It’s been a weird year in health care coverage. Political fighting in Washington over issues like the debt ceiling, repealing health reform, and Paul Ryan’s Medicare voucher plan got tons of coverage in the media– but at the end of the day, nothing really changed. Medicare and the Affordable Care Act are still intact, and deficit agreements that would have reduced health spending were blocked by Republicans.
Meanwhile, major health care stories outside of Washington that had a huge impact– like the famine in Somalia and major state-level changes in women’s access to abortion– went under-reported in the media.
And so, for our year end list, we present what we think were the real top five health stories of 2011.
1. Famine in Somalia
This summer, the Horn of Africa was struck by one of the worst droughts in 60 years. Somalia in particular has been devastated— The New York Times reported in August that tens of thousands of Somalis had died of malnutrition-related causes, and millions more were in urgent need of aid. The situation was especially dire in the southern part of the country, which is controlled by Al Shabab, a brutal Islamist group aligned with al-Qaeda. The Shabab had killed dozens of aid workers before forcing out Western aid groups altogether in 2010. During the famine they’ve continued to block many aid agencies and prevented starving people from leaving the country to refugee camps across the border.
Lately things have improved somewhat– the number of people facing imminent starvation has dropped from 750,000 to 250,000 thanks to rainfall and a massive relief effort– but the situation is still fragile:
Agencies warned that even with these improvements, “current levels of malnutrition and crude mortality remain two to four times higher than typical levels in Somalia for this time of year”. Under-five death rates remain up to six times the average level for sub-Saharan Africa.
The agencies noted that deaths are likely to continue over the coming months. Overall, food security levels remain the worst in the world, and the worst in Somalia since the 1991-92 famine. They warned that “any significant interruption to humanitarian assistance or trade would result in a return to famine”.
In December, the UN asked for $1.5 billion to continue dealing with the crisis in 2012 and the US announced it would boost its own assistance by $113 million.
If you’re interested in donating money to help victims of the famine Doctors Without Borders, UNICEF, and Oxfam are all working to bring food and medical supplies to those affected by the drought. The Times has a list of other aid groups here.
2. Gridlock in Washington
The biggest health care stories out of Washington this year were things that didn’t get passed. Republicans took control of the House in January and promptly voted to repeal health reform, with a bill that was of course dead on arrival in the Democratic-controlled Senate. That pretty much set the tone for the rest of the year:
- May: House Republicans passed a budget that would scrap the current Medicare system and replace it with a voucher program, while making massive cuts to Medicaid.
- August: The debt-ceiling debate ended in an ugly stalemate, thanks mainly to Congressional Republicans refusing to consider tax increases on wealthy Americans in order to cut the deficit.
- September: Republicans rejected President Obama’s plan to reduce the deficit by $2 trillion, along with his American Jobs Act.
Despite all the political games, little has changed. Aside from a tweak to a tax-reporting requirement and the White House announcing that it’s suspending the CLASS Act (which Republicans had nothing to do with– see #5 below), the Affordable Care Act is humming along the same as it was before the 2010 election. The one thing that has changed is the popularity of Congress, which has fallen to an all time low.
3. New air pollution rules
Programs like Medicare and the Affordable Care Act get all the attention, but the biggest improvement to Americans’ health this year will come from a handful of important new environmental regulations.
This year EPA finalized three new air pollution rules that will reduce toxic emissions from industrial boilers and power plants. These new regulations will prevent tens of thousands of avoidable deaths every year, while providing hundreds of billions of dollars worth of health benefits.
UPDATE: In response to a legal challenge from some utilities, a federal appeals court has delayed implementation of one of these rules— aimed at limiting harmful power plant pollution that crosses state lines.
4. Abortion Restrictions at the state level
Barely any health care legislation has gotten through Congress this year, but on the state level it’s been a totally different story– especially when it comes to abortion. A wave of new state-level restrictions have reshaped access to abortion more than any other year in three decades
The Washington Post’s Sarah Kliff reports:
Five states banned all abortions after 20 weeks of gestation; until last year, only Nebraska had such a restriction. Seven now require an ultrasound, or the offer of one, prior to the procedure. Eight will no longer allow private insurance plans to cover the procedure. A handful of states are, to this day, battling the Obama administration over whether they can bar abortion providers, such as Planned Parenthood, from receiving government funds, even for the non-abortion services they provide.
For a look at how these new laws could reshape access in many states, we definitely recommend reading her entire article here. Ironically, many of these state abortion laws, and others cutting access to contraception and pre-natal care, will likely drive up the abortion rate.
5. Repeal of the CLASS Act
The White House dropped a bombshell in October when it announced it was suspending a major (yet under-reported) section of the new health reform law. The CLASS Act would have created a new, voluntary national government-run insurance program for long term care– in other words a public option for long-term care. But the voluntary nature of the program was a problem– actuaries found that not enough healthy people would take advantage of CLASS, meaning eventually premiums would spiral out of control or the program would run out of money. [For more on what the CLASS Act is, and why it was destined to fail, check out our brief CLASS Act primer.]
Still the problem that CLASS was meant to solve remains, as Sebelius wrote in her letter to Congress:
By 2020, we know that an estimated 15 million Americans will need some kind of long term care and fewer than three percent have a long term care policy. These Americans are our family, our friends, and our neighbors. If they are to live productive and independent lives, we need to make sure that they have access to the long term care supports to make that possible.
Bonus: What health reform accomplished in 2011
The one silver lining to the stalemate in Washington is that it’s probably been good for health care. Provisions in the Affordable Care Act are starting to take effect, which means 2.5 million more young adults have coverage (thanks to the provision allowing them to stay on their parents’ insurance), many people now have access to free preventative care, and states have taken advantage of new rules allowing them to reject rate increases from insurers.
On the White House blog, Secretary of Health and Human Services Kathleen Sebelius outlines eight ways the health reform law is already helping.
Issues to watch in 2012
2012 is going to be the year this health reform thing gets settled once and for all. The Supreme Court will hear arguments at the end of March, with a ruling on whether the law is constitutional by June.
The fate of the new law also hinges on the results of the 2012 election. If President Obama wins and the Supreme Court upholds the law, then health reform is here to stay. But if Republicans manage to take control of the White House and the Senate, it’s hard to say what would happen exactly. A Republican president probably couldn’t repeal the law entirely, but major changes would be almost certain.
For more on these and other issues that will matter next year, check out California Healthline’s Five Health Care Issues to Watch in 2012.
We hope you had a great year, and hope you’ll continue to join us for what’s sure to be an exciting 2012!