What the end of the CDC’s COVID vaccine access program means for uninsured Americans
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(NEW YORK) — Updated COVID-19 vaccines will soon be rolled out ahead of the fall and winter season, but some Americans may not easily be able to access them.
In previous years, the Centers for Disease Control and Prevention had a Bridge Access Program, a public-private partnership that provided free COVID-19 vaccines to adults without health insurance and adults whose insurance does not cover all COVID-19 vaccine costs.
As a result of federal funding cuts, however, the program is ending this month.
Americans who are covered by Medicare, Medicaid or private insurance will still receive the updated vaccine at no cost. The 25 to 30 million adults who do not have insurance will have to pay out of pocket to get a shot.
“The timing is really unfortunate, because we don’t yet have the 2024-25 versions of the COVID shots generally available yet, so the Bridge program will end before those are available to uninsured individuals,” Dr. Nathaniel Hupert, an associate professor of population health sciences and of medicine at Weill Cornell Medical College, told ABC News.
The CDC has allocated $62 million in unused vaccine contract funding for state and local programs to buy COVID vaccines for uninsured and underinsured adults to help broaden access, but details remain scant.
“Yes, there were $62 million unspent funds, but state and local health departments have been depleted since the pandemic,” Dr. Rebecca Weintraub, an associate professor at Harvard Medical School and director of Better Evidence at Ariadne Labs, told ABC News. “They don’t have cash reserves to start paying in advance for this type of expensive vaccine.”
Dr. Raynard Washington, public health director of Mecklenburg County in North Carolina, said purchasing enough updated COVID vaccines will be a challenge.
There about 100,000 residents between ages 19 and 64 in Mecklenburg County who are uninsured. There are not enough local resources to purchase an adequate supply of vaccines for all those adults, Washington said.
“Even if 10% of those adults wanted to receive a vaccine or needed to receive a vaccine, that still would be several hundred thousand dollars of cost that we would not be able to be able to carry,” he told ABC News.
Washington said there are still some COVID funds available that will help cover the administration costs. However, the county cannot shoulder all of the costs, he explained.
“We are planning to purchase a limited supply but, again, it won’t be sufficient,” Washington said.
Last year, Pfizer and Moderna indicated the commercial price per dose for its vaccine would be between $110 and $130. This year, prices could be just as much or even higher.
Experts say the current prices are a huge financial burden for many Americans and simply out of reach for many uninsured adults.
“People have to make a choice about whether or not they cover the cost of health care or other basic needs,” Washington said.
For children whose parents or guardians cannot afford vaccine coverage for them, there is the federally funded Vaccines for Children Program, which provides free access to vaccines.
The experts told ABC News there is a need to establish a Vaccine for Adults Program, similar to the federal program available for children. They also recommended a pharmacy discount program to help save on the cost of vaccines for low-income or uninsured residents.
Although the lack of no-cost vaccines will be a barrier, vaccines are among the most effective tools when it comes to protecting against severe illness or hospitalization from COVID, they added.
“It still is the No. 1 best tool we have to keep people safe, healthy and alive,” Washington said. “I would certainly encourage folks — particularly those adults, children and residents who are more medically vulnerable or have underlying health conditions — to make sure that they consider vaccination when the vaccines are available, hopefully in the next several days.”
(WASHINGTON) When Congress passed the Inflation Reduction Act in 2022, there was a key provision that the Biden administration fought hard for. For years, private insurance companies negotiated with drug makers over prescription prices.
However, Medicare, representing 50 million seniors, did not have the same right to negotiate prices for its Part D coverage. This meant that Medicare basically had to accept the prices offered to them.
Health and Human Services Secretary Xavier Becerra joined “Start Here,” ABC News’ flagship daily news podcast, earlier this year to announce that negotiations were starting. They had selected 10 medications to prioritize and attempt to bargain down prices.
On Thursday, during the first public event held by President Biden and Vice President Harris since the Biden dropped out of the presidential race, they revealed that they had agreed on all issues. This is being described as a significant development for anyone on Medicare, and for anyone who pays taxes to fund the expenses of Medicare.
Secretary Becerra joined “Start Here” on Friday to discuss this further.
START HERE: Mr. Secretary, last time we spoke you had just identified the drugs…they included some diabetes drugs, some arthritis medications, treatments for blood clots and blood cancer. Where are we now?
