Latest news with #LaurenGardner
Politico
4 days ago
- Health
- Politico
Choppy waters ahead for health insurers
Presented by With Lauren Gardner and Ruth Reader Driving the Day TRIPLE THREAT — Insurers face a number of pressures that could lead to a jump in out-of-pocket health costs for Americans: cuts to Medicaid, federal policy changes that could hit Obamacare enrollment and medical costs rising faster than expected, Kelly reports. Several health insurers were already on unstable financial footing even before President Donald Trump signed into law the 'big, beautiful bill' — which could lead to millions of people losing coverage. The looming changes now create more uncertainty that could lead to a downturn for the health insurance industry and a jump in premiums for Americans purchasing coverage. 'You have this perfect storm here of very large changes happening all at once,' said Ellen Montz, a managing director with advisory firm Manatt Health and a former CMS official during the Biden administration. 'They're looking at pricing, what is potentially coming down the pike, and we're going to see some very large, both gross and net, premium increases.' Both Centene and Molina Healthcare slashed their yearly financial guidance over the past few weeks amid unexpectedly high medical costs in Medicaid and Obamacare plans. And health insurance giant UnitedHealthcare lowered its guidance in May because of higher-than-anticipated Medicare Advantage costs. 'As we see these cost pressures continue to mount, as we see them go unaddressed and continue to snowball in their effect, the inevitable result is that we will see higher premiums,' said David Merritt, senior vice president of policy and advocacy at the Blue Cross Blue Shield Association. Why it matters: The Congressional Budget Office estimated that an earlier version of the 'big, beautiful bill,' combined with the expiration of the enhanced Obamacare subsidies at the end of this year and new Trump administration Affordable Care Act policies that make it more difficult to enroll, could cause nearly 17 million people to become uninsured. Cushioning the blow: Insurers are pushing Congress and the Trump administration to mitigate some of the fallout, warning lawmakers in competitive districts that their constituents will face widespread coverage disruptions if the policies are implemented. The industry's most pressing concern is the expiration of the enhanced subsidies — which Congress must extend within the next few months to avoid 'very sudden' and 'severe' cost hikes and coverage losses nationwide, said Mike Tuffin, the CEO of health insurance trade group AHIP. So far, few Republican lawmakers have expressed interest in extending the subsidies, which CBO has estimated at $335 billion over 10 years. 'We know over the last 30 years that when people's coverage is disrupted, their access to health care is disrupted, there's an immediate political response, and both parties have seen that in the past, and we want to prevent that,' Tuffin said. What's next: Insurers will start posting their 2025 second-quarter earnings over the next few weeks, which will provide some insight into how they might adjust to rising medical costs. It may also shed light on how they're factoring in looming federal changes to their pricing. First up is Elevance Health, which will report its earnings Thursday. WELCOME TO TUESDAY PULSE. U.S. ice cream makers are pledging to stop using artificial dyes by 2028 — another win for HHS Secretary Robert F. Kennedy Jr.'s Make America Healthy Again initiative. Send your tips, scoops and feedback to khooper@ and sgardner@ and follow along @kelhoops and @sophie_gardnerj. In Congress AUTISM SPEAKS ON THE HILL — Advocates from the group Autism Speaks will head to the Capitol today to urge lawmakers to fund recently reauthorized research and service programs in the wake of the GOP megabill's steep Medicaid cuts. While the group will acknowledge their concerns about how those cuts could impact autism programs in the states, it plans to focus on the annual appropriations process 'since that's the next thing up, and something that we want to try to ensure that we're at least maintaining the levels of funding for those programs,' David Sitcovsky, Autism Speaks' vice president of advocacy, told Lauren. Congress reauthorized the Autism CARES Act in December, which Autism Speaks says is the primary federal funding source for monitoring, research, services and training programs in the autism community. The law's programs are spread across the CDC, the Health Resources and Services Administration and the NIH. The group plans to underscore in their meetings that autism is a lifelong condition — not just a childhood disorder, as often emphasized by Health Secretary Robert F. Kennedy Jr. — for which many people need support as they age. 