Author: Linda Rider

  • 9 Tips For Lowering Your Risk of Heart Disease

    9 Tips For Lowering Your Risk of Heart Disease

    Among Americans, heart disease is the leading cause of death. Someone has a heart attack every 40 seconds in the US. While heart disease statistics are scary, heart disease, generally speaking, is preventable for those who don’t have preexisting heart conditions. 

    However, there are challenges and several risk factors that can’t be changed, including family history, sex or age. Additionally, some people don’t have access to heart-healthy foods and others don’t have the opportunity to see a doctor and get insights about their current health status. 

    For the most part, however, the average person can significantly reduce their risk of heart disease with simple lifestyle changes, like the nine steps detailed here.

    Health tips don’t end here. Check out tips to help you quit drinking alcohol, a dietary supplement that doubles as a sleep aid, and the best food for lowering blood pressure

    a close-up of runner's shoes

    These lifestyle changes can significantly boost your heart health.


    Getty Images

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    1. Take a daily walk

    Decades of research support cardiovascular exercise as a first defense against heart disease. Walking is an easy, simple way to get cardio exercise in, and you can do it pretty much anywhere outdoors or indoors with a treadmill. 

    Studies show that walking can prevent heart disease risk despite being a less intense modality than other forms of cardio exercise, such as hiking, jogging or cycling. Plus, research suggests that more people stick to a walking plan over time versus other types of exercise, which makes walking more effective in the long run (no exercise is effective if you don’t keep it up). 

    And you can always make your walk harder if you want to improve your health even further. 

    Related: Best Treadmill for 2022

    2. Strength train a few times each week

    Most research on heart health and exercise has focused on aerobic exercise like walking. An emerging body of research points to resistance training as another way to reduce your risk of heart disease. In fact, a 2018 study found that lifting weights for less than one hour a week could reduce your risk for a heart attack or stroke by up to 70{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} — independent of aerobic exercise, making these results even more significant.  

    According to Johns Hopkins Medicine, this profound effect probably has something to do with the way weightlifting changes your body composition. Lifting weights helps you build muscle and lose fat. Excess body fat is a major risk factor for heart disease, so any exercise that helps you reduce body fat is helpful. 

    You don’t need a gym or fancy equipment to start strength training. Bodyweight exercises, such as air squats, push-ups and lunges, provide the same strengthening benefits at home.

    3. Eat heart-healthy foods

    Many delicious foods have a direct link to improved heart health. In general, a diet rich in whole grains, fruit, vegetables, lean protein and healthy fats from nuts, seeds, fish and oils promotes heart health. If you don’t have access to fresh produce, frozen and canned fruits and veggies work just as well (just be mindful of salt intake when eating canned foods). 

    4. Limit foods linked to heart disease

    On the flip side, several foods have direct links to heart disease. To reduce your risk of heart disease, limit high-fat and high-sugar foods such as potato chips and store-bought desserts. Highly processed foods, including most fast food, processed meats (think hot dogs and cured meats) and boxed snacks like Twinkies and crackers, also contain ingredients harmful to your heart. 

    Specifically, look out for trans fats (hydrogenated oils) and high-fructose corn syrup, two common key ingredients that aren’t great for your heart. Trans fats increase “bad” cholesterol and triglycerides in your blood, while high-fructose corn syrup is a driver of several heart disease risk factors and comorbidities. 

    Side note: Don’t be afraid of saturated fat on its own, as research has debunked the myth that saturated fat alone leads to heart disease. Many healthy foods, such as avocados and cheese, contain saturated fats. Processed foods are often high in saturated fat, but it’s more so the trans fats and refined carbohydrates to look out for. 

    5. Quit smoking

    It’s common knowledge by now that smoking is just plain bad for health. Your heart is no exception. According to the Food and Drug Administration, cigarette smoking is a leading cause of cardiovascular disease, including heart attacks and strokes. 

    Smoking impairs your cardiovascular system in a few ways: It leads to plaque buildup in your arteries, changes your blood chemistry and thickens blood, and permanently damages your heart muscle and blood vessels. The National Heart, Lung and Blood Institute says that even an occasional cigarette can cause substantial damage

    6. Limit alcohol intake

    We’re not here to tell you that you can’t enjoy your favorite cocktail or crack a cold one on game day, but we’d be remiss if we didn’t mention the consequences of excess alcohol consumption. Drinking too much is generally bad for all your body systems. 