BECERRA: We are done with the negotiation, Brad. We have completed 10 drugs. Every company joined in the negotiations. We had offers, counter offers, and we hit a sweet spot with all ten. And that sweet spot will save Americans on Medicare who need these drugs lots of money. And it will save taxpayers who help fund the Medicare program lots of money, in the billions.
START HERE: Yeah. How much of a discount are we talking about here?
BECERRA: So in some cases, the discount from the list price is up to 79%. I think the lowest discount is about 38%. And I do want to caveat that a bit. Very rarely does anybody pay list price for anything. And if you do, take it back and bargain a bit. Whether it’s that car at the dealership where you look at list price, you don’t pay that. When you go to the department store, you try to find everything you can on sale or, you know at some point it’s going to go on sale.
And so everybody makes the effort to try to get the best price for whatever the product is. In this case, it’s a very important product, it’s your prescription medication. But you should still be able to get a good price, and that’s what we did. We negotiated and got a much better price than what Medicare was getting.
START HERE: But just so we can we can be clear about that caveat. You’re saying it’s 68%, say it’s like 79% less than the list price. But you guys weren’t paying the list price earlier. Can you tell us how much you were paying on these drugs beforehand, and how much the new discount you’ve gotten is?
BECERRA: Yeah. And that’s where it gets a little dicey because there are lots of nooks and crannies in the health care system. Some of them include what are, what is considered proprietary information of the companies, the drug companies, that they don’t want disclosed. And so the net price that Medicare pays is lower than the list price, but still high.
START HERE: So there’s some contract somewhere being like “You guys, no one can disclose what you guys had originally been paying.”
BECERRA: Yeah. We can’t, we can’t take you behind the curtain unless the drug companies tell us it’s okay to do so.
START HERE: Were you able to actually push back against these drug companies, or was it kind of like “We’ll ask once and then we’ll have to take what we get. We’re not going to risk not giving Americans these, these drugs.”
BECERRA: Well, let’s just say that when they came in with their offer or counteroffer, the final price was neither our initial offer nor their official offer. But here’s what I will tell you. The Congressional Budget Office, which is Congress’ budget estimator, they’re the ones that keep tabs of what legislation will cost — will it save money or will it cost taxpayers money? And they are very stingy when it comes to saying “Oh, taxpayers will save money.” Right?
Well, the Congressional Budget Office said with regard to the Inflation Reduction Act and prescription drug negotiation, they said, we believe in the first year of negotiation — which we just finished — in that first year, and they’re projecting because they didn’t know which drugs it would be, etc.. They said, we believe the Department of Health Human Services will save $3.7 billion. Well, we’ve saved $6 billion.
And on top of that, we’re saving people out of pocket another billion and a half. But here’s the kicker. They said over 10 years, they assume that this new law, over 10 years of negotiating, will save $100 billion. So if we’re already almost double their first estimate for their first year, I guarantee you we’re going to do better than the 100 billion, over 10 years.
START HERE: Okay. When do the new prices go into effect, then I guess?
BECERRA: Jan. 1, 2026.
START HERE: Okay, so when that kicks in, how much of a discount will average Medicare patients actually see? Because, like, if you guys scored a 68% discount on Farxiga, like the diabetes kidney medication, does that mean that the person using that drug is going to pay, it doesn’t mean they’re going to pay 68% less. I mean, how much less would it be?
BECERRA: Yeah. So remember, and that’s also a difficult question because seniors don’t typically pay very much for their prescription medication. Medicare the program, that’s the beauty of Medicare, it covers the lion’s share of the cost of those drugs. Some Americans still have to pay some out-of-pocket costs for their drugs, especially the higher cost drugs. So we’re going to save folks quite a bit of money.
Let’s put it this way: I can talk to you in total aggregate terms. We can now look at the price that we negotiated and say “Okay, if we had this price back in 2023, what would our cost have been?” And the result is we would have saved $6 billion to the health care program, and Americans will be able to save about a billion and a half dollars collectively in their out-of-pocket costs.
START HERE: The trade group that represents companies like Pfizer, Lilly, Merck, they’ve said we might not see as much innovation because we’re not getting as much money. That’s, that’s constantly been sort of a critique of this. They also say that your math makes assumptions about how many people truly save money on this. They say a very small amount of people actually get this Part D plan in the way that would actually save the money here. What is your response to to to these pharmaceutical groups?
