Wednesday, August 14, 2024

Vance pivots with ‘surprise billing’

Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy.
Aug 14, 2024 View in browser
 
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By Ben Leonard and Chelsea Cirruzzo

With Sophie Gardner 

Driving The Day

Sen. JD Vance talks to reporters on an airport tarmac.

Vice presidential nominee JD Vance has been elusive when asked about issues like abortion and the child tax credit by shifting the conversation to a safer topic like surprise medical bills. | Alex Brandon/AP

SURPRISE, SURPRISE — In a string of national TV interviews, GOP vice presidential contender Sen. JD Vance has answered questions about how a Trump-Vance administration would approach abortion pills, the child tax credit and past comments about “childless cat ladies” with responses about ending surprise medical bills.

“We’ve also proposed legislation … to end this practice of parents getting these surprise medical bills where they go to the hospital, they have a baby, they choose an out-of-network provider and they come home with unexpected bills,” Vance told CBS’ Margaret Brennan after being asked about the child tax credit. “I’ve actually sponsored legislation to end that practice. So, we have a whole host of pro-family policies that are out there.”

Blindsided: Surprise medical bills come when insured patients unintentionally get care from out-of-network providers they didn’t choose. Congress added new protections against the bills, which went into effect in 2022.

It doesn’t appear Vance was talking about those. Instead, he may have been referencing legislation he proposed last year with three other Republicans to expand a 1993 law allowing employees to take leave for medical and family reasons with continued health care coverage. The Vance measure would bar employers from reclaiming health care premiums from employees who don’t return after taking leave following the birth of a child.

“This legislation would relieve a serious financial burden for working families all over America and steer Washington in a more pro-family direction,” Vance said in a release last year about the bill, which hasn’t seen action and is unlikely to become law unless Democrats get on board.

Zooming out: Vance’s rhetorical pivot aims to shift the focus away from issues where the GOP ticket is vulnerable, abortion and the child tax credit, to an idea that might resonate: Ending surprise bills — whatever the definition — is politically popular. Vance’s office and campaign declined to comment for this story.

In related news: The Washington Post reported last month that Vance worked with Sen. Tim Kaine (D-Va.) on legislation that would bar insurers from charging mothers for copays or other costs tied to childbirth but stopped talks as he became closer to being named former President Donald Trump’s running mate. A person familiar with the discussions granted anonymity to freely discuss the negotiations confirmed The Post’s characterization of the situation to Pulse.

Vance’s office said the legislation could still be introduced and get across the finish line.

“Our team thoroughly reviews all legislative proposals before they’re introduced,” his office said in a statement to The Post. “This is standard practice."

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Abortion

NEW ARIZONA, FLORIDA ABORTION POLLING — Ahead of ballot measure votes in November that would expand abortion rights in Arizona and Florida’s constitutions, new polling shows significant shares of women having had an abortion in the states.

KFF surveys of 298 reproductive-age women — between 18 and 49 — in Arizona and 512 in Florida found about 1 in 6 said they had an abortion. The margin of error was plus or minus 6 points in Florida and plus or minus 8 points in Arizona.

Nearly 1 in 6 reproductive-age women in Arizona and Florida have had an abortion data wrapper

That experience could be relevant for female voters and people close to them in the ballot measures — and also in the presidential and Senate races in the key swing state of Arizona. Former President Donald Trump and Sen. Rick Scott (R-Fla.) are expected to win in Florida.

Florida’s measure would overturn a six-week ban. And Arizona’s would repeal a 15-week ban and allow abortions until fetal viability — around 24 weeks — with exceptions.

Seventy-two percent of reproductive-age women in Florida said the procedure should be allowed in “all or most” situations, and 70 percent said the same in Arizona.

Trump said last week that the results would wind up in a more “liberal way” than might be anticipated.

Arizona’s measure officially qualified for the ballot on Monday.

