The overlooked epidemic: COVID-19 and its relationship to opioids

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By NCL Health Policy intern Talia Zitner

The coronavirus pandemic isn’t the only major public health crisis plaguing America. As the country struggles to contain COVID-19, the pandemic has seen a corollary rise in incidents of opioid usage and overdose. A major disruption in the way people suffering from opioid addiction receive treatment may ultimately prove critical to understanding how the opioid epidemic is directly affected by the coronavirus.

When lawmakers passed the Coronavirus Aid, Relief, and Economic Security (CARES) Act in March, opioid treatment centers were not eligible to receive any of the $50 billion in funding that was allocated for Medicare providers. As a result, these essential centers—often under-supported and understaffed—saw their workforce getting ill or leaving to care for loved ones. Additionally, job loss and illness have left those already at risk of opioid addiction more vulnerable to relapse and death.

A key problem is the patient’s ability to get a prescription for addiction-managing drugs. Many centers rightly offer only one pill a day to their patients, but as the pandemic has forced the need for physical distancing and lack of physical contact, it has become increasingly difficult for people to get their medication. Long lines and hours-long wait times dissuade patients from getting their daily dosage. Few patients qualify for more than one dose per day, and few doctors are authorized to prescribe larger amounts of opioid managing medication.

Sadly, the coronavirus pandemic has overshadowed the opioid epidemic that continues to haunt millions of Americans. During this difficult time, the government should focus on the risk of opioid abuse and overdose and put more money into treatment programs and centers. Without support, more people will succumb to opioid addiction, lack of access to treatment, and death, further burdening the health care system.

Talia is a Washington, DC native and a rising sophomore at Wesleyan University, where she is studying English. Beyond health policy, Talia’s interests are in journalism, law, and social justice.

NCL leads advocates in urging FDA to protect patient access to critical therapy for preterm birth

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By Sally Greenberg, NCL Executive Director

The National Consumers League and 14 leading health organizations and individual providers have collaborated in sending a letter to the Food and Drug Administration (FDA) as the agency considers whether to withdraw the only FDA-approved therapy that reduces the risk of preterm birth in women with a history of preterm birth.

Why did we and our fellow advocates decide to send this letter in the midst of the COVID-19 pandemic? Several important reasons.

First, preventing preterm birth is always a vital cause—during or without a pandemic. The leading cause of infant death in the United States, premature birth has devastating effects on families and is very costly to our health care system. For babies who do survive, short and long-term complications can accompany preterm birth. For mothers, a history of spontaneous preterm birth is a leading risk factor for recurrent preterm birth, yet providers have only one therapeutic option – hydroxyprogesterone caproate or “17P,” in one branded and five generic forms – to prevent recurrent preterm birth for these at-risk mothers.

Taking away these options—especially in the midst of a pandemic—would be concerning for pregnant women who are at high-risk for preterm birth, including those that reduce their risk of being admitted to the hospital for early delivery.

Secondly, as recent events surrounding both COVID-19 and continued fundamental rights injustices have reminded us, a profound and systemic inequity exists in the United States where institutional racism contributes to health disparities—including preterm birth and infant mortality. COVID-19 has disproportionally impacted African American women, the same population that is most likely to experience preterm birth. The preterm birth rate among U.S. black women is 49 percent higher than the rate among all other women, according to the March of Dimes.

Thirdly, 17P is the only FDA-approved therapy that reduces the risk of preterm birth and has been used for nearly a decade. We are concerned that removing access to the only FDA-approved therapy may deepen maternal and infant health inequities that exist within the U.S.

It is also troubling that if providers cannot access FDA-approved forms of 17P, this may expose pregnant women to compounded medications, which have no labeling to provide guidance on administration, contraindications, or potential side effects.

Removing 17P products in the absence of suitable alternatives would leave patients and providers significantly disadvantaged in the fight against prematurity. While we recognize the FDA is encountering tremendous challenges in addressing the COVID-19 pandemic, it is important to underscore the public health need for continued access to approved treatment options, and we trust that the agency will consider the patient impact as they evaluate this issue.

