The Host
Julie Rovner
KFF Well being Information
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 creator 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 12 months — which largely don’t embrace well being coverage. However well being is prone to play an necessary supporting function 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 record, together with finalizing a coverage that bars credit score bureaus from together with medical debt on people’ credit score stories.
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 Put up.
Panelists
Shefali Luthra
The nineteenth
Alice Miranda Ollstein
Politico
Lauren Weber
The Washington Put up
Among the many takeaways from this week’s episode:
- The 119th Congress is now in session. Well being care doesn’t make the record of priorities as lawmakers lay the desk for the incoming Trump administration — although Republicans have floated Medicaid work necessities to chop federal spending.
- Lots 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 Price range Committee provides to proof that personal fairness involvement in care is related to worse outcomes for sufferers — notably, lawmakers’ constituents.
- Because the nation bids a remaining farewell to former President Jimmy Carter, his international well being work, specifically, 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 stories. The surgeon common 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 look after 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 suppose it’s best to learn, too:
Julie Rovner: The Wall Road Journal’s “UnitedHealth’s Military of Medical doctors Helped It Accumulate 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 Might 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 Put up’s “Legal guidelines Limit U.S. Transport of Vape Merchandise. Many Firms Do It Anyway,” by David Ovalle and Rachel Roubein.
Additionally talked about on this week’s podcast:
The Senate Price range Committee’s “Earnings Over Sufferers: The Dangerous Results of Personal 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: Hey, 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 number of the greatest 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 may need modified by the point you hear this. So, right here we go.
Rovner: At the moment we’re joined through videoconference by Alice Miranda Ollstein of Politico.
Alice Miranda Ollstein: Hey.
Rovner: Lauren Weber of The Washington Put up.
Lauren Weber: Hey good day.
Rovner: And Shefali Luthra of The nineteenth.
Shefali Luthra: Hey.
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 need to begin by wanting forward. What’s on the rapid agenda right here in Washington for well being care? Anyone?
Ollstein: So well being care shouldn’t be the precedence proper now for the incoming administration, for the brand new Republican trifecta in Washington. It will possibly make it in, as a result of they’re speaking about these large, conglomerate payments that they’ve criticized previously and stated that they don’t like doing that, and they’d a lot somewhat vote on particular person issues one after the other.
However now they’re speaking about cramming every little thing into one large reconciliation invoice early within the new administration. And there’ll possible be some well being care elements. We don’t know but what these can be. Issues that purport to save cash are much more possible 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 will 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 folks’s protection and what it means when it comes to financial savings.
However I feel that loads of the formidable stuff that lawmakers tried to get via on the finish of the 12 months 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 received — they saved the federal government open, they usually received the federal government funded — that solely goes till March. I noticed kind of a plaintive electronic mail yesterday from Tom Cole, the Republican chairman of the Home Appropriations Committee, saying, Um, we’ve to begin 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, good day, the present fiscal 12 months shouldn’t be completed. They only managed to place issues off.
Lauren, you wished so as to add one thing?
Weber: Yeah. I simply wished to say, I really feel like we’ve entered the period of selling in relation to these payments. You’ve received President-elect [Donald] Trump saying he desires one massive, lovely invoice. That’s what he desires. He desires one massive, lovely invoice. And it’s not simply Trump. I imply, let’s have a look at the MAHA motion, the “Make America Wholesome Once more” motion.
I imply, I feel we’re getting into an period by which payments and actions all have catchy slogans. And I imply, heck, the American public could have a greater understanding, or a minimum of know what these individuals are telling them is occurring with this advertising, we’ll see. So I simply wished 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 verify, which is that they preserve speaking about this massive, lovely reconciliation invoice that they solely want Republican votes for. I’ve to remind folks yearly: With a view to do a reconciliation invoice, first they have to do a funds decision, in each homes. That has to go to the ground, be debated, needs to be reconciled between the Home and the Senate, about what the funds decision appears to be like like.
The entire level of what’s known as “reconciliation” is that it reconciles obligatory spending to the phrases of the funds decision. It takes a very long time to do a funds decision, even while you’re speeding it via.
Additionally, all this stuff that they’re speaking about placing into this reconciliation invoice should not allowed to enter funds 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 mainly all of the issues that may go in. Sorry, that’s the tip of my lecture.
Alice, did you need to add one thing?
Ollstein: Positive. I imply, I feel we’re already seeing cracks rising on this nice Republican unity that they’re attempting to venture. I imply, they will’t even agree but on whether or not to do one massive, lovely invoice or two. And the folks pushing for 2 are declaring 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 point out on your work.
