Policy News Roundup: January 27, 2022

Key reads

Federal agencies release report showing insufficient parity compliance

The Departments of Labor, Health and Human Services, and the Treasury released a report on health plans’ and insurance carriers’ compliance with parity, as required by the Consolidated Appropriations Act of 2021. The report found violations are still common. For example, the report cited a plan that excluded methadone and naltrexone as treatment for substance use disorder, plans that exclude a therapy for autism, and plans that covered nutritional counseling for conditions such as diabetes, but not for anorexia, bulimia and binge eating. The departments found that plans were failing to adequately conduct analyses showing that any limitations they apply to mental health and addiction benefits are applied the same way to medical/surgical benefits. The findings clearly indicate that health plans are falling short of providing parity at a time when mental health and addiction benefits are needed more than ever.

Source: The pandemic is a mental health crisis, but some health plans and insurance companies are ‘falling short’ on coverage, report says (MarketWatch)

Progress made in tobacco control efforts is threatened by vaping and flavored products

The American Lung Association released its 20th annual State of Tobacco Control report, finding significant progress as well as challenges posed by e-cigarettes and other flavored tobacco products. While the adult smoking rate has declined from 21.6% in 2003 to 14% in 2019, close to 4.5 million youth used tobacco products in 2020, and more than 2 million middle and high school students reported using e-cigarettes in 2021. The report evaluates state and federal policies and actions taken to eliminate tobacco use and recommends proven tobacco control policies. The country has made substantial progress in advancing state tobacco control policies over the past 20 years, including more comprehensive smoke-free laws, increased tobacco taxes and increased access to cessation treatments through Medicaid. However, there continues to be an unequal burden in BIPOC communities, and e-cigarettes and flavored tobacco products threaten previous progress made.

Source: New Report: Flavored Tobacco Products and Youth Vaping Threaten 20 Years of Tobacco Control Progress (American Lung Association)

HHS has worked to strengthen behavioral health care in the past year

The Department of Health and Human Services released a snapshot of its key initiatives from the past year. These include efforts to strengthen behavioral health care, such as releasing the new Overdose Prevention Strategy, establishing the Behavioral Health Coordinating Council, investing in 988 crisis response, awarding Certified Community Behavioral Health Clinic grants, forming the Substance Abuse and Mental Health Services Administration Recovery Office, and investing in the Community Mental Health Services and Substance Abuse Prevention and Treatment Block Grants. Other efforts include releasing new buprenorphine practice guidelines, approving California’s CalAIM program that includes contingency management, launching education campaigns, supporting research, investing in mental health and addiction services, issuing guidance and grants to state Medicaid programs for mobile crisis response and allowing federal funds to be used to purchase fentanyl test strips. It also highlights the administration’s commitment to the process of banning menthol cigarettes and flavored cigars, increases in health coverage and support for children and families.

Source: Snapshot: How HHS is Building a Healthier America (Department of Health and Human Services)

Supportive relationships and healthy habits were associated with better mental health among youth during COVID

A National Institute on Drug Abuse study found that supportive relationships with family and friends and healthy behaviors, such as engaging in physical activity and better sleep, appeared to shield against the harmful effects of the pandemic on adolescents’ mental health. It also found that girls were more likely than boys to experience psychological distress during the pandemic. Psychosocial factors, including poorer quality and functioning of family relationships, more screen time and witnessing discrimination in relation to the pandemic also predicted youth distress. The study was based on a survey of over 3,000 Adolescent Brain Cognitive Development (ABCD) Study participants aged 11-14 before and during the pandemic.

Source: Social connectedness, sleep, and physical activity associated with better mental health among youth during the COVID-19 pandemic (National Institute on Drug Abuse)

Despite state laws, marijuana companies are targeting youth on social media

A study found that despite state (Washington, Oregon, Colorado, Alaska) laws restricting marijuana advertising, some marijuana companies are targeting individuals under 21 on social media, using methods proven by tobacco and alcohol companies to appeal to youth. About 35% of posts looked at in the study featured discounts or promotions, 7% used pop culture references, 6% featured store-branded products and 6% used cartoon characters. About 12% also promoted the idea that you should use marijuana until you are very impaired. The posts also largely failed to include required warnings, including those on impaired driving and limiting marijuana use to those over 21. Partnership’s Vice President of Prevention Research and Analysis Linda Richter noted that this is happening in states with robust youth protection provisions in their marijuana laws, and that the state of affairs is likely even worse and more damaging to teens than reflected in the study.

Source: Many Marijuana Vendors Aim Advertising at Kids: Study (HealthDay)

Marijuana sales generate record tax revenue for states

Legal recreational marijuana sales boomed across the U.S. in 2021, reaching new levels in nearly a dozen states. Nationwide, those sales generated more than $3 billion in tax revenue for 11 states, higher than the $2.7 billion collected from the 10 states that allowed recreational sales in 2020. Seven out of the eleven states had their biggest year of marijuana tax revenue on record. Of the five states with the biggest revenues, recreational marijuana has been legal for at least eight years in two of them (Washington, Colorado).

Source: Recreational marijuana sales showered states with cash in 2021 (NBC)

West Virginia advancing bill that would increase penalties for exposing government employees to fentanyl

West Virginia lawmakers are poised to create two new criminal penalties for exposing police officers and first responders to contact with fentanyl, even though there is no real danger of airborne/skin exposure. West Virginia’s House passed, by a vote of 94-2, HB 2184. It would create a new misdemeanor crime for anyone who possesses fentanyl and exposes a government official, health care worker, police or correctional officer, utility worker or emergency responder, subject to a penalty of a maximum fine of $500 and up to one year in jail. If the government employees are harmed by the exposure, however, the crime becomes a felony, with a fine of up to $2,000 and a two- to five-year prison sentence. The bill now goes to the Senate.

Source: West Virginia Mulls New Criminal Penalties for Imaginary Threat of Police Fentanyl Exposure (Reason)

Coordinated federal strategy needed to address the overdose crisis

In an op-ed, Patrick Kennedy and Ryan Hampton explain steps the Biden-Harris administration needs to take to address the overdose crisis and create a strategic coordinated response across the federal government that goes further than small, incremental changes. A new strategy should focus on four areas. The first is emergency actions and declarations (such as broadening the emergency declaration to apply to all mental health and addiction rather than just opioids, declaring an emergency under the Stafford Act rather than just a Public Health Emergency and facilitating naloxone in all public places). The second is parity (including increasing enforcement in employer-sponsored, Medicaid and marketplace plans). The third is increasing access to medications for addiction treatment (such as eliminating the buprenorphine waiver). The fourth is strong leadership at the federal level (including a primetime address and regular discussion along with COVID-19 updates).

Source: A year into Biden’s presidency, we’re only burying more overdose victims (The Hill)

Overdose crisis response remains inadequate

Journalist and author Beth Macy outlines the inadequate response to the overdose crisis, due to stigma and bureaucratic ineptitude. Unlike the vast response to the COVID-19 pandemic, there have only been minor tweaks made in response to the overdose crisis. Some blue-leaning states and cities now offer evidence-based practices such as supplying clean needles and fentanyl test strips, but these are largely shunned. The pandemic-prompted loosening of federal regulations for the telehealth prescribing of buprenorphine has been a bright spot, but the change remains temporary, and the treatment gap has barely budged. Too many health care providers remain unable to identify and treat addiction. We must stop arresting and abandoning people who use substances and start meeting them where they are with treatment and compassion.

Source: Opinion: More than 1 million have died in the overdose crisis, but still the response is scandalously inadequate (Washington Post)

Renewed calls for naloxone in schools