A Raw and Relatable Plea for Action

By Juliana Keeping, communications manager
 

Our country has committed to write checks to the elderly that it won’t be able to cash — and the window for Congress and the president to act and fix the situation is closing fast. The Medicare program’s long-term fiscal challenges were underscored yet again by the release of the annual Medicare Trustees report. Each year, the trustees are required by law to report out to Congress on the financial and actuarial status of Medicare trust funds.

Why it Matters: Medicare’s yearly Magic 8 Ball shake was definitive, again. One key measure of health, the fund financing hospital spending, is going to run short in 2028, the report found. Medicare spending has been increasing due to rising per capita health care costs and the aging of the baby boomer generation, which is leading to higher enrollment. It is projected to consume nearly one-fifth of the federal budget in the next decade. Will taxpayers be obligated to pay big money to keep the program going as it currently stands? You may rely on it.

What’s Next: The latest report makes one thing very clear, write AV's Mark E. Miller, executive vice president of health care, and Erica Socker, vice president of health care: “It is critical for Congress and the president to work together — sooner rather than later — to enact meaningful Medicare reforms to shore up the program for the 62 million Americans who have paid in and earned these benefits.”

By Torie Ludwin, communications manager
 

With the recent Corinthian Colleges debt forgiveness announcement, federal financial aid for students is on everyone’s mind. As it turns out, the U.S. Department of Education has been working on rules regarding federal aid for nearly a year via the process of negotiated rulemaking. The rulemaking is heading toward the finish line, with the most recent step being the release of the Notice of Proposed Rulemaking (NPRM) in June and the public comment period on it that follows.

What’s Happening: The Notice of Proposed Rulemaking (NPRM) is the official notice of the agency’s plan to create a final regulation, in this case a draft set of rules on federal financial aid that will impact students, higher education institutions, and taxpayers. Before the draft becomes official rule, the Department of Education will hold a final call for public comments on the proposed regulations.

Why it Matters: These public comments are the last opportunity to modify the regulations before the Department of Education writes them in final form. Anyone can make comments, and the Education Department is legally required to review and respond to each (substantive) one. These rules will affect how schools can access federal aid and what happens to students if they have been defrauded by their school.

What’s Next: After the NPRM is released in June, the comment period on it will follow. (Visit reg​u​la​tions​.gov and look for the dedicated page for each set of proposed rules.) Once public comments are closed, the Department of Education will review, consider any changes to the proposed regulations and submit the rule for final publication in the Federal Register. Providing they are finalized by November 1, 2022, these regulations will go into effect in July 2023.
 

By Juliana Keeping, communications manager

June is Pride month, a celebration of LGBTQ+ communities and an opportunity to reflect on the challenges that disproportionately impact people especially vulnerable to health disparities. A pill that could prevent HIV infection — known as pre-exposure prophylaxis, or PrEP — received FDA approval in 2012, yet only a small fraction of the 1.2 million Americans at risk of HIV infection take the medication. People who are at highest risk of becoming infected with HIV include gay and bisexual men, individuals with an HIV-positive sex partner, transgender women, and people who inject drugs. People who live in the South, who are Hispanic, or Black have a higher chance of contracting HIV, but the use of PrEP is often much lower among these groups.

What's Happening: There are a variety of reasons for low uptake of the drug, as reported by AV grantee Tradeoffs — from stigma surrounding the drug’s use and a lack of access to health care, to lower awareness among women and primary care providers and affordability challenges with branded PrEP. Daunting medical bills stemming from quarterly doctor visits and lab tests also dissuade uptake of the drug, KHN reported — even among the privately insured.

What's Next: Arnold Ventures funded the creation of a novel policy proposal for a national program to finance and distribute these medications, moves that could put the U.S. on track to end the HIV epidemic. (Read more about it here.) The proposal envisions a national PrEP program that shores up persistent disparities in access impacting rural communities, communities of color, and people at high-risk of contracting HIV.

Related: Take a deep dive on issues surrounding PrEP with Tradeoffs.

Criminal Justice

• After a two-decade freeze on federal funding for gun violence research, researchers who received dollars from the 2019 allocation from Congress are getting close to releasing results from their studies, via The Trace.
   

• Marc Levin of the Council on Criminal Justice calls on Congress to pass the bipartisan EQUAL Act, which would shave 21,300 years off federal crack sentences over the next decade and save taxpayers more than $750 million, in this Hill op-ed.
   

• In a new essay for Philanthropy New York, AV's Dylan Hayre, director of criminal justice, shares three ideas funders can consider to maximize the impact of their justice reform investments.
   
• While San Francisco District Attorney Chesa Boudin lost his recall election, the Los Angeles Times editorial board points out that other reform prosecutors and candidates did well in California’s June 7 primary election, including civil rights attorney Pamela Price leading the pack in Alameda County’s district attorney race. 
  
  Related: "Reformers Score a Prosecutor Win in Iowa"
   
• Some prison sites are rethinking their approach to tourism, which has long turned "human suffering into a spectacle," reports The Marshall Project.
   

Health Care

• The House this week passed a sweeping package to reauthorize the fees that help fund the FDA. The Senate must commit to automatically withdrawing accelerated approval drugs if the clinical benefit isn’t confirmed, maintaining randomized controlled trials as the gold standard for demonstrating effectiveness, and increasing clinical trials diversity in its scheduled markup of the 2022 FDA user fee legislation.
   
