Tag: Multimedia

Watch: Fifty Years after ‘Roe,’ Abortion Rights Battle Shifts to the States

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Sunday marked the 50th anniversary of the Supreme Court’s landmark ruling in Roe v. Wade, granting federal constitutional protection for the right to seek an abortion. Last year, a very different Supreme Court overturned Roe, erasing that federal right for women across the United States and, instead, giving individual states broad authority to regulate and restrict abortion within their borders.

In this report co-produced by PBS NewsHour, KHN senior correspondent Sarah Varney joins “PBS News Weekend” anchor John Yang to discuss how abortion opponents and supporters are taking their campaigns to the states, the impact of abortion bans on medical care for women, and the emerging conflicts over medication abortion pills.

We asked people across the country what the abrupt shift in abortion access has meant to them, and we lay out the stakes in the political battles ahead.

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As US Bumps Against Debt Ceiling, Medicare Becomes a Bargaining Chip

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While repealing the Affordable Care Act seems to have fallen off congressional Republicans’ to-do list for 2023, plans to cut Medicare and Medicaid are back. The GOP wants Democrats to agree to cut spending on both programs in exchange for a vote to prevent the government from defaulting on its debts.

Meanwhile, the nation’s health care workers — from nurses to doctors to pharmacists — are feeling the strain of caring not just for the rising number of insured patients seeking care, but also more seriously ill patients who are difficult and sometimes even violent.

This week’s panelists are Julie Rovner of KHN, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, Tami Luhby of CNN, and Victoria Knight of Axios.

Among the takeaways from this week’s episode:

  • Conservative House Republicans are hoping to capitalize on their new legislative clout to slash government spending, as the fight over raising the debt ceiling offers a preview of possible debates this year over costly federal entitlement programs like Medicare.
  • House Speaker Kevin McCarthy said Republicans will protect Medicare and Social Security, but the elevation of conservative firebrands — like the new chair of the powerful House Ways and Means Committee — raises questions about what “protecting” those programs means to Republicans.
  • Record numbers of Americans enrolled for insurance coverage this year under the Affordable Care Act. Years after congressional Republicans last attempted to repeal it, the once highly controversial program also known as Obamacare appears to be following the trajectory of other established federal entitlement programs: evolving, growing, and becoming less controversial over time.
  • Recent reports show that while Americans had less trouble paying for health care last year, many still delayed care due to costs. The findings highlight that being insured is not enough to keep care affordable for many Americans.
  • Health care workers are growing louder in their calls for better staffing, with a nursing strike in New York City and recent reports about pharmacist burnout providing some of the latest arguments for how widespread staffing issues may be harming patient care. There is bipartisan agreement in Congress for addressing the nursing shortage, but what they would do is another question.

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

Julie Rovner: Roll Call’s “NIH Missing Top Leadership at Start of a Divided Congress,” by Ariel Cohen

Tami Luhby: CNN’s “ER on the Field: An Inside Look at How NFL Medical Teams Prepare for a Game Day Emergency,” by Nadia Kounang and Amanda Sealy

Joanne Kenen: The Atlantic’s “Don’t Fear the Handshake,” by Katherine J. Wu

Victoria Knight: The Washington Post’s “‘The Last of Us’ Zombie Fungus Is Real, and It’s Found in Health Supplements,” by Mike Hume

Also mentioned in this week’s podcast:

The New York Times’ “As France Moves to Delay Retirement, Older Workers Are in a Quandary,” by Liz Alderman

Stat’s “Congressional Medicare Advisers Warn of Higher Drug Prices, Despite New Price Negotiation,” by John Wilkerson

To hear all our podcasts, click here.

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GOP House Opens With Abortion Agenda

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Having spent its entire first week choosing a speaker, the Republican-led U.S. House finally got down to legislative business, including passing two bills backed by anti-abortion groups. Neither is likely to become law, because they won’t pass the Senate nor be signed by President Joe Biden. But the move highlights how abortion is sure to remain a high-visibility issue in the nation’s capital.

