The Host
Julie Rovner
KFF Well being Information
Julie Rovner is chief Washington correspondent and host of KFF Well being Information’ weekly well being coverage information podcast, “What the Well being?” A famous skilled on well being coverage points, Julie is the creator of the critically praised reference guide “Well being Care Politics and Coverage A to Z,” now in its third version.
The brand new, GOP-led, 119th Congress and President-elect Donald Trump have massive legislative plans for the yr — which largely don’t embody well being coverage. However well being is more likely to play an necessary 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 stories.
This week’s panelists are Julie Rovner of KFF Well being Information, Shefali Luthra of The nineteenth, Alice Miranda Ollstein of Politico, and Lauren Weber of The Washington Publish.
Panelists
Shefali Luthra
The nineteenth
Alice Miranda Ollstein
Politico
Lauren Weber
The Washington Publish
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 variety of well being laws hit the cutting-room flooring in December, together with a bipartisan proposal focusing on pharmacy profit managers — which might have saved the federal authorities and sufferers billions of {dollars}. And talking of bipartisan efforts, a congressional report from the Senate Price range Committee provides to proof that personal fairness involvement in care is related to worse outcomes for sufferers — notably, lawmakers’ constituents.
- Because the nation bids a remaining farewell to former President Jimmy Carter, his 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 stories. The surgeon basic cautions that alcohol ought to include warning labels noting most cancers threat. And the brand new Senate Republican chief is elevating abortion-related laws to require lifesaving take care of all infants born alive — but these protections exist already.
Plus, for “further credit score,” the panelists counsel well being coverage tales they learn this week that they assume you must learn, too:
Julie Rovner: The Wall Avenue Journal’s “UnitedHealth’s Military of Medical doctors Helped It Acquire Billions Extra From Medicare,” by Christopher Weaver, Anna Wilde Mathews, and Tom McGinty.
Alice Miranda Ollstein: The New York Instances’ “Ozempic, Lego Bricks and Listening to Aids: What Trump’s Greenland Plan May Hit,” by Ana Swanson and Jenny Gross.
Shefali Luthra: Vox.com’s “Gigantic SUVs Are a Public Well being Risk. Why Don’t We Deal with Them Like One?” by David Zipper.
Lauren Weber: The Washington Publish’s “Legal guidelines Prohibit U.S. Delivery of Vape Merchandise. Many Corporations Do It Anyway,” by David Ovalle and Rachel Roubein.
Additionally talked about on this week’s podcast:
The Senate 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 12 months, 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: Howdy, 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 greatest and smartest well being reporters in Washington. We’re taping this week on Thursday, Jan. 9, at 10 a.m. As all the time, information occurs quick and issues might need modified by the point you hear this. So, right here we go.
Rovner: At the moment we’re joined through videoconference by Alice Miranda Ollstein of Politico.
Alice Miranda Ollstein: Howdy.
Rovner: Lauren Weber of The Washington Publish.
Lauren Weber: Howdy good day.
Rovner: And Shefali Luthra of The nineteenth.
Shefali Luthra: Howdy.
Rovner: No interview this week — approach 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 wanting forward. What’s on the speedy agenda right here in Washington for well being care? Anyone?
Ollstein: So well being care just isn’t the precedence proper now for the incoming administration, for the brand new Republican trifecta in Washington. It could make it in, as a result of they’re speaking about these huge, conglomerate payments that they’ve criticized previously and stated that they don’t like doing that, and they’d a lot quite vote on particular person issues one after the other.
However now they’re speaking about cramming all the things into one large reconciliation invoice early within the new administration. And there’ll doubtless be some well being care elements. We don’t know but what these might 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 discuss 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 folks’s protection and what it means when it comes to financial savings.
