Happy Friday! A quick programming note before we dive into the week that was absolutely jampacked with news: The Friday Breeze is going on a little hiatus (as yours truly explores Vietnam for a few weeks). I’ll be back in your inboxes Oct. 11, but you can always keep up to date through our host of other newsletters by adjusting your KHN email preferences here.
Now on to what you may have missed!
To be frank, if you missed Thursday’s Democratic presidential debate, you didn’t actually miss much in the way of developments on the candidates’ health care positions. But the sharp divide between the moderates (build upon existing framework) and progressives (sweeping systematic changes) was on display — confirming for perhaps the millionth time that health care will be front and center in the 2020 election.
Beto O’Rourke drew praise from his rivals for how he handled the aftermath of the mass shooting in his hometown, El Paso, Texas — and also went big and bold on his gun control plan. “Hell, yes, we’re going to take your AR-15,” he said, in a declaration that in elections past would have been a nuclear bomb on a candidate’s campaign.
The “babies in cages” line is a go-to for many Democrats criticizing the Trump administration’s treatment of immigrant children in U.S. custody. It made for an awkward moment for former Vice President Joe Biden, who was part of the Obama administration that used the same facilities. “We didn’t lock people up in cages,” Biden said. “We didn’t separate families.” But a fact check shows that neither of those protestations is accurate.
And some people were left wondering after Thursday night: Where are the abortion questions? Considering all the developments that have occurred in the reproductive rights sphere over the past few months, debate watchers (and the candidates themselves!) were frustrated by the omission.
Amid an ever-escalating outbreak of a lung disease that public health officials still haven’t gotten a handle on, President Donald Trump announced that he plans to ban flavored e-cigarettes. A look behind the scenes from Politico shows that first lady Melania Trump — who can be fairly reticent when it comes to public policy — was a driving force behind the president’s decision, which bucks traditional Republican thinking on the matter.
Trump’s decision was just the latest in a broader shift toward public health issues ahead of the 2020 elections. Voters routinely rank health care as high on their list of priorities, but Republicans have been grappling with the reality that Democrats have the edge on things like insurance and costs. So where does that leave them? Looking elsewhere to rack up victories and build talking points.
And in that vein, Trump startled California leaders this week when he sent a delegation of officials to check out the state’s homeless crisis. As you can imagine, the governors and mayors — who have been on the receiving end of verbal elbow throwing from the president over the issue — had a less-than-thrilled response to Trump’s interest. The message from the governor’s office: “If the president is willing to put serious solutions — with real investment — on the table, California stands ready to talk. He could start by ending his plans to cut food stamps, gut health care for low-income people, and scare immigrant families from accessing government services.”
Details of House Speaker Nancy Pelosi’s much-awaited drug-pricing plan dropped this week and the proposal looks far more aggressive than some had expected. It would allow Medicare to negotiate prices on the top costliest 250 drugs, and then those prices would be available to all consumers, not just Medicare beneficiaries.
The political takeaways:
— If Trump was bluffing about his own drug-pricing rhetoric, Pelosi is calling him on it. Some of the ideas — like pegging costs to what other countries pay for the drugs — are straight out of his playbook. She could also be looking to back Senate Republicans into a corner on the issue.
— But some people say the progressive plan is a signal that any bipartisan hopes should be curtailed. If Pelosi had thought she could get something through the Senate, the plan would have lined up closer to the anticipated blueprint. This way, she avoids a battle with the left flank of her chamber.
Purdue Pharma announced a tentative settlement with thousands of municipal governments nationwide and nearly two dozen states. Essentially, the company would be dissolved, a new one would be formed to sell OxyContin (with profits going to the plaintiffs) and Purdue would donate drugs for addiction treatment and overdose reversal. The Sackler family would be personally on the hook for $3 billion.
That last bit has been a sticking point with the states that aren’t interested in the settlement — many see that as far too low a penalty for the family. The states in favor of the deal like the idea of avoiding the uncertainty of a trial.
For the first time in a decade, the number of uninsured Americans rose despite a strong economy. The Census Bureau report found an estimated 27.5 million people, 8.5% of the population, without coverage in 2018 (which is an increase of 1.9 million uninsured people, or half a percentage point). Democrats pounced on the numbers.
With Congress back in session, Democrats were adamant about pushing Republicans into acting on gun control. Both Pelosi and Senate Minority Leader Chuck Schumer urged Trump to resist the NRA’s influence and “seize this moment,” because Senate Majority Leader Mitch McConnell has repeatedly said he is not interested in even thinking about legislation that Trump wouldn’t sign.
Meanwhile, the gun lobby has been bombarding the White House, gaining access to Trump, and meeting with senior officials over the president’s expected gun violence proposal. But advocates on the other side can’t even get in the door.
Several companies are being lauded for their decision to wade into the gun debate with their requests that consumers don’t open-carry firearms into the stores. Are they trying to play both sides? Because legal experts say they could go further than mere “requests,” and they’ve decided not to.
And I’m always a sucker for a good history lesson:
So … it turns out Medicaid can function like a loan and not just government aid. For those of us who weren’t covering health policy in 1993 when then-President Bill Clinton signed the Medicaid Estate Recovery Program into law (making it mandatory that states seek repayment for Medicaid debts), The Atlantic offers a terrifying look at what happens when states come a-knockin. One woman received a 28-page, $198,660.26 itemized bill for “every Band-Aid, every can of Ensure” her mother used while on Medicaid.
In the miscellaneous file for the week:
- So, what’s up with all these blood pressure medication recalls? How did carcinogens get past the FDA’s regulation process? Well, it turns out that while the FDA has a rigorous approval process for new drugs, 90% of medications are generics. And those? They receive a lot less scrutiny.
- Frontline did an investigation into the Legionnaires’ disease outbreak linked to Flint’s water crisis and found that 115 people died of non-viral pneumonia. The official death count? 12.
- Any reader of the Breeze knows I can’t resist a superbug story, and this one is fairly traumatizing: It looks at how skilled nursing facilities — which are often understaffed and ill-equipped to handle rigorous quality control — have become the “dark underbelly” of drug-resistant infections.
- City leaders in Austin, Texas, found a workaround to strict regulations on providing public funding for abortions. If it can’t pay for the procedure itself, the city will help with auxiliary costs like transportation and child care.
- Why would a gay New York City council member want to repeal a ban on conversion therapy? It’s for the greater good, he says.
And that’s it from me for a bit! Have a great rest of the month!