• From AV’s grantees at the Program on Regulation, Therapeutics, And Law (PORTAL) comes a report published in JAMA that shows brand-name drug prices soared year over year between 2008 and 2021. Coverage here in Axios Vitals.
  
  Related: “This time around, lawmakers cannot ignore the fact that prices for new drugs are rising by 20 percent each year. Allowing Medicare to negotiate prices for newly marketed drugs would apply the brakes to this runaway train,” write study authors Drs. Benjamin N. Rome and Aaron S. Kesselheim and Alex C. Egilman, a research assistant at Harvard Medical School’s program on regulation, in an op-ed for The New York Times. (free link)
   

• The Federal Trade Commission is suing to block two separate hospital mergers in an effort to reduce anti-competitive consolidation that has been shown to hike hospital prices, according to Healthcare Dive.
   

• Reforms that lower drug prices are unlikely to curtail innovation, according to a new paper by the USC-Brookings Schaeffer Initiative for Health Policy — debunking pharma's claims otherwise.
   
• A North Carolina city is suing hospital giant HCA Healthcare for "predatory tactics designed to impede competition" and jack up prices, the Carolina Public Press reports.
   

• Many Medicare patients are priced out of life-saving cancer drugs. Hear from former nurse and cancer patient Lynn Scarfuto, who has to pay $12,000 for the cancer drug Imbruvica annually with Medicare, on why the Senate needs to pass comprehensive drug pricing reforms.
   

• Providers who oppose the Biden administration’s approach to implementing the No Surprises Act, protecting millions of Americans from surprise medical bills, are pursuing litigation to weaken it. AV grantee Katie Keith explains the lawsuits in a new Health Affairs Forefront blog.

Contraceptive Care & Access

• Gov. Ron DeSantis of Florida vetoes $2 million in funding for birth control for a second year in a row, reports the Tampa Bay Times. “Funding for this sensible investment in the health of our communities enjoys rare bipartisan support,” said Stephanie Fraim, the president and CEO of Planned Parenthood of Southwest and Central Florida. “And, thanks to President Biden, the Legislature was able to pass a balanced budget with plenty of money left in reserves. To take away health care from vulnerable people is just another example of his ongoing cruelty to Floridians.”
   

• A new poll by Data for Progress and Contraceptive Access Initiative shows bipartisan support for access to oral contraception without a prescription — and that a majority of voters across parties would vote for a candidate who supports expanding access in general to birth control.
   

• Dana Singiser, co-founder of Contraceptive Access Initiative, asserts in STAT News that “pink tape,” or the extra barriers and bureaucracy that women’s products undergo due to societal bias, is holding up the FDA approval process for over-the-counter birth control.

Higher Education

• The Century Foundation released a report on Parent PLUS loans, finding that more than 3.7 million families owe more than $104 billion in federal student loans. Researchers recommend a "larger reckoning on the underlying causes of dependency on this program."
   

• "Student Debt: Why Is It Out of Control?" explains the root causes of the student debt crisis and options to remedy them.
   
• The Institute for College Access & Success (TICAS) released a report this week on one of the key metrics used in determining gainful employment (earning power that outstrips debt) for students after they graduate: the high school earnings threshold. The Gainful Employment Rule, made to protect students from high-cost, low-quality programs, may be reinstated by the U.S. Department of Education this year via the process of negotiated rulemaking.
   

Journalism

• The Trace offers a deeply reported explainer on the history of the AR-15 — what it is, how it's defined, and the efforts underway to regulate it.

Related: ABC's Soul of a Nation Presents "PRIDE To Be Seen," hosted by Cara Delevingne, documenting the LGBTQ+ experience and examining what it means to be seen as a member of the community.  

Also: On Wednesday, AV grantee and Community Justice Action Fund Executive Director Gregory Jackson Jr. was among those who testified before Congress about his personal account of the long-lasting effects of gun violence. Watch the hearing here.

• John Arnold, co-founder and co-chair of Arnold Ventures, is the featured guest on Freakonomics' latest "People I (Mostly) Admire" podcast. Host Steve Levitt sits down for this interview despite the fact that, as Levitt jokes, Arnold "has rejected every grant proposal I have ever submitted to him for funding. Every single one." They talk about the mission of Arnold and his wife, AV co-founder and co-chair Laura Arnold, to give away their wealth for good and what that entails (a healthy dose of risk tolerance and a lot of work).
   
• The Marshall Project's Keri Blakinger discusses her new memoir, "Corrections in Ink," with CityCast's Lisa Gray in this two-part series. Blakinger's book documents her journey from competitive ice skating to drug addiction and prison, and her efforts to shine a critical light on our system of incarceration through her journalism. Read a review of the book in the Texas Observer.

• Mourning the lives lost in Uvalde with a folk ballad "“El Corrido de Los Angeles de Uvalde."
   

• At 83, Japan's Kenichi Horie has become the oldest person in the world to complete a solo, nonstop voyage across the Pacific Ocean — and he says he's not done yet.
   

• "This is the world that is coming. It's literally a question of when and for most of us, it's going to happen in our lifetimes," says molecular biologist David Sinclair, whose Harvard lab has reversed aging in mice.
   

• "A League of Their Own" is getting a reboot! Watch the trailer here.
   

• The top four tips from every graduation speech, ever.