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 end of the COVID-19 public health emergency is now in sight. The White House will extend the emergency declaration until May, then allow it to expire. The decision came on the same day that the World Health Organization ruled that the global pandemic is not yet over, but probably will end this year.
The White House wants to keep the emergency declaration in place because it keeps many programs, including COVID-19 testing and vaccinations, free. Not all such pandemic programs will continue once the emergency ends. The White House statement said:
An abrupt end to the emergency declarations would create wide-ranging chaos and uncertainty throughout the health care system — for states, for hospitals and doctors’ offices, and, most importantly, for tens of millions of Americans. During the PHE, the Medicaid program has operated under special rules to provide extra funding to states to ensure that tens of millions of vulnerable Americans kept their Medicaid coverage during a global pandemic.
In December, Congress enacted an orderly wind-down of these rules to ensure that patients did not lose access to care unpredictably and that state budgets don’t face a radical cliff. If the PHE were suddenly terminated, it would sow confusion and chaos into this critical wind-down. Due to this uncertainty, tens of millions of Americans could be at risk of abruptly losing their health insurance, and states could be at risk of losing billions of dollars in funding.
Additionally, hospitals and nursing homes that have relied on flexibilities enabled by the emergency declarations will be plunged into chaos without adequate time to retrain staff and establish new billing processes, likely leading to disruptions in care and payment delays, and many facilities around the country will experience revenue losses.
Finally, millions of patients, including many of our nation’s veterans, who rely on telehealth would suddenly be unable to access critical clinical services and medications. The most acutely impacted would be individuals with behavioral health needs and rural patients.
End of public health emergency ends Title 42. What’s next?
May 11 then also becomes a new date to circle on the calendar with respect to immigration. The public health emergency was the foundation of Title 42, the Trump-era policy that allowed the quick expulsion of people at the border. If Title 42 expires with the health emergency declaration, border cities say they would be flooded with migrants seeking asylum. The Biden administration wants to lift the Title 42 order, but the case is tied up in both the U.S. Supreme Court and a district court in Louisiana.
Xylazine: the drug behind the new ‘tranq’ craze
An animal sedative called xylazine is showing in street drugs nationwide and it is dangerous, even deadly. Smithsonian Magazine reports:
Public health officials say xylazine, also known as “tranq” or “tranq dope,” is infiltrating the nation’s illicit drug supply in substances such as heroin and fentanyl. It’s also becoming increasingly prevalent in overdose deaths.
A recent analysis by Brown University found xylazine in more than 40 percent of street drug samples in Rhode Island, reports ABC News’ Nicole Wetsman. Another recent study found the drug in 36 states and the District of Columbia. And in 2021, the most current data available, xylazine showed up in more than 90 percent of dope samples in Philadelphia.
One of the drug’s hallmarks in humans is the presence of gruesome wounds and decaying skin tissue called eschar, which can become infected and lead to amputation.
“The tranq dope literally eats your flesh,” says Brooke Peder, a 38-year-old tattoo artist in Philadelphia who has had a leg amputated due to an infected tranq wound, to the New York Times’ Jan Hoffman. “It’s self-destruction at its finest.”
The Food and Drug Administration recently issued a warning about “tranq” drugs:
Xylazine is not safe for use in humans and may result in serious and life-threatening side effects that appear to be similar to those commonly associated with opioid use, making it difficult to distinguish opioid overdoses from xylazine exposure.
However, we do not know if side effects from xylazine exposure can be reversed by naloxone. Since we do not know if reversal agents regularly used in veterinary medicine (e.g., yohimbine hydrochloride, tolazoline hydrochloride) are safe or effective in humans, they should not be used.
Gallup poll says the No. 1 problem in America is the government
A new Gallup poll says more than COVID-19, more than the economy, the No. 1 problem in America right now is the government:
More Americans name the government as the nation’s top problem in Gallup’s latest poll, which encompassed the rocky start of the 118th Congress’ term. With high prices persisting, inflation remains the second most-cited problem (15%), and amid elevated tensions about the southern U.S. border, illegal immigration edged up three percentage points to 11%. Mentions of the economy in general fell six points, to 10%, the lowest reading in a year.
