KHN’s ‘What the Health?’: A health-heavy State of the Union

Russia's attacks on Ukraine took the headlines for President Joe Biden's first official State of the Union address, but Biden made a point to highlight several of the administration's high-priority health issues, including covid, mental health, nursing home regulation, and ailments among military personnel from toxic burn pits.

Also this week, the Biden administration unveiled a program aimed at getting the country better prepared should another covid surge take place. Congress is also starting work on pandemic preparation legislation, although some lawmakers might be reluctant to spend still more money on the effort.

This week's panelists are Julie Rovner of KHN, Alice Miranda Ollstein of Politico, Amy Goldstein of The Washington Post, and Sarah Karlin-Smith of the Pink Sheet.

Among the takeaways from this week's episode:

• The Biden administration's proposals to improve nursing home care are a byproduct of the covid pandemic. Nearly a quarter of the 975,000 deaths in this country have been among people living or working in nursing homes.
• But the proposed changes will hit a hard reality: Nursing homes face severe labor shortages. Recruiting employees is a challenge because of the difficult work involved, the risks of covid, and the meager average pay.
• Improvements to nursing home care can be expected to take time. Some proposals will need congressional funding, and although nursing home safety has general bipartisan support, there are many interests competing for federal dollars. In addition, making changes through regulation is a time-consuming process.
• Biden also emphasized in his State of the Union speech the compelling need to boost mental health services in the nation, following problems such as increased suicides, depression among children, and opioid dependence, all of which have been compounded by the pandemic.
• Among the notable health care omissions in Biden's speech was a push for new Medicare benefits and the expansion of Medicaid in a few conservative states that have held off on accepting that option under the Affordable Care Act. Both controversial policies are prized by Democratic stalwarts, but they were provisions that helped stall the president's Build Back Better legislation.
• Following the State of the Union address, the administration rolled out plans to fight the covid virus long term and set the country on a less volatile course to handle furture outbreaks. The plan would also require congressional funding, but the administration has reduced its expectations because of bipartisan concerns in Congress about overall covid spending.
• Although mask mandates are lifting across the nation and covid cases have fallen dramatically, the administration is nervous about spiking the football too soon. Officials still are feeling repercussions from last summer, when they suggested that the arrival of a vaccine and declining illness signaled the country was past the worst of the pandemic. The delta and omicron variants quickly proved them wrong.
• The Senate has failed to advance the Women's Health Protection Act, a bill designed to ensure women have the right to abortion if the Supreme Court were to upend the landmark Roe v. Wade decision. The measure did not come close to getting the 60 votes needed in the Senate to stop a filibuster and did not draw even all the Democratic votes.
• Some opponents of the Women's Health Protection Act argue it goes too far beyond the protections of Roe, such as allowing minors to seek an abortion without parental involvement.
• As advocates and opponents gear up for a possible Supreme Court decision later this year that changes Roe, attention has turned to medical abortions. Many conservative states are working to restrict access to those pills, but a legal battle may be brewing over whether a state has the authority to limit medications approved by the FDA.

Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read, too:

Julie Rovner: The Wall Street Journal's "Why Is Everyone Standing So Close? Personal-Space Boundaries Shifted During the Pandemic," by Alex Janin

Alice Miranda Ollstein: The New York Times' "Time Is Running Out to Avert a Harrowing Future, Climate Panel Warns," by Brad Plumer, Raymond Zhong, and Lisa Friedman

Amy Goldstein: The Washington Post's "Ukraine Conflict Could Spark Surges of Covid, Polio, Other Diseases, Say Experts," by Loveday Morris and Dan Diamond

Sarah Karlin-Smith: KHN's "Covid Expert Joins Exodus Into Business, Where Science Parlays Into Profits," by Jay Hancock

Also discussed on this week's podcast:

KHN's "Biden's Promise of Better Nursing Home Care Will Require Many More Workers," by Jordan Rau

KHN’s "Biden Pledges Better Nursing Home Care, but He Likely Won't Fast-Track It," by Rachana Pradhan and Harris Meyer

The Washington Post's "Most Americans Say the Coronavirus Is Not Yet Under Control and Support Restrictions to Try to Manage It, Post-ABC Poll Finds," by Amy Goldstein and Emily Guskin

The New York Times' "Abortion Pills Now Account for More Than Half of U.S. Abortions," by Pam Belluck