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HEALTH POLICIES, ANALYSIS, AND RESOURCES

The Health Policy Domain tracks and reports on policies that deal with women’s health, the Affordable Care Act, Head Start, child care and child support services, the Children’s Health Insurance Program, and federal food and drug policy. This domain tracks policies emanating from the White House, the department of Health and Human Services, the US Food and Drug Administration and the Centers for Disease Control (CDC). Our Principal Analyst is Ann Furbush, who can be reached at ann@usresistnews.org.

Latest Health Posts

 

The Supreme Court Stands Tall for Reproductive Rights

Brief #50—Health Policy Last week, the Supreme Court took a stand against limiting reproductive rights in a recent ruling. The Court blocked a Louisiana law, in a 5-4 vote, that would have limited access to abortions in the state by only allowing one doctor in one...

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Say Goodbye to Surprise Medical Bills! Well, Not Entirely

Brief #48—Health Policy Summary Donald Trump and his administration have taken proactive steps to solve the nationwide issue of surprise hospital fees. Starting this month, Trump has mandated that hospitals publicly reveal prices for their services. These online...

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New Changes to Health Care Rights Law Threaten Transgender and Nonbinary Communities

New Changes to Health Care Rights Law Threaten Transgender and Nonbinary Communities

Policy
The Trump Administration’s Department of Health and Human Services (HHS) has submitted a major change to the administrative rule interpreting Section 1557 of the Affordable Care Act (ACA). This change will remove explicit protections for the LGBTQ+ community in healthcare programs and activities. Section 1557 was proposed by the Obama Administration intended to protect the LGBTQ community from discrimination based on sex stereotyping and gender identity. The specific Trump change of the rule removes gender identity and sexual orientation under the definition and category of sex discrimination. Under the Section 1557  change  the ACA still bans sex discrimination in the health-care industry, but defines sex “according to the plain meaning of the term” and removes any “excess” aka gender identity and sexual orientation, in accordance with a definition passed by congress in 1972. Such a change removes protections for those previously protected.

Analysis
The Office of Civil Rights (OCR) and the Trump Administration list 3 reasons for changing Section 1557. First is to alter the section so it “conforms to the law as written”, second is to reduce unnecessary spending by the OCR, and finally, OCR and the Administration found that rule exceeded the regulatory authority of the government.

Section 1557, as originally written, included gender identity and sexual orientation as a means of defining one’s sex. These attributes are not included in traditional definitions of sex. The Trump Administration argues there is no room for alterations in the meaning of sex and therefore gender identity and sexual orientation have no place, and should not be included  as a basis for protection against discrimination based on sex. The administration views that the definition of sex in Section 1557 is  more “powerful” than the  way in which the word is defined in other parts of the Affordable Care Act, and that the government exceeded its authority when it broadened the way in which the meaning of one’s sexuality is traditionally defined. The Trump Administration sees Section 1557 as creating false interpretations of the law and “unjustified cost and regulatory burdens”.

The change to Section 1557 is expected to save OCR a significant amount of money from a reduction of grievances and court fees. Because fewer people will be protected fewer people can file claims; resulting in OCR saving money. However, it is likely that the real reason behind this rule change comes from religious rights support, a key following of the Trump/Pence Administration. The religious right takes a strict traditional male/female only as options to defining one’s sexual identity; and many do not recognize the right of people to have gay lesbian, transgender, and sexual preferences or non-binary sexual identities.

Critics of this new rule highlight the likelihood of increased discrimination and a decrease of willingness to visit health care facilities by these affected communities as core reasons for rejecting proposed changes in Section 1557. The risk of trans and non-binary individuals being arbitrarily denied services or voluntarily avoiding facilities due to fear will only result in negative experiences and health complications.

The proposed rule change goes into effect after a 60-day commenting period, which will begin once it is officially submitted to the Federal Registrar.

Engagement Resources

  • American Civil Liberties Union : A national organization working to defend civil liberties across the United States.
  • Human Rights Campaign : America’s largest civil rights organization, working to achieve lesbian, gay, bisexual, transgender and queer equality.
  • Lambda Legal : A national organization committed to achieving full recognition of the civil rights of the LGBT community as well as those living with HIV/AIDS through litigation, societal education, and public policy work.
  • National Center for Transgender Equality : The nation’s leading social justice advocacy organization winning life-saving change for transgender people.

