Happy midday to you, Colorado, and welcome to another edition of The Temperature, where today we are talking about gorging snakes and potentially major changes to national health care law. Pythons and policy — just about sums up this newsletter’s eclectic tastes.
I am out of intro ideas today, so let’s check the ol’ inbox for inspiration. As always, these are real PR pitches that landed in my email.
“Why trying to take away someone else’s happiness will never help you be happy.” But what about misery loving company?
“Interview: The Holiday ‘Santa Baby’ Cover You Didn’t Know You Needed.” And still don’t!
“Social Media’s Most-Popular Pharmacist on 2024 Flu Shot.” Ah yes, here we go.
It’s respiratory virus season, so time to start thinking about ways to keep yourself and those around you healthy. The Colorado Department of Public Health and Environment is relaunching its 1, 2, 3 Protect You and Me campaign to encourage people to get vaccinated against flu, COVID and, if eligible, RSV.
“Immunizations are one of the most important gifts we can give to ourselves and others,” Dr. Ned Calonge, CDPHE’s chief medical officer, said in a statement.
Or, put another way, don’t take away my happiness by spreading your germs to me. It will never make you happy.
You know what does bring happiness? Helping to support local, community-focused organizations like this here news outlet. Early giving is open for Colorado Gives Day and your donation to The Sun will be matched dollar-for-dollar for a limited time. Double the impact, half the spending — makes me want to break out in song (just not “Santa Baby”).
Click here to make a donation to support The Sun’s journalism.
Now, onto the news.
Reporter
TEMP CHECK
HERPATOLOGY
Snakes on a gain: How gorging pythons may hold the key to treating certain heart diseases
Somewhere deep inside a forest in central Africa right now, there is a ball python waiting for its next meal.
And waiting.
And waiting.
The pythons can go months — perhaps even longer than a year — without eating. But when they do it is a gourmand’s feast, with the python sometimes consuming a meal equivalent to its entire body weight. Imagine fasting until next Halloween, then hitting up the McDonald’s drive-thru for 300 Big Macs.
Humans would die trying to live this way, but pythons have an extraordinary trick. To deal with all this nutrition at once and the stresses of pumping it through the bloodstream, its organ systems temporarily become HUGE. Its heart expands 25% or more. And, once the meal has been digested and its nutrients distributed, those organs, including the heart, shrink back to normal size without suffering any damage.
When Leslie Leinwand, a powerhouse biology professor and expert in cardiovascular health at the University of Colorado, first read about this, she was giddy.
“I walked out into the lab, and I said, ‘I think we ought to start working on pythons,’” she said. “And people looked at me like, ‘What?’”
Up until that point, Leinwand’s lab had been a fairly typical research operation. They worked with mice and rats.
But Leinwand knew that the rest of the animal kingdom held secrets that could benefit human health. Drugs like Ozempic that have revolutionized treatment for diabetes and obesity were developed based on research into Gila monster venom. The venom from deadly sea snails has been studied for potential therapeutic benefit.
So Leinwand plowed ahead. And now her nearly two-decade-long quest to understand python hearts has yielded valuable insights that could one day lead to treatments for multiple kinds of heart disease.
Take, for instance, the python’s expanding-shrinking heart trick. Leinwand and other researchers in her lab have discovered that python hearts are remarkably pliant. Understanding what makes them so could help treat a human condition called cardiac fibrosis — a stiffening of the heart associated with heart disease.
“We would love to know how to make stiff hearts much less stiff,” Leinwand said.
Or what about how a python is able to pump all that sludgy, fat-laden blood through its body following a big meal? A recent study from the lab looked at muscle cells called myofibers taken from ball pythons after feeding.
“We saw something really cool,” said Claudia Crocini, a researcher at Charité – Berlin University of Medicine in Germany who worked on the study while a post-doctoral student in Leinwand’s lab. “These myofibers after feeding were able to produce a lot more force compared to the non-fed python hearts.”
In other words, python hearts got stronger, something that could help treat human heart conditions involving a weakened heart.
And then there’s this little factoid: No matter how much they eat, pythons don’t seem to get heart disease. Leinwand’s tried, in an experiment she half-jokingly calls “‘Super Size Me’ in snakes.” She even tried to publish a journal article under that title, and also offered “Redefining snake oil.”
