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@commonwealthfund.org @nejm.org @wschpero.bsky.social @larryau.bsky.social @mskcancercenter.bsky.social

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Joshua Budhu @jbudhu.bsky.social · 2d

Joshua Budhu @jbudhu.bsky.social · 2d

6/6 🧵 We argue that states should have the flexibility to determine what works best for their populations.
A one-size-fits-all federal approach undermines effective, evidence-based care for immigrant communities — and burdens the hospitals that care for them.

Joshua Budhu @jbudhu.bsky.social · 2d

5/6🧵Unauthorized immigrants contribute billions to the U.S. health system — more than they receive in care.
In 2017 alone, net contributions totaled:
$20.8B to Medicare

$21.3B to Medicaid

$14.7B to private insurance

They are net funders, not burdens.

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Joshua Budhu @jbudhu.bsky.social · 2d

4/6 🧵
Emergency Medicaid spending is tiny:
💰 FY2023 = $3.8B, just 0.44% of total Medicaid ($860B). Even at its pandemic peak, it stayed below 1%. Yet it supports hospitals serving millions with no other coverage options.

Joshua Budhu @jbudhu.bsky.social · 2d

3/6 🧵
Emergency Medicaid was designed to reimburse hospitals for federally required emergency care — but some states have expanded coverage to include essential services like dialysis. This flexibility That flexibility has saved lives and reduced costs

Joshua Budhu @jbudhu.bsky.social · 2d

2/6 🧵
In May 2025, CMS issued new guidance warning states that use federal dollars for care to unauthorized immigrants beyond emergencies could face audits and fund recoupment.

This marks a major shift from decades of state flexibility under Emergency Medicaid.

Emergency Medicaid at Risk — Preserving State Authority and Access to Care | NEJM

Joshua Budhu @jbudhu.bsky.social · 2d

Emergency Medicaid accounts for <1% of Medicaid spending — yet saves lives & money.
Restricting it ignores evidence, burdens states, and harms communities.

Our latest via @nejm.org
Emergency Medicaid at Risk - Preserving State Authority and Access to Care

www.nejm.org/doi/full/10....

🧵1/6

States that use federal dollars to provide health care to unauthorized immigrants, beyond narrowly defined emergency services, will now face enforcement actions and potential recoupment of funds.

Emergency Medicaid at Risk — Preserving State Authority and Access to Care | NEJM

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Reposted by Joshua Budhu

William Schpero @wschpero.bsky.social · 2d

For decades, the narrowly defined Emergency Medicaid (EM) program has reimbursed hospitals for emergency care provided to uninsured, low-income immigrants.

In @nejm.org, we write in defense of state flexibilities in EM, which seem at risk: www.nejm.org/doi/full/10....

cc @chpc-cornell.bsky.social

States that use federal dollars to provide health care to unauthorized immigrants, beyond narrowly defined emergency services, will now face enforcement actions and potential recoupment of funds.

Emergency Medicaid at Risk — Preserving State Authority and Access to Care | NEJM

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Reposted by Joshua Budhu

Larry Au @larryau.bsky.social · 4d

Our new NEJM commentary argues on the need to preserve state autonomy for Emergency Medicaid, and the critical role EM plays in supporting undocumented immigrants and safety net hospitals

www.nejm.org/doi/full/10....

States that use federal dollars to provide health care to unauthorized immigrants, beyond narrowly defined emergency services, will now face enforcement actions and potential recoupment of funds.

Health disparities in neurology

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Reposted by Joshua Budhu

Diana Cejas, MD, MPH @dianacejasmd.bsky.social · 22d

Honored to share that I am a American Medical Women’s Association (AMWA) Inspire Award Recipient!

Congratulations to this incredible group of physicians!

www.amwa-doc.org/news/announc...

Announcement of the 2025 AMWA Inspire Awardees with photos of each recipient. One of the awardees, Diana Cejas, MD, MPH, wears a bright yellow dress and white floral earrings in her photo.

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Reposted by Joshua Budhu

Joshua Budhu @jbudhu.bsky.social · 28d

Disparities in neurology are not random. They stem from upstream determinants (classism, poverty, environment) & downstream barriers (access, treatment gaps).

Our @natrevneurol.nature.com review maps these drivers & highlights interventions to advance equity.

rdcu.be/eFqGX

Nature Reviews Neurology - This Review considers the aetiology of health disparities in neurology at an individual, interpersonal, community and societal level, and suggests practical interventions...

rdcu.be

Health disparities in neurology

Joshua Budhu @jbudhu.bsky.social · 28d

Disparities in neurology are not random. They stem from upstream determinants (classism, poverty, environment) & downstream barriers (access, treatment gaps).

