Without medication to manage her plaque psoriasis, Jennifer Brown’s face, scalp, trunk and neck periodically become covered in painful red, flaky patches so dry they crack and bleed.

She has gotten relief from medications, but they come at a high price. For a while she was on Humira, made by AbbVie, with an average retail price of roughly $8,600 for two monthly injections. When that drug stopped working for her, Brown’s doctor switched her to a different drug. Today she is using another injectable, Skyrizi, also by AbbVie, which costs about $36,000 for two quarterly injections — nearly 40% more annually than Humira.

The pharmaceutical company offers an assistance program to help consumers like Brown pay their share of the drug, and that has helped her cover her copayments. However, she faces the possibility of higher drug costs under a federal rule finalized this spring by the Trump administration.

The rule, an annual directive that sets health plan standards for 2021, permits employers and insurers not to apply drug company copayment assistance toward enrollees’ deductibles and out-of-pocket maximums for any drug. That means only payments made by the patients

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The U.S. public health system has been starved for decades and lacks the resources to confront the worst health crisis in a century.

Marshaled against a virus that has sickened at least 2.6 million in the U.S., killed more than 126,000 people and cost tens of millions of jobs and $3 trillion in federal rescue money, state and local government health workers on the ground are sometimes paid so little that they qualify for public aid.

They track the coronavirus on paper records shared via fax. Working seven-day weeks for months on end, they fear pay freezes, public backlash and even losing their jobs.

Since 2010, spending for state public health departments has dropped by 16% per capita and spending for local health departments has fallen by 18%, according to a KHN and Associated Press analysis of government spending on public health. At least 38,000 state and local public health jobs have disappeared since the 2008 recession, leaving a skeletal workforce for what was once viewed as one of the world’s top public health systems.

KHN and AP interviewed more than 150 public health workers, policymakers and experts, analyzed spending records from hundreds of state and local health departments, and

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MONROVIA, Calif. — Most mornings, like clockwork, you could find Art Ballard pumping iron.

At least five days a week, he drove to Foothill Gym, where he beat on the punching bag, rode a stationary bike and worked his abs. After he joined the gym five years ago, he dropped 20 pounds, improved his balance and made friends.

At 91, he’s still spry and doesn’t take any medication other than an occasional Tylenol for aches and pains.

“Doctors love me,” he said.

But when California enacted a statewide stay-at-home order in mid-March, his near-daily physical exercise and social interactions abruptly ended.

Ballard’s health started to deteriorate: His back hurt, his legs cramped and he started becoming short of breath. As happens too often with older people, he also started to feel isolated and depressed.

“I was deeply concerned for myself because I didn’t have an exercise routine at home,” he said.

Art Ballard is proud that he doesn’t have to rely on several medications at his age. He takes only Tylenol as needed for aches and pains.(Heidi de Marco/KHN)

Art Ballard worked out at Foothill Gym a few weeks before it was officially open to the public. “I’m

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KHN senior correspondent Markian Hawryluk joined KUNC’s Erin O’Toole on “Colorado Edition” to discuss his recent story that detailed the challenges in determining the full death toll from the coronavirus pandemic. He also appeared on WNHN’s “The Attitude with Arnie Arnesen” to discuss the article.

His reporting delved into the various ways that officials count deaths from the pandemic. Without widespread testing, he found, officials must sort through presumed COVID deaths and those who died with infections rather than from them. Then there are the indirect deaths of people who died from circumstances created by the pandemic.… Read more

DENVER — Melody Lewis lives like a nomad in the heart of downtown.

Poking her head out of her green tent on a recent June day, the 57-year-old pointed a few blocks away to the place where city crews picked up her tent from a sidewalk median earlier this spring and replaced it with landscaping rocks, fencing and signs warning trespassers to keep out.

Lewis then moved just a quarter-mile to a new cracked sidewalk, with new neighbors and potentially, homeless advocates fear, new sources of exposure to the coronavirus.

“Where else are we going to go?” Lewis asked. “What else are we going to do?”

Several cities across the U.S. are bucking recommendations from the Centers for Disease Control and Prevention by continuing sweeps of homeless encampments, risking further spread of the virus at a time when health officials seek to gain an upper hand on the pandemic.

Such struggles involving COVID-19 highlight the nation’s ongoing problem with housing. And they showcase the challenge public health officials face: Controlling the spread

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BROOMFIELD, Colo. — Sara Wittner had seemingly gotten her life back under control. After a December relapse in her battle with drug addiction, the 32-year-old completed a 30-day detox program and started taking a monthly injection to block her cravings for opioids. She was engaged to be married, working for a local health association and counseling others about drug addiction.

Then the COVID-19 pandemic hit.

The virus knocked down all the supports she had carefully built around her: no more in-person Narcotics Anonymous meetings, no talks over coffee with a trusted friend or her addiction recovery sponsor. As the virus stressed hospitals and clinics, her appointment to get the next monthly shot of medication was moved back from 30 days to 45 days.

As best her family could reconstruct from the messages on her phone, Wittner started using again on April 12, Easter Sunday, more than a week after her originally scheduled appointment, when she should have gotten her next injection. She couldn’t stave off the cravings any longer as she waited for her appointment that coming Friday. She used again that Tuesday

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