HEALTH CARE BRIEFING: U.S. Seeks to Blunt Impact of Medical Debt

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Vice President Kamala Harris announced new steps designed to cut down the cost of federal home loans for Americans saddled with medical debt and make it easier for veterans to get their health care bills forgiven.

Speaking at a White House event Monday, Harris said there are “so many people in so many communities in our nation who are struggling with this burden, many of whom are managing an illness or an injury at the same time—who stay up at night staring at the ceiling wondering if they’ll ever be able to pay off their medical debt.”

The efforts include a push within the federal government to stop considering medical debt when determining eligibility for loans. Because the government won’t consider how much applicants owe in medical expenses, people experiencing debt should receive more favorable terms on loans to buy or build new homes. And the Veterans Affairs Department will now cease reporting of debt that veterans owe the VA for their health coverage to credit reporting agencies. It will also modernize programs designed to help former service members have some of their medical debts forgiven.

One-third of American adults currently have medical debt, with Black and Hispanic households more likely to incur it than White households, according to the White House. Over 11 million Americans are estimated to have medical debts above $2,000, and it accounts for more debt collections than credit cards, utilities, and auto loans combined, it said. Harris made the announcement on Monday at an event with White House economic adviser Brian Deese, Health and Human Services Secretary Xavier Becerra, and budget director Shalanda Young.

The Department of Health and Human Services announced that it is requesting data from more than 2,000 medical providers on bill collection practices, financial product offerings, and debt-buying practices. The federal government says it’ll begin using that information as it determines federal grants, in a bid to dissuade hospitals and health care facilities from abusive billing practices. Read more from Justin Sink and Nancy Cook.

Around the Administration

White House Advances Nursing Home Staff Plan: Biden’s administration took its first step towards requiring minimum staffing levels in nursing homes. The U.S. Centers for Medicare and Medicaid Services asked for public feedback on the issue Monday and said it plans to release a proposal within a year. CMS, which spends $35 billion per year on nursing home care for the elderly and disabled, said it’s also considering tying some payments to the level of staff turnover, which has been linked to quality of care.

The proposal is part of President Joe Biden’s broad agenda to bring greater scrutiny to the nation’s nursing-home industry whose patients and workers have been devastated by the Covid pandemic. The industry opposes mandatory staffing limits due to labor shortages. Nursing-home facilities say they’ve lost about 15% of their workforce since the pandemic began, even as employment in other health-care settings has rebounded, John Tozzi reports.

NIH Leaders Target Racial Inequities in Research: Quashing decades of structural racism in the biomedical research space will require running a marathon, not a sprint. But it’s a race Monica Webb Hooper and Marie Bernard say they plan to help win. “The change may be incremental, but we already are starting to see some change, even in the sense that the conversations that have never happened before are happening,” Webb Hooper, the deputy leader of the National Institute on Minority Health and Health Disparities, said in a recent interview. “That’s the first step of what will be a long process.” Jeannie Baumann has more.

Immigration Agency Eyes Mental Health Policies: U.S. immigration officials will impose new policies to monitor and safeguard detained non-citizens with behavioral health disorders under new policies from U.S. Immigration and Customs Enforcement. The new order, among other provisions, would require ICE to provide the Justice Department with any mental health information that an immigration judge may need to decide whether individuals can represent themselves in deportation cases. Acting Director Tae Johnson said it’s part of efforts to implement a fair and “humane immigration system,” Ellen M. Gilmer reports.

Research Volunteer Rules Move Toward Agency Harmony: FDA regulations to protect research volunteers will catch up to their HHS counterpart in a key rulemaking step that’s over three years past the deadline. The White House Office of Management and Budget received two proposals that aim to harmonize the Food and Drug Administration’s human subject protection regulations with Health and Human Services Department regulations known as the Common Rule. OMB receipt and review of rules normally mark the final step before public release. Read more from Jeannie Baumann.

What Else to Know Today

Senators Seek FDA Enforcement on Baby Formula: Sens. Bob Casey (D-Pa.) and Sherrod Brown (D-Ohio) want Food and Drug Administration Commissioner Robert Califf to detail the agency’s actions and plans to investigate several reports of illness and death linked to recalled infant formula manufactured by Abbott Nutrition. Because of this recall, parents are now facing shortages of baby formula as well, according to a statement. The pair also wants to know what steps the FDA is taking to make sure there is enough infant formula on the shelves. Read their letter to Califf here.

Full Pfizer Shot Approval Didn’t Convince Unvaccinated: Full approval of Pfizer-BioNTech’s Covid-19 vaccine did little to change the minds of unvaccinated Americans, according to the latest study that could inform future immunization campaigns. The study, which JAMA Internal Medicine published Monday, comes as more than a third of Americans are still not fully vaccinated, although over 77% have received at least one dose, Centers for Disease Control and Prevention data show. The study surveyed 535 people who remained unvaccinated after full approval of Pfizer’s Comirnaty. Read more from Jeannie Baumann.

Urban Hospitals Win Challenge to Medicare Formula Change: A change in Medicare’s payment formula that resulted in lower reimbursements for certain urban hospitals violated the Medicare statute, a federal district court ruled. The change, released for fiscal 2020, was designed to to prevent hospitals from manipulating the process by which payments are adjusted to reflect wage differences among rural and urban areas. But the law didn’t license the Health and Human Services Department to fix anomalies rooted in statutory provisions, the U.S. District Court for the District of Columbia said. Christopher Brown has more.

Alabama Sued Over Law Criminalizing Trans Care: Alabama was hit with a federal lawsuit by the parents of two transgender teens challenging the state’s new law criminalizing gender-affirming medical care for kids as unconstitutional. The law, SB-184, makes it a crime to provide medical procedures or prescribe medications, such as testosterone or estrogen, to “alter” a minor’s gender or delay puberty. The law carries a penalty of up to 10 years in prison. The plaintiffs said that the law “unlawfully denies necessary and appropriate medical treatment,” according to the complaint. Read more from Peter Hayes.

With assistance from Ellen M. Gilmer

To contact the reporter on this story: Brandon Lee in Washington at

To contact the editor responsible for this story: Giuseppe Macri at

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