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The GOP Circles the Wagons on ACA

Episode 423

Nov. 20, 2025

Republicans are solidifying their opposition to extending pandemic-era subsidies for Affordable Care Act plans and seem to be coalescing around giving money directly to consumers to spend on health care. Meanwhile, HHS Secretary Robert F. Kennedy Jr. continues to leave his mark on the agency, with the CDC altering its website to suggest childhood vaccines could play a role in causing autism. Paige Winfield Cunningham of The Washington Post, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico Magazine, and Shefali Luthra of The 19th join KFF Health News’ Julie Rovner to discuss those stories and more. Also this week, Rovner interviews Avik Roy.

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COVID-19

Analysis: He Got Tested For Coronavirus. Then Came The Flood Of Medical Bills.

Hidden costs for ER visits and other fees could cost people thousands of dollars.

By Elisabeth Rosenthal and Emmarie Huetteman

April 1, 2020

Bill Of The Month

Her Genetic Test Revealed A Microscopic Problem — And A Jumbo Price Tag

Molecular diagnostics are at the frontier of science, but insurance and billing questions create a minefield for patients.

By Liz Szabo

March 31, 2020

Last Thing Patients Need During Pandemic: Being Last to Know a Doctor Left Network

Health plan network changes occur all the time as doctors retire, relocate or leave networks. Unfortunately, patients may be the last to find out about such changes because there are often few requirements that either providers or insurers inform them.

By Michelle Andrews

July 27, 2020

One Defensive Strategy Against Surprise Medical Bills: Set Your Own Terms

By writing in payment limits when signing hospital forms, patients might have leverage in negotiations over disputes that arise from surprise medical bills.

By Julie Appleby

Feb. 11, 2020

Bill Of The Month

COVID Tests Are Free, Except When They’re Not

Her doctor worried she had COVID-19 but couldn’t test her for it until she ruled out other things. That test cost a bundle.

By Carmen Heredia Rodriguez

April 29, 2020

Citing COVID, Sutter Pushes To Revisit Landmark Antitrust Settlement

Six months after agreeing to a $575 million settlement in a landmark antitrust case, Sutter Health has yet to pay a single dollar and now says the terms may be untenable, given the strain caused by the pandemic.

By Jenny Gold

June 17, 2020

Bill Of The Month

Appendicitis Is Painful — Add A $41,212 Surgery Bill To The Misery

A young man averted medical disaster after a friend took him to the nearest hospital just before his appendix burst. But more than a year later, he’s still facing a $28,000 balance bill for his out-of-network surgery.

By Julie Appleby

Jan. 29, 2020

KHN & PolitiFact HealthCheck

Trump Wrongly Said Health Insurers Will Pay For All Coronavirus Treatment

There are important distinctions between how insurance companies will cover the test and the treatment. This makes the president’s statement an exaggeration, at best.

By Shefali Luthra and Amy Sherman, PolitiFact

March 13, 2020

Analysis: Who Profits From Steep Medical Bills? The People Tasked With Fixing Them.

Surprise bills are just the latest weapons in a decades-long war among health care industry players over who gets to keep the fortunes generated each year from patient illness: $3.6 trillion in 2018. The practice is an outrage, yet no one in the health care sector wants to unilaterally make the type of big concessions that would change things.

By Elisabeth Rosenthal

Feb. 19, 2020

Bill Of The Month

For Her Head Cold, Insurer Coughed Up $25,865

A New York City woman, worried that her sore throat might be strep, got swabbed at her doctor’s office. The sample was sent to an out-of-network lab for sophisticated DNA tests ― with a price tag similar to a new SUV.

By Richard Harris, NPR News

Dec. 23, 2019

California Surprise-Billing Law Protects Patients But Aggravates Many Doctors

A California law, which took effect in July 2017, protects consumers who use an in-network hospital or other facility from surprise bills when cared for by an out-of-network doctor. But physicians say the law has allowed insurers to shrink networks, limiting access to those doctors who have contracted with the patients’ insurance plans.

By Michelle Andrews

Dec. 5, 2019

KHN Impact

Loophole Averted After Surprise-Bill Brouhaha In Texas

The Texas Medical Board bowed out of the rule-making process for a new law protecting consumers from surprise medical bills. Advocates hailed the new rules written by the state insurance regulators.

By Ashley Lopez, KUT

Dec. 19, 2019

Last-Minute Loophole Could Undermine Texas Law Against Surprise Medical Bills

Texas passed a bipartisan law against surprise medical billing, but advocates warn that a proposed rule could severely weaken it, continuing to allow surprise bills outside of emergencies.

By Ashley Lopez, KUT

Nov. 25, 2019

Podcast

KHN’s ‘What The Health?’: Live from D.C. With Rep. Donna Shalala

President Donald Trump’s proposed budget includes billions of dollars in health spending cuts, Congress gets back to work on surprise medical bills, and health care remains a top issue for the 2020 Democratic presidential candidates. Rep. Donna Shalala (D-Fla.), a former Health and Human Services secretary, joins the panel at a special taping before a live audience in Washington, D.C. Paige Winfield Cunningham of The Washington Post, Rebecca Adams of CQ Roll Call and Joanne Kenen of Politico join KHN’s Julie Rovner to discuss these issues and more.

Feb. 13, 2020

Affordable Mental Health Care? It’s Getting Even Tougher to Access

More than a decade after Congress passed a law mandating equal access for mental and physical health care, Americans struggle to find affordable, in-network mental health providers.

By Jenny Gold

Nov. 20, 2019

COVID-19

COVID-19 Bonanza: Stimulus Hands Health Industry Billions Not Directly Related To Pandemic

Congress retreats on long-planned cost cuts to benefit the health care industry with a grab bag full of incentives.

By Fred Schulte

March 30, 2020

Loopholes Limit New California Law To Guard Against Lofty Air Ambulance Bills

A new state law limits what consumers owe if they’re transported by an air ambulance that’s not part of their insurance network to the amount that they’d be charged if they used an in-network provider. But the law won’t protect millions of consumers whose health plans aren’t regulated by the state.

By Michelle Andrews

Jan. 14, 2020

Podcast

KHN’s ‘What The Health?’: Fact-Checking President Trump’s State Of The Union

President Donald Trump spent a good deal of time on health issues in his State of the Union address, but not everything he said checks out. Meanwhile, Iowa Democrats heading into the caucuses said health is their top issue, but it’s hard to see how that played out in their actual choices. Margot Sanger-Katz of The New York Times, Kimberly Leonard of the Washington Examiner and Alice Miranda Ollstein of Politico join KHN’s Julie Rovner to discuss this and more. Also, Rovner interviews KHN’s Julie Appleby and NPR’s Selena Simmons-Duffin about the latest “Bill of the Month” feature.

Feb. 6, 2020

When Your Doctor Is Also A Lobbyist: Inside The War Over Surprise Medical Bills

As lawmakers consider bills to protect patients against surprise medical bills, doctors have waged a stealth on-the-ground campaign to win over members of Congress. Here’s how they did it.

By Rachana Pradhan

Feb. 12, 2020

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