The Host
Julie Rovner
KFF Well being Information
Julie Rovner is chief Washington correspondent and host of KFF Well being Information’ weekly well being coverage information podcast, “What the Well being?” A famous knowledgeable on well being coverage points, Julie is the creator of the critically praised reference ebook “Well being Care Politics and Coverage A to Z,” now in its third version.
The brand new, GOP-led, 119th Congress and President-elect Donald Trump have huge legislative plans for the yr — which largely don’t embody well being coverage. However well being is more likely to play an essential supporting position in efforts to resume tax cuts, revise immigration insurance policies, and alter commerce — if solely to assist pay for some Republican initiatives.
In the meantime, the outgoing Biden administration is racing to complete its well being coverage to-do checklist, together with finalizing a coverage that bars credit score bureaus from together with medical debt on people’ credit score experiences.
This week’s panelists are Julie Rovner of KFF Well being Information, Shefali Luthra of The nineteenth, Alice Miranda Ollstein of Politico, and Lauren Weber of The Washington Put up.
Panelists
Shefali Luthra
The nineteenth
Alice Miranda Ollstein
Politico
Lauren Weber
The Washington Put up
Among the many takeaways from this week’s episode:
- The 119th Congress is now in session. Well being care doesn’t make the checklist of priorities as lawmakers lay the desk for the incoming Trump administration — although Republicans have floated Medicaid work necessities to chop federal spending.
- A whole lot of well being laws hit the cutting-room ground in December, together with a bipartisan proposal focusing on pharmacy profit managers — which might have saved the federal authorities and sufferers billions of {dollars}. And talking of bipartisan efforts, a congressional report from the Senate Price range Committee provides to proof that non-public fairness involvement in care is related to worse outcomes for sufferers — notably, lawmakers’ constituents.
- Because the nation bids a remaining farewell to former President Jimmy Carter, his world well being work, specifically, is being celebrated — particularly his efforts to eradicate such devastating illnesses as Guinea worm illness and river blindness.
- In the meantime, the Biden administration finalized the rule barring medical debt from showing on credit score experiences. The surgeon basic cautions that alcohol ought to include warning labels noting most cancers danger. And the brand new Senate Republican chief is elevating abortion-related laws to require lifesaving take care of all infants born alive — but these protections exist already.
Plus, for “further credit score,” the panelists counsel well being coverage tales they learn this week that they suppose you must learn, too:
Julie Rovner: The Wall Road Journal’s “UnitedHealth’s Military of Medical doctors Helped It Gather Billions Extra From Medicare,” by Christopher Weaver, Anna Wilde Mathews, and Tom McGinty.
Alice Miranda Ollstein: The New York Occasions’ “Ozempic, Lego Bricks and Listening to Aids: What Trump’s Greenland Plan Might Hit,” by Ana Swanson and Jenny Gross.
Shefali Luthra: Vox.com’s “Gigantic SUVs Are a Public Well being Menace. Why Don’t We Deal with Them Like One?” by David Zipper.
Lauren Weber: The Washington Put up’s “Legal guidelines Limit U.S. Transport of Vape Merchandise. Many Firms Do It Anyway,” by David Ovalle and Rachel Roubein.
Additionally talked about on this week’s podcast:
The Senate Price range Committee’s “Income Over Sufferers: The Dangerous Results of Non-public Fairness on the U.S. Well being Care System.”
CLick right here to open the transcript
Transcript: New Yr, New Congress, New Well being Agenda
[Editor’s note: This transcript was generated using both transcription software and a human’s light touch. It has been edited for style and clarity.]
Julie Rovner: Hiya, and welcome again to “What the Well being?” I’m Julie Rovner, chief Washington correspondent for KFF Well being Information, and I’m joined by a number of the finest and smartest well being reporters in Washington. We’re taping this week on Thursday, Jan. 9, at 10 a.m. As all the time, information occurs quick and issues may need modified by the point you hear this. So, right here we go.
Rovner: Right now we’re joined by way of videoconference by Alice Miranda Ollstein of Politico.
Alice Miranda Ollstein: Hiya.
Rovner: Lauren Weber of The Washington Put up.
Lauren Weber: Hiya hi there.
Rovner: And Shefali Luthra of The nineteenth.
Shefali Luthra: Hiya.
Rovner: No interview this week — method an excessive amount of information to compensate for. So allow us to get proper to it. So, welcome to the 119th Congress and, quickly, to a brand new presidential administration. We’ll return and recap what occurred in late December shortly, however I wish to begin by trying forward. What’s on the rapid agenda right here in Washington for well being care? Anyone?
Ollstein: So well being care shouldn’t be the precedence proper now for the incoming administration, for the brand new Republican trifecta in Washington. It might make it in, as a result of they’re speaking about these huge, conglomerate payments that they’ve criticized up to now and stated that they don’t like doing that, and they’d a lot reasonably vote on particular person issues one after the other.
However now they’re speaking about cramming all the pieces into one big reconciliation invoice early within the new administration. And there’ll doubtless be some well being care elements. We don’t know but what these will probably be. Issues that purport to economize are much more doubtless than issues that purport to value cash. Though, there’s typically some humorous math in that. Medicaid work necessities have been floated, and so we will speak about that. We all know, we’ve seen that film earlier than, and we all know how that may go, each when it comes to what it means for individuals’s protection and what it means when it comes to financial savings.