(Gallup)
The issue of “government” was the top choice of people who said they were Republicans as well as those who said they were Democrats. Democrats ranked race relations as a higher concern than Republicans. Republicans named immigration as a greater concern than Democrats.
Over the years, I have seen these kinds of polls come to life in the talking points that new Congresses spend much of their time discussing.
A record number of Americans signed up for Obamacare
A record-breaking 16.3 million Americans signed up for Affordable Care Act insurance plans during the program’s latest enrollment season. It is the highest number to enroll in the 10 years of the program. A fourth of the people who signed up for ACA coverage are new to the program. The enrollment marks a 50% increase in Obamacare coverage since Joe Biden became president.
When the ACA launched, public reaction was mixed, but the program started picking up public support in 2017. Obamacare has remained popular in recent years while scoring much higher favorability ratings among people who identify as Democrats.
(Kaiser Family Foundation, polling from March 2022)
The ACA gets the highest favorability ratings from younger Americans.
(Kaiser Family Foundation, polling from March 2022)
But beginning in April, the number of uninsured may rise again as states move more people off their Medicaid roles. The latest government funding bill ends COVID-era emergency dollars, which means states can move people off their Medicaid roles, which they could not do during the pandemic.
The Washington Post explains what’s next:
There are varying estimates about what could happen over the course of the next year-plus. In an August report, the federal health department predicted that roughly 15 million people could lose their Medicaid or Children’s Health Insurance Program coverage when the continuous enrollment provisions came to an end.
Roughly 2.7 million are expected to qualify for financial aid on the ACA health exchanges, and of those, 1.7 million are likely to be eligible for marketplace plans without any premiums.
About 5 million are expected to obtain other coverage, particularly through employer-sponsored plans.
How did America fall in love with the pickup truck?
Axios zeros in on a wonderful topic: how the pickup truck has become the best-selling vehicle in America.
In 2022, the top three best-selling vehicles in America were pickup trucks, and among them, the Ford F-series reigns supreme. The Ford F-150 has been the best-selling vehicle in the U.S. for more than 40 years, and for that reason, it’s a useful proxy for pickups overall.
But during those 40 years, pickups have changed significantly. They’ve become bigger, heavier and more tricked out, and they’ve transformed from workhorse vehicles to family cruisers.
Sales of these huge trucks are sustaining carmakers, bringing in record profits they can use to develop expensive technologies like electrification and automation that will drive the industry in the future.
Yet pedestrian and road safety advocates say today’s massive trucks are a hazard, given their size, weight and driver blind spots.
In the 1980s, about half of pickup trucks were categorized as small or midsize, but by the 2010s small pickups had nearly vanished and fullsize trucks dominated. Today, midsize trucks are making a comeback, but fullsize still make up a majority of sales.
The article shows how in the 1960s and 1970s, the pickup was two-thirds bed and one-third cab. Now, the typical truck bed is one-third of the vehicle. And expectations are way different:
(Axios)
The Axios story, which includes lots of interactive graphics, says that trucks today are getting bigger, which creates blind spots:
One result of supersized trucks: greater risks to pedestrians and other drivers. Drivers of today’s trucks sit much higher, creating a blind spot where small children or wheelchair users are hidden from view.
Moreover, pickups’ weight increased by 32% between 1990 and 2021, meaning they strike pedestrians with more force. In addition, the tall front of a truck strikes pedestrians in the torso or head, whereas the lower hoods of cars typically strike pedestrians at the legs. A 2004 study from the British Medical Journal found that light trucks — which includes pickups, SUVs, and minivans — were three times as likely as other vehicles to cause severe injuries, with twice the fatality rate in pedestrian strikes.
(GoodcarBadcar.net)
For reasons I don’t know, more pickup trucks are sold in the spring months than in other months. I am guessing here, but could that have to do with income tax refunds? Or does it have more to do with big commercial buyers replacing fleets?
Somewhere in here, I should disclose I drive a pickup and have since the 1970s, except for that unfortunate youthful and impoverished period when I drove a Ford Pinto. And then there was the purple van, which is better left unmentioned.