'It seems like most [of the] conversation about autism has been framed around childhood, and and I think what were really trying to do … is to remind people that [it's a] lifelong issue, and there are many adults who need better understanding and supportive services now,' said Dr. Andy Shih, Autism Speaks' chief science officer. At the Agencies DOC PAY OVERHAUL — The Centers for Medicare and Medicaid Services is proposing a boost in funding to doctors who participate in alternative payment models based on the quality of care delivered instead of individual services, POLITICO's Robert King reports. 'We're making it easier for seniors to access preventive services, incentivizing health care providers to deliver real results, and cracking down on abuse that drives up costs,' CMS Administrator Mehmet Oz said in a statement Monday when the agency released its proposed physician fee schedule that details changes to Medicare pay for 2026. What it means: Doctors participating in the models would receive a 3.83 percent boost to their payments starting in 2026. Doctors not participating in such models would get a 3.62 percent increase. Why it matters: If finalized, the rule would represent a departure from how CMS traditionally reimburses doctors. The agency typically has one rate update that applies to all doctors serving Medicare patients, regardless of whether they participate in an alternative payment model. Both Republican and Democratic administrations have sought to shift Medicare reimbursement away from payments for individual items or services. TECH TROUBLES — The Department of Veterans Affairs told a House panel Monday that it has implemented DOGE-directed cuts to optimize its IT infrastructure. But lawmakers say they want assurances that the agency's past problems with IT modernization won't be its future, Ruth reports. 'For years, this committee has highlighted the wasteful spending, the overbudget projects, poor outcomes that seem to come with all IT projects at the VA,' said Rep. Tom Barrett (R-Mich.), chair of the House Veterans Affairs' Technology Modernization Subcommittee. Since the beginning of the year, the VA's Office of Information and Technology has lost 1,100 employees — mostly from buy-out and early retirement offers — and its 2026 budget has shaved $500 million from its operating funding. Subcommittee ranking member Rep. Nikki Budzinski (D-Ill.) said she's concerned the cuts will undermine the agency's efforts. Eddie Pool, the VA's acting assistant secretary and chief information officer, assured lawmakers that more than three-quarters of the people who left the agency were going to retire soon. Why it matters: Veterans Affairs is in the midst of its latest attempt to update its IT infrastructure, including its electronic medical records system. The agency has been attempting to modernize since 2001 and has failed to do so multiple times, according to the Government Accountability Office. Carol Harris, the GAO's director of IT and cybersecurity, testified that the VA's IT office hasn't adequately taken stock of its workforce. For example, she said, it doesn't have an inventory of employees' current cybersecurity skills and competencies. The agency also hasn't comprehensively identified its current and future human capital needs, Harris added. The GAO has 26 open recommendations for improving the VA's IT and cybersecurity that it said the office still needs to complete. What's next: President Donald Trump recently announced his pick for chief information officer at the VA, Ryan Cote, who served as the Transportation Department's CIO in the first Trump administration. His confirmation hearing hasn't been scheduled yet. Health Costs MEDICAL DEBT RULE TOSSED OUT — A federal judge has overturned a Biden administration rule that would have removed $49 billion in medical debt from the credit reports of 15 million people, POLITICO's Katherine Hapgood reports. U.S. District Judge Sean Jordan of the Eastern District Court in Texas said the Consumer Financial Protection Bureau rule 'exceeds the bureau's statutory authority' and violates the law on permissible purposes of consumer reports. The decision aligns with the Trump administration's stance on the issue. The rule was finalized by then-CFPB Director Rohit Chopra, but the bureau under the Trump administration reversed its position on the rule and joined credit-reporting groups in challenging it. The rule had been set to take effect at the end of July. WHAT WE'RE READING POLITICO's Grace Yarrow and Rachel Shin report on how the White House doesn't plan to crack down on pesticides in farming. STAT's Lev Facher reports on an elite rehab center using GLP-1s to treat a range of addictions.
