Category Archives: Affordable Care Act
CDC Updates Guidelines on Health Worker Protective Gear when Treating Ebola Patients
The U.S. Centers for Disease Control and Prevention (CDC) announced last night that it is tightening its infection control guidance for health care workers caring for patients with Ebola, with a specific focus on several key steps:
- All health care workers must undergo rigorous training and become practiced and competent with protective equipment, including taking it on and off in a systemic manner.
- No skin exposure is allowed when the equipment is worn.
- All workers must be supervised by a trained monitor who watches each worker taking the equipment on and off.
The CDC is recommending all of the same equipment in its earlier guidance, with the addition of coveralls and single-use, disposable hoods. Single-use face shields are now recommended instead of goggles. Read more on Ebola.
Most People Polled Don’t Know New ACA Enrollment Period Begins in November
A poll just released from the Kaiser Family Foundation finds few people know that open enrollment for 2015 health insurance coverage under the Affordable Care Act begins next month. Other findings of the poll:
- Two-thirds of responders say they know “only a little” or “nothing at all” about the marketplaces where people who don’t get coverage through their employers can shop for insurance.
- Just over half say they know that financial assistance is available to help low- and moderate-income individuals purchase insurance.
Risk Factors for Sexual Assault Need to be Included in Prevention Efforts
Researchers who conducted a Danish study on sexual assault say that certain risk factors for the attacks—including the age of the victim and their prior relationship with the attacker—must be considered when developing strategies to help prevent sexual assaults. The researchers looked at data from more than 250 women who sought help at a Danish center for sexual assault victims between 2001 and 2010. The researchers found that 66 percent of the women were 15-24 years old and 75 percent had met their attacker before the assault. Nearly half of the women reported that the attacker was a current or former boyfriend, a family member or someone they considered a friend. Women who did not know their attacker previously were more likely to report the assault to the police. “We need to raise awareness of the fact that most sexual assaults are perpetrated by someone known to the woman, often in familiar surroundings ... in order to change the general attitudes towards sexual assault, this information should not only target young people, but also the police, health care professionals and the general public,” said Mie-Louise Larsen, of the Centre for Victims of Sexual Assault and the University of Copenhagen and a coauthor of the study, which appeared in BJOG: An International Journal of Obstetrics and Gynaecology. Read more on injury prevention.
Positive Images Improve Function in Older Adults
Older individuals who are subliminally exposed to positive stereotypes about aging showed improved physical functioning that can last for several weeks, according to work done by researchers at the Yale School of Public Health. The study, which will be published in Psychological Science, included 100 older individuals with an average age of 81 years. Some participants saw positive age stereotypes on a computer screen that flashed words such as “spry” and “creative.” Those participants who were exposed to positive messaging displayed both psychological and physical improvements but control participants did not. Read more on aging.
EBOLA UPDATE: Number of Cases Could Reach 1.4M by January in Worst-Case Scenario
(NewPublicHealth is monitoring the public health crisis in West Africa.)
As many as 1.4 million people could be infected by the Ebola outbreak in Liberia and Sierra Leone by the end of January, according to the latest estimates from the U.S. Centers for Disease Control and Prevention. Earlier this week, a study in the New England Journal of Medicine also “warned that the epidemic might never be fully controlled and that the virus could become endemic,” according to The Washington Post. U.S. officials, however, noted that neither of these worst-case scenario estimates take into account public health efforts enacted since August and other planned efforts in the weeks and months ahead. Read more on Ebola.
Health Insurance Marketplace Will Include 77 New Issuers in 2015
Next year will see a 25 percent increase in the number of issuers offering coverage on the Health Insurance Marketplace, according to a new report from the U.S. Department of Health and Human Services. Among the preliminary report’s findings:
- In the 44 states for which there is data, 77 issuers will be newly offering coverage in 2015
- The Federal Marketplace states will have 57 more issuers in 2015, a 30 percent net increase over this year
- The eight State-based Marketplaces where data is already available will have a total of six more issuers in 2015, a ten percent net increase over this year
- Four of the 36 states in the Federal Marketplace will have at least double the number of issuers they had in 2014
- In total, 36 states of the 44 will have at least one new issuer next year
Read more on the Affordable Care Act.
