Hello from the Common Health Coalition! The 2-4-2 Digest is a weekly snapshot for health leaders - 4 key insights in 2 minutes or with 2 swipes on your phone.

Weekly Health Insights

Childhood Immunizations: Yesterday, HHS announced changes to the U.S. childhood immunization schedule that reduce the number of recommended vaccines and move others to a risk-based recommendation and/or shared clinical decision-making. Families can still access all previously-recommended vaccines without out-of-pocket costs, and the underlying evidence supporting the AAP and AAFP schedules has not changed. 

Medicare: CMS plans to revise Medicare Advantage Star Ratings as part of a broader CMMI strategy that emphasizes preventive care, streamlined quality measures, and greater use of downside risk in value-based models. The changes signal a shift away from measure-heavy reporting toward fewer metrics tied more directly to prevention and chronic disease management.

Cervical Cancer Screening: New federal guidelines now endorse self-collected HPV testing as an acceptable option for cervical cancer screening, following FDA approval of the first at-home test and aligning with recent American Cancer Society guidance. The change aims to address declining screening rates and persistent gaps among uninsured, rural, and immigrant populations.

ACA Subsidies: The House is expected to consider legislation this week to retroactively extend Affordable Care Act subsidies for three years after they expired on Dec. 31. The bill is expected to pass the House and move to the Senate, where bipartisan negotiations are anticipated ahead of the Jan. 31 government funding deadline.

Colleague Corner

In a Washington Post opinion, Dr. Demetre C. Daskalakis examines proposals to replace the U.S. childhood vaccine schedule with Denmark’s, noting that differences in health care access, disease exposure, vaccination coverage, and follow-up capacity make direct comparisons misleading.

“The U.S. schedule is not a historical accident or the result of bureaucratic overreach. It is the product of decades of rigorous, U.S.-specific epidemiology, modeling and real-world data.”

– Dr. Demetre C. Daskalakis, MD, former director of the Centers for Disease Control’s National Center for Immunization and Respiratory Diseases

Data Watch

A JAMA Network Open analysis of 72,170 adolescents and adults found that state-level bans on flavored e-cigarettes were associated with a 6.1–percentage point drop in initiation among young adults ages 18–24, cutting initiation by more than half compared with pre-ban levels. The study found no significant change among adolescents or adults 25+, and effects were concentrated among higher-income and more advantaged young adults.

Figure. Mean State-Level E-Cigarette Initiation Rates Among Young Adults

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