“I love those titles,” she said. “But they didn’t.”
Section by John Ingold | Reporter
AFFORDABLE CARE ACT
Will Republicans try again to repeal the Affordable Care Act?
$493 million
The amount Colorado estimates consumers will save this year on health insurance premiums due to the state’s reinsurance program, which is made possible through the Affordable Care Act
For months while on the campaign trail, Republican leaders — including President-elect Donald Trump — have been talking about making big changes to the U.S. health insurance system.
It’s just not clear what those changes will be or how they would impact Colorado.
Declaring that “Obamacare sucks,” Trump has vowed to replace the Affordable Care Act, but he has also at other times expressed openness to keeping it. (The 14-year-old law is, of course, also known as Obamacare, given that it was passed during the Obama administration.) Asked at a debate what he plans to do, Trump said only that he has “concepts of a plan.”
House Speaker Mike Johnson has pledged to get rid of the Affordable Care Act without offering specifics, other than to promise “massive reform to make this work.”
In the absence of more concrete plans, let’s take a look at how a full repeal of the ACA might hit Colorado, and why it could be politically difficult to pull off.
Colorado law reinforces a lot of the Affordable Care Act
Some of the ACA’s most popular provisions are its insurance protections.
Under the law, you can’t be denied health coverage because of pre-existing conditions, and you can’t be charged more based on your health history. The ACA also requires insurers to provide a minimum level of coverage — the “essential health benefits” — so people don’t have to buy additional policies to cover, say, maternity care. (Prior to the ACA, just 12% of plans available to people who shop for insurance on their own offered maternity benefits. Most employer-sponsored plans offered maternity coverage.)
If the ACA were to be repealed, though, many of these protections would likely remain in Colorado. That’s because Colorado lawmakers years ago aligned state health insurance rules with those in the Affordable Care Act. So, state law also prohibits insurers from denying coverage based on pre-existing conditions or charging more based on medical history. (The essential health benefits are a little less clear because the state law that guarantees them refers to the text of the ACA to define what the benefits are.)
Insurance subsidies could go away
People who buy plans on their own currently benefit from advance tax credits to help them pay for their insurance premiums, provided they don’t make too much to qualify. About 80% of people who shop for coverage on Connect for Health Colorado this year will be eligible for the subsidies, the state estimates.
And those subsidies can really take the sting out of insurance prices. About 77% of people eligible for subsidies will be able to find a plan on Connect for Health with an after-subsidy premium of less than $100 per month, the state says.
Those subsidies are a function of the Affordable Care Act, meaning they will go away if the law is repealed — as will certain subsidies available to people with especially low incomes that help pay other out-of-pocket costs like deductibles or copays.
Even if the ACA isn’t repealed, some portion of the subsidies could still go away. Enhanced subsidies passed during the COVID pandemic are set to expire at the end of 2025 unless Congress reauthorizes them.
Insurance could become more expensive for other reasons
There’s one other way insurance in Colorado could become more expensive, and it’s something we’ve talked about before: Reinsurance.
The program uses a pool of government funding to help insurance carriers in the individual market pay their highest-cost claims, allowing those companies to lower rates for everybody.
This has been hugely successful in Colorado in reducing the prices that people pay for their insurance. Though prices have gone up in recent years, the state estimates that reinsurance will save Coloradans nearly a half billion dollars this year compared to what they would have paid without it.
But much of the money for the reinsurance program comes from the federal government via a provision of the ACA. So ending the ACA would slash money the state has available to fund the program.
State regulators would likely fight back
If some of this feels familiar, it’s because we’ve been here before, the last time Trump was president with a Republican-controlled Congress behind him. Then, after multiple attempts to repeal and replace the ACA, Trump and his Republican allies switched to plan B: expanded access to short-term insurance plans.
Such plans are not governed at the federal level by ACA rules, so they function more like pre-ACA plans. The idea was that by allowing people to stay on short-term plans longer, you could create a kind of non-ACA shadow insurance market.
But Colorado Insurance Commissioner Michael Conway blocked that by issuing a rule that short-term plans in Colorado have to abide by the same rules as ACA plans.
Expect the same kind of regulatory warfare this time around.
The Medicaid expansion could be at risk
The ACA allows states to expand Medicaid eligibility with a sweet deal: For those people eligible for Medicaid via the expansion, the federal government will pay 90% of the costs. Normally, Medicaid is an even 50/50 split for the state and the feds.