Study: The Younger a Person is When they First Drink, the More Likely they’ll Develop an Alcohol Problem
The younger a person is when they begin drinking, the more likely they are to develop an alcohol abuse problem, according to a new study in the journal Alcoholism: Clinical & Experimental Research. Researchers based their findings on a survey of 295 high school students—163 girls and 132 boys—which asked about when they first tried alcohol, when they first became drunk, how often they drank alcohol in the preceding month and how often they engaged in binge drinking. According to the researchers, their findings can help determine the best methods to stop alcohol abuse problems before they develop. "If age of any use is the primary risk factor, our efforts should be primarily focused on preventing initiation of any use. If, however, age of first intoxication—or delay from first use to first intoxication—is a unique risk factor above and beyond age of first use, prevention efforts should also target those who have already begun drinking in an effort to prevent the transition to heavy drinking,” said Meghan E. Morean, assistant professor of psychology at Oberlin College, Ohio and adjunct assistant professor of psychiatry at Yale School of Medicine, in a release. Read more on alcohol.
EBOLA UPDATE: Obama to Announce New Ebola Plan Tomorrow
(NewPublicHealth is monitoring the public health crisis in West Africa.)
President Obama is expected to make an announcement tomorrow detailing the United States’ increased involvement in combatting the Ebola outbreak in West Africa. The plan would likely involve an increased U.S. military presence; the government has already committed approximately $100 million related to protective equipment for health care workers; food; water; and medical and hygiene equipment. More than 2,400 people have so far died in the outbreak. Read more on Ebola.
HHS: $295M to Expand Health Services for 1.5M New Patients
Late last week, the U.S. Department of Health and Human Services (HHS) announced $295 million in funds to enable 1,195 health centers across the country to hire approximately 4,750 new staff, stay open later and expand their services to cover areas such as oral health, behavioral health, pharmacy and vision services. The funds are available through the Affordable Care Act. HHS estimates that this will help 1.5 million new patients. “These funds will enable health centers to provide high-quality primary health care to more people including the newly insured, many of whom may be accessing primary care for the first time,” said HHS Secretary Sylvia M. Burwell, in a release. Read more on the Affordable Care Act.
Study: 11 Million Unnecessary Antibiotic Prescriptions for Kids Annually
Physicians prescribe antibiotics for kids approximately twice as often than they are needed, contributing to the growing problem of antibiotic resistance, according to a new study in the journal Pediatrics. Researchers analyzed a selection of studies published between 2000 and 2011, as well as data on children examined at outpatient clinics, finding that an estimated 27 percent of U.S. children with infections of the ear, sinus area, throat or upper respiratory tract had illnesses caused by bacteria, yet antibiotics were prescribed for approximately 57 percent of these visits. They estimate that there are more than 11 million such unnecessary prescriptions for kids each year. Read more on prescription drugs.
A new Kaiser Health News (KHN) article describes the challenges of helping people who have never had health insurance sign up for coverage. The KHN profile looks at the Arab Community Center for Economic & Social Services (ACCESS) a nonprofit agency that is helping the large Arab-American population in Dearborn, Mich., sign up for coverage and access care.
The group has found that many of the people they are helping are immigrants who know little to nothing about health insurance concepts such as enrollment, copays and deductibles—an issue that also applies to millions of other people new to health insurance across the country. Immigrant and uninsured populations all over the country face cultural and language barriers to understanding and adopting U.S. insurance practices.
Ten million non-citizens living legally in the U.S. are expected to gain health insurance under the Affordable Care Act, according to KHN. The navigators at ACCESS are also trained to teach immigrants about free public health screenings for conditions such as breast cancer, which requires specialized training and conversations because of cultural stigmas associated with cancer.. At the ACCESS center in Dearborn, for example, women coming for free mammograms enter through an unmarked door.
Read the Kaiser Health News article.
- Kaiser Health News recently reported that, on average, premiums will decline in 16 major cities for the 2015 coverage year.
- Advertising for health insurance plans has already started across the country. Sign up for the 2015 coverage year begins October 15, 2014 and ends February 15, 2015, a period that is roughly three months shorter than last year’s enrollment period. Find information at healthcare.gov.
