ByShefali Luthra, Kaiser Health News and Anna Maria Barry-Jester |
PROVIDENCE, R.I. — The Trump administration is pushing ahead with its reproductive health agenda. It has rolled out changes to the Title X program, which funds family planning services for low-income people, that are designed to have a chilling effect on organizations that provide abortions or include this option in counseling. It also has nominated federal judges widely believed to support state-level abortion restrictions. Against that backdrop, Planned Parenthood, known as a staunch defender of abortion rights, is working to recast its public image. Under its president, Dr. Leana Wen, who took office in November, the nation’s largest reproductive health provider is highlighting the breadth of care it provides — treating depression, screening for cancer and diabetes, and taking on complex health problems like soaring maternal mortality rates.
Among the first things Democrats did after officially taking control of the House was to express support for efforts to appeal a Texas district court decision declaring the Affordable Care Act unconstitutional.
The number of people hospitalized because of amphetamine use is skyrocketing in the United States, but the resurgence of the drug largely has been overshadowed by the nation’s intense focus on opioids. Amphetamine-related hospitalizations jumped by about 245 percent from 2008 to 2015, according to a recent study in the Journal of the American Medical Association. That dwarfs the rise in hospitalizations from other drugs, such as opioids, which were up by about 46 percent. The most significant increases were in Western states. The surge in hospitalizations and deaths due to amphetamines “is just totally off the radar,” said Jane Maxwell, an addiction researcher.
Since his days on the campaign trail, President Donald Trump has promised to roll back environmental regulations, boost the use of coal and pull out of the Paris climate agreement — and he’s moving toward doing all those things. He has pushed ahead with such action even as a report by the United Nations’ Intergovernmental Panel on Climate Change released in October concluded that without much stronger measures to reduce the use of fossil fuels, a warming planet will witness the spread of tropical diseases, water shortages and crop die-offs affecting millions of people. Supporters of the administration’s changes — some of whom are skeptical of accepted science — say the administration’s moves will save money, produce jobs and give more power to states. But critics say new strictures on scientific research and efforts to overturn standards for protecting air, water and worker safety could have long-term, widespread effects that would upend hard-won gains in environmental and public health. The Trump administration’s many environmental proposals vary widely in target and reach.
ByPhil Galewitz and Julie Appleby, Kaiser Health News |
After two years of double-digit price hikes, the average premium for individual health coverage on the federal health law’s insurance marketplace will drop by 1.5 percent for 2019, the Trump administration said Thursday. The announcement marked the first time average premiums have fallen since the exchanges created by the Affordable Care Act went into effect in 2014. It also comes during a bitter midterm congressional campaign season in which health care is a central issue following last year’s efforts by Republicans to repeal the ACA. Administration officials claimed credit for the price drop, saying it was due to their actions to make changes to the law. Health policy experts said it was a reaction to insurers’ huge profits following hefty premium increases on plans offered this year.
The recent school shootings in Florida and Maryland have focused attention on the National Rifle Association’s clout in state and federal lobbying activities. Yet more than the NRA or even Wall Street, it’s the pharmaceutical industry that Americans think has the most muscle when it comes to policymaking. A poll from the Kaiser Family Foundation found that 72 percent of people think the drug industry has too much influence in Washington —outweighing the 69 percent who feel that way about Wall Street or the 52 percent who think the NRA has too much power. Only the large-business community outranked drugmakers. (Kaiser Health News is an editorially independent program of the foundation.)
Drug prices are among the few areas of health policy where Americans seem to find consensus.
The nation’s opioid epidemic has been called today’s version of the 1980s AIDS crisis. In a speech Monday, President Donald Trump pushed for a tougher federal response, emphasizing a tough-on-crime approach for drug dealers and more funding for treatment. And Congress is upping the ante, via a series of hearings — including one scheduled to last Wednesday through Thursday — to study legislation that might tackle the unyielding scourge, which has cost an estimated $1 trillion in premature deaths, health care costs and lost wages since 2001. Dr. Leana Wen, an emergency physician by training and the health commissioner for hard-hit Baltimore, said Capitol Hill has to help communities at risk of becoming overwhelmed. “We haven’t seen the peak of the epidemic.
Insurers will again be able to sell short-term health insurance good for up to 12 months under a proposed rule released Tuesday by the Trump administration that could further roil the marketplace. “We want to open up affordable alternatives to unaffordable Affordable Care Act policies,” said Health and Human Services Secretary Alex Azar. “This is one step in the direction of providing Americans health insurance options that are more affordable and more suitable to individual and family circumstances.”
The proposed rule said short-term plans could add more choices to the market at lower cost and may offer broader provider networks than Affordable Care Act plans in rural areas. But most short-term coverage requires answering a string of medical questions, and insurers can reject applicants with preexisting medical problems, which ACA plans cannot do. As a result, the proposed rule also noted that some people who switch to them from ACA coverage may see “reduced access to some services,” and “increased out of pocket costs, possibly leading to financial hardship.”
The directive follows an executive order issued in October to roll back restrictions put in place during the Obama administration that limited these plans to three months.
Gale Dunham, a pharmacist in Calistoga, Calif., knows the devastation the opioid epidemic has wrought, and she is glad the anti-overdose drug naloxone is becoming more accessible. But so far, Dunham said, she has not taken advantage of a California law that allows pharmacists to dispense the medication to patients without a doctor’s prescription. She said she plans to take the training required at some point but has not yet seen much demand for the drug. “I don’t think people who are heroin addicts or taking a lot of opioids think that they need it,” Dunham said. “Here, nobody comes and asks for it.”
In the three years since the California law took effect, pharmacists have been slow to dispense naloxone, which reverses the effects of an overdose.
The Trump administration — reversing guidelines put in place under President Barack Obama — is scaling back the use of fines against nursing homes that harm residents or place them in grave risk of injury. The shift in the Medicare program’s penalty protocols was requested by the nursing home industry. The American Health Care Association, the industry’s main trade group, has complained that under Obama inspectors focused excessively on catching wrongdoing rather than helping nursing homes improve. “It is critical that we have relief,” Mark Parkinson, the group’s president, wrote in a letter to then-President-elect Donald Trump in December 2016. Since 2013, nearly 6,500 nursing homes — 4 of every 10 — have been cited at least once for a serious violation, federal records show.