The Host
Julie Rovner
KFF Health News
Julie Rovner is chief Washington correspondent and host of KFF Health News’ weekly well being coverage information podcast, “What the Health?” A famous knowledgeable on well being coverage points, Julie is the writer of the critically praised reference e book “Health Care Politics and Policy A to Z,” now in its third version.
On September 2, 1974, President Gerald Ford signed into legislation the Employee Retirement Income Security Act, higher often called ERISA. While the legislation was primarily supposed to control and shield employee pensions, it additionally basically modified how medical health insurance is offered and controlled within the United States. Fifty years on, ERISA performs a task in almost each element of medical health insurance and has had a profound impression on the whole well being care sector.
To be aware this anniversary, on this week’s particular episode of KFF Health News’ “What the Health?”, host and KFF Health News chief Washington correspondent Julie Rovner discusses the legislation’s previous, current, and future with three consultants on ERISA: Larry Levitt of KFF, a well being info nonprofit that features KFF Health News; Paul Fronstin of the Employee Benefit Research Institute, a nonprofit; and Ilyse Schuman of the American Benefits Council, a commerce group advocating for employers that sponsor employee profit plans.
click on to open the transcript
Transcript: Happy fiftieth, ERISA
KFF Health News’ ‘What the Health?’ Episode Title: ‘Happy 50th, ERISA’ Episode Number: 360Published: Thursday, Aug. 15, 2024
[Editor’s note: This transcript was generated using both transcription software and a human’s light touch. It has been edited for style and clarity.]
Julie Rovner: Hello, and welcome again to “What the Health?” I’m Julie Rovner, chief Washington correspondent for KFF Health News. Usually, I’m joined by a number of the finest and smartest well being reporters in Washington, however at present, now we have a particular episode for you. We’re taping this week on Monday, Aug. twelfth, at 2 p.m. As at all times, information occurs quick, and issues may’ve modified by the point you hear this — though this time, I hope not. So right here we go.
So in case you observe well being coverage, you’re seemingly accustomed to the massive federal legal guidelines which have formed how well being care within the U.S. is organized and delivered and paid for. Medicare and Medicaid in 1965, HIPAA in 1996, and the Affordable Care Act in 2010, simply to call a couple of.
One chances are you’ll not have heard as a lot about is ERISA, the Employee Retirement Income Security Act, which was signed in 1974 by then-President Gerald Ford. This fall marks 50 years since ERISA turned legislation. ERISA, as its identify suggests, is usually about defending pension advantages for employees. It was impressed, at the very least partly, by the collapse of a pension fund when a plant that constructed Studebaker automobiles in Ohio shut down in 1963. But, at the very least as legend has it, on the final minute within the House-Senate Conference in 1974, somebody determined so as to add well being advantages to ERISA’s scope, and that actually modified the whole lot of how well being advantages are regulated within the U.S.
I’m happy to have an all-star panel right here to affix us to speak about what ERISA has meant to well being coverage and what it’s more likely to imply going ahead because it begins its second half-century. Larry Levitt is government vice chairman for coverage right here at KFF and one in every of only some individuals within the group even nerdier than I’m about issues like ERISA. Paul Fronstin is director of well being advantages analysis on the Employee Benefit Research Institute, a nonpartisan assume tank that does analysis and schooling. Paul has additionally taught me extra about ERISA over time than most likely some other single individual.
Finally, Ilyse Schuman is senior vice chairman of the American Benefits Council, which represents massive employers and different suppliers of well being and retirement advantages by means of employer-sponsored plans. Ilyse additionally spent a number of years on Capitol Hill engaged on the Senate committee that oversees ERISA coverage. So, a whole lot of information right here in our podcast field. Thanks for all of you for being right here.
Ilyse Schuman: Thank you
Larry Levitt: Great to be right here.
Rovner: So let’s begin in the beginning. How did well being advantages wind up being coated in a legislation that was geared toward retiree pensions?
Paul Fronstin: None of us have been right here or there on the time, so I believe something we all know is second- or third-hand info. And such as you stated, the availability was inserted on the final minute, however I believe there have been a whole lot of conversations about it main as much as it being inserted on the final minute. I believe a whole lot of it needed to do with some tensions between state regulation and federal regulation, as a result of there have been self-insured well being plans in existence and self-insured advantages extra typically in existence earlier than ERISA handed.
