Good morning ... Situational awareness: Oral arguments in Texas' lawsuit challenging the Affordable Care Act have been rescheduled for Sept. 5 — the same day Supreme Court nominee Brett Kavanaugh is slated to testify before the Senate Judiciary Committee.
Please put it on your calendar now to buy me a drink on the evening of Sept. 5. I'm gonna need it.
1 big thing: Employers' stake in solving the opioid crisis
Businesses with jobs to fill should have a strong incentive to help combat the opioid epidemic, my colleague Caitlin Owens writes this morning. That's because labor-force participation is down in places where opioid prescriptions are up.
The details: There's plenty of research suggesting that the country's declining labor force participation rate — the number of people who are employed or looking for work — is intertwined with the country's opioid crisis.
- The increase in opioid prescriptions between 1999 and 2015 could account for 20% of the decline in men's workforce participation over that same period, according to a study done by Princeton's Alan Krueger last year.
- Almost half of men who aren't in the workforce take pain medication on any given day, and two-thirds of those men take prescription painkillers, the same study states.
- Counties with high opioid prescription rates have a labor force participation rate that is 4.6% lower for men and 1.4% lower for women than counties with a low prescription rate, according to a paper by the Federal Reserve Bank of Cleveland.
What they're saying: Industries like construction and manufacturing have been particularly affected, says Katie Mahoney, vice president of health policy for the U.S. Chamber of Commerce.
- "It affects businesses [to] the point where companies are struggling to fill positions ... because there are drug test failings on a rapid and significant basis," she says.
2. Remember the underinsured
We’ve all focused on the problems of the uninsured, but we should think more broadly about anyone who can’t pay their medical bills, the Kaiser Family Foundation’s Drew Altman writes in his latest Axios column. If you add insured people who still can’t afford their share of medical costs, the problem is a lot bigger.
By the numbers:
- The percentage of the non-elderly population that is uninsured is now just under 11%.
- But another 15.5% who have insurance either skipped or delayed care because of the cost, or reported problems paying the bills.
- That brings the total with insurance and affordability problems to 26.2%.
- More striking: Nearly half of all people in fair or poor health — 46.4% — are uninsured or have affordability problems despite having coverage.
The bottom line: It’s going to take new measures to capture the true level of hardship Americans are experiencing.
3. Insurers' incredible bull market
The S&P 500 is up by more than 300% over the past nine years. The S&P Managed Care sector, which includes the country's biggest health insurers, is up more than 1,100% over the same period.
- That's a big surprise for some analysts, who in 2009 thought the ACA would be bad news for the insurance industry, CNBC reports.
Flashback: Insurers' stocks were at a particularly low point in 2009, when the overall stock market hit its recession-era bottom, in part because investors were worried about regulations in what would become the ACA.
Surprise! Giving an industry millions of new customers, with most of their purchases subsidized by the federal government, is actually quite good for the bottom line.
Between the lines: The ACA's Medicaid expansion has been the biggest boon, CNBC writes, because it coincided with so many states transitioning to Medicaid managed care — allowing private insurers to administer their programs.
- Diversification — like UnitedHealth Group's growing Optum unit — also helped.
The biggest winners, per CNBC:
- United's stock has gone up 1,400% since 2009. Centene is up 1,800%, and Medicaid insurer WellCare is up 4,000%.
Wall Street isn't worried about the future. Despite their panic about the ACA in 2009, at least some investors now aren't even too worried about the growing popularity of single-payer.
- "Even if it's Medicare for all, it would probably be Medicare Advantage for All," Standard & Poor's analyst Deep Banerjee tells CNBC. "Health care today is a public-private partnership ... it's very hard to see a system without a private player meaningfully involved."
4. While you were weekending ...
- The New York Times profiles one of the few emergency rooms that starts treating patients for opioid addiction when they come in with symptoms of withdrawal.
- More people get access to opioid treatment in states that expanded Medicaid, according to research in the Journal of the American Medical Association.
- British lawmakers are much more gung-ho on e-cigarettes as a less harmful alternative to traditional cigarettes than regulators in other countries, Politico reports.
- An endocrinologist who has been working with transgender patients for 30 years talks with the Fort Myers News-Press about how the medical side of the transition process has changed.
What we're watching this week: The Senate will consider the annual HHS spending bill, which has been bundled together with the Pentagon's annual spending bill.
Senate health committee hearing Thursday on "Science and Stewardship at the National Institutes of Health."
What else is on your mind? Let me know: firstname.lastname@example.org.