CMS Announces Plan to Disenroll Noncitizens From Medicaid and CHIP

 The Trump administration announced a new initiative Tuesday aimed at getting noncitizens disenrolled from the Medicaid program and the Children's Health Insurance Program (CHIP).

"CMS will begin providing states with monthly enrollment reports identifying individuals whose citizenship or immigration status could not be confirmed through federal databases," the agency said in a press releaseopens in a new tab or window. "States are responsible for reviewing cases, verifying the citizenship or immigration status of identified individuals, requesting additional documentation if needed, and taking appropriate actions when necessary, including adjusting coverage or enforcing noncitizen eligibility rules."

CMS said it would send the first set of reports to states on Tuesday, "with all states receiving a report over the course of a month. We expect states to take quick action and will monitor progress on a monthly basis."

"Medicaid is a lifeline for vulnerable Americans -- and I will protect it from abuse," HHS Secretary Robert F. Kennedy, Jr. said in the release. "We are tightening oversight of enrollment to safeguard taxpayer dollars and guarantee that these vital programs serve only those who are truly eligible under the law."

Tuesday's announcement is the second one the administration has made recently involving immigrants and the Medicaid program. Last month, CMS and the Department of Homeland Security agreed

opens in a new tab or window that CMS would hand over Medicaid enrollees' personal information -- including home addresses and ethnicities -- to Immigration and Customs Enforcement (ICE) for the purpose of tracking down potential illegal immigrants. However, that agreement was struck down earlier this monthopens in a new tab or window by a federal court, with Judge Vince Chhabria writing that "Using CMS data for immigration enforcement threatens to significantly disrupt the operation of Medicaid -- a program that Congress has deemed critical for the provision of health coverage to the nation's most vulnerable residents."

Also last month, the administration announced a plan to purge duplicate enrolleesopens in a new tab or window in Medicaid, CHIP, and Affordable Care Act insurance exchange plans. In its announcement, HHS said a recent analysis of 2024 enrollment data found that there were approximately 2.8 million people "either enrolled in Medicaid or the Children's Health Insurance Program in multiple states or simultaneously enrolled in both Medicaid/CHIP and a subsidized Affordable Care Act exchange plan."

Getting rid of these duplicate enrollments would save the federal government an estimated $14 billion annually, HHS said, noting that "CMS will work with states to prevent individuals from losing coverage inappropriately."

Duplicate enrollment can occur for various reasons, America's Health Insurance Plans, a trade group for health insurers, said in a March blog postopens in a new tab or window. "Complex individual circumstances can result in multiple residence changes for some beneficiaries," the post said. "For example, people experiencing chronic homelessness or in unstable housing situations, seasonal employees, people with frequent job changes, and/or people suffering from illnesses may relocate more often, resulting in lags to updated data."

Earlier last month, on July 4, President Trump signed the reconciliation bill into law; that measure will result in an estimated 10 million peopleopens in a new tab or window losing their health insurance, largely due to Medicaid work requirements, according to the Congressional Budget Office.

https://www.medpagetoday.com/publichealthpolicy/medicaid/117074

'Physicians Can Call New Hotline With Reproductive Health Questions'

 Healthcare providers with questions about reproductive and sexual health topics have a new resource at their disposal: an anonymous, confidential, and free physician-staffed hotline.

Reproductive Health Hotline, or ReproHH, launched earlier this summer and is staffed by clinicians at the University of California San Francisco (UCSF) with expertise in sexual and reproductive health.

The comprehensive reproductive and sexual health hotline is equipped to answer questions about complex contraceptive counseling; abortion, where legal; post-abortion and miscarriage care; early pregnancy management; sexually transmitted diseases; urinary tract infections and vaginitis; and pain management for gynecological procedures.

Jennifer Karlin, MD, PhD, an associate professor at UCSF who developed the hotline, told MedPage Today that ReproHH was partially inspired by the patient-facing M+A (Miscarriage and Abortion) Hotlineopens in a new tab or window and the National Clinician Consultation Centeropens in a new tab or window, another UCSF project that runs various clinician-to-clinician HIV, hepatitis C, and substance use hotlines.

"A bunch of us started realizing that there was a need to have a clinician-facing hotline that could support clinicians with sexual and reproductive health nationally," she said. "When we talk to physicians across the country about [ReproHH], people say, 'Oh my God, we've needed this for a decade!'"

The Dobbs v. Jackson Women's Health Organization Supreme Court decisionopens in a new tab or window that overturned Roe v. Wade and upended federal abortion rights further magnified the need for a resource like ReproHH, Karlin noted.

