The Host
Julie Rovner
KFF Well being Information
Julie Rovner is chief Washington correspondent and host of KFF Well being Information’ weekly well being coverage information podcast, “What the Well being?” A famous skilled on well being coverage points, Julie is the writer of the critically praised reference e-book “Well being Care Politics and Coverage A to Z,” now in its third version.
The brand new, GOP-led, 119th Congress and President-elect Donald Trump have massive legislative plans for the 12 months — which largely don’t embrace well being coverage. However well being is prone to play an essential supporting function in efforts to resume tax cuts, revise immigration insurance policies, and alter commerce — if solely to assist pay for some Republican initiatives.
In the meantime, the outgoing Biden administration is racing to complete its well being coverage to-do listing, together with finalizing a coverage that bars credit score bureaus from together with medical debt on people’ credit score reviews.
This week’s panelists are Julie Rovner of KFF Well being Information, Shefali Luthra of The nineteenth, Alice Miranda Ollstein of Politico, and Lauren Weber of The Washington Submit.
Panelists
Shefali Luthra
The nineteenth
Alice Miranda Ollstein
Politico
Lauren Weber
The Washington Submit
Among the many takeaways from this week’s episode:
- The 119th Congress is now in session. Well being care doesn’t make the listing of priorities as lawmakers lay the desk for the incoming Trump administration — although Republicans have floated Medicaid work necessities to chop federal spending.
- Quite a lot of well being laws hit the cutting-room ground in December, together with a bipartisan proposal concentrating on pharmacy profit managers — which might have saved the federal authorities and sufferers billions of {dollars}. And talking of bipartisan efforts, a congressional report from the Senate Price range Committee provides to proof that non-public fairness involvement in care is related to worse outcomes for sufferers — notably, lawmakers’ constituents.
- Because the nation bids a remaining farewell to former President Jimmy Carter, his world well being work, specifically, is being celebrated — particularly his efforts to eradicate such devastating ailments as Guinea worm illness and river blindness.
- In the meantime, the Biden administration finalized the rule barring medical debt from showing on credit score reviews. The surgeon basic cautions that alcohol ought to include warning labels noting most cancers danger. And the brand new Senate Republican chief is elevating abortion-related laws to require lifesaving take care of all infants born alive — but these protections exist already.
Plus, for “further credit score,” the panelists recommend well being coverage tales they learn this week that they assume you must learn, too:
Julie Rovner: The Wall Road Journal’s “UnitedHealth’s Army of Doctors Helped It Collect Billions More From Medicare,” by Christopher Weaver, Anna Wilde Mathews, and Tom McGinty.
Alice Miranda Ollstein: The New York Instances’ “Ozempic, Lego Bricks and Hearing Aids: What Trump’s Greenland Plan Could Hit,” by Ana Swanson and Jenny Gross.
Shefali Luthra: Vox.com’s “Gigantic SUVs Are a Public Health Threat. Why Don’t We Treat Them Like One?” by David Zipper.
Lauren Weber: The Washington Submit’s “Laws Restrict U.S. Shipping of Vape Products. Many Companies Do It Anyway,” by David Ovalle and Rachel Roubein.
Additionally talked about on this week’s podcast:
The Senate Price range Committee’s “Profits Over Patients: The Harmful Effects of Private Equity on the U.S. Health Care System.”
CLick right here to open the transcript
Transcript: New Yr, New Congress, New Well being Agenda
[Editor’s note: This transcript was generated using both transcription software and a human’s light touch. It has been edited for style and clarity.]
Julie Rovner: Whats up, and welcome again to “What the Well being?” I’m Julie Rovner, chief Washington correspondent for KFF Well being Information, and I’m joined by a number of the finest and smartest well being reporters in Washington. We’re taping this week on Thursday, Jan. 9, at 10 a.m. As at all times, information occurs quick and issues might need modified by the point you hear this. So, right here we go.
Rovner: Right this moment we’re joined through videoconference by Alice Miranda Ollstein of Politico.
Alice Miranda Ollstein: Whats up.
Rovner: Lauren Weber of The Washington Submit.
Lauren Weber: Whats up good day.
Rovner: And Shefali Luthra of The nineteenth.
Shefali Luthra: Whats up.
Rovner: No interview this week — means an excessive amount of information to make amends for. So allow us to get proper to it. So, welcome to the 119th Congress and, quickly, to a brand new presidential administration. We’ll return and recap what occurred in late December shortly, however I wish to begin by wanting forward. What’s on the quick agenda right here in Washington for well being care? Anyone?
Ollstein: So well being care just isn’t the precedence proper now for the incoming administration, for the brand new Republican trifecta in Washington. It may possibly make it in, as a result of they’re speaking about these huge, conglomerate payments that they’ve criticized up to now and mentioned that they don’t like doing that, and they’d a lot quite vote on particular person issues one after the other.
However now they’re speaking about cramming every little thing into one large reconciliation invoice early within the new administration. And there’ll seemingly be some well being care parts. We don’t know but what these shall be. Issues that purport to economize are much more seemingly than issues that purport to price cash. Though, there’s usually some humorous math in that. Medicaid work necessities have been floated, and so we will speak about that. We all know, we’ve seen that film earlier than, and we all know how that may go, each when it comes to what it means for individuals’s protection and what it means when it comes to financial savings.
