Federal Health Care News



Infant deaths from critical congenital heart disease (CCHD) declined more than 33 percent in eight states that mandated screening for CCHD using a test called pulse oximetry.

In addition, deaths from other or unspecified cardiac causes decreased 21 percent.

Pulse oximetry is a simple bedside test to determine the amount of oxygen in a baby’s blood and the baby’s pulse rate. Low levels of oxygen in the blood can be a sign of a CCHD.

CCHD screening nationwide could save at least 120 babies each year, according to a new study published in the Journal of the American Medical Association. This study is the first look at the impact of state policies to either require or recommend screening of infants for CCHD at birth.

The study, Association of U.S. State Implementation of Newborn Screening Policies for Critical Congenital Heart Disease With Infant Cardiac Deaths, shows that states that required their hospitals to screen newborns with pulse oximetry saw the most significant decrease in infant deaths compared with states without screening policies. Voluntary policies or mandated policies not yet implemented were not associated with reductions in infant death rates. The encouraging news is that 47 states and D.C. now have mandatory screening policies in place and one additional state, California,  requires screening be offered. These results serve as a reminder to hospitals across the country to remain vigilant in their screening for CCHD.

About 1 in 4 babies born with a congenital heart defect has CCHD and will need surgery or other procedures in the first year of life. In the U.S., about 7,200 babies born each year have one of seven CCHDs. Without screening by a pulse oximetry reading, some babies born with a congenital heart defect can appear healthy at first and be sent home with their families before their heart defect is detected.

CDC works to identify causes of congenital heart defects, find opportunities to prevent them, and improve the health of people living with these conditions.

For more information on congenital heart defects, visit https://www.cdc.gov/ncbddd/heartdefects/index.html and https://www.cdc.gov/features/congenitalheartdefects/.



In 2016, overall national health spending increased 4.3 percent following 5.8 percent growth in 2015, according to a study by the Office of the Actuary at the Centers for Medicare & Medicaid Services (CMS).

Following Affordable Care Act (ACA) coverage expansion and significant retail prescription drug spending growth in 2014 and 2015, health care spending growth decelerated in 2016. The report concludes that the 2016 expenditure slowdown was broadly based as growth for all major payers (private health insurance, Medicare, and Medicaid) and goods and service categories (hospitals, physician and clinical services, and retail prescription drugs) slowed in 2016. 

During 2014 and 2015, the health-spending share of the economy increased 0.5 percentage point from 17.2 percent in 2013 to 17.7 percent in 2015. The increases in the health-spending share of the economy in 2014 and 2015 were largely due to coverage expansion that contributed to 8.7 million individuals gaining private health insurance coverage and 10.2 million gaining Medicaid coverage over the period and to significant growth in retail prescription drug spending. Health care spending grew 1.5 percentage points faster than the overall economy in 2016, resulting in a 0.2 percentage-point increase in the health-spending share of the economy – from 17.7 percent in 2015 to 17.9 percent in 2016. 

Additional highlights from the report: 

Private health insurance spending increased 5.1 percent to $1.1 trillion in 2016, which was slower than the 6.9 percent growth in 2015. The deceleration was largely driven by slower enrollment growth in 2016 after two years of faster enrollment growth due to ACA coverage expansion.

Medicare spending grew 3.6 percent to $672.1 billion in 2016, which was slower growth than the previous two years when spending grew 4.8 percent in 2015 and 4.9 percent in 2014. The slower growth in 2016 was due to slower growth in spending for both Medicare fee-for-service (2.2 percent in 2015 compared to 1.8 percent in 2016) and Medicare Advantage (11.1 percent in 2015 compared to 7.4 percent in 2016). 

Medicaid spending growth slowed in 2016, increasing 3.9 percent to $565.5 billion. State and local Medicaid expenditures grew 3.2 percent in 2016, while federal Medicaid expenditures increased 4.4 percent in 2016. The slower overall growth in Medicaid spending was much lower than in the previous two years, when Medicaid spending grew 11.5 percent in 2014 and 9.5 percent in 2015. The higher growth in 2014 and 2015 was due in part to the initial impacts of the ACA’s expansion of Medicaid enrollment during that period.

