KHN’s ‘What the Health?’: Could the ACA really go away?

Reviewed by Kate Anderton, B.Sc. (Editor)Jul 11 2019

The Affordable Care Act was back in court again this week — this time before a three-judge panel at the 5th Circuit Court of Appeals in New Orleans.

A lower court ruled last December that the entire ACA is now unconstitutional because Congress in its 2017 tax bill eliminated the tax penalty for failing to maintain health insurance. It appeared that two of the three judges — both appointed by Republicans — seemed sympathetic to the arguments made by the plaintiffs, mostly attorneys general from Republican-led states.

Meanwhile, President Donald Trump on Wednesday signed an executive order calling for major changes in how the government pays for care for people with kidney disease, including making it financially easier for people to donate kidneys.

This week's panelists are Julie Rovner from Kaiser Health News, Joanne Kenen of Politico, Kimberly Leonard of the Washington Examiner and Alice Miranda Ollstein of Politico.

Among the takeaways from this week's podcast:

• Many people who have employer-based insurance and don't get coverage from the ACA don't realize that key protections they now enjoy come from that law. These include provisions such as allowing adult children to stay on their parents' plan until age 26 and barring insurers from using annual coverage caps or lifetime limits.
• The legal challenge to the ACA by conservative states is a real threat to the law, but the case could still be resolved in a wide variety of ways. It is likely, however, to be appealed to the Supreme Court at some point.
• The Trump administration's plan to revamp how kidney patients get care appears to have satisfied many different stakeholders and is being widely hailed — except by the two giant firms that profit from clinic-based kidney dialysis and the status quo.
• The administration this week had two setbacks on its efforts to slow the rise in prescription drug costs. A court, ruling on procedural grounds, set aside the government's plan to require drugmakers to add prices to television ads. Also, the administration announced it is shelving its rule that consumers get some of the rebates from drugmakers that pharmacy benefit managers negotiate for insurers.
• The legal challenge to the administration's rule that would restrict doctors and other health professionals who receive Title X federal family planning grants from referring women for an abortion has created chaos among those health care providers because the rules have been on and off again. But for groups supporting the right to an abortion, time is the name of the game. They hope to run out the clock and elect a different president in 2020.

Also this week, Rovner interviews University of Michigan law professor Nicholas Bagley about the latest legal threat to the ACA.

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

Julie Rovner: The Washington Post's "Hospices Go Unpunished for Reported Maggots and Uncontrolled Pain, Watchdog Finds," by Christopher Rowland

Joanne Kenen: The Los Angeles Times' "Trump Officials Tell One Court Obamacare Is Failing and Another It's Thriving," by Noam Levey

Alice Miranda Ollstein: CNN's "Exclusive: Joe Biden on Obamacare and Medicare for All: 'Starting Over Would Be, I Think a Sin,' by Eric Bradner

Kimberly Leonard: Vox's "Why I Gave My Kidney to a Stranger — and Why You Should Consider Doing It Too," by Dylan Matthews

And

Fox News' " I'm Becoming a Liver Donor for the Sister I Love, So She Can Live a Long and Healthy Life," by Ed Henry

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