FDA Approves New Oxycodone with Abuse-deterrent Properties
The U.S. Food and Drug Administration (FDA) has approved a new extended-release oxycodone with abuse-deterrent properties. Targiniq ER—which should be used to treat pain severe enough to require daily, around-the-clock, long-term opioid treatment—contains naloxone which blocks the euphoric effects of oxycodone when crushed and snorted, or crushed, dissolved and injected. The drug is consistent with the FDA’s 2013 draft guidance for industry, Abuse-Deterrent Opioids – Evaluation and Labeling. "The FDA is committed to combatting the misuse and abuse of all opioids, and the development of opioids that are harder to abuse is needed in order to help address the public health crisis of prescription drug abuse in the U.S.,” said Sharon Hertz, MD, deputy director of the Division of Anesthesia, Analgesia and Addiction Products in the FDA’s Center for Drug Evaluation and Research. “Encouraging the development of opioids with abuse-deterrent properties is just one component of a broader approach to reducing abuse and misuse, and will better enable the FDA to balance addressing this problem with meeting the needs of the millions of people in this country suffering from pain.” Read more on substance abuse.
HHS: 10.3 Million Adults Gained Coverage in the ACA’s First Open Enrollment Period
An estimated 10.3 million uninsured adults gained health care coverage following the first open enrollment period in the Health Insurance Marketplace, according to a new study from the U.S. Department of Health and Human Services appearing the New England Journal of Medicine. The study looked at insurance trends before and after the open enrollment period, finding that the uninsured rate for adults ages 18-64 dropped from 21 percent in September 2013 to 16.3 percent in April 2014, which corresponded to a 5.2 percentage-point change, or 10.3 million adults gaining coverage. Read more on the Affordable Care Act.
Study: Parents of Obese Kids Often Don’t Realize They’re Unhealthy
Parents of obese children often don’t see their child’s weight as unhealthy and are more likely to make changes in their eating habits than to increase exercise, according to a new study in the Journal of the Academy of Nutrition and Dietetics. In a survey of more than 200 families in 2008 and 2009 to evaluate their readiness to help their children lose weight, researchers found that 28 percent of the parents did not see their child's weight as a health problem and 31 percent thought their child’s health was excellent or very good. The study also found that while 61 percent said they were trying to improve eating habits, only 41 percent were attempting to increase their child's activity level. Read more on obesity.
Ukraine Crash Kills Scores of AIDS Researchers
Malaysian Flight 17, believed to have been shot down by a missile over Ukraine yesterday, included dozens of AIDs researchers headed to Melbourne for AIDS 2014, the annual international gathering of AIDS researchers. Global Health Now, a daily newsletter produced by the Johns Hopkins Bloomberg School of Public Health, interviewed Prof. Richard Boyd, director of the Monash Immunology and Stem Cell Laboratories in Melbourne, who said, "There were some serious HIV leaders on that plane. This will have ramifications globally because whenever you lose a leader in any field, it has an impact. That knowledge is irreplaceable.” Read more on HIV.
First Chikungunya Case Acquired in the United States reported in Florida
The first locally acquired case of Chikungunya was reported in Florida this week in a man who had not recently traveled outside the United States. The U.S. Centers for Disease Control and Prevention (CDC) is working with the Florida Department of Health to investigate how the patient contracted the virus and will also monitor for additional locally acquired U.S. cases of the virus.
“The arrival of chikungunya virus, first in the tropical Americas and now in the United States, underscores the risks posed by this and other exotic pathogens,” said Roger Nasci, PhD, chief of CDC’s Arboviral Diseases Branch. Chikungunya virus is transmitted to people by two species of mosquitoes, Aedes aegypti and Aedes albopictus. Both species are found in the southeastern United States and limited parts of the southwest; Aedes albopictus is also found further north up the East Coast, through the Mid-Atlantic States and is also found in the lower Midwest.
The CDC has asked state health departments to report cases of chikungunya to help track the virus in the United States. Local transmission occurs when a mosquito bites someone who is infected with the virus and then bites another person. People infected with chikungunya virus typically develop fever and joint pain. Other symptoms can include muscle aches, headaches, joint swelling or rash. Read more on infectious diseases.
HHS Releases Health Insurance Information for Immigrant Families
The U.S. Department of Health and Human Services (HHS) recently released information clarifying health insurance coverage options for immigrant families, including:
- In order to buy private health insurance through the Marketplace, individuals must be U.S. citizens or be lawfully present in the United States.
