Gregg's Top Three Health Policy Articles

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...

The Washington Post: After Chaotic Week, House Heads Home With Government Shutdown On Horizon House lawmakers left town Thursday after a dramatic three-day workweek that saw them launch a divisive impeachment inquiry and calls for the removal of Speaker Kevin McCarthy from his position, as they made little movement toward averting a government shutdown. Republicans also weren’t able to move forward a traditionally noncontroversial defense spending bill, stymied by deep divisions in the party despite a shared goal of approving 12 individual appropriations bills. (Sotomayor, Caldwell, Wang and Alemany, 9/14)

KFF Health News: Why The CDC Has Recommended New Covid Boosters For All The CDC advises that everyone over 6 months old should, for the broader benefit of all. Those at highest risk of serious disease include babies and toddlers, the elderly, pregnant women, and people with chronic health conditions including obesity. The risks are lower — though not zero — for everyone else. The vaccines, we’ve learned, tend to prevent infection in most people for only a few months. But they do a good job of preventing hospitalization and death, and by at least diminishing infections they may slow spread of the disease to the vulnerable, whose immune systems may be too weak to generate a good response to the vaccine. (Allen, 9/13)

Modern Healthcare: Government Shutdown Risk To DSH Payments, PEPFAR, Other Programs With all eyes on a possible government shutdown at the end of the month, Congress is also on the brink of plunging large swathes of the healthcare system into limbo. Numerous pieces of legislation meant to fund or reauthorize a slew of major programs affecting hospitals, federally qualified health centers, medical education programs, opioid and HIV/AIDS treatment programs and even pandemic preparedness expire on Sept. 30. (McAuliff, 9/13)

For a Deeper Dive...

Modern Healthcare: Why Unions See Nursing, Clinician Membership Increasing As health systems continue to wrestle with employee burnout, momentum within the healthcare industry to unionize its workforce may be on the upswing. In 2021, only 13.2% of healthcare workers were unionized, a percentage that hasn’t changed much in the past decade according to the most recent research published in JAMA Network Open. However, major healthcare labor groups say they are seeing increased interest in union representation from clinicians. This year, the National Labor Relations Board has received petitions for labor representation from groups of clinicians and other workers at more than 200 healthcare facilities. (Devereaux, 9/14)

AP: Republican Opposition To Abortion Threatens Global HIV/AIDS Program That Has Saved 25 Million Lives The graves at the edge of the orphanage tell a story of despair. The rough planks in the cracked earth are painted with the names of children, most of them dead in the 1990s. That was before the HIV drugs arrived. Today, the orphanage in Kenya’s capital is a happier, more hopeful place for children with HIV. But a political fight taking place in the United States is threatening the program that helps to keep them and millions of others around the world alive. The reason for the threat? Abortion. (Musambi, Amiri, Anna and Knickmeyer, 9/9)

AP: Americans Overwhelmingly Support Medicare Drug Negotiations, But Biden Sees Little Political Boost President Joe Biden is trumpeting Medicare’s new powers to negotiate directly with drugmakers on the cost of prescription medications — but a new poll shows that any immediate political boost that Biden gets for enacting the overwhelmingly popular policy may be limited. Three-quarters of Americans, or 76%, favor allowing the federal health care program for the elderly to negotiate prices for certain prescription drugs. That includes strong majorities of Democrats (86%) and Republicans (66%), according to a new poll from The Associated Press-NORC Center for Public Affairs Research. About one in five Americans are neutral on the issue, while 6% outright oppose it. (Kim and Sanders, 9/15)

Axios: Hospital Staffing Shortages Are Leading To Longer ER Visit Times Americans in need of urgent care are spending increasingly longer stretches of time in hospital emergency rooms, per recently released figures. The median time patients spent in emergency rooms was 2 hours, 40 minutes nationwide based on a 12-month average ending in the third quarter of 2022, according to the latest Centers for Medicare & Medicaid Services (CMS) data. (Fitzpatrick, 9/15)

AP: Child Poverty In The US Jumped And Income Declined In 2022 As Coronavirus Pandemic Benefits Ended Child poverty in the United States more than doubled and median household income declined last year when coronavirus pandemic-era government benefits expired and inflation kept rising, according to figures released Tuesday by the U.S. Census Bureau. At the same time, the official poverty rate for Black Americans dropped to its lowest level on record, and income inequality declined for the first time since 2007, when looking at pre-tax income, due to income declines in the middle and top income brackets. (Schneider, 9/12)

Politico: Unemployment Fraud Hit $100-135B During Covid, Watchdog Says As much as $135 billion in unemployment insurance benefits may have been lost to fraud during Covid-19, according to a Government Accountability Office report released Tuesday, more than double an earlier estimate. The federal watchdog estimated that fraudulent payments may have amounted to between 10 and 15 percent of the $900 billion spent on UI between April 2020 and May 2023, when the federal public health emergency ended. (Niedzwiadek, 9/12)

Modern Healthcare: Mental Health Startups Attract Private Equity, Other Buyers In 2021, venture capital firms spent nearly $5 billion to fund behavioral health startups, according to an estimate from research firm CB Insights. The funding bonanza helped start hundreds of companies offering remote therapy, medication prescription, wellness and other mental health services. A lot has changed in two years. Because of high interest rates, an oversaturated market and potential regulatory changes to remote prescribing, many of those mental health startups may look for an exit ramp, industry insiders said. (Perna, 9/12)

San Francisco Chronicle: Vaccine Hesitancy Isn’t Just For COVID. Why Rabies Could Come Back Approximately 5,000 cases of rabies in animals are reported in the United States annually .... This disease continues to pose a risk to the health of animals and their human contacts. That’s why we were dismayed to see a recent national survey conducted by researchers at the Boston University School of Public Health and published in the journal Vaccine that suggested the existence of a surprising degree of vaccine hesitancy in dog owner populations. Over half of the surveyed pet owners displayed some level of hesitancy to vaccinate their dogs, including vaccines against rabies. (Mani and Weese, 9/13)

Stat: In New Regeneron Deal For Covid Drug, White House Imposes Price Limits For First Time A groundbreaking clause in a new deal between the Department of Health and Human Services and the pharmaceutical company Regeneron marks the first time the Biden administration has directly used its leverage to challenge drugmakers’ list prices, experts told STAT. The contract between Regeneron and the government requires that the list price for a future monoclonal antibody drug to prevent Covid-19 is the same or lower in the United States as in other high-income countries. The release doesn’t explain which countries the government will be comparing prices with, or how pricing data will be determined. (Cohrs, 9/13)

The Wall Street Journal: Generic Drugs Should Be Cheap, But Insurers Are Charging Patients Thousands Of Dollars For Them The cancer drug Gleevec went generic in 2016 and can be bought today for as little as $55 a month. But many patients’ insurance plans are paying more than 100 times that. CVS Health and Cigna can charge $6,600 a month or more for Gleevec prescriptions, a Wall Street Journal analysis of pricing data found. They are able to do that because they set the prices with pharmacies, which they sometimes own. (Walker, 9/11)

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