POLICY BRIEFINGS


Senate to Prioritize Appropriations in Coming Weeks


Senate Majority Leader Mitch McConnell’s (R-Ky.) top priority when lawmakers return to Washington on April 29 is to reach an agreement on top-line federal spending levels. Negotiations are currently stalled due to Democratic demands for an increase in funding for domestic programs, while Republicans and the White House push to increase defense spending. Without a spending deal, lawmakers will have to pass a stopgap continuing resolution (CR) to keep funding at current levels or default to the sequestration cuts of the Budget Control Act (BCA), which are set to take effect in January 2020. Congress and President Trump will also have to strike a deal on raising the nation’s borrowing limit before the fall.


Number of Uninsured Increases by One Million


A new report from the Congressional Budget Office (CBO) indicates that more than one million Americans have lost health insurance coverage since 2016, with the number of uninsured individuals rising from 27.5 million in 2016 to 28.9 million in 2018. The CBO found that a reduction of the number of Americans purchasing coverage on the individual market outside of the federal and state-run exchanges was a main source of the decline. The number of people who bought unsubsidized insurance through the exchanges also declined slightly. CBO posted four new reports last week detailing its new approach for projecting health insurance coverage and premiums. The changes revise how the agency models consumers’ and employers’ behavior.


McConnell to Introduce Bill Raising Tobacco Purchasing Age


Senate Majority Leader Mitch McConnell (R-Ky.) announced plans to introduce legislation that would raise the minimum age to buy tobacco from 18 to 21. The policy would cover all tobacco products, including vaping devices, but would have exemptions for individuals who serve in the military. Eleven states have already enacted laws raising the age required to buy tobacco. McConnell’s legislation is expected to be introduced sometime in May. The Majority Leader has said that he is motivated by the rising popularity of vaping products among teenagers, and that he expects the policy to receive bipartisan support in the Senate. The change of tobacco purchasing age is supported by Altria, one of the largest U.S. tobacco companies.


Measles Cases on the Rise


The Centers for Disease Control and Prevention (CDC) has reported that the number of confirmed measles cases increased by 90 during the second week of April. This marks the third week in a row that the health officials have added to the list of people sickened by the disease, bringing the total number to 555 – the highest infection rate in the past five years and the second-greatest number of cases reported since 2000, when the CDC announced that the country was rid of measles. Twenty states have reported measles cases in 2019, but the majority of cases have been isolated to New York City, where officials have declared a public health emergency and ordered mandatory measles vaccinations or a $1,000 fine. The outbreak has been concentrated among Haredi -Orthodox Jews in Brooklyn; such insular communities have been particularly susceptible to anti-vaccine propaganda. The six current outbreaks across the U.S. are linked to travelers bringing back measles from other countries like Israel, Ukraine, and the Philippines, which are currently experiencing large measles outbreaks. Almost all states allow exemptions from vaccination requirements for people who have religious beliefs against vaccinations, with seventeen states allowing for both religious and personal or philosophical belief exemptions.

The World Health Organization (WHO) has reported that there are four times as many measles cases so far this year as there were at this time last year and has declared vaccine hesitancy as a top ten threat to global health. A total of 170 countries have reported 112,163 measles cases so far in 2019, with WHO estimating that less than 1 in 10 cases are actually reported. The measles vaccine is 97 percent effective, but a lack of access to the vaccine in poorer countries has resulted in recent outbreaks. Up to ninety percent of people who are not immune to measles will become infected if they are exposed to the virus; for every 1,000 children who get measles, one or two will die as a result. The disease can also have long-term effects on health.


FDA Commissioner Sharpless to Continue FDAs Current Agenda


Acting Commissioner of Food and Drugs Ned Sharpless made his first address to the agency last week at an allemployee meeting. One of his first acts in the position of acting commissioner will be to make product recalls and safety alerts more accessible on the Food and Drug Administration’s (FDA) website. Sharpless also stated that he will push for the use of real-world evidence (RWE) in the evaluation of medical device safety and in regulatory decision making. He stressed that the recent change in leadership will not impact the FDA’s priorities for prescription drug competition, e-cigarettes, and opioids, and that he would continue work to expedite generic and biosimilar drug and gene and cell therapy approvals, strengthen vaccine messaging, and build a diverse workforce at the agency.



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