DES MOINES, Iowa – A stopgap insurance plan presented this week to federal officials by Iowa's insurance commissioner needs to be re-worked to better protect low-income and older Iowans, according to the Child & Family Policy Center.

Mary Nelle Trefz, a health policy associate with the center, notes that the impetus for creating the plan was the expected exit of health insurer Medica from the Iowa independent health insurance market.

"So, I think this came out of the 'Oh no, we don't have any potential insurance carriers, what can we do in this emergency?' situation," she states.

Medica has since committed to staying in the market for 2018.

The stopgap plan adjusts Affordable Care Act subsidies in an effort to avoid premium spikes for Iowans who make slightly too much money to qualify for assistance.

Trefz says the state needs to go back to the drawing board in light of the Medica commitment because otherwise there will be harmful side effects focused disproportionately on low-income and older people.

Trefz adds that any stopgap measures presented to the federal government have to address what are known as the "Four Guardrails of Coverage" – comparable levels of coverage, number of individuals covered, affordability and deficit neutrality.

Trefz says the state's waiver request was well-intentioned, but the facts remain.

"The intent of this measure is really to provide more assistance to younger individuals and those with higher incomes and provide less assistance to older adults with lower incomes," she states.

Trefz suggests a variety of palatable adjustments that could be made to the state plan, such as focusing marketing efforts on attracting more younger and healthy people to the market and streamlining the signup process to make it as simple as possible to join.




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With flu and COVID-19 cases increasing during the holiday season, a Georgia doctor said now is the time to take steps to protect yourself and your loved ones.

Dr. Michael Satchell, family medicine physician at Phoebe Putney Memorial Hospital, encouraged everyone to consider flu and COVID-19 vaccinations to reduce the risk of serious illness, especially for those most vulnerable.

"Those who are vaccinated are actually 60% less likely to get a serious form of COVID or to be hospitalized," Satchell pointed out. "We're seeing that the vast majority and greater than 90% of those who are hospitalized are those who have not been vaccinated."

Satchell recommended everyone six months and older think about getting vaccinated, especially older adults and those with existing health conditions, to stay safer during the holiday season.

He acknowledged symptoms of flu and COVID-19 can overlap with a common cold but Satchell advised testing if you have symptoms like persistent cough, fatigue, or loss of taste and smell. He noted COVID-19 tests are still available online, and added it is important to consult with a provider if symptoms persist or exposure is suspected.

"It's important because there are still people dying from COVID," Satchell emphasized. "In Georgia, almost 300 people died in the last 3 months. So we're still seeing a lot of hospitalizations last season, the 2023-24 season, we had over 900,000 people across the country were hospitalized with COVID. So it's still out there."


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Groups fighting to improve access to health care are asking the U.S. Senate to reject Robert F. Kennedy Jr's nomination for Secretary of Health and Human Services.

Kennedy is an environmental lawyer who ran for president, then threw his support to Donald Trump in August.

Matthew Herdman, California state director for the nonprofit Protect our Care, said Kennedy has falsely linked vaccines to autism.

"When he went to American Samoa to talk about vaccine safety there, almost immediately afterward, there was a large measles outbreak that led to 83 Americans losing their lives," Herdman recounted. "I would be terrified to see that happen, spread nationwide across our country."

Kennedy has said one of his priorities would be to reexamine pesticides that are legal in the U.S. but banned or being phased out in Europe. He has also promoted raw milk, despite warnings from the Food and Drug Administration and the Centers for Disease Control and Prevention that unpasteurized milk can carry salmonella, E. coli, Listeria and the virus that causes bird flu.

Dr. Diana Dayal, an emergency room resident physician at UCLA Medical Center and a union representative, said she's troubled by Kennedy's beliefs.

"He has touted countless baseless claims time and time again that have later been contradicted by expert review," Dayal pointed out. "From his takes on vaccine development to fluoride safety, he misrepresents isolated data as conclusive and then interprets other studies incorrectly. Conveniently he then ignores vast scientific evidence and peer review that runs counter to his beliefs."

Chris Noble, organizing director for the group Health Access California, noted Kennedy once called the COVID-19 vaccine the "deadliest vaccine ever made."

"RFK Jr. will continue to propagate medical conspiracies that further erode trust in evidence-based medicine that will result in preventable death and grave threats to public health if given a seat of power," Noble contended.

Billions of dollars in federal subsidies for health plans on CoveredCA are set to expire next year unless the Republican-controlled Senate reinstates them. Kennedy has so far not taken a public position on the issue.

A new report on lung cancer by the American Lung Association showed Maryland has quite a bit of room to improve diagnoses and treatment but experts said the state has taken some big steps in tackling it.

The report showed almost 17% of Marylanders at high risk for lung cancer were screened, a little less than the national average. Maryland fared better in other metrics, including lower rates of adult smokers and people unable to access treatment.

Aleks Casper, Maryland director of advocacy for the American Lung Association, said to improve the state's standing, Marylanders at risk of lung cancer need to be screened at higher rates.

"If we can get people screened, our chances of impacting all the other metrics improve," Casper explained. "If we get people screened and we can find it early, then we can connect them to treatment and we can connect them to surgery, which impacts outcomes."

The report also noted Latinos in Maryland are the least likely group to be diagnosed early.

Casper pointed out certain policies in Maryland have removed barriers to diagnosis and treatment. Just this year, Maryland became one of 15 states to require insurance to cover biomarker testing, including for lung cancer. The National Cancer Institute described biomarker testing as using a sample of tissue, blood or other fluid to look for genes or chromosomes which could increase a person's likelihood of developing certain cancers, which Casper emphasized is critical.

"Being able to test and determine what the best type of treatment for that person's disease, that kind of really individualized care and giving people access to that, is really important," Casper added.

Those who want to find out if they're eligible to be screened for lung cancer can take a quick test at savedbythescan.org.


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