Meanwhile, as open enrollment for the Affordable Care Act nears its Jan. 15 close, a record number of people have signed up, taking advantage of renewed subsidies and other help with medical costs.

This week’s panelists are Julie Rovner of KHN, Margot Sanger-Katz of The New York Times, Alice Miranda Ollstein of Politico, and Sarah Karlin-Smith of the Pink Sheet.

Among the takeaways from this week’s episode:

  • The House now has a speaker after 15 rounds of full-chamber roll call votes. That paved the way for members to be sworn in, committee assignments to be made, and new committee chairs to be named. Cathy McMorris Rodgers (R-Wash.) and Jason Smith (R-Mo.) will be taking the helm of major health committees.
  • McMorris Rodgers will lead the House Energy and Commerce Committee; Smith will be the chairman of Ways and Means. Unlike McMorris Rodgers, Smith has little background in health issues and has mostly focused on tax issues in his public talking points. But Medicare is likely to be on the agenda, which will require the input of the chairs of both committees.
  • One thing is certain: The new GOP-controlled House will do a lot of investigations. Republicans have already reconstituted a committee to investigate covid-19, although, unlike the Democrats’ panel, this one is likely to spend time trying to find the origin of the virus and track where federal dollars may have been misspent.
  • The House this week began considering a series of abortion-related bills — “statement” or “messaging” bills — that are unlikely to see the light of day in the Senate. However, some in the caucus question the wisdom of holding votes on issues like these that could make their more moderate members more vulnerable. So far, bills have had mostly unanimous support from the GOP. Divisions are more likely to emerge on topics like a national abortion ban. Meanwhile, the Title X program, which pays for things like contraception and testing for sexually transmitted infections, is becoming a hot topic at the state level and in some lawsuits. A case in Texas would restrict contraception availability for minors through this program.
  • It’s increasingly clear that abortion pills are going to become an even bigger part of the abortion debate. On one hand, the FDA has relaxed some of the risk evaluation and mitigation strategies (REMS) from the prescribing rules surrounding abortion pills. The FDA puts these extra restrictions or safeguards in place for certain drugs to add additional protection. Some advocates say these pills simply do not bring that level or risk.
  • Anti-abortion groups are planning protests in early February at large pharmacies such as CVS and Walgreens to try to get them to walk back plans to distribute abortion pills in states where they are legal.
  • A growing number of states are pressuring the Department of Health and Human Services to allow them to import cheaper prescription drugs from Canada — or, more accurately, importing Canada’s price controls. While this has long been a bipartisan issue, it has also long been controversial. Officials at the FDA remain concerned about breaking the closed supply chain between drugs being manufactured and delivered to approved U.S. buyers. The policy is popular, however, because it promises lower prices on at least some drugs.
  • Also in the news from the FDA: The agency granted accelerated approval for Leqembi for the treatment of Alzheimer’s disease. Leqembi is another expensive drug that appears to work, but also carries big risks. However, it is generally viewed as an improvement over the even more controversial Alzheimer’s drug Aduhelm. Still to be determined is whether Medicare — which provides insurance to most people with Alzheimer’s — will cover the drug.
  • As the Affordable Care Act enrolls a record number of Americans, it is notable that repealing the law has not been mentioned as a priority for the new GOP majority in the House. Rather, the top health issue is likely to be how to reduce the price of Medicare and other health “entitlement” programs.

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

Julie Rovner: The Washington Post’s “Social Security Denies Disability Benefits Based on List With Jobs From 1977,” by Lisa Rein

Margot Sanger-Katz: Roll Call’s “Providers Say Medicare Advantage Hinders New Methadone Benefit,” by Jessie Hellmann

Alice Miranda Ollstein: The New York Times’ “Grant Wahl Was a Loving Husband. I Will Always Protect His Legacy.” By Céline Gounder

Sarah Karlin-Smith: KHN’s “Hospitals’ Use of Volunteer Staff Runs Risk of Skirting Labor Laws, Experts Say,” by Lauren Sausser

Also mentioned in this week’s podcast:

To hear all our podcasts, click here.

