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 writer of the critically praised reference e-book “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 12 months — which largely don’t embrace well being coverage. However well being is prone to play an necessary supporting function in efforts to resume tax cuts, revise immigration insurance policies, and alter commerce — if solely to assist pay for some Republican initiatives.
In the meantime, the outgoing Biden administration is racing to complete its well being coverage to-do listing, together with finalizing a coverage that bars credit score bureaus from together with medical debt on people’ credit score studies.
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 listing of priorities as lawmakers lay the desk for the incoming Trump administration — although Republicans have floated Medicaid work necessities to chop federal spending.
- A number of well being laws hit the cutting-room flooring in December, together with a bipartisan proposal concentrating 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 closing farewell to former President Jimmy Carter, his world well being work, specifically, is being celebrated — particularly his efforts to eradicate such devastating ailments as Guinea worm illness and river blindness.
- In the meantime, the Biden administration finalized the rule barring medical debt from showing on credit score studies. 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 “additional credit score,” the panelists recommend well being coverage tales they learn this week that they assume it’s best to learn, too:
Julie Rovner: The Wall Road Journal’s “UnitedHealth’s Military of Docs Helped It Accumulate 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 Personal 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: Whats up, 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 few 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 this time we’re joined by way of videoconference by Alice Miranda Ollstein of Politico.
Alice Miranda Ollstein: Whats up.
Rovner: Lauren Weber of The Washington Publish.
Lauren Weber: Whats up hi there.
Rovner: And Shefali Luthra of The nineteenth.
Shefali Luthra: Whats up.
Rovner: No interview this week — manner 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 instant agenda right here in Washington for well being care? Anyone?
Ollstein: So well being care isn’t 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 large, conglomerate payments that they’ve criticized up to now and stated that they don’t like doing that, and they’d a lot relatively vote on particular person issues one after the other.
However now they’re speaking about cramming every little thing into one large reconciliation invoice early within the new administration. And there’ll seemingly be some well being care elements. We don’t know but what these will likely be. Issues that purport to save cash are much more seemingly than issues that purport to price cash. Though, there’s usually 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 individuals’s protection and what it means when it comes to financial savings.
However I believe that numerous the formidable stuff that lawmakers tried to get by way of on the finish of the 12 months is now in query, as as to whether it has a future or not. As a result of the highest priorities of the brand new administration are extra on taxes and commerce and immigration and issues like that and never as a lot on well being coverage.
Rovner: Though, I might level out that that end-of-the-year rush that they acquired — they saved the federal government open, they usually acquired 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 following one quickly. All people’s busy speaking about this big tax invoice, reconciliation. What are we going to do about Medicaid? And it’s like, hi there, the present fiscal 12 months isn’t 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 with regards to these payments. You’ve acquired 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 believe we’re coming into an period wherein payments and actions all have catchy slogans. And I imply, heck, the American public could have a greater understanding, or at the very least know what these individuals are telling them is occurring with this advertising, 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 examine, which is that they preserve speaking about this massive, 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 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 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 speeding it by way of.
Additionally, all this stuff that they’re speaking about placing into this reconciliation invoice will not be 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 mainly 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 venture. I imply, they will’t even agree but on whether or not to do one massive, stunning invoice or two. And the individuals pushing for 2 are declaring that in the event 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 definately don’t actually have something to indicate to 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 would possibly 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 following few years.
Rovner: And in the event you thought that the Home was ungovernable with its tiny Republican majority within the final Congress, it’s even tinier now. In truth, we do have Speaker Mike Johnson. He did get elected on the primary poll, nevertheless it was not simple. 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 believe what will likely be actually attention-grabbing, as properly, is to see how this emerges in the entire extra fractious points among the many Republican Social gathering. I do know we’ve talked lots about how the Republican Social gathering may be very divided on numerous 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 will likely be attending to that very quickly. However it’s simply very clear that every one of those points, the place they venture unity, are fairly rapidly going to collapse with regards to partaking with the truth that this can be a very divided coalition, and numerous the issues they’re speaking about doing will not be highly regarded with voters. And so we’ll see how that impacts them as properly.