    In regard to heart health specifically, alcohol has been linked to various cardiovascular diseases, including hypertension, coronary artery disease, peripheral artery disease and stroke. However, the exact relationships vary greatly depending on the quantity and pattern of consumption. 

    The American Heart Association maintains that drinking in moderation is OK, but once you inch past that mark (one drink per day for women and two for men), things take a turn for the worse. And, no, the link between red wine and heart health isn’t all that clear

    7. Keep stress levels low

    More research is needed to understand exactly how stress contributes to heart disease, but scientists have observed a relationship between stress and heart health. For starters, high levels of chronic stress can trigger unhealthy coping habits, such as smoking, drinking alcohol or eating lots of high-fat or high-sugar food. Stress also undermines your body’s ability to rest and sleep. 

    Researchers have even identified a specific and unusual sort of heart attack called takotsubo cardiomyopathy, also known as stress cardiomyopathy and “broken heart syndrome.” This condition has been linked to emotional trauma, but many patients with this condition exhibit no identifiable cause

    So, don’t underestimate the impact of stress on your heart. While stress is inevitable and unavoidable at times, it helps to have a handful of stress-relief tactics to rely on in times of extreme duress. 

    8. Prioritize sleep

    If there were a miracle drug, sleep would probably be it, with exercise coming in a close second. Scientists have positioned sleep deprivation as a risk factor for heart disease because of inverse relationships between sleep duration and cardiovascular diseases: It seems the less sleep you get, the higher your risk for cardiovascular events. 

    Insomnia and sleep apnea have also been linked to heart disease, and sleep duration and quality seem to have a direct effect on blood pressure. Indirectly, sleep deprivation causes people to make poorer food choices and lack motivation to exercise, both of which increase the risk for heart disease. 

    Read more: Why You Should Skip Your Workout If You Didn’t Get Enough Sleep

    9. See your doctor and keep up with health records

    If you’re able to, schedule a yearly checkup with your doctor to make sure all’s in order. 

    Getting a blood panel that checks for cholesterol, triglycerides, blood sugar and other important health markers can help you keep close tabs on your heart health. If you don’t have a primary care doctor, call your nearest urgent care or walk-in clinic to see if it offers basic blood tests. At the very least, checking your blood pressure with an at-home monitor gives you some indication of how you’re doing. Keep track of your health records so you can identify any changes or patterns over time.

    If any indication of heart disease arises, don’t be afraid to ask your doctor any questions. Make sure you understand what the numbers mean, what changes you might need to make to your lifestyle, and if you’ll need any medications. Being an advocate for your own health gets you far. 

    Want more health tips? Read here how to naturally cure an upset stomach, 8 tips to help you quit smoking and how 15 minutes a day can make you more fit

    The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

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  • How rumours of Hollywood’s Ozempic drug use went mainstream, fuelling a shortage in diabetes medication

    How rumours of Hollywood’s Ozempic drug use went mainstream, fuelling a shortage in diabetes medication

    When talk show host Andy Cohen complained that some celebrities were dropping extreme amounts of weight, he unveiled Hollywood’s worst-kept secret.

    “Everyone is suddenly showing up 25 pounds lighter,” he tweeted.

    “What happens when they stop taking #Ozempic?????”

    He was referring to semaglutide, which is sold under the trade name Ozempic, a drug developed to treat type-2 diabetes by lowering blood sugar levels and regulating insulin.

    Taken in the form of weekly injections, it has been hailed as a game changer for American diabetics because of its effectiveness and ability to improve a patient’s quality of life.

    However, more recently, it has become known for its side effect: weight loss.

    One study, funded by the manufacturer, found the drug helps suppress hunger and prompts the stomach to empty more slowly.

    In the past year, the injectable drug has become increasingly popular with celebrities, tech moguls and TikTok influencers as a quick and effortless way to lose weight.

    Twitter owner Elon Musk told fans that he credits his “fit, ripped and healthy” appearance to a combination of fasting and injections of the drug.

    Hollywood trade publication Variety claimed that celebrities are forking out $2,200 every month for an off-label prescription of the drug to transform their bodies.

    However, as TikTok influencers hail the “skinny pen” as a quick weight-loss fix, diabetic patients who need the drug to manage their condition — and those who have been advised to lose weight for their health — are left in a desperate situation.