However I feel that a whole lot of the bold stuff that lawmakers tried to get by way 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 bought — they stored the federal government open, and so they bought the federal government funded — that solely goes till March. I noticed form of a plaintive e mail yesterday from Tom Cole, the Republican chairman of the Home Appropriations Committee, saying, Um, we now have to begin engaged on the subsequent one quickly. Everyone’s busy speaking about this large tax invoice, reconciliation. What are we going to do about Medicaid? And it’s like, good day, the present fiscal yr just isn’t completed. They simply 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 selling in relation to these payments. You’ve bought President-elect [Donald] Trump saying he desires one massive, stunning invoice. That’s what he desires. He desires one massive, stunning invoice. And it’s not simply Trump. I imply, let’s take a look at the MAHA motion, the “Make America Wholesome Once more” motion.
I imply, I feel we’re coming into an period during which payments and actions all have catchy slogans. And I imply, heck, the American public could have a greater understanding, or no less than know what these individuals are telling them is going on with this advertising and marketing, we’ll see. So I simply needed to flag that this appears to be the change over right here.
Rovner: And that is after I get to place in my different actuality verify, which is that they preserve speaking about this massive, stunning reconciliation invoice that they solely want Republican votes for. I’ve to remind folks yearly: With the intention to do a reconciliation invoice, first they need 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 necessary spending to the phrases of the price range decision. It takes a very long time to do a price range decision, even if you’re speeding it by way of.
Additionally, all these items that they’re speaking about placing into this reconciliation invoice are usually not allowed to enter price range reconciliation. It’s solely about necessary spending. It’s taxes. It’s Medicare and Medicaid and different necessary 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 feel we’re already seeing cracks rising on this nice Republican unity that they’re making an attempt to challenge. I imply, they will’t even agree but on whether or not to do one massive, stunning invoice or two. And the folks pushing for 2 are declaring 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 on your work.
Which after all is a scenario Congress has discovered itself in lots of occasions 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 may make it by way 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 continuing 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. In reality, 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 with a view 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 feel what might be actually fascinating, as properly, is to see how this emerges in all the extra fractious points among the many Republican Social gathering. I do know we’ve talked so much about how the Republican Social gathering may be very divided on a whole lot of problems with reproductive well being, together with abortion, one thing Alice and I each take into consideration on a regular basis. And—
Rovner: And we’ll get to in a couple of minutes.
Luthra: We might be attending to that very quickly. However it’s simply very clear that every one of those points, the place they challenge unity, are fairly rapidly going to collapse in relation to partaking with the truth that this can be a very divided coalition, and a whole lot of the issues they’re speaking about doing are usually not highly regarded with voters. And so we’ll see how that impacts them as properly.
Rovner: Sure. So let’s transfer again just a little bit. Once we left issues in December, we have been a day away from a doable authorities shutdown, which didn’t occur. However the different factor that didn’t occur was a giant bundle with principally a complete yr’s price of bipartisan well being coverage work in it, all the things from new transparency necessities for pharmacy advantages managers [PBMs], to renewals of packages to organize for the subsequent pandemic and to battle the opioid epidemic, to rolling again cuts to docs below Medicare. Most of that didn’t make it into the ultimate bundle that may preserve the federal government operating till March.
The tiny issues that did make it in have been extensions of telehealth authority for Medicare and funds for group well being facilities and another expiring packages — however once more, solely by way 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 now have any motive to assume that Congress goes to select it up and go it this yr? And even when they try this Trump would signal it? Or did all of that work final yr, is that every one simply principally for naught now?
Ollstein: I imply, I feel you possibly can make an argument both approach. You could possibly make an argument that it has an opportunity as a result of there may be bipartisan help. A few of these issues may save the federal government cash and assist pay for different issues that the Republican majority desires 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 desires to defend them proper now. So you can also make the argument that it has an opportunity due to that, however we’ve seen tons of well being insurance policies previously which have bipartisan help that might lower your expenses additionally fall by the wayside, simply because they aren’t priorities. And so, I feel, you can also make the optimistic or the pessimistic case on this one.
Rovner: Go forward, Lauren.
