issue: Health Care

New PPI Report Finds GOP’s Medicaid Cuts Reckless and Wasteful

Posted on by Alex Terr

WASHINGTON — As President Trump’s “Big Beautiful Bill” moves through Congress, one section included in the legislation will not only skyrocket the cost of living for many working-class Americans, but will also impact how they receive critical care. As part of the One Big Beautiful Bill Act, Congressional Republicans are presenting an $880 billion cut to Medicaid that will kick more than 8.6 million Americans off the program and slash critical health care funding in the communities that need it most.

In a new report for the Progressive Policy Institute (PPI), Alix Ware, Director of Health Care Policy, argues that the proposed Medicaid cuts harm working Americans trying to make ends meet, force rural and underresourced hospitals to close, and push more people to rely on emergency rooms for routine care. Titled “The High Cost of Republican Medicaid ‘Savings,’” Ware’s research dives into how the GOP cuts don’t actually save Americans money or make the program more efficient, instead excluding people from getting the necessary health care they need to survive.

“These cuts aren’t about efficiency — they’re about shifting costs onto working families while giving the wealthiest Americans a tax break,” said Ware. “The bill adds bureaucracy, guts coverage, and penalizes states for innovation, all under the false promise of ‘savings.’”

Key takeaways from the report include how, in its current form, the One Big Beautiful Bill Act:

  • Removes 8.6 million Americans from Medicaid;
  • Threatens the stability of hospitals in rural or underserved communities, many which will have to close or reduce hours;
  • Creates harmful work requirements for many recipients who already meet the requirements to be eligible for the program;
  • Forces Americans to go to emergency rooms for routine visits that cost more money and make hospitals more inefficient, or forgo medical treatment altogether;
  • Eliminates state Medicaid expansion programs that have saved millions; and
  • Reduces access to preventative care as red tape makes it difficult to schedule the necessary appointments to get the help they need before it’s too late

Ware argues that instead of pursuing reckless cuts that restrict Medicaid coverage for those who need it most, Congress should focus on improving the program’s efficiency by eliminating unnecessary red tape — such as work requirements that most recipients already meet — and streamlining paperwork to save both time and money.  States, Ware says, have been at the forefront of Medicaid innovation, like Oregon and Maryland, where pragmatic legislators have controlled care costs and made it easier for people to access affordable care — reducing the need for costly emergency room visits for routine health issues.

“The U.S. health system is a complicated mess,” said Ware. “Instead of restricting health care for people who cannot afford it, lawmakers from both parties should seek bipartisan consensus on provisions that reduce inefficiencies while increasing access to coordinated and comprehensive care like Coordinated Care Organizations that reduce emergency room visits,  and the Total Cost of Care Model that lowered costs and improved the quality of care.”

Read and download the report here.

Founded in 1989, PPI is a catalyst for policy innovation and political reform based in Washington, D.C. Its mission is to create radically pragmatic ideas for moving America beyond ideological and partisan deadlock. Find an expert and learn more about PPI by visiting progressivepolicy.org. Follow us @PPI.

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Media Contact: Ian O’Keefe – iokeefe@ppionline.org

The High Cost of Republican Medicaid “Savings”

Posted on by Alex Terr

Congressional Republicans are disingenuously presenting their $880 billion Medicaid cut in the budget reconciliation bill as an enormous savings to Americans. But this cut in federal health care spending will have very different repercussions for all Americans, regardless of whether they have Medicaid, Medicare, or private insurance.

The GOP’s “one, big, beautiful bill” will kick 8.6 million Americans off Medicaid, leaving them no recourse but to forgo medical treatment or go to hospital emergency rooms — absolutely the most expensive way to deliver care in America. We know from experience that most will choose the emergency room if they have no insurance.

The Republican plan will also reduce access to health care when hospitals close, and worse health outcomes when people delay care. The National Rural Health Association warns that “drastic cuts…will force many rural facilities to reduce or cut service lines or close their doors entirely, impacting access to care for everyone who lives in the community.” If fewer people seek medical help in the early stages of an illness or injury for even a short period, diminished patient flows will put safety net hospitals at risk for closing. If these facilities close, many Americans, particularly in rural parts of the country that voted heavily for President Trump, will be harmed.

Some House Republicans were so concerned with the threat to “the viability of hospitals, nursing homes, and safety-net providers nationwide,” they sent a letter to House Republican leadership. The letter acknowledged, “Many hospitals — particularly in rural and underserved areas — rely heavily on Medicaid funding, with some receiving over half their revenue from the program alone. Providers in these areas are especially at risk of closure, with many unable to recover.” Despite these dire concerns, Trump demanded their compliance, and eventually they capitulated.

The U.S. is already an outlier compared to similarly wealthy countries, spending nearly double per capita on health expenditures than the average of other similar countries. Switzerland is the closest in per capita spending at $9,688 compared to the $13,432 the U.S. spends. The U.S. spends a larger percentage of its GDP on health expenditures as well. Despite spending so much more, the U.S. has lower life expectancy, higher age-adjusted mortality rate, and a higher premature death rate. In the U.S., 26.8 patients out of every 100 patients skip a medical appointment due to cost, compared to an average of 7.0 in comparable countries. It is unacceptable for the U.S. to be falling this far behind. Congress needs to address this gap, but kicking millions off of Medicaid is not the way to do it.

Instead of reforming the system to reduce inefficiencies and drive down costs, Republicans are imposing changes that will force the middle and working classes to pay more. Health care, a necessity that already eats up too much of the average working family’s income, is therefore slated to become even more expensive — all so the rich can enjoy a tax cut.

Read the full report.

Republicans Surrender the War on Cancer

Posted on by Alex Terr

As we near President Donald Trump’s July 4 goal to have his big, beautiful bill, there has been plenty of debate and pushback within the republican party regarding how to handle Medicaid and state and local tax (SALT) deductions. In stark contrast, Republicans — outside of Senator Susan Collins calling them “very troubling” — have been nearly silent regarding the president’s proposed cuts to the National Institutes of Health (NIH) and cancer research. It appears Republicans will acquiesce to the president on these cuts and, a half-century after President Richard Nixon declared a war on cancer, Republicans will surrender that war.

