan Snyder is selling to a group led by investors Josh Harris and Mitchell Rales that includes Magic Johnson. The deal still needs to be approved by the league and fellow NFL owners. Snyder has been under fire for years and is in the midst of multiple investigations from the NFL and Congress into workplace misconduct and potential improprieties including sexual harassment. RADAR SWEEP A DIFFERENT KIND OF HOME — Across England, increasingly more people are moving into caravans — essentially mobile homes or trailers. In 2021, there were 104,000 households in caravans officially — 19,000 more than a decade ago. For some people, it offers flexibility not present when renting a home. But far from everyone lives in caravans by choice; a roiling housing crisis in England has made it difficult to afford or stay in homes. Daniel Lavelle takes us inside these caravan parks for The Guardian, speaking to residents and painting a picture of why people end up in caravans and the challenges associated with living in one. PARTING IMAGE On this date in 1955: Workmen label the priority packages of Salk polio vaccine for distribution to West Coast points. The Salk vaccine, just approved, helped to essentially eradicate polio around the world. | Ernest K. Bennett/AP Photo Did someone forward this email to you?  Sign up here .   Follow us on Twitter Charlie Mahtesian @PoliticoCharlie Calder McHugh @calder_mchugh Katherine Long @katherinealong   FOLLOW US

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"This is our moment": US Sen. Elizabeth Warren visits Chatham PART 2

 

"This is our moment": US Sen. Elizabeth Warren visits Chatham

Sarah Carlon Cape Cod Times 

Published May 1, 2022 

What the Cape wants to know

People from across the Cape attended the event and questions from the audience covered a range of topics.

The Q&A opened up with Warren's thoughts on the politicization of the Supreme Court. 

"We have an extremist Supreme Court, one that is way out of mainstream American thought," Warren said. 

Despite a challenge to Roe v. Wade being one of the biggest cases the Supreme Court will hear this year, only a marginal percentage of Americans are in favor of its repeal, she said.

"Back in the day, some of the court was liberal, some conservative, but that is just not where we're at right now," she said. "There's nothing sacrosanct about the court. It's been changed seven times, and I'm in favor of changing it for an eighth."

Resources for better elder services

One woman who identified herself as Deb asked the senator about care services for the elderly.

"There is a crisis in elder care and home care, and here on the Cape we're really struggling," she said to Warren.

Warren said that alongside her work on more funding for high-quality universal child care, she also sits on the Senate Special Committee on Aging.

The committee is working on a bill that is "lined up and ready to go" according to Warren that sends federal funding to both home- and community-based elder care.

"We need to get the wages up for both home- and community-based care so we can get the money to the states who can then get it down to the local level," she said. "We cannot ask caregivers to subsidize this work. It has got to be a federal thing."

Environmental issues and climate change

The environment was on the minds of attendees at the meet-and-greet as well.

Rosemary Shields from the Cape Cod League of Women Voters asked Warren for her thoughts on plans to potentially dump one million gallons of radioactively contaminated water from the now-closed Pilgrim power plant into Cape Cod Bay.

"The Nuclear Regulatory Commission needs to be on someone's side besides the nuclear industry," Warren said in response. "It's been been slow to get people in place, but you've done a wonderful job on the Cape in pushing back and saying to the NRC that their job is to watch out for us, not industry."

Another man who said he lives in Chatham made the point that the town is "one Category 3 hurricane away from devastation."

"What can happen at the federal level to address climate change?" he asked.

Warren said while funding to start addressing the climate crisis was included in the now-defeated Build Back Better bill, she has not given up hope.

"The infrastructure package has pieces for climate change, like electrification of school buses or public buses and trains," she said. "There's $9 billion available in infrastructure for Massachusetts, with $1 billion of it for bridges, but the rest of the money is so this can be done at a local level."

Student loan forgiveness on the horizon?

Becca, a Northeastern University graduate, asked Warren what her back-up plan is if President Biden does not forgive more student loan debt.