Weber: I’d simply add, I imply, a whole lot of issues that folks have been fairly upset about, when it comes to smaller issues, health-wise, additionally bought 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 variety of outcry after that bought 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 probably 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 complete measures to essentially prioritize some strain on the FDA [Food and Drug Administration] and different funding to enhance childhood most cancers analysis. And so I feel you’re going to proceed to see, no less than from the Dems, some declaring of those points going ahead as, I imply, childhood most cancers and 9/11 first responders are fairly sympathetic characters for funding.
Rovner: Yeah, I feel it’s going to be — I feel a whole lot of these new committee chairs, notably within the Senate, the place the Republicans are taking up, are going to must determine their approach out and attempt to decide up a number of the items. One fascinating factor that got here by way 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 may 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 a whole lot of discourse about personal fairness’s affect on well being take care of shoppers for years. That is very fascinating and necessary work, and it isn’t in any respect stunning.
And the opposite factor that we now have to recollect is that Donald Trump might be president. He’s ideologically very unpredictable. As an actor, he’s very unpredictable. And it’s simply very tough to guess what’s 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 based mostly on the final particular person he spoke to. We noticed this on a regular basis with drug pricing.
And I simply assume that we’ll 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 folks’s lives, that’s simply a lot, a lot tougher for us to essentially predict in a significant approach.
Rovner: Yeah, I feel all the things’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 feel the concept that you have got lawmakers issuing fairly strident releases that tie personal fairness to lower affected person outcomes of their particular districts is a little bit of a step ahead. I imply, you have got [Sen. Charles] Grassley saying: Look, none of those folks care about affected person care. They solely care about shareholders. I do assume that could be a shift in rhetoric, to an extent. We’ve seen a constructing for fairly a while. We’ve all talked about personal fairness on this podcast.
However I do assume when you have got lawmakers making that bounce to, Oh, folks in my district are getting worse well being care due to this, I feel you possibly can see extra motion.
Rovner: Yeah, it’s one thing I’m going to keep watch over. Like I stated, I used to be stunned to see that as a bipartisan report from a committee, although it’s the Price range Committee that doesn’t actually have authority to do something legislatively. Nonetheless, it was price noting.
Properly, in case there wasn’t already sufficient information this week, right here in Washington this very morning, we’re bidding farewell to former President Jimmy Carter, who died at age 100 late final month. Carter was one in every of a protracted checklist of Democratic presidents who tried and did not overhaul the nation’s well being care system. You may Google one thing known as “hospital value containment” if you wish to know extra. He additionally created the Well being Care Financing Administration to run Medicare and Medicaid, which bought renamed the Facilities for Medicare & Medicaid Companies within the early 2000s.
However Carter’s greatest well being achievements got here after he left workplace. His work by way of his basis addressed, and in some instances almost eradicated, some largely uncared for tropical illnesses that largely afflict the poorest and most marginalized folks on the planet. That’s going to be one in every of his actual main legacies, was bringing world well being dwelling. Proper, Alice?
Ollstein: Yeah, and I feel that’s fascinating, given the popularity of his legacy proper now, round his funeral, and mendacity in state within the Capitol, with the Trump administration coming into workplace, being very in opposition to our bodies just like the WHO [World Health Organization] and worldwide cooperation on well being care, very vocally essential of how worldwide cooperation occurred through the covid-19 pandemic. And so I feel that’s going to be an fascinating distinction, given what Carter was in a position to obtain by way of such cooperation.
Rovner: Yeah. Lauren?
Weber: Yeah, I simply needed so as to add, I imply, it’s a mannequin that I feel then seeped into different presidents, proper? I imply, you’ve seen [former president George W.] Bush’s funding in world well being, and so forth. And I do assume, as Alice well identified, there may be, clearly, a pointy distinction. However I imply, what Carter was in a position to do for river blindness and Guinea worm is unprecedented. And I feel what was most shifting 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 tender energy to demand motion, by flying out to far-flung corners of the world, to satisfy with farmers who had been disabled by Guinea worm, to make it possible for this didn’t occur to future generations.