To add your voice to the letter to FDA, urging the agency to preserve patient access to the only FDA-approved therapy to reduce the risk of preterm birth, you can sign on here.

The impact of COVID-19 on child labor

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By Child Labor Coalition intern Ellie Murphy

Combatting child labor during a global pandemic is a staggering challenge. In countries like Ghana, the Ivory Coast, Bangladesh—and dozens more—school cancellations and lost family income may push children into the labor market. Once in, it may be hard for them to get out and return to school. In the face of this dire emergency, governments, the corporate world, and charitable institutions will need to support vulnerable families during this unprecedented time.

There is a strong correlation between access to education and preventing child labor. “Lack of access to education keeps the cycle of exploitation, illiteracy, and poverty going—limiting future options and forcing children to accept low-wage work as adults and to raise their own children in poverty,” noted the children’s advocacy group, Their World.

With nine in 10 children across the globe prevented from attending school in person, Human Rights Watch notes that interrupting formal education will have a huge impact on children and jeopardize their opportunity for better employment opportunities in the future: “For many children, the COVID-19 crisis will mean limited or no education, or falling further behind their peers.”

Poverty is the single greatest cause of child labor. Because many parents have lost or will lose their jobs, children are facing increased pressure to supplement family incomes. “Children work because their survival and that of their families depend on it, and in many cases because unscrupulous adults take advantage of their vulnerability,” notes the International Labour Organization.

Countries are being impacted by COVID-19 differently, but developing countries are expected to feel more negative consequences than developed countries, according to a report from WorldAtlas.com. Tourism and trade helps fuel many of these economies and the COVID pandemic has devastated both sectors.

Developing countries—primarily in Africa and Asia—already house 90 percent of working children, according to the International Journal of Health Sciences. Economic pressure from the pandemic will likely drive even more children into the workforce.

Before the pandemic, child labor in West Africa was widespread. 2.1 million child laborers were employed by cocoa farms in the Ivory Coast and 900,000 children on cocoa farms in Ghana, according to researchers from Tulane University. Ghana and the Ivory Coast produce about 60 percent of the world’s cocoa—a critical ingredient in chocolate. A recent Voice of America (VOA) article included predications that “there will be increased economic pressures on farming families, and ongoing school closures in Ghana [meaning] children are more likely to accompany their parents to their farms and be exposed to hazardous activities.”

The VOA cited research by the International Cocoa Initiative that analyzed the impacts of income loss on child labor rates in the Ivory Coast and found that a 10 percent drop in income for families in the cocoa industry is expected to produce a 5 percent increase in child labor.

Bangladesh, which had a reported 1.2 million children trapped in the worst forms of child labor in 2015, according to the ILO, is also at risk of seeing child labor increase. Most Bangladeshi workers—87 percent—earn money in the informal economy performing daily labor, unpaid work for their family, or piece-rate work. COVID-19 impacts have left families struggling with a severe drop in income of around 70 percent in many cases. Many adults and children who work making parts of products like garments have seen their income disappear entirely. “Those who depend on daily wages, for example, day labourers, rickshaw pullers, construction workers, street vendors, workers at small informal factories have lost their incomes with the hit of the pandemic,” noted researchers with the Institute for Development Studies. With this dramatic loss of income, it is expected that families will turn to their children to earn more money to buy basic necessities for survival.

In an effort to combat the potential increase in child labor, human rights organizations have urged governments to support families during this crisis—including the use of cash transfer programs. This entails direct cash payments to destitute families. Sometimes there are strings attached to the payments. Families that accept the money must promise to keep children in school and not allow them to enter the labor market. Cash transfers, often involving small amounts of money, have proven effective, in varying degrees, in reducing child labor in many countries.

