Latest news with #MakeAmericaHealthyAgainCommission
Yahoo
24-06-2025
- Health
- Yahoo
'Lying and dishonest': RFK Jr. grilled over error-ridden MAHA report during House hearing
Health Secretary Robert F. Kennedy Jr. was on the defense Tuesday during an appearance before a House subcommittee. While Kennedy was there to answer questions about his department's fiscal 2026 budget request, Democratic lawmakers seized on the opportunity to grill him over three-plus hours. Democratic Rep. Raul Ruiz of California used his time to question Kennedy about 'The MAHA Report: Make Our Children Healthy Again.' The congressman asked whether Kennedy, as chair of the Make America Healthy Again Commission, had read and fact-checked the report's sources before publication. After Kennedy conceded that he had not fact-checked the report, Ruiz pointed out that the document had several citation errors, with references to papers that do not exist. 'How does that happen under your leadership, sir?' Ruiz asked. Kennedy responded by telling the congressman that 'all of the foundational assertions in that report are accurate.' 'They did not exist,' Ruiz interjected. 'How can they be accurate if they did not exist, sir?' Ruiz added: 'I was a premed [student] at UCLA. … If somebody turned this in, as an undergrad, to their professor at UCLA, they would have received an 'F,' sir, an 'F' — for the misinterpretation, the falsehoods, the denials, and also citing references that don't even exist. That's lying and dishonest, sir.' When it came time for Rep. Alexandria Ocasio-Cortez to question Kennedy, the New York Democrat asked whether he knew that the Justice Department is reportedly investigating UnitedHealth Group over allegations of Medicare fraud. 'I am not aware of that investigation,' Kennedy replied. Ocasio-Cortez appeared to be in disbelief: 'You are not aware that the Trump Department of Justice is investigating the largest insurance company in America for fraud in Medicare Advantage?' Kennedy repeated that he was not aware but said it did not surprise him. At one point, the hearing was halted after Kennedy hurled accusations at Rep. Frank Pallone after the New Jersey Democrat questioned the health secretary about his recent changes to the Advisory Committee on Immunization Practices, or ACIP. 'You have made a number of major decisions about vaccines. And … there's been no public comment process or public accountability on that either. What are you afraid of?' Pallone asked. He added: 'The bottom line is here: We have no transparency. ... You feel no responsibility to Congress whatsoever, and you just continue this ideology that's anti-science, anti-vaccine.' While answering a subsequent question from Rep. Neal Dunn, R-Fla., Kennedy turned back to Pallone and accused him of changing his views on vaccines after allegedly receiving money from pharmaceutical companies. 'Fifteen years ago, you and I met. You were, at that time, a champion for people who had suffered injuries from vaccines. ... Since then, you've accepted $2 million from pharmaceutical companies in contributions, more than any other member of this committee,' Kennedy alleged. 'And your enthusiasm for supporting the old ACIP committee, which was completely rife and pervasive with pharmaceutical conflicts, seems to be an outcome of those contributions.' Rep. Diana DeGette, D-Colo., quickly raised a point of order with the subcommittee's chair, Republican Rep. Buddy Carter of Georgia, accusing Kennedy of 'impugning the reputation of a member of Congress.' Shortly thereafter, Carter said DeGette had raised a valid point of order, and he asked the health secretary to 'please take back those words.' 'They're retracted,' Kennedy said. This article was originally published on
Miami Herald
23-06-2025
- Health
- Miami Herald
‘Problematic' MAHA report minimizes success of lifesaving asthma medicines, doctors say
Medical experts are dismayed over a federal report's claim that kids are overprescribed asthma medications, saying it minimizes how many lives the drugs save. Safe treatment protocols for asthma management have been carefully studied over the years, said Dr. Perry Sheffield, a pediatrician and professor at the Icahn School of Medicine at Mount Sinai. "The federal government actually has some really beautiful and clear guidelines and strategies, and things that are vetted by and carefully edited by many experts in the field," said Sheffield, who co-directs a region of the federally funded Pediatric Environmental Health Specialty Units that serves New Jersey, New York, Puerto Rico and the U.S. Virgin Islands. Asthma affects more than 4.6 million American children, according to the federal Centers for Disease Control and Prevention. It's one of the most common long-term diseases in U.S. children. The Make America Healthy Again Commission report released in late May, parts of which have been widely criticized, alleges that American children are on too much medication of various kinds, including asthma treatments. Experts worry that the administration will set policy based on the assessment that would dissuade insurers