    There is now a severe shortage of semaglutide in many countries around the world.

    Australians who rely on it have been told they may have to go without until at least March.

    Hollywood’s obsession with weight loss and the rise of this drug

    The rush on semaglutide and its popularity on TikTok has coincided with what style writers claim is a global resurgence of the “skinny trend”.

    With Y2K-inspired low-rise jeans back in fashion and the hashtag #SkinnyLegend doing the rounds on TikTok, health experts feared a surge in toxic diet culture was imminent.

    “We tried this in the 90s and millions of people developed eating disorders,” British actress and body-positivity advocate Jameela Jamil has said.

    “We’re not doing this again. We’re not going back. Our bodies are not trends.”

    Jameela Jamil poses in a black strapless gown
    British actress Jameela Jamil says misuse of semaglutide is behind “the notable plummeting of weight” among celebrities. (Reuters: Aude Guerrucci)

    Jamil has also slammed GPs, medical spas and beauticians for helping celebrities access the drug for aesthetic reasons.

    “Don’t take the ‘skinny pen’ — or whatever other normalising names they have given — for a new starvation method,” she said.

    Semaglutide works by imitating a gut hormone called GLP1, which allows the body to feel fuller for longer and reduces appetite.

    It comes in two primary dose levels, one — sold as Ozempic — has been available in the US since 2017 and Australia since 2019 and has primarily been used for diabetes patients because of its ability to manage glycated haemoglobin.

    When blood sugar levels start to rise after eating, the drug stimulates the body to produce more insulin, helping to reduce blood sugar levels.

    The other option, Wegovy, is a newer, higher-dose version that was approved by the US Food and Drug Administration last year, and works similarly but is prescribed exclusively to patients who want to “eat fewer calories, and lose weight“. It is not yet available in Australia.

    Semaglutide can be highly effective, with one study attracting attention last year after finding participants lost on average 15 per cent of their body weight.

    “The older drugs that we’ve had for weight management, we’ve had those for over 10 years, some of them we’ve had since the 1950s, like phentermine,” said Amanda Velazquez, who works at Cedars-Sinai Center for Weight Management and Metabolic Health in Los Angeles.

    Medical consultation between patient and practitioner.
    Doctors have been urged to prescribe alternative treatments for diabetes that may be just as effective as semaglutide.(Pixabay)

    “Those medications help people lose somewhere around 5 to 10 per cent of their weight. [But] people didn’t pay as much attention to these medications until Wegovy came around.”

    As the pens became more and more popular, both options suffered from supply shortages.

    This, in turn, worked “like a domino effect”, sparking shortages worldwide and forcing patients to move on to other drugs such as Trulicity, said chair of the diabetes network at the The Royal Australian College of General Practitioners Gary Deed.

    TikTok videos advertising to people who ‘may not need the medication’

    Health authorities in the US and the UK have confirmed shortages of semaglutide, but have said only that an increase in demand is to blame.

    Meanwhile, in Australia, the Therapeutic Goods Administration (TGA) has suggested the drug’s popularity online had sparked the shortages.

    “When videos about achieving rapid weight loss with Ozempic went viral on TikTok, the trend was also reported online and across other media,” the TGA said in November last year.

    “This triggered a huge demand for the product that the manufacturer was not prepared for, and it quickly developed into a worldwide shortage.”

    The drug’s Danish manufacturer, Novo Nordisk Pharmaceuticals, reported that it struggled to keep up with an “unexpected increase in consumer demand” in 2022.

    The TGA said it’s investigating what could be unlawful advertising of Ozempic in Australia, and is in touch with social media platforms, including TikTok, to discuss the ways the drug is being discussed online.

    A screenshot of a page displaying videos of people talking about Ozempic.
    The drug’s hashtag has received more than 383 million views on TikTok.(Supplied)

    The search for this drug has generated more than 383 million views on TikTok, with many crediting it for their shrinking bodies.

    Under the hashtag, users share before and after videos of themselves or detail their weight-loss journey.

    However, health experts warn it’s not a cure-all.

    “I worry that, with the TikTok videos and things like that, it’s broadcasting and advertising to populations who are not in need of this medication, and perhaps using it for the wrong intentions,” Dr Velazquez said.