Out-of-pocket spending includes direct consumer payments such as copayments, deductibles, and spending not covered by insurance.  Out-of-pocket spending grew 3.9 percent to $352.5 billion in 2016, faster than the 2.8 percent growth in 2015.  Additionally, 2016 was the fastest rate of growth since 2007 and was higher than the average annual growth of 2.0 percent during 2008-15. The faster growth in 2016 was due in part to a continued shift towards enrollment in high-deductible health plans, which was somewhat offset by a continued decrease in the number of uninsured in 2016. 

Retail prescription drug spending slowed in 2016, increasing 1.3 percent to $328.6 billion. The slower growth in 2016 follows two years of significant growth in 2014 and 2015, 12.4 percent and 8.9 percent, respectively. This significant growth in 2014 and 2015 was largely attributable to increased spending on new medicines and price growth for existing brand-name drugs, particularly for drugs used to treat hepatitis C.  Growth slowed in 2016 primarily due to fewer new drug approvals, slower growth in brand-name drug spending as spending for hepatitis C drugs declined, and a decline in spending for generic drugs as price growth slowed.

In 2016, the federal government and households accounted for the largest shares of spending (28 percent each) followed by private businesses (20 percent), state and local governments (17 percent), and other private revenue (7 percent). After two consecutive years of rapid growth (10.9 percent in 2014 and 8.9 percent in 2015), federal government spending for health care slowed, increasing 3.9 percent in 2016. The primary reason for the deceleration in federal spending growth in 2016 was federal Medicaid spending, which grew more slowly in 2016 as a result of less Medicaid enrollment growth. 

The CMS Office of the Actuary’s report will appear on the CMS website at: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html

An article about the study is also being published by Health Affairs as a Web First (http://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2017.1299) and will also appear in the journal’s January 2018 issue. 


A new CDC Vital Signs report finds that HIV is being diagnosed sooner after infection than was previously reported.

According to the report, the estimated median time from HIV infection to diagnosis was three years in 2015. CDC previously estimated that, in 2011, the median time from HIV infection to diagnosis was three years and seven months.

The seven-month improvement is a considerable decrease over a four-year period and reinforces other recent signs that the nation’s approach to HIV prevention is paying off. Overall, 85 percent of the estimated 1.1 million people living with HIV in 2014 knew their HIV status. CDC estimates about 40 percent of new HIV infections originate from people who don’t know they have HIV.

Getting an HIV test is the first step to learning how to reduce future risk for people who do not have HIV and to starting treatment and getting the virus under control for people living with HIV. Taking HIV medicine as prescribed allows people with the virus to live a long, healthy life and protect their partners from acquiring HIV.

CDC recommends testing all people ages 13-64 for HIV at least once in their lifetime, and people at higher risk for HIV at least annually. Healthcare providers may find it beneficial to test some sexually active gay and bisexual men more frequently (e.g., every three to six months).

The Vital Signs analysis found that the percentage of people at increased risk for HIV who reported getting an HIV test the previous year has increased. Despite that progress, too few are tested. A multi-city study found that people who reported that they did not get an HIV test in the last year included 29 percent of gay and bisexual men, 42 percent of people who inject drugs, and 59 percent of heterosexuals at increased risk for HIV. The same study also found that seven in 10 people at high risk who were not tested for HIV in the past year saw a healthcare provider during that time — signaling a missed opportunity to get high-risk individuals tested as frequently as needed.

The Vital Signs analysis suggests that, without increased testing, many people living with undiagnosed HIV may not know they have HIV for many years. A quarter of people diagnosed with HIV in 2015 lived with HIV for seven or more years without knowing it.

In 2015, estimated timing from HIV infection to diagnosis varied by risk group and by race/ethnicity.

Estimated timing from HIV infection to diagnosis ranged from a median of five years for heterosexual males to two-and-a-half years for heterosexual females and females who inject drugs. The median was three years for gay and bisexual males.

Estimated timing from HIV infection to diagnosis ranged from a median of four years for Asian Americans to two years for white Americans and about three years for African Americans and Latinos.

CDC funding supports more than 3 million tests across the country each year that identify on average more than 12,000 people with HIV who were not previously diagnosed — accounting for one-third of all HIV diagnoses a year in the United States.


According to a new study published in the New England Journal of Medicine finds 57 percent of today’s children will be obese by the time they are 35. 

