State lawmakers should reconsider plans to end highly successful health program
Patients have their blood pressure checked and other vitals taken at a mobile dental and medical clinic. (Photo by)
One of the most encouraging public health initiatives to come along in several years is a state Department of Health and Human Services pilot program launched in 2022 called 'Healthy Opportunities.'
The program is based on the simple premise that providing for food, transportation, housing, and other non-medical health-related needs of people enrolled in Medicaid would improve their physical health.
And you know what? It did. Program participants were healthier and ended up in hospital emergency rooms less. Indeed, when researchers compared health care costs in the 12 months before and the 12 months after enrollment in Healthy Opportunities, they found cost savings of 85 dollars per person per month.
Talk about improving health care system efficiency.
Unfortunately, neither of the recent budget bills passed by the state House and Senate would keep the program up and running and that's a big mistake.
The bottom line: Healthy Opportunities is the kind of commonsense program the state needs more of, not less. Lawmakers should find the money to keep and expand it.
For NC Newsline, I'm Rob Schofield.
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Politico
35 minutes ago
- Politico
HHS justifies decision to stop recommending Covid shots during pregnancy with studies supporting the shots' safety
The Department of Health and Human Services is circulating a document on Capitol Hill to explain its decision to remove the Covid-19 vaccine recommendation for pregnant women — citing studies that largely found the shot is safe. The document, which HHS sent to lawmakers days before Secretary Robert F. Kennedy Jr. announced his plan to fire the panel that advises the CDC on immunizations, says that studies have shown that women who got the vaccine during pregnancy had higher rates of various complications. And it claims that 'a number of studies in pregnant women showed higher rates of fetal loss if vaccination was received before 20 weeks of pregnancy,' footnoting a research paper on vaccination during pregnancy. But Dr. Maria P. Velez of McGill University, the lead author of one of the studies, told POLITICO in an email that 'the results of our manuscript were misinterpreted.' The 2023 study shows a slightly higher rate of miscarriages among women who were immunized against Covid-19 during their pregnancies. But, Velez said, that after adjusting for 'variables that can confound a crude association,' like 'age, rurality, neighbourhood income quintile, immigration status, comorbidity' and other factors that could affect the outcome, Canadian researchers found 'no association between SARS-CoV-2 vaccination and an increased risk of miscarriage.' Raw numbers don't account for significant differences among the groups being compared — such as underlying conditions and when during pregnancy the people were vaccinated, said Katelyn Jetelina, an epidemiologist who's consulted for the Centers for Disease Control and Prevention. Scientists, including the Canadian researchers, use statistical methods to adjust for those factors, she said, which is how they determined the vaccine wasn't associated with miscarriage. In a statement, HHS spokesperson Andrew Nixon pointed to the raw study data, which showed a slightly higher rate of miscarriage in the first half of pregnancy for women who were vaccinated against Covid compared with those who weren't. 'The underlying data speaks for itself — and it raises legitimate safety concerns,' he said. 'HHS will not ignore that evidence or downplay early pregnancy loss.' Nixon added that HHS and the CDC encourage people to talk to their providers 'about any personal medical decision.' Vaccine researchers and obstetricians criticized the decision to remove the recommendation for pregnant women, and researchers cited in the HHS document largely dismissed any connection between Covid vaccination and miscarriages. 'Given that COVID-19 infection during pregnancy is associated with serious maternal and neonatal morbidity, the current study can inform healthcare providers, pregnant women and those considering a pregnancy about the safety of SARS-CoV-2 vaccination in relation to miscarriage risk,' Velez and her co-authors wrote in the study. That research was based on health-system data from Ontario, Canada, and aligned with similar population studies in the U.S., Scotland and Norway. Similarly, HHS cited an April 2022 study in its document concerning mRNA vaccination in people undergoing in-vitro fertilization, which also found no adverse effects on conception rates or on early pregnancy outcomes. 'Administration of COVID-19 mRNA vaccines was not associated with an adverse effect on stimulation or early pregnancy outcomes after IVF,' the New York City-based researchers at the Icahn School of Medicine at Mount Sinai and Mount Sinai West hospital wrote in the study. 