Tagged Surprise Bills

KHN’s ‘What The Health?’: Despite Booming Economy, Uninsured Rate Ticks Up


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The annual report from the Census Bureau, released this week, found that 27.5 million Americans were without health insurance last year, an increase of nearly 2 million from 2017. The 0.5 percentage point increase in the uninsured rate — to 8.5% — was the first in a decade and came as unemployment and other economic indicators have been good.

Meanwhile, the Trump administration signaled that it is moving to ban flavored vaping liquid used in e-cigarettes. Companies making the products have been accused of marketing to underage users with flavors like mango and bubble gum.

And Congress is back from its summer break, with legislation to address rising prescription drug prices and surprise medical bills still on the agenda.

This week’s panelists are Julie Rovner of Kaiser Health News, Joanne Kenen of Politico, Tami Luhby of CNN and Rebecca Adams of CQ Roll Call.

Among the takeaways from this week’s podcast:

  • The Census Bureau’s report this week defied usual economic models. Normally, the more people employed, the more people insured.
  • Health advocates blame a variety of actions by the Trump administration for the lower rate of insured Americans. Those include policies intended to deter people from staying on or signing up for Medicaid; the elimination of the tax penalty for not having coverage; and the announcement that immigrants’ use of public benefits such as Medicaid could affect their ability to get a green card allowing them to live and work in the U.S.
  • The biggest surprise in the Census Bureau report was the increase in children without insurance. Coverage for kids has generally been a bipartisan goal on Capitol Hill. It’s not clear what caused that drop. It could just be a result of differences in how the survey was conducted, or it may be another sign of immigrants worried about whether using public insurance could lead to their deportation.
  • The administration’s announcement that it is moving forward on a ban of flavored vaping products comes as worries grow among parents and public health officials about an epidemic of lung problems around the country. Among those worried parents is first lady Melania Trump.
  • House Speaker Nancy Pelosi appears to be inching closer to releasing her plan to curb high drug prices. It’s not clear yet whether President Donald Trump will sign on to her effort. But Sen. Chuck Grassley (R-Iowa) is seeking support for his more modest plan instead, arguing to his Republican colleagues that if they don’t stand with him, they may be forced to accept Pelosi’s legislation if she manages to make a deal with the president.
  • Opponents of some of the legislation to curb surprise medical bills appear to have made progress over Congress’ August recess with a major advertising campaign saying the measures would hurt local hospitals and doctors. Advocates say the legislation is not dead, but the strong momentum it had is waning.

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

Julie Rovner: Vox.com’s “This life-threatening pregnancy complication is the next frontier in the abortion debate,” by Anna North

Joanne Kenen: The New York Times’ “Nursing Homes Are a Breeding Ground for a Fatal Fungus,” by Matt Richtel and Andrew Jacobs

Rebecca Adams: Kaiser Health News’ “‘UVA Has Ruined Us’: Health System Sues Thousands Of Patients, Seizing Paychecks And Claiming Homes,” by Jay Hancock and Elizabeth Lucas

Tami Luhby: The New York Times’ “Bernie Sanders Went to Canada, and a Dream of ‘Medicare for All’ Flourished,” by Sydney Ember

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Legislation To End Surprise Medical Bills Has High Public Support — In Both Parties

Nearly 8 in 10 Americans support legislation to protect people from surprise medical bills, a new poll from the Kaiser Family Foundation shows.

That support persisted no matter which party was asked: 84% of Democrats, 78% of independents and 71% of Republicans said they support surprise billing legislation, according to the poll. (Kaiser Health News is an editorially independent program of the foundation.)

Surprise bills are the unexpected ― and often expensive — charges patients receive after getting care from a doctor or hospital not in their insurance network. The issue has attracted a lot of attention in recent years, with ongoing projects like KHN-NPR’s “Bill of the Month” series and Vox’s look at emergency room bills illuminating the scope of the problem. The White House and both parties on Capitol Hill have expressed interest in finding ways to protect consumers from the practice.

But Congress has been bombarded by relentless attack ads and deep-pocketed lobbying against legislation that would end surprise billing.

And with lawmakers returning to work this week after the summer recess, some of the supporters of legislation on Capitol Hill worry that effort may destroy their chances of passing an effective law.

Critics claim that the primary legislation under consideration — in which a patient’s insurance would pay the out-of-network provider based on the average of what other doctors nearby are paid — would result in doctors and hospitals being paid less.

But the KFF poll found 57% of respondents support passing legislation to address the problem even after hearing the critics’ argument.

And as Democratic and Republican politicians alike discuss dismantling the ACA, whether through implementing a “Medicare for All” plan or ruling the existing law unconstitutional, the poll also found the public has some reservations about making drastic changes to the health system.

Ahead of Thursday night’s Democratic presidential debate, the poll found that 55% of Democrats and Democratic-leaning independents prefer a presidential candidate who wants to build on the ACA. About 40% said they prefer one who wants to replace it with a Medicare for All plan, which some advocates such as Democratic presidential candidate Sen. Bernie Sanders suggest would provide a single health plan for the entire country and replace all private insurance.

Those numbers are nearly identical to the findings in KFF’s last tracking poll in July.

KFF’s new poll showed the polarization that could undermine Democrats’ chances of unifying behind a single presidential candidate in 2020: 14% of Democrats and Democratic-leaning independents said they would vote only for a candidate who wants to replace the ACA with Medicare for All.

It also found 69% of all Americans support a government-administered public option health plan that consumers could opt into, a policy former Vice President Joe Biden included in his health plan. About 41% of Republicans said they support a public option.

That said, the poll shows many respondents do not see the difference between the policies that Democratic candidates are pitching: About 47% said a public option and a Medicare for All plan are similar.

The new poll also shows that support for the Affordable Care Act has hit an all-time high among Democrats, with 84% saying they view it favorably. The ACA became law in 2010.

KFF’s findings confirm that the Donald Trump presidency has galvanized Democratic support for the ACA, former President Barack Obama’s signature domestic policy. The percentage of Democrats who favor the law has increased by 11 percentage points since February 2017.

Among other policy questions, 70% of those surveyed said lowering prescription drug costs should be a major health care-related priority for Congress, and 69% said maintaining the ACA’s protections for those with preexisting conditions should be a top priority.

The KFF poll was conducted Sept. 3-8, with researchers surveying 1,205 adults by landline and cellphone, in English and Spanish. The margin of error is plus or minus 3 percentage points.