    “We have specific criteria from our national guidelines as to who would benefit most from the medication and, if someone does not meet those criteria, they should not be taking these medications.”

    Those taking the injections are required to make changes to their lifestyle, whether that be adopting healthy eating habits and/or increasing their exercise regimes.

    There are also the drug’s side effects, the most common including nausea and constipation, while some patients have also reported losing their appetite and no longer finding food appealing.

    The drug can also be expensive for patients without insurance in America, costing upwards of $US892 ($1,300) for a month’s supply.

    It is much cheaper in Australia when accessed via the Pharmaceutical Benefits Scheme, at around $130 per month.

    For most patients, some slightly uncomfortable symptoms may be worth it, but Dr Valazquez said the drug was not recommended for people deemed to be in a healthy weight range hoping to lose a few kilograms.

    “We don’t have any research yet for that population who does not meet the criteria [for the drug] to know if there’s going to be long-term consequences for them [using it],” she said.

    A study has also found that, once patients stopped taking the drug, they were more likely to gain the weight back.

    At the end of the day, Dr Velazquez said, the primary goals was to “make these medications accessible to the patients who need them the most”.

    “So anyone who’s taking the medication, when it’s not indicated for them, based off of guidelines, is one less person who can’t take it, who may need it.”

    Diabetics lose out

    With the drug in short supply in Australia, diabetics have gone online to explain how the run on it has impacted their daily lives.

  • 6 fitness questions, answered | MD Anderson Cancer Center

    6 fitness questions, answered | MD Anderson Cancer Center

    Some individuals make training search so quick. They’re at the gym a number of times a week, submitting jogging moments from their physical fitness application. It’s like they know something the rest of us do not.

    So, what do they know that the relaxation of us really don’t? We talked to MD Anderson fitness professional Carlos Duncan and received his just take on frequent conditioning concerns.

    1. What is the solution to keeping inspired?

    Motivation will come and goes. Arranging and willpower are key to attaining any objective you want to execute.

    Come across fitness things to do you delight in so doing the job out doesn’t come to feel like a chore. Get an accountability companion who shares related targets. If you are someone who struggles with time administration, put work out on your calendar. If you get started to shed determination, test one thing new to give you a strengthen.

    2. Which is better for dropping bodyweight: eating plan or exercise?

    Controlling what you eat will make a increased impact on fat decline. Your energy intake has to be a lot less than your vitality expenditure. But it will just take a blend of both equally diet plan and exercising to preserve the weight off. Exercise will help you get energy and stamina while sculpting the entire body.

    Without having exercise, you can eliminate fat, but you also shed muscle, strength and endurance in the method.

    3. How lengthy does it consider to see outcomes?

    This can differ depending on a lot of components which includes dietary practices, frequency of workout, and intensity and period of workouts. On common, most people will see visible actual physical variations following 6 to 8 weeks of regular physical exercise.

    But really do not target on aesthetics only, particularly if you are undergoing cancer procedure. Pay attention to your body and recognize the other positive aspects of exercising — elevated electricity, endurance, and strength, which may possibly start off to seem in as very little as two to 4 months.  

    4. Can I get the similar benefits if I really do not have exercise devices?

    You do not require a good deal of tools for an effective training. Quite a few easy house things can effortlessly be employed to simulate typical health club machines. An illustration is h2o bottles for weights or stairs for phase-ups. Moreover, there are numerous exercises you can carry out that have to have only your human body bodyweight as resistance – for case in point, lunges or squats into a chair.

    5. Do I need to physical exercise each day to notice overall health rewards?

    Physical activity requirements vary dependent on the person and their specific physical fitness objectives. MD Anderson endorses at minimum 150 minutes of reasonable exercising or 75 minutes of vigorous exercising every single 7 days, moreover, toughness instruction physical exercises two instances a 7 days. Most cancers individuals may possibly want to stick to reasonable workout like going for walks or swimming.

    If these quantities seem like a good deal, keep in mind that any amount of work out is beneficial, even 5 or 10 minutes a few of instances a working day. Do whatsoever you can manage on that certain working day.

    6. What is your exercising motto?

    I often notify individuals, ‘It’s progress, not perfection.’ It is not likely to be perfect. Things come up, you get unwell, you have to decide on up the young children from college, and you simply cannot usually adhere to your system. But you’re almost certainly doing additional than you have been in the earlier, and that’s a acquire.

