Skip to main content
Category

Roundup

Roundup: Medical Community Supports Xavier Becerra’s Nomination As HHS Secretary

Xavier Becerra, President Biden’s pick to lead the Department of Health and Human Services, has strong support from the medical community. The top experts who know health care the best praise his willingness to work with medical experts, his trust in science, and his decades of experience advancing health policies to improve the lives of Americans. Becerra is deeply committed to ending the pandemic, addressing racial disparities in health care, and making health care more affordable. The support of these well respected health care groups show Becerra is a highly qualified nominee who knows what’s at stake and who will work to ensure a healthy future for all Americans.

American College of Clinical Pharmacy: “We urge swift confirmation of Attorney General Becerra as HHS Secretary… As communities across the country struggle to respond to the COVID pandemic, a comprehensive strategy to ensure a truly team-based, patient-centered approach to patient care, consistent with evolving integrated delivery models, must be prioritized.” (Full statement)

American College of Radiology: “Becerra is incredibly qualified for this position. During his time in Congress, former Rep. Becerra worked closely with the ACR to improve the American health care system and protect patient access to high quality imaging care.” (Full statement)

The American Hospital Association: “The AHA has worked with Becerra throughout his long career as a former member of the U.S. House of Representatives, including as a member of the Ways and Means Committee’s health subcommittee. He has been a champion for health care coverage and affordable health care, which the AHA has long supported. Throughout his time in public service, it is clear that Becerra has consistently made people across America and their health a priority.” (Full statement)

American Medical Association: “The American Medical Association strongly supports the nominations of Xavier Becerra to be the next Secretary of Health and Human Services (HHS) and Vivek Murthy, M.D., to be Surgeon General of the U.S. Public Health Service. While in Congress, then-Rep. Becerra worked closely with the AMA to pass the Affordable Care Act (ACA) and eliminate the Sustainable Growth Rate. As Attorney General of California, he led a coalition of 17 states defending the ACA in the case of Texas v. United States – a case in which the AMA filed an amicus brief championing access to meaningful, affordable health care for all Americans.” (Full statement)

American Physical Therapy Association: “As a congressman, Attorney General Becerra was a staunch advocate for access to health care services. He helped lead a successful effort to eliminate arbitrary caps on seniors’ access to necessary outpatient physical therapy services and championed legislation to ultimately remedy this issue for millions of Medicare beneficiaries.” (Full statement)

American Society for Clinical Laboratory Science: “As a Congressman, Attorney General Becerra was a staunch advocate for access to health care services. Clinical laboratory scientists have a critical health care role to play and we must ensure access to clinical laboratory services is unfettered especially during this coronavirus (COVID-19) pandemic.” (Full statement)

American Society of Radiologic Technologists: “During his time in Congress, former Rep. Becerra was involved and instrumental (serving on the House Ways and Means Committee) on a wide array of health care issues and worked closely with the ASRT and the medical imaging community to improve the American health care system and ensure patient access to high quality imaging care.” (Full statement)

Association for Clinical Research Professionals: “President-Elect Biden made a wise choice in the selection of California Attorney General Xavier Becerra to lead the department at this time as the country continues to address the array of challenges the pandemic presents… Attorney General Becerra brings to the agency knowledge of the disparities in access to health services in the U.S. He is well positioned to address these disparities.” (Full statement)

Blue Shield of California: Blue Shield values Attorney General Becerra’s leadership and commitment to preserving access to affordable, comprehensive health care for millions of Californians. As Attorney General, he repeatedly defended key Affordable Care Act (ACA) protections and fought for lower drug prices.” (Full statement)

Dental Trade Alliance: “During his twelve terms in Congress, Attorney General Becerra spent much of his time working on health care issues impacting U.S. citizens as a member of the House Ways and Means Committee.” (Full statement)

Federation of American Hospitals: “Secretary-designate Becerra is, first and foremost, a champion for patients. A seasoned public servant, his lifelong commitment and dedication to public health will help him confront the many challenges that face us, from achieving health equity to reducing the cost of prescription drugs to reinforcing access to care in rural and underserved communities. He is highly qualified, time-tested, and will be ready on day 1.” (Full statement)

Home Care Association of America: “As a Congressman, Xavier Becerra was a staunch advocate for access to health care services… Attorney General Becerra brings his experience as an administrator having run the California Department of Justice since 2017. In this position he addressed an array of health and other matters that prepare him well to handle the significant challenges of running an agency as large and diverse as the U.S. Department of Health and Human Services.” (Full statement)

International Association of Forensic Nurses: “In addition to his experience on health care matters, Attorney General Becerra brings his experience as an administrator having run the California Department of Justice since 2017. In this position he addressed an array of health and other matters that prepare him well to handle the significant challenges of running an agency as large and diverse as the U.S. Department of Health and Human Services.” (Full statement)

National Mobility Equipment Dealers Association: “During his tenure in the House of Representatives, Congressman Becerra demonstrated a thorough understanding of federal programs that support the aging and disability communities – most notably the Social Security Disability Insurance, Medicare, and Medicaid programs – and made significant and meaningful contributions to disability-related policies.” (Full statement) 

National Organization of Social Security Claimants’ Representatives: “As both Ranking Member and as a member of the House of Representatives Ways and Means Social Security Subcommittee, Attorney General Becerra championed important pieces of legislation affecting the lives of millions of beneficiaries of Social Security Disability, SSI, Medicare and Medicaid. NOSSCR awarded then Congressman Becerra our ‘Award for Excellence in Social Security Disability Advocacy.’ Attorney General Becerra understands beneficiaries’ needs and the interaction between Social Security benefits, Medicare and Medicaid health insurance, and an individual’s overall wellbeing.” (Full statement)

National Alliance of Safety Net Hospitals: We worked with Mr. Becerra when he was a member of Congress and served on the House Ways and Means Committee and can attest to his understanding of the distinct challenges low-income and underserved communities face and his sincere interest in using public policy to help address those challenges.” (Full statement)

Private Essential Access Community Hospitals: “Mr. Becerra served on the House Ways and Means Committee and showed a commitment to developing and supporting public policies that reflected his understanding of the distinct challenges low-income and underserved communities face and made a difference in the lives of the people he represented. We are confident he would do the same as Secretary of Health and Human Services, including pursuing a much-needed effort to address the underlying health equity challenges that we must address as a nation.” (Full statement)