'Our findings contribute to the growing body of evidence regarding the safety of COVID-19 vaccination in women who are trying to conceive.' The HHS document also includes an incorrect link for that study, instead leading to a different study — also cited in HHS' document — by Israeli researchers that found the vaccine 'appears to be safe during pregnancy,' with no increase in preterm labor or in newborns with low birth weight. That February 2022 study did note a possible increase in preterm birth rates for women vaccinated during the second trimester, and the authors suggested future investigations of outcomes based on the timing of immunization. HHS' assertion about significant risks to pregnant women 'contradicts the bulk of published studies,' said Dr. Paul Offit, an expert who has served as an outside adviser on vaccines to the FDA and the CDC. HHS deviated from past practice when it changed the Covid vaccine guidance last month, announcing the decision without the endorsement of an existing outside panel of expert advisers. Dr. Steven Fleischman, president of the American College of Obstetricians and Gynecologists, told POLITICO at the time that he was disappointed by HHS' decision, and pointed to data showing that newborns can benefit from maternal antibodies from the vaccine for protection from Covid. 'In fact, growing evidence shows just how much vaccination during pregnancy protects the infant after birth, with the vast majority of hospitalized infants less than 6 months of age — those who are not yet eligible for vaccination — born to unvaccinated mothers,' Fleischman said.


Politico
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Dr. Jay in the hot seat
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By the numbers: A New York Times analysis found that the NIH had spent about $1.6 billion less between the time Trump took office Jan. 20 and the end of April compared to the same period the year before. Bhattacharya told advocates for research last month that he'd spend all of the agency's $48 billion budget for this year by the end of September. In the hot seat: Democrats will get a chance to ask Bhattacharya for more details when he testifies before a Senate Appropriations subcommittee this morning. Thus far, they've focused more on the cuts than on where the money will go, reflecting their view that Trump and his Department of Government Efficiency wanted to slash government spending, not target that spending on different priorities. Trump's budget proposal, released last month, suggested as much with its call for a 40 percent reduction in the NIH's total budget. The NIH is putting $500 million into a universal vaccine, which will target multiple strains of a virus. It also recently solicited proposals for autism research, with $50 million on offer. Last month, when Bhattacharya's boss, Health and Human Services Secretary Robert F. Kennedy Jr., testified before a House Appropriations subcommittee, ranking Democrat Rosa DeLauro of Connecticut pressed him: 'Are you planning to break the law by impounding congressionally appropriated funds?' Kennedy said no: 'If Congress appropriates me the money, I'm going to spend the money.' WELCOME TO TUESDAY PULSE. I'm Robert King, POLITICO's CMS reporter, filling in for Kelly today. It will be a busy week for health policy wonks as we wait for more news on whether the Senate makes changes to Medicaid in the 'big beautiful bill.' If you have any tips or news, don't hesitate to shoot me a message. Send tips, scoops and general thoughts to rking@ and khooper@ Follow along @rking_19 and @Kelhoops. AROUND THE AGENCIES RFK'S BOLDEST VACCINE STEP YET — HHS Secretary Robert F. Kennedy Jr. made his most dramatic move yet to overhaul vaccine approvals, firing all 17 members of the panel that advises the Centers for Disease Control and Prevention on vaccines. Kennedy said in an opinion piece for The Wall Street Journal that the Advisory Committee on Immunization Practices is rife with conflicts of interest and has acted as a rubber stamp for vaccines. This is the latest step for Kennedy, who has questioned the safety and effectiveness of vaccines, in changing how vaccines are approved and recommended by the federal government. He said in the op-ed that his goal is to restore faith in vaccines. It will now be up to Kennedy to pick new members to serve four-year terms on the panel, which votes on updates to CDC's vaccine schedule. The CDC director can override the recommendation but rarely does. His decision appears to contradict a promise he made to Sen. Bill Cassidy (R-La.) to secure the senator's vote for confirmation. Kennedy had promised to maintain ACIP 'without changes,' according to a speech Cassidy made on the Senate floor announcing his support for the nomination. Cassidy responded to the firings, writing on X that 'now the fear is that ACIP will be filled up with people who know nothing about vaccines except suspicion.' He added that he spoke with Kennedy and will continue to speak with him 'to ensure this is not the case.' Cassidy — who chairs the Senate Health, Education, Labor and Pensions Committee — later told reporters that the assurance he got from Kennedy was on the ACIP process rather than who sits on the panel. Sen. Susan Collins (R-Maine), who voted for Kennedy and sits on HELP, was taken by surprise. 'I don't know who serves on those committees, but it seems to be excessive to ask for everybody's resignations,' she told reporters. 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Yahoo
