KHN’s ‘What the Health?’: Record ACA enrollment puts pressure on Congress

Reviewed by Emily Henderson, B.Sc.Jan 27 2022

The Biden administration announced that 14.5 million Americans have signed up for health insurance under the Affordable Care Act for 2022. That's a record, and several states are still enrolling people. But many millions of those newly insured could face significantly higher premiums for 2023 unless Congress extends the temporary subsidies it passed last year.

Meanwhile, lawmakers are again working to salvage parts of the president's Build Back Better social spending bill that failed to garner enough votes to pass the Senate. Separately, lawmakers are looking to remake the federal public health apparatus to better prepare for the next pandemic.

This week's panelists are Julie Rovner of KHN, Joanne Kenen of Politico and the Johns Hopkins Bloomberg School of Public Health, Sarah Karlin-Smith of the Pink Sheet, and Anna Edney of Bloomberg News.

Among the takeaways from this week's episode:

• Replacing Supreme Court Justice Stephen Breyer, who announced his retirement this week, adds to an already long to-do list in the Senate. Lawmakers must still fund the government for the remainder of the fiscal year and find an acceptable compromise on President Joe Biden's big social spending bill. Approving a Supreme Court justice in a 50-50 Senate will not be easy, but the realization that the replacement will not change the ideological balance on the court could take off some of the pressure.
• As Democrats contemplate advancing a slimmed-down Build Back Better package, health provisions — including ones to lower the price of prescription drugs — seem near certain to make the cut. One reason: Democrats generally agree on them. Also, though, Democrats are likely to suffer in the midterm elections unless they manage to get something passed.
• Meanwhile, Sens. Patty Murray (D-Wash.) and Richard Burr (R-N.C.), members of the Senate Committee on Health, Education, Labor, and Pensions, have put forth a new framework to upgrade the federal government's public health apparatus for future pandemics. Their plan includes changes such as requiring Senate confirmation for the position of director of the Centers for Disease Control and Prevention, ramping up national health-related data collection, and shoring up the strategic national stockpile.
• In its first full year, the Biden administration has had successes and failures dealing with the covid pandemic. Among the successes is the effective distribution of vaccines. One of its biggest failures, however, has been its inability to communicate to the public how the changing virus necessitated changed behaviors.
• Anti-vaccine activists — who historically have held fringe positions on both the far left and far right — increasingly seem to be part of the GOP coalition. The concept is tied up in the movement to promote individual liberties. And it is starting to appear that the strength of the anti-vaccine movement will outlive the pandemic.

Also this week, Rovner interviews Diana Greene Foster of the Bixby Center for Global Reproductive Health at the University of California-San Francisco. She is the lead researcher of the "Turnaway Study," which followed a thousand women who sought abortions for several years afterward to see how their lives turned out.

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

Julie Rovner: KHN's "After Miscarriages, Workers Have Few Guarantees for Time Off or Job-Based Help," by Bryce Covert

Anna Edney: The AP's "How a Kennedy Built an Anti-Vaccine Juggernaut amid COVID-19," by Michelle R. Smith

Joanne Kenen: HuffPost's "The Right's War on Government Is Working and It Could Cost Lives," by Jonathan Cohn

Sarah Karlin-Smith: The Column's "Covid Isn't a Human Being, It Doesn't Care What You Think About It," by Adam Johnson