from covering asthma prescriptions. They also say that the report's assertions could worsen disparities that affect children's access to those medications and undermine years of research around the drugs. The MAHA commission has until August to release a strategy based on the findings in the report. Black and Indigenous children as well as those living in inner cities or in lower-income households are among those with the highest rates of asthma. Pollution disproportionately shrouds communities of color and can be a trigger that exacerbates the disease. The report's message could heighten those disparities, said Dr. Elizabeth Matsui, a University of Texas at Austin professor and a past chair of the American Academy of Pediatrics' Section on Allergy and Immunology. "One thing that has been very clear is that kids of color are less likely to be appropriately managed in terms of their asthma medication management," she said. "So a message of overprescription that is simply not supported by the evidence also could potentially exacerbate already-existing racial and ethnic disparities in asthma that we have really not made much headway on." The commission's claims The report touches on childhood prediabetes, obesity and mental health. However, firearm injuries - the leading cause of death for children and teens in 2020 and 2021, according to the CDC - weren't mentioned. The 70-page report from the commission, chaired by Secretary of Health and Human Services Robert F. Kennedy Jr., claims four main issues are the drivers behind childhood chronic disease: poor diet, aggregation of environmental chemicals, lack of physical activity and chronic stress, and "overmedicalization." Matsui and other experts said the report's use of that word is "problematic." "The implication could be, unfortunately, that when a child has asthma - so, they have coughing, chest tightness, wheezing - that that is not really a disease," said Matsui. "We know for a fact that that's a disease, and we know that it is quite treatable, quite controllable, and that it has profound impacts on the child's day-to-day life." Other scientists have similarly criticized the report, saying it makes sweeping and misleading generalizations about children's health without sufficient evidence. The White House corrected the report after nonprofit news outlet NOTUS found that it cited studies that didn't exist. In an emailed statement to Stateline, Health and Human Services press secretary Emily Hilliard wrote: "The MAHA report discusses concerns about the potential overprescription of asthma medications - particularly in mild cases - not to question their importance, but to encourage evidence-based prescribing." When it comes to asthma, the report says, "Asthma controller prescriptions increased 30% from 1999-2008." That sentence originally cited a broken link to a study from 2011; the link was later replaced. Controller meds include inhalers. The MAHA report also claims that "There is evidence of overprescription of oral corticosteroids for mild cases of asthma." The original version of the report listed estimated percentages of oral corticosteroids overuse, citing a nonexistent study. The wording was changed and the citation was later replaced with a link to a 2017 study by pediatric pulmonologist Dr. Harold Farber. The study was not a randomized controlled trial, which increases reliability. Farber told NOTUS that the report made an "overgeneralization" of his research. Stateline also reached out to Farber, whose public relations team declined an interview request. Oral corticosteroids are liquid or tablet medications used to reduce inflammation for conditions including allergies, asthma, arthritis and Crohn's disease. For asthma, they're used to treat severe flare-up episodes. The Asthma and Allergy Foundation of America says the medications have been shown to reduce emergency room visits and hospitalizations, and that while they do come with risk of side effects, they're mostly used in acute flare-ups. And while rare, asthma-related deaths in kids do occur, and are often preventable. "Asthma medications, including oral steroids, are lifesaving," said Dr. Elizabeth Friedman, a pediatrician at Children's Mercy Kansas City. "I believe that physicians, not politicians, are best equipped and most effectively trained to make the determination of whether or not these medications are needed for our patients." Friedman worries that federal characterizations of asthma meds will affect how state Medicaid agencies cover the drugs. When Medicaid coverage changed for a common prescribed inhaler last year, many of her Missouri Medicaid patients were suddenly without the drug. They ended up hospitalized, she said. Friedman directs Region 7 of the Pediatric Environmental Health Specialty Units, a network of experts that works to address reproductive and children's environmental health issues. Region 7 provides outreach and education in Iowa, Kansas, Missouri and Nebraska. She also said she's concerned that the report is "making a broad, sweeping statement based on one epidemiologic study from one state." Increased