Providence: Our health system looks forward to working with Mr. Becerra in his new capacity once confirmed, as we take on critical health issues facing our nation and communities… We have had the privilege of working with Mr. Becerra during his tenure in Congress and as Attorney General in California, another state where Providence has a large footprint. We have experienced, firsthand, Mr. Becerra’s leadership in ensuring access to care for vulnerable communities and addressing racial and ethnic inequities in health care.” (Full statement)

Urgent Care Association: The HHS Secretary must work collaboratively across many organizations, including associations like UCA, to ensure integrity and effective cooperation. In addition, the Secretary should have an expansive perspective on all aspects of healthcare delivery including scopes of care, an understanding of business, legal and regulatory requirements and barriers. Attorney General Becerra is uniquely qualified and experienced in all of these areas.” (Full statement)

ROUNDUP: Drug Companies Hiked The Prices Of Nearly 1,000 Drugs In January

Multiple analyses confirm that drug companies hiked the prices of hundreds of drugs in January, as the pandemic surged across the nation. Meanwhile, new research shows that Americans are paying the price for these hikes: drugs in the U.S. are more than 2.5 times more expensive than in peer nations. These price increases come as more than one in four voters say they or a family member have been unable to afford a prescribed medication in the past year. There has never been a more urgent time to ensure that people have access to the medications they need as millions of Americans have lost jobs and their health care during the pandemic. Drug pricing remains a top issue for voters, with recent polling showing that nearly 9 in 10 say addressing high prices should be a top priority for the Biden administration. 

2021 Hikes

GoodRx Analysis Found That More Than 800 Drugs Saw Prices Increases In January — The “Largest Number Of Increases In Years.” “In January, 832 drugs increased in price by an average of 4.6%. This breaks down to 822 brand drugs and 10 generic drugs and includes all over-the-counter and healthcare practitioner-administered medications. On top of that, 175 drugs that increased this year were specialty drugs, which means that they were likely already quite expensive.” [GoodRx, 2/2/21

An Analysis From 46brooklyn Found That U.S. Saw Brand Name Drug Price Increases Surpass 900 In January 2021, The Highest In Over A Decade. “It’s official: Americans have now seen more brand-name prescription drug price increases this month than for any January in the previous decade…With a week left, this month already has seen price increases for 905 prescription drugs, which tops the mark of 895 established for all of January 2018. Unlike previous years, every price change so far has represented an increase.” [The Columbus Dispatch, 1/24/21

A Report By Patients For Affordable Drugs Found That Drug Companies Raised Prices On Over 600 Drugs At The Beginning Of The New Year, With Hikes Averaging 5 Percent. “More than 100 pharmaceutical companies raised prices on over 600 drugs at the beginning of the new year, according to a new report from the advocacy group Patients for Affordable Drugs…By the numbers: 95% of price hikes were on brand-name drugs. The median increase was about 5%, and almost all of them were greater than inflation.” [Axios, 1/14/21

3 Axis Advisors: Drugmakers To Hike Prices On More Than 300 Drugs On January 1, 2021. “Drugmakers including Pfizer Inc, Sanofi SA, and GlaxoSmithKline Plc plan to raise U.S. prices on more than 300 drugs in the United States on Jan. 1, according to drugmakers and data analyzed by healthcare research firm 3 Axis Advisors…The companies kept their price increases at 10% or below, and the largest drug companies to raise prices so far, Pfizer and Sanofi, kept nearly all of their increases 5% or less, 3 Axis said. 3 Axis is a consulting firm that works with pharmacists groups, health plans and foundation on drug pricing and supply chain issues.” [Reuters, 12/31/20

As Drug Companies Continue To Pursue Unjustified Price Hikes, Research Confirms Americans Are Paying The Price

January 2021 Report By The RAND Corporation Shows That U.S. Drug Prices Are 256% Higher Than 32 Other Countries. “Prescription drug prices in the U.S. are more than 256% higher than other 32 other countries, with the gap driven by brand-name drugs, a new report by nonpartisan RAND Corporation shows. The big picture: Drug spending in the U.S. jumped by 76% between 2000 and 2017, and the costs are expected to only increase over the next decade, per the report.” [Axios, 1/28/21

February 2021 Kaiser Family Foundation Analysis Found That Half Of All Drugs Covered By Medicare Part D Had Price Increases Between 2018 And 2019 That Outpaced Inflation. ”Our analysis finds half of all Part D-covered drugs (50%, or 1,646 drugs) had list price increases that exceeded the rate of inflation between July 2018 and July 2019, which was 1.8% (Figure 1). Among the drugs with list price increases exceeding inflation between 2018 and 2019, the median list price increase was 6.4%, or 3.5 times the rate of inflation.” [Kaiser Family Foundation, 2/4/21

January 2021 Analysis By The Institute for Clinical and Economic Review Found That Unjustified Price Hikes Of Seven Drugs Cost The U.S. $1.2 Billion In 2019. “During 2019, drug makers raised prices on seven widely used medicines by substantial amounts without any new clinical evidence to justify the increases, leading patients and insurers in the U.S. to spend an added $1.2 billion that year, according to a new analysis. For instance, Salix Pharmaceuticals raised the price on Xifaxan, its irritable bowel disease treatment, by 13%, after accounting for rebates, discounts and other fees, which led to an extra $173 million in spending had the company not raised the price. And Amgen (AMGN) boosted the price of its Enbrel medicine for rheumatoid arthritis and other ailments by 8.9%, after rebates and fees, which cost the U.S. health care system an extra $403 million.”  [Stat, 1/12/21

Roundup: Reporting on Protect Our Care’s New Polling Reinforces Findings Showing Voters’ Disapproval of Trump’s Coronavirus Response in Key Battleground States

On Thursday, Protect Our Care released a new survey conducted with Public Policy Polling in the key battleground states of Michigan, North Carolina, Pennsylvania and Wisconsin on voter attitudes towards Trump’s handling of the coronavirus. News coverage of POC’s polling reinforced the fact that majorities of voters in these key 2020 states disapprove of Trump’s handling of the coronavirus crisis, trust their governors far more and oppose relaxing social distancing and recent protests to end stay-at-home orders. 