Politico
10-07-2025
- Health
- Politico
The fight over fluoridation
With help from Lauren Gardner Driving the Day FLUORIDE'S LAST STAND? Health Secretary Robert F. Kennedy Jr. looks poised to win the battle over fluoride, to the dismay of dentists and oral health advocates, POLITICO's Danny Nguyen reports. Florida and Utah banned the cavity-fighting mineral from their drinking water this year, and several other Republican-led states are considering similar measures. Oklahoma has dropped its recommendation that localities fluoridate. Why it matters: The nearly three-quarters of Americans who drank fluoridated water before Kennedy became HHS secretary is set to plummet. For Kennedy, who's long believed drinking fluoride is unhealthy, that's a win. 'Fluoride's predominant benefit to teeth comes from topical contact with the outside of the teeth, not from ingestion,' an HHS spokesperson told POLITICO. 'There is no need, therefore, to ingest fluoride.' The impact of the retreat from fluoridation on oral health will reveal whether dentists are correct when they predict a cavity crisis will follow, or whether Kennedy's view that Americans can get the fluoride they need through toothpaste and mouthwash will bear out. Drilling down: The CDC has included fluoridation in its list of the 10 greatest public health achievements of the 20th century, citing data that it reduces tooth decay by as much as 70 percent in children and tooth loss by as much as 60 percent in adults. Kennedy nonetheless believes the case to remove fluoride is urgent because of reports that it could curtail children's brain development. It's a position bolstered by a report from the National Institutes of Environmental Health Sciences — although none of the studies were conducted in the U.S., and the levels of fluoride they examined were higher than what Americans typically consume — and a federal judge's order in September that the Environmental Protection Agency regulate fluoride in drinking water, citing risks that higher levels could impact intellectual development. Dentists see it differently. 'This is revving up an antiscience narrative,' said Dr. Brett Kessler, the president of the American Dental Association, the country's leading dentists' group. 'There are ways to get fluoride in toothpaste, some of the foods we eat, some of the drinks we drink, topical fluoride mouthwashes. … But without fluoridated water, you're already behind the eight ball because you've got vulnerable teeth.' WELCOME TO THURSDAY PULSE. Former President Joe Biden's doctor declined to answer questions today about Biden's health during the presidency in a GOP House probe, citing patient confidentiality and the Fifth Amendment. Send your tips, scoops and feedback to khooper@ and sgardner@ and follow along @kelhoops and @sophie_gardnerj. AROUND THE AGENCIES THE SCOTUS ORDER FALLOUT — HHS employees are bracing for the Trump administration to move forward with mass firings after a Tuesday order from the Supreme Court cleared the way, POLITICO's Erin Schumaker reports. The set-to-be-terminated employees' final hope rests on the ruling's suggestion that lower courts could still consider direct challenges to agencies' reorganization plans. But that will require plaintiffs to bring more detailed cases quickly and convince judges to stop the layoffs before they become a fait accompli. As cases become more granular, plaintiffs will likely face an uphill battle. The White House said it plans to restart the terminations immediately. Federal workers, who have long seen civil service laws and collective bargaining agreements as shields protecting their jobs, told POLITICO their world has been shaken. 'All of my friends are resigned to the worst,' said a National Institutes of Health staffer who was granted anonymity due to fear of retribution. On Wednesday, federal workers remained in wait-and-see mode, uncertain and awaiting word from agency lawyers on how to interpret the ruling's implications for them. Staffers at HHS described feeling anxious and exhausted by the back-and-forth over their jobs. 'Fuck it,' another NIH staffer said. 'I'm ready to retire if I can.' Key context: A number of more limited challenges to the layoffs remain viable, said attorney Max Stier, founding president and CEO of the Partnership for Public Service, a nonprofit group that aims to improve the way the government functions. '[The order] shouldn't, in and of itself, resolve those other cases,' he said. The administration, for example, faces other legal challenges over its restructuring of HHS, which saw a quarter of its workforce bought out or let go, although hundreds of those workers have since been reinstated. 