And clearly these plans wished some federal safety relating to what they have been doing, and the states wished extra regulation. And I’ve learn a little bit bit about this over time, and there was actually some lobbying for and towards having a provision in there to guard self-insured plans from state regulation. So the conversations have been occurring. It simply … the language most likely simply didn’t make it into the laws until the final minute.
Schuman: And I believe actually the panorama again in 1974, as Paul talked about, was that increasingly states have been creating, with respect to well being care, their very own variations of varied legal guidelines. And so self-funded plans, massive employers like our members — quite a few them have been again in existence 50 years in the past, some weren’t — have been discovering it more and more tough to have the ability to administer their self-funded plans on a uniform foundation nationwide.
So it wasn’t within the backrooms after they have been truly drafting the laws, however actually be aware that the nationwide panorama on this rising patchwork of state well being legal guidelines was changing into more and more problematical for self-funded well being plans.
Levitt: Yeah. I imply, this was additionally a interval when medical health insurance was altering fairly dramatically. I imply, earlier than this time medical health insurance was fairly easy. It was known as indemnity insurance coverage, proper.
You went to the physician, you went to the hospital, you bought a declare, you filed it along with your insurance coverage firm, they usually paid 80% of it. This was a time when PPOs [preferred provider organizations] have been beginning, managed care, HMOs have been actually simply getting their begin. So there was a necessity for far more regulation as a result of insurance coverage was getting extra sophisticated.
Fronstin: Yeah. To some extent, the HMO Act of, what, 1973, proper, simply the yr earlier than. So HMOs have been simply approaching the scene, and that will have performed into this as effectively.
Rovner: So again in 1945, when actually none of us have been within the room, Congress handed one thing known as the McCarran-Ferguson Act, which was supposed to make sure that states relatively than the federal authorities retained the authority to control insurance coverage. What occurred in ERISA to vary that? Ilyse, I believe you have been already form of referring to this. And what can we imply after we speak about ERISA preemption? That’s a phrase that individuals hear lots and their eyes glaze over.
Schuman: Sure. Well, their eyes could glaze over but it surely actually is foundational to tens of millions of Americans and their households which are coated by employers who determine that they need to self-fund their plans. That signifies that they’re those that determine that, “Hey, we’re going to take the risk as offering these benefits instead of the carrier.”
Rovner: So they’re not truly shopping for insurance coverage as a result of …
Schuman: That’s …
Rovner: … they’re paying the payments.
Schuman: They’re doing extra than simply paying the invoice. They’re those which are finally assuming the dangers of these claims, too. And I believe the worth. So perhaps — simply to step again earlier than we speak about what a preemption is — is what we speak about employers who determine to self-fund versus people who don’t. Admittedly, lots of people who self-fund are bigger employers, however once more, they are saying that “We will take the risk of paying for the claims of our health insurance coverage instead of the carrier. But along with that, we get the flexibility and we get the ability to design and implement health coverage that we think meets the needs of our population. That’s enabled us to” — talking once more from self-funded employers — “to implement innovative designs with the assurances that they could implement those, they could administer that on a uniform basis nationwide.” So that’s actually what we’re speaking about. Preemption is the power of self-funded employers to manage these advantages on a uniform foundation nationwide.
And sure, getting again to McCarran-Ferguson, and if you wish to speak by means of the form of varied layers of ERISA preemption, is there’s one thing known as the financial savings clause, which is OK. So ERISA says: “First threshold level, we are going to preempt state laws.” But there’s a financial savings provision that claims mainly: “If you’re in the business of insurance, states can regulate that.” But then there’s this deemer clause — that is actually nerdy now, so a few of your viewers could also be questioning right here what we’re speaking about …
Rovner: I keep in mind studying this many, a few years in the past.
Schuman: No. Yeah. So in case you’re in legislation college, take be aware that the deemer clause signifies that self-funded group well being plan is deemed to not be within the enterprise of insurance coverage; which means that they don’t need to adjust to these state insurance coverage legal guidelines.
Levitt: And right here’s the place this will get actually tangible for individuals, proper? So 150 million individuals have insurance coverage protection by means of an employer. It’s the most important supply of well being protection. But 65% of them are in self-insured plans, like Ilyse was speaking about. And these self-insured plans are exempt from state regulation.
So if a state is regulating insurance coverage, let’s say mandating advantages, mandating protection of IVF, mandating protection of preventive care, mastectomies, no matter — these laws that states are setting up don’t apply to most individuals with employer-sponsored insurance coverage as a result of they’re in these self-funded plans.