However I believe that plenty of the bold stuff that lawmakers tried to get by means of on the finish of the yr is now in query, as as to if it has a future or not. As a result of the highest priorities of the brand new administration are extra on taxes and commerce and immigration and issues like that and never as a lot on well being coverage.
Rovner: Though, I’d level out that that end-of-the-year rush that they obtained — they stored the federal government open, they usually obtained the federal government funded — that solely goes till March. I noticed form of a plaintive electronic mail yesterday from Tom Cole, the Republican chairman of the Home Appropriations Committee, saying, Um, we’ve got to begin engaged on the subsequent one quickly. All people’s busy speaking about this big tax invoice, reconciliation. What are we going to do about Medicaid? And it’s like, hi there, the present fiscal yr shouldn’t be completed. They only managed to place issues off.
Lauren, you needed so as to add one thing?
Weber: Yeah. I simply needed to say, I really feel like we’ve entered the period of promoting relating to these payments. You’ve obtained President-elect [Donald] Trump saying he needs one huge, stunning invoice. That’s what he needs. He needs one huge, stunning invoice. And it’s not simply Trump. I imply, let’s have a look at the MAHA motion, the “Make America Wholesome Once more” motion.
I imply, I believe we’re coming into an period wherein payments and actions all have catchy slogans. And I imply, heck, the American public might have a greater understanding, or no less than know what these persons are telling them is going on with this advertising and marketing, we’ll see. So I simply needed to flag that this appears to be the change over right here.
Rovner: And that is once I get to place in my different actuality test, which is that they maintain speaking about this huge, stunning reconciliation invoice that they solely want Republican votes for. I’ve to remind individuals yearly: In an effort to do a reconciliation invoice, first they have to do a price range decision, in each homes. That has to go to the ground, be debated, needs to be reconciled between the Home and the Senate, about what the price range decision appears to be like like.
The entire level of what’s known as “reconciliation” is that it reconciles obligatory spending to the phrases of the price range decision. It takes a very long time to do a price range decision, even whenever you’re dashing it by means of.
Additionally, all these items that they’re speaking about placing into this reconciliation invoice aren’t allowed to enter price range reconciliation. It’s solely about obligatory spending. It’s taxes. It’s Medicare and Medicaid and different obligatory spending. And it’s the debt ceiling. And people are principally all of the issues that may go in. Sorry, that’s the tip of my lecture.
Alice, did you wish to add one thing?
Ollstein: Positive. I imply, I believe we’re already seeing cracks rising on this nice Republican unity that they’re making an attempt to challenge. I imply, they’ll’t even agree but on whether or not to do one huge, stunning invoice or two. And the individuals pushing for 2 are stating that when you put all of your eggs in a single basket and that basket breaks and falls aside and all of the eggs smash on the ground, then you definitely don’t actually have something to indicate in your work.
Which after all is a state of affairs Congress has discovered itself in lots of instances over the previous a number of years. And so, these of us are saying it’s a lot much less dangerous to interrupt it up and have it in separate payments, in order that if one goes down in flames, the opposite would possibly make it by means of. However sure, as soon as once more, we’re seeing each Home vs. Senate tensions, in addition to Congress vs. Trump and Trump’s advisers tensions. And I think about that’s going to be a relentless for the subsequent few years.
Rovner: And when you thought that the Home was ungovernable with its tiny Republican majority within the final Congress, it’s even tinier now. Actually, we do have Speaker Mike Johnson. He did get elected on the primary poll, nevertheless it was not straightforward. There have been a few holdouts who needed to take calls from the president-elect in an effort to change their votes. So it’s fairly tenuous there.
Shefali, earlier than we transfer on, did you wish to add one thing?
Luthra: No, I imply, I believe what will probably be actually fascinating, as properly, is to see how this emerges in all the extra fractious points among the many Republican Get together. I do know we’ve talked so much about how the Republican Get together could be very divided on plenty of problems with reproductive well being, together with abortion, one thing Alice and I each take into consideration on a regular basis. And—
Rovner: And we are going to get to in a couple of minutes.
Luthra: We will probably be attending to that very quickly. However it’s simply very clear that each one of those points, the place they challenge unity, are fairly shortly going to disintegrate relating to partaking with the truth that it is a very divided coalition, and plenty of the issues they’re speaking about doing aren’t extremely popular with voters. And so we’ll see how that impacts them as properly.
Rovner: Sure. So let’s transfer again a bit bit. Once we left issues in December, we had been a day away from a potential authorities shutdown, which didn’t occur. However the different factor that didn’t occur was an enormous bundle with principally a complete yr’s price of bipartisan well being coverage work in it, all the pieces from new transparency necessities for pharmacy advantages managers [PBMs], to renewals of packages to arrange for the subsequent pandemic and to combat the opioid epidemic, to rolling again cuts to medical doctors beneath Medicare. Most of that didn’t make it into the ultimate bundle that can maintain the federal government working till March.
The tiny issues that did make it in had been extensions of telehealth authority for Medicare and funds for neighborhood well being facilities and another expiring packages — however once more, solely by means of the center of March, which is when the remainder of this funding invoice expires.
