Affordable Care Act, Global Health, Medicare, The Lancet

Biden unwinds Trump health-care policies

Volume 397, Issue 10272
30 January 2021

 

WORLD REPORT A Democrat in the White House and a Democratic Congress could bring big changes to US health policy, but challenges remain. Susan Jaffe reports from Washington, DC. 

…Before the Biden Administration can tackle other health priorities, the first order of business is the fight against the COVID-19 pandemic, which has killed more than 420 000 Americans—a death toll higher than that of any other nation—and has exposed health-care inequities and crippled the economy. …Although Biden will have a lot of support for his health-care agenda, “that doesn’t mean that it’s smooth sailing”, said Lanhee Chen, a public policy fellow at the Stanford University’s Hoover Institution. “I think there are still a lot of people who are very upset about the outcome of the election.” [Full story here.]

CDC, The Lancet

New leadership at the US CDC

Volume 397, Issue 10270
16 January 2021

 

WORLD REPORT Rochelle Walensky, an infectious diseases expert, promises to provide transparency, accountability, and restored trust at the embattled organisation. Susan Jaffe reports from Washington, DC.  [Full story here.]

CDC, The Lancet, Uncategorized

Rochelle Walensky: New Director of the US CDC

Volume 397, Issue 10271 
14 January 2021
PROFILE  Rochelle Walensky 

A highly respected researcher, Walensky has published nearly 300 papers, many focused on the cost-effectiveness of HIV interventions and aimed at improving patients’ care. “I call the research that I do policy motivating”, Walensky says. One example is a 2006 landmark study showed that advances in HIV treatment in the USA added nearly 3 million years to patients’ lives.[Full story here.]

CMS, Long term care

Nursing Homes Fined for COVID Infection Control Lapses

By Susan Jaffe  | Contributing Writer | MedPageToday  | November 25, 2020

During the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS) has fined 218 nursing homes more than $17.6 million for the most serious infection control violations that put residents in “immediate jeopardy,” conditions CMS believes are likely to seriously injure or kill them.

More than 91,000 residents and staff of long-term care facilities have died after contracting COVID-19 — about 40% of the total deaths in the U.S., according to a Kaiser Family Foundation analysis. …Frustrated by repeated violations of infection control requirements during the pandemic, CMS raised the penalty amounts and announced a crackdown on egregious offenders in August. But the hard-line approach doesn’t seem to have produced the intended results. (Click here for a list of nursing homes that were fined.)  [Continued here.]

Affordable Care Act, Medicaid, Medicare, The Lancet

US Supreme Court poised to keep the Affordable Care Act

Volume 396, Issue 10263
21 November  2020

 

WORLD REPORT A lawsuit to overturn the Affordable Care Act may be floundering after Supreme Court justices questioned why the law should be dismantled. Susan Jaffe reports from Washington, DC.

The fate of the Affordable Care Act (ACA) is again in the hands of the US Supreme Court, after close calls in lawsuits in 2012 and 2015. But last week’s hearing was different: justices who once voted to overturn the law— along with President Donald Trump’s recent court appointees—bombarded opponents with sceptical questions. 

After oral arguments in the case, known as California v. Texas, legal experts believe President Barack Obama’s signature health reform law is not in mortal danger.  [Continued here.] 

Affordable Care Act, Drugs, FDA, HHS, Long term care, Medicaid, Medicare, The Lancet

US election 2020: the future of the Affordable Care Act

Volume 396, Number 10260     31 October 2020 

WORLD REPORT   President Donald Trump pledges to replace the Affordable Care Act while his Democratic opponent Joe Biden offers detailed proposals to improve it. Susan Jaffe reports from Washington, DC.

Since winning the presidency in 2016 in large part by promising to eliminate Obamacare, otherwise known as the Affordable Care Act (ACA), Donald Trump has promised more than a dozen times that his replacement plan would be ready soon. The plan would be released in 2 weeks, a White House spokeswoman said 2 months ago.

