A billion four would leave a hole in Maryland's budget the size of the Hogan admin's incompetence. How did that minus number emerge? Better news -- a Year of Service program that seems realistically based and at the proper scale for a start-up program. Plus: a federal shutdown is still possible and the state is getting ready for it. And: tackling the problem of mass incarceration from both directions; Baltimore tech hub; a grant for fighting Alzheimer's; catching tropical fish in the Bay; lots of national and state news from outside our boundaries too. It's News You Can Use for this week, from Progressive Maryland's eyeballs to you.

FIRST, ALL THE STUFF FROM MARYLAND

Audit Finds State Could Be Out $1.4b In Unreimbursed Federal Funds:A new report by the Office of Legislative Audits found that the state has not been reimbursed for $1.4 billion in expenditures at the Maryland Department of Health. The report indicates there was poor documentation for a variety of spending, which ultimately led to the lack of reimbursement from the federal government. WBFF-TV News. MORE  The state had spent the money on a variety of health care programs, including Medicaid, but without proper documentation the department may not get reimbursed by the federal government as expected. If the state does not get paid for the $1.4 billion, it could cause a significant hole in the overall state budget, which runs about $63 billion. The Baltimore Banner (paywalled) STILL MORE The Maryland legislature has been raising questions about how the Health Department documented and utilized some of the millions of dollars of federal COVID funding it received, but the state agency had few answers. “I’ve never seen an audit like this. This is the worst audit I’ve ever seen. And it’s every worse nightmare pulled together,” said Sen. Clarence Lam (D-Howard), Senate chair of the Joint Audit and Evaluation Committee.Maryland Matters.

Moore Launches Year Of Service Program With 280 Participants: The University of Maryland fight song echoed through the college’s Reckord Armory Friday as dancers performed routines and a tunnel of cheerleaders welcomed the participants of Gov. Wes Moore’s Maryland Corps and Service Year Option to celebrate its pilot launch. Capital News Service/Maryland Reporter MORE While starting with 280 participants this year, Moore has talked about growing to become a major state-backed program, one available to every graduate in the state and a model for others to replicate across the country. Baltimore Sun. STILL MORE The effort is a key step toward one of Democratic Gov. Wes Moore’s signature campaign promises: to eventually create a pathway for every recent high school graduate to spend a year in the workforce in jobs that serve the greater good. WaPo

Fishing Fans Finding New “Tropical” Species in the Bay -- For the most part, the Chesapeake Bay and its tidal rivers remain an anglers’ paradise. But what they’re angling for is beginning to shift as water temperatures warm, according to climate and fishery experts. Many recreational fishermen say they’re already seeing a difference. A spate of recent research across the globe suggests the warming climate will likely drive many fish species northward to flee the heat. Bay Journal

Program Would Aid Essential Workers When Federal Govt Shuts Down: With another government shutdown deadline less than a month away and no end in sight to the feuding over who House Republicans will elect speaker, Maryland officials are setting up a new lifeline for some federal employees who may soon be forced to work without pay. Baltimore Sun.

Baltimore Region Designated National Tech Hub: The Baltimore region has been awarded a federal designation as a national tech hub, which could generate hundreds of millions of dollars of investment and create tens of thousands of jobs. Baltimore Sun

Md Health Gets $2.5m Grant To Increase Alzheimer’s Awareness: The Maryland Department of Health is receiving a $2.5 million grant from the Centers for Disease Control and Prevention to increase the general understanding and awareness of Alzheimer’s Disease and related dementias and to help the state government implement its Alzheimer’s roadmap. WYPR-FM.

 State Preps For Uptick In Jobless Claims From Federal Shutdown: State Labor Department officials are preparing for a potential uptick in unemployment insurance claims tied to a possible federal government shutdown next month. Congress narrowly averted a shutdown at the end of September with a 45-day resolution meant to provide extra time to cut a budget deal. Reaching an agreement is now complicated by an ongoing battle within the Republican Party to elect a new House Speaker.  Maryland Matters. MORE Maryland officials also are setting up a new lifeline for some federal employees who may soon be forced to work without pay. The program --- approved at Wednesday’s state Board of Public Works meeting — would offer small, no-interest loans to civilian federal employees who work in Maryland but are not otherwise eligible for unemployment insurance benefits.  Baltimore Sun.

Atty Gen, Public Defender Team Up To End Mass Incarceration: Maryland Attorney General Anthony Brown (D) and Maryland Public Defender Natasha Dartigue said some people view their offices as adversarial because of their different missions in the criminal justice system. But on Wednesday at Bowie State University, they stood side-by-side to launch the Maryland Equitable Justice Collaborative, an effort to eliminate mass incarceration. Maryland Matters. MORE Representatives from over 40 such agencies and groups attended the launch of the Maryland Equitable Justice Collaborative at Bowie State University, kicking off a multi-year process that officials said will include legislative and funding recommendations for the coming General Assembly session. Capital News Service/MarylandReporter.com.