So what occurs to issues just like the PBM invoice that fell by the wayside? Do we’ve got any purpose to suppose that Congress goes to choose it up and go it this yr? And even when they do this Trump would signal it? Or did all of that work final yr, is that each one simply principally for naught now?
Ollstein: I imply, I believe you possibly can make an argument both method. You could possibly make an argument that it has an opportunity as a result of there may be bipartisan assist. A few of these issues might save the federal government cash and assist pay for different issues that the Republican majority needs to do, like minimize taxes.
Rovner: I’d say the PBM invoice was like $5 billion in financial savings, as I recall.
Ollstein: Precisely. And it’s not like PBMs are super-popular and everybody needs to defend them proper now. So you can also make the argument that it has an opportunity due to that, however we’ve seen tons of well being insurance policies up to now which have bipartisan assist that will get monetary savings additionally fall by the wayside, simply because they don’t seem to be priorities. And so, I believe, you can also make the optimistic or the pessimistic case on this one.
Rovner: Go forward, Lauren.
Weber: I’d simply add, I imply, plenty of issues that folks had been fairly upset about, when it comes to smaller issues, health-wise, additionally obtained minimize from the invoice. I imply, there was funding for 9/11 most cancers funds, for those who had been uncovered to poisonous chemical compounds, first responders, and so forth. A whole lot of outcry after that obtained stripped out of the invoice. Understandably so, contemplating, principally all of the advocates stated: We don’t wish to parade our dying first responders to Congress yearly to get funds. Actually, you narrow this out?
So there does appear to be some momentum to doubtlessly add that in once more. There was additionally hullabaloo round childhood most cancers analysis. They ended up passing a separate smaller invoice, nevertheless it didn’t embody the total measures to actually prioritize some strain on the FDA [Food and Drug Administration] and different funding to enhance childhood most cancers analysis. And so I believe you’re going to proceed to see, no less than from the Dems, some stating of those points going ahead as, I imply, childhood most cancers and 9/11 first responders are fairly sympathetic characters for funding.
Rovner: Yeah, I believe it’s going to be — I believe plenty of these new committee chairs, notably within the Senate, the place the Republicans are taking up, are going to need to determine their method out and attempt to choose up a number of the items. One fascinating factor that got here by means of my inbox this week was a bipartisan report from the Senate Price range Committee that discovered, and I’m quoting from the headline within the press launch, “Non-public Fairness in Well being Care Proven to Hurt Sufferers, Degrade Care and Drive Hospital Closures.” Does this counsel that Congress would possibly attempt to do one thing on this extraordinarily fraught topic?
Shefali, you’re smiling. I imply—
Luthra: I’m smiling as a result of a few issues, and the primary is that there was plenty of discourse about non-public fairness’s impression on well being take care of shoppers for years. That is very fascinating and essential work, and it isn’t in any respect shocking.
And the opposite factor that we’ve got to recollect is that Donald Trump will probably be president. He’s ideologically very unpredictable. As an actor, he’s very unpredictable. And it’s simply very tough to guess what is going to really change into regulation and getting his signature. And a part of that’s as a result of, we will bear in mind from the final time he was president, he fairly often would change what he believed primarily based on the final individual he spoke to. We noticed this on a regular basis with drug pricing.
And I simply suppose that we are going to see actually fascinating bipartisan analyses of issues that would make actual variations for shoppers on well being care, however whether or not they change into regulation, whether or not they change individuals’s lives, that’s simply a lot, a lot tougher for us to actually predict in a significant method.
Rovner: Yeah, I believe all the pieces’s fairly onerous to foretell proper now. Lauren?
Weber: Yeah, I simply needed so as to add, I imply, I do know, clearly onerous to foretell, however I believe the concept that you may have lawmakers issuing fairly strident releases that tie non-public fairness to lower affected person outcomes of their particular districts is a little bit of a step ahead. I imply, you may have [Sen. Charles] Grassley saying: Look, none of those individuals care about affected person care. They solely care about shareholders. I do suppose that could be a shift in rhetoric, to an extent. We’ve seen a constructing for fairly a while. We’ve all talked about non-public fairness on this podcast.
However I do suppose when you may have lawmakers making that bounce to, Oh, individuals in my district are getting worse well being care due to this, I believe you possibly can see extra motion.
Rovner: Yeah, it’s one thing I’m going to keep watch over. Like I stated, I used to be stunned to see that as a bipartisan report from a committee, despite the fact that it’s the Price range Committee that doesn’t actually have authority to do something legislatively. Nonetheless, it was price noting.
Nicely, in case there wasn’t already sufficient information this week, right here in Washington this very morning, we’re bidding farewell to former President Jimmy Carter, who died at age 100 late final month. Carter was certainly one of a protracted checklist of Democratic presidents who tried and did not overhaul the nation’s well being care system. You’ll be able to Google one thing known as “hospital value containment” if you wish to know extra. He additionally created the Well being Care Financing Administration to run Medicare and Medicaid, which obtained renamed the Facilities for Medicare & Medicaid Providers within the early 2000s.
