Congress tries to buy itself time to debate FY25 appropriations
Congressional leaders have made a deal to avert a government shutdown on October 1, by advancing a continuing resolution (CR) until December 20 that will keep funding for FY25 at the same level as FY24. Speaker Johnson had been attempting to pass a six-month CR with unrelated legislation requiring proof of citizenship to vote in federal elections, however this plan was rejected by a bipartisan vote. Shortly after both chambers pass the CR, Congress will go on recess to campaign until mid-November. During the “lame duck” after they come back, they will face a large list of must-pass and really-want-to-pass legislation, including a government funding bill, the National Defense Authorization Act, farm bill, Medicare telehealth authority, pharmacy benefit manager authorization, and Medicare physician payment reform.
- AcademyHealth meets with Congressional staff and Members year-round to support adequate funding for researchers, including by leading the Friends of AHRQ and serving on the Executive Committee for the Friends of NCHS. This advocacy work, funded through AcademyHealth membership, has led to tens of millions of dollars in new AHRQ spending in recent years. We are actively working with appropriators on FY25 to oppose the House attempts to zero out AHRQ and health equity research and to promote the Senate proposal to increase AHRQ spending as a floor of acceptable outcomes.
HHS announced a new AI strategy is coming
At AcademyHealth’s Health Datapalooza, HHS Deputy Secretary Andrea Palm announced that HHS is working on a new AI strategy that will be released in January, and is working on creating an AI safety plan with assurance labs. HHS Acting Chief Artificial Intelligence Officer Micky Tripathi separately discussed the assurance labs, which he thinks would supplement FDA regulation of AI-powered medical devices, including tools that fall outside of the FDA’s regulatory scope. He noted that they are waiting for AI developers and purchases to reach consensus on what the vetting process should include.
- AcademyHealth recently sent a letter to the Coalition for Health AI (CHAI) with our concerns that AI developers do not fully understand the problems around bias in the data and algorithms. We provided lessons from the field of health services research and possible paths forward.
GAO reprimands HHS for duplicative public health preparedness data systems
The Government Accountability Office (GAO) released a report on HHS data systems used to inform public health preparedness and response. They found that HHS has not developed a comprehensive list of all of its systems, and GAO and HHS identified 99 separate data systems with frequently overlapping and duplicative data. Many of these systems contained personally identifiable information yet did not have key privacy safeguards.
Health insurance coverage was stable in 2023 at the start of Medicaid winddown
The Census Bureau reported that the proportion of Americans without health insurance remained stable in 2023, close to the record low of 2022. About 8% of Americans were uninsured, a statistically insignificant increase of just 0.1 percentage point from a year earlier. But because of the Census survey’s methodology, the findings likely don’t capture the experience of tens of millions of Americans purged from Medicaid rolls after pandemic-era protections expired in spring 2023.
Biden Administration pushes for mental health parity
The Biden administration is finalizing a sweeping expansion of regulations that require insurers to cover mental health and addiction care on the same terms as other care. Administration officials said insurers have flouted a 2008 law requiring so-called mental health parity — and are expanding the rules, with potential fines for violators. However, the administration’s decision is expected to draw legal challenges from the industry. Officials said the rules reinforce that insurers can’t use tools like prior authorization and standards determining out-of-network payment rates for mental health that are more restrictive than for other types of care.
What we are reading
There are few who would say that working on a PhD had no impact on their mental health. However, Bergvall et al wrote in Scandinavian Working Papers in Economics that by using Swedish administrative records they found that PhD studies had a clear increase in use of psychiatric medication. They found that following the start of a PhD program, the use of medication increases substantially, up to a 40 percent increase by the 5th year of the degree compared to pre-degree levels. After the fifth year, which corresponds to average program length, medication usage notably declines.
As we note the recent 61st anniversary of the March on Washington, it is an important time to reflect on the legacy of exclusionary practices. Dr. Leia Belt, AcademyHealth’s health data fellow, wrote about the legacy of sundown towns. She finds that measures of sundown towns, any organized jurisdictions that employed violence to enforce exclusionary and segregation policies against Black, Indigenous, and People of Color, is critical in HSR to identify root causes of health inequities, especially in the Midwest and West.
Does AI produce more research ideas than researchers? A preliminary study published in Arxiv recruited researchers in natural language processing to generate and write about ideas based on one of seven topics, as well as used an LLM to generate 4,000 ideas on the topics and rank them by originality. They then randomly assigned ideas to 79 reviewers to score the ideas on their novelty, excitement, feasibility, and effectiveness. On average, the reviewers scored the AI-ideas as more original and exciting. However, when the team reviewed all 4000 generated ideas, they found that only 200 were truly unique, showing that the AI became less original as it went.