The Host
Julie Rovner
KFF Well being Information
Learn Julie’s tales.
Julie Rovner is chief Washington correspondent and host of KFF Well being Information’ weekly well being coverage information podcast, “What the Well being?” A famous professional on well being coverage points, Julie is the writer of the critically praised reference guide “Well being Care Politics and Coverage A to Z,” now in its third version.
The brand new, GOP-led, 119th Congress and President-elect Donald Trump have massive legislative plans for the yr — which largely don’t embody well being coverage. However well being is prone to play an vital supporting position in efforts to resume tax cuts, revise immigration insurance policies, and alter commerce — if solely to assist pay for some Republican initiatives.
In the meantime, the outgoing Biden administration is racing to complete its well being coverage to-do listing, together with finalizing a coverage that bars credit score bureaus from together with medical debt on people’ credit score studies.
This week’s panelists are Julie Rovner of KFF Well being Information, Shefali Luthra of The nineteenth, Alice Miranda Ollstein of Politico, and Lauren Weber of The Washington Submit.
Panelists
Shefali Luthra
The nineteenth
Alice Miranda Ollstein
Politico
Lauren Weber
The Washington Submit
Among the many takeaways from this week’s episode:
- The 119th Congress is now in session. Well being care doesn’t make the listing of priorities as lawmakers lay the desk for the incoming Trump administration — although Republicans have floated Medicaid work necessities to chop federal spending.
- Plenty of well being laws hit the cutting-room flooring in December, together with a bipartisan proposal concentrating on pharmacy profit managers — which might have saved the federal authorities and sufferers billions of {dollars}. And talking of bipartisan efforts, a congressional report from the Senate Funds Committee provides to proof that non-public fairness involvement in care is related to worse outcomes for sufferers — notably, lawmakers’ constituents.
- Because the nation bids a ultimate farewell to former President Jimmy Carter, his international well being work, particularly, is being celebrated — particularly his efforts to eradicate such devastating ailments as Guinea worm illness and river blindness.
- In the meantime, the Biden administration finalized the rule barring medical debt from showing on credit score studies. The surgeon basic cautions that alcohol ought to include warning labels noting most cancers threat. And the brand new Senate Republican chief is elevating abortion-related laws to require lifesaving take care of all infants born alive — but these protections exist already.
Plus, for “additional credit score,” the panelists counsel well being coverage tales they learn this week that they assume you need to learn, too:
Julie Rovner: The Wall Road Journal’s “UnitedHealth’s Military of Docs Helped It Acquire Billions Extra From Medicare,” by Christopher Weaver, Anna Wilde Mathews, and Tom McGinty.
Alice Miranda Ollstein: The New York Instances’ “Ozempic, Lego Bricks and Listening to Aids: What Trump’s Greenland Plan May Hit,” by Ana Swanson and Jenny Gross.
Shefali Luthra: Vox.com’s “Gigantic SUVs Are a Public Well being Menace. Why Don’t We Deal with Them Like One?” by David Zipper.
Lauren Weber: The Washington Submit’s “Legal guidelines Prohibit U.S. Delivery of Vape Merchandise. Many Corporations Do It Anyway,” by David Ovalle and Rachel Roubein.
Additionally talked about on this week’s podcast:
The Senate Funds Committee’s “Income Over Sufferers: The Dangerous Results of Non-public Fairness on the U.S. Well being Care System.”
CLick right here to open the transcript
Transcript: New Yr, New Congress, New Well being Agenda
[Editor’s note: This transcript was generated using both transcription software and a human’s light touch. It has been edited for style and clarity.]
Julie Rovner: Whats up, and welcome again to “What the Well being?” I’m Julie Rovner, chief Washington correspondent for KFF Well being Information, and I’m joined by a few of the finest and smartest well being reporters in Washington. We’re taping this week on Thursday, Jan. 9, at 10 a.m. As all the time, information occurs quick and issues might need modified by the point you hear this. So, right here we go.
Rovner: In the present day we’re joined by way of videoconference by Alice Miranda Ollstein of Politico.
Alice Miranda Ollstein: Whats up.
Rovner: Lauren Weber of The Washington Submit.
Lauren Weber: Whats up whats up.
Rovner: And Shefali Luthra of The nineteenth.
Shefali Luthra: Whats up.
Rovner: No interview this week — manner an excessive amount of information to make amends for. So allow us to get proper to it. So, welcome to the 119th Congress and, quickly, to a brand new presidential administration. We’ll return and recap what occurred in late December shortly, however I wish to begin by wanting forward. What’s on the speedy agenda right here in Washington for well being care? Anyone?
Ollstein: So well being care just isn’t the precedence proper now for the incoming administration, for the brand new Republican trifecta in Washington. It might make it in, as a result of they’re speaking about these large, conglomerate payments that they’ve criticized up to now and mentioned that they don’t like doing that, and they’d a lot relatively vote on particular person issues one after the other.
However now they’re speaking about cramming every thing into one big reconciliation invoice early within the new administration. And there’ll seemingly be some well being care elements. We don’t know but what these will probably be. Issues that purport to save cash are much more seemingly than issues that purport to price cash. Though, there’s usually some humorous math in that. Medicaid work necessities have been floated, and so we are able to discuss that. We all know, we’ve seen that film earlier than, and we all know how that may go, each when it comes to what it means for individuals’s protection and what it means when it comes to financial savings.