However Carter’s greatest well being achievements got here after he left workplace. His work by means of his basis addressed, and in some instances almost eradicated, some largely uncared for tropical illnesses that largely afflict the poorest and most marginalized individuals on the planet. That’s going to be certainly one of his actual main legacies, was bringing world well being house. Proper, Alice?
Ollstein: Yeah, and I believe that’s fascinating, given the popularity of his legacy proper now, round his funeral, and mendacity in state within the Capitol, with the Trump administration coming into workplace, being very towards our bodies just like the WHO [World Health Organization] and worldwide cooperation on well being care, very vocally important of how worldwide cooperation occurred through the covid-19 pandemic. And so I believe that’s going to be an fascinating distinction, given what Carter was in a position to obtain by means of such cooperation.
Rovner: Yeah. Lauren?
Weber: Yeah, I simply needed so as to add, I imply, it’s a mannequin that I believe then seeped into different presidents, proper? I imply, you’ve seen [former president George W.] Bush’s funding in world well being, and so forth. And I do suppose, as Alice well identified, there may be, clearly, a pointy distinction. However I imply, what Carter was in a position to do for river blindness and Guinea worm is unprecedented. And I believe what was most transferring in all the recaps of his work is that these are people who don’t have a voice. They don’t have a place of energy within the nation they reside in. I imply, that is him utilizing his delicate energy to demand motion, by flying out to far-flung corners of the world, to fulfill with farmers who had been disabled by Guinea worm, to ensure that this didn’t occur to future generations.
And a few of these biographers have posited that’s due to his upbringing as a poor farmer in Georgia. So I believe that is form of a once-in-a-generation second to take a look at this impression somebody has on world well being. And as Alice identified, I don’t know what we’ll see going ahead on that.
Rovner: It’s onerous to think about Donald Trump making eradication of Guinea worm a serious precedence. Nicely, we’re additionally bidding farewell over the subsequent two weeks to the Biden administration, which is utilizing its final days to attempt to get as a lot completed and trumpet as many victories as it will possibly. We’ll begin with the Inexpensive Care Act, the place the administration simply introduced that with per week left to go within the official sign-up interval in most states, 24 million individuals have now been enrolled in ACA plans. That’s up 3 million simply from final yr and greater than double the quantity from 2021 when [Joe] Biden took workplace.
After all, that is more likely to be the excessive water mark. This yr marked the primary that the so-called Dreamers, these individuals introduced illegally to the U.S. as youngsters by their mother and father, they may enroll, no less than for now. That’s one thing President Trump and the Republican Congress is taken into account more likely to finish. Plus, the extra tax credit that had been put in place through the pandemic expire on the finish of this yr, until Congress renews them. What’s the outlook for ACA enrollment?
Ollstein: Nicely, Democratic senators are beginning to make a push to increase these subsidies, introducing laws and making an enormous splash about it immediately. There’s been plenty of lobbying from the well being care sector, the hospitals, all of the gamers who don’t wish to see these tax credit expire, and in addition to affected person advocacy teams. Actually, my inbox has been flooded with issues associated to that and calling on Congress to increase these subsidies.
After all, they value some huge cash, and the brand new congressional majority undoubtedly has different issues they wish to spend that cash on, that aren’t serving to individuals purchase medical insurance plans as a part of the Inexpensive Care Act. And so, I believe there may be more likely to be plenty of wrangling and horse-trading round this. I don’t suppose the subsidies are essentially toast, however I don’t suppose that they’re a completed deal, both.
Rovner: Yeah, I imply, I maintain saying, I believe everyone’s first inclination after Election Day is that they had been toast, as a result of Republican trifecta. However, whenever you really dig into the numbers, the largest will increase have are available crimson states.
Ollstein: Completely.
Rovner: So the people who find themselves profiting from these further subsidies are people who find themselves in Republican states and voted for Republicans and are represented by Republicans. And also you’ve obtained to wonder if they wish to, all of a sudden subsequent January, or actually subsequent October, November, when individuals understand: Oh my goodness, my premiums for my medical insurance are going to quadruple. How did this occur? Possibly they’ll take into consideration that once they’re placing all of those huge, stunning payments collectively, possibly?
Ollstein: Yeah, we’ve began to see some feedback from some Republicans. After all, it’s those who’ve been prepared to work with Democrats up to now, like Lisa Murkowski within the Senate, saying that we should always have a look at extending these subsidies. You’re not listening to that from most Republicans by any stretch of the creativeness, however I believe you’re beginning to hear these rumblings as a result of, such as you stated, Julie, they don’t wish to have a bunch of constituents lose their insurance coverage or have their insurance coverage get far more costly once they’re in energy.
Rovner: Yeah, the benefit and drawback of the trifecta. Lauren?
Weber: I simply needed to ask, I imply, a query for the panel. I imply, there’s all this speak about “DOGE” [the “Department of Government Efficiency”] and reducing all this cash, however as you simply said, Alice, they’re doubtless to not eliminate these subsidies. Johnson went on the file, I believe this week or final week, to say Medicare shouldn’t be going to get impacted. Medicaid cuts appear to be coming, however pricey God, when you don’t minimize a few of these different issues, I don’t know the way you may get to the cash quantities that they’re speaking about, particularly in well being.
