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What Has Mike Pence Done in Health? What Has Mike Pence Done in Health?
(3 days later)
WASHINGTON — When President Trump announced Wednesday that Vice President Pence would take charge of the nation’s coronavirus response, he repeatedly touted the “great health care” in Indiana during Mr. Pence’s time as governor there, adding, “He’s got a certain talent for this.”WASHINGTON — When President Trump announced Wednesday that Vice President Pence would take charge of the nation’s coronavirus response, he repeatedly touted the “great health care” in Indiana during Mr. Pence’s time as governor there, adding, “He’s got a certain talent for this.”
So what does Mr. Pence’s record on health care look like? He has no training or expertise in health policy. Paradoxically, the two health initiatives that he got the most attention for in Indiana are actions that many in the Republican Party have strongly opposed.So what does Mr. Pence’s record on health care look like? He has no training or expertise in health policy. Paradoxically, the two health initiatives that he got the most attention for in Indiana are actions that many in the Republican Party have strongly opposed.
In 2015, he was one of the first Republican governors who agreed to expand Medicaid under the Affordable Care Act, a move that others in his party have shunned because of their opposition to the law.In 2015, he was one of the first Republican governors who agreed to expand Medicaid under the Affordable Care Act, a move that others in his party have shunned because of their opposition to the law.
That same year, he allowed — albeit reluctantly — a program to provide clean needles for intravenous drug users in a rural county that was in the throes of an HIV outbreak.That same year, he allowed — albeit reluctantly — a program to provide clean needles for intravenous drug users in a rural county that was in the throes of an HIV outbreak.
For weeks, Mr. Pence delayed permitting public health workers to distribute the clean needles to slow the epidemic, stating moral opposition to drug use. He relented as the number of HIV cases approached 100 (they ultimately surpassed 200) and doctors from the Centers for Disease Control and Prevention pleaded with him — and after taking a few more nights to “pray on it,” according to Dr. Jerome Adams, the state health commissioner at the time and now the United States surgeon general.For weeks, Mr. Pence delayed permitting public health workers to distribute the clean needles to slow the epidemic, stating moral opposition to drug use. He relented as the number of HIV cases approached 100 (they ultimately surpassed 200) and doctors from the Centers for Disease Control and Prevention pleaded with him — and after taking a few more nights to “pray on it,” according to Dr. Jerome Adams, the state health commissioner at the time and now the United States surgeon general.
Today, his decision to allow a needle exchange — initially only for 30 days — is believed to have played an important role in slowing the epidemic.Today, his decision to allow a needle exchange — initially only for 30 days — is believed to have played an important role in slowing the epidemic.
But while his decision allowed such exchanges to open statewide, no state funding was made available for them. More broadly, critics said that Mr. Pence, like previous Indiana governors, had failed to invest adequately in public health.But while his decision allowed such exchanges to open statewide, no state funding was made available for them. More broadly, critics said that Mr. Pence, like previous Indiana governors, had failed to invest adequately in public health.
“All his public health policies in Indiana were more about his beliefs or ideology, and not evidence based or around data,” said Carrie Ann Lawrence, associate director of the Rural Center for AIDS/STD Prevention at Indiana University.“All his public health policies in Indiana were more about his beliefs or ideology, and not evidence based or around data,” said Carrie Ann Lawrence, associate director of the Rural Center for AIDS/STD Prevention at Indiana University.
As a member of Congress from 2001 to 2013, his deep opposition to abortion led him to initiate efforts to strip federal funding from Planned Parenthood. A Planned Parenthood clinic had been the only place for HIV testing in Scott County, where the outbreak took place. It closed in 2013, largely due to cuts in state public health funding.As a member of Congress from 2001 to 2013, his deep opposition to abortion led him to initiate efforts to strip federal funding from Planned Parenthood. A Planned Parenthood clinic had been the only place for HIV testing in Scott County, where the outbreak took place. It closed in 2013, largely due to cuts in state public health funding.
A 2018 study from researchers at the Yale School of Public Health estimated that putting in place a robust public health response, including needle exchanges and stepped-up HIV testing, in 2013, when Mr. Pence took office and opioid abuse was quickly growing in the state, would have averted dozens of HIV cases.A 2018 study from researchers at the Yale School of Public Health estimated that putting in place a robust public health response, including needle exchanges and stepped-up HIV testing, in 2013, when Mr. Pence took office and opioid abuse was quickly growing in the state, would have averted dozens of HIV cases.
Mr. Pence initially refused to expand Medicaid as other, mostly Democratic-led states hurried to do so in 2014, when the Affordable Care Act started giving them the option to do so with the federal government paying nearly all the cost. But he ultimately persuaded the Obama administration to let him expand the program on his own terms, including some that had not been allowed before under federal rules. Mr. Pence designed the plan with Seema Verma, then his top health policy adviser and now the administrator of the Centers for Medicare and Medicaid Services.Mr. Pence initially refused to expand Medicaid as other, mostly Democratic-led states hurried to do so in 2014, when the Affordable Care Act started giving them the option to do so with the federal government paying nearly all the cost. But he ultimately persuaded the Obama administration to let him expand the program on his own terms, including some that had not been allowed before under federal rules. Mr. Pence designed the plan with Seema Verma, then his top health policy adviser and now the administrator of the Centers for Medicare and Medicaid Services.