However I feel that a number of the formidable stuff that lawmakers tried to get by on the finish of the yr is now in query, as as to if it has a future or not. As a result of the highest priorities of the brand new administration are extra on taxes and commerce and immigration and issues like that and never as a lot on well being coverage.
Rovner: Though, I might level out that that end-of-the-year rush that they acquired — they stored the federal government open, they usually acquired the federal government funded — that solely goes till March. I noticed form of a plaintive e-mail yesterday from Tom Cole, the Republican chairman of the Home Appropriations Committee, saying, Um, we now have to start out engaged on the following one quickly. Everyone’s busy speaking about this enormous tax invoice, reconciliation. What are we going to do about Medicaid? And it’s like, whats up, the present fiscal yr just isn’t completed. They only managed to place issues off.
Lauren, you needed so as to add one thing?
Weber: Yeah. I simply needed to say, I really feel like we’ve entered the period of selling with regards to these payments. You’ve acquired President-elect [Donald] Trump saying he needs one massive, stunning invoice. That’s what he needs. He needs one massive, stunning invoice. And it’s not simply Trump. I imply, let’s take a look at the MAHA motion, the “Make America Wholesome Once more” motion.
I imply, I feel we’re coming into an period during which payments and actions all have catchy slogans. And I imply, heck, the American public might have a greater understanding, or a minimum of know what these persons are telling them is occurring with this advertising, we’ll see. So I simply needed to flag that this appears to be the change over right here.
Rovner: And that is after I get to place in my different actuality test, which is that they preserve speaking about this massive, stunning reconciliation invoice that they solely want Republican votes for. I’ve to remind individuals yearly: With a view to do a reconciliation invoice, first they need to do a finances decision, in each homes. That has to go to the ground, be debated, must be reconciled between the Home and the Senate, about what the finances decision seems to be like.
The entire level of what’s known as “reconciliation” is that it reconciles obligatory spending to the phrases of the finances decision. It takes a very long time to do a finances decision, even whenever you’re dashing it by.
Additionally, all these items that they’re speaking about placing into this reconciliation invoice usually are not allowed to enter finances reconciliation. It’s solely about obligatory spending. It’s taxes. It’s Medicare and Medicaid and different obligatory spending. And it’s the debt ceiling. And people are principally all of the issues that may go in. Sorry, that’s the top of my lecture.
Alice, did you wish to add one thing?
Ollstein: Certain. I imply, I feel we’re already seeing cracks rising on this nice Republican unity that they’re making an attempt to venture. I imply, they’ll’t even agree but on whether or not to do one massive, stunning invoice or two. And the individuals pushing for 2 are mentioning that should you put all of your eggs in a single basket and that basket breaks and falls aside and all of the eggs smash on the ground, you then don’t actually have something to indicate on your work.
Which in fact is a state of affairs Congress has discovered itself in lots of instances over the previous a number of years. And so, these people are saying it’s a lot much less dangerous to interrupt it up and have it in separate payments, in order that if one goes down in flames, the opposite may make it by. However sure, as soon as once more, we’re seeing each Home vs. Senate tensions, in addition to Congress vs. Trump and Trump’s advisers tensions. And I think about that’s going to be a continuing for the following few years.
Rovner: And should you thought that the Home was ungovernable with its tiny Republican majority within the final Congress, it’s even tinier now. In truth, we do have Speaker Mike Johnson. He did get elected on the primary poll, but it surely was not straightforward. There have been a few holdouts who needed to take calls from the president-elect so as to change their votes. So it’s fairly tenuous there.
Shefali, earlier than we transfer on, did you wish to add one thing?
Luthra: No, I imply, I feel what will probably be actually attention-grabbing, as effectively, is to see how this emerges in all the extra fractious points among the many Republican Celebration. I do know we’ve talked rather a lot about how the Republican Celebration could be very divided on a number of problems with reproductive well being, together with abortion, one thing Alice and I each take into consideration on a regular basis. And—
Rovner: And we’ll get to in a couple of minutes.
Luthra: We will probably be attending to that very quickly. However it’s simply very clear that each one of those points, the place they venture unity, are fairly rapidly going to disintegrate with regards to partaking with the truth that it is a very divided coalition, and a number of the issues they’re speaking about doing usually are not very talked-about with voters. And so we’ll see how that impacts them as effectively.
Rovner: Sure. So let’s transfer again a bit of bit. Once we left issues in December, we had been a day away from a doable authorities shutdown, which didn’t occur. However the different factor that didn’t occur was a giant bundle with principally a whole yr’s price of bipartisan well being coverage work in it, every thing from new transparency necessities for pharmacy advantages managers [PBMs], to renewals of packages to arrange for the following pandemic and to combat the opioid epidemic, to rolling again cuts to docs below Medicare. Most of that didn’t make it into the ultimate bundle that can preserve the federal government working till March.
The tiny issues that did make it in had been extensions of telehealth authority for Medicare and funds for group well being facilities and another expiring packages — however once more, solely by the center of March, which is when the remainder of this funding invoice expires.
