Health
End of COVID-19 pandemic could bring major turbulence for US health care
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When the tip of the COVID-19 pandemic comes, it might create main disruptions for a cumbersome U.S. well being care system made extra beneficiant, versatile and up-to-date technologically via a raft of short-term emergency measures.
Winding down these insurance policies might start as early because the summer season. That might power an estimated 15 million Medicaid recipients to search out new sources of protection, require congressional motion to protect broad telehealth entry for Medicare enrollees, and scramble particular COVID-19 guidelines and fee insurance policies for hospitals, docs and insurers. There are additionally questions on how emergency use approvals for COVID-19 therapies shall be dealt with.
The array of points is tied to the coronavirus public well being emergency first declared greater than two years in the past and periodically renewed since then. It’s set to finish April 16 and the expectation is that the Biden administration will prolong it via mid-July. Some would love an extended off-ramp.
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Transitions don’t bode properly for the complicated U.S. well being care system, with its combine of personal and authorities insurance coverage and its labyrinth of insurance policies and procedures. Well being care chaos, if it breaks out, might create midterm election complications for Democrats and Republicans alike.
“The flexibilities granted via the general public well being emergency have helped individuals keep lined and get entry to care, so transferring ahead the important thing query is the best way to construct on what has been a hit and never lose floor,” mentioned Juliette Cubanski, a Medicare professional with the nonpartisan Kaiser Household Basis, who has been researching potential penalties of winding down the pandemic emergency.
MEDICAID CHURN
Medicaid, the state-federal medical insurance program for low-income individuals, is overlaying about 79 million individuals, a file partly as a result of pandemic.
However the nonpartisan City Institute suppose tank estimates that about 15 million individuals might lose Medicaid when the general public well being emergency ends, at a charge of not less than 1 million per thirty days.
Congress elevated federal Medicaid funds to states due to COVID-19, however it additionally required states to maintain individuals on the rolls through the well being emergency. In regular occasions states routinely disenroll Medicaid recipients whose incomes rise past sure ranges, or for different life adjustments affecting eligibility. That course of will swap on once more when the emergency ends, and a few states are keen to maneuver ahead.
Just about all of these shedding Medicaid are anticipated to be eligible for another supply of protection, both via employers, the Reasonably priced Care Act or — for teenagers — the Kids’s Well being Insurance coverage Program.
However that’s not going to occur mechanically, mentioned Matthew Buettgens, lead researcher on the City Institute research. Value and lack of know-how about choices might get in the way in which.
Folks dropped from Medicaid might not understand they’ll decide up taxpayer-subsidized ACA protection. Medicaid is normally free, so individuals supplied office insurance coverage might discover the premiums too excessive.
“That is an unprecedented state of affairs,” mentioned Buettgens. “The uncertainty is actual.”
The federal Facilities for Medicare and Medicaid Companies, or CMS, is advising states to take it sluggish and join Medicaid recipients who’re disenrolled with different potential protection. The company will keep watch over states’ accuracy in making eligibility choices. Biden officers need protection shifts, not losses.
“We’re centered ensuring we maintain on to the positive factors in protection we have now made beneath the Biden-Harris administration,” mentioned CMS Administrator Chiquita Brooks-LaSure. “We’re on the strongest level in our historical past and we’re going guarantee that we maintain on to the protection positive factors.”
ACA protection — or “Obamacare” — is an choice for a lot of who would lose Medicaid. However will probably be much less inexpensive if congressional Democrats fail to increase beneficiant monetary help referred to as for in President Joe Biden’s social laws. Democrats stalling the invoice would face blame.
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Republicans in principally Southern states which have refused to develop Medicaid are additionally susceptible. In these states, it may be very troublesome for low-income adults to get protection and extra individuals might wind up uninsured.
State Medicaid officers don’t need to be the scapegoats. “Medicaid has performed its job,” mentioned Matt Salo, head of the Nationwide Affiliation of Medicaid Administrators. “Now we have regarded out for bodily, psychological and behavioral well being wants. As we come out of this emergency, we’re alleged to right-size this system.”
