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should the person in charge of medicare…understand medicare?

the top things to know in women’s health and wellness today: 

  • RFK, Jr. had a second nomination hearing today and showed how little he knows about Medicare and Medicaid, the massive federal health programs he would be in charge of running.
     
  • A randomized clinical trial found that immunotherapy given in addition to chemotherapy after surgery to women with “triple negative” breast cancer didn’t decrease the spread of cancer compared to just chemotherapy after surgery.
     
  • The New England Journal of Medicine has a deep dive on “shield laws” that aim to protect physicians who prescribe abortion pills via telehealth to women in abortion ban states. One issue? Licensing shared across states

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Everything
Pregnancy + Postpartum
Abortion Access
Oncology

EVERYTHING

RFK Jr. Has Another Bad Hearing (And Is Still Confused About Medicare)

What: RFK, Jr. had his second Senate confirmation hearing today, where he continued to be confused about the massive federal health programs he would oversee if confirmed to lead the Department of Health and Human Services. He did so poorly that it is not clear (yet) that he will even make it out of committee and get a vote on the Senate floor.

Key line: “[Democratic Sen. Maggie] Hassan, who sits on both panels, asked Kennedy on Thursday to explain what each part of Medicare is. But he struggled to identify and explain the fundamental aspects of the program, which provides coverage to older and disabled Americans. When asked what Medicare Part A is for, Kennedy said it is ‘mainly for primary care or physicians.’ Hassan clarified that it is coverage for seniors who receive inpatient care at hospitals.”

Source: CNBC

PREGNANCY + POSTPARTUM

Finding Ways to Flag Potential PPD

What: Researchers say they have potentially found a biomarker that could flag women most likely to experience postpartum depression after giving birth. They focused on the balance of two steroids that affect the amount of progesterone in the body. When women in the study had too much progesterone or were breaking down more of a steroid known as isoallopregnanolone, which can affect progesterone amount, they were four times more likely to develop PPD.

Key line: “The findings of the study open the door to a potential preventive treatment for pregnant women whose blood tests reveal neuroactive steroid levels associated with an increased risk of postpartum depression. ‘We don’t know if these drugs would work as a preventive measure for people who are at risk of developing postpartum depression, but based on our findings, they have the potential to prevent the development of postpartum depression,’ said Dr. Osborne. The researchers plan to replicate their findings in a larger, more diverse group of patients.”

Source: Weill Cornell Medicine

Texas Expanded Medicaid for New Moms. Does Anyone Know?

What: Texas is one of many states that has expanded Medicaid coverage to moms for a year after birth. But the Texas Tribune reports that many women *and* doctors are unaware that the expanded Medicaid coverage is now active for patients who gave birth in the past year.

Key line: “Doctors also report confusion about who is responsible for overseeing this year of health care. Texas Medicaid changed its policy to allow an OB/GYN to serve as a patient’s doctor for the whole year, but the survey found many doctors across specialties were not aware of that and, when asked, said they would prefer patients be handed off to a primary care provider. ‘Patients have been seeing their obstetrician this whole time and the health care system is not good at handing them back to a primary care physician for the rest of that period,’ Kent Davis said. ‘This is a significant culture shift for patients and providers.’”

Source: The Texas Tribune

ABORTION ACCESS

Shield Laws May Miss Medical Licensing Problems

What: The New England Journal of Medicine looks at “shield laws” designed to protect health care providers in states that permit abortion when they prescribe, via telehealth, the abortion pill to women who live in abortion ban states. They flag issues with a multi-state licensing platform, IMLC, and doctors having their licenses automatically suspended for 90 days in all participating states if an anti-abortion state in the IMLC revokes their license.

Key line: “The [IMLC] hasn’t made any public statements about the validity of shield laws for protecting participating physicians. It did, however, release a memo on the Supreme Court’s Dobbs v. Jackson Women’s Health Organization decision stating that states can pursue for disciplinary purposes a physician who provides abortion care where such care is prohibited and that physicians providing abortion care using a license from a state allowing such care are only protected if the patient is located in the permitting state at the time of treatment. The emphasis on the location of the patient suggests that the commission wouldn’t defer to a shield law holding that the patient’s location is irrelevant.”

Source: New England Journal of Medicine

ONCOLOGY

Immunotherapy Doesn’t Help in Triple Negative Breast Cancer Trial

What: A randomized clinical trial of over 2,000 patients found an immunotherapy treatment given after surgery for “triple negative” breast cancer did not make a difference in preventing cancer from coming back. Triple negative breast cancer grows faster and has fewer treatment options than other forms of breast cancer.

Key line: “This international, open-label, phase 3 trial randomized 2199 patients with stage II or III triple-negative breast cancer who had completed definitive surgery to receive standard-of-care curative-intent chemotherapy with or without atezolizumab-mediated immune therapy and did not demonstrate an improvement in recurrence rates and/or death with the addition of immune therapy (primary end point: invasive disease–free survival).”

Source: JAMA