Rovner: And, in fact, the persevering with issues that lots of people who’re in these self-funded plans don’t understand it as a result of they’ve an insurance coverage card and it says Blue Cross or Aetna or no matter, as a result of, of their case, they’ve an insurance coverage card, however the insurer just isn’t offering insurance coverage, proper?
Levitt: No, it’s outstanding. We did a survey of shoppers about their experiences with medical health insurance. And we requested them, “What government agency do you think you would turn to with a problem with your insurance?” And actually zero individuals stated the Department of Labor, which is the federal government company that really enforces ERISA.
Rovner: But I suppose what I used to be asking about are third-party directors, which I believe most individuals have by no means heard of till they uncover that they’re not topic to their state’s requirement.
Levitt: Absolutely. I imply, it will get actually complicated, proper? Because it is perhaps that UnitedHealthcare is administering this self-funded plan, however you, as an worker on this plan, don’t have any means of actually understanding is {that a} self-insured plan administered by UnitedHealthcare? Or is that an insurance coverage plan administered by UnitedHealthcare? And then there are these third-party directors that you just’ve by no means even heard of which are administering them for a lot of employers.
Rovner: Paul, you wished so as to add one thing.
Fronstin: We want to tell apart between ERISA and self-insured plans, proper, as a result of they’re not one and the identical. ERISA additionally covers totally insured plans.
Schuman: Right.
Fronstin: So totally insured plans are regulated each by ERISA and on the state degree. And then you definately’ve acquired some self-insured plans like authorities plans that aren’t coated by ERISA, proper? But they’re self-insured. So it’s much more sophisticated than what we’re making it out to be after we speak about ERISA, preemption, and self-insurance. That’s only one side of ERISA.
Schuman: And I believe to the purpose about workers undecided what covers them, what doesn’t cowl them. Again, for self-funded massive employers, I imply, I believe many of the workers perceive from their employer, from the group well being plan, what the phrases of the plan are, and what the advantages are. And I believe in some methods, maybe much less complicated than, OK, in case you’re an worker working in Kentucky, you’ve gotten one plan. If you’re an worker working in New York, you’ve gotten one other plan. And workers speaking to one another and saying, “Hey, how come you have that and I don’t have this?”
So I believe that the readability or the consistency is essential not only for employers who’re administering the plan, however for workers understanding what the phrases of the plans are. And additionally, two issues about form of the advantages and what’s coated. There’s a distinction between a state saying, “OK, you have to cover this benefit and have to cover it in precisely this way” versus employers who say, “Look, it’s really important for our population, to be healthy and productive, to have these benefits, and so we’re going to offer this benefit. We’re just going to do it in the same way nationwide.”
And keep in mind, ERISA, if the federal authorities, because it has achieved over the previous, needs to make adjustments to … which are relevant to group well being plans, it could possibly amend and has amended ERISA to try this. So the market reforms, for instance, within the Affordable Care Act, have been relevant, and the Public Health Service Act, have been form of integrated into ERISA. The Genetic Information Nondiscrimination Act, for instance, amended ERISA. So it’s like that’s the lever to make adjustments to ERISA that might be relevant to self-funded plans as effectively is on the federal degree.
Rovner: When I used to be first protecting Congress within the 19… late-Nineteen Eighties and early-Nineteen Nineties, you didn’t go there. If you wished to do one thing about well being coverage, you didn’t contact ERISA. I believe lawmakers have been afraid of reopening it and moving into all types of fights. Why did that lastly change?
Levitt: I imply, I believe there was a rising recognition, notably with the Affordable Care Act, that there have been just a few minimal thresholds that well being protection needed to meet to be reputable protection. So in case you have a look at what the ACA did, and as Ilyse stated, these utilized to all employers, all group well being plans by means of the amendments to ERISA.
And these have been issues like no preexisting situation exclusions, protection of preventive companies with no affected person value sharing, no annual on lifetime limits, a cap on out-of-pocket prices. And most likely the most well-liked provision of the ACA, protection of dependents as much as age 26. There was no technique to attain everybody with insurance coverage with out amending ERISA below the Affordable Care Act.
Fronstin: Yeah. But there have been examples, pre-ACA, that affected all plans, or most plans, like psychological well being parity we didn’t point out. Well, there’s been a few situations of that. And actually the Clinton well being plan tried this and didn’t succeed within the early Nineteen Nineties.