Elementary Schools' Fresh Fruit, Veggie Program To Expand: Maryland’s education department is using $4.7 million in federal grant money to fund a program geared at expanding students’ access to fresh fruits and vegetables during the school day. The Maryland State Department of Education said it will distribute funds to 213 elementary schools statewide — up from 196 schools during the previous school year — from the U.S. Department of Agriculture’s Fresh Fruit and Vegetable Program. WTOP-FM

AROUND THE STATES AND CITIES

States both Blue and Red Slash Taxes Despite Expert Warnings -- Flush after years of thriving economies, states this year have continued a yearslong trend of tax cutting. Strong consumer spending, increasing property values and inflation have boosted state revenues along with an influx of billions from the federal government. Many lawmakers view tax cuts as a logical response to boom times: returning excess taxpayer dollars to taxpayers. But some experts think states have cut too deep, using short-term revenue trends to justify permanent reductions in state revenue, often through cuts that benefit the wealthiest residents. And they warn that some states already are starting to bring in less money.

Free Community College: Maine college students are continuing to choose the state’s free community college program instead of four-year universities. The Maine Community College System saw a 16% increase in enrollment this year compared to last, the Portland Press Herald reports. Meanwhile, undergraduate enrollment in the University of Maine System dropped by 2.4%, continuing a decadelong decline. Stateline Daily

Social Media: A bipartisan coalition of 33 attorneys general [including Maryland’s] sued Meta, the parent company of Facebook and Instagram, in the Northern District of California over alleged harms to minors after a two-year investigation. Attorneys general from eight other states and the District of Columbia will file separate but related lawsuits against the company. Utah Gov. Spencer Cox (R) compared the litigation to prior lawsuits against the opioid industry and Big Tobacco. (Pluribus News) more here at Northeast Public Media.

Staff is Permitted to Organize Union -- The Illinois House voted to allow legislative staff to organize for collective bargaining rights. Illinois would become the fourth state to allow staff to form a union, after Maine, Oregon and California. (WBEZ)

NATIONAL NEWS AND NOTES

National stuff from People’s Action federal affairs monitor Megan Essaheb: Lots to talk about this Monday including a fully Trump-approved House Speaker and news on AI regulation, health care moves and housing.

House Republicans finally elected a Speaker of the House last week, Rep. Mike Johnson of Louisiana is an extremely right wing evangelical who opposes abortion rights, gay marriage and trans rights. He’s also a 2020 election denier who is close to Trump. Why Johnson? He is described as “kinder” than the others but the real reason may be he has only been in Congress since 2016 and has not had time to make as many enemies as those who failed to win. The freedom caucus seem to be giving Johnson some room to govern as they have signaled they are open to passing a continuing resolution funding the government at current levels until January or April. However, he is setting up a fight between House Republicans and Senate Republicans this week over a military aid package to Ukraine and Israel. Johnson and many other House Republicans no longer want to fund Ukraine’s defense against Russia. Biden and both Senate Democratic and Republican leadership seek to pass a package that attaches aid to Ukraine and Israel in order to get the Ukraine package passed. Johnson plans to pass an aid package to Israel this week that cuts funding in other places in the federal budget (likely domestic programs) in order to offset this spending. This bill is a nonstarter for Democrats in the Senate.

ARTIFICIAL INTELLIGENCE: President Biden will sign an executive order guiding the development of AI technology, requiring businesses to develop safety and security standards and introducing consumer protections. The order will rely on the Defense Production Act requiring developers to share safety test results and other information with government. (Associated Press) via Pluribus

ISSUE UPDATE: HEALTHCARE

Wyden targets Medicare Advantage "ghost networks"

Axios, Peter Sullivan, October 26, 2023.  Senate Finance Chairman Ron Wyden is hoping to get a new bill cracking down on "ghost networks" in Medicare Advantage into an end-of-year package, he told Axios. Why it matters: The effort is part of a push to improve access to care, especially for mental health, and make sure insurers' provider directories are up to date so that patients can actually find providers who are covered. Driving the news: Wyden introduced the bill last week with Sen. Michael Bennet and, notably, a Republican, Sen. Thom Tillis. The bill strengthens requirements for MA plans to have up-to-date and accurate provider directories, and prevents patients from having to pay higher out-of-pocket costs if their insurer said a provider was in-network when it actually wasn't. What they're saying: "I hope that we can make that part of the end-of-year package," Wyden said of the bill.

