Tagged Trump Administration

Podcast: KHN’s ‘What The Health?’ You Have Questions, We Have Answers

This week, KHN’s “What the Health?” panelists answered questions submitted by listeners.

Among the topics covered were what might happen to parts of the Affordable Care Act if a lawsuit now working its way through the courts succeeds in declaring the health law unconstitutional, and how Medicare and Medicaid deal with surprise medical bills from out-of-network providers.

This week’s panelists are Julie Rovner of Kaiser Health News, Jennifer Haberkorn of the Los Angeles Times, Joanne Kenen of Politico and Kimberly Leonard of the Washington Examiner.

The panel addressed questions including the following:

  • What would happen to the Medicare Part D “doughnut hole” if the entire ACA is struck down, and would newer bills, such as the Bipartisan Budget Act, which helped close the coverage gap for brand-name drugs one year early, prevent this feature of the ACA from being eliminated?
  • Will the Health Insurance Portability and Accountability Act (HIPAA) of 1996 remain if the ACA is completely overturned?
  • Since surprise medical bills aren’t allowed in Medicare and Medicaid, what happens when an anesthesiologist or contract emergency room doctor who doesn’t accept Medicare or Medicaid treats an enrolled patient? Do they take a lower rate? Does the hospital make up the difference? Why can’t this be applied to all out-of-network arrangements?
  • Statistics show that approximately 5% to 10% of the population accounts for about 50% of total health care spending. Who makes up this population? Are there any reasonable proposals to address the health of this population and perhaps reduce spending while improving outcomes?

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

Julie Rovner: Kaiser Health News’ “Lethal Plans: When Seniors Turn To Suicide In Long-Term Care,” by Melissa Bailey and JoNel Aleccia

Jennifer Haberkorn: The New York Times’ “Insurers Want to Know How Many Steps You Took Today,” by Sarah Jeong

Joanne Kenen: Vox.com’s “Walmart’s $25 Insulin Can’t Fix the Diabetes Drug Price Crisis,” by Julia Belluz

Kimberly Leonard: The [Columbia, S.C.] State’s “SC Inmate’s Baby Died in Toilet: Lawsuits Allege Rampant Medical Neglect in Prisons,” by Emily Bohatch

And, The Atlanta Journal-Constitution’s “For Some in Ga. Prisons and Jails, Diabetes Has Meant a Death Sentence,” by Danny Robbins

To hear all our podcasts, click here.

And subscribe to What the Health? on iTunesStitcher, Google Play or Spotify.

Podcast: KHN’s ‘What The Health?’ You Have Questions, We Have Answers

This week, KHN’s “What the Health?” panelists answered questions submitted by listeners.

Among the topics covered were what might happen to parts of the Affordable Care Act if a lawsuit now working its way through the courts succeeds in declaring the health law unconstitutional, and how Medicare and Medicaid deal with surprise medical bills from out-of-network providers.

This week’s panelists are Julie Rovner of Kaiser Health News, Jennifer Haberkorn of the Los Angeles Times, Joanne Kenen of Politico and Kimberly Leonard of the Washington Examiner.

The panel addressed questions including the following:

  • What would happen to the Medicare Part D “doughnut hole” if the entire ACA is struck down, and would newer bills, such as the Bipartisan Budget Act, which helped close the coverage gap for brand-name drugs one year early, prevent this feature of the ACA from being eliminated?
  • Will the Health Insurance Portability and Accountability Act (HIPAA) of 1996 remain if the ACA is completely overturned?
  • Since surprise medical bills aren’t allowed in Medicare and Medicaid, what happens when an anesthesiologist or contract emergency room doctor who doesn’t accept Medicare or Medicaid treats an enrolled patient? Do they take a lower rate? Does the hospital make up the difference? Why can’t this be applied to all out-of-network arrangements?
  • Statistics show that approximately 5% to 10% of the population accounts for about 50% of total health care spending. Who makes up this population? Are there any reasonable proposals to address the health of this population and perhaps reduce spending while improving outcomes?

