Federal policy

FDA moves to ban menthol cigarettes with aim of reducing smoking-related disparities

The Food and Drug Administration (FDA) on Thursday announced a plan to ban sales of menthol-flavored cigarettes in the United States, a measure many public health experts hailed as the government’s most meaningful action in more than a decade of tobacco control efforts (Source: “F.D.A. Moves to Ban Sales of Menthol Cigarettes,” New York Times, April 28).
 
The ban would most likely have the deepest impact on Black smokers, nearly 85% of whom use menthol cigarettes, compared with 29% of white smokers, according to a government survey. If effective in reducing smoking, the ban could significantly diminish the burden of chronic disease and limit the number of lives cut short by one of the most hazardous legal products available.
 
Public health experts say menthol cigarettes have been heavily marketed to Black people, to devastating effect: African American men have the highest rates of lung cancer in America, according to the Centers for Disease Control and Prevention.


Federal legislation proposed to reduce maternal deaths

The push to reduce poor maternal health outcomes has seen new momentum as federal lawmakers and Biden administration officials previewed their priorities — including reversing a rise in maternal disparities among Black women (Source; “Lawmakers, advocates hopeful for more bills to curb maternal deaths,” Roll Call, April 20).
 
The United States leads among developed nations in its poor maternal mortality rates, referring to deaths during or up to one year after childbirth. These deaths — alongside maternal morbidity, or long-term health problems arising from pregnancy or childbirth — are growing problems nationally.
 
Last week, HPIO released a fact sheet titled “Racial and geographic disparities in maternal morbidity and mortality.” The fact sheet includes an analysis of the drivers of maternal morbidity and mortality in Ohio and descriptions of what works to reduce disparities.


400k Ohioans may lose Medicaid benefits this summer, report estimates

Hundreds of thousands of Ohioans may lose Medicaid coverage this summer when the federal government's COVID-19 emergency declaration ends, according to a new national report (Source: “More than 400,000 Ohioans at risk of losing Medicaid coverage this summer as COVID emergency ends,” Cincinnati Enquirer, April 19).

Around 3.3 million Ohioans were enrolled in Medicaid this fiscal year as of February, an increase from around 2.8 million from 2020. Under the declaration, Ohio and other states were unable to take people off Medicaid, even if they become ineligible. A new Commonwealth Fund report estimates that as many as 400,000 Ohioans could lose their coverage at the conclusion of the public health emergency.

Last week, HPIO released a new fact sheet, “Ohio Medicaid Basics Update: Trends in Enrollment and Expenditures During the COVID-19 Pandemic,” which details enrollment and spending trends in Ohio Medicaid due to the COVID-19 pandemic.

HPIO is also hosting a free online forum May 3, titled “What’s on the Horizon for Ohio’s Medicaid Program? Innovation, Equity and Unwinding the Public Health Emergency.”


White House plan to reduce drug overdose deaths leans on harm reduction strategies

President Joe Biden is sending his administration’s first national drug control strategy to Congress as the U.S. overdose death toll hit a new record of nearly 107,000 during the past 12 months (Source: “Biden drug control plan stresses harm reduction, treatment,” Associated Press, April 21).

The strategy, released Thursday, is the first national plan to prioritize harm reduction, said White House drug czar Dr. Rahul Gupta. The strategy calls for changes in state laws and policies to support the expansion of harm reduction.

For an overview of harm reduction policy in Ohio, see HPIO’s “Ohio Addiction Policy Scorecard: Overdose Reversal and Other Forms of Harm Reduction.”


Feds extend COVID public health emergency another three months

The United States on Wednesday renewed the COVID-19 public health emergency, allowing millions of Americans to keep getting free tests, vaccines and treatments for at least three more months (Source: “U.S. renews COVID-19 public health emergency,” Reuters, April 13).

The public health emergency was initially declared in January 2020, when the coronavirus pandemic began. It has been renewed each quarter since and was due to expire on April 16.

The Department of Health and Human Services (HHS) in a statement said it was extending the public health emergency and that it will give states 60 days notice prior to termination or expiration.


