Health
RFK Jr. Appears Unfamiliar With Key Elements of Medicare and Medicaid
In a tense exchange with Senator Bill Cassidy, Republican of Louisiana, Robert F. Kennedy Jr. displayed a surprising lack of familiarity with Medicare and Medicaid, the government programs responsible for covering more than 150 million Americans.
At times, Mr. Kennedy seemed to confuse the two programs. Medicare is a federal program that provides coverage to older and disabled Americans, while Medicaid is a state-federal program that covers low-income people.
When he first described Medicare, he seemed to ignore the half of the Medicare program that relies on private insurance plans to provide care. Later, he acknowledged that he was enrolled in a private Medicare Advantage plan and said he thought “more people would rather be on Medicare Advantage because it offers very good services.”
Medicare Advantage plans have been heavily criticized by lawmakers, including by federal regulators Mr. Kennedy would oversee if confirmed and by public advocacy groups. They have accused the plans, including those offered by the nation’s biggest insurers, of overcharging the government, delaying and denying access to care. Regulators have penalized some insurers for overbilling.
Mr. Kennedy described Medicaid as “fully paid for by the federal government.” In fact, Medicaid, which provides health insurance coverage to nearly 80 million low-income Americans, is financed through a combination of state and federal funds.
Mr. Kennedy also claimed that many Medicaid enrollees were frustrated by high costs they face with their public insurance coverage.
“Most people who are on Medicaid are not happy,” Mr. Kennedy claimed. “The premiums are too high. The deductibles are too high.”
He repeated a similar argument later in the hearing, facing questioning from Senator Ben Ray Lujan, Democrat of New Mexico. “The premiums are too high, the deductibles are too high, and everybody’s getting sicker,” he said.
But the vast majority of Medicaid enrollees do not pay any premiums or deductibles for their coverage. Federal law specifically prohibits premiums for the lowest-income Medicaid enrollees. Patients typically do not have to pay anything when they go to the doctor, aside from a handful of state-based experiments that have tested out small fees.
Recent research on Medicaid does not support Mr. Kennedy’s contention that “everyone’s getting sicker.” Studies generally find that increased Medicaid enrollment improves people’s access to health care. Some studies have also found that Medicaid improves health outcomes, although that is a more limited body of research.
Senator Cassidy asked Mr. Kennedy to describe how he would reform the Medicaid program. While other Trump nominees have offered concrete policy proposals — Russell Vought, the nominee to run the Office of Budget and Management, suggested a work requirement for the program in his confirmation hearing last week — Mr. Kennedy described vaguer changes.
He said he supported changes to “increase transparency” and “increase accountability.”
When Mr. Cassidy pressed him to be more specific, Mr. Kennedy responded, “I don’t have a broad proposal for dismantling the program.”
Mr. Kennedy did seem prepared, however, to be asked about the enrollment figures for Medicaid, accurately telling senators that the program covers about 72 million people through the traditional public insurance program and an additional seven million through a targeted benefit, the Children’s Health Insurance Program.
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Dementia risk signals could lie in simple blood pressure readings, researchers say
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Simple measurements taken during routine blood pressure checks could predict dementia risk years before symptoms appear.
That’s according to new research presented this week at the American College of Cardiology’s Annual Scientific Session in Louisiana.
The findings draw on two studies led by researchers at Georgetown University, which suggest that monitoring how blood vessels age and stiffen over time can provide a window into future cognitive health.
LURKING DEMENTIA RISK EXPOSED BY BREAKTHROUGH TEST 25 YEARS BEFORE SYMPTOMS
Data shows rates of dementia and aging-related cognitive decline are expected to increase as populations age, and half of U.S. adults have high blood pressure (hypertension).
Scientists believe that efforts to better address hypertension, a key contributor to heart disease and a risk factor for dementia, could affect both cardiac and brain health.
Data shows rates of dementia and aging-related cognitive decline are expected to increase as populations age. Meanwhile, half of U.S. adults have high blood pressure. (iStock)
“Blood pressure management isn’t just about preventing heart attacks and strokes; it may also be one of the most actionable strategies for preserving cognitive health,” Dr. Newton Nyirenda, the study’s lead author and an epidemiologist at Georgetown University in Washington, said in a press release.
The research focused on two metrics, the pulse pressure-heart rate index and estimated pulse wave velocity. Both were calculated using data collected during standard doctor visits, such as heart rate, age and blood pressure.
“Blood pressure management isn’t just about preventing heart attacks and strokes; it may also be one of the most actionable strategies for preserving cognitive health.”
Researchers examined five years of data patterns for more than 8,500 people in the SPRINT trial, a large study of adults 50 years and older with hypertension. In the follow-up, 323 of the participants developed probable dementia.
HIDDEN BRAIN CONDITION MAY QUADRUPLE DEMENTIA RISK IN OLDER ADULTS, STUDY SUGGESTS
In one study, the team found the pulse pressure-heart rate index was a strong independent predictor of dementia risk in adults over 50. For participants under 65, every one-unit increase was associated with a 76% higher risk of developing dementia.
For participants under 65, an increase in the pulse pressure-heart rate index was associated with a 76% higher risk of developing dementia. (iStock)
The second study found that adults with consistently elevated or rapidly increasing pulse wave velocity were more likely to develop dementia than those with stable velocity, even after accounting for factors like smoking, gender and cardiovascular history.
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“Our findings suggest that vascular aging patterns may provide meaningful insight into future dementia risk,” said Nyirenda. “This reinforces the idea that managing vascular health earlier in life may influence long-term brain health.”
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The team emphasized that clinicians should tailor risk assessments and treatment strategies to the individual.
Further studies are needed to confirm these parameters and determine whether changing vascular aging trajectories reduces dementia risk. (iStock)
“You don’t want to wait until a patient starts manifesting cognitive decline before you act,” said senior study author Sula Mazimba, an associate professor at the University of Virginia.
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Researchers noted the study could not establish causation. Other limitations included the fact that participants already had hypertension and elevated cardiovascular risk, meaning the findings may not apply to people without those conditions.
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Further studies are needed to confirm these findings and to determine whether improving blood vessel health over time could reduce dementia risk.
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