In the COVID-19 pandemic, even small amounts of money might prevent starvation—or keep children out of the labor market. Save the Children argues that cash transfers help reduce the rate of child mortality, increase access to education, and reduce child abuse. Researchers Jacobus DeHoop and Eric Edmonds recently noted that 133 countries were working on social protection responses that provide financial support to vulnerable families in an effort to combat an increase in child labor during this time. Human Rights Watch has a series of recommendations for governments, including cash transfer payments.

Government efforts alone may not be enough. Companies that employ vulnerable demographics must also respond. Verité, an organization that works to eliminate abusive labor and empower workers, issued a series of recommendations to help companies address COVID impacts. Among the recommendations was a call for companies that work in areas with high rates of child labor to monitor “hot spots” for exploitation and intervene when necessary. Additionally, Verite urged companies to provide benefits for families who experience a loss of a parent due to the pandemic, make work remote when possible, and provide longer sick leaves for employees.

The COVID-19 crisis calls for innovative efforts to protect vulnerable families and children. As Jo Becker, the children’s rights advocacy director at Human Rights Watch, notes “the choices governments make now are crucial, not only to mitigate the worst harm of the pandemic, but also to benefit children over the long term.” By providing families with desperately needed resources during this unprecedented time, it may be possible to help curtail the increase of child labor worldwide.

In the last two decades, the world has seen the number of child laborers drop by nearly 100 million. “We do not want to see those hard-won gains reversed,” said Reid Maki, director of child labor advocacy for the National Consumers League and the coordinator of the Child Labor Coalition. “Concerted and robust action is required.” The actions that those in power take today will have long-lasting impacts that go far beyond COVID-19.

Ellie Murphy is a rising junior at Tufts University, majoring in International Relations and Sociology.

NCL statement condemning threats to public health officials

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June 25, 2020

Media contact: National Consumers League – Carol McKay, carolm@nclnet.org, (412) 945-3242 or Taun Sterling, tauns@nclnet.org, (202) 207-2832

Washington, DC—The National Consumers League (NCL) is deeply concerned with the rise in harassment and threats to public health leaders across the country in response to the nationwide shutdowns due to COVID-19.

Public health leaders are being subjected to pressure following guidelines regarding social distancing and face mask usage. Critics of these guidelines have politicized preventive health measures due to perceived disruptions in personal liberties. They have resorted to “doxxing” public health officials—a practice that involves revealing someone’s private information, such as place of employment and residential address, publicly over the Internet. Other intimidation tactics that have been employed include protesting outside of health officials’ homes to incite fear.

These tactics have created hostile work environments for public health officials, leading to 27 resignations or request of reassignments across 13 states—in the interest of personal safety. Public health workers also fear that these actions could potentially have a negative effect on recruiting people into pursuing careers in the public health field.

“Public health departments are already underfunded and understaffed, and in the midst of this pandemic, we need our full arsenal of public health experts on the front lines,” said NCL Executive Director Sally Greenberg. “We cannot afford to lose any personnel in this space at this time. The U.S. is already behind regarding testing and other preventive measures. We need to let public health workers do their jobs to keep us safe, informed, and empowered regarding our health.

“NCL unequivocally condemns the threats placed against our public health workers. We rely on these individuals to keep us healthy, and we need them now more than ever. All they ask from us in return in our cooperation in flattening the curve.”

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About the National Consumers League (NCL)

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

Vaccine hesitancy and the unique challenge of COVID-19

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headshot of NCL Health Policy intern Talia

By NCL Health Policy intern Talia Zitner

Around the globe, researchers and scientists are racing to find a vaccine for the COVID-19 virus. Developing a safe, effective, and affordable vaccine is already a challenging feat, but vaccine hesitancy presents another unique challenge to scientists, government researchers, and community leaders.

“Vaccine hesitancy” refers to the reluctance or refusal to be vaccinated or have one’s children vaccinated against a disease, even if a vaccine is proven to be safe and effective. Vaccine hesitancy poses dangers to both the individual and their community, since exposure to a contagious disease puts the person at risk, and they are far more likely to spread the disease to others if they won’t get vaccinated. Ironically, these communities may be the most vulnerable to COVID-19, and a serious effort must be made to create a sense of comfort around the COVID-19 vaccine once it’s available to the public.

