Selena Simmons-Duffin

Selena Simmons-Duffin reports on health policy for NPR.

She has worked at NPR for ten years as a show editor and producer, with one stopover at WAMU in 2017 as part of a staff exchange. For four months, she reported local Washington, DC, health stories, including a secretive maternity ward closure and a gesundheit machine.

Before coming to All Things Considered in 2016, Simmons-Duffin spent six years on Morning Edition working shifts at all hours and directing the show. She also drove the full length of the U.S.-Mexico border in 2014 for the "Borderland" series.

She won a Gracie Award in 2015 for creating a video called "Talking While Female," and a 2014 AAAS Kavli Science Journalism Award for producing a series on why you should love your microbes.

Simmons-Duffin attended Stanford University, where she majored in English. She took time off from college to do HIV/AIDS-related work in East Africa. She started out in radio at Stanford's radio station, KZSU, and went on to study documentary radio at the Salt Institute, before coming to NPR as an intern in 2009.

She lives in Washington, DC, with her spouse and kids.

Lost in all the brouhaha about President Trump's scuttled plan to buy Greenland from Denmark has been this: What do the Greenlandic people think about the whole thing?

In the small capital city of Nuuk, "everybody is talking about it," says Alexander Montgomery-Andersen, a 30-year-old Greenlandic dancer and choreographer. "It's a little comical."

Good news came out from the Centers for Disease Control and Prevention Wednesday: Preliminary data shows reported drug overdoses declined 4.2% in 2018, after rising precipitously for decades.

High drug prices are a hot topic in politics right now. President Trump has made lowering them a cornerstone of his re-election bid and is pushing a variety of ideas to get that done.

The Trump administration has dropped one of the meatiest portions of its plan to reduce drug prices.

The Department of Health and Human Services said it will no longer pursue a rule that would have prohibited the payment of certain rebates on drugs in Medicare Part D and Medicaid plans.

The idea was to target the middlemen, pharmacy benefit managers, whose negotiations with drugmakers and insurers influence the costs consumers pay for drugs.

Updated 6:30 p.m.

The Trump administration has announced an ambitious plan to change treatment for kidney disease in the United States.

President Trump signed an executive order Wednesday directing the Department of Health and Human Services to develop policies addressing three goals: reducing the number of patients developing kidney failure, reducing how many Americans get dialysis treatment at dialysis centers and making more kidneys available for transplant.

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AUDIE CORNISH, HOST:

Now let's bring NPR's Selena Simmons-Duffin to explain how today's news fits into this long history of challenges to the Affordable Care Act.

Welcome to the studio, Selena.

SELENA SIMMONS-DUFFIN, BYLINE: Hi.

The federal government's rule designed to support health workers who opt out of providing care that violates their moral or religious beliefs will not go into effect in July as scheduled. The effective date has been delayed by four months, according to court orders.

Louisiana officials announced a deal Wednesday with Asegua Therapeutics, a subsidiary of Gilead Sciences, that would allow the state to provide hepatitis C treatment to its Medicaid and prison populations. They also secured the necessary clearance from the federal government Wednesday for a novel approach to paying for the drugs and expect the program to start July 15.

Editor's note: The day after this story published, Mary Washington Healthcare announced it will suspend its practice of suing patients for unpaid bills, stating: "We are committed to a complete re-evaluation of our entire payment process to ensure that all patients know they have access to care." When asked what they will do about any patient whose wages are currently being garnished, Eric Fletcher, Mary Washington's senior vice president, said in a statement to NPR: "

Updated 4:03 p.m.

President Trump signed an executive order Monday on price transparency in health care that aims to lower rising health care costs by showing prices to patients. The idea is that if people can shop around, market forces may drive down costs.

"Hospitals will be required to publish prices that reflect what people pay for services," said President Trump at a White House event. "You will get great pricing. Prices will come down by numbers that you wouldn't believe. The cost of healthcare will go way, way down."

In Florida, Gov. Ron DeSantis signed a bill last week that, if federal authorities give it their go-ahead — still a very big if — would allow his state to import prescription drugs from Canada. That makes Florida the third state to pass such a law, joining Vermont and Colorado. More such legislative attempts are in the works.

Carol Burgos is worried her neighbors think she is bringing the neighborhood down.

She lives in a mobile home park in a woodsy part of Columbia County, N.Y, just off a two-lane highway. The homes have neat yards and American flags. On a spring Saturday, some neighbors are out holding yard sales, with knickknacks spread out on folding tables. Others are out doing yardwork.

Burgos' lawn is unruly and overgrown.

"How bad do I feel when these little old ladies are mowing their lawn and I can't because I'm in so much pain?" she says.

Moral and religious objections to providing health care sometimes arise in medicine: A medical assistant might not agree with blood transfusions. A nurse might not want to assist in sex reassignment surgery.

When the first HIV drug, AZT, came to market in 1987, it cost $10,000 a year.

That price makes Peter Staley laugh today. "It sounds quaint and cheap now, but $10,000 a year at that time was the highest price ever set for any drug in history," he says.

If you've ever had a little one at home with a fever, you might have noticed two options for Tylenol at the store.