Coverage of Protect Our Care’s Polling: 

The Hill: EXCLUSIVE: Voters In Swing States Trust Governors Over Trump On Reopening Economy, Poll Finds. “The president’s approval ratings in North Carolina, Pennsylvania and Wisconsin are 46 percent, 44 percent and 45 percent, respectively, in this poll, while his disapproval numbers stand at 49 percent, 52 percent and 48 percent. PPP surveyed more than 1,200 voters in each state on behalf of Protect Our Care, a group devoted to defending the 2010 Affordable Care Act, also known as ObamaCare. “What I think we’ve seen is that President Trump can’t bullshit his way through this pandemic. You have to show genuine competency, genuine leadership and genuine empathy,” said Brad Woodhouse, the executive director of Protect Our Care.” [The Hill, 4/23/20

NBC News: Trump’s Coronavirus Approval Rating Underwater In Key States, Surveys Find. “New surveys out Thursday show President Donald Trump’s approval rating for his handling of the coronavirus pandemic is underwater among voters in four critical states this election while state governors receive high marks for their responses to the virus. By and large, these key voters also oppose protests against stay-at-home orders and efforts to relax social distancing measures. The polling, conducted by the progressive firm, Public Policy Polling, on behalf of Protect Our Care — a left-of-center health care advocacy group — finds that 45 percent of voters in Michigan, North Carolina, Pennsylvania, and Wisconsin approve of Trump’s management of the crisis while 50 percent disapprove on average. The governors of those states, in contrast, receive a net approval rating for their handling of the pandemic that’s 32 percentage points higher than the president’s with 58 percent approving and 31 percent disapproving.” [NBC News, 4/23/20

VICE News: New Polls In 5 Swing States Are Looking Scary For Trump. “Biden is up 51%-44% in both Michigan and Pennsylvania, 50%-45% in Wisconsin, and 49%-46% in North Carolina, according to polls conducted by the Democratic firm Public Policy Polling for the liberal healthcare group Protect Our Care. Those polls also found a huge trust deficit between Trump and the states’ Democratic governors on how to handle the coronavirus. In Michigan, voters said by 57%-37% that they trusted Gov. Gretchen Whitmer (D) more than Trump on the question of who they trusted more to protect their state from the pandemic. In North Carolina, Gov. Roy Cooper (D) led by 58%-33%. In Pennsylvania, Gov. Tom Wolf (D) led by 58%-35%, and in Wisconsin Gov. Tony Evers led by 54%-39%.” [VICE News, 4/23/20

Up North News: Wisconsin Trusts Evers Over Trump on Coronavirus Reopening. “Nearly two-thirds of Wisconsinites said they oppose protesters who want to end restrictions that have slowed the spread of coronavirus. That same survey, done by Public Policy Polling, shows Gov. Tony Evers getting a net approval rating that is nearly 20 points higher than President Trump when it comes to handling the pandemic crisis.” [Up North News, 4/23/20

Wisconsin Examiner: What Is The Republican Position On The Pandemic? No, Really. “Across swing states, the polling suggests that the pandemic is hurting Trump’s re-election chances. Trump trails former Vice President Joe Biden in all four states PPP polled — Wisconsin, Michigan, Pennsylvania and North Carolina. And in all of those states, voters trust their governors significantly more than Trump. “It’s no secret why voters in these states trust their governors more than President Trump to keep them safe during this crisis – his incoherent and disastrous response continues to put their health and safety at risk,” says Protect Our Care Executive Director Brad Woodhouse, whose group commissioned the polling.” [Wisconsin Examiner, 4/24/20

Politics PA: PPP Poll: Wolf Holds Strong Approval on COVID-19, Trump Trails Biden by 7. “Another poll of battleground states shows Gov. Tom Wolf receiving high marks for his response to COVID-19 in comparison to President Donald Trump, while former Vice President Joe Biden also holds a lead in a head to head matchup over the president in the Keystone State. According to a new Public Policy Polling survey, a Democratic-affiliated polling firm that commissioned this poll with Protect Our Care, a significant majority of Pennsylvanians back Wolf’s actions in response to COVID-19, while Trump’s ratings on the issue are under water.” [Politics PA, 4/24/20

The Dispatch: The Latest Polls Bear Bad News for Trump. “When you drill down to the states most pivotal to Trump’s re-election, the numbers don’t look better. A recent Public Policy Polling survey of voters in Michigan, Pennsylvania, Wisconsin, and North Carolina found that, on average, ‘the Democratic governors of those four battleground states have a net approval rating for their job on handling the coronavirus crisis that is 32 points higher than Trump’s.’” [The Dispatch, 4/24/20

Roundup: Affordable Care Act Improves Cancer Treatment For People of Color

Research presented at the annual meeting of the American Society of Clinical Oncology this past weekend found the Affordable Care Act to be linked to a reduction in racial disparities in cancer care as well as earlier diagnosis and treatment. Here’s how these findings were covered:

Essence: While Republicans Work To Dismantle The Affordable Care Act, It’s Saving Black Cancer Patients’ Lives. “The Affordable Care Act (ACA), or Obamacare, does more than just make health care affordable to all, it’s also opening doors to life-saving treatment for Black cancer patients. New studies find that the ACA is linked to minimizing racial disparities within the care of cancer patients and earlier diagnoses for ovarian cancer patients, which often goes undetected until it spreads and becomes fatal, according to The Mayo Clinic.” [Essence, 6/3/19]

The Root: Affordable Care Act Reduces Racial Disparities In Cancer Treatment. “It turns out the Affordable Care Act may have acted to make care affordable and accessible to black folks. According to new research, the law has been linked to a reduction in racial disparities in the care of cancer patients and to earlier diagnoses and treatment for ovarian cancer, according to the Washington Post… Today, black adults in states with expanded Medicaid under the ACA are almost entirely caught up with white patients for early treatment.” [The Root, 6/2/19]

Washington Post: ACA Linked To Reduced Racial Disparities, Earlier Diagnosis And Treatment In Cancer Care. “Proponents of the embattled Affordable Care Act got additional ammunition Sunday: New research links the law to a reduction in racial disparities in the care of cancer patients and to earlier diagnoses and treatment of ovarian cancer, one of the most dangerous malignancies. According to researchers involved in the racial-disparity study, before the ACA went into effect, African Americans with advanced cancer were 4.8 percentage points less likely to start treatment for their disease within 30 days of being given a diagnosis. But today, black adults in states that expanded Medicaid under the law have almost entirely caught up with white patients in getting timely treatment, researchers said. Another study showed that after implementation of the law, ovarian cancer was diagnosed at earlier stages and that more women began treatment within a month. The speedier diagnoses and treatment were likely to have increased patients’ chances of survival, the researchers said.” [Washington Post, 6/2/19]

