The Top News Story of 2019, According to Our Readers

This year, The American Journal of Managed Care^® asked readers to pick the most important healthcare news story for 2019. Here are the results.

5. A judge strikes down Medicaid work rules in Kentucky and Arkansas.

In March 2019, a US District Court judge in Washington, DC, agreed with plaintiffs who argued that HHS did not act reasonably in allowing Kentucky and Arkansas to create work requirements for beneficiaries to receive healthcare. In separate opinions, the judge said that approval of both programs failed to consider the core purpose of Medicaid—to provide healthcare for the needy. About 18,000 people lost healthcare coverage alone in Arkansas before the program was halted.

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4. The uninsured rate hits a 4-year high.

In January 2019, a Gallup poll reported that in the fourth quarter of 2018, the US uninsured rate landed at 13.7%, the highest level since the first quarter of 2014. According to Gallup, while still below the uninsured rate of 18% prior to the implementation of the Affordable Care Act (ACA)’s individual mandate, the rate is still well above the 10.9% mark in 2016.

3. Doctors link a mysterious lung illness to vaping.

Over the summer of 2019, teenagers and young adults began presenting to hospitals in multiple states with unusual and severe lung illnesses, and by August, the CDC said it was investigating a “cluster” of such cases. By year’s end, the CDC had given the condition a name, EVALI, for e-cigarette, or vaping, product use—associated lung injury. The CDC said that vitamin E acetate used in the products may be a factor, but also said that there may be other “chemicals of concern.” As of December 10, 2019, 52 people have died and 2409 cases requiring hospitalization have been reported to the CDC.

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2. An appeals court brings uncertainty to the future of the ACA.

The Fifth Circuit Court of Appeals, in December 2019, struck down the individual mandate—the heart of the ACA that requires everyone to have health coverage and lays the groundwork for a risk pool that is more balanced between the sick and the healthy, the young and the old. The appeals panel sent the case back to the federal district court in Texas to determine whether other parts of the law, such as provisions to require plans to cover preexisting conditions, are constitutional and can exist without the mandate.

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1. Dr. Scott Gottlieb steps down as FDA commissioner.

Although the initial nomination of Scott Gottlieb, MD, to head the agency was met with some criticism, his 2-year tenure at the FDA wound up receiving bipartisan praise, particularly efforts to restructure the drug review process, curb teen vaping, and battle the opioid crisis. Gottlieb returned to the American Enterprise Institute as a resident fellow.

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