KHN’s ‘What the Health?’: Biden doubles down on Obamacare

Reviewed by James Ives, M.Psych. (Editor)Jul 19 2019

Former Vice President Joe Biden has said if he's elected president he would build on the Affordable Care Act rather than move to a whole new health care system, such as the "Medicare for All" plan supported by some of his primary opponents for the Democratic nomination. But his campaign's new health plan would include many things Congress tried and failed to pass as part of the health law, including a government-run "public option" plan that would be widely available.

Meanwhile, the U.S. House voted to repeal one of the ACA's key financing mechanisms, voting overwhelmingly to cancel the so-called "Cadillac tax," which was set to take effect in 2022. It is a 40% excise tax on the most generous employer-provided health plans.

And it was not a good week for Planned Parenthood. The women's health provider parted ways with its president of less than a year, Leana Wen. And the Trump administration announced it would begin enforcement of new rules for the federal family planning program that Planned Parenthood said will force it to stop participating.

This week's panelists are Julie Rovner from Kaiser Health News, Joanne Kenen of Politico, Kimberly Leonard of the Washington Examiner and Margo Sanger-Katz of The New York Times.

Among the takeaways from this week's podcast:

• Biden's health proposal seeks to lower out-of-pocket costs for many people in several ways. For example, it would make federal premium help available to all who buy their own insurance, not just those with low and middle incomes. It would also change how federal premium subsidies are determined. It would base the assistance on the cost of a gold plan, rather than the current practice of using the second lowest priced silver plan. Since gold plans are more generous, using that standard could lower the amount of deductibles and copayments people getting subsidies have to pay.
• The ACA's Cadillac tax has been strongly endorsed by health economists, who view it as a way to cut the amount of unnecessary care some people with generous plans seek. But many employers, consumers and labor unions don't want to tinker with the current tax system of job-based insurance.
• The administration's decision to go forward with its new rules for the Title X family planning program — while critics are challenging those regulations in the courts — will have a significant effect on Planned Parenthood's finances. But the group gets even more government money through the Medicaid program.
• Despite two setbacks last week in the administration's efforts to reduce drug prices, President Donald Trump is continuing to hint that he wants to go forward with a plan to tie some Medicare drug prices to what people in other countries pay for the medications.
• Federal officials have announced that opioid deaths have declined, but it is not clear that opioid overdoses or addiction has declined.

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

Julie Rovner: The New York Times's "Where Roe v Wade Matters Most," by Quoctrung Bui, Claire Cain Miller and Margot Sanger-Katz.

Joanne Kenen:  Scientific American's "Why Doctors Are Drowning in Medical School Debt," by Daniel Barron.

Margot Sanger-Katz: Bloomberg News' "Deadly Disease Is Treatable, But Newborn Screening Patchwork Leaves Many Vulnerable," by Michelle Cortez.

Kimberly Leonard: The Washingtonian's "DC Types Have Been Flocking to Shrinks Ever Since Trump Won. And a Lot of the Therapists Are Miserable," by Britt Peterson.

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