Rovner: Sure. So let’s transfer again slightly bit. After we left issues in December, we have been a day away from a attainable authorities shutdown, which didn’t occur. However the different factor that didn’t occur was an enormous package deal with mainly a whole 12 months’s price of bipartisan well being coverage work in it, every little thing from new transparency necessities for pharmacy advantages managers [PBMs], to renewals of applications to arrange for the following pandemic and to struggle the opioid epidemic, to rolling again cuts to docs beneath Medicare. Most of that didn’t make it into the ultimate package deal 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 neighborhood well being facilities and another expiring applications — 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 cause to assume that Congress goes to choose it up and move it this 12 months? And even when they do this Trump would signal it? Or did all of that work final 12 months, is that every one simply mainly for naught now?
Ollstein: I imply, I believe you can make an argument both manner. You possibly can make an argument that it has an opportunity as a result of there may be bipartisan help. A few of these issues might save the federal government cash and assist pay for different issues that the Republican majority desires to do, like reduce taxes.
Rovner: I might 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 up to now which have bipartisan help that will get monetary savings additionally fall by the wayside, simply because they aren’t priorities. And so, I believe, you can also make the optimistic or the pessimistic case on this one.
Rovner: Go forward, Lauren.
Weber: I might simply add, I imply, numerous issues that folks have been fairly upset about, when it comes to smaller issues, health-wise, additionally acquired reduce 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 number of outcry after that acquired stripped out of the invoice. Understandably so, contemplating, mainly 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 embrace the complete measures to essentially prioritize some stress 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, at the very least 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 believe it’s going to be — I believe numerous these new committee chairs, notably within the Senate, the place the Republicans are taking up, are going to need to determine their manner out and attempt to decide up a few of the items. One attention-grabbing 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, “Personal Fairness in Well being Care Proven to Hurt Sufferers, Degrade Care and Drive Hospital Closures.” Does this recommend that Congress would possibly attempt to do one thing on this extraordinarily fraught topic?
Shefali, you might be smiling. I imply—
Luthra: I’m smiling as a result of a few issues, and the primary is that there was numerous discourse about non-public fairness’s influence on well being take care of customers for years. That is very attention-grabbing and necessary work, and it’s not in any respect shocking.
And the opposite factor that we now have to recollect is that Donald Trump will likely 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 truly change into regulation and getting his signature. And a part of that’s as a result of, we will keep in mind from the final time he was president, he fairly often would change what he believed primarily based on the final individual he spoke to. We noticed this on a regular basis with drug pricing.
And I simply assume that we’ll see actually attention-grabbing bipartisan analyses of issues that might make actual variations for customers 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 more durable for us to essentially predict in a significant manner.
Rovner: Yeah, I believe every little thing’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 you have got lawmakers issuing fairly strident releases that tie non-public fairness to lower affected person outcomes of their particular districts is a little bit of a step ahead. I imply, you have got [Sen. Charles] Grassley saying: Look, none of those individuals care about affected person care. They solely care about shareholders. I do assume that may be a shift in rhetoric, to an extent. We’ve seen a constructing for fairly a while. We’ve all talked about non-public fairness on this podcast.
However I do assume when you have got lawmakers making that bounce to, Oh, individuals in my district are getting worse well being care due to this, I believe you can see extra motion.
Rovner: Yeah, it’s one thing I’m going to control. Like I stated, I used to be shocked to see that as a bipartisan report from a committee, though 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 considered one of an extended listing of Democratic presidents who tried and did not overhaul the nation’s well being care system. You possibly can Google one thing known as “hospital price containment” if you wish to know extra. He additionally created the Well being Care Financing Administration to run Medicare and Medicaid, which acquired 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 ailments that largely afflict the poorest and most marginalized individuals on the planet. That’s going to be considered one of his actual main legacies, was bringing world well being house. Proper, Alice?
Ollstein: Yeah, and I believe that’s attention-grabbing, 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 vital of how worldwide cooperation occurred throughout the covid-19 pandemic. And so I believe that’s going to be an attention-grabbing 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 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 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 believe what was most shifting in the entire 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 stay in. I imply, that is him utilizing his gentle energy to demand motion, by flying out to far-flung corners of the world, to fulfill with farmers who had been disabled by Guinea worm, to be sure that this didn’t occur to future generations.