However I believe that lots of the formidable stuff that lawmakers tried to get by on the finish of the 12 months is now in query, as as to if it has a future or not. As a result of the highest priorities of the brand new administration are extra on taxes and commerce and immigration and issues like that and never as a lot on well being coverage.
Rovner: Though, I’d level out that that end-of-the-year rush that they obtained — they saved the federal government open, and so they obtained the federal government funded — that solely goes till March. I noticed kind of a plaintive electronic mail yesterday from Tom Cole, the Republican chairman of the Home Appropriations Committee, saying, Um, we’ve to start out engaged on the subsequent one quickly. Everyone’s busy speaking about this large tax invoice, reconciliation. What are we going to do about Medicaid? And it’s like, good day, the present fiscal 12 months just isn’t completed. They only managed to place issues off.
Lauren, you wished so as to add one thing?
Weber: Yeah. I simply wished to say, I really feel like we’ve entered the period of selling with regards to these payments. You’ve obtained President-elect [Donald] Trump saying he needs one massive, stunning invoice. That’s what he needs. He needs one massive, stunning invoice. And it’s not simply Trump. I imply, let’s take a look at the MAHA motion, the “Make America Wholesome Once more” motion.
I imply, I believe we’re getting into an period through which payments and actions all have catchy slogans. And I imply, heck, the American public could have a greater understanding, or not less than know what these persons are telling them is going on with this advertising and marketing, we’ll see. So I simply wished to flag that this appears to be the change over right here.
Rovner: And that is once I get to place in my different actuality examine, which is that they maintain speaking about this massive, stunning reconciliation invoice that they solely want Republican votes for. I’ve to remind individuals yearly: With a view to do a reconciliation invoice, first they have to do a price range decision, in each homes. That has to go to the ground, be debated, needs to be reconciled between the Home and the Senate, about what the price range decision seems to be like.
The entire level of what’s referred to as “reconciliation” is that it reconciles necessary spending to the phrases of the price range decision. It takes a very long time to do a price range decision, even if you’re dashing it by.
Additionally, all this stuff that they’re speaking about placing into this reconciliation invoice aren’t allowed to enter price range reconciliation. It’s solely about necessary spending. It’s taxes. It’s Medicare and Medicaid and different necessary spending. And it’s the debt ceiling. And people are principally all of the issues that may go in. Sorry, that’s the tip of my lecture.
Alice, did you wish to add one thing?
Ollstein: Certain. I imply, I believe we’re already seeing cracks rising on this nice Republican unity that they’re making an attempt to mission. I imply, they will’t even agree but on whether or not to do one massive, stunning invoice or two. And the individuals pushing for 2 are mentioning that when you put all of your eggs in a single basket and that basket breaks and falls aside and all of the eggs smash on the ground, then you definitely don’t actually have something to point out in your work.
Which in fact is a state of affairs Congress has discovered itself in lots of instances over the previous a number of years. And so, these people are saying it’s a lot much less dangerous to interrupt it up and have it in separate payments, in order that if one goes down in flames, the opposite would possibly make it by. However sure, as soon as once more, we’re seeing each Home vs. Senate tensions, in addition to Congress vs. Trump and Trump’s advisers tensions. And I think about that’s going to be a continuing for the subsequent few years.
Rovner: And when you thought that the Home was ungovernable with its tiny Republican majority within the final Congress, it’s even tinier now. Actually, we do have Speaker Mike Johnson. He did get elected on the primary poll, however it was not simple. There have been a few holdouts who needed to take calls from the president-elect with a purpose to change their votes. So it’s fairly tenuous there.
Shefali, earlier than we transfer on, did you wish to add one thing?
Luthra: No, I imply, I believe what shall be actually attention-grabbing, as properly, is to see how this emerges in all the extra fractious points among the many Republican Get together. I do know we’ve talked loads about how the Republican Get together could be very divided on lots of problems with reproductive well being, together with abortion, one thing Alice and I each take into consideration on a regular basis. And—
Rovner: And we’ll get to in a couple of minutes.
Luthra: We shall be attending to that very quickly. However it’s simply very clear that each one of those points, the place they mission unity, are fairly rapidly going to disintegrate with regards to participating with the truth that this can be a very divided coalition, and lots of the issues they’re speaking about doing aren’t very fashionable with voters. And so we’ll see how that impacts them as properly.
Rovner: Sure. So let’s transfer again a little bit bit. After we left issues in December, we had been a day away from a doable authorities shutdown, which didn’t occur. However the different factor that didn’t occur was a giant bundle with principally a whole 12 months’s value of bipartisan well being coverage work in it, every little thing from new transparency necessities for pharmacy advantages managers [PBMs], to renewals of applications to organize for the subsequent pandemic and to struggle the opioid epidemic, to rolling again cuts to medical doctors below Medicare. Most of that didn’t make it into the ultimate bundle that may maintain the federal government operating till March.
The tiny issues that did make it in had been extensions of telehealth authority for Medicare and funds for group well being facilities and another expiring applications — however once more, solely by the center of March, which is when the remainder of this funding invoice expires.