STAT: The Affordable Care Act Erased A Racial Disparity In Cancer Care, A New Study Says. “The expansion of Medicaid under the Affordable Care Act in 2010 nearly erased a key disparity in access to cancer care for white and African-American patients, according to a new study…Without Medicaid expansion, white patients received chemotherapy within a month of their cancer diagnosis 48.3% of the time. But African-American patients received chemotherapy within a month 43.5% of the time, 4.8-point difference. In states where Medicaid was expanded, this 4.8-point difference decreased to 0.8 points, a difference that was not statistically significant. In white patients, the Medicaid expansion increased the percent of patients who received chemotherapy in a month by two points; among African- Americans, there was a six-point change.” [STAT, 6/2/19]

CNN: Medicaid Expansion Tied To ‘Timely’ Treatment For Black Cancer Patients, Study Says. “‘The new findings came as no surprise to Dr. Georges Benjamin, executive director of the American Public Health Association, who was not involved in the research. ‘It tells you that insurance is important. Insurance matters,’ Benjamin said…So again you’re beginning to see more and more of this evidence that the states that did not expand are putting their citizens at extraordinary risk, which is preventable,’ Benjamin said. ‘They’re missing an opportunity to improve the health of their population and with this new cancer study, it shows that they’re also missing an opportunity to address issues around health equity.’” [CNN, 6/2/19]

Associated Press: More Blacks Got Timely Cancer Care Under ‘Obamacare.’ “New research suggests that states that expanded Medicaid coverage under the Affordable Care Act eliminated racial differences in being able to quickly start on treatment after a diagnosis of advanced cancer. The law that is often called “Obamacare” let states expand Medicaid eligibility and offer subsidies to help people buy health insurance.” [Associated Press, 6/2/19]

Wall Street Journal: One New Study Showed Earlier Diagnosis And Treatment Of Ovarian Cancer Under ACA. “One of the new studies concluded that the rates of diagnosis of earlier-stage ovarian cancer and start of treatment within 30 days improved after the implementation of the ACA. The study, led by researchers at Johns Hopkins University’s department of gynecology and obstetrics in Baltimore, used data on more than 70,000 patients from the National Cancer Database, which is run by medical groups and includes information about roughly 70% of newly diagnosed cancer patients…The study found a 1.7% relative improvement in early-stage ovarian-cancer diagnosis among women under 65, and a 1.6% gain in their start of treatment within 30 days of diagnosis. Dr. Anna Jo Smith, the lead study author, said the ACA improved patients’ access to primary-care doctors, which may have helped detect early-stage ovarian cancers.” [Wall Street Journal, 6/2/19]

Roundup: Trump Administration Urges States To “Demolish” Basic Structure Of Affordable Care Act

Today, the Trump administration announced its latest effort to sabotage the Affordable Care Act by mounting an unprecedented attack on the ACA’s marketplaces.

Here’s what media, experts, and patient groups had to say:

Washington Post: Trump Administration “Demolishing” Basic Rule Of Affordable Care Act That Federal Subsidies May Only Be Used To Purchase Plans In Federal Marketplace. “The Trump administration is urging states to tear down pillars of the Affordable Care Act, demolishing a basic rule that federal insurance subsidies can be used only for people buying health plans in marketplaces created under the law…The changes go beyond a variety of other steps Trump administration health officials have taken in the past year to weaken the ACA, which the president has opposed vociferously…The new steps go further by undercutting the basic ACA structure of the insurance marketplaces created for those who cannot get affordable health benefits through a job.” [Washington Post, 11/29/18]

American Lung Association: New 1332 Waiver Guidance “Would Further Erode Patient Protections, Undermine Care For People With Lung Disease.” [American Lung Association, 11/29/18]

Wall Street Journal: “The Waivers Have The Potential To Be One Of The Most Decisive Factors In Letting States Go Separate Ways On Health Care.” “The waivers have the potential to be one of the most decisive factors in letting states go separate ways on health care. Some are likely to keep the current system, where premium tax credits go to consumers who buy ACA-compliant plans on the exchanges, while others may upend much of that system altogether.” [Wall Street Journal, 11/29/18]

Larry Levitt, Senior Vice President Of Kaiser Family Foundation: New Guidance Allows States To Offer Subsidies For Plans That Do Not Cover Pre-existing Conditions And Paves Way For States To Increase Subsidies For Higher-income People And Reduce Subsidies For Lower-income People. “The Trump administration has filled in details of ACA waiver guidance, illustrating how states could restructure premium subsidies, including subsidizing lower premium plans that don’t cover pre-existing conditions…Under the new ACA waiver rules, states could restructure premium subsidies so they are based only on age and not by income, increasing subsidies for higher-income people and reducing them for lower-income people.”“ [Larry Levitt, 11/29/18]

Sabrina Corlette, Senior Research Fellow At Georgetown University’s Center On Health Insurance Reforms: It’s “Really Hard To See How Any Of These Concepts (Except Reinsurance) Can Meet The Statutory Guidelines.” [Sabrina Corlette, 11/29/18]

HealthLeaders Media: “Verma Lambastes ACA, Giving States 4 Ways To Bypass It.” [HealthLeaders Media, 11/29/18]

And here’s how legislators reacted:

Democratic Leader Nancy Pelosi: Trump Administration Is “Cynically Working To Make Health Insurance More Expensive And To Leave More Americans Without Dependable Coverage At All.” “The American people just delivered an overwhelming verdict against Republicans’ cruel assault on families’ health care.  But instead of heeding the will of the people or the requirements of the law, the Trump Administration is still cynically working to make health insurance more expensive and to leave more Americans without dependable coverage at all.The Trump Administration is trying to push more Americans into junk insurance plans that do not cover essential health care, leaving families exposed to crushing out-of-pocket costs after an injury or illness.  Meanwhile, Republicans continue to push their monstrous lawsuit to strike down the vital protections for people with pre-existing conditions.” [Democratic Leader, 11/29/18]

