The Institute for Aging in San Francisco helps seniors get to doctor appointments and social activities. (Photo/Susan Jaffe)
Susan Jaffe | Washington Correspondent for The Lancet | 28th March 2018
A day after the horrific mass shooting at Marjory Stoneman Douglas High School in Parkland, Florida on February 14, where 17 students and faculty were murdered and 14 injured, Health and Human Services Secretary Alex Azar fielded budget questions from a congressional committee. In response to Representative Kathy Castor, a Democrat from Tampa, Florida, Azar said there is no restriction on the ability of the Centers for Disease Control and Prevention (CDC) to conduct research into the causes of gun violence.
Questions about CDC’s ability to investigate gun violence—as it
“March for Our Lives” rally in Washington, D. C. March 24, 2018. (Photo/Susan Jaffe)
would other public health threats—have persisted ever since Congress passed the 1996 Dickey Amendment prohibiting the use of research funds to advocate or promote gun control.
“We don’t believe that it gets in the way of our ability to do violence research or firearms violence research at any part of HHS,” Azar told another congressional panel a month later. “I think we’ve now made it quite publicly—and within the administration—clear that we don’t see any barriers around violence or firearm violence research. We’re in the evidence and science-gathering business.”
His assurances were also included in the instructions that accompanied the budget agreement Congress approved and President Donald Trump signed into law last week. While some observers believe this means CDC has permission from Congress to proceed, some leading experts in firearms research are skeptical. There may be no barriers, but they say there’s no funding either.[Continued here]
Volume 391, Number 10126
WORLD REPORT Medicaid work requirements would make the health insurance programme a pathway out of poverty, say top US health officials. Susan Jaffe, The Lancet’s Washington correspondent, reports.
Beneficiaries can lose their health care if they fail to pay a premium, submit documentation that they qualify for an exemption, or to report a change in eligibility. “All roads lead to people being terminated from the programme or locked out of coverage,” said Leonardo Cuello, an attorney and director of health policy at the National Health Law Program in Washington, DC.
“This is not about punishing anyone”, said Arkansas Governor Asa Hutchinson. “It’s about giving people an opportunity to work and give them the training they need and help them move out of poverty and up the economic ladder.” [Full article here.]
Last month’s budget deal means Medicare beneficiaries are eligible for physical and occupational therapy indefinitely. Plus, prescription drug costs will fall for more seniors.
Physical therapy helps Leon Beers, 73, get out of bed in the morning and
Leon Beers gets help from caregiver Timothy Wehe. (Bert Johnson for KHN)
maneuver around his home using his walker. Other treatment strengthens his throat muscles so that he can communicate and swallow food, said his sister Karen Morse. But in mid-January, his home health care agency told Morse it could no longer provide these services because he had used all his therapy benefits allowed under Medicare for the year.
… Under a recent change in federal law, people who qualify for Medicare’s [physical, occupational and speech] therapy services will no longer lose them solely because they used too much.
“It is a great idea,” said Beers. “It will help me get back to walking.” [Continued at Kaiser Health News, NPR and The Washington Post]
Colin Campbell (Heidi de Marco/KHN)
Colin Campbell needs help dressing, bathing and moving between his bed and his wheelchair. He has a feeding tube because his partially paralyzed tongue makes swallowing “almost impossible,”he said.
Campbell, 58, spends $4,000 a month on home health care services so he can continue to live in his home just outside Los Angeles. Eight years ago, he was diagnosed with amyotrophic lateral sclerosis, or “Lou Gehrig’s disease,” which relentlessly attacks the nerve cells in his brain and spinal cord and has no cure.
The former computer systems manager has Medicare coverage because of his disability, but no fewer than 14 home health care providers have told him he can’t use it to pay for their services. That’s an incorrect but common belief…. [Continued at Kaiser Health News and NPR]
Volume 391, Number 10121
WORLD REPORT The CDC has indicated it will reduce its foreign presence, and proposed budget cuts make some fear its core functions are threatened. Susan Jaffe, The Lancet’s Washington correspondent, reports.
“We don’t know what the next outbreak organism will be; we don’t know where it will come from, or when it will emerge”, [former CDC director Dr. Tom] Frieden said. “But we are 100% certain there will be a next one and if we are not better prepared than we were during Ebola, shame on us.” [Full article here.]
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 M
arch. 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]