Not to be confused with the vaccine-hesitant, “anti-vaxxers” represent a movement of people who dispute the safety of vaccinations and challenge laws that mandate vaccinations. This is a more insidious movement funded by dubious sources (reportedly, one New York couple has donated millions of dollars to the movement) that deceptively politicize public health measures under the guise of protecting personal liberties.

Public health agencies are trying to get vaccination levels to 95 percent to guarantee herd immunity. Some concerns that are top of mind for consumers include knowing the timeframe for a vaccine, who will have access to it, what it will cost consumers, if anything, and how states will determine methods of enforcing vaccination. The possibility of a COVID-19 vaccine also begs the question of whether vaccination will be mandatory for public schools and government workers.

Perhaps one of the most important projects right now surrounding vaccine hesitancy is the Vaccine Confidence Project (VCP), which is dedicated to “conducting a global study to track public sentiment and emotions around current and potential measures to contain and treat COVID-19.” Using a mix of population surveys and social media tracking, VCP “will investigate perception and sentiment of COVID-19 social distancing measures and potential medical tools globally.” This project will be essential moving forward, as it will continue to inform understanding on how the global population perceives the eventual vaccine.

As of now, VCP reports that only 25 percent of African Americans—a population that has been disproportionately hit by the virus—plan to get the COVID-19 vaccine. Why is this the case? Due to lack of access to hospitals, pharmacies, doctors and clinics in Black communities, failure to expand Medicaid, and other root causes; the COVID-19 pandemic has laid bare the disparities in our health care system.

To ensure herd immunity—which is somewhere north of 90 percent immunity—much work needs to be done, especially with the Black community, to increase confidence when a COVID-19 vaccine is released. At this time, Black leaders such as former U.S. Surgeon General, Dr. Regina Benjamin, and current U.S. Surgeon General Dr. Jerome Adams, are among those leading the charge to encourage public health efforts such as advocating for face-mask usage and collaborating with the National Newspaper Publishers Association (NNPA) Coronavirus Task Force and Resource Center, which provides expertise on the virus and its impact on the Black community.

Another community that will be crucial to prioritize surrounding vaccine hesitancy is the older Americans. The New York Times reported that of the “241 interventional COVID-19 studies undertaken in the United States and listed on clinicaltrials.gov…37 of these trials—testing drugs, vaccines and devices—set specific age limits and would not enroll participants older than 75, 80 or 85 years old. A few even excluded those over 65.” Why would older Americans trust a vaccine not tested for their age groups? Clinical trials will need to include people across all ages, otherwise, this will only increase vaccine hesitation. The vaccine must be safe and effective, and ample outreach must be conducted to ensure vaccine confidence across all demographics.

There are many questions left to be addressed. As we continue to navigate preventive measures for COVID-19, independent researchers and organizations will become increasingly more important to guiding decision making before and after a vaccine is developed.

Vaccine hesitancy is a global problem that will only be compounded by the COVID-19 pandemic. Fostering vaccine confidence will be imperative when the second wave of the virus sweeps the globe, as it inevitably will.

Talia is a Washington, D.C. native, and a rising sophomore at Wesleyan University, where she majors in English. Beyond health, Talia’s interests are in journalism, law, and social justice.

Top of mind: HHS’s reversal of Obama-era transgender nondiscrimination healthcare protections

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Nissa Shaffi

By Nissa Shaffi, NCL Associate Director of Health Policy

On June 12, the Trump Administration finalized a rule that proposed to revise, and in effect reverse, Obama-era protections offered in Section 1557 of the Affordable Care Act (ACA). Section 1557, known as the Health Care Rights Law, prevents discrimination of patients based on “race, color, national origin, sex, age, or disability.” In 2016, the Obama Administration expanded the definition of sex to encompass aspects of gender identity as well—extending protections to transgender and gender non-conforming individuals. 