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KHN’s ‘What the Health?’: Year-End Bill Holds Big Health Changes

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Julie Rovner photo

The year-end government spending bill includes a lot of changes to federal health programs, including changes to Medicare payments and some structure for states to begin to disenroll people on Medicaid whose eligibility has been maintained through the pandemic.

Separately, the Biden administration took several steps to expand the availability of the abortion pill, which in combination with another drug can end a pregnancy within about 10 weeks of gestation. Anti-abortion forces have launched their own campaign to limit the reach of the abortion pill.

This week’s panelists are Julie Rovner of KHN, Rachel Cohrs of Stat, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, and Rachel Roubein of The Washington Post.

Among the takeaways from this week’s episode:

  • Congress ended the year by passing a nearly $1.7 trillion government spending package. The legislation included smaller-than-scheduled cuts to Medicare payments for physicians, extended telehealth flexibilities, and funding boosts for programs like the Indian Health Service and the federal 988 mental health hotline.
  • But lawmakers left out many priorities, such as more money in response to the covid-19 emergency, and included a change to Medicaid eligibility that could result in millions of Americans losing their health insurance.
  • The Biden administration took perhaps its biggest stand on abortion rights since the Supreme Court overturned Roe v. Wade last year, with the FDA announcing that retail pharmacies will be permitted to dispense abortion pills for the first time, and the Justice Department confirming that it is legal to send the pills through the U.S. Postal Service.
  • A new congressional report on Aduhelm, the controversial Alzheimer’s drug, reveals its manufacturer, Biogen, knew the impact its pricing could have on the Medicare program — and priced it high anyway. The report also raises big questions about the FDA’s decision-making in approving the drug and what some officials were willing to do to make it happen.
  • And in price transparency news, insurers are now required to provide patients with cost-estimating tools designed to make more than 500 nonemergency services “shoppable.” But it is unclear whether insurance companies are prepared to help consumers access and use that information.

Also this week, Rovner interviews Mark Kreidler, who wrote the latest NPR-KHN “Bill of the Month” feature, about two patients with the same name and a mistaken bill. If you have an outrageous or exorbitant medical bill you want 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: The New York Times’ “The F.D.A. Now Says It Plainly: Morning-After Pills Are Not Abortion Pills,” by Pam Belluck

Joanne Kenen: Politico Magazine’s “Racist Doctors and Organ Thieves: Why So Many Black People Distrust the Health Care System,” by Joanne Kenen and Elaine Batchlor

Rachel Cohrs: The New York Times’ “‘Major Trustee, Please Prioritize’: How NYU’s E.R. Favors the Rich,” by Sarah Kliff and Jessica Silver-Greenberg

Rachel Roubien: KHN’s “Hundreds of Hospitals Sue Patients or Threaten Their Credit, a KHN Investigation Finds. Does Yours?” by Noam N. Levey

Also mentioned in this week’s podcast:

Stat’s “’Rife With Irregularities’: Congressional Investigation Reveals FDA’s Approval of Aduhelm Marked by Secret Discussions, Breaches of Protocol,” by Rachel Cohrs

KHN’s “Want a Clue on Health Care Costs in Advance? New Tools Take a Crack at it,” by Julie Appleby

Stat’s “Congress Reaches Major Health Policy Deal on Medicare, Medicaid, and Pandemic Preparedness,” by Rachel Cohrs and Sarah Owermohle

USA Today’s “Half of Ambulance Rides Yield Surprise Medical Bills. What’s Being Done to Protect People?” by Ken Alltucker

To hear all our podcasts, click here.

And subscribe to KHN’s “What the Health?” on Spotify, Apple Podcasts, Stitcher, Pocket Casts, or wherever you listen to podcasts.

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KHN’s ‘What the Health?’: The Covid Response Coordinator Speaks

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Click here for a transcript of the episode.

Dr. Ashish Jha, the White House covid-19 response coordinator, is the guest for a wide-ranging interview on this week’s “What the Health?” podcast.