Sen. Patty Murray, Ranking Member Of Senate Health, Education, Labor, And Pensions Committee: “The Trump Administration Is Brazenly Warping A Tool Meant To Help States Innovate And Lower Prices So It Can Further Gut Protections For People With Pre-existing Conditions And Drive Up Health Care Costs.” “These new templates are nothing more than a how-to guide for health care sabotage. The Trump administration is brazenly warping a tool meant to help states innovate and lower prices so it can further gut protections for people with pre-existing conditions and drive up health care costs. Congress created these waivers and included guardrails to allow for innovation while making sure people could get high-quality, affordable coverage—however the Trump Administration’s guidance takes us in the opposite direction.” [U.S. Senate Committee On Health, Education, Labor & Pensions, 11/29/18]

Sen. Ron Wyden, Ranking Member Of Senate Finance Committee: Trump Administration Has Created “Fast Lane To Flood Health Care Markets With Junk Plans And Quarantine Older Americans And Those With Pre-existing Conditions Apart From Everyone Else.” “The Trump administration has created a fast lane to flood health care markets with junk plans and quarantine older Americans and those with pre-existing conditions apart from everyone else…Section 1332 was created to generate new and better ideas that improve families’ health – the Trump administration’s approach warms over old and bad ideas that increase costs for consumers and lowers the quality of care. Trump’s sabotage crusade continues to deprive working Americans with the health care security they need, and today’s news accelerates America’s slide back to the days when health care was reserved for the healthy and wealthy.” [U.S. Senate Committee On Finance, 11/29/18]

ROUNDUP: Experts Slam Trump’s Backdoor Repeal through 1332 Waivers

Experts condemned the Trump Administration’s new federal policy to water down the guardrails ensuring health insurance plans sold in states that are seeking approvals of “1332 waivers” provide the full range of benefits and the cost-sharing protections in the Affordable Care Act. Here’s a look:

Larry Levitt, Senior Vice President Of Kaiser Family Foundation: Trump 1332 Waiver Guidance Gives States Much The Same Flexibility As Repeal Would. “Republicans couldn’t repeal and replace the ACA last year, but this guidance gives states the flexibility to shift the law in much the same way…It’s hard to overstate how much flexibility states will have under the Trump administration’s new guidance for ACA waivers,” he said. “This will likely widen the gap between red states and blue states for access, affordability, regulation, and protections for pre-existing conditions.” [Business Insider, 10/22/18]

HuffPost: 1332 Waiver Rule Change “Almost Certainly Means That, Overall, People With Serious Medical Problems Are Likely To Have A Harder Time Finding Coverage.” “But Monday’s rule change almost certainly means that, overall, people with serious medical problems are likely to have a harder time finding coverage ― and, ultimately, paying their medical bills. Under guidance from the Department of Health and Human Services that takes effect immediately but likely won’t affect insurance markets for another year, state governments will have new leeway to request waivers from some of the federal health care law’s core requirements…But this latest regulatory change is a reminder that the GOP has never given up on its goal of wiping ‘Obamacare’ off the books, and that people with serious medical problems are likely to suffer as a result.” [HuffPost, 10/22/18]

Axios: The Waiver Announced Yesterday “Could Add Up To One Of Its Most Substantive Blows Yet Against The Affordable Care Act.” “As in-the-weeds as a revised waiver process sounds, the practical effects of what the Trump administration announced yesterday could add up to one of its most substantive blows yet against the Affordable Care Act…Under the Obama administration, states seeking a waiver from the ACA’s rules had to show that their alternatives would cover just as many people as the ACA, with insurance that’s just as robust, for the same cost. That’s why only 8 waivers have ever been granted. But under the Trump administration’s approach, if the same number of people have access to ACA-level coverage, that’ll count — even if few of them actually choose it.” [Axios, 10/23/18]

Sabrina Corlette, Research Professor At Georgetown University: New Guidance Essentially Means That It’s Okay If Certain Subpopulations Are Harmed So Long As Things Work Out In Aggregate. “‘The guidance under Obama… meant that a state’s plan couldn’t result in fewer people enrolled in affordable, comprehensive coverage,’ Corlette explained. ‘This new guidance is saying that so long as people in the state have ‘access’ to [comprehensive] coverage, it doesn’t matter what they actually do… If un-insurance spikes or there’s a big movement to [less comprehensive plans] a state won’t get dinged for that.’ Corlette noted that the Obama administration insisted that state waivers not hurt certain vulnerable populations, including those with severe medical needs. ‘This is saying that so long as things work out in the aggregate, then it’s OK if certain subpopulations are harmed,’ she said.” [HuffPost, 10/22/18]

Waiver Could Allow States To Let Residents Use Subsidies Intended For Comprehensive Coverage To Cover Junk Plans. “Perhaps the biggest change states could enact would involve who would receive Obamacare’s federal premium subsidies, which have been critical to sustaining enrollment in recent years. Currently, subsidies can only be used to buy policies on the exchanges and can only go to those who earn less than 400% of the poverty level (just over $48,500 for a single person or $100,000 for a family of four). States could file waivers asking to provide subsidies to those buying short-term health plans, for instance, Verma said on a call with reporters. The Trump administration is pushing these policies, which have terms of less than a year, as a more affordable alternative to Obamacare. These plans typically have lower premiums so they could be more attractive to younger and healthier people who may not need all of the benefits required under Obamacare.” [CNN, 10/22/18]

New York Times: Timing Of The Announcement Was “Puzzling” Coming Just Before An Election In Which Protection Of People With Pre-existing Conditions Has Been Top Tier Issue. “Coming two weeks before Election Day, the new policy appeared to be a political gift to Democrats, who are making health care a potent campaign theme…The timing of the announcement, just before an election in which the protection of people with pre-existing conditions has been a top-tier issue, was puzzling.” [New York Times, 10/22/18]

Trump Administration Opening Door For States To Gut Protections For People With Pre-existing Conditions. “But the latest administration proposal to weaken insurance standards comes as President Trump and Republican congressional candidates are intensifying their bid to convince voters that the GOP backs patient protections in the 2010 law, often called Obamacare…The new proposal from the Department of Health and Human Services and the Treasury Department would not explicitly scrap the law’s protections, which bar health plans from denying coverage to people with preexisting medical conditions. But the administration plan would dramatically reshape rules established by the 2010 law that were designed to prevent states from weakening these protections.” [Los Angeles Times, 10/22/18]

Roundup: Trump’s Latest Attempt To Deceive The American People

From all four corners of the internet, Trump’s pack of health care lies in USA TODAY has been exposed. People will remember this as Trump’s latest detached-from-reality attempt to cover up the truth about the GOP’s war on health care.

