The elusive ERA's health implications

The ideas and innovators shaping health care

Apr 28, 2023 View in browser   By Erin Schumaker, Carmen Paun, Ben Leonard and Ruth Reader WASHINGTON WATCH The stars haven't aligned to ratify the Equal Rights Amendment, but if they ever do it could affect health care. | Getty Images Senate Democrats learned on Thursday what it will take to give the Equal Rights Amendment a shot at ratification: Seven more votes. If Democrats ever get them — besides the additional senators, they'll also probably need control of the House and the presidency — the ERA's ratification would have health care implications. ERA backers believe that having the amendment in the Constitution would provide a new legal argument for people to bring gender-based discrimination cases in court. "It also bolsters the argument that judicial review of cases alleging sex discrimination should utilize a higher level of scrutiny," Sabrina Talukder, director of the Women’s Initiative at the Center for American Progress, a progressive think tank, told Erin. Right now, it's hard for people to bring claims of pregnancy discrimination or domestic violence in court. "They're easy to throw out," Talukder said. That's because protections vary from state to state in the absence of a national standard. What the ERA could mean for reproductive health: Even prior to Roe's fall last year, conservatives worried that the ERA could be used as a tool against abortion restrictions, since such restrictions might be considered discriminatory if they only applied to women. Test case: In New Mexico, which has ERA-like language in its constitution, the state Supreme Court found that denying Medicaid coverage for medically necessary abortions violated its constitution. Since medically necessary treatments for men were covered by Medicaid without restriction, medically necessary care for women must also be covered, the court found. "It's a great way to look at what might happen on a federal level,” Talukder said. Why it failed in the Senate: Fifty-one senators voted Thursday to end debate on a resolution that would remove Congress' long-past deadline to ratify the ERA and allow it to proceed now that 38 states have backed it. But the Senate standard for ending debate is 60 votes. What's next: Democrats are actually only seven short, since Majority Leader Chuck Schumer (D-N.Y.) changed his vote — a technical move that allows him to try to pass the resolution at a later date — and California Democrat Dianne Feinstein was absent due to illness. The House would also have to pass the resolution removing the ratification deadline and the president would have to sign it for the amendment to have a chance to advance, though Republicans have already signaled they’d protest in court any move to alter the original congressional deadline for ratification, which passed in 1982.   STEP INSIDE THE WEST WING: What's really happening in West Wing offices? Find out who's up, who's down, and who really has the president’s ear in our West Wing Playbook newsletter, the insider's guide to the Biden White House and Cabinet. For buzzy nuggets and details that you won't find anywhere else, subscribe today.     WELCOME TO FUTURE PULSE National Arboretum, Washington, D.C. | Shawn Zeller This is where we explore the ideas and innovators shaping health care. It’s not only human mothers who take their kids to school. A mother duck in Virginia recently did, too. Share any thoughts, news, tips and feedback with Ben Leonard at bleonard@politico.com, Ruth Reader at rreader@politico.com, Carmen Paun at cpaun@politico.com or Erin Schumaker at eschumaker@politico.com. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp. Today on our Pulse Check podcast, Carmen talks with Krista Mahr about the CDC’s 2021 Youth Risk Behavior survey, which offers a troubling window into high school students’ physical, emotional and mental health. Listen to today’s Pulse Check podcast DANGER ZONE Unbeknownst to them, many fentanyl users are also smoking a horse tranquilizer. | Getty Images How did a horse sedative become an ingredient in fatal fentanyl overdoses and an “emerging public health threat?” The White House Office of National Drug Control Policy tried to shed some light on that mystery in an article published this week in the New England Journal of Medicine. Three top ONDCP officials write that drug dealers discovered that mixing the sedative xylazine, informally known as tranq, with the opioid fentanyl lengthens the feeling of euphoria users crave. It’s more lethal too. Xylazine doesn’t respond to the opioid overdose reversal drug naloxone. “Additional supportive care may therefore be necessary in the treatment of xylazine overdose,” write the ONDCP’s director, Rahul Gupta, and colleagues David Holtgrave and Michael Ashburn. Such care may include administering supplemental oxygen, performing rescue breathing and treating hypotension, they write. Still unsolved: For those that don’t overdose, xylazine can cause flesh-rotting wounds that appear anywhere on the body, not only at the injection site. The ONDCP officials said they don’t know why.   LISTEN TO POLITICO'S ENERGY PODCAST: Check out our daily five-minute brief on the latest energy and environmental politics and policy news. Don't miss out on the must-know stories, candid insights, and analysis from POLITICO's energy team. Listen today.     TECH MAZE Schatz is almost ready to go with a new telehealth bill, lobbyists say. | AP Hawaii Democrat Brian Schatz’s pending Senate telehealth bill will encourage advocates of virtual care. So say lobbyists and a congressional aide familiar with the draft version of his CONNECT for Health Act and whom POLITICO granted anonymity to discuss what’s in it. What is in it? A permanent extension of pandemic-era rules that allowed Medicare to reimburse providers offering telehealth visits to their patients, the lobbyists and aide said. The legislation would also permanently repeal Medicare’s in-person requirement for virtual mental health care, another significant industry ask. “It's definitely taken a significant step toward what the industry has asked for," one lobbyist said. What isn’t in it? Schatz has not agreed to include a provision allowing Medicare to permanently reimburse providers for audio-only telehealth care going forward, the lobbyists and aide said. Lobbyists also lamented that the draft bill wouldn’t permanently allow high-deductible health plans to offer telehealth pre-deductible, or permit companies to offer telehealth permanently as an added benefit that’s separate from broader health insurance coverage. What’s next: The lobbyists expect Schatz will introduce the bill in a matter of weeks.   Follow us on Twitter Ben Leonard @_BenLeonard_ Ruth Reader @RuthReader Carmen Paun @carmenpaun Erin Schumaker @erinlschumaker   Follow us

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