In 1937, the U.S. formally declared its intent to be a leader in cancer research when President Franklin D. Roosevelt signed the National Cancer Act, which created the National Cancer Institute (NCI). In the succeeding nearly 90 years, presidents and Congresses led by both Democrats and Republicans have recommitted to the promise of finding a cure for cancer. This consistent bipartisan support has created better diagnostic tools to find cancer sooner, a better understanding of how cancer metastasizes, and how to target different cancers. Since the early 1990s, the U.S. has made major strides in survival rates of cancer. In addition, the U.S. has increased access to palliative care to treat the whole person, not just the disease, and introduced concurrent care for children to ensure patients, families, and communities are supported through a cancer diagnosis. Much of these improvements in care were from U.S. innovation through partnerships between academic centers, life sciences companies, private foundations, and the federal government. The majority of the support is through funding from the NIH and NCI which has made the U.S. the international leader in funding cancer research.

Regardless of improved prognosis and better support, we are still in search of a cure for cancer so a diagnosis remains scary. The U.S. needs to continue to push forward with innovative treatments and research. However, President Trump has repeatedly committed to cutting science and innovation funding at the NIH, NCI, the Department of Health and Human Services, and the Centers for Disease Control and Prevention. This is in addition to the devastating and haphazard cuts to NIH grants by Elon Musk and DOGE. These federal cuts to cancer research have already stopped current research and will cause the U.S. to lose its place as the leader in cancer research. Where are the Congressional Republicans to push back on the cuts to NIH and NCI? Do they not realize this research helps all Americans, including them, their staff, and their constituents? Cancer does not discriminate based on political party, being a leader in cancer research is good for all Americans.

Representative Sean Casten (D-Ill.) recently spoke on the House floor about the federal cuts to research after hearing from a constituent whose son is fighting cancer. Casten was appropriately indignant when he stated: “Republicans fear Trump more than they fear cancer.” At first, this statement seems incredulous since cancer’s impact touches so many, it is hard to find an American who has not been impacted — whether experiencing it themselves, by their family, or in their community. Approximately 40% of people will be diagnosed with cancer in their lifetimes and, in 2024 alone, almost 15,000 children were diagnosed with cancer. Surely, Republicans do not fear losing their job more than cancer, right?

Although private foundations and the life science industries may increase their funding of cancer research, it will not be enough to make up for the nearly $8 billion the federal government provides. Nor will this replace the unique and necessary perspective of the federal government. So who picks up the mantle and leads in this space? On May 5, the European Union and France announced an over half-billion-dollar initiative to do just that. French President Emmanuel Macron and European Commission President Ursula von der Leyen announced the initiative would fund research and bring foreign scientists to Europe. American scientists have already signaled they are likely to take advantage of an opportunity like this. This investment as the U.S. divests from research is going to have devastating impacts on generations of Americans. Americans will no longer be the first to access groundbreaking treatment or better diagnostics and once scientists leave the U.S. for other opportunities it is going to take a herculean effort to convince them to return.

Waiting until 2026 or 2028 for a Congress or administration who believes in science again is not enough as every day nearly 5,500 Americans are diagnosed and 1,600 die from cancer. They need the trials and research to continue now and in their communities. For individuals enrolled in the trials stopped or delayed by Trump and DOGE, I imagine they would not say they “didn’t get anything out of it,” as Trump indicated. If Congressional Republicans acquiesce to Trump and further cut research, Representative Casten will be completely right about them fearing Trump and losing their job more than they fear cancer. They will have surrendered the war on cancer and that will be devastating for all Americans.

The Media’s Misguided Coverage of Smoke-Free Nicotine Products

Posted on by Alex Terr

Recent coverage regarding smoke-free nicotine products is more than just unfair – it’s irresponsible and damaging to public health. A recent story in the New York Post should be cheered by tobacco companies: its distortion of the facts will keep adult smokers using the most harmful nicotine delivery method – combustible cigarettes.

Unfortunately, this is par for the course when it comes to how the media covers cigarette alternatives such as nicotine pouches and heated tobacco products, which offer adults better options than continuing to smoke.

Critics of nicotine pouches often contend that they are not authorized by the U.S. Food and Drug Administration (FDA). This is false. The most popular nicotine pouch in the U.S., ZYN, recently received marketing authorization for all 20 of its products, including flavored varieties. In its January decision, the FDA noted that “these products offer greater benefits to population health” and “meet that bar by benefiting adults who use cigarettes and/or smokeless tobacco products and completely switch to these products.”

Another common misperception is that nicotine pouches are increasingly used by young people. But according to the U.S. Centers for Disease Control and Prevention’s latest National Youth Tobacco Survey, “youth nicotine pouch use did not show a statistically significant change from 2023” and remains low, at just 1.8 percent.

Heated tobacco products are another promising innovation that offer adults a better alternative to cigarettes. To be clear, IQOS is the only FDA-authorized heated tobacco product on the market in the U.S., and the agency acknowledges it significantly reduces the production of harmful chemicals compared to cigarette smoke.

Personally, I was a smoker with the lung capacity of someone 165 years old. I switched to heat-not-burn and now have the lung capacity of someone 50. Many other adult smokers have similar success stories – stories the media should cheer instead of sneer at.

The media has a responsibility to report the facts so the American public is fully informed about the realities of FDA-authorized smoke-free products, including their health benefits compared to smoking.

When the media fails to get the facts right, adult smokers pay the price. We can – and must – do better.

Why the U.S. Senate Should Reject RFK Jr.

Posted on by Max Sherrill

The nomination of Robert F. Kennedy Jr. to lead the Department of Health and Human Services comes at a pivotal moment for public health policy. Americans’ trust in public health institutions is at an all-time low, while the promise of rapidly advancing biotechnology is at an all-time high. 

