News

GOP Lawmakers Eye Cuts to Medicare, Social Security, and Medicaid With An Upcoming Debate Over the Debt Ceiling and Appropriations 

Republicans have not shied away from stating their goal for the 118th Congress: cutting Medicare, Social Security, and Medicaid. For months, GOP lawmakers have said they will rip away the basic benefits that are a lifeline for millions of seniors and working families. Cuts to Medicare and Social Security would disproportionately hurt people of color and rural Americans. Coverage dating back to before the election shows that Republicans have made crystal clear that they want to use their House majority to slash these vital programs to fund tax breaks for big corporations.  

Insider: Republicans’ Plans to Slash Social Security and Medicare Are Becoming Clearer: ‘We Have No Choice but to Make Hard Decisions.’ “‘We have no choice but to make hard decisions,’ Rep. Kevin Hern of Oklahoma, leader of the conservative Republican Study Committee, told The Post. ‘Everybody has to look at everything.’ The Post reported that in the past few days, a group of Republican lawmakers have pushed for House panels that would recommend changes to Social Security and Medicare.” [Insider, 1/25/23]

Washington Post: House GOP Eyes Social Security, Medicare Amid Spending Battle. “Only weeks after taking control of the chamber, GOP lawmakers under new Speaker Kevin McCarthy (R-Calif.) have rallied around firm pledges for austerity, insisting their efforts can improve the nation’s fiscal health. They have signaled they are willing to leverage the fight over the debt ceiling — and the threat of a fiscal doomsday — to seek major policy concessions from the Biden administration.” [Washington Post, 1/24/23]

HuffPost: Republicans Signal Cuts To Social Security, Medicare With New House Majority. “Their plans to target health care programs follow demands from a group of conservatives that helped elect House Speaker Kevin McCarthy (R-Calif.) over the weekend. Those far-right lawmakers have sought across-the-board spending cuts in order to tackle the growing national debt. But the narrow House GOP majority ― McCarthy can afford to lose just four votes on any bill ― is far more divided on cuts to defense spending than for entitlement programs. ‘I’m all for a balanced budget, but we’re not going to do it on the backs of our troops and our military,’ Rep. Michael Waltz (R-Fla.), a former Army Green Beret, said Monday during an interview on Fox Business. ‘If we really want to talk about the debt and spending, it’s the entitlements programs.’”[HuffPost, 1/9/23]

Axios: Debt Ceiling Fight Looms Over Medicare and Medicaid. “Why it matters: It’s not clear which cuts House Republicans will push for in exchange for raising the debt ceiling later this year — likely this summer — but at least some say Medicare and Medicaid should be on the table. Others, anticipating Democratic attacks, are saying they want to steer clear of the programs. What they’re saying: ‘We’re going to have to look at the whole board,’ conservative Rep. Barry Loudermilk told Axios, including mandatory spending like Medicare and Medicaid. ‘The easiest to start with is discretionary, but the main driver of the national debt is the mandatory.’ ‘Everything’s on the table,’ he added.” [Axios, 1/12/23]

Axios: GOP Floats Medicare Changes While Ducking Details. “What they’re saying: ‘If we’re going raise the debt ceiling, we can’t just raise it without focusing on some way to address the debt and the deficit,’ Rep. Bruce Westerman (R-Ark.), a member of the House GOP’s health care task force, told Axios, adding Medicare should be made ‘sustainable over time.’ ‘We’re going to have a lot of hearings on this,’ Rep. Jason Smith (R-Mo.), the current top Republican on the Budget Committee who wants to move up to chairman of Ways and Means, told Axios. ‘I’m not going to get into the inner details.’ ‘Everything is on the table, we haven’t really nailed down any specific policies one way or the other,’ Rep. Buddy Carter (R-Ga.), who is running to chair the House Budget panel. ‘I think it could be wrapped up with that [debt ceiling talks], that’s shaping up to be pretty dynamic.’ [Axios, 11/3/22]

New York Times: Republicans, Eyeing Majority, Float Changes to Social Security and Medicare. “The Republican leaders who would decide what legislation the House and the Senate would consider if their party won control of Congress have not said specifically what, if anything, they would do to the programs. Yet several influential Republicans have signaled a new willingness to push for Medicare and Social Security spending cuts as part of future budget negotiations with President Biden. Their ideas include raising the age for collecting Social Security benefits to 70 from 67 and requiring many older Americans to pay higher premiums for their health coverage. The ideas are being floated as a way to narrow government spending on programs that are set to consume a growing share of the federal budget in the decades ahead.” [New York Times, 11/2/22]

Fox News: Republicans Eye Using Debt Limit Hike to Overhaul Entitlement Programs if Entrusted With Majority. “Still, some Republicans say the key to shoring up both Social Security and Medicare might be by means-testing welfare programs and putting work requirements in place for beneficiaries. ‘There are over 70-plus federal welfare programs. The American people believe there should be work requirements for all those programs for able-bodied healthy adults,’ said Rep. Jason Smith of Missouri, who is vying to lead the House Ways and Means Committee.” [Fox News, 10/19/22]

