Podcast: KHN’s ‘What The Health?’ The GOP’s Health Reform Whiplash

April 4, 2019

President Donald Trump last week insisted that Republicans would move this year to “repeal and replace” the Affordable Care Act. Or possibly not. Senate Majority Leader Mitch McConnell made it clear the GOP Senate did not plan to spend time on the effort as long as the House is controlled by Democrats. So, the president changed his tune. At least for the moment.

Meanwhile, states with legislatures and governors that oppose abortion are racing to pass abortion bans and get them to the Supreme Court, where, they hope, the new majority there will overturn or scale back the current right to abortion.

This week’s panelists are Julie Rovner of Kaiser Health News, Rebecca Adams of CQ Roll Call, Anna Edney of Bloomberg News and Alice Miranda Ollstein of Politico.

Also, Rovner interviews KHN’s Paula Andalo, who wrote the latest “Bill of the Month” feature about a very expensive knee brace.

If you have an exorbitant or inexplicable medical bill you’d like to submit for our series, you can do that here.

Among the takeaways from this week’s podcast:

Although Trump’s political base may support his actions to undermine the entire federal health law, Republican lawmakers are flummoxed. They are hesitant to take up the cause because Democrats used the issue so effectively against Republicans in last fall’s election. They also know that many Republicans like key provisions of the health law, such as its closing of the doughnut hole in the Medicare drug benefit, letting adult children stay on parents’ plans up to the age of 26 and protecting people with preexisting conditions.
The unveiling this week of a new Democratic health initiative — Medicare X — signals an increasing push by party moderates to move away from progressives’ call to dramatically reshape American health care with a “Medicare-for-all” system. Medicare X is a much smaller initiative that would allow some people to buy in to the Medicare system, but it would be rolled out gradually over a number of years.
In other ACA news, a federal judge struck down the administration’s regulations allowing small businesses to join association health plans, saying it was an end run to avoid the health law. Thousands of people could be affected by the decision, and Labor Secretary Alex Acosta said he will decide by the end of the May whether to appeal.
Anti-abortion activists in many states are pushing new laws to test whether the retirement last summer of Justice Anthony Kennedy has left the Supreme Court more willing to turn back the Roe v. Wade decision. Among the types of cases going forward are state laws that would ban abortions once a fetal heartbeat could be determined, which often happens about six weeks into a pregnancy or before many women even know they are pregnant.
Despite a stiff rejection last week by a federal judge who overturned the Trump administration’s permission for work requirements in the Medicaid expansion approved in Arkansas and Kentucky, federal officials said that Utah could go forward with a plan to start work requirements as part of a partial expansion. Supporters of the ACA insist that expansion should be for anyone earning up to 138% of the federal poverty level. But the issue is tough for Democrats, some of whom say a partial expansion is better than none.

Ask Us Anything!

Do you have a health policy question you’d like the panelists to answer? You can send it to whatthehealth@kff.org. Please include where you’re from and how to pronounce your name.