TELEHEALTH STATIC
Hundreds of thousands of People found telehealth in 2020 when coronavirus shutdowns led to the suspension of routine medical consultations. In-person visits are once more the norm, however telehealth has proven its usefulness and gained broader acceptance.
The top of the general public well being emergency would jeopardize telehealth entry for tens of millions enrolled in conventional Medicare. Restrictions predating COVID-19 restrict telehealth primarily to rural residents, partly to mitigate in opposition to well being care fraud. Congress has given itself 151 days after the tip of the general public well being emergency to provide you with new guidelines.
“If there are not any adjustments to the legislation after that, most Medicare beneficiaries will lose entry to protection for telehealth,” the Kaiser Basis’s Cubanski mentioned.
A serious exception applies to enrollees in non-public Medicare Benefit plans, which usually do cowl telehealth. Nevertheless, almost 6 in 10 Medicare enrollees are within the conventional fee-for-service program.
TESTS, VACCINES, TREATMENTS, PAYMENTS & PROCEDURES
Widespread entry to COVID-19 vaccines, assessments and coverings rests on authorized authority linked to the general public well being emergency.
One instance is the Biden administration’s requirement for insurers to cowl as much as eight free at-home COVID-19 assessments per thirty days.
An space that’s notably murky is what occurs to assessments, therapies and vaccines lined beneath emergency use authorization from the Meals and Drug Administration.
Some consultants say emergency use approvals final solely via the period of the general public well being emergency. Others say it’s not so simple as that, as a result of a distinct federal emergency statute additionally applies to vaccines, assessments and coverings. There’s no clear course but from well being officers.
The FDA has granted full approval to Pfizer-BioNTech’s COVID-19 vaccine for these 16 and older and Moderna’s for these 18 and older, so their continued use wouldn’t be affected.
However hospitals might take a monetary hit. At the moment they’re paid 20% extra for the care of COVID-19 sufferers. That added fee is simply at some point of the emergency.
And Medicare enrollees would have extra hoops to leap via to be authorised for rehab in a nursing house. A suspended Medicare rule requiring a previous three-day hospital keep would come again into impact.
Well being and Human Companies Secretary Xavier Becerra not too long ago instructed The Related Press that his division is dedicated to giving “ample discover” when it ends the general public well being emergency.
“We need to be certain that we’re not placing in a detrimental place People who nonetheless want our assist,” Becerra mentioned. “The one which individuals are actually nervous about is Medicaid.”
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Health
Many families take patients off life support too soon after traumatic brain injuries: study
Many patients who died after traumatic brain injuries may have survived and recovered if their families had waited to take them off life support, a new study found.
Researchers from Massachusetts General Hospital, Harvard Medical School and other universities analyzed “potential clinical outcomes” for patients with traumatic brain injury (TBI) who were removed from life support, according to a press release.
The study included 1,392 patients who were treated in 18 trauma centers across the U.S. over a 7½-year period.
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Using a mathematical model, the researchers compared patients for whom life support was withdrawn to similar patients who were kept on life support.
Among the group for whom life support was not withdrawn, more than 40% recovered at least some independence, according to a press release.
The researchers also discovered that the notion of remaining in a vegetative state was an “unlikely outcome” six months after injury.
When designing the study, the team didn’t know what to expect, according to study author Yelena Bodien, PhD, of the Department of Neurology’s Center for neurotechnology and neurorecovery at Massachusetts General Hospital.
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“Our anecdotal experience was that some families are told their loved ones had no chance for recovery, they would never walk, talk, work or have a meaningful relationship again — yet they chose not to discontinue life support and their loved one made a remarkable recovery,” she told Fox News Digital.
“On the other hand, clinicians are under a lot of pressure to make early prognoses and do not want to commit someone to a life that would never be acceptable to them, so it could be that those patients who died after life support was withdrawn would have had very significant impairments otherwise.”
“I think there are two stories here,” said Bodien.
“One is that some patients with traumatic brain injury who died because life support was withdrawn may have recovered, but the other is that many would have died even if life support was continued.”
A patient’s prognosis after severe traumatic brain injury is highly uncertain, she noted. “Sometimes patients with the most devastating injuries survive and make meaningful recoveries.”