Telehealth

NEW EVIDENCE ON VIRTUAL CARE — Virtual care for congestive heart failure isn’t tied to a higher likelihood of emergency room visits or hospitalizations versus in-person care, according to new data from Epic Research.

Epic examined records from more than 62,000 patients diagnosed with the cardiac condition — the second most common cause of hospitalization in the U.S. outside of maternal health — between January 2017 and December 2022. The patients had five visits in the year after being diagnosed, and researchers adjusted for demographic factors and comorbidities.

Patients with a higher share of telehealth weren’t more likely to have adverse outcomes than those with a higher share of in-person care, the researchers found.

“Telehealth may be considered a substitute for in-person office visits for patients with CHF without affecting the likelihood of CHF-related ED visits or hospital admissions,” the researchers wrote.

The bigger picture: As telehealth becomes increasingly cemented in the health care system, the evidence is still building on its effectiveness in various treatment areas. So far, mental health care and substance use disorder and hepatitis C treatments have shown promise, but virtual care hasn’t been a panacea for issues of cost and access.

Global Health

MPOX EMERGENCY — The World Health Organization on Wednesday will consider designating an mpox outbreak as a “public health emergency of international concern.”

Only seven such declarations have been made since 2005, including those for the Covid-19 pandemic and Ebola.

A committee of independent advisers will meet virtually to advise WHO Director-General Tedros Adhanom Ghebreyesus.

Tedros said the decision was due to the spread of mpox outside of the Democratic Republic of the Congo and the possibility of more transmission within and outside Africa. He said Sunday that a “deadlier strain” of the virus had spread to multiple African countries.

The meeting comes after the Africa Centres for Disease Control and Prevention on Tuesday declared a public health emergency of continental security related to an mpox outbreak, its first declaration since it was established in 2017.

The agency said that Africa needs 10 million-plus vaccine doses but has only 200,000 available, adding that more than 15,000 cases and 461 deaths have been reported in Africa this year.

Vaccine maker Bavarian Nordic said Tuesday that the European Health Emergency Preparedness and Response Authority will procure more than 175,000 doses of its FDA-approved vaccine to donate to the Africa CDC. Bavarian Nordic will also donate 40,000 doses.

In the U.S.: The CDC is helping monitor wastewater for mpox amid the outbreak and working with some airports to determine whether the virus’ deadlier version has spread to the U.S.

AROUND THE AGENCIES

CDC WARNS OF PARVOVIRUS B19 The U.S. is seeing unusual levels of parvovirus B19, a seasonal respiratory virus, according to an alert from the CDC on Tuesday, Sophie reports. While most people have no signs or symptoms, it can sometimes cause mild flu-like symptoms.

There’s no routine surveillance for parvovirus B19 in the U.S., and it’s not considered a notifiable condition — meaning health providers don’t need to report cases to state or local public health officials.

But unusual levels of the virus have recently shown up in clinical specimens and pooled plasma from a large commercial laboratory, the CDC reports. The agency has also seen an increase in reports of clusters of parvovirus B19-associated complications among pregnant people and people with sickle cell disease.

The numbers: The prevalence of parvovirus B19 DNA in samples of blood plasma donors increased from 1.5 percent in December 2023 to nearly 20 percent this June.

What’s next: The CDC encouraged providers to be on the lookout for the virus in patients with compatible symptoms.

Names in the News

Dr. Stanley Crittenden has been named chief medical officer at Quantum Health. He previously served in the same role at Evergreen Nephrology.

Robin Sanders has been promoted to vice president of litigation and risk at the Blue Cross Blue Shield Association, and Deidra Jackson, previously of the Health Care Services Corporation, has joined BCBS’ Federal Employee Program as vice president of product marketing and engagement.

 

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WHAT WE'RE READING

STAT reports on why “U.S. health care cybersecurity laws are better at protecting a corpse’s privacy than patients’ lives.”

Fierce Healthcare reports on embattled Steward Health Care agreeing to sell its physicians network to a private equity-owned group.

 

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