The U.S. House of Representatives and U.S. Senate approved Medicaid extensions in the last session, in separate measures that were never reconciled or signed into law, reports Politico Pro . The Senate in December folded the extenders into a continuing resolution that has been delayed by the fracas over border wall funding. The Medicaid bill features an almost three-month extension of spousal impoverishment rules to allow married couples to guard certain assets while seeking Medicaid coverage for home- and community-based services. It also allocates $112 million for an approximately three-month extension of the Money Follows the Person demonstration program to assist state Medicaid programs in transitioning older adults and people with chronic illnesses back into their communities. House Energy and Commerce Chairman Rep. Frank Pallone (D-N.J.) said their bill will "give the committee time to work on a long-term solution."

Maryland's Medicaid program has been expanded to cover hearing aids for all adults, as opposed to only children and adults under 21, reports WTOP . The new coverage is applicable to medically necessary hearing aids, cochlear implants, and auditory osseointegrated devices. "Our office received calls asking for financial assistance to help cover the cost of hearing aids due to the high out-of-pocket costs and the lack of coverage through Maryland Medicaid, so we worked with the Department of Health to address this significant gap," notes Kelby Brick with the Governor's Office of the Deaf and Hard of Hearing. "The Hogan administration's expansion of Maryland Medicaid coverage for adults provides tremendous financial relief for thousands of eligible Marylanders in need of these vital services." Maryland Department of Health Secretary Robert R. Neall says about 1.2 million Marylanders are deaf or hard of hearing. To qualify for the new coverage, residents are required to contact their primary care physician for a referral to an audiologist to complete an evaluation.

A study published in Diabetologia suggests older people with type 2 diabetes may have more difficulty recalling words than their non-diabetic counterparts, reports Reuters Health . Researchers monitored 705 older adults with no dementia, age 50 to 90, for an average of 4.6 years; 348 were diabetic. Verbal fluency declined slightly among diabetics and improved moderately in those without diabetes. At three points during the study, participants underwent brain scans and took cognitive tests involving verbal skills. The diabetics already had more brain atrophy at the start of the study, but scans showed no difference between them and non-diabetics in the rate of brain contraction. Atrophy also did not seem to account for the connection between diabetes and cognitive decline. However, the outcomes imply that brain changes related to diabetes may commence earlier than previously assumed, possibly in middle age.

A study of 119 people 60 and older published in Science Translational Medicine sought to explore the link between poor sleep and Alzheimer's, reports HealthDay News . Eighty percent of the participants had no thinking or memory problems, while the rest just had mild problems. Those with less slow-wave sleep exhibited elevated levels of the brain protein tau, a possible symptom of Alzheimer's. "We saw this inverse relationship between decreased slow-wave sleep and more tau protein in people who were either cognitively normal or very mildly impaired, meaning that reduced slow-wave activity may be a marker for the transition between normal and impaired," notes Washington University Sleep Medicine Center Professor Brendan Lucey. "Measuring how people sleep may be a noninvasive way to screen for Alzheimer's disease before or just as people begin to develop problems with memory and thinking." Lucey also observes that subjects with higher tau levels "were actually sleeping more at night and napping more in the day, but they weren't getting as good quality sleep." He suggests sleep monitoring could be a potential supplement to brain scans or cerebrospinal fluid analysis for identifying early hallmarks of Alzheimer's.

A study published in Health Affairs found a large number of older people with hearing aids, especially those in lower income brackets, still have difficulty hearing and accessing hearing care services, reports News-Medical . Analysis of 1,133 Medicare beneficiaries determined having a well-functioning hearing aid seemed to rely significantly on income level. Twenty-seven percent of low-income Medicare enrollees dually eligible for Medicaid reported having problems hearing with a hearing aid. Meanwhile, only 11 percent of those in the highest income category noted significant hearing-aid difficulties. Overall, 39 percent of the study group had used hearing care services in the previous year, while 71 percent of hearing-aid users in the lowest income cohort had not. The researchers are urging the federal government to expand Medicare and/or Medicaid coverage of hearing care services to mitigate this problem. They have further recommended the inclusion of hearing care services as a mandatory Medicaid benefit.

