INSIDE THE ISSUE

> Premium Subsidies
> Vaccine Bruhaha
> Safe Communities Act
> Needed Relief on South Shore

MONDAY REPORT

Rumors, But No Announcement, on Premium Subsidies

Washington last week was rife with speculation over whether there would be any sort of extension of the soon-to-expire enhanced Affordable Care Act (ACA) subsidies.

Since the start of the pandemic, the subsidies have assisted people in buying health insurance under the ACA. Without the subsidies, premiums for a large number of people would spike upwards at the end of December. Dispute over extending the subsidies led to the 43-day government shutdown that only ended when Senate Majority Leader John Thune (R-S.Dak.) – but not House Speaker Mike Johnson (R-La.) – promised to allow a vote on an extension proposal by mid-December.

Last Monday, some news outlets reported what D.C. insiders had heard over the weekend – namely that the Trump administration would announce a plan to continue the subsidies with conditions, including income caps and elimination of “zero-premium” plans for the very poor.

Some Democrats were cautiously supportive of the rumored plan, with Sen. Maggie Hassan (D-N.H.) calling it “a starting point,” while some Republicans – most notably Speaker Johnson – reportedly warned the White House that any extension of the subsidies is a no-go for House Republicans.

Science vs. CDC: Vaccines Do Not Cause Autism

The gap between the federal and state response to vaccinations has grown even wider since U.S. Health and Human Services Secretary Robert Kennedy recently directed the Center for Disease Control and Prevention to insert this language in a highlighted box at the top of the CDC’s Autism and Vaccines page: “The claim ‘vaccines do not cause autism’ is not an evidence-based claim because studies have not ruled out the possibility that infant vaccines cause autism. Studies supporting a link have been ignored by health authorities.”

Beneath that statement is the main title of the page: “Vaccines do not cause Autism.*” The asterisk leads to a footnote explaining the headline remains “due to an agreement” with the chair of the U.S. Senate Health, Education, Labor, and Pensions Committee, Dr. Bill Cassidy (R-La.).

Massachusetts officials slammed HHS for once again roiling the waters over vaccines. Governor Maura Healey issued a statement, saying, “It is disturbing and sad to witness the federal government undermining the very foundation of public health based on conspiracy theories and false information. But that’s what’s been happening. The Centers for Disease Control and Prevention – once the world’s foremost source of evidence-driven public health guidance – has taken another step down a dangerous path shaped by ideology rather than science and data. The posting last week on CDC’s website – at the direction of Secretary Kennedy – insinuating a link between vaccines and autism is the latest troubling installment. This claim is wrong and directly contradicts to decades of scientific research involving millions of people.”

Massachusetts Medical Society President Dr. Olivia Liao issued a statement, saying, “Clinical research and scientific evidence have demonstrated no credible link between vaccines and autism.”

Even the normally conservative Wall Street Journal criticized Kennedy, editorializing, “Without adults to supervise the Secretary, he’s damaging public trust in immunizations, and now the Centers for Disease Control and Prevention has been conscripted into his anti-vaccine campaign.”

Under the leadership of Department of Public Health Commissioner Robbie Goldstein, M.D., Massachusetts has stood up its own vaccine recommendations and resources and joined the Northeast Public Health Collaborative to help disseminate evidence-based public health policies.

MHA Testifies on Safe Communities Act

Last Tuesday at the State House, MHA joined a panel of healthcare providers to testify in favor of H.2580/S.1681, An Act to Protect the Civil Rights and Safety of All Massachusetts Residents, otherwise known as the “Safe Communities Act”

The bills, sponsored by Reps. Manny Cruz (D-Salem) and Priscila Sousa (D-Framingham) and Sen. Jamie Eldridge (D-Acton), would establish basic due process rights for people detained in state and local facilities for civil immigration violations, prevent law enforcement from asking people about their immigration status, and bar official collaboration agreements that deputize local law enforcement as federal deportation agents.

MHA’s Director of Health Equity Walae Hayek, testified before the Joint Committee on Public Safety and Homeland Security, saying, “We are at a time when anti-immigration rhetoric is on the rise — a climate in which misinformation and deep fears are discouraging patients and their families from engaging with the very civic, public health, and healthcare institutions that are meant to serve them … When people fear that accessing healthcare, enrolling in supportive services, or even showing up for routine appointments could expose them or their families to legal challenges, deportation threats, or discriminatory immigration accusations, they become disengaged and anxious, which in turn creates a cycle of health-related and stress-induced complications that exacerbate ongoing chronic illnesses and behavioral health problems.”

Dr. Mary Beth Miotto, speaking on behalf of the Massachusetts Medical Society, told the committee, “Across community health centers, hospitals, and medical practices of all kinds, physicians share with me the same troubling stories – families in our care are staying home in fear of immigration enforcement. Reports of detainments of both undocumented and documented individuals in cities and states across the state are keeping parents in hiding and children home from school … My patients no longer feel safe in healthcare or school settings.”

She said that many of the immigrant patients of color she treats at the Mattapan Community Health Center tell her they avoid pharmacies and medical appointments “because any outing could tempt fate.”

“When people feel safe advocating for their needs and accessing care, we see earlier intervention and better health outcomes,” MHA’s Hayek told the committee. “This is health equity in practice.”

South Shore Capacity Expands Through New Short-Stay Unit

South Shore Health announced last week that it is opening a new 10-bed short stay unit, which combined with the reopening of 10 inpatient med-surg beds, results in a net gain of 20 beds across the hospital.

The new West Unit will primarily serve patients who come through the emergency department and require additional monitoring, testing, or treatment before a decision is made about admission versus discharge.

“This expansion allows us to care for more patients in the most appropriate setting, while also reducing wait times and improving patient flow throughout the hospital,” said Sam Skura, executive vice president and chief operating officer of South Shore Health.

South Shore gained recognition for its over-and-above, coordinated response to a series of events that put enormous capacity pressures on it. The earlier closure of Quincy Medical Center’s emergency department, compounded with the abrupt shuttering of Compass Medical, Norwood Hospital due to flooding, and Signature Brockton Hospital (now reopened) due to a fire all diverted patient to South Shore, as did the collapse of Steward Health Care, which drove patients to it from nearby Brockton Good Samaritan and Dorchester’s Carney Hospital. Good Sam was bought by Boston Medical Center and is now known as Boston Medical Center – South; the future of the Carney site is still being determined. The return to previous capacity at Brockton hospitals has eased South Shore’s pressures a bit as has the new West Unit funded in full by South Shore Board Member Alan McKim’s McKim Family Foundation.

“We are deeply grateful to Alan for his remarkable commitment to South Shore Health and the community it serves,” said Allen Smith, M.D., president and CEO of South Shore Health, and a member of the MHA Board of Trustees.

John LoDico, Editor