 2020 Candidate Involvement:

  • TX-D Beto O’Rourke: Advocate for same sex rights and protections against discrimination.
  • CA-D Kamala Harris: Historically refused to defend CA’s Proposition 8, which would ban same sex marriage.
  • MA-D Elizabeth Warren: Co-sponsor of the Equality Act, scores a 100% rating on Human Rights Campaign Congressional Scorecard.
  • IN-D Pete Buttigieg: Pledged to pass federal legislation making it illegal to discriminate based on sexual orientation, strong advocate for the Equality Act.
  • NY-D Kirsten Gillibrand: Advocate for the repeal of Don’t Ask Don’t Tell, supporter of the Equality Act.

 

Photo By unsplash-logoDenin Lawley

Trump Administration Proposes New Faith-Based Protections for Health-care Providers

Trump Administration Proposes New Faith-Based Protections for Health-care Providers

Policy
The Trump Administration has announced an expansion of the Conscience Rule, allowing medical professionals to refuse providing or payment of services should professionals choose. The US Department of Health and Human Services has expanded upon its rule within the Protecting Statuary Conscience Rights in Health Care policy. The rule specifies that clinicians and institutions do not have to provide, participate in, pay for, cover or make referrals for procedures they object to on moral or religious grounds. Additionally, the rule provides protections involving advance directives that detail a patient’s wishes for care at the end of life. According to HHS the rule mandates that hospitals, clinics, universities and other institutions that receive federal funding  comply with such rules. While this expansion is not a creation of a new law, the rule guarantees and mandates that the law and protections will be enforced.

Analysis
Rules like this one will pave the way for discrimination for countless demographics. The expansion of this rule undermines access to care for women, people of color, and members of the LGBTQ+ community. The oath taken by medical professionals instils a commitment to providing safe healthcare with no discrimination.  Permitting such allowances puts the previously mentioned groups in harm’s way.  Residents of rural areas will also be affected. Many rural area medical facilities are religious hospitals which prohibit procedures deemed “intrinsically immoral”. These  procedures include abortion, preventative care for HIV or AIDS, providing naloxone, sterilization, contraception and assisted suicide, in addition to treating people of the LGBTQ+ community, all of which would fall into the category of “intrinsically immoral.”

Such a regulations ensure facilities comply by holding necessary funding ransom.  If a provider decides not to comply with the conscience regulations, they face losing federal funding. The Office for Civil Right’s Conscience and Religious Freedom Division will oversee complaints of violated rights

While this expansion is focused on protecting the rights of the providers, it ignores the rights of patients based on moral belief, regardless of medical necessity. A major portion of Trump’s base, religious conservatives, find the conscience rule is key in protecting their rights. It can be assumed that this rule expansion was created to directly connect with his base amid similar court cases and the 2020 election. A person’s belief should in no way determine the services a patient should receive.  By allowing this expansion of the conscience rule the Trump Administration is permitting the discrimination and harm of patients with impunity.

In addition to civil liberty organizations like the ACLU and Planned Parenthood, other opponents like San Francisco City Attorney Dennis Herrera have all promised to fight and bring lawsuits against the expansion of the Conscience Rule,  citing that the expansion will reduce access by vulnerable groups to critical healthcare.

Engagement Resources:

  • American Civil Liberties Union : A national organization working to defend civil liberties across the United States.
  • The National Women’s Law Center : A non-profit that advocates for women’s rights through litigation and policy initiatives.
  • Planned Parenthood : Reproductive rights advocacy group that provides affordable and accessible health services to women across the US.
  • Human Rights Campaign : America’s largest civil rights organization, working to achieve lesbian, gay, bisexual, transgender and queer equality.
  • Lambda Legal : A national organization committed to achieving full recognition of the civil rights of the LGBT community as well as those living with HIV/AIDS through litigation, societal education, and public policy work.