It is unfortunate that Kennedy seems a poor steward of both. His vaccine skepticism seems designed to relitigate public health battles of the past, while his distrust of the medical profession and pharmaceutical companies could imperil new drug discovery and approval. While the right has long questioned federal health initiatives, Kennedy’s nomination — alongside a slate of other science skeptics in key health roles — augurs a more consequential change than a reshuffling of political appointees: the Republican Party has rejected modern science. The Senate should reject this nomination due to the clear harm Kennedy would do to the nation’s health.

Rapid advancements in biotechnology promise exciting innovation in pharmaceuticals, alongside enormous potential risks. This is especially true with the development of artificial intelligence tools for drug discovery.  This will be a pivotal time for the Food and Drug Administration, as the number of new drugs and novel therapeutics they have to approve dramatically increases. For example, the FDA made history in 2023 by approving the first CRISPR-based gene-edited drugs to treat sickle cell anemia. The agency will have to innovate and modernize to keep up with scientific developments.

It’s also an important moment for public health. In the wake of the COVID pandemic, trust in government health agencies has eroded. Partisanship has infected discussions of public health as climate change and dual-use technologies exacerbate the risk of future pandemics. Other than some modest internal reform at the Centers for Disease Control, the Biden administration did not give priority to fixing the structural issues that led to a shaky initial federal government response to COVID.  Rebuilding public trust while balancing future pandemic risk would be a challenge for any incoming administration. 

Unfortunately, Robert F. Kennedy Jr. is ill-suited to fulfill his department’s critical dual mandate to advance biomedical innovation while protecting Americans from disease. Kennedy’s unfounded skepticism of vaccines leaves America in danger of missing out on breakthrough drugs and treatments while leaving us vulnerable to diseases of the past. His strong opposition to the weight loss drug Ozempic also betrays a reflexive anti-progress attitude poorly suited to the coming acceleration of drug development.  Kennedy also seems uninterested in future pandemic prevention, reportedly saying,  “We’re going to give infectious disease a break for about eight years.”  

Kennedy’s anti-vaccine activism warrants particular attention, given its grave real-world consequences. During a 2019 measles outbreak in Samoa that left 83 people dead, Kennedy’s organization, Children’s Health Defense, helped spread misinformation that contributed to vaccination rates dropping from 60% to 31%. Though Kennedy later claimed he “had nothing to do with people not vaccinating in Samoa,” he had visited the country months before the outbreak, supporting local anti-vaccine activists and suggesting the vaccine itself might be responsible for the deaths.  Children’s Health Defense also funded the viral conspiracy film “Plandemic,” which falsely claims that influenza vaccines can cause COVID, and that the virus was somehow “manipulated.” That’s in line with his musings that COVID may have been deliberately engineered to target “Caucasians and Black people” while sparing “Ashkenazi Jews and Chinese.”

Kennedy may have a public health crisis waiting for him if he is confirmed.  The United States currently faces its largest-ever outbreak of H5N1 bird flu:57 people and 689 herds of cows have tested positive for the virus. The most troubling news from the ongoing outbreak is the two patients, a man in Missouri and a child in California,  who tested positive without any known ties to infected animals. A bird flu pandemic could cause catastrophic harm, and the speed and transparency of the current response do not induce confidence.  Kennedy is poorly suited to lead this response given his promotion of raw milk consumption, which is currently being recalled for contamination with extremely high levels of bird flu virus.  

Some of Trump’s other health nominations have similar involvements with pseudoscience.  Like Kennedy, Dr. David Weldon, Trump’s nominee for CDC director, believes the measles vaccine causes autism.  Dr. Mehmet Oz, the president-elect’s nominee for the Centers for Medicare & Medicaid Services, has a well-documented history of promoting questionable medical treatments and products on his television show. A 2014 study in the British Medical Journal found that nearly half of his medical recommendations either lacked evidence or contradicted medical research.

Anti-vaccine paranoia on the right predates Trump. State legislatures, particularly in Republican-governed states, have already expanded vaccine exemptions and limited public health powers over the past decade, while Project 2025 proposed paying damages to all medical professionals who were dismissed due to the CMS vaccine mandate, effectively undermining established public health protocols and potentially setting a dangerous precedent for future health crises. It also calls for expanding federal religious exemptions for both taking and administering vaccines.

 Trump has proved reluctant to tout the main health policy success of his first term: Operation Warp Speed. A Progressive Policy Institute report found that the COVID vaccines saved 2.9 million lives, avoided 12.5 million hospitalizations, and saved $500 billion in hospitalization costs. This was an enormous success of government collaboration with the private sector, and it is very telling that the former president is shying away from claiming this victory. 

The nomination of Robert F. Kennedy Jr. isn’t just a concerning personnel decision — it represents a dangerous turning point in American politics. While vaccine skepticism and distrust of medical institutions have long simmered on the fringes, their embrace by a major political party marks a stark departure from evidence-based public health policy. This rejection of scientific consensus comes at a particularly perilous moment: as we face evolving threats from bird flu, climate change, and emerging pathogens, while simultaneously standing on the cusp of revolutionary biotechnology breakthroughs. The Senate must reject this nomination to protect our public health institutions at this critical moment for America’s scientific future.

New PPI Report Proposes Solutions to Reduce Health Care Costs for Working Americans

Posted on by Alex Terr

WASHINGTON — As the 2024 U.S. presidential election draws near, high health care costs remain a top concern for voters without a four-year degree. A new report from the Progressive Policy Institute (PPI), “A Comprehensive Plan to Lower Health Costs Without Reducing Coverage,” outlines a set of innovative reforms to reduce health care costs for working Americans.

This new publication is a key output of PPI’s Campaign for Working America, launched earlier this year in partnership with former U.S. Representative Tim Ryan of Ohio. The Campaign aims to develop and test new themes, ideas, and policy proposals that help Democrats and other center-left leaders make a compelling economic offer to working Americans, bridge divides on cultural issues like health care, immigration, and education, and rally public support for the defense of democracy and freedom globally.

As part of PPI’s Campaign for Working America, this report, authored by Erin Delaney, PPI’s Director of Health Care Policy, addresses the growing affordability crisis in health care and offers a range of policy solutions to lower costs for working families. According to a recent YouGov poll commissioned by PPI, rising medical bills are a critical financial worry for voters without college degrees, with health insurance, hospital costs, and prescription drugs cited as the most significant burdens. Delaney highlights that high prices, exacerbated by an inefficient fee-for-service model, have made health care inaccessible for many working-class Americans.

