Federal policy

Advocates push state to use more federal dollars for school-based health clinics

Ohio child advocacy groups and doctors are pushing for more state funding to add additional school-based health clinics in the state (Source: “Child advocacy groups, doctors want to see more state funding for school-based health clinics,” News 5 Cleveland, Oct. 20).

The Children’s Defense Fund-Ohio and other child advocacy groups are asking the state to allocate $25 million from the American Rescue Plan Act for the next two years to help set up clinics for additional districts in the state.

Ohio received about $5 billion from the federal government as part of the American Rescue Plan Act. So far, about $3 billion has yet to be allocated. According to the Treasury Department, funds must be incurred by Dec. 31, 2024.

FDA approves e-cigarette product for first time

Federal health regulators Tuesday for the first time authorized the legal marketing of an electronic cigarette, saying the product from RJ Reynolds could help addicted adult smokers (Source: “FDA authorizes an e-cigarette for first time, citing benefit for smokers,” The Hill, Oct. 12).

The Food and Drug Administration said the company's refillable Vuse Solo closed device and tobacco-flavored e-liquid pods could benefit addicted adult smokers who switch by reducing their exposure to harmful chemicals.

The first-of-its-kind authorization comes amid an effort by the FDA to regulate the massive vaping industry and determine which products are allowed to stay on the market. 

It signals the agency may look more favorably on tobacco-flavored products than the fruity ones that are most popular among teenagers, even though some feature extremely high nicotine content.

Federal ban on surprise medical bills on track for Jan. 1 rollout, officials say

The Biden administration on Thursday put final touches on consumer protections against so-called “surprise” medical bills (Source: “Ban on ‘surprise’ medical bills on track for Jan. 1 rollout,” Associated Press, Sept. 30).

The ban on unexpected charges to insured patients is on track to take effect Jan. 1, officials said.

Patients will no longer have to worry about getting a huge bill following a medical crisis if the closest hospital emergency room happened to have been outside their insurance plan’s provider network. They’ll also be protected from unexpected charges if an out-of-network clinician takes part in a surgery or procedure conducted at an in-network hospital. In such situations, patients will be liable only for their in-network cost-sharing amount.

The rules released Thursday spelled out for the first time a key part of the new system: a behind-the-scenes dispute resolution process that hospitals, doctors and insurers will use to haggle over fees, without dragging patients into it.

CDC OKs COVID vaccine booster for workers at risk

The director of the Centers for Disease Control and Prevention on Friday overruled a recommendation by an agency advisory panel that had refused to endorse booster shots of the Pfizer-BioNTech Covid vaccine for frontline workers (Source: “C.D.C. Chief Overrules Agency Panel and Recommends Pfizer-BioNTech Boosters for Workers at Risk,” New York Times, Sept. 24).

It was a highly unusual move for the director, Dr. Rochelle Walensky, but aligned CDC policy with the Food and Drug Administration’s endorsements over her own agency’s advisers.

The CDC’s Advisory Committee on Immunization Practices on Thursday recommended the boosters for a wide range of Americans, including tens of millions of older adults and younger people at high risk for the disease. But they excluded health care workers, teachers and others whose jobs put them at risk. That put their recommendations at odds with the FDA’s authorization of booster shots for all adults with a high occupational risk.

The White House could begin promoting and rolling out a plan for booster shots as soon as Friday. 

Biden unveils vaccine mandate for 100 million American workers

President Biden on Thursday ordered sweeping new federal vaccine requirements for as many as 100 million Americans — private-sector employees as well as healthcare workers and federal contractors — in an all-out effort to curb the surging COVID-19 delta variant (Source: “Sweeping new vaccine mandates for 100 million Americans,” Associated Press via Dayton Daily News, Sept. 9).

Speaking at the White House, Biden sharply criticized the tens of millions of Americans who are not yet vaccinated, despite months of availability and incentives.

“We’ve been patient. But our patience is wearing thin, and your refusal has cost all of us," he said. The unvaccinated minority “can cause a lot of damage, and they are.”

The expansive rules mandate that all employers with more than 100 workers require them to be vaccinated or test for the virus weekly, affecting about 80 million Americans. And the roughly 17 million workers at health facilities that receive federal Medicare or Medicaid also will have to be fully vaccinated.

Biden is also requiring vaccination for employees of the executive branch and contractors who do business with the federal government — with no option to test out. That covers several million more workers.