Jha, who is on leave from his “day job” as dean of the Brown University School of Public Health, said he’s particularly worried about the nation making the transition from public health emergency status back to a more normal footing and routine — particularly for low-income and uninsured people who may not be able to get the kind of covid tests, treatments, and vaccines that have so far been free through federal subsidies.

Jha said the Biden administration is doing more than the public realizes to study “long covid,” a set of conditions among a subset of patients who continue to suffer from an infection or its aftereffects, and to improve the quality of indoor air, which can help stem the spread of not only the coronavirus but other communicable respiratory diseases as well.

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KHN’s ‘What the Health?’: Health Spending? Only Congress Knows

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Congress has a tentative framework for government spending through this fiscal year. Now, lawmakers must fill in the blanks, including on key health care provisions, and get it passed. The Biden administration will send more free covid-19 home tests to Americans after initial fears the program was running out of money.

And there’s plenty of news coming in from the states, where this week a Texas judge tossed out a lawsuit based on the state’s so-called vigilante abortion law, and the governor of Florida is asking for a grand jury investigation into harm caused by covid vaccines.

This week’s panelists are Mary Agnes Carey of KHN, Rachel Cohrs of Stat, Alice Miranda Ollstein of Politico, and Rebecca Adams of KHN.

Among the takeaways from this week’s episode:

  • Congressional appropriators have settled on an omnibus framework that would set government spending through next fall and hope to pass it by the end of next week. But lawmakers still have details to iron out. While health measures like extended flexibilities for telehealth are likely to get approved — and others, like more money for pandemic response, are not — the outcome is less clear for some key provisions. Will lawmakers relax or even nix Medicare pay cuts for doctors scheduled for next year?
  • Pharmacy chains CVS and Walgreens announced a major settlement this week in lawsuits alleging they mishandled opioid prescriptions. Most of the settlement money awarded in ongoing opioid epidemic litigation is earmarked to pay for opioid-related treatment, and families of victims are also asking for compensation for the harm opioids have caused. Meanwhile, federal lawmakers have shown little urgency to respond to the country’s epidemic of opioid-related overdoses.
  • Abortion fights continued to play out in the states this week, including in Iowa, where a judge blocked an effort to ban most abortions in the state. In Texas, a judge dealt a blow to the state’s so-called vigilante law, ruling that an individual who is not directly affected by an abortion may not sue for violations of the state’s ban. Watch for the legal challenges to continue, especially as some state legislatures return to session in January for the first time since the Supreme Court overturned Roe v. Wade.
  • In pandemic news, the Biden administration plans to reopen its program allowing Americans to request free covid home tests through the U.S. Postal Service. And the House of Representatives select committee investigating the pandemic wrapped up its work this week, with Democrats and Republicans coming to different conclusions and issuing recommendations unlikely to come to pass — a reflection of partisan tensions and a loss of public interest in the pandemic.
  • And Gov. Ron DeSantis of Florida, a Republican who is considered a possible 2024 presidential candidate, has called for a grand jury to examine alleged “crimes and wrongdoing” related to the covid vaccines.

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

Mary Agnes Carey: Scientific American’s “Kindness Can Have Unexpectedly Positive Consequences,” by Amit Kumar

Rachel Cohrs: The Washington Post’s “From Heart Disease to IUDs: How Doctors Dismiss Women’s Pain,” by Lindsey Bever

Alice Miranda Ollstein: Stat’s “Watch: With Little More Than a Typewriter, an Idaho Man Overturns the Entire State’s Policy on Hepatitis C Treatment in Prison,” by Nicholas Florko

Rebecca Adams: KHN’s “Mass Shootings Reopen the Debate Over Whether Crime Scene Photos Prompt Change or Trauma,” by Lauren Sausser

Also mentioned in this week’s podcast:

To hear all our podcasts, click here.

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KHN’s ‘What the Health?’: Congress Races the Clock

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The lame-duck Congress is making slow progress on its long to-do-before-the-end-of-the-year list. Democrats agreed to lift the covid-19 vaccine mandate for the military as part of the big defense authorization bill, but efforts to ease federal restrictions on marijuana didn’t succeed.

