NATIONAL. Doctors, public health workers, patient advocates — even insurers — oppose latest ACA repeal

By Kim Krisberg

Senate Republicans are again trying to ram through an Affordable Care Act replacement that threatens the health and well-being of millions of Americans. It’s shameful. But don’t take my word for it. Let’s look at what people who actually work in health care are saying about the Graham-Cassidy-Heller-Johnson bill.

In this interview, Sen. Bill Cassidy insists that his bill would protect people with pre-existing conditions. Blue Cross Blue Shield Association disagrees. (Cassidy also says in that same interview that his bill would work through the Children’s Health Insurance Program (CHIP), which he said has been reauthorized. That’s totally false — CHIP has not been reauthorized and its funding expires Sept. 30.) But back to pre-existing conditions — here’s what Blue Cross Blue Shield had to say:

Although we support providing states with greater flexibility in shaping health care options for their residents, we share the significant concerns of many health care organizations about the proposed Graham-Cassidy bill. The bill contains provisions that would allow states to waive key consumer protections, as well as undermine safeguards for those with pre-existing medical conditions. The legislation reduces funding for many states significantly and would increase uncertainty in the marketplace, making coverage more expensive and jeopardizing Americans’ choice of health plans...

And let’s not forget public health. The ACA’s Prevention and Public Health Fund (PPHF) has become an absolutely critical source of funding for the nation’s public health agencies. Cassidy’s bill would eliminate that fund. Here’s what the Big Cities Health Coalition, a forum for the country’s largest metropolitan health departments, had to say about the fund’s potential elimination:

Among the programs at risk at the CDC are the 317 Immunization Program, Epidemiology and Laboratory Capacity Grants, the Childhood Lead Poisoning Prevention Program, and a host of chronic disease programs. The PPHF provides vital resources to governmental public health at all levels, and its elimination will further erode our fragile health system.

Eliminating public health programs that are now funded by the ACA would seriously undermine the ability of cities and counties to protect and promote health. The loss of hundreds of millions of dollars would hamper efforts to respond to food borne illness outbreaks, prevent emerging infectious diseases like Ebola and Zika, and respond to natural disasters like Hurricanes Irma and Harvey.

And in a letter to senators from the American Public Health Association, Executive Director Georges Benjamin writes:

The Graham-Cassidy plan would also eliminate the Prevention and Public Health Fund, the first and only mandatory funding stream specifically dedicated to public health and prevention activities. The fund has already provided more than $6 billion to support a variety of public health activities in every state including tracking and preventing infectious diseases like the Ebola and Zika viruses, community and clinical prevention programs, preventing childhood lead poisoning and expanding access to childhood immunizations. Eliminating the fund would devastate the budget of the Centers for Disease Control and Prevention. The fund currently makes up 12 percent of CDC’s budget and eliminating this funding stream would force Congress to replace the funding through the regular appropriations process where resources for nondefense discretionary programs are already too low.

Graham-Cassidy-Heller-Johnson is a threat to America’s health. If you’d like to voice your opinion, the American Public Health Association has an easy-to-use template to help you reach your representatives in Congress. For more information on the ACA replacement, NPR has a fantastic explainer.

Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for 15 years. Follow me on Twitter — @kkrisberg.

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Coalition Members Featured at Drexel University Urban Health Symposium, “Reimagining Health in Cities: From Local to Global"

On Sept. 7 and 8, 2017, the Drexel Urban Health Collaborative hosted the second Urban Health Symposium, “Reimagining Health in Cities: From Local to Global.” The event — which was held at the Dornsife School of Public Health — drew around 300 researchers, practitioners and policymakers from a variety of organizations and educational institutions. The Symposium featured two jam-packed days of inspiring speakers, poster presentations, and global networking opportunities. 

Highlights included a lively session with U.S. health leaders; an innovative session on novel uses of data; and a keynote address from Mindy Fullilove, MD, Professor at the Parsons School of Design, The New School. 

In addition to the informative and insightful sessions, the Symposium also featured over 60 posters, covering a broad range of research topics related to urban health. Selected posters were displayed for five categories: novel urban health research methods; built environment and climate change; health disparities and special populations; program and policies to improve health in cities; and addressing urban challenges, health behaviors and mental health. Thank you to all of our poster presenters and attendees! 