So what occurs to issues just like the PBM invoice that fell by the wayside? Do we’ve any purpose to assume that Congress goes to choose it up and go it this 12 months? And even when they do this Trump would signal it? Or did all of that work final 12 months, is that each one simply principally for naught now?
Ollstein: I imply, I believe you might make an argument both means. You can make an argument that it has an opportunity as a result of there’s bipartisan help. A few of these issues may save the federal government cash and assist pay for different issues that the Republican majority needs to do, like lower taxes.
Rovner: I’d say the PBM invoice was like $5 billion in financial savings, as I recall.
Ollstein: Precisely. And it’s not like PBMs are super-popular and everybody needs to defend them proper now. So you may make the argument that it has an opportunity due to that, however we’ve seen tons of well being insurance policies up to now which have bipartisan help that might get monetary savings additionally fall by the wayside, simply because they aren’t priorities. And so, I believe, you may make the optimistic or the pessimistic case on this one.
Rovner: Go forward, Lauren.
Weber: I’d simply add, I imply, lots of issues that individuals had been fairly upset about, when it comes to smaller issues, health-wise, additionally obtained lower from the invoice. I imply, there was funding for 9/11 most cancers funds, for people who had been uncovered to poisonous chemical substances, first responders, and so forth. Quite a lot of outcry after that obtained stripped out of the invoice. Understandably so, contemplating, principally all of the advocates mentioned: We don’t wish to parade our dying first responders to Congress yearly to get funds. Actually, you chop this out?
So there does appear to be some momentum to probably add that in once more. There was additionally hullabaloo round childhood most cancers analysis. They ended up passing a separate smaller invoice, however it didn’t embrace the total measures to actually prioritize some stress on the FDA [Food and Drug Administration] and different funding to enhance childhood most cancers analysis. And so I believe you’re going to proceed to see, not less than from the Dems, some mentioning of those points going ahead as, I imply, childhood most cancers and 9/11 first responders are fairly sympathetic characters for funding.
Rovner: Yeah, I believe it’s going to be — I believe lots of these new committee chairs, notably within the Senate, the place the Republicans are taking up, are going to need to determine their means out and attempt to decide up a number of the items. One attention-grabbing factor that got here by my inbox this week was a bipartisan report from the Senate Price range Committee that discovered, and I’m quoting from the headline within the press launch, “Private Equity in Health Care Shown to Harm Patients, Degrade Care and Drive Hospital Closures.” Does this recommend that Congress would possibly attempt to do one thing on this extraordinarily fraught topic?
Shefali, you might be smiling. I imply—
Luthra: I’m smiling as a result of a few issues, and the primary is that there was lots of discourse about non-public fairness’s impression on well being take care of customers for years. That is very attention-grabbing and essential work, and it’s not in any respect stunning.
And the opposite factor that we’ve to recollect is that Donald Trump shall be president. He’s ideologically very unpredictable. As an actor, he’s very unpredictable. And it’s simply very tough to guess what’s going to really grow to be regulation and getting his signature. And a part of that’s as a result of, we will bear in mind from the final time he was president, he fairly often would change what he believed based mostly on the final individual he spoke to. We noticed this on a regular basis with drug pricing.
And I simply assume that we are going to see actually attention-grabbing bipartisan analyses of issues that would make actual variations for customers on well being care, however whether or not they grow to be regulation, whether or not they change individuals’s lives, that’s simply a lot, a lot tougher for us to actually predict in a significant means.
Rovner: Yeah, I believe every little thing’s fairly arduous to foretell proper now. Lauren?
Weber: Yeah, I simply wished so as to add, I imply, I do know, clearly arduous to foretell, however I believe the concept that you will have lawmakers issuing fairly strident releases that tie non-public fairness to lower affected person outcomes of their particular districts is a little bit of a step ahead. I imply, you will have [Sen. Charles] Grassley saying: Look, none of those individuals care about affected person care. They solely care about shareholders. I do assume that could be a shift in rhetoric, to an extent. We’ve seen a constructing for fairly a while. We’ve all talked about non-public fairness on this podcast.
However I do assume when you will have lawmakers making that soar to, Oh, individuals in my district are getting worse well being care due to this, I believe you might see extra motion.
Rovner: Yeah, it’s one thing I’m going to regulate. Like I mentioned, I used to be stunned to see that as a bipartisan report from a committee, although it’s the Price range Committee that doesn’t actually have authority to do something legislatively. Nonetheless, it was value noting.
Nicely, in case there wasn’t already sufficient information this week, right here in Washington this very morning, we’re bidding farewell to former President Jimmy Carter, who died at age 100 late final month. Carter was one in all a protracted listing of Democratic presidents who tried and didn’t overhaul the nation’s well being care system. You possibly can Google one thing referred to as “hospital price containment” if you wish to know extra. He additionally created the Well being Care Financing Administration to run Medicare and Medicaid, which obtained renamed the Facilities for Medicare & Medicaid Companies within the early 2000s.
However Carter’s largest well being achievements got here after he left workplace. His work by his basis addressed, and in some circumstances practically eradicated, some largely uncared for tropical ailments that largely afflict the poorest and most marginalized individuals on the planet. That’s going to be one in all his actual main legacies, was bringing world well being house. Proper, Alice?