Meanwhile, the fight against high drug prices has spread to employers, which are trying a variety of strategies to spend less on prescription drugs while still giving workers access to needed medications.

This week’s panelists are Julie Rovner of KHN, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, Anna Edney of Bloomberg News, and Sandhya Raman of CQ Roll Call.

Among the takeaways from this week’s episode:

  • The race to the holiday break is on, with no agreement so far on spending as current government funding is set to expire on Dec. 16. Although another continuing resolution is expected, it would likely leave out measures such as addressing mental health, so lawmakers would need to start over next year. The annual defense authorization bill is also in the works and would end the military’s covid vaccine mandate.
  • In the wake of the infant formula shortage, an FDA advisory group report this week said the agency’s work on food regulation needs a major overhaul, especially when it comes to enforcement power and leadership.
  • In drug pricing news, Americans can expect to see the costs of covid testing, vaccines, and treatments rise as federal subsidies run out and leave the pandemic response subject to the same cost and access disparities common to the nation’s health care system. Meanwhile, entrepreneur Mark Cuban’s discount prescription drugs company is teaming up with EmsanaRx, a nonprofit pharmacy benefit manager — thereby cutting out for-profit PBMs in another attempt to cut costs for patients.
  • Health care providers are pushing Congress to stop a long-planned cut in Medicare payments, while a new report from KFF shows the three largest for-profit hospital chains are seeing operating margins that exceed pre-pandemic levels. The Centers for Medicare & Medicaid Services also issued new rules this week on “prior authorization” that providers say could temper the bureaucratic hassle of dealing with Medicare. And private equity firms are getting into the game of running clinical trials, while in insurance, UnitedHealth Group is buying up providers.
  • On reproductive health, an Alabama woman is suing the county government that jailed her on the suspicion she had exposed her fetus to drugs. Her issue? She was not pregnant. The case raises questions about how changes to abortion access are playing out across the country.

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

Julie Rovner: The AP Stylebook’s “Abortion Topical Guide,” by The Associated Press

Anna Edney: The Washington Post’s “Drugs Killed 8 Friends, One by One, in a Tragedy Seen Across the U.S.,” by Lenny Bernstein and Jordan-Marie Smith

Joanne Kenen: Columbia Journalism Review’s “Anonymous Woman,” by Becca Andrews

Sandhya Raman: CQ Roll Call’s “At International Conference, Dobbs Dominates Debate,” by Sandhya Raman

Also mentioned in this week’s podcast:

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And subscribe to KHN’s What the Health? on Spotify, Apple Podcasts, Stitcher, Pocket Casts, or wherever you listen to podcasts.

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KHN’s ‘What the Health?’: Medicaid Machinations

Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts, or wherever you listen to podcasts.

The lame-duck Congress is back in Washington with a long list of bills it would like to pass and a short time to do it before Republicans take over the House majority in January. How many health-related items can be accomplished depends largely on how much money Congress agrees to spend overall, as it hashes out the annual federal spending bills.

Meanwhile, some of the remaining states that have not yet expanded the Medicaid program may be warming up to the idea, particularly North Carolina and Kansas, which have Democratic governors and Republican legislatures.

This week’s panelists are Julie Rovner of KHN, Alice Miranda Ollstein of Politico, Rachel Cohrs of Stat, and Sarah Karlin-Smith of the Pink Sheet.