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

Julie Rovner: Kaiser Health News’ “Lethal Plans: When Seniors Turn To Suicide In Long-Term Care,” by Melissa Bailey and JoNel Aleccia

Jennifer Haberkorn: The New York Times’ “Insurers Want to Know How Many Steps You Took Today,” by Sarah Jeong

Joanne Kenen: Vox.com’s “Walmart’s $25 Insulin Can’t Fix the Diabetes Drug Price Crisis,” by Julia Belluz

Kimberly Leonard: The [Columbia, S.C.] State’s “SC Inmate’s Baby Died in Toilet: Lawsuits Allege Rampant Medical Neglect in Prisons,” by Emily Bohatch

And, The Atlanta Journal-Constitution’s “For Some in Ga. Prisons and Jails, Diabetes Has Meant a Death Sentence,” by Danny Robbins

To hear all our podcasts, click here.

And subscribe to What the Health? on iTunesStitcher, Google Play or Spotify.

Planned Parenthood’s ‘Risky Strategy’ To Update Its Image

PROVIDENCE, R.I. — The Trump administration is pushing ahead with its reproductive health agenda. It has rolled out changes to the Title X program, which funds family planning services for low-income people, that are designed to have a chilling effect on organizations that provide abortions or include this option in counseling. It also has nominated federal judges widely believed to support state-level abortion restrictions.

Against that backdrop, Planned Parenthood, known as a staunch defender of abortion rights, is working to recast its public image. Under its president, Dr. Leana Wen, who took office in November, the nation’s largest reproductive health provider is highlighting the breadth of care it provides — treating depression, screening for cancer and diabetes, and taking on complex health problems like soaring maternal mortality rates.

This strategy, analysts say, could buttress Planned Parenthood against the efforts by the White House and other abortion opponents. But it’s complicated. Even as the organization leans into its community health work, Wen isn’t abandoning the abortion-related services that have helped form the organization’s identity — and its opposition.

“We cannot separate out one of our services. That’s not how medicine works,” Wen told Kaiser Health News.

This effort to thread the needle could, if successful, change the public’s perception of Planned Parenthood. But if it backfires, it could make the organization even more vulnerable. Some people are skeptical of the payoff, given how polarizing abortion politics are.

“The minute you start talking about abortion, it’s a risky strategy,” said Karen O’Connor, a political scientist at American University who studies the politics of reproductive health care. It’s likely to attract strong reactions from people who see abortion providers not as reproductive health professionals but as “baby killers,” she said.

“If I was doing it — and this is as somebody who studies social movements and women’s organizations — I would take abortion out of the equation and talk about ‘reproductive health is health care.’”

Already, the new strategy is drawing fire from abortion opponents, who dismiss Planned Parenthood’s positioning as a frontline community health provider.

“This framing is simply a PR exercise,” said Mallory Quigley, vice president of communications at the Susan B. Anthony List, a Washington-based anti-abortion group. “I don’t think this campaign will be successful, and I don’t think it will last long.”

Reproductive health experts have a different view, saying Planned Parenthood’s effort to promote its array of health care offerings — including abortion — is consistent with reality and in line with top medical standards. To bolster this message, Wen, a former Baltimore health commissioner and the first physician to take the group’s helm, has embarked on a national listening tour.

“It’s who we are. We are a health care organization,” Wen said. “That’s what all of our affiliates do around the country, is meeting people where they are with the health services they need.”

So far, Wen and other Planned Parenthood officials have visited 17 affiliates in locations around the country. They plan to visit several more, Wen’s staff confirmed.

The idea is not to standardize what Planned Parenthood sites offer, Wen said, arguing that each clinic should take the lead in devising its own public health programs, based on its patients. Even so, the organization’s national leadership is working to identify the health programs that could be expanded and encouraging clinics around the country to consider implementing those best practices.

Recently, Wen and her team visited the organization’s Rhode Island clinic to investigate how it is planning to expand its primary care offerings.

The clinic, a 10-minute walk from downtown Providence, serves patients of all genders and ages, its staff noted. It has upped its focus on things like wellness visits, along with its programs to make sure patients who want to have children are healthy before they get pregnant.

Wen also focused on the clinic’s efforts to reduce the area’s maternal mortality rates, a problem that afflicts low-income and black women at far greater rates. In 2018, 18.3 Rhode Island women per 100,000 births died from causes related to the pregnancy; for black women, the figure was 47.2 per 100,000, and for white women, 18.1. Planned Parenthood leadership touted proposed state legislation that would extend Medicaid coverage to doulas, non-medical birth coaches often seen as a valuable resource in reducing maternal deaths.