So what occurs to issues just like the PBM invoice that fell by the wayside? Do we now have any cause to assume that Congress goes to choose it up and cross it this yr? And even when they do this Trump would signal it? Or did all of that work final yr, is that each one simply principally for naught now?
Ollstein: I imply, I feel you could possibly make an argument both manner. You can make an argument that it has an opportunity as a result of there may be bipartisan help. A few of these issues might save the federal government cash and assist pay for different issues that the Republican majority needs to do, like minimize taxes.
Rovner: I might say the PBM invoice was like $5 billion in financial savings, as I recall.
Ollstein: Precisely. And it’s not like PBMs are super-popular and everybody needs to defend them proper now. So you can also make the argument that it has an opportunity due to that, however we’ve seen tons of well being insurance policies up to now which have bipartisan help that may lower your expenses additionally fall by the wayside, simply because they don’t seem to be priorities. And so, I feel, you can also make the optimistic or the pessimistic case on this one.
Rovner: Go forward, Lauren.
Weber: I might simply add, I imply, a number of issues that folks had been fairly upset about, when it comes to smaller issues, health-wise, additionally acquired minimize from the invoice. I imply, there was funding for 9/11 most cancers funds, for people who had been uncovered to poisonous chemical substances, first responders, and so forth. Plenty of outcry after that acquired stripped out of the invoice. Understandably so, contemplating, principally all of the advocates mentioned: We don’t wish to parade our dying first responders to Congress yearly to get funds. Actually, you narrow this out?
So there does appear to be some momentum to probably add that in once more. There was additionally hullabaloo round childhood most cancers analysis. They ended up passing a separate smaller invoice, but it surely didn’t embody the complete measures to actually prioritize some stress on the FDA [Food and Drug Administration] and different funding to enhance childhood most cancers analysis. And so I feel you’re going to proceed to see, a minimum of from the Dems, some mentioning of those points going ahead as, I imply, childhood most cancers and 9/11 first responders are fairly sympathetic characters for funding.
Rovner: Yeah, I feel it’s going to be — I feel a number of these new committee chairs, significantly within the Senate, the place the Republicans are taking on, are going to must determine their manner out and attempt to choose up a few of the items. One attention-grabbing factor that got here by my inbox this week was a bipartisan report from the Senate Funds Committee that discovered, and I’m quoting from the headline within the press launch, “Non-public Fairness in Well being Care Proven to Hurt Sufferers, Degrade Care and Drive Hospital Closures.” Does this counsel that Congress may attempt to do one thing on this extraordinarily fraught topic?
Shefali, you’re smiling. I imply—
Luthra: I’m smiling as a result of a few issues, and the primary is that there was a number of discourse about non-public fairness’s influence on well being take care of shoppers for years. That is very attention-grabbing and vital work, and it isn’t in any respect stunning.
And the opposite factor that we now have to recollect is that Donald Trump will probably be president. He’s ideologically very unpredictable. As an actor, he’s very unpredictable. And it’s simply very tough to guess what is going to truly grow to be legislation and getting his signature. And a part of that’s as a result of, we are able to bear in mind from the final time he was president, he fairly often would change what he believed primarily based on the final individual he spoke to. We noticed this on a regular basis with drug pricing.
And I simply assume that we’ll see actually attention-grabbing bipartisan analyses of issues that might make actual variations for shoppers on well being care, however whether or not they grow to be legislation, whether or not they change individuals’s lives, that’s simply a lot, a lot tougher for us to actually predict in a significant manner.
Rovner: Yeah, I feel every thing’s fairly laborious to foretell proper now. Lauren?
Weber: Yeah, I simply needed so as to add, I imply, I do know, clearly laborious to foretell, however I feel the concept you could have lawmakers issuing fairly strident releases that tie non-public fairness to lower affected person outcomes of their particular districts is a little bit of a step ahead. I imply, you could have [Sen. Charles] Grassley saying: Look, none of those individuals care about affected person care. They solely care about shareholders. I do assume that may be a shift in rhetoric, to an extent. We’ve seen a constructing for fairly a while. We’ve all talked about non-public fairness on this podcast.
However I do assume when you could have lawmakers making that soar to, Oh, individuals in my district are getting worse well being care due to this, I feel you could possibly see extra motion.
Rovner: Yeah, it’s one thing I’m going to control. Like I mentioned, I used to be stunned to see that as a bipartisan report from a committee, though it’s the Funds Committee that doesn’t actually have authority to do something legislatively. Nonetheless, it was price noting.
Effectively, in case there wasn’t already sufficient information this week, right here in Washington this very morning, we’re bidding farewell to former President Jimmy Carter, who died at age 100 late final month. Carter was certainly one of a protracted listing of Democratic presidents who tried and didn’t overhaul the nation’s well being care system. You may Google one thing known as “hospital price containment” if you wish to know extra. He additionally created the Well being Care Financing Administration to run Medicare and Medicaid, which acquired renamed the Facilities for Medicare & Medicaid Providers within the early 2000s.
However Carter’s largest well being achievements got here after he left workplace. His work by his basis addressed, and in some circumstances practically eradicated, some largely uncared for tropical ailments that largely afflict the poorest and most marginalized individuals on the planet. That’s going to be certainly one of his actual main legacies, was bringing international well being residence. Proper, Alice?
