Tagged Uninsured

Must-Reads Of The Week From Brianna Labuskes

Happy Friday! Before we dive in to the harder news, please join me in enjoying this story about scientists dosing a shy breed of octopus with ecstasy to see if the animal became cuddly and friendly while high. (I swear, it relates to health care: More studies are evaluating psychedelic drugs as outside-the-box treatments, especially for post-traumatic stress disorder in veterans.)

Now, here’s what else you may have missed:

Senators were busy bees this week on the Hill. In a rare bipartisan feat, the upper chamber passed a sweeping opioids package … but there’s some fine print. Lawmakers still have to iron out the (harder, more controversial) differences between the Senate and House versions of the legislation, and they probably won’t do that work until November — conveniently, after midterms. Until then, they have a talking point!

And you know that “doughnut hole” change (which forces drugmakers to pay more for medication used by Medicare beneficiaries) that pharma hates and has been pestering lawmakers about for ages? Congress might tuck a measure rolling that back into the opioid package.

The Associated Press: GOP, Dems Unite Behind Senate Bill Fighting Addictive Drugs

Stat: GOP Lawmakers Seeking to Use Opioids Bill to Deliver Drug Industry Major Victory

It’s not all roses for drugmakers, though: A Senate-passed bill would ban “gag clauses,” which currently keep pharmacists from talking to consumers about lower-cost options.

Stat: Senate Passes Bill That Would Ban ‘Gag Clauses’ Limiting Disclosures on Drug Prices

In a sharp divergence from the budget spectacles of years past, the Senate quietly OK’d a measure to avert a government shutdown. The measure included a big, 5 percent boost to the National Institutes of Health, which was the fourth-straight significant increase for the agency.

The Associated Press: Senate Backs Bill to Avert Shutdown, Boost Military Spending

There’s a real fear out there that we’re all one bad accident away from financial ruin. A bipartisan group of senators wants to protect patients from that worry with its proposed measure on surprise bills, otherwise known as “balance billing.” (Bonus: Check out the KHN story that Republican Sen. Bill Cassidy cited in his announcement.)

The Hill: Bipartisan Senators Unveil Proposal to Crack Down on Surprise Medical Bills

As the news continues to evolve over the sexual assault allegations against Supreme Court nominee Brett Kavanaugh, here’s a health tidbit you might have missed if you didn’t scan all the way to the bottom of today’s stories. Gov. Bill Walker of Alaska, an independent, and his lieutenant governor, Byron Mallott, both came out against Kavanaugh’s nomination — not because of the accusations, but because they’re worried he’s going to jeopardize Medicaid coverage. It will be interesting to see if that’s enough to sway Alaska Sen. Lisa Murkowski, a Republican, who is being watched closely as a possible swing vote.

The New York Times: Christine Blasey Ford Opens Negotiations on Testimony Next Week

Attorney general races are rarely the belles of the ball when it comes to elections. But as more of them use their position to try to check President Donald Trump’s policies (especially ones chipping away at the health law), the campaigns are drawing more eyes.

Politico: Obamacare Lawsuit Boosts Democrats in State AG Races

Preexisting conditions have been a bomb Republicans have been trying to defuse for weeks on the campaign trail, but even GOP strategists call it a losing battle. “What you have to do at this point is duck and cover,” said one in Politico’s coverage.

Politico: Republicans ‘Duck and Cover’ on Pre-Existing Conditions

A new, more detailed report has emerged of the slow-moving medical catastrophe that was Hurricane Maria. It’s also a grim insight into why counting a death toll becomes so complicated.

The Associated Press: Maria’s Death Toll Climbed Long After Rain Stopped

Meanwhile, an investigation has been launched into why two mentally ill women who were seeking care were taken from a safe hospital and driven into Florence’s floodwaters, where they both drowned.

The New York Times: They Were Seeking Mental Health Care. Instead They Drowned in a Sheriff’s Van.

In the miscellaneous, must-read file for the week:

  • The U.S. is the most dangerous place to have a baby in the developed world, yet states are doing little to address the issue. And the ones that are, often blame the moms.