'HHS previously announced our plans to transform this Department to Make America Healthy Again and we intend to do just that,' HHS spokesperson Andrew Nixon wrote in a text Wednesday. At the Courts DOJ TARGETS TRANS CARE — President Donald Trump's Justice Department intensified its campaign against gender-affirming medical care Wednesday, issuing subpoenas to at least 20 doctors and clinics that treat transgender minors, POLITICO's Simon Levien reports. The DOJ's announcement coincided with a Federal Trade Commission hearing where opponents of gender transition-related medical care accused providers of not being truthful about the consequences of the treatments, such as counseling, hormone replacement therapy and surgery. Chad Mizelle, DOJ chief of staff, said the providers 'perpetrated one of the greatest medical frauds.' The DOJ didn't name the clinics but said it's also investigating false statements. 'Medical professionals and organizations that mutilated children in the service of a warped ideology will be held accountable by this Department of Justice,' said Attorney General Pam Bondi in a press release. Why it matters: Trump has long assailed gender-affirming care for children, making his opposition to it a keystone of his 2024 campaign. HHS issued a report in May arguing there was little evidence to show the care is effective and 'a growing body of evidence pointing to significant risks.' But most major U.S. medical organizations say the treatments are safe, can boost patients' quality of life and save children's lives. The subpoenas are the administration's latest attempt to crack down on the small number of health care clinics that provide gender-affirming care to minors. Most states already restrict or ban the practice for children. What's next: FTC Commissioner Melissa Holyoak said her agency would scrutinize how providers describe gender-affirming care when consulting patients. In Congress FIRST IN PULSE: BIPARTISAN PBM BILL — Rep. Buddy Carter, a GOP pharmacist running for a Georgia Senate seat, will introduce legislation today with 11 bipartisan colleagues that would overhaul the practices of the drug-price middlemen known as pharmacy benefit managers — an industry that's become a perennial congressional target, Lauren reports. The bill incorporates proposals — including two dropped from the recently passed Republican megabill — addressing a range of issues that PBM critics say contribute to high health care costs and low reimbursement rates for independent pharmacies. The package would resurrect a ban on spread-pricing in Medicaid and a survey requirement for retail pharmacies to report their drug-acquisition costs — provisions dropped from the reconciliation bill after the Senate parliamentarian ruled the Medicaid language would be subject to the 60-vote Byrd rule point of order. It also would aim to limit pharmacy steering of Medicare Part D beneficiaries and delink PBM compensation from drug costs. 'It's time to bust up the PBM monopoly, which has been stealing hope and health from patients for decades,' Carter said in a statement. 'As a pharmacist, I've seen how PBMs abuse patients firsthand, and believe that the cure to this infectious disease is transparency, competition, and accountability, which is exactly what our bipartisan package provides.' Original co-sponsors include Reps. Rick Allen (R-Ga.), Jodey Arrington (R-Texas), Debbie Dingell (D-Mich.), Vicente Gonzalez (D-Texas), Diana Harshbarger (R-Tenn.), Raha Krishnamoorthi (D-Ill.), Nicole Malliotakis (R-N.Y.), Greg Murphy (R-N.C.), John Rose (R-Tenn.), Deborah Ross (D-N.C.) and Derek Tran (D-Calif.). GLOBAL HEALTH CUT CONCERNS — Some Republican senators expressed concerns about slashing funding for global health at their weekly lunch Wednesday, arguing that the White House's request to claw back $9.4 billion in congressionally approved funding should be tweaked. Those concerns included the impact of slashing global AIDS funding and other international health funds, POLITICO's Jordain Carney reports. Republicans also sought clarity in the meeting about proposed reductions to food aid to other countries. The pushback is the latest sign Republicans will have to make changes to the administration's rescissions package if they hope to pass it. 'Just by listening to the conversations — one, members still need to understand it better,' Sen. John Hoeven (R-N.D.) said in a brief interview after the closed-door Republican lunch. He added, 'I think we will get it passed, but in all likelihood it will be modified.' Sen. Josh Hawley (R-Mo.) said, 'I just heard a lot of concerns raised in this meeting just now. People have a lot of stuff they want changed.' What's next: Congress has until the end of the day on July 18 to get the legislation to President Donald Trump's desk or the rescissions request expires, forcing the administration to spend the money as Congress originally intended. And assuming the Senate does make changes, it would bounce the legislation back to the House for a final vote. Senate leaders are gambling that their counterparts across the Capitol will just swallow those revisions. WHAT WE'RE READING The New York Times' Joseph Goldstein reports that 1.5 million New Yorkers could lose health insurance under the One Big, Beautiful Bill Act. STAT's Katie Palmer reports on the challenges health systems face when trying to implement AI tools.
