KHN’s ‘What the Health?’: How to Expand Health Coverage

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Democrats in Congress and in several states are trying to improve health coverage, but their ideas are very different. Some are working to expand the Medicaid program, others want to build on the Affordable Care Act, and others want to expand Medicare. And while Washington’s support for a government-led “public option” plan is waning, several states are trying their own proposals.

In the meantime, efforts to curb prescription drug prices continue and lawmakers may need to reach an agreement if the savings from these proposals are to fund their coverage expansion.

This week’s panelists are Julie Rovner from KHN, Alice Miranda Ollstein from Politico, Tami Luhby from CNN and Shefali Luthra from The 19th.

Among the takeaways from this week’s episode:

  • The draft by Sen. Ron Wyden (D-Ore.) To lower Medicare drug prices leaves many questions unanswered. This includes, among other things, what kind of mechanism it would use to set drug prices, which drugs would be subject to price reductions, how the government would set prices, and whether price controls would affect health plans for younger people who are not Medicare members.
  • Finding a way to bring down Medicare drug prices could be a big win for the federal government, and the Democrats hope it would help fund other programs, such as: B. The permanent increase in premium subsidies for insurance plans bought on the Affordable Care Act insurance marketplaces. But proponents of efforts to lower drug prices are not yet backed by all democratic lawmakers, many of whom have close ties to drug manufacturers.
  • It is also unclear whether drug prices are a top priority for administration. President Joe Biden has said he supports efforts to reduce drug costs, but he has not emphasized this in his budget or policy initiatives.
  • Democratic Party’s progressive wing lawmakers are signaling that they hope to lower the Medicare eligibility age and expand its benefits as part of a budget deal this summer. Biden ran on a platform to create a government-run health plan – known as a “public option” – that consumers could choose from on the ACA marketplace, but that’s not much discussed right now.
  • For progressives, this public option has never been more enticing than a government-run depository plan that would cover the entire nation. And since the healthcare industry could fight a public option as vehemently as it would a pay-in plan, expanding Medicare seems like a better choice for these liberals.
  • Democratic lawmakers are also looking for ways to provide health coverage to uninsured, low-income people living in states that have refused to accept the ACA’s Medicaid extension. Some are proposing bills that would allow cities or counties to opt for the expansion program if state officials fail to do so, or while others support proposals that would allow these consumers to buy subsidized plans on the ACA marketplaces, a provision that was not included in the landmark health law because it was believed that states would expand their Medicaid programs.
  • Missouri lawmakers have started negotiations to renew funding proposals for long-term care in the state’s traditional Medicaid program. As part of this effort, they are considering new limits for the contraceptives that Medicaid covers. Legislators are considering banning reimbursement of IUDs and emergency contraceptives because they mistakenly believe that these methods are abortion drugs.
  • Colorado and Nevada are establishing public options for their residents at the initiative of the State of Washington. But the programs won’t necessarily lower premiums, and if the federal government chooses to make the increased premium subsidies that came into effect this year for marketplace customers across the country permanent, such government efforts might seem less attractive.
  • Even as the US begins to return to more normal routines and open businesses and events as the pandemic subsides, concerns are growing about the Delta variant of the Covid virus, which is rapidly spreading across the country and around the world. Public health experts are working to encourage residents who have not been vaccinated to get vaccinated as it can prevent serious illness. Officials were interested in using incentives to get people to vaccinate – for example, money and goods prices – but they were reluctant to punish someone who did not vaccinate. This strategy may not work.

Also this week, Rovner is interviewing Michelle Andrews, who covered and wrote on last month’s KHN-NPR.Bill of the month“Episode about a very expensive sleep study. If you have an outrageous medical bill you’d like to send us, you can do that here.

In addition, for added recognition, panellists recommend their favorite health policy stories of the week, which they think you should also read:

Julie Rowner: The Washington PostWellness programs in the workplace are big business. They may not work“By Katherine Baicker and Zirui Song

Tami Luhby: The Associated Press’ “Watchdog: Nursing Home Deaths Up 32% in 2020 Amid Pandemic“By Ricardo Alonso-Zaldivar

Alice Miranda Ollstein: The New York Times’ “Desperate for Covid Care, undocumented immigrants resort to unproven medicationBy Amy Maxmen

Shefali Luthra: KHNs “Cramped at home, nonprofit hospitals look for profits overseas“By Jordan Rau

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KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health topics. Along with Policy Analysis and Polling, KHN is one of the three main operational programs at KFF (Kaiser Family Foundation). KFF is a non-profit foundation that provides the country with information on health issues.


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