If you missed a session, or perhaps you’d like to re-live the Urban Health Symposium, check out our YouTube playlist to watch the sessions.

SAN DIEGO. California Today: A Deadly Outbreak Stalks San Diego. (The New York TImes)

In a typical year, San Diego County might see a few dozen cases of hepatitis A.

So far this year? More than 400, with 15 people now killed by the liver disease.

“This is an outbreak like none other that we’ve ever had,” said Dr. Wilma Wooten, the region’s public health officer. Dr. Wooten said the response has been complicated by the infection’s nebulous spread.

Whereas past outbreaks have commonly been traced to a single food source, allowing the threat to be swiftly contained, this one is passing person to person. San Diego’s homeless population has been hit hardest by the virus, which stalks its victims more readily in areas of poor sanitation.

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MINNEAPOLIS. White House cuts to federal grants endanger sex education for teens (Minneapolis Star Tribune)

Founded 46 years ago by faith leaders, Annex Teen Clinic provided sexual health services to 1,782 youth in 2016. It takes its message to public schools, contributing to a dramatic drop in Hennepin County’s teen birthrate. Annex installs health mentors in some schools to work one-on-one with students and provides training for teachers and parents, in addition to its clinical services.

Now some of the clinic’s programs and jobs, and other Hennepin County efforts to prevent teen pregnancy, are at risk. President Donald Trump’s administration in July announced an abrupt end — two years early — to what were supposed to be five-year grants specifically aimed at preventing teen pregnancy.

In all, the U.S. Health and Human Services Department notified 81 programs in 31 states and the District of Columbia that $214 million in funding will end June 30, 2018, instead of in 2020.

Officials here and across the country are fighting to save the grants, but worry that the Republican-controlled Congress will not restore funding. Hennepin County Commissioner Mike Opat said he’ll urge the county to fill the gap if its appeal fails...

Efforts to reverse the grants’ demise have spread across the country. Health officials from 20 U.S. cities have written to HHS Secretary Tom Price to denounce the grants’ elimination. Minnesota Reps. Keith Ellison, Betty McCollum and Tim Walz are among 148 House Democrats who sent a July 25 letter to Price demanding an explanation within 45 days for the decision, which came just three months after Congress voted to provide full funding for the latest grants.

“At a time when young people are most in need of information and education to protect their sexual and reproductive health, this administration is denying evidence and science,” the legislators wrote.

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NATIONAL. Trump Administration Abruptly Cuts Funding to Teen Pregnancy Prevention Programs. (NBCNEWS)

By Elizabeth Chuck

In the meantime, health commissioners from 20 large cities have written to Price, pleading for a change of heart.

"Cutting TPPP funding and shortening the project period will not only reverse historic gains made in the U.S. in reducing teen pregnancy rates, but also make it difficult to truly understand what practices are most effective in our communities across the nation," the letter, from the Big Cities Health Coalition, read.

Senate Democrats wrote a letter, too, calling the move "short-sighted." They also praised the teen pregnancy prevention program as a "pioneering example of evidence-based policymaking."

"Despite these successes, HHS has apparently elected to eliminate the final two years of TPP Program grants without cause or a rationale for the termination," they wrote.''

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NATIONAL. Trump Administration Cuts Down Funding for Teen Pregnancy Prevention Programs. (Christianity Daily)

by Jessica Lim

Federal funding for teen pregnancy prevention programs around the country was stripped last month by the Trump Administration. A five year-grant that was awarded to 81 organizations in the country has now been cut to three years.

Teen pregnancy rates in the United States has dropped continuously over the last two decades, going from 61.8 births per 1,000 females between the ages of 15 and 19 to 24.2 births per 1,000 teen females in 2014, according to the Centers for Disease Control.

Though there is a steep decline in 2010 when the grant from the Department of Health and Human Service took effect, some argue that the grants may have influenced this trend, but are not the only reason.

“Some of that leaves you scratching your head wondering, why mess with success?” stated Bill Albert, chief innovation officer at the National Campaign to Prevent Teen and Unplanned Pregnancy.

