Happy Friday! Apologies for unexpectedly going MIA last week, but your girl here decided she needed some firsthand experience with the health care system via a trip to the emergency room. (Hot tip: Stay hydrated during stomach bug season, folks!) Many thanks to the wonderful Damon Darlin (also known as KHN’s executive editor) for filling in last week. Make sure to check it out if you missed it.
Onward to this week, though, where we’re finally starting to slow down as we drift toward the holidays.
“I hate to panic, but …” was a quote from NPR’s coverage of the health law enrollment numbers that pretty much summed up the atmosphere the day before the sign-up deadline. The big number to focus on here is that there are nearly 20 percent fewer new enrollees than at about this same time last year. The lag has advocates pointing nervous fingers at the Trump administration’s efforts to chip away at the health law.
But some experts eschew Chicken Little predictions (at least quite yet), saying that fewer sign-ups don’t necessarily mean more people will be uninsured. For one, the unemployment level is the lowest in decades (although that has nuances that are too complex to get into right here) so people who used to get health law plans might be covered by their employers. Secondly, the sign-up numbers don’t reflect anyone who is sticking with the plan they currently have.
Either way, we won’t have long to wait to see how it shakes out.
NPR: Enrollment in HealthCare.Gov Plans May Be Down for 2019
The Associated Press: Health Law Sign-Ups Lagging As Saturday Deadline Is Looming
Amid all that talk of sabotage and low numbers came a study that found 4.2 million Americans are actually eligible to get what amounts to free health care through the exchanges, as an unintended consequence of President Donald Trump nixing key health law payments last year.
The Hill: Study: 4.2 Million Uninsured People Eligible for Free ObamaCare Coverage
A quietly simmering debate over fetal tissue research brewing the past few months has started to come to a boil this week. (Although, if you’ve been reading your Morning Briefing regularly, this won’t come as a surprise.) Back in September, the administration launched an audit of all federally funded research that uses fetal tissue. The far-reaching ramifications were felt recently when a lab that has played an integral role in testing for HIV cures was put on notice that its funding could be canceled.
The sides are firmly drawn here and have deep roots in abortion politics (as witnessed in this quote from CQ’s coverage of Thursday’s heated House hearing on the topic: “Obviously the 800-pound gorilla in the room is that we know aborted tissue is being used,” said Georgia Republican Rep. Jody Hice).
With the National Institutes of Health signaling interest in pumping $20 million into finding an alternative to fetal tissue for research purposes, I don’t think this topic is going away anytime soon.
The New York Times: Fetal Tissue Research Is Curtailed by Trump Administration
The Hill: NIH to Fund Research Into Fetal Tissue Alternatives
The death of a 7-year-old Guatemalan girl who had been taken into Border Patrol custody is likely to intensify scrutiny of the care immigrants detained by the U.S. government are receiving. U.S. Customs and Border Protection said the girl had not eaten or consumed water in several days, and it’s unclear whether the agents had tried to rectify that situation. Advocates are saying the death is reflective of a “culture of cruelty” within the agency.
Meanwhile, there are nearly 15,000 migrant children in detention facilities in the country, where issues with background checks, abuse and neglect continue to make headlines.
NPR: Almost 15,000 Migrant Children Now Held at Nearly Full Shelters
More voices are starting join the growing chorus of advocates, doctors and city leaders who oppose the administration’s proposed policy to penalize immigrants who are accepting government aid (such as Medicaid). It’s not just about public health, they say. The policy would also take a heavy financial toll.
There was some shade being thrown at the Supreme Court this week, when the justices declined to take up a case on state Medicaid funding and Planned Parenthood. Justice Clarence Thomas called out his conservative colleagues Chief Justice John Roberts and Justice Brett Kavanaugh for dodging the case. “So what explains the court’s refusal to do its job here? I suspect it has something to do with the fact that some respondents in these cases are named ‘Planned Parenthood,'” he wrote. The case itself was somewhat complex, but essentially the decision leaves in place Medicaid patients’ right to sue over provider issues.
The Associated Press: Justices Won’t Hear States’ Appeal Over Planned Parenthood
The maker of a device that reverses overdoses recently drew fire for jacking up the list price of its injector from $575 to $4,100 during a span of time that opioid-related deaths were also accelerating rapidly. As you can imagine, this did not go over well with either lawmakers or the public when it came to light. Now Kaleo, in damage-control mode, is releasing a generic version that comes with a $178 price tag. The whole journey is quite the snapshot of what’s going wrong with high health care costs.
Stat: Kaleo, Maker of $4,100 Overdose Antidote, to Offer Generic For $178
Speaking of, you have to check out the salacious details emerging in this case that started as an antitrust lawsuit against just two drugs and has ballooned into this sweeping investigation into price-fixing allegations in the generics marketplace.
The Washington Post: Generic Drug Price-Fixing Investigation Expands to 300 Drugs and 16 Companies
Pharma, meanwhile, is sweating over the Democrats taking power in the House. Once a political powerhouse of nearly mythological proportions, the industry has lost clout in recent years, and companies don’t think the new power structure will work in their favor.
Stat: Will Democrats in Congress Keep the Door Open for Pharma — or Slam It?
Whew! That was not as short as expected. Just in case you want some more great reads for your weekend, check out the miscellaneous file:
• What happens to your life when millions of people have witnessed you hit rock bottom? As the opioid epidemic dug deep roots into the country, there was this trend where videos and photos of people overdosing would go absolutely viral. Public health officials and cops at the time justified putting them up because the videos could act as a deterrent for drug use. For the people used as the face of the crisis, however, it was deeply life-altering.
The New York Times: How Do You Recover After Millions Have Watched You Overdose?
• Baby boomers are now aging alone more than any other generation in U.S. history. That isn’t just a sad statistic — it’s also a looming public health crisis. Loneliness has been as closely linked to early mortality as smoking up to 15 cigarettes or consuming more than six alcoholic drinks a day.
The Wall Street Journal: The Loneliest Generation: Americans, More Than Ever, Are Aging Alone
• A rash of recent headlines explores whether trauma is passed down through genes. It’s a very buzzy idea, but the evidence that trauma can leave a signature that lasts generations is circumstantial at best.
The New York Times: Can We Really Inherit Trauma?
I’ll leave you with some bah-humbug! warnings about not eating that raw cookie dough this holiday season (even though it’s clearly the best part of making cookies). Have a great weekend!
