February 14, 2020
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.
10 Deaths in 6 weeks in Overcrowded, Underfunded Mississippi Prison
A series of deaths in the Mississippi State Penitentiary at Parchman underscore the dangerous conditions of prisons in the state. James Allen Brown, 54, died on February 10th, which is the 10th death to occur at Parchman in the past 6 weeks and the 16th death since December. This spike in mortality has prompted legal responses. The Department of Justice announced a civil rights probe into the Mississippi prison system, releasing a statement that called for a focus on violence and suicide prevention, and ensuring adequate mental health resources are avialable. There is also a federal lawsuit against the state of Mississippi, filed by more than 2 dozen current inmates at Parchman alleging dangerous and inhumane conditions at the facility. 

Although recent events have brought national attention to prison health in Mississippi, these problems have existed for a long time. A ProPublica investigation from August 2019 found a longstanding epidemic of violence in Mississippi prisons, including both state-run facilities and prisons contracted out to private companies. One likely cause is the state of Mississippi has cut spending on prisons while simultaneously incarcerating more people. The unpleasant conditions make it difficult to hire jail staff, which are also paid less than in Mississippi than in any other state. However, criminal justice advocates have argued the inhumane treatment of prisoners at Parchman Penitentiary will not be solved by a nominal budget increase. The Mississippi Prison Reform Coalition, for instance, has called for a complete shutdown of Parchman Penitentiary. 

Sources: KHN , NPR , MCIR/ProPublica
New Health Data Interoperability Rules Receive Mixed Feedback
In February 2019, the US Department of Health and Human Services (HHS), Center for Medicare/Medicaid Service (CMS) and the Office of National Coordinator for Health Information Technology (ONC) proposed new rules for data interoperability in healthcare. These rules mandate organizations to allow patients access to their electronic health data for free, and require hospitals to work towards open data-sharing between providers, payers and patients. The intent to allow patients to own and access their private health information, improve care coordination through data exchange and increase competition by preventing entities from withholding data. This proposal is preceded by the 21st Century Cures Act , passed under the Obama Administration, which outlined the future of regulation and development of health IT.

The rules have received mixed feedback. Most notably, Epic , the premier electronic health record company in the U.S., submitted a letter of opposition to the proposal in solidarity with 60 health systems, voicing concerns about patient privacy. In addition, the letter expressed concerns with “the scope of regulated data, the timeline for compliance, and the significant costs and penalties.” In contrast, technology companies, like Apple, Google and Microsoft, favor the proposal because it simplifies their entry in the health care sector. With the proliferation of digital health apps, companies believe this new rule will make them more competitive against companies like Epic which currently dominate the market and encourage consumer choice.

Trump Administration’s Budget Proposal Slashes Safety Net Programs
President Trump released a FY 2021 budget proposal Monday that includes steep reductions in 
Medicaid, Medicare, and other social safety net programs over the next ten years while increasing defense spending.

The following is a breakdown of some of the notable proposals:
  • Medicaid: $920 billion reduction
  • Medicare: $451 billion reduction
  • Social Security: $25 billion reduction
  • Supplemental Nutrition Assistance Program: $220 billion reduction
  • Temporary Assistance for Needy Families: $21 billion reduction
  • NIH’s National Institute of Allergy and Infectious Diseases (which is testing a novel coronavirus vaccine and other solutions): $430 million reduction
  • CDC’s Public Health Preparedness and Response Program: $25 million reduction
  • CDC’s Emerging and Zoonotic Infection Disease Program: $85 million reduction
  • HHS’ Hospital Preparedness Program: $18 million reduction
  • Defense spending: $34 billion increase

Language in the proposal illustrates the administration’s continued support for Medicaid work requirements and new explicit support for block grants. For example, one passage attacks the “financial bias that currently favors able-bodied working-age adults over the truly vulnerable,” according to the Associated Press . However, the exemptions from being considered “able-bodied” are quite narrow . The proposed cuts to Medicaid come as the program is being threatened elsewhere by the Medicaid Fiscal Accountability Regulation, a proposed rule from CMS that experts predict would reduce funding by 8% annually. 

While these proposals are largely a formality, they signal the president’s priorities to Congress and can in some ways shape the budgeting process.

One-Liners
  • LGBTQ+ Health: Earlier this month, Virginia policymakers passed legislation that will protect residents based on their sexual orientation and gender identity. This legislation was rejected several times in the past (The Hill). 
  • E-Cigarettes: New legislation barred Juul and other e-cigarette manufacturers from selling flavored products except for menthol and tobacco, but public health officials say this is not enough to deter the vaping epidemic among youth. (The Hill)
  • Reproductive Justice: Due to Trump’s “gag rule,” over 1,000 women’s health clinics lost Title X funding, resulting in 1.6 million women losing access to reproductive healthcare services. (Guttmacher Institute)
  • Opioids: Officials warn that a new drug called “gray death” is so lethal that it should not even be touched; it looks like concrete and is a mix of heroin and synthetic opioids, which is 80-100 times more powerful than heroin (CBS News). 
  • Coronavirus: This week had the largest one-day increase in the number of Coronavirus cases reported, and the total number of cases worldwide is now close to 60,000 (New York Times).