Daily on Healthcare: El Salvador aid groups warn that Trump’s decision to cut assistance will increase migration

EL SALVADOR AID GROUPS WARN THAT TRUMP’S DECISION TO CUT ASSISTANCE WILL INCREASE MIGRATION: Aid groups are warning that President Trump‘s threat to cut off aid to El Salvador would worsen the humanitarian crisis at the border, writes Cassidy Morrison.

“This is a serious problem and not a short-term solution,” said Ken Baker, CEO of Glasswing International, a group that funds community schools and emergency health centers for poor Salvadorans in violent areas.

Most foreign aid funding is allocated to rural areas of the country, ones that lack schools and medical clinics and suffer rampant violence and poverty. Salvadorans often decide to make the grueling, life-threatening trip north to escape those conditions. Humanitarian groups say that by the time they reach the U.S.-Mexico border, the window for problem-solving has closed.

Many groups that provide aid to El Salvador had success in recent years in gaining support from Congress for humanitarian efforts, before Trump said that he’d cut off aid to the Northern Triangle for failing to limit illegal immigration. Now, they are lobbying Congress to stop the administration from carrying out the threat, making the case for lowering migration by strengthening rural areas in El Salvador.

“There is pretty bipartisan support to attack problems at the base,” Baker said. “People who agree with other border policies still don’t agree with this policy, and once the problem is at the border, it’s too late.”

Bill O’Keefe, executive vice president for mission and mobilization at Catholic Relief Services, said the logic of cutting foreign aid is “completely counterproductive.” His organization teaches Salvadoran farmers sustainable techniques, crop diversification, and marketing of the cash crop cacao, as well as providing vocational training and job placement support.

O’Keefe says that the group has been working closely with Congress to find ways to keep Salvadorans in their native country by helping people in rural areas get better education and farm better.

Foreign aid is primarily sent to individual contractors and religious organizations like Catholic Relief Services. The Salvadoran government has little say in how these funds are allocated, because aid is meant to help the citizens rather than help out politicians. Charitable organizations on the ground decide how to spend money and how it can directly help citizens, whether it is meant to rebuild schools, open medical facilities, or provide job training.

O’Keefe says he is confident that he and other groups working in El Salvador can convince administration officials not to go through with the cut to aid funding. “They’ll develop a more nuanced perspective on this” and find an alternative approach to deal with rising rates of migration, he said.

“No matter how high the wall is, how deep the sea is, you cannot underestimate the desperation and the ingenuity of people to get to where they need to go,” O’Keefe said.

From September 2018 to January 2019, 242,667 migrants from El Salvador, as well as Guatemala and Honduras, had crossed the border. In the months leading to the 2018 midterm elections, the GOP worked to highlight the caravan moving toward the U.S.-Mexico border.

Salvadorans sometimes travel in large groups because of a “safety in numbers” philosophy. The journey from El Salvador to El Paso exceeds 1,300 miles, and many do not survive, whether the cause of death is the extreme climate and landscape, the lack of food and water, or violence along the monthlong walk.

Trump made the announcement to cut foreign aid last month, but it has yet to be implemented. The State Department has said that it will work with Congress to carry out Trump’s order.

Good morning and welcome to the Washington Examiner’s Daily on Healthcare! This newsletter is written by senior healthcare reporter Kimberly Leonard (@LeonardKL) and healthcare reporter Cassidy Morrison (@CassMorrison94). You can reach us with tips, calendar items, or suggestions at [email protected]. If someone forwarded you this email and you’d like to receive it regularly, you can subscribe here.

WHITE HOUSE SAYS IT’S READY TO FOCUS ON HEALTHCARE AFTER MUELLER REPORT: After two years of questions, subpoenas, and court appearances, White House officials said a cloud had been lifted from the Trump presidency with publication of the Mueller report and promised to get on with tackling healthcare and the immigration crisis.

Hogan Gidley, White House deputy press secretary, said a cloud had been lifted from the American people and the country, offering a chance for the president to get on with the business of governing.

“And in the last two years of his first term we expect Congress to work with this administration on infrastructure, healthcare, and drug pricing, and solving the immigration crisis,” Gidley said.

CMS REDUCES USER FEES, RESULTING IN SLIGHTLY LOWER OBAMACARE PREMIUMS: The Centers for Medicare and Medicaid Services announced Thursday that it would be lowering user fees that insurers pay to take part in Healthcare.gov, from 3.5% to 3%. Agency officials said they were able to reduce the fees, which get passed onto customers in the form of higher premiums, because they spend less on outreach and the website has been working better.