Ollstein: Yeah, and I believe that’s attention-grabbing, given the popularity of his legacy proper now, round his funeral, and mendacity in state within the Capitol, with the Trump administration coming into workplace, being very in opposition to our bodies just like the WHO [World Health Organization] and worldwide cooperation on well being care, very vocally essential of how worldwide cooperation occurred in the course of the covid-19 pandemic. And so I believe that’s going to be an attention-grabbing distinction, given what Carter was in a position to obtain by such cooperation.
Rovner: Yeah. Lauren?
Weber: Yeah, I simply wished so as to add, I imply, it’s a mannequin that I believe then seeped into different presidents, proper? I imply, you’ve seen [former president George W.] Bush’s funding in world well being, and so forth. And I do assume, as Alice neatly identified, there’s, clearly, a pointy distinction. However I imply, what Carter was in a position to do for river blindness and Guinea worm is unprecedented. And I believe what was most shifting in all the recaps of his work is that these are people who don’t have a voice. They don’t have a place of energy within the nation they dwell in. I imply, that is him utilizing his mushy energy to demand motion, by flying out to far-flung corners of the world, to fulfill with farmers who had been disabled by Guinea worm, to guarantee that this didn’t occur to future generations.
And a few of these biographers have posited that’s due to his upbringing as a poor farmer in Georgia. So I believe that is sort of a once-in-a-generation second to have a look at this impression somebody has on world well being. And as Alice identified, I don’t know what we’ll see going ahead on that.
Rovner: It’s arduous to think about Donald Trump making eradication of Guinea worm a significant precedence. Nicely, we’re additionally bidding farewell over the subsequent two weeks to the Biden administration, which is utilizing its final days to try to get as a lot executed and trumpet as many victories as it could. We’ll begin with the Inexpensive Care Act, the place the administration simply introduced that with every week left to go within the official sign-up interval in most states, 24 million individuals have now been enrolled in ACA plans. That’s up 3 million simply from final 12 months and greater than double the quantity from 2021 when [Joe] Biden took workplace.
After all, that is prone to be the excessive water mark. This 12 months marked the primary that the so-called Dreamers, these individuals introduced illegally to the U.S. as youngsters by their mother and father, they might enroll, not less than for now. That’s one thing President Trump and the Republican Congress is taken into account prone to finish. Plus, the extra tax credit that had been put in place in the course of the pandemic expire on the finish of this 12 months, until Congress renews them. What’s the outlook for ACA enrollment?
Ollstein: Nicely, Democratic senators are beginning to make a push to increase these subsidies, introducing laws and making a giant splash about it at present. There’s been lots of lobbying from the well being care sector, the hospitals, all of the gamers who don’t wish to see these tax credit expire, and in addition to affected person advocacy teams. Actually, my inbox has been flooded with issues associated to that and calling on Congress to increase these subsidies.
After all, they price some huge cash, and the brand new congressional majority undoubtedly has different issues they wish to spend that cash on, that aren’t serving to individuals purchase medical health insurance plans as a part of the Inexpensive Care Act. And so, I believe there’s prone to be lots of wrangling and horse-trading round this. I don’t assume the subsidies are essentially toast, however I don’t assume that they’re a executed deal, both.
Rovner: Yeah, I imply, I maintain saying, I believe all people’s first inclination after Election Day is that they had been toast, as a result of Republican trifecta. Then again, if you really dig into the numbers, the most important will increase have are available in purple states.
Ollstein: Completely.
Rovner: So the people who find themselves benefiting from these further subsidies are people who find themselves in Republican states and voted for Republicans and are represented by Republicans. And also you’ve obtained to wonder if they wish to, instantly subsequent January, or actually subsequent October, November, when individuals notice: Oh my goodness, my premiums for my medical health insurance are going to quadruple. How did this occur? Possibly they’ll take into consideration that after they’re placing all of those massive, stunning payments collectively, perhaps?
Ollstein: Yeah, we’ve began to see some feedback from some Republicans. After all, it’s those who’ve been keen to work with Democrats up to now, like Lisa Murkowski within the Senate, saying that we should always take a look at extending these subsidies. You’re not listening to that from most Republicans by any stretch of the creativeness, however I believe you’re beginning to hear these rumblings as a result of, such as you mentioned, Julie, they don’t wish to have a bunch of constituents lose their insurance coverage or have their insurance coverage get far more costly after they’re in energy.
Rovner: Yeah, the benefit and drawback of the trifecta. Lauren?
Weber: I simply wished to ask, I imply, a query for the panel. I imply, there’s all this speak about “DOGE” [the “Department of Government Efficiency”] and slicing all this cash, however as you simply said, Alice, they’re seemingly to not eliminate these subsidies. Johnson went on the document, I believe this week or final week, to say Medicare just isn’t going to get impacted. Medicaid cuts appear to be coming, however pricey God, when you don’t lower a few of these different issues, I don’t understand how you may get to the cash quantities that they’re speaking about, particularly in well being.