Ollstein: Yeah, and I feel that’s attention-grabbing, given the popularity of his legacy proper now, round his funeral, and mendacity in state within the Capitol, with the Trump administration coming into workplace, being very towards our bodies just like the WHO [World Health Organization] and worldwide cooperation on well being care, very vocally vital of how worldwide cooperation occurred through the covid-19 pandemic. And so I feel that’s going to be an attention-grabbing distinction, given what Carter was capable of obtain by such cooperation.
Rovner: Yeah. Lauren?
Weber: Yeah, I simply needed so as to add, I imply, it’s a mannequin that I feel then seeped into different presidents, proper? I imply, you’ve seen [former president George W.] Bush’s funding in international well being, and so forth. And I do assume, as Alice neatly identified, there may be, clearly, a pointy distinction. However I imply, what Carter was capable of do for river blindness and Guinea worm is unprecedented. And I feel what was most shifting in all the recaps of his work is that these are people who don’t have a voice. They don’t have a place of energy within the nation they stay in. I imply, that is him utilizing his mushy energy to demand motion, by flying out to far-flung corners of the world, to satisfy with farmers who had been disabled by Guinea worm, to ensure that this didn’t occur to future generations.
And a few of these biographers have posited that’s due to his upbringing as a poor farmer in Georgia. So I feel that is form of a once-in-a-generation second to have a look at this influence somebody has on international well being. And as Alice identified, I don’t know what we’ll see going ahead on that.
Rovner: It’s laborious to think about Donald Trump making eradication of Guinea worm a significant precedence. Effectively, we’re additionally bidding farewell over the following two weeks to the Biden administration, which is utilizing its final days to try to get as a lot finished and trumpet as many victories as it may. We’ll begin with the Inexpensive Care Act, the place the administration simply introduced that with per week left to go within the official sign-up interval in most states, 24 million individuals have now been enrolled in ACA plans. That’s up 3 million simply from final yr and greater than double the quantity from 2021 when [Joe] Biden took workplace.
After all, that is prone to be the excessive water mark. This yr marked the primary that the so-called Dreamers, these individuals introduced illegally to the U.S. as kids by their mother and father, they might enroll, a minimum of for now. That’s one thing President Trump and the Republican Congress is taken into account prone to finish. Plus, the extra tax credit that had been put in place through the pandemic expire on the finish of this yr, until Congress renews them. What’s the outlook for ACA enrollment?
Ollstein: Effectively, Democratic senators are beginning to make a push to increase these subsidies, introducing laws and making a giant splash about it at the moment. There’s been a number of lobbying from the well being care sector, the hospitals, all of the gamers who don’t wish to see these tax credit expire, and in addition to affected person advocacy teams. Actually, my inbox has been flooded with issues associated to that and calling on Congress to increase these subsidies.
After all, they price some huge cash, and the brand new congressional majority undoubtedly has different issues they wish to spend that cash on, that aren’t serving to individuals purchase medical health insurance plans as a part of the Inexpensive Care Act. And so, I feel there may be prone to be a number of wrangling and horse-trading round this. I don’t assume the subsidies are essentially toast, however I don’t assume that they’re a finished deal, both.
Rovner: Yeah, I imply, I preserve saying, I feel everyone’s first inclination after Election Day is that they had been toast, as a result of Republican trifecta. Alternatively, whenever you truly dig into the numbers, the most important will increase have are available purple states.
Ollstein: Completely.
Rovner: So the people who find themselves benefiting from these additional subsidies are people who find themselves in Republican states and voted for Republicans and are represented by Republicans. And also you’ve acquired to wonder if they wish to, immediately subsequent January, or actually subsequent October, November, when individuals understand: Oh my goodness, my premiums for my medical health insurance are going to quadruple. How did this occur? Perhaps they’ll take into consideration that once they’re placing all of those massive, stunning payments collectively, possibly?
Ollstein: Yeah, we’ve began to see some feedback from some Republicans. After all, it’s those who’ve been prepared to work with Democrats up to now, like Lisa Murkowski within the Senate, saying that we must always take a look at extending these subsidies. You’re not listening to that from most Republicans by any stretch of the creativeness, however I feel you’re beginning to hear these rumblings as a result of, such as you mentioned, Julie, they don’t wish to have a bunch of constituents lose their insurance coverage or have their insurance coverage get far more costly once they’re in energy.
Rovner: Yeah, the benefit and drawback of the trifecta. Lauren?
Weber: I simply needed to ask, I imply, a query for the panel. I imply, there’s all this discuss “DOGE” [the “Department of Government Efficiency”] and reducing all this cash, however as you simply said, Alice, they’re seemingly to not eliminate these subsidies. Johnson went on the report, I feel this week or final week, to say Medicare just isn’t going to get impacted. Medicaid cuts appear to be coming, however expensive God, should you don’t minimize a few of these different issues, I don’t understand how you may get to the cash quantities that they’re speaking about, particularly in well being.