Senate Hearing Examines Medicare Advantage Marketing and Misinformation

Medicare Rights Center, Lindsey Copeland, October 26, 2023.  On October 18, the Senate Finance Committee held a hearing on Medicare Advantage (MA) marketing practices, with a focus on deceptive plan and broker behaviors that can derail beneficiary decision-making and access to care. Troublingly, such messaging is often, and increasingly, designed to confuse. According to the Centers for Medicare and Medicaid Services (CMS), beneficiary complaints about misleading marketing more than doubled from 2020 to 2021. The Senate Finance Committee initially reviewed MA marketing challenges in a November 2022 report, documenting the alarming methods plans, brokers, and agents sometimes employ to boost enrollment and profits. The report also outlined steps CMS could take to curb these harmful practices. Since then, CMS finalized key marketing restrictions and heightened oversight of advertising activities.

Overall Satisfaction with Medicare is High, But Beneficiaries Under Age 65 With Disabilities Experience More Insurance Problems Than Older Beneficiaries. In 2022, 7.7 million people under age 65 with disabilities were covered by Medicare, representing 12% of all Medicare beneficiaries. Younger beneficiaries who qualify for Medicare because of disability are more likely than those who qualify based on age to have lower incomes and education levels, to be Black or Hispanic, and to be in worse health.

 Smaller Employers Weigh a Big-Company Fix for Scarce Primary Care: Their Own Clinics

KFF Health News, Phil Galewitz, October 27, 2023.  With his company’s health costs soaring and his workers struggling with high blood pressure and other medical conditions, Winston Griffin, CEO of Laurel Grocery Co., knew his company had to do something. So the London, Kentucky, wholesaler opened a health clinic… At Laurel Grocery’s in-house clinic, workers can get checkups, blood tests, and other primary care needs fulfilled free, without leaving the workplace. But Griffin’s move is notable because of his company’s size: only about 250 employees. Nationwide, a modest number of small- and medium-size employers have set up their own health clinics at or near their workplaces, according to surveys and interviews with corporate vendors and consulting firms that help employers open such facilities.

More Americans downgrading insurance plans to cope with rising costs

 The survey found more than half of Americans could not pay off an unexpected $5,000 health care out-of-pocket expense. Consumers are feeling the financial pain of rising prices and stubborn inflation, and their physical health may suffer as a result. The latest Nationwide Retirement Institute Health Care Cost in Retirement survey found that more than half of respondents lack confidence in their ability to pay for health care costs as they age, and a similar number also worry about their ability to pay for caregiving for their partner or spouse.

One-third of Americans burdened by medical debt: study

Insurance coverage often fails to help Americans avoid medical debt, a new survey from the Commonwealth Fund revealed. The report showed that, in addition to the 51% of Americans that struggle to afford their healthcare, there is growing concern over medical expenses causing worse health and economic outcomes. “While having health insurance is always better than not having it, the survey findings challenge the implicit assumption that health insurance in the U.S. buys affordable access to care,” said the study’s authors.

ISSUE UPDATE: HOUSING

Time published a short documentary on KC Tenants organizing over the last few years. 

Majorities in Massachusetts support rent control, 'right to shelter' law, UMass Amherst/WCVB poll finds

New York City Has a Bold Plan to Fix Its Housing Crisis. Will It Work?

Last month, Mayor Eric Adams unveiled a big plan to tackle New York City’s housing shortage and make the city more affordable. The plan, the city says, would make way for something on the order of 100,000 additional homes over the next 15 years, mainly through changes to the city’s zoning code. While an ambitious target, it may not be enough to bring down rents or home prices: One report released this month by Up for Growth, a Washington policy and research group, estimated that the New York City metropolitan area was short nearly 340,000 homes as of 2021. And the need for housing — and in particular affordable housing — remains extremely high. Still, the plan is among the biggest local efforts to address the shortage, and could have some significant effects across the city.

'Rents are just too high' | Housing advocates urge Newsom to support rent control ballot initiative Renters and housing advocates are urging Governor Gavin Newsom to support a rent control ballot initiative eligible to appear on the November 2024 ballot. Supporters of the Justice for Renters Act, as it's called, gathered on the steps of the state Capitol Wednesday afternoon. Organizers brought more than 730,000 letters from constituents asking for Newsom's support. If approved by voters, the proposal would allow local governments to set limits on how much rent can be raised on housing. The goal of supporters is to stop skyrocketing rents.

ISSUE UPDATE: OVERDOSE

This article by KFF news published by NPR on how opioid settlement funds are being spent around the country (including by giving big amounts to law enforcement in some places --sigh) has a photo of People’s Action’s action on the Drug Enforcement Agency at our convention.