Photo by Aaron Burden

Fetal Heartbeat Bills are Mounting Against Women’s Reproductive Rights

Fetal Heartbeat Bills are Mounting Against Women’s Reproductive Rights

Policy
Governor Brian Kemp recently made Georgia the fourth state to pass a “Heartbeat Bill”. Georgia joined Ohio, Kentucky and Mississippi in passing restrictive bills banning abortions into law. Georgian legislators passed the “Living Infants Fairness and Equality (LIFE) Act” also known as a “heartbeat bill”, which criminalizes and prohibits abortions once a fetal heartbeat can be detected, as early as five to six weeks into pregnancy. The current gestational limit women in Georgia have to get an abortion is 20 weeks. This bill also includes an exception for rape, incest (both only with the accompaniment of a police report), situations where the mother’s health is at risk, and if a pregnancy is deemed “medically futile”). Such a law adds to other anti-abortion laws by Georgia such as women being required to wait 24 hours between requesting and obtaining an abortion, and minors being required to notify their parents before receiving an abortion. This law is set to take effect January 1st, 2020.

Analysis
This law and ones found in other state’s legislation are a direct attack on women’s reproductive rights, with opponents labeling this a “forced pregnancy” bill. The specific wording, targeting a heartbeat of a fetus, strictly prohibits women from having an abortion before many even know they are pregnant, essentially banning abortions entirely. The criminalization of abortions for women in Georgia and the mentioned states will not lower the need nor attempted abortions, but instead will create numerous health difficulties for women, resulting in additional health complications in a state with a devastatingly high maternal mortality rate.

One glaring issue with this bill has been its socially given name, a “heartbeat bill”. This is because the legislation calls for the prohibition of an abortion in the presence of a heartbeat and the associated time of six weeks. However, medical professionals will note that at six weeks what appears to be a heartbeat is not the case, instead it is simple vibration of developing tissue that is only present due to the mother. This vibration is called embryonic cardiac activity, which leads the unfamiliar reader or listener to believe that this occurrence is in fact the presence of a heartbeat. With the removal of this essential clause in restricting abortions, the viability and impact of this bill are reduced, and a later gestational week must be provided for permissible abortions. To the dismay of anti-abortion advocates, if this change was to be made, this would allow women to realize they were pregnant (at or around six weeks of pregnancy) and then legally get an abortion within the mandated time period, should they wish to. This specific clause with the faulty justification is an intentional attempt to restrict abortions to the fullest extent.

While this law will undoubtably be challenged, the ultimate goal of anti-abortion advocates is for such a case to be enforced in the state and should it be blocked by a federal judge, face appeals by the state and then make its way to the now right-leaning Supreme Court only to then be ruled valid. Should this occur, Roe v. Wade would be threatened by appeals, reducing the ruling’s legitimacy and constitutional power. The historic Supreme Court ruling protects a woman’s right to an abortion up until fetal viability or around 25 weeks. Laws like this one passed by Georgia are meant to eradicate protections and implement aggressive restrictions. Organizations like the American Civil Liberties Union and the Center for Reproductive Rights have vowed to challenge the legislation well before it goes into effect in January 2020.

*Interactive map and extended list of states that recently introduced restrictive bills.*

Engagement Resources:

  • Planned Parenthood : Reproductive rights advocacy group that provided affordable and accessible health services to women across the US.
  • National Abortion Federation : Advocacy group which respects women’s ability to make informed decisions about her reproductive health.
  • Spark Reproductive Justice Now: A reproductive justice organization based in Atlanta, Georgia, advocating for policies that protect and expand access to sexual health and resources.
  • ACLU of Georgia : A national organization working to defend civil liberties across the United States.
  • Center for Reproductive Rights : Legal group ensuring the protection of reproductive rights for every woman around the world.

Photo by Maria Oswalt

2020 Budget Proposal Slashes Funding for Medicaid and Medicare

2020 Budget Proposal Slashes Funding for Medicaid and Medicare

Policy
In early March, the Trump administration announced its 2020 budget proposal with controversial cuts. The proposal included a $1.5 trillion cut to Medicaid and a $845 billion cut to Medicare over the next 10 years. The main reason for cutting Medicaid is due to its connection to the Affordable Care Act (ACA), also known as Obamacare, which Trump and the Republicans abhor. Proposed budget cuts to the program  eliminate extra Medicaid funding for states that have expanded the program under the ACA. Additionally, the budget proposal would give states the power to design their own Medicaid programs, including, controversially, allowing states to get a block grant or to introduce a per-person cap for Medicaid recipients. The proposed changes  to Medicare are supposedly  aimed to address and combat waste and abuse in the healthcare system, therefore making Medicare more efficient.

