KHN’s ‘What’s the Health?’: ACA Open Enrollment Without the Drama


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It’s open enrollment time for Affordable Care Act health coverage. And for the first time, people are registering with relatively little controversy, as most Republicans have moved on from trying to repeal the law.

On the campaign trail, meanwhile, Democrats are complaining that if Republicans gain a majority in the US House or Senate, they will try to cut Social Security and Medicare.

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

Among the takeaways from this week’s episode:

  • The ACA has had some big changes since last year. The Biden administration has used his authority to close the “family gap” that prevented many families of low- and moderate-income workers from getting subsidies to buy insurance through healthcare.gov or state marketplaces.
  • Also new this year, states are required to offer “standard” plans with similar benefits so consumers can compare them.
  • Another important change: For the first time, low-income people (below 150 percent of the federal poverty level) can enroll in ACA plans at any time instead of just open enrollment. This could become especially important in 2023, as many people could lose their Medicaid coverage when the Biden administration ends the Covid-related public health emergency.
  • Health overall was not as big of a campaign issue as usual. With few exceptions, most Republicans on the campaign trail seem to have moved on from promises to repeal the Affordable Care Act.
  • Abortion was expected to be a top concern of voters in this year’s election, but inflation and the state of the economy appear to have largely dwarfed it. At least one Democratic candidate, Michigan Gov. Gretchen Whitmer, is trying to consolidate the issues. He is claiming that if voters in his state approve a constitutional amendment protecting abortion rights, businesses in states that ban abortion will be more likely to move there. It’s not clear if that will happen, though.
  • The Justice Department won its first criminal case this week alleging violations of labor laws. A Nevada staffing agency that supplies school nurses entered into an agreement with a similar agency in an adjacent county not to hire nurses across county lines in an effort to prevent nurses from seeking higher wages.

Also this week, Rovner interviews KHN’s Arthur Allen, who wrote the latest KNH-NPR Bill of the Month, about an old but still very expensive cancer drug. Have an excessive or confusing medical bill you’d like to share with us? You can do it here.

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

Julie Rovner: Modern Healthcare’s “Elon Musk Buys Twitter. Should healthcare professionals be concerned? By Caroline Hudson

From Joan: Mountain State Spotlight’s “Stimulate, Blame, Then Restrict: How This West Virginia Town Has Responded to the Opioid Epidemic,” by Ellie Heffernan

Tami Luhby: The Washington Post “had 880 patients on a psychiatry wait list; A Hospital Could Not Be Held,” by Rachel Zimmerman

Julie Appleby: KHN’s “‘Fourth Trimester’ Focus Presses on Preventing Maternal Deaths,” by April Dembowski

Also mentioned in this week’s episode:

Politico’s “Michigan Democrats pitch to voters: Banning abortion is bad for business,” by Alice Miranda Wolstein

Bloomberg Law’s “DOJ Notes First No-Poach Win With Staffing Firm Punishment,” by Dan Papskun


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