"There is no plan B. You need to do this, Mr. President. There is no exit door for him on this," she said. "He has the power. Trump forgave student loan debt, as did Obama, and Biden has already forgiven $18 billion already, but now is the moment for him to make a real difference in the lives of millions of people."

In an interview with the Times prior to Saturday's event, Warren said she is optimistic the president will grant further student loan forgiveness.

But while Biden has said he is taking a "hard look" at student loan forgiveness, Warren conceded it will likely be less than the $50,000 she has pushed for.

"We are seeing that a post-high school degree is becoming increasingly a necessity," she sad. "Public education helps to close the opportunity gaps in the country, but every kid willing to work hard and to work more, that opportunity has disappeared."

Warren feels further loan forgiveness will help rather than hinder the Democrats in the upcoming midterms, and many Republicans are trying to block debt forgiveness because they know it is popular. 

"Americans want to see student loan debt eliminated," she said. "We don't build a future for rich kids to go to college and come out debt-free, and kids that are not as fortunate to have to start the adult race 100 yards behind the line."

What's next for Democrats and uncertainty for 2024

Many of the questions for the senator followed a similar theme: uncertainty for the future of the country and the prospects of Democrats in 2024.

One man named Simon brought up President Biden and Vice President Harris' low approval ratings, and wondered what Warren thought of the Democrats chances going into the midterms.

Another woman named Jane noted that she found a book in her living room from 1965 about world hunger that she said sounds like it could have been written today.

"When are Democrats going to get tough?" one woman finally asked Warren.

Not soon enough, says Warren.

"I'm sick to the teeth with what's going on in D.C.," Warren said. "We need to be and needed to be tough, but as your senator, I feel torn. I only have 24 hours in a day and 7 days in a week, and I want to get all of this other stuff done."

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"This is our moment": US Sen. Elizabeth Warren visits Chatham PART 1

 

"This is our moment": US Sen. Elizabeth Warren visits Chatham

Sarah Carlon Cape Cod Times 

Published May 1, 2022 

'This is our moment'

 In Chatham visit, Warren urges Cape Codders to stay involved and push lawmakers on climate change, child care, student loan forgiveness   

U.S. Sen. Elizabeth Warren, met a packed room of Cape Codders with questions to spare at a Saturday meet-and-greet in the Chatham Community Center.

On hand were state Sen. Julian Cyr, D-Truro, and state Rep. Sarah Peake, D-Provincetown, who introduced Warren.

"I feel a little bit like the opening act," Peake joked. "But I don't need to tell anyone in this room what a hero Elizabeth Warren is."

"One of the things I love about Massachusetts is that people actually show up for events here," Warren remarked after a standing ovation from the crowd. 

Warren urged the crowd  to let the government know the people are paying attention.

She launched, in her words, into a "speed-dating" update of what she's been working on and her projects for the future, including climate change efforts, economic recovery in the face of the pandemic and recent inflation, universal child care, the housing crisis and student loan forgiveness.

"We are at a fork in the road going into 2022," she said. "This is our moment. Send an email to your representatives, call the White House, text your friends, raise these issues. Hearing from you is what makes democracy work."

Warren said the nation has made great strides since Joe Biden became president.

"Remember where we were about a year-and-a-half ago," Warren said. "Donald Trump was still president, vaccines were impossible to find, economists were saying it was going to take four to six years to dig out of the pandemic. So, we roll forward."

Since the beginning of the Biden administration, COVID-19 vaccines and testing are now "free and available to all" and despite recent problems with inflation, low rates of unemployment suggest a "strong underlying economy" in the country, she said.

"On the economic front, we are working on bringing prices down for families," Warren said. "I am tired of corporate price-gouging."

The senator made sure to touch on topics that she and her colleagues weren't able to deliver on as well— particularly voting rights and abortion access in health care.

Even with these setbacks, Warren isn't deterred.

"Get us some Democrats and we'll get it done," she said. "I am staying in the fight."

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