And a few of these biographers have posited that’s due to his upbringing as a poor farmer in Georgia. So I feel that is form of a once-in-a-generation second to have a look at this affect 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 significant precedence. Properly, 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 achieved and trumpet as many victories as it could actually. We’ll begin with the Reasonably priced 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 folks have now been enrolled in ACA plans. That’s up 3 million simply from final yr and greater than double the quantity from 2021 when [Joe] Biden took workplace.
In fact, that is more likely to be the excessive water mark. This yr marked the primary that the so-called Dreamers, these folks introduced illegally to the U.S. as kids by their mother and father, they might 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 have been put in place through the pandemic expire on the finish of this yr, except Congress renews them. What’s the outlook for ACA enrollment?
Ollstein: Properly, Democratic senators are beginning to make a push to increase these subsidies, introducing laws and making a giant splash about it at present. There’s been a whole lot 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.
In fact, they value some huge cash, and the brand new congressional majority positively has different issues they wish to spend that cash on, that aren’t serving to folks purchase medical insurance plans as a part of the Reasonably priced Care Act. And so, I feel there may be more likely to be a whole lot of wrangling and horse-trading round this. I don’t assume the subsidies are essentially toast, however I don’t assume that they’re a achieved deal, both.
Rovner: Yeah, I imply, I preserve saying, I feel everyone’s first inclination after Election Day is that they have been toast, as a result of Republican trifecta. Alternatively, if you really dig into the numbers, the largest will increase have are available in purple states.
Ollstein: Completely.
Rovner: So the people who find themselves making the most of these further subsidies are people who find themselves in Republican states and voted for Republicans and are represented by Republicans. And also you’ve bought to wonder if they wish to, all of a sudden subsequent January, or actually subsequent October, November, when folks understand: Oh my goodness, my premiums for my medical insurance are going to quadruple. How did this occur? Possibly they’ll take into consideration that after they’re placing all of those massive, stunning payments collectively, perhaps?
Ollstein: Yeah, we’ve began to see some feedback from some Republicans. In fact, it’s those who’ve been keen to work with Democrats previously, like Lisa Murkowski within the Senate, saying that we should always take a look at extending these subsidies. You’re not listening to that from most Republicans by any stretch of the creativeness, however I feel you’re beginning to hear these rumblings as a result of, such as you stated, Julie, they don’t wish to have a bunch of constituents lose their insurance coverage or have their insurance coverage get far more costly after 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 discuss “DOGE” [the “Department of Government Efficiency”] and reducing all this cash, however as you simply acknowledged, Alice, they’re doubtless to not do away with these subsidies. Johnson went on the document, I feel this week or final week, to say Medicare just isn’t 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: Properly, 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 assume that Trump of all folks would know higher, as a result of he tried to repeal the Reasonably priced Care Act within the first hundred days in 2017, and that didn’t go so properly. However apparently he has a brief reminiscence, too.
Properly, 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 stories. It’s already been sued for exceeding its authority by two commerce teams representing collectors. How necessary would this transformation be if it really survives?
Luthra: One thing like this could possibly be actually significant. I bear in mind speaking to households about their efforts to purchase properties 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 normally not deliberate. It’s in all probability really virtually all the time not deliberate, since you don’t hope to fall sick. You don’t attempt to get a devastating damage that your insurance coverage is not going to totally cowl the prices for.
And this was one thing that had actually been championed by of us within the shopper advocacy house for a really very long time, properly earlier than the Biden administration. Shedding it could actually have implications for folks throughout the political spectrum, particularly as we’re on this house the place housing stays very costly, the place medical debt is an actual concern, and the place having it have an effect on your credit score may actually put an affordable mortgage simply out of attain for lots of People.
Rovner: Properly, lastly, as one in every of his parting suggestions, outgoing Surgeon Common Vivek Murthy has issued a report recommending that alcoholic drinks carrying warning labels that they will trigger most cancers, similar to tobacco merchandise. His report calls alcohol the third-leading preventable reason for most cancers. However this doesn’t really feel super-likely to occur, between the facility of the alcohol trade and the mistrust of science, notably when it recommends issues folks in all probability don’t wish to hear. I assume no person right here is betting on this occurring anytime quickly?