Euronews
10-07-2025
- Health
- Euronews
US measles cases reach 33-year high
The United States is having its worst year for measles spread in more than three decades. The national case count reached 1,288 on Wednesday, according to the US Centers for Disease Control and Prevention (CDC), though public health experts say the true figure may be higher. The CDC's count is 14 infections higher than 2019, when the US almost lost its status of having eliminated the vaccine-preventable illness – something that could happen this year if the virus spreads without stopping for 12 months. But the US is still far from 1991, when there were 9,643 confirmed cases. In a short statement, the federal government said that the CDC 'continues to recommend (measles, mumps and rubella) vaccines as the best way to protect against measles'. It also said it is 'supporting community efforts' to tamp down ongoing outbreaks as requested. Fourteen states have active outbreaks; four other states' outbreaks have ended. The largest outbreak started five months ago in undervaccinated communities in West Texas. Three people have died – two children in Texas and an adult in New Mexico – and dozens of people have been hospitalized across the US. 'What concerned me early on in this outbreak was is it spreading to other parts of the United States, and that's definitely what's happening now,' said Katherine Wells, the public health director from Lubbock County in Texas. In 2000, the World Health Organization (WHO) and CDC said measles had been eliminated from the US. But continuing vaccine hesitancy could threaten that status. 'What we're seeing with measles is a little bit of a 'canary in a coal mine,'' said Lauren Gardner, leader of Johns Hopkins University's independent measles and COVID-19 tracking databases. 'It's indicative of a problem that we know exists with vaccination attitudes in this county and just, I think, likely to get worse'.
Japan Today
09-07-2025
- Health
- Japan Today
U.S. having its worst year for measles in more than three decades
By DEVI SHASTRI The U.S. is having its worst year for measles spread in more than three decades, with a total of 1,288 cases nationally and another six months to go in 2025. The U.S. Centers for Disease Control and Prevention said Wednesday that the national case count surpassed 2019, when there were 1,274 cases for the year and the country almost lost its status of having eliminated the vaccine-preventable illness. That could happen this year if the virus has nonstop spread for 12 months. This year's outbreaks, some of them interconnected, started five months ago in undervaccinated communities in West Texas. Three people have died — two children in Texas and an adult in New Mexico — and dozens of people have been hospitalized. Public health experts maintain the true case count may be higher than state health departments have confirmed. North America has three other major measles outbreaks, with 2,966 cases in Chihuahua state, Mexico, 2,223 cases in Ontario, Canada and 1,230 in Alberta, Canada. Thirteen other states have current confirmed outbreaks of three or more people — Arizona, Colorado, Georgia, Illinois, Iowa, Kansas, Michigan, Missouri, Montana, New Mexico, North Dakota, Oklahoma and Utah — and four other states saw their outbreaks end. The measles, mumps and rubella vaccine is 97% effective at preventing measles after two doses. The World Health Organization said in 2000 that measles had been eliminated from the U.S. The CDC identified 22 outbreaks in 2019, the largest being two separate clusters in New York — 412 in New York state and 702 in New York City. These were linked because as measles was spreading through close-knit Orthodox Jewish communities, the CDC said. It's a similar situation in North America this year, where the Canada, Mexico and Texas outbreaks stem from large Mennonite communities in the regions. Mennonite churches do not formally discourage vaccination, though more conservative Mennonite communities historically have low vaccination rates and a distrust of government. A recent study found childhood vaccination rates against measles fell after the COVID-19 pandemic in nearly 80% of the more than 2,000 U.S. counties with available data, including in states that are battling outbreaks this year. Only 92.7% of kindergarteners in the U.S. had the measles, mumps and rubella vaccine in the 2023-2024 school year, below the 95% needed to prevent outbreaks. In Gaines County, Texas, the epicenter of the Texas outbreak, only 82% of kindergarteners were up-to-date with MMR vaccines. State and federal leaders have for years kept funding stagnant for local public health departments' vaccination programs that are tasked with reversing the trend. 