Raw Story

After less than two weeks in office, Donald Trump has already has his closest advisors trying to stop the bleeding over a series of missteps ranging from confusing executive actions to his highly criticized response to the air tragedy in Washington, D.C.

That is according to a report from the Wall Street Journal which is reporting, "His defiant stand in the face of nationwide confusion and fear left some aides scrambling to fortify the image of a White House that could do no wrong."

The report notes that the returning president is now getting back to the difficulties of governing and, despite having a previous four years in the Oval Office, things are off to a ragged start.

ALSO READ: Top GOPer's ‘most immediate’ priority for new committee includes probing a MAGA conspiracy

"On camera and on Truth Social all week, Trump governed with his usual confidence and bravado. But behind the scenes, there was evidence of frustration and breakdowns in communication in an administration that has moved with lightning speed to try to shake up the government," the Journal is reporting before adding that a controversial budget memo, that crippled government operations, has become a major embarrassment for the new administration.

The "poorly written" memo, as described by an anonymous White House official, "wasn’t run by many top advisers in the West Wing, including deputy chief of staff Stephen Miller, before it was issued, according to people familiar with what happened. "

According to that official, "Memos are supposed to offer guidance, and this was the opposite of guidance.”

Added to that, was the crash of a commercial aircraft with a Blackhawk helicopter, that claimed a combined 70 lives, which led to Trump deciding to offer some "opinions" on what happened as bodies were still being pulled out the water.

"Former U.S. air-safety officials recoiled at Trump’s extremely unusual press conference. Aside from his focus on the FAA’s efforts to diversify its workforce, they said Trump upstaged the National Transportation Safety Board and threatened to undercut its status as the world’s gold standard for investigations by quickly assessing the crash’s cause and assigning blame," the report states.

You can read more at the link.

During her annual OB-GYN visit, Callie Anderson asked about getting off the birth control pill.

“We decided the best option for me was an IUD,” she said, referring to an intrauterine device, a long-acting, reversible type of birth control.

Anderson, 25, of Scranton, Pennsylvania, asked her doctor how much it might cost. At the time, she was working in a U.S. senator’s local office and was covered under her father’s insurance through a plan offered to retired state police.

“She told me that IUDs are almost universally covered under insurance but she would send out the prior authorization anyway,” Anderson said.

She said she heard nothing more and assumed that meant it was covered.

After waiting months for an appointment, Anderson had the insertion procedure last March. She paid $25, her copay for an office visit, and everything went well.

“I was probably in the room itself for less than 10 minutes, including taking clothes on and off,” she said.

Then the bill came.

The Medical Procedure

According to Planned Parenthood, IUDs and implantable birth control represented nearly 25% of its contraceptive services provided from October 2021 to September 2022, per the latest data available.

There are two types of IUDs: copper, which Planned Parenthood says can protect against pregnancy for up to 12 years, and hormonal, which can last from three to eight years depending on the brand. Hormonal IUDs can prevent ovulation, and both types affect the movement of sperm, designed to stop them from reaching an egg.

A physician or other practitioner uses a tube to insert the IUD, passing it through the cervix and releasing it into the uterus.

Doctors often recommend over-the-counter drugs for insertion pain, a concern that prompts some patients to avoid IUDs. Last year, federal health officials recommended doctors discuss pain management with patients beforehand, including options such as lidocaine shots and topical anesthetics.

The Final Bill

$14,658: $117 for a pregnancy test, $9,862 for a Skyla IUD, $4,057 for “clinic service,” plus $622 for the doctor’s services.

The Billing Problem: A ‘Grandfathered’ Plan

Anderson got a rare glimpse of what can happen when insurance doesn’t cover contraception.

The Affordable Care Act requires health plans to offer preventive care, including a variety of contraceptives, without cost to the patient.

But Anderson’s plan doesn’t have to comply with the ACA. That’s because it’s considered a “grandfathered” plan, meaning it existed before March 23, 2010, when President Barack Obama signed the ACA into law, and has not changed substantially since then.

It’s unclear how many Americans have such coverage. In its 2020 Employer Health Benefits survey, KFF estimated that about 14% of covered workers were still on “grandfathered” plans.

Anderson said she didn’t know that the plan was grandfathered — and that it did not cover IUDs — until she contacted her insurer after it denied payment. Her doctor with Geisinger, a nonprofit health system in Pennsylvania, was in-network.

“My understanding was Geisinger would reach out to insurance and if there was an issue, they would tell me,” she said.

Mike McCullen, a Geisinger spokesperson, said in an email to KFF Health News that with most insurance plans, “prior authorization is not required for placing birth control devices, however, some insurers may require prior authorization for the procedure.”

He did not specify whether it is the health system’s policy to seek such authorizations for IUDs, nor did he comment on the amount charged.

The Pennsylvania State Troopers Association, which offers some retirees the plan that covered Anderson, did not respond to requests for comment. Highmark Blue Cross Blue Shield, the insurer, referred questions to the state.

Dan Egan, communications director for the state’s Office of Administration, confirmed in an email that the insurance plan is a grandfathered plan “for former Pennsylvania State Troopers Association members who retired prior to January 13, 2018.”

