Plus, more than 7 million kids could lose Medicaid | Monday, February 27, 2023
| | | | | | | Presented By PhRMA | | | | Axios Vitals | | By Tina Reed · Feb 27, 2023 | | Happy Monday, Vitals readers. Today's newsletter is 880 words or a 3½-minute read. 🍻 On tap this week: President Biden will head to Virginia Beach, Virginia, tomorrow with plans to talk about his health care priorities. | | | | | | 1 big thing: New COVID lab leak assessment reignites furor over pandemic origins |  | | | Illustration: Allie Carl/Axios | | | | A report that a U.S. agency believes COVID likely originated from a lab leak ignited yet another round of political furor around the topic, adding to many Republicans' anger over how the pandemic was handled even as many scientists remain convinced the virus most likely originated naturally, Axios' Caitlin Owens, Adriel Bettelheim and I write. Why it matters: Even though U.S. intelligence agencies are divided on which direction the evidence points, some prominent members of the GOP are already seizing on the news as evidence that they were right all along. - But the implications of the virus' origins go well beyond politics and could threaten what's already an increasingly tense U.S.-China relationship.
Driving the news: Department of Energy scientists concluded in a "low confidence" assessment that COVID-19 likely most arose from a laboratory leak, the Wall Street Journal reported Sunday. - The department was previously undecided on a cause, and the new report underscored how American intelligence is split over the answer, with none having reached a conclusion with a high degree of confidence.
- The National Intelligence Council and four government agencies officials declined to identify still assess with "low confidence" that the virus came about through natural transmission from an infected animal, the WSJ reported.
What they're saying: "The same people who shamed us, canceled us, & wanted to put us in jail for saying covid came from the Wuhan Lab ... are starting to say what we said all along," tweeted Rep. Marjorie Taylor-Greene (R-Ga.). - "When an agency comes out and says they're leaning this way but with 'low confidence?' I mean, how do you interpret that?" Michael Osterholm, director of the University of Minnesota's Center for Infectious Disease Research and Policy, told Axios. "The question is: 'Why did you even put it out there?'" he said.
🎙 Listen in: Axios' Niala Boodhoo and I discuss the changing conversation around COVID's origins. |     | | | | | | 2. Kids could soon fall of Medicaid rolls |  | | | Illustration: Aïda Amer/Axios | | | | Almost 7 million children and teens are at risk of losing their health coverage when the public health emergency ends, new estimates from the Georgetown University Health Policy Institute show, Axios' Arielle Dreher writes. Why it matters: States in April will begin redetermining Medicaid eligibility as pandemic-inspired coverage requirements lapse and enhanced federal matching funds dry up. - Kids will fall off program rolls even though upward of 70% will remain technically eligible, per federal estimates. Confusing messaging and lack of enough staffing at state agencies are expected to factor in the churn.
By the numbers: States face the daunting task of redetermining eligibility for more than 83 million people, including 34.2 million children, by the spring of 2024. - 54% of children and teens are covered by Medicaid or CHIP.
- While most states have continuous coverage safeguards for children, 17 don't, which could increase the likelihood of eligible kids dropping out.
"Millions of (kids) will fall by the wayside if states don't get this right," Joan Alker, executive director of the Georgetown Center for Children and Families, told Axios. "That's consequential for everyone this will be an administrative and cost burden for providers; this will have ripple effects." Go deeper: | | | | | | | | 3. Biden admin seeks limits on telehealth prescriptions |  | | | Adderall is pictured in a Massachusetts pharmacy. Photo: JB Reed/Bloomberg via Getty Images | | | | The Biden administration is moving to require doctors to evaluate patients in person before writing prescriptions for some controlled medications, such as Adderall and OxyContin, Axios' Sareen Habeshian writes. Driving the news: The Drug Enforcement Administration announced it's seeking to roll back rule changes under the COVID-19 public health emergency that allowed doctors to prescribe powerful drugs via telehealth appointments. Why it matters: The proposed changes will make it harder for Americans to access some medications used for treating pain and mental health disorders — but that can also lead to addiction. - Though the Biden administration is planning to extend telehealth flexibilities for common, non-controlled medications, it will ban doctors from prescribing schedule II medications and narcotics without an in-person appointment.
- Under the proposed rules, doctors will only be able to prescribe other controlled medications — such as Ambien and Xanax, as well as medications used to treat opioid addiction — for 30 days, with any refills requiring an in-person evaluation.
- The move comes as the opioid crisis rages on and overdoses from controlled substances like fentanyl continue to ravage communities.
What's next: The DEA said the public has 30 days to submit comments on the proposed changes. | | | | | | | | A message from PhRMA | | Data shows insurers and their PBMs shift costs to patients | | |  | | | | Costly OOP expenses tied to deductible and coinsurance requirements are a leading concern for patients with commercial insurance. These harmful practices put in place by insurers and pharmacy benefit managers (PBMs) are even causing patients to abandon their medicines. Learn more. | | | | | | 4. Tweet du jour |  | | | Screenshot: @helenbranswell (Twitter) | | | | Health officials investigating the death of a Cambodian girl from H5N1 bird flu say she, as well as her father who has tested positive for the virus, were both infected by an endemic stain — not the newer strain that's been raising global alarm bells about the potential threat to humans in recent months, Reuters reports. - As Helen Branswell, a journalist at STAT tweeted, if these cases were detected a year ago "the wider world probably wouldn't have blinked."
| | | | | | | | 5. While you were weekending |  | | | Illustration: Aïda Amer/Axios | | | | 💰 A Christian health nonprofit saddled thousands with debt as it built a family empire including a pot farm, a bank and an airline. (ProPublica) 😷 Residents near the Ohio train derailment have been diagnosed with ailments associated with chemical exposure. (NBC News) 👀 CDC issues warning about a rise in a highly drug-resistant stomach bug. (Washington Post) 💬 ChatGPT is poised to upend medical information. For better and worse. (USA Today) | | | | | | | | A message from PhRMA | | Data show PBMs shift costs to patients | | |  | | | | Costly out-of-pocket expenses tied to deductible and coinsurance requirements are a leading concern for patients with commercial insurance. New IQVIA data break down how insurers and their PBMs are impacting how patients access and afford their medicines. | | | | Have a news tip? Just reply to this email. Did someone forward this email? Subscribe here. Thanks for reading, and thanks to senior health care editor Adriel Bettelheim and senior copy editor Bryan McBournie for the edits. |  | | Dive deeper into the future of health care | | | | | | Axios thanks our partners for supporting our newsletters.
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