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Deb Gordon

Deborah D. Gordon has spent her career trying to level the playing field for healthcare consumers. She is co-founder of Umbra Health Advocacy, a marketplace for patient advocacy services, and co-director of the Alliance of Professional Health Advocates, the premiere membership organization for independent advocates. She is the author of "The Health Care Consumer's Manifesto: How to Get the Most for Your Money," based on consumer research she conducted as a senior fellow in the Harvard Kennedy School's Mossavar-Rahmani Center for Business and Government. Deb previously spent more than two decades in healthcare leadership roles, including chief marketing officer for a Massachusetts health plan and CEO of a health technology company. Deb is an Aspen Institute Health Innovators Fellow, an Eisenhower Fellow and a Boston Business Journal 40-under-40 honoree. Her contributions have appeared in JAMA Network Open, the Harvard Business Review blog, USA Today, RealClear Politics, The Hill and Managed Care Magazine. She earned a BA in bioethics from Brown University and an MBA with distinction from Harvard Business School.

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August Policy Roundup

Chronic Care Issues

1. The Inflation Reduction Act, enacted this month, offers savings on prescription drugs and health insurance premiums

This month, President Biden signed into law the Inflation Reduction Act, which includes several measures aimed at reducing healthcare costs. Notably, the new law gives Medicare the authority to negotiate the price of 10 prescription drugs in 2026, increasing to 20 by 2029. The law also lowers coinsurance for Part D catastrophic coverage in 2024 and caps out-of-pocket costs for Part D to $2,000 per year in 2025. Further, the law caps Medicare enrollees’ out-of-pocket expenses for insulin to $35 per month. The Inflation Reduction Act also extends health insurance subsidies, called premium tax credits, that were expanded in 2021 as part of the American Rescue Plan but set to expire at the end of 2022.

2. The medical, financial and social realities of post-Roe America

HealthyWomen Senior Policy Advisor Martha Nolan wrote an op-ed on the medical, financial and social realities of post-Roe America. The piece was prominently featured in The Hill. Nolan addressed the direct and indirect economic costs of pregnancy, from recent data suggesting that childbirth and postpartum care costs an average of nearly $19,000. She also wrote about the physical impact of pregnancy that can lead to chronic health challenges for some women and the broader economic costs of pregnancy, such as lost productivity and increased use of support services, where such services even exist. Nolan argued for Congress to take actions to require paid family and maternity leave, affordable childcare, and full prenatal and postpartum health coverage for all women of childbearing age.

3. The PACT Act opens access to care for veterans exposed to burn pits in Iraq and Afghanistan

This month, President Biden signed the PACT Act, a law that expands health coverage for veterans who were exposed to burn pits, a crude way the military disposed of waste on bases during the wars in Iraq and Afghanistan. As many as 3.5 million service members have been exposed to harmful chemicals from prolonged exposure to burn pits since the early 1990s when the Iraq War began. This exposure has been linked to cancer, respiratory illnesses and cardiovascular disease, with 12,500 veterans submitting claims for conditions they blamed on burn-pit exposure. Of those, only 2,800 claims were approved by the Department of Veterans Affairs. The legislation makes it easier for veterans to access Veterans Affairs services for conditions they likely developed as a result of burn-pit exposure.

4. Help the National Institutes of Health set women’s health research priorities

The National Institutes of Health (NIH) Office of Research on Women’s Health (ORWH) is seeking comments from stakeholders to inform its 2024-2029 NIH-wide strategic plan for research on the health of women. The agency is seeking input on research needs and opportunities as well as themes that should be incorporated into future goals and objectives. See ORWH’s previous strategic plan and a recently published report, Perspectives on Advancing NIH Research to Inform and Improve the Health of Women, for context. Submit your ideas by September 29, 2022.

5. Cervical cancer rates are declining, but new research shows that late-stage diagnoses are increasing

A study published this month in the International Journal of Gynecological Cancer showed that rates of stage 4 cervical cancer increased steadily between 2001 and 2018, despite declining cervical cancer rates overall. Late-stage cervical cancer diagnoses increased by an average of 1.3% per year. Overall, Black women had higher rates of late-stage cervical cancer, with 1.55 Black women per 100,000 being diagnosed compared with 0.92 white women per 100,000.

6. State Medicaid coverage limitations hit postpartum women and transgender people

The Texas Health and Human Services Commission reported that the federal government will not approve its proposal to expand Medicaid coverage for new mothers from two to six months. Legislators who support expanding coverage reportedly believe the application won’t be approved because of language passed by Texas lawmakers in 2021 that implies that women who terminate their pregnancies for medical necessity could be excluded from Medicaid postpartum coverage.

In other Medicaid news, Florida ended Medicaid coverage for gender-affirming care for transgender people, affecting approximately 9,000 Floridians. The Florida Board of Medicine banned puberty-blocking medications and hormone replacement therapy for both young people and adults, after initially stating its concern was about treatment guidelines for teens and kids. At least nine other states have banned Medicaid from covering gender-affirming care.

7. Researchers discover causes of birth defects and preterm labor

A new report in the New England Journal of Medicine says that a new method of testing for potential birth defects may make such testing much faster and less expensive. The method uses a small, relatively inexpensive device to detect missing or extra chromosomes that commonly cause miscarriages or birth defects. If validated with additional research, this method may allow women to more quickly learn the health of their embryos during in vitro fertilization processes or the cause of miscarriage.

In a new study published this month in The Journal of Physiology, researchers found a potential cause of preterm labor, labor that starts before 37 weeks of pregnancy. Preterm labor can lead to premature birth, which in turn can lead to health risks to the baby. Researchers found the protein called Piezo1 regulates the uterus and allows it to continue expanding during 40 weeks of pregnancy. Understanding the mechanism that enables a full-term pregnancy — and what may short-circuit that process — could ultimately lead to new treatments to prevent preterm labor.

8. The FDA approved a new treatment for a common subtype of breast cancer

This month, the FDA announced it has approved a new treatment for HER2-low breast cancer that has spread to other parts of the body or is not removable by surgery. HER2-low is a newly identified subset of HER2-negative breast cancer, which an estimated 80% to 85% of new breast cancer cases were previously thought to be. Approximately 60% of women previously classified as having HER2-negative breast cancer are now considered HER2-low.

9. Nearly half of cancers are preventable, according to a new study

New research shows just how dangerous smoking, drinking and having a high body mass index may be. According to a study published in The Lancet, nearly half (44%) of all cancer deaths worldwide can be attributed to these risk factors and are therefore considered preventable. The study also found that 42% of healthy years lost could be prevented. Cancers considered most preventable include tracheal, bronchus and lung cancer. Cancer deaths that can be blamed on risk factors increased more than 20% between 2010 and 2019.

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