USA Today: Maternal Deaths: What States Aren’t Doing to Save New Mothers’ Lives

  • We’re on the precipice of some amazing breakthroughs for cancer treatments, yet Native Americans and black patients are missing out because they’re underrepresented in clinical trials.

ProPublica/Stat: Black Patients Are Being Left Out of Clinical Trials for New Cancer Therapies

  • Personal health aides can be a lifeline for elderly patients. Inviting a stranger into your home, though, is inherently risky and there’s few regulations that exist to weed out predators.

Boston Globe: Stranger in the House

  • And a fascinating Alzheimer’s treatment called “reminiscence therapy” has seen success overseas and is gaining traction here. Check out this one facility that recreated a 1950s town square, complete with Buddy Holly on the jukebox and an old-fashioned diner.

The Wall Street Journal: To Help Alzheimer’s Patients, A Care Center Re-Creates The 1950s

As a newsroom that has a dedicated chocolate drawer and sweet treats brought in by colleagues a few times a week, this article on employers cutting down on sugary snacks sparked a bit of a debate here. To ban or not to ban, that is the question of the week.

Have a great weekend!

CHIP Coffers Are Habitually Raided To Finance Other Parts Of The Budget. Take A Look At How It Survives.

Funds for the Children’s Health Insurance Program are technically outside the jurisdiction of the Appropriations Committees and don’t count against annual discretionary caps, and the pool of “contingency money” dedicated to the program has been tapped sparingly. Medicaid news comes out of Alabama and Maine, as well.

Former Tennessee Governor Touts Deep Medicaid Cuts In Race For Senate Seat

While governor, Phil Bredesen (D-Tenn.) faced a budget that advisers said was the toughest they’d seen in their careers. In a new campaign ad, Bredesen says he “saved TennCare,” but those fixes came at a cost and proved controversial for many at the time. Bredesen is running for the Senate against Rep. Marsha Blackburn (R-Tenn.) Medicaid news comes out Iowa and Michigan, as well.

Former Tennessee Governor Touts Deep Medicaid Cuts In Race For Senate Seat

Former Gov. Phil Bredesen (D-Tenn.) was facing a budget that advisers said was the toughest they’d seen in their careers. In a new campaign ad, Bredesen says he “saved TennCare,” but those fixes came at a cost and proved controversial for many at the time. Bredesen is running for the Senate against Rep. Marsha Blackburn (R-Tenn.) Medicaid news comes out Iowa and Michigan, as well.

Must-Reads Of The Week From Brianna Labuskes

If you’ve been glued to your preferred weather service (as I have) over the past few days watching Hurricane Florence lumber toward the East Coast, you may have missed that it was a fairly huge news week for health. So, let’s get right to it!

President Donald Trump shocked and angered both allies and critics with accusations that the latest death toll from Hurricane Maria was inflated by the Democrats to make him look bad.

Bloomberg: Trump Defies Science With Rejection of Puerto Rico Death Toll

4 Takeaways On Puerto Rico’s Death Toll, In The Wake Of Trump’s Tweet Storm

For the first time since 2010, the decline in the uninsured rate stalled. Some blame the Trump administration’s whacks at the health law, but others say it’s just the marketplace leveling off.

The Washington Post: For First Time Since 2010, America’s Progress on Health Insurance Stalls

The fact that Sen. Joe Manchin (D-W.Va.) is using health care while campaigning in a deep-red state that loves Trump shows just how far politics has evolved on the issue. (Even though he’s certainly not mentioning “Obamacare” by name.)

The New York Times: Manchin Counts on Health Care to Stave Off Republican Tide in West Virginia

But a look at tweets on the topic shows it doesn’t matter to Russian trolls which way that popularity pendulum swings — they recognize the health law as a plank sure to sow discord and pit sides against each other.

The Wall Street Journal: Nearly 600 Russia-Linked Accounts Tweeted About the Health Law

Baltimore health commissioner Dr. Leana Wen, an emergency room physician with a reputation for fiercely taking on the Trump administration, has been tapped as Planned Parenthood’s next president. Wen brings firsthand experience with the organization as a child of a low-income family.

