Alice Ollstein

Alice Ollstein is a reporter at Talking Points Memo, covering national politics. She graduated from Oberlin College in 2010 and has been reporting in DC ever since, covering the Supreme Court, Congress and national elections for TV, radio, print, and online outlets. Her work has aired on Free Speech Radio News, All Things Considered, Channel News Asia, and Telesur, and her writing has been published by The Atlantic, La Opinión, and The Hill Rag. She was elected in 2016 as an at-large board member of the DC Chapter of the Society of Professional Journalists. Alice grew up in Santa Monica, California and began working for local newspapers in her early teens.

Articles by Alice

Members of Congress on both sides of the aisle are pushing back forcefully against the Trump administration’s new position on whether Native Americans can be forced to comply with Medicaid work requirements, telling TPM that allowing individual states to make that call is a “disaster” with serious “constitutional problems.”

The Trump administration’s lead Medicaid official Seema Verma said Monday in a speech to the American Hospital Association that HHS is dropping its previous claim that giving tribal members any kind of exemption from Medicaid work requirements “could raise civil rights issues,” because it would be an illegal racial preference.

“We believe we can give states flexibility and discretion to implement the community engagement requirements with respect to local tribal members,” Verma said. “We look forward to working with states and tribes to try to help them achieve their goals and determine how to best apply community engagement to serve their populations.”

But Republican and Democratic lawmakers say this new stance is just as bad, if not worse, than the administration’s original position.

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Though Republicans in Congress are pushing a new bill to repeal Obamacare and block-grant Medicaid, it has a slim-to-zero chance of passage this year. The real wars over Medicaid and the Affordable Care Act are still raging on the state level.

Trump’s CMS Administrator Seema Verma made three big announcements on Monday: She approved New Hampshire’s bid to become the fourth state to impose Medicaid work requirements, rejected Kansas’ proposal to kick people off of Medicaid after three years, and punted the decision down to individual states on whether Native Americans have to follow the new Medicaid work rules.

The Kansas waiver denial is significant, sending the message to other states applying for some kind of lifetime limit on Medicaid — including Arizona, Maine, Wisconsin, and Utah — to slow their roll. Even as CMS approves work requirements, premiums, and other hurdles for enrollees in state Medicaid programs, lifetime limits are apparently a bridge too far.

As CMS considers waivers from nearly a dozen more states, Michigan’s Medicaid work requirement proposal has come under fire for privileging the state’s more rural, whiter population over its inner-city residents of color. Michigan’s waiver would exempt people who live in counties where the unemployment rate is higher than 8.5 percent. Even though the unemployment rate is much higher than that in Detroit and Flint, the cities’ more affluent suburbs make the county rate lower overall, meaning people in those cities would not qualify and would have to comply with the work requirement.

Verma said in a Monday speech that Medicaid as it functions today is “on an unsustainable trajectory” and that policies like work requirements can ease the burden. But a new study out of Alaska finds that the requirements might cost even more to implement than they will save — even if, as is predicted, they lead to tens of thousands of people per state losing their health coverage.

Meanwhile, Maine Gov. Paul LePage (R) is still refusing to expand Medicaid six months after residents of his state voted overwhelmingly to do so, and his own Attorney General is refusing to defend him in the ensuing lawsuit. LePage is term-limited out of office this fall, but he may inspire other anti-Medicaid governors to slow-walk their own expansions.

As of this week, Utahans have enough signatures to put a Medicaid expansion on their ballot this November; advocates in Montana are still gathering signatures.

And finally, the prophesied 2019 Obamacare rate hikes have begun to arrive.

On Friday, Virginia’s two biggest insurers announced huge increases for their individual market customers, with some jumping as much as 64 percent. Maryland insurers on Monday asked for rate hikes ranging from 18.5 to 91.4 percent. While most people receive a subsidy and will be protected from the increase, those with middle class incomes will feel the pain. Insurance companies and industry groups have said openly for months that Trump administration policies are largely to blame — including the repeal of the individual mandate, the proliferation of skimpy, deregulated plans, and the sabotage of open enrollment.

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The Trump administration is rejecting a proposal by Kansas to kick people off of Medicaid after three years, and also plans to allow states to exempt American Indian tribal members from Medicaid work requirement rules.

The twin announcements came in a speech Monday morning given by the Trump administration’s top Medicaid and Medicare official, Seema Verma, to the American Hospital Association.