Ollstein: Nicely, and Elon Musk has already walked again his projection of how a lot he’ll be capable of minimize, saying that $2 trillion was aspirational and hopefully they’ll get $1 trillion. And so that you’re already beginning to see the walk-back of a number of the preelection guarantees on that entrance as they begin to confront a number of the realities you talked about, Lauren.
Rovner: Yeah, there’s nothing just like the optimism of early January, when a brand new Congress and a brand new president say, We’re going to do all of this within the first hundred days. You’ll suppose that Trump of all individuals would know higher, as a result of he tried to repeal the Inexpensive Care Act within the first hundred days in 2017, and that didn’t go so properly. However apparently he has a brief reminiscence, too.
Nicely, talking of issues which can be more likely to be undone, the Shopper Monetary Safety Bureau finalized its rule this week barring the usage of medical debt on credit score experiences. It’s already been sued for exceeding its authority by two commerce teams representing collectors. How essential would this variation be if it really survives?
Luthra: One thing like this could possibly be actually significant. I bear in mind speaking to households about their efforts to purchase houses and sometimes struggling to take action as a result of their medical debt had harmed their credit score rating. And the factor about medical debt is that it’s often not deliberate. It’s most likely really virtually all the time not deliberate, since you don’t hope to fall sick. You don’t attempt to get a devastating harm that your insurance coverage won’t totally cowl the prices for.
And this was one thing that had actually been championed by of us within the client advocacy area for a really very long time, properly earlier than the Biden administration. Dropping it will actually have implications for individuals throughout the political spectrum, particularly as we’re on this area the place housing stays very costly, the place medical debt is an actual concern, and the place having it have an effect on your credit score might actually put an inexpensive mortgage simply out of attain for lots of Individuals.
Rovner: Nicely, lastly, as certainly one of his parting suggestions, outgoing Surgeon Normal Vivek Murthy has issued a report recommending that alcoholic drinks carrying warning labels that they’ll trigger most cancers, similar to tobacco merchandise. His report calls alcohol the third-leading preventable explanation for most cancers. However this doesn’t really feel super-likely to occur, between the ability of the alcohol business and the mistrust of science, notably when it recommends issues individuals most likely don’t wish to hear. I assume no one right here is betting on this taking place anytime quickly?
Ollstein: No, you’ve already seen members of Congress for whom the alcohol and beverage business could be very economically essential for his or her state, all the oldsters who symbolize breweries and distilleries and wineries, already talking out and sharing issues about this. However I believe that simply the surgeon basic utilizing the bully pulpit to shine a lightweight on this, it generated plenty of information protection. That’s essential.
It’s essential for shoppers to see that and be capable of make selections. And also you’re already seeing some tendencies of youthful of us being extra form of sober-curious. And there’s plenty of speak about Dry January being a wholesome factor to do. And much more bars you’re seeing provide low-alcohol or nonalcoholic choices. And so I believe that is one thing that persons are slowly turning into extra conscious of and extra involved about, whether or not the federal government steps in or not.
Rovner: Yeah, I believe it might be like tobacco, the place everyone smoked after which progressively fewer and fewer and fewer individuals did. Lauren, did you wish to say one thing?
Weber: Yeah, I imply, I’ve written so much about meals labels within the final couple of years, and, I imply, that’s simply been a torturous course of. So the concept that something on alcohol would change at something sooner than a glacial tempo I believe might be problematic, contemplating there’s plenty of attorneys on this city and there’s some huge cash in lawmakers’ pockets on this city. So simply needed so as to add that.
Rovner: And alcohol’s actually common — and authorized. Nicely, let’s flip to abortion reproductive well being. All issues thought-about, it’s really been form of quiet on the abortion entrance for the previous couple of weeks. However there has all the time been information, as is predictable when Republicans take over the Home, Senate, and White Home on the identical time. New Senate Majority Chief John Thune has introduced his intention to deliver up an abortion invoice. On this case, not a nationwide ban, which President-elect Trump has stated he wouldn’t signal, however reasonably the, quote, “Born-Alive Abortion Survivors Safety Act.” What is that this invoice? And what would it not do? And the way is it completely different from a similar-sounding invoice that Congress handed and President George W. Bush signed in 2002?
Luthra: We had been chatting about this prematurely of taping the podcast, and that is actually fascinating for lots of causes. What this invoice would do is, primarily, if somebody offers beginning, the hospital or the well being care supplier is required to offer all types of lifesaving care, even when it looks like the new child won’t reside. And that is related in plenty of locations. It’s related when, as an example, you possibly expertise a really, very early supply, wherein viability is simply not on the desk.
We do know that the overwhelming majority of abortions occur properly earlier than the purpose when there may be really going to be one thing that resembles an toddler being born. And so what this really does in follow, plenty of well being care suppliers have sounded the alarms about, is stigmatize abortion and sow extra distrust of the well being care suppliers who carry out it. And it additionally, in instances the place somebody does give beginning to a baby that won’t reside, forces medical doctors to offer medical interventions that possibly received’t make a distinction however that can delay the chance or stop the chance for palliative care, which is actually unhappy.
