KHN’s ‘what the health?’: The return of the public option

The "public option" is back — both in Washington, D.C., and the states. President Joe Biden as a candidate supported the idea of a government-run or heavily regulated insurance plan that would compete with private insurance. But until now it has been more of a concept than a plan. Two top health leaders in Congress say they will try to put a plan together, while public options in various forms work their way through legislatures in Colorado and Nevada.

Meanwhile, bioethicists are debating whether the U.S. should be vaccinating low-risk adolescents against covid-19 while high-risk adults in other countries remain vulnerable.

This week's panelists are Julie Rovner of KHN, Margot Sanger-Katz of The New York Times, Alice Miranda Ollstein of Politico and Rachana Pradhan of KHN.

Among the takeaways from this week's podcast:

• Sen. Patty Murray (D-Wash.) and Rep. Frank Pallone (D-N.J.), who each chair key health committees on Capitol Hill, have put out a request for ideas about the public option. The idea has been championed by many Democrats since it was excluded from the Affordable Care Act, and some lawmakers have introduced bills to set up such a program. The sound bites are appealing but creating such a program would be exceedingly complicated. Murray and Pallone's initiative is an effort to start a detailed inquiry into what would be needed for a public option and where the political fault lines lie.

• State efforts to set up public options are generally seen as much less effective than a national program would be.

• Five Senate Republicans joined Democrats to support the confirmation of Chiquita Brooks-LaSure as administrator of the Centers for Medicare & Medicaid Services. Although the agency isn't exactly considered a glamour post, it is one of the most influential jobs in government. By controlling spending and administration of both Medicare and Medicaid, as well as the ACA's insurance marketplaces, the agency controls about a quarter of all federal spending.

• Early reports of Biden's first budget suggest that while he will not be putting dollars behind plans to lower Medicare eligibility or establish a government-run public insurance option on the ACA marketplaces, he will acknowledge that those options are goals he would like to see Congress pursue.

• Biden is also expected to signal he wants federal funding bills to no longer include the Hyde Amendment, a long-standing federal policy to deny government funding for abortion in most cases. Many Democrats have complained that the provision keeps low-income women who have Medicaid insurance or federal workers who are covered through their jobs from securing an abortion if they need it. Republicans have argued that taxpayers shouldn't have to finance abortion if they are morally opposed to it.

• New federal data shows that more than 50% of adults have been vaccinated against covid. But the success of the U.S. inoculation campaign is raising questions about what Americans should be doing to help other countries. Some argue that vaccine supplies here should be given to countries that are struggling before many lower-risk people in this country — including children — get their shots.

• New reports are casting suspicions on the assumption that covid came from a natural transmission from animal to human in China and suggest it may be tied to a viral research lab in Wuhan, China. This could have implications for research protocols in the future and U.S.-Chinese relations on health studies and other issues.

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

Julie Rovner: The New York Times' "Covid Killed His Father. Then Came $1 Million in Medical Bills," by Sarah Kliff

Alice Miranda Ollstein: HuffPost's "Can America Close the COVID Vaccine Race Gap?" by Jonathan Cohn

Margot Sanger-Katz: KHN's "Corporations Encourage Employee Vaccination but Stop Short of Mandates," by Anna Almendrala

Rachana Pradhan: The Wall Street Journal's "Intelligence on Sick Staff at Wuhan Lab Fuels Debate on Covid-19 Origin," by Michael R. Gordon, Warren P. Strobel and Drew Hinshaw