February 26, 2021
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: Matthew Dunn, Magdalena Mihaylova, Atticus Raasch, and Brynna Thigpen
Chiquita Brooks-LaSure nominated to head CMS
Nominee joins Xavier Becerra as President Biden’s leading healthcare deputies
by Brynna Thigpen
Prior to the COVID-19 pandemic, then-presidential candidate Biden centered healthcare reform and access expansion as major planks of his platform. Now, mid-pandemic and as President, Biden has tapped two progressive healthcare advocates with experience with the Affordable Care Act (ACA) to bring his proposals to fruition.

In December, Biden nominated Xavier Becerra, a former U.S. House Representative from L.A. who helped oversee passage of the ACA and most recently served as California’s Attorney General. Becerra has led several lawsuits in defense of President Obama’s signature healthcare bill, and faced confirmation hearings this week. This month, President Biden nominated Chiquita Brooks-LaSure to lead the Centers for Medicare and Medicaid Services (CMS). Brooks-LaSure is a former Obama administration official with an extensive background in healthcare: she guided implementation of the ACA in the White House and CMS, worked as a health staffer on the House Ways and Means Committee (where she met and built a relationship with Becerra), and served on Biden’s transition team. Brooks-LaSure most recently worked as a health policy consultant with Manatt Health, where her work centered around expanding coverage and promoting health equity. Notably, Brooks-LaSure would also be the first Black woman to lead CMS. 

The CMS role is considered the second most powerful health-related role in the executive branch, and if confirmed, Brooks-LaSure would be charged with expanding the ACA and undoing some of the damage the previous administration attempted to inflict on it. CMS is a trillion-dollar agency that oversees Medicare (for elderly Americans), Medicaid (for low-income patients), the Children’s Health Insurance Program (CHIP), and the ACA. She’s tasked with the delicate balancing act of working out persistent issues with these programs while pushing for Biden’s progressive reform proposals, potentially without the full support of a closely divided Congress. Brooks-LaSure herself has advocated for extending coverage to fully cover low-income Americans and fully expanding Medicaid nationally (a dozen states have still refused to expand the program). She also has experience advising states on public option design, which she worked on while at Manatt. 

Global inequalities in vaccine distribution
by Matthew Dunn
An important step in COVID-19 vaccine roll-out was achieved Wednesday, when the FDA announced the Johnson & Johnson single-dose vaccine was approved for emergency use. While not yet available to the public, it is believed such authorization is likely to follow - which would bring a third COVID-19 vaccine into circulation in the United States. However, even as more shots become available, inequalities of distribution persist at a global and domestic level. In the U.S., some of the populations in most need of the vaccine have been the most excluded, and there continues to be under-vaccination of Black-, Hispanic-, and Native Americans.

Problems exist on a global level as well, as vaccination progress in lower-income countries greatly lags behind wealthier countries. President Biden pledged $4 Billion of support to international efforts in vaccine development, but Biden also announced that the U.S. will not donate any vaccines to poorer countries until all Americans who want a shot have received one. Global health advocates have warned that existing disparities will continue, and potentially worsen, without a vaccine-sharing agreement among the worlds’ economic powers. This announcement from Biden follows recent comments from French President Emmanuel Macron, who said he hoped to convince other G-7 world leaders to immediately begin sharing 3-5% of their vaccine supply. 

In the private sector, Pfizer has also drawn sharp criticism for their treatment of multiple low- and middle- income countries, especially in Latin America. A new report from the Bureau of Investigative Journalism found that Pfizer has been withholding vaccine deals from countries not providing sufficient immunity against lawsuits from adverse reactions. 

A government official from Argentina said that Pfizer demanded a much greater-than-normal sum of money as compensation for potential damages. In another unnamed country in Latin America, Pfizer reportedly demanded sovereign assets, such as embassy buildings and military bases, as collateral for future lawsuits. The pharmaceutical giant holds significant leverage in these negotiations because further delay in vaccine development will only exacerbate mortality from COVID-19. In fact, Brazil and Argentina still do not have national deals with Pfizer. An unnamed official described their country as being “held to ransom” by Pfizer’s “high-level bullying.” 

Nursing school enrollment bump during pandemic
by Atticus Raasch
According to a survey conducted by the American Association of Colleges in Nursing, enrollment in baccalaureate nursing programs saw a 6% increase in 2020. In addition, Medical schools also saw an 18% boost in their applications last year, a jump that experts think can partially be attributed to high profile news stories of the pandemic and key doctors, such as Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, during the crisis.

Demand for nurses was strong even before COVID-19, and nursing shortages amid the pandemic further stressed hospital systems. In November, there was record demand for travel nurses, who take out-of-town assignments on short-term contracts of 13 weeks or less at elevated wages. Per diem nurses, who are willing to take a shift or two in their local hospitals, have been pressed into service. 

Currently, there are roughly 3 million registered nurses in the United States, but employment is expected to grow over the next decade, according to the Bureau of Labor Statistics, faster than the 4% average for all occupations. Many hospital medical staffs are stretched to the breaking point as they deal with a surge of COVID-19 patients, and at the same time cope with staff shortages as medical personnel have become sick or had to quarantine due to COVID-19.

One-Liners
by Magdalena Mihaylova
  • COVID-19: As U.S. case numbers begin to decline, with 4% of the population vaccinated, some begin hoping for a relatively normal summer while others warn that the numbers may be deceptive due to irregular testing.
  • Global Health: Health leaders in Myanmar are calling for global support against a Feb. 1 military coup that they say poses a risk to the health and human rights of their people, citing lack of access to essential medicines and a deterioration of clinical services as severe consequences of military rule.
  • Immigration: While President Biden has brought back policies that allow migrants to stay in the U.S. temporarily without fear of deportation, and suspended Trump-forced agreements that required asylum seekers to seek asylum in the first “safe” country through which they transited, deportations have continued at roughly the same rate as they did during the Trump administration, with some citing pandemic-related migration laws as a cause of this.
  • Legal: After a report was released last month claiming that the New York Health Department underreported the COVID-19 death toll at nursing homes by close to 50%, New York Governor Andrew Cuomo’s administration is under investigation by the FBI and the U.S. Attorney in Brooklyn.
  • Southern Storms: After unprecedented winter storms hit the South last week, Texans suffered massive power outages, water shortages, and flooding that led to injury and death, raising conversations about climate change and proper political response. 
  • Women’s Health: The emergence of 3D breast mammography has been touted as more effective at detecting tumors while also lowering “false alarm” rates; however, new research finds that Black and Hispanic women, along with low-income and less-educated women, are less likely to have access to this technology than their white, more-educated, higher-income counterparts.