KHN’s ‘What the Health?’: Election Preview: What’s Next for Health?

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Voters say health issues — from the Affordable Care Act to COVID-19 to prescription drug prices — are important considerations in the November general election. But which issues are truly moving voters to participate in a year as politically polarized as 2020?

Former Vice President Joe Biden says he wants to expand the Affordable Care Act if he’s elected and Democrats win the Senate. President Donald Trump says he will find a way to protect people with preexisting conditions if his Supreme Court nominee helps strike down the ACA. And both candidates insist they will successfully control the coronavirus pandemic.

This week’s panelists are Julie Rovner of Kaiser Health News, Margot Sanger-Katz of The New York Times, Joanne Kenen of Politico and Rebecca Adams of CQ Roll Call.

Among the takeaways from this week’s podcast:

• The presidential debate Tuesday night didn’t illuminate much about health care for voters. Biden, the Democratic candidate, wasn’t incisive about his plan and mischaracterized a key provision, the public option he hopes to add to the Affordable Care Act. Trump, a Republican, misrepresented much of the information he offered about his efforts on health care.
• Nonetheless, the debate did portray the growing interest among partisans to use health care as a critical issue in the final weeks of the campaign and brought the fate of the ACA back to the top of Democrats’ talking points.
• Trump and other Republicans who want to get rid of the ACA often promise to protect health coverage for people with preexisting medical issues, even though they have not offered any evidence of how they would accomplish that. Recent polls suggest that GOP voters believe they will follow through on that pledge. The health law made guarantees to insurers that, if they accepted those expensive customers, the costs would be covered because they would have more people buying insurance.
• Although protections for preexisting conditions are popular, Democrats are finding it somewhat challenging to get voters excited about the issue because they don’t think Republicans would actually get rid of the popular provision. In addition, many people have forgotten the difficulty that patients had getting insurance before the ACA became law.
• The coronavirus pandemic will play a role in voters’ decisions, but it might play out in different ways. Some people are concerned that the federal effort hasn’t worked effectively, while others are concerned about the economic meltdown the outbreak caused. At the same time, people are overwhelmed by the magnitude of the catastrophe and finding it hard to process that 800 to 1,000 people are dying daily from the disease.
• The health care topic that seems to have truly galvanized the president — ever since his first campaign — is high drug prices. Although he has pushed hard on the issue, to make any progress he needs legislation from Congress, and Republicans on Capitol Hill have not been willing to follow him on policies that are directly opposed by drugmakers and, in some cases, may involve price- setting.
• If Biden were elected, his plans to expand the ACA through a public option or even to lower the eligibility age for Medicare would face a tough time in Congress, even if Democrats win back the Senate.

This week, Rovner also interviews KHN’s Laura Ungar, who wrote the latest installment of KHN-NPR’s “Bill of the Month.” This month’s patient, Matthew Fentress, had insurance but still received a giant bill because he is among those Americans whose insurance is not considered adequate. If you have an enormous medical bill you would like 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 Washington Post’s “7 former FDA commissioners: The Trump Administration Is Undermining the Credibility of the FDA,” by Robert Califf, Scott Gottlieb, Margaret Hamburg, Jane Henney, David Kessler, Mark McClellan and Andy von Eschenbach

Joanne Kenen: The New York Times’ “How Trump Voters View His Position on Pre-existing Conditions,” by Sarah Kliff and Margot Sanger-Katz

Margot Sanger-Katz: The New York Times’ “Immigrants Say They Were Pressured Into Unneeded Surgeries,” by Caitlin Dickerson, Seth Freed Wessler and Miriam Jordan

Rebecca Adams: ProPublica’s “Investors Extracted $400 Million From a Hospital Chain That Sometimes Couldn’t Pay for Medical Supplies or Gas for Ambulances,” by Peter Elkind with Doris Burke

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Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

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