- People who recently gained U.S. citizenship or had a change in their immigration status may qualify for a Special Enrollment Period.
- Many immigrant families are of “mixed status,” with members having different immigration and citizenship statuses. Mixed status families can apply for a tax credit or lower out-of-pocket costs for private insurance for their dependent family members who are eligible for coverage in the Marketplace or for Medicaid and CHIP coverage. Family members who aren't applying for health coverage for themselves won't be asked if they have eligible immigration status.
- Federal and state Marketplaces and state Medicaid and CHIP agencies can’t require people to provide information about the citizenship or immigration status of any family or household members who aren’t applying for coverage.
- States can’t deny benefits because a family or household member who isn't applying hasn’t provided his or her citizenship or immigration status.
- Information provided to the Marketplace won’t be used for immigration enforcement purposes.
- If a person is not eligible for Marketplace coverage or can't afford a health plan, they can get low-cost health care at a nearby community health center. Community health centers provide primary health care services to all residents, including immigrant families, in the health center’s service area.
Read more on the Affordable Care Act.
RWJF Analysis of ACA Effects Finds No Increase in New Patient Visits
A new report, ACAView, from the Robert Wood Johnson Foundation (RWJF) and athenahealth, finds that in the first five months of 2014 there was no increase in new patient visits, when compared to the same time last year. The ACAView initiative was created to measure the impact of the Affordable Care Act (ACA) on providers, patients and physicians from 2014 through 2016. The report focuses on the provider perspective, showcasing how the ACA affects the practice patterns and economics of physicians and other care team members around the country. Potential reasons for the lack of an increase in visits include the newly insured being unfamiliar with the health care system, or even the winter weather. Read more on the Affordable Care Act.
Study: Nickel in an iPad Linked to Boy’s Allergic Skin Reaction
An ever-increasing reliance on consumer electronics may also mean rarer allergies are becoming more common, according to researchers who linked an 11-year-old boy’s allergic skin reaction to the nickel found in a first-generation Apple iPad. The study was published in the journal Pediatrics. Previous studies have linked the nickel in computers, smartphones and other electronics to allergic reactions; other common sources of nickel include ear piercings, clothing fasteners and dental work. “With the increasing prevalence of nickel allergy in the pediatric population, it is important for clinicians to continue to consider metallic-appearing electronics and personal effects as potential sources of nickel exposure,” according to the study. Read more on pediatrics.
Study: Changing Generic Pill Color, Shape Can Decrease Prescription Adherence
In addition to known considerations such as side effects and cost, the change in the appearance of prescription medications may also lead some people to stop taking their prescriptions, according to a new study in the Annals of Internal Medicine. In a study of more than 11,000 patients, researchers determined that a change in pill color would increase the odds that a patient would stop taking their heart medication by 34 percent, while a change in pill shape would increase the chances by 66 percent. This adds another wrinkle to the series problem of medication adherence; the American Heart Association estimates that three out of four Americans do not take their medication as directed. Read more on prescription drugs.
Application Problems Mean 2.2M People Risk Losing ACA Coverage
Inconsistencies in their application data means that approximately 2.2 million people who enrolled for coverage under the Affordable Care Act could risk losing their coverage in isolated cases. A report from the U.S. Centers for Medicare and Medicaid Services (CMS) found that 1.2 million people filed health insurance enrollment applications with questionable income data, 461,000 had issues with citizenship and another 505,000 had issues with immigration. However, CMS also noted that 59 percent of the applications were within a 90-day window allowing them to resolve the problems. “Consumers experience regular changes in income and various life circumstances and the law accounts for these kinds of situations," said CMS, according to Reuters. "It is not surprising that there are income discrepancies given that this is a brand new process." As of mid-April more than 8 million people had enrolled for health coverage. Read more on the Affordable Care Act.
Study: Skipping Breakfast Doesn’t Hurt Efforts to Lose Weight
Common wisdom holds that people who skip breakfast actually increase their risk of obesity. However, a new study in the American Journal of Clinical Nutrition found that passing up on the first meal of the day neither helps nor hurts a person’s efforts to lose weight. The study involved 309 overweight and obese adults between the ages of 20 and 65—who were told to either eat or skip breakfast—and a control group provided with health nutrition information. Researchers found no difference when it came to efforts to lose weight. "The field of obesity and weight loss is full of commonly held beliefs that have not been subjected to rigorous testing; we have now found that one such belief does not seem to hold up when tested," senior investigator David Allison, director of the UAB Nutrition Obesity Research Center, said in a university news release. "This should be a wake-up call for all of us to always ask for evidence about the recommendations we hear so widely offered." Read more on obesity.