I imply, you give beginning to a baby that received’t reside, and it will possibly’t spend its few moments with some form of consolation. As a substitute, it’s given medical remedies that won’t actually assist them. This invoice differs from the regulation signed beneath President Bush in that it will add penalties. However the different factor that’s price noting is that killing infants is already unlawful. We now have legal guidelines that ban murder. And so, when abortion rights supporters and authorized students say that this type of regulation can be redundant, they’re proper. We have already got methods to penalize killing individuals. However what we don’t have are nationwide restrictions that stigmatize abortion to the extent that will probably be carried out much less and fewer.
However the different factor I believe is price noting, to your level, Julie, is that it is a huge step again, particularly for Senator Thune, who was on the file supporting a 15-week nationwide abortion ban and is not. And that helps us underscore that nationwide abortion restrictions are very poisonous and that, as a substitute, the GOP is actually making an attempt to give attention to instances the place they suppose they could have a greater likelihood of profitable, by specializing in the very finish of being pregnant, areas the place they see the assist for abortion rights publicly go down, and begin with restrictions there, earlier than, in the event that they ever wish to do one thing extra sweeping, ready a bit extra time for that to be politically viable.
Rovner: Mainly, it’s a messaging invoice to attempt to put supporters of abortion rights on the spot and say, In the event you received’t vote for this, then you definitely’re for infanticide. I imply, that’s primarily what the controversy’s going to be. Proper, Alice?
Ollstein: Yeah. Nicely, and simply so of us are conscious, the timing of that is across the March for Life arising in a pair days after the inauguration. And virtually yearly, Republicans in Congress try to carry some form of messaging vote to coincide with that huge anti-abortion demonstration in Washington, D.C.
Rovner: I’d say the anti-abortion demonstration is when it’s as a result of that was the anniversary of Roe v. Wade. That’s why they arrive to D.C. in January.
Ollstein: Yeah. As an apart, they thought-about transferring it to June to mark the anniversary of Dobbs however determined to maintain it in January to proceed to watch the anniversary of Roe anyhow. However like Shefali stated, it’s fascinating that, even provided that that is only a messaging vote, they’re nonetheless aiming so much decrease than they’ve up to now and never introducing the large, sweeping anti-abortion insurance policies that the advocacy teams on that aspect wish to see, when it comes to restrictions on abortion remedy, or like up to now, 15-week bans, 20-week bans, one thing like that. As a substitute, that is form of a distinct segment and arguably duplicative coverage that they’re placing ahead.
Rovner: Nicely, we will definitely watch that area. Additionally, over the vacation break, an OB-GYN on the College of Indiana sued the Indiana Division of Well being, claiming the state’s new abortion reporting necessities violate the federal HIPAA [Health Insurance Portability and Accountability Act] affected person privateness guidelines. Failure to comply with the state regulation might end in potential felony legal responsibility or lack of medical license, however federal regulation is meant to preempt state regulation.
Alongside those self same strains, Senate Finance Committee Chairman, now rating member, Ron Wyden of Oregon launched a report in December, which adopted up on the reporting that we’ve talked about from ProPublica, about pregnant girls dying from preventable and/or treatable problems. Wyden’s employees discovered that medical doctors in states with abortion bans have been unable to get ample authorized recommendation and/or steering from their hospital officers in a well timed method.
Quoting from the report, “Medical doctors are taking part in lawyer, and attorneys are taking part in physician, whereas pregnant girls experiencing something in need of what quantities to a dire emergency are despatched away and informed to return to the emergency room as soon as a preventable state of affairs turns into life-threatening.” Is there something on the horizon that will kind out what medical doctors can and may’t do in states with abortion bans? This continues to be — we maintain listening to story after story after story about this.
Ollstein: So the anti-abortion motion’s response to that is that the legal guidelines themselves don’t have to be modified, they usually as a substitute are introducing these new, what they name “med ed” payments that principally order the federal government, in collaboration with anti-abortion teams, to develop supplies that medical doctors and medical college students should overview, that purport to elucidate what’s and isn’t allowed when it comes to abortion care and emergency care beneath these restrictions.
One state to this point has carried out this, South Dakota, and they’re trying to introduce it in a bunch of different states. Now, the medical neighborhood says there’s no method a video goes to unravel this. These are extremely complicated conditions. You’ll be able to’t cowl all the pieces which may come up. You’ll be able to’t cowl each situation a pregnant individual might have. And so they see it as form of a CYA — if of us are accustomed to “cowl your behind” — transfer, when it comes to legal responsibility and an try and put the onus on particular person medical doctors who’re already struggling, and to say that any of those opposed outcomes are the fault of medical doctors for not understanding or appropriately abiding by these authorized restrictions on care.
Whereas the medical doctors say that: We will’t get steering from our personal employers. We will’t get ample steering from the state. And these actually tie our arms in these very delicate, time-sensitive, and medically delicate conditions.
Rovner: And we’ve seen instances, I imply like in Texas, the place the legal professional basic has threatened in writing to prosecute medical doctors for issues that medical doctors say is normal medical follow.
Ollstein: Proper, so even when a physician got here ahead and stated, It’s my medical judgment that this individual wants an abortion for medical causes, we noticed the legal professional basic there step in and say: I’m overruling your judgment. No, she doesn’t. And in order that has, primarily based on many interviews I’ve completed, and I’m certain Shefali has completed, created an actual chilling impact, the place persons are afraid of being second-guessed like that. And even brief delays, the place somebody is making an attempt to seek the advice of with an legal professional on what to do, even a brief delay could be lethal for a affected person in a kind of conditions.