Washington Post: GOP To Use Debt Limit To Force Spending Cuts, McCarthy Says. “Sen. Ron Johnson (R-Wis.) has suggested that Social Security and Medicare be eliminated as federal entitlement programs, and that they should instead become programs approved by Congress on an annual basis as discretionary spending. … In an interview in August, Johnson, who is seeking a third term in the Senate, lamented that the Social Security and Medicare programs automatically grant benefits to those who meet the qualifications — that is, to those who had been paying into the system over their working life. ‘If you qualify for the entitlement, you just get it no matter what the cost,’ Johnson said. ‘And our problem in this country is that more than 70 percent of our federal budget, of our federal spending, is all mandatory spending. It’s on automatic pilot.’” [Washington Post, 10/18/22]

Bloomberg: House GOP’s Scalise Defends Medicare, Social Security Plans. “Scalise is a member of largest House GOP caucus, the Republican Study Committee, which has proposed changes that would result in lower benefits for some future recipients. Scalise’s office said in an email he hasn’t specifically signed on to the RSC plan, however. … The RSC proposal would gradually raise the eligibility ages for both programs and slow the growth of benefits for higher earners in Social Security.  Medicare would transition to a new model where seniors would receive premium subsidies to buy a government run public option or privately run insurance.” [Bloomberg, 10/16/22]

Bloomberg: Entitlement, Spending Cap Plans Linked by GOP to Debt-Limit Deal. “The four Republicans interested in serving as House Budget Committee chairman in the next Congress said in interviews that next year’s deadline to raise or suspend the debt ceiling is a point of leverage if their party can win control of the House in the November midterm elections. The Republican position — which members are still formulating — could set the stage for an explosive standoff next year, reminiscent of the 2011 negotiations when the Tea Party wave of Republicans took on the Obama administration over spending.” [Bloomberg, 10/11/22]

Coverage is More Affordable Than Ever Before Thanks to The Inflation Reduction Act

Yesterday, the Department of Health and Human Services announced that 16.3 million people have signed up for health coverage during the 2023 open enrollment period. This represents a record number of Americans who signed up for coverage under the Affordable Care Act (ACA). This is more than a 12 percent increase from the same time last year. In California, New Jersey, New York, Rhode Island, and Washington DC, residents can continue to sign up for coverage through January 31. 

President Biden and Democrats in Congress have made incredible progress to ensure millions more Americans have the health care they deserve. This includes passing the American Rescue Plan and the Inflation Reduction Act, which provided enhanced premium tax credits to make coverage more affordable than ever before. The Biden administration also funded the  Navigator program with the single-largest investment ever to focus on outreach to racial and ethnic minorities, people in rural areas, LGBTQ+ people, and other underserved communities. In addition, the Biden administration fixed the family glitch, which previously blocked millions of families from receiving affordable coverage under the ACA, allowing an estimated 200,000 uninsured Americans to gain coverage and save hundreds of dollars each month on health premiums. President Biden and Congressional Democrats are to thank for this immensely successful open enrollment period.

HEADLINES

The New York Times: Record 16 Million Sign Up for Affordable Care Plans. “The growing enrollment follows the passage of legislation during the coronavirus pandemic to increase federal subsidies for people buying the plans — substantially lowering prices for nearly every American who buys their own insurance. Around 3.6 million people selected plans in the Obamacare marketplaces who did not receive coverage through them last year. Last year’s total had been the highest in the law’s history.” [The New York Times, 1/25/23]

The Hill: A Record of Over 16 Million People Signed Up for Insurance Through Obamacare. “More than 16.3 million people enrolled in a health plan through the Affordable Care Act (ACA) during the most recent open enrollment period, marking the highest number of enrollees since the program was signed into law 10 years ago.” [The Hill, 1/25/23]

Reuters: U.S. Signs Up Over 16 Million People for Obamacare Health Insurance. “About 12 million people enrolled from the 33 U.S. states that use the online marketplace funded by the federal government and about 4 million people from states that sell the insurance directly to their residents…About 3.6 million people who have signed up for the plans are new enrollees, White House Domestic Policy Advisor Susan Rice said on a press call.” [Reuters, 1/25/23]

CNN: Obamacare Sign-Ups Soar to Record 16.3 Million for 2023. “Sign-ups on the federal exchange, healthcare.gov, have skyrocketed nearly 50% since the Biden administration took office in 2021, thanks in large part to enhanced federal premium subsidies and increased outreach efforts. Plan selections are up 13% from this time last year.” [CNN, 1/25/23]

(AZ) Cronkite News: Record Numbers Sign Up for Obamacare Health Coverage in Arizona, U.S. “A record number of Arizonans signed up for health insurance this year under the Affordable Care Act, as enrollment in the program continues to rebound from the Trump administration’s efforts to suppress coverage…who trimmed funding and outreach and shortened the open enrollment period in an effort to handicap the ACA. President Joe Biden reversed those efforts shortly after taking office.” [Cronkite News, 1/25/23]

