Senate Republicans Unveil ACA Repeal Bill

The New York Times (6/22, Pear, Kaplan, Subscription Publication) reports that on Thursday, Senate Republicans “took a major step” towards their goal of repealing and replacing the Affordable Care Act by “unveiling a bill to cut Medicaid deeply and end the health law’s mandate that most Americans have health insurance.” The measure “would create a new system of federal tax credits to help people buy health insurance, while offering states the ability to drop many of the benefits required by the Affordable Care Act, like maternity care, emergency services and mental health treatment.” The article says that although GOP senators had promised their ACA repeal bill would significantly modify the American Health Care Act which the House passed last month, the proposal which was put forward maintains the AHCA’s “structure, with modest adjustments.”

USA Today (6/22, Kelly, Collins) reports the Senate’s bill differs from the AHCA in that “it does away with a controversial House provision – which critics dubbed an ‘age tax’ – that would greatly increase costs for older Americans who need subsidies to pay for medical coverage.” In addition, the Senate’s version “would tie subsidies to income rather than age,” but this would “make it harder for people to qualify for the subsidies by tightening the income requirements.” Republican leaders are saying this bill is the party’s best option to keep conservatives’ promise to repeal and replace the ACA.

The Wall Street Journal (6/22, A1, Armour, Peterson, Radnofsky, Subscription Publication) reports on its front page that the bill would unwind major provisions of the ACA, such as its expansion of Medicaid. The article says Republicans are hoping to move quickly to pass an ACA repeal bill before the July 4 recess. However, some GOP lawmakers in the Senate say they are worried about some of the changes included in the measure.

The Los Angeles Times (6/22, Levey, Mascaro) reports that the bill includes “a drastic reduction in federal healthcare spending that threatens to leave millions more Americans uninsured, drive up costs for poor consumers and further destabilize the nation’s health insurance markets.”

On its website, ABC News (6/22, Stracqualursi, Adam Kelsey, Rogin) says top medical groups criticized the bill. For instance, the American Psychiatric Association’s CEO and Medical Director Saul Levin, MD, said, “The Senate proposal represents a significant move in the wrong direction, resulting in fewer people having access to insurance, fewer patient protections, and less coverage for essential behavioral health care.”

The Huffington Post (6/22, Holmes) reports, “Mental health organizations have been expressing concern about how the Republican effort to repeal and replace” the Affordable Care Act “could affect people living with mental illness.” For example, “American Psychiatric Association officials noted that they were not consulted on the House version or the Senate’s draft legislation.”

Psychiatric News (6/22) quotes Dr. Levin, who also said, “We urge the Senate to reject this harmful legislation and start again on a health care bill that puts patients first.” Meanwhile, APA President-Elect Altha Stewart, MD, said in a June 21 press release, “Eliminating requirements for coverage of key benefits, including mental health and substance use disorders and other patient protections that are part of the Affordable Care Act, will have detrimental impacts for millions.” Dr. Stewart added, “Mental health is critical to overall health and needs to be equally accessible.”

Related Links:

— “Senate Health Care Bill Includes Deep Cuts to Medicaid,” ROBERT PEAR and THOMAS KAPLAN, New York Times, June 23, 2017.

Opioid Crisis Fueling Black Market Due To Lack Of Treatment Options

The Wall Street Journal (6/22, King, Subscription Publication) reports that healthcare professionals say that patients who struggle with opioid addiction are increasingly turning to the black market due to a lack of access to treatment options, especially medication-based addiction treatment. Experts are increasingly recommending medication-based treatment, combined with counseling, to treat opioid addiction.

Related Links:

— “Lacking Treatment Options, Opioid Addicts Turn to Black Market,” Kate King, Wall Street Journal, June 22, 2017.

More Than One In Five Kids With Tourette Syndrome May Also Test Positive For Autism

HealthDay (6/22, Preidt) reports, “More than one in five children with Tourette syndrome also tests positive for autism,” investigators found in a study including “535 children and adults with Tourette’s.” It is unlikely, however, that “so many children actually have both disorders.” What appears more likely is that “Tourette’s symptoms often mimic or seem quite similar to those of autism, the researchers noted.” The findings were published in the July issue of the Journal of the American Academy of Child and Adolescent Psychiatry.

Related Links:

— “When is Tourette Syndrome Actually Autism?,” Robert Preidt, HealthDay, June 22, 2017.

ACA Repeal Bill Would Harm People Receiving Addiction Treatment Through Medicaid

The New York Times (6/20, A1, Pear, Steinhauer, Subscription Publication) reports on its front page that growing dissension “among Senate Republicans over federal spending on Medicaid and the opioid epidemic is imperiling legislation to repeal the Affordable Care Act that Senate leaders are trying to put to a vote by the end of next week.” The article says although President Trump urged senators to be more generous in their bill than the House was, on Tuesday, GOP leaders in the Senate “appeared to be drafting legislation that would do even more to slow the growth of Medicaid toward the end of the coming decade.” The piece adds that several lawmakers are warning the current measure would imperil consumers’ access to addiction treatment.