2 hours ago
- Yahoo
New York legislature passes medical aid in dying bill
Jun. 10—ALBANY — The New York state legislature has passed a bill to legalize physician-assisted suicide, a program supporters are calling "medical aid in dying." On Monday evening, with just a few days left for voting for the scheduled legislative session, the state Senate voted to pass its copy of the legislation. The state Assembly passed it earlier this year, and the bill now awaits Gov. Kathleen C. Hochul's decision to sign, veto or amend the legislation. Under the terms of the bill, people with a terminal illness who have an estimated six months or less before their disease will kill them can ask their physician for a prescription for life-ending drugs, which they can take home and consume on their own. The legislation has some protections, requiring a physician to evaluate the patient's ability to make decisions and refer them for psychiatric evaluation if there are questions over capacity. Patients have to make an oral and written request for the life-ending drugs, and the request be witnessed by two adults who are not closely related to the patient or likely to benefit after their death. It also permits medical professionals to recuse themselves from requests for medically assisted suicide, ordering them to refer requests they refuse to other doctors. Supporters of the bill say it will give New Yorkers suffering from terminal illnesses a safe, humane way to end their lives. They point to cases where terminally ill people have chosen to stop eating or drinking or chosen to end their lives in other, not legally sanctioned ways. Opponents of the bill raise concerns over the message it sends to sick people, that they should choose death rather than fight for their health, as well as practical concerns over whether the medication that would be prescribed could be a health hazard if not properly stored. They also expressed concerns over the bill's approach to how the death will be recorded. Under the bill's terms, someone who takes advantage of the program would have their cause of death listed as their terminal illness, not the ingestion of life-ending drugs. They also raised concerns over the lack of post-dispensation tracking for the lethal drugs, raising concerns they could be misused. The bill has circulated in Albany for nearly a decade, going most years without a floor vote in either chamber. Just last year, it lacked majority support in the Senate, but a successful lobbying effort this year pushed it to approval in the Assembly and now in the Senate. Debate stretched into Monday evening, with detractors in the Senate expressing concern. Sen. Steven D. Rhoads, R-Nassau, questioned why the bill doesn't include a specific requirement that doctors review a patient's medical records before prescribing the medication. "There is nothing in the bill that requires that," he said during floor debate. But proponents of the bill said it's a meaningful step towards medical autonomy and the right to choose — Senator Brad Hoylman-Sigal, D-Manhattan, the Senate sponsor of the bill, said that some identified gaps in the bill will be filled in the regulation-crafting process with the state Department of Health, which will be tasked with overseeing the implementation and authorization necessary to allow New York doctors and pharmacies to dispense these lethal medications. The lobbying isn't over yet. A major opponent of the bill, the New York State Catholic Conference, took to the halls of the Capitol on Monday in a last-ditch effort to kill the bill's chances in the Senate. Their effort was unsuccessful, but they've continued to push the governor to reject the bill. Sen. Mark C. Walczyk, R-Sackets Harbor, said in a statement that he was sad to see the bill pass. "I have tremendous sympathy for those with terminal illnesses and respect families who face end-of-life decisions," Walczyk said in a statement. "This legislation lacks critical protections for the vulnerable, structurally incentivizes suicide, and devalues human life. We need only look at the examples of states and nations that have promoted this policy. Instead of providing an option for individuals to end their lives, we should focus on improving health care for the vulnerable and enhancing hospice and palliative care for the terminally ill to ensure that every New Yorker has access to compassionate support during their most vulnerable moments, rather than offering a misguided solution that encourages despair."