THIS WEEK IN REVIEW: Monday, Oct. 14th – Friday, Oct. 18th

October 18, 2019 by B. Cameron Webb, MD, JD

THIS WEEK IN REVIEW: Monday, October 14th – Friday, October 18th

The air is getting cooler, the leaves are getting crispier, and the health policy keeps getting…healthier…? 

If you’ve been keeping up with the Democratic debates, you saw that healthcare is a front running topic. Sen. Elizabeth Warren (D- Mass.) and Sen. Bernie Sanders (I-Vt.) support Medicaid for All, while other more moderate candidates like Ind. Mayor Pete Buttigieg, Sen. Amy Klobuchar (D-Minn.), and former Vice President Joe Biden question its affordability. Other candidates like Kamala Harris (D-Calif.) and Cory Booker (D- initially supported Medicare for All, but have since toned down their support as polls increasingly show voter discomfort. The Kaiser Family Foundation polled public opinion this month on the topic: among Democrats, the poll found that 51% support Medicaid for All and 47% oppose, but for a Public Option 73% support and only 24% oppose.

News sources and politicians have been citing a study recently released by the Urban Institute this week comparing potential Federal costs for different health plans. They predicted that maintaining our mixed public-private health care system, but providing more subsidizes to reach universal coverage would increase Federal spending by $122.1 billion in 2020, or $1.5 trillion over 10 years. A single-payer approach to universal coverage, eliminating out-of-pocket costs, would cost $2.8 trillion in 2020, or $34.0 trillion over 10 years. And a third alternative, a single-payer “lite” with some out-of-pocket spending and fewer benefits, would increase spending by $1.5 trillion in 2020, or by $17.6 trillion over 10 years. These debates have highlighted the contention between the value of healthcare and its price tag.

Staying at the federal level, on Tuesday, Judge Reed O’Connor struck down Affordable Care Act (ACA) protections for transgender patients, which previously banned the denial of health services or coverage on the basis of sex or gender identity. Judge O’Connor, who made headlines last year for his ruling on the unconstitutionality of the ACA, cited the regulation’s violation of the Religious Freedom Restoration Act. In agreement with previous challengers of the ACA policy, Judge O’Connor argued that the protections infringed upon the religious freedom of physicians who were compelled by the law to act against their moral beliefs. Proponents of the ACA protections, however, claim that the recent ruling puts transgender patients at risk for future discrimination by health care providers and insurers. 

A landmark settlement is set to be reached soon in the major trial between a collection of local governments and a group of major pharmaceutical companies. The Ohio trial, in which opening statements are set to begin on Monday, could end as soon as it started if stakeholders on both sides agree to what is expected to be a $50 billion settlement from drug companies such as Johnson & Johnson, (insert company here), and (insert company here). As of Friday, both parties were scheduled to meet to negotiate the deal. Judge Dan Polster, who is presiding over this case and summoned the meeting, has said this settlement could potentially provide immediate relief to counties that have been burdened by the epidemic.

Democrats in the House of Representatives have altered a bill seeking to address high drug costs after fielding concerns from more progressive members that it was not strong enough of an effort. The bill, which authorizes the Secretary of Health and Human Services to negotiate lower costs for up to 250 drugs, has been changed to require at least 35 drugs to be negotiated for cost (up from the original minimum of 25 drugs).  While some progressive members have both shown support for these changes, some still think that there is more that can be done, while Senate Majority Leader Mitch McConnell (R-KY) has reiterated his intent to squash what he sees as a “socialist” bill.

Looking at the states, middle-class residents of California seeking health insurance will be experiencing a nice little financial boost starting in January – individuals and families with between 200% and 600% of the Federal Poverty Level will qualify for new subsidies for plans from Covered California, the state’s Affordable Care Act exchange. Those between 200% and 400%, who already qualify for existing tax credits, will receive about $15 monthly, and those between 400% and 600% who don’t already qualify for such credits will receive $170 a month. A total of $429 million will be used to ease financial pressures for an estimated 1 million Californians – especially those otherwise likely to fall out of compliance with California’s individual mandate law passed in July that will penalize those who go without insurance for more than three months.

California may also soon begin screening school children for Adverse Childhood Experiences (ACEs), which are traumatic events that children can experience at young ages such as abuse and family instability. ACEs have been shown to be the root cause for many childrens’ (and adults’) behavioral and emotional concerns, and Dr. Nadine Burke Harris, California’s Surgeon General, has voiced support for screenings in order to allow for educators and staff to better understand and react to children’s behaviors and needs. 

We’d like to finish off this week by extending our deepest condolences to the family and friends of Congressman Elijah Cummings. The powerful attorney and civil rights activist passed away Thursday in his hometown of Baltimore. Cummings served 12 terms in Maryland’s 7th Congressional District and most recently served as the head of the House Committee on Oversight and Reform. Earlier this month he had just introduced the Family Asthma Act which would expand efforts to improve care for individuals with asthma. Congressman Cummings was dedicated not only to his district but to all Americans – “He worked until his last breath because he believed our democracy was the highest and best expression of our collective humanity and that our nation’s diversity was our promise, not our problem.”

 


This Week’s Viewpoints Writing Team:
Avery Bullock, Carina Clawson, Jo McClain, Steven Moore and Nana Owusu