“Health care costs are outpacing inflation, putting significant strain on household budgets,” said Delaney. “Our recommendations focus on targeted reforms that will make health care more affordable while ensuring families have access to the care they need.”

Capping prices for out-of-network care based on Medicare rates to curb excessive charges and lower premiums, ensuring site-neutral payments to eliminate discrepancies in costs between different care settings, banning anti-competitive practices like “pay-for-delay” and “evergreen patents” to improve access to affordable generic drugs, and expanding telehealth services under Medicare to provide more convenient, cost-effective care for working families.

Delaney emphasized that addressing the structural drivers of medical inflation is essential to keeping health care costs in check: “Without bold reforms, health care costs will continue to rise, further squeezing working families.”

The report also explores solutions to improve maternal health, expand the nursing workforce, and support reproductive health services, ensuring comprehensive care for all Americans.

Read and download the report here.

The Progressive Policy Institute (PPI) is a catalyst for policy innovation and political reform based in Washington, D.C. Its mission is to create radically pragmatic ideas for moving America beyond ideological and partisan deadlock. Learn more about PPI by visiting progressivepolicy.org. Find an expert at PPI and follow us on Twitter.

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Media Contact: Ian O’Keefe – iokeefe@ppionline.org

A Comprehensive Plan to Lower Health Costs Without Reducing Coverage

Posted on by Alex Terr

Campaign for Working America PPI

Introduction

The U.S. economy is growing at a healthy clip, but working Americans continue to identify high prices and living costs as their chief economic worry in this crucial election year. According to a recent YouGov poll commissioned by PPI, soaring medical bills are a top financial concern for voters without college degrees. Asked specifically which health care costs hit them hardest, they say health insurance, hospitals and drugs.

According to a 2023 report from the Centers for Medicare & Medicaid Services (CMS), health care spending increased by 4.8% in 2022, outpacing the 3.2% rise in the Consumer Price Index (CPI), which measures inflation. This disparity underscores the worsening affordability crisis in health care, where the cost of medical services, including hospital visits, prescription drugs, and insurance premiums, is escalating more rapidly than general living costs. Consequently, households are feeling the pinch as a larger portion of their budgets is consumed by health care expenses, leaving less room for other essential needs.

Every dollar that is spent on out-of-pocket medical costs is a dollar less to pay for food, gas, and other household necessities. Three out of every four families report they are worried about being able to afford unexpected medical bills, which have left millions of households collectively shouldering more than $200 billion in medical debt. Anxiety about household expenses is especially acute in households making less than $40,000 annually, leading families to prioritize pressing financial needs over preventive or routine medical care.

Voters generally have greater trust in the Democratic Party than the Republican Party when it comes to managing high health care costs and ensuring access to abortion services. Surveys consistently indicate that a majority of voters trust Democrats more when it comes to reproductive health and reducing health care expenses.

During her debate with former President Donald Trump, Vice President Kamala Harris committed to capping insulin prices, limiting patient cost-sharing for generic drugs, and expanding Medicare’s authority to negotiate drug prices. She also vowed to protect and enhance the Affordable Care Act (ACA), promising to make permanent the Biden-Harris administration’s enhanced tax credits, which have lowered premiums by an average of $800 annually for millions of Americans.

Despite his repeated failures to convince Congress to repeal the ACA during his presidency, Trump in the debate vowed again to replace it with “something better.” When pressed for specifics, however, he could only reference a vague “concept of a plan,” nearly a decade after his initial promise to provide a viable alternative. Over that period, public support for the ACA has risen dramatically, from 38% to 62%, according to polling by KFF.6 Nonetheless, Congressional Republicans are still trying to weaken the law by pushing for the elimination of enhanced tax credits passed during the COVID-19 pandemic. This would mean higher premiums for working Americans with modest incomes.

Trump also is trying to distance himself from the public backlash against the Supreme Court’s decision striking down abortion rights. Since the Court overturned Roe v. Wade in June 2022, Republican-controlled states enacted laws that either ban abortion outright or impose strict restrictions on access to reproductive health care, affecting 25 million women. This shift has resulted in a patchwork of laws, with many states erecting significant barriers to abortion access. Consequently, millions of American women are at risk of not receiving timely reproductive health care.

Beyond restricting abortion access, the impact of the Roe decision has complicated life for women seeking maternal care services. Many hospitals in states with stringent abortion laws have closed their maternity wards or significantly reduced maternal health services in response to legal challenges from right-wing politicians and pressure groups. Tragically, this led to the death of Amber Thurman, a 28-year-old nursing assistant and mother of a six-year-old son who succumbed to an infection after medical providers delayed care for the effects of a medication abortion in a state with such a ban, according to an investigation by ProPublica.

Maternal mortality review committees, like the one in Georgia that examined this case, typically operate with a two-year delay in reviewing the cases they investigate. As a result, experts are only now beginning to assess deaths that occurred after the Supreme Court’s ruling. As this data is reviewed and released, more such stories are likely to emerge.

Having stacked the Supreme Court with antiabortion ideologues, Trump now offers the ludicrous defense that Americans — who strongly supported the national right to abortion established by Roe — were clamoring for states to decide whether abortion should be legal. He now claims to support exceptions to abortion bans for rape and incest, drawing fire from outraged Christian conservatives who’ve accused him of political opportunism. Trying to avoid another minefield, the former president has also declared himself a “leader in fertilization” and proposed mandating free access to in vitro fertilization (IVF). Congressional Republicans, however, have blocked the Right to IVF Act.

Harris has vowed to push for national legislation restoring Americans’ reproductive rights; assuring access to contraception; and safeguarding families’ rights to access IVF if they can’t have children on their own. She also promised to continue to advocate for access to FDA-approved abortion drugs and select judges who uphold reproductive freedom.