And a few of these biographers have posited that’s due to his upbringing as a poor farmer in Georgia. So I believe that is sort of a once-in-a-generation second to have a look at this influence 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 following two weeks to the Biden administration, which is utilizing its final days to try to get as a lot performed and trumpet as many victories as it might. We’ll begin with the Inexpensive Care Act, the place the administration simply introduced that with every week left to go within the official sign-up interval in most states, 24 million individuals have now been enrolled in ACA plans. That’s up 3 million simply from final 12 months and greater than double the quantity from 2021 when [Joe] Biden took workplace.
After all, that is prone to be the excessive water mark. This 12 months marked the primary that the so-called Dreamers, these individuals introduced illegally to the U.S. as kids by their mother and father, they may enroll, at the very least for now. That’s one thing President Trump and the Republican Congress is taken into account prone to finish. Plus, the extra tax credit that have been put in place throughout the pandemic expire on the finish of this 12 months, 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 in the present day. There’s been numerous 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 price 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 prone to be numerous wrangling and horse-trading round this. I don’t assume the subsidies are essentially toast, however I don’t assume that they’re a performed deal, both.
Rovner: Yeah, I imply, I preserve saying, I believe all people’s first inclination after Election Day is that they have been toast, as a result of Republican trifecta. However, whenever you truly dig into the numbers, the most important will increase have are available in pink states.
Ollstein: Completely.
Rovner: So the people who find themselves benefiting from these additional subsidies are people who find themselves in Republican states and voted for Republicans and are represented by Republicans. And also you’ve acquired to wonder if they wish to, instantly subsequent January, or actually subsequent October, November, when individuals notice: Oh my goodness, my premiums for my medical insurance are going to quadruple. How did this occur? Perhaps they’ll take into consideration that once they’re placing all of those massive, stunning payments collectively, possibly?
Ollstein: Yeah, we’ve began to see some feedback from some Republicans. After all, it’s those who’ve been keen to work with Democrats up to now, like Lisa Murkowski within the Senate, saying that we must always take a look at extending these subsidies. You’re not listening to that from most Republicans by any stretch of the creativeness, however I 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 discuss “DOGE” [the “Department of Government Efficiency”] and reducing all this cash, however as you simply acknowledged, Alice, they’re seemingly to not eliminate these subsidies. Johnson went on the document, I believe this week or final week, to say Medicare isn’t going to get impacted. Medicaid cuts appear to be coming, however pricey God, in the event you don’t reduce a few of these different issues, I don’t know the way you might 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 reduce, saying that $2 trillion was aspirational and hopefully they’ll get $1 trillion. And so that you’re already beginning to see the walk-back of a few of the preelection guarantees on that entrance as they begin to confront a few 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’d assume 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 might be prone to be undone, the Shopper Monetary Safety Bureau finalized its rule this week barring using medical debt on credit score studies. It’s already been sued for exceeding its authority by two commerce teams representing collectors. How necessary would this transformation be if it truly survives?
Luthra: One thing like this might be actually significant. I keep 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 truly virtually all the time not deliberate, since you don’t hope to fall sick. You don’t attempt to get a devastating harm that your insurance coverage won’t absolutely cowl the prices for.
And this was one thing that had actually been championed by of us within the shopper advocacy area for a really very long time, properly earlier than the Biden administration. Shedding it could 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 People.
Rovner: Nicely, lastly, as considered one of his parting suggestions, outgoing Surgeon Normal 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 explanation for most cancers. However this doesn’t really feel super-likely to occur, between the facility of the alcohol business and the mistrust of science, notably when it recommends issues individuals in all probability don’t wish to hear. I assume no one right here is betting on this occurring anytime quickly?
Ollstein: No, you’ve already seen members of Congress for whom the alcohol and beverage business may be very economically necessary for his or her state, all the parents who characterize breweries and distilleries and wineries, already talking out and sharing considerations about this. However I believe that simply the surgeon basic utilizing the bully pulpit to shine a lightweight on this, it generated numerous information protection. That’s necessary.
It’s necessary for customers to see that and be capable of make selections. And also you’re already seeing some traits of youthful of us being extra form of sober-curious. And there’s numerous 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 believe that is one thing that individuals are slowly changing 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 all people smoked after which regularly fewer and fewer and fewer individuals did. Lauren, did you wish to say one thing?
