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State Medical Associations Rally Against Trump Cuts

Recently, a group of 40 state medical associations, including Minnesota’s, sent a letter to congressional leaders urging rejection of the proposed cuts to health care funding. The cuts will result in the loss of coverage for at least 7.6 million Americans on Medicaid, including children, veterans, people with disabilities, seniors, pregnant women and low-income workers. This will lead to even more crowding of emergency departments, closures of rural hospitals and community physician practices, as well as widespread health and economic instability. Citing bipartisan research, estimated project cuts in payments to states would result in nearly $200 billion less to systems already struggling to provide patient care, devastate state budgets and force states to raise taxes.

Several comments and recommendations were made, including:

• Opposition to the provision that addresses taxes on hospitals, managed care organizations, nursing homes and other providers. The uniformity rule is unfair and unrealistic for states to meet. In states with low proportions of commercially insured individuals, restructuring their programs to meet these new requirements will be near impossible without massive tax increases resulting in higher premiums.
• Opposition to proposed limits on state-directed payments and a freeze on provider taxes. This freeze amounts to a long-term funding cut as it will not keep pace with increasing health care costs. It forces states to reduce benefits for Medicaid recipients, diminishing care, especially in rural communities.
• Opposition to the proposed Medicare payment cap. This will negatively impact public hospitals and physicians who care for the most critically ill patients and complex cases. The Medicare physician fee schedule is an inadequate benchmark for state- directed Medicaid payments. When adjusted for inflation, Medicare payments have declined by 33% over the past two decades and do not cover the costs to provide care.
• Opposition to cost-sharing mandates on extremely low-income Medicaid enrollees. A $35 copay/visit or a 5% income contribution on an annual income of $15,600 creates a significant barrier to care. Instead, these individuals, many of whom are chronically ill or disabled, will end up hospitalized, driving up costs.
• Opposition to proposed additional paperwork to ensure compliance with receiving less money, such as verifying employment status, on a monthly basis, of benefit recipients.

State medical associations and physicians nationwide are urging Congress to reject the harmful cuts to Medicaid, a proven, cost-effective safety net, that serves 80 million vulnerable Americans, nearly 25% of the nationwide population.

Mayo Study Explores Telehealth Benefits

A recent study from the Mayo Clinic found that telehealth dramatically improved health care outcomes across a broad range of services. The 2022 annual survey from the American Hospital Association, and other sources, were analyzed, looking at data from over 1,000 acute care general hospitals that included community indicators. Specific areas of the study included telestroke, telepsychiatry and addiction treatment, teleconsultation and office visits, tele-intensive care units, telemonitoring postdischarge, and ongoing chronic care management. Although the value of telehealth continues to grow, limited study exists of how social determinants of health are addressed in using it as a tool for care delivery.

The new study showed that patients who received telehealth monitoring support after discharge achieved significantly better outcomes with less follow-up care than those without monitoring.

“This study explores the relationship between hospitals’ implementation of telehealth services and the impact on patients’ social needs,” says Aaron Spaulding, PhD, senior study author. 

When patients used online therapy, they were much more likely to say their overall health had improved compared to those who did not receive such services. This shows telehealth’s ability to address social determinants of health and offer a path for future research into ways to enhance overall patient-centered care. “There has been significant research identifying gaps in health care due to social determinants of health,” says Dr. Spaulding. “The publication team has explored various avenues to understand the barriers to access and areas that inadvertently worsen outcomes related to social determinants.” Dr. Spaulding notes that telehealth, when combined with in-person visits, has the potential to help create a more integrated approach to health care delivery, but that it should be treated as a complementary tool and that any approach needs to be personalized. “Different patients require varying levels of care, and while our systems are improving, some patients may benefit from telehealth, while others may prefer in-person care. Additionally, a combination of approaches might be beneficial for certain individuals,” says Dr. Spaulding. He added, “We must continue to assess the most effective ways to use telehealth to benefit patients. This evaluation should consider both hospital-specific outcomes, such as readmissions and emergency department visits, as well as patient experience and patient-reported outcomes.”

Allina Physicians Join Picket Lines

 Making Minnesota history, physicians recently joined picket lines with other health care providers outside four Allina Clinics to protest working conditions, voicing frustration with what they called the “factory style” of modern medicine. Physicians voted overwhelmingly in favor of joining Doctors Council – SEIU in October 2023, forming the nation’s largest private-sector doctors union with more than 600 members across 60 Allina clinics in Minnesota and Wisconsin. This historic protest resulted after not enough progress was made in contract negotiations. Unionized physician assistants and nurse practioners joined the picket lines, and all carried signs with slogans such as “Fair Contract for Patient Care” and “Fair Contract Now.” Contract negotiations have been ongoing for over a year. Union leaders seek fair wages, fair benefits, safe working conditions and also that caregiver voices are heard. They claim Allina is trying to eliminate sick time and cut pay.

In response, Allina stated that they deeply value the dedication of its care team members and assured there would be no disruption in care during the pickets. The claimed they would continue to negotiate in good faith and seek to reach responsible agreements that maintain competitive pay and benefits for providers while ensuring it can sustain its caring mission during these extremely uncertain economic times.  

After nearly 40 negotiating sessions, Chris Antolak, a family physician union member at the Coon Rapids Clinic, said, “We’re not seeing Allina come to the table with meaningful proposals. We’re here today to picket because we need to prove to Allina that we’re standing in strength and solidarity.” Similar protests took place at Bloomington, Maplewood and West St. Paul clinics.

