Health Insurance
Year ends with no extension for ACA subsidies
Fierce Healthcare reported that the House of Representatives this week passed a health care bill with provisions that included allowing employers to pool resources and buy insurance coverage, but that bill didn’t address the ACA premium tax subsidies, which will expire Dec. 31. Axios reported that four moderate House Republicans in swing districts joined Democrats in forcing a vote on extending the ACA premium tax credits, but that vote will likely not take place until January. The Democrats have proposed extending premium subsidies for three years, while the Senate has already voted down such a proposal. Axios also reported, however, that Senate moderates see an extension being passed in the House in the new year as a path toward a compromise on the issue. Moderate Republicans in the Senate favor a two-year extension for ACA premium subsidies while putting an income cap on eligibility.
Veteran Care
News outlets report that the VA this month will cancel 35,000 jobs
The VA this month plans to eliminate about 35,000 jobs, mostly for unfilled positions. The move will include open positions for doctors, nurses and clinical support staff. Forbes reported that a VA spokesperson said most of those positions had been created during covid and were no longer needed. CNN reported that earlier this year, administration officials announced they would terminate about 80,000 VA positions, an estimate they walked back this summer after reducing the total VA workforce by about 30,000. Veterans’ groups and union officials who represent VA employees pushed back against this month’s announcement, pointing out that the VA has been understaffed for years. News reports also noted that the number of job applications being made to the VA this year fell 57% from the previous year.
Organized Medicine
HHS yanks millions in grants to American Academy of Pediatrics
The increasingly tense relationship between the HHS and the American Academy of Pediatrics just got more heated as the HHS terminated seven grants that had been given to the association. Those grants cancel millions of dollars of funding for initiatives that support SIDS prevention, birth-defect prevention and early identification of autism, among other projects. NBC News reported that an HHS spokesperson noted that the grants were terminated because the initiatives being funded “no longer align with the department’s mission or priorities.” This summer, the AAP, along with other medical groups, brought a lawsuit against HHS over changes being made to federal vaccine policy and the removal and replacement of CDC’s vaccine advisory panel.
Infectious Diseases
Measles continues to spread, with new hotspot in S.C.
Cases of the measles are on the rise again, with hundreds of people in quarantine. CBS News reported that from Friday to Tuesday of this week, authorities in South Carolina confirmed 27 new measles cases near Spartanburg County. More than 100 people have contracted the virus there in the last two months, and more than 250 people are in quarantine. An outbreak in Arizona and Utah has grown since August, with Utah confirming 115 cases this year and Arizona confirming 176. Nationwide, there have been nearly 2,000 cases of the measles reported this year, which may lead the U.S. to lose its elimination status. Public health experts say most cases have been seen in people who are unvaccinated against the virus.
Workforce
U.S. rural areas lost 11% of family physicians from 2017-2023
New data show that the number of family physicians practicing in rural areas has shrunk 11%, dropping from 11,847 in 2017 to 10,544 in 2023. A report in Healio said that workforce experts weren’t surprised by the trend, but they weren’t expecting the drop to be so steep. The loss of family physicians in rural areas was highest in the Northeast, which saw a 15.3% drop in family physicians practicing in that part of the country. The West lost the fewest practicing family physicians in rural areas: 3.2%. The data, which were published in Annals of Family Medicine, also found that the number of women working as family physicians jumped from 35.5% in 2017 to 41.8% in 2023.
In Case You Missed It
What factors help (or hurt) career satisfaction for hospitalists?
What are the top factors that contribute to hospitalist career satisfaction—and dissatisfaction? In our latest survey, we asked respondents to rank a list of factors that make them satisfied (or not) with their careers. The most important factor in boosting career satisfaction for hospitalists who treat adults was compensation, which two-thirds of respondents ranked as their top factor. For more information about satisfiers and dissatisfiers for hospitalists,see Today’s Hospitalist survey coverage.
End-of-life talk vs. “serious illness discussions”
End-of-life conversations in the hospital are much easier when they start as “serious illness discussions” and patients are still stable. In a new Today’s Hospitalist report, two palliative care experts talk about how and when to initiate that discussion. They also share tips on how to make a prognosis and manage end-of-life symptoms..
