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In this latest health policy update, I focus on news surrounding the impact of the midterm elections on healthcare, current threats to LGBTQ health, and the ongoing gun control debate.

The Affordable Care Act
Following the midterm elections, in which the Democratic party regained control of the House of Representatives, there have been many conversations on what issues the Democrats in the House will be focusing on. Many experts have contended that very little healthcare reform will result from the new power balance between the Democrats and the Republicans, due to inevitable gridlock. John Kelliher, the Managing Director of the Berkeley Research Group, stated that, “it’s highly unlikely that in the next Congress there’ll be any meaningful healthcare legislation”. It’s important to note, however, that because of the control the Democrats now have, they have the ability to block the changes that the Republicans have proposed to make to the ACA, effectively protecting the legislation.

LGBTQ Health
The Department of Health and Human Services is considering a change to the Title IX definition of gender, which would effectively abolish civil rights protections for transgender people. This new definition of gender would be determined by the individual’s genitalia that they were born with. This is yet another example of how the Trump Administration is attempting to limit the civil rights of transgender people, including the removal of certain protections for transgender students and restricting transgender people from serving in the military. This proposed change to the Title IX definition of gender would significantly hurt programs meant to protect the physical and mental health of transgender people, which is a demographic at an alarmingly high risk for suicide. In 2017, the American Foundation for Suicide Prevention found that 41% of transgender people have attempted suicide in the past, in comparison to 4.6% of the overall U.S. population.

Medicaid Expansion
Following the midterm elections, 37 states including the District of Columbia voted for Medicaid expansion. These states can implement the expansion at any time and remain eligible for enhanced federal financing within the next two years. Studies have associated the expansion of Medicaid with better “coverage, access to care, service utilization, and state budgets and economies”. The states that voted to expand Medicaid include some historically conservative states, such as Idaho, Montana, Nebraska, and Utah.

Gun Control
Tensions have been rising recently between healthcare providers and the National Rifle Association (NRA), as more physicians have been speaking out about the horrors they have witnessed in the operating room as a result of gun violence. On November 8th, the NRA posted tweet stating, “Someone should tell self-important anti-gun doctors to stay in their lane. Half of the articles in Annals of Internal Medicine are pushing for gun control. Most upsetting, however, the medical community seems to have consulted NO ONE but themselves.” In response to being told to stay in their lane, many physicians have been posting gruesome photos of what operating rooms look like after treating a victim of gun violence. As tensions rise in this ever-present debate on gun control, more physicians are starting to step outside of the hospital and into the political arena.