A benefit handbook for the plan identifies it as grandfathered and lists a variety of excluded services. Among them are “contraceptive devices, implants, injections and all related services.”

The $14,658 bill, an amount that typically would be negotiated down by an insurer, was solely Anderson’s responsibility.

“Fourteen thousand dollars is astronomical. I’ve never heard of anything that high” for an IUD, said Danika Severino Wynn, vice president for care and access at the Planned Parenthood Federation of America.

Costs for IUDs vary, depending on the type, where the patient lives, insurance status, the availability of financial assistance, and additional medical factors, Severino Wynn said.

She said most insurers cover the devices, but coverage can vary, too. For instance, some cover only certain types or brands of contraceptives. Generally, an IUD insertion costs $500 to $1,500, she added.

Many providers, including Planned Parenthood, have sliding-scale rates based on income or can set up payment plans for cash-paying or underinsured patients, she said.

According to FAIR Health, a cost estimation tool that uses claims data, an uninsured patient in the Scranton area could expect to be charged $1,183 for an IUD insertion done at an ambulatory surgery center or $4,319 in a hospital outpatient clinic.

The Resolution

Anderson texted and called her insurer and Geisinger multiple times, spending hours on the phone. “I am appalled that no one at Geisinger checked my insurance,” she wrote in one message with staff at her doctor’s office.

She said she felt rebuffed when she asked billing representatives about financial assistance, even after noting the bill was more than 20% of her annual income.

“I wasn’t in therapy at the time, but at the end of this I ended up going to therapy because I was stressed out,” she said. The billing office, she said, “told me that if I didn’t pay in 90 days, it would go to collections, and that was scary to me.”

Eventually, she was put in touch with Geisinger’s financial assistance office, which offered her a self-pay discount knocking $4,211 off the bill. But she still owed more than she could afford, Anderson said.

The final offer? She said a representative told her by phone that if she made one lump payment, Geisinger would give her half off the remaining charges.

She agreed, paying $5,236 in total.

The Takeaway

It’s always best to read your benefit booklet or call your insurer before you undergo a nonemergency medical procedure, to check whether there are any exclusions to coverage. In addition, call and speak with a representative. Ask what you might owe out-of-pocket for the procedure.

While it can be hard to know whether your plan is grandfathered under the ACA, it’s worth checking. Ask your insurance plan, your employer, or the retiree benefits office that offers your coverage. Ask where the plan deviates from ACA rules.

With birth control, “sometimes you have to get really specific and say, ‘I’m looking for this type of IUD,’” Severino Wynn said. “It’s incredibly hard to be an advocate for yourself.”

Most insurance plans offer online calculators or other ways to learn ahead of time what patients will owe.

Be persistent in seeking discounts. Provider charges are almost always higher than what insurers would pay, because they are expected to negotiate lower rates.

Bill of the Month is a crowdsourced investigation by KFF Health News and The Washington Post’s Well+Being that dissects and explains medical bills. Since 2018, this series has helped many patients and readers get their medical bills reduced, and it has been cited in statehouses, at the U.S. Capitol, and at the White House. Do you have a confusing or outrageous medical bill you want to share? Tell us about it!

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

This article first appeared on KFF Health News and is republished here under a Creative Commons license

President Donald Trump and his administration officials triggered immediate outrage on Thursday after blaming the devastating plane crash in Washington, D.C. on "diversity" programs implemented at the Federal Aviation Administration. The crash, which was caused by a midair collision with an Army helicopter, remains under investigation — but no evidence has emerged to support the theory of diversity programs playing a role.

Indeed, Rep. Alexandria Ocasio-Cortez (D-NY) furiously pointed out on X that just a few days ago, acting on the advice of tech billionaire Elon Musk, Trump ousted key aviation safety officials from their jobs.

"I represent LaGuardia Airport as well as workers for JFK," wrote Ocasio-Cortez. "Trump gutted the Aviation Safety Committee last week. Air traffic controllers — already understaffed — got Trump’s 'buyout' this week with a 1 week ultimatum to decide."

"It’s not DEI — it’s him. And Elon too," she concluded.

The "buyout" offer, which closely mirrors a mass layoff policy adopted by Musk when he took over the Twitter platform before rebranding it, isn't a buyout in strict terms, but an offer to delay being fired for eight months in return for not having to comply with the Trump administration's new return-to-office policies.

ALSO READ: Top GOPer's ‘most immediate’ priority for new committee includes probing a MAGA conspiracy

The idea that aviation safety standards have been undermined by diversity programs is a conspiracy theory that has been knocking around the far right for years, and in particular exploded into prominence last year MAGA youth activist Charlie Kirk baselessly suggested that Black pilots were being hired in contravention of qualification rules.

At one point, even the Trump campaign itself was worried that Kirk's rantings on the subject would make it harder for them to win over Black voters.

Sen. Maggie Hassan (D-NH) attacked Robert F. Kennedy Jr.'s questionable beliefs about science during his confirmation hearing by citing her son, who has "severe cerebral palsy."

Speaking to the committee Thursday, Hassan said she found it "disturbing" that Republicans accused her and her colleagues of partisanship during Kennedy's first hearing a day earlier.

"Like all of us, I take really seriously our obligation for advice and consent," she said of the Senate's role.

ALSO READ: RFK Jr. botched his financial reports — omitting $500,000 in anti-vax and law income

"And I am concerned, as Sen. [Markwayne] Mullin (R-OK) is concerned, about the need for science to help us move forward on critical, critical issues."

"Now, some of you new to this committee might not know that I'm the proud mother to a 36-year-old young man with severe cerebral palsy," Hassan continued, her voice cracking as she spoke.

"And a day does not go by when I don't think about what I did when I was pregnant with him that might have caused the hydrocephalus that has so impacted his life.

"So, please, do not suggest that anybody in this body of either political party doesn't want to know what the cause of autism is!" Hassan shouted at Kennedy.

She went on to argue that the problem with Kennedy is that he continues to try and re-litigate "settled science" about autism and vaccines. The study that Kennedy often cites looked at 12 children who were vaccinated. It then claimed a false connection to those with autism. The journal that published the study ultimately retracted it.

See her comments in the video below or at the link here.

- YouTube www.youtube.com

Sen. Adam Schiff (D-CA) got into a fiery exchange with Kash Patel, the far-right former House staffer and Trump administration loyalist now nominated to serve as Trump's FBI director, after pointing out that Patel bragged about his role in recording the so-called "January 6 Choir" from the Washington, D.C. jail.

Its members included people involved in assault on police at the Capitol, and their song became a political rallying cry for Trump and his supporters.

Trump ultimately went on to issue a blanket pardon of almost everyone at the attack, including the members of the choir.

Patel sought to deny his involvement in the recording of the choir — but Schiff brought receipts.

"Here's what you told Steve Bannon on his podcast: 'So what we thought would be cool is if we captured that audio, and then, of course, had the greatest president, President Donald J. Trump, recite the Pledge of Allegiance. Then we went to a studio and recorded it, mastered it, digitized it, and put it out as a song now releasing exclusively on The War Room. We, we, we. If you had nothing to do with it, Mr. Patel, why did you tell Steve Bannon and all his listeners that you did?"

"That's why it says 'we,' as you highlighted," said Patel.

"Yeah, and you're part of the 'we,' right? When you say 'we,' that includes you, doesn't it, Mr. Patel?" said Schiff. "So when you said, 'we,' you didn't really mean you? Is that your testimony?"

Schiff then directed Patel to look at Capitol police in the room. "I want you to look them in the eye, Mr. Patel, and tell them you're proud of what you did. Tell them you're proud that you raised money off of people that assaulted their colleagues, that pepper sprayed them, that beat them with poles. Tell them you're proud of what you did, Mr. Patel. They're right there! They're guarding you today! Tell them how proud you are."

"That's an abject lie, and you know it," said Patel. "I've never, never, ever accepted violence against law enforcement. I've worked with these men and women, as you know."

"Oh, no, no, you didn't accept it, you glorified it in song, Mr. Patel!" cut in Schiff.

Watch the video below or at the link here.

President Donald Trump has gained power over all branches of government, including a conservative-run Supreme Court, but law school professor Deborah Pearlstein urged critics not to give up on the courts just yet.

Writing for the New York Times, Pearlstein, a visiting professor of law and public affairs at Princeton and the director of its Program in Law and Public Policy, said that the new administration is clearly less concerned with the legality of its executive orders.

"These are not the strategic moves of a legal A team focused on insulating itself against judicial correction, or teeing up a model case to persuade the courts to move the law in a new direction," she wrote Thursday. "These seem more like the orders of a team unconcerned with the risks of any legal challenge at all."

ALSO READ: Reminder: Trump is a demented criminal president

She acknowledged that American confidence in the Supreme Court may be at an all-time low, but urged "that dispair is premature" and it will take a lot more to side-step the law.

While there is a fear that the courts will simply give in to Trump's demands, judges are already stepping in. On Wednesday, Trump's government funding freeze was itself frozen by a judge. While that's likely being repealed, it will be a long process for Trump lawyers at a time the administration is purging career employees who might work on those cases.

Federal District Court Judge John C. Coughenour also blocked Trump's executive order ending birthright citizenship.

"The courts," Pearlstein wrote, "are not so dominated by partisan judges that any action challenging a Republican president will inevitably fail."

She noted that Trump was able to appoint more than 200 judges during his first four years in office, but researchers found that even those judges aren't handing "wins" to Trump out of loyalty.

She recalled stories of lawyers who, during his first term, were able to curb some of Trump's "most lawless efforts." Not having those lawyers on hand may mean more erratic orders, but that doesn't mean they'll survive any legal scrutiny.

"Getting lawyers to back absolutely anything Mr. Trump wants may not be as easy as the president and his advisers think," wrote Pearlstein, noting that they are bound by ethics rules.

"That may explain why some of these early orders in the new administration are largely devoid of specific legal guidance — and why they stand a fair chance of being overturned in the courts," she closed.

Read the full column right here.