Which in fact is a scenario Congress has discovered itself in lots of instances over the previous a number of years. And so, these of us 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 would possibly make it via. 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 relentless 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 simple. There have been a few holdouts who needed to take calls from the president-elect with a purpose to change their votes. So it’s fairly tenuous there.
Shefali, earlier than we transfer on, did you need to add one thing?
Luthra: No, I imply, I feel what can be actually fascinating, as nicely, is to see how this emerges in all the extra fractious points among the many Republican Social gathering. I do know we’ve talked loads about how the Republican Social gathering may be very divided on loads 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 are going to get to in a couple of minutes.
Luthra: We can be attending to that very quickly. However it’s simply very clear that every one of those points, the place they venture unity, are fairly rapidly going to disintegrate in relation to participating with the truth that this can be a very divided coalition, and loads of the issues they’re speaking about doing should not extremely popular with voters. And so we’ll see how that impacts them as nicely.
Rovner: Sure. So let’s transfer again slightly bit. After we left issues in December, we have been a day away from a potential authorities shutdown, which didn’t occur. However the different factor that didn’t occur was an enormous package deal with mainly a complete 12 months’s value of bipartisan well being coverage work in it, every little thing from new transparency necessities for pharmacy advantages managers [PBMs], to renewals of packages to arrange for the following pandemic and to battle the opioid epidemic, to rolling again cuts to medical doctors beneath Medicare. Most of that didn’t make it into the ultimate package deal that can preserve the federal government working till March.
The tiny issues that did make it in have been extensions of telehealth authority for Medicare and funds for neighborhood well being facilities and another expiring packages — however once more, solely via 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’ve any motive to suppose that Congress goes to select it up and go it this 12 months? And even when they do this Trump would signal it? Or did all of that work final 12 months, is that every one simply mainly for naught now?
Ollstein: I imply, I feel you may make an argument both manner. You would make an argument that it has an opportunity as a result of there’s bipartisan assist. A few of these issues might save the federal government cash and assist pay for different issues that the Republican majority desires 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 desires 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 previously which have bipartisan assist that might lower your expenses additionally fall by the wayside, simply because they aren’t 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, loads of issues that individuals have been fairly upset about, when it comes to smaller issues, health-wise, additionally received minimize from the invoice. I imply, there was funding for 9/11 most cancers funds, for people who had been uncovered to poisonous chemical compounds, first responders, and so forth. Lots of outcry after that received stripped out of the invoice. Understandably so, contemplating, mainly all of the advocates stated: We don’t need 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 doubtlessly 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 embrace the total measures to essentially prioritize some strain 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 declaring 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 loads of these new committee chairs, notably within the Senate, the place the Republicans are taking up, are going to must determine their manner out and attempt to choose up a number of the items. One fascinating factor that got here via my inbox this week was a bipartisan report from the Senate Price range Committee that discovered, and I’m quoting from the headline within the press launch, “Personal Fairness in Well being Care Proven to Hurt Sufferers, Degrade Care and Drive Hospital Closures.” Does this counsel that Congress would possibly attempt to do one thing on this extraordinarily fraught topic?
Shefali, you might be smiling. I imply—
Luthra: I’m smiling as a result of a few issues, and the primary is that there was loads of discourse about personal fairness’s affect on well being look after customers for years. That is very fascinating and necessary work, and it’s not in any respect stunning.
And the opposite factor that we’ve to recollect is that Donald Trump can be president. He’s ideologically very unpredictable. As an actor, he’s very unpredictable. And it’s simply very tough to guess what’s going to truly turn into legislation and getting his signature. And a part of that’s as a result of, we will bear in mind from the final time he was president, he fairly often would change what he believed based mostly on the final individual he spoke to. We noticed this on a regular basis with drug pricing.
And I simply suppose that we’ll see actually fascinating bipartisan analyses of issues that would make actual variations for customers on well being care, however whether or not they turn into legislation, whether or not they change folks’s lives, that’s simply a lot, a lot more durable for us to essentially predict in a significant manner.
Rovner: Yeah, I feel every little thing’s fairly arduous to foretell proper now. Lauren?
