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 ebook “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 yr — which principally 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 record, together with finalizing a coverage that bars credit score bureaus from together with medical debt on people’ credit score stories.
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 Put up.
Panelists
Shefali Luthra
The nineteenth
Alice Miranda Ollstein
Politico
Lauren Weber
The Washington Put up
Among the many takeaways from this week’s episode:
- The 119th Congress is now in session. Well being care doesn’t make the record of priorities as lawmakers lay the desk for the incoming Trump administration — although Republicans have floated Medicaid work necessities to chop federal spending.
- A number of well being laws hit the cutting-room flooring in December, together with a bipartisan proposal focusing 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 Funds Committee provides to proof that personal 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 international 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 stories. The surgeon normal cautions that alcohol ought to include warning labels noting most cancers threat. 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 need to learn, too:
Julie Rovner: The Wall Avenue Journal’s “UnitedHealth’s Military of Medical doctors Helped It Acquire Billions Extra From Medicare,” by Christopher Weaver, Anna Wilde Mathews, and Tom McGinty.
Alice Miranda Ollstein: The New York Occasions’ “Ozempic, Lego Bricks and Listening to Aids: What Trump’s Greenland Plan May Hit,” by Ana Swanson and Jenny Gross.
Shefali Luthra: Vox.com’s “Gigantic SUVs Are a Public Well being Risk. Why Don’t We Deal with Them Like One?” by David Zipper.
Lauren Weber: The Washington Put up’s “Legal guidelines Limit U.S. Delivery of Vape Merchandise. Many Corporations Do It Anyway,” by David Ovalle and Rachel Roubein.
Additionally talked about on this week’s podcast:
The Senate Funds Committee’s “Income Over Sufferers: The Dangerous Results of Non-public Fairness on the U.S. Well being 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: Hiya, 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 among the finest and smartest well being reporters in Washington. We’re taping this week on Thursday, Jan. 9, at 10 a.m. As all the time, information occurs quick and issues might need modified by the point you hear this. So, right here we go.
Rovner: In the present day we’re joined through videoconference by Alice Miranda Ollstein of Politico.
Alice Miranda Ollstein: Hiya.
Rovner: Lauren Weber of The Washington Put up.
Lauren Weber: Hiya hi there.
Rovner: And Shefali Luthra of The nineteenth.
Shefali Luthra: Hiya.
Rovner: No interview this week — method 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 need to begin by wanting forward. What’s on the rapid agenda right here in Washington for well being care? Anyone?
Ollstein: So well being care will not be the precedence proper now for the incoming administration, for the brand new Republican trifecta in Washington. It could make it in, as a result of they’re speaking about these huge, conglomerate payments that they’ve criticized previously and stated 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 all the things into one big reconciliation invoice early within the new administration. And there’ll possible be some well being care elements. We don’t know but what these might be. Issues that purport to economize are much more possible than issues that purport to value cash. Though, there’s usually some humorous math in that. Medicaid work necessities have been floated, and so we are able to speak about that. We all know, we’ve seen that film earlier than, and we all know how that may go, each by way of what it means for folks’s protection and what it means by way of financial savings.
However I feel that a number of the bold stuff that lawmakers tried to get via on the finish of the yr is now in query, as as to whether 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 received — they saved the federal government open, and so they received the federal government funded — that solely goes till March. I noticed type of a plaintive e-mail yesterday from Tom Cole, the Republican chairman of the Home Appropriations Committee, saying, Um, we’ve to begin engaged on the following one quickly. All people’s busy speaking about this big tax invoice, reconciliation. What are we going to do about Medicaid? And it’s like, hi there, the present fiscal yr will not be completed. They only managed to place issues off.
Lauren, you needed so as to add one thing?
Weber: Yeah. I simply needed to say, I really feel like we’ve entered the period of promoting in relation to these payments. You’ve received President-elect [Donald] Trump saying he needs one massive, lovely invoice. That’s what he needs. He needs one massive, lovely 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 feel we’re coming 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 a minimum of know what these persons are telling them is going on with this advertising and marketing, we’ll see. So I simply needed to flag that this appears to be the change over right here.
