KHN’s ‘What The Health?’: Tennessee Seeks Medicaid Changes

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Tennessee announced this week that it hopes to become the first state to take the Trump administration up on its offer to transform funding for its Medicaid program into a block grant. Tennessee, expected to formally file its plan this fall, is betting it can find ways to lower the costs of caring for its low-income patients without cutting benefits or enrollment. But it remains unclear if Tennessee’s plan could be allowed under Medicaid law.

Meanwhile, open enrollment for the Affordable Care Act starts in less than six weeks. By all indications, consumers in most parts of the country will have more choices and smaller premium increases than in previous years, even without the legal requirement for most people to have coverage or pay a tax penalty.

And Congress is still struggling to find compromises on legislation to address rising prescription drug prices and surprise medical bills.

This week’s panelists are Julie Rovner of Kaiser Health News, Anna Edney of Bloomberg News, Jennifer Haberkorn of the Los Angeles Times and Kimberly Leonard of the Washington Examiner.

Also this week, Rovner interviews Johns Hopkins surgeon Dr. Marty Makary, who has a new book, “The Price We Pay,” exploring why health care in the U.S. costs so much.

Among the takeaways from this week’s podcast:

The Trump administration and some conservative Republican lawmakers have long sought to move Medicaid to a block-grant system, in which states would get a defined federal payment and thus have more control over how to spend the money to provide health care to low-income residents. But the big unknown is the risk states take with such a system, especially if some economic factor suddenly makes more people eligible for Medicaid. The improved conditions for consumers buying health insurance on the marketplaces in November come despite the GOP’s elimination of the tax penalty for not having insurance. So were Presidents Barack Obama and Donald Trump wrong in arguing that the ACA couldn’t stand without the mandate? Earlier this summer, one thing seemed certain: Congress would pass some sort of legislation to protect consumers against surprise medical bills, which they get after being treated by a doctor or hospital outside their insurance network. Democrats, Republicans and the White House wanted it. But an advertising blitz by private equity firms that own physician practices seems to be fraying that resolve. House Speaker Nancy Pelosi’s plan to curb drug prices — announced Thursday — is likely to face a tough time getting through a Republican Senate. But it could prove a potent argument for the Democrats in the 2020 elections. The Democratic presidential candidates’ fight over where the party is headed on health policy is confusing voters and may make them a bit cynical about the chances of fixing current problems. That could have dire consequences for the party, since much of the Democrats’ success in the 2018 midterm elections was attributed to their message about health care.

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

Julie Rovner: Bloomberg News’ “ Carcinogens Have Infiltrated the Generic Drug Supply in the U.S.” by Anna Edney, Susan Berfield and Evelyn Yu, and “ Carcinogen Scare Sets off Global Race to Contain Tainted Zantac,” by Edney

Anna Edney: The Washington Post’s “ The Vaping Industry Has Close Ties to Trump. His Ban Still Caught Them Off Guard,” by Laurie McGinley, Neena Satija, Josh Dawsey and Yasmeen Abutaleb

Jennifer Haberkorn: The Los Angeles Times’ “ Americans’ Struggles With Medical Bills Are a Foreign Concept in Other Countries,” by Noam Levey

Kimberly Leonard: The (Toronto) Globe and Mail’s “ Toronto-Based Hospital Network Commits Land to Building Affordable Housing,” by Kelly Grant

To hear all our podcasts,  click here.

And subscribe to What the Health? on  iTunes,  Stitcher,  Google Play,  Spotify, or  Pocket Casts.

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