The New York Times: Planned Parenthood Names Leana Wen, a Doctor, Its New President

More than 4,300 beneficiaries in Arkansas were kicked off the state’s Medicaid rolls after failing to report their required work hours. Republican Gov. Asa Hutchinson focused on the 1,000 or so residents who have found employment under the new regulations, but critics were quick to point to the number as confirmation of their worst fears that the new fervor for work requirements will lead to a lot of Americans losing insurance.

The Associated Press: Arkansas Drops 4,300 From Medicaid Plan Over New Work Rules

A letter alleging a sexual misconduct incident in Supreme Court nominee Brett Kavanaugh’s past, which Sen. Dianne Feinstein (D-Calif.) has turned over to the FBI, is adding fuel to an already fiery battle on the Hill.

A Sexual-Misconduct Allegation Against the Supreme Court Nominee Brett Kavanaugh Stirs Tension Among Democrats in Congress

Meanwhile, accusations of bribery are coming out of Maine, where advocates have guaranteed $1 million in fundraising pledges to Republican Sen. Susan Collins’ 2020 opponent if she votes to confirm Kavanaugh.

The Associated Press: $1 Million Pledged Against Collins If She Backs Kavanaugh

A pharma exec’s defense that raising drug prices 400 percent was a “moral requirement” raised more than a few eyebrows. It was a bold claim in an era where most companies are trying to at least appear concerned about the topic.

Financial Times: Pharma Chief Defends 400% Drug Price Rise As a ‘Moral Requirement’

Want to know how those pharmacy benefit managers (yup, the ones now getting lots of fingers pointed at them for the high cost of drugs) can pocket almost $200 for a bottle of pills that’s valued at $6? Check out Bloomberg’s explainer.

In the interest of making this “breezy,” here are some other big news stories from the week: Apple kills two birds with one stone with its new watch: convincing people they need to buy a low-selling product and edging into the health care industry; the number of immigrant teens being held by the government has ballooned; and lawmakers may perform what might be called, in this partisan landscape, a miracle and actually fund the government on time. (See, I was not exaggerating about the amount of news this week!)

Stat: The New Apple Watch, With FDA’s Blessing, Comes With an EKG App

The New York Times: Detention of Migrant Children Has Skyrocketed to Highest Levels Ever

Stat: Trump Wants Drug Prices in TV Ads. The Latest Roadblock? Republicans

Politico: Congress Dares Trump To Shut Down The Government In New Spending Deal

In a story that you can’t make up: A member of the family that owns Purdue Pharma (the maker of OxyContin and subject of more than 1,000 lawsuits regarding its role in the opioid epidemic) has been awarded a patent for a treatment for opioid use disorder.

Stat: Richard Sackler, Member of Clan Behind OxyContin, Has Patent for Opioid Treatment

If all of that wasn’t enough for you, here are a few must-read miscellaneous stories from the week: Nearly two decades after Kendra Webdale was pushed to her death in the subway, the law named in her honor designed to shore up mental health systems is acting more like a band-aid than a cure; advocates are shifting gears on gun safety by going after bullets, which are largely unregulated; recent transparency controversies have some asking: Why do medical journals still take authors at their word?; and a look at the people behind suicide hotlines.

The New York Times: A Horrific Crime on the Subway Led to Kendra’s Law. Years Later, Has It Helped?

The New York Times: California Tries New Tack on Gun Violence: Ammunition Control

Stat: Why Do Medical Journals Keep Taking Authors at Their Word?

CNN: When Someone Is Thinking of Suicide, These Are the People Who Talk Them Out of It

If you had a gloomy 2017, at least take heart in the fact that it wasn’t just you.

Please have a safe weekend if you’re in Florence’s path!

In Trump’s First Year, Nation’s Uninsured Rate Unchanged

Despite Republicans’ resistance to the federal health law, the percentage of Americans without health insurance in 2017 remained the same as during the last year of the Obama administration, according to a closely watched report from the Census Bureau released Wednesday.

However, the uninsured rate did rise in 14 states. It was not immediately clear why, because the states varied dramatically by location, politics and whether they had expanded Medicaid under the federal health law. Those states included Texas, Florida, Vermont, Minnesota and Oregon.