Rovner: And that is after I get to place in my different actuality examine, which is that they hold speaking about this massive, lovely reconciliation invoice that they solely want Republican votes for. I’ve to remind folks yearly: To be able to do a reconciliation invoice, first they have to do a funds decision, in each homes. That has to go to the ground, be debated, must be reconciled between the Home and the Senate, about what the funds decision appears like.
The entire level of what’s known as “reconciliation” is that it reconciles obligatory spending to the phrases of the funds decision. It takes a very long time to do a funds decision, even whenever you’re dashing it via.
Additionally, all this stuff that they’re speaking about placing into this reconciliation invoice are usually not allowed to enter funds reconciliation. It’s solely about obligatory spending. It’s taxes. It’s Medicare and Medicaid and different obligatory 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 need to add one thing?
Ollstein: Positive. I imply, I feel we’re already seeing cracks rising on this nice Republican unity that they’re attempting to venture. I imply, they’ll’t even agree but on whether or not to do one massive, lovely invoice or two. And the folks pushing for 2 are mentioning that for those who 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 definately don’t actually have something to point out in your work.
Which in fact is a scenario 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 may make it via. 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 following few years.
Rovner: And for those who thought that the Home was ungovernable with its tiny Republican majority within the final Congress, it’s even tinier now. In truth, we do have Speaker Mike Johnson. He did get elected on the primary poll, but it surely was not straightforward. There have been a few holdouts who needed to take calls from the president-elect so as to change their votes. So it’s fairly tenuous there.
Shefali, earlier than we transfer on, did you need to add one thing?
Luthra: No, I imply, I feel what might be actually fascinating, as nicely, is to see how this emerges in the entire extra fractious points among the many Republican Get together. I do know we’ve talked quite a bit about how the Republican Get together could be very divided on a number 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 might be attending to that very quickly. However it’s simply very clear that every one of those points, the place they venture unity, are fairly shortly going to crumble in relation to partaking with the truth that this can be a very divided coalition, and a number of the issues they’re speaking about doing are usually not very talked-about with voters. And so we’ll see how that impacts them as nicely.
Rovner: Sure. So let’s transfer again a bit of bit. After we left issues in December, we have been a day away from a attainable authorities shutdown, which didn’t occur. However the different factor that didn’t occur was a giant package deal with principally a complete yr’s value of bipartisan well being coverage work in it, all the things from new transparency necessities for pharmacy advantages managers [PBMs], to renewals of applications to organize for the following 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 package deal that may hold the federal government operating till March.
The tiny issues that did make it in have been extensions of telehealth authority for Medicare and funds for neighborhood well being facilities and another expiring applications — however once more, solely via 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 motive to assume that Congress goes to choose it up and cross it this yr? And even when they do this Trump would signal it? Or did all of that work final yr, is that every one simply principally for naught now?
Ollstein: I imply, I feel you possibly can make an argument both method. You possibly can make an argument that it has an opportunity as a result of there may be 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 reduce 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 can also make the argument that it has an opportunity due to that, however we’ve seen tons of well being insurance policies previously which have bipartisan help that will lower your expenses additionally fall by the wayside, simply because they aren’t priorities. And so, I feel, you can also make the optimistic or the pessimistic case on this one.
Rovner: Go forward, Lauren.
Weber: I’d simply add, I imply, a number of issues that folks have been fairly upset about, by way of smaller issues, health-wise, additionally received reduce from the invoice. I imply, there was funding for 9/11 most cancers funds, for those who had been uncovered to poisonous chemical substances, first responders, and so forth. A number of outcry after that received stripped out of the invoice. Understandably so, contemplating, principally all of the advocates stated: We don’t need to parade our dying first responders to Congress yearly to get funds. Actually, you narrow this out?