The loss of funding for these programs has pushed health commissioners that are a part of the Big Cities Health Coalition to write a letter to the Secretary of the Depart of Health and Human Services, Thomas Price, which stated that “cutting TPPP funding and shortening the project period will not only reverse historic gains made in the U.S. in reducing teen pregnancy rates, but also make it difficult to truly understand what practices are most effective in our communities across the nation.”

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SEATTLE. US Cuts Funds Aimed at Reducing Teen Births. (The Skanner)

by Melanie Sevcenko

Just two years into the federally-funded Teen Pregnancy Prevention Program (TPPP), the U.S. Department of Health & Human Services has announced it plans to pull the plug on funding in June of next year.

That’s two years shy of the five years of funding the program promised.

Moreover, the announcement to shorten the TPPP funds, issued by the Office of Adolescent Health on Jul. 6, came with no warning, explanation or alternative.

The lack of dollars, say Big Cities Health Coalition (BCHC) – a forum for the leaders of America’s largest metropolitan health departments – will severely impact evidence-based programs, services, and research for reducing teen pregnancies.

According to the Centers for Disease Control and Prevention, one in four teens will become pregnant by age 20.

In protest to the funding cut, 37 Democratic senators sent a letter to U.S. Department of Health and Human Services Secretary Tom Price, questioning why crucial funding is being yanked out of public health departments across the U.S, two years too soon.  

Days later, the BCHC sent its own letter to Price, signed by 20 health commissioners and echoing the sentiment of the senators.

The health advocates argue that the TPPP has made unprecedented progress in reducing teen pregnancies. 

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NATIONAL. Why Are Teen Pregnancy Programs Getting Cut? (CityLab)

By Allstair Boone

The teen birth rate in the U.S. is at a record low: Since 1991, it’s declined by 67 percent. A large chunk of that drop occurred in the last 6 years, when the Obama Administration’s Teen Pregnancy Prevention Program began.

Now, in its second round of grants, the TPP Program (not to be confused with the trade agreement) is currently funding 84 communities across the country. Between 2010 and 2016, the years during which TPP funds started flowing, the national rate plunged 41 percent.

Lawmakers and public health advocates have voiced dismay about the cuts to TPP. A group of Democratic lawmakers—37 senators and 149 representatives—have written to Health and Human Services secretary Tom Price, asking for an explanation. The nonprofit Big Cities Health Coalition—a forum for leaders of America’s largest metropolitan health departments—sent a letter to Price, appealing this decision. The group emphasized a key concern with the early end to the program—the cuts will make it more difficult for researchers to obtain the evidence-based results that measure the effectiveness of individual programs:

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NATIONAL. Why the Trump administration is cutting teen pregnancy prevention funding. (CNN)

By Jacqueline Howard

The Office of Adolescent Health's Teen Pregnancy Prevention Program currently funds 84 grants to reduce teen pregnancy across clinics, schools and communities, by implementing and evaluating prevention programs and supporting technology- and program-based approaches, according to the office's website. Their end date is now June 30.

Members of the Big Cities Health Coalition, a coalition of health officials from the 28 largest cities in the US, wrote a joint letter to Price last month urging him to reconsider the decision to cut the project period and funds.

The letter indicated that teen birth rates in the US dropped to a record low last year, following a long-term trend, and the letter suggested that reducing funding for teen prevention programs might reverse that trend.

"Cutting TPPP funding and shortening the project period will not only reverse historic gains made in the US in reducing teen pregnancy rates, but also make it difficult to truly understand what practices are most effective in our communities across the nation," the letter said.

Patty Hayes, director of public health for Seattle and King County, said she has seen the teen prevention programs have a positive impact in her community.

"We have been so successful in King County with our teen pregnancy rates reducing by 55%" since 2008, said Hayes, who also signed the Big Cities Health Coalition letter.

"If something works, you invest in it," she said. "We need for our community to respect science, to move forward with this and to make sure that we are not moving backwards. ... I'm very wound up about this."

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NATIONAL. Pregnancy Prevention Groups Scramble After Cuts. (U.S. News)

By Gabrielle Levy

The Hill reported Friday that the decision last month to pull the plug two years early on five-year grants made as part of the Teen Pregnancy Prevention Program came in some cases with no notice and no explanation. The Department of Health and Human Services informed 81 organizations participating in the program that their grants, totaling $213 million, would end in June 2018. Officials said in a statement the decision was due to "very weak evidence of positive impact of these programs."