Analysis
This is a rollback of the Medicaid expansion under Obamacare, which allowed states to offer Medicaid coverage to a larger share of low-income people. Trump’s budget proposal would cut federal funding for the expansion, forcing states to either drop it or foot the bill themselves, in addition to cutting payments to hospitals and other healthcare providers.

Lower rates proposed for Medicare services would force providers to charge the government less for services. According to the Committee for a Responsible Federal Budget,  Overall, nearly all premiums, deductibles and copays would be left unaffected, but states would have the option of opting out of providing some services  due to the lack of federal subsidies. However Trump’s proposed budget  also could result in raising raise-out of pocket drug prices charged  under Medicare Part D.

While the plan proposed by the Administration must still go through Congress, where it likely won’t survive, the initiation of this proposal, highlights the Administration’s disregard towards the American people’s health,  and will surly leave those in the proposal’s crosshairs with negative feelings. The proposed cuts would dramatically increase the number of people without  health insurance. While this proposal is being presented as a method to correct systematic errors, millions would be negatively impacted by this ego driven proposal.

Engagement Resources:

Photo by unsplash-logoKendal James

EPA Finally Vows to Regulate Cancer Causing Toxins

EPA Finally Vows to Regulate Cancer Causing Toxins

Policy Summary
After persistent national outcry, the EPA has announced it will regulate a group of long-lasting chemicals, called polyfluoroalkyl and perfluoroalkyl substances (PFAS), which have been linked to reproductive and developmental, liver and kidney, and immunological effects. The action plan creates a “maximum contaminate level” for PFAS, therefore lowering the ratio between drinking water and the substances that have also been found to contribute to low birth weights, thyroid problems and some cancers. The widespread contamination of these compounds has been felt across America, as they are used in nonstick cookware, water-repellant fabrics, grease-resistant paper products, and firefighting foams. The acting EPA Administrator Andrew Wheeler stated in a news conference in Philadelphia that the EPA would set a limit for the chemicals under the Safe Drinking Act by the end of this year. This action plan’s key components are: nationwide drinking water monitoring of PFAS,  expand research on managing the risks and effects of PFAS, and continue and develop groundwater cleanup strategies.

Analysis
The unregulated contamination of drinking water has left communities and military bases fearful and scrambling upon the revelation of high PFAS in drinking water. Military bases and areas around them are exponentially affected due to the use of fire fighting foams that are knowingly riddled with PFAS during training exercises. The presence of PFAS are not new and the implementation of this act is coming at a time when lives have already been affected. Critics finds that the EPA and administration are making grandiose claims implying  stark changes, but recalling past approaches and responses to such outcry, little optimism exists. Last year, the Trump administration also tried to block the publication of a  health study(cite) by the federal Agency for Toxic Substances and Disease Registry that suggested the current regulations were inadequate and urged a much lower threshold of exposure to these compounds. In response to the EPA’s ineptitude, many states have already taken steps in limiting or banning such PFAS and addressing their threat to public safety*.

While this is a step in the right direction, the process of getting a handle on such toxins will take months, if not years, due to their widespread use and presence. Additionally, there is reasonable concern about  this action plan being successfully executed due to Trump’s recent proposal to reduce the EPA’s funding by 31% ; Reduced spending reduces resources, which reduces the efficacy of this plan in cleaning up communities saturated with PFAS. Finally, this plan of action is exactly what the name suggests, a plan, but not definitive policy or mandates that are enforced and causing concrete change.

*States that took action are Minnesota, New Jersey, New York and Vermont.

  • Resistance Resources:
  • Comment directly on EPA proposed regulations, make your voice heard – Note: Commenting privileges are available for 60-90 days after a proposed regulation is announced.
  • Clean water for all campaign : An organization promoting water access as a human right.
  • National Drinking Water Alliance : A network of organizations and individuals across America working to ensure all children have access to safe drinking water.