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President Donald Trump and his attorney Rudy Guiliani’s off-the-cuff and misleading remarks on television and social media regarding ongoing negotiations for the release of U.S. hostages in North Korea may put those individuals at risk, the Washington Post reported.

By commenting publicly and inaccurately on sensitive backchannel negotiations, experts told the Post, the Trump administration may increase the hostages’ value and push the North Korean regime to demand more concessions for their release.

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Following the panic trigged by his freewheeling TV interviews earlier this week, in which he acknowledged for the first time that President Trump reimbursed attorney Michael Cohen for the $130,000 paid to adult film actress Stormy Daniels, former New York City mayor and current Trump attorney Rudy Giuliani released a statement Friday afternoon to “clarify the views I expressed.”

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When the Director of the Bureau of Indian Affairs (BIA) abruptly resigned last week after less than six months in his post, the agency gave no explanation.

But an e-mail from a BIA employee obtained by TPM claims the director, Bryan Rice, exhibited aggressive and intimidating behavior toward her in an incident she believes was captured by a surveillance camera. The woman involved and her supporters have been urging tribal leaders — via e-mail and social media — to submit Freedom of Information Act (FOIA) requests to the Interior Department for the video of the alleged incident. At least five did so in the weeks leading up to Rice’s resignation, according to the agency’s FOIA logs.

The five identically worded FOIA queries read: “Request footage of the Indian Affairs FOIA Officer, Jessica Rogers and Bryan Rice, Bureau of Indian Affairs Director on the 4th floor north and south hallway in the main Interior building on December 6, 2017, between on or about 9 am and noon.”

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Last November, Mainers overwhelmingly voted in favor of a ballot measure that would expand Medicaid. Until now, the state’s firebrand Republican Governor Paul LePage has successfully blocked the expansion by simply ignoring his constituents and refusing to move forward on its implementation. The standoff may soon have to end: On Monday, a group of health-care advocates in the state sued LePage, saying his foot-dragging is directly harming the 80,000 low-income people who were supposed to be eligible to enroll in Medicaid this year.

Because LePage is term-limited and cannot be reelected this fall, his stonewalling can only delay implementation of the Medicaid expansion for so long. But already his defiance is inspiring other anti-ACA Republicans to follow suit.

In Idaho, where pro-Medicaid advocates announced Monday that they’ve surpassed the amount of required signatures to put expansion on the ballot this November, a far-right candidate for governor has already vowed to pull a LePage if it passes.

In a GOP gubernatorial primary debate last week, Rep. Raul Labrador (R-ID) said he “would look at all the options” for overturning the initiative to expand Medicaid to cover 62,000 more people in the state. His opponent, Lt. Gov. Brad Little, disagreed, promising instead to “adhere to the will of the voters.”

Supporters of the Medicaid expansion insist they will prevail both at the ballot box and in the courts, but Maine’s experience with a hostile governor serves as a cautionary tale for advocates working to gather signatures for expansion initiatives in Idaho, Nebraska and Utah.

Meanwhile, the uproar over Trump’s HHS’ suggestion that it may force Native American tribes to comply with Medicaid work requirements continues. Ten senators — nine Democrats and Sen. Lisa Murkowski (R-AK) — wrote to the agency expressing alarm at HHS’ position that exempting tribes from the requirements would be giving them an illegal race-based privilege. “Tribes are not a racial group but rather political communities,” the senators wrote. “The views expressed fail to recognize the unique legal status of Indian tribes and their members under federal law, the U.S. Constitution, treaties, and the federal trust relationship.”

As more states with Native American tribal populations seek permission to implement Medicaid work requirements, including OhioMichiganArizona, this is likely to become a major legal fight in the months ahead. Ohio, which just submitted its work-requirements proposal Monday night, estimates that 18,000 people could be kicked off Medicaid. Health advocates say the actual number’s much higher, and are exploring a lawsuit. 

Finally, a new study from the Commonwealth Fund released Tuesday finds that Trump administration policies are driving up the number of uninsured Americans. About four million working-age people have lost insurance coverage since 2016, the group reports, citing a laundry list of federal actions exacerbating the trend, including “deep cuts in advertising and outreach during the marketplace open-enrollment periods, a shorter open enrollment period,” the repeal of the individual mandate, Medicaid work requirements, and “recent actions to increase the availability of insurance policies that don’t comply with ACA minimum benefit standards.”

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