ACA

In more encouraging public health news, the Centers for Disease Control and Prevention reports that vaccination rates among kindergarteners have remained stable, with the median vaccine exemption rate at 2 percent. Some states even reported an increase in immunization rates. In a study published last week in CDC’s Morbidity and Mortality Weekly Report, researchers examined 2016-2017 data from 49 states regarding coverage of three vaccines: measles, mumps and rubella (MMR); diphtheria, tetanus and acellular pertussis (DTaP); and varicella, more commonly known as chickenpox. Researchers also…
In yet another attempt to repeal and replace the Affordable Care Act, much of the GOP justification boils down to one argument: that the ACA isn’t working. Never mind that we don’t really know what constitutes a “working” health care system for Republicans. For a while, Republicans said the ACA wasn’t working because some U.S. counties didn’t have an insurer. Today, no county is without an insurer. Then there’s the argument that ACA premiums are too high. However, the research shows that while premiums have gone up, the rise in premiums has been slower under the ACA than it was before the ACA…
Senate Republicans are again trying to ram through an Affordable Care Act replacement that threatens the health and well-being of millions of Americans. It’s shameful. But don’t take my word for it. Let’s look at what people who actually work in health care are saying about the Graham-Cassidy-Heller-Johnson bill. In this interview, Sen. Bill Cassidy insists that his bill would protect people with pre-existing conditions. Blue Cross Blue Shield Association disagrees. (Cassidy also says in that same interview that his bill would work through the Children’s Health Insurance Program (CHIP), which…
Earlier this week, members of the Senate Finance Committee announced an agreement to extend funding for the Children’s Health Insurance Program. The announcement had been anxiously awaited by families and advocates across the nation, as the program’s federal funding expires in about two weeks. The agreement is good news, but coverage for CHIP’s 8.9 million children isn’t safe just yet. According to reports, the agreement would extend CHIP’s funding for five years — a win for advocates worried that lawmakers might propose another two-year extension as it did in 2015. The agreement would also…
The idea that the Affordable Care Act is a job killer is one of those regularly debunked talking points that won’t disappear. So, here’s yet more evidence that the ACA has had very little impact on the labor market. In a new study from the National Bureau of Economic Research, a team of Stanford University economists found that even though different regions experienced varying labor market effects likely related to the ACA, the overall impact to jobs numbers was insignificant. In particular, researchers wrote: “Our findings indicate that the average labor supply effects of the ACA were close…
Umair Shah’s story isn’t an uncommon one in public health. Starting out in medicine, with a career as an emergency department doctor, he said it quickly became clear that most of what impacts our health happens outside the hospital and in the community. Today, that philosophy drives his work as executive director of Harris County Public Health (HCPH) in Houston, Texas — an agency that serves the third-largest county in the nation, home to about 4.5 million residents. In fact, Shah, who first joined the agency in 2004 and become director in 2013, said the agency’s mantra is this: “Health…
With the future of the Affordable Care Act still up in the air, most of the news coverage has gone to insurance coverage, premiums and Medicaid. And rightly so. But also included in the massive health reform law were a number of innovative measures to improve the quality and value of the medical care we actually get in the doctor’s office. With repeal still on the table, those measures are at risk too. One of those ACA efforts is the Hospital Readmissions Reduction Program, which reduces Medicare payments to hospitals with relatively high rates of often-preventable hospital readmissions. The…
In Cuyahoga County, Ohio, nearly 200 people have died from opioid-related overdoses in the first five months of this year. That means that this one U.S. county is on pace to lose more than 700 people to fatal overdoses by the end of 2017. Terry Allan, health commissioner at the Cuyahoga County Board of Health, and colleagues across the county have spent years building and scaling up a multifaceted response to the opioid addiction and overdose epidemic that includes getting people into treatment, changing clinical prescribing habits, preventing deadly overdoses, and dealing with the often-…
This is from Parents magazine: When you talk about “preexisting conditions,” you probably think of things like diabetes, heart disease and cancer. But the reality is that healthcare companies consider a whole slew of common health concerns preexisting conditions. Odds are, if you’re a mom, you probably already have one of them. And now that the American Healthcare Act passed the House of Representatives today—if it becomes law, your health insurer could charge you thousands more for your coverage or reduce your insurance coverage because of these "preexisting conditions." "Things that are…
The House and Senate health care bills are overflowing with proposals that will strip Americans of access to quality, affordable health care. But perhaps the cruelest part is what they do to children — the most vulnerable and powerless among us. Children can’t show up at the ballot box to protect their health and so it truly is up to the rest of us. Right now, after decades of hard work, the U.S. has achieved near-universal insurance coverage of its littlest residents. About 95 percent of U.S. kids have health insurance. Unfortunately, the House and Senate proposals to replace the Affordable…
