The Problem With Prison

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Electing to Remain Patient-Centered

Check out my latest post on the Differential: Electing to Remain Patient-Centered

Health Care Reform: Upheld by the Supreme Court

On Thursday, June 28, the Supreme Court upheld President Obama's Patient Protection and Affordable Care Act (ACA). The law seeks to make health insurance more affordable for all and provide increased consumer protections (e.g. prevent discrimination by health insurance companies against individuals with pre-existing health conditions). But what are some of the actual act's directives?


Since 2010, the law has already:

• ended discrimination against children with pre-existing conditions.
• extended coverage to younger adults (up to age 26) by allowing them to stay on their parents health insurance plan
• prohibited health insurance companies from dropping people's coverage when they get sick.
• increased federal matching funds for Medicaid.
• set forth initiatives to strengthen the primary care workforce.
• sought to bring down the price of health care premiums by requiring that at least 85% of all premium dollars collected by insurance companies be spent on health care services and health care quality improvement (rather than for profit).
• encouraged the use of integrated health systems (i.e. Accountable Care Organizations).
• required federal agencies to record a wider range of demographic data in an effort to understand health disparities.

In 2013, the law will:

• provide new funding to state Medicaid programs that choose to cover preventive services for patients at little or no cost.
• establish a national pilot program to encourage hospitals, doctors, and other providers to work together to improve the coordination and quality of patient care.
• increase Medicaid payments for primary care doctors.
• provide additional funding for the Children's Health Insurance Program (CHIP).

In 2014, the law will:

•  require individuals to purchase health insurance (this is the "individual mandate" that was the subject of debate). If affordable coverage is not available to an individual, they will be eligible for an exemption.
• prohibit insurance companies from refusing to sell coverage or renew policies because of an individual's pre-existing conditions.
• prohibit plans from imposing annual dollar limits on the amount of coverage an individual may receive.
• provide tax credits to make it easier for the middle class to afford insurance.
• ask States to open health insurance exchanges to enable all Americans to easily shop for more affordable private insurance.
• increase access to medicaid for Americans who earn less than 133 percent of poverty limit.

Finally, in 2015 the law will:

• compensate physicians for the quality of care they provide to their patients rather than the volume of services they provide.

While many of these provisions will not be well-received by everyone, and some of these provisions admittedly do not do enough to reform the health care system, this is a step in the right direction.

Federal Plan to Reduce Asthma Disparities Released

Yesterday, the President’s Task Force on Environmental Health Risks and Safety Risks to Children announced a new initiative to reduce asthma disparities among children, but especially children from ethnic minority groups and/or a low socioeconomic background. The U.S. Department of Health and Human Services, Department of Housing and Urban Development, Environmental Protection Agency and several other federal bodies have teamed up to execute a plan of action. Read the fact sheet here.

The initiative promotes collaboration among federal entities and streamlines resources and knowledge surrounding asthma health disparities among children. This partnership also encourages teamwork among individual, local, state and national leaders from various sectors. This forces us to think about asthma in a more holistic manner. Asthma disparities in the United States are not just a medical problem, but also the product of environmental and social inequities.


Asthma can be deadly if children do not seek routine medical care and do not regularly take the proper medication. Environmental factors such as air quality and allergens can also cause asthma attacks. Kathleen Sebelius, Secretary of the Department of Health and Human Services spoke yesterday in Washington D.C. about the new action plan. She said the following:

Minority children today are both more likely to have asthma and less likely to be prescribed or take recommended treatments to control their asthma...Without health coverage, you’re less likely to get the preventive medicine you need to keep the condition under control, making you more likely to suffer an attack...you can get great care for asthma at your doctor’s office, but it won’t do much good if they don’t know how to treat it at your school. And you can have a great community health center down the street, but it will be hard to stay healthy if the air in your neighborhood is polluted...If we’re going to reduce these disparities, we have to work together, not just across the federal government, but with state and local partners, and community and private leaders on every front.

Collaboration and leadership among governing bodies is important, and is just one of many partnerships needed to end health disparities. United, we can enact change!  

Read more about reducing health disparities here.

A Change of Heart: "Abstinence-Only Plus" Sexual Education

By Alexa Mieses

When I read an article this morning in the the Texas Tribune about abstinence-only sexual education, I was reminded of my work at Gay Men's Health Crisis (GMHC) in 2009. While working for GMHC's public policy department, I had an opportunity to research various policy issues, write articles, voter's guides and policy briefs. One brief I wrote was on abstinence-only sexual education funds drying up, and President Obama replacing them with evidence-based sexual education. Former US President/Texas Governor George W. Bush was known for supporting public school sexual education programs that encouraged children and adolescents to refrain from having sex; such program did not teach the science behind conception and sexually transmitted infections, nor about condoms and other contraceptives. Studies have even found that children taught abstinence-only, tend to have more gender-biased attitudes, have higher rates of teenage pregnancy and certain sexually transmitted infections. Despite President Obama's support for comprehensive sexual education programs, the Texas health department did not apply for federal funding that would help get these programs off the ground and into Texas public schools.



The Tribune article describes a recent trend in Texas to implement "abstinence-plus" sexual education. While abstinence is still encouraged, children in the seventh and eighth grade will also learn about condoms and other forms of contraception and protection from sexually transmitted infections. This change of heart is the result of an increasingly large number of teenage girls becoming pregnant and growing statistics of contraction of sexually transmitted infections among adolescents, within the state. While we all hope people engage in sex only when they are mature mentally as well as physically, it is not realistic to assume all teenagers will abstain from sex until marriage. Instead, it is better to empower them with the tools (mental and physical tools) to take charge of their sexual health and act responsibly.