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The Health 202: Republican-backed ACA lawsuit also threatens Medicaid as enrollment grows during pandemic

But the health-care law’s Medicaid expansion played a bigger role in extending health coverage – and is now enrollment is surging amid the coronavirus pandemic. Coverage for Americans enrolled in this program is also threatened by the lawsuit, a detail getting far less attention on the campaign trail. 

Nearly 4 million more people enrolled in the health insurance program for the low income between February and June. 

Medicaid enrollment grew 6.2 percent over the spring and early summer, the Centers for Medicare and Medicaid Services reported this week. 

It’s an abrupt reversal of the direction enrollment had previously been moving as it trended downward over the last several years. Yet the surge isn’t terribly surprising, given the nation’s widespread job losses during the first wave of the pandemic and subsequent lockdowns. More than one in five Americans – about 75 million – now rely on Medicaid or the Children’s Health Insurance Program for their coverage.

Many states have seen double-digit percentage increases in their Medicaid enrollment during the pandemic. 

In Nebraska, enrollment climbed from fewer than 644,000 in February to about 731,000 through August, my colleague Amy Goldstein reported.

“That 13.5 percent increase places Nevada among at least three states, along with Kentucky and Minnesota, where the cadre of people on Medicaid has spiked that much,” Amy wrote. “But increases are widespread: Caseloads had risen on average 8.4 percent through July in 30 states for which researchers have enrollment information. And in 14 states with enrollment data through August, the average is 10 percent.”

Around 15 million of Medicaid enrollees nationwide are eligible for the program because of the Affordable Care Act, which gave states dollars to expand their programs to earners up to 133 percent of the federal poverty level.

The outcome of the ACA lawsuit could affect their coverage. 

Just days after the election, the court is scheduled to hear a lawsuit challenging the ACA’s constitutionality. The confirmation of conservative nominee Amy Coney Barrett – a process the Senate is embarking upon in 10 days – could increase the court’s chances of knocking down some or all of the 2010 health care law.

Some ACA advocates have noted the much broader impact of tossing out the health care law, beyond those with preexisting conditions.

Charles Gaba, an ACA analyst, has been tweeting out how many people in each state could get kicked off Medicaid expansion:

It’s understandable why Democrats are focusing on the preexisting condition protections over Medicaid expansion.

Preexisting condition protections are especially popular, with 72 percent of Americans saying it’s “very important” they stay in place.

And were the court to toss out any part of the ACA, the preexisting condition protections would be the first to go. It’s harder to imagine the court ruling that the entire law including its Medicaid expansion must fall. 

Still, rarely does presidential nominee Joe Biden speak without mentioning preexisting conditions, and the phrase shows up constantly in Democrats’ campaign ads and speeches.

“We’ll show America which party stands

Investors eye discounted U.S. healthcare sector as Biden’s lead in polls grows

By Lewis Krauskopf



FILE PHOTO: Pharmaceutical tablets and capsules are arranged on a table in this picture illustration taken in Ljubljana


© Reuters/Srdjan Zivulovic
FILE PHOTO: Pharmaceutical tablets and capsules are arranged on a table in this picture illustration taken in Ljubljana

NEW YORK (Reuters) – Investors are looking for bargains among healthcare stocks, even as prospect of a Democratic “Blue Sweep” in next month’s elections threatens more volatility for a sector already trading near a historical discount to the broader market.

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A victory by former Vice President Joe Biden over President Donald Trump on Nov. 3 and a potential Democratic takeover of the Senate could clear the way for prescription drug price and healthcare coverage reforms, generally seen as potential negatives for companies in the sector.

Some investors are betting these factors have already been priced into healthcare shares or may not be as detrimental as feared, while the companies stand to benefit from relatively stable earnings prospects and their medical innovations.

“For high-quality companies that are trading at reasonable valuations … there is a strong argument to be made for adding some healthcare exposure to portfolios,” said James Ragan, director of wealth management research at D.A. Davidson.

Biden’s improving election prospects have weighed on healthcare stocks for much of 2020, according to investors, with the S&P 500 healthcare sector <.spxhc> climbing just 7% since the end of April, against a 17% gain for the overall S&P 500 <.spx>.

A Reuters/Ipsos poll on Sunday showed Biden opened his widest lead in a month after Trump contracted COVID-19.

The healthcare sector now trades at a 26% discount to the S&P 500 on a price-to-earnings basis, according to Refinitiv Datastream. The sector’s 15.8 P/E ratio is well below the S&P 500’s 21.3 ratio, which last month rose to its highest valuation since 2000.

The gap between the sector’s P/E ratio and that of the S&P stood at its widest in at least 25 years last month, though it has narrowed in recent weeks.

“As Biden started to do better in the polls, you saw healthcare start to underperform a bit as the rest of the market recovered,” said Ashtyn Evans, a healthcare analyst with Edward Jones.

While Biden may shake up insurance coverage by offering a “public option” government plan, he is also expected to seek to strengthen the Affordable Care Act – the signature healthcare law enacted when he was vice president – under which companies are used to operating.

Any significant drug pricing legislation may need to wait until the pandemic is more contained, as the government relies on the pharmaceutical industry to develop COVID-19 therapies and vaccines. Trump has also vowed to lower drug prices, making the issue arguably less partisan.

