October 11, 2017

Why doctors and health groups are criticizing EPA's proposed repeal of the Clean Power Plan

Daily Briefing

    The American Lung Association and several other medical groups this week criticized the Trump administration's proposal to repeal the Clean Power Plan, expressing concerns that the move could jeopardize public health. 

    Background

    The Clean Power Plan, finalized by former President Barack Obama's administration in 2015, aimed to reduce greenhouse gas emissions and shift states from coal to energy sources that produced fewer carbon emissions.

    According to the New York Times, the plan when released in 2015 was projected to curb power sector emissions by 32 percent by 2030, compared with emissions in 2005. The rule gave states broad leeway to determine how to meet those goals, such as by closing coal plants and promoting energy conversation efforts, Bloomberg reports.

    However, in 2016, the Supreme Court stayed the rule while lower courts considered challenges filed by the coal industry and 29 states, which alleged the plan was "the most far-reaching and burdensome rule the [Environmental Protection Agency (EPA)] has ever forced onto the states."

    Administration moves to roll back plan

    According to Bloomberg, EPA on Tuesday announced that EPA Administrator Scott Pruitt had filed a notice of proposed rulemaking in the Federal Register that would repeal the Obama administration's Clean Power Plan. In a press release, Pruitt said the Obama administration had in the original rule "pushed the bounds of their authority" by mandating that states change how they sourced their power.

    EPA has not committed to developing a new rule governing power plants' greenhouse emissions. Rather, the agency said it would formally seek public comment on whether a replacement is needed and—if so—how that replacement should be established.

    According to Bloomberg, several industry groups have praised the Trump administration's move. However, several environmental groups and state leaders—including New York Attorney General Eric Schneiderman (D)—have said they will file lawsuits challenging the move.  

    Proposed repeal faces backlash from health care providers

    During a media briefing on Monday, several health care experts cited research linking increased pollution with poor public health and raised concerns about the EPA's proposal to repeal the Clean Power Plan.

    Jonathan Buonocone of the Harvard T.H. Chan School of Public Health cited the findings of his recent research suggesting that the Clean Power Plan would reduce premature deaths associated with air pollution by about 3,500 each year. "Our research showed that cutting carbon emissions from power plants would reduce other harmful emissions, leading almost immediately to cleaner air and improved health," he said, adding that if the plan were weakened so as to focus on increasing efficiency at power plants, some regions in the United States could see more heart attacks and premature deaths due to increased air pollution.

    George Thurston of the American Thoracic Society and New York University School of Medicine, cited separate research showing pollution accounts for seven million additional deaths each year.

    Paul Billings, SVP for advocacy at the American Lung Association, said the repealing the Clean Power Plan was "a dangerous step that will return our nation to the days of unlimited pollution from power plants." Specifically, Billings said the plan would harm adults and children who suffer from asthma.

    Billings also said while the draft suggests "EPA may consider other options for limiting carbon pollution from power plants in the future, … there is no commitment to doing so." Citing an EPA proposal that would only require power plant upgrades feasible within facilities, such as new technology investments, Billings said the approach "may actually lead to an increase in pollution from power plants."

    Separately, the Medical Society Consortium on Climate and Health also came out against the proposed repeal, saying, "A decision to repeal the Clean Power Plan is a choice that puts American lives at greater risk from unhealthy air and the health harms from climate change"

    (Thielking, STAT News, 10/10; Boyles, MedPage Today, 10/9; Friedman/Plumer, New York Times, 10/9; Liptak/Davenport, New York Times, 2/9/16; Dlouhy/Polson, Bloomberg, 10/10).

    From healthy food access to stable housing: The case for collaboration with community partners

    Population health leaders know that health care delivery is incomplete without addressing the social determinants of health. But effective patient management cannot only include tasking care teams with addressing patients' social needs on top of their complex clinical needs.

    Instead, providers should also partner with community-based organizations already providing quality non-clinical support for a range of needs, from healthy food access to stable housing, to scale patient management beyond traditional care settings.

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