Earlier this week, Senator Bill Cassidy (R-LA) introduced S.191, the Patient Freedom Act (PFA) of 2017, as a potential replacement for the Affordable Care Act (ACA). The PFA gives states three options: (1) Keep ACA; (2) implement market-based health care and insurance, with funds in individual Roth health savings plans (HSAs) and autoenrollment in a basic high-deductible plan for all state residents except those who opt out from having insurance altogether; or (3) opt for no federal plan or funding.
I describe the plan in more detail in “ACA Replacement Plans: Your Money Or Your Life, Part 1,” and will post more information over the next few days. But while working on part 2 of that article, I came across a fairly standard passage in the bill that has horrifying potential implications under the Trump administration, especially if the new secretary of Health and Human Services is even remotely (or politically) unclear on the science behind childhood immunizations.
It also highlights a serious potential issue with putting our nation’s healthcare in the hands of states—vaccine-preventable illnesses do not respect state borders, and herd immunity is essential to the effectiveness of immunization. This means that a high percentage of the population needs to be vaccinated to prevent spread of the disease, especially to infants, pregnant women, and others who can’t be vaccinated.
The passage in question in the PFA 2017 describes what the default health insurance will cover, including:
childhood immunizations without cost sharing requirements to the extent such immunizations have in effect a recommendation from the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention.
Under any other administration, this passage wouldn’t raise alarm bells. Just the opposite, in fact, because health care should be science based, and following CDC recommendations for immunizations accomplishes this.
But what happens if the secretary of Health and Human Services, under which the CDC falls, is anti-vaccine or even noncommittal on the importance of immunizations for herd immunity?
At Price’s confirmation hearing before the Senate Finance Committee, he did confirm that science shows no link between vaccines and autism, but when Senator Chuck Grassley (R-IA) asked whether Price would “recommend that families follow the recommended vaccine schedule that has been established by experts and is constantly reviewed,” Price did not say that he would. He instead offered a waffly non-answer: “I think that the science and healthcare has identified a very important aspect of public health, and that is the role of vaccinations.”
Further, Price is a member of the anti-government, antiscience political organization Association of American Physicians and Surgeons (AAPS), a name that is “coincidentally” similar to that of legitimate medical organizations, like the American College of Physicians and the American College of Surgeons. As David Gorski notes in an article on Price’s connection to AAPS, the organization promotes and publishes in its vanity journal (Journal of American Physicians and Surgeons) medical conspiracy theories, anti-vaccine pseudoscience, and “rejects even the concept of a scientific consensus about anything.”
Price’s comment in the hearing on vaccines and autism shows that he does not subscribe (or is pretending not to subscribe) to every ridiculous AAPS position, but add this to an administration that is openly hostile to science and facts, to the point of insisting all EPA data and research go through Trump’s staff before (or rather than) being released to the public, an administration creating lists of federal employees working on issues that don’t align with the administration’s politics, led by an openly anti-vaccine president, and I honestly can’t say with any confidence that the CDC vaccine advisory committee will remain a reliable source on immunizations–or that it will remain at all.
Featured image by Bill Smith