KHN’s ‘What The Health?’: ACA Still Under A Cloud After Court Ruling

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The destiny of the Affordable Care Act continues to be doubtful after a federal appeals court docket ruling in New Orleans. By a 2-1 vote, the three-judge panel dominated that the “individual mandate” provision of the well being legislation — which requires individuals to have well being protection — is unconstitutional now that Congress has decreased the penalty to zero. But the judges despatched the case again to the decrease court docket to find out how a lot else of the legislation can stay in mild of that discovering.

Meanwhile, on Capitol Hill, lawmakers are making ready to depart for the yr having completed a huge spending invoice that features many modifications to well being coverage. However, the 2 greatest well being priorities of the yr — doing one thing about “surprise” medical payments and prescription drug costs — stay undone.

This week’s panelists are Julie Rovner from Kaiser Health News, Margot Sanger-Katz of The New York Times, Kimberly Leonard of the Washington Examiner and Alice Miranda Ollstein of Politico.

Among the takeaways from this week’s podcast:

The federal appeals court docket determination on the way forward for the ACA means the District Court decide will probably have to think about Congress’ intent when it dropped the penalty for not having insurance coverage however made no different modifications to the legislation. Although the authorized ramifications of the fifth Circuit Court of Appeals’ determination gained’t be clear for months, the ruling might have an effect on the 2020 marketing campaign season. Republicans could also be relieved that the way forward for the ACA is just not entrance and middle, however Democrats have a gap to argue that the legislation remains to be very a lot endangered, in addition to its fashionable provision guaranteeing protection to individuals with preexisting medical issues. One of the surprises in Congress’ spending invoice was a provision that preserves states’ skill to approve “silver loading” by insurers on the ACA’s insurance coverage marketplaces. Under that workaround, insurers elevate the costs of midlevel silver-level plans to recoup some bills that the federal authorities is not paying. In some states, not solely has this labored properly for the insurer, it has pushed federal subsidies increased so that customers can extra simply purchase plans. The spending invoice additionally included the CREATES Act, which goals to foster competitors and drive down prescription drug prices by making it simpler for generic drugmakers to develop and check their merchandise. The administration Wednesday unveiled a proposed rule for states to import medication from Canada, however it’s anticipated to take months, if not longer, earlier than any federal approvals are issued.

Plus, for additional credit score, the panelists advocate their favourite well being coverage tales of the week they assume it’s best to learn, too:

Julie Rovner: The New York Times’ “In France, Dying at Home Can Mean a Long Wait for a Doctor,” by Norimitsu Onishi

Margot Sanger-Katz: ProPublica’s “What Happens When a Health Plan Has No Limits? An Acupuncturist Earns $677 a Session,” by Marshall Allen

Alice Miranda Ollstein: Nature’s “US Biomedical Agency Has Investigated Hundreds of Claims of Inappropriate Conduct This Year,” by Nidhi Subbaraman

Kimberly Leonard: BuzzFeed News’ “The Last Decade Was Disastrous for Abortion Rights. Advocates Are Trying to Figure Out What’s Next,” by Ema O’Connor

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Kaiser Health News (KHN) is a nationwide well being coverage information service. It is an editorially impartial program of the Henry J. Kaiser Family Foundation which isn’t affiliated with Kaiser Permanente.

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