Weber: Yeah, I simply wished so as to add, I imply, I do know, clearly arduous to foretell, however I feel the concept you’ve gotten lawmakers issuing fairly strident releases that tie personal fairness to lower affected person outcomes of their particular districts is a little bit of a step ahead. I imply, you’ve gotten [Sen. Charles] Grassley saying: Look, none of those folks care about affected person care. They solely care about shareholders. I do suppose that may be a shift in rhetoric, to an extent. We’ve seen a constructing for fairly a while. We’ve all talked about personal fairness on this podcast.
However I do suppose when you’ve gotten lawmakers making that soar to, Oh, folks in my district are getting worse well being care due to this, I feel you may see extra motion.
Rovner: Yeah, it’s one thing I’m going to keep watch over. Like I stated, I used to be shocked to see that as a bipartisan report from a committee, regardless that it’s the Price range Committee that doesn’t actually have authority to do something legislatively. Nonetheless, it was value noting.
Properly, 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 an extended record of Democratic presidents who tried and didn’t overhaul the nation’s well being care system. You possibly can 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 received renamed the Facilities for Medicare & Medicaid Companies within the early 2000s.
However Carter’s largest well being achievements got here after he left workplace. His work via his basis addressed, and in some circumstances almost eradicated, some largely uncared for tropical ailments that largely afflict the poorest and most marginalized folks 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 fascinating, 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 important of how worldwide cooperation occurred throughout the covid-19 pandemic. And so I feel that’s going to be an fascinating distinction, given what Carter was capable of obtain via such cooperation.
Rovner: Yeah. Lauren?
Weber: Yeah, I simply wished 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 suppose, as Alice well identified, there’s, 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 dwell in. I imply, that is him utilizing his gentle 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 guarantee 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 type of a once-in-a-generation second to take a look at this affect 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 arduous to think about Donald Trump making eradication of Guinea worm a serious precedence. Properly, we’re additionally bidding farewell over the following two weeks to the Biden administration, which is utilizing its final days to attempt to get as a lot finished and trumpet as many victories as it may well. We’ll begin with the Reasonably priced 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 folks have now been enrolled in ACA plans. That’s up 3 million simply from final 12 months 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 12 months marked the primary that the so-called Dreamers, these folks introduced illegally to the U.S. as kids by their dad and mom, they may 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 have been put in place throughout the pandemic expire on the finish of this 12 months, except Congress renews them. What’s the outlook for ACA enrollment?
Ollstein: Properly, Democratic senators are beginning to make a push to increase these subsidies, introducing laws and making an enormous splash about it right now. There’s been loads of lobbying from the well being care sector, the hospitals, all of the gamers who don’t need 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 need to spend that cash on, that aren’t serving to folks purchase medical health insurance plans as a part of the Reasonably priced Care Act. And so, I feel there’s prone to be loads of wrangling and horse-trading round this. I don’t suppose the subsidies are essentially toast, however I don’t suppose 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 have been toast, as a result of Republican trifecta. Then again, while you truly dig into the numbers, the largest will increase have are available crimson 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 received to wonder if they need to, all of a sudden subsequent January, or actually subsequent October, November, when folks understand: Oh my goodness, my premiums for my medical health insurance are going to quadruple. How did this occur? Possibly they’ll take into consideration that once they’re placing all of those massive, lovely payments collectively, perhaps?
Ollstein: Yeah, we’ve began to see some feedback from some Republicans. After all, it’s those who’ve been keen to work with Democrats previously, like Lisa Murkowski within the Senate, saying that we must always have 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 stated, Julie, they don’t need 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 wished 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 acknowledged, Alice, they’re possible to not do away with these subsidies. Johnson went on the document, I feel this week or final week, to say Medicare shouldn’t be going to get impacted. Medicaid cuts appear to be coming, however pricey God, should you don’t minimize a few of these different issues, I don’t know the way you may get to the cash quantities that they’re speaking about, particularly in well being.
Ollstein: Properly, and Elon Musk has already walked again his projection of how a lot he’ll be capable to 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 number of the preelection guarantees on that entrance as they begin to confront a number 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’ll suppose that Trump of all folks would know higher, as a result of he tried to repeal the Reasonably priced Care Act within the first hundred days in 2017, and that didn’t go so nicely. However apparently he has a brief reminiscence, too.
Properly, talking of issues which might be prone to be undone, the Shopper Monetary Safety Bureau finalized its rule this week barring using medical debt on credit score stories. It’s already been sued for exceeding its authority by two commerce teams representing collectors. How necessary would this modification be if it truly survives?
Luthra: One thing like this may very well be actually significant. I bear in mind speaking to households about their efforts to purchase houses and sometimes 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 in all probability truly virtually all the time not deliberate, since you don’t hope to fall sick. You don’t attempt to get a devastating damage that your insurance coverage won’t totally cowl the prices for.
