By Sharona Hoffman
As state and federal public health authority erodes, employers may increasingly find themselves playing a central role in promoting public health. For example, during the COVID-19 pandemic, many employers either incentivized or required employees and customers to be vaccinated and/or masked even in the absence of federal and state mandates. In the future, they may frequently take the lead in implementing public health measures.
By Leslie C. Griffin
You will be surprised I’ve been through all the experiences described in this post, and that I’m still alive to tell you about them. Even I can’t believe it some days. It’s quite a list, so sometimes I mention it to my friends, so they will be as amazed as I am.
I am a lifelong academic, so I also think about what lessons they’ve taught me.
One is the philosophical principle of autonomy, which I regularly teach in my bioethics class. In my opinion, it means you always have to be prepared for the very worst. You have to live knowing it could happen to you. The worst doesn’t always occur. But when it does, you need to find a positive way to look at it and to make good decisions about it.
Two is the practical decision to have your legal documents in place. A durable power of attorney. Health insurance and property insurance. These practical items also help a lot in getting you through terrible situations. Lack of insurance makes everything dreadful.
Autonomy and insurance help you through a lot of crises. My crises include a blizzard, a tornado, an earthquake, a car accident, a hurricane, and two murderers.
You also need good luck.
By Cathy Zhang
The COVID-19 Public Health Emergency (PHE) expires at the end of this week, with Department of Health and Human Services (HHS) Secretary Xavier Becerra expected to renew the PHE once more to extend through mid-July.
When the PHE ultimately expires, this will also trigger the end of the Medicaid continuous enrollment requirement, under which states must provide continuous Medicaid coverage for enrollees through the end of the last month of the PHE in order to receive enhanced federal funding. This policy improves coverage and helps reduce churn, which is associated with poor health outcomes.
After the PHE, states can facilitate smooth transitions for those no longer eligible for Medicaid by taking advantage of the full 12- to 14- month period that the Centers for Medicare & Medicaid Services (CMS) has established for redetermining eligibility.
In August 2021, CMS released guidance giving states up to 12 months following the end of the PHE to redetermine whether Medicaid enrollees were still eligible and renew coverage. Last month, CMS released new guidance specifying that states must initiate redeterminations and renewals within 12 months of the PHE ending, but have up to 14 months to complete them. The agency is encouraging states to spread its renewals over the course of the full 12-month unwinding period, processing no more than 1/9th of their caseloads in a month, in order to reduce the risk of inappropriate terminations.
By Bailey Kennedy
Statistics released at the end of last year confirmed what many already knew anecdotally to be true. Many women had turned to home births during the pandemic.
While the absolute number of women who chose to use home birth to deliver their children was quite small — about 9,000 more women chose to give birth at home in 2020 versus 2019 — the percentage increase was notable. In South Dakota, an eye-popping 68% more women gave birth at home during the first year of the pandemic, as opposed to prior years.
The reasons for this shift were as varied as the women who made the decision to give birth in a non-hospital setting. Some women cited concerns that they were especially susceptible to COVID-19; others feared not having access to the support of family and friends if they chose to give birth in a hospital. Others, of course, had been interested in giving birth outside of a hospital prior to COVID, and would have done so even in the absence of the virus.
By Cathy Zhang
Today, the Department of Health and Human Services — alongside the Department of Labor, the Department of the Treasury, and the Office of Personnel Management — published an interim final rule requiring health insurance plans and issuers on the marketplace to report data on prescription drug and health care spending to the three Departments.
This rule is part of a series of rules issued by the Biden Administration to implement Title I (No Surprises Act) and Title II (Transparency) of the Consolidated Appropriations Act, 2021.
By Cathy Zhang
At the start of the month, Democrats announced a new drug pricing plan, detailed in the House’s Build Back Better Act (H.R. 5376). In the immediate short term, the drug pricing plan has enabled the $1.75 trillion bill to go forward through the House. If ultimately enacted, it will generate savings for consumers, some more directly than others, and at a more modest pace and magnitude than many had hoped.
By Bailey Kennedy
Though Pres. Biden’s expansive infrastructure and social spending bills remain mired in Congress, it still seems likely that his administration will preside over one of the most dramatic revisions in America’s public safety net since the Great Society.
One of the most discussed provisions in the omnibus bill would expand Medicare benefits to include hearing, vision, and dental care. Currently, millions of Americans are forced to go without the types of care that the proposed Medicare expansion would address. And seniors, in particular, are likely to deal with vision and hearing-related health care issues, which pose a high financial burden.
While the proposed expansion has met pushback, including these aspects of health care in standard insurance plans is significantly overdue.
By Cathy Zhang
During the COVID-19 pandemic, ensuring widespread health coverage took on a new sense of urgency, leading many states to implement policies to address the longstanding problem of Medicaid churn.
Churn is a persistent problem in the U.S. health care system. Changes in health insurance coverage disrupt care and worsen self-reported health at significant rates, even for individuals who go from one insurer to another with no gap in coverage. Legislation enacted as a stopgap measure during the pandemic may present a path forward for securing more durable Medicaid coverage beyond the public health emergency.
By Dessie Otachliska
The COVID-19 pandemic has shone a light on the underinsurance crisis that has long kept millions of Americans on the precipice of financial disaster — just one unexpected illness or injury away from bankruptcy.
A 2019 Gallup poll showed that 25% of Americans reported delaying treatment for serious medical conditions due to cost concerns — the highest proportion since Gallup first began asking the question in 1991. Even during the pandemic, when medical treatment could mean the difference between life and death, studies show that nearly 1 in 7 Americans would avoid seeking medical care if they experienced key COVID-19 symptoms because of fears associated with the cost of treatment.
These statistics are unsurprising, and the concerns they underscore well-founded: the average treatment costs for COVID patients with symptoms serious enough to require inpatient hospital stays range from $42,486 for relatively mild cases to $74,310 for patients with major complications or comorbidities.
In the pandemic context, hesitance to seek medical treatment due to fear of the associated cost has proved tragically fatal. Darius Settles died after being dissuaded from seeking further COVID-19 treatment due to his uninsured status. The Nashville, TN hospital where Settles originally received care had failed to disclose the possibility that his medical costs would be covered by the federal government. And, despite the availability of reimbursement funds, the hospital nonetheless sent his widow a bill for a portion of his treatment costs.
By Anna C F Lewis and Anya E R Prince
On July 1, a law banning the use of genetic information by life, long-term care, and disability income insurers took effect in Florida.
Florida’s success marks a potential turning point of bipartisan appeal for this issue.
The passage of this law, which we explore in a recent article published in Genetics in Medicine, the official journal of the American College of Medical Genetics and Genomics (ACMG), was propelled by a campaign that argued that an individual’s DNA should not be weaponized against them, that affordable insurance shouldn’t just be for the genetic elite, and that an individual should be able to keep their genetic data private.