Dr. Leana Wen, president of Planned Parenthood, speaks with staff from Planned Parenthood Mar Monte.(Anna Maria Barry-Jester)

Wen tours a lab in the basement of a San Jose, Calif., clinic that processes tests for gonorrhea and chlamydia. “When I was in college, we did all the pipetting manually,” she told the staff.(Anna Maria Barry-Jester)

At a Planned Parenthood Mar Monte clinic in San Jose, Calif., staff members highlighted the facility’s mental health services — keeping behavioral health professionals in the building to help patients transition seamlessly into care — and its in-house testing center for sexually transmitted infections.

At both clinics, staffers talked about helping patients who face a threat of domestic violence find safe housing resources, and steering them toward available resources for things like healthy food.

Even while promoting that work — often overlooked by the public — Wen, a 36-year-old emergency doctor by training, emphasizes abortion services at each stop, trying to weave the message into the public health narrative.

In Providence, the Planned Parenthood team stopped by a news conference to talk about a local bill that, if the Supreme Court scales back Roe v. Wade, would explicitly legalize abortion protections in Rhode Island.

“Abortion is part of the spectrum of full reproductive health care, and we know reproductive health care is health care,” Wen said to applause. “And health care is a human right.”

But it’s unclear how the listening tour and messaging efforts will pan out politically. While a majority of Americans have positive opinions of Planned Parenthood, they are, polling suggests, evenly split on abortion.

“Planned Parenthood to some extent is taking a risky strategy by trying to thread these two. I see these as very different messages,” said O’Connor, the political scientist. “If you take out the ‘abortion is’ and go to reproductive health, you have a winning message that is very simple.”

In other ways, though, this branding effort perhaps comes at the right time, suggested Lucinda Finley, a law professor at the University at Buffalo. She ties the organization to what polling suggests is voters’ No. 1 concern, especially going into the 2020 election: health care.

Framing it as “‘Abortion is health care, health care is a human right’ links it to the larger debate about health care, and how we should provide health care to people in this country,” Finley said.

When asked if this messaging could politically insulate Planned Parenthood from conservative attacks — or win the organization new supporters — Wen suggested the community health emphasis is simply a response to medical needs.

“I don’t want people to think we are doing this because it’s politically the right thing to do,” she said. “It’s the right thing to do because that’s what our patients are requesting.”

Watch: ACA’s Future And ‘Medicare-For-All’ Front And Center As Candidates Line Up For 2020

Julie Rovner, KHN’s chief Washington correspondent, joined C-SPAN host Bill Scanlan Tuesday morning on “Washington Journal” to discuss how health care is playing out in the current political debate. They talked about the Republican-sponsored lawsuit to overturn the Affordable Care Act and the backing by many Democratic candidates of a “Medicare-for-all” health plan, and took questions from viewers about a wide variety of health issues. The video is available on the C-SPAN website.

Rovner also was on NPR’s “Weekend Edition Saturday” with host Scott Simon to talk about Sen. Bernie Sander’s “Medicare-for-all” proposal. That is available on the NPR website.

Watch: ACA’s Future And ‘Medicare-For-All’ Front And Center As Candidates Line Up For 2020

Julie Rovner, KHN’s chief Washington correspondent, joined C-SPAN host Bill Scanlan Tuesday morning on “Washington Journal” to discuss how health care is playing out in the current political debate. They talked about the Republican-sponsored lawsuit to overturn the Affordable Care Act and the backing by many Democratic candidates of a “Medicare-for-all” health plan, and took questions from viewers about a wide variety of health issues. The video is available on the C-SPAN website.

Rovner also was on NPR’s “Weekend Edition Saturday” with host Scott Simon to talk about Sen. Bernie Sander’s “Medicare-for-all” proposal. That is available on the NPR website.

Mulvaney: Trump Brought Down Drug Prices For The First Time In 50 Years

President Donald Trump announced last month that the GOP will become “the party of health care,” and news reports suggest he intends to make it a top issue in his reelection campaign.

So when Mick Mulvaney, the acting White House chief of staff, touted the administration’s work on prescription drug prices — a hot-button issue that has drawn scrutiny from across the political spectrum, and one that voters say should be a top priority — we were intrigued.

On “Fox News Sunday” April 7, Mulvaney said: “Drug prices in this country actually came down last year for the first time in 50 years. That’s because Donald Trump’s president.”

