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Trump says he will hold summit with North Korean leader Kim Jong Un in Singapore on June 12



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President Donald Trump announced Thursday that his long-expected summit with North Korean leader Kim Jong Un will take place in Singapore on June 12.

“The highly anticipated meeting between Kim Jong Un and myself will take place in Singapore on June 12th. We will both try to make it a very special moment for World Peace!” the president tweeted.

The announcement comes just hours after three American detainees were freed from North Korea and arrived back in the U.S.

It will be the first time a sitting U.S. president meets with the leader of North Korea.

Trump has said he hopes that the summit will lead to the denuclearization of the Korean Peninsula.

The deal to meet is a notable shift in what has been, at times, a tense and confrontational relationship between the two men, marked by caustic language.

Trump has repeatedly derided Kim as “Rocket Man” or “Little Rocket Man,” and said in August that if North Korea threatened the U.S., “they would be met with fire and fury like the world has never seen.”

Kim has referred to Trump as “a gangster” and previously said he would “tame the mentally deranged U.S. dotard with fire.”

Trump, however, says the U.S. is developing a better relationship with the North Korean leader. Secretary of State Mike Pompeo recently visited North Korea and met with Kim.

Vice President Mike Pence said Thursday that the release of Americans was “all a direct result of the strong and clear leadership that President Trump has provided on the world stage in this moment. Think about how far we’ve come in the last year.”

“From very early in this administration, President Trump changed the policies of the United States from an era of strategic patience with North Korea to move toward the kind of campaign that would bring economic and diplomatic pressure to bear while reserving all other options, with the clear objective — of achieving the denuclearization of the Korean peninsula,” Pence told NBC’s Andrea Mitchell in an interview.

“We appreciate Kim Jong Un’s efforts so far,” Pence said, but noted that the administration has “no illusions” about the challenges ahead.

The announcement of the summit comes after punishing sanctions were leveled against North Korea in response to its missile and nuclear tests.

Last month, Kim said he would suspend nuclear and missile tests, stating that further ones were unnecessary. He also met South Korean President Moon Jae-in at a historic summit in late April.

The White House has credited its campaign of “maximum pressure” for creating an atmosphere for dialogue with North Korea.

But it is unclear what may come out of the talks. Trump has stated that his goal is the denuclearization of the Korean Peninsula, but added, “If the meeting, when I’m there, isn’t fruitful, I will respectfully leave the meeting.”

Earlier Thursday, Trump expressed gratitude to Kim for the return of the detainees and said he was optimistic about their planned talks.

“We want to thank Kim Jong Un,” the president said as he greeted the returning Americans. “I really think he wants to do something … and bring his country into the real world. I really think we have a very good chance of doing something very meaningful.”

The detainees, Kim Hak-song, Kim Dong-chul and Kim Sang-duk, who is also known as Tony Kim, were granted amnesty from North Korean labor campsby Kim after spending up to two years in detention accused of crimes against the regime.

“It is like a dream. We are very, very happy,” Kim Dong-chul told reporters through a translator after arriving back in the U.S.

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Biden wants to strengthen Medicaid, but Trump left major hurdles for him



In rural Clay County, Georgia, access to health care is not always easy to come by. So when an area hospital that had long been on the financial brink closed in October because of the pandemic, Dr. Karen Kinsell, the only doctor in the county, was left with even fewer resources to treat her neighbors.

It’s rare that Kinsell’s patients have insurance or are even covered by Medicaid, the federal and state program aimed to help the country’s poorest receive medical care. In this southwest corner of Georgia, one of the dozen states that still hasn’t expanded Medicaid, it’s typical for her patients to have no health care coverage at all.

So Kinsell charges $10 for a doctor’s visit, less if patients can’t afford it.

“Everybody is born, everybody dies, and most people get sick in between,” Kinsell said. “For one of the richest countries in the world, one of the most medically advanced, to just be leaving out 10 to 20 percent of their population from participating in that service is just wrong. It’s immoral and not sustainable. It hurts the entire system.”

Dr. Karen Kinsell checks a patient at Clay County Medical Center in 2017.Hyosub Shin / Atlanta Journal-Constitution via AP file

It hurts particularly bad in Georgia, which has the third highest rate of uninsured people in the country, according to the Census Bureau. It’s also a state where lawmakers have forgone billions of federal dollars that would have helped provide hundreds of thousands of Georgians with health care coverage by expanding Medicaid enrollment.

The Biden administration hopes to quickly help those uninsured in Georgia, as well as in 11 other states, by providing incentives to expand Medicaid. The efforts won’t be easy, however: Some state leaders, like Gov. Brain Kemp last year, pursued a variation of Medicaid expansion pushed by the Trump administration — a version that undercuts the federal insurance program, implements work requirements and leaves hundreds of thousands of people without access to coverage.

Republican lawmakers maintain that expansion is too heavy a financial burden for states to take on, even though the federal government will pay for 90 percent of it. There is also ideological opposition to the program, especially as it was formed under the umbrella of Obamacare.

The governor’s office did not respond to a request for comment.

So far, 38 states have expanded Medicaid; Georgia, Mississippi, Tennessee, Alabama, Florida, North Carolina, South Carolina, Texas, Wyoming, Kansas, South Dakota and Wisconsin have not. That has left millions of people without coverage more than a decade after states were eligible to enroll in Medicaid expansion through the Affordable Care Act.

