The president released his proposed 2018 budget which would, among other things, reduce healthcare spending by $866 billion over 10 years primarily through limits to Medicaid; and cut over $1.2 billion from the CDC, including eliminating the REACH program, the Prevention Research Centers, the Injury Control Research Centers, and the Elderly Falls program. CDC chronic disease prevention programs alone face cuts of $222 million. The proposal also would cut the CDC's HIV prevention programs next year by 19 percent, or $149 million. Likewise, it would slash the CDC's STD prevention programs by $27 million and eliminate the Ryan White Program's AIDS Education and Training Centers, among other programs, Politico reports.
The Congressional Budget Office this week released its analysis of the effect of the American Health Care Act that passed the House in early May: 23 million Americans would lose their health insurance by 2026, the Washington Post reports. Fourteen million would lose their insurance in just one year after passage, and premiums will rise in 2018 and 2019, Politico reports. Mother Jones notes a little-reported element: “The AHCA eliminates the requirement that insurers charge the same rates to everyone, even those with pre-existing conditions. They still can't flatly turn you down, but they can do the next best thing: make insurance so expensive for those with pre-existing conditions that most people can't afford it.” Now that the CBO analysis is out, the bill heads to the Senate for consideration, where majority leader McConnell has said he is not sure how Republicans will muster the 50 votes needed to pass the legislation, Reuters reports.
Politico reports that new FDA Commissioner Scott Gottlieb is ending a hiring freeze that's been in place at the agency since late January. Now the agency can start filling its roughly 1,000 vacancies.
The Atlantic reports on the family experiences behind a decades-long lawsuit about lead poisoning in New Orleans public housing. “As the case continued, the issues of lead poisoning and other environmental dysfunctions in the HANO projects continued unresolved. Even though the pressure on HANO from the lawsuit spurred a limited campaign of lead abatement in the projects, kids still showed up poisoned at doctor’s visits. For seven years after Gambel and Bruno’s team filed the lawsuit in district court, the lead levels in homes and in children’s blood remained high enough to qualify them to join the class. As the list of plaintiffs compounded, Gambel and the other lawyers who frequently visited plaintiffs and advocated on their behalf became known to the residents of the HANO housing developments as “the babies’ lawyers,” although the people they represented stopped being babies long before the case approached resolution. Those children had children, and those children grew up in those same projects. The group of mothers who’d led the charge against HANO as young adults themselves began to watch a generation of their grandchildren grow up in their homes and choke on the same lead dust.”
The Sacramento Bee reported this week that a single-payer plan moving through the California legislature would cost $400 billion per year, requiring the state to find an extra $200 billion in revenue.
The New York Times examines EPA administrator Scott Pruitt’s record so far: “In just the last three months, with Mr. Pruitt in charge, the E.P.A. postponed a long-planned rule requiring companies like Devon [Energy] to retrofit drilling equipment to prevent leaks of methane gas — a major contributor to climate change — and to collect more data on how much of the gas is spewing into the air… The Interior Department, meanwhile, announced this month that it would reconsider a separate rule limiting the burning of unwanted methane gas from wells drilled on federal and Indian lands, a process called flaring. That announcement came the same day the Senate narrowly rejected industry calls to repeal the same rule… Interior officials have also announced their intention to repeal or revise a contentious rule requiring companies like Devon to take extra steps to prevent groundwater contamination caused by hydraulic fracturing, also known as fracking, a drilling technique in which chemicals and water are forced into rock formations…”
Mother Jones reports that immigration arrests have spiked nearly 40% since Trump entered office. “In a splashy statement, ICE said its agents arrested more than 41,000 people in the 100 days since Trump signed his executive orders on immigration.”
In an interview with Vox, Bloomberg School of Public Health professor Stefan Baral raised the alarm about Attorney General Jeff Sessions’ move to crack down on drug crimes, including low-level offenses, and the likely public health ramifications of such an action. Baral co-authored a review published in The Lancet HIV that found that “criminalization is associated with harmful effects for those targeted by the laws as well as their communities: increasing drug use, increasing the use of shared needles for drug injections, and driving up HIV infections, among other troubling effects… One big reason why, Baral explained: Criminalization drives injection drug users underground, making them more likely to share needles — and helping diseases like HIV spread more rapidly among users.”
Writing for STAT, Lev Facher looks at some of the most significant ways President Trump’s proposed budget would affect public health. Included in his list of most notable reductions are cuts to the budget of the Substance Abuse and Mental Health Services Administration, including “a $116 million cut to mental health services block grants, and a $136 million reduction in ‘programs of regional and national significance.’”
U.S. Food & Drug Administration Commissioner Scott Gottlieb is calling for “more forceful steps” to address opioid addiction. In his first FDA Voice blog, he announced that he has convened an Opioid Policy Steering Committee to look at the possibility of mandatory education for health care professionals, standards to guide prescribing practices, and changes to drug review and approval processes.
A study published in the Annals of Emergency Medicine found that opioid prescribing guidelines for emergency physicians in Ohio were associated with a decline in the number of prescriptions that ER doctors wrote for opioids overall as well as a decline in the number of prescriptions for supplies of more than three days. The authors noted that the guidelines were implemented along with other strategies designed to reduce opioid misuse that also may have contributed to the decline.