The health care ballot measures to watch Tuesday – POLITICO

Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy.
Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy.
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By DANIEL PAYNE and KRISTA MAHR 

Presented by
Voters will decide the future of abortion in some states on Tuesday. | Drew Angerer/Getty Images
PUTTING IT TO A VOTE — The first major election in a post-Roe America will let voters have a voice in how the government should handle abortion.
But the measures offered on ballots throughout the country go beyond abortion — covering medical debt, Medicaid expansion, vaping and marijuana. More on those below.
— ABORTION. Five states are asking voters how to handle reproductive rights now that states have more leeway in legislating on the issue.
Voters in Montana and Kentucky can weigh in on whether they want their state governments to restrict abortion access. In Michigan, California and Vermont, voters will be asked whether abortion access should be protected under state law.
If approved by voters, Michigan’s measure would overturn a nearly century-old law that currently prohibits abortion. Voters in California will decide whether the right to abortion should be guaranteed, as will voters in Vermont.
If Kentucky’s measure passes, an amendment would be added to the state constitution that would explicitly state abortion isn’t legally protected — and tax dollars can’t go toward it. If Montana’s ballot initiative passes, it would become illegal (and punishable by up to 20 years in prison and a $50,000 fine) for a health care worker to not try to save the life of a “born-alive infant.”
Ballot measures have given activists on both sides of the issue an opportunity to move policy, even when state governments would be unlikely to change it. The votes will be key data points on the political and policy future of abortion in America.
Tuesday’s ballot initiatives come in the wake of a similar vote in Kansas, where voters rejected a policy that would restrict abortion access.
WELCOME TO MONDAY PULSE in a busy election week. Half of dentists say patients come to appointments high on marijuana or another substance — which can sometimes result in needing another visit. Extra anxiety and paranoia in the dental chair is recommended by zero out of 10 dentists.
Keep us up to date on the latest dentist/marijuana (and health care) news. Drop us a line at [email protected] and [email protected].
TODAY ON OUR PULSE CHECK PODCAST, Megan Messerly talks with Katherine Ellen Foley about the top races she’s watching that will impact who can obtain an abortion, where and how. Also, Alice Miranda Ollstein provides a dispatch from Kentucky about that state’s upcoming abortion vote.

A message from PhRMA:
The 340B program may be driving up costs for some patients. A new analysis finds average costs per prescription for a patient is more than 150% greater at 340B hospitals than at non-340B hospitals. It’s time to fix the 340B program. Learn more.
Voters in California will decide on Tuesday whether flavored vapes should be taken off the market in their state. | Mary Altaffer/AP Photo
BIG BALLOT MEASURES (II) — Other measures across the health care spectrum, though not focused on as much as abortion, are on the ballot Tuesday.
— MEDICAID EXPANSION. We may be at the end of an era with South Dakota’s ballot initiative to expand Medicaid under Obamacare.
The vote may be one of the last in the near future where voters can decide whether to grow the program. Of the 11 states that haven’t expanded Medicaid, only three have the option of getting it done through a ballot measure (and none of the three seem close to a campaign to do it).
South Dakota will become the seventh GOP-controlled state to expand Medicaid if voters say yes to its measure.
— A MEDICAL DEBT MODEL? Arizona voters will decide whether to prevent creditors from gouging people with medical bills.
It’s an approach that could be a model for Democrats in red states, especially in the absence of a federal package to address the issue.
The measure would significantly reduce the amount of interest that can be charged for medical debt — from 10 to 3 percent. It would also increase the value of the debtor’s home protection from $250,000 to $400,000 — and decrease the portion of weekly disposable income subject to debt collection from 25 percent to 10 percent.
Democrats in red states might view the ballot measure as another way to enact progressive policy when right-leaning state governments are unlikely to do so.
— HEALTH AS A HUMAN RIGHT. A ballot initiative in Oregon would, if passed, make health care a human right under the state constitution.
The state would be obligated to ensure every Oregonian has access to health care, which has led to lawmakers disagreeing about the measure’s cost and implications.
Though it hasn’t been given much national attention amid the flood of abortion policies, the measure is another strategy to further involve the government in health care at the state level.
— A BAN ON FLAVORED VAPES. California is considering a measure that would ban flavored tobacco. The results may point to the ways tobacco regulations could continue changing across the country well beyond the midterms.
The initiative led anti-smoking advocates to outspend the tobacco industry in efforts to support the ban.
— MARIJUANA LEGALIZATION. Several states are putting marijuana legalization on the ballot for voters to decide.
The measures, though some vary from state to state, focus on legalizing recreational use — and are being considered in Arkansas, Maryland, Missouri, North Dakota and South Dakota.