And this was one thing that had actually been championed by of us within the shopper advocacy house for a really very long time, nicely earlier than the Biden administration. Dropping it could actually have implications for folks throughout the political spectrum, particularly as we’re on this house 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 affordable mortgage simply out of attain for lots of Individuals.
Rovner: Properly, 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 will trigger most cancers, similar to tobacco merchandise. His report calls alcohol the third-leading preventable reason behind most cancers. However this doesn’t really feel super-likely to occur, between the ability of the alcohol trade and the mistrust of science, notably when it recommends issues folks in all probability don’t need to hear. I assume no person right here is betting on this occurring anytime quickly?
Ollstein: No, you’ve already seen members of Congress for whom the alcohol and beverage trade may be very economically necessary for his or her state, all the oldsters who symbolize breweries and distilleries and wineries, already talking out and sharing issues about this. However I feel that simply the surgeon common utilizing the bully pulpit to shine a lightweight on this, it generated loads of information protection. That’s necessary.
It’s necessary for customers to see that and be capable to make decisions. And also you’re already seeing some traits of youthful of us being extra kind of sober-curious. And there’s loads of discuss Dry January being a wholesome factor to do. And much more bars you’re seeing supply low-alcohol or nonalcoholic choices. And so I feel that is one thing that individuals are slowly changing 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 folks did. Lauren, did you need to say one thing?
Weber: Yeah, I imply, I’ve written loads 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 quicker than a glacial tempo I feel might be problematic, contemplating there’s loads of legal professionals on this city and there’s some huge cash in lawmakers’ pockets on this city. So simply wished so as to add that.
Rovner: And alcohol’s actually in style — and authorized. Properly, let’s flip to abortion reproductive well being. All issues thought of, it’s truly been kind of quiet on the abortion entrance for the previous couple of weeks. However there has all the time been information, as is predictable when Republicans take over the Home, Senate, and White Home on the similar 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 stated he wouldn’t signal, however somewhat the, quote, “Born-Alive Abortion Survivors Safety Act.” What is that this invoice? And what would it not do? And the way is it totally different from a similar-sounding invoice that Congress handed and President George W. Bush signed in 2002?
Luthra: We have been chatting about this prematurely of taping the podcast, and that is actually fascinating 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 offer all types of lifesaving care, even when it looks as if the new child won’t dwell. And that is related in loads of locations. It’s related when, for example, you perhaps expertise a really, very early supply, by which viability is simply not on the desk.
We do know that the overwhelming majority of abortions occur nicely earlier than the purpose when there’s truly going to be one thing that resembles an toddler being born. And so what this truly does in follow, loads 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 dwell, forces medical doctors to offer medical interventions that perhaps received’t make a distinction however that can delay the chance or stop the chance for palliative care, which is absolutely unhappy.
I imply, you give beginning to a baby that received’t dwell, and it may well’t spend its few moments with some type of consolation. As an alternative, it’s given medical therapies that won’t actually assist them. This invoice differs from the legislation signed beneath President Bush in that it could add penalties. However the different factor that’s value noting is that killing infants is already unlawful. We’ve got legal guidelines that ban murder. And so, when abortion rights supporters and authorized students say that this sort of legislation can be redundant, they’re proper. We have already got methods to penalize killing folks. 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 value noting, to your level, Julie, is that this can be a massive step again, particularly for Senator Thune, who was on the document 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 an alternative, the GOP is absolutely attempting to give attention to circumstances the place they suppose they may have a greater likelihood of successful, by specializing in the very finish of being pregnant, areas the place they see the assist for abortion rights publicly go down, and begin with restrictions there, earlier than, in the event that they ever need to do one thing extra sweeping, ready a bit extra time for that to be politically viable.
Rovner: Mainly, it’s a messaging invoice to attempt to put supporters of abortion rights on the spot and say, Should 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. Properly, and simply so of us 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 kind 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 of 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 stated, it’s fascinating that, even provided that that is only a messaging vote, they’re nonetheless aiming loads decrease than they’ve previously and never introducing the massive, sweeping anti-abortion insurance policies that the advocacy teams on that aspect need to see, when it comes to restrictions on abortion treatment, or like previously, 15-week bans, 20-week bans, one thing like that. As an alternative, that is kind of a distinct segment and arguably duplicative coverage that they’re placing ahead.