The finalized rule will drastically impact how LGBTQ individuals navigate their health care and health insurance, with regard to nondiscrimination protections. The rule would essentially affect aspects of coverage related to access, cost-sharing, and health plan benefits, specifically, denial of treatment based on someone’s gender transition and/or a provider’s moral or religious beliefs.

The U.S. Department of Health and Human Services (HHS) released a statement following this news expressing that reinstating the original definition of the protections offered would relieve the American people of approximately $2.9 billion in “unnecessary regulatory burdens”. These so-called burdens also include eliminating mandates for regulated entities to provide patients and customers with language accessibility pertaining to health care literature.

Considering the nexus of a global pandemic, civil unrest due to systemic racism, compounded by the epidemic of fatal violence against Black transgender people – the timing of this rule is not only inopportune but exceptionally cruel. The National Consumers League is appalled at the reversal of these protections during a pandemic that is disproportionately impacting vulnerable communities. We urge health insurers and providers to do the right to protect patients by keeping politics out of professional medical judgment when providing services to their patients and customers.

Keeping meatpacking workers safe in the age of COVID-19: A view from the front lines

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By Nailah John, Linda Golodner Food Safety and Nutrition Fellow

Meatpacking plants across America have become hot spots for COVID-19. Many plants have had to close due to the rapid increase in cases, with hundreds of workers contracting COVID-19 and a tragic number dying from the deadly virus.

Many packing plants have reopened over the past couple of weeks but the question still remains:  what measures have been put in place to address working conditions?

We interviewed someone who has firsthand knowledge of what is happening on the inside.  Robyn Robbins is the director of occupational health and safety at the United Food and Commercial Workers Union (UFCW). She has worked for UFCW for the past 24 years and prior to this position she was the Assistant Director for 18 years. UFCW is one of the largest labor unions in America. The Union represents workers in meatpacking, poultry, food processing industry, retail grocery, and healthcare—all considered to be essential workers.

Robbins told us: “Many workers are getting sick and dying, and the industry has a history of exploiting workers.” Indeed, the meat industry does not have an admirable record on protecting workers from hazards long before COVID-19. Meatpacking plants on average can employ up to 5,000 workers under one roof, and the conditions are very challenging.  Workers work closely on production lines, sometimes “shoulder to shoulder,” and the areas where they congregate off the line—such as break rooms and locker rooms—can get crowded.  The virus can spread quite easily under these conditions. And the industry has not done enough to allow workers to socially distance both on the production floor and off, or to notify the union when workers are infected, and who else has been exposed, so that the spread of the virus can be contained.

Even amid the pandemic, the demand for meat and poultry is constant. As a result, meatpacking plants have reopened, albeit not at full capacity.  Robbins noted that OSHA (Occupational Safety and Health Administration)—the federal agency that regulates safety and healt—has taken a backseat and has not done on-site inspections. “There are no safety standards that regulate COVID-19 and no clear requirements or regulations that companies are required to follow and therefore there is no way to force companies to actually take precautionary measures recommended by the CDC to protect workers,” Robbins said. She went onto say that “OSHA is the only Federal government entity that can require companies to do anything to protect workers during this pandemic.”

UFCW local union representatives and stewards are in the plants and work hard to get companies to do the right thing to protect workers through the collective bargaining process. “The challenge is trying to get the companies to space workers out on the production floor, which does require some slowing down of line speeds; some of the companies are doing the right thing by spacing workers out but many are not, and are relying too much on protective equipment and plastic barriers, which have not been proven to offer any protection, when it is really about putting more distance between people,” Robbins told us. Social distancing in break rooms is another challenge. Companies have made some effort to effectively separate tables and are putting tents outside for workers to take breaks in those designated areas. They are also staggering shift times in order to reduce the number of workers in break areas at any one time.

