Happy Friday! The question for the day is: If there were a drug that would turbocharge your brain, would you take it? I’ve seen enough sci-fi movies to make me, uh, less than enthused about the idea, but as my second cup of coffee of the day has yet to kick in, I find it interesting to ponder.
Anyway, on to this roller coaster of a news week!
Republicans on the Hill have been quietly pretending they might wake up and this renewed focus on the health law will all have been a fever dream. But Democrats are doing their best to make sure everyone knows exactly where everyone stands on President Donald Trump’s recent legal attacks. On Wednesday, the House Dems officially voted to condemn the president’s decision to tell the courts to nullify the entire health law instead of just parts of it. In practice, this means nothing, but it puts Republicans on record of once again voting against popular health law provisions.
Trump, meanwhile, softly backpedaled on his promises that Republicans were coming up with a “spectacular” replacement plan before 2020. This came after a talk with Senate Majority Leader Mitch McConnell — who essentially channeled his inner Ariana Grande and said thank u, next to the issue that has left the party with political bruises the past two years.
But Trump is remaining steadfast in his message that Republicans need to reclaim health care as a winning topic for 2020. “We can’t run away” from health care, he said. “We’ll lose.”
The bumpy week, for some, was a reminder of the surprises that could be in store for the upcoming election season.
Going on name only, the Violence Against Women Act sounds like one of the least controversial bills out there, but a closer look at its history reveals fault lines. The House this week passed its version of the legislation (which is geared toward protecting women from violence and domestic abuse and has to be renewed every few years), but don’t expect smooth sailing the rest of the way. This time the underlying drama stems from a new provision that expanded law enforcement’s ability to strip domestic abusers of their guns.
Fill-in-the-blank copycat bills powered by special interests and businesses have infiltrated the legislative process to a shocking extent. USA Today, The Arizona Republic and the Center for Public Integrity has an amazing two-year investigation that examined nearly 1 million bills in all 50 states and Congress to root out legislation that was nearly identical to others. These measures touched on almost every subject imaginable, from sugary drinks to “right-to-try” legislation to abortion to gun control. The investigation found that these bills are often drafted with deceptive titles, include misleading information on the extent of expert or public support, and push agendas that override the will of voters. Be sure to check out this story — it has examples of the bills, data and charts, and all kinds of fun goodies to delve into.
A veritable flurry of movement on drug pricing bills is coming up in the next week or so, with legislation and hearings that will focus on PBMs, the price of insulin, transparency, public accountability for pharma and more. With that as context …
Express Scripts this week announced that it is capping the price of insulin at $25 per month. Under the new plan, employers who cover their workers through Cigna and Express Scripts can opt into the program, and the extra costs will be picked up by the three drugmakers that sell insulin — Eli Lilly, Novo Nordisk and Sanofi. Advocates deemed the decision nothing but a PR move, saying it does little to address the actual problems of high list prices for people who aren’t lucky enough to be on one of the plans.
“One medical emergency, that’s all it would take to wipe me out financially,” is something I’ve heard friends worry about time and again, so a grim new report about the reality of paying for health care in America came as no surprise. Over the past year, Americans have borrowed $88 billion (billion! with a b!) to pay for health care. A survey went on to report that nearly half of Americans are haunted by fears of medical-related bankruptcy, and 1 in 4 people have skipped needed care because of the cost. Not only that, about 70% of respondents across the political spectrum said they had no confidence in their elected officials to bring prices down.
This technically happened last Friday, but not in time for the Breeze: The Trump administration approved a work-requirements waiver for Utah — just days after similar restrictions were struck down for both Kentucky and Arkansas. The Utah story is even more nuanced, though, because voters in that state approved full expansion of the program. Lawmakers have been scrambling to put rules into place ever since the ballot measure passed.
Meanwhile, both HHS Secretary Alex Azar and CMS Administrator Seema Verma have been quietly trying to sell states on applying for block grant waivers, with Verma, in particular, pushing Alaska to become the first in the nation to apply. A legal challenge would almost certainly follow any such decision.
In the same vein as this happened late last week but you should know about it: The Trump administration announced the recipients of $250 million in Title X federal family planning grants, including a chain of anti-abortion clinics designed to siphon off patients from Planned Parenthood. The group had been turned down last year because it doesn’t provide birth control other than natural family planning and abstinence. Meanwhile, Planned Parenthood and its affiliates saw a steep drop in what it had been previously receiving — going from about $50 million-$60 million to $16 million.
In the miscellaneous file this week:
• A look at how a former congressman has become a one-man gate-keeping operation when it comes to lobbying the VA.
• A wild investigation into how high-speed chases, while frowned upon in other agencies, are a strategy often used by the Border Patrol, despite the fact that they can often end in gruesome injuries and death.
• Torture, rape, murder and other violence in the Alabama prison system is “severe and systematic,” a new Department of Justice report finds. Fair warning, the details are pretty disturbing, but it’s worth a read.
• Can getting drugs to treat libido issues or thinning hair be as easy as ordering off a restaurant menu? That’s what these new types of websites offer: a way for patients to self-diagnose their problems and then get a sign-off from a doctor whom they don’t even meet with. The sites often don’t include warnings about side effects of the medications, and it’s entirely unclear whether their doctor-screening process follows any kind of standards.
• The “lede” on this story was a cold reality check about the intersection of public health fears and prejudice when it comes to vulnerable populations. Rockland County, N.Y., where one of the country’s largest measles outbreaks is rippling through the Jewish Orthodox community, is serving as a model of how those tensions can boil over in times of crisis.
• “Healthy Holly” may sound like an innocuous children’s book, but the controversy surrounding it — and its author, Baltimore Mayor Catherine Pugh — will likely bring down several careers.
And make sure to check out this fun history on how the concept of personal space is hard-wired into our brains. Have a great weekend!
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