Rovner: Properly, we will definitely watch that house. 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 observe the state legislation might end in potential felony legal responsibility or lack of medical license, however federal legislation is meant to preempt state legislation.
Alongside those self same traces, 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 ladies dying from preventable and/or treatable problems. Wyden’s workers discovered that medical doctors 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, “Medical doctors are taking part in lawyer, and legal professionals are taking part in physician, whereas pregnant ladies experiencing something in need of what quantities to a dire emergency are despatched away and advised to return to the emergency room as soon as a preventable scenario turns into life-threatening.” Is there something on the horizon that might kind out what medical doctors can and may’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 have to be modified, they usually as an alternative are introducing these new, what they name “med ed” payments that mainly order the federal government, in collaboration with anti-abortion teams, to develop supplies that medical doctors and medical college students must evaluate, that purport to clarify what’s and isn’t allowed when it comes to abortion care and emergency care beneath these restrictions.
One state to date has carried out this, South Dakota, and they’re making an attempt to introduce it in a bunch of different states. Now, the medical neighborhood says there’s no manner a video goes to resolve this. These are extremely complicated conditions. You possibly can’t cowl every little thing which may come up. You possibly can’t cowl each situation a pregnant individual might have. They usually see it as kind of a CYA — if of us are conversant in “cowl your behind” — transfer, when it comes to legal responsibility and an try to put the onus on particular person medical doctors who’re already struggling, and to say that any of those opposed outcomes are the fault of medical doctors for not understanding or accurately abiding by these authorized restrictions on care.
Whereas the medical doctors say that: We will’t get steerage from our personal employers. We will’t get ample 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 lawyer common has threatened in writing to prosecute medical doctors for issues that medical doctors say is normal medical follow.
Ollstein: Proper, so even when a health care provider got here ahead and stated, It’s my medical judgment that this individual wants an abortion for medical causes, we noticed the lawyer common there step in and say: I’m overruling your judgment. No, she doesn’t. And in order that has, based mostly on many interviews I’ve finished, and I’m certain Shefali has finished, created an actual chilling impact, the place individuals are afraid of being second-guessed like that. And even quick delays, the place somebody is attempting to seek the advice of with an lawyer on what to do, even a brief delay may be lethal for a affected person in a kind of conditions.
Rovner: Properly, turning to this week in medical misinformation, the massive information, in fact, is that Fb goes to disband its fact-checking unit and mainly 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 suppose. Despite the fact that Fb wasn’t doing such an excellent job earlier than on permitting misinformation and disinformation to unfold. Is that this going to have an enormous 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 loads of claims of voter fraud. There are loads of, How did Trump get into workplace? They instituted fact-checking to allegedly type of pander to individuals who felt like that there was loads of misinformation unfold then. Now they’re shifting away from fact-checking as a result of they really feel like then it offers folks the flexibility to replicate what the neighborhood desires. I feel it’s reflecting the development we’re seeing on X. We’ll see extra Neighborhood Notes. It makes journalists’ job all of the extra necessary, to truly distill what’s true and what’s false.
Rovner: You’re our misinformation professional. Oh, go forward, Alice.
Ollstein: Oh, I wished 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 should not. That was the body of that announcement, mainly. 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 folks be capable to submit about these issues, to submit correct issues about these issues on these platforms? Or will that be restricted sooner or later? It’s additionally drawing consideration for that motive.
Luthra: And if I can add yet one more level to what Alice talked about, I imply, one of many very specific areas the place Mark Zuckerberg stated he would love extra room for disagreement and extra room for discourse is on the traces of gender, and really explicitly eradicating restrictions on utilizing very, fairly frankly, misogynistic phrases about how ladies ought to exist in our society, about LGBTQ+ folks, about explicitly permitting customers to name them mentally sick.
And this has very significant implications for gender equality, certain, but additionally for well being care, as a result of we’re seeing that probably the most politicized areas of well being care in our nation is entry to well being look after trans folks, is entry to well being care for ladies. And it’s simply very arduous to not have a look at this and suppose, oh, there can be no implication for a way folks conceive of well being care and the way folks conceive of those that obtain this sort of well being care.
Rovner: And we must always level out, which I ought to have firstly, this isn’t simply Fb — that is all of Meta. So that is Fb and Instagram and Threads. It’s mainly, as a result of I do know that solely kind of previous folks like me are nonetheless on Fb, however a lot of individuals are on Instagram and Threads, and that is clearly going to have some fairly massive implications as we go ahead.
