PI's Weekly Media Digest:Graham-Cassidy threatens to rollback healthcare gains, environmental injustice under the Trump admin, Oakland bans flavored tobacco products
The Graham-Cassidy healthcare bill continues to gain momentum, with a vote expected in the Senate next week. The bill would zero out the Prevention and Public Health Fund, and rapidly phase out the Medicaid expansion and health exchange subsidies, and enact steep cuts to Medicaid, slashing benefits and throwing millions of the most vulnerable people off of healthcare coverage. Under the guise of “state flexibility,” the bill would allow states to apply for waivers to avoid most consumer protections created by the Affordable Care Act. The bill defunds Planned Parenthood for one year, and instates a variety of abortion coverage restrictions. The bill would also redistribute funds from states that expanded Medicaid to those that didn’t, resulting in even steeper cuts to coverage and benefits in states that have adopted the Medicaid expansion. Reporter Vann R. Newkirk II described this as “in essence, […] taking half the amount of butter and spreading it over twice the slices of bread.” The vote is expected to go through a committee hearing in front of Homeland Security (which has never before ‘considered’ a healthcare bill), and then proceed to the floor with less than two minutes of total debate time, no amendments, and no Congressional Budget Office score on expected healthcare coverage losses. If it passes the Senate, it will proceed to the House, which can either reject the bill or pass it as is.
The Environmental Data and Governance Initiative released a new report on environmental justice concerns under the Trump administration this week. Pursuing a Toxic Agenda tracks the negative impacts of Trump administration policies on pesticides, pipelines, and more. Mustafa Santiago Ali, former head of the environmental justice program at the Environmental Protection Agency, described 2017 as “one of the most challenging times for the agency… There seems to be a direct assault on communities of color, low income communities, and indigenous communities based on the policies that [the Trump administration] have proposed and tried to move forward on.”
STAT profiles Dr. Dennis Charney, a psychiatrist and dean of research at Mt. Sinai Heath System who studied trauma and resilience and then became a trauma survivor himself. Dr. Charney ended up in intensive care for five days after a former researcher who Sinai dismissed for misconduct stalked and shot him in the shoulder. An essential part of Dr. Charney’s recovery is serving as a resource and role model for others who experience trauma.
In an Opinion piece in The New York Times, Zack McDermott chronicles his experiences returning to work as a legal aid attorney after time off following a psychotic break. He writes about the criminalization of people with mental health conditions, many of whom were his clients; the effect of stress on mental health; and the importance of the love and support of his mother in his recovery.
A surge in drug overdose deaths among young children is another sign of the magnitude of the nation’s opioid epidemic, The New York Times reports. Infants and toddlers are dying after inhaling, touching, and ingesting drugs in their households. A nine-month-old boy rolled onto a needle while in bed with his father. A toddler died after drinking from a water bottle containing methadone. The article cites Centers for Disease Control and Prevention numbers that show 87 children died of opioid intoxication in 2015, up from 16 in 1999.
Vox reports a study published in JAMA shows that life expectancy in the U.S. ticked down from 2014 to 2015, due in large part to drug overdose deaths. “In total, the researchers said decreased death rates related to heart disease, cancer, cerebrovascular diseases, diabetes, influenza and pneumonia, chronic lower respiratory diseases, and kidney disease contributed to a gain of about two years and three months in life expectancy from 2000 to 2015,” the article says. “But increases in drug overdoses, suicide, chronic liver disease and cirrhosis, and alcohol poisonings pushed down the overall gains.”
Many insurance plans make it easier for patients to access addictive pain medications than less addictive but more expensive alternatives, according to an analysis of Medicare prescription drug plans by ProPublica and The New York Times. The investigation also found there’s less coverage for medications that address addiction and other addiction treatment options. On a more promising note, as concern (and litigation) over the opioid epidemic has increased, some plans have moved to limit new prescriptions for opioids and to provide more coverage for addiction treatment medications.
Meanwhile, the Trump Administration continues to move forward with a public-private partnership with pharma companies to develop non-opioid pain medications, Politico reports. The partnership was among the recommendations of the commission the President convened to address the epidemic. The Administration has yet to act on some of the other recommendations, including declaring the epidemic a national emergency.
Most parents lack confidence that schools can deal with their children’s mental health needs, according a recent survey conducted for C. S. Mott Children’s Hospital in Michigan. The national survey of about 2,000 parents found that just 38 percent are confident that their school can help children experiencing anxiety, depression or other mental health concerns.
On Tuesday, the Oakland City Council approved the ‘Oakland Children Smoking Prevention Ordinance,’ a ban on flavored tobacco products that will take effect in 2018. Flavored tobacco products have long been marketed to children, acting as an on-ramp for a lifetime addiction to tobacco, and are marketed aggressively to people of color and LGBTQ people. The Oakland City Council’s approval of the ban is a critical win for prevention and health equity.
Last week, the California State Senate and State Assembly passed Senate Bill 5, which would place a $4 billion bond on the June 2018 ballot to fund parks, safe drinking water, and flood control infrastructure in California. Senate President pro Tem Kevin de León, who authored the bond meausre, said, "Over one million Californians still lack access to safe drinking water, and too many children lack access to healthy outdoor spaces... SB 5 will finally give voters a chance to fund these critical priorities and protect our quality of life.”
Vox reports on the lingering health effects of hurricanes Harvey and Irma: “In the weeks following Hurricane Irma, parts of Florida have been awash in millions of gallons of sewage. Meanwhile, in Texas, oil refineries and chemical plants have dumped a year’s worth of cancer-causing pollutants into the air following Hurricane Harvey. In both states, doctors are on the lookout for an uptick in respiratory problems, skin infections, and mosquito-borne diseases brought on by the water and mold the storms left behind… Health officials are warning about the much longer-term health fallout from this year’s hurricane season. America’s Gulf Coast region perennially records some of the worst health outcomes in the US — and they’ll almost surely be aggravated by the storms that recently slammed the southern states.”