Ollstein: Nicely, and Elon Musk has already walked again his projection of how a lot he’ll have the ability to lower, saying that $2 trillion was aspirational and hopefully they’ll get $1 trillion. And so that you’re already beginning to see the walk-back of a number of the preelection guarantees on that entrance as they begin to confront a number of the realities you talked about, Lauren.
Rovner: Yeah, there’s nothing just like the optimism of early January, when a brand new Congress and a brand new president say, We’re going to do all of this within the first hundred days. You’d assume that Trump of all individuals would know higher, as a result of he tried to repeal the Inexpensive Care Act within the first hundred days in 2017, and that didn’t go so properly. However apparently he has a brief reminiscence, too.
Nicely, talking of issues which can be prone to be undone, the Shopper Monetary Safety Bureau finalized its rule this week barring the usage of medical debt on credit score reviews. It’s already been sued for exceeding its authority by two commerce teams representing collectors. How essential would this transformation be if it really survives?
Luthra: One thing like this might be actually significant. I bear in mind speaking to households about their efforts to purchase houses and sometimes struggling to take action as a result of their medical debt had harmed their credit score rating. And the factor about medical debt is that it’s often not deliberate. It’s most likely really virtually at all times not deliberate, since you don’t hope to fall sick. You don’t attempt to get a devastating harm that your insurance coverage is not going to totally cowl the prices for.
And this was one thing that had actually been championed by people within the shopper advocacy house for a really very long time, properly earlier than the Biden administration. Shedding it could actually have implications for individuals throughout the political spectrum, particularly as we’re on this house the place housing stays very costly, the place medical debt is an actual concern, and the place having it have an effect on your credit score may actually put an inexpensive mortgage simply out of attain for lots of People.
Rovner: Nicely, lastly, as one in all his parting suggestions, outgoing Surgeon Normal Vivek Murthy has issued a report recommending that alcoholic drinks carrying warning labels that they will trigger most cancers, similar to tobacco merchandise. His report calls alcohol the third-leading preventable reason behind most cancers. However this doesn’t really feel super-likely to occur, between the facility of the alcohol trade and the mistrust of science, notably when it recommends issues individuals most likely don’t wish to hear. I assume no one right here is betting on this taking place anytime quickly?
Ollstein: No, you’ve already seen members of Congress for whom the alcohol and beverage trade could be very economically essential for his or her state, all the oldsters who characterize breweries and distilleries and wineries, already talking out and sharing issues about this. However I believe that simply the surgeon basic utilizing the bully pulpit to shine a light-weight on this, it generated lots of information protection. That’s essential.
It’s essential for customers to see that and have the ability to make decisions. And also you’re already seeing some traits of youthful people being extra kind of sober-curious. And there’s lots of speak about Dry January being a wholesome factor to do. And much more bars you’re seeing supply low-alcohol or nonalcoholic choices. And so I believe that is one thing that persons are slowly turning into extra conscious of and extra involved about, whether or not the federal government steps in or not.
Rovner: Yeah, I believe it could be like tobacco, the place all people smoked after which progressively fewer and fewer and fewer individuals did. Lauren, did you wish to say one thing?
Weber: Yeah, I imply, I’ve written loads about meals labels within the final couple of years, and, I imply, that’s simply been a torturous course of. So the concept that something on alcohol would change at something quicker than a glacial tempo I believe might be problematic, contemplating there’s lots of attorneys on this city and there’s some huge cash in lawmakers’ pockets on this city. So simply wished so as to add that.
Rovner: And alcohol’s actually in style — and authorized. Nicely, let’s flip to abortion reproductive well being. All issues thought-about, it’s really been kind of quiet on the abortion entrance for the previous few weeks. However there has at all times been information, as is predictable when Republicans take over the Home, Senate, and White Home on the identical time. New Senate Majority Chief John Thune has introduced his intention to deliver up an abortion invoice. On this case, not a nationwide ban, which President-elect Trump has mentioned he wouldn’t signal, however quite the, quote, “Born-Alive Abortion Survivors Safety Act.” What is that this invoice? And what wouldn’t it do? And the way is it completely different from a similar-sounding invoice that Congress handed and President George W. Bush signed in 2002?
Luthra: We had been chatting about this upfront of taping the podcast, and that is actually attention-grabbing for lots of causes. What this invoice would do is, basically, if somebody provides start, the hospital or the well being care supplier is required to offer all types of lifesaving care, even when it looks like the new child is not going to dwell. And that is related in lots of locations. It’s related when, as an illustration, you perhaps expertise a really, very early supply, through which viability is simply not on the desk.
We do know that the overwhelming majority of abortions occur properly earlier than the purpose when there’s really going to be one thing that resembles an toddler being born. And so what this really does in apply, lots of well being care suppliers have sounded the alarms about, is stigmatize abortion and sow extra distrust of the well being care suppliers who carry out it. And it additionally, in circumstances the place somebody does give start to a baby that won’t dwell, forces medical doctors to offer medical interventions that perhaps gained’t make a distinction however that may delay the chance or forestall the chance for palliative care, which is basically unhappy.
