The Health 202: 11202018-health202 – The Washington Post


THE PROGNOSIS

About 12,000 pregnant girls who’re incarcerated annually could also be free of shackling all through their pregnancies — together with throughout labor and supply of their infants — beneath a prison justice invoice Congress might attempt to move earlier than yr’s finish.

That’s a provision contained within the First Step Act — a invoice loosening some obligatory minimal sentencing legal guidelines that Congress would in all probability use as a framework for prison justice reform. The measure, which gained assist from President Trump final week, is considered amongst only a few duties lawmakers may undertake on a bipartisan foundation in the course of the lame-duck session.

The essential level of the invoice, which simply handed the House in May and has been revised within the Senate, is to get nonviolent offenders out of jail quicker and assist them keep out. A big share of the U.S. jail inhabitants, which is already a lot greater than in different international locations, is made up of nonviolent offenders charged with drug crimes.

But the measure additionally incorporates a nod to the actual challenges girls prisoners can face, particularly in the event that they’re pregnant. Incarcerated girls are routinely shackled throughout being pregnant and childbirth within the 32 states that don’t have any limits on the apply, prompting calls from medical organizations and civil-rights group to ban what they time period an inhumane apply.

Being shackled, for instance, could make it extra doubtless for pregnant girls to journey and fall, probably inflicting hurt to the fetus. Women have additionally been shackled to beds whereas delivering their infants, despite the fact that having one’s actions restricted could make labor pains even worse. (It additionally strikes your Health 202 creator — who has undergone childbirth thrice — as a fairly not possible time to chop and run.)

“Shackling pregnant prisoners endangers the health and safety of both the mother and the fetus, and is almost never justified by the need for safety and security for medical staff, the public or correctional officers,” says a truth sheet from the American Civil Liberties Union, which backs the invoice.

The First Step Act bans jail guards from shackling prisoners from the time they’re decided to be pregnant till they’ve accomplished a interval of postpartum restoration. It additionally directs that prisoners are incarcerated as shut as doable to their households — making it simpler for a lot of new moms to see their infants repeatedly — and mandates that tampons and sanitary pads are supplied  free to those that want them.

These are modifications backed by a slew of medical teams, together with the American Medical Association and the American Congress of Obstetricians and Gynecologists, and by these all alongside the political spectrum (together with the libertarian-minded Koch political group). Over the weekend, two Republican senators known as on Senate Majority Leader Mitch McConnell (R-Ky.) to deliver the Senate model to the ground.

“I’m urging Mitch McConnell, put this bill on the floor,” Sen. Lindsey O. Graham (R-S.C.) stated on NBC’s “Meet the Press,” predicting that it might get “80 votes.” Sen. Rand Paul (R-Ken.) additionally stated he thinks it might move with 65 to 70 votes.

“It’s all up to one person,” Paul stated on CBS’s “Face the Nation.” “Sen. McConnell has the ability to call any vote he wants to anytime.”

Criminal justice reform can be a selected precedence for Jared Kushner, Trump’s son-in-regulation and senior adviser. In a Sunday op-ed in USA Today, Kushner argued the First Step Act would go a great distance towards decreasing incarceration prices and recidivism.

Add all of it collectively, and also you’d assume the First Step Act can be a shoo-in. “The criminal justice overhaul, scaled back from its initial ambitious Senate draft but vastly more comprehensive than legislation the House passed this year, could be one of the most significant and bipartisan laws signed by Trump in his first two years in office,” my colleagues Seung Min Kim and Josh Dawsey wrote final week.

But it’s nonetheless unclear whether or not the Senate will finally act. McConnell informed Trump final week that there in all probability wasn’t sufficient time to debate it earlier than the top of this calendar yr, Dawsey and Philip Rucker report.