(FL) Miami Herald: Florida Sets Record in Obamacare Enrollment as People Clamor for Health Insurance. “In Florida, enrollment ballooned to 3.2 million, a 19% jump over last year’s open enrollment period under the health law, commonly known as Obamacare. The 3.2 million represents 20 percent of all enrollees nationwide, even though Florida, the third most populous state in the country with 22 million people, accounts for only about 7 percent of the U.S. population.” [Miami Herald, 1/26/23]

(MD) The Baltimore Sun: Obamacare Enrollment Increased for 2023 Coverage in Maryland With More Black, Hispanic Participants. “The number of Marylanders who enrolled in health coverage for 2023 through the state insurance exchange increased slightly from last year, to a record 182,166, the Maryland Health Benefit Exchange announced in a news release Tuesday.Although total enrollment in what is known as Obamacare only climbed by about 560 people from 2022, enrollment continued to grow for members of communities that are more likely to lack coverage, such as Black and Hispanic residents.” [The Baltimore Sun, 1/24/23]

(NV) KSNV: Nearly 100,000 Nevadans Signed Up for Health Insurance This Year. “Nevada Health Link has announced that nearly 100,000 Nevadans have enrolled in qualified, affordable health insurance plans during this year’s Open Enrollment Period (OEP), which ran from November 1, 2022, through January 15, 2023…This year’s Open Enrollment was Nevada Health Link’s second highest to record, just down less than 5% from last year’s record-breaking Open Enrollment.” [KSNV, 1/24/23]

(GA) The Taccoa Record: Affordable Care Act Achieves Record Number in Georgia. “A record number of Georgians – over 846,000 – signed up for health insurance for 2023 under the Affordable Care Act during the latest open enrollment period, which ended on Sunday. That’s about 8 percent of the state’s population, and at least 145,000 more than signed up for the program last year.” [The Taccoa Record, 1/23/23]

Seniors Are Already Saving Big After the Inflation Reduction Act’s Insulin Cap Took Effect January 1 

New estimates from the Department of Health and Human Services found that 1.5 Million seniors using insulin would have saved hundreds of dollars annually had the Inflation Reduction Act taken effect in 2020. In total, Medicare beneficiaries would have saved $761 million on insulin costs in 2020 — an average of $500 per patient. As insulin costs continue to skyrocket, the Inflation Reduction Act’s insulin cap is a godsend for seniors who have little to spare. 

HEADLINES 

(GA) Atlanta Journal-Constitution: HHS Says Americans Already Seeing Benefits Of New Insulin Price Cap. “The U.S. Department of Health and Human Services estimated that a $35 cap on monthly insulin costs for Medicare enrollees that took effect Jan. 1, will save Georgians over $21 million. The monthly cap in out-of-pocket costs for insulin was made under a provision of the larger Inflation Reduction Act, targeted to ease financial strains on people covered by Medicare.” [Atlanta Journal-Constitution, 1/25/23] 

(OH) Cleveland.com: Ohioans On Medicare Will Save More Than $36 Million Yearly On Insulin Under New Law, Feds Predict. “The U.S. Department of Health and Human Services announced Tuesday that a new law that caps monthly out-of-pocket insulin costs for Medicare beneficiaries at $35 will likely save more than $36 million in yearly costs for more than 72,000 Medicare beneficiaries in Ohio. Using statistics from 2020, a new report from HHS says the $35 monthly cap on out-of-pocket insulin costs, which went into effect on Jan. 1 as part of the Inflation Reduction Act, would have saved 1.5 million Americans who use Medicare an average of $500 in their insulin costs that year.” [Cleveland.com, 1/24/23] 

(PA) Philadelphia Inquirer: How Much Will People With Diabetes In Pa. And N.J. Save With The New Medicare Insulin Cap? “The Department of Health and Human Services estimates the change will save insulin users an average of $500 a year, based on 2020 medication costs. In Pennsylvania, nearly 80,200 people stand to save an average of $543 a year. And in New Jersey, about 39,600 insulin users with Medicare could save an average of $511 a year, according to HHS estimates. … The insulin price cap is one of several measures in the Inflation Reduction Act intended to stem high and rising prescription-drug costs. The legislation also allowed Medicare to begin negotiating prices for a small number of high-use medications and capped the total amount people with Medicare can pay for prescription drugs.” [Philadelphia Inquirer, 1/24/23] 

(VA) Richmond Times-Dispatch: Cap On Insulin Said To Save $18.6 Million A Year For More Than 36,000 Virginians. “More than 36,000 Virginians with diabetes will collectively save $18.6 million a year on the purchase of insulin under federal legislation that capped out-of-pocket costs at $35 a month, effective Jan. 1 for most Medicare members, a federal agency says. The cap, part of the Inflation Reduction Act that President Joe Biden signed into law last year, would save the average Virginian an estimated $510 a year on insulin, according to a national study the White House released Tuesday morning.” [Richmond Times-Dispatch, 1/24/23] 