Rovner: And HIPAA …
Levitt: I imply …
Rovner: … which was, I suppose, the primary main stroll into ERISA since ERISA had been handed.
Levitt: Right. Or even COBRA. The means to proceed your insurance coverage after you allow an employer was an modification to ERISA.
Rovner: That’s proper. And that was in 1986.
Fronstin: Yeah, and even that might be complicated as a result of it exempts smaller employers, proper. But you bought the mini-COBRA legal guidelines at state degree that have an effect on a few of these employers, however not each state has one.
Rovner: Yeah. And Paul, you have been referring to this. We ought to most likely speak about who’s not topic to ERISA as a result of I don’t assume anyone talked about church plans. There’s a rule, after which there’s all these exceptions.
Fronstin: I believe the 2 main classes are church plans, and I’m undecided we actually have a good deal with on how many individuals are coated by church plans as a result of a whole lot of them are typically small companies, they usually could not even supply protection. And federal, state, and native authorities. I’m undecided if there’s one other class in there that’s not coated by ERISA. I consider that the state and native governments have their very own legislation that’s much like ERISA, but it surely’s not ERISA.
Schuman: And I believe after we speak about coated by ERISA, actually it’s, What does ERISA afford? It’s not nearly self-funded employers with the ability to supply uniform advantages nationwide. There are essential protections. There are essential disclosure necessities for workers, for contributors which are included in there which are relevant to all ERISA plans, self-funded and insured plans, and clearly on the retirement plans, too.
But I simply assume it’s actually essential that we glance to see the concept behind ERISA was that, sure, there might be this uniformity for self-funded plans. But for all ERISA plans, there are these protections and safeguards in there which are embedded within the legislation for the advantage of contributors.
Rovner: And that’s why you used to get a phone-book-thick, “This is your plan documentation.” Now, it’s all on-line, and it’s all in 4-point sort. But that’s the place that comes from, proper? At the requirement that you just be informed all the pieces that your plan covers.
Schuman: Right. Correct.
Rovner: So, Larry, you form of referred to this earlier. Self-funded ERISA plans are regulated not by the states however by the Department of Labor, which most individuals don’t know. And for a very long time, in case you have been injured or somebody died on account of being denied care, the one factor that they might recuperate was the price of the care that was denied. Not any damages for what occurred. When did that lastly change? And has it lastly modified? What do you do now in case you’re injured — you’ll be able to’t go to your state regulatory company?
Levitt: No, there have been some adjustments to that, however enforcement of ERISA continues to be comparatively mild on the administrative degree in comparison with what state insurance coverage departments do. And the Department of Labor simply appears very far-off to individuals in comparison with a state insurance coverage division.
I believe it’s actually this construction of ERISA that, Julie, you stated individuals have been at all times immune to amending in Congress, that has been immune to modification, proper? I imply, this concept that states regulate insurance coverage immediately however that states can not regulate group well being plans below ERISA. And that’s had far-reaching well being coverage implications. So states trying to do employer mandates or something that immediately impacts these group well being plans, employer well being plans, and that’s perhaps …
Rovner: Also, states trying to do single-payer plans, proper?
Levitt: Yeah. No, I imply, single-payer there is perhaps some methods round ERISA by means of single-payer and taxation, however ERISA has been a barrier to state well being reform efforts, for higher or for worse.
Schuman: If perhaps we are able to simply step again 50 years, I believe it’s … I wrote down this quote from one of many authors of ERISA, particularly on the ERISA preemption, and that was by Rep. John Dent, who was a Democrat from Pennsylvania who recognized the ERISA preemption because the legislation’s crowning achievement.
And he stated it was the crowning achievement as a result of, with out it, the laws wouldn’t have loved the help of each labor and administration because it’s so basic for the power of multistate employers to sponsor profit plans to employees nationwide. So I believe simply form of getting again into the minds of the drafters of ERISA, that cut price, if you’ll, that turned ERISA preemption was actually foundational to the legislation passing.
Rovner: And you could possibly see why it might make sense. If you’re employed for a nationwide firm and also you get transferred from one state to a different, your insurance coverage shouldn’t change dramatically.
Schuman: Yeah. And I believe fast-forward 50 years, and we’ve acquired, actually, post-pandemic or after the pandemic, an more and more cell and distant workforce. And now we have heard repeatedly about how ERISA preemption actually promotes that employee mobility and the power to work out of your own home in one other state or to have the ability to switch from one location to a different.
