Health Highlights: June 22, 2021

Medicaid Enrollment Reaches Record High During Pandemic

Nearly 10 million Americans signed up for Medicaid through January, and the 80 million people now enrolled in the program is the most in its history.

The surge in enrollment during the coronavirus pandemic means that a quarter of the U.S. population is now covered by the public health insurance program for the poor, The New York Times reported.

The new figures were in a government report released Monday.

"The purpose of Medicaid is for times like this, when there is an economic downturn," Peggah Khorrami, a researcher with Harvard's Chan T.H. School of Public Health who has studied the boost in Medicaid enrollment during the pandemic, told the Times.

"As people are losing jobs, that's where Medicaid comes in and we get people insured that way," according to Khorrami.

"In past economic downturns, there has been substantial growth in Medicaid enrollment but it was concentrated among children," Rachel Garfield, co-director of the Kaiser Family Foundation's Program on Medicaid and the Uninsured, told the Times.

"This time, it's interesting we're seeing much of the enrollment happening among adults."

Under the Affordable Care Act, Medicaid has been transformed from a targeted health care benefit meant to help certain groups of people -- such as expectant mothers and those with disabilities -- to a much wider program that provides largely free coverage to most people below a certain income threshold. The exception is in 12 states, mostly in the South, that have resisted expanding Medicaid.

Large Increase Seen in U.S. Nursing Home Deaths in 2020

There was a 32% increase in deaths among Medicare patients in U.S. nursing homes last year, according to a new report from the Department of Health and Human Services.

It said there were 169,291 more deaths among Medicare patients in nursing homes in 2020 than in 2019, and that about 4 in 10 had or likely had COVID-19 in 2020, the Associated Press reported.

Compared to 2019, death rates were higher every month last year, with two spikes, in April (81,484 deaths) and in December (74,299 deaths).

"We knew this was going to be bad, but I don't think even those of us who work in this area thought it was going to be this bad," Harvard health policy professor David Grabowski told the AP. The nationally recognized expert on long-term care reviewed the report for the news agency.

"This was not individuals who were going to die anyway," Grabowski noted. "We are talking about a really big number of excess deaths."

"This is happening long after it was clear that nursing homes were particularly vulnerable," Nancy Harrison, a deputy regional inspector general who worked on the report, told the AP. "We really have to look at that. Why did they remain so vulnerable?"

The new report includes data from early in 2020, making it the most comprehensive to date from the government. Nursing homes weren't required to alert Medicare about COVID-19 cases and deaths that occurred before May 8, 2020, the AP reported.

The report uncovered another fact: COVID-19 cases and deaths among Asian American patients tracked with the more severe impacts seen among Blacks and Latinos, the AP reported. In fact, Asian Medicare enrollees in nursing homes saw the highest increase in death rates, with 27% dying in 2020 compared to 17% the previous year. For whites, the death rate grew to 24% in 2020 from 18% in 2019, a significant increase but not as pronounced. Death rates for Hispanic and Black patients were 23% last year, up from 15% in 2019.

Medicare covers the vast majority of nursing home patients, and the report included long-term residents as well as those temporarily at a facility for rehab care, the AP said.

"Hopefully, COVID will go away," Harrison told the AP. "But once that happens, there will always be infectious diseases, and we all need to ask ourselves what we can do to protect vulnerable nursing home residents going forward."

James Michael Tyler, Who Played Gunther on 'Friends,' Has Advanced Prostate Cancer

Actor James Michael Tyler, who played Central Perk waiter Gunther on 'Friends,' has revealed that he was diagnosed with advanced prostate cancer in September 2018. Tyler is urging all men to get screened for the disease.

"I was diagnosed with advanced prostate cancer, which had spread to my bones," Tyler said on "TODAY" on Monday, NBC News reported. "I've been dealing with that diagnosis for almost the past three years. ... It's stage 4 (now). Late-stage cancer. So eventually, you know, it's gonna probably get me."

The 56-year-old actor said the stage 4 cancer was first detected during an annual checkup.

"I was 56 years old at the time, and they screen for PSA, which is prostate-specific antigen," Tyler said.

"That came back at an extraordinarily high number ... So I knew immediately when I went online and I saw the results of my blood test and blood work that there was obviously something quite wrong there. Nearly immediately, my doctor called me and said 'Hey, I need you to come in tomorrow because I suspect that you may have quite a serious problem with your prostate.'"

He said he was put on hormone therapy, which "worked amazingly for about a year," and enabled him to "go about life regularly" while taking a regimen of three drugs, NBC News reported.

"All I had to do was take a pill in the morning and the night, and boom, life was pretty much normal," said Tyler. "I had it then, but (was) able to function normally. I was feeling fine, honestly. I had no symptoms, I didn't feel any symptoms. And it was very easy to regulate."

However, the cancer eventually spread to his bone and spine, causing paralysis of the lower body. Tyler said he is currently undergoing chemotherapy.

Screening and early diagnosis can lead to far better prognoses for prostate cancer patients, he emphasized.

"There are other options available to men if they catch it before me," Tyler said. "Next time you go in for just a basic exam or your yearly checkup, please ask your doctor for a PSA test. It's easily detectable. ... If it spreads beyond the prostate to the bones, which is most prevalent in my form, it can be a lot more difficult to deal with."

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