Podcast: KHN’s ‘What the Health?’ Whither work requirements?

Jul 6 2018

A federal District Court judge in Washington, D.C., has — for now — blocked Kentucky's proposal to add a work requirement for much of its adult Medicaid population. The decision, while far from final, is likely to prompt lawsuits from advocates in other states where the Department of Health and Human Services has approved similar proposals.

Also this week, HHS released updated enrollment information about those purchasing health insurance in the individual market. Despite efforts by the Trump administration and Republicans in Congress to depress enrollment by cutting outreach and canceling federal payments to insurers, the number of people who actually paid their first month's premium was up slightly in 2018, compared with 2017.

This week's panelists for KHN's "What the Health?" are: Julie Rovner of Kaiser Health News, Stephanie Armour of The Wall Street Journal, Anna Edney of Bloomberg News and Joanne Kenen of Politico.

Among the takeaways from this week's podcast:

• While the overall number of people buying coverage in the health law's exchanges rose, the number of people not getting help with their premiums fell for the third-straight year. While some consumers may have found other coverage (through Medicare or jobs), rising premiums have been a problem.
• The court decision blocking Kentucky's Medicaid work requirement does not necessarily preclude other states' work requirements from going forward. But the decision is likely to spark lawsuits in those states that have already had their work programs approved by HHS.
• The window for bipartisan action on health care costs on Capitol Hill has closed. The Justice Department's decision to join the state attorneys general lawsuit on preexisting conditions was likely the last straw. Issues surrounding coverage of preexisting conditions will now likely dominate the political discussion leading up to the midterm elections this fall.
• Two things worth noting from the month of June. First, the recent court decision on risk-corridor payments to insurers seems to be a significant blow to the industry. Also, the Trump administration announced a major reorganization of Cabinet-level agencies. Although this is a common step for an administration, and something that rarely moves beyond "pie-in-the-sky" discussions, this one seems to be encapsulating the debate about the safety-net and social welfare programs.

Read the latest on the Bill of the Month series:

"Father's And Son's Injuries Lead To The Mother Of All Therapy Bills," By Stephanie O'Neill.

If you have a medical bill you'd like NPR and KHN to investigate, you can submit it here.

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

Julie Rovner: Kaiser Health News’ "Unlocked And Loaded: Families Confront Dementia And Guns," by JoNel Aleccia and Melissa Bailey

Stephanie Armour: NPR's "Rising Cost of PrEP to Prevent HIV Infection Pushes It Out of Reach for Many," by Shefali Luthra and Anna Gorman

Anna Edney: The New York Times' "Emergency Rooms Run Out of Vital Drugs, and Patients Are Feeling It," by Katie Thomas

Joanne Kenen: The Washington Post's "College Students Are Forming Mental-Health Clubs — and They're Making a Difference," By Amy Ellis Nutt

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