June Policy Roundup
Deb Gordon
Deborah D. Gordon has spent her career trying to level the playing field for healthcare consumers. She is co-founder of Umbra Health Advocacy, a marketplace for patient advocacy services, and co-director of the Alliance of Professional Health Advocates, the premiere membership organization for independent advocates. She is the author of "The Health Care Consumer's Manifesto: How to Get the Most for Your Money," based on consumer research she conducted as a senior fellow in the Harvard Kennedy School's Mossavar-Rahmani Center for Business and Government. Deb previously spent more than two decades in healthcare leadership roles, including chief marketing officer for a Massachusetts health plan and CEO of a health technology company. Deb is an Aspen Institute Health Innovators Fellow, an Eisenhower Fellow and a Boston Business Journal 40-under-40 honoree. Her contributions have appeared in JAMA Network Open, the Harvard Business Review blog, USA Today, RealClear Politics, The Hill and Managed Care Magazine. She earned a BA in bioethics from Brown University and an MBA with distinction from Harvard Business School.
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1. A Proposed Bill Boosts Funding for Women's Health
The U.S. House of Representatives Appropriations Committee released a draft Labor, Health and Human Services, Education, and Related Agencies funding bill for fiscal year 2022. The proposed bill includes an additional $55.2 billion for maternal health, mental health, gun violence prevention and opioid abuse. The bill proposes $61 million for the Office of Research on Women's Health, an $18 million increase over 2021, and $42 million for the Office on Women's Health.
Funding would also increase by 22% to $868.7 million for the Health Resources and Services Administration Maternal and Child Health block grants. These funds would go toward reducing inequities in maternal health, reducing bias among healthcare providers, supporting women through prenatal and postpartum periods and creating a maternal mental health hotline.
2. Share Your Input for the NIH's Upcoming Women's Health Consensus Conference
The National Institutes of Health (NIH) Office of Research on Women's Health (ORWH) is planning a Women's Health Consensus Conference in October 2021 to address specific areas of women's health: maternal health, debilitating chronic diseases and cervical cancer. The congressionally requested conference will address existing women's health research efforts and concerns that women's health research funding is disproportionately low. ORWH is seeking comments from professional associations, organizations and the general public relating to research gaps, pitfalls in clinical practice and real-world patient experiences in these specific areas. Share your comments by September 15, 2021, to inform ORWH's planning efforts.
3. Medicaid Expansion Efforts Are Stymied in Some States
Expanding Medicaid eligibility to cover more people with low incomes is a state-level decision. Despite federal financial incentives and evidence that Medicaid expansion improves health and reduces deaths, 12 states have still not expanded Medicaid.
In Mississippi, where 400,000 people could benefit from Medicaid expansion, advocates recently dropped efforts to put Medicaid expansion on the 2022 ballot, and a judge recently ruled in favor of Missouri's efforts to block Medicaid expansion despite a successful ballot initiative last summer.
Meanwhile in Congress, Senate Democrats have proposed legislation for the federal government to cover Americans with low incomes in nonexpansion states.
4. Democrats Include Healthcare Priorities in Their $3.5 Trillion Proposed Budget — But It Still Needs to Pass
Democrats in the U.S. Senate have developed a $3.5 trillion budget that includes funding for Medicaid expansion in states that haven't done so, extends subsidies for people with low incomes who enroll in Marketplace insurance and expands Medicare benefits to include dental, hearing and vision coverage as well as home-based services. These priorities would be paid for with savings from lower drug prices. Lawmakers still need to work out the details and pass the budget through a reconciliation process that allows Democrats to work around Republicans, who are unlikely to support the budget.
5. The Biden Administration Seeks to Boost Obamacare as Millions Enroll
More than 2 million people have signed up for health insurance via the Affordable Care Act (ACA) Marketplace during the special enrollment period that runs through August 15. To keep that momentum going, the Biden administration recently proposed a rule that would expand regular open enrollment by 30 days, so it would run from November 1 through January 15 each year instead of ending on December 15. The administration also hopes to create additional enrollment windows for people with low income, reinstate requirements that navigators support consumers after enrollment and reverse a Trump-era policy that allowed states to bypass the Marketplace and let consumers buy individual insurance directly from carriers.
6. Period Equity Marches Forward in Several States
Effective July 1, 2021, tampons, pads, panty liners and other menstrual products are tax-free in Vermont. The law, signed on June 8, makes Vermont the 23rd state to remove taxes on menstruation products, known as the "tampon tax." In late June, the governor of Louisiana signed a similar bill making feminine hygiene products and diapers tax exempt. Several other states have introduced similar legislation, according to Period Equity.
7. The FDA May Call for Long-Term Studies on the Effects of Breast Cancer Drugs
The U.S. Food and Drug Administration (FDA) may require post-marketing studies to analyze long-term effects of breast cancer drugs on both pre- and postmenopausal women, according to guidance issued in June. This is new because, historically, studies of breast cancer drugs have excluded premenopausal women.
8. Cancer Deaths Declined Among Women
A new report from the National Cancer Institute showed that cancer deaths decreased between 2014 and 2018 by an average of 1.7% for women and 2.2% for men. However, cancer incidence — the rate of new cancers each year — increased slightly for women while remaining steady for men. Of the 20 most common cancers in women, 14 had decreases in deaths. Melanoma and lung cancer had the greatest reduction in deaths while uterine, liver, brain and pancreatic cancer were among those with increased mortality for women. New cases in eight of the 19 most common cancers in women — including breast, kidney, pancreatic and uterine — increased between 2013 and 2017.
9. A Judge Ruled That a Private Health Insurer Is Subject to Anti-Transgender Discrimination Policies
A federal judge in West Virginia recently ruled that a private health insurer accused of denying hormone replacement therapy to two transgender men must comply with anti-discrimination provisions of the Affordable Care Act. The judge refused to dismiss the case, stating that Congress intended to prohibit discrimination by any entity within the health system, including health plans. The case is still pending in U.S. federal court.
10. It's Official: Sleep Is Essential to Health
A recently published position statement from the American Academy of Sleep Medicine asserts that sleep is essential to health in adults as well as children and adolescents. The statement urges healthcare providers, along with government agencies and employers, to promote the importance of healthy sleep. The authors argue that chronic insufficient sleep leads to increased risk of heart disease, diabetes, obesity and accidents.
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