Susan Jaffe | Washington Correspondent for The Lancet | 22nd January 2018
On the first anniversary of Donald Trump’s inauguration as the 45th 
president of the United States on January 20, 2018, the federal government ground to a shutdown and hundreds of thousands of women and their supporters rallied against the new president in dozens of cities across the country. [Continued here.]
Volume 391, Number 10117
WORLD REPORT The tax overhaul pushed by Republicans could jeopardise the ACA’s health insurance marketplaces. Susan Jaffe, The Lancet’s Washington correspondent, reports.
…The new tax law contains a provision aimed at an… administration target, the Patient Protection and Affordable Care Act (ACA). Next year, it eliminates the ACA’s tax penalty for Americans who disregard the requirement to have health insurance, one of the law’s most unpopular features. Even though the ACA’s health insurance mandate is still quite intact, Trump and others claim there is effectively no mandate without a penalty.
“When the individual mandate is being repealed, that means Obamacare is being repealed”, Trump said shortly before signing the tax bill into law last month. “And we’ll come up with something that will be much better, whether it’s block grants or whether it’s taking what we have and doing something terrific.” [full story here]
Susan Jaffe | Washington Correspondent for The Lancet | 29th December 2017
Despite wide bipartisan support for the Children’s Health Insurance Program (CHIP), Congress agreed last week to continue coverage for 8.9 million children only through the end of March. But several of the program’s state directors say the $2.85 billion rescue plan won’t even last that long, and federal health officials are not offering much reassurance. [Continued here.] Temporary CHIP 122917
Susan Jaffe | Washington Correspondent for The Lancet | 27th December 2017
But critics say Azar has the wrong kind of experience. When he appeared before Senate Committee on Health, Education, Labor and Pensions (HELP) last month, the committee’s senior Democrat Patty Murray of Washington said if Azar runs HHS then “the fox is guarding the hen house.” [Continued here] Volume 390, Number 10114 
WORLD REPORT Without adequate federal funding, CHIP is on the verge of collapse in several states. Susan Jaffe, The Lancet’s Washington correspondent, reports.
“Whoever would have thought that health care for children—that has support on both sides of the aisle—would be in this situation?” asked Deborah Oswalt, executive director of the Virginia Health Care Foundation. [full story here]
Volume 390, Number 10108
WORLD REPORT As the Presidential Commission releases its recommendations, Trump moves closer to defining his policies against the opioid epidemic Susan Jaffe, The Lancet’s Washington correspondent, reports.
“Having failed to recognise how this epidemic was going to grow in proportion and take vigorous enough action, we need to be willing to be far more vigorous so we don’t continue with that mistake,” said Food and Drug Administration Commissioner Scott Gottlieb. [full story here]
By Susan Jaffe | Kaiser Health News | Oct. 17, 2017 | This article also ran in 
and 
noticed an uptick in mail solicitations from health insurance companies, which can mean only one thing: It’s time for the annual Medicare open enrollment.
[UPDATE: Since this article was published, Medicare officials extended the deadline for applying for an exemption to the Part B late enrollment penalty to Sept. 30, 2018. The announcement came in a fact sheet posted on Oct. 12, 2017.]
Many older Americans who have Affordable Care Act insurance policies are going to miss a Sept. 30 deadline to enroll in Medicare, and they need more time to make the change, advocates say.
A lifetime of late enrollment penalties typically await people who don’t sign up for Medicare Part B — which covers doctor visits and other outpatient services — when they first become eligible. That includes people who mistakenly thought that because they had insurance through the ACA marketplaces, they didn’t need to enroll in Medicare.
Medicare officials are offering to waive those penalties under a temporary rule change that began earlier this year, but the deal ends Sept. 30.
On Wednesday, more than 40 groups, including consumer health advocacy organizations and insurers, asked Medicare chief Seema Verma to extend the waiver deadline through at least Dec. 31, because they are worried that many people who could be helped still don’t know about it. [Continued at Kaiser Health News and NPR]
WORLD REPORT After the latest repeal bill was withdrawn and the budget reconciliation has expired, what does the future hold for the ACA? Susan Jaffe, The Lancet’s Washington correspondent, reports.
Republicans claim the ACA isn’t working and point to the rising cost of monthly premiums and the various counties across the USA where only one or two insurers offer coverage through the ACA’s online insurance marketplaces.… “[But] they’re not letting it fail, they’re making it fail,” said Stan Dorn, a senior fellow at Families USA, a consumer advocacy group that worked to help pass the ACA. [Continued here]
Volume 390, Number 10099WORLD REPORT As Congress considers how to fund the government next year, scientists hope spending for research will not be curtailed. Susan Jaffe, The Lancet’s Washington correspondent, reports.