Ollstein: No, you’ve already seen members of Congress for whom the alcohol and beverage trade may be very economically necessary for his or her state, all the parents who symbolize breweries and distilleries and wineries, already talking out and sharing issues about this. However I feel that simply the surgeon basic utilizing the bully pulpit to shine a lightweight on this, it generated a whole lot of information protection. That’s necessary.
It’s necessary for shoppers to see that and be capable of make decisions. And also you’re already seeing some developments of youthful of us being extra form of sober-curious. And there’s a whole lot of discuss Dry January being a wholesome factor to do. And much more bars you’re seeing provide low-alcohol or nonalcoholic choices. And so I feel that is one thing that individuals are slowly turning into extra conscious of and extra involved about, whether or not the federal government steps in or not.
Rovner: Yeah, I feel it could be like tobacco, the place everyone smoked after which regularly fewer and fewer and fewer folks did. Lauren, did you 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 feel might be problematic, contemplating there’s a whole lot 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 in style — and authorized. Properly, 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 few weeks. However there has all the time been information, as is predictable when Republicans take over the Home, Senate, and White Home on the similar time. New Senate Majority Chief John Thune has introduced his intention to deliver up an abortion invoice. On this case, not a nationwide ban, which President-elect Trump has stated he wouldn’t signal, however quite the, quote, “Born-Alive Abortion Survivors Safety Act.” What is that this invoice? And what would it not do? And the way is it totally different from a similar-sounding invoice that Congress handed and President George W. Bush signed in 2002?
Luthra: We have been chatting about this upfront of taping the podcast, and that is actually fascinating for lots of causes. What this invoice would do is, primarily, if somebody provides start, the hospital or the well being care supplier is required to offer all types of lifesaving care, even when it looks as if the new child is not going to reside. And that is related in a whole lot of locations. It’s related when, as an example, you perhaps expertise a really, very early supply, during which 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 apply, a whole lot 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 start to a toddler that won’t reside, forces docs to offer medical interventions that perhaps received’t make a distinction however that may delay the chance or forestall the chance for palliative care, which is basically unhappy.
I imply, you give start to a toddler that received’t reside, and it could actually’t spend its few moments with some form of consolation. As an alternative, it’s given medical therapies that won’t actually assist them. This invoice differs from the regulation signed below President Bush in that it could add penalties. However the different factor that’s price noting is that killing infants is already unlawful. We’ve 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 folks. However what we don’t have are nationwide restrictions that stigmatize abortion to the extent that will probably be carried out much less and fewer.
However the different factor I feel is price noting, to your level, Julie, is that this can be a massive step again, particularly for Senator Thune, who was on the document supporting a 15-week nationwide abortion ban and is no longer. And that helps us underscore that nationwide abortion restrictions are very poisonous and that, as an alternative, the GOP is basically making an attempt to deal with instances the place they assume they may have a greater likelihood of successful, by specializing in the very finish of being pregnant, areas the place they see the help for abortion rights publicly go down, and begin with restrictions there, earlier than, in the event that they ever 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 case 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. Properly, and simply so of us are conscious, the timing of that is across the March for Life developing in a pair days after the inauguration. And virtually yearly, Republicans in Congress try to carry some form of messaging vote to coincide with that massive anti-abortion demonstration in Washington, D.C.
Rovner: I’d say the anti-abortion demonstration is when it’s as a result of that was the anniversary of Roe v. Wade. That’s why they arrive to D.C. in January.
Ollstein: Yeah. As an apart, they thought-about shifting it to June to mark the anniversary of Dobbs however determined to maintain it in January to proceed to watch the anniversary of Roe in any case. However like Shefali stated, it’s fascinating that, even on condition that that is only a messaging vote, they’re nonetheless aiming so much decrease than they’ve previously and never introducing the massive, sweeping anti-abortion insurance policies that the advocacy teams on that facet wish to see, when it comes to restrictions on abortion treatment, or like previously, 15-week bans, 20-week bans, one thing like that. As an alternative, that is form of a distinct segment and arguably duplicative coverage that they’re placing ahead.