This is the harsh reality of the Senate health care bill: it provides tax cuts to the wealthiest Americans, while taking away access to timely medical care from the poorest, most vulnerable Americans. You’ve probably been hearing this point a lot about the GOP’s repeal-and-replace efforts, and it’s easy to relegate it to partisan hyperbole. But the sad truth is that, well, it’s the sad truth. The Senate’s “draft” health care bill, released this morning, proposes sweeping changes to the Medicaid system, which now provides health coverage for 76 percent of poor children, 60 percent of children…
Last year’s emergency Zika funding is about to run out and there’s no new money in the pipeline. It’s emblematic of the kind of short-term, reactive policymaking that public health officials have been warning us about for years. Now, as we head into summer, public health again faces a dangerous, highly complex threat along with an enormous funding gap. “The Zika threat will get worse,” said Claude Jacob, chief public health officer at the Cambridge Public Health Department in Massachusetts and president of the National Association of County & City Health Officials (NACCHO). “And the…
When you ask public health advocates about President Trump’s recent budget proposal, you typically get a bewildered pause. Public health people don’t like to exaggerate — they follow the science, they stay calm, they face off against dangerous threats on a regular basis. Exaggerating doesn’t help contain diseases, it only makes it harder. So it’s concerning when you hear words like this about Trump’s budget: “devastating,” “not serious,” “ludicrous,” “unfathomable.” Released in late May, Trump’s fiscal year 2018 federal budget proposal calls for cutting the budget at the Centers for Disease…
To the surprise of literally no one, President Trump’s 2018 budget proposed stripping all federal funds, including Medicaid dollars, from Planned Parenthood. Proponents of this argue that if Planned Parenthood clinics end up shuttered, women can simply access care elsewhere. But growing research shows that’s the opposite of what actually happens. We got even more evidence of this with a report on the capacity of federally qualified health centers (FQHCs) to fill the gaps left when a Planned Parenthood clinic is forced to close its doors. In a policy paper from the Guttmacher Institute…
More than 8 million U.S. children depend on the Children’s Health Insurance Program for access to timely medical care. The program is authorized through 2019, but its federal funding expires in September and it’s unclear what Congress will do. That uncertainty stresses all the systems and families that depend on CHIP, but it may be especially risky for the 2 million chronically ill children who get care through the program, which was originally designed for families falling in the gap between market affordability and Medicaid eligibility. In a study published this month in Health Affairs,…
There was always an assumption that the Affordable Care Act would need time to find its sea legs. That’s why it included measures to shield insurers from the potential profit losses that inherently come with offering millions more people better health coverage at more reasonable prices. Insurers operate on profit margins and the ACA took that into account, for better or for worse. But it’s still been a rocky road for insurers. (Insert argument here for single-payer health care, but that’s a different story.) On the patient side, with 20 million more Americans insured and growing accounts of…
Public health is in trouble. Last month, President Trump released his proposed budget for fiscal year 2018. It was more of an outline, really, and didn’t provide many details, but it did call for a nearly 18 percent cut to the U.S. Department of Health and Human Services and for block granting the budget at the Centers for Disease Control and Prevention. At the same time, the White House supports repealing the Affordable Care Act. That repeal would also eliminate the Prevention and Public Health Fund, which now accounts for about 12 percent of CDC’s budget and funds critical public health…
Yesterday, House Republicans failed to find enough votes to pass their Affordable Care Act replacement. It was a very good day for the millions of Americans projected to lose their coverage under the GOP plan. But let’s be clear: Obamacare is not safe. In a last-ditch effort to round up more votes, House Speaker Paul Ryan, R-Wis., proposed an amendment that would have, beginning in 2018, allowed states to determine the kinds of essential health benefits required in insurance plans purchased with tax credits. Under Obama’s health care law, insurance plans sold via the federal health care…
In real estate. I'm not an expert on this but I've seen the sausage being made a few times. Individuals with investment money, commercial businesses that might use new space, other possible tenants, maybe or maybe not some designers or builders, municipal or other government stakeholders, community stakeholders such as neighborhood associations, etc. consider a real estate deal. Perhaps there is a bit of condemned land the county wants to sell cheap if only you clean up the brownfield and develop something nice. Maybe the investors include a person who owns an underexploited business…
A few of the recent pieces I recommend reading: Sarah Kliff & Ezra Klein at Vox: The Lessons of Obamacare Chris Ladd in Forbes: Unspeakable Realities Block Universal Health Coverage in the US Donelle Eller in the Des Moines Register: Iowa pollution enforcement could lose big under Trump EPA cuts, critics warn Teddy Wilson at Rewire: Texas Legislators "Ignore" Spiking Black Maternal Mortality Rates Linda-Gail Bekker & Anthony S. Fauci at STAT: Women are Leading the Way in HIV Research And because the House Republicans' healthcare bill is so consequential for public health and there's…