BECERRA: Well, remember, they’re more than 50 million Americans who have prescription coverage under Medicare, the Part D program. There are about 9 million people in the Medicare program who use one of these 10 drugs. It’s not a small universe of people. And these are very expensive drugs. When you can bring the price down of a drug that’s listed for, say, $10,000, $12,000 to $3,000. That’s a pretty good deal. It’s still $3,000, but it sure saved you a ton of money. If you were paid $12,000 or 13,000 before that.
And so this will save not just the Medicare program money, but it will save Medicare beneficiaries money. And it certainly will pay taxpayers who today, when they work, have some of their money from their paycheck taken out so they could cover their Medicare investment into the future so that when they get turned 65, they can qualify. They will get to benefit from a strengthened Medicare program that will have those new resources available, because we didn’t have to spend it at, for overcharging us for the prescription medication.
START HERE: Well, so now, I mean, the idea is that you’ll negotiate more drug prices, right? So you got these 10 out of the way. What are the next 10 or the next 20, or do you guys have a sense of what types of drugs you’re looking to target?
BECERRA: Yeah. And here I have to be careful, because everything we say about a drug can move the price on the market. Right? And I don’t want to be accused of trying to influence the price up or down. And so what I can tell you is the statute, the new law, the Inflation Reduction Act, gave a pretty clear prescription of how to select these, set of drugs that will be negotiated. That’s a, it’s a good thing in the way, in a sense that it doesn’t let politics enter into this. It was pretty clear which drugs count. In this case, the first 10, they had to be the most expensive drugs in the Medicare system.
START HERE: All right. So then we’ll see what happens next. All right. Secretary Xavier Becerra, thank you so much.
(NEW YORK) — Gen X and Millennials in the U.S. are at greater risk for 17 cancers than were previous generations, a major new study revealed.
Researchers at the American Cancer Society analyzed data from millions of people born between 1920 and 1990 who were diagnosed with 34 common types of cancer between 2000 and 2019. They also reviewed death records from the same period.
The cancers on the rise included two types of stomach cancer, small intestine cancer, estrogen receptor (ER) positive breast cancer, ovarian, liver, bile duct and colorectal cancer, uterine and testicular cancer, gall bladder, kidney and pancreatic cancer, and two types of blood cancer: myeloma and leukemia.
A subset of mouth and throat cancers in females, anal cancer in males, and Kaposi sarcoma in males were also increasingly diagnosed in people at a younger age than in previous generations, according to the study.
The cancers with the most rapidly growing incidence among younger generations are thyroid, pancreatic, kidney, small intestine, and liver cancer in females, all of which were diagnosed at rates two to four times greater for people born in 1990 compared to 1955.
Of the cancers that are being detected more frequently, nine had previously shown a decline in successive generations at some point since 1955.
Trends in cancer death rates
While death rates from most of these cancers have decreased or stabilized, younger generations are also dying at higher rates from some of them, including colorectal cancer, which is screened for in the United States.
There could be something different about the biology of cancer in younger patients, suggested William Dahut, MD, a medical oncologist and the American Cancer Society’s chief scientific officer.
“We probably need to think of different ways to screen for these cancers,” he said.
Kevin Nead, MD, a radiation oncologist and assistant professor in the department of epidemiology at MD Anderson Cancer Center, concurred: “We should actively assess and adjust screening practices for younger individuals so that we are not missing opportunities to find these cancers early and cure them,” he told ABC News, but added that screening is a complex topic and further research is needed to identify who is at greatest risk before any changes are made.
Decoding the cancer youth wave
There are various ideas behind why people are being diagnosed with cancer at younger ages.
Ten of the cancers noted in the study are associated with body weight, the researchers wrote, implying a possible link to higher obesity rates in younger generations.
“Perhaps that is a good place to [focus] efforts for people’s overall health,” Nead suggested.
But obesity is only one piece of the puzzle. The study’s authors also suggest exposures to potential carcinogens, and lifestyle habits such as processed food consumption, alcohol use, and lower physical activity levels, may negatively affect the health of younger generations more than it did previous ones.
But Dahut admitted the evidence attributing any specific factor to the findings is still murky.
“It’s almost impossible to point to one thing,” he said. “It’s so easy for us to say ‘yes, it’s obesity’; ‘yes, it’s lack of exercise’; ‘yes, it’s processed food.’ But we do not have the data to point to.”
Some bright spots in the data
Fortunately, not everything the study uncovered is bad news.
The researchers noted substantial declines in smoking-related cancers like lung cancer among young people compared to older generations. The incidence of cervical cancer is also decreasing, likely due to the success of the HPV vaccination.