The Consumer Financial Protection Bureau (CFPB) has released the 2018 Financial Literacy Annual Report and made it available to the general public on the agency's website . In reading the report, people will discover the numerous tools and programs the CFPB provides to help enhance the financial knowledge and skills of Americans nationwide, from childhood to one's senior years, so they can build financial well-being. Financial education is a big part of the agency's mission to empower citizens to take more control over their economic lives. The 2018 Financial Literacy Annual Report details how the CFPB works toward this goal by: one, providing financial education directly to the public; two, sharing research on effective financial education and financial well-being with financial educators; and, finally, addressing needs for inclusion and financial security of older Americans, military service members and veterans, historically underserved communities, and students.

California Gov. Gavin Newsom has announced plans to expand the state's authority to negotiate prescription drug prices and broaden health coverage for undocumented immigrants, reports the Wall Street Journal . "We will use both our market power and our moral power to demand fairer prices for prescription drugs," he promised in his inaugural address. His executive order directs California's Department of Health Care Services to negotiate prescription drug prices for the 13 million residents using the Medi-Cal program for low-income citizens. It also consolidates existing procurement entities' purchasing power to obtain better prices, giving private employers room to join the new purchasing pool. Newsom added that he would propose expanded coverage in California under the Affordable Care Act (ACA) and pressure the federal government to permit his state to migrate to a state-run single-payer health system. Newsom wants to cover illegal immigrants 26 and younger under the Medi-Cal program, and his proposed budget would hike subsidies under the ACA for households that currently receive them, as well as extend subsidy eligibility to people with higher incomes than sanctioned under current law. Among those advocating Newsom's single-payer proposal is Public Citizen's Peter Maybarduk, who notes, "Drug sellers take advantage of fragmented purchasing systems. A single large purchaser should be harder to manipulate."

A study published in the Journal of the American Medical Directors Association found better application of standard assessment tools could help long-term care communities identify new residents at risk of hospitalization or death in the first 90 days of admission, reports Medical Xpress . The researchers analyzed data from 143,067 residents 65 or older admitted to long-term care communities in Ontario, Alberta, and British Columbia, from 2010 to 2016. More than 15 percent of residents had a history of heart failure and were more likely to be hospitalized and twice as likely to have higher mortality rates than those without. One year after admission, residents with a history of heart failure had a mortality rate more than 10 percent higher. The study concluded that newly admitted residents' history of heart failure, and their scores on the interRAI Changes to Health, End-Stage disease, Signs, and Symptoms (CHESS) scale, can accurately evaluate those most at risk. Residents with high CHESS scores, even with no heart failure history, were more likely to die when hospitalized. Mortality rates for those with the highest scores were 80 percent, and most of these individuals died while hospitalized. "These two factors independently identified this increased risk," says University of Waterloo Professor George Heckman. "By making clinical assessments early, advance care planning discussions can take place."

Samsung announced programs to incorporate robotics into senior care under a project called Samsung Bot Care at this week's CES 2019, reports Ubergizmo . One such innovation is a self-guiding robot that can give users health briefings as well as check their vital signs. The machine also can monitor the user's sleep cycles and alert emergency services if it detects that something is wrong. Samsung Bot Care has other health-related features at its disposal, including music therapy, medicine tracking, and exercise guides.

A study published in Molecular Psychiatry explored how the nutrient choline could be used to combat Alzheimer's, reports Medical Xpress . When fed high concentrations of choline, mice engineered to exhibit Alzheimer's-like symptoms bore offspring with better spatial memory, compared to those receiving a normal choline regimen in utero. Analysis of mouse tissue extracted from the hippocampus verified the epigenetic modifications caused by choline supplementation. "We found that early choline supplementation decreased homocysteine while increasing methionine, suggesting that high choline levels convert homocysteine to methionine," says Arizona State University's Ramon Velazquez. "This conversion happens thanks to an enzyme known as betaine-homocysteine methyltransferase (BMHT). We found that choline supplementation increased the production of BMHT in 2 generations of mice." Choline supplementation also limits the activation of microglial cells that clear debris in the brain, which is typically excessive in Alzheimer's pathology.