Medical Monday: Belated Bullet Version

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Policy News 

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In the name of choice, the Trump administration is proposing new rules to allow small businesses to circumvent the stipulations of the ACA and create cheap/incomplete heath insurance plans exempt from covering various "essential benefits” like: 

 

  • mental health care 
  • emergency services 
  • maternity care 
  • newborn care 
  • prescription drugs

 

How is this even classifiable as insurance ? How many will be duped into buying this ? It will be just like the old days and those that cannot afford to pay for what their insurance does not cover will leave the rest of us and the medical system to foot the bill. Their cheap incomplete insurance will put little into the collective pot, cover little, and leave much unpaid. 

 

Deja vu: 

 

To repair or replace the ACA ( Affordable Care Act), that is the question. That is the question the GOP is asking itself. And it was the same exact question this time last year. GOP moderates say repair, GOP conservatives say replace. Nobody can say what to replace it with.  

 

Forget about the ACA ? Here's FAQs:

 

  • Requires every consumer to hold health insurance of some kind or face penalty fee. (The Individual mandate) 
  • The Fed supplies subsidies to insurance companies to enable them to charge consumers lower premiums and to provide comprehensive coverage. 
  • There are no lifetime limits on health insurance benefits. 
  • Essential health benefits ( see above) must be covered by all new plans. 
  • Contraception should be covered through the “ contraceptive mandate”. 
  • A consumer cannot be dropped by health insurance except through committing fraud. 
  • Covers preventive services and immunizations. 
  • Covers dependents until 26. 
  • Creates a cap on insurance company administrative expenditures. 

 

The law had many more provisions but these are arguably the main ones of consumer interest. 

 

Since the Trump administration came to power, the following have been rescinded, weakened, or questioned : 

  • The individual mandate
  • Federal subsidies 
  • The contraceptive mandate 
  • Essential services 

 

Now that the holidays are over, Congress must find a way to save CHIP, the Children’s Health Insurance Program. Prior to Christmas, Republicans stole from Peter ( preventive health care under the ACA) to pay Paul (CHIP). That stopgap fund will run out in another couple months. 

 

Medical News 

 

First in the no-surprises department: 

 

  • Smoking during pregnancy is associated with increased rates of ADHD. 
  • Puerto Rico is facing an ongoing public health crisis without power, water and food. 
  • Influenza is widespread in the US, especially the South. 
  • Pregnant women in polluted areas have higher risks of birth defects. 
  • Pregnancy weight continue to rise in the US, and with them pregnancy complications. 
  • Maternal mortality is increased yet again in Texas. 

 

Good News Department: 

 

  • A brand new programs on reducing Maternal Mortality, the Alliance for Innovation in Maternal Health, has already reduced maternal death rates in four states by 20%. 
  • Estrogen cream may go generic soon, thereby reducing the very high cost of comfort. 
  • Prescription of multivitamins and/or folic acid during prenatal care is associated with lower risk of autism in offspring. This was a 12 year study on over 40,000 children .
  • The cancer death rate in the US has declined 1.7% just since 2015. Could this be related to the affordability of cancer screening covered through Obamacare ? 

Stay tuned for more breaking news from the world of Obstetrics and Gynecology, next week, right here on Medical Monday.