(CT) CT Insider: New Monthly Savings on Insulin for Medicare Enrollees. “1.5 million Americans who are on Medicare Part B and D would have saved an average of about $500 in 2020 if the insulin cost-sharing limit were in place. In Connecticut specifically, seniors would have saved slightly above the average out-of-pocket savings for Medicare beneficiaries across the U.S. About 11,444 Medicare enrollees in Connecticut would have received out-of-pocket savings in 2020 under the Inflation Reduction Act. Those beneficiaries would have saved an estimated total of about $6.7 million with an average annual savings of $590 per enrollee.” [CT Insider, 1/25/23]

(NJ) NJ.com: Here is How Much New Jerseyans Will Save With New Insulin Price Cap. “Medicare recipients won’t have to pay more than $35 a month for insulin, and that should save nearly 40,000 New Jersey residents an average of $511 a year, the U.S. Department of Health and Human Services said Tuesday. Had the new benefit been in effect in 2020, that would have saved 39,641 New Jersey recipients $20.2 million, the agency said as officials touted the provision, which was part of last year’s climate change and health care law that passed Congress without Republican support and was signed by President Joe Biden.” [NJ.com, 1/24/23]

(MD) New Year, New Rules. Maryland Diabetics Won’t Have To Break The Bank For Insulin In 2023. “Hundreds of thousands of Maryland residents with diabetes will have one less thing to stress about in the New Year: the volatile cost of insulin, a lifesaving medication that enables chronically ill people with diabetes to keep their blood sugar in a safe range. That’s because new laws at the state and federal level cap the price of insulin for patients who are covered by Medicare and those with commercial insurance policies. In August, Congress passed the Inflation Reduction Act, a wide-ranging law that mandates all individuals covered by Medicare won’t pay more than $35 for a month’s supply of insulin, or $420 each year… Maryland’s new state law caps the patient cost for a 30-day supply of insulin to $30 or below, even for patients with private commercial insurance plans often through an employer.” [WYPR News, 12/30/23]

(CO) KRDO: New HHS Report Finds More Savings for Colorado Seniors. “Insulin-dependent seniors are getting some unexpected relief, thanks to president Biden’s Inflation Reduction Act. At the start of this year, a cap of $35 was placed on a monthly supply of insulin for seniors. A new report from the U.S. Department of Health and Human Services shows that if this cap had been implemented in 2020, Medicaid beneficiaries would have saved an average of $500. Researchers say this cap will affect about 1.5 million seniors across the country. White House advocates say, this provision – and other parts of the Inflation Reduction act – are evidence of president Biden’s promise to lower health care costs in America.” [KRDO, 1/25/23]

(TN) Chattanooga Times Free Press: How Much Will Tennesseans With Medicare Save Due to Insulin Cap? “The White House estimates that Tennesseans on Medicare who take insulin will save on average $494 per year with the new $35 monthly out-of-pocket spending cap on the drug, a provision of the Inflation Reduction Act that’s now in effect. Cost savings estimates are based on a report from the U.S. Department of Health and Human Services released Tuesday. The report is based on Medicare prescription data from 2020, at which time there were 39,562 Medicare enrollees in Tennessee who filled insulin prescriptions. During a media call Tuesday, Dr. Ben Sommers, deputy assistant secretary for health policy at Health and Human Services, said the data may not include thousands or more Medicare beneficiaries who didn’t pick up the insulin because they couldn’t afford it. According to the release, 37% of insulin prescription fills for people with Medicare in 2019 required beneficiaries to pay more than $35 out of pocket, including 24% that exceeded $70 per fill.” [Chattanooga Times Free Press, 1/24/23]

(TX) KVIA: Insulin Price Cap Helping El Paso Medicare Recipients Save Money. “El Pasoans on Medicare part D will not have to pay more than $35 a month for their insulin, thanks to the Inflation Reduction Act. Currently, only patients on Medicare part D are covered, but according to Health and Human Services Agency, starting in July, diabetes patients on Medicare part B will have access to the same savings. According to the El Paso Center for Diabetes, 13.9% of people in the El Paso region have diabetes. That compares to 10.5% of people in the United States. This includes people with both Type 1 and Type 2 diabetes. The local diabetes center added that the $35 cap is going to alleviate some of the burdens, especially for our seniors who are on a fixed income. They said many seniors wouldn’t have to choose between paying rent or groceries over their life-saving insulin.” [KVIA, 1/24/23]

Coverage is More Affordable Than Ever Before Thanks to President Biden and Democrats in Congress

Washington, DC — Today, the Department of Health and Human Services announced that 16.3 million people have signed up for health coverage during the 2023 open enrollment period. This represents a record number of Americans who signed up for coverage under the Affordable Care Act. This is more than a 12 percent increase from the same time last year. In California, New Jersey, New York, Rhode Island, and Washington DC, residents can continue to sign up for coverage through January 31. 

