Axios Vitals

A briefcase with a red cross on the front.

July 28, 2022

Happy Thursday, Vitals readers. Today's newsletter is 921 words, or a 3-minute read.

1 big thing: Contraception anxiety peaks

Illustration of an IUD forming the "no" symbol.

Illustration: Maura Losch/Axios

Democrats' anxiety over access to birth control is peaking as more red states attempt to adopt restrictions on emergency contraception and IUDs and could move to potentially ban them, Axios' Oriana Gonzalez writes.

The big picture: Congressional Democrats are trying to codify some Supreme Court precedents addressing contraception, anticipating the court's 6-3 conservative majority could overturn them in a future term, said Kaiser Family Foundation senior vice president Alina Salganicoff.

What they're saying: "We've had, for years, an effort by abortion opponents to conflate contraception with abortion, and we've seen it specifically around emergency contraception and IUDs" said Elizabeth Nash, lead state policy analyst for the Guttmacher Institute, a research organization that supports abortion rights.

By the numbers: Nine states have restrictions on emergency contraception, including allowing insurance companies to decline to cover it and letting pharmacists opt out of dispensing it on religious or moral grounds, per Guttmacher.

  • 12 states have laws that let some health care providers refuse to provide services related to contraception based on their personal beliefs.

What we're watching: States with restrictions could go further if the Supreme Court overturns decisions that protect contraception access.

  • Since contraceptives are FDA-approved, it may be difficult for states to make them illegal.
  • They could make it more difficult to access them through age restrictions, limiting public funding and the amount of information available around contraception.

Go deeper.

2. Democrats' insulin dilemma

Illustration of hands in a suit chiseling a dollar sign into a pill

Illustration: Sarah Grillo/Axios

Even if Democrats soon pass a massive health care bill on a party line vote, there's a chance they could fail to deliver on one of their most politically appealing drug price reforms: capping what patients pay out-of-pocket for insulin, Axios' Caitlin Owens writes.

Between the lines: Insulin-specific policies are absent from a compromise reconciliation deal, while a bipartisan pair of senators push a stand-alone insulin plan. Such a two-track approach risks leaving the insulin bill behind and alienating patients with diabetes heading into the midterms.

State of play: The House-passed Build Back Better Act included insulin co-pay caps along with measures that allow Medicare to negotiate drug prices, limit drug price hikes and restructure the Part D benefit.

  • But a scaled-down compromise negotiated by Senate Majority Leader Chuck Schumer and Sen. Joe Manchin (D-W. Va.) doesn't include the insulin policies. Some are in the stand-alone bill championed by Sens. Jeanne Shaheen (D-N.H.) and Susan Collins (R-Maine) — including a cap on cost-sharing at $35 per month within private insurance and Medicare.
  • The Shaheen-Collins measure would require 60 votes — including at least 10 Republicans — to pass the Senate, and it's not clear yet whether enough members support the bill.

What we're watching: Whether Democrats try to add the insulin components back into their reconciliation bill — and whether those provisions would even comply with Senate rules.

  • If they don't and wind up passing the bigger health bill through the partisan reconciliation process, they'll be hard-pressed to convince 10 Republicans to collaborate on anything else before the midterms.

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3. Travel nurse demand cools off

Illustration of a nurse's scrubs, stethoscope and mask, standing with no nurse inside them.

Illustration: Brendan Lynch/Axios

Pandemic-fueled demand for travel nurses is leveling off, providing some relief for hospital operators who grappled with labor costs during COVID surges, the Wall Street Journal reports.

How it works: Many travel nurses were making at least $90 an hour during the height of the pandemic as hospitals struggled to keep their beds staffed.

But demand has dropped as the pandemic entered a different phase and hospitalizations fell. Jefferies analyst Brian Tanquilut sees weekly pay for temporary nurses dropping about 15% more to the low $3,000s a week, the WSJ reported.

Yes, but: Gaps in the health care workforce should sustain demand for contract labor.

  • John Martins, CEO of Cross Country Healthcare, another staffing firm, expects the market will grow from 40,000 travel nurses in 2018 to 80,000 in 2023, per the WSJ.

4. More LGBTQ youth with trauma tried suicide

One in four LGBTQ young people experiencing high levels of trauma said they had attempted suicide in 2021, Oriana writes on a new survey from The Trevor Project.

The big picture: More than 300 anti-LGBTQ laws have been introduced this year and at least 25 have passed. Medical experts say the rancor surrounding issues like restrictions on gender-affirming medical care can weigh heavily on LGBTQ young people's mental health.

Details: 25% of LGBTQ youth with anxiety and other high trauma symptoms reported a suicide attempt last year, compared to 3% of those with no symptoms and 9% of those with "low or moderate" symptoms.

  • LGBTQ young people with high levels of trauma "had over three times greater odds" of attempting suicide in 2021 compared to those with no symptoms or "low or moderate" symptoms.
  • Symptoms of trauma are relatively common among LGBTQ youth, with more than one in three (37%) between the ages of 13 and 24 reporting symptoms at high levels.

Go deeper.

5. Catch up quick

The FDA supplemented the license for the Jynneos monkeypox vaccine, helping Bavarian Nordic make nearly 800,000 more doses available for distribution. (Axios)

The Biden administration spent $25,750 and authorized another $30,500 for media training and executive coaching for CDC Director Rochelle Walensky. (Politico)

Tight funds and a lack of urgency stand in the way of efforts to make better, more universal COVID vaccines. (Science)