'What we're seeing with measles is a little bit of a 'canary in a coal mine,'" said Lauren Gardner, leader of Johns Hopkins University's independent measles and COVID tracking databases. "It's indicative of a problem that we know exists with vaccination attitudes in this county and just, I think, likely to get worse.' © Copyright 2025 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed without permission.
Los Angeles Times
09-07-2025
- Health
- Los Angeles Times
The U.S. is having its worst year for measles in more than three decades
The U.S. is having its worst year for measles spread in more than three decades, with a total of 1,288 cases nationally and another six months to go in 2025. The U.S. Centers for Disease Control and Prevention said Wednesday that the national case count surpassed 2019, when there were 1,274 cases for the year and the country almost lost its status of having eliminated the vaccine-preventable illness. That could happen this year if the virus has nonstop spread for 12 months. This year's outbreaks, some of them interconnected, started five months ago in undervaccinated communities in West Texas. Three people have died — two children in Texas and an adult in New Mexico — and dozens of people have been hospitalized. Public health experts maintain the true case count may be higher than state health departments have confirmed. North America has three other major measles outbreaks, with 2,966 cases in Chihuahua state, Mexico, 2,223 cases in Ontario, Canada and 1,230 in Alberta, Canada. Twelve other states have current confirmed outbreaks of three or more people — Arizona, Colorado, Georgia, Illinois, Iowa, Kansas, Michigan, Montana, New Mexico, North Dakota, Oklahoma and Utah — and four other states saw their outbreaks end. The measles, mumps and rubella vaccine is 97% effective at preventing measles after two doses. The World Health Organization said in 2000 that measles had been eliminated from the U.S. The CDC identified 22 outbreaks in 2019, the largest being two separate clusters in New York — 412 in New York state and 702 in New York City. These were linked because as measles was spreading through close-knit Orthodox Jewish communities, the CDC said. It's a similar situation in North America this year, where the Canada, Mexico and Texas outbreaks stem from large Mennonite communities in the regions. Mennonite churches do not formally discourage vaccination, though more conservative Mennonite communities historically have low vaccination rates and a distrust of government. A recent study found childhood vaccination rates against measles fell after the COVID-19 pandemic in nearly 80% of the more than 2,000 U.S. counties with available data, including in states that are battling outbreaks this year. Only 92.7% of kindergarteners in the U.S. had the measles, mumps and rubella vaccine in the 2023-2024 school year, below the 95% needed to prevent outbreaks. In Gaines County, Texas, the epicenter of the Texas outbreak, only 82% of kindergarteners were up-to-date with MMR vaccines. State and federal leaders have for years kept funding stagnant for local public health departments' vaccination programs that are tasked with reversing the trend. 'What we're seeing with measles is a little bit of a 'canary in a coal mine,'' said Lauren Gardner, leader of Johns Hopkins University's independent measles and COVID tracking databases. 'It's indicative of a problem that we know exists with vaccination attitudes in this county and just, I think, likely to get worse.' Shastri writes for the Associated Press. The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute's Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