In addition, Harris’ proposals provide a promising foundation for lowering medical bills for working families. But Democrats should be thinking about a bolder, more comprehensive attack on the structural drivers of medical inflation, which makes the U.S. health care system by far the most expensive in the world. In this report, PPI offers a radically pragmatic slate of new ideas for assuring access to providers, driving down medical prices, and improving health care outcomes for working Americans.

Read the full report.

Harris’ Pledge: Affordable Health Care and Reproductive Rights

Posted on by Max Sherrill

Health care costs and reproductive health were key topics in Tuesday night’s debate. Vice President Harris presented concrete solutions for managing costs — such as addressing insulin and prescription drug prices and strengthening the ACA — while criticizing Trump for failing to deliver an alternative to the ACA despite promises since 2016. Additionally, Harris delivered impactful critiques by emphasizing Trump’s central role in undermining American women’s reproductive rights. This focus is particularly relevant, given the ongoing strain of high health care costs on American households and Trump’s continued efforts, alongside Republicans, to undermine reproductive health.

A recent Progressive Policy Institute poll reveals that working-class Americans are deeply concerned about soaring health care costs, which they largely blame on drug manufacturers, insurance companies, and hospitals. Key issues include opaque hospital pricing and high drug prices. In response, Harris has pledged to address these concerns as part of her health care platform, which was highlighted in the debate. Her proposals include capping insulin prices, limiting cost-sharing for generic drugs, and expanding Medicare’s ability to negotiate drug prices.

Harris’s evolution from support for Medicare for All to these more prosaic concerns is welcome.  This pragmatic approach is likely due to the political decision to tamper the announcement of any major policy reform that would be targeted by the Trump campaign. Harris intends to instead protect and bolster the Affordable Care Act (ACA), along with making the Biden-Harris tax credit enhancements permanent, which are reducing health care premiums by an average of around $800 annually for millions of Americans.

Meanwhile, Trump’s inconsistent stance on repealing and replacing the ACA underscores his lack of seriousness and leadership on the issue, as evidenced by his vague statement during the debate: “I have a concept of a plan” to address or alter the law. Thanks to the ACA, a record percentage of Americans (92%) have access to health insurance. The Biden-Harris admin made an important contribution to this achievement by including enhanced subsidies for the ACA marketplace in its landmark Inflation Reduction Act. A record 21 million people enrolled through the ACA this year alone, reducing the uninsured rate from 16% in 2010 to under 8% today. But health care costs remain exorbitantly expensive, forcing working families to reprioritize their immediate financial needs over preventive or ongoing medical care.

Meanwhile, reproductive health care access remained a critical focus for Harris throughout the debate, as she vowed to reinstate Americans’ reproductive rights that were undermined when Trump’s Supreme Court justices overturned Roe v. Wade. Harris promised to seek national legislation to restore the legal right to abortion; enhance access to contraception; safeguard a woman’s right to access IVF, and repeal the Hyde Amendment. She also promised to continue to advocate for access to FDA-approved abortion drugs and select judges who uphold reproductive freedom.

Trump proved once again that he and the Republican Party are completely out of touch with working-class Americans who are increasingly distressed about the state of abortion access since the end of Roe. Refuting his record and providing faltering answers on reproductive access, Harris swung back, reiterating that Trump should “not be telling a woman what to do with her body.”

In PPI’s Winning Back Working America poll, 56% of participants said they are concerned about abortion access. Trump’s relentless effort to curtail access to reproductive health care is directly opposed to the majority of Americans’ wishes, eroding the foundation of democracy and their personal liberty. Harris and Democrats are aptly appealing to working-class voters, including Independents and Republicans, who are anxious about the fragile state of access to reproductive care in the 2024 election and beyond.

Harris’ focus on reducing health care costs and enhancing reproductive health access in the debate and in her campaign represents a refreshing shift that addresses the concerns of working-class voters. Even those with coverage often encounter substantial out-of-pocket expenses. Similarly, despite some states protecting reproductive freedom, individuals still face barriers and threats from Trump and Republicans seeking to undermine these protections. Harris and Democratic lawmakers present a promising vision for working Americans seeking relief from harmful Republican policies that threaten to increase costs and reduce access to care.

Listen up Democrats: Don’t Forget Health Care

Posted on by Max Sherrill

In 1992, James Carville coined his famous phrase, “It’s the economy, stupid.” Inside the Clinton campaign, a laser-like focus on economic issues resonated deeply with voters grappling with a recession they attributed to the policies of George H.W. Bush. Carville’s focus ultimately propelled Clinton to victory. But that famous slogan was only one of three key messages on which the Clinton campaign focused. The lesser-known others were “Change vs. more of the same” and “Don’t forget health care.”

As Democrats gear up for the upcoming elections, it’s clear that voters have a lot on their minds. Recent swing state polling data, commissioned by the Progressive Policy Institute, sheds light on what’s really driving voter concerns. The full poll results and an accompanying memo present a golden opportunity for Democrats to solidify their standing as the party of pragmatic solutions for Americans’ concerns on the economy and where voters believe healthcare costs have run amok.

Let’s face it: The economy is top of mind for most voters. Inflation and the skyrocketing costs of food and housing are causing serious anxiety across the board. This trend cuts across all demographics, signaling a pressing need for an effective economic strategy accompanied with a simple message that voters can understand. Democrats have long struggled in the past to win over voters on economic issues, but there’s a real chance to change that narrative by tackling these concerns head-on.

When it comes to health care policy in general, voters generally trust Democrats to handle the policy. Half of the voters trust Democrats more on setting policy related to the price of prescription medications, compared to 40% who trust Republicans. Democrats are also seen as more reliable when it comes to ensuring U.S. drug makers continue to innovate and develop new treatments. And with abortion rights under threat, Democrats will again mobilize voters as they vow to protect access to abortion, contraception, and women’s health care priorities.

Looking specifically at health care costs, while important, they rank third on the list of costs that are most concerning to voters — well below food and housing. A total of 13% of respondents named health care costs as their most pressing concern, compared to 22% who said food and another 19% who pointed to housing costs This suggests that while health care costs remain critical, Democrats need to balance their focus with broader economic policies to truly resonate with the electorate.

