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KHN’s ‘What The Health?’: Elections Matter


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Big Democratic wins in the 2019 off-year elections could spell big changes for Medicaid and other health policies in Virginia and Kentucky.

Meanwhile, on the campaign trail, Mass. Sen. Elizabeth Warren’s new “Medicare For All” plan is getting hammered from all parts of the political spectrum, including most of her opponents for the Democratic presidential nomination.

And in Georgia, Republican Gov. Brian Kemp wants permission from the federal government to make major changes to both his state’s Medicaid program and the way people purchase individual insurance under the Affordable Care Act.

This week’s panelists are Julie Rovner of Kaiser Health News, Joanne Kenen of Politico, Caitlin Owens of Axios and Kimberly Leonard of the Washington Examiner.

Among the takeaways from this week’s podcast:

  • In Kentucky, the governor’s race featured incumbent Republican Matt Bevin, an opponent of the Affordable Care Act, versus Attorney General Andy Beshear, a supporter. Under Bevin, Kentucky tried to institute a work requirement for Medicaid recipients (currently blocked by federal courts). Beshear said in his victory speech Tuesday night he would withdraw the plan.
  • The Kentucky race is not quite over, however. The margin of victory for Beshear was so small that Bevin is not yet conceding.
  • Meanwhile, in Virginia, Democrats won both houses of the state legislature — giving them complete control of the state capital. Virginia struggled to pass Medicaid expansion and ultimately was able to do so only by including a work requirement to gain some GOP support. It’s not likely that policy will now take effect.
  • A common thread in these elections is that Medicaid has proven to be a popular political issue. Republicans have embraced a strategy in which opposing Medicaid would garner support but this is proving not the case.
  • In Georgia, GOP Gov. Brian Kemp wants to add his own work requirement as a condition for the state to expand Medicaid. He also wants to reconfigure the individual insurance market to allow people to get federal subsidies to purchase cheaper plans with fewer benefits.
  • Democratic presidential candidate Sen. Elizabeth Warren is still getting heat over her proposal to pay for the Medicare For All plan she has been pushing.
  • It’s clear that Warren’s plan — or any Medicare For All plan — would be an enormous lift both politically and financially and would cause significant dislocation in more than just the health care industry.
  • Also still a question is whether putting out so much detail is good for Warren politically. If she wins the nomination, support for such a dramatic change might alienate more moderate voters. On the other hand, candidates frequently moderate their positions between primary and general elections.

Also this week, Rovner interviews KHN’s Laura Ungar, who wrote the latest KHN-NPR “Bill of the Month” installment about a women who bought a health insurance policy that didn’t cover some services — and then ended up needing those services. If you have an outrageous medical bill you would like to share with us, you can do that here.

Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read too:

Julie Rovner: Politico’s “Why North Carolina might be the most innovative health care state in America,” by Joanne Kenen

Caitlin Owens: ProPublica’s “How One Employer Stuck a New Mom With a $898,984 Bill for Her Premature Baby,” by Marshall Allen

Joanne Kenen: Politico’s “How the FDA and EPA’s failure to communicate could put patients in danger,” by Sarah Karlin-Smith, Annie Snider and Sarah Owermohle

Kimberly Leonard: Bloomberg Businessweek’s “America’s Largest Health Insurer Is Giving Apartments to Homeless People,” by John Tozzi


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Related Topics

Cost and Quality Elections Health Industry Insurance Medicaid Multimedia States The Health Law