So there does appear to be some momentum to doubtlessly add that in once more. There was additionally hullabaloo round childhood most cancers analysis. They ended up passing a separate smaller invoice, but it surely didn’t embrace the total measures to actually prioritize some strain on the FDA [Food and Drug Administration] and different funding to enhance childhood most cancers analysis. And so I feel you’re going to proceed to see, a minimum of 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 feel it’s going to be — I feel a number of these new committee chairs, significantly within the Senate, the place the Republicans are taking up, are going to need to determine their method out and attempt to decide up among the items. One fascinating factor that got here via my inbox this week was a bipartisan report from the Senate Funds Committee that discovered, and I’m quoting from the headline within the press launch, “Non-public Fairness in Well being Care Proven to Hurt Sufferers, Degrade Care and Drive Hospital Closures.” Does this recommend that Congress may 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 a number of discourse about non-public fairness’s influence on well being take care of shoppers for years. That is very fascinating and essential work, and it isn’t in any respect stunning.
And the opposite factor that we’ve to recollect is that Donald Trump might be president. He’s ideologically very unpredictable. As an actor, he’s very unpredictable. And it’s simply very tough to guess what is going to really change into legislation and getting his signature. And a part of that’s as a result of, we are able to bear in mind from the final time he was president, he fairly often would change what he believed primarily based 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 fascinating bipartisan analyses of issues that would make actual variations for shoppers on well being care, however whether or not they change into legislation, whether or not they change folks’s lives, that’s simply a lot, a lot more durable for us to actually predict in a significant method.
Rovner: Yeah, I feel all the things’s fairly exhausting to foretell proper now. Lauren?
Weber: Yeah, I simply needed so as to add, I imply, I do know, clearly exhausting to foretell, however I feel the concept you’ve got 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’ve got [Sen. Charles] Grassley saying: Look, none of those folks care about affected person care. They solely care about shareholders. I do assume that may 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’ve got lawmakers making that bounce to, Oh, folks in my district are getting worse well being care due to this, I feel you possibly can see extra motion.
Rovner: Yeah, it’s one thing I’m going to regulate. Like I stated, I used to be stunned to see that as a bipartisan report from a committee, although it’s the Funds Committee that doesn’t actually have authority to do something legislatively. Nonetheless, it was value noting.
Effectively, 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 every of a protracted record of Democratic presidents who tried and did not overhaul the nation’s well being care system. You may Google one thing known as “hospital value containment” if you wish to know extra. He additionally created the Well being Care Financing Administration to run Medicare and Medicaid, which received renamed the Facilities for Medicare & Medicaid Companies within the early 2000s.
However Carter’s greatest well being achievements got here after he left workplace. His work via his basis addressed, and in some instances practically eradicated, some principally uncared for tropical ailments that principally afflict the poorest and most marginalized folks on the planet. That’s going to be one in every of his actual main legacies, was bringing international well being residence. Proper, Alice?
Ollstein: Yeah, and I feel that’s fascinating, 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 towards our bodies just like the WHO [World Health Organization] and worldwide cooperation on well being care, very vocally vital of how worldwide cooperation occurred throughout the covid-19 pandemic. And so I feel that’s going to be an fascinating distinction, given what Carter was capable of obtain via such cooperation.
Rovner: Yeah. Lauren?
Weber: Yeah, I simply needed so as to add, I imply, it’s a mannequin that I feel then seeped into different presidents, proper? I imply, you’ve seen [former president George W.] Bush’s funding in international well being, and so forth. And I do assume, as Alice well identified, there may be, clearly, a pointy distinction. However I imply, what Carter was capable of do for river blindness and Guinea worm is unprecedented. And I feel what was most transferring in the entire recaps of his work is that these are those that don’t have a voice. They don’t have a place of energy within the nation they reside in. I imply, that is him utilizing his comfortable 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 be sure 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 feel that is sort of a once-in-a-generation second to have a look at this influence somebody has on international well being. And as Alice identified, I don’t know what we’ll see going ahead on that.