Within hours of posting, Trump’s article received criticism from those who know health care the best. Here’s what they had to say:

Washington Post: “Almost Every Sentence Contained A Misleading Statement Or Falsehood.” “President Trump wrote an opinion article for USA Today on Oct. 10 regarding proposals to expand Medicare to all Americans — known as Medicare-for-All — in which almost every sentence contained a misleading statement or a falsehood. Many of these are claims we have already debunked. Presumably, the president is aware of our fact checks — he even links to two — but chose to ignore the facts in service of a campaign-style op-ed.” [Washington Post, 10/10/18]

Vox: Trump’s USA Today Op-ed On Health Care Is An Absurd Tissue Of Lies. “USA Today published an op-ed bylined by President Donald Trump Wednesday morning that’s so dishonest it could almost have been Trump speaking extemporaneously at a rally. In fact, it’s so dishonest that some clever editor appears to have subversively snuck links into the text that debunk some of its key claims — it’s hard to believe that Trump or his communications staff would have done so…Follow the ‘pre-existing conditions’ link and you’ll get a Washington Post fact-check item explaining that Trump has betrayed this promise. Follow the ‘new health care insurance options’ link and you’ll find Trump talking during the campaign about allowing insurance plans to be sold across state lines, which hasn’t happened. Most importantly of all, if you follow the link for ‘eviscerated Medicare’ you find a New York Times analysis of Sen. Bernie Sanders’s Medicare-for-all plan that concludes that Medicare enrollees ‘would have more generous coverage’ under his plan. This is the core lie of Trump’s op-ed.” [Vox, 10/10/18]

New York Magazine: “The Most Perfectly Emblematic Fact About Trump’s Health-care Record Is That He Has Written An Op-ed Pointing Out That He Has Broken His Own Promises.” “The most striking thing about the op-ed, other than the ludicrous claim to have fulfilled his promise on preexisting conditions, is that it does not mention his biggest and most important health-care campaign promise: to cover everybody. Trump promised this over and over…If protections for people with preexisting conditions remain in place, it will be only because his administration loses its legal fight to eliminate them. Whether Trump is more than dimly aware of any of these facts is an open question. The most perfectly emblematic fact about Trump’s health-care record is that he has written an op-ed pointing out that he has broken his own promises.” [New York Magazine, 10/10/18]

PolitiFact: Trump’s Claims on Medicare Are “Horrible Mischaracterization.” “This is a ‘horrible mischaracterization of the proposal,’ said Linda Blumberg of the Urban Institute. Medicare for All would actually give an expanded version of traditional Medicare to everyone, with broader coverage — including items such as dental and vision care — while eliminating virtually all out of pocket costs, she said.” [PolitiFact, 10/10/18]

Michael Hiltzik For Los Angeles Times: “The op-ed Bristles With Lies And Misrepresentations.” “USA Today gave President Trump a big gift Wednesday by publishing a largely fact-free attack on the “Medicare for all” plan promoted by Sen. Bernie Sanders (I-Vt.), disguised as an op-ed written by Trump himself. In strictly factual terms, the op-ed bristles with lies and misrepresentations about Medicare for all, Medicare itself, Trump’s own healthcare policies, and Democratic and Republican approaches to Medicare.” [Los Angeles Times, 10/10/18]

NPR: “The President Is Trying To Play On The Fears Of Seniors.” “The president is trying to play on the fears of seniors — who vote in large numbers — with the claim that any effort to improve health security for younger Americans must come at their expense. But that is a false choice.” [NPR, 10/10/18]

Trump Claims Health Premiums Are Decreasing, When Some Are In Fact Rising. PolitiFact: “Trump references an article about the cost of ‘benchmark’ plans under the Affordable Care Act falling 2 percent in 2019. But it’s worth noting that the decline occurred after ACA premiums rose significantly in 2018 due to uncertainty about what the Trump administration would do with the law. In addition, ACA premiums are a minority of all private health insurance premiums. In its annual survey of health insurance benefits, Kaiser reported earlier this month that for employer-sponsored health insurance, the average premium for a solo policyholder increased 3 percent over the past year, while the average family premium increased by 5 percent. That exceeded the growth in employee wages and overall inflation.” [PolitiFact, 10/10/18]

Media Matters: “The Piece Is A Conglomeration Of Previously Debunked Distortions And Outright Lies.” “The piece is a conglomeration of previously debunked distortions and outright lies common to Trump’s stump speeches, leading several reporters to criticize the paper for its role…In one particularly gobsmacking case, USA Today allowed Trump to claim that as ‘a candidate, I promised that we would protect coverage for patients with pre-existing conditions’ and that as president, he has ‘kept that promise.’ The paper’s Twitter feed even highlighted that passage in a tweet. Republicans’ position on this issue is one of bottomless bad faith, an effort to confuse the public by saying they supports protections for people with pre-existing conditions while acting to deregulate the health insurance industry.” [Media Matters, 10/10/18]

Jim Acosta, CNN’s Chief White House Correspondent: “This Column May Break The Record For The Number Of Falsehoods From A President Ever Published In A Newspaper Op-ed.” “This column may break the record for the number of falsehoods from a President ever published in a newspaper op-Ed. Just this tweet alone is false – ‘outlaw private health care plans’ and ‘letting anyone cross our border’ Huh? Fact check: false and false. Come on USA Today.” [Acosta, 10/10/18]

Dan Gillmor, Professor At Arizona State University’s Walter Cronkite School of Journalism And Mass Communication: Op-ed “Full Of Outright Lies.” “Publishing this op-ed is journalistic malpractice. It is full of outright lies, easily demonstrated lies. Disgraceful.” [Gillmor, 10/10/18]

GQ: Publishing Lie-ridden Op-ed Launders Trump’s “Standard-issue Dishonesty Through A Medium That Readers Depend On For Independence And Objectivity.” “At this point we all know that the president is an unhinged serial liar who literally makes things up for applause. Because the First Amendment exists, there is no way to prevent him from doing so. But publishing this embarrassing collection of inane vagaries—and hiding behind its “opinion” framing, as if there is no distinction between good-faith, fact-based disagreements and facially absurd lies—launders his standard-issue dishonesty through a medium that readers depend on for independence and objectivity.” [GQ, 10/10/18]

The Root: USA Today Allows Trump To Publish Fake News. “For some reason—possibly because USA Today is trying to get into the good graces of the president, or maybe they just wanted some press—USA Today allowed the Donald J. Trump to publish an op-ed that is full of mistruths that only become apparent when you’re done reading the lies. In short, USA Today published fake news.” [The Root, 10/10/18]

Roundup: Trump Justice Department Argues that Protections for Pre-existing Conditions are Unconstitutional

Tonight, the Trump Administration went to court to take away protections away from 52 million Americans with pre-existing conditions, and raise costs for millions more.

