Commentary, public health, Trump Administration

Congress sneaking in last-minute change to make Trumpcare even worse

Ahead of a floor vote scheduled for later today, Republican leadership in the House has realized that they do not have enough votes right now to pass the American Health Care Act (AHCA), the Trump-Ryan proposal to repeal and replace the Affordable Care Act (ACA). As a result, Trump and others are trying to sneak in disastrous last-minute changes to an already terrible bill to win over conservative votes at the expense of millions of lives.

One such change that they are proposing is repealing the requirement that health insurance plans cover a core set of essential health benefits. This guarantees that plans provide coverage for core services, such as hospitalizations, maternity care, prescription drugs, as well as mental health and substance use disorder treatment.

If this provision is repealed, insurers could offer bare-bones plans that don’t cover services that North Carolinians need, meaning only the most expensive, premium plans would cover services like treatment for opioid addition, for example.

What’s more, other key consumer protections would fall apart. While the AHCA does not repeal the ACA’s prohibition on lifetime limits and annual caps on services, that protection is useless without the essential health benefits requirement. Current law only applies these protections to services considered essential health benefits. If this provision is repealed, insurers may be free once again to arbitrarily cut off coverage for patients because their treatment is too expensive.

The haste with which Congress and Trump are moving to repeal our health care is telling; why rush to change one-sixth of the U.S. economy and millions of lives unless you don’t want the public to see what you’re doing? After all, we still haven’t seen the bill language that the House will vote on today. It seems like the Republicans may have to pass the bill to find out what’s in it.

News, public health

What you need to know about the Republican plan for replacing the Affordable Care Act (Audio)

If you missed it over the weekend, be sure to check out Chris Fitzsimon’s radio interview with health policy analyst Brendan Riley of the NC Justice Center. Riley discusses the Republican plan for replacing the Affordable Care Act, what subsidies could look like, and how many people could lose coverage under the new Republican proposal.

Also take time to read Health Advocacy Project analyst Ciara Zachary’s take on the replacement plan for the ACA over on Policy Watch’s main site.

Environment, public health

Former DHHS deputy Randall Williams nominated to head Missouri health department

Missouri Gov. Eric Greitens (left) has nominated Randall Williams, former NC Deputy Secretary of DHHS, to lead Missouri’s health department. (Photo: Gov. Geitens’s Facebook page)

Randall Williams, among the state officials entangled in the coal ash and drinking water controversy, could be the next leader of the Missouri health and senior services department. The story was reported today by The Kansas City Star.

Williams, who served as the deputy secretary of the the NC Health and Human Services, was nominated by Missouri Gov. Eric Greitens, a Republican. The Missouri Senate still must confirm Williams.

In a Facebook post, Gov. Greitens wrote, “Our new Director of the Department of Health and Senior Services, Dr. Randall Williams, is an exceptional leader who will put the people of Missouri first.”

The post continued:

As the State Health Director and Deputy Secretary for Health Services in North Carolina, Dr. Williams helped lead a 17,000 member agency with a 20 billion dollar budget. But even as he helped lead such a large organization, he never forgot that he was there to serve the people. He visited all 100 counties in North Carolina to understand and listen to the needs of their rural, underserved patients. And after each visit, he took action. And he got results. He’s committed to doing the same here in Missouri. … Now, he’ll serve the people of Missouri with the same commitment and compassion. Together, I know that we can create a health system that ensures that everyone has access to quality care, and nobody is forgotten.”

Williams became central to the coal ash scandal for his role in reversing the do not drink orders to households whose wells may have been contaminated by discharge from Duke Energy coal ash basins. Those letters, which rescinded previous “do not drink” advisories, downplayed the health risks of hexavalent chromium in drinking water.

Shortly before leaving office, Gov. Pat McCrory appointed Williams to the state’s oil and gas commission. Obviously, Williams must resign that position to take the Missouri job. Fun fact: Greitens, a former Navy SEAL and amateur boxer, graduated from Duke University in 1996.

News, public health

WATCH: Governor Cooper explain his plan for Medicaid expansion

Governor Roy Cooper will file the paperwork this week asking the federal government to amend the state’s Medicaid plan, opening door for expansion. While conservative legislators staunchly oppose Medicaid expansion, Cooper told business leaders Wednesday it makes sense fiscally.

North Carolina’s new governor says expansion would bring $2-4 billion in new investment to the state and create between 20,000-40,000 jobs.

Watch Cooper’s remarks below:

Environment, public health

How to become an AirKeeper for your neighborhood

A smog-filled cityscape of Beijing, China.

Become an AirKeeper: Don’t let your neighborhood air get as filthy as Beijing’s. (Photo: Creative Commons)

The power to monitor the air can sit in the palm of your hand.

Clean Air Carolina, a Charlotte-based nonprofit, has launched an AirKeeper program that deploys citizen scientists and sensors into neighborhoods, schools, even private back yards.

Today, NCPW posted a story about how citizens are filling in the monitoring gaps created by a lack of funding and political will on the state and federal level.

The group is soliciting donations for the programs; for $450, an individual, group or even city/county can get an air sensor, a mobile device for uploading the data, plus training and technical expertise. The AirKeeper program uses sensors that measure particulate matter, PM 2.5, microscopic pollution, which can damage the lungs and heart. Next year, Clean Air Carolina plans to expand the monitoring to include ozone.

Terry Lansdell, program director for Clean Air Carolina, said citizens can use what’s known as fixed monitoring: Placing a sensor outside a home, school or community center, for a span of time, usually a month, where the air can be constantly monitored. All the information collected is uploaded online as part of a crowd-sourcing data management. “We can look at data in real time,” Lansdell said. “It’s a powerful tool.”

People can also use a sensor for mobile monitoring. They can walk around their neighborhood or in suspected pollution hotspots to get real-time data. Or a person with asthma could carry a sensor for a day to determine if they should avoid certain areas. The data could also be useful in looking back to see if an asthma attack might have been triggered by pollution.

To contact Clean Air Carolina about the program, call Terry Lansdell at 980-213-6446 or email him at terry@cleanaircarolina.org. More info is also available from Medical Advocates for Healthy Air, which is part of Clean Air Carolina. Laura Wenzel of Chapel Hill is the manager of that program: Laura@CleanAirCarolina.org