Rovner: It’s exhausting to think about Donald Trump making eradication of Guinea worm a significant precedence. Effectively, we’re additionally bidding farewell over the following two weeks to the Biden administration, which is utilizing its final days to attempt to get as a lot carried out and trumpet as many victories as it may. 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 folks have now been enrolled in ACA plans. That’s up 3 million simply from final yr 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 yr marked the primary that the so-called Dreamers, these folks introduced illegally to the U.S. as youngsters by their mother and father, they may enroll, a minimum of 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 have been put in place throughout the pandemic expire on the finish of this yr, except Congress renews them. What’s the outlook for ACA enrollment?
Ollstein: Effectively, Democratic senators are beginning to make a push to increase these subsidies, introducing laws and making a giant splash about it right now. There’s been a number of lobbying from the well being care sector, the hospitals, all of the gamers who don’t need 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 value some huge cash, and the brand new congressional majority positively has different issues they need to spend that cash on, that aren’t serving to folks purchase medical insurance plans as a part of the Inexpensive Care Act. And so, I feel there may be prone to be a number 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 carried out deal, both.
Rovner: Yeah, I imply, I hold saying, I feel everyone’s first inclination after Election Day is that they have been toast, as a result of Republican trifecta. However, whenever you really dig into the numbers, the most important will increase have are available crimson 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 received to wonder if they need to, out of the blue subsequent January, or actually subsequent October, November, when folks understand: Oh my goodness, my premiums for my medical insurance are going to quadruple. How did this occur? Perhaps they’ll take into consideration that once they’re placing all of those massive, lovely payments collectively, possibly?
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 previously, like Lisa Murkowski within the Senate, saying that we must 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 feel you’re beginning to hear these rumblings as a result of, such as you stated, Julie, they don’t need to have a bunch of constituents lose their insurance coverage or have their insurance coverage get far more costly once they’re in energy.
Rovner: Yeah, the benefit and drawback of the trifecta. Lauren?
Weber: I simply needed to ask, I imply, a query for the panel. I imply, there’s all this speak about “DOGE” [the “Department of Government Efficiency”] and reducing all this cash, however as you simply acknowledged, Alice, they’re possible to not do away with these subsidies. Johnson went on the document, I feel this week or final week, to say Medicare will not be going to get impacted. Medicaid cuts appear to be coming, however expensive God, for those who don’t reduce a few of these different issues, I don’t understand how you might get to the cash quantities that they’re speaking about, particularly in well being.
Ollstein: Effectively, and Elon Musk has already walked again his projection of how a lot he’ll be capable to reduce, 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 among the preelection guarantees on that entrance as they begin to confront among 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’ll assume that Trump of all folks 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 nicely. However apparently he has a brief reminiscence, too.
Effectively, talking of issues which are prone to be undone, the Shopper Monetary Safety Bureau finalized its rule this week barring the usage of medical debt on credit score stories. 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 could possibly 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 in all probability really virtually all the time not deliberate, since you don’t hope to fall sick. You don’t attempt to get a devastating harm that your insurance coverage won’t absolutely 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, nicely earlier than the Biden administration. Dropping it might actually have implications for folks 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 affordable mortgage simply out of attain for lots of Individuals.
Rovner: Effectively, lastly, as one in every of his parting suggestions, outgoing Surgeon Normal Vivek Murthy has issued a report recommending that alcoholic drinks carrying warning labels that they’ll trigger most cancers, identical to tobacco merchandise. His report calls alcohol the third-leading preventable reason for most cancers. However this doesn’t really feel super-likely to occur, between the facility of the alcohol trade and the mistrust of science, significantly when it recommends issues folks in all probability don’t need 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 parents who signify breweries and distilleries and wineries, already talking out and sharing issues about this. However I feel that simply the surgeon normal utilizing the bully pulpit to shine a light-weight on this, it generated a number of information protection. That’s essential.
It’s essential for shoppers to see that and be capable to make decisions. And also you’re already seeing some developments of youthful people being extra type of sober-curious. And there’s a number 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 feel 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 feel it could be like tobacco, the place everyone smoked after which regularly fewer and fewer and fewer folks did. Lauren, did you need to say one thing?
