|THIS WEEK IN HEALTHCARE
What happened in healthcare this week—and what we think about it.
The future of the ACA takes center stage yet again
Across four nights of a national convention that was anything but conventional, with the nominating process, acceptance speeches, and traditional pomp and circumstance forced into a virtual format due to the coronavirus pandemic, Democrats returned to the healthcare playbook widely viewed as successful in the 2018 midterm elections. In addition to promising a more robust and concerted response to the COVID crisis gripping the nation, party leaders vowed to protect and expand the Affordable Care Act (ACA), rather than aiming to replace it with the more aggressive “Medicare for All” (M4A) approach that dominated much of the discussion during the primary campaign. In his acceptance speech on Thursday, Democratic nominee Joseph R. Biden, Jr. promised “a healthcare system that lowers premiums, deductibles, and drug prices by building on the Affordable Care Act he’s trying to rip away,” referring to President Trump’s continued support for the full repeal of the 2010 healthcare reform law. Earlier, progressive runner-up and vocal M4A advocate Sen. Bernie Sanders signaled a closing of the party’s ranks around Biden’s more moderate approach: “While Joe and I disagree on the best path to get to universal coverage, he has a plan that will greatly expand healthcare and cut the cost of prescription drugs. Further, he will lower the eligibility age of Medicare from 65 to 60.” Several other speakers highlighted the need to protect the ACA’s guarantee of affordable insurance to those with preexisting conditions, most powerfully the prominent M4A crusader Ady Barkan, who suffers from amyotrophic lateral sclerosis (ALS). “Even during this terrible crisis,” Barkan said, “Donald Trump and Republican politicians are trying to take away millions of people’s health insurance.”
In the Democrats’ successful campaign to retake the House in 2018, voters cited concerns about healthcare as their number one issue, so it was no surprise that it featured so prominently in this week’s convention. It will likely be a key rallying issue as Democrats try to win back the Senate as well; the Supreme Court announced this week that it will hear oral arguments in the Trump administration-backed lawsuit to overturn the ACA on November 10th, just a week after Election Day. Whether Republicans also choose to highlight healthcare during their nominating convention next week remains to be seen, with President Trump considering issuing an executive order to protect those with preexisting conditions, and promising to release an ACA replacement plan of his own. Either way, it seems certain that the future of the ACA will feature prominently in yet another national election cycle, as it has each time voters have gone to the ballot box in the decade since its passage. With pandemic response also on voters’ minds this year, healthcare is as polarizing a political issue in this country as it has ever been.
Pharmacists authorized to deliver childhood vaccinations
On Wednesday, the Department of Health and Human Services (HHS) issued a directive allowing pharmacists to administer childhood vaccinations, in an effort to address falling vaccination rates during the pandemic. The directive temporarily overrides restrictions in 22 states that limit pharmacists’ ability to deliver childhood immunizations for the duration of the COVID-19 emergency declaration, and enables pharmacists to deliver any FDA-approved vaccine to children age three or older, meaning infants and toddlers receiving their frequent early rounds of shots will still need to visit a doctor. Public health officials worry the pandemic has depressed vaccination rates—immunizations in children older than two fell 91 percent in the first two months of the pandemic in New York City—leaving the population exposed to outbreaks of measles and other preventable diseases. The American Academy of Pediatrics responded that the directive was “incredibly misguided” and will have little impact on vaccine hesitancy, and that pediatricians’ offices are open, safe and able to meet patients’ vaccine needs, which include reassurance and guidance from their doctor. Among specialties, pediatric office visits have been the slowest to rebound, with visits among school-age children seeing the sharpest declines. While receiving vaccines in the context of a well-child visit with a pediatrician is clearly ideal, enabling pharmacists to deliver immunizations opens another important channel for patients, and could help stave off a “crisis within a crisis” of outbreaks of preventable diseases.
Uber launches home prescription delivery service
Ride-share heavyweight Uber announced it will enter the prescription delivery business through a partnership with on-demand, digital-prescription startup NimbleRx. Uber will utilize its Uber Direct platform to deliver prescriptions directly to consumers’ homes, starting in the Seattle and Dallas markets. The company plans to expand into other cities in the coming months, building on NimbleRX’s relationships with over 700 pharmacies, mainly smaller to midsize chains, across 34 states. Uber’s entry into prescription delivery comes as national drugstore chains CVS and Walgreens have seen an exponential increase in home deliveries during the pandemic, a service they began expanding in the wake of Amazon’s acquisition of online pharmacy PillPack two years ago. In this new partnership, Uber could find demand among COVID-cautious consumers, who want to avoid unnecessary in-person visits to pharmacies and physician offices, as well as aging Baby Boomers who have growing prescription needs. And with the cost cutting fracas at the US Postal Service already delaying prescription deliveries, Uber’s offering may provide an appealing alternative for the one in five Americans who receive their medications through the mail.