Robbins noted: “not all companies are testing workers when they should be, which is a major problem.” UFCW is calling on meatpacking plants to test workers, but companies are reluctant. “If companies worked more closely with the union, they would collectively be able to come up with strategies to isolate workers, redistribute the work, and be more effective over all in addressing the issues relating to COVID-19 and meatpacking workers.”

UFCW doesn’t agree that reopening of plants should take place where there have been outbreaks and where unsafe working conditions exist, unless the companies have taken the steps necessary to protect workers from exposure to COVID-19. “The companies that did shut down made the right decision to sanitize and clean the plants,” said Robbins. “Some have also started screening workers, set up hand sanitizing stations, providing masks, spacing out common areas, giving workers face shields and putting up plastic barriers on the floor between workers where it is possible – although again, there is no data to show that plastic barriers do anything to stem the spread of the virus.”

But this is still not enough. UFCW wants to see workplaces reconfigured so that workers can be six feet apart, both on the production floor and off. This is crucial for stemming the spread of the virus.

Robbins said sick leave policies vary tremendously. “There are 500 local unions around the country, and the UFCW has been pushing for 14 days’ sick leave, successfully bargaining for this in contracts. Some companies are using a combination of different ways to allow workers to stay home when sick, many suspending their normal sick leave policy and making them more flexible. Some companies use a combination of paid sick days and short-term disability so that workers can stay home to recover and then return to work in a safe way. But not all companies are doing this; a few are even revoking paid sick leave policies that were in place at the beginning of this crisis.  This only will result in sick workers coming to work, because they have to in order to earn a living, and the virus will continue to spread, both inside plants, and outside in their communities.  It is bad corporate policy.”

Due to the thousands of cases of COVID-19 in meatpacking plants and many plants not operating at full capacity, meat shortages may continue. In closing, we so appreciate UFCW representing worker interests and Robyn Robbins’ service on NCL’s Board of Directors.

Observing World Food Safety Day: Food safety, foodborne illnesses, and the pandemic.

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By Nailah John, Linda Golodner Food Safety and Nutrition Fellow

Happy World Food Safety Day! June 7 is a special day designated by the United Nations to draw global attention to the health consequences of contaminated food and water.

The concept of food safety encompasses all practices that are used to keep our food safe and relies on the joint efforts of everyone involved in our food supply. “Everyone” refers to all actors in the food chain, farmers, manufacturers, wholesalers, retailers, restaurants, caterers, and many more. Laws and regulations are in place to reduce the risk of contamination under the Food Safety Modernization Act, which is transforming the nation’s food safety system by shifting the focus from responding to foodborne illness to preventing it.

In the United States, the Centers for Disease Control and Prevention CDC estimates that each year 48 million people get sick from a foodborne illness, 128,000 are hospitalized, and 3,000 die. There are more than 250 types of foodborne diseases, caused by bacteria, viruses, and parasites. Some common foodborne illnesses that are found in our country include:

Norovirus: a contagious virus that causes vomiting and diarrhea. You can get norovirus from:

  • Direct contact with an infected person
  • Consuming contaminated food or water
  • Touching contaminated surfaces, then putting unwashed hands in your mouth

Salmonella: lives in the intestines of people and animals. can come from infection from a variety of sources, including:

  • Eating contaminated food or drinking contaminated water
  • Touching infected animals, their feces, or their environment.
  • The bacteria cause about 1.35 million infections, 26,500 hospitalizations, and 240 deaths in the United States every year.

Clostridium perfringens: a spore-forming bacterium that is found in the environment as well as in the intestines of humans and animals. It is also commonly found in raw meat and poultry, beef, poultry, gravies and dried of pre-cooked foods

  • Infections often occur when foods are prepared in large quantities and kept warm for a long time before serving. Outbreaks often happen in institutions, such as hospitals, school cafeterias, prisons, and nursing homes, or at events with catered food.

Campylobacter: the most common bacterial cause of diarrheal illness in the United States.