use An increase in inhaler prescriptions is not necessarily a bad thing, experts say. It's a sign that kids are getting their medication. There has been an increase in inhaler prescriptions, along with a corresponding decrease in the oral corticosteroids, which is what experts would want to see, said Chelsea Langer, bureau chief of the New Mexico Department of Health's Environmental Health Epidemiology Bureau. She said that means kids are "following their asthma action plans and taking the controller medications to prevent needing the relief or treatment (oral) meds." Asthma prevalence has increased over the years, meaning more people need medication, noted Dr. Alan Baptist, division head of Allergy and Clinical Immunology at Henry Ford Health in Michigan. He said that because steroid tablets come with risk of side effects, it is best to limit them. But for kids without access to a regular pediatric provider or to health insurance that covers an inhaler, cost can be an obstacle, he said. Fluticasone propionate, an FDA-approved medicine for people 4 and older, costs on average $200 or more for one inhaler without insurance. "What often happens with kids, and especially kids who are in Medicaid, or who are in an underserved or disadvantaged population, they are not given appropriate asthma controller medication," said Baptist, who helped write federal guidelines for asthma treatment best practices as part of a National Institutes of Health committee. Baptist noted that while he was glad to see pollution mentioned in the report as a danger for kids, it's at odds with the recent cuts to environmental health grants that aimed to address such asthma triggers. "They're somewhat cherry-picking some of the data that they're putting down," he said. "It says the U.S. government is 'committed to fostering radical transparency and gold-standard science' to better understand the potential cumulative impacts of environmental exposure. If that's what they're saying, then they should be funding even greater studies that look at the effects." Dr. Priya Bansal, an Illinois pediatrician and past president of the Illinois Society of Allergy, Asthma and Immunology, said she's concerned the report doesn't define mild, moderate or severe asthma to differentiate the different best-practice treatment plans. Bansal also said she worries that federal officials' characterization of an FDA-approved drug will lead to insurance companies refusing to cover inhalers or oral steroids for her patients who rely on them. "I'm going to be worried about coverage for my asthmatics," she said. "The question is, what's the next move that they're going to make? If they think that, are they going to now say, 'Hey, we're not going to cover inhalers for mild asthmatics'?" _____ Copyright (C) 2025, Tribune Content Agency, LLC. Portions copyrighted by the respective providers.
The Hill
16-06-2025
- Health
- The Hill
Making America healthy begins with farmers
In January 2019, at the age of 36, I was diagnosed with metastatic cancer. Amid all of the fear and worry over my health and my future, my biggest question was, 'why did this happen?' Now, President Trump's Make America Healthy Again Commission has been established to uncover the causes of the epidemic of chronic disease in our nation's young people, particularly children, and to do something about it. The MAHA Commission's assessment report marks a historic recognition of a crisis decades in the making: The American diet, shaped by a highly consolidated food system dominated by a handful of corporations, is fueling a chronic-disease crisis. Crucially, the report emphasizes that American farmers must be at the center of the nation's health. As the sixth-generation on my own family's farm, I couldn't agree more. American farmers have contributed to an abundant and affordable food supply, but a growing share of the value created by farmers' work has been captured by major food manufacturers, processors and retailers. This concentration of corporate power has not only weakened rural economies and limited market access for farmers, it has reshaped the American diet around government-subsidized, ultra-processed products that contribute to rising rates of chronic illnesses. This crisis would not be what it is without decades of unchecked mergers and acquisitions. A handful of companies now control most of the U.S. food and farm sectors, so they decide how farmers farm and what consumers eat. The way out is by investing in healthier local food systems and enforcing antitrust laws. The government, the nation's largest food purchaser, should spend its funds with producers who use regenerative, organic and grass-fed practices. Pairing this with stronger country-of-origin meat labeling and forcing the breakup of multinational monopolies will help reshape our system and allow farmers to feed their neighbors again. The MAHA Commission's report notes how powerful corporate interests have manipulated public policy to serve industry profits over public health. To undo that influence, we must reject current attempts by pesticide companies to shield