Episode #36 Deep Dive – Health Care Hunger Games
A deep dive into this week's episode of Paging America
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››› FDA’s top vaccine regulator says COVID-19 vaccines killed ten kids
POLITICO reports that the Trump administration is offering states a bribe: pledge to enact policies that make the White House happy for a chance to win a bigger share of the $50 billion “Rural Health Transformation Program”, the Hunger Games fund created by Trump’s Big Bill last summer:
7.5 percent of the [fund’s] total, hinges on whether states pass a series of policies. States will receive “full credit” for laws they’ve already changed, and “partial credit” for pledges to make those changes. But if states don’t implement those promised policies by the end of 2027, or 2028 for some of the more complex ones, the Trump administration has threatened to “claw back” a portion of the money. [...]
None of the policies are specific to rural residents, and would impact states’ entire populations. [...]
“It’s a bad way to care for human beings, and it’s bad for rural economies,” said Matt Klein, an internal medicine doctor and Democratic [Minnesota] state senator… “And if that rural hospital fund is tied to sort of blackmail policy initiatives that are unacceptable to the people of Minnesota, we’ll have to figure out our own pathway to care for our members.” [...]
“We’re not going to sell ourselves out to do this for $1 here, $1 there,” Delaware Gov. Matt Meyer, a Democrat, told POLITICO.
The policies in question include food stamp restrictions and the deregulation of short-term junk health insurance plans. One complicating factor is that states had just a few weeks to put together their applications this fall which is a time when almost all state legislatures were not in session and unable to pass the required legislation.
››› Everyone Can Be a Bounty Hunter with the New Texas Abortion Law
This past week, a new Texas abortion law went into effect. Known as “a bounty hunter law”, it allows private citizens to sue abortion pill providers and manufacturers who send abortion pills into the state.
The law, which [went] into effect December 4, creates civil penalties for health care providers who make abortion medications available in Texas, allowing any private citizen to sue medical providers for a minimum penalty of $100,000. The bill’s backers have said it would also allow suits against drug manufacturers. It would not enable suits against the people who get abortions.
Though other states have passed legislation targeting abortion medications — classifying them as a controlled substance, for instance — the Texas law is novel in its approach to targeting the people who distribute them and its reliance on civil suits.
More from The Texas Tribune:
Anyone can bring a lawsuit. If they win, plaintiffs can get at least $100,000 from the defendant if they are related to the fetus. If they are not, they can only receive $10,000 and would have to donate the rest of the money to a charity or nonprofit. The charity of their choosing, however, cannot be one that they or their family members receive a salary or any financial benefits from.
The bill’s author called it “compassionate to its core.”
John Seago, the president of Texas Right to Life and one of the main architects behind Texas’s new abortion ban, told The Guardian, “We think there is going to be a kind of this standoff between Texas and New York that maybe goes back to the supreme court. I would be very interested to get that case. We’re actually looking to spur that on.”
››› Even More CDC Vaccine Turmoil
Last Friday, the Committee on Immunization Practices (ACIP) voted to remove their recommendation that all newborns receive the Hepatitis B vaccine. As The Guardian points out, no new evidence on harms from the vaccine, which has been given to 1.4 billion people for more than three decades with a stellar safety record, was presented at the meeting.
One presenter, Mark Blaxill, recently named a senior adviser at the CDC, pointed to a study in which 18% of vaccine recipients reported minor side-effects like fatigue or weakness, diarrhea and irritability and said if you compare those descriptions to definitions of encephalitis, “those are possibly connected.” Via The Guardian:
“Irritability, fatigue, weakness, diarrhea, that is absolutely not encephalitis,” said Cody Meissner, a pediatrician and ACIP member, after Blaxill’s presentation. “That’s not a statement that a physician would make. They are not related to encephalitis and you can’t say that.
“There were so many statements that I don’t agree with that it’s hard to be succinct,” Meissner said in response to the presentations on the safety and effectiveness of the vaccine.
Following their decision, Kirk Milhoan, the new anti-vaxx chair of the panel who replaced Bond villain Dr. Martin Kuldorff, said that he felt like panel members were “puppets on a string“ instead of an independent advisory board.
Bizarrely, one of the presenters at the ACIP meeting was Aaron Siri, a leading anti-vaccine trial lawyer. After his presentation, Dr. Meissner told him, “What you have said is a terrible, terrible distortion of all the facts.” Another member, Joseph Hibbeln, said he repeatedly asked for data to support the change but “no data of harm was presented.” It’s no wonder that Republican Sen. Bill Cassidy called ACIP “totally discredited.”
The same day the ACIP made their decision, Trump praised the decision and ordered federal health officials to review the decades-old U.S. childhood immunization schedule and consider reducing the number of recommended vaccinations to align with developed nations like Denmark and Japan.
Then, this week, the FDA announced that it will launch an investigation into whether there are adult deaths linked to COVID-19 vaccine.