So far, ReproHH has received a couple dozen calls, but the team said the word is only starting to get out. About half of calls have come from physicians, mostly in primary care. The rest of calls have been from community health workers, health educators, and advanced care providers, like nurse practitioners and physician assistants.

When a healthcare provider calls the hotline, they must first acknowledge ReproHH's terms of serviceopens in a new tab or window. Next comes a live triage where a hotline worker checks if the caller is a healthcare provider and asks if they are located in or outside of California. If the caller is a community health worker, they don't ask any additional questions, including whether or not they are from California. Patients who call ReproHH are given the contact information for the M+A Hotline.

California-based clinicians are given the opportunity to provide some demographic data about themselves if they choose, like their specialty, how many years they've been practicing, the setting they work in, if they have access to reproductive healthcare specialists, and broad demographic questions about the communities in which they operate. This voluntary information will help inform potential trainings and capacity building initiatives in the state. ReproHH does not collect information on the specifics of queries from states other than California, nor does the project know if a non-California caller is dialing in from New York, Florida, or Louisiana.

"We ask that people not provide PHI [personal health information] or any specific information about any of the cases that any of the clinicians are calling about, so that we can provide clinical information based on best practices in the literature and evidence-based practice and the licensure of our state," Karlin explained.

Additionally, if a clinician is inquiring about how to obtain abortion pills or how to do an abortion, ReproHH asks whether the caller is in a state where abortion, to the best of their knowledge, is legal. In order for the hotline to provide information about procuring an abortion, that person must say yes. However, if the patient has already had a miscarriage, received abortion pills, or had an abortion, clinicians can still get information about how to manage those situations.

Nikki Zite, MD, MPH, of the University of Tennessee Graduate School of Medicine in Knoxville, who is not involved in ReproHH, said that the hotline "has the potential to support healthcare workers that don't have easy access to a more experienced provider or clinical information."

Zite said she's seen fellow physicians seek clinical guidance on other platforms where evidence-based answers are not a guarantee.

"As we see the number of maternity and healthcare deserts expand, I am grateful that they plan to focus on reducing misinformation, promoting equitable access to quality healthcare, and ensuring providers in any setting are able to confidently provide care," Zite said. "As outlets like UpToDate get more expensive, some providers may not have access to these sources and knowing a reliable institution like UCSF is working to make evidence-based information easily accessible should be reassuring."

David Hackney, MD, a maternal-fetal medicine physician at Case Western Reserve University in Cleveland, who also is not involved in ReproHH, noted that as reproductive healthcare access contracts, patients are seeking care wherever they can.

"Unfortunately patients often now find themselves in emergency departments, urgent cares, and primary care offices in which healthcare workers provide the best care they can, though may not be specifically trained in obstetrics and gynecology, particularly for nuanced or complicated issues," he said. "Although the optimal solution would be to have regional providers with reproductive expertise, services such as ReproHH will likely become critical over the years to come and until our access situations are improved."

Even before the proliferation of abortion bans post-Dobbs, Hackney noted that rural labor and delivery units had been closing under financial pressure, and impending Medicaid cuts and other legislation further threaten access to comprehensive reproductive care.

Before launching ReproHH, the team conducted a needs assessment to prepare for common queries. So far, the top reason for calling has been complex contraception issues, which the team predicted. One surprising topic has been syphilis, though Karlin said it lines up with the rise in casesopens in a new tab or window and complicated disease management.

To access ReproHH, healthcare providers can call 1-844-ReproHH (1-844-737-7644).

https://www.medpagetoday.com/obgyn/generalobgyn/117077

'Hawkish' FOMC Minutes Shows 'Majority' Fear Higher Inflation More Than Lower Employment

 Since the last 'dovish' FOMC statement (and Powell's post-statement 'hawkish' presser) on July 30th, we have had 'cool' payrolls print and 'hot' inflation prints with retail sales mixed... and now everyone is anticipating Friday's speech by Powell at Jackson Hole. So, maybe these Minutes will be a nothingburger...

Source: Bloomberg

Overall, rate-cut expectations are higher...

Source: Bloomberg

...with September price-in as almost a done-deal for a cut...

Source: Bloomberg

Markets have generally gone nowhere in that time (except for crude prices, which have plunged on the heels of potential peace breaking out). Under the hood, there is some considerable pain in stock land (as momo and retail favorites have all suffered in recent days)

Source: Bloomberg

So, with two dissents (preferring to cut than hold), we anxiously await The Fed Minutes to see what Powell and his pals want us to know about the division within The (expensive) Eccles Building...

