KHN’s ‘What the Health?’: Trump merges health and immigration

Reviewed by Kate Anderton, B.Sc. (Editor)Oct 10 2019

President Donald Trump has merged two of his favorite hot-button topics by requiring new immigrants to either purchase health insurance within 30 days of arrival or prove they can pay for medical expenses on their own.

Meanwhile, the Supreme Court has agreed to hear an abortion case out of Louisiana and could soon take another from Indiana. Either or both could be used to weaken or possibly roll back Roe v. Wade, the 1973 ruling that legalized abortion nationwide.

And on the Democratic presidential campaign trail, Vermont Sen. Bernie Sanders has a heart attack and South Bend, Ind., Mayor Pete Buttigieg has a drug plan. Also, Republicans have a unified message: They say Democrats are pushing socialism.

This week's panelists are Julie Rovner of Kaiser Health News, Alice Miranda Ollstein of Politico, Julie Appleby of Kaiser Health News and Paige Winfield Cunningham of The Washington Post.

Among the takeaways from this week's podcast:

• In his surprise announcement last week setting requirements for legal immigrants to have health insurance, Trump based the new policy on concerns about the burden uninsured people put on the health system. That is an argument often used by supporters of the Affordable Care Act, which Trump strongly criticizes.
• The Supreme Court likely has four options in the Louisiana abortion case it accepted last week. The state law in question requires that doctors performing abortions be accredited at local hospitals - an issue at the heart of a Texas law that the justices rejected several years ago. The court could say the Louisiana law is much like Texas' and strike it down; use the new law to overturn abortion rights; say the Texas decision was not correct and let stand the Louisiana law; or say the facts are different in Louisiana and its law can stand.
• Somewhat overlooked in the court's acceptance of the case is that it will also rule on another abortion issue: whether health care providers can sue to stop restrictive state laws. If the court says they can't and instead the burden is on women seeking an abortion, it will make challenging state statutes much more difficult.
• The executive order signed by Trump last week could result in significant changes to Medicare, allowing doctors to opt out of the program and set up private contracts with patients.
• Sen. Bernie Sanders' heart attack has raised questions - again - about how transparent presidential candidates should be about their health.
• As both Republican critics of the ACA and its supporters await a decision by the 5th Circuit Court of Appeals on a Texas lawsuit that could strike down the federal health law, GOP officials are growing nervous about timing. The case will be appealed to the Supreme Court, but some administration officials would like that to not hit the court during the 2020 presidential campaign and are considering ways to prolong the appeal process.

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

Julie Rovner: Kaiser Health News' "Why Hospitals Are Getting Into The Housing Business," by Markian Hawryluk

Alice Miranda Ollstein: The New York Times' "Sexually Transmitted Disease Cases Rise to Record High, C.D.C. Says," by Liam Stack

Paige Winfield Cunningham: Bloomberg's "AbbVie, Bristol-Myers Among Patient Advocacy Groups' Big Backers," by Alex Ruoff. Also, Kaiser Health News' database of pharma contributions to patient advocacy groups can be found here.

Julie Appleby: Kaiser Health News' "They Enrolled In Medical School To Practice Rural Medicine. What Happened?" by Lauren Weber

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