Ollstein: Effectively, and Elon Musk has already walked again his projection of how a lot he’ll be capable of minimize, saying that $2 trillion was aspirational and hopefully they’ll get $1 trillion. And so that you’re already beginning to see the walk-back of a few of the preelection guarantees on that entrance as they begin to confront a few of the realities you talked about, Lauren.
Rovner: Yeah, there’s nothing just like the optimism of early January, when a brand new Congress and a brand new president say, We’re going to do all of this within the first hundred days. You’d assume that Trump of all individuals would know higher, as a result of he tried to repeal the Inexpensive Care Act within the first hundred days in 2017, and that didn’t go so effectively. However apparently he has a brief reminiscence, too.
Effectively, talking of issues which might be prone to be undone, the Client Monetary Safety Bureau finalized its rule this week barring the usage of medical debt on credit score studies. It’s already been sued for exceeding its authority by two commerce teams representing collectors. How vital would this alteration be if it truly survives?
Luthra: One thing like this might be actually significant. I bear in mind speaking to households about their efforts to purchase properties and infrequently struggling to take action as a result of their medical debt had harmed their credit score rating. And the factor about medical debt is that it’s normally not deliberate. It’s most likely truly virtually all the time not deliberate, since you don’t hope to fall sick. You don’t attempt to get a devastating harm that your insurance coverage won’t absolutely cowl the prices for.
And this was one thing that had actually been championed by people within the client advocacy area for a really very long time, effectively earlier than the Biden administration. Shedding it will actually have implications for individuals throughout the political spectrum, particularly as we’re on this area the place housing stays very costly, the place medical debt is an actual concern, and the place having it have an effect on your credit score might actually put an inexpensive mortgage simply out of attain for lots of Individuals.
Rovner: Effectively, lastly, as certainly one of his parting suggestions, outgoing Surgeon Basic Vivek Murthy has issued a report recommending that alcoholic drinks carrying warning labels that they’ll trigger most cancers, identical to tobacco merchandise. His report calls alcohol the third-leading preventable reason for most cancers. However this doesn’t really feel super-likely to occur, between the facility of the alcohol business and the mistrust of science, significantly when it recommends issues individuals most likely don’t wish to hear. I assume no one right here is betting on this taking place anytime quickly?
Ollstein: No, you’ve already seen members of Congress for whom the alcohol and beverage business could be very economically vital for his or her state, all the oldsters who characterize breweries and distilleries and wineries, already talking out and sharing issues about this. However I feel that simply the surgeon basic utilizing the bully pulpit to shine a lightweight on this, it generated a number of information protection. That’s vital.
It’s vital for shoppers to see that and be capable of make selections. And also you’re already seeing some tendencies of youthful people being extra form of sober-curious. And there’s a number of discuss Dry January being a wholesome factor to do. And much more bars you’re seeing provide low-alcohol or nonalcoholic choices. And so I feel that is one thing that persons are slowly turning into extra conscious of and extra involved about, whether or not the federal government steps in or not.
Rovner: Yeah, I feel it could be like tobacco, the place everyone smoked after which step by step fewer and fewer and fewer individuals did. Lauren, did you wish to say one thing?
Weber: Yeah, I imply, I’ve written rather a lot about meals labels within the final couple of years, and, I imply, that’s simply been a torturous course of. So the concept something on alcohol would change at something sooner than a glacial tempo I feel might be problematic, contemplating there’s a number of attorneys on this city and there’s some huge cash in lawmakers’ pockets on this city. So simply needed so as to add that.
Rovner: And alcohol’s actually standard — and authorized. Effectively, let’s flip to abortion reproductive well being. All issues thought-about, it’s truly been form of quiet on the abortion entrance for the previous few weeks. However there has all the time been information, as is predictable when Republicans take over the Home, Senate, and White Home on the identical time. New Senate Majority Chief John Thune has introduced his intention to carry up an abortion invoice. On this case, not a nationwide ban, which President-elect Trump has mentioned he wouldn’t signal, however relatively the, quote, “Born-Alive Abortion Survivors Safety Act.” What is that this invoice? And what wouldn’t it do? And the way is it completely different from a similar-sounding invoice that Congress handed and President George W. Bush signed in 2002?
Luthra: We had been chatting about this prematurely of taping the podcast, and that is actually attention-grabbing for lots of causes. What this invoice would do is, primarily, if somebody offers beginning, the hospital or the well being care supplier is required to supply all types of lifesaving care, even when it looks as if the new child won’t stay. And that is related in a number of locations. It’s related when, for example, you possibly expertise a really, very early supply, during which viability is simply not on the desk.
We do know that the overwhelming majority of abortions occur effectively earlier than the purpose when there may be truly going to be one thing that resembles an toddler being born. And so what this truly does in observe, a number of well being care suppliers have sounded the alarms about, is stigmatize abortion and sow extra distrust of the well being care suppliers who carry out it. And it additionally, in circumstances the place somebody does give beginning to a baby that won’t stay, forces docs to supply medical interventions that possibly received’t make a distinction however that can delay the chance or forestall the chance for palliative care, which is absolutely unhappy.