Key highlights from the Minutes:

The Minutes suggest members believe rates are not restrictive... 

Several Officials Said Current Rate May Not Be Far Above Neutral - Minutes

"Several participants commented that the current target range for the federal funds rate may not be far above its neutral level; among the considerations cited in support of this assessment was the likelihood that broader financial conditions were either neutral or supportive of stronger economic activity."

But clearly they are front and center terrified about inflation:

Many Noted Full Effect Of Tariffs Could Take Some Time

"Participants judged that considerable uncertainty remained about the timing, magnitude, and persistence of the effects of this year’s increase in tariffs. In terms of timing, many participants noted that it could take some time for the full effects of higher tariffs to be felt in consumer goods and services prices. Participants cited several contributors to this likely lag. These included the stockpiling of inventories in anticipation of higher tariffs; slow pass-through of input cost increases into final goods and services prices; gradual updating of contract prices; maintenance of firm–customer relationships; issues related to tariff collection; and still-ongoing trade negotiations."

Majority Saw Employment Risk Outweighed By Inflation Risk (remember this was prior to the payrolls revisions)

"Participants generally pointed to risks to both sides of the Committee’s dual mandate, emphasizing upside risk to inflation and downside risk to employment. A majority of participants judged the upside risk to inflation as the greater of these two risks, while several participants viewed the two risks as roughly balanced, and a couple of participants considered downside risk to employment the more salient risk."

Despite zero evidence of this (and in fact the opposite - remember the Japanese automakers)...

Several Expected Firms Would Pass Tariffs To Customers

"Several participants, drawing on information provided by business contacts or business surveys, expected that many companies would increasingly have to pass through tariff costs to end-customers over time. However, a few participants reported that business contacts and survey respondents described a mix of strategies as being undertaken to avoid fully passing on tariff costs to customers. Such strategies included negotiating with or switching suppliers, changing production processes, lowering profit margins, exerting more wage discipline, or exploiting cost-saving efficiency measures such as automation and new technologies."

"few participants observed that evidence so far suggested that foreign exporters were paying at most a modest part of the increased tariffs, implying that domestic businesses and consumers were predominantly bearing the tariff costs

Few participants stressed inability to pass through price increases

A few participants stressed that current demand conditions were limiting firms’ ability to pass tariff costs into prices. Regarding inflation persistence, a few participants emphasized that they expected higher tariffs to lead only to a one-time increase in the price level that would be realized over a reasonably contained period. A few participants remarked that tariff-related factors, including supply chain disruptions, could lead to stubbornly elevated inflation and that it may be difficult to disentangle tariff-related price increases from changes in underlying trend inflation

The future is scary...

Several Flagged Risk Of Inflation Expectations Unanchoring

"Participants noted that longer-term inflation expectations continued to be well anchored and that it was important that they remain so. Several participants emphasized that inflation had exceeded 2 percent for an extended period and that this experience increased the risk of longer-term inflation expectations becoming unanchored in the event of drawn-out effects of higher tariffs on inflation.

Does this look like its 'unanchored'?

But wait, there's more fearmongering... Several Noted Concerns About Elevated Asset Valuations (We are surprised only 'several' saw that?

"The staff provided an updated assessment of the stability of the U.S. financial system and, on balance, continued to characterize the system’s financial vulnerabilities as notable. The staff judged that asset valuation pressures were elevated. In equity markets, price-to-earnings ratios stood at the upper end of their historical distribution, while spreads on high-yield corporate bonds narrowed notably and were low relative to their historical distribution. Housing valuations edged down but remained elevated"

Some Stressed Interplay between Tariffs and monetary policy

"Some participants stressed that the issue of the persistence of tariff effects on inflation would depend importantly on the stance of monetary policy."

Some Expected Economic Activity To remains Solid

"Some participants noted that economic activity would nevertheless be supported by financial conditions, including elevated household net worth, and a couple of participants highlighted stable or low credit card delinquencies"

But, Several Saw Slowdown in the second half

"Participants observed that growth of economic activity slowed in the first half of the year, driven in large part by slower consumption growth and a decline in residential investment. Several participants stated that they expected growth in economic activity to remain low in the second half of this year."

Many talked about stablecoins

"Many participants discussed recent and prospective developments related to payment stablecoins and possible implications for the financial system. These participants noted that use of payment stablecoins might grow following the recent passage of the GENIUS Act (Guiding and Establishing National Innovation for U.S. Stablecoins Act). They remarked that payment stablecoins could help improve the efficiency of the payment system. They also observed that such stablecoins could increase the demand for the assets needed to back them, including Treasury securities. In addition, participants who commented raised concerns that stablecoins could have broader implications for the banking and financial systems as well as monetary policy implementation, and thus warranted close attention, including monitoring of the various assets used to back stablecoins."