  • Causes 1.5 million illnesses each year.
  • caused by eating raw or undercooked poultry or consuming something that has come into contact with raw or undercooked poultry, seafood and untreated drinking water.

Staphylococcus (Staph): a gastrointestinal illness caused by eating foods contaminated with these toxins.

  • symptoms include sudden nausea, vomiting and stomach cramps, diarrhea.
  • Not washing hands if food is contaminated with Staph, the bacteria can multiply in the food
  • Foods that are not cooked after handling, such as sliced meats, puddings, pastries and sandwiches are especially risky if contaminated with Staph.

As we note efforts worldwide to ensure that our human food supply is safe, we would be remiss in 2020 if we did not note the increased food safety concerns during the COVID-19 pandemic.

According to the CDC, there is currently no evidence to support transmission of COVID associated with food. It is important that consumers wash hands with soap and water for 20 seconds when handling food. The CDC highlights that, because of poor survivability of these coronaviruses on many surfaces, there is likely low risk of spread from food products or packaging. The CDC also reinforces the need to avoid cross-contamination of foods in preparing food safely by keeping raw meat separate from other foods, cooking meat to the recommended temperature, which kills harmful bacteria and ensuring that perishable foods are refrigerated.

It is also important to always rinse fresh fruits and vegetables under running water, including melons and other produce with skins and rinds. Scrub the produce firmly with a clean brush, also remember to clean the lids of canned goods before opening them, says the FDA. Washing produce and cooking meats, fish, and poultry thoroughly is key during this pandemic, especially with so many people preparing their meals at home. Our message to consumers and restaurants and anyone who handles food: as we mark World Food Safety Day, follow these important food safety practices to help prevent foodborne illness and stay healthy and safe during these uncertain times.

The National Consumers League supports expanded COBRA coverage

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By Sally Greenberg, NCL Executive Director

In a perfect world, every person in the United States would have quality health care coverage, irrespective of whether they were employed or whether their employer-offered health insurance. The National Consumers League (NCL) has long advocated for universal access to health insurance for every American.

For political reasons, however, we still have a hybrid, expensive, and patchwork health care system. Thankfully, the Affordable Care Act addresses some of these disparities for millions, but our health care system in the United States still leaves many gaps in who can get coverage. And now, with the COVID-19 pandemic, the gaps in our social safety net have been made very stark indeed. Estimates are that 27 million Americans who have lost their jobs have lost their health insurance as well, according to an analysis from the Kaiser Family Foundation.

An estimate from the Robert Wood Johnson Foundation found between 25 million and 43 million people could lose their employer-sponsored insurance in the coming months if job losses continue.

However, help is on the way.

The Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act passed the House of Representatives on May 15, 2020. The bill addresses the COVID-19-induced massive unemployment/loss of health insurance crisis for Americans who receive their health insurance through their employer.

The HEROES Act allows individuals eligible for Consolidated Omnibus Budget Reconciliation Act (COBRA) coverage to maintain their employer-sponsored coverage after a layoff, reduction in hours or furlough without having to pay premiums through January 2021. The bill also would provide two special enrollment opportunities for individuals to obtain health insurance: (a) during the emergency period for Medicare-eligible individuals residing in an emergency area who have not previously enrolled in Medicare and (b) during an eight-week enrollment period for an Affordable Care Act exchange for individuals who are uninsured for whatever reason. The bill would authorize veterans without a disability or health insurance to qualify for special enrollment in the Veterans Affairs (VA) healthcare system for a 12-month period. Finally, the bill would expand the Medicaid expansion pathway provided for in Families First, which covered 100 percent of testing costs. HEROES would expand this pathway to include full federal coverage for COVID-19 treatment and vaccines without cost-sharing for certain Medicaid enrollees.

There are issues, of course, with handing over billions of dollars to the health care industry through expanded COBRA that they might not have received otherwise. Among them, they pay excessive salaries to their CEOs that should trouble all of us who pay insurance premiums.

