KHN’s “What the Health?”: All about budgeting



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President Joe Biden has said he still wants a bipartisan bill to allow for the next round of covid relief. But if it doesn’t, the House committees set out this week to work on a budget vote bill that the Senate could pass by a simple majority. In addition to covid-related issues, the proposals also address some significant changes to the Medicaid program and the Affordable Care Act.

Meanwhile, the Centers for Disease Control and Prevention has issued new guidelines for wearing masks. But the guidelines are confusing to many, underscoring the rapidly changing science surrounding the virus, leaving many laypeople unsure of how best to go about it.

This week’s panelists are Julie Rovner of Kaiser Health News, Joanne Kenen of Politico, Paige Winfield Cunningham of the Washington Post, and Sarah Karlin-Smith of Pink Sheet.

Among the takeaways from this week’s podcast:

  • The Biden administration told the Supreme Court on Wednesday that it would undo the federal government’s official support for the Republican states’ challenge to the Affordable Care Act. The case was discussed in November 2020, so it is unclear what impact the change in management position might have.
  • More interesting than the expected government announcement on the ACA lawsuit is how Congress will react if portions of the law are overturned by the judges. The Democrats did not add any remedial action to the reconciliation bill now going through Congress, but they will have options that they could implement instead.
  • Regarding the auxiliary law, there does not seem to be much progress on a bipartisan compromise. However, using the highly technical and limited option of a reconciliation law to enforce the president’s funding plans may limit some efforts by the Democrats to use the process for broader health packages going forward.
  • A suggestion in the relief plan would dramatically change the way premium subsidies are set for people who buy insurance in the ACA marketplaces. Instead of tying the subsidy amount to the federal poverty line, a subsidy would be based on insurance costs and family income. This will help high-income, middle-class families and those living in high-cost regions.
  • Another proposal would make changes to Medicaid funding for states that now agree to expand their adult eligibility. In many of these states, however, resistance to expansion is pervasive, and even additional federal funding cannot change people’s minds.
  • The Medicaid proposal would also increase the amount of time low-income women can stay in the program during pregnancy and after having a child. This could help reduce maternal mortality in the country.

In honor of Valentine’s Day, panelists voted their favorite #healthpolicyvalentines from Twitter. KHN is also choosing its own range to be released on Friday.

As additional credit, panelists recommend their favorite health stories of the week that they think you should read too:

Julie Rovner: The Washington Post says, “Oh, we’re still at it.” The pandemic wall is here ”by Maura Judkis

Joanne Kenen: Atul Gawande’s New Yorker “At the Worst-Hit County in the Worst Affected State in the Worst Affected Country”

Paige Winfield Cunningham: The “frustration of the Atlantic is spreading faster than the vaccine” by Anne Applebaum

Sarah Karlin-Smith: HuffPosts “Delaying Second Dose? A Guide to the Latest COVID-19 Vaccine Debate “by Jonathan Cohn


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