Weber: Yeah, I imply, I’ve written lots about meals labels within the final couple of years, and, I imply, that’s simply been a torturous course of. So the concept something on alcohol would change at something sooner than a glacial tempo I believe might be problematic, contemplating there’s numerous legal professionals 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 well-liked — and authorized. Nicely, let’s flip to abortion reproductive well being. All issues thought-about, it’s truly 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 similar time. New Senate Majority Chief John Thune has introduced his intention to convey up an abortion invoice. On this case, not a nationwide ban, which President-elect Trump has stated he wouldn’t signal, however relatively the, quote, “Born-Alive Abortion Survivors Safety Act.” What is that this invoice? And what wouldn’t it 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 have been chatting about this upfront of taping the podcast, and that is actually attention-grabbing for lots of causes. What this invoice would do is, primarily, if somebody offers start, the hospital or the well being care supplier is required to supply all types of lifesaving care, even when it looks as if the new child won’t stay. And that is related in numerous 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 truly going to be one thing that resembles an toddler being born. And so what this truly does in apply, numerous 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 baby that won’t stay, forces docs to supply medical interventions that possibly gained’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 baby that gained’t stay, and it might’t spend its few moments with some sort 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 could 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 sort 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 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 concentrate on instances the place they assume they may have a greater probability of profitable, 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: Principally, it’s a messaging invoice to try to put supporters of abortion rights on the spot and say, When you gained’t vote for this, then you definately’re for infanticide. I imply, that’s primarily what the controversy’s going to be. Proper, Alice?
Ollstein: Yeah. 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 massive anti-abortion demonstration in Washington, D.C.
Rovner: I might 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 look at the anniversary of Roe anyhow. However like Shefali stated, it’s attention-grabbing that, even on condition that that is only a messaging vote, they’re nonetheless aiming lots decrease than they’ve up to now and never introducing the large, sweeping anti-abortion insurance policies that the advocacy teams on that facet wish to see, when it comes to restrictions on abortion medicine, 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 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 ladies dying from preventable and/or treatable problems. Wyden’s workers 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 manner.
Quoting from the report, “Docs are enjoying lawyer, and legal professionals are enjoying physician, whereas pregnant ladies 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 scenario turns into life-threatening.” Is there something on the horizon that will 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 should be modified, they usually as an alternative are introducing these new, what they name “med ed” payments that mainly order the federal government, in collaboration with anti-abortion teams, to develop supplies that docs and medical college students should evaluate, that purport to elucidate what’s and isn’t allowed when it comes to abortion care and emergency care beneath these restrictions.
One state thus far has applied this, South Dakota, and they’re trying to introduce it in a bunch of different states. Now, the medical neighborhood says there’s no manner a video goes to resolve this. These are extremely advanced conditions. You possibly can’t cowl every little thing which may come up. You possibly can’t cowl each situation a pregnant individual might have. They usually see it as form of a CYA — if of us are conversant in “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 opposed outcomes are the fault of docs for not understanding or accurately 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 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 docs for issues that docs say is commonplace medical apply.
Ollstein: Proper, so even when a health care provider got here ahead and stated, It’s my medical judgment that this individual wants an abortion for medical causes, we noticed the legal professional 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 performed, and I’m positive Shefali has performed, 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 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 mainly 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 might assume. Despite the fact that Fb wasn’t doing such an incredible 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 partially after the 2016 election when there was numerous claims of voter fraud. There are numerous, How did Trump get into workplace? They instituted fact-checking to allegedly sort of pander to individuals who felt like that there was numerous misinformation unfold then. Now they’re shifting away from fact-checking as a result of they really feel like then it offers individuals the power to replicate what the neighborhood desires. I believe it’s reflecting the development 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 knowledgeable. 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 will not be. That was the body of that announcement, mainly. And in order that, I’ve already seen, is elevating considerations in some teams on the left, and medical teams, about entry to details about sorts of care which might be restricted in Texas, like abortion care, like trans care.
Will individuals be capable of publish about these issues, to publish correct issues about these issues on these platforms? Or will that be restricted sooner or later? It’s additionally drawing consideration for that cause.
Luthra: And if I can add yet one more level to what Alice talked about, I imply, one of many very specific areas the place Mark Zuckerberg stated he would love 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 ladies ought to exist in our society, about LGBTQ+ individuals, about explicitly permitting customers to name them mentally ailing.