I imply, you give start to a baby that gained’t dwell, and it could’t spend its few moments with some sort of consolation. As a substitute, it’s given medical remedies that won’t actually assist them. This invoice differs from the regulation signed below President Bush in that it could add penalties. However the different factor that’s value noting is that killing infants is already unlawful. We have now legal guidelines that ban murder. And so, when abortion rights supporters and authorized students say that this sort of regulation could be redundant, they’re proper. We have already got methods to penalize killing individuals. However what we don’t have are nationwide restrictions that stigmatize abortion to the extent that will probably be carried out much less and fewer.
However the different factor I believe is value noting, to your level, Julie, is that this can be a massive step again, particularly for Senator Thune, who was on the document supporting a 15-week nationwide abortion ban and is no longer. And that helps us underscore that nationwide abortion restrictions are very poisonous and that, as a substitute, the GOP is basically making an attempt to give attention to circumstances the place they assume they could have a greater probability of successful, by specializing in the very finish of being pregnant, areas the place they see the help for abortion rights publicly go down, and begin with restrictions there, earlier than, in the event that they ever wish to do one thing extra sweeping, ready a bit extra time for that to be politically viable.
Rovner: Principally, it’s a messaging invoice to try to put supporters of abortion rights on the spot and say, For those who gained’t vote for this, then you definitely’re for infanticide. I imply, that’s basically what the talk’s going to be. Proper, Alice?
Ollstein: Yeah. Nicely, and simply so people are conscious, the timing of that is across the March for Life developing in a pair days after the inauguration. And virtually yearly, Republicans in Congress try to carry some kind of messaging vote to coincide with that massive anti-abortion demonstration in Washington, D.C.
Rovner: I’d say the anti-abortion demonstration is when it’s as a result of that was the anniversary of Roe v. Wade. That’s why they arrive to D.C. in January.
Ollstein: Yeah. As an apart, they thought-about shifting it to June to mark the anniversary of Dobbs however determined to maintain it in January to proceed to watch the anniversary of Roe anyhow. However like Shefali mentioned, it’s attention-grabbing that, even on condition that that is only a messaging vote, they’re nonetheless aiming loads decrease than they’ve up to now and never introducing the large, sweeping anti-abortion insurance policies that the advocacy teams on that aspect wish to see, when it comes to restrictions on abortion remedy, or like up to now, 15-week bans, 20-week bans, one thing like that. As a substitute, that is kind of a distinct segment and arguably duplicative coverage that they’re placing ahead.
Rovner: Nicely, we will definitely watch that house. Additionally, over the vacation break, an OB-GYN on the College of Indiana sued the Indiana Division of Well being, claiming the state’s new abortion reporting necessities violate the federal HIPAA [Health Insurance Portability and Accountability Act] affected person privateness guidelines. Failure to observe the state regulation may end in potential felony legal responsibility or lack of medical license, however federal regulation is meant to preempt state regulation.
Alongside those self same strains, Senate Finance Committee Chairman, now rating member, Ron Wyden of Oregon launched a report in December, which adopted up on the reporting that we’ve talked about from ProPublica, about pregnant girls dying from preventable and/or treatable issues. Wyden’s employees discovered that medical doctors in states with abortion bans have been unable to get adequate authorized recommendation and/or steering from their hospital officers in a well timed means.
Quoting from the report, “Docs are taking part in lawyer, and attorneys are taking part in physician, whereas pregnant girls experiencing something in need of what quantities to a dire emergency are despatched away and informed to return to the emergency room as soon as a preventable state of affairs turns into life-threatening.” Is there something on the horizon that might kind out what medical doctors can and might’t do in states with abortion bans? This continues to be — we maintain listening to story after story after story about this.
Ollstein: So the anti-abortion motion’s response to that is that the legal guidelines themselves don’t must be modified, and so they as a substitute are introducing these new, what they name “med ed” payments that principally order the federal government, in collaboration with anti-abortion teams, to develop supplies that medical doctors and medical college students must overview, that purport to clarify what’s and isn’t allowed when it comes to abortion care and emergency care below these restrictions.
One state thus far has applied this, South Dakota, and they’re making an attempt to introduce it in a bunch of different states. Now, the medical group says there’s no means a video goes to unravel this. These are extremely complicated conditions. You possibly can’t cowl every little thing that may come up. You possibly can’t cowl each situation a pregnant individual may have. They usually see it as kind of a CYA — if people are acquainted with “cowl your behind” — transfer, when it comes to legal responsibility and an try and put the onus on particular person medical doctors who’re already struggling, and to say that any of those hostile outcomes are the fault of medical doctors for not understanding or appropriately abiding by these authorized restrictions on care.
Whereas the medical doctors say that: We are able to’t get steering from our personal employers. We are able to’t get ample steering from the state. And these actually tie our arms in these very delicate, time-sensitive, and medically delicate conditions.
Rovner: And we’ve seen circumstances, I imply like in Texas, the place the lawyer basic has threatened in writing to prosecute medical doctors for issues that medical doctors say is commonplace medical apply.
Ollstein: Proper, so even when a health care provider got here ahead and mentioned, It’s my medical judgment that this individual wants an abortion for medical causes, we noticed the lawyer basic there step in and say: I’m overruling your judgment. No, she doesn’t. And in order that has, based mostly on many interviews I’ve executed, and I’m positive Shefali has executed, created an actual chilling impact, the place persons are afraid of being second-guessed like that. And even quick delays, the place somebody is making an attempt to seek the advice of with an lawyer on what to do, even a brief delay may be lethal for a affected person in a type of conditions.