Ohio to push for reinstatement of Medicaid work requirement

Ohio will appeal a move by the Biden administration to rescind federal approval of a work requirement that the state wants to use to determine Medicaid eligibility, Gov. Mike DeWine announced Thursday (Source: “Ohio seeks to reinstate Medicaid work requirement in appeal to Biden administration move,” Columbus Dispatch, Sept. 9).

Attorney General Dave Yost filed a notice of appeal with the Centers for Medicare & Medicaid Services weeks after the agency withdrew its approval for the "community engagement" requirement. The measure would require all new adult group beneficiaries under 50 years old to complete 80 hours per month of employment, education or job skills training.   

Federal officials approved Ohio's requirement under former President Trump in 2019, but the COVID-19 pandemic prevented it from going into effect this year. DeWine and other Republicans say it's necessary to encourage self-sufficiency and relieve the burden on taxpayers.

COVID-19 booster shots could begin Sept. 20 in Ohio, ODH director says

Ohio Health Department Director Dr. Bruce Vanderhoff said the state is getting ready to give booster shots for adults who received either the Pfizer or Moderna vaccines starting as early as Sept. 20 (Source: “Ohio prepares to administer COVID-19 booster shots as early as Sept. 20,” Columbus Dispatch, Aug. 18). 

"This plan is still subject to the FDA’s evaluation and determination of the safety and effectiveness of a booster dose," Vanderhoff said. 

The news comes hours after the Biden administration announced it was asking the U.S. Food and Drug Administration to authorize a third shot for the general population. The Centers for Disease Control and Prevention recommended the third shot for immunocompromised Americans last week as infections from the delta variant continue to rise. 

Vanderhoff said vaccines such as the COVID-19 shot aren't designed to provide indefinite immunity to infection. What they give people is "a reserve of cells" that protect against severe illness, hospitalization and death. 

"I’ll reiterate what I’ve said before. Protection against severe illness and death was the target of the vaccine," Vanderhoff said. 

White House announced $8.5 billion for rural healthcare providers

The White House announced last week that it is allocating nearly $9 billion to help healthcare providers in rural U.S. communities that are struggling to fight COVID-19 (Source: “White House announces $8.5B boost to help rural areas fight COVID-19,” United Press International, Aug. 13).

The funding, $8.5 billion from the American Rescue Plan, will go to help rural hospitals stay open long-term, improve rural healthcare and strengthen their ability to fight COVID-19.

Other actions for the funding include expanding access to vaccines, testing and supplies, training new health providers, expanding telehealth services, opening access to pulmonary rehabilitation services and expanding Veterans Affairs training programs.

Biden administration revokes permission for Ohio Medicaid work requirements

The federal Centers for Medicare and Medicaid Services told the Ohio Department of Medicaid this week that it cannot proceed with its plans to require some people on the health coverage program to work to keep their coverage (Source: “Biden administration nixes Ohio’s Medicaid work requirements,” Cleveland Plain Dealer, Aug. 11).

In a 23-page letter, sent to the state on Tuesday, CMS says that work requirements do not “ promote the statutory objectives of Medicaid” because they would likely result in thousands of people losing coverage.

This is a change from the administration of former President Donald Trump, which had approved the state’s work requirements program in 2019. The Ohio Department of Medicaid was directed to submit a work requirement program by the Ohio General Assembly in the 2017 budget bill.

Work requirements were supposed to begin Jan. 1, but were postponed because of the coronavirus pandemic.

Medicare eligibility drives down racial disparities, study finds

Access to Medicare may help address racial disparities in insurance coverage, access and self-reported outcomes, according to a new study (Source: “Medicare eligibility erases many healthcare disparities in US,” Healthcare Dive, July 26).

The research, published in JAMA Internal Medicine, tracked more than 2.4 million Americans and found that immediately after turning 65, and thus becoming eligible for Medicare, coverage for Black respondents increased from 86.3% to 95.8%. Among Hispanic respondents, coverage increased from 77.4% to 91.3%.

The JAMA study has validated the importance of Medicare in terms of leveling the playing field for Americans when it comes to healthcare access — a gap that has been exacerbated by the COVID-19 pandemic. Whereas there are significant gaps in access to healthcare and disparities among ethnic groups, reaching Medicare age wipes much of them out.

Disparities in insurance coverage were cut by 53% between Black people and white people, and 51% for Latino people versus white people. The proportion of Black and Latino people who self-reported their health as poor also dropped significantly after they became eligible for Medicare.