• Akron Beacon Journal, Sep. 10
The effort to stabilize the online insurance exchanges has begun on Capitol Hill. Governors and state insurance commissioners shared their views with a Senate committee last week. The consensus, beyond the need for cost-sharing reduction payments, reinsurance mechanisms and greater flexibility for states? Keep the money flowing to outreach and enrollment initiatives.
Unfortunately, the Trump White House, just days earlier, announced plans to slash the advertising budget for the upcoming enrollment period. The funding would go from the current $100 million to $10 million next year. More, federal support for “navigators,” hired by nonprofit organizations to guide people through the individual market, would be reduced 40 percent, from $62.5 million to $36.8 million.
These initiatives serve as the primary vehicles for enhancing awareness, understanding and boosting the number of people who gain health coverage. Contrary to the claims of the Trump administration, they have been successful.
Researchers from the Robert Wood Johnson Foundation and the Wesleyan Media Project recently looked at Kentucky, where a change in governors saw a dramatic shift. The state went from an aggressive program to promote enrollment to practically none at all.
No surprise that enrollment levels have declined. The researchers found that television advertising proved the most effective.
State-based exchanges, as in Kentucky, must support their own outreach. California spends roughly $100 million a year, or a sum equivalent to what the federal government has devoted to Ohio and the three dozen other states using the federal exchange.
Now cut by 90 percent?
Officials at the Department of Health and Human Services argue that consumers already are familiar with the exchanges. Yet this has been such a confusing time, the White House and the department casting much doubt about the exchanges, along with shrinking the enrollment period by six weeks.
If anything, outreach is more important. Recall the start of the Trump presidency, the administration ditching a last-minute advertising campaign, and enrollment numbers falling off.
Lisa Hamler-Fugitt, the executive director of the Ohio Association of Foodbanks, has seen how well the navigator concept has worked. She greeted the news about sharply reduced support with testimonials about navigators helping families after the loss of employer-based insurance, individuals making the transition from Medicaid and workers back in school to upgrade their skills who need coverage for a time.
If the goal is to see the exchanges succeed, then it follows many will need help with something as complex as health insurance. Success depends, more than anything, on achieving a balanced risk pool, between the healthier and sicker. That, too, goes to outreach and enrollment programs. When they deliver, premiums increases are more manageable, coverage more accessible and affordable.
• The (Toledo) Blade, Sep. 10
Solving the opioid epidemic in Toledo and around Ohio certainly will not be as easy as winning a courtroom victory against pharmaceutical companies. But a judgment or a settlement in such a case could go a long way toward funding the larger fight and holding those companies accountable for their part in the crisis.
Toledo Democratic mayoral candidate Wade Kapszukiewicz says the city should join Dayton, Cincinnati, Lorain, Findlay, and others that have sued large drug makers.
Ohio Attorney General Mike DeWine filed a lawsuit against five drug manufacturers in May.
Those lawsuits filed this summer blame the companies’ negligent marketing of dangerous painkillers for the current opioid epidemic that killed more than 4,000 Ohioans in 2016.
Incumbent Democratic Mayor Paula Hicks-Hudson — who has been in office for about two and a half years as the epidemic raged on — said she did not have an opinion, but would ask the city’s legal department to study the matter.
Their Republican opponent, City Councilman Tom Waniewski, said legal fees for such a case would be better spent directly on the fight — paying for education and resources for law enforcement.
Mr. Waniewski pointed to other lawsuits, saying that Toledo would do better to spend its money on other opioid-fighting initiatives and let the state fund the legal fight against pharmaceutical companies.
In May, Ohio Attorney General Mike DeWine filed a lawsuit against five drug manufacturers. Other state attorneys general — in West Virginia and Mississippi — have filed similar lawsuits. The Mississippi case is still working its way through the courts, but in West Virginia’s case, the state has been able to get a settlement of $20 million from Ohio’s Cardinal Health.
That kind of settlement money will help West Virginia fund its fight against the epidemic, paying for treatment and enlightened enforcement.
Ohio — and Toledo — could benefit from a similar settlement.
There were 288 confirmed opioid overdose deaths across a 21-county region of northwest Ohio and southeast Michigan last year. That tops the 215 fatal opioid overdoses in the region recorded in 2015 and 145 in 2014.
Taking drug companies to court should not be taken lightly. These lawsuits will be expensive and time-consuming, and there is no guarantee of victory for the cities and states that file them.
But Toledo has a big stake in this fight and leaving it to other cities or state attorneys general is not necessarily the safe choice in this case. Having the winning court strategy or forcing a settlement from the drug makers may be a matter of getting enough plaintiffs and enough legal minds from enough cities and states to join the fight.
Moreover, a victory could mean substantial funds for Drug Abuse Response Teams, expanded drug courts, more overdose-reversing naloxone for first responders, and more treatment facilities.
Joining the list of communities taking drug companies to court is a risk and an investment, but this is a battle Toledo should seriously consider.