I imply, you give beginning to a baby that received’t stay, and it may’t spend its few moments with some form of consolation. As an alternative, it’s given medical remedies that won’t actually assist them. This invoice differs from the legislation signed below President Bush in that it will add penalties. However the different factor that’s price noting is that killing infants is already unlawful. We have now legal guidelines that ban murder. And so, when abortion rights supporters and authorized students say that this type of legislation can be redundant, they’re proper. We have already got methods to penalize killing individuals. However what we don’t have are nationwide restrictions that stigmatize abortion to the extent that it will likely be carried out much less and fewer.
However the different factor I feel is price noting, to your level, Julie, is that it is a massive step again, particularly for Senator Thune, who was on the report supporting a 15-week nationwide abortion ban and is no longer. And that helps us underscore that nationwide abortion restrictions are very poisonous and that, as a substitute, the GOP is absolutely making an attempt to give attention to circumstances the place they assume they could have a greater likelihood of successful, by specializing in the very finish of being pregnant, areas the place they see the help for abortion rights publicly go down, and begin with restrictions there, earlier than, in the event that they ever wish to do one thing extra sweeping, ready a bit extra time for that to be politically viable.
Rovner: Principally, it’s a messaging invoice to try to put supporters of abortion rights on the spot and say, In the event you received’t vote for this, you then’re for infanticide. I imply, that’s primarily what the controversy’s going to be. Proper, Alice?
Ollstein: Yeah. Effectively, and simply so people are conscious, the timing of that is across the March for Life developing in a pair days after the inauguration. And virtually yearly, Republicans in Congress try to carry some form of messaging vote to coincide with that massive anti-abortion demonstration in Washington, D.C.
Rovner: I might say the anti-abortion demonstration is when it’s as a result of that was the anniversary of Roe v. Wade. That’s why they arrive to D.C. in January.
Ollstein: Yeah. As an apart, they thought-about shifting it to June to mark the anniversary of Dobbs however determined to maintain it in January to proceed to look at the anniversary of Roe in any case. However like Shefali mentioned, it’s attention-grabbing that, even on condition that that is only a messaging vote, they’re nonetheless aiming rather a lot decrease than they’ve up to now and never introducing the large, sweeping anti-abortion insurance policies that the advocacy teams on that facet wish to see, when it comes to restrictions on abortion medicine, or like up to now, 15-week bans, 20-week bans, one thing like that. As an alternative, that is form of a distinct segment and arguably duplicative coverage that they’re placing ahead.
Rovner: Effectively, we will definitely watch that area. Additionally, over the vacation break, an OB-GYN on the College of Indiana sued the Indiana Division of Well being, claiming the state’s new abortion reporting necessities violate the federal HIPAA [Health Insurance Portability and Accountability Act] affected person privateness guidelines. Failure to comply with the state legislation might lead to potential prison legal responsibility or lack of medical license, however federal legislation is meant to preempt state legislation.
Alongside those self same strains, Senate Finance Committee Chairman, now rating member, Ron Wyden of Oregon launched a report in December, which adopted up on the reporting that we’ve talked about from ProPublica, about pregnant girls dying from preventable and/or treatable problems. Wyden’s employees discovered that docs in states with abortion bans have been unable to get ample authorized recommendation and/or steerage from their hospital officers in a well timed manner.
Quoting from the report, “Docs are taking part in lawyer, and attorneys are taking part in physician, whereas pregnant girls experiencing something wanting what quantities to a dire emergency are despatched away and informed to return to the emergency room as soon as a preventable state of affairs turns into life-threatening.” Is there something on the horizon that may type out what docs can and might’t do in states with abortion bans? This continues to be — we preserve listening to story after story after story about this.
Ollstein: So the anti-abortion motion’s response to that is that the legal guidelines themselves don’t must be modified, they usually as a substitute are introducing these new, what they name “med ed” payments that principally order the federal government, in collaboration with anti-abortion teams, to develop supplies that docs and medical college students should overview, that purport to clarify what’s and isn’t allowed when it comes to abortion care and emergency care below these restrictions.
One state to date has applied this, South Dakota, and they’re making an attempt to introduce it in a bunch of different states. Now, the medical group says there’s no manner a video goes to unravel this. These are extremely advanced conditions. You may’t cowl every thing which may come up. You may’t cowl each situation a pregnant individual might have. And so they see it as form of a CYA — if people are conversant in “cowl your behind” — transfer, when it comes to legal responsibility and an try and put the onus on particular person docs who’re already struggling, and to say that any of those adversarial outcomes are the fault of docs for not understanding or appropriately abiding by these authorized restrictions on care.
Whereas the docs say that: We will’t get steerage from our personal employers. We will’t get sufficient steerage from the state. And these actually tie our palms in these very delicate, time-sensitive, and medically delicate conditions.
Rovner: And we’ve seen circumstances, I imply like in Texas, the place the legal professional basic has threatened in writing to prosecute docs for issues that docs say is customary medical observe.
Ollstein: Proper, so even when a health care provider got here ahead and mentioned, It’s my medical judgment that this individual wants an abortion for medical causes, we noticed the legal professional basic there step in and say: I’m overruling your judgment. No, she doesn’t. And in order that has, primarily based on many interviews I’ve finished, and I’m positive Shefali has finished, created an actual chilling impact, the place persons are afraid of being second-guessed like that. And even quick delays, the place somebody is making an attempt to seek the advice of with an legal professional on what to do, even a brief delay will be lethal for a affected person in a type of conditions.
