Health Policy Happenings, 11.04.21

I feel like a broken record on Groundhog’s Day, but like the past few weeks, there is still so much movement and fluidity to the spending package deal that it’s anyones guess how long this news will be accurate for…there were reports of vote whipping (a process undertaken to determine who will be voting in favor/opposition of a piece of legislation) for the Build Back Better plan, as the spending bill is known as but its unclear when a vote might actually take place. But while BBB is front and center, there’s still so much more going on!

While world leaders met to discuss global approaches to curbing (although, lets be honest, we’re really at the mitigation and not prevention stage) the impacts of climate change, there are local efforts underway like this pioneering technology to literally suck excess carbon dioxide out of the air and the recent approval by voters in Ithaca, New York to decarbonize and electrify its buildings. As the article about Ithaca goes on to say, “Buildings account for nearly 40 percent of greenhouse gas emissions in the United States. Ithaca’s initiative is projected to cut about that much from the city’s overall carbon footprint — saving approximately 160,000 tons of carbon dioxide. That’s the equivalent of the emissions from about 35,000 cars driven for a year.”

And for something more interactive, this detailed map shows cancer-causing industrial pollution around the U.S. in more than 1,000 hotspots that could have exposed over 250,000 people to toxic chemicals above allowable EPA levels. For more on what this means, what laws regulate air pollution, and what can be done to protect yourself and community, click here.

The little data we have on breakthrough infections is showing concerning patterns of racial and ethnic inequities, even as vaccination rates continue to rise across the board. However, the CDC stopped reporting most breakthrough cases in May and is not reporting the publicly available data they do share with information on race or ethnicity, making it harder to investigate these patterns.

Understaffing in prisons is having a significant effect on the health of those remaining staff, as well as the health and safety of those who are incarcerated. We have seen states take measures to reduce incarcerated populations as a means to reduce the spread of COVID-19 and some recent research has shown that detention facilities acted much like the Broad Street water pump, the famous source of a cholera outbreak traced by the “father of epidemiology” John Snow.

The consequences of underfunding public health has had a direct impact on the work of the CDC and clinics, drastically limiting their attempts to prevent the transmission of infections like syphilis. Congenital syphilis – which is transmitted from mom to fetus – can cause serious health problems including facial deformities, deafness, palate defects, and death. But it is preventable if mom is treated with penicillin. The number of syphilis cases in the U.S. has doubled between 2014 and 2019, when over 129,000 cases were reported. In that same five year period, 1,870 babies were born with syphilis and 128 babies died. The CDC has not yet released the 2020 numbers but say they have already exceeded 2019.

Nearly 90% of all adults in Puerto Rico are vaccinated against COVID-19, making it the most highly vaccinated state or territory in the U.S. Much of that success is thanks to mandates that required vaccination and making it accessible for months, even at places like beaches or bars. The adjunct general of the Puerto Rico National Guard played an instrumental role in the vaccination strategy that should be the envy of many states.

Voters in Maine approved a first-of-its-kind amendment to their state constitution that enshrines the “right to food” defined as the ability to “grow, raise, harvest, produce, and consume the food of their own choosing,” so long as it does not violate other laws (i.e. trespassing, stealing). This language is ambitious but ambiguous and it’s unclear how this will actually work in practice. However, from a symbolic perspective, it can be interpreted as strong support of access to food as a basic human right.

Nearly 7 in 10 Medicaid beneficiaries in 47 states receive their services through some type of managed care organization, an arrangement where the state pays private insurers a flat rate per beneficiary to provide care for Medicaid enrollees. This set up was created with the lofty goals of reducing cost and improving quality of care. Research has shown, however, that those goals remain elusive – although it does help states better plan their budgets. This new report explores Medicaid policies around the country, with particular attention to managed care, and the budgetary impact.

And if Medicaid isn’t your jam, maybe Medicare is. This report takes a look at the Medicare Part D prescription drug plans that will be offered in 2022. Medicare enrollment runs until December 7 and beneficiaries will have 54 plans to choose from for next year.

The pandemic has greatly impacted the public health workforce, another consequence of which is the loss of staff at public health laboratories that do important large scale disease testing and surveillance.

A historic plan to give Medicare the ability to negotiate the cost of some drugs and cap out-of-pocket costs for drugs for seniors is back in the spending package for now.

The CDC added mood disorders to the list of conditions that raise an individual’s risk of COVID-19, making a mental health diagnosis alone a criteria of eligibility for booster doses.

The supply chain is not only impacting holiday shopping, it’s seriously hindering the health care system and access to gloves, crutches, catheters, and more items used on a daily basis in health care facilities.

Over 18 months into the pandemic and at home rapid tests in the U.S. are still impossible to come by, no matter the fact that they cost a staggering $23 for two tests. This investigation into the issue is superb and necessary reading.

23andMe has big goals that go beyond collecting your DNA and giving you details on your genetic makeup.

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