HHS: $300M Available to Expand Services at Community Health Centers
An additional $300 million in funding is available to community health centers as part of the Affordable Care Act, U.S. Health and Human Services Secretary Kathleen Sebelius announced this week. The funds will go toward expanding service hours and the hiring of more medical providers, as well as the expansion or addition of oral health, behavioral health, pharmacy and vision services. There are approximately 1,300 health centers operating more than 9,000 service delivery sites and providing care for more than 21 million U.S. patients. Read more on community health.
GlaxoSmithKline, Local Organizations to Give Nearly $1M in Grants to Nonprofits that Improve Community Health
In partnership with local community organizations, GlaxoSmithKline (GSK) is offering non-profit organizations 20 grants totaling $40,000 each in the Durham, N.C. and Philadelphia, Penn. regions through its GSK IMPACT Awards. The annual grants will be awarded to nonprofits in recognition of their exceptional achievements in contributing to a health in their regions. “Where we live matters to our health,” said Katie Loovis, Director, U.S. Community Partnerships and Stakeholder Engagement, GSK. “Through the GSK IMPACT Awards, we will find and honor some of the most outstanding local nonprofit organizations that are leading the difficult and often thankless work of making our community a healthier place to live.” Read more on community health.
Study: Climate Change Will Make it Harder to Keep Ozone Pollution in Check
Rising temperatures due to climate change will make it more difficult to monitor and keep in check ozone pollution in the continental United States, according to a new report from the National Center for Atmospheric Research (NCAR). The study, to be published in the Journal of Geophysical Research-Atmospheres, estimates there to be a risk for a 70 percent increase in unhealthy summertime ozone levels by 2050. “It doesn’t matter where you are in the United States—climate change has the potential to make your air worse,” said NCAR scientist Gabriele Pfister, the lead author of the new study, in a release. “A warming planet doesn’t just mean rising temperatures, it also means risking more summertime pollution and the health impacts that come with it.” The American Public Health Association (APHA) expressed strong support for the report’s findings. “As public health workers we can act to protect people from climate change’s long reach by working in concert across sectors,” said Georges Benjamin, MD, executive director of APHA. “Life-saving prevention is within reach, but must include collaboration between health practitioners and our energy, agriculture and transportation leaders.” Read more on air quality.
New Rule Requires Employers to Notify Laid-off Workers of Option to Enroll for Coverage Under ACA
In addition to paying for the full cost of laid-off employees’ work-based health coverage under COBRA, employers must now also notify laid-off workers of their option to purchase health care coverage through the Affordable Care Act’s online marketplaces, according to The Wall Street Journal. The rule was issued late last week by the Obama administration. COBRA—short for the Consolidated Omnibus Budget Reconciliation Act of 1985—allows laid-off workers to maintain their work-based coverage as long as they keep paying their share of the premium. The cost can be “a shock to people,” according to the newspaper, and ACA coverage can provide an alternative. Read more on the Affordable Care Act.
A new article from The Atlantic Cities reports on a recent study that finds that restaurants are shifting to become the predominant teen hang-out spot, rather than the malls of the past. According to a recent report on teen behavior, teenagers now spend more money on food and events than on clothes. And while an increase in mall closings may be driving younger people to eateries, the report finds that a greater interest in hanging out at restaurants also drove some of the drop in mall traffic—along with competition from the Internet.
The report doesn’t say what the teens are eating while they mingle, but the trend comes at a good time for them to access information on healthier diets, as under the Affordable Care Act many restaurants must now post nutrition information. Though studies have been mixed about the results of menu labeling, the U.S. Centers for Disease Control and Prevention notes that, overall, public health studies may be beginning to show that menu labeling may influence consumers to choose healthier options. And while many food outlets have chosen to share that information online rather than on walls, digital-savvy teens may already have the tools to find it—though they may need a push from social media or other educational outreach channels to do so.
Read the article from The Atlantic Cities.