Georgia Gov. Brian Kemp greets President Donald Trump as Trump arrives at Hartsfield-Jackson Atlanta International Airport on July 15.Evan Vucci / AP file

Hours after Joe Biden took the oath of office as president, the White House dedicated last Thursday to the signing of an executive order to take steps to “strengthen Medicaid and initiate an open enrollment period under the ACA,” also known as the Affordable Care Act or Obamacare.

The White House declined multiple requests to provide more specifics about the order and how it would strengthen Medicaid, but many policy experts say it will address the numerous waivers provided by the Trump administration.

During the Trump administration, the Centers for Medicare & Medicaid Services, or CMS, provided a series of waivers — in essence, agreements between states and the federal governments about the implementation of Medicaid — for states to pursue their own goals with the program.

Most notably, the Trump White House pushed to provide waivers to allow states to enact work requirements to receive state Medicaid benefits, which no administration had done before and which Congress had voted down in 2017.

Now many wonder what it will take for the Biden administration to unwind some of those policies and expand access to health care as he promised.

“Each administration does have some discretion and flexibility, but given all the litigation we saw, that discretion is not unlimited,” said Robin Rudowitz, vice president of the Kaiser Family Foundation’s Program on Medicaid and the Uninsured. “It certainly is still being tested in the courts, but I think it’s not disputed that there’s flexibility for a new administration to rescind and issue new guidance on what waivers they’d like to promote and encourage. For anything that’s pending, those are negotiations between the administration and the state.”

That has, in essence, left behind a political bomb for Biden and the new administration to defuse, most likely at the cost of political capital, while increasing tension between states and the federal government.

Some criticize the Trump administration’s oversight of health care coverage, especially during the pandemic.

A mobile medical unit being set up to treat Covid-19 patients outside the emergency entrance at WellStar Kennestone Hospital in Marietta, Ga., on March 16.Curtis Compton / Atlanta Journal-Constitution via AP file

“The fact that during a pandemic, when Medicaid is a first responder, they were spending so much time trying to booby-trap the program and handcuff the Biden administration when they walked in the door is abhorrent,” said Joan Alker, executive director of Georgetown University’s Center for Children and Families.

Nineteen states have approved or pending work requirement waivers, which critics say damaged Americans’ access to a vital safety net program and could cause quite a bit of trouble for the Biden administration to dismantle.

Arkansas, New Hampshire, Kentucky and Michigan have Trump administration-approved waivers that are held up by litigation; Utah, Nebraska, Arizona, Wisconsin, Indiana, Ohio, South Carolina and Georgia have waivers approved by the Trump administration; and Idaho, Montana, South Dakota, Oklahoma, Mississippi, Alabama and Tennessee are waiting for approval.

As of October, Georgia was one of the states most recently to have adopted a variation of expansion with the approval of the Trump administration’s Department of Health and Human Services.

Georgia got a waiver from the department, essentially allowing it to bend the policy and cover Georgians only up to 100 percent of the federal poverty line as long as they worked 80 hours a month or pursued educations. Most would also have to pay monthly premiums, and they would lose coverage if they couldn’t afford to pay.

The policy would allow only about 64,300 to get coverage, according to state estimates — rather than the state’s estimate of 480,000 to 600,000 who would gain access through full Medicaid expansion.

Critics say requiring people to work to get health care coverage during a pandemic that has sparked the worst employment crisis since the Great Depression completely misses the mark.

A man uses his phone to copy phone numbers posted on the locked doors of a Georgia Labor Department office in Norcross on May 7.John Bazemore / AP file

“As we’ve seen with many, many big policy changes, this is a lot more about politics than the actual data and policy, which the vast majority of Georgians and Americans agree on,” said Laura Colbert, executive director of Georgians for a Healthy Future.

Kemp has taken a fair amount of flak for the initiative from Democrats and policy experts, but the Trump administration had already provided the waiver, which creates a particularly difficult path forward.

The Trump administration also went further, trying to bolster the agreements by establishing new procedural rights for any future waiver withdrawals by the Centers for Medicare & Medicaid Services.

“At the very end of the Trump administration, the CMS director, Seema Verma, was encouraging states to sign letters of agreement basically trying to make it more difficult for the next administration to go back on some of these approved waivers,” Rudowitz said. “I think that we’re going to see that tested.”

The Biden administration also has to figure out how to contend with the lawsuits that have blocked four of the waivers.

The Supreme Court has taken up the Arkansas and New Hampshire cases for consideration, and Trump’s health and human services secretary, Alex Azar, filed a brief supporting the cases the day before he left office.

“Fundamentally we’re in unprecedented territory here,” Alker said, noting that Biden’s Justice Department will have to figure out its position in the litigation. “We’ve never had an administration that essentially attempted to rewrite the Medicaid statute through the waiver process and authorized things that Congress had explicitly not allowed, like work requirements.”

All of that is likely to create a policy and political headache for the Biden administration, as well as the states that hope to maintain work requirements.

Dr. Karen Kinsell at her medical practice in Fort Gaines, Ga.Mickey Welsh / Advertiser vie USA Today Network

But on the ground in Georgia, Kinsell and others are left to navigate the realities of those policy choices. For her, the choice is simple, and she doesn’t understand why the state’s leaders wouldn’t pursue a program that would cover as many as 600,000 Georgians, rather than 64,400.

Every day in her office, Kinsell said, she sees unmet health care needs that lead to disability and unemployment. A patient who couldn’t afford to treat her diabetes lost both her legs, and it is cases like that that weigh heavy on her mind.

“That can’t be fiscally responsible or a good idea,” she said. “It’s really not moral, Christian or smart from where I’m sitting, either.”

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