US health insurers see profits soar; Missouri votes for Medicare expansion; Trump expands telehealth

Healthcare in politics, week 5

Healthcare has been hot button a political issue for decades, with fights over Medicare going back to the mid-60s. The issue has been especially fractious over the last decade with the implementation of the Affordable Care Act, which passed without a single Republican voting for it.

It's with that backdrop that we now find ourselves in the midst of what HHS declared on January 31, 2020 to be a public health emergency. COVID-19 has upended the healthcare system in ways that nobody could have foreseen; thanks, in part, to CMS waiving telehealth regulations in April, combined with the necessity of using virtual care to see a doctor, that sector has been explosive growth in just a few months. 

As this is an election year, the delineations between what the two sides believe in, and their vision for how healthcare should work, will be made clear. That is what will be discussed at the Healthcare in Politics salon, hosted by Vator, HP and UCSF Healthhub, on October 7. Every week until then we will be doing a roundup of some of the biggest healthcare news and what Trump, Biden and the biggest healthcare agencies are up to:     

Trump signs EO to help rural health care, expand telehealth

Missouri votes for Medicaid expansion

Voters Missouri approved Medicaid expansion under the Affordable Care Act, making it the 38th state to do so, and the sixth state in three years to pass it by ballot measure. Voters approved of the measure 53 percent to 46 percent.

This will expand the state's MO HealthNet program to anyone earning less than 133 percent of the poverty level, which is less than $18,000 a year for an individual, and less than $30,000 for a family of three. The expansion will take effect on July 1, 2021.

In Missouri, adults who do not have disabilities and who do not have minor children living at home cannot qualify for Medicaid coverage, no matter how much money they make. Parents with dependent children can only earn up to 21 percent of the poverty level, which is roughly $2,700 each.

Missouri is the second state to expand Medicaid during the pandemic, following Oklahoma's vote in July. 

CDC expects 2020 outbreak of AFM

The Centers for Disease Control and Prevention is anticipating that the U.S. will see another peak year for cases of acute flaccid myelitis (AFM), which it calls "an uncommon but serious neurologic condition that affects mostly children." Since 2014, the disease has peaked every two years between August and November.

AFM is likely in patients that have sudden limb weakness, recent respiratory illness or fever and the presence of neck or back pain or any neurologic symptom.There were 238 cases in 42 states in 2018, of which 94 percent were in children, and 86 percent of patients had AFM onset during August through November. Most patients had a fever and/or respiratory illness approximately six days before limb weakness onset. Other common early symptoms were difficulty walking, neck or back pain, fever, and limb pain.

The CDC recommends that patients should seek immediate medical care, even in areas with high COVID-19 activity, as ut is not known how the COVID-19 pandemic and the social distancing measures may affect the circulation of viruses that can cause AFM.

“As we head into these critical next months, CDC is taking necessary steps to help clinicians better recognize signs and symptoms of AFM in children,” CDC Director Robert Redfield, M.D. said in a statement.  “Recognition and early diagnosis are critical. CDC and public health partners have strengthened early disease detection systems, a vital step toward rapid treatment and rehabilitation for children with AFM.”

There is currently no specific test, proven treatment or prevention method for AFM. 

Six states band together to secure rapid COVID testing

The governors of six states announced a bipartisan interstate compact with the Rockefeller Foundation that will allow them to expand the use of rapid point-of-care antigen tests. The idea is to slow the spread of COVID-19 and allow the states to safely reopen. The states are currently in discussions with Becton Dickinson and Quidel, companies that are manufacturing of antigen tests and which have already been authorized by the FDA, to purchase 500,000 tests per state, for a total of three million tests.

The compact includes Maryland Governor Larry Hogan, Louisiana Governor John Bel Edwards, Massachusetts Governor Charlie Baker, Michigan Governor Gretchen Whitmer, Ohio Governor Mike DeWine, and Virginia Governor Ralph Northam; three of those governors are Democrats and three are Republicans. 

Governor Hogan, who is in his final days as chair of the National Governors Association, negotiated the compact with the Rockefeller Foundation. 

"With severe shortages and delays in testing and the federal administration attempting to cut funding for testing, the states are banding together to acquire millions of faster tests to help save lives and slow the spread of COVID-19," Hogan said in a statement. "I want to thank my fellow governors for signing on to this groundbreaking bipartisan agreement, which we have just finalized after weeks of discussions with the Rockefeller Foundation. We will be working to bring additional states, cities, and local governments on board as this initiative moves forward."

U.S. health insurers see big profits during COVID