The AP (6/20, Alonso-Zaldivar) reports that the effort to repeal the ACA “is colliding with the opioid epidemic. Medicaid cutbacks would hit hard in states deeply affected by the addiction crisis and struggling to turn the corner, according to state data and concerned lawmakers in both parties.” Figures indicate “Medicaid expansion accounted for 61 percent of total Medicaid spending on substance abuse treatment in Kentucky, 47 percent in West Virginia, 56 percent in Michigan, 59 percent in Maryland, and 31 percent in Rhode Island.” The article adds that during a recent hearing, HHS Secretary Tom Price “defended the Trump administration and raised questions about how much difference Medicaid actually makes.” He explained that HHS’ “budget for the opioid crisis is more than three times greater than two years ago, $811 million versus $245 million,” which “reflects increases approved by Congress beyond what Medicaid spends.”

Related Links:

— “G.O.P. Rift Over Medicaid and Opioids Imperils Senate Health Bill,” ROBERT PEAR and JENNIFER STEINHAUER, New York Times, June 20, 2017.

Opioid Addiction Is “Swamping” Hospitals, Federal Data Show.

The Washington Post (6/20, Achenbach, Keating) reports that the opioid epidemic is “swamping hospitals,” with a report by the Agency for Healthcare Research and Quality “showing 1.27 million emergency room visits or inpatient stays for opioid-related issues in a single year.” According to the report, Maryland tops the list for inpatient care due to opioids.

Related Links:

— “In just one year, nearly 1.3 million Americans needed hospital care for opioid-related issues,” Joel Achenbach and Dan Keating, Washington Post, June 20, 2017.

Op-Ed: Changes Needed To Reduce Police Shootings Of People With Mental Illnesses.

In an opinion piece in the New York Times (6/21, A21, Subscription Publication), Phillip Atiba Goff, president of the Center for Policing Equity, and Kim Shayo Buchanan, senior academic writer at that same center, write in wake of the recent Seattle police shooting of Charleena Lyles, a pregnant woman with mental illness, “People with untreated mental illnesses are disproportionately likely to attract police attention.” In particular, “the combination of mental illness, racial segregation and poverty is…likely to result in police contact, often leading to arrest.”

Over the past five decades, however, the US “has seen a stunning decline in resources devoted to public mental health.” Goff and Buchanan conclude, “The cure for these too frequent police-involved shootings must include serious changes within law enforcement” coupled with a recommitment “to changing how we manage mental health if we are to reduce the chances that illness will be treated with gunshots.”

Related Links:

— “Charleena Lyles Needed Health Care. Instead, She Was Killed.,” PHILLIP ATIBA GOFF and KIM SHAYO BUCHANAN, New York Times, June 20, 2017.

Opioid-Related Hospitalizations Increasing Faster Among Women

HealthDay (6/21, Preidt) reports, “Opioid-related hospitalizations among women in the United States increased far faster than among men between 2005 and 2014,” according to the U.S. Agency for Healthcare Research and Quality (AHRQ). Data indicate “hospitalizations involving opioid painkillers or heroin rose 75 percent” among women versus 55 percent among men.

Related Links:

— “Opioid-Linked Hospitalizations Rising Fastest for Women: Study,” Robert Preidt, HealthDay, June 21, 2017.

Treating Depression, COPD In Patients With Both May Reduce ED Use, Hospitalizations

MedPage Today (6/21, Boyles) reports, “Treating depression and chronic obstructive pulmonary disease (COPD) in patients with both conditions reduced hospital emergency department (ED)” use “and hospitalizations,” researchers found in an analysis of Medicare data including some 16,075 beneficiaries. The findings were published in the August issue of Respiratory Medicine.

Related Links:

— “Study Looks at ‘Interplay’ of COPD and Depression Meds,” Salynn Boyles, MedPage Today, June 21, 2017.

Suicide Rate Among US Farmers Remains Much Higher Than Among Other Workers

HealthDay (6/21, Preidt) reports that about 20 years “after the US farm crisis, the suicide rate among American farmers remains much higher than among other workers,” researchers found. The study revealed that between 1992 and 2010, “230 US farmers died by suicide.” Farmers “in the West had the highest rate, accounting for 43 percent of all farmer suicides, followed by those in the Midwest (37 percent), the South (13 percent), and the Northeast (6 percent).” The findings were published online May 2 in the Journal of Rural Health.

Related Links:

— “Suicide Risk Especially High for U.S. Farmers,” Robert Preidt, HealthDay, June 21, 2017.

In Typical US Week, 25 Children Die Of Gunshot Wounds, Researchers Say

The New York Times (6/19, Bakalar, Subscription Publication) reports that “25 children die from bullet wounds” in an average week in the United States, according to “researchers writing in the journal Pediatrics” who “analyzed data gathered by the Centers for Disease Control and Prevention and by the National Electronic Injury Surveillance System.” The Times says researchers found that African-American children had “nearly 10 times” the annual rate of firearm homicides found among whites, and white children had “almost four times” the suicide rate found among blacks. The article quotes lead author and CDC behavioral scientist Katherine A. Fowler as saying, “There isn’t a single issue in isolation that increases the likelihood of gun death.”

USA Today (6/19, Rossman) reports that, in an average day, the study revealed that “19 children in the United States are either killed or injured by a firearm.” In addition, the CDC found “a 60% increase in kids aged 10 to 17 committing suicide with a firearm” from 2007 to 2014. The article says Fowler recommends street outreach programs and school programs to reduce street gun violence and help children manage emotions that lead to gun violence.

Related Links:

— “A Dire Weekly Total for the U.S.: 25 Children Killed by Guns,”Nicholas Bakalar, The New York Times, June 19, 2017.