Rovner: Properly, we will definitely watch that house. Additionally, over the vacation break, an OB-GYN on the College of Indiana sued the Indiana Division of Well being, claiming the state’s new abortion reporting necessities violate the federal HIPAA [Health Insurance Portability and Accountability Act] affected person privateness guidelines. Failure to observe the state regulation may end in potential legal legal responsibility or lack of medical license, however federal regulation is meant to preempt state regulation.
Alongside those self same traces, Senate Finance Committee Chairman, now rating member, Ron Wyden of Oregon launched a report in December, which adopted up on the reporting that we’ve talked about from ProPublica, about pregnant girls dying from preventable and/or treatable issues. Wyden’s employees discovered that docs in states with abortion bans have been unable to get adequate authorized recommendation and/or steering from their hospital officers in a well timed approach.
Quoting from the report, “Medical doctors are enjoying lawyer, and attorneys are enjoying physician, whereas pregnant girls experiencing something wanting what quantities to a dire emergency are despatched away and advised to return to the emergency room as soon as a preventable scenario turns into life-threatening.” Is there something on the horizon that might kind out what docs can and might’t do in states with abortion bans? This continues to be — we preserve 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 must be modified, and so they as an alternative are introducing these new, what they name “med ed” payments that principally order the federal government, in collaboration with anti-abortion teams, to develop supplies that docs and medical college students must evaluation, that purport to elucidate what’s and isn’t allowed when it comes to abortion care and emergency care below these restrictions.
One state to date has applied this, South Dakota, and they’re trying to introduce it in a bunch of different states. Now, the medical group says there’s no approach a video goes to resolve this. These are extremely advanced conditions. You may’t cowl all the things which may come up. You may’t cowl each situation a pregnant particular person may have. And so they see it as form of a CYA — if of us are acquainted with “cowl your behind” — transfer, when it comes to legal responsibility and an try and put the onus on particular person docs who’re already struggling, and to say that any of those adversarial outcomes are the fault of docs for not understanding or appropriately abiding by these authorized restrictions on care.
Whereas the docs say that: We are able to’t get steering from our personal employers. We are able to’t get enough steering from the state. And these actually tie our fingers in these very delicate, time-sensitive, and medically delicate conditions.
Rovner: And we’ve seen instances, I imply like in Texas, the place the lawyer basic has threatened in writing to prosecute docs for issues that docs say is normal medical apply.
Ollstein: Proper, so even when a health care provider got here ahead and stated, It’s my medical judgment that this particular person wants an abortion for medical causes, we noticed the lawyer basic there step in and say: I’m overruling your judgment. No, she doesn’t. And in order that has, based mostly on many interviews I’ve achieved, and I’m certain Shefali has achieved, created an actual chilling impact, the place individuals 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 lawyer on what to do, even a brief delay will be lethal for a affected person in a kind of conditions.
Rovner: Properly, turning to this week in medical misinformation, the massive 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 massive implications for well being misinformation, I’d assume. Though Fb wasn’t doing such an excellent job earlier than on permitting misinformation and disinformation to unfold. Is that this going to have a giant impact?
Luthra: I imply, I feel that is simply, to some extent, an indication of Fb shifting with the political winds, proper? I imply, the fact-checking got here out partially after the 2016 election when there was a whole lot of claims of voter fraud. There are a whole lot of, How did Trump get into workplace? They instituted fact-checking to allegedly form of pander to individuals who felt like that there was a whole lot of misinformation unfold then. Now they’re shifting away from fact-checking as a result of they really feel like then it provides folks the power to mirror what the group desires. I feel it’s reflecting the pattern we’re seeing on X. We’ll see extra Neighborhood Notes. It makes journalists’ job all of the extra necessary, to truly distill what’s true and what’s false.
Rovner: You’re our misinformation skilled. Oh, go forward, Alice.
