December 6, 2022

Healthy About Liver

Masters of Health

Biden still hasn’t banned the short-term health plans he called ‘junk’

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Happy Thursday morning, where it’s actually The Health 202’s Friday ☀️ We’ll be back in your inboxes Tuesday-Thursday next week, which is our twist on an abbreviated congressional schedule. 

Today’s edition: The Biden administration is extending the mask mandate for public transit — at least for another two weeks. The White House picks a new top deputy for the nation’s coronavirus response team. But first … 

Biden lambasted Trump’s short-term health plans, but they’re still around

President Biden called short-term health insurance “junk” plans during his 2020 campaign.

But his administration hasn’t yet reversed the Trump-era rule allowing such plans, which he argued undermines insurance coverage for millions of people. 

At issue: The Trump administration finalized an expansion of short-term plans — cheaper, skimpier coverage that isn’t required to comply with the Affordable Care Act’s consumer protections. For years, Democrats have derided such plans, which were originally intended to help fill brief gaps in people’s coverage, as “junk insurance.”

Over the past few months, congressional Democrats and patient groups have increased calls for the Department of Health and Human Services to quickly limit the length of time people are allowed to enroll in short-term health plans. 

When it comes to Obamacare, cracking down on such plans is a big piece of unfinished business for Biden. Last week, his administration proposed a change to allow millions more families to buy health coverage through the health law’s insurance marketplaces. Some ACA supporters say addressing short-term plans should be up next — and it’s another action Biden can take on his own as his legislative agenda remains stalled on Capitol Hill. 

  • “The longer this persists, the harder it gets to clean up — and the time was really yesterday,” said Katie Berge, the federal government affairs director for the Leukemia and Lymphoma Society, which has urged the Biden administration to change the rules.

The Obama administration imposed a three-month limit on short-term plans. But in 2018, President Donald Trump’s health department significantly changed that timeframe, allowing people to stay on those plans for up to a year. They could renew such coverage for up to three years.

Restoring the three-month duration has long been a priority for Democrats, who accused Trump of “Obamacare sabotage.” That’s because the plans don’t have to cover preexisting conditions and are allowed to sidestep the ACA’s requirement to cover services such as maternity care and mental health treatment. A 2020 probe from House Democrats found that some of the plans’ marketing materials provide misleading information about a plan’s exclusions.

Biden appeared to allude to short-term plans in an executive order issued during the second week of his presidency — and in another order out last week. In last year’s rulemaking agenda, HHS said it intended to issue a proposal by August 2022. (Bear in mind: That agenda is a nonbinding list of the administration’s regulatory priorities.) 

But some Democrats are urging a quicker timeline. 

  • “It is past time for us to take action,” 40 Senate Democrats wrote in a February letter to HHS Secretary Xavier Becerra.
  • A group of House Democrats is also working on a letter to the administration as lawmakers ramp up communications on the policy, Rep. Kathy Castor (D-Fla.) said in an interview.

In response to the Senate push, Becerra pointed to the announcement in last year’s regulatory agenda on the administration’s “intent to propose amendments to the current definition of [short-term plans].”

“These proposals would be designed to ensure this type of coverage does not undermine the Affordable Care Act,” Becerra wrote in a letter sent Tuesday to Sen. Tammy Baldwin (D-Wis.), which was obtained by The Health 202.

In a statement, a spokesperson for the Centers for Medicare and Medicaid Services declined to specify timing but pointed to Biden’s executive order on bolstering Obamacare signed last week. “Strengthening the ACA is a priority for the administration,” the spokesperson wrote.

But how many people are on short-term plans? Multiple experts said data was spotty and there wasn’t one comprehensive source on this. They pointed to a House Energy and Commerce Committee Democratic staff report from 2020, which estimated that at least 3 million people were enrolled in short-term plans in 2019. 

Those who crafted the expansion have warned against rolling it back. 

  • “If you are limited to three months, people get sick, the coverage period ends and then they can’t get health insurance because their short-term plan is expired,” said Brian Blase, who helped write the rules for the Trump administration and is now the president of Paragon Health Institute.

But it’s possible that interest in such plans could have declined over the past year, said Karen Pollitz, a senior fellow at the Kaiser Family Foundation. She pointed to a law Democrats passed last spring making it significantly cheaper for low- and middle-income Americans to buy Obamacare plans. That financial aid is set to run out at the end of this year unless Congress extends it.

Coming soon? Possibly a booster shot for 5-to-11-year-olds

A booster of the Pfizer-BioNTech vaccine bolsters immune protection against the coronavirus in school-aged children, especially against omicron, our colleague Carolyn Y. Johnson reports.The companies made the announcement this morning and say they plan to request authorization from the Food and Drug Administration in the coming days. Such an additional shot was given six months after children were fully vaccinated, but the new data comes as initial uptake of the vaccine has been slow in this age group.