    Also, really don’t examine on your own to other individuals. In its place, concentration on how considerably you’ve occur from in which you started. Keep in mind that your journey is yours and how you get there will be various from anybody else’s. People men and women you see on social media or in journals make going to the fitness center like a task. They may be working out for 2 or 3 hours at a time, which is unachievable for most folks.

    Target on how you feel and do what you can do at that instant. Attempt to take in healthily and watch your portions. It is all based on your way of living.

    Ask for an appointment at MD Anderson on line or by calling 1-877-632-6789.

  • Podcast: No Health Care News Shortage in 2023

    Podcast: No Health Care News Shortage in 2023

    00;00;08;27 – 00;00;19;24
    Kathleen Haddad
    Hello and welcome to another episode of “Health Affairs This Week”, the podcast where Health Affairs editors go beyond the headlines to explore the health policy news of the week. I’m Kathleen Haddad.

    00;00;20;17 – 00;00;21;20
    Chris Fleming
    And I’m Chris Fleming.

    00;00;21;29 – 00;00;49;00
    Kathleen Haddad
    So, Chris, last episode, we recapped the major developments of last year. But one last piece of health policy news broke after our last show. The 1.7 trillion omnibus spending bill that was enacted right before Christmas. It not only kept government open but contained important health policy advancements. Before we get rolling on that discussion, though, there were two news items of the past week that received scant attention.

    00;00;49;16 – 00;01;07;16
    Kathleen Haddad
    First, the FDA announced that misoprostol could be sold in pharmacies. That’s the abortion pill, and it can be prescribed via telemedicine appointments. Previously, the drug could only be given at a doctor’s office, which was an inconvenience and that made it inaccessible for many women.

    00;01;08;01 – 00;01;11;01
    Chris Fleming
    And Kathleen, what’s what’s the second news item that you mentioned?

    00;01;11;21 – 00;01;38;14
    Kathleen Haddad
    Chris, there’s a new COVID variant amongst us. Yeah, it’s called XBB.1.5. Dr. Zeke Emanuel, a former White House COVID policy adviser, says this this new variant comprises about 40{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of current infections, which seem to be rising or are expected to rise after the effects of the holidays show in the data.

    00;01;39;05 – 00;01;47;26
    Chris Fleming
    Oh, well, it seems kind of redundant to say this with any sentence that it contains the word new variant and COVID, but that really doesn’t sound like good news, Kathleen.

    00;01;48;14 – 00;02;08;25
    Kathleen Haddad
    Well, medical experts say it’s the most infectious variant yet. And that will be interesting just to see how it plays out and how much strain it puts on the hospital system. But Chris, let’s move on to the huge government funding law enacted just before Christmas. It’s hard to know where to start in dissecting this massive law, but what can you tell us?

    00;02;09;19 – 00;02;36;23
    Chris Fleming
    Well, Kathleen, as you know, and you referred to earlier, we’ve developed this habit of ending our congressional sessions with these very large, catch-all bills at the end of the session. And, you know, I’d say that this is a crazy way to run a railroad if I wasn’t watching the as we record today on January 5th, the House trying to choose a speaker and going through multiple ballots for the first time in a century.

    00;02;37;15 – 00;03;19;16
    Chris Fleming
    But anyway, these these omnibus bills, as they’re referred to, they’re always chock full of pretty much everything and then certainly chock full of important health policy provisions. And this year was no exception. One example, physicians were facing a reduction in Medicare payment of, I think, 8.5{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} for 2023. And needless to say, they weren’t particularly happy about that. The omnibus eliminated a big chunk of that impending cut — that made physicians happier –but it still left a 2{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} cut for this year, for this year, for 2023, plus another 3.5{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} cut scheduled for next year for 2024.

    00;03;19;16 – 00;03;28;24
    Chris Fleming
    And that, needless to say, made physicians less happy. But the nature of these huge bills is that, you know, you tend to get half a loaf, you know, rather than the whole loaf.

    00;03;29;17 – 00;03;32;27
    Kathleen Haddad
    So, Chris, what about the value based payment?

    00;03;33;06 – 00;03;54;02
    Chris Fleming
    Right. So Congress, there was a value-based care bonus for physicians who participate in alternative payment arrangement. That would not…before the omnibus that would not have been available next year. Congress did make it available, but they reduced it. Used to be 5{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}. They cut it down to 3.5{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}.