President Biden and Democrats in Congress have made incredible progress to ensure millions more Americans have the health care they deserve. This includes passing the American Rescue Plan, the Inflation Reduction Act, and funding the Navigator program with the single-largest investment ever to focus on outreach to racial and ethnic minorities, people in rural areas, LGBTQ+ people, and other underserved communities. In addition, the Biden administration solved the family glitch, which previously blocked millions of families from receiving affordable coverage under the ACA, was also eliminated, allowing an estimated 200,000 uninsured Americans to gain coverage and save hundreds of dollars each month on health premiums. The work put in by President Biden and Congressional Democrats is to thank for this immensely successful open enrollment period. In response, Protect Our Care Executive Director Leslie Dach issued the following statement: 

“President Biden and Democrats in Congress deserve all the credit for the success of this open enrollment period. Health insurance is more affordable than ever as a direct result of Democratic leadership. While Republicans opposed every move and spent years trying to dismantle the Affordable Care Act, President Biden and Democrats delivered on their promise to protect and expand it. By eliminating the family glitch rule and passing the American Rescue Plan and the Inflation Reduction Act, these strides made health care through the ACA marketplaces more affordable than ever before. The Biden administration also funded the Navigator program with the single-largest investment ever to help connect underserved communities to the care they so desperately need.

“President Biden and Congressional Democrats will not give up the fight until every American has access to the high-quality, affordable health care they need to thrive. The nation’s uninsured rate is at the lowest it has ever been in history. 16.3 Million Americans signing up for coverage is a big deal. These record numbers show that Americans want and need the affordable, quality health care made possible through the ACA.”

***MEDIA ADVISORY FOR WEDNESDAY, JANUARY 25 AT 11:30AM EST***

Thanks to the Inflation Reduction Act, Pennsylvania seniors are saving on health care costs

Philadelphia, PA – On Wednesday, January 25 at 11:30AM, Senator Bob Casey, Dr. Ala Stanford, PA Health Access Network (PHAN), and health care advocates will join Protect Our Care Pennsylvania to highlight how seniors in Pennsylvania and across the country are saving on insulin costs and life-saving vaccines thanks to the Inflation Reduction Act.

The Inflation Reduction Act is lowering costs and improving health care for millions of Americans – including the record number who purchased ACA marketplace coverage with lower premiums for 2023 thanks to the Advanced Premium Tax Credits extended under the Inflation Reduction Act. Additionally, effective January 1, 2023, insulin copays are capped at $35 per month for more than three million people with diabetes covered by Medicare. Additionally, all adults on Medicare Part D have access to covered vaccines, such as shingles and Tdap, at no cost. These policies alone will save seniors in Pennsylvania and across the country hundreds of dollars on their health care costs, keep millions of people healthy, and prevent dangerous complications associated with diabetes, shingles, and other serious diseases.

Speakers will discuss how these provisions are keeping costs low for Pennsylvanians, discuss additional savings to come, and highlight how seniors in the state can access these benefits.

WHO:
U.S. Senator Bob Casey
U.S. Department of Health and Human Services Region III Director Dr. Ala Stanford
Antoinette Kraus, Executive Director, Pennsylvania Health Access Network (PHAN)
Peggy Walsh of Bucks County, a senior who delayed shingles vaccine due to cost
Michael Berman, Protect Our Care Pennsylvania

WHAT: Virtual Press and Constituent Briefing

WHEN: Wednesday, January 25 at 11:30AM EST

WHERE: Register to join the Zoom event (Registration required)

Washington DC — Yesterday, U.S. Senator Jeanne Shaheen (D-NH) reintroduced legislation to lower health care costs and extend affordable coverage to millions of Americans. The Improving Health Insurance Affordability Act would make permanent enhanced tax credits passed under the Inflation Reduction Act and make health care even more affordable for millions of Americans. In response, Protect Our Care Chair Leslie Dach issued the following statement: 

“Senator Shaheen is a true health care champion. Her leadership was key to the passage of the  Inflation Reduction Act, which is reducing the cost of health care premiums by $2,400 for the average family purchasing insurance on the ACA marketplace and helping the uninsured rate reach an all-time low. Increasing coverage means millions of families can finally afford quality care without sacrificing other basic needs like gas, child care, and rent. This added peace of mind is especially beneficial for communities of color and Americans in rural areas. The Inflation Reduction Act’s lifesaving tax credits should now be made permanent. Polling shows that health care remains a top issue for voters and that the American people want their elected officials to continue making progress to lower costs and improve care. The Improving Health Insurance Affordability Act is an essential next step to deliver on these promises and work toward a future where everyone can get the care they need to live longer, healthier lives.”

This week, we spotlight the recent 7th Annual Day of Racial Healing, new academic initiatives to build the workforce of the future, state and local-level action to promote equity, academic-industry partnerships to generate better information to guide ongoing health promotion efforts, and new national research that underscores the urgency of these issues. 

Addressing systemic racial, ethnic, and other inequities in health is among the most pressing issues in America. The causes of these inequities, and the corresponding actions needed to tackle them head on, are multi-faceted. As it stands, marginalized communities, including people of color, rural Americans, LGBTQ+ people, and people with disabilities, face worse access to quality, affordable health coverage, which contributes to dangerous health outcomes.

Protect Our Care is dedicated to making high-quality, affordable and equitable health care a right, and not a privilege, for everyone in America. 

