Illinois Attorney General Kwame Raoul joined nearly two dozen colleagues this week to request the Supreme Court uphold an Affordable Care Act provision that guarantees access to preventative care. [ Health News Illinois ] 

The 24 attorneys general, led by Raoul, asked the justices in an amicus brief to reverse a lower court’s decision that struck down the law’s requirement for health plans to cover certain preventive services and treatments without charging out-of-pocket costs.

The brief argues that eliminating the provision could create a gap in health coverage that states could not fill due to federal law that prevents them from regulating certain insurance plans. State-level mandates, it argued, would not be as effective without corresponding federal guidance on implementation and enforcement.

Additionally, the attorneys general said the preventative care provision expanded healthcare access for women, specifically to contraceptives, and reduced socioeconomic, racial and ethnic disparities in healthcare.

“All patients in Illinois and across the country deserve continued access to what are often lifesaving, preventive health services,” Raoul said in a statement.

The initial lawsuit was brought in 2020 by Christian-owned companies who challenged the requirement that their employer-sponsored insurance plans cover preventive medicines for HIV.

The 5th Circuit Court of Appeals ruled this summer that the provision was unconstitutional, but froze a lower court decision that would scrap the requirement. The appeals court said only the plaintiffs could exclude the services from their plans as the case continues to work through the legal system.

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Throughout her career, Tanzeem Choudhury, PhD, has worked at the intersection of wearable computing, AI, and health care. Over time, she came to see that tracking activity-related behaviors with wearable devices had the potential to support well-being before people became sick. Today she also thinks about how AI tools can be used to efficiently test and deliver new ideas for technology-assisted well-being in the real world. [JAMA}

This conversation is part of a series of interviews in which JAMA Network editors and expert guests explore issues surrounding the rapidly evolving intersection of artificial intelligence (AI) and medicine.

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You may be interested in this Artificial Intelligence & Healthcare webinar on Oct. 29, 2024- more details here> 

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From March of 2020 to May of 2023, 1.38 million more people died in the United States than would have been expected — 1.38 million lives that, had circumstances been different, would not have been lost. [MedScape]

This is the legacy of the COVID pandemic. And I want to be clear that not all of these deaths are directly due to COVID; we’ll explore the deaths attributable to the virus in a minute. But the pandemic itself, the changes it wrought on society — the delayed cancer screenings, the missed outpatient appointments — all of these acted to change our fundamental understanding of the risk of living in this country.

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Illinois has invested more than $46 million in breast and cervical cancer screenings and education over the past three years, according to a website launched Wednesday by Illinois Comptroller Susan Mendoza’s office.  [Health News Illinois]

The funds come from a state program that provides free mammograms, breast exams, pelvic exams and pap smears for eligible women, including those without insurance or whose insurance does not cover the screenings.

Mendoza said the goal is to provide full transparency for taxpayers on where state money is being spent.

“This is a data set the state should be proud of, and a clear return on investment for Illinois taxpayers,” she said.

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After nearly a year as interim leader, Dr. Erik Mikaitis was nominated Wednesday as the permanent CEO of Cook County Health. [Health News Illinois]

The decision by the health system's board of directors follows an eight-month national search to replace Israel Rocha Jr., who stepped down last December. 

Lyndon Taylor, board chair, said in a statement that Mikaitis “stood out in the field of multiple high-caliber candidates for his commitment to quality and process improvement, strategic vision and dedication to the health system’s mission.”

The Cook County Board of Commissioners is set to consider the appointment next week.

Mikaitis began as interim CEO last December. He joined the organization in 2022 as chief quality officer.

