December 13th, 2019
The Out-of-Pocket Health News Digest
Below you will find briefs about recent health policy news stories. Our hope is for students to have an information outlet at their fingertips to keep up-to-date with the most pressing news stories in health policy.
This compilation is produced by the HPSA Education Committee: Sharoni Bandyopadhyay, Matthew Dunn, Payton Watt and Courtney Zott.
Hundreds of Thousands Americans Losing SNAP Benefits Under New Work Requirement
On December 4th, the Trump administration approved a bill (effective April 1st, 2020) that will result in almost 700,000 Americans losing SNAP benefits . The bill requires that individuals ages 18-49 will have to work at least 20 hours per week in order to be eligible. This bill does not apply to children, those with a disability, those over 50 years old, or pregnant women. Currently, any “work-eligible, able-bodied” adult without dependents can receive up to three months of SNAP benefits during a three year period if they do not meet the work requirement. However, many states have waived this in the past to ensure more individuals were able to receive benefits. The new bill will make receiving this waiver much more difficult. The only exception will be counties who have an unemployment rate of 6% or above . 

The issue with the unemployment rate is that it only captures individuals who are actively searching for a job, so the number is not reflective of all individuals who are out of work. This does not include individuals who are working part-time and would like to work full-time, and individuals who have given up in the search. If all of these individuals were to be reflected, the U.S. unemployment rate in January would have been 8.1% instead of 4.0% . Furthermore, the U.S. currently has a concentration of high-skill, high-pay jobs, and low-skill, low-pay jobs, without many options in the middle. In fact, 44% of U.S. workers aged 25-54 years old get paid $18,000 or less , and the number of low-paying jobs is increasing. In addition, 62% of employees did not have a wage increase in 2018 . Therefore, for the average American, it can be incredibly difficult to find and get a decent-paying job. 

It is also important to consider that adding work requirements to social benefits does not typically result in the intended effect. The Trump administration has stated that, “SNAP was never intended to be a way of life” and “ we need everyone who can work, to work ” and that these cuts will save $5.5 billion over five years; however, pilot programs that have previously enforced work requirements for SNAP have resulted in “an increase in food insecurity, stagnant employment, and stress on the emergency food system.” In addition, many states have predicted that this will cause a huge administrative burden on social services, and could harm the economy by individuals spending less to account for added food expenses. SNAP benefits were already modest with an average of $127/recipient and $256/household per month , but now individuals who are losing benefits will likely have to take money from rent, utilities, and healthcare costs in order to ensure they can eat. In conclusion, “we’re not talking about cash, we’re not talking about superfluous things… it ultimately comes down to a meal .” 

House Passes the NDAA: Is it a Win for Progressives?

On Wednesday, the Democrat-controlled House of Representatives passed the National Defense Authorization Act with bipartisan support, allocating $738 billion dollars to the U.S. military budget, a $22 billion dollar increase compared to last year. Democrats negotiated heavily to incorporate 12 weeks of paid leave for all 2 million federal employees, in exchange for the creation of Trump’s long-anticipated “Space Force.” Previously, the federal government only provided 12 weeks of unpaid leave to its employees, making it the only developed nation without paid leave for new parents or caretakers. The bill also increases benefits for family members of deceased military members that were previously denied their entitled amount. An estimated 65,000 are qualified for monthly benefits from both the Department of Defense and the VA, but the federal government has only allowed individuals to receive whichever benefit is greater and denied the difference, commonly referred to as the “Widow’s Tax.”  Lastly, while the bill does not entirely repeal the Feres Doctrine , which prevents those who were injured during military service from suing the government, it does include a new provision that will allow for troops to bring malpractice claims against military health providers.

While some consider the passing of the bill a success for progressives, several provisions that Democrats had originally included were excluded. These include barring military funding from being used for the border wall, repealing the ban on transgender people from serving in the military, requiring congressional approval to enter a war with Iran, banning new detainees from being imprisoned at Guantánamo Bay, and withdrawing financial support for Saudi Arabia’s genocide in Yemen. Finally, while House Democrats had originally included a provision that authorized the use of federal funding to clean up PFAS spills and requiring the EPA to establish a maximum PFAS contaminant level, the bill instead only bans the use of PFAS foam in the Pentagon’s firefighting equipment.

The Republican Senate is expected to pass the bill by the end of next week and Trump is eager to sign it into law.

Sources: Politico , The Hill , Vox , NYT , Reuters
ProPublica Investigation Reveals Horrific Neglect Experienced by Teenage Migrant in U.S. Custody - Undermining Official Account from Border Patrol
In May 2019, it was announced that another migrant child died while under custody of U.S. immigration, the 5th death in the previous 6 months. Carlos Gregorio Hernandez Vasquez , a 16-year-old from Guatemala, told staff he was not feeling well while detained at the Rio Grande Valley Sector’s Central Processing Center. A nurse practitioner determined he had influenza A and prescribed medicine. Although his condition worsened, Carlos was not transferred to a hospital, and tragically died overnight. According to a Customs and Border Patrol (CBP) Official, no alarms were raised until Carlos was found unresponsive the next morning, during a routine welfare check.

Those initial reports depicted an already disturbing account of a child who was not cared for. However, a ProPublica investigation published on December 5th uncovered video surveillance that indicates on-duty CBP officials could have only missed Carlos’s suffering through extraordinary neglect. The viral video of the holding cell shows he was lying motionless on the floor for 4.5 hours, at some point transitioning from unconsciousness to death. During this time period, a CBP agent logged that they performed 3 separate checks on Carlos, yet somehow did not notice anything was wrong. In fact, no one entered Carlos’s cell between 12:20 AM and 6:00 AM. Furthermore, the video shows that Carlos was discovered by his teenage cellmate the next morning, who then alerted a staff member. This is in direct contradiction to CBP’s claim that a staff member made the discovery.

What happened to Carlos may be indicative of a larger pattern of detained migrants being mistreated. For instance, on December 9th a group of doctors marched to a children’s detention center in San Ysirdo, CA, demanding approval to provide flu vaccines at no cost to the government. 3 children in U.S. custody died from the flu in the past year, but so far CBP has maintained their policy of not providing vaccines. 

Note that while the ProPublica investigation is included as a source, we feel that their inclusion of the video is disturbing and insensitive to Carlos’s family, who have requested that the video be removed. Thus, we have not included the link to the article in order to respect their wishes and refrain from circulating the video.

Sources: NBCNews , ProPublica, San Diego Union Tribune , CBS
One-Liners
  • Primary Care: A new Commonwealth Fund study found stark differences in U.S. primary care compared to other high-income countries, including lower rates of home visits, coordination with specialists, and interoperability with other providers. (Commonwealth Fund)
  • Drug Pricing: The U.S. House of Representatives passed a bill to lower drug prices and save the federal government $400 billion by allowing Medicare to directly negotiate the price of insulin products and up to 250 additional drugs annually. (STAT)
  • Long-Term Care: The number of people dying from natural causes in hospitals and nursing homes in the U.S. is declining - from 40% to 30% and 24% to 21% across 2003 to 2017 respectively - as more people choose to die at home and hospice care becomes more prevalent, according to a new study. (New York Times)
  • Measles Outbreak: The CDC sent a team on December 11 to address a measles outbreak in American Samoa that has affected 4,900 people and killed 71 - mostly children under 5 years old. (The Washington Post)
  • Health Insurers: On December 10, the Supreme Court began hearing and seemed sympathetic to a lawsuit brought by several health insurance companies seeking incentive payments for offering plans on ACA exchanges that Congress suspended. (Reuters)