Contact: This brief was authored by Taylor J Smith Contact: Taylor@usresistnews.org

  • Learn More
  • EPA official statement announcing plan
  • EPA Per- and Polyfluoroalkyl Substances (PFAS) Action Plan – Full
  • EPA Per- and Polyfluoroalkyl Substances (PFAS) Action Plan – Fact sheet
  • Community in Michigan drastically impacted by PFAS.
  • Additional criticism of “action” plan.
  • Announcement by Andrew Wheeler and America’s history with PFAS:
  • Proposed budget cuts, EPA is severely impacted.
  • Additional article on regulation of PFAS
Judge Rules HIV Status is Not an Exclusionary Factor in the Ability to Serve

Judge Rules HIV Status is Not an Exclusionary Factor in the Ability to Serve

Brief #51—Health

Policy
A federal judge put a stop to the recent attacks on military members, referred to as  the “Deploy or Get Out” ;policy. This policy , sponsored by the former Defense Secretary Jim Mattis, effectively mandated that any military personnel who were not deployable worldwide be cut. This policy affects personnel deemed non-deployable due to medical reasons, directly affected two HIV positive airmen, who recently sued the Department of Defense. In this case, U.S. District Judge Leonie M. Brinkema of Alexandria, Virginia, ordered that the US Air Force stop discharging service members who are HIV positive. The Judge found the policy to be “irrational” and “outdated”, and noted that because of the advances in treatment and medicine, the disease “does not impose unreasonable burdens on the military when compared with similar conditions” nor does HIV “seriously jeopardize the health or safety of the service members or his companions in service. “These justifications were central in the judge’s ruling that the military cannot claim HIV status to be an exclusionary factor in ability to serve.

Analysis
According to the “Deploy or Get Out” policy. the HIV status of these airmen meant that they could not be deployed around the world and therefore must be discharged from military service, Not only is this a direct attack on those with medical conditions that do not impair their ability to serve but this also reduces the readiness of the Airforce and other military branches by reducing their enlistment numbers. This policy additionally affects those most effected by HIV, gay males, continuing the administration’s attack on the LGBTQ community, like the transgender ban.

The original policy, according to Mattis, was put in place to ensure fairness in deployment rates. Specific articles within this policy state that military members who have been non-deployable for the past twelve months or more will be separated from the military, with the expectation of having only deployable personnel and reducing individuals from avoiding deployments. However, service members in the Air Force claim they are being discharged despite the recommendations and influence of their doctors and commanding officers who claim they are fit to serve and are being removed due to their HIV status. While this policy looks to “trim the fat”, it simply reduces the number of available military personnel by arbitrarily choosing individuals to remove from service.

By focusing on the nonexistent impact that HIV has on military abilities and acknowledging that the military cannot make the decision to remove individuals according to outdated biases, the court ruling protects the liberties of U.S. military personnel globally.

  • Resistance Resources:
  • Outserve SLDN : Organization providing legal defense for LGBTQ service members.
  • Human Rights Campaign : LGBT civil rights advocacy group who works toward equal rights.
  • Lambda Legal : A  nonprofit, national organization committed to achieving full recognition of the civil rights of lesbians, gay men, bisexuals, transgender people and everyone living with HIV through impact litigation, education and public policy work.

Contact: This Brief was authored by Taylor J Smith Contact: Taylor@usresistnews.org 

Learn More:

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The Trump Administration Tries to Further Limit Women’s Reproductive Rights

The Trump Administration Tries to Further Limit Women’s Reproductive Rights

Brief #52—Health

Policy
The Trump administration made another calculated move in the war on Planned Parenthood and women’s reproductive rights late last month. Under this new policy provided by Trump and Pence, massive changes to Title X, the federal program that provides birth control and other reproductive health services to an estimated four million low-income Americans, have been finalized. This rule effectively changes what kinds of family planning clinics can receive federal funding, specifically stating that any organizations that provide or refer patients for abortions are ineligible for Title X funding ( covering STD prevention, cancer screenings and contraception). Additionally, the rule says any group or clinician receiving Title X funding must be physically and financially separate from any group that provides abortions, specifically targeting Planned Parenthood and its clinicians where that separation is practically not possible.