Rovner: Nicely, turning to this week in medical misinformation, the large information, after all, is that Fb goes to disband its fact-checking unit and principally undertake the anything-goes-and-if-you-don’t-like-it-correct-it-yourself system now utilized by X. This might have huge implications for well being misinformation, I’d suppose. Though Fb wasn’t doing such an awesome job earlier than on permitting misinformation and disinformation to unfold. Is that this going to have an enormous impact?
Luthra: I imply, I believe that is simply, to some extent, an indication of Fb shifting with the political winds, proper? I imply, the fact-checking got here out partly after the 2016 election when there was plenty of claims of voter fraud. There are plenty of, How did Trump get into workplace? They instituted fact-checking to allegedly form of pander to individuals who felt like that there was plenty of misinformation unfold then. Now they’re transferring away from fact-checking as a result of they really feel like then it offers individuals the flexibility to replicate what the neighborhood needs. I believe it’s reflecting the pattern we’re seeing on X. We’ll see extra Group Notes. It makes journalists’ job all of the extra essential, to really distill what’s true and what’s false.
Rovner: You’re our misinformation knowledgeable. Oh, go forward, Alice.
Ollstein: Oh, I needed to additionally flag that a part of Fb’s announcement was that they’re transferring a few of their groups from California to Texas, as a result of Californians are too biased to do any content material moderation and Texans presumably aren’t. That was the body of that announcement, principally. And in order that, I’ve already seen, is elevating issues in some teams on the left, and medical teams, about entry to details about sorts of care which can be restricted in Texas, like abortion care, like trans care.
Will individuals be capable of put up about these issues, to put up correct issues about these issues on these platforms? Or will that be restricted sooner or later? It’s additionally drawing consideration for that purpose.
Luthra: And if I can add yet one more level to what Alice talked about, I imply, one of many very express areas the place Mark Zuckerberg stated he would really like extra room for disagreement and extra room for discourse is on the strains of gender, and really explicitly eradicating restrictions on utilizing very, fairly frankly, misogynistic phrases about how girls ought to exist in our society, about LGBTQ+ individuals, about explicitly permitting customers to name them mentally in poor health.
And this has very significant implications for gender equality, certain, but additionally for well being care, as a result of we’re seeing that some of the politicized areas of well being care in our nation is entry to well being take care of trans individuals, is entry to well being care for ladies. And it’s simply very onerous to not have a look at this and suppose, oh, there will probably be no implication for a way individuals conceive of well being care and the way individuals conceive of those that obtain this type of well being care.
Rovner: And we should always level out, which I ought to have firstly, this isn’t simply Fb — that is all of Meta. So that is Fb and Instagram and Threads. It’s principally, as a result of I do know that solely form of previous individuals like me are nonetheless on Fb, however plenty of persons are on Instagram and Threads, and that is clearly going to have some fairly huge implications as we go ahead.
All proper, properly, talking of misinformation, one mark of accountable science is fessing up when you’re unsuitable. And this week we’ve got an enormous unsuitable factor to speak about. Again in November, we talked a couple of examine that discovered that black plastic cooking utensils and takeout containers had been harmful as a result of they had been comprised of recycled electronics and had been leaching quantities of fireside retardants and different chemical compounds into your meals.
Nicely, it seems that you simply most likely nonetheless ought to eliminate the black plastic in your kitchen, however know that they’re not fairly as harmful as initially marketed. It seems that the authors of the examine made a math error that exaggerated the degrees of poisons by an element of 10. Nonetheless, when you don’t wish to be uncovered to fireside retardants and different nasty stuff, you would possibly wish to cook dinner with steel or silicone or one thing that isn’t black plastic. I do suppose that is essential, as a result of it does present science is an iterative course of. It’s uncommon to see somebody step up and say: Oh, oops, we obtained this unsuitable. However right here, it doesn’t change our basic conclusion about this. However you must know that once we make a mistake, we’re going to repair it. I imply, that appears to be very uncommon on this world proper now.
Ollstein: It’s so onerous, since you see the act of admitting error and correcting it — that may gas mistrust. Individuals level to that and say: See, they obtained that unsuitable. They should be getting all this different stuff unsuitable, too. However after all, not correcting misinformation is much worse. And so, in a time of such mistrust, communication is actually, actually onerous. And did all of the individuals who noticed the primary wave of reports in regards to the black plastic additionally see the correction and see that it wasn’t true? How are these items framed? Had been the splashy articles that had been run, had been they corrected? Had been they retracted? It’s onerous to place the toothpaste again within the tube.
Rovner: Yeah, however science is an imperfect course of. And it’s a course of. It could assist, I believe, if individuals understood that science is extra of a course of than a, that is what’s. However that’s what we’re all right here for, and that’s why all of us nonetheless have jobs. All proper, that’s the information for this week.
Now it’s time for our extra-credit section. That’s the place we every acknowledge the story we learn this week we predict you must learn, too. Don’t fear. In the event you miss it, we are going to put the hyperlinks in our present notes in your telephone or different cellular system.
Lauren, you had been first this week, so why don’t you go first?