So assume a little bit bit if we simply see how the workforce itself has developed, I believe that ERISA preemption provision could change into much more essential. And I believe more and more, it’s not simply massive employers that discover themselves — like nationwide or multistate employers — however as a result of the workforce is extra distant and cell, and needs to be, that increasingly employers of multistate employers, too.
Levitt: I’d say now we have more and more seen smaller employers self-funding, and there are some benefits to that, proper? They don’t essentially need to pay premium taxes to states, and they’re exempt from state profit mandates that apply over and above past the Affordable Care Act. I imply, insurers have give you very artistic methods of permitting smaller companies to self-fund and avoiding a number of the threat by layering numerous reinsurance on prime of that.
Fronstin: I used to be going to say, together with self-funding comes ease of administration right here. Ilyse, you name it uniformity of advantages. But I consider employers, they don’t need to offer 50 completely different well being plans in 50 completely different states. And to the diploma you’ve acquired the states doing one thing — whether or not it’s a single-payer or one thing in need of that — employers, they simply need to supply everybody the identical profit and make it as straightforward as potential to take action.
And my concern is that if they needed to adjust to 50 completely different state legal guidelines to take action or create 50 completely different profit plans, particularly at present with the ACA assured subject and sponsored protection, you’ll get to the purpose the place if employers didn’t have the power to supply one profit plan throughout all 50 states, they’re not going to do it anymore, proper? They’ve acquired … pre-ACA may’ve been completely different, however now they’ve acquired another the place their workers may get protection in the event that they didn’t supply protection themselves.
Rovner: So that was all predicted. This large motion away from employer-provided protection after the ACA handed was predicted, and it didn’t occur.
Fronstin: I used to be a type of individuals predicting it. Yeah. Before the ACA handed, I used to be a type of individuals predicting it. And I believe what occurred is: One, being employers, they nonetheless worth the profit. They nonetheless perceive there are enterprise causes to supply it, they usually haven’t had a great excuse to eliminate it.
We haven’t had — aside from the recession tied to covid — we haven’t had a recession. Our unemployment price has been at traditionally low charges. And I believe employers, they don’t need to mess with one thing that’s working for essentially the most half as a result of they use it to recruit and retain workers for a similar factor they have been doing again within the Nineteen Forties and ’50s after they first began providing it.
Schuman: I believe it’s essential to delineate the employer voice in right here. And I believe perhaps there’s a notion that employers are simply writing the checks or employers and well being plans are form of conflated. But employers are doing much more than simply writing a examine. And I believe these, once more, which have determined to self-fund need to have the ability to have management over how they’re spending their well being care {dollars}. So once more, they’ll attempt to drive extra reasonably priced, higher-value, higher-quality well being care.
And so it’s not nearly who writes the examine, however the causes behind employers saying, “Hey, we’re going to be spending … we spend a whole lot of money on our health benefits because we recognize that it’s good business. It’s good for employees. But we want to be able to have the ability to try to drive improvements in that to drive higher-value care.” And in order that’s enabled by ERISA. So the well being reforms and the well being innovation, actually there’s lots coming from the states, however there’s lots coming from employers, too.
Rovner: So what are the massive points going ahead for ERISA? I imply, clearly, there’s nonetheless, in case you Google ERISA, you get all types of lawsuits and challenges. And I imply, it’s nonetheless a really energetic a part of the legislation 50 years on.
Levitt: I imply, I believe, Julie, you talked about these lawsuits, and that’s doubtlessly an enormous subject going ahead. Something known as the Consolidated Appropriations Act added some transparency in charges that self-insured employer plans paid to suppliers. And that’s opened the door to some lawsuits difficult whether or not group well being plans, ERISA plans, are performing as acceptable fiduciaries in making an attempt to get the bottom prices, notably for prescribed drugs. And these began out as form of a fringe motion, however I believe pose some potential dangers for group well being plans.
Rovner: Ilyse, what are employers most involved about?
Schuman: Well, I believe that employers seeing the rising variety of states which are making an attempt to chip away, if not erode in a basic means, ERISA preemption is basically alarming. Lots of these efforts have come up round pharmacy profit managers and efforts to control pharmacy profit managers on the state degree.
