Good morning. I’m Jazmin Orozco Rodriguez, a KFF Health News correspondent based in Elko, Nev., a land of sagebrush and mines located in the fourth-largest county in the Lower 48. Email me about your experiences with health care in rural America at jorozco@kff.org.
Today’s edition: The Senate health committee is set to vote on investigating the bankruptcy of Steward Health Care and subpoenaing its CEO. The nation’s infant mortality rate increased for the second year in a row. But first …
Post-Roe abortion policies have sent women in rural areas scrambling for care
Not so long ago, Bonner General Health, the hospital in Sandpoint, Idaho, had four OB/GYNs on staff, who treated patients from multiple rural counties.
That was before Idaho’s near-total abortion ban went into effect almost two years ago, criminalizing most abortions. All four of Bonner’s OB/GYNs left by last summer, some citing fears that the state’s ban exposed them to legal peril for doing their jobs.
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The exodus forced Bonner General to shutter its labor and delivery unit and sent patients scrambling to seek new providers more than 40 miles away in Coeur d’Alene or Post Falls, or across the state border to Spokane, Wash. It has made Sandpoint a “double desert,” meaning it lacks access to both maternity care and abortion services.
One patient, Jonell Anderson, was referred to an OB-GYN in Coeur d’Alene, roughly an hour’s drive from Sandpoint, after an ultrasound showed a mass growing in her uterus. Anderson made multiple trips to the out-of-town provider. Previously, she would have found that care close to home.
The experience isn’t limited to this small Idaho town.
A 2023 analysis by ABC News and Boston Children’s Hospital found that more than 1.7 million women of reproductive age in the United States live in a “double desert.” About 3.7 million women live in counties with no access to abortion and little to no maternity care.
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Texas, Mississippi and Kentucky have the highest numbers of women of reproductive age living in double deserts, according to the analysis.
Amelia Huntsberger, one of the OB/GYNs who chose to leave Sandpoint — despite having practiced there for a decade — did so because she felt she couldn’t provide the care her patients needed under a law as strict as Idaho’s.
The growing provider shortages in rural states affect not only pregnant and postpartum women, but all women, said Usha Ranji, an associate director for Women’s Health Policy at KFF, a health information nonprofit that includes KFF Health News.
“Pregnancy is obviously a very intense period of focus, but people need access to this care before, during and after, and outside of pregnancy,” Ranji said.
The problem is expected to worsen.
In Idaho, the number of applicants to fill spots left by departing doctors has “absolutely plummeted,” said Susie Keller, CEO of the Idaho Medical Association.
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“We are witnessing the dismantling of our health system,” she said.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — an independent source of health policy research, polling, and journalism.
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On the Hill
Senate health committee prepares for landmark subpoena vote
The Senate Health, Education, Labor and Pensions Committee has scheduled a 10 a.m. hearing for votes on authorizing an investigation into the bankruptcy of hospital chain Steward Health Care and whether to subpoena Ralph de la Torre, the company’s CEO, to give testimony, The Post’s Dan Diamond reports.
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Steward, which runs 31 hospitals across the country, declared bankruptcy in May amid allegations that its leaders and owners mismanaged the company and prioritized profits over patient care. The Justice Department is probing Steward over fraud allegations.
The HELP committee’s probe has bipartisan support: Sens. Bernie Sanders (I-Vt.) and Bill Cassidy (R-La.), the panel’s chair and ranking member, have both spoken out about their frustrations with Steward, including de la Torre’s prior refusal to testify.
Cassidy’s statement: “Subpoenas should only be used when absolutely necessary. When all other efforts have failed. The subpoena we are voting on today meets that criteria.”
How we got here: Steward has been in HELP’s crosshairs for months, with lawmakers saying they are worried about patient care in communities served by the now-bankrupt company.
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Sens. Ed Markey and Elizabeth Warren, the HELP committee’s two Massachusetts Democrats, held a field hearing in Boston in April where they criticized Steward and its former private equity owners.
Ahead of the vote: Markey and Rep. Pramila Jayapal (D-Wash.) will introduce the Health Over Wealth Act, which aims to boost transparency for private equity firms and for-profit companies that own health-care entities.