The paper also talked to Dr. Leana Wen, health commissioner in Baltimore, where a program to decrease the teen birth rate will lose $3.5 million.

"We don't have another way to fill this deficit. This will leave a huge hole in our ability to deliver health education," Wen said.

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NATIONAL.Trump administration cuts short teen pregnancy prevention program funding. (CBS News)

By Kathryn Watson

The Department of Health and Human Services is cutting off grants for teen pregnancy prevention programs across the country, leaving the groups that receive the grants -- and Democratic members of Congress -- perplexed. 

"These notices of shortened project periods are highly unusual, especially given that Congress has yet to act on FY 2018 appropriations," a July 21 letter from 37 Democratic senators reads. "This action is short-sighted and puts at risk the health and well-being of women and our most vulnerable youth who depend on the evidenced-based work that TPP Program grantees are doing across the nation."

"It would be fanciful at best to say these programs were solely responsible for the decline, of course that's not the case," Albert said. 

But he believes the funding has contributed to the continuing downward trend. 

"Some of that leaves you scratching your head wondering, why mess with success?" Albert said.

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SEATTLE. King County Health Officials Protest Early End Of Sex Ed Grant (KNKX)

By Ed Ronco

The public health department is in year three of a five-year grant from the U.S. Department of Health and Human Services. The $5 million pays for sexual health education curriculum, teacher training, and efforts to reduce teen pregnancy. It also funds research into how well the curriculum is working.

“One key principle for our work in public health is that we act based on science and evidence,” said Patty Hayes, director of public health in King County. “We need the evidence that a new system or rule or intervention is necessary – and that it’s effective.”

King County and other urban public health agencies have filed a formal protest with the Trump administration. They’re organized by the Big Cities Health Coalition, which calls the early termination of the grant “highly disruptive to work already underway.”

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NATIONAL. Local Health Officials Sound Alarm on Trump Efforts to Defund Teen Pregnancy Prevention. (Route Fifty)

By Quinn Libson

Last month, the federal Office of Adolescent Health, which is overseen by the Department of Health and Human Services, informed researchers, local health workers and educators that the grant funding for 81 teen pregnancy prevention programs which was intended to last for five years would be cut short two years early—a decision that took place outside the normal budgeting process.

The city of Baltimore, as The Washington Postrecently reported, is one of the places affected by the funding cut. Health programs run by the city will lose out on $3.5 million dollars set to support classes in anatomy and physiology as well as counseling on issues related to sex for 20,000 teens. The money would have also provided training for 115 teachers. While Baltimore has made progress on reducing teen births—the rate dropped by nearly a third from 2009 to 2013—there’s still much work to be done. The teen pregnancy rate in Baltimore remains significantly higher than the national average.

King County, Washington, which includes Seattle, is like many of the other grant recipients. The $5 million in funding there pays for more than curriculum, programming and teacher training. The federal funding is also spent on figuring out just how well all of those efforts are working.

“One key principle for our work in public health is that we act based on science and evidence,” Patty Hayes, director of public health in King County told KNKX public radio. “We need the evidence that a new system or rule or intervention is necessary—and that it’s effective.” The county is currently in the process of collecting efficacy data on FLASH, a curriculum developed by the county and implemented in schools throughout the South and the Midwest. As many as 4,000 students are affected.

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NATIONAL. Big city health officials decry Trump administration’s cuts to teen pregnancy prevention programs (The Washington Post)

By Ariana Eunjung Cha

The federal funding was curtailed last month without explanation and without warning: $214 million for teen pregnancy prevention programs across the country.

The city of Baltimore lost $3.5 million, money that Health Commissioner Leana Wen said had supported classes in anatomy and physiology and counseling in social and emotional issues related to sex for 20,000 teens, plus training for 115 teachers. She worries what the loss of funds will mean for local teen pregnancy rates, which already are twice as high as the state's and much higher than the U.S. average.

“This is a central health issue for thousands of vulnerable teens,” she said. “What is going to be the downstream effect on society?”