ANTIVIRAL COULD LESSEN LONG COVID RISK, STUDY SAYS — Taking Paxlovid could reduce the risk of long Covid, according to new research from the VA. The study is a preprint that hasn’t undergone peer review.
Getting the drug within five days of infection had about a 25-percent risk reduction for 10 long Covid symptoms.
Those benefits are in addition to the well-documented effect of less hospitalization and death for people taking the drug.
“Paxlovid reduces the risk of severe COVID-19 in the acute phase, and now, we have evidence that it can help reduce the risk of long COVID,” Ziyad Al-Aly, chief of research and development at the VA St. Louis Health Care System, who led the study said in a statement announcing the results. “This treatment could be an important asset to address the serious issue of long COVID.”

FLU AND RSV HITTING HARD — The U.S. is seeing the highest rates of hospitalization for flu in more than a decade, the Centers for Disease Control and Prevention said Friday.
At the same time, early cases of respiratory syncytial virus have been surging, Krista reports, with caseloads recently slamming some children’s hospitals.
It comes as public health experts worry about Covid-19 cases rising through the winter — a “tripledemic,” as it’s been dubbed.
Still, officials said an earlier flu season doesn’t necessarily mean the virus will be more severe than in earlier years.

A message from PhRMA:
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WAITING ON TRIALS FOR EBOLA VACCINES — Clinical trials for three Ebola vaccine candidates have been held up in Uganda as they await approval to begin the research, POLITICO’s Carmen Paun reports.
The outbreak in Uganda is six weeks old, but the start date for trials is uncertain. Though the WHO and Ugandan government have said trials will begin “in the coming weeks,” health experts worry the outbreak, left unchecked, could lead to more spread — especially as the virus has reached the capital city of Kampala, home to some 1.5 million people.
Ugandan officials said they’re confident they’ve identified and quarantined nearly all contacts of confirmed cases.
COP27 IS HERE — The United Nations’ climate talks, which began Sunday in Egypt, will include reports on climate change’s impact on health care.
At the Conference of Parties of the United Nations Framework Convention on Climate Change, the WHO is expected to urge that attention be given to both health care and climate change — with officials emphasizing the connection between environmental and public health.
The conversation about international cooperation on climate and public health comes as several international groups look to continue building plans for global pandemic preparedness.

Jon Maack was named president of Definitive Healthcare. He was most recently chief strategy and corporate development officer at Athenahealth.
Jack Marzulli is now assistant secretary for health for New York State. He most recently was a senior manager at Bain & Company.

The New York Times’ Richard Sandomir writes about the legacy of Samuel L. Katz, who helped develop the measles vaccine.
The Washington Post’s Katherine Ellison explores the lack of treatments for alcoholism.

A message from PhRMA:
The 340B program grew, yet again, hitting a whopping $43.9 billion in sales at the discounted 340B price in 2021. But there has not been evidence of corresponding growth in care provided to vulnerable patients at 340B covered entities. And making matters worse, fresh data show that 340B may actually be driving up costs for some patients and our health care system as whole. The program of today is having the opposite effect of what Congress intended when they created 340B. That’s a problem. It’s time to fix the 340B program. Learn more.
© 2022 POLITICO LLC

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