Headlines are emphasizing just how significant this decision is:

Washington Post: Trump Administration Won’t Defend ACA In Case Brought By GOP States. [6/7/18]

Vox: The Trump Administration Believes Obamacare’s Preexisting Conditions Protections Are Now Unconstitutional. [6/7/18]

CNN: Trump Administration Tells Court It Won’t Defend Key Provisions Of The Affordable Care Act. [6/7/18]

Axios: Trump’s Justice Department Says The ACA Is Unconstitutional. [6/7/18]

Politico: Trump Administration Backs Court Case To Overturn Obamacare Provisions. [6/7/18]

Talking Points Memo: Trump’s Justice Department Refuses To Defend Obamacare In Court. [6/7/18]

The Hill: Justice Dept. Argues Key Parts Of ObamaCare Are Unconstitutional. [6/7/18]

Washington Examiner: Trump Administration Tells Court It Won’t Defend Obamacare Against Lawsuit Seeking To Cripple It. [6/7/18]

Reuters: U.S. Justice Department Says Obamacare Individual Mandate Unconstitutional. [6/7/18]

And experts underscore just how dangerous it will be:

Larry Levitt, Vice President For Health Policy At Kaiser Family Foundation: “The Justice Department’s brief creates another cloud of uncertainty for insurers, just as they’re filing proposed ACA rates for 2019. When insurance companies face uncertainty, they increase premiums.” “The Trump administration is arguing in court that the ACA’s protections for people with pre-existing conditions should be thrown out. The Justice Department’s brief creates another cloud of uncertainty for insurers, just as they’re filing proposed ACA rates for 2019. When insurance companies face uncertainty, they increase premiums…27% of non-elderly adults have pre-existing conditions. Arguing in court that protections for them should be eliminated, as the Trump administration is now doing, could provoke a backlash in an election year.” [Larry Levitt, 6/7/18]

Andy Slavitt, Former Director Of Centers For Medicare And Medicaid Services: “The Biggest Health Care News of the Year.” “BREAKING: The biggest health care news of the year. The Trump DOJ tonight just told the courts to dismantle pre-existing conditions protections and other consumer protections. This may seem predictable, but these actions are unprecedented.” [Andy Slavitt, 6/7/18]

Nicholas Bagley, Health Law Professor at University of Michigan: “I’m at a loss for words to explain how big of a deal this is.” “This is an enormous blow to the integrity of DOJ…I am at a loss for words to explain how big of a deal this is. The Justice Department has a durable, longstanding, bipartisan commitment to defending the law when non-frivolous arguments can be made in its defense. This brief torches that commitment.” [Nicholas Bagley, 6/7/18]

Sam Berger, Senior Advisor At Center For American Progress: DOJ Wants To Take Health Care Away From Those With Pre-Existing Conditions. “For those who don’t have time to read the DOJ brief, a quick summary of the argument: ‘We want to take away health care from people with pre-existing conditions and are willing to make patently absurd legal arguments to do so.’ DOJ’s argument was so inconsistent with the law, that career lawyers actually asked the court to remove them from the case, so that they would not have to be associated with it. That almost never happens, and tells you how terrible DOJ’s legal argument is.” [Sam Berger, 6/7/18]

Topher Spiro, Vice President For Health Policy At Center For American Progress: “This Is A Political Attack On The ACA And People With Pre-Existing Conditions.” “Three respected career DOJ attorneys withdrew from the case in protest just before this brief was filed. That tells you how politicized this is. This is a political attack on the ACA and people with pre-existing conditions.” [Topher Spiro, 6/7/18]

Andy Slavitt, Former Director Of Centers For Medicare And Medicaid Services: “Collusion Between Conservative Plaintiffs And The ‘Defense’ Would Make Pre-Existing Protections And Age Rating Protections Unconstitutional.” “The DOJ, responsible for upholding the rule of law, is not defending the people in a frivolous lawsuit to say that without the mandate, the rest of the ACA can’t be enforced. This collusion between the conservative plaintiffs and the “defense” would make pre-ex protections and age rating protections unconstitutional. In an active of savage cynicism, the Trump Administration doesn’t want this to go into effect until after the election.” [Andy Slavitt, 6/7/18]

Sam Baker, Health Reporter At Axios: “Sick People Would Just Be Out.” “If DOJ gets its way here, insurers would be free to deny people coverage based on pre-existing conditions. Forget complicated market interactions — sick people would just be out.” [Sam Baker, 6/7/18]

Matthew Yglesias, Co-founder Of Vox: “Good Reminder Of The Real Stakes In The Midterms.” “Good reminder of the real stakes in the midterms; if Republicans do well, they will try as hard as they can to take people’s health care away.” [Matthew Yglesias, 6/7/18]

Editorial Roundup: Across the Country, Standing Up to Health Care Sabotage

Across the country, editorial boards are speaking out against Republicans’ repeal-and-sabotage war on health care as rising costs and higher uninsurance rates take a toll on American communities:

San Antonio Express-News: Health Care Numbers Moving In The Wrong Direction. [5/27/18]

Los Angeles Times: CA Should Fight The Good Fight Against Bad Health Insurance Policies. [5/25/18]

Boston Globe: Repeal Failed, But The GOP’s ACA Attack Continues. [5/12/18]

Charlotte Observer: Get ready for Obamacare Sticker Shock. [5/9/18]

Valley News: Health-Care Sabotage Begins to Kick In. [5/7/18]

Washington Post: Americans Are Starting To Suffer From Trump’s Health Care Sabotage. [5/6/18]

Florida Times-Union: Obamacare has become Trumpcare. [4/12/18]

Des Moines Register: Elected officials undermine Iowans’ health insurance. [4/3/18]

Minneapolis Star Tribune: Sabotaging the Affordable Care Act will lead to pricier insurance. [3/27/18]

Portland Press Herald: Republicans responsible for looming chaos in health care marketplaces. [3/22/18]

Star-Ledger: State Lawmakers Must Rescue Obamacare. [3/11/18]

St. Louis Post-Dispatch: In Iron County, the rural health care catastrophe comes home. [3/8/18]

New York Times: Trump Tries to Kill Obamacare By A Thousand Cuts. [2/21/18]

Los Angeles Times: The Trump administration wants to cut premiums for the healthy at the expense of the sick. Again. [2/21/18]

Research Roundup: Studies Show Better Health Care Outcomes, Stronger Household Finances Thanks to Affordable Care Act & Medicaid Expansion

Six new studies highlight the positive impact of the Affordable Care Act is having on health care in America. Three outcomes-focused studies show clear improvements in care for gynecological cancer, head and neck cancer, and serious psychological distress, while two Medicaid Expansion studies find that expanded coverage leads to lower out-of-pocket costs and stabler household finances. Meanwhile, health care reform has entirely closed the demographic coverage gap between Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPIs) and white Americans.