7TH ANNUAL NATIONAL DAY OF RACIAL HEALING 

EIN Newswire: The National Collaborative for Health Equity Launches New Scholarly Papers on Racial Health Equity to Mark the 7th Annual National Day of Racial Healing. “Celebrating the 7th annual National Day of Racial Healing, the National Collaborative for Health Equity (NCHE) today released an inspiring roundtable discussion with NCHE Senior Scholars on striving for racial equity and announced the launch of their new podcast series, NCHE PRESENTS: Leaders Pursuing Health Equity In America. It was seven years ago today that the National Day of Racial Healing was launched by the W. K. Kellogg Foundation as part of a comprehensive framework that calls for acknowledgement of the pain caused by racism and provides concrete methods of healing the wounds of the past and moving forward towards racial equity in our communities. The next issue of Health Equity, which will be published on January 20, 2023, will include articles by the NCHE Senior Scholars. Their work aligns with the pillars of a framework that engages communities, organizations, and individuals from multiple sectors across the United States in racial healing and addressing present-day inequities linked to historic and contemporary beliefs in a hierarchy of human value.” [EIN Newswire, 1/17/23]

Every Child Thrives: Calls for Solidarity After the National Day of Racial Healing. “We celebrated the 7th National Day of Racial Healing this week with millions of others across the country. While a major milestone moment, racial healing is not limited to a single moment in time. Each of us – with our families, friends, neighbors, co-workers and communities – can show up 365 days a year to act on a commitment to racial healing. Perhaps you participated in an event, watched the town hall on MSNBC or Telemundo or discovered new resources. But what’s next? What are some ways you can take action to advance racial healing throughout the year? Engaging with the Solidarity Council on Racial Equity (SCoRE) is a great way to start! Through SCoRE, the Kellogg Foundation works in partnership with global change leaders in advocacy, the arts, business, education, faith and media. Each of these changemakers stands at the forefront of equity in the public arena, and each is celebrated in their professional sphere. SCoRE members draw people toward collaboration in pursuit of healing, racial progress and transformation. They work individually and collaboratively, and stand collectively – inspiring others to dismantle systemic injustice. They demonstrate throughout the year ways each one of us has a role in this effort.” [Every Child Thrives, 1/19/23]

WORKFORCE AND EDUCATIONAL INITIATIVES

Nashville Post: Meharry Set to Establish a New School of Public Health. “Meharry Medical College announced Wednesday that it has launched a Global Health Equity Institute. The institute serves as the first step in creating a school for global public health. Meharry is touted as the first historically black college or university to establish such a school, according to a press release. The goal is to open the school by 2026. National Health Equity figure Daniel Dawes will lead the institute and plans to establish the future school. He will also work to earn accreditation and hire 21 faculty members. Dawes was formerly executive director of the Satcher Health Leadership Institute, the health equity and advocacy branch of the Morehouse School of Medicine in Atlanta. He announced his move to Meharry in December. [Nashville Post, 1/19/23]

PR Newswire: Xavier University and Ochsner Health Partner to Create a New HBCU College of Medicine. “The two institutions will create a strong physician pipeline that addresses longstanding inequities within the nation’s health care system and builds the health care workforce of the future. This initiative builds on a long-standing partnership between Ochsner and Xavier that dates to the early 1980s, when Ochsner and Xavier’s College of Pharmacy came together to offer more clinical training sites for pharmacy students. Xavier’s College of Pharmacy is the oldest in Louisiana and has for years been among the top in the nation in producing African American graduates with Doctor of Pharmacy degrees. To launch the College of Medicine, Ochsner and Xavier will form a nonprofit corporation, create a new curriculum and use facilities, personnel, and administrative processes of both institutions. The new College of Medicine will be governed by a board of directors nominated by Ochsner and Xavier, with each institution appointing an equal number of directors.” [PR Newswire, 1/17/23]

Patient Engagement HIT: The Potential of Value-Based Care Models to Create More Equitable Patient Care. “Medical Home Network (MHN) isn’t new to care coordination. For 20 years, the Chicago-based accountable care organization (ACO) has focused on bringing care coordination into the primary care office, using community health workers to provide whole-person care. But now, as a part of the ACO REACH Model, MHN looks forward to a future free from the constraints of fee-for-service and focused on health equity and social determinants of health. CMS launched the ACO REACH (Realizing Equity, Access, and Community Health) model in February 2022 as a replacement for the Global and Professional Direct Contracting model. The agency said ACO REACH will promote health equity and address health disparities while centering provider-led organizations. When an organization participates in a capitated value-based care model, it enjoys more freedom to innovate in community-based care. An organization like MHN participating in ACO REACH will be totally focused on outcomes, [Abigail] DeVries said, and less on fee-for-service. DeVries indicated that something like the ACO REACH model is a key solution to ensure traditionally marginalized patients—who mostly visit FQHCs or else get their care from high-acuity settings like the emergency department—would be left behind. But that emphasis on traditionally underserved groups is made evident through certain parameters that participants must hit as part of ACO REACH. For one thing, MHN must report on its health equity data as part of its participation in the model. A separate $250,000 grant from the Health Resources and Services Administration (HRSA) will help MHN train unlicensed folks as community health workers to support maternal health coaching efforts. These community health workers will be part of the care team, helping to coach during pregnancy and offering support post-partum.” [Patient Engagement HIT, 1/9/23]