Analysis
Singling out providers like Planned Parenthood would then put the communities and individuals that they serve at risk, due to the lack of replacement services and providers to fill in should this order nullify their effective aid to the 2.4 million patients provided for just last year. This policy states “a Title X project may not perform, promote, refer or support abortion as a method of family planning”, actively targeting more liberal organizations and promoting conservative services like abstinence counseling. While this rule does not prevent providers from discussing abortions all together, clinicians are essentially bound by a gag order when discussing anything leaning towards a patient opting for an abortion. Health care providers are forced to either provide patients with cumulative and accurate information, or forgo Title X funding, which will likely result in a sacrifice to the detriment of the patient.

Essentially, this rule requires Planned Parenthood to drastically change its operations or relinquish an estimated $60 million in annual funding, in an attempt to reduce access to abortions nationwide. While Title X changes specifically focus on ensuring clinics do not use the funding to provide abortion care, no federal funds from Title X havde ever been used to pay for abortions, as mandated in Title X’s creation. In support of analysis like this, a coalition of twenty states* and California’s Attorney General Xavier Becerra announced multiple lawsuits earlier this week to prevent the changes from going into effect in 60 days. This policy by the Trump Administration pushes conservative views and limits access to comprehensive healthcare for vulnerable populations at risk by reinforcing the power of the purse.

*States include : Oregon, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, North Carolina, Pennsylvania, Rhode Island, Vermont, Virginia and Wisconsin, in addition to the District of Columbia, California AG and civil liberties unions.

Resistance Resources

  • American College of Obstetricians and Gynecologist : An organization dedicated to the improvement of women’s health. Click here to help #SaveTitleX and click here for additional resources.
  • Planned Parenthood: A nonprofit organization that provides reproductive healthcare. Click here to take a stand against Title X.
  • Contact your representatives here : call, email or send a letter to your local representative stating you oppose the changes to Title X.
  • Contact: This Brief was authored by Taylor J Smith Contact: Taylor@usresistnews.org

Learn More:

unsplash-logoAndrej Lišakov

The Supreme Court Stands Tall for Reproductive Rights

The Supreme Court Stands Tall for Reproductive Rights

Brief #50—Health

Policy
Last week, the Supreme Court took a stand against limiting reproductive rights in a recent ruling. The Court blocked a Louisiana law, in a 5-4 vote, that would have limited access to abortions in the state by only allowing one doctor in one clinic, in the entire state, to legally provide abortions. Liberal Judges – Ginsberg, Sotomayor, Kagan and Breyer were joined by Chief Justice Roberts in the opposition vote, while Justices Thomas, Kavanaugh, Gorsuch and Alito were in favor of this law. The Louisiana law specifically mandates that all doctors performing abortions have admitting privileges at nearby hospitals, as enacted in 2014 but was then struck down in 2017 by Baton Rouge Federal Court. This stipulation thus reduces accessibility to abortions in the state of Louisiana.

Analysis
One of the key reasons for challenging and blocking this law is to protect and promote both women’s health and their reproductive rights. This law would mandate the admitting privileges by the doctors, or they cannot practice, which has been highlighted as restrictive due to reasons unrelated to their competencies. Additionally, the law would then construct obstacles and burdens on the legal and constitutional right to an abortion. Obstacles include: reducing available clinics from three to one for the over 52,000 sq/mi of the state and requiring a single doctor to administer abortion services to approximately 10,000 women annually in Louisiana. By dismissing such a law reaffirms the constitutional protections of abortion, which were established through Roe v. Wade in 1973.

While this ruling is a step in the right direction, the ruling will likely be challenged in the coming term and many more abortion cases like this will make its way to the Court. The fate of later cases are still unknown, especially with Chief Justice Roberts’ unexpectedly liberal vote, compared to his last dissent on a similar case in 2016, and the recent appointment of conservative Justice Kavanaugh has shifted the court to the right, directly threatening Roe v. Wade and future reproductive rights’ cases.

  • Resistance Resources:
  • Planned Parenthood : Reproductive rights advocacy group that provided affordable and accessible health services to women across the US.
  • National Abortion Federation : Advocacy group which respects women’s ability to make informed decisions about her reproductive health.
  • Center for Reproductive Rights : Legal group ensuring the protection of reproductive rights for every woman around the world.