And this has very significant implications for gender equality, positive, but additionally for well being care, as a result of we’re seeing that one of the vital 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 take a look at this and assume, oh, there will likely be no implication for a way individuals conceive of well being care and the way individuals conceive of those that obtain this sort of well being care.
Rovner: And we must always level out, which I ought to have at first, this isn’t simply Fb — that is all of Meta. So that is Fb and Instagram and Threads. It’s mainly, as a result of I do know that solely form of outdated individuals like me are nonetheless on Fb, however numerous 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 when you find yourself unsuitable. And this week we now have an enormous unsuitable 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 constructed from recycled electronics and have been leaching quantities of fireside retardants and different chemical compounds into your meals.
Nicely, it seems that you simply in all probability 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 research made a math error that exaggerated the degrees of poisons by an element of 10. Nonetheless, in the event you don’t wish to be uncovered to fireplace retardants and different nasty stuff, you would possibly wish to cook dinner with steel or silicone or one thing that’s not 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 acquired this unsuitable. However right here, it doesn’t change our basic conclusion about this. However it’s best to 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 gasoline mistrust. Individuals level to that and say: See, they acquired that unsuitable. They should be getting all this different stuff unsuitable, too. However after all, not correcting misinformation is way 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 reports in regards to the black plastic additionally see the correction and see that it wasn’t true? How are this stuff framed? Had been the splashy articles that have been run, have been they corrected? Had been they retracted? It’s 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 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 phase. That’s the place we every acknowledge the story we learn this week we predict it’s best to learn, too. Don’t fear. When you miss it, we’ll put the hyperlinks in our present notes in your cellphone or different cell gadget.
Lauren, you have been first this week, so why don’t you go first?
Weber: I like this story, and I’m clearly biased, however by my colleagues David Ovalle and Rachel Roubein, on how “Legal guidelines prohibit U.S. delivery of vape merchandise. Many firms do it anyway.” Primarily, you shouldn’t be delivery flavored vapes throughout the nation, however a bunch of firms do. And my colleagues have 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 manner, once 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, find out how to cease the delivery of those vapes, nevertheless it’s probably not occurring. So it’s sort of a take a look at one of the best intentions is probably not the fact on the bottom.
Rovner: Usually. Alice.
Ollstein: So I’ve a bit 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 considered one of Trump’s newest obsessions.
And this piece is declaring that tariffs on Denmark would influence numerous issues the U.S. inhabitants depends upon. Particularly, the pharma large Novo Nordisk is predicated there and manufactures tons of medicines, together with Ozempic, and different weight reduction medicine and diabetes medicine in that household which might be extremely well-liked proper now, and in addition to listening to aids, different medical gadgets, different medicines. And so this might influence customers, if it ever have been to occur, which who even is aware of.
Rovner: Sure. Nicely, we’ll discuss 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 sensible. I like this framing. It first lays out the proof for why, when automobiles 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 truly deal with this as a public well being menace?
They usually 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 believe that is actually attention-grabbing for lots of causes. One is that public well being is basically expansive and we must always give it some thought in an expansive manner and take into account all of the completely different components, like automobile measurement, 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 in regards to the surgeon basic’s alcohol warning, in that even in need of 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 individuals in a course towards being more healthy and holding our fellow People more healthy. And that’s actually attention-grabbing 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 Road Journal. It’s known as “UnitedHealth’s Military of Docs Helped It Accumulate Tens of millions Extra From Medicare,” by Christopher Weaver, Anna Wilde Mathews, and Tom McGinty. And it’s mainly 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 save lots of the insurer cash. It is a story about how United is forcing the docs who work for the corporate — and there are numerous them, like 10,000 — to mainly 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 median of 55%, which was, quoting from the story, “roughly equal to each affected person getting newly identified with HIV … and breast most cancers,” mainly maximizing income 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, in the event you benefit from the podcast, you can subscribe wherever you get your podcasts. We’d admire it in the event you left us a evaluate. That helps different individuals discover us, too. Particular thanks, once more this week, to our non permanent 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 [email protected], or you may nonetheless discover me at X, @jrovner, and more and more at Bluesky, @julierovner.bsky.social. The place are you guys largely today? 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 likely 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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