The bill seeks to enact safeguards to protect workers and patients, as well as ensure the quality, access and safety of health care. The final version, building on an April discussion draft, also includes language requiring bankruptcy courts to consider the impacts on health-care access and provider employment in its decision making, among other provisions.
In case you missed it: The Health Brief spoke to Markey earlier this year about the bill, which was inspired by Steward’s bankruptcy filing. Read our conversation here.
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Meanwhile …
On our radar: A bipartisan bill aimed at cracking down on the illicit drug trade is on its way to President Biden’s desk.
The legislation from Sens. Catherine Cortez Masto (D-Nev.) and John Cornyn (R-Tex.) directs the Government Accountability Office to investigate how transnational criminal organizations finance synthetic-drug trafficking to help federal officials target them more effectively.
Why it matters: There were an estimated 107,543 overdose deaths nationwide in 2023, 74,702 of which were attributed to synthetic opioids such as fentanyl, according to provisional data from the Centers for Disease Control and Prevention.
Across South Texas, we see the drug trade's impact on our cities and towns. Knowing how these narcotrafficking organizations conduct their financing and business models will increase our chances of defeating them and saving American lives. Thank you to @JohnCornyn for leading the… pic.twitter.com/vmfsscc9JE
— Rep. Monica De La Cruz (@RepMonicaDLC) July 24, 2024Data point
Infant mortality rates climb for the second year
New this a.m.: There were 20,577 infant deaths reported in the United States in 2022, up 3 percent from the previous year, according to a report from the CDC released today.
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The data marks the second year-over-year increase in the nation’s infant mortality rate, following more than two decades of declines.
A closer look: Wide disparities continue to persist among different racial demographics. Deaths among infants of Black women remained the highest of all groups, with 10.90 deaths per 1,000 live births. In contrast, infants of Asian women had the lowest mortality rate at 3.51.
- The report also highlights state-by-state differences. Massachusetts boasts the lowest state-level mortality rate at 3.32 deaths per 1,000 live births, while Mississippi records the highest at 9.11.
Agency alert
U.S. pledges funds for global pandemic preparedness
The United States has pledged $667 million to the World Bank’s Pandemic Fund, which was established in 2022 to boost pandemic prevention, preparedness and response in low- and middle-income countries.
Treasury Secretary Janet Yellen announced the commitment during a G-20 finance leaders’ meeting yesterday, where she urged other donors to double their contributions to help meet the fund’s $2 billion target.
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Yes, but: The pledge needs congressional approval. With deep partisan divides over spending and the November elections looming, it’s uncertain whether the commitment will be fulfilled.
Today, I announced the U.S. is pledging up to $667 million to support the @Pandemic_Fund through 2026.
This investment will help the world prevent and respond to the next pandemic — protecting Americans and others globally. pic.twitter.com/loyI9VZiTA
— Secretary Janet Yellen (@SecYellen) July 24, 2024Meanwhile, at the Food and Drug Administration ...
On the move: Jeff Shuren, the FDA’s director of the Center for Devices and Radiological Health, will step down after nearly 15 years in the role. Michelle Tarver, deputy center director for transformation, will serve as acting director starting July 28, with Shuren assisting in the search for his permanent successor, according to an announcement shared with the Health Brief.
Federal regulators finalized guidance directing drug sponsors to submit protocols and statistical analysis plans before using electronic health records or medical claims data in clinical studies measuring the safety and effectiveness of their product.
In other health news
- Presumptive Democratic presidential nominee Kamala Harris vowed twice this week to revive Democratic plans to expand the “care economy,” previewing a campaign message against Donald Trump and potentially signaling one of her top priorities should she be elected, The Post’s Jeff Stein reports.
- The Arkansas Supreme Court has ordered the state to start counting signatures of support for a proposed ballot initiative to expand abortion access, excluding those collected by paid canvassers, Antoinette Grajeda reports for the Arkansas Advocate.
- CVS Caremark, one of the nation’s largest pharmacy benefit managers, will pay Illinois at least $45 million to settle allegations that it failed to pass on drug manufacturer rebates to the state for four years, Stat’s Ed Silverman reports.
Health reads
Sugar rush
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