themselves from accountability; oppose legislation (such as the EATS Act) that strips local governments of their authority; and reform USDA's commodity checkoff programs, which feed farmer dollars into the pockets of lobbying groups, including many of those opposing the work of the MAHA Commission. And we should implement a mandatory cooling-off period for those employees moving between USDA and the agribusinesses the agency regulates. As the administration examines pesticides for its 2026 health assessment, the process must be free of conflicts of interest. In the meantime, we can gain independence from multinational chemical suppliers by putting a priority on diversified, low-input systems (such as organic, non-GMO and regenerative) that offer similar or greater productivity and profitability compared to conventional models. Moreover, practices like cover cropping, rotational grazing and composting help build long-term soil health, improve water retention and increase farm resilience. With the right policy support, these models can form the backbone of a food system that enables farmers to be the drivers of improved health outcomes. Finally, if we want more healthy foods, the government must invest in them. Current taxpayer-backed farm programs drive the production of commodity field crops such as corn and soybeans. Farmers have shown up to the task of producing these crops, but it's been at the expense of more nutritious crops such as fruits, vegetables, nuts and whole grains, which are deemed 'specialty crops.' These programs are undermining food security and increasing our agriculture trade deficit as we rely on other countries for fruits and vegetables. The crops the government chooses to subsidize with our tax money will be most accessible for Americans. Today, those are ingredients for ultra-processed foods and feed for livestock. Health and Human Services Secretary Robert F. Kennedy Jr. has said, 'a healthy person has a thousand dreams; a sick person only has one.' I know too well the truth in these words. There is nothing more important for the future of our country than for our elected officials to set aside political differences, shake off undue corporate influence and rise to this opportunity to put American farmers, not corporate profits, at the center of our nation's health. Angela Huffman is a co-founder and president of Farm Action. She has spent 15 years in food and agriculture policy reform and market development, and raises sheep on her family's sixth-generation farm in Ohio.
Politico
09-06-2025
- Politics
- Politico
Soothing farm groups' MAHA tensions
QUICK FIX — White House officials are meeting with farm groups after weeks of backlash to a Make America Healthy Again Commission report that targeted pesticides. — Employees who left USDA will be allowed to come back to help fight fires this summer. — The Senate is looking to unveil a scaled-back version of the House GOP-led reconciliation agriculture plans this week. HAPPY MONDAY, JUNE 9. Welcome to Morning Agriculture. I'm your host Grace Yarrow. Send tips to gyarrow@ Follow us at @Morning_Ag for more. Want to receive this newsletter every weekday? Subscribe to POLITICO Pro. You'll also receive daily policy news and other intelligence you need to act on the day's biggest stories. Driving the day HEALING MAHA WOUNDS: The White House is setting up meetings this week to discuss farm groups' concerns with a recent Make America Healthy Again report that targeted pesticides, according to two people familiar with the plans. Officials will meet with several groups at a time across the commodity, food manufacturing and pesticide industries for hour-long conversations, said the people, who were granted anonymity to share further details. The meeting invitations come after farm groups spent the last few weeks aggressively lobbying the Trump administration to open up public comment and gather industry input privately before releasing its final list of MAHA policy recommendations, which is due in August. One agriculture industry insider, granted anonymity so they could candidly share their thoughts, said that it's 'not clear' how this effort will influence the final recommendations. 'We're all very interested to see how these meetings play out over the next week and if it is a meaningful gesture or not,' the person said. 'Is this just an exercise in placating stakeholders?' How we got here: Groups that have kept quiet in the face of President Donald Trump's tariff plans and funding cuts drew the line at supporting HHS Secretary Robert F. Kennedy Jr.'s MAHA Commission report, which targets the use of glyphosate and atrazine, according to industry representatives and former and current administration officials, granted anonymity to discuss the behind-the-scenes tensions. The initial report, which came out in May, only briefly mentions that glyphosate and atrazine — two of the most widely used herbicides — could lead to adverse health impacts, and it notes that federal reviews of data have not established a direct link. But groups are nevertheless worried that the report could create the impression that U.S.