Monday Morning Quarterbacks: Pros And Cons Of Work Requirements; What If A Doctor Won’t Help?

USA Today: On Medicaid Work Requirements, Who Will Judge The Character Judges?
Meet some of the people who benefited from the Obamacare expansion of Medicaid: A bedridden woman with a severe hernia who had the surgery she needed and went back to work. A person now getting treatment for bronchitis and asthma so “I'm able to be healthier and be more functional at work and able not to miss work.” People who said “I had a lot of health problems before. … Now I am able to work more.” And “I am finally getting everything that was wrong with me fixed so that I can go back to work.” . ... No doubt there are malingerers and cheaters on Medicaid, just like there are people and companies that “game the system” to get tax breaks, subsidies or government contracts. But I don’t want my country to make medical care contingent on some politician’s view of what constitutes a deserving person. (Jill Lawrence, 1/22)

Charlotte Observer: Medicaid Expansion Compromise Would Be Good For North Carolina
Republicans have stripped Gov. Roy Cooper of some of his power and Cooper has tried to block their excesses wherever he could. All of which makes what’s happening in the capital now especially noteworthy. Specifically: Cooper’s administration is seeking permission from the Trump administration to require Medicaid recipients to work, if the legislature expands Medicaid to some 400,000 North Carolinians who don’t currently qualify. (1/19)

Modern Healthcare: Medicaid Work Requirements, End Of Individual Mandate Raise Responsibility Questions
Less than one-third of the 80 million people on Medicaid are working-age adults. Of that group, 60% are already working full- or part-time and qualify for Medicaid because they make so little money. Among the remaining 10 million, over 90% are disabled, in school or taking care of someone at home. That leaves less than 1 million people nationwide who are unemployed, able to work and on Medicaid. It's shocking the number is that low. (Merrill Goozner, 1/20)

Chicago Tribune: Is A Medicaid Work Requirement Fair?
Illinois has moved many Medicaid beneficiaries to managed care in the past few years to cut costs and improve quality. Imposing a work requirement wouldn’t knock the neediest off the rolls. But it could prompt many to get jobs — and thus health coverage via employers. There are potential pitfalls. Medicaid was designed to help people gain routine health coverage. The Obamacare Medicaid expansion was supposed to help keep people out of the emergency room for such routine care. If many of these recipients lose that coverage because of the work requirement, they could wind up using the emergency room for basic care. That’s hugely expensive and wasteful. That said, we’re reminded of dire predictions that accompanied welfare reform — predictions that didn’t come true. (1/21)

Roll Call: Now More Than Ever, Medicare Needs Its Public Trustees
Lost in Washington’s political cacophony is the alarming erosion of the financial foundations of Social Security and Medicare. Focused on more immediate crises and reluctant to touch this “third rail” of politics, today’s lawmakers, like many before them, have avoided even discussing the inevitable painful adjustments they will be forced to make. Whenever Congress shakes off its inertia and begins to take action, it will look to independent analysis of the programs’ finances. That analysis is currently provided by the boards overseeing Social Security and Medicare, but unfortunately, the seats of their two public trustees — who are essential to maintaining public confidence in the findings — have been empty for more than two years. (Charles P. Blahous III and Robert Reischauer, 1/22)

Columbus Dispatch: Number Of Uninsured Isn't Only Thing Going Up
In what might be the most predictable trend of the Trump era, the uninsured rate appears to be increasing. Because young people (along with African-Americans and Hispanics) saw the biggest declines in coverage, health-care premiums will likely rise for most Americans faster than they otherwise would. (1/19)

The Wall Street Journal: A Dose Of Accountability For The FDA
One welcome development last year was a productive Food and Drug Administration, which approved more than 1,000 generic drugs and dozens of novel therapies. But FDA rejections can also be important for patients and innovation, and Commissioner Scott Gottlieb can prioritize a project that would add more public accountability to the approval process. Mr. Gottlieb said in a speech last week that the agency is looking into releasing more information in “complete response letters,” the euphemism for FDA rejection notices. Under current practice FDA doesn’t release details of why the agency is withholding approval, and the agency’s justification is that this protects the proprietary information of drug sponsors. ... Yet this can leave the public with little understanding of why a therapy wasn’t approved. Especially with treatments for rare or deadly diseases, patients deserve to know why a promising therapy will be delayed or isn’t going to pan out. (1/21)

Los Angeles Times: We're Underfunding Research On Vaccines That May Be Able To Prevent Another Terrible Flu Season
Seasonal influenza — the flu — sickens and kills many Americans in a good year, and this is already a bad one. According to the Centers for Disease Control and Prevention, since 2010, flu has annually caused "between 9.2 million and 35.6 million illnesses, between 140,000 and 710,000 hospitalizations and between 12,000 and 56,000 deaths." In this season, which began in November and won't end until March, hospital emergency rooms are overflowing, deaths are running ahead of recent years and pharmacies are low on the anti-flu drug Tamiflu and intravenous solutions needed to keep patients hydrated. (Henry I. Miller, 1/19)

Los Angeles Times: The Trump Administration Just Found Another Way To Deny Women Their Right To An Abortion
Doctors who don't want to assist with abortions, sterilizations or suicides can now turn to a new office within the federal Department of Health and Human Services for help — a "Conscience and Religious Freedom Division," part of the HHS office tasked with stopping discrimination and privacy violations by federally funded agencies, hospitals and universities. But what about people who need one of those procedures but can't find a doctor willing to help? That particular bit of fallout appears to have escaped HHS' notice. (Jon Healey, 1/19)

Boston Globe: A New Rule Allows Discrimination Against Transgender Individuals For Medical Care
It seems too cruel, even by the standards of the Trump administration: This week, officials said they would allow medical professionals and institutions who claim religious objections to deny coverage to transgender people and other individuals. ...Under the administration’s new regulations, a new federal agency will be responsible for fielding and investigating complaints from doctors, nurses, and other health care providers who feel they have been coerced into serving transgender individuals or women seeking abortions or sterilizations. (1/20)