“We think there remains a reasonably good probability that the next Congress will institute moderate health policy changes that will create long-term clarity for the sector and investors,” Eric Potoker, an analyst at UBS Global Wealth Management, said in a note last month.

Healthcare stocks have been prone to volatility around elections.

Ahead of the 2016 vote, which pitted Trump against former Secretary of

Stephen Miller Tests Positive as White House Outbreak Grows

Here’s what you need to know:

Credit…Anna Moneymaker for The New York Times

On Tuesday evening, senior administration officials confirmed that Stephen Miller, Mr. Trump’s top speechwriter and a policy adviser, had tested positive for the coronavirus, joining a growing list of Mr. Trump’s close aides who have the virus.

“Over the last five days I have been working remotely and self-isolating, testing negative every day through yesterday,” Mr. Miller said in a statement. “Today, I tested positive for Covid-19 and am in quarantine.”

Mr. Miller is married to Katie Miller, Vice President Mike Pence’s communications director. A senior administration official said Ms. Miller, who contracted the virus this spring and returned to work in May, was tested Tuesday morning and was negative for any new infection.

On Tuesday, many White House offices were empty as officials stayed home to wait out the infectious period from an outbreak of the coronavirus within the building and among people who had been there.

President Trump was in the White House residence, convalescing, as a number of advisers and other officials stayed home, either because they had contracted the coronavirus or had been near people who did.

The White House communications and press shops were bereft of people. The White House press secretary, Kayleigh McEnany, announced on Monday that she had tested positive. Two other press office aides have also contracted the virus, and two more aides on Tuesday were said to have tested positive, people familiar with the results said.

The outbreak in the White House, which has extended to some lawmakers on Capitol Hill, has raised concerns in the city that surrounds it. Washington, D.C., which has managed to bring infection rates down in recent weeks through preventive laws and high rates of compliance, has almost no control over the federal government.

The city reported 105 new coronavirus cases on Tuesday, the highest number since June 3.

The gathering at the Rose Garden would have violated the city’s mandates limiting the size of gatherings and requiring masks. But because the White House is on federal property, it is exempt from such rules.

City officials said they would be closely monitoring infection trends for several days to see if the Capitol and White House cases affected the city’s overall infection rate.

Credit…Doug Mills/The New York Times

The White House physician, Dr. Sean P. Conley, said on Tuesday that President Trump was experiencing no symptoms of Covid-19 and doing “extremely well” on his first full day at home since a three-night stay in the hospital.

But outside doctors and medical experts in Covid-19 and lung disease said they were struggling to piece together an accurate picture of Mr. Trump’s health. Far from having vanquished Covid-19, the outside experts said, Mr. Trump is most

Coronavirus Outbreak Among UW’s Greek System Grows To 212 Cases

SEATTLE — A coronavirus outbreak among the University of Washington’s Greek system grew to 212 students Wednesday, up 35 cases from the day before. The latest surge in illnesses connected to off-campus fraternity and sorority houses in Seattle began with two cases reported Sept. 11. It is the second outbreak associated with UW’s Greek system since the pandemic began.

On Tuesday, the university and Public Health – Seattle & King County sent a joint letter to the Interfraternity Council and Panhellenic chapters, urging members to step up and help prevent further spread by following established guidelines.

The letter goes on to remind students that failing to comply with university and Public Health guidance could lead to “additional steps” being taken, including disciplinary actions up to expulsion. Other actions, officials said, could include sending notices to landlords of off-campus properties, if parties, gatherings and “flagrant disregard” for prevention measures continue.

“This isn’t the college environment anyone was expecting, but COVID-19 is a reality we need to adapt to by changing our behaviors and activities for the foreseeable future,” officials wrote. “Driving down infection rates in order to minimize loss of life and livelihood requires sustained action and mutual support across all sectors of our community and we ask that you honor and abide by the Husky Pledge.”

Dr. Jeff Duchin, health officer for King County, said failure to follow precautionary measures in settings especially prone for spread makes an outbreak inevitable.

“It doesn’t matter whether you’re talking about the White House in the other Washington or a Greek house at the University of Washington, COVID-19 spreads effectively with close contact and crowding, especially when masks are not worn,” Duchin said. “Rapid testing, isolation of people with symptoms and a 14-day quarantine of exposed students are essential to containing the outbreak.”

UW is encouraging all students to sign up for the Husky Coronavirus Testing Program, powered by the Seattle Flu Study, to help track the virus’s spread and connect infected students with resources.

Health officials say quelling the outbreak off-campus will limit the likelihood illness will sweep through the university and its neighbors.

“We don’t want to see this spread to the greater UW community or surrounding areas or threaten our ability to have in-person learning in the future,” Duchin said. “I encourage Greek life alums and fraternity and sorority advisory and house corporation board members to reach out to your chapter houses and encourage and support students in taking the necessary COVID-19 prevention and response actions.”

Learn more about the outbreak on the Public Health Insider blog, the University of Washington website, and the case tracking dashboard.

How to prevent outbreaks in congregate settings (from Public Health – Seattle & King County)

  • Wear face coverings in all communal spaces outside of bedrooms in congregate living facilities.

  • Wear face coverings when interacting with anyone in social settings.

  • Socially distance at least six feet at all times.

  • Practice frequent and diligent hand hygiene.

  • Increase cleaning and disinfecting of high touch surfaces.