The Morning Meeting with Al Tompkins is a daily Poynter briefing of story ideas worth considering and more timely context for journalists, written by senior faculty Al Tompkins. Sign up here to have it delivered to your inbox every weekday morning.
The Food and Drug Administration is making it easier for anyone to buy a life-saving drug that reverses opioid overdoses. Narcan, the spray version of naloxone, requires no special training and will be available without a prescription by early summer.
In recent years, smaller studies have found naloxone has directly saved one in 10 lives of opioid users. The National Institute on Drug Abuse reported:
A naloxone distribution program in Massachusetts reduced opioid overdose deaths, without increasing opioid use, by an estimated 11 percent in the nineteen communities that implemented the program.
- A large-scale national study showed that opioid overdose deaths decreased by 14 percent in states after they enacted naloxone access laws.
- Statistical modeling suggests that high rates of naloxone distribution among laypersons and emergency personnel could avert 21 percent of opioid overdose deaths, and the majority of overdose death reduction would result from increased distribution to laypersons.
- Administering naloxone in cases of opioid overdose can cause withdrawal symptoms when the person is dependent on opioids; this is uncomfortable without being life threatening.
- The risk that someone overdosing on opioids will have a serious adverse reaction to naloxone is far less than their risk of dying from overdose.
- Naloxone works if a person has opioids in their system and has no harmful effect if opioids are absent. Naloxone should be given to any person who shows signs of an opioid overdose or when an overdose is suspected.
We do not yet know the price the manufacturer will charge for the drug, which of course will affect how widely used it will be.
The Washington Post’s check a couple of weeks ago found:
Right now, some harm-reduction groups say the discounted price is around $47 for a two-pack of the Narcan brand sprays, doses they hand out to users at no cost. Prices for prescription Narcan vary widely, depending on insurance coverage — at one D.C. chain pharmacy this week, it was selling for $73 without insurance.
The FDA says:
Drug overdose persists as a major public health issue in the United States, with more than 101,750 reported fatal overdoses occurring in the 12-month period ending in October 2022, primarily driven by synthetic opioids like illicit fentanyl.
The Indiana State Department of Health published a brochure trying to dispel myths about naloxone. It is worth explaining these myths to the public. Of course, after Wednesday’s FDA ruling, myth No. 4 is easily explained since the drug is about to become OTC.
(Indiana State Department of Health)
What is the Medicaid ‘unwinding’ that begins April 1?
15 million low-income Americans may be on the verge of losing Medicaid coverage. For the past three years, the federal government promised that Medicaid would not kick anybody off its rolls during the national health emergency brought on by the pandemic.
But with the COVID-19 emergency subsiding, the so-called “unwinding” will soon begin and every state will have to decide who is now eligible for Medicaid. This will affect almost one in 10 people currently on the program.
About a third of the people who lose Medicaid coverage in the coming weeks qualify for subsidized Affordable Care Act (aka Obamacare) coverage. The Department of Health and Human Services says, “Among these individuals, over 60 percent (1.7 million) are expected to be eligible for zero-premium Marketplace plans under the provisions of the American Rescue Plan (ARP). Another 5 million would be expected to obtain other coverage, primarily employer-sponsored insurance.”
Even the federal government estimates that nearly half of the people who could lose their coverage are still eligible, but many might not know why they are being removed or how to stay enrolled. That is why journalists should get involved in this issue now.
Some states have already started the unwinding. Ohers will begin Saturday. All states plan to complete the unwinding by July.
(Medicaid.gov)
(Medicaid.gov)
The unwinding is a return to the prepandemic norm of having to prove one’s eligibility every year. But, as The Washington Post says, this will probably be messy:
The number of Americans relying on Medicaid has soared by about one-third — to nearly 85 million as of late last year — since just before the coronavirus pandemic took hold in early 2020. Those who joined during that time did not need to pay attention to renewal notices from their states — which now could cost them their insurance.
And within state governments, many Medicaid agencies are strained by shortages of eligibility workers and call-center staffers to advise beneficiaries, while employees hired in the past three years have not until now needed to learn how to conduct renewals.
This is why I am urging journalists to get involved; to help explain the process and hold decision-makers accountable. We have known this day would be coming since the pandemic-era coverage began. HHS says:
- Children and young adults will be impacted disproportionately, with 5.3 million children and 4.7 million adults ages 18-34 predicted to lose Medicaid/CHIP coverage. Nearly one-third of those predicted to lose coverage are Latino (4.6 million) and 15 percent (2.2 million) are Black.
