Nov. 1 marks the start of Open Enrollment for people buying their own coverage for 2019 in most states. Despite the turmoil surrounding the Affordable Care Act, most consumers will have more choices and mostly flat — and in some cases lower — premiums.
What will happen to the health law going forward, however, will depend largely on what happens in the midterm elections Tuesday. Important health decisions will result not just from which party controls the U.S. House and Senate, but who wins governorships and comes to control state legislatures as well.
This week's panelists for KHN's "What the Health?" are Julie Rovner of Kaiser Health News, Anna Edney of Bloomberg News, Margot Sanger-Katz of The New York Times and Joanne Kenen of Politico.
Among the takeaways from this week's podcast:
- With changes in the ACA marketplace for 2019, it will be very important for consumers to look at the variety of options. Those earning less than 200 percent of the federal poverty level (just under $24,300 for an individual) are likely well served by silver plans on the federal health law's exchanges. But the choices for benefits and prices are much more complicated for people earning more than that.
- People who don't get insurance through work or the government and earn too much to qualify for premium subsidies under the health law might be tempted to try the new, less-expensive short-term plans being touted by the Trump administration. But they should be cautious and consider two major downsides: The plans likely won't cover preexisting conditions, and the benefits will be skimpier than those of ACA plans. For example, many short-term plans are expected not to cover mental health and maternity services or prescription drugs.
- Federal officials announced Wednesday that Wisconsin could implement work requirements for some Medicaid enrollees. They also said, however, that the state could not begin drug testing for the enrollees.
- If Democrats take control of the House or Senate, it's possible that they could work with President Donald Trump on some specific issues, especially efforts to bring down drug prices or consumer protections against surprise medical bills.
- Perhaps the biggest change that could come from the election results is an increase in the number of states that expand Medicaid under a provision of the ACA. Seventeen states have not taken that step, but several deep-red states in the West have the question on their ballots, and the outcomes from governors' races in other states could also lead to expansion.
Rovner also interviews Barbara Feder Ostrov, who wrote the latest "Bill of the Month" feature for Kaiser Health News and NPR. It's about a California college professor whose skin rash led to a $48,000 bill for allergy skin testing. You can read the story here.
If you have a medical bill you would like NPR and KHN to investigate, you can submit it here.
Plus, for extra credit, the panelists recommend their favorite health stories of the week they think you should read, too:
Julie Rovner: The Washington Post and Kaiser Health News’ "For The Disabled, A Doctor's Visit Can Be Literally An Obstacle Course — And The Laws Can't Help," by Rachel Bluth.
Anna Edney: Bloomberg Businessweek’s "Your DNA Is Out There. Do You Want Law Enforcement Using It?" by Drake Bennett and Kristen V Brown.
Margot Sanger-Katz: The Federalist’s "How An Obscure Regulatory Change Could Transform American Health Insurance," by Christopher Jacobs.
Joanne Kenen: The Atlantic’s "The Harder, Better, Faster, Stronger Language Of Dieting," by Amanda Mull.
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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.