There is also the possibility that increasing access to private insurance via COBRA subsidies could stunt nationwide efforts to expand Medicaid for more vulnerable populations, to some degree.

But this is a case where we cannot let the pursuit of perfection be the enemy of the good. For nearly 40 million Americans struggling with loss of employment, passage of the HEROES Act will mean that they will not have to worry that neither they, nor their families, will lose health insurance.

We agree with Actors’ Equity, which issued this statement before the HEROES Act was adopted, “it is time for Congress to consider a 100% COBRA subsidy to ensure that no one loses their health care in the middle of a pandemic.” Similarly, our friends at Families USA have echoed the call for fully subsidizing COBRA coverage for displaced workers, among other robust consumer assistance measures. To read more, click here.  

Fully or heavily subsidizing COBRA coverage will have multiple benefits – particularly for consumers with chronic illnesses who have already satisfied their annual deductible- who would either be faced with potentially starting a new deductible from scratch, or with an entirely new provider altogether. By subsidizing COBRA coverage, families will be able to seek medical care, access vaccines and testing for COVID, and will have the full array of health care protections. It is a measure that will be good for the entire nation and will lessen the already frightening and painful loss of employment.

As a result, NCL strongly supports the HEROES Act provisions to subsidize COBRA benefits to the many millions who have lost employment. The House of Representatives has done its part. Now we need the Senate to approve the HEROES Act and move it to the President’s desk for signature. The nation will be far healthier if everyone can have access to health care in the age of this catastrophic COVID-19 pandemic.

A prescription for surviving COVID-19 nutritionally intact: eat well, get sunshine

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By Nailah John, Linda Golodner Food Safety and Nutrition Fellow

Overeating or eating poorly during this pandemic is understandable. However, a healthy diet is vital for you and your family’s health. As most people are aware, a healthy diet consists of protein, fruits, vegetables, and grains and is low in salt, unsaturated fats, and free sugars. But there’s more to it than that.

While it’s important to have protein in one’s diet, it is not always necessary to get protein from meat products. One of the best sources is legumes (as known as beans) such as white peas, kidney beans, moong, masoor, chickpeas, lentils, and many others according to Thrive Global. Consider whipping up a salad, making tasty lentil soup with carrots and cilantro, or a chickpea curry to quench your taste buds! Preparing a simple, easy, and delicious meal doesn’t have to be hard, you can find many recipes and cooking guides on YouTube or Google Search.

Eating healthy sometimes means breaking bad habits, so the first step is by keeping healthy and nutritious snacks around, such as cheese with an apple, hummus and carrots, or nuts and dried fruit. Eating yogurt once a day is a good habit to get into along with fruit and cereal. If you’re full from a good breakfast, you are less likely to snack on junk food. Thrive Global noted that certain bacteria are highly recommended to keep you healthy and fit.

Remember to top up on your fruits! They are a rich source of minerals and vitamin C, which is especially good for boosting your immune system during COVID-19. Rangers, Apples, kiwis, and persimmons are just a few fruits rich in vitamin C. Kale, brussels sprout, broccoli, and parsley are also on the list. Vitamin D is also important in the immune response to COVID-19 due to its anti-inflammatory properties. Vitamin D is usually sourced by the action of sunlight on the body but since many of us are staying at home due to the lockdown and unable to get the necessary daily exposure, we must depend on vitamin D rich food sources such as; salmon, swordfish, oysters, mushrooms, and eggs, according to 10FAQ Health. And these vitamin D rich foods can make for very delicious dishes like garlic butter baked salmon or chargrilled oysters. Check out recipe sites like Food Network for more meal ideas.

Eating healthy is particularly important during the time of COVID-19. By incorporating foods of color—carrots, beans, various cheeses, kale, and more—you can make delicious dishes. Try new recipes and enjoy a healthy nutritious meal. And remember, eating healthy contributes to the boosting of the immune system. Let us all try to stay healthy and safe during COVID-19!