    00;03;55;04 – 00;03;57;16
    Kathleen Haddad
    So what’s in the law on the hospital side, Chris?

    00;03;58;09 – 00;04;28;14
    Chris Fleming
    Ah, well, the omnibus. One of the things the omnibus did is it extended through 2025 two programs that help out rural hospitals that were scheduled to expire this year. The programs are the low-volume hospital program, which helps hospitals with a small number of Medicare patients. And on the other end, the Medicare Dependent Hospital program. And that’s a program that helps hospitals where the Medicare share of total patients is high.

    00;04;29;13 – 00;05;10;10
    Chris Fleming
    Would also, the omnibus also does extend for two years some telehealth flexibilities that were introduced during the pandemic through CMS waivers. These relax the site restrictions the the restrictions on the geographic sites that telehealth can be used for. And also it provide some flexibility regarding the use of audio only telehealth. We tend to think of video and high tech when we talk about telehealth, but turned out, maybe surprisingly to some, that audio-only because some people just don’t have access to broadband.

    00;05;10;10 – 00;05;38;02
    Chris Fleming
    And for other reasons, audio-only became very important during the pandemic. Many had hoped that that that these would be these would be extended permanently. But, you know, obviously, two years, in the view of many is better than nothing. And back to the half a loaf theme from earlier now. And I also should add very quickly that the omnibus also extended something called the Hospital Home program, and that’s something that was important during the pandemic.

    00;05;38;02 – 00;05;47;06
    Chris Fleming
    It allows hospitals to treat more acute care patients at home through mechanisms like remote patient monitoring, telehealth and in-person care.

    00;05;47;16 – 00;06;01;01
    Kathleen Haddad
    Right. And I think what the Health Affairs journal, we’ve published a number of articles on that topic. Let’s go move forward to the Medicaid related provisions. What do you know about that?

    00;06;01;09 – 00;06;31;08
    Chris Fleming
    Yeah, there’s there was some really important stuff that, you know, raising will raise some challenges, but there’s some the omnibus attempted to to meet that challenge by including some some safeguards as well. Let’s back up a little bit in the Families First back, I think in 2020, early in the COVID pandemic, in the Families First Act, Congress gave states this bump in Medicaid funding, I think 6.2 percentage points.

    00;06;31;08 – 00;07;00;08
    Chris Fleming
    But to get that money, states had to to to do follow what are called, “maintenance of effort” requirements, which meant that they had to suspend Medicaid eligibility redeterminations during the public health emergency. And that was declared by the federal government in connection with COVID. So once someone was on Medicaid, you couldn’t go through and do the sort of the normal process that states do of checking whether they were still eligible.

    00;07;00;18 – 00;07;22;06
    Chris Fleming
    So this is a big deal because, you know, during the pandemic, the that was a big deal because that Medicaid program grew. It grew like 30{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}. And the program had, you know, really it was a really huge kind of pillar for folks trying to weather the pandemic who might have lost their jobs and would have lost health insurance.

    00;07;22;28 – 00;07;44;14
    Chris Fleming
    So the emergency that this was tied to, the public health emergency, is still in effect. But the omnibus actually ended this maintenance of effort requirement, and that ends as of April of this year, April 2023. And that means that states at that point will be able to return to normal eligibility redeterminations.

    00;07;44;21 – 00;07;50;22
    Kathleen Haddad
    Chris, what are the protections against immediate disenrollment for Medicaid enrollees?

    00;07;51;10 – 00;08;13;29
    Chris Fleming
    Right, and that’s that’s an important question, because the worry is, you know, that it won’t just be people who are actually, who’ve who’ve become ineligible that would lose their eligibility would be pushed off the rolls. It might be people who were still eligible, but they’re you know, communications issues, getting in touch with many Medicaid beneficiaries, there are bureaucratic errors.

    00;08;14;09 – 00;08;50;16
    Chris Fleming
    So, you know, the omnibus tries to deal with that. It has this instead of just eliminating that 6.2 percentage point bump in Medicaid payment entirely, it has a transitional phase where the payment is still there for the rest of 2023, but goes away in stages. And to get that money, states do have to agree to some safeguards. So, for instance, if they try to mail…reach a Medicaid enrollee by mail and don’t get a response, they just can’t kick him off the roll– him or her– off the rolls.