The poll then delves into health care costs more specifically. The cost of health insurance is by far the biggest worry, with 28% of voters citing it as their top issue. Out-of-pocket costs and the expense of doctors and hospitals are also major concerns, particularly among Republicans and non-college white voters. While capping the cost of key prescription drugs like insulin is a popular move and common talking point by Democrats on the campaign trail, only 8% of voters think Congress should prioritize expanding Medicare negotiations for more medicines. Voters are much more concerned about the overall cost of health insurance and are looking for more from their leaders on this challenge.

Additionally, the poll highlights several other policy areas that voters prioritize. When asked about the most important policy priorities for the party that controls Congress next year, a significant 30% of voters want to see more investment in manufacturing, energy production, and other industries. Another 24% support increased IRS action to ensure billionaires and millionaires pay their fair share of taxes. These priorities show that voters are looking for comprehensive economic strategies that extend beyond health care.

The poll’s findings underscore the need for strategic messaging that balances health care costs and more pressing economic priorities. When crafting their pitch, Democrats should consider:

• First and foremost, emphasizing broader economic policies that address inflation, housing, and food costs, which align with voters’ top concerns.

• Advocating for investment in manufacturing and fair taxation policies, which resonate strongly with key voter demographics and are more top of mind than health care costs.

• Refocusing the primary message on health care costs to address the cost of health insurance message, rather than solely the cost of prescription drugs, in order to better match voter priorities.

By adopting a balanced approach that addresses both healthcare and broader economic issues, Democrats can effectively connect with voters and reinforce their position as practical leaders committed to addressing the most pressing concerns of the American people.

Paying for Progress: A Blueprint to Cut Costs, Boost Growth, and Expand American Opportunity

Posted on by The Progressive Policy Institute

The next administration must confront the consequences that the American people are finally facing from more than two decades of fiscal mismanagement in Washington. Annual deficits in excess of $2 trillion during a time when the unemployment rate hovers near a historically low 4% have put upward pressure on prices and strained family budgets. Annual interest payments on the national debt, now the highest they’ve ever been in history, are crowding out public investments into our collective future, which have fallen near historic lows. Working families face a future with lower incomes and diminished opportunities if we continue on our current path.

The Progressive Policy Institute (PPI) believes that the best way to promote opportunity for all Americans and tackle the nation’s many problems is to reorient our public budgets away from subsidizing short-term consumption and towards investments that lay the foundation for long-term economic abundance. Rather than eviscerating government in the name of fiscal probity, as many on the right seek to do, our “Paying for Progress” Blueprint offers a visionary framework for a fairer and more prosperous society.

Our blueprint would raise enough revenue to fund our government through a tax code that is simpler, more progressive, and more pro-growth than current policy. We offer innovative ideas to modernize our nation’s health-care and retirement programs so they better reflect the needs of our aging population. We would invest in the engines of American innovation and expand access to affordable housing, education, and child care to cut the cost of living for working families. And we propose changes to rationalize federal programs and institutions so that our government spends smarter rather than merely spending more.

Many of these transformative policies are politically popular — the kind of bold, aspirational ideas a presidential candidate could build a campaign around — while others are more controversial because they would require some sacrifice from politically influential constituencies. But the reality is that both kinds of policies must be on the table, because public programs can only work if the vast majority of Americans that benefit from them are willing to contribute to them. Unlike many on the left, we recognize that progressive policies must be fiscally sound and grounded in economic pragmatism to make government work for working Americans now and in the future.

If fully enacted during the first year of the next president’s administration, the recommendations in this report would put the federal budget on a path to balance within 20 years. But we do not see actually balancing the budget as a necessary end. Rather, PPI seeks to put the budget on a healthy trajectory so that future policymakers have the fiscal freedom to address emergencies and other unforeseen needs. Moreover, because PPI’s blueprint meets such an ambitious fiscal target, we ensure that adopting even half of our recommended savings would be enough to stabilize the debt as a percent of GDP. Thus, our proposals to cut costs, boost growth, and expand American opportunity will remain a strong menu of options for policymakers to draw upon for years to come, even if they are unlikely to be enacted in their entirety any time soon.

The roughly six dozen federal policy recommendations in this report are organized into 12 overarching priorities:

I. Replace Taxes on Work with Taxes on Consumption and Unearned Income
II. Make the Individual Income Tax Code Simpler and More Progressive
III. Reform the Business Tax Code to Promote Growth and International Competitiveness
IV. Secure America’s Global Leadership
V. Strengthen Social Security’s Intergenerational Compact
VI. Modernize Medicare
VII. Cut Health-Care Costs and Improve Outcomes
VIII. Support Working Families and Economic Opportunity
IX. Make Housing Affordable for All
X. Rationalize Safety-Net Programs
XI. Improve Public Administration
XII. Manage Public Debt Responsibly

Read the full Blueprint. 

Read the Summary of Recommendations.

Read the PPI press release.

See how PPI’s Blueprint compares to six alternatives. 

Media Mentions:

PPI Leads Letter to Advance Site-Neutral Payment Reform to Protect Patients from High Hospital Bills, Promote Fairer Billing

Posted on by Max Sherrill

WASHINGTON — Today, the Progressive Policy Institute (PPI) is leading an open letter with nearly 30 other organizations calling on the Senate Finance Committee to advance site-neutral payment reform through the Site-based Invoicing and Transparency Enhancement (SITE) Act, a bipartisan bill introduced by Senators Maggie Hassan (D-N.H.), Mike Braun (R-Ind.), and John Kennedy (R-La.). PPI has long been supportive of site-neutral payment reform and legislative efforts to address this issue.

Medicare, and in many cases, commercial insurers, pay hospital-owned facilities higher rates than independent medical practices and other outpatient facilities for the exact same services. These higher payment rates actually create an incentive for hospitals to acquire these independent practices, resulting in higher prices charged to patients and taxpayers. The SITE Act would promote fairer billing by both ending dishonest billing practices that occur when a hospital acquires a doctor’s office and charges hospital prices despite performing services in the same location, and it would enact site-neutral payment reform to ensure Medicare reimburses providers at the same price for the same service.