Weber: Yeah, I imply, I’ve written quite a bit about meals labels within the final couple of years, and, I imply, that’s simply been a torturous course of. So the concept something on alcohol would change at something quicker than a glacial tempo I feel might be problematic, contemplating there’s a number of attorneys on this city and there’s some huge cash in lawmakers’ pockets on this city. So simply needed so as to add that.
Rovner: And alcohol’s actually fashionable — and authorized. Effectively, let’s flip to abortion reproductive well being. All issues thought of, it’s really been type of quiet on the abortion entrance for the previous few weeks. However there has all the time been information, as is predictable when Republicans take over the Home, Senate, and White Home on the similar 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 stated 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 totally different from a similar-sounding invoice that Congress handed and President George W. Bush signed in 2002?
Luthra: We have been chatting about this prematurely of taping the podcast, and that is actually fascinating for lots of causes. What this invoice would do is, primarily, if somebody provides delivery, 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 won’t reside. And that is related in a number of locations. It’s related when, as an illustration, you possibly 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 nicely earlier than the purpose when there may be really going to be one thing that resembles an toddler being born. And so what this really does in observe, a number 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 instances the place somebody does give delivery to a baby that won’t reside, forces medical doctors to offer medical interventions that possibly received’t make a distinction however that may delay the chance or stop the chance for palliative care, which is de facto unhappy.
I imply, you give delivery to a baby that received’t reside, and it may’t spend its few moments with some sort of consolation. As a substitute, it’s given medical therapies that won’t actually assist them. This invoice differs from the legislation signed below President Bush in that it might add penalties. However the different factor that’s value noting is that killing infants is already unlawful. Now we have legal guidelines that ban murder. And so, when abortion rights supporters and authorized students say that this sort of legislation can be redundant, they’re proper. We have already got methods to penalize killing folks. 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 feel 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 not. And that helps us underscore that nationwide abortion restrictions are very poisonous and that, as an alternative, the GOP is de facto attempting to deal with instances the place they assume they could have a greater likelihood 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 need 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 attempt to put supporters of abortion rights on the spot and say, In the event you received’t vote for this, then you definately’re for infanticide. I imply, that’s primarily what the controversy’s going to be. Proper, Alice?
Ollstein: Yeah. Effectively, 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 type 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 of transferring it to June to mark the anniversary of Dobbs however determined to maintain it in January to proceed to watch the anniversary of Roe in any case. However like Shefali stated, it’s fascinating that, even on condition that that is only a messaging vote, they’re nonetheless aiming quite a bit decrease than they’ve previously and never introducing the massive, sweeping anti-abortion insurance policies that the advocacy teams on that aspect need to see, by way of restrictions on abortion treatment, or like previously, 15-week bans, 20-week bans, one thing like that. As a substitute, that is type of a distinct segment and arguably duplicative coverage that they’re placing ahead.
Rovner: Effectively, 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 legislation may lead to potential legal legal responsibility or lack of medical license, however federal legislation is meant to preempt state legislation.
Alongside those self same traces, 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 workers 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 method.
Quoting from the report, “Medical doctors are enjoying lawyer, and attorneys are enjoying physician, whereas pregnant girls experiencing something wanting what quantities to a dire emergency are despatched away and instructed to return to the emergency room as soon as a preventable scenario turns into life-threatening.” Is there something on the horizon that will type out what medical doctors can and may’t do in states with abortion bans? This continues to be — we hold 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 have to be modified, and so they as an alternative 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 elucidate what’s and isn’t allowed by way of abortion care and emergency care below these restrictions.
One state to this point has carried out this, South Dakota, and they’re trying to introduce it in a bunch of different states. Now, the medical neighborhood says there’s no method a video goes to resolve this. These are extremely complicated conditions. You may’t cowl all the things that may come up. You may’t cowl each situation a pregnant individual may have. They usually see it as type of a CYA — if people are aware of “cowl your behind” — transfer, by way of legal responsibility and an try to put the onus on particular person medical doctors who’re already struggling, and to say that any of those opposed outcomes are the fault of medical doctors for not understanding or accurately 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 sufficient steering from the state. And these actually tie our palms in these very delicate, time-sensitive, and medically delicate conditions.