-produced food products aren't safe. 'American agriculture does not feel sufficiently protected against government mandates that would outlaw chemicals they need,' said one agriculture advocate granted anonymity to share concerns about the administration's work. 'How do we know that the nanny-state side of RFK Jr.'s agenda isn't going to show itself?' The White House didn't respond to a request for comment about the meetings, but spokesperson Kush Desai said in a statement earlier Friday that the MAHA Commission will 'continue to engage with stakeholders' as it drafts next steps. 'President Trump's initiative to Make America Healthy Again is a bottom-up movement, with stakeholders across the board — including farmers, everyday parents, local governments, and family physicians — having a role to play,' Desai said. A former Biden administration official, granted anonymity to discuss the private lobbying efforts, said farmers 'basically instinctively trust Trump' on tariff and other agricultural policies, but don't have the same belief in Kennedy. 'They think [Trump] has a master plan and that ultimately it will all work out,' the person said. 'That is not the feeling about this report.' Read more from your host here. AROUND THE AGENCIES SMOKEY BEAR BACKUP: Forest Service employees who accepted President Donald Trump's offer to resign will still be allowed to take on wildfire assignments this summer, according to a new agency memo obtained by our Jordan Wolman. The announcement comes as the U.S. barrels toward fire season and as officials around the country worry about the Forest Service's ability to staff response efforts now that thousands of employees have been fired from or have quit their posts under the Trump administration. More details: The option to return to fire assignments is targeted at employees who held some wildland-fighting qualifications, known as 'red cards.' Interested workers can register for fire assignments through Sept. 30, the expiration date for their administrative leave under the deferred resignation program, according to the memo. 'Many employees enrolled in the Deferred Resignation Program (DRP) expressed willingness to perform critical wildfire operations before their employment term ends,' the memo said. Forest Service and USDA officials worked to 'develop a solution that will allow employees on administrative leave to temporarily return to active service.' The memo outlines procedures for these workers to follow, including a call to bring their personal devices and computers 'to operate self-sufficiently' and to ensure dispatch centers have their personal contact information. The workers will be able to expense any flights, hotels or rental cars necessary for their fire assignments with proper approvals. 'Secretary [Brooke] Rollins has made it a top priority for the Department to ensure the entire agency is geared to respond to what is already an above normal summer fire season,' USDA spokesperson Alec Varsamis said in a statement when asked for further details. On The Hill LATEST IN SNAP CLASHES: The Senate Ag Committee is looking to release plans for their version of agriculture spending cuts to pay for farm bill programs and Republicans' policy megabill. They're looking to hit $150 billion in net cuts, and will need $220 billion in spending slashes to pay for $70 billion in farm bill programs. Several senators have privately raised concerns with the House's proposal to cut federal spending by forcing states to foot more of the bill for the Supplemental Nutrition Assistance Program. Also this week: The Senate will vote to proceed with the confirmation process for Stephen Vaden to be deputy secretary at USDA. TRADE CORNER VIETNAM'S AG DEALS: Vietnam's agriculture officials announced plans to buy $3 billion in U.S. agricultural products after meeting with American ag leaders last week, which could give producers up to a 23 percent boost in exports to the Southeast Asian country. Do Duc Duy, Vietnam's minister of agriculture and environment, led a delegation of 50 ag agencies and organizations to Iowa, Ohio, Maryland and Washington, D.C., last week. Stepping back: Rollins is scheduled to visit Vietnam in the coming months on one of her overseas trade missions. Ag groups and lobbyists are especially watching her meetings in Vietnam and India, hoping for more opportunities in the two countries for high-value products like meat and ethanol. The U.S. had a $123.5 billion trade deficit with Vietnam in 2024. U.S. goods exported to Vietnam last year were valued at $13.1 billion. NEXT UP: The U.S. and China will hold their next round of trade talks in London on Monday as the two countries attempt to lower tensions and chart a path toward a trade deal, our Daniel Desrochers writes. Treasury Secretary Scott Bessent, Commerce Secretary Howard Lutnick and U.S. Trade Representative Jamieson Greer will meet with their Chinese counterpart, Vice Premier He Lifeng, Trump said Friday in a post on Truth Social. Row Crops — Eggs linked to a salmonella outbreak have made dozens of people sick in seven states in the West and Midwest. (The Associated Press) — Archaeologists in northern Michigan have uncovered what is likely the largest intact remains of an ancient Native American agricultural site in the eastern half of the U.S. (NPR) — ICYMI: Some Senate Republicans are angling to have their states reap benefits from Rollins' plan to spread more department employees across the country, our Samuel Benson reports. THAT'S ALL FOR MA! Drop us a line and send us your agriculture job announcements or events: gyarrow@ marciabrown@ jwolman@ sbenson@ rdugyala@ and gmott@
