KHN’s ‘What the Health?’: Washington’s Slow Churn

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In the wake of three high-profile mass shootings in less than a month, lawmakers on Capitol Hill have renewed negotiations over legislation that could stem gun violence. But even those who are trying to reach an agreement on the long-divisive issue acknowledge that finding consensus remains an enormous task.

Meanwhile, Congress is running out of time to decide whether to extend the current additional subsidies for people buying their own health insurance under the Affordable Care Act. States and insurers are now setting rates for 2023; in the absence of congressional action, those much-higher premiums would become public right before the midterm elections.

This week’s panelists are Julie Rovner of KHN, Margot Sanger-Katz of The New York Times, Sandhya Raman of CQ Roll Call, and Rachel Cohrs of Stat.

Among the takeaways from this week’s episode:

Medicare officials were under pressure from lawmakers on Capitol Hill to lower beneficiaries’ premiums after they jumped 12% this year because of expectations that the federal health plan for seniors would be hit with high bills for covering an expensive new medicine to treat some cases of Alzheimer’s disease. When Medicare opted to limit coverage of that medication, Aduhelm, over concerns about its safety and effectiveness, the premium increase appeared likely to be reduced. But officials said last week that they wouldn’t make the adjustment until next year’s premiums.That decision appears to have been made because a midyear change in premiums has not been attempted before and could prove administratively complex.Although Medicare costs and benefits are often politically salient issues, this large premium increase did not generate much criticism. That may be because the average Social Security payment also increased substantially this year, which helped cover the price hike.Negotiations among senators on possible measures to tamp down gun violence are hitting topics that have eluded approval after past mass shootings, leading to concerns that this effort could easily fall apart, too. The talks are not touching on most of the controversial steps that gun control advocates generally want, but negotiators also may be willing to discuss more than what many gun-rights advocates have felt comfortable with in the past. So far, Republicans and Democrats involved in the talks both appear engaged in trying to find a path forward, but the effort is delicate and no one is predicting yet how it will end.Sen. Joe Manchin (D-W.Va.), who at the end of last year walked away from negotiations on President Joe Biden’s “Build Back Better” legislation, signaled last week that curbing drug price increases, a part of that package, remains a key concern of his. That may also signal that negotiations on a more limited legislative package may be moving forward.Democrats are also under pressure to move quickly if they want to extend the premium subsidies for plans purchased on the ACA insurance marketplaces. Those larger subsidies are set to expire at the end of the year, but state regulators are already working to set prices for the 2023 plans and some of those calculations depend on estimates of how many people will enroll.As the latest covid-19 variant triggers a new surge, one group of Americans stands out as unprotected: children under age 5. The frustration among parents is growing, although federal regulators are looking at requests from drugmakers to authorize vaccines. Those vaccines, however, are for an older version of the virus and may have limited effectiveness against current variants.In reaction to a leaked draft opinion suggesting that the Supreme Court is preparing to overturn the constitutional protections for abortion in its 1973 Roe v. Wade decision, some local prosecutors have announced they would not bring criminal cases against health care professionals providing abortions. But that is unlikely to be of much help to local clinics or doctors, who are expected to stop providing such care if they could face criminal charges.

Also this week, Rovner interviews Michelle Andrews, who reported and wrote the latest KHN-NPR “Bill of the Month” episode about a too-common problem that patients getting colonoscopies face when they try to access no-cost preventive care under the ACA. If you have an outrageous medical bill 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 they think you should read, too:

Julie Rovner: NPR Throughline’s “Before Roe: The Physicians’ Crusade,” by Rund Abdelfatah, Ramtin Arablouei, Julie Caine, Laine Kaplan-Levenson, Lawrence Wu, Victor Yvellez, Casey Miner, Yolanda Sangweni, Anya Steinberg, and Deborah George

Rachel Cohrs: The Wall Street Journal’s “Baby-Formula Shortage Worsened by Drop in Breast-Feeding Rates,” by Jennifer Maloney

Margot Sanger-Katz: The Washington Post’s “Opinion: Breastfeeding Isn’t ‘Free.’ Here’s What It Cost Me,” by Alyssa Rosenberg

Sandhya Raman: News From the States’ “From Skepticism to Insurance Denials, Long COVID Patients Face More Than Only Health Challenges,” by Annmarie Timmins

Also discussed on this week’s podcast:

Politico Pro’s “Health Agency Starts Environmental Justice Initiative,” by Sarah Owermohle

Stat’s “There May Be a Backdoor Way for Hospitals to Get Paid for Uninsured Covid-19 Care,” by Rachel Cohrs

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