The uninsured rate fell in three states: California, New York and Louisiana.

An estimated 8.8 percent of the population, or about 28.5 million people, did not have health insurance coverage at any point in 2017. That was slightly higher than the 28.1 million in 2016, but did not affect the uninsured rate. The difference was not statistically significant, according to the Census report.

About 17 percent of Americans were uninsured in 2010, the year the Affordable Care Act was enacted.

The Census numbers are considered the gold standard for tracking who has insurance because the survey samples are so large.

(Courtesy of the U.S. Census Bureau)

Analysts credit the health law with helping drive down the number of uninsured. But also a factor: The proportion of people without insurance typically falls as unemployment rates decline. That’s because more people can get health coverage at work or can better afford buying insurance on their own.

The nation’s unemployment rate has generally been falling since before 2011 and was 4.1 percent for the last quarter of 2017, the lowest level since before the Great Recession began in December 2007.

Critics of the health law said the report emphasized its deficiencies. “Today’s report is another reminder that Obamacare has priced insurance out of the reach of millions of working families,” Marie Fishpaw and Doug Badger of the Heritage Foundation said in a statement. “Despite a growing economy and very low unemployment rate, the uninsured rate remains virtually unchanged.”

But the law’s supporters instead saw the glass as half full.

“These numbers show the resilience of the Affordable Care Act,” said Judith Solomon, senior fellow at the Center on Budget and Policy Priorities. She said people still value the coverage they receive from the health law even as it’s been under attack by President Donald Trump and Republicans who want to repeal it. “It’s good news because the numbers show the strength of the ACA but bad news in that we have not seen further progress.”

Solomon expressed concern, though, about the large number of states seeing uninsured rates increase.

Uninsured rates last year ranged from a high of more than 17 percent in Texas to low of just under 3 percent in Massachusetts.

West Virginia had one of the sharpest increases in uninsured.

About 14 percent of the state’s residents were uninsured in 2013 before the ACA’s premium subsidies and Medicaid expansion began. That rate fell by nearly two-thirds by 2016. Last year, however, West Virginia’s uninsured rate crept up 0.8 percentage points to 6.1 percent, according to the Census report.

Carol Bush, who has worked as a health insurance navigator the past three years in West Virginia, expects to be uninsured by month’s end. She is losing her job amid Trump administration cuts to the Affordable Care Act navigator program.(Courtesy of Carol Bush)

Carol Bush, 58, of Elkins, W.Va., expects to lose coverage Oct. 1 because her job is ending.

The unfortunate twist is that her job, for the past three years, has been working as a navigator helping people in her community find coverage in the health law marketplaces. Federal officials have largely scrapped that program.

The Trump administration cut funding by more than 80 percent during the past two years, saying it had no proof that navigators were helping people find coverage. Only if consumers signed up in the presence of the navigator was a session considered a success.

Bush had coverage through the University of West Virginia, which has a navigator contract that ends at the end of this month. Without employer coverage, Bush said, the cheapest insurance she could find would be about $1,100 a month. She won’t qualify for a federal subsidy to lower her premium because of her family’s income. Her husband is insured through Medicare.

Although she said she has strongly considered going without insurance because of the cost, she knows she needs it.

“In all honesty, I’ve always had some kind of health insurance, and the thought of being without it worries me,” she said. “I can’t risk getting seriously ill and incurring enormous debt at this point in my life. Peace of mind has a value too.”

Shenandoah Community Health Center, a federally funded health clinic in Martinsburg, W.Va., has started to see an increase in uninsured patients the past year, although it’s still below levels it saw before the health law’s coverage expansion began in 2014, said CEO Michael Hassing. Hassing said he believes many patients have dropped coverage, thinking the ACA’s individual mandate was repealed.

“Folks say, ‘I don’t need to have it anymore,’ and they let it go,” he said.

While the GOP failed last year to repeal the law, Congress was able to strip out one of its key features — the individual penalty for not having coverage. The vote last December eliminated that penalty starting in 2019 — meaning Americans are still required this year to have health coverage or face the consequences on their 2018 taxes.