Colorado was one of the early states to take up the expansion, which extends Medicaid coverage to people making just above the poverty line. As of last summer, more than 600,000 people were covered under the Medicaid expansion in Colorado, though that number has likely decreased as the state has ramped up eligibility renewals following the end of pandemic-era federal rules.
The last time Trump was in the Oval Office, Congressional Republicans proposed a plan that would have phased out the expansion and/or left it up to the state to pick up more of the cost. According to an estimate by the Colorado Health Institute in 2017, if Colorado kept the expansion but reverted to a 50/50 cost split for those covered by it, the state would be on the hook for an extra $800 million a year. That’s almost certainly a nonstarter in a state budget that is already struggling to afford its Medicaid program.
Public support for the ACA is actually pretty strong
One thing that makes an ACA repeal even more challenging now is that polls show people generally like it — even more so than during Trump’s first term.
The latest KFF tracking poll shows the ACA this year hitting its all-time high for favorability, with 62% of adults saying they hold a favorable view of the law. A poll from the Democratic-leaning firm Global Strategy Group found similar numbers.
A Morning Consult poll taken this month found that 55% of voters are in favor of keeping the ACA as is or expanding it, compared with 31% who want to see it repealed in whole or part. That’s stronger support than the law had in 2017 — and even Republicans are less in favor of repealing the law, 54% in favor this year compared with 76% in favor in 2017.
Section by John Ingold | Reporter
MORE HEALTH NEWS
CHART OF THE WEEK
The precarious support for the measles vaccine
Up above, we talked about how health coverage programs in the United States may change during the second Trump administration. But there are other ways the U.S. health systems could change depending on what role Robert F. Kennedy Jr. is given in the White House.
Kennedy — a noted critic of vaccines, the pharmaceutical industry and fluoride in the water; an ardent supporter of raw milk and psychedelic therapies — could exert broad influence over U.S. public health policy. In public comments, he has mostly focused his attention on changing how the Food and Drug Administration regulates medicines to be less favorable to drug companies and more open to alternative treatments. Though best known for his work opposing vaccines, Kennedy has told news outlets since the election that he’s not going to take away vaccines.
“I’m going to make sure scientific safety studies and efficacy are out there, and people can make individual assessments about whether that product is going to be good for them,” Kennedy told NBC News.
That’s still significant, though, because multiple polls show that many Americans aren’t quite sure what to make of statements about vaccines that are, frankly, not supported by most of the scientific literature.
Take the measles vaccine, for instance. The nonpartisan health policy think tank KFF has for a couple years been running a tracking poll on health misinformation. And, at first glance, the answers from the latest edition of that poll appear to show solid support for vaccines.
In February, KFF found that 79% of adults say it is false that the measles vaccine is more dangerous than the disease, compared with only 19% who say it is true. But, read another way, the poll shows high levels of uncertainty — 57% say they are not definitely sure of their answer, either way.
And this slice of data is only from people who say they have heard such claims about the vaccine. The large majority of people polled — 82% — say they have not heard the claim.
A Gallup poll from this summer echoes these findings. The poll found fewer Americans who believe childhood vaccines are extremely important, and a rising number who believe vaccines are more dangerous than the diseases they target.
The percentages are still small — only 20% of people polled said vaccines are more dangerous, up from 6% in 2001. The rise in distrust comes almost entirely from Republicans and Republican-leaning voters.
Gallup also asked about the belief that vaccines cause autism — which numerous studies have rebutted. People who reject the idea outnumbered those who believe it by nearly 3-to-1. But the majority of people polled — 51% — said they aren’t sure what to think.
These polls show that there are a large number of Americans who, while generally supportive of vaccines, are not entirely certain about that support. And that shows how changes in U.S. public health policy could have a big influence — even if those changes involve using the power of the government as a supplier of information, rather than as a regulator.
Section by John Ingold | Reporter
Oof, that was a heavy one. Remember how much fun we had at the beginning learning about snake hearts? Yeah, that was great.
These are stressful times, so feel free to be like a python and sit very, very still while waiting for your moment to reengage with the world. (And, no, “be more python-like” is not advice I ever thought I’d be doling out.)
We’ll see you back here next time.
— John & Michael
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