KHN’s ‘What the Health?’: Year-End Bill Holds Big Health Changes

The year-end government spending bill includes a lot of changes to federal health programs, including changes to Medicare payments and some structure for states to begin to disenroll people on Medicaid whose eligibility has been maintained through the pandemic.

Separately, the Biden administration took several steps to expand the availability of the abortion pill, which in combination with another drug can end a pregnancy within about 10 weeks of gestation. Anti-abortion forces have launched their own campaign to limit the reach of the abortion pill.

This week’s panelists are Julie Rovner of KHN, Rachel Cohrs of Stat, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, and Rachel Roubein of The Washington Post.

Among the takeaways from this week’s episode:

• Congress ended the year by passing a nearly $1.7 trillion government spending package. The legislation included smaller-than-scheduled cuts to Medicare payments for physicians, extended telehealth flexibilities, and funding boosts for programs like the Indian Health Service and the federal 988 mental health hotline.
• But lawmakers left out many priorities, such as more money in response to the covid-19 emergency, and included a change to Medicaid eligibility that could result in millions of Americans losing their health insurance.
• The Biden administration took perhaps its biggest stand on abortion rights since the Supreme Court overturned Roe v. Wade last year, with the FDA announcing that retail pharmacies will be permitted to dispense abortion pills for the first time, and the Justice Department confirming that it is legal to send the pills through the U.S. Postal Service.
• A new congressional report on Aduhelm, the controversial Alzheimer’s drug, reveals its manufacturer, Biogen, knew the impact its pricing could have on the Medicare program — and priced it high anyway. The report also raises big questions about the FDA’s decision-making in approving the drug and what some officials were willing to do to make it happen.
• And in price transparency news, insurers are now required to provide patients with cost-estimating tools designed to make more than 500 nonemergency services “shoppable.” But it is unclear whether insurance companies are prepared to help consumers access and use that information.

Also this week, Rovner interviews Mark Kreidler, who wrote the latest NPR-KHN “Bill of the Month” feature, about two patients with the same name and a mistaken bill. If you have an outrageous or exorbitant medical bill you want to share with us, you can do that here.

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’ “The F.D.A. Now Says It Plainly: Morning-After Pills Are Not Abortion Pills,” by Pam Belluck

Joanne Kenen: Politico Magazine’s “Racist Doctors and Organ Thieves: Why So Many Black People Distrust the Health Care System,” by Joanne Kenen and Elaine Batchlor

Rachel Cohrs: The New York Times’ “‘Major Trustee, Please Prioritize’: How NYU’s E.R. Favors the Rich,” by Sarah Kliff and Jessica Silver-Greenberg

Rachel Roubien: KHN’s “Hundreds of Hospitals Sue Patients or Threaten Their Credit, a KHN Investigation Finds. Does Yours?” by Noam N. Levey

Also mentioned in this week’s podcast:

Stat’s “’Rife With Irregularities’: Congressional Investigation Reveals FDA’s Approval of Aduhelm Marked by Secret Discussions, Breaches of Protocol,” by Rachel Cohrs

KHN’s “Want a Clue on Health Care Costs in Advance? New Tools Take a Crack at it,” by Julie Appleby

Stat’s “Congress Reaches Major Health Policy Deal on Medicare, Medicaid, and Pandemic Preparedness,” by Rachel Cohrs and Sarah Owermohle

USA Today’s “Half of Ambulance Rides Yield Surprise Medical Bills. What’s Being Done to Protect People?” by Ken Alltucker

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