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The Health 202

A newsletter briefing on the health-care policy debate in Washington.

Medicaid will become available to some California inmates

The Health 202

A newsletter briefing on the health-care policy debate in Washington.

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Today’s edition: The Food and Drug Administration will ease a blood donation ban on gay men in the coming days. Vaccine advisers endorsed retiring the original coronavirus vaccine and using the newer shots instead. But first …

In a California pilot program, prisoners can enroll in Medicaid three months ahead of their release

California’s Medicaid program is testing out something new.

The state will soon begin paying for certain care for those in prison, jail and juvenile detention centers three months before they’re released. The idea is to enroll those eligible in Medicaid early in an effort to provide an easier transition as they exit the criminal justice system.

Federal health officials signed off on the plan yesterday, which is the first time the safety net program will provide coverage before inmates are released from prison. And it’s a model that could soon become more prevalent across the country with at least a dozen other states already seeking approval for their own twist on the idea. 

  • “CMS’ decision is groundbreaking,” Vikki Wachino, the executive director of the Health and Reentry Project and a former Centers for Medicare and Medicaid Services official, wrote in an email. “It overcomes a major, longstanding barrier that has stood in the way of low income people getting health care when they need it.”
The details

Federal law prohibits Medicaid for paying for most health services for people who are incarcerated, a policy that’s known as the “inmate exclusion.” 

Insurance coverage plays a limited role in correctional health, and governments are required to provide those in jails and prisons with health services. There isn’t a single approach to providing health care services in prisons and jails, according to a report from the Council on Criminal Justice, a think tank, and there’s a substantial variation in the quality of care that’s provided.

But under the newly approved California plan, the state’s Medicaid program can begin to cover certain services for up to 90 days before a person is expected to be released from prison. This includes substance use disorder treatment, physical and behavioral health consultations, laboratory and radiology services, and medications. 

Americans moving in and of the justice system are often a low-income population with substantial physical and health needs, according to the Kaiser Family Foundation. This includes high rates of opioid addiction and other substance use disorders, as well as chronic diseases. 

The California effort is essentially a test and is slated to expire at the end of 2026 (though CMS often renews programs the agency likes and believes work). Top California health officials say it’ll take time to ramp up, estimating that the new project will begin in the first jails in April 2024 and phase in over the next two years. 

What’s next

Even though the program has never been implemented, the idea has been gaining some traction.

For instance: A previous iteration of Democrats’ economic bill would have allowed Medicaid dollars to be used to pay for some services 30 days before release from prison. Similar bills were introduced in the House and the Senate with bipartisan support. Other states like West Virginia, Vermont and New Mexico have submitted their own plans for federal approval. 

In particular, Democratic-led states tend to closely watch the novel programs California takes on, and sometimes follow the state’s lead. And federal health officials are indicating they’re itching to greenlight more state plans. 

  • “We hope that what we are approving today is an exciting model for what we are able to partner with states across the country on to really advance coverage and access and health equity for this population,” Daniel Tsai, the director of the federal Center for Medicaid and CHIP Services, said in a press call yesterday. 

On the Hill

Buchanan named vice chair of House Ways and Means Committee

Rep. Vern Buchanan (R-Fla.) will serve as vice chair of the House Ways and Means Committee, the panel’s chair Jason Smith (R-Mo.) announced yesterday.

The slot is essentially a consolation prize for Buchanan, who lost the top spot on the committee to Smith in a contentious three-way race earlier this year despite holding seniority among GOP members on the powerful panel.

Buchanan ultimately secured the gavel of the Ways and Means health subcommittee, which has broad jurisdiction over Medicare, medical education, private health insurance programs and issues related to the quality of and access to care.

Agency alert

FDA to ease blood donation ban on gay men

Gay and bisexual men who say they are in monogamous relationships will no longer be required to abstain from sex to donate blood under federal guidelines to be proposed in the coming days, our colleagues Laurie McGinley, Teddy Amenabar and Fenit Nirappil report. 

The details: The new approach by the Food and Drug Administration focuses on sexual behaviors by people that pose a higher risk of contracting and transmitting HIV, according to an official with direct knowledge of the plan. Gay men would be allowed to give blood if they hadn’t had a new anal sexual partner in the prior three months, and the agency is expected to adopt the proposal after a public comment period. 

The planned relaxation of the restrictions ends a remnant of the earliest days of the AIDS crisis, and follows years of pressure by blood banks, the American Medical Association and LGBT rights advocates to abandon rules that some experts say are outdated, homophobic and ineffective at keeping the nation’s blood supply safe. 

