Gregg's Top Three Health Policy Articles

For the week of May 5-12, 2023

Health policy impacts everyone, but it can be hard to know what is important. If you can only read three things about health policy this week, I suggest...

The Top Three...

AP: As Public Health Emergency Ends, Pandemic-Era Support Programs Have Already Been Fading Away The formal end of the national Public Health Emergency on Thursday is largely a symbolic and psychological step, representing the country’s formal emergence from the COVID-19 pandemic. But behind the scenes, several core aspects of America’s pandemic-era emergency safety net are also coming to a close, from extra food assistance to automatic re-enrollment in Medicaid. While these measures were always designed to be temporary, their expiration is inevitably producing hardship and confusion. (Khalil, 5/11)

Politico: What Title 42's End Means For The Future Of Immigration Policy The pandemic-era policy used to block migrants at the southern border is coming to an end this week. Lifting so-called Title 42 will mean a major policy shift, one expected to draw an increase of asylum seekers to the U.S. — and scrutiny over how the Biden administration will handle that influx. ... The government has used Title 42 to turn away asylum seekers more than 2 million times for more than three years. But it’s not actually an immigration policy. Section 265 of Title 42 of U.S. Code addresses public health, social welfare and civil rights. In March 2020, the Trump administration ordered the CDC chief to implement the Title 42 authority and turn people away at the border on public health grounds. (Ward, 5/10)

The Hill: Senate Panel Advances Drug Pricing Bills, Including PBM Reforms The bill would prohibit a PBM practice known as “spread pricing,” or charging health plans more for a drug than the PBM reimburses to the pharmacy, a tactic that’s drawn harsh criticism from lawmakers. It would also implement new requirements designed to increase the transparency of PBM contracts and pricing practices and mandate that PBMs pass 100 percent of the rebates collected from drug makers to health plans. (Weixel, 5/11)

For a Deeper Dive...

Politico: CDC Head Resigns, Blindsiding Many Health Officials Rochelle Walensky gave no specific reason for the decision to resign, writing that “at this pivotal moment for our nation and public health, having worked together to accomplish so much over the last two-plus years, it is with mixed emotions that I will step down.” Walensky touted the administration’s Covid response, the CDC’s decision to declare racism a serious public health threat and its efforts to contain mpox among the accomplishments on her watch. (Mahr and Cancryn, 5/5)

The New York Times: Public Health Lessons Learned From The Coronavirus Pandemic A lot went wrong during the coronavirus pandemic as the virus tore through a polarized nation and public health leaders, policymakers and elected officials struggled to respond. Chronic underinvestment in public health at the federal, state and local levels only made things worse. All told, more than 1.1 million people have died of Covid-19 in the United States, and more than 1,000 are still dying each week. (Stolberg and Weiland, 5/11)

The New York Times: Biden Woos Republican Moderates In Debt Ceiling Standoff President Biden sought to drive a wedge among Republicans in their escalating dispute over spending and debt on Wednesday, effectively reaching out to moderates in hopes of convincing them to break away from Speaker Kevin McCarthy rather than risk triggering a national default that could throw the economy into a tailspin. Appearing in a competitive suburb with a vulnerable House Republican in his sights, Mr. Biden accused Mr. McCarthy of pursuing a radical strategy at the behest of the “extreme” wing of his party loyal to former President Donald J. Trump, putting the country in economic jeopardy in a way that he said reasonable Republicans of his own era in the Senate would not have done. (Baker and Fandos, 5/10)

Stat: Insulin Makers, PBMs Echo Old Finger-Pointing In Senate Hearing A Senate hearing on high insulin costs billed as a blockbuster showdown with drugmakers and middlemen turned out to be a familiar case of political theater that appeared to satisfy no one. The nation’s three biggest insulin makers, Eli Lilly, Novo Nordisk, and Sanofi, and the trio of middlemen known as pharmacy benefit managers, Express Scripts, OptumRx and CVS Health, testified Wednesday in a three-hour hearing before the Senate Health, Education, Labor, and Pensions Committee. The hearing sets up a debate by the same committee Thursday over a package of bills aimed at PBM reform. (Owermohle, 5/10)

NBC News: FDA Panels Back Making Opill Birth Control Pill Available OTC The 17-0 vote by two advisory panels came despite serious reservations from agency officials about the quality of the data used to support switching the birth control pill, called Opill, from prescription to over the counter. The agency did not have concerns about the safety and effectiveness of the drug. The FDA is not required to follow the recommendation of the committees, though the vote is expected to weigh heavily on its final decision, expected in late summer. (Lovelace Jr., 5/10)

The New York Times: The U.S. Built A European-Style Welfare State. It’s Largely Over. In the early, panicked days of the pandemic, the United States government did something that was previously unimaginable. It transformed itself, within weeks, into something akin to a European-style welfare state. Congress rapidly fortified the social safety net, making it much stronger than at any point. It made policies like Medicaid and food stamps more generous. It created new federal benefits like paid sick and caregiving leave, and free school lunches. And it made some pandemic benefits, like stimulus checks and child allowances, nearly universal. The government is estimated to have spent about $5 trillion helping individuals and businesses since March 2020. (Miller and Parlapiano, 5/11)

Axios: The Fight Over Nursing Home Staffing Mandates A fight over nursing home staffing mandates is pitting an industry that was at the epicenter of the pandemic against organized labor and some senior lawmakers in Congress. The Biden administration this spring wants to make every facility have enough adequately trained staff to provide high-quality care. But operators say they can't hire people out of thin air after COVID-19 hollowed out the long-term care workforce. (Dreher, 5/12)

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For the Visual Among Us...

A few years ago I started a weekly e-mail for friends and colleagues who want to keep up on major federal health policy developments but did not have time to plod through all the minutiae--they were busy doing important things like running organizations and taking care of patients! Much to my surprise, it became pretty popular. I have now converted to a weekly newsletter format so you can manage your own subscription preferences and forward to others that might be interested.

These summaries represent my judgement on health policy issues that may not on the front pages, but are relevant to clinicians, administrators, and educators. I monitor many news sources and clipping services to identify content for this newsletter and I try hard to be as factual, balanced, and non-partisan as possible. While the articles are written by others (with credit attributed), the choice of what to include is entirely mine. If you are interested in receiving a daily summary of health policy news, you might consider signing up for the KHN Morning Briefing. If you enjoy podcasts, I suggest What the Health? and Tradeoffs.

-Gregg S. Margolis, PhD