Weber: I like this story, and I’m clearly biased, however by my colleagues David Ovalle and Rachel Roubein, on how “Legal guidelines limit U.S. delivery of vape merchandise. Many corporations do it anyway.” Primarily, you shouldn’t be delivery flavored vapes throughout the nation, however a bunch of corporations do. And my colleagues had been in a position to order and get their arms on fairly a number of of these flavored vapes.
My favourite half is the kicker within the story, wherein one firm stated, You’re not sanctioned to make use of our title in any method, once we reached out for remark after they’d shipped us vapes illegally. So I assumed that was fairly one thing. However primarily, it will get at what’s a flaw on this piece of the regulation, which is that the USPS [U.S. Postal Service] is meant to implement, or somebody is meant to implement, how you can cease the delivery of those vapes, nevertheless it’s probably not taking place. So it’s form of a have a look at the very best intentions is probably not the truth on the bottom.
Rovner: Typically. Alice.
Ollstein: So I’ve a chunk from the New York Occasions known as “Ozempic, Lego Bricks and Listening to Aids: What Trump’s Greenland Plan Might Hit.” And that is coming off of Trump threatening to impose tariffs on Denmark if it refuses to permit the U.S. to take over Greenland, which has change into certainly one of Trump’s newest obsessions.
And this piece is stating that tariffs on Denmark would impression plenty of issues the U.S. inhabitants is dependent upon. Particularly, the pharma big Novo Nordisk relies there and manufactures tons of medicines, together with Ozempic, and different weight reduction medication and diabetes medication in that household which can be extremely common proper now, and in addition to listening to aids, different medical gadgets, different medicines. And so this might impression shoppers, if it ever had been to occur, which who even is aware of.
Rovner: Sure. Nicely, we are going to speak extra about tariffs and the medical business in a future podcast, however thanks for noting that. Shefali.
Luthra: My piece is from Vox. It’s by David Zipper. The headline is “Gigantic SUVs are a public well being menace. Why don’t we deal with them like one?”
I believe the story is so good. I like this framing. It first lays out the proof for why, when vehicles attain a sure measurement, they’re very harmful and more likely to kill individuals. After which it will get into the dialog: Why don’t we really deal with this as a public well being menace?
And so they have a look at the conflict on tobacco and the conflict on smoking to suppose by means of: What did it seem like to take one thing that was so ubiquitous in our tradition and really persuade the American public to shift away from it? I believe that is actually fascinating for lots of causes. One is that public well being is actually expansive and we should always give it some thought in an expansive method and contemplate all of the completely different components, like automobile measurement, that do have an effect on our lives and life expectancy.
And I additionally do suppose this ties very well to the dialog we had in regards to the surgeon basic’s alcohol warning, in that even in need of coverage adjustments, there’s a lot that we will do as a society to shift the general public’s understanding of well being dangers from issues that we take without any consideration, and we will nonetheless transfer individuals in a course towards being more healthy and holding our fellow Individuals more healthy. And that’s actually fascinating and essential to consider.
Rovner: Most likely simpler to do one thing about giant SUVs than alcohol, however sure, I’m so glad you linked these two issues. My story this week is from The Wall Road Journal. It’s known as “UnitedHealth’s Military of Medical doctors Helped It Gather Tens of millions Extra From Medicare,” by Christopher Weaver, Anna Wilde Mathews, and Tom McGinty. And it’s principally the flip aspect of the story that Stat Information has been throughout, about how United has used varied strategies to disclaim care to its Medicare Benefit sufferers to save lots of the insurer cash. It is a story about how United is forcing the medical doctors who work for the corporate — and there are plenty of them, like 10,000 — to principally run by means of a guidelines of potential diagnoses for each Medicare Benefit affected person, to encourage medical doctors to make these sufferers appear sicker, even when they’re not, as a result of then the corporate will get more cash for Medicare.
The investigation discovered that the, quote, “illness scores” for sufferers transferring from conventional Medicare to United’s Medicare Benefit elevated a median of 55%, which was, quoting from the story, “roughly equal to each affected person getting newly recognized with HIV … and breast most cancers,” principally maximizing earnings from each ends. It’s fairly the story, and I like to recommend it extremely.
OK, that’s this week’s present. I hope you’re feeling caught up and prepared for the remainder of 2025. As all the time, when you benefit from the podcast, you possibly can subscribe wherever you get your podcasts. We’d respect it when you left us a overview. That helps different individuals discover us, too. Particular thanks, once more this week, to our short-term manufacturing group, Taylor Prepare dinner and Lonnie Ro, in addition to our editor, Emmarie Huetteman.
As all the time, you possibly can electronic mail us your feedback or questions. We’re at whatthehealth@kff.org, or you possibly can nonetheless discover me at X, @jrovner, and more and more at Bluesky, @julierovner.bsky.social. The place are you guys largely as of late? Alice?
Ollstein: I’m @alicemiranda on Bluesky, largely.
Rovner: Shefali.
Luthra: You will discover me on Bluesky, @shefali.
Rovner: Lauren.
Weber: Nonetheless simply chilling on X, @LaurenWeberHP.
Rovner: We will probably be again in your feed subsequent week. Till then, be wholesome.
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Audio producer
Lonnie Ro
Audio producer
Emmarie Huetteman
Editor
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