Trump  Make America Healthy Again

Nearly half of the U.S. population is pre-diabetic or has type-2 diabetes. Every month, diabetes causes 13,000 new amputations, 5,000 new cases of kidney failure and up to 2,000 new cases of blindness in our country. In 1960, approximately 13 percent of American adults were obese. Now, more than 40 percent of Americans are obese, and more than 70 percent are either obese or overweight.

Even more shockingly, one-quarter of our teenagers today are pre-diabetic or have type-2 diabetes, and obesity is the leading medical reason that 71 percent of young Americans are disqualified from military service.  Learn More >>> The Hill 

6 positions 

1. Mr. Kennedy has prioritized addressing chronic disease, which accounts for over $1 trillion in annual U.S. healthcare costs. He has stated that President-elect Trump seeks "measurable impacts" to combat the chronic disease epidemic within two years — a goal that has drawn attention from healthcare leaders, some of whom have praised its ambition while noting potential challenges.

Mr. Kennedy identified chronic disease as a key priority before his nomination to lead HHS. "I'm going to urge President Trump on day one to do the same thing they did in COVID, which is to declare a national emergency, but not for infectious disease, but for chronic disease," Mr. Kennedy said in a Sept. 26 interview, about one month after he dropped out of the presidential race.

His vision extends beyond healthcare delivery to address broader contributors to chronic disease. Mr. Kennedy has criticized the influence of the pharmaceutical and food industries, linking issues like obesity and diabetes to ultra-processed foods, federal subsidies and dietary guidelines. He has called for reforms targeting food additives, pesticides and environmental health risks, alongside overhauls of agencies like the CDC and FDA.

Health systems may find some common ground in Mr. Kennedy's focus on prevention and early intervention to reduce chronic disease burdens, which could align with some of their efforts to address social determinants of health. However, experts, including former CDC Director Tom Frieden, MD, caution against oversimplification. "There are some things that RFK Jr. gets right," Dr. Frieden told NPR. "We do have a chronic disease crisis in this country, but we need to avoid simplistic solutions and stick with the science."

2. He's called for an end to direct-to-consumer advertising for prescription drugs. Mr. Kennedy has criticized the advertising relationships between pharmaceutical companies and news outlets, arguing that pharmaceutical advertising influences editorial content and public discourse beyond its intended purpose of promoting products. When his campaign was active in early 2024, Mr. Kennedy said if elected he would issue an executive order on his first day in office to ban pharmaceutical advertising on television.

Direct-to-consumer advertising of prescription drugs surged after the FDA eased restrictions in 1997 and totaled nearly $10 billion in 2016. Proponents argue it educates consumers and empowers patient involvement, while critics warn it can misinform patients, drive inappropriate prescribing and inflate healthcare costs. Concerns also include promoting costly brand-name drugs over cheaper alternatives, straining patient-physician relationships.

3. He has expressed interest in redirecting Medicare spending toward promoting healthy behaviors rather than covering certain pharmaceuticals. Mr. Kennedy has been a vocal opponent of Medicare and Medicaid funding for GLP-1 drugs used for weight loss, arguing that these programs should instead prioritize covering gym memberships and healthier food options for enrollees.

"For half the price of Ozempic, we could purchase regeneratively raised, organic food for every American, three meals a day and a gym membership, for every obese American," Mr. Kennedy said during a Congressional roundtable in September, as reported by the Associated Press.

The Biden administration recently proposed broader coverage of GLP-1 and weight loss drugs for Americans with obesity, a move that could put Mr. Kennedy in a reactive position if he secures confirmation to lead HHS.

4. He is considering changes to the Medicare physician fee schedule. Mr. Kennedy and his advisers are considering an overhaul of Medicare's payment formula, four anonymous sources told The Washington Post in November. The move could mark a bid to shift the health system's incentives toward primary care and prevention.

The Medicare physician fee schedule was adopted in 1992, establishing a complex system of administrative pricing based on the resource inputs used in producing physician services. It influences not only Medicare payments, but also private insurance payment systems, which often mirror Medicare's methodologies.

Sources told The Post that discussions about the fee schedule are in their early stages and have involved a plan to review the thousands of billing codes that determine how much physicians get paid for performing procedures and services. These codes are integral to determining reimbursement rates and have faced criticism for historically favoring procedural and specialty care over primary care services. An overhaul could address these disparities and potentially reshape the economics of medical practice across the country.