This new research joins a growing body of work that leads to a simple conclusion: the Affordable Care Act provides measurable benefits for Americans’ health and financial well-being. Here’s a look at the six studies:

Effects of the Affordable Care Act on Young Women With Gynecologic Cancers [Obstetrics & Gynecology, 5/7/18]

This study finds that the ACA’s expansion of access of coverage allowed more young women to catch gynecologic cancer early, improving the likelihood of successful treatment.

  • The study examined nearly 4,000 cases of gynecologic cancer among 21-26-year-old-women and more than 20,000 cases among 27-35-year-old women, comparing those which came about before the ACA and those after its implementation, finding that those with access were more likely to be treated.
  • The study found that prior to the ACA just one in three women between the ages of 19 and 26 were insured, but after its implementation, more than nearly four in five women were covered, helping to account for the diagnoses.
  • The report concluded that, “Young women with gynecologic cancer were more likely to be insured and diagnosed at an early stage of disease.”
  • “This study adds to the evidence of the positive effects of improved coverage through the ACA on young women’s healthcare costs and choices,” noted Dr. Laura Havrilesky, a gynecologist at the Duke University Medical Center, in an editorial published in accordance with the findings.

Changes in Health Insurance Coverage and Barriers to Health Care Access Among Individuals with Serious Psychological Distress Following the Affordable Care Act [Administration and Policy in Mental Health and Mental Health Services Research, 5/12/18]

This study examined mental health outcomes in accordance with the Affordable Care Act, concluding that the ACA has led to better coverage outcomes and increased affordability for non-elderly adults with serious psychological distress (SPD).

  • Examining non-elderly adults with SPD from 2014-2016, the study’s authors found that these adults saw increased coverage and a reduction in the delaying or foregoing of necessary care due to the ACA, and that the law “reduced the odds of an individual with SPD not being able to afford mental health care.”
  • As the study’s authors note, “Mental health care access among racial and ethnic minority populations and people with low income has improved during 2014–2016,” something almost certainly attributable, at least in part, to the ACA

ACA Decreased Non-Insurance Rates Among Patients With Head and Neck Cancer [American Head & Neck Society, 4/19/18]

Another new study finds that in states that expanded Medicaid, patients with head and neck cancer had better health care access.

  • The study analyzed more than 89,000 patients, finding higher coverage rates among both Medicaid enrollees and private insurance, as well as an uninsured rate among diagnoses which decreased nearly 50% after January 2014, in states which expanded Medicaid.
  • The study found that those lacking coverage had an overall survival rate of just 49% compared to 63% among those insured, as well as a a 5-year disease-specific survival rate of just 57% compared to 72% among those insured.

The Effect of the Affordable Care Act Medicaid Expansions on Financial Wellbeing [Journal of Public Economics, 5/7/18]

Another study compiled by employees of the Federal Reserve Bank of Chicago and the University of Illinois, University of Michigan, and Northwestern University found that low-income residents saw better financial outcomes in states which expanded Medicaid.

  • Using credit reporting agency data, the researchers compared the financial outcomes among low-income adults in states which expanded Medicaid and those which did not, determining that Medicaid expansion “significantly reduced d the number of unpaid bills and the amount of debt sent to third-party collection agencies among those residing in zip codes with the highest share of low-income, uninsured individuals.”
  • The study found that Medicaid expansion lowered unpaid balances in collections “by between $65 and $88,” while Medicaid enrollees saw their amount of unpaid balances in collections decrease “by approximately $1,140.”
  • As the authors note: “Our findings suggest that the ACA Medicaid expansions had important financial impacts beyond increasing health care use.”

The Effect of ACA State Medicaid Expansions on Medical Out-of-Pocket Expenditures [Medical Care Research and Review, 5/10/18]

A new analysis from the University of Michigan’s Institute for Social Research finds that Medicaid expansion lowered out-of-pocket medical expenses.

  • The study, conducted by Joelle Abramowitz of the Institute of Social Research, analyzed data from the Current Population Survey Annual Social and Economic Supplement between 2011-2016, finding that those in states which expanded Medicaid saw their medical spending decreases, due to fewer premiums and reduced out-of-pocket medical expenses.
  • The study’s findings “suggest that the expansions were associated with a relatively larger likelihood of having zero premium expenditures and of having zero nonpremium medical out-of-pocket expenditures for low-income individuals,” as well as suggest “that the expansions were effective in reducing medical out-of-pocket expenditures.”

Health Insurance for Asian Americans, Native Hawaiians, and Pacific Islanders Under the Affordable Care Act [JAMA Internal Medicine, 4/30/18]

Researchers from the Harvard T.H. Chan School of Public Health analyzed the impact of the Affordable Care Act on coverage among Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPIs), finding that the ACA closed the uninsured rate gap between AANHPIs and white Americans.

  • Using data from the American Community Survey, the researchers examined the uninsured rate among AANHPIs prior to the ACA and after its implementation, the first study of its kind, finding that unlike other minority groups which saw a decrease in the coverage gap between themselves and white Americans, the coverage gap among AANHPIS was eliminated.
  • Overall, the uninsured rate among AANHPIs dropped 7.3% following the ACA. Among the subgroups of AANHPIs, all saw significant drops: 14.3% among Guamanian or Chamorro, 6.5% among Samoan, and 4.9% among Native Hawaiians, as well as 5.9% among other AANHPIs.
  • “The notable gains in health insurance coverage for AANHPI groups represent valued progress toward health equity,” said senior author Howard Koh, the Harvey V. Fineberg Professor of the Practice of Public Health Leadership at Harvard Chan School and Harvard Kennedy School.