Among the takeaways from this week’s episode:

  • How much the lame-duck Congress manages to accomplish will partly hinge on whether congressional leaders opt for an omnibus spending bill — which would complete the unfinished spending bills through September 2023 — versus a continuing resolution, which would simply extend what’s already on the books into sometime in the new year. Bottom line: Health priorities are competing for a pot of money, but it’s unclear how large that pot will be. Some insiders describe it as a traffic jam.
  • At the top of that list are FDA reforms that didn’t make it into the prescription drug user-fee reauthorization bill that passed this year. Lawmakers fought to keep that measure “clean,” leaving the door open to tackle some leftover issues. What, if anything, will make the final cut is yet to be seen.
  • Other things on the lame-duck list include reversing a 4% scheduled cut to Medicare providers’ reimbursements; weighing proposals related to pandemic preparedness; addressing Medicaid funding for U.S. territories; addressing the end of the public health emergency; and scrutinizing telehealth policy.
  • Among the states that have yet to expand Medicaid under the Affordable Care Act, action is possible by those with a Democratic governor and Republican legislature — Kansas and North Carolina, in particular. Advocates are targeting such places because coverage for hundreds of thousands of people could be at risk, especially as the official end of the public health emergency looms. The financial well-being of some rural and safety-net hospitals also is in jeopardy.
  • Georgia is poised to expand Medicaid eligibility somewhat, but only to people who can prove they worked or did community service for 80 hours per month. This comes after a federal judge ruled that the Biden administration’s move to cancel a Trump administration-approved waiver was “arbitrary and capricious.” The only other Medicaid work requirement that has taken effect, in Arkansas, ended up taking coverage away from thousands of people who were eligible and working, due to its complicated reporting system.
  • Anti-abortion groups seem keen on finding creative ways to take aim at the so-called abortion pill, which recently became the most common method of ending pregnancy in the United States. Medication abortions are much more difficult for anti-abortion groups to target, because women do not have to go to a clinic to receive the drugs.
  • One lawsuit sought to force the FDA to rescind its approval of mifepristone, dating to 2000. Anti-abortion groups say the agency didn’t have the authority to approve the drug through the “expedited” pathway it chose.
  • Another strategy from anti-abortion groups claims that the use of abortion pills is contaminating wastewater and groundwater; they seek to deploy environmental laws to block the use of the drugs.
  • Despite Americans’ desire to put the covid-19 pandemic in the rearview mirror, the virus may have other plans. The Biden administration wants another $10 billion before the end of the year to pay for its anti-covid campaign, although even Democrats in Congress are not pushing hard for that funding. Meanwhile, governments and social media platforms are still struggling to address covid misinformation and disinformation.

Also this week, Rovner interviews KHN’s Fred Clasen-Kelly, who reported and wrote the latest KHN-NPR “Bill of the Month,” about a mysterious mishap during minor surgery. If you have an enormous or mystifying medical bill you’d 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: Stat’s “Resistance to FDA’s Opioid-Disposal Plan Raises Concerns About CADCA, a Powerful Advocacy Group,” by Lev Facher

Alice Miranda Ollstein: ProPublica and The New York Times’ “She Wanted an Abortion. A Judge Said She Wasn’t Mature Enough to Decide,” by Lizzie Presser

Rachel Cohrs: The New Yorker’s “How Hospice Became a For-Profit Hustle,” by Ava Kofman

Sarah Karlin-Smith: The New York Times’ “Jail Is a Death Sentence for a Growing Number of Americans,” by Shaila Dewan

Also mentioned in this week’s episode:

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‘An Arm and a Leg’: When Insurance Won’t Pay, Abortion Assistance Funds Step In

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Click here for a transcript of the episode.

As Americans choose their insurance plans for next year, some might wonder: How does the recent rise in state abortion restrictions affect insurance plans?

There’s no single answer, but for a lot of people, insurance has rarely helped pay for abortions. Most pay cash, and many can’t afford it.

That’s where abortion funds come in. These organizations have been providing financial and logistical assistance to people seeking abortion care for decades.

The “An Arm and a Leg” podcast spoke with Oriaku Njoku, executive director of the National Network of Abortion Funds, and Tyler Barbarin, a board member with the New Orleans Abortion Fund, to understand the history behind these services and how they’re operating in a post-Roe v. Wade environment.

“An Arm and a Leg” is a co-production of KHN and Public Road Productions.

To keep in touch with “An Arm and a Leg,” subscribe to the newsletter. You can also follow the show on Facebook and Twitter. And if you’ve got stories to tell about the health care system, the producers would love to hear from you.

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