- An estimated 383,000 individuals projected to lose eligibility for Medicaid would fall in the coverage gap in the remaining 12 non-expansion states – with incomes too high for Medicaid, but too low to receive Marketplace tax credits. State adoption of Medicaid expansion in these states is a key tool to mitigate potential coverage loss at the end of the PHE.
- States are directly responsible for eligibility redeterminations, while CMS provides technical assistance and oversight of compliance with Medicaid regulations. Eligibility and renewal systems, staffing capacity, and investment in end-of-PHE preparedness vary across states.
Again, I emphasize that states should have plans to deal with this disruption. It is not unexpected and has been on the horizon for years. It will be especially disruptive after the nation’s uninsured rate declined to a historic low of 8% in the first quarter of 2022, which was partly the product of the pandemic-era policies of maintaining coverage.
“Between February 2020 and December 2021, Medicaid enrollment grew by approximately 15.5 million individuals, from 71.2 million to 86.7 million (a 21.8 percent increase),” HHS says. “Many of these individuals gained Medicaid eligibility due to pandemic-related changes in income and employment, while others may have enrolled in Medicaid during this time due to a change in family composition (e.g., the addition of a child), disability, or pregnancy status. Research indicates that Medicaid enrollment growth during the pandemic was primarily driven by increased retention of existing enrollees rather than new applications.”
I know this is a heavy and sometimes hard-to-visualize issue, but it involves huge amounts of tax dollars and millions of Americans, including the most vulnerable among us.
4 of the 10 most popular apps used in the US come from Chinese developers
While Congress and President Joe Biden zero in on TikTok’s Chinese ownership and raise questions about whether the app spies on American users, keep in mind that four of the 10 most downloaded apps in the U.S. have Chinese developers, including Temu, SHEIN, TikTok and CapCut.
Business news site Leaders.com reports:
Temu and SHEIN are online retail apps. Temu has a broad selection of merchandise, ranging from clothing to home goods to electronics. SHEIN predominantly sells low-cost clothing.
TikTok and CapCut are the other two most popular Chinese apps in the U.S. TikTok is a swiftly growing social-media app especially popular among younger users. CapCut is also owned by TikTok’s parent company ByteDance. CapCut is a video-editing app where users can create better-quality videos to post on their social media accounts.
The wait for passports is now nearly 3 months
It seems that Americans have big travel plans for this summer. Secretary of State Antony Blinken says the State Department is “getting 500,000 applications a week for passports,” which is about 30% more than a year ago. As a result, the wait is between 10 to 14 weeks. If you want to pay extra, you can get the passport in seven to nine weeks. The State Department is trying out an online portal for passport renewals but after a half million applications poured in, the government “paused” the site to fine-tune it.
44% of American adults have lost at least one parent
The U.S. Census Bureau generated a report that finds, “More than a quarter of the U.S. population in 2021 (26.4%) had lost both parents.” The figures partly reflect the cost of the pandemic, which claimed more than a million lives. Young Black adults are more than twice as likely to have lost at least one parent than young white adults.
Among those who had ever lost a parent, 50.7% had lost their mother and 69.2% their father by age 50, according to an analysis of recent estimates from the 2021 Survey of Income and Program Participation (SIPP).
(Census.gov)
The graphic above shows the age at which Americans lose their parents.
It is finally major league baseball season again
We start the day today with the Tampa Bay Rays unbeaten in the 2023 season. By tonight, 15 teams will be having a losing season.
It is finally baseball season again and, may I say, we have Wander Franco and you don’t.
Seeing the games in person is not cheap. Axios illustrates the 2022 data from TeamMarketing.com:
(Axios)
(webstaurantstore.com)
See the total list of 2022 MLB beer prices here. While you are at it, compare the amount of beer in a typical “large” cup versus a “small” cup. I worked in a concession stand for a couple of seasons supporting a charity and I can tell you that depending on who is doing the pouring, there was often almost no difference in the total amount in the cup.
(webstaurantstore.com)
See a total list of 2022 MLB hot dog prices here. Here is a fantasy baseball cheat sheet by ESPN.
Here’s more on this season from ESPN:
