Taiwan President Visit, Medicaid Rule Expires, Nashville Vigil
12:34 Share

Taiwan's leader is in New York today. China looks unfavorably on her tour of the U.S. and Central America, where she counts some of her dwindling allies. What can she accomplish? I'm E. Martinez, that's Sasha Pfeiffer, and this is Up First from NPR News.

Millions of Americans with lower incomes or disabilities stand to lose Medicaid health coverage this week. Pandemic era protections are expiring. So how will these patients access care now and how will providers get paid? And Nashville mourns its dead after a school shooting. Evelyn Dykus, Haley Scruggs, William Kenney.

Cynthia Peek, Catherine Kuntz, and Mike Hill. How does the city recover and will this tragedy lead to more urgent action on gun control? So stay with us. We'll give you the news you need to start your day.

Taiwan's President Tsai Ing-wen is in the U.S. today. Yes, he's in New York as part of a high-stakes trip to Central America and the U.S. Taiwan is heading into a presidential election year. And of course, China is closely watching the visit as well, saying it, quote, damages peace and threatening to take resolute measures to fight back. With us now is NPR's Emily Fang in Taipei to explain why this trip is so important. Hi, Emily. Hi.

Hi, Sasha. Good morning. Tell us more about this trip and the itinerary for the president.

And Tai's visit to Central America comes at a pretty critical moment for Taiwan because just last week, Honduras, another Latin American country, switched its recognition from Taiwan to Beijing. So the real excuse for this trip actually has been for her to go to Central America, but she's stopping over in the U.S.,

Before she heads to Taiwan, she'll stop again in Los Angeles, where she's scheduled to meet with House Speaker Kevin McCarthy. And the fact that they're doing this meeting in the U.S. is actually a bit of a compromise because McCarthy originally wanted to go to Taiwan. But to lower the temperature geopolitically in the room, this meeting is going to be in the U.S.,

Tsai and the Taiwan government have been really, really clear they don't want to be pushed around by China with this compromise, but they're also going to travel without being intimidated. Here's Tsai right before departing from Taiwan yesterday. She says external pressure will not hinder our determination to go to the world. We are calm and confident. We will neither yield nor provoke. And Emily, what is China saying about this?

while unsurprisingly, China is not happy. China's government body on Taiwan issues yesterday had this statement: "If Taiwan's regional leader Cai Nguyen meets with House Speaker Kevin McCarthy, it would be a provocation." And they said they were going to take "resolute measures" to counter this. Now what those measures are is not clear, and China says this every time Taiwan's president meets with U.S. officials or travels to the U.S. Before the pandemic, by the way, Cai came to the U.S. basically once a year.

But Beijing does have a serious range of retaliatory measures it could take. For example, last summer when former Speaker Nancy Pelosi came to Taiwan, China responded with this multi-day military exercise around the island. And that's a really big reason why McCarthy is meeting Tsai in L.A. this time.

And the U.S. has been really careful about this meeting. They're calling her visit a stopover. This is not an official trip to the U.S. The official language is that she is simply transiting through as a private individual, albeit a transit that's going to take several days. And interestingly,

And interestingly, at the same time that Tsai is in the U.S., former Taiwanese President Ma Ying-jeou is in China. Ma's office has said this trip is a coincidence, that the timing was not planned. But in a way, his trip to China while Tsai is in the U.S. counterbalances the political risks of Tsai's trip. And in terms of Tsai's trip, what would success look like for her?

She needs to defend Taiwan's interests without rocking the boat because this year is an election year for Taiwan. They have a presidential race just like us, January of 2024. Tsai is not running, but she needs to prove to her party that strengthening ties with the U.S. is worth the risk of worsening relations with China. And so she needs to come back with some kind of concrete benefit.

Right now, relations are close. But for example, U.S. weapons sales to Taiwan have been delayed. So Tsai is under pressure to deliver and show that Taiwan has friends in the world, including the U.S. That's NPR's Emily Feng in Taipei. Thanks, Emily. Thanks, Sasha.

Millions of Americans could lose their health insurance over the coming months. That's because a federal rule that protected people's Medicaid coverage during the pandemic expires this Friday at midnight. NPR health correspondent Maria Godoy is with us with details. Hi, Maria. Hi, Sasha. Why is this happening? Well, it's the end of a pandemic era protection. So Medicaid is the public health insurance program for low-income people. Before the pandemic, they had to re-enroll every year, and it's a big red tape hassle.

People often got dropped even if they did qualify for coverage. And a lot of times they only found this out when they showed up at the ER or they went to the pharmacy to refill a prescription and they were told you're no longer covered. That sounds like a very inefficient system. Well, right. So back in 2020, lawmakers passed this rule that prevented states from dropping people from Medicaid. But that protection ends on March 31st.

Maria, how many millions of people are on Medicaid and what does it mean for them? Well, there's roughly 85 million people on Medicaid and every one of them is going to have to re-enroll to keep their benefits. But to be clear, it's not going to happen all at once. States are going to start sending out notices to people telling them when it's time to re-enroll. Some states are asking people now to submit paperwork to prove they're still eligible. Some people might be getting termination notices on April 1st, although they can't appeal.