Federal public transportation mask mandate stands — for now

The Centers for Disease Control and Prevention announced that face coverings will continue to be required when using public transportation until at least May 3, The Post’s Lori Aratani and Ian Duncan report. 

The mask mandate for air travel and other public transit was set to expire April 18. But health officials said they wanted to monitor the impact of the rise in coronavirus cases due to the spread of the BA.2 subvariant before getting rid of the requirement. 

But the Biden administration is under increasing pressure to lift the mandate.

  • Twenty-one mostly GOP-led states sued the administration last month to end the requirement.
  • In a letter to Biden last week, top Republican lawmakers on congressional transportation committees said that the decision to extend the requirement could “further erode public trust” in the government because it conflicts with updated guidance from the CDC that allowed most Americans to forgo masks indoors.

Some that previously supported the mandate are changing their stance, too. 

  • Executives from some of the country’s largest airlines urged Biden last month to consider dropping the mandate because of the CDC’s new framework for determining when masks are necessary.

Yet, others, like Sen. Edward J. Markey (D-Mass.), contend that the mandate is still necessary to protect the country’s elderly, immunocompromised and people with disabilities. 

Also on Wednesday … HHS renewed the public health emergency for the coronavirus another three months, ensuring the continuation of critical resources to battle the pandemic.

The emergency powers are facing pushback from Republicans, who argue it’s time to begin unwinding the declaration. The PHE has fueled a rise in telehealth visits, allowed new flexibilities for government insurance programs, and let state and local health departments divert grant-funded personnel to work on covid-19.

Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation:

On the move: The White House has selected Lisa Barclay — a senior lawyer with HHS — to replace Natalie Quillian as the top deputy overseeing the nation’s coronavirus response, our colleague Dan Diamond scooped. 

  • The selection is being touted by officials as a complement to Biden’s new coronavirus czar Ashish K. Jha, a longtime physician and academic with minimal official government experience.
  • Barclay, who has worked across three administrations, also served as chief of staff at the Food and Drug Administration under Obama and as an FDA speechwriter during the Clinton administration.

Ashish K. Jha, the White House coronavirus response coordinator:

A consulting firm, opioid makers, government agencies and a potential web of conflicting interests

A review of documents by the New York Times found that consulting firm McKinsey & Company allowed its employees to consult for a government agency while also serving opioid manufacturers

The dynamic was outlined in a report released yesterday from the Democratic staff of the House Committee on Oversight and Reform. The probe has attracted the attention of lawmakers, including Sen. Marco Rubio (R-Fla.), who called for government agencies to cut ties with the firm “immediately.”

  • Since 2010, at least 22 McKinsey consultants have worked for both the Food and Drug Administration and major opioid manufacturer Purdue Pharma.
  • The documents show that McKinsey touted inside access in pitches to private clients, the NYT writes.
  • Employees advising Purdue also helped to shape materials intended for government leaders and agencies, including a memo for Trump’s incoming HHS secretary that cut references to the severity of the opioid crisis that were included in a draft.

The committee said that the firm didn’t provide them with any evidence that it disclosed the conflict of interest, an “apparent violation” under federal contracting rules. 

On the other side: “McKinsey says that its consultants are forbidden to share confidential information or discuss their work with clients that have competing interests, and in a statement a spokesman disputed that there was a disclosure requirement related to the work it did for the F.D.A.,” the NYT reports.

Sen. Richard Blumenthal (D-Conn.):

To repeal or not to repeal …

Sen. Chuck Grassley (R-Iowa) said this week that Republicans will not try to repeal the Affordable Care Act if they retake the Senate in the midterm elections, our colleague Felicia Sonmez reports. 

The big picture: The comment from Grassley — who was a vocal opponent of the law when it was initially being considered in Congress — is the latest signal that the GOP has abandoned efforts to scrap Obamacare. A spokesman for Grassley said the senator was making a prediction about whether the health-care law would be repealed and can’t speak for all his Republican colleagues. 

Iowa Starting Line, a liberal news website

  • Starting in the fall of 2023, CMS will publicly designate “birthing-friendly” hospitals as a part of the Biden administration’s larger effort to improve perinatal and maternal health outcomes.
  • Kentucky’s Republican-led legislature overrode the Democratic governor’s veto of a bill banning most abortions after 15 weeks. Planned Parenthood and the American Civil Liberties Union immediately announced they’d file lawsuits over the move.
  • Five Ukrainian surrogates pregnant with unborn Americans were among 60 individuals evacuated from the country by a Florida-based nonprofit group amid the Russian assault, The Hill reports.

Thanks for reading! See y’all Tuesday.