The study found only half of the kids will be obese when they are 20 years old, while the other half will become obese during their 20s or 30s.

The study results suggest that health experts have missed the big picture when it comes to childhood obesity.

 “Our findings highlight the importance of promoting a healthy weight throughout childhood and adulthood,” the researchers wrote. “A narrow focus solely on preventing childhood obesity will not avert potential future health damage that may be induced by the ongoing obesity epidemic.”

The team at the Harvard T.H. Chan School of Public Health wanted to predict for children now at a certain weight and certain age, the probability that they will have obesity at the age of 35.

The study found that at any age, kids who are obese are more likely than their non-obese peers to be obese at age 35. They also found that older obese kids are more likely to be obese on their 35th birthday.

For instance, a 2-year-old who is obese has a 75 percent chance of being obese at age 35, the researchers calculated. But a 19-year-old who is obese has an 88 percent chance of being obese at age 35.

Compared to a 2-year old who is not obese, an obese 2-year-old is 30 percent more likely to be obese on her 35th birthday. By age 19, the risk of being obese at 35 is nearly twice as high for an obese teen as for her non-obese counterpart.

Not surprisingly, the heaviest children face the greatest risk of being obese adults. A severely obese 2-year-old faces a 79 percent chance of being obese at age 35, while a severely obese 19-year-old has a 94 percent chance of being obese at 35.

Just as in the real population, the risk of obesity in the virtual population varies according to race and ethnicity. By age 2, African American and Latino children are more than twice as likely as white children to be obese. Those disparities follow them through adulthood.

The only kids who face better-than-even odds of not being obese by age 35 are those who currently have a healthy weight, according to the study.



The U.S. Department of Health and Human Services appointed 14 members to the new Tick-Borne Disease Working Group.

The 21st Century Cures Act established the Tick-Borne Disease Working Group improve federal coordination of efforts related to tick-borne diseases. Members will review all HHS efforts related to tick-borne diseases to provide expertise and help ensure interagency coordination and minimize overlap, examine research priorities and identify unmet needs. The Working Group expects to issue its first report to the HHS Secretary and Congress by December 2018.

Lyme disease accounts for the majority of tick-borne disease in the United States. The Centers for Disease Control and Prevention (CDC) estimates that more than 300,000 people are diagnosed with Lyme disease each year—but only about 30,000 of those cases are reported to local and state health departments and the CDC.  While most cases of Lyme disease are treated successfully with short courses of antibiotics, some individuals who contract this illness may develop debilitating health problems.

The Working Group’s members represent a diverse set of stakeholders, including physicians and other medical providers with experience in diagnosing and treating tick-borne diseases; scientists or researchers with expertise in this field; patients and family members; patient advocates; and federal experts who work in related areas.

Members of the public may attend the meeting in person or via webcast.
The Working Group members are:



The Tick-Borne Working Group will hold its inaugural public meetings on Dec. 11-12, 2017, in the Great Hall of the Hubert H. Humphrey Building, 200 Independence Avenue, S.W., Washington, D.C. For more information, visit the Tick-Borne Disease Working Group webpage.


The Centers for Medicare & Medicaid Services (CMS) announced the 2018 premiums, deductibles and coinsurance amounts for the Medicare Part A and Part B programs.

Medicare Part B covers physician services, outpatient hospital services, certain home health services, durable medical equipment, and other items.

The standard monthly premium for Medicare Part B enrollees will be $134 for 2018, the same amount as in 2017. Some beneficiaries who were held harmless against Part B premium increases in prior years will have a Part B premium increase in 2018, but the premium increase will be offset by the increase in their Social Security benefits next year.

CMS estimates that the Medicare Advantage average monthly premium will decrease by $1.91 (about 6 percent) in 2018, from an average of $31.91 in 2017 to $30. More than three-fourths (77 percent) of Medicare Advantage enrollees remaining in their current plan will have the same or lower premium for 2018. The average basic premium for a Medicare prescription drug plan in 2018 is projected to decline to an estimated $33.50 per month. This represents a decrease of approximately $1.20 below the average basic premium of $34.70 in 2017. The Medicare prescription drug plan average basic premium is projected to decline for the first time since 2012.