This statement is particularly hard to prove affirmatively. Drug prices are measured through a host of metrics and affected by all sorts of political and economic forces.

We reached out to the White House for more explanation. Its staff directed us to a report published last October by its Council of Economic Advisers, as well as to data suggesting the consumer price index for prescription drugs declined in January 2019 compared with January 2018.

But experts who reviewed that data said it doesn’t necessarily support Mulvaney’s claim — and certainly not by the magnitude he suggests.

A Broad Brush, And Some Missing Data

We interviewed five experts who all agreed that, no matter which metric was used, evidence is lacking to unequivocally say drug prices decreased last year. The most generous reading came from Matthew Fiedler, a health economist at the Brookings Institution: It’s “within spitting distance of something that’s true.”

But with more examination, the claim’s veracity became murkier.

“Drug prices” can refer to many things: a list price, a net price (what is paid after rebates, or the discounts negotiated by insurers or other payers), the pharmacy’s price or total national spending on prescription drugs.

Let’s start with the latter. Data from the Kaiser Family Foundation shows total spending on prescription drug prices has climbed during the past several years. (KHN is an editorially independent program of the foundation.) In 2018, total spending continued to grow, just at a slower pace. That’s a positive trend, experts noted, but it isn’t the same thing as spending going down.

“It doesn’t mean we’re spending less money on drugs than before,” said Stacie Dusetzina, an associate professor of health policy at Vanderbilt University.

We also examined the CPI data the White House provided. It could suggest that in the past year prescription drugs’ list prices have indeed dropped, and even by a meaningful amount.

But the CPI data doesn’t account for whether manufacturers lowering their list prices have also changed the size of the rebates they provide. That’s essential information in understanding if the real price of a drug — what insurance pays and, ultimately, what consumers pay — has actually changed.

These trend lines also vary depending on the 12-month period they cover, argued Walid Gellad, an associate health policy professor at the University of Pittsburgh. January to January could show a list price decrease, but July to July could show an increase.

Plus, the CPI data includes only drugs sold through retail, or about three-fourths of all prescriptions. That excludes many high-priced specialty meds sold only via mail order, argued Michael Rea, who heads Rx Savings Solutions, a consulting firm.

It also paints with a broad brush — obscuring, many said, just how many list prices are continuing to climb.

This year, the list price of more than 3,000 drugs went up, while the price of only 117 went down, according to data compiled by Rx Savings Solutions. Last year, an analysis by the Associated Press revealed that, from January to July, 4,412 branded drug prices went up, while 46 were cut.

So, Mulvaney’s downward price claim didn’t come out of thin air. But interpreting the data to mean that drug prices are down ignores crucial parts of the prescription drug marketplace.

The White House’s Work

Mulvaney also said Trump has played a key role in bringing down drug prices. When we asked the administration what he meant, a spokesman pointed to their efforts to bring more generic drugs to market — a boost the White House said has fueled competition and helped make lower-price alternatives available to consumers.

But there’s no evidence yet to suggest that the boost in generic drug approvals has that effect. Experts said it takes time for these products to reach the marketplace, create competition and demonstrate a measurable impact on prices.

Indeed, many of those generics, while approved, never went to market. This White House assertion also doesn’t account for high-priced, branded drugs that lack a generic counterpart.

Yes, Trump’s tough talk — accusing pharma companies of “getting away with murder” — may have persuaded some drug manufacturers to hold off on increasing their prices — at least temporarily, or until after the government releases key stats on how many prices have gone up, Dusetzina said. But it’s hard to separate that phenomenon from the pressure also levied by Congress and state legislatures.

For what it’s worth, the administration has proposed many new policies meant to curb drug prices, many noted, such as eliminating some kinds of rebates, or changing how Medicare Part B pays for drugs. But none of those have taken effect — so they haven’t brought prices down.

Our Ruling

Mulvaney said, “Drug prices in this country actually came down last year for the first time in 50 years. That’s because Donald Trump’s president.”

At first glance, CPI data could conceivably support the argument that the list prices for some prescription drugs dipped. But that data doesn’t include many high-priced specialty drugs that drive costs up, and the pattern it illustrates can change based on the time frame selected.

The CPI data set obscures the individual drugs for which the list prices have increased — with far more going up than down. It also does not account for a drug’s true “net price.”