The dramatic defeat of the Republicans’ Affordable Care Act (ACA) repeal legislation still looms over the US Capitol as Congress reconvenes this month for more tough decisions, including many that will affect health and science research programmes. …The prospects for science funding will depend on competing budget pressures and political fissures. “There are a lot of moving parts and a lot of uncertainty”, said Matt Hourihan, at the American Association for the Advancement of Science. “And while a spending deal [agreement] is certainly possible, it’s hard to see how they get there from here.” [Continued here]
By Susan Jaffe | KAISER HEALTH NEWS | July 31, 2017 |This story also ran in 
Ten years ago, a driver ran a stop sign as Jim McIlroy rode into the intersection on his motorcycle. Serious injuries left McIlroy paralyzed from the chest down. But, after spending some time in a nursing home, he returned to his home near Bethel, Maine.
McIlroy does most of his own cooking since Maine’s Medicaid program paid for a stovetop that he can roll his wheelchair underneath to reach the food-prep area. His
Esther Ellis received a new mattress earlier this year from Partners in Care, a nonprofit that runs four of the dozens of sites in California’s Multipurpose Senior Services Program, a Medicaid-funded home services program. (Heidi de Marco/KHN)
new kitchen sink has the same feature. Wheelchair-friendly wood flooring has replaced McIlroy’s wall-to-wall carpeting.
The alterations plus a personal care aide — all paid for by Medicaid — enable McIlroy to stay in his house that he and his wife, who has since died, “worked really hard to own,” he said. The arrangement also saves Medicaid roughly two-thirds of what it would cost if he lived in a nursing home.
McIlroy depends on the federal-state program’s growing support of home-based care services — along with 2 million elderly or disabled Americans who rely on them to live at home for as long as possible.
However, that crucial help could face severe cuts if congressional Republicans eventually succeed in their push to sharply reduce federal Medicaid funds to states. [Continued at Kaiser Health News and USA Today]
Volume 390, Number 10093WORLD REPORT If Congress doesn’t repeal the ACA, President Trump’s changes could go a long way to fulfil Republicans’ pledge to scrap it. Susan Jaffe, The Lancet’s Washington correspondent, reports. [Continued here]
Volume 389, Number 10088WORLD REPORT Slow appointments and vacant positions in federal agencies challenge the stability of research in the USA. Susan Jaffe, The Lancet’s Washington correspondent, reports.
As President Donald Trump rolls out his domestic agenda, his proposed budget cuts and lingering vacancies in key federal agencies have rattled some people in the biomedical research and science community.
“This has been the most anxious time in science that I have seen in this country”, said Rush Holt, chief operating officer at the American Association for the Advancement of Science (AAAS), which represents 250 scientific societies and academies serving 10 million members. Holt cited a litany of reasons: “fake news” that distorts science, “policy making based on wishful thinking rather than evidence, funding proposals that are nonsensical, and unfilled positions in government agencies”. [Continued here]
[UPDATE: Since this article was published, Medicare officials extended the deadline for applying for an exemption to the Part B late enrollment penalty to Sept. 30, 2018. The announcement came in a fact sheet posted on Oct. 12, 2017.]
Each year, thousands of Americans miss their deadline to enroll in Medicare, and federal officials and consumer advocates worry that many of them mistakenly think they don’t need to sign up because they have purchased insurance on the health law’s marketplaces. That decision can leave them facing a lifetime of enrollment penalties.
Now Medicare has temporarily changed its rules to offer a reprieve from penalties for people who kept Affordable Care Act policies after becoming eligible for Medicare.
“Many of these individuals did not receive the information necessary [when they became eligible for Medicare or when they initially enrolled] in coverage through the marketplace to make an informed decision regarding” Medicare enrollment, said a Medicare spokesman, explaining the policy change.
Those who qualify include people 65 and older who have a marketplace plan or had one they lost or canceled, as well as people who have qualified for Medicare due to a disability but chose to use marketplace plans. They have until Sept. 30 to request a waiver of the usual penalty Medicare assesses when people delay signing up for Medicare’s Part B, which covers visits to the doctor and other outpatient care…
“This has been a problem from the beginning of the Affordable Care Act, because the government didn’t understand that people would not know when they needed to sign up for Medicare,” said Bonnie Burns, a consultant for California Health Advocates, a consumer group. “Once they had insurance, that relieved all the stress of not having coverage and then when they became eligible for Medicare, nobody told them to make that change.”[Continued at Kaiser Health News and NPR]
Volume 389, Number 10084 27 May 2017
WORLD REPORT Scott Gottlieb becomes commissioner of the FDA, as the agency’s role is threatened by an administration adverse to regulation. Susan Jaffe, The Lancet’s Washington correspondent, reports.
Only 6 months ago, Scott Gottlieb was still a resident fellow at the American Enterprise Institute, a co
nservative thinktank, when he presented testimony to a US Senate committee investigating prescription drug prices. Before he began, he volunteered that he was “a reformed government bureaucrat, having worked at FDA [US Food and Drug Administration] for a number of years”. He blamed astonishing price hikes—500% in the case of Mylan’s EpiPen—on “regulatory failures stemming from FDA policy, and I think that policy can be fixed”.
Gottlieb was sworn in as the 23rd commissioner of the FDA after being approved earlier this month by the US Senate, over the strong objections of most Democrats. Now Gottlieb will have a chance to fix a daunting array of policies. [Continued here]