And Sen. Tom Cotton (R-Arkansas) has emerged because the invoice’s loudest critic on Capitol Hill. Cotton and Sen. Mike Lee (R-Utah) received right into a Twitter struggle yesterday over the measure:

Cotton pushed again:

Lee wrote that Cotton does not perceive how these credit work:

AHH, OOF and OUCH

AHH: Tom Price, the disgraced former Health and Human Services secretary, has been named to the transition group for Republican Brian Kemp, the incoming governor of Georgia. Kemp introduced members of his transition group throughout a press convention yesterday, at some point after the Associated Press declared him the winner of a detailed gubernatorial race. His Democratic opponent Stacey Abrams successfully ended her bid for governor on Friday.

Price, an outspoken critic of the Affordable Care Act, will assist Georgia search federal waivers to assist stabilize market premiums however will not push the state towards accepting the ACA’s Medicaid enlargement, Kemp stated. “Price and different members of Kemp’s ‘Georgians First’ group will spend the following two months additional creating coverage initiatives, hashing out his preliminary price range proposal and proposing appointments to a strong posts and boards,” the Atlanta Journal-Constitution’s Greg Bluestein reviews.

Price resigned from his position on the head of HHS in September 2017 following criticism for his in depth use of taxpayer-funded constitution flights.

OOF: Scott Lloyd, the director of the Office of Refugee Resettlement at HHS, is altering roles inside the division. Lloyd had been criticized for his position overseeing the Trump administration’s now-reverted “household separation” coverage that separated minors from their mother and father on the U.S.-Mexico border.

He will now be in a place at HHS’s Center for Faith and Opportunity Initiatives, based on the Associated Press. The Daily Caller first reported the transfer.

“While I have valued my time at the Office of Refugee Resettlement, I am excited to take on this new challenge,” Lloyd stated in an announcement to the publication. “I am grateful to Assistant Secretary Johnson and the incredible people at ORR and the Administration for Children and Families, and I am proud of what we have accomplished together.”

Lloyd had been director of ORR since March 2017.

“A top HHS official has been reviewing the department’s handling of the migrant crisis, and senior officials believe Lloyd mismanaged aspects of the response,” Politico’s Rachana Pradhan reviews. “For instance, Lloyd told staff to stop keeping a spreadsheet tracking separated families. At one point during the height of the crisis, HHS Secretary Alex Azar personally stepped in to review case files after he learned Lloyd’s office had yet to review hundreds.”

OUCH: California’s air air pollution stage surpassed world well being requirements by 60 occasions final week following a spate of devastating blazes, together with the deadliest wildfire the state has ever seen.

Air particulates reached as much as 1,500 micrograms per cubic meter. That’s in contrast with the usual of 25 set by the World Health Organization, Bloomberg’s Brian Okay Sullivan reviews. “Lower levels on Monday still exceeded the benchmark,” he provides.

“On Monday, Sacramento’s air was listed as unhealthy and particulates reached a level of 135.4 micrograms per cubic meter, according to the U.S. Forest Service. San Francisco has a reading of 55 with San Jose at 76.1 and Stockton at 152,” Sullivan reviews.

“The particulates can irritate lungs, eyes and nasal passages and are particularly dangerous for people with respiratory diseases,” he provides. “In addition to the smoke, fires cause ground-level ozone to form, triggering more-severe health issues.”

OPIOID OPTICS

— A drug producer inflated the value of an overdose reversing medicine by greater than 600 %, based on an investigative report launched by Sens. Rob Portman (R-Ohio) and Thomas R. Carper (D-Del.).

The report from the Senate Homeland Security and Governmental Affair’s Permanent Subcommittee on Investigations discovered that by 2016 the corporate kaléo elevated the value of its naloxone drug EVZIO by greater than 600 % — the drug went from an preliminary value of $575 per unit in 2014 to $three,750 in 2016 and $four,100 in 2017, the investigation discovered.

The report was detailed throughout a Sunday night time episode of CBS News’s “60 Minutes.”

“The company’s sales force focused on ensuring doctors’ offices signed necessary paperwork indicating that EVZIO was medically necessary, ensuring the drug would be covered by government programs like Medicare and Medicaid,” based on a information launch from Portman’s workplace. “The plan worked, resulting in increased costs to taxpayers, to date, totaling more than $142 million in just the last four years, despite the fact that less costly versions of naloxone exist.”

