Health Policy Happenings, 10.22.21

It’s Friday and we made it through another week! I’m currently finishing up an elective in the trauma intensive care unit and very much looking forward to this weekend off. On the health policy front, the reconciliation bill is still being discussed and altered and is taking it’s sweet time getting through Congress. It remains to be seen not only what will be included in the bill, but how much the package will end up costing. The longer something takes to get through Congress, the less it usually ends up spending (lots of infuriating nips and tucks happening). So let’s take a gander at what else is going on:

There has already been some good analysis of who remains unvaccinated and why, but this piece is a good reminder that a big barrier for many folks is a lack of a primary care provider due to a lack of insurance and a general lack of trust in the medical system.

The decision of the Supreme Court to allow the ACA’s Medicaid Expansion to be optional for states continues to have serious effects for the 2.2 million adults who fall in the gap between Medicaid eligibility and subsidized ACA Marketplace eligibility and remains frustratingly hard to fix.

Climate change has contributed to an increasing number of intense and devastating weather events that threaten both people and property. The White House, intelligence agencies, and Pentagon are also raising the alarm that climate change is a threat to global security. A new report from the Lancet details how human-made climate change is worsening human health in every measurable way and we’re quickly closing in on the time left for world leaders to address it. [If this makes you anxious, as it does me, I highly recommend checking out this post for a podcast recommendation on how to manage our eco-anxiety (which yes, is a very real and valid concern!).]

There are some excellent reasons to use telehealth, which has been a lifeline for many and become much more widespread during the last year and a half – I’ve personally used it for a quick prescription refill when I didn’t have time to make an in-person appointment – but patients still prefer to see their doctor in person.

The Congressional Budget Office estimates on the number of people who would gain health insurance from the Build Back Better Act is remarkable.

There’s a good chance your local or state public health department has been gutted during the pandemic – employees resigning or quitting from the stress, mental toll, and outright threats; decades of underinvestment; new laws and regulations that hamper typical public health activities. Public health is and has been in crisis – this piece takes an alarming inside look at what that means.

There have been unsuccessful attempts to reign in prescription drug prices for decades and the most promising avenue lies in repealing a prohibition on the governments ability to negotiate the price of drugs in Medicare, which was passed in 2003 to help secure the Medicare Part D drug benefit. But for all its popularity, giving the government the ability to negotiate lower drug prices still might not happen.

The physical and emotional toll of miscarriage and stillbirth cannot be overstated, and yet people are expected to return to work quickly as if it was a typical medical issue – or even work through it. In March, New Zealand adopted a policy to grant three days paid leave following a miscarriage or stillbirth. In the U.S., some state and federal lawmakers have started to push for paid time off but it continues to be a slow process.

Listen to:

  • This episode of Vox’s The Weeds on the fight for an incredible conversation on the need for an expansion of funding for home and community-based services (HCBS), which is included in President Biden’s Build Back Better agenda. HCBS is the part of Medicaid that funds support services for older adults and people with disabilities living at home rather than in institutions and consistently has incredibly long waiting lists for those seeking services (up to 20 years for some services!).
  • Housing is intricately tied to health – not only if one has a home, but the safety of their environment and neighborhood. This episode of WBUR’s On Point looks into California’s housing crisis and the possible impact of new zoning laws meant to increase the number of housing units.

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