FDA meets with states over plans to import drugs from Canada

The FDA has started discussions with states over creating a way to import drugs from Canada — a policy the Biden and Trump administrations both embraced to bring down health costs but which experts regard as having limited impact (Source: “FDA mulls drug importation with states,” Axios, April 12).

The FDA last week held its first meeting with five states — Florida, Colorado, Vermont, Maine and New Mexico — that have submitted reimportation plans or are thinking about doing so.

President Biden's executive order on promoting competition directed the FDA to work with states and Native American tribes on safely importing prescription drugs from Canada.


Federal report calls for overhaul of nursing home system

A new federal report calls for wholesale changes to the nursing home industry (Source: “Nursing home care, funding system need overhaul, report says,” Associated Press, April 6).
 
The 605-page report, released Wednesday by of the National Academies of Sciences, Engineering, and Medicine, found that nursing home residents are subjected to ineffective care and poor staffing, while facility finances are shrouded in secrecy and regulatory lapses go unenforced. The authors of the report insist that it could be an impetus to address issues that have gotten little more than lip service for decades, but have moved into the spotlight during the COVID-19 pandemic.
 
“The public is so concerned about the quality of care that most people really fear their family having to be in a nursing home,” said Betty Ferrell, a nurse who chaired the report committee. “We’re very optimistic that our government officials will respond to what has really been a travesty.”


CDC: More than 90% of Americans live in areas where masks not needed

The U.S. Centers for Disease Control and Prevention (CDC) on Thursday said 93% of the U.S. population live in locations where COVID-19 levels are low enough that people do not need to wear masks indoors (Source: “More than 90% of U.S. population in areas where masks not needed -CDC,” Reuters, March 3).

Last week, the CDC dramatically eased its COVID-19 guidelines for when Americans should wear masks indoors, saying they could drop them in counties experiencing what it described as low or medium COVID-19 levels.

The latest figures are an increase from just a week ago, a further indication that COVID hospitalizations - a key benchmark for the new masking recommendations - continue to fall. The agency said on Thursday that 85.4% of counties now rank as low or medium risk and 92.9% of the population lives in those counties.


CMS proposes adding Health Equity Index to Medicare Advantage, Part D star ratings

The annual rule governing Medicare Advantage and Part D is putting a focus on health equity, the Biden administration announced earlier this month (Source: “CMS puts focus on health equity in Medicare Advantage, Part D Advance Notice,” Fierce Healthcare, Feb. 3).

The Centers for Medicare and Medicaid Services (CMS) issued its proposed Advance Notice for Medicare Advantage and Part D in 2023, and in the regulation the agency proposes updating the MA and Part D star ratings to account for how well a plan tackles health equity.

CMS is seeking comment specifically on a potential quality measure for the star ratings that would assess how often plans are screening for common social needs such as food insecurity, housing insecurity and transportation challenges.

CMS Deputy Administrator and Center for Medicare Director Meena Seshamani, M.D., said in a statement that the proposed Heath Equity Index aims to enhance transparency around how MA plans are treating "our most vulnerable beneficiaries" as well as encourage improvements in their care.


States brace for Medicaid redetermination following end of health emergency

The Biden administration and state officials are bracing for a great unwinding: Millions of people losing their Medicaid benefits when the pandemic health emergency ends (Source: “Why Millions on Medicaid Are at Risk of Losing Coverage in the Months Ahead,” Kaiser Health News, Feb. 14).

Before the public health crisis, states regularly reviewed whether people still qualified for the safety-net program, based on their income or perhaps their age or disability status. While those routines have been suspended for the past two years, enrollment climbed to record highs. As of July, 76.7 million people, or nearly 1 in 4 Americans, were enrolled, according to the Centers for Medicare and Medicaid Services.

When the public health emergency ends, state Medicaid officials face a huge job of reevaluating each person’s eligibility and connecting with people whose jobs, income and housing might have been upended in the pandemic. People could lose their coverage if they earn too much or don’t provide the information their state needs to verify their income or residency.

The Biden administration is giving states a year to go through the process, but officials say financial pressures will push them to go faster. Congress gave states billions of dollars to support the coverage requirement. But the money will dry up soon after the end of the public emergency — and much faster than officials can review the eligibility of millions of people, state Medicaid officials say.