No final rule on abortions yet: The agency did not yet decide whether it would implement a rule that would obligate states to make sure insurers on the exchanges offer a plan that does not cover abortions. The rule would affect states such as California and Oregon, which say plans must cover abortions if they cover maternity care.

No decision on ‘silver loading’: The term refers to how insurers stack subsidies to make up for Trump cutting off direct government payments to insurers, known as cost-sharing reduction subsidies. The structure shoulders more costs onto the federal government instead of onto customers. CMS had proposed disallowing the practice in 2021, so it will continue for 2020.

MCCONNELL CALLS FOR RAISING THE MINIMUM AGE FOR TOBACCO PRODUCTS TO 21: Senate Majority Leader Mitch McConnell, R-Ky., announced Thursday that he will introduce a bill in May to raise the minimum age to buy tobacco products, including e-cigarettes, from 18 to 21. McConnell, whose state is one of the biggest producers of tobacco, cited the rise of youth vaping in calling for the measure.

MONTANA LEGISLATURE EXTENDS MEDICAID EXPANSION WITH WORK REQUIREMENTS: The legislature preserved the expansion, which covers 96,000 people, through a tax on hospitals in a measure passed Thursday that Democratic Gov. Steve Bullock said he would sign. The expansion will last another six years, and the state will ask the Trump administration to add a work requirement but will still proceed with the expansion even if it is rejected. A ballot measure to extend the expansion through a tobacco tax failed in the midterm elections. If the legislature hadn’t passed it, then the expansion would have ended June 30.

HHS ANNOUNCES NEW STUDY TO REDUCE OPIOID USE BY 40 PERCENT: The National Institutes of Health, alongside the National Institute of Drug Abuse and the Substance Abuse and Mental Health Services Administration, announced a comprehensive new study Thursday meant to reduce opioid dependence by 40 percent over a three-year period in communities that have been hardest-hit by the opioid crisis. NIH announced grants to four universities totalling $350 million. Funding will go to Kentucky, New York, Massachusetts, and Ohio, where researchers will each focus on 15 communities each. The study is part of the NIH HEAL (Helping to End Addiction Long-term) Initiative.

NORTH CAROLINA GOVERNOR VETOES ‘BORN ALIVE’ BILL: North Carolina Gov. Roy Cooper has vetoed legislation that would have clarified that babies born alive after botched abortions are to receive medical care that is similar to what other premature babies would receive. Cooper, a Democrat, said that other laws already protect newborn babies and that this bill is “an unnecessary interference between doctors and their patients.” A similar measure failed in the U.S. Senate in February following opposition from Democrats.

TRUMP SIGNS BILL TO ALTER MEDICAID AUTHORITY: Trump signed the Medicaid Services Investment and Accountability Act of 2019 into law Thursday. The new law extends protection for Medicaid recipients of home and community-based services against spousal impoverishment, establishes a state public option to provide coordinated care for children with advanced medical disabilities in health homes, prevents the misclassification of prescription drugs for the purposes of the Medicaid drug rebate program, and modifies other funding provisions for Medicaid.

MARK YOUR CALENDARS: The Washington Examiner is hosting its next “Examining Healthcare” event on Wednesday May 1 at 8 a.m. The event will feature interviews by Kimberly with Sens. Bill Cassidy, R-La., and Doug Jones, D-Ala. Breakfast is provided. Register here.

The Rundown

Los Angeles Times Americans are delaying healthcare until tax refunds arrive

The Washington Post A rare deterrent to limitless drug price increases may die under Trump

The Wall Street Journal New York City issues summonses to parents of three unvaccinated children

The Associated Press Cancer-causing chemical taints water after California blaze

The New York Times This genetic mutation makes people feel full — all the time

Calendar

FRIDAY | April 19

House and Senate in recess.

MONDAY | April 22

April 22-25. Atlanta. Rx Drug Abuse and Heroin Summit. Agenda.

10 a.m. 1330 G St. NW. Kaiser Family Foundation event on “The Trump Administration’s HIV Initiative: What It Will Take to End the US Epidemic.” Details.

5 p.m. 1775 Massachusetts Ave. NW. Brookings conversation with author Dr. William A. Haseltine on “World Class: A Story of Adversity, Transformation, and Success at NYU Langone Health.” Details.