Wen, a physician, was one of 20 health officials from the nation's largest cities who joined Wednesday to denounce the Trump administration for the cuts and who warned that the consequences could be severe. The teen pregnancy prevention program is among many reproductive health initiatives targeted in recent months. Federal officials have also tried to eliminate funding for Planned Parenthood, family planning clinics abroad and grants for scientific research in the field.

Experts have credited better access to contraception and more convenient contraception for teens as well as their increased abstinence. Fewer teens are having sex as a gradual decades-long decline continues, with the latest surveys finding that about 42 percent of girls and about 44 percent of boys ages 15 to 19 report that they have had sex.

Patty Hayes, health commissioner for Seattle & King County in Washington state, signed the letter urging that the prevention grants be restored. Even if you believe in abstinence education, she said Wednesday, science shows that “teaching abstinence alongside birth control has increased abstinence.”

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NATIONAL. Programs that Fight Teenage Pregnancy Are at Risk of Being Cut (The New York Times)

By Pam Belluck

Health commissioners from 20 large cities are protesting, writing to Tom Price, the health and human services secretary, that cutting funding will not only reverse historic gains made in the U.S. in reducing teen pregnancy rates, but also make it difficult to truly understand what practices are most effective.

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NATIONAL. Teen Pregnancy Program Surprised by Trump Cuts (NewsMax)

By Theodore Bunker

President Donald Trump's administration has issued widespread funding cuts at short notice, including one to the Teen Pregnancy Prevention program.

"There was no communication about the reason. The notice of the award just stated that instead of a five-year grant, it is now a three year grant," Baltimore City Health Commissioner Dr. Leana Wen told The Hill.

The city's health department administered one of the TPP-funded initiatives with the aim of bringing down the teen birth rate, which is three times the national average. The program loses $3.5 million over two years without the grant, leaving 20,000 students without access to reproductive health education and related services.

"We don't have another way to fill this deficit. This will leave a huge hole in our ability to deliver health education," she added.

The health commissioners from 20 cities wrote to HHS secretary Tom Price in July, warning that these cuts "will not only reverse historic gains made in the U.S. in reducing teen pregnancy rates, but also make it difficult to truly understand what practices are most effective.

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NATIONAL. Here’s How Trump’s Budget Will Specifically Hurt Girls (Romper)

By Tiffany Thomas

The Trump administration has already started cutting back funding for the Teen Pregnancy Prevention Program, The New York Times reported. If the president’s budget is enacted as written, the program could go away entirely, putting a full stop to proving which prevention strategies actually help teen girls avoid unintended pregnancy, according to that report.

So far, more than 20 health commissioners from major cities have protested Trump’s budget cuts. But in a Congress stacked with conservatives wedded to the widely disproven notion that abstinence-only education works for teens — with other, major agency reductions at stake — there’s more than enough reason to worry that girls will be worse off if this budget passes. If enacted, Trump’s plan could leave millions of teen girls who need comprehensive sex education and access to birth control in a far worse position than they deserve to be. And it could certainly affect the ability of young girls growing up now to get the sex education they need as they age.

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NATIONAL. Daily News Roundup: Groups Fighting Teen Pregnancy Set to Lose Millions (The Chronicle of Philanthropy)

Some 80 organizations that provide education about abstinence, contraception, and sexually transmitted diseases would lose federal funding next year under the White House budget plan, which calls for eliminating the Obama administration’s Teen Pregnancy Prevention Program, writes The New York Times. 

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NATIONAL. Critics decry Trump gutting teen pregnancy prevention grants (The Washington Times)

By Tom Howell Jr.

The Trump administration is cutting short a batch of Teen Pregnancy Prevention grants, angering big-city health department chiefs who said Wednesday they will no longer be able to figure out what’s working to cut pregnancy rates.

For instance, Seattle and King County schools in Washington wanted to know whether their sexed curriculum, known as FLASH, caused students to delay having sex or whether those who did used condoms or other forms of birth control.

“Now the money will be yanked from us midstream,” said Patty Hayes, the region’s public health director. “We won’t have the funding to gather the final data and analyze the results.”

Baltimore stands to lose $3.5 million, and Health Commissioner Leana Wen said city official

Senate Democrats last month told HHS Secretary Thomas Price that his decision to shorten the grant period unilaterally was “highly unusual,” particularly since Congress hasn’t acted on funding bills for fiscal 2018.

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