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| Presented By Kaiser Permanente |
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| Axios Vitals |
| By Tina Reed · May 18, 2023 |
| 👋 Good morning, Vitals readers. Today's newsletter is 1,016 words or a 4-minute read. Situational awareness: It's been exactly one year since the U.S. confirmed its first case of mpox — formerly known as monkeypox — in a man in Massachusetts. |
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| 1 big thing: Axios-Ipsos poll: Americans back work requirements for Medicaid, SNAP |
 Data: Axios-Ipsos poll; Chart: Jared Whalen/Axios Nearly two-thirds of Americans — including half of Democrats — back attaching work requirements to Medicaid and Supplemental Nutritional Assistance Program benefits, as House Republicans want to do in a debt limit deal, Axios' Adriel Bettelheim writes from the latest Axios-Ipsos American Health Index. Why it matters: Work requirements are a major sticking point in debt ceiling talks. - President Biden on Wednesday reiterated his opposition to imposing them when it comes to health care, but the new findings show how popular, at least on the surface, the idea is with Republicans and independents — and how it divides Democrats.
Progressives have warned that Biden risks major backlash for ceding ground, but the Axios-Ipsos poll showed the public is receptive to new conditions on federal aid programs. - Overall, 63% strongly or somewhat support requiring Medicaid or SNAP recipients to show proof of work to receive benefits.
- 66% of independents and 49% of Democrats back the policy change, along with 80% of Republicans.
Yes, but: Sentiment is much stronger against cutting entitlement programs as part of a spending deal, with just 22% favoring cutting Medicare or Social Security to reduce the deficit. What they're saying: "Americans have a long-standing belief in the value of work. Consequently, when presented with work requirements for government aid, particularly aid most people don't personally access, we see majorities supporting the policy change," said Cliff Young, president of Ipsos U.S. Public Affairs. - Biden sent a strong signal Wednesday that he'd oppose work requirements for Medicaid: "I'm not going to accept any work requirements that's going to impact on medical health needs of people."
- But he hedged on changes to other programs: "It's possible there could be a few others, but not anything of any consequence."
Margaret Talev contributed to this report. Go deeper. |
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| 2. Gun violence a top public health worry |
 Data: Axios-Ipsos poll; Chart: Jared Whalen/Axios The Axios-Ipsos poll also found gun violence has surged ahead of the opioid crisis as Americans' top public health concern, Adriel writes. Zoom in: 26% of respondents said "access to guns or firearms" is the No. 1 threat to American public health, up from 17% in our last poll in February. - 25% said the biggest threat is opioids and fentanyl, virtually unchanged since the last poll.
- 20% said obesity, also almost unchanged.
- COVID-19 slipped to the bottom of public health threats at 3%, tied with smoking, alcohol abuse and unsafe driving.
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| 3. Court skeptical of FDA's abortion pill approval |
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| Abortion rights activists rallied outside the U.S. Supreme Court in Washington, D.C., on April 14. Photo: Probal Rashid/LightRocket via Getty Images |
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| A federal appellate court on Wednesday seemed skeptical of nearly every argument from the Biden administration as it defended the FDA's power to approve a widely used abortion pill, Axios' Oriana González writes. Why it matters: The New Orleans-based U.S. 5th Circuit Court of Appeals could decide in the coming weeks to uphold a federal court ruling that ordered the FDA to withdraw its authorization of mifepristone used in medication abortion. Catch up quick: The lower court ruling, issued by U.S. District Judge Matthew Kacsmaryk in Amarillo, Texas, marked the first time that a court has ordered the FDA to withdraw a drug authorization, in this case for a product that's been on the market for over two decades. - The Supreme Court last month temporarily blocked Kacsmaryk's decision while the 5th Circuit, known for its conservative lean, considers the case.
State of play: The three-judge panel that presided over the case included two Trump appointees, Judges James Ho and Cory Wilson, and one Bush appointee, Judge Jennifer Walker Elrod. - Mifepristone is considered safe and effective by major medical groups.
Read the rest. |
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| A message from Kaiser Permanente |
| See all that health care can be |
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| Some health care experiences can be fragmented and impersonal, with the responsibility on the patient to make it work. But at Kaiser Permanente, everything works together to provide equitable, high-quality, affordable care and coverage that support the unique needs of each member. See how. |
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| 4. House panel advances transparency and PBM bills |
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| Illustration: Gabriella Turrisi/Axios |
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| A House Energy and Commerce Committee health markup on Wednesday offered more evidence that price transparency and pharmacy benefit manager regulation are two issues that have enough bipartisan support to move ahead in this Congress, Axios' Peter Sullivan writes. Among the measures the panel advanced on a unanimous 27-0 vote: - Codifying and strengthening Trump-era rules for hospitals and insurers to make health care prices available and more transparent.
- Imposing new transparency requirements on PBMs and banning "spread pricing" in Medicaid, where PBMs charge more than they pay for a drug and keep the difference.
Yes, but: The committee took a pass on major measures to provide for site neutral payment reforms in Medicare that address the way hospitals charge more for outpatient services that can be done in less-expensive settings. - In a sign the issue is not dead, Chair Cathy McMorris Rodgers (R-Wash.) offered and withdrew an amendment, saying there is "more work to do" on the measures.
- "It's not a secret that hospitals have concerns with these proposals," she said, but argued that there should be other ways to support hospitals than overpaying for certain services.
A version of this story was published first on Axios Pro. Get news like this by subscribing. Use code POLICY100 which gives you $100 off. |
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| 5. Insurers to give back more than $1B in rebates |
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| Illustration: Aïda Amer/Axios |
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| Insurers will have to rebate about $1.1 billion to enrollees this year for not spending enough of their premium revenues on medical claims under the Affordable Care Act, a KFF analysis shows, Axios' Arielle Dreher writes. Why it matters: Since rebates are based on a three-year average of insurers' experience, the givebacks reflects the pandemic experience, when patients canceled elective procedures and generally used less care. - The ACA requires insurers in specified markets to spend at least 80% of premium income on health care claims and quality improvement, leaving the remainder for administration and overhead. Carriers that don't hit the threshold have to pay back the difference.
In 2022, the average rebate in the individual market per person was $205, per KFF, while the average rebate for the small- and large-group markets was $169 and $110, respectively. |
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| 6. Catch up quick |
| 💰 Families raised millions and handed rare disease therapies off to biotechs. But companies have backed out. (Endpoints) 👀 A congressional committee and regulators question Cigna's system that lets its doctors deny claims without reading patient files. (ProPublica) 🏥 Sen. Bernie Sanders renews push for Medicare for All to end "totally broken" health care system. (CNBC) 💻 VA seeks to hold Oracle Cerner accountable with a revised EHR deal. (Modern Healthcare) ⚕️ Texas set to ban trans medical care for minors. (Axios) |
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| A message from Kaiser Permanente |
| See all that health care can be |
| |
| |
| |
| Some health care experiences can be fragmented and impersonal, with the responsibility on the patient to make it work. But at Kaiser Permanente, everything works together to provide equitable, high-quality, affordable care and coverage that support the unique needs of each member. See how. |
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| Thanks for reading Axios Vitals, and to senior editor Adriel Bettelheim and senior copy editor Bryan McBournie. Please ask your friends and colleagues to sign up. |
 | | Dive deeper into the future of health care | | |
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