Today's News and Commentary

About insurance

ObamaCare enrollment declines slightly to 11.4M sign-ups for 2019: The final numbers are in and show ACA exchange enrollment down by 400,000 from last year. Premiums were up 1.5% on average, but most articles about this news item fail to report the huge price disparities among states. The exact reasons for the drop were not reported. Some blame Trump administration actions to limit enrollment assistance. Others raise the possibility that the fall is good news- more people are employed and are thus on their workplace insurance plans.

Read the announcement

In shift, Trump administration backs judge’s ruling that would kill Obamacare: The healthcare story of the day is that the Trump administration has changed its stance in the appeal of the legality of the ACA. Recall that a US District judge in Texas ruled that because the penalty for not having insurance was repealed, and because the Supreme Court based its constitutionality decision on the presence of the penalty (which the Court ruled was really a tax), the ACA should now be considered void in toto. The justice department originally said the whole law should not be repealed; now it sides with the District Court’s decision and will back it when several states’ attorneys general appeal the case.

Read the story
Read the legal brief of the appeal

Today, House Speaker Pelosi will announce a Democratic outline for a health proposal

You can access the speech here

State-by-State Estimates of the Coverage and Funding Consequences of Full Repeal of the ACA: To provide an understanding of the impact of ACA repeal, read this Urban Institute report published about a week ago.

Read the report

Extended Non-Enforcement of Affordable Care Act-Compliance With Respect to Certain Policies: When the ACA was passed in 2010, certain non-compliant plans were “grandfathered” in for a time. The idea was to give these plans time to come into compliance. CMS has just issued a notice that the grandfathered plans will be allowed for yet another year. This move is another attempt to undermine the ACA.

Read the announcement

About the public’s health

Americans are getting more miserable, and there’s data to prove it: American’s self-reported happiness is the lowest it’s been since at least 1976. Interestingly, Republicans are much happier than Democrats. Health status is also a significant contributor to happiness.

Read the article (From the Washington Post but appears to be open access)

Public Policies to Reduce Sugary Drink Consumption in Children and Adolescents: The American Academy of Pediatrics and American Heart Association have issued a number of recommendations to curb sugary drink use in children and adolescents. Two policies are noteworthy: imposition of increased costs (through such measures as higher taxes) and restrictions on advertising to this group.

Read the policy paper

New guideline recommends low-dose aspirin for many fewer patients: This new guideline has been in the news for the past week. The short article distills it with some other health recommendations from the American Heart Association and American College of Cardiology.

Read the report

Acute Illness Associated With Cannabis Use, by Route of Exposure: An Observational Study: Regardless of your personal feelings about the legality of cannabis availability, a major issue is safety. One problem with promoting safety is that cannabis preparations do not have standardized contents of the active ingredients (THC and CBD). The result is that: “ [Emergency Department, ED] Visits attributable to inhaled cannabis are more frequent than those attributable to edible cannabis, although the latter is associated with more acute psychiatric visits and more ED visits than expected.”

Read the article abstract

About devices

FDA Issues Warning Over Paclitaxel-Coated Balloons, Stents: Paclitaxel is a chemotherapy agent that has been found to slow tissue growth inside blood vessels if it is coated on balloons that expand blockages or stents that hold the vessel open. Based on an updated review of a meta analysis published several months ago, the FDA has issued a warning covering use of such coated devices. The research showed “among the 975 subjects in… 3 trials, there was an approximately 50% increased risk of mortality in subjects treated with paclitaxel-coated devices versus those treated with control devices (20.1% versus 13.4% crude risk of death at 5 years).”

Read the short announcement
Read the FDA letter

About pharma

20 most expensive drugs in the US in 2019: This article is FYI. It excludes drugs that are administered by a healthcare provider. So they are not truly the most expensive. Still, it provides some useful information.

Read the list