While the rates of leukemia and myeloma are increasing, the rate at which people are dying from them has declined, which Nead attributed to improvements in treatments.
So, while the overall picture may be concerning, Nead cautioned that it’s important to keep the study’s findings in context.
“It’s a huge period of time and so many things changed … between 1920 to 1990,” he told ABC News, adding, “It is possible that we are just finding more cancer that may have gone undetected before.”
Screening and lifestyle changes essential
Patients should continue to prioritize cancer screening, Dahut advised, in order to minimize the risk of undiagnosed cancers. There is also ample evidence to show decreasing alcohol and tobacco use can lower the risk of cancer, he added.
“This paper doesn’t answer … what are the risk factors for cancer,” said Nead. “But a lot is related to lifestyle factors. One of the best things that you can do … for cancer and other major health issues is take consistent steps towards a healthier lifestyle, whether that’s exercise or diet or body habits.”
(WASHINGTON) — Vice President Kamala Harris, the Democratic presidential nominee, ended weeks of speculation after selecting Minnesota Gov. Tim Walz as her running mate on Tuesday.
During his time as a member of the U.S. House of Representatives and governor of the North Star State, Walz has pushed for access to abortion and other reproductive health care. He’s also lowered drug prices and has proposed a public buy-in option for insurance.
Here’s where Walz stands on various health care issues:
Reproductive rights
Walz has been a supporter of abortion rights and was vocal about protecting access after the U.S. Supreme Court overturned Roe v. Wade in 2022.
In January 2023, he signed the Protect Reproductive Options (PRO) Act, which says everyone has a “fundamental right to make decisions about reproductive health” including abortion care, fertility treatments, contraception, sterilization and other care.
Prior to the PRO Act being signed, Minnesota already had strong abortion laws. The state does not prohibit abortion based on how far along someone is in their pregnancy and a 1995 state Supreme Court case held that the state Constitution protects the right to choose to have an abortion.
Walz, however, said the law is a “firewall against efforts to reverse reproductive freedom.”
In April 2023, he also signed the Reproductive Freedom Defense Act, which protects patients who travel to Minnesota to seek abortion care — as well as abortion providers — from legal action in other states.
Additionally, when Harris became the first vice president to visit an abortion clinic run by Planned Parenthood this year, she was joined by Walz.
The governor has also spoken about protecting access to fertility treatments and IVF. The issue is a personal one for Walz; his wife, Gwen, underwent IVF procedures for years before welcoming the first of their two children.
“When my wife and I decided to have children, we spent years going through infertility treatments,” Walz said Tuesday during his first joint appearance with Harris at a rally in Philadelphia. “I remember praying every night for a call for good news, the pit in my stomach when the phone rang and the agony when we heard that the treatments hadn’t worked.”
Access to health insurance
During his inaugural speech in 2019, Walz called health care “a basic human right.”
“What Minnesotans want from their health care is simple,” he said. “They don’t want to get sick in the first place. But if they do, they want care at a price they can afford and at a location close to home.”
During his time in the U.S. House of Representatives, where he served from 2007 to 2019, Walz voted for the Affordable Care Act in 2010, the landmark health care bill that was signed into law by then-President Barack Obama.
Walz and the Democratic leadership in Minnesota have attempted to expand MinnesotaCare, the state’s public health insurance program, to allow all residents — regardless of income — the option to buy in.
There are two bills currently under consideration in the Minnesota Legislature – HF 4745 and SF 4778 — but the governor’s office told local media the bills would not likely pass this year.
The governor has worked to expand access to health care with a record 146,445 residents signing up for private health plans for 2024 during the open enrollment period for MNsure, the state’s official health insurance marketplace, the governor’s office said.
Capping drug prices
In 2020, Walz signed the Alec Smith Insulin Affordability Act, allowing those in urgent need of insulin to go to their pharmacy once in a 12-month period and receive a one-time, 30-day supply of insulin for a $35 co-pay.
The long-term component of the law allows eligible individuals to receive insulin for up to one year, with an option to renew, and receive a 90-day supply with a co-pay cap of $50.
The governor also announced earlier this year that the state’s Department of Health was publishing a list of more than 300 drugs whose prices will be required to be reported by manufacturers, wholesale retailers and pharmacies.
These policies are similar to those implemented under the Biden-Harris administration. The cost of insulin has been capped at $35 per month for many Americans, and the federal government has begun direct price negotiations on 10 widely used drugs paid for by Medicare Part D, with plans to add more drugs to the list in the future.
