KHN’s ‘What the Health?’: Drama-Free ACA Open Enrollment


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It’s time to sign up for health coverage under the Affordable Care Act. And for the first time, people are signing up with relatively little controversy, as most Republicans have given up trying to repeal the law.

Meanwhile, Democrats have charged on the campaign trail that if Republicans win a majority in the U.S. House or Senate, they will try to cut Social Security and Medicare.

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

Among the takeaways from this week’s episode:

  • There have been some big changes to the ACA since years past. The Biden administration is using its powers to close a “family gap” that has prevented many families of low- and middle-income workers from getting subsidies to buy insurance on healthcare.gov 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 (below 150 percent of the federal poverty level) can enroll in ACA plans at any time, instead of only during open enrollment. This could become especially important in 2023, as many people are likely to lose their Medicaid coverage when the Biden administration ends the public health emergency related to Covid.
  • Health in general is not as big of a campaign issue as it usually is. With a few exceptions, most Republicans on the campaign trail appear to have backed away from promises to repeal the Affordable Care Act.
  • Abortion was expected to be the top concern of voters in this year’s election, but it appears that in most cases it has been overshadowed by inflation and the state of the economy. At least one Democratic candidate, Michigan Gov. Gretchen Whitmer, is trying to compound the issues. She argues that if voters in her state approve a constitutional amendment protecting abortion rights, businesses in abortion-ban states will be more likely to relocate there. However, it is not clear whether this will happen.
  • The Justice Department this week scored its first victory in a criminal case alleging violations of labor antitrust rules. A Nevada staffing agency that supplies school nurses had an agreement with a similar agency in a neighboring county not to hire nurses from 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 bill of the month for KNH-NPR, about an old but still very expensive cancer drug. Do you have an exorbitant or confusing medical bill that you want to share with us? You can do that here.

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

Julie Rovner: “Elon Musk bought Twitter from Modern Healthcare. Should Health Professionals Be Worried?” by Caroline Hudson

Joan by: “Stigma, Blame, Then Restrict: How This West Virginia Town Responded to the Opioid Epidemic” from Mountain State Spotlight by Ellie Heffernan

Tammy Luby: The Washington Post’s psychiatry waiting list includes 880 patients; a hospital can’t handle’ by Rachel Zimmerman

Julie Appleby: “KHN’s ‘Fourth Trimester’ Focus Aims at Preventing Maternal Deaths,” by April Demboski

Also mentioned in this week’s episode:

“Michigan Democrats’ pitch to Politico voters: Abortion bans are bad for business,” by Alice Miranda Olstein

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


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And subscribe to KHN’s What’s Health? on Spotify, Apple Podcasts, Stitcher, Pocket Casts, or wherever you listen to podcasts.

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