KHN’s ‘What the Health?’: Remaking Medicaid — maybe

Reviewed by Kate Anderton, B.Sc. (Editor)Jan 30 2020

The Trump administration is trying to achieve a goal for Republicans that dates to the 1980s — allowing states to obtain at least some of their funding for Medicaid as a block grant. The trade-off for states is that, while potentially getting less money from Washington, D.C., they would be free of some federal rules and requirements for the program. Advocates for patients warn it could mean less care for fewer people.

Meanwhile, as the novel coronavirus continues to spread from China, public health officials are not the only ones working frantically. The fear resulting from the ailment is starting to have ripple effects on the world economy, trade and transportation.

And, in reproductive health news, the Trump administration is challenging California over its law requiring most insurance plans to cover abortion services. The administration said that violates federal law and warned that if California does not change the law, it could lose its federal health and education funding.

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

Among the takeaways from this week's podcast:

• The Trump administration's decision to encourage states to move to Medicaid block grants is likely to be challenged in court, but it's not clear if critics have to wait for a state to implement such a plan before they can seek a judicial review.
• One item in the administration's announcement on Medicaid that is likely to win support among both liberal and conservative local officials would be the ability of state programs to limit their prescription drug formularies. Even some progressive states, such as Massachusetts, have called for that flexibility, although they are not likely to want to move to a block grant.
• As the new coronavirus outbreak in China makes headlines in the U.S., it's important to note that scientists still have many things to learn about the virus, including how dangerous it is. China does not seem to be monitoring or counting the number of mild cases of infection, so it's difficult to determine how lethal the virus is.
• The effort by China to quarantine areas hit by the coronavirus and other countries' travel and trade restrictions are hard to enforce — and they may create difficulties in fighting the spread of disease if infected people subvert the limits on movement without officials realizing what's happening.
• The Supreme Court this week gave a temporary green light to the Trump administration's rule to consider whether immigrants seeking residency in the U.S. have used public assistance programs, such as Medicaid or food stamps. But that is not the court's final word on what's known as the "public charge" rule. It is merely allowing the program to go forward while it is evaluated by lower courts.
• As anti-abortion supporters rallied in Washington last week, the administration announced its plan to cut funds to California over the abortion issue. Federal officials are expected to notify a half-dozen other states with similar rules for insurers that they could face the same consequences.

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' "A Guide To Following The Health Debate In The 2020 Elections," by Julie Rovner

Joanne Kenen: ProPublica and Kentucky Center for Investigative Reporting's "How These Jail Officials Profit From Selling E-Cigarettes to Inmates," by R.G. Dunlop

Kimberly Leonard: BillyPenn's "When Philly Paramedics Arrive, Many Overdose Victims Have Vanished," by Max Marin

Erin Mershon: Stat's "It's the Insulin, Stupid: How Drug Pricing's Simplest Case Study Became a Top Issue for 2020 Democrats," by Lev Facher

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