But the way in which that they’ve achieved it, the states have actually taken direct goal at ERISA preemption and self-funded plans and, I believe, has a lot broader implications for self-funded group well being plans past simply the PBM context. And so I believe that they’re wanting on the rising variety of states which are occupied with passing legal guidelines that basically erode ERISA preemption as very alarming.
Rovner: So I need to go across the desk earlier than we finish. Sort of what do you assume has been the most important impression on the well being system of ERISA, each for good and for not so good? I imply, it’s actually one of many issues that makes it so complicated to grasp and clarify. Larry, you need to go first?
Levitt: I believe the most important impression of ERISA has been placing the brakes on some state well being reform efforts. States have discovered methods to get round it. Some elevate some points for employers, like Ilyse was saying, but it surely has actually circumscribed what states can do round well being reform. That stated, ERISA has offered a really steady regulatory setting for employers and sure allowed employer protection to develop over time in that setting.
Rovner: Paul?
Fronstin: Yeah, I’d say, along with that, it’s allowed employers to be progressive. Not each self-insured employer has been progressive, proper? And there’s one thing like one million employers on the market with a thousand or extra workers. And the smaller of these are usually not essentially being progressive, however they’re studying from the biggest ones, proper? The jumbo employers, who’re making an attempt to do various things with regards to partaking the well being system, proper? Engaging hospitals and physicians and pharmaceutical managers.
And I believe that that … the teachings realized from what they’re doing trickles all the way down to the smaller self-insured employers, and it trickles out to the well being insurers which are providing totally insured plans to small employers.
Rovner: Ilyse.
Schuman: I believe ERISA has allowed employers to supply value-driven, complete, reasonably priced, higher-quality well being protection to working households throughout the nation — 150 million, 180 million, guess it relies upon what stats you’re taking a look at, and that it’s withstood the take a look at of time.
And I believe that most likely no stressor, just like the pandemic, the place many questioned what would emerge from that, and with some dents, but in addition with a whole lot of silver linings when it comes to employers providing advantages to assist their workers navigate by means of the pandemic. And so I believe there’s a resiliency to the employer-sponsored system coupled with the innovation that Paul has talked about.
Rovner: Last query. Yes or no? Is ERISA going to be round in one other 50 years? In different phrases, are we nonetheless going to have this method of well being protection? I promise I can’t maintain you to it. Just finest guess. Larry.
Levitt: I say no.
Rovner: Paul.
Fronstin: I reply “don’t know.”
Rovner:: That’s OK. Ilyse.
Schuman: Well, I’ll say that I only in the near past acquired a tortoise for my household that I’ve discovered will reside 50 or 100 years, so past me. So will ERISA be round so long as Veggie, the tortoise? I don’t know.
I believe that there’s actually an essential inflection level. And I believe if addressing a number of the underlying drivers of rising well being care prices and consolidation, I believe that if these are addressed, I believe employer-provided protection actually has the power to face up to the take a look at of time over the subsequent 50 years.
Rovner: Good. Thank you all a lot. This has been nice.
Schuman: Thanks lots.
Levitt: Great. Thanks, Julie.
Schuman: Thank your workforce.
Levitt: Thanks all.
Schuman: Bye-bye.
Fronstin: Take care, everyone.
Levitt: Bye.
Rovner: Bye. OK, that’s our ERISA anniversary present. Big due to our company, Larry Levitt of KFF, Paul Fronstin of EBRI, and Ilyse Schuman of the American Benefits Council. And earlier than we go this week, we’re in search of your assistance on a undertaking right here at KFF Health News. Are you a younger grownup confused about navigating the exchanges used to choose plans? Have you purchased a plan on an ACA change and located that it didn’t cowl care you wanted? Have you married or taken a job simply to get insurance coverage? Did you determine to go with out protection?
Whatever your story, KFF Health News and The New York Times need to hear it. Email your expertise to Elisabeth Rosenthal — that’s elisabethr with an S, not a Z — @kff.org. As at all times, in case you benefit from the podcast, you’ll be able to subscribe wherever you get your podcasts. We’d admire it in case you left us a overview; that helps different individuals discover us, too. Special thanks, as typical, to our technical guru, Francis Ying, and our editor, Emmarie Huetteman. As at all times, you’ll be able to e mail us your feedback or questions. We’re at whatthehealth, all one phrase, @kff.org, the place you’ll be able to nonetheless discover me. I’m @jrovner on X. We’ll be again in your feed subsequent week. Until then, be wholesome.
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