Editor’s Note: Kendall Brown is a digital strategist and writer currently based in Oklahoma. She previously served as digital strategist for the Oklahoma Health Care Authority, which administers Medicaid in the state of Oklahoma. Follow her on Twitter at @KendallyBrown. The views expressed here are hers. Read more opinion on CNN.
As the coronavirus continues to spread and the number of infected individuals surpasses 100,000, President Donald Trump and his allies are doing their best to convince Americans that it’s not a major cause for concern and may actually have some benefits for the American economy.
Last Wednesday, Trump told Fox News viewers he had a “hunch” that WHO estimates on the virus’s mortality rate were wrong and that many Americans infected with the virus could continue to go to work. Trump surrogate Rep. Matt Gaetz of Florida emphasized the “hilarity” of the virus by wearing a gas mask during the House vote on funding to fight the virus.
Days after his gas mask stunt, Florida officials announced that the coronavirus had killed one of Gaetz’s constituents. And Monday afternoon, Gaetz announced he was self-quarantining after being informed a person he had contact with during last week’s CPAC conference had since tested positive for coronavirus. He had spent the weekend with Trump at his resort in Florida.
But by far the most prevalent party line among those seeking to distract from the Trump administration’s early bungling of their response to the coronavirus has been reassuring the public that the virus really “only” severely impacts chronically ill or elderly Americans, so the average American shouldn’t worry.
In case the President and his allies have forgotten, let me remind you: elderly and chronically ill Americans are still, well, Americans. Our lives matter every bit as much as those of our healthy neighbors. And in a nation where, according to the CDC, six in 10 American adults live with at least one chronic disease, the potential impact of a highly communicable virus is much larger than one man’s reelection chances. Government officials have an obligation to not only implement policies that keep Americans as a whole safe in the face of potential pandemics but also take every step necessary to make sure that disabled and chronically ill people are shielded from the harm those policies might cause them.
Thus far, Trump and his coronavirus “task force” seem largely focused on staging PR events designed to limit the President’s political exposure. Trump appeared confused about the differences between vaccines (which would help prevent the spread of the virus) and therapeutic medications (whose purpose is to treat those infected with the virus) during last Monday’s bizarre roundtable event with pharmaceutical executives, for example, which only highlighted just how little he understands about the situation.
But elected officials in Washington should be focused on taking steps to proactively limit the very real harm that could come to disabled and chronically ill Americans – who the Trump administration has acknowledged are most at risk – as the coronavirus continues to spread.
Congress has primarily focused on funding for the coronavirus response, passing an $8.3 billion emergency spending bill, which Trump signed into law Friday morning. The bipartisan bill, which was more than three times the size of the Trump administration’s initial request, is certainly a critical part of the coronavirus response by federal, state and local health officials. But the funding bill does little to address the specific risks that chronically ill Americans face in the event of the coronavirus spreading.
Those risks are not limited to the coronavirus itself. In fact, some of the preventative measures the Centers for Disease Control and Prevention has issued could inadvertently harm America’s most medically fragile citizens unless steps are taken immediately to mitigate those dangers.
Chief among them is the impact of social distancing – which includes avoiding large gatherings or public transportation, for example, in an effort to slow the spread of contagious diseases.
If the United States health care system becomes overwhelmed with coronavirus cases and social distancing measures are implemented, millions of chronically ill Americans who rely on one or more prescription medications need access to an emergency stockpile. The CDC’s guidance for normal preparedness recommends Americans “keep at least a 7 to 10-day supply of prescription medications,” although some health care professionals are currently recommending patients obtain a 30-day supply whenever possible.
This represents a huge problem. Most payers (including Medicare, Medicaid and private health insurance companies) have restrictions on how often they will cover the cost of refilling a member’s prescription medications, often limiting patients to 30-day supplies with a short two- to three-day window for refills prior to a medication running out. These payers will most likely cover the cost of an emergency supply of medications only if forced to do so by law – a law that Congress can and should take immediate steps to implement.
Further complicating things, millions of Americans (myself included) rely on controlled substances to manage chronic pain and other health conditions such as anxiety and ADHD. Due to increasingly restrictive state and federal laws on Schedule II, III and IV drugs in America – including opioid pain medications and those meant for the treatment of anxiety disorders – obtaining these medications frequently requires monthly doctor visits and urinalysis tests, and the medications often cannot be purchased in advance at all. Not only are these medications crucial for maintaining basic quality of life for millions of Americans, many of them also carry the potential for severe withdrawal symptoms that are worsened by a patient stopping the medication cold turkey, putting patients at severe risk in the event of social distancing measures preventing their refills.
Even if strict social distancing measures are not implemented in America, requiring chronically ill patients – who are often immunocompromised – to physically visit their doctors’ office to obtain their monthly prescriptions while the coronavirus is still active in America puts those patients at higher risk of coming into contact with an infected person, increasing the chances of the virus continuing to spread and putting all of us at higher risk.
Under the Public Health Service Act, some of these issues could be addressed under the authority of the secretary of Health and Human Services, Alex Azar. In January, Azar declared a public health emergency nationwide in regard to the coronavirus. Under this declaration, Azar has the authority to waive many of the restrictions and requirements relating to the dispensing of prescription medications.
But his authority as it relates to private health insurance companies is limited. Even if Azar waived the restrictions and requirements on dispensing opioids, the issue of how millions of Americans who rely on private health insurance would cover the cost would be left to Congress to solve. And given the Trump administration’s focus on increasing restrictions surrounding opioids – and Trump’s frequently stated desire to make drug laws even harsher – it is unlikely that Azar would exercise this right.
In the meantime, it’s clear that Americans cannot afford to wait around for the Trump administration to take action. Congress must move to pass legislation that allows for the adjustment of prescription medication laws in the event of an emergency such as the coronavirus. If social distancing begins to be implemented, it is critical that the government allow patients to obtain a 30-day emergency reserve supply of their prescription medications, temporarily waive requirements for patients to attend in-person doctor visits and urinalysis tests, and require that both government and private health care payers cover the cost of a small emergency supply of all prescription medications.