There's one for infants and one for children. They contain the same amount of medicine — 160 milligrams of acetaminophen per 5 milliliters of liquid — but the infant version costs three times more.

What gives? It turns out, there's a backstory.

RACHEL MARTIN, HOST:

The Trump administration wants to redefine the word sex, at least in terms of the Affordable Care Act and who gets protected from discrimination. With us now to explain, NPR's Selena Simmons-Duffin, who is following this. Thanks for being here, Selena.

SELENA SIMMONS-DUFFIN, BYLINE: Hi.

MARTIN: So explain this. We're talking specifically about transgender people - right? - and what kind of health care they can receive.

The toddler looking up at Dr. Melanie Seifman in her Washington, D.C., exam room seems a little dazed.

It could be because she just woke up from a nap at daycare. It could be that she remembers the shots she got last time, and she knows what's coming.

The little girl is catching up on some vaccines she's behind on: missing doses of the DTaP and polio vaccines. She's over two years old — both of those shots are supposed to happen at a baby's six-month check up.

Connecticut Attorney General William Tong has a skin condition called rosacea, and he says he takes the antibiotic doxycycline once a day for it.

In 2013, the average market price of doxycycline rose from $20 to $1,829 a year later. That's an increase of over 8,000%.

When health care workers feel they have been forced to do something they disagree with on moral or religious grounds, they can file complaints with the Department of Health and Human Services' Office for Civil Rights. Some high-profile cases have involved nurses who objected to providing abortion services.

The Trump administration moved forward on Wednesday with its plan to lower prescription drug prices by requiring drugmakers to display the list price "in a legible textual statement at the end of the advertisement."

Secretary of Health and Human Services Alex Azar said today that when it comes to changing prescription drug prices, "putting prices in TV ads may be the most significant single step any administration has ever taken." But patient advocates are not convinced it will have an immediate impact on drug pricing.

At my baby's six-month appointment a few months back, I got a one-pager from the pediatrician titled "Starting Solid Foods."

"It is critical that the baby develop a taste for rice cereal at the beginning, to offset the loss of iron from formula or breast milk," it reads.

Sounds serious. Then come the all caps: "THE FIRST TWO WEEKS OF FEEDING GIVE RICE CEREAL ONLY." That is followed by advice to introduce pureed vegetables before fruits so the baby doesn't develop a sweet tooth.

I obediently went out and bought some sand-textured baby cereal. (Organic, of course.)

In his State of the Union address this year, President Trump announced an initiative "to eliminate the HIV epidemic in the United States within 10 years."

The man who pitched the president on this idea is Alex Azar, the Secretary of the Department of Health and Human Services.

Trump administration health officials are spelling out their ambitious plan to stop the spread of HIV in the U.S. within the next 10 years.

The plan would target 48 counties where the rate of HIV spread is the highest, along with Washington, D.C., and San Juan, Puerto Rico. Seven states with high rates of HIV in rural areas would also be targeted, including Oklahoma, Missouri, Kentucky, Arkansas, Alabama, South Carolina and Mississippi.

The list of things you're supposed to avoid when you're pregnant (like I am) is comically long. Hot baths. Alcohol. Soft cheeses. Tuna and lunch meat. Sprouts.

So it felt a little odd to be offering up my arm for a vaccine a few weeks ago, at the start of my third trimester. Really? No ibuprofen or Pepto, but yes vaccines?

The student comes in for a pregnancy test — the second time she's asked for one in matter of weeks.

She's 15. She lives with her boyfriend. He wants kids — he won't use protection. She loves him, she says. But she doesn't want to get pregnant. She knows how much harder it would be for her to finish high school.

At many schools, she would have gotten little more than some advice from a school nurse. But here at Anacostia High School in Washington, D.C., she gets a dose of midwife Loral Patchen.

Sometimes 11-year-old B. comes home from school in tears. Maybe she was taunted about her weight that day, called "ugly." Or her so-called friends blocked her on their phones. Some nights she is too anxious to sleep alone and climbs into her mother's bed. It's just the two of them at home, ever since her father was deported back to West Africa when she was a toddler.

The Trump administration has made clear it would like to remake the American health care system. There's been the protracted battle over the Affordable Care Act. Now, there are some new moves on the future of Medicaid.

On Monday, the federal government released decisions on requests from two states to change the way they administer the health care program for low-income people.

The first decision came on lifetime caps. Kansas wanted to cut off Medicaid benefits for some people after 36 months.

Most people are familiar with some form of triage: When you go to an emergency room, you first sit down with a triage nurse who records your symptoms, takes your vital signs and assesses the urgency of your medical need.

As of Thursday, that's happening over the phone for 911 callers in Washington, D.C., where triage nurses now sit alongside 911 dispatchers to help field calls.

A big part of Washington D.C.'s plan to get its HIV rate down is to get more uninfected people on PrEP, a two-medicine combination pill that's also sold under the brand name Truvada.

The new horror movie A Quiet Place is a hit at the box office and with critics. It's also notable for its lack of sound, which poses a problem for lovers of movie-theater popcorn.

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