5. He has raised controversial and widely challenged claims about vaccine safety for nearly 20 years. Mr. Kennedy's suspicion of vaccines dates back to at least 2005, when he published an article called "Deadly Immunity" in unusual publications for the topic: Rolling Stone magazine (print) and Salon (digital). The article claimed that thimerosal, eliminated in routine childhood vaccines in 2001, caused autism. The article was amended and corrected several times before, years later, Salon announced in 2011 that it was retracting "Deadly Immunity" in entirety. An explanation of that decision and the corrections made to Mr. Kennedy's article are detailed by Salon here.

More recently, Mr. Kennedy said in a 2023 podcast interview that, "There's no vaccine that is safe and effective." The nonprofit Mr. Kennedy was aligned with for nearly a decade, Children's Health Defense, has been a vocal critic of COVID-19 vaccines and public health mandates, with its claims frequently challenged by public health experts. The group has filed dozens of federal and state lawsuits since 2020, many challenging vaccines and public health mandates. Mr. Kennedy has been on leave from the group as its founder, chairman and chief litigation counsel since he announced his plans to run for president in April 2023.

When described as anti-vaccine, Mr. Kennedy has pushed back. Instead, he argues that he wants to improve the science of vaccine safety. "We're not going to take vaccines away from anybody," he told NPR in November. "We are going to make sure that Americans have good information. Right now the science on vaccine safety particularly has huge deficits in it, and we're going to make sure those scientific studies are done and that people can make informed choices about their vaccinations and their children's vaccinations."

6. He supports abortion rights up to the point of fetal viability, after which he favors restrictions. Mr. Kennedy believes abortion should be legal up to a point he describes as when the fetus becomes viable outside the womb, after which he supports restrictions. Mr. Kennedy clarified this position in a video released in June 2024, though he did not specify an exact number of weeks for viability. He acknowledged that his views on abortion have evolved over time as he continued to explore the issue. In May 2024, he had expressed support for a woman's right to choose an abortion at any stage of pregnancy, including full term.

Mr. Kennedy has also pointed to the importance of addressing economic factors in discussions about abortion and reproductive health. "We should be looking at why there are so many abortions in the first place," he said, emphasizing the need to understand the financial challenges and economic pressures that contribute to abortion rates among individuals and families.

Mr. Kennedy introduced a plan while running for president called "More Choices, More Life" that called for a subsidized daycare initiative aimed at making childcare more accessible. He said universal childcare has the capacity to add $1 trillion to the U.S. GDP. "And since economics is a major driver of abortion, this policy will do more to lower abortion rates than any coercive measure ever could," the website for the plan states.    ^{Becker Hospital Review} * 

#ACA / ObamaCare Preventative Care & Wellness Programs

Anthem Preventative Care

• Here’s a Plain English List!  from HealthCare.Gov  of preventative services you can get with NO DEDUCTIBLE.
  • For all adults
  • For women
  • For children
• However, if Preventive care is given during an Office Visit or as an outpatient or vice versa ^{Covered CA}  it might not be covered under the Preventative Care section of your policy   Check with your doctor. Preventative Screenings and other services are covered with no deductible for adults and children with no current symptoms or history of a health problem. ^{Specimen Policy Page 92} 
  • If one has history or symptoms, then it’s covered under the diagnostic benefit ^{Page 74}  Subject to Co-Pays & the Deductible.   Maintenance of a known problem, like those listed below as common risk factors,  is certainly preventative, but isn’t defined that way under ObamaCare and is subject to the regular co-pays and deductibles.  Peter Lee of Covered CA thinks that’s a BIG problem, read more by on the link.  Annual physicals may not be a benefit ^{LA Times 8.2.2016}
    • Ouch. That ‘Free’ Annual Checkup Might Cost You. Here’s Why 
    • Preventive care doctor visits are free, but if you bring up a health concern during the appointment, the visit may turn into a traditional doctor visit. That means you would have to pay a copay. The same could go for any tests that lead to more treatment or follow-up visits.  Learn More Covered CA  *
• Health Care Reform hopes to save premium dollars as 20% of Employee Health Care Spending is on these common risk factors: ^{health net pulse.com/}
  • stress
  • depression
  • high blood pressure
  • high cholesterol
    • What It Means if You Have Borderline High Cholesterol—And What to Do About It
  • obesity
    • poor diet
    • physical inactivity
    • high blood glucose
  • excessive alcohol use
  • tobacco use
    • CDC on How to Quit Smoking
  • US Preventative Services Task Force – Consumer Information for tons of different problems