Mulvaney’s statement also does not reflect trends showing that, nationally, spending on drugs has continued to climb, even if that growth has slowed. There is also no evidence to support the argument that Trump himself is responsible for changes in drug pricing.

This claim has an element of truth, but it ignores key facts and context that would give a very different impression. We rate this claim Mostly False.

Must-Reads Of The Week From Brianna Labuskes

Happy Friday! The question for the day is: If there were a drug that would turbocharge your brain, would you take it? I’ve seen enough sci-fi movies to make me, uh, less than enthused about the idea, but as my second cup of coffee of the day has yet to kick in, I find it interesting to ponder.

Anyway, on to this roller coaster of a news week!

Republicans on the Hill have been quietly pretending they might wake up and this renewed focus on the health law will all have been a fever dream. But Democrats are doing their best to make sure everyone knows exactly where everyone stands on President Donald Trump’s recent legal attacks. On Wednesday, the House Dems officially voted to condemn the president’s decision to tell the courts to nullify the entire health law instead of just parts of it. In practice, this means nothing, but it puts Republicans on record of once again voting against popular health law provisions.

Trump, meanwhile, softly backpedaled on his promises that Republicans were coming up with a “spectacular” replacement plan before 2020. This came after a talk with Senate Majority Leader Mitch McConnell — who essentially channeled his inner Ariana Grande and said thank u, next to the issue that has left the party with political bruises the past two years.

But Trump is remaining steadfast in his message that Republicans need to reclaim health care as a winning topic for 2020. “We can’t run away” from health care, he said. “We’ll lose.”

The bumpy week, for some, was a reminder of the surprises that could be in store for the upcoming election season.

The Wall Street Journal: Democrats, Trump Try to Keep Spotlight on Health Care

The Associated Press: Pivoting on Pledges, Trump Explores Art of the Climb-Down

Bloomberg: Trump Says GOP `Blew It’ on Health Care and Must Run on New Plan

Politico: Killing Obamacare Kills Trump’s Health Agenda, Too


Going on name only, the Violence Against Women Act sounds like one of the least controversial bills out there, but a closer look at its history reveals fault lines. The House this week passed its version of the legislation (which is geared toward protecting women from violence and domestic abuse and has to be renewed every few years), but don’t expect smooth sailing the rest of the way. This time the underlying drama stems from a new provision that expanded law enforcement’s ability to strip domestic abusers of their guns.

The New York Times: A Brief History of the 25-Year Debate Over the Violence Against Women Act


Fill-in-the-blank copycat bills powered by special interests and businesses have infiltrated the legislative process to a shocking extent. USA Today, The Arizona Republic  and the Center for Public Integrity has an amazing two-year investigation that examined nearly 1 million bills in all 50 states and Congress to root out legislation that was nearly identical to others. These measures touched on almost every subject imaginable, from sugary drinks to “right-to-try” legislation to abortion to gun control. The investigation found that these bills are often drafted with deceptive titles, include misleading information on the extent of expert or public support, and push agendas that override the will of voters. Be sure to check out this story — it has examples of the bills, data and charts, and all kinds of fun goodies to delve into.

USA Today: Abortion, Gun Control: How Special Interest Groups Push Legislation


A veritable flurry of movement on drug pricing bills is coming up in the next week or so, with legislation and hearings that will focus on PBMs, the price of insulin, transparency, public accountability for pharma and more. With that as context …

Express Scripts this week announced that it is capping the price of insulin at $25 per month. Under the new plan, employers who cover their workers through Cigna and Express Scripts can opt into the program, and the extra costs will be picked up by the three drugmakers that sell insulin — Eli Lilly, Novo Nordisk and Sanofi. Advocates deemed the decision nothing but a PR move, saying it does little to address the actual problems of high list prices for people who aren’t lucky enough to be on one of the plans.

The New York Times: Express Scripts Offers Diabetes Patients a $25 Cap for Monthly Insulin

Stat: House Committee to Weigh Bills Aimed at Shedding Light on High Drug Prices


“One medical emergency, that’s all it would take to wipe me out financially,” is something I’ve heard friends worry about time and again, so a grim new report about the reality of paying for health care in America came as no surprise. Over the past year, Americans have borrowed $88 billion (billion! with a b!) to pay for health care. A survey went on to report that nearly half of Americans are haunted by fears of medical-related bankruptcy, and 1 in 4 people have skipped needed care because of the cost. Not only that, about 70% of respondents across the political spectrum said they had no confidence in their elected officials to bring prices down.