Yahoo
06-06-2025
- Health
- Yahoo
'Problematic' MAHA report minimizes success of lifesaving asthma medicines, doctors say
Jun. 6—Medical experts are dismayed over a federal report's claim that kids are overprescribed asthma medications, saying it minimizes how many lives the drugs save. Safe treatment protocols for asthma management have been carefully studied over the years, said Dr. Perry Sheffield, a pediatrician and professor at the Icahn School of Medicine at Mount Sinai. "The federal government actually has some really beautiful and clear guidelines and strategies, and things that are vetted by and carefully edited by many experts in the field," said Sheffield, who co-directs a region of the federally funded Pediatric Environmental Health Specialty Units that serves New Jersey, New York, Puerto Rico and the U.S. Virgin Islands. Asthma affects more than 4.6 million American children, according to the federal Centers for Disease Control and Prevention. It's one of the most common long-term diseases in U.S. children. The Make America Healthy Again Commission report released in late May, parts of which have been widely criticized, alleges that American children are on too much medication of various kinds, including asthma treatments. Experts worry that the administration will set policy based on the assessment that would dissuade insurers from covering asthma prescriptions. They also say that the report's assertions could worsen disparities that affect children's access to those medications and undermine years of research around the drugs. The MAHA commission has until August to release a strategy based on the findings in the report. Black and Indigenous children as well as those living in inner cities or in lower-income households are among those with the highest rates of asthma. Pollution disproportionately shrouds communities of color and can be a trigger that exacerbates the disease. The report's message could heighten those disparities, said Dr. Elizabeth Matsui, a University of Texas at Austin professor and a past chair of the American Academy of Pediatrics' Section on Allergy and Immunology. "One thing that has been very clear is that kids of color are less likely to be appropriately managed in terms of their asthma medication management," she said. "So a message of overprescription that is simply not supported by the evidence also could potentially exacerbate already-existing racial and ethnic disparities in asthma that we have really not made much headway on." The commission's claims The report touches on childhood prediabetes, obesity and mental health. However, firearm injuries — the leading cause of death for children and teens in 2020 and 2021, according to the CDC — weren't mentioned. The 70-page report from the commission, chaired by Secretary of Health and Human Services Robert F. Kennedy Jr., claims four main issues are the drivers behind childhood chronic disease: poor diet, aggregation of environmental chemicals, lack of physical activity and chronic stress, and "overmedicalization." Matsui and other experts said the report's use of that word is "problematic." "The implication could be, unfortunately, that when a child has asthma — so, they have coughing, chest tightness, wheezing — that that is not really a disease," said Matsui. "We know for a fact that that's a disease, and we know that it is quite treatable, quite controllable, and that it has profound impacts on the child's day-to-day life." Other scientists have similarly criticized the report, saying it makes sweeping and misleading generalizations about children's health without sufficient evidence. The White House corrected the report after nonprofit news outlet NOTUS found that it cited studies that didn't exist. In an emailed statement to Stateline, Health and Human Services press secretary Emily Hilliard wrote: "The MAHA report discusses concerns about the potential overprescription of asthma medications—particularly in mild cases—not to question their importance, but to encourage evidence-based prescribing." When it comes to asthma, the report says, "Asthma controller prescriptions increased 30% from 1999-2008." That sentence originally cited a broken link to a study from 2011; the link was later replaced. Controller meds include inhalers. The MAHA report also claims that "There is evidence of overprescription of oral corticosteroids for mild cases of asthma." The original version of the report listed estimated percentages of oral corticosteroids overuse, citing a nonexistent study. The wording was changed and the citation