Read the full Minutes below:

https://www.zerohedge.com/markets/fomc-28

US Banks Cut Back Muni Exposure to Lowest Since Financial Crisis

 

US banks are holding the smallest share of debt sold by states and localities since the financial crisis despite attractive valuations and a heavy flow of new bond sales.

In total, banks hold nearly $295 billion of securities and around $190 billion in direct loans from municipalities, according to an analysis by Municipal Market Analytics of second quarter Federal Deposit Insurance Corporation data. That means municipal securities make up about 1.18% of total bank assets, the lowest since the financial crisis.

https://www.bloomberg.com/news/articles/2025-08-20/us-banks-cut-back-muni-exposure-to-lowest-since-financial-crisis

Bed Bath & Beyond says 'no' to California, pulls zero punches outlining economic 'reality'

 Bed Bath & Beyond’s Executive Chairman Marcus Lemonis announced on Wednesday that the company won't open or operate retail stores in California, saying the decision "isn’t about politics – it’s about reality." 

Lemonis said in a statement posted on X that the decision was driven by the fact that the company wouldn't be able to sustain operations in the state due to higher taxes, higher fees and higher wages coupled with "endless regulations that strangle growth."

"California has created one of the most overregulated, expensive, and risky environments for businesses in America," Lemonis said, noting that the state's policies created a system "that makes it harder to employ people, harder to keep doors open, and harder to deliver value to customers." 

Lemonis said the state's budget surpluses come at the expense of "ordinary citizens who are paying too much and businesses who are squeezed until they break."

Lemonis said the company won't participate in a system that he says undermines both its customers and shareholders. But the company isn't alienating its California customers. Instead, Lemonis said the company is investing in a strategy that will enable Californians to get products from BedBathandBeyond.com that will be delivered between 24 and 48 hours. In many cases, same-day service will be offered, Lemonis said, noting that it will help the company avoid the "inflated costs created by an unsustainable model." 

This comes as the ailing company fights its way back to relevance after it collapsed in 2023 from mounting debt and several failed turnaround strategies. Under its parent company, renamed from Beyond Inc. to Bed Bath & Beyond this week, the retailer is returning to brick-and-mortar shops with the first Bed Bath & Beyond Home store opening in Nashville earlier this month. 

In 2023, the original Bed Bath & Beyond filed for Chapter 11 bankruptcy and shuttered all physical stores after contending with issues such as "poor inventory management, slow adoption of online shopping trends and overreliance on coupon shopping," according to Reuters.

Overstock.com purchased its brand name, domain and other intellectual property for $21.5 million in June 2023 and subsequently relaunched its website under the Bed Bath & Beyond banner by August. In November 2023, Overstock rebranded its corporate identity as Beyond, Inc. But Kirkland’s Inc. finalized a $25 million investment deal with Beyond, which is also the parent company of Overstock, Zulily and BuyBuy Baby, in February, enabling Kirkland's to become the exclusive brick-and-mortar operator and licensee for new, smaller-format "neighborhood" Bed Bath & Beyond locations nationwide. 

Bed Bath & Beyond is attempting to make a comeback after filing for bankruptcy in 2023. (Scott Eells/Bloomberg via / Getty Images)

Earlier this week, Lemonis said the company changed its corporate name to Bed Bath & Beyond, Inc. and its common stock will begin trading under the ticker symbol BBBY on the New York Stock Exchange effective Aug. 29 as it seeks to highlight what he says are the "most valuable pieces of intellectual property that investors and consumers know today." 

The company's goal is to grow the Bed Bath & Beyond brand while simultaneously building Overstock.com "back to a billion-dollar nameplate" and maximizing value within its blockchain assets tZERO and GrainChain.

https://www.foxbusiness.com/lifestyle/major-retailer-says-no-california-pulls-zero-punches-outlining-economic-reality

Senior ISIS member killed in US military operation in Syria, official says

 A pre-dawn U.S. military raid in northwestern Syria early on Wednesday targeted and killed a senior member of the Islamic State group

https://www.reuters.com/world/middle-east/senior-isis-member-killed-us-military-operation-syria-official-says-2025-08-20/

NRx Pharmaceuticals outlines expanded fast track for NRX-100

  Targets $750M ketamine market following balance sheet strengthening

https://seekingalpha.com/news/4487558-nrx-pharmaceuticals-outlines-expanded-fast-track-for-nrxminus-100-and-targets-750m-ketamine