Health Leaders: Duke and Evidation Partner to Combat Inequities in the Digital Health Studies. “Duke University is joining forces with a California-based digital health firm to develop technology to measure health equity in clinical studies. Studies indicate that racial and ethnic minorities only comprise 6% of clinical trial populations, yet account for 28% of the US population. Duke’s BIG IDEAs Lab uses biomedical and health data to create programs for the early detection, intervention, and prevention of disease. This includes projects that highlight ‘improved health monitoring through personalized, real-time risk classification and tailored, remote intervention strategies.’ ‘Inclusion of underserved and underrepresented populations in research and study adherence among all groups are key challenges for enabling patient-centered healthcare,’ added Iredia M. Olaye, PhD, MSc, MHA, a member of Evidation and the Covered By Group investment and advisory firm.” [Health Leaders, 1/17/23]

Healthcare Innovation: Notre Dame and Accenture Launch New Health Equity Data Lab. “On Jan. 4, South Bend, Ind.-based University of Notre Dame announced via a press release it is partnering with Accenture to launch a health equity data lab. ‘With the support of a gift from Accenture, the first undertaking for the lab is the Accenture Health Equity Data project, led by Nitesh Chawla, the institute’s founding director and the Frank M. Freimann Professor of Computer Science and Engineering. Accenture has also committed to a fundraising campaign with its employees and alumni, including those who have ties to Notre Dame, over a three-year period.’ The Accenture Health Equity Data project will use artificial intelligence and machine learning to address healthcare challenges. The project will convene a business forum of leaders that include academics, government, corporations, and non-governmental organizations to talk about specific community healthcare inequities and solutions.” [Healthcare Innovation, 1/9/23]

CHALLENGES

Health Affairs: New Study Shows Inequities of Care Along Racial Lines for Medicare Recipients Struggling with Mental Health and Substance Abuse Disorders. “Medicare introduced cost-sharing parity for outpatient MHSUD care during the period 2010–14, reducing beneficiaries’ out-of-pocket share of MHSUD spending from 50 percent to 20 percent. Among traditional Medicare beneficiaries ages sixty-five and older, we examined changes in MHSUD use and spending during the period 2008–18 for low-income beneficiaries with the cost-sharing reduction versus a control group of beneficiaries with free care throughout the study period among Black, Hispanic, Asian, and American Indian/Alaska Native versus White beneficiaries. Among older Medicare beneficiaries, overall use of MHSUD services increased during this period. For White beneficiaries, MHSUD cost-sharing parity was associated with an increased likelihood of having specialty MHSUD visits and medication use and a reduced likelihood of having unmonitored MHSUD medication use and MHSUD emergency department visits and hospitalizations. However, cost-sharing parity was associated with smaller or no gains in MHSUD services use for racial and ethnic minority beneficiaries compared with White beneficiaries, thus widening racial and ethnic disparities in MHSUD care.” [Health Affairs, 1/9/23]

CBS News: Trans Patients Are Struggling to Find Doctors in Rural America. “Accurately counting the number of transgender people in rural America is hindered by a lack of U.S. census data and uniform state data. However, the Movement Advancement Project, a nonprofit organization that advocates for LGBTQ+ issues, used 2014-17 Centers for Disease Control and Prevention data from selected ZIP codes in 35 states to estimate that roughly 1 in 6 transgender adults in the U.S. live in a rural area. When that report was released in 2019, there were an estimated 1.4 million transgender people 13 and older nationwide. That number is now at least 1.6 million, according to the Williams Institute, a nonprofit think tank at the UCLA School of Law. One in 3 trans people in rural areas experienced discrimination by a health care provider in the year leading up to the 2015 U.S. Transgender Survey Report, according to an analysis by MAP. Additionally, a third of all trans individuals report having to teach their doctor about their health care needs to receive appropriate care, and 62% worry about being negatively judged by a health care provider because of their sexual orientation or gender identity, according to data collected by the Williams Institute and other organizations. A lack of local rural providers knowledgeable in trans care can mean long drives to gender-affirming clinics in metropolitan areas. Rural trans people are three times as likely as all transgender adults to travel 25 to 49 miles for routine care.” [CBS News, 1/20/23]

Axios: Mothers in States Which Have Banned Abortion Almost Three Times As Likely to Die. “The U.S. has the highest maternal mortality rate among developed nations, and government officials and health experts are concerned that conditions will worsen now that a federal right to abortion has been struck down. The Gender Equity Policy Institute divided states into three groups — supportive of abortion access, restrictive and banned — and compared data on reproductive health outcomes between 2015 and 2021. 29 states were in the ‘banned’ and ‘restrictive categories’ and 21 states and the District of Columbia were in the ‘supportive’ category. The report found that maternal mortality rates in states with bans was “significantly higher” than in supportive states. In 2018, the maternal mortality rate in banned states was nearly two times higher than in supportive states, by 2021, it was 2.4 times higher. Maternal mortality weighed heaviest on women of color: Native American women’s maternal mortality rates were 4.5 times higher than those of white women and Black women’s rates were 2.6 times the rate of white women.” [Axios, 1/19/23]

