There's hope for combating maternal mortality

The ideas and innovators shaping health care

Dec 01, 2022 View in browser   By Grace Scullion , Ruth Reader and Ben Leonard PROBLEM SOLVERS 2.7 per 10,000 The maternal mortality rate for Black mothers in the top 20 percent of the income distribution and white mothers in the bottom 20 percent Health economists at Stanford University are the latest to report dispiriting data about who dies most often in the United States after giving birth. The risks are much greater for Black people of all income levels and low-income people. This summer, the CDC said that most pregnancy-related deaths are preventable. Policymakers at the federal, state and local levels are grappling with how they can prevent them: Legislators on both sides of the aisle are trying to pass the Pregnant Workers Fairness Act, POLITICO's Eleanor Mueller reports. The act, which the House passed 315-101 in May behind a united Democratic caucus and about half of Republicans, would require employers to accommodate pregnant workers with more frequent bathroom breaks, the ability to carry a water bottle and the option to sit during a shift. Baltimore has seen success in sending health care workers to new mothers' homes to help them with safe sleeping habits and parenting skills. Baltimore's program reduced Black infant mortality by 40 percent from 2008 to 2019, but some of those gains eroded when in-person outreach paused during the pandemic.  This summer, multiple states took advantage of a provision in the 2021 Covid relief and economic stimulus law to extend Medicaid coverage of postpartum care for low and lower-middle income people. Now, 26 states and the District of Columbia cover postpartum care up to a year post-birth. Seven more states are planning to follow suit.  One-quarter of pregnancy-related deaths occur on the day of delivery or within a week after, according to the Centers for Disease Control and Prevention. Most (53 percent) occur in the year following pregnancy. And, according to the CDC, the leading cause of maternal death isn't physical: 23 percent of pregnancy-related deaths are due to mental health conditions, which include death by suicide and overdose. Depression affects 10 to 20 percent of pregnant people.   POLITICO APP USERS: UPGRADE YOUR APP BY DECEMBER 19! We recently upgraded the POLITICO app with a fresh look and improved features for easier access to POLITICO's scoops and groundbreaking reporting. Starting December 19, users will no longer have access to the previous version of the app. Update your app today to stay on top of essential political news, insights, and analysis from the best journalists in the business. UPDATE iOS APP – UPDATE ANDROID APP .     WELCOME TO FUTURE PULSE The Seine with the Louvre beyond, Paris | Ben Leonard This is where we explore the ideas and innovators shaping health care.  Elon Musk says his brain technology firm Neuralink will implant a chip in humans next year. Neuralink's brain-computer interface aims to give people with Lou Gehrig's disease and other mobility issues a way to connect to mobile phones and the internet. But Musk frequently misses these self-imposed deadlines and the FDA has not given the company the go ahead to move forward. What do you think? Are brain chips coming to a human body near you? Share news, tips and feedback with Ben Leonard at bleonard@politico.com, Ruth Reader at rreader@politico.com , Carmen Paun at cpaun@politico.com or Grace Scullion at gscullion@politico.com.  Send tips securely through SecureDrop, Signal, Telegram or WhatsApp. Today on our Pulse Check podcast, Megan Messerly talks with Megan Wilson about North Carolina's and Kansas' latest attempts to expand Medicaid — and how increased federal incentives and Medicaid expansion advocates have gradually worn down GOP opposition. Listen to today's Pulse Check podcast WASHINGTON WATCH Pennsylvania Sen. Bob Casey is well-positioned to advance legislation on children's mental health. | Getty Images A bipartisan Senate duo is ramping up for a legislative push on children's mental health in the new year. The top Democrat and Republican on the Senate Health, Education, Labor and Pensions Subcommittee on Children and Families used a hearing Wednesday on the mental health of students transitioning from high school to college to promote legislation they hope to advance in the new Congress. Subcommittee Chair Bob Casey (D-Pa.) and ranking member Bill Cassidy (R-La.) said they'd push for enactment of: the Health Care Capacity for Pediatric Mental Health Act to create grant programs to expand mental health integration into pediatric care the Respond, Innovate, Succeed and Empower Act to streamline administrative processes affecting students with disabilities to ensure their smooth transitions from high school to college the Investing in Kids' Mental Health Now Act to increase Medicaid reimbursement for children's mental health services and ensure timely access to care the Mental Health Reform Reauthorization Act to provide grants for mental health programs and promote the integration of mental health services into primary care, education, and the criminal justice system  "Accessing timely mental health care that is covered by insurance shouldn't feel like winning the lottery; it should be the same as getting care for any other health condition," Casey said at the hearing. Cassidy is slated to move up to the ranking member slot of the full HELP Committee in January.   TUNE IN TO THE PULSE CHECK PODCAST: Keep your finger on the pulse of the biggest stories in health care by listening to our daily Pulse Check podcast. POLITICO's must-listen briefing decodes healthcare policy and politics, and delivers reality checks from health professionals on the front lines. SUBSCRIBE NOW AND START LISTENING .     ART OF MEDICINE Proponents say so-called magic mushrooms could help people suffering from depression and other mental health ailments. | AP Psychedelic medicine is on the rise, according to a report from psychedelic investment firm Psych Capital. Pharmaceutical companies are testing drugs that produce changes in perception, mood and thought processes as treatments for post-traumatic stress disorder, anxiety, treatment-resistant depression, major depressive disorder, schizophrenia, addiction and palliative care. While several psychedelic medicines remain in legal limbo, ketamine, a surgical anesthetic, is booming. Psych Capital expects ketamine-assisted therapy to generate $230 million in revenue for 2022. By 2028, it estimates the market for ketamine therapy will surpass $1 billion. Already, 150 clinical trials have examined ketamine's use in mental health. In the report, Psych Capital says: the U.S. could save an estimated $270 billion in mental health costs through psychedelic medicine. FDA approval of MDMA, a mildly psychedelic derivative of amphetamine, for posttraumatic stress disorder is anticipated in 2023. (The chemical is also found in the street drug ecstasy.) psilocybin, a psychedelic found in so-called magic mushrooms, is legal, decriminalized or effectively legalized by lack of enforcement in 27 countries. in the U.S., mushrooms are legal in Colorado and Oregon, and several cities have passed laws decriminalizing them. Another 15 states are looking into legalizing the substance.  Europe is likely to approve mushrooms for treatment-resistant depression in 2025. Patent disputes over new psychedelics are coming. While traditional psychedelic drugs are off patent, pharmaceutical companies are developing new psychedelics with similar properties so they can patent them. In some cases, these new psychedelics have improvements over their ancestors. But they also create an opportunity for the companies to charge more for them and protect their inventions from competition.   Follow us on Twitter Ben Leonard @_BenLeonard_ Ruth Reader @RuthReader Carmen Paun @carmenpaun   Follow us

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