Rovner: Nicely, turning to this week in medical misinformation, the large information, in fact, is that Fb goes to disband its fact-checking unit and principally undertake the anything-goes-and-if-you-don’t-like-it-correct-it-yourself system now utilized by X. This might have massive implications for well being misinformation, I’d assume. Despite the fact that Fb wasn’t doing such a terrific job earlier than on permitting misinformation and disinformation to unfold. Is that this going to have a giant impact?
Luthra: I imply, I believe that is simply, to some extent, an indication of Fb shifting with the political winds, proper? I imply, the fact-checking got here out partly after the 2016 election when there was lots of claims of voter fraud. There are lots of, How did Trump get into workplace? They instituted fact-checking to allegedly sort of pander to individuals who felt like that there was lots of misinformation unfold then. Now they’re shifting away from fact-checking as a result of they really feel like then it provides individuals the flexibility to mirror what the group needs. I believe it’s reflecting the pattern we’re seeing on X. We’ll see extra Neighborhood Notes. It makes journalists’ job all of the extra essential, to truly distill what’s true and what’s false.
Rovner: You’re our misinformation skilled. Oh, go forward, Alice.
Ollstein: Oh, I wished to additionally flag that a part of Fb’s announcement was that they’re shifting a few of their groups from California to Texas, as a result of Californians are too biased to do any content material moderation and Texans presumably aren’t. That was the body of that announcement, principally. And in order that, I’ve already seen, is elevating issues in some teams on the left, and medical teams, about entry to details about sorts of care which can be restricted in Texas, like abortion care, like trans care.
Will individuals have the ability to submit about these issues, to submit correct issues about these issues on these platforms? Or will that be restricted sooner or later? It’s additionally drawing consideration for that purpose.
Luthra: And if I can add another level to what Alice talked about, I imply, one of many very specific areas the place Mark Zuckerberg mentioned he would love extra room for disagreement and extra room for discourse is on the strains of gender, and really explicitly eradicating restrictions on utilizing very, fairly frankly, misogynistic phrases about how girls ought to exist in our society, about LGBTQ+ individuals, about explicitly permitting customers to name them mentally in poor health.
And this has very significant implications for gender equality, positive, but in addition for well being care, as a result of we’re seeing that probably the most politicized areas of well being care in our nation is entry to well being take care of trans individuals, is entry to well being care for girls. And it’s simply very arduous to not take a look at this and assume, oh, there shall be no implication for the way individuals conceive of well being care and the way individuals conceive of those that obtain this sort of well being care.
Rovner: And we should always level out, which I ought to have initially, this isn’t simply Fb — that is all of Meta. So that is Fb and Instagram and Threads. It’s principally, as a result of I do know that solely kind of previous individuals like me are nonetheless on Fb, however a lot of persons are on Instagram and Threads, and that is clearly going to have some fairly massive implications as we go ahead.
All proper, properly, talking of misinformation, one mark of accountable science is fessing up if you find yourself mistaken. And this week we’ve a giant mistaken factor to speak about. Again in November, we talked a couple of examine that discovered that black plastic cooking utensils and takeout containers had been harmful as a result of they had been created from recycled electronics and had been leaching quantities of fireplace retardants and different chemical substances into your meals.
Nicely, it seems that you simply most likely nonetheless ought to eliminate the black plastic in your kitchen, however know that they’re not fairly as harmful as initially marketed. It seems that the authors of the examine made a math error that exaggerated the degrees of poisons by an element of 10. Nonetheless, when you don’t wish to be uncovered to fireplace retardants and different nasty stuff, you would possibly wish to cook dinner with steel or silicone or one thing that isn’t black plastic. I do assume that is essential, as a result of it does present science is an iterative course of. It’s uncommon to see somebody step up and say: Oh, oops, we obtained this mistaken. However right here, it doesn’t change our basic conclusion about this. However you must know that after we make a mistake, we’re going to repair it. I imply, that appears to be very uncommon on this world proper now.
Ollstein: It’s so arduous, since you see the act of admitting error and correcting it — that may gas mistrust. Individuals level to that and say: See, they obtained that mistaken. They should be getting all this different stuff mistaken, too. However in fact, not correcting misinformation is way worse. And so, in a time of such mistrust, communication is basically, actually arduous. And did all of the individuals who noticed the primary wave of reports concerning the black plastic additionally see the correction and see that it wasn’t true? How are this stuff framed? Have been the splashy articles that had been run, had been they corrected? Have been they retracted? It’s arduous to place the toothpaste again within the tube.
Rovner: Yeah, however science is an imperfect course of. And it’s a course of. It will assist, I believe, if individuals understood that science is extra of a course of than a, that is what’s. However that’s what we’re all right here for, and that’s why all of us nonetheless have jobs. All proper, that’s the information for this week.
Now it’s time for our extra-credit phase. That’s the place we every acknowledge the story we learn this week we expect you must learn, too. Don’t fear. For those who miss it, we’ll put the hyperlinks in our present notes in your cellphone or different cell gadget.