Rovner: And we’ve seen instances, I imply like in Texas, the place the legal professional normal has threatened in writing to prosecute medical doctors for issues that medical doctors say is commonplace medical observe.
Ollstein: Proper, so even when a health care provider got here ahead and stated, It’s my medical judgment that this individual wants an abortion for medical causes, we noticed the legal professional normal there step in and say: I’m overruling your judgment. No, she doesn’t. And in order that has, primarily based on many interviews I’ve carried out, and I’m certain Shefali has carried out, created an actual chilling impact, the place persons are afraid of being second-guessed like that. And even quick delays, the place somebody is attempting to seek the advice of with an legal professional on what to do, even a brief delay might be lethal for a affected person in a kind of conditions.
Rovner: Effectively, turning to this week in medical misinformation, the massive 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. Although Fb wasn’t doing such an important job earlier than on permitting misinformation and disinformation to unfold. Is that this going to have a giant impact?
Luthra: I imply, I feel 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 a number of claims of voter fraud. There are a number of, How did Trump get into workplace? They instituted fact-checking to allegedly sort of pander to individuals who felt like that there was a number of misinformation unfold then. Now they’re transferring away from fact-checking as a result of they really feel like then it provides folks the power to mirror what the neighborhood needs. I feel 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 needed to additionally flag that a part of Fb’s announcement was that they’re transferring 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 are usually not. 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 are restricted in Texas, like abortion care, like trans care.
Will folks be capable 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 motive.
Luthra: And if I can add yet another level to what Alice talked about, I imply, one of many very express areas the place Mark Zuckerberg stated he would really like extra room for disagreement and extra room for discourse is on the traces 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+ folks, about explicitly permitting customers to name them mentally sick.
And this has very significant implications for gender equality, certain, but additionally for well being care, as a result of we’re seeing that one of the crucial politicized areas of well being care in our nation is entry to well being take care of trans folks, is entry to well being care for ladies. And it’s simply very exhausting to not take a look at this and assume, oh, there might be no implication for the way folks conceive of well being care and the way folks conceive of those that obtain this sort of well being care.
Rovner: And we must always level out, which I ought to have at first, 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 type of outdated folks like me are nonetheless on Fb, however a number of persons are on Instagram and Threads, and that is clearly going to have some fairly massive implications as we go ahead.
All proper, nicely, talking of misinformation, one mark of accountable science is fessing up when you find yourself unsuitable. And this week we’ve a giant unsuitable factor to speak about. Again in November, we talked a couple of research that discovered that black plastic cooking utensils and takeout containers have been harmful as a result of they have been constituted of recycled electronics and have been leaching quantities of fireside retardants and different chemical substances into your meals.
Effectively, it seems that you simply in all probability nonetheless ought to do away with 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 research made a math error that exaggerated the degrees of poisons by an element of 10. Nonetheless, for those who don’t need to be uncovered to fireside retardants and different nasty stuff, you may need to prepare dinner with metallic or silicone or one thing that’s not 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 received this unsuitable. However right here, it doesn’t change our normal conclusion about this. However you need to 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 exhausting, since you see the act of admitting error and correcting it — that may gasoline mistrust. Individuals level to that and say: See, they received that unsuitable. They should be getting all this different stuff unsuitable, too. However in fact, not correcting misinformation is way worse. And so, in a time of such mistrust, communication is de facto, actually exhausting. 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? Had been the splashy articles that have been run, have been they corrected? Had been they retracted? It’s exhausting to place the toothpaste again within the tube.
Rovner: Yeah, however science is an imperfect course of. And it’s a course of. It might assist, I feel, if folks 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 need to learn, too. Don’t fear. In the event you miss it, we’ll put the hyperlinks in our present notes in your cellphone or different cellular system.
Lauren, you have been first this week, so why don’t you go first?