    00;08;50;29 – 00;09;15;12
    Chris Fleming
    They need to try to reach the person at least one other way. Joan Alker on the “Say Ahhh!” blog and many of her colleagues at Georgetown, they do a great job of covering these safeguards and the omnibus in general. They note also, for instance, importantly, that, you know, there are some some pro-coverage elements involved as well. So states will end up covering children continuously

    00;09;15;12 – 00;09;35;09
    Chris Fleming
    now for 12 months in Medicaid and CHIP as a result of the omnibus, regardless of changed circumstances. And the omnibus also extends the overall CHIP funding with some important policies, such as express lane eligibility for two years. And I think now through the end of fiscal year 2029.

    00;09;35;09 – 00;10;10;21
    Kathleen Haddad
    I think HHS estimates that 15 million people could could lose Medicaid coverage and that maybe half of them or almost half are are eligible, even though they might get notices or be dropped. So these protections are important. I wanted also to note that Medicaid can now extend post-natal coverage from two months to 12 months. That’s a permanent provision. Now, I think currently 27 states do that.

    00;10;11;07 – 00;10;40;19
    Kathleen Haddad
    And so that is something that’s important for post-natal health and mental health. I wanted also to mention, Chris, that the omnibus provides a lot of funding for mental health programs and changes in Medicare mental health coverage. Previously, Medicare didn’t pay for counseling provided by marriage and family therapists or licensed mental health counselors. Now, Medicare will pay for that under the law.

    00;10;41;02 – 00;11;19;28
    Kathleen Haddad
    And to address the mental health workforce shortage, the law funds 200 new residency slots with half reserved for training psychiatrists. The 988 emergency mental health line colloquially only known as the Suicide Hotline, received $400 million in increased funding to address the opioid crisis. The law now allows doctors to prescribe buprenorphine without a special waiver from the DEA. The drug used to treat its use to treat opioid use disorders, and advocates say it is simply not being used widely enough.

    00;11;19;28 – 00;11;26;13
    Kathleen Haddad
    So this provision is aimed at increasing the use of appropriate use of buprenorphine.

    00;11;26;26 – 00;11;46;25
    Chris Fleming
    And now let’s bring it back to the public health arena where we started this this session. One of the things about the omnibus that’s interesting from a health policy point of view is it requires, I believe, Senate confirmation of the CDC director, right? That that sounds like it’ll be a non-contentious confirmation hearing.

    00;11;47;26 – 00;12;17;16
    Kathleen Haddad
    Right, Chris. So currently the CDC director appointment does not require Senate confirmation as do other agency heads. But beginning in January of 2025, confirmation will be required. And the interesting part of this is that it was a bipartisan bill or effort that put this provision in sponsored by Patty Murray and Richard Burr. I it’s going to be interesting to see how it plays out.

    00;12;18;00 – 00;12;33;10
    Kathleen Haddad
    Their purpose, legislative intent, there was to cope with another pandemic more easily than we did this one. But like you say, it’ll be interesting to see if that’s that’s really the case.

    00;12;33;10 – 00;12;45;08
    Chris Fleming
    Well, I think, you know, there’s much more to be said about the omnibus and the other news that you started us out with. But I think we’re we’re pretty much running out of time today, so I think we may have to end it there.

    00;12;46;00 – 00;13;22;01
    Kathleen Haddad
    As you say, Chris, the omnibus is chock full of health policy provisions, including many we haven’t been able to get to. I also want to remind listeners that next week, on January 11th, we’ll be restarting our “Health Affairs Pathways” podcast series, which is our fellowship program. Next week we begin with Michael Shen who is a physician. He talks about how Medicare payment and Medicaid payment to hospitals doesn’t fund everything they need funded in order to do their jobs.

    00;13;22;14 – 00;13;44;15
    Kathleen Haddad
    The podcast is terrific. I suggest you listen if you want to understand anything about payment to hospitals in our disjointed health care system. This is where to learn it. But thanks for your knowledge, Chris, and Happy New Year and thanks to our listeners. Be sure to subscribe to “Health Affairs This Week” wherever you get your podcasts.

    00;13;45;02 – 00;13;55;27
    Chris Fleming
    Thanks, Kathleen. It was it was fun, as always.

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