The New York Times: Americans Borrowed $88 Billion to Pay for Health Care Last Year, Survey Finds


This technically happened last Friday, but not in time for the Breeze: The Trump administration approved a work-requirements waiver for Utah — just days after similar restrictions were struck down for both Kentucky and Arkansas. The Utah story is even more nuanced, though, because voters in that state approved full expansion of the program. Lawmakers have been scrambling to put rules into place ever since the ballot measure passed.

The New York Times: Trump Administration Approves Medicaid Work Requirements in Utah

Meanwhile, both HHS Secretary Alex Azar and CMS Administrator Seema Verma have been quietly trying to sell states on applying for block grant waivers, with Verma, in particular, pushing Alaska to become the first in the nation to apply. A legal challenge would almost certainly follow any such decision.

The Hill: Trump Administration Urging Alaska to Be First to Apply for Medicaid Block Grant


In the same vein as this happened late last week but you should know about it: The Trump administration announced the recipients of $250 million in Title X federal family planning grants, including a chain of anti-abortion clinics designed to siphon off patients from Planned Parenthood. The group had been turned down last year because it doesn’t provide birth control other than natural family planning and abstinence. Meanwhile, Planned Parenthood and its affiliates saw a steep drop in what it had been previously receiving — going from about $50 million-$60 million to $16 million.

Politico: Millions in Family Planning Grants Given to Groups and States Fighting Trump’s Policy Changes


In the miscellaneous file this week:

• A look at how a former congressman has become a one-man gate-keeping operation when it comes to lobbying the VA.

Politico: Millions in Family Planning Grants Given to Groups and States Fighting Trump’s Policy Changes

• A wild investigation into how high-speed chases, while frowned upon in other agencies, are a strategy often used by the Border Patrol, despite the fact that they can often end in gruesome injuries and death.

Los Angeles Times/ProPublica: Border Patrol Agents Are Granted Wide Latitude When Trying to Catch Drivers Seeking to Enter U.S. Illegally

• Torture, rape, murder and other violence in the Alabama prison system is “severe and systematic,” a new Department of Justice report finds. Fair warning, the details are pretty disturbing, but it’s worth a read.

The New York Times: Alabama’s Gruesome Prisons: Report Finds Rape and Murder at All Hours

• Can getting drugs to treat libido issues or thinning hair be as easy as ordering off a restaurant menu? That’s what these new types of websites offer: a way for patients to self-diagnose their problems and then get a sign-off from a doctor whom they don’t even meet with. The sites often don’t include warnings about side effects of the medications, and it’s entirely unclear whether their doctor-screening process follows any kind of standards.

The New York Times: Drug Sites Upend Doctor-Patient Relations: ‘It’s Restaurant-Menu Medicine’

• The “lede” on this story was a cold reality check about the intersection of public health fears and prejudice when it comes to vulnerable populations. Rockland County, N.Y., where one of the country’s largest measles outbreaks is rippling through the Jewish Orthodox community, is serving as a model of how those tensions can boil over in times of crisis.

The New York Times: An Outbreak Spreads Fear: Of Measles, of Ultra-Orthodox Jews, of Anti-Semitism

• “Healthy Holly” may sound like an innocuous children’s book, but the controversy surrounding it — and its author, Baltimore Mayor Catherine Pugh — will likely bring down several careers.

The Baltimore Sun: As a Maryland Senator, Pugh Pushed Bills to Benefit Hospitals While Getting Book Payments From Medical System


And make sure to check out this fun history on how the concept of personal space is hard-wired into our brains. Have a great weekend!

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

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.

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 “The Doctor’s Strike That Nearly Killed Canada’s Medicare-for-All Plan, Explained,” by Sarah Kliff

Rebecca Adams: CQ Roll Call’s “Legal Challenges Are Threatening Trump Administration Changes to the ACA,” by Sandhya Raman

Anna Edney: The Baltimore Sun’s “Baltimore Mayor Pugh to Take Leave of Absence in Midst of ‘Healthy Holly’ Book Controversy” by Ian Duncan and Yvonne Wenger

Alice Miranda Ollstein: The New York Times’ “Rituals of Honor in Hospital Hallways,” by Dr. Tim Lahey

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