— Bisexual girls usually tend to abuse prescription opioid medicine, based on a brand new research from the New York University School of Medicine.

It discovered that people who determine as lesbian, homosexual or bisexual are total extra more likely to have interaction in opioid abuse. The research, printed Monday within the American Journal of Preventive Medicine, “is the first to use a nationally representative sample of adults in the United States to examine sexual orientation as a risk factor for prescription opioid misuse,” our Post colleague Samantha Schmidt reviews.

“Its findings shed light on the disproportionate risks faced by members of the LGBT community amid the ongoing opioid epidemic, which resulted in nearly 50,000 overdose deaths last year,” Schmidt writes. “The study’s authors said the results are consistent with other research showing that sexual minorities, particularly bisexual women, are more likely to report alcohol and substance abuse — and poorer health overall.”

Lead research creator Dustin Duncan, an affiliate professor within the Department of Population Health at NYU School of Medicine, “attributes this pattern to the ‘minority stress model,’ the idea that members of minority teams are likely to expertise better levels of stress on account of stigma and discrimination,” Schmidt writes. Duncan argues that bisexual girls are a minority inside a minority, not belonging absolutely to lesbian or homosexual circles. The stigma and discrimination they face on account of being  girl and being a member of the LGBT group might add stressors that “might predispose them to elevated fee of substance abuse,” Schmidt provides. 

HEALTH ON THE HILL

— Sen. Ron Johnson (R-Wis.) is asking on the Centers for Medicare and Medicaid Services to supply info on an audit displaying California’s Medicaid program might have made eligibility errors costing the federal authorities billions of . The chairman of the Senate Committee on Homeland Security and Governmental Affairs needs to know if the company “intends to attempt to recoup from California more than $3.3 billion in potential wasted federal Medicaid funds.”

The letter to CMS administrator Seema Verma cites a report from the California auditor from October that discovered “the state made at least $4 billion in questionable Medicaid payments between 2014 and 2017 on behalf of more than 450,000 people marked as Medicaid-eligible in the state system but ineligible in the county systems.”

“This audit, in conjunction with a separate federal review, shows that potential improper payments in California have cost federal taxpayers more than $3.3 billion. I respectfully request your assistance in understanding how the Centers for Medicare and Medicaid Services (CMS) plans to address the findings of these audits,” Johnson wrote within the letter.

REPRODUCTIVE WARS

— The analysis arm of antiabortion group Susan B. Anthony List discovered that 65 % of state alternate plans by way of the Affordable Care Act for 2019 cowl abortions, which is about 650 plans.

Analysis from the Charlotte Lozier Institute (CLI) discovered the protection represented a rise from 527 plans, or 53 % of those plans, this yr. In eight states and the District of Columbia, 100 % of particular person and household plans on the alternate cowl abortion, the group discovered.

“Our research reveals that consumers across nearly half the country have even fewer pro-life policy options to choose from on their state health insurance exchanges in 2019. In several states and the District of Columbia, there are no pro-life plans offered at all,” CLI President Chuck Donovan stated in an announcement.

TRUMP TEMPERATURE

— And listed here are a number of extra good reads from The Post and past:

STATE SCAN

MEDICAL MISSIVES

How a few years can we lose to the air we breathe?

The common individual on Earth would stay 2.6 years longer if their air contained not one of the deadliest sort of air pollution, based on researchers on the University of Chicago’s Energy Policy Institute. Your quantity relies on the place you reside.

Bonnie Berkowitz, John Muyskens, Manas Sharma and Monica Ulmanu

INDUSTRY RX

DAYBOOK

Coming Up

  • The American Enterprise Institute holds an occasion with CMS Administrator Seema Verma on “The new Medicare doctor fee regulation” on Nov. 27.
  • The Heritage Foundation holds a dialogue about fetal tissue analysis on Nov. 27.
  • The Senate Health, Education, Labor and Pensions Committee holds a listening to on decreasing well being care prices on Nov. 28. 

SUGAR RUSH

From The Post’s Anna Rothschild: “Dealing with anxiousness as a child”:



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