Rovner: Effectively, turning to this week in medical misinformation, the large information, in fact, is that Fb goes to disband its fact-checking unit and principally undertake the anything-goes-and-if-you-don’t-like-it-correct-it-yourself system now utilized by X. This might have massive implications for well being misinformation, I might assume. Despite the fact that Fb wasn’t doing such a terrific job earlier than on permitting misinformation and disinformation to unfold. Is that this going to have a giant impact?
Luthra: I imply, I feel that is simply, to some extent, an indication of Fb shifting with the political winds, proper? I imply, the fact-checking got here out partly after the 2016 election when there was a number of claims of voter fraud. There are a number of, How did Trump get into workplace? They instituted fact-checking to allegedly form of pander to individuals who felt like that there was a number of misinformation unfold then. Now they’re shifting away from fact-checking as a result of they really feel like then it offers individuals the flexibility to mirror what the group needs. I feel it’s reflecting the pattern we’re seeing on X. We’ll see extra Neighborhood Notes. It makes journalists’ job all of the extra vital, to truly distill what’s true and what’s false.
Rovner: You’re our misinformation professional. Oh, go forward, Alice.
Ollstein: Oh, I needed to additionally flag that a part of Fb’s announcement was that they’re shifting a few of their groups from California to Texas, as a result of Californians are too biased to do any content material moderation and Texans presumably usually are not. That was the body of that announcement, principally. And in order that, I’ve already seen, is elevating issues in some teams on the left, and medical teams, about entry to details about sorts of care which might be restricted in Texas, like abortion care, like trans care.
Will individuals be capable of publish about these issues, to publish correct issues about these issues on these platforms? Or will that be restricted sooner or later? It’s additionally drawing consideration for that cause.
Luthra: And if I can add another level to what Alice talked about, I imply, one of many very express areas the place Mark Zuckerberg mentioned he would really like extra room for disagreement and extra room for discourse is on the strains of gender, and really explicitly eradicating restrictions on utilizing very, fairly frankly, misogynistic phrases about how girls ought to exist in our society, about LGBTQ+ individuals, about explicitly permitting customers to name them mentally ailing.
And this has very significant implications for gender equality, positive, but in addition for well being care, as a result of we’re seeing that one of the vital politicized areas of well being care in our nation is entry to well being take care of trans individuals, is entry to well being care for ladies. And it’s simply very laborious to not take a look at this and assume, oh, there will probably be no implication for the way individuals conceive of well being care and the way individuals conceive of those that obtain this type of well being care.
Rovner: And we must always level out, which I ought to have initially, this isn’t simply Fb — that is all of Meta. So that is Fb and Instagram and Threads. It’s principally, as a result of I do know that solely form of outdated individuals like me are nonetheless on Fb, however a number of persons are on Instagram and Threads, and that is clearly going to have some fairly massive implications as we go ahead.
All proper, effectively, talking of misinformation, one mark of accountable science is fessing up if you end up flawed. And this week we now have a giant flawed factor to speak about. Again in November, we talked a few examine that discovered that black plastic cooking utensils and takeout containers had been harmful as a result of they had been produced from recycled electronics and had been leaching quantities of fireplace retardants and different chemical substances into your meals.
Effectively, it seems that you just most likely nonetheless ought to eliminate the black plastic in your kitchen, however know that they’re not fairly as harmful as initially marketed. It seems that the authors of the examine made a math error that exaggerated the degrees of poisons by an element of 10. Nonetheless, should you don’t wish to be uncovered to fireplace retardants and different nasty stuff, you may wish to cook dinner with metallic or silicone or one thing that isn’t black plastic. I do assume that is vital, as a result of it does present science is an iterative course of. It’s uncommon to see somebody step up and say: Oh, oops, we acquired this flawed. However right here, it doesn’t change our basic conclusion about this. However you need to know that after we make a mistake, we’re going to repair it. I imply, that appears to be very uncommon on this world proper now.
Ollstein: It’s so laborious, since you see the act of admitting error and correcting it — that may gas mistrust. Folks level to that and say: See, they acquired that flawed. They should be getting all this different stuff flawed, too. However in fact, not correcting misinformation is way worse. And so, in a time of such mistrust, communication is absolutely, actually laborious. And did all of the individuals who noticed the primary wave of stories concerning the black plastic additionally see the correction and see that it wasn’t true? How are these items framed? Have been the splashy articles that had been run, had been they corrected? Have been they retracted? It’s laborious to place the toothpaste again within the tube.
Rovner: Yeah, however science is an imperfect course of. And it’s a course of. It could assist, I feel, if individuals understood that science is extra of a course of than a, that is what’s. However that’s what we’re all right here for, and that’s why all of us nonetheless have jobs. All proper, that’s the information for this week.
Now it’s time for our extra-credit phase. That’s the place we every acknowledge the story we learn this week we expect you need to learn, too. Don’t fear. In the event you miss it, we’ll put the hyperlinks in our present notes in your telephone or different cellular system.
Lauren, you had been first this week, so why don’t you go first?