Our @natrevneurol.nature.com review maps these drivers & highlights interventions to advance equity.

rdcu.be/eFqGX

Nature Reviews Neurology - This Review considers the aetiology of health disparities in neurology at an individual, interpersonal, community and societal level, and suggests practical interventions...

rdcu.be

From Many Nations, One Mission—The Importance of Immigrant Neurologists in US Health Care | Neurology

Joshua Budhu @jbudhu.bsky.social · 29d

Nearly 1 in 3 neurologists in the US trained abroad. Immigrant neurologists fill critical gaps in underserved communities but face visa barriers & uncertainty. Supporting them is essential for equitable neurologic care. My latest in @greenjournal.bsky.social

www.neurology.org/doi/10.1212/...

www.neurology.org

From Many Nations, One Mission—The Importance of Immigrant Neurologists in US Health Care | Neurology

Reposted by Joshua Budhu

Joshua Budhu @jbudhu.bsky.social · Aug 31

Immigrant neurologists face uncertainty about visas, careers, and families. They care for some of our most vulnerable patients. Supporting them is both a moral obligation and essential to the future of our field. My viewpoint in @greenjournal.bsky.social

www.neurology.org/doi/10.1212/...

www.neurology.org

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Joshua Budhu @jbudhu.bsky.social · Aug 31

Immigrant neurologists face uncertainty about visas, careers, and families. They care for some of our most vulnerable patients. Supporting them is both a moral obligation and essential to the future of our field. My viewpoint in @greenjournal.bsky.social

www.neurology.org/doi/10.1212/...

From Many Nations, One Mission—The Importance of Immigrant Neurologists in US Health Care | Neurology

www.neurology.org

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Reposted by Joshua Budhu

Joshua Budhu @jbudhu.bsky.social · Jun 21

Father’s Day marked 17 years since my brother died—sedated, shackled, and alone in a hospital bed.
His death wasn’t inevitable. It was systemic.
I share his story, and what it taught me about health, justice, and memory.
Thank you @nejm.org
www.nejm.org/doi/full/10....

My Brother’s Keeper | NEJM

Intubated, chemically sedated, and immobilized, Ravi developed a massive pulmonary embolism and died handcuffed to a hospital bed. He’d been caught in a system that worked against him at every turn.

My Brother’s Keeper | NEJM

Joshua Budhu @jbudhu.bsky.social · Jun 21

Father’s Day marked 17 years since my brother died—sedated, shackled, and alone in a hospital bed.
His death wasn’t inevitable. It was systemic.
I share his story, and what it taught me about health, justice, and memory.
Thank you @nejm.org
www.nejm.org/doi/full/10....

Intubated, chemically sedated, and immobilized, Ravi developed a massive pulmonary embolism and died handcuffed to a hospital bed. He’d been caught in a system that worked against him at every turn.

Renewing the Commitment to Diversity in Neurology: Resisting the Backlash

Joshua Budhu @jbudhu.bsky.social · Jun 18

A bit late in sharing, but proud of this piece published in
@pedneurojournal.bsky.social. As DEI efforts face backlash, we argue why neurologists must stay committed to equity for the health of our profession and our patients.

www.pedneur.com/article/S088...

@dianacejasmd.bsky.social

The COVID-19 pandemic disproportionately affected underprivileged and marginalized groups in the United States.1 Although while this disparate impact was unsurprising to health disparities researchers...

www.pedneur.com

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Reposted by Joshua Budhu

Nuclear Medicine and Neurooncology (NMN) @nmnsymposium.bsky.social · May 3

Response Assessment in Neuro-Oncology (RANO) 2009-2025: Broad Scope and Implementation - A Progress Report.
academic.oup.com/neuro-oncolo...

Response Assessment in Neuro-Oncology (RANO) 2009-2025: Broad Scope and Implementation - A Progress Report

Abstract. Since its first activities in 2008 and 2009, the Response Assessment in NeuroOncology (RANO) group has given guidance on response assessment, tri

academic.oup.com

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Joshua Budhu @jbudhu.bsky.social · Apr 6

So excited for #AANAM 2025! Join us for a session on Neurologic Consultations in Cancer Patients on Sunday, 4/6/25 at 3:30pm!