Contact:

This Brief was authored by Taylor J Smith Contact: Taylor@usresistnews.org

Learn More:

Photo by Monica Melton

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Say Goodbye to Surprise Medical Bills! Well, Not Entirely

Say Goodbye to Surprise Medical Bills! Well, Not Entirely

Brief #48—Health

Policy Summary
Donald Trump and his administration have taken proactive steps to solve the nationwide issue of surprise hospital fees. Starting this month, Trump has mandated that hospitals publicly reveal prices for their services. These online master lists of services are called “chargemasters” and are the administration’s central component in reducing shock over medical bills and promoting transparency in healthcare. Within each list is an exorbitant amount of procedures and services that are provided in an a-la carte fashion, where patients must know every element to a procedure in order to have an accurate pricing expectation. Alternatively, a singular procedure like a vitamin D blood test can easily be found and compared across providers.

Analysis
While it is beneficial to the patients to be provided with the resources describing their hospital fees, it isn’t likely that the average hospital-goer will be able to decipher the medical codes. “Chargemasters” are often hundreds of pages long with an overwhelming amount of abbreviations, codes and medical jargon. Additionally, prices are often found to be inflated and inconsistent, rendering their transparency useless. Another issue with the provided prices is they do not account for  the different insurance policies of patients and hospitals, again being rendered impractical. Finally, with individual hospitals producing their own list, there is little consistency among procedure or service descriptions, thus negating any consistency needed for comparing and finding the right price for consumers. Proponent for this mandate will note the issues with the “Chargemasters”, but will also state how they promotes transparency and allow patients to effectively advocate for themselves with factual information. On the contrary, while revealing pricing is key in medical reform, this does not address the larger issue of the high-priced American medical system, which can cripple patients after hospital visits. Overall, the attempt by the administration is well intended, but inefficient.

Resistance Resources:

  • Vox Media – Follow Senior Policy Correspondent Sarah Kliff, who has spent the past year exposing ER/hospital billing in the US.
  • National Assosciation of Healthcare Advocacy – When making important health decisions, having someone who is familiar with the health sector can help you make the best decision for both your health and your wallet. Use this association to find a healthcare advocate near you.
  • Change happens through the patients: To report inconsistencies, concerns or issues with Chargemasters, contact and notify your desired hospital.

Contact: This Brief was authored by Taylor J Smith Contact: Taylor@usresistnews.org

Photo by Olga DeLawrence

Threats to the Affordable Care Act Amid Midterm Medicaid Success

Threats to the Affordable Care Act Amid Midterm Medicaid Success

Brief #48—Health

Policy Summary
Throughout the Trump Administration’s tenure, there has been an underlying campaign promise: dismantling and destroying the Affordable Care Act. Translation: cutting off healthcare to millions of families. The key policies in the administration have been to expand access to junk plans offered by insurance companies often out of the ACA marketplace, keep preexisting condition exclusion principles in place, and limit the reach of Medicare and Medicaid. Early in November, there was movement to continue to kick people off of Medicare to lower drug costs, which mainly affects the most vulnerable in American society. This movement directly contradicted the majority of people’s opinions on healthcare. Even extremely Republican states (e.g. Idaho) passed by a popular vote increasing access to Medicaid.

Analysis
Ultimately, the midterm success of Democrats supporting more universal healthcare has indicated the slowing of these policies meant to destroy access to healthcare. The Trump Administration and Director of Medicare and Medicaid, Seema Verma, are attempting to reform healthcare to offer more choice of private and public plans to the public. However, this is a terrible method to try to encourage those that can’t afford to sign up for healthcare to sign up. The free market approach to healthcare just ensures that the richest and most privileged in our society have access to adequate healthcare. This is why so many democrats (especially those from Republican majority states) that will be taking office support universal healthcare and ran heavily on that platform.  While less people are signing up for the ACA plans, the popular approval for expanding public healthcare could indicate long term success for the ACA. This would hopefully hold true for the 2020 general elections. Ideally, the Trump Administration’s attacks on Medicaid and Medicare will be limited because of their unpopularity, however, there is no question that the effects have already been felt and have hindered the effectiveness of Obama-era healthcare reform.

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Resistance Resources:

  • National Patient Advocate Foundation-Advocates for and promotes action for supporting Medicare/Medicaid for underserved populations. Volunteer with a center near you help clarify the healthcare process and get people covered.

This Brief was submitted by USRESIST NEWS Healthcare Policy Analyst-Sophia Adams Name: Contact Sophia.lorene30@gmail.com

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