KHN’s ‘What 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 enrolling with comparatively little controversy, as most Republicans have moved on from trying to repeal the law.

On the campaign trail, meanwhile, Democrats are charging that if Republicans win majorities in the U.S. House or Senate, they will try to cut Social Security and Medicare.

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 Julie Appleby of KHN.

Among the takeaways from this week’s episode:

  • There are some big changes to the ACA from years past. The Biden administration used its authority to close the “family glitch” that had prevented many families of low- and moderate-income workers from getting subsidies to purchase insurance on or state marketplaces.
  • Also new this year, states are required to offer “standardized” plans with the same benefits so consumers can better compare them.
  • Another important change: For the first time, people with low incomes (under 150 percent of the federal poverty level) can enroll in ACA plans anytime, instead of only during open enrollment. This could become particularly important in 2023, as many people are likely to lose their Medicaid coverage when the Biden administration ends the covid-related public health emergency.
  • Health overall has not been as big a campaign issue as usual. With a few exceptions, most Republicans on the campaign trail seem to have moved on from vows to repeal the Affordable Care Act.
  • Abortion was expected to be the top voter concern in this year’s elections, but it seems to have been trumped in most cases by inflation and the state of the economy. At least one Democratic candidate, Michigan Gov. Gretchen Whitmer, is trying to combine the issues. She is claiming that if voters in her state approve a constitutional amendment protecting the right to abortion, businesses in states with abortion bans will be more likely to move there. It’s unclear whether this will happen, though.
  • The Justice Department this week had its first-ever win in a criminal case alleging that labor antitrust rules had been violated. A Nevada staffing agency that supplies school nurses had an agreement with a similar agency in an adjacent county not to hire nurses across the county line, in an effort to prevent the 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. Do you have an exorbitant or baffling 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: Modern Healthcare’s “Elon Musk Bought Twitter. Should Healthcare Professionals Be Worried?” by Caroline Hudson

Joanne Kenen: Mountain State Spotlight’s “Stigmatize, Blame, Then Restrict: How This West Virginia City Responded to the Opioid Epidemic,” by Ellie Heffernan

Tami Luhby: The Washington Post’s “A Psychiatry Wait List Had 880 patients; a Hospital Couldn’t Keep Up,” by Rachel Zimmerman

Julie Appleby: KHN’s “‘Fourth Trimester’ Focus Is Pushed to Prevent Maternal Deaths,” by April Dembosky

Also mentioned in this week’s episode:

Politico’s “Michigan Democrats’ Pitch to Voters: Abortion Bans Are Bad for Business,” by Alice Miranda Ollstein

Bloomberg Law’s “DOJ Notches First No-Poach Win With Staffing Firm’s Sentencing,” by Dan Papscun

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