Ollstein: Oh, I needed to additionally flag that a part of Fb’s announcement was that they’re shifting a few of their groups from California to Texas, as a result of Californians are too biased to do any content material moderation and Texans presumably are usually not. That was the body of that announcement, principally. And in order that, I’ve already seen, is elevating issues in some teams on the left, and medical teams, about entry to details about sorts of care which can be restricted in Texas, like abortion care, like trans care.
Will folks be capable of submit about these issues, to submit correct issues about these issues on these platforms? Or will that be restricted sooner or later? It’s additionally drawing consideration for that motive.
Luthra: And if I can add yet 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 traces of gender, and really explicitly eradicating restrictions on utilizing very, fairly frankly, misogynistic phrases about how girls ought to exist in our society, about LGBTQ+ folks, about explicitly permitting customers to name them mentally in poor health.
And this has very significant implications for gender equality, certain, but in addition 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 folks, is entry to well being care for ladies. And it’s simply very onerous to not take a look at this and assume, oh, there might be no implication for the way folks conceive of well being care and the way folks conceive of those that obtain this type of well being care.
Rovner: And we should always level out, which I ought to have in the beginning, 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 outdated folks like me are nonetheless on Fb, however a number of individuals are on Instagram and Threads, and that is clearly going to have some fairly massive implications as we go ahead.
All proper, properly, talking of misinformation, one mark of accountable science is fessing up if you end up incorrect. And this week we now have a giant incorrect factor to speak about. Again in November, we talked a few research that discovered that black plastic cooking utensils and takeout containers have been harmful as a result of they have been created from recycled electronics and have been leaching quantities of fireplace retardants and different chemical compounds into your meals.
Properly, it seems that you just in all probability nonetheless ought to do away with the black plastic in your kitchen, however know that they’re not fairly as harmful as initially marketed. It seems that the authors of the research made a math error that exaggerated the degrees of poisons by an element of 10. Nonetheless, when you don’t wish to be uncovered to fireplace retardants and different nasty stuff, you may wish to prepare dinner with metallic or silicone or one thing that isn’t black plastic. I do assume that is necessary, 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 bought this incorrect. However right here, it doesn’t change our basic conclusion about this. However you must know that after we make a mistake, we’re going to repair it. I imply, that appears to be very uncommon on this world proper now.
Ollstein: It’s so onerous, since you see the act of admitting error and correcting it — that may gas mistrust. Individuals level to that and say: See, they bought that incorrect. They should be getting all this different stuff incorrect, too. However after all, not correcting misinformation is much worse. And so, in a time of such mistrust, communication is basically, actually onerous. And did all of the individuals who noticed the primary wave of stories concerning the black plastic additionally see the correction and see that it wasn’t true? How are these items framed? Have been the splashy articles that have been run, have been they corrected? Have 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 will assist, I feel, if folks understood that science is extra of a course of than a, that is what’s. However that’s what we’re all right here for, and that’s why all of us nonetheless have jobs. All proper, that’s the information for this week.
Now it’s time for our extra-credit section. That’s the place we every acknowledge the story we learn this week we expect you must learn, too. Don’t fear. In case you miss it, we’ll put the hyperlinks in our present notes in your cellphone or different cellular machine.
Lauren, you have been first this week, so why don’t you go first?
Weber: I really like this story, and I’m clearly biased, however by my colleagues David Ovalle and Rachel Roubein, on how “Legal guidelines prohibit U.S. transport of vape merchandise. Many corporations do it anyway.” Basically, you shouldn’t be transport flavored vapes throughout the nation, however a bunch of corporations do. And my colleagues have been in a position to order and get their fingers on fairly a couple of of these flavored vapes.
My favourite half is the kicker within the story, during which one firm stated, You’re not sanctioned to make use of our title in any approach, after we reached out for remark after that they had shipped us vapes illegally. So I believed 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, the best way to cease the transport of those vapes, nevertheless it’s not likely occurring. So it’s form of a take a look at the perfect intentions will not be the fact on the bottom.
Rovner: Usually. Alice.