Resources & Links

• A federal appeals court in Texas  on 6.21.2024 (read courts actual ruling)  found unconstitutional a key component of the Affordable Care Act that grants a health task force the effective authority to require that insurers both cover an array of preventive health interventions and screenings and refrain from imposing out-of-pocket costs for them. ^{NBC News} *
  • Appeals Court Hears Appeal Over Obamacare’s Preventive Care Mandate KFF 3.5.2024
  • The Texas ruling of March 30, 2023 (KFF Summary) * KFF update 4.7.2023 *  doesn’t count in CA.  Please don’t take blanket summaries & hype as gospel.  Read the sources links
• California law that requires all health plans regulated by the State of California to cover the same necessary preventive services at no cost to the patient, consumers enrolled in plans offered through Covered California will continue to have access to these critical health care services without disruption.  ^{Covered CA Email dated 4.6.2023 * Joint Statement *} 
• FAQ finding doctors, labs and hospitals, when there’s confusion

#Mammogram coverage under Medicare

Breast cancer screening (mammograms)

Breast cancer is the most common non-skin cancer in women and the second leading cause of cancer death in women in the U. S. Every woman is at risk, and this risk increases with age. Breast cancer usually can be treated successfully when found early. Medicare covers screening mammograms and digital technologies to check for breast cancer before you or a doctor may be able to find it manually.

Who’s covered?

Women 40 and older are eligible for a screening mammogram every 12 months. Medicare also covers one baseline mammogram for women between 35–39.

How often is it covered?

Once every 12 months.

Your costs if you have Original Medicare

You pay nothing for the test if the doctor accepts assignment.

Am I at high risk for breast cancer?

Your risk of developing breast cancer increases if any of these are true:

• You had breast cancer in the past.

• You have a family history of breast cancer (like a mother, sister, daughter, or 2 or more close relatives who’ve had breast cancer).

• You had your first baby after age 30.

• You’ve never had a baby.

Other pages on our website dealing with cancer and how Insurance and Rx Prescription coverage might pay for it

How often are Eye exams covered?

Medicare doesn’t cover routine eye exams (sometimes called “eye refractions”) for eyeglasses or contact lenses. Medicare Part B (Medical Insurance) covers some preventive and diagnostic eye exams:

• Yearly eye exam
• Glaucoma tests
• Macular degeneration
• Medicare Part B (Medical Insurance) covers a yearly eye exam for diabetic retinopathy
  • ICD 10
  • Web MD

by an eye doctor who’s legally allowed to do the test in your state.

Who’s eligible?

All people with Part B who have diabetes are covered.

Your costs in Original Medicare

You pay 20% of the Medicare-approved amount for the doctor’s services, and the Part B deductible applies. In a hospital outpatient setting, you pay a copayment.

Note

To find out how much your specific test, item, or service will cost, talk to your doctor or other health care provider. The specific amount you’ll owe may depend on several things, like other insurance you may have, how much your doctor charges, whether your doctor accepts assignment, the type of facility, and the location where you get your test, item, or service. ^{medicare.gov yearly-eye-exam}

• cms.gov/VisionServices_FactSheet
• FAQs / Ask Us a Question
• ICD billing codes
  • 92012 Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient
  • 92083 — extended examination (eg, Goldmann visual fields with at least 3 isopters plotted and static determination within the central 30 degrees, or quantitative, automated threshold perimetry, Octopus programs G-1, 32 or 42, Humphrey visual field analyzer full threshold programs 30-2, 24-2, or 30/60-2).
  • 92083 — extended examination (eg, Goldmann visual fields with at least 3 isopters plotted and static determination within the central 30 degrees, or quantitative, automated threshold perimetry, Octopus programs G-1, 32 or 42, Humphrey visual field analyzer full threshold programs 30-2, 24-2, or 30/60-2).

Child & Related Pages – Site Map 

Medi-Cal Share of Cost

If you are low income you might check out LIS – Low Income Subsidy – Extra Help to pay the Rx costs that are not covered.  LIS may also pay your Part D and Part B premiums and you might also qualify for Medi-Cal.

Part D Rx Low Income Subsidy – LIS – Extra Help

• More help – beyond LIS
  • Rx Assistance from Manufacturer
  • Rx Covered Under Part B