Under his program, called Health Indiana Plan 2.0, low-income adults above the poverty level had to pay monthly premiums equaling two percent of their household income, instead of receiving care entirely for free. In a first for the Medicaid program, they could be disenrolled for six months if they failed to pay. Newly eligible adults below the poverty level did not have to pay premiums, but got more health benefits if they did.Under his program, called Health Indiana Plan 2.0, low-income adults above the poverty level had to pay monthly premiums equaling two percent of their household income, instead of receiving care entirely for free. In a first for the Medicaid program, they could be disenrolled for six months if they failed to pay. Newly eligible adults below the poverty level did not have to pay premiums, but got more health benefits if they did.
“It gives Hoosiers the dignity to pay for their own health insurance,” Mr. Pence said at the time, “and that transaction is important to starting people on a path toward really embracing greater ownership of their health care.”“It gives Hoosiers the dignity to pay for their own health insurance,” Mr. Pence said at the time, “and that transaction is important to starting people on a path toward really embracing greater ownership of their health care.”
A state evaluation in 2017 found more than half of those who signed up for the program and were supposed to pay premiums during the first two years failed to do so, most before their coverage even kicked in. Many said the program was confusing as well as unaffordable.A state evaluation in 2017 found more than half of those who signed up for the program and were supposed to pay premiums during the first two years failed to do so, most before their coverage even kicked in. Many said the program was confusing as well as unaffordable.
Still, from 2013 to 2016, Indiana’s uninsured rate fell by 7 percentage points, more than both the national average decrease of 5.2 percentage points and the 5.5 percentage point decrease in all Medicaid expansion states, according to the Kaiser Family Foundation, a health policy research organization.Still, from 2013 to 2016, Indiana’s uninsured rate fell by 7 percentage points, more than both the national average decrease of 5.2 percentage points and the 5.5 percentage point decrease in all Medicaid expansion states, according to the Kaiser Family Foundation, a health policy research organization.
The expansion was approved just in time to provide health coverage to people newly infected with HIV as a result of the outbreak.The expansion was approved just in time to provide health coverage to people newly infected with HIV as a result of the outbreak.
Updated June 2, 2020 Updated June 5, 2020
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
More than 40 million people — the equivalent of 1 in 4 U.S. workers — have filed for unemployment benefits since the pandemic took hold. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
“Through the Health Indiana Plan model of Medicaid expansion, we learned firsthand the immense value of health insurance as a tool for responding to public health crises,” said Susan Jo Thomas, executive director of Covering Kids and Families of Indiana, a nonprofit group that advocates for health coverage. “We are all grateful that Indiana has the HIP program.”“Through the Health Indiana Plan model of Medicaid expansion, we learned firsthand the immense value of health insurance as a tool for responding to public health crises,” said Susan Jo Thomas, executive director of Covering Kids and Families of Indiana, a nonprofit group that advocates for health coverage. “We are all grateful that Indiana has the HIP program.”
A staunch conservative and evangelical Christian, Mr. Pence was also known for promoting anti-abortion legislation during his time as governor, including a law that, among other things, required that miscarried or aborted fetuses be cremated or interred. Women expressed outrage about the law on social media in a campaign that became known as #periodsforpence.A staunch conservative and evangelical Christian, Mr. Pence was also known for promoting anti-abortion legislation during his time as governor, including a law that, among other things, required that miscarried or aborted fetuses be cremated or interred. Women expressed outrage about the law on social media in a campaign that became known as #periodsforpence.
In brief remarks on Wednesday evening after Mr. Trump announced his new role, Mr. Pence mentioned only one experience handling a public health crisis: the first domestic case of Middle East respiratory syndrome, a highly infectious and dangerous virus known as MERS, in 2014, in an Indiana health care worker who had recently returned from Saudi Arabia.In brief remarks on Wednesday evening after Mr. Trump announced his new role, Mr. Pence mentioned only one experience handling a public health crisis: the first domestic case of Middle East respiratory syndrome, a highly infectious and dangerous virus known as MERS, in 2014, in an Indiana health care worker who had recently returned from Saudi Arabia.
At the time, the C.D.C. praised the hospital where the patient had shown up in the emergency room for its infection control, including its rapid isolation of about 50 hospital workers who were exposed to the patient. Mr. Pence’s role was largely receiving updates from the state health department. According to the Fort Wayne Journal Gazette, he also held a news conference at the hospital, in Munster, a few days after the diagnosis, “partly to show that it was safe to be there.”At the time, the C.D.C. praised the hospital where the patient had shown up in the emergency room for its infection control, including its rapid isolation of about 50 hospital workers who were exposed to the patient. Mr. Pence’s role was largely receiving updates from the state health department. According to the Fort Wayne Journal Gazette, he also held a news conference at the hospital, in Munster, a few days after the diagnosis, “partly to show that it was safe to be there.”
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