There’s bad news for CBD fans

The FDA announced yesterday that products infused with CBD, which is derived from cannabis or hemp and used in items ranging from soap to seltzer, do not appear to meet federal safety standards and require stricter regulations, our colleagues Laura Reiley and Daniel Gilbert write. 

The announcement delivered a blow to the quickly growing industry, which had hoped that the agency would greenlight CBD’s use. Instead, the FDA said the market needs closer oversight than it can provide under its current framework and punted the responsibility of crafting a new regulatory pathway to Congress. 

What they’re saying: There’s not enough evidence about CBD to confirm that it’s safe for use in foods or as a dietary supplement, especially for long-term consumption, FDA Principal Deputy Commissioner Janet Woodcock said in a statement. Questions remain about its potential impact on the liver and the male reproductive system, as well as its risks to those who are pregnant and children, she added. 

More from Woodcock:


Vaccine advisers recommend retiring original coronavirus vaccine in favor of updated shots

The FDA’s panel of independent advisers unanimously endorsed the agency’s proposal to simplify the nation’s strategy for vaccinating people against the coronavirus, The Post’s Carolyn Y. Johnson and Laurie McGinley report.

If adopted by the FDA, the recommendation would effectively retire Pfizer-BioNTech and Moderna’s original coronavirus vaccine formula that entered the market in 2020. Instead, the drugmakers’ updated bivalent vaccine, which targets the original virus as well as the omicron variant, would be used for all shots. 

The change would have a minimal impact on most people, largely affecting unvaccinated adults who were still being offered two initial shots of the original vaccine formula. The bivalent shot that is replacing the original formulation has been used as a booster since September.

In addition, the committee considered, but didn’t vote on, the FDA’s proposal to implement a once-a-year regimen for coronavirus immunizations — a shift from the agency’s current strategy of pushing routine boosters to counter variant threats. Many committee members were supportive of the idea, but called for more data to understand whether additional doses were needed for those who are older or immunocompromised, as well as young children who haven’t been vaccinated before.

Both potential changes are aimed at streamlining a complex vaccine schedule that has confused the public and health-care providers alike, with the ultimate goal of boosting the nation’s vaccine uptake.

State scan

Virginia Democrats defeat three bills to restrict abortion

A Democrat-led Senate panel in the Virginia General Assembly thwarted three different attempts to further restrict abortion access in the state in a series of key votes yesterday, The Post’s Gregory S. Schneider and Laura Vozzella report. 

The Republican-backed measures included a 15-week ban on abortions with exceptions for rape, incest and to protect the life of the pregnant woman, which was introduced at the behest of Virginia Gov. Glenn Youngkin (R). Several related bills remain alive in the Republican-controlled House, although anything that clears the chamber is likely to meet the same fate in the Senate. 

The bigger picture: Yesterday’s votes appear to end the fight in the current legislative session to change abortion laws in Virginia, where the procedure is legal through the second trimester. The future of abortion in the state could be determined in the fall, where all 140 legislative seats will be on the ballot. 

Sen. Louise Lucas (D-Portsmouth), chair of the Virginia Senate’s Education and Health Committee:

In other health news

  • New this a.m.: The Keep Us Covered campaign and its partners are pressing the administration to end a Trump-era expansion of short-term plans, according to a letter shared with The Health 202. It’s been almost two years since President Biden signed an executive order directing federal agencies to review Trump-era regulations, and in a recent rulemaking agenda, the federal health department said it intends to issue a proposal by April, but that’s timeline isn’t binding.
  • On tap today: The World Health Organization’s emergency committee is meeting to consider whether the coronavirus pandemic still represents a global health emergency after three years. 
  • The FDA withdrew its emergency use authorization of AstraZeneca’s coronavirus treatment Evusheld after concluding that the antiviral is ineffective against the variants currently circulating throughout the United States, the company announced.

Quote of the week

Health reads

Did Your Health Plan Rip Off Medicare? (By Fred Schulte l Kaiser Health News)

The unexpected alliance lobbying for Medicare to pay for new obesity drugs (By Rachel Cohrs | Stat)

FBI shuts down ransomware gang that targeted schools and hospitals (By Joseph Menn, Perry Stein and Aaron Schaffer | The Washington Post)

Sugar rush

He’s just like us?

Thanks for reading! See y’all Monday.