Axios Vitals

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May 10, 2022

Good morning, Vitals readers. Today's newsletter is 809 words or a 3-minute read.

🎉 A big congrats to all of the Pulitzer prize winners, which included multiple examples of terrific health journalism.

1 big thing: The future of women's health without Roe

Illustration of a row of standing gavels set up and toppling like dominoes
Illustration: Annelise Capossela/Axios

If the U.S. Supreme Court overturns Roe v. Wade, it could begin a ripple effect that subsumes many other facets of reproductive health care — a reflection, in part, of decades' worth of medical advances that make the subject much more complicated than it was 50 years ago, Axios' Caitlin Owens writes.

Why it matters: Striking down the federal right to abortion could impact how people prevent becoming pregnant, how families grow, and how miscarriages are managed.

Where it stands: If a leaked draft of the SCOTUS opinion to overturn abortion rights is finalized, states would decide whether abortion is legal, under what terms, and even how abortion is defined.

  • More than a dozen states already have laws in place that would automatically ban abortions if Roe is overturned.
  • The language of these laws varies. But legal experts say they and other state laws create a hornet's nest of legal ambiguities.

What they're saying: "Banning abortion definitely has implications for other aspects of care, without a doubt. And it is everything from how you deal with miscarriages all the way to thinking about which methods of contraception are going to be acceptable," said Kaiser Family Foundation's Alina Salganicoff.

  • "It's very complicated, and I think we're going to see a lot of laws as well as legal challenges to laws that we haven't seen before," she said.

Between the lines: One immediate issue is the way state laws define "unborn human beings," and the way some definitions potentially make bans apply to embryos created through the IVF process and some forms of birth control.

Go deeper.

2. Coverage loss looms

Illustration: Annelise Capossela/Axios

Between 5.3 million and 14.2 million people could lose their health coverage when temporary pandemic-inspired reforms to Medicaid expire at the end of the public health emergency, Axios' Adriel Bettelheim writes about a new Kaiser Family Foundation analysis.

The big picture: Democrats who hoped they'd enact transformational health legislation with control of the White House and Congress could instead face a historic jump in the U.S. uninsured rate.

Background: Congress in 2020 included measures in pandemic relief legislation that increased the share of federal Medicaid spending if states offered continuous coverage to enrollees, suspending the program's usual churn.

The extra allowances sunset with the end of the public health emergency, which is due to expire July 15 unless the Biden administration extends it again.

Go deeper: Kaiser examined scenarios for how states can determine whether their Medicaid enrollees are still eligible for coverage when policy changes hit the safety net program.

  • The biggest losses are expected to be among adults who gained coverage through the Affordable Care Act's Medicaid expansion, other adults eligible for reasons other than a disability, as well as children.
  • Medicaid enrollment is expected to grow 25%, or by 22.2 million people, from fiscal 2019 through 2022, mostly because of the pandemic-driven allowances, the researchers project.

3. ⚡️ Business lightning round

Monday was not a stellar day on Wall Street as traders looked to sell off just about everything, Axios' Javier David writes.

Here's how some big health care names fared amid yesterday's big slide.

⬇️ CVS: Down 1.8% to close at $98.86.

⬇️ Universal Health Services: Down 1.9% to close at $125.33

⬇️ Community Health Systems: Down 6% to close at $6.61

⬇️ Teladoc: Down 8.8% to close at $30.52

⬇️ UnitedHealth Group: Down 2.6% to close at $486.82

⬇️ Cigna: Down 2% to close at $261.41

⬇️ GoodRx: Down 15.6% to close at $10.75

⬇️ Pfizer: Down about 0.8% to close at $48.64

⬆️ Moderna: Up about 1% to close at $135.80.

4. African cancer deaths could top 1 million

Sub-Saharan Africa could average roughly 1 million cancer deaths a year by 2030 if urgent changes aren't made, according to a report from a new Lancet Oncology commission.

  • That would be nearly double the 520,000 cancer deaths reported in 2020.

Driving the news: The commission is calling for improvements in access to cancer care and prevention and the creation of a national control plan for each country.

  • Factors contributing to the crisis include infections, environmental exposures, aging populations, increasing adoption of westernized lifestyles and infrastructure challenges.
  • But there are other culprits, like a high incidence of people abandoning treatments and lack of awareness about cancer risk factors. For instance, treatment abandonment for breast cancer is as high as 38% in some countries.
  • "Projected trends underscore the devastating costs of inaction on cancer incidence rates and cancer mortality in sub-Saharan Africa," said Commission chair Wilfred Ngwa of Johns Hopkins Medicine in a statement.

5. Quote du jour

"In the fall, if we are hit by new variants, it will be too late to get the tools needed for protection critical treatments that will be available in Europe, but not the United States..."
— President Biden in a statement, pressing Congress for more COVID spending even as he endorsed splitting pandemic countermeasures off from legislation that would provide aid to Ukraine after lawmakers stalled on a combined package.