CMS also announced that the annual deductible for all Medicare Part B beneficiaries will be $183 in 2018, the same annual deductible in 2017. Premiums and deductibles for Medicare Advantage and Medicare Prescription Drug plans are already finalized and are unaffected by this announcement.

Medicare Part A covers inpatient hospital, skilled nursing facility, and some home health care services. About 99 percent of Medicare beneficiaries do not have a Part A premium since they have at least 40 quarters of Medicare-covered employment.

The Medicare Part A annual inpatient hospital deductible that beneficiaries pay when admitted to the hospital will be $1,340 per benefit period in 2018, an increase of $24 from $1,316 in 2017.

For a fact sheet on the 2018 Medicare Parts A & B premiums and deductibles, please visit: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2017-Fact-Sheet-items/2017-11-17.html


The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule in the Federal Register that will result in lower premiums and increased plan choices for Medicare beneficiaries.

During this year’s Medicare Advantage Open Enrollment, which occurs Oct. 15 – Dec. 7, seniors enrolling in Medicare Advantage have seen average monthly premiums drop by 6 percent, and CMS is proposing changes to continue to drive affordable options for Medicare beneficiaries that meet their unique health needs. 

Medicare Advantage remains a popular choice among beneficiaries and has high beneficiary satisfaction. Enrollment in Medicare Advantage is at an all-time high as approximately one-third of Medicare beneficiaries are in a Medicare Advantage plan. The number of Medicare Advantage plans available to individuals to choose from across the country is increasing from about 2,700 to more than 3,100 – and more than 85 percent of Medicare beneficiaries will have access to 10 or more Medicare Advantage plan choices.

CMS is providing new flexibility for customized benefit designs that address the specific health needs of certain beneficiaries. This new flexibility will allow additional plan variety and options, reduced cost sharing for customized benefits and different cost-sharing for beneficiaries that meet specific medical criteria. CMS is also proposing to provide greater flexibility to encourage lower maximum out of pocket levels of beneficiary cost sharing.

This year, CMS received numerous ideas on how to improve Medicare Advantage from beneficiaries, Medicare Advantage plans, advocacy groups, and other stakeholders. The policies in the proposed rule are responsive to this feedback.

The proposed rule also furthers CMS’ Patients Over Paperwork initiative, which is an effort that aims to remove regulatory obstacles in order to empower patients and providers to make healthcare decisions; to develop innovative approaches to improving quality, accessibility, and affordability; and to improve Medicare beneficiaries’ customer experience. Specifically, the proposed rule would reduce regulatory burdens by:

For a fact sheet on the proposed rule, please visit: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2017-Fact-Sheet-items/2017-11-16.html.


Just 1 in 10 adults meet the federal fruit or vegetable recommendations, according to a new study published by the Center for Disease Control and Prevention (CDC).

Depending on their age and gender, federal guidelines recommend that adults eat at least 1½ to 2 cups per day of fruit and 2 to 3 cups per day of vegetables as part of a healthy eating pattern. Yet in 2015, just 9 percent of adults met the intake recommendations for vegetables, ranging from 6 percent in West Virginia to 12 percent in Alaska. Only 12 percent of adults met the recommendations for fruit, ranging from 7 percent in West Virginia to 16 percent in Washington, D.C. Results showed that consumption was lower among men, young adults, and adults living in poverty.

Seven of the top 10 leading causes of death in the United States are from chronic diseases. Eating a diet rich in fruits and vegetables daily can help reduce the risk of many leading causes of illness and death, including heart disease, type 2 diabetes, some cancers, and obesity.

The findings indicate a need to identify and address barriers to fruit and vegetable consumption. Previous studies have found that high cost, limited availability and access, and perceived lack of cooking/preparation time can be barriers to fruit and vegetable consumption.

The CDC Guide to Strategies to Increase the Consumption of Fruits and Vegetables suggests 10 strategies to increase access to fruits and vegetables, including these:

CDC researchers analyzed data from the 2015 Behavioral Risk Factor Surveillance System to estimate the percentage of each state’s population meeting the intake recommendations by age, sex, race/ethnicity, and poverty-income ratio for the 50 states and District of Columbia (DC).

To learn more about how CDC works to make healthy eating and active living accessible for all Americans, visit the Division of Nutrition, Physical Activity and Obesity.


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