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Pregnancy and infant health outcomes in the US continue to lag behind other countries with similar economic performance, with rates of infant and neonatal mortality and preterm birth typically 2 to 3 times higher than that of other high-income nations.¹ These adverse outcomes also differentially occur in patients by race, ethnicity, socioeconomic status, or rural vs urban residence.^2,3 As a result, there have been myriad programs and policies enacted on the state or local levels to address, and hopefully improve, the ultimate health of pregnant patients, newborns, and infants. Unfortunately, there is little information to help guide policymakers, advocates, or clinicians on the population health impact of such programs. The article by Chang et al⁴ provides some evidence that state-level policies may influence pregnancy and newborn outcomes. This study calculated yearly state and local government expenditures per person with low income in multiple social programs, including state refundable earned income tax credits, cash assistance, childcare assistance, housing and community development, and public health. They found that, for every increase of $1000 per person with low income, overall rates of preterm birth, defined as delivery of a live-born infant at a gestational age of less than 37 weeks, was decreased by 1.4%. This effect was larger in infants of Black mothers and for expenditures in cash assistance, housing, and community development. Such research suggests that public policies on social programs may have short- and long-term impacts on infant health and may impact specific infant populations to a greater degree. [JAMA Network]

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Cook County Board President Toni Preckwinkle released a nearly $9.9 billion spending plan on Thursday. (Health News Illinois]

Preckwinkle said the plan does not include new taxes, fines or fees. 

“This strong fiscal foundation is because we have been consistent in setting priorities and making the tough decisions to enact them,” she said. “The result of these difficult decisions and hard votes by our Cook County Board of Commissioners over the years is a fiscally responsible and community-focused budget that fosters safe, thriving and healthy communities.”

Preckwinkle highlighted several health initiatives in the plan, like establishing 11 regional collaboratives to assist in behavioral health services and opening a clinical triage and stabilization center at Provident Hospital.

More than half the budget is dedicated to Cook County Health. 

Preckwinkle’s office said the system’s Medicaid managed care plan retained more members than expected, after the return of the Medicaid redetermination process following a hiatus during the pandemic.

The budget plan pauses a pandemic-era program that provides $500 a month in guaranteed income to low-income families. Preckwinkle told reporters the program will take a break, pending an independent review.

The county board will take up the proposal in the coming weeks.

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Infection from COVID-19 appeared to significantly increase the risk of heart attack, stroke, and death for up to three years among unvaccinated people early in the pandemic when the original SARS-CoV-2 virus strain emerged, according to a National Institutes of Health (NIH)-supported study. The findings, among people with or without heart disease, confirm previous research showing an associated higher risk of cardiovascular events after a COVID-19 infection but are the first to suggest the heightened risk might last up to three years following initial infection, at least among people infected in the first wave of the pandemic. [NIH]

Compared to people with no COVID-19 history, the study found those who developed COVID-19 early in the pandemic had double the risk for cardiovascular events, while those with severe cases had nearly four times the risk. The findings were published in the journal Arteriosclerosis, Thrombosis, and Vascular Biology.

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Nearly 1 in 3 Americans — in the only wealthy country in the world to not have a developed universal health care system — lack reliable primary care access. Meanwhile, unlike JD Vance, Americans are getting shorter due in part to poor access to quality health care and nutrition. [KFF Health News}

Newsweek: Map Reveals US States Where Healthcare Is Least AccessibleAffordable healthcare is essential for public health and equality. However, access varies widely across the nation. ... Zoi Galarraga, Senior Digital PR Manager at Forbes Advisor, the group who led the study, told Newsweek. "A recent survey from Gallup and West Health found that just 55 percent of U.S. adults can access and afford quality healthcare when needed. "Additionally, over 100 million Americans—nearly one third of the nation— do not have access to a usual source of primary care, according to the National Association Of Community Health Centers." (Dewan, 10/8)

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Chicago must replace every toxic lead pipe connecting homes to water mains within two decades — an aggressive deadline imposed this week by President Joe Biden after his administration initially proposed giving city officials twice as long to complete the job. [Chicago Tribune]

The more stringent requirement is part of a broader package of changes in federal regulations intended to protect Americans from a metal so dangerous it is unsafe at any level of exposure.

More than 9 million homes nationwide get drinking water from a service line made of lead. Chicago has more than 400,000 of the toxic pipes, by far the most of any U.S. city. Illinois has more than any other state.

Biden, who will speak about the new regulations Tuesday in Wisconsin, promised during his 2020 campaign to accelerate service line replacements after decades of inaction from federal and state officials. One of the big infrastructure bills his administration brokered with Congress earmarked $15 billion toward the effort. Billions more will be needed in Chicago alone.

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