Ollstein: So I’ve a chunk from the New York Instances known as “Ozempic, Lego Bricks and Listening to Aids: What Trump’s Greenland Plan May Hit.” And that is coming off of Trump threatening to impose tariffs on Denmark if it refuses to permit the U.S. to take over Greenland, which has change into one in every of Trump’s newest obsessions.
And this piece is declaring that tariffs on Denmark would affect a whole lot of issues the U.S. inhabitants is dependent upon. Particularly, the pharma large Novo Nordisk relies there and manufactures tons of medicines, together with Ozempic, and different weight reduction medicine and diabetes medicine in that household which can be extremely in style proper now, and in addition to listening to aids, different medical gadgets, different drugs. And so this might affect shoppers, if it ever have been to occur, which who even is aware of.
Rovner: Sure. Properly, we’ll speak extra about tariffs and the medical trade in a future podcast, however thanks for noting that. Shefali.
Luthra: My piece is from Vox. It’s by David Zipper. The headline is “Gigantic SUVs are a public well being menace. Why don’t we deal with them like one?”
I feel the story is so good. I really like this framing. It first lays out the proof for why, when automobiles attain a sure dimension, they’re very harmful and more likely to kill folks. After which it will get into the dialog: Why don’t we really deal with this as a public well being menace?
And so they take a look at the conflict on tobacco and the conflict on smoking to assume by way 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 feel that is actually fascinating for lots of causes. One is that public well being is basically expansive and we should always give it some thought in an expansive approach and think about all of the totally different components, like automotive dimension, that do have an effect on our lives and life expectancy.
And I additionally do assume this ties very well to the dialog we had concerning the surgeon basic’s alcohol warning, in that even wanting coverage modifications, 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 as a right, and we will nonetheless transfer folks in a course towards being more healthy and preserving our fellow People more healthy. And that’s actually fascinating and necessary to consider.
Rovner: Most likely simpler to do one thing about giant SUVs than alcohol, however sure, I’m so glad you linked these two issues. My story this week is from The Wall Avenue Journal. It’s known as “UnitedHealth’s Military of Medical doctors Helped It Acquire Hundreds of thousands Extra From Medicare,” by Christopher Weaver, Anna Wilde Mathews, and Tom McGinty. And it’s principally the flip facet of the story that Stat Information has been throughout, about how United has used numerous strategies to disclaim care to its Medicare Benefit sufferers to avoid wasting the insurer cash. This can be a story about how United is forcing the docs who work for the corporate — and there are a whole lot of them, like 10,000 — to principally run by way of a guidelines of potential diagnoses for each Medicare Benefit affected person, to encourage docs 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 shifting from conventional Medicare to United’s Medicare Benefit elevated a mean of 55%, which was, quoting from the story, “roughly equal to each affected person getting newly identified with HIV … and breast most cancers,” principally maximizing earnings from each ends. It’s fairly the story, and I like to recommend it extremely.
OK, that’s this week’s present. I hope you’re feeling caught up and prepared for the remainder of 2025. As all the time, when you benefit from the podcast, you possibly can subscribe wherever you get your podcasts. We’d admire it when you left us a evaluation. That helps different folks discover us, too. Particular thanks, once more this week, to our momentary manufacturing group, Taylor Cook dinner and Lonnie Ro, in addition to our editor, Emmarie Huetteman.
As all the time, you may e mail us your feedback or questions. We’re at whatthehealth@kff.org, or you may nonetheless discover me at X, @jrovner, and more and more at Bluesky, @julierovner.bsky.social. The place are you guys largely lately? Alice?
Ollstein: I’m @alicemiranda on Bluesky, largely.
Rovner: Shefali.
Luthra: You’ll find me on Bluesky, @shefali.
Rovner: Lauren.
Weber: Nonetheless simply chilling on X, @LaurenWeberHP.
Rovner: We might be again in your feed subsequent week. Till then, be wholesome.
Credit
Taylor Cook dinner
Audio producer
Lonnie Ro
Audio producer
Emmarie Huetteman
Editor
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