Lauren, you had been first this week, so why don’t you go first?
Weber: I really like this story, and I’m clearly biased, however by my colleagues David Ovalle and Rachel Roubein, on how “Laws restrict U.S. shipping of vape products. Many companies do it anyway.” Primarily, you shouldn’t be transport flavored vapes throughout the nation, however a bunch of firms do. And my colleagues had been in a position to order and get their arms on fairly a couple of of these flavored vapes.
My favourite half is the kicker within the story, through which one firm mentioned, You’re not sanctioned to make use of our identify in any means, after we reached out for remark after that they had shipped us vapes illegally. So I believed that was fairly one thing. However basically, it will get at what’s a flaw on this piece of the regulation, which is that the USPS [U.S. Postal Service] is meant to implement, or somebody is meant to implement, easy methods to cease the transport of those vapes, however it’s probably not taking place. So it’s sort of a take a look at the very best intentions will not be the truth on the bottom.
Rovner: Usually. Alice.
Ollstein: So I’ve a bit from the New York Instances referred to as “Ozempic, Lego Bricks and Hearing Aids: What Trump’s Greenland Plan Could Hit.” And that is coming off of Trump threatening to impose tariffs on Denmark if it refuses to permit the U.S. to take over Greenland, which has grow to be one in all Trump’s newest obsessions.
And this piece is mentioning that tariffs on Denmark would impression lots of issues the U.S. inhabitants relies on. Particularly, the pharma large Novo Nordisk is predicated there and manufactures tons of medicines, together with Ozempic, and different weight reduction medication and diabetes medication in that household which can be extremely in style proper now, and in addition to listening to aids, different medical gadgets, different medicines. And so this might impression customers, if it ever had been to occur, which who even is aware of.
Rovner: Sure. Nicely, we’ll speak extra about tariffs and the medical trade in a future podcast, however thanks for noting that. Shefali.
Luthra: My piece is from Vox. It’s by David Zipper. The headline is “Gigantic SUVs are a public health threat. Why don’t we treat them like one?”
I believe the story is so good. I really like this framing. It first lays out the proof for why, when vehicles attain a sure measurement, they’re very harmful and more likely to kill individuals. After which it will get into the dialog: Why don’t we really deal with this as a public well being menace?
They usually take a look at the struggle on tobacco and the struggle on smoking to assume by: What did it appear to be to take one thing that was so ubiquitous in our tradition and really persuade the American public to shift away from it? I believe that is actually attention-grabbing for lots of causes. One is that public well being is basically expansive and we should always give it some thought in an expansive means and think about all of the completely different components, like automobile measurement, that do have an effect on our lives and life expectancy.
And I additionally do assume this ties rather well to the dialog we had concerning the surgeon basic’s alcohol warning, in that even in need of coverage adjustments, there’s a lot that we will do as a society to shift the general public’s understanding of well being dangers from issues that we take as a right, and we will nonetheless transfer individuals in a route towards being more healthy and holding our fellow People more healthy. And that’s actually attention-grabbing and essential to consider.
Rovner: Most likely simpler to do one thing about giant SUVs than alcohol, however sure, I’m so glad you linked these two issues. My story this week is from The Wall Road Journal. It’s referred to as “UnitedHealth’s Army of Doctors Helped It Collect Millions More From Medicare,” by Christopher Weaver, Anna Wilde Mathews, and Tom McGinty. And it’s principally the flip aspect of the story that Stat News has been throughout, about how United has used numerous strategies to disclaim care to its Medicare Benefit sufferers to save lots of the insurer cash. This can be a story about how United is forcing the medical doctors who work for the corporate — and there are lots of them, like 10,000 — to principally run by a guidelines of potential diagnoses for each Medicare Benefit affected person, to encourage medical doctors to make these sufferers appear sicker, even when they’re not, as a result of then the corporate will get more cash for Medicare.
The investigation discovered that the, quote, “illness scores” for sufferers shifting from conventional Medicare to United’s Medicare Benefit elevated a median of 55%, which was, quoting from the story, “roughly equal to each affected person getting newly recognized with HIV … and breast most cancers,” principally maximizing income from each ends. It’s fairly the story, and I like to recommend it extremely.
OK, that’s this week’s present. I hope you are feeling caught up and prepared for the remainder of 2025. As at all times, when you benefit from the podcast, you might subscribe wherever you get your podcasts. We’d admire it when you left us a overview. That helps different individuals discover us, too. Particular thanks, once more this week, to our momentary manufacturing workforce, Taylor Cook dinner and Lonnie Ro, in addition to our editor, Emmarie Huetteman.
As at all times, you possibly can electronic mail us your feedback or questions. We’re at whatthehealth@kff.org, or you possibly can nonetheless discover me at X, @jrovner, and more and more at Bluesky, @julierovner.bsky.social. The place are you guys largely as of late? Alice?
Ollstein: I’m @alicemiranda on Bluesky, largely.
Rovner: Shefali.
Luthra: You could find me on Bluesky, @shefali.
Rovner: Lauren.
Weber: Nonetheless simply chilling on X, @LaurenWeberHP.
Rovner: We shall be again in your feed subsequent week. Till then, be wholesome.
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