was later replaced with a link to a 2017 study by pediatric pulmonologist Dr. Harold Farber. The study was not a randomized controlled trial, which increases reliability. Farber told NOTUS that the report made an "overgeneralization" of his research. Stateline also reached out to Farber, whose public relations team declined an interview request. The implication could be, unfortunately, that when a child has asthma ... that that is not really a disease. We know for a fact that that's a disease. — Dr. Elizabeth Matsui, University of Texas at Austin professor Oral corticosteroids are liquid or tablet medications used to reduce inflammation for conditions including allergies, asthma, arthritis and Crohn's disease. For asthma, they're used to treat severe flare-up episodes. The Asthma and Allergy Foundation of America says the medications have been shown to reduce emergency room visits and hospitalizations, and that while they do come with risk of side effects, they're mostly used in acute flare-ups. And while rare, asthma-related deaths in kids do occur, and are often preventable. "Asthma medications, including oral steroids, are lifesaving," said Dr. Elizabeth Friedman, a pediatrician at Children's Mercy Kansas City. "I believe that physicians, not politicians, are best equipped and most effectively trained to make the determination of whether or not these medications are needed for our patients." Friedman worries that federal characterizations of asthma meds will affect how state Medicaid agencies cover the drugs. When Medicaid coverage changed for a common prescribed inhaler last year, many of her Missouri Medicaid patients were suddenly without the drug. They ended up hospitalized, she said. Friedman directs Region 7 of the Pediatric Environmental Health Specialty Units, a network of experts that works to address reproductive and children's environmental health issues. Region 7 provides outreach and education in Iowa, Kansas, Missouri and Nebraska. She also said she's concerned that the report is "making a broad, sweeping statement based on one epidemiologic study from one state." Increased use An increase in inhaler prescriptions is not necessarily a bad thing, experts say. It's a sign that kids are getting their medication. There has been an increase in inhaler prescriptions, along with a corresponding decrease in the oral corticosteroids, which is what experts would want to see, said Chelsea Langer, bureau chief of the New Mexico Department of Health's Environmental Health Epidemiology Bureau. She said that means kids are "following their asthma action plans and taking the controller medications to prevent needing the relief or treatment [oral] meds." Asthma prevalence has increased over the years, meaning more people need medication, noted Dr. Alan Baptist, division head of Allergy and Clinical Immunology at Henry Ford Health in Michigan. He said that because steroid tablets come with risk of side effects, it is best to limit them. But for kids without access to a regular pediatric provider or to health insurance that covers an inhaler, cost can be an obstacle, he said. Fluticasone propionate, an FDA-approved medicine for people 4 and older, costs on average $200 or more for one inhaler without insurance. "What often happens with kids, and especially kids who are in Medicaid, or who are in an underserved or disadvantaged population, they are not given appropriate asthma controller medication," said Baptist, who helped write federal guidelines for asthma treatment best practices as part of a National Institutes of Health committee. Baptist noted that while he was glad to see pollution mentioned in the report as a danger for kids, it's at odds with the recent cuts to environmental health grants that aimed to address such asthma triggers. "They're somewhat cherry-picking some of the data that they're putting down," he said. "It says the U.S. government is 'committed to fostering radical transparency and gold-standard science' to better understand the potential cumulative impacts of environmental exposure. If that's what they're saying, then they should be funding even greater studies that look at the effects." Dr. Priya Bansal, an Illinois pediatric allergist and immunologist and past president of the Illinois Society of Allergy, Asthma and Immunology, said she's concerned the report doesn't define mild, moderate or severe asthma to differentiate the different best-practice treatment plans. Bansal also said she worries that federal officials' characterization of an FDA-approved drug will lead to insurance companies refusing to cover inhalers or oral steroids for her patients who rely on them. "I'm going to be worried about coverage for my asthmatics," she said. "The question is, what's the next move that they're going to make? If they think that, are they going to now say, 'Hey, we're not going to cover inhalers for mild asthmatics'?" Editor's note: This story has been updated with a response from the U.S. Department of Health and Human Services. Stateline reporter Nada Hassanein can be reached at [email protected]. YOU MAKE OUR WORK POSSIBLE.