Weber: I really like this story, and I’m clearly biased, however by my colleagues David Ovalle and Rachel Roubein, on how “Legal guidelines limit U.S. transport of vape merchandise. Many corporations do it anyway.” Primarily, you shouldn’t be transport flavored vapes throughout the nation, however a bunch of corporations do. And my colleagues had been capable of order and get their palms on fairly just a few of these flavored vapes.
My favourite half is the kicker within the story, during which one firm mentioned, You’re not sanctioned to make use of our title in any manner, after we reached out for remark after that they had shipped us vapes illegally. So I assumed that was fairly one thing. However primarily, it will get at what’s a flaw on this piece of the legislation, which is that the USPS [U.S. Postal Service] is meant to implement, or somebody is meant to implement, how one can cease the transport of those vapes, but it surely’s probably not taking place. So it’s form of a take a look at one of the best intentions is probably not the truth on the bottom.
Rovner: Typically. Alice.
Ollstein: So I’ve a chunk from the New York Instances known as “Ozempic, Lego Bricks and Listening to Aids: What Trump’s Greenland Plan May Hit.” And that is coming off of Trump threatening to impose tariffs on Denmark if it refuses to permit the U.S. to take over Greenland, which has grow to be certainly one of Trump’s newest obsessions.
And this piece is mentioning that tariffs on Denmark would influence a number of issues the U.S. inhabitants is dependent upon. Particularly, the pharma big Novo Nordisk is predicated there and manufactures tons of medicines, together with Ozempic, and different weight reduction medicine and diabetes medicine in that household which might be extremely standard proper now, and in addition to listening to aids, different medical units, different drugs. And so this might influence shoppers, if it ever had been to occur, which who even is aware of.
Rovner: Sure. Effectively, we’ll discuss extra about tariffs and the medical business in a future podcast, however thanks for noting that. Shefali.
Luthra: My piece is from Vox. It’s by David Zipper. The headline is “Gigantic SUVs are a public well being risk. Why don’t we deal with them like one?”
I feel the story is so sensible. I really like this framing. It first lays out the proof for why, when vehicles attain a sure measurement, they’re very harmful and more likely to kill individuals. After which it will get into the dialog: Why don’t we truly deal with this as a public well being risk?
And so they take a look at the conflict on tobacco and the conflict on smoking to assume by: What did it appear like to take one thing that was so ubiquitous in our tradition and truly persuade the American public to shift away from it? I feel that is actually attention-grabbing for lots of causes. One is that public well being is absolutely expansive and we must always give it some thought in an expansive manner and take into account all of the completely different components, like automotive measurement, that do have an effect on our lives and life expectancy.
And I additionally do assume this ties rather well to the dialog we had concerning the surgeon basic’s alcohol warning, in that even wanting coverage adjustments, there’s a lot that we are able to do as a society to shift the general public’s understanding of well being dangers from issues that we take without any consideration, and we are able to nonetheless transfer individuals in a route towards being more healthy and retaining our fellow Individuals more healthy. And that’s actually attention-grabbing and vital to consider.
Rovner: Most likely simpler to do one thing about giant SUVs than alcohol, however sure, I’m so glad you linked these two issues. My story this week is from The Wall Road Journal. It’s known as “UnitedHealth’s Military of Docs Helped It Acquire Hundreds of thousands Extra From Medicare,” by Christopher Weaver, Anna Wilde Mathews, and Tom McGinty. And it’s principally the flip facet of the story that Stat Information has been throughout, about how United has used varied strategies to disclaim care to its Medicare Benefit sufferers to avoid wasting the insurer cash. It is a story about how United is forcing the docs who work for the corporate — and there are a number of them, like 10,000 — to principally run by a guidelines of potential diagnoses for each Medicare Benefit affected person, to encourage docs to make these sufferers appear sicker, even when they’re not, as a result of then the corporate will get extra money for Medicare.
The investigation discovered that the, quote, “illness scores” for sufferers shifting from conventional Medicare to United’s Medicare Benefit elevated a mean of 55%, which was, quoting from the story, “roughly equal to each affected person getting newly identified with HIV … and breast most cancers,” principally maximizing earnings from each ends. It’s fairly the story, and I like to recommend it extremely.
OK, that’s this week’s present. I hope you’re feeling caught up and prepared for the remainder of 2025. As all the time, should you benefit from the podcast, you could possibly subscribe wherever you get your podcasts. We’d recognize it should you left us a overview. That helps different individuals discover us, too. Particular thanks, once more this week, to our non permanent manufacturing crew, Taylor Prepare dinner and Lonnie Ro, in addition to our editor, Emmarie Huetteman.
As all the time, you possibly can e-mail us your feedback or questions. We’re at [email protected], or you possibly can nonetheless discover me at X, @jrovner, and more and more at Bluesky, @julierovner.bsky.social. The place are you guys largely nowadays? Alice?
Ollstein: I’m @alicemiranda on Bluesky, largely.
Rovner: Shefali.
Luthra: Yow will discover me on Bluesky, @shefali.
Rovner: Lauren.
Weber: Nonetheless simply chilling on X, @LaurenWeberHP.
Rovner: We will probably be again in your feed subsequent week. Till then, be wholesome.
Credit
Taylor Prepare dinner
Audio producer
Lonnie Ro
Audio producer
Emmarie Huetteman
Editor
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