THIS WEEK IN REVIEW: Monday, Feb. 12th – Friday, Feb. 16th
We’ll begin this week’s review with the story that has our nation grieving this weekend—Wednesday’s tragic events at Parkland, Florida’s Marjory Stoneman Douglas High School. Fourteen students and three faculty members were killed, while fourteen more individuals were hospitalized in what was the 17th school shooting in the United States so far in 2018. Amidst renewed calls for action from Washington, President Trump responded with a focus on addressing mental health, while many others called for a public health policy approach to gun violence. By Thursday, Health and Human Services (HHS) Secretary Alex Azar made headlines when he opened the door to the CDC resuming research on gun violence for the first time since the Dickey Amendment passed in 1996. With House Judiciary Chairman Bob Goodlatte (R-VA) echoing those sentiments, many advocates are hopeful that this latest horrific tragedy might actually inspire some meaningful federal action on gun violence. In the meantime, our thoughts and prayers are with everyone who has been affected by these terrible events in Parkland.
Now to our review of the other health policy news from the week—a week that began with President Trump releasing his proposed budget for the 2019 fiscal year. Factoring in last week’s bipartisan budget deal, this $4.4 trillion budget carries with it numerous healthcare implications. Among those, the proposed budget calls for…(deep breath)…$5 billion over five years to combat the opioid crisis, drug pricing demonstrations in Medicaid and Medicare, cuts of $451 million from health professions training, elimination of the Agency for Healthcare Research and Quality (AHRQ), increases in funding for infectious disease programs, and various policy proposals that—in aggregate—would be tantamount to repealing/replacing the ACA (exhale). Secretary Azar from HHS was quick to show his support for the budget blueprint, emphasizing his belief that it supports his agency’s four priorities: “addressing the opioid crisis, bringing down the high price of prescription drugs, increasing the affordability and accessibility of health insurance, and improving Medicare in ways that push our health system toward paying for value rather than volume.”
For a particularly interesting angle on weighing the healthcare merits of the President’s budget proposal, look no farther than the Centers for Medicare and Medicaid Services (CMS) ten-year projections of National Health Expenditures, released on Wednesday. Over the next decade, CMS actuaries predict a rise in the health share of GDP (from its current 17.9 percent up to 19.7 percent by 2026), increased government (federal, state and local) percentage of health expenditures, significant annual growth in Medicare, and a decline in the share of the population with health insurance. Interestingly, prescription drugs are expected to experience the fast growth among healthcare goods and services, with a projected 6.3 percent increase in spending each year. As if current realities of drug pricing were not enough, this last point puts even more pressure on the Administration to be successful in their stated priority of reducing drug prices for Americans.
In news from the Hill, nearly 90 percent of the House Democrats joined together to draft a letter to HHS Secretary Azar voicing their strong opposition to the incorporation of work requirements in Medicaid programs across the country. These 172 Congressional Representatives demanded that all pending requests to institute work requirements be denied, citing evidence that such policies would only be hurtful to beneficiaries. In another letter—this one from the Senate—37 Democrats asked the Trump Administration to reinstate protections for qualified women’s health care providers like Planned Parenthood to participate in state Medicaid programs. Largely symbolic overtures, this trend of open-letter advocacy represents only the latest wave in the ideological healthcare battles being waged in Congress. Time will tell whether, and how, the GOP will double down and continue advancing its ideology as election season approaches.
Speaking of battles, several states set the stage for some serious debate this week. In Idaho, only two weeks after state regulators welcomed the sale of health insurance plans that were non-compliant with the Affordable Care Act (ACA), Blue Cross of Idaho unveiled coverage plans that break with the current healthcare law of the land. It is now up to HHS Secretary Azar to decide whether to enforce federal law (i.e., the ACA) in Idaho, or to set a precedent for other states by allowing this departure from the rules. In Oregon, the House of Representatives sent a bill to the Senate that would amend the state’s constitution to classify healthcare as a basic human right. Last (but certainly not least), Virginia Delegate Terry Kilgore, a Republican, announced his support for state Medicaid expansion, boosting the chances of the commonwealth becoming the nation’s 34 to expand their program.
So, all around the nation, it appears that battle lines are being drawn and gauntlets thrown. Looking forward to another dynamic health policy week ahead!
Student Contributors on this Article:
Marissa Alvarez, Chad Fletcher, Shaina Haque, Virginia Wright