Happy Friday, at last! A quick programming note: This is the last Breeze of the month (year/decade!). I’ll see you guys back here in 2020!
Since everyone seemed determined to fit at least two weeks’ of news into this past five days, though, I’m thinking today’s edition will hold you over. Let’s get to it!
In some kind of poetic timing, the long-awaited court decision about the constitutionality of the health law dropped on Wednesday — the day open enrollment ended (since it was extended because of technical glitches). I would guess one or two health wonks who are also betting aficionados won their pools with that prediction.
The big decision itself was a bit anticlimatic: The appeals court did rule that the individual mandate that requires people to have coverage was unconstitutional since Congress zeroed out the penalty so it could no longer be thought of as a tax. But the judges kicked it back to the lower court for a closer review of the whether that invalidated other portions of the law.
Out of all the things this does, the most notable is that it buys Republicans some political breathing room. GOP lawmakers were facing a repeat of the midterms where Dems capitalized on their attacks of popular provisions in the health law to sweep into the House on a blue wave. Had the ruling instead immediately struck down the law — and its guarantees of coverage for people with preexisting medical conditions — it could have been used as a potent political weapon in 2020.
For now, the health law’s fate remains in limbo — which seems to be its natural state even as it nears its 10-year anniversary.
For once, lawmakers didn’t act like college students with a term paper due at midnight— they announced their spending deal on Monday, the House passed it on Tuesday and the Senate even voted at a reasonable hour Thursday to send it to President Donald Trump.
Here are some of the health highlights:
— The smoking age will be raised to 21.
— Gun violence research is being funded for the first time in more than two decades.
— Three health law taxes, including the highly unpopular “Cadillac Tax,” are being repealed. (An early Christmas gift to insurers if ever there was one.)
— Puerto Rico’s Medicaid funding is being slashed (apparently because of personal intervention from President Donald Trump).
What was missing? Any proposals to curb surprise medical bills, which left many to think that out of the winners and losers in this deal (and there were plenty of both), patients were firmly slotted into that second category.
Health care was no longer the belle of the ball at the last presidential candidate debate of the decade (yes, I am that annoying person who keeps making note of that). There was a brief clash between Vice President Joe Biden and Sen. Bernie Sanders (I-Vt.) where teasing escalated to shouting — both covering well-worn ground with their points (“Medicare for All costs a lot! Not doing anything isn’t good either!). For the most part though, health care — and coverage especially — took a back seat.
Trump unveiled his plan to allow states to import drugs from Canada — which critics say looks good on paper politically but does little in reality to cut costs for patients. Mainly because Canada is over there being like, “Excusez-moi, you want to do what now?” Officials there aren’t supper jazzed about the idea of becoming America’s pharmacy, and even if they were, the supply likely could not meet our demand. Apart from that, regulation costs would certainly cut into savings and drugmakers would have to cooperate (which is even more absurd than thinking Canada wants to get on board this train).
Meanwhile, with their sweeping drug prices bill that passed the House, the Democrats have put Republicans between a rock and a hard place (aka angering the powerful pharma lobby or angering voters). Things are getting tense as the GOP tries not to wind up holding the bag when drug prices are brought up on the campaign trail.
An intensive investigation by USA Today reveals widespread and startling incidents of sexual violence, routine use of physical force, poor medical care and deaths at facilities overseen by the U.S. Immigration and Customs Enforcement agency. Under the Trump administration there have been at least 29 fatalities at these facilities, including seven suicides. With most of the country focused on the separation crisis at the border, this detention system can fly under the radar.
How much money does the Sackler family — which owns the firm that made Oxycontin — really have? It’s a question that’s been plaguing anyone paying attention to the opioid crisis lawsuits. The problem is, no one really knows that answer (except, I presume, the family themselves). That message was driven home once more when it was revealed that the Sacklers transferred $1.36 billion to overseas accounts and affiliated companies after 2008, part of $10.3 billion in total profits distributed out of the company.
Currently, the Sacklers have agreed to pay $3 billion as a way to settle lawsuits over their role in the opioid crisis. But when tidbits like this come out, critics of the deal are left wondering how much that would even hurt the family’s coffers.
Meanwhile, it seems undeniable at this point that another meth crisis is brewing and ready to bubble over — this time with an even more potent form of the drug. (One expert explains the difference between today’s meth and the kind from the ’90s: “It’s like they were drinking Mountain Dew and now they are injecting Red Bull.) But advocates, cities and states are struggling to hold the epidemic at bay. Why? Because public health funding these days is locked up fighting the opioid crisis.
In the miscellaneous file for the week:
— What would happen if there were no restrictions on the specialists that insurance plans would cover? It sounds great for patients in theory, but a closer look at a plan for New Jersey teachers paints a grim picture of just how out-of-control that kind of strategy can get.
— Even in the midst of the lung disease outbreak linked to e-cigarettes, the rates of teens who vape marijuana are skyrocketing. There is some good news, though: their use of hard drugs and alcohol is dropping off.
— There’s only one federal law that protects children who are not in state custody who are neglected and abused. Not a single state fully complies with that law — and the consequences can be deadly.
— For a good, long holiday-travel read, check out this piece on the movement to have family and friends care for the body of loved ones after they die instead of having them whisked off to the funeral parlor to deal with.
And with that, I wish you a restful, joyous, wonderful last two weeks of the decade! (See, I told you I’m that person.)