All proper, nicely, talking of misinformation, one mark of accountable science is fessing up when you’re fallacious. And this week we’ve an enormous fallacious factor to speak about. Again in November, we talked a few examine that discovered that black plastic cooking utensils and takeout containers have been harmful as a result of they have been made out of recycled electronics and have been leaching quantities of fireplace retardants and different chemical compounds into your meals.
Properly, it seems that you just in all probability nonetheless ought to do away with 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 need to be uncovered to fireplace retardants and different nasty stuff, you would possibly need to cook dinner with metallic or silicone or one thing that isn’t black plastic. I do suppose that is necessary, 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 received this fallacious. However right here, it doesn’t change our common conclusion about this. However it’s best to know that once 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 arduous, since you see the act of admitting error and correcting it — that may gas mistrust. Individuals level to that and say: See, they received that fallacious. They should be getting all this different stuff fallacious, too. However in fact, not correcting misinformation is way worse. And so, in a time of such mistrust, communication is absolutely, actually arduous. And did all of the individuals who noticed the primary wave of reports concerning the black plastic additionally see the correction and see that it wasn’t true? How are this stuff framed? Had been the splashy articles that have been run, have been they corrected? Had been they retracted? It’s arduous 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 folks 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 predict it’s best to learn, too. Don’t fear. Should you miss it, we are going to put the hyperlinks in our present notes in your telephone or different cell system.
Lauren, you have 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. delivery of vape merchandise. Many corporations do it anyway.” Basically, you shouldn’t be delivery flavored vapes throughout the nation, however a bunch of corporations do. And my colleagues have 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, by which one firm stated, You’re not sanctioned to make use of our identify in any manner, once we reached out for remark after that they had shipped us vapes illegally. So I believed 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, find out how to cease the delivery of those vapes, but it surely’s probably not occurring. So it’s type of a have a look at the very best intentions might not be the fact on the bottom.
Rovner: Usually. Alice.
Ollstein: So I’ve a bit from the New York Instances known as “Ozempic, Lego Bricks and Listening to Aids: What Trump’s Greenland Plan Might 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 turn into certainly one of Trump’s newest obsessions.
And this piece is declaring that tariffs on Denmark would affect loads of issues the U.S. inhabitants depends upon. Particularly, the pharma large Novo Nordisk relies there and manufactures tons of medicines, together with Ozempic, and different weight reduction medicine and diabetes medicine in that household which might be extremely in style proper now, and in addition to listening to aids, different medical gadgets, different medicines. And so this might affect customers, if it ever have been to occur, which who even is aware of.
Rovner: Sure. Properly, we are going to discuss extra about tariffs and the medical trade 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 automobiles attain a sure measurement, they’re very harmful and more likely to kill folks. After which it will get into the dialog: Why don’t we truly deal with this as a public well being risk?
They usually have a look at the battle on tobacco and the battle on smoking to suppose via: What did it appear to be to take one thing that was so ubiquitous in our tradition and really persuade the American public to shift away from it? I feel that is actually fascinating 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 contemplate all of the totally different components, like automobile measurement, that do have an effect on our lives and life expectancy.
And I additionally do suppose this ties very well to the dialog we had concerning the surgeon common’s alcohol warning, in that even in need of coverage modifications, there’s a lot that we will 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 will nonetheless transfer folks in a course towards being more healthy and conserving our fellow Individuals more healthy. And that’s actually fascinating and necessary to consider.
Rovner: Most likely simpler to do one thing about massive 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 Medical doctors Helped It Accumulate Thousands and thousands Extra From Medicare,” by Christopher Weaver, Anna Wilde Mathews, and Tom McGinty. And it’s mainly the flip aspect 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 medical doctors who work for the corporate — and there are loads of them, like 10,000 — to mainly run via a guidelines of potential diagnoses for each Medicare Benefit affected person, to encourage medical doctors 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,” mainly maximizing income 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 may subscribe wherever you get your podcasts. We’d admire it should you left us a evaluate. That helps different folks discover us, too. Particular thanks, once more this week, to our non permanent manufacturing staff, Taylor Cook dinner and Lonnie Ro, in addition to our editor, Emmarie Huetteman.
As all the time, you possibly can electronic 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: You will discover me on Bluesky, @shefali.
Rovner: Lauren.
Weber: Nonetheless simply chilling on X, @LaurenWeberHP.
Rovner: We can be again in your feed subsequent week. Till then, be wholesome.
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Audio producer
Lonnie Ro
Audio producer
Emmarie Huetteman
Editor
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