Weber: I like this story, and I’m clearly biased, however by my colleagues David Ovalle and Rachel Roubein, on how “Legal guidelines limit U.S. delivery of vape merchandise. Many corporations do it anyway.” Basically, you shouldn’t be delivery flavored vapes throughout the nation, however a bunch of corporations do. And my colleagues have been capable of order and get their palms on fairly a number of of these flavored vapes.
My favourite half is the kicker within the story, through which one firm stated, You’re not sanctioned to make use of our title in any method, after we reached out for remark after that they had shipped us vapes illegally. So I assumed that was fairly one thing. However primarily, it will get at what’s a flaw on this piece of the legislation, which is that the USPS [U.S. Postal Service] is meant to implement, or somebody is meant to implement, easy methods to cease the delivery of those vapes, but it surely’s not likely taking place. So it’s sort of a take a look at the very best intentions might not be the fact on the bottom.
Rovner: Usually. Alice.
Ollstein: So I’ve a bit from the New York Occasions known as “Ozempic, Lego Bricks and Listening to Aids: What Trump’s Greenland Plan May 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 change into one in every of Trump’s newest obsessions.
And this piece is mentioning that tariffs on Denmark would influence a number of issues the U.S. inhabitants depends upon. Particularly, the pharma big Novo Nordisk relies there and manufactures tons of medicines, together with Ozempic, and different weight reduction medicine and diabetes medicine in that household which are extremely fashionable proper now, and in addition to listening to aids, different medical gadgets, different drugs. And so this might influence shoppers, if it ever have been to occur, which who even is aware of.
Rovner: Sure. Effectively, we’ll discuss 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 well being risk. Why don’t we deal with them like one?”
I feel the story is so good. I like this framing. It first lays out the proof for why, when vehicles attain a sure dimension, they’re very harmful and more likely to kill folks. After which it will get into the dialog: Why don’t we really deal with this as a public well being risk?
They usually take a look at the conflict on tobacco and the conflict on smoking to assume via: What did it appear like to take one thing that was so ubiquitous in our tradition and truly persuade the American public to shift away from it? I feel that is actually fascinating for lots of causes. One is that public well being is de facto expansive and we must always give it some thought in an expansive method and contemplate all of the totally different parts, like automotive dimension, that do have an effect on our lives and life expectancy.
And I additionally do assume this ties very well to the dialog we had concerning the surgeon normal’s alcohol warning, in that even wanting coverage adjustments, there’s a lot that we are able to do as a society to shift the general public’s understanding of well being dangers from issues that we take without any consideration, and we are able to nonetheless transfer folks in a route towards being more healthy and retaining our fellow Individuals more healthy. And that’s actually fascinating 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 Avenue Journal. It’s known as “UnitedHealth’s Military of Medical doctors Helped It Acquire Hundreds of thousands Extra From Medicare,” by Christopher Weaver, Anna Wilde Mathews, and Tom McGinty. And it’s principally the flip aspect of the story that Stat Information has been throughout, about how United has used varied 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 a number of them, like 10,000 — to principally run via 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 extra money for Medicare.
The investigation discovered that the, quote, “illness scores” for sufferers transferring 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 identified with HIV … and breast most cancers,” principally maximizing earnings 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’re feeling caught up and prepared for the remainder of 2025. As all the time, for those who benefit from the podcast, you possibly can subscribe wherever you get your podcasts. We’d respect it for those who left us a overview. That helps different folks discover us, too. Particular thanks, once more this week, to our momentary manufacturing crew, Taylor Prepare dinner and Lonnie Ro, in addition to our editor, Emmarie Huetteman.
As all the time, you possibly can e-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 principally as of late? Alice?
Ollstein: I’m @alicemiranda on Bluesky, principally.
Rovner: Shefali.
Luthra: Yow will discover me on Bluesky, @shefali.
Rovner: Lauren.
Weber: Nonetheless simply chilling on X, @LaurenWeberHP.
Rovner: We might be again in your feed subsequent week. Till then, be wholesome.
Credit
Taylor Prepare dinner
Audio producer
Lonnie Ro
Audio producer
Emmarie Huetteman
Editor
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