“We’re going to have a health-care plan that will be second to none”, Trump said in 2017. “It’s going to be great and the people will see that.” And at last week’s final presidential debate, he vowed “to terminate Obamacare, [and] come up with a brand new beautiful health care”.

A decade after the ACA—President Barack Obama’s signature achievement—became law, repealing and replacing Obamacare is again central to Trump’s re-election. And improving and expanding the law is a crucial part of the campaign of his challenger, former Vice President Joe Biden. [Continued here.]     

CDC, FDA, NIH, The Lancet

US election 2020: research and health institutions

Volume 396, Number 10259

24 October 2020

 

WORLD REPORT   How will the NIH, CDC, and FDA change if President Donald Trump wins a second term or if his Democratic challenger, Joe Biden, defeats him? Susan Jaffe reports from Washington, DC. 

Whoever wins the presidency needs to “restore the CDC and improve it by letting [scientists] know that they will have an opportunity to do the best science and make the best recommendations…” says James Curran, dean of the Rollins School of Public Health at Emory University in Atlanta. [Continued here.]

Affordable Care Act, CDC, Drugs, Global Health, The Lancet

US election 2020: public health

Volume 396, Number 10256

3 October 2020

 

WORLD REPORT   In the race for the White House, where do US President Donald Trump and his Democratic challenger, former Vice President Joe Biden, stand on public health? Susan Jaffe reports from Washington, DC. 

Analyzing the candidates’ plans to address the opioid epidemic, gun violence, women’s health, global health and COVID-19.

Unlike more conventional presidential candidates, Trump does not intend to issue formal policy proposals or position papers. With less than 5 weeks remaining before the election, his campaign says he will share “details about his plans through policy-focused speeches on the campaign trail”. …Joe Biden’s campaign has released a total of 51 policy proposals outlining how he will accomplish his goals if he wins in November. [Continued here.]

CDC, Drugs, HHS, The Lancet

Media reports reveal political interference at the US CDC

Volume 396, Number 10255

26 September 2020

 

WORLD REPORT  News accounts say that Trump administration officials wanted to edit and approve COVID-19 studies and publish guidance without the usual scientific review. Susan Jaffe reports.

After news stories about attempts by members of the Trump administration to manipulate COVID-19 reports published by the US Centers for Disease Control and Prevention (CDC) and over-rule its scientists, one top official is taking a sudden leave of absence for health reasons. Another’s government contract has abruptly ended. The 2-month absence of Michael Caputo, chief spokesman for the US Department of Health and Human Services (HHS), comes after he claimed that a CDC “resistance unit” seeks to undermine Trump. He and an adviser reportedly demanded the right to revise and approve COVID-19 studies published in the CDC’s highly respected Morbidity and Mortality Weekly Report journal.  [Continued here.]

Medicaid, Medicare

Pandemic Deals Another Blow To Nursing Homes: Plummeting Occupancy

BY SUSAN JAFFE  |  CONNECTICUT HEALTH INVESTIGATIVE TEAM   |  SEPTEMBER 16, 2020    
       

While the deadly coronavirus seems to be subsiding in Connecticut for now, its impact on nursing homes has not. More than 6,700 beds are empty, and it may take many months of financial struggle before occupancy climbs back to pre-pandemic levels.

Of the approximately 200 nursing homes in Connecticut that receive payments from Medicaid, the government health insurance program for  low-income people, only 15 were 

 70% or less occupied in January, according to the Connecticut Health Investigative Team’s analysis of state data. By August, almost five times as many facilities saw occupancy drop to that level or less….

Owners say the state and federal governments aren’t doing enough to shore up their industry and protect residents during the pandemic. And in some cases, policies intended to control the virus can make things worse.  [Continued here, with map and table of dangerously low occupancy nursing homes.]

Long term care, Medicare

CMS Warns of COVID-19 Spike in Nursing Homes

Medicare chief says “significant deficiencies in infection control practices” in nursing homes have doubled weekly COVID-19 cases, but “this isn’t a time of fines and being punitive.”