Millions of Americans and their families are deeply concerned about the high cost of living and struggling to afford medical care. Every dollar that is spent on high out-of-pocket costs means a dollar less to pay for food, clothing, and other necessities for themselves and their families. This leads to difficult decisions about prioritizing immediate financial needs over preventive or ongoing medical care.

“Ending harmful billing practices like the policies suggested in the SITE Act is crucial in reducing the financial strain that comes from irrationally high medical costs,” said Erin Delaney, PPI’s Director of Health Care Policy. “It is critical that the Senate Finance Committee move forward with this important piece of legislation.”

Read and download the letter here.

The Progressive Policy Institute (PPI) is a catalyst for policy innovation and political reform based in Washington, D.C. Its mission is to create radically pragmatic ideas for moving America beyond ideological and partisan deadlock. Learn more about PPI by visiting progressivepolicy.org. Find an expert at PPI and follow us on Twitter.

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Media Contact: Ian O’Keefe – iokeefe@ppionline.org

PPI Statement on House Committee on Oversight and Accountability Hearing on FDA Oversight, Tobacco Regulation

Posted on by Max Sherrill

Washington, D.C. — Today, Lindsay Lewis, Executive Director at the Progressive Policy Institute, released the following statement in response to the House Committee on Oversight and Accountability hearing on “Oversight of the Food and Drug Administration” with FDA Commissioner Dr. Robert Califf. Part of the hearing included the FDA’s response to regulating tobacco and nicotine products through its Center for Tobacco Products (CTP).

“Today’s hearing in the House Committee on Oversight and Accountability highlights the FDA’s failure to provide clear and fair regulatory pathways for smoke-free products, which are far less harmful alternatives than combustible cigarettes. It is the FDA’s responsibility to implement the 2009 Tobacco Control Act, and it has failed spectacularly to approve a majority of the premarket tobacco smoke-free products.

“Not only is this a clear market failure, it’s a public health failure. New nicotine delivery products, like heat-not-burn and vapes, provide an off-ramp to adult cigarette smokers that are 95-99% less harmful than traditional combustible cigarettes. The FDA must provide clear and achievable approval pathways, that are scientifically validated and do not appeal to youth, to provide millions of adult smokers an option for better smoking alternatives.”

The Progressive Policy Institute (PPI) is a catalyst for policy innovation and political reform based in Washington, D.C. Its mission is to create radically pragmatic ideas for moving America beyond ideological and partisan deadlock. Learn more about PPI by visiting progressivepolicy.org.

Follow the Progressive Policy Institute.

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Media Contact: Tommy Kaelin – tkaelin@ppionline.org

PPI Statement on the 51st Anniversary of Roe v. Wade

Posted on by The Progressive Policy Institute

Erin Delaney, Director of Health Care Policy at the Progressive Policy Institute (PPI), released the following statement on the would-be 51st anniversary of the passage of Roe v. Wade, the United States Supreme Court’s landmark decision that recognized the constitutional right to an abortion and legalized the procedure nationwide:

“Thanks to former President Donald Trump and his appointments of right-wing activist judges to the Supreme Court, a new generation of Americans are now living with a reversal of rights that their parents and grandparents fought for. The onslaught of restrictions and bans to reproductive health care that have come in the wake of Dobbs further inflicts suffering on families and their ability to make their own decisions about their own health and when and how to grow their family.

“The Republican Party is out of touch with working-class Americans who are increasingly distressed about the state of abortion access since the end of Roe. In PPI’s Winning Back Working America poll, 56% of participants said they are concerned about abortion access. Republican’s relentless effort to curtail access to reproductive health care is directly opposed to the majority of Americans’ wishes, eroding the foundation of democracy and their personal liberty.

“Democrats must continue to expand their majority by appealing to working-class voters, including Independents and Republicans who are anxious about the fragile state of access to reproductive care in the 2024 election and beyond.

“PPI firmly believes in and will always defend reproductive freedom by fighting against far-right extremism and working to expand access to comprehensive reproductive health care for all Americans.”

The Progressive Policy Institute (PPI) is a catalyst for policy innovation and political reform based in Washington, D.C. Its mission is to create radically pragmatic ideas for moving America beyond ideological and partisan deadlock. Learn more about PPI by visiting progressivepolicy.org.

Follow the Progressive Policy Institute.

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Media Contact: Amelia Fox, afox@ppionline.org

Quantifying the Economic and Health Benefits from COVID-19 Vaccines and Boosters

Posted on by Max Sherrill

Washington, D.C. — With the recent surge of new COVID-19 variants, the question of whether to receive a COVID-19 booster has become front of mind for many Americans. The development, manufacturing, and administration of COVID-19 vaccines to the great majority of the adult United States population has been an impressive scientific and policy achievement.

Today, the Progressive Policy Institute (PPI) released a new report “Quantifying the Economic and Health Benefits from Rapid-Development COVID-19 Vaccines and Boosters” by Michael Mandel, Ph.D., Chief Economist at the Progressive Policy Institute, Robert Popovian, Pharm D., M.S. Senior Health Policy Fellow at the Progressive Policy Institute, and Wayne Winegarden, Ph.D., Director at the Center for Medical Economics and Innovation Pacific Research Institute.

Using conservative assumptions, the report finds that the COVID-19 vaccines saved 2.9 million lives, avoided 12.5 million hospitalizations, and saved $500 billion in hospitalization costs. This is in comparison to the counterfactual of no successful vaccine, relying instead on the development of natural immunity through infection.

Looking forward, the report uses the same framework to examine the decision to receive a new COVID-19 booster each year, which boosts protection against severe outcomes. The analysis assumes that existing protection against severe outcomes decays as new variants arise and that the benefits of the booster depend on the nature and speed of changes in the virus.

The report provides illustrative calculations of the benefits from annual COVID-19 boosters at different ages. One such illustrative calculation shows that the expected 5-year economic losses to an individual choosing not to receive boosters rises from $654 at age 30 to more than $65,000 at age 75.