Fatherly: Wealthiest Black Moms Are More Likely to Die During Childbirth Than the Poorest White Moms. “When women in America suffer, Black women suffer the most. Never is this truer than when it comes to pregnancy, where staggering racial disparities in maternal and infant health represent an ongoing public health crisis in dire need of solutions. Here, in the only industrialized country where overall maternal mortality is rising, Black women remain between three and four times more likely than their white or Hispanic counterparts to die from pregnancy-related complications. And although Black women suffer above-average rates of pregnancy-related complications such as preeclampsia, uterine fibroids, and preterm birth, they’re also less likely to have access to quality care, creating a double-edged sword with compounding factors on both sides. A new study finds that even the wealthiest Black women are unable to escape this harm. In fact, the effects caused by structural racism are so strong that even the wealthiest Black women and their newborns experience worse outcomes than those from the lowest-income white families. In other words, the maternal health gap is a trap of systemic racism with roots so deep that no amount of money can buy a Black woman a path out of it. And because the data used in the study all came from California, a state that regularly lands way above national averages for different maternal health metrics, these trends are likely to also be true elsewhere in the country — and may even be more exaggerated in other states.” [Fatherly, 1/7/23]

Healio: Social Factors Linked to Health Disparities in Black and White Prostate Cancer Patient Outcomes. “A relationship between race and social determinants of health contributed to significantly higher prostate cancer-specific morality among Black men in the United States, results of a meta-analysis in JAMA Network Open showed. Previous studies of Black men in the U.S. with prostate cancer showed consistent disparities in social determinants of health that have been associated with poorer health care outcomes, according to Randy A. Vince Jr., MD, MS, of University Hospitals Urology Institute and UH Seidman Cancer Center in Cleveland, and colleagues. The study population comprised 1,019,908 men (median age, 66.4 years; interquartile range [IQR], 64.8-69), including 843,880 white men and 176,028 Black men. [T]he investigators observed significant interactions between race and social determinants of health for both PCSM (regression coefficient = –0.041; 95% CI, –0.059 to 0.023) and OS (meta-regression coefficient = –0.017; 95% CI, –0.033 to –0.002).” [Healio, 1/11/23]

Washington Post: Natural Disasters Further Emphasizing Racial Health Disparities in Cities Like Buffalo. “The recent Christmas blizzard in Buffalo was one for the ages, dropping more than 50 inches of snow — and putting the city over 100 inches for the season, a bit more than its average annual total. Now many Buffalo residents are making legitimate complaints about how unevenly the weather and the snow have affected Black and White residents. Most tragically, Black people have been overrepresented among the dead. Community leaders point out that Buffalo’s whiter neighborhoods and suburbs were better prepared for the weather. And in the aftermath of the storm, their streets were cleared of snow more quickly than those in Black neighborhoods. Great Lakes cities are as familiar with segregation as they are with snow. The region is well-represented on lists of the country’s most segregated cities, especially when it comes to Black-White segregation. To be sure, the Rust Belt is not the only part of the United States with separate neighborhoods for Blacks and Whites. Crises have exposed similar disparities in the South and West — for example, Houston’s uneven recovery from Hurricane Harvey and the decades-in-the-making water crisis in Jackson, Miss. Clearly, unequal support for Black and White neighborhoods is not uniquely a Buffalo problem. Nor can it be solved simply by electing Black leaders. Buffalo has had a Black mayor, Byron Brown, since 2006. Black voters have long since learned that solving a systemic problem requires far more than changing who’s in office.” [Washington Post, 12/31/22]

Washington DC — News reports indicate President Joe Biden is expected to name Jeff Zients as his next chief of staff. Zients gained his reputation as a strong, skilled manager after running the Biden administration’s response to the COVID-19 pandemic and serving in key positions in the Obama administration, including Acting OMB Director and Director of the National Economic Council. In response, Protect Our Care Chair Leslie Dach issued the following statement: 

“Jeff Zients is an outstanding choice for the next White House chief of staff. Ron Klain is stepping down after helping lead the Biden administration through two years of historic accomplishments, including by delivering the most important health care reform since the Affordable Care Act. Jeff is the right choice to lead the next stage of President Biden’s highly successful presidency. I’ve had the privilege of working with Jeff in both the Obama and Biden administrations and have seen firsthand Jeff’s ability to navigate the most difficult challenges, inspire teams, and deliver for the American people. 

“When President Biden took office, Jeff fearlessly led the COVID-19 task force, helping get shots in arms and steering the country through the public health crisis. His work saved hundreds of thousands of lives. In the Obama administration, he led the effort to get the ACA website to fully deliver on the promise of expanding affordable health care for all Americans. He was an integral part of the president’s economic team and brought jobs and growth across the country.  We look forward to working with Jeff to make health care better, more affordable, and more equitable, and to stop Republican efforts to gut the ACA, the Inflation Reduction Act, Medicaid, and Medicare.”