“I’m a union kid. My parents were teachers … I never thought I would be union until I realized the power that we have as a single voice,” said Dr. Kara Larson, who has worked as a pediatrician at the Coon Rapids Clinic since 1999. “The union brought us together to advocate for change for our patients.”

The two sides have come to tentative agreements over the control of their schedules, creation of a mentorship program and labor management committee, and protections against unfair discipline. Serious differences, however, remain to be resolved.

Mental Health Social Media Warning Label Enacted

The Minnesota Legislature recently passed a provision requiring mental health warning labels on social media platforms. The law requires that by July 1, 2026, all social media platforms must display a clear mental health warning label to users in Minnesota and is a bold step toward protecting youth mental health. Authored by Rep. Zach Stephenson, DFL-District 35A, the legislation reflects the rising urgency among lawmakers nationwide to address the mental health crisis fueled by unregulated social media. Similar bills are now advancing in Texas, California and New York.

“This legislation is a critical victory for young people and families in Minnesota,” said Erich Mische, CEO of Suicide Awareness Voices of Education (SAVE). “We applaud Representative Stephenson and members of the Legislature for responding to a public health emergency that’s playing out in children’s lives every single day. Mental health warning labels won’t solve everything, but they are a necessary first step in helping families and youth navigate a digital landscape that too often puts profit over protection.” 

Founded in 1989 and based in Minnesota, SAVE is one of the nation’s first organizations dedicated to the prevention of suicide. For many Minnesotans, the fight for accountability on social media is personal. Bridgette Norring, whose 19-year-old son, Devin Norring, died after purchasing a fentanyl-laced pill through Snapchat, has been a leading voice calling for stronger protections.

“Devin didn’t get a second chance. One pill on a social media app was all it took,” said Norring, Devin’s mother. “If this warning label law can spark just one conversation, prevent just one loss, or make one teen think twice, it will have done something powerful. Our kids deserve to be protected, and this legislation helps shine a much-needed light on the real dangers hiding behind the screens. I’m proud that Minnesota is taking this step, and I’m thankful for the leadership that made it happen.”

With this new law, Minnesota joins a growing chorus of voices demanding change from an industry that has little to no regulation or accountability.

Federal Judge Strikes Down Trump NIH Cuts

Judge William Young, a 1985 Reagan appointee, recently issued a ruling from the U.S. District Court in Massachusetts that the termination of National Institutes of Health (NIH) grants by the Trump administration was “void and illegal.” The ruling further accused the government of discriminating against racial minorities and LGBTQ people. Since Trump has returned to office the NIH has terminated 2,100 research grants totaling about $9.5 billion, as well as an additional $2.6 billion in research-related contracts. Hundreds of research projects — many of which have been underway for years, representing thousands of hours of work and billions of dollars in investment — were abruptly cancelled without a scientifically valid explanation. The court reversed the grant terminations at issue in the case, stating that the government must immediately make the funds available ordering the administration to “promptly comply.”

“The ideologically motivated directives to terminate grants alleged to constitute DEI, ‘gender ideology,’ or other forbidden topics were, in fact, arbitrary and capricious, and have now been ruled unlawful,” said Peter Lurie, MD, head of the Center for Science in the Public. The administration has attempted to justify its sweeping grant cancellations by vaguely citing connections to “gender identity” or “diversity, equity, and inclusion” (DEI), without defining these terms or explaining how they apply to the terminated research. The recent ruling was in response to an early April lawsuit filed by the American Civil Liberties Union, and many others, challenging the abrupt cancellations on behalf of individual researchers, the United Automobile, Aerospace and Agricultural Implement Workers of America (UAW) and many others. Many similar suits have been filed around the country. As with other rulings unfavorable to Trump edicts that have been deemed illegal and/or unconstitutional, it is likely this ruling will be appealed.  

Referring to the termination of research grants Young said that in four decades on the bench, he had “never seen a record where racial discrimination was so palpable” and that he would be blind not to call it out. “This represents racial discrimination and discrimination against America’s LGBTQ community. You are bearing down on people of color because of their color,” he said, referring to the Trump administration. “The Constitution will not permit that.” He indicated there were further actions he might take.

Minnesota Survey Strongly Opposes Medicaid Cuts

A recent statewide survey, conducted by the Minnesota Department of Health (MDH) and the State Health Access Data Assistance Center (SHADAC), showed 72% of respondents supported providing Medicaid health insurance to people in need. Results said that Medicaid (known as Medical Assistance in Minnesota) was “very important” to people in their local community. Support for Medicaid was seen across all demographics and all areas of the state. “Minnesotans know that Medicaid matters, and these survey results show that,” said State Medicaid Director and Minnesota Department of Human Services (DHS) Deputy Commissioner John Connolly. “The proposed federal cuts to Medicaid mean tens of thousands of our friends, neighbors and loved ones will lose their health coverage.”  

Most survey respondents had heard about changes to Medicaid being considered by lawmakers in Congress, but only 15.6% thought the changes would improve the health of people on Medicaid. Eight out of 10 respondents opposed reducing the amount of money the federal government puts toward the Medicaid expansion.  

“The consequences of having a large number of people without health insurance are significant — not only for the people who do not have coverage but for our health care system and everyone in Minnesota,” said Minnesota Commissioner of Health Dr. Brooke Cunningham. “In the long run, access to health care coverage through Medicaid saves resources, saves money and saves lives.”

Proposed changes to Medicaid in Congress include federal funding cuts, which would increase the costs for states, counties, Tribes, providers and enrollees. The proposed changes also call for new work requirements and other reforms that would reduce the number of people who qualify and increase the amount of information people who remain enrolled have to submit. It would also create more administrative burden for staff implementing the program.