Podcast: KHN’s ‘What the Health?’ Insurance enrollment is lagging — and there are lots of reasons why

Reviewed by James Ives, M.Psych. (Editor)Dec 14 2018

With less than a week to go before the deadline in most states, enrollment in health insurance for 2019 under the Affordable Care Act is lagging compared with the pace of previous years. That was expected, given last year's tax law eliminated the tax penalty for not having coverage starting Jan. 1. But analysts say there are other reasons for the downturn as well.

Reproductive health is also in the news. The Supreme Court declined to take a case that could have allowed states to disqualify Planned Parenthood from participating in the Medicaid program. And the National Institutes of Health is quietly preventing researchers from obtaining samples of fetal tissue for their research, despite the fact that such research has been explicitly legal for 2½ decades.

This week's panelists for KHN's "What the Health?" are Julie Rovner of Kaiser Health News, Alice Ollstein of Politico, Anna Edney of Bloomberg News and Rebecca Adams of CQ Roll Call.

Among the takeaways from this week's podcast:

• Even as ACA marketplace enrollment lags by about half a million customers, many people will still have coverage because those exchanges automatically re-enroll customers who don't make a choice on their own.
• Among factors that appear to have stunted marketplace enrollment — other than the end of the tax penalty for not having insurance — are the lack of government funding for outreach and assistance; a rise in employment, which likely means more people getting insurance through work; Virginia's expansion of Medicaid; and the Trump administration's relaxation of rules making cheaper, short-term plans more easily available.
• Many people were surprised this week when two conservative Supreme Court justices sided with liberals and kept the court from taking a case involving states' efforts to kick Planned Parenthood out of their Medicaid program.  But the decision may have been an effort by Chief Justice John Roberts to buttress a nonpartisan reputation for the court. However, other abortion cases coming up from the states may make it to the court.
• About 200,000 comments have been submitted on the Trump administration's proposal to change federal rules so that more types of public assistance given to immigrants be considered when they apply for a green card or citizenship. Many health officials and medical providers say the rule would hurt public health efforts by keeping people from seeking food and medical aid.

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

Julie Rovner: The Wall Street Journal's "The Loneliest Generation: Americans, More Than Ever, Are Aging Alone," by Janet Adamy and Paul Overberg

Alice Ollstein: Politico's "Establishment Looks to Crush Liberals on Medicare for All," by Adam Cancryn

Rebecca Adams: Bloomberg News's "This Killer Opioid Could Become a Weapon of Mass Destruction," by Anna Edney

Anna Edney: The Washington Post's "Investigation of Generic 'Cartel' Expands to 300 Drugs," by Christopher Rowland

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