“Families can advocate for delaying a decision to discontinue life support if this is aligned with what they believe their loved one would want.”
The problem, Bodien said, is that health care providers lack the tools required to determine which patients with devastating injuries will recover, to what extent they will recover — and how long that will take.
‘Very important’ study
Dr. Marc Siegel, clinical professor of medicine at NYU Langone Medical Center and a Fox News medical contributor, was not involved in the research but said it was a “very important” study.
“Previous research shows a high-level recovery from mild TBI and a significant recovery percentage even with moderate to severe injury,” Siegel told Fox News Digital.
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“After head trauma, the brain may swell, and the use of mannitol and steroids and even sometimes surgery — where the top of the skull is removed — can be used to decrease pressure on the brain and increase chance of a full recovery,” he continued.
Rehabilitation is also crucial, Siegel added.
“All of these tools should be given a chance to work in most cases.”
Based on the study findings, Bodien recommended that clinicians should be “very cautious” with “irreversible decisions” like withdrawing life support in the days following traumatic brain injury.
“Families should also be aware of our results so that they can advocate for delaying a decision to discontinue life support if this is aligned with what they believe their loved one would want,” she added.
Limitations of the research
There were some limitations to the study, Bodien said.
“The sample size of the study was small, which made it difficult to find an adequate number of participants who did not have life support discontinued and were clinically similar, or ‘matched,’ to those who had life support discontinued,” she told Fox News Digital.
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Among the participants who did not have life support discontinued, the researchers were not able to follow all of them for a six-month period.
Another limitation is that the researchers used clinical variables that were available on the day of, or the day after, hospitalization — but sometimes decisions to discontinue life support are made several days later.
“There are many considerations that may lead to a decision to discontinue life support after traumatic brain injury that we were unable to factor into our analyses,” she continued.
“For example, personal beliefs, religion and advanced directives could all affect decision-making but were not captured in our study.”
Bodien also noted that the Harvard study was focused on traumatic brain injury and cannot be generalized to other injuries and illnesses.
For more Health articles, visit www.foxnews.com/health.
Health
7 important health stories you might have missed this week: Catch up here
Every day of the week, Fox News Digital publishes a range of health pieces to keep you up-to-date on the most important wellness news.
We cover cutting-edge medical research, breakthrough medications, mental health challenges, personal medical dramas and more.
In case you missed them, here are a few of our biggest health stories from this week.
CLICK HERE TO SIGN UP FOR OUR HEALTH NEWSLETTER
You can see a full list of recent health pieces at http://www.foxnews/health.
1. Hunger could be tied to sleep, expert says
If you’re feeling hungrier than usual lately, your sleep routine could be the culprit. A nutritional biologist offers tips for regulating sleep and curbing unhealthy cravings. Click here to get the story.
2. Health agencies issue bird flu update: ‘Alert, not alarmed’
The CDC and WebMD teamed up this week to deliver an hour-long update on Thursday about the current bird flu outbreak. Fox News Digital breaks down the most important points. Click here to get the story.
3. Melanoma patients share their stories
For Skin Cancer Awareness Month, two melanoma patients are speaking up about their symptoms, treatment and prevention tips to help others avoid the potentially deadly disease. Click here to get the story.
4. Report reveals staggering discrepancy in health care costs
Patients with private health insurance could be charged up to 300% more than those with Medicare, a new report reveals. Doctors explain the reasons for the sticker shock. Click here to get the story.
5. Pastor shares important message about depression
A Dallas pastor who fought his own depression battle shares how he overcame the disease – and why it’s so important for those in church leadership to seek help when they need it. Click here to get the story.
6. Nurse’s depression is cured through breakthrough tech
A Chicago nurse struggled with COVID-19-related PTSD and depression for years until electrical brain tapping therapy finally gave her a new lease on life. Click here to get the story.
7. Young vaper shares warning after nearly dying
A 22-year-old man in Nebraska required a double lung transplant due to vaping. Jackson Allard shares his story as a cautionary tale. “I had a 1% chance to live,” he said. Click here to get the story.
For more Health articles, visit www.foxnews.com/health.
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