But the problem is not everyone is going to get these notices or complete the paperwork on time. This sounds like a major administrative undertaking and potentially chaotic. Right. It's massive because if you think about it, it's been three whole years since people had to renew Medicaid. Now there's more people than ever on the program. A lot of people have moved since the pandemic. Maybe they didn't update their contact information, so they're not going to get those renewal notices from the state. Right.

I spoke with Elizabeth Edwards. She's with an advocacy group, the National Health Law Program. She told me Medicaid offices in many states are understaffed and just overwhelmed. Advocates are starting to see problems at call centers with long wait times, as well as call centers just stopping accepting calls because they have enough for the day or they're closed on a certain day to catch up on work.

And, you know, roughly one in four Americans are on Medicaid right now. So that's a lot of people to process. Right, about a quarter of the country. So, Maria, for people going through this and trying to keep their coverage, what are some other roadblocks they might run into when trying to re-enroll? Well, there's concern about people with limited English and also those with disabilities re-enrolling.

Certain disabilities qualify you for Medicaid, but Edwards says some of the renewal paperwork in some states isn't asking the right questions that can flag conditions that might qualify someone. She says they're also seeing problems with notices that don't tell people why they lost coverage. And if you don't know why, it makes it really hard to appeal. You're describing what could be enormous upheaval in people's lives that they may not even know is coming.

Right. And, you know, there's a real human impact here that I don't want to be missed, especially if you have a chronic health condition, a gap in coverage could be incredibly disruptive.

Estimates suggest as many as 18 million people are going to lose coverage during this process. So in terms of helping people, is there anything that people going through re-enrollment can do to make this process go more smoothly? Yeah. So make sure your contact information is up to date with your state or local Medicaid agency or the insurance company that runs Medicaid in your state. And please watch your mail for renewal notices. Thank you for those tips. That is NPR Health Correspondent Maria Godoy. My pleasure.

The community of Nashville is trying to heal after a school shooting this week left six dead, including three nine-year-old children. At a citywide vigil last night, Nashville Mayor John Cooper recognized police officers who rushed the shooter at the Covenant School and pleaded for a new way free of such violence. With God's help, let us resolve to go forward to create a better future.

And a future that does not repeat this week's tragedy. First Lady Jill Biden joined Mayor Cooper and other civic leaders, along with several musicians who performed at the event that drew hundreds of mourners. NPR's Claudia Grisales joins us now from Nashville. Good morning, Claudia. Good morning, Sasha. This was one of several vigils planned for Nashville this week. You were there. What kind of things were you hearing people say? Vigil.

This is obviously a community in the midst of deep suffering and trying to make sense of a senseless tragedy. It was held in the center of the city in downtown Nashville at Public Square Park. This is a popular gathering place here, but of course the occasion was much more somber. Dozens of local and state officials led this vigil as many in the crowd held candles.

And we heard moving performances by several musicians, including singer Sheryl Crow. You could see many friends and families huddling in groups, embracing each other, holding each other up in some cases, and some praying and some visibly crying. Did you talk to anyone individually?

Yes, and I heard a real range of emotions from people there, from obvious sadness to anger. I spoke with one woman who had been praying with the group she'd just met at the vigil, Carly Spaeth, a 19-year-old who attends university about two miles from the Covenant School, who said the vigil marked a significant moment. I think tonight it's really important that we come together just to honor the children and the adults and the families and the

the school and just the community that was impacted and just continue to pray. Spaeth said she had friends who taught at the school and they're all trying to lean on each other now. And Claudia, this is again creating a debate over access to guns. Did you talk to people in the community about that?

Yes, and I heard from a lot of people who say the country's woefully behind on limiting access to weapons. One of those was Ray Carol Woodard. She runs a nonprofit called Equity Alliance focused on black communities. She said the Covenant school shooting has ripped through the entire community, and she's really frustrated.

We don't have gun laws, period. We think we do, but they're not sufficient. And also, we're losing our children at the cost of someone's agenda, as someone being mad about a red or a blue party when it's so much bigger than that.

She said she was moved to see so many representatives from around the state and the First Lady there at the vigil. And that it was a reminder that there is still immense support to address gun control. But that all said, this remains an especially difficult issue around the country and especially in Tennessee, which is led by a Republican governor, a Republican legislature. And they've moved in the opposite direction in recent years to actually ease access to weapons.

That is NPR's Claudia Grisales in Nashville. Claudia, thank you. Thank you so much.

And that's Up First for Thursday, March 30th. I'm Sasha Pfeiffer. And I'm A. Martinez. Up First is produced by Katie Klein and Shelby Hawkins. Our editors are Olivia Hampton and Alice Wolfley. Our technical director is Brian Jarboe. Start your day here with us tomorrow. Ready for more NPR news? There's a radio show for that. Find NPR's Morning Edition on your NPR station at stations.npr.org. And for podcasts, local news, and the latest headlines, take NPR everywhere with the NPR One app. Find it in your app store.