“The data shows that COVID-19 vaccines have provided enormous health and economic benefits to the United States, saving millions of lives and hospitalizations, as well as $500 billion in hospital costs,” said Dr. Michael Mandel. “This comprehensive report also analyzes the individual consequences of deciding whether or not to receive a COVID-19 booster and finds that there is a great economic benefit to getting COVID boosters.”

“Immunization continues to be the most cost-effective and clinically safe way of gaining immunity against viral pathogens of COVID-19. While the data demonstrates that both prior infection and vaccination provide similar protection against future COVID-19 infections, there are typically more health and economic consequences from obtaining protection through prior infection compared to vaccination,” said Dr. Robert Popovian.

Read and download the full report here.

The Progressive Policy Institute (PPI) is a catalyst for policy innovation and political reform based in Washington, D.C. Its mission is to create radically pragmatic ideas for moving America beyond ideological and partisan deadlock. Learn more about PPI by visiting progressivepolicy.org. Find an expert at PPI and follow us on Twitter.

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Media Contact: Amelia Fox – afox@ppionline.org

Quantifying the Economic and Health Benefits from Rapid-Development COVID-19 Vaccines and Boosters

Posted on by Max Sherrill

ABSTRACT

This paper assesses the health and economic benefits of the rapid development of COVID-19 vaccines. Using a simple framework of stylized facts, we find that the COVID-19 vaccines saved 2.9 million lives, avoided 12.5 million hospitalizations, and saved $500 billion in hospitalization costs. Importantly, these are conservative estimates, based on the assumption that successfully surviving COVID-19 infection offers protection against future severe outcomes similar to vaccination.

Using the same framework, we examine the consequences to individuals of choosing to receive or not receive new COVID-19 boosters, given the continued evolution of the virus. An illustrative calculation shows that the expected 5-year economic losses to an individual from choosing not to receive boosters rises from $654 at age 30 to more than $65,000 at age 75.

INTRODUCTION

From the moment COVID-19 was first identified, researchers were projecting the potential economic and human cost of an unchecked major pandemic and the corresponding economic and human benefits of an effective COVID-19 vaccine. Some of these projections were exceedingly influential in guiding private and public responses to the pandemic.

The development, testing, manufacturing, and administration of COVID-19 vaccines to almost 80% of the population over the age of 12 in the United States (fully vaccinated) has been a tremendous scientific and policy achievement. Globally, about 67% of the world population was fully vaccinated as of March 2023.

Unfortunately, hopes that a sufficiently vaccinated population could mostly avoid initial infections have turned out to be excessively optimistic. As of November 2022, 77.5% of the population was estimated to have been infected by COVID-19 at least once. In the 16- to 49- year-old age group, the percentage infected is closer to 85%.

In particular, the Omicron variant turned out to be extremely contagious in the U.S. and globally. As of April 2022, 60 to 80% of the European population was estimated to have been infected with COVID-19. More recent estimates are even higher. According to one model, an estimated 95% of the European population has been infected at least once as of December 2022. In Japan, the cumulative infection rate, measured by antibody tests, rose sharply from 28.6% in November 2022 to 42.3% in February 2023. In Japan, an estimated 80% of the population has been infected at least once. In Korea, the cumulative infection rate was 83%. Even the draconian measures applied by the Chinese government were unable to contain the wave of infections.

A related observation is that neither infection nor vaccination with the current generation of vaccines appears to offer long-lasting immunity against reinfections. Past a certain point, the spread of the virus through the population could not have been prevented by a more aggressive vaccination program or other policy interventions.

However, the exceedingly good news is that vaccination appears to provide durable protection against severe outcomes such as invasive ventilation and death. Obviously, that might change as new variants arise, but for now, that’s what current evidence shows.

Notably, prior infection also appears to provide durable protection against severe outcomes, even for those people who have not been vaccinated. This is no longer a “novel” pathogen attacking unprepared immune systems. Once again, this could change for a sufficiently different variant.

So now we can get a clearer picture of the benefits of COVID-19 vaccination. Vaccination provided a much lower risk path for achieving protection against severe outcomes. Without vaccines, many more people would have died or have been hospitalized.

This paper has both a backward-looking component and a forward-looking component. Based on the evidence, the backward-looking component constructs a set of stylized facts that allow us to understand the economic and health benefits of a rapid-development COVID-19 vaccine compared to reasonable counterfactuals (including no vaccine and more rapid roll-out of the vaccine at the beginning of 2021). These estimates include the mortality and hospitalization outcomes of the “worst case” counterfactual of no successful vaccine, along with the associated health-related costs.

Read the full report.

House Takes Critical Step in Creating Fairer Pricing, More Transparency for Health Care Costs

Posted on by Alyssa Brown

Today, Erin Delaney, Director of Health Care Policy at the Progressive Policy Institute (PPI), released the following statement on the House passage of the Lower Cost, More Transparency Act:

“PPI applauds the House passage of the bipartisan Lower Cost, More Transparency Act, a critical step to hold the health care system more accountable and encourage much-needed transparency around health care costs. This legislation creates more fairness in what people are paying for health care and provides more accurate and timely information about the cost of services and procedures to empower patients to make more informed decisions about the care they receive. Making patients informed consumers of health care through price transparency can leverage competition to control costs.

“We are particularly pleased to see that through this legislation, Congress is progressing in addressing site-neutral payment reform to prevent patients from being charged more for the exact same care because of the location where they received it. We hear plenty of stories about how patients are increasingly confused by the shockingly expensive bills they receive, especially when their medical care shifts from an outpatient to a hospital-based setting.

“As we head into the holiday season — when millions of Americans and their families are hyper-focused on the high cost of living and struggling to afford medical care — it is a relief to see that lawmakers are taking the next important step to reduce the financial strain that comes from irrationally high medical costs. As PPI continues to support efforts to make health care costs more transparent and affordable for all Americans, we are reassured to see the House passage of this important legislation and encourage a swift passage in the Senate.”

The Progressive Policy Institute (PPI) is a catalyst for policy innovation and political reform based in Washington, D.C. Its mission is to create radically pragmatic ideas for moving America beyond ideological and partisan deadlock. Learn more about PPI by visiting progressivepolicy.org.

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Media Contact: Amelia Fox, afox@ppionline.org