››› The Absurd State of ACA Enhanced Premium Tax Credits
The day before a scheduled vote in the Senate on the Democrats’ plan to extend the enhanced premium tax credits for Affordable Care Act health care plans for three years, Republican Senators have gone from planning to offer no plan of their own to deciding to vote on one from Sens. Bill Cassidy and Mike Crapo which relies exclusively on health savings accounts and does not extend the enhanced ACA subsidies:
Cassidy and Crapo’s legislation would give HSA funding to those earning less than 700 percent of the poverty level, $1,000 for people ages 18 to 49 and $1,500 for those 50 to 65.
However, to get the HSA an individual must purchase a bronze or catastrophic plan on an Obamacare exchange. The bronze plans offer lower premiums than other plan tiers but have higher out-of-pocket costs, such as deductibles and co-pays.
The average deductible for a bronze plan was roughly $7,000 last year, according to data from the nonpartisan health policy research organization KFF.
Neither plan has the 60 votes needed to pass in the Senate.
Meantime, in the House, things are even more ridiculous. There are different plans being offered by the GOP to counter efforts by Democrats to extend the subsidies:
At a conference meeting on Tuesday, House Speaker Mike Johnson showed a slide with ten policies that could get votes that included things like “innovation” and “Codify Trump Administration rules to fix Unaffordable Care Act”:
Some later expressed their dismay at how poorly they believe GOP leaders have handled the topic.
“There was a general uneasiness because nothing is coming together,” said a House Republican, one of several granted anonymity to speak candidly about the private meeting.
“We wasted so much time,” one conservative Republican said, also lamenting the lack of a unified GOP plan with just seven session days left in the year.
One House plan, offered by Reps. Jen Kiggans and Josh Gottheimer, would extend enhanced premium tax credits for one year with new income caps and guardrails to crack down on fraud. The bill would also require a vote by July 2026 on other policies designed to reduce Americans’ health insurance premiums.
One group of at least six Republicans signed a discharge petition yesterday to force a vote on another plan from Reps. Brian Fitzpatrick and Jared Golden that would extend the expiring tax credits for two years while imposing new eligibility requirements:
The move to sidestep Speaker Mike Johnson came as a growing number of mainstream House Republicans publicly warned that their leaders’ apparent plan to allow the tax credits to expire without a replacement in place will cost them their majority in next year’s midterm elections.
Following a House GOP conference meeting yesterday morning, Rep. Ralph Norman, a member of the conservative Freedom Caucus, hilariously told Kyle Stewart of NBC News, “The consensus is we need to come up with something.”
Another House Republican, Rep. Jeff Van Drew, said, “To me, the game plan is get on your knees and pray. … I don’t think that’s a smart thing to do.”
Meanwhile, anti-abortion groups are in the background demanding that any approach contains Hyde Amendment restrictions and Trump is AWOL. He has endorsed none of the proposals and repeated some version “give money to the people, not the insurance companies.” For example, on Tuesday he said:
“I love the idea of money going directly to the people, not to the insurance companies, going directly to the people. It can be in the health savings account, it can be a number of different ways. And the people go out and buy their own insurance which can be really much better health insurance, health care.”
Links for a deeper dive on Episode #35
POLITICO: ‘Sort of blackmail’: Billions in rural health funding hinge on states passing Trump-backed policies
The 19th: Texas’ new abortion ban aims to stop doctors from sending abortion pills to the state
The Texas Tribune: New Texas law restricting abortion pills beefs up an existing legal tool
The Guardian: New Texas law allows residents to sue those suspected of providing access to abortion pills
The Guardian: CDC advisers delay vote on restricting infant hepatitis B vaccinations in tense meeting
MedPage Today: ACIP Leadership Shake-Up Before Hep B Vaccine Vote Alarms Experts
POLITICO: RFK Jr. ally, anti-vaccine lawyer to brief CDC vaccine meeting
MedPage Today: CDC Panel Targets Size of Childhood Vaccine Schedule, Safety of Aluminum Adjuvants
The Hill: CDC adviser: Newborn vaccine rollback ‘wasn’t based on data’
The Hill: Cassidy calls ACIP ‘totally discredited’ ahead of vaccine guidance votes
The Hill: Trump hails vaccine panel’s hepatitis B vote as ‘very good decision’
The Washington Post: FDA to investigate whether adult deaths linked to coronavirus vaccine
POLITICO: Senate Republicans set to put Cassidy-Crapo health proposal up for a vote Thursday
POLITICO: Cassidy, Crapo unveil alternative to Obamacare subsidies
POLITICO: House GOP erupts over health care as leaders hunt for a plan
POLITICO: New ACA subsidy extension bill draws 16 GOP co-sponsors
POLITICO: Frustrated Republicans move to force Obamacare vote as warnings mount about the midterms
NBC News: ‘We need to come up with something’: House Republicans struggle to agree on a health care plan
POLITICO: Anti-abortion group warns against forcing vote to expand Obamacare subsidies
POLITICO: Trump still hasn’t endorsed a plan to avoid impending Obamacare hikes for millions
TIME: I Left the CDC 100 Days Ago. My Worst Fears About the Agency Are Coming True