By Susan Jaffe  | Contributing Writer | MedPageToday  | August 20, 2020

The Centers for Medicare & Medicaid Services (CMS) wants nursing homes to ramp up efforts to control COVID-19 inside facilities after the number of residents infected with the highly contagious virus has reached a record high, and as new deaths have started rising once again.

In the early spring, the number of virus cases in nursing homes was about 11,000 a week, which dropped to 6,319 cases by the end of June, CMS Aministrator Seema Verma told facility operators last week in a conference call. But CMS strike force teams have found “significant deficiencies in infection control practices” that have pushed up weekly cases to about 12,000 by the end of July, she said. “And we’re seeing an uptick unfortunately in the losses.”

Residents in about half the nation’s nursing homes have been infected, Verma told MedPage Today in an exclusive interview on Tuesday. [Continued here.]

CMS, Medicare, Medicare costs

House Committee Approves Bill to Ease Medicare Part B Enrollment

Seniors would be notified about eligibility to avoid late fees, coverage gap

By Susan Jaffe  | Contributing Writer | MedPageToday  | July 15, 2020

A House committee unanimously approved legislation Wednesday that would make changes for the first time in 50 years to the complex rules for enrolling in Medicare’s Part B, which covers doctor visits and other outpatient care.

Currently, seniors who don’t get Part B when they first become eligible for Medicare pay permanent, recurring late enrollment penalties and can only sign up during the first 3 months of the year for coverage that begins July 1, unless they qualify for an exception. To make matters worse, they cannot buy other health insurance during their months-long wait. [Continued here.]

HHS, The Lancet

US Supreme Court upholds abortion rights, for now

Volume 396, Number 10244

11 July 2020

 

WORLD REPORT The court’s decision means that Louisiana’s three abortion clinics will remain open. Susan Jaffe reports.

The US Supreme Court delivered the Trump administration’s third defeat in as many weeks when it overturned a Louisiana law requiring physicians who provide abortions to have local hospital-admitting privileges.

In an opinion written by Justice Stephen Breyer, the court declared on June 29 that “enforcing the admitting privileges requirement would drastically reduce the number and geographic distribution of abortion providers, making it impossible for many women to obtain a safe, legal abortion in the State and imposing substantial obstacles on those who could”.  [Continued here.]

Affordable Care Act, HHS, The Lancet

LGBTQ discrimination in US health care under scrutiny

Volume 395    Number 10242     
27 June 2020                          
WORLD REPORT  A US Supreme Court ruling could undermine the Trump Administration’s plan to roll back some protections against sex discrimination. Susan Jaffe reports. 

The Trump administration suffered a major defeat last week a major defeat last week in the US Supreme Court, which could undermine its attempt to scrap protections under the Affordable Care Act (ACA) against sex discrimination. In a landmark decision on June 15, the court ruled that the Civil Rights Act protects gay and transgender workers from discrimination by their employers. But days later, Trump Administration officials at the Department of Health and Human Services (HHS) finalised a more permissive standard for discrimination in health care. [Continued here.]  

CMS, HHS, Long term care

Whether By Luck Or Safety Protocols, Some Nursing Homes Remain COVID-19 Free

BY SUSAN JAFFE  |  CONNECTICUT HEALTH INVESTIGATIVE TEAM   |  JUNE 15,2020           

The coronavirus has decimated many of the nation’s nursing homes, and elderly, chronically ill residents of these facilities account for 64% of the state’s 4,201 death toll. They are roughly 100 times more likely to die of the virus than other people in the state.

So, the fact that some 41 of Connecticut’s 214 nursing homes have managed to keep out the virus, according to an analysis by C-HIT, is both remarkable and mystifying. Did they just get lucky?

This article also ran on Connecticut Public Radio.

Administrators at several COVID-19-free facilities use the word “fortunate” to describe a situation they acknowledge could change at any time. [Continued here, with map and table of COVID-19 free nursing homes.]